CN106456175B - Fastener cartridge including organizational controls feature structure - Google Patents

Fastener cartridge including organizational controls feature structure Download PDF

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Publication number
CN106456175B
CN106456175B CN201580032277.5A CN201580032277A CN106456175B CN 106456175 B CN106456175 B CN 106456175B CN 201580032277 A CN201580032277 A CN 201580032277A CN 106456175 B CN106456175 B CN 106456175B
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CN
China
Prior art keywords
nail
protruding portion
tissue
warehouse
platform
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN201580032277.5A
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Chinese (zh)
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CN106456175A (en
Inventor
E·A·谢林
F·E·谢尔顿四世
J·L·哈里斯
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ethicon Endo Surgery Inc
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Ethicon Endo Surgery Inc
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Filing date
Publication date
Priority claimed from US14/319,002 external-priority patent/US9877721B2/en
Application filed by Ethicon Endo Surgery Inc filed Critical Ethicon Endo Surgery Inc
Publication of CN106456175A publication Critical patent/CN106456175A/en
Application granted granted Critical
Publication of CN106456175B publication Critical patent/CN106456175B/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07292Reinforcements for staple line, e.g. pledgets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00057Light
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00115Electrical control of surgical instruments with audible or visual output
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681Aspects not otherwise provided for
    • A61B2017/00734Aspects not otherwise provided for battery operated
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07235Stapler heads containing different staples, e.g. staples of different shapes, sizes or materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07242Stapler heads achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07257Stapler heads characterised by its anvil
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07257Stapler heads characterised by its anvil
    • A61B2017/07264Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07271Stapler heads characterised by its cartridge
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214Stapler heads
    • A61B2017/07278Stapler heads characterised by its sled or its staple holder

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention discloses a kind of fastener cartridge, which may include that (one) includes that the warehouse of platform and multiple securing member chambers and (two) are located in multiple fasteners in the securing member chamber.The platform may include the feature structure for controlling the flowing of the tissue relative to the platform.In some cases, the feature structure can support the fastener when fastener is ejected from the securing member chamber.

Description

Fastener cartridge including organizational controls feature structure
Cross reference to related applications
According to the regulation of 35U.S.C. § 119 (e), this non-provisional requires the name for being filed on April 16th, 2014 The referred to as U.S. of " FASTENING INSTRUMENTS AND FASTENING CARTRIDGES FOR USE THEREWITH " The equity of temporary patent application sequence number 61/980,281, being incorporated by reference for this application are incorporated herein.
Background technique
The present invention relates to suture instruments, and in various embodiments, are related to being used to prepare one or more staples Surgery suturing appliance.
Suture instruments may include the elongated nip component of a pair of of cooperation, wherein each jaw member may be adapted to be inserted into patient's body It is interior and relative to have it is to be stapled and/or incision tissue positioning.In various embodiments, one in jaw member can prop up Support wherein accommodates the nail bins of at least two rows of laterally spaced nails, and another jaw member it is sustainable have in nail bin The anvil block of the nail shapes pit of staple alignment.In general, suture instruments may also include push rod and blade, the push rod and blade It can be slided relative to jaw member by the cam face on push rod and/or by convex in the wedge-shaped slides of push rod pushing Wheel surface will be followed closely and successively be ejected from nail bin.In at least one embodiment, cam face be configured to starting by Storehouse carrying and multiple staple drivers associated with nail, lean against on anvil block and are being held between jaw member to push nail Tissue in form laterally spaced deformation staple.In at least one embodiment, blade can follow cam face and edge Route between staple cut tissue.The example of this suture instruments is in entitled " SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING There is disclosed, the whole of the patent in the United States Patent (USP) 7,794,475 of INSTRUMENTS FOR DEPLOYING THE SAME " Disclosure is incorporated herein by reference.
The current each aspect of the relevant technologies in technical field only for the purpose of illustration discussed above, without answering When being considered as the negative to scope of the claims.
Detailed description of the invention
Each feature of the embodiment described herein is described in detail in the dependent claims.However, closing In the various embodiments of the tissue of operation and the various embodiments of method and its advantage in combination with following attached drawing according to following Illustrate to understand:
Fig. 1 is the front view of surgery suturing appliance;
Fig. 2 is the sectional view of the end effector of the surgery suturing appliance of the Fig. 1 intercepted along the line 2-2 of Fig. 1;
Fig. 3 is the sectional perspective view of the end effector of Fig. 1;
Fig. 4 is the sectional view of the end effector of Fig. 1, and it illustrates the nails in non-percussion configuration being included therein;
Fig. 5 is to show the schematic diagram of the nail of Fig. 4 in percussion configuration;
Fig. 6 is to show the schematic diagram of the end effector for the Fig. 1 for being used for suture and transecting patient tissue;
According to Fig. 7 at least one embodiment include from warehouse extend multiple spines nail bin perspective view;
Fig. 8 is the detail drawing of the nail bin of Fig. 7;
Fig. 8 A is the sectional view of the nail bin of Fig. 7;
Fig. 9 is the detail drawing of the nail in the nail cavity shown in the nail bin for being located in and being defined in Fig. 7;
At least one alternate embodiment includes the multiple Lateral ridges extended from warehouse according to Figure 10 The local perspective view of nail bin;
At least one alternate embodiment includes the multiple Lateral ridges extended from warehouse according to Figure 11 The local perspective view of nail bin;
At least one alternate embodiment includes around the nail cavity opening being defined in warehouse according to Figure 12 Proximal end and distal end multiple spines nail bin local perspective view;
At least one alternate embodiment includes around the nail cavity opening being defined in warehouse according to Figure 13 Proximal end and distal end multiple spines nail bin local perspective view;
At least one alternate embodiment includes the multiple annular knurl spines extended from warehouse according to Figure 14 The local perspective view of nail bin;
At least one alternate embodiment includes the multiple annular knurl spines extended from warehouse according to Figure 15 The local perspective view of nail bin;
The perspective view of the pyramid annular knurl of at least one embodiment according to Figure 15 A;
The perspective view of the conical butt annular knurl of at least one embodiment according to Figure 15 B;
The perspective view of the triangle annular knurl of at least one embodiment according to Figure 15 C;
At least one alternate embodiment includes entirely around the nail cavity being defined in warehouse according to Figure 16 The local perspective view of the nail bin of multiple spines of opening;
At least one alternate embodiment includes entirely around the nail cavity being defined in warehouse according to Figure 16 A The local perspective view of the nail bin of multiple spines of opening;
At least one alternate embodiment includes the multiple longitudinal ridges extended from warehouse according to Figure 17 The local perspective view of nail bin;
Figure 18 is the detail drawing of the nail bin of Figure 17;
Figure 19 is the perspective view of the surgical instruments with interchangeable shaft assembly, and the interchangeable shaft assembly is operatively coupled To the surgical instruments;
Figure 20 is the interchangeable shaft assembly of Figure 19 and the decomposition assembling figure of surgical instruments;
Figure 21 is the decomposition assembling figure of a part of the surgical instruments of Figure 19 and Figure 20;
Figure 22 is another decomposition assembling figure, shows interchangeable shaft assembly and the part of surgical instruments of Figure 19 to Figure 21;
The nail bin perspective view of at least one embodiment being located in the end effector of surgical instruments according to Figure 23, Wherein nail bin includes the multiple spines extended from the warehouse of nail bin;
The front view of the nail of at least one embodiment according to Figure 24;
Figure 25 is the front view of the nail of Figure 24 in the nail cavity being located in nail bin;
The front view of the nail of at least one embodiment according to Figure 26;
The front view of the asymmetric nail of at least one embodiment according to Figure 27;
The front view of another asymmetric nail of at least one embodiment according to Figure 28;
The front view of another asymmetric nail of at least one embodiment according to Figure 29;
Figure 30 is the front view for showing the nail in part deformation state;
Figure 31 is the front view of the nail of Figure 30 in the state of being badly deformed;
Figure 32 is the bottom perspective view of elongated passageway;
Figure 33 is the sectional perspective view of another elongated passageway;
Figure 34 is another sectional view of the elongated passageway of Figure 33, roughly shown with cutting head in the elongated passageway;
Figure 35 is the bottom view of the elongated passageway of Figure 33 and Figure 34;
Figure 36 is the bottom view of another elongated passageway;
Figure 37 is the bottom view of another elongated passageway;
Figure 38 is the bottom view of another elongated passageway;
Figure 39 is the bottom view of another elongated passageway;
Figure 40 is the partial side view of elongated passageway and cutting head, and wherein elongated passageway is shown in section and surgical staples The part in storehouse is omitted for clarity and wherein cutting head is in the unlocked position and is ready to fire;
Figure 41 is the elongated passageway of Figure 40 and another partial side view of cutting head, and wherein cutting head is biased in locking bit It sets;
Figure 42 is the perspective view of cutting head and trigger shaft embodiment;
Figure 43 is the perspective view that the other end actuator and axis are arranged;
Another perspective view of end effector and axis arrangement that Figure 44 is Figure 43, wherein for the sake of clarity, having been omitted from outer A part of axis;
Figure 45 is the partial side view that the other end actuator and axis are arranged;
Figure 46 is the partial side elevational view of end effector arrangement, wherein for the sake of clarity, having been omitted from elongated passageway;
Figure 47 is the top view of anvil block embodiment;
Figure 48 is the top view of another anvil block embodiment;
The sectional view of the end effector of the surgical instruments of at least one embodiment according to Figure 49, the end execute Device includes nail bin, and the nail bin includes staged storehouse platform;
Figure 49 A is same profile figure shown in Figure 49, the anvil for showing staged storehouse platform and relatively positioning with it Various clearance heights between seat;
The front view of the asymmetric nail of at least one embodiment according to Figure 50;
The front view of another asymmetric nail of at least one embodiment according to Figure 51;
The front view of another asymmetric nail of at least one embodiment according to Figure 52;
The perspective view of the nail sliding part of at least one embodiment according to Figure 53;
The top view for the nail sliding part that Figure 54 is Figure 53;
Figure 54 A is the partial top view of the nail bin of Figure 23, shows the nail sliding of Figure 53 in nearside, non-firing position Part;
Figure 54 B is the partial perspective cutaway view of the nail bin of Figure 23;
Figure 54 C is the schematic partial front perspective view of the nail bin of Figure 23;
The perspective view for the nail sliding part that Figure 54 D is Figure 53;
Figure 55 is the perspective view of the distal end of the nail bin of Figure 23;
Figure 55 A is the perspective view of the protruding portion extended from the nail bin of Figure 23;
According to Figure 56 at least one embodiment include from nail bin platform extend spine's pattern nail bin perspective Figure;
Figure 57 is spine's pattern of the nail bin of Figure 56 and the detail drawing of platform;
At least one embodiment includes from the part of the nail bin of spine's pattern of nail bin platform extension according to Figure 58 Perspective view;
The local perspective view of the nail bin of at least one embodiment according to Figure 59, the nail bin include being defined in nail bin to put down Protruding portion pattern in platform;
Figure 60 is the detail drawing of protruding portion shown in Figure 59;
The local perspective view of the nail bin of at least one embodiment according to Figure 61, the nail bin include prolonging from nail bin platform The dome pattern stretched;
Figure 62 is the detail drawing of dome shown in Figure 61;
The local perspective view for the protruding portion that the slave nail bin platform of at least one embodiment extends according to Figure 63;
Figure 64 is the decomposition perspective view of surgery nail bin and warehouse lid;
Figure 65 is the nail bin of Figure 64 and the sectional view of warehouse lid, and wherein warehouse lid is mounted on nail bin;
The perspective view of the anvil block of the surgery suturing appliance of at least one embodiment according to Figure 66, the anvil block include from it The protruding portion of extension;
Figure 67 is the detail drawing of protruding portion shown in Figure 66;
The local perspective view of the anvil block of the surgery suturing appliance of at least one embodiment according to Figure 68, the anvil block include Protruding portion extending therefrom;
The sectional view of the anvil block of the surgery suturing appliance of at least one embodiment according to Figure 69, the anvil block include and Adjacent the first protruding portion array with the first height of one nail pit adjacent with the second nail pit has the second height The second protruding portion array and the third protruding portion array with third height adjacent with third nail pit;
The perspective view of the nail bin of at least one embodiment according to Figure 70, the nail bin include extending from nail bin platform Protruding portion;
Figure 71 is the detail drawing of the distal end of staged platform surface and the protruding portion of Figure 70;
Figure 72 is the detail drawing of the proximal end of staged platform surface and the protruding portion of Figure 70;
The perspective view of the nail bin of at least one embodiment according to Figure 73, the nail bin include flat from the staged of nail bin The protruding portion that platform surface extends;
The local perspective view of the nail bin of at least one embodiment according to Figure 74;
The sectional view of the end effector of the surgery suturing appliance of at least one embodiment according to Figure 75, the end Actuator includes multiple tissue engaging members disposed;
The sectional view of the end effector of the surgery suturing appliance of at least one embodiment according to Figure 76, the end Actuator includes the multiple protruding portion extended from staged storehouse platform surface;
The section of the storehouse platform of the nail bin of at least one embodiment and the protruding portion extended from platform according to Figure 77 Figure, the platform are configured to the support nail when disposing nail from nail cavity;
Another storehouse platform of the nail bin of at least one embodiment and the protruding portion extended from platform according to Figure 78 Sectional view, the platform are configured to the support nail when disposing nail from nail cavity;
The partial plan layout of the storehouse platform of the nail bin of at least one embodiment according to Figure 79, the nail bin include from flat The protruding portion that platform extends, platform are configured to the nail that support is removedly stored in nail cavity, and the nail cavity is limited to nail In storehouse;
The partial cutaway of the nail bin including the first protruding portion and the second protruding portion of at least one embodiment according to Figure 80 Face figure, the first protruding portion are configured to the first leg of the nail that support is removably positioned in nail cavity, the second protruding portion It is configured to the second leg of support nail;
The perspective view of the distal end of the nail bin of at least one embodiment according to Figure 81, the nail bin include platform, The multiple nail cavities being defined in the platform and the various protruding portions extended from the platform;
The local perspective view of the nail bin of at least one embodiment according to Figure 82, the nail bin include platform, are defined in Multiple nail cavities in platform and the multiple protruding portion from platform extension, the protruding portion surround the end of some nail cavities but do not surround The end of other nail cavities.
The local perspective view of the nail bin of at least one embodiment according to Figure 83, the nail bin include platform, are defined in Multiple nail cavities in platform and the multiple protruding portion from platform extension, the protruding portion surround certain ends of nail cavity but do not surround Other ends.
The partial cutaway view of the nail bin of at least one embodiment according to Figure 84, the nail bin include: platform and restriction Multiple nail cavities in the platform;The nail array being located in the nail cavity, it is described nail array nail bin proximal end and Extend between distal end, wherein the nail array includes various nails;With the protruding portion array extended from the platform, The protruding portion array extends between the proximal end and the distal end of the nail bin, wherein the protruding portion battle array Column have various height;
The partial cutaway of the nail bin platform of at least one embodiment and the protruding portion extended from the platform according to Figure 85 A Face figure, wherein the protruding portion is made of conformable material and is shown at uncompressed state;
Figure 85 B is the nail bin platform of Figure 85 A and the partial cutaway view of protruding portion, is shown prominent in some compression Portion out;
Figure 85 C is the nail bin platform of Figure 85 A and the partial cutaway view of protruding portion, shows the protrusion in compressive state Portion;
The partial cutaway view of the nail bin of at least one embodiment according to Figure 86 A, the nail bin include by flexible material The warehouse in unbent condition of composition;
Figure 86 B is the partial cutaway view for being shown at the nail bin of Figure 86 A of bending state;
The perspective view of the anvil block of at least one embodiment according to Figure 87, the anvil block include from the multiple of anvil block extension Protruding portion;
Figure 88 is the detail drawing of a part of the anvil block of Figure 87;
The local perspective view of the anvil block of at least one embodiment according to Figure 89, the anvil block include extending from anvil block Multiple protruding portion;
The perspective view of the component of at least one embodiment according to Figure 90, the component include staple drivers and move Pit expander;
Figure 91 is the exploded view of the component of Figure 90;
Figure 92 is using the sectional perspective view of the nail bin of the component of Figure 90, and the component is shown at non-deployable state;
Figure 93 is the cross-section front view of the nail bin of Figure 92, shows the component of Figure 90 in deployable state and in not The component of Figure 90 of deployable state;
Figure 94 is the top view of surgery staple drivers;
Figure 95 is the perspective view of the surgery staple drivers of Figure 94;
Figure 96 is the perspective view of another surgery staple drivers;
Figure 97 is the top view of the staple drivers pit in a part of surgery nail bin;
The front view of the anvil block of at least one embodiment according to Figure 98, the anvil block include having from what anvil block extended The protruding portion of different height;
The perspective view of the fastener cartridge of at least one embodiment according to Figure 99;
Figure 100 is the plan view of the fastener cartridge of Figure 99;
Figure 101 is the local perspective view of the proximal end of the fastener cartridge of Figure 99;And
Figure 102 is the partial plan layout of the proximal end of the fastener cartridge of Figure 99.
Through multiple views, corresponding reference symbol indicates corresponding component.Example shown in this article shows in one form Various embodiments of the present invention are gone out, this example should not be not understood as limiting the scope of the invention in any way.
Specific embodiment
Present applicant possesses following patent application, and the patent application is submitted by one day with the application and full text Respectively it is herein incorporated by reference:
Entitled " FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENT The U.S. Patent Application Serial of CONFIGURATIONS " (attorney number END7460USNP/140136) Number _ _ _ _ _ _ _ _ _ _;
Entitled " FASTENER CARTRIDGE COMPRISING TISSUE CONTROL FEATURES " (agent File number END7461USNP/140137) U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _;
Entitled " END EFFECTOR COMPRISING AN ANVIL INCLUDING PROJECTIONS The U.S. Patent Application Serial of EXTENDING THEREFROM " (attorney number END7462USNP/140138) Number _ _ _ _ _ _ _ _ _ _;
Entitled " SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZING The U.S. Patent Application Serial Number of ARRANGEMENTS " (attorney number END7463USNP/140139) _ _ _ _ _ _ _ _ _ _;
Entitled " SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITORING The U.S. Patent Application Serial Number of ARRANGEMENTS " (attorney number END7464USNP/140140) _ _ _ _ _ _ _ _ _ _;
Entitled " FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS " (attorney Reel number END7465USNP/140141) U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _;
Entitled " FASTENER CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGING The U.S. Patent Application Serial Number of MEMBERS " (attorney number END7466USNP/140142) _ _ _ _ _ _ _ _ _ _;
Entitled " FASTENER CARTRIDGE ASSEMBLIES AND STAPLE RETAINER COVER The U.S. Patent Application Serial Number of ARRANGEMENTS " (attorney number END7468USNP/140144) _ _ _ _ _ _ _ _ _ _; And
Entitled " FASTENER CARTRIDGE INCLUDING A LAYER ATTACHED THERETO " (agent File number END7469USNP/140145) U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _.
Present applicant also possesses the following patent application for being filed on March 1st, 2013, and wherein each is each From being hereby incorporated herein by full:
Entitled " ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS The U.S. Patent Application Serial Number 13/782,295 of FOR SIGNAL COMMUNICATION ";
Entitled " ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS's " U.S. Patent Application Serial Number 13/782,323;
The U.S. of entitled " THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS " Patent application serial number 13/782,338;
Entitled " ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAY The U.S. Patent Application Serial Number 13/782,499 of ARRANGEMENT ";
Entitled " MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICAL The U.S. Patent Application Serial Number 13/782,460 of INSTRUMENTS ";
The United States Patent (USP) of entitled " JOYSTICK SWITCH ASSEMBLIES FOR SURGICAL INSTRUMENTS " Patent application serial numbers 13/782,358;
Entitled " SENSOR STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGH The U.S. Patent Application Serial Number 13/782,481 of TROCAR ";
Entitled " CONTROL METHODS FOR SURGICAL INSTRUMENTS WITH REMOVABLE The U.S. Patent Application Serial Number 13/782,518 of IMPLEMENT PORTIONS ";
Entitled " ROTARY POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OF The U.S. Patent Application Serial Number 13/782,375 of FREEDOM ";And
The U.S. Patent Application Serial Number 13/782,536 of entitled " SURGICAL INSTRUMENT SOFT STOP ".
Present applicant also possesses the following patent application for being filed on March 14th, 2013, and wherein each Respectively it is hereby incorporated herein by full:
Entitled " ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE's " U.S. Patent Application Serial Number 13/803,097;
Entitled " CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL The U.S. Patent Application Serial Number 13/803,193 of INSTRUMENT ";
Entitled " INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL The U.S. Patent Application Serial Number 13/803,053 of INSTRUMENT ";
Entitled " ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION The U.S. Patent Application Serial Number 13/803,086 of LOCK ";
Entitled " SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR The U.S. Patent Application Serial Number 13/803,210 of SURGICAL INSTRUMENTS ";
The U.S. Patent application of entitled " MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT " Sequence number 13/803,148;
Entitled " DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL The U.S. Patent Application Serial Number 13/803,066 of INSTRUMENTS ";
Entitled " ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL The U.S. Patent Application Serial Number 13/803,117 of INSTRUMENTS ";
Entitled " DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL The U.S. Patent Application Serial Number 13/803,130 of INSTRUMENTS ";And
The U.S. of entitled " METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT " is special Sharp patent application serial numbers 13/803,159.
Present applicant also possesses the following patent application for being filed on March 26th, 2014, and wherein each Respectively it is hereby incorporated herein by full:
The beauty of entitled " POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS " State's patent application serial number 14/226,106;
The U.S. Patent Application Serial Number 14/226 of entitled " STERILIZATION VERIFICATION CIRCUIT ", 099;
Entitled " VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT's " U.S. Patent Application Serial Number 14/226,094;
Entitled " POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT The U.S. Patent Application Serial Number 14/226,117 of AND WAKE UP CONTROL ";
Entitled " MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT The U.S. Patent Application Serial Number 14/226,075 of ASSEMBLIES ";
Entitled " FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL The U.S. Patent Application Serial Number 14/226,093 of INSTRUMENTS ";
The U.S. Patent application of entitled " SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION " Sequence number 14/226,116;
Entitled " SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR " U.S. Patent Application Serial Number 14/226,071;
The United States Patent (USP) of entitled " SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS " Patent application serial numbers 14/226,097;
The United States Patent (USP) of entitled " INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS " Patent application serial numbers 14/226,126;
The U.S. Patent Application Serial Number 14/226 of entitled " MODULAR SURGICAL INSTRUMENT SYSTEM ", 133;
The U.S. of entitled " SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT " Patent application serial number 14/226,081;
Entitled " POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE The U.S. Patent Application Serial Number 14/226,076 of VOLTAGE PROTECTION ";
The U.S. Patent Application Serial Number 14/ of entitled " SURGICAL STAPLING INSTRUMENT SYSTEM " 226,111;And
The United States Patent (USP) Shen of entitled " SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT " It please sequence number 14/226,125;
Present applicant also possesses the U.S. Patent application being identified below, these U.S. Patent applications are respectively complete Text is herein incorporated by reference:
The U.S. of entitled " SURGICAL INSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS " Patent application serial number 12/894,311 (being now U.S. Patent Publication 2012/0080496);
Entitled " SURGICAL STAPLE CARTRIDGES SUPPORTING NON-LINEARLY ARRANGED STAPLES AND SURGICAL STAPLING INSTRUMENTS WITH COMMON STAPLE-FORMING POCKETS” U.S. Patent Application Serial Number 12/894,340 (being now U.S. Patent Publication 2012/0080482);
The United States Patent (USP) Shen of entitled " JAW CLOSURE ARRANGEMENTS FOR SURGICAL INSTRUMENTS " It please sequence number 12/894,327 (being now U.S. Patent Publication 2012/0080499);
Entitled " SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH SEPARATE AND The U.S. Patent Application Serial Number of DISTINCT FASTENER DEPLOYMENT AND TISSUE CUTTING SYSTEMS " 12/894,351 (being now U.S. Patent Publication 2012/0080502);
Entitled " IMPLANTABLE FASTENER CARTRIDGE HAVING A NON-UNIFORM The U.S. Patent Application Serial Number 12/894,338 (being now U.S. Patent Publication 2012/0080481) of ARRANGEMENT ";
Entitled " IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER " U.S. Patent Application Serial Number 12/894,369 (being now U.S. Patent Publication 2012/0080344);
The beauty of entitled " IMPLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS " State's patent application serial number 12/894,312 (being now U.S. Patent Publication 2012/0080479);
The U.S. of entitled " SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE " is special Sharp patent application serial numbers 12/894,377 (being now United States Patent (USP) 8,393,514);
Entitled " SURGICAL STAPLING INSTRUMENT WITH COMPACT ARTICULATION CONTROL The U.S. Patent Application Serial Number 12/894,339 (being now U.S. Patent Publication 2012/0080500) of ARRANGEMENT ";
Entitled " SURGICAL STAPLING INSTRUMENT WITH A VARIABLE STAPLE FORMING The U.S. Patent Application Serial Number 12/894,360 (being now U.S. Patent Publication 2012/0080484) of SYSTEM ";
Entitled " SURGICAL STAPLING INSTRUMENT WITH INTERCHANGEABLE STAPLE The U.S. Patent Application Serial Number 12/894,322 (being now United States Patent (USP) 8,740,034) of CARTRIDGE ARRANGEMENTS ";
Entitled " SURGICAL STAPLE CARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES " U.S. Patent Application Serial Number 12/894,350 (being now U.S. Patent Publication 2012/0080478);
Entitled " IMPLANTABLE FASTENER CARTRIDGE COMPRISING BIOABSORBABLE The U.S. Patent Application Serial Number 12/894,383 (being now United States Patent (USP) 8,752,699) of LAYERS ";
The U.S. Patent Application Serial Number 12/894,389 of entitled " COMPRESSIBLE FASTENER CARTRIDGE " (being now United States Patent (USP) 8,740,037);
The United States Patent (USP) of entitled " FASTENERS SUPPORTED BY A FASTENER CARTRIDGE SUPPORT " Patent application serial numbers 12/894,345 (being now U.S. Patent Publication 2012/0080483);
The U.S. Patent Application Serial Number 12/894,306 of entitled " COLLAPSIBLE FASTENER CARTRIDGE " (being now U.S. Patent Publication 2012/0080332);
Entitled " FASTENER SYSTEM COMPRISING A PLURALITY OF CONNECTED RETENTION The U.S. Patent Application Serial Number 12/894,318 (being now U.S. Patent Publication 2012/0080480) of MATRIX ELEMENTS ";
Entitled " FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND AN ALIGNMENT The U.S. Patent Application Serial Number 12/894,330 (being now United States Patent (USP) 8,757,465) of MATRIX ";
The U.S. Patent application sequence of entitled " FASTENER SYSTEM COMPRISING A RETENTION MATRIX " Row number 12/894,361 (being now United States Patent (USP) 8,529,600);
Entitled " FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEM The U.S. Patent Application Serial Number 12/894,367 of COMPRISING A RETENTION MATRIX " (is now U.S. Patent Publication 2012/0080485);
The beauty of entitled " FASTENER SYSTEM COMPRISING A RETENTION MATRIX AND A COVER " State's patent application serial number 12/894,388 (being now United States Patent (USP) 8,474,677);
Entitled " FASTENER SYSTEM COMPRISING A PLURALITY OF FASTENER CARTRIDGES " U.S. Patent Application Serial Number 12/894,376 (being now U.S. Patent Publication 2012/0080486);
Entitled " SURGICAL STAPLER ANVIL COMPRISING A PLURALITY OF FORMING The U.S. Patent Application Serial Number 13/097,865 (being now U.S. Patent Publication 2012/0080488) of POCKETS ";
The United States Patent (USP) of entitled " TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER " Patent application serial numbers 13/097,936 (being now United States Patent (USP) 8,657,176);
Entitled " STAPLE CARTRIDGE COMPRISING A VARIABLE THICKNESS COMPRESSIBLE The U.S. Patent Application Serial Number 13/097,954 (being now U.S. Patent Publication 2012/0080340) of PORTION ";
Entitled " STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A The U.S. Patent Application Serial Number 13/097,856 of COMPRESSIBLE PORTION THEREOF " (is now U.S. Patent Publication 2012/0080336);
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING DETACHABLE PORTIONS's " U.S. Patent Application Serial Number 13/097,928 (being now United States Patent (USP) 8,746,535);
Entitled " TISSUE THICKNESS COMPENSATOR FOR A SURGICAL STAPLER COMPRISING The U.S. Patent Application Serial Number 13/097,891 of AN ADJUSTABLE ANVIL " (is now U.S. Patent Publication 2012/ 0080489);
The beauty of entitled " STAPLE CARTRIDGE COMPRISING AN ADJUSTABLE DISTAL PORTION " State's patent application serial number 13/097,948 (being now U.S. Patent Publication 2012/0083836);
The U.S. Patent Application Serial Number 13/ of entitled " COMPRESSIBLE STAPLE CARTRIDGE ASSEMBLY " 097,907 (being now U.S. Patent Publication 2012/0080338);
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING PORTIONS HAVING The U.S. Patent Application Serial Number 13/097,861 of DIFFERENT PROPERTIES " (is now U.S. Patent Publication 2012/ 0080337);
The U.S. Patent Application Serial Number 13/097 of entitled " STAPLE CARTRIDGE LOADING ASSEMBLY ", 869 (being now U.S. Patent Publication 2012/0160721);
Entitled " COMPRESSIBLE STAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS's " U.S. Patent Application Serial Number 13/097,917 (being now U.S. Patent Publication 2012/0083834);
The United States Patent (USP) Shen of entitled " STAPLE CARTRIDGE COMPRISING A RELEASABLE PORTION " It please sequence number 13/097,873 (being now United States Patent (USP) 8,740,038);
Entitled " STAPLE CARTRIDGE COMPRISING COMPRESSIBLE DISTORTION RESISTANT The U.S. Patent Application Serial Number 13/097,938 (being now U.S. Patent Publication 2012/0080491) of COMPONENTS ";
Entitled " STAPLE CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR's " U.S. Patent Application Serial Number 13/097,924 (being now U.S. Patent Publication 2012/0083835);
The U.S. Patent Application Serial Number 13/ of entitled " SURGICAL STAPLER WITH FLOATING ANVIL " 242,029 (being now U.S. Patent Publication 2012/0080493);
The U.S. Patent application sequence of entitled " CURVED END EFFECTOR FOR A STAPLING INSTRUMENT " Row number 13/242,066 (being now U.S. Patent Publication 2012/0080498);
The U.S. Patent Application Serial of entitled " STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK " Number 13/242,086 (being now U.S. Patent Publication 2013/0075450);
The U.S. of entitled " STAPLE CARTRIDGE INCLUDING COLLAPSIBLE DECK ARRANGEMENT " Patent application serial number 13/241,912 (being now U.S. Patent Publication 2013/0075448);
The U.S. Patent application of entitled " SURGICAL STAPLER WITH STATIONARY STAPLE DRIVERS " Sequence number 13/241,922 (being now U.S. Patent Publication 2013/0075449);
Entitled " SURGICAL INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATING The U.S. Patent Application Serial Number 13/241,637 of MULTIPLE ACTUATION MOTIONS " (is now U.S. Patent Publication 2012/0074201);
Entitled " SURGICAL INSTRUMENT WITH SELECTIVELY ARTICULATABLE END The U.S. Patent Application Serial Number 13/241,629 (being now U.S. Patent Publication 2012/0074200) of EFFECTOR ";
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF The U.S. Patent Application Serial Number 13/433,096 (being now U.S. Patent Publication 2012/0241496) of CAPSULES ";
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF LAYERS " U.S. Patent Application Serial Number 13/433,103 (being now U.S. Patent Publication 2012/0241498);
The U.S. Patent Application Serial Number of entitled " EXPANDABLE TISSUE THICKNESS COMPENSATOR " 13/433,098 (being now U.S. Patent Publication 2012/0241491);
The United States Patent (USP) of entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A RESERVOIR " Patent application serial numbers 13/433,102 (being now U.S. Patent Publication 2012/0241497);
Entitled " RETAINER ASSEMBLY INCLUDING A TISSUE THICKNESS COMPENSATOR's " U.S. Patent Application Serial Number 13/433,114 (being now U.S. Patent Publication 2012/0241499);
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING AT LEAST ONE The U.S. Patent Application Serial Number 13/433,136 (being now U.S. Patent Publication 2012/0241492) of MEDICAMENT ";
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING CONTROLLED RELEASE AND The U.S. Patent Application Serial Number 13/433,141 (being now U.S. Patent Publication 2012/0241493) of EXPANSION ";
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING FIBERS TO PRODUCE A The U.S. Patent Application Serial Number 13/433,144 (being now U.S. Patent Publication 2012/0241500) of RESILIENT LOAD ";
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING STRUCTURE TO PRODUCE A The U.S. Patent Application Serial Number 13/433,148 (being now U.S. Patent Publication 2012/0241501) of RESILIENT LOAD ";
The beauty of entitled " TISSUE THICKNESS COMPENSATOR COMPRISING RESILIENT MEMBERS " State's patent application serial number 13/433,155 (being now U.S. Patent Publication 2012/0241502);
Entitled " METHODS FOR FORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTS The U.S. Patent Application Serial Number 13/433,163 of FOR SURGICAL STAPLERS " (is now U.S. Patent Publication 2012/ 0248169);
The U.S. Patent Application Serial Number 13/433,167 of entitled " TISSUE THICKNESS COMPENSATORS " (being now U.S. Patent Publication 2012/0241503);
The U.S. Patent Application Serial Number 13/ of entitled " LAYERED TISSUE THICKNESS COMPENSATOR " 433,175 (being now U.S. Patent Publication 2012/0253298);
Entitled " TISSUE THICKNESS COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS " U.S. Patent Application Serial Number 13/433,179 (being now U.S. Patent Publication 2012/0241505);
The U.S. Patent Application Serial Number 13/763,028 of entitled " ADHESIVE FILM LAMINATE " (is now the U.S. Patent disclosure 2013/0146643);
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING CAPSULES DEFINING A The U.S. Patent Application Serial Number 13/433,115 of LOW PRESSURE ENVIRONMENT " (is now U.S. Patent Publication 2013/ 0256372);
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISED OF A PLURALITY OF The U.S. Patent Application Serial Number 13/433,118 (being now U.S. Patent Publication 2013/0256365) of MATERIALS ";
Entitled " MOVABLE MEMBER FOR USE WITH A TISSUE THICKNESS COMPENSATOR's " U.S. Patent Application Serial Number 13/433,135 (being now U.S. Patent Publication 2013/0256382);
Entitled " TISSUE THICKNESS COMPENSATOR AND METHOD FOR MAKING THE SAME's " U.S. Patent Application Serial Number 13/433,140 (being now U.S. Patent Publication 2013/0256368);
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF The U.S. Patent Application Serial Number 13/433,129 (being now U.S. Patent Publication 2013/0256367) of MEDICAMENTS ";
Entitled " STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED The U.S. Patent Application Serial Number 11/216,562 (being now United States Patent (USP) 7,669,746) of STAPLE HEIGHTS ";
Entitled " SURGICAL STAPLING DEVICE WITH ANVIL HAVING STAPLE FORMING The U.S. Patent Application Serial Number 11/714,049 of POCKETS OF VARYING DEPTHS " (is now U.S. Patent Publication 2007/0194082);
Entitled " SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING The U.S. Patent Application Serial Number 11/711,979 (being now United States Patent (USP) 8,317,070) of DIFFERENT LENGTHS ";
Entitled " SURGICAL STAPLING DEVICE WITH STAPLE DRIVERS OF DIFFERENT The U.S. Patent Application Serial Number 11/711,975 (being now U.S. Patent Publication 2007/0194079) of HEIGHT ";
Entitled " SURGICAL STAPLING DEVICE WITH STAPLE DRIVER THAT SUPPORTS MULTIPLE WIRE DIAMETER STAPLES " U.S. Patent Application Serial Number 11/711,977 (be now United States Patent (USP) 7, 673,781);
Entitled " SURGICAL STAPLING DEVICE WITH MULTIPLE STACKED ACTUATOR WEDGE CAMS FOR DRIVING STAPLE DRIVERS " U.S. Patent Application Serial Number 11/712,315 (be now United States Patent (USP) 7, 500,979);
Entitled " STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED The U.S. Patent Application Serial Number 12/038,939 (being now United States Patent (USP) 7,934,630) of STAPLE HEIGHTS ";
Entitled " SURGICAL STAPLING SYSTEMS THAT PRODUCE FORMED STAPLES HAVING The U.S. Patent Application Serial Number 13/020,263 (being now United States Patent (USP) 8,636,187) of DIFFERENT LENGTHS ";
Entitled " ROBOTICALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCE The U.S. Patent Application Serial Number 13/118,278 of FORMED STAPLES HAVING DIFFERENT LENGTHS " (is now beauty State's patent disclosure 2011/0290851);
The beauty of entitled " ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS " State's patent application serial number 13/369,629 (being now U.S. Patent Publication 2012/0138660);
Entitled " SURGICAL STAPLING DEVICES FOR FORMING STAPLES WITH DIFFERENT The U.S. Patent Application Serial Number 12/695,359 (being now United States Patent (USP) 8,464,923) of FORMED HEIGHTS ";
Entitled " STAPLE CARTRIDGES FOR FORMING STAPLES HAVING DIFFERING FORMED The U.S. Patent Application Serial Number 13/072,923 (being now United States Patent (USP) 8,567,656) of STAPLE HEIGHTS ";
The U.S. Patent application sequence of entitled " LAYER OF MATERIAL FOR A SURGICAL END EFFECTOR " Row number 13/766,325 (being now U.S. Patent Publication 2013/0256380);
The beauty of entitled " ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR " State's patent application serial number 13/763,078 (being now U.S. Patent Publication 2013/0256383);
The U.S. Patent application of entitled " LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS " Sequence number 13/763,094 (being now U.S. Patent Publication 2013/0256377);
The U.S. of entitled " END EFFECTOR COMPRISING A DISTAL TISSUE ABUTMENT MEMBER " Patent application serial number 13/763,106 (being now U.S. Patent Publication 2013/0256378);
The United States Patent (USP) Shen of entitled " TISSUE THICKNESS COMPENSATOR COMPRISING CHANNELS " It please sequence number 13/433,147 (being now U.S. Patent Publication 2013/0256369);
The beauty of entitled " SURGICAL STAPLING CARTRIDGE WITH LAYER RETENTION FEATURES " State's patent application serial number 13/763,112 (being now U.S. Patent Publication 2013/0256379);
Entitled " ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM A The U.S. Patent Application Serial Number 13/763,035 of FASTENER CARTRIDGE " (is now U.S. Patent Publication 2013/ 0214030);
Entitled " RELEASABLE TISSUE THICKNESS COMPENSATOR AND FASTENER CARTRIDGE The U.S. Patent Application Serial Number 13/763,042 (being now U.S. Patent Publication 2013/0221063) of HAVING THE SAME ";
Entitled " FASTENER CARTRIDGE COMPRISING A RELEASABLE TISSUE THICKNESS The U.S. Patent Application Serial Number 13/763,048 (being now U.S. Patent Publication 2013/0221064) of COMPENSATOR ";
Entitled " FASTENER CARTRIDGE COMPRISING A CUTTING MEMBER FOR RELEASING A The U.S. Patent Application Serial Number 13/763,054 of TISSUE THICKNESS COMPENSATOR " (is now U.S. Patent Publication 2014/0097227);
Entitled " FASTENER CARTRIDGE COMPRISING A RELEASABLY ATTACHED TISSUE The U.S. Patent Application Serial Number 13/763,065 of THICKNESS COMPENSATOR " (is now U.S. Patent Publication 2013/ 0221065);
The U.S. Patent application of entitled " STAPLE CARTRIDGE COMPRISING A RELEASABLE COVER " Sequence number 13/763,021;
The beauty of entitled " ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END EFFECTOR " State's patent application serial number 13/763,078 (being now U.S. Patent Publication 2013/0256383);
The United States Patent (USP) Shen of entitled " LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES " It please sequence number 13/763,095 (being now U.S. Patent Publication 2013/0161374);
The U.S. of entitled " IMPLANTABLE ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES " Patent application serial number 13/463,147 (being now U.S. Patent Publication 2013/0292398);
Entitled " MULTIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STAPLING The U.S. Patent Application Serial Number 13/763,192 (being now U.S. Patent Publication 2013/0146642) of DEVICES ";
Entitled " RELEASABLE LAYER OF MATERIAL AND SURGICAL END EFFECTOR HAVING The U.S. Patent Application Serial Number 13/763,161 (being now U.S. Patent Publication 2013/0153641) of THE SAME ";
Entitled " ACTUATOR FOR RELEASING A LAYER OF MATERIAL FROM A SURGICAL END The U.S. Patent Application Serial Number 13/763,177 (being now U.S. Patent Publication 2013/0146641) of EFFECTOR ";
The United States Patent (USP) of entitled " STAPLE CARTRIDGE COMPRISING A COMPRESSIBLE PORTION " Patent application serial numbers 13/763,037;
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING TISSUE INGROWTH The U.S. Patent Application Serial Number 13/433,126 (being now U.S. Patent Publication 2013/0256366) of FEATURES ";
Entitled " DEVICES AND METHODS FOR ATTACHING TISSUE THICKNESS The U.S. Patent Application Serial Number of COMPENSATING MATERIALS TO SURGICAL STAPLING INSTRUMENTS " 13/433,132 (being now U.S. Patent Publication 2013/0256373).
Entitled " FASTENER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR The U.S. Patent Application Serial Number 13/851,703 of INCLUDING OPENINGS THEREIN ";
Entitled " TISSUE THICKNESS COMPENSATOR COMPRISING A CUTTING MEMBER PATH " U.S. Patent Application Serial Number 13/851,676;
The U.S. Patent Application Serial Number 13/851,693 of entitled " FASTENER CARTRIDGE ASSEMBLIES ";
Entitled " FASTENER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR The U.S. Patent Application Serial Number 13/851,684 of AND A GAP SETTING ELEMENT ";
The U.S. Patent Application Serial of entitled " STAPLE CARTRIDGE INCLUDING A BARBED STAPLE " Number 14/187,387 (being now U.S. Patent Publication 2014/0166724);
The U.S. Patent Application Serial of entitled " STAPLE CARTRIDGE INCLUDING A BARBED STAPLE " Number 14/187,395 (being now U.S. Patent Publication 2014/0166725);
The U.S. Patent Application Serial of entitled " STAPLE CARTRIDGE INCLUDING A BARBED STAPLE " Number 14/187,400 (being now U.S. Patent Publication 2014/0166726);
Entitled " IMPLANTABLE LAYERS AND METHODS FOR ALTERING IMPLANTABLE LAYERS The U.S. Patent Application Serial Number 14/187,383 of FOR USE WITH SURGICAL FASTENING INSTRUMENTS ";
Entitled " IMPLANTABLE LAYERS AND METHODS FOR ALTERING ONE OR MORE The U.S. of PROPERTIES OF IMPLANTABLE LAYERS FOR USE WITH FASTENING INSTRUMENTS " is special Sharp patent application serial numbers 14/187,386;
Entitled " IMPLANTABLE LAYERS AND METHODS FOR MODIFYING THE SHAPE OF THE The United States Patent (USP) Shen of IMPLANTABLE LAYERS FOR USE WITH A SURGICAL FASTENING INSTRUMENT " It please sequence number 14/187,390;
The U.S. Patent Application Serial Number 14/187,389 of entitled " IMPLANTABLE LAYER ASSEMBLIES ";
The U.S. Patent application of entitled " IMPLANTABLE LAYERS COMPRISING A PRESSED REGION " Sequence number 14/187,385;And
The United States Patent (USP) of entitled " FASTENING SYSTEM COMPRISING A FIRING MEMBER LOCKOUT " Patent application serial numbers 14/187,384;
Many specific details are set forth, so that reader is to described in specification and embodiment shown in the drawings Overall structure, function, manufacture and purposes have thorough understanding.It will be understood by those skilled in the art, however, that can not have in this way Specific detail in the case where implement the present embodiment.In other cases, well known operation, component and member are not described in Part, in order to avoid keep embodiment described in specification smudgy.It will be understood by those skilled in the art that described herein The embodiment with shown in is non-limiting example, thus it can be appreciated that, specific structural and functional details disclosed herein can It is representative and illustrative.Can these embodiments be carried out with modification without departing from the scope of the claims and changed Become.
" various embodiments ", " some embodiments ", " embodiment " or " implementation that this specification refers in the whole text Scheme " etc., it is meant that be included at least one embodiment in conjunction with the specific features of embodiment description, structure or characteristic In.Therefore, this specification occurs in the whole text phrase " in various embodiments ", " in some embodiments ", " in a reality Apply in scheme " or " in embodiments " etc. be not necessarily all referring to identical embodiment.In addition, in one or more embodiment party In case, specific features, structure or characteristic can combine in any suitable manner.Therefore, under unconfined situation, in conjunction with one Specific features that embodiment shows or describes, structure or characteristic can entirely or partly with one or more of the other embodiment Feature, structure or characteristic combination.In addition, it should be understood that for simplicity and clarity, it herein can be for example with reference to shown embodiment party Case uses the spatial terminology of such as "vertical", "horizontal", "up" and "down" etc.However, these terms for assist reader and It is not intended to limitation and absolute.
Fig. 1 is gone to, surgical stapling and cutting device 10 may include that can be manipulated to tool portion 14 being located in operation Shank 12 in position.In various embodiments, tool portion 14 may include the end effector 16 for being attached to elongated shaft 18. In several cases, the size of tool portion 14 and construction can be set to be inserted into Surgery by the intubation of trochar (not shown) In position, to execute such as endoscope type or laparoscopic surgery.End effector 16 may include upper jaw or anvil block 20 And lower jaw 22, wherein when the closure trigger 24 of the movement of pistol grip 26 of present dynasty's shank 12 or pressing shank 12, anvil Seat 20 can move between the open and the closed positions.In various embodiments, pressing closure trigger 24 can promote carefully The outer closure sleeve 28 of long axis 18, wherein outer closure sleeve 28 can contact anvil block 20 and anvil block 20 be pivoted to its closure Position.In some cases, surgeon can be such that tool portion 14 rotates around its longitudinal axis by torsional axis knob 30. Under any circumstance, when end effector 16 has been inserted into gas injection body cavity, for example, with regard to releasable closure trigger 24, from And anvil block 20 is allowed to bias by spring (not shown) and position relative to target tissue.In various embodiments, closure touching Hair device 24 may be locked in its depressed state, and at least one embodiment, shank 12 may also include can be pressed with Actuator 44 is discharged to the locking that closure trigger 24 unlocks.Once anvil block 20 and lower jaw 22 are relative in operative site When the appropriate positioning of tissue, so that it may depress closure trigger 24 again so as to closed anvil 20 and against being attached to bottom jaw 22 Nail bin 42 compresses tissue.
When anvil block 20 has been closed, so that it may percussion touching is pulled or pressed towards closure trigger 24 and pistol grip 26 Device 32 is sent out, so that percussion force or movement are applied to firing member and never firing position propulsion firing member.In various realities It applies in scheme, firing member may include the nearside trigger shaft 34 for being attached to distal side trigger shaft 36.In at least one such embodiment party In case, trigger shaft 34 and/or trigger shaft 36 be may be supported in the frame 38 in axis 18, which may extend away holds in shank 12 and end Between row device 16.Due to being applied to the percussion campaign of firing member, then trigger shaft 36 can be in the elongated staple cartridge channel of lower jaw 22 40 and the nail bin 42 that is located in warehouse channel 40 in promoted towards distal side.In various embodiments, referring to fig. 2, trigger shaft 36 It may include attachment part 48, the attachment part is attached to the E mast 50 that can be translated in end effector 16.E mast 50 can Including vertical portion 52, the vertical portion can extend through the group in anvil block 20 when E mast 50 is promoted towards distal side Knit narrow longitudinal anvil block slot 58 of contact surface 60, in narrow vertical slit 62 and elongate staple channel 40 in nail bin 42 Narrow longitudinal channel 64.Referring now to Fig. 2 and Fig. 3, anvil block slot 58 can be extended up in anvil block 20 and can be wrapped The end being passed through in the vertical passage 66 of lateral widening is included, the vertical passage 66 of the lateral widening is sized and configured so that it Receive the upper pin 54 being laterally extended from vertical portion 52.Similarly, passage slot 64 can extend downwardly into channel 40 and It may include the end being passed through in the vertical passage 68 of lateral widening, the size and construction of the vertical passage 68 of the lateral widening make It obtains it and receives the one or more lower legs 70 being laterally extended from vertical portion 52.
In various embodiments, as above it is further described that E mast 50 may also include one or more intermediate pins 72, the intermediate pin can be laterally extended from vertical portion 52 and be configured to the top on the chassis 74 along nail bin 42 Surface sliding.In certain embodiments, intermediate pin 72 is configured to fixed nail bin 42, or ensures that nail bin 42 is kept In channel 40.The size for the longitudinal percussion groove 75 being formed in the nail bin 42 of 74 top of chassis is set to allow for intermediate pin 72 translate across nail bin 42.In various embodiments, E mast 50 may also include distal side driving surface 76, the distal side driving Surface is configured to translate across the vertical slit 62 in nail bin 42 and passes through towards distal side driving wedge-shaped slides 78 Nail bin 42.In certain embodiments, wedge block 78 can be integrally formed in E mast 50, and in other embodiments, wedge Shape sliding part 78 may be present in nail bin 42 and can contact driving surface 76 when E mast 50 is promoted towards distal side.E mast 50 Vertical portion 52 may additionally include the cutting that 76 top of distal side driving surface and 54 lower section of upper pin extend along distal side edge Surface 80, the cutting surfaces clamped tissue 46 of cutting when organizing 46 to be just sewn.Referring now to Fig. 4, wedge-shaped slides 78 are configured to engage one or more staple drivers 82 and drive up staple drivers 82 towards anvil block 20.Various In embodiment, nail (such as following closely 83) can for example be located at and/or be supported in other ways by staple drivers 82, so that when nail driving When device 82 is lifted up, nail 83 can also be lifted up.In at least one such embodiment, nail 83 can also at least partly be determined Position in the staple cartridge body 85 of nail bin 42 nail cavity or pit 84 in, wherein when nail 83 is lifted up, follow closely 83 accessible anvil blocks 20 And it can be ejected from nail cavity 84.In at least one embodiment, referring again to Fig. 4, chassis 74 could attach to warehouse 85, so as to Staple drivers 82 and nail 83 are maintained in nail bin 42 until coming as described above from its deployment nail 83.
Referring now to Figures 5 and 6, in use, anvil block 20 can be located in the side of tissue 46 and bottom jaw 22 can be determined 46 opposite side is being organized in position, so that when anvil block 20 is closed into tissue, the tissue contacting surface 60 and nail bin 42 of anvil block 20 Tissue contact platform 90 can compress tissue 46 between uncompressed thickness 91 and compressed thickness 92.In order to suture and crosscutting group 46 are knitted, as described above, wedge block 78 can be promoted towards distal side to promote staple driver 82 simultaneously towards anvil 20 in nail bin 42 And deform staple 83.In various embodiments, each staple drivers 82 may include that be defined in one or more narrow Slot, the slit are configured to receive the pedestal 87 of nail 83 and are releasably held in appropriate location.At least In one such embodiment, each nail 83 may include the one or more nail legs 88 extended from pedestal 87, and wherein nail leg 88 can It extends up in nail cavity 84.In various embodiments, when nail 83 is in its non-firing position, the end of nail leg 88 can phase Platform or tissue contacting surface 90 for warehouse 85 are recessed.When being lifted up nail 83 by driver 82, the end of nail leg 88 End can eject from nail cavity 84, penetrate tissue 46 and contact the anvil block forming pit 89 relatively positioned with nail cavity 84.Anvil block at Shape pit 89 is configured to that nail 83 is made to be deformed into any suitable shape, B shape shape such as shown in Figure 5.Now Referring to Fig. 6, when deployment nail 83, blade 80 can transecting patient tissue 46 enter in sutured portion 94.
As described above, the jaw member of end effector is configured to for compression pressure or compressing force being applied to The tissue being just sewn.However, in several cases, tissue may be, for example, that sliding and tissue at least part can be relative to Jaw member sliding.In some cases, tissue can skid off in a longitudinal direction from the distal end of end effector and/or can It is skidded off along transverse to the direction of longitudinal direction from the side of end effector.In some cases, when compressing tissue, tissue Part can be squeezed out from the side of the distal end of end effector and/or end effector.In a variety of realities disclosed herein It applies in scheme, nail bin may include one or more tissue holding features structures, and the tissue holding features structure can be configured to It can prevent or at least reduce a possibility that tissue being located in end effector is relative to end effector movement.
In various embodiments, referring now to Fig. 7 and Fig. 8, nail bin (for example, nail bin 142) may include warehouse 185 and The multiple nails (such as, following closely 187 (Fig. 9)) being located in warehouse 185.Warehouse 185 may include proximal end 141 and distal end 143, wherein proximal end 141 is configured in the proximal end of insertion staple cartridge channel and distal end 143 can quilt It is constructed to be permeable in the distal end of insertion staple cartridge channel.In at least one embodiment, warehouse 185 may include multiple nail cavities 184, it can respectively be configured in the nail cavity receive nail 187.In certain alternate embodiments, although not showing Out, but nail cavity may include the more than one nail being positioned in.Under any circumstance, nail cavity 184 can arrange in warehouse 185 At multiple rows.More specifically, at least one embodiment, nail cavity 184 can for example on the first side 145 of warehouse 185 cloth It is set to three staples and can for example be arranged to three staples in second side 147 of warehouse 185.In at least one such implementation In scheme, the first side 145 of warehouse 185 and second side 147 can be separated by cutter slit 162, and the cutter slit is configured to Enough slideably received within cutting element in it.In a variety of other embodiments, nail bin can be for example in each of cutter slit 162 Side includes any other appropriate number of staple, such as two staples or four staples.Referring to Fig. 9, in various embodiments, Nail bin 142 may also include the multiple staple drivers for being configured to support nail 187 and/or ejecting nail 187 from nail cavity 184 182.In certain embodiments, each nail cavity 184 may include the open end in the platform 190 of warehouse 185 or opening 110, nail 187 passes through 110 ejection of open end or opening.
In various embodiments, referring primarily to Fig. 8, it is vertical that nail cavity 184, which may be arranged so that them relative to each other, To staggered.For example, nail cavity 184 on the first side 145 of warehouse 185 for example can be with the most interior row of nail cavity 184, nail cavity 184 The outermost arrangement of intermediate row and nail cavity 184 is set, and the nail cavity 184 in one of row can be one or both of with other rows In nail cavity 184 be laterally aligned.In at least one embodiment, each nail cavity 184 may include proximal end 111 and distal side End 112, wherein the proximal end 111 of each nail cavity 184 may be positioned to the nearside than distal end 112 closer to warehouse 185 End 141.Equally, the distal end 112 of each nail cavity 184 may be positioned to than proximal end 111 closer to the distal side of warehouse 185 End 143.In various embodiments, the most interior row of nail cavity 184 can be oriented so that the distal side of the nail cavity 184 in most interior row End 112 is positioned relative to the distal end 112 of the nail cavity 184 in intermediate row nail cavity 184 towards distal side.Similarly, nail cavity 184 Most outlet can be oriented so that the distal end 112 of the nail cavity 184 in most outlet relative to the nail cavity in intermediate row nail cavity 184 Distal end 112 towards distal side position.For example, the farthest side nail cavity 184 in most interior row can be relative to the farthest side in intermediate row Nail cavity 184 positions in distal side, and similarly, the farthest side nail cavity 184 in most outlet can be relative to the farthest side in intermediate row Nail cavity 184 positions in distal side.In certain embodiments, most interior nail chamber 184 and outermost nail chamber 184 can be laterally Ground alignment, so that the distal end 112 of (one) most interior nail cavity 184 is aligned with the distal end 112 of outermost nail cavity 184 and (two) The proximal end 111 of most interior nail cavity 184 is aligned with the proximal end 111 of outermost nail cavity 184.In various embodiments, each Nail cavity 184 and its opening 110 can have identical or at least roughly the same configuration, and at least one embodiment, nail Chamber 184 can equally spacedly or be at least substantially equally spaced apart relative to each other in staple.
In various embodiments, referring again to Fig. 7 and 8, the warehouse 185 of nail bin 142, which may also include, to be for example configured to It can contact and compress one or more spines of target tissue, such as spine 113,114 and 115.More specifically, referring now to figure 8A can be closed the anvil block 120 of end effector to compress tissue T against nail bin 142, wherein in such cases, tissue Contact platform 190 and the engageable tissue of spine extending therefrom 113,114 and 115.In some cases, work as closed anvil When 120, anvil block 120 can be towards 142 pushes against tissue of nail bin, so that tissue contacts spine 113,114 and 115 first and then contacts Storehouse platform 190.In other cases, before the tissue contacts storehouse platform 190, nail bin 142 can be positioned against tissue, so that spine 113,114 and 115 contact tissues.Under any circumstance, spine 113,114 and 115 is prevented from or at least once contacting tissue Limit the relative motion between tissue and nail bin 142.In certain embodiments, spine 113,114 and 115 can from flat or At least substantially flat storehouse platform 190 upwardly extends and can limit one or more pits or channel, the pit or logical It is for example configured to receive a part of tissue in road, and therefore inhibition group is woven in the longitudinal direction of end effector And/or the relative motion in transverse direction, especially when tissue is at least partly compressed in anvil block 120 and 113,114 He of spine When between 115.In various embodiments, when spine 113,114 and 115 extends to 190 top of storehouse platform, in compression set It is compressible to be located among anvil block 120 and spine 113,114 and 115 before the tissue among anvil block 120 and storehouse platform 190 Tissue.Therefore, in some such cases, the other parts of the tissue in compression set between anvil block 120 and storehouse platform 190 Before, can precommpression (that is, at least partly compress) be located in the tissue between anvil block 120 and spine 113,114 and 115.More In the case of kind, before tissue obtains compression completely, since this precommpression just controls or prevents the part of tissue from holding from end Row device skids off, as described in more detail below.
In various embodiments, referring again to Fig. 7 and 8, the spine 113 extended from storehouse platform 190 can open around nail cavity The proximal end 111 of mouth 110 extends.Similarly, the spine 114 extended from storehouse platform 190 can surround the distal side of nail cavity opening 110 End 112 extends.In various embodiments, it is fixed to be configured to engagement for these nearside spines 113 and distal side spine 114 Position nail cavity 184 above and/or around tissue and when tissue just by compression and/or suture when by these parts of tissue guarantor It holds in place.In other words, the tissue for remaining positioned in 184 top of nail cavity and/or surrounding can be for the tissue that will be sutured Part provides Partial controll, and thus prevents or at least limit the relative motion between these parts of tissue and nail bin 142. In various embodiments, spine 113 and 114 can surround whole nail cavities 184 or only the opening 110 of some nail cavities 184 positions.? In at least one embodiment, warehouse may include only around the nail cavity 184 in the most outlet of the first side 145 and second side 147 Spine 113 and 114.It in such embodiment, can be enough that group is hindered to be woven in end execution around the spine of outermost nail chamber 184 Transverse movement in device.In certain embodiments, warehouse can only include the proximal end 111 for surrounding recent side nail cavity 184 Nearside spine 113 and/or the distal side spine 114 of the distal end 112 around farthest side nail cavity 184.In such embodiment, Spine around nearest side and farthest side nail cavity 184 can be enough that group is hindered to be woven in the longitudinal movement in end effector.
In various embodiments, as above it is further described that each nearside spine 113 may include for example surrounding to open The arch or curved profile of the proximal end 111 of mouth 110.The arcuate profile of each nearside spine 113 can be by a kind of radius of curvature Or more than one radius of curvature limits.Similarly, each distal end spine 114 may include for example around opening 110 The arch or curved profile of distal end 112.The arcuate profile of each distal end spine 114 can be by a kind of radius of curvature or more than one Kind radius of curvature limit.In certain embodiments, as above it is further described that each spine 113 and 114 can shape At pit, the pit can receive a part of tissue being compressed and prevent the part of tissue relative to nail bin 142 Longitudinally and/or laterally move.In various embodiments, nail bin 142 may also include intermediate spine 115, the intermediate spine It can extend and/or connect adjacent ridges 113 and 114 between the adjacent ridges 113 and 114 in the adjacent row of nail cavity 184.? In at least one such embodiment, one or more spines 113,114 and 115 can interoperatively be formed across warehouse 185 The waveform spine that first side 145 or second side 147 extend, wherein at least one embodiment, waveform spine can be in warehouse Extend between 142 central part and side.In various embodiments, each waveform spine may include for example around nail cavity Multiple wave portions of 184 proximal end and distal end winding.In various embodiments, each 113,114 He of spine 115 can have the height limited by storehouse platform 190, wherein in certain embodiments, each spine 113,114 and 115 is across it The height of length can be uniform or at least substantially uniform.In at least one embodiment, each spine 113,114 It can having the same or at least substantially identical height with 115.
In various embodiments, as described above, the nail cavity being defined in staple cartridge body may include the nail being positioned in, Wherein when nail is in its non-firing position, the whole of nail be can be positioned under top surface or the tissue contacting surface of storehouse platform Side.In certain other embodiments, when nail is in its non-firing position, at least part (such as end of nail leg) of nail Such as it may extend into above top surface or the tissue contacting surface of storehouse platform.In some such embodiments, the end of nail Obstacle can be caused from platform protrusion and organizationally when nail bin is inserted into operative site.In at least one embodiment In, referring now to Fig. 9, when following closely when its non-firing position extends to above storehouse platform 190, it is flat to extend to such as tissue contact storehouse The spine 113 and 114 of 190 top of platform can at least partly about and protection nail 187 nail leg 183.Although spine 113 and 114 It can not extend completely about each opening 110, but in various embodiments, nearside spine 113 can be sufficiently around nail leg One of end, and distal side spine 114 can be sufficiently around another nail leg end, so that carrying out in tissue against nail bin 142 Compression and/or nail 187 are before the ejection of nail bin 142, and nail leg end is not in contact with tissue.In at least one embodiment, Nail leg end can be positioned on 116 lower section of top surface of spine 113 and 114.In certain embodiments, nail leg end can be with ridge The top surface 116 in portion 113 and 114 is coplanar.In various embodiments, it is protected as provided by spine 113 and 114, example It is prominent from nail bin 142 in its non-firing position without following closely end as the nail with higher staple height can be used.In certain realities It applies in scheme, referring again to Fig. 9, spine 113 and 114 is extensible or increases wherein controllable and/or support nail 187 nail leg 183 length.In at least one such embodiment, each spine 113 and 114 can extend or increase wherein can be at three of them The length of nail leg 183 is supported on side.Such embodiment can prevent or at least reduce nail leg 183 being inserted through fine and close group When knitting (such as bronchial tissue) a possibility that buckling.
In various embodiments, referring again to Fig. 4, warehouse 85 may include for example being defined in therein to reduce warehouse 85 Intensity chamber 84, slit 62 and channel 86.In several cases, especially when warehouse 85 is compressed by anvil block 20, for example, storehouse Body 85 can be bent because of the load applied thereon.In at least one such embodiment, storehouse platform 90 extends on channel 86 Part may be, for example, especially thin and can especially be subjected to flexure and/or damaged.In certain embodiments, referring again to figure 7 and 8, spine 113,114 and/or 115 is configured to that warehouse 185 is made to strengthen and/or be hardened.In at least one such reality It applies in scheme, spine 113 and 114 can for example extend around opening 110, to make partial reinforment of the warehouse 185 around nail cavity 184 And/or it is hardened.In certain embodiments, spine 115 is such as upper the channel 86 being defined in warehouse 185 can laterally prolonging It stretches, so that spine 115 can make the warehouse for surrounding channel 86 185 strengthen and/or be hardened.In a variety of other embodiments, warehouse 185 may include the spine of any suitable quantity and configuration extending therefrom to realize advantage described herein.
In various embodiments, staple cartridge body 185 can be by such as plastic material, metal material, and/or ceramic material group At.Some such materials may include liquid crystal polymer (such as Vectra), thermoplastic polymer (such as polycarbonate, ABS, Noryl, polyamide (nylon), polyether sulfone, polyetherimide (such as Ultem)), and/or above-mentioned thermoplastic polymer in two The blend polymer of kind or more, wherein in various embodiments, warehouse 185 can be formed by such as Shooting Technique.One A little such materials may include thermosetting polymer (such as thermosetting polyester), model casting stainless steel (such as 17-4PH) and/or Metal injection molded stainless steel (such as 17-4PH).In at least one such embodiment, spine 113,114 and/or 115 can be with storehouse The storehouse platform 190 of body 185 is integrally formed.In certain embodiments, can for example by least one adhesive by spine 113, 114 and/or 115 are attached to storehouse platform 190.
In various embodiments, referring now to Figure 12, nail bin (such as nail bin 342) for example may include warehouse 385, limit Multiple nail cavities 384 in warehouse 385 and the nail being located in each in nail cavity 384.In certain embodiments, storehouse Body 385 may also include the first side 345 with first group of nail cavity 384, with second side 347 of second group of nail cavity 384, Yi Jicang Platform 390.In various embodiments, warehouse 385, which may also include from what storehouse platform 390 extended, can be positioned on a nail chamber 384 In adjacent nail cavity 384 among multiple spines 315.In at least one embodiment, each spine 315 may include such as ten Font or X-shaped configuration.In at least one such embodiment, for example, each spine 315 may include can be at least partly about The V-shaped part 313 of the proximal end 311 of nail cavity opening 310 and furthermore can another at least partly about nail cavity opening 310 Distal end 312 V-shaped part 314.In certain embodiments, only outermost 384 row of nail cavity in warehouse 385 can at least portion Ground is divided to be surround by spine 315.In certain other embodiments, referring now to Figure 13, staple cartridge body 385' may include spine 315, The opening 310 of each nail cavity 384 in at least partly about warehouse of spine.Under any circumstance, in various embodiment party In case, each spine 315 be configured to as described above compress and control against nail bin 342 position tissue and/or Around the nail leg for extending to the nail above platform 390.
In various embodiments, referring now to Figure 16, nail bin (such as nail bin 542) for example may include warehouse 585, limit Multiple nail cavities 584 in warehouse 585 and the nail being located in each in nail cavity 584.In certain embodiments, storehouse Body 585 may also include the first side 545 with first group of nail cavity 584, with second side 547 of second group of nail cavity 584, Yi Jicang Platform 590.In various embodiments, warehouse 585 may also include the multiple spines 515 extended from storehouse platform 590, wherein each Spine 515 can entirely around or wrapping nail cavity opening 510.As shown in figure 16, some chambers opening 510 in warehouse 585 can not be by Spine 515 surround;Each chamber but in various alternate embodiments, referring now to Figure 16 A, in warehouse 585 ' Opening 510 can all be surround by spine 515.Imagining warehouse includes by first group of circular nail cavity 584 of spine 515 and not by spine The multiple embodiments of 515 second group of circular nail cavity 584, wherein the nail with higher staple height can be positioned on first group of nail cavity In 584 and wherein the nail with shorter staple height can be positioned in second group of nail cavity 584, so that higher nail and shorter nail are not It is prominent from nail bin 542.In at least one such embodiment, for example, warehouse is configured in a nail chamber 584 Shorter nail is used using higher nail and in another nail chamber 584.In certain embodiments, spine 515 can surround warehouse In outermost nail chamber 584 in whole nail cavities 584 so that can be used in most outlet compared with Gao Ding and shorter nail can be used for for example In the most interior row of nail cavity 584 and/or intermediate row.
In various embodiments, referring now to Figure 14, nail bin (such as nail bin 442) for example may include warehouse 485, limit Multiple nail cavities 484 in warehouse 485 and the nail being located in each in nail cavity 484.In certain embodiments, storehouse Body 485 may also include the first side 445 with first group of nail cavity 484, with second side 447 of second group of nail cavity 484, Yi Jicang Platform 490.In various embodiments, warehouse 445 may also include the multiple spines 415 extended from storehouse platform 490, wherein each Spine 415 may include multiple annular knurls or annular knurl array.When in use, anvil block can be used for carrying out position tissue against annular knurl, so that group Knit the profile for conforming to annular knurl.In various embodiments, each spine 415 may include for example, at least partially around one or The multiple pyramids or diamond-shaped knurling of multiple nail cavity openings 410, wherein at least one embodiment, pyramid annular knurl can be from On storehouse platform 490 is directed toward.In at least one embodiment, each pyramid annular knurl may include four triangle sides, described Four triangle sides, which can be focused at, is formed together cusp.In certain embodiments, referring to Figure 15 A, the pyramid of spine 415 Annular knurl can be to be truncated, wherein may include the flat top surface for being inclined by side surrounding at the top of each annular knurl.Although can make With four side pyramid annular knurls, referring now to Figure 15 C, it is contemplated that having less than four sides or be more than four sides (such as three Side) other pyramidal shapes.In various embodiments, one or more spines 415 may include multiple conical annular knurls, Wherein each conical annular knurl may include circular or at least substantially circular pedestal, and the pedestal is tapered to form point upwards Point.In certain embodiments, referring now to Figure 15 B, conical annular knurl can be it is truncated, wherein the top of each annular knurl can wrap Include the flat top surface circular by annular side.In various embodiments, referring again to Figure 14, the annular knurl of spine 415 can Extend along the side of nail cavity opening 410 and/or between adjacent nail cavity opening 410.In at least one embodiment, annular knurl It can extend around the proximal end 411 and/or distal end 412 of nail cavity opening 410.In certain embodiments, spine 415 Annular knurl can be only around some in nail cavity 484, and in certain other embodiments, and referring to Figure 15, the annular knurl of spine 415 is for example The whole or at least substantially whole of storehouse platform 490 can be covered.
In various embodiments, referring now to Figure 10, nail bin (such as nail bin 242) for example may include warehouse 285, limit Multiple nail cavities 284 in warehouse 285 and the nail being located in each in nail cavity 284.In certain embodiments, storehouse Body 285 may also include the first side 245 with first group of nail cavity 284, with second side 247 of second group of nail cavity 284, Yi Jicang Platform 290.In various embodiments, warehouse 285 may also include the multiple spines extended from storehouse platform 290 or bump 215. In at least one such embodiment, each spine 215 can the warehouse 245 that neighbouring cutter slit 262 positions center or in Between part the side of warehouse 245 between be laterally extended.More specifically, referring particularly to the first side 245 of warehouse 285, each Spine 215 may include the second of the first side 261 positioning of the first end 213 that neighbouring cutter slit 262 positions and neighbouring warehouse 285 End 214.Similarly, referring now to second side 247 of warehouse 285, each spine 215 may include that neighbouring cutter slit 262 positions First end 213 and neighbouring warehouse 285 the second end 214 that positions of second side 263.In at least one embodiment, Each spine 215 can have the height measured from platform 290, wherein at least one such embodiment, each spine 215 Height can vary along its length.In certain embodiments, the second end 214 can be higher than first end 213, and each ridge The height in portion 215 can be tapered between the second end 214 and first end 213.In certain alternate embodiments, to the greatest extent Pipe is not shown, but the first end 213 of spine 215 can be higher than the second end 214.In at least one embodiment, each ridge The height in portion 215 can be linear between end 213 and 214 or at least substantially linearly tapered.In at least one such implementation In scheme, the height of each spine 215 can taper to complete at first end 213 from the maximum height from the second end 214 Zero elevation.In certain embodiments, the height of each spine 215 can between end 213 and 214 Geometrical change.Certain In alternate embodiment, referring now to Figure 11, each spine 215' can have the uniform height across its length.
As described above, the inner end 213 of spine 215 can be shorter than the outer end 214 of spine 215.Therefore, in several cases, Compared to outer end 214, inner end 213 can apply smaller pressure to the tissue being clamped between anvil block and nail bin 242.In various realities It applies in scheme, as described above, each spine 215 can extend across storehouse platform 290.In certain embodiments, each spine 215 It can extend along spine's axis, the longitudinal axis 299 of the crosscutting warehouse 285 of spine's axis.In at least one such embodiment party In case, spine's axis can perpendicular to or be at least substantially orthogonal to longitudinal axis 299.In various embodiments, nail cavity 284 Multiple rows can be arranged to, wherein each nail chamber 284 can be limited along following longitudinal axis, the longitudinal axis can be parallel to Or at least substantially parallel to longitudinal axis 299.In at least one embodiment, spine's axis of spine 215 can be along The direction of the longitudinal axis of crosscutting nail cavity 284 extends.In at least one such embodiment, spine's axis of spine 215 can Along perpendicular to or be at least substantially orthogonal to nail cavity 284 longitudinal axis direction extend.In various embodiments, then It is secondary referring to Figure 10, each spine 215 may include bizet 209 and furthermore extend in the inclination between bizet 209 and storehouse platform 290 Surface 208.In certain embodiments, each inclined surface 208 may include for example one or more flat surfaces, bending table Face, concave surface, and/or nonreentrant surface.In various embodiments, each spine 215 can extend along following path, the path One or more openings 210 across nail cavity 284 extend.In at least one such embodiment, such opening 210 can prolong upwards Extend through spine 215.When spine 215 is laterally extended across storehouse platform 290, spine 215 (being similar to spine 115) can increase warehouse 285 intensity and/or hardness.
In various embodiments, referring now to Figure 17 and 18, nail bin (such as nail bin 642) for example may include warehouse 685, The multiple nail cavities 684 being defined in warehouse 685 and the nail being located in each nail cavity 684.In certain embodiments, storehouse Body 685 may also include the first side 645 with first group of nail cavity 684, with second side 647 of second group of nail cavity 684, Yi Jicang Platform 690.In various embodiments, warehouse 685 may also include the multiple spines extended from storehouse platform 690 or bump 615. In at least one such embodiment, each spine 615 can extend in a longitudinal direction, wherein each spine 615 may include Distal end 613 and proximal end 614, wherein the distal end 613 of spine 615 may be positioned to the distal side of closer warehouse 685 End 643, and wherein the proximal end 614 of spine 615 may be positioned to closer proximal end 641.In at least one implementation In scheme, each spine 615 can have the height measured from platform 690, wherein at least one such embodiment, each The height of spine 615 can vary along its length.In certain embodiments, proximal end 614 can be higher than distal end 613 and each spine 615 height can be tapered between proximal end 614 and distal end 613.In certain alternate embodiments, although being not shown, But the distal end 613 of spine 615 can be higher than proximal end 614.In at least one embodiment, the height of each spine 615 Degree can be linear between end 613 and 614 or at least substantially linearly tapered.In at least one such embodiment, often The height of a spine 615 can the maximum height proximally at end 614 taper to the complete zero elevation at distal end 613.? In certain embodiments, the height of each spine 615 can between end 613 and 614 Geometrical change.Certain alternative In embodiment, each spine 615 can have the uniform height across its length.
As described above, the distal end 613 of spine 615 can be shorter than the proximal end 614 of spine 615.Therefore, a variety of In the case of, compared to proximal end 614, distal end 613 can apply smaller to the tissue being clamped between anvil block and nail bin 642 Pressure.In various embodiments, as described above, each spine 615 can be across the longitudinal extension of storehouse platform 690.In certain realities Apply in scheme, each spine 615 can extend along spine's axis, spine's axis be parallel to or at least substantially parallel to The longitudinal axis 699 of warehouse 685.In various embodiments, nail cavity 684 can be arranged to multiple rows, wherein can be along as follows Longitudinal axis limits each nail chamber 684, the longitudinal axis can be parallel to or at least substantially parallel to spine 615 ridge Portion's axis.In at least one embodiment, referring again to Figure 18, each spine 615 may include inclined surface, the nauropemeter Face may include for example one or more flat surfaces, curved surface, concave surface, and/or nonreentrant surface.In at least one such implementation In scheme, the bottom of inclined surface can be towards distal side, so that is conducive to group when that will organize and position in the end effector It is woven on entire nail bin 642 and slides.In various embodiments, each spine 615 can extend along following path, the path One or more openings 610 across nail cavity 684 extend.In at least one such embodiment, such opening 610 can prolong upwards Extend through spine 615.When spine 615 is laterally extended across storehouse platform 690, spine 615 can increase warehouse 685 intensity and/or Hardness.
In various embodiments, in addition to described above, surgical staples may include titanium, such as titanium silk.In certain embodiments In, surgical staples can be made of the alloy for example comprising titanium, aluminium and/or vanadium.In at least one embodiment, surgical staples can be by example If surgery stainless steel and/or alloy are constituted, the alloy is made of cobalt and chromium.Under any circumstance, surgical staples can be by metal (example Such as titanium) and metal oxide outer surface (such as titanium oxide) composition.In various embodiments, metal oxygen can be coated with material Compound outer surface.In certain embodiments, coating material may include that for example polytetrafluoroethylene (PTFE) (PTFE) is (such as) And/or tetrafluoroethene (TFE) (such as ethylene-tetrafluoroethylene (ETFE), perfluoroalkyl ethylene oxy-tetrafluoroethene (PFA)) and/or Fluorinated ethylene propylene (FEP).Certain coatings may include silicon.In multiple embodiments, such coating material can be prevented or at least Metal is hindered further to aoxidize.In certain embodiments, coating material can provide one or more lubricated surfaces, anvil block or nail Pit can against these surfaces contact stud, to reduce the frictional force between them.In several cases, follow closely and follow closely cavity it Between relatively low-frictional force can reduce make nail deformation needed for power.
It is filed in the U.S. Patent Application Publication 2012/ of on September 29th, 2010 entitled " STAPLE CARTRIDGE " 0074198 (being now United States Patent (USP) 8,733,613) and it is filed on 2 21st, 2013 entitled " STAPLE The disclosure of the U.S. Patent Application Publication 2013/0161375 of CARTRIDGE " is incorporated by reference accordingly to be incorporated herein.
The end effector of surgery suturing appliance is shown in Figure 23 and Figure 55.End effector may include anvil block such as anvil block It 20 and jaw or is configured to that nail bin is removedly supported in staple cartridge channel 22 therein.Nail bin 2000 is for example It is positioned in warehouse channel 22.Nail bin 2000 may include warehouse 2010, and the warehouse includes being defined in multiple nail cavities therein 2050.Each nail cavity 2050 is configured to removedly be stored in nail wherein.Warehouse 2010 may include platform surface 2011 and be limited in platform surface 2011 be configured to firing member and/or blade are removedly received in it In longitudinal slit 2015.Warehouse 2010 may also include distal end 2013, proximal end 2016 and in distal end 2013 The opposite longitudinal direction side 2012 extended between proximal end 2016.In all cases, side 2012 may include adjoining longitudinally in each Or continuous edge may be not present and be defined in interruption therein.When comparing (for example) Fig. 7 and Figure 23, it will be appreciate that, in Fig. 7 Shown in the longitudinal direction side of nail bin 142 include being defined at least one recess therein, and longitudinal direction side 2012 does not include such recess.
Referring primarily to Figure 55, warehouse 2010 may also include the multiple protruding portion 2051 extended from platform surface 2011.It is prominent Portion 2051 is configured to the tissue that engagement is located among anvil block 20 and storehouse 2000 and controls tissue relative to storehouse 2000 Movement.In all cases, tissue can be mobile relative to storehouse 2000.In at least one situation, when anvil block 20 is in open position It sets when being moved between (Figure 23) and closed position, tissue can be flowed relative to storehouse 2000, in the closed position, Tissue approximation Between anvil block 20 and storehouse 2000.In such cases, tissue can laterally be flowed towards longitudinal direction side 2012, towards distal end 2013 flow towards distal side and/or proximally flow towards proximal end 2016.In at least one other situation, work as knife When sword is advanced through tissue of the capture between anvil block 20 and storehouse 2000 towards distal side, tissue can be flowed relative to storehouse 2000.Herein In the case of class, tissue can laterally, towards distal side and/or proximally flow, but since blade is moved distally, tissue is main It is flowed towards distal side.In all cases, protruding portion 2051 is configured to limit or prevent stream of the tissue relative to nail bin It is dynamic.Protruding portion 2051 can be positioned at the proximal end and/or distal end of nail cavity 2050.In all cases, each prominent Portion 2051 may include the hoop extended around the end of nail cavity 2050 out.In all cases, each protruding portion 2051 may include enclosing The arch spine extended around the end of nail cavity 2050.
Referring primarily to Figure 55, warehouse 2010 may include extending between the distal end and platform surface 2011 of warehouse 2010 Angled transition 2014.When storehouse 2000 and anvil block 20 to be located in operative site, angled transition 2014 can promote storehouse 2000 Movement relative to tissue.In such cases, tissue can slide on inclined surface 2014.In all cases, nauropemeter Face 2014 may include rounded surface.In all cases, inclined surface 2014 may include angled faces.In some cases, incline Skewed surface 2014 may include concave surface and/or nonreentrant surface.In at least one situation, as shown in figure 55, inclined surface 2014 can Including distal side concave surface, which is transited into flat angled faces, which is transited into for example close Side nonreentrant surface.
The nail cavity 2050 being defined in warehouse 2010 can be arranged to longitudinal row.For example, three longitudinal nail chambers 2050 can It is arranged on the first side of longitudinal slit 2015, and three longitudinal nail chambers 2050 may be arranged at the second of longitudinal slit 2105 On side.Row may include adjacent to the farthest side nail cavity 2050 of distal end 2013 and adjacent to the nearest of proximal end 2016 longitudinally in each Side nail cavity 2050.In all cases, warehouse 2010 may also include the protruding portion 2053 extended from platform surface 2011.Protruding portion 2053 can be positioned at the distal end of farthest side nail cavity 2050.Each protruding portion 2053 may include such as distal ramped surface, The distal ramped surface is configured to that tissue is promoted to be inserted between nail bin 2000 and anvil block 20.In all cases, most Distal chamber 2050 can respectively include the protruding portion 2053 positioned at its distal end and be located at its proximal end prominent Portion 2051 out.
Each protruding portion 2051 and/or protruding portion 2053 are configured to support and are removedly stored in nail cavity 2050 In nail at least part.In all cases, each protruding portion 2051 can be such that the end wall 2052 of nail cavity 2050 extends to flat On platform 2011.In some cases, referring generally to Figure 24 and Figure 26 to Figure 29, the nail being located in nail cavity 2050 can be wrapped Include base portion, the first leg extended with first angle from base portion and the second leg extended with second angle from base portion.First Leg can be contacted with the first end wall 2052 (Figure 55) of nail cavity 2050 and the second leg can be with the second end wall of the nail cavity 2052 contacts.In some cases, the distance between first leg Yu the second leg of nail or spread can be greater than end wall 2052 it Between distance so that when nail is located in nail cavity 2050, leg is inwardly biased by end wall 2052.When nail is stored in nail cavity 2050 Its do not fire or when non-raised position, the end of nail leg be can be positioned in protruding portion 2051.In such cases, protruding portion 2051 on the end support of nail leg to platform 2011 and can will protect the end.In some cases, when nail is in it not When firing position, the end of nail leg be can be positioned under protruding portion 2051, and therefore, when nail is at its non-firing position When, protruding portion 2051 can not support nail leg.When such nail is fired or is lifted out nail cavity 2050, nail leg then can be with protruding portion 2051 contact and are supported by the protruding portion.Under any circumstance, protruding portion 2051 can support nail leg when disposing nail, directly Nail cavity 2050 is sufficiently fired and/or is lifted out to nail, so that nail leg is no longer contacted with protruding portion 2051.Protruding portion 2053 can It is run with being similar to the mode in conjunction with described in protruding portion 2051.
In all cases, over and above what is described above, protruding portion 2051 can make nail cavity 2050 extend to the flat of warehouse 2010 On platform 2011.In some cases, protruding portion 2051 be configured to so that the end wall 2052 of nail cavity 2050 seamlessly It extends in protruding portion 2051.In other words, seamless surface can be limited between end wall 2052 and protruding portion 2051.Such seamless table Face can reduce the nail leg edge that is defined in nail cavity 2050 of contact or ladder against end wall 2052 and the biasing of protruding portion 2051 and/ Or a possibility that piercing in the end wall of nail cavity 2050.Figure 55 A shows the rank being defined between protruding portion 2051 and end wall 2052 Ladder 2056.Although ladder 2056 includes outside ladder rather than inside ladder, ladder 2056 can be eliminated to provide institute as above The seamless surface of discussion.In the embodiment that wherein warehouse 2010 is formed during injection moulding process, storehouse 2010 may be formed at limit Due in the mold cavity between two half blocks of injection mold.Two half blocks of injection mold can be in contact with each other with seal or at least Substantially sealed mold cavity.Joint portion between two die halfs is commonly known as seal line or die parting line, and in general, Small chimb or antelabium are formed with along seal line in warehouse.When seal line is used to that air to be discharged from mold cavity during injection moulding process When, it is especially true.This chimb or antelabium are commonly known as " flash ".Injection mold can carefully design so that seal line is in end wall 2052 and/or protruding portion 2051 towards chimb or antelabium are not generated in inner surface.In at least one situation, protruding portion 2051 It may include the transition portion 2058 held hoop portion point 2057 and extend to platform 2011 from the opposed end of hoop portion point.Two molds Seal line between half block may be chosen such that seal line extends along the top surface of protruding portion 2051.It is shown in Figure 55 A Example seal line 2059, but can choose other suitable seal lines.
Nail bin 2800 is shown in Figure 56 and Figure 57.Nail bin 2800 may include warehouse 2810.Warehouse 2810 may include distal side End 2813, proximal end 2816 and opposite flank 2812.Similarly as described above, each side 2812 may include wherein Jagged adjacent edge is not limited.Multiple nail cavities that warehouse 2810 may also include platform 2811, be defined in platform 2811 2850 and be configured to receive such as firing member blade longitudinal slit 2815.Warehouse 2810 may also include from The spine 2851 that platform 2811 extends.In all cases, spine 2851 may include pattern.In at least one situation, each Spine 2851 can extend between side 2812 and longitudinal slit 2815.Each spine 2851 may include any suitable configuration, Such as platform.One or more nail cavities 2850 can extend across spine 2851.In some cases, the nail in interior nail chamber 2850 In at least part of chamber 2850, at least part, and/or outlet nail cavity 2850 of nail cavity 2850 in intermediate row nail cavity 2850 At least part of nail cavity 2850 can extend across the platform of spine 2851.Each spine 2851 may include neighbouring longitudinal slit The outer end 2859 that the inner end 2858 of 2815 positioning and adjacent side face 2812 position.In some cases, inner end 2858 can be opposite It is positioned in outer end 2859 in distal side.In other cases, although being not shown, outer end 2859 can be relative to inner end 2858 in distal side Positioning.Spine 2851 may be, for example, parallel.In some cases, spine 2851 may include such as tread pattern.At least one Kind in the case of, on the first side of longitudinal slit 2815 from platform 2811 extend spine 2851 may include in longitudinal slit 2815 Second side on from platform extend spine 2851 mirror image.In all cases, between being limited between spine 2851 Gap.Tissue for example can flow into the gap when tissue is compressed by anvil block against storehouse platform 2811.It the gap can be along expectation Direction guidance tissue flowing.
Nail bin 2900 is as shown in figure 50.Nail bin 2900 may include warehouse 2910.Warehouse 2910 may include distal end 2913, Proximal end and opposite flank 2912.It is similarly as described above, each side 2912 may include do not limit wherein it is jagged Adjacent edge.The multiple nail cavities 2950 and be configured to that warehouse 2910 may also include platform 2911, be defined in platform 2911 The longitudinal slit 2915 of the blade of such as firing member can be received.Warehouse 2910 may also include the spine extended from platform 2911 2951.In all cases, spine 2951 may include pattern.Each spine 2951 can warehouse 2910 distal end 2913 with Extend between proximal end.In at least one situation, each spine 2951 can be towards side 2912 and towards longitudinal slit 2915 extend.In all cases, each spine 2951 may include the angled portion 2954 inwardly and extended proximally, indulge Straight portion 2955 and angled portion 2956 that is inside and extending towards distal side to extension.Spine 2951 can surround nail cavity 2950 extend and/or extend between the nail cavity.In at least one situation, angled portion 2954 and angled portion 2956 can extend between the nail cavity 2950 of longitudinal nail chamber 2950.Spine 2951 can be for example parallel to each other.In some cases, Spine 2951 may include such as tread pattern.In at least one situation, from platform on the first side of longitudinal slit 2915 2911 spines 2951 extended may include in second side of longitudinal slit 2915 from the mirror image of the spine 2951 of platform extension Picture.In all cases, gap can be limited between spine 2951.Tissue can for example be compressed by anvil block against storehouse platform in tissue The gap is flowed into when 2911.The gap can guide the flowing of tissue along desired direction.
Nail bin may include uniform protruding portion array extending therefrom.In other cases, array can not be uniform.At certain In a little situations, the protruding portion in array can not be such that nail cavity extends.In all cases, the protruding portion in array can not support nail.
Nail bin 3000 is shown in Figure 59 and Figure 60.Nail bin 3000 may include warehouse 3010.Warehouse 3010 may include distal side End 3013, proximal end and opposite flank 3012.Similarly as described above, each side 3012 may include not limiting wherein Fixed jagged adjacent edge.Warehouse 3010 may also include platform 3011, be defined in platform 3011 multiple nail cavities 3050, with And it is configured to receive the longitudinal slit 3015 of the blade of such as firing member.Warehouse 3010 may also include from storehouse platform 3011 protruding portions 3051 extended.In all cases, protruding portion 3051 may include pattern.In at least one situation, each Protruding portion 3051 may include pyramid configuration.Pyramid configuration may include for example with four sides of termination.Alternatively, this four A side can for example be terminated with flat surface.Alternatively, pyramid configuration may include for example with three sides of termination.? In any case, as shown in figure 59, protruding portion array 3051 can be cross-platform 3011 between longitudinal slit 3015 and side 3012 Extend.Protruding portion 3051 can be arranged around nail cavity 3050.Nail cavity 3050 can be arranged to longitudinal row and protruding portion 3051 can position Among the nail cavity 3050 in longitudinal nail chamber 3050.Protruding portion 3051 can be positioned on the nail cavity in adjacent longitudinal nail chamber 3050 Among 3050.Protruding portion 3051 can be positioned among most interior nail chamber 3050 and vertical passage 3015.Protruding portion 3051 can position Among outermost nail chamber 3050 with lateral edge 3012.Protruding portion 3051 can be fixed in distal side relative to farthest side nail cavity 3050 Position.Protruding portion 3051 can be relative to recent side nail cavity 3050 proximally-oriented.Protruding portion 3051 can be relative to longitudinal slit 3015 Distal end distal side position.In other cases, protruding portion 3051 can exist relative to the distal end of longitudinal slit 3015 Distal side positioning.
Nail bin 3100 is shown in Figure 61 and Figure 62.Nail bin 3100 may include warehouse 3110.Warehouse 3110 may include distal side End 3113, proximal end and opposite flank 3112.Similarly as described above, each side 3112 may include not limiting wherein Fixed jagged adjacent edge.Warehouse 3110 may also include platform 3111, be defined in platform 3111 multiple nail cavities 3150, with And it is configured to receive the longitudinal slit 3115 of the blade of such as firing member.Warehouse 3110 may also include from storehouse platform 3111 protruding portions 3151 extended.In all cases, protruding portion 3151 may include pattern.In at least one situation, each Protruding portion 3151 may include dome-shaped configuration.Dome-shaped configuration may include such as hemispherical projections.In some cases, dome Vertex can be flat surfaces.As shown in Figure 61, protruding portion array 3151 can prolong between longitudinal slit 3115 and side 3112 It stretches across platform 3111.Protruding portion 3151 can be arranged around nail cavity 3150.Nail cavity 3150 can be arranged to longitudinal row and protruding portion 3151 can be positioned among the nail cavity 3150 in longitudinal nail chamber 3150.Protruding portion 3151 can be positioned on adjacent longitudinal nail chamber Among nail cavity 3150 in 3150.Protruding portion 3151 can be positioned among most interior nail chamber 3150 and vertical passage 3115.It is prominent Portion 3151 can be positioned among outermost nail chamber 3150 and lateral edge 3112.Protruding portion 3151 can be relative to farthest side nail cavity 3150 position in distal side.Protruding portion 3151 can be relative to recent side nail cavity 3150 proximally-oriented.Protruding portion 3151 can be relative to The distal end of longitudinal slit 3115 positions in distal side.In other cases, protruding portion 3151 can be relative to longitudinal slit 3115 Distal end distal side position.
Nail bin 3200 is shown in Figure 63.Nail bin 3200 may include warehouse 3210.Warehouse 3210 may include distal end 3213, proximal end and opposite flank 3212.It is similarly as described above, each side 3212 may include do not define wherein it is recessed The adjacent edge of mouth.Warehouse 3210 may also include platform 3211, be defined in platform 3211 multiple nail cavities 3250 and by structure Cause can to receive the longitudinal slit 3215 of the blade of such as firing member.Warehouse 3210 may also include to be extended from storehouse platform 3211 Protruding portion 3251.Similar to protruding portion 2051, protruding portion 3251 is configured to engagement and is located in anvil block and storehouse 3200 Intermediate tissue simultaneously controls movement of the tissue relative to storehouse 3200.In all cases, protruding portion 3251 is configured to Limitation prevents flowing of the tissue relative to nail bin.Protruding portion 3251 can be positioned in the proximal end of nail cavity 3250 and/or remote At side end.In all cases, each protruding portion 3251 may include the hoop extended around the end of nail cavity 3250.In various feelings Under condition, each protruding portion 3251 may include the arch spine extended around the end of nail cavity 3250.In all cases, each prominent Portion 3251 may include the one or more protrusions 3254 limited thereon out.Protrusion 3254 can provide grain surface, the texture table Face improves the clamping or holding that protruding portion 3251 can be applied to the tissue being located among anvil block and nail bin 3200.In various situations Under, each protrusion 3254 may include such as convex block.In some cases, each protrusion 3254 may include dome.In at least one In the case of, protrusion 3254 can be made of elastic material, such as rubber, thermoplastic elastomer (TPE) and/or santoprene, the elastic material Being molded into can be by protruding portion 3251 that such as plastics form.In all cases, protrusion 3254 can be made of simultaneously pliable material And the tissue compressed by protrusion 3254 can not be damaged.Warehouse 3210 may also include protruding portion 3253.Similar to protruding portion 2053, dash forward Portion 3253 can be positioned at the distal end of farthest side nail cavity 3250 out.Each protruding portion 3253 may include such as distal side nauropemeter Face, the distal ramped surface are configured to that tissue is promoted to be inserted between nail bin 3200 and anvil block.In all cases, most Distal chamber 3250 can respectively include the protruding portion 3253 positioned at its distal end and be located at its proximal end prominent Portion 3251 out.It is also similarly to described above, each protruding portion 3251 and/or protruding portion 3253 are configured to support can It is stored at least part of the nail in nail cavity 3250 with removing.
Nail 2130 is as shown in figure 24 including base portion 2131, the first nail leg 2132a extended from the first end of base portion 2131 With the second nail leg 2132b extended from the second end of base portion 2131.The first end of base portion 2131 and the second of base portion 2131 The distance between end is referred to alternatively as hat away from and being indicated by size E.First nail leg 2132a includes extending from base portion 2131 The first part 2133a and second part 2134a extended from first part 2133a.First part 2133a can be with first angle Extend from base portion 2131.The first angle can be indicated by the angle F measured from vertical direction.Second part 2134a can be with second Angle extends from first part 2133a.The second angle can be indicated by the angle K equally measured from vertical direction.Reader will manage Solution, first part 2133a and second part 2134a are not on the same line;But first part 2133a is along first axle Line 2137a extends and second part 2134a extends along the second axis 2138a different from first axle 2137a.Connector First part 2133a and second part 2134a is interconnected and is located at from the support table being defined on 2131 bottom of base portion by 2135a At the distance D that face 2139 measures.Second part 2134a includes being located at the distance C that base portion supports surface 2139 measures.First Part 2133a may include the first cantilever extended from base portion 2131 and second part 2134a may include prolonging from first part 2133a The second cantilever stretched.Distance D, which can limit the difference between the first hron spacing and distance C and distance D, can limit the second cantilever arm From.
Second nail leg 2132b includes the first part 2133b extended from base portion 2131 and extends from first part 2133b Second part 2134b.First part 2133b can be extended with first angle from base portion 2131.This first angle can be by from vertical side It is indicated to the angle G of measurement.Angle G can be identical to or may differ from above-mentioned angle F.When the second nail leg 2132b is relative to first For nail leg 2132a when distal side positions, at least one situation, angle G is smaller than such as angle F.Alternatively, when the first nail leg 2132a is relative to the second nail leg 2132b when distal side positions, and at least one situation, angle F is smaller than such as angle G.The Two part 2134b can be extended with second angle from first part 2133b.This second angle can be by the angle that also measures from vertical direction Spending H indicates.Angle H can be identical to or may differ from above-mentioned angle K.When the second nail leg 2132b exists relative to the first nail leg 2132a When distal side positions, at least one situation, angle H is smaller than such as angle K.Alternatively, when the first nail leg 2132a relative to For second nail leg 2132b when distal side positions, at least one situation, angle K is smaller than such as angle H.It will be appreciate that the A part of 2133b and second part 2134b is not on the same line;But first part 2133b is along first axle 2137b extends and second part 2134b extends along the second axis 2138b different from first axle 2137b.Connector 2135b First part 2133b and second part 2134b is set to interconnect and be located at from the support surface on the bottom for being defined in base portion 2131 At the distance B of 2139 measurements.Distance B can be identical to or may differ from above-mentioned distance D.Second part 2134b includes being located at from base The leg end 2136b at distance A that portion's support surface 2139 measures.Distance A can be identical to or may differ from above-mentioned distance C.The A part of 2133b may include the first cantilever extended from base portion 2131 and second part 2134b may include from first part The second cantilever that 2133b extends.Distance B, which can limit the difference between the first hron spacing and distance A and distance B, can limit Two hron spacings.Between the first end 2136a of first nail leg 2132a and the second end 2136b of the second nail leg 2312 away from From nail leg 2132a can be limited, distance is spreaded between 2132b, and indicated by distance J.On distance J can be wider than or can be not wider than Hat described in text is away from E.
Figure 25 shows the nail supported in the nail cavity 2150 for being located in and being defined in storehouse 2110 and by staple drivers 2040 2130.It is inwardly biased or is bent by the end wall of nail cavity 2150 it will be appreciate that following closely 2130 leg 2132a and 2132b.Therefore, Distance A, B, C, D, E and J may have changed and be represented respectively by A ', B ', C ', D ', E ' and J '.Nail 2130 can be all by elastic material As stainless steel and/or titanium form, and when from the ejection of nail cavity 2150 nail 2130, the change of these distances be can be reversed or at least It is partly reversed.Similarly, angle F, G, H and K may change and due to will follow closely 2130 and be located in nail cavity 2150 respectively by angle F ', G ', H ' and K ' is spent to represent.As described above, nail 2130 can be made of elastic material, and 2130 are followed closely when ejecting from nail cavity 2150 When, the change of these distances can be reversed or at least partly reversed.Figure 25 shows 2130 He of nail in non-firing position Driver 2040.It may extend into the platform surface in storehouse 2110 in the end 2136a of the non-firing position, the first nail leg 2132a On 2111 and it can be positioned on out of platform surface 2111 extends protruding portion 2150a and protected by the protruding portion, and phase As, the end 2136b of the second nail leg 2132b may extend on platform surface 2111 and can be positioned on from platform surface It is protected in the 2111 protruding portion 2150b extended and by the protruding portion.
Nail 2230 is as shown in figure 26.Nail 2230 may include base portion 2231, from base portion 2231 extend the first leg 2232a, And the second leg 2232b extended from base portion 2231.First leg 2232a may include the first part for being connected to base portion 2231 The 2233a and second part 2234a extended from first part 2233a.Second leg 2232b may include being connected to base portion 2231 First part 2233b and from first part 2233b extend second part 2234b.Base portion 2231, first part 2233a It may include substantially V-shaped configuration with first part 2233b.In all cases, second part 2234a can at connector 2235a from First part 2233a extends internally, and similarly, and second part 2234b can be at connector 2235b from first part 2233b It extends internally.Base portion 2231, the first leg 2232a and the second leg 2232b can be constructed and arranged to scheming so that following closely 2230 It is symmetrical in its unshaped (or not firing) configuration shown in 26.In all cases, the first leg 2232a can be relative to Two leg 2232b are positioned in distal side.Alternatively, the first leg 2232a can be relative to the second leg 2232b proximally-oriented.
Nail 2330 is as shown in figure 27.Nail 2330 may include base portion 2331, from base portion 2331 extend the first leg 2332a, And the second leg 2332b extended from base portion 2331.First leg 2332a may include being connected to base portion along what axis extended 2331 straight portion 2333a.Second leg 2332b may include being connected to the first part 2333b of base portion 2331 and from first part The second part 2334b that 2333b extends.Base portion 2331, straight portion 2333a and first part 2333b may include substantially V-shaped configuration. In all cases, second part 2334b can extend internally at connector 2335b from first part 2333b.Base portion 2331, One leg 2332a and the second leg 2332b can be constructed and arranged to so that following closely 2330 its unshaped shown in Figure 27 (or not Percussion) it is asymmetric in configuration.In all cases, the first leg 2332a can be fixed in distal side relative to the second leg 2332b Position.Alternatively, the first leg 2332a can be relative to the second leg 2332b proximally-oriented.
Nail 2430 is as shown in figure 28.Nail 2430 may include base portion 2431, from base portion 2431 extend the first leg 2432a, And the second leg 2432b extended from base portion 2431.First leg 2432a may include the first part for being connected to base portion 2431 The 2433a and second part 2434a extended from first part 2433a.Second leg 2432b may include being connected to base portion 2431 First part 2433b and from first part 2433b extend second part 2434b.Base portion 2431, first part 2433a It may include substantially V-shaped configuration with first part 2433b.In all cases, second part 2434a can at connector 2435a with First angle extends internally from first part 2433a, and similarly, and second part 2434b can be at connector 2435b with second Angle extends internally from first part 2433b.First angle and second angle can be different.Base portion 2431, the first leg 2432a and Second leg 2432b can be constructed and arranged to so that following closely in 2430 its unshaped (or not firing) configuration shown in Figure 28 is It is asymmetric.In all cases, the first leg 2432a can be positioned relative to the second leg 2432b in distal side.Alternatively, One leg 2432a can be relative to the second leg 2432b proximally-oriented.
Nail 2530 is as shown in figure 29.Nail 2530 may include base portion 2531, from base portion 2531 extend the first leg 2532a, And the second leg 2532b extended from base portion 2531.First leg 2532a may include the first part for being connected to base portion 2531 The 2533a and second part 2534a extended from first part 2533a.Second leg 2532b may include being connected to base portion 2531 The first part 2533b and second part 2534b extended from first part 2533b.Base portion 2531, first part 2533a and A part of 2533b may include substantially V-shaped configuration.In all cases, second part 2534a can be at connector 2535a with first Angle extends internally from first part 2533a, and similarly, and second part 2534b can be at connector 2535b with second angle It extends internally from first part 2533b.First angle and second angle can be different.Base portion 2531, the first leg 2532a and second Leg 2532b can be constructed and arranged to so that it is not right for following closely in 2530 its unshaped (or not firing) configuration shown in Figure 29 Claim.Nail 2530 can be similar to nail 2430 in many aspects, and at least one situation, such as may include than base portion 2431 Broader base portion 2531.In some cases, when nail leg 2532a and/or nail leg 2532b are on the direction closer to vertical direction When extension, broader base portion be may be housed in given nail cavity.In all cases, the first leg 2532a can be relative to second Leg 2532b is positioned in distal side.Alternatively, the first leg 2532a can be relative to the second leg 2532b proximally-oriented.
As discussed above, tissue of the capture between the anvil block and nail bin of surgical end-effector can held during use It moves in portion's actuator or is flowed relative to end effector.As also discussed above, this movement or flowing can generally be Towards distal side, because the firing member of end effector is moved distally to fire the nail being removedly stored in nail bin and cut Enter tissue.If firing member proximally moves, the movement or flowing organized be will be substantially proximally.But it organizes Nail can be made to shift during percussion process towards distal side towards distal side flowing.This phenomenon is as shown in figure 30.Figure 30 is shown from being defined in The nail 2630 that nail cavity 2650 in warehouse 2610 ejects.Nail 2630 is shown at the position at least partly fired, wherein following closely Driver 2640 moves up the base portion 2631 of nail 2630 towards anvil block 20, and the wherein leg 2632a of nail 2630, 2632b appears from nail cavity 2650 and has contacted anvil block 20.Such as it will be appreciate that, nail cavity 2650 may include the first protruding portion 2651a and the first end wall 2652a, first protruding portion and the first end wall are configured to the first nail leg 2632a of support, and And similarly, it may include the second protruding portion 2651b and second sidewall 2652b, second protruding portion and second sidewall are constructed The second nail leg 2632b is supported at when can be ejected by driver 2640 from nail cavity 2650 following closely 2630.However, as shown in figure 30, Nail 2630 can be shifted towards distal side so that nail leg 2632a is shifted far from the first end wall 2652a and nail leg during percussion process The second protruding portion 2651b is crossed in 2632b displacement.Although nail 2630 is shifted towards distal side, the first leg 2632a has still been received In first forming cup 22a of the nail pit being defined in anvil block 20 and the second leg 2632b has still been received the of nail pit In two forming cup 22b.Although nail leg 2632a, 2632b can contact its corresponding forming cup 22a, 22b, nail 2630 towards distal side Displacement may not obtain symmetrically shaped nail, as shown in such as Figure 31.Figure 31, which is shown, to be promoted by staple drivers 2640 to height In the storehouse platform surface 2611 of warehouse 2610 position and be deformed into the nail 2630 of its complete firing configuration.
As discussed above, due to the tissue displacement being trapped in end effector, symmetrical nail can asymmetrically become Shape.In all cases, the asymmetric nail that for example can compensate for this displacement, such as Figure 24 and Figure 27 to Figure 29 institute can be used in nail bin The asymmetric nail shown.The nail leg of these asymmetric nails can be constructed in the following manner: when asymmetric nail is shifted towards distal side, they can It is displaced in the orientation that them can be made to be deformed into symmetrical or at least more symmetrical percussion configuration.Figure 84 shows nail bin 4800, should Nail bin includes: warehouse 4810, which includes being defined in multiple nail cavities 4850 therein;It is located in asymmetric in nail cavity 4850 Nail;And it is configured to eject multiple drivers 4840 of nail from nail cavity 4850.Warehouse 4810 may include distal end 4813 and proximal end 4816, wherein nail cavity 4850 can be arranged to the longitudinal row being defined in warehouse 4810.Warehouse 4810 exists By transversal at longitudinal direction nail chamber 4850 as to show one in Figure 84.In some cases, it is removedly stored in vertical Nail into nail chamber 4850 can have identical asymmetric configuration, and in other cases, as shown in Figure 84, nail can have There is different asymmetric configurations.For example, nail 4830 ' is stored in the proximal end longitudinally arranged, and follows closely 4830 " and be stored in longitudinal row Distal end in.Similarly as described above, each nail 4830 ' may include the first nail leg 4832a ' and the second nail leg 4832b ', Wherein one or both of nail leg may include several segments, such as the segment 4833b ' and 4834b ' of the second nail leg 4832b '. It is also similarly to described above, each nail 4830 " may include the first nail leg 4832a " and the second nail leg 4832b ", wherein in nail leg One of or both may include several segments, such as the segment 4833a " and 4834a " and the second nail leg of the first nail leg 4832a " The segment 4833b " and 4834b " of 4832b '.Comparison nail 4830' and nail 4830 " after, it will be appreciate that, nail 4830 " segment Angle between the segment 4833b' and 4834b' of angle between 4833b " and 4834b " than following closely 4830' becomes apparent from or bigger. In other words, distal side nail 4830 " is less symmetrical than nearside nail 4830 '.In some cases, the distal end of nail bin 4800 The tissue that tissue movement at 4813 can be greater than at proximal end 4816 is mobile, and correspondingly, the displacement in nail orientation is being followed closely Than bigger at proximal end 4816 at the distal end 4813 in storehouse 4800.Compared to the nearside nail for being subjected to shifting compared with tingle 4830 ' lesser asymmetry, the biggish asymmetry of distal side nail 4830 " can compensate for biggish nail displacement.This is one A example and different nail can be compensated using the nail of any suitable species in staple and shift.For example, it is contemplated that being located in vertical There is bigger asymmetry than the nail being located at the distal end longitudinally arranged to the nail at the proximal end of row.It is contemplated that Longitudinal row, which can be used, is more than two groups of asymmetric nails.
As described above, in all cases, the tissue at end effector distal end is mobile or flowing can be greater than end Tissue at actuator proximal end is mobile or flows.Such situation can due in end effector firing member towards distal side move It moves and occurs.Although firing member is configured to progressively suture and cut tissue when it is moved distally, percussion Component can also plough dynamic or promotion tissue towards distal side.This promotion or the dynamic effect of plough may begin at the proximal end of end effector simultaneously And it can be aggravated when firing member is moved distally so that realizing maximum promotion or plough at the distal end of end effector Dynamic effect.Therefore, in addition to described above, can be compensated in longitudinal staple using the gradient in nail asymmetry tissue it is mobile and Gradient in nail displacement.
In addition to or replace it is described above, nail bin the protruding portion with different height can be used control group be woven in end execute Movement in device.In all cases, the protruding portion disclosed herein extended from the platform of nail bin can reduce end effector Nail bin and anvil block between gap.Therefore, compared to the embodiment of not protruding portion, protruding portion can be located in anvil block with Tissue among nail bin applies bigger local pressure.In all cases, the protruding portion with high height can be applied to tissue Add biggish compressing force or pressure, and the protruding portion with shorter height can apply relatively small compressing force or pressure to tissue Power.Along these lines, shorter protruding portion is compared, higher protruding portion mobile to tissue can provide biggish control.As reader will remember It rising, the mobile tissue being smaller than at end effector distal end of the tissue at end effector proximal end is mobile, and because This, referring again to Figure 84, nail bin 4800 can at the proximal end 4816 of warehouse 4810 using shorter protruding portion 4851 ' and Higher protruding portion 4851 " is used at distal end 4813.In at least one situation, shorter protruding portion 4851 ' can be from warehouse 4810 4811 extended distance 4855 ' of platform surface, and higher protruding portion 4851 " can from shorter protruding portion 4851 ' extend away from From 4855 ".It in some cases, may include prolonging between the proximal end and distal end of warehouse from the protruding portion that warehouse extends The gradient for the height stretched.In at least one situation, as discussed above, the highest protruding portion of gradient can be located at the distal side of warehouse End, and the shorter protruding portion of gradient can be located at the proximal end of warehouse.In other cases, the highest protruding portion of gradient It can be located at the proximal end of warehouse, and the shorter protruding portion of gradient can be located at the distal end of warehouse.
As discussed above, when just following closely from cartridge deployment, tissue movement can be such that nail shifts.In all cases, it compares Shorter protruding portion, higher protruding portion can provide biggish control to such displacement.More specifically, comparing referring again to Figure 84 Short proximal projections 4851 ', higher distal projections 4851 " can make nail pit 4850 extend more, so that compared to nail 4830 ' It is controlled by proximal projections 4851 ', nail 4830 " controls longer distance by distal projections 4851 ".Compared to following closely wherein 4830 ' the distances being lifted up are followed closely in 4830 ' leg before appearing from chamber 4850, higher protruding portion 4851 " can also increase wherein 4830 " the distances being lifted up are followed closely before appearing from chamber 4850 in the leg of nail 4830 ".Such arrangement, which can be reduced, wherein follows closely 4830 " cruelly Reveal the distance and/or time mobile to the larger tissue at such as 4800 distal end of nail bin.
As discussed above, nail bin can use more than one nail configuration in longitudinal staple.In all cases, nail bin can The nail with various configuration is used in different longitudinal staples.In at least one situation, nail bin may include in first longitudinal direction There is the nail of the second configuration with the first configuration in staple and in second longitudinal direction staple.Turning now to Figure 49 and Figure 49 A, nail Storehouse 2700 for example may include being defined in multiple nail cavities 2750 longitudinally arranged therein, wherein the nail cavity 2750 being defined in first row It can respectively include removedly being stored in 2730 ' (Figure 50) of the first nail therein, the nail cavity 2750 being defined in second row can be each 2730 " (Figure 51) are followed closely from including being removedly stored in therein second, and the nail cavity 2750 being defined in third row can be each From including being removedly stored in third nail 2730 therein " ' (Figure 52).First nail 2730' can be positioned on most interior longitudinal nail In chamber 2750, the second nail 2730 " can be positioned in intermediate row nail cavity 2750, and third nail 2730 " ' it can be positioned on outermost longitudinal row In nail cavity 2750.When with first height A'(Figure 50) first nail 2730' and with the second height A " (Figure 51) second nail When 2730 " being in its non-percussion configuration, the second nail 2730 " can be higher than the first nail 2730'.Similarly, when second follows closely 2730 " and tool When having third height A " ' the third of (Figure 52) nail 2730 " ' in its non-percussion configuration, third nail 2730 " ' the second nail can be higher than 2730″。
In all cases, the nail arranged longitudinally in each can be supported by longitudinal nail driver.For example, first longitudinal direction nail is driven Dynamic device can support first row first and follow closely 2730', and second longitudinal direction nail driver can support the nail of second row second 2730 ", and third Longitudinal nail driver, which can support third, ranked third nail 2730 " '.In some cases, with reference to Figure 49 and Figure 49 A, a nail is driven Dynamic device 2742 can support the nail 2730' of first row first and the nail of second row second 2730 " makes each staple drivers 2742 can be such as It supports and fires at least one first nail 2730' and at least one the second nail 2730 ".One nail driver 2740 can support third Ranked third nail 2730 " ', so that each staple drivers 2740 are sustainable and fire at least one third nail 2730 " '.Staple drivers 2742 can respectively include being configured to the first base 2741 ' of the first nail of support 2730' and being configured to support The second base 2741 " of second nail 2730 ", and similarly, staple drivers 2740 can respectively include being configured to support Third follows closely 2730 " ' third pedestal 2741 " '.When staple drivers 2740 and 2742 are in its non-firing position, such as Figure 49 A institute Show, first base 2741 ' can be supported on 23 first distance 2732 ' of first row forming pit that distance is defined in anvil block 20 Place, second base 2741 " can be supported on 23 second distance 2732 " of second row forming pit that distance is defined in anvil block 20 Place, and third pedestal 2741 " ' can be supported on third row's 23 third distance of forming pit that distance is defined in anvil block 20 2732 " ' at.First distance may differ from second distance and/or second distance may differ from third distance.As shown in figure 49, One distance is shorter than second distance and second distance is shorter than third distance.When driver 2740 and 2742 by firing member 2760 towards When anvil block 20 is promoted for example to follow closely 2730 ', 2730 " and 2730 " ' from the ejection of nail cavity 2750, the first nail 2730', the second nail 2730 " And/or third nail 2730 " ' it may be deformed to different forming heights.For example, most interior nail (that is, nail 2730') is formed as first Forming height, intermediate nail (that is, nail 2730 ") are formed as the second forming height, and outer nail (that is, nail 2730 " ') can be formed For third forming height.First height can be shorter than the second height, and the second height can be shorter than third height.It is published in 2012 Entitled " the SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING on November 27 The United States Patent (USP) 8,317,070 of DIFFERENT LENGTHS " is incorporated by.
In all cases, the storehouse platform of nail bin can be flat.In such cases, protruding portion as described herein can Extend from flat platform surface.In other cases, the storehouse platform of nail bin may include stepped surface, the stepped surface packet Include for example, at least two stepped surfaces.Referring again to Figure 49 and Figure 49 A, the warehouse 2710 of nail bin 2700 may include be located in it is vertical It the first platform side on first side in knife channel 2715 and is located in the second side in longitudinal knife channel 2,715 second flat Platform side.Each platform side include such as the first ladder 2711', the second ladder 2711 " and third ladder 2711 " '.First longitudinal direction row Nail cavity 2750 can be defined in the first ladder 2711', and second longitudinal direction nail chamber 2750 can be defined in the second ladder 2711 " in, and Third longitudinal direction nail chamber 2750 can be defined in third ladder 2711 " ' in.When anvil block 20 is in its closed position, anvil block 20 Tissue contacting surface 21 can be positioned adjacent to the platform surface of warehouse 2710.In such cases, tissue contacting surface 21 can position With the first ladder 2711 ' away from the first distance 2712 ', with the second ladder 2711 " away from the second distance 2712 ", with third rank Ladder 2711 " ' is at third distance 2712 " '.In all cases, first distance, second distance and/or third distance can be with It is different.As shown in Figure 49 and Figure 49 A, first distance 2712 ' is shorter than second distance 2712 ", and second distance 2712 " is shorter than Three distances 2712 " '.In all cases, first distance 2712 ' can limit first between the first ladder 2711 ' and anvil block 20 Tissue space, second distance 2712 " can limit minor microstructure gap, and third between the second ladder 2711 " and anvil block 20 Third tissue space is limited between distance 2712 " ' can be in third ladder 2711 " ' and anvil block 20.It is located in most interior nail chamber 2750 On the first tissue gap be smaller than the third tissue space being located on outermost nail chamber 2750.It is centrally positioned nail chamber Minor microstructure gap on 2750 can be greater than the first tissue gap but be less than third tissue space.
In addition to described above, and referring again to Figure 49 and Figure 49 A, first longitudinal direction arranges protruding portion 2751 ' can be from the first rank Ladder 2711 ' extends, and second longitudinal direction row's protruding portion 2751 " can extend from the second ladder 2711 ", and third longitudinally arranges protruding portion 2751 " ' can extend from third ladder 2711 " '.First protruding portion 2751' can be limited by the first height 2755', the second protruding portion 2751 " can be by the second height 2755 " limit, and third protruding portion 2751 " ' can be by third height 2755 " ' limit.First height, Second height and/or third height can be different.As shown in Figure 49 and Figure 49 A, the first height 2755 ' can be shorter than the second height 2755 ", and the second height 2755 " can be shorter than third height 2755 " '.In all cases, most short longitudinal row's protruding portion, i.e., Protruding portion 2751 ' can extend along most interior nail chamber 2750, and highest longitudinally arranges protruding portion, i.e. protruding portion 2751 " ', it can be along most outlet Nail cavity 2750 extends, and has alto protruding portion, i.e. protruding portion 2751 ", can extend along intermediate row nail cavity 2750.Figure 76 show alternate embodiment, and wherein highest longitudinally arranges protruding portion, i.e. protruding portion 2751 " ', along most interior nail chamber 2750 extend, and most short longitudinal row's protruding portion, i.e. protruding portion 2751 ' extend, and have medium altitude along outermost nail chamber 2750 Protruding portion, i.e. protruding portion 2751 " can extend along intermediate row nail cavity 2750.
Referring again to Figure 76, nail bin 4000 can be similar to nail bin 2700 as discussed above in many aspects.Similar to nail Storehouse 2700, nail bin 4000 may include longitudinal nail chamber 2750, and the longitudinal direction nail chamber includes first row nail cavity 2750, the second nail Chamber 2750 and third nail chamber 2750, first row nail cavity include removedly being stored in the first nail 2730 ' therein, the second nail Chamber includes removedly being stored in the second nail 2730 " therein, and third nail chamber includes removedly being stored in third therein Nail 2730 " '.With nail bin 2700 on the contrary, the first nail 2730' includes outermost nail and third nail 2730 " ' it include most interior row Nail.Nail bin 4000 may include driver 4040 and 4042, and the driver is configured at driver 4040 and 4042 In not firing or when non-raised position, by the 2730 " ' support of third nail at anvil block 20 at a distance of third forming distance 2732 " ', will Second nail 2730 " support at anvil block 20 at a distance of the second forming distance 2732 ", by first nail 2730 ' support at 20 phase of anvil block Away from the first forming distance 2732 '.It is high that driver 4040 and 4042 can make most interior nail (that is, nail 2730 " ') be deformed into third forming Degree makes intermediate nail (that is, nail 2730 ") be deformed into the second forming height, and is deformed into outermost nail (that is, nail 2730') First forming height.For example, third forming height can be higher than the second forming height and the second forming height can be higher than the first forming Highly.Similar to nail bin 2700, nail bin 4000 may include staged platform surface;However, third ladder 2711 " ' can be along most Interior nail chamber 2750 extends and the first ladder 2711' can extend along outermost nail chamber 2750.It is limited by the first clearance distance 2712' Fixed the first tissue gap can be relative to by the second clearance distance 2712 " the minor microstructure gap limited is positioned towards laterally outside, Second clearance distance 2712 " can be relative to by third space distance 2712 " ' the third tissue space that limits is fixed towards laterally outside Position.
Figure 70 shows nail bin 3600 into Figure 72.Nail bin 3600 may include warehouse 3610.Warehouse 3610 may include distal side End 3613, proximal end 3616 and opposite flank 3612.Warehouse 3610 may also include platform 3611, be defined in platform 3611 In multiple nail cavities 3650 and be configured to receive such as firing member blade longitudinal slit 3615.Warehouse 3610 may also include the protruding portion 2051 and 2053 extended from storehouse platform 3611.Warehouse 3610 may also include to be prolonged from storehouse platform 3611 The protruding portion 3651 stretched.Similar to protruding portion 2051, protruding portion 3651 is configured to engagement and is located in anvil block and storehouse The tissue of 3600 centres simultaneously controls movement of the tissue relative to storehouse 3600.In all cases, protruding portion 3651 can limit or Prevent flowing of the tissue relative to nail bin.Protruding portion 3651 can be positioned at the proximal end and/or distal end of nail cavity 3650. In all cases, each protruding portion 3651 may include the hoop extended around the end of nail cavity 3650.In all cases, each Protruding portion 3651 may include the arch spine extended around the end of nail cavity 3650.In all cases, protruding portion 3651 may It is not high as protruding portion 2051 and/or protruding portion 2053.Compared with shorter protruding portion 3651, higher protruding portion 2051 can be to group It knits and applies bigger local pressure.In all cases, protruding portion 2051 can provide tissue enough control to fire Assembling is held in place during journey.In this case, prominent other than protecting and guiding the nail being located in nail cavity 3650 Portion 3651 can also provide tissue some other control.
In addition to described above, platform 3611 may include ladder 2711 ', 2711 " and 2711 " ', the ladder is adapted to Tissue of enough compression sets among warehouse 3610 and anvil block.In all cases, third ladder 2711 " ' it may include along most The lowest deck surface that outlet nail cavity 3650 and the distal end 3613 for surrounding warehouse 2610 extend.Second ladder 2711 " can be from Lowest deck surface 2711 " ' upwardly extend and the first ladder 2711' can be from the second ladder 2711 " upwardly extends.When warehouse 3610 When relative to tissue sliding, organize the flowable distal end 3613 for crossing warehouse 3610 and flow to ladder 2711 ', 2711 " and 2711 " ' top.Warehouse 3610 may also include slope 3614 ' and 3614 ", and the slope is respectively configured to can aid in group It knits and slides on ladder 2711 ' and 2711 " respectively.It is as also discussed above, ladder 2711 ' can be used, 2711 " and 2711 " ' come Control flowing of the tissue relative to nail bin 3600.Referring primarily to Figure 71, in all cases, compared to being defined in ladder 2711 " Tissue space between anvil block and/or be defined in ladder 2711 " ' and anvil block between tissue space, ladder 2711 ' can be in storehouse Lesser tissue space is limited between 3600 and the anvil block that relatively positions with storehouse 3600.Between ladder 2711' and minimum tissue In the case that gap is adjacent with longitudinal slit 3615, with compared with the tissue of ladder 2711' lateral register, with longitudinal slit 3615 adjacent tissues can be subjected to more compressing and more controlling.Such embodiment can be advantageous because of many reasons. For example, can attempt to make to capture the tissue nail bin 3600 and anvil block across the cutting element of longitudinal slit 3615 occurs position It moves, and due to the compression that most interior ladder 2711 ' applies, the displacement of tissue can be prevented from, mitigates or reduce.
As discussed above in association with embodiment shown in Figure 76, nail bin may include wherein minimum tissue space and outermost longitudinal direction The coextensive staged platform surface of nail chamber.In this case, minimum tissue space can be adjacent with the side in storehouse, and due to most The compression that outer ladder is applied can prevent, mitigate or reduce the displacement of tissue, the lateral displacement especially organized.In certain feelings Under condition, referring again to Figure 70 to Figure 72, the lateral displacement for capturing the tissue between nail bin 3600 and anvil block can be by lateral side wall 3617 prevent, mitigate or reduce.Each lateral side wall 3617 can extend from the side of warehouse 3,610 3612 and stop the side of tissue To movement.Side wall 3617 may include any suitable configuration.In at least one situation, each side wall 3617 may include for example justifying Dentation top surface.Turning now to Figure 73, nail bin 3700 may include warehouse 3710, and the warehouse includes from the side of warehouse 3710 3712 lateral side walls 3717 extended.In at least one situation, each lateral side wall 3717 may include for example straight top surface.
Turning now to Figure 74, nail bin 3800 may include warehouse 3810, and the warehouse includes distal end 3813 and nail cavity 3850.Similar to above-mentioned, warehouse 3810 may include the protruding portion 2053 at the distal end of farthest side nail cavity 3850.Equally Similarly as described above, warehouse 3810 may include the proximal end and/or distal end portion that can surround at least some nail cavities 3850 The protruding portion 2051 in portion.In addition to or replace protruding portion 2051 and 2053, staple cartridge body 3810 may also include protruding portion extending therefrom 3851.Each protruding portion 3851 can extend around the end of more than one nail cavity 3850.In at least one situation, each protrusion It portion 3851 can the end of nail cavity 3850 for example in most interior nail chamber 3850, nail cavity 3850 in outermost nail chamber 3850 The end of nail cavity 3850 in end and/or intermediate row nail cavity extends.It is at least one under such circumstances, protruding portion 3851 First part can be such that the first nail cavity 3850 extends on storehouse platform surface, and the second part of protruding portion 3851 can make the second nail cavity 3850 extend on storehouse platform surface, and the Part III of protruding portion 3851 can make third nail cavity 3850 extend to storehouse platform On surface.The first part of protruding portion 3851 can protect, guide and/or keep the first nail, and second part can be protected, be guided And/or the second nail is kept, and Part III can protect, guide and/or keep third to follow closely.In all cases, protruding portion 3851 can extend in the longitudinal slit 3615 being defined in warehouse 3810 and between the lateral side wall 3717 that warehouse 3810 extends. It is at least one under such circumstances, protruding portion 3851 can extend across the first ladder 2711', the second ladder 2711 " and/or the Three ladders 2711 " '.In other words, protruding portion 3851 can extend across the height change in the platform of warehouse 3810.In some feelings Under condition, although there are height change, the top of protruding portion 3851 or tissue engagement surfaces to be flat on storehouse platform surface.? In other situations, the top of protruding portion 3851 or tissue engagement surface can also change in height.As at least one In the case of, the top surface of protruding portion 3851 can be increased for example when platform surface increases in height in height and when flat Platform surface reduces in height when reducing in height.In other cases, the top surface of protruding portion 3851 can be for example when flat It reduces when platform surface increases in height and is increased in height when platform surface reduces in height in height.
In all cases, referring again to Figure 74, warehouse 3810 may include laterally projecting portion extending therefrom or rib 3817. Laterally projecting portion 3817 can extend transverse to longitudinal slit 3615 and/or lateral side wall 3717.In at least one situation, laterally Protruding portion 3817 can extend along the direction for being transversely to the machine direction slit 3615 and/or lateral side wall 3717.In at least one situation, Laterally projecting portion 3817 can extend between protruding portion 3851 and side wall 3717.It laterally projecting portion 3817 can also be in protruding portion 2051 Extend between side wall 3717, and similarly, extends between protruding portion 2053 and side wall 3717.In some cases, prominent Portion 3817 and side wall 3717 can be identical height.In other cases, protruding portion 3817 and side wall 3717 can be different height Degree.Referring to Figure 74, side wall 3717 is for example higher than protruding portion 3817.Under any circumstance, laterally projecting portion 3817 can limit or It prevents from for example organizing relative to nail bin 3800, particularly along the flowing of distal side or longitudinal direction.
Turning now to Figure 81, nail bin 4500 may include warehouse 4510, which includes platform 4511, proximal end, distal side End 4513 and the longitudinal knife slot 3615 extended between proximal end and distal end 4513.Warehouse 4510 may include, In addition to other feature structure, angled transition 2014,2051,2053 He of protruding portion at least partly around nail cavity 3650 3651 and lateral side wall 3617.In fact, it is contemplated that arriving various embodiments, wherein various embodiments disclosed herein Organizational controls feature structure can be combined with the organizational controls feature structure of the other embodiments disclosed herein.In addition, Whole disclosed herein is the nail cavity being wherein defined in nail bin may include the various of the protruding portion of at least partly about nail cavity Embodiment.Other embodiments are contemplated that, wherein being not all of nail cavity all and including the protrusion of at least partly about nail cavity Portion.Turning now to Figure 82, nail bin 4600 may include warehouse 4610, and the warehouse includes platform 4611, proximal end 4616, distal side End 4613 and the longitudinal knife slot 4615 extended between proximal end 4616 and distal end 4613.Warehouse 4610 can Including some protruding portions 2051 and 2053 extended from platform 4611 and at least partly about nail cavity 4650.For example, Be defined in the nail cavity 4650 in the distal end 4613 of nail bin 4600 proximal end and/or distal end can at least partly by Protruding portion 2051 is surround, and similarly, be defined in the nail cavity 4650 in the proximal end 4616 of nail bin 4600 proximal end and/ Or distal end can at least partly be surround by protruding portion 2051.In such embodiment, it is defined in 4610 middle part of warehouse (i.e. Between the proximal end 4616 and distal end 4613 of nail bin) nail cavity 4650 can be for example not by protruding portion 2051 and/or any Other protruding portions are surround.Turning now to Figure 83, nail bin 4700 may include warehouse 4710, and the warehouse includes platform 4711, nearside End and distal end 4713.Warehouse 4710, which may also include, is defined in multiple nail cavities 4750 therein.Farthest side nail cavity 4750 can Including by the circular distal end of protruding portion 2053 and the proximal end circular by protruding portion 2051.Other nail cavities 4750 may include By the circular distal end of protruding portion 2051 and proximal end not circular by protruding portion.Certain nail cavities 4750 may include being dashed forward The circular proximal end in portion 2051 and distal end not circular by protruding portion out.
As discussed above, protection, support and/or guidance is configured to from the protruding portion that platform surface extends to determine Nail of the position in nail pit.Figure 77 shows the nail bin 4100 including warehouse 4110, and the warehouse includes platform 4111, is defined in Nail cavity 4150 in platform 4111 and the protruding portion 4151 from the extension of platform 4111.Nail bin 4100 may also include removedly The nail 4130 being located in nail cavity 4150.Protruding portion 4151 may include being defined in slit 4154 therein, and the slit can be by structure Cause can when nail 4130 stores in nail cavity 4150 and/or follow closely 4130 just from nail cavity 4150 eject when support nail 4130 leg 4132.Slit 4154 may include the extension of nail cavity end wall 4152.When nail 4130 is in non-firing position, nail Chamber end wall 4152 and/or slit 4154 can cooperate to support nail leg 4132.When from the ejection of chamber 4150 nail 4130, leg 4132 can Appear from protruding portion 4151, as shown in Figure 77.In this case, end wall 4152 and/or slit 4154, which can support, not yet ejects The part of the nail 4130 of nail cavity 4150.In some cases, protruding portion 4151 can not provide the lateral support to nail leg 4132.More Specifically, referring to Figure 77, slit 4154 may include opposite side 4155, and the opposite side can be with the side of nail leg 4132 It is spaced apart, and does not contact the side of nail leg 4132.In all cases, when nail 4130 is still positioned at least partially at nail cavity 4150 When middle, nail 4130 may be deformed to its configuration that is badly deformed.It is at least one under such circumstances, end wall 4152 and/or slit 4154 can nail 4130 entire forming process in support nail 4130.In other cases, nail 4130 can be elevated out narrow at it Reach its configuration that is badly deformed after on slot 4154 and promotion to protruding portion 4151.In this case, end wall 4152 and narrow Slot 4154 can in its entire forming process not support nail 4130.
Figure 78 shows the nail bin 4200 including warehouse 4210, and the warehouse includes platform 4211, is defined in platform 4211 In nail cavity 4250 and from platform 4211 extend protruding portion 4251.Nail bin 4200, which may also include, is removably positioned in nail Nail 4130 in chamber 4250.Protruding portion 4251 may include being defined in slit 4254 therein, and the slit is configured to The leg of support nail 4130 when nail 4130 stores in nail cavity 4250 and/or when nail 4130 is just ejected from nail cavity 4250 4132.Slit 4254 may include the extension of nail cavity end wall 4252.When nail 4130 is in non-firing position, nail cavity end wall 4252 And/or slit 4254 can cooperate to support nail leg 4132.When from the ejection of chamber 4250 nail 4130, leg 4132 can be from protruding portion 4251 appear, as shown in Figure 78.In this case, end wall 4252 and/or the sustainable not yet ejection nail cavity 4250 of slit 4254 Nail 4130 part.In some cases, protruding portion 4251 can provide the lateral support to nail leg 4132.More specifically, ginseng See that Figure 78, slit 4254 may include opposite side 4255, the opposite side can contact the side of nail leg 4132.Various In the case of, when nail 4130 is still positioned at least partially in nail cavity 4250, nail 4130 may be deformed to its configuration that is badly deformed.? It is at least one under such circumstances, end wall 4252 and/or slit 4254 can in the entire forming process of nail 4130 support nail 4130.In other cases, nail 4130 can reach after it is elevated out slit 4254 and is promoted on protruding portion 4251 Its configuration that is badly deformed.In this case, end wall 4252 and slit 4254 can in its entire forming process not support nail 4130。
Figure 79 shows the nail bin 4300 including warehouse 4310, and the warehouse includes platform 4311, is defined in platform 4311 In nail cavity 4350 and from platform 4311 extend protruding portion 4351.Nail bin 4300, which may also include, is removably positioned in nail Nail 4130 in chamber 4350.Each protruding portion 4351 may include being defined in tapered slit 4354 therein, and the tapered slit can Be configured to when nail 4130 stores in nail cavity 4350 and/or follow closely 4130 just ejected from nail cavity 4350 when support The leg 4132 of nail 4130.Each slit 4354 may include the extension of nail cavity end wall 4352 and may include end wall 4355.When When nail 4130 is in non-firing position, the end wall 4355 of each slit 4354 can cooperate to support nail leg 4132.If reader is from figure It will be understood that, nail leg 4132 can not be supported by end wall 4352 in 79.When from the ejection of chamber 4350 nail 4130, leg 4132 can be from protrusion Portion 4351 appears.In this case, the portion of the sustainable nail 4130 for not yet ejecting nail cavity 4350 of the end wall 4355 of slit 4354 Point.In some cases, the side wall 4155 of protruding portion 4351 can provide lateral support to nail leg 4132.In all cases, when When nail 4130 is still positioned at least partially in nail cavity 4350, nail 4130 may be deformed to its configuration that is badly deformed.In at least one Under such circumstances, slit 4354 can nail 4130 entire forming process in support nail 4130.In other cases, 4130 are followed closely Its configuration that is badly deformed can be reached after it is elevated out slit 4354 and is promoted on protruding portion 4351.In such case Under, slit 4354 can in its entire forming process not support nail 4130.
Figure 80 shows the nail bin 4400 including warehouse 4410, and the warehouse includes platform 4411, is defined in platform 4411 In nail cavity 4450 and from platform 4411 extend protruding portion 4451a and 4451b.Nail bin 4400 may also include for example removable The nail 4130 being located in except ground in nail cavity 4450.Nail cavity 4450 may include be configured to support and guide nail 4130 first First end wall 4452a of leg and be configured to support and guide nail 4130 the second leg the second end wall 4452b.Protruding portion 4451a can extend first distance 4455a from platform 4411, and protruding portion 4451b can prolong from platform 4411 Reach the second distance 4455b on protruding portion 4451a.Therefore, in all cases, protruding portion 4451a is sustainable and guides First nail leg first distance and protruding portion 4451b can support and the second nail leg second distance of guidance, and wherein second distance can be longer than First distance.In some cases, protruding portion 4451b can be positioned at the distal end of nail cavity 4450 and protruding portion 4451a can It is positioned at the proximal end of nail cavity 4450.It is followed closely when by firing member and being moved distally towards distal side promotion for tissue knife When 4130 (as discussed above), such embodiment can be advantageous.Alternatively, protruding portion 4451b can be positioned on nail cavity At 4450 proximal end and protruding portion 4451a can be positioned at the distal end of nail cavity 4450.Under any circumstance, protruding portion 4451b may include such as stair-stepped configuration.In at least one situation, protruding portion 4451b may include for example being limited by height 4455a Fixed first part and the second part limited by height 4455b.
Figure 85 A to Figure 85 C shows the nail bin 4900 including warehouse 4910, and the warehouse includes platform 4911.Various In embodiment, warehouse 4910 can be made of flexible material.In certain embodiments, warehouse 4910 can be by rigid material and soft Property material constitute, wherein at least platform 4911 can be made of flexible material.Flexible material may include certain plastic materials, such as poly- Propylene and/or elastic material, such as rubber, thermoplastic elastomer (TPE) and/or santoprene.In all cases, platform 4911 can be by Pliable material is constituted.Under any circumstance, platform 4911 may include protruding portion 4951 extending therefrom.Similar to above-mentioned, protrusion Portion 4951 can protect, support and/or guide nail 4130.It is also similarly to described above, protruding portion 4951 can be prevented or at least be limited Movement of the tissue processed relative to nail bin 4900.When anvil block is moved in the closed position opposite with nail bin 4900, or alternatively, When nail bin 4900 is moved in the closed position relative to anvil block, protruding portion 4951 can be positioned among anvil block and nail bin 4900 Tissue compression.Figure 85 A to Figure 85 C shows sequence of events, and wherein protruding portion 4951 is by increased compressing force.Figure 85 A Show the protruding portion 4951 in uncompressed configuration.It, can be between protruding portion 4951 and the nail leg for following closely 4130 in this configuration In the presence of compression or interference engagement.Figure 85 B is shown in response to applying compressing force to it and in the protruding portion 4951 of compressed configuration. By comparing Figure 85 A and Figure 85 B, it is to be understood that the top surface 4956 of protruding portion 4951 is pushed down on towards platform 4911a The distance 4955 and shape of protruding portion 4951 has deformed.In the configuration, protruding portion 4951 can grasp the nail leg of nail 4130 And/or nail leg is held in place.Figure 85 C shows the bigger compressing force for being applied to protruding portion 4951.By comparing Figure 85 B With Figure 85 C, it is to be understood that the top surface 4956 of protruding portion 4951 is further pushed down on and protruded towards platform 4911 The shape in portion 4951 further deforms.In addition, protruding portion 4951 can increase the chucking power for being applied to nail leg in this configuration.
Figure 86 A and Figure 86 B show the nail bin 5000 including warehouse 5010, and the warehouse includes platform 5011.Warehouse 5010 may also include the multiple protruding portion 5051 for being defined in multiple nail cavities 5050 therein and extending from platform 5011, described prominent Portion is configured to the nail 5030 that protection, support and/or guidance are removably positioned in nail cavity 5050 out.Similar to above Described, nail bin 5000 may also include staple drivers 5040 and 5042, and the staple drivers are configured in non-firing position Nail 5030 is supported and promoted between firing position.Figure 86 A and Figure 86 B show the nail 5030 in part firing position, The end of middle nail 5030 partly appears from protruding portion 5051.Similar to above-mentioned, warehouse 5010 can be made of flexible material.It is soft Property material may include certain plastic materials, such as polypropylene and/or elastic material, such as rubber, thermoplastic elastomer (TPE) and/or Santoprene.In all cases, warehouse 5010 can be made of pliable material.When applying compressing force to warehouse 5010, warehouse 5010 is flexible, as shown in Figure 86 B.When the platform 5011 of warehouse 5010 is bent downwardly as shown in Figure 86 B, protruding portion 5051 can Deflect down distance 5055.In this way, protruding portion 5051 can be moveable.
Various embodiments are susceptible to, wherein the protruding portion extended from nail bin platform can be mobile relative to platform.At least In a kind of situation, protruding portion in first position and second or can be reduced and be moved between position, and in the first position, protruding portion makes to follow closely Chamber extends on platform, this second or reduce position, protruding portion, which can be such that nail cavity extends to, does not also make nail cavity on platform It extends on platform.It in all cases, can be collapsible from one or more protruding portions that platform extends.It is collapsible prominent Portion can move between first position and second or collapsed position out, and in the first position, protruding portion makes nail cavity extend to platform On, this second or collapsed position, protruding portion can make nail cavity extend on platform do not make yet nail cavity extend to platform it On.In at least one situation, collapsible protruding portion can be elastically restored to its non-collapsed configuration, and in some cases, Protruding portion can incomplete recovery to its non-collapsed configuration.It in all cases, can from one or more protruding portions that platform extends It can be crushed.Protruding portion, which can be crushed, to be moved between first position and second or conquassation position, prominent in the first position Portion extends to nail cavity on platform, this second or conquassation position, protruding portion nail cavity can be made to extend on platform also not Extend to nail cavity on platform.It protruding portion can be crushed may not be restored to it and not be crushed configuration.
As discussed above, when nail removedly stores in nail bin, the nail of nail bin can be supported by staple drivers.Equally As discussed above, staple drivers can be lifted up by firing member such as firing member 2760.In all cases, turn now To Figure 53 and Figure 54, firing member is configured to promote nail sliding part to follow closely sliding part 2870 such as with towards anvil towards distal side Seat promotes staple drivers and nail.Following closely sliding part 2870 may include main body 2871 and shoulder 2876, and the shoulder can be by percussion structure Part 2760 engages and supports firing member 2760.Sliding part 2870 may also include such as ramp type or inclined surface 2872,2873, 2874 and/or 2875, the surface is configured to slide below staple drivers and when sliding part 2870 drives in nail Staple drivers are lifted up when sliding below device.In all cases, in addition to described above, such as first slope surface 2872 can It is configured to contact and promoted the staple drivers in first row staple drivers, the second ramped surfaces 2873 are configured to The staple drivers in second row staple drivers are enough contacted and are promoted, third ramped surfaces 2874 are configured to contact and mention The staple drivers in third nail driver are risen, and the 4th ramped surfaces 2875 are configured to contact and promote the 4th Staple drivers in nail driver.
In all cases, than that described above, sliding part 2870 can promote the driving of the nail in four nail drivers simultaneously Device.In some cases, sliding part 2870 can staple drivers in Synchronous lifting this four nails driver.In such cases, The distal end of four ramped surfaces 2872,2873,2874 and 2875 is configured to contact four nails drives simultaneously Dynamic device and along four it is parallel promoted surfaced lifts they so that staple drivers reach identical height simultaneously.In addition, in such situation Under, ramped surfaces 2872,2873,2874 and 2875 can be all with equal length.In other cases, despite with staggered Mode, but sliding part 2870 can promote the staple drivers in four nail drivers in every row simultaneously.Referring primarily to Figure 54, first tiltedly The distal end 2872a on slope 2872 can be aligned with the distal end 2875a on the 4th slope 2875.In all cases, first tiltedly Slope 2872 can be parallel to the 4th slope 2875.In addition, first slope 2872 can limit first slope length, the first slope length It is identical as the 4th slope length that the 4th slope 2875 limits.The distal end 2873a on the second slope 2873 can be relative to first The distal end 2872a on slope 2872 and the distal end 2875a on the 4th slope 2875 are existed with the distance indicated by distance 2879a Distal side positioning.Second slope 2873 can be not parallel to first slope 2872 and/or the 4th slope 2875.In addition, the second slope 2873 can limit the second slope length for being longer than first slope length and/or the 4th slope length.The distal side on third slope 2874 The distance that end 2874a can be indicated relative to the distal end 2873a on the second slope 2873 by distance 2878a is determined in distal side Position.Third slope 2874 can be not parallel to first slope 2872, the second slope 2873 and/or the 4th slope 2875.In addition, third Slope 2874 can limit the third slope length for being longer than first slope length, the second slope length and/or the 4th slope length.
When sliding part contacts staple drivers, in addition to described above, can also be generated between sliding part and staple drivers anti- Active force and/or torque, so as to rotate sliding part and/or staple drivers in response to reaction force and/or torque.Figure 53 and The arrangement of slope shown by Figure 54 can be contacted in sliding part 2870 and while promoting staple drivers prevent or at least limit slippage part 2870 rotation.In addition, sliding part 2870 may include stabilizing member 2877, the stabilizing member extends towards distal side with Stable sliding Part 2870 and the shake or rotation for preventing and/or inhibiting sliding part 2870.Stabilizing member 2877 can be respectively relative to slope 2872, 2873,2874 and 2875 distal end 2872a, 2873a, 2874a and 2875a extends towards distal side.
Turning now to Figure 54 A to Figure 54 D, sliding part 2870 is configured to for example when sliding part 2870 is from nail bin The distal end 2013 of 2000 proximal end 2016 towards nail bin 2000 is disposed from nail bin 2000 when mobile and is followed closely.Nail bin 2000 And/or sliding part 2870 may include the spy that sliding part 2870 can be made to be releasably held in the proximal end 2016 of nail bin 2000 Levy structure.In all cases, the warehouse 2010 of nail bin 2000 may include detent 2019, and the detent is configured in cunning The nearside of moving part, non-firing position engaging slide part 2870 simultaneously releasably hold sliding part 2870, as shown in Figure 54 A.Extremely In a kind of few situation, referring primarily to Figure 54 B and Figure 54 C, each detent 2019 may include extending inwardly into longitudinal slit 2015 Rib or spine.Spine can extend in such as longitudinal slit 2015 in vertical direction.Than that described above, the master of sliding part 2870 Body 2871 can be positioned in longitudinal slit 2015 and can be when sliding part 2870 be in its nearside, non-firing position and detent 2019 Engagement, as shown in Figure 54 A.In all cases, detent 2019 can define therebetween the gap smaller than the width of main body 2871.? In such situation, interference fit may be present between detent 2019 and the main body of sliding part 2,870 2871, so that detent 2019 can Sliding part 2870 is grasped and is held in place.When firing member pushes sliding part 2870 towards distal side, main body 2871 can be pushed To be detached from the engagement of detent 2019, and sliding part 2870 can be promoted towards distal side to fire the nail being stored in nail bin 2000. In all cases, referring now to Figure 54 D, the main body 2871 of sliding part 2870 may include being defined in groove 2018 therein, institute Groove is stated to be configured to releasedly receive detent 2019.Groove 2018 and detent 2019 can limit cunning when aligned The nearside of moving part 2870, non-firing position.Although there is two groups of grooves 2018 and detent 2019 in the illustrated embodiment, Sliding part 2870 can be made to releasably hold in place using single group.In other cases, it can be used and be more than two groups of grooves 2018 With detent 2019.In some cases, detent 2019 can extend from the main body 2871 of sliding part 2870 and groove 2018 can limit In warehouse 2010.
As discussed above, warehouse may include tissue scaffold platform and the protruding portion from platform extension, the protruding portion It is configured to: one, control flowing of the tissue relative to warehouse;Two, so that the nail cavity being defined in warehouse is extended to platform On;And/or three, the nail in nail cavity is protected and/or is guided in support.In all cases, warehouse and protruding portion can be by Single piece of material is constituted.In at least one situation, protruding portion can be integrally formed with warehouse.Warehouse and protruding portion can be by plastic materials It forms and can be formed during such as injection moulding process.In some cases, protruding portion may fitted to warehouse.In at least one feelings Under condition, protruding portion can be attached to such as warehouse.Warehouse and protruding portion can be made of identical material or different materials.At least In a kind of situation, warehouse can be made of plastic material and protruding portion can by elastic material such as rubber, thermoplastic elastomer (TPE) and/ Or santoprene is formed.In all cases, protruding portion can be made of pliable material and can not damage the tissue compressed by protruding portion. Protruding portion 3051 (Figure 60) and/or protruding portion 3151 (Figure 61) for example can by elastic material such as rubber, thermoplastic elastomer (TPE) and/ Or santoprene is formed.In at least one situation, warehouse can be formed during plastic injection molding process, and ratio can be used in protruding portion The material that the material of composition warehouse is more flexible is formed on warehouse during the second moulding process.In all cases, protruding portion 3051 and/or 3151 for example may include texture platform surface.In some cases, protruding portion 3051 and/or 3151 for example can be by Material with the coefficient of friction higher than warehouse is constituted.Such embodiment can improve the grasping force between warehouse and tissue.
It in all cases, can be from the protruding portion that warehouse extends static, and they can not be moved relative to warehouse It is dynamic.In some cases, as discussed above, protruding portion can be flexible and can deform relative to warehouse.In some cases, Same as discussed above, warehouse can be flexible, this allows protruding portion mobile when warehouse is bent.Nail bin may include can The protruding portion extended relative to warehouse.Turning now to Figure 75, nail bin 3900 may include having to be defined in multiple chambers 3950 therein Warehouse 3910.In all cases, chamber 3950 may include be positioned in dispose tissue engaging member 3940.Each structure Part 3940 never deployed position can be moved to deployed position.When component 3940 is in its non-deployed position, component 3940 can not Extend on platform 3911, and when component 3940 is in its deployed position, component 3940 may extend into platform 3911 it On.Alternatively, component 3940 may extend on platform 3911 when being in its non-deployed position.It is real as at least one It applies in scheme, the engageable tissue in its non-deployed position and its deployed position of tissue engaging member 3940.In any situation Under, component 3940 may include protruding portion 3951 extending therefrom, the protruding portion is configured to engagement, stablize and/or Tissue of the compression set among anvil block 20 and storehouse 3900.
Referring again to Figure 75, component 3940 can be by longitudinally traversing warehouse 3910 from its proximal end to its distal end Sliding part 3970 is disposed.Sliding part 3970 may include slope 3972, and the slope is configured to not dispose position in component It sets and successively engagement member 3940 and lifting member 3940 between its deployed position.In at least one situation, each component 3940 may include the skewed surface or angled faces 3942 that can be contacted by slope 3972.Slope surface 3972 can be slided below component 3940 And component 3940 is promoted onto surface 3979.When sliding part 3970 is promoted by firing member such as firing member 2760 towards distal side When, component 3940 can be maintained at its deployed position by surface 3979.As shown in Figure 75, surface 3979 can long enough to prop up on it Support several components 3940.In addition, surface 3979 can long enough with executed by firing member 2760 nail forming and tissue cutting Supporting member 3940 in the process.In at least one situation, surface 3979 can be leading, or relative to the knife of firing member 2760 Mouth 2761 positions in distal side.In such cases, when blade 2761 is moved distally across tissue, component 3940 can keep phase The tissue positioned for blade 2761 towards distal side.In other words, tissue engaging member 3940 can be deployed in tissue part's quilt A part of the tissue is grasped before suture and/or incision.Chamber 3950 is configured to support and guiding elements 3940 simultaneously And the lateral Horizon in chamber 3950 of component 3940 is inhibited to move or rotate.The proximal end on surface 3979 can be constructed and arranged to make Once obtaining blade 2761 has passed through component 3940, sliding part 3970 can release component 3940.In at least one such situation Under, once blade 2761 is slided by component 3940, surface 3979 can no longer supporting member 3940.
Than that described above, referring again to Figure 75, chamber 3950 can be arranged to longitudinal row.For example, chamber 3950 can be arranged to Including two most interior rows, two most outlets and six of row longitudinal rows for being located in each most interior row and outermost centre.It is susceptible to Other embodiments, lumen 3950 are arranged to less than six rows or more than six rows.Under any circumstance, it is defined in warehouse 3910 In chamber 3950 in it is some be all configured to support and guiding elements 3940, as discussed above, and in chamber 3950 It is some may include for example removedly being stored in nail therein, such as follow closely 2630.Sliding part 3970 is configured to portion Affix one's name to component 3940 also, in addition, percussion nail.It is at least one under such circumstances, sliding part 3970 may also include at least one Slope 2873, at least one described slope include ramped surfaces 3971, which is configured to for example towards anvil block 20 promote staple drivers 2640, as discussed above can percussion nail 2630.In all cases, slope 3972 can leading slope 2873.In such cases, the nail promotion of adjacent member 3940 can be fully formed position to it on slope 2873 by slope 3972 In before component 3940 is deployed in its deployed position.Various embodiments are susceptible to, wherein most outlet chamber 3950 includes depositing It is stored in tissue engaging member 3940 therein, and most interior row and intermediate row chamber 3950 are therein including being removedly stored in Nail.Such embodiment can include that two nails and a row organize engagement structure on the every side for the longitudinal knife slot being defined in warehouse Part 3940.Other embodiments are susceptible to, wherein any suitable arrangement of component 3940 and nail can be used.
As discussed above, it is envisioned that such embodiment: wherein nail bin may include that multiple rows of follow closely disposes group with multiple rows of Knit engagement member.In at least one embodiment, can dispose tissue engaging member can not intersperse among in staple.It is susceptible to other Embodiment is dispersed in staple wherein tissue engaging member can be disposed.It is same as discussed above, it is anticipated that such reality Apply scheme: tissue engaging member can be disposed by wherein being stored using nail cavity.Certain embodiments are susceptible to, wherein tissue engagement structure Part is not stored in nail cavity and is storable in the staple of neighbouring nail cavity.
Figure 90 to Figure 93 shows the another embodiment including that can dispose tissue engagement protruding portion.Nail bin 5300 for example may be used Including warehouse 5310, the warehouse includes being defined in platform 5311 therein and multiple nail cavities 5350.Nail bin 5310 may include can It removes the nail 5330 that is stored in nail cavity 5350 of ground and is configured to eject the multiple drivings for following closely 5330 from nail cavity 5350 Device 5340.Nail bin 5310, which may also include the one or more being removedly stored in nail cavity 5350, can dispose protruding portion 5351, It discusses in more detail as discussed further below.Each driver 5340 may include the pedestal for being configured to support nail 5330 5341, and furthermore, it may include it is configured to the driving surface 5342 engaged by sliding part such as sliding part 5370.It is similar In above-mentioned, sliding part 5370 can promote driver 5340 between non-deployed position and deployed position.Figure 92 shows driving Device 5340 and nail 5330 in its non-deployed position.Referring primarily to Figure 93, driver 5340 can be in non-deployed position and portion Protruding portion 5351 can be disposed by being promoted between administration position.It is at least one under such circumstances, referring primarily to Figure 90 and Figure 91, each Driver 5340 can be assembled first positioned in the proximal end around driver 5340 and can dispose protruding portion 5351 and surround The second of the distal end positioning of driver 5340 can dispose between protruding portion 5351, and wherein moving up for driver 5340 can Protruding portion 5351 can be disposed so that protruding portion 5351 is moved to its deployed position by being passed to.It is prominent at least one situation Portion 5351 can be frictionally engaged with driver 5340.When driver 5340 is moving upward, driver 5340 and protruding portion 5351 Between frictional fit protruding portion 5351 can be lifted up.Each protruding portion 5351 may include being configured to contact group Knit and apply to tissue the tissue engagement portion 5352 of compressing force.In all cases, protruding portion 5351 can apply pressure to tissue Contracting power, until compressing force is more than the static friction between protruding portion 5351 and the driver 5340 for moving up protruding portion 5351 Power.At this moment, driver 5340 can be mobile relative to protruding portion 5351 or be slided.In other words, driver 5340 can with its phase Associated protruding portion 5341 is detached from.
In all cases, protruding portion can be disposed when protruding portion 5351 is in its non-deployed position referring again to Figure 93 5351 tissue engagement portion 5352 can not extend on platform 5311.In other cases, when protruding portion 5351 is in it When non-deployed position, the tissue engagement portion 5352 that can dispose protruding portion 5351 be may extend on platform 5311.Any In the case of, when protruding portion 5351 is in its deployed position, the tissue engagement portion 5352 that can dispose protruding portion 5351 is extensible To on platform 5311.Than that described above, the frictional fit between each protruding portion 5351 and driver 5340 can be identical, so that Driver 5340 can be identical for each protruding portion 5351 by the power (that is, sliding force) slided relative to protruding portion 5351.Imagine To other embodiments, the frictional fit between some of them protruding portion 5351 and certain drivers 5340 may differ from other prominent Portion 5351 and other drivers 5340 out.Sliding force in such embodiment, between protruding portion 5351 and driver 5340 It can be different.In at least one embodiment, being located in the first protruding portion 5351 at the distal end of driver 5340 can open Begin to slide with the first sliding force and the second protruding portion 5351 being located at the proximal end of driver 5340 can start with difference It is slided in the second sliding force of the first sliding force.In all cases, due to above-mentioned, protruding portion 5351 can be to the pressure of tissue application Contracting power can be restricted.Further, since above-mentioned, distance that protruding portion 5351 can extend from the platform 5311 of warehouse 5310 can be by Limitation.In all cases, protruding portion 5351 may include the variable response to the organization type and/or tissue thickness that are sewn. For example, when organizing thinner and/or more flexible, protruding portion 5351 can be further from compared to when organizing thicker and/or more rigid Platform 5311 is disposed.Under any circumstance, being slidably matched between driver 5340 and protruding portion 5351 can prevent tissue from being dashed forward 5351 overcompression of portion out.
Than that described above, protruding portion 5351 can float relative to storehouse platform 5311.In all cases, protruding portion 5351 can It is dynamically responsive to the compression pressure formed in the tissue being trapped between anvil block 20 and nail bin 5300.In at least one situation Under, firing member 2760 can be pushed when firing member 2760 is promoted towards distal side towards 5300 cam of nail bin or mobile anvil block 20. When anvil block 20 is mobile towards nail bin 5300, tissue can be compressed by anvil block 20, wherein in response to this, protruding portion 5351 can be downward Movement is retracted into such as warehouse 5310.
In all cases, nail bin may include the protruding portion rigidly extended from the platform of warehouse.In at least one situation, Platform and protruding portion can not be moved relative to each other.In other cases, platform can be mobile relative to protruding portion.In at least one Under such circumstances, protruding portion can firmly extend from warehouse, and platform may include movable surface.When tissue is compressed in When between anvil block and such nail bin, platform can be moved down relative to protruding portion.Platform can be in first position and the second position Between move.When platform is in its first position, protruding portion can not extended on the top surface of platform.In such case Under, when platform is in its first position, protruding portion can be recessed lower than the top surface of platform.When platform is moved to its second When setting middle, protruding portion can be exposed and be extended on the top surface of platform.Alternatively, when platform be in its first position and When its second position, protruding portion can extend over top platform surface.In either case, wherein platform relative to protruding portion Mobile distance can be the function for being applied to the pressure of tissue.For example, when applying larger compressing force to tissue, platform moveable Relatively large distance, and when applying smaller compressing force to tissue, platform moveable small distance.Top platform surface may be in response to It is applied to its compression pressure and floats.Certain embodiments are susceptible to, wherein platform includes single piece of material.It is susceptible to other realities Scheme is applied, wherein platform includes multiple portions.In at least one such embodiment, each part can be independently of other parts It makes a response.In all cases, the elastic material that platform can be deflected by the compression pressure that may be in response to be applied to it is constituted. In at least one situation, platform can be made of such as foam.In some cases, platform can be by such as oxidized regenerated cellulose It constitutes.Platform can be made of implantable material or implantable material.Platform, which had both been implanted into, can not also be implanted to patient's body.? In various situations, platform may include being defined in hole therein, and the hole allows the relative movement between platform and protruding portion.? Under such circumstances, hole may include through-hole at least one, and protruding portion can be positioned in through-hole.In some cases, Kong Ke Including clearance slot, the clearance slot extends around nail cavity and the one or more protruding portions extended around nail cavity.Work as nail When ejecting from nail cavity, nail may pass through the opening provided by clearance slot.In some cases, at least part of platform can be by following closely Capture is to be implanted into platform against the tissue being sewn.
In all cases, nail bin disclosed herein may include auxiliary material.Auxiliary material may include at least one material The bed of material, at least one described material layer are located on the platform of nail bin and are for example implanted to patient from the nail of cartridge deployment In.In all cases, at least one layer of material may include such as backing material and/or tissue thickness compensation part.It is described extremely A few material layer can be by such as Gore SeamGuard material, Synovis Peri-Strips material and/or polyurethane group At.The multiple bibliography for disclosing such layer have been incorporated by reference.On 2 28th, the 2013 entitled " LAYER submitted The U.S. Patent Application Serial Number 13/763,095 of ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES " is (existing For U.S. Patent Application Publication 2013/0161374) complete disclosure it is incorporated herein by reference.June 25 in 2012 Entitled " the TISSUE STAPLER HAVING A THICKNESS COMPENSATOR COMPRISING that day submits The U.S. Patent Application Serial Number 13/531,619 of INCORPORATING A HEMOSTATIC AGENT " (is now United States Patent (USP) Shen Qing Publication 2012/0318842), entitled " the TISSUE STAPLER HAVING A that submits on June 25th, 2012 The U.S. Patent application of THICKNESS COMPENSATOR INCORPORATING AN OXYGEN GENERATING AGENT " Sequence number 13/531,623 (being now U.S. Patent Application Publication 2012/0318843), on June 25th, 2012 are submitted entitled “TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORATING AN ANTI- The U.S. Patent Application Serial Number 13/531,627 of MICROBIAL AGENT " (is now U.S. Patent Application Publication 2012/ And entitled " the TISSUE STAPLER HAVING A THICKNESS that submits on June 25th, 2,012 0312860) The U.S. Patent Application Serial Number 13/ of COMPENSATOR INCORPORATING AN ANTI-INFLAMMATORY AGENT " The complete disclosure of 531,630 (being now U.S. Patent Application Publication 2012/0318844) is incorporated herein by reference. Layer can be made of bioabsorbable material and/or non-bioabsorbable material.In some cases, material layer could attach to flat Platform.In at least one situation, layer is releasably attached to platform using at least one adhesive.In some cases, Material layer is releasably attached to platform using for example one or more suture line or belts.In some cases, the layer can Including solid material piece.In some cases, layer may include being defined in hole therein.It is at least one under such circumstances, layer It can be used together with such as nail bin 2000, and may include for example being defined in hole, slit and/or slit therein, it is the hole, narrow Seam and/or slit are aligned with the protruding portion 2051 and/or protruding portion 2053 extended from the platform 2011 of nail bin 2010.In certain feelings Under condition, hole may include the through-hole or window for extending fully through layer.Such as such as blade type can be used in hole, slit and/or slit Cutting element is cut in layer.In some cases, such as hole, slit and/or slit can be formed in such as moulding layer.? In some cases, such as such as laser cutting parameter can be used to be formed in layer for hole, slit and/or slit.In some cases, Hole may include the groove for not extending completely through layer being defined in layer.In all cases, protruding portion can be closely received in Make to prevent or at least limit the relative movement between warehouse 2010 and layer in hole.It is at least one under such circumstances, Interference fit may be present between protruding portion and the side wall in hole.
Than that described above, auxiliary layer can be made of such as weaving layer and/or non-woven layer.Layer can be made of such as film.? In various situations, layer may include the texture for example extending therefrom that can be prevented or at least limit flowing of the tissue relative to nail bin Surface, protruding portion and/or protrusion.Layer may include first group of region and second group of region, and first group of region is by from nail bin top Nail joint out is closed and/or is captured in the nail, and second group of region is not closed or captured in the nail by the nail joint.? In various situations, second group of region can be modified.In at least one situation, layer can be made of film, and second group of region of film It can be modified to include such as hole, slit and/or slit.In at least one situation, the periphery of such layer may include being defined in The notch at the edge therein for softening layer.In some cases, cut-out pattern can be made in layer.As at least one In the case of, cut-out pattern may include the notch for example extended relative to each other with 45 degree of angles.In some cases, the depth of notch Degree, width and/or spacing can be arbitrarily.Above-mentioned notch can make more flexible film layer, draftability and/or flexibility.It is above-mentioned Notch can be fabricated on for example woven or nonwoven material.Any suitable technique can be used, such as by mechanical bit system And/or laser cutting system, to make above-mentioned notch.It in all cases, can not be first group of modifying layer as discussed above Region.
As discussed above, the layer being made of solid material piece can be modified to make more flexible layer, draftability and/or soft It is pliable.Layer can be assembled by the several material pieces being bonded together.In at least one situation, between the material piece of bonding Such as hole, slit and/or slit may be present.It in some cases, can be by the tape welding of the stiff absorbable polymer of height It is connected in relatively thin more flexible film to provide stretching in certain anticipated orientations and limit the stretching on other directions.Such item Band can also be used in the high stress portion for enhancing film, while the other parts of film being allowed to keep soft and submissive.Realize this effect A kind of mode will make several thin strips, the thin strip is made of harder polymer such as Vicryl.These bands Can be wide for such as about 0.015 " to 0.030 ", and extend the whole length of such as staple line.Six bands can be arranged with six The staple line of a longitudinal direction staple laterally spreads correspondence.Then, thin continuous film layer can be welded to this six bands, the film layer is Such as about 0.003 " to 0.005 " is wide and by the polymer of soft and elastic such as Monocryl or 36/64PGA/PCL group At.In some cases, compression moulding moulding process can be used.It as a result will be that there is soft side and be easy to lateral rather than longitudinal drawing The highly reinforcing staple line for the ability stretched.The band extended from film, which even can produce, will make the tissue on the film in desired direction Flow the towed holding feature structure minimized.In some cases, it can modify and to be made of weaving and/or non-woven material Some regions of the layer so as to cured layer, such as first group of region.And then can lead to by flat extrusion fiber weaving at band, Cross using felt and/or another technology based on heat, can will such as first group of area fusing together to be solidified.One In a little situations, the whole of layer can be fused together.
As discussed above, nail bin may include the protruding portion extended from warehouse.In addition to or instead of these protruding portions, anvil block can Including protruding portion extending therefrom, the protruding portion is configured to: one, control stream of the tissue relative to anvil block and warehouse It is dynamic;Two, extend nail cavity from the opposite side of tissue;And/or three, it supports and/or guides when nail is just ejected from nail cavity Nail.
Anvil block 3320 is shown in Figure 66 and Figure 67.Anvil block 3320 may include distal end 3323, proximal end 3326, with And tissue engagement surface 3321.Anvil block 3320 may also include pivot 3327, and anvil block 3320 can be around the pivot in open position It is rotated between closed position.Anvil block 3320, which may also include, is defined in longitudinal slit 3325 therein, and the longitudinal slit is by structure It causes a part of percussion and/or cutting element can be received wherein.Anvil block 3320 may also include side, and the side can Including longitudinally projecting portion extending therefrom or wall 3323.In all cases, longitudinal wall 3323 may include such as scalloped surface. In some cases, longitudinal wall 3323 may include such as flat surfaces.Similar to above-mentioned, wall 3323 can be limited or be hindered for example Organize the lateral flow relative to anvil block 3320.
In addition to described above, anvil block 3320 may include being defined in multiple nail shapes pits 3322 therein, the nail forming Pit may be disposed to longitudinal row, and longitudinal row can be aligned with the nail cavity being defined in nail bin.For example, forming pit 3322 can quilt It is arranged in the row 3328b among most interior row 3328a, most outlet 3328c and most interior row 3328a and most outlet 3328c.Extremely In a kind of few situation, each nail shapes pit 3322 may include first or distal side forming cup 3322a and second or nearside forming cup 3322b.First forming cup 3322a is configured to receive and deform the first leg of nail, and the second forming cup 3322b It is configured to receive and deform the second leg of nail.First forming cup 3322a and the second forming cup 3322b can be by planes 3322c is separated.Anvil block 3320 may also include tissue engagement protruding portion 3324.Protruding portion 3324 can be positioned on the first forming cup Among 3322a and the second forming cup 3322b.First protruding portion 3324 can be positioned in the first side of plane 3322c and second Protruding portion 3324 can be positioned in the second side of plane 3322c.The protruding portion 3324 extended from anvil block 3320 can with from nail bin The protruding portion cooperation of extension is to guide and support the nail just ejected from nail bin.In at least one situation, anvil block protruding portion 3324 It is interlockable with nail bin protruding portion.In all cases, storehouse protruding portion can extend from the end of nail cavity and anvil block protruding portion 3324 can It is located among the supermedial storehouse protruding portion of such as nail cavity.Anvil block protruding portion 3324 and storehouse protruding portion can cooperate so that nail cavity is prolonged It stretches and is supported when nail is just formed against anvil block 3320 and guide nail.The storehouse protruding portion extended from the end of nail cavity can be in nail leg Appear and support and guide when contacting anvil block 3320 leg of nail from nail cavity.When nail leg deformation in forming cup 3322a, 3322b When, nail leg can be supported by the protruding portion 3324 extended from anvil block and guiding.In all cases, nail leg can be simultaneously by storehouse protruding portion It supports and guides with anvil block protruding portion 3324.In some cases, nail leg can be supported by storehouse protruding portion and anvil block protruding portion 3324 And guidance, but be not simultaneously.
In all cases, forming cup 3322a, 3322b are configured to receive from the prominent of nail bin therein extension At least part in portion out.It is at least one under such circumstances, each forming cup 3322a, 3322b may include wide outer end and narrow Inner end, the width outer end are configured to receive the protruding portion extended from nail bin.The wide outer end of forming cup 3322a, 3322b are also It is configured to initially receive nail leg.Forming cup 3322a, 3322b may also include curved surface, the curved surface quilt It is constructed to be permeable to towards forming cup 3322a, the narrow inner end of 3322b is oriented to nail leg.Then nail leg can exit forming from narrow inner end Cup 3322a, 3322b, wherein protruding portion 3324 is configured to support and guide nail leg.Each forming cup 3322a, 3322b can be wrapped Include the angled faces among wide outer end and narrow inner end.Nail leg, limitation in angled faces bootable forming cup 3322a, 3322b The lateral movement of nail leg and improve being aligned for nail leg and narrow inner end.
Than that described above, protruding portion 3324 can engage tissue in suture and/or transecting patient tissue and keep tissue just Position.In some cases, each protruding portion 3324 may include the putting down including flat surfaces extended from tissue engagement surface 3321 Platform.Figure 89 shows the alternate embodiment including anvil block 5220, and the anvil block is recessed including being defined in forming therein Hole 3322 and tissue extending therefrom engage protruding portion 5224.Similar to protruding portion 3224, each protruding portion 5224 may include The terrace part 5224a and flat surfaces 5224b for being configured to engagement tissue.In addition, each protruding portion 5224 can wrap Include the transitional surface 5224c among terrace part 5224a and flat surfaces 5224c.In all cases, transitional surface 5224c may include such as radius.In some cases, transitional surface 5224c may include such as inclined-plane.
Anvil block 5120 is shown in Figure 87 and Figure 88.Anvil block 5120 may include distal end 5123, proximal end 5126, with And tissue engagement surface.Tissue engagement surface may include ladder.For example, tissue engagement surface may include such as the first ladder 5121' and the second ladder 5121 ".Second ladder 5121 " can be higher than the first ladder 5121' and can extend from the first ladder 5121'. Anvil block 5120 may also include pivot 3327, and anvil block 3320 can rotate between the open position and the closed position around the pivot. Anvil block 5120, which may also include, is defined in longitudinal slit 5125 therein, the longitudinal slit be configured to will to fire and/or A part of cutting element receives wherein.Anvil block 5120 may also include side 5123, and the side both may include that can not also wrap Include longitudinally projecting portion extending therefrom or wall.In all cases, higher second ladder 5121 " can neighbouring longitudinal slit 5125, And the first ladder 5121 ' can adjacent side face 5123.In all cases, compared with the first ladder 5121', the second ladder 5121 " Bigger compressing force can be applied to tissue.In various optionally embodiments, higher second ladder 5121 " can be with 5123 phase of side It is adjacent and the first ladder 5121' can be adjacent with longitudinal slit 5125.Although anvil block 5120 includes two ladders, anvil block 5120 can be wrapped Include more than two ladder.Under any circumstance, anvil block 5120 may include between the first ladder 5121 ' and the second ladder 5121 " What is extended can promote ramped surfaces 5128 " of the anvil block 5120 relative to tissue positioning.
In addition to described above, anvil block 5120 may include being defined in multiple nail shapes pits 5122 therein, the nail forming Pit can be arranged to longitudinal row, and longitudinal row can be aligned with the nail cavity being defined in nail bin.In all cases, most outlet Forming pit 5122 can be limited in the first ladder 5121 '.Most interior row's forming pit 5122 and intermediate row forming pit 5122 can It is limited in such as the second ladder 5121 ".Other embodiments are susceptible to, wherein intermediate row forming pit 5122 is limited to first In ladder 5121 '.Under any circumstance, anvil block 5120 may include tissue engagement protruding portion 5124 extending therefrom.In various feelings Under condition, each protruding portion 5124 may include such as H-shaped configuration.Protruding portion 5124 can be between for example adjacent forming pit 5122 Extend.Protruding portion 5124 can extend between the adjacent forming cup in such as forming pit 5122.In all cases, protruding portion 5124 can be around the end of forming cup to support and guide the nail leg formed by forming cup.Protruding portion 5124 can be recessed along for example shaping The side in hole 5122 extends.Protruding portion 5124 can prolong along such as side of the first forming pit 5122 and the second forming pit 5122 It stretches.The side of forming pit 5122 can be for example parallel.In all cases, the nail in the bootable forming cup of protruding portion 5124 Leg and the lateral movement for limiting nail leg.Figure 88 shows the protruding portion 5124 on every side of forming pit 5122.Figure 88 Also show the protruding portion 5124 on every side of the forming cup of forming pit 5122.In various other embodiments, Protruding portion can only one more only and/or in the forming cup of forming pit 5122 in the forming pit 5122 of neighbouring anvil block 5120 A little positioning.
It in all cases, can height having the same from the protruding portion that anvil block extends.In other cases, prolong from anvil block The protruding portion stretched can have different height.Turning now to Figure 69, anvil block 3520 may include tissue engagement surface 3321 and limit Due to the longitudinal slit 3325 of a part therein for being configured to receive percussion and/or cutting element.Anvil block 3520 is also It may include side, the side may include longitudinally projecting portion extending therefrom or wall 3323.It is similarly as described above, anvil block 3520 May include forming pit, the forming pit be disposed in most interior row 3328a, most outlet 3328c and most interior row 3328a with most In row 3328b among outlet 3328c.In all cases, anvil block 3520 may include for example adjacent with most interior row 3328a indulges To ranked first protruding portion 3551a, the longitudinal direction adjacent with intermediate row 3328b ranked second protruding portion 3551b and with most outlet 3228c adjacent longitudinal direction ranked third protruding portion 3551c.First protruding portion 3551a can extend first from tissue engagement surface 3221 Distance and the second protruding portion 3551b can extend the second distance different from first distance from tissue engagement surface 3221.Third is prominent Portion 3551c can extend the third distance that may differ from first distance and/or second distance from tissue engagement surface 3221 out.Each In the case of kind, third protruding portion 3551c can be higher than the second protruding portion 3551b and the second protruding portion 3551b can be higher than first and protrude Portion 3551a.In various optionally embodiments, protruding portion 3551a can be with such as intermediate row 3328b and/or most outlet 3328c phase Neighbour's positioning, protruding portion 3551b can be with for example most interior row 3328a and/or most outlet 3328c adjacent positioned and/or protruding portion 3551c can be with for example most interior row 3328a and/or intermediate row 3328b adjacent positioned.
Anvil block 3420 is as shown in Figure 66.Anvil block 3420 may include distal end 3423, proximal end and tissue table of joint Face 3321.Anvil block 3420 may also include pivot 3327, anvil block 3420 can around the pivot open position and closed position it Between rotate.Anvil block 3420, which may also include, is defined in longitudinal slit 3325 therein, and the longitudinal slit is configured to hit A part of hair and/or cutting element receives wherein.Anvil block 3420 may also include side, and the side may include from its extension Longitudinally projecting portion or wall 3323.Anvil block 3420 may include being defined in multiple nail shapes pits 3322 therein, the nail forming Pit may be disposed to longitudinal row, and longitudinal row can be aligned with the nail cavity being defined in nail bin.In all cases, except it is above-mentioned with Outside, anvil block 3420 may include protruding portion extending therefrom.For example, anvil block 3420 may include pyramid protruding portion extending therefrom 3051 and/or dome-shaped protruding portion 3151.Protruding portion 3051 and/or protruding portion 3151 can improve the clamping that can apply to tissue Power.
In all cases, anvil block and from anvil block extend protruding portion can be made of single piece of material.In at least one situation Under, protruding portion can be integrally formed with anvil block.Anvil block and protruding portion can be made of metal material such as stainless steel, and can be for example It is formed during machining and/or moulding process.In some cases, protruding portion may fitted to anvil block.In at least one situation Under, protruding portion may be affixed to such as warehouse.Anvil block and protruding portion can be made of identical material or different materials.At least one In the case of kind, anvil block can be made of metal material and protruding portion can by elastic material such as rubber, thermoplastic elastomer (TPE) and/or Santoprene is formed.In all cases, protruding portion can be made of pliable material and can not damage the tissue compressed by protruding portion.It is prominent Portion 3051 and/or protruding portion 3151 can for example be formed by elastic material such as rubber, thermoplastic elastomer (TPE) and/or santoprene out. In at least one situation, anvil block can be formed during machining and/or moulding process, and protruding portion can be used than composition The material that the material of anvil block is more flexible is formed on anvil block during moulding process.In all cases, protruding portion 3051 and/or 3151 for example may include texture anvil faces.In some cases, protruding portion 3051 and/or 3151 for example can be by having than anvil block The material of high coefficient of friction is constituted.Such embodiment can improve the grasping force between anvil block and tissue.
Than that described above, anvil block may include uniform protruding portion array extending therefrom.In other cases, array can not be Uniformly.Referring again to Figure 68, protruding portion 3051 can extend on the first side of longitudinal slit 3325 from anvil faces 3321 and Protruding portion 3151 can extend in second side of longitudinal slit 3325 from anvil faces 3321.In all cases, protruding portion can It is positioned relative to such as forming pit 3322 in distal side.In some cases, protruding portion may be interspersed between forming pit 3322.It is prominent Out portion can from the surface 3429a being for example limited among most internal shaping pit 3322 and slit 3325, to be limited to most internal shaping recessed The surface 3429b of 3322 centre of hole 3322 and intermediate forming pit, intermediate forming pit 3322 and outermost forming pit are limited to The surface 3429c of 3322 centres, and/or the surface 3429d extension for being limited to outermost forming pit 3322 with 3323 centre of side wall.
Figure 98 shows anvil block 5920.Anvil block 5920 may include that distal end 5923, proximal end 5926 and tissue connect Close surface 5921.Anvil block 5920 may also include the tissue engaging member extended from surface 5921, and the tissue engaging member is by structure It causes to prevent or limit flowing of the tissue relative to anvil block 5920.In at least one situation, anvil block 5920 may include example Such as protruding portion 5924 ' and protruding portion 5924 ".Protruding portion 5924 " can be higher than protruding portion 5924'.This difference in height is by size 5925 It indicates.As shown in Figure 98, protruding portion 5924 " can be positioned relative to protruding portion 5924' in distal side.In all cases, protruding portion 5924 " and protruding portion 5924' can be a part of longitudinal row's protruding portion.In some cases, protruding portion 5924 " and protruding portion 5924' can be a part of different longitudinal row's protruding portions.In some cases, although being not shown, protruding portion 5924' can be opposite It " is positioned in distal side in protruding portion 5924.
In all cases, anvil block disclosed herein may include auxiliary material.Auxiliary material may include for example being located in At least one layer of material of patient's body is implanted on the tissue engagement surface of anvil block and by the nail from cartridge deployment.In various feelings Under condition, at least one layer material may include such as backing material and/or tissue thickness compensation part.At least one described material layer It can be made of such as Gore SeamGuard material, Synovis Peri-Strips material and/or polyurethane.Such layer is disclosed Multiple bibliography be incorporated by reference.On 2 28th, 2013 entitled " the LAYER ARRANGEMENTS submitted The U.S. Patent Application Serial Number 13/763,095 of FOR SURGICAL STAPLE CARTRIDGES " (is now United States Patent (USP) Shen The complete disclosure that please be announced 2013/0161374) is incorporated herein by reference.On June 25th, 2012 title submitted For " TISSUE STAPLER HAVING A THICKNESS COMPENSATOR COMPRISING INCORPORATING A The U.S. Patent Application Serial Number 13/531,619 of HEMOSTATIC AGENT " (is now U.S. Patent Application Publication 2012/ 0318842) entitled " the TISSUE STAPLER HAVING A THICKNESS that, on June 25th, 2012 submits The U.S. Patent Application Serial Number 13/ of COMPENSATOR INCORPORATING AN OXYGEN GENERATING AGENT " Entitled " the TISSUE that 531,623 (being now U.S. Patent Application Publication 2012/0318843), on June 25th, 2012 submit STAPLER HAVING A THICKNESS COMPENSATOR INCORPORATING AN ANTI-MICROBIAL AGENT” U.S. Patent Application Serial Number 13/531,627 (being now U.S. Patent Application Publication 2012/0312860) and in June, 2012 Entitled " the TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORATING submitted for 25th The U.S. Patent Application Serial Number 13/531,630 of AN ANTI-INFLAMMATORY AGENT " (is now U.S. Patent application public affairs Cloth 2012/0318844) complete disclosure it is incorporated herein by reference.Layer can by bioabsorbable material and/or not Bioabsorbable material is constituted.In some cases, material layer could attach to anvil block.In at least one situation, using extremely Layer is releasably attached to anvil block by a kind of few adhesive.In some cases, material layer is using such as one or more seam It closes line or belt and is releasably attached to anvil block.In all cases, layer may include protruding portion extending therefrom, and the protruding portion can It extends in the forming pit being defined in anvil block.Protruding portion can be arranged to array or pattern pair with forming pit in anvil block Neat array or pattern.In at least one situation, protruding portion can be snugly fit inside in forming pit.Protruding portion can be constructed At can limiting layer relative to the lateral of anvil block and/or longitudinal movement.
In some cases, layer may include solid material piece.In some cases, layer may include being defined in hole therein. Layer can be used together with such as anvil block 3320 under such circumstances at least one, and may include for example be defined in it is therein Hole, slit and/or slit, the hole, slit and/or slit and the protrusion extended from the tissue engagement surface 3321 of anvil block 3320 Portion's alignment.In some cases, hole may include the through-hole or window for extending fully through layer.Such as hole, slit and/or slit can It is cut in layer using such as blade type cutting element.In some cases, such as hole, slit and/or slit can be for example It is formed when moulding layer.In some cases, such as such as laser cutting parameter can be used to be formed in layer for hole, slit and/or slit In.In some cases, hole may include the groove for not extending completely through layer being defined in layer.In all cases, prominent Portion, which can be closely received in hole, to prevent or at least limit the relative movement between anvil block 3320 and layer.In at least one Under such circumstances, interference fit may be present between protruding portion and the side wall in hole.
Than that described above, auxiliary layer can be made of such as weaving layer and/or non-woven layer.Layer can be made of such as film.? In various situations, layer may include the texture for example extending therefrom that can be prevented or at least limit flowing of the tissue relative to anvil block Surface, protruding portion and/or protrusion.Layer may include first group of region and second group of region, and first group of region is by from nail bin top Nail joint out is closed and/or is captured in the nail, and second group of region is not closed or captured in the nail by the nail joint.? In various situations, second group of region can be modified.In at least one situation, layer can be made of film, and second group of region of film It can be modified to include such as hole, slit and/or slit.In at least one situation, the periphery of such layer may include being defined in The notch at the edge therein for softening layer.In some cases, cut-out pattern can be made in layer.As at least one In the case of, cut-out pattern may include the notch for example extended relative to each other with 45 degree of angles.In some cases, the depth of notch Degree, width and/or spacing can be arbitrarily.Above-mentioned notch can make more flexible film layer, draftability and/or flexibility.It is above-mentioned Notch can be fabricated on for example woven or nonwoven material.Any suitable technique can be used, such as by mechanical bit system And/or laser cutting system, to make above-mentioned notch.It in all cases, can not be first group of modifying layer as discussed above Region.
As discussed above, the layer being made of solid material piece can be modified to make more flexible layer, draftability and/or soft It is pliable.Layer can be assembled by the several material pieces being bonded together.In at least one situation, between the material piece of bonding Such as hole, slit and/or slit may be present.It in some cases, can be by the tape welding of the stiff absorbable polymer of height It is connected in relatively thin more flexible film to provide stretching in certain anticipated orientations and limit the stretching on other directions.Such item Band can also be used in the high stress portion for enhancing film, while the other parts of film being allowed to keep soft and submissive.Realize this effect A kind of mode will make several thin strips, the thin strip is made of harder polymer such as Vicryl.These bands Can be wide for such as about 0.015 " to 0.030 ", and extend the whole length of such as nail shapes pit line.It can arrange six items Band is corresponding laterally to spread with the staple line of six longitudinal staples.Then, thin continuous film layer can be welded to this six bands, institute Stating film layer is such as about 0.003 wide " to 0.005 " and by the polymer of soft and elastic such as Monocryl or 36/ 64PGA/PCL composition.In some cases, compression moulding moulding process can be used.It as a result will be that there is soft side and be easy to lateral Rather than the highly reinforcing staple line of the ability of longitudinal stretching.The band extended from film, which even can produce, will make along desired direction Film on tissue flowing minimize towed holding feature structure.In some cases, it can modify by weaving and/or non-knit The layer of producing material material composition is so as to some regions of cured layer, such as first group of region.Can by flat extrusion fiber weaving at band, And then, by using felt and/or another technology based on heat, can will such as first group of area fusing together with will It solidifies.In some cases, the whole of layer can be fused together.
Disclosed herein is the various embodiments for including the nail being removedly stored in nail bin, the nail is at one or more It is end-to-end arrangement in a longitudinal row.Similarly, disclosed herein is the various embodiments including anvil block, the anvil block include with The nail shapes pit of corresponding end-to-end arrangement.It is susceptible to other nails and arrangement of nail-forming pit, and these cloth It sets and may be adapted to embodiments disclosed herein.Such arrangement may include or may not include end-to-end arrangement.On May 29th, 2012 Entitled " the SURGICAL STAPLING SYSTEMS AND STAPLE CARTRIDGES FOR DEPLOYING announced All public affairs of the United States Patent (USP) 8,186,560 of SURGICAL STAPLES WITH TISSUE COMPRESSION FEATURES " Content is opened to be herein incorporated by reference.On 2 5th, 2013 entitled " the SURGICAL STAPLES HAVING announced DISSOLVABLE,BIOABSORBABLE OR BIOFRAGMENTABLE PORTIONS AND STAPLING The complete disclosure of the United States Patent (USP) 8,365,976 of INSTRUMENTS FOR DEPLOYING THE SAME " is with the side of reference Formula is incorporated herein.
Figure 19 to Figure 22 shows recycling or motor-driven surgical can not be recycled to cut and fastening instrument 1010. In the shown embodiment, instrument 1010 includes shell 1012, and the shell includes being configured to be grabbed by clinician The shank 1014 held, manipulate and activated.Shell 1012 is configured to be operatively attached to interchangeable shaft assembly 1200, this can It exchanges shaft assembly and has and be configured to execute the outer of one or more surgical tasks or operation with what it was operatively coupled Section's end effector 1300.With continued reference to present embodiment, it should be understood that various forms of interchangeable axis disclosed herein The surgery system that the various unique and novel structures of component can also be controlled effectively with robot is used together.Therefore, art Language " shell " can also cover the receiving of robot system or in other words be operably supported the shell of at least one drive system Or similar portions, wherein at least one described drive system be configured to generate and apply can be used for activating it is disclosed herein Interchangeable shaft assembly and its corresponding equivalent at least one control movement.Term " frame " can refer to hand-held surgical instrument A part.Term " frame " can also indicate a part of the surgical instruments of robot control and/or can be used for robot system In a part for being operatively controlled surgical instruments.For example, interchangeable shaft assembly disclosed herein can with entitled “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS” U.S. Patent Application Serial Number 13/118,241 (be now each disclosed in U.S. Patent Application Publication US 2012/0298719) Kind robot system, instrument, component and method are used together.Entitled " SURGICAL STAPLING INSTRUMENTS The U.S. Patent Application Serial Number 13/118,241 of WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS " It (is now incorporated by reference and is incorporated herein for U.S. Patent Application Publication US 2012/0298719).
Shell 1012 shown in Figure 19 to Figure 21 is shown and the interchangeable shaft assembly including end effector 1300 1200 connections, the end effector include being configured to that surgery nail bin 1304 is operationally supported in surgery therein Cutting and clamp device.Shell 1012 can be configured to connect with the interchangeable shaft assembly for including end effector, the end Portion's actuator is suitable for supporting the nail bin of different sizes and type, has not coaxial length, size and type, etc..In addition, shell 1012 can also effectively be used together with various other interchangeable shaft assemblies, and other interchangeable shaft assemblies include being configured to Other movements and form of energy can be applied to the end effector arrangement being used in combination that is suitable for applying and performing the operation with various surgeries Those of (such as radio frequency (RF) energy, ultrasonic energy and/or movement) component.In addition, end effector, shaft assembly, shank, outer Section's instrument and/or surgical instrument system can use any suitable one or more fasteners with fastening tissue.E.g., including The fastener cartridge for the multiple fasteners being removedly stored therein can be removably inserted into and/or be attached to the end of shaft assembly Portion's actuator.
Figure 19 shows the surgical instruments 1010 with the interchangeable shaft assembly 1200 being operatively coupled with it.Figure 20 and Figure 21 shows the attachment of interchangeable shaft assembly 1200 to shell 1012 or shank 1014.As shown in Figure 21, shank 1014 can Handle shell section 1016 and 1018 can be interconnected including a pair, this to can interconnect handle shell section can be by screw, snap in features knot The interconnection such as structure, adhesive.In shown arrangement, handle shell section 1016,1018 cooperation with formed can by clinician grasp and The pistol grip portion 1019 of manipulation.As that will discuss in further detail below, shank 1014 is operably supported therein Multiple drive systems, the drive system be configured to generate various controls movements and control movement is applied to and The corresponding portion of its interchangeable shaft assembly being operationally attached.
Referring now to Figure 21, shank 1014 may also include the frame 1020 for being operably supported multiple drive systems.For example, Frame 1020 can be operably supported be typically expressed as 1030 " first " or closure drive system, can be used " first " or It is closed interchangeable shaft assembly 1200 of the drive system will be closed and open movement is applied to and it is operationally attached or couples. In at least one form, closure drive system 1030 may include 1032 shape of closure trigger being pivotally supported by frame 1020 The actuator of formula.More specifically, as shown in figure 21, closure trigger 1032 is pivotally coupled to shell via pin 1033 1014.Such arrangement enables closure trigger 1032 to be manipulated by clinician, so that when clinician grasps shank 1014 When pistol grip portion 1019, closure trigger 1032 easily can be pivoted to " actuating " position from starting or " not activating " position It sets, and more particularly, is pivoted to compression or fully actuated position completely.Closure trigger 1032 can be by spring or other Bias structure (not shown) is biased to unactuated position.In various forms, closure drive system 1030 further includes pivotly It is connected to the closed connecting rod component 1034 of closure trigger 1032.Same as shown in Figure 21, closed connecting rod component 1034 can wrap The first closed connecting rod 1036 and the second closed connecting rod 1038 are included, first closed connecting rod and second closed connecting rod are via pin 1035 It is pivotally coupled to closure trigger 1032.Second closed connecting rod 1038 is also referred to as " attachment members " herein and wraps Include lateral attachment pin 1037.
Referring also to Figure 21, it can be observed that the first closed connecting rod 1036 can have latch wall or end 1039 disposed thereon, The closure release component 1060 that the latch wall or end were configured to and were pivotally coupled to frame 1020 cooperates.At least In a kind of form, closure release component 1060 may include with the locking pawl 1064 towards distal side protrusion being formed on Release button component 1062.Release button component 1062 can be released spring (not shown) and pivot in the counterclockwise direction.When facing When pistol grip portion 1019 of the bed doctor by closure trigger 1032 from its unactuated position towards shank 1014 presses, first is closed It closes connecting rod 1036 and is to pivot upwardly to that wherein locking pawl 1064 is fallen into and latch wall 1039 in the first closed connecting rod 1036 is protected Hold point of the engagement to prevent closure trigger 1032 from returning to unactuated position.Therefore, closure release component 1060 facilitate by Closure trigger 1032 is locked in fully actuated position.When clinician wishes to unlock closure trigger 1032 to allow its quilt When being biased to unactuated position, clinician simply pivotally closes release button component 1062, so that 1064 quilt of locking pawl It is moved to and is disengaged with the latch wall 1039 in the first closed connecting rod 1036.When locking pawl 1064 has been moved into and first When closed connecting rod 1036 is disengaged, closure trigger 1032 pivotably returns to unactuated position.Other closure touchings can also be used Send out device locking and release arrangement.
Arm 1061 can extend from closure release button 1062.Such as permanent magnet of magnetic element 1063 can be installed to arm 1061.When being closed release button 1062 and rotating from its first position to its second position, magnetic element 1063 can be towards circuit board 1100 is mobile.Circuit board 1100 may include at least one sensor for being configured to the movement of detection magnetic element 1063. In at least one embodiment, such as " Hall effect " sensor (not shown) can be installed to the bottom table of circuit board 1100 Face.Hall effect transducer is configured to be caused around detection Hall effect transducer by the movement of magnetic element 1063 Changes of magnetic field.Hall effect transducer can carry out signal communication with such as microcontroller, which can determine that closure is released Button 1062 is put whether in its first position, the opening structure of the microcontroller and closure trigger 1032 and end effector The unactuated position (its second position) of type, the actuating position with the closed configuration of closure trigger 1032 and end effector It sets and/or any position between first position and the second position is associated.
In at least one form, shank 1014 and frame 1020, which can be operatively supported at, herein referred to as fires Another drive system of drive system 1080, which, which is configured to fire to move, is applied to interchangeable axis group The corresponding portion for being attached to it of part.Percussion drive system 1080 is also referred to as " the second drive system " herein.Percussion is driven Dynamic system 1080 can be using the electric motor 1082 in the pistol grip portion 1019 of shank 1014.In various forms In, motor 1082 can be the DC brush drive motor of the maximum (top) speed for example with about 25,000RPM.In other arrangements In, motor may include brushless motor, wireless motor, syncmotor, stepper motor or any other suitable electric motor.Motor 1082 can be by may include that the power supply 1090 of removable power source group 1092 is powered in one form.As shown in Figure 21, for example, it is electric Source group 1092 may include being configured to be attached to the nearside casing part 1094 of distal side casing part 1096.Nearside casing part 1094 and distal side casing part 1096 be configured to operationally be supported in multiple batteries 1098 wherein.Battery 1098 can It respectively include such as lithium ion (" LI ") or other suitable batteries.Distal side casing part 1096 is configured to removably It is operatively attached to equally be operably coupled to the circuit board assemblies 1100 of motor 1082.Can be used can be connected in series it is more Power supply of a battery 1098 as surgical instruments 1010.In addition, power supply 1090 can be replaceable and/or chargeable.
As summarized above with respect to various other forms, electric motor 1082 may include operationally with gear reduction unit The rotatable shaft (not shown) that component 1084 joins, the The gear deceleration device assembly are engaged with the sliding tooth 1122 of one group or rack gear It is mounted in longitudinally movable drive member 1120.In use, polarity of voltage provided by power supply 1090 can be along clockwise Direction operation electric motor 1082, wherein can be reversed by the polarity of voltage that battery is applied to electric motor, so as to along counterclockwise Direction operation electric motor 1082.When electric motor 1082 rotates in one direction, drive member 1120 will be along distal direction " DD " is axially driven.When motor 82 is driven along opposite direction of rotation, drive member 1120 will be along proximal direction " PD " is axially driven.Shank 1014 may include switch, and the switch is configured to make to be applied to by power supply 1090 The pole reversal of electric motor 1082.As other forms as described herein, shank 1014 may also include sensor, the sensing Device is configured to detect the position of drive member 1120 and/or the wherein mobile direction of drive member 1120.
The actuating of motor 1082 can be controlled by the firing trigger 1130 being pivotably supported on shank 1014 System.Firing trigger 1130 can pivot between unactuated position and actuated position.Firing trigger 1130 can be by spring 1132 Or other bias structures are biased to unactuated position, so that when clinician discharges firing trigger 1130, it can be by spring 1132 or bias structure be pivoted to or return in other ways unactuated position.In at least one form, firing trigger 1130 can be positioned at closure trigger 132 " outside ", as discussed above.In at least one form, firing trigger is pacified Full button 1134 can be pivotally mounted to closure trigger 1032 via pin 1035.Safety switch 1134 can be positioned on percussion triggering Between device 1130 and closure trigger 1032, and there is the pivotal arm 1136 from its protrusion.Referring to fig. 21.Work as closure trigger 1032 when being in unactuated position, and safety switch 1134 is accommodated in shank 1014, and clinician possibly can not be easily at this time Ground touches the button and it is made to prevent the home activated to firing trigger 1130 and wherein firing trigger 1130 It is moved between the firing position that can be fired.When clinician presses closure trigger 1032, safety switch 1134 and percussion Trigger 1130 pivots downwards, and wherein they can then be manipulated by clinician.
As described above, at least one form, longitudinally movable drive member 1120 has the tooth being formed on The tooth 1122 of item is engaged for the respective drive gear 1086 with The gear deceleration device assembly 1084.At least one form further includes Manually actuable " relief " component 1140, the component are configured to make clinician in the case where motor 1082 disables Longitudinally movable drive member 1120 can manually be retracted.Succouring component 1140 may include manually being pivoted into The lever or relief handle assembly 1142 engaged with 1124 ratchet of tooth being also disposed in drive member 1120.Therefore, clinical doctor Life can manually retract drive member 1120 by using relief handle assembly 1142, so that drive member 1120 is along nearside Direction " PD " engagement.U.S. Patent Application Publication US2010/0089970 (being now United States Patent (USP) 8,608,045) discloses relief Structure and other components, structure and the system that can also be used together with various instruments disclosed herein.It is entitled “POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM " U.S. Patent Application Serial Number 12/249,117 (being now United States Patent (USP) 8,608,045) full text accordingly with Way of reference is incorporated to.
Turning now to Figure 20 and Figure 22, interchangeable shaft assembly 1200 includes surgical end-effector 1300, the surgical end Actuator includes being configured to that nail bin 1304 is operationally supported in elongated passageway 1302 therein.End effector 1300 may also include anvil block 1306, which is pivotally supported relative to elongated passageway 1302.Interchangeable shaft assembly 1200 may be used also Including actuated articulation joints 1270 and end effector 1300 can be made to be releasably held in expectation relative to axial line SA-SA Position joint motions lock.Construction and behaviour in relation to end effector 1300, actuated articulation joints 1270 and joint motions lock The details of work is in entitled " the ARTICULATABLE SURGICAL INSTRUMENT for being filed on March 14th, 2013 It is illustrated in the U.S. Patent Application Serial Number 13/803,086 of COMPRISING AN ARTICULATION LOCK ".It submits In entitled " the ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN on March 14th, 2013 The complete disclosure of the U.S. Patent Application Serial Number 13/803,086 of ARTICULATION LOCK " is accordingly by reference It is incorporated herein.Such as in Figure 22 as it can be seen that interchangeable shaft assembly 1200 may also include be made of nozzle segment 1202 and 1203 it is close Side shell or nozzle 1201.Interchangeable shaft assembly 1200 may also include closed tube 1260, the closed tube can be used for closing and/or Open the anvil block 1306 of end effector 1300.Shaft assembly 1200 may include backbone 1210, the backbone can (one) wherein Firing member is slidingly supported, and (two) slidingly support the closed tube 1260 extended around backbone 210.Backbone 210 is also It is configured to slidingly support proximal joint motion drive.Articulation drive has that be configured to can The operatively distal end of connecting joints movement lock.Joint motions lock and articulation frame join, and the articulation frame is suitable In the drive pin being operatively engaged on end effector frame.As noted above, in relation to joint motions lock and joint motions Other details of the operation of frame are found in U.S. Patent Application Serial Number 13/803,086.In all cases, backbone 1210 It may include the proximal end 1211 being pivotally supported in chassis 1240.In such as one arrangement, the nearside of backbone 1210 End 1211 has the screw thread 1214 formed thereon for by being threadably attached to backbone bearing 1216, the backbone bearing It is configured to be supported in chassis 1240.Referring to fig. 22.Such arrangement promotes backbone 1210 and is rotatably attached to bottom Disk 1240, so that backbone 1210 can selectively be rotated relative to chassis 1240 around axial line SA.
Referring primarily to Figure 22, interchangeable shaft assembly 1200 includes closure spindle moving part 1250, which slidingly supports Axially move it can relative to the chassis.It includes a pair of proximally outstanding for being closed spindle moving part 1250 Hook 1252, the hook are configured to be attached to attachment pin 1037 (Figure 20 and Figure 21), and the attachment pin is attached to the second closure Connecting rod 1038, is discussed in detail as discussed further below.The proximal end 1261 of closed tube 1260 is connected to closure spindle moving part 1250 To rotate relative to it.For example, U-shaped connector 1263 is inserted into the narrow annular slot 1262 in the proximal end 1261 of closed tube 1260 And it is maintained in the vertical slit 1253 in closure spindle moving part 1250.Such arrangement is for closed tube 1260 to be attached to relatively It is rotated in closure spindle moving part 1250 around axial line SA.Spindle moving part 1250 is closed axially to advance with it, while making closed tube 1260 can 1268 axle journal of closing spring be connected in closed tube 1260 and on proximal direction " PD " biased closed pipe 1260, this can be used for that closure trigger being pivoted in unactuated position when shaft assembly is operably linked to shank 1014.
In at least one form, interchangeable shaft assembly 1200 may also include actuated articulation joints 1270.However, other can Exchanging shaft assembly possibly can not carry out joint motions.It such as can be seen in fig. 22, for example, actuated articulation joints 1270 include double pivots Axis is closed sheath assembly 1271.According to various forms, double pivot closure sleeve assembly 1271 include have towards distal side it is outstanding on The end effector of tang 1273 and lower tang 1274 is closed sheath assembly 1272.End effector is closed sheath assembly 1272 and wraps Shape of a hoof hole 1275 and inserted sheet 1276 are included for be filed in the entitled " ARTICULATABLE on March 14th, 2013 The U.S. Patent Application Serial Number 13/ of SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK " Various modes described in 803,086 engage the opening inserted sheet on anvil block 1306, and the U.S. Patent application is by reference It is incorporated herein.If described in further detail herein, when anvil block 1306 is opened, shape of a hoof hole 1275 and inserted sheet 1276 are engaged Inserted sheet on anvil block.The double pivot links 1277 in top include the distally and proximally pivot pin projected upwards, the pivot pin difference Engage top distal side pin hole in the upper tang 1273 proximally outstanding in closed tube 1260 and towards distal side upper handle outstanding Top nearside pin hole in foot 1264.The double pivot links 1278 in lower part include the distally and proximally pivot pin projected upwards, described Pivot pin engages lower distal pin hole in proximally lower tang 1274 outstanding and respectively towards distal side lower tang outstanding Lower part nearside pin hole in 1265.See also Figure 22.
In use, closed tube 1260 is translated towards distal side (direction " DD "), so as to (for example) in response to closure trigger 1032 actuating and anvil block 1306 is closed.Anvil block 1306 is closed and being translated to the far side closed tube 1260, and therefore, axis Closure sheath assembly 1272 causes mode described in its U.S. Patent Application Serial Number 13/803,086 with aforementioned reference to be rushed Hit the proximal face on anvil block 1360.Also as detailed in this reference, anvil block 1306 is by proximally translating closed tube 1260 and axis closure sheath assembly 1272 and opens, cause inserted sheet 1276 and shape of a hoof hole 1275 contact and push anvil block inserted sheet with Promote anvil block 1306.In anvil block open position, axis closed tube 1260 is moved to its proximal position.
As also described above, interchangeable shaft assembly 1200 further includes hitting of being supported for axially advancing in axle ridge column 1210 Send out component.Firing member includes the intermediate percussion shaft portion 1222 for being configured to be attached to distal incision part or knife bar.In Between percussion shaft portion 1222 can its distal end include be configured to receive be located at distal blade bar proximal end on The longitudinal slit of inserted sheet.The size and construction of longitudinal slit and proximal end can be configured to allow relative motion therebetween, and It and may include slip joint.Slip joint, which allows the intermediate percussion shaft portion 1222 of percussion driver to be moved into, holds end Row device 1300 carries out joint motions, without mobile or at least substantially move knife bar.Once end effector 1300 is suitably Orientation, centre percussion shaft portion 1222 can be promoted towards distal side, until proximal sidewall and the inserted sheet of longitudinal slit are in contact, with Just it promotes knife bar and fires the nail bin being located in channel 1302.It is special that the further describing of the operation of firing member is found in the U.S. Sharp patent application serial numbers 13/803,086.
As it can be seen that shaft assembly 1200 further includes the switch drum being rotatably received in closed tube 1260 such as in Figure 22 1500.Switching drum 1500 includes hollow shaft section 1502, which has axis protrusion formed thereon, the axis protrusion For outwardly projecting actuating pin joint to be closed at wherein.In all cases, actuating pin, which extends through, is provided in indulging in lock tube Promote the axial movement of lock tube when lock tube is engaged with articulation drive to slit.Rotation torsionspring 1420 is constructed At a part of the protrusion and nozzle housing 1203 that can engage on switch drum 1500 bias force is applied to switch drum 1500.Switch drum 1500, which may also include, is defined at least partly peripheral openings 1506 therein, these openings are configured to Enough receive the periphery mounting base extended from nozzle half block 1202,1203, and allow to switch drum 1500 and nearside nozzle 1201 it Between relative rotation rather than relative translation.Mounting base extends also through the opening 1266 in closed tube 1260 to be placed in axle ridge In groove in column 1210.However, nozzle 1201 to mounting base reaches the end of its respective slots 1506 in switch drum 1500 The rotation of the point in portion will lead to the rotation that switch drum 1500 surrounds axial line SA.The rotation of switch drum 1500 will eventually lead to activate Pin and lock tube rotate between its bonding station and disengaging configuration.Therefore, generally, nozzle 1201 can be used for be filed in 2014 The United States Patent (USP) Shen of entitled " the SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM " on March 26, in The various modes that please be described in further detail in sequence number 13/803,086 and U.S. Patent Application Serial Number 14/226,142 can operate Joint motion drive system is engaged and is detached from percussion drive system by ground, in the respective entire disclosure of U.S. Patent application Appearance is hereby incorporated by reference.
Same as shown in figure 22, shaft assembly 1200 may include slip ring assembly 1600, which is configured to Such as conduct power to end effector 1300 and/or from its conduct power, and/or send the signal to end effector 1300 and/or receive from it signal.Slip ring assembly 1600 may include the chassis flange 1242 that installation extremely extends from chassis 1240 Proximal connector flange 1604, and the distal connector flange being located in the slit being defined in shaft housing.Nearside connection Device flange 1604 may include the first face and distal connector flange may include neighbouring first face positioning and can be relative to the first face Second face of movement.Distal connector flange can be rotated around axial line SA relative to proximal connector flange 1604.Nearside connects Connecing device flange 1604 may include the multiple concentric or at least substantially concentric conductor being defined in its first face.Connector can pacify On the nearside of connector flange and there can be multiple contacts, wherein each contact is corresponding and electric with one of the conductor Contact.Such arrangement allows the relative rotation between proximal connector flange 1604 and distal connector flange, while keeping it Between electrical contact.Proximal connector flange 1604 may include electric connector 1606, and the electric connector can place conductor Signal communication is carried out at the axis circuit board 1610 for being for example installed to axis chassis 1240.In at least one situation, including it is multiple The harness of conductor can extend between electric connector 1606 and axis circuit board 1610.Electric connector 1606 can extend proximally across The connector opening 1243 being defined in chassis mounting flange 1242.Referring to fig. 22.It is filed in the entitled of on March 13rd, 2013 The U.S. Patent Application Serial Number 13/800 of " STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM ", 067 is incorporated by reference and is incorporated herein.It is filed in entitled " the STAPLE CARTRIDGE TISSUE on March 13rd, 2013 The U.S. Patent Application Serial Number 13/800,025 of THICKNESS SENSOR SYSTEM ", which is incorporated by reference, to be incorporated herein. Other details in relation to slip ring assembly 1600 are found in U.S. Patent Application Serial Number 13/803,086.
As discussed above, shaft assembly 1200 may include that can be fixedly secured to the portions of proximal of shank 1014 and can surround The distal part of longitudinal axis rotation.Rotatable distal shaft part can be as discussed above around slip ring assembly 1600 relative to close Side section rotation.The distal connector flange of slip ring assembly 1600 can be positioned in rotatable distal shaft part.In addition, except above-mentioned In addition, switch drum 1500 is alternatively positioned in rotatable distal shaft part.When the rotation of rotatable distal shaft part, distal side connection Device flange and switch drum 1500 can rotate synchronously with one another.In addition, switch drum 1500 can be relative to distal connector flange the It is rotated between one position and the second position.When switching drum 1500 and being in its first position, joint motion drive system can It is operatively detached from percussion drive system, and therefore, the operation of percussion drive system can not be such that the end of shaft assembly 1200 executes Device 1300 does joint motions.When switch drum 1500 be in its second position when, joint motion drive system can operationally with Percussion drive system engagement, and therefore, the operation of percussion drive system can be such that the end effector 1300 of shaft assembly 1200 closes Section movement.When switch drum 1500 moves between its first position and its second position, switch drum 1500 connects relative to distal side It is mobile to connect device flange.In all cases, shaft assembly 1200 may include the position for being configured to detection switch drum 1500 At least one sensor.
Referring again to Figure 22, chassis 1240 includes tapered attached of at least one and preferably two formed thereon Socket part point 1244, the attachment part are adapted to be received in the correspondence in the distal side attachment flange portion 1700 for being formed in frame 1020 In dovetail slot 1702.Referring to fig. 21.Each dovetail slot 1702 can be tapered, or be slightly v-shaped in other words , seamlessly attachment part 1244 to be received in wherein.Such as can in Figure 22 further seen in, axis means of attachment lugs 1226 is in Between beating shaft 1222 proximal end on formed.As that will discuss in further detail below, when interchangeable shaft assembly 1200 When being connected to shank 1014, axis is attached ear 1226 and receives the percussion in the distal end 1125 for being formed in zigzag tread patterns component 1120 In axis attachment base 1126.Referring to fig. 21.
Shaft assembly 1200 is removably coupled to shell using latch system 1710 by various shaft assembly embodiments 1012, and more particularly, it is connected to frame 1020.Such as in Figure 22 it is seen, for example, at least one form, latch System 1710 includes the locking component or lock yoke 1712 for being movably coupled to chassis 1240.In the embodiment illustrated, for example, lock Yoke 1712 has U-shape, and there are two the legs 1714 extended downwardly spaced apart for shape tool.Leg 1714 respectively has shape At pivot ears 1715 thereon, the pivot ears are adapted to be received in the corresponding aperture 1245 being formed in chassis 1240.It is such Arrangement promotes lock yoke 1712 to be attached pivotally to chassis 1240.Locking yoke 1712 may include two proximally lock ears 1716 outstanding, The lock ear is configured to and corresponding in the distal side of frame 1020 attachment flange 1700 locks detent or groove 1704 can The engagement of release ground.Referring to fig. 21.In various forms, lock yoke 1712 by spring or biasing member (not shown) in a proximal direction Biasing.The actuating of lock yoke 1712 can realize that the latched press-button is slidably mounted in installation extremely by latched press-button 1722 On the latch actuator component 1720 on chassis 1240.Latched press-button 1722 can bias in a proximal direction relative to lock yoke 1712. If that will discuss in further detail below, lock yoke 1712 can be moved to unlock by biased latch button in a distal direction Position, this also result in lock yoke 1712 be switched to the distal side of frame 1020 attachment flange 1700 do not remain engaged with.When lock yoke 1712 And when the distal side of frame 1020 is attached flange 1700 " remaining engaged with ", lock ear 1716 is fixedly mounted on distal side attachment flange 1700 In corresponding locking detent or groove 1704 in.
When using include type described herein be suitable for cutting and the end effector of fastening tissue and other types of When the interchangeable shaft assembly of end effector, it may be necessary to prevent interchangeable shaft assembly from outer in the activating of end effector Shell is undesirably fallen off.For example, in use, closure trigger 32 may be actuated to grasp destination organization and be manipulated in clinician Desired position.Once destination organization is oriented desired orientation in end effector 1300, clinician can be complete Actuating closure trigger 1032 is to close anvil block 1306 and clamp destination organization in place to be cut and be sutured.In this feelings Under condition, the first drive system 1030 has been fully actuated.It, may after destination organization has been clamped in end effector 1300 It needs to prevent shaft assembly 1200 from undesirably falling off from shell 1012.A kind of form of latch system 1710 is configured to prevent here Class is undesirably fallen off.
Such as it can be seen that lock yoke 1712 includes at least one and preferably two latch hooks 1718, institute most specifically in Figure 22 It states latch hook and is adapted for contact with the correspondence lock ear part 1256 being formed on closure spindle moving part 1250.When closure spindle moving part 1250 is in not When actuated position (that is, first drive system 1030 does not activate and anvil block 1306 is opened), lock yoke 1712 can be in a distal direction It pivots to unlock interchangeable shaft assembly 1200 from shell 1012.When at that position, 1718 not contact closure shuttle of latch hook is dynamic Lock ear part 1256 on part 1250.However, when closure spindle moving part 1250 is moved to actuated position (that is, the first drive system 1030 actuating and anvil block 1306 it is in the close position) when, lock yoke 1712 be prevented from being pivoted to unlocked position.In other words, such as Fruit clinician attempts will to lock yoke 1712 and is pivoted to unlocked position, such as lock yoke 1712 may be otherwise caused to it Towards distal side pivotably by accident collision or contact, then the latch hook 1718 locked on yoke 1712 will be on contact closure spindle moving part 1250 Lock ear 1256 and prevent lock yoke 1712 be moved to unlocked position.
The attachment that interchangeable shaft assembly 1200 arrives shank 1014 will now be described.Start connection process, clinician can By the chassis 1240 of interchangeable shaft assembly 1200 be located in frame 1020 distal side attachment flange 1700 top or near so that shape It is aligned at the tapered attachment part 1244 on chassis 1240 with the dovetail slot 1702 in frame 1020.Then, clinician Shaft assembly 1200 can be moved along the mounting axis perpendicular to axial line SA attachment part 1244 to be positioned to and corresponding dovetail It receives slit 1702 " being operatively engaged ".When carrying out such operation, the axis on intermediate beating shaft 1222 is attached ear 1226 Also it will be placed in the pedestal 1126 of longitudinally movable drive member 1120, and the pin 1037 in the second closed connecting rod 1038 Part will be in the correspondence hook 1252 that be placed in closed yoke 1250.As used herein, in the context of two part devices, Term " being operatively engaged " refers to that described two components fully engage each other, so that once applying actuating movement, portion to it Its expected activity, function and/or program can be performed in part.
At least five systems of interchangeable shaft assembly 1200 can operationally it is corresponding at least five of shank 1014 system System connection.The first system may include coupling the frame of shaft assembly 1200 or backbone with the frame 1020 of shank 1014 and/or right Neat frame system.Another system may include closure drive system 1030, which being capable of closing shank 1014 Trigger 1032 is closed to be operably connected with the closed tube 1260 of shaft assembly 1200 and anvil block 1306.As outlined above, shaft assembly Pin 1037 in 1200 closed tube attachment engageable second closed connecting rod 1038 of yoke 1250.Another system may include percussion driving System 1080, the percussion drive system can be by the intermediate beating shafts of the firing trigger 1130 of shank 1014 and shaft assembly 1200 1222 are operably connected.As outlined above, axis attachment ear 1226 can be grasped with the pedestal 1126 of zigzag tread patterns component 1120 Make ground connection.Another system may include electrical system, which can be with: send such as shaft assembly (such as shaft assembly 1200) signal being operatively engaged with shank 1014 is to the controller in shank 1014, such as microcontroller;And/or its Two, conduct power and/or signal of communication between shaft assembly 1200 and shank 1014.For example, shaft assembly 1200 may include that can grasp Make the electric connector 1810 of ground installation to axis circuit board 1610.Electric connector 1810 be configured to on shank control panel 1100 Corresponding electric connector 1800 cooperate engagement.Other details in relation to circuit and control system are found in U.S. Patent Application Serial Number 13/803,086 and U.S. Patent Application Serial Number 14/226,142, the complete disclosure in above-mentioned patent each exists Previously it is herein incorporated by reference.5th system can be by the door bolt for shaft assembly 1200 to be releasably locked to shank 1014 Lock system composition.
Surgical stapler uses in the prior art, to cut longitudinal cut in the tissue simultaneously and by rows of suture Nail is applied to the opposite sides of notch.This instrument usually includes a pair of jaw member to cooperate, if be intended to instrument For endoscope type or laparoscopic type application, then jaw member can pass through sleeve channel.The reception of one of jaw member has nail bin, The nail bin has at least two nails being spaced laterally apart.Another jaw member limits anvil block, which has and the staple pair in storehouse Quasi- nail shapes pit.Instrument includes multiple reciprocating wedges, and when present dynasty distal side drives, the multiple reciprocating wedge is worn The driver being open and engage support nail in nail bin is crossed, to realize the percussion of nail towards anvil block.
Tissue is cut off while by forming staple on the every side of notch, it is possible to reduce is bled and is simplified surgical operation.By In endoscope type and the post-operative recovery time of laparoscopic surgery be less and further advantage, therefore abdominal is compared, these Operation is more and more preferred.Endoscope type suture and cutting off apparatus, which use, often to be upward deflected when being clamped in thick tissue Elongated nip component.In thick tissue, upward deflect can be because between anvil block and storehouse for this of freedom (distal side) end of jaw Distant gap leads to the difference in height of forming nail greater than nearside gap.To ensure that more consistent nearside follows closely forming, anvil block to distal side It inwardly arches upward or is bent generally toward nail bin.This arch upward relatively is suitable for thick tissue and can make when on thin tissue relatively tight Nail formed at the distal end.To overcome this close distal side closure, increase to the clamping surface of the neighbouring storehouse distal end in storehouse If pin or bump.Closure on anvil block to pin ensures the minimum clearance at distal end.However, surgeon worries pin Or bump will lead to tissue trauma.
To cope with such challenge, various arrangements have been developed.For example, a kind of arrangement includes " E mast " cutting head or percussion Bar, " the E mast " or trigger shaft are configured to effectively be spaced apart anvil block with the elongated passageway of support nail cartridge.It is such E mast cutting head or trigger shaft are arranged in for example entitled " SURGICAL STAPLING INSTRUMENT It is disclosed in the United States Patent (USP) 6,978,921 of INCORPORATING AN E-BEAM FIRING MECHANISM ", the United States Patent (USP) Complete disclosure be hereby incorporated by reference.
For example, tissue cutting head includes the E mast that can be translated in end effector 16 as shown in Fig. 2 and Fig. 3 of this paper 50.As described above, E mast 50 may include vertical portion 52, the vertical portion can be passed through when E mast 50 is promoted towards distal side prolongs Extend through narrow longitudinal anvil block slot 58 of the tissue contacting surface 60 in anvil block 20, the narrow vertical slit 62 in nail bin 42, And the narrow longitudinal channel 64 in elongate staple channel 40.Anvil block slot 58 can be extended up in anvil block 20 and can be wrapped The end being passed through in the vertical passage 66 of lateral widening is included, the vertical passage 66 of the lateral widening is sized and configured so that it Receive the upper pin 54 being laterally extended from vertical portion 52.Similarly, passage slot 64 can extend downwardly into channel 40 and It may include the end being passed through in the vertical passage 68 of lateral widening, the size and construction of the vertical passage 68 of the lateral widening make It obtains it and receives the one or more lower legs 70 being laterally extended from vertical portion 52.E mast 50 may also include one or more Intermediate pin 72, the intermediate pin can be laterally extended from vertical portion 52 and be configured to the chassis 74 along nail bin 42 Top surface sliding.In certain embodiments, intermediate pin 72 is configured to fixed nail bin 42, or ensures nail bin 42 remain in channel 40.The size for the longitudinal percussion groove 75 being formed in the nail bin 42 of 74 top of chassis is set to allow for Intermediate pin 72 translates across nail bin 42.
Various elongated passageways arrangement includes elongated or longitudinal slit, described elongated or longitudinal slit E mast cutting head in Extend between starting position and the end position adjacent with the distal end of elongated passageway in the portions of proximal of elongated passageway.E The vertical portion of mast cutting head extends through longitudinal slit, and the lower leg part of E mast is along the bottom of elongated passageway Surface extension.Pin portions can help to effectively be spaced anvil block relative to elongated passageway, and also act as clinician Find out the convenient manner of position of the cutting head in elongated passageway.By observing the cutting when cutting head is advanced through storehouse towards distal side The position of head pin, clinician will definitely instruct position of the cutting head in storehouse.For interval anvil block and monitoring cutting head While position provides effective means, such to be arranged in elongated passageway using longitudinal slit, which can reduce channel Rigidity and channel are to torsion and the resistance extended.
For the such extension for avoiding elongated passageway, it may be necessary to eliminate elongated passageway to enhance when suturing thick tissue to torsion The resistance for turning and extending.However, such arrangement may make surgeon that can not check seam by observing the position of knife pin Conjunction have been carried out how far.Figure 32 show can be similar with various elongated passageways disclosed herein in addition to following difference it is elongated Channel 6022, the elongated passageway 6022 include such as elongated passageway 22 and 302.Elongated passageway 6022 can be by suitable polymeric material Material moulds and/or is machined and/or is formed in other ways, and including substantially solid bottom surface portion 6024. Elongated passageway 6022 is configured to support surgery nail bin (not shown) wherein.Elongated passageway 6022 may include from two to The elongated interior slit 6026 that the chimb part 6028 of interior extension limits.The chimb part 6028 to extend internally is also in chimb part Internal path 6030 is limited between 6028 and solid bottom part 6024.Although elongated interior slit 6026 extends up to elongated passageway 6022 most of length, but its bottom surface 6024 for not extending across elongated passageway 6022.The ruler of the internal path 6030 It is very little to be set to slidably receive the one or more pins for being formed in or being otherwise affixed to cutting head.
Figure 42 shows the E mast cutting head 6050 for example used in combination with elongated passageway 6022.However, will such as become aobvious And be clear to, elongated passageway 6022 can also be arranged with a variety of different cutting heads and is used in combination, a variety of different cutting head cloth It sets on the bottom of cutting head using single pin or multiple pins.Referring to fig. 42, cutting head 6050 includes laterally being prolonged with two The vertical portion 6052 that the lower leg 6070 stretched terminates.Vertical portion 6052 is configured to across elongated slot 6026, So that lower leg 6070 is received in corresponding 6028 lower section of chimb part.
Referring again to Figure 32, elongated passageway 6022 may also include the close of the bottom part 6024 that elongated passageway 6022 is arranged in Proximal channel opening 6040 in side end.Proximal channel opening 6040 can allow clinician that can be in cutting head 6050 and open At least one of the pin 6070 of observation cutting head 6050 or one or more of the other part when beginning or non-firing position.This " starting position " can also be with the cutting head when cutting head 6050 is in the locked position of coupler that will such as discuss in further detail below The location of 6050 is corresponding.Similarly, distal channel opening 6042 is equipped in the distal end of bottom part 6024, this is remote Wing passage opening can allow clinician being capable of the observation cutting when cutting head 6050 is in its " percussion completely " or " end position " At least one of first 6050 pin 6070 or one or more of the other part.This arrange provides to clinician for visiting Know that cutting head is to be in its end position in its starting position while providing elongated compared to extending longitudinally through The method of the relatively harder elongated passageway in other channels of the longitudinal slit of the bottom in channel.Proximal channel opening 6040 and distal side Access portal 6042 can be configured with light into elongated passageway 6022 conducive to such as cutting head 6050 in a manner of shown in Figure 32 Installation (passing through proximal channel opening 6040) and cutting head 6050 (are open from the removal of elongated passageway 6022 by distal channel 6042).Therefore, elongated passageway 6022 has including opening corresponding with the beginning and end of cutting head firing schedule respectively 6040,6042 closing bottom.It is this to arrange the beginning and end for allowing to see percussion and allow cutting head to such as be under The latched position that text is discussed in further detail moves downward.
Elongated passageway 6022 can effectively with cutting that is manually advancing or being promoted by motro drivien trigger system Head assembly is used together.For example, surgical instruments 10 described above includes the cutting manually advanced by actuating trigger 32 First 50.In various arrangements, cutting head 50 can be advanced to stop bits from its starting position by activating firing trigger 32 three times It sets.Thus, for example, cutting head can be moved distally starting position and stop bits by an actuating trigger 32 in elongated passageway The one third (" the first firing position ") the distance between set.Second of startup trigger can lead to the traveling of cutting head 50 and start 2/3rds (" the second firing positions ") and third time startup trigger 32 of distance between position and end position can lead to Propulsion of the cutting head 50 from the second firing position to end position.Therefore, when cutting head 6050 can be open by distal channel 6042 when seeing, clinician will be appreciated by cutting head 6050 and be fired completely.Such elongated passageway 6022 can also be with electric power type (Figure 19 to Figure 22) is used in combination surgical instruments 1010.
Figure 33 to Figure 35 shows another elongated passageway that elongated passageway 6022 is similar in addition to the difference being previously mentioned Arrangement 6122.The part those of identical as the part of elongated passageway arrangement 6022 of elongated passageway arrangement 6122 will share identical Element number.In particular, as shown in Figure 33, a series of indicator openings spaced apart are provided in bottom part 6124 6144.Indicator opening 6144 can change in quantity, size and spacing, but at least one arrangement, indicator opening 6144 have identical size and evenly-spaced in a row so that they lead in elongated interior access 6030.It such as can be at that Seen in a little figures, indicator opening 6144 is circular shape.It is same as shown in Figure 33, it can be in the proximal end of elongated passageway 6122 Light source 6160 is installed in portion projects light onto light source 6160 in internal path 6030 (with dotted line " L " in Figure 33 and Figure 34 It indicates).Light source 6160 may include for example one or more light emitting diodes (" LED ") or other light sources arrangement, it is one or Multiple light emitting diodes or other light sources arrangement can receive across conductor 6164 electric power, the conductor be connected to surgical instruments or The shank of robot system etc., elongated passageway 6122 are operatively attached to the shank.When light source 6160 is powered, light will It projects in internal path 6030.When cutting head 6050 is in starting position, cutting head 6050 can stop any light " L " to pass through Indicator opening any one of 6144 and it is visible.Therefore, when there is no light " L " to pass through indicator opening any one of 6144 It can be seen that when, clinician will be appreciated by cutting head 6050 and be in starting position.When cutting head 6050 is advanced through indicator towards distal side Be open 6144 when, light " L " will be mapped on cutting head 6050 and at least through the unobstructed indicator close to cutting head 6050 Opening 6144 is as it can be seen that as shown in figure 34.Therefore, such arrangement enable the clinician in cutting head in elongated passageway 6122 from Its starting position monitors the process of cutting head 6050 when being moved distally its end position.This elongated passageway arrangement is also than tool There is those of the most elongated slot for the bottom surface for extending fully through elongated passageway elongated passageway arrangement more firmly and more Rigidity.In one arrangement, clinician can determine the position of cutting head, because no illumination was shot through where cutting head Indicator opening.All other indicator opening by have from its irradiation across light.Therefore, in one arrangement, " black " Or not bright indicator opening is the position where cutting head.In other embodiments, light source can be omitted.Clinician can be still Position of the cutting head 6050 in elongated passageway 6122 is monitored by the position by 6144 observation pin 6070 of indicator opening It sets.
Figure 36 shows another elongated passageway arrangement 6222 that elongated passageway 6122 is similar in addition to the difference being previously mentioned. Identical element number will be shared by being identical to those of the elongated passageway arrangement 6222 of the part of elongated passageway arrangement 6122 part. As seen in this figure, a series of indicator openings 6144 spaced apart are disposed through bottom surface 6224.It is arranged shown in In, indicator opening 6144 be of the same size with shape but be configured at different intervals pass through bottom surface 6224. For example, recent side indicator opening 6144P can be spaced the first distance " FSD " with proximal open 6040, first spacing Distance open at least one of pin 6070 or other parts of (for example) cutting head 6050 can when cutting head 6050 is in It is observed when beginning position by first distance.Equally, farthest side indicator opening 6144D can be with adjacent instruction Device opening 6144 is spaced apart the second spacing distance " SSD " different from the first spacing distance FSD.As can be seen in Figure 36, example Such as, SSD is greater than FSD.Farthest side indicator is open 6144D can be corresponding in the position of cutting head 6050 of its end position. Therefore, elongated passageway arrangement 6222 shows variable spacing indicator opening, wherein when you are proximally distally moved, opening Quantity reduce.
Figure 37 shows another elongated passageway arrangement 6322 that elongated passageway 6122 is similar in addition to the difference being previously mentioned. Identical element number will be shared by being identical to those of the elongated passageway arrangement 6322 of the part of elongated passageway arrangement 6122 part. As seen in this figure, elongated passageway arrangement 6322 includes a series of elongated discrete indicator openings 6144 '.It is arranged shown in In, indicator opening 6144 ' is of the same size with shape and arranges at uniform intervals.
Figure 38 shows another elongated passageway arrangement 6422 that elongated passageway 6222 is similar in addition to the difference being previously mentioned. Identical element number will be shared by being identical to those of the elongated passageway arrangement 6422 of the part of elongated passageway arrangement 6222 part. As seen in this figure, only two " discrete " indicators openings 6144 spaced apart " are disposed across bottom surface 6424.Institute In the arrangement shown, indicator opening 6144 " be of the same size with shape but be configured at different intervals pass through bottom Surface 6424.For example, recent side indicator opening 6144P " can be spaced apart with proximal open 6,040 first spacing distance " FSD " and Farthest side indicator opening 6144D " can be with recent side indicator opening 6144 " is spaced apart different from the first spacing distance FSD's Second spacing distance " SSD ".In for example, at least one arrangement, when elongated passageway 6422 and pass through actuating firing trigger hand The cutting head assembly promoted is used together dynamicly when, " first stroke " or first of firing trigger is passed through in cutting head assembly When actuating promotes, at least one pin or the other parts for cutting head assembly are visible by nearside indicator opening 6144P ".Together Sample, during the second stroke or the second actuation sequence of firing trigger, cut head assembly at least one pin or other portions Divide visible by farthest side indicator opening 6144D ".Therefore, elongated passageway 6422 include elongated slot shape indicator be open with And when you to the circular indicators that offer when remote movement be more closed/is less opened by being closely open.
Figure 39 shows another elongated passageway arrangement 6522 that elongated passageway 6422 is similar in addition to the difference being previously mentioned. Identical element number will be shared by being identical to those of the elongated passageway arrangement 6522 of the part of elongated passageway arrangement 6422 part. As seen in this figure, elongated passageway 6522 includes combination and the circle uniform intervals of recent side elongated indicator opening 6144P " The combination for the indicator opening 6144 opened, the recent side elongated indicator opening are enabled the clinician in firing trigger At least one pin or other parts of observation cutting head assembly during first stroke or actuation sequence.Therefore, elongated passageway 6522 use the combination of open flume type slit and elongated slot.Any one of above-mentioned elongated passageway arrangement is in combination with light source 6160, the light source has been described in detail herein in conjunction with embodiment shown in Figure 33 or above-mentioned elongated passageway cloth Any one of setting can use in the case where no light source.
Other cutting head monitoring arrangements may include the opening for example in channel or the slit projection along channel interior One or more light sources of light are arranged or light emitting diode (" LED ") arrangement.This will greatly enhance user's positional dissection head and exist The location of in its stroke and determine whether total kilometres are completed.In some arrangements, for example, LED may include with cutting Head along channel further discriminate between cutting head promote and from green to blue multi-colored led (or other color cloth It sets).
In various end effectors arrangement, it would be desirable to, using for unless unspent nail bin can operate Ground is installed in an elongated channel the system for otherwise just preventing cutting head from promoting or firing.For example, entitled " SURGICAL The United States Patent (USP) 6,988,649 of STAPLING INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT " and Entitled " SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR The United States Patent (USP) 7,044,352 of PREVENTION OF FIRIN " discloses various locking systems, and the United States Patent (USP) is respective Complete disclosure is herein incorporated by reference.In this locking arrangement, cutting head or " trigger shaft " are usually by spring cloth It sets and is biased to latched position.Before not used storehouse has been installed in an elongated channel, cutting head can not be in other ways by outer The percussion drive system of section's instrument promotes.
Referring to fig. 40 to Figure 42, it illustrates the cutting heads 6050 for being attached to trigger shaft 6080.As shown, trigger shaft 6080 be laminar construction.However, trigger shaft 6080 can be solid-state construction.In either case, trigger shaft 6080 all with The percussion drive system of surgical instruments described herein or other known operativelys interface with.The actuating of percussion drive system will be hit Hair bar 6080 and cutting head 6050 are axially advanced the surgery nail bin being passed through in elongated passageway 6122.Cutting head 6050 Vertical portion 6052 includes the tissue cutting surface 6053 being located between upper end part 6054 and center hook portion 6056.Ginseng See Figure 42.Upper pin or upper inserted sheet 6058 are laterally extended from every side of upper end part 6054.Upper inserted sheet 6058 is configured to It can be slidably received in the upper access in anvil block, which is operably mounted into elongated passageway, as discussed further below It discusses.
Figure 41 shows cutting head 6050 and trigger shaft 6080 when surgery nail bin is not present in elongated passageway 6122 Position.When at that position, trigger shaft 6080 and cutting head 6050 are biased on " D " by spring arm 6090 in downward direction, and And it is coupled to the axle ridge column (not shown) support of elongated passageway 6122.As seen in this figure, spring arm 6090 is hit with being formed in Spring tail portion 6082 in hair 6080 distal end of bar is sliding engaged.When cutting head 6050 is in locking bit as shown in figure 41 When setting, the bottom part of spring tail portion 6082 is biased in the inclined surface 6123 being formed on elongated passageway 6122.It such as can be Further finding in Figure 41, when cutting head 6050 is in the locked position, if clinician attempts cutting head unintentionally 6050 pass through elongated passageway 6122 towards distal side propulsion or " percussion ", then a multiple or lower leg 6070 may contact elongated logical The bottom in road 6122.In other words, when cutting head 6050 is in the locked position, pin 6070 is not and in elongated passageway 6122 Internal path 6030 is aligned, and therefore cutting head assembly 6050 can not promote axially therein.Clinician will pass through sight It examines position of the pin 6070 in proximal open 6040 and knows that cutting head is locked.
Figure 40 shows the cutting head when unspent surgery nail bin has been operatively supported in elongated passageway 6122 6050 and trigger shaft 6080 position.Although the main body of surgery nail bin is not shown in Figure 40, wedge slider assembly is shown 6078.It should be appreciated that wedge slider assembly 6078 will do not fire or not used nail bin in the position shown in Figure 40. When at that position, wedge slider assembly 6078 is engaged with the hook portion 6056 on cutting head 6050 in upward direction Cutting head 6050 is raised to a bit on (arrow " U " in Figure 40), at this point, when cutting head 6050 is promoted towards distal side, Pin 6070 thereon will enter the internal path 6030 in elongated passageway 6122.When use has close push button or substantially closes When the elongated passageway of the button (all as those described herein) of conjunction, may meaning it is envisioned that sized stacks situation occurs, at this In the case of, when being cut using end effector with stitch pole thin tissue, between the bottom of the channel and one or more knife pins It may interfere.If such as organize excessively thin, tissue compression resistance may be not enough to anvil block being forced away from elongated passageway simultaneously That two components are loaded against cutting head inserted sheet.In case of such case, one or more knife pins may extend into elongated logical Road bottom part down is remote enough, so that cutting head can not be promoted towards distal side.6050 He of head assembly is cut shown in Figure 40 and Figure 41 Elongated passageway arrangement 6122 can prevent this from occurring.
It is seen, for example, the distal end of each pin 6070 can have chamfering formed thereon as in Figure 40 and Figure 41 6072.Chamfering 6072 is configured to when cutting head 6050 is promoted towards distal side so that pin 6070 enters internal path 6030 Engage the corresponding part of elongated passageway 6122.Therefore, the formation of chamfering 6072 helps for pin 6070 to be directed in access 6030 Small " introducing " slope.As it can be seen that the distal end portion of the restriction internal path 6030 of elongated passageway 6122 in same such as Figure 40 and Figure 41 The part in portion 6131 can have chamfering 6133 or otherwise inclination as shown in the figure thereon.In alternative layouts, pin 6070 (or single pins) may be provided with chamfering 6072 or the proximal end part 6131 of internal path 6030 and may be provided with down Angle 6133 or two kind of chamfering arrangement can be provided as shown in Figure 40 and Figure 41.
Figure 43 and Figure 44 shows end effector 7016, the end effector can be similar to such as end effector 16 or 300 or disclosed herein other end effectors.In this arrangement, closed tube or casing 7028 are in wherein with a series of fingers Show that device opening 7144, the indicator opening are enabled the clinician to through the indicator open view trigger shaft 6080.It hits Hair bar 6080 can be provided with status indication 6084 thereon, and when trigger shaft 6080 is promoted towards distal side, clinician can pass through finger Show the 7144 observation status indication of device opening.Status indication 6084 can simply include japanning label or will act as reference marker Other feature structure.In one arrangement, status indication 6084 includes the surgical instruments being attached to by end effector 7016 Or the one or more light emitting diodes (LED) or other light sources of the power supply power supply in surgery system.
Figure 45 shows the other end actuator 7016, and wherein stall section of jurisdiction section 7030 includes indicator window 7032, The indicator window enables the clinician to determine whether cutting head is in its latched position.In this arrangement, if clinical doctor Life can see spring tail portion 6082 by indicator window 7032, then cutting head is not at its latched position.If clinician Spring tail portion 6082 can not be seen by indicator window 7032, then cutting head is in its latched position.In alternative cloth In setting, indicator window 7032 be may be provided in such position (for example, in the section of stall section of jurisdiction on the lower), so that if spring Tail portion 6082 passes through indicator window 7032 as it can be seen that then cutting head is in its latched position, and if spring tail portion 6082 is logical Cross indicator opening it is invisible, then cutting head is not at its latched position.In order to assist clinician to determine the position of cutting head, Cutting head can be provided with certain luminance or iridescent.These color placements may, for example, be based on radium.In addition, the face of cutting head Color can be varied so that clinician can easily find out its position along its length.
Figure 47 shows anvil block 7020, which includes multiple or a series of indicator opening 7044, the indicator Opening provides that the upper end part 6054 to the observation in channel 7022, on cutting head 6050 is axial to be penetrated into the access.? In embodiment shown in Figure 47, indicator opening 7044 has circular shape and the length uniform intervals along anvil block 7020 It opens.In the embodiment shown in Figure 48, indicator opening 7044 is closer to be spaced together at the proximal end of anvil block 7020 It opens.Interval between indicator opening 7044 is gradually increased with moving toward the far side in anvil block 7020.However, indicator is opened Size, shape and the variable spaced of mouth 7044.Referring to fig. 42, indicating element 6059 may be provided at the top of cutting head 6050 In portion 6054.In one embodiment, indicating element 6059 include can by pass through trigger shaft 6080 conductor 6081 from The one or more light emitting diodes or other light sources of surgical instruments acquisition electric power.Such arrangement enables the clinician to cutting First 6050 are open 7044 sight indicator components 6059 when being advanced through end effector by the indicator in anvil block 7020 Position.In other arrangements, it can not be provided in cutting head indicating element (light emitting diode, lamp).However, the top of cutting head End can will improve it and be provided by the visual color or fluorescent marker of the instruction opening in anvil block.For example, color can To be based on radium.Cutting head is alternatively provided with the component through laser scribing, to provide for determining cutting head in channel Or the device of the position in anvil block.
Anvil block 7020 shown in Figure 46 uses the indicator system for being generally designated as 7200.In this embodiment, it indicates Device system 7200 includes the axle journal connection at least at its proximal end 7204 in the slit 7021 being arranged in anvil block 7020 Flexible strip or waveform spring 7202.Waveform spring 7202 extend the length of anvil block 7020 and with have across its indicator The part of the anvil block 7020 of opening 7044 is at least co-extensive.As shown in Figure 46, a series of indicating elements 7206 are attached to flexibility Band 7202 is slidingly supported at each indicating element 7206 in corresponding indicator opening 7044.Each indicator structure Part 7206, which is initially supported in its corresponding indicator opening 7044, protrudes it from indicator opening.In other words, Waveform spring 7202 is configured to so that indicating element 7206 is biased to initial position, in the initial position, instruction Device component is not prominent from its corresponding indicator opening 7044.However, being executed when cutting head 6050 is advanced through end towards distal side When device, the top section 6054 of cutting head 6050 along waveform spring 7202 basal sliding and for upwardly biasing waveform spring 7202 make when cutting head slides below a part for being attached with indicating element 7206 of waveform spring 7202, indicator Component 7206 is caught to protrude from indicator opening 7044, as shown in figure 46.Therefore, clinician can be by noticing which is indicated Device component 7206 is open 7044 protrusions from its indicator to monitor position of the cutting head 6050 in end effector.
Therefore, huge changing of the several offers in elongated passageway arrangement disclosed herein better than existing elongated passageway arrangement Into.For example, elongated slot of at least some of the described elongated passageway arrangement without using the bottom surface for extending through channel.Cause This, this elongated passageway arranges often harder and anti-extension during operation.These advantages have also been implemented, while being also clinic Doctor provides the mode for monitoring cutting head process.For example, some elongated passageways arrangements provides the length along channel Period visuality is to notify clinician's cutting head the location of in firing cycle.When cutting head is in complete deployed position When, and when cutting head is in fully retracted position, at least some elongated passageway arrangements also enable the clinician to see To at least part of cutting head.In addition, at least some channels and/or anvil block arrangement are provided from the side of end effector Or top is at least part of visuality of cutting head, or provide in other ways for from the side of end effector or Find out the mode of cutting head position in top.
As described above, a series of staple drivers are operably supported at wherein by surgery nail bin, the staple drivers are respectively One or more surgical staples are supported on.Staple drivers are supported in the respective shapes for being arranged to linear orientation in warehouse Nail pit in.Surgical staples are movably supported on driver, so that nail is driven when driver is driven upwardly in storehouse It is contacted across the tissue being clamped in storehouse and anvil block and with the bottom side of anvil block.When anvil block is opened, nail is protected with suture tissue It holds together.Since nail " loosely " is supported in its corresponding pit on its staple drivers, so if before use, nail bin It is surprisingly turned upside down, then follows closely possible meaning and conceivably dropped out from nail bin.To avoid such case, warehouse lid usually makes With being preceding removably attached to warehouse.When being attached to storehouse, warehouse lid covering nail pit is remained at that will follow closely, but regardless of storehouse How is position.When storehouse is installed in end effector by clinician's expectation, lid can be removed in a pre-installation.
If further discussed above, the wedge shape that staple drivers are driven together with cutting head assembly towards distal side in storehouse is sliding Moving part drives upwards in turn.In at least some arrangements, therefore wedge-shaped slides are oriented in not used storehouse before firing At recent side " beginning " position.Actually also as discussed above, at least some arrangements need wedge-shaped slides (to open when in it When beginning position) and cutting head (when be in its latched position when) between interact to by cutting head remove latched position with It makes it ready for firing.However, storehouse lacks for ensuring that wedge-shaped slides are using preceding holding at least some previous arrangements Device or structure in its starting position.Warehouse lid 7250 shown in Figure 64 and Figure 65 can handle problems.
Figure 64 shows the surgery nail bin 7220 with warehouse 7222, and the warehouse is in each of the slit 7224 longitudinally extended Multiple staple drivers are operably supported at wherein (not shown) on side.The slit 7224 longitudinally extended can be conducive to cut Head is cut to be longitudinally travelled across storehouse.As can be seen in Figure 65, storehouse 7220 also supports the place adjacent with the proximal end of warehouse 7222 Wedge-shaped slides 7230 in starting position.Figure 64 and Figure 65 also shows the warehouse lid 7250 including top section 7252, described Top section is configured to cover storehouse platform 7226 when warehouse lid 7250 is mounted on storehouse 7220.More specifically, top Points 7252 can cover all fasteners in the platform 7226 of warehouse 7222 when top section 7252 is in " covering position " Chamber opening.A pair of of flexible attachment arm 7254 that warehouse lid 7250 can by being able to maintain engage warehouse 7222 is removably attached to Nail bin 7220.Clinician can be easy to remain engaged with by the way that flexible attachment arm 7254 is pried open Cheng Buyu warehouse 7222 to remove storehouse Lid 7250.Warehouse lid 7250 may also include to be extended downwardly for a pair for being located in the warehouse lid 7250 on storehouse 7220 in desired locations Side panel 7255.For example, side panel 7255 can be positioned so that is formed on each side for be bonded on storehouse platform 7226 extends laterally Antelabium 7227.Warehouse lid 7250 may also include the positioning fin 7256 being centrally located, which is oriented to work as warehouse lid 7250 such as When being attached to storehouse 7220 shown in Figure 65, receive in the slit 7224 longitudinally extended.Positioning fin 7256 includes engagement recesses 7258 Or one or more of the other formation, the engagement recesses or one or more of the other formation are configured to remain engaged with Wedge-shaped slides 7230 are simultaneously maintained at its starting position by a part of wedge-shaped slides 7230.Therefore, when warehouse lid 7250 is installed When on to nail bin 7220, nail be maintained in its corresponding pit, but regardless of storehouse 7220 orientation how.In addition, wedge-shaped slides 7230 are maintained at its starting position.In various arrangements, positioning fin can be sized relative to the slit 7224 longitudinally extended with Frictional fit is established between them.In such arrangement, frictional fit can be used for for lid 7250 being held in place on storehouse 7220 Without using attachment arm 7254.In other arrangements, it is built between positioning fin 7256 and warehouse 7222 and attachment arm 7254 On the warehouse 7222 that vertical frictional fit can be used for for lid 7250 being maintained in covering position.In addition, can be on positioning fin 7256 Holding rib 7257 is formed further to establish frictional fit with warehouse 7222.In addition, as can be seen in Figure 65, surgery nail bin 7220 distal end 7221 can have the leading edge surface 7223 being angularly orientated relative to storehouse platform 7226.In various arrangements In, warehouse lid 7250 may also include engage the distal end 7221 of surgery nail bin 7220 leading edge portion 7251 with being able to maintain.Example Such as, leading edge portion 7251 is configured to the leading edge surface 7223 in covering storehouse 7220 and including being arranged to the shape with hook The distal side that formula engages the distal end 7221 in storehouse 7220 keeps inserted sheet 7253.In addition, disengaging can be formed in leading edge portion 7251 Inserted sheet or protrusion 7259 are to be conducive to keep the disengaging of inserted sheet 7253 and storehouse 7220.Therefore, in some arrangements, warehouse lid 7250 Distal end can allow for it to absorb all one's effort for decline of diving and the power be transferred directly to storehouse 7220, and almost without lid 7250 longitudinal movement relative to warehouse 7222.It is this to be disposed to prevent the proximally mobile sliding under these conditions of lid 7250 Part 7230.When clinician's expectation is using storehouse 7220, warehouse lid 7250 is removed.In at least some arrangements, it can exist with reception The corresponding particular color of the size of nail in nail bin 7220 provides warehouse lid 7250.
As discussed in detail above, in various embodiments, surgical staples are supported in " driver ", and the driver can It is operatively supported in the pit formed in the main body to nail bin.Various forms of drivers can be used.For example, driver can quilt It is constructed to be permeable to support single surgical staples, and other drivers can support multiple surgical staples.Row branch of the driver longitudinally to extend In warehouse, the row longitudinally extended is arranged on each side for the elongated slot being centrally located, described elongated narrow for support Slot accommodates the access of the cutting element or cutting head that pass therethrough.If being previously discussed as herein, cutting head includes wedge shape sliding Part cooperates with wedge-shaped slides, the wedge-shaped slides be configured to successively to contact driver with by them in its pit In drive up.When driver moves upwards in nail bin, the one or more surgical staples being supported on are driven upwardly It is contacted across the tissue being clamped in storehouse and anvil block and with the formation of the bottom side of anvil block.
As it is known that the bottom side of anvil block includes " nail formed " surface, " nail forming " surface generally include to be arranged to by A series of nail shapes pits of the end contact of nail leg.Pit is set and is shaped so that when being contacted by nail leg, and leg is forced Portion is bent around pit and ultimately forms the closure nail for being approximately similar to " B shape ".Nail leg during forming process, which is misaligned, to be led Cause nail at deformity, this can lead to undesirable leakage in severe case.Staple drivers configuration can shown in Figure 94 and Figure 95 Help to keep nail alignment during percussion process.In addition, if driver is not protected in its corresponding pit during percussion It holds and is properly aligned with, then must generate higher percussion force to fire the nail being supported on.
Figure 94 and Figure 95 shows " double " staple drivers 7300.As in those figures as it can be seen that staple drivers 7300 include first Driver portion 7310 and the second driver portion 7350, the first driver portion and the second driver portion taking with " staggeredly " Separate to the partition part 7340 by being centrally located.Staple drivers 7300 can be integral type construction, and for example by suitably gathering Object material is closed to be molded.First driver portion 7310 includes the first chamber 7312 being centrally located, which drives first Dynamic device 7310 is divided into the first nearside and erects support section 7320 and the first distal side setting support section 7330.First nearside is erect Support section 7320 has the first proximal body portion 7321, and first proximal body portion has upper end part 7322, The upper end part has in the first proximal base segment 7324 wherein formed.Similarly, support portion is erect in the first distal side Divide 7330 there is the first distal body portion 7331, first distal body portion has the first distal end 7332, described First distal end has in the first distal side pedestal segment 7334 wherein formed.First nearside bottom segment 7324 and first is remote Wing base segment 7334 is aligned and can be in the base portion for wherein supporting surgical staples.As seen in Figure 94 furthermore, it can be seen that working as from top When examining, the first nearside, which erects support section 7320, has slightly tapered shape.In other words, the first nearside erects support section 7320 have the first proximal end 7326, and first proximal end has not lend oneself to worry and anxiety less than in the first proximal body portion 7321 Spend the width " PW " of " CW ".Equally, support section 7330 is erect in the first distal side has the first distal end 7336, and described first is remote Side end has the distal width " DW " of the center width " CW " less than the first distal body portion 7331.In at least one arrangement In, distal width " DW " is equal to nearside width " PW ".
Referring also to Figure 94, the second driver portion 7350 includes the second chamber 7352 for being centrally located, and second chamber is by second Driver portion 7310 is divided into the second nearside and erects support section 7360 and the second distal side setting support section 7370.Second is close Support section 7360 is erect in side has the second proximal body portion 7361, and second proximal body portion has upper end 7362, the upper end has in the second proximal base segment 7364 wherein formed.Similarly, support portion is erect in the second distal side Divide 7370 there is the second distal body portion 7371, second distal body portion has the second distal end 7372, described Second distal end has in the second distal side pedestal segment 7374 wherein formed.Second proximal base segment 7364 and second is remote Wing base segment 7374 is aligned and can be in the base portion for wherein supporting another surgical staples.As in Figure 94 furthermore, it can be seen that when from upper When side's observation, the second nearside, which erects support section 7360, has slightly tapered shape.In other words, the second nearside erects support Part 7360 has proximal end 7366, and the proximal end has the center width less than the second proximal body portion 7361 The width " PW " of " CW ".Equally, support section 7370 is erect in the second distal side has distal end 7376, and the distal end has Less than the distal width " DW " of the center width " CW " of the second distal body portion 7371.Therefore, the first driver portion 7310 There is similar shape with the second driver portion 7350.
For bigger stability, the first driver portion 7310 and second are provided to staple drivers 7300 during percussion Driver portion 7350 can be further provided with arranges with the stabilizer of the nail pit cooperation of the complementary shape in cartridge body.Example Such as, the first staple drivers part 7310 can have 7327 side of the first nearside group that is formed in its first proximal end 7326 to prominent The support column 7328,7329 risen.Also the first distal end 7336 of support section 7330 can be erect in the first distal side as shown in the figure It is upper that the support column 7338,7339 of first distally group, 7337 lateral protrusion is provided.Equally, the second staple drivers part 7350 can have The support column 7368,7369 of 7367 lateral protrusion of the second nearside group formed in its second proximal end 7366.It can also be such as figure It is shown to provide the second distally group 7377 lateral protrusion in the second distal end 7376 that support section 7370 is erect in the second distal side Support column 7378,7379.
As noted above, staple drivers 7300 and the nail pit of complementary shape are movably supported in nail bin.Work as wedge When shape sliding part drives towards distal side, corresponding part contacts the partition part 7340 being centrally located and in a driving manner by driver 7300 drive up.It is each in the support column 7328,7329,7338,7339,7368,7369,7378 and 7379 of lateral protrusion It is a all to receive in staple cartridge body in the groove of respective shapes, and for keeping the alignment of driver 7300 and preventing in driver Driver reverses during promoting towards anvil block.In one arrangement, driver 7300 is molded by solid material or with other Mode is formed.However, in other arrangements, the first driver portion 7310 and the second driver portion 7350 can be hollow , so that these parts of driver 7300 can slightly have flexible and flexibility, to further keep driver at it Alignment in corresponding pit and to further decreasing required driving force.In any one arrangement, by providing two drives Alignment post on two ends of dynamic device part, further enhances alignment of the driver in its corresponding pit.
Figure 96 shows another " double " staple drivers 7400, and " double " staple drivers are configured to receive in shape At in the nail pit of the complementary shape in surgery nail bin main body.As can be seen in Figure 96, staple drivers 7400 include by occupying The partition part 7440 of middle setting is separated into the first driver portion 7410 and the second driver portion 7450 of " staggeredly " orientation. Staple drivers 7400 can be integral type construction, and for example be formed by suitable molded of polymeric material.First driver portion 7410 include the first chamber 7412 being centrally located, and the first driver 7410 is divided into the first nearside by first chamber being centrally located It erects support section 7420 and support section 7430 is erect in the first distal side.It is close with first that first nearside erects support section 7420 Side main part 7421, first proximal body portion have upper end 7422, and the upper end, which has, wherein to be formed First proximal base segment 7424.Similarly, support section 7430 is erect in the first distal side has the first distal body portion 7431, First distal body portion has the first distal end 7432, and first distal end has in first wherein formed Distal side pedestal segment 7434.First proximal base segment 7424 and the first distal side pedestal segment 7434 are aligned and can prop up wherein Support the base portion of surgical staples.Such as further finding, the first nearside support section 7420 and the setting of the first distal side can be erect in Figure 96 Support section respectively has the shape being slightly tapered.
Referring still to Figure 96, the second driver portion 7450 includes the second chamber 7452 being centrally located, described to be centrally located The second chamber the second driver portion 7450 be divided into the second nearside erect support section 7460 and the second distal side and erect support portion Divide 7470.Second nearside, which erects support section 7460, has the second proximal body portion 7461, second proximal body portion With upper end 7462, the upper end has in the second proximal base segment 7464 wherein formed.Similarly, the second distal side Erectting support section 7470 has the second distal body portion 7471, and second distal body portion has the second distal end 7472, second distal end has the second distal side pedestal segment 7474 wherein formed.Second proximal base segment 7464 With the second distal side pedestal segment 7474 alignment and can be in the base portion for wherein supporting another surgical staples.
For bigger stability, the first driver portion 7410 and second are provided to staple drivers 7400 during percussion Driver portion 7450 can be further provided with arranges with the stabilizer of the nail pit cooperation of the complementary shape in cartridge body.Example Such as, the first staple drivers part 7410 can have 7427 side of the first nearside group that is formed in the first proximal body portion 7421 to The support column 7428,7429 of protrusion.Also the first distal body portion of support section 7430 can be erect in the first distal side as shown in the figure Divide on 7431 and the support column 7438,7439 of first distally group, 7437 lateral protrusion is provided.Equally, the second staple drivers part 7450 There can be the support column 7468,7469 of 7467 lateral protrusion of the second nearside group formed in the second proximal body portion 7461. Also the second distally group can be provided in the second distal body portion 7471 that support section 7470 is erect in the second distal side as shown in the figure The support column 7478,7479 of 7477 lateral protrusions.
As noted above, staple drivers 7400 and the nail pit of complementary shape are movably supported in nail bin.Work as wedge When shape sliding part is driven towards distal side, corresponding portion drivingly contacts the partition part 7440 being centrally located and by driver 7400 drive up.It is each in the support column 7428,7429,7438,7439,7468,7469,7478 and 7479 of lateral protrusion Person is received in the groove of the respective shapes in cartridge body and is used to keep the alignment of driver 7400 and prevents the drive Dynamic device distorts during it is promoted towards anvil block.In one arrangement, driver 7400 is molded by solid material or with other Mode is formed.However, in other arrangements, the first driver portion 7410 and the second driver portion 7450 can for it is hollow with These parts of driver 7400 are enabled to be slightly flexible and submissive further to keep the driver in its phase The alignment in pit is answered, to be further reduced required driving force.In any one arrangement, by providing two driver portions The alignment post on two ends being divided to, further enhances alignment of the driver in its corresponding pit.
Figure 97 shows the nail or driver pit 7510 formed in the main part 7502 of nail bin 7500.The nail or driving Device pit 7510 is configured to for " single " staple drivers of complementary shape being operably supported at wherein.It can in such as figure See, there are two nearly jamb members 7512, the 7514 and two distal side columns to extend internally to extend internally for the formation of nail pit 7510 7516,7518.Column 7512,7514,7516 and 7518 can slideably extend to the respective lateral being arranged in staple drivers In groove.This driver pit configuration is used to provide further stable and alignment of the driver when it drives from pit.To the greatest extent Pipe Figure 97, which is shown, is configured to for single staple drivers being operably supported at nail or driver pit therein, but phase Same concept can be applied to be configured to support and be configured to support those of the driver of multiple surgical staples driver recessed Hole.For example, support column employed in driver embodiment shown in Figure 94 to Figure 96 can be replaced and be configured to The groove correspondence column being formed in nail pit side being slidably received in warehouse.
As shown in Figure 94 to Figure 96, various driver arrangements substantially may include drive body or drive body portion Point, the drive body or drive body part include outer surface and front-end and back-end.In various arrangements, outer surface Size and shape can be configured to avoid to support any part of the inner wall in nail pit wherein (to remove with moving with outer surface Feature structure/the support column that extends laterally formed on nail pit) contact.For example, double staple drivers shown in Figure 96 7400 include the first driver portion 7410 and the second driver portion 7450.First driver portion 7410 and the second driver Part 7450 can be sized relative to nail pit, so that the side being only partially formed at thereon contacted with nail pit inner wall To the feature structure of extension, such as element 7428,7429,7438,7439,7468,7469.First driver portion 7410 is most Proximal end may include " front end ", and the farthest side end of the second driver portion 7450 may include " rear end ".At another In arrangement, for example, the corresponding part that front-end and back-end can receive the front-end and back-end relative to the reception of nail pit is sized, So that gap between the corresponding pit portion in these ends be less than other driver portions and follow closely pit other parts it Between gap.The size of such gap value can be set to improve the driver lateral stability of activating, without in driver Outer surface and follow closely pit inner wall between establish frictional fit.In another arrangement, driver can be relative to nail pit structure It makes (for example, be sized and shape), so that the one or more of driver contacted with nail pit inner wall section only has part It is made of one or more formations (support column) on the front end and/or rear end of driver.On the contrary, front end and/or after Settable one or more groove in end, the groove are configured to receive being correspondingly formed in nail pit inner wall section Object, wherein these formations are that the one or more between driver activating driver and nail pit inner wall only contacts Point.As noted above, driver generally can longitudinally extend nail pit row is supported in warehouse, described longitudinally to extend Nail pit row is arranged on each side for the elongated slot being centrally located, and what the elongated slot receiving passed therethrough cuts Cut the access of component or cutting head.In some arrangements, disclosed herein using one or more support columns/extend laterally The various drivers of feature structure can be used be located on elongated slot one or both sides the longitudinal nail pits row of one or more (or The part longitudinally arranged) in.For example, the nail pit row near warehouse edge on the every side of elongated slot may include using support The driver of the formation for column/extend laterally, but conventional drives can be used in other nail pits row.This arrangement can also be with nail pit 7510 are used together.That is, nail pit 7510 be only available on the one or both sides of elongated slot certain longitudinal nail pits (or The part longitudinally arranged) in.
Tissue flowing can be to cause one of the problem of nail deformity.During suture, organize towards distal side and laterally to flow, Middle lateral movement is than longitudinal movement nocuousness.Using tissue flowing and high compression forces, will nail from its corresponding pit laterally and towards remote Side guidance.By the cooperation between tightening driver and the storehouse part of neighbouring driver, nail is during percussion to side or front The reduced capability waved, because the ability that driver waves also weakens.Various drivers disclosed herein and nail pit arrangement For making this to wave minimum.The feature structure for support column disclosed herein/extend laterally may be provided at All Drives Driver (for example, driver in outlet in storehouse) that is upper or being simply to set into specific region.Such support column/lateral The feature structure of extension can be located on such as driver side, driver end or the two.It is disclosed herein for describing The term " support column " that driver stablizes arrangement cover as the present invention it is shown in the drawings it is various extend laterally, vertical elongated shape At object.Term " support column " can also cover the various feature structures of different shapes extended laterally, and the feature structure is constructed At can actively receive in the groove for the correspondingly-shaped being arranged in nail pit inner wall (wherein support column/extend laterally Feature structure is located at the arrangement on driver) or (the wherein spy for support column/extend laterally received in various driver portions Structure is levied from nail pit inner wall arrangement outstanding), it is subject to concrete condition.Support column can be for example including the spy individually extended laterally It levies structure or it may include the feature structure of multiple alignment extended laterally.For example, support column can be by column segment or alignment Partially/formation composition.In other other arrangements, other shape for lugs can be used.
For various embodiments disclosed herein, fastener cartridge may include the material layer of implantable patient's body. Such layer may include for example one or more fid tablets and/or one or more tissue thickness compensation parts.It is filed in Entitled " the STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A on April 29th, 2011 The U.S. Patent Application Serial Number 13/097,856 of COMPRESSIBLE PORTION THEREOF " is incorporated by reference this Text.Turning now to Figure 99 to Figure 102, nail bin 8000 includes warehouse 8010 and implantable layer 8020.Warehouse 8010 includes proximal end Portion 8012, distal end 8014 and the platform 8016 extended between proximal end 8012 and distal end 8014.Platform 8016 can when tissue is clamped between nail bin 8000 and anvil block supporting tissue.Warehouse 8010 further include be defined in it is therein Securing member chamber, the securing member chamber are respectively configured to such as follow closely fastener and be stored in wherein.Each securing member chamber packet Include proximal end and distal end.Compared with the distal end of each securing member chamber, the proximal end of each securing member chamber is more leaned on The proximal end 8012 of nearly warehouse 8010, and correspondingly, the distal end of each securing member chamber is closer to the distal side of warehouse 8010 End 8014.
In addition to described above, warehouse 8010 includes the protruding portion extended from platform 8016.In all cases, protruding portion can With the alignment of any suitable arrangement.For example, distal projections 8017 can with the distal end adjacent positioned of securing member chamber and nearside Protruding portion 8019 can be with the proximal end adjacent positioned of securing member chamber.Similar to above, distal projections 8017 and/or nearside are prominent Portion 8019 is configured to guide the fastener being stored in securing member chamber when fastener is ejected from securing member chamber out.? In this case, distal projections 8017 and/or proximal projections 8019 can make securing member chamber extend beyond platform 8016.It is some Securing member chamber can have adjacent distal projections 8017 and proximal projections 8019, and other securing member chambers can only have wherein One of.One or more fasteners chamber can both not have distal projections 8017 associated there, not have associated there close yet Side protruding portion 8019.
Layer 8020 includes layer main body 8026, and the layer main body includes proximal end 8022 and distal end 8024.Layer main body The neighbouring or positioning of proximal end 8012 relative to warehouse 8010 of 8026 proximal end 8022 and distal end 8024 it is neighbouring or It is positioned relative to distal end 8014.In some cases, layer 8026 may include solid material piece.In all cases, layer master Body 8026 can extend in the one or more securing member chambers being defined in warehouse 8010.It is at least one under such circumstances, Layer main body 8026 includes the part 8025 extended in securing member chamber.When fastener is ejected from securing member chamber, fastener can be Wherein capture portion 8025, so that layer 8020 is remained to tissue.In some cases, layer main body 8026 may include and warehouse The opening of one or more fasteners chamber alignment in 8010.
Layer main body 8026 may include being defined in hole therein, the protruding portion alignment that the Kong Yucong platform 8016 extends.Example Such as, layer main body 8026 may include the distal aperture 8027 being aligned at least some distal projections 8017 and/or with it is at least some remote The proximal aperture 8029 that side protruding portion 8019 is aligned.In all cases, distal aperture 8027 and the size of distal projections 8017 and Configuration can be set so that there is gap between the two.Similarly, proximal aperture 8029 and the size of proximal projections 8019 and Configuration can be set so that there is gap between the two.In some cases, distal aperture 8027 and distal projections 8017 Size and configuration can be set so that has interference fit between the two.In addition, similarly, proximal aperture 8029 and nearside are prominent The size and configuration in portion 8019 can be set so that there is interference engagement therebetween.It is at least one under such circumstances, it is prominent Layer 8020 can be releasably held warehouse 8010 by the interference engagement between portion and hole.In use, it is stored in warehouse 8010 In fastener can when fastener is ejected from warehouse 8010 contact layer 8020 part 8025, and layer 8020 promoted separate Platform 8016 is simultaneously disengaged hole with protruding portion.
Layer main body 8026 may include hole 8028, and the hole is respectively configured to dash forward distal projections 8017 and nearside Portion 8019 is received in wherein out.Each hole 8028 may include elongated slot, and the elongated slot, which has, to be configured to receive The proximal end of distal projections 8017 and the distal end for being configured to reception proximal projections 8019.In some feelings It, can there are clearance fits between hole 8028 and protruding portion 8017 and 8019 under condition.In some cases, it in hole 8028 and can dash forward There are clearance fits between portion 8017 and 8019 layer 8020 is releasably held warehouse 8010 out.In at least one situation Under, the size and configuration in hole 8028 can be configured to stretch to accommodate distal projections 8017 and proximal projections wherein 8019。
Layer 8020 can be removably attached to warehouse 8010.In some cases, the distal end 8024 of layer 8020 can To be removably attached to the distal end 8014 of warehouse 8010.In some cases, the proximal end 8022 of layer 8020 can be with It is removably attached to the proximal end 8012 of warehouse 8010.In at least one example, it can utilize attachment part 8021 will Layer 8020 releasably holds warehouse 8010.
Layer, such as backing material can be made of any biocompatible materials.Backing material can by natural material and/or Synthetic material is formed.Backing material can be bioabsorbable and/or not bioabsorbable.It should be appreciated that can be used it is natural, Synthesis, bioabsorbable and not bioabsorbable material any combination form backing material.It can be made into the material of backing material Material some non-limiting examples include but is not limited to for example polylactic acid, polyglycolic acid, poly butyric ester, poly-phosphine piperazine, polyester, Polyethylene glycol, polyacrylamide, poly-hydroxyethyl methyl acrylate, polyvinylpyrrolidone, polyvinyl alcohol, gathers at polyethylene oxide Acrylic acid, poly- acetic acid esters, polycaprolactone, polypropylene, aliphatic polyester, glycerol, poly- (amino acid), copolymerization (ether-ether), poly- alkylene Base oxalate, polyamide, poly- (iminocarbonic ester), polyalkylenes oxalates, polyoxaesters, polyorthoester, polyphosphazene and its Copolymer, block copolymer, homopolymer, blend and/or their combination.
Natural biological copolymer can be used to form support material.Suitable natural biological copolymer includes but is not limited to example As collagen, gelatin, fibrin, fibrinogen, elastin laminin, keratin, albumin, hydroxyethyl cellulose, cellulose, Oxycellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose, chitan, chitosan, and/or their group Close object.Natural biological copolymer can be combined with other polymer materials as described herein to prepare backing material.People and/or animal The collagen in source, such as I type pig or bovine collagen, I type people's collagen or type III people's collagen, can be used to form backing material.Fid Material can at least partly lose its helical structure, mainly by non-hydrated chain by denatured collagen or by heating or any other method The collagen of composition and molecular weight close to such as 100kDa are made.Term " denatured collagen " refers to the collagen for losing its helical structure. Collagen for porous layer as described herein can be native collagen or Atelocollagen, especially such as pass through pepsin digestion And/or it is obtained after such as example previously described mild heat.Collagen may previously pass through oxidation, methylation, amber Amber is acylated, ethylize and/or any other known procedure carries out chemical modification.
In the case where backing material is fibrous material, fiber can for suitable for being knitted or woven precursor or line, or It can such as be usually used in preparing those of non-woven material for staple fiber.Fiber can be made of any biocompatible materials.Fiber It can be formed by natural material or synthetic material.The material for forming fiber can be biological absorptive material or non-bioabsorbable material Material.It should be appreciated that any combination of natural, synthesis, bioresorbable and non-bioabsorbable materials can be used to form fiber. The some non-limiting examples that can be made into the material of fiber include but is not limited to polylactic acid, polyglycolic acid, poly butyric ester, gather Phosphine piperazine, polyethylene glycol, polyethylene oxide, polyacrylamide, poly-hydroxyethyl methyl acrylate, polyvinylpyrrolidone, gathers polyester Vinyl alcohol, polyacrylic acid, poly- acetic acid esters, polycaprolactone, polypropylene, aliphatic polyester, glycerol, poly- (amino acid), copolymerization (ether Ester), polyalkylenes oxalates, polyamide, poly- (iminocarbonic ester), polyalkylenes oxalates, polyoxaesters, polyorthoester, Polyphosphazene and its copolymer, block copolymer, homopolymer, blend and/or their combination.It is fibrous material in backing material In the case where, backing material, which can be used, to be suitable for forming any method of fibre structure to be formed, the method includes but it is unlimited In such as knitting, woven, nonwoven techniques etc..In the case where backing material is foam, porous layer can be used and suitably form bubble Any method of foam or sponge is formed, including but not limited to the freeze-drying and freeze-drying of such as composition.
Backing material can have hemostatic properties.Can be used to provide, there is auxiliary to stop bleeding or the fid of the ability of bleeding The material of material illustrates that example includes but is not limited to for example poly- (lactic acid), poly- (glycolic), poly- (butyric ester), poly- (in oneself Ester), poly- (dioxanone), polyalkylene oxide, copolymerization (ether-ether), collagen, gelatin, fibrin ferment, fibrin, fibrin Original, fibronectin splicing variants, elastin, albumin, hemoglobin, ovalbumin, polysaccharide, hyaluronic acid, chondroitin sulfate, hydroxyl Hydroxyethyl starch, hydroxyethyl cellulose, cellulose, oxycellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose Element, chitosan, chitosan, agarose, maltose, maltodextrin, alginates, coagulation factor, methyl acrylate, polyamine group first Acid esters, cyanoacrylate, platelet agonist, vasoconstrictor, alum, calcium, RGD peptide, albumen, protamine sulfate, ε- Aminocaproic acid, ferric sulfate, iron sulfite, iron chloride, zinc, zinc chloride, aluminium chloride, aluminum sulfate, aluminium acetate, permanganate, tannin, Bone wax, polyethylene glycol, fucosan and/or their combination.The use of natural biological copolymer and especially albumen can be fitted It is used to form the backing material with hemostatic properties.Suitable natural biological copolymer include but is not limited to for example collagen, gelatin, Fibrin, fibrinogen, elastin laminin, keratin, albumin and/or their combination.Natural biological copolymer can It is combined with any other hemostat to prepare the porous layer of supporter.Entitled " the BUTTRESS that on July 30th, 2013 announces The complete disclosure of the United States Patent (USP) 8,496,683 of AND SURGICAL STAPLING APPARATUS " is by reference simultaneously Enter herein.
The entire disclosure of following patent is hereby incorporated by reference:
The U.S. for being published in entitled " the ELECTROSURGICAL HEMOSTATIC DEVICE " on April nineteen ninety-five 4 is special Benefit 5,403,312;
It is published on 2 21st, 2006 entitled " SURGICAL STAPLING INSTRUMENT HAVING The United States Patent (USP) 7,000,818 of SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS ";
It is published on September 9th, 2008 entitled " MOTOR-DRIVEN SURGICAL CUTTING AND The United States Patent (USP) 7,422,139 of FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK ";
It is published in entitled " the ELECTRO-MECHANICAL SURGICAL INSTRUMENT on December 16th, 2008 The United States Patent (USP) 7,464,849 of WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS ";
It is published in entitled " the SURGICAL INSTRUMENT HAVING AN ARTICULATING on March 2nd, 2010 The United States Patent (USP) 7,670,334 of END EFFECTOR ";
It is published in the United States Patent (USP) of entitled " the SURGICAL STAPLING INSTRUMENTS " on July 13rd, 2010 7,753,245;
It is published in entitled " the SELECTIVELY ORIENTABLE IMPLANTABLE on March 12nd, 2013 The United States Patent (USP) 8,393,514 of FASTENER CARTRIDGE ";
The United States Patent (USP) Shen of entitled " SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES " It please sequence number 11/343,803 (being now United States Patent (USP) 7,845,537);
It is filed on 2 14th, 2008 entitled " SURGICAL CUTTING AND FASTENING INSTRUMENT The U.S. Patent Application Serial Number 12/031,573 of HAVING RF ELECTRODES ";
It is filed on 2 15th, 2008 entitled " END EFFECTORS FOR A SURGICAL CUTTING AND The U.S. Patent Application Serial Number 12/031,873 (being now United States Patent (USP) 7,980,443) of STAPLING INSTRUMENT ";
The U.S. Patent Application Serial Number of entitled " MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT " 12/235,782 (being now United States Patent (USP) 8,210,411);
Entitled " POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM " U.S. Patent Application Serial Number 12/249,117 (be now United States Patent (USP) 8,608, 045);
It is filed in entitled " the MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT on December 24th, 2009 The U.S. Patent Application Serial Number 12/ of WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY " 647,100 (being now United States Patent (USP) 8,220,688);
It is filed in the U.S. Patent Application Serial Number 12/ of on September 29th, 2012 entitled " STAPLE CARTRIDGE " 893,461 (being now United States Patent (USP) 8,733,613);
It is filed in the United States Patent (USP) Shen of on 2 28th, 2011 entitled " SURGICAL STAPLING INSTRUMENT " It please sequence number 13/036,647 (being now United States Patent (USP) 8,561,870);
Entitled " SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT The U.S. Patent Application Serial Number 13/118,241 of ARRANGEMENTS " (is now U.S. Patent Application Publication 2012/ 0298719);
It is filed in entitled " the ARTICULATABLE SURGICAL INSTRUMENT on June 15th, 2012 The U.S. Patent Application Serial Number 13/524,049 of COMPRISING A FIRING DRIVE " (is now U.S. Patent Application Publication 2013/0334278);
It is filed in entitled " the STAPLE CARTRIDGE TISSUE THICKNESS SENSOR on March 13rd, 2013 The U.S. Patent Application Serial Number 13/800,025 of SYSTEM ";
It is filed in entitled " the STAPLE CARTRIDGE TISSUE THICKNESS SENSOR on March 13rd, 2013 The U.S. Patent Application Serial Number 13/800,067 of SYSTEM ";
It is filed in entitled " the SURGICAL CUTTING AND FASTENING INSTRUMENT on January 31st, 2006 The U.S. Patent Application Publication 2007/0175955 of WITH CLOSURE TRIGGER LOCKING MECHANISM ";
It is filed in entitled " the SURGICAL STAPLING INSTRUMENT WITH AN on April 22nd, 2010 ARTICULATABLE END EFFECTOR " U.S. Patent Application Publication 2010/0264194 (be now United States Patent (USP) 8,308, 040) it, is all hereby incorporated by reference.
Although certain disclosed embodiments has been combined to be described the multiple embodiments of described device herein, The many modifications and variations of these embodiments can be implemented.In addition, in the open material for certain components In the case of, other materials can be used.In addition, single component can be replaced by multiple components, and more according to multiple embodiments A component can also be replaced by single component, to execute given one or more functions.Above-mentioned specific embodiment and following Claim is intended to cover all such modifications and variations.
Apparatus as disclosed herein is designed to be dropped after a single use or it is designed to using more It is secondary.However, in either case, can prosthetic device to be reused after use at least once.Reparation may include following Any combination of step: then provision for disengagement is cleaned or is replaced specific component and then re-assemblied.In particular, Detachable apparatus, and optionally replace or remove in any combination any number of specific component or the portion of device Part.After cleaning and/or replacing particular elements, device can be reassembled for then at the repair facility or just in surgical operation It is used before by operating team.It will be apparent to one skilled in the art that the reparation of device can utilize it is various for dismantle, clean/ The technology replaced and re-assemblied.The purposes of such technology and resulting repaired device are within the scope of application.
Preferably, invention as described herein will the processing before surgical operation.Firstly, obtaining and if necessary clear Clean new or used instrument.Then it can sterilize to instrument.In a kind of sterilization technology, by instrument be placed on closure and it is close In the container of envelope, in such as plastics or TYVEK bag.Then container and instrument are placed in the radiation field that can penetrate the container, such as γ radiation, x- ray or high energy electron.The bacterium in instrument and in container is killed in radiation.Then the instrument after sterilizing can be stored In sterile chamber.Sealing container makes instrument keep sterile, until it is opened in medical facilities.
It, can also be right in the spirit and scope of the disclosure although the present invention has been described as having illustrative design The present invention modifies.Therefore this application is intended to cover any modification, purposes or the modified versions using general principles. In addition, this application is intended to cover known to belonging in technology belonging to the present invention or usual practice relative to the such of the disclosure Deviate.
Any patent, announcement or other public materials incorporated in this article in full or in part by reference only simultaneously It is incorporated herein in the conflicting range of the existing definitions, statements, or other disclosure materials that the material entered is not proposed with the disclosure. Similarly and at the necessary level, the disclosure being expressly recited herein is any instead of what is be herein incorporated by reference Conflict material.It is any to be herein incorporated by reference but mutually rushed with existing definitions, statements, or other disclosure materials as described herein Prominent any material or part thereof does not only generate under the degree of conflict simultaneously between the incorporated material and the existing public material Enter herein.

Claims (14)

1. a kind of fastener cartridge, comprising:
Warehouse, the warehouse include:
It is configured to the platform of supporting tissue, wherein the platform includes:
First longitudinal direction terrace part with the first height;And
Second longitudinal direction terrace part, the second longitudinal direction terrace part have the second height different from first height;
First longitudinal direction arranges securing member chamber, and the first longitudinal direction row securing member chamber is limited in the first longitudinal direction terrace part;
Second longitudinal direction arranges securing member chamber, and the second longitudinal direction row securing member chamber is limited in the second longitudinal direction terrace part;With And
Protruding portion, the protruding portion extend from the first longitudinal direction terrace part and the second longitudinal direction terrace part;And
Multiple fasteners, the multiple fastener are removedly stored in the securing member chamber.
2. fastener cartridge according to claim 1, wherein the protruding portion crosses over the first longitudinal direction terrace part and institute State second longitudinal direction terrace part.
3. fastener cartridge according to claim 1, wherein the protruding portion traverses the first longitudinal direction terrace part and institute State second longitudinal direction terrace part.
4. fastener cartridge according to claim 1, wherein the protruding portion includes top surface, and the wherein top Portion surface is flat.
5. fastener cartridge according to claim 1, further includes:
Proximal end;
Distal end;
The first side extended between the proximal end and the distal end;With
The second side extended between the proximal end and the distal end.
6. fastener cartridge according to claim 5, wherein the protruding portion is transverse to the first side and described The side of two side faces upwardly extends.
7. fastener cartridge according to claim 5, wherein the protruding portion is on the direction for being parallel to the distal end Extend.
8. fastener cartridge according to claim 5, wherein the protruding portion makes in the first longitudinal direction row securing member chamber Intermediate securing member chamber in intermediate securing member chamber and second longitudinal direction row's securing member chamber extends.
9. a kind of fastener cartridge, comprising:
Warehouse, the warehouse include:
It is configured to the platform of supporting tissue, wherein the platform includes:
First longitudinal direction terrace part, the first longitudinal direction terrace part have the first height;With
Second longitudinal direction terrace part, the second longitudinal direction terrace part have the second height different from first height;
First longitudinal direction arranges securing member chamber, and the first longitudinal direction row securing member chamber is limited in the first longitudinal direction terrace part;
Second longitudinal direction arranges securing member chamber, and the second longitudinal direction row securing member chamber is limited in the second longitudinal direction terrace part;
The first protruding portion extended from the first longitudinal direction terrace part;
The second protruding portion extended from the second longitudinal direction terrace part;And
Interconnection structure, the interconnection structure connect first protruding portion and second protruding portion;With
Multiple fasteners, the multiple fastener are removedly stored in the securing member chamber.
10. fastener cartridge according to claim 9, wherein first protruding portion, second protruding portion and it is described mutually Even structure qualification top surface, and wherein the top surface is flat.
11. fastener cartridge according to claim 9, further includes:
Proximal end;
Distal end;
The first side extended between the proximal end and the distal end;With
The second side extended between the proximal end and the distal end.
12. fastener cartridge according to claim 11, wherein first protruding portion and second protruding portion are in transverse direction It is upwardly extended in the side of the first side and the second side.
13. fastener cartridge according to claim 11, wherein first protruding portion is with second protruding portion parallel It is upwardly extended in the side of the distal end.
14. fastener cartridge according to claim 11, wherein first protruding portion makes the first longitudinal direction row fastener Intermediate securing member chamber in chamber extends, and second protruding portion makes the intermediate fastening in the second longitudinal direction row securing member chamber Part chamber extends.
CN201580032277.5A 2014-04-16 2015-04-15 Fastener cartridge including organizational controls feature structure Active CN106456175B (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US201461980281P 2014-04-16 2014-04-16
US61/980,281 2014-04-16
US14/319,002 2014-06-30
US14/319,002 US9877721B2 (en) 2014-04-16 2014-06-30 Fastener cartridge comprising tissue control features
PCT/US2015/025855 WO2015160877A1 (en) 2014-04-16 2015-04-15 Fastener cartridge comprising tissue control features

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CN106456175B true CN106456175B (en) 2019-08-23

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CN102973300A (en) * 2012-12-13 2013-03-20 常州市新能源吻合器总厂有限公司 Tissue clamping member of linear cutting anastomat and nail granary of tissue clamping member
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US5452837A (en) * 1994-01-21 1995-09-26 Ethicon Endo-Surgery, Inc. Surgical stapler with tissue gripping ridge
EP1316290A2 (en) * 2001-11-28 2003-06-04 Ethicon Endo-Surgery (Europe) GmbH Surgical stapling instrument
EP1479346A1 (en) * 2003-05-20 2004-11-24 Ethicon Endo-Surgery Surgical stapling instrument incorporating keyed firing mechanism
CN101073509A (en) * 2006-05-18 2007-11-21 Tyco医疗健康集团 Surgical stapler with multiple suture nail dimension nail-bins
CN103140180A (en) * 2010-09-29 2013-06-05 伊西康内外科公司 Staple cartridge
CN102973300A (en) * 2012-12-13 2013-03-20 常州市新能源吻合器总厂有限公司 Tissue clamping member of linear cutting anastomat and nail granary of tissue clamping member

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JP6648034B2 (en) 2020-02-14
RU2016144676A3 (en) 2018-11-15
CN106456175A (en) 2017-02-22
RU2695564C2 (en) 2019-07-24
JP2017513592A (en) 2017-06-01
RU2016144676A (en) 2018-05-17

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