BR112017012874B1 - Conjunto de eixo intercambiável para um instrumento cirúrgico compreendendo um membro de acionamento móvel - Google Patents
Conjunto de eixo intercambiável para um instrumento cirúrgico compreendendo um membro de acionamento móvel Download PDFInfo
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- BR112017012874B1 BR112017012874B1 BR112017012874-8A BR112017012874A BR112017012874B1 BR 112017012874 B1 BR112017012874 B1 BR 112017012874B1 BR 112017012874 A BR112017012874 A BR 112017012874A BR 112017012874 B1 BR112017012874 B1 BR 112017012874B1
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- proximal
- distal
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- trigger
- assembly
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00371—Multiple actuation, e.g. pushing of two buttons, or two working tips becoming operational
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00464—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable for use with different instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07271—Stapler heads characterised by its cartridge
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2947—Pivots
Abstract
A presente invenção refere-se a um conjunto de eixo para um instrumento cirúrgico que inclui um membro de acionamento móvel. Em ao menos uma forma, o instrumento cirúrgico inclui um conjunto de dorso que é acoplável ao instrumento cirúrgico e tem um atuador de extremidade cirúrgico acoplado ao mesmo por meio de uma junta articulada. O conjunto de eixo, em uma forma, inclui um membro de disparo proximal e um membro de disparo intermediário que é acoplado a um membro de disparo distal. O membro de disparo distal é configurado para percurso seletivo através do atuador de extremidade cirúrgico. Ao menos um acionador de articulação é acoplado ao atuador de extremidade cirúrgico para aplicar movimentos de articulação ao mesmo. Um conjunto de embreagem faz interface com os membros de disparo primário e intermediário e o acionador de articulação, de modo que quando em uma orientação de articulação, o movimento do membro de acionamento resulte no movimento do acionador de articulação, e quando em uma orientação de disparo, o movimento do membro de acionamento resulte no movimento dos membros de disparo intermediário e distal. Um motor de articulação separado pode ser empregado para acionar o acionador de articulação.
Description
[001] A presente invenção se refere a instrumentos cirúrgicos e, em várias modalidades, a instrumentos cirúrgicos de grampeamento e/ou de corte e a cartuchos de grampos para uso com os mesmos.
[002] As características e vantagens desta invenção, e a maneira de obter as mesmas se tornarão mais evidentes, e a invenção em si será mais bem compreendida por referência à descrição das modalidades da invenção apresentada a seguir, considerada em conjunto com os desenhos em anexo, nos quais:
[003] Figura 1 ilustra uma vista em perspectiva de um instrumento cirúrgico equipado com motor, compreendendo um cabo, um eixo de acionamento e um atuador de extremidade articulável;
[004] Figura 2 é uma vista de montagem explodida de um compartimento de instrumento cirúrgico;
[005] Figura 3 é uma vista em seção transversal de uma porção de um conjunto de eixo de acionamento intercambiável;
[006] Figura 4 é uma vista em perspectiva parcial de uma porção do conjunto de eixo de acionamento intercambiável da Figura 3 com o tambor de trava e o bocal omitidos para fins de clareza;
[007] Figura 5 é uma vista em perspectiva em seção transversal parcial do conjunto de eixo de acionamento intercambiável da Figura 4;
[008] Figura 6 é uma vista em perspectiva em seção transversal de uma porção do conjunto de eixo de acionamento intercambiável da Figura 5;
[009] Figura 7 é uma outra vista em seção transversal do conjunto de eixo de acionamento intercambiável e uma porção do atuador de extremidade cirúrgico com o atuador de extremidade em uma orientação não articulada;
[0010] Figura 8 é uma outra vista em seção transversal do conjunto de eixo de acionamento intercambiável da Figura 7 com o atuador de extremidade em uma orientação articulada;
[0011] Figura 9 é uma vista em perspectiva parcial de uma porção de um outro conjunto de eixo de acionamento intercambiável;
[0012] Figura 10 é uma outra vista em perspectiva da porção do conjunto de eixo de acionamento intercambiável da Figura 9, com vários componentes omitidos para fins de clareza;
[0013] Figura 11 é uma outra vista em seção transversal parcial de uma porção do conjunto de eixo de acionamento intercambiável da Figura 10, com alguns componentes omitidos para fins de clareza;
[0014] Figura 12 é uma vista em seção transversal parcial de uma porção de um outro conjunto de eixo de acionamento intercambiável em uma configuração não articulada;
[0015] Figura 13 é uma outra vista em seção transversal parcial do conjunto de eixo de acionamento intercambiável da Figura 12 em uma configuração articulada;
[0016] Figura 14 é uma outra vista em perspectiva de uma porção de um outro conjunto de eixo de acionamento intercambiável;
[0017] Figura 15 é uma outra vista em perspectiva da porção do conjunto de eixo de acionamento intercambiável da Figura 14, com vários componentes omitidos para fins de clareza;
[0018] Figura 16 é uma outra vista em perspectiva de uma porção do conjunto de eixo de acionamento intercambiável das Figuras 14 e 15, com vários componentes omitidos para fins de clareza;
[0019] Figura 17 é uma vista parcial da montagem explodida de uma porção do conjunto de eixo de acionamento intercambiável das Figuras 14 a 16;
[0020] Figura 18 é uma vista em seção transversal de uma porção do conjunto de eixo de acionamento intercambiável das Figuras 14 a 17, com vários componentes omitidos para fins de clareza e em que o conjunto de embreagem está em uma orientação articulada;
[0021] Figura 19 é uma vista em seção transversal de uma porção do conjunto de eixo de acionamento intercambiável das Figuras 14 a 18, com vários componentes omitidos para fins de clareza e em que o conjunto de embreagem está em uma orientação de disparo;
[0022] Figura 20 é uma outra vista em seção transversal de uma porção do conjunto de eixo de acionamento intercambiável das Figuras 14 a 19 com o atuador de extremidade em uma orientação não articulada;
[0023] Figura 21 é uma outra vista em seção transversal de uma porção do conjunto de eixo de acionamento intercambiável das Figuras 14 a 20 com o atuador de extremidade em uma orientação articulada;
[0024] Figura 22 uma vista em seção transversal do conjunto de eixo de acionamento intercambiável das Figura 14 a 21 ao longo das linhas 22-22 na Figura 21;
[0025] Figura 23 é uma outra vista em seção transversal de uma porção do conjunto de eixo de acionamento intercambiável das Figuras 14 a 22 com o atuador de extremidade em uma orientação articulada e o conjunto de embreagem em uma orientação de disparo;
[0026] Figura 24 uma vista em seção transversal do conjunto de eixo de acionamento intercambiável das Figura 14 a 23 ao longo das linhas 24-24 na Figura 23;
[0027] Figura 25 é uma vista em perspectiva de um outro instrumento cirúrgico com um atuador de extremidade cirúrgico operacionalmente acoplado ao mesmo;
[0028] Figura 26 é uma vista em perspectiva de uma porção de cabo do instrumento cirúrgico da Figura 25 com uma porção do compartimento do bocal omitida para fins de clareza;
[0029] Figura 27 é uma vista em perspectiva explodida de uma porção do instrumento cirúrgico das Figuras 25 e 26;
[0030] Figura 28 é uma vista da montagem explodida de porções de um conjunto de trava do instrumento cirúrgico das Figuras 25 a 27;
[0031] Figura 29 é uma vista em seção transversal do conjunto de eixo de acionamento alongado de um instrumento cirúrgico;
[0032] Figura 30 é uma vista em seção transversal de um outro conjunto de eixo de acionamento alongado de um outro instrumento cirúrgico;
[0033] Figura 31 é uma vista diagramática de uma porção de um outro instrumento cirúrgico; e
[0034] Figura 32 é uma vista diagramática de uma porção de um outro instrumento cirúrgico.
[0035] Os caracteres de referência correspondentes indicam as partes correspondentes através das várias vistas. As exemplificações apresentadas na presente invenção ilustram certas modalidades da invenção, em uma forma, e tais exemplificações não devem ser entendidas como limitadoras do escopo da invenção de nenhuma maneira.
[0036] A requerente do presente pedido é a autora dos seguintes pedidos de patente que foram depositados em 01 de março de 2013 e que estão, todos, aqui incorporados por referência, em sua totalidade:
[0037] - Pedido de Patente US n° de série 13/782.295, intitulado ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS FOR SIGNAL COMMUNICATION, agora publicação de pedido de Patente US n° 2014/0246471;
[0038] - Pedido de Patente US n° de série 13/782.323, intitulado ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL Instruments, agora publicação de pedido de Patente US n° 2014/0246472;
[0039] - Pedido de Patente US n° de série 13/782.338, intitulado THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS, agora publicação de Patente US n° 2014/0249557;
[0040] - Pedido de Patente US n° de série 13/782.499, intitulado ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAY ARRANGEMENT, agora publicação de pedido de Patente US n° 2014/0246474;
[0041] - Pedido de Patente US n° de série 13/782.460, intitulado MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICAL INSTRUMENTS, agora publicação de Patente US n° 2014/0246478;
[0042] - Pedido de Patente US n° de série 13/782.358, intitulado JOYSTICK SWITCH ASSEMBLIES FOR SURGICAL INSTRUMENTS, agora publicação de Patente US n° 2014/0246477;
[0043] - Pedido de Patente US n° de série 13/782.481, intitulado SENSOR STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGH TROCAR, agora publicação de Patente US n° 2014/0246479;
[0044] - Pedido de Patente US n° de série 13/782.518, intitulado CONTROL METHODS FOR SURGICAL INSTRUMENTS WITH REMOVABLE IMPLEMENT PORTIONS, agora publicação de Patente US n° 2014/0246475;
[0045] - Pedido de Patente US n° de série 13/782.375, intitulado ROTARY POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OF FREEDOM, agora publicação de pedido de Patente US n° 2014/0246473; e
[0046] - Pedido de Patente US n° de série 13/782.536, intitulado SURGICAL INSTRUMENT SOFT STOP, agora publicação de pedido de Patente US n° 2014/0246476;
[0047] O requerente do presente pedido também detém os seguintes pedidos de patente que foram depositados em quinta-feira, 14 de março de 2013 e que estão, cada um, aqui incorporados por referência em suas respectivas totalidades:
[0048] - Pedido de Patente US n° de série 13/803.097, intitulado ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, agora publicação de pedido de Patente US n° 2014/0263542;
[0049] - Pedido de Patente US n° de série 13/803.193, intitulado CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT, agora publicação de Patente US n° 2014/0263537;
[0050] - Pedido de Patente US n° de série 13/803.053, intitulado CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT, agora publicação de Patente US n° 2014/0263564;
[0051] - Pedido de Patente US n° de série 13/803.086, intitulado ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, agora publicação de pedido de Patente US n° 2014/0263541;
[0052] - Pedido de Patente US n° de série 13/803.210, intitulado SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS, agora publicação de pedido de Patente US n° 2014/0263538;
[0053] - Pedido de Patente US n° de série 13/803.148, intitulado MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT, agora publicação de pedido de Patente US n° 2014/0263554;
[0054] - Pedido de Patente US n° de série 13/803.066, intitulado DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, agora publicação de pedido de Patente US n° 2014/0263565;
[0055] - Pedido de Patente US n° de série 13/803.117, intitulado ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS, agora publicação de pedido de Patente US n° 2014/0263553;
[0056] - Pedido de Patente US n° de série 13/803.130, intitulado DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, agora publicação de pedido de Patente US n° 2014/0263543; e
[0057] - Pedido de Patente US n° de série 13/803.159, intitulado METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT, agora publicação de Patente US n° 2014/0277017;
[0058] O requerente do presente pedido também detém os seguintes pedidos de patente que foram depositados em 7 de março de 2014 e estão aqui incorporados a título de referência, em sua totalidade:
[0059] - Pedido de Patente US n° de série 14/200.111, intitulado CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS, agora publicação de Patente US n° 2014/0263539.
[0060] O requerente do presente pedido também detém os seguintes pedidos de patente que foram depositados 26 de março de 2014 e que estão, cada um, aqui incorporados, por referência, em suas respectivas totalidades:
[0061] Pedido de Patente US n° de série 14/226.106, intitulado POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS;
[0062] Pedido de Patente US n° de série 14/226.099, intitulado STERILIZATION VERIFICATION CIRCUIT;
[0063] Pedido de Patente US n° de série 14/226.094, intitulado VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT;
[0064] Pedido de Patente US n° de série 14/226.117, intitulado POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL;
[0065] Pedido de Patente US n° de série 14/226.075, intitulado MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES;
[0066] Pedido de Patente US n° de série 14/226.093, intitulado FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS;
[0067] Pedido de Patente US n° de série 14/226.116, intitulado SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION;
[0068] Pedido de Patente US n° de série 14/226.071, intitulado SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR;
[0069] Pedido de Patente US n° de série 14/226.097, intitulado SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS;
[0070] Pedido de Patente US n° de série 14/226.126, intitulado INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS;
[0071] Pedido de Patente US n° de série 14/226.133, intitulado MODULAR SURGICAL INSTRUMENT SYSTEM;
[0072] Pedido de Patente US n° de série 14/226.081, intitulado SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT;
[0073] Pedido de Patente US n° de série 14/226.076, intitulado POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION;
[0074] Pedido de patente n° de série U.S. 14/226.111, intitulado SURGICAL STAPLING INSTRUMENT SYSTEM; e
[0075] Pedido de Patente US n° de série 14/226.125, intitulado SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT.
[0076] O requerente do presente pedido também detém os seguintes pedidos de patente que foram depositados em sexta-feira, 5 de setembro de 2014 e que estão, cada um, aqui incorporados por referência em suas respectivas totalidades:
[0077] - Pedido de Patente US n° de série 14/479.103, intitulado CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE;
[0078] - Pedido de Patente US n° 14/479.119, intitulado ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION;
[0079] - Pedido de Patente US n° 14/478.908, intitulado MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION;
[0080] Pedido de Patente US n° 14/478.895, intitulado MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION;
[0081] Pedido de Patente US n° 14/479.110, intitulado USE OF POLARITY OF HALL MAGNET DETECTION TO DETECT MISLOADED CARTRIDGE;
[0082] - Pedido de Patente US n° de série 14/479.098, intitulado SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION;
[0083] - Pedido de Patente US n° de série 14/479.115, intitulado MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE; e
[0084] - Pedido de Patente US n° de série 14/479.108, intitulado LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION.
[0085] O requerente do presente pedido também detém os seguintes pedidos de patente que foram depositados em quarta-feira, 9 de abril de 2014 e que estão, cada um, aqui incorporados por referência em suas respectivas totalidades:
[0086] - Pedido de Patente US n° de série 14/248.590, intitulado SMOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS, agora publicação de pedido de Patente US n° 2014/0305987;
[0087] - Pedido de Patente US n° de série 14/248.581, intitulado SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRING DRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT, agora publicação de pedido de Patente US n° 2014/0305989;
[0088] - Pedido de Patente US n° de série 14/248.595, intitulado SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING THE OPERATION OF THE SURGICAL INSTRUMENT, agora publicação de Patente US n° 2014/0305988;
[0089] - Pedido de Patente US n° de série 14/248.588, intitulado POWERED LINEAR SURGICAL STAPLER, agora publicação de pedido de Patente US n° 2014/0309666;
[0090] - Pedido de Patente US n° de série 14/248.591, intitulado CTRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT, agora publicação de Patente US n° 2014/0305991.
[0091] - Pedido de Patente US n° de série 14/248.584, intitulado MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS, agora publicação de pedido de Patente US n° 2014/0305994;
[0092] - Pedido de Patente US n° de série 14/248.587, intitulado POWERED SURGICAL STAPLER, agora publicação de Patente US n° 2014/0309665;
[0093] - Pedido de Patente US n° de série 14/248.586, intitulado DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT, agora publicação de Patente US n° 2014/0305990; e
[0094] - Pedido de Patente US n° de série 14/248.607, intitulado MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS, agora publicação de pedido de Patente US n° 2014/0305992;
[0095] O requerente do presente pedido também detém os seguintes pedidos de patente que foram depositados em terça-feira, 16 de abril de 2013 e que estão, cada um, aqui incorporados por referência em suas respectivas totalidades:
[0096] - Pedido de patente provisório US n° de série 61/812.365, intitulado SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR;
[0097] - Pedido de patente provisório US n° de série 61/812.376, intitulado LINEAR CUTTER WITH POWER;
[0098] - Pedido de patente provisório US n° de série 61/812.382, intitulado LINEAR CUTTER WITH MOTOR AND PISTOL GRIP;
[0099] - Pedido de patente provisório US n° de série 61/812.385, intitulado SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS AND MOTOR CONTROL; e
[00100] - Pedido de patente provisório US n° de série 61/812.372, intitulado SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR;
[00101] O requerente do presente pedido também detém os seguintes pedidos de patente que foram depositados na mesma data do presente pedido e que estão, todos, aqui incorporados a título de referência, em sua totalidade:
[00102] - Pedido de Patente US n° de série _______ , intitulado SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER; n° do documento do procurador END7415USNP/140289;
[00103] - Pedido de Patente US n° de série _______ , intitulado SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS; n° do documento do procurador END7416USNP/140291;
[00104] - Pedido de patente n° de série U.S. _______ , intitulado LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH ARTICULATABLE SURGICAL END EFFECTORS, N° da Súmula do Advogado END7417USNP/140293;
[00105] - Pedido de Patente US n° de série _______ , intitulado SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE, n° do documento do procurador END7485USNP/140295;
[00106] - Pedido de Patente US n° de série _______ , intitulado SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS; n° do documento do procurador END7486/140296;
[0107] - Pedido de Patente US n° de série_______ , intitulado SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS, n° do documento do procurador END7489USNP/140299;
[00108] - Pedido de Patente US n° de série _______ , intitulado SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS, n° do documento do procurador END7491USNP/140301;
[00109] - Pedido de Patente US n° _______ , intitulado SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM; n° do documento do procurador END7492USNP/140302; e
[00110] - Pedido de Patente US n° _______ , intitulado SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION SYSTEM; n° do documento do procurador END7494USNP/140304.
[00111] Numerosos detalhes específicos são apresentados para fornecer um completo entendimento da estrutura, função, fabricação e uso geral das modalidades conforme descrito no relatório descritivo e ilustrado nos desenhos anexos. Operações, componentes e elementos bem conhecidos foram descritos em detalhes de modo a não obscurecer as modalidades descritas no relatório descritivo. O leitor entenderá que as modalidades descritas e ilustradas na presente invenção são exemplos não limitadores e, portanto, pode-se entender que os detalhes estruturais e funcionais específicos revelados na presente invenção podem ser representativos e ilustrativos. Podem ser feitas variações e alterações a isso, sem se desviar do escopo das concretizações.
[00112] Os termos "compreende" (e qualquer forma de compreende, como "compreende" e "que compreende"), "tem" (e qualquer forma de tem, como "tem" e "que tem"), "inclui" (e qualquer forma de inclui, como "inclui" e "que inclui") e "contém" (e qualquer forma de contém, como "contém" e "que contém") são verbos de ligação irrestritos. Como um resultado, um sistema, dispositivo ou aparelho cirúrgico que "compreende", "tem", "inclui" ou "contém" um ou mais elementos possui aqueles um ou mais elementos, mas não é limitado a possuir somente aqueles um ou mais elementos. Da mesma forma, um elemento de um sistema, dispositivo ou aparelho cirúrgico que "compreende", "tem", "inclui" ou "contém" um ou mais recursos possui aqueles um ou mais recurso, mas não é limitado a possuir somente aqueles um ou mais recursos.
[00113] Os termos "proximal" e "distal" são usados na presente invenção com referência a um médico que manipula a porção de punho do instrumento cirúrgico. O termo "proximal" refere-se à porção mais próxima ao médico, e o termo "distal" refere-se à porção situada na direção oposta ao médico. Também será entendido que, por uma questão de conveniência e clareza, termos espaciais como "vertical", "horizontal", "para cima" e "para baixo" podem ser usados na presente invenção com relação aos desenhos. Entretanto, instrumentos cirúrgicos podem ser usados em muitas orientações e posições, e esses termos não se destinam a ser limitadores e/ou absolutos.
[00114] São fornecidos vários dispositivos e métodos exemplificadores para a realização de procedimentos cirúrgicos laparoscópicos e minimamente invasivos. Entretanto, o leitor entenderá prontamente que os vários métodos e dispositivos revelados na presente invenção podem ser usados em inúmeros procedimentos e aplicações cirúrgicas, incluindo, por exemplo, em conexão com procedimentos cirúrgicos abertos. Com o avanço da presente Descrição Detalhada, o leitor entenderá adicionalmente que os vários instrumentos aqui revelados podem ser inseridos em um corpo de qualquer maneira, como através de um orifício natural, através de uma incisão ou perfuração formada em tecido, etc. As porções funcionais ou porções do atuador de extremidade dos instrumentos podem ser inseridas diretamente no corpo de um paciente ou podem ser inseridas por meio de um dispositivo de acesso que tenha uma canaleta de trabalho através da qual o atuador de extremidade e o eixo de acionamento alongado de um instrumento cirúrgico podem ser avançados.
[00115] O sistema de grampeamento cirúrgico pode compreender um eixo de acionamento e um atuador de extremidade que se estende do eixo de acionamento. O atuador de extremidade compreende uma primeira garra e uma segunda garra. A primeira garra compreende um cartucho de grampos. O cartucho de grampos é inserível na e removível da primeira garra; entretanto, são previstas outras modalidades nas quais um cartucho de grampos não é removível, ou ao menos prontamente substituível, da primeira garra. A segunda garra compreende uma bigorna configurada para deformar grampos ejetados a partir do cartucho de grampos. A segunda garra é pivotante em relação à primeira garra ao redor de um eixo geométrico da tampa; entretanto, outras modalidades são previstas nas quais a primeira garra é pivotante em relação à segunda garra. O sistema de grampeamento cirúrgico compreende, adicionalmente, uma junta de articulação configurada para permitir que o atuador de extremidade seja girado ou articulado em relação ao eixo de acionamento. O atuador de extremidade é giratório em torno de um eixo geométrico de articulação que se estende através da junta de articulação. Outras modalidades são previstas que não incluem uma junta de articulação.
[00116] O cartucho de grampos compreende um corpo do cartucho. O corpo de cartucho inclui uma extremidade proximal, uma extremidade distal, e uma plataforma que se estende entre a extremidade proximal e a extremidade distal. Em uso, o cartucho de grampos é posicionado em um primeiro lado do tecido a ser grampeado e a bigorna é posicionada em um segundo lado do tecido. A bigorna é movida em direção ao cartucho de grampos para comprimir e prender o tecido contra a plataforma. Depois disso, os grampos armazenados de modo removível no corpo de cartucho podem ser distribuídos para o tecido. O corpo do cartucho inclui cavidades de grampo definidas no mesmo, sendo que os grampos são armazenados de modo removível nas cavidades de grampo. As cavidades de grampo são dispostas em seis fileiras longitudinais. Três fileiras de cavidades de grampo são posicionadas em um primeiro lado de uma fenda longitudinal e três fileiras de cavidades de grampos são posicionadas em um segundo lado da fenda longitudinal. Outras disposições de cavidades de grampo e grampos podem ser possíveis.
[00117] Os grampos são sustentados por acionadores de grampos no corpo de cartucho. Os acionadores são móveis entre uma primeira posição, ou posição não disparada, e uma segunda posição, ou posição disparada, para ejetar os grampos a partir de cavidades de grampo. Os acionadores são retidos no corpo de cartucho por um retentor que se estende em torno do fundo do corpo de cartucho e inclui membros resilientes configurados para prender o corpo de cartucho e reter o retentor no corpo de cartucho. Os acionadores são móveis entre suas posições não disparadas e suas posições disparadas por um deslizador. O deslizador é móvel entre uma posição proximal adjacente à extremidade proximal e uma posição distal adjacente à extremidade distal. O deslizador compreende uma pluralidade de superfícies inclinadas configuradas para deslizar sob os acionadores e levantar os acionadores, e os grampos sustentados no mesmo, em direção à bigorna.
[00118] Adicionalmente ao exposto acima, o deslizador é movido distalmente por um membro de disparo. O membro de disparo é configurado para estar em contato com o deslizador e empurrar o deslizador em direção à extremidade distal. A fenda longitudinal definida no corpo de cartucho é configurada para receber o membro de disparo. A bigorna inclui, também, uma fenda configurada para receber o membro de disparo. O membro de disparo compreende, ainda, um primeiro came que se engata à primeira garra e um segundo came que se engata à segunda garra. Conforme o membro de disparo é avançado distalmente, o primeiro came e o segundo came podem controlar a distância, ou vão de tecido, entre a plataforma do cartucho de grampos e a bigorna. O membro de disparo compreende, também, uma faca configurada para fazer uma incisão no tecido capturado entre a bigorna e o cartucho de grampos. É desejável que a faca seja posicionada ao menos parcialmente proximal às superfícies inclinadas, de modo que os grampos sejam ejetados à frente da faca.
[00119] A Figura 1 ilustra um de instrumento cirúrgico acionado por motor 10 exemplificador (ou "equipado com motor") que inclui um compartimento 100, um conjunto de eixo de acionamento intercambiável alongado 200 e um atuador de extremidade cirúrgico 300 que é operacionalmente ao conjunto de eixo de acionamento intercambiável alongado 200. Embora o conjunto de eixo de acionamento representado seja removível do compartimento 100, várias características inovadoras e únicas podem ser igualmente apreciadas com disposições que empregam um conjunto de eixo de acionamento dedicado (não intercambiável). O atuador de extremidade cirúrgico 300 conforme mostrado, é configurado para atuar como um endocortador para pinçar, separar e grampear o tecido. Entretanto, será entendido que várias modalidades alternativas podem incluir atuadores de extremidade configurados para atuar como outros dispositivos cirúrgicos, incluindo, por exemplo, garras, cortadores, grampeadores, aplicadores de clipes, dispositivos de acesso, dispositivos de aplicação de terapia farmacológica/gênica, ultrassom, RF, e/ou dispositivo de energia laser, etc. Conforme indicado acima e será descrito adicionalmente abaixo, várias porções do instrumento cirúrgico 10 são acionadas por motor. Detalhes adicionais relacionados aos muitos aspectos dos componentes do instrumento cirúrgico acionado por motor 10 podem ser encontrados, por exemplo, no pedido de Patente US n° 13/803.086, intitulado ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, agora a publicação de pedido de patente n° 2014/0263541 A1 foi incorporada em sua totalidade a título de referência. Entretanto, será compreendido que as várias disposições e características reveladas aqui podem também ser eficazmente empregadas em relação a sistemas cirúrgicos controlados roboticamente. Por exemplo, várias disposições reveladas na presente invenção podem ser empregadas com vários sistemas, instrumentos, componentes e métodos robóticos revelados no pedido de Patente US n° 13/118.241, intitulado SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, agora publicação de pedido de Patente US n° 2012/0298719, bem como na Patente US n° 6.132.368, intitulada MULTI-COMPONENT TELEPRESENCE SYSTEM AND METHOD, na Patente US n° 5.878.193, intitulada AUTOMATED ENDOSCOPE SYSTEM FOR OPTIMAL POSITIONING, na Patente US n° 5.792.135, intitulado ARTICULATED SURGICAL INSTRUMENT FOR PERFORMING MINIMALLY INVASIVE SURGERY WITH ENHANCED DEXTERITY AND SENSITIVITY, na Patente US n° 6.231.565, intitulada ROBOTIC ARM DLUS FOR PERFORMING SURGICAL TASKS, na Patente US n° 6.783.524, intitulada ROBOTIC SURGICAL TOOL WITH ULTRASOUND CAUTERIZING AND CUTTING INSTRUMENT, na Patente US n° 6.364.888, intitulada ALIGNMENT OF MASTER AND SLAVE IN A MINIMALLY INVASIVE SURGICAL APPARATUS, na Patente US n° 7.524.320, intitulada MECHANICAL ACTUATOR INTERFACE SYSTEM FOR ROBOTIC SURGICAL TOOLS, na Patente US n° 7.691.098, intitulada PLATFORM LINK WRIST MECHANISM, na Patente US n° 7.806.891, intitulada REPOSITIONING AND REORIENTATION OF MASTER/SLAVE RELATIONSHIP IN MINIMALLY INVASIVE TELESURGERY, e na Patente US n° 7.824.401, intitulada SURGICAL TOOL WITH WRITED MONOPOLAR ELECTROSURGICAL END EFFECTORS a totalidade das revelações de cada um incorporadas a título de referência na presente invenção.
[00120] Dessa forma, como usado aqui, o termo "compartimento" também pode abranger um compartimento ou porção similar de um sistema robótico que aloja ou sustenta de qualquer modo ao menos um sistema de acionamento configurado para gerar e aplicar ao menos um movimento de controle que possa ser usado para acionar os conjuntos de eixos intercambiáveis descritos na presente invenção e seus respectivos equivalentes. O termo "estrutura" pode referir-se a uma porção de um instrumento cirúrgico de mão, por exemplo um "cabo". O termo "estrutura" também pode representar uma porção de um instrumento cirúrgico controlado roboticamente e/ou uma porção do sistema robótico que podem ser usadas para controlar operacionalmente o instrumento cirúrgico.
[00121] Deve-se notar que termos espaciais como vertical, horizontal, à direita, à esquerda, são dados na presente invenção com referência às Figuras assumindo que o "eixo geométrico do eixo de acionamento" ou longitudinal do instrumento cirúrgico 10 é coaxial ao eixo geométrico central do eixo de acionamento 200. Na prática, contudo, o instrumento cirúrgico 10 pode ser orientado em vários ângulos, e, como tal, esses termos espaciais são usados em relação ao próprio instrumento cirúrgico. Adicionalmente, para um compartimento portátil, "proximal" é usado para denotar a perspectiva de um médico que está atrás do cabo, que posiciona o atuador de extremidade cirúrgico 300 distalmente ou na direção oposta a si mesmo ou mesma. Como usado aqui, a frase, "substancialmente transversal ao eixo geométrico longitudinal" onde o "eixo geométrico longitudinal" é o eixo geométrico do eixo de acionamento, refere-se a uma direção que é quase perpendicular ao eixo geométrico longitudinal. Será entendido, entretanto, que as direções que desviam um pouco da perpendicular ao eixo geométrico longitudinal, também são substancialmente transversais ao eixo geométrico longitudinal.
[00122] Como pode ser visto na Figura 1, o atuador de extremidade 300 é conectado de maneira articulada ao conjunto de eixo de acionamento 200 na junta articulada 240. Uma variedade de juntas articuladas e sistemas de controle são revelados em várias patentes e pedidos de patente que foram incorporados a título referência e podem ser empregados em conjunto com vários aspectos aqui revelados e reivindicados. Outras juntas articuladas e sistemas de articulação são reveladas na Patente US n° 7.753.245, intitulada SURGICAL STAPLING INSTRUMENTS e na Patente US n° 7.670.334, intitulada SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR, a totalidade das revelações estão incorporadas a título de referência na presente invenção. Vários outros meios para articular o atuador de extremidade 300 são discutidos em mais detalhes abaixo.
[00123] O atuador de extremidade cirúrgico 300 inclui um canal alongada 302 que é configurada para operacionalmente suportar um cartucho de grampos cirúrgicos 310 em seu interior. O cartucho de grampos 310 inclui um corpo do cartucho 312 que operacionalmente suporta uma pluralidade de grampos ou prendedores cirúrgicos (não mostrados) em seu interior. Em uma implementação, os grampos são operacionalmente suportados em acionadores que são suportados de modo móvel com bolsos de grampo 314 formados no corpo do cartucho 312. O corpo do cartucho 312 inclui adicionalmente uma fenda alongada 316 que é disposta centralmente entre as linhas grampos nos bolsos 314. A fenda alongada 316 é configurada para acomodar um membro de corte de tecido (não mostrado), que é suportado para passar longitudinalmente através do corpo do cartucho 312 mediante a aplicação de um movimento de disparo ao mesmo a partir de um sistema de disparo, conforme será discutido adicionalmente em detalhe abaixo. Em certas implementações, o membro de corte de tecido pode fazer interface com um membro atuador, algumas vezes chamado de um "deslizador de corpo triangular" ou simplesmente "deslizador", que está configurado para aplicar um movimento ascendente para os acionadores de grampo à medida que o deslizador de corpo triangular é acionado distalmente com membro de corte de tecido. Como pode ser visto na Figura 1, o atuador de extremidade 300 inclui uma bigorna 320 que é suportada de modo móvel sobre o canal alongado 302 para o curso seletivo em direção e na direção oposta ao canal alongado 302 e o cartucho de grampos 310 suportado no mesmo. O canal alongado e a bigorna também podem ser chamados de "garras" que são móveis entre as posições aberta e fechada. A bigorna 320 tem uma superfície inferior formadora de grampo (não mostrada) que serve para formar as extremidades dos grampos à medida que eles são acionados na formação de contato com ela. A bigorna 320 é móvel entre uma posição aberta e outra fechada, por meio de um conjunto de um membro de fechamento 210 que faz interface com um sistema de fechamento que é operacionalmente suportado pelo compartimento 100, conforme será discutido adicionalmente em detalhe abaixo. Na modalidade ilustrada, a bigorna 320 é movida em direção ao cartucho de grampos 310 para uma posição fechada quando o conjunto de membro de fechamento 210 é acionado na direção distal "DD" e retornado à posição aberta quando o conjunto de membro de fechamento 210 é movido em uma direção proximal "DP". Uma variedade de diferentes disposições e construções de atuador de extremidade são conhecidas e podem ser empregadas com várias características inovadoras e exclusivas reveladas na presente invenção. Dessa forma, muitas das concretizações apresentadas na presente invenção podem não estar limitadas à disposição específica do atuador de extremidade descrito na Figura 1, por exemplo. Mais detalhes referentes à construção e operação específica de atuadores de extremidade podem ser encontrados em várias patentes e pedidos de Patente US que foram aqui incorporados, a título de referência.
[00124] Na forma ilustrada, o instrumento cirúrgico 10 inclui um compartimento 100 que compreende um cabo 102. Em ao menos uma forma, o cabo 102 compreende um par de segmentos de compartimento do cabo interconectáveis 104, 106, que podem ser interconectados por parafusos, recursos de encaixe por pressão, adesivos, etc. Na disposição ilustrada, os segmentos do compartimento do cabo 104, 106 cooperam para formar uma porção da empunhadura de pistola 108 que pode ser empunhada e manipulada pelo médico. Como será discutido em mais detalhes abaixo, o punho 102 sustenta operacionalmente, em seu interior, uma pluralidade de sistemas de acionamento, que são configurados para gerar e aplicar vários movimentos de controle às porções correspondentes do conjunto de eixo intercambiável que está operacionalmente fixado ao mesmo.
[00125] Agora com referência à Figura 2, o punho 102 pode incluir, também, uma estrutura 110 que sustenta operacionalmente uma pluralidade de sistemas de acionamento. Por exemplo, a estrutura 110 pode suportar operacionalmente um "primeiro" sistema de acionamento ou sistema de acionamento de fechamento, designado, de modo geral, como 120, que pode ser empregado para aplicar movimentos de fechamento e abertura ao conjunto de eixo de acionamento intercambiável 200 que está fixado ou acoplado operacionalmente à mesma. Em ao menos uma forma, o sistema de acionamento de fechamento 120 pode incluir um atuador sob a forma de um gatilho de fechamento 122, sustentado de forma articulada pela estrutura 110. Mais especificamente, como ilustrado na Figura 2, o gatilho de fechamento 122 pode ser sustentado de forma articulada pela estrutura 110, de modo que, quando o médico pegue a empunhadura 108 do punho 102, o gatilho de fechamento 122 seja facilmente articulado de uma posição inicial, ou desativada, para uma posição ativada, e, mais particularmente, para uma posição completamente pressionada, ou posição completamente ativada. O gatilho de fechamento 122 pode ser deslocado para a posição não acionada por uma mola ou outra disposição de deslocamento (não mostrada). Sob várias formas, o sistema de acionamento de fechamento 120 inclui adicionalmente um sistema articulado de fechamento 124, que é acoplado de forma articulada ao gatilho de fechamento 122. Como pode ser visto na Figura 2, o conjunto de articulação de fechamento 124 pode incluir uma primeira articulação de fechamento 126 que é acoplada de modo pivotante ao gatilho de fechamento 122. Além disso, o conjunto de articulação de fechamento 124 inclui outra articulação de fechamento 127 que tem um par de pinos ou porções de fixação 128 que se estendem lateralmente se projetando desse.
[00126] Ainda com referência à Figura 2, é possível observar que a articulação de fechamento 126 pode conter uma parede de travamento 130 nele, configurada para cooperar com um conjunto de liberação do fechamento 140, acoplado de modo pivotante à estrutura 110. Em pelo menos uma forma, o conjunto de liberação do fechamento 140 pode compreender um conjunto de botão de liberação 142, que possui um braço seguidor de came em projeção distal 144 formado no mesmo. O conjunto do botão de liberação 142 pode ser articulado em sentido anti-horário por uma mola de liberação 146. Conforme o médico pressiona o gatilho de fechamento 122 de sua posição desativada em direção à porção da empunhadura 108 do punho 102, a articulação de fechamento 126 revolver-se para cima, até um ponto em que o braço seguidor de came 144 entra em engate de retenção com a parede de travamento 130 na articulação de fechamento 126, impedindo, assim, que o gatilho de fechamento 122 retorne à posição desativada. Desse modo, o conjunto de liberação de fechamento 140 serve para travar o gatilho de fechamento 122 na posição completamente atuada. Quando o médico deseja destravar o gatilho de fechamento 122 de forma a permitir que seja tracionado à posição não atuada, basta articular o conjunto do botão de liberação do fechamento 142 de modo que o braço seguidor de came 144 seja liberado do engate com a parede de travamento 130 na articulação de fechamento 126. Quando o braço seguidor de came 144 tiver sido liberado do engate com a articulação de fechamento 126, o gatilho de fechamento 122 pode se articular de volta à posição não atuada. Outras disposições para travamento e liberação do gatilho de fechamento também podem ser empregadas.
[00127] Em ao menos uma forma, o cabo 102 e a estrutura 110 podem operacionalmente suportar um outro sistema de acionamento, chamado, na presente invenção, de sistema de acionamento de disparo 150, que é configurado para aplicar movimentos de disparo às porções correspondentes do conjunto de eixo de acionamento intercambiável 200 fixado ao mesmo. O sistema de acionamento de disparo pode também ser chamado na presente invenção de "segundo sistema de acionamento". O sistema de acionamento de disparo 150 pode empregar um motor elétrico ("motor de disparo") 152 situado na porção da empunhadura da pistola 108 do cabo 102. Em várias formas, o motor de disparo 152 pode ser um motor de acionamento com escovas de corrente contínua, com uma rotação máxima de, aproximadamente, 25.000 RPM, por exemplo. Em outras disposições, o motor de disparo pode incluir um motor sem escovas, um motor sem fio, um motor síncrono, um motor de passo ou qualquer outro motor elétrico adequado. Uma bateria 154 (ou "fonte de alimentação" ou "conjunto de baterias"), como uma bateria de íons de Li, por exemplo, pode ser acoplada ao cabo 102 para fornecer energia, a um conjunto de placa de circuito de controle 156 e, por fim, ao motor de disparo 152.
[00128] O motor de disparo 152 pode incluir um eixo giratório (não mostrado), que, de modo operacional, faz interface com um conjunto redutor de engrenagem 158, que está montado em engate de acoplamento com um conjunto ou cremalheira, de dentes de acionamento 162 em um membro de acionamento longitudinalmente móvel 160. Em uso, uma polaridade de tensão fornecida pela bateria é capaz de operar o motor de disparo 152 em sentido horário, sendo que a polaridade de tensão aplicada ao motor elétrico pela bateria pode ser invertida de forma a operar o motor elétrico 152 em sentido anti- horário. Quando o motor elétrico 152 é girado em uma direção, o elemento de acionamento 160 será axialmente ativado na direção distal "DD". Quando o motor 152 é acionado em uma direção giratória oposta, o elemento de acionamento 160 será axialmente ativado na direção proximal "PD". O cabo 102 pode incluir uma chave que pode ser configurada para inverter a polaridade aplicada ao motor de disparo 152 pela bateria. Assim como com as outras formas descritas na presente invenção, o cabo 102 também pode incluir um sensor ou sensores configurados para detectar a posição(ões) do membro de acionamento 160 e/ou a direção em que o membro de acionamento 160 está sendo movido.
[00129] No instrumento ilustrado, o acionamento do motor de disparo 152 é controlado por um gatilho de disparo 170 suportado de modo pivotante no cabo 102. O gatilho de disparo 170 pode ser girado entre uma posição não acionada e uma posição acionada. O gatilho de disparo 170 pode ser deslocado para a posição acionada por uma mola (não mostrada) ou outra disposição de deslocamento, de forma que, quando o médico libera o gatilho de disparo 170, este pode ser girado, ou outro modo, retorna à posição não acionada pela mola ou disposição de deslocamento. Na forma ilustrada, o gatilho de disparo 170 é posicionado "distante" do gatilho de fechamento 122, como discutido acima. Em ao menos uma forma, um botão de segurança do gatilho de disparo 172 é montado de forma pivotante no gatilho de fechamento 122. O botão de segurança 172 é posicionado entre o gatilho de disparo 170 e o gatilho de fechamento 122 e tem um braço de pivô 174 que se projeta a partir do mesmo. Quando o gatilho de fechamento 122 está na posição não atuada, o botão de segurança 172 está contido no compartimento do cabo 100, onde o médico não pode acessá-lo prontamente e movê-lo entre uma posição de segurança, que impede a atuação do gatilho de disparo 170, e uma posição de disparo na qual o gatilho de disparo 170 pode ser disparado. Conforme o médico pressiona o gatilho de fechamento 122, o botão de segurança 172 e o gatilho de disparo 170 articulam-se para baixo, numa posição em que podem ser manipulados pelo médico.
[00130] Como indicado acima, em ao menos uma forma, o elemento de acionamento móvel longitudinalmente 160 tem uma cremalheira de dentes 162 formada na mesma para o engate por engrenamento com a engrenagem de acionamento correspondente 159 do conjunto do redutor de engrenagem 158. Ao menos uma forma pode incluir também um conjunto de "resgate" atuável manualmente 180 que é configurado para permitir ao médico retrair manualmente o membro de acionamento móvel longitudinalmente 160 caso o motor 152 desligue. O conjunto de ejeção 180 pode incluir um conjunto de punho de ejeção ou alavanca 182, configurado para ser articulado manualmente de forma a engatar-se por catraca nos dentes 162 no elemento de acionamento 160. Dessa forma, o médico pode retrair manualmente o membro de acionamento 160 usando o conjunto de cabo de resgate 182 para ajustar o membro de acionamento na direção proximal "DP". A publicação de pedido de Patente US n° 2010/0089970 revela disposições de resgate e outros componentes, disposições e sistemas que também podem ser empregados com os vários instrumentos aqui revelados. O pedido de Patente US n° de série 12/249.117, intitulado POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, agora publicação de pedido de Patente US n° 2010/0089970, é aqui incorporado em sua totalidade a título de referência.
[00131] A Figura 1 ilustra o instrumento cirúrgico 10 com um conjunto de eixo intercambiável 200 acoplado de modo operável ao mesmo. Conforme indicado acima, o conjunto de eixo de acionamento 200 pode ser configurado por fixação e desprendimento rápido no compartimento 100. O conjunto de membro de fechamento 210 inclui um segmento distal do membro de fechamento 220, que é fixado de modo pivotante a um segmento proximal do membro de fechamento 230 na junta articulada 240. O segmento distal do membro de fechamento 220 inclui uma abertura em formato de U que é configurada para abertura 222 para engatar operacionalmente uma aba vertical da bigorna 322 na bigorna 320 quando o membro de fechamento é formado no conjunto de direção proximal "DP". Quando a abertura em formato de U 222 engata a aba da bigorna 322, a bigorna 320 é pivotada para uma posição aberta. Detalhes específicos considerando alguns exemplos da junta articulada 240 e ou outras disposições de junta articulada adequada podem ser encontrados nos vários documentos que foram aqui incorporados por referência.
[00132] Agora com referência às Figuras 3 e 7, o conjunto de eixo de acionamento 200 inclui um conjunto dorsal 250 sobre o qual o conjunto de membro de fechamento 210 é suportado de modo móvel. O conjunto dorsal 250 inclui extremidade distal 252 que é fixado de modo pivotante à extremidade proximal 304 do canal alongado 302. Vide Figura 7. Tal disposição facilita a articulação pivotante do atuador de extremidade 300 em relação à extremidade distal 252 do conjunto dorsal 250 em torno de um eixo geométrico articulado A-A que é transversal ao eixo geométrico do eixo de acionamento SA-SA. Vide Figura 1. Em várias implementações, o atuador de extremidade 300 pode também ser seletivamente girado em relação ao compartimento 100 sobre a eixo geométrico do eixo de acionamento SA-SA (representado pela seta "R" na Figura 1). Porque o atuador de extremidade 300 é diretamente fixado à extremidade distal 252 do conjunto dorsal 250, a rotação do conjunto dorsal 250 em relação ao compartimento 100, resulta em rotação do atuador de extremidade 300 também. Na implementação ilustrada, o conjunto de eixo de acionamento intercambiável 200 inclui um bocal giratório 400 é giratoriamente assentado ou, de outro modo, giratoriamente apoiado pelo cabo 102. Na implementação ilustrada, por exemplo, o bocal giratório 400 compreende porções de dois bocais 402, 404 que são acoplados um ao outro por recursos de encaixe por pressão, parafusos, adesivo, etc. e incluem duas pastilhas opostas, que se estendem para dentro 406, que estão colocadas em entalhes correspondentes 254 na extremidade proximal 252 do conjunto dorsal 250. Vide Figura 3. Essa disposição facilita a rotação do conjunto dorsal 250 quando o bocal 400 é girado.
[00133] A articulação do atuador de extremidade 300 em torno do eixo geométrico A-A, é acompanhada pela atuação de um sistema de articulação 500. Na implementação ilustrada, por exemplo, o sistema de articulação 500 inclui um motor de articulação 510 que é usado para atuar o primeiro e o segundo acionadores de articulação 520, 530. Vide Figuras 5 e 6. O motor de articulação 510 pode compreender um motor similar a um motor de disparo ou qualquer uma das várias configurações de motor aqui discutidas e inclui uma engrenagem de acionamento de articulação 512 que está em engate engrenado com a primeira cremalheira da engrenagem 524 sobre a extremidade proximal 522 do primeiro acionador de articulação 520. A engrenagem de articulação 512 está também em engate engrenado com uma segunda cremalheira da engrenagem 534 sobre a extremidade proximal 532 do segundo acionador de articulação 530. Como pode ser mais particularmente visto na Figura 5, engrenagem de articulação 512 é disposta de modo central entre as primeira e segunda cremalheiras de engrenagem 524, 534 de modo que a rotação da engrenagem de articulação em uma primeira direção resultará no movimento axial do primeiro acionador de articulação 520 em uma direção distal "DD", o movimento axial simultâneo da segunda acionador de articulação 530 na direção proximal "DP" ou axial oposta. Da mesma forma, a rotação da engrenagem de articulação em uma segunda direção rotativa 512 resultará no movimento axial do segundo acionador de articulação 530 na direção distal "DD" e o movimento axial simultâneo do primeiro acionador de articulação 520 na direção proximal ou oposta "DP". Com referência à Figura 7, a extremidade distal 526 do primeiro acionador de articulação 520 inclui uma fenda 528 que é configurada para receber um pino correspondente 304 formado no canal alongado 302. De modo semelhante, a extremidade distal 536 do segundo acionador de articulação 530 inclui uma fenda 538 que é configurada para receber um pino correspondente 306 formado no canal alongado 302. Dessa forma, o movimento axial dos acionadores de articulação 520, 530 da maneira acima descrita, aplicará simultaneamente movimentos de "empurrar e puxar", ao canal alongado 302 e, assim resulta na articulação pivotante do atuador de extremidade 300 em torno do eixo geométrico de articulação A-A.
[00134] Como acima indicado, o instrumento cirúrgico 10 inclui também um membro de corte de tecido que é configurado para se deslocar axialmente através da fenda alongada 316 no cartucho de grampos cirúrgicos 310. Na implementação ilustrada, por exemplo, o membro de corte de tecido ou a superfície de corte de tecido (não mostrado) é formado sobre ou, de outro modo, fixado a um membro de disparo distal 550. O membro de disparo distal 550 pode ser de construção laminada para facilitar a flexão em redor do eixo geométrico de articulação A-A ao mesmo tempo em que permanece suficientemente rígido para permitir que o gume cortante de tecido seja inserido através do tecido que está preso entre a bigorna e o cartucho de grampos cirúrgicos, bem como acionar o deslizador de corpo triangular através do mesmo. Várias configurações de membros de disparo e de membros de corte de tecido distal são conhecidas e são reveladas nas patentes e/ou pedidos de patente que foram aqui incorporados por referência. O membro de disparo distal 550 é fixado a um membro de disparo proximal 560 que é apoiado para se deslocar axialmente em relação ao conjunto dorsal 250. O membro de disparo proximal 560 tem uma fenda axial centralmente disposta 562 nele para acomodar o eixo de acionamento 511 do motor de articulação 510. Vide Figura 5. Essa disposição facilita o deslocamento axial do membro de disparo proximal 560 em resposta a movimentos de disparo aplicados ao mesmo pelo sistema de disparo. A extremidade proximal 564 do membro de disparo proximal 560 inclui um pino 566 que é configurado para ser recebido em uma base de acoplamento do eixo de acionamento de disparo 164 fornecida na extremidade distal 162 do membro de acionamento móvel 160. Vide Figura 2. Dessa forma, a atuação do motor de disparo 152 irá resultar no movimento axial do membro de acionamento móvel 160 e do membro de disparo proximal 560 e do membro de disparo distal 550.
[00135] O motor de disparo 152 e o motor de articulação 510 se comunicam com o circuito de controle 156 (Figura 2) e são intertravados por uma disposição de chaveamento, em geral, designada como 600. Na configuração ilustrada, a disposição de chaveamento 600 inclui um tambor de chaveamento 610 que é giratoriamente apoiado sobre o segmento proximal do membro de fechamento 230. Vide Figura 3. O tambor de chaveamento 610 inclui uma saliência estendendo-se lateralmente 611, que tem um pino de came 612 (retido) estendendo-se para dentro, lateralmente montado no mesmo. O pino de came 612 estende-se para dentro de uma fenda de came 232 fornecida no segmento proximal do membro de fechamento 230. Vide Figura 4. O tambor de chaveamento 610 inclui adicionalmente fendas opostas 614 que são configuradas para acomodar a rotação dos pinos do bocal 406 através das mesmas. Uma fenda de articulação 617 é também fornecida para facilitar a rotação do tambor de chaveamento 610 em relação ao motor de articulação 510. Vide Figura 3. A disposição de chaveamento 600 também inclui um conjunto de anel de deslizamento 620 que é configurado para conduzir a energia elétrica e/ou sinais para e/ou a partir do atuador de extremidade cirúrgico 300 para o cabo 102 e, mais particularmente, para o circuito de controle 156 dentro do cabo 102. O conjunto de anel coletor 620 inclui uma pluralidade de condutores concêntricos 622, ou ao menos substancialmente concêntricos, em lados opostos do mesmo, os quais podem ser configurados para permitir a rotação relativa entre as metades do conjunto de anel coletor 620 e ao mesmo tempo manter os circuitos condutores de eletricidade entre si. Exemplos de tais conjuntos de anel de deslizamento são revelados no pedido de Patente US n° de série 13/800.067, intitulado STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, agora publicação de pedido de Patente US n° 2014/0263552 e no pedido de Patente US n° 13/800.025, intitulado STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, agora publicação de pedido de Patente US n° 2014/0263551 cada um dos quais está aqui incorporado na íntegra, a título de referência. Na implementação ilustrada, o conjunto de anel de deslizamento 620 inclui um anteparo 624 que tem um componente de chaveamento 626 que se comunica através do conjunto de anel de deslizamento 620 com o circuito de controle 156. A disposição de chaveamento 600 inclui, também, um componente de chaveamento móvel 618 que é montado em uma porção do braço de chaveamento 616 do tambor de chaveamento 610.
[00136] Com referência à Figura 4, pode notar-se que a fenda de came 232 tem uma primeira porção 232A e uma segunda porção 232B. Quando o membro de fechamento está na posição proximal 230 (não atuada) o pino de came 612 está na primeira porção 232A da fenda de came 232. Uma trava de mola 630 é montada sobre a saliência do tambor de chaveamento 611 para forçar o tambor de chaveamento 610 naquela primeira posição sendo que o pino de came 612 está na primeira porção 232A da fenda do came 232. Consulte a figura 3. Quando naquela primeira posição, o componente de chaveamento móvel 618 não está em contato ou em "proximidade de atuação" com o componente de chaveamento 626. Quando nesta posição de "trava de acionamento", o circuito de controle evita a atuação do motor de disparo 152. Dito de outra forma, a menos que o componente de chaveamento móvel 618 ative o componente de chaveamento 626, não é fornecida energia ao motor de disparo 152. Dessa forma, mesmo se o médico for atuar o gatilho de disparo 170 em uma tentativa de atuar do motor de disparo 152, o motor de disparo 152 poderia não atuar.
[00137] Durante um procedimento cirúrgico típico, o médico pode introduzir o atuador de extremidade 300 no local cirúrgico através de um trocarte ou outra abertura no paciente para acessar o tecido-alvo. Em um esforço para posicionar o atuador de extremidade em uma posição desejada em relação ao tecido alvo, o médico pode acionar o motor de articulação 510, mediante o acionamento de uma chave osciladora 515 montada sobre o cabo 102. A chave osciladora 515 se comunica com o circuito de controle 156 e a agitação da chave osciladora 515 em uma primeira direção fará o motor de articulação 510 girar em uma primeira direção e resulte na articulação do atuador de extremidade 300 em uma primeira direção de articulação. A agitação da chave 515 em uma segunda direção resultará na rotação do motor de articulação 510 em uma direção de rotação oposta e fará com que o atuador de extremidade cirúrgico 300 seja articulado em uma segunda direção de articulação oposta. Quando o médico tiver posicionado o atuador de extremidade cirúrgico 300 em uma posição desejada, o médico pode liberar a chave 515 para parar a articulação. Neste ponto, o tecido-alvo pode ser posicionado entre o cartucho de grampos cirúrgicos 310 e a bigorna 320. O médico pode, então, mover a bigorna 320 para uma posição fechada em que o tecido alvo é fixado entre a bigorna 320 e o cartucho de grampos 310.
[00138] O conjunto de membro de fechamento 210 é atuado pelo conjunto de atuação do gatilho de fechamento 122. A extremidade proximal do segmento proximal membro de fechamento 230 é suportada em um gancho de fixação do membro de fechamento (não mostrado) que é suportado de modo móvel em uma porção da estrutura (não mostrada) do conjunto de eixo de acionamento 200. Exemplos do gancho de fixação de membro de fechamento e da porção da estrutura do conjunto de eixo de acionamento são descritos em mais detalhes no pedido de Patente US n° 13/803.097, intitulado ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, agora publicação de pedido de Patente US n° 2014/0263542, que foi aqui incorporada a título de referência, em sua totalidade Quando o médico pressiona o gatilho de fechamento 122, o conjunto de membro de fechamento 210 é movido na direção distal "DD" o que por fim faz com que a bigorna 320 pivote para a posição presa sobre o tecido alvo. À medida que o conjunto de membro de fechamento 210 se move distalmente, o pino de came 612 interage com a fenda de came 232 e é colocado em came na porção 232B da fenda de came 232. O movimento do pino de came 612 na porção 232B da fenda de came 232 resulta em um movimento giratório do conjunto de tambor de chave 610 na direção da atuação (representado pela seta "AD" na Figura 3). À medida que o tambor de chaveamento 610 é forçado para a direção de atuação "AD" contra a força da mola 630, o componente de chaveamento 618 é colocado em ativação/registro componente de chaveamento 626 que faz com que a placa de circuito controle 156 permita que a energia flua para o motor de disparo 152, mediante a atuação do gatilho de disparo 170. Quando naquela posição fechada, o conjunto de membro de fechamento 210 e a bigorna 320 são travados na posição fechada da maneira acima descrita. O circuito de controle 156 pode ser configurado de modo que quando os componentes de chaveamento 618 e 626 estão em registro de atuação, o circuito de controle 156 impede qualquer fluxo de energia para o motor de articulação 510 se a chave osciladora 515 for atuada inadvertidamente. Uma vez que o conjunto de membro de fechamento 210 e a bigorna 320 são travados na posição apertada, o médico pode atuar o gatilho de disparo 170 para acionar o membro de corte através do atuador de extremidade 300 e cortar o tecido preso no mesmo e disparar os prendedores cirúrgicos em cada lado da linha de corte do tecido. O atuador de extremidade 300 pode também ser equipado com sensores que se comunicam com o circuito de controle 156 para detectar quando o membro de corte de tecido alcançou sua posição mais distal para, assim, sinalizar para o motor de disparo 152 para reverter sua direção e para retrair o membro de corte de tecido para sua posição inicial. Outros sensores podem ser empregados para detectar quando o membro de corte de tecido retornou à posição inicial e se comunicar com o circuito de controle 156 para, assim, fornecer ao médico uma indicação da situação do membro de corte de tecido e/ou permitir que o conjunto de membro de fechamento seja destravado. Quando o conjunto de membro de fechamento 210 tiver sido destravado, a trava por mola 630, que atua sobre o tambor de chaveamento 610, induzirá o pino de came 612 a retornar de forma giratória à porção 232A da fenda de came 232. A rotação do tambor de chaveamento 610 de volta à posição inicial, desativará a chave 626 que impedirá novamente, a atuação do motor de disparo 152.
[00139] As Figuras 9 a 11 ilustram um outro conjunto de eixo de acionamento 200’ que é substancialmente similar ao conjunto de eixo de acionamento 200 exceto as diferenças discutidas abaixo. As porções/componentes do conjunto de eixo de acionamento 200' que também são encontrados no conjunto de eixo de acionamento 200 serão designados pelos números dos membros similares. Conforme pode ser visto nas Figuras 9 a 11, o conjunto de eixo de acionamento 200’ inclui um sistema de articulação 500' que compreende um motor de articulação 510’ que é usado para atuar o primeiro e o segundo acionadores de articulação 520', 530'. Vide Figuras 10 e 11. O motor de articulação 510’ inclui uma engrenagem de rosca sem-fim de articulação 512' que está em engate engrenado com um conjunto de engrenagem de articulação 700. Em uma forma, o conjunto de engrenagem de articulação compreende uma roda dentada de articulação 702 que está em engate engrenado com a engrenagem de rosca sem-fim de articulação 512’ e uma engrenagem de acionamento de articulação 704 que está em engate engrenado com as primeira e segunda porções dos acionadores de articulação 520', 530'. O conjunto de engrenagem de articulação 700 e, mais particularmente, a engrenagem de acionamento 704 está centralmente disposta entre uma primeira cremalheira 524’ no primeiro acionador de articulação 520' e uma segunda cremalheira articulada 534’ no segundo acionador de articulação 530'. A rotação da engrenagem de acionamento de articulação 704 em uma primeira direção resultará no movimento axial do primeiro acionador de articulação 520’ em uma direção distal "DD" e o movimento axial simultâneo do segundo acionador de articulação 530’ na direção proximal "DP" ou axial oposta. Da mesma forma, a rotação da engrenagem de acionamento de articulação em uma segunda direção rotativa 704 resultará no movimento axial do segundo acionador de articulação 530’ na direção distal "DD" e o movimento axial simultâneo do primeiro acionador de articulação 520’ na direção proximal ou oposta "DP".
[00140] Com referência à Figura 11, a extremidade distal 526’ do primeiro acionador de articulação 520’ inclui uma fenda 528’ que é configurada para receber um pino correspondente 304 formado no canal alongado do atuador de extremidade 300. De modo semelhante, a extremidade distal 536’ do segundo acionador de articulação 530 inclui uma fenda 538’ que é configurada para receber um pino correspondente 306 formado no canal alongado. Dessa forma, o movimento axial dos acionadores de articulação 520’, 530’ da maneira acima descrita, aplicará simultaneamente movimentos de "empurrar e puxar", ao canal alongado do atuador de extremidade 300 e, assim resulta na articulação pivotante do atuador de extremidade 300 em torno do eixo geométrico de articulação. Como acima indicado, o instrumento cirúrgico 10 inclui também um membro de corte de tecido que é configurado para se deslocar axialmente através da fenda alongada no cartucho de grampos cirúrgicos que é suportado no atuador de extremidade 300. O membro de corte de tecido ou a superfície de corte de tecido (não mostrado) é formado sobre ou, de outro modo, fixado ao membro de disparo distal 550. O membro de disparo distal 550 é fixado a uma haste de disparo 560’ que é suportado para se deslocar axialmente dentro do conjunto dorsal 250. O membro de disparo proximal 560' tem uma fenda axial centralmente disposta no mesmo (não mostrada) para acomodar o eixo de acionamento da engrenagem 701 sobre a qual a roda dentada da articulação 702 e a engrenagem de acionamento de articulação 704 são montadas. Vide Figuras 9 e 10. Essa disposição facilita o deslocamento axial do membro de disparo proximal 560’ em resposta a movimentos de disparo aplicados ao mesmo pelo sistema de disparo. A extremidade proximal 564’ do membro de disparo proximal 560’ inclui um pino 566’ que é configurado para ser recebido em uma base de acoplamento da haste de disparo 164 fornecida na extremidade distal 163 do membro de acionamento móvel 160. Vide Figura 2. Dessa forma, a atuação do motor de disparo 152 irá resultar no movimento axial do membro de acionamento 160 e do membro de disparo proximal 560 e do membro de disparo distal 550.
[00141] O motor de disparo 152 e o motor de articulação 510 se comunicam com o circuito de controle 156 (Figura 2) e são intertravados por uma disposição de chaveamento, em geral, designada como 600. Na configuração ilustrada, a disposição de chaveamento 600 inclui um tambor de chaveamento 610’ que é giratoriamente apoiado sobre o segmento proximal do membro de fechamento 230’. O tambor de chaveamento 610’ inclui uma saliência estendendo-se lateralmente 611’ que tem um pino de came 612’ estendendo-se para dentro, montado no mesmo. Similar à disposição descrita acima, o pino de came 612’ estende-se para dentro de uma fenda de came fornecida no membro de fechamento 230'. O tambor de chaveamento 610’ inclui adicionalmente fendas opostas 614’ que são configuradas para acomodar a rotação dos pinos do bocal 406 através das mesmas. O tambor de chaveamento 610’ tem uma porção inferior aberta 613', para facilitar a rotação do tambor de chaveamento 610’ em relação ao motor de articulação 510' e o conjunto de engrenagem de articulação 700. Vide Figura 9. A disposição de chaveamento 600’ inclui, também, um componente de chaveamento móvel 618’ que é montado em uma porção do braço de chaveamento 616’ do tambor de chaveamento 610’.
[00142] Conforme discutido acima, quando o membro de fechamento 230’ está na posição proximal (não atuada), o pino de came 612’ está na primeira porção da fenda de came. Uma trava de mola 630’ é montada sobre a saliência do tambor de chaveamento 611’ para forçar o tambor de chaveamento 610’ naquela primeira posição sendo que o pino de came 612’ está na primeira porção da fenda do came. Quando naquela primeira posição, o componente de chaveamento móvel 618’ não está em contato ou em "proximidade de atuação" com o componente de chaveamento 626. Quando nesta posição de "trava de acionamento", o circuito de controle evita a atuação do motor de disparo 152. Dito de outra forma, a menos que o componente de chaveamento móvel ative o componente de chaveamento 626, não é fornecida energia ao motor de disparo 152. Dessa forma, mesmo se o médico for atuar o gatilho de disparo 170 em uma tentativa de atuar do motor de disparo 152, o motor de disparo 152 poderia não atuar.
[00143] No exemplo ilustrado, o conjunto de membro de fechamento 230’ é atuado pelo conjunto de atuação do gatilho de fechamento 122. Quando o médico pressiona o gatilho de fechamento 122, o conjunto de membro de fechamento 230’ é movido na direção distal "DD" o que por fim faz com que a bigorna pivote para a posição presa sobre o tecido alvo. À medida que o conjunto de membro de fechamento 230’ se move distalmente, o pino de came 612’ interage com a fenda de came que resulta no movimento giratório do conjunto de tambor de chaveamento 610’. À medida que o tambor de chaveamento 610’ é forçado para uma direção de atuação "AD" contra a força da mola 612’, o componente de chaveamento 618’ é colocado em ativação/registro componente de chaveamento 626 que faz com que a placa de circuito controle 156 permita que a energia flua para o motor de disparo 152, mediante a atuação do gatilho de disparo 170. Quando naquela posição fechada, o conjunto de membro de fechamento 210’ e a bigorna são travados na posição fechada da maneira acima descrita. O circuito de controle 156 pode ser configurado de modo que quando os componentes de chaveamento 618’ e 626 estão em registro de atuação, o circuito de controle 156 impede qualquer fluxo de energia para o motor de articulação 510’ se a chave osciladora 515 for atuada inadvertidamente. Uma vez que o conjunto de membro de fechamento 210’ e a bigorna são travados na posição apertada, o médico pode atuar o gatilho de disparo 170 para acionar o membro de corte através do atuador de extremidade 300 e cortar o tecido preso no mesmo e disparar os prendedores cirúrgicos em cada lado da linha de corte do tecido. O atuador de extremidade 300 pode também ser equipado com sensor(es) (não mostrado) que se comunicam com o circuito de controle 156 para detectar quando o membro de corte de tecido alcançou sua posição mais distal para, assim, fornecer o circuito de controle com ações para fazer o motor de disparo 152 parar e reverter sua direção e retrair o membro de corte de tecido para sua posição inicial. Outro(s) sensor(es) podem ser empregados para detectar quando o membro de corte de tecido retornou à posição inicial e se comunica com o circuito de controle 156 para, assim, comunicar aquela informação ao médico e/ou permitir que o conjunto de membro de fechamento seja destravado. Uma vez que o conjunto de membro de fechamento 210’ foi destravado, a trava de mola 630’, que atua sobre o tambor de chaveamento 610’, induzirá o pino de came 612’ a retornar de modo giratório o tambor de chaveamento 610’ de volta para aquela posição de partida que desativará a chave 626 e novamente a ativação do motor de disparo 152 será evitada pelo circuito de controle.
[00144] As Figuras 12 a 13 ilustram um conjunto de eixo de acionamento 200” alternativo que é substancialmente similar ao conjunto de eixo de acionamento 200 exceto as diferenças discutidas abaixo. As porções/componentes do conjunto de eixo de acionamento 200” que também são encontrados no conjunto de eixo de acionamento 200 serão designados pelos números dos membros similares. Conforme pode ser visto nessas Figuras, o conjunto de eixo de acionamento 200” inclui um conjunto dorsal 250” que compreende uma extremidade de estrutura proximal ou membro de estrutura proximal 252” que é fixado a uma estrutura de eixo de acionamento 260 que está acoplado de modo pivotante ao membro inserível da estrutura do atuador de extremidade 330 que é fixado ao canal alongado 302. A estrutura do eixo de acionamento 260 inclui um pino pivotante 262 que é configurado para ser recebido de forma giratória dentro de uma abertura pivotante (não mostrado) no membro inserível da estrutura do atuador de extremidade 330. Essa disposição serve para definir a junta articulada 240 em torno da qual o atuador de extremidade 300 pode se articular.
[00145] O conjunto de eixo de acionamento 200” ilustrado inclui o primeiro e o segundo acionadores de articulação 520”, 530” que são similares aos acionadores de articulação 520, 530 conforme discutido acima, exceto pelas diferenças descritas abaixo. Como pode ser visto nas Figuras 12 e 13, por exemplo, o primeiro e o segundo acionadores de articulação 520”, 530” são suportados de maneira deslizante entre o conjunto dorsal 250” e um conjunto de membro de fechamento 210”. Dessa forma, os acionadores de articulação 520”, 530” deslizam axialmente entre esses componentes quando atuados para articular o atuador de extremidade 300 em torno da junta articulada 240. Para fornecer suporte ao primeiro e ao segundo acionadores de articulação 520”, 530” durante a ativação dos mesmos, uma engrenagem intermediária 264 é disposta centralmente entre os acionadores de articulação 520” e 530”. O primeiro acionador de articulação 520” inclui uma primeira cremalheira distal 527 e o segundo acionador de articulação 530” inclui uma segunda cremalheira distal 537. A primeira e a segunda cremalheiras distais 527, 537 estão em engate engrenado com a engrenagem intermediária 264 conforme mostrado. Além disso, o segmento de membro de fechamento proximal 230” inclui um primeiro detentor gerador de fricção ou dente de travamento 234 que é configurado para engatar de maneira deslizante uma primeira porção dentada ou serrilhada 529 no primeiro acionador de articulação 520”. O segmento de membro de fechamento proximal 230” também inclui um primeiro detentor gerador de fricção ou dente de travamento 236 que é configurado para engatar de maneira deslizante uma segunda porção dentada ou serrilhada 539 no segundo acionador de articulação 530”. Para facilitar alguma flexão das porções dentadas 529, 539 do primeiro e do segundo acionadores de articulação 520”, 530”, respectivamente, durante a articulação do atuador de extremidade 300, uma distância é fornecida entre a porção correspondente do membro de estrutura proximal 252” e as porções serrilhadas 529, 539 dos acionadores de articulação 520”, 530”. Por exemplo, as porções do membro de estrutura proximal 252” que não correspondem às porções serrilhadas 529, 539 podem ter um diâmetro "D" e a porção do membro de estrutura proximal 252” que corresponde às porções serrilhadas 529, 539 pode ter um diâmetro mínimo de "M" sendo que M < D. Essa disposição fornece distância para a flexão dos acionadores de articulação 520”, 530” à medida que os acionadores 520”, 530” são axialmente deslocados. Durante tal deslocamento axial, os dentes detentores 234, 236 se engatam nas porções serrilhadas correspondentes 529, 539 para evitar que os acionadores de articulação 520”, 530” se movimentem e, essencialmente, "travam" o atuador de extremidade na posição. Isto não é apenas vantajoso para manter o atuador de extremidade em uma orientação articulada durante o desempenho de um procedimento cirúrgico, mas também durante o transporte do dispositivo que pode evitar que porções do mesmo tornem-se danificadas inadvertidamente. Além disso, tais dispositivos de travamento servem para reter os acionadores de articulação em suas respectivas posições de fixação antes da fixação do conjunto de eixo de acionamento ao cabo ou ao compartimento. Em disposições alternativas, o detentor que gera fricção ou os dentes de travamento podem ser ativados por mola em contato com as porções serrilhadas correspondentes dos acionadores de articulação. Por exemplo, cada dente pode ser separadamente móvel em direções transversais às porções serrilhadas. Um membro de deslocamento ou mola podem ser colocados em conexão com cada dente de travamento para forçar o dente no engate de retenção com a porção serrilhada correspondente.
[00146] As Figuras 14 a 24 ilustram as porções de um outro conjunto de eixo de acionamento intercambiável 1200 pode ser empregado com o instrumento cirúrgico 10. Os componentes do conjunto de eixo de acionamento intercambiável 1200 que são idênticos aos componentes do conjunto de eixo de acionamento intercambiável 200 descrito acima serão descritos a seguir, com números similares. Na disposição ilustrada, o conjunto de eixo de acionamento 1200 inclui um conjunto dorsal 1250 sobre o qual um conjunto de membro de fechamento 1210 é suportado de modo móvel. O conjunto dorsal 1250 inclui um segmento dorsal proximal 1252 suportado de modo giratório em uma porção da estrutura do conjunto do eixo de acionamento 1200. O segmento dorsal proximal 1252 tem dois entalhes diametralmente opostos 1253 que são configurados para receber porções correspondentes da saliência 1406 estendendo-se para dentro de porções do bocal 1402. Detalhes adicionais relacionados com a estrutura do conjunto de eixo de acionamento e a fixação giratória do segmento dorsal proximal 1252 ali, bem como a fixação das porções do bocal 1402 para este efeito podem ser encontrados no pedido de Patente US n° 13/803.097, intitulado ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, publicação de pedido de Patente US n° 2014/0263542 que foi aqui incorporado a título de referência, em sua totalidade.
[00147] Com referência às Figuras 16, 17, 18, 19, 22 e 24, o segmento dorsal proximal 1252 é acoplado a um membro de estrutura distal 1256 por meio de uma nervura estrutural 1254 estendendo-se entre si dentro do conjunto de membro de fechamento 1210. Como pode ser visto nas Figuras 20 e 21, o membro de estrutura distal 1256 é acoplado a uma estrutura 1260. O atuador de extremidade 1300 é similar ao atuador de extremidade 300 e é configurado para cortar e grampear/tecido das maneiras descritas acima. O atuador de extremidade 1300 inclui um canal alongado 1302 que tem um membro inserível de estrutura do atuador de extremidade 1330 fixado ao mesmo. Detalhes adicionais relacionados com o membro inserível de estrutura e o atuador de extremidade podem também ser encontrados no pedido de Patente US n° 13/803.097, intitulado ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, publicação de pedido de Patente US n° 2014/0263542. A estrutura do eixo de acionamento 1260 inclui um pino pivotante 1262 que é configurado para ser recebido de forma giratória dentro de uma abertura pivotante (não mostrado) no membro inserível da estrutura do atuador de extremidade 1330. Essa disposição serve para definir a junta articulada 1240 em torno da qual o atuador de extremidade 1300 pode se articular. Na implementação ilustrada, o conjunto de eixo de acionamento intercambiável 1200 inclui um acionador de articulação proximal 1242 com uma articulação que faz interface com uma trava 1270. Detalhes adicionais relacionados à trava de articulação 1270 podem também ser encontrados no pedido de Patente US n° 13/803.097, intitulado ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, publicação de pedido de Patente US n° 2014/0263542. Conforme discutido em maiores detalhes nesse pedido de patente, o movimento do acionador de articulação proximal 1240, seja proximal ou distal, pode destravar a trava de articulação 1270.
[00148] Ainda com referência às Figuras 19 e 20, a trava de articulação 1270 inclui um acionador de articulação distal 1272 que é acoplado de modo móvel a um pino de acionamento 1332 no membro inserível da estrutura do atuador de extremidade 1330. Por exemplo, o pino de acionamento 1332 é recebido sem folga em uma fenda de pino 1274 definida na extremidade distal 1273 do acionador de articulação distal 1272, de modo que o pino de acionamento 1332 possa apoiar-se contra uma parede lateral proximal da fenda de pino 1274 e transmitir uma força de compressão proximal P ao acionador de articulação distal 1272. Tal força de propulsão proximal P servirá apenas para aumentar o engate de travamento obtido pela trava de articulação 1270. De forma a liberar o engate de travamento, e permitir ao atuador de extremidade 1300 ser girado na direção indicada pela seta 1241, com referência agora à Figura 21, o acionador de articulação proximal 1242 é puxado proximalmente para destravar suficientemente os componentes de trava e permitir que o acionador de articulação distal 1272 seja movido proximalmente. Em várias circunstâncias, o acionador de articulação proximal 1242 pode continuar a ser puxado proximalmente até a porção distal do mesmo puxar proximalmente o acionador de articulação distal 1272 para articular o atuador de extremidade 1300. Depois de o atuador de extremidade 1300 ter sido adequadamente articulado na direção da seta 1241, o acionador de articulação proximal 10040 pode ser liberado, em várias circunstâncias, para permitir que a trava de articulação 1270 trave novamente o membro de articulação distal 1272 em posição. Detalhes adicionais em relação à construção e operação da trava de articulação 1270 podem ser encontrados no pedido de Patente US n° 13/803.097, intitulado ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, publicação de pedido de Patente US n° 2014/0263542, que foi aqui incorporado a título de referência, em sua totalidade.
[00149] Conforme discutido acima, uma forma de um conjunto de eixo de acionamento intercambiável 1200 compreende sistema acionador de articulação incluindo um acionador de articulação proximal 1242 e um acionador de articulação distal 1272. Quando uma força motriz é transmitida para o acionador de articulação proximal 1242, seja na direção proximal, ou na direção distal, a força motriz pode ser transmitida para o acionador de articulação distal 1272 por meio da trava de articulação 1270. Em várias circunstâncias, além do que foi dito acima, um membro de acionamento 160 do instrumento cirúrgico 10 pode ser usado para conferir essa força motriz ao acionador de articulação proximal 1242. Por exemplo, o conjunto de eixo de acionamento intercambiável 1200 inclui um sistema de engate cíclico 1700 que pode ser configurado para conectar seletivamente o acionador de articulação proximal 1242 ao membro de acionamento 160 do instrumento cirúrgico 10, de modo que o movimento do membro de acionamento 160 seja conferido ao acionador de articulação proximal 1242. Em uso, o sistema de engate cíclico 1700 é móvel entre um estado engatado (Figura 22) em que o acionador de articulação proximal 1242 está engatado operacionalmente com um membro de disparo proximal 1560 (e com o membro de acionamento 160), e um estado desengatado (Figura 24) em que o acionador de articulação proximal 1242 está operacionalmente engatado com o membro disparador proximal 1560 (e com o membro de acionamento 160).
[00150] Em uma forma, o sistema de engate cíclico 1700 compreende um membro de engate 1710, que pode ser configurado para conectar diretamente o acionador de articulação proximal 1242 ao membro de disparo proximal 1560. Como pode ser visto na Figura 16, por exemplo, o acionador de articulação proximal 1242 inclui uma aba proximal 1243 que é recebida no interior de um sulco anular 1712 fornecido no perímetro do membro de engate 1710 para conectar o acionador de articulação proximal 1242 ao membro de engate 1710 ao mesmo tempo em que permite a rotação relativa entre os mesmos. Como pode ser visto na Figura 17, o membro de disparo proximal 1560 inclui uma porção de haste alongada 1562 que tem um pino de fixação 1564 formado na extremidade proximal da mesma. O pino de fixação 1564 é configurado para ser giratoriamente apoiado na base 162 sobre o membro de acionamento 160. Vide Figura 2. Como pode ser visto adicionalmente na Figura 17, o membro de disparo proximal 1560 compreende adicionalmente um acoplador da haste de disparo 1566 que é formado na extremidade distal da haste 1562. O acoplador da haste de disparo 1566 inclui uma extremidade distal fechada 1567 que define uma passagem cilíndrica 1568. Uma abertura 1569 é formada através da extremidade distal fechada 1567 que é adaptada para receber de maneira deslizante uma extremidade proximal 1572 de um membro de disparo intermediário 1570 através da mesma. No exemplo ilustrado, o membro de disparo intermediário 1570 inclui um membro de parada na forma de um disco 1574 que é formado sobre a extremidade proximal 1572 do mesmo e é dimensionado para deslocamento deslizante dentro da passagem cilíndrica 1568 no acoplador de haste de disparo 1566. A extremidade distal do membro de disparo intermediário 1570 está acoplada à extremidade proximal do membro de disparo distal 550 das várias maneiras reveladas em, por exemplo, pedido de Patente US n° 13/803,097, intitulado ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, publicação de pedido de Patente US n° 2014/0263542, que foi aqui incorporado a título de referência. Na disposição ilustrada, os dois sulcos de engate diametralmente opostos, em formato de V 1580 são formados no perímetro do acoplador de haste de disparo 1566. Vide Figuras 17 a 19. Os sulcos em formato de V 1580 são configurados para receber de maneira deslizante os detentores de articulação em formato de V correspondentes 1714, 1715 formados sobre a superfície interna 1713 do membro de engate 1710.
[00151] Adicionalmente ao exposto acima, novamente com referência às Figuras 16 a 24, o sistema de engate cíclico 1700 compreende também um membro atuador 1720 que é configurado para se mover axialmente sobre o membro de engate 1710. Como pode ser mais particularmente visto na Figura 17, por exemplo, um primeiro pino de engate 1716 se estende para fora do membro de engate 1710, e é configurado para ser de recebido de maneira deslizante dentro de uma fenda 1722 estendendo-se através do membro atuador 1720. Essa disposição facilita o movimento axial relativo do membro atuador 1720 e do membro de engate 1710 que permite que o membro atuador 1720 e o membro de engate 1710 girem como uma unidade. Também na disposição ilustrada, o sistema de engate cíclico 1700 inclui um pino de came 1724 que se projeta a partir do membro atuador 1720. Como com a disposição descrita acima, o pino de came 1724 se estende para fora através de uma fenda de came 1232 em um segmento de membro de fechamento proximal 1230. Vide Figura 15.
[00152] O motor de disparo 152 se comunica com o circuito de controle 156 e uma disposição de chaveamento, em geral, designada como 1600. Na configuração ilustrada, a disposição de chaveamento 1600 inclui um tambor de chaveamento 1610 que é giratoriamente apoiado sobre o segmento proximal do membro de fechamento 1230. O tambor de chaveamento 1610 inclui uma saliência estendendo-se lateralmente 1611 que é adaptada para receber uma extremidade do pino de came 1724 na mesma. O tambor de chaveamento 1610 inclui adicionalmente fendas opostas 1614 que são configuradas para acomodar a rotação dos pinos do bocal 1406 através das mesmas. Consulte a figura 14. A disposição de chaveamento 1600 também inclui um conjunto de anel de deslizamento 1620 que é configurado para conduzir a energia elétrica e/ou sinais para e/ou a partir do atuador de extremidade cirúrgico 1300 para o cabo 102 e, mais particularmente, para o circuito de controle 156 dentro do cabo 102. O conjunto de anel coletor 1620 inclui uma pluralidade de condutores concêntricos 1622, ou ao menos substancialmente concêntricos, em lados opostos do mesmo, os quais podem ser configurados para permitir a rotação relativa entre as metades do conjunto de anel coletor 1620 e ao mesmo tempo manter os circuitos condutores de eletricidade entre si. Na implementação ilustrada, o conjunto de anel de deslizamento 1620 inclui um anteparo 1624 que tem um componente de chaveamento 1626 que se comunica através do conjunto de anel de deslizamento 1620 com o circuito de controle 156. A disposição de chaveamento 1600 inclui, também, um componente de chaveamento móvel 1618 que é montado em uma porção do braço de chaveamento 1616 do tambor de chaveamento 1610. Vide Figura 14.
[00153] Conforme discutido acima, durante um procedimento cirúrgico típico, o médico pode introduzir o atuador de extremidade 1300 no local cirúrgico através de um trocarte ou outra abertura no paciente para acessar o tecido alvo. A Figura 20 ilustra a posição do atuador de extremidade 1300, para a inserção através de uma porta de trocarte ou, de outro modo, dentro do paciente para acessar o tecido alvo. Conforme pode ser visto nessa Figura, o atuador de extremidade 1300 é não articulado ou, de uma outra forma, é axialmente alinhado com o eixo geométrico do eixo de acionamento SA-SA. Uma vez que o atuador de extremidade 1300 passa através da porta do trocarte, por exemplo, o médico pode precisar articular o atuador de extremidade 1300 para posicioná-lo vantajosamente adjacente ao tecido alvo. As Figuras 15, 18, 20, 21 e 22 ilustram as posições dos componentes do sistema de engate cíclico quando o sistema de engate cíclico 1700 está na orientação articulada. Durante o processo de articulação, o atuador de extremidade 1300 está em uma posição aberta. Dito de outra forma, o conjunto de membro de fechamento 1210 é posicionado na sua posição "não atuada" proximal, de modo que a extremidade distal da bigorna do atuador de extremidade 1300 seja espaçada em relação ao cartucho de grampos cirúrgicos. A Figura 15 ilustra a posição do segmento do membro de fechamento proximal 1230 quando na posição não atuada ou aberta. Conforme pode ser visto nessa Figura, o pino de came 1724 está situado na porção superior da fenda de came 1232. Quando naquela posição, o pino de came 1724 situa o tambor de chaveamento 1610 de tal modo que o componente de chaveamento 1618 sobre o braço de chaveamento 1616 não estejam em proximidade ou alinhamento de ativação com o componente de chaveamento 1626 sobre o anteparo de chaveamento 1624. Dessa forma, quando a chave 1626 não é atuada pela chave 1618, o circuito de controle 156 pode ser configurado para permitir que o motor de disparo 152 dispare por um curso de fechamento limitado, mas incapaz de disparar por um período que seja suficiente para atuar ou avançar o membro de disparo intermediário 1570 e o membro de disparo distal 550, conforme será discutido adicionalmente em detalhes abaixo. Como pode ser visto na Figura 14, uma mola de travamento do sistema de disparo 1150 é fornecida na saliência 1611 do tambor de chaveamento 1610 para forçar o tambor de chaveamento 1610 e, por fim, o pino de came 1724 na porção superior da fenda de came 1232 na posição não atuada ou aberta. Consulte a figura 14. Dessa forma, quando o conjunto de membro de fechamento 1210 e por fim bigorna do atuador de extremidade 1300 estão na posição aberta, a ativação do motor de disparo 152 não resultará no avanço do membro de disparo intermediário 1570 do membro de disparo distal 550 através do atuador de extremidade 1300.
[00154] Com referência às Figuras 18 e 22, quando o sistema de engate cíclico 1700 está na orientação articulada, os detentores em formato de V 1714, 1715 não estão alinhados com as fendas em formato de V 1580 correspondentes no acoplador da haste de disparo 1566. Dessa forma, o deslocamento do membro de acionamento 160 e do membro de disparo proximal 1560 na direção distal "DD", resultará no deslocamento distal do acionador de articulação proximal 1242, conforme mostrado na Figura 21, por exemplo. Essa disposição serve para girar o atuador de extremidade 1300 na direção representada pela seta 1241 na Figura 21. O membro de acionamento 160 e o membro de disparo proximal 1560 são deslocados distalmente mediante a atuação do motor de disparo 152 em uma primeira direção. Em uma implementação, o motor de disparo 152 pode ser atuado mediante a ativação de uma chave osciladora 515 montada sobre o cabo 102 em uma primeira direção. Para girar o atuador de extremidade 1300 em uma segunda direção oposta (representada pela seta 1243 na Figura 21) a chave osciladora 515 é atuada em uma segunda direção ou oposta. Em qualquer caso, entretanto, devido ao fato de que o conjunto de membro de fechamento 1210 estar na posição aberta e a chave 1618 sobre o tambor de chaveamento 1610 estar fora da orientação atuada com a chave 1626 sobre o anteparo de chaveamento 1624, o circuito de controle 156 permite apenas a ativação do motor de disparo 152 pelo tempo necessário para se alcançar o curso de articulação desejado, mas não de duração suficiente de modo a avançar o membro de disparo intermediário 1570 distalmente. A Figura 20 ilustra a posição do membro de parada 1574, situado na extremidade distal do membro de disparo intermediário 1570 dentro da passagem cilíndrica 1568 no acoplador de haste de disparo 1566 quando o sistema de engate cíclico 1700 está no modo de articulação, mas antes da ativação do motor de disparo 152. A Figura 21 ilustra a posição do membro de parada 1574 no interior da passagem cilíndrica 1568 após o motor de disparo 152 ter sido atuado para acionar o membro de disparo proximal 1560 na direção proximal "DP". Porque os detentores em formato de V 1714 e 1715 não estão alinhados com as fendas em formato de V 1580 correspondentes, o movimento do membro de disparo proximal 1560 e do acoplador da haste de disparo 1566 na direção proximal "DP" faz com que o fundo da haste de disparo 1566 entre em contato com os detentores proximais 1715 e com o membro de engate 1710 também na direção proximal "DP". O movimento do acoplador da haste de disparo 1566 também aciona o acionador de articulação 1242 na direção proximal, assim, fazendo com que o atuador de extremidade 1300 se articule na direção representada pela seta 1241 na Figura 21. A ativação do motor de disparo 152 em uma direção giratória oposta fará com que o membro de disparo proximal 1560 se mova na direção distal "DD" tal que a extremidade distal 1567 do mesmo entre em contato com os detentores 1714 para ativar o membro de engate 1710 distalmente. Tal movimento distal do membro de engate 1710 também induz o acionador de articulação 1242 na direção distal "DD" o que resulta na articulação do atuador de extremidade 1300 em uma direção de articulação oposta (representada pela seta 1243 na Figura 21). Dessa forma, pode ser entendido a partir da discussão anterior, que o membro de disparo proximal 1560 pode mover axialmente por uma quantidade predeterminada de deslocamento axial, sem deslocar axialmente o membro de disparo intermediário 1570 e o membro de disparo distal 550 fixada ao mesmo. Esta quantidade predeterminada de deslocamento axial pode ser definida pelo comprimento axial "L" da passagem cilíndrica 1568 no acoplador da haste de disparo 1566. Vide Figura 19.
[00155] Quando o clínico tiver posicionado o atuador de extremidade 1300 na orientação desejada em que o tecido alvo está situado entre a bigorna e o cartucho de grampos, o médico pode então fechar a bigorna para prender o tecido alvo entre a bigorna e o cartucho de grampos. Conforme discutido acima, a bigorna pode ser fechada por meio da atuação do gatilho de fechamento 122 para deslocar axialmente o conjunto de membro de fechamento 1210 na direção distal "DD". À medida que o conjunto de membro de fechamento 1210 se move distalmente, a fenda de came 1232 no segmento do membro de fechamento proximal 1230 faz com que o pino de came 1724 se mova até o fundo da fenda de came 1232 (esse movimento é representado pela seta 1725 na Figura 15). Como o pino de came 1724 se move na direção 1725, o tambor de chaveamento 1610 é girado sobre o conjunto de membro de fechamento 1210, de modo que o braço chaveamento 1616 move o componente de chaveamento 1618 dentro do registro de atuação com o componente de chaveamento 1626 para, assim, fornecer o circuito de controle 156 com um sinal que indica que o conjunto de membro de fechamento 1210, e, mais precisamente, que a bigorna está em uma posição fechada e pronta para disparo. O circuito de controle 156, permitirá que o motor de disparo 152, mediante a atuação do gatilho de disparo 170, gire por um tempo de disparo suficiente de modo a acionar o membro de disparo distal 550 (e o instrumento de corte fixado ao mesmo ou de outra forma montado sobre o mesmo) para sua posição completamente disparada ou final, dentro do atuador de extremidade 1300. As Figuras 19, 23 e 24 ilustram as posições dos vários componentes do sistema de engate cíclico 1700 na orientação de disparo.
[00156] Muitos instrumentos cirúrgicos para corte e fixação motorizados utilizam uma haste de acionamento separada 'para articulação e para o disparo do dispositivo. Embora esse método empregue uma arquitetura um tanto simples, pode ser dispendioso e aumentar as preocupações quanto à confiabilidade, devido ao fato de que os sistemas de acionamento completo são replicados no desenho. Várias disposições aqui reveladas empregam um único mecanismo de acionamento de articulação tanto para articulação quanto para disparo que também fornece meios para travar a articulação antes do disparo.
[00157] Quando um atuador de extremidade articulável é usado em cirurgia, é desejável evitar a separação inadvertida do atuador de extremidade do instrumento cirúrgico, particularmente quando o atuador de extremidade está em uma orientação articulada. Este problema pode ser exacerbado com o uso de instrumentos cirúrgicos que empregam conjuntos de eixo de acionamento intercambiáveis que são removíveis do cabo ou compartimento do instrumento. Por exemplo, durante uso ele é importante para evitar a separação inadvertida ou em alguns casos descuidada do conjunto de eixo de acionamento ou do atuador de extremidade do instrumento quando o atuador de extremidade está em uma orientação articulada. A Figura 25 ilustra um outro instrumento cirúrgico articulável 2010 que inclui um conjunto de eixo de acionamento intercambiável 2200 que é montado de modo removível no cabo 2102 do instrumento 2010. Um atuador de extremidade 2300 está fixado ao conjunto de eixo de acionamento intercambiável 2200 e é seletivamente articulável sobre um eixo geométrico de articulação B-B. O conjunto de eixo de acionamento 2200 inclui um exclusivo e inovador sistema de travamento para evitar a separação do conjunto de eixo de acionamento intercambiável 2200 do cabo 2102 quando o atuador de extremidade está em uma orientação articulada. O instrumento cirúrgico 2010 é idêntico ao instrumento cirúrgico 10 descrito acima, exceto ao menos, pelas diferenças discutidas abaixo. Conforme pode ser visto nessa Figura, o instrumento cirúrgico 2010 mostrado é acionado por motor (ou "equipado com motor") e inclui um compartimento ou cabo 2102 que tem um conjunto de eixo de acionamento intercambiável 2200 operacionalmente fixado a eles. Várias características e detalhes com relação ao conjunto de eixo de acionamento intercambiável, podem ser encontrados no pedido de Patente US n° 13/803.053, intitulado INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT, publicação de pedido de Patente US n° 2014/0263564, cuja descrição é aqui incorporada a título de referência e no pedido de Patente US n° de série 14/226.075, depositado em 26 de março de 2014, intitulado MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES, cuja descrição inteira é aqui incorporada a título de referência.
[00158] Ainda com referência à Figura 25, um atuador de extremidade 2300 está operacionalmente fixado ao conjunto de eixo de acionamento intercambiável 2200. O atuador de extremidade 2300 pode ser idêntico ao atuador de extremidade 300, por exemplo, e inclui, entre outras coisas, um canal alongado 2302 que é configurado para suportar operacionalmente, um cartucho de grampos 2310 nele. O atuador de extremidade 2300 inclui adicionalmente uma bigorna 2350 que tem uma superfície inferior de formação de grampos na mesma. A bigorna 2350 é movida entre as posições aberta e fechada por um conjunto de tubo de fechamento 2120 que é axialmente avançado nas direções distal e proximal por meio da atuação de um gatilho de fechamento 2122. O conjunto de tubo de fechamento 2120 inclui um segmento de eixo de acionamento do tubo de fechamento proximal 2230 que está operacionalmente acoplado a um segmento de tubo de fechamento distal 2220 por meio de uma junta articulada 2240 para facilitar a articulação do atuador de extremidade 2300 em torno de um de eixo geométrico de articulação B-B, que é transversal ao eixo geométrico do eixo de acionamento SA-SA definido pelo conjunto de eixo de acionamento intercambiável 2200.
[00159] Com referência à Figura 26, o conjunto de eixo de acionamento 2200 inclui um chassi 2270 que é configurado para ser acoplado de modo removível ao cabo 2102. Várias modalidades do conjunto de eixo empregam um sistema de travas 2280 para acoplar de modo removível o conjunto de eixo de acionamento 2200 ao cabo 2102 e mais especificamente à estrutura do cabo. Como pode ser visto na Figura 26, por exemplo, em ao menos uma forma, o sistema de travas 2280 inclui um elemento de travamento ou forquilha de travamento 2282 que é acoplado de forma móvel ao chassi 2270. Na modalidade ilustrada, por exemplo, a forquilha de travamento 2282 tem um formato de U com duas pernas espaçadas que se estendem para baixo 2284. As pernas 2284 têm cada uma um pino pivotante 2285 formado sobre as mesmas, que são adaptados para serem recebidos em orifícios correspondentes (não mostrado) formados no chassi 2270. Vide Figura 27. Tal disposição facilita a fixação pivotante da forquilha de travamento 2282 ao chassi 2270. A forquilha de travamento 2282 pode incluir dois pinos de travamento que se projetam proximalmente 2286 que são configurados para engatar de forma liberável os detentores ou sulcos de travamento correspondentes 2105 no flange de fixação distal 2103 da estrutura. Vide Figura 27. A forquilha de travamento 2282 pode ser forçada na direção proximal "DP", por meio de uma primeira mola ou membro de deslocamento (não mostrado). A atuação da forquilha de travamento 2282 pode ser feita por um botão de travamento 2287 que é montado de maneira deslizante em um conjunto do atuador de travamento que é montado no chassi 2270. O botão de travamento 2287 pode ser forçado em uma direção proximal em relação à forquilha de travamento 2282. Conforme será discutido em mais detalhes abaixo, a forquilha de travamento 2282 pode ser movida para uma posição destravada por forçar o botão de travamento 2287 na direção distal "DD", o que também faz com que a forquilha de travamento 2282 gire para fora de engate de retenção com o flange de fixação distal 2103 da estrutura. Quando a forquilha de travamento 2282 está em "engate de retenção" com o flange de fixação distal 2103 da estrutura, os pinos de travamento 2286 são assentados com retenção dentro dos detentores ou sulcos de travamento correspondentes 2105 no flange de fixação distal 2103.
[00160] O conjunto de eixo de acionamento intercambiável 2200 inclui um elemento de transporte de fechamento 2136 que é suportado de maneira deslizante dentro do chassi 2270. A extremidade do tubo de fechamento proximal 2230 é acoplada ao elemento de transporte de fechamento 2136 para rotação em relação ao mesmo. Por exemplo, um conector em forma de U 2137 é inserido em uma fenda anular 2231 no segmento do tubo de fechamento proximal 2230 e é retido dentro das fendas verticais no elemento de transporte de fechamento 2136. Essa disposição serve para fixar o segmento do tubo de fechamento proximal 2230 ao elemento de transporte de fechamento 2136 para deslocamento axial com o mesmo, ao mesmo tempo em que se possibilita que o segmento do tubo de fechamento 2230 gire em relação ao elemento de transporte de fechamento 2136 ao redor do eixo geométrico do eixo de acionamento SA-SA. O elemento de transporte de fechamento 2136 inclui ganchos 2138 que são adaptados para engatar em modo de conexão um pino de fixação (não mostrado) que é fixado a uma segunda conexão de fechamento (não mostrada) que é operacionalmente acoplada ao gatilho de fechamento 2122, conforme descrito em detalhes no pedido de Patente US n° de série 14/226.075. Conforme descrito nessa referência, a atuação do gatilho de fechamento 2122 irá deslocar distalmente a conexão de fechamento e aplicar um movimento de fechamento distal a um elemento de transporte de fechamento proximal 2136 e, finalmente, para o segmento do tubo de fechamento proximal 2230. Uma mola de fechamento (não mostrada) é assentada sobre o segmento do tubo de fechamento proximal 2230 e serve para forçar o segmento do tubo de fechamento 2230 na direção proximal "DP", o que pode servir para girar o gatilho de fechamento 2122 para a posição não atuada quando o conjunto de eixo de acionamento 2200 é operacionalmente acoplado ao cabo 2102.
[00161] O conjunto de eixo de acionamento 2200 adicionalmente inclui um sistema de articulação 2500 para a aplicação de movimentos de articulação à primeira e à segunda barras de articulação 2510, 2520 que se estendem através do conjunto de eixo de acionamento operacionalmente com o atuador de extremidade 2300. No exemplo ilustrado, o sistema de articulação 2500 inclui ainda um atuador articulação 2550 que é suportado de modo giratório em um compartimento de bocal 2530 que está apoiado sobre o chassi 2270. O compartimento pode compreender dois segmentos de bocal 2532, 2534 que são acoplados por meio de uma pluralidade de prendedores 2536. O atuador de extremidade 2550 compreende um botão de articulação um atuador pegador de articulação 2552 que é acoplado a um conjunto de engrenagens de articulação 2560 que tem uma engrenagem pivotante de articulação 2562 sobre o mesmo. A engrenagem pivotante de articulação 2562 é suportada em engate engrenado com uma primeira cremalheira articulada 2512 que é fixado à primeira barra de articulação 2510 e uma segunda cremalheira de articulação 2522 que é fixada à segunda barra de articulação 2520. A rotação do botão de articulação 2552 aciona o deslocamento das barras de articulação 2510, 2520 em uma direção proximal ou distal, e a outra das barras de articulação 2510, 2520 na direção oposta para fazer com que o atuador de extremidade 2300 se articular em torno do eixo geométrico de articulação na direção desejada.
[00162] O atuador de extremidade cirúrgico 2300 inclui um membro de disparo na forma de um membro de corte de (não mostrado) de um membro de corte de tecido. O conjunto de eixo de acionamento intercambiável 2200 também inclui substituir um segmento de haste de disparo 2570 que é configurado para aplicar movimentos de disparo ao membro de disparo. No exemplo ilustrado, o segmento de haste de disparo se move axialmente através do conjunto de eixo de acionamento 2200 por meio do sistema de disparo acionado por motor nas várias maneiras descritas em detalhes adicionais nas várias referências incorporadas.
[00163] Para evitar a separação inadvertida do conjunto de eixo de acionamento intercambiável 2200 de cabo 2102 quando o atuador de extremidade 2300 está em uma orientação articulada, o conjunto de eixo de acionamento 2200 adicionalmente inclui um exclusivo e inovador conjunto de trava em geral designado como 2580. No exemplo ilustrado, o conjunto de engrenagem 2560 inclui adicionalmente um flange de travamento 2564 que tem um entalhe de travamento 2566 no mesmo. O conjunto de travamento 2580 inclui adicionalmente um membro de trava 2582 que tem a extremidade distal afunilada ou pontiaguda 2584 que é configurada para travar o engate com o entalhe de trava 2566. O membro de trava 2582 é fixado à forquilha de travamento 2282. No exemplo ilustrado, o membro de trava 2582 tem uma abertura 2588 que é adaptada para receber uma saliência de travamento 2283 formada sobre a forquilha de travamento 2282 para facilitar a fixação do membro de trava 2582 sobre a forquilha de travamento 2282. Vide Figura 26. No exemplo ilustrado, o botão de fixação 2552 é fixado ao conjunto de trava de articulação 2560, de modo que o entalhe de travamento 2566 é alinhado para engate de travamento com o membro de trava 2582 quando as porções de aleta do atuador 2553 do botão de articulação 2552 são axialmente alinhadas com a eixo geométrico do eixo de acionamento A-A. Vide Figura 25. Em tal disposição, as porções de aleta indicam ao médico que o atuador de extremidade 2300 está não articulado e essencialmente em alinhamento axial com o eixo geométrico do eixo de acionamento SA. Além disso, quando nessa posição, a extremidade distal 2584 do membro de trava 2582 é recebida no entalhe de travamento 2566. Quando nesta posição, uma folga suficiente é fornecida entre a extremidade distal 2584 do membro de trava 2582 e o entalhe de travamento 2566 para permitir que a forquilha de travamento 2282 seja movida na direção distal, de modo a separar o conjunto de eixo de acionamento intercambiável 2200 do cabo. Dessa forma, quando o atuador de extremidade está na orientação não articulado, o conjunto de eixo de acionamento 2200 é separável do cabo ou do compartimento.
[00164] Quando o médico deseja articular o atuador de extremidade 2300, o médico aplica uma força giratória a porções da aleta de articulação 2553 que é suficiente para causar a rotação do conjunto de engrenagens 2560. À medida que o conjunto de engrenagens 2560 é girado, o membro de trava 2582 se move na direção proximal para permitir que a extremidade 2584 do membro de trava 2582 se mova para fora do entalhe de travamento 2566. A extremidade 2584 se desloca em torno da borda do flange de travamento 2564 durante a articulação. Quando nessa posição, o membro de trava 2582 evita que a forquilha de travamento 2282 se mova para suficientemente longe na direção distal para permitir a separação do conjunto de eixo de acionamento 2200 do cabo. Dessa forma, quando o atuador de extremidade está em uma posição articulada, a forquilha de travamento é impedida de se mover para uma posição destravada ou separada. Esta disposição não apenas impede a separação inadvertida do conjunto de eixo de acionamento do cabo (isto é, por acidente) como também impede o médico de separar o conjunto de eixo de acionamento 2200 usando o botão de trava 2287.
[00165] A Figura 28 é uma vista em seção transversal através de um membro de junta articulada flexível 2600 do tipo, por exemplo, mostrado na Figura 25. O membro de junta compreende um corpo flexível 2602 que tem uma passagem centralmente disposta 2604, que é configurada para suportar de modo deslizante um feixe de disparo flexível 2610 através da mesma. Nesta disposição, o corpo 2602 inclui duas passagens superiores 2606 que são dimensionadas e dispostas para acomodar um cabo de articulação correspondente 2620 através das mesmas. Os cabos de articulação 2620 realizam as mesmas funções que os acionadores de articulação aqui revelados. Por exemplo, cada um dos cabos 2620 é fixado ou de outro modo faz interface com o atuador de extremidade cirúrgico. As extremidades proximais ou as porções dos cabos 2620 fazem interface com um sistema de controle de articulação para atuar os cabos para articular o atuador de extremidade. O corpo 2602 inclui adicionalmente duas passagens inferiores 2608 que são adaptadas para acomodar as porções correspondentes de um conjunto de estrutura 2630. Neste exemplo, o conjunto de estrutura inclui uma primeira banda estrutural 2640 e uma segunda banda estrutural 2650. As bandas 2640, 2650 são situadas em cada lado lateral do feixe de disparo flexível 2610 e se estende para trás do cabo ou do compartimento. Cada banda 2640, 2650 pode compreender um braço de mola em cantiléver que se estende através das passagens inferiores correspondentes 2608 e é acoplado ou de outro modo faz interface com o atuador de extremidade. Por exemplo, a extremidade distal de cada banda 2640, 2650 pode ser fixada nas porções correspondentes do canal alongado do atuador de extremidade. As bandas 2640, 2650 se flexionarão para acomodar a articulação do atuador de extremidade. Como pode ser visto na Figura 28, entretanto, cada banda 2640, 2650 é configurada para engate por atrito com as porções correspondentes das paredes 2609 de cada uma das passagens inferiores 2608. No exemplo ilustrado, cada banda 2640, 2650 inclui um pino de fricção ou formação 2642, 2652 sobre o mesmo, conforme mostrado. Essa disposição serve para reter por atrito a porção do corpo 2602 na orientação articulada.
[00166] A Figura 29 é uma vista em seção transversal através de um membro de junta articulada flexível 2700 do tipo, por exemplo, mostrado na Figura 25. O membro de junta compreende um corpo flexível 2702 que tem uma passagem centralmente disposta 2704, que é configurada para suportar de modo deslizante um feixe de disparo flexível 2610 através da mesma. Nesta disposição, o corpo 2702 inclui duas passagens laterais 2706 que são dimensionadas e dispostas para acomodar um cabo de articulação correspondente 2620 através das mesmas. Na disposição ilustrada, as passagens 2706 são dimensionadas em relação aos cabos 2620 de modo que o atrito é gerado entre cada cabo e as paredes da passagem correspondente 2706. O corpo 2702 inclui adicionalmente uma passagem inferior 2708 que é adaptada para acomodar as porções correspondentes de um conjunto de estrutura 2730. Neste exemplo, o conjunto de estrutura inclui uma primeira banda estrutural 2740 e uma segunda banda estrutural 2750. As bandas 2740, 2750 são situadas abaixo do feixe de disparo flexível 2610 e se estende para trás do cabo ou do compartimento. Cada banda 2740, 2750 pode compreender um braço de mola em cantiléver que se estende através das passagens inferiores correspondentes 2708 e é acoplado ou de outro modo faz interface com o atuador de extremidade. Por exemplo, a extremidade distal de cada banda 2740, 2750 pode ser fixada nas porções correspondentes do canal alongado do atuador de extremidade. As bandas 2740, 7650 se flexionarão para acomodar a articulação do atuador de extremidade. Como pode ser visto na Figura 29, as bandas 2740, 2750 estão em engate por atrito com o feixe de disparo 2610 bem como com as paredes da passagem inferior 2708. Essa disposição serve para reter por atrito a porção do corpo 2702 na orientação articulada.
[00167] A Figura 31 ilustra de forma um tanto diagramática, um instrumento cirúrgico 3010 com um atuador de extremidade articulável 3300 que emprega um sistema de articulação exclusivo e inovador 3500 para a articulação do atuador de extremidade 3300 em uma junta articulada, em geral, denominada 3240. Em particular, o instrumento cirúrgico 3010 inclui um conjunto de estrutura 3600 que é fixado ao canal alongado 3302 do atuador de extremidade cirúrgico 3300 de tal modo que o atuador de extremidade cirúrgico 3300 pode ser seletivamente articulado em torno da junta articulada 3240. O sistema de articulação 3500 inclui um primeiro membro ou barra de articulação 3510 e um segundo membro ou barra de articulação 3520. Cada uma dentre a primeira e a segunda barras de articulação 3510, 3520 é fixada ao canal alongado 3302 do atuador de extremidade cirúrgico 3300 e é disposta para movimento axial em relação ao conjunto de estrutura 3600. Por exemplo, a primeira barra de articulação 3510 pode ser suportada para movimento axial em relação ao conjunto de estrutura 3600 por meio de um primeiro rolamento 3511 e a segunda barra de articulação 3520 pode ser suportada para movimento axial em relação ao conjunto de estrutura 3600 por meio de um segundo rolamento 3521.
[00168] O atuador de extremidade cirúrgico 3300 pode compreender um dispositivo cirúrgico de grampeamento e de corte e incluir um membro de disparo (não mostrado) que é configurado para se deslocar axialmente dentro do atuador de extremidade 3300, conforme apresentado em muitas das referências que foram incorporadas aqui a título de referência. O instrumento cirúrgico 3010 é equipado com um membro ou haste de disparo 3560 que é configurado para se mover axialmente em resposta a movimentos de acionamento a partir de um sistema acionador de disparo de diversos tipos revelados aqui, bem como revelados nas várias referências aqui incorporadas. O sistema de articulação 3500, representada genericamente na Figura 31, inclui um conjunto de acionamento de articulação 3530 que é configurado operacionalmente para fazer interface com o sistema de acionamento de disparo para receber movimentos de disparo a partir do mesmo. Por exemplo, o acionador de articulação 3532 do conjunto de acionamento de articulação 3530 pode fazer interface operacionalmente com a haste de disparo 3560 através de uma disposição de chaveamento ou acoplamento 3600 do tipo revelado aqui e/ou aqui mencionadas incorporadas. Dessa forma, quando a disposição de chaveamento 3600 está no "modo de articulação", a operação do acionador de disparo é transferida para o acionador de articulação 3532 para aplicar um movimento de articulação axial ao mesmo. Quando a disposição de chaveamento 3600 está no "modo de disparo", a atuação do acionador de disparo resultará no deslocamento axial do membro de disparo dentro do atuador de extremidade cirúrgico 3300.
[00169] Como pode ser visto na Figura 31, o conjunto de acionamento de articulação 3532 inclui adicionalmente um conjunto de solenoide de dupla atuação 3534 que é fixado ao acionador de articulação 3532. O conjunto de solenoide 3534 inclui um membro de engate de articulação 3536 que é disposto para engate de acionamento seletivo com uma porção do primeiro acionador de articulação 3510. Além disso, o conjunto de solenoide 3534 inclui um segundo membro de engate de articulação 3538 que é disposta para engate de acionamento seletivo com a segunda barra de articulação 3520. Por exemplo, a Figura 31 ilustra uma porção do primeiro acionador 3536 recebida em uma primeira abertura de acionamento 3512 no primeiro acionador de articulação 3510. Uma segunda abertura de acionamento similar 3522 é mostrada no segundo acionador de articulação 3520, entretanto, na Figura 31, o segundo acionador está em uma posição retraída ou desengatada 3538. Outras disposições para engatar e desengatar por meio de acionamento o conjunto de acionamento de articulação 3530 podem também ser empregadas. Dessa forma, quando o primeiro membro de engate 3536 está engatado por meio de acionamento com o primeiro acionador de articulação 3510, a atuação do sistema de acionamento de disparo resultará no deslocamento axial do primeiro acionador de articulação 3510, e quando o segundo membro de engate de articulação 3538 está em engate de acionamento com o segundo acionador de articulação 3520, a atuação do sistema acionador de disparo resultará no deslocamento axial do segundo acionador de articulação 3520.
[00170] Conforme discutido em detalhes adicionais na presente invenção, pode ser desejável para o instrumento cirúrgico empregar meios para travar os acionadores de articulação em uma posição antes do uso do dispositivo e/ou após o atuador de extremidade ter sido articulado para uma posição desejada. Para este fim, o instrumento cirúrgico 3010 é mostrado com um sistema de travamento de articulação 3700. O sistema de travamento de articulação 3700 compreende um primeiro membro de trava 3702 configurado para travamento por engate com uma primeira porção de travamento dentada ou serrilhada 3514 do primeiro acionador de articulação 3510 e um segundo membro de trava 3704 configurado para travamento por engate com uma segunda porção de dentada ou de travamento 3524 do segundo acionador de articulação 3520. Quando o primeiro membro de trava 3702 é engatado com a primeira porção serrilhada 3514 do primeiro acionador de articulação 3510, o primeiro acionador de articulação 3510 será retido naquela posição axial. De modo similar, quando o segundo membro de trava 3704 é engatado com a segunda porção serrilhada 3524 do segundo acionador de articulação 3520, o segundo acionador de articulação 3520 será retido naquela posição axial.
[00171] A Figura 31 ilustra o primeiro membro de engate de articulação 3536 em acionamento por engate com a abertura 3512. Conforme pode ser visto nessa Figura, ao menos uma porção correspondente 3516 do primeiro acionador de articulação 3510 é movida lateralmente na primeira direção lateral "FLD" de modo que a primeira porção serrilhada 3514 é movida para fora do engate com o primeiro membro de trava 3702. Conforme pode também ser visto na Figura 31, o segundo membro de engate de articulação 3538 é retraído para fora do engate com a abertura para articulação 3522. Quando naquela posição, o primeiro acionador de articulação 3510 está em uma orientação destravada e está livre para ser axialmente deslocado na direção distal "DD" para articular o atuador de extremidade cirúrgico 3300 em uma primeira direção de articulação "FAD" ao redor da junta articulada 3240. À medida que o primeiro acionador de articulação 3510 é movido distalmente, o segundo acionador de articulação 3520 se moverá necessariamente na direção proximal "DP", devido a sua conexão ao canal alongado 3302 do atuador de extremidade cirúrgico 3300. Esse movimento proximal do segundo acionador de articulação 3520 pode ser acomodado pelo segundo membro de trava 3704 ou "colidindo" ou conduzindo ou deslizando sobre os serreados correspondentes 3524. De modo semelhante, para articular o atuador de extremidade cirúrgico em uma segunda direção de articulação "SAD" ao redor da junta articulada 3240, o primeiro membro de engate de articulação 3536 é retraído para fora do engate com a primeira abertura para articulação 3512 e o segundo membro de engate de articulação 3538 é movido lateralmente na segunda direção lateral "SLD" no engate com a segunda abertura para articulação 3522 para forçar ou, de outro modo, mover a segunda porção serrilhada 3524 do segundo acionador de articulação 3520 fora de engate com o segundo membro de trava 3707. Quando naquela posição, o segundo acionador de articulação 3520 está em uma orientação destravada e está livre para ser axialmente deslocado na direção distal "DD" para articular o atuador de extremidade cirúrgico 3300 em uma segunda direção de articulação "SAD" ao redor da junta articulada 3240. À medida que o segundo acionador de articulação 3520 é movido distalmente, o primeiro acionador de articulação 3510 se moverá necessariamente na direção proximal "DP", devido a sua conexão ao canal alongado 3302 do atuador de extremidade cirúrgico 3300. Esse movimento proximal do primeiro acionador de articulação 3510 pode ser acomodado pelo primeiro membro de trava 3702 ou "colidindo" ou conduzindo ou deslizando sobre os serreados correspondentes 3514.
[00172] A Figura 32 ilustra de forma um tanto diagramática, um instrumento cirúrgico 4010 com um atuador de extremidade articulável 4300 que emprega um sistema de articulação exclusivo e inovador 4500 para a articulação do atuador de extremidade 4300 em uma junta articulada, em geral, denominada 4240. Em particular, o instrumento cirúrgico 4010 inclui um conjunto de estrutura 4600 que é fixado ao canal alongado 4302 do atuador de extremidade cirúrgico 4300 de tal modo que o atuador de extremidade cirúrgico 4300 pode ser seletivamente articulado em torno da junta articulada 4240. O sistema de articulação 4500 inclui um primeiro membro ou barra de articulação 4510 e um segundo membro ou barra de articulação 4520. Cada uma dentre a primeira e a segunda barras de articulação 4510, 4520 é fixada ao canal alongado 4302 do atuador de extremidade cirúrgico 4300 e é disposta para movimento axial em relação ao conjunto de estrutura 4600. Por exemplo, a primeira barra de articulação 4510 pode ser suportada para movimento axial em relação ao conjunto de estrutura 4600 por meio de um primeiro rolamento 4511 e a segunda barra de articulação 4520 pode ser suportada para movimento axial em relação ao conjunto de estrutura 4600 por meio de um segundo rolamento 4521.
[00173] O atuador de extremidade cirúrgico 4300 pode compreender um dispositivo cirúrgico de grampeamento e de corte e incluir um membro de disparo (não mostrado) que é configurado para se deslocar axialmente dentro do atuador de extremidade 4300, conforme apresentado em muitas das referências que foram incorporadas aqui a título de referência. O instrumento cirúrgico 4010 é equipado com um membro ou haste de disparo 4560 que é configurado para se mover axialmente em resposta a movimentos de acionamento a partir de um sistema acionador de disparo de diversos tipos revelados aqui, bem como nas várias referências aqui incorporadas. O sistema de articulação 4500, conforme genericamente representado na Figura 32, inclui um primeiro motor de acionamento de articulação 4530 que é configurado para fazer interface operacionalmente com o primeiro acionador de articulação 4510 de modo que a operação do motor de articulação em uma primeira direção resulte em deslocamento axial da primeira barra de articulação 4510 na direção distal "DD" e a operação do primeiro sistema de acionamento de articulação em uma direção oposta resulta no movimento axial da primeira barra de articulação 4510 em uma direção proximal "DP". De modo similar, o sistema de articulação ainda compreende uma segunda articulação 4500 motor de acionamento que é configurado de maneira operável 4540 interface com o segundo condutor de modo que a operação de articulação do 4520 segunda articulação de acionamento do motor em uma direção resultará 4540 em avanço axial da segunda articulação condutor na direção distal "DD", a operação do motor em uma segunda direção oposta de articulação irá resultar no avanço axial da segunda articulação condutor na direção proximal "DP". O primeiro e o segundo motores de acionamento de articulação 4530, 4540 são controlados por um circuito de controle e uma disposição controladora, de modo que, quando um dos motores de acionamento 4530 é operado para acionar o acionador de articulação operacionalmente fixado ao mesmo, em uma direção axial por uma primeira distância axial, o outro motor de acionamento de articulação é operacionalmente acoplado ao mesmo em uma direção oposta para uma direção axial oposta por uma segunda distância axial que é igual à primeira distância axial para acomodar a articulação do atuador de extremidade cirúrgico.
[00174] Exemplo 1 - Um conjunto de eixo de acionamento para um instrumento cirúrgico que compreende um membro de acionamento móvel, sendo que o conjunto de eixo de acionamento compreende um conjunto dorsal que é acoplável operacionalmente ao instrumento cirúrgico. Um atuador de extremidade cirúrgico é acoplado ao conjunto dorsal por meio de uma junta articulada. Um membro de disparo proximal faz interface com o membro de acionamento móvel e é apoiado para percurso móvel em relação ao conjunto dorsal. Um membro de disparo intermediário é apoiado para percurso móvel em relação ao conjunto dorsal, e um membro de disparo distal faz interface com o membro de disparo intermediário e é apoiado para percurso axial seletivo através de ao menos uma porção do atuador de extremidade cirúrgico. Um acionador de articulação faz interface com o atuador de extremidade para aplicar movimentos de articulação a ele. O instrumento cirúrgico compreende adicionalmente um sistema de embreagem que é seletivamente móvel entre uma orientação de articulação e uma orientação de disparo, de modo que quando o sistema de embreagem está na orientação de articulação, o movimento do membro de acionamento móvel é transmitido ao acionador de articulação através do membro de disparo proximal, e quando o sistema de embreagem está na orientação de disparo, o movimento do membro de acionamento móvel é transmitido ao membro de disparo distal através do membro de disparo proximal e do membro de disparo intermediário.
[00175] Exemplo 2 - O conjunto de eixo de acionamento do Exemplo 1, em que o membro de disparo intermediário é acoplado ao membro de disparo proximal, de modo que quando o sistema de embreagem está na orientação de articulação, o membro de disparo proximal é móvel em relação ao membro de disparo intermediário, e quando o sistema de embreagem está na orientação de disparo, o membro de disparo intermediário se move axialmente com o membro de disparo proximal.
[00176] Exemplo 3 - O conjunto de eixo de acionamento do Exemplo 2, em que o membro de disparo intermediário é acoplado ao membro de disparo proximal por um acoplador que compreende uma extremidade de acoplador proximal fixada a uma extremidade distal do membro de disparo proximal e a extremidade de acoplador distal espaçada a partir da extremidade de acoplador proximal para definir uma passagem axial incluída entre elas a fim de receber de forma móvel uma extremidade proximal do membro de disparo intermediário nela.
[00177] Exemplo 4 - O conjunto de eixo de acionamento do Exemplo 3, em que o sistema de embreagem compreende um membro de engate que é apoiado para percurso giratório em torno de um perímetro externo do acoplador, e em que o acionador de articulação é acoplado ao membro de engate para percurso axial com ele. Um primeiro detentor proximal e um primeiro detentor distal estão localizados no membro de engate O primeiro detentor distal é espaçado a partir do primeiro detentor proximal e é orientado para alinhamento axial com ele. O sistema de embreagem compreende adicionalmente um primeiro sulco axial em uma superfície externa do acoplador, de modo que quando os primeiros detentores proximal e distal estão alinhados com o primeiro sulco axial, o acoplador é móvel axialmente em relação ao membro de engate, e quando os primeiros detentores proximal e axial estão desalinhados do primeiro sulco axial, o movimento axial do acoplador em uma direção distal moverá o acionador de articulação na direção distal, e o movimento do acoplador em uma direção proximal moverá o acionador de articulação na direção proximal.
[00178] Exemplo 5 - O conjunto de eixo de acionamento do Exemplo 4, em que o conjunto de eixo de acionamento compreende adicionalmente um segundo detentor proximal no membro de engate diametralmente oposto ao primeiro detentor proximal. O conjunto de eixo de acionamento compreende também um segundo detentor distal no membro de engate diametralmente oposto ao primeiro detentor distal e alinhado axialmente com o segundo detentor proximal. Um segundo sulco axial é fornecido na superfície externa do acoplador em uma orientação que é diametralmente oposta ao primeiro sulco axial, de modo que quando os primeiros detentores proximal e distal estão desalinhados com o primeiro sulco axial, os segundos detentores proximal e distal estão desalinhados com o segundo sulco axial, e quando os primeiros detentores proximal e distal estão alinhados axialmente com o primeiro sulco axial, os segundos detentores proximal e distal estão alinhados axialmente com o segundo sulco axial.
[00179] Exemplo 6 - O conjunto de eixo de acionamento do Exemplo 4 ou 5, em que o acionador de articulação compreende uma aba em uma extremidade proximal do acionador de articulação que é recebida dentro de um sulco anular em um perímetro do membro de engate para facilitar a rotação do membro de engate em relação ao acionador de articulação.
[00180] Exemplo 7 - O conjunto de eixo de acionamento do Exemplo 5 que compreende adicionalmente um meio para rotação do membro de engate no acoplador entre a orientação de articulação, em que os primeiros detentores proximal e distal estão alinhados com o primeiro sulco axial, e os segundos detentores proximal e distal estão alinhados com o segundo sulco axial e a orientação de disparo, sendo que os primeiros detentores proximal e distal não estão alinhados com o primeiro sulco axial, e os segundos detentores proximal e distal não estão alinhados com o segundo sulco axial.
[00181] Exemplo 8 - O conjunto de eixo de acionamento dos Exemplos 1, 2, 3, 4, 5, 6 ou 7, em que o atuador de extremidade cirúrgico compreende uma primeira garra acoplada à junta articulada e uma segunda garra que é apoiada de forma adjacente à primeira garra. As primeira e segunda garras são apoiadas uma em relação à outra de modo que uma dentre as primeira e segunda garras é seletivamente móvel em direção à outra garra dentre as primeira e segunda garras e na direção oposta à mesma entre as posições aberta e fechada por meio de percurso axial de um membro de fechamento que faz interface com elas.
[00182] Exemplo 9 - O conjunto de eixo de acionamento do Exemplo 8, em que o meio para rotação compreende um membro de atuação que é apoiado no membro de engate de modo que a rotação do membro de atuação causa a rotação do membro de engate. O meio de rotação compreende adicionalmente um pino de came que está situado no membro de atuação e que é configurado para fazer interface com uma fenda de came no membro de fechamento de modo que quando o membro de fechamento está em uma posição não ativada que corresponde à posição aberta das primeira e segunda garras, o pino de came permite que o membro de engate seja forçado para a posição de articulação, e quando o membro de fechamento está em uma posição ativada que corresponde às posições fechadas das primeira e segunda garras, a fenda de came faz com que o pino do came gire o membro de ativação e o membro de engate para a posição de disparo.
[00183] Exemplo 10 - O conjunto de eixo de acionamento do Exemplo 9 compreendendo adicionalmente um tambor de chaveamento que faz interface com o membro de atuação para enviar um sinal para um circuito de controle no instrumento cirúrgico quando o membro de engate está na orientação de disparo.
[00184] Exemplo 11 - Um conjunto de eixo de acionamento para um instrumento cirúrgico que compreende um membro de acionamento móvel, sendo que o conjunto de eixo de acionamento compreende um conjunto dorsal que é acoplável operacionalmente ao instrumento cirúrgico. Um atuador de extremidade cirúrgico é acoplado ao conjunto dorsal por meio de uma junta articulada. Um membro de disparo proximal faz interface com o membro de acionamento móvel e é apoiado para percurso móvel em relação ao conjunto dorsal. Um membro de disparo distal faz interface com o membro de disparo proximal e é apoiado para percurso axial seletivo através de ao menos uma porção do atuador de extremidade cirúrgico. Ao menos um acionador de articulação faz interface com o atuador de extremidade para aplicar movimentos de articulação a ele. Um motor de articulação é apoiado pelo conjunto dorsal e faz interface de modo acionável com o ao menos um acionador de articulação. O conjunto de eixo de acionamento compreende adicionalmente meios para evitar a ativação do membro de acionamento móvel quando o motor de articulação está sendo acionado.
[00185] Exemplo 12 - O conjunto de eixo de acionamento do Exemplo 11, em que o membro de acionamento móvel é ativado por um motor de disparo e em que os meios para evitar a ativação compreendem um conjunto de chave que compreende um conjunto de anel de deslizamento que se comunica com um circuito de controle para o instrumento cirúrgico. O circuito de controle se comunica com o motor de disparo e o motor de articulação. Um tambor de chaveamento é apoiado para percurso móvel no conjunto de estrutura entre uma primeira posição que corresponde a uma posição de articulação e uma segunda posição que corresponde a uma posição de disparo, de modo que quando o tambor de chaveamento está na segunda posição, o conjunto de anel de deslizamento comunica um status de disparo do tambor de chaveamento para o circuito de controle que possibilita que o motor de disparo seja ativado, e quando o tambor de chaveamento está na primeira posição, o circuito de controle evita a ativação do motor de disparo e permite a ativação do motor de articulação.
[00186] Exemplo 13 - O conjunto de eixo de acionamento do Exemplo 12, que compreende adicionalmente meios para mover o tambor de chaveamento entre as primeira e segunda posições.
[00187] Exemplo 14 - O conjunto de eixo de acionamento do Exemplo 13, em que os meios para mover o tambor de chaveamento compreendem um membro de mola que é configurado para forçar o tambor de chaveamento para a primeira posição.
[00188] Exemplo 15 - O conjunto de eixo de acionamento dos Exemplos 11, 12, 13, ou 14, em que o atuador de extremidade cirúrgico compreende uma primeira garra que é acoplada à junta articulada e uma segunda garra que é apoiada de forma adjacente à primeira garra. A primeira e a segunda garras são apoiadas uma em relação à outra de modo que uma dentre as primeira e segunda garras é seletivamente móvel em direção à outra e na direção oposta da mesma dentre a primeira e a segunda garras entre as posições aberta e fechada por percurso axial de um membro de fechamento que faz interface com elas.
[00189] Exemplo 16 - O conjunto de eixo de acionamento do Exemplo 15, em que os meios para mover o tambor de chaveamento compreendem adicionalmente um pino de came que está situado no tambor de chaveamento e que faz interface com uma fenda de came no membro de fechamento, de modo que quando o membro de fechamento está em uma posição não ativada que corresponde à posição aberta das primeira e segunda garras, o pino de came permite que o tambor de chaveamento seja forçado para uma posição de articulação pela mola, e quando o membro de fechamento está em uma posição ativada que corresponde às posições fechadas das primeira e segunda garras, a fenda de came faz com que o pino de came mova o tambor de chaveamento para a segunda posição.
[00190] Exemplo 17 - O conjunto de eixo de acionamento dos Exemplos 11, 12, 13, 14, 15 ou 16 em que o ao menos um acionador de articulação compreende os primeiro e segundo acionadores de articulação que fazem interface com o motor de articulação, de modo que o acionamento do motor de articulação aciona os primeiro e segundo acionadores de articulação em direções opostas.
[00191] Exemplo 18 - O conjunto de eixo de acionamento do Exemplo 17, que compreende adicionalmente meios para apoiar as porções distais dos primeiro e segundo acionadores de articulação durante o acionamento dos mesmos em direções opostas.
[00192] Exemplo 19 - O conjunto de eixo de acionamento do Exemplo 18, em que os meios de apoio compreendem uma engrenagem intermediária distal em ponto morto que está centralmente disposta entre as porções distais dos primeiro e segundo acionadores de articulação e em engate engrenado com eles.
[00193] Exemplo 20 - O conjunto de eixo de acionamento do Exemplo 18 ou 19, sendo que o conjunto de eixo de acionamento compreende adicionalmente um primeiro dente de detenção que se projeta para dentro a partir do membro de fechamento para engate com uma primeira porção serrilhada do primeiro acionador de articulação. O conjunto de eixo de acionamento compreende adicionalmente um segundo dente de detenção que se projeta para dentro a partir do membro de fechamento para engate com uma segunda porção serrilhada do segundo acionador de articulação.
[00194] A totalidade das revelações de:
[00195] Patente US n° 5.403.312, intitulada ELECTROSURGICAL HEMOSTATIC DEVICE, que foi concedida em 4 de abril de 1995;
[00196] Patente US n° 7.000.818, intitulada SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, que foi concedida em 21 de fevereiro de 2006;
[00197] Patente US n° 7.422.139, intitulada MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK, que foi concedida em 9 de setembro de 2008;
[00198] Patente US n° 7.464.849, intitulada ELECTROMECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS, que foi concedida em 16 de dezembro de 2008;
[00199] Patente US n° 7.670.334, intitulada SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR, que foi concedida em 2 de março de 2010;
[00200] Patente US n° 7.753.245, intitulada SURGICAL STAPLING INSTRUMENTS, que foi concedida em 13 de julho de 2010;
[00201] Patente US n° 8.393.514, intitulada SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE, que foi concedida em 12 de março de 2013;
[00202] Patente US n° de série 7.845.537, intitulada SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES; concedida em 7 de dezembro de 2010;
[00203] Pedido de Patente US n° de série 12/031.573, intitulado SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES, depositado em 14 de fevereiro de 2008;
[00204] Patente US n° 7.980.443, intitulada END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, concedida em 19 de julho de 2011;
[00205] Patente US n° 8.210.411, intitulada MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, que foi concedida 3 de julho de 2012;
[00206] Patente US n° 8.608.045, intitulada POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, concedida em 17 de dezembro de 2013;
[00207] Patente US n° 8.220.688, intitulada MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY, concedida em 17 de julho de 2012;
[00208] Patente US n° 8.733.613, intitulada STAPLE CARTRIDGE, concedida em 27 de maio de 2014;
[00209] Patente US n° 8.561.870, intitulada SURGICAL STAPLING INSTRUMENT, concedida em 22 de outubro de 2013;
[00210] Pedido de Patente US n° de série 2012/0298719, intitulado SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, depositado em 27 de maio de 2011;
[00211] Publicação de pedido de Patente US n° 2013/0334278, intitulada ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, depositado em 15 de junho de 2012;
[00212] Pedido de Patente US n° de série 13/800.025, intitulado STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, depositado em 13 de março de 2013;
[00213] Pedido de Patente US n° de série 13/800.067, intitulado STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, depositado em 13 de março de 2013;
[00214] Publicação de pedido de Patente US n° 2007/0175955, intitulada SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM, depositada em 31 de janeiro de 2006; e
[00215] Patente US n° 8.308.040, intitulada SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR, concedida em 13 de novembro de 2012, estão aqui incorporados, a título de referência.
[00216] Embora várias modalidades dos dispositivos tenham sido aqui descritas em conexão com determinadas modalidades reveladas, podem ser implementadas muitas modificações e variações dessas modalidades. Além disso, onde forem revelados materiais para certos componentes, outros materiais podem ser usados. Além disso, de acordo com várias modalidades, um único componente pode ser substituído por múltiplos componentes e múltiplos componentes podem ser substituídos por um único componente, para executar uma ou mais funções determinadas. A descrição mencionada anteriormente e as concretizações seguintes são destinadas a abranger todas essas modificações e variações.
[00217] Com respeito ao uso de substancialmente quaisquer termos plurais e/ou singulares na presente invenção, os versados na técnica podem mudar do plural para o singular e/ou do singular para o plural conforme seja adequado ao contexto e/ou aplicação. As várias permutações singular/plural não estão expressamente apresentadas na presente invenção por motivos de clareza.
[00218] O assunto descrito na presente invenção ilustra por vezes componentes distintos contidos em outros componentes distintos, ou a eles relacionados. É necessário compreender que essas arquiteturas representadas são meramente exemplificadoras, e que, de fato, podem ser implementadas muitas outras arquiteturas que alcancem a mesma funcionalidade. No sentido conceitual, qualquer disposição de componentes para alcançar a mesma funcionalidade está efetivamente "associada" se a funcionalidade desejada for alcançada. Assim, quaisquer dois componentes mencionados na presente invenção que sejam combinados para alcançar uma funcionalidade específica podem ser vistos como "associados" um ao outro se a funcionalidade desejada é alcançada, independentemente das arquiteturas ou dos componentes intermediários. De modo semelhante, quaisquer desses dois componentes assim associados também podem ser vistos como estando "conectados de modo operável" ou "acoplados de modo operável" um ao outro para alcançar a funcionalidade desejada, e quaisquer desses dois componentes capazes de serem associados dessa forma podem ser vistos como sendo "acopláveis de modo operável" um ao outro para alcançar a funcionalidade desejada. Exemplos específicos de componentes operacionalmente acopláveis incluem, mas não se limitam a, componentes fisicamente encaixáveis e/ou em interação física, e/ou os que podem interagir por conexão sem fio, e/ou que interajam por lógica, e/ou podem interagir por lógica.
[00219] Embora várias modalidades tenham sido descritas na presente invenção, muitas modificações, variações, substituições, alterações e equivalentes a essas modalidades podem ser implementadas e irão ocorrer aos versados na técnica. Além disso, onde forem revelados materiais para certos componentes, outros materiais podem ser usados. Deve-se compreender, portanto, que a descrição precedente e as concretizações anexas pretendem cobrir todas essas modificações e variações abrangidas pelo escopo das modalidades apresentadas. As concretizações a seguir pretendem englobar todas essas modificações e variações.
[00220] Os dispositivos aqui revelados podem ser projetados para que sejam descartados após um único uso, ou podem ser projetados para que sejam usados múltiplas vezes. Em qualquer dos casos, entretanto, o dispositivo pode ser recondicionado para reuso após ao menos um uso. O recondicionamento pode incluir qualquer combinação das etapas de desmontagem do dispositivo, seguida de limpeza ou substituição de peças específicas e subsequente remontagem. Em particular, o dispositivo pode ser desmontado e qualquer número de peças ou partes específicas do dispositivo podem ser seletivamente substituídas ou removidas, em qualquer combinação. Mediante a limpeza e/ou substituição de partes específicas, o dispositivo pode ser remontado para uso subsequente na instalação de recondicionamento ou por uma equipe cirúrgica, imediatamente antes de um procedimento cirúrgico. Os versados na técnica entenderão que o recondicionamento de um dispositivo pode usar uma variedade de técnicas para desmontar, limpar/substituir e remontar. O uso de tais técnicas, e o dispositivo recondicionado resultante, estão todos dentro do escopo do presente pedido.
[00221] De preferência, a invenção aqui descrita será processada antes da cirurgia. Primeiramente, um instrumento novo ou usado é obtido e, se necessário, limpo. O instrumento pode ser, então, esterilizado. Em uma técnica de esterilização, o instrumento é disposto em um recipiente fechado e vedado, como uma bolsa plástica ou de TYVEK. O recipiente e o instrumento são, então, colocados em um campo de radiação que pode penetrar no recipiente, como radiação gama, raios X ou elétrons de alta energia. A radiação extermina bactérias no instrumento e no recipiente. O instrumento esterilizado pode ser, então, armazenado em um recipiente estéril. O recipiente vedado mantém o instrumento estéril até que o mesmo seja aberto na unidade médica.
[00222] Qualquer patente, publicação ou outro material de descrição, no todo ou em parte, que seja tido como incorporado a título de referência à presente invenção, é incorporado à presente invenção apenas até o ponto em que os materiais incorporados não entrem em conflito com definições, declarações ou outros materiais de descrição existentes apresentados nesta descrição. Desse modo, e na medida em que for necessário, a descrição como explicitamente aqui apresentada substitui qualquer material conflitante incorporado à presente invenção a título de referência. Qualquer material, ou porção do mesmo, tido como aqui incorporado a título de referência, mas que entre em conflito com as definições, declarações, ou outros materiais de descrição existentes aqui apresentados estará aqui incorporado apenas na medida em que não haja conflito entre o material incorporado e o material de descrição existente.
[00223] Em resumo, foram descritos inúmeros benefícios que resultam do emprego dos conceitos descritos no presente documento. A descrição anteriormente mencionada de uma ou mais modalidades foi apresentada para propósitos de ilustração e descrição. Essa descrição não pretende ser exaustiva ou limitar a invenção à forma precisa apresentada. Modificações e variações são possíveis à luz dos ensinamentos acima. Uma ou mais modalidades foram escolhidas e descritas com a finalidade de ilustrar os princípios e a aplicação prática para, assim, permitir que o versado na técnica use as diversas modalidades e com inúmeras modificações, conforme sejam convenientes ao uso específico contemplado. Pretende-se que as concretizações apresentadas em anexo definam o escopo global.
Claims (10)
1. Conjunto de eixo (1200) intercambiável para um instrumento cirúrgico (10) compreendendo um membro de acionamento móvel (160), o conjunto de eixo (1200) compreendendo: um conjunto de dorso (1250) operacionalmente acoplável ao instrumento cirúrgico (10); um atuador de extremidade cirúrgico (1300) acoplado ao conjunto de dorso (1250) por uma articulada (1240); um membro de disparo proximal (1560) para interface com o membro de acionamento móvel (160) e suportado para translado móvel em relação ao conjunto de dorso (1250); um membro de disparo distal (550) suportado para translado axial seletivo através de ao menos uma porção do atuador de extremidade cirúrgico (1300); um acionador de articulação (1242) fazendo interface com o atuador de extremidade (1300) para aplicar movimentos de articulação ao mesmo; e um sistema de embreagem (1700) seletivamente móvel entre uma orientação de articulação e uma orientação de disparo; e caracterizado pelo fato de que ainda compreende: um membro de disparo intermediário (1570) suportado para translado móvel em relação ao conjunto de dorso (1250); em que: o membro de disparo distal (550) faz interface com o membro de disparo intermediário (1570); e quando o sistema de embreagem (1700) estiver na orientação de articulação, movimento do membro de acionamento móvel (160) é transmissível ao acionador de articulação (1242) através do membro de disparo proximal (1560), e quando o sistema de embreagem (1700) estiver na orientação de disparo, movimento do membro de acionamento móvel (160) é transmissível ao membro de disparo distal (550) através do membro de disparo proximal (1560) e do membro de disparo intermediário (1570).
2. Conjunto de eixo (1200) intercambiável, de acordo com a reivindicação 1, caracterizado pelo fato de que o membro de disparo intermediário (1570) é acoplado ao membro de disparo proximal (1560) de modo que quando o sistema de embreagem (1700) estiver na orientação de articulação, o membro de disparo proximal (1560) é móvel em relação ao membro de disparo intermediário (1570), e quando o sistema de embreagem (1700) estiver na orientação de disparo, o membro de disparo intermediário (1570) se move axialmente com o membro de disparo proximal (1560).
3. Conjunto de eixo (1200) intercambiável, de acordo com a reivindicação 1 ou 2, caracterizado pelo fato de que o membro de disparo intermediário (1570) é acoplado ao membro de disparo proximal (1560) por um acoplador (1566) compreendendo uma extremidade de acoplador proximal fixada a uma extremidade distal do membro de disparo proximal (1560) e extremidade de acoplador distal (1567) espaçada da extremidade de acoplador proximal para definir uma passagem axial (1568) enclausurada entre as mesmas para receber de forma móvel uma extremidade proximal (1572) do membro de disparo intermediário (1570) na mesma.
4. Conjunto de eixo (1200) intercambiável, de acordo com a reivindicação 3, caracterizado pelo fato de que o sistema de embreagem (1700) compreende: um membro de engate (1710) suportado para translado giratório ao redor de um perímetro externo do acoplador (1566) e em que o acionador de articulação (1242) é acoplado ao membro de engate (1710) para translado axial com o mesmo; um primeiro detentor proximal (1715) no membro de engate (1710); um primeiro detentor distal (1714) no membro de engate (1710) espaçado do primeiro detentor proximal (1715) e em alinhamento axial com o mesmo; e um primeiro sulco axial (1580) em uma superfície externa do acoplador (1566) de modo que quando os primeiros detentores proximal e distal (1715, 1714) estiverem alinhados com o primeiro sulco axial (1580) o acoplador (1566) é móvel axialmente em relação ao membro de engate (1710), e quando os primeiros detentores proximal e distal (1715, 1714) estiverem desalinhados do primeiro sulco axial (1580), movimento axial do acoplador (1566) em uma direção distal moverá o acionador de articulação (1242) na direção distal, e movimento do acoplador (1566) em uma direção proximal moverá o acionador de articulação (1242) na direção proximal.
5. Conjunto de eixo (1200) intercambiável, de acordo com a reivindicação 4, caracterizado pelo fato de que ainda compreende: um segundo detentor proximal (1715) no membro de engate (1710) diametralmente oposto ao primeiro detentor proximal (1715); um segundo detentor distal (1714) no membro de engate (1710) diametralmente oposto ao primeiro detentor distal (1714) e axialmente alinhado com o segundo detentor proximal (1715); e um segundo sulco axial (1580) na superfície externa do acoplador (1566) e diametralmente oposto ao primeiro sulco axial (1580), de modo que quando os primeiros detentores proximal e distal (1715, 1714) estiverem desalinhados com o primeiro sulco axial (1580), os segundos detentores proximal e distal (1715, 1714) estão desalinhados com o segundo sulco axial (1580), e quando os primeiros detentores proximal e distal (1715, 1714) estiverem axialmente alinhados com o primeiro sulco axial (1580), os segundos detentores proximal e distal (1715, 1714) estão axialmente alinhados com o segundo sulco axial (1580).
6. Conjunto de eixo (1200) intercambiável, de acordo com a reivindicação 4 ou 5, caracterizado pelo fato de que o acionador de articulação (1242) compreende uma aba (1243) em uma extremidade proximal do acionador de articulação (1242) que é recebida dentro de um sulco anular (1712) em um perímetro do membro de engate (1710) para facilitar rotação do membro de engate (1710) em relação ao acionador de articulação (1242).
7. Conjunto de eixo (1200) intercambiável, de acordo com a reivindicação 5, caracterizado pelo fato de que ainda compreende meios para rotação do membro de engate (1710) no acoplador (1566) entre a orientação de articulação em que os primeiros detentores proximal e distal (1715, 1714) estão alinhados com o primeiro sulco axial (1580) e os segundos detentores proximal e distal (1715, 1714) estão alinhados com o segundo sulco axial (1580) e a orientação de disparo em que os primeiros detentores proximal e distal (1715, 1714) não estão alinhados com o primeiro sulco axial (1580) e os segundos detentores proximal e distal (1715, 1714) não estão alinhados com o segundo sulco axial (1580).
8. Conjunto de eixo (1200) intercambiável, de acordo com qualquer uma das reivindicações 1 a 7, caracterizado pelo fato de que o atuador de extremidade cirúrgico (1300) compreende: uma primeira garra acoplada à junta articulada (1240); e uma segunda garra suportada de modo adjacente à primeira garra, as primeira e segunda garras suportadas uma em relação à outra de modo que uma dentre as primeira e segunda garras é seletivamente móvel em direção à, e na direção oposta da, outra dentre as primeira e segunda garras entre posições aberta e fechada por translado axial de um membro de fechamento (1230) fazendo interface com as mesmas.
9. Conjunto de eixo (1200) intercambiável, de acordo com a reivindicação 8 quando dependendo da reivindicação 7, caracterizado pelo fato de que os meios para rotação compreendem: um membro de atuação (1720) suportado no membro de engate (1710) de modo que rotação do membro de atuação (1720) causa rotação do membro de engate (1710); e um pino de came (1724) no membro de atuação (1720) e fazendo interface com uma fenda de came (1232) no membro de fechamento (1230) de modo que quando o membro de fechamento (1230) estiver em uma posição não ativada correspondendo à posição aberta das primeira e segunda garras, o pino de came (1724) permite o membro de engate (1710) a ser tendenciado para a posição de articulação e quando o membro de fechamento (1230) estiver em uma posição ativada correspondendo às posições fechadas das primeira e segunda garras, a fenda de came (1232) leva o pino de came (1724) a girar o membro de atuação (1720) e o membro de engate (1710) para a posição de disparo.
10. Conjunto de eixo (1200) intercambiável, de acordo com a reivindicação 9, caracterizado pelo fato de que ainda compreende um interruptor tambor (1610) fazendo interface com o membro de atuação (1720) para enviar um sinal para um circuito de controle (156) no instrumento cirúrgico (10) quando o membro de engate (1710) estiver na orientação de disparo.
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2014
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2015
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- 2015-12-04 JP JP2017532967A patent/JP6689861B2/ja not_active Expired - Fee Related
- 2015-12-04 BR BR112017012874-8A patent/BR112017012874B1/pt active IP Right Grant
- 2015-12-04 WO PCT/US2015/063963 patent/WO2016099958A1/en active Application Filing
- 2015-12-04 MX MX2017008117A patent/MX2017008117A/es unknown
- 2015-12-04 CN CN201580076405.6A patent/CN107257663B/zh active Active
- 2015-12-17 EP EP15200655.7A patent/EP3034013A1/en not_active Withdrawn
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2017
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US11399831B2 (en) | 2022-08-02 |
RU2017125363A (ru) | 2019-01-18 |
CN107257663B (zh) | 2020-07-28 |
JP2017538523A (ja) | 2017-12-28 |
JP6689861B2 (ja) | 2020-04-28 |
US20160174978A1 (en) | 2016-06-23 |
RU2017125363A3 (pt) | 2019-06-04 |
US20200397434A1 (en) | 2020-12-24 |
US10743873B2 (en) | 2020-08-18 |
WO2016099958A1 (en) | 2016-06-23 |
MX2017008117A (es) | 2018-03-06 |
RU2711421C2 (ru) | 2020-01-17 |
BR112017012874A2 (pt) | 2018-01-09 |
CN107257663A (zh) | 2017-10-17 |
EP3034013A1 (en) | 2016-06-22 |
US20180110518A1 (en) | 2018-04-26 |
US9844375B2 (en) | 2017-12-19 |
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