CN108135602B

CN108135602B - Surgical instrument comprising a system for ensuring correct sequential operation of the surgical instrument

Info

Publication number: CN108135602B
Application number: CN201680056881.6A
Authority: CN
Inventors: A·K·纳拉加特拉; S·B·帕特尔; F·E·谢尔顿四世
Original assignee: Ethicon LLC
Current assignee: Ethicon LLC
Priority date: 2015-07-30
Filing date: 2016-07-18
Publication date: 2021-04-23
Anticipated expiration: 2036-07-18
Also published as: CN108135602A; RU2018107124A3; RU2721286C2; RU2018107124A; JP2018521787A; JP6821653B2; BR112018001852A2; BR112018001852B1

Abstract

A surgical instrument includes a tissue clamping system, a staple firing system, and a tissue cutting system. The systems of the surgical instrument can cooperate with one another to prevent the systems from operating in an inverted order and/or to prevent the systems from operating in an undesirable order.

Description

Surgical instrument comprising a system for ensuring correct sequential operation of the surgical instrument

Background

The present invention relates to surgical instruments and, in various embodiments, to surgical stapling and cutting instruments and staple cartridges for use therewith.

The stapling instrument can include a pair of cooperating elongated jaw members, wherein each jaw member is adapted to be inserted into a patient and positioned relative to tissue to be stapled and/or incised. In various embodiments, one of the jaw members can support a staple cartridge having at least two laterally spaced rows of staples housed therein, and the other jaw member can support an anvil having staple-forming pockets aligned with the rows of staples in the staple cartridge. In general, the stapling instrument can further include a pusher bar and a knife blade that are slidable relative to the jaw members to sequentially eject staples from the staple cartridge via camming surfaces on the pusher bar and/or camming surfaces on a wedge sled that is pushed by the pusher bar. In at least one embodiment, the camming surfaces can be configured to actuate a plurality of staple drivers carried by the cartridge and associated with the staples to push the staples against the anvil and form laterally spaced rows of deformed staples in the tissue clamped between the jaw members. In at least one embodiment, the blades can follow the cam surface and cut tissue along the path between the rows of staples.

The above discussion is intended to be merely illustrative of the present aspects of the relevant art in the field of the present invention and should not be taken as negating the scope of the claims.

Drawings

Various features of the embodiments described herein and their advantages can be understood from the following description in conjunction with the following drawings:

FIG. 1 is a perspective view of a surgical stapling instrument in accordance with at least one embodiment;

FIG. 2 is a perspective view of the surgical stapling instrument of FIG. 1 with components of the surgical stapling instrument removed for illustration purposes;

FIG. 3 is an exploded perspective view of a surgical stapling instrument including a handle, a shaft, and an end effector in accordance with at least one embodiment;

FIG. 4 is a partial cross-sectional elevation view of the handle of FIG. 3 shown in an undamped, unfired configuration;

FIG. 5 is a partial cross-sectional elevation view of the handle of FIG. 3 shown in a clamped, unfired configuration;

FIG. 6 is a partial cross-sectional elevation view of the handle of FIG. 3 shown in a clamped, partially fired configuration;

FIG. 7 is a partial cross-sectional elevation view of the handle of FIG. 3 shown in a clamped, fully fired configuration;

FIG. 8 is a partial cross-sectional elevation view of the handle of FIG. 3 prior to returning to an undamped configuration;

FIG. 9 is a front view of a surgical stapling instrument including a handle, a shaft, and an end effector in accordance with at least one embodiment;

FIG. 10 is an exploded perspective view of a staple cartridge for use with the surgical stapling instrument of FIG. 9;

FIG. 11 is a perspective view showing the staple cartridge of FIG. 10 being assembled to the surgical stapling instrument of FIG. 9;

FIG. 12 is a cross-sectional view showing the staple cartridge of FIG. 10 positioned in the end effector of the surgical instrument of FIG. 9 and showing the end effector in a clamped configuration;

FIG. 13 is a cross-sectional view showing the staple cartridge of FIG. 10 positioned in the end effector of the surgical instrument of FIG. 9 and showing the staple drivers of the end effector being moved to a fired configuration by the firing system;

FIG. 14 is a cross-sectional view showing the staple cartridge of FIG. 10 positioned in the end effector of the surgical instrument of FIG. 9 and showing staple drivers operably disengaged from the firing system;

FIG. 15 is a cross-sectional view showing the staple cartridge of FIG. 10 positioned in the end effector of the surgical instrument of FIG. 9 and showing the cutting member being actuated by the firing system;

FIG. 16 is an exploded view of a surgical stapling instrument according to at least one embodiment, with components shown removed for illustration purposes;

FIG. 17 is a detail view of a progress indicator of the surgical stapling instrument of FIG. 16;

FIG. 18 is a cross-sectional view of the end effector of the surgical stapling instrument shown in a clamped, but unfired configuration;

FIG. 19 is a cross-sectional view of the end effector of FIG. 18 shown in a staple firing mode;

FIG. 20 is a cross-sectional view of the end effector of FIG. 18, showing the end effector transitioning between its staple firing mode and a tissue cutting mode.

FIG. 21 is a cross-sectional view of the end effector of FIG. 18 shown in its tissue cutting mode;

FIG. 22 is an exploded view of a surgical stapling instrument according to at least one embodiment, with components shown removed for illustration purposes;

FIG. 23 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22 shown in an undamped, unfired configuration;

FIG. 23A is a detail view of the delivery device of the surgical stapling instrument of FIG. 22;

FIG. 24 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22 shown in a clamped configuration prior to a firing stroke;

FIG. 25 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22 shown in a clamped configuration after a firing stroke;

FIG. 26 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22 shown in a clamped, fired configuration prior to a transection stroke;

FIG. 27 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22 shown in a clamped, fired configuration after a transection stroke;

FIG. 28 is a perspective view of a delivery device of the surgical stapling instrument of FIG. 22;

FIG. 28A is another perspective view of the transfer device of FIG. 28;

FIG. 29 is an exploded view of a surgical stapling instrument according to at least one embodiment, with components shown removed for illustration purposes;

FIG. 30 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29 shown in an undamped, unfired configuration;

FIG. 30A is a detail view of the delivery device of the surgical stapling instrument of FIG. 29 shown in a configuration corresponding to the undamped, unfired configuration shown in FIG. 30;

FIG. 31 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29 shown in a clamped, unfired configuration;

FIG. 31A is a detail view of the transmission of the surgical stapling instrument of FIG. 29 shown in a configuration corresponding to the clamped, unfired configuration shown in FIG. 31;

FIG. 32 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29 shown in a clamped configuration with staples being deployed from the surgical instrument;

FIG. 32A is a detail view of the transmission of the surgical stapling instrument of FIG. 29 shown in a configuration corresponding to the clamped, fired configuration shown in FIG. 32;

FIG. 33 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29 shown in a clamped configuration in which tissue is being transected by the surgical instrument;

FIG. 33A is a detail view of the transmission of the surgical stapling instrument of FIG. 29 shown in a configuration corresponding to the clamped, fired configuration shown in FIG. 33;

FIG. 34 is an exploded view of a surgical stapling instrument according to at least one embodiment, with components shown removed for illustration purposes;

FIG. 35 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34 in an undamped, unfired configuration;

FIG. 36 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34 in a clamped configuration prior to a firing stroke;

FIG. 37 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34 in a clamped, fired configuration prior to traverse travel;

FIG. 38 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34 in a clamped, fired configuration after a transection stroke;

FIG. 39 is an exploded view of a surgical stapling instrument according to at least one embodiment, with components shown removed for illustration purposes;

FIG. 40 is a partial cross-sectional view of the handle of the surgical stapling instrument of FIG. 39 shown in an undamped configuration;

FIG. 41 is a partial cross-sectional view of the handle of FIG. 40 shown in a tissue stapling mode of operation;

FIG. 42 is a partial cross-sectional view of the handle of FIG. 40 shown in a fired configuration;

FIG. 43 is a partial cross-sectional view of the handle of FIG. 40, showing the handle being switched between its tissue stapling and transecting modes of operation;

FIG. 44 is a partial cross-sectional view of the handle of FIG. 40 after a tissue transection stroke;

FIG. 45 is a partial cross-sectional view of a surgical stapling instrument that includes a staple firing bar, a blade bar, and a lockout configured to hold the firing bar in place as the blade bar advances relative to the firing bar in accordance with at least some embodiments;

FIG. 46 shows the firing bar of FIG. 45 in a firing position and a lockout positioned behind the staple firing bar;

FIG. 47 illustrates the blade bar of FIG. 45 in a firing position;

FIG. 48 illustrates the lockout of FIG. 45 disengaged from the staple firing bar such that the firing bar may be retracted;

FIG. 49 is a partial cross-sectional view of a surgical stapling instrument including a manually releasable lock in accordance with at least one alternative embodiment;

fig. 50 is a partial cross-sectional view of a surgical stapling instrument shown in an undamped configuration in accordance with at least one alternative embodiment;

FIG. 51 is a partial cross-sectional view of the surgical stapling instrument of FIG. 50 shown in a clamped configuration;

FIG. 52 is a partial cross-sectional view of the surgical stapling instrument of FIG. 50 shown in a staple firing configuration;

FIG. 53 is a partial cross-sectional view of the surgical stapling instrument of FIG. 50 shown in a tissue cutting configuration;

FIG. 54 is a partial perspective view of an end effector configured to successively fire staples and incise tissue captured within the end effector, the end effector shown with components removed for illustration purposes, according to at least one embodiment;

FIG. 55 is a partial perspective view of the end effector of FIG. 54 shown in a staple firing mode of operation;

FIG. 56 is a partial perspective view of the end effector of FIG. 54 shown in a tissue transection mode of operation;

FIG. 57 is a perspective view, partially in section, of an end effector according to at least one embodiment;

FIG. 58 is a perspective, partially cut-away view of the end effector of FIG. 57 shown in a staple firing mode of operation;

FIG. 59 is a partial perspective view of the end effector of FIG. 57 shown in a tissue transection mode of operation;

FIG. 60 is a partial cross-sectional view of a surgical stapling instrument in accordance with at least one embodiment;

FIG. 61 is a partial cross-sectional view of the surgical stapling instrument of FIG. 60 shown in a staple firing mode of operation;

FIG. 62 is a partial cross-sectional view of the surgical stapling instrument of FIG. 60 transitioning between a staple firing mode of operation and a tissue transecting mode of operation;

FIG. 63 is a partial cross-sectional view of the surgical stapling instrument of FIG. 60 in its tissue transecting mode of operation;

FIG. 64 is a perspective view, partially in section, of a surgical stapling instrument shown in a partially fired state in accordance with at least one embodiment; and is

FIG. 65 is a partial cross-sectional elevation view of the surgical stapling instrument of FIG. 64 shown in a partially fired state.

Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate various embodiments of the invention, in one form, and such exemplifications are not to be construed as limiting the scope of the invention in any manner.

Detailed Description

The applicant of the present application owns the following patent applications, filed on even date herewith and each incorporated herein by reference in its entirety:

U.S. patent application Ser. No. __________ entitled "SURGICAL INSTRUMENT COMPLEMENTING SEPARATATE SECURING AND TISSUE CUTTING SYSTEMS" (attorney docket No. END7668 USNP/150103);

U.S. patent application Ser. No. __________ entitled "SURGICAL INSTRUMENT COMPLEMENTING SYSTEMS FOR PERMITTING THE OPTIONAL TRANSCTIONION OF TISSUE" (attorney docket No. END7669 USNP/150104); and

U.S. patent application Ser. No. __________ entitled "SURGICAL INSTRUMENT COMPLEMENTING A SYSTEM FOR BYPASSING AN OPERATIONAL STEP OF THE SURGICAL INSTRUMENT" (attorney docket number END7670 USNP/150105).

Numerous specific details are set forth herein to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments described in the specification and illustrated in the accompanying drawings. Well-known operations, components and elements have not been described in detail so as not to obscure the embodiments described in the specification. The reader will understand that the embodiments described and illustrated herein are non-limiting examples and that specific structural and functional details disclosed herein are representative and illustrative. Variations and changes may be made to these embodiments without departing from the scope of the claims.

The terms "comprises" (and "comprising") in any form, such as "comprises" and "comprising", "having" (and "having"), any form, such as "having" and "having", "(and" comprising "), any form, such as" comprising "and" comprising ", and" containing "(and" containing "), and any form, such as" containing "and" containing ", such as" containing "and" containing "), are open-ended verbs. Thus, a surgical system, device, or apparatus that "comprises," "has," "contains," or "contains" one or more elements possesses those one or more elements, but is not limited to possessing only those one or more elements. Likewise, a system, apparatus, or device that "comprises," "has," "includes," or "contains" one or more features possesses those one or more features, but is not limited to possessing only those one or more features.

The terms "proximal" and "distal" are used herein with respect to a clinician manipulating a handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician and the term "distal" refers to the portion located away from the clinician. It will be further appreciated that for simplicity and clarity, spatial terms such as "vertical," "horizontal," "up," and "down" may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein may be used in a variety of surgical procedures and applications, including, for example, in conjunction with open surgery. With continued reference to the present detailed description, the reader will further appreciate that the various instruments disclosed herein may be inserted into the body in any manner, such as through a natural orifice, through an incision or puncture formed in tissue, and the like. The working portion or end effector portion of the instrument may be inserted directly into the patient's body or may be inserted through an access device having a working channel through which the end effector and elongate shaft of the surgical instrument may be advanced.

Certain prior surgical stapling instruments are disclosed in the following patents:

european patent application No. 795298 entitled "LINEAR STAPLER WITH IMPROVED FIRING STROKE" filed on 12.3.1997;

U.S. patent 5,605,272 entitled "TRIGGER MECHANISM FOR SURGICAL INSTRUMENTS" published on 25.2.1997;

U.S. patent 5,697,543 entitled "LINEAR STAPLER WITH IMPROVED dressing strong" published on 16.12.1997;

U.S. patent application publication 2005/0246881 entitled "METHOD FOR creating a SURGICAL STAPLER" published on 11/10 2005;

U.S. patent application publication 2007/0208359 entitled "METHOD FOR laminating TISSUE", published on 6.9.2007;

U.S. patent 4,527,724 entitled DISPOSABLE LINEAR SURGICAL STAPLING INSTRUMENT, published on 9.7.1985;

U.S. patent 5,137,198 entitled "FAST CLOSURE DEVICE FOR LINEAR SURGICAL STAPLING INSTRUMENT" published on 8, 11.1992; and U.S. patent 5,405,073 entitled "FLEXIBLE SUPPORT SHAFT ASSEMBLY" published on 11.4.1995, the entire disclosures of which are incorporated herein by reference.

A surgical stapling instrument 100 is disclosed in fig. 1 and 2. The instrument 100 includes a handle 110, a shaft 140 extending from the handle 110, and an end effector 150. The handle 110 includes a housing 111, a frame 114 extending through a shaft 140, a closure trigger 120, and a firing trigger 130. Operation of the closure trigger 120 moves the end effector 150 between an open configuration (FIG. 1) and a closed configuration. Referring primarily to fig. 2, the closure trigger 120 is pivotally mounted to the handle housing 111 about a pivot 121 and includes a drive portion 122 that rotates distally when the closure trigger 120 moves between an open position (fig. 1) and a closed position. The closure trigger 120 is part of a closure driver that also includes a linkage 123 and a closure rod 126. The link 123 is rotatably pinned to the drive portion 122 of the closure trigger 120 about a pin 124, and the link 123 is rotatably pinned to the closure bar 126 about a pin 125. As the drive portion 122 of the closure trigger 120 is rotated distally, the drive portion 122 drives the closure bar 126 to move the staple cartridge 160 of the end effector 150 toward the anvil 170 of the end effector 150 to clamp tissue between the staple cartridge 160 and the anvil 170 during the closure stroke of the closure driver. The drive portion 122 includes a lock slot 127 defined therein, the lock slot 127 configured to receive the distal end 117 of the closure lockout 112 when the closure trigger 120 reaches its fully clamped position. The closure lock 112 is rotatably mounted to the handle housing 111 about a pivot pin 113 and is biased against a drive portion 122 of the closure trigger 120 by a biasing member, such as a spring.

Operation of the firing trigger 130 fires staples removably stored in the staple cartridge 160 toward the anvil 170. Referring primarily to fig. 2, the firing trigger 130 is pivotally mounted to the handle housing 111 about a pivot 131 and includes a drive portion that rotates distally as the firing trigger 130 moves between an unactuated position (fig. 1) and an actuated position. The firing trigger 130 is part of a firing drive that also includes a firing bar 136, which firing bar 136 is driven distally as the firing trigger 130 moves toward its actuated position. The firing driver also includes staple drivers and a cutting member that are advanced distally by the firing bar 136 during the firing stroke of the firing driver. The frame 114, the closure bar 126, and the firing bar 136 are surrounded, or at least substantially surrounded, by a shaft housing 144.

The handle 110 may further comprise a firing return spring configured to return the firing trigger 130 to its unactuated position to reset the firing system after the firing stroke has been completed and the firing trigger 130 has been released by the clinician. Similarly, the handle 110 can further include a closure return spring configured to return the closure trigger 120 to its open position and reset the closure system after the closure lockout 112 has been depressed by the clinician to disengage the closure lockout 112 from the lock slot 127.

Referring to the embodiment disclosed in fig. 1 and 2, the firing trigger 130 is actuated to staple and incise tissue clamped in the end effector 150 in a single stroke of the firing trigger 130. Furthermore, the embodiments disclosed in fig. 1 and 2 do not provide the clinician operating the instrument with the ability to pause between the staple firing function and the tissue cutting function of the firing system. Furthermore, the instrument does not provide any feedback to the clinician as to whether the instrument is performing a staple forming function or a tissue cutting function. Various improvements to the instrument are provided below.

Surgical stapling instrument 200 is illustrated in fig. 3-8 and is similar in many respects to instrument 100 and/or other surgical instruments disclosed herein. For example, referring primarily to fig. 4, the instrument 200 includes a closure trigger 120 that, when actuated, drives the closure bar 126 distally to close the end effector of the instrument 200 by the closure trigger 120. Actuation of the closure trigger 120 also advances a firing bar 236 of the firing system at least partially distally to a preset position wherein the firing trigger 130 may be subsequently actuated to fire staples from a staple cartridge positioned in the end effector. The firing trigger 130 includes a drive portion 132 that aligns the drive portion 132 with the proximal end 133 of the firing bar 236 once the firing bar 236 has been moved to its preset position. At this point, referring now to FIG. 5, the firing trigger 130 can be actuated to move the firing bar 236 distally and fire the staples from the staple cartridge. However, actuation of the firing trigger 130 and distal advancement of the firing bar 236 is limited by a stop or switch 280. The switch 280 stops the distal advancement of the firing bar 236 before the firing bar 236 transects tissue captured within the end effector. To transect tissue, the switch 280 is actuated to release the firing bar 236, as shown in FIG. 6, such that the firing stroke of the firing actuator 130 can be completed, as shown in FIG. 7. In this manner, the firing of the staples and transection of the tissue may comprise separate and discrete operational steps of the instrument 200. In such cases, the clinician may select when to cut the tissue and/or whether to cut the tissue.

As discussed above, and referring primarily to fig. 5, the firing bar 236 is stopped by the switch 280 during distal advancement of the firing bar 236. The firing bar 236 includes a slot 285 defined therein, and the switch 280 is removably positioned in the slot 285. Switch 280 is pivotally mounted to handle housing 111 about a pivot pin 281 and includes a locking arm 282 positioned in a slot 285. The firing bar 236 may be advanced distally by the firing trigger 130 until the proximal end of the slot 285 contacts the lockout arm 282. At this point, further distal movement of the firing bar 236 is prevented by the lockout arm 282. A spring 284 is positioned between locking arm 282 and handle housing 111 to bias locking arm 282 into slot 285 and hold locking arm 282 in place until switch 280 is actuated, as shown in fig. 6. When the switch 280 is actuated, the locking arm 282 rotates out of the slot 285 and the firing bar 236 may then be advanced distally again, as shown in FIG. 7. When the firing bar 236 advances toward the end of its firing stroke, the lockout arm 282 is no longer aligned with the slot 285, and the spring 284 biases the lockout arm 282 against the bottom surface of the firing bar 236. When the firing bar 236 is retracted toward its unfired position after the tissue has been cut, the locking arm 282 may again be aligned with the slot 285 and the spring 284 may bias the locking arm 282 into the slot 285.

In addition to the above, the staples are fully formed when the firing bar 236 is stopped by the switch 280. In such instances, the tissue may be fully stapled before the cutting portion of the firing bar 236 is advanced to cut the tissue. Alternative embodiments are contemplated in which the staples are only partially formed when the firing bar 236 is stopped by the switch 280. In such embodiments, the tissue is cut at the same time as staple formation is completed. In either case, a pause is provided after the first step in the operation of the instrument 200, which requires intervention by the clinician to selectively decide whether to perform the second step, even though both steps are performed by one actuation of the trigger. In other words, the switch 280 stops the firing trigger 130 during the actuation stroke of the firing trigger 130, and the stopping function of the switch 280 must be disabled before the actuation stroke can be completed. The switch 280 may be operated at a time deemed appropriate by the clinician. In some instances, the switch 280 may be operated immediately after the switch 280 stops firing the lever 236 or alternatively, after a period of time. In some cases, the switch 280 may be operated prior to stopping the firing bar 236, thereby allowing the first and second steps to be selectively combined.

In addition to the above, clinicians may or may not remove their hands from the firing trigger 130 during the pause provided by the switch 280. In either case, it is desirable to prevent the firing bar 236 from being abruptly and/or accidentally retracted. To this end, the instrument 200 also includes a lockout 290 configured to releasably hold the firing bar 236 in place. The locking member 290 includes a ratchet system; however, any suitable locking member may be used. The lockout 290 is rotatably mounted to the housing 111 about a pivot pin 291 and includes a pawl 292 extending therefrom, the pawl 292 configured to engage ratchet teeth 295 defined in the firing bar 236. Locking member 290 also includes a proximal arm 293 and a spring 294 positioned intermediate proximal arm 293 and housing 111, spring 294 being configured to bias pawl 292 into engagement with teeth 295. When the pawl 292 is engaged with the teeth 295, the lockout 290 is configured to allow distal movement of the firing bar 236 but prevent proximal movement of the firing bar 236. The handle 210 of the instrument 200 also includes a switch 296 configured to engage the proximal arm 293 of the lock 290 and rotate the pawl 292 away from the firing bar 236 and disengage the pawl 292 from the teeth 295. At this point, the firing bar 236 may be retracted.

To retract the firing bar 236, the clinician may push the closure lock 112 to disengage the closure lock 112 from the closure trigger 120 and move the closure trigger 120 to its unactuated position (fig. 4), and/or the handle 210 may include a return spring configured to bias the closure trigger 120 to its unactuated position. In either case, movement of the closure trigger 120 toward its unactuated position can pull the link 123 proximally, which in turn can pull the closure bar 126 and firing bar 236 proximally. More specifically, pin 125 connecting link 123 also extends through a longitudinal hole defined in closure bar 126 and firing bar 236, such as longitudinal hole 129 defined in firing bar 236, and when link 123 is pulled proximally by closure trigger 120, pin 125 can contact a proximal end of hole 129 and a proximal end of the longitudinal hole defined in closure bar 126 and pull firing bar 236 and closure bar 126 proximally. Proximal movement of the firing bar 236 may also urge the firing actuator 120 back to its unactuated position, and/or the firing actuator 120 may be returned to its unactuated position by a return spring. In either case, once the firing bar 236 has returned to its unactuated position, the lockout 290 may be reset by pushing the switch 296 distally to allow the pawl 292 to reengage the teeth 295.

In addition to the above, the pawl 292 can be configured to produce an audible sound, such as a clicking sound, as the teeth 295 of the firing bar 236 slide over the pawl 292. Such an audible sound may provide feedback to the surgeon that the firing bar 236 is moving distally. Such audible sounds may also provide the surgeon with feedback regarding the speed of the firing bar 236, as sounds made at a faster pace will indicate that the firing bar 236 is moving at a faster speed and sounds made at a slower pace will indicate that the firing bar 236 is moving at a slower speed.

The surgical stapling instrument 300 is shown in fig. 9-15 and is similar in many respects to the

instruments

100, 200 and/or other surgical instruments disclosed herein. The instrument 300 includes an end effector 350, the end effector 350 including a staple cartridge 360 and an anvil 170. In use, tissue is positioned between the staple cartridge 360 and the anvil 170 and is subsequently captured in the end effector 350 by the deployable tissue pins 379. The tissue pins 379 are stored in the pin cavities 378 of the staple cartridge 360 and move distally toward the anvil 170. As the staple cartridge 360 is moved to the closed position, the tissue pins 379 may be pushed distally, as discussed in further detail below. The tissue pin 379 includes a lateral clamping member 377 configured to allow a clinician to push the pin 379 toward the anvil 170 and/or retract the pin 379 into the staple cartridge 360. Staple cartridge 360 includes a lateral slot 375 defined therein, which lateral slot 375 is configured to guide the longitudinal movement of clamping member 377 and tissue pin 379. Movement of the tissue pins 379 is limited by the anvil 170 and the proximal end plate 376.

Referring primarily to fig. 9, the instrument 300 further includes a closure trigger 120 that, when actuated, drives the closure bar 126 distally to close the end effector 350 of the instrument 300 and clamp tissue between the staple cartridge 360 and the anvil 170. The instrument 300 further includes a firing trigger 130 that, when actuated, pushes the firing bar 336 distally to eject staples from a staple cartridge 360 positioned in the end effector 350. Referring to fig. 10-15, the staple cartridge 360 comprises a cartridge body 361, which cartridge body 361 includes a plurality of

staple cavities

361a, 361b and a knife blade slot 366 defined therein. Staple cavity 361a is positioned on a first side of blade slot 366 and staple cavity 361b is positioned on a second side of blade slot 366. Although not shown, staples are stored in the

staple cavities

361a, 361b and are ejected from the

staple cavities

361a, 361b as the staple drivers 362 are moved toward the anvil 170 by the firing bar 336. Staple driver 362 includes a plurality of staple supports or cradles 362a configured to drive staples stored in staple cavities 361a and a plurality of staple supports or cradles 362b configured to drive staples stored in staple cavities 361 b. The staple drivers 362 further include

longitudinal rails

368a and 368b configured to control and/or constrain the motion of the staple drivers 362 to a longitudinal path.

In addition to the above, staple cartridge 360 includes a cutting member or blade 367 slidably positioned in blade slot 366. The staple driver 362 includes first and second blade latches 364a, 364b that are configured to releasably retain the blade 366 and the staple driver 362 together, as described in greater detail below. The staple driver 362 includes a first pivot joint 363a and a second pivot joint 363 b. The first blade latch 364a is rotatably positioned in the first pivot joint 363a and the second blade latch 364b is rotatably positioned in the second pivot joint 363 b. First and second blade latches 364a, 364b are rotatable between a clamped position (fig. 12 and 13) in which they engage blade 367, and an undamped position (fig. 14 and 15) in which they disengage blade 367. When the first and second blade latches 364a, 364b are in their clamped positions, the staple drivers 362 and blade 367 move together. In use, the staple drivers 362 and blade 367 are pushed distally by the firing bar 336 to move the staples between an unfired position (FIG. 12) and a fired position (FIG. 13). As can be appreciated from fig. 13, when the staple drivers 362 are moved to their fired positions, the cutting edge of the blade 367 is not exposed from the cartridge body 361 to cut the tissue captured between the cartridge body 361 and the anvil 170. Instead, the blade 367 is in a staged position below the deck surface of the cartridge body 361.

As seen in fig. 12 and 13, the firing bar 336 contacts the first and second blade latches 364a, 364b to urge the staple drivers 362 distally. Referring to fig. 11-13, the first blade latch 364a is releasably engageable with the blade support 369 such that actuation of the staple driver 362 may be transmitted to the blade 367. More specifically, the first blade latch 364a includes a ridge 365a positioned within a groove 369a defined in the blade support 369 and, similarly, the second blade latch 364b includes a ridge 365b positioned within a groove 369b defined in the blade support 369. The

ridges

365a, 365b are fixedly received within their

respective grooves

369a, 369b such that the driving force delivered by the firing bar 336 is transmitted to the staple drivers 362 and the blade 367 to deform the staples against the anvil 170. The

ridges

365a, 365b and the

grooves

369a, 369b are configured such that the

ridges

365a, 365b remain engaged with the

grooves

369a, 369b until a threshold force is reached at which time the blade latches 364a, 364b move outwardly away from the blade support 369, as shown in fig. 14 and 15. The threshold force may include, for example, the force required to fully form the staple. At this point, the firing bar 336 can no longer be operatively engaged with the staple drivers 362, and the firing bar 336 can be moved distally relative to the staple drivers 362. The firing bar 336 can then directly contact the blade support 369 to drive the blade 367 toward the anvil 170 and transect the tissue. As can be seen in fig. 15, the blade 367 moves relative to the staple drivers 362 after the staple drivers 362 have been separated from the blade 367.

In addition to the above, the firing system of the instrument 300 includes two separate and discrete stages: a first or staple firing stage and a second or tissue cutting stage. The operation of the blade latches 364a, 364b defines the boundary between these two phases. When the blade latches 364a, 364b are clamped to the blade 367, the firing system is in its staple firing state. When the blade latches 364a, 364b are not gripping the blade 367, the firing system is in its tissue cutting state. The two stages are separate and distinct and there is no overlap between the two; however, embodiments are contemplated in which there may be at least some overlap between these two stages.

Surgical stapling instrument 400 is shown in fig. 16 and 17 and is similar in many respects to

instruments

100, 200, 300 and/or the surgical instruments disclosed herein. For example, instrument 400 includes a handle 410, and handle 410 includes a housing 411, which housing 411 is similar in many respects to housing 111. The instrument 400 further includes a closure bar 126, which closure bar 126, in addition to the above, moves the staple cartridge toward the anvil to clamp tissue therebetween. As discussed above, the closure trigger 120 is actuated to move the closure bar 126 distally. Additionally, as discussed above, the closure trigger 120 also advances the firing bar 136 to a preset position when the closure trigger 120 is actuated. The firing trigger 130 can then be actuated to move the firing bar 136 distally and fire the staples from the staple cartridge, and subsequently incise the tissue. Thus, it can be said that the firing bar 136 moves distally during all three operating states (the closed operating state, the staple firing operating state, and the tissue incising operating state). The instrument 400 also includes a progress indicator that displays the operational status of the instrument 400, as discussed in more detail below.

In addition to the above, referring primarily to FIG. 17, the progress indicator includes a demarcation line 418 on the firing bar 136. The demarcation line 418 includes a protrusion extending laterally from the firing bar 136; however, in various other instances, the demarcation line 418 may include indicia, for example, printed on the firing bar 136. The progress indicator also includes a progress bar 415 positioned within a window 414 defined in the handle housing 411. Progress bar 415 includes indicia 416 corresponding to the three operating states of instrument 400. For example, the indicia 416 include a first indicia "clamp" corresponding to a tissue clamping operating state, a second indicia "staple" corresponding to a staple firing operating state, and a third indicia "cut" corresponding to a tissue incising operating state. The progress bar 415 also includes three lines 417 corresponding to the completion of the operational state. In use, the demarcation line 418 on the firing bar 136 is aligned with the first line 417 when the closure stroke has been completed, as shown in FIG. 17, the second line 417 when the staples have been fully fired, and the third line 417 when the cutting stroke has been completed. In other words, as the firing bar 136 advances distally, the demarcation line 418 moves distally along the progress bar 415 to indicate the progress of the firing bar 136. Such movement of demarcation line 418 can be observed by an operator of surgical instrument 400 through window 414 defined in handle housing 411. In at least one embodiment, the portion of the progress bar 415 associated with the clamping operation state can be a first color, such as green, the portion of the progress bar 415 associated with the staple firing operation state can be a second color, such as yellow, and the portion of the progress bar 415 associated with the tissue incising operation state can be a third color, such as red. In an alternative embodiment, a progress bar 415 may be mounted to the firing bar 136, and a demarcation line 418 may extend from the handle housing 411.

A surgical stapling instrument 500 is shown in fig. 18-21. Instrument 500 is similar in many respects to

instruments

100, 200, 300, and/or 400. The instrument 500 includes an end effector 550, the end effector 550 including a staple cartridge 560 and an anvil 170. The staple cartridge 560 includes a cartridge body 561 which includes staple cavities 561a defined therein. Staples are removably stored in the staple cavities 561 a. The staple cartridge 560 further includes staple drivers 562, which staple drivers 562 include pushers 562a configured to move the staples toward the anvil 170 and eject the staples from the staple cavities 561 a. The instrument 500 also includes a firing bar 536, the firing bar 536 being configured to urge the staple drivers 562 distally toward the anvil 170. The staple drivers 562 include a proximally extending flange 564 that is engaged by the firing bar 536 as the firing bar 536 advances distally. When the end effector 550 is in the undamped, but unfired configuration, as shown in fig. 18, the flange 564 is positioned within the channel 568 defined in the cartridge 561. In fact, the flanges 564 are deflected or biased inwardly by the sidewalls of the channel 568 and slide along the sidewalls as the staple drivers 562 move distally. The flange 564 engages and is retained in its inwardly flexed position by the channel sidewall throughout the firing stroke of the staples. The end of the staple firing stroke is shown in FIG. 19.

The staple cartridge 560 further includes a cutting member 567 movably positioned within a blade slot 566 defined in the cartridge body 561. The cutting member 567 includes a base 569 that is clamped between the flanges 564 such that the cutting member 567 moves with the staple drivers 562 as the staple drivers 562 are driven distally by the firing bar 563. Referring again to fig. 19, which illustrates the end of the staple firing stroke, it should be appreciated that the cutting member 567 has not yet emerged from the cartridge body 561. Thus, the staple firing operation of the instrument 500 is separate and discrete from the tissue incising operation of the instrument 500. When the flange 564 releases the cutting member 567, the instrument 500 transitions between its staple firing operation and its tissue lancing operation. By comparing fig. 19 and 20, it will be appreciated that flange 564 curves laterally outwardly when the proximal end of flange 564 is no longer biased inwardly by the sidewall of channel 568. More specifically, the flange 564 flexes outwardly upon exiting the distal end 565 of the passage 568. At this point, flange 564 is no longer engaged with cutting member 567. Further, at this point, the flange 564 can no longer engage the firing bar 536, and thus the firing bar 536 can no longer push the staple drivers 562 distally. Conversely, when the firing bar 536 is advanced distally, the firing bar 536 may directly contact the base 569 of the cutting member 567 and advance the cutting member 567 distally, as shown in fig. 21, to transect tissue captured between the anvil 170 and the staple cartridge 560.

In addition to the above, the point at which the instrument 500 transitions between the staple firing mode of operation and the tissue cutting mode of operation depends upon the distance the firing bar 536 has been moved. Other instruments disclosed herein transition between staple firing and tissue cutting modes of operation, for example, depending on the force transmitted through a firing bar of the instrument. Some embodiments may employ a combination of these two conversion approaches.

A surgical stapling instrument 600 is shown in fig. 22-28A. The instrument 600 is similar in many respects to the

instruments

100, 200, 300, 400, 500, and/or other surgical instruments disclosed herein. The instrument 600 includes a handle 610, the handle 610 including a closure trigger 620 configured to operate a closure system or tissue clamping system and a firing trigger 630 configured to operate a firing system. The closure trigger 620 is rotatable between an unactuated position (fig. 24) and an actuated position (fig. 25). The closure system of instrument 600 is similar in many respects to that of instrument 100 and will not be described in detail herein for the sake of brevity. In various instances, the instrument 600 includes a lockout system that prevents actuation of the firing trigger 630 prior to actuation of the closure trigger 620.

In addition to the above, the closure trigger 620 includes a drive portion 622 that pushes the link 123 distally to clamp the end effector of the surgical instrument 600 to tissue. The drive portion 622 includes a clearance slot 628 defined therein such that the drive portion 622 is movable relative to a shaft 634 that extends through the clearance slot 628.

The firing system and closure system of the instrument 600 are separate and discrete. The firing system has two separate and discrete operational functions, namely, a staple firing function and a tissue incising function. The staple firing function occurs during a first actuation of the firing trigger 630 and the tissue incising function occurs during a second actuation of the firing trigger 630. Similar to the above, the firing trigger 630 is rotatably coupled to the housing 111 about the pivot 131. Referring primarily to fig. 23, 23A, 28, and 28A, the firing trigger 630 includes a gear portion 632 in meshing engagement with a pinion gear 633. The pinion gear 633 is mounted to a shaft 634, the shaft 634 being rotatably mounted to the handle housing 111. More specifically, the pinion gear 633 is mounted to the first portion 634a of the shaft 634 such that the pinion gear 633 and the shaft portion 634a rotate together. Thus, actuation or rotation of the firing trigger 630 rotates the pinion gear 633 and the first shaft portion 634 a.

Referring again to fig. 28 and 28A, the shaft 634 also includes a second portion 634b, the second portion 634b being selectively engageable with the first portion 634a at a ratchet interface 639. When the second shaft portion 634b is operatively engaged with the first portion 634a, rotation of the first portion 634a is transmitted to the second portion 634b and the first and

second shaft portions

634a, 634b rotate together. The output pinion 635 is mounted to the second shaft portion 634b such that the pinion 635 rotates with the second shaft portion 634 b. The pinion 635 is in meshing engagement with a rack 637 defined on the proximal end of the firing bar 636. In use, referring now to fig. 25, the ratchet interface 639 is configured to transmit a rotary motion to the firing bar 636 and drive the firing bar 636 distally (direction D in fig. 28) when the firing trigger 630 is actuated.

In addition to the above, referring again to FIG. 25, a first actuation of the firing trigger 630 pushes the firing bar 636 distally to fire the staples. After the first actuation, the surgeon may release the firing trigger 630 and allow a return spring to be operably coupled with the firing trigger 630 to return the firing trigger 630 to its unfired position, as shown in fig. 26. Alternatively, the surgeon may manually return the firing trigger 630 to its unactuated position. In either case, the ratchet interface 639 is configured to allow the first shaft portion 634a to rotate relative to the second shaft portion 634b when the firing trigger 630 is returned to its unfired position. More specifically, the first shaft portion 634a includes ratchet teeth that slide relative to corresponding ratchet teeth defined on the second shaft portion 634b when the firing trigger 630 is returned to its unactuated position. To accommodate such relative movement, the first shaft portion 634a is allowed to move away from the second shaft portion 634 b. The handle 610 further includes a biasing member, such as a spring, configured to re-engage the first shaft portion 634a with the second shaft portion 634b once the firing trigger 630 has returned to its unactuated position.

Referring again to FIG. 26, the reader will appreciate that the firing bar 636 has been only partially advanced during the first stroke of the firing trigger 630. Such partial advancement of the firing bar 630 during the first stroke of the firing trigger 630 fires or fully forms staples stored within the end effector of the instrument 600, but which do not transect tissue captured within the end effector. Referring now to FIG. 27, the firing trigger 630 can be actuated a second time to fully advance the firing bar 630 and transect the tissue. As outlined above, actuation or rotation of the firing trigger 630 drives the pinion 633, shaft 634, and output pinion 635 to advance the firing bar 636 distally. In various circumstances, the surgeon may choose not to transect the tissue and instead may unclamp the tissue after firing the staples. In such circumstances, the surgeon will not actuate the firing trigger 630 a second time. In various instances, the teachings described above in connection with instrument 600 may be used in connection with, for example, instruments 400 and/or 500.

A surgical stapling instrument 700 is shown in fig. 29-33A. The instrument 700 is similar in many respects to the

instruments

100, 200, 300, 400, 500, 600, and/or other surgical instruments disclosed herein. The instrument 700 includes a handle 710, the handle 710 including a closure trigger 620 configured to operate a closure system or tissue clamping system and a firing trigger 630 configured to operate a firing system. The closure trigger 620 is rotatable between an unactuated position (fig. 30) and an actuated position (fig. 31). The closure system of instrument 700 is similar in many respects to that of instrument 100 and will not be described in detail herein for the sake of brevity. In various instances, the instrument 700 includes a lockout system that prevents actuation of the firing trigger 630 prior to actuation of the closure trigger 620.

The firing system and the closure system of the instrument 700 are separate and discrete. The firing system has two separate and discrete operational functions, namely, a staple firing function and a tissue incising function. Actuation of the firing trigger 630 performs two functions, as described in greater detail further below. A firing trigger 630 is rotatably mounted to the handle 710 about a pivot 131, and the firing trigger 630 includes a gear portion 632. The teeth of the gear portion 632 are in meshing engagement with a pinion 733, which pinion 733 is rotatably mounted in the shank 710 about the shaft 734. The shaft 734 also includes two cam projections mounted thereto, namely a first cam projection 735a and a second cam projection 735 b. The first cam projection 735a is configured to engage and advance the staple firing bar 736a, and the second cam projection 735b is configured to engage and advance the tissue cutting bar 736 b. The

cam projections

735a, 735b are mounted to the shaft 734 such that they rotate with the shaft 734.

Prior to actuation of the firing trigger 630, referring to fig. 31, the first cam projection 735a is aligned with a first cam surface 737a defined on the proximal end of the staple firing bar 736a, and the second cam projection 735b is aligned with a second cam surface 737b defined on the proximal end of the tissue cutting bar 736 b. The first and

second cam projections

735a, 735b are mounted to the shaft 734 in a staggered relationship. When the firing trigger 630 is in its unactuated position, as shown in fig. 31, the first cam protrusion 735a is positioned adjacent the first cam surface 737a and the second cam protrusion 735b is spaced apart from the second cam surface 737 b.

In addition to the above, the firing trigger 630 is actuated to drive the staple firing bar 736a and the tissue cutting bar 736b during a single stroke of the firing trigger 630. A first portion of the firing trigger actuation drives the staple firing bar 736a distally and a second portion of the firing trigger actuation drives the tissue cutting bar 736b distally. The first portion of the firing trigger actuation does not overlap the second portion. In other words, the staple firing process is completed before the tissue cutting process begins. In use, the ramp 738a of the first cam projection 735a moves the staple firing bar 736a distally until the ramp 738a passes the first cam surface 737 a. At this time, the dwell 739a of the first cam protrusion 735a is aligned with the first cam surface 737a, and the staple firing bar 736a is no longer advanced distally by the first cam protrusion 735 a. In various other embodiments, the dwell 739a of the first cam projection 735a may complete the staple forming process. In such a case, the ramp 738a of the first cam projection 735a starts the staple forming process and the hold-down portion 739a completes the staple forming process. In at least one instance, the ramp 738a can complete more staple forming processes than the hold down portion 739 a. In such cases, the staples rapidly grasp the tissue and then slowly close to fully secure the tissue therein. Alternatively, the dwell 739a may complete more staple forming process than the ramp 738 a. In such cases, the compressive pressure applied by the staples may be applied over a longer period of time, which may better allow fluid to flow out of the tissue during the staple forming process. In either case, the second cam projection 735b is spaced from the ramp 738a by a relief portion 739 a. When the shaft 734 is rotated by the firing actuator 630, as shown in fig. 32 and 32A, the second cam projection 735b rotates into contact with the second cam surface 737b and completes the staple cutting process, as shown in fig. 33 and 33A.

In various instances, in addition to the above, the instrument 700 can include stops that define transitions between staple firing processes and tissue cutting processes. The stop can, for example, prevent or inhibit movement of the firing actuator 630 after the staple firing bar 736a has been fully advanced and before the tissue cutting bar 736b has been advanced. The handle 710 may include a stop release that, once actuated, may allow the surgeon to complete the firing stroke of the firing actuator 630. Such embodiments may allow the surgeon to select whether to perform the tissue cutting function of instrument 700. In certain instances, the instrument 700 can generate sensory feedback, such as audible and/or tactile feedback, when the firing actuator 630 crosses the transition point between the staple firing function and the tissue cutting function.

In various alternative embodiments, in addition to the above, the tissue cutting process can at least partially overlap with the staple forming process. In such embodiments, the first and

second cam projections

735a, 735b are positioned and arranged on the shaft 734 such that the first cam projection 735a can drive the staple firing bar 736a at the same time that the second cam projection 735b drives the tissue cutting bar 736 b.

In addition to the above, the firing actuator 630 can return to its unactuated position after it has been actuated to fire staples and/or incise tissue. The handle 710 may include a return spring engaged with the firing actuator 630 that is biased to return the firing actuator 630 to its unactuated position. In addition to or in lieu of the above, the instrument 700 can include one or more biasing members engaged with the

rods

736a, 736b that are configured to return the

rods

736a, 736b to their unfired positions. When the firing actuator 630 is returned to its unactuated position, the gear portion 632 rotates the pinion 733, the shaft 734, and the

cam projections

735a, 735b in opposite directions to disengage the

cam projections

735a, 735b from the

rods

736a, 736b, respectively.

A surgical stapling instrument 800 is shown in fig. 34-38. The instrument 800 is similar in many respects to the

instruments

100, 200, 300, 400, 500, 600, and/or 700 and/or other surgical instruments disclosed herein. The instrument 800 includes a handle 810, the handle 810 including a closure trigger 620 configured to operate a closure system or a tissue clamping system. The instrument 800 also includes a firing trigger 830a configured to operate the staple firing system and a cutting trigger 830b configured to operate the tissue cutting system. The closure trigger 620 is rotatable between an unactuated position (fig. 35) and an actuated position (fig. 36). The closure system of instrument 800 is similar in many respects to that of instrument 100 and will not be described in detail herein for the sake of brevity. In various instances, the instrument 800 includes a lockout system that prevents actuation of the firing trigger 830a and/or the cutting trigger 830b prior to actuation of the closure trigger 620.

The firing system and closure system of the instrument 800 are separate and discrete. Actuation of the firing trigger 830a operates the staple firing system to deform staples removably stored in the end effector of the instrument 800. A firing trigger 830a is rotatably mounted to the handle 810 about a pivot 131 between an unfired position (fig. 36) and a fired position (fig. 37). The firing trigger 830a includes a curved cam member 832a extending therefrom that moves distally when the firing trigger 830a is actuated, as shown in FIG. 36. As the cam member 832a advances distally, the cam member 832a contacts the proximal end 837a of the staple firing rod 836a to drive and deform staples removably stored in the end effector of the instrument 800.

The cutting system of the instrument 800 is separate and discrete from the firing and closure systems. Actuation of the cutting trigger 830b operates the tissue cutting system to cut tissue captured within the end effector of the instrument 800. The cutting trigger 830b is rotatably mounted to the handle 810 about the pivot 131 between an unactuated position (fig. 37) and an actuated position (fig. 38). Cutting trigger 830b includes a curved cam member 832b extending therefrom that moves distally when cutting trigger 830b is actuated, as shown in fig. 38. As the cam member 832b advances distally, the cam member 832b contacts the proximal end 837b of the tissue cutting rod 836b to cut tissue.

The firing actuator 830a is rotated through a first range of motion to complete the firing stroke of the firing bar 836a, and the cutting actuator 830b is rotated through a second range of motion to complete the cutting stroke of the cutting bar 836 b. The firing stroke and the cutting stroke have the same length or at least substantially the same length; however, other embodiments are contemplated in which the length of the firing stroke is different than the length of the cutting stroke. Further, the first range of motion of the firing actuator 830a is the same, or at least substantially the same, as the second range of motion of the cutting actuator 830 b; however, other embodiments are contemplated in which the first range of motion is different than the second range of motion.

Referring again to fig. 37 and 38, the firing actuator 830a includes a recess 839 defined therein. The recess 839 is configured to receive or at least partially receive the cutting actuator 830b therein. As shown in FIG. 36, when the firing actuator 830a and the cutting actuator 830b are in their unactuated positions, the cutting actuator 830b is nested with the firing actuator 830 a. When the firing actuator 830a is moved to its actuated position, as shown in FIG. 37, the

actuators

830a, 830b can become non-nested as the cutting actuator 830b can remain in its unactuated position. Actuation of the cutting actuator 830b can then cause the actuator 830b to re-nest with the firing actuator 830a, as shown in FIG. 38.

In addition to the above, separate and

discrete actuators

830a, 830b can allow the staple firing system and the tissue cutting system of the instrument 800 to be selectively operated in a separate and discrete manner. Even so, the surgeon has the option of actuating the

actuators

830a, 830b of the instrument 800 simultaneously. In such instances, the instrument 800 will simultaneously staple and cut the tissue captured in the end effector. Alternatively, in at least one embodiment, the instrument 800 can include a lockout configured to prevent the cutting actuator 830b from being actuated prior to full actuation of the firing actuator 830 a. In such embodiments, the surgeon will not have the option of actuating both

actuators

830a and 830b simultaneously, but will still have the option of selectively actuating cutting actuator 830 b. In another alternative embodiment, the cutting actuator 830b can be unlocked at some point during actuation of the firing actuator 830a such that the

actuators

830a, 830b can then be simultaneously actuated by the surgeon if desired. Such embodiments can ensure that the staples have been at least partially fired, or at least fully fired, prior to cutting the tissue.

A surgical stapling instrument 900 is shown in fig. 39-44. The instrument 900 is similar in many respects to the

instruments

100, 200, 300, 400, 500, 600, 700, 800 and/or other surgical instruments disclosed herein. The instrument 900 comprises a handle 910, the handle 910 comprising a housing 911, a closure trigger 620 configured to operate a closure system or a tissue clamping system, and a handle configured to operate: first, staple firing system and second, the firing trigger 930a of the tissue cutting system. The closure trigger 620 is rotatable between an unactuated position (fig. 40) and an actuated position (fig. 41). The closure system of instrument 900 is similar in many respects to that of instrument 100 and will not be described in detail herein for the sake of brevity. In various circumstances, the instrument 900 can include a lockout system that prevents actuation of the firing trigger 930 prior to actuation of the closure trigger 620.

In addition to the above, a firing trigger 930 is rotatably mounted to the handle housing 911 about a pivot 131 between an unactuated position (fig. 41) and an actuated position (fig. 42). As described in greater detail below, the firing trigger 930 operates the staple firing system (fig. 42) during a first actuation of the firing trigger 930 and operates the tissue cutting system (fig. 43) during a second actuation of the firing trigger 930. The firing trigger 930 includes a curved cam portion 932 that moves distally when the firing trigger 930 is actuated. As cam portion 932 is rotated distally, cam portion 932 contacts cam plate 985. A cam plate 985 is slidably mounted in the handle housing 911. Cam plate 985 is longitudinally slidable as it is pushed distally by cam portion 932. The cam plate 985 includes a drive slot defined between

arms

986, 987 extending from a distal end of the cam plate 985. The drive slot is configured to receive a proximal end of the staple firing bar 936a such that when the cam plate 985 is pushed distally, the cam plate 985 drives the firing bar 936a distally to fire staples removably stored within the end effector of the instrument 900. More specifically, the distal extension arm 986 contacts the proximal end 987a of the staple firing bar 936a to push the firing bar 936a distally.

In addition to the above, the cam plate 985 is also able to slide laterally. More specifically, the cam plate 985 is slidable between a first position in which the cam plate 985 is operatively engageable with the staple firing bar 936a (fig. 41 and 42) and a second position in which the cam plate 985 is operatively engageable with the tissue cutting bar 936b (fig. 43 and 44). The handle 910 also includes a push block 980 engaged with the cam plate 985. The push block 980 includes a push pin 981 extending therefrom that extends through the handle housing 911. The push block 980 may include another push pin 981 extending through the handle housing 911 in the opposite direction. In any event, a user of surgical instrument 900 can transition push block 980 between its first position and its second position by applying a force to one of push pins 981. When push block 980 is in its second position, tissue cutting bar 936b is positioned in the drive slot defined between

arms

986 and 987. At this point, the cam plate 985 can be operatively coupled with the tissue cutting bar 936b and subsequent actuation of the firing trigger 930 will actuate the tissue cutting system.

In use, the instrument 900 is positioned within a patient and the end effector of the instrument 900 is positioned relative to the tissue to be treated. The closure trigger 620 is then actuated to clamp the end effector to the tissue. At this point, the push block 980 is positioned in its first position and is configured to be operatively engaged with the staple firing bar 936 a. Actuation of the firing trigger 930 then advances the staple firing bar 936a distally; however, when the cam sled 985 is not engaged with the tissue cutting bar 936b, such actuation of the firing trigger 930 does not advance the tissue cutting bar 936 b. After the firing trigger 930 has been actuated, the firing trigger 930 may be released and returned to its unactuated position, as shown in FIG. 43. Similar to the above, the handle 910 may include a return spring configured to return the firing trigger 930 to its unactuated position. As further illustrated in FIG. 43, the firing bar 936a remains in its fired position when the firing trigger 930 is returned to its unactuated position. Turning now to fig. 44, the push block 980 can be moved to its second position to disengage the push block 980 from the staple firing bar 936a and to engage the push block 980 with the tissue cutting bar 936 b. Actuation of the firing trigger 930 may then advance the tissue cutting bar 936b distally to cut tissue; however, the surgeon has the option of not cutting tissue and may release tissue from the end effector without actuating the firing trigger 930a second time. The handle 910 can include a release mechanism configured to return the closure trigger 620 and closure system to their unfired position. In any event, instrument 900 can include one or more return springs and/or return mechanisms for returning

levers

936a, 936b to their unactuated positions. In at least one instance, the

levers

936a, 936b can be reset upon reopening of the end effector.

As discussed above, the staple firing bar 936a remains in its distal firing position when the firing trigger 930 is re-actuated to drive the tissue cutting bar 936b distally. In various circumstances, the firing bar 936a can remain in its fired position due to, for example, friction between the firing bar 936a and the frame of the instrument 900; however, such frictional forces may be overcome and the firing bar 936a may be pushed proximally. In certain instances, turning now to fig. 45, the staple firing bar and/or the tissue cutting bar can comprise a means for positively retaining the bar in an actuated or at least partially actuated position.

In at least one exemplary embodiment, in addition to the above, the surgical instrument 1000 comprises a handle 1010, the handle 1010 comprising a handle housing 1011. The instrument 1000 further includes a staple firing bar 1036a that is configured to eject and deform staples removably stored in the end effector of the instrument 1000 when the firing bar 1036a is pushed distally. The instrument 1000 also includes a tissue cutting bar 1036b configured to incise tissue captured within the end effector of the instrument 1000. The handle 1010 includes, for example, a lockout 1090 that is configured to hold the firing bar 1036a in place while the cutting bar 1036b is being actuated. The lockout 1090 includes a first end mounted to the handle housing 1011 and a second or cantilevered end 1092 that engages the rack 1093a of the firing bar 1036 a. The rack 1093a includes a longitudinal array of teeth configured to allow the firing bar 1036a to move distally relative to the lockout 1090, as shown in fig. 46, and prevent the firing bar 1036a from moving proximally relative to the lockout 1090 until the lockout 1090 is released from the firing bar 1036 a.

In addition to the above, as the firing bar 1036a passes through the lockout 1090, the lockout 1090 positions itself behind each tooth of the rack 1093a in series. If the surgeon were to halt the advancement of the firing bar 1036a at some point during the firing stroke of the firing bar 1036a, the lock 1090 may hold the firing bar 1036a in place until the firing stroke is restarted. After the staple firing stroke has been completed, a lockout 1090 is positioned behind the most proximal tooth of the firing bar 1036 a. At this point, the lockout 1090 is held by the tissue cutting bar 1036b in engagement with the firing bar 1036 a. The cutting bar 1036b includes a rack 1093b defined thereon, the rack 1093b being similar to that described above and including a longitudinal array of teeth configured to permit distal movement of the cutting bar 1036b relative to the lock 1090, as shown in fig. 47, and to prevent proximal movement of the cutting bar 1036b relative to the lock 1090 until the cutting bar 1036b has completed its cutting stroke, as shown in fig. 48. At this point, the lockout 1090 may slide off the ends of the firing bar 1036a and the cutting bar 1036b and out of engagement with the

bars

1036a and 1036 b.

In addition to the above, the locking member 1090 is held in a flexed configuration by the

stems

1036a and 1036b such that after the

racks

1093a and 1093b have passed the locking member 1090, the locking member 1090 can resiliently expand and disengage itself from the

stems

1036a and 1036 b. The rack 1093a is defined on a flexible cantilever 1094a extending proximally from the firing bar 1036a, and the rack 1093b is defined on a flexible cantilever 1094b extending proximally from the cutting bar 1036 b. The

racks

1093a and 1093b are configured to flex in cooperation with the locking member 1090. In any event, after the locking member 1090 has disengaged from the

racks

1093a and 1093b, the

rods

1036a and 1036b can return to their unactuated positions, respectively. In various circumstances, one or more return springs can be associated with the

stems

1036a and 1036b to return the

stems

1036a and 1036b to their unactuated positions.

Turning now to fig. 49, the instrument 1000 can include a reset actuator, such as an actuator 1190, which can disengage the lockout 1090 from the firing bar 1036a and/or cutting bar 1036b prior to completion of the firing and/or cutting strokes of the instrument 1000. The actuator 1190 includes a first end 1191 rotatably mounted to the handle housing via a pivot pin 1193 and a second end 1192 that is further configured to engage the lock 1090. The button 1194 is operatively engageable with the first end 1191 of the actuator 1190 and is configured to rotate the second end 1192 of the actuator 1190 into engagement with the locking member 1090 when the button 1194 is depressed, as shown in fig. 49. In such instances, the actuator 1190 flexes the second end 1092 of the locking member 1090 away from the

posts

1036a and 1036b and disengages the locking member 1090 from the

racks

1093a and 1093 b. At this point,

rods

1036a and 1036b can be retracted to their unactuated position. Such a release actuation system may allow instrument 1000 to be quickly opened and loosened from tissue at any suitable point during operation of instrument 1000. Button 1194 can be depressed during the firing stroke, after the firing stroke, during the cutting stroke, and/or after the cutting stroke to release lock 1090.

Referring to fig. 50-53, the surgical instrument 1200 includes an end effector 1250 and a closure system configured to close the end effector 1250. The end effector 1250 includes a staple cartridge 1260 and an anvil 170. The staple cartridge 1260 comprises a cartridge body 161, a plurality of staple cavities defined therein, and staples removably stored in the staple cavities. The staple cartridge 1260 is movable between an open position (fig. 50) and a closed position (fig. 51) toward the anvil 170 to compress tissue between the cartridge body 161 and the anvil 170. The instrument 1200 also includes a closure bar 126 mounted to the cartridge body 161. The closure bar 126 can be advanced distally to move the staple cartridge 1260 distally and retracted proximally to move the staple cartridge 1260 proximally. The end effector 1250 further includes a rail 168 that is configured to guide the staple cartridge 1260 along a longitudinal axis as the staple cartridge 1260 moves proximally and distally.

Referring primarily to fig. 50 and 51, distal advancement of the closure bar 126 also advances the tissue pin 379 distally to capture tissue within the end effector 1250. More specifically, the closure bar 126 includes a drive pin 128a extending laterally therefrom, the drive pin 128a configured to engage one or more tissue pin actuators 372 as the closure bar 126 is moved distally. The tissue pin actuator 372 is rotatably mounted to the shaft frame 114 about a pivot pin 118 and is movable between an unactuated position (fig. 50) and an actuated position (fig. 51). Each tissue pin actuator 372 includes a drive portion 373 configured to engage and push the base portion 374 of the tissue pin 379. The tissue pin 379 is slidably retained within a cavity 378 defined in the end effector 1250 such that movement of the tissue pin 379 is constrained to a longitudinal path. The anvil 170 includes pin holes 179 defined therein, the pin holes 179 configured to receive the tissue pins 379 when the tissue pins 379 have reached their fully deployed position.

In addition to the above, staple cartridge 1260 is moved toward anvil 170 prior to tissue pins 379 being deployed. In such cases, the tissue is continuously clamped and then captured within the end effector 1250; however, alternative embodiments are contemplated in which tissue is simultaneously grasped by the cartridge 1260 and captured within the end effector 1250 by the tissue pin 379. Other embodiments are contemplated in which the tissue pins 379 are deployed prior to distal movement of the staple cartridge 1260 to compress tissue.

In addition to the above, the staple cartridge 1260 further comprises staple drivers 162 configured to drive staples toward the anvil 170. The anvil 170 includes forming pockets 171 defined therein that are configured to deform the staples. As described in greater detail below, the staple drivers 162 are pushed distally by the firing bar 1236. Referring again to fig. 50 and 51, the closure bar 126 further includes a second drive pin 128b extending laterally therefrom, the second drive pin 128b configured to engage the firing bar 1236 and move the firing bar 1236 distally with the cartridge 1260 when the cartridge 1260 is moved distally to clamp tissue. In this manner, the relative positions of the firing bar 1236 and the staple cartridge 1260 can be maintained, or at least substantially maintained, during closure of the end effector 1250.

The firing bar 1236 does not directly push the staple drivers 162; instead, the firing bar 1236 directly pushes the intermediate driver 1263, which intermediate driver 1263 transmits the motion of the firing bar 1236 to the staple drivers 162. More specifically, the intermediate driver 1263 includes a plurality of drive arms 1264 extending distally therefrom, the plurality of drive arms 1264 being in contact with drive surfaces 1265 defined on the proximal side of the staple driver 162. When the firing bar 1236 is being advanced distally to deform the staples against the anvil 170, as shown in fig. 52, the drive arm 1264 transmits force between the firing bar 1236 and the staple drivers 162.

Each of the drive arms 1264 is rotatably connected to the intermediate drive 1263 about a pivot pin 1266. Each drive arm 1264 is constructed and arranged such that it can transmit a specific amount of force to the staple drivers 162, and the drive arms 1264 can rotate to a collapsed position when the force transmitted through the drive arms 1264 exceeds a threshold force, as shown in fig. 53. The threshold force is selected such that it is consistent with the force required to deform the staples into their formed or fired configuration; however, it should be understood that a range of forces may be suitable for deforming the staples to the appropriate formed height, and that the threshold force may be any force within this appropriate range or may be greater than this range. In any event, the collapse of the drive arms 1264 allows the intermediate drivers 1263 to move relative to or toward the staple drivers 162, and at this point the staple drivers 162 can no longer move toward the anvil 170. Further, at this point, the staple firing process has been completed, and relative movement, now possible between the intermediate drivers 1263 and the staple drivers 162, is used to deploy the cutting member or blade toward the anvil 170 to cut tissue. The cutting stroke of the blade begins when the drive arm 1264 begins to collapse and ends when the drive arm 1264 contacts a support surface 1239 defined on the intermediate driver 1263. As a result of the foregoing, the tissue cutting operation is separate and discrete from the staple firing operation. Further, the staple firing operation and the tissue cutting operation occur continuously and non-overlapping. Such an arrangement prevents transection of the tissue before the staples are fully formed.

The reader should appreciate that the operator of the surgical instrument 1200 can retract the firing bar 1236 to its unfired position at any point during the staple firing operation of the instrument 1200. More specifically, the firing bar 1236 may be returned proximally until it contacts the second drive pin 128b of the closure bar 126. The reader should also appreciate that the operator of the surgical instrument may open the end effector 1250 and move the staple cartridge 1260 away from the anvil 170 at any point during the staple firing operation of the instrument 1200. Even so, instrument 1200 includes a lockout system configured to prevent end effector 1250 from being opened during a tissue cutting operation. In addition, the blade member must be fully retracted by the firing rod 1236 before the tissue pin 379 can be retracted and/or the end effector 1250 can be opened. Such a latching system is shown in fig. 51-53.

Referring to fig. 51, each drive arm 1264 of the staple firing system includes a latch 1267 extending therefrom. Each locking pin 1267 is positioned within a locking slot defined in the cartridge body 161 wherein each locking slot comprises a first portion 1268 and a second portion 1269. As discussed in more detail below, the detents 1267 are positioned in the first portion 1268 during staple forming operations and in the second portion 1269 during tissue cutting operations. During a staple forming operation of the instrument 1200, the locking pin 1267 slides distally within the first portion 1268 of the locking slot, as shown in fig. 52. In fact, the latch 1267 can be moved proximally and distally within the first portion 1268, thereby allowing the firing bar 1236 to be selectively advanced and retracted during a staple forming operation, as described above. Further, such positioning of the pins 1267 within the first portion 1268 allows the staple cartridge 1261 to be selectively moved proximally away from the anvil 170 of the instrument 1200, as further described above, in order to open the end effector 1250. However, during a tissue cutting operation, the locking pin 1267 enters the second portion 1269 of the locking slot. At this point, the side walls of the second portion 1269 prevent the cartridge body 161 from retracting relative to the firing bar 1236. In this manner, the staple cartridge 1260 is locked in place when the cutting member is or may be exposed. In such cases, the end effector 1250 cannot be opened until the cutting member is retracted, or at least fully retracted. The cutting member is retracted when the firing bar 1236 is pulled proximally. As the firing member 1236 is pulled proximally, the locking pin 1267 moves from the second portion 1269 of the lock slot into the first portion 1268 and unlocks the cartridge body 161. At this point, lock pin 379 may be retracted and/or end effector 1250 may be opened.

An alternative embodiment of the tissue stapling and cutting mechanism of the surgical instrument 1300 is shown in fig. 54-56. Instrument 1300 includes a cartridge jaw 1360, which cartridge jaw 1360 includes: a plurality of staple drivers 1362 configured to eject staples from the staple cartridge 1360 to staple tissue; and a blade member 1367 configured to cut into tissue. The staple drivers 1362 and blade member 1367 are deployed by the firing member 1336; however, as discussed below, the deployment of staple drivers 1362 and blade members 1367 are staggered. The firing member 1336 includes a toothed rack 1369 that moves or translates distally in direction D to deploy the staple drivers 1362 and the blade member 1367. Instrument 1300 further includes a gear train 1366 operably engaged or meshed with rack 1369, gear train 1366 including a plurality of rotatable gears. The rack 1369 and gear train 1366 are configured to convert the translational motion of the firing member 1336 into rotational motion of the gear train 1366.

Gear train 1366 includes first and second output gears 1368. Each output gear 1368 is mounted to shaft 1363 such that shaft 1363 and gear 1368 rotate together. Gear train 1366 also includes staple firing

output cams

1364a, 1364b mounted to each of shafts 1363. In the illustrated embodiment, each shaft 1363 includes first and second staple deployment cams 1364a mounted thereto for rotation with shaft 1383. Each cam 1364a includes a contoured surface configured to engage a drive surface 1365a defined on the bottom of the staple drivers 1362. As the cam 1364a is rotated by the shaft 1363, the cam profile rotates between a first orientation (fig. 54) associated with the unfired position of the staple drivers 1362 and a second orientation (fig. 55) associated with the fired position of the staple drivers 1362. The first orientation and the second orientation are spaced apart, for example, by about 180 degrees. Such movement of the cams 1364a and staple drivers 1362 constitutes the firing stroke of the instrument 1300, and the peaks of the cams 1364a contact the drive surface 1365a when the staple drivers 1362 have reached the end of the firing stroke, as shown in FIG. 55.

In addition to the above, instrument 1300 includes four staple firing cams 1364 a; however, any suitable number of cams 1364a may be used. Four staple firing cams 1364a are positioned and arranged relative to the drive surface 1365a to provide a balanced or symmetrical firing load to the staple drivers 1362. By comparing fig. 54 and 55, the reader will appreciate that the staple firing cam 1364a moves the staple drivers 1362 relative to the blade member 1367. Blade member 1367 is deployed independently of staple drivers 1362 as discussed below.

Gear train 1366 also includes a tissue cutting output cam 1364b mounted to each of shafts 1363. Cam 1364b is configured to deploy blade member 1367. Similar to the above, cam 1364b is rotated between the first orientation (fig. 54) and the second orientation (fig. 55) during the staple firing process discussed above; however, cam 1364b does not push staple driver 1362 or blade member 1367 distally during such rotation. Referring now to fig. 56, subsequent rotation of shaft 1363 and cam 1364b places cam 1364b in engagement with drive surface 1365b of blade member 1367, thereby urging blade member 1367 distally to cut stapled tissue. Such subsequent rotation also rotates the peaks of the staple firing cam 1364a out of engagement with the drive surface 1365 a. In such instances, the staple drivers 1362 may float back or may be allowed to retract back into the staple cartridge 1360 as the tissue is being cut.

As discussed above,

cams

1364a and 1364b are positioned and arranged on shaft 1363 such that the staple firing operation and the tissue cutting operation do not occur simultaneously. In some cases,

cams

1364a and 1364b can be arranged such that there is an intermittence between staple firing operations and tissue cutting operations. In at least one such instance, cam 1364a and/or cam 1364b can comprise a dwell portion that creates a pause between staple firing operations and tissue cutting operations. Such pauses can provide the surgeon with an opportunity to stop operation of the instrument 1300 between staple firing strokes and tissue cutting strokes. In alternative embodiments,

cams

1364a and 1365b can be positioned and disposed on shaft 1363 such that there is overlap between the staple firing operation and the tissue cutting operation. Such overlap allows for rapid actuation of the instrument.

An alternative embodiment of the tissue stapling and severing mechanism of the surgical instrument 1400 is shown in fig. 57-59. The instrument 1400 includes a staple cartridge jaw 1460 that includes a cartridge body 1461, a plurality of staple drivers 1462 configured to eject staples from the cartridge body 1461 to staple tissue, and a blade member 1467 configured to cut into tissue. The staple driver 1462 and blade member 1467 are deployed by the firing member 1436; however, as discussed below, the deployment of the staple drivers 1462 and blade members 1467 is staggered. The staple driver 1462 and blade member 1467 move distally between a first or unactuated position (FIG. 57) and a second position (FIG. 58) corresponding to the end of the staple firing process. The blade member 1467 can then be moved relative to the staple driver 1462 to a third position, as illustrated in FIG. 59.

In addition to the above, the firing member 1436 includes a ramped drive surface 1464 defined thereon. In use, the staple drivers 1462 and the blade member 1467 are urged distally by the drive surface 1464 to fire the staples from the cartridge body 1461. More specifically, the drive surface 1464 pushes the blade member 1467 distally, which in turn pushes the staple drivers 1462 distally at least during the staple firing process. The blade member 1467 includes

rollers

1465a and 1465b that contact the ramp surface 1464. The

rollers

1465a and 1465b are rotatably mounted to the blade member 1467 about

drive pins

1469a and 1469b, respectively. The drive pins 1469a and 1469b are positioned within

drive slots

1463a and 1463b, respectively, defined in a frame 1468 to which the staple drivers 1462 are attached. The drive pins 1469a, 1469b are configured to abut distal side walls of the

drive slots

1463a, 1463b, respectively, as the blade member 1467 is pushed distally by the firing member 1436. In this manner, staple firing forces are transmitted from the firing bar 1436 to the staple drivers 1462 via the driver ramps 1464, rollers 1465a, rollers 1465b, drive pins 1469a, drive pins 1469b, and drive

slots

1463a, 1463 b. The distal movement of the staple drivers 1462 is limited by stop surfaces 1466 defined in the cartridge body 1461, for example. When the staple driver frame 1468 contacts the stop surface 1466, referring to FIG. 58, the firing stroke of the instrument 1400 is completed. At this point, only a portion of the cutting surface of the blade member 1467 has been exposed from the cartridge body 1461; however, the tissue is not yet exposed at the cutting surface. More specifically, the jaw or anvil opposite staple cartridge 1460 may include a cavity configured to receive the exposed portion of the cutting surface, thereby reducing the likelihood that blade member 1467 will cut tissue during operation of instrument 1400 at this time.

As discussed above, the distal movement of the staple driver 1462 and the blade member 1467 is constrained by the stop surface 1466 at the end of the firing stroke, and therefore, additional distal or longitudinal motion of the firing bar 1436 will no longer be translated into distal or longitudinal motion of the staple driver 1462 and the blade member 1467. Conversely, referring to fig. 59, additional distal movement of the firing bar 1436 is translated into lateral movement of the blade member 1467. More specifically, the additional distal movement of the ramp surface 1464 generates a reaction force between the blade member 1467 and the now stationary driver frame 1468 that moves the blade member 1467 laterally along the descending ramp surface 1464. The

rollers

1465a, 1465b facilitate lateral movement of the blade member 1467; however, without the assistance of the

rollers

1465a, 1465b, the blade member 1467 can slide along the drive ramp 1464 to account for continued distal movement of the firing member 1436.

In addition to the above, blade member 1467 cuts stapled tissue as it moves laterally through staple cartridge 1460. The blade member 1467 moves along a cutting axis that is transverse to a longitudinal firing axis defined by the action of the firing member 1436. The cutting axis is perpendicular or at least substantially perpendicular to the firing axis; however, any suitable arrangement may be used. Additionally in addition to the above, the cutting stroke of the blade member 1467 begins at the end of the firing stroke of the driver 1462; however, it is contemplated that a delay may be provided between the cutting stroke and the firing stroke.

Many of the surgical instruments disclosed herein can use a single firing bar for actuating the staple deployment system and the tissue cutting system. Such instruments may benefit from the use of audible and/or tactile feedback that may convey certain information to the user of the surgical instrument regarding the current operating state of the surgical instrument. In at least one example, a firing bar of a surgical instrument can include a first array of teeth and a second array of teeth that can slide relative to one or more snap elements in a handle of the surgical instrument. The interaction between the first array of teeth and the catch element may produce a clicking sound and/or vibration during a staple firing operation of the surgical instrument. The first array of teeth may be arranged on the firing bar such that feedback is generated, for example, near the end of the firing stroke. With such feedback, if the surgeon desires to at least pause operation of the surgical instrument, for example, between a staple firing mode of operation and a tissue cutting mode of operation, they can slow the advancement of the firing bar. Alternatively, the surgeon may choose not to cut the tissue. The second array of teeth may be arranged on the cutting bar such that feedback is generated, for example, near the end of the cutting stroke. In certain embodiments, an array of teeth can be arranged on the firing bar such that feedback is generated between the staple firing mode of operation and the tissue cutting mode of operation. The above-described feedback may be used with an instrument that includes a staple firing bar and a separate tissue cutting bar.

A surgical instrument 1500 is disclosed in fig. 61-64. The instrument 1500 includes a shaft 1540 and a circular end effector 1550 for stapling and transecting a lumen, for example. [ incorporated by reference. End effector 1550 includes a staple cartridge 1560, which staple cartridge 1560 comprises a circular cartridge body 1561 and a plurality of staples removably stored in the cartridge body 1561 in a circular array. The staple cartridge 1560 further comprises staple drivers 1562 configured to eject staples from the cartridge body 1561. Staple drivers 1562 are also arranged in a circular array and connected to a common drive frame; however, any suitable arrangement may be used. For example, the staple drivers 1562 may not be connected to each other. The end effector 1550 further includes a circular anvil 1570, the circular anvil 1570 configured to compress a portion of the lumen against the cartridge body 1561. The anvil 1570 is attached to the closure actuator 1526 which extends through the shaft 1540. The closure actuator 1526 is configured to move the anvil 1570 toward and away from the staple cartridge 1560 between a clamped and undamped position. Fig. 61-64 all show the anvil 1570 in a clamped position. The anvil 1570 further includes a circular array of forming pockets 1571 configured to deform staples as they are ejected from the staple cartridge 1560.

The surgical instrument 1500 also includes a cutting member 1567, the cutting member 1567 configured to incise tissue captured between the anvil 1570 and the staple cartridge 1560. In use, the staple drivers 1562 drive the staples against the anvil 1570 during the staple forming process (fig. 61), and the cutting member 1567 cuts tissue during the tissue cutting process (fig. 63). As discussed below, the staple forming process and the tissue cutting process occur continuously and there is no overlap between the two; however, embodiments are contemplated in which the staple forming process and the tissue cutting process may occur simultaneously or at least partially simultaneously.

In addition to the above, and referring primarily to FIG. 60, when the anvil 1570 is moved to its clamped position, the staple drivers 1562 and cutting member 1567 are stored in an unactuated position within the end staple cartridge 1560. The staple drivers 1562 and cutting member 1567 are then moved distally during the staple forming process by the firing member 1536 to deform the staples, as shown in FIG. 61. More specifically, a distal end 1538 of firing member 1536 engages a washer 1539 positioned between firing member 1536 and driver 1562 and cutting member 1567, which in turn engages driver 1562 and cutting member 1567. The firing stroke of the staple drivers 1562 is completed when the drivers 1562 contact the proximal side of the cartridge body 1561. Notably, the cutting members 1567 are not exposed from the cartridge body 1561 during the staple forming process; instead, the cutting member 1567 remains positioned within the cartridge body 1561 during the staple forming process, despite its movement toward the anvil 1570.

Once the staple drivers 1562 have bottomed out against the cartridge body 1561, the surgeon can understand that the staple forming process has been completed. At this point, the surgeon may then retract the firing member 1536 and skip through the tissue cutting step (if they so choose). Alternatively, the surgeon may apply a pushing force to the firing member 1536 to puncture the washer 1539, as shown in fig. 62. This pushing force is greater than the force required to fire the staples. Thus, after the end of the staple firing stroke, the surgeon will experience a significantly increased force required to advance the firing member 1536. If the firing member 1536 is driven by a manually operated actuator, the surgeon will have to autonomously choose to increase the force applied to the firing member 1536 in order to initiate the tissue cutting stroke. The washer 1539 may be configured such that it can withstand up to a threshold force, wherein the distal end 1538 of the firing member 1536 can push through the washer 1539 once the threshold force has been met or exceeded.

In some cases, in addition to the above, the gasket 1539 may be configured such that it breaks or fails suddenly once a threshold force applied to the gasket 1539 has been met. In at least one such case, the gasket 1539 can include a weakened portion that facilitates failure of the gasket 1539 in a defined area, such as the annular groove 1537. In some cases, the distal end 1538 of the firing member 1536 can include a cut portion that intersects the washer 1539. In any event, the washer 1539 may act as a fuse that must fail before a cutting stroke can begin.

Once the gasket 1539 is broken or transected, or has otherwise failed, referring to fig. 63, the gasket 1539 will comprise two separate parts: a first portion 1539a that can be pushed distally by a firing member 1536 and a second portion 1539b that remains stationary. The groove 1537 is located intermediate the first portion 1539a and the second portion 1539b of the gasket 1539. The groove 1537 creates a significantly breakable gasket 1539 such that the gasket 1539 breaks once an appropriate level of force has been applied to the gasket 1539. In at least one instance, the gasket 1539 is constructed of, for example, plastic. The first washer portion 1539a is pushed distally by the firing member 1536 to move the cutting member 1567 distally to complete the cutting stroke of the instrument 1500.

In addition to or in lieu of a manually operated actuator, the instrument 1500 may include an electric motor configured to drive a firing member 1536. Such systems may also use at least one sensor configured to detect the load experienced by the firing member, and a controller in additional communication with the load sensor and the electric motor that may control operation of the electric motor based on data received from the load sensor. Such a system may recognize that the staple drivers 1562 have seen a bottom and in response, halt the electric motors. Such pauses can allow the surgeon to choose whether to open the anvil 1570 or instruct the controller to perform a tissue cutting procedure after the staple firing procedure. The instrument 1500 may include a first button that may be actuated by a surgeon, for example, to open the anvil 1570 and a second button that may be actuated by a surgeon, for example, to perform a tissue cutting procedure.

In addition to the above, each of the surgical instruments disclosed herein may include or may be modified to include one or more manually operated triggers and/or one or more electric motors for operating the instrument. The

surgical instruments

100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, 1400, and 1500 may include a manually operated closure system that transmits force between a closure trigger and an end effector of the surgical instrument. For example, the instrument 100 includes a manually operated closure system configured to transmit rotation of the closure trigger 120 to the end effector 150. In an alternative embodiment, any of the instruments disclosed herein can include an electric motor configured to operate the closure system of the instrument. Similar to the above, the instrument may further include a control system configured to operate the electric motor in response to one or more inputs from the surgeon and/or data received from one or more sensors of the instrument.

In addition to or in lieu of the above, the

surgical instruments

100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, 1400, and 1500 may include manually operated firing systems that transmit force between a firing trigger and an end effector of the surgical instrument. For example, the instrument 100 includes a manually operated firing system configured to transmit rotation of the firing trigger 130 to the end effector 150. In alternative embodiments, any of the instruments disclosed herein can include an electric motor configured to operate the firing system of the instrument. Similar to the above, the instrument may further include a control system configured to operate the electric motor in response to one or more inputs from the surgeon and/or data received from one or more sensors of the instrument.

The reader should appreciate that

surgical instruments

100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, and 1400 are commonly used in surgical techniques in which one or more large incisions are made in a patient to provide access to a surgical site in the patient. These surgical techniques are commonly referred to as "open" surgical techniques. The teachings provided herein are applicable to surgical techniques in which an instrument is inserted through one or more trocars or cannulas, for example, through a small incision to provide access into a patient. Open surgical techniques generally provide the clinician with a better view of the surgical site, while laparoscopic surgical techniques generally produce smaller scars on the patient. The instrument 1500 can be inserted through a natural orifice of a patient, such as the anus. The teachings provided herein are applicable to surgical techniques in which an instrument is inserted through one or more natural orifices of a patient.

The reader should appreciate that the staples of the

surgical instruments

100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, 1400, and 1500 are deployed longitudinally, i.e., along, parallel to, or substantially parallel to a longitudinal axis defined by the shaft of the surgical instrument. Other embodiments are contemplated in which the staples are deployed along one or more axes transverse to the longitudinal axis. Fig. 64 and 65 disclose one such exemplary surgical instrument, surgical instrument 1600. The surgical instrument 1600 includes a staple cartridge jaw 1660 and an anvil jaw 1670. The staple cartridge jaw 1660 and/or the anvil jaw 1670 are movable to clamp tissue therebetween. The staple cartridge jaw 1660 comprises a cartridge body 1661, which cartridge body 1661 comprises a plurality of staple cavities defined therein. The cartridge jaw 1660 further comprises a plurality of staples 1669 removably stored in the staple cavities and a plurality of staple drivers 1662 configured to eject the staples 1669 from the staple cavities. The instrument 1600 also includes a firing bar 1636 that is distally movable to lift the staple drivers 1662 and staples 1669 toward the anvil jaw 1670. The anvil jaw 1670 includes staple forming pockets 1671, the staple forming pockets 1671 configured to deform staples 1669, as shown in fig. 64 and 65. The teachings provided herein are applicable to surgical instrument 1600, and the like.

A surgical stapling system may include a shaft and an end effector extending from the shaft. The end effector includes a first jaw and a second jaw. The first jaw includes a staple cartridge. A staple cartridge is insertable into and removable from the first jaw; however, other embodiments are contemplated in which the staple cartridge is not removable or at least not easily replaceable from the first jaw. The second jaw includes an anvil configured to deform staples ejected from the staple cartridge. The second jaw is pivotable relative to the first jaw about a closure axis; however, other embodiments are contemplated in which the first jaw is pivotable or movable relative to the second jaw. The surgical stapling system further comprises an articulation joint configured to allow rotation or articulation of the end effector relative to the shaft. The end effector is rotatable about an articulation axis extending through the articulation joint. Other embodiments are contemplated that do not include an articulation joint.

The staple cartridge includes a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck extending between the proximal end and the distal end. In use, the staple cartridge is positioned on a first side of tissue to be stapled and the anvil is positioned on a second side of the tissue. The anvil is moved toward the staple cartridge to compress and clamp the tissue against the deck. Staples removably stored in the cartridge body can then be deployed into tissue. The cartridge body includes staple cavities defined therein, wherein the staples are removably stored in the staple cavities. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of the longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal slot. Other arrangements of the staple cavities and staples are also possible.

The staples are supported by staple drivers in the cartridge body. The driver is movable between a first or unfired position and a second or fired position to eject the staples from the staple cartridge. The driver is retained in the cartridge body by a retainer that extends around a bottom of the cartridge body and includes a resilient member configured to grip the cartridge body and retain the retainer to the cartridge body. The driver is movable between its unfired and fired positions by the sled. The slider is movable between a proximal position adjacent the proximal end and a distal position adjacent the distal end. The sled includes a plurality of ramp surfaces configured to slide under and lift the drivers toward the anvil, and the staples are supported on the drivers.

In addition to the above, the sled can be moved distally by the firing member. The firing member is configured to contact the sled and urge the sled toward the distal end. A longitudinal slot defined in the cartridge body is configured to receive a firing member. The anvil also includes a slot configured to receive the firing member. The firing member also includes a first cam that engages the first jaw and a second cam that engages the second jaw. The first and second cams can control a distance or tissue gap between a deck of the staple cartridge and the anvil as the firing member is advanced distally. The firing member also includes a knife blade configured to incise tissue captured intermediate the staple cartridge and the anvil. It is desirable that the blade be positioned at least partially adjacent to the ramp surface so that the staples are ejected prior to the blade.

The surgical instrument systems described herein have been described in connection with the deployment and deformation of staples; however, the embodiments described herein are not so limited. For example, various embodiments are contemplated in which fasteners other than staples, such as clamps or tacks, are deployed. Moreover, various embodiments are also contemplated that utilize any suitable means for sealing tissue. For example, an end effector according to various embodiments may include an electrode configured to heat and seal tissue. In addition, for example, an end effector according to certain embodiments can apply vibrational energy to seal tissue.

Examples

Example 1-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, wherein the end effector is configurable in an open configuration and a closed configuration. The end effector comprises a first jaw; a second jaw, wherein the second jaw is movable toward the first jaw to place the end effector in the closed configuration; a cartridge body comprising staple cavities; staples removably stored in said staple cavities; and an anvil configured to deform the staples. The surgical stapler further comprises a closure system configured to move the second jaw toward the first jaw; a firing system comprising a firing driver configured to eject the staples from the staple cavities toward the anvil during a firing stroke and a cutting member configured to cut the tissue during a cutting stroke and configured to retract the cutting member during a retraction stroke; and means for preventing the end effector from returning to the open configuration until after the retraction stroke has been completed.

Example 2-the surgical stapler of example 1, wherein the means allows the end effector to return to the open configuration during the firing stroke.

Example 3-the surgical stapler of examples 1 or 2, wherein the means allows the end effector to return to the open configuration after the firing stroke is complete and before the cutting stroke begins.

Example 4-the surgical stapler of examples 1, 2, or 3, further comprising a tissue pin movable between a non-deployed position and a deployed position, wherein the tissue pin is configured to capture the tissue within the end effector; and a tissue pin actuator configured to extend the tissue pin between the non-deployed position and the deployed position during a deployment stroke and to retract the tissue pin toward the non-deployed position during a retraction stroke, wherein the device prevents the tissue pin from being retracted toward the non-deployed position during the cutting stroke.

Example 5-the surgical stapler of examples 1, 2, or 3, further comprising a tissue pin movable between a non-deployed position and a deployed position, wherein the tissue pin is configured to capture the tissue within the end effector; and a tissue pin actuator configured to extend the tissue pin between the non-deployed position and the deployed position during a deployment stroke and to retract the tissue pin toward the non-deployed position during a retraction stroke, wherein the device prevents the tissue pin from being retracted toward the non-deployed position during the firing stroke.

Example 6-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, wherein the end effector is configurable in an open configuration and a closed configuration. The end effector comprises a first jaw; a second jaw, wherein the second jaw is movable toward the first jaw to place the end effector in the closed configuration; a cartridge body comprising staple cavities; staples removably stored in said staple cavities; and an anvil configured to deform the staples. The surgical stapler further comprises a closure system configured to move the second jaw toward the first jaw; a firing system comprising drivers configured to eject the staples from the staple cavities toward the anvil during a firing stroke and a cutting member configured to cut the tissue during a cutting stroke, wherein the cutting member comprises a cutting edge exposed from the cartridge body during the cutting stroke; and means for preventing the closure system from returning to the open configuration upon exposure of the cutting member.

Example 7-the surgical stapler of example 6, wherein the means allows the end effector to return to the open configuration during the firing stroke.

Example 8-the surgical stapler of examples 6 or 7, wherein the means allows the end effector to return to the open configuration after the firing stroke is complete and before the cutting stroke begins.

Example 9-the surgical stapler of examples 6, 7, or 8, wherein the means allows the end effector to return to the open configuration after the firing stroke is complete and before the cutting member is exposed.

Example 10-the surgical stapler of examples 6, 7,8, or 9, further comprising a tissue pin movable between a non-deployed position and a deployed position, wherein the tissue pin is configured to capture the tissue within the end effector; and a tissue pin actuator configured to extend the tissue pin between the non-deployed position and the deployed position during a deployment stroke and to retract the tissue pin toward the non-deployed position during a retraction stroke, wherein the device prevents the tissue pin from being retracted toward the non-deployed position when the cutting member is exposed.

Example 11-the surgical stapler of examples 6, 7,8, or 9, further comprising a tissue pin movable between a non-deployed position and a deployed position, wherein the tissue pin is configured to capture the tissue within the end effector; and a tissue pin actuator configured to extend the tissue pin between the non-deployed position and the deployed position during a deployment stroke and to retract the tissue pin toward the non-deployed position during a retraction stroke, wherein the device prevents the tissue pin from being retracted toward the non-deployed position during the firing stroke.

Example 12-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, wherein the end effector is configurable in an open configuration and a closed configuration. The end effector comprises a first jaw; a second jaw, wherein the second jaw is movable toward the first jaw to place the end effector in the closed configuration; a cartridge body comprising staple cavities; staples removably stored in said staple cavities; and an anvil configured to deform the staples. The surgical stapler further comprises a closure system configured to move the second jaw toward the first jaw; a firing system comprising staple drivers, wherein the firing system is configured to push the staple drivers toward the anvil during a firing stroke and retract the staple drivers during a retraction stroke, and a cutting member configured to cut the tissue during a cutting stroke, wherein the cutting member comprises a cutting edge exposed from the cartridge body during the cutting stroke; and means for preventing retraction of the staple drivers upon exposure of the cutting member.

Example 13-the surgical stapler of example 12, wherein the means allows the end effector to return to the open configuration during the firing stroke.

Example 14-the surgical stapler of examples 12 or 13, wherein the means allows the end effector to return to the open configuration after the firing stroke is complete and before the cutting stroke begins.

Example 15-the surgical stapler of examples 12, 13, or 14, wherein the means allows the end effector to return to the open configuration after the firing stroke is complete and before the cutting member is exposed.

Example 16-the surgical stapler of examples 12, 13, 14, or 15, further comprising a tissue pin movable between a non-deployed position and a deployed position, wherein the tissue pin is configured to capture the tissue within the end effector; and a tissue pin actuator configured to extend the tissue pin between the non-deployed position and the deployed position during a deployment stroke and to retract the tissue pin toward the non-deployed position during a retraction stroke, wherein the device prevents the tissue pin from being retracted toward the non-deployed position during the cutting stroke.

Example 17-the surgical stapler of examples 12, 13, 14, or 15, further comprising a tissue pin movable between a non-deployed position and a deployed position, wherein the tissue pin is configured to capture the tissue within the end effector; and a tissue pin actuator configured to extend the tissue pin between the non-deployed position and the deployed position during a deployment stroke and to retract the tissue pin toward the non-deployed position during a retraction stroke, wherein the device prevents the tissue pin from being retracted toward the non-deployed position during the firing stroke.

Example 18-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle, a shaft extending from the handle, an end effector extending from the shaft, wherein the end effector is configurable in an open configuration and a closed configuration. The end effector comprises a first jaw; a second jaw, wherein the second jaw is movable toward the first jaw to place the end effector in the closed configuration; a cartridge body comprising staple cavities; staples removably stored in said staple cavities; an anvil configured to deform the staples; and a tissue pin movable between a non-deployed position and a deployed position, wherein the tissue pin is configured to capture the tissue within the end effector. The surgical stapler further comprises a closure system configured to move the second jaw toward the first jaw; a tissue pin actuator configured to move the tissue pin between the non-deployed position and the deployed position during a deployment stroke and retract the tissue pin toward the non-deployed position during a retraction stroke; a firing system comprising staple drivers, wherein the firing system is configured to push the staple drivers toward the anvil during a firing stroke, and a cutting member configured to cut the tissue during a cutting stroke, wherein the cutting member comprises a cutting edge exposed from the cartridge body during the cutting stroke; and means for preventing retraction of the pin when the cutting member is exposed.

Example 19-the surgical stapler of example 18, wherein the means allows the end effector to return to the open configuration during the firing stroke.

Example 20-the surgical stapler of examples 18 or 19, wherein the means allows the end effector to return to the open configuration after completion of the firing stroke and before the cutting stroke begins.

Example 21-the surgical stapler of examples 18, 19, or 20, wherein the means allows the end effector to return to the open configuration after the firing stroke is complete and before the cutting member is exposed.

Example 22-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle; a shaft extending from the handle; and an end effector extending from the shaft, the end effector comprising a first jaw, a second jaw, wherein one of the first jaw and the second jaw is movable relative to the other of the first jaw, a cartridge body comprising staple cavities, staples removably stored in the staple cavities, and an anvil configured to deform the staples. The surgical stapler further comprises a firing system configured to eject the staples from the staple cavities toward the anvil during a firing stroke and to cut the tissue during a cutting stroke after the firing stroke has been completed.

Example 23-the surgical stapler of example 22, wherein the firing system comprises a firing bar, and wherein the firing bar is movable toward the end effector to perform the firing stroke and the cutting stroke.

Example 24-the surgical stapler of examples 22 or 23, further comprising a stop configured to stop the firing bar after the firing stroke.

Example 25-the surgical stapler of example 24, wherein the stop is manually actuatable to release the firing member such that the firing member is configured to perform the cutting stroke.

Example 26-the surgical stapler of examples 22, 23, 24, or 25, wherein the firing system further comprises staple drivers configured to eject the staples from the staple cavities and a cutting member configured to cut the tissue, wherein the cutting member moves with the staple drivers during the firing stroke, and wherein the cutting member does not cut the tissue during the firing stroke.

Example 27-the surgical stapler of example 26, wherein the cutting member is coupled to the staple drivers during the firing stroke, and wherein the cutting member is separated from the staple drivers during the cutting stroke.

Example 28-the surgical stapler of examples 26 or 27, further comprising a clamp releasably retaining the cutting member to the staple driver during the firing stroke of the firing member, wherein the clamp is configured to release the cutting member from the staple driver when a force transmitted through the firing member exceeds a threshold force.

Example 29-the surgical stapler of examples 26 or 27, further comprising a clamp configured to releasably hold the staple drivers to the cutting member during the firing stroke of the firing member; and a clamp limiter configured to releasably hold the clamp in a clamped state during the firing stroke and to allow the clamp to be biased open to disengage the firing member from the firing bar during the cutting stroke.

Example 30-the surgical stapler of examples 22, 23, 24, 25, 26, 27, 28, or 29, wherein said handle comprises a firing trigger operably coupled with said firing member, wherein said firing trigger is rotatable through a first range of motion and a second range of motion, wherein said firing trigger moves said firing member through said firing stroke when said firing trigger moves through said first range of motion, and wherein said trigger moves said firing member through said cutting stroke when said firing trigger moves through said second range of motion.

Example 31-the surgical stapler of example 30, wherein the first range of motion is discrete relative to the second range of motion.

Example 32-the surgical stapler of examples 30 or 31, wherein the first range of motion and the second range of motion occur during a single actuation of the firing trigger.

Example 33-the surgical stapler of examples 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, or 32, further comprising an indicator configured to provide a first indication when the firing stroke is complete and a second indication when the cutting stroke is complete, and wherein the first indication is different than the second indication.

Example 34-the surgical stapler of example 33, wherein the first indication comprises one of a visual indication, an audible indication, and a tactile indication, and wherein the second indication comprises one of a visual indication, an audible indication, and a tactile indication.

Example 35-the surgical stapler of example 30, wherein the first range of motion occurs during one actuation of the firing trigger, and wherein the second range of motion occurs during another actuation of the firing trigger.

Example 36-the surgical stapler of example 30, further comprising an indicator configured to provide a first indication when one actuation of the firing trigger is complete and a second indication when another actuation of the firing trigger is complete, and wherein the first indication is different from the second indication.

Example 37-the surgical stapler of examples 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, or 36, wherein the firing system comprises a firing bar configured to eject the staples from the staple cavities during the firing stroke, and a blade bar configured to cut the tissue during the cutting stroke.

Example 38-the surgical stapler of example 37, wherein the firing system further comprises a firing trigger, wherein the firing bar is driven toward the end effector during actuation of the firing trigger, and wherein the blade bar is driven toward the end effector during the actuation of the firing trigger.

Example 39-the surgical stapler of example 38, wherein said firing trigger is transitionable between a first position wherein said firing trigger is operably engaged with said firing bar and a second position wherein said firing trigger is operably engaged with said firing bar.

Example 40-the surgical stapler of examples 38 or 39, further comprising a switching mechanism configured to automatically switch the firing trigger out of engagement with the firing bar and into engagement with the blade bar after the firing stroke.

Example 41-the surgical stapler of examples 38, 39, or 40, further comprising a switching mechanism configured to allow manual switching of the firing trigger out of engagement with the firing bar and into engagement with the blade bar after the firing stroke.

Example 42-the surgical stapler of example 37, wherein the firing system further comprises a firing trigger, wherein the firing bar is driven toward the end effector during a first actuation of the firing trigger, and wherein the blade bar is driven toward the end effector during a second actuation of the firing trigger.

Example 43-the surgical stapler of example 37, wherein the firing system further comprises a firing trigger operably engaged with the firing bar, wherein actuation of the firing trigger moves the firing bar through the firing stroke; and a cutting trigger operatively engageable with the blade bar, wherein actuation of the cutting trigger moves the blade bar through the cutting stroke.

Example 44-the surgical stapler of examples 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, or 43, wherein the firing system is further configured to pause operation of the surgical stapler after completion of the firing stroke so as to allow a user of the surgical stapler to optionally select whether to perform the cutting stroke with the surgical stapler.

Example 45-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle; a shaft extending from the handle; and an end effector extending from the shaft, the end effector comprising a first jaw, a second jaw, wherein one of the first jaw and the second jaw is movable relative to the other of the first jaw, a cartridge body comprising staple cavities, staples removably stored in the staple cavities, and an anvil configured to deform the staples. The surgical stapler further comprises a firing bar configured to eject the staples from the staple cavities during a firing stroke; a blade bar configured to cut the tissue during a cutting stroke; a firing trigger operably engageable with said firing bar, wherein actuation of said firing trigger moves said firing bar through said firing stroke; and a cutting trigger operatively engageable with the blade bar, wherein actuation of the cutting trigger moves the blade bar through the cutting stroke.

Example 46-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle; a shaft extending from the handle; and an end effector extending from the shaft, the end effector comprising a first jaw, a second jaw, wherein one of the first jaw and the second jaw is movable relative to the other of the first jaw, a cartridge body comprising staple cavities, staples removably stored in the staple cavities, and an anvil configured to deform the staples. The surgical stapler further comprises a firing system configured to eject the staples from the staple cavities toward the anvil during a firing stroke; a cutting system configured to cut the tissue during a cutting stroke; and means for preventing the cutting system from performing the cutting stroke until the firing system has completed the firing stroke.

Example 47-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft. The end effector comprises a first jaw; a second jaw, wherein one of the first jaw and the second jaw is movable relative to the other of the first jaw; a cartridge body comprising staple cavities; staples removably stored in said staple cavities; and an anvil configured to deform the staples. The surgical stapler further comprises a firing system configured to eject the staples from the staple cavities toward the anvil during a firing stroke and to cut the tissue during a cutting stroke after the firing stroke has been completed; and means for allowing a user of a surgical instrument to select whether to perform the cutting stroke with the surgical stapler after the firing stroke.

Example 48-the surgical stapler of example 47, further comprising a feedback device for indicating when the firing stroke is complete.

Example 49-the surgical stapler of examples 47 or 48, further comprising a feedback device for indicating when the firing system is nearing the end of the firing stroke.

Example 50-the surgical stapler of examples 47, 48, or 49, further comprising a feedback device for indicating when the cutting stroke is complete.

Example 51-the surgical stapler of examples 47, 48, 49, or 50, further comprising a feedback device for indicating when the firing system is near an end of the cutting stroke.

Example 52-the surgical stapler of examples 47, 48, 49, 50, or 51, further comprising a visual indicator strip comprising a first range and a second range, wherein the first range indicates progress of the firing stroke and the second range indicates progress of the cutting stroke.

Example 53-the surgical stapler of examples 47, 48, 49, 50, 51, or 52, wherein the device comprises a stop configured to stop the firing system after the firing stroke, and wherein the stop is selectively releasable by the user of the surgical stapler.

Example 54-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle; a shaft extending from the handle; and an end effector extending from the shaft, the end effector comprising a first jaw, a second jaw, wherein one of the first jaw and the second jaw is movable relative to the other of the first jaw, a cartridge body comprising staple cavities, staples removably stored in the staple cavities, and an anvil configured to deform the staples. The surgical stapler further comprises a firing system configured to eject the staples from the staple cavities toward the anvil during a firing stroke; a cutting system configured to cut the tissue during a cutting stroke after the firing stroke has been completed; and means for allowing a user of the surgical stapler to select whether to perform the cutting stroke with the surgical stapler.

Example 55-the surgical stapler of example 54, further comprising a feedback device to indicate when the firing stroke is complete.

Example 56-the surgical stapler of examples 54 or 55, further comprising a feedback device for indicating when the firing system is nearing the end of the firing stroke.

Example 57-the surgical stapler of examples 54, 55, or 56, further comprising a feedback device for indicating when the cutting stroke is complete.

Example 58-the surgical stapler of examples 54, 55, 56, or 57, further comprising a feedback device for indicating when the cutting system is nearing the end of the cutting stroke.

Example 59-the surgical stapler of examples 54, 55, 56, 57, or 58, further comprising a visual indicator strip comprising a first range and a second range, wherein the first range indicates progress of the firing stroke and the second range indicates progress of the cutting stroke.

Example 60-the surgical stapler of examples 54, 55, 56, 57, 58, or 59, wherein the firing system comprises a firing trigger; a firing bar operably engageable with said firing trigger, wherein actuation of said firing trigger advances said firing member toward said end effector during said firing stroke; and a tactile feedback generator engaged with the firing bar.

Example 61-the surgical stapler of example 60, wherein the tactile feedback generator is configured to generate a series of sounds that become increasingly louder as the firing stroke progresses.

Example 62-the surgical stapler of examples 60 or 61, wherein the tactile feedback generator is silent during a first portion of the firing stroke and audible during a second portion of the firing stroke.

Example 63-the surgical stapler of examples 60, 61, or 62, wherein the tactile feedback generator is configured to generate a series of sounds having a rate that increases as the firing stroke progresses.

Example 64-the surgical stapler of examples 60, 61, 62, or 63, wherein the tactile feedback generator generates tactile feedback when the firing bar reaches the end of its firing stroke.

Example 65-the surgical stapler of examples 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, or 64, wherein the device comprises a stop configured to stop the firing system after the firing stroke, and wherein the stop is selectively releasable by the user of the surgical stapler.

Example 66-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle; a shaft extending from the handle; and an end effector extending from the shaft, the end effector comprising a first jaw, a second jaw, wherein one of the first jaw and the second jaw is movable relative to the other of the first jaw, a cartridge body comprising staple cavities, staples removably stored in the staple cavities, and an anvil configured to deform the staples. The surgical stapler further comprises a firing system configured to eject the staples from the staple cavities toward the anvil during a firing stroke; a cutting system configured to cut the tissue during a cutting stroke after the firing stroke has been completed; and a feedback generator configured to indicate a transition between the firing stroke and the cutting stroke.

Example 67-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, wherein the end effector is configurable in an open configuration and a closed configuration. The end effector comprises a first jaw; a second jaw, wherein the second jaw is movable toward the first jaw to place the end effector in the closed configuration; a cartridge body comprising staple cavities; staples removably stored in said staple cavities; and an anvil configured to deform the staples. The surgical stapler further comprises a closure system configured to move the second jaw toward the first jaw; and a firing system comprising staple drivers, wherein the firing system is configured to push the staple drivers toward the anvil during a firing stroke and retract the staple drivers during a retraction stroke, and a cutting member configured to cut the tissue during a cutting stroke, wherein the cutting member comprises a cutting edge exposed from the cartridge body during the cutting stroke. The surgical stapler further comprises a lockout configured to prevent the staple driver from being retracted during the firing stroke; and a bypass device configured to overcome the lockout such that the staple drivers can be retracted during the firing stroke.

Example 68-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, wherein the end effector is configurable in an open configuration and a closed configuration. The end effector comprises a first jaw; a second jaw, wherein the second jaw is movable toward the first jaw to place the end effector in the closed configuration; a cartridge body comprising staple cavities; staples removably stored in said staple cavities; and an anvil configured to deform the staples. The surgical stapler further comprises a closure system configured to move the second jaw toward the first jaw; and a firing system comprising staple drivers, wherein the firing system is configured to push the staple drivers toward the anvil during a firing stroke and retract the staple drivers during a retraction stroke, and a cutting member configured to cut the tissue during a cutting stroke, wherein the cutting member comprises a cutting edge exposed from the cartridge body during the cutting stroke. The surgical stapler further comprises a lock configured to prevent the staple driver from being retracted prior to completion of the cutting stroke; and a bypass device configured to overcome the lock such that the staple driver can be retracted prior to completion of the cutting stroke.

Example 69-a surgical stapler for treating tissue of a patient, the surgical stapler comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, wherein the end effector is configurable in an open configuration and a closed configuration. The end effector comprises a first jaw; a second jaw, wherein the second jaw is movable toward the first jaw to place the end effector in the closed configuration; a cartridge body comprising staple cavities; staples removably stored in said staple cavities; and an anvil configured to deform the staples. The surgical stapler further comprises a closure system configured to move the second jaw toward the first jaw; and a firing system comprising staple drivers, wherein the firing system is configured to push the staple drivers toward the anvil during a firing stroke and retract the staple drivers during a retraction stroke, and a cutting member configured to cut the tissue during a cutting stroke, wherein the cutting member comprises a cutting edge exposed from the cartridge body during the cutting stroke. The surgical stapler further comprises a lockout configured to prevent the cutting member from being retracted during the cutting stroke; and a bypass device configured to overcome the latch such that the cutting member can be retracted during the cutting stroke.

The entire disclosures of the following patents are hereby incorporated by reference:

U.S. patent 5,403,312 entitled "ELECTROSURURGICAL HEMOSTATIC DEVICE" published on 4.4.1995;

U.S. patent 7,000,818 entitled "SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS" published on 21.2.2006;

U.S. Pat. No. 7,422,139 entitled "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK" published on 9.9.2008;

U.S. patent 7,464,849 entitled "ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS" published on 16.12.2008;

U.S. patent 7,670,334 entitled "SURGICAL INSTRUMENT HAVATING AN ARTICULATING END EFFECTOR" published on 3, 2/2010;

U.S. patent 7,753,245 entitled "SURGICAL STAPLING INSTRUMENTS" published on 13.7.2010;

U.S. patent 8,393,514 entitled "SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE" published on 12.3.2013;

U.S. patent application Ser. No. 11/343,803 entitled "SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES"; now us patent 7,845,537;

U.S. patent application Ser. No. 12/031,573 entitled "SURGICAL CUTTING AND FASTENING INSTRUMENTT HAVAGING RF ELECTRODES" filed on 14.2.2008;

U.S. patent application Ser. No. 12/031,873, filed on 15.2.2008, entitled "END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT," now U.S. patent 7,980,443;

U.S. patent application Ser. No. 12/235,782 entitled "MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT," now U.S. Pat. No. 8,210,411;

U.S. patent application Ser. No. 12/249,117 entitled "POWER SURGICAL CUTTING AND STAPLING APPATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM", now U.S. patent 8,608,045;

U.S. patent application Ser. No. 12/647,100 entitled "MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY" filed 24.12.2009; now us patent 8,220,688;

U.S. patent application serial No. 12/893,461, now U.S. patent 8,733,613, entitled "STAPLE CARTRIDGE", filed 9/29/2012;

U.S. patent application serial No. 13/036,647 entitled "SURGICAL STAPLING INSTRUMENT" filed on 28.2.2011, now U.S. patent 8,561,870;

U.S. patent application Ser. No. 13/118,241 entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS," now U.S. Pat. No. 9,072,535;

U.S. patent application Ser. No. 13/524,049 entitled "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE" filed 6, 15/2012; now U.S. patent application publication 2013/0334278;

U.S. patent application serial No. 13/800,025 entitled "STAPLE CARTRIDGE TISSUE thickingsenser SYSTEM" filed on 13/3/2013, now U.S. patent application publication 2014/0263551;

U.S. patent application serial No. 13/800,067 entitled "STAPLE CARTRIDGE TISSUE thickingsenser SYSTEM" filed on 13/3/2013, now U.S. patent application publication 2014/0263552;

U.S. patent application publication 2007/0175955 entitled "SURGICAL CUTTING AND FASTENING INSTRUMENTT WITH CLOSURE TRIGGER LOCKING MECHANISM" filed on 31.1.2006; and

U.S. patent application publication 2010/0264194 entitled "SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR" filed on 22.4.2010, now U.S. Pat. No. 8,308,040.

While various embodiments of the device have been described herein in connection with certain disclosed embodiments, many modifications and variations to these embodiments may be implemented. In addition, where materials for certain components are disclosed, other materials may also be used. Further, according to various embodiments, a single component may be replaced with multiple components, and multiple components may also be replaced with a single component, to perform a given function or functions. The foregoing detailed description and the following claims are intended to cover all such modifications and variations.

The device disclosed herein may be designed to be disposed of after a single use, or it may be designed to be capable of multiple uses. In either case, however, the device may be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, cleaning or replacement of particular pieces, and subsequent reassembly. In particular, the device may be disassembled, and any number of the particular pieces or parts of the device may be selectively replaced or removed in any combination. After cleaning and/or replacement of particular components, the device may be reassembled for subsequent use either at a reconditioning facility, or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that the prosthetic device may be disassembled, cleaned/replaced, and reassembled using a variety of techniques. The use of such techniques and the resulting prosthetic devices are within the scope of the present application.

By way of example only, aspects described herein may be processed prior to surgery. First, new or used instruments may be obtained and cleaned as needed. The instrument may then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container (such as a plastic or TYVEK bag). The container and instrument may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the instrument and in the container. The sterilized instrument may then be stored in a sterile container. Sealing the container may maintain the instrument in a sterile state until the container is opened in a medical facility. The device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.

While this invention has been described as having an exemplary design, the present invention may be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles.

Any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. Thus, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.

Claims

1. A surgical stapler for treating tissue of a patient, the surgical stapler comprising:

a handle;

a shaft extending from the handle;

an end effector extending from the shaft, wherein the end effector is configurable in an open configuration and a closed configuration, and wherein the end effector comprises:

a first jaw;

a second jaw, wherein the second jaw is movable toward the first jaw to place the end effector in the closed configuration;

a cartridge body comprising staple cavities;

a staple removably stored in the staple cavity; and

an anvil configured to deform the staples;

a closure system configured to move the second jaw toward the first jaw;

a firing system, the firing system comprising:

a staple driver, wherein the firing system is configured to push the staple driver toward the anvil during a firing stroke and retract the staple driver during a retraction stroke; and

a cutting member configured to cut the tissue during a cutting stroke, wherein the cutting member comprises a cutting edge exposed from the cartridge body during the cutting stroke; and

means for preventing retraction of the staple drivers upon exposure of the cutting member.

2. The surgical stapler of claim 1, wherein said means allows said end effector to return to said open configuration during said firing stroke.

3. The surgical stapler of claim 1, wherein said means allows said end effector to return to said open configuration after completion of said firing stroke and before commencement of said cutting stroke.

4. The surgical stapler of claim 1, wherein said means allows said end effector to return to said open configuration after completion of said firing stroke and prior to exposure of said cutting member.

5. The surgical stapler of claim 1, further comprising:

a tissue pin movable between a non-deployed position and a deployed position, wherein the tissue pin is configured to capture the tissue within the end effector; and

a tissue pin actuator configured to extend the tissue pin between the non-deployed position and the deployed position during a deployment stroke and to retract the tissue pin toward the non-deployed position during a retraction stroke, wherein the device prevents the tissue pin from being retracted toward the non-deployed position during the cutting stroke.

6. The surgical stapler of claim 1, further comprising:

a tissue pin actuator configured to extend the tissue pin between the non-deployed position and the deployed position during a deployment stroke and to retract the tissue pin toward the non-deployed position during a retraction stroke, wherein the device prevents the tissue pin from being retracted toward the non-deployed position during the firing stroke.

7. A surgical stapler for treating tissue of a patient, the surgical stapler comprising:

a handle;

a shaft extending from the handle;

a first jaw;

a cartridge body comprising staple cavities;

a staple removably stored in the staple cavity;

an anvil configured to deform the staples; and

a tissue pin movable between a non-deployed position and a deployed position,

wherein the tissue pin is configured to capture the tissue within the end effector;

a closure system configured to move the second jaw toward the first jaw;

a tissue pin actuator configured to move the tissue pin between the non-deployed position and the deployed position during a deployment stroke, and retract the tissue pin toward the non-deployed position during a retraction stroke;

a firing system, the firing system comprising:

a staple driver, wherein the firing system is configured to urge the staple driver toward the anvil during a firing stroke;

a locking pin configured to engage a portion of the cartridge body to prevent retraction of the tissue pins upon exposure of the cutting member.

8. The surgical stapler of claim 7, wherein said lock pin engages another portion of said cartridge body to allow said end effector to return to said open configuration during said firing stroke.

9. The surgical stapler of claim 7, wherein said lock pin engages another portion of said cartridge body to allow said end effector to return to said open configuration after completion of said firing stroke and before commencement of said cutting stroke.

10. The surgical stapler of claim 7, wherein said lock pin engages another portion of said cartridge body to allow said end effector to return to said open configuration after said firing stroke is completed and before said cutting member is exposed.