BR112021002997A2 - instrumentos cirúrgicos articuláveis equipados com motor, com disposições de motor de articulação dedicadas - Google Patents
instrumentos cirúrgicos articuláveis equipados com motor, com disposições de motor de articulação dedicadas Download PDFInfo
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- BR112021002997A2 BR112021002997A2 BR112021002997-4A BR112021002997A BR112021002997A2 BR 112021002997 A2 BR112021002997 A2 BR 112021002997A2 BR 112021002997 A BR112021002997 A BR 112021002997A BR 112021002997 A2 BR112021002997 A2 BR 112021002997A2
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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
-
- 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
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
-
- 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
-
- 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
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00039—Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
-
- 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
-
- 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
- A61B2017/00407—Ratchet means
-
- 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
-
- 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
- A61B2017/00473—Distal part, e.g. tip or head
-
- 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
- A61B2017/07257—Stapler heads characterised by its anvil
-
- 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
-
- 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
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
-
- 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
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
-
- 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
-
- 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
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
-
- 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
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2944—Translation of jaw members
-
- 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
- A61B2017/2946—Locking means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/30—Surgical robots
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
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Abstract
INSTRUMENTOS CIRÚRGICOS ARTICULÁVEIS EQUIPADOS COM MOTOR, COM DISPOSIÇÕES DE MOTOR DE ARTICULAÇÃO DEDICADAS. A presente invenção refere-se a um instrumento cirúrgico que inclui um gabinete que define um eixo geométrico longitudinal. Um conjunto de eixo de acionamento alongado é operacionalmente acoplado ao gabinete por um conjunto de rotador do eixo de acionamento para rotação seletiva ao redor do eixo geométrico longitudinal em relação ao gabinete. Um primeiro motor é suportado pelo gabinete e configurado para aplicar seletivamente os primeiros movimentos giratórios de atuação a um primeiro eixo de acionamento que é operacionalmente suportado pelo gabinete e faz interface operacional com um primeiro atuador do eixo de acionamento. Um segundo motor é suportado pelo conjunto de rotador do eixo de acionamento, de modo que o segundo motor é giratório ao redor do eixo geométrico longitudinal e está configurado para aplicar segundos movimentos giratórios de atuação a um segundo atuador do eixo de acionamento.
Description
Relatório Descritivo da Patente de Invenção para "INS-
[001] A presente invenção refere-se a instrumentos cirúrgicos e, em várias disposições, a instrumentos cirúrgicos para grampeamento e corte, e a cartuchos de grampos para uso com os mesmos, que são projetados para grampear e cortar tecido.
[002] Várias características das modalidades aqui descritas, jun- tamente com suas vantagens, podem ser entendidas de acordo com a descrição apresentada a seguir, considerada em conjunto com os de- senhos em anexo, conforme exposto a seguir:
[003] a Figura 1 é uma vista em perspectiva de um sistema de grampeamento cirúrgico equipado com motor;
[004] a Figura 2 é uma vista de montagem explodida de um con- junto de eixo de acionamento do sistema de grampeamento cirúrgico equipado com motor da Figura 1;
[005] a Figura 3 é uma vista em seção transversal de uma porção do conjunto de eixo de acionamento e de um atuador de extremidade cirúrgico do sistema de grampeamento cirúrgico equipado com motor da Figura 1, com uma bigorna do atuador de extremidade cirúrgico em uma posição aberta;
[006] a Figura 4 é uma vista de topo de uma porção do conjunto de eixo de acionamento e do atuador de extremidade cirúrgico da Fi- gura 3 em uma posição não articulada;
[007] a Figura 5 é uma outra vista de topo de uma porção do con- junto de eixo de acionamento e do atuador de extremidade cirúrgico da Figura 3 em uma posição articulada;
[008] a Figura 6 é uma vista de montagem explodida de uma em- punhadura ou gabinete do sistema de grampeamento cirúrgico equi- pado com motor da Figura 1;
[009] a Figura 7 é uma vista em seção transversal da empunha- dura da Figura 6 com porções do conjunto de eixo de acionamento omitidas para fins de clareza;
[0010] a Figura 8 é uma vista em seção transversal ampliada da empunhadura e do conjunto de eixo de acionamento da Figura 7;
[0011] a Figura 9 é uma outra vista em seção transversal ampliada da empunhadura e do conjunto de eixo de acionamento da Figura 7;
[0012] a Figura 10 é uma outra vista em seção transversal lateral da empunhadura e do conjunto de eixo de acionamento da Figura 7 em uma posição que resulta nas garras do atuador de extremidade cirúrgico sendo orientadas em uma posição aberta;
[0013] a Figura 11 é uma outra vista em seção transversal lateral da empunhadura e do conjunto de eixo de acionamento da Figura 7 em uma posição que resulta no fechamento das garras do atuador de extremidade;
[0014] a Figura 12 é uma comparação gráfica de forças de fecha- mento entre uma modalidade de instrumento cirúrgico que emprega um sistema de acionamento de fechamento progressivo e dois instru- mentos cirúrgicos anteriores que empregam diferentes disposições de sistema de acionamento de fechamento;
[0015] a Figura 13A é uma representação gráfica de uma força para disparar (FPD) e uma força para fechar (FPF) experimentadas por uma modalidade de instrumento cirúrgico anterior, que emprega superfícies de atuação de came em uma bigorna do mesmo, conforme um membro de disparo ou faca do mesmo se desloca através da bi- gorna, de uma posição inicial mais proximal a uma posição final mais distal na bigorna (distância da cruzeta em polegadas);
[0016] a Figura 13B é uma representação gráfica de uma força para disparar (FPD) e uma força para fechar (FPF), altura da bigorna e altura da mola experimentadas por uma modalidade de instrumento cirúrgico que emprega um sistema de acionamento de fechamento progressivo;
[0017] a Figura 14 é uma vista em perspectiva parcial de uma por- ção de um conjunto de eixo de acionamento;
[0018] a Figura 15 é uma vista em elevação lateral de uma porção de um outro instrumento cirúrgico equipado com motor;
[0019] a Figura 16 é uma vista em perspectiva parcial de uma por- ção do instrumento cirúrgico equipado com motor da Figura 15, com porções do mesmo omitidas para fins de clareza;
[0020] a Figura 17 é uma outra vista em perspectiva parcial de uma porção do instrumento cirúrgico equipado com motor da Figura 15, com porções do mesmo omitidas para fins de clareza;
[0021] a Figura 18 é uma outra vista em perspectiva parcial de uma porção do instrumento cirúrgico equipado com motor da Figura 15, com porções do mesmo omitidas para fins de clareza;
[0022] a Figura 19 é uma vista em perspectiva de um sistema de chaveamento do motor do instrumento cirúrgico equipado com motor da Figura 15, com porções do mesmo omitidas para fins de clareza;
[0023] a Figura 20 é uma vista em perspectiva de um segmento de bocal proximal ou segmento de aleta de um conjunto de bocal do ins- trumento cirúrgico equipado com motor da Figura 15;
[0024] a Figura 21 é uma vista em perspectiva parcial de porções do instrumento cirúrgico equipado com motor da Figura 15, com uma porção de bocal distal omitida para fins de clareza;
[0025] a Figura 22 é uma vista em elevação lateral de porções de uma porção de chassi e um segmento de bocal proximal do instrumen- to cirúrgico equipado com motor da Figura 15, com porções do conjun-
to de bocal do mesmo omitidas para fins de clareza;
[0026] a Figura 23 é uma representação gráfica de posições de chaves do sistema de chaveamento da Figura 19, em relação a uma posição de um cursor de chave do mesmo em relação a uma posição articulada de um atuador de extremidade do instrumento cirúrgico equipado com motor da Figura 15;
[0027] a Figura 24 é uma outra representação gráfica de posições de chaves do sistema de chaveamento da Figura 19 em relação a uma outra posição do cursor de chave em relação a uma posição articulada do atuador de extremidade do instrumento cirúrgico equipado com mo- tor da Figura 15;
[0028] a Figura 25 é uma outra representação gráfica de posições de chaves do sistema de chaveamento da Figura 19 em relação a uma outra posição do cursor de chave em relação a uma posição articulada do atuador de extremidade do instrumento cirúrgico equipado com mo- tor da Figura 15;
[0029] a Figura 26 é uma outra representação gráfica de posições de chaves do sistema de chaveamento da Figura 19 em relação a uma outra posição do cursor de chave em relação a uma posição articulada do atuador de extremidade do instrumento cirúrgico equipado com mo- tor da Figura 15;
[0030] a Figura 27 representa formatos de porções de três modali- dades de cursor de chave diferentes que podem ser empregadas no sistema de chaveamento da Figura 19;
[0031] a Figura 28 é uma comparação gráfica entre velocidades de motor para cada formato geométrico de cursor de chave representado na Figura 27, em um ângulo de articulação de um atuador de extremi- dade cirúrgico acoplado ao mesmo; e
[0032] a Figura 28 A ilustra uma forma de circuito de controle que pode ser empregada para controlar um motor de articulação do ins-
trumento cirúrgico equipado com motor da Figura 16.
[0033] Caracteres de referência correspondentes indicam partes correspondentes através das várias vistas. Os exemplos aqui descritos ilustram várias modalidades da invenção, em uma forma, e tais exem- plos não devem ser considerados de forma alguma como limitadores do escopo da invenção.
[0034] O requerente do presente pedido detém os seguintes pedi- dos de patente US, que foram depositados na mesma data do presen- te pedido e que estão, cada um, aqui incorporados a título de referên- cia em suas respectivas totalidades:
[0035] - pedido de patente US n° de série __________, intitulado "METHOD FOR FABRICATING SURGICAL STAPLER ANVILS", n° do documento do procurador END8577USNP/180088M;
[0036] - pedido de patente US n° de série __________, intitulado "REINFORCED DEFORMABLE ANVIL TIP FOR SURGICAL STA- PLER ANVIL", n° do documento do procurador END8578USNP/180393;
[0037] - pedido de patente US n° de série __________, intitulado "SURGICAL STAPLER ANVILS WITH STAPLE DIRECTING PRO- TRUSIONS AND TISSUE STABILITY FEATURES", n° do documento do procurador END8579USNP/180089;
[0038] - pedido de patente US n° de série __________, intitulado "FABRICATING TECHNIQUES FOR SURGICAL STAPLER ANVILS", n° do documento do procurador END8580USNP/180090;
[0039] - pedido de patente US n° de série __________, intitulado "SURGICAL STAPLING DEVICES WITH IMPROVED CLOSURE MEMBERS", n° do documento do procurador END8581USNP/180091;
[0040] - pedido de patente US n° de série __________, intitulado "SURGICAL STAPLER ANVILS WITH TISSUE STOP FEATURES
CONFIGURED TO AVOID TISSUE PINCH", n° do documento do pro- curador END8582USNP/180092;
[0041] - pedido de patente US n° de série __________, intitulado "METHOD FOR OPERATING A POWERED ARTICULATABLE SUR- GICAL INSTRUMENT", n° do documento do procurador END8583USNP/180093M;
[0042] - pedido de patente US n° de série __________, intitulado "SURGICAL INSTRUMENTS WITH PROGRESSIVE JAW CLOSURE ARRANGEMENTS", n° do documento do procurador END8584USNP/180094;
[0043] - pedido de patente US n° de série __________, intitulado "POWERED SURGICAL INSTRUMENTS WITH CLUTCHING AR- RANGEMENTS TO CONVERT LINEAR DRIVE MOTIONS TO RO- TARY DRIVE MOTIONS", n° do documento do procurador END8585USNP/180095;
[0044] - pedido de patente US n° de série __________, intitulado "POWERED ARTICULATABLE SURGICAL INSTRUMENTS WITH
CLUTCHING AND LOCKING ARRANGEMENTS FOR LINKING AN ARTICULATION DRIVE SYSTEM TO A FIRING DRIVE SYSTEM", n° do documento do procurador END8586USNP/180096;
[0045] - pedido de patente US n° de série __________, intitulado "SWITCHING ARRANGEMENTS FOR MOTOR POWERED ARTICU- LATABLE SURGICAL INSTRUMENTS", n° do documento do procura- dor END8588USNP/180098; e
[0046] - pedido de patente de design US n° de série __________, intitulado "SURGICAL INSTRUMENT ANVIL", n° do documento do procurador END8581USDP/180099D.
[0047] O requerente do presente pedido detém os seguintes pedi- dos de patente US e patentes US que estão, cada um, aqui incorpora- dos a título de referência em suas respectivas totalidades:
[0048] - pedido de patente US n° de série 15/386.185, intitulado "SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIES THEREOF", publicação de pedido de patente US n° 2018-0168642;
[0049] - pedido de patente US n° de série 15/386.230, intitulado "ARTICULATABLE SURGICAL STAPLING INSTRUMENTS", publica- ção de pedido de patente US n° 2018-0168649;
[0050] - pedido de patente US n° de série 15/386.221, intitulado "LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS", publicação de pedido de patente US n° 2018-01686;
[0051] - pedido de patente US n° de série 15/386.209, intitulado "SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF", publicação de pedido de patente US n° 2018-0168645;
[0052] - pedido de patente US n° de série 15/386.198, intitulado "LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS AND REPLACEABLE TOOL ASSEMBLIES", publicação de pedido de patente US n° 2018-0168644;
[0053] - pedido de patente US n° de série 15/386.240, intitulado "SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEM- BERS THEREFOR", publicação de pedido de patente US n° 2018-
0168651.
[0054] - pedido de patente US n° de série 15/385.939, intitulado "STAPLE CARTRIDGES AND ARRANGEMENTS de STAPLES AND STAPLE CAVITIES THEREIN", publicação de pedido de patente US n° 2018-0168629;
[0055] - pedido de patente US n° de série 15/385.941, intitulado "SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGE-
CLOSURE STROKE REDUCTION FEATURES AND ARTICULATION AND FIRING SYSTEMS", publicação de pedido de patente US n°
2018-0168630;
[0056] - pedido de patente US n° de série 15/385.943, intitulado "SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS", publicação de pedido de patente US n° 2018-0168631;
[0057] - pedido de patente US n° de série 15/385.950, intitulado "SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE RE- DUCTION FEATURES", publicação de pedido de patente US n° 2018- 0168635;
[0058] - pedido de patente US n° de série 15/385.945, intitulado "STAPLE CARTRIDGES AND ARRANGEMENTS de STAPLES AND STAPLE CAVITIES THEREIN", publicação de pedido de patente US n° 2018-0168632;
[0059] - pedido de patente US n° de série 15/385.946, intitulado "SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS", publicação de pedido de patente US n° 2018-0168633;
[0060] - pedido de patente US n° de série 15/385.951, intitulado "SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASING A JAW OPENING DISTANCE", publicação de pedido de patente US n° 2018-0168636;
[0061] - pedido de patente US n° de série 15/385.953, intitulado "METHODS OF STAPLING TISSUE", publicação de pedido de patente US n° 2018-0168637;
[0062] - pedido de patente US n° de série 15/385.954, intitulado "FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FOR SURGICAL END EFFECTORS", publicação de pe- dido de patente US n° 2018-0168638;
[0063] - pedido de patente US n° de série 15/385.955, intitulado "SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOP ARRANGEMENTS", publicação de pedido de patente US n° 2018- 0168639;
[0064] - pedido de patente US n° de série 15/385.948, intitulado "SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS", publicação de pedido de patente US n° 2018-0168584;
[0065] - pedido de patente US n° de série 15/385.956, intitulado "SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEA- TURES", publicação de pedido de patente US n° 2018-0168640;
[0066] - pedido de patente US n° de série 15/385.958, intitulado "SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS
FOR PREVENTING FIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT", publicação de pedi- do de patente US n° 2018-0168641;
[0067] - pedido de patente US n° de série 15/385.947, intitulado "STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES THEREIN", publicação de pedido de patente US n° 2018-0168634;
[0068] - pedido de patente US n° de série 15/385.896, intitulado "METHOD FOR RESETTING A FUSE OF A SURGICAL INSTRU- MENT SHAFT", publicação de pedido de patente US n° 2018- 0168597;
[0069] - pedido de patente US n° de série 15/385.898, intitulado "STAPLE-FORMING POCKET ARRANGEMENT TO ACCOMMODA- TE DIFFERENT TYPES OF STAPLES", publicação de pedido de pa- tente US n° 2018-0168599;
[0070] - pedido de patente US n° de série 15/385.899, intitulado "SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CON- TROL", publicação de pedido de patente US n° 2018-0168600;
[0071] - pedido de patente US n° de série 15/385.901, intitulado "STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COM- PRISING WINDOWS DEFINED THEREIN", publicação de pedido de patente US n° 2018-0168602;
[0072] - pedido de patente US n° de série 15/385.902, intitulado "SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER", publicação de pedido de patente US n° 2018-0168603;
[0073] - pedido de patente US n° de série 15/385.904, intitulado "STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/OR SPENT CARTRIDGE LOCKOUT", publicação de pedido de patente US n° 2018-0168605;
[0074] - pedido de patente US n° de série 15/385.905, intitulado "FIRING ASSEMBLY COMPRISING A LOCKOUT", publicação de pe- dido de patente US n° 2018-0168606;
[0075] - pedido de patente US n° de série 15/385.907, intitulado "SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EF- FECTOR LOCKOUT AND A FIRING ASSEMBLY LOCKOUT", publica- ção de pedido de patente US n° 2018-0168608;
[0076] - pedido de patente US n° de série 15/385.908, intitulado "FIRING ASSEMBLY COMPRISING A FUSE", publicação de pedido de patente US n° 2018-0168609;
[0077] - pedido de patente US n° de série 15/385.909, intitulado "FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE", publicação de pedido de patente US n° 2018-0168610;
[0078] - pedido de patente US n° de série 15/385.920, intitulado "STAPLE-FORMING POCKET ARRANGEMENTS", publicação de pe- dido de patente US n° 2018-0168620;
[0079] - pedido de patente US n° de série 15/385.913, intitulado "ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS", publicação de pedido de patente US n° 2018-0168614;
[0080] - pedido de patente US n° de série 15/385.914, intitulado "METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT
TYPES OF STAPLE CARTRIDGES WITH THE SAME SURGICAL STAPLING INSTRUMENT", publicação de pedido de patente US n°
2018-0168615;
[0081] - pedido de patente US n° de série 15/385.893, intitulado "BILATERALLY ASYMMETRIC STAPLE-FORMING POCKET PAIRS", publicação de pedido de patente US n° 2018-0168594;
[0082] - pedido de patente US n° de série 15/385.929, intitulado "CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS
FOR SURGICAL INSTRUMENTS WITH SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS", publicação de pedido de patente US n° 2018-0168626;
[0083] - pedido de patente US n° de série 15/385.911, intitulado "SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING AND FIRING SYSTEMS", publicação de pedido de patente US n° 2018-0168612;
[0084] - pedido de patente US n° de série 15/385.927, intitulado "SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES", publicação de pedido de patente US n° 2018- 0168625;
[0085] - pedido de patente US n° de série 15/385.917, intitulado "STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPING BREADTHS", publicação de pedido de patente US n° 2018-0168617;
[0086] - pedido de patente US n° de série 15/385.900, intitulado "STAPLE-FORMING POCKET ARRANGEMENTS COMPRISING PRIMARY SIDEWALLS AND POCKET SIDEWALLS", publicação de pedido de patente US n° 2018-0168601;
[0087] - pedido de patente US n° de série 15/385.931, intitulado "NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGE- MENTS FOR SURGICAL STAPLERS", publicação de pedido de pa- tente US n° 2018-0168627;
[0088] - pedido de patente US n° de série 15/385.915, intitulado
"FIRING MEMBER PIN ANGLE", publicação de pedido de patente US n° 2018-0168616;
[0089] - pedido de patente US n° de série 15/385.897, intitulado "STAPLE-FORMING POCKET ARRANGEMENTS COMPRISING ZO- NED FORMING SURFACE GROOVES", publicação de pedido de pa- tente US n° 2018-0168598;
[0090] - pedido de patente US n° de série 15/385.922, intitulado "SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES", publicação de pedido de patente US n° 2018-0168622;
[0091] - pedido de patente US n° de série 15/385.924, intitulado "SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PRO- CESSORS", publicação de pedido de patente US n° 2018-0168624;
[0092] - pedido de patente US n° de série 15/385.910, intitulado "ANVIL HAVING A KNIFE SLOT WIDTH", publicação de pedido de patente US n° 2018-0168611;
[0093] - pedido de patente US n° de série 15/385.903, intitulado "CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRU- MENTS", publicação de pedido de patente US n° 2018-0168604;
[0094] - pedido de patente US n° de série 15/385.906, intitulado "FIRING MEMBER PIN CONFIGURATIONS", publicação de pedido de patente US n° 2018-0168607;
[0095] - pedido de patente US n° de série 15/386.188, intitulado "STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STA- PLES", publicação de pedido de patente US n° 2018-0168585;
[0096] - pedido de patente US n° de série 15/386.192, intitulado "STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAP SETTING FEATURES", publicação de pedido de patente US n° 2018-0168643;
[0097] - pedido de patente US n° de série 15/386.206, intitulado "STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION
FEATURES", publicação de pedido de patente US n° 2018-0168586;
[0098] - pedido de patente US n° de série 15/386.226, intitulado "DURABILITY FEATURES FOR END EFFECTORS AND FIRING AS- SEMBLIES OF SURGICAL STAPLING INSTRUMENTS", publicação de pedido de patente US n° 2018-0168648;
[0099] - pedido de patente US n° de série 15/386.222, intitulado "SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITH POSITIVE OPENING FEATURES", publicação de pedido de pa- tente US n° 2018-0168647;
[00100] - pedido de patente US n° de série 15/386.236, intitulado "CONNECTION PORTIONS FOR DEPOSABLE LOADING UNITS FOR SURGICAL STAPLING INSTRUMENTS", publicação de pedido de patente US n° 2018-0168650;
[00101] - pedido de patente US n° de série 15/385.887, intitulado "METHOD FOR ATTACHING A SHAFT ASSEMBLY TO A SURGICAL INSTRUMENT AND, ALTERNATIVELY, TO A SURGICAL ROBOT", publicação de pedido de patente US n° 2018-0168589;
[00102] - pedido de patente US n° de série 15/385.889, intitulado "SHAFT ASSEMBLY COMPRISING A MANUALLY-OPERABLE RE-
TRACTION SYSTEM FOR USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM", publicação de pedido de patente US n° 2018-0168590;
[00103] - pedido de patente US n° de série 15/385.890, intitulado "SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE AND RETRACTABLE SYSTEMS", publicação de pedido de patente US n° 2018-0168591;
[00104] - pedido de patente US n° de série 15/385.891, intitulado "SHAFT ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO
ADAPT THE OUTPUT OF A ROTARY FIRING MEMBER TO TWO DIFFERENT SYSTEMS", publicação de pedido de patente US n°
2018-0168592;
[00105] - pedido de patente US n° de série 15/385.892, intitulado "SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATA-
BLE INTO AN ARTICULATION STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM", publicação de pedido de patente US n° 2018-0168593;
[00106] - pedido de patente US n° de série 15/385.894, intitulado "SHAFT ASSEMBLY COMPRISING A LOCKOUT", publicação de pe- dido de patente US n° 2018-0168595;
[00107] - pedido de patente US n° de série 15/385.895, intitulado "SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICU- LATION LOCKOUTS", publicação de pedido de patente US n° 2018- 0168596;
[00108] - pedido de patente US n° de série 15/385.916, intitulado "SURGICAL STAPLING SYSTEMS", publicação de pedido de patente US n° 2018-0168575;
[00109] - pedido de patente US n° de série 15/385.918, intitulado "SURGICAL STAPLING SYSTEMS", publicação de pedido de patente US n° 2018-0168618;
[00110] - pedido de patente US n° de série 15/385.919, intitulado "SURGICAL STAPLING SYSTEMS", publicação de pedido de patente US n° 2018-0168619;
[00111] - pedido de patente US n° de série 15/385.921, intitulado "SURGICAL STAPLE CARTRIDGE WITH MOVABLE CAMMING
MEMBER CONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES", publicação de pedido de patente US n° 2018- 0168621;
[00112] - pedido de patente US n° de série 15/385.923, intitulado "SURGICAL STAPLING SYSTEMS", publicação de pedido de patente US n° 2018-0168623;
[00113] - pedido de patente US n° de série 15/385.925, intitulado "JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING AD- VANCEMENT OF A FIRING MEMBER IN A SURGICAL END EFFEC-
TOR UNLESS AN UNFIRED CARTRIDGE IS INSTALLED IN THE END EFFECTOR", publicação de pedido de patente US n° 2018- 0168576;
[00114] - pedido de patente US n° de série 15/385.926, intitulado "AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYING CLOSURE MOTIONS TO JAWS OF SURGICAL INS- TRUMENTS", publicação de pedido de patente US n° 2018-0168577;
[00115] - pedido de patente US n° de série 15/385.928, intitulado "PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFA-
CE BETWEEN A MOVABLE JAW AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT", publicação de pedido de patente US n° 2018-0168578;
[00116] - pedido de patente US n° de série 15/385.930, intitulado "SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERA-
TING OPENING FEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS", publicação de pedido de patente US n° 2018- 0168579;
[00117] - pedido de patente US n° de série 15/385.932, intitulado "ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMME- TRIC SHAFT ARRANGEMENT", publicação de pedido de patente US n° 2018-0168628;
[00118] - pedido de patente US n° de série 15/385.933, intitulado "ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLE LINKAGE DISTAL OF AN ARTICULATION LOCK", publi- cação de pedido de patente US n° 2018-0168580;
[00119] - pedido de patente US n° de série 15/385.934, intitulado "ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END
EFFECTOR IN AN ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE SYSTEM", publicação de pedido de patente US n° 2018-0168581;
[00120] - pedido de patente US n° de série 15/385.935, intitulado "LATERALLY ACTUATABLE ARTICULATION LOCK ARRANGE- MENTS FOR LOCKING AN END EFFECTOR OF A SURGICAL INS- TRUMENT IN AN ARTICULATED CONFIGURATION", publicação de pedido de patente US n° 2018-0168582;
[00121] - pedido de patente US n° de série 15/385.936, intitulado "ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULA- TION STROKE AMPLIFICATION FEATURES", publicação de pedido de patente US n° 2018-0168583;
[00122] - pedido de patente US n° de série 14/318.996, intitulado "FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENT CONFIGURATIONS", publicação de pedido de patente US n° 2015-0297228;
[00123] - pedido de patente US n° de série 14/319.006, intitulado "FASTENER CARTRIDGE COMPRISING FASTENER CAVITIES IN- CLUDING FASTENER CONTROL FEATURES", agora patente US n°
10.010.324;
[00124] - pedido de patente US n° de série 14/318.991, intitulado "SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS", agora patente US n° 9.833.241;
[00125] - pedido de patente US n° de série 14/319.004, intitulado "SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITO- RING ARRANGEMENTS", agora patente US n° 9.844.369;
[00126] - pedido de patente US n° de série 14/319.008, intitulado "FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTE- NERS", publicação de pedido de patente US n° 2015-0297232;
[00127] - pedido de patente US n° de série 14/318.997, intitulado
"FASTENER CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGING MEMBERS", publicação de pedido de patente US n° 2015-0297229;
[00128] - pedido de patente US n° de série 14/319.002, intitulado "FASTENER CARTRIDGE COMPRISING TISSUE CONTROL FEA- TURES", agora patente US n° 9.877.721;
[00129] - pedido de patente US n° de série 14/319.013, intitulado "FASTENER CARTRIDGE ASSEMBLIES AND STAPLE RETAINER COVER ARRANGEMENTS", publicação de pedido de patente US n° 2015-0297233; e
[00130] - pedido de patente US n° de série 14/319.016, intitulado "FASTENER CARTRIDGE INCLUDING A LAYER ATTACHED THE- RETO", publicação de pedido de patente US n° 2015-0297235.
[00131] O requerente do presente pedido detém os seguintes pedi- dos de patente US que foram depositados em 24 de junho de 2016, e que estão, cada um, aqui incorporados a título de referência em suas respectivas totalidades:
[00132] - pedido de patente US n° de série 15/191.775, intitulado "STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAM- PED STAPLES";
[00133] - pedido de patente US n° de série 15/191.807, intitulado "STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAM- PED STAPLES";
[00134] - pedido de patente US n° de série 15/191.834, intitulado "STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SA- ME";
[00135] - pedido de patente US n° de série 15/191.788, intitulado "STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES"; e
[00136] - pedido de patente US n° de série 15/191.818, intitulado "STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL
[00137] O requerente do presente pedido detém os seguintes pedi- dos de patente US que foram depositados em 24 de junho de 2016, e que estão, cada um, aqui incorporados a título de referência em suas respectivas totalidades:
[00138] - pedido de patente de design US n° de série 29/569.218, intitulado "SURGICAL FASTENER";
[00139] - pedido de patente de desenho industrial US n° de série 29/569.227, intitulado "SURGICAL FASTENER";
[00140] - pedido de patente de desenho industrial US n° de série 29/569.259, intitulado "SURGICAL FASTENER CARTRIDGE"; e
[00141] - pedido de patente de desenho industrial US n° de série 29/569.264, intitulado "SURGICAL FASTENER CARTRIDGE".
[00142] O requerente do presente pedido detém os seguintes pedi- dos de patente que foram depositados em 1 de abril de 2016 e que estão, cada um, aqui incorporados a título de referência em suas res- pectivas totalidades:
[00143] - pedido de patente US n° de série 15/089.325, intitulado "METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM";
[00144] - pedido de patente US n° de série 15/089.321, intitulado "MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DIS- PLAY";
[00145] - pedido de patente US n° de série 15/089.326, intitulado "SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLU- DING A RE-ORIENTABLE DISPLAY FIELD";
[00146] - pedido de patente US n° de série 15/089.263, intitulado "SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFI- GURABLE GRIP PORTION";
[00147] - pedido de patente US n° de série 15/089.262, intitulado "ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY
[00148] - pedido de patente US n° de série 15/089.277, intitulado "SURGICAL CUTTING AND STAPLING END EFFECTOR WITH AN- VIL CONCENTRIC DRIVE MEMBER";
[00149] - pedido de patente US n° de série 15/089.296, intitulado "INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SUR-
[00150] - pedido de patente US n° de série 15/089.258, intitulado "SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION";
[00151] - pedido de patente US n° de série 15/089.278, intitulado "SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SE- LECTIVE CUTTING OF TISSUE";
[00152] - pedido de patente US n° de série 15/089.284, intitulado "SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT";
[00153] - pedido de patente US n° de série 15/089.295, intitulado "SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COM- PRESSION LOCKOUT";
[00154] - pedido de patente US n° de série 15/089.300, intitulado "SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT";
[00155] - pedido de patente US n° de série 15/089.196, intitulado "SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT";
[00156] - pedido de patente US n° de série 15/089.203, intitulado "SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACH- MENT LOCKOUT";
[00157] - pedido de patente US n° de série 15/089.210, intitulado
[00158] - pedido de patente US n° de série 15/089.324, intitulado "SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHA- NISM";
[00159] - pedido de patente US n° de série 15/089.335, intitulado "SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS";
[00160] - pedido de patente US n° de série 15/089.339, intitulado "SURGICAL STAPLING INSTRUMENT";
[00161] - pedido de patente US n° de série 15/089.253, intitulado "SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNU- LAR ROWS OF STAPLES HAVING DIFFERENT HEIGHTS";
[00162] - pedido de patente US n° de série 15/089.304, intitulado "SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FOR- MING POCKET";
[00163] - pedido de patente US n° de série 15/089.331, intitulado "ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS";
[00164] - pedido de patente US n° de série 15/089.336, intitulado "STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES";
[00165] - pedido de patente US n° de série 15/089.312, intitulado "CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TIS- SUE SUPPORT";
[00166] - pedido de patente US n° de série 15/089.309, intitulado "CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM"; e
[00167] - pedido de patente US n° de série 15/089.349, intitulado "CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL".
[00168] O requerente do presente pedido detém também os pedi- dos de patente US identificados abaixo, os quais foram depositados em 31 de dezembro de 2015, os quais estão, cada um, aqui incorpo- rados a título de referência em suas respectivas totalidades:
[00169] - pedido de patente US n° de série 14/984.488, intitulado "MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAI- LURE IN POWERED SURGICAL INSTRUMENTS";
[00170] - pedido de patente US n° de série 14/984.525, intitulado "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS"; e
[00171] - pedido de patente US n° de série 14/984.552, intitulado "SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MO- TOR CONTROL CIRCUITS".
[00172] O requerente do presente pedido detém também os pedi- dos de patente US identificados abaixo, os quais foram depositados em 9 de fevereiro de 2016, os quais estão, cada um, aqui incorporados a título de referência em suas respectivas totalidades:
[00173] - pedido de patente US n° de série 15/019.220, intitulado "SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLY TRANSLATABLE END EFFECTOR";
[00174] - pedido de patente US n° de série 15/019.228, intitulado "SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATION ARRANGEMENTS";
[00175] - pedido de patente US n° de série 15/019.196, intitulado "SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTED SECONDARY CONSTRAINT";
[00176] - pedido de patente US n° de série 15/019.206, intitulado "SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS
[00177] - pedido de patente US n° de série 15/019.215, intitulado "SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICU-
[00178] - pedido de patente US n° de série 15/019.227, intitulado "ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTI- CULATION LINK ARRANGEMENTS";
[00179] - pedido de patente US n° de série 15/019.235, intitulado "SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLE DRIVEN ARTICULATION SYSTEMS";
[00180] - pedido de patente US n° de série 15/019.230, intitulado "ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FI- RING BEAM ARRANGEMENTS"; e
[00181] - pedido de patente US n° de série 15/019.245, intitulado "SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTION ARRANGEMENTS".
[00182] O requerente do presente pedido detém também os pedi- dos de patente US identificados abaixo, os quais foram depositados em 12 de fevereiro de 2016, os quais estão, cada um, aqui incorpora- dos a título de referência em suas respectivas totalidades:
[00183] - pedido de patente US n° de série 15/043.254, intitulado "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS";
[00184] - pedido de patente US n° de série 15/043.259, intitulado "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS";
[00185] - pedido de patente US n° de série 15/043.275, intitulado "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS"; e
[00186] - pedido de patente US n° de série 15/043.289, intitulado "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS".
[00187] O requerente do presente pedido detém os seguintes pedi-
dos de patente que foram depositados em 18 de junho de 2015 e que estão, cada um, aqui incorporados a título de referência em suas res- pectivas totalidades:
[00188] - pedido de patente US n° de série 14/742.925, intitulado "SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING AR- RANGEMENTS";
[00189] - pedido de patente US n° de série 14/742.941, intitulado "SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSING FEATURES";
[00190] - pedido de patente US n° de série 14/742.914, intitulado "MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTI- CULATABLE SURGICAL INSTRUMENTS";
[00191] - pedido de patente US n° de série 14/742.900, intitulado "ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE
[00192] - pedido de patente US n° de série 14/742.885, intitulado "DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS"; e
[00193] - pedido de patente US n° de série 14/742.876, intitulado "PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATA- BLE SURGICAL INSTRUMENTS".
[00194] O requerente do presente pedido detém os seguintes pedi- dos de patente que foram depositados em 6 de março de 2015 e que estão, cada um, aqui incorporados a título de referência em suas res- pectivas totalidades:
[00195] - pedido de patente US n° de série 14/640.746, intitulado "POWERED SURGICAL STAPLER", agora publicação de pedido de patente US n° 2016/0256184;
[00196] - pedido de patente US n° de série 14/640.795, intitulado
"MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWERED SURGICAL INSTRUMENTS", agora publicação de pedido de patente US n° 2016/02561185;
[00197] - pedido de patente US n° de série 14/640.832, intitulado "ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATES FOR MULTIPLE TISSUE TYPES", agora publica- ção de pedido de patente US n° 2016/0256154;
[00198] - pedido de patente US n° 14/640.935, intitulado "OVER- LAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYS- TEM TO MEASURE TISSUE COMPRESSION", agora publicação de pedido de patente US n° 2016/0256071;
[00199] - pedido de patente US n° de série 14/640.831, intitulado "MONITORING SPEED CONTROL AND PRECISION INCREMEN- TING OF MOTOR FOR POWERED SURGICAL INSTRUMENTS", agora publicação de pedido de patente US n° 2016/0256153;
[00200] - pedido de patente US n° de série 14/640.859, intitulado "TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETER- MINE STABILITY, CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES", agora publicação de pedido de patente US n° 2016/0256187;
[00201] - pedido de patente US n° de série 14/640.817, intitulado "INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS", agora publicação de pedido de patente US n° 2016/0256186;
[00202] - pedido de patente US n° de série 14/640.844, intitulado "CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED
WITHIN MODULAR SHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE", agora publicação de pedido de patente US n° 2016/0256155;
[00203] - pedido de patente US n° de série 14/640.837, intitulado
"SMART SENSORS WITH LOCAL SIGNAL PROCESSING", agora publicação de pedido de patente US n° 2016/0256163;
[00204] - pedido de patente n° de série US 14/640.765, intitulado "SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGE INTO A SURGICAL STAPLER", agora publicação de pe- dido de patente US n° 2016/0256160;
[00205] - pedido de patente US n° 14/640.799, intitulado "SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A RO- TATABLE SHAFT", agora publicação de pedido de patente US n° 2016/0256162; e
[00206] - pedido de patente US n° de série 14/640.780, intitulado "SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING", agora publicação de pedido de patente US n° 2016/0256161.
[00207] O requerente do presente pedido detém os seguintes pedi- dos de patente que foram depositados em 27 de fevereiro de 2015 e que estão, cada um, aqui incorporados a título de referência em suas respectivas totalidades:
[00208] - pedido de patente n° de série US 14/633.576, intitulado "SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION", agora publicação de pedido de patente US n° 2016/0249919;
[00209] - pedido de patente US n° de série 14/633.546, intitulado "SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A
PERFORMANCE PARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND", agora publica- ção de pedido de patente US n° 2016/0249915;
[00210] - pedido de patente n° de série US 14/633.560, intitulado "SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CON- DITIONS ONE OR MORE BATTERIES", agora publicação de pedido de patente US n° 2016/0249910;
[00211] - pedido de patente US n° de série 14/633.566, intitulado "CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTI- ONS FOR CHARGING A BATTERY", agora publicação de pedido de patente US n° 2016/0249918;
[00212] - pedido de patente US n° de série 14/633.555, intitulado "SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRU- MENT NEEDS TO BE SERVICED", agora publicação de pedido de patente US n° 2016/0249916;
[00213] - patente US n° de série 14/633.542, intitulado "REINFOR- CED BATTERY FOR A SURGICAL INSTRUMENT", agora publicação de pedido de patente US n° 2016/0249908;
[00214] - pedido de patente US n° de série 14/633.548, intitulado "POWER ADAPTER FOR A SURGICAL INSTRUMENT", agora publi- cação de pedido de patente US n° 2016/0249909;
[00215] - pedido de patente US n° de série 14/633.526, intitulado "ADAPTABLE SURGICAL INSTRUMENT HANDLE", agora publicação de pedido de patente US n° 2016/0249945;
[00216] - pedido de patente US n° de série 14/633.541, intitulado "MODULAR STAPLING ASSEMBLY", agora publicação de pedido de patente US n° 2016/0249927; e
[00217] - pedido de patente US n° de série 14/633.562, intitulado "SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF- LIFE PARAMETER", agora publicação de pedido de patente US n° 2016/0249917.
[00218] O requerente do presente pedido detém os seguintes pedi- dos de patente que foram depositados em 18 de dezembro de 2014 e que estão, cada um, aqui incorporados a título de referência em suas respectivas totalidades:
[00219] - pedido de patente US n° de série 14/574.478, intitulado
"SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULA- TABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FI- RING STROKE OF A FIRING MEMBER", agora publicação de pedido de patente US n° 2016/0174977;
[00220] - pedido de patente US n° de série 14/574.483, intitulado "SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS", agora publicação de pedido de patente US n° 2016/0174969;
[00221] - pedido de patente US n° de série 14/575.139, intitulado "DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INS- TRUMENTS", agora publicação de pedido de patente US n° 2016/0174978;
[00222] - pedido de patente US n° de série 14/575.148, intitulado "LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEM- BLIES WITH ARTICULATABLE SURGICAL END EFFECTORS", ago- ra publicação de pedido de patente US n° 2016/0174976;
[00223] - pedido de patente US n° de série 14/575.130, intitulado "SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE", agora publicação de pedido de patente US n° 2016/0174972;
[00224] - pedido de patente US n° de série 14/575.143, intitulado SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRAN- GEMENTS, agora publicação de pedido de patente US n° 2016/0174983;
[00225] - pedido de patente US n° de série 14/575.117, intitulado SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFEC- TORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS, agora publicação de pedido de patente US n° 2016/0174975;
[00226] - pedido de patente US n° de série 14/575.154, intitulado
SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFEC- TORS AND IMPROVED FIRING BEAM SUPPORT ARRANGE- MENTS, agora publicação de pedido de patente US n° 2016/0174973;
[00227] - pedido de patente US 14/574.493, intitulado SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULA- TION SYSTEM, agora publicação de pedido de patente US n° 2016/0174970; e
[00228] - pedido de patente US n° de série 14/574.500, intitulado
SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION SYSTEM, agora publicação de pedido de patente US n° 2016/0174971.
[00229] O requerente do presente pedido detém os seguintes pedi- dos de patente que foram depositados em 1 de março de 2013 e que estão, cada um, aqui incorporados a título de referência em suas res- pectivas totalidades:
[00230] - 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;
[00231] - 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;
[00232] - pedido de patente US n° de série 13/782.338, intitulado "THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INS- TRUMENTS", agora publicação de pedido de patente US n° 2014/0249557;
[00233] - pedido de patente US n° de série 13/782.499, intitulado "ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAY ARRANGEMENT", agora patente US n° 9.358.003;
[00234] - pedido de patente US n° de série 13/782.460, intitulado "MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICAL INSTRUMENTS", agora publicação de pedido de patente US n° 2014/0246478;
[00235] - pedido de patente US n° de série 13/782.358, intitulado "JOYSTICK SWITCH ASSEMBLIES FOR SURGICAL INSTRU- MENTS", agora patente US n° 9.326.767;
[00236] - pedido de patente US n° de série 13/782.481, intitulado "SENSOR STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGH TROCAR", agora patente US n° 9.468.438;
[00237] - pedido de patente US n° de série 13/782.518, intitulado "CONTROL METHODS FOR SURGICAL INSTRUMENTS WITH RE- MOVABLE IMPLEMENT PORTIONS", agora publicação de pedido de patente US n° 2014/0246475;
[00238] - pedido de patente US n° de série 13/782.375, intitulado "ROTARY POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OF FREEDOM", agora patente US n° 9.398.911; e
[00239] - pedido de patente US n° de série 13/782.536, intitulado "SURGICAL INSTRUMENT SOFT STOP", agora patente US n°
9.307.986.
[00240] O requerente do presente pedido detém também os seguin- tes pedidos de patente que foram depositados em 14 de março de 2013 e que estão, cada um, aqui incorporados a título de referência em suas respectivas totalidades:
[00241] - pedido de patente US n° de série 13/803.097, intitulado "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FI- RING DRIVE", agora publicação de pedido de patente US n° 2014/0263542;
[00242] - pedido de patente US n° de série 13/803.193, intitulado "CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SUR-
GICAL INSTRUMENT", agora patente n° 9.332.987;
[00243] - pedido de patente US n° de série 13/803.053, intitulado "INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT", agora publicação de pedido de patente US n° 2014/0263564;
[00244] - pedido de patente US n° de série 13/803.086, intitulado "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN AR- TICULATION LOCK", agora publicação de pedido de patente US n° 2014/0263541;
[00245] - pedido de patente US n° de série 13/803.210, intitulado "SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYS- TEM FOR SURGICAL INSTRUMENTS", agora publicação de pedido de patente US n° 2014/0263538;
[00246] - pedido de patente US n° de série 13/803.148, intitulado "MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT", ago- ra publicação de pedido de patente US n° 2014/0263554;
[00247] - 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;
[00248] - pedido de patente US n° de série 13/803.117, intitulado "ROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS", agora patente US n° 9.351.726;
[00249] - pedido de patente US 13/803.130, intitulado "DRIVE
TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS", agora patente US n° 9.351.727; e
[00250] - pedido de patente US n° de série 13/803.159, intitulado "METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRU- MENT", agora publicação de pedido de patente US n° 2014/0277017.
[00251] O requerente do presente pedido também detém o seguinte pedido de patente que foi depositado em 7 de março de 2014 e está aqui incorporado a título de referência em sua totalidade:
[00252] - pedido de patente US n° de série 14/200.111, intitulado "CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS", agora pu- blicação de pedido de patente US n° 2014/0263539.
[00253] O requerente do presente pedido detém também os seguin- tes pedidos de patente que foram depositados em 26 de março de 2014 e que estão, cada um, aqui incorporados a título de referência em suas respectivas totalidades:
[00254] - pedido de patente US n° de série 14/226.106, intitulado "POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS", agora publicação de pedido de patente US n° 2015/0272582;
[00255] - pedido de patente US n° de série 14/226.099, intitulado "STERILIZATION VERIFICATION CIRCUIT", agora publicação de pe- dido de patente US n° 2015/0272581;
[00256] - pedido de patente US n° de série 14/226.094, intitulado "VERIFICATION OF NUMBER OF BATTERY EXCHAN- GES/PROCEDURE COUNT", agora publicação de pedido de patente US n° 2015/0272580;
[00257] - pedido de patente US n° de série 14/226.117, intitulado "POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEG- MENTED CIRCUIT AND WAKE UP CONTROL", agora publicação de pedido de patente US n° 2015/0272574;
[00258] - pedido de patente US n° de série 14/226.075, intitulado "MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHA- BLE SHAFT ASSEMBLIES", agora publicação de pedido de patente US n° 2015/0272579;
[00259] - pedido de patente US n° de série 14/226.093, intitulado "FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR
SURGICAL INSTRUMENTS", agora publicação de pedido de patente US n° 2015/0272569;
[00260] - pedido de patente US n° de série 14/226.116, intitulado "SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION", ago- ra publicação de pedido de patente US n° 2015/0272571;
[00261] - pedido de patente US n° de série 14/226.071, intitulado "SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR", agora publicação de pedido de patente US n° 2015/0272578;
[00262] - pedido de patente US n° de série 14/226.097, intitulado "SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS", agora publicação de pedido de patente US n° 2015/0272570;
[00263] - pedido de patente US n° de série 14/226.126, intitulado "INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRU- MENTS", agora publicação de pedido de patente US n° 2015/0272572;
[00264] - pedido de patente US n° de série 14/226.133, intitulado "MODULAR SURGICAL INSTRUMENT SYSTEM", agora publicação de pedido de patente US n° 2015/0272557;
[00265] - pedido de patente US n° de série 14/226.081, intitulado "SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT", agora publicação de pedido de patente US n° 2015/0277471;
[00266] - pedido de patente US n° de série 14/226.076, intitulado "POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION", agora publicação de pedido de patente US n° 2015/0280424;
[00267] - pedido de patente US n° de série 14/226.111, intitulado "SURGICAL STAPLING INSTRUMENT SYSTEM", agora publicação de pedido de patente US n° 2015/0272583; e
[00268] - pedido de patente US n° de série 14/226.125, intitulado
"SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT", agora publicação de pedido de patente US n° 2015/0280384.
[00269] O requerente do presente pedido detém também os seguin- tes pedidos de patente que foram depositados em 5 de setembro de 2014 e que estão, cada um, aqui incorporados a título de referência em suas respectivas totalidades:
[00270] - pedido de patente US n° de série 14/479.103, intitulado "CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE", agora publicação de pedido de patente US n° 2016/0066912;
[00271] - pedido de patente US n° de série 14/479.119, intitulado "ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION", agora publicação de pedido de patente US n° 2016/0066914;
[00272] - pedido de patente US n° de série 14/478.908, intitulado "MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION", agora publicação de pedido de patente US n° 2016/0066910;
[00273] - pedido de patente US n° de série 14/478.895, intitulado "MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION", agora publi- cação de pedido de patente US n° 2016/0066909;
[00274] - pedido de patente US n° de série 14/479.110, intitulado "POLARITY OF HALL MAGNET TO DETECT MISLOADED CAR- TRIDGE", agora publicação de pedido de patente US n° 2016/0066915;
[00275] - pedido de patente US n° de série 14/479.098, intitulado "SMART CARTRIDGE WAKE UP OPERATION AND DATA RETEN- TION", agora publicação de pedido de patente US n° 2016/0066911;
[00276] - pedido de patente US n° de série 14/479.115, intitulado "MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE",
agora publicação de pedido de patente US n° 2016/0066916; e
[00277] - pedido de patente US n° de série 14/479.108, intitulado "LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION", agora publicação de pedido de patente US n° 2016/0066913.
[00278] O requerente do presente pedido detém também os seguin- tes pedidos de patente que foram depositados em 9 de abril de 2014 e que estão, cada um, aqui incorporados a título de referência em suas respectivas totalidades:
[00279] - pedido de patente US n° de série 14/248.590, intitulado "MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS", agora publicação de pedido de patente US n° 2014/0305987;
[00280] - 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 OU- TPUT", agora publicação de pedido de patente n° 2014/0305989;
[00281] - pedido de patente US n° de série 14/248.595, intitulado "SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING THE OPERATION OF THE SURGICAL INSTRU- MENT", agora publicação de pedido de patente US n° 2014/0305988;
[00282] - pedido de patente US n° de série 14/248.588, intitulado "POWERED LINEAR SURGICAL STAPLER", agora publicação de pe- dido de patente US n° 2014/0309666;
[00283] - pedido de patente US n° de série 14/248.591, intitulado "TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRU- MENT", agora publicação de pedido de patente US n° 2014/0305991;
[00284] - 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;
[00285] - pedido de patente US n° de série 14/248.587, intitulado "POWERED SURGICAL STAPLER", agora publicação de pedido de patente US n° 2014/0309665;
[00286] - pedido de patente US n° de série 14/248.586, intitulado "DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT", agora publicação de pedido de patente n° 2014/0305990; e
[00287] - pedido de patente US n° de série 14/248.607, intitulado "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS", agora publicação de pedi- do de patente US n° 2014/0305992.
[00288] O requerente do presente pedido detém também os seguin- tes pedidos de patente que foram depositados em 16 de abril de 2013 e que estão, cada um, aqui incorporados a título de referência em suas respectivas totalidades:
[00289] - pedido de patente provisório US n° de série 61/812.365, intitulado "SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR";
[00290] - pedido de patente provisório US n° de série 61/812.376, intitulado "LINEAR CUTTER WITH POWER";
[00291] - pedido de patente provisório US n° de série 61/812.382, intitulado "LINEAR CUTTER WITH MOTOR AND PISTOL GRIP";
[00292] - pedido de patente provisório US n° de série 61/812.385, intitulado "SURGICAL INSTRUMENT HANDLE WITH MULTIPLE AC- TUATION MOTORS AND MOTOR CONTROL"; e
[00293] - pedido de patente provisório US n° de série 61/812.372, intitulado "SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR".
[00294] Numerosos detalhes específicos são apresentados para fornecer um completo entendimento da estrutura, da função, da fabri- cação e do uso geral das modalidades descritas no relatório descritivo e ilustradas nos desenhos em anexo. Operações, componentes e ele- mentos bem conhecidos não foram descritos com detalhes de modo a não obscurecer as modalidades descritas no relatório descritivo. O lei- tor 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 descritos na pre- sente invenção podem ser representativos e ilustrativos. Podem ser feitas variações e alterações a isso, sem se desviar do escopo das rei- vindicações.
[00295] Os termos "compreende" (e qualquer forma de compreen- de, 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. Co- mo resultado, um sistema, dispositivo ou aparelho cirúrgico que "com- preende", "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 recursos, mas não é limitado a possuir somente aqueles um ou mais recursos.
[00296] Os termos "proximal" e "distal" são usados na presente in- venção com referência a um médico que manipula a porção de cabo do instrumento cirúrgico. O termo "proximal" se refere à porção mais próxima ao médico, e o termo "distal" se refere 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 cirúrgi- cos podem ser usados em muitas orientações e posições, e esses termos não se destinam a ser limitadores e/ou absolutos.
[00297] São fornecidos vários dispositivos e métodos exemplifica- dores para a realização de procedimentos cirúrgicos laparoscópicos e minimamente invasivos. Entretanto, o leitor entenderá prontamente que os vários métodos e dispositivos descritos na presente invenção podem ser usados em numerosos procedimentos e aplicações cirúrgi- cas, inclusive, por exemplo, procedimentos cirúrgicos abertos. Con- forme prossegue a presente Descrição Detalhada, o leitor entenderá ainda que os vários instrumentos aqui descritos podem ser inseridos em um corpo, de qualquer maneira, como através de um orifício natu- ral, através de uma incisão ou perfuração formada em tecido, etc. As porções funcionais ou porções do atuador de extremidade dos instru- mentos 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 podem ser avançados o atu- ador de extremidade e o eixo de acionamento alongado de um instru- mento cirúrgico.
[00298] O sistema de grampeamento cirúrgico pode compreender um eixo de acionamento e um atuador de extremidade que se estende a partir do eixo de acionamento. O atuador de extremidade compreen- de uma primeira garra e uma segunda garra. A primeira garra compre- ende um cartucho de grampos. O cartucho de grampos é inserível na, e removível da, primeira garra; entretanto, são previstas outras moda- lidades 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 os grampos eje- tados a partir do cartucho de grampos. A segunda garra é pivotante em relação à primeira garra ao redor de um eixo geométrico de fe- chamento; entretanto, são previstas outras modalidades 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 atua- dor de extremidade é giratório em torno de um eixo geométrico de arti- culação que se estende através da junta de articulação. Outras moda- lidades são previstas que não incluem uma junta de articulação.
[00299] O cartucho de grampos compreende um corpo do cartucho. O corpo do cartucho inclui uma extremidade proximal, uma extremida- de distal, e uma plataforma que se estende entre a extremidade pro- ximal e a extremidade distal. Em uso, o cartucho de grampos é posici- onado 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 do cartucho podem ser empregados no tecido. O corpo do cartucho inclui cavidades de grampo definidas no mesmo, sendo que os grampos são armazenados de modo removível nas ca- vidades de grampo. As cavidades de grampo são dispostas em seis fileiras longitudinais. Três fileiras de cavidades de grampo são posicio- nadas em um primeiro lado de uma fenda longitudinal e três fileiras de cavidades de grampos são posicionadas em um segundo lado da fen- da longitudinal. Outras disposições de cavidades de grampo e gram- pos podem ser possíveis.
[00300] Os grampos são sustentados por acionadores de grampos no corpo do cartucho. Os acionadores são móveis entre uma primeira posição, ou posição não disparada, e uma segunda posição, ou posi- ção disparada, para ejetar os grampos das cavidades de grampo. Os acionadores são retidos no corpo do cartucho por um retentor que se estende em torno do fundo do corpo do cartucho e inclui membros re- silientes configurados para prender o corpo do cartucho e reter o re- tentor no corpo do cartucho. Os acionadores são móveis entre suas posições não disparadas e suas posições disparadas por um desliza- dor. O deslizador é móvel entre uma posição proximal adjacente à ex- tremidade proximal e uma posição distal adjacente à extremidade dis- tal. O deslizador compreende uma pluralidade de superfícies inclina- das configuradas para deslizar sob os acionadores e levantar os acio- nadores, e os grampos sustentados no mesmo, em direção à bigorna.
[00301] Adicionalmente ao exposto acima, o deslizador é movido distalmente por um membro de disparo. O membro de disparo é confi- gurado para entrar em contato com o deslizador e empurrar o desliza- dor em direção à extremidade distal. A fenda longitudinal definida no corpo do 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 en- gata à segunda garra. Conforme o membro de disparo é avançado dis- talmente, o primeiro came e o segundo came podem controlar a dis- tância, ou vão de tecido, entre a plataforma do cartucho de grampos e a bigorna. O membro de disparo compreende, também, uma faca con- figurada 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.
[00302] A Figura 1 representa um instrumento cirúrgico de corte e fixação acionado por motor 10, que pode ou não ser reutilizado. Na modalidade ilustrada, o instrumento 10 inclui um compartimento 100 que compreende uma empunhadura 110 que está configurada para ser pega, manipulada e acionada pelo médico. No exemplo ilustrado, um conjunto de eixo de acionamento 1000 dedicado é operacional- mente acoplado à empunhadura 110. Em modalidades alternativas, entretanto, o conjunto de empunhadura está configurado para ser em- pregado com vários conjuntos de eixo de acionamento intercambiáveis diferentes, cada um dos quais tendo um atuador de extremidade cirúr- gico operacionalmente acoplado ao mesmo, que está configurado para executar uma ou mais tarefas ou tarefas ou procedimentos cirúrgicos. Por exemplo, os conjuntos de eixo de acionamento intercambiáveis aqui descritos podem ser usados com vários sistemas robóticos, ins- trumentos, componentes e métodos descritos no pedido de patente US n° de série 13/118.241, depositado em 27 de maio de 2011, agora pa- tente US n° 9.072.535, intitulada "SURGICAL STAPLING INSTRU- MENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGE- MENTS", que está aqui incorporada a título de referência em sua tota- lidade.
[00303] Conforme prossegue a presente Descrição Detalhada, será entendido que os vários aspectos do conjunto de eixo de acionamento 1000 aqui descritos podem também ser empregados eficazmente em conexão com sistemas cirúrgicos roboticamente controlados. Portanto, o termo "gabinete" pode também abranger um gabinete ou porção si- milar de um sistema robótico que abrigue ou, de outro modo, dê apoio operacional, ou que esteja de outro modo associado a pelo menos um sistema de acionamento que está configurado para gerar e aplicar ao menos um movimento de controle o qual poderia ser usado para atuar os conjuntos de eixo de acionamento intercambiáveis aqui descritos, e seus respectivos equivalentes. O termo "estrutura" pode referir-se a uma porção de um instrumento cirúrgico de mão. O termo "estrutura" também pode representar uma porção de um instrumento cirúrgico ro- boticamente controlado e/ou uma porção do sistema robótico que pode ser usada para controlar operacionalmente o instrumento cirúrgico. Além disso, vários componentes podem estar "alojados" ou contidos no gabinete, ou vários componentes podem estar "associados a" um gabinete. Nesses casos, os componentes podem não estar contidos com o gabinete ou ser diretamente suportados pelo gabinete.
[00304] A modalidade ilustrada é um instrumento endoscópico e, em geral, as modalidades do instrumento 10 aqui descrito são instru- mentos cirúrgicos endoscópicos de corte e fixação. Deve-se notar, en- tretanto, que de acordo com várias modalidades, o instrumento pode ser um instrumento cirúrgico não endoscópico de corte e fixação, por exemplo. Vários instrumentos cirúrgicos são descritos na patente US n° 7.845.537, intitulada "SURGICAL INSTRUMENT HAVING RECOR- DING CAPABILITIES"; na patente US n° 8.608.045, intitulada "PO-
WERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM"; e na patente US n°
9.050.083, intitulada "MOTORIZED SURGICAL INSTRUMENT", cujas descrições estão aqui incorporadas a título de referência em sua tota- lidade.
[00305] Com referência à Figura 2, no exemplo ilustrado, o conjunto de eixo de acionamento 1000 inclui um atuador de extremidade 1500 que está configurado para cortar e grampear tecidos. O atuador de ex- tremidade 1500 compreende uma primeira garra 1510 e uma segunda garra 1600 que é suportada de modo móvel na primeira garra 1510. A primeira garra compreende um canal alongado 1520 que está configu- rado para suportar operacionalmente um cartucho de grampos cirúrgi- cos 1540 em seu interior. A segunda garra 1600 compreende uma bi- gorna 1610 que inclui um corpo de bigorna alongado 1612 e uma por- ção de montagem de bigorna 1620. São contempladas disposições alternativas, porém, sendo que a primeira garra compreende uma bi- gorna e a segunda garra compreende um cartucho de grampos cirúr-
gicos ou um canal configurado para suportar um cartucho de grampos cirúrgicos. No exemplo ilustrado, o corpo de bigorna alongado 1612 inclui uma subsuperfície formadora de grampos 1614 sobre a mesma, que é adaptada para uma relação confrontante em relação ao cartucho de grampos cirúrgicos 1540. A bigorna 1610 é suportada de modo pi- votante, ou suportada de modo móvel, sobre o canal alongado 1520, por meio de um par de pinos giratórios da bigorna 1622 que são for- mados na porção de montagem da bigorna 1620. Cada pino giratório 1622 é recebido de modo pivotante em um correspondente apoio para pino giratório 1524 formado em uma porção de extremidade proximal do canal alongado 1520. Os pinos giratórios 1622 são retidos de modo pivotante dentro de seus respectivos apoios 1524 por meio de um re- tentor de bigorna 1530.
[00306] Ainda com referência à Figura 2, o conjunto de eixo de aci- onamento 1000 inclui um conjunto de coluna central 1200, que inclui um eixo de acionamento de coluna central 1210 que está configurado para, um, suportar de modo deslizante um conjunto do membro de disparo 1900 em seu interior e, dois, suportar de modo deslizante um conjunto de membro de fechamento 2000, o qual se estende em torno do conjunto de coluna central 1200. O conjunto de coluna central 1200 inclui adicionalmente escoras superior e inferior da coluna central 1220 e 1230 que são apoiadas por meio do eixo de acionamento de coluna central 1210. Como pode ser visto na Figura 2, uma extremidade distal 1212 de eixo de acionamento de coluna central 1210 termina em um recurso de montagem de patilha superior 1240 e em um recurso de montagem de patilha inferior 1250. O recurso de montagem de patilha superior 1240 é formado com uma fenda de patilha 1242 em seu inte- rior, que é adaptada para suportar de maneira montável, em seu inte- rior, a extremidade distal 1222 da escora superior da coluna central
1220. De modo similar, o recurso de montagem de patilha inferior 1250 é formado com uma fenda de patilha 1252 em seu interior, que é adap- tada para suportar de maneira montável, em seu interior, a extremida- de distal 1232 da escora inferior da coluna central 1230. A extremida- de distal 1222 da escora superior da coluna central 1220 inclui em seu interior um soquete de pivô 1224 que está adaptado para receber de modo giratório em seu interior um pino pivô 1532, que é formado em uma tampa de canal ou retentor de bigorna 1530. A extremidade distal 1232 da escora inferior da coluna central 1230 inclui um pino pivô infe- rior 1234 que está adaptado para ser recebido no interior de um orifício para pivô (não mostrado) formado na porção de extremidade proximal 1522 do canal alongado 1520. O pino pivô inferior 1234 é verticalmen- te alinhado com o soquete de pivô 1224 para definir um eixo geométri- co de articulação AA em redor do qual o atuador de extremidade cirúr- gico 1500 pode se articular em relação ao eixo de acionamento 1000. Consulte a Figura 3.
[00307] Na disposição ilustrada, o conjunto de membro de fecha- mento 2000 compreende um segmento de tubo de fechamento proxi- mal ou segmento de membro de fechamento 2010. O segmento de tubo de fechamento proximal 2010 está operacionalmente acoplado a um conjunto de luva de fechamento de pivô duplo 2020 que define uma junta de articulação 2105 em torno da qual o atuador de extremi- dade 1500 pode se articular em relação à porção restante do conjunto de eixo de acionamento 1000. Outros conjuntos de eixo de aciona- mento, contudo, podem não ser capazes de articulação. Como pode ser visto na Figura 2, em uma forma, o conjunto de luva de fechamen- to de pivô duplo 2020 compreende um segmento de tubo de fecha- mento intermediário 2030 que é fixado a uma extremidade distal 2012 do segmento de tubo de fechamento proximal 2010. Além disso, o conjunto de luva de fechamento de pivô duplo 2020 inclui um tubo de fechamento do atuador de extremidade ou tubo de fechamento distal
2040 que tem protuberâncias superior e inferior 2042, 2044 projetan- do-se distalmente. Um elo de pivô duplo superior 2060 inclui pinos pi- vôs distal e proximal que se projetam para cima, e que respectivamen- te engatam um orifício de pino distal superior na protuberância superi- or que se projeta proximalmente 2042 e um orifício de pino proximal superior em uma protuberância superior que se projeta distalmente 2032 no segmento de tubo de fechamento intermediário 2030. Um elo de pivô duplo inferior 2070 inclui pinos pivôs distal e proximal que se projetam para cima, e que respectivamente engatam um orifício de pi- no distal inferior na protuberância inferior que se projeta proximalmen- te 2044 e um orifício de pino proximal inferior na protuberância inferior que se projeta distalmente 2034. Consulte as Figuras 2 e 3.
[00308] Conforme será discutido com mais detalhes abaixo, a bi- gorna 1610 é movida de uma posição aberta para uma posição fecha- da mediante a translação do conjunto de membro de fechamento 2000 na direção distal ("DD"). A bigorna 1610 é aberta mediante a transla- ção proximal do conjunto de membro de fechamento 2000, que faz com que a luva de fechamento do atuador de extremidade 2020 intera- ja com a bigorna 1610 e a pivote para uma posição aberta. Com refe- rência às Figuras 4 e 5, em ao menos uma disposição, o membro de fechamento distal ou tubo de fechamento do atuador de extremidade 2040 usa dois recursos de abertura de garra positivos proximal e distal axialmente deslocados 2050 e 2052. Nas Figuras 4 e 5, o recurso de abertura de garra positivo proximal 2050 está situado no lado direito (conforme visto por um usuário do conjunto de ferramenta) do eixo ge- ométrico do eixo de acionamento SA. Os recursos de abertura de gar- ra positivos 2050, 2052 estão configurados para interagir com as cor- respondentes áreas em relevo (não mostradas) e porções com de- graus (não mostradas) que são formadas na porção de montagem de bigorna 1620, conforme descrito com mais detalhes no pedido de pa-
tente US n° de série 15/635.631, depositado em 28 de junho de 2017, intitulado "SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER", cuja descrição está aqui incorporada a título de referência em sua totalidade, bem como em outras referências aqui incorporadas. Podem também ser usadas outras disposições de aber- tura da garra.
[00309] No exemplo ilustrado, bem como em outras configurações de bigorna descritas em referências aqui incorporadas, a porção de montagem de bigorna 1620 tem uma ou mais superfícies de came 1624 formadas sobre a mesma. Conforme o tubo de fechamento do atuador de extremidade 2040 é movido distalmente, uma superfície de came formada em uma extremidade distal do tubo de fechamento do atuador de extremidade 2040 interage com as superfícies de came 1624 na porção de montagem de bigorna 1620 para acionar por came a bigorna 1610 até uma posição fechada.
[00310] Conforme foi também indicado acima, o conjunto de eixo de acionamento 1000 inclui adicionalmente um conjunto de membro de disparo 1900 que é suportado para deslocamento axial no interior do eixo de acionamento de coluna central 1210. O conjunto do membro de disparo 1900 inclui uma porção do eixo de acionamento de disparo intermediário 1910, que está configurada para fixação a uma porção cortante distal ou barra de corte 1930. A porção do eixo de acionamen- to de disparo intermediário 1910 pode incluir uma fenda longitudinal 1912 em sua extremidade distal, a qual pode estar configurada para receber uma aba 1932 na extremidade proximal da barra de corte dis- tal 1930. A fenda longitudinal 1932 e a aba da extremidade proximal 1932 podem ser dimensionadas e configuradas para permitir movi- mento relativo entre si, e podem compreender uma junta deslizante
1940. A junta deslizante 1940 pode permitir que a barra de corte 1930 se mova axialmente em relação à porção do eixo de acionamento de disparo intermediário 1910 para acomodar a articulação do atuador de extremidade 1500, por exemplo. A barra de corte 1930 inclui uma por- ção de faca 1950 que inclui uma lâmina ou gume cortante para tecido 1952 e inclui uma aba superior de engate da bigorna 1954 e abas infe- riores de engate do canal 1956. Várias configurações e operações do membro de disparo são descritas em várias outras referências que es- tão aqui incorporadas a título de referência.
[00311] No exemplo ilustrado, o atuador de extremidade cirúrgico 1500 é seletivamente articulável em torno do eixo geométrico de arti- culação AA por meio de um sistema de acionamento de articulação
2100. Em uma forma, o sistema de acionamento de articulação 2100 inclui um acionador de articulação proximal 2110 que é operacional- mente acoplado a um acionador de articulação intermediário 2120, que é acoplado de modo pivotante a um elo de articulação distal 2130. Como pode ser mais particularmente visto nas Figuras 4 e 5, uma pati- lha de fixação de deslocamento 2122 é formada em uma extremidade distal do acionador de articulação intermediário 2120. Um orifício de pivô 2123 é formado na patilha de fixação de deslocamento 2122 e está configurado para receber de modo pivotante em seu interior um pino de ligação proximal 2134 formado na extremidade proximal 2132 do elo de articulação distal 2130. Uma extremidade distal 2136 do elo de articulação 2120 inclui um orifício de pivô 2138 que está configura- do para receber de modo pivotante em seu interior um pino de canal 1526 que é formado na porção de extremidade proximal 1522 do canal alongado 1520. Dessa forma, o movimento axial do acionador de arti- culação intermediário 2120 aplicará, assim, movimentos de articulação ao canal alongado 1520 para fazer assim com que o atuador de ex- tremidade cirúrgico 1500 se articule ao redor do eixo geométrico de articulação AA em relação ao conjunto de coluna central 1200.
[00312] Agora com relação às Figuras 6 e 7, a empunhadura 110 compreende segmentos de gabinete da empunhadura 116, 118 que cooperam para formar uma porção de preensão de pistola 119 que pode ser empunhada e manipulada pelo médico. Conforme será discu- tido com mais detalhes abaixo, a empunhadura 110 suporta operacio- nalmente em seu interior uma pluralidade de sistemas de acionamento que são configurados para gerar e aplicar vários movimentos de con- trole ao conjunto de eixo de acionamento 1200. Agora com referência à Figura 2, a empunhadura 110 pode adicionalmente incluir um con- junto de estrutura ou chassis 200 que suporta operacionalmente uma pluralidade de sistemas de acionamento. Por exemplo, o conjunto de estrutura 200 pode suportar operacionalmente um "primeiro" sistema, ou sistema de acionamento de fechamento, genericamente designado como 300, o qual pode ser empregado para aplicar movimentos de fechamento e abertura ao atuador de extremidade 1500 do conjunto de eixo de acionamento 1000. No exemplo ilustrado, o conjunto de es- trutura 200 inclui uma porção direita da estrutura 210 e uma tampa da estrutura 212 que é fixada à mesma por recursos de encaixe por pres- são, patilhas, parafusos etc., a fim de definir em seu interior uma cavi- dade de elemento reciprocante 214. Consulte as Figuras 6 e 7.
[00313] Em ao menos uma forma, o sistema de acionamento de fechamento 300 pode incluir um atuador sob a forma de um gatilho de fechamento 332 que é suportado de modo pivotante pelo conjunto de estrutura 200. Mais especificamente, conforme ilustrado nas Figuras 6 e 7, o gatilho de fechamento 332 é acoplado de modo pivotante ao conjunto de estrutura 200 por meio de um pino 333. Essa disposição permite que o gatilho de fechamento 332 seja manipulado por um mé- dico de modo que, quando o médico empunha a porção de preensão de pistola 119 da empunhadura 100, o gatilho de fechamento 332 pos- sa ser facilmente girado de uma posição inicial ou "não atuada" para uma posição "atuada" e, mais particularmente, para uma posição com-
pletamente comprimida ou completamente atuada. O gatilho de fe- chamento 332 pode ser propendido para a posição não atuada por meio de uma mola ou de outra disposição de propensão. Em várias formas, o sistema de acionamento de fechamento 300 inclui adicio- nalmente um conjunto de elos de fechamento 340, que é acoplado de modo pivotante ao gatilho de fechamento 1032. Como pode ser visto na Figura 6, o conjunto de elos de fechamento 340 pode incluir um primeiro elo de fechamento 342 e um segundo elo de fechamento 344, cada um dos quais é acoplado de modo pivotante ao gatilho de fe- chamento 332 por meio de um pino 335.
[00314] Ainda com referência à Figura 6, pode-se observar que o primeiro elo de fechamento 342 pode ter no mesmo uma parede ou extremidade de travamento 345, configurada para cooperar com um conjunto de liberação de fechamento 350 que é acoplado de modo pi- votante à porção direita da estrutura 210. Em ao menos uma forma, o conjunto de liberação de fechamento 350 pode compreender um con- junto de botão de liberação 352 que tem, formada sobre o mesmo, uma lingueta de travamento que se projeta distalmente 354. O conjun- to de botão de liberação 352 pode ser pivotado em sentido anti-horário por uma mola de liberação (não mostrada). Conforme o médico pres- siona o gatilho de fechamento 332 de sua posição não atuada em di- reção à porção da preensão de pistola 119 da empunhadura 100, o primeiro elo de fechamento 342 gira para cima, para um ponto em que a lingueta de travamento 354 cai em um engate de retenção com a parede de travamento 345 no primeiro elo de fechamento 344, impe- dindo assim que o gatilho de fechamento 332 retorne à posição não atuada. Desse modo, o conjunto de liberação de fechamento 350 ser- ve para travar o gatilho de fechamento 332 na posição completamente atuada. Quando o médico deseja destravar o gatilho de fechamento 332 para permitir que o mesmo seja propendido para a posição não atuada, o médico simplesmente gira o conjunto do botão de liberação de fechamento 352, de modo que a lingueta de travamento 354 seja movida para fora do engate com a parede de travamento 345 no pri- meiro elo de fechamento 344. Quando a lingueta de travamento 354 tiver sido movida para fora do engate com o primeiro elo de fechamen- to 344, o gatilho de fechamento 332 pode pivotar de volta à posição não atuada. Outras disposições para travamento e liberação do gatilho de fechamento também podem ser empregadas.
[00315] No exemplo ilustrado, um braço 355 se estende a partir do botão de liberação de fechamento 352. Um elemento magnético 356, como um magneto permanente, por exemplo, pode ser montado ao braço 355. Quando o botão de liberação de fechamento 352 é girado de sua primeira posição para sua segunda posição, o elemento mag- nético 356 pode se mover em direção a uma placa de circuito 400. A placa de circuito 400 pode incluir ao menos um sensor que é configu- rado para detectar o movimento do elemento magnético 356. Em ao menos uma modalidade, por exemplo, um sensor de efeito Hall (não mostrado) pode ser montado na superfície de fundo da placa de circui- to 400. O sensor de efeito Hall pode ser configurado para detectar alte- rações em um campo magnético que circunda o sensor de efeito Hall causadas pelo movimento do elemento magnético 356. O sensor de efeito Hall pode estar em comunicação de sinal com um microcontro- lador, por exemplo, que pode determinar se o botão de liberação de fechamento 352 está na sua primeira posição, que está associada com a posição não atuada do gatilho de fechamento 332 e a configuração aberta do atuador de extremidade, na sua segunda posição, que está associada com a posição atuada do gatilho de fechamento 332 e a configuração fechada do atuador de extremidade, e/ou em qualquer posição entre a primeira posição e a segunda posição.
[00316] Em ao menos uma forma, a empunhadura 100 e o conjunto de estrutura 200 suportam operacionalmente um outro sistema de aci- onamento aqui chamado de sistema de acionamento de disparo 500, que está configurado para aplicar movimentos de disparo ao conjunto do membro de disparo 1900 no conjunto de eixo de acionamento
1000. O sistema de acionamento de disparo 500 pode também ser aqui chamado de um "segundo sistema de acionamento". O sistema de acionamento de disparo 500 pode empregar um motor elétrico 502 que está localizado na porção de preensão da pistola 119 da empu- nhadura 100. Em várias formas, o motor 502 pode ser um motor de acionamento de corrente contínua com escovas, com uma rotação máxima de, aproximadamente, 25.000 RPM, por exemplo. Em outras disposições, o motor pode incluir um motor sem escovas, um motor sem fio, um motor síncrono, um motor de passo ou qualquer outro mo- tor elétrico adequado. O motor 502 pode ser alimentado por uma fonte de alimentação 510 que, em uma forma, pode compreender uma fonte de energia removível 512. Conforme pode ser visto na Figura 8, por exemplo, a fonte de energia removível 512 pode suportar uma plurali- dade de baterias 514 em seu interior. Cada uma das baterias 514 po- de compreender, por exemplo, uma bateria de íons de lítio ("LI") ou outra bateria adequada. A fonte de energia removível 512 é configura- da para fixação operável removível ao conjunto da placa de circuito 400, a qual é também operacionalmente acoplada ao motor 502. Vá- rias baterias 514 podem ser conectadas em série e podem ser usadas como fonte de energia para o instrumento cirúrgico 10. Além disso, a fonte de energia 510 pode ser substituível e/ou recarregável.
[00317] Conforme descrito acima em relação a outras várias for- mas, o motor elétrico 502 pode incluir um eixo de acionamento girató- rio 506, que faz interface operacional com um conjunto redutor de en- grenagem 520, que está montado em engate de acoplamento com um conjunto ou cremalheira, de dentes de acionamento em um membro de acionamento longitudinalmente móvel 530. Uma patilha de fixação 1916 é formada em uma extremidade proximal 1914 da porção do eixo de acionamento de disparo intermediário 1910. A patilha de fixação 1916 está configurada para ser recebida no interior de um apoio de fixação 536 que é formado em uma extremidade distal do membro de acionamento longitudinalmente móvel 530. Em uso, uma polaridade de tensão fornecida pela fonte de alimentação 510 pode operar o motor elétrico 502 no sentido horário, sendo que a polaridade de tensão apli- cada ao motor elétrico pela bateria pode ser revertida de modo a ope- rar o motor elétrico 502 em um sentido anti-horário. Quando o motor elétrico 502 é girado em uma direção, o membro de acionamento 530 será axialmente acionado na direção distal "DD". Quando o motor 502 for acionado na direção de giro oposta, o membro de acionamento 530 será axialmente acionado em uma direção proximal "DP". A empunha- dura 100 pode incluir uma chave, a qual pode estar configurada para reverter a polaridade aplicada ao motor elétrico 502 pela fonte de ali- mentação 510. Assim como com as outras formas aqui descritas, a empunhadura 100 pode também incluir um sensor que está configura- do para detectar a posição do membro de acionamento 530 e/ou a di- reção na qual o membro de acionamento 530 está sendo movido.
[00318] O acionamento do motor 502 pode ser controlado por um gatilho de disparo 540 que é suportado de modo pivotante no punho
100. O gatilho de disparo 540 pode ser pivotado entre uma posição não atuada e uma posição atuada. O gatilho de disparo 540 pode ser propendido para a posição não atuada por meio de uma mola 542 ou outra disposição de propensão, de modo que, quando o médico libera o gatilho de disparo 540, este pode ser pivotado ou, de outro modo, retornado à posição não atuada por meio da mola ou disposição de propensão. Em ao menos uma forma, o gatilho de disparo 540 pode estar posicionado "exteriormente" ao gatilho de fechamento 332, con-
forme foi discutido acima. Em ao menos uma forma, um botão de se- gurança do gatilho de disparo 550 pode ser montado de forma pivotan- te ao gatilho de fechamento 332. O botão de segurança 550 pode ser posicionado entre o gatilho de disparo 540 e o gatilho de fechamento 332, e ter um braço de pivô que se projeta a partir do mesmo. Quando o gatilho de fechamento 332 está na posição não atuada, o botão de segurança 550 está contido no 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 540, e uma posição de disparo na qual o gatilho de disparo 540 pode ser disparado. Quando o médico pressiona o gatilho de fechamento 332, o botão de segurança 550 e o gatilho de disparo 540 pivotam para baixo, para uma posição na qual eles podem, então, ser manipulados pelo médico.
[00319] Conforme indicado acima, em pelo menos uma forma, o membro de acionamento longitudinalmente móvel 530 tem uma cre- malheira de dentes formada no mesmo para o engate engrenado com a engrenagem de acionamento correspondente do conjunto redutor de engrenagem 520. Ao menos uma forma inclui também um conjunto de "retração" 560 manualmente atuável, que está configurado para possi- bilitar que o médico retraia manualmente o membro de acionamento longitudinalmente móvel 530, caso o motor 502 deixe de funcionar. Consulte a Figura 7. O conjunto de retração 560 pode incluir uma ala- vanca ou um conjunto de empunhadura de retração 562 que está con- figurado para ser manualmente pivotado para engate de catraca com os dentes 532, também dispostos no membro de acionamento 530. Dessa forma, o médico pode retrair manualmente o membro de acio- namento 530 usando o conjunto de empunhadura de retração 562 pa- ra engrenar o membro de acionamento 530 na direção proximal DP. O pedido de patente US n° de série 12/249.117, depositado em 10 de outubro de 2008, agora patente US n° 8.608.045, intitulada "POWE-
RED SURGICAL CUTTING AND STAPLING APPARATUS WITH MA- NUALLY RETRACTABLE FIRING SYSTEM", descreve disposições de retração e outros componentes, disposições e sistemas que podem também ser empregados com os vários instrumentos aqui descritos. A patente US n° 8.608.045, é por meio desta aqui incorporada a título referência em sua totalidade.
[00320] Um método de fixação do conjunto de eixo de acionamento 1000 à empunhadura será agora descrito com referência às Figuras 6 a 9. No exemplo ilustrado, o conjunto de eixo de acionamento 1000 inclui um conjunto de bocal 2200 que inclui um conjunto de bocal pro- ximal 2210 e um conjunto de bocal distal 2250. O conjunto de bocal proximal 2210 inclui um segmento de bocal proximal direito 2220 e um segmento de bocal proximal esquerdo 2230. Os segmentos de bocal proximal 2220, 2230 podem ser fixados uns aos outros por meio de patilhas de encaixe por pressão, parafusos, adesivo etc. O conjunto de bocal distal 2250 inclui um segmento de bocal distal direito 2260 e um segmento de bocal distal esquerdo 2270. O segmento de bocal distal direito 2260 e o segmento de bocal distal esquerdo 2270 são acopla- dos um ao outro por meio de recursos de encaixar por pressão, pati- lhas, parafusos, adesivo etc. O conjunto de bocal proximal 2210 e o conjunto de bocal distal 2250 podem ser fixados um ao outro por meio de adesivo, atrito, etc. O conjunto de bocal 2200 é assentado sobre o gabinete 100 para rotação seletiva em relação ao mesmo ao redor do eixo geométrico do eixo de acionamento SA. No exemplo ilustrado, o conjunto de bocal distal 2250 é dotado de um flange de montagem proximal estendendo-se para dentro 2252, que faz interface com um flange de montagem de estrutura 220 formado na porção de estrutura 210 do conjunto de estrutura 200. O conjunto de bocal proximal 2210 é formado com aletas 2212 para facilitar a rotação do conjunto de bocal 2200 ao redor do eixo geométrico do eixo de acionamento SA.
[00321] Na disposição ilustrada, o conjunto de eixo de acionamento 1000, incluindo o atuador de extremidade 1500 fixado ao mesmo, é giratório ao redor do eixo geométrico do eixo de acionamento SA me- diante a rotação do conjunto de bocal 2200 em relação à empunhadu- ra 100. Como pode ser visto na Figura 8, por exemplo, o conjunto de bocal distal 2250 inclui um flange de engate do eixo de acionamento 2254 que se estende para dentro através das aberturas de engate do bocal 2016 em uma porção de extremidade proximal 2014 do segmen- to de tubo de fechamento proximal 2010. Essa disposição permite que o conjunto de eixo de acionamento 1000 seja girado ao redor do eixo geométrico do eixo de acionamento SA, quando o médico gira o con- junto de bocal 2200. As aberturas de engate do bocal 2016 são di- mensionadas de modo a permitir o movimento axial do segmento de tubo de fechamento proximal 2010 em relação ao flange de engate do eixo de acionamento 2254. Ainda com referência à Figura 8, o conjun- to de bocal distal 2250 pode adicionalmente incluir uma porção de luva de suporte 2256 configurada para suportar de modo móvel em seu in- terior o segmento de tubo de fechamento proximal 2010. Além disso, como pode ser visto na Figura 9, cada uma dentre uma extremidade proximal 1226 da escora superior da coluna central 1220 e uma ex- tremidade proximal 1236 da escora inferior da coluna central 1230 é suportada em um mancal da coluna central 1260 que é suportado de modo giratório no conjunto de estrutura 200.
[00322] Agora com referência às Figuras 6, 8 e 9, a porção de ex- tremidade proximal 2014 do segmento de tubo de fechamento proxi- mal 2010 é suportada de modo móvel em um elemento reciprocante de fechamento 360 que está conectado ao segundo elo de fechamento 344 do conjunto de elos de fechamento 340 (Figura 6). O elemento reciprocante de fechamento 360 é suportado de maneira deslizante na cavidade de elemento reciprocante 214 no conjunto de estrutura 200.
A porção de extremidade proximal 2014 do segmento de tubo de fe- chamento proximal 2010 se estende através uma abertura de apoio em formato de U 362 no elemento reciprocante de fechamento 360 a ser suportado de maneira giratória em seu interior. Essa disposição permite que a porção de extremidade proximal 2014 do segmento de tubo de fechamento proximal 2010 gire em relação ao elemento reci- procante de fechamento 360 quando o conjunto de eixo de aciona- mento 1000 é girado em relação à empunhadura 100. Além disso, quando o médico pressiona o gatilho de fechamento 332, o elemento reciprocante de fechamento é movido na direção distal DD no interior da cavidade de elemento reciprocante 214, e também faz com que o conjunto de membro de fechamento 2000 na direção distal apliquem movimentos de fechamento ao atuador de extremidade 1500.
[00323] Como pode ser visto nas Figuras 8 e 9, uma primeira mola 370 é assentada na porção proximal 2014 do segmento de tubo de fechamento proximal 2010 entre a parede do apoio 362 do elemento reciprocante de fechamento 360 e uma parede de extremidade distal 219 formada na porção direita da estrutura 210 (primeiro espaço de mola 221). O comprimento axial do primeiro espaço de mola é deno- minado X1. A primeira mola 370 propende o elemento reciprocante de fechamento 360 proximalmente (seta DP) para a posição inicial, que corresponde a uma posição completamente aberta da bigorna. Consul- te a Figura 10. No exemplo ilustrado, um flange proximal 2018 é for- mado na porção de extremidade proximal 2014 do segmento de tubo de fechamento proximal 2010. O flange proximal 2018 está configura- do para deslocar-se de modo deslizante no interior de um fechamento ou segunda cavidade 364, que é formada no elemento reciprocante de fechamento 360, conforme mostrado. O comprimento axial da segunda cavidade ou do segundo espaço de mola 363 é denominado X2. Em ao menos uma disposição, por exemplo, X1 > X2. Uma segunda mola de fechamento ou membro de propensão 380 está situada no interior do segundo espaço de mola 363 para propender o flange proximal 2018 no segmento de tubo de fechamento proximal 2010 na direção distal DD contra a parede de apoio 362 do elemento reciprocante de fecha- mento 360.
[00324] Durante a preensão inicial do tecido-alvo entre a bigorna 1610 e o cartucho de grampos cirúrgicos 1540, o sistema de aciona- mento de fechamento 300 precisa aplicar uma quantidade suficiente de força de fechamento axial à bigorna 1610, a fim de pivotar a bigor- na 1610 para uma posição fechada e retê-la naquela posição ao longo de todo o processo de formação de grampo. O termo "procedimento de fechamento" em ao menos uma aplicação se refere ao processo de mover a bigorna de uma posição completamente aberta a uma posição fechada sobre o tecido-alvo e retendo a bigorna na posição fechada até que o processo de formação de grampo tenha sido totalmente concluído e a bigorna esteja pronta para ser reaberta para liberar o tecido-alvo do atuador de extremidade. A quantidade de força de fe- chamento necessária para fechar a bigorna e retê-la em uma posição fechada pode variar durante o processo de grampeamento devido à "fluência do tecido". Por exemplo, conforme a bigorna comprime o te- cido-alvo, o fluido no interior do tecido-alvo pinçado pode "fluir" ou mi- grar no interior do tecido e até mesmo fluir para tecidos não pinçados adjacentes. Adicionalmente, a fluência do tecido pode ser experimen- tada conforme a porção de faca 1950 é acionada através do tecido- alvo pinçado. Assim, a fluência do tecido pode também afetar a quan- tidade de força de disparo necessária para cortar o tecido-alvo e dispa- rar os grampos no interior do cartucho de grampos. Conforme a por- ção de faca 1950 se aproxima do fim de seu curso, a quantidade de força de disparo necessária pode ser reduzida, pois o fluido em deslo- camento completou a migração para o tecido não pinçado adjacente.
[00325] A Figura 10 ilustra o sistema de acionamento de fechamen- to 300 em uma orientação não atuada.
Como pode ser visto na Figura 10, a primeira mola 370 propendeu o elemento reciprocante de fecha- mento 360 proximalmente na direção DP no interior da cavidade de elemento reciprocante 214 no conjunto de estrutura 200 até sua posi- ção mais proximal ou posição inicial.
Como um resultado do elemento reciprocante de fechamento 360 ser fixado ao gatilho de fechamento 332 pelo conjunto de elos de fechamento 340, o gatilho de fechamento 332 é pivotado para a posição inicial não atuada.
Quando o sistema de acionamento de fechamento 300 está naquela posição não atuada, a bigorna 1610 está em uma posição completamente aberta.
Em ao me- nos um exemplo, a primeira mola 370 é "mais fraca" que a segunda mola 380. Dito de outro modo, a segunda mola 380 é mais rígida que a primeira mola 370. Ou seja, a constante de mola K1 da primeira mola 370 é menor que a constante de mola K2 da segunda mola 380. Por- tanto, K2 > K1. Em algumas disposições, por exemplo, K2 pode ser até dez vezes maior que K1. Em outras disposições, K2/K1 > 1. Em dispo- sições alternativas, K2 < K1. O médico inicia o processo de fechamento pressionando o gatilho de fechamento 332 em direção à empunhadura de pistola 119 do gabinete 100. Essa ação começa a mover o elemen- to reciprocante de fechamento 360 na direção distal DD, o que começa a comprimir a primeira mola 370. Conforme o elemento reciprocante de fechamento 360 começa a se mover distalmente, o elemento reci- procante de fechamento 360 também começa a mover distalmente o segmento de tubo de fechamento proximal 2010. Conforme o segmen- to de tubo de fechamento proximal 2010 se move distalmente, a totali- dade do conjunto de membro de fechamento 2000 (do qual faz parte o segmento de tubo de fechamento proximal 2010) se move distalmente para aplicar movimentos de fechamento à bigorna 1610. Conforme o médico continua a pivotar o gatilho de fechamento 332 em direção à preensão de pistola 119, o elemento reciprocante de fechamento 360 continua a se mover distalmente e a comprimir a primeira mola 370. Conforme a bigorna 1610 começa a se fechar, a quantidade de forças de fechamento necessária pode começar a aumentar, já que a bigorna 1610 começa a comprimir o tecido-alvo. Conforme o tecido-alvo come- ça a ser comprimido, o fluido contido em seu interior pode começar a fluir dentro do tecido-alvo, o que pode afetar diretamente a quantidade de forças de fechamento necessárias para fechar completamente a bigorna. Conforme aumenta a resistência ao fechamento, o conjunto de membros de fechamento 2000 pode mover-se na direção proximal DP contra a força de fechamento aplicada pela segunda mola 380 ao segmento de tubo de fechamento proximal 2010. A Figura 11 repre- senta o sistema de acionamento de fechamento 300 em uma posição completamente fechada que corresponde a uma posição completa- mente fechada da bigorna 1610. Desse modo, a quantidade final de força de fechamento aplicada à bigorna 1610 através do conjunto de membro de fechamento 2000 pode variar, devido à capacidade da se- gunda mola 380 para comprimir-se em resposta à resistência ao fe- chamento experimentada pela bigorna durante o procedimento de fe- chamento. Desse modo, a bigorna pode "fechar-se progressivamente", conforme experimenta alterações na quantidade de resistência criada pelo tecido-alvo. Isso pode também ser aqui mencionado como gera- ção de uma "força de fechamento progressiva".
[00326] Uma vez que as garras 1510, 1600 estejam fechadas sobre o tecido-alvo e travadas naquela posição, o médico pode então iniciar o processo de disparo mediante compressão do gatilho de disparo 540, o que faz com que a barra de corte 1910 conduza a porção de faca 1950 através do tecido-alvo pinçado. Conforme a porção de faca 1950 é acionada distalmente através do atuador de extremidade 1500, a lâmina de faca 152 corta através do tecido-alvo. Além disso, em ao menos uma disposição, a porção de faca 1950 engata e conduz dis- talmente um conjunto de came, às vezes chamado de deslizador em cunha 1970, que é suportado de modo deslizante no cartucho de grampos cirúrgicos 1540. Conforme o deslizador em cunha 1970 é acionado distalmente através do cartucho de grampos 1540, os cames formados no deslizador em cunha 1970 se engatam por came aos aci- onadores de grampo (não mostrados) que são suportados de modo móvel no interior do cartucho de grampos 1540. Cada acionador de grampo pode suportar sobre o mesmo um ou mais grampos cirúrgicos. Os acionadores de grampo são comumente apoiados em linhas dis- postas axialmente em cada lado de uma fenda alongada que é forma- da no cartucho de grampos. Conforme o deslizador em cunha 1570 entra em contato com os acionadores de grampo, estes são acionados para cima (em direção à bigorna fechada) 1610 conduzindo assim os um ou mais grampos apoiados sobre os mesmos através do tecido- alvo e até a formação de contato com a subsuperfície formadora de grampos 1614 do corpo da bigorna 1612. O deslizador em cunha 1570 está em posição distal à lâmina de faca para corte de tecido, portanto os grampos são implantados através do tecido-alvo, antes que o teci- do-alvo seja cortado.
[00327] Adicionalmente, conforme a porção de faca 1950 é aciona- da através do tecido-alvo, abas ou flanges formados na porção de faca se engatam à bigorna 1610, bem como ao canal alongado 1510, e re- tém a bigorna 1610 e o canal 1510 fechados e espaçados em uma disposição de espaçamento desejado durante o processo de grampe- amento. Embora esse avanço distal da porção de faca possa reduzir a quantidade de força de fechamento necessária a partir do sistema de fechamento, uma quantidade significativa de "forças de disparo" preci- sa ser gerada pelo sistema de disparo para empurrar a porção de faca 1950 através do tecido-alvo e para superar as forças de resistência e atrito do sistema, conforme o deslizador em cunha atua os acionado- res de grampo. Dessa forma, o sistema de disparo precisa ser capaz de gerar forças de disparo suficientes, e os componentes do sistema de disparo precisam ser suficientemente robustos para acomodar efi- cazmente essas forças, ao mesmo tempo em que também são flexí- veis o bastante para acomodar a articulação do atuador de extremida- de. Esses requisitos de design dos sistemas de fechamento e de dis- paro podem também ser exacerbados pelo tipo e composição do teci- do-alvo. Adicionalmente, os componentes desses sistemas precisam ser suficientemente pequenos para serem inseridos através das pe- quenas cânulas de trocarte.
[00328] A Figura 12 é uma comparação gráfica entre o instrumento cirúrgico 10, que emprega o sistema de acionamento de fechamento progressivo 300 descrito acima, e dois instrumentos cirúrgicos anterio- res A e B, que empregam diferentes disposições de acionamento de fechamento. O instrumento cirúrgico anterior A emprega um sistema de acionamento de fechamento que é diretamente conectado ao atua- dor de fechamento ou gatilho de fechamento. Embora o instrumento cirúrgico anterior A empregue uma mola para propender o sistema de fechamento até uma posição não atuada, o instrumento anterior A não emprega um segundo membro de propensão como o instrumento ci- rúrgico 10 descrito acima. Além disso, a bigorna do instrumento cirúr- gico A carece de uma superfície de atuação do came ou de superfícies como a bigorna 1610, descrita acima. Em vez disso, a bigorna no ins- trumento cirúrgico A tem uma borda dura que está disposta de modo a receber o contato do tubo ou membro de fechamento. Conforme o membro de fechamento entra em contato com aquela borda dura, a bigorna é pivotada para fechar-se.
[00329] Ainda com referência à Figura 12, o instrumento cirúrgico anterior B é similar em alguns aspectos ao instrumento cirúrgico ante-
rior A, pelo fato de que o instrumento cirúrgico B tem um primeiro membro de propensão para propender o sistema de fechamento até uma posição não atuada. Entretanto, o instrumento cirúrgico B não emprega um segundo membro de propensão, como o instrumento 10 descrito acima. A bigorna do instrumento cirúrgico B, entretanto, em- prega superfícies de atuação de came que são configuradas para re- ceberem o contato do membro de fechamento para pivotar a bigorna até uma posição fechada. A Figura 12 é um gráfico mostrando a quan- tidade de tempo para concluir o procedimento de fechamento versus a quantidade de forças de fechamento necessárias durante o procedi- mento para cada um dos três instrumentos cirúrgicos: instrumento ci- rúrgico 10, instrumento cirúrgico A e instrumento cirúrgico B. Como pode ser visto na Figura 12, a quantidade de forças de fechamento necessárias ao longo do procedimento de fechamento para o instru- mento cirúrgico 10 é menor que as forças de fechamento necessárias para os instrumentos cirúrgicos A e B. Embora as forças de fechamen- to necessárias ao instrumento cirúrgico B sejam menores que as for- ças de fechamento necessárias ao instrumento cirúrgico A, as forças de fechamento necessárias ao instrumento cirúrgico 10 são considera- velmente menores que as forças de fechamento necessárias tanto pa- ra A como para B ao longo do processo de fechamento.
[00330] As Figuras 13A e 13B comparam a força para disparar (FPD), a força para fechar (FPF) experimentada pelo instrumento ci- rúrgico 10 e pelo instrumento cirúrgico B (com as superfícies de atua- ção de came na bigorna) conforme o membro de disparo ou a faca se desloca através da bigorna, de uma posição inicial mais proximal até uma posição final mais distal na bigorna (distância da cruzeta). A Figu- ra 13A ilustra FPD, FPF e a altura da bigorna durante o procedimento de disparo para o instrumento cirúrgico B. A Figura 13B ilustra FPD, FPF, altura da bigorna e altura da mola do instrumento cirúrgico 10.
Como pode ser visto a partir da referência às Figuras 13A e 13B, a al- tura inicial da bigorna para o instrumento cirúrgico B foi de 0,0510 po- legadas e a altura inicial da bigorna para o instrumento cirúrgico 10 foi de 0,511 polegadas. O pico de força de fechamento FPF em libras pa- ra o instrumento cirúrgico B foi de 51,5 libras e para o instrumento ci- rúrgico 10 foi de 98,7 libras. O pico de FPD em libras para o instru- mento cirúrgico B foi de 48,9 libras e para o instrumento cirúrgico 10 foi de 36,4 libras. Assim, o instrumento cirúrgico 10 experimentou uma redução de 25,6 % na quantidade de forças de fechamento necessá- rias ao instrumento cirúrgico 10. Essa redução na quantidade de força de disparo necessária pode permitir que os componentes do sistema de disparo sejam fabricados a partir de disposições de componentes mais leves e/ou menores.
[00331] Conforme indicado acima, o instrumento cirúrgico 10 inclui um sistema de acionamento de articulação 2100 que está configurado para seletivamente articular o atuador de extremidade cirúrgico 1500 em relação ao conjunto de eixo de acionamento 1000 ao redor de um eixo geométrico de articulação AA, que é transversal ao eixo geométri- co do eixo de acionamento SA. Consulte a Figura 14. O sistema de acionamento de articulação 2100 inclui um conjunto acionador de arti- culação 2102 que compreende um acionador de articulação proximal 2110 que é acoplado a um acionador de articulação intermediário 2120 que é acoplado de modo pivotante a um elo de articulação distal 2130 que é fixado à extremidade proximal do canal alongado 1520. Consulte a Figura 2. Em um exemplo, o elo de articulação distal 2130 é fixado ao acionador de articulação intermediário 2120 em um lado do eixo geométrico do eixo de acionamento SA. O elo de articulação distal 2130 é fixado ao canal alongado 1520 no lado oposto do eixo geomé- trico do eixo de acionamento SA, de modo que o elo de articulação distal 2130 se estenda transversalmente ao longo do eixo geométrico do eixo de acionamento SA. No exemplo ilustrado, a articulação entre o acionador de articulação proximal 2110 e o acionador de articulação intermediário 2120 pode também funcionar como um conjunto de trava de articulação 2121, que serve para reter o atuador de extremidade cirúrgico 1500 em uma posição articulada após ser descontinuado o movimento de articulação aplicado ao acionador de articulação proxi- mal 2110. No exemplo ilustrado, uma extremidade distal 2112 do acio- nador de articulação proximal 2110 é rosqueada. A extremidade distal rosqueada 2112 do acionador de articulação proximal 2110 está em engate por rosca com um soquete rosqueado 2126 em uma extremi- dade proximal 2124 do acionador de articulação intermediário 2120. A rotação do acionador de articulação proximal 2110 em uma primeira direção de giro fará com que o acionador de articulação intermediário 2120 se mova axialmente em uma primeira direção, ou direção distal DD. O movimento do acionador de articulação intermediário 2120 na direção distal DD fará com que o atuador de extremidade cirúrgico 1500 pivote ao redor do eixo geométrico de articulação AA em uma primeira direção de articulação AD1. A rotação do acionador de articu- lação proximal em uma segunda direção de giro fará com que o acio- nador de articulação intermediário 2120 se mova em uma segunda di- reção, ou direção proximal DP. O movimento axial do acionador de articulação intermediário 2120 na direção proximal DP fará com que o atuador de extremidade cirúrgico 1500 pivote ao redor do eixo geomé- trico de articulação AA em uma segunda direção de articulação AD2.
[00332] No exemplo ilustrado, o gabinete 100 ou a empunhadura 110 define um eixo geométrico longitudinal LA. Consulte as Figuras 15 e 16. Conforme indicado acima, o conjunto de eixo de acionamento 1000 também define um eixo geométrico do eixo de acionamento SA. O eixo geométrico do eixo de acionamento SA e o eixo geométrico longitudinal LA podem ser coaxiais. O sistema de acionamento de arti-
culação longitudinal 2100 inclui um motor de articulação 2140 que está montado no interior de um conjunto de bocal distal 2250 para deslo- camento rotacional com o mesmo em uma órbita ao redor do eixo ge- ométrico longitudinal LA, quando o usuário gira o conjunto de bocal 2250 em relação ao gabinete 100. O conjunto de bocal distal 2250 po- de também ser mencionado aqui como um "conjunto de rotador do ei- xo de acionamento" que está configurado para acoplar de modo girató- rio o conjunto de eixo de acionamento 1000 ao gabinete 100. Em uma disposição, o motor de articulação 2140 inclui uma configuração de engrenagem que inclui uma engrenagem de saída do motor 2142. A engrenagem de saída do motor 2142 gira ao redor do eixo geométrico MA do motor, que é paralelo a e deslocado do eixo geométrico longi- tudinal LA.
Consulte a Figura 16. No exemplo ilustrado, a engrenagem de saída do motor 2142 está em engate engrenado com uma engre- nagem de chave de controle 2152 de um sistema de chaveamento do motor 2150. A engrenagem de chave de controle 2152 está em engate engrenado com uma engrenagem de acionamento de articulação pro- ximal 2118 que é formada em uma extremidade proximal 2116 do aci- onador de articulação proximal 2110. Assim, a rotação da engrenagem de saída do motor 2142 em uma direção resultará na rotação do acio- nador de articulação proximal 2110 na primeira direção, o que fará com que o acionador de articulação intermediário 2120 se mova na direção distal e faça com que o atuador de extremidade cirúrgico 1500 se articule na primeira direção de articulação AD1. De modo semelhan- te, a rotação do motor de articulação em uma direção de giro oposta fará com que o acionador de articulação proximal 2110 gire em uma segunda direção de giro e faça, assim, com que o acionador de articu- lação intermediário 2120 se mova na direção proximal DP.
O movi- mento do acionador de articulação intermediário 2120 na direção pro- ximal DP fará com que o atuador de extremidade cirúrgico 1500 se ar-
ticule na segunda direção de articulação AD2. Em várias modalidades, o motor de articulação 2140 e a configuração de engrenagem podem, por exemplo, ter menos que 12 mm de diâmetro e menos que 1,5 po- legadas de comprimento. O motor de articulação 2140 pode ter um design com escovas com menos de 1,5 watt de saída de potência. Em ao menos algumas modalidades, a saída de potência do motor 2140 é de aproximadamente 0,75 a 1,0 watt. A configuração de engrenagem pode ser apoiada pelo gabinete do motor, ou pode ser separada do gabinete do motor. Em ao menos um exemplo, a configuração de en- grenagem tem uma redução de 100:1, embora possam ser emprega- das configurações de engrenagem com razões de redução mais altas. Em disposições alternativas, podem ser empregadas outras configura- ções de motor.
[00333] No que diz respeito à trava de articulação 2121, as roscas na extremidade distal 2112 do acionador de articulação proximal 2110 podem, por exemplo, compreender um parafuso n° 2 com uma rosca fina (por exemplo, 64 fios/polegada) ou uma rosca grossa (menos que 64 fios/polegada) fornece vantagem mecânica suficiente para que o motor de articulação 2140 cause a articulação do atuador de extremi- dade cirúrgico 1500, ao mesmo tempo em que também funciona como uma trava para impedir o movimento do atuador de extremidade cirúr- gico 1500 após o motor de articulação 2140 ter sido desligado. Con- forme pode também ser visto na Figura 2, o acionador de articulação proximal 2110 pode ser dotado de uma porção de ombro de apoio 2119, que tem um diâmetro maior do que as porções adjacentes do acionador de articulação proximal 2110. O ombro maior 2119 faz uma interface deslizante com o eixo de acionamento da coluna central 1210 para suporte adicional quando na posição travada.
[00334] Ainda com referência às Figuras 16 a 19, o sistema de cha- veamento do motor 2150 inclui um cursor de chave 2170 que é ros-
queado em um parafuso acionador da chave 2160 que é fixado à en- grenagem de chave de controle 2152. A rotação da engrenagem de saída do motor 2142 fará girar a engrenagem de chave de controle 2152, o que por fim faz girar o parafuso acionador da chave 2160. A rotação do parafuso acionador da chave 2160 resulta no movimento axial do cursor de chave 2170 em relação a um gabinete da chave 2162 montado no conjunto de bocal distal 2250. O gabinete da chave 2162 suporta operacionalmente uma pluralidade de chaves limite que estão em comunicação com a placa de circuito de controle 400 que é suportada em ou, de outro modo, associada com o gabinete 100, con- forme será adicionalmente discutido abaixo.
Consulte a Figura 16. No exemplo ilustrado, são empregadas três chaves limite: uma chave limi- te central 2172, uma chave limite proximal 2174 e uma chave limite distal 2176. As chaves 2172, 2174, 2176 são conectadas por fio a uma série de trilhas de circuito ou condutores 2222, 2224, 2226, 2228 que estão montados no interior do conjunto de bocal proximal 2210. Con- sulte a Figura 20. As trilhas de circuito 2222, 2224, 2226 e 2228 são conectadas por fio ou eletricamente acopladas ao motor de articulação 2140 e às chaves 2172, 2174, 2176 por meio de fios ou de condutores de circuito flexíveis (não mostrados). Com referência às Figuras 21 e 22, um bloco de contato 410 é montado de maneira fixa no conjunto de estrutura 200 e inclui os contatos 412, 424, 416 e 418 que correspon- dem respectivamente às trilhas de circuito 2222, 2224, 2226 e 2228. Os contatos 412, 414, 416, 418 são conectados por fio à placa de cir- cuito de controle 400. Conforme o conjunto de bocal proximal 2210 é girado em relação ao gabinete 100 ao redor do eixo geométrico do ei- xo de acionamento SA, sinais de potência/controle podem ser forneci- dos entre a placa de circuito de controle 400 e o motor de articulação 2140 e as chaves 2172, 2174, 2176 através de um conjunto de junta deslizante 411, o qual compreende as trilhas de circuito 2222, 2224,
2226, 2228 e os contatos 412, 414, 416, 418 para facilitar a rotação do motor de articulação 2140 e do conjunto de chave de controle em rela- ção ao gabinete 100 ao redor do eixo geométrico do eixo de aciona- mento SA. As chaves de controle de articulação 2180 são montadas em cada lado do gabinete 100 e são usadas para controlar a rotação do motor de articulação 2140. Consulte a Figura 15. As chaves 2180 podem compreender chaves do tipo "gangorra" que, quando pressio- nadas em uma direção (seta 2182), o motor de articulação 2140 gira a engrenagem de saída do motor 2142 em uma direção de giro e, quan- do uma chave 2180 é pressionada em uma direção oposta (seta 2184) o motor de articulação gira a engrenagem de saída do motor 2142 em uma direção de giro oposta.
[00335] Agora com referência às Figuras 19 e 23 a 26, as posições de chaves 2172, 2174, 2176 em relação à trajetória do cursor de cha- ve 2170 servem para definir a faixa de articulação do atuador de ex- tremidade cirúrgico 1500. A chave 2172 compreende a chave central ou de posição inicial, que corresponde à posição não articulada do atuador de extremidade cirúrgico 1500. Quando naquela posição, um eixo geométrico central do atuador de extremidade EA está de modo geral alinhado ao eixo geométrico do eixo de acionamento SA. Quan- do nessa posição, por exemplo, o atuador de extremidade 1500 pode ser inserido ou removido através de uma cânula de trocarte. A chave 2174 corresponde a um limite de articulação de -60° à esquerda e a chave 2176 corresponde a um limite de articulação de +60° à direita. O limite de articulação de -60° à esquerda pode também ser chamado aqui de "primeira posição articulada máxima" do atuador de extremi- dade cirúrgico 1500 situado em um "primeiro lado", ou lado esquerdo, do eixo geométrico do eixo de acionamento SA. O ângulo de -60° à esquerda (LA na Figura 26) pode também ser chamado de "primeiro ângulo de articulação máximo" e compreende o ângulo entre o eixo geométrico do atuador de extremidade EA e o eixo geométrico do eixo de acionamento SA, quando o atuador de extremidade cirúrgico 1500 está na primeira posição articulada máxima. De modo similar, o limite de articulação de +60° à direita pode também ser chamado aqui de "segunda posição articulada máxima" do atuador de extremidade ci- rúrgico 1500 situado em um "segundo lado", ou lado direito, do eixo geométrico do eixo de acionamento SA. O ângulo de +60° à direita (RA na Figura 23) pode também ser chamado de "segundo ângulo de articulação máximo" e compreende o ângulo entre o eixo geométrico do atuador de extremidade EA e o eixo geométrico do eixo de aciona- mento SA, quando o atuador de extremidade cirúrgico 1500 está na segunda posição articulada máxima. Assim, no exemplo ilustrado, as posições de chaves 2174 e 2176 estabelecem as posições de articula- ção máximas para cada direção de articulação (esquerda e direita). Em disposições alternativas, apenas duas chaves (2174, 2176) podem ser empregadas. As chaves 2172, 2174, 2176 podem compreender chaves mecânicas, chaves de efeito Hall, etc.
[00336] Em ao menos um exemplo, a chave central de posição ini- cial 2172 pode também ser usada para desacelerar o motor de articu- lação 2140 antes de cruzar a posição inicial ou não articulada, a fim de permitir que o usuário determine mais facilmente quando o atuador de extremidade 1500 está alinhado ao conjunto de eixo de acionamento 1000 que facilitaria a remoção através de um trocarte, por exemplo.
[00337] Em um exemplo, o formato geométrico do cursor de chave na região que está configurada para engatar as chaves 2172, 2174, 2176 é selecionado para ter uma largura de modo que engate as cha- ves a "X" graus a partir da posição inicial, e seja capaz de permanecer em contato com a chave de =X graus a -X graus. Em ao menos um exemplo, X = aproximadamente 10 graus, mas X poderia ter outros valores, também. As Figuras 23 a 26 ilustram a relação entre o cursor de chave 2170 e as chaves 2172, 2174, 2176 e a posição articulada do atuador de extremidade cirúrgico 1500. Por exemplo, na Figura 25, quando o cursor de chave 2170 está naquela posição, o atuador de extremidade cirúrgico 1500 pode estar em uma primeira posição arti- culada no primeiro lado do eixo geométrico do eixo de acionamento SA, sendo que o eixo geométrico do atuador de extremidade cirúrgico EA está posicionado em um primeiro ângulo de articulação LA1 em re- lação ao eixo geométrico do eixo de acionamento SA. De modo seme- lhante, quando o cursor de chave 2170 está na posição ilustrada na Figura 24, por exemplo, o atuador de extremidade cirúrgico 1500 pode estar em uma segunda posição articulada situada em um segundo la- do do eixo geométrico do eixo de acionamento SA, sendo que o eixo geométrico do atuador de extremidade cirúrgico EA está posicionado em um segundo ângulo de articulação LA2 em relação ao eixo geomé- trico do eixo de acionamento SA. Em ao menos uma disposição, LA1 = LA2 = aproximadamente 10°, por exemplo.
[00338] A Figura 27 fornece formatos geométricos alternativos do cursor de chave 2170, quando visto a partir do lado livre do cursor de chave 2170, que está configurado para interagir com as chaves 2172, 2174, 2176. A Figura 28 é uma comparação gráfica de velocidades de motor (para cada formato geométrico 2170A, 2170B, 2170C) e ângulo de articulação. O cursor de chave 2170A é também representado nas Figuras 23 a 26. 2170C tem um ponto de atuador 21701C formado no mesmo para atuação mais precisa das chaves 2172, 2174, 2176. Co- mo pode ser visto na Figura 28, a velocidade do motor MS2C só cai quando o ponto de atuador 2171C está em contato de atuação com uma das chaves 2172, 2174, 2176, que corresponde aos ângulos de articulação de -60°, 0°, +60°. 2170A tem uma espessura em seção transversal CTA que resulta em uma primeira velocidade do motor MS1A para uma faixa de ângulos de articulação entre -10° e +10°. Para os ângulos de articulação de -10° a -60° e +10° a +60°, o motor de ar- ticulação 2140 pode funcionar a uma segunda velocidade de motor MS2A que é maior que MS1A. 2170B tem uma espessura em seção transversal CTB que é maior que a espessura em seção transversal CTA e resulta em uma primeira velocidade do motor MS1B para um ân- gulo de articulação na faixa entre -20° e +20°. Para ângulos de articu- lação entre -20° e -50° e +20° e +50°, o motor de articulação 2140 po- de funcionar a uma segunda velocidade do motor MS2B que é maior que MS1B. Para ângulos de articulação de -50 a -60 e +50 a +60 o mo- tor de articulação 2140 pode funcionar a uma terceira velocidade do motor MS3B. No exemplo ilustrado, MS3B = MS1B.
[00339] Em várias disposições, a placa de circuito de controle 400 pode incluir as chaves 420, 422, 424, 426 que definem os limites de articulação, bem como uma chave biestável ou de relé 428 que contro- la a posição central ou inicial do atuador de extremidade. Consulte a Figura 28A. Nessa disposição, conforme o motor de articulação 2140 conduz o atuador de extremidade até a posição reta ou inicial, a chave biestável ou de relé 428 poderia ser acionada, o que desativaria o mo- tor de articulação 2140. Liberar a chave de controle de articulação 2180 poderia ativar um relé de desvio que poderia desativar a chave central ou de posição inicial 2172 e pressionar a chave de controle 2180 novamente poderia permitir que a articulação continuasse atra- vés da posição inicial. Consulte a Figura 28A. Exemplos
[00340] Exemplo 1 - Um instrumento cirúrgico que compreende um gabinete que define um eixo geométrico longitudinal. Um conjunto de eixo de acionamento alongado é operacionalmente suportado por um conjunto de rotador do eixo de acionamento que é acoplado de modo giratório ao gabinete para possibilitar que o conjunto de eixo de acio- namento alongado seja seletivamente girado ao redor do eixo geomé-
trico longitudinal, em relação ao gabinete. O conjunto de eixo de acio- namento alongado compreende um primeiro atuador do eixo de acio- namento e um segundo atuador do eixo de acionamento. O instrumen- to cirúrgico compreende adicionalmente um primeiro motor que é su- portado pelo gabinete e está configurado para aplicar seletivamente os primeiros movimentos giratórios de atuação a um primeiro eixo de aci- onamento que é operacionalmente suportado pelo gabinete e faz inter- face operacional com o primeiro atuador do eixo de acionamento. O instrumento cirúrgico compreende adicionalmente um segundo motor que é suportado pelo conjunto de rotador do eixo de acionamento, de modo que o segundo motor é giratório ao redor do eixo geométrico longitudinal com o conjunto de rotador do eixo de acionamento em re- lação ao gabinete. O segundo motor está configurado para aplicar os segundos movimentos giratórios de atuação ao segundo atuador do eixo de acionamento.
[00341] Exemplo 2 - O instrumento cirúrgico do Exemplo 1, sendo que o gabinete compreende uma empunhadura.
[00342] Exemplo 3 - O instrumento cirúrgico dos Exemplos 1 ou 2, compreendendo adicionalmente um atuador de extremidade cirúrgico que está operacionalmente acoplado ao conjunto de eixo de aciona- mento alongado.
[00343] Exemplo 4 - O instrumento cirúrgico do Exemplo 3, sendo que o atuador de extremidade cirúrgico compreende uma primeira gar- ra que compreende um cartucho de grampos cirúrgicos que armazena operacionalmente em seu interior uma pluralidade de grampos cirúrgi- cos. Uma segunda garra é operacionalmente acoplada à primeira gar- ra, e é seletivamente móvel entre as posições aberta e fechada. A se- gunda garra compreende uma bigorna. Um membro de disparo está configurado para se mover axialmente de uma posição inicial a uma posição final no interior dos cartuchos de grampos cirúrgicos, a fim de acionar os grampos cirúrgicos armazenados em seu interior para que façam contato com a bigorna, em resposta aos primeiros movimentos de disparo recebidos do primeiro atuador do eixo de acionamento.
[00344] Exemplo 5 - O instrumento cirúrgico dos Exemplos 3 ou 4, sendo que o atuador de extremidade cirúrgico está acoplado de ma- neira móvel ao conjunto de eixo de acionamento alongado para articu- lação seletiva em relação ao mesmo ao redor de um eixo geométrico de articulação que é transversal a um eixo geométrico do eixo de acio- namento que é definido pelo conjunto de eixo de acionamento alonga- do.
[00345] Exemplo 6 - O instrumento cirúrgico do Exemplo 5, sendo que o dito segundo atuador do eixo de acionamento compreende um conjunto acionador de articulação que está configurado para receber os segundos movimentos giratórios de atuação do segundo motor e aplicar movimentos de articulação axial ao atuador de extremidade ci- rúrgico.
[00346] Exemplo 7 - O instrumento cirúrgico do Exemplo 6, sendo que o conjunto acionador de articulação compreende um eixo de acio- namento de articulação proximal que está configurado para receber os segundos movimentos giratórios de atuação do segundo motor, e um conjunto acionador de articulação distal que faz interface operacional com o eixo de acionamento de articulação proximal e o atuador de ex- tremidade cirúrgico, e está configurado para se mover axialmente em resposta à rotação do eixo de acionamento de articulação proximal.
[00347] Exemplo 8 - O instrumento cirúrgico do Exemplo 7, sendo que o conjunto acionador de articulação distal compreende um acio- nador de articulação intermediário que é suportado para deslocamento axial. O acionador de articulação intermediário está preso de forma rosqueável ao eixo de acionamento de articulação proximal, de modo que o acionador de articulação intermediário se mova axialmente em resposta à rotação do eixo de acionamento de articulação proximal. Um elo de articulação distal é fixado ao atuador de extremidade cirúr- gico e ao acionador de articulação intermediário.
[00348] Exemplo 9 - O instrumento cirúrgico dos Exemplos 1, 2, 3, 4, 5, 6, 7 ou 8, que compreende adicionalmente uma placa de circuito de controle suportada pelo gabinete e sendo que o segundo motor é eletricamente acoplado à placa de circuito de controle por meio de um conjunto de anel deslizante. O conjunto de anel deslizante compreen- de ao menos um contato elétrico que está fixado ao gabinete e está em comunicação elétrica com a placa de circuito de controle. Um membro condutivo é operacionalmente suportado no conjunto de rota- dor do eixo de acionamento, e está em constante contato giratório com um contato correspondente dentre os ao menos um dos contatos elé- tricos. O membro condutivo está em comunicação elétrica com o se- gundo motor.
[00349] Exemplo 10 - Um instrumento cirúrgico que compreende um gabinete que define um eixo geométrico longitudinal. O instrumen- to cirúrgico compreende adicionalmente um conjunto de eixo de acio- namento alongado que é operacionalmente suportado por um conjunto de rotador do eixo de acionamento que é acoplado de modo giratório ao gabinete para possibilitar que o conjunto de eixo de acionamento alongado seja seletivamente girado ao redor do eixo geométrico longi- tudinal, em relação ao gabinete. Um atuador de extremidade cirúrgico é acoplado de maneira móvel ao conjunto de eixo de acionamento alongado para articulação seletiva em relação ao mesmo ao redor de um eixo geométrico de articulação que é transversal a um eixo geomé- trico do eixo de acionamento que é definido pelo conjunto de eixo de acionamento alongado. Um primeiro motor é suportado de modo não móvel no gabinete e está configurado para aplicar seletivamente os primeiros movimentos giratórios de atuação a um primeiro eixo de aci-
onamento que é operacionalmente suportado no gabinete, e que faz interface operacional com um primeiro atuador do eixo de acionamento que é operacionalmente suportado no conjunto de eixo de acionamen- to alongado e faz interface com o atuador de extremidade cirúrgico. Um segundo motor é suportado no conjunto de rotador do eixo de aci- onamento, de modo que o segundo motor é giratório em uma órbita ao redor do eixo geométrico longitudinal com o conjunto de rotador do ei- xo de acionamento em relação ao gabinete, sendo que o segundo mo- tor está configurado para aplicar os segundos movimentos giratórios de atuação a um conjunto acionador de articulação operacionalmente acoplado ao atuador de extremidade cirúrgico, para aplicar movimen- tos de articulação ao mesmo em resposta aos segundos movimentos giratórios de atuação.
[00350] Exemplo 11 - O instrumento cirúrgico do Exemplo 10, que compreende adicionalmente meios para travar o atuador de extremi- dade cirúrgico em uma posição articulada após os segundos movimen- tos giratórios de atuação serem descontinuados.
[00351] Exemplo 12 - O instrumento cirúrgico do Exemplo 11, sen- do que os meios para travamento compreenderem uma conexão ros- queada entre uma primeira porção do conjunto acionador de articula- ção que está configurado para receber os segundos movimentos gira- tórios de atuação do segundo motor e uma segunda porção do conjun- to acionador de articulação que está operacionalmente acoplada ao atuador de extremidade cirúrgico.
[00352] Exemplo 13 - O instrumento cirúrgico do Exemplo 12, sen- do que a primeira porção do conjunto acionador de articulação com- preende um eixo de acionamento de articulação proximal giratório que está configurado para receber os segundos movimentos giratórios de atuação do segundo motor. Um acionador de articulação intermediário axialmente móvel está preso de forma rosqueável ao eixo de aciona-
mento de articulação proximal giratório, de modo que o acionador de articulação intermediário se mova axialmente em resposta à rotação do eixo de acionamento de articulação proximal. Um elo de articulação distal é fixado ao atuador de extremidade cirúrgico e ao acionador de articulação intermediário.
[00353] Exemplo 14 - O instrumento cirúrgico do Exemplo 13, sen- do que o elo de articulação distal é fixado ao acionador de articulação intermediário em um lado do eixo geométrico do eixo de acionamento e sendo que o elo de articulação distal é fixado ao atuador de extremi- dade cirúrgico em um outro lado do eixo geométrico do eixo de acio- namento.
[00354] Exemplo 15 - O instrumento cirúrgico dos Exemplos 10, 11, 12, 13 ou 14, que compreende adicionalmente uma placa de circuito de controle que é associada ao gabinete e sendo que o segundo motor está acoplado eletricamente à placa de circuito de controle por um conjunto de anel deslizante que está configurado para facilitar a comu- nicação elétrica entre a placa de circuito de controle e o segundo mo- tor ao mesmo tempo em que possibilita que o segundo motor seja se- letivamente girado em relação ao gabinete na órbita.
[00355] Exemplo 16 - O instrumento cirúrgico do Exemplo 15, sen- do que o conjunto de anel deslizante compreende ao menos um conta- to elétrico que está fixado ao gabinete e está em comunicação elétrica com a placa de circuito de controle. Um membro condutivo é operacio- nalmente suportado no conjunto de rotador do eixo de acionamento, em constante contato giratório com um contato correspondente dentre os contatos elétricos. O membro condutivo está em comunicação elé- trica com o segundo motor.
[00356] Exemplo 17 - Um instrumento cirúrgico que compreende uma empunhadura que define um eixo geométrico longitudinal. Um conjunto de eixo de acionamento alongado é operacionalmente supor-
tado por um conjunto de bocal que é acoplado de modo giratório ao gabinete para possibilitar que o conjunto de eixo de acionamento alon- gado seja seletivamente girado ao redor do eixo geométrico longitudi- nal, em relação à empunhadura. Um atuador de extremidade cirúrgico é acoplado de maneira móvel ao conjunto de eixo de acionamento alongado para articulação seletiva em relação ao mesmo ao redor de um eixo geométrico de articulação que é transversal a um eixo geomé- trico do eixo de acionamento que é definido pelo conjunto de eixo de acionamento alongado. Um primeiro motor é suportado de modo não móvel na empunhadura e está configurado para aplicar seletivamente os primeiros movimentos giratórios de atuação a um primeiro eixo de acionamento que é operacionalmente suportado na empunhadura, e que faz interface operacional com um primeiro atuador do eixo de aci- onamento que é operacionalmente suportado no conjunto de eixo de acionamento alongado e faz interface com o atuador de extremidade cirúrgico. Um segundo motor é suportado no conjunto de bocal, de modo que o segundo motor é giratório em uma órbita ao redor do eixo geométrico longitudinal com o conjunto de bocal em relação à empu- nhadura. O segundo motor está configurado para aplicar segundos movimentos giratórios de atuação a um conjunto acionador de articu- lação que é operacionalmente acoplado ao atuador de extremidade cirúrgico para aplicar movimentos de articulação ao mesmo, em res- posta aos segundos movimentos giratórios de atuação.
[00357] Exemplo 18 - O instrumento cirúrgico do Exemplo 17, sen- do que o atuador de extremidade cirúrgico compreende uma primeira garra que compreende um cartucho de grampos cirúrgicos que arma- zena operacionalmente em seu interior uma pluralidade de grampos cirúrgicos. Uma segunda garra é operacionalmente acoplada à primei- ra garra, e é seletivamente móvel entre as posições aberta e fechada. A segunda garra compreende uma bigorna. Um membro de disparo está configurado para se mover axialmente de uma posição inicial a uma posição final no interior dos cartuchos de grampos cirúrgicos, a fim de acionar os grampos cirúrgicos armazenados em seu interior pa- ra que façam contato com a bigorna, em resposta aos primeiros movi- mentos de disparo recebidos do primeiro atuador do eixo de aciona- mento.
[00358] Exemplo 19 - O instrumento cirúrgico dos exemplos 17 ou 18, sendo que o conjunto de eixo de acionamento alongado compre- ende adicionalmente um membro de fechamento axialmente móvel que está configurado para mover a bigorna de uma posição aberta pa- ra uma posição fechada, em resposta a um movimento de fechamento gerado pelo sistema de fechamento suportado pela empunhadura.
[00359] Exemplo 20 - O instrumento cirúrgico dos exemplos 17, 18 ou 19, que compreende adicionalmente meios para travar o atuador de extremidade cirúrgico em uma posição articulada ao ocorrer a descon- tinuação dos segundos movimentos giratórios de atuação.
[00360] Muitos dos sistemas de instrumento cirúrgico aqui descritos são acionados por um motor elétrico; entretanto, os sistemas de ins- trumento cirúrgico aqui descritos podem ser induzidos de qualquer maneira adequada. Em vários exemplos, os sistemas de instrumento cirúrgico aqui descritos podem ser induzidos, por exemplo, por um ga- tilho manualmente operado. Em certos casos, os motores descritos no presente documento podem compreender uma porção ou porções de um sistema roboticamente controlado. Além disso, qualquer um dos atuadores de extremidade e/ou conjuntos de ferramenta apresentados na presente invenção pode ser utilizado com um sistema de instru- mento cirúrgico robótico. O pedido de patente US n° de série 13/118.241, intitulado "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS", agora pa- tente US n° 9.072.535, por exemplo, descreve com mais detalhes vá-
rios exemplos de um sistema de instrumento cirúrgico robótico.
[00361] Os sistemas de instrumento cirúrgico aqui descritos foram descritos em conexão com a implantação e a deformação dos gram- pos; entretanto, as modalidades descritas na presente invenção não são limitadas dessa forma. Várias modalidades são previstas, as quais implantam prendedores além de grampos, como garras ou tachas, por exemplo. Além disso, várias modalidades são contempladas, as quais utilizam quaisquer meios adequados para vedar o tecido. Por exemplo, um atuador de extremidade, de acordo com várias modalidades, pode compreender eletrodos configurados para aquecer e vedar o tecido. Da mesma forma, por exemplo, um atuador de extremidade de acordo com certas modalidades, pode aplicar energia vibracional para vedar o tecido.
[00362] A totalidade das descrições de:
[00363] - patente US n° 5.403.312, intitulada "ELECTROSURGICAL HEMOSTATIC DEVICE", que foi concedida em 4 de abril de 1995;
[00364] - patente US n° 7.000.818, intitulada "SURGICAL STA-
PLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS", que foi concedida em 21 de fevereiro de 2006;
[00365] - patente US n° 7.422.139, intitulada "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTI- LE POSITION FEEDBACK", que foi concedida em 9 de setembro de 2008;
[00366] - patente US n° 7.464.849, intitulada "ELECTRO-
MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS", que foi concedida em 16 de dezembro de 2008;
[00367] - patente US n° 7.670.334, intitulada "SURGICAL INS- TRUMENT HAVING AN ARTICULATING END EFFECTOR", que foi concedida em 2 de março de 2010;
[00368] - patente US n° 7.753.245, intitulada "SURGICAL STA- PLING INSTRUMENTS", que foi concedida em 13 de julho de 2010;
[00369] - patente US n° 8.393.514, intitulada "SELECTIVELY ORI- ENTABLE IMPLANTABLE FASTENER CARTRIDGE", que foi conce- dida em 12 de março de 2013;
[00370] - pedido de patente US n° de série 11/343.803, intitulado "SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES", agora patente US n° 7.845.537;
[00371] - 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;
[00372] - pedido de patente US n° de série 12/031.873, intitulado "END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT", depositado em 15 de fevereiro de 2008, agora patente US n° 7.980.443;
[00373] - pedido de patente US n° de série 12/235.782, intitulado "MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT", agora pa- tente US n° 8.210.411;
[00374] - pedido de patente US n° de série 12/235.972, intitulado "MOTORIZED SURGICAL INSTRUMENT", agora patente US n°
9.050.083;
[00375] - pedido de patente US n° de série 12/249.117, intitulado "POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM", agora patente US n° 8.608.045;
[00376] - pedido de patente US n° de série 12/647.100, intitulado "MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELEC- TRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY", deposita- do em 24 de dezembro de 2009, agora patente US n° 8.220.688;
[00377] - pedido de patente US n° de série 12/893.461, intitulado
"STAPLE CARTRIDGE", depositado em 29 de setembro de 2012, ago- ra patente US n° 8.733.613;
[00378] - pedido de patente US n° de série 13/036.647, intitulado "SURGICAL STAPLING INSTRUMENT", depositado em 28 de feverei- ro de 2011, agora patente US n° 8.561.870;
[00379] - pedido de patente US n° de série 13/118.241, intitulado "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS", agora patente US n° 9.072.535;
[00380] - pedido de patente US n° de série 13/524.049, intitulado "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FI- RING DRIVE", depositado em 15 de junho de 2012, agora patente US n° 9.101.358;
[00381] - pedido de patente US n° de série 13/800.025, intitulado "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", depositado em 13 de março de 2013, agora patente US n° 9.345.481;
[00382] pedido de patente US n° de série 13/800.067, intitulado "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", depositado em 13 de março de 2013, agora publicação de pedido de patente US n° 2014/0263552;
[00383] - 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
[00384] - publicação de pedido de patente US n° 2010/0264194, intitulada "SURGICAL STAPLING INSTRUMENT WITH AN ARTICU- LATABLE END EFFECTOR", depositada em 22 de abril de 2010, ago- ra patente US n° 8.308.040, estão aqui incorporados por referência.
[00385] Embora vários dispositivos tenham sido aqui descritos em conexão com determinadas modalidades, modificações e variações dessas modalidades podem ser implementadas. Os recursos, estrutu-
ras ou características específicos podem ser combinados de qualquer maneira adequada em uma ou mais modalidades. Portanto, os recur- sos, as estruturas ou as características específicos ilustrados ou des- critos em conexão com uma modalidade podem ser combinados, no todo ou em parte, com os recursos, estruturas ou características de uma ou mais outras modalidades, sem limitação. Além disso, quando forem descritos materiais para determinados componentes, outros ma- teriais podem ser usados. Além disso, de acordo com várias modali- dades, um único componente pode ser substituído por múltiplos com- ponentes e múltiplos componentes podem ser substituídos por um úni- co componente, para executar uma ou mais funções determinadas. A descrição mencionada anteriormente e as reivindicações seguintes são destinadas a abranger todas essas modificações e variações.
[00386] Os dispositivos aqui descritos podem ser projetados para serem descartados após um único uso, ou podem ser projetados para serem usados múltiplas vezes. Em qualquer um dos casos, entretanto, um dispositivo pode ser recondicionado para reuso após ao menos um uso. O recondicionamento pode incluir qualquer combinação das eta- pas incluindo, mas não se limitando a, a desmontagem do dispositivo seguida de limpeza ou substituição de peças específicas do dispositivo e remontagem subsequente do dispositivo. Em particular, uma instala- ção de recondicionamento e/ou equipe cirúrgica pode desmontar um dispositivo e, após a limpeza e/ou substituição de partes particulares do dispositivo, o dispositivo pode ser remontado para uso subsequen- te. 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 dessas técnicas, bem como o dis- positivo recondicionado resultante, estão todos no escopo do presente pedido.
[00387] Os dispositivos descritos aqui podem ser processados an-
tes da cirurgia. Primeiro, um instrumento novo ou usado pode ser obti- do e, se necessário, limpo. O instrumento pode ser, então, esterilizado. Em uma técnica de esterilização, o instrumento é disposto em um re- cipiente fechado e vedado, como uma bolsa plástica ou de TYVEK. O recipiente e o instrumento podem, então, ser colocados em um campo de radiação que possa penetrar no recipiente, como radiação gama, raios X e/ou elétrons de alta energia. A radiação pode exterminar as bactérias no instrumento e no recipiente. O instrumento esterilizado pode, então, ser armazenado em um recipiente estéril. O recipiente vedado pode manter o instrumento estéril até que seja aberto na insta- lação médica. Um dispositivo pode também ser esterilizado com o uso de qualquer outra técnica conhecida, incluindo, mas não se limitando a, radiação beta, radiação gama, óxido de etileno, peróxido de plasma e/ou vapor d´água.
[00388] Embora esta invenção tenha sido descrita como tendo de- signs exemplificadores, a presente invenção pode ser adicionalmente modificada dentro do espírito e do escopo da descrição. Pretende-se, portanto, que este pedido cubra quaisquer variações, usos ou adapta- ções da invenção com o uso de seus princípios gerais.
Claims (20)
1. Instrumento cirúrgico, caracterizado pelo fato de que compreende: um gabinete definindo um eixo geométrico longitudinal; um conjunto de eixo de acionamento alongado operacio- nalmente suportado por um conjunto de rotador do eixo de acionamen- to que é acoplado de modo giratório ao dito gabinete para possibilitar que o dito conjunto de eixo de acionamento alongado seja seletiva- mente girado ao redor do dito eixo geométrico longitudinal, em relação ao dito gabinete, sendo que o dito conjunto de eixo de acionamento alongado compreende: um atuador do primeiro eixo de acionamento; e um atuador do segundo eixo de acionamento e sendo que o dito instrumento cirúrgico compreende adicionalmente: um primeiro motor suportado pelo dito gabinete e configu- rado para aplicar seletivamente os primeiros movimentos giratórios de atuação a um primeiro eixo de acionamento operacionalmente supor- tado pelo dito gabinete e em interface operacional com o dito primeiro atuador do eixo de acionamento; e um segundo motor suportado pelo dito conjunto de rotador do eixo de acionamento, de modo que o dito segundo motor seja gira- tório ao redor do dito eixo geométrico longitudinal com o dito conjunto de rotador do eixo de acionamento em relação ao dito gabinete, es- tando o dito segundo motor configurado para aplicar segundos movi- mentos giratórios de atuação ao dito segundo atuador do eixo de acio- namento.
2. Instrumento cirúrgico, de acordo com a reivindicação 1, caracterizado pelo fato de que o dito gabinete compreende uma em- punhadura.
3. Instrumento cirúrgico, de acordo com a reivindicação 1,
caracterizado pelo fato de que compreende adicionalmente um atua- dor de extremidade cirúrgico operacionalmente acoplado ao dito con- junto de eixo de acionamento alongado.
4. Instrumento cirúrgico, de acordo com a reivindicação 3, caracterizado pelo fato de que o dito atuador de extremidade cirúrgico compreende: uma primeira garra compreendendo um cartucho de gram- pos cirúrgicos armazenando operacionalmente uma pluralidade de grampos cirúrgicos em seu interior; uma segunda garra operacionalmente acoplada à dita pri- meira garra e sendo seletivamente móvel entre as posições aberta e fechada, sendo que a dita segunda garra compreende uma bigorna; e um membro de disparo configurado para se mover axial- mente de uma posição inicial a uma posição final no interior dos ditos cartuchos de grampos cirúrgicos, a fim de acionar os ditos grampos cirúrgicos armazenados em seu interior para que façam contato com a dita bigorna, em resposta aos primeiros movimentos de disparo rece- bidos do dito primeiro atuador do eixo de acionamento.
5. Instrumento cirúrgico, de acordo com a reivindicação 3, caracterizado pelo fato de que o dito atuador de extremidade cirúrgico está acoplado de maneira móvel ao dito conjunto de eixo de aciona- mento alongado para articulação seletiva em relação ao mesmo ao redor de um eixo geométrico de articulação que é transversal a um ei- xo geométrico do eixo de acionamento definido pelo dito conjunto de eixo de acionamento alongado.
6. Instrumento cirúrgico, de acordo com a reivindicação 5, caracterizado pelo fato de que o dito segundo atuador do eixo de acio- namento compreende um conjunto acionador de articulação configura- do para receber os ditos segundos movimentos giratórios de atuação do dito segundo motor e aplicar movimentos de articulação axial ao dito atuador de extremidade cirúrgico.
7. Instrumento cirúrgico, de acordo com a reivindicação 6, caracterizado pelo fato de que o dito conjunto acionador de articulação compreende: um eixo de acionamento de articulação proximal configura- do para receber os ditos segundos movimentos giratórios de atuação do dito segundo motor; e um conjunto acionador de articulação distal, em interface operacional, com um dito eixo de acionamento de articulação proximal e um dito atuador de extremidade cirúrgico, e que está configurado para se mover axialmente em resposta à rotação do dito eixo de acio- namento de articulação proximal.
8. Instrumento cirúrgico, de acordo com a reivindicação 7, caracterizado pelo fato de que o dito conjunto acionador de articulação distal compreende: um acionador de articulação intermediário suportado para deslocamento axial e preso de forma rosqueável ao dito eixo de acio- namento de articulação proximal, de modo que o dito acionador de ar- ticulação intermediário se mova axialmente em resposta à rotação do dito eixo de acionamento de articulação proximal; e um elo de articulação distal fixado ao dito atuador de ex- tremidade cirúrgico e ao dito acionador de articulação intermediário.
9. Instrumento cirúrgico, de acordo com a reivindicação 1, caracterizado pelo fato de que compreende adicionalmente uma placa de circuito de controle no dito gabinete, e sendo que o dito segundo motor está eletricamente acoplado à dita placa de circuito de controle por meio de um conjunto de anel deslizante que compreende: ao menos um contato elétrico fixado ao dito gabinete e em comunicação elétrica com a dita placa de circuito de controle; e um membro condutivo operacionalmente suportado no dito conjunto de rotador do eixo de acionamento em constante contato gi- ratório com um contato correspondente dentre os ditos ao menos um dos contatos elétricos, sendo que o dito membro condutivo está em comunicação elétrica com o dito segundo motor.
10. Instrumento cirúrgico, caracterizado pelo fato de que compreende: um gabinete definindo um eixo geométrico longitudinal; um conjunto de eixo de acionamento alongado operacio- nalmente suportado por um conjunto de rotador do eixo de acionamen- to que é acoplado de modo giratório ao dito gabinete para possibilitar que o dito conjunto de eixo de acionamento alongado seja seletiva- mente girado ao redor do dito eixo geométrico longitudinal, em relação ao dito gabinete; um atuador de extremidade cirúrgico acoplado de maneira móvel ao dito conjunto de eixo de acionamento alongado para articula- ção seletiva em relação ao mesmo ao redor de um eixo geométrico de articulação que é transversal a um eixo geométrico do eixo de aciona- mento definido pelo dito conjunto de eixo de acionamento alongado; um primeiro motor suportado de modo não móvel no dito gabinete e configurado para aplicar seletivamente os primeiros movi- mentos giratórios de atuação a um primeiro eixo de acionamento ope- racionalmente suportado no dito gabinete, e em interface operacional com um primeiro atuador do eixo de acionamento em interface com o dito atuador de extremidade cirúrgico; e um segundo motor suportado no dito conjunto de rotador do eixo de acionamento, de modo que o dito segundo motor é giratório em uma órbita ao redor do dito eixo geométrico longitudinal com o dito conjunto de rotador do eixo de acionamento em relação ao dito gabi- nete, sendo que o dito segundo motor está configurado para aplicar os segundos movimentos giratórios de atuação a um conjunto acionador de articulação operacionalmente acoplado ao dito atuador de extremi- dade cirúrgico, para aplicar movimentos de articulação ao mesmo em resposta aos ditos segundos movimentos giratórios de atuação.
11. Instrumento cirúrgico, de acordo com a reivindicação 10, caracterizado pelo fato de que compreende adicionalmente os meios para travar o dito atuador de extremidade cirúrgico em uma po- sição articulada após os ditos segundos movimentos giratórios de atu- ação serem descontinuados.
12. Instrumento cirúrgico, de acordo com a reivindicação 11, caracterizado pelo fato de que os ditos meios para travamento compreendem uma conexão rosqueada entre uma primeira porção do dito conjunto acionador de articulação que está configurado para rece- ber os ditos segundos movimentos giratórios de atuação do dito se- gundo motor e uma segunda porção do dito conjunto acionador de ar- ticulação operacionalmente acoplada ao dito atuador de extremidade cirúrgico.
13. Instrumento cirúrgico, de acordo com a reivindicação 12, caracterizado pelo fato de que a dita primeira porção do dito con- junto acionador de articulação compreende: um eixo de acionamento de articulação proximal giratório, configurado para receber os ditos segundos movimentos giratórios de atuação do dito segundo motor; um acionador de articulação intermediário axialmente móvel preso de forma rosqueável ao dito eixo de acionamento de articulação proximal giratório, de modo que o dito acionador de articulação inter- mediário se move axialmente em resposta à rotação do dito eixo de acionamento de articulação proximal; e um elo de articulação distal fixado ao dito atuador de ex- tremidade cirúrgico e ao dito acionador de articulação intermediário.
14. Instrumento cirúrgico, de acordo com a reivindicação
13, caracterizado pelo fato de que o dito elo de articulação distal é fi- xado ao dito acionador de articulação intermediário em um lado do dito eixo geométrico do eixo de acionamento, e sendo que o dito elo de articulação distal está fixado ao dito atuador de extremidade cirúrgico em um outro lado do dito eixo geométrico do eixo de acionamento.
15. Instrumento cirúrgico, de acordo com a reivindicação 11, caracterizado pelo fato de que compreende adicionalmente uma placa de circuito de controle associada ao dito gabinete, e sendo que o dito segundo motor é acoplado eletricamente à dita placa de circuito de controle por um conjunto de anel deslizante configurado para facili- tar a comunicação elétrica entre a dita placa de circuito de controle e o dito segundo motor, ao mesmo tempo em que possibilita que o dito segundo motor seja seletivamente girado em relação ao dito gabinete na dita órbita.
16. Instrumento cirúrgico, de acordo com a reivindicação 15, caracterizado pelo fato de que o dito conjunto de anel deslizante compreende: ao menos um contato elétrico fixado ao dito gabinete e em comunicação elétrica com a dita placa de circuito de controle; e um membro condutivo operacionalmente suportado no dito conjunto de rotador do eixo de acionamento em constante contato gi- ratório com um contato correspondente dentre os ditos ao menos um contato elétrico, sendo que o dito membro condutivo está em comuni- cação elétrica com o dito segundo motor.
17. Instrumento cirúrgico, caracterizado pelo fato de que compreende: uma empunhadura definindo um eixo geométrico longitudi- nal; um conjunto de eixo de acionamento alongado operacio- nalmente suportado por um conjunto de bocal que é acoplado de mo-
do giratório ao dito gabinete para possibilitar que o dito conjunto de eixo de acionamento alongado seja seletivamente girado ao redor do dito eixo geométrico longitudinal, em relação à dita empunhadura; um atuador de extremidade cirúrgico acoplado de maneira móvel ao dito conjunto de eixo de acionamento alongado para articula- ção seletiva em relação ao mesmo ao redor de um eixo geométrico de articulação que é transversal a um eixo geométrico do eixo de aciona- mento definido pelo dito conjunto de eixo de acionamento alongado; um primeiro motor suportado de modo não móvel na dita empunhadura e configurado para aplicar seletivamente os primeiros movimentos giratórios de atuação a um primeiro eixo de acionamento operacionalmente suportado na dita empunhadura, e em interface ope- racional com um primeiro atuador do eixo de acionamento operacio- nalmente suportado no dito conjunto de eixo de acionamento alongado e em interface com o dito atuador de extremidade cirúrgico; e um segundo motor suportado no dito conjunto de bocal de modo que o dito segundo motor é giratório em uma órbita ao redor do dito eixo geométrico longitudinal com o dito conjunto de bocal em rela- ção à dita empunhadura, sendo que o dito segundo motor está confi- gurado para aplicar segundos movimentos giratórios de atuação a um conjunto acionador de articulação operacionalmente acoplado ao dito atuador de extremidade cirúrgico, para aplicar movimentos de articula- ção ao mesmo em resposta aos ditos segundos movimentos giratórios de atuação.
18. Instrumento cirúrgico, de acordo com a reivindicação 17, caracterizado pelo fato de que o dito atuador de extremidade cirúr- gico compreende: uma primeira garra compreendendo um cartucho de gram- pos cirúrgicos armazenando operacionalmente uma pluralidade de grampos cirúrgicos em seu interior;
uma segunda garra operacionalmente acoplada à dita pri- meira garra e sendo seletivamente móvel entre as posições aberta e fechada, sendo que a dita segunda garra compreende uma bigorna; e um membro de disparo configurado para se mover axialmente de uma posição inicial a uma posição final no interior dos ditos cartuchos de grampos cirúrgicos, a fim de acionar os ditos grampos cirúrgicos ar- mazenados em seu interior para que façam contato com a dita bigor- na, em resposta aos primeiros movimentos de disparo recebidos do dito primeiro atuador do eixo de acionamento.
19. Instrumento cirúrgico, de acordo com a reivindicação 18, caracterizado pelo fato de que o dito conjunto de eixo de aciona- mento alongado compreende adicionalmente um membro de fecha- mento axialmente móvel, configurado para mover a dita bigorna de uma posição aberta para uma posição fechada, em resposta a um mo- vimento de fechamento gerado pelo sistema de fechamento suportado pela dita empunhadura.
20. Instrumento cirúrgico, de acordo com a reivindicação 19, caracterizado pelo fato de que compreende adicionalmente meios para travar o atuador de extremidade cirúrgico em uma posição articu- lada, ao ocorrer a descontinuação dos ditos segundos movimentos gi- ratórios de atuação.
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US16/105,119 US11253256B2 (en) | 2018-08-20 | 2018-08-20 | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
PCT/IB2019/056910 WO2020039316A1 (en) | 2018-08-20 | 2019-08-14 | Articulatable motor powered surgical instruments with dedicated articulation motor arrangements |
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BR112021002997A2 true BR112021002997A2 (pt) | 2021-05-11 |
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BR112021002997-4A BR112021002997A2 (pt) | 2018-08-20 | 2019-08-14 | instrumentos cirúrgicos articuláveis equipados com motor, com disposições de motor de articulação dedicadas |
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US (1) | US11253256B2 (pt) |
EP (1) | EP3613357A1 (pt) |
JP (2) | JP2021534866A (pt) |
CN (1) | CN112888378A (pt) |
BR (1) | BR112021002997A2 (pt) |
WO (1) | WO2020039316A1 (pt) |
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2018
- 2018-08-20 US US16/105,119 patent/US11253256B2/en active Active
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2019
- 2019-08-14 CN CN201980067245.7A patent/CN112888378A/zh active Pending
- 2019-08-14 WO PCT/IB2019/056910 patent/WO2020039316A1/en active Application Filing
- 2019-08-14 BR BR112021002997-4A patent/BR112021002997A2/pt unknown
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2023
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US11253256B2 (en) | 2022-02-22 |
EP3613357A1 (en) | 2020-02-26 |
US20200054330A1 (en) | 2020-02-20 |
CN112888378A (zh) | 2021-06-01 |
JP2021534866A (ja) | 2021-12-16 |
WO2020039316A1 (en) | 2020-02-27 |
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