CN105007835B - 具有多个自由度的旋转电动外科器械 - Google Patents

具有多个自由度的旋转电动外科器械 Download PDF

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Publication number
CN105007835B
CN105007835B CN201480011713.6A CN201480011713A CN105007835B CN 105007835 B CN105007835 B CN 105007835B CN 201480011713 A CN201480011713 A CN 201480011713A CN 105007835 B CN105007835 B CN 105007835B
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end effector
motor
assembly
nearside
sensor
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CN105007835A (zh
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M·D·奥尔德
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Ethicon Endo Surgery Inc
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Ethicon Endo Surgery Inc
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Abstract

本发明公开了一种外科器械，该外科器械包括被构造为能够用电力产生多个独立的旋转控制运动的驱动系统。在至少一个形式中，该外科器械可包括细长轴组件，该细长轴组件能够可操作地联接到驱动系统，以用于从其接收第一旋转控制运动，以使得细长轴组件围绕轴的轴线旋转。该细长轴组件还被构造为能够从驱动系统接收第二旋转控制运动并且将第二旋转控制运动传递到外科端部执行器，该外科端部执行器可操作地联接到细长轴组件，以使外科端部执行器相对于细长轴组件围绕轴的轴线旋转。细长轴组件还被构造为能够从驱动系统接收第三旋转控制运动并且将第三旋转控制运动传递到关节运动接头，该关节运动接头与细长轴组件和外科端部执行器连通，以使得外科端部执行器围绕基本上横向于轴的轴线的关节运动轴线进行关节运动。

Description

具有多个自由度的旋转电动外科器械
技术领域
本发明涉及一种外科器械，并且在各种布置中，本发明涉及被设计成用于切割和缝合组织的外科切割和缝合器械及其钉仓。
背景技术
外科缝合器通常用于将缝钉部署到软组织中，以例如尤其在组织被横切时减少或消除软组织的出血。诸如直线切割器的外科缝合器例如可包括端部执行器，该端部执行器能够相对于细长轴组件运动或铰接。端部执行器经常被构造为能够将软组织固定在第一钳口构件和第二钳口构件之间，其中第一钳口构件经常包括被构造为能够在其中可移除地储存缝钉的钉仓，第二钳口构件经常包括砧座。此类外科缝合器可包括用于使砧座相对于钉仓枢转的闭合系统。
如上文所述，外科缝合器可被构造为能够使得端部执行器的砧座相对于钉仓枢转，以便将软组织捕获于两者间。在各种情况下，砧座可被构造为能够对软组织施加夹持力，以便将软组织牢固地保持在砧座和钉仓之间。然而，如果外科医生不满意端部执行器的位置，则外科医生通常必须启用外科缝合器上的释放机构来将砧座枢转至打开位置并且随后重新定位端部执行器。然后，缝钉通常由驱动器从钉仓部署，该驱动器横贯钉仓中的通道，并且使得缝钉抵靠砧座而变形，并且将软组织层固定在一起。如本领域所知，缝钉经常以若干缝钉行或排部署，以将组织层更可靠地固定在一起。端部执行器还可包括诸如刀具的切割构件，在软组织层已经被缝合在一起之后，该切割构件在两排缝钉之间推进以切除软组织。
此类外科缝合器和执行器的尺寸和配置可被设计成通过套管针或其他进入开口插入体腔中。端部执行器通常联接到尺寸被设计成穿过套管针或开口的细长轴。细长轴组件通常可操作地联接到柄部，该柄部支撑用于控制端部执行器的操作的控制系统和/或触发器。为了促进端部执行器在体内的正确定位和取向，许多外科器械被构造为能够促进端部执行器相对于细长轴的一部分进行关节运动。
上述讨论仅是为了举例说明本发明技术领域中相关技术目前的每个方面，而不应当视为对权利要求范围的否定。
附图说明
通过结合附图来参考本发明实施例的以下说明，本发明的特征和优点以及其获取方法将会变得更加明显，并可更好地理解发明本身，其中：
图1为本发明的一种形式的外科缝合器械的透视图；
图2为图1的外科器械的另一个透视图，其中柄部外壳的一部分被移除；
图3为本发明的一个执行器布置的分解组件图；
图4为图1和2的外科器械的端部执行器和细长轴组件的一部分的局部剖视图，其中砧座组件处于打开位置；
图5为图4的端部执行器和细长轴组件的另一个局部剖视图，其中砧座组件处于击发之前的闭合位置；
图6为组织切割构件已推进至端部执行器内的最远侧位置之后的图4和图5的端部执行器和细长轴组件的另一个局部剖视图；
图7为本发明的联接器组件布置的透视图；
图8为图7的联接器组件的分解组件图；
图9为端部执行器的近侧端部以及细长轴组件和与其附接的联接器组件的远侧端部的透视图；
图10为图9的端部执行器的近侧端部的正视图；
图11为图9的联接器组件的远侧端部的正视图；
图12为端部执行器与细长轴组件联接之前的端部执行器和细长轴组件的一部分的透视组件图；
图13为端部执行器已初始与细长轴组件的联接器组件部分接合之后的端部执行器和细长轴组件布置的一部分的另一个透视图；
图14为端部执行器已联接到细长轴组件的联接器组件部分之后的图13所示的部件的另一个透视图；
图15为本发明的关节运动控制布置的透视图；
图16为关节运动轴段布置的一部分的透视图；
图17为本发明的关节运动接头布置的分解透视图；
图18为图17的关节运动接头布置的透视图；
图19为图17和图18的关节运动接头布置的顶视图；
图20为图19所示的部件的剖视图；
图21为图19和图20的关节运动接头的另一个剖视图；
图22为处于关节运动构型的图21的关节运动接头的另一个剖视图；
图23为本发明的击发系统布置的透视图；
图24为本发明的端部执行器旋转系统布置的透视图；
图25为本发明的关节运动接头和联接器组件的一部分的透视图；
图26为本发明的轴旋转系统布置的透视图；
图27为图1和图2的外科器械的分解透视图；
图28为本发明的可拆卸的驱动安装件布置的分解透视图；
图28A为附接到马达安装组件布置的图28的可拆卸的驱动安装件布置的一部分的端部正视图；
图28B为图28A的可拆卸的驱动安装件布置和马达安装组件布置的一部分的透视图；
图29为柄部组件布置的一部分的剖视图；
图30为位于柄部外壳部分内的可拆卸的驱动安装件和马达安装组件的分解组件图；
图31为马达安装组件布置的分解组件图；
图32为位于柄部外壳部分内的可拆卸的驱动安装件和马达安装组件的另一个分解剖视组件图；
图33为柄部组件的一部分的侧正视图，其中为清楚起见省略了多个部件；
图34为本发明的开关布置的底部透视图；
图35为图34的开关布置的分解组件图；
图36为安装有柄部组件的图34和图35的开关布置的一部分的剖视图，其中操纵杆控制部分处于未致动位置；
图37为图36的开关布置的另一个剖视图，其中操纵杆控制部分处于致动位置；
图38为图36的开关布置的侧剖视图；
图39为图37的开关布置的侧剖视图；
图40为图34-39的开关布置的侧正视图；
图41为图34-40的开关布置的前正视图；
图42为图34-41的开关布置的另一个分解组件图；
图43为处于致动位置的压轮桨叶控制组件布置的后正视图；
图44为处于另一个致动位置的压轮桨叶控制组件布置的另一个后正视图；
图45为端部执行器和细长轴组件布置的另一个局部剖视图；
图46为关节运动接头布置和联接器组件布置的一部分的放大剖视图，所述联接器组件布置具有与其联接的端部执行器；
图47为柄部组件布置的一部分的透视图，其中柄部外壳的一部分被移除；
图48为示出导体联接布置的柄部组件的一部分的放大透视图；
图49为另一个联接器组件布置和关节运动接头布置的一部分的分解透视图；
图50为本发明的另一个关节运动接头布置的透视图；
图51为图50中的关节运动接头布置的分解组件图；
图52为图50和图51的关节运动接头布置的剖视图；
图53为图50-52的关节运动接头布置的另一个剖视透视图；
图54为本发明的另一个关节运动接头布置的透视图；
图55为图54的关节运动接头布置的分解组件图；
图56为图54和图55的关节运动接头布置的局部剖视图；
图57为图54-56的关节运动接头布置的另一个局部剖视图；
图58为图54-57的关节运动接头布置的另一个局部透视剖视图；
图59为图54-58的关节运动接头布置的另一个局部透视剖视图，其中接头处于关节运动取向；
图60为图54-59的关节运动接头布置的另一个局部透视剖视图，其中接头处于另一个关节运动取向；
图61为本发明的另一个关节运动接头布置的透视图；
图62为处于关节运动取向的图60的关节运动接头布置的另一个透视图；
图63为图61和图62的关节运动接头的分解组件图；
图64为图61-63的关节运动接头布置的剖视图；
图65为图61-64的关节运动接头布置的另一个剖视透视图；
图66为图61-65的关节运动接头布置的另一个剖视透视图；
图67为本发明的另一个马达安装组件布置的透视图；
图68为图67的马达安装组件布置的前正视图；
图69为图67和图68的马达安装组件布置的分解组件图；
图70示出了与外科器械一起使用的电外科端部执行器的一些形式的透视图；
图71示出了图70的端部执行器的一些形式的透视图，其中钳口闭合并且可轴向运动的构件的远侧端部处于部分推进位置；
图72为图70的端部执行器的可轴向运动的构件的一些形式的透视图；
图73为图70的端部执行器的一些形式的剖视图；
图74-75示出了与外科器械一起使用的超声端部执行器的一个形式；
图76-77示出了图74的端部执行器的可轴向运动的构件的一个形式的附加视图；
图78示出了可与外科器械一起使用的线性缝合端部执行器的一个形式；
图79示出了可与外科器械一起使用的圆形缝合端部执行器的一个形式；
图80示出了与外科器械一起使用的若干示例电源线；
图81示出了可与外科器械一起使用的若干示例轴；
图82为示出多个控制元件的外科器械的柄部组件的框图；
图83示出了包括本文所述的电路的各种端部执行器执行部分的一个形式；
图84为示出控制构型的一个形式的框图，所述控制构型通过控制电路来实现以控制外科器械；
图85为示出用于实现图84的控制算法的处理流程的一个示例形式的流程图；
图86为示出控制构型的另一个形式的框图，所述控制构型通过控制电路来实现以控制外科器械；
图87为示出用于实现图86的控制算法的处理流程的一个示例形式的流程图；
图88示出了在柄部中包括中继站的外科器械的一个形式；
图89示出了具有传感器模块的端部执行器的一个形式，所述传感器模块被构造为能够传递设置于其中的信号；
图90为示出传感器模块的一个形式的框图；
图91为示出中继站的一个形式的框图；
图92为示出中继站的一个形式的框图，所述中继站被构造为能够转换所接收的低功率信号；
图93为用于传送指示端部执行器处的状态的信号指示的方法的一个形式的流程图；
图94示出了根据本文所述的某些方面的包括如图1所示的机械止动件的器械的远侧部分；
图95为根据本文所述的某些方面的适于与机电止动件一起使用的包括功率源、控制系统和驱动马达的系统的简图；
图96为示出根据本文所述的某些方面的与包括不具有软止动件的机电止动件的器械相关的电流随时间的变化的示意图；
图97示出了根据本文所述的某些方面的配备有包括软止动件的机电止动件的器械的远侧部分，其中驱动构件在与行程末端的第二位置处的软止动件接触之前被致动到某一位置；
图98示出了根据本文所述的某些方面的图97所示的器械，其中驱动构件被致动穿过行程末端的第一位置到达行程末端的第二位置；
图99为示出根据本文所述的某些方面的与包括具有软止动件的机电止动件的器械相关的电流随时间的变化的示意图；
图100为另选的马达安装组件的透视图，所述另选的马达安装组件采用齿轮驱动的驱动安装件组件；
图101为图100的马达安装组件的另一个透视图，其中为清楚起见省略了远侧轴外壳；
图102为图100和图101的马达安装组件的另一个透视图；
图103为图100-102的马达安装组件的剖视图；并且
图104为图100-103的马达安装组件的顶视图。
图105示出了包括处于关节运动状态的传感器拉直式端部执行器的外科器械的一个形式。
图106示出了处于拉直状态的图105的外科器械。
图107示出了插入外科外管中的传感器拉直式端部执行器的一个形式。
图108示出了插入外科外管中的处于关节运动状态的传感器拉直式端部执行器的一个形式。
图109示出了处于关节运动状态的传感器拉直式端部执行器的一个形式。
图110示出了处于拉直状态的图109的传感器拉直式端部执行器的一个形式。
图111示出了与传感器拉直式端部执行器一起使用的磁性环的一个形式。
图112示出了包括磁性传感器的传感器拉直式端部执行器的一个形式。
图113示出了磁簧传感器的一个形式。
图114示出了模块化马达控制平台的一个形式。
图115示出了包括多个马达-控制器对的模块化马达控制平台的一个形式。
图116示出了包括主控制器和从控制器的模块化马达控制平台的一个形式。
图117示出了可通过多个马达控制的外科器械执行的控制程序的一个形式。
具体实施方式
本申请的申请人还拥有以下专利申请，所述专利申请与本申请同一天提交并且全文各自以引用的方式并入本文：
-名称为“Rotary Powered Articulation Joints For Surgical Instruments”的美国专利申请，代理人案卷号END7188USNP/120280；
-名称为“Articulatable Surgical Instruments With Conductive PathwaysFor Signal Communication”的美国专利申请，代理人案卷号END7187USNP/120279；
-名称为“Thumbwheel Switch Arrangements For Surgical Instruments”的美国专利申请，代理人案卷号END7189USNP/120281；
-名称为“Joystick Switch Assemblies For Surgical Instruments”的美国专利申请，代理人案卷号END7192USNP/120284；
-名称为“Electromechanical Soft Stops For Surgical Instruments”的美国专利申请，代理人案卷号END7196USNP/120288；
-名称为“Electromechanical Surgical Device With Signal RelayArrangement”的美国专利申请，代理人案卷号END7190USNP/120282；
-名称为“Sensor Straightened End Effector During removal ThroughTrocar”的美国专利申请，代理人案卷号END7193USNP/120285；
-名称为“Multiple Processor Motor Control For Modular Surgical Device”的美国专利申请，代理人案卷号END7091USNP/120283；和
-名称为“Control Methods for Surgical Instruments with RemovableImplement Portions”的美国专利申请，代理人案卷号END7194USNP/120286。
现在将描述某些示例性实施例，以从整体上理解本文所公开的装置和方法的结构、功能、制造和用途原理。这些实施例的一个或多个例子在附图中示出。本领域的普通技术人员将会理解，在本文中具体描述并示出于附图中的装置和方法为非限制性的示例性实施例，并且本发明的多个实施例的范围仅由权利要求书限定。结合一个示例性实施例进行图解说明或描述的特征可与其他实施例的特征进行组合。这些修改形式和变化形式旨在包括在本发明的范围之内。
术语“包括”(和包括的任何形式，例如“包括(comprises)”和“包括(comprising)”)、“具有”(和具有的任何形式，例如“具有(has)”和“具有(having)”)、“包括”(和包括的任何形式，例如“包括(includes)、和“包括(including)以及“含有”(和含有的任何形式，例如“含有(contains)”和“含有(containing)”)为开放式系动词。因此，“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件，但不限于仅具有这些一个或多个元件。同样，“包括(comprises)”、“具有”、“包括(includes)”或“含有”一个或多个特征结构的系统、装置、或设备的元件具有那些一个或多个特征结构，但不限于仅具有那些一个或多个特征结构。
术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分，并且术语“远侧”是指远离临床医生的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用例如“竖直”、“水平”、“上”和“下”之类的空间术语。然而，外科手术器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以执行腹腔镜式和微创外科手术。然而，本领域的普通技术人员将容易理解，本文所公开的各种方法和装置可用于许多外科手术和应用中，包括例如与开放式外科手术相结合。继续参阅本具体实施方式，本领域的那些普通技术人员将进一步理解，本文所公开的各种器械可以任何方式插入身体中，诸如通过自然孔、通过形成于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可直接插入患者身体中或可通过具有工作通道的进入装置而插入，外科器械的端部执行器和细长轴能够通过所述工作通道而推进。
转到附图，其中在所有视图中，类似的数字代表类似的部件，图1-3示出了外科器械10，所述外科器械10能够对与其可操作地联接的执行部分100施加旋转致动运动。如将在下文进一步详细讨论，器械10可与可互换地联接到器械10的多个不同工具一起有效地使用。图1和图2的布置例如被示为联接到被构造为能够切割和缝合组织的端部执行器102。然而，其他工具布置也可通过器械10来操作。
端部执行器
图1-6所示的端部执行器102包括可被构造为能够可操作地并且可移除地支撑钉仓130的细长通道构件110。钉仓130可包括上表面或仓平台132，所述上表面或仓平台132包括多个钉凹坑134，所述多个钉凹坑134在细长狭槽136的每一侧以交错方式来成行地进行布置。参见图3。多个外科钉140支撑在对应的钉驱动器138上，所述钉驱动器138可操作地支撑在钉凹坑134内。此外，如在图3中可见，在一个形式中，端部执行器102包括端部基座150，所述端部基座150被构造为能够联接到钉仓130的近侧端部并且置于细长通的110的近侧端部内。例如，端部基座150可形成有远侧延伸的闩锁突片152，所述远侧延伸的闩锁突片被构造为能够接收在仓平台132中对应闩锁狭槽142内。此外，端部基座150可设置有侧向延伸的附接凸耳154，以用于将端部基座150附接到细长通道110。例如，附接凸耳154可被构造为能够接收在细长通道110中的对应附接孔112中。
在一个形式中，端部基座150包括居中设置的狭槽156，所述居中设置的狭槽156被构造为能够支撑组织切割构件160和滑动件170。组织切割构件160可包括主体部分162，所述主体部分在其上具有或具有与其附接的组织切割部分164。主体部分162可通过螺纹轴颈连接在端部执行器驱动螺杆180上，所述端部执行器驱动螺杆180可旋转地安装在细长通道110内。滑动件170被支撑以用于相对于端部执行器驱动螺杆180轴向行进，并且可被构造为能够与组织切割构件160的主体部分162交接。当朝远侧驱动组织切割构件160时，通过组织切割构件160朝远侧驱动滑动件170。当朝远侧驱动滑动件170时，形成于其上的楔形件172用于将驱动器138向上推进到钉仓130内。
端部执行器102还可包括砧座组件190，所述砧座组件190被支撑以用于相对于钉仓130的选择性运动。在至少一个形式中，砧座组件190可包括第一砧座部分192，所述第一砧座部分192联接到后部砧座部分194和顶部砧座部分196。后部砧座部分194可具有一对侧向突出的凸耳198，所述一对侧向突出的凸耳被构造为能够接收在细长通道110中的对应凸耳孔或腔体114中以促进砧座组件190相对于细长通道110和支撑于其中的钉仓130的可运动或枢转的行进。
组织切割构件160可设置有一对侧向突出的致动器突片166，所述一对侧向突出的致动器突片被构造为能够被滑动地接收在砧座组件190中的狭槽199内。此外，组织切割构件160还可具有底座168，所述底座的尺寸设定成接合细长通道110的底部部分，使得当朝远侧驱动组织切割构件160时，突片166和底座168使得砧座组件190运动到闭合位置。突片166和底座168可用于当切割和缝合组织时使得砧座组件190相对于钉仓130隔开。第一砧座部分192可在其上具有钉成形下侧面193，从而当驱动外科缝钉140接触钉成形下侧面时使得外科缝钉成形。图4示出了当砧座组件190处于打开位置时的砧座组件190和切割构件160的位置。图5示出了砧座组件190已闭合之后但组织切割构件160已朝远侧推进或“击发”之前的砧座组件190和切割构件160的位置。图6示出了组织切割构件160已推进至其在钉仓130内的最远侧位置之后的位置。
端部执行器驱动螺杆180可旋转地支撑在细长通道110内。在一个形式中，例如，端部执行器驱动螺杆180可具有联接到驱动轴附接构件184的近侧端部182，所述驱动轴附接构件184可被构造为能够与联接器组件200交接。驱动轴附接构件184可被构造为能够附接到端部执行器驱动螺杆180的近侧端部182。例如，驱动轴附接构件184可具有从其延伸的六边形突出部186，所述六边形突出部被构造为能够不可旋转地接收在对应的六边形插座中，所述六边形插座包括通常命名为500的击发系统的一部分。端部执行器驱动螺杆180沿第一方向的旋转使得组织切割构件160沿远侧方向运动。在各种形式中，钉仓130可配有一对缓冲器174，该对缓冲器用于在滑动件170到达其在细长通道110内的最远侧位置时对其缓冲。缓冲器174可各自具有弹簧176，以对缓冲器提供所需的缓冲量。
端部执行器联接器组件
各种形式的工具100可通过联接器组件200可操作地联接到外科器械10。图7-14示出了联接器组件200的一个形式。联接器组件200可包括联接器外壳段202，所述联接器外科段能够可操作地支撑统称为220的驱动齿轮组件。在至少一个形式中，驱动齿轮组件220包括输入齿轮222、传递齿轮228和输出齿轮232。参见图8。输入齿轮222安装到或形成于输入轴224上，所述输入轴能够由第一和第二隔板构件204,206旋转地支撑。输入轴224具有被构造为能够与远侧击发轴段510配合的近侧端部226，所述远侧击发轴段510包括将在下文进一步详细描述的独特的和新型的击发系统500的一部分。例如，近侧端部226可被构造为能够具有六边形横截面形状，以用于不可旋转地插入形成于远侧击发轴段510的远侧端部中的六边形插座512内。传递齿轮228可安装到或形成于传递轴230上，所述传递轴能够通过挡板构件204,206旋转地支撑。输出齿轮232可安装到或形成于输出驱动轴234上，所述输出驱动轴234能够通过挡板构件204,206旋转地支撑。为了组装目的，输出驱动轴234的远侧端部236可被构造为能够不可旋转地附接到朝远侧突伸穿过远侧端盖210的输出插座238。在一个布置中，远侧端盖210可通过紧固件208或任何其他合适的紧固件布置而附接到联接器外壳202。输出插座238可销接到输出驱动轴234的远侧端部236。输出插座238可被构造为能够与驱动轴附接构件184不可旋转地配合。例如，输出插座238被构造为能够具有六边形形状，以使其可与驱动轴附接构件184上的六边形突出部186配合。此外，为了促进工具100可操作地附接到联接器组件200，附接凸耳可形成或附接到端盖210。
联接器组件200的一个布置还可包括通常命名为240的锁定组件。在至少一个形式中，锁定组件240包括弹簧偏置的锁定构件或销242，所述弹簧偏置的锁定构件或销242被运动地支撑在形成于联接器外壳段202中的锁定狭槽214中。锁定销242被构造为能够在锁定狭槽214内轴向运动，以使其锁定端部244突伸穿过端盖210中的孔211。参见图8。锁定弹簧246轴颈连接在锁定销242上，以在锁定狭槽214内沿远侧方向“DD”偏置锁定销242。致动器臂248可形成于或者附接到锁定销242上，使得用户能够沿近侧方向“PD”对锁定销242施加解锁运动。
如在图3、图9、和图10中可见，端部执行器102的细长通道110可具有近侧端壁116，所述近侧端壁116具有形成于其中的联接开口118，以用于将附接凸耳212接收于其中。在一个布置中，例如，附接凸耳212可包括颈部部分213，所述颈部部分具有形成于其上的蘑菇附接头部215。联接开口118可具有第一圆形部分120，所述第一圆形部分的尺寸设定成使得附接头部215能够插入其中。联接开口118还可具有形成于其中的狭窄狭槽122，所述狭窄狭槽122的尺寸设定成使得颈部213能够接收于其中。近侧端壁116还可具有锁定孔124，以用于将锁定销242的远侧端部244接收于其中。
将端部执行器102附接到外科器械10的联接组件200的一种方法可参照图12-14理解。例如，为了将端部执行器102附接到联接组件200，用户可将驱动轴附接构件184上的六边形突出部186与六边形输出插座238对齐。同样，可将蘑菇头部215与联接开口118的圆形开口部分120对齐，如图9和图12所示。然后，用户可将突出部186轴向地插入插座238中并且将附接头部215轴向地插入联接开口118中，如图13所示。然后，用户可旋转端部执行器102(由图14中的箭头“R”表示)，使得颈部213进入狭槽122并且使得锁定销242的远侧端部244卡合到锁定孔124中，从而阻止端部执行器102与联接组件200之间的进一步相对旋转。此类布置用于将端部执行器102可操作地联接到外科器械10。
为了使得端部执行器102从联接组件200拆卸，用户可对致动器臂246施加解锁运动，从而沿近侧方向“PD”偏置锁定销。锁定销242的此类运动使得锁定销242的远侧端部244运动离开细长通道110的端壁116中的锁定孔124。然后用户相对于联接组件沿相反方向自由地旋转端部执行器102，使得附接按钮212的颈部部分213运动离开狭槽122，以使附接头部215能够轴向地拉出端部执行器102的联接开口118，由此将端部执行器102从联接组件200拆卸。如上文可见，联接组件200提供了独特的和新型的布置，以用于可操作地联接外科工具100，所述外科工具可通过对外科器械10施加的旋转驱动运动来操作。具体地讲，联接组件200使多种不同的外科工具100或端部执行器102能够可操作地联接到外科器械10的细长轴组件30。
关节运动系统
如在图1和图2中可见，细长轴组件30可限定轴的轴线A-A。在至少一个形式中，细长轴组件30可包括关节运动系统300，以用于使端部执行器102围绕关节运动轴线B-B进行选择性的关节运动，所述关节运动轴线B-B基本上横向于轴的轴线A-A。关节运动系统300的一个形式示于图15和图16中。如在这些附图中可见，关节运动系统300可包括电动关节运动接头310。在至少一个布置中，关节运动接头310包括远侧接头部分或远侧连接叉312，所述远侧接头部分或远侧连接叉312可通过远侧外壳轴承314旋转地支撑在联接器外壳段202的近侧延伸的衬套部分203上。参见图20。远侧连接叉312可通过限定关节运动轴线B-B的关节运动销332枢转地附接到近侧接头部分或近侧连接叉330。参见图18。远侧连接叉312可包括远侧突出的附接衬套316，所述朝远侧突出的附接衬套316的尺寸设定成接收在联接器外壳段202的近侧端部内。附接衬套316可在其中具有环形沟槽318，所述环形沟槽318被构造为能够在其中接收附接销320。参见图8。附接销320用于将联接器外壳段202附接到远侧连接叉312，使得联接器外壳段202可相对于远侧连接叉312围绕轴的轴线A-A旋转。如在图20中可见，远侧击发轴段510延伸穿过联接器外壳段202的衬套部分203并且可通过安装在衬套部分203内的远侧击发轴轴承322相对于衬套部分被旋转地支撑。
为了促进对端部执行器102施加旋转驱动或击发运动，以及为了促进端部执行器102相对于细长轴30围绕轴的轴线A-A的旋转，同时保持端部执行器102相对于细长轴组件30围绕关节运动轴线B-B关节运动的能力，关节运动接头310可包括独特的或新型的通常命名为350的“嵌套”齿轮组件并且所述齿轮组件被定位在远侧连接叉312和近侧连接叉330之间的齿轮区域351内。参见图18-20。在至少一个形式中，例如，嵌套齿轮组件350可包括与外部端部执行器齿轮系或“第二齿轮系”380“嵌套”的内部驱动轴齿轮系或“第一齿轮系”360。如本文所用，术语“嵌套”可为指第一齿轮系360的任何部分未径向向外延伸越过第二齿轮系380的任何部分。此类独特的和新型的齿轮布置为紧凑的并且促进将旋转控制运动传递到端部执行器，同时还使得远侧连接叉部分能够相对于近侧连接叉部分枢转。如将在下文进一步详细讨论，内部驱动轴齿轮系360促进通过关节运动接头310将旋转驱动或击发运动从近侧击发轴段520施加到远侧击发轴段510。同样，外部端部执行器齿轮系380促进将旋转控制运动从端部执行器旋转系统550施加到联接器组件200，如将在下文进一步详细讨论。
在至少一个形式中，例如，内部驱动轴齿轮系360可包括远侧驱动轴锥齿轮362，所述远侧驱动轴锥齿轮可通过螺杆364附接到远侧击发轴段510的近侧端部。参见图17。内部驱动轴齿轮系360还可包括通过螺杆368附接到近侧击发轴段520的近侧驱动轴锥齿轮366。参见图20。此外，内部驱动轴齿轮系360还可包括安装在传递齿轮轴承374上的驱动轴传递齿轮370，所述传递齿轮轴承安装在横向齿轮轴372上。参见图17。此类内部驱动轴齿轮系360可促进通过关节运动接头310将旋转驱动运动从近侧击发轴段520传递到远侧击发轴段510。
如上所述，嵌套齿轮组件350还包括外部端部执行器齿轮系380，所述外部端部执行器齿轮系促进通过关节运动接头310将旋转控制运动从端部执行器旋转系统550施加到联接器组件200。在至少一个形式中，外部端部执行器齿轮系380可例如包括不可旋转地(如，键入)到联接器外壳段202的近侧延伸的衬套部分203上的输出锥齿轮382。外部端部执行器齿轮系380还可包括输入锥齿轮384，所述输入锥齿轮384不可旋转地附接到(如，键入到)端部执行器旋转系统550的近侧旋转轴段552。此外，外部端部执行器齿轮系380还可包括安装在外部传递齿轮轴承386上的旋转轴传递齿轮388，所述外部传递齿轮轴承支撑在横向延伸的关节运动销332上。参见图17。关节运动销332延伸穿过中空横向齿轮轴372并且用于将远侧连接叉312销接到近侧连接叉330以用于围绕横向关节运动轴线B-B进行关节运动。关节运动轴332可通过弹簧夹334保持在适当位置。独特的和新型的关节运动接头310和嵌套齿轮组件350促进通过细长轴组件30将多个控制运动从柄部组件20传递到端部执行器102，同时使得端部执行器102能够围绕细长轴的轴线A-A旋转并且能够围绕关节运动轴线B-B进行关节运动。
端部执行器102相对于细长轴组件30围绕关节运动轴线B-B的关节运动可通过关节运动控制系统400来实现。在各种形式中，关节运动控制系统400可包括可操作地支撑在柄部组件20中的关节运动控制马达402。参见图15。关节运动控制马达402可联接到关节运动驱动组件410，所述关节运动驱动组件可操作地支撑在可拆卸的驱动安装件700上，所述可拆卸的驱动安装件700可移除地支撑在柄部组件20中，如将在下文进行更详细地讨论。在至少一个形式中，关节运动驱动组件410可包括近侧关节运动驱动轴段412，所述近侧关节运动驱动轴段412可旋转地支撑在可拆卸的驱动安装件700的轴外壳组件710中。参见图27和图28。例如，近侧关节运动驱动轴段412可通过关节运动轴承414可旋转地支撑在远侧轴外壳部分712内。此外，近侧关节运动驱动轴段412可通过轴承415可旋转地支撑在近侧轴外壳部分714中。参见图28。关节运动控制系统400还可包括由关节运动控制马达402围绕轴的轴线A-A可旋转地驱动的近侧关节运动轴段420。如另外在图15中可见，关节运动驱动组件410还可包括用于驱动关节运动驱动带418的一对关节运动驱动滑轮416,417。因此，关节运动控制马达402的关节运动可导致近侧关节运动轴段420围绕轴的轴线A-A的旋转。参见图15。
如在图15和图16中可见，近侧关节运动轴段420具有螺纹部分422，所述螺纹部分422适于与关节运动驱动联接件424螺纹配合。远侧关节运动驱动轴段420沿第一方向的旋转可沿远侧方向“DD”轴向地驱动关节运动驱动联接件424，并且远侧关节运动驱动轴段420沿相反或第二方向的旋转可使得关节运动驱动联接件424沿近侧方向“PD”轴向地运动。关节运动驱动联接件424可通过销428来销接到关节运动杆426。关节运动杆426可继而通过销429来销接到远侧连接叉312。参见图17。因此，当临床医生希望端部执行器102或工具100围绕关节运动轴线B-B相对于细长轴组件30进行关节运动时，临床医生致动关节运动控制马达402，使得关节运动控制马达402旋转近侧关节运动轴段420，从而沿所需方向致动关节运动杆426以沿所需方向枢转远侧连接叉312(和与其附接的端部执行器102)。参见图21和图22。
击发系统
如上所述，端部执行器102可通过由击发系统500对端部执行器驱动螺杆180施加的旋转控制运动来操作，所述击发系统500包括远侧击发轴段510和近侧击发轴段520。参见图23。近侧击发轴段520包括细长轴组件30的一部分并且可通过远侧轴承套筒522可旋转地支撑在中空近侧旋转轴段552内。参见图20。再次参见图23，在至少一个形式中，击发系统500包括可操作地支撑在柄部组件20中的击发马达530。近侧击发轴段520的近侧端部可旋转地支撑在可拆卸的驱动安装件700内并且可被构造为能够按照下文进一步详细讨论的方式联接到马达530。如在图30中可见，近侧击发轴段520的近侧端部可旋转地支撑在推力轴承524中，所述推力轴承与驱动安装隔板组件720的远侧隔板板材722安装在一起。击发马达530的关节运动将最终导致端部执行器驱动螺杆180的旋转，以将旋转控制运动施加到端部执行器102。
端部执行器旋转系统
在各种形式中，外科器械10还可包括端部执行器旋转系统或“远侧滚动系统”550，以用于使得端部执行器102相对于细长轴组件30围绕轴的轴线A-A选择性地旋转。端部执行器旋转系统550可包括近侧旋转轴段552，所述近侧旋转轴段552还包括细长轴组件30的一部分。如在图20中可见，近侧旋转轴段552可通过远侧轴承554和近侧轴承556可旋转地支撑在近侧连接叉330内。此外，近侧旋转轴段552可通过远侧轴承套筒558和近侧轴承559可旋转地支撑在近侧关节运动轴段420内。参见图20和图30。近侧旋转轴段552的近侧端部还可通过近侧轴承555可旋转地支撑在驱动安装隔板组件720内，如在图30中可见。
在至少一个形式中，端部执行器旋转系统550可包括可操作地支撑在柄部组件20中的端部执行器旋转或“远侧滚动”马达560。参见图24。端部执行器旋转马达560可联接到旋转驱动组件570，所述旋转驱动组件570可操作地支撑在可拆卸的驱动安装件700上。在至少一个形式中，旋转驱动组件570包括近侧旋转驱动轴段572，所述近侧旋转驱动轴段可旋转地支撑在可拆卸的驱动安装件700的轴外壳组件710中。参见图27。例如，近侧旋转驱动轴段572可通过轴承576可旋转地支撑在远侧轴外壳部分712内。此外，近侧旋转驱动轴段572通过轴承577可旋转地支撑在近侧外壳部分714中。参见图28。如在图24和图28中可见，旋转驱动组件570还可包括用于驱动旋转驱动带578的一对旋转驱动滑轮574,575。因此，端部执行器旋转马达560的关节运动将导致近侧旋转轴段552围绕轴的轴线A-A的旋转。近侧旋转轴段552的旋转导致联接器组件200旋转并且最终导致与其联接的端部执行器102旋转。
轴旋转系统
外科器械10的各种形式还可包括通常命名为600的轴旋转系统。轴旋转系统在本文还可称为“近侧滚动系统”。在至少一个形式中，轴旋转系统600包括近侧外部轴段602，所述近侧外部轴段602还包括细长轴组件30的一部分。近侧外部轴段602具有远侧端部604，所述远侧端部不可旋转地联接到近侧连接叉330。如在图19和图26中可见，远侧端部604在其中具有间隙凹口606，以用于允许关节运动杆426相对于间隙凹口606进行关节运动。轴旋转系统600可包括可操作地支撑在柄部组件20中的轴旋转或“近侧滚动”马达610。轴旋转马达610可联接到可操作地支撑在可拆卸的驱动安装件700上的轴驱动组件620。在至少一个形式中，轴驱动组件620包括近侧驱动轴段622，所述近侧驱动轴段通过轴承624可旋转地支撑在可拆卸的驱动安装件700的远侧轴外壳部分712中。参见图28。此外，近侧驱动轴段622通过轴承626可旋转地支撑在近侧驱动轴外壳部分714中。如在图26和图28中可见，轴驱动组件620还可包括用于驱动轴驱动带634的一对旋转驱动滑轮630,632。驱动滑轮632不可旋转地附接到近侧驱动轴段602，使得驱动滑轮632的旋转导致近侧驱动轴段602和与其附接的端部执行器102围绕轴的轴线A-A的旋转。如在图28和图30中还可见，近侧驱动轴段602通过一对套筒轴承607和608可旋转地支撑在远侧轴外壳部分712内。
本发明的独特的和新型的关节运动系统布置向端部执行器提供多个自由度，同时促进对其施加旋转控制运动。例如，结合一些外科操作，将端部执行器定位在与靶组织共面的位置内可为必要的。例如，本发明的各种布置给端部执行器提供至少三个自由度，同时满足在执行腹腔镜式外科手术时常常遇到的尺寸局限性。
本发明的外科器械的各种形式促进在相对于靶组织定位端部执行器的过程中提供改善的用户灵巧性、精确性和效率。例如，常用于功率传递的常规轴关节运动接头在很多情况下采用万向接头、铰接脊椎件和挠性顺应性联接件。所有这些方法可往往会经受性能缺陷，包括弯曲半径和过量长度特征方面的缺陷。当与其他常规关节运动布置进行比较时，本文所公开的独特的和新型的细长轴组件和驱动系统的各种形式例如允许关节运动轴线和端部执行器之间的距离最小化。本文所公开的细长轴组件和关节运动接头布置促进向端部执行器传递至少一个旋转控制运动，同时向端部执行器提供多个自由度，以使得端部执行器被构造为能够相对于靶组织精确地定位。
在端部执行器102或工具100已被使用之后，其可从外科器械10的联接器组件200拆卸，并且被处理掉或单独重新加工，并且利用适当的消毒方法进行消毒。外科器械10可结合新端部执行器/工具使用多次。根据特定应用，可期望对外科器械10进行重新消毒。例如，器械10可在用于完成另一个外科手术之前来重新消毒。
外科器械在使用之前必须为无菌的。用于对医疗装置进行消毒的一个通用方法涉及将该装置在所需温度的湿润蒸汽下暴露所需时间段。此类消毒过程尽管有效，但通常不适用于对采用电子部件的外科器械消毒，因为在使用蒸汽消毒方法时产生高温。此类装置常常通过使其暴露于诸如环氧乙烷之类的气体来消毒。
外科器械10的各种形式可使用常规消毒方法来消毒。在至少一个形式中，例如，细长轴组件30可由可通过采用较高消毒温度的方法来有效消毒的部件和材料制成。然而，可为理想的是，当对柄部组件消毒时，例如使用具有较低操作温度的消毒方法以避免可能性地损坏电子部件。因此，可为理想的是将容纳多个电子部件的柄部组件20与细长轴组件30分开进行消毒。为了促进使用此类独立的消毒过程，在至少一个形式中，细长轴组件30可从柄部组件20拆卸。
可拆卸的驱动安装件组件
更具体地讲并且参考图28，可拆卸的驱动安装件组件700可操作地支撑在柄部组件20的一部分内。在一个形式中，例如，可拆卸的驱动安装件组件700可安装在远侧柄部外壳段21和22内，所述远侧柄部外壳段21和22可通过卡合特征结构、螺杆或其他紧固件布置进行互连。联接到一起的远侧柄部外壳段21和22在本文中可称为“远侧柄部外壳部分”或“外壳”25。可拆卸的驱动安装件组件700可例如包括轴外壳组件710，所述轴外壳组件710包括远侧轴外壳712和近侧轴外壳714。可拆卸的驱动安装件组件700还可驱动安装隔板组件720，所述驱动安装隔板组件720包括远侧隔板板材722和近侧联接器隔板板材724。如上所述，在至少一个形式中，可拆卸的驱动安装件组件700可操作地支撑关节运动驱动组件410、近侧击发轴段520的近侧端部、旋转驱动组件570和轴驱动组件620。为了促进将击发轴段520、关节运动驱动组件410、旋转驱动组件570和轴驱动组件620分别快速地联接到击发马达530、关节运动控制马达402、端部执行器旋转马达560和轴旋转马达610，可采用独特的和新型的联接器布置。
马达安装组件
在至少一个形式中，例如，可拆卸的驱动安装件组件700可被构造为能够可移除地联接到通常命名为750的马达安装组件。马达安装组件750可支撑在柄部外壳段23和24内，所述柄部外壳段23和24可通过卡合特征结构、螺钉等联接在一起并且用于形成柄部组件20的手枪式握把部26。参见图1。联接到一起的柄部外壳段23和24在本文中可称为“近侧柄部外壳部分”或“外壳”28。参见图29-32，马达安装组件750可包括可移除地支撑在柄部外壳段23和24内的马达安装件752。在至少一个形式中，例如，马达安装件752可具有底板754和竖直延伸的马达隔板组件756。底板754可具有形成于其上的紧固件突片758，所述紧固件突片758被构造为能够保持性地配合以接收在可拆卸的驱动安装件700的底板部分730内。此外，右定位器销772和左定位器销774安装在马达隔板组件756中并且穿过其朝远侧突出到形成于近侧轴外壳部分714中的对应的右和左插座管716,718中。参见图32。
在至少一个构型中，可拆卸的驱动安装件组件700可通过可释放闩锁布置760可移除地联接到马达安装组件750。如在图31中可见，例如，可释放闩锁布置760可被定位在马达安装组件750的每一横向侧。每个可释放闩锁布置760可包括闩锁臂762，所述闩锁臂762通过对应的销764枢转地附接到马达隔板组件756。每个闩锁臂762可向外突伸穿过形成于马达隔板组件756的远侧上的对应紧固件凸耳766。紧固件凸耳766可被构造为能够被滑动地接收在对应的接收器构件726内，收器构件726从近侧联接器隔板板材724朝近侧突出。参见图30和图32。当驱动安装件组件700与马达安装组件750配合接合时，紧固件凸耳766滑动到对应的接收器构件726内，使得闩锁臂762保持接合对应接收器构件726的闩锁部分728。每个闩锁臂762具有与其相关联的对应闩锁弹簧768，以将闩锁臂762偏置成保持与对应的闩锁部分728接合，以保持可拆卸的驱动安装件组件700联接到马达安装组件750。此外，在至少一个形式中，每个闩锁布置760还包括释放按钮770，所述释放按钮770可运动地联接到马达隔板756并且被取向成与其选择性地接触。每个释放按钮770可包括释放弹簧771，所述释放弹簧771将按钮770偏置成与其对应的闩锁臂762脱离接触。当临床医生期望将可拆卸的驱动安装件组件700从马达安装组件750拆卸时，临床医生仅向内推压每个按钮770，以将闩锁臂762偏置成与接收器构件726上的闩锁部分728脱离保持接合，并且随后牵拉可拆卸的驱动安装件组件700以与马达安装组件750脱离配合接合。其他可释放闩锁布置可用于可释放地联接可拆卸的驱动安装件组件700，可拆卸的驱动安装件组件700可移除地联接到马达安装组件750。
外科器械10的至少一种形式还可采用联接器组件，以用于将控制马达联接到其相应的驱动组件，所述驱动组件可操作地支撑安装在可拆卸的驱动安装件700上。更具体地讲并且参考图28-32，联接器组件780用于将关节运动驱动组件410可移除地联接到关节运动控制马达402。联接器组件780可包括近侧联接器部分782，所述近侧联接器部分782可操作地联接到关节运动控制马达402的驱动轴404。此外，联接器组件780还可包括附接到近侧关节运动驱动轴412的远侧联接器部分784。参见图28和图32。每个远侧联接器部分784可具有多个(示出三个)联接器突起786，所述联接器突起786被设计成与形成于近侧联接器部分782中的对应扇形区域788不可旋转地安置在一起。参见图30。相似地，另一个远侧联接器部分784可附接到旋转驱动组件570的近侧旋转驱动轴572，并且对应的近侧联接器部分782附接到旋转马达驱动轴562。此外，另一个远侧联接器部分784可附接到近侧击发轴段520，并且对应的近侧联接器部分782附接到击发马达驱动轴532。另一个远侧联接器部分784可附接到轴驱动组件620的近侧驱动轴段622，并且对应的近侧联接器部分782附接到轴旋转马达610的驱动轴612。此类联接器组件780促进在不考虑驱动轴和马达轴的位置的情况下将控制马达联接到其相应的驱动组件。
上文所述的独特的和新型的柄部组件布置的各种形式使得细长轴组件30能够从柄部组件20的保持部分容易地拆卸，所述柄部组件20容纳马达402,530,560和610以及构成通常命名为800的控制系统的各个电子部件。因此，细长轴组件30和可拆卸的驱动安装件部分700可与容纳马达和控制系统的柄部组件的保持部分分开来消毒，所述马达和控制系统可因采用高温消毒的方法而损坏。此类独特的和新型的可拆卸的驱动安装布置还可与以下布置结合使用，其中驱动系统(马达和控制部件)包括可为或可并非为手持式的机器人系统的一部分。
齿轮驱动的驱动安装件布置
图100-103示出了另选的驱动安装件5700，所述驱动安装件5700采用齿轮驱动的集合，以用于将驱动运动从马达传递到其对应的轴。如在图100中可见，驱动安装件5700可包括远侧轴外壳组件5710，所述远侧轴外壳组件5710包括可操作地支撑多个齿轮系布置的远侧轴外壳5712。远侧轴外壳5712被构造为能够可移除地安装到近侧联接器隔板板材5724，所述近侧联接器隔板板材5724具有一对安装插座5725，以用于接收从远侧轴外壳5712突出的对应安装凸耳5713，如在图100中可见。如在上述布置中，击发或横切马达530的轴通过联接器组件5780直接联接到近侧击发轴段5520，如在图103中可见。端部执行器旋转系统550的近侧旋转轴段5552通过通常示为5565的齿轮系进行旋转。在至少一个形式中，例如，齿轮系5565包括从动齿轮5566，所述从动齿轮5566附接到近侧旋转轴段5552并且被支撑以与驱动齿轮5567啮合接合。如在图103中最具体可见，驱动齿轮5567被安装到可旋转地支撑在远侧轴外壳5712中的正轴5568。正轴5568通过联接器组件5780联接到端部执行器旋转或远侧滚动马达560的轴。
近侧关节运动轴段5420通过通常示为5430的齿轮系进行旋转。在至少一个形式中，例如，齿轮系5430包括从动齿轮5432，所述从动齿轮5432附接到近侧关节运动轴段5420并且被支撑以与驱动齿轮5434啮合接合。如在图102中最具体可见，驱动齿轮5434被安装到可旋转地支撑在远侧轴外壳5712中的正轴5436。正轴5436通过联接器组件5780联接到关节运动控制马达402的轴。
近侧外部轴段5602通过通常示为5640的齿轮系进行旋转。在至少一个形式中，例如，齿轮系5640包括从动齿轮5642，所述从动齿轮5642附接到近侧外部轴段5602并且被支撑以与复合锥齿轮5644啮合接合，所述复合锥齿轮5644可旋转地支撑在远侧轴外壳5712内。复合锥齿轮5644与驱动锥齿轮组件5646啮合接合，所述驱动锥齿轮组件5646安装到还可旋转地支撑在远侧轴外壳5712中的正轴5648。正轴5648通过联接器组件5780联接到轴旋转或近侧滚动马达610的轴。参见图101。可使用另选的驱动安装件5700马达和齿轮系以按照本文所述的方式来供能和控制外科器械。
动力和控制系统
在各种形式中，外科器械10可采用通常命名为800的控制系统，以用于控制用于该器械中的多个马达。马达402,530,560和610及其相关的控制部件在本文还可称为通常命名为398的“驱动系统”。在一个形式中，驱动系统398用于“用电力产生”多个控制运动。术语“用电力产生”是指使用电信号来致动马达或其他电动装置并且可区别于不使用电流而手动或以其他方式机械地产生的控制运动。在一个形式中，驱动系统398可操作地支撑在柄部组件内，所述柄部组件可保持在临床医生的手中。然而，在其他形式中，驱动系统398可包括机器人系统的部件，并且/或者可由机器人系统操作和/或支持。
在一个形式中，马达402,530,560和610及其相关的控制部件可接收来自电池802的功率，所述电池802容纳在柄部组件20的手枪式握把部26内。在其他布置中，电池可例如由机器人系统支持。然而，在其他实施例中，柄部组件20可具有从其突出的电线(未示出)，以用于从另一个功率源提供功率。在其他布置中，马达和电子部件可接收来自机器人系统的功率和控制信号。控制系统800可包括各种控制系统部件，所述控制系统部件可包括例如支撑在可拆卸的驱动安装件700上的远侧电路板810。远侧电路板810可包括电连接器812和/或电子部件，所述电连接器812和/或电子部件可利用常规蒸汽消毒技术以及通过其他低温消毒方法来消毒。控制系统800还可包括近侧电路板820，所述近侧电路板820支撑在由柄部外壳段23和24形成的柄部组件20的一部分中。近侧电路板820被构造为能够在可拆卸的驱动安装件700已联接到马达安装组件750时电联接到远侧电路板810。
外科器械10的各种形式可采用独特的和新型的控制开关布置830，所述控制开关布置830可操作地容纳在柄部组件20的手枪式握把部26内或者由其支撑。例如，在至少一个形式中，控制开关布置830可包括独特的和新型的操纵杆控制器840，所述操纵杆控制器840使得用户能够通过单个接口来最大化外科器械10的各个方面的功能控制。更具体地讲并且参考图33-39，操纵杆控制器840的一个形式可包括可操作地附接到操纵杆开关组件850的操纵杆控制杆842，所述操纵杆开关组件850可运动地容纳在开关外壳组件844内。开关外壳组件844可安装在柄部组件20的手枪式握把部26内。在至少一个形式中，例如，开关外壳组件844可包括外壳主体846和后外壳板848。如在图35-39中最具体可见，操纵杆印刷电路板852可通过后安装板854可操作地支撑在操纵杆开关组件850上。后安装板854可被构造为能够作为与开关外壳844内的操纵杆开关组件850和操纵杆印刷电路板电路852一起的单元运动。操纵杆弹簧856可支撑在后外壳板848和后安装板854之间，以沿着向前或远侧方向偏置操纵杆开关组件850和操纵杆控制杆842。参见图36和图38。
操纵杆控制器840可通过各种联接器缆线864电联接到控制系统800的近侧电路板820和电池802，以用于对外科器械10的多个马达402,530,560和610提供控制功率。例如，通过摇摆或以其他方式致动操纵杆控制杆842，用户可控制关节运动控制马达402和/或远侧滚动马达560和/或近侧滚动马达610。
操纵杆控制开关组件850在本文中可称为“第一开关”，以用于控制驱动系统的一个或多个马达。操纵杆控制器840还可包括第一传感器860，所述第一传感器860可包括例如磁体，所述磁体可安装到印刷电路板852的操纵杆以用于与其一起可运动行进。此外，第二或固定传感器862可安装在后外壳板848内。第二传感器862可包括例如“霍尔效应”传感器或类似的感测装置。例如，在至少一个布置中，传感器862可被构造为能够与击发马达530连通。第一和第二传感器860,862在本文中可称为通常命名为858的“第二开关”。当用户按压操纵杆控制杆842时，上述布置允许操纵杆开关组件850向内和向外轴向地运动。通过平衡整个操纵杆开关组件850的向内和向外运动，在至少一个形式中，该设计基本上由开关内的开关组成。在未致动位置中，操纵杆弹簧856沿向前(远侧)方向偏置操纵杆开关组件850。当临床医生向内(朝近侧)推压操纵杆842时，第一传感器860运动更靠近第二传感器862。第一传感器860运动更靠近第二传感器862可导致所谓的第二开关858的致动，这可导致横切或击发马达530的致动。
当使用端部执行器102执行手术时，临床医生可希望打开和闭合砧座组件190，以将靶组织操纵到所需位置中而不横切或切割组织。在一个形式中，当临床医生初始按压操纵杆控制杆842时，第二开关858导致击发马达530启动，由此使得组织切割构件160开始朝远侧运动。在各种形式中，组织切割构件160被布置在端部执行器102内，使得组织切割构件160沿远侧方向的初始运动使得砧座组件190闭合(即，朝钉仓130枢转而不切割组织或击发外科缝钉)。当临床医生释放操纵杆控制杆842时，操纵杆弹簧856将朝远侧偏置操纵杆组件850，由此使第一传感器860远离第二传感器862运动。传感器860远离第二传感器862的运动可降低击发马达530的旋转速度，直至击发马达530最终停止或停用。在至少一个形式中，此第二开关布置858可被构造为能够使得击发马达530的旋转速度与用户按压操纵杆控制杆842的速度成正比。
一旦临床医生已将所需组织定位并且捕获在端部执行器102内，可通过完全按压操纵杆控制杆842来致动或“击发”端部执行器102。在各种形式中，操纵杆开关组件850还可具有一体化形成于其中并且还与控制系统800连通的第三压缩开关866。操纵杆控制杆842的完全压下可导致第三开关866的启动。在至少一个形式中，当启动第三开关866时，击发马达530将保持启动，即使临床医生释放操纵杆控制杆842。在击发行程已完成之后(即，组织切割构件160已被驱动到其在端部执行器102中的最远侧位置)，用户可再次完全压下操纵杆控制杆842，以释放第三开关866并且由此返回第二开关858对击发马达530的控制。因此，如果临床医生在第二次完全压下操纵杆控制杆842之后将其释放，则操纵杆弹簧856将操纵杆开关组件850偏置到起始位置。控制系统800将使得击发马达530沿相反方向旋转，直至组织切割构件160已返回到其起始位置，由此使得砧座组件190再次运动到打开位置，以使得端部执行器102能够释放横切的组织。
在各种形式中，开关布置830还可采用独特的和新型的压轮控制组件870。如在图42中可见，压轮控制组件870可旋转地安装在开关外壳组件844的朝远侧突出的衬套部分845上，使得压轮控制组件870能够围绕开关轴线SA-SA枢转。这种定位将压轮控制组件870的压轮致动器构件872方便地置于以下位置，在该位置，临床医生可在抓握柄部组件20的手枪式握把部26时利用拇指和/或食指来枢转压轮致动器构件。压轮致动器构件872可附接到压轮衬圈874，所述压轮衬圈874被接收在衬套部分845上并且可通过由柄部段23和24形成的安装凸缘27来可旋转地保持在适当位置。左传感器(磁体)876和右传感器(磁体)878安装到压轮衬圈874，如图41所示。传感器876和878可具有相反的极性。固定传感器880可安装到开关外壳组件844，使得其居中设置在左传感器876和右传感器878之间。固定传感器880可包括例如“霍尔效应”传感器并且联接到控制系统800的近侧电路板820以用于对控制马达中的一者进行控制。例如，压轮控制组件870可用于控制例如近侧滚动或轴旋转马达610。在其他布置中，压轮控制组件870可用于控制远侧滚动马达560，以使端部执行器相对于细长轴组件围绕轴的轴线旋转。一对定心弹簧882可用于将压轮衬圈874偏置到中心或中性位置。如图41所示，当压轮衬圈874处于中性位置时，轴旋转或近侧滚动马达610(或远侧滚动马达560-可为任何一种情况)被停用。
当用户将压轮致动器872沿顺时针方向枢转到图43所示的位置时，控制系统800可导致轴旋转马达610围绕轴的轴线A-A沿顺时针方向旋转细长轴组件30。同样，当用户将压轮致动器872沿逆时针方向枢转到图44所示的位置时，控制系统800可导致轴旋转马达610围绕轴的轴线A-A沿逆时针方向旋转细长轴组件30。换句话讲，当用户顺时针或逆时针枢转压轮致动器872时，固定传感器880根据左传感器876和右传感器878与固定传感器880的接近关系来控制细长轴组件30的旋转方向。固定传感器880的响应可被构造为能够当用户增大压轮致动器872的旋转时，马达610旋转细长轴组件30的相对速度增大。如在图41-44中可见，止动凸耳847可形成于开关外壳组件844上，以与压轮衬圈中的凹口875配合，从而阻止可运动传感器876,878和固定传感器880之间的接触。本领域的普通技术人员将会理解，压轮控制组件870可用于控制外科器械10的其他马达中的任一个。相似地，操纵杆控制器840可被构造为能够控制外科器械10中的任何一个或多个马达。本文所公开的独特的和新型的压轮控制组件布置使得用户能够通过人体工程学压轮致动器接口的旋转来进行功能控制。在另选的形式中，可运动传感器876,878可包括各自与马达连通的霍尔效应传感器。固定传感器880可包括磁体。
在各种形式中，外科器械10的马达中的每一个可设置有对应的编码器，所述编码器与近侧电路板820上的微处理器芯片连通。例如，关节运动控制马达402可具有与其可操作地联接的编码器404，所述编码器404与近侧电路板820连通。击发或横切马达530可具有与其可操作地联接的编码器534，所述编码器534与近侧电路板820连通。端部执行器旋转或远侧滚动马达560可具有与其可操作地联接的编码器564，所述编码器564与近侧电路板820连通。轴旋转或近侧滚动马达610可具有与其可操作地联接的编码器614，所述编码器614与近侧电路板820连通。编码器可用于为对应的微处理器芯片提供与每个马达的旋转次数和旋转方向相关的反馈。在一些形式中，除了编码器之外，旋转驱动组件570可采用传感器布置以跟踪各个轴段的旋转。例如，如在图15、28和29中可见，关节运动驱动滑轮417可具有安装到其的第一关节运动传感器419，所述第一关节运动传感器419能够通过第二关节运动传感器421检测，所述第二关节运动传感器421可包括例如安装到远侧电路板810的霍尔效应传感器。第一关节运动传感器419和第二关节运动传感器421用于提供另外的反馈装置，以用于跟踪近侧关节运动轴420的可旋转位置。同样，旋转驱动组件570的远侧滚动滑轮575可安装到其的第一远侧滚动传感器580，所述第一远侧滚动传感器580能够通过安装到远侧电路板810的第二远侧滚动传感器582检测。参见图24、28和29。第一远侧滚动传感器580和第二远侧滚动传感器582用于提供另外的反馈装置，以用于跟踪近侧旋转轴段552的可旋转位置。此外，近侧滚动驱动组件620的滑轮632可具有第一近侧滚动传感器634，所述第一近侧滚动传感器634能够通过安装到远侧电路板810的第二近侧滚动传感器636检测。参见图26、28和29。第一近侧滚动传感器634和第二近侧滚动传感器636用于提供另外的反馈装置，以用于跟踪近侧外部轴段602的可旋转位置。
从端部执行器到柄部组件的导电性通路
如本文所述，外科器械10的各种形式可有效地与多种不同的端部执行器或外科工具结合使用，所述端部执行器或外科工具需要或者采用用于端部执行器/工具操作或操纵的旋转或其他运动。例如，端部执行器102的一个形式需要旋转控制运动，以打开和闭合砧座组件190、驱动外科缝钉、以及横切组织。端部执行器102的一个形式还可配有远侧传感器布置，以用于感测砧座组件190相对于外科钉仓130所达到的闭合程度或量。例如，砧座组件190可包括安装在其远侧端部中的第一砧座传感器890。参见图3。砧座传感器890可包括例如霍尔效应传感器，所述霍尔效应传感器被构造为能够检测安装在外科钉仓130的远侧端部中的第二钉仓传感器(磁体)892。在至少一个形式中，第一砧座传感器890可与安装在如图所示的砧座组件190上的至少一个端部执行器导体894连通。在一个形式中，例如，端部执行器导体894包括扁平金属条，所述扁平金属条具有形成于其近侧端部上的柔性钩896。通常如本文所用，术语“导体”或“导电性”是指能够通过其导电的构件或部件。导体可包括例如一根或多根导线、柔性导电条或金属迹线、多通道导电带缆等。如本文所用，术语“电接触”和“电连通”是指其间被构造为能够传送电流或电信号的部件。
现在参见图45和图46，可以看出，柔性钩896可被取向成用于与锁定销242的远侧端部244接触。锁定销242可例如由导电材料布置，并且可涂覆有绝缘涂层(如，聚合物等)以使得锁定销242与联接器外壳段202电绝缘，但具有被构造为能够与钩896电接触的暴露顶端。此外，锁定弹簧246也可由导电材料(如，金属)制成。锁定弹簧246可附接(如，焊接等)到锁定销242，使得锁定销242和锁定弹簧246形成导电联接件通路，以用于通过联接器组件200传导电流。锁定弹簧246还可涂覆有绝缘涂层，以使其与联接器外壳段202电绝缘。锁定销242和锁定弹簧246可在本文中统称为“锁定销组件”249。锁定弹簧246可终止于近侧端部247中，所述近侧端部247被构造为能够与近侧导体组件250可滑动地电接触，所述近侧导体组件250安装到关节运动接头310的远侧连接叉312。
如在图8中可见，近侧导体组件250的一个形式可包括导线/电线/迹线252和呈例如导电垫圈254形式的环形电导体。如在图46中可见，导体252与近侧导体部分256连通，所述近侧导体部分256突伸穿过远侧连接叉312以与由柔性接头覆盖件900支撑的关节运动接头导体258连通，所述柔性接头覆盖件900在关节运动接头310上延伸。在至少一个形式中，接头覆盖件900包括中空主体902，所述中空主体902具有开口近侧端部904和开口远侧端部906以及在两者间延伸的接头接收通道908。中空主体902可包含多个肋910并且可由聚合物或类似的非导电材料制成，所述材料可全方位拉伸以适应关节运动接头部件的运动。然而，接头覆盖件900还可由其他合适的材料和布置(例如，柔性微切割管等)制成。关节运动接头导体258可包括例如传导性带缆、导线、电线、迹线等。如还可在图46中可见，关节运动接头导体258的近侧端部电联接到近侧外部轴段602上的轴导体260。
现在参见图47和图48，在至少一个形式中，轴导体260的近侧端部可被取向成与安装在柄部组件20中的环形导体环262滑动接触。当细长轴组件30相对于柄部组件20围绕轴的轴线A-A旋转时，此类布置可使得电流能够在轴导体260和导体环262之间流动。如还可在图47和图48中可见，导体264联接到导体环262并且朝近侧延伸穿过柄部外壳20。导体264可包括导线或其他合适的电导体并且具有近侧端部266，所述近侧端部266被构造为能够柔性接触左定位器销774的顶端。具体地讲，例如，近侧端部266可延伸穿过左定位器插座718的壁，使得当左定位器销774插入其中时，导体264的近侧端部部分266与左定位器销774接触。在至少一个形式中，左定位器销774由导电材料(金属)制成，使得当导体164的近侧端部266与其接触时，电流可在那些部件之间流动。此外，附接导体776用于将左定位器销774电联接到近侧电路板组件820，以促进电流在两者间的传递。
上述布置促进电流在端部执行器或外科工具与控制系统部件之间流过，所述端部执行器或外科工具已附接到外科器械10的细长轴组件30，所述控制系统部件位于外科器械10的柄部组件20中。此导电性通路可得到保持，同时仍能保持端部执行器相对于细长轴组件旋转、端部执行器相对于细长轴组件进行关节运动、以及端部执行器和细长轴组件作为一个单元旋转的能力。接头覆盖件900可在细长轴和端部执行器之间提供电连通路径。接头覆盖件900可包含电挠曲带、导线、迹线等以传导用于电连通的不止一个信号。因此，多个不同的传感器或电子部件可用于端部执行器中以向用户提供各种形式的反馈。例如，传感器可用于测定使用循环的次数、跟踪击发期间端部执行器内的切割器械的进程、为控制系统提供反馈以自动地控制柄部组件中的多个马达等等。
图49示出了被构造为能够允许电流或信号从中穿过的另选的关节运动接头310’。在此形式中，远侧电接头导体270被提供为穿过远侧连接叉312’以接触嵌入其中的远侧金属垫圈272，如图所示。近侧连接叉330’可具有安装到其的近侧金属垫圈274，以用于当远侧连接叉312’按照上述方式联接到近侧连接叉330”时旋转地接触远侧金属垫圈272。近侧金属垫圈274可为弯曲的或倾斜的，以保持垫圈272,274之间的滑动接触。呈例如导体带、导线、迹线形式的近侧电接头导体276附接到垫圈274，并且被构造为能够与近侧外部轴段602上的轴导体260电接触。因此，此类布置促进电流或信号从端部执行器102通过锁定销242、锁定弹簧242(即，锁定销组件249)、导体环252、远侧电接头导体270、垫圈272,274和近侧电接头导体276传送到轴导体260。
另选的关节运动接头布置
图50-53示出了关节运动接头1000的另一个形式。此类关节运动接头1000可促进与其附接的端部执行器或外科工具相对于附接到关节运动接头1000的细长轴的轴的轴线A-A进行关节运动和旋转。关节运动接头还可促进端部执行器或外科工具的此类运动，同时还对端部执行器/工具提供旋转控制运动以用于其致动或操纵。关节运动接头1000可联接到细长轴组件(所述细长轴组件具有类似于上述细长轴组件30的构造)，或者其可联接到其他合适的轴组件。细长轴组件可联接到容纳多个马达的柄部组件。一个马达可用于对柔性电缆构件1010施加控制运动，所述柔性电缆构件1010延伸穿过细长轴组件并且可操作地联接到关节运动接头1000。例如，柔性电缆1010可附接到槽轮或滑轮组件，所述槽轮或滑轮组件与对应马达的轴可操作地附接或连通，以使得马达的操作导致缆线1010被致动。柄部组件还可包括击发马达，所述击发马达可操作地附接到近侧击发轴1030，所述近侧击发轴1030延伸穿过细长轴组件以与关节运动接头1000交接，如将在下文进一步详细讨论。柄部组件还可包括与端部执行器或远侧滚动轴1040可操作地交接的马达，所述端部执行器或远侧滚动轴1040将旋转控制运动传递到关节运动接头1000，所述关节运动接头1000可用于使得端部执行器或外科工具相对于细长轴围绕轴的轴线A-A旋转。柄部组件还可包括近侧滚动马达，所述近侧滚动马达用于使细长轴组件按照上文所述的方式围绕轴的轴线A-A旋转。
在至少一个形式中，关节运动接头1000可包括近侧连接叉组件1020，所述近侧连接叉组件1020附接到或形成于细长轴组件的端部上。在图50-53所示的布置中，近侧连接叉组件1020形成于细长轴组件30’的远侧端部上。如在这些附图中可见，近侧连接叉组件1020具有远侧端壁1022和一对隔开的连接叉臂1024,1026。近侧连接叉1020被构造为能够通过用于限定关节运动轴线B-B的枢转轴1051可枢转地联接到远侧连接叉1050。关节运动轴线B-B可基本上横向于轴的轴线A-A。
远侧连接叉1050具有形成于其上的插座1052和一对远侧连接叉臂1054,1056。枢转轴1051居中地延伸穿过连接叉臂1024,1054,1056和1026，如图53所示。连接叉臂1054可具有形成于其上以与柔性电缆1010附接的缆线滑轮1058。因此，缆线1010通过其对应马达的旋转将导致远侧连接叉1050相对于近侧连接叉1020围绕关节运动轴线B-B进行旋转。
在各种形式中，关节运动接头1000还可包括可旋转的安装衬套1060，所述安装衬套1060可旋转地接收在插座1052内。安装衬套1060可具有与其附接的环形齿轮1062，所述环形齿轮1062能够与远侧滚动小齿轮1064啮合接合。远侧滚动小齿轮1064附接到小齿轮轴1066，所述小齿轮轴1366可旋转地支撑在远侧连接叉1050的端壁1053中。小齿轮轴1066具有与其附接的远侧滚动输出齿轮1068。远侧滚动输出齿轮1068被支撑以与远侧滚动传递齿轮1070(其可旋转地轴颈连接枢转轴1051上)啮合接合并且与远侧滚动输入齿轮1072啮合接合。远侧滚动输入齿轮1072被安装到远侧滚动轴1040。远侧滚动输出齿轮1068、远侧滚动传递齿轮1070和远侧滚动输入齿轮1072在本文中称为通常命名为1069的“远侧滚动齿轮系”。远侧滚动传递齿轮1070在枢转轴1051上“自由转动”，使得远侧滚动轴1040的旋转最终导致远侧滚动小齿轮1064的旋转而未旋转枢转轴1051。远侧滚动小齿轮1064在环形齿轮1062内的旋转导致安装衬套1060围绕轴的轴线A-A的旋转。在各种形式中，端部执行器或外科工具可直接联接到安装衬套1060，使得安装衬套1060的旋转导致端部执行器/工具的旋转。例如，安装衬套1060可形成有衬套插座1061，所述衬套插座1061的尺寸设定成将端部执行器/工具的一部分保持性地接收于其中。在另选的布置中，安装衬套1060可包括端部执行器的整体部分，或者端部执行器可通过其他紧固件布置附接到安装衬套1060。例如，安装衬套1060可附接到具有上文所述的类型和构造的联接组件，并且随后端部执行器/工具可拆卸地附接到联接组件。
关节运动接头1000还可促进将旋转控制运动通过接头1000传递到与其附接的端部执行器/工具。如在图52和53中可见，近侧击发轴1030的远侧端部由近侧连接叉组件1020的远侧端壁1022可旋转地支撑，并且具有与其附接的输入击发齿轮1080。输入击发齿轮1080与轴颈连接在枢转轴1051上的击发传递齿轮1082啮合接合。击发传递齿轮1082与击发输出齿轮1084啮合接合，所述击发输出齿轮1084安装在击发输出轴1090上，所述击发输出轴1090安装在远侧连接叉1050的端壁1053中。击发输出轴1090可被构造为能够与端部执行器/工具上的对应驱动构件或轴驱动接合。例如，击发输出轴1090的远侧端部1092可形成有六边形形状，以使其可接收在形成于安装凸缘1094中的六边形插座中，所述安装凸缘1094可被构造为能够附接到端部执行器/工具的驱动轴。击发输入齿轮1080、击发传递齿轮1082、和击发输出齿轮1084在本文中称为通常命名为1081的“击发轴齿轮系”。击发传递齿轮1082在枢转轴1051上“自由转动”，使得近侧击发轴1030的旋转最终导致击发输出轴1090的旋转而未旋转驱动轴1051。远侧滚动齿轮系1069和击发轴齿轮系1081基本上“嵌套”在一起，以促进端部执行器/工具相对于细长轴组件的关节运动，同时促进将旋转控制运动传递到端部执行器，并且同时促进端部执行器围绕轴的轴线A-A的旋转。
图54-60示出了另一个另选的关节运动接头布置1100。在至少一个形式中，关节运动接头1100可包括近侧连接叉1110、中心连接叉1130和远侧连接叉1150。关节运动接头1100可被构造为能够促进与其联接的端部执行器或外科工具围绕两个不同的关节运动轴线B-B和C-C进行关节运动，所述关节运动轴线B-B和C-C基本上横向于彼此以及横向于附接端部执行器或外科工具的细长轴组件30”的轴的轴线A-A。例如，关节运动接头1100可被构造为能够使得中心连接叉1130可相对于第一连接叉1110围绕一关节运动轴线B-B进行枢转，并且使得远侧连接叉1150可相对于中心连接叉1130围绕第二关节运动轴线C-C进行枢转。关节运动接头1100还可促进端部执行器或外科工具的此类关节运动，同时还对端部执行器/工具提供旋转控制运动以用于其致动或操纵。
关节运动接头1100可联接到细长轴组件(所述细长轴组件具有类似于上述细长轴组件30的构造)，或者其可联接到其他合适的轴组件。在一个布置中，近侧连接叉1110与细长轴组件30”一体化形成。如在图54-60中可见，近侧连接叉1110具有上近侧连接叉臂1112和下近侧连接叉臂1114。中心连接叉1130还具有上中心连接叉臂1132和下中心连接叉臂1134。上近侧连接叉臂通过近侧枢转销1116可枢转地联接到上中心连接叉臂1132。近侧枢转销1116还将下近侧连接叉臂1114可枢转地联接到下中心连接叉臂1134。近侧枢转销1116用于限定第一关节运动轴线B-B。
另外，在至少一个布置中，中心连接叉1130具有右中心连接叉臂1136和左中心连接叉臂1138。远侧连接叉1150具有右远侧连接叉臂1152和左远侧连接叉臂1154。右中心连接叉臂1136通过远侧枢转销1156可枢转地联接到右远侧连接叉臂1152。左中心连接叉臂1138通过远侧枢转销1156可枢转地联接到左远侧连接叉臂1154。远侧枢转销1156限定第二关节运动轴线C-C。在一个布置中，远侧枢转销1156不可枢转地附接到右远侧连接叉臂1152和左远侧连接叉臂1154，使得远侧枢转销1156与远侧连接叉1150一起相对于中心连接叉1130旋转。
细长轴组件30”可联接到容纳多个马达的柄部组件。一个马达可用于对第一柔性电缆构件1170施加控制运动，所述第一柔性电缆构件1170延伸穿过细长轴组件30”并且可操作地联接到关节运动接头1100。例如，第一柔性电缆1170可附接到第一槽轮或滑轮组件，所述第一槽轮或滑轮组件可操作地附接到对应马达的轴或与其连通，使得马达的操作导致第一缆线1170被致动。
在一个布置中，第一柔性电缆1170可用于使得中心连接叉1130相对于近侧连接叉1110围绕第一关节运动轴线B-B选择性地枢转。在此类布置中，例如，第一缆线1170围绕附接到中心连接叉1130的第一滑轮或槽轮1180延伸。例如，第一滑轮1180附接到上中心连接叉臂1132并且可枢转地轴颈连接在近侧枢转销1116上。第一缆线1170的致动将导致中心连接叉1130相对于近侧连接叉1110围绕第一关节运动轴线B-B枢转。
关节运动接头1100还可采用第二柔性电缆1190，所述第二柔性电缆1190接收在槽轮或滑动组件上，所述槽轮或滑动组件可操作地附接到柄部组件内的对应马达的轴或与其连通，使得马达的操作导致第二电缆1190被致动。第二缆线1190可用于使得远侧连接叉1150相对于中心连接叉1130围绕第二关节运动轴线C-C选择性地枢转。在此类布置中，例如，第二缆线1190围绕第二滑轮或槽轮1158延伸，所述第二滑轮或槽轮1158不可旋转地附接到远侧枢转销1156。第二缆线1190的致动将导致远侧枢转销1156和与其附接的远侧连接叉1150相对于中心连接叉1130围绕第二关节运动轴线C-C旋转。
关节运动接头1100还可促进将旋转控制运动通过接头1100传递到与其附接的端部执行器/工具。近侧旋转击发轴1200可延伸穿过细长轴组件30”并且可操作地联接到柄部组件中的击发马达以用于对其施加旋转击发运动。在一个布置中，近侧击发轴1200可为中空的，使得第二缆线1190可从中延伸穿过。近侧击发轴1200可操作地与近侧击发齿轮系1210交接，所述近侧击发齿轮系1210可操作地支撑在关节运动接头1100中。例如，在一个布置中，第一击发齿轮系1210可包括附接到近侧击发轴1200的近侧输入击发齿轮1212。近侧输入击发齿轮1212被取向成与近侧击发传递齿轮1214啮合接合，所述近侧击发传递齿轮1214轴颈连接在近侧枢转轴1116上从而可在其上自由旋转。近侧击发传递齿轮1212被取向成与近侧击发输出齿轮1216啮合接合，所述近侧击发输出齿轮1216联接到中心击发轴1218，所述中心击发轴1218可旋转地穿过中心连接叉1131的中心腹板。
关节运动接头1100还可包括远侧击发齿轮系1220，所述远侧击发齿轮系1220与近侧击发齿轮系1210相配合以通过关节运动接头1100传递旋转击发或控制运动。远侧击发齿轮系1220可包括安装到中心击发轴1216的远侧击发输入齿轮1222。远侧击发输入齿轮1222与远侧击发传递齿轮1224啮合接合，所述远侧击发传递齿轮1224可旋转地安装到远侧枢转销1156从而可在其上自由旋转。远侧击发传递齿轮1224与远侧击发输出齿轮1226啮合接合，所述远侧击发输出齿轮1226可旋转地支撑在远侧连接叉1150内。远侧击发输出齿轮1226可被构造为能够与端部执行器/工具上的对应驱动构件或轴驱动接合。
图61-66示出了关节运动接头1300的另一个形式。此类关节运动接头1300可促进与其附接的端部执行器或外科工具相对于附接到关节运动接头1300的细长轴的轴的轴线A-A进行关节运动和旋转。关节运动接头还可促进端部执行器或外科工具的此类运动，同时还对端部执行器/工具提供旋转控制运动以用于其致动或操纵。关节运动接头1300可联接到细长轴组件(所述细长轴组件具有类似于上述细长轴组件30的构造)，或者其可联接到其他合适的轴组件。细长轴组件可联接到容纳多个马达的柄部组件。一个马达可用于对柔性电缆1310施加控制运动，所述柔性电缆1310延伸穿过细长轴组件并且可操作地联接到关节运动接头1300。例如，柔性电缆1310可附接到槽轮或滑轮组件，所述槽轮或滑轮组件与对应马达的轴可操作地附接或连通，使得马达的操作导致缆线1310被致动。柄部组件还可包括击发马达，所述击发马达可操作地附接到近侧击发轴1330，所述近侧击发轴1030延伸穿过细长轴组件以与关节运动接头1300交接，如将在下文进一步详细讨论。柄部组件还可包括与柔性远侧滚动轴1340可操作地交接的马达，所述柔性远侧滚动轴1040将控制运动传递到关节运动接头1300，所述关节运动接头1000可用于使端部执行器或外科工具相对于细长轴围绕轴的轴线A-A旋转。柄部组件还可包括近侧滚动马达，所述近侧滚动马达用于使细长轴组件按照上文所述的方式围绕轴的轴线A-A旋转。
在至少一个形式中，关节运动接头1300可包括近侧连接叉组件1320，所述近侧连接叉组件1020附接到或形成于细长轴组件的端部处。在图61-66所示的布置中，近侧连接叉组件1320形成于形成细长轴组件30”的一部分的外管的远侧端部上。如在这些附图中可见，近侧连接叉组件1320具有远侧端壁1322和一对隔开的连接叉臂1324,1326。近侧连接叉1320被构造为能够通过上枢转轴1351和下枢转轴1353可枢转地联接到远侧连接叉1350，所述上枢转轴1351和下枢转轴1353用于限定关节运动轴线B-B。关节运动轴线B-B基本上横向于轴的轴线A-A。
远侧连接叉1350具有形成于其上的插座1352和一对远侧连接叉臂1354,1356。上枢转轴1351居中地延伸穿过连接叉臂1324和1354。下枢转轴1353延伸穿过连接叉臂1356和1026，如图64所示。连接叉臂1356还具有形成于其上或与其附接的缆线滑轮1358。柔性电缆1310附接到缆线滑轮1358，使得缆线1310的致动将导致远侧连接叉1350相对于近侧连接叉1320围绕关节运动轴线B-B进行关节运动。
在各种形式中，关节运动接头1300还可包括可旋转的安装衬套1360，所述安装衬套1360可旋转地接收在插座1052内。安装衬套1060可具有与其附接的从动齿轮1362，所述从动齿轮1362能够与远侧滚动小齿轮1364啮合接合。远侧滚动小齿轮1364附接到小齿轮轴1366，所述小齿轮轴1366可旋转地支撑在远侧连接叉1350的端壁1355中。在至少一个布置中，远侧滚动小齿轮1364通过柔性远侧滚动轴1340进行操作，所述柔性远侧滚动轴1340延伸穿过近侧支撑轴1342，所述近侧支撑轴1342延伸穿过细长轴组件30”。在各种形式中，端部执行器或外科工具可直接联接到安装衬套1360，使得安装衬套1360的旋转导致端部执行器/工具的旋转。例如，安装衬套1360可形成有衬套插座1361，所述衬套插座1361的尺寸设定成将端部执行器/工具的一部分保持性地接收于其中。在另选的布置中，安装衬套1360可包括端部执行器的整体部分，或者端部执行器可通过其他紧固件布置来附接到安装衬套1360。例如，安装衬套1360可附接到具有上文所述的类型和构造的联接组件，并且随后端部执行器/工具可拆卸地附接到联接组件。
关节运动接头1300还可促进将旋转控制运动通过接头1300传递到与其附接的端部执行器/工具。如在图63和64中可见，近侧击发轴1330的远侧端部由近侧连接叉组件1320的远侧端壁1322可旋转地支撑，并且具有与其附接的击发输入齿轮1380。输入击发齿轮1380与轴颈连接在下枢转轴1353上的击发传递齿轮1382啮合接合。击发传递齿轮1382与击发输出齿轮1384啮合接合，所述击发输出齿轮1384安装在击发输出轴1390上，所述击发输出轴1390延伸穿过远侧连接叉1350的端壁1355和安装衬套1360的端壁1370。击发输出轴1390可被构造为能够与端部执行器/工具上的对应驱动构件或轴驱动接合。例如，击发输出轴1390的远侧端部1392可形成有六边形形状，以使其可接收在形成于安装凸缘1394中的六边形插座中，所述安装凸缘1394可被构造为能够附接到端部执行器/工具的驱动轴。击发输入齿轮1380、击发传递齿轮1382、和击发输出齿轮1384在本文中称为通常命名为1381的击发轴齿轮系。击发传递齿轮1382在下枢转轴1353上“自由转动”，使得近侧击发轴1330的旋转最终导致击发输出轴1390的旋转而未旋转下枢转轴1353。远侧滚动齿轮系1369和击发轴齿轮系1381促进端部执行器/工具相对于细长轴组件的关节运动，同时促进将旋转控制运动传递到端部执行器，并且促进端部执行器围绕轴的轴线A-A的旋转。
另选的马达安装组件
图67-69示出了通常命名为1750的另选的马达安装组件。马达安装组件1750可支撑在柄部外壳段23和24内，所述柄部外壳段23和24可通过卡合特征结构、螺钉等联接在一起并且用于形成柄部组件20的手枪式握把部26。在至少一个形式中，马达安装组件1750可包括马达外壳1752，所述马达外壳1752可移除地支撑在柄部外壳段23和24内。在至少一个形式中，例如，马达外壳1752具有与其附接的马达隔板组件1756。马达外壳1752用于支撑马达402,530,560和610。每个马达具有与其附接的自身电路控制板1780，以用于按照本文所述的各种方式来控制各个马达的操作。
在一些形式中，执行部分100可包括电外科端部执行器，所述电外科端部执行器使用电能来治疗组织。电外科端部执行器和相关器械在以下专利中有所描述：名称为“Surgical End Effector Jaw and Electrode Configurations”的美国专利申请No.13/536,393，代理人案卷号END7137USNP/120141；和名称为“Electrode Connections forRotary Drive Surgical Tools”的美国专利申请No.13/536,417，代理人案卷号END7149USNP/120153，上述两个专利均全文以引用方式并入本文。70-73示出了构成另选的执行部分100的示例端部执行器3156。端部执行器3156可能够捕获并横切组织，且同时通过能量(例如，射频(RF)能量)的受控施加来焊接所捕获的组织。第一钳口3160A和第二钳口3160B可闭合，从而围绕由可轴向运动的构件3182限定的纵向轴线3194来捕获或接合组织。第一钳口3160A和第二钳口3160B还可对组织施加压缩。
图70示出了与外科器械10一起使用的电外科端部执行器3156的一些形式的透视图。图70示出了端部执行器3156，其中钳口3160A,3160B打开。图71示出了端部执行器3156的一些形式的透视图，其中钳口3160A,3160B闭合。如上所述，端部执行器3156可包括上部第一钳口3160A和下部第二钳口3160B，它们可是直的或弯曲的。第一钳口3160A和第二钳口3160B可各自包括沿它们相应的中间部分向外设置的细长狭槽或通道3162A和3162B(图70)。另外，第一钳口3160A和第二钳口3160B各自可具有设置在第一钳口3160A和第二钳口3160B的内部部分上的组织夹持元件，例如齿状物3198。第一钳口3160A可包括上部第一钳口主体3200A，所述上部第一钳口主体3200A具有上部第一向外表面3202A和上部第一能量递送表面3204A。第二钳口3160B可包括下部第二钳口主体3200B，所述下部第二钳口主体3200B具有下部第二向外表面3202B和下部第二能量递送表面3204B。第一能量递送表面3204A和第二能量递送表面3204B可围绕端部执行器3156的远侧端部以“U”形延伸。应当理解，端部执行器3156可按照类似于本文参照端部执行器102所述的方式进行旋转和关节运动。
图72示出了端部执行器3156的可轴向运动的构件3182的一个形式。可轴向运动的构件3182由带螺纹驱动轴3151驱动。(图70)带螺纹驱动轴3151的近侧端部可被构造为能够不可旋转地联接到输出插座238，并且由此接收由马达530提供的旋转运动。可轴向运动的构件3182可包括带螺纹螺母3153以用于接收带螺纹驱动轴3151，使得带螺纹驱动轴3151的旋转导致可轴向运动的构件3182沿着轴线3194朝远侧和朝近侧平移。(图72)可轴向运动的构件3182可包括一个或若干个零件，但在任何情况下，其均可相对于伸长轴158和/或钳口3160A,3160B运动或平移。另外，在至少一些形式中，可轴向运动的构件3182可由17-4沉淀硬化不锈钢制成。可轴向运动的构件3182的远侧端部可包括带凸缘的“I”形梁，所述“I”形梁可被构造为能够在钳口3160A和3160B中的通道3162A和3162B内滑动。可轴向运动的构件3182可在通道3162A,3162B内滑动，以打开和闭合第一钳口3160A和第二钳口3160B。可轴向运动的构件3182的远侧端部还可包括上凸缘或“c”形部分3182A以及下凸缘或“c”形部分3182B。凸缘3182A和3182B分别限定内部凸轮表面3206A和3206B，以用于接合第一钳口3160A和第二钳口3160B的向外表面。钳口3160A和3160B的打开和闭合可使用凸轮机构对组织施加极高的压缩力，所述凸轮机构可包括可运动的“I形梁”、可轴向运动的构件3182、以及钳口3160A,3160B的向外表面3208A,3208B。
更具体地讲，现在参见图70-72，可轴向运动的构件3182的远侧端部的内部凸轮表面3206A和3206B共同地能够分别可滑动地接合第一钳口3160A的第一向外表面3208A和第二钳口3160B的第二向外表面3208B。第一钳口3160A内的通道3162A和第二钳口3160B内的通道3162B的尺寸可被设计成且可被构造为能够适应可轴向运动的构件3182的运动，该可轴向运动的构件3182可包括组织切割元件3210，例如，包括锐利的远侧边缘。例如，图71示出了至少部分地推进穿过通道3162A和3162B(图70)的可轴向运动的构件3182的远侧端部。可轴向运动的构件3182的推进可将端部执行器3156从图70中所示的打开构型闭合。在图71所示的闭合位置，上部第一钳口3160A和下部第二钳口3160B分别限定第一钳口3160A的第一能量递送表面3204A和第二钳口3160B的第二能量递送表面3204B之间的间隙或尺寸D。在各种实施例中，尺寸D可等于约0.0005"至约0.040"，例如，在一些形式中，在约0.001"至约0.010"之间。另外，第一能量递送表面3204A和第二能量递送表面3204B的边缘可为圆形的以防止切开组织。
图73为端部执行器3156的一些形式的剖视图。下部钳口3160B的接合或组织接触表面3204B能够至少部分地通过导电-电阻基质(诸如可变电阻正温度系数(PTC)主体)向组织递送能量。上部钳口3160A和下部钳口3160B中的至少一者可承载被构造为能够将能量从发生器3164递送到捕获组织的至少一个电极3212。上部钳口3160A的接合或组织接触表面3204A可承载类似的导电-电阻基质(即，PTC材料)，或者在一些形式中，该表面可是例如导电电极或绝缘层。作为另外一种选择，钳口的接合表面可承载2001年10月22日提交的名称为“ELECTROSURGICAL JAW STRUCTURE FOR CONTROLLED ENERGY DELIVERY”的美国专利No.6,773,409中所公开的任何能量递送部件，该专利的全部公开内容以引用方式并入本文。
第一能量递送表面3204A和第二能量递送表面3204B可各自与发生器3164电连通。发生器3164经由诸如导体3172,3174之类的合适传递介质连接到端部执行器3156。在一些形式中，发生器3164联接到控制器，诸如，例如控制单元3168。在各种形式中，控制单元3168可与发生器3164整体形成或者可作为电联接到发生器3164(以虚线显示以示出此选项)的独立电路模块或装置而提供。发生器3164可实施为设备的外部零件和/或可与外科器械10一体地实施。
第一能量递送表面3204A和第二能量递送表面3204B可被构造为能够接触组织并且将能够密封或焊接组织的电外科能量递送到捕获的组织。控制单元3168调节由电发生器3164递送的电能，所述电发生器3164继而向第一能量递送表面3204A和第二能量递送表面3204B递送电外科能量。控制单元3168可在启动期间调节由发生器3164产生的功率。
如上所述，由电发生器3164递送并且由控制单元3168调节或以其他方式控制的电外科能量可包括射频(RF)能量，或其他合适形式的电能。另外，相对的第一能量递送表面3204A和第二能量递送表面3204B可承载可变电阻正温度系数(PTC)主体，所述主体与发生器3164和控制单元3168电连通。有关电外科端部执行器、钳口闭合机构、以及电外科能量递送表面的附加细节在以下美国专利和已公布的专利申请中有所描述：美国专利No.7,087,054、No.7,083,619、No.7,070,597、No.7,041,102、No.7,011,657、No.6,929,644、No.6,926,716、No.6,913,579、No.6,905,497、No.6,802,843、No.6,770,072、No.6,656,177、No.6,533,784、和No.6,500,176；以及美国专利申请公布No.2010/0036370和No.2009/0076506，所有这些专利和专利申请公布均全文以引用方式并入本文并构成本说明书的一部分。
合适的发生器3164为得自Ethicon Endo-Surgery,Inc.(Cincinnati,Ohio)的型号GEN11。另外，在一些形式中，发生器3164可实施为电外科单元(ESU)，所述电外科单元能够提供足以利用射频(RF)能量来执行双极电外科手术的功率。在一个形式中，ESU可为ERBEUSA,Inc.(Marietta,Georgia)出售的双极ERBE ICC 350。在一些形式中，诸如对于双极性电外科手术应用而言，可利用具有有源电极和返回电极的外科工具，其中有源电极和返回电极可抵靠、邻近待处理的组织来定位和/或与待处理的组织电连通，使得电流可从有源电极通过正温度系数(PTC)主体并通过组织流到返回电极。因此，在各种形式中，使用端部执行器3156的外科器械10创建了供给路径和返回路径，其中正被处理的所捕获组织完成或闭合电路。在一些形式中，发生器3164可为单极性RF ESU并且外科器械10可包括其中集成一个或多个有源电极的单极性端部执行器。对于此类系统而言，发生器3164可使用位于远离操作位点的位置处与患者紧密接触的返回垫，和/或其他合适的返回路径。返回垫可经由缆线连接到发生器3164。
在电外科器械150的操作过程中，用户通常抓紧组织，向捕获的组织提供能量以形成焊接或密封，然后驱动可轴向运动的构件3182的远侧端部处的组织切割元件3210穿过捕获的组织。根据各种形式，可轴向运动的构件3182的轴向运动的平移可为有节奏的或以其他方式受控制的，以有助于以合适的行进速率来驱动可轴向运动的构件3182。通过控制行进速率，所捕获组织在经切割元件3210横切之前已被适当地和功能性地密封的可能性增加。
在一些形式中，执行部分100可包括超声端部执行器，所述超声端部执行器使用谐波或超声能量治疗组织。图74示出了与外科器械10一起使用的超声端部执行器3026的一个形式。端部执行器组件3026包括夹持臂组件3064和刀片3066以形成夹紧机构的钳口。刀片3066可为声学上联接到位于端部执行器3026内的超声换能器3016的可超声致动刀片。小尺寸换能器和包括换能器的端部执行器的例子提供于名称为“Ultrasonic SurgicalInstruments with Distally Positioned Transducers”的共同未决的美国专利申请序列No.13/538,601和美国专利申请公布No.2009/0036912中。换能器3016可经由波导3078声学上联接(如，直接地或间接地机械联接)到刀片3066。
管状致动构件3058可沿方向3062A将夹持臂组件3064运动到打开位置，在该位置夹持臂组件3064和刀片3066相对于彼此间隔设置，并且沿方向3062B将夹持臂组件运动到夹持或闭合位置，在该位置夹持臂组件3064和刀片3066配合以夹持其间的组织。管状往复式管状致动构件3058的远侧端部机械地接合到端部执行器组件3026。在图示的形式中，管状往复式管状致动构件3058的远侧端部机械地接合可围绕枢转点3070枢转的夹持臂组件3064，以打开和闭合夹持臂组件3064。例如，在图示的形式中，当往复式管状致动构件3058朝近侧缩回时，夹持臂组件3064可围绕枢转点3070沿方向3062B从打开位置运动到闭合位置。当往复式管状致动构件3058朝远侧平移时，夹持臂组件3064可围绕枢转点3070沿方向3062A从闭合位置运动到打开位置。(图75)
管状致动构件3058可因带螺纹驱动轴3001的旋转而朝近侧和远侧平移。带螺纹驱动轴3001的近侧端部可被构造为能够不可旋转地联接到输出插座238，并且由此接收由马达530提供的旋转运动。管状致动构件3058可包括带螺纹螺母3059以用于接收带螺纹驱动轴3001，使得带螺纹驱动轴3001的旋转导致管状致动构件3058朝远侧和近侧平移。图76-77示出了可轴向运动的构件3058和管状螺母3059的一个形式的附加视图。在一些形式中，管状致动构件3058限定腔体3003。波导3078和/或刀片3066的一部分可延伸穿过腔体3003，如图74所示。
在一个示例形式中，超声传递波导3078的远侧端部可通过内部螺纹连接而联接到刀片3066的近侧端部，优选地位于或靠近波腹。可设想，刀片3066可通过例如焊接接头或类似方法等任何合适的手段附接到超声传递波导3078。虽然刀片3066可从超声传递波导3078上拆卸，但也可设想，单个元件端部执行器(如刀片3066)和超声传递波导3078形成为单个一体部件。
称为“Langevin叠堆”的超声换能器3016通常响应于由发生器3005提供的电信号而振动(图74)。例如，换能器3016可包括多个压电元件或其他元件以用于将来自发生器3005的电信号转换成机械能，该机械能主要导致超声换能器3016和端部执行器组件3026的刀片3066部分出现以超声频率纵向振动运动的超声驻波。超声换能器3016的长度可以但不一定等于二分之一系统波长的整数倍(nλ/2；其中“n”为任何正整数；如，n＝1、2、3…)。换能器3016和刀片3066的合适的振动频率范围可为约20Hz至32kHz，并且最合适的振动频率范围可为约30-10kHz。合适的工作振动频率可为例如大约55.5kHz。
发生器3005可为任何合适类型的发生器，所述发生器被定位在外科器械10的内部或外部。合适的发生器为得自Ethicon Endo-Surgery,Inc.(Cincinnati,Ohio)的型号GEN11。当换能器3016通电时，振动运动驻波通过波导3078和刀片3066产生。端部执行器3026被设计为在共振时工作，从而产生预定振幅的声学驻波图案。沿着换能器3016、波导3078和刀片3066的任何点处的振动运动的振幅取决于沿着这些部件测量振动运动的位置。振动运动驻波的最小或零交点通常称为波节(即运动最小的位置)，驻波的局部最大绝对值或峰值通常称为波腹(即局部运动最大的位置)。波腹与距其最近的节点之间的距离为四分之一波长(λ/4)。
在一个示例性形式中，刀片3066的长度基本上等于二分之一系统波长的整数倍(nλ/2)。刀片3066的远侧端部可设置在波腹附近，以便提供远侧端部的最大纵向偏移。当换能器组件通电时，刀片3066的远侧端部可被构造为能够以例如55kHz的预定振动频率在例如大约10至500微米峰到峰的范围内移动，并且优选地在约30至64微米的范围内移动。
在一个示例性形式中，刀片3066可联接到超声传递波导3078。示出的超声刀3066和超声传递波导3078由适于超声能量传递的材料形成为单个单元构造。此类材料的例子包括Ti6Al4V(含有铝和钒的钛合金)、铝、不锈钢或其他合适的材料。刀片3066也可与超声传递波导3078分开(并且由不同的组合物制成)，以及通过(例如)双头螺栓、焊接、粘合剂、快速连接或其他合适的已知方法连接这两个部件。超声传递波导3078的长度可基本上等于例如二分之一波长的整数倍(nλ/2)。超声传递波导3078可优选地由使用适合高效传播超声能量的材料(例如上述钛合金(即Ti6Al4V))或任何适合的铝合金或其他合金材料制造的实芯轴加工而成。
在一些形式中，外科器械10还可与其他缝合器型端部执行器一起使用。例如，图78示出了可与外科器械10一起使用的线性缝合端部执行器3500的一个形式。端部执行器3500包括砧座部分3502和能够平移的钉通道3514。能够平移的钉通道3514能够沿远侧方向和近侧方向平移，如由箭头3516所指的那样。例如，如上所述，带螺纹驱动轴3506可联接到输出插座238，以接收由马达530提供的旋转运动。带螺纹驱动轴3506可联接到柔性联接到到钉通道3514的带螺纹螺母3508，使得带螺纹驱动轴3506的旋转导致钉通道3514沿箭头3516所指的方向平移。螺母3508还可联接到驱动器3510，所述驱动器3510继而可接触钉仓3512。当驱动器3510朝远侧平移时，其可从钉仓3512抵靠砧座3502推动钉，由此驱动钉穿过定位在钉通道3514和砧座3502之间的任何组织。
另外，在一些形式中，外科器械可与圆形缝合端部执行器一起使用。图79示出了可与外科器械10一起使用的圆形缝合端部执行器3520。端部执行器3520包括砧座3522和钉部分3524。带螺纹驱动轴3530从砧座3522延伸穿过钉部分3524。例如，如上所述，带螺纹驱动轴3530可联接到输出插座238，以接收由马达530提供的旋转运动。带螺纹螺母3532可联接到钉部分3524，从而带螺纹驱动轴3530的旋转使得钉部分3524如箭头3534所指的那样朝远侧和近侧交替地平移。带螺纹轴还可联接到驱动器3528，使得钉部分3524的远侧运动将驱动器3528朝远侧推动到钉仓3526内，由此将钉从仓3526驱动到位于砧座3522和钉部分3524之间的任何组织内。在一些实施例中，端部执行器3520还可包括刀片或切割工具3535，以用于在缝合之前切割组织。
除了不同的端部执行器之外，应当理解，其他执行部分可相对于外科器械10进行替换。例如，外科器械10的一些形式采用不同的电源线。图A示出了与外科器械一起使用的若干示例电源线3540,3542,3544。电源线3540,3542,3544中的每一个包括用于联接到外科器械10的插座3546。电源线3540,3542,3544可用于将外科器械10连接到多个功率源。例如，电源线3540和3542包括由发生器(例如，Ethicon Endo-Surgery,Inc(Cincinnati,Ohio)的型号GEN11发生器)接收的插座3550,3552。此类发生器可对器械10提供电能并且/或者可提供信号，以驱动电外科和/或超声端部执行器。电线3544包括可插入壁插座内的插头3548，以对器械10提供电能(例如，代替电池802)。
在一些形式中，外科器械还可包括可替换的执行部分，所述可替换的执行部分包括不同的轴。图81示出了可与外科器械10一起使用的若干示例轴3554,3556,3558。每个轴3554,3556,3558包括类似于可拆卸的驱动安装件部分700的可拆卸的驱动安装件部分700’,700”,700”’，所述可拆卸的驱动安装件部分700可由器械10接收，如上文所述。每个轴3554,3556,3558还包括联接器组件3557，以用于按照类似于上文所述的联接器组件200的方式来接收端部执行器。在一些实施例中，不同的轴被构造为能够在联接器组件3557处接收不同类型的端部执行器。轴3554,3556,3558可各自包括不同的特征，所述特征包括例如不同的长度、存在或不存在关节运动、无源或有源的关节运动、不同程度的关节运动、不同的直径、不同的曲率等。例如，轴3554限定偏离轴中心轴线的弯曲3559。轴3558限定关节运动接头3560，所述关节运动接头3560可按照类似于上文关于关节运动接头310所述的方式进行关节运动。
应当理解，不同类型的执行部分100(如，电源线、轴、端部执行器等)需要各种马达和外科器械10的其他部件以按照不同方式来操作。例如，电动端部执行器(例如，电外科端部执行器3156和超声端部执行器3026)需要能量信号，以用于为电极和/或超声刀片供电。不同的端部执行器还可需要多个马达402,560,530,610的不同运动来致动，包括例如不同马达的致动、不同扭矩量的提供等。在各种形式中，执行部分100可为外科器械10提供控制参数。
图82为示出多个控制元件的外科器械10的柄部组件20的框图。图82中所示的控制元件被构造为能够接收来自各个执行部分的控制参数并且基于接收的控制参数和基于接收自临床医生的一个或多个输入控制信号来控制外科器械10(如，经由操纵杆控制器840或其他合适的致动装置)。控制元件可包括用于控制外科器械10的控制电路3702。在各种形式中，控制电路3702可执行控制算法，以用于操作包括任何已安装的执行部分的外科器械10。在一些形式中，控制电路3702实现在上文所述的近侧电路板820上。控制电路3702包括微处理器3706以及相关的存储器和/或数据存储装置3708。在一些形式中，控制电路3702还可包括发生器电路3704，以用于为超声和/或电外科装置提供功率信号。发生器电路3704可作为独立部件来工作，或者可结合外部发生器来工作。
图82还示出了马达3714，所述马达3714可对应于上文所述的马达402,560,530,610。电池3713可对应于上文所述的电池802。控制电路3702的输入可由操纵杆控制器840或其他合适的致动装置来提供。本文所述的多个外科执行部分100可在相应的插座3710,3712处联接到柄部20。插座3712可接收轴，例如轴3554,3556,3558。例如，插座3712可类似于以下方式来接收轴，所述方式类似于上文所述的柄部20接收可拆卸的驱动安装件700的方式。插座3710可被构造为能够接收电线插座，例如上文所述的插座3546。
结合多个其他控制元件(例如插座3710,3712)的控制电路3702可接收来自各个已安装的执行部分的控制参数。控制参数可包括例如描述执行部分的属性的数据、描述用于操作具有已安装的执行部分的器械10的算法的数据等。插座3710,3712可机械地并且连通地联接到各个执行部分。例如，各个执行部分可包括用于存储控制参数的电路3720。此类电路3720结合图80的电源线3540,3542,3544并且结合图81的轴3554,3556,3558示出。另外，图83示出了包括本文所述的电路3720的各个端部执行器执行部分3730,3732,3734,3736,3738的一个形式。电路3720可包括用于存储提供给控制电路3702的控制参数的一个或多个数据存储部件。此类数据存储部件可包括任何合适类型的存储器装置(如，电可擦可编程只读存储器(EEPROM)、数字寄存器、任何其他类型的存储器等)。存储器装置还可包括线圈或其他硬件部件，所述线圈或其他硬件部件被构造为能够例如响应于射频识别(RFID)询问信号来调节预定控制参数。在一些形式中，电路3720例如通过相应的插座3710,3712直接有线连接到控制电路3702。因此，控制电路3702可与各个电路3720直接连通以接收控制参数。
在一些形式中，电路3720包括无源或有源RFID装置。柄部20可包括一个或多个天线3716,3718，所述天线3716,3718可被定位在相应的插座3710,3712处或附近。控制电路3702可利用天线3716,3718来询问已安装的执行部分上的电路3720以接收控制参数。在一些形式中，控制电路3702被编程以在启动时和/或指示执行部分已安装和/或移除时询问各个执行部分。作为响应，控制电路3702可接收来自RFID装置的反射信号。反射信号可指示相关的控制参数。在一些形式中，电路3720可包括有源RFID装置，所述有源RFID装置例如在安装时传递描述其相关执行部分的数据。
如图81所示，一些轴形式可包括位于远侧部分处的天线3719。天线3719可通过延伸穿过相应轴的导体(未示出)与控制电路3702连通，从而允许控制电路3702询问端部执行器(例如，端部执行器3730,3732,3734,3736,3738)上的RFID装置电路3720。在一些形式中，定位在柄部中的天线3718可接收和传递足够的功率，以便询问端部执行器上的RFID装置电路3720，而无需轴中的单独天线379。在一些布置中，电路3720可被构造为能够有线连接到控制电路3702。例如，天线3716,3718,3719可被省去。
图84为示出控制构型3800的一个形式的框图，所述控制构型3800通过控制电路3702来执行以控制外科器械10。根据构型3800，控制电路3702利用控制算法3802进行编程。控制算法3802接收来自已安装的执行部分的以输入变量3801形式的控制参数。输入变量3801可描述已安装的执行部分的特性。控制算法3802还接收一个或多个输入控制信号3818(例如，来自操纵杆控制器840、机器人系统、或由临床医生操作的其他合适的致动装置)。基于输入变量3801，控制算法3802可通过以下方式来操作外科器械10：将一个或多个输入控制信号3818转换成输出马达控制信号3814，以用于控制马达3714和任选的输出能量控制信号3816以用于控制超声和/或电外科端部执行器。应当理解，并非外科器械10的所有形式需要接收来自全部所列执行部分的输入变量。例如，外科器械的一些形式包括单个轴和/或固定的端部执行器。另外，外科器械的一些形式(或其构型)可省去电线。
控制算法3802可实现与外科器械10的不同方面相关的多个功能模块3804,3806,3810,3812。击发模块3804可将一个或多个输入控制信号3818转换成一个或多个输出马达控制信号3814，以用于控制相应的马达3714以击发器械10。关节运动模块3806可将一个或多个输入控制信号3818转换成一个或多个输出马达控制信号3814，以用于使得器械10的轴进行关节运动。功率模块3812可通过已安装的电线(根据需要)将电能传递到外科器械10的各个部件。对于在端部执行器处使用能量的器械10的形式(例如，超声和/或电外科器械)而言，能量模块3810可将一个或多个输入控制信号3818转换成输出能量信号3816以提供给端部执行器。能量信号3816可通过发生器3704和/或通过外部发生器(图84中未示出)产生并且可提供给端部执行器处的换能器3016和/或能量递送表面3204A,3204B。
控制算法3802的多个模块3804,3806,3810,3812可采用输入变量3801形式的控制参数以将一个或多个输入控制信号3818转换成输出信号3814,3816。例如，接收自不同执行部分的输入变量3801可利用不同的方式来影响控制算法3802。接收自电线(例如，3540,3542,3544)的输入变量3801可包括例如电线类型、电线是否连接到外部目标(例如，发生器或电力插座)、连接到电线的外部目标的同一性等。一种类型的电线(例如，电线3544)可被构造为能够从外部电力插座(壁电源插座)接收功率。当控制电路3702确定此类型的电线已被安装(例如，在插座3710处)时，功率模块3812可被编程以配置控制电路3702，以通过已安装的电线工具提供的功率为马达3714和/或能量元件供能。通过已安装的电线工具提供的功率可用于附加到或代替由电池3713提供的功率。
另一类型的电线(例如，3540,3542)可被构造为能够与外部发生器连通。功率模块3812和/或能量模块3810可配置控制电路3702以基于通过已安装的电线接收的能量信号来为能量元件供能。此外，能量模块3810可配置控制电路3702以通过已安装的电线来为发生器提供输入。此类输入可包括例如指示临床医生已请求能量的输入控制信号3818。在一些形式中，接收自电线的输入变量3801还可指示电源线被构造为能够联接到(和/或联接到)的发生器的类型。示例发生器可包括独立的电外科发生器、独立的超声发生器、组合的电外科/超声发生器等。在一些形式中，接收自电线的输入变量3801还可指示电线被构造为能够联接的发生器的类型。在一些形式中，所指示的发生器类型可影响控制算法3802的工作。例如，不同的发生器类型可具有不同的控制接口并且期望来自外科器械10的不同形式或指令，并且/或者可提供不同形式的输出。
当轴(例如轴3554,3556,3558中的一个)为可移除的执行部分时，接收自轴的输入变量3801可指示轴的各种特性。此类特性可包括例如轴的长度、轴的位置和弯曲程度(如果有的话)、描述轴的关节运动接头(如果有的话)的参数等。可通过例如控制算法3802的击发模块3804和/或关节运动模块3806来使用轴的长度以及轴的位置和弯曲程度来确定转矩需求和/或公差。描述轴的关节运动接头的参数可指示或允许关节运动模块3806获得使轴沿不同方向进行关节运动所需的各种马达运动。在一些实施例中，输入变量3801还可指示可允许的关节运动程度，所述可允许的关节运动程度可被关节运动模块3806转换成最大可允许的马达运动。在一些形式中，接收自轴的输入变量3801还可指示已安装的轴是否支持轴旋转和/或是端部执行器旋转。此类变量3801可由控制算法3802使用，以获得哪个或哪些马达3714被致动以用于轴和/或端部执行器旋转、指示针对每个马达3714的转矩和旋转的次数等。
接收自端部执行器执行部分的输入变量3801可基于所用的端部执行器的类型而具有不同的形式。例如，直线切割器和其他缝合器端部执行器(例如，上文所述的端部执行器102)可提供变量值，所述变量值指示端部执行器的长度(例如，45mm或60mm的钉线)、砧座和细长通道是直的还是弯曲的、联接到驱动轴(例如驱动轴180)的马达3714等。输入变量3801可由击发模块3804使用以将请求击发器械10的输入控制信号3818转换成输出马达控制信号3814。例如，端部执行器的长度、曲率等可确定待启动的马达3714、需要提供的力或转矩的量、击发所需的马达旋转次数等。相似地，接收自直线或圆形缝合器端部执行器(例如，3500和3520)的输入变量3818可由击发算法3804使用以确定被致动以击发的马达3714、响应于有关击发的输入控制信号3818的不同水平而需要提供的力或转矩的量、击发所需的马达旋转次数等。
当端部执行器为能量端部执行器(例如，电外科端部执行器3156或超声端部执行器3026时，接收的输入变量3801可描述有关端部执行器的闭合运动的信息、以及描述能量元件的信息(包括例如击发情形下的能量供应的定时)。描述闭合运动的信息可例如由击发模块3804使用以确定哪个或哪些马达3714被致动以用于击发和/或缩回、指示针对每个马达3714的转矩和旋转次数等。描述能量元件的信息可例如由能量模块3810使用以产生输出能量信号3816。例如，能量模块3810可确定所需的输出能量信号3816的类型(例如，电压、电流等)、信号是否可通过内部发生器3704产生、是否存在利用信号实现的任何锁定。示例锁定可阻止在不提供能量的情况下发生击发运动，和/或可阻止在未发生击发运动的情况下提供能量。在一些实施例中，能量模块3810还可获得器械击发行程情形下的输出能量信号3816的定时。例如，参见电外科端部执行器3156，能量模块3810可获得应在推进组织切割元件3210之前多长时间来启动能量递送表面3204A,3204B。
图85为示出利用控制电路3702执行控制算法3802的处理流程3600的一个示例形式的流程图。在3602处，控制电路3702可接收执行部分(例如，电线、轴、端部执行器等)的存在的指示。指示可在执行部分安装时自动产生。例如，在执行部分包括有源RFID的形式中，执行部分存在的指示可由有源RFID提供。另外，在一些实施例中，将执行部分连接到器械10的插座3710,3712可包括指示执行部分存在的开关。在3604处，控制电路3702可询问执行部分的输入变量3801。当执行部分包括无源RFID装置时，询问可包括利用射频信号来照射RFID装置。当执行部分与控制电路3702有线连通时，询问可包括将请求发送到与执行部分相关的存储器装置。
在3606处，控制电路3702可接收来自执行部分的输入变量3801。输入变量3801可以任何合适的方式来接收。例如，当执行部分包括无源RFID装置时，输入变量3801可通过解调来自RFID装置的返回信号来获得。当在执行部分和电路3702之间存在有线连接时，输入变量3801可直接接收自执行部分处的存储器装置等。在3608处，例如，控制电路3702可将输入变量3801施加到控制算法3802，如上文所述。这可具有将现有算法3802配置成能够操作安装有任何执行部分的器械10的效果。
图86为示出控制构型3900的一个形式的框图，所述控制构型3900由控制电路3702来执行以控制外科器械10。在构型3900中，接收自各个执行部分的控制参数包括用于控制相应执行部分的算法。控制电路3702执行包括操作系统3904的壳控制算法3902。操作系统3904被编程以询问已安装的执行部分，由此接收执行算法3906形式的控制参数。每个执行算法3906可描述将输入控制信号3908转换成输出马达控制信号3910和输出能量信号3912的方式。当接收执行算法3906时，操作系统3904可执行算法3906以操作器械10。
在一些实施例中，操作系统3904还可协调各种算法3906。例如，接收自能量端部执行器的执行算法3906可基于该器械与外部发生器连通或者使用内部发生器3704而采取不同的构型。因此，操作系统3904可基于执行算法3906是否已接收自能够与外部发生器联接的对应电线来为能量端部执行器配置执行算法3906。另外，在一些形式中，针对击发端部执行器所需的公差和/或旋转次数可取决于轴的构型。因此，操作系统3904可被构造为能够基于接收自轴的对应执行算法3906来修改接收自端部执行器的执行算法3906。
图87为示出利用控制电路3702执行控制算法3902的处理流程3400的一个示例形式的流程图。在3402处，控制电路3702可执行操作系统3904。操作系统3904可对控制电路3702编程，以相对于控制构型3900来采取本文所述的其他动作。在3404处，控制电路3702可询问例如已与外科器械10安装在一起的一个或多个执行部分，如本文所述。在3406处，控制电路3702可接收执行算法3906，如本文所述。在3408处，控制电路3702可应用所接收的算法3906以操作外科器械。应用所接收的算法3906可包括例如协调算法3906，如上文所述。
图88和图89示出了外科器械4010的一个形式，所述外科器械4010包括被定位于端部执行器4002中的感测模块4004。在一些形式中，外科器械4010可类似于外科器械10，并且端部执行器4002可类似于上文所述的端部执行器102。感测模块4004可被构造为能够测量端部执行器4002处的一个或多个状态。例如，在一个布置中，感测模块4004可包括组织厚度感测模块，所述组织厚度感测模块感测端部执行器4002中夹持在钉仓130和砧座组件190之间的组织的厚度。感测模块4004可被构造为能够产生指示端部执行器4002处的一个或多个测得状态的无线信号。根据图89所示的一个布置，感测模块4004可位于端部执行器4002的远侧端部处，使得当钉被击发时感测模块4004不妨碍钉仓130的钉。在各种形式中，感测模块4004可包括传感器、无线电模块和功率源。参见图90。传感器可设置在端部执行器4002的远侧端部中(如图89所示)、电动关节运动接头310处、或执行部分100的任何其他合适部分处。
在各种布置中，传感器可包括任何合适的传感器，以用于检测端部执行器4002处的一个或多个状态。例如并且非限制地，位于端部执行器4002的远侧端部处的传感器可包括组织厚度传感器(例如，霍尔效应传感器或磁簧开关传感器)、光学传感器、磁感传感器、力传感器、压力传感器、压阻膜传感器、超声传感器、电涡流传感器、加速度计、脉搏血氧传感器、温度传感器、被构造为能够检测组织通路的电特征(例如，电容或电阻)的传感器、或者它们的任何组合。又如并且非限制地，位于电动关节运动接头310处的传感器可包括电位差计、电容传感器(滑动电位差计)、压阻膜传感器、压力传感器、压力传感器、或任何其他合适的传感器类型。在一些布置中，感测模块4004可包括位于端部执行器4002中的多个位置的多个传感器。感测模块4004还可包括包括一个或多个视觉标记，以例如通过视频反馈向用户提供端部执行器4002处的当前状态的视觉指示。
感测模块4004可包括无线电模块，所述无线电模块被构造为能够产生和发射指示测量端部执行器4002处的测得状态的无线信号。参见图90。无线电模块可包括被构造为能够以第一频率发射无线信号的天线。感测模块4004的发射功率可由可定位在感测模块4004中的天线和功率源的尺寸来限制。端部执行器4002的尺寸可减少用于放置天线或功率源的可用空间，所述天线或功率源足够强效以将来自感测模块4004的信号发射到远程位置，例如视频监视器4014。由于天线的受约束尺寸以及由功率源递送到感测模块4004的低功率，感测模块4004可产生能够短距离传递的低功率信号4006。例如，在一些形式中，感测模块4004可将来自端部执行器4002的信号发射到位于端部执行器4002近侧的中继站4008。例如，中继站4008可位于器械4010的柄部4020处、轴4030(例如，轴4030的近侧部分)中、和/或定位在患者身上或体内的可植入装置中。
中继站4008可被构造为能够接收来自感测模块4004的低功率信号4006。低功率信号4006受到天线和功率源的尺寸限制，所述天线和功率源可位于端部执行器4002中以作为感测模块4004的一部分。中继站4008可被构造为能够接收低功率信号4006并且将所接收的信号重新发射为高功率信号4012。高功率信号4012可被发射到远程网络或装置，例如，被构造为能够显示测量端部执行器4002处的测得状态的图形表示的视频监视器4014。尽管感测模块4004和中继站4008已相对于外科器械4010进行大体描述，但本领域的技术人员将认识到，感测模块4004和中继站4008布置可与任何合适的外科系统(例如，机器人外科系统)一起使用。例如，中继站4008可定位在机器人外科器械的轴和/或器械部分中。合适的机器人外科系统在名称为“Surgical Instruments with Articulating Shafts”的美国专利申请No.13/538,700中有所描述，该专利全文以引用方式并入本文。
在一些形式中，视频监视器4014可包括用于显示端部执行器4002处的测得状态的独立单元、用于内窥镜式、腹腔镜检式、或开放式手术的标准观察监视器、或任何其他合适的监视器。所显示的图形表示可在显示在视频监视器上的视频反馈或其他信息上进行显示。在一些形式中，高功率信号4012可中断视频监视器4014显示并且可导致视频监视器仅显示端部执行器4002处的测得状态的图形表示。接收器模块4015可与视频监视器4014交接，以允许视频监视器4014接收来自中继站4008的高功率信号4012。在一些布置中，接收器模块4015可与视频监视器4014一体地形成。高功率信号4012可无线发射、通过有线连接发射、或这两者。高功率信号4012可通过广域网(WAN)、局域网(LAN)、或任何其他合适的网络或装置来接收。
在一些形式中，视频监视器4014可基于包含在所接收的高功率信号4012中的数据来显示图像。例如，临床医生可在涉及外科器械4010的整个外科过程中看到关于夹持组织的厚度的实时数据。视频监视器4014可包括监视器(例如，阴极射线管(CRT)监视器)、等离子体监视器、液晶显示器(LCD)监视器、或任何其他合适的视觉显示监视器。视频监视器4014可基于包含在所接收的高功率信号4012中的数据来显示端部执行器4002处的状态的图形表示。视频监视器4014可用任何合适的方式来显示端部执行器4002处的状态，例如，将端部执行器处的状态的图形表示叠加在显示在视频监视器4014的视频反馈或其他数据上。在一些形式中，视频监视器4014可被构造为能够仅显示接收自高功率信号4012的数据。相似地，高功率信号4012可被计算机系统(未示出)接收。计算机系统可包括用于与中继站4008连通的射频模块(例如，接收器模块4015)。计算机系统可将得自高功率信号4012的数据保存在存储器单元(例如，ROM或硬盘驱动器)中，并且可利用处理器来处理数据。
在一些形式中，中继站4008将低功率信号4006的功率放大成高功率信号4012，但在其他方面不改变低功率信号4006。中继站4008可被构造为能够将高功率信号4012重新发射到远程网络或装置。在一些布置中，中继站4008可在重新发射高功率信号4012之前改变或处理所接收的低功率信号4006。中继站4008可被构造为能够将所接收的信号从由感测模块4004发射的第一频率转换成可由远程网络或装置(例如，视频监视器4014)接收的第二频率。例如，在一个布置中，感测模块4004可利用包括人体组织可透过的频率的第一频率来发射低功率信号4006。人体组织可透过的频率可包括被构造为能够以最小信号衰减穿过人体组织的频率。例如，频率可被选定在水吸收谱带之外，以限制由人体组织(其可包含高百分比的水)带来的信号衰减。例如，感测模块4004可使用医疗植入连通服务(MICS)频率带(402-405MHz)、合适的工业、科学和医疗(ISM)无线电频带(诸如，433MHz中心频率或915MHz中心频率)、近场连通带(13.56MHz)、蓝牙连通带(2.4GHz)、超声频率、或任何其他合适的人体组织可透过的频率或频率带。中继站4008可接收第一频率中的低功率信号4006。中继站4008可将低功率信号4006从第一频率转换成第二频率，所述第二频率适于通过空气长范围传递。中继站4008可使用例如任何合适的频率来发射高功率信号4012，诸如，Wi-Fi频率(2.4GHz或5GHz)。
在一些形式中，中继站4008可在发射高功率信号4012之前将所接收的低功率信号4006从第一连通协议转换成第二连通协议。例如，感测模块4004可例如利用第一连通协议来发射低功率信号4006，诸如，近场连通(NFC)协议、蓝牙连通协议、专用连通协议、或任何其他合适的连通协议。中继站4008可利用第一连通协议接收低功率信号4006。中继站4008可包括协议转换模块，以将所接收的信号从第一连通协议转换成第二连通协议，诸如，例如TCP/IP、UDP、或任何其他合适的连通协议。
图90为示出感测模块4104的框图，其表示上文所述的感测模块4004的示例布置。感测模块4104可包括传感器4116、控制器4118、无线电模块4124和功率源4126。控制器4118可包括处理器单元4120和存储器单元4122。传感器4116可设置在端部执行器4002(如图89所示)的远侧端部中、关节运动接头310处、或执行部分100的任何其他合适的部分处。在各种形式中，传感器4116可包括任何合适的传感器，以用于检测端部执行器处的一个或多个状态。
在一些布置中，传感器4116可包括例如组织厚度传感器，诸如，霍尔效应传感器。组织厚度传感器可基于由定位在例如砧座组件190的远侧端部处的磁体4042产生的磁场来检测夹持在端部执行器4002中的组织的厚度。参见图89。当临床医生闭合砧座组件190时，磁体4042更靠近感测模块4004向下旋转，从而在砧座组件190旋转到闭合(或夹持)位置时改变由感测模块4004检测到的磁场。来自磁体4042的由感测模块4004感测的磁场的强度指示通道130和砧座组件190之间的距离，该距离指示当端部执行器4002处于闭合(或夹持)位置时夹持在通道130和砧座组件190之间的组织的厚度。
感测模块4104可被构造为能够产生指示端部执行器处的测得状态的无线信号。无线信号可由无线电模块4124产生。在一些形式中，无线电模块4124的发射功率受限于包含在无线电模块4124中的天线的尺寸和定位在感测模块4104中的功率源4126的尺寸。端部执行器4002的尺寸可减少用于放置天线或功率源4126的可用空间，所述天线或功率源足够强效例如以将来自传感器4116的信号发射到远程位置，诸如，视频监视器4014。由于天线的限制以及由功率源4126递送的低功率，无线电模块4124仅可产生低功率信号4006，所述低功率信号4006能够短距离(例如，到轴4030的近侧端部的距离)传递。例如，在一个形式中，无线电模块4124可将来自端部执行器4002的低功率信号4006发射到外科器械4010的柄部4020。在一些布置中，能够递送较高功率水平的功率源4126可产生低功率信号4006，以长效化外科器械4010的操作。
控制器4118的存储器单元4122可包括一个或多个固态只读存储器(ROM)和/或随机存取存储器(RAM)单元。在各种布置中，处理器4120和存储器单元4122可集成在单个集成电路(IC)或多个IC中。ROM存储器单元可包括闪存存储器。ROM存储器单元可存储将由控制器4118的处理器4120执行的代码指令。此外，ROM存储器单元4122可存储指示仓130的仓类型的数据。即，例如，ROM存储器单元4122可存储指示钉仓130的型号的数据。在一些布置中，外科器械4010的柄部4020中的控制器可使用钉仓130的状态信息和型号来检测外科器械4010的正确操作。例如，感测模块4004可被构造为能够测量组织厚度。组织厚度信息和仓型号可用于基于特定钉仓130的指定组织厚度范围来确定夹持在端部执行器4002中的组织是否过厚或过薄。无线电模块4124可为低功率、双向无线电模块，其使用无线数据连通协议与外科器械4010的柄部4020中的中继站4008进行无线连通。无线电模块4124可包括任何合适的天线以用于发射低功率信号4006。例如，无线电模块4124可包括偶极天线、半波偶极天线、单极天线、近场连通天线、或任何其他合适的天线，以用于发射低功率信号4006。天线的尺寸以及由此可用的发射功率和频率可受限于端部执行器4002的尺寸。
根据各种形式，无线电模块4124可使用人体组织可透过的频率来与中继站4008连通。例如，无线电模块4124和中继站4008之间的连通可使用医疗植入连通服务(MICS)频率带(402-405MHz)、合适的工业、科学、和医疗(ISM)无线电频带(诸如433MHz中心频率或915MHz中心频率)、近场连通带(13.56MHz)、蓝牙连通带(2.4GHz)、超声频率、或任何其他合适的人体组织可透过的频率或频率带。功率源4126可包括为感测模块4004的部件供电的合适的电池单元，例如，锂离子电池或某些其他合适的电池单元。
在一些形式中，感测模块4104的部件可位于端部执行器4002中、轴4030上、或外科器械4010的任何其他合适的位置中。例如，传感器4116可位于端部执行器4002的远侧端部中。控制器4118、无线电模块4124、功率源4126可位于轴4030上。一根或多根导线可将传感器4116连接到控制器4118、无线电模块4124和功率源4126。在一些形式中，端部执行器4002和轴4030的功能可限制感测模块4104的放置。例如，在图示的形式中，端部执行器4002能够通过电动关节运动接头310进行关节运动和旋转。将导线放置在电动关节运动接头310上可导致导线的扭曲或卷曲并且可妨碍电动关节运动接头310的操作。感测模块4004部件的放置可受限于电动关节运动接头310远侧的位置，以避免关节运动接头310或感测模块4004的操作问题。
在一些布置中，感测模块4104可包括模数转换器或(ADC)4123。传感器4116可产生表示端部执行器4002处的状态的模拟信号。表示端部执行器4002处的状态的信号的无线传递可需要模拟信号转换成数字信号。由传感器4116产生的模拟信号可在低功率信号4006的产生和发射之前通过ADC4123转换成数字信号。ADC 4123可包括在控制器4118中或者可包括独立的控制器，诸如，例如微处理器、可编程门阵列、或任何其他合适的ADC电路。
图91为示出中继站4208的框图，其表示上文所述的中继站4008的一个示例布置。中继站4208可例如位于轴的近侧，诸如，紧邻电池4226，并且通过例如轴4030与端部执行器4002中的感测模块4004隔开。例如，中继站4208可被位于端部执行器4010的柄部4020中。因此，中继站4208可接收来自感测模块4004的无线信号。中继站4208可包括可释放模块，所述可释放模块可选择性地与外科器械4002的柄部4020交接。
如图91所示，中继站4208可包括无线电模块4228和放大模块4230。在一些布置中，无线电模块4228被构造为能够接收低功率信号4006。低功率信号4006可从感测模块4004发射并且指示端部执行器4002处的状态。中继站4208的无线电模块4228接收低功率信号4006并且将低功率信号4006提供给放大模块4230。放大模块4230可将低功率信号4006放大成高功率信号4012，所述高功率信号4012适于比低功率信号4006在更长范围上传递。在将所接收的低功率信号4006放大成高功率信号4012之后，放大模块4230可例如将高功率信号4012提供给无线电模块4228以用于发射到远程网络或装置，诸如，视频监视器4014。放大模块4230可包括任何合适的放大电路，例如，晶体管、运算放大器(op-amp)、全差分放大器、或任何其他合适的信号放大器。
图92为示出中继站4308的框图，其表示上文所述的中继站4008的另一个示例布置。在图示的形式中，中继站4308包括无线电模块4328、放大模块4330和处理模块4336。放大模块4330可在通过处理模块4336处理之前、在处理模块4336已处理所接收的低功率信号4006之后，或者在通过处理模块4336处理之前和之后来放大所接收的低功率信号4006。无线电模块4328可包括接收器模块4332和发射器模块4334。在一些形式中，接收器模块4332和发射器模块4334可组合成信号收发器模块(未示出)。接收器模块4332可被构造为能够接收来自感测模块4004的低功率信号4006。接收器模块4332可将所接收的低功率信号4006提供给处理模块4336。
在图示的布置中，处理模块4336包括频率转换模块4338和协议转换模块4340。频率转换模块4338可被构造为能够将所接收的低功率信号4006从第一频率转换成第二频率。例如，感测模块4004可利用第一频率(例如，MICS或ISM频率)发射适于通过人体组织传递的低功率信号4006。接收器模块4332可接收处于第一频率的低功率信号4006。频率转换模块4338可将低功率信号4006从第一频率转换成第二频率，所述第二频率适于通过空气长范围传递。频率转换模块4338可例如将所接收的低功率信号4006转换成任何合适的频率以用于发射高功率信号，诸如，Wi-Fi频率(2.4GHz或5GHz频率)。
协议转换模块4340被构造为能够将所接收的信号从第一连通协议转换成第二连通协议。例如，感测模块4004可例如利用第一连通协议来发射低功率信号4006，诸如，近场连通(NFC)协议、蓝牙连通协议、专用连通协议、或任何其他合适的连通协议。中继站4308可利用第一连通协议接收低功率信号4006。中继站4308可包括协议转换模块4340以将所接收的低功率信号4006从第一连通协议转换成第二连通协议，诸如，例如TCP/IP协议、蓝牙协议、或任何其他合适的连通协议。包括频率转换模块4338和协议转换模块4340的处理模块4336可包括一个或多个微处理器、可编程门阵列、集成电路、或任何其他合适的控制器、或者它们的任何组合。
在一些形式中，频率转换模块4338和/或协议转换模块4340可为可编程的。网络、视频监视器、或其他接收设备可被构造为能够接收特定频率和特定协议的信号。例如，局域网(LAN)可被构造为能够利用802.11无线标准接收无线信号，这需要以2.4GHz或5GHz频率并且使用TCP/IP连通协议来发射。用户可从由中继站4308存储的多个连通标准中选择802.11无线连通标准。存储器模块可包括在中继站4308中以存储多个连通标准。用户可从由存储器模块存储的多个连通标准中选择用于高功率信号4012的连通标准。例如，用户可选择802.11连通标准作为发射高功率信号4012的连通标准。当用户选定连通标准时，频率转换模块4338或协议转换模块4340可通过存储器模块进行编程，以将所接收的低功率信号4006通过转换所接收的低功率信号4006的频率或连通协议而转换成所选定的连通标准。在一些布置中，中继站4308可自动地检测正确的频率和连通协议，以用于接收低功率信号4006或发射高功率信号4012。例如，中继站4308可检测医院无线连通网络。中继站4308可自动地对频率转换模块4338和协议转换模块4340编程，以将所接收的低功率信号4006转换成正确的频率和协议以用于将高功率信号4012传送到医院无线连通网络。
在图示的形式中，处理模块4336可将经处理的信号提供给放大模块4330，以用于在发射之前将经处理的信号放大成高功率信号4012。放大模块4330可将经处理的信号放大到合适的水平以用于由发射模块4334来发射。放大模块4330可包括任何合适的放大电路，例如，晶体管、运算放大器(op-amp)、全差分放大器、或任何其他合适的电子放大器。放大模块4330可包括电池(未示出)，或者可连接到位于外科器械4010的柄部4020内的功率源4326。放大模块4330可为可编程的，以响应于选择的特定连通类型来提供一个或多个放大水平。
放大模块4330可将高功率信号4012提供给发射模块4334以用于发射。尽管无线电模块4328、处理模块4336和放大模块4330被示为独立的模块，但本领域的技术人员将认识到，所示模块中的任一个或全部可结合到信号集成电路或多个集成电路内。
图93示出了用于传递指示端部执行器4400处的状态的信号的方法的一个实施例。方法4400可包括通过感测模块(例如，本文所述的感测模块4004)产生4402指示端部执行器(例如，端部执行器4002)处的状态的信号。信号可表示端部执行器4002处的任何可测量状态，诸如，例如夹持在端部执行器4002中的组织的厚度。感测模块可利用传感器(诸如，例如图90所示的感测模块4104的传感器4116)产生信号。方法4400还可包括通过无线电模块来发射4404所产生的作为低功率信号的信号。例如，图90所示的无线电模块4124可发射低功率信号4006。在实施过程中，无线电模块的发射功率可受限于可设置在端部执行器4002中的天线和功率源的尺寸。考虑到受限的空间，无线电模块的发射功率可被限制为低功率信号4006。低功率信号4006可使用无线电模块以下述功率水平来发射，所述功率水平允许低功率信号4006被外科器械4010的柄部4020中的中继站4008接收。
用于传递指示端部执行器4400处的状态的信号的方法还可包括通过中继站(诸如，例如中继站4008)接收4406低功率信号。在接收低功率信号之后，中继站可将低功率信号转换4408成高功率信号，诸如，例如高功率信号4012。低功率信号向高功率信号的转换可包括通过放大模块(诸如，图91所示的放大模块4230)放大低功率信号。低功率信号向高功率信号的转换也可包括将低功率信号的连通标准转换成适于高功率信号的发射的连通标准。例如，方法4400可包括利用处理模块将所接收的低功率信号从第一频率转换4408成第二频率。
在将低功率信号转换4408成高功率信号之后，方法4400还可通过中继站将高功率信号发射4410到远程位置，诸如，例如手术室观察屏幕或医院网络。高功率信号可被观察屏幕接收4412，所述观察屏幕将表示端部执行器处的状态的图形表示显示给用户。在一些布置中，该方法可包括在低功率信号的转换之前由用户选择针对高功率信号的频率和/或连通协议。频率和连通协议可选自存储在中继站的存储器模块中的多个频率。
机电软止动件
在各种形式中，外科器械可采用机械止动件，所述机械止动件能够使得马达驱动元件在驱动行程末端处或附近停止或减速。根据各种形式，机械止动件可包括硬止动件和/或软止动件，所述硬止动件被构造成突然地终止马达驱动元件的运动，所述软止动件被构造成使得马达驱动元件在行程末端处或附近减速。如下文所详述，在某些形式中，此类器械可包括：机电止动件，所述机电止动件包括机械止动件；和控制系统，所述控制系统被构造为能够测量和/或监测提供给用于驱动马达驱动元件的马达的电流。在一个形式中，控制系统被构造为能够在确定满足预定参数的电流产生时，终止为马达供能或以其他方式解除马达驱动元件的驱动运动。
应当认识到，为了简明和便于理解，本文所述的机械和机电止动件的各个方面通常相对于包括切割和紧固装置的外科器械和相关驱动构件进行描述。然而，本领域的技术人员将会知道，本公开并非进行如此限制并且本文所公开的各种机械止动件和相关机电特征可与本领域已知的多种其他装置一起使用。例如，尽管另外的使用在下文中将变得更明显，但本文所公开的各种机械止动件可用于任何装置，所述装置包括例如电控制马达和/或控制或驱动系统以及非内窥镜式外科器械(诸如，腹腔镜式器械)。再次参见图1-6，其示出了根据一个方面的配有机械止动件的一个形式的机电外科器械10。柄部组件20可操作地联接到细长轴组件30，所述细长轴组件30的远侧部分可操作地附接到端部执行器102。端部执行器102包括近侧端部103和远侧端部104。如上所述，细长通道构件110可被构造为能够可操作地和可移除地支撑钉仓130，并且砧座组件190可相对于钉仓130在打开位置(参见图4)和打开位置(参见图6)之间选择性地运动，以捕获其间的组织。
在某些形式中，器械10包括驱动构件，所述驱动构件可为可通过马达的作用而运动的器械10的任何部分或部件。在各种形式中，驱动构件可包括细长轴组件30、端部执行器102、或者它们的一个或多个部分或部件，诸如，滑动件170或组织切割构件160，所述组织切割构件160的主体部分162可通过螺纹轴颈连接在端部执行器驱动螺杆180上，使得其可旋转地安装在细长通道110内。如上所述，滑动件170可被支撑以用于相对于端部执行器驱动螺杆180轴向行进，并且可被构造为能够与组织切割构件160的主体部分162交接。端部执行器驱动螺杆180能够旋转地支撑在细长通道110内，如上所述。端部执行器驱动螺杆180沿第一方向的旋转导致组织切割构件160沿远侧方向运动通过驱动行程。当组织切割构件160朝远侧驱动通过驱动行程时，组织切割构件160朝远侧驱动滑动件170。在各种形式中，钉仓130可配有包括软止动件的机械止动件。根据一个方面，软止动件包括一个或多个缓冲器174，以在滑动件170到达细长通道110内的最远侧位置附近的行程末端时来缓冲该滑动件。缓冲器174可各自具有与阻力构件175相关联，诸如弹簧176，以提供具有所需缓冲量的缓冲器。
如在上文更详细所述，滑动件170和组织切割构件160可沿着延伸在端部执行器102的近侧端部103和端部执行器102的远侧端部104之间的轴的轴线A-A运动通过驱动行程，以同时切割和紧固组织。尽管图示的端部执行器102被构造为能够充当直线切割器以夹持、切断和缝合组织，但在其他方面，可使用不同类型的端部执行器，例如用于其他类型的外科装置(例如，抓紧器、切割器、缝合器、施夹器、进入装置、药物/基因理疗装置、超声、射频或激光装置等)的端部执行器。
参见图94，其示出了图1-6所示的端部执行器102的远侧端部104，包括滑动件170和切割构件160的驱动构件158可运动通过沿着近侧起始位置和远侧行程末端位置之间的轴的轴线A-A限定的驱动行程。在一个方面，行程末端位置限定在第一位置S1和第二位置S2(参见图97和图78)之间。在各种形式中，起始位置和行程末端中的至少一者包括机械止动件，诸如，硬止动件或软止动件，所述机械止动件可物理地阻止(例如，阻挡或限制)越过相应止动位置的附加纵向运动。在一个形式中，起始位置和行程末端均包括机械止动件。如图所示，驱动构件158朝远侧设置在行程末端之前或附近。
如上所述，外科器械10可采用控制系统以用于控制一个或多个马达和相关的驱动部件，如上所述。图95为示出根据各个方面的包括控制系统1400、驱动马达1402、和功率源1404的系统的一个形式的示简图，所述系统可与采用机电止动件的外科器械，所述机电止动件可包括机械软止动件或硬止动件。外科系统包括通过控制系统1400可操作地联接到驱动马达1402的功率源1404。功率源1404可被构造为能够为驱动马达1402提供电能以驱动驱动构件，例如，驱动构件158。在某些方面，功率源1404可包括任何方便的功率源，例如，电池、交流插座、发电机等。控制系统1400可包括多个模块或电路，并且可操作以控制各个系统部件，例如，驱动构件158、功率源1404、或用户接口。控制系统1400可被构造为能够控制、监测、测量例如各种器械10操作、信号、输入、输出、或参数。
在各种形式中，控制系统1400可类似于上文所述的控制系统800。例如，在各个方面，控制系统1400可被构造为能够“用电力产生”多个控制运动。术语“用电力产生”是指使用电信号来致动或以其他方式控制马达1402(例如，马达402,530,560和610)或其他电动装置并且可区别于不使用电流而手动或机械产生的控制运动。例如，控制系统1400可用电力产生控制运动，例如，旋转控制运动，其包括可响应于用户指令(诸如，通过致动器(此驱动或击发触发器与柄部组件20相关联)的致动提供给控制系统的电信号)来将功率递送到驱动马达。在某些方面，控制系统1400可用电力产生旋转控制运动，其包括可响应于使致动器或击发触发器返回到打开位置的用户或偏置机构来终止对驱动马达1402的功率递送。在至少一个方面，控制系统1400可用电力产生旋转控制运动，其包括因所测量的电参数达到预定值而终止或减少对驱动马达1402的功率递送。例如，当所测量的电流达到预定阈值时，控制系统1400可终止对驱动马达1402的功率传送。
通常参见图1以及图94和图95，在各种形式中，外科器械10包括配有用户接口的柄部组件20，所述用户接口被构造为能够将来自用户(例如，临床医生)的致动信号传递到控制系统1400，以相对于细长轴组件30、端部执行器102、或驱动构件158用电力产生控制运动。例如，在某些方面，用户接口包括具有致动器或触发器的触发器组件，所述致动器或触发器可操作以将输入信号提供给控制系统1400，以控制对驱动马达1402(例如，击发马达530(参见图23))的功率供应。该组件可包括用于闭合和/或锁定砧座组件190的闭合触发器以及用于致动端部执行器102(例如，驱动驱动构件158通过驱动行程)的击发触发器。在操作中，首先可致动闭合触发器，由此使得砧座组件190进入闭合位置，例如，将组织捕获在钉仓130和砧座组件190之间。一旦临床医生对于端部执行器102的定位感到满意，则临床医生可将闭合触发器拉回至其完全闭合、锁定位置。击发触发器随后可从打开位置致动到闭合位置，以致动驱动构件158通过驱动行程。在各个方面，击发触发器可在临床医生移除压力时返回到打开位置，或者可通过操作地连接到驱动构件158或独立机构的致动来机械地重新设定到打开位置。在一个方面，击发触发器可为多位置触发器，因此驱动构件158一旦已到达行程末端的位置或附近，击发触发器就可从第二打开位置致动到第二闭合位置，以朝近侧向起始位置致动驱动构件158。在一些此类方面，第一和第二打开和闭合位置可基本上相同。根据所需的构型，在某些方面，释放按钮或闩锁可被构造为能够从锁定位置释放闭合触发器。如将在下文进行更详细地说明，在击发触发器从打开位置致动到闭合位置之后，击发触发器可操作性地脱离，例如，击发触发器的致动可提供初始致动输入信号，所述初始致动输入信号可被传送到控制系统1400以命令控制系统1400来引发驱动构件158的致动。在某些构型中，如果不存在用户覆写特征，则驱动构件158的致动将通过控制系统引发的动作而在行程末端处或附近终止(例如，解除或中断驱动马达的功率递送)，甚至当击发触发器处于闭合位置时。
在一个形式中，触发器组件包括操纵杆控制器，所述操纵杆控制器可类似于上文所述的操纵杆控制器840。例如，如图33-39所示，操纵杆控制器可有利地通过单个接口使得用户能够对外科器械10的各个方面的功能控制最大化。在一个方面，操纵杆控制杆842可操作性地附接到操纵杆开关组件850，所述操纵杆开关组件850可运动地容纳在开关外壳组件844内，使得开关外壳组件844被安装在柄部组件20的手枪式握把26内。开关外壳组件844可包括偏置构件856，所述偏置构件856在不经受例如用户外部定位时将操纵杆开关组件850和操纵杆控制杆842偏置到所需位置。操纵杆控制器840可电联接到控制系统1400，以向控制系统1400提供控制指令。例如，操纵杆控制杆842的操纵(例如，按压或定向运动)可允许用户控制与外科器械10相关的各种控制运动，所述控制运动可包括驱动构件158的致动。
如上所述，外科器械10的各种形式包括一个或多个电力操作的或电动的马达，诸如，马达402,530,560和610。所述一个或多个马达可例如位于器械10的柄部组件20或细长轴组件30的一部分中，并且可操作以在起始位置和行程末端之间驱动驱动构件158。在一个形式中，马达可包括无刷马达、无线马达、同步马达、步进马达或任何其他合适的电动马达。在某些布置中，马达可以旋转或线性致动模式(例如，线性致动器)来操作，并且可包括驱动马达1402和驱动构件158之间的传递联接件以将驱动马达1402的旋转运动转换成线性运动或联接多个部件之间的旋转运动。在各种形式中，包括一个或多个齿轮或互锁元件(例如，带或滑轮)的传递联接件可操作以将来自驱动马达1400的旋转运动传递到细长轴组件30的一个或多个区段以致动端部执行器102。例如，端部执行器驱动螺杆180沿第一方向旋转导致驱动构件158沿着轴的轴线A-A在第一方向(例如，远侧方向)上运动。在各个方面，端部执行器驱动螺杆180沿与第一方向相反的第二方向的旋转导致驱动构件158沿着轴的轴线A-A在第二方向(例如，近侧方向)上运动。在一个方面，驱动马达1400朝行程末端将驱动构件158向远侧驱动，并且可反转以朝起始位置向近侧驱动驱动构件158。例如，驱动马达1402可通过反转电压源的极性来进行反向，由此产生马达的反向旋转或运动并且因此产生驱动构件158的反向运动。因此，驱动构件158可通过常规方法或诸如美国专利申请序列No.12/235,782所公开的那些方法之类的方法来在沿驱动行程的位置之间沿着近侧和远侧方向运动，该专利全文以引用方式并入本文。值得注意的是，尽管本文所述的器械10通常指包括柄部的手持式器械，但在各种形式中，包括机械止动件(可充当机电止动件的一部分)的器械10可适用于机器人系统使用的机器人或类似装置中。
在某些方面，外科器械10包括可反转马达并且包括近侧机械止动件和远侧机械止动件。在各个方面，如上所述，致动击发触发器发信号通知驱动构件158致动通过驱动行程。当驱动构件158到达驱动行程的末端时，例如，当切割构件160到达其切割行程的远侧末端时，行程末端或方向开关例如可切换到闭合位置，以反转施加到马达1402的电压的极性，由此反转马达1402的旋转方向。此类开关可与控制系统1400相关联，并且此外或作为另外一种选择可终止对驱动马达1402的功率递送。然而，值得注意的是，在其他方面，可提供手动返回开关以反转马达1402并且使得驱动构件158返回到其初始或起始位置。
机械止动件设置在行程末端处或附近，并且被构造成对驱动构件158通过行程末端的运动增加阻力。机械止动件包括软止动件，所述软止动件包括各自操作地联接到阻力构件175的一对缓冲器174。缓冲器174被构造为能够在行程末端处或附近接触驱动构件158。例如，图94所示的缓冲器174被构造成接触至少一个楔形件172的接触表面173。在各个方面，缓冲器174的尺寸可被设计为与接触表面173的尺寸互补。例如，在至少一个方面，缓冲器174的尺寸可被设计为提供基本上等同于接触表面173的成角表面。这样，缓冲器174和楔形件172之间的接触稳定性可增加并且施加到接触表面173的力可沿楔形件174的较大结构区域分布。相似地，在一个方面，缓冲器174包括柔性表面，例如，弹性表面或缓冲表面，以接收接触表面173并且减少部件损坏。在一个形式中，阻力构件175各自包括定位在缓冲器174和硬止动件178之间的弹簧176，以在行程末端158处或附近提供对驱动构件158的阻力和减速。
应当理解，外科器械10的各个方面可配有多个缓冲器174和阻力构件175，并且缓冲器174和阻力构件175可被构造成接触驱动构件158的其他部分。例如，器械10可包括附加止动件，所述附加止动件可另外添加到或取代上述硬止动件178和/或软止动件布置。因此，在一个形式中，参见图94，驱动螺杆180可配有止动件，所述止动件可包括软止动件，所述软止动件包括与阻力构件291相关联的缓冲器290，所述缓冲器290沿着驱动行程定位并且与驱动构件158的接触表面292相对。在一个形式中，阻力构件291包括弹性体材料，所述弹性体材料可压缩在缓冲器292和硬止动件294之间以吸收驱动构件158的纵向力。在某些方面，多个软止动件可被构造为能够在不同的预定位置处接触驱动构件158。例如，在一个形式中，驱动构件158在缓冲器174之前接触缓冲器290，以提供例如较易识别的电流尖峰，例如，产生以下电流尖峰，所述电流尖峰包括两个不同电流尖峰成分，所述两个不同电流尖峰分量的幅值和/或时间间隔可用于增加电流尖峰的出现的确定性。
在各种形式中，阻力构件175包括可压缩部分，所述可压缩部分可或不可与硬止动件178相关联。例如，在一个方面，阻力构件175可容纳在硬止动件178和缓冲器174之间，并且可包括可压缩部分(例如，弹簧176)、弹性体材料(例如，聚合物、泡沫、或凝胶)。在操作中，缓冲器174可在与驱动构件158接触时朝可压缩部分推进，由此可压缩部分压缩了给定程度。在各个方面，阻力构件175可包括减速部分，例如，制动器。在一个方面，减速构件包括可压缩单元，例如，液压气动式单元，与驱动构件158接触的所述可压缩单元可压缩该单元内的活塞以赋予增加的压力，从而被构造为能够使得驱动构件158减速或制动。在某些方面，软止动件可被构造成施加关于时间和/或距离的平滑或渐变阻力和/或减速度。例如，具有相同或不同可压缩特性的一个或多个螺旋弹簧可被构造成或可被布置成例如以渐变或步进方式来精确地控制减速构件的减速或制动。在一个形式中，软止动件可被构造成对驱动构件158的远侧运动施加渐进阻力。
在各种形式中，软止动件包括被构造为能够偏置接触构件以远离硬止动件的偏置构件。应当理解，在一些方面，偏置构件可与阻力构件175相同，或者可与阻力构件175共享类似的部件。因此，在一些形式中，偏置构件可被构造成通过驱动构件158的纵向致动力压缩在缓冲器174和硬止动件178之间，并且此后在力移除时返回到预压缩状态。在某些方面，偏置构件可为可致动的、可运动的、和/或可压缩的，以抗衡驱动构件158的致动运动。值得注意的是，压缩或以其他方式抗衡与阻力构件175相关联的偏置构件可导致能量传递，所述能量传递可至少暂时地由软止动件存储或保持在势能位置中。在一个方面，阻力构件175可通过例如闩锁、钩、或障碍物来保持在势能位置中，所述闩锁、钩、或障碍物可阻止一个或多个阻力构件175返回到预压缩状态。有利地，所存储的能量可例如由用户和/或控制系统1400释放，由此所存储的能量的至少一部分用于使驱动构件158返回到起始位置。
在各个方面，阻力构件175可包括另外的构型。例如，在一个方面，一个或多个磁体(例如，永磁体)可被定位成排斥与驱动构件158相关的相对永磁体。例如，一个或多个磁体可为可旋转的或可运动的，以调节抵制纵向运动的相斥磁场的大小。多个其他方面可在驱动构件158成功减速之前或之后采用电联接到控制系统的线圈磁体来进行致动。另外的阻力构件175可包括往复式结构，所述往复式结构包括例如实施滑轮和/或齿轮的布置。
在各个方面，机械止动件包括可或不可与硬止动件178相关联的软止动件。例如，在一些形式中，软止动件包括硬止动件178，而在其他形式中，软止动件不包括硬止动件或硬止动件178可充当辅助性止动件。在一些形式中，软止动件可包括弹簧加载的硬止动件178，从而对驱动构件158的驱动行程或减速提供渐变和/或渐进阻力。例如，软止动件可被构造为能够通过对由驱动马达1402施加到驱动构件158或存在于系统的惯性中的近侧或远侧力提供阻力来逐渐地减慢驱动构件158的速度。在至少一个形式中，由软止动件提供的用以抗衡或减缓致动或驱动运动的阻力的量值可进行选择性地调节。例如，器械10可配有一个或多个软止动件，所述软止动件可滑动或旋转到沿驱动行程的多个位置。因此，用户可定制软止动件的位置以用于特定应用。在一个形式中，包括软止动件的电化学装置可包括可调节转盘，以调节由软止动件沿行程末端提供的阻力。在一些此类形式中，调节该转盘可同时调节由软止动件涵盖的纵向距离(以及行程末端的纵向距离)以及与确定电流尖峰相关的阈值，如将在下文进行更详细地说明。在一个形式中，当设手动设定值被设定为超过预定机械公差时，可向用户提供警告信号。
再次参见图95，在各种形式中，控制系统1400被构造为能够阐释和/或响应于反馈信息，所述反馈信息至少部分地源自由控制系统1400测量的信息或得自其他系统部件的信息。例如，在一个方面，控制系统1400可被构造为能够响应于输入信号(诸如，由用户提供的指令)来引发对系统部件的功率递送。在某些方面，控制系统1400可通过用户界面(例如，视觉或音频显示器)来向用户产生或提供信息，例如警告或器械状态。由控制系统1400产生的信号或输入可例如响应于由用户、器械部件提供的其他信号或输入，或者可为与器械10相关的一个或多个测量结果的函数。在某些方面，控制系统1400可被构造为能够监测或接收各种测量结果，然后对信息解译、计算、和/或解码，并且以预定方式进行响应。
在一个方面，控制系统1400包括半导体、计算机芯片、或存储器后者可与它们选择性地相关联。如上所述，提供给或来自控制系统1400的输入(诸如，由用户提供的或由控制系统1400响应于指令、信号、或测量参数产生的输入)可为模拟的或数字的。因此，在一些形式中，控制系统1400可被构造为能够向器械部件或从器械部件发送模拟或数字输入或信号。在各个方面，控制系统1400可使用软件，所述软件可采用一个或多个算法以进一步阐释输入信号，由此控制和监视器械部件。此类阐释的输入信号可为由控制系统1400测量和/或计算的判据的函数，或者在一些情况下，可由另一个器械部件、用户、或与控制系统1400操作性地连通的独立系统提供给控制系统1400。例如，控制系统1400可通过致动或停用驱动马达1402、终止、启动对驱动马达1402或附加系统部件供能、或者提供用于这些或其他操作的指令或附加输入来作出响应。在各个方面，控制系统1400可包括电路(例如，晶体管或开关)，所述可被构造为能够监测与器械10的操作相关的电参数。例如，当与器械10的操作相关的电参数达到阈值(例如，由电路构造测定的电流尖峰)时，控制系统电路可被构造为能够启动或停用驱动马达1402或者打开或闭合驱动马达1402的功率递送路径。
在某些形式中，采用机械止动件的外科器械10和系统可以开环方式操作。例如，在一个形式中，器械可在无需来自位置反馈装置的辅助的情况下进行操作，所述反馈装置可被构造为能够为控制系统1400提供有关器械10如何响应输入的信息，使得控制系统1400可修改输出。在各个方面，如上所述，控制系统1400可监测对驱动马达1402的功率递送，以确定驱动构件158的行程末端位置。即，例如，通过可利用机械止动件来至少部分地探知电流(即，电流尖峰)的各种电压监测技术，控制系统1400可进行确定。例如，控制系统1400可监测电压以确定相对于对驱动马达1402并且因此对驱动构件158的功率递送的电流，如上所述。驱动行程的阻力可增加驱动马达1402上的扭矩，从而导致相对于递送到驱动马达1402的功率的可检测电流尖峰。因此，当驱动构件158接触机械止动件时，控制系统1400可测得大的电流尖峰，此时控制系统1400可通过终止对驱动马达1402的功率递送而作出响应。因此，机械止动件提供物理力来使得驱动构件158减速并且产生电流尖峰，所述电流尖峰可由控制系统1400探知以引发驱动马达1400的脱离。
如上所述，在某些方面，控制系统1400被构造为能够控制器械10的各种操作。例如，在某些方面，控制系统1400包括操作地可联接到驱动电路1408的控制电路1406。驱动电路1408可被构造为能够将来自功率源1404的功率递送到驱动马达1402，以驱动驱动构件158。控制电路1406可被构造为能够控制对驱动电路1408的功率递送。因此，控制电路1406可被构造为能够通过控制对驱动电路1408的功率递送来控制驱动马达1402。控制电路1406还被构造为能够监测(例如，取样或测量)递送到驱动马达1402的功率。例如，控制电路1406可对驱动电路1408的一个或多个位点处的输入/输出电压和/或电流取样，通过所述一个或多个位点驱动马达1402接收功率以致动驱动构件158。在各个方面，控制电路1406可包括或联接到驱动电路1408，通过所述驱动电路1408可例如在联接到与所述驱动电路1408相关的电流路径的电阻器两端监测输入/输出电压。本领域的技术人员将会知道，上述说明仅为测量和/或监测提供给驱动马达1402的电流的一种方式，并且还将认识到，电流可通过本领域已知的替代方法进行类似地测量和/或监测，因此此类方法位于本公开的范围内。在一些形式中，当控制电路1406检测到提供给驱动马达1402的电流尖峰时，控制系统1400通过驱动电路1408来终止对驱动马达1402的能量递送。在各个方面，控制系统1400还可响应于测得的电流尖峰来至少暂时地解除驱动马达1402和驱动构件158之间的操作联接(例如，传递)。
在某些构型中，当机电止动件包括被设计成突然地终止驱动行程的硬止动件时，器械10可易于因例如电流尖峰的检测与驱动马达1402提供的致动力的随后解除之间的时间延迟而经受机械故障。另外，由于该系统的惯性，例如，驱动构件158还可在到达行程末端之后继续被致动或驱动，尽管驱动马达1402的功率递送已终止。在一些情况下，驱动构件158的致动力的解除延迟可将驱动构件158、驱动马达1402、驱动螺杆180、或其他传递联接件驱动，从而导致机械故障。
图96为示出采用机电止动件的器械10的电流随时间变化的示意图，所述机电止动件包括硬止动件178而不包括软止动件。对应于驱动构件158在行程末端近侧的位置的时间A与对应于驱动构件158在接触硬止动件178时的位置的时间B之间的电流为相对较低的或稳定的。然而，在时间B处，电流尖峰表示驱动构件158和定位在行程末端处的硬止动件之间的接触。当终止驱动构件158的功率递送时，由于时间B之后某一时间的电流尖峰的检测与驱动马达1402的功率递送终止之间的时间延迟，驱动马达1402继续但不成功地将驱动构件158驱动从而抵靠硬止动件178直至时间C。尽管未示出，但在时间C之后的一段时间，系统的惯性也可继续致动驱动构件158以抵靠硬止动件178。
如上所述，尽管提供了开环操作的便利性，但如图76所示进行操作的外科器械可易于因例如电流尖峰的检测与致动运动的随后解除之间的时间延迟而经受机械故障。根据各种形式，参见图97和图98，本文所公开的器械10可包括机电止动件，所述机电止动件包括软止动件结构，所述软止动件结构在到达行程末端之前接触并且减缓驱动构件158，以导致可识别的电流尖峰，由此增加控制系统1400检测和响应电流尖峰的时间量。外科器械10包括类似于图1和图70所示的各种特征结构；因此，类似的特征结构使用类似的数字标识符来标识，并且为简明起见将不再进行描述。器械10包括机电止动件，所述机电止动件包括软止动件，所述软止动件在驱动行程末端或其某一段或附近(例如，在第一软止动件位置S1和第二软止动件位置S2之间沿轴的轴线A-A延伸的近侧起始位置或行远侧行程末端处)抵制驱动构件158的运动。机电止动件还包括设置在位置H处的硬止动件178。软止动件包括缓冲器174和阻力构件175，所述阻力构件175设置在行程末端处或附近，例如，至少部分地位于第一软止动件位置S1和第二软止动件位置S2内。缓冲器174和阻力构件175用于在限定于第一软止动件位置S1和第二软止动件位置S2之间的行程末端内对驱动构件158提供阻力。在各种形式中，缓冲器174和阻力构件175还可用于从第一软止动件位置S1到第二软止动件位置S2减缓驱动构件158。在某些形式中，软止动件可定位在任何优选的位置，在所述位置希望为驱动构件158提供阻力或使其开始减速。
图97示出了在延伸穿过驱动行程的过程中处于靠近第一软止动件位置S1的位置处的驱动构件158。图98示出了越过行程末端的第一软止动件位置S1使得定位在行程末端的第二软止动件位置S2处从而完全延伸穿过驱动行程之后的驱动构件158。因此，软止动件被定位成在第一软止动件位置S1处接触驱动构件158，并且然后由于在位置H处与硬止动件的压缩作用而向远侧朝第二软止动件位置S2压缩。因此，第二软止动件位置S2可有效地包括相对于驱动构件的硬止动件位置H*和行程末端的极限远侧终点。在各个方面，驱动构件158可在到达硬止动件位置H*之前在第二软止动件位置S2处完全或显著减速。因此，在这些方面，硬止动件(如果存在)可包括冗余或安全特征。
机械止动件对致动运动提供的阻力(可伴有减速力或制动力)可例如相对于距离和/或时间为渐变的、渐进的、或步进的。即，在一些方面，软止动件提供了第一软止动件位置S1和第二软止动件位置S2之间的增大阻力路径。值得注意的是，行程末端并不一定意味着驱动构件的功能操作延伸贯穿整个行程末端，例如，到达第二软止动件位置S2。例如，在一个形式中，行程末端被定位在最远侧钉处或与其稍近侧。在另一个形式中，开始接触软止动件的位置(例如，在第一软止动件位置S1处)位于最远侧钉的远侧。即，驱动构件158可在驱动行程中对纵向运动不接触或经受显著的阻力，直至最远侧钉已被顶出，此时增大的阻力和/或减速可出现。这样，驱动构件的运动将不因控制系统1400的动作而受到过早地限制。
图75为示出根据各个方面的采用包括软止动件的机电止动件的器械10的电流随时间变化的示意图。对应于驱动构件158在行程末端近侧的位置的时间A*和对应于驱动构件158在接触软止动件时的位置(例如，在缓冲器174处)的时间B* 0之间的电流为相对低的或稳定的。然而，在时间B* 0之后，电流逐渐地开始出现尖峰，这表示对驱动构件的纵向运动的增大的阻力。在各个方面，阻力的逐渐增加可促进增加出现电流尖峰的时间，例如，在时间B* 0和B* 2之间，从而有效地减慢响应时间以向控制系统1400赋予反应时间，由此使上文参考图96解释的时间延迟的不利效果最小化。在某些方面，控制系统1400可监测电压并且测量提供给驱动马达1402的电流，如上所述。控制系统1400可被构造为能够以预定方式响应电流的变化。例如，当在例如时间B* 1处达到阈值电流时，控制系统1400可终止对驱动马达1402的功率供应。在一个构型中，阈值电流可包括时间分量。例如，阈值电流可包括特定时间段内的电流差分。在某些构型中，电流尖峰可包括多个预定电流阈值中的一个，每个阈值由特定时间段内的电流差分的比率来限定。如在图99中可见，阻力的逐渐增加还可有利地降低端部执行器102当在时间B* 2处接触硬止动件时的冲击负荷，以及缩短驱动马达1402在远侧运动已停止之后继续致动驱动构件158以抵靠硬止动件178的时间段B* 2至C*。
在某些方面，控制系统1400可确定预定电流阈值(如通过电流随时间变化的增量或斜率测得)例如已达到并且可随后终止提供给驱动马达1402的功率输入信号。例如，在一个构型中，控制系统1400可监测电流，并且因此当电流的量值在给定时间段内增加预定量时终止对驱动马达1402的功率递送。在各个方面，这些值或其他值(诸如，阈值)可通过用户(诸如，手动)或通过经由管理员链接来访问机载协议(诸如，通过计算机)进行调节。在至少一个构型中，驱动电路1408或控制电路1406包括可变电阻器，使得用户可通过相对于触发器改变致动范围来改变提供给驱动马达1402的电流。例如，击发马达530的旋转可与用户施加到致动器或触发器的压力或运动成比例。在一个形式中，控制电路1406可与驱动电路1408连通，使得阈值可升高或失去敏感性。
在某些构型中，多个传感器或电子部件可用于端部执行器102中以向用户提供各种形式的反馈。在一个方面，传感器可对控制系统1400提供反馈，以自动地控制与器械相关联的多个马达。例如，在一个方面，外科器械包括多个马达，例如，马达402,530,560和/或610，所述马达可由一个或多个控制系统(例如，控制系统800和1400)致动以用电力产生控制运动。控制系统可被构造为能够可操作地控制马达，并且接收来自被构造为能够检测位置信息的多个传感器的位置反馈。在某些方面，控制系统例如可利用位置信息以通过控制一个或多个马达的功率递送来用电力产生改变的或调制的控制运动或者可为用户提供多个位置信息。在各个方面，控制系统可在混合的开环系统和/或闭环系统中操作。例如，控制系统1400可被构造为能够在如本文所述的开环中操作驱动马达1402(诸如，击发马达530)，同时也在例如闭环中操作各种其他马达(诸如，轴旋转马达610)。在一个方面，控制系统1400可被构造为使得用户可选择性地选择控制系统1400可在闭环或开环中操作的马达，从而例如根据需要来定制器械10的各种操作。
应当理解，一个或多个输入可由用户提供，所述一个或多个输入可能经受或者可能未经受由控制系统1400的评估。例如，控制系统1400可包括覆写模式，其中由一个或多个用户或与控制系统1400连通的其他控制系统提供给控制系统1400的一个或多个输入可转发和/或提供给器械10。例如，当驱动构件158处于起始位置时，控制系统1400可锁定、阻止、或忽略指令，以联接驱动马达1402的功率递送或以其他方式接合驱动马达1402，由此用电力产生驱动构件158的致动运动。在至少一个方面，锁定存在或者为系统的默认状态或条件，直至发生一个或多个事件，例如，砧座190的闭合或者足够的机械或电反馈(诸如，例如件的闩锁、用户启动的覆写、驱动构件路径处、驱动构件路径附近、或沿驱动构件路径的测得参数的变化)。
在各个方面，根据本公开的包括软止动件组件的一个或多个机械止动件可以套件提供。套件可专门应用于一个或多个选定装置，或者可为通用的或可进行修改以通用于多个装置。例如，软止动件组件套件可包括替换减速构件，例如，阻力构件和/或接触构件(例如，缓冲器)。在一个形式中，套件包括替换或售后轴衬，所述替换或售后轴衬可用作外壳或者可插入外壳内，所述外壳的尺寸被设计为支撑阻力构件，以便增加软止动件在沿驱动行程的一个或多个位置处提供的阻力。在各种形式中，可提供垫片以调节装置的止动件和主体之间的间隙。在一些方面，接触构件可包括永久性或临时性的(例如，可替换的、可修改的)接触防护件，所述接触防护件被构造成设置在驱动构件与缓冲器、阻力构件、和/或硬止动件之间。接触防护件可由弹性材料或其他材料形成，所述弹性材料或其他材料在被驱动构件的加速块接触或冲击到软或硬止动件上时为至少部分可压缩的。防护件的一个方面可为聚合物，所述聚合物可滑移、滑动、卡合、或模塑到驱动构件158的部分(例如，接触表面158)上。在另一方面，防护件可装配或能够装配到缓冲器174的表面上。在又一方面，缓冲器174可包括触点，所述触点可被构造为能够接触并且至少部分地吸收驱动构件158的加速块的力，以避免或部分地限制驱动构件158、驱动马达1402、驱动螺杆180、或相关部件的物理损坏或机械故障程度。
在一些形式中，从患者移除外科器械(例如，图1和图2所示的外科器械10)可为困难的，因为端部执行器102可处于关节运动或旋转位置，从而阻止端部执行器102穿过套管针或其他进入点进入患者体内。临床医生可不知道端部执行器102，诸如，例如沿关节运动轴线B-B进行关节运动的当前关节运动状态，并且可尝试移出端部执行器10而不首先拉直端部执行器102。在各种形式中，外科器械可被构造为使得其端部执行器基于来自传感器的输入而被拉直(例如，该器械可具有传感器拉直式端部执行器)。这样，例如在从患者诸如通过套管针移出端部执行器102之前，临床医生可确保端部执行器102相对于关节运动轴线B-B为直的。在各种形式中，当从患者移出端部执行器时，传感器可被构造为能够触发电动拉直事件。
图105示出了包括传感器拉直式端部执行器5802的外科器械5810的一个形式。传感器5826a,5826b可检测外科器械5810的总体近侧运动。总体近侧运动可指示外科器械5810正诸如通过套管针或外管从患者移出。最小阈值近侧运动可被设定成阻止端部执行器5802在治疗期间因外科器械5810的轻微近侧调节而拉直。在各种形式中，当外科器械5810的总体近侧运动超过最小阈值时，传感器5826a,5826b可将信号发送到马达(例如，关节运动控制马达402)，从而使得马达拉直端部执行器5802。
在一些形式中，传感器5826a,5826b可位于轴5831、端部执行器5802、柄部5820或任何其他合适的位置中，以检测外科器械5810的总体近侧运动。在各种形式中，传感器5826a,5826b可包括任何合适的传感器以用于检测外科器械5810的运动。例如，传感器5826a,5826b可包括被构造为能够测量加速度的传感器，诸如，加速度计。当加速度计检测到沿近侧方向的加速度超过预定阈值时，加速度计可向关节运动控制马达402发送信号以启动拉直程序。又如，传感器5826a,5826b可包括接近传感器(例如，磁性传感器、霍尔效应传感器、磁簧开关传感器)、或任何其他合适的接近传感器。在各种形式中，接近传感器可被构造为能够测量传感器5826a,5826b与固定点(例如，套管针5858或外管5960)的接近度。当外科器械5810沿近侧方向抽出时，传感器5826a,5826b与固定点之间的接近度可降低，从而导致传感器5826a,5826b将信号发送到关节运动控制马达402，以启动端部执行器5802的电动拉直程序。在各种形式中，可包括多个传感器，以提供用于拉直程序的冗余检查。
在一个形式中，第一传感器5826a和第二传感器5826b可设置在外科器械5810上。第一传感器5826a可位于轴5831的近侧部分上，并且第二传感器5826b可位于轴5831的远侧部分上。本领域的技术人员将会认识到，第一传感器5826a和第二传感器5826b可位于外科器械5810的任何合适的部分中，诸如，例如柄部5820、可拆卸的外科模块、轴5831、或传感器拉直式端部执行器5802。在一些形式中，第一传感器5826a可包括加速度计，所述加速度计被构造为能够检测外科器械5810的总体近侧运动。在一些形式中，第二传感器5826b可包括接近传感器，所述接近传感器被构造为能够检测第二传感器5826b和固定点(诸如，例如套管针5858)之间的距离。在图示的形式中，套管针5858包括多个磁体5822。多个磁体5822可产生恒定的磁场。第二传感器5826b可被构造为能够检测到磁场强度的增加，由此指示出第二传感器5826b以及因此传感器拉直式端部执行器5802朝套管针5858的运动。
在一个形式中，第一传感器5826a和第二传感器5826b可被构造为能够启动传感器拉直式端部执行器5802的电动拉直程序。在操作中，第一传感器5826a可通过检测超过预定阈值的近侧加速度来检测外科器械5810的总体近侧运动。第一传感器5826a可将第一信号发送到关节运动控制马达402以启动电动拉直程序。在一些形式中，第二传感器5826b还可通过检测传感器5826b和固定点(诸如套管针5858)之间的磁场强度的变化来检测端部执行器的总体近侧运动。第二传感器5826b可将第二信号发送到关节运动控制马达402以启动电动拉直程序。
如图105所示，传感器拉直式端部执行器5802已在关节运动轴线B-B(图1所示)处进行关节运动。传感器拉直式端部执行器5802可联接到轴5831。操作者可使外科器械5810沿近侧方向运动，从而使得轴5831和传感器拉直式端部执行器5802沿近侧方向运动。近侧运动可由第一传感器5826b检测。第一传感器5826a可包括加速度计。第一传感器5826a可将信号发送到关节运动控制马达，诸如，例如关节运动控制马达402，以启动电动拉直程序。近侧运动还可由第二传感器5826检测。第二传感器5826b可包括磁性接近传感器，诸如，例如霍尔效应传感器或磁簧开关传感器。第二传感器5826b可将信号发送到关节运动控制马达402，以启动电动拉直程序。第二传感器5826b可与第一传感器5826a无关地向关节运动控制马达402发送信号。
当临床医生从套管针5858移出外科器械5810时，电动拉直程序拉直传感器拉直式端部执行器5802。在电动拉直程序已完成之后，传感器拉直式端部执行器5802处于拉直状态，如图106所示。拉直的传感器拉直式端部执行器5802可通过套管针5858抽出，而不损伤患者或套管针5858并且不需要临床医生手动地拉直传感器拉直式端部执行器5802。在一些形式中，外科器械5810可为用户提供反馈信号，以指示电动拉直程序的启动或进程。例如，在一些形式中，发光二极管(LED)可位于柄部5820上。LED可在电动拉直程序期间照亮，以向用户提供电动拉直程序正在进行的视觉指示。
在一些形式中，第一传感器5826a和第二传感器5826b可用于对拉直程序进行冗余检查。例如，在一些形式中，第一传感器5826a和第二传感器5826b可向关节运动控制马达402提供信号以启动拉直程序。来自第一传感器5826a或第二传感器5826b的信号可导致关节运动控制马达402拉直传感器拉直式端部执行器5802。在一些形式中，电动拉直程序可不执行，直至已从第一传感器5826a和第二传感器5826b接收到信号。在一些形式中，第一传感器5826a或第二传感器5826b可独立地启动电动拉直程序，但如果在预定时限内未从第一传感器5826a和第二传感器5826a5826b两者接收到信号，则该程序可被中止。例如，由来自第一传感器5826a的信号可引发电动拉直程序。如果在预定时限内未从第二传感器5826b接收到信号，则电动拉直程序可被外科器械5810中止。
在一些形式中，外科器械5810可包括止动传感器。止动传感器可在拉直程序期间检测传感器拉直式端部执行器5802和组织部分之间的接触。如果止动传感器检测到传感器拉直式端部执行器5802和组织部分之间的接触，则止动传感器可将信号发送到关节运动控制马达402，以停用拉直程序，从而避免对患者的损伤。在一些形式中，当止动传感器确定传感器拉直式端部执行器5802不再接触组织部分时，止动传感器可将信号发送到关节运动控制马达402，以继续拉直程序。在一些形式中，止动传感器可例如通过反馈装置来将信号发送到操作者，以向用户通知传感器拉直式端部执行器5802已接触组织部分并且拉直程序已被停用。止动传感器可包括例如设置在传感器拉直式端部执行器5802上的压力传感器。
图107和图108示出了传感器拉直式端部执行器5902的一个形式。在一些形式中，传感器拉直式端部执行器5902可通过外管5960插入患者中。外管5960可包括位于外管5960的远侧端部上的磁性环5922。第一传感器5926a和第二传感器5926b可被构造为能够在轴5931从外管5960抽出时检测到传感器拉直式端部执行器5902的运动。在一些形式中，第一传感器5926a可包括加速度计并且第二传感器5926b可包括磁性接近传感器。当第二传感器5926b沿近侧方向朝磁性环5922运动时，第二传感器5926b可检测磁场强度的变化。当第二传感器5926b接近磁性环5922时，第二传感器5926b可产生信号以引发端部执行器5902的电动拉直程序。第二传感器5926b可包括用于变化感测磁场的任何合适的传感器，诸如，例如磁簧开关传感器或霍尔效应传感器。如上所述，第一传感器5926a和第二传感器5926b可提供用于电动拉直程序的冗余检查。本领域的技术人员将认识到，在一些形式中，可包括仅第一传感器5926a或第二传感器5926b。在一些形式中，可包括另外的传感器，以检测外科器械5910的总体近侧运动。
图109和图110示出了在从套管针6058移出期间从关节运动状态转变成拉直状态的传感器拉直式端部执行器6002的一个形式。在图109中，传感器拉直式端部执行器6002相对于轴6031处于关节运动位置。临床医生可开始通过套管针6058沿近侧方向抽出传感器拉直式端部执行器6002，如箭头“A”所示。近侧运动可由第一传感器6026a、第二传感器6026b、或者第一传感器6026a和第二传感器6026a6026b两者检测到。第一传感器6026a可包括被构造为能够检测轴6031的总体近侧运动的加速度计。第二传感器6026b可包括磁性传感器，所述磁性传感器被构造为能够检测第二传感器6026b和固定点(诸如，例如套管针6058)之间的磁场变化。套管针6058可包括磁体6022以产生磁场。当通过套管针6058抽出轴6031时，磁性传感器6026b检测的磁场强度将相对于磁性传感器6026b和磁体6022之间的距离成比例地变化。第一传感器6026a或第二传感器6026b可对关节运动控制马达402产生信号，以启动电动拉直程序，由此相对于轴6831拉直传感器拉直式端部执行器6002。
在电动拉直程序已完成之后，传感器拉直式端部执行器6002处于如图110所示的拉直状态。在拉直状态下，传感器拉直式端部执行器6002可通过套管针6058抽出，而不损伤患者或套管针6058并且不需要临床医生手动地拉直传感器拉直式端部执行器6002。在一些形式中，临床医生可能够覆写电动拉直程序，并且在传感器拉直式端部执行器6002从套管针6058移出期间保持传感器拉直式端部执行器6002处于关节运动状态。
图111示出了可附接到套管针5858,6058或外管5960的磁性环6121的一个形式。磁性环6121可包括可产生磁场的多个磁体6122。磁场可通过设置在外科器械上的磁性传感器(诸如，例如第二传感器6026b)来检测。磁性传感器6026b可被构造为能够在磁性传感器检测到由磁性环6121产生的磁场时保持传感器拉直式端部执行器(例如，端部执行器6002)处于拉直状态。例如，在一个形式中，如果磁性传感器6026b检测到超出预定阈值的磁场，则磁性传感器6026b可被构造为能够产生锁定信号以阻止端部执行器的关节运动。预定阈值可基于以下磁场的强度来确定，所述磁场由对应于位于套管针5858或外管5960外部的关节运动轴线B-B的特定距离处的磁性环6121产生。在一些形式中，磁性传感器6026b可在检测到的磁场强度超过预定阈值时启动电动拉直程序并且可启动锁定信号以阻止传感器拉直式端部执行器6002的关节运动，直至检测到的磁场强度下降到预定阈值之下。
图112和113示出了包括磁簧开关传感器的磁性传感器6226的一个形式。磁簧开关可包括由所施加的磁场操作的电子开关6250。一对触点可设置在气密密封的玻璃封套中的含铁金属磁簧上。触点可通常为打开并且在磁场存在时闭合，或者通常闭合并且在施加磁场时打开。
现在参考图105和106，公开了一种用于控制传感器拉直式端部执行器的方法。尽管用于控制传感器拉直式端部执行器的方法在本文中参考图105和106来进行描述，但本领域的技术人员将认识到，该方法可与本文所公开的传感器拉直式端部执行器的任何形式(例如，图107-113所示的形式)一起使用。在一个形式中，该方法可包括通过第一传感器5826a检测外科器械5810的总体近侧运动。外科器械5810可包括传感器拉直式端部执行器5802。临床医生可在治疗期间使得传感器拉直式端部执行器5802进行关节运动。一旦治疗完成，临床医生就可开始从患者抽出外科器械5810，由此使得外科器械5810沿近侧方向运动。外科器械5810的近侧运动可由第一传感器5826a检测。在一些形式中，第一传感器5826a可包括加速度计，所述加速度计可被构造为能够检测外科器械5810的总体近侧运动。该方法还可包括由第一传感器5826a产生指示已检测到总体近侧运动的信号。信号由第一传感器5826a传递到用于关节运动控制马达402的控制器，诸如，例如图82所示的控制电路3702之类的控制电路。另外的马达控制器参照图84、114-116等来提供和描述。该方法还可包括通过关节运动控制马达402接收来自第一传感器5826a的信号，并且响应于所接收的信号通过关节运动控制马达402启动电动拉直程序以拉直传感器拉直式端部执行器5802的关节运动角度。电动拉直程序可使传感器拉直式端部执行器5802返回到零关节运动状态。
在一些形式中，该方法还可包括由第二传感器5826b检测外科器械5810的总体近侧运动。在一些形式中，第二传感器5826b可包括磁性接近传感器，例如，霍尔效应传感器或磁簧开关传感器。第二传感器5826b可被构造为能够检测第二传感器5826b和固定点(例如，套管针5858或外管5960)之间的距离。用于控制传感器拉直式端部执行器5802的方法还可包括由第二传感器5826b产生指示已检测到总体近侧运动的信号。第二信号可被传递到关节运动控制马达402。该方法还可包括通过关节运动控制马达402接收第二信号，并且通过关节运动控制马达402启动电动拉直程序以拉直传感器拉直式端部执行器5802的关节运动角度。在一些形式中，第二传感器5826b可与第一传感器5826a无关地产生第二信号。
在一些形式中，第一传感器5826a和第二传感器5826a5826b可用于对拉直程序进行冗余检查。例如，在一些形式中，第一传感器5826a和第二传感器5826b两者可向关节运动控制马达402提供信号以启动拉直程序。来自第一传感器5826a或第二传感器5826b的信号可导致关节运动控制马达402拉直传感器拉直式端部执行器5802。在一些形式中，电动拉直程序可不执行，直至已从第一传感器5826a和第二传感器5826b两者接收到信号。在一些形式中，第一传感器5826a或第二传感器5826b可独立地启动电动拉直程序，但如果在预定时限内未从第一传感器5826a和第二传感器5826b两者接收到信号，则该程序可被中止。例如，由来自第一传感器5826a的信号可引发电动拉直程序。如果在预定时限内未从第二传感器5826b接收到信号，则电动拉直程序可被外科器械5810中止。
在一个形式中，各种外科器械可采用模块化马达控制平台。例如，模块化控制平台可通过控制电路3702来实现。图114示出了包括主控制器6306、一个或多个马达-控制器对6309a-6309c的模块化马达控制平台6300的一个形式。平台6300可控制一个或多个马达6318a,6318b,6318c。马达6318a,6318b,6318c可为用于外科器械的任何马达。例如，在一些形式中，马达6318a,6318b,6318c中的一个或多个可对应于关节运动马达402、击发马达530、端部执行器旋转马达560、和/或轴旋转马达610中的一个或多个。
在各种形式中，相应的控制器6306,6309a-6309c可利用一个或多个处理器(例如，在控制电路3702上实现的处理器)来实现。模块化马达控制平台6300可适于控制马达控制的外科器械，诸如，例如图1和图2所示的外科器械10。在各种形式中，主控制器6306可安装在远侧电路板810或近侧电路板820上。第一马达控制器6314a可操作地联接到第一马达6318a，从而为第一马达6318a提供一个或多个控制信号。第二马达控制器6314b可操作地联接到第二马达6318b，并且第三马达控制器6314c可操作地联接到第三马达6318c。马达控制器6314a-6314c与主控制器6306电连通。主控制器6306基于用于控制端部执行器6302的一个或多个功能的主控制程序来向马达控制器6314a-6314c提供控制信号。主控制程序可为预定义的程序、用户定义的程序、或装置产生的程序。
在一个形式中，主控制程序可限定可由外科器械10执行的一个或多个外科操作，包括轴30和端部执行器102的一个或多个功能。例如，在一个形式中，主控制程序可限定外科器械10的切割和密封操作。切割和密封操作可包括外科器械10的多个功能，诸如，例如夹持功能、缝合功能、切割功能和松开功能。用户可通过任何合适的方式(例如，按压柄部20上的按钮或开关)来指示切割和密封操作的启动。本领域的技术人员将认识到，任何合适的输入方法可用于启动外科器械10的一个或多个功能。
在一个形式中，例如当临床医生诸如通过按压柄部20上的按钮来指示切割和密封操作的启动时，主控制器6306可产生一系列控制信号并且将控制信号提供给一个或多个马达控制器6314a-6314c。例如，在时间t0处，可启动切割和密封操作。主控制器6306可产生指示应执行夹持功能的第一控制信号。第一控制信号可被传递到联接到第一马达6318a的第一马达控制器6314a，所述第一马达6318a被构造为能够控制端部执行器6302的夹持运动。第一马达控制器6314a可继而向第一马达6318a提供一个或多个信号，从而致动第一马达6318a，以枢转端部执行器102的砧座组件190，由此夹持位于砧座组件190和仓130之间的组织。主控制器6306可轮询第一马达控制器6314a的状态信号，直至第一马达控制器6314a指示夹持操作已完成。在时间t1处，第一马达控制器6314a可向主控制器6306提供信号，以指示夹持功能已完成。
在时间t2处，可从主控制器6306传递第二控制信号，以指示缝合和切割操作应被执行。可将第二控制信号发送到联接到第二马达6318b的第二马达控制器6314b。第二马达6318b被构造为能够控制设置在端部执行器102内的切割部分164和/或滑动件170的近侧和远侧运动。缝合和切割操作控制信号可导致第二马达控制器6314b致动第二马达6318b，以沿远侧方向推进切割部分164和/或滑动件170，从而导致钉仓130击发并且导致切割部分164切割由砧座组件190夹持的组织，如上文更详细所述。在时间t3处，切割部分164到达最远侧点并且第二马达控制器6314b可向主控制器6306提供信号以指示缝合和切割操作已完成。第二马达控制器6314b可自动地产生针对第二马达6318b的控制信号，以反转切割部分164的方向，直至切割部分164已完全缩回。
当在时间t3处接收到来自第二马达控制器6314b的信号之后，主控制器6306可向第一马达控制器6314a提供第三控制信号，以指示应执行释放功能。第一马达控制器6314a可产生针对第一马达6318a的控制信号，以使得第一马达6318a撤销较早的夹持操作并且松开砧座组件190。释放功能可由第一马达控制器6314a和第一马达6318a执行，与此同时反转第二马达6318b以使得切割部分164缩回到其起始位置。主控制器6306和单独马达控制器6314a,6314b的使用允许外科器械10同时地执行多个操作，而不会使单独控制器6306,6314a,6314b中的任何一个超负载。
马达控制器6314a-6314c可包括一个或多个独立程序，以用于监测和控制外科操作，诸如，例如马达的运动。在一些形式中，马达控制器6314a-6314c可被构造为能够操作一个或多个控制反馈环机构。例如，在一些形式中，马达控制器6314a-6314c可被构造为能够作为闭环控制器，诸如，单输入单输出(SISO)或多输入多输出(MIMO)控制器。在一些形式中，马达控制器6314a-6314c可充当比例积分微分(PID)控制器。PID控制器可使用三个调谐项(比例增益项、积分增益项和微分增益项)来操作控制环。PID控制器可包括控制程序，所述控制程序被构造为能够测量指定的变量，并且比较指定变量的测量值与指定变量的期望值或设定点。PID控制器可基于指定变量的测量值和预期值之间的差值来调节控制变量。在一些形式中，马达控制器6314a-6314c可包括PID速度控制器。例如，第一马达控制器6314a可测量指定的变量，诸如，马达6314a的位置。第一马达控制器6314a可基于测量的马达6314a的位置与马达6314a的设定点或期望位置之间的差值来调节控制变量，诸如，马达6314a的速度。
在一些形式中，马达控制器6314a-6314c可被构造为能够作为故障检测控制器。故障检测控制器可操作故障检测程序。在一些形式中，故障检测控制器可操作直接模式识别故障程序，所述直接模式识别故障程序包括监测被构造为能够直接指示故障的一个或多个传感器，这种程序可称为基于信号处理的故障检测。在一些形式中，将由传感器提供的传感器值与得自由故障检测控制器控制的外科程序的模型的传感器的预期值进行比较，这种程序可称为基于模型的故障检测。本领域的技术人员将认识到，基于信号处理和模型的故障检测的组合可通过马达控制器来使用。
在一些形式中，马达控制器6314a-6314c可被构造为能够作为电流/力限制控制器。电流/力限制控制器可被构造为能够将测量值(诸如，递送到马达的电流或由马达施加的力)限定到预定值。例如，在一个形式中，第一马达控制器6314a可被构造为能够将夹持操作期间施加的力限定到预定值。力传感器可监测由第一马达6318a提供的力，所述第一马达6318a被构造为能够控制外科器械的夹持操作。当力传感器测得的力值匹配预定值时，第一马达控制器6314a可停止第一马达6318a的操作。在一些形式中，马达控制器6314a-6314c被构造为能够监测递送到马达6318a-6318c的电流。由马达6318a-6318c消耗的电流可指示马达6318a-6318c的一个或多个功能，诸如，外科操作期间的马达的速度或由马达施加的力。如果马达6318a-6318c消耗的电流超过预定阈值，则马达控制器6314a-6314c可停止马达的操作，以避免损伤患者和外科器械。
在一些形式中，马达控制器6314a-6314c可对由主控制器6306执行的主控制程序提供独立验证。例如，马达控制器6314a-6314c可在请求的动作执行之前验证由主控制器6306请求的动作是否为有效的动作。在一些形式中，马达控制器6314a-6314c可使用状态信息来验证请求的工作是否有效。例如，在一个形式中，第一马达控制器6314a可接收来自主控制器6306的指令，以执行切割和缝合操作。第一马达控制器6314a可检查外科器械的当前状态，诸如，例如检查砧座组件190是否处于夹持位置。如果状态信息匹配用于执行切割和缝合操作的有效状态，则第一马达控制器6314a可执行切割和缝合操作。然而，如果状态信息不匹配用于切割和缝合的有效状态，则第一马达控制器6314a可指示主控制器6306或主控制程序中的故障。本领域的技术人员将认识到，马达控制器6314a-6314c可包括一个或多个控制程序和一种或多种类型的控制程序。
图115示出了包括主控制器6406和四个马达-控制器对6409a-6409d的模块化马达控制平台6400的一个形式。模块化马达控制平台6400也可通过上文所述的例如使用一个或多个处理器的控制电路3702来实现。模块化马达控制平台6400可被构造为能够控制各种马达。例如，远侧滚动马达6418a可按照类似于本文参考端部执行器旋转马达560所述的方式来操作。关节运动马达6418b可按照类似于本文参考关节运动马达402所述的方式来操作。近侧滚动马达6418c可按照类似于本文关于轴旋转马达610所述的方式来操作。横切马达6418d可按照类似于本文关于击发马达530所述的方式来操作。
主控制器6406可电联接到一个或多个马达控制器6414a-6414d。主控制器6406可通过有线或无线连接来联接到一个或多个马达控制器6414a-6414d。在一些形式中，马达6418a-6418d可包括被构造为能够提供指示马达轴的位置的信号的相关马达编码器6416a-6416d。在一些形式中，马达编码器6416a-6416d可被省去。在一个形式中，主控制器6406可被构造为能够与任何数量的马达控制器6414a-6414d(诸如，例如一至十个马达控制器)连通。在一些形式中，主控制器6406可被构造为能够与一个或多个附加外围控制器(未示出)连通，其中外围控制器被构造为能够控制一个或多个非马达式外科功能，例如，超声功能、电外科功能、或外科器械的任何其他合适的功能。
在一个形式中，主控制器6406可与马达控制器6414a-6414d同步连通。来自主控制器6406的连通可包括例如提供指令以执行马达控制器6414a-6414d的特定子程序或功能、针对状态更新查询马达控制器6414a-6414d、以及接收来自马达控制器6414a-6414d的反馈信息。同步连通可为主控制器6406和马达控制器6414a-6414d之间的同步连通，其中连通为时间同步的。例如，在图114所示的形式中，主控制器6406可在预定时间窗口内与马达控制器6414a-6414d中的每一个连通。在另一个形式中，可在马达控制器6414a-6414d之间传送令牌以允许马达控制器6414a-6414d当前保持令牌，从而允许在预定时间段期间与主控制器6406连通。
在一个形式中，主控制器6406可执行主控制程序。主控制程序可监测用户输入、执行外科器械10的操作、向用户提供反馈、或者执行外科器械10的任何其他功能。例如，在一个形式中，主控制器6406可执行包括切割和密封操作的主控制程序。在一些形式中，主控制程序向马达控制器6414a-6414d中的每一个提供控制信号。马达6418a-6418d的各个功能的执行可通过马达控制器6414a-6414d来控制。在一些形式中，主控制程序可基于模块外科部件(例如，模块化轴30或执行部分100)的附接或移除来启动或停用马达6418-6418d中的一个或多个。主控制器6406可向马达控制器6414a-6414d提供控制信号，并且可接收来自马达控制器6414a-6414d的状态信号。状态信号可包括例如功能完成信号、故障信号、空闲信号、或反馈信号。
在一些形式中，功能信号可通过马达-控制器对6409a-6409d来指示功能执行的操作或完成状态。例如，功能信号可指示夹持操作正发生或已完成。功能信号也可指示操作的成功，诸如，例如指示夹持操作期间由所夹持的组织施加的力的量。如果马达控制器6414a-6414d检测到相关马达6418a-6418d中或外科器械完成过程中的错误，则马达控制器6414a-6414d可产生故障信号。故障信号可导致主控制器6406向操作者产生故障信号，诸如，例如视觉指示或听觉指示。故障信号也可导致主控制器6406将控制信号发送到马达控制器6414a-6414d，以停滞任何当前执行的功能。
空闲信号可由马达控制器6414a-6414d提供给主控制器6406，以指示相关马达6418a-6418d为空闲的并且可用于执行外科器械10的相关功能。在一个形式中，空闲信号可指示功能已由马达6418a-6418d执行。例如，在一个形式中，第一马达控制器6414a可接收来自主控制器6406的控制信号以执行夹持操作。第一马达控制器6414a可将来自主控制器6406的控制信号转换成用于马达6418a的一个或多个控制信号。一旦马达6418a已执行所指示的功能，马达控制器6414a就可向主控制器6406传递空闲信号，以指示马达6418a已完成请求的功能。
在各种形式中，反馈信号可由马达控制器6414a-6414d提供给主控制器6406。主控制器6406可具有一个或多个相关的反馈装置(未示出)以向操作者提供反馈。接收自马达控制器6414a-6414d的控制信号可通过主控制器6406转换成用于反馈装置的控制信号。在一些形式中，马达控制器6414a-6414d可直接向反馈装置提供反馈信号。
在一些形式中，主控制器6406和马达控制器6414a-6414d之间的同步连通可被覆写信号中断。覆写信号可导致主控制器6406停止同步连通并且与产生覆写信号的马达控制器6414a连通。在各种形式中，覆写信号可由于马达故障、来自用户的输入信号、或者基于在一个或多个反馈信号中的预定阈值来由马达控制器6414a产生。覆写信号可导致主控制器6406向马达控制器6414a-6414d中的每一个发送信号以停止马达6418a-6418d的全部操作，直至导致覆写信号产生的情况已被解决。在一个形式中，主控制器6406可产生用于反馈装置的信号，以向操作者通知覆写信号。
图116示出了双控制器模块化马达控制平台6500的一个形式。平台6500也可通过控制电路3702来实现，如本文所述。双控制器模块化马达控制平台6500包括主控制器6506、从控制器6507、和四个马达-控制器对6509a-6509d。模块化马达控制平台6400可被构造为能够控制马达6518a,6518b,6518c,6518c。例如，远侧滚动马达6518a可按照类似于本文关于端部执行器旋转马达560所述的方式来操作。关节运动马达6518b可按照类似于本文关于关节运动马达402所述的方式来操作。近侧滚动马达6518c可按照类似于本文关于轴旋转马达610所述的方式来操作。横切马达6518d可按照类似于本文关于击发马达530所述的方式来操作。
模块化马达控制平台6400可被构造为能够控制关节运动马达402、击发马达530、端部执行器旋转或“远侧滚动”马达560、和轴旋转或“近侧滚动”马达610。主控制器6506和从控制器6507可各自与可用马达控制器的子组相关联。例如，在图示的形式中，主控制器6506与第一和第二马达控制器6526a-6526b相关联，并且从控制器6507与第三和第四马达控制器6526c-6526d相关联。主控制器6506和从控制器6507可进行电连通。在一些形式中，从控制器6507可位于远侧电路板810或近侧电路板820上。从控制器6507可通过减少主控制器6506必须连通和控制的马达控制器6526a-6526d的数目来减少主控制器6506上的负载。主控制器6506和从控制器6507可接收一个或多个控制器输入6508。
在一个形式中，主控制器6506可直接向第一马达控制器6526a和第二马达控制器6526提供控制信号。主控制器6506也可向从控制器6507提供控制信号。从控制器可向第三马达控制器6526c和第四马达控制器6526d提供控制信号。通过减少主控制器6506必须查询和控制的马达控制器6526a-6526d的数目，双控制器模块化马达控制平台6500可增加响应次数或者使主控制器6506的附加处理负载致力于其他任务。在一个形式中，主控制器6506可执行主控制程序，并且从控制器6507可执行从控制程序以基于来自主控制器6506的输入来产生用于马达控制器6526a-6526d的一个或多个信号。在一个形式中，从控制器6507可接收来自一个或多个用户控制器(诸如，例如夹持按钮或击发开关)的控制器输入。在一个形式中，主控制器6506可与一个或多个从控制器6507连通，并且可不直接向马达控制器6526a-6526d提供任何控制信号。
在一个形式中，可将另外的从控制器6507添加到系统，以控制另外的马达控制器或外科模块。在一个形式中，可仅在需要马达控制器的预定义阈值时采用从控制器6507。例如，在图115所示的形式中，将四个马达控制器6526a-6526d连接到双控制器模块化马达控制平台6500。主控制器6506和从控制器6507各自与两个马达控制器6526a-6526d相关联。一个或多个马达的停用(例如，仅对用于关节运动的马达需要将轴30替换成不同的轴)可导致从控制器6507停用，因为不需要从控制器6507的附加处理功率来降低主控制器6506上的处理负载。在一些形式中，一个或多个马达控制器6526a-6526d的停用可导致剩余的马达控制器被分配给空闲的从控制器6507。例如，第三和第四马达6518c,6518d的停用将导致从控制器6507空闲。第二马达控制器6526b可与主控制器6506断开连接并且连接到从控制器6507，以减轻主控制器6506的负荷。可执行一个或多个负荷平衡程序作为主控制程序的一部分，以确保主控制器6506和一个或多个从控制器6507之间的控制的任选分配。
现在重新参照图114-116，本发明公开了包括多个马达控制器的模块化外科器械10。尽管用于控制模块化外科器械10的方法参考图114-116进行了讨论，但本领域的技术人员将认识到该方法可用于本文所述的外科器械或多个控制平台的任何实施例。该方法可包括通过主控制器6506产生包括一个或多个控制信号的主控制程序。该方法还可包括将产生的控制信号从主控制器6506传递到一个或多个马达控制器6526a-6526d。马达控制器6526a-6526d可接收传递的控制信号。在一些形式中，由第一马达控制器6526a接收的控制信号的子组可包括由主控制器6506在某特定时间段期间传递的控制信号，其中主控制器6506和第一马达控制器6526a同步连通。该方法还包括通过马达控制器6526a-6526d基于接收自主控制器6506的控制信号来控制一个或多个相关联的马达6518a-6518d。
在一些形式中，该方法可包括通过主控制器6506将一个或多个控制信号传递到从控制器6507。从控制器6507可与一个或多个马达控制器6526c-6526d电连通。从控制器6507可基于接收自主控制器6506的输入来执行包括产生一个或多个马达控制信号的从控制程序。从控制程序还可包括通过从控制器6507来向一个或多个电联接的马达控制器6526c-6526d传递马达控制信号。该方法还可包括响应于所接收的马达控制信号由马达控制器6526c-6526d控制一个或多个相关联的马达。在各种形式中，可将所产生的马达控制信号的子组在预定时间段期间同步传递到马达控制器6526c-6526d中的每一个。
图117示出了主控制程序6600的一个形式，所述主控制程序6600可由主控制器(例如，图114-116所示的主控制器或任何其他合适的主控制器)来执行。在一个形式中，外科器械10可包括四个马达(例如，关节运动马达402、击发马达530、端部执行器旋转或“远侧滚动”马达560、以及轴旋转或“近侧滚动”马达610)和操纵杆842。外科器械10可被构造为能够执行远侧旋转功能、抓握功能、夹持功能和击发功能。外科器械10可包括用于控制外科器械10的各种操作的一个或多个按钮，例如，起始按钮、去负载按钮、抓握按钮、夹持按钮、或击发按钮。外科器械10还可包括可发光二极管(LED)以向用户提供有关外科器械10的操作的视觉反馈。
在一些形式中，当外科器械10启动时，主控制器6406将该装置放置于默认模式。在图示的主控制程序6600中，默认模式为关节运动状态6602。关节运动状态6602可包括启动四个可用马达中的三个。启动的马达可控制轴30(例如，轴旋转马达610)、端部执行器102(例如，端部执行器旋转马达560)的旋转、和/或端部执行器102(例如，关节运动马达410)的关节运动。在默认关节运动模式下，操纵杆842可为有效的。在关节运动状态6602下，操纵杆842可用于控制轴30和端部执行器102的关节运动或旋转。远侧旋转功能可为有效的(或可用的)，而抓握、夹持和击发功能为不可用的。起始按钮也可在默认状态下启动。LED可为绿色的，以指示其中外科器械10处于可安全运动的状态。
用户可按压起始按钮6604，使得外科器械10返回起始状态6606，例如，初始状态，其中端部执行器102相对于轴30拉直并且轴30和端部执行器102返回到零旋转状态。起始状态6606可用于从一个操作运动到另一个操作，或者可允许用户在操作期间快速地重新定向外科器械10。一旦起始状态6606已达到，主控制程序6600可返回到6605默认关节运动状态6602。
在一个形式中，图1和图2所示的端部执行器102可释放地连接到轴30，以允许不同的工具附接到轴30。轴30可释放地连接到柄部20，以允许各种轴附接到外科器械10。在一个形式中，主控制器6406可感测来自外科器械10的端部执行器102或轴30的顶出6608，并且可停用外科器械10的操作，直至新轴或执行部分已附接到外科器械10并且外科器械10已返回到起始状态6606。在主控制程序6600已检测到新端部执行器102，并且已返回到起始状态6606之后，主控制程序6600可进入默认状态6602。
在一个形式中，外科器械10可具有附接的端部执行器102。端部执行器102可被构造为能够执行抓握功能。抓握功能可包括抓握端部执行器102的砧座组件190和仓130之间的组织区域。外科器械10可包括抓握按钮以启动抓握功能。当用户按压6614抓握按钮时，外科器械10可进入抓握模式6616，从而锁定端部执行器102的运动，例如，相对于轴30的旋转或关节运动。抓握模式6616可启动第四马达(例如，击发马达530)，以使得端部执行器102的一部分抓握组织部分，诸如，例如将砧座组件190从打开位置运动到闭合位置。当外科器械10进入抓握状态时，可启动夹持按钮。
在一些形式中，临床医生可按压6620a夹持按钮，以使得外科器械10进入夹持模式6622。在夹持模式6622中，外科器械10可锁定第四马达，以阻止后续操作期间的组织部分释放。夹持模式6622可启动位于柄部20上的击发按钮。一旦外科器械10已进入夹持模式6622，主控制器6406就可将LED改变为蓝色，以向临床医生指示组织已夹持在砧座组件190中并且外科器械10可被击发以引起缝合操作和切割操作。
临床医生可按压6626a击发按钮以使得外科器械10进入击发模型6628。在击发模式6628中，外科器械10可停用被构造为能够控制外科器械10的运动的马达，诸如，例如马达1-3。击发模式6628可启动第四马达，所述第四马达能够控缝合和切割操作，如上所述。击发按钮可保持按下，以使得主控制器6406产生用于与第四马达相关的马达控制器的控制信号，以启动缝合和切割操作，从而导致切割部分164和/或滑动件170推进到位于端部执行器102中的钉仓130内。在击发序列期间，LED可通过主控制器6406设定成红色，以向临床医生警示外科器械10正在击发。“击发标记”可通过主控制器6406设定为真，以指示外科器械已被击发并且不可被再次击发。当切割部分164已到达端部执行器102的远侧端部时，主控制器6406或与第四马达相关的马达控制器可自动地缩回切割部分164。一旦切割部分164已完成反向行程并且回到其起始位置，主控制程序6600可返回6630到夹持状态6622。
临床医生可通过按下夹持按钮来停用6624夹持状态6622。当夹持状态6622停用时，主控制程序6600将产生一个或多个控制信号以返回到抓握状态6616。临床医生可随后释放6618抓握状态6616并且转变到关节运动状态6602或者任何其他合适的默认状态。本领域的技术人员将认识到，可修改主控制程序6600，以适应由外科器械10或任何附接的外科模块执行的任何外科操作或功能。在一些形式中，主控制程序6600可基于附接的轴、端部执行器、或功率模块来自动地配置。
根据一个一般形式，提供了一种外科器械，所述外科器械包括柄部组件，所述柄部组件被构造为能够同时并且独立地用电力产生至少两个独立的旋转控制运动。外科器械还可包括细长轴组件，所述细长轴组件与柄部组件可操作地交接，以用于独立并且同时地接收至少两个独立的旋转控制运动，并且将其传递到可操作地联接到细长轴组件的端部执行器。
根据另一个一般形式，提供了一种外科器械，所述外科器械包括柄部组件，所述柄部组件被构造为能够同时并且独立地产生至少三个独立的旋转控制运动。外科器械还可包括细长轴组件，所述细长轴组件与柄部组件可操作地交接，以用于独立并且同时地接收至少三个独立的旋转控制运动，并且将其传递到可操作地联接到细长轴组件的端部执行器。
根据另一个一般形式，提供了一种外科器械，所述外科器械包括被构造为能够用电力产生多个独立的旋转控制运动的驱动系统。外科器械还可包括细长轴组件，所述细长轴组件可操作地联接到驱动系统，以用于从其接收第一旋转控制运动，以使得细长轴组织围绕轴的轴线旋转。细长轴组件可被构造为能够从驱动系统接收第二旋转控制运动并且将第二旋转控制运动传递到外科端部执行器，所述外科端部执行器可操作地联接到细长轴组件，以使外科端部执行器相对于细长轴组件围绕轴的轴线旋转。细长轴组件还可被构造为能够从驱动系统接收第三旋转控制运动并且将第三旋转控制运动传递到关节运动接头，所述关节运动接头与细长轴组件和外科端部执行器连通，以使得外科端部执行器围绕基本上横向于轴的轴线的关节运动轴线进行关节运动。
根据另一个一般形式，提供了一种用于外科器械的关节运动接头，所述外科器械包括细长轴组件和驱动系统，所述驱动系统被构造为能够对细长轴组件产生并且施加多个旋转控制运动。在至少一个形式中，关节运动接头包括联接到细长轴组件的近侧接头部分和被构造为能够运动地联接到近侧接头部分并且被构造为能够与外科端部执行器交接的远侧接头部分。第一齿轮系可与细长轴组件的近侧击发轴部分可操作地交接。远侧击发轴可与外科端部执行器可操作地交接，以用于将旋转击发运动从近侧击发轴传递到外科端部执行器，同时促进远侧接头部分相对于近侧接头部分进行关节运动。第二齿轮系可与细长轴组件的近侧旋转轴部分可操作地交接，以用于将远侧旋转控制运动传递到外科端部执行器，从而使得外科端部执行器相对于细长轴组件旋转，同时促进远侧接头部分相对于近侧接头部分进行关节运动。
根据另一个一般形式，提供了一种用于外科器械的关节运动接头，所述外科器械具有细长轴组件和驱动系统，所述驱动系统被构造为能够对细长轴组件产生并且施加多个旋转控制运动。在至少一个形式中，关节运动接头包括近侧连接叉和远侧连接叉，所述近侧连接叉联接到细长轴组件，所述远侧连接叉可枢转地销接到近侧连接叉以用于相对其围绕关节运动轴线选择性地枢转行进，所述关节运动轴线基本上横向于由细长轴组件限定的轴的轴线。第一齿轮系可支撑在限定在近侧连接叉和远侧连接叉之间的齿轮区域中，使得第一齿轮系的任何部分均未径向向外延伸越过关节运动接头的任何部分。第一齿轮系可与细长轴组件的近侧击发轴部分可操作地交接。远侧击发轴可与外科端部执行器可操作地交接，以用于将旋转击发运动从近侧击发轴传递到外科端部执行器，同时促进远侧连接叉相对于近侧连接叉的枢转行进。第二齿轮系可支撑在齿轮区域中，使得第一齿轮系的任何部分均未径向向外延伸越过关节运动接头的任何部分。第二齿轮系可与细长轴组件的近侧旋转轴部分可操作地交接，以用于将远侧旋转控制运动传递到外科端部执行器，从而使得外科端部执行器相对于细长轴组件旋转，同时促进远侧连接叉相对于近侧连接叉进行关节运动。
根据另一个一般形式，提供了一种外科器械，所述外科器械包括被构造为能够产生多个旋转控制运动的驱动系统。细长轴组件与驱动系统可操作地交接，并且可包括外部轴段，所述外部轴段可与驱动系统可操作地交接，以从其接收远侧旋转控制运动。关节运动轴可与驱动系统可操作地交接，以从其接收旋转关节运动。细长轴组件还可包括近侧击发轴段，所述近侧击发轴段与驱动系统可操作地接合以从其接收旋转击发运动。外科器械还可包括关节运动接头，所述关节运动接头可包括近侧连接叉和远侧连接叉，所述近侧连接叉联接到细长轴组件，所述远侧连接叉可枢转地销接到近侧连接叉以用于相对其围绕关节运动轴线选择性地枢转行进，所述关节运动轴线基本上横向于由细长轴组件限定的轴的轴线。联接组件可与远侧连接叉可旋转地接合并且被构造为能够附接到外科端部执行器。远侧击发轴段可由联接组件可操作地支撑并且被构造为能够与外科端部执行器的驱动轴部分交接。第一齿轮系可与近侧击发轴段和远侧击发轴段可操作地交接，以用于将旋转击发运动从近侧击发轴段传递到远侧击发轴段，同时使得远侧连接叉能够相对于近侧连接叉选择性地枢转。第二齿轮系可与近侧旋转轴可操作地交接，以用于将远侧旋转控制运动传递到联接组件，同时使得远侧连接叉能够相对于近侧连接叉选择性地枢转。关节运动驱动联接件可与关节运动轴和远侧连接叉交接，并且可被约束为响应于施加到关节运动轴的旋转关节运动来相对于关节运动接头轴向地运动。
根据又一个一般形式，提供了一种用于关节运动接头的覆盖件，所述关节运动接头支撑在外科器械的细长轴组件中，所述细长轴组件可操作地联接到外科端部执行器，所述外科端部执行器在其中具有至少一个端部执行器导体。在至少一个形式中，覆盖件包括不导电的中空主体，所述中空主体具有开口远侧端部和开口近侧端部以及在两者间延伸以用于将关节运动接头接收于其中的接头接收通道。中空主体被构造为能够允许关节运动接头的部分相对于彼此选择性地进行关节运动，同时将所述部分基本上包封在中空主体内。至少一个导电通路从中空主体的远侧端部延伸到中空主体的近侧端部。所述至少一个导电通路中的每一个具有远侧端部部分和近侧端部部分，所述远侧端部部分被构造为能够在端部执行器已联接到细长轴组件时电接触相应的端部执行器导体，所述近侧端部部分被构造为能够电接触细长轴组件中的相应轴导体。
根据另一个一般形式，提供了一种外科器械，所述外科器械包括其中具有至少一个电轴导体的细长轴组件以及关节运动接头。在至少一个形式中，关节运动接头包括联接到细长轴组件的近侧接头部分。远侧接头部分能够运动地联接到近侧接头部分，以用于相对于其选择性地进行关节运动。联接器组件可旋转地联接到远侧接头部分，以用于相对于其选择性地旋转。联接器组件可被构造为能够可拆卸地联接到外科端部执行器并且形成从端部执行器中的端部执行器导体到关节运动接头的导电联接器通路。外科器械还可包括关节运动接头导体，所述关节运动接头导体接触导电联接器通路并且穿过关节运动接头以接触相应的轴导体，以在两者间形成导电路径。
根据另一个一般形式，提供了一种外科器械，所述外科器械包括控制系统，所述控制系统包含至少一个电控制部件。外科器械还包括细长轴组件，所述细长轴组件具有电轴导体，所述电轴导体与至少一个电控制部件可操作地连通。外科器械还可包括关节运动接头，所述关节运动接头包括联接到细长轴组件的近侧连接叉。远侧连接叉可枢转地联接到近侧连接叉，以用于相对于其选择性地枢转行进。外科器械还可包括联接到远侧连接叉的联接器组件和可释放地联接到联接器组件的外科端部执行器。外科端部执行器可包括端部执行器导体，所述端部执行器导体被布置成当外科端部执行器已联接到联接器组件时与形成于联接器组件中的导电联接器通路电接触。关节运动接头导体可穿过关节运动接头并且与穿过联接器组件和轴导体的导电性通路电接触。
根据又一个一般形式，提供了一种外科器械，所述外科器械包括柄部组件，所述柄部组件具有可操作地与其联接并且被构造为能够可操作地附接到外科端部执行器的细长轴组件。马达由柄部组件支撑并且被构造为能够将旋转运动施加到与其联接的细长轴或外科端部执行器中的一者。压轮控制组件可操作地支撑在柄部组件上并且与马达连通，使得当压轮控制组件的致动器部分沿第一方向枢转时，马达沿第一方向对细长轴组件和端部执行器中的一者施加旋转运动，并且使得当致动器部分沿第二方向枢转时，马达沿第二方向对细长轴组件和端部执行器中的一者施加旋转运动。
根据另一个一般形式，提供了一种外科器械，所述外科器械包括柄部组件，所述柄部组件具有被构造为能够旋转地与其联接的细长轴组件并且被构造为能够可操作地附接到外科端部执行器。马达由柄部组件支撑并且被构造为能够将旋转运动施加到细长轴组件以用于围绕轴的轴线的选择性旋转。外科器械还包括压轮控制组件，所述压轮控制组件包括相对于柄部组件被枢转地支撑的压轮致动器构件。第一磁体支撑在压轮致动器构件上，并且第二磁体支撑在压轮致动器构件上。当压轮致动器构件处于未致动位置时，固定传感器居中设置在第一和第二磁体之间。固定传感器与马达连通，使得当沿第一方向枢转压轮致动器时，马达沿第一方向对细长轴组件施加旋转运动，并且使得当沿第二方向枢转压轮致动器构件时，马达沿第二方向对细长轴组件施加旋转运动。
根据另一个一般形式，提供了一种外科器械，所述外科器械包括具有细长轴组件的柄部组件，所述细长轴组件被构造为能够旋转地连接到组件并且被构造为能够可操作地附接到外科端部执行器，使得端部执行器可相对于细长轴组件围绕轴的轴线选择性地旋转。马达由柄部组件支撑并且被构造为能够对端部执行器或细长轴组件的联接器部分施加旋转运动，端部执行器联接到细长轴组件的联接器部分以用于其围绕轴的轴线的选择性旋转。外科器械还包括压轮控制组件，所述压轮控制组件包括相对于柄部组件被枢转地支撑的压轮致动器构件。第一和第二磁体支撑在压轮致动器构件上。当压轮致动器构件处于未致动位置时，固定传感器居中设置在第一和第二磁体之间。固定传感器与马达连通，使得当沿第一方向枢转压轮致动器时，马达沿第一方向对端部执行器或联接器位置施加旋转运动，并且使得当沿第二方向枢转压轮致动器构件时，马达沿第二方向对细长轴组件或联接器部分施加旋转运动。
根据又一个一般形式，提供了一种外科器械，所述外科器械包括支撑多个马达的外壳。外科器械还包括操纵杆控制组件，所述操纵杆组件包括由外壳运动地支撑的第一开关组件并且包括操纵杆，所述操纵杆运动地安装到第一开关组件，以使得操纵杆相对于第一开关组件的枢转运动导致将至少一个相应控制信号发送到与其连通的至少一个马达。操纵杆组件还包括第二开关组件，所述第二开关组件包括第一传感器和第二传感器，所述第二开关组件可与第一开关组件运动一起运动，使得第二传感器相对于第一传感器的运动导致将至少另一个控制信号发送到与其连通的另一个马达。
根据另一个一般形式，提供了一种外科器械，所述外科器械包括柄部组件，所述柄部组件具有相对其可旋转地支撑的细长轴组件。近侧滚动马达由柄部组件支撑并且被构造为能够将旋转运动施加到细长轴组件以使得细长轴组件相对于柄部组件围绕轴的轴线旋转。外科端部执行器可操作地联接到细长轴组件并且被构造为能够在对其施加至少一个击发运动时执行外科手术。击发马达由柄部组件支撑并且被构造为能够将击发运动施加到细长轴组件的一部分，以用于传递到外科端部执行器。外科器械还包括操纵杆控制组件，所述操纵杆组件包括由柄部组件运动地支撑的第一开关组件并且包括操纵杆，所述操纵杆运动地安装到第一开关组件，以使得操纵杆相对于第一开关组件的枢转运动导致将至少一个相应控制信号发送到近侧滚动马达。操纵杆组件还包括第二开关组件，所述第二开关组件包括第一传感器和第二传感器，所述第二开关组件可与第一开关组件运动一起运动，使得第二传感器相对于第一传感器的运动导致将至少另一个控制信号发送到击发马达。
根据另一个一般形式，提供了一种外科器械，所述外科器械包括柄部组件，所述柄部组件具有相对其可旋转地支撑的细长轴组件。外科器械还包括关节运动接头，所述关节运动接头包括联接到细长轴组件的近侧接头部分和能够运动地联接到近侧接头部分的远侧接头部分。关节运动马达由柄部组件支撑并且被构造为能够将关节运动施加到关节运动接头，从而使得远侧接头部分相对于近侧接头部分运动。外科端部执行器可操作地联接到细长轴组件并且被构造为能够在对其施加至少一个击发运动时执行外科手术。击发马达由柄部组件支撑并且被构造为能够将击发运动施加到细长轴组件的一部分，以用于传递到外科端部执行器。外科器械还包括操纵杆控制组件，所述操纵杆组件包括由柄部组件可运动地支撑的第一开关组件和可运动地安装到其的操纵杆，使得操纵杆相对于第一开关组件的枢转运动导致将至少一个对应的控制信号发送到至少一个与其连通的马达。操纵杆组件还包括第二开关组件，所述第二开关组件包括可相对于第一开关组件运动的第一传感器和第二传感器，使得第二传感器相对于第一传感器的运动导致将至少另一个控制信号发送到击发马达。
根据另一个一般形式，提供了一种作用于组织的外科器械。该器械包括至少一个处理器和可操作地相联的存储器、与处理器连通的至少一个马达、和至少一个致动装置。处理器被编程以从可移除的执行部分接收描述可移除的执行部分的第一变量。处理器还被编程以将第一变量应用到器械控制算法。另外，处理器被编程以从致动装置接收输入控制信号并且根据考虑输入控制信号的器械控制算法来控制至少一个马达以操作与可移除工具结合的外科器械。
根据另外的一般形式，处理器可被编程以从可移除工具接收描述与可移除工具结合的外科器械的操作的工具控制算法。处理器还可被编程以从致动装置接收输入控制信号并且根据考虑输入控制信号的工具控制算法来控制至少一个马达以操作与可移除工具结合的外科器械。
根据另一个一般形式，可公开一种外科器械，所述外科器械被构造为能够将来自端部执行器的低功率信号传递到远程装置。外科器械可包括柄部、从柄部朝远侧延伸的轴、和附接到轴的远侧端部的端部执行器。传感器可设置在端部执行器中。传感器可产生指示端部执行器处的状态的信号。发射器可位于端部执行器中。发射器可以第一功率水平发射来自传感器的信号。信号可被位于外科器械的柄部中的中继站接收。中继站被构造为能够放大并且以第二功率水平重新发射信号，其中第二功率水平高于第一功率水平。
根据另一个一般形式，可公开一种中继站，所述中继站用于将来自外科器械的端部执行器的信号传递到远程装置。中继站包括被构造为能够接收来自设置在端部执行器中的传感器的信号的接收器。信号以第一功率水平进行发射。中继站还包括被构造为能够将信号放大成第二功率水平的放大器。发射器被构造为能够以第二功率水平发射信号。第二功率水平高于第一功率水平。
根据一般形式，可公开一种用于传递接收自端部执行器中的感测模块的信号的方法。该方法包括通过传感器产生指示外科端部执行器处的状态的第一信号。传感器位于端部执行器中。该方法还包括利用发射器以第一功率水平发射第一信号，并且在中继站处利用接收器接收发射的信号。中继站利用放大器将第一信号放大成具有第二功率水平的高功率信号。第二功率水平大于第一功率水平。利用中继站以第二功率水平发射高功率信号。高功率信号由远程装置(诸如，视频监视器)接收。视频监视器显示外科端部执行器处的状态的图形表示。
上文的一些部分以计算机存储器内的数据位的操作的方法和符号表示来提供。本领域的技术人员利用这些描述和表示来向本领域的其他技术人员最有效地传达他们的工作要旨。方法在本文中并且通常被设想为导致所需结果的自洽动作序列(指令)。动作为需要物理量的物理操作的动作。通常但非必要地，这些量的形式为能够被存储、传递、组合、比较以及以其他方式操纵的电、磁、或光信号。主要就通常用途的原因而言，有时方便的是将这些信号称为位、值、元素、符号、字符、术语、数字等。此外，有时还方便的是将需要物理量的物理操作的某些动作布置称为模块或代码装置，而不失一般性。
本发明的某些方面包括本文以方法形式描述的处理步骤和指令。应当指出的是，本发明的处理步骤和指令可以软件、固件或硬件来实施，并且当以软件实施时，可被下载以保存到多种操作系统所使用的不同平台上并且可在这些平台上进行操作。
本发明还涉及用于执行本文的操作的设备。该设备可被专门构造用于所需目的，或者其可包括通用计算机，所述通用计算机由存储于计算机中的计算机程序来选择性地启动或重新配置。此类计算机程序可存储在计算机可读存储介质中，例如但不限于任何类型的磁盘，包括软盘、光盘、CD-ROM、磁性光盘、只读存储器(ROM)、随机存取存储器(RAM)、EPROM、EEPROM、磁卡或光卡、专用集成电路(ASIC)、或者适用于存储电子指令并且各自联接到计算机系统总线的任何类型的介质。此外，本说明书中涉及的计算机和计算机系统可包括单个处理器或者可为采用多个处理器设计以增加计算能力的架构。
本文提供的方法和显示器并非固有地与任何特定计算机或其他设备相关。各种通用系统也可与根据本文的教导内容的程序一起使用，或者可证明方便的是构造更专业设备来执行所需的方法动作。用于各种此类系统的所需结构将根据上述说明而变得显而易见。此外，本发明未参考任何特定的编程语言来进行描述。应当理解，各种编程语言可用于实施本文所述的本发明的教导内容，并且上文针对特定语言的任何参考文献被提供用于本发明的实现和最佳模式的公开内容。
在各种形式中，公开了一种外科器械，所述外科器械被构造为能够将来自端部执行器的低功率信号传递到远程装置。外科器械可包括柄部、从柄部朝远侧延伸的轴、和附接到轴的远侧端部的端部执行器。传感器可设置在端部执行器中。传感器可产生指示端部执行器处的状态的信号。发射器可位于端部执行器中。发射器可以第一功率水平发射来自传感器的信号。信号可被位于外科器械的柄部中的中继站接收。中继站被构造为能够放大并且以第二功率水平重新发射信号，其中第二功率水平高于第一功率水平。
在各种形式中，公开了一种中继站，所述中继站用于将来自外科器械的端部执行器的信号传递到远程装置。中继站包括被构造为能够接收来自设置在端部执行器中的传感器的信号的接收器。信号以第一功率水平进行发射。中继站还包括被构造为能够将信号放大成第二功率水平的放大器。发射器被构造为能够以第二功率水平发射信号。第二功率水平高于第一功率水平。
在各种形式中，公开了一种用于传递接收自端部执行器中的感测模块的信号的方法。该方法包括通过传感器产生指示外科端部执行器处的状态的第一信号。传感器位于端部执行器中。该方法还包括利用发射器以第一功率水平发射第一信号，并且在中继站处利用接收器接收发射的信号。中继站利用放大器将第一信号放大成具有第二功率水平的高功率信号。第二功率水平大于第一功率水平。利用中继站以第二功率水平发射高功率信号。高功率信号由远程装置(诸如，视频监视器)接收。视频监视器显示外科端部执行器处的状态的图形表示。
在各种形式中，公开了一种传感器拉直式端部执行器。传感器拉直式端部执行器可包括在关节运动点处联接到轴的端部执行器。端部执行器能够相对于轴成角度地进行关节运动。传感器可设置在传感器拉直式端部执行器上，诸如轴上或端部执行器上。传感器被构造为能够检测外科器械的总体近侧运动。当检测到总体近侧运动时，传感器可产生信号以控制马达来相对于轴拉直端部执行器。
在各种形式中，公开了一种包括传感器拉直式端部执行器的外科器械。外科器械可包括柄部。轴可从柄部朝远侧延伸。马达可设置在柄部内，以用于控制外科器械的关节运动。关节运动式端部执行器设置在轴的远侧端部处。传感器可设置在柄部、轴、或端部执行器中。传感器被构造为能够检测外科器械的总体近侧运动。当传感器检测到总体近侧运动时，传感器可启用电动拉直程序，从而导致马达拉直关节运动的端部执行器。在一些形式中，多个传感器可提供拉直程序的冗余检查。
在各种形式中，公开了一种用于操作包括传感器拉直式端部执行器的外科器械的方法。该方法可包括通过第一传感器检测外科器械的近侧运动。第一传感器可位于外科器械的任何合适的部分中，诸如，柄部、轴、或端部执行器。第一传感器可为加速度计、磁性传感器、或任何其他合适的传感器类型。传感器可产生指示已检测到总体近侧运动的信号。该方法还可包括通过马达接收从第一传感器产生的信号。马达可响应于所接收的信号来拉直马达控制的关节运动式端部执行器的关节运动角度。第二传感器可产生第二信号以提供冗余检查。
在各种形式中，本公开涉及一种包括模块化马达控制平台的马达驱动式外科器械。主控制器可执行主控制程序，以用于控制外科器械的一个或多个操作。第一马达控制器和第二马达控制器可操作地联接到主控制器。第一马达控制器可具有相关联的第一马达，并且第二马达控制器可具有相关联的第二马达。主控制程序可产生用于第一和第二马达控制器的控制信号。第一和第二马达控制器可响应于控制信号来操作第一和第二马达。在一些形式中，模块化马达控制系统可包括从控制器，所述从控制器被构造为能够基于由从控制器从主控制器接收的一个或多个控制信号来控制一个或多个马达控制器。
在各种形式中，模块化马达控制系统可包括各自具有相关马达的一个或多个马达控制器。所述一个或多个马达控制器可与主控制器连通。主控制器被构造为能够向马达控制器提供控制信号，以作为主控制程序的一部分。马达控制器可响应于所接收的控制信号来控制相关联的马达。在一些形式中，所述一个或多个马达控制器和相关联的马达可位于柄部内，所述柄部适于接纳模块化轴、模块化端部执行器、和模块化功率源。柄部可提供马达与模块化轴和端部执行器之间的接口。
在各种形式中，外科器械可包括模块化马达控制系统。外科器械可包括主控制器。外科器械被构造为能够接收模块化外科部件，诸如，模块化轴和执行部分。外科器械可具有安装在其中的一个或多个马达和相关的马达控制器。马达控制器可操作地联接到马达。马达可被构造为能够控制附接的轴或执行部分的一个或多个运动。主控制器和马达控制器可进行电连通。主控制器被构造为能够向马达控制器提供一个或多个控制信号，以作为主控制程序的一部分。马达控制器可响应于所接收的控制信号来控制马达。
在各种形式中，公开了一种用于控制马达驱动式外科器械的方法。该方法可包括通过主控制器来产生一个或多个控制信号。可将第一控制信号发射到被构造为能够控制第一马达的第一马达控制器。第一马达控制器可响应于接收自主控制器的第一控制信号来操作第一马达。可将第二控制信号发射到被构造为能够控制第二马达的第二马达控制器。第二马达控制器可响应于接收自主控制器的第二控制信号来操作第二马达。在一些形式中，第二控制信号可由从控制器产生。
根据一个一般形式，提供了一种包括驱动马达和驱动构件的外科器械，所述驱动构件可通过驱动马达来运动通过起始位置和行程末端位置之间的驱动行程。行程末端位置在第一位置和第二位置之间延伸。机械止动件可设置在行程末端位置处或附近并且可被构造成增加驱动构件运动通过从第一位置到第二位置的驱动行程的阻力。机械止动件可包括缓冲器和阻力构件。缓冲器可从第一位置运动到第二位置并且被构造为能够在第一位置处接触驱动构件。阻力构件可操作地联接到缓冲器并且被构造为能够增加驱动构件从第一位置运动到第二位置的阻力。阻力构件可被构造为能够在驱动构件致动到第二位置之前使驱动构件减速。在一个形式中，阻力构件被构造成可压缩的，以渐进地增加驱动构件在第一位置和第二位置之间运动的阻力。在一个形式中，阻力构件可包括弹簧。缓冲器可包括接触表面，所述接触表面的尺寸被设计为与在第一位置处接触的驱动构件表面的尺寸互补。
在一个形式中，控制系统被构造为能够检测电流尖峰，所述电流尖峰与驱动构件运动的增加阻力相关。控制系统可监测与驱动马达的功率递送相关的电压，以检测电流尖峰。电流尖峰可包括预定阈值电流。预定阈值电流可包括至少一个定义的时间周期内的至少一个预定阈值电流差分。当控制系统检测到电流尖峰时，可中断对驱动马达的功率递送。在一个形式中，机械止动件还可包括硬止动件，所述硬止动件可阻止驱动构件运动越过第二位置。
根据一个一般形式，提供了一种机械止动件，所述机械止动件可用于外科器械中以产生与机电止动件相关的可检测电流尖峰。例如，机械止动件可设置在与驱动构件的驱动行程相关的行程末端处或附近。行程末端可在第一位置和第二位置之间延伸。机械止动件可包括一个或多个缓冲器和一个或多个阻力构件。缓冲器可从第一位置运动到第二位置，并且可被构造为能够在第一位置处接触驱动构件。阻力构件可操作地联接到缓冲器并且被构造为能够增加驱动构件从第一位置运动到第二位置的阻力，从而产生电流尖峰。阻力构件被构造为能够在驱动构件致动到第二位置之前使驱动构件减速。一个或多个阻力构件可被构造成可压缩的，以渐进地增加驱动构件在第一位置和第二位置运动的阻力。一个或多个阻力构件还可被构造成可压缩的并且可包括至少一个弹簧。缓冲器可包括接触表面，所述接触表面的尺寸被设计为与在第一位置处接触的驱动构件表面的尺寸互补。与增加的阻力相关的电流尖峰可通过与机电外科器械相关的控制系统来检测。控制系统可被构造为能够监测与驱动马达的功率递送相关的电压，并且当电流尖峰包括至少一个预定阈值电流时中断对驱动马达的功率递送。至少一个阈值电流可包括至少一个定义的时间周期内的电流差分。在一个形式中，机械止动件还包括硬止动件，以用于阻止驱动构件运动越过第二位置。
可将本发明所公开的装置设计成单次使用后即进行处理，或者可将它们设计成是多次使用的。然而，在任一种情形下，所述装置均可进行修复，以在至少一次使用后再次使用。修复可包括拆卸装置、清洗或更换具体部件以及后续重新组装的其中任意几个步骤组合。特别是，该装置可拆卸，并且可以任意组合有选择地置换或移除任意数目的某些部分或零件。清洗和/或置换特定部分后，该装置可在修复设施处重新组装以便随后使用，或者在即将进行外科手术前由外科队重新组装。本领域的技术人员将会知道，装置的重新修复可利用多种用于拆卸、清洗/更换和重新组装的技术。这些技术的用途以及得到的重新修复装置均在本发明的范围内。
优选的是，在手术前处理本文所述的发明。首先，获取新的或用过的器械，并根据需要进行清洗。然后对器械进行消毒。在一种消毒技术中，将该器械放置在闭合且密封的容器中，诸如塑料或TYVEK袋中。然后将容器和器械置于可穿透该容器的辐射场中，例如γ辐射、x-射线或高能电子。辐射杀死器械上和容器中的细菌。然后将消毒后的器械存储在无菌容器中。该密封容器使器械保持无菌直至在医疗设施中打开该容器为止。
以引用方式全文或部分地并入本文的任何专利、公布或其他公开材料均仅在所并入的材料不与本公开所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。同样地并且在必要的程度下，本申请明确阐述的公开内容取代了以引证方式并入本申请的任何冲突材料。任何以引用方式并入本文但与本文所述的现有定义、陈述或其他公开材料相冲突的任何材料或其部分，仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。
尽管本发明已被描述为具有示例性的设计，但还能够在本公开的实质和范围内对本发明进行修改因此本专利申请旨在涵盖采用本发明一般原理的任何变型、用途或修改形式。此外，本专利申请旨在涵盖本发明所属领域中属于已知或惯有实践范围内的与本公开不同的形式。

Claims (8)

1.一种外科器械，包括：
柄部组件，所述柄部组件被构造为能够同时并且独立地用电力产生至少两个独立的旋转控制运动；以及
细长轴组件，所述细长轴组件与所述柄部组件可操作地交接，以用于独立并且同时地接收所述至少两个独立的旋转控制运动并且将所述至少两个独立的旋转控制运动传递到可操作地联接到所述细长轴组件的端部执行器，
其中所述细长轴组件还包括关节运动接头，所述关节运动接头包括：
近侧连接叉，所述近侧连接叉可操作地联接到所述细长轴组件；和
远侧连接叉，所述远侧连接叉可枢转地联接到所述近侧连接叉，以用于相对于所述近侧连接叉选择性地枢转行进，
其中所述关节运动接头还包括：
第一齿轮系，所述第一齿轮系与近侧击发轴和远侧击发轴可操作地交接，所述近侧击发轴可操作地联接到所述柄部组件，所述远侧击发轴与所述端部执行器可操作地交接，以用于将旋转击发运动从所述近侧击发轴传递到所述端部执行器，同时促进所述远侧连接叉相对于所述近侧连接叉进行关节运动；以及
第二齿轮系，所述第二齿轮系与近侧旋转轴可操作地交接，所述近侧旋转轴可操作地联接到所述柄部组件以用于将远侧旋转控制运动传递到所述端部执行器，从而使所述端部执行器相对于所述细长轴组件旋转，同时促进所述远侧连接叉相对于所述近侧连接叉进行关节运动。
2.根据权利要求1所述的外科器械，其中所述细长轴组件限定轴的轴线，并且其中所述至少两个独立的用电力产生的旋转控制运动选自由以下运动组成的旋转控制运动组：
旋转关节运动，其用于使所述端部执行器围绕基本上横向于所述轴的轴线的关节运动轴线进行关节运动；
旋转击发运动，其被配置为能够使所述端部执行器执行至少一个外科动作；
滚转运动，其被配置为能够使所述端部执行器相对于所述细长轴组件围绕所述轴的轴线旋转；以及
旋转轴运动，其用于使所述细长轴组件和端部执行器同时围绕所述轴的轴线旋转。
3.根据权利要求1所述的外科器械，其中所述端部执行器被构造为能够在对其施加所述旋转控制运动中的至少一个时横切并且缝合组织。
4.根据权利要求1所述的外科器械，还包括关节运动轴，所述关节运动轴可操作地联接到所述柄部组件并且与所述远侧连接叉交接，使得施加到所述关节运动轴的旋转关节运动导致所述远侧连接叉相对于所述近侧连接叉进行关节运动。
5.根据权利要求4所述的外科器械，还包括：
击发马达，所述击发马达由所述柄部组件可操作地支撑并且与所述近侧击发轴可操作地交接以用于对其施加所述旋转击发运动；
远侧滚动马达，所述远侧滚动马达由所述柄部组件可操作地支撑并且与所述近侧旋转轴可操作地交接以用于对其施加所述远侧旋转控制运动；以及
关节运动马达，所述关节运动马达由所述柄部组件可操作地支撑并且与所述关节运动轴可操作地交接以用于对其施加所述旋转关节运动。
6.根据权利要求5所述的外科器械，还包括旋转轴马达，所述旋转轴马达由所述柄部组件可操作地支撑并且与所述细长轴组件可操作地交接，以使所述细长轴组件相对于所述柄部组件选择性地旋转。
7.根据权利要求1所述的外科器械，其中所述细长轴组件能够从所述柄部组件选择性地断开连接。
8.根据权利要求5所述的外科器械，还包括可拆卸的驱动安装件，所述可拆卸的驱动安装件在其中可操作地支撑所述近侧击发轴、所述近侧旋转轴和所述关节运动轴的部分，以便可释放地附接到所述柄部组件，从而使得在所述可拆卸的驱动安装件联接到所述柄部组件时，所述近侧击发轴可释放地联接到所述击发马达，所述近侧旋转轴可释放地联接到所述远侧滚动马达，并且所述关节运动轴可释放地联接到所述关节运动马达。
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AU2014223714A1 (en) 2015-08-06
EP2772206B1 (en) 2017-11-08
AU2014223714B2 (en) 2017-10-26
AU2014226427A1 (en) 2015-08-20
US9307986B2 (en) 2016-04-12
CN105025813B (zh) 2018-01-26
CN105025821A (zh) 2015-11-04
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CN105007836A (zh) 2015-10-28

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