CN104394783A

CN104394783A - Replaceable clip cartridge for a clip applier

Info

Publication number: CN104394783A
Application number: CN201380034195.5A
Authority: CN
Inventors: F·E·谢尔顿四世; C·O·巴克斯特三世
Original assignee: Ethicon Endo Surgery Inc
Current assignee: Ethicon Endo Surgery Inc
Priority date: 2012-06-28
Filing date: 2013-06-21
Publication date: 2015-03-04
Also published as: EP2866687A1; IN2014DN11033A; JP6266611B2; BR112014032731A2; RU2637625C2; JP2015521908A; RU2015102580A

Abstract

A surgical device (100) for clipping tissue can include a replaceable cartridge (130) comprising a stack of clips (140) contained therein and a firing drive configured to reciprocatingly eject, or deploy, the clips from the cartridge. The cartridge (130) and/or the surgical device (100) can include a firing chamber (149) wherein the clips (140) can be sequentially pushed into the firing chamber along a supply axis (138). The firing drive can include a firing member which is moved along a firing axis (139) to deploy a clip (140) positioned in the firing chamber (149) wherein the supply axis (138) is transverse to the firing axis.

Description

For the replaceable squeeze of applicator

Background technology

Multiple securing member can be utilized process, clamp, fastening, fixing and/or keep tissue.Then folder relative to the tissue positioned of operative site being arranged in patient, and can be out of shape such as apply clamping force to tissue.

Accompanying drawing explanation

Carry out the following explanation with reference to exemplary embodiment of the present invention in conjunction with the drawings, the features and advantages of the present invention and the method obtaining them thereof will become more obvious, and invention itself will be understood better, wherein:

Fig. 1 is the fragmentary, perspective view of applicator;

Fig. 2 is the sectional view of the end effector of the applicator of Fig. 1, and this end effector comprises removable squeeze, for sequentially advancing the reciprocating percussion driving device of folder, for receiving the receptor of folder and the crimping driving device for making folder be out of shape;

Fig. 3 is the partial sectional view of the applicator being in the Fig. 1 opening configuration;

Fig. 4 is the partial sectional view of the applicator of the Fig. 1 being in closed configuration;

Fig. 5 is the sectional view of the end effector of the Fig. 2 being in the condition of percussion;

Fig. 6 is the sectional view of the end effector of Fig. 2, and it illustrates the percussion driving device being in part percussion condition, folder is advanced in receptor by the firing member of wherein pulling the trigger driving device;

Fig. 7 is the sectional view of the end effector of Fig. 2, it illustrates and the percussion driving device crimping driving device and carry out engaging;

Fig. 8 is the sectional view of the end effector of Fig. 2, it illustrates the crimping driving device being at least part of percussion condition;

Fig. 9 is the sectional view of the end effector of Fig. 2, it illustrates the percussion driving device departed from from firing member;

Figure 10 is the sectional view of the end effector of Fig. 2, it illustrates and is in the crimping driving device that it pulls the trigger condition completely;

Figure 11 is the sectional view being in the percussion driving device of portion rebounds position of the end effector of Fig. 2, and wherein percussion driving device and firing member are re-engaged;

Figure 12 is the sectional view of the percussion driving device from the disengaging of crimping driving device of the end effector of Fig. 2;

Figure 13 is the perspective view of the folder shown in Fig. 2-12;

Figure 14 is the front view comprising the storehouse of multiple folder shown in Fig. 1-12, and wherein the part in storehouse is removed to illustrate the folder be kept in storehouse;

Figure 15 is the side view in the storehouse of Figure 14, and this storehouse shows for part is removed to illustrate the folder be kept in storehouse;

Figure 16 is the section plan in storehouse of the Figure 14 intercepted along the line 16-16 in Figure 15;

Figure 17 is the side view in alternative storehouse that can be combined with the applicator of Fig. 1-12 or any other suitable applicator, and wherein storehouse shows for part is removed biasing member to be shown and to be positioned at the biasing member push pedal middle with the folder be included in wherein;

Figure 18 is the side view in the storehouse according at least one alternative embodiment, and this storehouse shows for part is removed biasing member to be shown and to be positioned at the biasing member latch plate middle with the folder be included in wherein;

Figure 19 is the section plan in storehouse of the Figure 18 intercepted along the line 19-19 in Figure 18;

Figure 20 is the side view in other alternative storehouse that can be combined with the applicator of Fig. 1-12 or any other suitable applicator, wherein storehouse can comprise shell, it shows that this latch plate comprises the guiding piece that can cooperate with the guiding piece be limited in the shell of storehouse for part is removed latch plate is shown;

Figure 21 is the section plan in storehouse of the Figure 20 intercepted along the line 21-21 in Figure 20;

Figure 22 is the front view of the percussion driving device according at least one embodiment, and this percussion driving device comprises rotation input component, rotation output, the percussion nut engaged with rotation output and is in the Transmission Part of pulling the trigger configuration;

Figure 23 is the perspective view of the percussion driving device of Figure 22, it illustrates the percussion nut being in non-firing position;

Figure 24 is the perspective view of the percussion driving device of Figure 22, it illustrates along rotating the percussion nut that output advances and the cam extended from percussion nut;

Figure 25 is the perspective view of the percussion driving device of Figure 22, it illustrates the cam of the percussion nut engaged with the Transmission Part of pulling the trigger driving device and is in the Transmission Part of reverse configuration;

Figure 26 is the perspective view of the percussion driving device of Figure 22, and it illustrates the percussion nut being in advanced position and the second cam extended from percussion nut, this percussion nut engages with Transmission Part pulls the trigger configuration so that Transmission Part is moved to it from its reverse configuration;

Figure 27 is the perspective view of robotic surgical Instrument's system, and this system operable ground supports multiple surgical technique and tools that can use together with the applicator of Fig. 2-12 or any other suitable applicator;

Figure 28 be comprise actuator module, the perspective view of surgical technique and tools of the axle that extends from actuator module and replaceable end effector;

Figure 29 is the perspective view of the shank actuator that can use together with the applicator of Fig. 2-12 or any other suitable applicator;

Figure 30 is the sectional view of the actuated articulation joints shown in Fig. 2;

Figure 31 is the rear view of alternative actuator module, and this actuator module can be used for the actuator module of alternative Figure 28, being removed at least partially of its shell;

Figure 32 is the exploded view of a part for the actuator module of Figure 31;

Figure 33 is the part sectioned view of the actuator module of Figure 31; With

Figure 34 is the sectional view of the joint motions actuator of the actuator module of Figure 31.

Detailed description of the invention

The applicant of present patent application also has the following patent application submitted to same date with this patent, and these patent applications full content separately is all incorporated herein by reference:

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Flexible Drive Member " (attorney END7131USNP/120135).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Multi-FunctionalPowered Surgical Device with External Dissection Features " (attorney END7132USNP/120136).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Coupling Arrangementsfor Attaching Surgical End Effectors to Drive Systems Therefor " (attorney END7133USNP/120137).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Rotary ActuatableClosure Arrangement for Surgical End Effector " (attorney END7134USNP/120138).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Surgical End EffectorsHaving Angled Tissue-Contacting Surfaces " (attorney END7135USNP/120139).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Interchangeable EndEffector Coupling Arrangement " (attorney END7136USNP/120140).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Surgical End Effector Jawand Electrode Configurations " (attorney END7137USNP/120141).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Multi-Axis Articulatingand Rotating Surgical Tools " (attorney END7138USNP/120142).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Differential LockingArrangements for Rotary Powered Surgical Instruments " (attorney END7139USNP/120143).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Interchangeable ClipApplier " (attorney END7140USNP/120144).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Firing System LockoutArrangements for Surgical Instruments " (attorney END7141USNP/120145).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Rotary Drive ShaftAssemblies for Surgical Instruments with Articulatable End Effectors " (attorney END7142USNP/120146).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Rotary DriveArrangements for Surgical Instruments " (attorney END7143USNP/120147).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Robotically PoweredSurgical Device With Manually-Actuatable Reversing System " (attorney END7144USNP/120148).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Empty Clip CartridgeLockout " (attorney END7146USNP/120150).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Surgical InstrumentSystem Including Replaceable End Effectors " (attorney END7147USNP/120151).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Rotary Support JointAssemblies for Coupling a First Portion of a Surgical Instrument to a SecondPortion of a Surgical Instrument " (attorney END7148USNP/120152).

U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ _ _ _, name is called " Electrode Connections forRotary Driven Surgical Tools " (attorney END7149USNP/120153).

Applicant also has following patent application, and these patent applications are incorporated to its corresponding full text with way of reference separately:

U.S. Patent Application Serial Number 13/118,259, name is called " Surgical Instrument WithWireless Communication Between a Control Unit of a Robotic System andRemote Sensor ", U.S. Patent Application Publication 2011-0295270 A1;

U.S. Patent Application Serial Number 13/118,210, name is called " Robotically-ControlledDisposable Motor Driven Loading Unit ", U.S. Patent Application Publication 2011-0290855A1;

U.S. Patent Application Serial Number 13/118,194, name is called " Robotically-ControlledEndoscopic Accessory Channel ", U.S. Patent Application Publication 2011-0295242;

U.S. Patent Application Serial Number 13/118,253, name is called " Robotically-ControlledMotorized Surgical Instrument ", U.S. Patent Application Publication 2011-0295269 A1;

U.S. Patent Application Serial Number 13/118,278, name is called " Robotically-ControlledSurgical Stapling Devices That Produce Formed Staples Having DifferentLengths ", U.S. Patent Application Publication 2011-0290851 A1;

U.S. Patent Application Serial Number 13/118,190, name is called " Robotically-ControlledMotorized Cutting and Fastening Instrument ", U.S. Patent Application Publication 2011-0288573 A1;

U.S. Patent Application Serial Number 13/118,223, name is called " Robotically-Controlled ShaftBased Rotary Drive Systems For Surgical Instruments ", U.S. Patent Application Publication 2011-0290854 A1;

U.S. Patent Application Serial Number 13/118,263, name is called " Robotically-ControlledSurgical Instrument Having Recording Capabilities ", U.S. Patent Application Publication 2011-0295295 A1;

U.S. Patent Application Serial Number 13/118,272, name is called " Robotically-ControlledSurgical Instrument With Force Feedback Capabilities ", U.S. Patent Application Publication 2011-0290856 A1;

U.S. Patent Application Serial Number 13/118,246, name is called " Robotically-Driven SurgicalInstrument With E-Beam Driver ", U.S. Patent Application Publication 2011-0290853 A1; With

U.S. Patent Application Serial Number 13/118,241, name is called " Surgical Stapling InstrumentsWith Rotatable Staple Deployment Arrangements ".

Now some exemplary embodiment will be described, to understand the structure of apparatus and method disclosed herein, function, manufacture and purposes on the whole.One or more examples of these exemplary embodiments are shown in the drawings.Those of ordinary skill in the art will be understood that, specifically describes in this article and apparatus and method shown in the drawings are nonrestrictive exemplary embodiment, and the scope of various exemplary embodiment of the present invention is only defined by the claims.The feature of carrying out graphic extension or description in conjunction with an exemplary embodiment can combine with the feature of other exemplary embodiments.This type of modification and version are intended to comprise within the scope of the present invention.

The phrase " in various exemplary embodiments " used in entire description, " in some exemplary embodiments ", " in one embodiment " or " in an embodiment " etc. might not all refer to identical embodiment.In addition, in other exemplary embodiments one or more, the special characteristic of one or more exemplary embodiment, structure or characteristic can be combined in any suitable manner.This type of modification and version are intended to comprise within the scope of the present invention.

In various operating process, folder can be applied to the tissue of patient by surgeon or other clinicians, to realize various effect and/or therapeutic outcome.See Fig. 1, one or more folder such as can be applied to the tissue of the operative site being arranged in patient by surgical instruments (such as applicator 100).In general, referring now to Figure 13, applicator 100 can be constructed and arranged to relative to tissue positioned folder 140, so that the tissue in compression clip 140.Such as, as shown in Figures 3 and 4 and as hereafter described in more detail further, applicator 100 can make folder 140 be out of shape.Each folder 140 can comprise base portion 142 and the relative leg 144 extended from base portion 142.Base portion 142 and leg 144 can comprise any suitable shape, and can limit the configuration of such as basic U-shaped and/or the configuration of basic V-arrangement.Base portion 142 can comprise the angled portion 141 linked together by joint 143.In use, can the leg 144 of folder 140 be positioned on the opposite side of tissue, wherein can by leg 144 towards promoting each other with the tissue of compression set between leg 144.Joint 143 can allow base portion 142 angled portion 141 and from its extend leg 144 to internal strain.In all cases, when folder 140 is sufficiently compressed, folder 140 can flexing or plastic deformation, but may occur a certain amount of elastic deformation or resilience in shape deforming clip 140.

Referring now to Fig. 1 and 2, applicator 100 can comprise axle 110, end effector 120 and replaceable squeeze or box 130.See Figure 14-16, multiple folders 140 that squeeze 130 can comprise shell 132 and be positioned in shell 132.Shell 132 can limit apotheca 134, wherein can stacking folder 140.Apotheca 134 can comprise around or at least substantially around the sidewall that the periphery of folder 140 extends.Refer again to Figure 13, each folder 140 can comprise opposite face, such as press from both sides the end face 145 on the opposite side of 140 and bottom surface 146, wherein, when folder 140 is stacked in shell 132, the end face 145 of folder 140 can be located against the bottom surface 146 of contiguous folder 140, and wherein the bottom surface 146 of folder 140 can be located against the end face 145 of another contiguous folder 140.In all cases, the bottom surface 146 of folder 140 can face downwards and be limited to one or more bracing frame in shell 132 or platform 135, and press from both sides 140 end face 145 can upwards bracing frame 135 dorsad.In some cases, the end face 145 of folder 140 can be identical or at least substantially the same with bottom surface 146, and in other cases, end face 145 and bottom surface 146 can be different.Stacking of folder 140 shown in Figure 14-16 comprises such as five folders 140; But be susceptible to other embodiments, wherein folder 140 stacks and can comprise more than five folders 140 or be less than five folders 140.Under any circumstance, squeeze 130 also can comprise at least one biasing member, and the top be such as such as positioned in the stacking of shell 132 and folder 140 press from both sides the biasing members 136 of 140 centres.As described in greater detail below, biasing member 136 can be biased the bottom folder 140 in stacking of folder 140, or more particularly, against the bottom surface 146 of the bracing frame 135 biased bottom folder 140 be limited in shell 132.Biasing member 136 can comprise such as spring and/or any suitable compression elastic element, and it can apply bias force to folder 140 or at least apply bias force to top folder 140, and this bias force stacks downward transmission through folder 140.

When folder 140 is located against bracing frame 135 as mentioned above, folder 140 can be supported in firing position, and wherein pressing from both sides 140 can advance from storehouse 130 and penetrate.In all cases, bracing frame 135 can limit percussion room 149 at least partially, wherein folder 140 sequentially can be positioned in firing position.In some cases, percussion room 149 can be limited in storehouse 130 completely, or in other cases, percussion room 149 can be limited in axle 110 and storehouse 130 and/or between axle 110 and storehouse 130.Under any circumstance, as hereafter described in more detail further, applicator 100 can comprise percussion driving device, firing member can be advanced in storehouse 130 by it, and folder 140 is pushed to wherein double-layered quilt from it against the firing position that bracing frame 135 is located and is received in firing position in the end effector 120 of applicator 100.First see Figure 14-16, the shell 132 in storehouse 130 can comprise proximal open or window 133, it can be aimed at bracing frame 135 or at least substantial registration, makes firing member enter into storehouse 130 by proximal open 133 and folder 140 is distally released storehouse 130.In at least one this type of embodiment, shell 132 also can comprise distally or exhaust openings or window 137, it is also aimed at bracing frame 135, make folder 140 can along extending through such as proximal open 133, the percussion axis 139 of percussion room 149 and distal openings 137 distally advances or pulls the trigger.

To being described further above, in order to folder 140 is released storehouse 130, the firing member of percussion driving device can be advanced in storehouse shell 132, and in all cases, be advanced in percussion room 149.As hereafter open in more detail further, firing member can pass completely through storehouse 130, to be advanced to by folder 140 in its firing position in end effector 120.As above summarize, after distally advanced the folder 140 be positioned in percussion room 149 by firing member, firing member can fully bounce back, and makes biasing member 136 another can be pressed from both sides 140 and locates against bracing frame 135.In all cases, when firing member is positioned in shell 132, biasing member 136 can be biased folder 140 against firing member.This type of folder 140 can be called as queue folder.After firing member fully bounces back and skids off below queue folder 140, then biasing member 136 can be biased folder 140 against bracing frame 135, and wherein folder prepares the next stroke carrying out reciprocating firing member.First see Fig. 2 and 14-16, storehouse 130 such as can supply folder 140 along predetermined path (such as supplying axis 138) to percussion room 149.Supply axis 138 can transverse to percussion axis 139, and folder 140 is admitted in percussion room 149 through the direction in the direction of percussion room 149 to be different from wherein firing member.In at least one this type of embodiment, such as, supply axis 138 can perpendicular to or be at least substantially perpendicular to percussion axis 139.

Refer again to Fig. 2, axle 110 can comprise such as hole, storehouse or cartridge apertures 131, and its size and configuration can be designed to squeeze 130 to be received in wherein.The size in hole, storehouse 131 and configuration can be designed so that the shell 132 in storehouse 130 is closely received in hole, storehouse 131.The sidewall being used for limiting hole, storehouse 131 can limit or at least substantially limit the lateral movement of storehouse 130 relative to axle 110.Axle 110 and/or storehouse 130 also can comprise one or more locks that storehouse 130 can be remained on releasedly in hole, storehouse 131.As shown in Figure 2, at least one embodiment, along with supply axis 138 axis that is parallel or conllinear, storehouse 130 can be loaded in hole, storehouse 131.Equally as shown in Figure 2, axle 110 also can comprise the pad or seat 118 that extend from the sidewall 111 of axle 110, wherein pads in 118 shells 132 that can be received in storehouse 130 and/or engages.The size of pad 118 and configuration can be designed to closely be received in the groove 148 that is defined in the shell of storehouse, pad 118 can be limited or at least substantially limit the lateral movement of storehouse 130 relative to axle 110.Size and the configuration of pad 118 can be designed to make storehouse 130 aim in axle 110 and/or support storehouse shell 132.

Referring now to Fig. 5 and 6, once squeeze 130 has been located or has been seated in axis hole 131, then the percussion driving device 160 of actuatable applicator 100 is to have advanced folder 140 from squeeze 130, as mentioned above.The replaceable percussion nut 163 that percussion driving device 160 can comprise such as rotary drive input (such as drive screw 161) and operationally engage with drive screw 161.Drive screw 161 can comprise at least one and drive screw thread 162, and it can be threadably engaged with extending through the screwed hole of pulling the trigger nut 163.In various embodiments, applicator 100 also can comprise the electro-motor such as operationally connected with drive screw 161.In all cases, such as, drive screw 161 can with comprise hand-held apparatus or mechanical arm surgical instrument system motor being operable connect.Under any circumstance, can retrain the motion of the percussion nut 163 in axle 110, make when drive screw 161 is rotated around longitudinal axis 164 by motor, percussion nut 163 along the longitudinal axis 164 moves.Such as, when drive screw 161 is rotated along first direction by motor, percussion nut 163 can distally advance to end effector 120 by drive screw 161, as shown in Figure 6.When drive screw 161 is rotated relative to the direction of first direction by motor edge, drive screw 161 can make percussion nut 163 proximally bounce back away from end effector 120.Axle 110 can comprise can one or more bearings of rotatably support drive screw rod 161.Such as, bearing 159 can the distal end of rotatably support drive screw rod 161, such as, as illustrated in Figures 5 and 6.

Percussion driving device 160 also can comprise the firing member 165 extended from percussion nut 163, and this firing member 165 can distally advance with percussion nut 163 and proximally bounce back, as hereafter described in more detail further.Comparison diagram 5 and 6 time, reader will notice, percussion nut 163 and firing member 165 are advanced to the distally firing position shown in Fig. 6 from the non-firing position of the nearside shown in Fig. 5, and wherein folder 140 is advanced to end effector 120 from squeeze 130 by firing member 165.First see Fig. 5, squeeze 130 is shown as including multiple folders 140 stored therein, and wherein of pressing from both sides in 140 is positioned in firing position, as mentioned above.As illustrated in Figures 5 and 6, firing member 165 can comprise distal part 166, when distally advancing firing member 165 and percussion nut 163, this distal part 166 can be advanced in nail bin 130 along percussion axis 167 and engage the folder 140 be positioned in firing position.In some cases, firing member 165 can comprise linear structure, and in other cases, the distal end 166 of firing member 165 can such as upwards extend from firing member 165.To being described further above, folder 140 distally can be released squeeze 130 and enter into along percussion axis 167 and be defined in the reception cavity 122 of end effector 120 by firing member 165.

In all cases, firing member 165 can be attached to percussion nut 163 and distally extend from percussion nut 163, and in other cases, firing member 165 and percussion nut 163 may be operably coupled to each other by percussion actuator 168.Percussion actuator 168 can be pivotally mounted on firing member 165 at pivot 169 place, and can comprise distal arm 170a and proximal arm 170b, and described arm can engage with the longitudinal slit 113 in the shell 112 being defined in axle 110.In at least one this type of embodiment, each in arm 170a, arm 170b comprises respectively from the ledge that it extends, and such as ledge 171a and 171b, described ledge can slide in longitudinal slit 113.To being described further above, percussion nut 163 also can comprise the percussion pin 172 extended from it, and this percussion pin 172 can engage distal arm 170a, distally to advance actuator 168 and firing member 165, as mentioned above.In use, refer again to the progress shown in Fig. 5 and 6, distally advance percussion nut 163 by drive screw 161, the percussion pin 172 be wherein positioned in the middle of distal arm 170a and proximal arm 170b can contact distal arm 170a and distally drive actuator 168 and firing member 165.When distally advancing actuator 168, laterally move relative to longitudinal axis slit 113 due to the one or both in ledge 171a and 171b of slip in axle slit 113 can be prevented, until actuator 168 arrives the position shown in Fig. 6, so can prevent actuator 168 from rotating around pivot pin 169.

When actuator 168 arrives the position shown in Fig. 6, distal projections divides 171a can enter into the distally slotted portion 114 of longitudinal slit 113, and it can pivoted actuator 168 downwards, or allows actuator 168 by downward pivotable, as shown in Figure 9.In at least one this type of embodiment, distal projections divide 171a can with the sidewall contact of distally slotted portion 114, when actuator 168 is pushed ahead by percussion nut 163, this sidewall can guide distal projections to divide 171a downwards and around pivot 169 pivoted actuator 168.In this pivot position, the percussion pin 172 extended from percussion nut 163 can no longer engage with the distal arm 170a of actuator 168, and wherein pulling the trigger nut 163 subsequently distally can move independent of actuator 168, thus leaves actuator 168 and firing member 165.In other words, the distal end 114 of longitudinal axis slit 113 can be stopped using firing member 165, and wherein now, the position of firing member 165 can represent complete firing position or the farthest side position of firing member 165.In this position, folder 140 has been pushed completely and has entered in reception cavity or receptor 122.In addition, to being described further, in this position, the next one folder 140 in reception cavity 122 to be advanced to can be biased against the top surface of firing member 165 above.

To being described further, once folder 140 has been positioned in reception cavity 122, by such as crimping driving device 180, folder 140 is out of shape above.Referring now to Fig. 3 and 4, the end effector 120 of applicator 100 also can comprise the first jaw 123a and the second jaw 123b, and wherein the first jaw 123a and the second jaw 123b can limit receiving chamber 122 at least in part.As shown in Figures 3 and 4, the first jaw 123a can comprise first passage 124a and the second jaw 123b can comprise second channel 124b, described passage can receive wherein separately with propclip 140 at least partially.First jaw 123a by pin 125a with can the mode of pivotable be connected to the framework 111 of axle 110 and the second jaw 123b by pin 125b so that the mode of pivotable framework 111 can be connected to.In use, crimping driving device 180 can make the first jaw 123a rotate towards the second jaw 123b and/or the second jaw 123b be rotated towards the first jaw 123a, so that compression set folder 140 betwixt.In at least one this type of embodiment, crimping driving device 180 can comprise cam actuator 181, it can engage and be limited to the first cam face 126a on the first jaw 123a and the second cam face 126b on the second jaw 123b, to make the first jaw 123a and the second jaw 123b court pivotally.Cam actuator 181 can comprise at least in part around the lining ring of the first jaw 123a and the second jaw 123b.In at least one this type of embodiment, lining ring can comprise inner cam surface 182, and this cam face can be contoured with cam face 126a, 126b of contact jaw 123a, 123b and by them towards inwardly driving each other.In all cases, before actuating crimping driving device 180, the folder 140 be positioned in the receiving chamber 122 that is defined in end effector 120 can relative to tissue to positioning.In some cases, before relative to tissue positioned folder 140, crimping driving device 180 can be activated at least in part, so that compression clip 140 at least in part.In some cases, size and the configuration of folder 140 and receiving chamber 122 can be designed so that when end effector 120 is in its non-actuating state, and folder 140 can be biased or inwardly bend, as shown in Figure 3.In all cases, crimp the first jaw 123a and the second jaw 123b can activated flexibly to crimp and/or permanently crimp the folder 140 be positioned at therebetween.

To being described further above, percussion nut 163 can activate crimping driving device 180.More particularly, referring now to Fig. 7, crimping driving device 180 can comprise operationally connect with cam actuator 181 crimp actuating device 188, wherein pull the trigger nut 163 distally advanced time, crimping actuating device 188 is optionally engaged, as mentioned above by percussion nut 163.In at least one this type of embodiment, percussion nut 163 also can comprise such as from the second percussion pin that it extends, and such as pulls the trigger pin 184, and when pulling the trigger nut 163 and advancing percussion actuator 168, this percussion pin can engage crimping actuating device 188.Refer again to Fig. 7, crimping actuating device 188 is positioned in unactuated position, and when fully advancing percussion nut 163 to engage the distal arm 190a crimping actuating device 188, in the actuated position that percussion nut 163 can make crimping actuating device 188 be rotated upwardly to as shown in Figure 8.Equally as shown in Figure 8, distal arm 190a and proximal arm 190b can comprise respectively from the ledge that it extends separately, such as ledge 191a and 191b, described ledge can be positioned in second longitudinal slit (such as slit 115) of being such as defined in axle 110.When crimping actuating device 188 and rotating up around pivot 189 from its unactuated position, ledge 191a and 191b can move to a part for the longitudinal slit 115 being essentially linear from the proximal bend end 116 of longitudinal slit 115.Be similar to mentioned above, the sidewall of longitudinal slit 115 can retrain the motion in crimping actuating device 188 path along the longitudinal, and after crimping actuating device 188 has been rotated upwardly at least part of actuated position, can limit or prevent the rotation crimping actuating device 188, as mentioned above.As reader will be understood that, the percussion pin 172 of percussion driving device 160 and the percussion pin 184 of crimping driving device 180 all extend from percussion nut 163.Conveniently with the object demonstrated, percussion pin 172 and 184 is illustrated as extending from the same side of percussion nut 163; But, it is contemplated that, percussion pin 172 can from percussion nut 163 first side extend, and pull the trigger pin 184 can from percussion nut 163 another side extend.In this case, percussion actuator 168 can be positioned on by the first side of drive screw 161, and crimps actuating device 188 and can be positioned on by the opposite flank of drive screw 161.Correspondingly, longitudinal slit 113 can be defined in the first side of shaft housing 112, and longitudinal slit 115 can be defined in the opposite flank of shaft housing 112.

To being described further above, cam actuator 181 operationally can connect with crimping actuating device 188, make when distally being advanced crimping actuating device 188 by percussion nut 163, can distally advance cam actuator 181, as shown in figures 8 and 10, until the distal projections that distally arm 190a extends divides 191a to arrive the distal end 117 of longitudinal slit 115.In this distal position, cam actuator 181 can be in and advance position completely, and the folder 140 be positioned in receiving chamber 122 can be in be badly deformed configuration or crimping configuration.Then, cam actuator 181 can bounce back and end effector 120 can reopen.More particularly, drive screw 161 can rotate in opposite direction, to make percussion nut 163 proximally move and make cam actuator 181 bounce back, wherein in some cases, end effector 120 also can comprise biasing member, and the first jaw 123 and the second jaw 123b can be biased to the open position shown in Fig. 3 or non-firing position from the make position shown in Fig. 4 or firing position by it.When pulling the trigger nut 163 and bouncing back from its position shown in Figure 10, the percussion pin 184 extended from percussion nut 163 can engage the proximal arm 190b of crimping actuating device 188 and makes crimping actuating device 188 and proximally move from its cam actuator 181 extended, as shown in figure 12.Be similar to mentioned above, the proximal projections extended from the proximal arm 190b of crimping actuating device 188 divides 191b can contact the sidewall of bending proximal end 116, and wherein this sidewall can guide crimping actuating device 188 downwards and crimping actuating device 188 is rotated around pivot 189.Now, percussion pin 184 can no longer with crimp actuating device 188 and engages, cam actuator 181 can bounce back completely, and pulls the trigger nut 163 and can continue proximally to bounce back relative to crimping actuating device 188.

To being described further above, referring now to Figure 11, when pulling the trigger nut 163 and proximally bouncing back, percussion nut 163 can be re-engaged percussion actuator 168.As mentioned above, when pulling the trigger actuator 168 and arriving the distal end 114 of longitudinal slit 113, percussion actuator 168 is rotated down, and therefore, when pulling the trigger nut 163 and proximally bouncing back to be re-engaged percussion actuator 168, percussion actuator 168 still can be in its position be rotated down.As shown in figure 11, the percussion pin 172 extended from percussion nut 163 can engage the proximal arm 170b pulling the trigger actuator 168, and when pulling the trigger nut 163 and bouncing back further, percussion nut 163 can make percussion actuator 168 rotate up, and makes ledge 171a and 171b extended from arm 170a and 170b respectively can reenter the longitudinal component of longitudinal slit 113.Then, percussion nut 163 can bounce back, until pull the trigger actuator 168 and turned back to their original position shown in Fig. 5 or non-firing position from the firing member 165 of its extension.In this case, when firing member 165 is proximally bounced back by percussion nut 163, firing member 165 can exit from squeeze 130, and the percussion making new folder 140 be biased to squeeze 130 by biasing member 136 is indoor.Once firing member 165 and percussion actuator 168 retracted to their original position and next folder 140 to be positioned in percussion indoor, just percussion driving device 160 can again be activated, so that making percussion nut 163 and firing member 165 distally moves to be pressed from both sides by the next one 140 is advanced in end effector 120.Equally, when pulling the trigger nut 163 and again distally moving, percussion nut 163 can activate crimping driving device 180 again, to make the distortion of next folder 140.Then, percussion nut 163 can be made to bounce back, again to reset crimping driving device 180 and percussion driving device 160.This process can be repeated until the folder 140 of sufficient amount has been applied to destination organization and/or until the folder 140 be included in squeeze 130 exhausts.When needing other folder 140, used squeeze 130 can be removed from axle 110 and the replacement squeeze 130 comprising other folder 140 can be inserted into axle 110.In some cases, the squeeze 130 exhausted at least partly can be replaced with identical or at least almost identical replacement squeeze 130, and in other cases, squeeze 130 can be replaced with such as to have and be included in the squeeze of folder 140 wherein greater or less than five and/or there is the squeeze of the folder except the folder 140 be included in wherein.

Refer again to Fig. 6-9, the percussion nut 163 of illustrated embodiment can depart from from pulling the trigger actuator 168 with crimping while actuating device 188 engages at percussion nut 163.In other words, inactively while startup crimping driving device 180 driving device 160 can be pulled the trigger.In all cases, such as when the distal end 114 of longitudinal slit 113 is aimed at the proximal end 116 of second longitudinal slit 115 or at least substantial registration time, this timing can realize.In illustrated embodiment and/or any other suitable embodiment, between the inactive and startup of crimping driving device 180 of percussion driving device 160, delay can be there is.In some cases, this delay can be formed between the end of the percussion stroke of firing member 165 and the beginning of the percussion stroke of cam actuator 181, to guarantee made before folder 140 is out of shape by cam actuator 181, folder 140 has been located in its complete seat seated position in receiving chamber 122.In all cases, such as, when the distal end 114 of longitudinal slit 113 is proximally located relative to the proximal end 116 of second longitudinal slit 115, this delay can be formed.In illustrated embodiment and/or any other suitable embodiment, stopping using of percussion driving device 160 can occur after the startup of crimping driving device 180.In certain embodiments, such as can be formed this overlapping between the end of the percussion stroke of firing member 165 and the beginning of the percussion stroke of cam actuator 181, during to move to its complete seat seated position in receiving chamber 122 at folder 140, the inside pressure of at least some is applied to folder 140, so that the relative motion between the sidewall reducing or eliminating folder 140 and receiving chamber 122.In all cases, such as, when the distal end 114 of longitudinal slit 113 is distally located relative to the proximal end 116 of second longitudinal slit 115, this overlap can be formed.

In the illustrated embodiment and/or any other suitable embodiment of Fig. 1, turn to Figure 17 now, squeeze (such as squeeze 230) such as can comprise and is positioned at the push pedals 248 that biasing member 136 and the top be stacked in squeeze 230 press from both sidess 140 centres.That push pedal 248 can be rigidity or rigidity at least substantially, and clutch shaft bearing surface can be comprised, biasing member 136 can apply bias force against this clutch shaft bearing surface.Push pedal 248 also can comprise the second bearing surface, and bias force can be transferred to the top surface 145 of top folder 140 by this second bearing surface.Push pedal 248 can be made up of such as stainless steel material sheet material, but push pedal 248 can comprise any suitable shape and can be made up of any suitable material.In some cases, push pedal 248 can not be attached to biasing member 136, and in other cases, push pedal 248 is attachable to biasing member 136, and push pedal 248 is not separated with storehouse shell 132.In all cases, the size of push pedal 248 and configuration can be designed so that it can not through the proximal open 133 be defined in storehouse shell 132 and/or distal openings 137.

In the illustrated embodiment and/or any other suitable embodiment of Fig. 1, turn to now Figure 18 and 19, squeeze (such as squeeze 330) such as can comprise latch members, be included in all folders 140 in squeeze 330 from storehouse 330 penetrate after, this latch members can be positioned in the percussion room 149 of squeeze 330.Latch members can comprise latch plate 348, and this latch plate can be positioned on biasing member 136 and presss from both sides in the middle of the top surface 145 of 140 with the top be included in squeeze 330.In use, to being described further above, folder 140 can sequentially be positioned in the percussion room 149 of squeeze 130, and then distally release folder shell 132, wherein, after last folder 140 is pushed out folder shell 132 and firing member 165 exits from squeeze 130, biasing member 136 can be biased latch plate 348 against frame 135.In this position, latch plate 348 can be aimed at proximal open 133 and distal openings 137, firing member 165 can not be entered or at least substantially enter squeeze 130.In this case, latch plate 348 can stop that firing member 165 enters and pass shell 132, and therefore, prevents the accident of applicator 100 from pulling the trigger after squeeze 130 is finished folder.When the operator of applicator 100 will activate percussion driving device 160 and attempt firing member 165 to be advanced in empty squeeze 130, firing member 165 will contact and adjacent latch plate 348, wherein in this case, compressive load can be formed in firing member 165.Applicator 100 also can comprise clutch, and when the compressive load formed in firing member 165 exceedes a certain amount of or scheduled volume, this clutch can slide and motor is operationally disconnected from drive screw 161.Except clutch or replace clutch, motor and/or the motor controller of the applicator 100 of operation percussion driving device 160 such as can comprise the load cell that can detect the load produced in firing member 165, and when the load formed in firing member 165 exceedes a certain amount of or scheduled volume, can cut off and/or reduce to be supplied to voltage and/or the electric current of motor.Under any circumstance, with configuration, the size of latch plate 348 can be designed so that latch plate 348 is not separated by distal openings 137 and/or proximal open 133 when firing member 165 contacts latch plate 348.In order to reuse applicator 100, the operator of applicator 100 can remove hole capital after selling all securities 330 and new squeeze 330 being inserted into such as axle 110 from axle 110.Now, folder 140 can be positioned in the percussion room 149 of new squeeze 330, and firing member 165 can be distally advanced in the intersphincteric plane to dispose folder 140 in new squeeze 330, as mentioned above.

In the illustrated embodiment and/or any other suitable embodiment of Fig. 1, referring now to Figure 20 and 21, squeeze (such as squeeze 430) such as can comprise the guiding piece that can limit or retrain the motion of latch members in squeeze 430.Be similar to mentioned above, latch members can comprise latch plate 448, and such as, it can be positioned on biasing member 136 and presss from both sides in the middle of the top surface 145 of 140 with the top be included in the shell 432 of squeeze 430.In use, be similar to mentioned above, when folder 140 sequentially penetrates from squeeze 430, latch plate 448 can be pushed downwards in percussion room 149 gradually.The size of latch plate 448 and configuration can be designed so that its close receipt is in storehouse shell 432, and the relative lateral movement between latch plate 448 with shell 432 can be limited, to reduce or to prevent the probability of latch plate 448 misalignment in squeeze 430.When latch plate 448 in squeeze 430 by misalignment, latch plate 448 can be combined in shell 432, and prevents biasing member 136 to such as pressing from both sides 140 stack and apply suitable bias force.As shown in figs 20 and 21, latch plate 438 also can comprise the guiding elements 447 extended from it, and this guiding elements can be received in the guide slit 446 that is defined in storehouse shell 432.The size of guiding elements 447 and guide slit 446 and configuration can be designed so that guiding elements 447 is closely received in guide slit 446, and the relative lateral movement between latch plate 438 with storehouse shell 432 can be limited.Each in guide slit 446 can be limited by opposing sidewalls 445, this sidewall can limit distance therebetween, described distance equals or is slightly greater than the width of the guiding elements 447 be positioned at wherein, and guiding elements 447 can be slided between the opposing sidewalls 445 between the top 443 of guide slit 446 and bottom 444.Therefore, although guiding elements 447 and guide slit 446 can limit lateral movement therebetween, but as mentioned above, guiding elements 447 and guide slit 446 can allow such as along being parallel to supply axis 138 or and the relative motion of predefined paths between latch plate 438 and storehouse shell 432 of its conllinear.When latch plate 438 be biased component 136 push percussion room 149 time, latch plate 438 can suppress the propelling of firing member 165 and the operation of applicator 100, as mentioned above, until empty squeeze 430 is replaced by another suitable squeeze.

In the illustrated embodiment and/or any other suitable embodiment of Fig. 1, as mentioned above, drive screw 161 can rotate distally advance percussion nut 163 along first direction, and rotates along second direction or inverse direction to make percussion nut 163 proximally bounce back.In order to along first direction and second direction rotary actuation screw rod 161, can operate along corresponding first direction and second direction with the electro-motor that drive screw 161 operationally connects.In the illustrated embodiment and/or any other suitable embodiment of Fig. 1, applicator can utilize and only carry out along first direction the motor that operates, and wherein motor can be used for distally advancing percussion nut and percussion nut proximally being bounced back along the rotation in this single direction.Turn to Figure 22-26 now, the output of electro-motor transfers to drive system 560 by transmission system 550.Transmission system 550 can comprise the power shaft 552 carrying out along single direction operating, wherein transmission system 550 can carry out switching or changing between the first state or configuration and the second state or configuration, in described first state or configuration, transmission system 550 makes the drive screw 561 of drive system 560 rotate along first direction, and in described second state or configuration, transmission system 550 makes drive screw 561 rotate along second direction or rightabout.First state of transmission system 550 is shown in Figure 22-24, and the second state of transmission system 550 is shown in Figure 25 and 26.

Refer again to Figure 22-24, power shaft 552 can comprise the input gear 551 be installed on it, and this input gear and shift unit gear 553 operationally connect or engage with engagement system, makes the rotation of power shaft 552 be transferred to shift unit gear 553.With reference to all gears discussed herein, operationally connect each other or can comprise any suitable tusk with the gear that engagement system engages and arrange, such as, it can by the rotary transfer of a gear to another gear.When power shaft 552 rotates along first direction, shift unit gear 553 rotates along second direction or rightabout.In the first state of transmission system, shift unit gear 553 is in primary importance, and wherein shift unit gear 553 operationally connects with idler gear 554, wherein when shift unit gear 553 is rotated along second direction by input gear 551, as mentioned above, idler gear 554 rotates along first direction.Although not shown, idler gear 554 rotatably can support in the axle 110 of such as applicator 100.Idler gear 554 also operationally can connect with the output gear 555 be installed on drive screw 561, makes the rotation of idler gear 554 can transfer to output gear 555.When idler gear 554 be shifted device gear 553 drive along first direction time, as mentioned above, idler gear 554 can along second direction driver output gear 555 and drive screw 561.Be similar to mentioned above, percussion nut 563 can operationally connect with drive screw 561 and constrain in suitably in axle 110, makes when drive screw 561 rotates along second direction, and percussion nut 563 is distally advanced, indicated by arrow D.

Be similar to mentioned above, percussion nut 563 can be advanced its farthest side position shown in Figure 24, to be advanced to end effector 120 from squeeze 130 by folder 140, and folder 140 is crimped, as mentioned above.As shown in figs. 23 and 24, percussion nut 563 also can comprise the cam lever 569 extended from it, and this cam lever can make transmission system 550 from its first State Transferring to its second state.When relatively Figure 24 and Figure 25, reader will notice, shift unit gear 553 can move between the first location and the second location, and in described primary importance, transmission system 550 is in its first state, and in the described second position, transmission system 550 is in its second state.More particularly, shift unit gear 553 is installed on shift unit 556, this shift unit can rotate around power shaft 552, shift unit gear 553 can be rotated from its primary importance and the second position thereof, in described primary importance, shift unit gear 553 operationally engages with input gear 551 and idler gear 554, and in the described second position, shift unit gear 553 operationally departs from from idler gear 554.Although when shift unit gear 553 is in its second position, shift unit gear 553 operationally departs from from idler gear 554, but shift unit gear 553 operationally can connect with input gear 551 and output gear 555, rotary motion is transferred to drive screw 561 from power shaft 552.As shown in FIG. 24 and 25, shift unit 556 can comprise centre bore, and power shaft 552 can extend through this centre bore; But shift unit 556 operationally can not engage with power shaft 552, and therefore, the rotation of power shaft 552 can non rotating shift unit 556, and equally, the rotation of shift unit 556 can non rotating power shaft 552.Under any circumstance, shift unit 556 also can comprise the cam follower 558 extended from it, and when pulling the trigger nut 563 and distally being advanced, this cam follower can be engaged by the cam 568 be limited on cam lever 569.When cam 568 engaging cam follower 558, cam 568 can make shift unit 556 and shift unit gear 553 rotate between its primary importance and its second position, as mentioned above.

When shift unit gear 553 is in its second position and transmission system 550 is in its second state, as mentioned above, power shaft 552 and drive screw 561 all can rotate along first direction.More particularly, when rotating along first direction, power shaft 552 can rotate input gear 551 along first direction, and when shift unit gear 553 directly engages with input gear 551, shift unit gear 553 will rotate along second direction.Reader will notice, compared to when transmission system 550 is in its first state, shift unit gear 553 rotates along first direction or rightabout, and when transmission system 550 is in its second state, shift unit gear 553 rotates along second direction.When relatively Figure 24 and 25, to being described further above, reader will be understood that, when transmission system 550 is in its second state, idler gear 554 is no longer operationally positioned in the middle of input gear 551 and shift unit gear 553, thus causes the rotation of different directions.Due to when shift unit gear 553 is in its second position, shift unit gear 553 operationally engages with input gear 551 and output gear 555, so shift unit gear 553 can rotate output gear 555 along first direction and be connected to the drive screw 561 of output gear 555.When drive screw 561 rotates along first direction, as shown in figs. 25 and 26, percussion nut 563 can proximally bounce back, and is switched on again and firing member 165 is bounced back to allow end effector 120.First see Figure 26, percussion nut 563 also can comprise the second cam lever 567 comprising cam 566 extended from it, and when pulling the trigger nut 563 and proximally retracting to its complete advanced position, this second cam lever can contact the cam follower 558 of shift unit 556.In this case, shift unit 556 can to back in its primary importance and to make it operationally engage with idler gear 554 by cam 566, make transmission system 550 can reset to its first state, and applicator 100 can activated again.

As mentioned above, the percussion driving device of applicator 100 can be operated by the surgical instrument system comprising electro-motor.Robotic surgical Instrument's system 20 is shown in Figure 27, and can comprise multiple lever arm 30.Each arm 30 can comprise actuator module 32, and it comprises the electro-motor that can provide rotary motion to the axle 110 of applicator 100 and/or any other suitable surgical instruments.Referring now to Figure 28, end effector 620 can optionally engage with the actuator shaft 610 of applicator and depart from, and its end effector 620 can comprise the proximal end 621 of the distal end 611 that can be connected to axle 610.The proximal end 621 of end effector 620 can comprise shell 629, extends through the framework of shell 629, extend through the outer driving shaft of framework, and extends through the interior driving shaft of outer driving shaft.Similarly, the outer driving shaft 662 that the distal end 611 of axle 610 can comprise shell 619, extend through the framework 663 of shell 619, extends through framework 663, and the interior driving shaft 661 extending through outer driving shaft 662.The distal end 611 of reference axis 610, framework 663, outer driving shaft 662 and interior driving shaft 661 can comprise a part for the ligule adapter 613 extended from it separately and be defined in a part for connector groove 612 wherein, wherein ligule adapter 613 can be received in the ligule groove 623 that is defined in the proximal end 621 of end effector 620, and wherein ligule groove 612 can receive the ligule adapter 622 extended from the proximal end 621 of end effector 620.Be similar to the ligule adapter 613 of framework 663, outer driving shaft 662 and the interior driving shaft 661 extending across distal shaft end 611, the framework of the proximal end 621 of ligule adapter 622 extensible leap end effector 620, outer driving shaft and interior driving shaft.In addition, be similar to the ligule groove 612 of framework 663, outer driving shaft 662 and the interior driving shaft 661 extending across distal shaft end 611, the framework of the proximal end 621 of ligule groove 623 extensible leap end effector 620, outer driving shaft and interior driving shaft.In configuration shown in Figure 28, the ligule adapter 622 of end effector 620 laterally can slide in the ligule groove 612 of axle 610 while the ligule adapter 613 of axle 610 laterally slides in the ligule groove 623 of end effector 620.Due to this assembly, the framework of end effector 620 can be connected to the framework 663 of axle 610 securely, the outer driving shaft of end effector 620 operationally can be connected to the outer driving shaft 662 of axle 110, and the interior driving shaft of end effector 620 operationally can be connected to the interior driving shaft 661 of axle 110.Reader will notice, when end effector 620 is assembled on axle 610, the part of ligule adapter 612 is aligned with each other, and the part of ligule groove 613 is aligned with each other, and the part of ligule groove 622 is aligned with each other, and the part of ligule adapter 623 is aligned with each other.After assembling, the outer driving shaft of the rotatable end effector 620 of outer driving shaft 662 of axle 110, and the interior driving shaft of the rotatable end effector of interior driving shaft 661 620 of axle 610.When outer driving shaft 662 and/or interior driving shaft 661 rotate, the part of ligule adapter 612, the part of ligule groove 613, the part of ligule groove 622 and the part of ligule adapter 623 can no longer be aimed at.In order to remove end effector 620 from axle 610, interior driving shaft 661 and/or outer driving shaft 662 can be rotated in one or more position, and wherein ligule adapter 612 and 623 and ligule groove 613 and 622 are fully aimed at.

Refer again to Figure 28, the shell 619 of axle 610 also can comprise stop part 614, and time in the distal end 611 that end effector 620 laterally slides into axle 610, this stop part can the lateral movement of confinement end executor 620.Stop part 614 can provide the interior driving shaft 661 of the interior driving shaft of end effector 620 and axle 610 longitudinally axis 615 aim at, the outer driving shaft of end effector 620 and other driving shafts 662 of axle 610 longitudinally axis 615 are aimed at, and/or the framework 663 of the framework of end effector 620 and axle 610 longitudinally axis 615 aim at data.To being described further above, interior driving shaft 661 may extend in actuator module 632, and this actuator module can comprise the electro-motor operationally connected with interior driving shaft 661 and/or gear train 664 that can rotate interior driving shaft 661.In addition, actuator module 632 can comprise second electro-motor operationally engaged with the second driving shaft 662 and gear train that can drive the second driving shaft 662.As described in greater detail below, the second electro-motor can be used for making end effector 620 carry out joint motions.In addition, to being described further above, the shell 619 of axle 610 and/or framework 663 also can comprise the gear 617 be installed on it, this gear operationally engages with electro-motor and gear train 618, and described electro-motor and gear train can around longitudinal axis 615 rotating shaft 610 and end effectors 620.Such as, if electro-motor and gear train 618 operate along first direction, then axle 610 and end effector 620 can rotate around axis 615 along clockwise direction, if and electro-motor and gear train 618 operate along second direction, then axle 610 and end effector 620 can rotate around axis 615 in the counterclockwise direction, to position and orientation end effector 620.

As mentioned above, end effector 620 can optionally be attached with axle 610 and be separated.Reader will notice, the principle discussed in conjunction with end effector 620 and axle 610 similarly can be applicable to the end effector 120 and axle 110 etc. of embodiment disclosed in Fig. 1.That is, refer again to Figure 27, such as, in mechanical arm 30 one end effector 120 optionally engaging applicator, or any other suitable end effector, the end effector of such as surgical stapling device.In this case, end effector 120 optionally can exchange with another end effector, and therefore, single mechanical arm 30 can be used for performing more than a kind of function.In other words, applicator 100 can comprise replaceable loading unit, its can by another applicator loading unit and/or any other suitable replaceable loading unit is replaced or with its exchange.Turn to Figure 29 now, the end effector 120 of applicator 100 can use with axle 110 together with comprising the surgical instrument system of shank 700.Shank 700 can comprise actuator 701, and it can be operated or extrude towards holder 702, to apply rotary motion to drive screw 161, as mentioned above.In some cases, the rotation of actuator 701 can mechanically be transferred to drive screw 161, and in other cases, actuator 701 can operate the motor being operationally connected to drive screw 161.

To being described further above, the end effector 120 of applicator 100 and axle 110 can be aimed at along the longitudinal axis of applicator 100.Turn to Figure 30 now, end effector 120 and/or axle 110 also can comprise actuated articulation joints 101, and it can allow end effector 120 to carry out joint motions relative to the longitudinal axis of applicator 100.Axle 110 can comprise shell or frame part 119, and it can comprise proximal end 102 and can comprise the distal part of actuated articulation joints 101.Proximal end 102 can comprise spherical or at least substantially spherical end 102, and such as, it can be received in spherical or at least substantially spherical chamber 104, and this chamber is defined in actuated articulation joints component 103.Actuated articulation joints component 103 can comprise spherical or at least substantially spherical end 105, and such as, it can be received in spherical or at least substantially spherical chamber 107, and this chamber is defined in axle frame part 106.The proximal end 102 of axle 110 can be captured in chamber 104 at least in part, makes proximal end 102 be not easy to remove from chamber 104.That is, the size in proximal end 102 and chamber 104 and configuration can be designed to allow proximal end 102 and rotate along suitable direction any in chamber 104.Also as shown in figure 30, applicator 100 also can comprise joint motions control 108a and 108b, such as it can extend across actuated articulation joints 101 and can comprise the distal end be arranged on respectively in installing hole 109a and 109b, and described installing hole is limited in the proximal end 102 of shaft housing 119.In use, joint motions control 108a and 108b can be pushed and/or pull, to make proximal end 102 mobile in chamber 104.To being described further above, the end 105 of actuated articulation joints component 103 can be captured in the chamber 107 that is defined in axle frame part 106 at least in part, makes end 105 be not easy to remove from chamber 107.That is, the size in end 105 and chamber 107 and configuration can be designed to, when shaft end 102 is promoted by actuator 108a and 108b and/or pulls, allow end 105 to rotate along suitable direction any in chamber 107, as mentioned above.

To being described further, refer again to Figure 30 above, drive screw 161 such as can pass through power shaft (such as power shaft 152) and rotate.Power shaft 152 can extend across the hole 156 in the proximal end 102 being limited to axle frame part 106, actuated articulation joints component 103 and shaft housing 119.Power shaft 152 can comprise the input gear 151 being installed to its distal end, and this input gear operationally can connect with the output gear 155 of the proximal end being installed to drive screw 161.In use, power shaft 152 rotates by above-described electro-motor, wherein the rotatable drive screw 161 of power shaft 152.As mentioned above, what actuated articulation joints 101 can allow end effector 120 and axle 110 carries out joint motions relative to the longitudinal axis limited by applicator 100 at least partially.In order to adapt to this motion, what extend through the power shaft 152 of actuated articulation joints 101 can be enough flexible at least partially.

Turn to Figure 31-35 now, joint motions actuator 108a and 108b can be operated by such as actuator module (such as module 832).First see Figure 31, actuator module 832 can comprise rotatable joint motions driver 833, and it can promote and pull joint motions actuator 108a and 108b.Joint motions driver 833 can comprise columniform or columniform lining ring 835 at least substantially, and this lining ring comprises hole 837, this hole can wherein receiving axes framework 106 at least partially, rotatably to support lining ring 835.Joint motions driver 833 also can comprise input gear part 834, it operationally can connect with the electro-motor of module 832 and gear train 831, wherein when electro-motor and gear train 831 activated, joint motions driver 833 can rotate around axle framework 106.First see Figure 32 and 34, joint motions driver 833 also can comprise two cam slot in the sidewall being defined in lining ring hole 837, but reader will notice, a cam slot 835a is only shown in the view provided.Cam slot 835a can receive the cam follower 838a extended from joint motions driver 108a, and wherein cam follower 838a can slide in cam slot 835a.When joint motions driver 833 rotates, the helical profile of cam slot 835a such as can distally actuating cam driven member 838a or proximally pull cam follower 838, and this depends on the direction that wherein joint motions driver 833 rotates.As the nearside of cam follower 838 or the result of distal movement, cam actuator 108a can proximally or distally move respectively.Although not shown, joint motions driver 108b can comprise the cam follower being similar to cam follower 838a, and it can slide in other cam slot above-mentioned.When other cam slot can make that joint motions actuator 108a is distally driven by joint motions driver 833 when joint motions driver 833 rotates along first direction, joint motions actuator 108b can proximally be pulled.Similarly, other cam slot can make when when joint motions driver 833 rotates along second direction, joint motions actuator 108a is proximally pulled by joint motions driver 833, and joint motions actuator 108b can distally be driven.First see Figure 32, axle frame part 106 can comprise the clearance slot 839 be defined in wherein, and cam actuator 838 extends by this clearance slot.Although discuss above-mentioned feature in conjunction with actuator module 832, this category feature can use in conjunction with other actuator modules disclosed herein.

example

Applicator loading unit can comprise axle, and described axle comprises distal end, proximal end and framework, and described framework comprises the frame attacher that can be attached to the framework of actuator releasedly.The end effector that applicator loading unit also can comprise multiple folder and extend from the distal end of axle, the receptor that its end effector comprises the first jaw, movable second jaw and is limited between the first jaw and the second jaw.Receptor can receive folder, and wherein the second jaw can towards the first jaw motion to make location folder distortion in the receiver.Applicator loading unit also can comprise percussion driving device, this percussion driving device comprises distal part and portions of proximal, folder can be advanced in receptor by described distal part, and described portions of proximal comprises the driving adapter that can be attached to releasedly in the driver of actuator.

Applicator loading unit can comprise axle, and described axle comprises distal end, proximal end, framework and bearing, and described framework comprises and can be attached releasedly and the frame attacher be separated with the framework of actuating unit.The end effector that applicator loading unit also can comprise multiple folder and extend from the distal end of axle, the second jaw that its end effector comprises the first jaw, can move relative to the first jaw, and the receptor be limited between the first jaw and the second jaw, wherein receptor can receive folder.Applicator loading unit also can comprise reciprocating rotation percussion driving device, it comprises the threaded rotatable driver of tool, wherein rotatable driver is rotatably supported by bearing, and in addition, percussion nut and being threaded through of rotatable driver are threadedly engaged, wherein when driver rotates along first direction, percussion nut can distally advance end, wherein when driver rotates along the second direction relative to first direction, percussion nut can bounce back away from distal end, and wherein when distally end advances percussion nut, folder can be advanced in receptor by percussion nut.

Applicator loading unit comprises axle, and described axle comprises distal end, proximal end, framework and the connecting device for framework being attached to releasedly actuator.The end effector that applicator also can comprise multiple folder and extend from the distal end of axle, the receptor that its end effector comprises the first jaw, moveable second jaw and is limited between the first jaw and the second jaw, wherein receptor can receive folder, and wherein the second jaw can move to make location folder distortion in the receiver towards the first jaw.Applicator loading unit also can comprise for pressing from both sides the percussion lock be advanced in receptor.

Applicator for grasping tissue can comprise axle, and described axle comprises distal part, the distal openings be limited in distal part, and box opening.Applicator also can comprise the case assembly be positioned at removedly in box opening, wherein case assembly comprises shell, the apotheca be limited in shell, percussion platform, is positioned at multiple folders in apotheca removedly, and can be biased the biasing member of folder towards percussion platform.Applicator also can comprise the percussion driving device that folder can be advanced from box through distal openings.

The case assembly used together with applicator can comprise shell, the apotheca be limited in shell, percussion platform, be positioned at multiple folders in apotheca removedly, and can be biased the biasing member of folder towards percussion platform.

Applicator surgical instruments can comprise axle, the storehouse assembly that described axle comprises distal part and storehouse receptor and is positioned at removedly in the receptor of storehouse.Storehouse assembly can comprise shell; Be limited to the apotheca in shell; Exhaust openings; Folder stacks, and described folder is positioned in apotheca removedly; With the biasing member that folder can be made to aim at exhaust openings, stacking of wherein pressing from both sides comprises stacking multiple folders on top of each other.Applicator surgical instruments also can comprise the percussion driving device that folder can be advanced from box through exhaust openings.

The storehouse assembly used together with applicator can comprise shell; Be limited to the apotheca in shell; Exhaust openings; Folder stacks, and described folder is positioned in apotheca removedly; With the biasing member that folder can be made to aim at exhaust openings, stacking of wherein pressing from both sides comprises stacking multiple folders on top of each other.

Surgical device for using folder can comprise axle, and described axle comprises distal part, the load ports be limited in distal part, and exhaust openings.Surgical device also can comprise the squeeze be positioned at removedly in load ports, and wherein squeeze comprises the biasing member stacking, folder can be made to aim at exhaust openings of folder, and the percussion driving device that folder can be advanced from squeeze through exhaust openings.

The squeeze used together with applicator removedly can be positioned in the load ports of applicator, and wherein squeeze can comprise the biasing member stacking He folder can be made to aim at exhaust openings of folder.

Surgical device for using folder can comprise axle, provide the feeding mechanism of multiple folder for edge supply axis, and for advancing the percussion lock of folder along percussion axis from pre-firing position to firing position, wherein supply axis is transverse to percussion axis.

The end effector that applicator for grasping tissue comprises axle, pulls the trigger room, extends from axle, its end effector comprises crimping room, and case assembly, described case assembly comprises shell, the apotheca be limited in shell, be positioned at multiple folder in apotheca and the biasing member that folder sequentially can be biased to from apotheca percussion room removedly.Applicator also can comprise the reciprocating percussion driving device that the folder be positioned in percussion room can be advanced in crimping room, and be positioned at biasing member and multiple latch plate of pressing from both sides centre, after whole wherein in multiple folder are advanced in crimping room, latch plate can be biased in percussion room by biasing member, and wherein latch plate can stop percussion driving device.

The case assembly used together with applicator can comprise shell, the apotheca be limited in shell, be positioned at multiple folders in apotheca removedly, and folder sequentially can be biased to the biasing member percussion room from apotheca.Case assembly also can comprise be positioned at biasing member and multiple press from both sides in the middle of latch plate, wherein in multiple folder whole from shell advance after, latch plate can be biased in percussion room by biasing member, and wherein latch plate can stop that percussion driving device enters percussion room.

Surgical device for using folder can comprise axle, comprise the end effector of receptor, Yi Jicang, and described storehouse comprises shell; Be limited to the apotheca in shell; Folder stacks, and described folder is positioned in apotheca removedly; Percussion platform and the biasing member that folder sequentially can be biased to from apotheca percussion platform.Surgical device also can comprise the reciprocating percussion driving device that the folder be positioned on percussion platform can be advanced in receptor, and be positioned at the latch members stacking centre of biasing member and folder, wherein after all double-layered quilts are advanced in receptor, biasing member can be biased latch members against percussion platform, and wherein latch members can stop percussion driving device.

The storehouse used together with applicator can comprise shell; Be limited to the apotheca in shell; Folder stacks, and described folder is positioned in apotheca removedly; Percussion platform and the biasing member that folder sequentially can be biased to from apotheca percussion platform.Storehouse also can comprise the latch members stacking centre being positioned at biasing member and folder, and wherein after all double-layered quilts release shell, biasing member can be biased latch members against percussion platform, and wherein latch members can stop that percussion driving device is through shell.

Surgical device for grasping tissue can comprise axle, comprise the end effector of receptor, Yi Jicang, and described storehouse comprises shell; Be limited to the apotheca in shell; Folder stacks, and described folder is positioned in apotheca removedly; Percussion room and the biasing member that folder sequentially can be biased to from apotheca percussion room.Surgical device also can comprise the reciprocating percussion driving device that can be advanced to by the folder be positioned in percussion room during percussion stroke in receptor, and suppresses percussion driving device to complete the retention device of percussion stroke after being advanced in receptor at all double-layered quilts.

The storehouse used together with applicator can comprise shell; Be limited to the apotheca in shell; Folder stacks, and described folder is positioned in apotheca removedly; Percussion room and the biasing member that folder sequentially can be biased to from apotheca percussion room.Storehouse also can comprise for suppressing percussion driving device to complete the retention device of percussion stroke at all folders after shell advances.

Can be namely process apparatus design disclosed in this invention after single uses, or they can be designed to can repeatedly use.But in any one situation, described device all can be repaired, to reuse after using at least one times.Again the combination in any that can comprise the steps is recovered: dismantle this device, then clean or replace some part and assemble subsequently.Particularly, described device can be dismantled, and combination in any can optionally replace or remove specific component or the part of this device arbitrary number.Cleaning and/or displacement specific part after, this device can re-assembly to use subsequently at restoration facilities place, or is re-assemblied by surgical team before being about to carry out surgical operation.One skilled in the art will appreciate that the reparation of device can utilize the multiple technology for dismantling, cleaning/replace and re-assembly.The use of these technology and the prosthetic device of gained are all within the scope of the invention.

Although describe the present invention in conjunction with exemplary embodiment disclosed in some herein, many amendments and modification can be implemented to those exemplary embodiments.Such as, dissimilar end effector can be adopted.In addition, when disclosing the material for some parts, all other materials can be used.Foregoing description and following claim are intended to contain all this type of amendment and modification.

Be published in the United States Patent (USP) 8,075,571 that in December, 2011 name of 13 days is called " SURGICAL CLIP APPLIERMETHODS "; The United States Patent (USP) 8,038,686 that the name being published on October 18th, 2011 is called " CLIP APPLIER CONFIGURED TO PREVENT CLIP FALLOUT "; Be called that whole disclosures of the United States Patent (USP) 7,699,860 of " SURGICAL CLIP " are incorporated herein by reference accordingly with the name being published on April 20th, 2010.

With way of reference in full or be partly incorporated to open or other the open material of any patent herein, patent and all only with in existing definition of the present invention, statement or the afoul scope of other open material be not incorporated to herein at be incorporated to material.Thus, under the degree of necessity, the disclosure clearly set forth herein will replace any afoul material be incorporated herein by reference.If according to state be incorporated herein by reference but with existing definition as herein described, statement or the afoul any material of other open material or its part, be incorporated to herein under only not producing the degree of conflict between be incorporated to material and existing open material.

Claims

1., for an applicator for grasping tissue, comprising:

Axle, described axle comprises:

Distal part;

Distal openings, described distal openings is limited in described distal part; With box opening;

Case assembly, described case assembly can be positioned in described box opening removedly, and wherein said case assembly comprises:

Shell;

Apotheca, described apotheca limits in the housing;

Percussion platform;

Multiple folder, described multiple folder is positioned in described apotheca removedly; With

Biasing member, described biasing member can be biased described folder towards described percussion platform; With percussion driving device, folder can be advanced through described distal openings from described box by described percussion driving device.

2. applicator according to claim 1, wherein said axle also comprises:

Portions of proximal; With

Actuated articulation joints, described actuated articulation joints rotatably connects the described portions of proximal of described axle and described distal part.

3. applicator according to claim 1, wherein said case assembly also comprises the push pedal be positioned in the middle of described biasing member and described multiple folder.

4. applicator according to claim 1, wherein said shell also comprises the proximal open that can receive described percussion driving device.

5. applicator according to claim 4, also comprise the latch plate be positioned in the middle of described biasing member and described multiple folder, described latch plate can be biased to and aim at described proximal open by wherein said biasing member, to stop that described percussion driving device enters described apotheca after described case assembly injection at described folder.

6. applicator according to claim 5, wherein said latch plate comprises multiple guiding piece, and wherein said shell comprises multiple cooperation guiding piece, described cooperation guiding piece can cooperate with described guiding piece to limit described latch plate moving along predetermined path.

7. applicator according to claim 5, wherein said percussion platform comprises shelf, and wherein said biasing member can be biased described folder against described shelf, and wherein said shelf is aimed at described distal openings.

8. applicator according to claim 1, also comprise first jaw and the second jaw of locating relative to described distal openings, wherein said first jaw can towards described second jaw motion to make to be positioned at the folder distortion in the middle of described first jaw and described second jaw.

9. applicator according to claim 8, also comprise the crimping driving device that described first jaw can be made towards described second jaw motion, wherein said crimping driving device can activate in order with described percussion driving device.

10. applicator according to claim 1, also comprise at described folder from the device stopping described percussion driving device after the injection of described case assembly.

11. applicators according to claim 1, wherein said firing member can enter in described shell along percussion axis, described folder can be biased in firing position along supply axis by wherein said biasing member, and wherein said supply axis is transverse to described percussion axis.

12. applicators according to claim 11, wherein said supply axis is perpendicular to described percussion axis.

13. applicators according to claim 1, also comprise the storehouse lock that described case assembly can be remained on releasedly in described cartridge apertures.

14. 1 kinds of applicator surgical instrumenties, comprising:

Axle, described axle comprises:

Distal part; With

Storehouse receptor;

Storehouse assembly, described storehouse assembly can be positioned in the receptor of described storehouse removedly, and wherein said storehouse assembly comprises:

Shell;

Apotheca, described apotheca limits in the housing;

Exhaust openings;

Folder stacks, and described folder is positioned in described apotheca removedly, and wherein said folder stacks and comprises stacking multiple folders on top of each other; With

Biasing member, described biasing member can make described folder aim at described exhaust openings; With

Percussion driving device, described folder can be advanced through described exhaust openings from described box by described percussion driving device.

15. applicator surgical instrumenties according to claim 14, wherein said axle also comprises:

Portions of proximal; With

16. applicator surgical instrumenties according to claim 14, also comprise and be positioned at described biasing member and described folder and stack middle latch plate, wherein said shell also comprises the proximal open that can receive described percussion driving device, and described latch plate can be biased to and aim at described proximal open by wherein said biasing member, to stop that described percussion driving device enters described apotheca after the injection of described storehouse assembly at described folder.

17. applicator surgical instrumenties according to claim 16, wherein said latch plate comprises multiple guiding piece, and wherein said shell comprises multiple cooperation guiding piece, described cooperation guiding piece can cooperate with described guiding piece to limit described latch plate moving along predetermined path.

18. applicator surgical instrumenties according to claim 16, wherein said shell comprises shelf, and wherein said biasing member can be biased described folder against described shelf, and wherein said shelf is aimed at described exhaust openings.

19. applicator surgical instrumenties according to claim 14, wherein said firing member can enter in described shell along percussion axis, described folder can be biased in firing position along supply axis by wherein said biasing member, and wherein said supply axis is transverse to described percussion axis.

20. 1 kinds, for using the surgical device of folder, comprising:

Axle, described axle comprises:

Distal part;

Load ports, described load ports is limited in described distal part; With

Exhaust openings;

Squeeze, described squeeze can be positioned in described load ports removedly, and wherein said squeeze comprises folder and stacks;

Biasing member, described folder can be aimed at described exhaust openings by described biasing member; With

Percussion driving device, described folder can be advanced through described exhaust openings from described squeeze by described percussion driving device.

21. 1 kinds, for using the surgical device of folder, comprising:

Axle;

Feeding mechanism, described feeding mechanism is used for supplying multiple folder along supply axis; With

Percussion lock, described percussion lock is used for, along percussion axis, described folder is advanced to firing position from pre-firing position, and wherein said supply axis is transverse to described percussion axis.