CN106456160B - Surgical end-effector with percussion element monitoring arragement construction - Google Patents

Surgical end-effector with percussion element monitoring arragement construction Download PDF

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Publication number
CN106456160B
CN106456160B CN201580032323.1A CN201580032323A CN106456160B CN 106456160 B CN106456160 B CN 106456160B CN 201580032323 A CN201580032323 A CN 201580032323A CN 106456160 B CN106456160 B CN 106456160B
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CN
China
Prior art keywords
nail
protruding portion
tissue
elongated passageway
opening
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
CN201580032323.1A
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Chinese (zh)
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CN106456160A (en
Inventor
T·W·休伊坦马
C·J·沙伊布
C·E·亨德森
F·E·谢尔顿四世
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Ethicon Endo Surgery Inc
Original Assignee
Ethicon Endo Surgery Inc
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Filing date
Publication date
Priority claimed from US14/319,004 external-priority patent/US9844369B2/en
Application filed by Ethicon Endo Surgery Inc filed Critical Ethicon Endo Surgery Inc
Publication of CN106456160A publication Critical patent/CN106456160A/en
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Publication of CN106456160B publication Critical patent/CN106456160B/en
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • A61B17/105—Wound clamp magazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07292—Reinforcements for staple line, e.g. pledgets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00057—Light
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00115—Electrical control of surgical instruments with audible or visual output
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00734—Aspects not otherwise provided for battery operated
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07235—Stapler heads containing different staples, e.g. staples of different shapes, sizes or materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07242—Stapler heads achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder

Abstract

The invention discloses a kind of surgical end-effectors, the surgical end-effector includes elongated passageway and percussion element, the elongated passageway is configured to be operably supported nail bin wherein, and the percussion element is configured to move between the start position and the end position in the elongated passageway.Various arragement constructions include opening, and the opening allows to observe the percussion element when firing element and moving between the start position and the end position across the bottom of the elongated passageway.Anvil block can be supported for movably advancing relative to the elongated passageway, and including passing through its multiple openings to allow to observe the cutting element when cutting element moves between the start position and the end position.Various arragement constructions include the trigger shaft for being attached to percussion element, and the trigger shaft is for moving the percussion element between the start position and the end position.The trigger shaft can movably be supported by hollow shaft, and the hollow shaft has multiple openings across it for monitoring the position of trigger shaft.

Description

Surgical end-effector with percussion element monitoring arragement construction
Cross reference to related applications
This non-provisional requires the equity of following patent application according to 35U.S.C. § 119 (e): being filed in 2014 Entitled " fastening instrument and fastening storehouse (the FASTENING INSTRUMENTS AND using it on April 16, in FASTENING CARTRIDGES FOR USE THEREWITH) " U.S. Provisional Patent Application Serial No. 61/980,293, institute It states patent application and is incorporated by reference and be incorporated herein.
Background technique
The present invention relates to suture instruments, and in various embodiments, are related to one kind and are used to prepare one or more nails The surgery suturing appliance of row.
Suture instruments may include the elongated nip component that a pair of matched is closed, wherein each jaw member is inserted into patient's body It is interior and relative to it is to be stapled and/or cutting tissue positioning.In various embodiments, one in jaw member is sustainable Wherein accommodate the nail bin for the staple that at least two are laterally spaced apart, and another jaw member it is sustainable have in nail bin Staple alignment nail shapes pit anvil block.In general, suture instruments may also include push rod and blade, the push rod and knife Piece can be slided relative to jaw member by the cam face on push rod and/or by convex in the wedge-shaped slides of push rod pushing Wheel surface will be followed closely and successively be ejected from nail bin.In at least one embodiment, cam face be configured to starting by Storehouse carrying and multiple staple drivers associated with nail, so as to push nail be resisted against on anvil block and be held on jaw member it Between tissue in form the deformation staple being laterally spaced apart.In at least one embodiment, blade can follow cam face simultaneously And tissue is cut along the route between staple.The example of this suture instruments " has for that will organize to be fixed on entitled The surgical staples of therein compressible or extrudable component and suture instruments (SURGICAL STAPLES for disposing it HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME) " United States Patent (USP) 7,794,475 in have disclosed, institute The complete disclosure for stating patent is herein incorporated by reference.
The current each aspect of the relevant technologies in the field of the invention only for the purpose of illustration discussed above, without should It is considered as the negative to scope of the claims.
Detailed description of the invention
The various features of the embodiment described herein are elaborated in the dependent claims.However, closing In the various embodiments of the tissue of operation and the various embodiments of method and its advantage in combination with following attached drawing according to following Illustrate to understand:
Fig. 1 is the front view of surgery suturing appliance；
Fig. 2 is the sectional view along the end effector of the surgery suturing appliance of the line 2-2 of Fig. 1 Fig. 1 intercepted；
Fig. 3 is the sectional perspective view of the end effector of Fig. 1；
Fig. 4 is the sectional view of the end effector of Fig. 1, and it illustrates be contained in the nail therein in non-percussion configuration；
Fig. 5 is to show the figure of the nail of Fig. 4 in percussion configuration；
Fig. 6 is to show to be used to suture the figure with the end effector of Fig. 1 of transecting patient tissue；
The perspective view of the nail bin of at least one embodiment according to Fig. 7, the nail bin include from the multiple of warehouse extension Spine；
Fig. 8 is the detail drawing of the nail bin of Fig. 7；
Fig. 8 A is the sectional view of the nail bin of Fig. 7；
Fig. 9 is the detail drawing of the nail in the nail cavity shown in the nail bin for being located in and being defined in Fig. 7；
The local perspective view of the nail bin of at least one alternative embodiment according to Figure 10, the nail bin includes prolonging from warehouse The multiple Lateral ridges stretched；
The local perspective view of the nail bin of at least one alternative embodiment according to Figure 11, the nail bin includes prolonging from warehouse The multiple Lateral ridges stretched；
The local perspective view of the nail bin of at least one alternative embodiment according to Figure 12, the nail bin include around restriction The proximal end of nail cavity opening in warehouse and multiple spines of distal end；
The local perspective view of the nail bin of at least one alternative embodiment according to Figure 13, the nail bin include around restriction The proximal end of nail cavity opening in warehouse and multiple spines of distal end；
The local perspective view of the nail bin of at least one alternative embodiment according to Figure 14, the nail bin includes prolonging from warehouse The multiple annular knurl spines stretched；
The local perspective view of the nail bin of at least one alternative embodiment according to Figure 15, the nail bin includes prolonging from warehouse The multiple annular knurl spines stretched；
The perspective view of the taper annular knurl of at least one embodiment according to Figure 15 A；
The perspective view of the conical butt annular knurl of at least one embodiment according to Figure 15 B；
The perspective view of the triangle annular knurl of at least one embodiment according to Figure 15 C；
The local perspective view of the nail bin of at least one alternative embodiment according to Figure 16, the nail bin include entirely around It is defined in multiple spines of the nail cavity opening in warehouse；
The local perspective view of the nail bin of at least one alternative embodiment according to Figure 16 A, the nail bin includes complete ring Around the multiple spines for the nail cavity opening being defined in warehouse；
The perspective view of the nail bin of at least one alternative embodiment according to Figure 17, the nail bin includes extending from warehouse Multiple longitudinal ridges；
Figure 18 is the detail drawing of the nail bin of Figure 17；
Figure 19 is the perspective view of the surgical instruments with the interchangeable shaft assembly for being operably linked to it；
Figure 20 is the interchangeable shaft assembly of Figure 19 and the decomposing assembly figure of surgical instruments；
Figure 21 is the decomposing assembly figure of a part of the surgical instruments of Figure 19 and Figure 20；
Figure 22 is another decomposing assembly figure for showing the part of interchangeable shaft assembly and surgical instruments of Figure 19 to Figure 21；
The perspective for the nail bin of at least one embodiment being located in the end effector of surgical instruments according to Figure 23 Figure, wherein nail bin includes the multiple spines extended from the warehouse of nail bin；
The front view of the nail of at least one embodiment according to Figure 24；
Figure 25 is the front view of the nail of Figure 24 in the nail cavity being located in nail bin；
The front view of the nail of at least one embodiment according to Figure 26；
The front view of the asymmetric nail of at least one embodiment according to Figure 27；
The front view of another asymmetric nail of at least one embodiment according to Figure 28；
The front view of another asymmetric nail of at least one embodiment according to Figure 29；
Figure 30 is the front view for being shown at the nail of part deformation condition；
Figure 31 is the front view of the nail of Figure 30 in the situation of being badly deformed；
Figure 32 is the bottom perspective view of elongated passageway；
Figure 33 is the sectional perspective view of another elongated passageway；
Figure 34 is another sectional view of the elongated passageway of Figure 33, wherein schematically showing in the elongated passageway Cutting head；
Figure 35 is the bottom view of the elongated passageway of Figure 33 and Figure 34；
Figure 36 is the bottom view of another elongated passageway；
Figure 37 is the bottom view of another elongated passageway；
Figure 38 is the bottom view of another elongated passageway；
Figure 39 is the bottom view of another elongated passageway；
Figure 40 is the partial side view of elongated passageway and cutting head, and wherein elongated passageway is shown in section and surgical staples The part in storehouse is omitted for clarity and wherein cutting head is in the unlocked position and is ready to fire；
Figure 41 is the elongated passageway of Figure 40 and another partial side view of cutting head, and wherein cutting head is biased at locking Position；
Figure 42 is the perspective view of cutting head and trigger shaft embodiment；
Figure 43 is the perspective view of the other end actuator and axis arragement construction；
Figure 44 is the end effector of Figure 43 and another perspective view of axis arragement construction, and wherein a part of outer shaft is clear For the sake of and be omitted；
Figure 45 is the partial side view of the other end actuator and axis arragement construction；
Figure 46 is the partial side elevational view of end effector arragement construction, and wherein elongated passageway is saved for clarity Slightly；
Figure 47 is the top view of anvil block embodiment；
Figure 48 is the top view of another anvil block embodiment；
The sectional view of the end effector of the surgical instruments of at least one embodiment according to Figure 49, the end execute Device includes nail bin, and the nail bin includes staged storehouse platform；
Figure 49 A is same profile figure shown in Figure 49, it illustrates staged storehouse platform and is located in staged platform phase Various clearance heights between the anvil block of opposite side；
The front view of the asymmetric nail of at least one embodiment according to Figure 50；
The front view of another asymmetric nail of at least one embodiment according to Figure 51；
The front view of another asymmetric nail of at least one embodiment according to Figure 52；
The perspective view of the nail sliding part of at least one embodiment according to Figure 53；
The top view for the nail sliding part that Figure 54 is Figure 53；
Figure 54 A is the partial top view of the nail bin of Figure 23, and it illustrates the nail in the non-firing position of nearside of Figure 53 is sliding Moving part；
Figure 54 B is the partial perspective cutaway view of the nail bin of Figure 23；
Figure 54 C is the schematic partial front perspective view of the nail bin of Figure 23；
The perspective view for the nail sliding part that Figure 54 D is Figure 53；
Figure 55 is the perspective view of the distal end of the nail bin of Figure 23；
Figure 55 A is the perspective view of the protruding portion extended from the nail bin of Figure 23；
The perspective view of the nail bin of at least one embodiment according to Figure 56, the nail bin include extending from nail bin platform Spine's pattern；
Figure 57 is spine's pattern of Figure 56 and the detail drawing of nail bin platform；
The local perspective view of the nail bin of at least one embodiment according to Figure 58, the nail bin include prolonging from nail bin platform The spine's pattern stretched；
The local perspective view of the nail bin of at least one embodiment according to Figure 59, the nail bin include being defined in nail bin to put down Protruding portion pattern in platform；
Figure 60 is the detail drawing of protruding portion shown in Figure 59；
The local perspective view of the nail bin of at least one embodiment according to Figure 61, the nail bin include prolonging from nail bin platform The dome pattern stretched；
Figure 62 is the detail drawing of dome shown in Figure 61；
The local perspective view for the protruding portion that the slave nail bin platform of at least one embodiment extends according to Figure 63；
Figure 64 is the decomposition perspective view of surgery nail bin and warehouse lid；
Figure 65 is the nail bin of Figure 64 and the sectional view of warehouse lid, and wherein warehouse lid is mounted on nail bin；
The perspective view of the anvil block of the surgery suturing appliance of at least one embodiment according to Figure 66, the anvil block include from Its protruding portion extended；
Figure 67 is the detail drawing of protruding portion shown in Figure 66；
The local perspective view of the anvil block of the surgery suturing appliance of at least one embodiment according to Figure 68, the anvil block packet Include protruding portion extending therefrom；
The sectional view of the anvil block of the surgery suturing appliance of at least one embodiment according to Figure 69, the anvil block include with Adjacent the first protruding portion array with the first height of first nail pit, it is adjacent with the second nail pit have it is second high The the second protruding portion array and the third protruding portion array with third height adjacent with third nail pit of degree；
The perspective view of the nail bin of at least one embodiment according to Figure 70, the nail bin include flat from the staged of nail bin The protruding portion that platform surface extends；
Figure 71 is the detail drawing of the distal end of staged platform surface and the protruding portion of Figure 70；
Figure 72 is the detail drawing of the proximal end of staged platform surface and the protruding portion of Figure 70；
The perspective view of the nail bin of at least one embodiment according to Figure 73, the nail bin include flat from the staged of nail bin The protruding portion that platform surface extends；
The local perspective view of the nail bin of at least one embodiment according to Figure 74；
The sectional view of the end effector of the surgery suturing appliance of at least one embodiment according to Figure 75, the end Actuator includes multiple tissue engaging members disposed；
The sectional view of the end effector of the surgery suturing appliance of at least one embodiment according to Figure 76, the end Actuator includes the multiple protruding portion extended from staged storehouse platform surface；
It the storehouse platform of the nail bin of at least one embodiment and is cutd open from the protruding portion that the platform extends according to Figure 77 Face figure, the protruding portion are configured to the support nail when disposing nail from nail cavity；
Another storehouse platform of the nail bin of at least one embodiment and the protruding portion extended from the platform according to Figure 78 Sectional view, the protruding portion be configured to from nail cavity dispose follow closely when support nail；
The partial plan layout of the platform of the nail bin of at least one embodiment according to Figure 79, the nail bin include from described The protruding portion that platform extends, the platform are configured to support and are removedly stored in the nail cavity being defined in nail bin Nail；
The partial cutaway view of the nail bin of at least one embodiment according to Figure 80, the nail bin include the first protruding portion and Second protruding portion, first protruding portion are configured to the first leg of the nail that support is removably positioned in nail cavity, Second protruding portion is configured to support the second leg of the nail；
The perspective view of the distal end of the nail bin of at least one embodiment according to Figure 81, the nail bin include platform, The multiple nail cavities being defined in the platform and the various protruding portions extended from the platform；
The local perspective view of the nail bin of at least one embodiment according to Figure 82, the nail bin include platform, are defined in Multiple nail cavities in the platform and the multiple protruding portion from platform extension, the protruding portion surround one in the nail cavity End of a little ends without surrounding other nail cavities；
The local perspective view of the nail bin of at least one embodiment according to Figure 83, the nail bin include platform, are defined in Multiple nail cavities in the platform and the multiple protruding portion from platform extension, the protruding portion are certain around the nail cavity End, without surrounding other ends；
The partial cutaway view of the nail bin of at least one embodiment according to Figure 84, the nail bin include: platform and restriction Multiple nail cavities in the platform；The nail array being located in the nail cavity, it is described nail array nail bin proximal end and Extend between distal end, wherein the nail array includes various nails；With the protruding portion array extended from the platform, The protruding portion array extends between the proximal end and the distal end of the nail bin, wherein the protruding portion battle array Column include various height；
The partial cutaway of the nail bin platform of at least one embodiment and the protruding portion extended from the platform according to Figure 85 A Face figure, wherein the protruding portion is made of conformable material and is shown at uncompressed state；
Figure 85 B is the nail bin platform of Figure 85 A and the partial cutaway view of protruding portion, and it illustrates be in some compression Protruding portion；
Figure 85 C is the nail bin platform of Figure 85 A and the partial cutaway view of protruding portion, and it illustrates the protrusions for being in compressive state Portion；
According to Figure 86 A at least one embodiment include the warehouse being made of flexible material nail bin part section Figure, the nail bin are shown at unbent condition；
Figure 86 B is the partial cutaway view for being shown at the nail bin of Figure 86 A of bending state；
The perspective view of the anvil block of at least one embodiment according to Figure 87, the anvil block include extending from the anvil block Multiple protruding portion；
Figure 88 is the detail drawing of a part of the anvil block of Figure 87；
The local perspective view of the anvil block of at least one embodiment according to Figure 89, the anvil block include prolonging from the anvil block The multiple protruding portion stretched；
The perspective view of the component of at least one embodiment according to Figure 90, the component include staple drivers and can transport Dynamic pit extension；
Figure 91 is the exploded view of the component of Figure 90；
Figure 92 is using the sectional perspective view of the nail bin of the component of Figure 90, and the component is shown at non-deployable state；
Figure 93 is the cross-section front view of the nail bin of Figure 92, it illustrates the component of Figure 90 in deployable state and in not The component of Figure 90 of deployable state；
Figure 94 is the top view of surgery staple drivers；
Figure 95 is the perspective view of the surgery staple drivers of Figure 94；
Figure 96 is the perspective view of another surgery staple drivers；
Figure 97 is the top view of the staple drivers pit in a part of surgery nail bin；
The front view of the anvil block of at least one embodiment according to Figure 98, the anvil block include extending therefrom with not Level protruding portion；
The perspective view of the fastener cartridge of at least one embodiment according to Figure 99；
Figure 100 is the plan view of the fastener cartridge of Figure 99；
Figure 101 is the local perspective view of the proximal end of the fastener cartridge of Figure 99；And
Figure 102 is the partial plan layout of the proximal end of the fastener cartridge of Figure 99.
In all several views, corresponding reference symbol indicates corresponding component.Exemplifications set out herein is with a kind of shape Formula shows various embodiments of the present invention, and this example is not necessarily to be construed as the model limiting the invention in any way It encloses.
Specific embodiment
Present applicant possesses following patent application, the patent application and the application and submits in same date and each It is incorporated herein from being incorporated by reference:
Entitled " fastener cartridge (the FASTENER CARTRIDGES including the extension with various configuration INCLUDING EXTENSIONS HAVING DIFFERENT CONFIGURATIONS) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney number END7460USNP/140136)；
Entitled " fastener cartridge (the FASTENER including the securing member chamber with fastener controlling feature structure CARTRIDGE COMPRISING FASTENER CAVITIES INCLUDING FASTENER CONTROL FEATURES)” U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney number END7461USNP/140137)；
Entitled " end effector (the END EFFECTOR including the anvil block with protruding portion extending therefrom COMPRISING AN ANVIL INCLUDING PROJECTIONS EXTENDING THEREFROM) " U.S. Patent application Sequence number _ _ _ _ _ _ _ _ _ _ (attorney number END7462USNP/140138)；
It is entitled " to stablize surgical fastener storehouse (the SURGICAL FASTENER of arragement construction with driver CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney number END7463USNP/140139)；
Entitled " fastener cartridge (the FASTENER CARTRIDGE COMPRISING NON- including non-uniform fastener UNIFORM FASTENERS) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney number END7465USNP/ 140141)；
Entitled " fastener cartridge (the FASTENER CARTRIDGE COMPRISING including tissue engaging member can be disposed DEPLOYABLE TISSUE ENGAGING MEMBERS) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney docket Number END7466USNP/140142)；
Entitled " fastener cartridge (the FASTENER CARTRIDGE COMPRISING including organizational controls feature structure TISSUE CONTROL FEATURES) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney number END7467USNP/140143)；
It is entitled that " fastener cartridge assembly and nail retainer cover arragement construction (FASTENER CARTRIDGE ASSEMBLIES AND STAPLE RETAINER COVER ARRANGEMENTS) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney number END7468USNP/140144)；And
Entitled " fastener cartridge (the FASTENER CARTRIDGE INCLUDING A including being attached to its layer LAYER ATTACHED THERETO) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney number END7469USNP/140145)。
Present applicant, which also possesses, to be filed on March 1st, 2013 and is respectively herein incorporated by reference this in full The following patent application of text:
Entitled " the surgical instruments for capableing of joint motions with the conductive path group for signal communication (Articulatable Surgical Instruments With Conductive Pathways For Signal Communication U.S. Patent Application Serial Number 13/782,295) "；
Entitled " rotary electrification actuated articulation joints (the Rotary Powered for surgical instruments Articulation Joints For Surgical Instruments) " U.S. Patent Application Serial Number 13/782,323；
Entitled " thumbwheel switch arragement construction (the Thumbwheel Switch Arrangements for surgical instruments For Surgical Instruments) " U.S. Patent Application Serial Number 13/782,338；
Entitled " electro-mechanical device surgical (the Electromechanical Surgical with signal relaying arragement construction Device with Signal Relay Arrangement) " U.S. Patent Application Serial Number 13/782,499；
Entitled " multi-processor motor control part (the Multiple Processor for modularization surgical instruments Motor Control for Modular Surgical Instruments) " U.S. Patent Application Serial Number 13/782, 460；
Entitled " lever switch device component (the Joystick Switch Assemblies For for surgical instruments Surgical Instruments) " U.S. Patent Application Serial Number 13/782,358；
It is entitled that " end effector (Sensor Straightened is straightened in the sensor during passing through trochar and removing End Effector During Removal Through Trocar) " U.S. Patent Application Serial Number 13/782,481；
Entitled " control method (the Control Methods for for the surgical instruments with removable tool portion Surgical Instruments with Removable Implement Portions) " U.S. Patent Application Serial Number 13/782,518；
Entitled " rotating type strip electrosurgical unit (the Rotary Powered Surgical with multiple freedom degrees Instruments With Multiple Degrees of Freedom) " U.S. Patent Application Serial Number 13/782,375； And
The U.S. Patent application sequence of entitled " surgical instruments soft stop stops (Surgical Instrument Soft Stop) " Row number 13/782,536.
Present applicant, which also possesses, to be filed on March 14th, 2013 and is respectively herein incorporated by reference this in full The following patent application of text:
Entitled " surgical instruments (the ARTICULATABLE for capableing of joint motions including firing driving device SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE) " U.S. Patent Application Serial Number 13/803, 097；
Entitled " control arragement construction (the CONTROL ARRANGEMENTS FOR of the drive member for surgical instruments A DRIVE MEMBER OF A SURGICAL INSTRUMENT) " U.S. Patent Application Serial Number 13/803,193；
Entitled " interchangeable shaft assembly (the INTERCHANGEABLE SHAFT being used together with surgical instruments ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT) " U.S. Patent Application Serial Number 13/803, 053；
Entitled " surgical instruments (the ARTICULATABLE for capableing of joint motions including joint motions locking piece SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK) " U.S. Patent Application Serial Number 13/ 803,086；
Entitled " sensor arrangement structure (the SENSOR ARRANGEMENTS of the absolute positioning system for surgical instruments FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 13/803,210；
Entitled " Multifunction motor (the MULTI-FUNCTION MOTOR FOR A SURGICAL for surgical instruments INSTRUMENT U.S. Patent Application Serial Number 13/803,148) "；
Entitled " drive system latching member arragement construction (the DRIVE SYSTEM for modularization surgical instruments LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 13/803,066；
It is entitled " for capableing of the articulation control system (ARTICULATION of the surgical instruments of joint motions CONTROL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 13/803,117；
It is entitled that " the driving system for modularization surgical instruments controls arragement construction (DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 13/803, 130；And
It is entitled " for operating method and system (the METHOD AND SYSTEM FOR OPERATING A of surgical instruments SURGICAL INSTRUMENT) " U.S. Patent Application Serial Number 13/803,159.
Present applicant, which also possesses to be filed on March 26th, 2014 and be respectively incorporated by reference, to be incorporated herein Following patent application:
Entitled " power management control system (the POWER MANAGEMENT CONTROL for surgical instruments SYSTEMS FOR SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 14/226,106；
The United States Patent (USP) Shen of entitled " disinfection verifying circuit (STERILIZATION VERIFICATION CIRCUIT) " It please sequence number 14/226,099；
Entitled " verifying (the VERIFICATION OF NUMBER OF of battery altering/programmed counting number BATTERY EXCHANGES/PROCEDURE COUNT) " U.S. Patent Application Serial Number 14/226,094；
It is entitled " to pass through segment circuit and the power management (POWER of sleep option and the progress that wake up control piece MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL) " U.S. Patent Application Serial Number 14/226,117；
Entitled " Modular belts electrosurgical unit (the MODULAR POWERED with dismountable shaft assembly SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES) " U.S. Patent Application Serial Number 14/ 226,075；
Entitled " feedback algorithm (the FEEDBACK ALGORITHMS FOR of the manual salvage system for surgical instruments MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 14/226, 093；
It is entitled " to utilize the adaptive surgical instruments of sensor (SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION) " U.S. Patent Application Serial Number 14/226,116；
Entitled " surgical instruments control circuit (the SURGICAL INSTRUMENT CONTROL with safe processor CIRCUIT HAVING A SAFETY PROCESSOR) " U.S. Patent Application Serial Number 14/226,071；
Entitled " surgical instruments (the SURGICAL INSTRUMENT COMPRISING including interactive system INTERACTIVE SYSTEMS) " U.S. Patent Application Serial Number 14/226,097；
Entitled " interface system (the INTERFACE SYSTEMS FOR USE WITH being used together with surgical instruments SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 14/226,126；
The U.S. of entitled " modularization surgical instrument system (MODULAR SURGICAL INSTRUMENT SYSTEM) " Patent application serial number 14/226,133；
It is entitled " for controlling system and method (the SYSTEMS AND METHODS FOR of segment circuit CONTROLLING A SEGMENTED CIRCUIT) " U.S. Patent Application Serial Number 14/226,081；
Entitled " power management (the POWER MANAGEMENT carried out by segment circuit and variable voltage protection THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION) " U.S. Patent Application Serial Number 14/226,076；
The U.S. of entitled " surgery suturing appliance system (SURGICAL STAPLING INSTRUMENT SYSTEM) " is special Sharp patent application serial numbers 14/226,111；And
Entitled " surgical instruments (the SURGICAL INSTRUMENT COMPRISING A including rotatable shaft ROTATABLE SHAFT) " U.S. Patent Application Serial Number 14/226,125；
Present applicant also possesses the U.S. Patent application being identified below, these U.S. Patent applications are respectively complete Text is herein incorporated by reference:
Entitled " surgical instruments (the SURGICAL INSTRUMENTS WITH with restructural shaft part RECONFIGURABLE SHAFT SEGMENTS) " U.S. Patent Application Serial Number 12/894,311 (be now that United States Patent (USP) is public Cloth 2012/0080496)；
Entitled " surgery nail bin of the nail of support non-linear arrangement and the surgery suturing appliance with common nail shapes pit (SURGICAL STAPLE CARTRIDGES SUPPORTING NON-LINEARLY ARRANGED STAPLES AND SURGICAL STAPLING INSTRUMENTS WITH COMMON STAPLE-FORMING POCKETS) " United States Patent (USP) Patent application serial numbers 12/894,340 (being now U.S. Patent Publication 2012/0080482)；
Entitled " jaw closed arrangement structure (the JAW CLOSURE ARRANGEMENTS FOR for surgical instruments SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 12/894,327 (be now U.S. Patent Publication 2012/ 0080499)；
Entitled " the surgery cuts and fastening instrument with separated and different fastener deployment and tissue diced system (SURGICAL CUTTING AND FASTENING INSTRUMENTS WITH SEPARATE AND DISTINCT FASTENER DEPLOYMENT AND TISSUE CUTTING SYSTEMS) " U.S. Patent Application Serial Number 12/894, 351 (being now U.S. Patent Publication 2012/0080502)；
Entitled " implantable fastener cartridge (the IMPLANTABLE FASTENER with non-uniform arragement construction CARTRIDGE HAVING A NON-UNIFORM ARRANGEMENT) " U.S. Patent Application Serial Number 12/894,338 it is (existing For U.S. Patent Publication 2012/0080481)；
Entitled " implantable fastener cartridge (the IMPLANTABLE FASTENER CARTRIDGE including supporting retainer COMPRISING A SUPPORT RETAINER) " U.S. Patent Application Serial Number 12/894,369 (be now that United States Patent (USP) is public Cloth 2012/0080344)；
It is entitled " including multiple layers of implantable fastener cartridges (IMPLANTABLE FASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS) " U.S. Patent Application Serial Number 12/894,312 (be now U.S. Patent Publication 2012/0080479)；
Entitled " implantable fastener cartridge (the SELECTIVELY ORIENTABLE being optionally orientated IMPLANTABLE FASTENER CARTRIDGE) " U.S. Patent Application Serial Number 12/894,377 (be now United States Patent (USP) 8, 393,514)；
Entitled " surgery suturing appliance (the SURGICAL STAPLING with compact joint motions control arragement construction INSTRUMENT WITH COMPACT ARTICULATION CONTROL ARRANGEMENT) " U.S. Patent Application Serial Number 12/894,339 (being now U.S. Patent Publication 2012/0080500)；
Entitled " surgery suturing appliance (the SURGICAL STAPLING INSTRUMENT with variable nail formation system WITH A VARIABLE STAPLE FORMING SYSTEM) " U.S. Patent Application Serial Number 12/894,360 (be now beauty State's patent disclosure 2012/0080484)；
Entitled " surgery suturing appliance (the SURGICAL STAPLING with interchangeable nail bin arragement construction INSTRUMENT WITH INTERCHANGEABLE STAPLE CARTRIDGE ARRANGEMENTS) " U.S. Patent application Sequence number 12/894,322 (being now United States Patent (USP) 8,740,034)；
Entitled " surgery nail bin (the SURGICAL STAPLE CARTRIDGES WITH with interchangeable support construction DETACHABLE SUPPORT STRUCTURES) " U.S. Patent Application Serial Number 12/894,350 (be now that United States Patent (USP) is public Cloth 2012/0080478)；
Entitled " implantable fastener cartridge (the IMPLANTABLE FASTENER including bioabsorbable layer CARTRIDGE COMPRISING BIOABSORBABLE LAYERS) " U.S. Patent Application Serial Number 12/894,383 it is (existing For United States Patent (USP) 8,752,699)；
The U.S. Patent application of entitled " compressible fastener cartridge (COMPRESSIBLE FASTENER CARTRIDGE) " Sequence number 12/894,389 (being now United States Patent (USP) 8,740,037)；
It is entitled " by fastener (the FASTENERS SUPPORTED BY A FASTENER of fastener cartridge supports support CARTRIDGE SUPPORT) " U.S. Patent Application Serial Number 12/894,345 (be now U.S. Patent Publication 2012/ 0080483)；
The U.S. Patent application of entitled " collapsible fastener cartridge (COLLAPSIBLE FASTENER CARTRIDGE) " Sequence number 12/894,306 (being now U.S. Patent Publication 2012/0080332)；
Entitled " fastener system (the FASTENER SYSTEM including multiple connection holding matrix elements COMPRISING A PLURALITY OF CONNECTED RETENTION MATRIX ELEMENTS) " U.S. Patent application Sequence number 12/894,318 (being now U.S. Patent Publication 2012/0080480)；
Entitled " fastener system (the FASTENER SYSTEM COMPRISING including holding matrix and alignment matrix A RETENTION MATRIX AND AN ALIGNMENT MATRIX) " U.S. Patent Application Serial Number 12/894,330 it is (existing For United States Patent (USP) 8,757,465)；
Entitled " fastener system (the FASTENER SYSTEM COMPRISING A including holding matrix RETENTION MATRIX) " U.S. Patent Application Serial Number 12/894,361 (being now United States Patent (USP) 8,529,600)；
It is entitled " for dispose include holding matrix fastener system fastening instrument (FASTENING INSTRUMENT FOR DEPLOYING A FASTENER SYSTEM COMPRISING A RETENTION MATRIX) " U.S. Patent Application Serial Number 12/894,367 (being now U.S. Patent Publication 2012/0080485)；
Entitled " fastener system (the FASTENER SYSTEM COMPRISING A including holding matrix and capping RETENTION MATRIX AND A COVER) " U.S. Patent Application Serial Number 12/894,388 (be now United States Patent (USP) 8, 474,677)；
Entitled " fastener system (the FASTENER SYSTEM COMPRISING A including multiple fastener cartridges PLURALITY OF FASTENER CARTRIDGES) " U.S. Patent Application Serial Number 12/894,376 (be now United States Patent (USP) It announces 2012/0080486)；
Entitled " surgical stapler anvil (the SURGICAL STAPLER ANVIL including multiple forming pits COMPRISING A PLURALITY OF FORMING POCKETS) " U.S. Patent Application Serial Number 13/097,865 it is (existing For U.S. Patent Publication 2012/0080488)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR for surgical stapling device FOR A SURGICAL STAPLER) " U.S. Patent Application Serial Number 13/097,936 (be now United States Patent (USP) 8,657, 176)；
Entitled " nail bin (the STAPLE CARTRIDGE COMPRISING A including variable thickness compressible portion VARIABLE THICKNESS COMPRESSIBLE PORTION) " U.S. Patent Application Serial Number 13/097,954 (now for U.S. Patent Publication 2012/0080340)；
It is entitled " including nail bin (the STAPLE CARTRIDGE COMPRISING for the nail being located in its compressible portion STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF) " U.S. Patent Application Serial Number 13/097,856 (being now U.S. Patent Publication 2012/0080336)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR including removable section COMPRISING DETACHABLE PORTIONS) " U.S. Patent Application Serial Number 13/097,928 (be now United States Patent (USP) 8, 746,535)；
Entitled " tissue thickness compensation part (the TISSUE for the surgical stapling device including adjustable anvil block THICKNESS COMPENSATOR FOR A SURGICAL STAPLER COMPRISING AN ADJUSTABLE ANVIL)” U.S. Patent Application Serial Number 13/097,891 (being now U.S. Patent Publication 2012/0080489)；
Entitled " nail bin (the STAPLE CARTRIDGE COMPRISING AN including distal part is adjusted ADJUSTABLE DISTAL PORTION) " U.S. Patent Application Serial Number 13/097,948 (be now U.S. Patent Publication 2012/0083836)；
The U.S. of entitled " compressible nail bin component (COMPRESSIBLE STAPLE CARTRIDGE ASSEMBLY) " Patent application serial number 13/097,907 (being now U.S. Patent Publication 2012/0080338)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS including the part with different performance COMPENSATOR COMPRISING PORTIONS HAVING DIFFERENT PROPERTIES) " U.S. Patent application sequence Row number 13/097,861 (being now U.S. Patent Publication 2012/0080337)；
The U.S. Patent application of entitled " nail bin charging assembly (STAPLE CARTRIDGE LOADING ASSEMBLY) " Sequence number 13/097,869 (being now U.S. Patent Publication 2012/0160721)；
Entitled " compressible nail bin (the COMPRESSIBLE STAPLE CARTRIDGE including alignment member COMPRISING ALIGNMENT MEMBERS) " U.S. Patent Application Serial Number 13/097,917 (be now U.S. Patent Publication 2012/0083834)；
Entitled " nail bin (the STAPLE CARTRIDGE COMPRISING A RELEASABLE including releasable portion PORTION U.S. Patent Application Serial Number 13/097,873 (being now United States Patent (USP) 8,740,038)) "；
Entitled " nail bin (the STAPLE CARTRIDGE COMPRISING including resisting compressible deformation component COMPRESSIBLE DISTORTION RESISTANT COMPONENTS) " U.S. Patent Application Serial Number 13/097,938 (being now U.S. Patent Publication 2012/0080491)；
Entitled " nail bin (the STAPLE CARTRIDGE COMPRISING A TISSUE including tissue thickness compensation part THICKNESS COMPENSATOR) " U.S. Patent Application Serial Number 13/097,924 (be now U.S. Patent Publication 2012/ 0083835)；
Entitled " surgical stapling device (the SURGICAL STAPLER WITH FLOATING with floating anvil block ANVIL U.S. Patent Application Serial Number 13/242,029 (being now U.S. Patent Publication 2012/0080493)) "；
Entitled " crooked end actuator (the CURVED END EFFECTOR FOR A for suture instruments STAPLING INSTRUMENT) " U.S. Patent Application Serial Number 13/242,066 (be now U.S. Patent Publication 2012/ 0080498)；
Entitled " nail bin (the STAPLE CARTRIDGE INCLUDING COLLAPSIBLE including collapsible platform DECK U.S. Patent Application Serial Number 13/242,086 (being now U.S. Patent Publication 2013/0075450)) "；
Entitled " nail bin (the STAPLE CARTRIDGE INCLUDING including collapsible platform arrangement structure COLLAPSIBLE DECK ARRANGEMENT) " U.S. Patent Application Serial Number 13/241,912 (be now U.S. Patent Publication 2013/0075448)；
Entitled " surgical stapling device (the SURGICAL STAPLER WITH STATIONARY with fixed staple drivers STAPLE DRIVERS) " U.S. Patent Application Serial Number 13/241,922 (being now U.S. Patent Publication 2013/0075449)；
It is entitled " to there is the surgical instruments (SURGICAL for generating the trigger assembly of multiple actuating movements INSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATING MULTIPLE ACTUATION MOTIONS)” U.S. Patent Application Serial Number 13/241,637 (being now U.S. Patent Publication 2012/0074201)；
It is entitled " to there is the surgical instruments (SURGICAL for capableing of the selectively end effector of joint motions INSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR) " U.S. Patent Application Serial Number 13/241,629 (being now U.S. Patent Publication 2012/0074200)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR including multiple packaging bodies COMPRISING A PLURALITY OF CAPSULES) " U.S. Patent Application Serial Number 13/433,096 it is (now special for the U.S. 2012/0241496) benefit is announced；
It is entitled " including multiple layers of tissue thickness compensation parts (TISSUE THICKNESS COMPENSATOR COMPRISING A PLURALITY OF LAYERS) " U.S. Patent Application Serial Number 13/433,103 (be now United States Patent (USP) It announces 2012/0241498)；
Entitled " tissue thickness compensation part (the EXPANDABLE TISSUE THICKNESS that can be expanded COMPENSATOR U.S. Patent Application Serial Number 13/433,098 (being now U.S. Patent Publication 2012/0241491)) "；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR including reservoir COMPRISING A RESERVOIR) " U.S. Patent Application Serial Number 13/433,102 (be now U.S. Patent Publication 2012/ 0241497)；
Entitled " holding device assembly (the RETAINER ASSEMBLY INCLUDING A including tissue thickness compensation part TISSUE THICKNESS COMPENSATOR) " U.S. Patent Application Serial Number 13/433,114 (be now U.S. Patent Publication 2012/0241499)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR comprising at least one drug COMPRISING AT LEAST ONE MEDICAMENT) " U.S. Patent Application Serial Number 13/433,136 it is (now special for the U.S. 2012/0241492) benefit is announced；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS including controlled release and expansion COMPENSATOR COMPRISING CONTROLLED RELEASE AND EXPANSION) " U.S. Patent Application Serial Number 13/433,141 (being now U.S. Patent Publication 2012/0241493)；
It is entitled " tissue thickness compensation part (the TISSUE THICKNESS of elastic load to be generated comprising fiber COMPENSATOR COMPRISING FIBERS TO PRODUCE A RESILIENT LOAD) " U.S. Patent Application Serial Number 13/433,144 (being now U.S. Patent Publication 2012/0241500)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS including the structure to generate elastic load COMPENSATOR COMPRISING STRUCTURE TO PRODUCE A RESILIENT LOAD) " U.S. Patent application Sequence number 13/433,148 (being now U.S. Patent Publication 2012/0241501)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR including elastic component COMPRISING RESILIENT MEMBERS) " U.S. Patent Application Serial Number 13/433,155 (be now U.S. Patent Publication 2012/0241502)；
It is entitled " to be used to form the method (METHODS of the tissue thickness compensation part arragement construction for surgical stapling device FOR FORMING TISSUE THICKNESS COMPENSATOR ARRANGEMENTS FOR SURGICAL STAPLERS)” U.S. Patent Application Serial Number 13/433,163 (being now U.S. Patent Publication 2012/0248169)；
The U.S. Patent application sequence of entitled " tissue thickness compensation part (TISSUE THICKNESS COMPENSATORS) " Row number 13/433,167 (being now U.S. Patent Publication 2012/0241503)；
Entitled " layer-stepping tissue thickness compensation part (LAYERED TISSUE THICKNESS COMPENSATOR's) " U.S. Patent Application Serial Number 13/433,175 (being now U.S. Patent Publication 2012/0253298)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS for circular surgical staplers COMPENSATORS FOR CIRCULAR SURGICAL STAPLERS) " U.S. Patent Application Serial Number 13/433,179 (being now U.S. Patent Publication 2012/0241505)；
The U.S. Patent Application Serial Number 13/ of entitled " binder film lamilate (ADHESIVE FILM LAMINATE) " 763,028 (being now U.S. Patent Publication 2013/0146643)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS including limiting the packaging body of environment under low pressure COMPENSATOR COMPRISING CAPSULES DEFINING A LOW PRESSURE ENVIRONMENT) " the U.S. it is special Sharp patent application serial numbers 13/433,115 (being now U.S. Patent Publication 2013/0256372)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR being made of multiple material COMPRISED OF A PLURALITY OF MATERIALS) " U.S. Patent Application Serial Number 13/433,118 (be now beauty State's patent disclosure 2013/0256365)；
Entitled " movable link (the MOVABLE MEMBER FOR USE WITH being used together with tissue thickness compensation part A TISSUE THICKNESS COMPENSATOR) " U.S. Patent Application Serial Number 13/433,135 (be now that United States Patent (USP) is public Cloth 2013/0256382)；
Entitled " tissue thickness compensation part and preparation method thereof (TISSUE THICKNESS COMPENSATOR AND METHOD FOR MAKING THE SAME) " U.S. Patent Application Serial Number 13/433,140 (be now U.S. Patent Publication 2013/0256368)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR comprising a variety of drugs COMPRISING A PLURALITY OF MEDICAMENTS) " U.S. Patent Application Serial Number 13/433,129 (be now beauty State's patent disclosure 2013/0256367)；
It is entitled " to be used to form nail bin (the STAPLE CARTRIDGES FOR of the nail with differing formed staple height FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS) " U.S. Patent Application Serial Number 11/216,562 (being now United States Patent (USP) 7,669,746)；
Entitled " surgical stapling device (the SURGICAL of the anvil block with the nail shapes pit with varying depth STAPLING DEVICE WITH ANVIL HAVING STAPLE FORMING POCKETS OF VARYING DEPTHS)” U.S. Patent Application Serial Number 11/714,049 (being now U.S. Patent Publication 2007/0194082)；
It is entitled " to produce surgical stapling device (the SURGICAL STAPLING with the forming nail of different length DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS) " U.S. Patent application Sequence number 11/711,979 (being now United States Patent (USP) 8,317,070)；
Entitled " surgical stapling device (the SURGICAL STAPLING DEVICE of the staple drivers with different height WITH STAPLE DRIVERS OF DIFFERENT HEIGHT) " U.S. Patent Application Serial Number 11/711,975 (now for U.S. Patent Publication 2007/0194079)；
Entitled " surgical stapling device (the SURGICAL STAPLING with the staple drivers for supporting multiple line footpath nails DEVICE WITH STAPLE DRIVER THAT SUPPORTS MULTIPLE WIRE DIAMETER STAPLES) " beauty State's patent application serial number 11/711,977 (being now United States Patent (USP) 7,673,781)；
It is entitled " to there is the surgical stapling device for driving multiple stacking actuator wedge cams of staple drivers (SURGICAL STAPLING DEVICE WITH MULTIPLE STACKED ACTUATOR WEDGE CAMS FOR DRIVING STAPLE DRIVERS) " U.S. Patent Application Serial Number 11/712,315 (be now United States Patent (USP) 7,500, 979)；
It is entitled " to be used to form nail bin (the STAPLE CARTRIDGES FOR of the nail with differing formed staple height FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS) " U.S. Patent Application Serial Number 12/038,939 (being now United States Patent (USP) 7,934,630)；
It is entitled " to produce surgical stapling system (the SURGICAL STAPLING with the forming nail of different length SYSTEMS THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS) " U.S. Patent application Sequence number 13/020,263 (being now United States Patent (USP) 8,636,187)；
It is entitled " to produce the surgical stapling device being controlled by robot with the forming nail of different length (ROBOTICALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS) " U.S. Patent Application Serial Number 13/118,278 (be now U.S. Patent Publication 2011/0290851)；
Entitled " surgical end-effector (the ROBOTICALLY-CONTROLLED based on the cable being controlled by robot CABLE-BASED SURGICAL END EFFECTORS) " U.S. Patent Application Serial Number 13/369,629 it is (now special for the U.S. 2012/0138660) benefit is announced；
It is entitled " to be used to form surgical stapling device (the SURGICAL STAPLING of the nail with differing formed height DEVICES FOR FORMING STAPLES WITH DIFFERENT FORMED HEIGHTS) " U.S. Patent Application Serial Number 12/695,359 (being now United States Patent (USP) 8,464,923)；
It is entitled " to be used to form nail bin (the STAPLE CARTRIDGES FOR of the nail with differing formed staple height FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS) " U.S. Patent Application Serial Number 13/072,923 (being now United States Patent (USP) 8,567,656)；
Entitled " material layer (the LAYER OF MATERIAL FOR A SURGICAL for surgical end-effector END EFFECTOR) " U.S. Patent Application Serial Number 13/766,325 (being now U.S. Patent Publication 2013/0256380)；
It is entitled " to be attached to anvil block layer (the ANVIL LAYER ATTACHED TO A of the proximal end of end effector PROXIMAL END OF AN END EFFECTOR) " U.S. Patent Application Serial Number 13/763,078 (be now United States Patent (USP) It announces 2013/0256383)；
Entitled " layer (the LAYER COMPRISING DEPLOYABLE ATTACHMENT including attachment members can be disposed MEMBERS U.S. Patent Application Serial Number 13/763,094 (being now U.S. Patent Publication 2013/0256377)) "；
Entitled " end effector (the END EFFECTOR COMPRISING A including distal tissue adjoining members DISTAL TISSUE ABUTMENT MEMBER) " U.S. Patent Application Serial Number 13/763,106 (be now that United States Patent (USP) is public Cloth 2013/0256378)；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR including channel COMPRISING CHANNELS) " U.S. Patent Application Serial Number 13/433,147 (be now U.S. Patent Publication 2013/ 0256369)；
It is entitled " surgery nail bin (the SURGICAL STAPLING CARTRIDGE WITH of feature structure to be kept with layer LAYER RETENTION FEATURES) " U.S. Patent Application Serial Number 13/763,112 (be now U.S. Patent Publication 2013/0256379)；
It is entitled " for from fastener cartridge release tissue thickness compensation part actuator (ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM A FASTENER CARTRIDGE) " the U.S. it is special Sharp patent application serial numbers 13/763,035 (being now U.S. Patent Publication 2013/0214030)；
Entitled " releasable tissue thickness compensation part and the fastener cartridge with the releasable tissue thickness compensation part (RELEASABLE TISSUE THICKNESS COMPENSATOR AND FASTENER CARTRIDGE HAVING THE SAME U.S. Patent Application Serial Number 13/763,042 (being now U.S. Patent Publication 2013/0221063)) "；
Entitled " fastener cartridge (the FASTENER CARTRIDGE including releasable tissue thickness compensation part COMPRISING A RELEASABLE TISSUE THICKNESS COMPENSATOR) " U.S. Patent Application Serial Number 13/ 763,048 (being now U.S. Patent Publication 2013/0221064)；
Entitled " fastener cartridge (the FASTENER including the cutting element for discharging tissue thickness compensation part CARTRIDGE COMPRISING A CUTTING MEMBER FOR RELEASING A TISSUE THICKNESS COMPENSATOR U.S. Patent Application Serial Number 13/763,054 (being now U.S. Patent Publication 2014/0097227)) "；
It is entitled " including fastener cartridge (the FASTENER CARTRIDGE for the tissue thickness compensation part being releasedly attached COMPRISING A RELEASABLY ATTACHED TISSUE THICKNESS COMPENSATOR) " U.S. Patent application Sequence number 13/763,065 (being now U.S. Patent Publication 2013/0221065)；
It is entitled " including nail bin (the STAPLE CARTRIDGE COMPRISING A RELEASABLE releasably covered COVER U.S. Patent Application Serial Number 13/763,021) "；
It is entitled " to be attached to anvil block layer (the ANVIL LAYER ATTACHED TO A of the proximal end of end effector PROXIMAL END OF AN END EFFECTOR) " U.S. Patent Application Serial Number 13/763,078 (be now United States Patent (USP) It announces 2013/0256383)；
Entitled " layer arrangement structure (the LAYER ARRANGEMENTS FOR SURGICAL for surgery nail bin STAPLE CARTRIDGES) " U.S. Patent Application Serial Number 13/763,095 (be now U.S. Patent Publication 2013/ 0161374)；
Entitled " implantable arragement construction (the IMPLANTABLE ARRANGEMENTS FOR for surgery nail bin SURGICAL STAPLE CARTRIDGES) " U.S. Patent Application Serial Number 13/463,147 (be now U.S. Patent Publication 2013/0292398)；
It is entitled that " multiple thickness for surgical stapling device can plant layer (MULTIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STAPLING DEVICES) " U.S. Patent Application Serial Number 13/763, 192 (being now U.S. Patent Publication 2013/0146642)；
Entitled " releasable material layer and the surgical end-effector (RELEASABLE with releasable material layer LAYER OF MATERIAL AND SURGICAL END EFFECTOR HAVING THE SAME) " U.S. Patent application sequence Row number 13/763,161 (being now U.S. Patent Publication 2013/0153641)；
It is entitled " for actuator (the ACTUATOR FOR RELEASING from surgical end-effector layers of release material A LAYER OF MATERIAL FROM A SURGICAL END EFFECTOR) " U.S. Patent Application Serial Number 13/763, 177 (being now U.S. Patent Publication 2013/0146641)；
Entitled " nail bin (the STAPLE CARTRIDGE COMPRISING A including compressible portion COMPRESSIBLE PORTION) " U.S. Patent Application Serial Number 13/763,037；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS including tissue in-growth feature structure COMPENSATOR COMPRISING TISSUE INGROWTH FEATURES) " U.S. Patent Application Serial Number 13/433, 126 (being now U.S. Patent Publication 2013/0256366)；
It is entitled " for tissue thickness's compensating material to be attached to the device and method (DEVICES of surgery suturing appliance AND METHODS FOR ATTACHING TISSUE THICKNESS COMPENSATING MATERIALS TO SURGICAL STAPLING INSTRUMENTS) " U.S. Patent Application Serial Number 13/433,132 (be now U.S. Patent Publication 2013/ 0256373)；
It is entitled " including wherein include opening tissue thickness compensation part fastener cartridge (FASTENER CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR INCLUDING OPENINGS THEREIN U.S. Patent Application Serial Number 13/851,703) "；
Entitled " tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR including cutting element path COMPRISING A CUTTING MEMBER PATH) " U.S. Patent Application Serial Number 13/851,676；
The U.S. Patent Application Serial of entitled " fastener cartridge assembly (FASTENER CARTRIDGE ASSEMBLIES) " Number 13/851,693；
Entitled " fastener cartridge (the FASTENER CARTRIDGE including tissue thickness compensation part and gap sets element COMPRISING A TISSUE THICKNESS COMPENSATOR AND A GAP SETTING ELEMENT) " the U.S. it is special Sharp patent application serial numbers 13/851,684；
It is entitled " including nail bin (the STAPLE CARTRIDGE INCLUDING A BARBED followed closely with barb STAPLE U.S. Patent Application Serial Number 14/187,387 (being now U.S. Patent Publication 2014/0166724)) "；
It is entitled " including nail bin (the STAPLE CARTRIDGE INCLUDING A BARBED followed closely with barb STAPLE U.S. Patent Application Serial Number 14/187,395 (being now U.S. Patent Publication 2014/0166725)) "；
It is entitled " including nail bin (the STAPLE CARTRIDGE INCLUDING A BARBED followed closely with barb STAPLE U.S. Patent Application Serial Number 14/187,400 (being now U.S. Patent Publication 2014/0166726)) "；
Entitled " implantable layer and the method for changing the implantable layer being used together with reuse surgical fasteners tool (IMPLANTABLE LAYERS AND METHODS FOR ALTERING IMPLANTABLE LAYERS FOR USE WITH SURGICAL FASTENING INSTRUMENTS) " U.S. Patent Application Serial Number 14/187,383；
Entitled " implantable layer and the one or more spy for changing the implantable layer being used together with fastening instrument Method (the IMPLANTABLE LAYERS AND METHODS FOR ALTERING ONE OR MORE PROPERTIES of property OF IMPLANTABLE LAYERS FOR USE WITH FASTENING INSTRUMENTS) " U.S. Patent Application Serial Number 14/187,386；
Entitled " the side of implantable layer and the shape for modifying the implantable layer being used together with reuse surgical fasteners tool Method (IMPLANTABLE LAYERS AND METHODS FOR MODIFYING THE SHAPE OF THE IMPLANTABLE LAYERS FOR USE WITH A SURGICAL FASTENING INSTRUMENT) " U.S. Patent Application Serial Number 14/ 187,390；
The U.S. Patent Application Serial of entitled " implantable layer assembly (IMPLANTABLE LAYER ASSEMBLIES) " Number 14/187,389；
Entitled " implantable layer (the IMPLANTABLE LAYERS COMPRISING A PRESSED including compressive region REGION U.S. Patent Application Serial Number 14/187,385) "；And
Entitled " fastening system (the FASTENING SYSTEM COMPRISING A including firing member latching member FIRING MEMBER LOCKOUT) " U.S. Patent Application Serial Number 14/187,384.
Many details are listed, herein to provide to whole with embodiment shown in the drawings described in specification Body structure, function, the thorough understanding of manufacture and purposes.However, it will be appreciated by those skilled in the art that can not have in this way Detail in the case where implement these embodiments.In other cases, do not elaborate it is well known operation, component and Element, in order to avoid keep embodiment described in specification smudgy.It will be understood by those skilled in the art that this paper institute Stating the embodiment with shown in is non-limiting example, thus it can be appreciated that, specific structural and functional details disclosed herein It can be representative and illustrative.Without departing from the scope of the claims can to these embodiments carry out modification and Change.
" various embodiments ", " some embodiments ", " embodiment " or " implementation that this specification refers in the whole text Scheme " etc. means that the special characteristic structure illustrated in conjunction with the embodiment, structure or characteristic are included at least one implementation In scheme.Therefore, this specification occurs in the whole text phrase " in various embodiments ", " in some embodiments ", " one In a embodiment " or " in embodiments " etc. be not necessarily all referring to identical embodiment.In addition, one or more real It applies in scheme, specific features structure, structure or characteristic can combine in any suitable manner.Therefore, under unconfined situation, The special characteristic structure that shows or illustrate in conjunction with an embodiment, structure or characteristic can entirely or partly with one or more The feature structure of other embodiments, structure or characteristic combination.In addition, it should be understood that for simplicity and clarity, can join herein Shown embodiment is examined for example using spatial terminologies such as "vertical", "horizontal", "up" and "down".However, these terms are used In auxiliary reader and it is not intended to limitation and absolute.
Fig. 1 is gone to, surgical stapling and cutting off apparatus 10 may include that can be manipulated to tool portion 14 being located in operation Handle portions 12 in position.In various embodiments, tool portion 14 may include being attached to the end execution of elongated shaft 18 Device 16.In all cases, the size of tool portion 14 and construction can be configured to insert by the intubation of trochar (not shown) Enter in operative site, to execute such as endoscope type or laparoscopic surgery.End effector 16 may include upper jaw Or anvil block 20 and lower jaw 22, the wherein movement of pistol grip 26 of present dynasty's handle portions 12 or closing for pressing handle portions 12 When closing trigger 24, anvil block 20 can move between the open and the closed positions.In various embodiments, pressing closure touching Hair device 24 can promote the outer closure sleeve 28 of elongated shaft 18, and wherein outer closure sleeve 28 can contact anvil block 20 and by anvil block 20 are pivoted to its closed position.In some cases, surgeon can be such that tool portion 14 surrounds by torsional axis knob 30 The rotation of its longitudinal axis.Under any circumstance, when end effector 16 has been inserted into the body cavity of inflation, for example, can release Closure trigger 24 is put, so that anvil block 20 be allowed to open by the biasing of spring (not shown) and position relative to target tissue.? In various embodiments, closure trigger 24 may be locked in its depressed state, and at least one embodiment, shank portion 12 are divided to may also include the lock release actuator 44 that can be pressed to unlock to closure trigger 24.Once anvil block 20 and lower jaw 22 relative to the tissue in operative site when suitably positioning, so that it may depress closure trigger 24 again to close anvil block 20 simultaneously And tissue is compressed against the nail bin 42 for being attached to bottom jaw 22.
Once anvil block 20 has been closed, so that it may percussion triggering is pulled or pressed towards closure trigger 24 and pistol grip 26 Device 32, percussion force or movement to be applied to firing member and never firing position promotes firing member.In various realities It applies in scheme, firing member may include the nearside percussion connecting rod 34 for being attached to distal side trigger shaft 36.In at least one such implementation In scheme, percussion connecting rod 34 and/or trigger shaft 36 be can support in the frame 38 in axis 18, and the axis can be in 12 He of handle portions Extend between end effector 16.Due to being applied to the firing action of firing member, then trigger shaft 36 can be in the thin of lower jaw 22 It is promoted in long staple cartridge channel 40 and the nail bin 42 being located in warehouse channel 40 towards distal side.In various embodiments, referring to figure 2, trigger shaft 36 may include attachment part 48, and the attachment part is attached to the E mast 50 that can be translated in end effector 16. E mast 50 may include vertical portion 52, and the vertical portion can extend through anvil block 20 when E mast 50 is promoted towards distal side In narrow longitudinal anvil block slot 58 of tissue contacting surface 60, the narrow vertical slit 62 in nail bin 42 and elongated nail it is logical Narrow longitudinal channel 64 in road 40.Referring now to Fig. 2 and Fig. 3, anvil block slot 58 can be extended up in anvil block 20 simultaneously And may include the end for being passed through the vertical passage 66 laterally widened, the size and construction quilt of the vertical passage 66 laterally widened It is set to receive the upper pin 54 extended laterally from vertical portion 52.Similarly, passage slot 64 can extend downwardly into channel 40 In and may include the end being passed through in the vertical passage 68 laterally widened, the size of the vertical passage 68 laterally widened and Construction is configured to receive from foot 70 under the one or more that vertical portion 52 extends laterally.
In various embodiments, than that described above, E mast 50 may also include one or more intermediate pins 72, it is described in Between pin can extend laterally and be configured to sliding along the top surface of the bottom tray 74 of nail bin 42 from vertical portion 52 It is dynamic.In certain embodiments, intermediate pin 72 is configured to nail bin 42 is placed in or ensured the holding placement of nail bin 42 In channel 40.The longitudinal percussion groove 75 formed in nail bin 42 above bottom tray 74 is sized in permission Between pin 72 translate across nail bin 42.In various embodiments, E mast 50 may also include distal side driving surface 76, the distal side Driving surface is configured to translate across the vertical slit 62 in nail bin 42 and wears towards distal side driving wedge-shaped slides 78 Cross nail bin 42.In certain embodiments, wedge-shaped slides 78 can be integrally molded in E mast 50, and in other embodiments In, wedge-shaped slides 78 can be located in nail bin 42 and can contact driving surface 76 when E mast 50 is promoted towards distal side.E mast 50 vertical portion 52 may additionally include 76 top of distal side driving surface and 54 lower section of upper pin along distal side edge extension Cutting surfaces 80, the cutting surfaces cut off clamped tissue 46 when organizing 46 to be just sewn.Referring now to Fig. 4, wedge shape Sliding part 78 is configured to engage one or more staple drivers 82 and drives up staple drivers 82 towards anvil block 20.? In various embodiments, nail (such as following closely 83) for example be can be placed on staple drivers 82 and/or in other ways by staple drivers 82 supports, so that nail 83 can also be lifted up when staple drivers 82 are lifted up.In at least one such embodiment, Nail 83 can be also positioned at least partially in the nail cavity in the staple cartridge body 85 of nail bin 42 or pit 84, wherein when nail 83 is lifted up When, it follows closely 83 accessible anvil blocks 20 and can be ejected from nail cavity 84.In at least one embodiment, referring again to Fig. 4, bottom support Disk 74 could attach to warehouse 85, so that staple drivers 82 and nail 83 are maintained in nail bin 42, until coming as described above from its portion Administration's nail 83.
Referring now to Fig. 5 and Fig. 6, when in use, anvil block 20 can be located on the side of tissue 46 and bottom can be clamped Mouth 22 is located on the opposite side of tissue 46, so that when anvil block 20 is closed into tissue, the tissue contacting surface 60 of anvil block 20 And the tissue contact platform 90 of nail bin 42 can compress tissue 46 between uncompressed thickness 91 and compressed thickness 92.In order to suture and Transecting patient tissue 46, as described above, wedge-shaped slides 78 can be promoted towards distal side to promote nail driving towards anvil block 20 in nail bin 42 Device 82 and make nail 83 deformation.In various embodiments, each staple drivers 82 may include be defined in one of those or it is more A slit, the slit are configured to receive the base portion 87 of nail 83 and it are made to releasably hold in place.At least one In a such embodiment, each nail 83 may include the one or more nail legs 88 extended from base portion 87, and wherein nail leg 88 can be to On extend in nail cavity 84.In various embodiments, when nail 83 is in its non-firing position, the end of nail leg 88 can be opposite It is recessed in the platform or tissue contacting surface 90 of warehouse 85.When being lifted up nail 83 by driver 82, the end of nail leg 88 It can be ejected from nail cavity 84, penetrate tissue 46 and contact the anvil block forming pit 89 for being located in the opposite side of nail cavity 84.Anvil block at Shape pit 89 is configured to that nail 83 is made to be deformed into any suitable shape, such as B shape shape such as shown in Figure 5. Referring now to Fig. 6, when deployment nail 83, cutting edge 80 can will be organized 46 crosscutting at sutured portion 94.
As described above, the jaw member of end effector is configured to for compression pressure or compressing force being applied to just The tissue being sewn.However, in all cases, tissue can be that at least part that is for example eely and organizing can be opposite It is slided in jaw member.In some cases, tissue can skid off in a longitudinal direction from the distal end of end effector and/or It can be skidded off along transverse to the direction of longitudinal direction from the side of end effector.In some cases, when compressing tissue, group The part knitted can be squeezed out from the distal end of end effector and/or the side of end effector.Disclosed herein various In embodiment, nail bin may include one or more tissue holding features structures, and the tissue holding features structure can be constructed At can prevent or at least reduce a possibility that tissue that is located in end effector is relative to end effector movement.
In various embodiments, referring now to Fig. 7 and Fig. 8, nail bin (such as nail bin 142) for example may include warehouse 185 Such as it is located in multiple nails (such as 187 (Fig. 9) of nail) in warehouse 185.Warehouse 185 may include proximal end 141 and distal side End 143, wherein proximal end 141 be configured to insertion staple cartridge channel proximal end in and distal end 143 It is configured in the distal end of insertion staple cartridge channel.In at least one embodiment, warehouse 185 may include multiple Nail cavity 184, the nail cavity are respectively configured to receive nail 187 wherein.In certain optionally embodiments, although not It shows, but nail cavity may include the more than one nail being positioned in.Under any circumstance, nail cavity 184 can in warehouse 185 cloth It is set to multiple rows of.More specifically, at least one embodiment, nail cavity 184 can for example on the first side 145 of warehouse 185 cloth It is set to three staples and can for example be arranged to three staples in second side 147 of warehouse 185.In at least one such implementation In scheme, the first side 145 of warehouse 185 and second side 147 can be spaced apart by cutter groove 162, and the cutter groove is configured to Cutting element is received slidably therein.In various other embodiments, nail bin can be wrapped for example on every side of cutter groove 162 Include any other appropriate number of staple (such as two staples or four staples).Referring to Fig. 9, in various embodiments, nail Storehouse 142 may also include the multiple staple drivers 182 for being configured to support nail 187 and/or ejecting nail 187 from nail cavity 184. In certain embodiments, each nail cavity 184 may include the open end in the platform 190 of warehouse 185 or opening 110, nail 187 may pass through 110 ejection of open end or opening.
In various embodiments, referring primarily to Fig. 8, nail cavity 184 may be arranged so that they are longitudinal relative to each other Staggeredly.For example, the nail cavity 184 on the first side 145 of warehouse 185 can for example be arranged to most interior nail chamber 184, intermediate row nail cavity 184 and outermost nail chamber 184, nail cavity 184 in one of row can not be with the nail cavity 184 in one or both of other rows Laterally it is aligned.In at least one embodiment, each nail cavity 184 may include proximal end 111 and distal end 112, In the proximal end 111 of each nail cavity 184 may be positioned to the proximal end 141 than distal end 112 close to warehouse 185.Equally, The distal end 112 of each nail cavity 184 may be positioned to the distal end 143 than proximal end 111 close to warehouse 185.Various In embodiment, most interior nail chamber 184 can be oriented so that the distal end 112 of the nail cavity 184 in most interior row relative in Between the distal end 112 of nail cavity 184 in nail chamber 184 positioned towards distal side.Similarly, outermost nail chamber 184 can be positioned so that So that distal end 112 court of the distal end 112 of the nail cavity 184 in most outlet relative to the nail cavity in intermediate row nail cavity 184 Distal side positioning.For example, the farthest side nail cavity 184 in most interior row can be fixed towards distal side relative to the farthest side nail cavity 184 in intermediate row Position, and similarly, the farthest side nail cavity 184 in most outlet can be fixed towards distal side relative to the farthest side nail cavity 184 in intermediate row Position.In certain embodiments, the nail cavity 184 of most interior row and the nail cavity 184 of most outlet can be aligned transverse to each other, so that (one) The distal end 112 of most interior nail cavity 184 be aligned with the distal end 112 of outermost nail cavity 184 and (two) most interior nail cavity 184 it is close Side end 111 is aligned with the proximal end 111 of outermost nail cavity 184.In various embodiments, each nail cavity 184 and its opening 110 can have identical or at least roughly the same configuration, and at least one embodiment, the phase in staple of nail cavity 184 For can equidistantly or at least substantially be equally spaced each other.
In various embodiments, referring again to Fig. 7 and Fig. 8, the warehouse 185 of nail bin 142, which may also include, to be for example constructed At the one or more spines that can contact and compress target tissue, such as spine 113,114 and 115.More specifically, referring now to Fig. 8 A can be closed the anvil block 120 of end effector to compress tissue T against nail bin 142, wherein in this case, group Knit contact platform 190 and spine extending therefrom 113,114 and 115 engageable tissues.In some cases, work as closed anvil When 120, anvil block 120 can be towards 142 pushes against tissue of nail bin, so that tissue contacts spine 113,114 and 115 first and then contacts Storehouse platform 190.In other cases, nail bin 142 can be positioned against tissue, so that before tissue contacts storehouse platform 190, spine 113,114 and 115 the tissue is contacted.Under any circumstance, spine 113,114 and 115 is prevented from or extremely once contacting tissue The relative motion between tissue and nail bin 142 is limited less.In certain embodiments, spine 113,114 and 115 can be from flat Or at least substantially flat storehouse platform 190 upwardly extends and can limit for example one or more pits or channel, it is described recessed Hole or channel are configured to wherein receiving a part of tissue, and group is therefore forbidden to be woven in the vertical of end effector Relative motion on direction and/or transverse direction, especially when tissue be at least partly compressed in anvil block 120 and spine 113, When between 114 and 115.It in various embodiments, can be when spine 113,114 and 115 extends to 190 top of storehouse platform Compression set before the tissue among anvil block 120 and storehouse platform 190 compression set in anvil block 120 and spine 113,114 and 115 Intermediate tissue.It therefore, in some such cases, can be in tissue of the compression set between anvil block 120 and storehouse platform 190 Before other parts, precommpression (that is, at least partly compressing) is located in the group between anvil block 120 and spine 113,114 and 115 It knits.In all cases, before tissue obtains compression completely, due to this precommpression, part that is controllable or preventing tissue It is skidded off from end effector, as described in more detail below.
In various embodiments, referring again to Fig. 7 and Fig. 8, the spine 113 extended from storehouse platform 190 can surround nail cavity The proximal end 111 of opening 110 extends.Similarly, the spine 114 extended from storehouse platform 190 can be around the remote of nail cavity opening 110 Side end 112 extends.In various embodiments, these nearside spines 113 and distal side spine 114 are configured to engage It is located in the tissue of 184 top of nail cavity and/or surrounding and makes these parts of tissue when organizing just by compression and/or suture It is held in place.In other words, tissue is made to remain positioned in nail cavity 184 top and/or can be to will be sewn around nail cavity 184 The part of tissue provides Partial controll, and thus prevents or at least limit the phase between these parts of tissue and nail bin 142 To movement.In various embodiments, spine 113 and 114 can surround all nail cavities 184 or the only opening 110 of some nail cavities 184 Positioning.In at least one embodiment, warehouse may include only around the nail in the most outlet of the first side 145 and second side 147 The spine 113 and 114 of chamber 184.In such an implementation, around the spine of outermost nail chamber 184 can be enough that group is hindered to be woven in Lateral movement in end effector.In certain embodiments, warehouse can only include the proximal end for surrounding recent side nail cavity 184 The nearside spine 113 in portion 111 and/or the distal side spine 114 of the distal end 112 around farthest side nail cavity 184.In such implementation In scheme, the spine around recent side and farthest side nail cavity 184 can be enough that group is hindered to be woven in the longitudinal movement in end effector.
In various embodiments, than that described above, each nearside spine 113 may include for example around the close of opening 110 The arch or curved profile of side end 111.The arcuate profile of each nearside spine 113 can be by a kind of radius of curvature or more than one Radius of curvature limits.Similarly, each distal side spine 114 may include the arch for example around the distal end 112 of opening 110 Or curved profile.The arcuate profile of each distal side spine 114 can be limited by a kind of radius of curvature or more than one radius of curvature. In certain embodiments, than that described above, each spine 113 and 114 can form pit, and the pit, which can receive, just to be compressed Tissue a part and prevent the part of tissue from longitudinally and/or laterally moving relative to nail bin 142.Various In embodiment, nail bin 142 may also include intermediate spine 115, and the intermediate spine can be in the adjacent ridge in adjacent row nail cavity 184 Extend and/or connect adjacent ridges 113 and 114 between portion 113 and 114.In at least one such embodiment, one or more The waveform that a spine 113,114 and 115 can interoperatively be developed across the first side 145 of warehouse 185 or second side 147 extends Spine, wherein at least one embodiment, waveform spine can extend between the central part and side of warehouse 142.? In various embodiments, each waveform spine may include for example around the more of proximal end and the distal end winding of nail cavity 184 A wave portion.In various embodiments, each spine 113,114 and 115 may include the height limited by storehouse platform 190, Wherein in certain embodiments, the height of each spine 113,114 and 115 can be across the length is uniform or at least bases It is uniform in sheet.In at least one embodiment, each spine 113,114 and 115 can be having the same or at least substantially Identical height.
In various embodiments, as described above, the nail cavity being defined in staple cartridge body may include the nail being positioned in, In when nail is in its non-firing position, the whole of nail can be positioned below top surface or the tissue contacting surface of storehouse platform. In certain other embodiments, when nail is in its non-firing position, at least part (such as end of nail leg) example of nail It such as may extend into above top surface or the tissue contacting surface of storehouse platform.In some such embodiments, the end of nail can Obstacle can be caused from platform protrusion and organizationally when nail bin is inserted into operative site.In at least one embodiment, Referring now to Fig. 9, when nail is when its non-firing position extends to above storehouse platform 190, such as tissue contact storehouse platform is extended to The spine 113 and 114 of 190 tops can at least partly about and protection nail 187 nail leg 183.Although spine 113 and 114 can Do not extend completely about each opening 110, but in various embodiments, nearside spine 113 can be sufficiently around nail leg end One of end, and distal side spine 114 can be sufficiently around another nail leg end, so that being pressed in tissue against nail bin 142 Before the ejection of nail bin 142, nail leg end does not contact tissue for contracting and/or nail 187.In at least one embodiment, nail leg end End can be positioned on 116 lower section of top surface of spine 113 and 114.In certain embodiments, nail leg end can be with spine 113 It is coplanar with 114 top surface 116.In various embodiments, due to the protection provided by spine 113 and 114, such as can make With the nail with higher staple height, and it is prominent not from nail bin 142 in its non-firing position to follow closely end.In certain embodiments, Referring again to Fig. 9, spine 113 and 114 is extensible or increases the length of wherein controllable and/or support nail 187 nail leg 183. In at least one such embodiment, each spine 113 and 114 can extend or increase can wherein support on three of them side The length of nail leg 183.Such embodiment can for example prevent or at least reduce nail leg 183 being inserted through compact tissue (example Such as bronchial tissue) when buckling a possibility that.
In various embodiments, referring again to Fig. 4, warehouse 85 may include for example being defined in therein to reduce warehouse 85 Intensity chamber 84, slit 62 and channel 86.In all cases, in particular, for example when warehouse 85 is compressed by anvil block 20, storehouse Body 85 can be deflected because of the load applied thereon.In at least one such embodiment, storehouse platform 90 extends on channel 86 Part may be, for example, especially thin and can especially be subjected to deflection and/or damaged.In certain embodiments, referring again to Fig. 7 And Fig. 8, spine 113,114 and/or 115 are configured to that warehouse 185 is made to strengthen and/or be hardened.It is such at least one In embodiment, spine 113 and 114 for example can around opening 110 extend, so as to make warehouse 185 circular nail cavity 184 part Strengthen and/or is hardened.In certain embodiments, spine 115 is lateral such as that can go up the channel 86 being defined in warehouse 185 Extend, so that spine 115 can make the warehouse for surrounding channel 86 185 strengthen and/or be hardened.In various other embodiments, storehouse Body 185 may include the spine of any suitable quantity and configuration extending therefrom to realize advantage described herein.
In various embodiments, staple cartridge body 185 can be for example by plastic material, metal material, and/or ceramic material structure At.Some such materials may include such as liquid crystal polymer (such as Vectra), thermoplastic polymer (such as polycarbonate, ABS, Noryl, polyamide (nylon), polyether sulfone, polyetherimide (such as Ultem)), and/or above-mentioned thermoplastic polymer in The blend polymer of two or more, wherein in various embodiments, warehouse 185 can be for example, by injection molding mistake Journey is formed.Some such materials may include such as thermosetting polymer (such as thermosetting polyester), model casting stainless steel (such as 17-4PH) and/or metal injection molded molding stainless steel (such as 17-4PH).In at least one such embodiment, spine 113, 114 and/or 115 can be integrally formed with the storehouse platform 190 of warehouse 185.In certain embodiments, spine 113,114 and/or 115 can be attached to storehouse platform 190 for example, by least one adhesive.
In various embodiments, referring now to Figure 12, nail bin (such as nail bin 342) for example may include warehouse 385, limit Multiple nail cavities 384 in warehouse 385 and the nail in each of being located in nail cavity 384.In certain embodiments, storehouse Body 385 may also include the first side 345 with first group of nail cavity 384, with second side 347 of second group of nail cavity 384, Yi Jicang Platform 390.In various embodiments, warehouse 385, which may also include from what storehouse platform 390 extended, can be positioned on a nail chamber 384 In adjacent nail cavity 384 among multiple spines 315.In at least one embodiment, each spine 315 may include such as ten Font or X-shaped configuration.In at least one such embodiment, for example, each spine 315 may include can be at least partly about The V-shaped part 313 of the proximal end 311 of nail cavity opening 310 and furthermore can another at least partly about nail cavity opening 310 Distal end 312 V-shaped part 314.In certain embodiments, the only outermost nail chamber 384 in warehouse 385 can at least portion Ground is divided to be surround by spine 315.In certain other embodiments, referring now to Figure 13, staple cartridge body 385' may include spine 315, The opening 310 of each nail cavity 384 in at least partly about warehouse of spine.Under any circumstance, in various embodiment party In case, each spine 315 is configured to the tissue and/or ring compressed as described above and control is positioned against nail bin 342 Around the nail leg for extending to the nail above platform 390.
In various embodiments, referring now to Figure 16, nail bin (such as nail bin 542) for example may include warehouse 585, limit Multiple nail cavities 584 in warehouse 585 and the nail in each of being located in nail cavity 584.In certain embodiments, storehouse Body 585 may also include the first side 545 with first group of nail cavity 584, with second side 547 of second group of nail cavity 584, Yi Jicang Platform 590.In various embodiments, warehouse 585 may also include the multiple spines 515 extended from storehouse platform 590, wherein each Spine 515 can entirely around or surround nail cavity opening 510.As shown in figure 16, some chambers opening 510 in warehouse 585 can not be by Spine 515 surround；And in various optionally embodiments, referring now to Figure 16 A, each of warehouse 585' chamber opening 510 It can be surround by spine 515.Imagining its middle warehouse includes not surround by first group of circular nail cavity 584 of spine 515 and by spine 515 Second group of nail cavity 584 various embodiments, wherein can be positioned in first group of nail cavity 584 simultaneously with the nail of higher staple height And wherein the nail with lower staple height can be positioned in second group of nail cavity 584, so that higher nail and lower nail be not from nail bin 542 is prominent.In at least one such embodiment, for example, warehouse be configured to using in a nail chamber 584 compared with Lower nail in height nail and another nail chamber 584.In certain embodiments, spine 515 can surround the outermost nail in warehouse All nail cavities 584 in chamber 584 so that for example can in most outlet using it is higher nail and can be in most interior row and/or intermediate row Lower nail is utilized in nail cavity 584.
In various embodiments, referring now to Figure 14, nail bin (such as nail bin 442) for example may include warehouse 485, limit Multiple nail cavities 484 in warehouse 485 and the nail in each of being located in nail cavity 484.In certain embodiments, storehouse Body 485 may also include the first side 445 with first group of nail cavity 484, with second side 447 of second group of nail cavity 484, Yi Jicang Platform 490.In various embodiments, warehouse 445 may also include the multiple spines 415 extended from storehouse platform 490, wherein each Spine 415 may include multiple annular knurls or annular knurl array.When in use, using anvil block against annular knurl position tissue, so that tissue Conform to the profile of annular knurl.In various embodiments, each spine 415 may include for example, at least partially around one or more The multiple tapers or diamond-shaped knurling of a nail cavity opening 410, wherein at least one embodiment, taper annular knurl can be from storehouse platform 490 are directed toward.In at least one embodiment, each taper annular knurl may include four triangle sides, four triangles Shape side can be focused at and be formed together cusp.In certain embodiments, referring to Figure 15 A, the taper annular knurl of spine 415 can be to cut Short, wherein may include the flat top surface for being inclined by side surrounding at the top of each annular knurl.Although four sides can be used to bore Shape annular knurl, referring now to Figure 15 C, it is contemplated that have for example less than four sides or more than its of four sides (such as three sides) Its conical by its shape.In various embodiments, one or more spines 415 may include multiple conical annular knurls, wherein each circle Taper annular knurl may include circular or at least substantially circular base portion, and the base portion is tapered to form cusp upwards.At certain In a little embodiments, referring now to Figure 15 B, conical annular knurl can be it is truncated, wherein may include by ring at the top of each annular knurl The flat top surface of shape side surrounding.In various embodiments, referring again to Figure 14, the annular knurl of spine 415 can be along nail Chamber opening 410 side and/or extend between adjacent nail cavity opening 410.In at least one embodiment, annular knurl can surround The proximal end 411 and/or distal end 412 of nail cavity opening 410 extend.In certain embodiments, the annular knurl of spine 415 can Only around some in nail cavity 484, and in certain other embodiments, referring to Figure 15, the annular knurl of spine 415 can be covered for example The whole of storehouse platform 490 is at least substantially whole.
In various embodiments, referring now to Figure 10, nail bin (such as nail bin 242) for example may include warehouse 285, limit Multiple nail cavities 284 in warehouse 285 and the nail in each of being located in nail cavity 284.In certain embodiments, storehouse Body 285 may also include the first side 245 with first group of nail cavity 284, with second side 247 of second group of nail cavity 284, Yi Jicang Platform 290.In various embodiments, warehouse 285 may also include the multiple spines extended from storehouse platform 290 or bump 215. In at least one such embodiment, the center or centre of the warehouse 245 that each spine 215 can position in neighbouring cutter groove 262 It is laterally extended between part and the side of warehouse 245.More specifically, referring particularly to the first side 245 of warehouse 285, each ridge Portion 215 may include the second end of the first side 261 positioning of the first end 213 that neighbouring cutter groove 262 positions and neighbouring warehouse 285 214.Similarly, referring now to second side 247 of warehouse 285, each spine 215 may include first that neighbouring cutter groove 262 positions The second end 214 that second side 263 of end 213 and neighbouring warehouse 285 positions.In at least one embodiment, each ridge Portion 215 may include the height measured from platform 290, wherein at least one such embodiment, the height of each spine 215 It can change along its length.In certain embodiments, the second end 214 can be higher than first end 213, and each spine 215 height can be tapered between the second end 214 and first end 213.In certain optionally embodiments, although not showing Out, but the first end 213 of spine 215 can be higher than the second end 214.In at least one embodiment, each spine 215 Height can be linearly or at least substantially linearly tapered between end 213 and 214.In at least one such embodiment In, the height of each spine 215 can taper to the zero elevation at first end 213 from the maximum height from the second end 214.? In certain embodiments, the height of each spine 215 can between end 213 and 214 Geometrical change.In certain optionally embodiment party In case, referring now to Figure 11, each spine 215' may include the even height across its length.
As described above, the inner end 213 of spine 215 can be shorter than the outer end 214 of spine 215.Therefore, in all cases, phase Than in outer end 214, inner end 213 can apply smaller pressure to the tissue being clamped between anvil block and nail bin 242.In various implementations In scheme, as described above, each spine 215 can be laterally extended across storehouse platform 290.In certain embodiments, each spine 215 can extend along spine's axis, the longitudinal axis 299 of the crosscutting warehouse 285 of spine's axis.In at least one such implementation In scheme, spine's axis can perpendicular to or be at least substantially orthogonal to longitudinal axis 299.In various embodiments, nail cavity 284 Can be arranged to it is multiple rows of, wherein each nail chamber 284 can be limited along following longitudinal axis, the longitudinal axis can be parallel to or Person is at least substantially parallel to longitudinal axis 299.In at least one embodiment, spine's axis of spine 215 can be along crosscutting nail The direction of the longitudinal axis of chamber 284 extends.In at least one such embodiment, spine's axis of spine 215 can along perpendicular to or The direction that person is at least substantially orthogonal to the longitudinal axis of nail cavity 284 extends.In various embodiments, referring again to Figure 10, often A spine 215 may include bizet 209 and furthermore extend in the inclined surface 208 between bizet 209 and storehouse platform 290.At certain In a little embodiments, each inclined surface 208 may include for example one or more flat surfaces, curved surface, concave surface, And/or convex surface.In various embodiments, each spine 215 can open along the one or more for extending across nail cavity 284 The path of mouth 210 extends.In at least one such embodiment, such opening 210 can extend up through spine 215.When When spine 215 is laterally extended across storehouse platform 290, spine 215 (be similar to spine 115) can increase warehouse 285 intensity and/or Rigidity.
In various embodiments, referring now to Figure 17 and Figure 18, nail bin (such as nail bin 642) for example may include warehouse 685, the multiple nail cavities 684 being defined in warehouse 685 and the nail being located in each nail cavity 684.In certain embodiments In, warehouse 685 may also include the first side 645 with first group of nail cavity 684, second side 647 with second group of nail cavity 684, And storehouse platform 690.In various embodiments, warehouse 685 may also include the multiple spines extended from storehouse platform 690 or protuberance Block 615.In at least one such embodiment, each spine 615 can be extendd in the longitudinal direction, wherein each spine 615 can Including distal end 613 and proximal end 614, wherein the distal end 613 of spine 615 be may be positioned to closer to warehouse 685 Distal end 643, and wherein the proximal end 614 of spine 615 may be positioned to closer to proximal end 641.At at least one In embodiment, each spine 615 may include the height measured from platform 690, wherein at least one such embodiment, The height of each spine 615 can change along its length.In certain embodiments, proximal end 614 can be higher than distal end 613 and the height of each spine 615 can be tapered between proximal end 614 and distal end 613.In certain optionally embodiment party In case, although being not shown, the distal end 613 of spine 615 can be higher than proximal end 614.In at least one embodiment, The height of each spine 615 can be linearly or at least substantially linearly tapered between end 613 and 614.At at least one In such embodiment, the height of each spine 615 can the maximum height proximally at end 614 taper to distal end 613 The zero elevation at place.In certain embodiments, the height of each spine 615 can between end 613 and 614 Geometrical change.? In certain optionally embodiments, each spine 615 may include the uniform height across its length.
As described above, the distal end 613 of spine 615 can be shorter than the proximal end 614 of spine 615.Therefore, in various feelings Under condition, compared to proximal end 614, distal end 613 can apply lesser to the tissue being clamped between anvil block and nail bin 642 Pressure.In various embodiments, as described above, each spine 615 can be across the longitudinal extension of storehouse platform 690.In certain implementations In scheme, each spine 615 can extend along spine's axis, and spine's axis is parallel to or at least substantially parallel to storehouse The longitudinal axis 699 of body 685.In various embodiments, nail cavity 684 can be arranged to multiple rows of, wherein can be along following longitudinal direction Axis limits each nail chamber 684, the longitudinal axis can be parallel to or at least substantially parallel to spine 615 spine Axis.In at least one embodiment, referring again to Figure 18, each spine 615 may include ramped surfaces, and the ramped surfaces can Including for example one or more flat surfaces, curved surface, concave surface, and/or convex surface.In at least one such implementation In scheme, the bottom of ramped surfaces can be towards distal side, so that is conducive to group when that will organize and position in the end effector It is woven on entire nail bin 642 and slides.In various embodiments, each spine 615 can be along extending across one of nail cavity 684 Or the path of multiple openings 610 extends.In at least one such embodiment, such opening 610 can extend up through ridge Portion 615.When spine 615 is laterally extended across storehouse platform 690, spine 615 can increase the intensity and/or rigidity of warehouse 685.
In various embodiments, than that described above, surgical staples can be for example made of titanium (such as titanium silk).In certain implementations In scheme, surgical staples can be made of the alloy for example comprising titanium, aluminium and/or vanadium.In at least one embodiment, surgical staples can It is constituted by surgery stainless steel and/or by the alloy that such as cobalt and chromium are constituted.Under any circumstance, surgical staples can be for example by metal (such as titanium) and metal oxide outer surface (such as titanium oxide) is constituted.In various embodiments, metal can be coated with material Oxide outer surface.In certain embodiments, coating material for example can be by polytetrafluoroethylene (PTFE) (PTFE) (such as) And/or tetrafluoroethene (TFE) (such as ethylene-tetrafluoroethylene (ETFE), perfluoroalkyl ethylene oxy-tetrafluoroethene (PFA)) and/or Fluorinated ethylene propylene (FEP) is constituted.Certain coatings may include silicon.In various embodiments, such coating material can prevent or At least inhibit the further oxidation of metal.In certain embodiments, coating material can provide one or more lubricated surfaces, anvil Seat or nail pit can against these surfaces contact stud, to reduce frictional force therebetween.In all cases, follow closely and follow closely pit Between relatively low-frictional force can reduce make nail deformation needed for power.
It is filed in the U.S. Patent Application Publication of on September 29th, 2010 entitled " nail bin (STAPLE CARTRIDGE) " 2012/0074198 (being now United States Patent (USP) 8,733,613) and it is filed on 2 21st, 2013 entitled " nail bin (STAPLE CARTRIDGE the disclosure of U.S. Patent Application Publication 2013/0161375) " is incorporated by reference accordingly to be incorporated to.
The end effector of surgery suturing appliance is as shown in Figure 23 and Figure 55.End effector may include that for example anvil block is (all Such as anvil block 20) and be configured in the wherein removedly jaw or staple cartridge channel 22 of support nail cartridge.Nail bin 2000 is for example It is positioned in warehouse channel 22.Nail bin 2000 may include warehouse 2010, and the warehouse includes being defined in multiple nail cavities therein 2050.Each nail cavity 2050 is configured to removedly store nail wherein.Warehouse 2010 may include platform surface 2011 and the longitudinal slit 2015 that is defined in platform surface 2011, the longitudinal slit be configured to can be removed wherein Ground receives firing member and/or cutting edge.Warehouse 2010 may also include distal end 2013, proximal end 2016 and remote The opposite longitudinal direction side 2012 extended between side end 2013 and proximal end 2016.In all cases, side 2012 longitudinally in each It may include infinitely due to the adjoining of interruption therein or continuous boundary.After comparison diagram 7 and Figure 23, for example, reader will appreciate that Fig. 7 Shown in the longitudinal direction side of nail bin 142 include being defined at least one recess therein and longitudinal direction side 2012 does not include such recess.
Referring primarily to Figure 55, warehouse 2010 may also include the multiple protruding portion 2051 extended from platform surface 2011.It is prominent Portion 2051 is configured to the tissue that engagement is located among anvil block 20 and storehouse 2000 and controls tissue relative to storehouse 2000 movement.Tissue can be moved relative to storehouse 2000 in all cases.In at least one situation, when anvil block 20 is being opened Position (Figure 23) and wherein tissue is compressed in when moving between the closed position between anvil block 20 and storehouse 2000, tissue can be opposite It is flowed in storehouse 2000.In this case, tissue can be flowed towards 2012 lateral flow of longitudinal direction side towards 2013 distal side of distal end Dynamic and/or proximally facing 2016 nearside of end flowing.In at least one other situation, when cutting edge is advanced through towards distal side When the tissue being trapped between anvil block 20 and storehouse 2000, tissue can be flowed relative to storehouse 2000.In this case, tissue can side It to flowing, flows towards distal side, and/or proximally flows, but it is mainly flowed towards distal side due to the distal movement of cutting edge.Each In the case of kind, protruding portion 2051 is configured to the flowing that tissue is restricted or prevented relative to nail bin.Protruding portion 2051 can It is located at the proximal end and/or distal end of nail cavity 2050.In all cases, each protruding portion 2051 may include surrounding The hoop that the end of nail cavity 2050 extends.In some cases, each protruding portion 2051 may include prolonging around the end of nail cavity 2050 The arch spine stretched.
Referring primarily to Figure 55, warehouse 2010 may include extending between the distal end and platform surface 2011 of warehouse 2010 Angled transition 2014.Angled transition 2014 can be conducive to the storehouse 2000 when storehouse 2000 and anvil block 20 to be located in operative site Movement relative to tissue.In this case, tissue can slide on inclined surface 2014.In all cases, nauropemeter Face 2014 may include curved surfaces.In all cases, inclined surface 2014 may include angled faces.In some cases, incline Skewed surface 2014 may include concave surface and/or convex surface.In at least one situation, as shown in figure 55, inclined surface 2014 can be transited into flat angled faces for example including distal side concave surface, the distal side concave surface, it is described it is flat at Angle surface is transited into nearside convex surface.
The nail cavity 2050 being defined in warehouse 2010 can be arranged to longitudinal row.For example, three longitudinal nail chambers 2050 can It is disposed on the first side of longitudinal slit 2015, and three longitudinal nail chambers 2050 can be disposed in longitudinal slit 2105 In second side.Row may include the farthest side nail cavity 2050 and neighbouring proximal end 2016 of neighbouring distal end 2013 longitudinally in each Recent side nail cavity 2050.In all cases, warehouse 2010 may also include the protruding portion 2053 extended from platform surface 2011.It is prominent Portion 2053 can be positioned at the distal end of farthest side nail cavity 2050 out.Each protruding portion 2053 may include for example being adapted to Enough be conducive to the distal ramped surface for the insertion that group is woven between nail bin 2000 and anvil block 20.In all cases, farthest side chamber 2050 can respectively include the protruding portion 2053 positioned at its distal end and the protruding portion 2051 being located at its proximal end.
Each protruding portion 2051 and/or protruding portion 2053 are configured to support and are removedly stored in nail cavity 2050 In nail at least part.In all cases, each protruding portion 2051 can make the end wall 2052 of nail cavity 2050 in platform 2011 tops extend.In some cases, referring generally to Figure 24 and Figure 26 to Figure 29, the nail being located in nail cavity 2050 may include Base portion, the first leg extended with first angle from the base portion and the second leg extended with second angle from the base portion. First leg can be contacted with the first end wall 2052 (Figure 55) of nail cavity 2050 and the second leg can be with the second end of the nail cavity Wall 2052 contacts.In some cases, the distance between first leg and the second leg of nail or extension can be wider than end wall 2052 The distance between, so that leg is inwardly biased by end wall 2052 when nail is located in nail cavity 2050.When nail is in nail cavity 2050 Storage does not fire in it or when non-raised position, and the end of nail leg can be positioned in protruding portion 2051.In this case, it dashes forward Portion 2051 in 2011 upper support of platform and can protect the end of nail leg out.In some cases, when nail does not fire position in it When setting, the end of nail leg can be positioned on 2051 lower section of protruding portion, and therefore, when nail is in its non-firing position, protruding portion 2051 can not support nail leg.When this nail is fired or is lifted out nail cavity 2050, nail leg can then connect with protruding portion 2051 It touches and is supported by protruding portion 2051.Under any circumstance, protruding portion 2051 can continue to support nail leg when disposing nail, until Nail is sufficiently fired and/or is lifted out nail cavity 2050, so that nail leg is no longer contacted with protruding portion 2051.Protruding portion 2053 can be with It is executed similar to the mode in conjunction with described in protruding portion 2051.
In all cases, than that described above, protruding portion 2051 can make nail cavity 2050 on the platform 2011 of warehouse 2010 Fang Yanshen.In some cases, it is prominent to can be configured so that the end wall 2052 of nail cavity 2050 seamlessly extends to for protruding portion 2051 Out in portion 2051.In other words, seamless surface can be limited between end wall 2052 and protruding portion 2051.This seamless surface can reduce The nail leg for being biased against end wall 2052 and protruding portion 2051 contacts the edge being defined in nail cavity 2050 or ladder and/or digs into nail A possibility that side wall of chamber 2050.Figure 55 A shows the ladder 2056 being defined between protruding portion 2051 and end wall 2052.Although Ladder 2056 includes outside ladder rather than inside ladder, but ladder 2056 can be excluded to provide as discussed above Seamless surface.In the embodiment formed during wherein warehouse 2010 is in injection molding, storehouse 2010 can be defined in note It is formed in mold cavity between the two half-unit of mould.The two half-unit of injection mold can be in contact with each other to seal or at least base Sealed mold chamber in sheet.Joint portion between the two die halfs is commonly known as seal line or die parting line, and usually edge Seal line small flange or antelabium are formed in warehouse.When empty from mold cavity discharge using seal line during injection molding It is especially true when gas.This flange or antelabium are commonly known as ' flash '.Injection mold, which can be carefully designed into, makes seal line Not in the end wall 2052 of protruding portion 2051 and/or face generation flange or antelabium in interior surface.In at least one situation, dash forward Portion 2051 may include the transition portion held hoop portion point 2057 and extend to platform 2011 from the opposite both ends of hoop portion point out 2058.Seal line between the two mold half portions may be chosen such that it extends along the top surface of protruding portion 2051. Other suitable seal lines may be selected as shown in Figure 55 A in example seal line 2059.
Nail bin 2800 is as shown in Figure 56 and Figure 57.Nail bin 2800 may include warehouse 2810.Warehouse 2810 may include distal end portion Portion 2813, proximal end 2816 and opposite flank 2812.Similar to above-mentioned, each side 2812 may include infinitely due to it In recess adjacent edge.Multiple nail cavities that warehouse 2810 may also include such as platform 2811, be defined in platform 2811 2850 and be configured to accommodate firing member the edge of a knife longitudinal slit 2815.Warehouse 2810 may also include flat from storehouse The spine 2851 that platform 2811 extends.In all cases, spine 2851 may include pattern.In at least one situation, each ridge Portion 2851 can extend between side 2812 and longitudinal slit 2815.Each spine 2851 for example may include any suitable structure Type, such as platform part.One or more nail cavities 2850 can extend across spine 2851.In some cases, interior nail chamber 2850 In nail cavity 2850 at least part, at least part and/or outlet nail cavity of nail cavity 2850 in intermediate row nail cavity 2850 At least part of nail cavity 2850 in 2850 can extend across the platform part of spine 2851.Each spine 2851 may include neighbouring The outer end 2859 that the inner end 2858 and adjacent side face 2812 that longitudinal slit 2815 positions position.In some cases, inner end 2858 It can be positioned relative to outer end 2859 towards distal side.In other cases, although being not shown, outer end 2859 can be relative to inner end 2858 It is positioned towards distal side.Spine 2851 can be for example parallel.In some cases, spine 2851 may include such as tread contour.? In at least one situation, the first side of longitudinal slit 2815 from the spine 2851 that platform 2811 extends may include in longitudinal slit The mirror image for the spine 2851 that 2815 second side extends from the platform.In all cases, it can be limited between spine 2851 Gap.Tissue for example can flow into the gap when tissue is compressed by anvil block against storehouse platform 2811.The gap can be constructed At the flowing that can guide tissue along desired direction.
Nail bin 2900 is as shown in figure 50.Nail bin 2900 may include warehouse 2910.Warehouse 2910 may include distal end 2913, Proximal end and opposite side 2912.Similar to above-mentioned, each side 2912 may include infinitely due to recess therein Adjacent edge.Warehouse 2910 may also include such as platform 2911, the multiple nail cavities 2950 being defined in platform 2911 and by structure Cause can to receive the longitudinal slit 2915 of the edge of a knife of firing member.Warehouse 2910 may also include the ridge extended from storehouse platform 2911 Portion 2951.In all cases, spine 2951 may include pattern.Each spine 2951 can be in the distal end 2913 of warehouse 2910 Extend between proximal end.In at least one situation, each spine 2951 can be towards side 2912 and towards longitudinal slit 2915 Extend.In all cases, each spine 2951 may include inwardly and extend proximally at angle part 2954, longitudinally extend Straight portion 2955 and inwardly and towards distal side extend at angle part 2956.Spine 2951 can be around nail cavity 2950 and/or in nail cavity Extend between 2950.In at least one situation, at angle part 2954 and can be in longitudinal nail chamber 2950 at angle part 2956 Nail cavity 2950 between extend.Spine 2951 can be for example parallel to each other.In some cases, spine 2951 may include for example Tread contour.In at least one situation, it can be wrapped in the first side of longitudinal slit 2915 from the spine 2951 that platform 2911 extends Include the mirror image for the spine 2951 that second side in longitudinal slit 2915 extends from the platform.It in all cases, can be in spine Gap is limited between 2951.Tissue for example can flow into the gap when tissue is compressed by anvil block against storehouse platform 2911.It is described Gap is configured to guide the flowing of tissue along desired direction.
Nail bin may include uniform protruding portion array extending therefrom.In other cases, the array can be non-uniform. In some cases, the protruding portion in the array can not be such that nail cavity extends.In all cases, the protruding portion in the array It can not support nail.
Nail bin 3000 is as shown in Figure 59 and Figure 60.Nail bin 3000 may include warehouse 3010.Warehouse 3010 may include distal end portion Portion 3013, proximal end and opposite side 3012.Similar to above-mentioned, each side 3012 may include unlimited due to wherein Recess adjacent edge.Warehouse 3010 may also include such as platform 3011, the multiple nail cavities 3050 being defined in platform 3011, And it is configured to receive the longitudinal slit 3015 of the edge of a knife of firing member.Warehouse 3010 may also include from storehouse platform 3011 The protruding portion 3051 of extension.In all cases, protruding portion 3051 may include pattern.In at least one situation, each protrusion Portion 3051 may include conical configuration.Conical configuration may include four sides for example to be terminated with point.Alternatively, this four sides It can for example be terminated with flat surface.Alternatively, conical configuration may include three sides for example to be terminated with point.Any In the case of, as shown in figure 59, protruding portion array 3051 can extend across platform between longitudinal slit 3015 and side 3012 3011.Protruding portion 3051 can be arranged around nail cavity 3050.Nail cavity 3050 can be arranged to longitudinal row and protruding portion 3051 can position Among the nail cavity 3050 in longitudinal nail chamber 3050.Protruding portion 3051 can be positioned on the nail cavity in adjacent longitudinal nail chamber 3050 Among 3050.Protruding portion 3051 can be positioned among most interior nail chamber 3050 and vertical passage 3015.Protruding portion 3051 can position Among outermost nail chamber 3050 with lateral edge 3012.Protruding portion 3051 can be fixed towards distal side relative to farthest side nail cavity 3050 Position.Protruding portion 3051 can proximally be positioned relative to recent side nail cavity 3050.Protruding portion 3051 can be relative to longitudinal slit 3015 Distal end towards distal side position.In other cases, protruding portion 3051 can not be relative to the distal end of longitudinal slit 3015 It is positioned towards distal side.
Nail bin 3100 is as shown in Figure 61 and Figure 62.Nail bin 3100 may include warehouse 3110.Warehouse 3110 may include distal end portion Portion 3113, proximal end and opposite side 3112.Similar to above-mentioned, each side 3112 may include unlimited due to wherein Recess adjacent edge.Warehouse 3110 may also include such as platform 3111, the multiple nail cavities 3150 being defined in platform 3111, And it is configured to receive the longitudinal slit 3115 of the edge of a knife of firing member.Warehouse 3110 may also include from storehouse platform 3111 The protruding portion 3151 of extension.In all cases, protruding portion 3151 may include pattern.In at least one situation, each protrusion Portion 3151 may include dome configuration.Dome configuration may include such as hemispherical projections.In some cases, dome can be with flat table Face and terminate.As shown in Figure 61, protruding portion array 3151 can extend across platform between longitudinal slit 3115 and side 3112 3111.Protruding portion 3151 can be arranged around nail cavity 3150.Nail cavity 3150 can be arranged to longitudinal row and protruding portion 3151 can position Among the nail cavity 3150 in longitudinal nail chamber 3150.Protruding portion 3151 can be positioned on the nail cavity in adjacent longitudinal nail chamber 3150 Among 3150.Protruding portion 3151 can be positioned among most interior nail chamber 3150 and vertical passage 3115.Protruding portion 3151 can position Among outermost nail chamber 3150 with lateral edge 3112.Protruding portion 3151 can be fixed towards distal side relative to farthest side nail cavity 3150 Position.Protruding portion 3151 can proximally be positioned relative to recent side nail cavity 3150.Protruding portion 3151 can be relative to longitudinal slit 3115 Distal end towards distal side position.In other cases, protruding portion 3151 can not be relative to the distal end of longitudinal slit 3115 It is positioned towards distal side.
Nail bin 3200 is as shown in Figure 63.Nail bin 3200 may include warehouse 3210.Warehouse 3210 may include distal end 3213, Proximal end and opposite side 3212.Similar to above-mentioned, each side 3212 may include infinitely due to recess therein Adjacent edge.Warehouse 3210 may also include such as platform 3211, the multiple nail cavities 3250 being defined in platform 3211 and by structure Cause can to receive the longitudinal slit 3215 of the edge of a knife of firing member.Warehouse 3210 may also include from the prominent of the extension of storehouse platform 3211 Portion 3251 out.Similar to protruding portion 2051, protruding portion 3251 is configured to engagement and is located among anvil block and storehouse 3200 Tissue and control movement of the tissue relative to storehouse 3200.In all cases, protruding portion 3251 is configured to limit Make or prevent tissue relative to the flowing of nail bin.Protruding portion 3251 can be positioned on the proximal end and/or distal end portion of nail cavity 3250 At portion.In all cases, each protruding portion 3251 may include the hoop extended around the end of nail cavity 3250.In certain situations Under, each protruding portion 3251 may include the arch spine extended around the end of nail cavity 3250.In all cases, each protrusion Portion 3251 may include the one or more protrusions 3254 limited thereon.Protrusion 3254 can provide texturizing surfaces, so as to improve The chucking power or retentivity that protruding portion 3251 can apply to the tissue being located among anvil block and nail bin 3200.In various situations Under, each protrusion 3254 may include such as convex block.In some cases, each protrusion 3254 may include dome.In at least one In the case of, protrusion 3254 can be by the elastomeric material that is for example molded on the protruding portion 3251 that can be for example made of plastic material (such as rubber, thermoplastic elastomer (TPE) and/or santoprene) is constituted.In all cases, protrusion 3254 can be made of pliable material And the tissue compressed by protrusion 3254 may not be injured.Warehouse 3210 may also include protruding portion 3253.Similar to protruding portion 2053, protruding portion 3253 can be positioned at the distal end of farthest side nail cavity 3250.Each protruding portion 3253 may include for example by It is constructed to be permeable to be conducive to the distal ramped surface for the insertion that group is woven between nail bin 3200 and anvil block.In all cases, most Distal chamber 3250 respectively may include the protruding portion 3253 positioned at its distal end and the protrusion being located at its proximal end Portion 3251.It is also similar to above-mentioned, each protruding portion 3251 and/or protruding portion 3253 are configured to support and removedly deposit Store up at least part of the nail in nail cavity 3250.
Nail 2130 is as shown in figure 24 including base portion 2131, the first nail leg 2132a extended from the first end of base portion 2131 With the second nail leg 2132b extended from the second end of base portion 2131.The first end of base portion 2131 and the second of base portion 2131 The distance between end is referred to alternatively as hat distance, and is indicated by dimension E.First nail leg 2132a includes extending from base portion 2131 The first part 2133a and second part 2134a extended from first part 2133a.First part 2133a can with first angle from Base portion 2131 extends.This first angle can be indicated by the angle F measured from vertical direction.Second part 2134a can be with second jiao Degree extends from first part 2133a.This second angle can be indicated by the angle K measured from vertical direction.Reader will appreciate that first Part 2133a and second part 2134a is not on the same line；But first part 2133a is along first axle 2137a Extend and second part 2134a extends along the second axis 2138a different from first axle 2137a.Connector 2135a makes first Part 2133a and second part 2134a is interconnected and is located at from the support surface 2139 on the bottom for being defined in base portion 2131 and measures Distance D at.Second part 2134a includes being located at from the leg top at the distance C that base portion supports surface 2139 measures 2136a.First part 2133a may include the first cantilever extended from base portion 2131 and second part 2134a may include from first The second cantilever that part 2133a extends.Distance D can limit the difference between the first hron spacing and distance C and distance D and can limit Second hron spacing.
Second nail leg 2132b includes the first part 2133b extended from base portion 2131 and extends from first part 2133b Second part 2134b.First part 2133b can be extended with first angle from base portion 2131.This first angle can be by from vertical side It is indicated to the angle G of measurement.Angle G can both be identical to may also differ from above-mentioned angle F.When the second nail leg 2132b is relative to When one nail leg 2132a is positioned towards distal side, at least one situation, angle G can be, for example, less than angle F.Alternatively, when the first nail When leg 2132a is positioned relative to the second nail leg 2132b towards distal side, at least one situation, angle F can be, for example, less than angle G. Second part 2134b can be extended with second angle from first part 2133b.This second angle can be by also measuring from vertical direction Angle H is indicated.Angle H can both be identical to may also differ from above-mentioned angle K.When the second nail leg 2132b is relative to the first nail leg When 2132a is positioned towards distal side, at least one situation, angle H can be, for example, less than angle K.Alternatively, when the first nail leg When 2132a is positioned relative to the second nail leg 2132b towards distal side, at least one situation, angle K can be, for example, less than angle H.It reads Person will be appreciated that first part 2133b and second part 2134b not on the same line；But first part 2133b along First axle 2137b extends and second part 2134b extends along the second axis 2138b different from first axle 2137b.It connects Head 2135b makes first part 2133b and second part 2134b interconnect and be located at from the support on the bottom for being defined in base portion 2131 At the distance B that surface 2139 measures.Distance B can both be identical to may also differ from above-mentioned distance D.Second part 2134b includes position In the leg end 2136b from the distance A that base portion supports surface 2139 measures.Distance A can both be identical to may also differ from above-mentioned Distance C.First part 2133b may include the first cantilever extended from base portion 2131 and second part 2134b may include from first The second cantilever that part 2133b extends.Distance B can limit the difference between the first hron spacing and distance A and distance B and can limit Second hron spacing.Between the first end 2136a of first nail leg 2132a and the second end 2136b of the second nail leg 2312 Distance can limit the extended range between nail leg 2132a, 2132b and be indicated by distance J.Distance J both can be wider than or be not wider than Above-mentioned hat distance E.
Figure 25 shows the nail supported in the nail cavity 2150 for being located in and being defined in storehouse 2110 and by staple drivers 2040 2130.It is inwardly biased or is bent by the end wall of nail cavity 2150 reader will appreciate that following closely 2130 leg 2132a and 2132b.Cause This, distance A, B, C, D, E and J may have changed and be represented respectively by A ', B ', C ', D ', E ' and J '.Nail 2130 can be for example by bullet Property material (such as stainless steel and/or titanium) constitute, and when follow closely 2130 from nail cavity 2150 eject when, the variation of these distances is reversible Turn, or at least partly reverses.Similarly, angle F, G, H and K may change because that will follow closely 2130 and be located in nail cavity 2150 and It is represented respectively by angle F ', G ', H ' and K '.As described above, nail 2130 can be made of elastic material, and work as nail 2130 from nail cavity When 2150 ejection, the variation of these distances is reversible, or at least partly reverses.Figure 25 shows the nail in non-firing position 2130 and driver 2040.The end 2136a of non-firing position herein, the first nail leg 2132a can be in the platform surface in storehouse 2110 2111 tops extend and can be positioned on out of platform surface 2111 extends protruding portion 2150a and protected by the protruding portion, and Similarly, the end 2136b of the second nail leg 2132b can extend above platform surface 2111 and can be positioned on from platform surface It is protected in the 2111 protruding portion 2150b extended and by the protruding portion.
Nail 2230 is as shown in figure 26.Nail 2230 may include base portion 2231, from base portion 2231 extend the first leg 2232a, And the second leg 2232b extended from base portion 2231.First leg 2232a may include the first part for being connected to base portion 2231 The 2233a and second part 2234a extended from first part 2233a.Second leg 2232b may include being connected to base portion 2231 The first part 2233b and second part 2234b extended from first part 2233b.Base portion 2231, first part 2233a and A part of 2233b may include substantially V-shaped configuration.In all cases, second part 2234a can be at connector 2235a from first Part 2233a extends internally, and similarly, and second part 2234b can inwardly prolong at connector 2235b from first part 2233b It stretches.Base portion 2231, the construction of the first leg 2232a and the second leg 2232b and arrangement can be set so that nail 2230 is being schemed It is symmetrical in its unshaped or non-percussion configuration shown in 26.In all cases, the first leg 2232a can be relative to the second leg 2232b is positioned towards distal side.Alternatively, the first leg 2232a can proximally be positioned relative to the second leg 2232b.
Nail 2330 is as shown in figure 27.Nail 2330 may include base portion 2331, from base portion 2331 extend the first leg 2332a, And the second leg 2332b extended from base portion 2331.First leg 2332a may include being connected to base portion along what axis extended 2331 straight portion 2333a.Second leg 2332b may include being connected to the first part 2333b of base portion 2331 and from first part The second part 2334b that 2333b extends.Base portion 2331, straight portion 2333a and first part 2333b may include substantially V-shaped configuration. In all cases, second part 2334b can extend internally at connector 2335b from first part 2333b.Base portion 2331, The construction and arrangement of one leg 2332a and the second leg 2332b can be set so that nail 2330 shown in Figure 27 its not at It is symmetrical in shape or non-percussion configuration.In all cases, the first leg 2332a can be fixed towards distal side relative to the second leg 2332b Position.Alternatively, the first leg 2332a can proximally be positioned relative to the second leg 2332b.
Nail 2430 is as shown in figure 28.Nail 2430 may include base portion 2431, from base portion 2431 extend the first leg 2432a, And the second leg 2432b extended from base portion 2431.First leg 2432a may include the first part for being connected to base portion 2431 The 2433a and second part 2434a extended from first part 2433a.Second leg 2432b may include being connected to base portion 2431 The first part 2433b and second part 2434b extended from first part 2433b.Base portion 2431, first part 2433a and A part of 2433b may include substantially V-shaped configuration.In all cases, second part 2434a can be at connector 2435a with first Angle extends internally from first part 2433a, and similarly, second part 2434b can at connector 2435b with second angle from First part 2433b extends internally.First angle and second angle can be different.Base portion 2431, the first leg 2432a and the second leg The construction and arrangement of portion 2432b can be set so that right in 2430 its unshaped shown in Figure 28 of nail or non-percussion configuration Claim.In all cases, the first leg 2432a can be positioned relative to the second leg 2432b towards distal side.Alternatively, the first leg 2432a can proximally be positioned relative to the second leg 2432b.
Nail 2530 is as shown in figure 29.Nail 2530 may include base portion 2531, from base portion 2531 extend the first leg 2532a, And the second leg 2532b extended from base portion 2531.First leg 2532a may include the first part for being connected to base portion 2531 The 2533a and second part 2534a extended from first part 2533a.Second leg 2532b may include being connected to base portion 2531 The first part 2533b and second part 2534b extended from first part 2533b.Base portion 2531, first part 2533a and A part of 2533b may include substantially V-shaped configuration.In all cases, second part 2534a can be at connector 2535a with first Angle extends internally from first part 2533a, and similarly, second part 2534b can at connector 2535b with second angle from First part 2533b extends internally.First angle and second angle can be different.Base portion 2531, the first leg 2532a and the second leg The construction and arrangement of portion 2532b can be set so that right in 2530 its unshaped shown in Figure 29 of nail or non-percussion configuration Claim.Nail 2530 can be similar in many aspects nail 2430 and may include the base for being for example wider than base portion 2431 at least one situation Portion 2531.In some cases, when nail leg 2532a and/or nail leg 2532b extends along the direction closer to vertical direction, Broader base portion can be accommodated in given nail cavity.In all cases, the first leg 2532a can be relative to the second leg 2532b is positioned towards distal side.Alternatively, the first leg 2532a can proximally be positioned relative to the second leg 2532b.
As discussed above, being trapped in the tissue between the anvil block of surgical end-effector and nail bin can exist during use It moves in end effector or is flowed relative to end effector.Also as discussed above, this movement or flowing can be held in end The firing member of row device moves toward the far side when removedly storing the nail in nail bin to fire and cut tissue as substantially distal side 's.If firing member proximally moves, then the movement or flowing organized may be substantially nearside.Nevertheless, tissue Distal side flowing can be such that nail shifts towards distal side during percussion.This phenomenon is shown in FIG. 30.Figure 30 is shown from being defined in storehouse The nail 2630 that nail cavity 2650 in body 2610 ejects.Nail 2630 is shown at least partly firing position, in this position, nail 2630 base portion 2631 is just moved upwards by staple drivers 2640 towards anvil block 20, and in this position, follows closely 2630 leg 2632a, 2632b are ejected from nail cavity 2650 and have been contacted anvil block 20.Such as reader will appreciate that, nail cavity 2650 may include being constructed At the first protruding portion 2651a and the first end wall 2652a that can support the first nail leg 2632a and similarly it is adapted to It is enough follow closely 2630 ejected by driver 2640 from nail cavity 2650 when support the second protruding portion 2651b and the of the second nail leg 2632b Two side wall 2652b.However, as shown in figure 30, nail 2630 can shift during percussion towards distal side, so that nail leg 2632a is separate First end wall 2652a is shifted and nail leg 2632b is shifted on the second protruding portion 2651b.Although nail 2630 is shifted towards distal side, First leg 2632a has still been received in the first forming cup 22a of the nail pit being defined in anvil block 20 and the second leg 2632b It has still received in the second forming cup 22b of nail pit.Although nail leg 2632a, 2632b can contact its correspondingly configured cup 22a, 22b, but the distal side displacement of nail 2630 may not cause to be symmetrically staple shown in such as Figure 31.Figure 31 is shown to be driven by nail Device 2640 is improved to greater than the position on the storehouse platform surface 2611 of warehouse 2610 and is deformed into the nail 2630 of its complete firing configuration.
As discussed above, symmetrical nail can asymmetrically be deformed because being trapped in the tissue displacement in end effector. In all cases, nail bin is for example followed closely using the asymmetry that can compensate for this displacement, such as shown in Figure 24 and Figure 27 to Figure 29 Asymmetry nail.These asymmetry nail nail legs can be configured so that in this way when asymmetry nail towards distal side shift when, it The orientation that them can be caused to be deformed into symmetrical or at least more symmetrical percussion configuration can be shifted into.Figure 84 is shown including warehouse 4810 nail bin 4800, the warehouse include the asymmetry for being defined in multiple nail cavities 4850 therein, being located in nail cavity 4850 It follows closely and is configured to that the multiple drivers 4840 ejected from nail cavity 4850 will be followed closely.Warehouse 4810 may include distal end 4813 and proximal end 4816, wherein nail cavity 4850 can be arranged to the longitudinal row being defined in warehouse 4810.Warehouse 4810 exists By transversal in a manner of such in Figure 84, so that showing such longitudinal nail chamber 4850.In some cases, it removedly deposits Store up nail in longitudinal nail chamber 4850 can asymmetric configuration having the same, and in other cases, as shown in Figure 84, nail can With different asymmetric configurations.For example, nail 4830' is stored in the proximal end longitudinally arranged and follows closely 4830 " and be stored in longitudinal direction In the distal end of row.Similar to above-mentioned, each nail 4830' may include the first nail leg 4832a' and the second nail leg 4832b', Described in one or both of nail leg for example may include several segments, such as segment 4833b' of the second nail leg 4832b' And 4834b'.It is also similar to above-mentioned, each nail 4830 " may include the first nail leg 4832a " and the second nail leg 4832b ", wherein institute Stating one or both of nail leg for example may include several segments, such as segment 4833a " of the first nail leg 4832a " and The segment 4833b " and 4834b " of 4834a " and the second nail leg 4832b'.After comparison nail 4830' and nail 4830 ", reader will Understand, between segment 4833b' and 4834b' of the angle between the segment 4833b " and 4834b " of nail 4830 " than following closely 4830' Angle becomes apparent from or bigger.In other words, distal side nail 4830 " is less symmetrical than nearside nail 4830'.In some cases, it follows closely Histokinesis at the distal end 4813 in storehouse 4800 can be greater than the histokinesis at proximal end 4816, and correspondingly, nail takes To displacement can at the distal end 4813 of nail bin 4800 ratio it is big at proximal end 4816.Compared to be subjected to compared with tingle shift Nearside nail 4830' smaller asymmetry, distal side nail 4830 " larger asymmetry can compensate for compared with spike shift.This is One example and different nail can be compensated using the nail of any suitable species in staple and shift.For example, it is envisioned that being located at longitudinal Nail at the proximal end of row, which can have, follows closely big asymmetry than being located at the distal end longitudinally arranged.It is contemplated that longitudinal row Using more than two groups asymmetry nails.
As described above, the histokinesis or flowing at the distal end of end effector can be greater than end in all cases Histokinesis or flowing at the proximal end of actuator.Such case can be transported because of distal side of the firing member in end effector It moves and occurs.Although firing member is configured to move toward the far side with it and progressively suture and cut tissue, hit Tissue can also be promoted or push towards distal side by sending out component.This push or propulsion efficiency can since the proximal end of end effector and It can be moved toward the far side with firing member and compound, so that realizing maximum promotion at the distal end of end effector or pushing away Into effect.Therefore, than that described above, histokinesis can be compensated using the gradient of nail asymmetry in longitudinal staple and nail moves The gradient of position.
In addition to or replace it is above-mentioned, nail bin can using have different height protruding portion be woven in end effector to control group Movement.In all cases, nail bin can be reduced from the protruding portion disclosed herein that the platform of nail bin extends and end executes Gap between the anvil block of device.Therefore, compared to the embodiment of not protruding portion, protruding portion can be to being located in anvil block and nail bin Intermediate tissue applies bigger local pressure.In all cases, with high height protruding portion can to tissue apply compared with Big compressing force or pressure and the protruding portion with lower height can apply relatively small compressing force or pressure to tissue.Along These lines, compared with lower protruding portion, higher protruding portion can provide histokinesis bigger control.If reader can remember, end Histokinesis at the proximal end of portion's actuator is smaller than the histokinesis at the distal end of end effector, and because This, referring again to Figure 84, nail bin 4800 can utilize lower protruding portion 4851' and the distal side at the proximal end 4816 of warehouse 4810 Higher protruding portion 4851 " at end 4813.In at least one situation, lower protruding portion 4851' can be from the flat of warehouse 4810 4811 extended distance 4855' of platform surface and higher protruding portion 4851 " can be from lower protruding portion 4851' extended distance 4855 ".At certain In a little situations, the protruding portion extended from warehouse may include the height ladder extended between the proximal end and distal end of warehouse Degree.In at least one situation, as discussed above, the highest protruding portion of the gradient can at the distal end of warehouse institute The minimum protruding portion for stating gradient can be at the proximal end of warehouse.In other cases, the highest protruding portion of the gradient can be At the proximal end of warehouse and the minimum protruding portion of the gradient can be at the distal end of warehouse.
As discussed above, histokinesis can make to follow closely and shift with it from cartridge deployment.In all cases, with it is lower Protruding portion is compared, and higher protruding portion can provide bigger control to this displacement.It is and lower more specifically, referring again to Figure 84 Proximal projections 4851' is compared, and higher distal projections 4851 " can be such that nail pit 4850 extends more, so that nail 4830 " is by remote The control of side protruding portion 4851 " is controlled longer distance by proximal projections 4851' than nail 4830'.It is being followed closely compared to nail 4830' The distance that the leg of 4830' is lifted up before the ejection of chamber 4850, higher protruding portion 4851 " can also increase nail 4830 " and follow closely The distance that 4830 " leg is lifted up before the ejection of chamber 4850.This arragement construction can shorten such as nail 4830 " in nail bin Distance and/or the time of larger histokinesis are exposed at 4800 distal end.
As discussed above, nail bin can utilize the nail of more than one configuration in longitudinal staple.In all cases, nail bin Using the nail with various configuration in different longitudinal staples.In at least one situation, nail bin may include first longitudinal direction nail The nail with the second configuration in the nail and second longitudinal direction staple with the first configuration in row.Turning now to Figure 49 and Figure 49 A, Nail bin 2700 for example may include being defined in multiple longitudinal nail chambers 2750 therein, wherein the nail cavity 2750 being defined in first row Respectively may include first nail 2730'(Figure 50 being removedly stored therein), the nail cavity 2750 being defined in second row is respective It may include second 2730 " (Figure 51) of nail being removedly stored therein, and the nail cavity 2750 being defined in third row respectively may be used Third including being removedly stored therein follows closely 2730 " ' (Figure 52).First nail 2730' can be positioned on most interior longitudinal nail chamber In 2750, the second nail 2730 " be can be positioned in intermediate row nail cavity 2750, and third nail 2730 " ' can be positioned on outermost longitudinal row In nail cavity 2750.When with first height A'(Figure 50) first nail 2730' and with the second height A " (Figure 51) second nail 2730 " be in its non-percussion configuration when, second nail 2730 " can be higher than first nail 2730'.Similarly, when the second nail 2730 " and tool When having the third nail 2730 " ' of third height A " ' (Figure 52) in its non-percussion configuration, third nail 2730 " ' can be higher than the second nail 2730”。
In all cases, nail can be supported by longitudinal nail driver longitudinally in each.For example, first longitudinal direction nail drives Device can support first row first and follow closely 2730', and second longitudinal direction nail driver can support the nail of second row second 2730 ", and third Longitudinal nail driver can support third ranked third nail 2730 " '.In some cases, 9 and Figure 49 A, a nail are driven referring to fig. 4 Dynamic device 2742 can support first row first and follow closely 2730' and the second nail 2730 ", so that each staple drivers 2742 are sustainable and hit For example, at least one first nail 2730' of hair and at least one second nail 2730 ".One nail driver 2740 can support third and arrange Three nails 2730 " ', so that each staple drivers 2740 are sustainable and fire at least one third nail 2730 " '.Staple drivers 2742 It respectively may include being configured to the first base 2741' of the first nail of support 2730' and being configured to support the second nail 2730 " second base 2741 ", and similarly, staple drivers 2740 respectively may include being configured to support third nail 2730 " ' third pedestal 2741 " '.When staple drivers 2740 and 2742 are in its non-firing position, as shown in Figure 49 A, the One pedestal 2741' can be supported on and be defined in the first row forming pit 23 in anvil block 20 and be separated by first distance 2732', the Two pedestals 2741 " can be supported on and be defined in the second row forming pit 23 in anvil block 20 and be separated by 2732 " place of second distance, and Third pedestal 2741 " ' can be supported on and be defined in the row's forming pit of the third in anvil block 20 and be separated by the place of third distance 2732 " '. First distance may differ from second distance and/or second distance may differ from third distance.As shown in figure 49, first distance is shorter than Second distance and second distance are shorter than third distance.When driver 2740 and 2742 is promoted by firing member 2760 towards anvil block 20, Such as when ejecting nail 2730', 2730 " and 2730 " ' from nail cavity 2750, the first nail 2730', the second nail 2730 " and/or third Nail 2730 " ' can be deformed into different forming heights.(that is, nail 2730') can shape as the first forming height for example, most interior nail, Intermediate nail (that is, nail 2730 ") can shape as the second forming height, and outer nail (that is, nail 2730 " ') can shape for third at Shape height.First height can be lower than the second height and the second height can be lower than third height.The name that on November 27th, 2012 announces Referred to as " generate surgical stapling device (the SURGICAL STAPLING DEVICES THAT with the forming nail of different length PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS) " 8,317,070 full text of United States Patent (USP) to draw It is incorporated to mode.
In all cases, the storehouse platform of nail bin can be flat.In this case, protruding portion as described herein can be from Flat platform surface extends.In other cases, the storehouse platform of nail bin may include for example at least two stepped surfaces Stepped surface.Referring again to Figure 49 and Figure 49 A, the warehouse 2710 of nail bin 2700 may include being located in longitudinal knife channel 2715 The first side on the first platform side and the second platform side for being located in the second side in longitudinal knife channel 2715.Each platform side Including such as the first ladder 2711', the second ladder 2711 " and third ladder 2711 " '.First longitudinal direction nail chamber 2750 can limit In the first ladder 2711', second longitudinal direction nail chamber 2750 can be defined in the second ladder 2711 ", and third longitudinal direction nail chamber 2750 can be defined in third ladder 2711 " '.When anvil block 20 is in its closed position, the tissue contacting surface 21 of anvil block 20 It can be positioned adjacent to the platform surface of warehouse 2710.In this case, tissue contacting surface 21 can be positioned so that and the first ladder 2711' is separated by first distance 2712', with the second ladder 2711 " be separated by second distance 2712 " and with 2711 " ' phase of third ladder Every third distance 2712 " '.In all cases, first distance, second distance and/or third distance can be different.Such as Figure 49 and figure Shown in 49A, first distance 2712' is shorter than second distance 2712 " and second distance 2712 " is shorter than third distance 2712 " '.Each In the case of kind, first distance 2712' can limit the first tissue gap, second distance between the first ladder 2711' and anvil block 20 2712 " can limit minor microstructure gap between the second ladder 2711 " and anvil block 20, and third distance 2712 " ' can be in third Ladder 2711 " ' third tissue space is limited between anvil block 20.It is located in the first tissue gap of most 2750 top of interior nail chamber It is smaller than the third tissue space for being located in outermost 2750 top of nail chamber.It is centrally positioned second group of 2750 top of nail chamber The first tissue gap can be greater than but be less than third tissue space by knitting gap.
Than that described above, and referring again to Figure 49 and Figure 49 A, first longitudinal direction arranges protruding portion 2751' can be from the first ladder 2711' extends, and second longitudinal direction row's protruding portion 2751 " can extend from the second ladder 2711 ", and third longitudinal direction row's protruding portion 2751 " ' It can extend from third ladder 2711 " '.First protruding portion 2751' can be limited by the first height 2755', and the second protruding portion 2751 " can 2755 " limited by the second height, and third protruding portion 2751 " ' can by third height 2755 " ' limit.It is first height, second high Degree and/or third height can be different.As shown in Figure 49 and Figure 49 A, the first height 2755' can be lower than the second height 2755 " and the Two height 2755 " can lower than third height 2755 " '.In all cases, minimum longitudinal row protruding portion (that is, protruding portion 2751') It can extend along most interior nail chamber 2750, highest longitudinal direction row's protruding portion (that is, protruding portion 2751 " ') can be along outermost nail chamber 2750 extend, and the protruding portion (that is, protruding portion 2751 ") with intermediate altitude can extend along intermediate row nail cavity 2750.Figure 76 Show alternative embodiment, wherein highest longitudinally row's protruding portion (that is, protruding portion 2751 " ') along most interior nail chamber 2750 Extending, minimum longitudinal row protruding portion (that is, protruding portion 2751') extends along outermost nail chamber 2750, and with intermediate altitude Protruding portion (that is, protruding portion 2751 ") can extend along intermediate row nail cavity 2750.
Referring again to Figure 76, nail bin 4000 can be similar to nail bin 2700 as discussed above in many aspects.Similar to nail Storehouse 2700, nail bin 4000 may include longitudinal nail chamber 2750, and the longitudinal direction nail chamber includes first row nail cavity 2750, the second nail Chamber 2750 and third nail chamber 2750, the first row nail cavity includes that first be removedly stored therein follows closely 2730', described Second row nail cavity includes the second nail 2730 " being removedly stored therein, and the third nail chamber includes removedly storing In third nail 2730 " ' wherein.With nail bin 2700 on the contrary, the first nail 2730' includes outermost nail and third nail 2730 " ' Including most interior nail.Nail bin 4000 may include driver 4040 and 4042, and the driver is configured in driver 4040 and 4042 in do not fire or when non-raised position by 2730 " ' the support of third nail at anvil block 20 be separated by third forming away from From 2732 " ', the 2730 " support of the second nail is separated by the second forming distance 2732 " at anvil block 20, and follow closely 2730' branch for first It supports into and is separated by the first forming distance 2732' with anvil block 20.Driver 4040 and 4042 can be such that most interior nail (that is, nail 2730 " ') becomes Shape is third forming height, and intermediate nail (that is, nail 2730 ") is made to be deformed into the second forming height, and make outermost nail (that is, Nail 2730') it is deformed into the first forming height.For example, third forming height can be higher than the second forming height and the second forming height The first forming height can be higher than.Similar to nail bin 2700, nail bin 4000 may include staged platform surface；However, third ladder 2711 " ' can along most interior nail chamber 2750 extend and the first ladder 2711' can extend along outermost nail chamber 2750.By first The first tissue gap that clearance distance 2712' is limited can be relative to the minor microstructure gap limited by the second clearance distance 2712 " It is positioned towards laterally outside, the second clearance distance 2712 " can be relative between the third tissue limited by third space distance 2712 " ' Gap is positioned towards laterally outside.
Nail bin 3600 is as shown in Figure 70 to Figure 72.Nail bin 3600 may include warehouse 3610.Warehouse 3610 may include distal end portion Portion 3613, proximal end 3616 and opposite side 3612.Warehouse 3610 may also include such as platform 3611, be defined in it is flat It multiple nail cavities 3650 in platform 3611 and is configured to receive the longitudinal slit 3615 of the edge of a knife of firing member.Warehouse 3610 may also include the protruding portion 2051 and 2053 extended from storehouse platform 3611.Warehouse 3610 may also include to be prolonged from storehouse platform 3611 The protruding portion 3651 stretched.Similar to protruding portion 2051, protruding portion 3651 is configured to engagement and is located in anvil block and storehouse It organizes among 3600 and controls movement of the tissue relative to storehouse 3600.In all cases, protruding portion 3651 can be constructed At flowing of the tissue relative to nail bin can be restricted or prevented.Protruding portion 3651 can be positioned on nail cavity 3650 proximal end and/ Or at distal end.In all cases, each protruding portion 3651 may include the hoop extended around the end of nail cavity 3650.At certain In a little situations, each protruding portion 3651 may include the arch spine extended around the end of nail cavity 3650.In all cases, it dashes forward Portion 3651 may not be high as protruding portion 2051 and/or protruding portion 2053 out.Compared with lower protruding portion 3651, higher protrusion Portion 2051 can apply bigger local pressure to tissue.In all cases, protruding portion 2051 can provide enough controls to tissue System is be held in place tissue during percussion.In this case, it is located in nail cavity 3650 in addition to protecting and guiding Other than nail, protruding portion 3651 can also provide tissue some other control.
Than that described above, platform 3611 may include ladder 2711', 2711 " and 2711 " ', and the ladder is configured to Tissue of the compression set among warehouse 3610 and anvil block.In all cases, third ladder 2711 " ' may include along outermost The lowest deck surface that nail chamber 3650 and the distal end 3613 for surrounding warehouse 2610 extend.Second ladder 2711 " can be from most Low platform surface 2711 " ' upwardly extends and the first ladder 2711' can be upwardly extended from the second ladder 2711 ".When 3610 phase of warehouse When for tissue sliding, tissue can be in the distal end 3613 of warehouse 3610 and to ladder 2711', 2711 " and 2711 " ' Flowing.Warehouse 3610 may also include slope 3614' and 3614 ", the slope be respectively configured to can aid in tissue to ladder The sliding of 2711' and 2711 ".It is also as discussed above, controlled using ladder 2711', 2711 " and 2711 " ' tissue relative to The flowing of nail bin 3600.Referring primarily to Figure 71, compared to the tissue space limited between ladder 2711 " and anvil block and/or Ladder 2711 " ' the tissue space that is limited between the anvil block, ladder 2711' can in all cases storehouse 3600 with it is described Smaller tissue space, the anvil block and 3600 relative positioning of storehouse are limited between anvil block.In ladder 2711' and minimum tissue space In the case where adjacent with longitudinal slit 3615, with compared with the tissue of ladder 2711' lateral register, with longitudinal slit 3615 Adjacent tissue can be subjected to more compressing and more controlling.This embodiment can be for various reasons advantageous. For example, can attempt to make to be trapped in the displacement of tissue nail bin 3600 and anvil block across the cutting element of longitudinal slit 3615, and By the compression that most interior ladder 2711' is applied, the displacement of tissue can be prevented, mitigates or reduced.
As discussed above in association with embodiment shown in Figure 76, nail bin may include wherein minimum tissue space and outermost longitudinal direction The coextensive staged platform surface of nail chamber.In this case, minimum tissue space can be adjacent with the side in storehouse, and due to most The compression that outer ladder is applied can prevent, mitigate or reduce the displacement of tissue, the lateral displacement especially organized.In certain feelings Under condition, referring again to Figure 70 to Figure 72, it can prevent, mitigate or reduce being trapped in nail bin 3600 and anvil by lateral side wall 3617 The lateral displacement of tissue between seat.Each lateral side wall 3617 can extend from the side of warehouse 3,610 3612 and hinder tissue Lateral movement.Side wall 3617 may include any suitable configuration.In at least one situation, each side wall 3617 may include example Such as crenation top surface.Turning now to Figure 73, nail bin 3700 may include warehouse 3710, and the warehouse includes from warehouse 3710 The lateral side wall 3717 that side 3712 extends.In at least one situation, each lateral side wall 3717 may include for example straight top Portion surface.
Turning now to Figure 74, nail bin 3800 may include warehouse 3810, and the warehouse includes distal end 3813 and nail cavity 3850.Similar to above-mentioned, warehouse 3810 may include the protruding portion 2053 at the distal end of farthest side nail cavity 3850.Also class Be similar to it is above-mentioned, warehouse 3810 may include can around at least some of nail cavity 3850 proximal end and/or distal end it is prominent Portion 2051 out.In addition to or replace protruding portion 2051 and 2053, staple cartridge body 3810 may also include protruding portion 3851 extending therefrom.Often A protruding portion 3851 can extend around the end of more than one nail cavity 3850.In at least one situation, each protruding portion 3851 Can the end of nail cavity 3850 for example in most interior nail chamber 3850, nail cavity 3850 in outermost nail chamber 3850 end And/or the end of the nail cavity 3850 in intermediate row nail cavity extends.In at least one such situation, first of protruding portion 3851 Dividing can make the first nail cavity 3850 extend beyond storehouse platform surface, and the second part of protruding portion 3851 can be such that the second nail cavity 3850 extends Part III more than storehouse platform surface, and protruding portion 3851 can make third nail cavity 3850 extend beyond storehouse platform surface.It is prominent The first part in portion 3851 can protect, guide and/or keep the first nail, and second part can protect, guide and/or keep second Nail, and Part III can protect, guide and/or keep third to follow closely.In all cases, protruding portion 3851 can be defined in warehouse Longitudinal slit 3615 in 3810 and extend between the lateral side wall 3717 that warehouse 3810 extends.In at least one such situation Under, protruding portion 3851 can extend across the first ladder 2711', the second ladder 2711 " and/or third ladder 2711 " '.In other words It says, protruding portion 3851 can extend across the variation of the height of the platform of warehouse 3810.In some cases, although storehouse platform surface Height variation, the top of protruding portion 3851 or tissue engagement surface still can be flat.In other cases, protruding portion 3851 top or tissue engagement surface can also change in height.In at least one such situation, the top of protruding portion 3851 Portion surface can for example be increased in height when platform surface increases in height and when platform surface reduces in height It is reduced in height.In other cases, the top surface of protruding portion 3851 can for example when platform surface increases in height It reduces in height and is increased in height when platform surface reduces in height.
In all cases, referring again to Figure 74, warehouse 3810 may include laterally projecting portion extending therefrom or rib 3817. Laterally projecting portion 3817 can extend transverse to longitudinal slit 3615 and/or lateral side wall 3717.In at least one situation, laterally Protruding portion 3817 can extend along the direction for being transversely to the machine direction slit 3615 and/or lateral side wall 3717.In at least one situation, Laterally projecting portion 3817 can extend between protruding portion 3851 and side wall 3717.It laterally projecting portion 3817 can also be in protruding portion 2051 Extend between side wall 3717, and similarly, extends between protruding portion 2053 and side wall 3717.In some cases, prominent Portion 3817 and side wall 3717 can be identical height.In other cases, protruding portion 3817 and side wall 3717 can be different height.Ginseng See Figure 74, side wall 3717 is for example higher than protruding portion 3817.Under any circumstance, laterally projecting portion 3817 is configured to limit It makes or prevents for example to organize relative to nail bin 3800, particularly along the flowing of distal side or longitudinal direction.
Turning now to Figure 81, nail bin 4500 may include warehouse 4510, and the warehouse includes platform 4511, proximal end, remote Side end 4513 and the longitudinal cutter groove 3615 extended between proximal end and distal end 4513.Except other feature structure In addition, warehouse 4510 may also include angled transition 2014, the protruding portion 2051 of at least partly about nail cavity 3650,2053 and 3651 and lateral side wall 3617.In fact, it is contemplated that going out the organizational controls feature of wherein various embodiments disclosed herein The various embodiments that structure can be combined with the organizational controls feature structure of the other embodiments disclosed herein.In addition, Whole disclosed herein is the nail cavity being wherein defined in nail bin may include the various of the protruding portion of at least partly about nail cavity Embodiment.Dream up wherein less than nail cavity whole include at least partly about nail cavity protruding portion other embodiment party Case.Turning now to Figure 82, nail bin 4600 may include warehouse 4610, and the warehouse includes platform 4611, proximal end 4616, distal side End 4613 and the longitudinal knife slot 4615 extended between proximal end 4616 and distal end 4613.Warehouse 4610 can Including some protruding portions 2051 and 2053 extended from platform 4611 and at least partly about nail cavity 4650.For example, Be defined in the nail cavity 4650 in the distal end 4613 of nail bin 4600 proximal end and/or distal end can at least partly by Protruding portion 2051 is surround, and similarly, be defined in the nail cavity 4650 in the proximal end 4616 of nail bin 4600 proximal end and/ Or distal end can at least partly be surround by protruding portion 2051.In such embodiment, it is defined in the middle part of warehouse 4610 The nail cavity 4650 of (that is, between proximal end 4616 and distal end 4613 of nail bin) can not by such as protruding portion 2051 and/or Any other protruding portion is surround.Turning now to Figure 83, nail bin 4700 may include warehouse 4710, the warehouse include platform 4711, Proximal end and distal end 4713.Warehouse 4710, which may also include, is defined in multiple nail cavities 4750 therein.Farthest side nail cavity 4750 may include by the circular distal end of protruding portion 2053 and the proximal end circular by protruding portion 2051.Other nail cavities 4750 It may include by the circular distal end of protruding portion 2051 and proximal end not circular by protruding portion.Certain nail cavities 4750 may include By the circular proximal end of protruding portion 2051 and distal end not circular by protruding portion.
As discussed above, protection, support and/or guidance is configured to from the protruding portion that platform surface extends to determine Nail of the position in nail pit.Figure 77 shows the nail bin 4100 including warehouse 4110, and the warehouse includes platform 4111, is defined in Nail cavity 4150 in platform 4111 and the protruding portion 4151 from the extension of platform 4111.Nail bin 4100 may also include removedly The nail 4130 being located in nail cavity 4150.Protruding portion 4151 may include being defined in slit 4154 therein, and the slit can be by structure Cause can when nail 4130 stores in nail cavity 4150 and/or when following closely 4130 and just being ejected from nail cavity 4150 support nail 4130 Leg 4132.Slit 4154 may include the extension of nail cavity end wall 4152.When nail 4130 is in non-firing position, nail cavity end wall 4152 and/or slit 4154 can altogether operation to support nail leg 4132.When following closely 4130 and ejecting from chamber 4150, leg 4132 can be from prominent Portion 4151 ejects out, as shown in Figure 77.In this case, end wall 4152 and/or slit 4154 are sustainable not yet from nail cavity The part of the nail 4130 of 4150 ejections.In some cases, protruding portion 4151 can not provide lateral support to nail leg 4132.More Body, referring to Figure 77, slit 4154 may include opposite side 4155, and the opposite side can be between the side of nail leg 4132 It separates, and does not contact the side of nail leg 4132.In all cases, when nail 4130 is still positioned at least partially in nail cavity 4150 When, nail 4130 may be deformed to its configuration that is badly deformed.In at least one such situation, end wall 4152 and/or slit 4154 can The support nail 4130 in the entire forming process of nail 4130.In other cases, nail 4130 can be elevated out slit at it 4154 and be more than to reach its configuration that is badly deformed after protruding portion 4151.In this case, end wall 4152 and slit 4154 can Not support nail 4130 in its entire forming process.
Figure 78 shows the nail bin 4200 including warehouse 4210, and the warehouse includes platform 4211, is defined in platform 4211 In nail cavity 4250 and from platform 4211 extend protruding portion 4251.Nail bin 4200, which may also include, is removably positioned in nail Nail 4130 in chamber 4250.Protruding portion 4251 may include being defined in slit 4254 therein, and the slit is configured to The leg of support nail 4130 when nail 4130 stores in nail cavity 4250 and/or when following closely 4130 and just being ejected from nail cavity 4250 4132.Slit 4254 may include the extension of nail cavity end wall 4252.When nail 4130 is in non-firing position, nail cavity end wall 4252 And/or slit 4254 can operate altogether to support nail leg 4132.When following closely 4130 from the ejection of chamber 4250, leg 4132 can be from protruding portion 4251 ejections, as shown in Figure 78.In this case, the sustainable nail 4130 of end wall 4252 and/or slit 4254 not yet from nail The part that chamber 4250 ejects.In some cases, protruding portion 4251 can provide lateral support to nail leg 4132.More specifically, ginseng See that Figure 78, slit 4254 may include opposite side 4255, the opposite side can contact the side of nail leg 4132.Various In the case of, when nail 4130 is still positioned at least partially in nail cavity 4250, nail 4130 may be deformed to its configuration that is badly deformed.? In at least one such situation, end wall 4252 and/or slit 4254 can in the entire forming process of nail 4130 support nail 4130. In other cases, nail 4130 can be elevated out slit 4254 at it and promoted complete higher than its is reached after protruding portion 4251 Full deformed configuration.In this case, end wall 4252 and slit 4254 can in its entire forming process not support nail 4130.
Figure 79 shows the nail bin 4300 including warehouse 4310, and the warehouse includes platform 4311, is defined in platform 4311 In nail cavity 4350 and from platform 4311 extend protruding portion 4351.Nail bin 4300, which may also include, is removably positioned in nail Nail 4130 in chamber 4350.Each protruding portion 4351 may include being defined in tapered slit 4354 therein, and the tapered slit can It is configured to the support nail when nail 4130 stores in nail cavity 4350 and/or when following closely 4130 and just ejecting from nail cavity 4350 4130 leg 4132.Each slit 4354 may include the extension of nail cavity end wall 4352 and may include side wall 4355.Work as nail 4130 when being in non-firing position, the side wall 4355 of each slit 4354 can altogether operation to support nail leg 4132.As reader will be from Figure 79 recognizes that nail leg 4132 can not be supported by end wall 4352.When following closely 4130 from the ejection of chamber 4350, leg 4132 can be from protrusion Portion 4351 ejects.In this case, the end wall 4355 of slit 4354 is sustainable not yet from the nail 4130 of the ejection of nail cavity 4350 Part.In some cases, the side wall 4155 of protruding portion 4351 can provide lateral support to nail leg 4132.In all cases, When nail 4130 is still positioned at least partially in nail cavity 4350, nail 4130 may be deformed to its configuration that is badly deformed.At least one In kind such situation, slit 4354 can in the entire forming process of nail 4130 support nail 4130.In other cases, 4130 are followed closely Its configuration that is badly deformed can be reached after it be elevated out slit 4354 and promotion is higher than protruding portion 4351.In this feelings Under condition, slit 4354 can in its entire forming process not support nail 4130.
Figure 80 shows the nail bin 4400 including warehouse 4410, and the warehouse includes platform 4411, is defined in platform 4411 In nail cavity 4450 and from platform 4411 extend protruding portion 4451a and 4451b.Nail bin 4400 may also include for example removable The nail 4130 being located in except ground in nail cavity 4450.Nail cavity 4450 may include the first end wall 4452a and the second end wall 4452b, described First end wall be configured to support and guide nail 4130 the first leg, second end wall be configured to support and Second leg of guidance nail 4130.Protruding portion 4451a can extend first distance 4455a from platform 4411 and protruding portion 4451b can The second distance 4455b of protruding portion 4451a is extended beyond from platform 4411.Therefore, in all cases, protruding portion 4451a can Support and the first nail leg first distance of guidance and protruding portion 4451b can support and the second nail leg second distance of guidance, wherein second Distance can be longer than first distance.In some cases, protruding portion 4451b can be positioned at the distal end of nail cavity 4450 and protrusion Portion 4451a can be positioned at the proximal end of nail cavity 4450.Such embodiment can be in nail 4130 by firing member and tissue knife Distal movement when being pushed towards distal side to be advantageous, as discussed above.Alternatively, protruding portion 4451b can be positioned on nail cavity At 4450 proximal end and protruding portion 4451a can be positioned at the distal end of nail cavity 4450.Under any circumstance, protruding portion 4451b may include such as stair-stepped configuration.In at least one situation, protruding portion 4451b may include for example being limited by height 4455a Fixed first part and the second part limited by height 4455b.
Figure 85 A to Figure 85 C shows the nail bin 4900 including the warehouse 4910 with platform 4911.In various embodiments In, warehouse 4910 can be made of flexible material.In certain embodiments, warehouse 4910 can be by rigid material and flexible material structure At wherein at least platform 4911 can be made of flexible material.Flexible material may include for example certain plastic materials (such as poly- third Alkene) and/or such as elastomeric material (such as rubber, thermoplastic elastomer (TPE) and/or santoprene).In all cases, platform 4911 can be made of pliable material.Under any circumstance, platform 4911 may include protruding portion 4951 extending therefrom.Similar to upper It states, nail 4130 can be protected, support and/or be guided to protruding portion 4951.It is also similar to above-mentioned, protruding portion 4951 can be prevented or at least be limited Movement of the tissue processed relative to nail bin 4900.When anvil block is moved to closed position with respect to nail bin 4900, or alternatively nail bin 4900 when being moved to closed position relative to anvil block, and protruding portion 4951 can be positioned in the tissue among anvil block and nail bin 4900 Compression.Figure 85 A to Figure 85 C is shown in which that protruding portion 4951 is subjected to the sequence of events of increased compressing force.Figure 85 A shows place In the protruding portion 4951 of uncompressed configuration.In this configuration, there can be compression between protruding portion 4951 and the nail leg for following closely 4130 Or interference fit.Figure 85 B is shown in response to applying compressing force to it and in the protruding portion 4951 of compressed configuration.In comparison diagram After 85A and Figure 85 B, it is possible to understand that the top surface 4956 of protruding portion 4951 downwardly toward 4911 actuating length 4955 of platform and is dashed forward The shape in portion 4951 has become distortion out.In this configuration, protruding portion 4951 can clamp the nail leg of nail 4130 and/or protect nail leg It holds in place.Figure 85 C shows the bigger compressing force for being applied to protruding portion 4951.After comparison diagram 85B and Figure 85 C, it is possible to understand that The top surface 4956 of protruding portion 4951 further downwardly toward platform 4911 push and protruding portion 4951 shape have become into The distortion of one step.In addition, protruding portion 4951 can increase the chucking power for being applied to nail leg in this configuration.
Figure 86 A and Figure 86 B show the nail bin 5000 including the warehouse 5010 with platform 5011.Warehouse 5010 can also wrap The multiple protruding portion 5051 for being defined in multiple nail cavities 5050 therein and extending from platform 5011 is included, the protruding portion is configured to It can protect, support and/or guide the nail 5030 being removably positioned in nail cavity 5050.Similar to above-mentioned, nail bin 5000 is also It may include staple drivers 5040 and 5042, the staple drivers are configured to prop up between non-firing position and firing position Support and promotion nail 5030.Figure 86 A and Figure 86 B show the end in wherein nail 5030 and partly eject from protruding portion 5051 Part firing position nail 5030.Similar to above-mentioned, warehouse 5010 can be made of flexible material.Flexible material may include for example (such as rubber, thermoplastic elastomer (TPE) and/or mountain are all for certain plastic materials (such as polypropylene) and/or such as elastomeric material It is flat).In all cases, warehouse 5010 can be made of pliable material.When applying compressing force to warehouse 5010, warehouse 5010 can It is bent as shown in Figure 86 B.When the platform 5011 of warehouse 5010 is bent downwardly as shown in Figure 86 B, protruding portion 5051 can downward bias Torque is from 5055.In this way, protruding portion 5051 can be and can move.
Dream up the various embodiments that the protruding portion wherein extended from nail bin platform can be moved relative to platform.At least In a kind of situation, protruding portion can both make in the first position that wherein protruding portion makes nail cavity extend beyond platform with wherein protruding portion Nail cavity can not also be made to extend beyond the second of platform or reduce to move between position.In all cases, one extended from platform A or multiple protruding portion can be collapsible.Collapsible protruding portion can make nail cavity extend beyond the first of platform in wherein protruding portion Position and wherein protruding portion can both be such that or not make nail cavity extends beyond to move between second or collapsed position of platform.At least In a kind of situation, collapsible protruding portion can elasticity be restored to its non-collapsed configuration, and in some cases, protruding portion may not It is completely recovered to its non-collapsed configuration.It in all cases, can be squeezable from one or more protruding portions that platform extends. Squeezable protruding portion can wherein protruding portion make nail cavity extend beyond the first position of platform can both make with wherein protruding portion or Nail cavity can not be made to extend beyond to move between second or extrusion position of platform.Squeezable protruding portion may not be restored to it It is not crushed configuration.
As discussed above, when nail removedly stores in nail bin, the nail of nail bin can be supported by staple drivers.Also such as As discussed above, staple drivers can be for example lifted up by firing member (such as firing member 2760).In all cases, existing Figure 53 and Figure 54 are being gone to, firing member is configured to for example to follow closely sliding part (such as nail sliding part 2870) towards distal side It promotes, staple drivers and nail is promoted towards anvil block.Following closely sliding part 2870 may include main body 2871 and shoulder 2876, the shoulder It is configured to be engaged by firing member 2760 and supports firing member 2760.Sliding part 2870 may also include such as slope Or inclined surface 2872,2873,2874 and/or 2875, the slope or inclined surface are configured to sliding part 2870 slide below staple drivers and slide below staple drivers and be lifted up staple drivers.In various situations Under, than that described above, for example, first slope surface 2872 is configured to contact and promoted in first row staple drivers Staple drivers, the second ramped surfaces 2873 are configured to contact and promoted the staple drivers in second row staple drivers, Third ramped surfaces 2874 are configured to contact and promoted the staple drivers in third nail driver, and the 4th slope Surface 2875 is configured to contact and promoted the staple drivers in the 4th nail driver.
In all cases, than that described above, sliding part 2870 is configured to promote four nail drivers simultaneously In staple drivers.In some cases, sliding part 2870 can staple drivers in Synchronous lifting this four nails driver.At this In the case of kind, the distal end of this four ramped surfaces 2872,2873,2874 and 2875 is configured to contact this simultaneously They are simultaneously promoted surfaced lifts along four by four staple drivers in parallel, so that these staple drivers reach identical height simultaneously Degree.In addition, in this case, ramped surfaces 2872,2873,2874 and 2875 can length having the same.In other feelings Under condition, sliding part 2870 can promote the staple drivers in every row in four nail drivers simultaneously, but in an interleaved manner.Main ginseng See that Figure 54, the distal end 2872a of first slope 2872 can be aligned with the distal end 2875a on the 4th slope 2875.Various In the case of, first slope 2872 can be parallel to the 4th slope 2875.In addition, first slope 2872 can limit and by the 4th slope The 2875 identical first slope length of the 4th slope length limited.The distal end 2873a on the second slope 2873 can be relative to The distal end 2872a of first slope 2872 and the distal end 2875a on the 4th slope 2875 are towards distal side positioning up to by distance The distance that 2879a is indicated.Second slope 2873 can be not parallel to first slope 2872 and/or the 4th slope 2875.In addition, second Slope 2873 can limit the second slope length for being longer than first slope length and/or the 4th slope length.Third slope 2874 Distal end 2874a can relative to second slope 2873 distal end 2873a towards distal side positioning up to being indicated by distance 2878a Distance.Third slope 2874 can be not parallel to first slope 2872, the second slope 2873 and/or the 4th slope 2875.In addition, the Three slopes 2874 can limit the third slope length for being longer than first slope length, the second slope length and/or the 4th slope length.
When sliding part contacts staple drivers, than that described above, reaction can be formed between sliding part and staple drivers Power and/or torque, and this can be such that sliding part and/or staple drivers rotate in response to the reaction force and/or torque.Figure 53 It can prevent or at least limit sliding when sliding part 2870 contacts and promotes staple drivers with the arragement construction on slope shown in Figure 54 The rotation of moving part 2870.In addition, sliding part 2870 may include stabilizing member 2877, the stabilizing member extends towards distal side with stabilization Sliding part 2870 and prevent and/or forbid waving or rotating for sliding part 2870.Stabilizing member 2877 can be respectively relative to tiltedly Distal end 2872a, 2873a, 2874a and the 2875a on slope 2872,2873,2874 and 2875 extend towards distal side.
Turning now to Figure 54 A to Figure 54 D, sliding part 2870 is configured to for example when sliding part 2870 is from nail bin The distal end 2013 of 2000 proximal end 2016 towards nail bin 2000 is disposed from nail bin 2000 when moving and is followed closely.Nail bin 2000 and/ Or sliding part 2870 may include the feature that sliding part 2870 can be made to be releasably held in the proximal end 2016 of nail bin 2000 Structure.In all cases, the warehouse 2010 of nail bin 2000 may include detent 2019, and the detent is configured to engagement and slides Moving part 2870 and sliding part 2870 is made to be releasably held in its nearside, non-firing position, as shown in Figure 54 A.At least one In the case of kind, referring primarily to Figure 54 B and Figure 54 C, each detent 2019 may include the rib extended inwardly into longitudinal slit 2015 Or spine.The spine for example can vertically extend in longitudinal slit 2015.Than that described above, the main body of sliding part 2870 2871 can be positioned in longitudinal slit 2015 and can connect when sliding part 2870 is in its nearside, non-firing position with detent 2019 It closes, as shown in Figure 54 A.In all cases, detent 2019 can limit the gap of the width less than main body 2871 therebetween.At this In the case of kind, there can be interference fit between detent 2019 and the main body of sliding part 2,870 2871, so that detent 2019 can press from both sides It holds sliding part 2870 and is held in place.When firing member pushes sliding part 2870 towards distal side, main body 2871 can be pushed away Move into be disengaged with detent 2019 and sliding part 2870 can by towards distal side promote to fire the nail being stored in nail bin 2000.? In various situations, referring now to Figure 54 D, the main body 2871 of sliding part 2870 may include being defined in groove 2018 therein, described Groove is configured to releasedly receive detent 2019.Groove 2018 and detent 2019 can limit sliding part in alignment 2870 nearside, non-firing position.It, can also benefit although there is two groups of grooves 2018 and detent 2019 in the illustrated embodiment Sliding part 2870 is set to releasably hold in place with single group.In other cases, using more than two groups of grooves 2018 and card Position 2019.In some cases, detent 2019 can extend from the main body 2871 of sliding part 2870 and groove 2018 can be defined in storehouse In body 2010.
As discussed above, warehouse may include tissue scaffold platform and the protruding portion from platform extension, the protrusion Portion is configured to (one) and controls flowing of the tissue relative to warehouse, and (two) extend beyond the nail cavity being defined in warehouse Nail in the platform, and/or (three) support, protection and/or guidance nail cavity.In all cases, warehouse and protruding portion can be by Single piece of material is constituted.In at least one situation, protruding portion can be integrally formed with warehouse.Warehouse and protruding portion can be by plastic materials It constitutes and can for example be formed during injection molding.In some cases, protruding portion may fitted to warehouse.In at least one feelings Under condition, protruding portion may be affixed to such as warehouse.Warehouse and protruding portion can be made of identical material or different materials.At least In a kind of situation, for example, warehouse can be molded of plastic material and protruding portion can be by elastomeric material (such as rubber, thermoplastic elastomehc Property body and/or santoprene) formed.In all cases, protruding portion can be made of pliable material and may not injure and be highlighted The tissue of portion's compression.For example, protruding portion 3051 (Figure 60) and/or protruding portion 3151 (Figure 61) for example can be (all by elastomeric material Such as rubber, thermoplastic elastomer (TPE) and/or santoprene) it constitutes.In at least one situation, warehouse can during injection molding shape At and protruding portion can be used and formed on warehouse during the second injection molding than the flexible material of material including warehouse.? In various situations, protruding portion 3051 and/or 3151 for example may include veining platform surface.In some cases, protruding portion 3051 and/or 3151 can be for example made of the material with the coefficient of friction higher than warehouse.This embodiment can improve warehouse Chucking power between tissue.
In all cases, the protruding portion extended from warehouse can be for static and it can not be moved relative to warehouse.At certain In a little situations, as discussed above, protruding portion can be flexible and can deform relative to warehouse.In some cases, also as above Text is discussed that warehouse can be flexible, and this allows protruding portion to move when warehouse deflects.Nail bin may include can be relative to storehouse The protruding portion that body extends.Turning now to Figure 75, nail bin 3900 may include with the warehouse for being defined in multiple chambers 3950 therein 3910.In all cases, chamber 3950 may include be positioned in dispose tissue engaging member 3940.Each component 3940 Never deployed position it can move to deployed position.When component 3940 is in its non-deployed position, component 3940 can not extend super Platform 3911 is crossed, and when component 3940 is in its deployed position, component 3940 can extend over platform 3911.Alternatively, structure Part 3940 can at which Yu Qiwei deployed position when extend beyond platform 3911.In at least one such embodiment, tissue The engageable tissue in its non-deployed position and its deployed position of engagement member 3940.Under any circumstance, component 3940 can Including protruding portion 3951 extending therefrom, the protruding portion is configured to engagement, stable and/or compression set in anvil block 20 with the tissue among storehouse 3900.
Referring again to Figure 75, component 3940 can be by longitudinally traversing warehouse 3910 from its proximal end to its distal end Sliding part 3970 is disposed.Sliding part 3970 may include slope 3972, and the slope is configured to sequentially engagement member 3940 and the lifting member 3940 between its non-deployed position and its deployed position.In at least one situation, each component 3940 may include can be by inclined-plane or angled faces 3942 that slope 3972 contacts.Slope 3972 can be slided simultaneously below component 3940 Component 3940 is promoted onto surface 3979.It surface 3979 can be as sliding part 3970 be by such as firing member (such as percussion structure Part 2760) it is promoted towards distal side and component 3940 is made to be maintained at its deployed position.As shown in Figure 75, surface 3979 can long enough with Several components 3940 are supported thereon.In addition, surface 3979 can long enough with executed by firing member 2760 nail forming and group Knit supporting member 3940 in cutting process.In at least one situation, surface 3979 can be leading, or relative to firing member 2760 edge of a knife 2761 is positioned towards distal side.In this case, component 3940 can be moved toward the far side with the edge of a knife 2761 across group It knits and positions tissue towards distal side relative to the edge of a knife 2761.In other words, tissue engaging member 3940, which can be deployed, to organize A part be clamped in front of the tissue part for being sewn and/or cutting.Chamber 3950 is configured to support and guide Component 3940 and forbid component 3940 lateral translation or rotation in chamber 3950.The construction and cloth of the proximal end on surface 3979 Setting can be set so that sliding part 3970 can release component 3940 once the edge of a knife 2761 has passed through component 3940.At least In a kind of such situation, once the edge of a knife 2761 slips over by component 3940, surface 3979 may no longer supporting member 3940.
Than that described above, referring again to Figure 75, chamber 3950 can be arranged to longitudinal row.For example, chamber 3950 can be arranged to Including two most interior rows, two most outlets and six of row longitudinal rows for being located in each most interior row and outermost centre.It dreams up Its lumen 3950 is arranged to less than six rows or the other embodiments arranged more than six.Under any circumstance, it is defined in storehouse Some in chamber 3950 in body 3910 are configured to support and guiding elements 3940, as discussed above, and chamber Some in 3950 contain the nail being for example removedly stored therein (such as follow closely 2630).Sliding part 3970 can be configured to Component 3940 and furthermore percussion nail can be disposed.In at least one such situation, sliding part 3970 may also include at least one A slope 2873, at least one described slope include ramped surfaces 3971, and the ramped surfaces are configured to for example to follow closely Driver 2640 is promoted towards anvil block 20, thus as discussed above can percussion nail 2630.In all cases, slope 3972 can be led First slope 2873.In this case, slope 3972 can promote the nail adjacent with component 3940 to it completely on slope 2873 Component 3940 is deployed to its deployed position before shaping position.Dreaming up wherein most outlet chamber 3950 includes being stored therein Tissue engaging member 3940 and most interior row and intermediate row chamber 3950 include the various embodiment party for the nail being removedly stored therein Case.This embodiment can include two nails and row's tissue engaging member on the every side for the longitudinal cutter groove being defined in warehouse 3940.Dream up other embodiments of wherein any suitably-arranged structure using component 3940 and nail.
As discussed above, it is contemplated that going out wherein nail bin may include multiple rows of nail and multiple rows of implementation for disposing tissue engaging member Scheme.In at least one embodiment, can dispose tissue engaging member can not intersperse among in staple.Dreaming up can wherein dispose Tissue engaging member is scattered in other embodiments in staple.It is also as discussed above, it is contemplated that go out wherein to deposit using nail cavity Store up the embodiment that can dispose tissue engaging member.Wherein tissue engaging member is dreamed up to be not stored in nail cavity but be storable in The intracavitary certain embodiments of one row of neighbouring nail cavity.
Figure 90 to Figure 93 shows the another embodiment including that can dispose tissue engagement protruding portion.Nail bin 5300 for example may be used Including warehouse 5310, the warehouse includes being defined in platform 5311 therein and multiple nail cavities 5350.Nail bin 5310 may include can The nail 5330 being stored in nail cavity 5350 with removing and the multiple drivers for being configured to follow closely 5330 from the ejection of nail cavity 5350 5340.Nail bin 5310, which may also include, to be removedly stored in one or more of nail cavity 5350 and can dispose protruding portion 5351, such as It will discuss in more detail further below.Each driver 5340 may include pedestal 5341 and furthermore driving surface 5342, The pedestal is configured to support nail 5330, and the driving surface is for example configured to (such as be slided by sliding part Part 5370) engagement.Similar to above-mentioned, sliding part 5370 is configured to be promoted between non-deployed position and deployed position Driver 5340.Figure 92 shows driver 5340 and the nail 5330 in its non-deployed position.Referring primarily to Figure 93, driver 5340, which are configured to the promotion between non-deployed position and deployed position, can dispose protruding portion 5351.It is at least one this In the case of class, referring primarily to Figure 90 and Figure 91, it is fixed that each driver 5340 may be mounted at the proximal end around driver 5340 The first of position, which can dispose protruding portion 5351 is positioned with the distal end around driver 5340 second, can dispose protruding portion 5351 Between, wherein driver 5340 moves upwards may pass to and can dispose protruding portion 5351, so that protruding portion 5351 moves to Its deployed position.In at least one situation, protruding portion 5351 can be frictionally engaged with driver 5340.When driver 5340 by When upper promotion, protruding portion 5351 can be lifted up by the frictional fit between driver 5340 and protruding portion 5351.Each protrusion Portion 5351 may include tissue engagement portion 5352, and the tissue engagement portion is configured to contact tissue and applies pressure to tissue Contracting power.In all cases, protruding portion 5351 can to tissue apply compressing force, until compressing force be more than protruding portion 5351 and upwards Move the stiction between the driver 5340 of protruding portion 5351.At the time of such, driver 5340 can be relative to protrusion The movement of portion 5351 or sliding.In other words, driver 5340 can be disengaged with protruding portion 5341 associated there.
In all cases, protruding portion can be disposed when protruding portion 5351 is in its non-deployed position referring again to Figure 93 5351 tissue engagement portion 5352 can be not extended past platform 5311.In other cases, when protruding portion 5351 is in its non-portion When affixing one's name to position, the tissue engagement portion 5352 that can dispose protruding portion 5351 can extend over platform 5311.In either case, when When protruding portion 5351 is in its deployed position, the tissue engagement portion 5352 that can dispose protruding portion 5351 can extend over platform 5311.Than that described above, the frictional fit between each protruding portion 5351 and driver 5340 can be identical, so that driver 5340 It can be identical for each protruding portion 5351 by the power (that is, sliding force) slided relative to protruding portion 5351.Dream up some of them Frictional fit between protruding portion 5351 and certain drivers 5340 may differ from other protruding portions 5351 and other drivers 5340 other embodiments.In such an implementation, the sliding force between protruding portion 5351 and driver 5340 can be different. In at least one embodiment, being located in the first protruding portion 5351 at the distal end of driver 5340 can start with first Sliding force slides and the second protruding portion 5351 being located at the proximal end of driver 5340 can start to be different from first and slide Second sliding force of power slides.In all cases, due to above-mentioned, protruding portion 5351 can be by the compressing force that tissue applies To limitation.Further, since above-mentioned, protruding portion 5351 can be restricted from the distance that the platform 5311 of warehouse 5310 extends.? In various situations, protruding portion 5351 may include the variable response to the organization type and/or tissue thickness that are sewn.For example, phase Than in when organizing thicker and/or more rigid, when organizing thinner and/or more flexible, protruding portion 5351 can be further from platform 5311 deployment.Under any circumstance, being slidably matched between driver 5340 and protruding portion 5351 can prevent tissue by protruding portion 5351 overcompression.
Than that described above, protruding portion 5351 can float relative to storehouse platform 5311.In all cases, protruding portion 5351 can It is dynamically responsive to the compression pressure formed in the tissue being trapped between anvil block 20 and nail bin 5300.In at least one situation Under, firing member 2760 can make anvil block 20 arch upward or move towards nail bin 5300 as firing member 2760 is promoted towards distal side.When When anvil block 20 is moved towards nail bin 5300, tissue can be compressed by anvil block 20, wherein in response to this, protruding portion 5351 can be transported for example downwards It moves or retracts in warehouse 5310.
In all cases, nail bin may include the protruding portion rigidly extended from the platform of warehouse.In at least one situation, Platform and protruding portion can not be movable with respect to each other.In other cases, platform can be moved relative to protruding portion.In at least one In such situation, protruding portion can rigidly extend from warehouse and platform may include the surface that can be moved.When tissue is compressed in When between anvil block and this nail bin, platform can be moved downward relative to protruding portion.Platform can be in first position and the second position Between move.When platform is in its first position, protruding portion can be not extended past the top surface of platform.In such case Under, when platform is in its first position, protruding portion can be recessed lower than the top surface of platform.When platform moves to its second When setting, protruding portion can expose and extend beyond the top surface of platform.Alternatively, when platform is in its first position and Qi When two positions, protruding portion can extend over top platform surface.In either case, platform relative to protruding portion move away from From may depend on the pressure for being applied to tissue.For example, platform can move relatively large distance when applying larger compression pressure to tissue And small distance is moved when applying smaller compression pressure to tissue.Top platform surface may be in response to the compression for being applied to it Pressure and float.Dream up certain embodiments that wherein platform includes single piece of material.Dreaming up wherein platform includes multiple portions The other embodiments divided.In at least one such embodiment, each part can work independently of other parts.Each In the case of kind, the elastic material that platform can be deflected by the compression pressure that may be in response to be applied to it is constituted.In at least one feelings Under condition, platform can be made of such as foam.In some cases, platform can be made of such as oxidized regenerated cellulose.Platform can It is made of implantable material or implantable material.Platform, which had both been implanted into, can not also be implanted to patient's body.In all cases, Platform may include the aperture for the relative motion being defined between permissible platform and protruding portion therein.In at least one such feelings Under condition, aperture may include through-hole and protruding portion can be positioned in the through-hole.In some cases, aperture may include around nail cavity The clearance groove of extension and the one or more protruding portions extended around the nail cavity.When nail from nail cavity eject when, nail may pass through by The opening that clearance groove provides.In some cases, at least part of platform can be by nail capture to plant against the tissue being sewn Enter platform.
In all cases, nail bin disclosed herein may include auxiliary material.Auxiliary material may include for example being located in At least one layer of material of patient's body is implanted to above the platform of nail bin and by the nail from cartridge deployment.In all cases, At least one layer material may include such as backing material and/or tissue thickness compensation part.At least one layer material can be by example As Gore SeamGuard material, Synovis Peri-Strips material and/or polyurethane are constituted.The multiple of this layer are disclosed Bibliography has been incorporated by reference.It is filed on 2 28th, 2013 entitled " the layer arrangement knots for surgery nail bin The U.S. Patent Application Serial Number 13/ of structure (LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES) " The entire disclosure of 763,095 (being now U.S. Patent Publication 2013/0161374) is herein incorporated by reference.Below specially The entire disclosure of benefit application is herein incorporated by reference: being filed in the entitled of on June 25th, 2012 " has comprising only Tissue stitching instrument (the TISSUE STAPLER HAVING A THICKNESS COMPENSATOR of the thickness compensation part of blood agent COMPRISING INCORPORATING A HEMOSTATIC AGENT) " U.S. Patent Application Serial Number 13/531,619 (being now U.S. Patent Publication 2012/0318842)；Being filed in the entitled of on June 25th, 2012 " has comprising oxygen generating agent Tissue stitching instrument (the TISSUE STAPLER HAVING A THICKNESS COMPENSATOR of thickness compensation part INCORPORATING AN OXYGEN GENERATING AGENT) " U.S. Patent Application Serial Number 13/531,623 (now for U.S. Patent Publication 2012/0318843)；Being filed in the entitled of on June 25th, 2012 " has the thickness comprising antimicrobial Spend tissue stitching instrument (the TISSUE STAPLER HAVING A THICKNESS COMPENSATOR of compensating part INCORPORATING AN ANTI-MICROBIAL AGENT) " U.S. Patent Application Serial Number 13/531,627 (be now beauty State's patent disclosure 2012/0312860)；And it is filed in the entitled " with the thickness comprising anti-inflammatory agent of on June 25th, 2012 Tissue stitching instrument (the TISSUE STAPLER HAVING A THICKNESS COMPENSATOR of compensating part INCORPORATING AN ANTI-INFLAMMATORY AGENT) " U.S. Patent Application Serial Number 13/531,630 (now for U.S. Patent Publication 2012/0318844).Layer can be made of bioabsorbable material and/or non-bioabsorbable material.One In a little situations, material layer could attach to platform.In at least one situation, using at least one adhesive by layer releasedly It is attached to platform.In some cases, material layer is releasably attached to put down using such as one or more suture line or belt Platform.In some cases, layer may include solid material piece.In some cases, layer may include being defined in aperture therein.Extremely In a kind of few such situation, layer can be used together with such as nail bin 2000, and may include for example be defined in it is therein with from nail bin Aperture, slit and/or the slit that the protruding portion 2051 and/or protruding portion 2053 that 2010 platform 2011 extends are aligned.Certain In the case of, aperture may include the through-hole or window for extending fully through layer.Aperture, slit and/or slit are for example using for example In the cutting element incision layer of band blade.In some cases, aperture, slit or/or slit for example can be in such as moulding layers It is formed.In some cases, aperture, slit or/or slit are for example formed in layer using such as laser cutting process.One In a little situations, aperture may include the groove for not extending completely through layer being defined in layer.In all cases, protruding portion can be tight It thickly receives in aperture, so that the relative motion between warehouse 2010 and layer can be prevented or at least be limited.It is at least one this In the case of class, there can be interference fit between protruding portion and the side wall of aperture.
Than that described above, auxiliary layer can be made of such as weaving layer and/or non-woven layer.Layer can be made of such as film.? In various situations, layer may include the stream for example extending therefrom for being configured to prevent or at least limit tissue relative to nail bin Dynamic texturizing surfaces, protruding portion and/or protrusion.Layer may include first group of region and second group of region, first group of region By closing and/or being captured in the nail from the nail joint that nail bin ejects, second group of region is not closed or is captured by the nail joint In the nail.In all cases, second group of region can be modified.In at least one situation, layer can be made of film and film Two groups of regions can be modified to include such as aperture, slit and/or slit.In at least one situation, the periphery of this layer can Notch including being defined in the edge therein for softening layer.In some cases, cut-out pattern can be made in layer.At least In a kind of such situation, cut-out pattern may include the notch for example extended relative to each other with 45 degree of angles.In some cases, it cuts The depth and width of mouth and/or interval can be random.Above-mentioned notch can make more flexible film layer, draftability and/or flexibility. Above-mentioned notch can be fabricated on for example woven or nonwoven material.For example any suitable process can be used in above-mentioned notch, such as Such as made by mechanical blades system and/or laser cutting system.It in all cases, can not modifying layer as discussed above First group of region.
As discussed above, the layer being made of solid material piece can be modified to make more flexible layer, draftability and/or soft It is pliable.Layer can be assembled by several material pieces being bonded together.It, can be between binding material piece at least one situation In the presence of such as aperture, slit and/or slit.In some cases, the non-resilient absorbable polymer band of height may be welded to more In thin, more flexible film, to provide the stretching along certain anticipated orientations and limit the stretching along other directions.This band is also It can be used for enhancing the high stress portion of film while the other parts of film being allowed to keep soft and submissive.A kind of side realizing this target Method will make several thin strips being made of for example harder polymer (such as Vicryl).These bands can be for for example about 0.015 " to 0.030 " is wide, and extends the overall length of such as staple line.Six bands can be arranged with the staple line with six longitudinal staples Laterally expand correspondence.It then, can will be for example by polymer (such as Monocryl or 36/64PGA/ of such as soft and elastic PCL) the thin continuous film layer of about 0.003 " to the 0.005 " thickness constituted is welded to this six bands.It in some cases, can benefit With compression molded operation.It as a result will be that there is soft-side and be easy to the highly reinforcing of the lateral rather than ability of longitudinal stretching Staple line.The band extended from film even can produce the towed guarantor that will minimize the tissue flowing on the film in desired direction Hold feature structure.In some cases, it can modify by weaving and/or the layer that constitutes of non-woven material so that some districts of such as layer Domain (such as first group of region) solidification.It can be by flat extrusion fiber weaving at band, then by using felting and/or another Technology of the kind based on heat, such as can be by first group of area fusing together so that they solidify.It in some cases, can be by layer All fuse together.
As discussed above, nail bin may include the protruding portion extended from warehouse.In addition to or instead of these protruding portions, anvil block can Including protruding portion extending therefrom, the protruding portion is configured to (one) and controls stream of the tissue relative to anvil block and warehouse Dynamic, (two) extend nail cavity from the opposite side of tissue and/or (three) support when nail is ejected from nail cavity and/or guidance nail.
Anvil block 3320 is as shown in Figure 66 and Figure 67.Anvil block 3320 may include distal end 3323, proximal end 3326 and Tissue engagement surface 3321.Anvil block 3320 may also include pivot 3327, anvil block 3320 can around the pivot open position with It is rotated between closed position.Anvil block 3320, which may also include, is defined in longitudinal slit 3325 therein, and the longitudinal slit is constructed At can be in a part for wherein receiving firing member and/or cutting element.Anvil block 3320 may also include side, and the side can Including longitudinally projecting portion extending therefrom or wall 3323.In all cases, longitudinal wall 3323 may include such as scalloped surface. In some cases, longitudinal wall 3323 may include such as flat surfaces.Similar to above-mentioned, wall 3323 can be configured to limit System hinders such as lateral flow of the tissue relative to anvil block 3320.
Than that described above, anvil block 3320 may include being defined in multiple nail shapes pits 3322 therein, and the nail forming is recessed Hole can be arranged to the longitudinal row that can be aligned with the nail cavity being defined in nail bin.For example, forming pit 3322 can be arranged to most Interior row 3328a, most outlet 3328c and the row 3328b among most interior row 3328a and most outlet 3328c.In at least one situation Under, each nail shapes pit 3322 may include first or distal side forming cup 3322a and second or nearside forming cup 3322b.First Forming cup 3322a be configured to receive nail the first leg and make its deform and the second forming cup 3322b can be constructed At the second leg that can receive nail and make its deformation.First forming cup 3322a and the second forming cup 3322b can be by planes 3322c is separated.Anvil block 3320 may also include tissue engagement protruding portion 3324.Protruding portion 3324 can be positioned on the first forming cup Among 3322a and the second forming cup 3322b.First protruding portion 3324 can be positioned in the first side of plane 3322c and second Protruding portion 3324 can be positioned in the second side of plane 3322c.The protruding portion 3324 extended from anvil block 3320 can with from nail bin The protruding portion of extension is operated altogether to guide and support the nail ejected from nail bin.In at least one situation, anvil block protruding portion 3324 It is interlockable with nail bin protruding portion.In all cases, storehouse protruding portion can extend from the end of nail cavity and anvil block protruding portion 3324 can It is located among the supermedial storehouse protruding portion of such as nail cavity.When nail is against the formation of anvil block 3320,3324 He of anvil block protruding portion Storehouse protruding portion can be operated altogether so that nail cavity extends and supports and guide nail.When nail leg is ejected from nail cavity and contacts anvil block 3320 When, the storehouse protruding portion extended from the end of nail cavity can support and guide nail leg.When nail leg deforms in forming cup 3322a, 3322b When, nail leg can be supported and be guided by the protruding portion 3324 extended from anvil block.In all cases, nail leg can be simultaneously by storehouse protruding portion It supports and guides with anvil block protruding portion 3324.In some cases, nail leg can be supported by storehouse protruding portion and anvil block protruding portion 3324 And it guides, but be not simultaneously.
In all cases, forming cup 3322a, 3322b is configured to wherein receiving from the prominent of nail bin extension At least part in portion out.In at least one such situation, each forming cup 3322a, 3322b may include being adapted to Enough receive the wide outer end and narrow inner end of the protruding portion extended from nail bin.The wide outer end of forming cup 3322a, 3322b can be also constructed At can initially receive nail leg.Forming cup 3322a, 3322b may also include curved surface, and the curved surface is configured to Nail leg is guided towards the narrow inner end of forming cup 3322a, 3322b.Nail leg then can be exited from narrow inner end forming cup 3322a, 3322b, wherein protruding portion 3324 is configured to support and guides nail leg.Each forming cup 3322a, 3322b may include outside width End and the angled faces among narrow inner end.Nail leg in bootable forming cup 3322a, 3322b of angled faces, limits the side of nail leg To movement, and improve the alignment of nail leg Yu narrow inner end.
Than that described above, protruding portion 3324 is configured to engage tissue in suture and/or transecting patient tissue and make Tissue is held in place.In some cases, each protruding portion 3324 may include extending from tissue engagement surface 3321 including flat The platform part on smooth surface.Figure 89, which is shown, is defined in forming pit 3322 therein and tissue extending therefrom engagement including having The alternative embodiment of the anvil block 5220 of protruding portion 5224.Similar to protruding portion 3224, each protruding portion 5224 may include platform The portion part 5224a and flat surfaces 5224b for being configured to engagement tissue.In addition, each protruding portion 5224 may include Transitional surface 5224c among platform part part 5224a and flat surfaces 5224c.In all cases, transitional surface 5224c It may include such as radius.In some cases, transitional surface 5224c may include such as inclined-plane.
Anvil block 5120 is as shown in Figure 87 and Figure 88.Anvil block 5120 may include distal end 5123, proximal end 5126 and Tissue engagement surface.Tissue engagement surface may include ladder.For example, tissue engagement surface may include such as the first ladder 5121' With the second ladder 5121 ".Second ladder 5121 " can be higher than the first ladder 5121' and can extend from the first ladder 5121'.Anvil block 5120 may also include pivot 3327, and anvil block 3320 can rotate between the open position and the closed position around the pivot.Anvil block 5120 may also include and be defined in longitudinal slit 5125 therein, and the longitudinal slit is configured to receive percussion structure wherein A part of part and/or cutting element.Anvil block 5120 may also include side 5123, the side both may include and also may not include from Its longitudinally projecting portion extended or wall.In all cases, higher second ladder 5121 " can it is adjacent with longitudinal slit 5125 and One ladder 5121' can be adjacent with side 5123.In all cases, compared with the first ladder 5121', the second ladder 5121 " can Apply bigger compressing force to tissue.In various optionally embodiments, higher second ladder 5121 " can be adjacent with side 5123 And the first ladder 5121' can be adjacent with longitudinal slit 5125.Although anvil block 5120 includes two ladders, anvil block 5120 may include More than two ladder.Under any circumstance, anvil block 5120 may include prolonging between the first ladder 5121' and the second ladder 5121 " The ramped surfaces 5128 " stretched, the ramped surfaces can be conducive to positioning of the anvil block 5120 relative to tissue.
Than that described above, anvil block 5120 may include being defined in multiple nail shapes pits 5122 therein, and the nail forming is recessed Hole can be arranged to the longitudinal row that can be aligned with the nail cavity being defined in nail bin.In all cases, outermost row's forming pit 5122 can be defined in the first ladder 5121'.Most interior row's forming pit 5122 and intermediate row forming pit 5122 can be defined in example As in the second ladder 5121 ".Dream up other implementations that wherein intermediate row forming pit 5122 is defined in the first ladder 5121' Scheme.Under any circumstance, anvil block 5120 may include tissue engagement protruding portion 5124 extending therefrom.In all cases, often A protruding portion 5124 may include such as H-shaped configuration.Protruding portion 5124 can extend between for example adjacent forming pit 5122.It is prominent Portion 5124 can extend between the adjacent forming cup in such as forming pit 5122.In all cases, protruding portion 5124 can enclose Around the end of forming cup to support and guide the nail leg formed by forming cup.Protruding portion 5124 can be along such as forming pit 5122 Side extend.Protruding portion 5124 can extend along such as side of the first forming pit 5122 and the second forming pit 5122. The side of forming pit 5122 can be for example parallel.In all cases, the nail leg in the bootable forming cup of protruding portion 5124 And limit the lateral movement of nail leg.Figure 88 shows the protruding portion 5124 on each side of forming pit 5122.Figure 88 also shows The protruding portion 5124 on each side positioned at the forming cup of forming pit 5122 is gone out.In various other embodiments, protruding portion Can with it is only some adjacent fixed more only and/or in the forming cup of forming pit 5122 in the forming pit 5122 of anvil block 5120 Position.
It in all cases, can height having the same from the protruding portion that anvil block extends.In other cases, prolong from anvil block The protruding portion stretched can have different height.Turning now to Figure 69, anvil block 3520 may include tissue engagement surface 3321 and limit In the longitudinal slit 3325 of a part therein for being configured to receive firing member and/or cutting element.Anvil block 3520 It may also include side, the side may include longitudinally projecting portion extending therefrom or wall 3323.Similar to above-mentioned, anvil block 3520 can Including being arranged to most interior row 3328a, most outlet 3328c and the row 3328b among most interior row 3328a and most outlet 3328c Forming pit.In all cases, anvil block 3520 may include that longitudinal direction for example adjacent with most interior row 3328a ranked first protruding portion 3551a, the longitudinal direction adjacent with intermediate row 3328b ranked second protruding portion 3551b and the longitudinal row adjacent with most outlet 3228c Third protruding portion 3551c.First protruding portion 3551a can extend first distance and the second protruding portion from tissue engagement surface 3221 3551b can extend the second distance for being different from first distance from tissue engagement surface 3221.Third protruding portion 3551c can be from tissue Engagement surface 3221 extends the third distance that may differ from first distance and/or second distance.In all cases, third is prominent Portion 3551c can be higher than the second protruding portion 3551b and the second protruding portion 3551b can be higher than the first protruding portion 3551a.Various alternative In embodiment, protruding portion 3551a can be with such as intermediate row 3328b and/or most outlet 3328c adjacent positioned, protruding portion 3551b It can be with for example most interior row with for example most interior row 3328a and/or most outlet 3328c adjacent positioned and/or protruding portion 3551c 3328a and/or intermediate row 3328b adjacent positioned.
Anvil block 3420 is as shown in Figure 66.Anvil block 3420 may include distal end 3423, proximal end and tissue table of joint Face 3321.Anvil block 3420 may also include pivot 3327, anvil block 3420 can around the pivot open position and closed position it Between rotate.Anvil block 3420, which may also include, is defined in longitudinal slit 3325 therein, and the longitudinal slit is configured at it Middle a part for receiving firing member and/or cutting element.Anvil block 3420 may also include side, and the side may include prolonging from it The longitudinally projecting portion stretched or wall 3323.Anvil block 3420 may include being defined in multiple nail shapes pits 3322 therein, it is described nail at Shape pit can be arranged to the longitudinal row that can be aligned with the nail cavity being defined in nail bin.In all cases, than that described above, anvil Seat 3420 may include protruding portion extending therefrom.For example, anvil block 3420 may include conical projections 3051 extending therefrom and/or Dome-shaped protruding portion 3151.Protruding portion 3051 and/or protruding portion 3151 can improve the chucking power that can apply to tissue.
In all cases, anvil block and from anvil block extend protruding portion can be made of single piece of material.In at least one situation Under, protruding portion can be integrally formed with anvil block.Anvil block and protruding portion can be made of such as metal material (such as stainless steel), and can be Such as it is formed in processing and/or punching course.In some cases, protruding portion may fitted to anvil block.In at least one situation, Protruding portion may be affixed to such as anvil block.Anvil block and protruding portion can be made of identical material or different materials.In at least one In the case of, anvil block can be made of metal material and protruding portion can be for example by elastomeric material (such as rubber, thermoplastic elastomer (TPE) And/or santoprene) formed.In all cases, protruding portion can be made of pliable material and may not injure by protruding portion pressure The tissue of contracting.Protruding portion 3051 and/or protruding portion 3151 for example can be by such as elastomeric material (such as rubber, thermoplastic elastic Body and/or santoprene) it constitutes.In at least one situation, anvil block can be formed in processing and/or punching course and protruding portion can It is formed on anvil block in molding process using the material more flexible than the material including anvil block.In all cases, protruding portion 3051 and/or 3151 for example may include veining anvil faces.In some cases, protruding portion 3051 and/or 3151 for example may be used It is made of the material with the coefficient of friction higher than anvil block.This embodiment can improve the chucking power between anvil block and tissue.
Than that described above, anvil block may include uniform protruding portion array extending therefrom.In other cases, the array can It is non-uniform.Referring again to Figure 68, protruding portion 3051 can prolong on the first side of longitudinal slit 3325 from anvil faces 3321 It stretches and protruding portion 3151 can extend in second side of longitudinal slit 3325 from anvil faces 3321.In all cases, prominent Portion can be positioned relative to such as forming pit 3322 towards distal side.In some cases, protruding portion can be interspersed in forming pit 3322 In.Protruding portion can from the surface 3429a being for example defined among most internal shaping pit 3322 and slit 3325, be defined in it is most interior at The surface 3429b of 3322 centre of shape pit 3322 and intermediate forming pit, intermediate forming pit 3322 and outermost forming are defined in The surface 3429c of 3322 centre of the pit and/or surface 3429d for being defined in outermost forming pit 3322 with 3323 centre of lateral sidewall Extend.
Figure 98 shows anvil block 5920.Anvil block 5920 may include that distal end 5923, proximal end 5926 and tissue connect Close surface 5921.Anvil block 5920 may also include the tissue engaging member extended from surface 5921, and the tissue engaging member is by structure It causes to prevent or limit flowing of the tissue relative to anvil block 5920.In at least one situation, anvil block 5920 may include example Such as protruding portion 5924' and protruding portion 5924 ".Protruding portion 5924 " can be higher than protruding portion 5924'.This difference in height is by dimension 5925 It indicates.As shown in Figure 98, protruding portion 5924 " can be positioned relative to protruding portion 5924' towards distal side.In all cases, protruding portion 5924 " and protruding portion 5924' can be a part of longitudinal row's protruding portion.In some cases, protruding portion 5924 " and protruding portion 5924' can be a part of different longitudinal row's protruding portions.In some cases, although being not shown, protruding portion 5924' can be opposite It is positioned in protruding portion 5924 " towards distal side.
In all cases, anvil block disclosed herein may include auxiliary material.Auxiliary material may include for example being located in At least one layer of material of patient's body is implanted to above the tissue engagement surface of anvil block and by the nail from cartridge deployment.Various In the case of, at least one layer material may include such as backing material and/or tissue thickness compensation part.At least one layer material It can be made of such as Gore SeamGuard material, Synovis Peri-Strips material and/or polyurethane.This layer is disclosed Multiple bibliography be incorporated by reference.It is filed on 2 28th, the 2013 entitled " layers for surgery nail bin The U.S. Patent application sequence of arragement construction (LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES) " The entire disclosure of row number 13/763,095 (being now U.S. Patent Publication 2013/0161374) is herein incorporated by reference. The entire disclosure of following patent application is herein incorporated by reference: being filed in the entitled of June 25 in 2012 " has Tissue stitching instrument (the TISSUE STAPLER HAVING A THICKNESS of thickness compensation part comprising hemostat COMPENSATOR COMPRISING INCORPORATING A HEMOSTATIC AGENT) " U.S. Patent Application Serial Number 13/531,619 (being now U.S. Patent Publication 2012/0318842)；Be filed on June 25th, 2012 it is entitled " have comprising Tissue stitching instrument (the TISSUE STAPLER HAVING A THICKNESS of the thickness compensation part of oxygen generating agent COMPENSATOR INCORPORATING AN OXYGEN GENERATING AGENT) " U.S. Patent Application Serial Number 13/ 531,623 (being now U.S. Patent Publication 2012/0318843)；Being filed in the entitled of on June 25th, 2012 " has comprising anti- Tissue stitching instrument (the TISSUE STAPLER HAVING A THICKNESS of the thickness compensation part of microorganism agent COMPENSATOR INCORPORATING AN ANTI-MICROBIAL AGENT) " U.S. Patent Application Serial Number 13/ 531,627 (being now U.S. Patent Publication 2012/0312860)；And it is filed in the entitled " with packet of on June 25th, 2012 Tissue stitching instrument (the TISSUE STAPLER HAVING A THICKNESS of thickness compensation part containing anti-inflammatory agent COMPENSATOR INCORPORATING AN ANTI-INFLAMMATORY AGENT) " U.S. Patent Application Serial Number 13/ 531,630 (being now U.S. Patent Publication 2012/0318844).Layer can be by bioabsorbable material and/or not bioabsorbable material Material is constituted.In some cases, material layer could attach to anvil block.In at least one situation, using at least one adhesive Layer is releasably attached to anvil block.In some cases, material layer can be released using such as one or more suture line or belt It is attached to anvil block with putting.In all cases, layer may include protruding portion extending therefrom, and the protruding portion, which may extend into, to be defined in In forming pit in anvil block.Protruding portion can be arranged to and the forming pit array or the pattern array or figure that are aligned in anvil block Case.In at least one situation, protruding portion can be snugly fit against in forming pit.Protruding portion is configured to limiting layer Lateral movement and/or longitudinal movement relative to anvil block.
In some cases, layer may include solid material piece.In some cases, layer may include being defined in therein open Hole.In at least one such situation, layer can be used together with such as anvil block 3320, and may include for example be defined in it is therein with Aperture, slit and/or the slit that the protruding portion extended from the tissue engagement surface 3321 of anvil block 3320 is aligned.In certain situations Under, aperture may include the through-hole or window for extending fully through layer.Aperture, slit and/or slit are for example using such as band knife In the cutting element incision layer of piece.In some cases, aperture, slit or/or slit can for example be formed in such as moulding layer. In some cases, aperture, slit or/or slit are for example formed in layer using such as laser cutting process.In some feelings Under condition, aperture may include the groove for not extending completely through layer being defined in layer.In all cases, protruding portion can be closely It receives in aperture, so that the relative motion between anvil block 3320 and layer can be prevented or at least be limited.In at least one such feelings Under condition, there can be interference fit between protruding portion and the side wall of aperture.
Than that described above, auxiliary layer can be made of such as weaving layer and/or non-woven layer.Layer can be made of such as film.? In various situations, layer may include for example extending therefrom being configured to prevent or at least limiting tissue relative to anvil block Texturizing surfaces, protruding portion and/or the protrusion of flowing.Layer may include first group of region and second group of region, first group of area By closing and/or being captured in the nail from the nail joint that nail bin ejects, second group of region is not closed or is captured by the nail joint in domain In the nail.In all cases, second group of region can be modified.In at least one situation, layer can be made of film and film Second group of region can be modified to include such as aperture, slit and/or slit.In at least one situation, the periphery of this layer It may include the notch for being defined in the edge therein for softening layer.In some cases, cut-out pattern can be made in layer.Extremely In a kind of few such situation, cut-out pattern may include the notch for example extended relative to each other with 45 degree of angles.In some cases, The depth and width of notch and/or interval can be random.Above-mentioned notch can make more flexible film layer, draftability and/or submissive Property.Above-mentioned notch can be fabricated on for example woven or nonwoven material.For example any suitable process, example can be used in above-mentioned notch As such as made by mechanical blades system and/or laser cutting system.In all cases, it can not modify as discussed above First group of region of layer.
As discussed above, the layer being made of solid material piece can be modified to make more flexible layer, draftability and/or soft It is pliable.Layer can be assembled by several material pieces being bonded together.It, can be between binding material piece at least one situation In the presence of such as aperture, slit and/or slit.In some cases, the non-resilient absorbable polymer band of height may be welded to more In thin, more flexible film, to provide the stretching along certain anticipated orientations and limit the stretching along other directions.This band is also It can be used for enhancing the high stress portion of film while the other parts of film being allowed to keep soft and submissive.A kind of side realizing this target Method will make several thin strips being made of for example harder polymer (such as Vicryl).These bands can be for for example about 0.015 " to 0.030 " is wide, and extends the overall length of such as nail shapes pit line.Six bands can be arranged to follow closely with six longitudinal directions The staple line of row laterally expands correspondence.It then, can will be for example by for example soft and elastomeric polymer (such as Monocryl or 36/ 64PGA/PCL) the thin continuous film layer of about 0.003 " to the 0.005 " thickness constituted is welded to this six bands.In some cases Under, using compression molded operation.It as a result will be that there is soft-side and be easy to lateral rather than the ability of longitudinal stretching height Spend the staple line of enhancing.The band extended from film, which even can produce, minimizes the tissue flowing on the film in desired direction Towed holding feature structure.In some cases, the layer being made of weaving and/or non-woven material can be modified so that such as layer Some regions (such as first group of region) solidification.It can be by flat extrusion fiber weaving at band, then by using felting And/or another technology based on heat, such as can be by first group of area fusing together so that they solidify.In some cases Under, the whole of layer can be fused together.
Disclosed herein is include removedly being stored in nail in end-to-end arragement construction in one or more longitudinal rows The various embodiments of nail in storehouse.Similarly, disclosed herein is include having to be arranged to corresponding end-to-end arragement construction The various embodiments of the anvil block of nail shapes pit.Dream up other nails and arrangement of nail-forming pit structure and the arragement construction It is applicable to embodiments disclosed herein.This arragement construction both may include or may not include end-to-end arragement construction.It is public It is distributed in the entitled " for disposing the surgical stapling system of the surgical staples with tissue compression feature structure of on May 29th, 2012 And nail bin (SURGICAL STAPLING SYSTEMS AND STAPLE CARTRIDGES FOR DEPLOYING SURGICAL STAPLES WITH TISSUE COMPRESSION FEATURES) " United States Patent (USP) 8,186,560 entire disclosure with Way of reference is incorporated herein.Be published on 2 5th, 2013 it is entitled " have it is dissolvable, bioabsorbable or biodegradable Partial surgical staples and for dispose its suture instruments (SURGICAL STAPLES HAVING DISSOLVABLE, BIOABSORBABLE OR BIOFRAGMENTABLE PORTIONS AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME) " the entire disclosure of United States Patent (USP) 8,365,976 be herein incorporated by reference.
Figure 19 to Figure 22 shows the both recycling motor driving surgery cuts that can not also be recycled and fastening instrument 1010.In the illustrated embodiment, instrument 1010 includes shell 1012, and the shell includes shank 1014, and the shank is by structure It causes to be grasped, manipulate and activate by clinician.Shell 1012 is configured to be operatively attached to interchangeable shaft assembly 1200, the interchangeable shaft assembly has the surgical end-effector 1300 for being operably linked to it, and the surgical end is held Row device is configured to execute one or more surgical tasks or operation.With continued reference to present embodiment, it should be understood that The various unique and novel arragement constructions of various forms of interchangeable shaft assemblies disclosed herein can also be effectively combined machine The surgery system of device people control uses.Therefore, term " shell " can also cover the receiving or in other ways of robot system It is operably supported the shell or similar portions of at least one drive system, wherein at least one described drive system is configured to It can generate and apply at least one control that can be used for activating interchangeable shaft assembly disclosed herein and its corresponding equivalent System movement.Term " frame " can refer to a part of hand-held surgical instrument.Term " frame " can also indicate the outer of robot control A part of section's instrument and/or a part that can be used for being operatively controlled surgical instruments of robot system.For example, this paper institute Disclosed interchangeable shaft assembly " can dispose the surgery suturing appliance of arragement construction with rotatable nail with entitled (SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS U.S. Patent Application Serial Number 13/118,241) " (is now U.S. Patent Application Publication 2012/ 0298719) various robot systems, instrument, component and method disclosed in are used together.It is entitled " to there is rotatable nail Dispose surgery suturing appliance (the SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE of arragement construction STAPLE DEPLOYMENT ARRANGEMENTS) " U.S. Patent Application Serial Number 13/118,241 (be now United States Patent (USP) Shen It please announce 2012/0298719) to be incorporated by reference and be incorporated herein.
Shell 1012 shown in Figure 19 to Figure 21 is shown in conjunction with interchangeable shaft assembly 1200, and the interchangeable shaft assembly includes End effector 1300, the end effector include being configured to wherein be operably supported surgery nail bin 1304 Surgery cuts and clamp device.Shell 1012 can be configured to that interchangeable shaft assembly is combined to use, the interchangeable shaft assembly Including end effector, the end effector can support the nail bin of different sizes and type, have different shaft lengths, ruler Very little and type etc..In addition, shell 1012 can also be effectively used together with various other interchangeable shaft assemblies, it is described it is various its Its interchangeable shaft assembly includes the end effector cloth being configured to being suitable for that the application of various surgeries and operation is combined to use It sets structure and applies for example other movements and the energy (such as radio frequency (RF) energy, ultrasonic energy and/or movement) of form Those components.In addition, end effector, shaft assembly, shank, surgical instruments and/or surgical instrument system can use any conjunction Suitable one or more fasteners will be will organize fastening.E.g., including multiple fasteners being removedly stored therein it is tight Firmware storehouse can be removably inserted into and/or be attached to the end effector of shaft assembly.
Figure 19 shows the surgical instruments 1010 with the interchangeable shaft assembly 1200 for being operably linked to it.Figure 20 and Figure 21 shows the attachment of interchangeable shaft assembly 1200 to shell 1012 or shank 1014.It such as can be in seen in fig. 21, shank 1014 may include that a pair can interconnect handle shell section 1016 and 1018, this can pass through screw, snap in features to handle shell section The interconnection such as structure, adhesive.In shown arragement construction, operation can be cured handle shell section 1016,1018 with being formed by clinic altogether The raw pistol grip portion 1019 grasped and manipulate.As that will discuss in further detail below, shank 1014 can be grasped wherein Make ground and support multiple drive systems, the drive system is configured to generate various controls movements and applies it to and can grasp It is attached to the corresponding portion of its interchangeable shaft assembly with making.
Referring now to Figure 21, shank 1014 may also include the frame 1020 for being operably supported multiple drive systems.For example, Frame 1020 can be operably supported be typically expressed as 1030 " first " or closure drive system, " first " or closure Drive system can be used for applying closure and open movement to the interchangeable shaft assembly 1200 for being operationally attached or coupled to it.? In at least one form, closure drive system 1030 may include 1032 form of closure trigger being pivotally supported by frame 1020 Actuator.More specifically, as shown in figure 21, closure trigger 1032 is pivotally coupled to shell 1014 by pin 1033. This arragement construction enables closure trigger 1032 to be manipulated by clinician, so that when clinician grasps shank 1014 When pistol grip portion 1019, closure trigger 1032 easily can be pivoted to " actuating " position from starting or " not activating " position It sets, and more specifically, is pivoted to compression or fully actuated position completely.Closure trigger 1032 can be by spring or other biasings Arragement construction (not shown) is biased to unactuated position.In various forms, closure drive system 1030 further includes pivotly It is connected to the closed connecting rod component 1034 of closure trigger 1032.Such as can be seen in fig. 21, closed connecting rod component 1034 can wrap Include the first closed connecting rod 1036 and the second closed connecting rod 1038 that closure trigger 1032 can be pivotally coupled to by pin 1035. Second closed connecting rod 1038 is also referred to as " attachment members " and herein including lateral attachment pin 1037.
Referring also to Figure 21, it can be observed that the first closed connecting rod 1036 can have latch wall or end disposed thereon 1039, the closure release component 1060 that the latch wall or end were configured to and were pivotally coupled to frame 1020 is total Operation.In at least one form, closure release component 1060 may include with the lock towards distal side protrusion being formed on Determine the release button component 1062 of pawl 1064.Release button component 1062 can be released spring (not shown) along side counterclockwise To pivot.When pistol grip portion 1019 of the clinician by closure trigger 1032 from its unactuated position towards shank 1014 is pressed When pressure, the first closed connecting rod 1036 is to pivot upwardly to wherein locking pawl 1064 and falls into and the lock in the first closed connecting rod 1036 Determine wall 1039 and remains engaged with the point for preventing closure trigger 1032 from returning to unactuated position.Therefore, closure release component 1060 help closure trigger 1032 being locked in fully actuated position.When clinician wishes to solve closure trigger 1032 When lock is to allow it to be biased to unactuated position, clinician simply pivotally closes release button component 1062, so that lock Determine pawl 1064 and move into be disengaged with the latch wall 1039 in the first closed connecting rod 1036.When locking pawl 1064 has moved When at being disengaged with closed connecting rod 1036, closure trigger 1032 can be pivoted back to unactuated position.It can also be used other Closure trigger locking and release arragement construction.
Arm 1061 can extend from closure release button 1062.Magnetic element 1063 (such as permanent magnet) for example may be mounted to arm 1061.When closure release button 1062 rotates to its second position from its first position, magnetic element 1063 can be towards circuit board 1100 movements.Circuit board 1100 may include at least one sensor, at least one described sensor is configured to detection magnetic The movement of property element 1063.In at least one embodiment, such as " Hall effect " sensor (not shown) can be installed to The bottom surface of circuit board 1100.Hall effect transducer is configured to detect to be caused by the movement of magnetic element 1063 The changes of magnetic field around Hall effect transducer.Hall effect transducer can carry out signal communication, institute with such as microcontroller Whether state microcontroller can determine closure release button 1062 in holding with the unactuated position of closure trigger 1032 and end Its associated first position of the open configuration of row device and the actuated position of closure trigger 1032 and the closure of end effector Any position between its associated second position of configuration, and/or first position and the second position.
In at least one form, shank 1014 and frame 1020, which can be operably supported at, herein referred to as fires Another drive system of drive system 1080, the drive system are configured to being attached to its interchangeable shaft assembly Corresponding portion apply percussion movement.Percussion drive system 1080 is also referred herein as " the second drive system ".Percussion is driven The electric motor 1082 in the pistol grip portion 1019 of shank 1014 can be used in dynamic system 1080.In various forms, Motor 1082 can be the DC brush drive motor of the maximum (top) speed for example with about 25,000RPM.In other arragement constructions In, motor may include brushless motor, wireless motor, syncmotor, stepper motor or any other suitable electric motor.Motor 1082 can be by may include that the power supply 1090 of removable power source group 1092 is powered in one form.It such as can be in seen in fig. 21, example Such as, power supply group 1092 may include nearside casing part 1094, and the nearside casing part is configured to be attached to distal side shell Part 1096.Nearside casing part 1094 and distal side casing part 1096 are configured to be operably supported wherein multiple Battery 1098.Battery 1098 may include respectively such as lithium ion (" LI ") battery or other suitable batteries.Distal side casing part 1096 are configured to be operably attached to circuit board assemblies 1100, and the circuit board assemblies are also operable to couple To motor 1082.Power supply of the multiple batteries 1098 that can be connected in series as surgical instruments 1010 can be used.In addition, power supply 1090 It can be replaceable and/or chargeable.
As summarized above with respect to various other forms, electric motor 1082 may include operationally with gear reduction unit The rotatable shaft (not shown) that component 1084 joins, the The gear deceleration device assembly and the sliding tooth 1122 of one group or a rack gear are nibbled Splice grafting conjunction is mounted in the drive member 1120 for capableing of longitudinal movement.In use, polarity of voltage provided by power supply 1090 can Electric motor 1082 is operated along clockwise direction, wherein can be inverted by the polarity of voltage that battery is applied to electric motor, so as to Electric motor 1082 is operated in the counterclockwise direction.When electric motor 1082 rotates in one direction, drive member 1120 is by edge Distal direction " DD " is axially driven.When motor 82 is driven along opposite direction of rotation, drive member 1120 will be along close Side direction " PD " is axially driven.Shank 1014 may include switch, and the switch is configured to make to be applied by power supply 1090 It is added to the polarity reversion of electric motor 1082.As other forms as described herein, shank 1014 may also include sensor, institute State the direction that sensor is configured to the position of detection drive member 1120 and/or drive member 1120 moves.
The actuating of motor 1082 can be controlled by the firing trigger 1130 being pivotally supported on shank 1014. Firing trigger 1130 can pivot between unactuated position and actuated position.Firing trigger 1130 can by spring 1132 or its Its offset placement configuration biases to unactuated position so that when clinician discharge firing trigger 1130 when, can be by spring 1132 or offset placement structure be pivoted to or return in other ways unactuated position.In at least one form, percussion triggering Device 1130 can be positioned at closure trigger 132 " outside ", as discussed above.In at least one form, firing trigger Safety switch 1134 can be pivotally mounted to closure trigger 1032 by pin 1035.Safety switch 1134 can be positioned on percussion Between trigger 1130 and closure trigger 1032, and there is the pivotal arm 1136 from its protrusion.Referring to fig. 21.When closure is touched When hair device 1032 is in unactuated position, safety switch 1134 is accommodated in shank 1014, and clinician is possibly at this time can not The button is touched easily and it is made to prevent the home activated to firing trigger 1130 and wherein firing trigger It is moved between 1130 firing positions that can be fired.When clinician presses closure trigger 1032,1134 He of safety switch Firing trigger 1130 pivots downwards, and wherein they can then be manipulated by clinician.
As described above, at least one form, the drive member 1120 of being capable of longitudinal movement, which has, to be formed on The tooth 1122 of one rack gear is engaged for the respective drive gear 1086 with The gear deceleration device assembly 1084.At least one shape Formula may also include manually actuable " relief " component 1140, and " relief " component is configured to make clinician in horse The drive member 1120 for capableing of longitudinal movement is manually retracted in the case where may disabling up to 1082.Relief component 1140 can wrap Include be configured to manually be pivoted into the lever engaged with 1124 ratchet of tooth being also disposed in drive member 1120 or Succour handle assembly 1142.Therefore, clinician can manually retract driving structure by using relief handle assembly 1142 Part 1120, so that drive member 1120 is engaged along proximal direction " PD " ratchet.U.S. Patent Application Publication US 2010/0089970 (being now United States Patent (USP) 8,608,045) discloses relief arragement construction and can also be used together with various instruments disclosed herein Other components, arragement construction and system.It is entitled " have can manual refraction trigger system band electrosurgical cut and suture set Standby (POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM) " U.S. Patent Application Serial Number 12/249,117 (being now United States Patent (USP) 8,608,045) accordingly full text It is herein incorporated by reference.
Turning now to Figure 20 and Figure 22, interchangeable shaft assembly 1200 includes surgical end-effector 1300, the surgery end Portion's actuator includes the elongated passageway 1302 being configured to being wherein operably supported nail bin 1304.End effector 1300 may also include the anvil block 1306 being pivotably supported relative to elongated passageway 1302.Interchangeable shaft assembly 1200 can also wrap It includes actuated articulation joints 1270 and is configured to releasably hold end effector 1300 relative to axial line SA-SA Joint motions in desired position are locked.Structure about end effector 1300, actuated articulation joints 1270 and joint motions lock The detailed content made and operated be set forth in be filed on March 14th, 2013 it is entitled " including joint motions lock being capable of joint Surgical instruments (the ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION of movement LOCK in U.S. Patent Application Serial Number 13/803,086) ".Be filed on March 14th, 2013 it is entitled " including joint fortune Surgical instruments (the ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN for capableing of joint motions of dynamic lock ARTICULATION LOCK) " U.S. Patent Application Serial Number 13/803,086 entire disclosure accordingly by reference It is incorporated herein.Such as can seen in fig. 22, interchangeable shaft assembly 1200 may also include be made of spray nozzle part 1202 and 1203 it is close Side shell or nozzle 1201.Interchangeable shaft assembly 1200 may also include closed tube 1260, the closed tube can be used for being closed and/or Open the anvil block 1306 of end effector 1300.Shaft assembly 1200 may include ridge 1210, and the ridge is configured to (one) and exists Firing member is wherein slidingly supported, and (two) slidingly support the closed tube 1260 extended around ridge 210.Ridge 210 is also It is configured to slidingly support proximal joint motion drive.Articulation drive has that be configured to can The operatively distal end of connecting joints movement lock.Joint motions are locked and can be operatively engaged on end effector frame The articulation frame of drive pin joins.As described above, operation about joint motions lock and articulation frame it is more in detail Thin content is found in U.S. Patent Application Serial Number 13/803,086.In all cases, ridge 1210 may include rotatably The proximal end 1211 being supported in chassis 1240.In an arragement construction, for example, the proximal end 1211 of ridge 1210 has It is formed on and is configured to be supported in the screw thread 1214 of the bearing of the ridge in chassis 1,240 1216 for being threadedly attached to.Ginseng See Figure 22.This arragement construction is conducive to the rotatable attachment of ridge 1210 to chassis 1240, so that the optionally phase of ridge 1210 Chassis 1240 is rotated around axial line SA.
Referring primarily to Figure 22, interchangeable shaft assembly 1200 includes closure spindle moving part 1250, and the closure spindle moving part is slidably Ground is supported in chassis 1240, so that it can be moved axially relative to the chassis.Being closed spindle moving part 1250 includes a pair of of court The hook 1252 of nearside protrusion, the hook are configured to be attached to attachment pin 1037 (Figure 20 and Figure 21), the attachment pin attachment To the second closed connecting rod 1038, will such as discuss in further detail below.The proximal end 1261 of closed tube 1260 is connected to Spindle moving part 1250 is closed to rotate relative to it.For example, U-shaped connector 1263 is inserted into the proximal end 1261 of closed tube 1260 Narrow annular slot 1262 and be maintained at closure spindle moving part 1250 in vertical slit 1253 in.This arragement construction is used to close Pipe 1260 is closed to be attached to closure spindle moving part 1250 with therewith axial traveling while enabling closed tube 1260 around axle center Line SA is rotated relative to closure spindle moving part 1250.1268 axle journal of closing spring is connected in closed tube 1260 and is used to be closed Pipe 1260 proximally direction " PD " biases, and this can be used to trigger closure when shaft assembly is operably linked to shank 1014 Device is pivoted to unactuated position.
In at least one form, interchangeable shaft assembly 1200 may also include actuated articulation joints 1270.However, other can Exchanging shaft assembly possibly can not carry out joint motions.It such as can be seen in fig. 22, for example, actuated articulation joints 1270 include double pivots Axis is closed sheath assembly 1271.According to various forms, double pivot closure sleeve assembly 1271 include have towards distal side it is outstanding on The end effector of tang 1273 and lower tang 1274 is closed sheath assembly 1272.End effector is closed sheath assembly 1272 and wraps Shape of a hoof aperture 1275 and fin 1276 are included, the shape of a hoof aperture and fin are used for be illustrated in following patent application Various modes engage the opening fins on anvil block 1306: what is be herein incorporated by reference is filed on March 14th, 2013 It is entitled " including surgical instruments (the ARTICULATABLE SURGICAL INSTRUMENT for capableing of joint motions hingedly locked COMPRISING AN ARTICULATION LOCK) " U.S. Patent Application Serial Number 13/803,086.As in further detail herein It illustrates, when anvil block 1306 is opened, shape of a hoof aperture 1275 and fin 1276 engage the fin on anvil block.The double pivot links in top 1277 include the distally and proximally pivot pin projected upwards, and the pivot pin engages proximally protruding in closed tube 1260 respectively Upper tang 1273 in top distal side pin hole and towards the top nearside pin hole in the upper tang 1264 outstanding of distal side.Lower part is double Pivot link 1278 includes the distally and proximally pivot pin projected upwards, and the pivot pin engages proximally lower handle outstanding respectively Lower distal pin hole in foot 1274 and towards the lower part nearside pin hole in the lower tang 1265 outstanding of distal side.See also Figure 22.
In use, closed tube 1260 is translated towards distal side (direction " DD "), such as in response to closure trigger 1032 It activates and closed anvil 1306.Anvil block 1306 is closed by following manner: being translated to the far side closed tube 1260 and therefore axis closes Trap tube assembly 1272, so as to cause it in the references to U.S. patent patent application serial numbers 13/803,086 that are previously mentioned The mode illustrated hits the proximal face on anvil block 1360.Also as elaborated in the bibliography, anvil block 1306 passes through Following manner and open: proximally translate closed tube 1260 and axis closure sheath assembly 1272, so as to cause fin 1276 and horse Ungulate aperture 1275 contacts and pushes anvil block fin to promote anvil block 1306.In anvil block open position, axis closed tube 1260 is transported It moves to its proximal position.
As also described above, interchangeable shaft assembly 1200 further includes the percussion for being supported for axially advancing in axle ridge 1210 Component.Firing member includes the intermediate percussion shaft portion 1222 for being configured to be attached to distal incision part or knife bar.It is intermediate Percussion shaft portion 1222 may include the wing being configured to receive in the proximal end of distal side knife bar in its distal end The longitudinal slit of piece.The size and construction of longitudinal slit and proximal end can be configured to allow relative motion therebetween, and It may include slip joint.The intermediate percussion shaft portion 1222 that slip joint can permit percussion driver, which is moved into, holds end Row device 1300 carries out joint motions, without movement or at least substantially moves knife bar.Once end effector 1300 is properly Ground orientation, centre percussion shaft portion 1222 can be promoted towards distal side, until proximal sidewall and the fin of longitudinal slit are in contact, To promote knife bar and to fire the nail bin being located in channel 1302.Beauty is found in being further described for operation of firing member In state's patent application serial number 13/803,086.
Such as can be seen in fig. 22, shaft assembly 1200 further includes the switch drum being rotatably received in closed tube 1260 1500.Switch drum 1500 include hollow shaft part 1502, the hollow shaft part have be formed on for receive wherein to The crown of roll platform of the actuating pin of outer protrusion.In all cases, actuating pin extends through longitudinal slit, and the longitudinal slit setting exists To be conducive to axial movement of the lock tube when it is engaged with articulation drive in lock tube.Rotary torsion spring 1420 is constructed At a part of the boss and nozzle housing 1203 that can engage on switch drum 1500 to apply bias force to switch drum 1500.It opens Closing drum 1500 may also include and is defined at least partly peripheral openings 1506 therein, the opening be configured to receive from The periphery mounting base that nozzle half 1202,1203 extends, and allow to switch opposite between drum 1500 and nearside nozzle 1201 Rotation rather than relative translation.Mounting base extends also through in the closed tube 1260 in the groove to be positioned in axle ridge 1210 Opening 1266.However, nozzle 1201 to mounting base reaches the point of the end of its respective slots 1506 in switch drum 1500 Rotation will lead to the rotation that switch drum 1500 surrounds axial line SA.The rotation of switch drum 1500 finally will lead to actuating pin and lock tube Rotation between its bonding station and disengaged position.Therefore, substantially, nozzle 1201 can be used in following patent Shen Please in the various modes that are explained in more detail so that joint motion drive system is operatively engaged and is detached from percussion drive system Engagement: it is filed in entitled " surgical instruments (the SURGICAL INSTRUMENT including sensing system on March 26th, 2014 COMPRISING A SENSOR SYSTEM) " U.S. Patent Application Serial Number 13/803,086 and U.S. Patent Application Serial Number 14/226,142, respective entire disclosure is hereby incorporated by reference.
Also as shown in figure 22, shaft assembly 1200 may include slip ring assembly 1600, and the slip ring assembly is configured to Such as conduct power to end effector 1300 and/or from its conduct power, and/or send the signal to end effector 1300 and/or from its send signal.Slip ring assembly 1600 may include proximal connector flange 1604 and distal connector flange, institute It states proximal connector flange and is installed to the chassis flange 1242 extended from chassis 1240, the distal connector flange is located in limit Due in the slit in shaft housing.Proximal connector flange 1604 may include the first face and distal connector flange may include neighbouring The positioning of first face and the second face that can be moved relative to the first face.Distal connector flange can be around axial line SA relative to close Side-connector flange 1604 rotates.Proximal connector flange 1604 may include be defined in its first face it is multiple with one heart or at least Substantially concentric conductor.Connector is mountable on the nearside of connector flange and can to have multiple contacts, wherein each touching Point is corresponding with one of the conductor and is in electrical contact.This arragement construction allows proximal connector flange 1604 to connect with distal side Relative rotation between device flange keeps electrical contact therebetween simultaneously.Proximal connector flange 1604 may include electric connector 1606, conductor can be positioned to lead to the progress signal of axis circuit board 1610 for being for example installed to axis chassis 1240 by the electric connector Letter.In at least one situation, the harness including multiple conductors can extend between electric connector 1606 and axis circuit board 1610. Electric connector 1606 can be extended proximally across the connector opening 1243 being defined in chassis mounting flange 1242.Referring to figure 22.It is filed in entitled " nail bin tissue thickness sensing system (the STAPLE CARTRIDGE TISSUE on March 13rd, 2013 THICKNESS SENSOR SYSTEM) " U.S. Patent Application Serial Number 13/800,067 be incorporated by reference and be incorporated to this Text.It is filed in entitled " nail bin tissue thickness sensing system (the STAPLE CARTRIDGE TISSUE on March 13rd, 2013 THICKNESS SENSOR SYSTEM) " U.S. Patent Application Serial Number 13/800,025 be incorporated by reference and be incorporated to this Text.Further detailed content about slip ring assembly 1600 is found in U.S. Patent Application Serial Number 13/803,086.
As discussed above, shaft assembly 1200 may include that can be fixedly secured to the portions of proximal of shank 1014 and can surround The distal part of longitudinal axis rotation.Rotatable distal shaft part can be as discussed above around slip ring assembly 1600 relative to close Side section rotation.The distal connector flange of slip ring assembly 1600 can be positioned in rotatable distal shaft part.In addition, except above-mentioned In addition, switch drum 1500 is alternatively positioned in rotatable distal shaft part.When the rotation of rotatable distal shaft part, distal side connection Device flange and switch drum 1500 can rotate synchronously with one another.In addition, switch drum 1500 can be relative to distal connector flange the It is rotated between one position and the second position.When switch drum 1500 be in its first position when, joint motion drive system can with hit Hair drive system is operatively disengaged from engagement, and therefore, the operation of percussion drive system can not be such that the end of shaft assembly 1200 holds Row device 1300 carries out joint motions.When switch drum 1500 is in its second position, joint motion drive system can drive with percussion Dynamic system is operatively engaged, and therefore, the operation of percussion drive system can make the end effector 1300 of shaft assembly 1200 into Row joint motions.When switch drum 1500 moves between its first position and its second position, drum 1500 is switched relative to remote The movement of side-connector flange.In all cases, shaft assembly 1200 may include the position for being configured to detection switch drum 1500 At least one sensor set.
Referring again to Figure 22, chassis 1240 includes at least one being formed on and preferably two tapered attachment parts 1244, the tapered attachment part can be received in the corresponding swallow formed in the distal side of frame 1020 attachment flange portion 1700 In tail slit 1702.Referring to fig. 21.Each dovetail slot 1702 can be tapered, or, in other words, slightly V-arrangement at it Middle resettlement receives attachment part 1244.Such as can in Figure 22 further seen in, axis means of attachment lugs 1226 is in intermediate beating shaft It is formed in 1222 proximal end.As that will discuss in further detail below, when interchangeable shaft assembly 1200 is connected to shank When 1014, axis means of attachment lugs 1226 receives the beating shaft attachment in the distal end 1125 for being formed in zigzag tread patterns component 1120 In pedestal 1126.Referring to fig. 21.
Shaft assembly 1200 is removably coupled to shell using latch system 1710 by various shaft assembly embodiments 1012 and more specifically it is connected to frame 1020.Such as can be seen in fig. 22, for example, at least one form, latch system 1710 include the locking component or lock yoke 1712 for being movably coupled to chassis 1240.In the illustrated embodiment, for example, lock yoke 1712 be in that there are two the U-shapeds of the leg 1714 extended downwardly spaced apart for tool.Leg 1714 respectively has the energy being formed on It is enough to receive the pivot lug 1715 in the corresponding aperture 1245 being formed in chassis 1240.This arragement construction is conducive to lock yoke 1712 to chassis 1240 pivotal attachment.Lock yoke 1712 may include the lock lug 1716 of two proximally protrusions, the lock lug Be configured to and the distal side of frame 1020 attachment flange 1700 in corresponding locking detent or groove 1704 be releasably engaged. Referring to fig. 21.In various forms, lock yoke 1712 is biased by spring or biasing member (not shown) along proximal direction.Lock yoke 1712 Actuating can realize that the latch is caused by the latched press-button 1722 being slidably mounted on latch actuator component 1720 Dynamic device assembly is installed to chassis 1240.Latched press-button 1722 can be biased relative to lock yoke 1712 along proximal direction.As will below It is discussed in further detail, lock yoke 1712 can be by keeping latched press-button not remote with frame 1020 along being also pivoted into lock yoke 1712 The distal direction of side attachment flange 1700 remained engaged with biases and moves to unlocked position.When lock yoke 1712 and frame 1020 When distal side is attached flange 1700 " remaining engaged with ", lock lug 1716 is retentively placed in the corresponding lock in distal side attachment flange 1700 Determine in detent or groove 1704.
When using including that can cut and the end effector of type described herein of fastening tissue and other types of When the interchangeable shaft assembly of end effector, it may be desirable to prevent in the interchangeable shaft assembly of the activating of end effector and outer Shell is undesirably fallen off.For example, in use, closure trigger 32 may be actuated to grasp destination organization and be manipulated in clinician At desired position.Once destination organization is oriented desired orientation in end effector 1300, clinician can be complete Full actuating closure trigger 1032 is clamped with closed anvil 1306 and by destination organization in place to be cut and be sutured.This In the case of, the first drive system 1030 has been fully actuated.After destination organization has been clamped in end effector 1300, It may be desirable to preventing undesirably falling off for shaft assembly 1200 and shell 1012.A form of latch system 1710 is configured to Prevent this undesirably fall off.
Such as can in Figure 22 most specifically seen in, lock yoke 1712 include at least one and preferably two latch hooks 1718, institute The corresponding lock ledge portion 1256 formed on closure spindle moving part 1250 can be contacted by stating latch hook.When closure spindle moving part 1250 is in When unactuated position (that is, first drive system 1030 does not activate and anvil block 1306 is opened), lock yoke 1712 can be along distal direction pivot Turn to unlock interchangeable shaft assembly 1200 with shell 1012.When in this positions, 1718 not contact closure shuttle of latch hook is dynamic Lock ledge portion 1256 on part 1250.However, when closure spindle moving part 1250 is moved to actuated position (that is, the first driving system System 1030 activates and anvil block 1306 is in the close position) when, lock yoke 1712 is prevented from being pivoted to unlocked position.In other words, false Lock yoke 1712 is pivoted to unlocked position as clinician repays examination, such as lock yoke 1712 unexpectedly may be made it with script It pivotably collides or contacts towards distal side, then the latch hook 1718 locked on yoke 1712 is convex by the lock on contact closure spindle moving part 1250 Ear 1256 and prevent lock yoke 1712 to unlocked position movement.
The attachment of interchangeable shaft assembly 1200 to shank 1014 will be illustrated now.It is clinical to start connection process Doctor the chassis 1240 of interchangeable shaft assembly 1200 can be located in frame 1020 distal side attachment flange 1700 top or near, So that the tapered attachment part 1244 formed on chassis 1240 is aligned with the dovetail slot 1702 in frame 1020.Clinician Can then be moved along the mounting axis perpendicular to axial line SA shaft assembly 1200 with by attachment part 1244 be positioned to accordingly Dovetail receives slit 1702 " being operatively engaged ".For this purpose, the axis means of attachment lugs 1226 on intermediate beating shaft 1222 also will placement The part of pin 1037 in the pedestal 1126 in the drive member 1120 for capableing of longitudinal movement and in the second closed connecting rod 1038 It will be placed in the respective hook in closed yoke 1,250 1252.As used herein, term " being operatively engaged " is in two components Refer to that described two components fully engage each other under background, so that once applying actuating movement to it, the component can Execute its expection movement, function and/or program.
At least five systems of interchangeable shaft assembly 1200 can be operated at least five corresponding systems of shank 1014 Ground connection.The first system may include that the frame of shaft assembly 1200 or ridge are coupled and/or are aligned with the frame 1020 of shank 1014 Frame system.Another system may include closure drive system 1030, and the closure drive system can be operably connected handle The closure trigger 1032 in portion 1014 and the closed tube 1260 of shaft assembly 1200 and anvil block 1306.As outlined above, shaft assembly 1200 closed tube attachment yoke 1250 can be engaged with the pin 1037 in the second closed connecting rod 1038.Another system may include that percussion is driven Dynamic system 1080, the percussion drive system can be operatively connected the firing trigger 1130 and shaft assembly 1200 of shank 1014 Intermediate beating shaft 1222.As outlined above, axis means of attachment lugs 1226 can be grasped with the pedestal 1126 of zigzag tread patterns component 1120 Make ground connection.Another system may include electrical system, and the electrical system can send such as shaft assembly (such as such as shaft assembly 1200) signal being operatively engaged with shank 1014 in such as shank 1014 controller (such as microcontroller) and/ Or (two) conduct power and/or signal of communication between shaft assembly 1200 and shank 1014.For example, shaft assembly 1200 may include electricity Connector 1810, the electric connector are operably mounted into axis circuit board 1610.Electric connector 1810 is configured to and handle Corresponding electric connector 1800 on portion's control panel 1100 cooperates engagement.Further detailed content about circuit and control system can See the U.S. Patent Application Serial Number 13/803,086 that its respective entire disclosure is herein incorporated by reference in advance In U.S. Patent Application Serial Number 14/226,142.5th system can be made of locking system with shaft assembly 1200 is releasable Ground is locked to shank 1014.
Surgical stapling device uses in the prior art, to cut longitudinal cut in the tissue simultaneously and by rows of nail It is applied to the opposite side of notch.This instrument generally includes the jaw member of a pair of of collaborative work, if be intended to the instrument For endoscope type or laparoscopic type application, then the jaw member can pass through pipe path.One of jaw member receives nail Storehouse, the nail bin have at least two staples being laterally spaced apart.Another jaw member limits anvil block, and the anvil block has and storehouse In staple alignment nail shapes pit.Instrument includes multiple reciprocating wedges, the multiple reciprocal when present dynasty distal side drives Formula wedge piece passes through the opening in nail bin and engages the driver of support nail, to realize the percussion of nail towards anvil block.
Tissue is cut off simultaneously when forming staple on the every side of notch, can reduce and bleed and simplify surgical operation.It is more and more Ground, endoscopic surgery and laparoscopic surgery are better than abdominal, because they reduce post-operative recovery time and further advantage. Endoscope type suture and cutting off apparatus use the elongated nip component often upward deflected when being clamped in thick tissue.In thickness Tissue, freedom (distal side) end of jaw this upward deflect can because the distant gap between anvil block and storehouse be greater than nearside gap And lead to the difference in height of forming nail.To ensure that nearside more evenly follows closely forming to distal side, anvil block usually inward towards nail bin flare or Bending.This flare is preferable for thick tissue and can lead to when using on thin tissue relatively tight at distal end Nail form.To overcome this close distal side closure, sells or swell to the clamping surface addition in the storehouse of the distal end in neighbouring storehouse Block.Closure on anvil block to pin ensures the minimum clearance at distal end.However, surgeon's concern causes the pin of tissue trauma Or bump.
Various arragement constructions have been developed to cope with this challenge.One arragement construction is true for example including being configured to " E mast " cutting head or trigger shaft that anvil block is spaced apart with the elongated passageway of support nail cartridge on the spot.This E mast cutting head and Trigger shaft arragement construction is disclosed in for example following patent: the entitled " surgery suturing appliance including E mast firing lock The beauty of (SURGICAL STAPLING INSTRUMENT INCORPORATING AN E-BEAM FIRING MECHANISM) " In state's patent 6,978,921, the entire disclosure of the patent is hereby incorporated by reference.
For example, tissue cutting head includes the E column that can be translated in end effector 16 as shown in Fig. 2 and Fig. 3 herein Bar 50.As described above, E mast 50 may include vertical portion 52, the vertical portion can be passed through when E mast 50 is promoted towards distal side Extend through narrow longitudinal anvil block slot 58 of the tissue contacting surface 60 in anvil block 20, the narrow vertical slit in nail bin 42 62 and elongate staple channel 40 in narrow longitudinal channel 64.Anvil block slot 58 can extend up in anvil block 20 and It may include the end for being passed through the vertical passage 66 laterally widened, the size and construction of the vertical passage laterally widened are set The upper pin 54 extended laterally at reception from vertical portion 52.Similarly, passage slot 64 can extend downwardly into channel 40 simultaneously And may include the end being passed through in the vertical passage 68 laterally widened, the size and configuration quilt of the vertical passage laterally widened It is set to receive from foot 70 under the one or more that vertical portion 52 extends laterally.E mast 50 may also include one or more Intermediate pin 72, the intermediate pin can extend laterally from vertical portion 52 and be configured to hold in the palm along the bottom of nail bin 42 The top surface of disk 74 slides.In certain embodiments, intermediate pin 72 is configured to nail bin 42 being placed in channel 40 In or ensure that nail bin 42 remains disposed in channel 40.The longitudinal direction percussion formed in nail bin 42 above bottom tray 74 is recessed The permission intermediate pin 72 that is sized to of slot 75 translates across nail bin 42.
Various elongated passageway arragement constructions include elongated or longitudinal slit, and described elongated or longitudinal slit is cut in E mast Head and prolongs at the starting position in the portions of proximal of elongated passageway between the end position adjacent with the distal end of elongated passageway It stretches.The vertical portion of E mast cutting head extends through the lower foot portion of the longitudinal slit and E mast along elongated passageway Bottom surface operation.Foot portion can help to be spaced apart anvil block relative to elongated passageway and be also used as facing What bed doctor found out position of the cutting head in elongated passageway facilitates device.By observation when cutting head is advanced through storehouse towards distal side When cutting head foot position, the position that clinician will accurately know that cutting head is located in storehouse.When offer is for being spaced apart When anvil block and the efficient apparatus of position for monitoring cutting head, this arragement construction not in elongated passageway use can reduce it is logical The longitudinal slit of the warp resistance and resistance to scalability in road rigidity and channel.
For this extension for avoiding elongated passageway, it may be desirable to which it is resistance to when suturing thick tissue to improve to eliminate longitudinal slit Warping property and resistance to scalability.However, this arragement construction can eliminate surgeon by observing the position of knife foot to understand seam Close the ability for having proceeded to which kind of degree.Figure 32, which is shown, can be similar to disclosed herein include for example in addition to following differences The elongated passageway 6022 of the various elongated passageways of elongated passageway 22 and 302.Elongated passageway 6022 can be by suitable polymer material It is molded and/or is process and/or formed in other ways and including substantially solid bottom surface portion 6024.Carefully Long-channel 6022 is configured to be operably supported surgery nail bin (not shown) wherein.Elongated passageway 6022 may include by The elongated interior slit 6026 that two chimb parts 6028 to extend internally limit.The chimb part 6028 to extend internally further defines Elongated interior access 6030 between chimb part 6028 and solid bottom part 6024.Although elongated interior slit 6026 Extend up to most of length of elongated passageway 6022, but its bottom surface 6024 for not extending across elongated passageway 6022.It is internal Being sized to be slidably received on cutting head for access 6030 forms or is otherwise affixed to cutting head One or more foots.
Figure 42 shows the E mast cutting head 6050 for example used in combination with elongated passageway 6022.However, will such as become aobvious And be clear to, elongated passageway 6022 may also be incorporated on the bottom of cutting head and be cut using the various differences of single foot or multiple foots Cut an arragement construction come using.Referring to fig. 42, cutting head 6050 includes perpendicular with the two lower foots 6070 extended laterally terminations Straight part 6052.Vertical portion 6052 is configured to across elongated slot 6026, so that lower foot 6070 receives corresponding 6028 lower section of chimb part.
Referring again to Figure 32, elongated passageway 6022 may also include the close of the bottom part 6024 that elongated passageway 6022 is arranged in Proximal channel opening 6040 in side end.Proximal channel opening 6040 can be provided to clinician and be opened when cutting head 6050 is in The foot 6070 of cutting head 6050 or the view of at least one of one or more of the other part when beginning or non-firing position.This " starting position " can also be with the cutting head when cutting head 6050 is in the latched position that will such as discuss in further detail below The location of 6050 is corresponding.Similarly, distal channel opening 6042 be set in the distal end of bottom part 6024 with to Clinician provide when cutting head 6050 be in its " complete fire " or " end position " foot 6070 of cutting head 6050 or The view of at least one of one or more of the other part.This arragement construction is provided to clinician for finding out cutting head It is to be in its end position in its starting position while providing compared to the bottom for extending longitudinally through elongated passageway The method of the relatively harder elongated passageway in other channels of the longitudinal slit in portion.Proximal channel opening 6040 and distal channel opening 6042 can shape in a manner of shown in Figure 32 to be conducive to such as light installation of the cutting head 6050 into elongated passageway 6022 and (pass through Proximal channel opening is 6040) and cutting head 6050 is from the removal of elongated passageway 6022 (passing through distal channel opening 6042).Therefore, Elongated passageway 6022 has the closure including opening 6040,6042 corresponding with the beginning and end of cutting head firing schedule respectively Bottom.This arragement construction allows to see the beginning and end of percussion and allows cutting head to such as will in further detail below The latched position of ground discussion moves downward.
Elongated passageway 6022 can effectively with the cutting head assembly that manually advances or use motor operated type trigger system The cutting head assembly of propulsion is used together.For example, surgical instruments 10 described above includes passing through actuating trigger 32 manually The cutting head 50 of propulsion.In various arragement constructions, cutting head 50 can be and activating firing trigger 32 since it three times Position is advanced to its end position.Thus, for example, one-shot trigger 32 can be such that cutting head transports in elongated passageway towards distal side Move the one third (" the first firing position ") of the distance between starting position and end position.Second of startup trigger can be led Cause 2/3rds (" the second firing positions ") of the distance between 50 traveling starting position of cutting head and end position and third time Startup trigger 32 can lead to propulsion of the cutting head 50 from the second firing position to end position.Therefore, when 6050 energy of cutting head When enough being seen by distal channel opening 6042, clinician will be appreciated by cutting head 6050 and be fired completely.It is this elongated logical Also in combination with operated type surgical instruments 1010, (Figure 19 to Figure 22) is used in road 6022.
Figure 33 to Figure 35 shows another elongated passageway cloth that elongated passageway 6022 is similar in addition to the difference being previously mentioned Set structure 6122.Being identical to those of elongated passageway arragement construction 6122 of the part of elongated passageway arragement construction 6022 part will Share identical element number.In particular, a series of indicators openings 6144 spaced apart are set as can be seen in Figure 33 It sets in bottom part 6124.Indicator opening 6144 can be upper different at quantity, size and interval, but at least one cloth It sets in structure, indicator opening 6144 is of the same size and is equally spaced apart by a row, so that it is passed through in elongated Portion's access 6030.As can be seen in those figures, indicator opening 6144 be circular shape.Also as can be seen in Figure 33, light Source 6160 is mountable in the proximal end of elongated passageway 6122, so that light source 6160 projects light onto internal path 6030 (being indicated by the dotted line " L " in Figure 33 and Figure 34).Light source 6160 may include for example one or more light emitting diodes (" LED ") or Other light source arragement constructions of electric power can be received by conductor 6164, the conductor is connected to surgical instruments or robot system etc. Shank, elongated passageway 6122 is operably attached to the shank.When light source 6160 is powered, light be would be projected to inside In access 6030.When cutting head 6050 is in starting position, cutting head 6050 can prevent any light " L " from passing through any indicator It is open 6144 visible.Therefore, when not having light " L " visible by any indicator opening 6144, clinician will be appreciated by cutting First 6050 are in starting position.When cutting head 6050 is advanced through indicator opening 6144 towards distal side, light " L " will be mapped to cutting As it can be seen that as shown in figure 34 on first 6050 and at least through the unobstructed indicator opening 6144 close to cutting head 6050.Cause This, this arragement construction allow the clinician to monitoring cutting head 6050 with its in elongated passageway 6122 from its start bit Set the process for moving toward the far side its end position.This elongated passageway arragement construction also extends fully through elongated lead to than having Those of most elongated slot of the bottom surface in road elongated passageway arragement construction is harder and more rigid.It is tied in an arrangement In structure, since there will be no the light for shining through the indicator opening that cutting head is located therein, clinician can determine cutting head Position.All other indicator opening will have the light for shining through it.Therefore, in an arragement construction, " black " or Non-luminous indicator opening is cutting head whereabouts.In other embodiments, light source can be omitted.Clinician still may be used Position of the cutting head 6050 in elongated passageway 6122 is monitored by the position through 6144 observation foot 6070 of indicator opening It sets.
Figure 36 shows another elongated passageway arragement construction that elongated passageway 6122 is similar in addition to the difference being previously mentioned 6222.Those of elongated passageway arragement construction 6222 of the part of elongated passageway arragement construction 6122 part is identical to by shared phase Same element number.Such as finding, a series of indicators openings 6144 spaced apart it can be arranged through bottom surface in the drawings 6224.In shown arragement construction, indicator opening 6144 is of the same size with shape but section is set at different intervals It sets across bottom surface 6224.For example, can be spaced apart such that with proximal open 6040 being capable of example by recent side indicator opening 6144P Such as observed in the foot 6070 or other parts of cutting head 6050 at least when cutting head 6050 is in starting position by it The first spacing distance " FSD " of one.Equally, farthest side indicator opening 6144D can be with 6144 interval of adjacent indicator opening Open the second spacing distance " SSD " different from the first spacing distance FSD.As can be seen in Figure 36, for example, SSD is greater than FSD. Farthest side indicator is open 6144D can be corresponding in the position of cutting head 6050 of its end position.Therefore, elongated passageway cloth Setting structure 6222 is shown in which open amount at you by being closely open to the variable interval indicator of reduction when remote movement.
Figure 37 shows another elongated passageway arragement construction that elongated passageway 6122 is similar in addition to the difference being previously mentioned 6322.Those of elongated passageway arragement construction 6322 of the part of elongated passageway arragement construction 6122 part is identical to by shared phase Same element number.It can finding, elongated passageway arragement construction 6322 include in the drawings such as a series of elongated independent indicators Be open 6144'.In shown arragement construction, indicator opening 6144' is of the same size with shape and with section at equal intervals Arrangement.
Figure 38 shows another elongated passageway arragement construction that elongated passageway 6222 is similar in addition to the difference being previously mentioned 6422.Those of elongated passageway arragement construction 6422 of the part of elongated passageway arragement construction 6222 part is identical to by shared phase Same element number.Such as can in the drawings seen in, only two " independence " indicators spaced apart are open 6144 " be arranged through bottom Portion surface 6424.In shown arragement construction, indicator opening 6144 " is of the same size with shape but at different intervals Section is arranged through bottom surface 6424.For example, recent side indicator opening 6144P " can be spaced apart the with proximal open 6040 One spacing distance " FSD " and farthest side indicator opening 6144D " can be with recent side indicator opening 6144 ", which be spaced apart, to be different from The second spacing distance " SSD " of first spacing distance FSD.In at least one arragement construction, for example, when elongated passageway 6422 with When being used together by activating the cutting head assembly that manually advances of firing trigger, cut head assembly at least one foot or Other parts can be indicated when cutting head assembly and being advanced through " first stroke " or the first actuating of firing trigger by nearside Device opening 6144P " observation.Equally, at least one foot or other parts for cutting head assembly can be the second of firing trigger Opening 6144D " observation is indicated by farthest side during stroke or the second actuation sequences.Therefore, elongated passageway 6422 includes elongated Slit shape indicator is open and when you are by closely to the circular indicators opening that offer when remote movement be more closed/is less open.
Figure 39 shows another elongated passageway arragement construction that elongated passageway 6422 is similar in addition to the difference being previously mentioned 6522.Those of elongated passageway arragement construction 6522 of the part of elongated passageway arragement construction 6422 part is identical to by shared phase Same element number.It can finding, elongated passageway 6522 include in the drawings such as allowing the clinician in firing trigger First stroke or actuation sequences during observation cutting head assembly at least one foot or other parts recent side dolichostenomelia Show the combination of device opening 6144P " and the combination of the round opening of indicator at equal intervals 6144.Therefore, elongated passageway 6522 uses The combination of open flume type slit and elongated slot.Any one of above-mentioned elongated passageway arragement construction is in combination with herein in conjunction with Figure 33 Light source 6160 that shown embodiment is specifically described or its can be used in the case where no light source.
Other cutting head monitoring arragement constructions may include the opening for example in channel or the slit along channel interior One or more light source arragement constructions or light emitting diode (" LED ") arragement construction of projection light.This will greatly enhance user and determine Position cutting head be in its stroke where with determine the whether completed ability of total kilometres.In some arragement constructions, example Such as, LED may include as cutting head is along the further discriminating between cutting head propulsion of channel and from green to the more of blue Color LED (or other color placement structures).
In the various end effector arragement constructions, it may be desirable to using for preventing cutting head propulsion or percussion be System, unless not used nail bin has been operably mounted in elongated passageway.For example, its respective entire disclosure accordingly with Entitled " surgery suturing appliance (the SURGICAL STAPLING with used storehouse latching member that way of reference is incorporated herein INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT) " United States Patent (USP) 6,988,649 and entitled " have For preventing surgery suturing appliance (the SURGICAL STAPLING INSTRUMENT HAVING of the single blocking mechanism of percussion A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING) " 7,044,352 disclosure of United States Patent (USP) Various locking systems.In this locking arragement construction, cutting head or " trigger shaft " are usually biased to by spring arragement construction Latched position.Before not used storehouse has been installed in an elongated channel, cutting head can not be in other ways by surgical instruments Percussion drive system promotes.
Referring to fig. 40 to Figure 42, show the cutting head 6050 for being attached to trigger shaft 6080.As shown, trigger shaft 6080 For laminar construction.However, trigger shaft 6080 can be solid construction.In either case, trigger shaft 6080 and as described herein Or the percussion drive system of the surgical instruments as known in other ways operativelys interface with.The actuating of percussion drive system will be hit Hair bar 6080 and the cutting head 6050 for being attached to it are axially advanced the surgery nail bin being passed through in elongated passageway 6122.It cuts The vertical portion 6052 for cutting first 6050 includes tissue cutting table between upper end part 6054 and center hook portion 6056 Face 6053.Referring to fig. 42.Upper pin or upper flap 6058 are extended laterally from each side of upper end part 6054.Upper flap 6058 be configured to be slidably received in it is such as that being operably mounted into of discussing in further detail below is elongated In upper passage in the anvil block in channel.
Figure 41 shows cutting head 6050 and trigger shaft 6080 when surgery nail bin is not present in elongated passageway 6122 Position.When in this positions, trigger shaft 6080 and cutting head 6050 are biased in a downwardly direction " D " by spring arm 6090, institute State the axle ridge (not shown) support that spring arm is coupled to elongated passageway 6122.Such as can in the drawings seen in, spring arm 6090 It is slidably engaged with the spring tail portion 6082 formed in the distal end of trigger shaft 6080.When cutting head 6050 is in such as Figure 41 institute When the latched position shown, the bottom part of spring tail portion 6082 is biased to the inclined surface formed on elongated passageway 6122 In 6123.Such as can in Figure 41 further seen in, when cutting head 6050 is in the locked position, if clinician is not intended to pilot scale Figure promotes cutting head 6050 towards distal side or " percussion " passes through elongated passageway 6122, then a multiple or Ge Xia foot 6070 may connect Touch the bottom of elongated passageway 6122.In other words, when cutting head 6050 is in the locked position, foot 6070 not with elongated passageway Internal path 6030 in 6122 is aligned and therefore cutting head assembly 6050 may not be axially advanced wherein.Clinician will Know that cutting head is locked by position of the observation foot 6070 in proximal open 6040.
Figure 40 shows the cutting head when not used surgery nail bin has been operably supported in elongated passageway 6122 6050 and trigger shaft 6080 position.Although the main body of surgery nail bin is not shown in Figure 40, wedge slider assembly is shown 6078.It should be appreciated that wedge slider assembly 6078 will do not fire or not used nail bin in the position shown in Figure 40. When in this positions, wedge slider assembly 6078 is engaged with the hook portion 6056 on cutting head 6050 so that cutting head 6050 in upward direction (arrow " U " in Figure 40) be increased to the wherein foot thereon when cutting head 6050 is promoted towards distal side 6070 will enter the point of the internal path 6030 in elongated passageway 6122.When using with closing bottom or substantially closed bottom When portion (all as those described herein), it is envisaged that ground is occurred dimension storehouse situation and held in this case when using end Interference between the bottom of the channel and one or more knife foot when cutting and suture very thin tissue, can occur for row device.If Tissue is too thin, for example, tissue crushing resistance may be not enough to push anvil block far from elongated passageway and load against cutting head fin Both parts.In case of such case, one or more knife foots can extend far enough in the bottom part down of elongated passageway So that cutting head can not be promoted towards distal side.Cutting head assembly 6050 and elongated passageway arragement construction shown in Figure 40 and Figure 41 6122 can prevent this from occurring.
As can be seen in Figure 40 and Figure 41, for example, the distal end of each foot 6070 can have and be formed on Inclined-plane 6072.Inclined-plane 6072 be configured to cutting head 6050 by towards distal side promote at make foot 6070 enter internal path The corresponding portion of elongated passageway 6122 is engaged when 6030.Therefore, the formation of inclined-plane 6072 helps foot 6070 being directed to access Small " introducing " slope in 6030.Also as the proximal end 6131 of internal path 6030 can be limited seen in Figure 40 and Figure 41 Elongated passageway 6122 part can on it have inclined-plane 6133 or in other ways as shown in the figure inclination.In alternative arrangement knot In structure, multiple foots 6070 (or single foot) can provide the close end part 6131 of inclined-plane 6072 or internal path 6030 It can provide inclined-plane 6133 or the two inclined-plane arragement constructions can be provided as shown in Figure 40 and Figure 41.
Figure 43 and Figure 44 is shown can be for example similar to end effector 16 or 300 disclosed herein or other end devices End effector 7016.In this arragement construction, closed tube or casing 7028 have wherein to be allowed the clinician to lead to It is crossed to observe a series of indicators of trigger shaft 6080 opening 7144.Trigger shaft 6080 can be provided on it can be in trigger shaft 6080 status indications 6084 observed by clinician by indicator opening 7144 when being promoted towards distal side.Status indication 6084 can Simply including will be as the printing mark or other feature structure of reference marker.In an arragement construction, status indication 6084 include one or more hairs of the surgical instruments as attached by end effector 7016 or the power supply power supply in surgery system Optical diode (LED) or other light sources.
Figure 45 is shown in which that closure casing section 7030 includes allowing the clinician to determine whether cutting head is in it The other end actuator 7016 of the indicator window 7032 of latched position.In this arragement construction, if clinician Ke Tong It crosses indicator window 7032 and sees spring tail portion 6082, then cutting head is not at its latched position.If clinician can not lead to It crosses indicator window 7032 and sees spring tail portion 6082, then cutting head is in its latched position.In alternative arrangement structure, instruction Device window 7032 may be provided on such a position (for example, lower in closure casing section) so that if spring tail portion 6082 pass through indicator window 7032 as it can be seen that then cutting head is in its latched position, and if spring tail portion 6082 passes through instruction Device opening is invisible, then cutting head is not at latched position.The position of cutting head is determined for auxiliary clinician, and cutting head can be with Especially bright color or fluorescence color provide.These color placements may, for example, be based on radium.In addition, the color of cutting head can It is varied so that clinician can easily find out its position along its length.
Figure 47 shows the access 7022 that the upper end part 6054 including being provided on cutting head 6050 enters axially into In observation multiple or a series of indicators opening 7044 anvil block 7020.In the embodiment shown in Figure 47, indicator is opened Mouth 7044 has circular shape and is spaced apart along the equal length of anvil block 7020.In the embodiment shown in Figure 48, instruction Device opening 7044 is closer to be spaced apart together at the proximal end of anvil block 7020.Indicator opening 7044 between interval with Move toward the far side and be gradually increased in anvil block 7020.However, size, shape and the variable spaced of indicator opening 7044 Change.Referring to fig. 42, indicating element 6059 may be provided in the top ends part 6054 of cutting head 6050.In an embodiment party In case, indicating element 6059 includes one for can obtaining electric power from surgical instruments by the conductor 6081 across trigger shaft 6080 Or multiple light emitting diodes or other light sources.This arragement construction allows the clinician to be advanced through end in cutting head 6050 By the indicator opening 7044 in anvil block 7020 come the position of sight indicator component 6059 when portion's actuator.In other arrangements In structure, indicating element (light emitting diode, lamp) can not be provided in cutting head.However, the top ends part of cutting head It can will be improved to provide by the visual color or fluorescent marker of the instruction opening in anvil block.For example, color can be Based on radium.Cutting head is provided with laser scribe number alternatively to provide for determining cutting head in channel or anvil block The device of position.
Anvil block 7020 shown in Figure 46 uses the indicator system for being generally designated as 7200.In this embodiment, it indicates Device system 7200 includes the axle journal connection at least at its proximal end 7204 in the slit 7021 being arranged in anvil block 7020 Flexible strip or waveform spring 7202.Waveform spring 7202 extend the length of anvil block 7020 and with have across its indicator The part of the anvil block 7020 of opening 7044 is at least coextensive.It finding, a series of indicating elements 7206 can such as be attached in figures 4-6 can Flexible strip 7202, so that each indicating element 7206 is slidably supported in respective indicator opening 7044.Each finger Show 7206 initial support of device component in its respective indicator opening 7044, so that it is not from indicator opening protrusion.It changes Sentence talk about, waveform spring 7202 be constructed such that indicating element 7206 be biased to wherein the indicating element not from it Respective indicator 7044 initial positions outstanding of opening.However, when cutting head 6050 is advanced through end effector towards distal side, The top section 6054 of cutting head 6050 is along the basal sliding of waveform spring 7202 and for waveform spring 7202 is upward Biasing, so that making to refer to when cutting head slides below a part of waveform spring 7202 attached by indicating element 7206 Show that device component 7206 is prominent from indicator opening 7044, as shown in figure 46.Therefore, which indicator clinician can be by paying attention to Position of the component 7206 from the outstanding monitoring cutting head 6050 of its indicator opening 7044 in end effector.
Therefore, several offers in elongated passageway arragement construction disclosed herein are better than existing elongated passageway arragement construction Vast improvement.For example, at least some of described elongated passageway arragement construction does not use the bottom surface for extending through channel Elongated slot.Therefore, this elongated passageway arragement construction is often harder and anti-extension during operation.It is mentioned when to clinician When for device for monitoring the process of cutting head, these advantages are also realized.For example, some elongated passageway arragement constructions provide edge The length in channel period visuality to notify clinician's cutting head the location of in firing cycle.It is described elongated logical At least some of road arragement construction is allowed the clinician to when cutting head is in complete deployed position and at cutting head At least part of cutting head is seen when fully retracted position.In addition, in the channel and/or anvil block arragement construction at least Some at least part for providing cutting heads provide use from the visuality at the side of end effector or top or in other ways In from end effector side or top find out cutting head position device.
As described above, surgery nail bin is wherein being operably supported respectively the one of the one or more surgical staples of support on it Serial staple drivers.Staple drivers are supported in the nail pit for the respective shapes for being arranged to linear orientation in warehouse.Surgery Nail is movably supported on driver so that when driver is driven upwardly in storehouse, nail be driven through be clamped in storehouse with Tissue between anvil block and formed and contacted with the bottom side of anvil block.When anvil block is opened, nail keeps together with suture tissue.By Yu Ding ' is loosely ' it is supported in its corresponding pit on its staple drivers, therefore follow closely it is envisioned that ground is using preceding quilt in nail bin It drops out in the case where unexpectedly overturning from nail bin.To avoid such case, warehouse lid is usually using preceding removedly attached It is connected to nail bin.When being attached to storehouse, warehouse lid covering nail pit is remained at that will follow closely, but regardless of storehouse position how.When facing When storehouse is installed in end effector by bed doctor's expectation, lid can be removed in a pre-installation.
It is such as further discussed above, staple drivers are sliding by the wedge shape driven together with cutting head assembly towards distal side in storehouse Moving part drives upwards in turn.In at least some arragement constructions, wedge-shaped slides therefore the before firing quilt in not used storehouse It is orientated to recent side " beginning " position.It is actually also as discussed above, at least some arragement constructions need wedge-shaped slides (when When in its starting position) and cutting head (when be in its latched position when) between interact to by cutting head remove lock Positioning is set to make it ready for firing.However, storehouse lacks for ensuring wedge-shaped slides at least some existing arragement constructions The device or structure of its starting position are maintained at before use.Warehouse lid 7250 shown in Figure 64 and Figure 65 can solve such ask Topic.
Figure 64 shows surgery nail bin 7220, and the surgery nail bin has warehouse 7222, and the warehouse can operate wherein Multiple staple drivers (not shown) on each side for the slit 7224 that ground support longitudinally extends.The slit 7224 longitudinally extended It is configured to be conducive to cutting head to be longitudinally travelled across storehouse.As can be seen in Figure 65, storehouse 7220 also supports and warehouse The adjacent wedge-shaped slides 7230 in starting position of 7222 proximal end.Figure 64 and Figure 65 also shows warehouse lid 7250, The warehouse lid includes top section 7252, and the top section is configured to cover when warehouse lid 7250 is mounted on storehouse 7220 Galenic platform 7226.More specifically, top section 7252 is configured to when top section 7252 is in " covering position " Cover all securing member chambers opening in the platform 7226 of warehouse 7222.Warehouse lid 7250 can be by being configured to retentively connect A pair of of the flexible attachment arm 7254 for closing warehouse 7222 is removably attached to nail bin 7220.Clinician can be easy by will be flexible Attachment arm 7254 is pried open Cheng Buyu warehouse 7222 and is remained engaged with to remove warehouse lid 7250.Warehouse lid 7250 may also include for being located in The side panel 7255 that a pair of warehouse lid 7250 on storehouse 7220 in desired locations extends downwardly.For example, side panel 7255 can quilt It is positioned to engage the antelabium 7227 extended laterally formed on every side of storehouse platform 7226.Warehouse lid 7250 may also include to be set between two parties The positioning flaps 7256 set, the positioning flaps, which are oriented to receive when warehouse lid 7250 is attached to storehouse 7220, longitudinally to be extended In slit 7224, as shown in Figure 65.Positioning flaps 7256 include being configured to be retentively engaged wedge-shaped slides 7230 A part and make wedge-shaped slides 7230 be maintained at its starting position engagement recesses 7258 or one or more of the other forming section. Therefore, when warehouse lid 7250 is installed on nail bin 7220, nail be maintained in its corresponding pit, but regardless of storehouse 7220 orientation such as What.In addition, wedge-shaped slides 7230 are maintained at its starting position.In various arragement constructions, the size of positioning flaps can be opposite It is set to establish frictional fit with it in the slit 7224 longitudinally extended.In this arragement construction, frictional fit can be used It is held in place in lid 7250 on storehouse 7220, without being attached arm 7254.In other arragement constructions, it may be used at positioning wing The frictional fit established is maintained at the lid 7250 on warehouse 7222 between piece 7256 and warehouse 7222 and attachment arm 7254 Covering position.In addition, holding rib 7257 can be formed on positioning flaps 7256 further to establish frictional fit with warehouse 7222. In addition, the distal end 7221 of surgery nail bin 7220 can have angled relative to storehouse platform 7226 as can be seen in Figure 65 The nose surface 7223 of ground orientation.In various arragement constructions, warehouse lid 7250, which may also include, to be configured to be retentively engaged The nose part 7251 of the distal end 7221 of surgery nail bin 7220.For example, nose part 7251 is configured to cover The nose surface 7223 in storehouse 7220 and the distal side for engaging the distal end 7221 in storehouse 7220 in the form of hook including being arranged to Retention tab 7253.Fin or protrusion 7259 are detached from addition, can be formed on nose part 7251 to be conducive to retention tab 7253 with the disengaging in storehouse 7220.Therefore, in certain arragement constructions, the distal end of warehouse lid 7250 is configured to allow it It absorbs all one's effort for decline of diving and the power is transferred directly to storehouse 7220, and almost without lid 7250 relative to warehouse 7222 Longitudinal movement.This arragement construction is used to prevent proximally move sliders 7230 under these conditions of lid 7250.When clinic is cured When raw expectation is using storehouse 7220, warehouse lid 7250 is removed.In at least some arragement constructions, warehouse lid 7250 can be with reception in nail bin The corresponding particular color of the size of nail in 7220 provides.
If being discussed in detail above, in various embodiments, surgical staples, which are supported on, to be operatively supported to form nail On " driver " in pit in the main body in storehouse.Various forms of drivers can be used.For example, driver is configured to Single surgical staples are enough supported, and other drivers can support multiple surgical staples.Driver is supported in setting in warehouse and is accommodating Across its cutting element or cutting head access the elongated slot being centrally located each side on the row longitudinally extended In.If being previously discussed as herein, cutting head includes wedge-shaped slides or operates altogether with it, and the wedge-shaped slides are adapted to Enough successively contact drivers are so that driver drives up in its corresponding pit.When driver moves upwards in nail bin, The one or more surgical staples being supported on are driven upwardly across the tissue being clamped in storehouse and anvil block and and anvil block Bottom side formed contact.
As it is known that the bottom side of anvil block includes " nail forming " surface, " nail forming " surface generally include to be arranged to by A series of nail shapes pits of the end contact of nail leg.Pit is set and is shaped so that when being contacted by nail leg, and leg is forced Portion is bent around pit and ultimately forms the closure nail for being approximately similar to " B shape ".Misalignment of the nail leg in forming process can be led Nail is caused to become deformity, and this can lead to undesirable leakage in severe cases.Staple drivers structure shown in Figure 94 and Figure 95 Type can help to keep nail alignment during percussion.In addition, if during percussion, driver in its corresponding pit not Holding is properly aligned with, then must generate higher percussion force to fire the nail being supported on.
Figure 94 and Figure 95 shows " double " staple drivers 7300.Such as can finding, staple drivers 7300 include in these figures The first driver portion 7310 and the second driver portion of " staggeredly " orientation are separated by the partition part 7340 being centrally located 7350.Staple drivers 7300 can be integral type construction, and for example be formed by suitable molded of polymeric material.First driver Part 7310 includes that the first driver 7310 is divided into the first nearside upright support portion 7320 and the first distal side upright support portion Divide 7330 the first chamber 7312 being centrally located.First nearside upright support portion 7320 has the first proximal body portion 7321, first proximal body portion has upper end part 7322, and the upper end part has in the wherein formed One proximal base segment 7324.Similarly, the first distal side upright support portion 7330 has the first distal body portion 7331, institute The first distal body portion is stated with the first distal end 7332, first distal end has remote in first wherein formed Wing base segment 7334.First nearside bottom segment 7324 and the first distal side pedestal segment 7334 are aligned and are configured to Wherein support the base portion of surgical staples.Such as can in Figure 94 further seen in, when viewed from above, the first nearside upright support portion Divide 7320 there is the shape being slightly tapered.In other words, the first nearside upright support portion 7320 has the first proximal end 7326, first proximal end has the width " PW " of the center width " CW " less than the first proximal body portion 7321.Together Sample, the first distal side upright support portion 7330 have the first distal end 7336, and first distal end has less than first The distal width " DW " of the center width " CW " of distal body portion 7331.In at least one arragement construction, distal width " DW " is equal to nearside width " PW ".
Referring still to Figure 94, the second driver portion 7350 includes the second chamber 7352 being centrally located, described to be centrally located The second chamber the second driver portion 7310 is divided into the second nearside upright support portion 7360 and the second distal side upright support portion Divide 7370.Second nearside upright support portion 7360 has the second proximal body portion 7361, second proximal body portion With upper end 7362, the upper end has in the second proximal base segment 7364 wherein formed.Similarly, second Distal side upright support portion 7370 has the second distal body portion 7371, and second distal body portion has the second distal side End 7372, second distal end have in the second distal side pedestal segment 7374 wherein formed.Second proximal base section Section 7364 and the second distal side pedestal segment 7374 are aligned and are configured in the base portion for wherein supporting another surgical staples.Such as may be used The further finding in Figure 94, when viewed from above, the second nearside upright support portion 7360 has the shape being slightly tapered. In other words, the second nearside upright support portion 7360 has proximal end 7366, and the proximal end has close less than second The width " PW " of the center width " CW " of side main part 7361.Equally, the second distal side upright support portion 7370 has distal side End 7376, the distal end have the distal width of the center width " CW " less than the second distal body portion 7371 "DW".Therefore, the first driver portion 7310 and the second driver portion 7350 have similar shape.
For bigger stability, the first driver portion 7310 and second are provided to staple drivers 7300 during percussion Driver portion 7350 can be further provided with the stabilizer operated altogether with the nail pit of the complementary shape in cartridge body and arrange Structure.For example, the first staple drivers part 7310 can have the branch of the lateral protrusion formed in its first proximal end 7326 First nearside group 7327 of dagger 7328,7329.It can also be first remote as shown in the figure in the first distal side upright support portion 7330 First distally group 7337 of the support column 7338,7339 of lateral protrusion is provided on side end 7336.Equally, the second staple drivers portion Divide 7350 there can be the second nearside group of support column 7368,7369 of the lateral protrusion formed in its second proximal end 7366 7367.Lateral protrusion can be also provided in the second distal end 7376 of the second distal side upright support portion 7370 as shown in the figure Second distally group 7377 of support column 7378,7379.
As described above, staple drivers 7300 are movably supported by the nail pit of the complementary shape in nail bin.When wedge shape is slided When part is driven towards distal side, corresponding portion drivingly contact the partition part 7340 being centrally located and by driver 7300 to Upper driving.Each of support column 7328,7329,7338,7339,7368,7369,7378 and 7379 of lateral protrusion receives In the groove of respective shapes in cartridge body and it is used to keep the alignment of driver 7300 and prevents the driver from existing It is distorted during promoting towards anvil block.In an arragement construction, driver 7300 is molded by solid material or with other side Formula is formed.However, the first driver portion 7310 and the second driver portion 7350 can be hollow in other arragement constructions So that these parts of driver 7300 can be slightly flexible and submissive further to keep the driver at it Alignment in corresponding pit, to be further reduced required driving force.In any one arragement construction, by providing two drives Alignment post on two ends of dynamic device part, further enhances alignment of the driver in its corresponding pit.
Figure 96 shows the nail pit for being configured to be received in the complementary shape formed in the main body of surgery nail bin In another " double " staple drivers 7400.As can be seen in Figure 96, staple drivers 7400 include the partition board portion by being centrally located Divide 7440 the first driver portions 7410 and the second driver portion 7450 for being separated into " staggeredly " orientation.Staple drivers 7400 can It constructs for integral type, and is for example formed by suitable molded of polymeric material.First driver portion 7410 includes setting between two parties First driver 7410 is divided into the first nearside upright support portion by the first chamber 7412 set, first chamber being centrally located 7420 and the first distal side upright support portion 7430.First nearside upright support portion 7420 has the first proximal body portion 7421, first proximal body portion has upper end 7422, and the upper end has close in first wherein formed Wing base segment 7424.Similarly, the first distal side upright support portion 7430 has the first distal body portion 7431, and described the One distal body portion has the first distal end 7432, and first distal end has at the first distal side bottom wherein formed Seat segment 7434.First proximal base segment 7424 and the first distal side pedestal segment 7434 are aligned and are configured to wherein Support the base portion of surgical staples.Such as can in Figure 96 further seen in, the first nearside upright support portion 7420 and the first distal side are straight Vertical support section respectively has the shape being slightly tapered.
Referring still to Figure 96, the second driver portion 7450 includes the second chamber 7452 being centrally located, described to be centrally located The second chamber the second driver portion 7450 is divided into the second nearside upright support portion 7460 and the second distal side upright support portion Divide 7470.Second nearside upright support portion 7460 has the second proximal body portion 7461, second proximal body portion With upper end 7462, the upper end has in the second proximal base segment 7464 wherein formed.Similarly, second Distal side upright support portion 7470 has the second distal body portion 7471, and second distal body portion has the second distal side End 7472, second distal end have the second distal side pedestal segment 7474 wherein formed.Second proximal base segment 7464 and second distal side pedestal segment 7474 alignment and be configured in the base portion for wherein supporting another surgical staples.
For bigger stability, the first driver portion 7410 and second are provided to staple drivers 7400 during percussion Driver portion 7450 can be further provided with the stabilizer operated altogether with the nail pit of the complementary shape in cartridge body and arrange Structure.For example, the first staple drivers part 7410 can have the lateral protrusion formed in the first proximal body portion 7421 First nearside group 7427 of support column 7428,7429.It can also be as shown in the figure the first of the first distal side upright support portion 7430 First distally group 7437 of the support column 7438,7439 of lateral protrusion is provided in distal body portion 7431.Equally, the second nail drives Dynamic device part 7450 can have the of the support column 7468,7469 of the lateral protrusion formed in the second proximal body portion 7461 Two nearside groups 7467.Can also above it be mentioned in the second distal body portion 7471 of the second distal side upright support portion 7470 as shown in the figure For the second distally group 7477 of the support column 7478,7479 of lateral protrusion.
As described above, staple drivers 7400 are movably supported by the nail pit of the complementary shape in nail bin.When wedge shape is slided When part is driven towards distal side, corresponding portion drivingly contact the partition part 7440 being centrally located and by driver 7400 to Upper driving.Each of support column 7428,7429,7438,7439,7468,7469,7478 and 7479 of lateral protrusion receives In the groove of respective shapes in cartridge body and it is used to keep the alignment of driver 7400 and prevents the driver from existing It is distorted during promoting towards anvil block.In an arragement construction, driver 7400 is molded by solid material or with other side Formula is formed.However, the first driver portion 7410 and the second driver portion 7450 can be hollow in other arragement constructions So that these parts of driver 7400 can be slightly flexible and submissive further to keep the driver at it Alignment in corresponding pit, to be further reduced required driving force.In any one arragement construction, by providing two drives Alignment post on two ends of dynamic device part, further enhances alignment of the driver in its corresponding pit.
Figure 97 shows the nail or driver pit 7510 formed in the main part 7502 of nail bin 7500.This nail or driving Device pit 7510 is configured in " list " staple drivers for being wherein operably supported complementary shape.It such as can be in the drawings Finding, there are two the nearly jamb members 7512,7514 to extend internally and two distal side columns to extend internally for the formation of nail pit 7510 7516,7518.Column 7512,7514,7516 and 7518, which is configured to slideably extend to, to be arranged in staple drivers In respective lateral groove.This driver pit configuration be used to provide driver its from pit drive when it is further stablize with Alignment.Although Figure 97 show be configured to it is recessed in the nail or driver for being wherein operably supported single staple drivers Hole, but identical concept is applicable to be configured to those of supporting driver driver pit, and the driver is by structure It causes to be used to support multiple surgical staples.For example, support column used in driver embodiment shown in Figure 94 to Figure 96 can quilt Replace with the groove of the corresponding column formed in the side for being configured to be slidably received in the pit of the nail in warehouse.
As shown in Figure 94 to Figure 96, various driver arragement constructions substantially may include with outer surface and forward position and after The drive body on edge or drive body part.In various arragement constructions, the size and shape of outer surface can be configured to Avoid any part for the inner wall for being movably supported in nail pit therein with outer surface (lateral in addition to being formed on nail pit Feature structure/support column of extension) contact.For example, double staple drivers 7400 shown in Figure 96 include the first driver portion 7410 and second driver portion 7450.The size of first driver portion 7410 and the second driver portion 7450 can be relative to Nail pit is set such that the part only contacted with the inner wall of nail pit is the feature structure extended laterally being formed on, example Such as element 7428,7429,7438,7439,7468,7469.The nearest side end of first driver portion 7410 may include " front end Portion " and the farthest side end of the second driver portion 7450 may include " rear end ".In another arragement construction, for example, preceding The size of end and rear end can relative to wherein its be received into the sky made between these ends and its corresponding pit part Gap is less than the corresponding portion setting of the nail pit in the gap between other driver portions and the other parts for following closely pit.This sky The size of gap amount can be configured to improve driver activating lateral stability without in the outer surface of driver and nail Frictional fit is established between the inner wall of pit.In another arragement construction, the configuration (for example, size and shape) of driver can phase It is set such that one or more parts of the only driver of the inner wall section of contact stud pit by driver nail pit One or more formed part (support columns) on front end and/or rear end form.On the contrary, can be in front end and/or rear end The one or more grooves of middle offer, one or more of grooves are configured to receive the phase in the inner wall section of nail pit Answer forming section, wherein these forming sections be driver activating driver and follow closely pit inner wall between only one or Multiple contact points.Receiving is set across its cutting element or is cut as described above, driver can be usually supported in warehouse It cuts in longitudinal extension nail pit on each side for the elongated slot of the access of head being centrally located.In certain arragement constructions In, it can be used for using the various drivers disclosed herein of the feature structure for one or more support columns/extend laterally elongated In the longitudinal nail pit (or the part longitudinally arranged) of one or more on the one or both sides of slit.For example, elongated slot is each This nail pit on side near warehouse edge may include using the driver of the forming section for support column/extend laterally, but its Legacy drive can be used in its nail pit.This arragement construction can be also used together with nail pit 7510.That is, nail pit 7510 It can be used in certain longitudinal nail pits (or the part longitudinally arranged) on the one or both sides of elongated slot.
Tissue flowing can be to cause one of the problem of nail deformity.During suture, tissue not only towards distal side but also laterally flowed, Wherein lateral movement is more harmful than longitudinal movement.Using tissue flowing and high compression forces, will nail from its corresponding pit laterally and Towards distal guide.By the cooperation between tightening driver and the storehouse part of neighbouring driver, nail during percussion to side or The reduced capability that front is waved, because the ability that driver waves also weakens.Various drivers disclosed herein and nail pit Arragement construction is used to make this to wave minimum.The feature structure for support column disclosed herein/extend laterally may be provided at institute Have on driver or is simply to set the driver into specific region (for example, driver in outlet in storehouse).This branch The feature structure for dagger/extend laterally can be located at the side of such as driver, driver end or both on.For illustrating this The term " support column " that driver disclosed in text stablizes arragement construction cover it is as shown in this figure it is various extend laterally it is vertical Elongated forming section.Term " support column " can also cover the various feature structures of different shapes extended laterally, described to extend laterally Feature structure be configured to movably to be received in the groove that the respective shapes in the inner wall of nail pit are arranged in (at it In the arragement construction of the feature structure for middle support column/extend laterally on a drive) or be received in various driver portions ( Wherein the feature structure for support column/extend laterally is from the arragement construction of the inner wall protrusion of nail pit), no matter which kind of feelings belonged to Condition.Support column can for example including the feature structure individually extended laterally or its may include the feature of multiple alignments extended laterally Structure.For example, support column can be made of column segment or alignment portion/forming section.In other arragement constructions, it can be used other prominent Play shape.
For various embodiments disclosed herein, fastener cartridge may include the material layer of implantable patient's body. Such layer may include for example one or more fid tablets and/or one or more tissue thickness compensation parts.It is filed in April 29 in 2011 it is entitled " including nail bin (the STAPLE CARTRIDGE for the nail being located in its compressible portion COMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF) " the U.S. it is special Sharp patent application serial numbers 13/097,856 are herein incorporated by reference.Turning now to Figure 99 to Figure 102, nail bin 8000 includes warehouse 8010 and implantable layer 8020.Warehouse 8010 is including proximal end 8012, distal end 8014 and in 8012 and of proximal end The platform 8016 extended between distal end 8014.Platform 8016 is configured to be clamped at nail bin 8000 and anvil in tissue Supporting tissue when between seat.Warehouse 8010 further includes being defined in securing member chamber therein, and the securing member chamber is respectively configured to Such as fastener (such as following closely) can be stored wherein.Each securing member chamber includes proximal end and distal end.With it is each tight The distal end of firmware chamber is compared, the proximal end 8012 of the proximal end of each securing member chamber closer to warehouse 8010, and phase Ying Di, the distal end 8014 of the distal end of each securing member chamber closer to warehouse 8010.
Than that described above, warehouse 8010 includes the protruding portion extended from platform 8016.In all cases, protruding portion can be with Any suitable arragement construction arrangement.For example, distal projections 8017 can with the distal end adjacent positioned of securing member chamber and it is close Side protruding portion 8019 can be with the proximal end adjacent positioned of securing member chamber.Similar to above-mentioned, distal projections 8017 and/or nearside Protruding portion 8019 is configured to guide the fastener being stored in securing member chamber when fastener is ejected from securing member chamber. In this case, distal projections 8017 and/or proximal projections 8019 can make securing member chamber extend beyond platform 8016.One A little securing member chambers can have adjacent distal projections 8017 and proximal projections 8019 and other securing member chambers can only have one Person or another one.One or more fasteners chamber can be both without distal projections 8017 or without proximal projections associated there 8019。
Layer 8020 includes layer main body 8026, and the layer main body includes proximal end 8022 and distal end 8024.Layer main body The neighbouring or positioning of proximal end 8012 relative to warehouse 8010 of 8026 proximal end 8022 and distal end 8024 it is neighbouring or It is positioned relative to distal end 8014.In some cases, layer 8026 may include solid material piece.In all cases, layer master Body 8026 can extend in the one or more securing member chambers being defined in warehouse 8010.In at least one such situation, layer Main body 8026 includes the part 8025 extended in securing member chamber.When fastener is ejected from securing member chamber, fastener can be at it Middle capture portion 8025, so that layer 8020 is remained to tissue.In some cases, layer main body 8026 may include and warehouse 8010 In one or more fasteners chamber alignment opening.
Layer main body 8026 may include being defined in the aperture therein being aligned with protruding portion that is extending from platform 8016.For example, Layer main body 8026 may include the distal side aperture 8027 being aligned at least some distal projections 8017 and/or at least some distal sides The nearside aperture 8029 that protruding portion 8019 is aligned.In all cases, the size of distal side aperture 8027 and distal projections 8017 It is set so that there is gap therebetween with configuration.Similarly, the size and structure of nearside aperture 8029 and proximal projections 8019 Type can be set so that there is gap therebetween.In some cases, the size of distal side aperture 8027 and distal projections 8017 It can be set so that there is interference fit therebetween with configuration.In addition, similarly, nearside aperture 8029 and proximal projections 8019 Size and configuration can be set so that therebetween exist interference fit.In at least one such situation, protruding portion and aperture Between interference fit layer 8020 can be releasably held warehouse 8010.In use, it is stored in tight in warehouse 8010 Firmware can eject from warehouse 8010 in fastener and promote layer 8020 far from platform 8016 and take off aperture with protruding portion The part 8025 of contact layer 8020 when from engagement.
Layer main body 8026 may include respectively being configured to receive distal projections 8017 and proximal projections wherein 8019 aperture 8028.Each aperture 8028 may include with the proximal end for being configured to reception distal projections 8017 With the elongated slot for the distal end for being configured to receive proximal projections 8019.It in some cases, can be in aperture There are gap cooperations between 8028 and protruding portion 8017 and 8019.It in some cases, can be in aperture 8028 and protruding portion 8017 And there is interference fit between 8019 layer 8020 is releasably held warehouse 8010.In at least one situation, aperture 8028 size and configuration can be configured to stretch to accommodate distal projections 8017 and proximal projections 8019 wherein.
Layer 8020 can be removably attached to warehouse 8010.In some cases, the distal end 8024 of layer 8020 can To be removably attached to the distal end 8014 of warehouse 8010.In some cases, the proximal end 8022 of layer 8020 can be with It is removably attached to the proximal end 8012 of warehouse 8010.In at least one example, it can utilize attachment part 8021 will Layer 8020 releasably holds warehouse 8010.
Such as layer (such as backing material) can be made of any biocompatible materials.Backing material can be by natural material And/or synthetic material is formed.Backing material can be bioabsorbable and/or not bioabsorbable.It should be appreciated that can be used Naturally, synthesis, bioabsorbable and not bioabsorbable material any combination form backing material.It can be made into backing material Some non-limiting examples of material include but is not limited to for example poly- (lactic acid), poly- (glycolic), poly- (butyric ester), poly- (phosphine piperazine), polyester, polyethylene glycol, polyethylene oxide, polyacrylamide, poly-hydroxyethyl methyl acrylate, polyvinylpyrrolidone, Polyvinyl alcohol, polyacrylic acid, poly- acetic acid esters, polycaprolactone, polypropylene, aliphatic polyester, glycerol, poly- (amino acid), copolymerization (ether Ester), polyalkylenes oxalates, polyamide, poly- (iminocarbonic ester), polyalkylenes oxalates, polyoxaesters, polyorthoester, Polyphosphazene and its copolymer, block copolymer, homopolymer, blend and/or their combination.
Natural biological copolymer can be used to form backing material.Suitable natural biological copolymer includes but is not limited to example Such as collagen, gelatin, fibrin, fibrinogen, elastin laminin, keratin, albumin, hydroxyethyl cellulose, fiber Element, oxycellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose, chitosan, chitosan and/ Or their combination.Natural biological copolymer can be combined with other polymer materials as described herein to prepare backing material.It can It is formed using the collagen (for example, I type pig or bovine collagen, I type people's collagen or type III people's collagen) of the mankind and/or animal origin Backing material.What backing material can be made of by such as denatured collagen or mainly the non-hydrated a chain of the molecular weight close to 100kDa Heating is passed through or any other method at least partly loses the collagen of its helical structure and is made.Term " denatured collagen " refers to The collagen of its helical structure is lost.Collagen for porous layer as described herein can such as pass through pepsin to be for example especially Digestion and/or the native collagen or Atelocollagen obtained after the appropriate heating of such as previous definition (atellocollagen).Collagen may previously pass through oxidation, methylation, succinylation, ethylization and/or it is any other Know that process carries out chemical modification.
In the case where backing material is fiber, fiber can be the long filament or line suitable for being knitted or weaving, or can be short Fiber, such as be usually used in preparing the staple fiber of non-woven material.Fiber can be made of any biocompatible materials.Fiber can be by Natural material or synthetic material are formed.It can be bioabsorbable or not bioabsorbable for forming the material of fiber.It should manage Natural, synthesis, bioabsorbable and not bioabsorbable material any combination can be used to form fiber for solution.It can be made into fibre Some non-limiting examples of the material of dimension including but not limited to poly- (lactic acid), poly- (butyric ester), are gathered poly- (glycolic) (phosphine piperazine), polyester, polyethylene glycol, polyethylene oxide, polyacrylamide, poly-hydroxyethyl methyl acrylate, polyvinylpyrrolidone, Polyvinyl alcohol, polyacrylic acid, poly- acetic acid esters, polycaprolactone, polypropylene, aliphatic polyester, glycerol, poly- (amino acid), copolymerization (ether Ester), polyalkylenes oxalates, polyamide, poly- (iminocarbonic ester), polyalkylenes oxalates, polyoxaesters, polyorthoester, Polyphosphazene and its copolymer, block copolymer, homopolymer, blend and/or their combination.In the feelings that backing material is fiber Under condition, any method for suitably forming fibre structure can be used to be formed for backing material, and is including but not limited to for example knitted, compiles It knits, nonwoven techniques etc..In the case where backing material is foam, porous layer, which can be used, suitably forms any of foam or sponge Method is formed, it may for example comprise but it is not limited to the freeze-drying and freeze-drying of such as composition.
Backing material can have hemostatic properties.Can be used to provide, there is auxiliary to stop bleeding or the fid of the ability of bleeding The exemplary example of the material of material includes but is not limited to for example poly- (lactic acid), poly- (glycolic), poly- (butyric ester), poly- (oneself Lactone), poly- (dioxanone), polyalkylene oxide, copolymerization (ether-ether), collagen, gelatin, fibrin ferment, fibrin, fibrin egg Bai Yuan, fibronectin, elastin laminin, albumin, hemoglobin, ovalbumin, polysaccharide, hyaluronic acid, chondroitin sulfate, hydroxyl second Base starch, hydroxyethyl cellulose, cellulose, oxycellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose, Chitosan, chitosan, agarose, maltose, maltodextrin, alginates, coagulation factor, methyl acrylate, poly- ammonia Ester, cyanoacrylate, platelet agonist, vasoconstrictor, alum, calcium, RGD peptide, albumen, protamine sulfate, ε-ammonia Base caproic acid, ferric sulfate, iron sulfite, iron chloride, zinc, zinc chloride, aluminium chloride, aluminum sulfate, aluminium acetate, permanganate, tannin, bone Wax, polyethylene glycol, fucosan and/or their combination.To natural biological copolymer and especially albumen using applicable There is the backing material of hemostatic properties in formation.Suitable natural biological copolymer includes but is not limited to such as collagen, gelatin, blood Fibrin, fibrinogen, elastin laminin, keratin, albumin and/or their combination.Natural biological copolymer can It is combined with any other hemostat to prepare the porous layer of supporter.Be filed on July 30th, 2013 it is entitled " supporter and The United States Patent (USP) 8,496,683 of surgery sewing equipment (BUTTRESS AND SURGICAL STAPLING APPARATUS) " Entire disclosure is herein incorporated by reference.
The entire disclosure of following patent is hereby incorporated by reference:
It is published in entitled " electrosurgery hemostasis device (the ELECTROSURGICAL HEMOSTATIC on 4 days April nineteen ninety-five DEVICE United States Patent (USP) 5,403,312) "；
It is published on 2 21st, the 2006 entitled " surgical stapling devices with individually different closures and trigger system Tool (SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS United States Patent (USP) 7,000,818) "；
It is published on September 9th, 2008 entitled " motor driving surgery cuts and fastener with tactile position feedback Tool (MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK) " United States Patent (USP) 7,422,139；
It is published in entitled " the electromechanical surgical instrument with closed system and anvil block aligning parts on December 16th, 2008 (ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS) " United States Patent (USP) 7,464,849；
It is published in the entitled " surgical instruments (SURGICAL with articulating end effector on March 2nd, 2010 INSTRUMENT HAVING AN ARTICULATING END EFFECTOR) " United States Patent (USP) 7,670,334；
It is published in entitled " surgery suturing appliance (the SURGICAL STAPLING on July 13rd, 2010 INSTRUMENTS United States Patent (USP) 7,753,245) "；
It is published in the entitled " implantable fastener cartridge (SELECTIVELY of alternative orientation on March 12nd, 2013 ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE) " United States Patent (USP) 8,393,514；
Entitled " surgical instruments (the SURGICAL INSTRUMENT HAVING RECORDING with registering capacity CAPABILITIES U.S. Patent Application Serial Number 11/343,803 (being now United States Patent (USP) 7,845,537)) "；
It is filed on 2 14th, 2008 entitled " surgery cuts and fastening instrument (SURGICAL with RF electrode CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES) " U.S. Patent Application Serial Number 12/031,573；
It is filed on 2 15th, 2008 entitled " for surgery cuts and the end effector (END of suture instruments EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT) " U.S. Patent Application Serial Number 12/031,873 (being now United States Patent (USP) 7,980,443)；
It is entitled that " motor drives surgical cutting instrument (MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT U.S. Patent Application Serial Number 12/235,782 (being now United States Patent (USP) 8,210,411)) "；
It is entitled " have can manual refraction trigger system band electrosurgical cut and robotic suturing device (POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM U.S. Patent Application Serial Number 12/249,117 (being now United States Patent (USP) 8,608,045)) "；
Being filed in the entitled of on December 24th, 2009 " there is the motor driving surgery of electric actuator Direction Control Unit to cut Cutter tool (MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY) " U.S. Patent Application Serial Number 12/647,100 (be now United States Patent (USP) 8, 220,688)；
It is filed in the U.S. Patent Application Serial of on September 29th, 2012 entitled " nail bin (STAPLE CARTRIDGE) " Number 12/893,461 (being now United States Patent (USP) 8,733,613)；
It is filed on 2 28th, 2011 entitled " surgery suturing appliance (SURGICAL STAPLING INSTRUMENT U.S. Patent Application Serial Number 13/036,647 (being now United States Patent (USP) 8,561,870)) "；
Entitled " surgery suturing appliance (the SURGICAL STAPLING with rotatable nail deployment arragement construction INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS) " U.S. Patent Application Serial Number 13/118,241 (being now U.S. Patent Application Publication 2012/0298719)；
It is filed in entitled " the joint motions surgical instruments including firing driving device on June 15th, 2012 The U.S. Patent application of (ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE) " Sequence number 13/524,049 (being now U.S. Patent Application Publication 2013/0334278)；
It is filed in entitled " nail bin tissue thickness sensing system (the STAPLE CARTRIDGE on March 13rd, 2013 TISSUE THICKNESS SENSOR SYSTEM) " U.S. Patent Application Serial Number 13/800,025；
It is filed in entitled " nail bin tissue thickness sensing system (the STAPLE CARTRIDGE on March 13rd, 2013 TISSUE THICKNESS SENSOR SYSTEM) " U.S. Patent Application Serial Number 13/800,067；
It is filed in entitled " surgery cuts and fastener with closure trigger locking mechanism on January 31st, 2006 Tool (SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM U.S. Patent Application Publication 2007/0175955) "；And
It is filed in the entitled " surgery suturing appliance with articulating end effector on April 22nd, 2010 The United States Patent (USP) of (SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR) " Shen Qing Publication 2010/0264194 (being now United States Patent (USP) 8,308,040).
It is implementable to this although certain disclosed embodiments has been combined to elaborate the various embodiments of device herein Many modifications and variations of a little embodiments.In addition, other materials can be used in the case where the open material for being used for certain components Material.In addition, single component can be replaced by multiple components, and multiple components can also be replaced by according to multiple embodiments Single component, to execute given one or more functions.Above description and following the claims are intended to cover all these repair Change and modification.
Apparatus as disclosed herein is designed to be dropped after a single use or it is designed to using more It is secondary.However, in either case, can prosthetic device to be reused after use at least once.Reparation may include following Any combination of step: then provision for disengagement is cleaned or is replaced specific component and then re-assemblied.In particular, Detachable apparatus, and optionally replace or remove in any combination any number of specific component or the portion of device Part.After cleaning and/or replacing particular elements, device can be reassembled for then at the repair facility or just in surgical operation It is used before by operating team.Those skilled in the art will be appreciated that the reparation of device can utilize it is various for dismantle, clean/ The technology replaced and re-assemblied.The use of such technology and gained prosthetic device are within the scope of application.
Preferably, invention as described herein will the processing before surgical operation.Firstly, obtaining and if necessary clear Clean new or used instrument.It then can be to sterilization of instruments.In a kind of disinfection technology, by instrument be placed on such as polybag or In the closing and sealing container of TYVEK bag.Then instrument and container are placed on to such as γ radiation that can penetrate container, x-ray Or in the radiation field of high energy electron.The bacterium in instrument and in container is killed in radiation.Then sterilized instrument can be stored in In sterile chamber.Sealing container makes instrument keep sterile, until it is opened in medical facilities.
Although the present invention has been described as with exemplary design, the present invention can in the spirit and scope of the disclosure into One step is modified.Therefore, this application is intended to cover use any modification of the invention of its General Principle, use or modification. In addition, this application is intended to cover known to belonging in fields of the present invention or usual practice relative to the such of the disclosure Deviate.
Any patent, announcement or other public materials incorporated in this article in full or in part by reference only simultaneously It is incorporated herein in the conflicting range of the existing definitions, statements, or other disclosure materials that the material entered is not proposed with the disclosure. Similarly and at the necessary level, the disclosure being expressly recited herein is any instead of what is be herein incorporated by reference Conflict material.It is any to be herein incorporated by reference but mutually rushed with existing definitions, statements, or other disclosure materials as described herein Prominent material or part thereof does not only generate between the incorporated material and the existing public material and is incorporated to this under the degree of conflict Text.

Claims (23)

1. a kind of surgical end-effector, comprising:
Elongated passageway, the elongated passageway include the bottom with proximal end and distal end, and the elongated passageway is constructed At nail bin can be operably supported wherein；
Element is fired, the percussion element is configured to translate between the start position and the end position, the start bit The proximal end of the bottom of the neighbouring elongated passageway is set, the end position is adjacent to described in the elongated passageway The distal end of bottom；
Proximal channel opening, proximal channel opening across the bottom of the elongated passageway the proximal end, with Be conducive to when the percussion element is in the initial position through its observation percussion element；With
Distal channel opening, distal channel opening across the bottom of the elongated passageway the distal end, with Be conducive to observe the percussion element through it when the percussion element is in the end position, and wherein described elongated The part of the bottom in channel extended between proximal channel opening and distal channel opening is closed, and not With other openings across it.
2. surgical end-effector according to claim 1, wherein the bottom of the elongated passageway described close The part that extends includes opening across its multiple independent indicators between wing passage opening and distal channel opening Mouthful, to provide across it when the percussion element moves between the initial position and the end position to the percussion The gradual observation of element.
3. surgical end-effector according to claim 2, wherein the multiple independent indicator opening is spaced each other Open equal distance.
4. surgical end-effector according to claim 2, wherein the multiple independent indicator opening is spaced each other Open unequal spacing distance.
5. surgical end-effector according to claim 4, wherein the multiple independent indicator opening includes:
First independent indicator opening, the first independent indicator opening is across the bottom of the elongated passageway；
Second independent indicator opening, the second independent indicator opening are described across the bottom of the elongated passageway Second independent indicator opening opens the first spacing distance in distal separation with the described first independent indicator opening；
Third independence indicator opening, the third independence indicator opening are described across the bottom of the elongated passageway Third independence indicator opening is opened from the described second independent indicator opening in distal separation different with first spacing distance The second spacing distance；With
4th independent indicator opening, the 4th independent indicator opening are described across the bottom of the elongated passageway 4th independent indicator opening is opened and first spacing distance and institute with third independence indicator opening in distal separation State the different third spacing distance of the second spacing distance.
6. surgical end-effector according to claim 5, wherein the third spacing distance is greater than second interval Distance.
7. surgical end-effector according to claim 6, wherein second spacing distance is greater than first interval Distance.
8. surgical end-effector according to claim 2, wherein the multiple independent indicator opening includes:
First independent indicator opening, the first independent indicator opening are described across the bottom of the elongated passageway First independent indicator opening opens the first spacing distance in distal separation with proximal channel opening；
Second independent indicator opening, the second independent indicator opening are described across the bottom of the elongated passageway Second independent indicator opening opens the second spacing distance in distal separation with the described first independent indicator opening；
Third independence indicator opening, the third independence indicator opening are described across the bottom of the elongated passageway Third independence indicator opening opens third spacing distance in distal separation with the described second independent indicator；With
4th independent indicator opening, the 4th independent indicator opening are described across the bottom of the elongated passageway 4th independent indicator opening opens the 4th spacing distance in distal separation with third independence indicator opening.
9. surgical end-effector according to claim 8, wherein first spacing distance, second interval distance It is equal from, the third spacing distance and the 4th spacing distance.
10. surgical end-effector according to claim 8, wherein first spacing distance, second interval distance It is unequal from, the third spacing distance and the 4th spacing distance.
11. surgical end-effector according to claim 10, in which:
Second spacing distance is greater than first spacing distance；
The third spacing distance is greater than second spacing distance；And
4th spacing distance is greater than the third spacing distance.
12. surgical end-effector according to claim 10, in which:
Second spacing distance is less than first spacing distance；
The third spacing distance is less than second spacing distance；And
4th spacing distance is less than the third spacing distance.
13. surgical end-effector according to claim 2, wherein the multiple independent indicator opening includes multiple only Vertical elongated slot.
14. surgical end-effector according to claim 2, wherein the multiple independent indicator opening includes at least one A independent circular hole and at least one independent elongated slot.
15. surgical end-effector according to claim 1, wherein the percussion element includes having at least one lateral The vertical portion of the lower foot extended, and wherein the elongated passageway include internal path in the percussion element described The lower foot that at least one is extended laterally described in receiving when moving between initial position and the end position.
16. surgical end-effector according to claim 15, wherein the bottom of the elongated passageway described The part extended between proximal channel opening and distal channel opening includes entering the internal path across it Multiple indicators opening, worn with being provided when the percussion element moves between the initial position and the end position Cross its gradual observation at least one lower foot extended laterally described in the percussion element.
It further include that be supported for can relative to the elongated passageway 17. surgical end-effector according to claim 1 The anvil block advanced dynamicly, the anvil block include for monitor the percussion element the initial position and the end position it Between the device that moves.
18. surgical end-effector according to claim 17, wherein the described device for monitoring includes across described Multiple indicators of anvil block are open, to mention when the percussion element moves between the initial position and the end position For the observation to the percussion element.
19. a kind of surgical end-effector, comprising:
Elongated passageway, the elongated passageway are configured to be operably supported nail bin；With
Anvil block, the anvil block include staple forming surface and outer surface, and plurality of separate aperture is defined as from the outside Surface passes through the anvil block and reaches the staple forming surface；
Element is fired, the percussion element is configured in the elongated passageway between the start position and the end position Translation；With
Indicator, the indicator are movably supported in each of the multiple separate aperture in the anvil block, often A indicator can move between the first position and the second position in the separate aperture in corresponding separate aperture, in institute A part of indicator described in the second position is stated corresponding independently to open when contacting to a part of the percussion element from described Hole protrusion.
20. surgical end-effector according to claim 19, wherein the multiple separate aperture includes that multiple independences are vertical To slit.
21. a kind of surgical end-effector, comprising:
Hollow shaft；
Elongated passageway, the elongated passageway and the hollow shaft operatively interface with and are configured to be operably supported nail Storehouse；
Element is fired, the percussion element is configured to translate between the start position and the end position, the start bit Set the proximal end of the neighbouring elongated passageway, distal end of the end position adjacent to the elongated passageway；
Elongated trigger shaft, the elongated trigger shaft are attached to the percussion element and are movably supported in the hollow shaft；
At least one status indication, at least one described status indication are located on the elongated trigger shaft；With
Multiple indicators opening, the multiple indicator opening across the hollow shaft a part in the elongated trigger shaft Observation at least one status indication described on the elongated trigger shaft is provided when moving in the hollow shaft.
22. a kind of surgical end-effector, comprising:
Elongated passageway, the elongated passageway include the bottom with proximal end and distal end, and the elongated passageway is constructed At nail bin can be operably supported wherein；
Element is fired, the percussion element is configured to translate between first position and end position, and described first The proximal end of the bottom of the neighbouring elongated passageway is set, the end position is adjacent to described in the elongated passageway The distal end of bottom, the percussion element include vertical portion and at least one lower foot extended laterally；
Internal path, the internal path extend in the elongated passageway and are configured to exist in the percussion element The lower foot that at least one is extended laterally described in receiving when moving between the first position and the end position；
Proximal channel opening, proximal channel opening across the bottom of the elongated passageway the proximal end, with Be conducive to pass through its observation percussion element, the ruler of the proximal channel opening when the percussion element is in the first position It is very little to be set to wherein receiving the lower foot that at least one is extended laterally described in described fire on element；With
Device, described device is used for will be described on the percussion element when initially applying firing action to the percussion element At least one lower foot is guided out the proximal channel opening and enters the internal path.
23. surgical end-effector according to claim 22, wherein the described device for guidance includes at least one Ramped surfaces, at least one described ramped surfaces are arranged in described in the restriction of at least one described lower foot and the elongated passageway In at least one of a part of proximal channel opening.
CN201580032323.1A 2014-04-16 2015-04-14 Surgical end-effector with percussion element monitoring arragement construction Active CN106456160B (en)

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US201461980293P 2014-04-16 2014-04-16
US61/980,293 2014-04-16
US14/319,004 2014-06-30
US14/319,004 US9844369B2 (en) 2014-04-16 2014-06-30 Surgical end effectors with firing element monitoring arrangements
PCT/US2015/025646 WO2015160733A1 (en) 2014-04-16 2015-04-14 Surgical end effectors with firing element monitoring arrangements

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JP6615779B2 (en) 2019-12-04

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