CN106714705A - End effector comprising an anvil including projections extending therefrom - Google Patents

End effector comprising an anvil including projections extending therefrom Download PDF

Info

Publication number
CN106714705A
CN106714705A CN201580032322.7A CN201580032322A CN106714705A CN 106714705 A CN106714705 A CN 106714705A CN 201580032322 A CN201580032322 A CN 201580032322A CN 106714705 A CN106714705 A CN 106714705A
Authority
CN
China
Prior art keywords
nail
protuberance
anvil block
tissue
warehouse
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.)
Granted
Application number
CN201580032322.7A
Other languages
Chinese (zh)
Other versions
CN106714705B (en
Inventor
E·A·谢林
B·W·史密斯
J·L·哈里斯
C·J·沙伊布
J·R·摩根
L·S·威纳
M·J·文德利
T·W·阿伦霍尔特
T·J·巴顿
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ethicon Endo Surgery Inc
Original Assignee
Ethicon Endo Surgery Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Priority claimed from US14/319,014 external-priority patent/US10542988B2/en
Application filed by Ethicon Endo Surgery Inc filed Critical Ethicon Endo Surgery Inc
Publication of CN106714705A publication Critical patent/CN106714705A/en
Application granted granted Critical
Publication of CN106714705B publication Critical patent/CN106714705B/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Abstract

An end effector can comprise, one, a fastener cartridge including a plurality of fasteners stored therein and, two, an anvil configured to deform the fasteners. The anvil can further comprise extensions extending therefrom which can control the flow of tissue relative to the fastener cartridge and/or support the fasteners as they are ejected from the fastener cartridge. The extensions can having different sizes and/or configurations.

Description

Including the end effector with the anvil block from its protuberance for extending
Cross-Reference to Related Applications
This non-provisional requires the rights and interests of following patent application according to 35U.S.C. § 119 (e):It is filed in 2014 The entitled of on April 16, " fastening instrument and uses its fastening storehouse (FASTENING INSTRUMENTS AND FASTENING CARTRIDGES FOR USE THEREWITH) " U.S. Provisional Patent Application Serial No. 61/980,339, institute Patent application is stated to be incorporated by reference in its entirety herein.
Background technology
The present invention relates to suture instruments, and in various embodiments, it is related to a kind of for preparing 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, and 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 position.In various embodiments, in jaw member one can support Wherein accommodate the nail bin of at least two staples being laterally spaced apart, and another jaw member it is sustainable have with 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 with by convex on the cam face on push rod and/or the wedge-shaped slides by push rod pushing relative to jaw member Wheel surface will be followed closely and ejected successively from nail bin.In at least one embodiment, cam face be configured to start by Storehouse carry and with multiple staple drivers for being associated of 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 the route cutting tissue between staple.The example of this suture instruments " has for tissue to be fixed on entitled Surgical staples of therein compressible or extrudable component and for disposing its suture instruments (SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME) " United States Patent (USP) 7, have disclosed in 794,475, institute The complete disclosure for stating patent is herein incorporated by reference.
Each aspect that correlation technique is current in the field of the invention only for the purpose of illustration discussed above, without should It is considered as the negative to right.
Brief description of the drawings
The various features of the embodiment described herein are elaborated in the dependent claims.However, closing Drawings described below can be combined according to following in the various embodiments of the tissue of operation and the various embodiments of method and its advantage Illustrate to be understood:
Fig. 1 is the front view of surgery suturing appliance;
Fig. 2 is the profile of the end effector of the surgery suturing appliance of the Fig. 1 intercepted along the line 2-2 of Fig. 1;
Fig. 3 is the profile perspective of the end effector of Fig. 1;
Fig. 4 is the profile of the end effector of Fig. 1, it illustrates being contained in the nail in non-percussion configuration therein;
Fig. 5 is the figure of the nail for showing the Fig. 4 in percussion configuration;
Fig. 6 is the figure of the end effector for showing the Fig. 1 for being used for suture and transecting patient tissue;
Fig. 7 is the perspective view of the nail bin according at least one embodiment, and the nail bin includes the multiple extended from warehouse Spine;
Fig. 8 is the detail drawing of the nail bin of Fig. 7;
Fig. 8 A are the profile of the nail bin of Fig. 7;
Fig. 9 is the detail drawing for showing the nail in the nail cavity in the nail bin for being positioned at and being defined in Fig. 7;
Figure 10 is the fragmentary, perspective view of the nail bin according at least one alternative embodiment, and the nail bin includes prolonging from warehouse The multiple Lateral ridges stretched;
Figure 11 is the fragmentary, perspective view of the nail bin according at least one alternative embodiment, and the nail bin includes prolonging from warehouse The multiple Lateral ridges stretched;
Figure 12 is the fragmentary, perspective view of the nail bin according at least one alternative embodiment, and the nail bin is included around restriction The proximal end of the nail cavity opening in warehouse and multiple spines of distal end;
Figure 13 is the fragmentary, perspective view of the nail bin according at least one alternative embodiment, and the nail bin is included around restriction The proximal end of the nail cavity opening in warehouse and multiple spines of distal end;
Figure 14 is the fragmentary, perspective view of the nail bin according at least one alternative embodiment, and the nail bin includes prolonging from warehouse The multiple annular knurl spines stretched;
Figure 15 is the fragmentary, perspective view of the nail bin according at least one alternative embodiment, and the nail bin includes prolonging from warehouse The multiple annular knurl spines stretched;
Figure 15 A are the perspective view of the taper annular knurl according at least one embodiment;
Figure 15 B are the perspective view of the conical butt annular knurl according at least one embodiment;
Figure 15 C are the perspective view of the triangle annular knurl according at least one embodiment;
Figure 16 be according at least one alternative embodiment nail bin fragmentary, perspective view, the nail bin include entirely around Multiple spines of the nail cavity opening being defined in warehouse;
Figure 16 A are the fragmentary, perspective view of the nail bin according at least one alternative embodiment, and the nail bin includes complete ring Multiple spines of the nail cavity opening in warehouse is defined in;
Figure 17 is the perspective view of the nail bin according at least one alternative embodiment, and the nail bin includes what is extended 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 for the surgical instruments of Figure 19 and Figure 20;
Figure 22 is another decomposing assembly figure of the part of the interchangeable shaft assembly and surgical instruments for showing Figure 19 to Figure 21;
Figure 23 is the perspective of the nail bin being positioned in the end effector of surgical instruments according at least one embodiment Figure, wherein nail bin include the multiple spines extended from the warehouse of nail bin;
Figure 24 is the front view of the nail according at least one embodiment;
Figure 25 is the front view of the nail of the Figure 24 in the nail cavity being positioned in nail bin;
Figure 26 is the front view of the nail according at least one embodiment;
Figure 27 is the front view of the asymmetric nail according at least one embodiment;
Figure 28 is the front view of another asymmetric nail according at least one embodiment;
Figure 29 is the front view of another asymmetric nail according at least one embodiment;
Figure 30 is the front view of the nail for being shown at part deformation condition;
Figure 31 is the front view of the nail of the Figure 30 in the situation of being badly deformed;
Figure 32 is the bottom perspective view of elongated passageway;
Figure 33 is the profile perspective of another elongated passageway;
Figure 34 is another profile of the elongated passageway of Figure 33, wherein schematically being shown 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 gets out percussion;
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 axle arrangement;
Figure 44 is the end effector of Figure 43 and another perspective view of axle arrangement, and a wherein part for outer shaft is clear For the sake of and be omitted;
Figure 45 is the partial side view of the other end actuator and axle arrangement;
Figure 46 is the partial side elevational view of end effector arrangement, 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;
Figure 49 is the profile of the end effector of the surgical instruments according at least one embodiment, and the end performs Device includes nail bin, and the nail bin includes staged storehouse platform;
Figure 49 A are the same profile figure shown in Figure 49, it illustrates staged storehouse platform and being positioned at staged platform phase Various clearance heights between the anvil block of offside;
Figure 50 is the front view of the asymmetric nail according at least one embodiment;
Figure 51 is the front view of another asymmetric nail according at least one embodiment;
Figure 52 is the front view of another asymmetric nail according at least one embodiment;
Figure 53 is the perspective view of the nail sliding part according at least one embodiment;
Figure 54 is the top view of the nail sliding part of Figure 53;
Figure 54 A are the partial top view of the nail bin of Figure 23, it illustrates the cunning of the nail in the non-firing position of nearside of Figure 53 Moving part;
Figure 54 B are the perspective cutaway view of the nail bin of Figure 23;
Figure 54 C are the schematic partial front perspective view of the nail bin of Figure 23;
Figure 54 D are the perspective view of the nail sliding part of Figure 53;
Figure 55 is the perspective view of the distal end of the nail bin of Figure 23;
Figure 55 A are the perspective view of the protuberance extended from the nail bin of Figure 23;
Figure 56 is the perspective view of the nail bin according at least one embodiment, and the nail bin includes what is extended from nail bin platform Spine's pattern;
Figure 57 is spine's pattern of Figure 56 and the detail drawing of nail bin platform;
Figure 58 is the fragmentary, perspective view of the nail bin according at least one embodiment, and the nail bin includes prolonging from nail bin platform The spine's pattern stretched;
Figure 59 is the fragmentary, perspective view of the nail bin according at least one embodiment, and the nail bin includes that being defined in nail bin puts down Protuberance pattern in platform;
Figure 60 is the detail drawing of the protuberance shown in Figure 59;
Figure 61 is the fragmentary, perspective view of the nail bin according at least one embodiment, and the nail bin includes prolonging from nail bin platform The dome pattern stretched;
Figure 62 is the detail drawing of the dome shown in Figure 61;
Figure 63 is the fragmentary, perspective view of the protuberance extended from nail bin platform according at least one embodiment;
Figure 64 is the decomposition diagram of surgery nail bin and Cang Gai;
Figure 65 is the nail bin of Figure 64 and the profile of Cang Gai, and wherein Cang Gai is arranged on nail bin;
Figure 66 is the perspective view of the anvil block of the surgery suturing appliance according at least one embodiment, the anvil block include from Its protuberance for extending;
Figure 67 is the detail drawing of the protuberance shown in Figure 66;
Figure 68 is the fragmentary, perspective view of the anvil block of the surgery suturing appliance according at least one embodiment, the anvil block bag Include the protuberance extended from it;
Figure 69 is the profile of the anvil block of the surgery suturing appliance according at least one embodiment, the anvil block include with With second high adjacent with the second nail pit of adjacent the first protuberance array with the first height of first nail pit The second protuberance array and the threeth protuberance array with third height adjacent with the 3rd nail pit of degree;
Figure 70 is the perspective view of the nail bin according at least one embodiment, and the nail bin includes being put down from the staged of nail bin The protuberance that platform surface extends;
Figure 71 is the detail drawing of the protuberance of the distal end and Figure 70 of staged platform surface;
Figure 72 is the detail drawing of the protuberance of the proximal end and Figure 70 of staged platform surface;
Figure 73 is the perspective view of the nail bin according at least one embodiment, and the nail bin includes being put down from the staged of nail bin The protuberance that platform surface extends;
Figure 74 is the fragmentary, perspective view of the nail bin according at least one embodiment;
Figure 75 is the profile of the end effector of the surgery suturing appliance according at least one embodiment, the end Actuator includes multiple tissue engaging members that can be disposed;
Figure 76 is the profile of the end effector of the surgery suturing appliance according at least one embodiment, the end Actuator includes the multiple protruding portion extended from staged storehouse platform surface;
Figure 77 is cuing open for the protuberance that extends according to the storehouse platform of the nail bin of at least one embodiment and from the platform Face figure, the protuberance is configured to the support nail when nail is disposed from nail cavity;
Figure 78 is another storehouse platform and the protuberance from platform extension of the nail bin according at least one embodiment Profile, the protuberance be configured to from nail cavity dispose follow closely when support nail;
Figure 79 is the partial plan layout of the platform of the nail bin according at least one embodiment, and the nail bin is included from described The protuberance that platform extends, the platform is configured to support and stores in the nail cavity being defined in nail bin with can removing Nail;
Figure 80 is the part sectioned view of the nail bin according at least one embodiment, the nail bin include the first protuberance and Second protuberance, first protuberance is configured to the first leg of the nail that support is positioned in nail cavity in which can remove Portion, second protuberance is configured to support the second leg of the nail;
Figure 81 is the perspective view of the distal end of the nail bin according at least one embodiment, the nail bin include platform, The multiple nail cavities being defined in the platform and the various protuberances extended from the platform;
Figure 82 is the fragmentary, perspective view of the nail bin according at least one embodiment, and the nail bin includes platform, is defined in Multiple nail cavities in the platform and the multiple protruding portion from platform extension, in the circular nail cavity of the protuberance one A little ends is without around the end of other nail cavities;
Figure 83 is the fragmentary, perspective view of the nail bin according at least one embodiment, and the nail bin includes platform, is defined in Multiple nail cavities in the platform and the multiple protruding portion from platform extension, the protuberance surround some of the nail cavity End, without around other ends;
Figure 84 is the part sectioned view of the nail bin according at least one embodiment, and the nail bin includes:Platform and restriction Multiple nail cavities in the platform;Be positioned at the nail array in the nail cavity, the nail array nail bin proximal end and Extend between distal end, wherein the nail array includes various nails;With the protuberance array extended from the platform, The protuberance array extends between the proximal end and the distal end of the nail bin, wherein protuberance battle array Row include various height;
Figure 85 A are the partial cutaway of the protuberance extended according to the nail bin platform of at least one embodiment and from the platform Face figure, wherein the protuberance is made up of conformable material and is shown at uncompressed state;
Figure 85 B are the nail bin platform of Figure 85 A and the part sectioned view of protuberance, it illustrates in some compression Protuberance;
Figure 85 C are the nail bin platform of Figure 85 A and the part sectioned view of protuberance, it illustrates the protrusion in compressive state Portion;
Figure 86 A are the part section according to the nail bin of warehouse of at least one embodiment including being made up of flexible material Figure, the nail bin is shown at unbent condition;
Figure 86 B are the part sectioned view of the nail bin of Figure 86 A for being shown at case of bending;
Figure 87 is the perspective view of the anvil block according at least one embodiment, and the anvil block includes what is extended from the anvil block Multiple protruding portion;
Figure 88 is the detail drawing of a part for the anvil block of Figure 87;
Figure 89 is the fragmentary, perspective view of the anvil block according at least one embodiment, and the anvil block includes prolonging from the anvil block The multiple protruding portion stretched;
Figure 90 is the perspective view of the component according at least one embodiment, and the component includes staple drivers and can transport Dynamic pit expander;
Figure 91 is the exploded view of the component of Figure 90;
Figure 92 is the profile perspective of the nail bin using 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 the 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 for surgery nail bin;
Figure 98 is the front view of the anvil block according at least one embodiment, the anvil block include from its extend with not Level protuberance;
Figure 99 is the perspective view of the fastener cartridge according at least one embodiment;
Figure 100 is the plan of the fastener cartridge of Figure 99;
Figure 101 is the fragmentary, 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 some views, corresponding reference symbol indicates corresponding part.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 limiting model of the invention by any way Enclose.
Specific embodiment
Present applicant possesses following patent application, and the patent application is submitted to and each with the application in same date From be incorporated by reference in its entirety herein:
Entitled " including fastener cartridge (the FASTENER CARTRIDGES of the securing member chamber with various configuration INCLUDING EXTENSIONS HAVING DIFFERENT CONFIGURATIONS) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney END7460USNP/140136);
Entitled " including the fastener cartridge (FASTENER of the securing member chamber with fastener controlling feature structure CARTRIDGE COMPRISING FASTENER CAVITIES INCLUDING FASTENER CONTROL FEATURES)” U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney END7461USNP/140137);
It is entitled " to there is surgical fastener storehouse (the SURGICAL FASTENER of driver stabilization arrangement CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney END7463USNP/140139);
It is entitled " to there is surgical end-effector (the SURGICAL END that percussion element monitors arrangement EFFECTORS WITH FIRING ELEMENT MONITORING ARRANGEMENTS) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney END7464USNP/140140);
Entitled " including fastener cartridge (the FASTENER CARTRIDGE COMPRISING NON- of non-uniform fastener UNIFORM FASTENERS) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney END7465USNP/ 140141);
Entitled " including fastener cartridge (the FASTENER CARTRIDGE COMPRISING of tissue engaging member can be disposed DEPLOYABLE TISSUE ENGAGING MEMBERS) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney docket Number END7466USNP/140142);
Entitled " including fastener cartridge (the FASTENER CARTRIDGE COMPRISING of organizational controls feature structure TISSUE CONTROL FEATURES) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney END7467USNP/140143);
Entitled " fastener cartridge assembly and nail retainer capping arrangement (FASTENER CARTRIDGE ASSEMBLIES AND STAPLE RETAINER COVER ARRANGEMENTS) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney END7468USNP/140144);And
Entitled " including fastener cartridge (the FASTENER CARTRIDGE INCLUDING A of the layer for being attached to it LAYER ATTACHED THERETO) " U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _ (attorney END7469USNP/140145)。
Present applicant also possesses and is filed on March 1st, 2013 and is each herein incorporated by reference this in full The following patent application of text:
It is entitled " to there is the surgical instruments for being capable of joint motions of 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) ";
It is entitled " to be used for rotary powered actuated articulation joints (the Rotary Powered of surgical instruments Articulation Joints For Surgical Instruments) " U.S. Patent Application Serial Number 13/782,323;
It is entitled " to be used for thumbwheel switch arrangement (the Thumbwheel Switch Arrangements of surgical instruments For Surgical Instruments) " U.S. Patent Application Serial Number 13/782,338;
It is entitled " to there is electro-mechanical device surgical (the Electromechanical Surgical that signal relays arrangement Device with Signal Relay Arrangement) " U.S. Patent Application Serial Number 13/782,499;
It is entitled " to be used for multi-processor motor control part (the Multiple Processor of modularization surgical instruments Motor Control for Modular Surgical Instruments) " U.S. Patent Application Serial Number 13/782, 460;
It is entitled " to be used for lever switch device component (the Joystick Switch Assemblies For of surgical instruments Surgical Instruments) " U.S. Patent Application Serial Number 13/782,358;
It is entitled that " sensor during being removed through trochar stretches end effector (Sensor Straightened End Effector During Removal Through Trocar) " U.S. Patent Application Serial Number 13/782,481;
It is entitled " to be used for control method (the Control Methods for of the surgical instruments with removable tool portion Surgical Instruments with Removable Implement Portions) " U.S. Patent Application Serial Number 13/782,518;
It is entitled " to there is rotating type strip electrosurgical unit (the Rotary Powered Surgical of multiple frees degree 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 is stopped (Surgical Instrument Soft Stop) " Row number 13/782,536.
Present applicant also possesses and is filed on March 14th, 2013 and is each herein incorporated by reference this in full The following patent application of text:
Entitled " including the surgical instruments (ARTICULATABLE for being capable of joint motions of percussion drive device SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE) " U.S. Patent Application Serial Number 13/803, 097;
It is entitled " to be used for control arrangement (the CONTROL ARRANGEMENTS FOR of the drive member of 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 " including joint motions lock the surgical instruments (ARTICULATABLE for being capable of joint motions of part SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK) " U.S. Patent Application Serial Number 13/ 803,086;
It is entitled " to be used for sensor arrangement structure (the SENSOR ARRANGEMENTS of the absolute positioning system of surgical instruments FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 13/803,210;
It is entitled " to be used for Multifunction motor (the MULTI-FUNCTION MOTOR FOR A SURGICAL of surgical instruments INSTRUMENT U.S. Patent Application Serial Number 13/803,148) ";
It is entitled " to be used for drive system latching member arrangement (the DRIVE SYSTEM of modularization surgical instruments LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 13/803,066;
Entitled " articulation control system (the ARTICULATION for being capable 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 " drivetrain for modularization surgical instruments controls arrangement (DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 13/803, 130;And
Entitled " method and system (the METHOD AND SYSTEM FOR OPERATING A for operating surgical instruments SURGICAL INSTRUMENT) " U.S. Patent Application Serial Number 13/803,159.
Present applicant also possess be filed on March 26th, 2014 and be each incorporated by reference in its entirety herein Following patent application:
It is entitled " to be used for power management control system (the POWER MANAGEMENT CONTROL of surgical instruments SYSTEMS FOR SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 14/226,106;
The United States Patent (USP) Shen of entitled " sterilization checking circuit (STERILIZATION VERIFICATION CIRCUIT) " Please sequence number 14/226,099;
Entitled " checking (the VERIFICATION OF NUMBER OF of the number of battery altering/programmed counting BATTERY EXCHANGES/PROCEDURE COUNT) " U.S. Patent Application Serial Number 14/226,094;
Entitled " power management (the POWER carried out by the sleep option of segment circuit and wake-up control piece MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL) " U.S. Patent Application Serial Number 14/226,117;
It is entitled " to there is Modular belts electrosurgical unit (the MODULAR POWERED of dismountable shaft assembly SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES) " U.S. Patent Application Serial Number 14/ 226,075;
It is entitled " to be used for feedback algorithm (the FEEDBACK ALGORITHMS FOR of the manual salvage system of surgical instruments MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 14/226, 093;
It is entitled " to utilize surgical instruments (the SURGICAL INSTRUMENT UTILIZING of sensor self adaptation SENSOR ADAPTATION) " U.S. Patent Application Serial Number 14/226,116;
It is entitled " to there is surgical instruments control circuit (the SURGICAL INSTRUMENT CONTROL of safe processor CIRCUIT HAVING A SAFETY PROCESSOR) " U.S. Patent Application Serial Number 14/226,071;
Entitled " including surgical instruments (the SURGICAL INSTRUMENT COMPRISING of 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;
Entitled " system and method (the SYSTEMS AND METHODS FOR for controlling segment circuit CONTROLLING A SEGMENTED CIRCUIT) " U.S. Patent Application Serial Number 14/226,081;
Entitled " power management (the POWER MANAGEMENT for protecting and carrying out by segment circuit and variable voltage 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 " including surgical instruments (the SURGICAL INSTRUMENT COMPRISING A of 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, and these U.S. Patent applications are each complete Text is herein incorporated by reference:
It is entitled " to there is surgical instruments (the SURGICAL INSTRUMENTS WITH of 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 " the surgery nail bin and the surgery suturing appliance with common nail shapes pit of the nail of support non-linear arrangement (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);
It is entitled " to be used for jaw closed arrangement structure (the JAW CLOSURE ARRANGEMENTS FOR of surgical instruments SURGICAL INSTRUMENTS) " U.S. Patent Application Serial Number 12/894,327 (be now U.S. Patent Publication 2012/ 0080499);
It is entitled " to there are the surgery cuts and fastening instrument of separate and different fastener deployments 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);
It is entitled " to there is implantable fastener cartridge (the IMPLANTABLE FASTENER of non-uniform arrangement CARTRIDGE HAVING A NON-UNIFORM ARRANGEMENT) " U.S. Patent Application Serial Number 12/894,338 it is (existing It is U.S. Patent Publication 2012/0080481);
Entitled " including implantable fastener cartridge (the IMPLANTABLE FASTENER CARTRIDGE of support 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);
Entitled " including implantable fastener cartridge (the IMPLANTABLE FASTENER CARTRIDGE of multiple layers 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);
It is entitled " to there are compact joint motions to control surgery suturing appliance (the SURGICAL STAPLING of arrangement INSTRUMENT WITH COMPACT ARTICULATION CONTROL ARRANGEMENT) " U.S. Patent Application Serial Number 12/894,339 (being now U.S. Patent Publication 2012/0080500);
It is entitled " to there is surgery suturing appliance (the SURGICAL STAPLING INSTRUMENT of variable nail formation system WITH A VARIABLE STAPLE FORMING SYSTEM) " U.S. Patent Application Serial Number 12/894,360 (be now U.S. State's patent disclosure 2012/0080484);
It is entitled " to there is surgery suturing appliance (the SURGICAL STAPLING of interchangeable nail bin arrangement INSTRUMENT WITH INTERCHANGEABLE STAPLE CARTRIDGE ARRANGEMENTS) " U.S. Patent application Sequence number 12/894,322 (being now United States Patent (USP) 8,740,034);
It is entitled " to there is surgery nail bin (the SURGICAL STAPLE CARTRIDGES WITH of interchangeable supporting 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 " including implantable fastener cartridge (the IMPLANTABLE FASTENER of bioabsorbable layer CARTRIDGE COMPRISING BIOABSORBABLE LAYERS) " U.S. Patent Application Serial Number 12/894,383 it is (existing It is 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 " fastener cartridge that can collapse (COLLAPSIBLE FASTENER CARTRIDGE) " Sequence number 12/894,306 (being now U.S. Patent Publication 2012/0080332);
Entitled " including multiple connections keep closure system (the FASTENER SYSTEM of matrix element 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 " including keep closure system (the FASTENER SYSTEM COMPRISING of matrix and alignment matrix A RETENTION MATRIX AND AN ALIGNMENT MATRIX) " U.S. Patent Application Serial Number 12/894,330 it is (existing It is United States Patent (USP) 8,757,465);
Entitled " including keep closure system (the FASTENER SYSTEM COMPRISING A of matrix RETENTION MATRIX) " U.S. Patent Application Serial Number 12/894,361 (being now United States Patent (USP) 8,529,600);
Entitled " fastening instrument (the FASTENING for disposing the closure system for including keeping matrix 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 " including keep closure system (the FASTENER SYSTEM COMPRISING A of 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 " including closure system (the FASTENER SYSTEM COMPRISING A of multiple fastener cartridges PLURALITY OF FASTENER CARTRIDGES) " U.S. Patent Application Serial Number 12/894,376 (be now United States Patent (USP) Announce 2012/0080486);
Entitled " including surgical stapler anvil (the SURGICAL STAPLER ANVIL of multiple forming pits COMPRISING A PLURALITY OF FORMING POCKETS) " U.S. Patent Application Serial Number 13/097,865 it is (existing It is U.S. Patent Publication 2012/0080488);
It is entitled " to be used for tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR of 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 " including nail bin (the STAPLE CARTRIDGE COMPRISING A of 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);
Entitled " including nail bin (the STAPLE CARTRIDGE COMPRISING of the nail being positioned 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 " including tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR of 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 including the surgical stapling device of 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 " including nail bin (the STAPLE CARTRIDGE COMPRISING AN of adjustable distal part 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 " including tissue thickness compensation part (the TISSUE THICKNESS of 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 " including compressible nail bin (the COMPRESSIBLE STAPLE CARTRIDGE of alignment member COMPRISING ALIGNMENT MEMBERS) " U.S. Patent Application Serial Number 13/097,917 (be now U.S. Patent Publication 2012/0083834);
Entitled " including nail bin (the STAPLE CARTRIDGE COMPRISING A RELEASABLE of releasable portion PORTION U.S. Patent Application Serial Number 13/097,873 (being now United States Patent (USP) 8,740,038)) ";
Entitled " including resist nail bin (the STAPLE CARTRIDGE COMPRISING of 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 " including nail bin (the STAPLE CARTRIDGE COMPRISING A TISSUE of tissue thickness compensation part THICKNESS COMPENSATOR) " U.S. Patent Application Serial Number 13/097,924 (be now U.S. Patent Publication 2012/ 0083835);
It is entitled " to there is surgical stapling device (the SURGICAL STAPLER WITH FLOATING of floating anvil block ANVIL U.S. Patent Application Serial Number 13/242,029 (being now U.S. Patent Publication 2012/0080493)) ";
It is entitled " to be used for crooked end actuator (the CURVED END EFFECTOR FOR A of suture instruments STAPLING INSTRUMENT) " U.S. Patent Application Serial Number 13/242,066 (be now U.S. Patent Publication 2012/ 0080498);
Entitled " including nail bin (the STAPLE CARTRIDGE INCLUDING COLLAPSIBLE of the platform that can collapse DECK U.S. Patent Application Serial Number 13/242,086 (being now U.S. Patent Publication 2013/0075450)) ";
Entitled " including nail bin (the STAPLE CARTRIDGE INCLUDING of the platform arrangement structure that can collapse COLLAPSIBLE DECK ARRANGEMENT) " U.S. Patent Application Serial Number 13/241,912 (be now U.S. Patent Publication 2013/0075448);
It is entitled " to there is surgical stapling device (the SURGICAL STAPLER WITH STATIONARY of 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 producing 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 being capable of the optionally 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 " including tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR of multiple packaging bodies COMPRISING A PLURALITY OF CAPSULES) " U.S. Patent Application Serial Number 13/433,096 (now for the U.S. is special 2012/0241496) profit is announced;
Entitled " including tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR of multiple layers COMPRISING A PLURALITY OF LAYERS) " U.S. Patent Application Serial Number 13/433,103 (be now United States Patent (USP) Announce 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 " including tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR of reservoir COMPRISING A RESERVOIR) " U.S. Patent Application Serial Number 13/433,102 (be now U.S. Patent Publication 2012/ 0241497);
Entitled " including holding device assembly (the RETAINER ASSEMBLY INCLUDING A of 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 medicine COMPRISING AT LEAST ONE MEDICAMENT) " U.S. Patent Application Serial Number 13/433,136 (now for the U.S. is special 2012/0241492) profit is announced;
Entitled " including controlled release and the tissue thickness compensation part of expansion (TISSUE THICKNESS 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 " to include fiber to produce tissue thickness compensation part (the TISSUE THICKNESS of elastic load 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 " including tissue thickness compensation part (the TISSUE THICKNESS of the structure for being used to produce 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 " including tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR of elastic component COMPRISING RESILIENT MEMBERS) " U.S. Patent Application Serial Number 13/433,155 (be now U.S. Patent Publication 2012/0241502);
Entitled " method (the METHODS for forming the tissue thickness compensation part arrangement 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);
It is entitled " to be used for tissue thickness compensation part (the TISSUE THICKNESS of 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 " including tissue thickness compensation part (the TISSUE THICKNESS of the packaging body for limiting 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 up of multiple material COMPRISED OF A PLURALITY OF MATERIALS) " U.S. Patent Application Serial Number 13/433,118 (be now U.S. 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 multi-medicament COMPRISING A PLURALITY OF MEDICAMENTS) " U.S. Patent Application Serial Number 13/433,129 (be now U.S. State's patent disclosure 2013/0256367);
Entitled " nail bin (the STAPLE CARTRIDGES FOR for forming 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);
Entitled " surgical stapling device (the SURGICAL STAPLING of forming nail of the production with 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);
It is entitled " to there is surgical stapling device (the SURGICAL STAPLING DEVICE of the staple drivers of 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);
It is entitled " to there is surgical stapling device (the SURGICAL STAPLING of the staple drivers of the multiple line footpath nails of support DEVICE WITH STAPLE DRIVER THAT SUPPORTS MULTIPLE WIRE DIAMETER STAPLES) " U.S. 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);
Entitled " nail bin (the STAPLE CARTRIDGES FOR for forming 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);
Entitled " surgical stapling system (the SURGICAL STAPLING of forming nail of the production with 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);
Entitled " the surgical stapling device robotically controlled of forming nail of the production with 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 cable robotically controlled CABLE-BASED SURGICAL END EFFECTORS) " U.S. Patent Application Serial Number 13/369,629 (now for the U.S. is special 2012/0138660) profit is announced;
Entitled " surgical stapling device (the SURGICAL STAPLING for forming 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);
Entitled " nail bin (the STAPLE CARTRIDGES FOR for forming 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);
It is entitled " to be used for material layer (the LAYER OF MATERIAL FOR A SURGICAL of 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) Announce 2013/0256383);
Entitled " including layer (the LAYER COMPRISING DEPLOYABLE ATTACHMENT of attachment members can be disposed MEMBERS U.S. Patent Application Serial Number 13/763,094 (being now U.S. Patent Publication 2013/0256377)) ";
Entitled " including end effector (the END EFFECTOR COMPRISING A of 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 " including tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR of passage COMPRISING CHANNELS) " U.S. Patent Application Serial Number 13/433,147 (be now U.S. Patent Publication 2013/ 0256369);
It is entitled " to there is layer to keep surgery nail bin (the SURGICAL STAPLING CARTRIDGE WITH of feature structure LAYER RETENTION FEATURES) " U.S. Patent Application Serial Number 13/763,112 (be now U.S. Patent Publication 2013/0256379);
Entitled " actuator (the ACTUATOR FOR for discharging tissue thickness compensation part from fastener cartridge 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 " including fastener cartridge (the FASTENER CARTRIDGE of 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 " including for discharging the fastener cartridge (FASTENER of the cutting element of 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)) ";
Entitled " including fastener cartridge (the FASTENER CARTRIDGE of 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);
Entitled " including nail bin (the STAPLE CARTRIDGE COMPRISING A RELEASABLE of releasable capping 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) Announce 2013/0256383);
It is entitled " to be used for layer arrangement (the LAYER ARRANGEMENTS FOR SURGICAL of surgery nail bin STAPLE CARTRIDGES) " U.S. Patent Application Serial Number 13/763,095 (be now U.S. Patent Publication 2013/ 0161374);
It is entitled " to be used for implantable arrangement (the IMPLANTABLE ARRANGEMENTS FOR of 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 " to be used for the implantable layer of multiple thickness (the MULTIPLE THICKNESS of surgical stapling device 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 " to be used 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 " including nail bin (the STAPLE CARTRIDGE COMPRISING A of compressible portion COMPRESSIBLE PORTION) " U.S. Patent Application Serial Number 13/763,037;
Entitled " including tissue thickness compensation part (the TISSUE THICKNESS of 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);
Entitled " device and method (the DEVICES for tissue thickness's compensating material to be attached to 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);
Entitled " including the fastener cartridge (FASTENER of the tissue thickness compensation part for wherein including opening CARTRIDGE COMPRISING A TISSUE THICKNESS COMPENSATOR INCLUDING OPENINGS THEREIN U.S. Patent Application Serial Number 13/851,703) ";
Entitled " including tissue thickness compensation part (the TISSUE THICKNESS COMPENSATOR in 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 " including fastener cartridge (the FASTENER CARTRIDGE of 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;
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)) ";
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)) ";
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 one or more spies 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 " implantable layer and the side for changing the shape of 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 " including implantable layer (the IMPLANTABLE LAYERS COMPRISING A PRESSED of compressive region REGION U.S. Patent Application Serial Number 14/187,385) ";And
Entitled " including fastening system (the FASTENING SYSTEM COMPRISING A of firing member latching member FIRING MEMBER LOCKOUT) " U.S. Patent Application Serial Number 14/187,384.
Many details are listed herein, to provide to the whole of the embodiment described in specification and shown in accompanying drawing The thorough understanding of body structure, function, manufacture and purposes.However, it will be appreciated by those skilled in the art that can be without so Detail in the case of implement these embodiments.In other cases, do not elaborate well known operation, part and Element, in case the embodiment illustrated in making specification is smudgy.It will be understood by those skilled in the art that this paper institutes It is non-limiting example to state with shown embodiment, so that it can be appreciated that, specific structural and functional details disclosed herein Can be representative and exemplary.These embodiments can be carried out without departing from the scope of the claims modification and Change.
" various embodiments ", " some embodiments ", " embodiment " or " implement that this specification is referred in the whole text Scheme " etc. means that the special characteristic structure illustrated with reference to 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 individual embodiment " or " in embodiments " etc. be not necessarily all referring to identical embodiment.Additionally, in one or more realities Apply in scheme, specific features structure, structure or characteristic can be combined in any suitable manner.Therefore, in the case of unrestricted, Special characteristic structure, structure or the characteristic for showing or illustrating with reference to an embodiment can whole or in part with one or more The feature structure of other embodiments, structure or property combination.Moreover, it will be appreciated that for the sake of concise and clear, can join herein Examine shown embodiment and for example use the spatial terminology such as " vertical ", " level ", "up" and "down".However, these terms are used In auxiliary reader and be not intended to limitation and it is absolute.
Fig. 1 is gone to, surgical stapling and cutting off apparatus 10 may include to be manipulated to that tool portion 14 is positioned at into operation Handle portions 12 in position.In various embodiments, tool portion 14 may include that the end for being attached to slender axles 18 performs Device 16.In all cases, the size of tool portion 14 and construction can be configured to be inserted by the intubation of trochar (not shown) In entering operative site, to perform such as endoscope type or laparoscopic type surgical operation.End effector 16 may include upper jaw Or anvil block 20 and lower jaw 22, the pistol grip 26 of wherein present dynasty's handle portions 12 moves or presses closing for handle portions 12 When closing trigger 24, anvil block 20 can be moved between the open and the closed positions.In various embodiments, pressing closure is touched Hair device 24 can advance the outer closure sleeve 28 of slender axles 18, and wherein outer closure sleeve 28 can contact anvil block 20 and by anvil block 20 are pivoted to its closing position.In some cases, surgeon can be made by torsional axis knob 30 tool portion 14 around Its longitudinal axis rotates.Under any circumstance, when end effector 16 has been inserted in the body cavity of inflation, for example, can release Closure trigger 24 is put, so as to allow anvil block 20 to pass through spring (not shown) and bias opening and be positioned 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 be unlocked 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 depresses closure trigger 24 again to close anvil block 20 simultaneously And carry out compression organization 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 motion to be applied into firing member and never firing position advances firing member.In various realities Apply in scheme, firing member may include to be attached to the nearside percussion connecting rod 34 of distally trigger shaft 36.In at least one such implementation In scheme, percussion connecting rod 34 and/or trigger shaft 36 can support in the framework 38 in axle 18, and the axle can be in the He of handle portions 12 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 Towards distally propulsion in staple cartridge channel long 40 and the nail bin 42 being positioned in warehouse channel 40.In various embodiments, referring to figure 2, trigger shaft 36 may include attachment part 48, and the attachment part is attached to the E masts 50 that can be translated in end effector 16. E masts 50 may include vertical portion 52, and the vertical portion can be worked as when E masts 50 are advanced towards distally and extend through anvil block 20 In tissue contacting surface 60 narrow longitudinal anvil slot 58, nail bin 42 in narrow vertical slit 62 and elongated nail it is logical Narrow longitudinal channel 64 in road 40.Referring now to Fig. 2 and Fig. 3, anvil slot 58 can be extended up in anvil block 20 simultaneously And may include to be passed through the end of the lateral vertical passage 66 widened, the size and construction quilt of the lateral vertical passage 66 widened It is set to the upper pin 54 for receiving and being extended laterally from vertical portion 52.Similarly, passage slot 64 can extend downwardly into passage 40 In and may include to be passed through the end in the lateral vertical passage 68 widened, the size of the lateral vertical passage 68 widened and Construction is configured to receive one or more the lower pins 70 extended laterally from vertical portion 52.
In various embodiments, than that described above, E masts 50 may also include one or more intermediate pins 72, it is described in Between pin can extend laterally from vertical portion 52 and be configured to be slided along the top surface of the bottom tray 74 of nail bin 42 It is dynamic.In certain embodiments, intermediate pin 72 be configured to by nail bin 42 be placed in or ensure nail bin 42 keep placement In passage 40.Longitudinal percussion groove 75 of formation is sized in permission in nail bin 42 above bottom tray 74 Between pin 72 translate across nail bin 42.In various embodiments, E masts 50 may also include distally driving surface 76, the distally Driving surface is configured to translate across the vertical slit 62 in nail bin 42 and drives wedge-shaped slides 78 to wear towards distally Cross nail bin 42.In certain embodiments, wedge-shaped slides 78 can be integrally molded in E masts 50, and in other embodiments In, wedge-shaped slides 78 can be located in nail bin 42 and driving surface 76 can be contacted when E masts 50 are advanced towards distally.E masts 50 vertical portion 52 may additionally include the top of distally driving surface 76 and the lower section of upper pin 54 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 drive up staple drivers 82 towards anvil block 20. In various embodiments, nail (such as following closely 83) for example can be placed on staple drivers 82 and/or otherwise by staple drivers 82 supports so that when staple drivers 82 are lifted up, can also be lifted up nail 83.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, nail 83 can contact anvil block 20 and can be ejected from nail cavity 84.In at least one embodiment, Fig. 4, bottom support are referred again to 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 positioned on the side of tissue 46 and can be clamped bottom Mouth 22 is positioned 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 nail bin 42 tissue contact platform 90 can between uncompressed thickness 91 and compressed thickness 92 compression organization 46.In order to suture and Transecting patient tissue 46, as described above, wedge-shaped slides 78 can be advanced to be driven towards the lifting nail of anvil block 20 towards distally in nail bin 42 Device 82 and deform nail 83.In various embodiments, each staple drivers 82 may include to be defined in one of those or it is many Individual slit, the slit is configured to receive the base portion 87 of nail 83 and make it releasably hold in place.At least one In individual such embodiment, each nail 83 may include one or more nail legs 88 extended from base portion 87, and wherein nail leg 88 can be to On extend to nail cavity 84.In various embodiments, when following closely 83 in its non-firing position, the end of nail leg 88 can be relative It is recessed in the platform or tissue contacting surface 90 of warehouse 85.When nail 83 is lifted up by driver 82, the end of nail leg 88 Can be ejected from nail cavity 84, penetrate tissue 46 and contact the anvil block forming pit 89 of the opposite side for being positioned at nail cavity 84.Anvil block into Shape pit 89 is configured to make nail 83 be deformed into any suitable shape, such as B shape shapes such as shown in Figure 5. Referring now to Fig. 6, when deployment nail 83, cutting edge 80 can will organize 46 crosscutting into sutured portion 94.
As described above, the jaw member of end effector is configured to be applied to compression pressure or compression stress just The tissue being sewn.However, in all cases, tissue can be that at least a portion that is for example eely and organizing can be relative Slided in jaw member.In some cases, tissue can be skidded off from the distal end of end effector in a longitudinal direction and/or Can be skidded off from the side of end effector along transverse to the direction of longitudinal direction.In some cases, when compression organization, group The part knitted can extrude from the side of the distal end of end effector and/or 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 Into being prevented from or at least reduce to be positioned at tissue in end effector relative to the possibility that end effector is moved.
In various embodiments, referring now to Fig. 7 and Fig. 8, nail bin (such as nail bin 142) for example may include warehouse 185 For example it is positioned at the multiple nails (such as following closely 187 (Fig. 9)) in warehouse 185.Warehouse 185 may include proximal end 141 and distally End 143, wherein proximal end 141 are configured in the proximal end for insert staple cartridge channel and distal end 143 It is configured in the distal end for insert staple cartridge channel.In at least one embodiment, warehouse 185 may include multiple Nail cavity 184, the nail cavity is each configured to receive nail 187 wherein.In some alternative embodiments, although not Show, but nail cavity may include the more than one nail that is 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 for example can be arranged to three staples on the second side 147 of warehouse 185.In at least one such implementation In scheme, first side 145 and the second side 147 of warehouse 185 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 nail 187 being ejected from nail cavity 184. In certain embodiments, each nail cavity 184 may include the openend being located in the platform 190 of warehouse 185 or opening 110, nail 187 may pass through openend or opening 110 ejects.
In various embodiments, referring primarily to Fig. 8, nail cavity 184 may be arranged so that their longitudinal directions 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 of other rows or both Laterally it is aligned.In at least one embodiment, each nail cavity 184 may include proximal end 111 and distal end 112, its In each nail cavity 184 proximal end 111 may be positioned to than distal end 112 near warehouse 185 proximal end 141.Equally, The distal end 112 of each nail cavity 184 may be positioned to the distal end 143 near warehouse 185 than proximal end 111.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 distally.Similarly, outermost nail chamber 184 can be positioned so that So that distal end 112 court of the distal end 112 relative to the nail cavity in intermediate row nail cavity 184 of the nail cavity 184 in outermost row Distally positions.For example, the farthest side nail cavity 184 in most interior row can be fixed towards distally relative to the farthest side nail cavity 184 in intermediate row Position, and similarly, the farthest side nail cavity 184 in outermost row can be fixed towards distally relative to the farthest side nail cavity 184 in intermediate row Position.In certain embodiments, the nail cavity 184 of the nail cavity 184 of most interior row and outermost row 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 near 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, Fig. 7 and Fig. 8 is referred again to, the warehouse 185 of nail bin 142 may also include and for example be constructed Into 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 close the anvil block 120 of end effector to carry out compression organization T against nail bin 142, wherein in this case, group Knit contact platform 190 and the engageable tissue in spine 113,114 and 115 extended from it.In some cases, when closure anvil block When 120, anvil block 120 can be towards the pushes against tissue of nail bin 142 so that tissue contacts spine 113,114 and 115 and then contacts first Storehouse platform 190.In other cases, nail bin 142 can be positioned against tissue so that before tissue contact storehouse platform 190, spine 113rd, 114 and 115 the tissue is contacted.Under any circumstance, spine 113,114 and 115 is prevented from or extremely once contacting tissue Relative motion between few limitation tissue and nail bin 142.In certain embodiments, spine 113,114 and 115 can be from flat It is described recessed or at least substantially flat storehouse platform 190 is upwardly extended and can limit such as one or more pits or passage Hole or passage are configured to receive wherein a part for tissue, and therefore forbid being organized in the vertical of end effector To the relative motion on direction and/or horizontal direction, especially when tissue be compressed at least in part anvil block 120 and spine 113, When between 114 and 115.In various embodiments, when spine 113,114 and 115 extends to storehouse 190 top of platform, can be Compression set is in anvil block 120 and spine 113,114 and 115 before tissue of the compression set in the middle of anvil block 120 and storehouse platform 190 Middle tissue.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, compressing at least in part) is positioned at anvil block 120 and spine 113, the group between 114 and 115 Knit.In all cases, before tissue obtains compression completely, due to this precommpression, part that is controllable or preventing tissue Skidded off from end effector, as described in more detail below.
In various embodiments, Fig. 7 and Fig. 8 is referred again to, the spine 113 extended from storehouse platform 190 can be around nail cavity The proximal end 111 of opening 110 extends.Similarly, the spine 114 for extending 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 distally spine 114 are configured to engagement It is positioned at the tissue of the top of nail cavity 184 and/or surrounding and makes these parts of tissue when tissue is 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 that 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 motion.In various embodiments, spine 113 and 114 can be around all nail cavities 184 or the only opening 110 of some nail cavities 184 Positioning.In at least one embodiment, warehouse may include the nail in the outermost row only around the first side 145 and the second side 147 The spine 113 and 114 in chamber 184.In such an implementation, the spine around outermost nail chamber 184 can be enough to hinder to be organized in Lateral movement in end effector.In certain embodiments, warehouse can only include the proximal end around recent side nail cavity 184 The nearside spine 113 in portion 111 and/or the distally 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 to hinder to be organized in the lengthwise movement in end effector.
In various embodiments, than that described above, each nearside spine 113 may include for example around the near 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 is limited.Similarly, each distally spine 114 may include the arch of the distal end 112 for for example surrounding opening 110 Or curved profile.The arcuate profile of each distally 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 can be received and just compressed Tissue a part and prevent the part of tissue from longitudinally and/or laterally being moved relative to nail bin 142.Various In embodiment, nail bin 142 may also include middle spine 115, and the middle 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 many Individual spine 113,114 and 115 can interoperatively be developed across the waveform that first side 145 or the second side 147 of warehouse 185 extend Spine, wherein at least one embodiment, waveform spine can extend between the core of warehouse 142 and sidepiece. In various embodiments, each waveform spine may include for example around nail cavity 184 proximal end and distal end wind it is many Individual 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 uniform or at least base across its length It is uniform in sheet.In at least one embodiment, each spine 113,114 and 115 can have identical or at least substantially Identical is highly.
In various embodiments, as described above, the nail cavity in being defined in staple cartridge body may include the nail being positioned in, its In when nail is in its non-firing position, the whole of nail can be positioned on top surface or the tissue contacting surface lower section of storehouse platform. In some other embodiments, when nail is in its non-firing position, at least a portion (end of such as nail leg) example of nail Such as may extend into top surface or the tissue contacting surface top of storehouse platform.In some such embodiments, the end of nail can Protruded from platform and can organizationally cause obstacle when nail bin is inserted in operative site.In at least one embodiment, Referring now to Fig. 9, when nail extends to storehouse 190 top of platform in its non-firing position, for example, extend to tissue contact storehouse platform 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 distally spine 114 can be sufficiently around another nail leg end so that pressed against nail bin 142 in tissue From 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 the lower section of top surface 116 of spine 113 and 114.In certain embodiments, nail leg end can be with spine 113 Top surface 116 with 114 is coplanar.In various embodiments, due to the protection provided by spine 113 and 114, for example, can make With the nail with staple height higher, and follow closely end and do not protruded from nail bin 142 in its non-firing position.In certain embodiments, Fig. 9 is referred again to, spine 113 and 114 is extensible or increases the length of the wherein nail leg 183 of controllable and/or support nail 187. In at least one such embodiment, each spine 113 and 114 can extend or increase can wherein be supported on its three sides 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 flexing possibility.
In various embodiments, Fig. 4 is referred again to, warehouse 85 may include for example to be defined in and therein reduce warehouse 85 The chamber 84 of intensity, slit 62 and passage 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 for applying thereon.In at least one such embodiment, storehouse platform 90 extends on passage 86 Part for example can be especially thin and can especially undergo deflection and/or damaged.In certain embodiments, Fig. 7 is referred again to And Fig. 8, spine 113,114 and/or 115 is configured to make warehouse 185 strengthen and/or be hardened.It is such at least one In embodiment, spine 113 and 114 can for example extend around opening 110, to make the part of the circular nail cavity 184 of warehouse 185 Strengthen and/or be hardened.In certain embodiments, spine 115 for example can be in the grade of passage 86 being defined in warehouse 185 laterally Extend so that spine 115 can make the warehouse 185 for surrounding passage 86 strengthen and/or be hardened.In various other embodiments, storehouse Body 185 may include the spine of any suitable quantity and configuration extended from it to realize advantage as herein described.
In various embodiments, staple cartridge body 185 can for example by plastic material, metal material, and/or ceramic material structure Into.Some such materials can comprising such as liquid crystal polymer (such as Vectra), thermoplastic polymer (such as makrolon, ABS, Noryl, polyamide (nylon), polyether sulfone, PEI (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 can be comprising such as thermosetting polymer (such as thermosetting polyester), model casting stainless steel (such as 17-4PH) and/or it is 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 being positioned in each in nail cavity 384.In certain embodiments, storehouse Body 385 may also include with first group of first side 345 of nail cavity 384, with second group of second side 347, Yi Jicang of nail cavity 384 Platform 390.In various embodiments, warehouse 385 to may also include and can be positioned on a nail chamber 384 from what storehouse platform 390 extended In adjacent nail cavity 384 in the middle of 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 in addition can at least partly about another 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 some other embodiments, referring now to Figure 13, staple cartridge body 385' may include spine 315, The opening 310 of each nail cavity 384 at least partly about warehouse of spine.Under any circumstance, in various embodiment party In case, each spine 315 is configured to compression as described above and controls the tissue and/or ring against the positioning of nail bin 342 Around the nail leg of the nail for extending to the top of 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 being positioned in each in nail cavity 584.In certain embodiments, storehouse Body 585 may also include with first group of first side 545 of nail cavity 584, with second group of second side 547, Yi Jicang of nail cavity 584 Platform 590.In various embodiments, warehouse 585 may also include from storehouse platform 590 extend multiple spines 515, wherein each Spine 515 can entirely around or surround nail cavity opening 510.As shown in figure 16, some the chamber openings 510 in warehouse 585 can not be by Spine 515 surround;And in various alternative embodiments, referring now to Figure 16 A, each the chamber opening 510 in warehouse 585' Can be surround by spine 515.Envisioning its middle warehouse includes being surround by first group of circular nail cavity 584 of spine 515 and not by spine 515 Second group of nail cavity 584 various embodiments, wherein the nail with staple height higher can be positioned in first group of nail cavity 584 simultaneously And wherein during the nail with relatively low staple height can be positioned on second group of nail cavity 584 so that nail higher and relatively low nail be not from nail bin 542 protrude.In at least one such embodiment, for example, warehouse be configured to using in a nail chamber 584 compared with Relatively low 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 be in outermost row using nail higher and can be in most interior row and/or intermediate row Relatively low 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 being positioned in each in nail cavity 484.In certain embodiments, storehouse Body 485 may also include with first group of first side 445 of nail cavity 484, with second group of second side 447, Yi Jicang of nail cavity 484 Platform 490.In various embodiments, warehouse 445 may also include from storehouse platform 490 extend multiple spines 415, 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 many Multiple tapers of individual nail cavity opening 410 or diamond-shaped knurling, wherein at least one embodiment, taper annular knurl can be from storehouse platform 490 point to.In at least one embodiment, each taper annular knurl may include four triangle sides, four triangles Shape side can be assembled and form cusp together.In certain embodiments, referring to Figure 15 A, the taper annular knurl of spine 415 can be to cut Short, wherein may include to be inclined by the flat top surface of side surrounding at the top of each annular knurl.Although can be used four sides to bore Shape annular knurl, referring now to Figure 15 C, it is contemplated that with for example less than four sides or its more than four sides (such as three sides) Its conical by its shape.In various embodiments, one or more spines 415 may include multiple cone 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 what is truncated, wherein be may include by ring at the top of each annular knurl The flat top surface of shape side surrounding.In various embodiments, Figure 14 is referred again to, the annular knurl of spine 415 can be along nail The side of chamber opening 410 and/or the extension between adjacent nail cavity opening 410.In at least one embodiment, annular knurl can be around 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 some 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 being positioned in each in nail cavity 284.In certain embodiments, storehouse Body 285 may also include with first group of first side 245 of nail cavity 284, with second group of second side 247, Yi Jicang of nail cavity 284 Platform 290.In various embodiments, warehouse 285 may also include the multiple spines or bump 215 extended from storehouse platform 290. In at least one such embodiment, each spine 215 can be at the center or centre of the warehouse 245 of the neighbouring positioning of cutter groove 262 Extended laterally between part and the sidepiece of warehouse 245.More specifically, referring particularly to the first side 245 of warehouse 285, each ridge Portion 215 may include the second end that the first end 213 of the neighbouring positioning of cutter groove 262 and first side 261 of neighbouring warehouse 285 position 214.Similarly, referring now to the second side 247 of warehouse 285, each spine 215 may include the first of the neighbouring positioning of cutter groove 262 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 from the measurement of platform 290, wherein at least one such embodiment, the height of each spine 215 Can be along its length change.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 some alternative embodiments, although not showing Go 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 at the second end 214. In some embodiments, the height of each spine 215 can between end 213 and 214 Geometrical change.In some alternatives embodiment party In case, referring now to Figure 11, each spine 215' may include the even height across its length.
As described above, inner the 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 213 smaller pressure can be applied to the tissue being clamped between anvil block and nail bin 242.In various implementations In scheme, as described above, each spine 215 can extend laterally 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 axle 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 parallel to or Person is at least substantially parallel to longitudinal axis 299.In at least one embodiment, spine's axle of spine 215 can be along crosscutting nail The direction of the longitudinal axis in chamber 284 extends.In at least one such embodiment, spine's axle 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, Figure 10 is referred again to, often Individual spine 215 may include bizet 209 and extend in inclined surface 208 between bizet 209 and storehouse platform 290 in addition.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 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 Spine 215 across storehouse platform 290 extend laterally when, spine 215 (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 685th, the multiple nail cavities 684 being defined in warehouse 685 and the nail being positioned in each nail cavity 684.In some embodiments In, warehouse 685 may also include with first group of first side 645 of nail cavity 684, with second group of second side 647 of nail cavity 684, And storehouse platform 690.In various embodiments, warehouse 685 may also include the multiple spines or protuberance extended from storehouse platform 690 Block 615.In at least one such embodiment, each spine 615 can be extendable in the longitudinal direction, and wherein each spine 615 can Including distal end 613 and proximal end 614, the distal end 613 of wherein spine 615 may be positioned to closer to warehouse 685 Distal end 643, and the proximal end 614 of wherein spine 615 may be positioned to closer to proximal end 641.At least one In embodiment, each spine 615 may include the height from the measurement of platform 690, wherein at least one such embodiment, The height of each spine 615 can be along its length change.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 some alternatives embodiment party In case, although 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 least one In such embodiment, the maximum height that the height of each spine 615 can be proximally at end 614 tapers 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 some alternative 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 less 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 extending of storehouse platform 690.In some implementations In scheme, each spine 615 can extend along spine axis, and spine's diameter parallel is in or at least substantially parallel to storehouse The longitudinal axis 699 of body 685.In various embodiments, nail cavity 684 can be arranged to it is multiple rows of, wherein can be along following longitudinal direction Axis limits each nail chamber 684, the longitudinal axis can parallel to or at least substantially parallel to spine 615 spine Axle.In at least one embodiment, Figure 18 is referred again to, each spine 615 may include ramped surfaces, and the ramped surfaces can Including such as 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 distally, so that be conducive to group when tissue is positioned in end effector It is woven on whole 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 extends laterally 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 for example can be made up of titanium (such as titanium silk).In some implementations In scheme, surgical staples can be made up of the alloy for for example including titanium, aluminium and/or vanadium.In at least one embodiment, surgical staples can Constituted by surgery stainless steel and/or by the alloy that such as cobalt and chromium are constituted.Under any circumstance, surgical staples can 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 PEP (FEP) is constituted.Some coatings can include silicon.In various embodiments, such coating material can prevent or At least suppress 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 nail pit Between relatively low-frictional force can reduce make nail deform needed for power.
It is filed in the U.S. Patent Application Publication of in September, 2010 entitled " nail bin (the STAPLE CARTRIDGE) " of 29 days 2012/0074198 (being now United States Patent (USP) 8,733,613) and it is filed in the entitled " nail bin (STAPLE of on 2 21st, 2013 The disclosure of U.S. Patent Application Publication 2013/0161375 CARTRIDGE) " is incorporated by reference in its entirety accordingly.
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 to can to remove wherein support nail storehouse jaw or staple cartridge channel 22.Nail bin 2000 Such as 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 store nail with can removing wherein.Warehouse 2010 may include platform surface 2011 are configured to move wherein with the longitudinal slit 2015 being defined in platform surface 2011, the longitudinal slit Except ground receives firing member and/or cutting edge.Warehouse 2010 may also include distal end 2013, proximal end 2016, Yi Ji The relative longitudinal direction side 2012 extended between distal end 2013 and proximal end 2016.In all cases, side longitudinally in each 2012 may include the infinitely adjoining due to interruption therein or continuous boundary.After comparison diagram 7 and Figure 23, for example, reader will The longitudinal direction side of the nail bin 142 shown in solution Fig. 7 include being defined at least one recess therein and longitudinal direction side 2012 do not include it is 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 engage the tissue that is positioned in the middle of anvil block 20 and storehouse 2000 and controls tissue relative to storehouse 2000 motion.Tissue can be moved relative to storehouse 2000 in all cases.In the case of at least one, when anvil block 20 is being opened Position (Figure 23) and wherein tissue are compressed between the closing position between anvil block 20 and storehouse 2000 when moving, and tissue can be relative Flowed in storehouse 2000.In this case, tissue can be towards the lateral flow of longitudinal direction side 2012, towards the distally of distal end 2013 stream It is dynamic, and/or the flowing of the nearside of proximally facing end 2016.At least one in the case of other, when cutting edge is advanced through towards distally During the tissue being trapped between anvil block 20 and storehouse 2000, tissue can flow relative to storehouse 2000.In this case, tissue can side To flowing, towards distally flowing, and/or proximally flow, but it is main towards distally flowing because the distally of cutting edge is moved.Each In the case of kind, protuberance 2051 is configured to that flowing of the tissue relative to nail bin is restricted or prevented.Protuberance 2051 can It is positioned at the proximal end of nail cavity 2050 and/or distal end.In all cases, each protuberance 2051 may include around The hoop that the end of nail cavity 2050 extends.In some cases, each protuberance 2051 may include to prolong around the end of nail cavity 2050 The arch spine stretched.
Referring primarily to Figure 55, warehouse 2010 may include to extend 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 are positioned in operative site Relative to the motion of tissue.In this case, tissue can be slided 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 the case of at least one, as shown in figure 55, inclined surface 2014 can for example include distally concave surface, and the distally concave surface is transited into flat angled faces, it is described it is flat into 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 On second side.Row may include the farthest side nail cavity 2050 of neighbouring distal end 2013 and adjacent to proximal end 2016 longitudinally in each Recent side nail cavity 2050.In all cases, warehouse 2010 may also include the protuberance 2053 extended from platform surface 2011.It is prominent Go out portion 2053 to can be positioned at the distal end of farthest side nail cavity 2050.Each protuberance 2053 may include for example to be adapted to The distal ramped surface of enough insertions for being conducive to being organized between nail bin 2000 and anvil block 20.In all cases, farthest side chamber 2050 can each include the protuberance 2053 being positioned at its distal end and the protuberance 2051 being positioned at its proximal end.
Each protuberance 2051 and/or protuberance 2053 are configured to support and store in nail cavity with can removing At least a portion of nail in 2050.In all cases, each protuberance 2051 can make the end wall 2052 of nail cavity 2050 flat The top of platform 2011 extends.In some cases, referring generally to Figure 24 and Figure 26 to Figure 29, the nail being positioned in nail cavity 2050 can be wrapped Include base portion, the first leg extended from the base portion with first angle and the second leg extended from the base portion with second angle 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 of the nail cavity End wall 2052 is contacted.In some cases, the distance between first leg and the second leg of nail or extension can be wider than end wall The distance between 2052 so that when nail is positioned in nail cavity 2050, leg is inwardly biased by end wall 2052.When nail is in nail cavity 2050 memory storages are not fired or during non-raised position in it, and the end of nail leg can be positioned in protuberance 2051.In this feelings Under condition, protuberance 2051 in the upper support of platform 2011 and can protect the end of nail leg.In some cases, when nail is in it not During firing position, the end of nail leg can be positioned on the lower section of protuberance 2051, and therefore, when nail is in its non-firing position, Protuberance 2051 can not support nail leg.When this nail is fired or is lifted out nail cavity 2050, nail leg then can be with protuberance 2051 Come in contact and supported by protuberance 2051.Under any circumstance, protuberance 2051 can continue support nail when nail is disposed Leg, until nail has fully been fired and/or is lifted out nail cavity 2050 so that nail leg is no longer contacted with protuberance 2051.Protuberance 2053 can perform similar to the mode combined described in protuberance 2051.
In all cases, than that described above, protuberance 2051 can make nail cavity 2050 on the platform 2011 of warehouse 2010 Fang Yanshen.In some cases, to can be configured so that the end wall 2052 of nail cavity 2050 is seamlessly extended to prominent for protuberance 2051 Go out in portion 2051.In other words, seamless surface can be limited between end wall 2052 and protuberance 2051.This seamless surface can be reduced It is biased against edge that the nail leg contact of end wall 2052 and protuberance 2051 is defined in nail cavity 2050 or ladder and/or digs nail The possibility of the side wall in chamber 2050.Figure 55 A show the ladder 2056 being defined between protuberance 2051 and end wall 2052.Although Ladder 2056 includes that outside ladder can be excluded to provide as discussed above rather than inside ladder, but ladder 2056 Seamless surface.During warehouse 2010 is the embodiment formed during injection molding wherein, storehouse 2010 can be defined in note Formed in mold cavity between the two half-unit of mould.The two half-unit of injection mold can contact with each other to seal or at least base Sealed mold chamber in sheet.Junction surface between the two die halfs is commonly known as seal line or die parting line, and usually edge Seal line and small flange or antelabium is formed in warehouse.It is empty when being discharged from mold cavity using seal line during injection molding It is especially true during gas.This flange or antelabium are commonly known as ' flash '.Injection mold can be carefully designed into and cause seal line Flange or antelabium are not produced in the end wall 2052 of protuberance 2051 and/or the surface in facing.In the case of at least one, dash forward Go out the transition portion that portion 2051 may include to hold hoop portion point 2057 and extend to platform 2011 from the relative both ends of hoop portion point 2058.Seal line between the two mould half portions may be chosen such that it extends along the top surface of protuberance 2051. Example seal line 2059 may be selected other suitable seal lines as shown in Figure 55 A.
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 to schedule it In recess joining edge.Warehouse 2810 may also include such as platform 2811, the multiple nail cavities being 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 the case of at least one, 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 a portion, intermediate row nail cavity 2850 in nail cavity 2850 at least a portion and/or outer nail chamber At least a portion 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 inner 2858 and adjacent side face 2812 of the positioning of longitudinal slit 2815 are positioned.In some cases, inner 2858 Can be positioned towards distally relative to outer end 2859.In other cases, although not shown, outer end 2859 can be relative to inner 2858 Towards distally positioning.Spine 2851 can be for example parallel.In some cases, spine 2851 may include such as tread contour. In the case of at least one, the spine 2851 extended from platform 2811 in the first side of longitudinal slit 2815 may include in longitudinal slit The mirror image of the spine 2851 that 2815 the second side extends from the platform.In all cases, can be limited between spine 2851 Gap.Tissue for example can flow into the gap when tissue is compressed against storehouse platform 2811 by anvil block.The gap can be constructed Into the flowing that can be organized along the guiding of 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 relative side 2912.Similar to above-mentioned, each side 2912 may include infinitely due to recess therein Joining edge.Warehouse 2910 may also include such as platform 2911, the multiple nail cavities 2950 being defined in platform 2911 and by structure The longitudinal slit 2915 of the edge of a knife for causing that firing member can be received.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 and proximal end between.In the case of at least one, each spine 2951 can be towards side 2912 and towards longitudinal slit 2915 Extend.In all cases, each spine 2951 may include inwardly and proximally to extend into angle part 2954, Longitudinal extending Straight portion 2955 and inwardly and towards distally extend into angle part 2956.Spine 2951 can be around nail cavity 2950 and/or in nail cavity Extend between 2950.In the case of at least one, into angle part 2954 and can be in longitudinal nail chamber 2950 into 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 the case of at least one, the spine 2951 extended from platform 2911 in the first side of longitudinal slit 2915 can wrap Include the mirror image of the spine 2951 extended from the platform in the second side of longitudinal slit 2915.In all cases, can be in spine Gap is limited between 2951.Tissue for example can flow into the gap when tissue is compressed against storehouse platform 2911 by anvil block.It is described Gap is configured to the flowing along desired direction guiding tissue.
Nail bin may include the uniform protuberance array extended from it.In other cases, the array can be uneven. In some cases, the protuberance in the array can not extend nail cavity.In all cases, the protuberance in the array 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 relative side 3012.Similar to above-mentioned, each side 3012 may include unlimited due to wherein Recess joining 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 the longitudinal slit 3015 of the edge of a knife of reception firing member.Warehouse 3010 may also include from storehouse platform 3011 The protuberance 3051 of extension.In all cases, protuberance 3051 may include pattern.In the case of at least one, each protrusion Portion 3051 may include conical configuration.Conical configuration may include four sides for for example being terminated with point.Alternatively, this four sides For example can be terminated with flat surface.Alternatively, conical configuration may include three sides for for example being terminated with point.Any In the case of, as shown in figure 59, protuberance array 3051 can extend across platform between longitudinal slit 3015 and side 3012 3011.Protuberance 3051 can be arranged around nail cavity 3050.Nail cavity 3050 can be arranged to longitudinal direction row and protuberance 3051 can be positioned In the middle of nail cavity 3050 in longitudinal nail chamber 3050.Protuberance 3051 can be positioned on the nail cavity in adjacent longitudinal nail chamber 3050 In the middle of 3050.Protuberance 3051 can be positioned in the middle of most interior nail chamber 3050 and vertical passage 3015.Protuberance 3051 can be positioned In the middle of outermost nail chamber 3050 and lateral edge 3012.Protuberance 3051 can be fixed towards distally relative to farthest side nail cavity 3050 Position.Protuberance 3051 can proximally be positioned relative to recent side nail cavity 3050.Protuberance 3051 can be relative to longitudinal slit 3015 Distal end towards distally position.In other cases, protuberance 3051 can be not with respect to the distal end of longitudinal slit 3015 Towards distally positioning.
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 relative side 3112.Similar to above-mentioned, each side 3112 may include unlimited due to wherein Recess joining 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 the longitudinal slit 3115 of the edge of a knife of reception firing member.Warehouse 3110 may also include from storehouse platform 3111 The protuberance 3151 of extension.In all cases, protuberance 3151 may include pattern.In the case of at least one, 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, protuberance array 3151 can extend across platform between longitudinal slit 3115 and side 3112 3111.Protuberance 3151 can be arranged around nail cavity 3150.Nail cavity 3150 can be arranged to longitudinal direction row and protuberance 3151 can be positioned In the middle of nail cavity 3150 in longitudinal nail chamber 3150.Protuberance 3151 can be positioned on the nail cavity in adjacent longitudinal nail chamber 3150 In the middle of 3150.Protuberance 3151 can be positioned in the middle of most interior nail chamber 3150 and vertical passage 3115.Protuberance 3151 can be positioned In the middle of outermost nail chamber 3150 and lateral edge 3112.Protuberance 3151 can be fixed towards distally relative to farthest side nail cavity 3150 Position.Protuberance 3151 can proximally be positioned relative to recent side nail cavity 3150.Protuberance 3151 can be relative to longitudinal slit 3115 Distal end towards distally position.In other cases, protuberance 3151 can be not with respect to the distal end of longitudinal slit 3115 Towards distally positioning.
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 relative side 3212.Similar to above-mentioned, each side 3212 may include infinitely due to recess therein Joining edge.Warehouse 3210 may also include such as platform 3211, the multiple nail cavities 3250 being defined in platform 3211 and by structure The longitudinal slit 3215 of the edge of a knife for causing that firing member can be received.Warehouse 3210 may also include from dashing forward that storehouse platform 3211 extends Go out portion 3251.Similar to protuberance 2051, protuberance 3251 is configured to engagement and is positioned in the middle of anvil block and storehouse 3200 Tissue and control tissue relative to the motion in storehouse 3200.In all cases, protuberance 3251 is configured to limit Tissue is made or prevented relative to the flowing of nail bin.Protuberance 3251 can be positioned on the proximal end and/or distal end portion of nail cavity 3250 At portion.In all cases, each protuberance 3251 may include the hoop extended around the end of nail cavity 3250.In some situations Under, each protuberance 3251 may include the arch spine extended around the end of nail cavity 3250.In all cases, each protrusion Portion 3251 may include to limit one or more projections 3254 thereon.Projection 3254 can provide texturizing surfaces, so as to improve Chucking power or confining force that protuberance 3251 can apply to the tissue being positioned in the middle of anvil block and nail bin 3200.In various situations Under, each projection 3254 may include such as projection.In some cases, each projection 3254 may include dome.In at least one In the case of, projection 3254 can be by the elastomeric material that is for example molded on the protuberance 3251 that can be for example made up of plastic material (such as rubber, thermoplastic elastomer (TPE) and/or santoprene) is constituted.In all cases, projection 3254 can be made up of pliable material And the tissue compressed by projection 3254 may not be injured.Warehouse 3210 may also include protuberance 3253.Similar to protuberance 2053, protuberance 3253 can be positioned at the distal end of farthest side nail cavity 3250.Each protuberance 3253 may include for example by It is constructed to be permeable to be conducive to the distal ramped surface of insertion being organized between nail bin 3200 and anvil block.In all cases, most Distal chamber 3250 each may include to be positioned at the protuberance 3253 at its distal end and the protrusion being positioned at its proximal end Portion 3251.It is also similar to above-mentioned, each protuberance 3251 and/or protuberance 3253 are configured to support and can remove ground Store at least a portion 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 The the second nail leg 2132b extended with the second end from 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 being preced with distance, and is represented by dimension E.First nail leg 2132a includes what is extended from base portion 2131 The Part I 2133a and Part II 2134a extended from Part I 2133a.Part I 2133a can with first angle from Base portion 2131 extends.This first angle can be represented by the angle F for measuring from vertical direction.Part II 2134a can be with second jiao Degree extends from Part I 2133a.This second angle can be represented by the angle K for measuring from vertical direction.Reader will appreciate that, first Part 2133a and Part II 2134a are not on the same line;But, Part I 2133a is along first axle 2137a Extend and Part II 2134a extends along the second axis 2138a different from first axle 2137a.Joint 2135a makes first Part 2133a and Part II 2134a is interconnected and measured positioned at from the support surface 2139 being defined on the bottom of base portion 2131 At D.Part II 2134a includes being located at the leg top at C from the measurement of base portion supports surface 2139 2136a.Part I 2133a may include the first cantilever extended from base portion 2131 and Part II 2134a may include from first The second cantilever that part 2133a extends.Can limit the first hron spacing and the difference apart from C and between D apart from D can limit Second hron spacing.
Second nail leg 2132b includes what is extended from the Part I 2133b of the extension of base portion 2131 and from Part I 2133b Part II 2134b.Part I 2133b can be extended with first angle from base portion 2131.This first angle can be by from vertical side Represented to the angle G of measurement.Angle G can both be same as may also differ from above-mentioned angle F.When the second nail leg 2132b is relative to One nail leg 2132a towards distally position when, in the case of at least one, angle G can be, for example, less than angle F.Alternatively, when the first nail Leg 2132a relative to the second nail leg 2132b towards distally position when, in the case of at least one, angle F can be, for example, less than angle G. Part II 2134b can be extended with second angle from Part I 2133b.This second angle can be by also measuring from vertical direction Angle H is represented.Angle H can both be same as may also differ from above-mentioned angle K.When the second nail leg 2132b is relative to the first nail leg 2132a towards distally position when, in the case of at least one, angle H can be, for example, less than angle K.Alternatively, when the first nail leg 2132a relative to the second nail leg 2132b towards distally position when, in the case of at least one, angle K can be, for example, less than angle H.Read Person will be appreciated that Part I 2133b and Part II 2134b not on the same line;But, Part I 2133b along First axle 2137b extends and Part II 2134b extends along the second axis 2138b different from first axle 2137b.Connect Head 2135b makes Part I 2133b and Part II 2134b interconnect and positioned at from the support being defined on the bottom of base portion 2131 Surface 2139 measurement at B.Can both be same as may also differ from apart from B above-mentioned apart from D.Part II 2134b includes position In the leg end 2136b at A measured from base portion supports surface 2139.Can both be same as may also differ from apart from A above-mentioned Apart from C.Part I 2133b may include the first cantilever extended from base portion 2131 and Part II 2134b may include from first The second cantilever that part 2133b extends.Can limit the first hron spacing and the difference apart from A and between B apart from B can limit Second hron spacing.Between the second end 2136b of the first end 2136a of the first nail leg 2132a and the second nail leg 2312 Distance can limit the extended range between nail leg 2132a, 2132b and be represented by apart from J.Can be both wider than apart from J or be not wider than Above-mentioned hat is apart from E.
Figure 25 shows the nail for being supported in the nail cavity 2150 for being positioned at and being defined in storehouse 2110 and by staple drivers 2040 2130.Reader will appreciate that, the leg 2132a and 2132b of nail 2130 are by inwardly biasing or the bending of the end wall of nail cavity 2150.Cause This, may change and respectively by A ', B ', C ', D ', E ' and J ' representative apart from A, B, C, D, E and J.Nail 2130 can for example by bullet Property material (such as stainless steel and/or titanium) constitute, and when follow closely 2130 ejected from nail cavity 2150 when, the change of these distances is reversible Turn, or reverse at least in part.Similarly, angle F, G, H and K may because will nail 2130 be positioned in nail cavity 2150 and change and Represented by angle F ', G ', H ' and K ' respectively.As described above, nail 2130 can be made up of elastomeric material, and when nail 2130 from nail cavity During 2150 ejection, the change of these distances can be reversed, or reverse at least in part.Figure 25 shows the nail in non-firing position 2130 and driver 2040.Non- firing position herein, the end 2136a of the first nail leg 2132a can be in the platform surface in storehouse 2110 2111 tops extend and can be positioned in the protuberance 2150a extended from platform surface 2111 and by protuberance protection, and Similarly, the end 2136b of the second nail leg 2132b can extend and can be positioned on from platform surface in the top of platform surface 2111 In the 2111 protuberance 2150b for extending and by protuberance protection.
Follow closely 2230 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 to be connected to the Part I of base portion 2231 The 2233a and Part II 2234a extended from Part I 2233a.Second leg 2232b may include to be connected to base portion 2231 The Part I 2233b and Part II 2234b extended from Part I 2233b.Base portion 2231, Part I 2233a and A part of 2233b may include substantially V-shaped configuration.In all cases, Part II 2234a can be at joint 2235a from first Part 2233a extends internally, and similarly, Part II 2234b can inwardly prolong at joint 2235b from Part I 2233b Stretch.Base portion 2231, the construction of the first leg 2232a and the second leg 2232b and arrangement can be set so that nail 2230 in figure 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 distally.Alternatively, the first leg 2232a can proximally be positioned relative to the second leg 2232b.
Follow closely 2330 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 to be connected to base portion along what axis extended 2331 straight portion 2333a.Second leg 2332b may include to be connected to the Part I 2333b of base portion 2331 and from Part I The Part II 2334b that 2333b extends.Base portion 2331, straight portion 2333a and Part I 2333b may include substantially V-shaped configuration. In all cases, Part II 2334b can extend internally at joint 2335b from Part I 2333b.Base portion 2331, The construction of one leg 2332a and the second leg 2332b and arrangement can be set so that nail 2330 shown in Figure 27 its not into It is symmetrical in shape or non-percussion configuration.In all cases, the first leg 2332a can be fixed towards distally relative to the second leg 2332b Position.Alternatively, the first leg 2332a can proximally be positioned relative to the second leg 2332b.
Follow closely 2430 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 to be connected to the Part I of base portion 2431 The 2433a and Part II 2434a extended from Part I 2433a.Second leg 2432b may include to be connected to base portion 2431 The Part I 2433b and Part II 2434b extended from Part I 2433b.Base portion 2431, Part I 2433a and A part of 2433b may include substantially V-shaped configuration.In all cases, Part II 2434a can be at joint 2435a with first Angle extends internally from Part I 2433a, and similarly, Part II 2434b can at joint 2435b with second angle from Part I 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 nail 2430 is right in its unshaped or non-percussion configuration shown in Figure 28 Claim.In all cases, the first leg 2432a can be positioned relative to the second leg 2432b towards distally.Alternatively, the first leg 2432a can proximally be positioned relative to the second leg 2432b.
Follow closely 2530 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 to be connected to the Part I of base portion 2531 The 2533a and Part II 2534a extended from Part I 2533a.Second leg 2532b may include to be connected to base portion 2531 The Part I 2533b and Part II 2534b extended from Part I 2533b.Base portion 2531, Part I 2533a and A part of 2533b may include substantially V-shaped configuration.In all cases, Part II 2534a can be at joint 2535a with first Angle extends internally from Part I 2533a, and similarly, Part II 2534b can at joint 2535b with second angle from Part I 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 nail 2530 is right in its unshaped or non-percussion configuration shown in Figure 29 Claim.Nail 2530 can may include for example to be wider than the base of base portion 2431 similar to nail 2430 and in the case of at least one in many aspects Portion 2531.In some cases, when nail leg 2532a and/or nail leg 2532b closer to the direction of vertical direction along extending, 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 distally.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 Moved in end effector or flowed relative to end effector.Also as discussed above, this motion or flowing can hold in end The firing member of row device is moved when store the nail in nail bin with can removing and cut tissue firing as substantially remote towards distally Side.If firing member is proximally moved, then the motion organized or flowing may be substantially nearside.Even so, tissue Distally flowing can make during percussion nail towards distally shift.This phenomenon figure 30 illustrates.Figure 30 is shown from being defined in The nail 2630 of the ejection of nail cavity 2650 in warehouse 2610.Nail 2630 is shown at least part of firing position, in the position, The base portion 2631 of nail 2630 is just moved upwards by staple drivers 2640 towards anvil block 20, and in the position, the leg of nail 2630 2632a, 2632b have been ejected from nail cavity 2650 and have been contacted anvil block 20.As reader will appreciate that, nail cavity 2650 may include to be constructed It is adapted into the first protuberance 2651a and the first end wall 2652a that can support the first nail leg 2632a and similarly It is enough follow closely 2630 ejected from nail cavity 2650 by driver 2640 when support the second protuberance 2651b and the of the second nail leg 2632b Two side wall 2652b.However, as shown in figure 30, nail 2630 can during percussion towards distally shift so that nail leg 2632a away from First end wall 2652a is shifted and nail leg 2632b is shifted on the second protuberance 2651b.Although nail 2630 is shifted towards distally, 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 Still receive in the second forming cup 22b of nail pit.Although nail leg 2632a, 2632b can contact its correspondingly configured cup 22a, 22b, but nail 2630 distally displacement may not cause to be symmetrically staple for example shown in Figure 31.Figure 31 is shown and driven by nail Device 2640 is improved to greater than the position of 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 deform because being trapped in the tissue displacement in end effector. In all cases, for example available asymmetric nail that can compensate for this displacement of nail bin, such as shown in Figure 24 and Figure 27 to Figure 29 Asymmetric nail.The nail leg of these asymmetric nails can be configured so that in this way when it is asymmetric nail shifted towards distally when, it Displaceable into the orientation that them can be caused to be deformed into symmetrical or at least more symmetrical percussion configuration.Figure 84 is shown including warehouse 4810 nail bin 4800, the warehouse include be defined in multiple nail cavities 4850 therein, be positioned at it is asymmetric in nail cavity 4850 Follow closely and be 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 direction row being defined in warehouse 4810.Warehouse 4810 exists By transversal in such mode in Figure 84 so that show such longitudinal nail chamber 4850.In some cases, can remove ground Storing the nail in longitudinal nail chamber 4850 can have the asymmetric configuration of identical, and in other cases, as shown in Figure 84, nail There can be different asymmetric configurations.For example, follow closely 4830' storages follows closely 4830 in the longitudinally proximal end of row " store vertical In distal end to row.Similar to above-mentioned, each nail 4830' may include the first nail leg 4832a' and the second nail leg 4832b', One of wherein described nail leg or both for example may include some fragments, the such as fragment of the second nail leg 4832b' 4833b' 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 ", One of wherein described nail leg or both for example may include some fragments, such as the first nail leg 4832a " fragment The fragment 4833b of 4833a " and 4834a " and the second nail leg 4832b' " and 4834b ".In contrast nail 4830' and nail 4830 " Afterwards, reader will appreciate that, nail 4830 " fragment 4833b " and 4834b " between angle than follow closely 4830' fragment 4833b' and Angle between 4834b' becomes apparent from or bigger.In other words, distally nail 4830 " is less symmetrical than nearside nail 4830'.One In the case of a little, the histokinesis at the distal end 4813 of nail bin 4800 can be more than the histokinesis at proximal end 4816, and Correspondingly, nail orientation displacement can at the distal end 4813 of nail bin 4800 ratio it is big at proximal end 4816.Compared to warp The smaller asymmetry of 4830', distally nail 4830 are followed closely by the nearside that is shifted compared with tingle " larger asymmetry can compensate for compared with spike Displacement.This is an example and can be compensated different nails displacements using the nail of any suitable species in staple.For example, setting Wanting to be located at the nail at the proximal end that longitudinal direction is arranged can have than following closely big asymmetry at the distal end of longitudinal direction row.Also Longitudinal direction row is envisioned using more than two groups of asymmetric nails.
As described above, the histokinesis or flowing at the distal end of end effector can in all cases be more than end Histokinesis or flowing at the proximal end of actuator.Such case can be transported because of distally of the firing member in end effector Move and occur.Although firing member is configured to, as it is progressively sutured towards distally motion and cuts tissue, hit Hair component also can be advanced or promoted and organize towards distally.This promote or propulsion efficiency can since the proximal end of end effector and Can be combined as firing member is moved towards distally so that the promotion of maximum is realized at the distal end of end effector or is pushed away Enter effect.Therefore, than that described above, histokinesis and nail shifting can be compensated using the gradient for following closely asymmetry in longitudinal staple The gradient of position.
Except or replace above-mentioned, nail bin can utilize the protuberance with different height control to be organized in end effector Motion.In all cases, the protuberance disclosed herein for extending from the platform of nail bin can reduce nail bin and be performed with end Gap between the anvil block of device.Therefore, compared to the embodiment without protuberance, protuberance can be to being positioned at anvil block and nail bin Middle tissue applies bigger local pressure.In all cases, the protuberance with high height can to tissue apply compared with Big compression stress or pressure and the protuberance with lower height can apply relatively small compression stress or pressure to tissue.Along These lines, compared with relatively low protuberance, protuberance higher can provide bigger control to histokinesis.As reader can remember, hold Histokinesis at the proximal end of portion's actuator is smaller than the histokinesis at the distal end of end effector, and because This, refers again to Figure 84, and nail bin 4800 can utilize relatively low protuberance 4851' and the distally at the proximal end 4816 of warehouse 4810 Protuberance higher 4851 at end 4813 ".In the case of at least one, relatively low protuberance 4851' can be from the flat of warehouse 4810 The extended distance 4855' of platform surface 4811 and protuberance higher 4851 " can be from relatively low protuberance 4851' extended distances 4855 ".At certain In the case of a little, the protuberance extended from warehouse may include the height ladder extended between the proximal end and distal end of warehouse Degree.It is as discussed above in the case of at least one, the highest protuberance of the gradient can at the distal end of warehouse institute The minimum protuberance for stating gradient can be at the proximal end of warehouse.In other cases, the highest protuberance of the gradient can be At the proximal end of warehouse and the minimum protuberance of the gradient can be at the distal end of warehouse.
As discussed above, histokinesis can be such that nail is shifted from cartridge deployment with it.In all cases, with it is relatively low Protuberance is compared, and protuberance higher can provide bigger control to this displacement.It is and relatively low more specifically, refer again to Figure 84 Proximal projections 4851' is compared, distal projections higher 4851 " nail pit 4850 can be made to extend more so that nail 4830 " by remote Side protuberance 4851 " control ratio nail 4830' is controlled longer distance by proximal projections 4851'.Compared to nail 4830' in nail The distance that the leg of 4830' is lifted up before being ejected from chamber 4850, protuberance higher 4851 " can also increase nail 4830 " in nail 4830 " distance that leg is lifted up before being ejected from chamber 4850.This arrangement can shorten for example follows closely 4830 " in nail bin Distance exposed to larger histokinesis and/or time at 4800 distal end.
As discussed above, nail bin can utilize the nail of the more than one configuration in longitudinal staple.In all cases, nail bin Using the nail with various configuration in different longitudinal staples.In the case of at least one, nail bin may include that first longitudinal direction is followed closely The nail with the second configuration in 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 to be defined in multiple longitudinal direction nail chambers 2750 therein, wherein the nail cavity 2750 in being defined in first row Each may include first nail 2730'(Figure 50 being stored therein with can removing), the nail cavity 2750 being defined in second row is each From the second nail 2730 that may include to be stored therein with can removing " (Figure 51), and the nail cavity 2750 being defined in the 3rd row is each From the 3rd nail 2730 that may include to be stored therein with can removing " ' (Figure 52).First nail 2730' can be positioned on most interior longitudinal direction During in nail chamber 2750, the second nail 2730 " can be positioned on intermediate row nail cavity 2750, and the 3rd nail 2730 " ' can be positioned on outermost In longitudinal nail chamber 2750.When with first height A'(Figure 50) the first nail 2730' and with the second height A " (Figure 51) When second nail 2730 " is in its non-percussion configuration, the second nail 2730 " can be higher than the first nail 2730'.Similarly, when the second nail 2730 " and with third height A " the 3rd nail 2730 of (Figure 52) ' " ' in its non-percussion configuration when, the 3rd nail 2730 " ' can be high 2730 are followed closely in second ".
In all cases, nail can be supported by longitudinal nail driver longitudinally in each.For example, first longitudinal direction nail drives The sustainable nail of first row first 2730' of device, the sustainable nail of second row second 2730 of second longitudinal direction nail driver ", and the 3rd Longitudinal nail driver the sustainable 3rd ranked third nail 2730 " '.In some cases, referring to Figure 49 and Figure 49 A, a nail is driven Dynamic device 2742 can support the nail 2730' of first row first and the second nail 2730 " so that each staple drivers 2742 is sustainable and hits For example, at least one first nail 2730' of hair and at least one second nails 2730 ".One nail driver 2740 the sustainable 3rd arranges the Three nails 2730 " ' so that each staple drivers 2740 is sustainable and fires at least one the 3rd nails 2730 " '.Staple drivers 2742 Each may include that being configured to support first follows closely the first base 2741' of 2730' and be configured to support second to follow closely 2730 " second base 2741 ", and similarly, staple drivers 2740 each may include to be configured to support the 3rd nail 2730 " ' the 3rd base 2741 " '.When staple drivers 2740 and 2742 are in its non-firing position, as shown in Figure 49 A, the The first row forming pit 23 that one base 2741' can be supported on and be defined in anvil block 20 is separated by first at 2732', and Two bases 2741 " can be supported on and the second row forming pit 23 that is defined in anvil block 20 is separated by second distance 2732 " place, and 3rd base 2741 " ' can be supported on and the 3rd row's forming pit for being defined in anvil block 20 is separated by the 3rd distance 2732 " ' place. First distance may differ from second distance and/or second distance may differ from the 3rd distance.As shown in figure 49, the first distance is shorter than Second distance and second distance is shorter than the 3rd distance.When driver 2740 and 2742 is lifted by firing member 2760 towards anvil block 20, For example 2730', 2730 are followed closely with from the ejection of nail cavity 2750 " and 2730 " ' when, the first nail 2730', the second nail 2730 " and/or the 3rd Nail 2730 " ' can be deformed into different forming heights.For example, it is the first forming height that most interior nail (that is, following closely 2730') is formable, It is the second forming height that middle nail (that is, follow closely 2730 ") is formable, and it is the three one-tenth that outer nail (that is, follow closely 2730 " ') is formable Shape is highly.First height can be less than the second height and the second height can be less than third height.The name that on November 27th, 2012 announces Referred to as " produce surgical stapling device (the SURGICAL STAPLING DEVICES THAT of the forming nail with different length PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS) " the full text of United States Patent (USP) 8,317,070 drawing It is incorporated to mode.
In all cases, the storehouse platform of nail bin can be flat.In this case, protuberance as herein described can be from Flat platform surface extends.In other cases, the storehouse platform of nail bin may include for example there is at least two stepped surfaces Stepped surface.Figure 49 and Figure 49 A are referred again to, the warehouse 2710 of nail bin 2700 may include to be positioned at longitudinal knife passage 2715 The first side on the first platform side and the second platform side for being positioned on the second side of longitudinal knife passage 2715.Each platform side Including such as the first ladder 2711', the second ladder 2711 " and the 3rd 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 " in, and the 3rd longitudinal nail chamber 2750 can be defined in the 3rd ladder 2711 " ' in.When anvil block 20 is in its closing position, the tissue contacting surface 21 of anvil block 20 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 apart from 2712', with the second ladder 2711 " be separated by second distance 2712 " and with the 3rd ladder 2711 " ' phase Every the 3rd distance 2712 " '.In all cases, the first distance, second distance and/or the 3rd distance can be different.Such as Figure 49 and Tu Shown in 49A, first is shorter than second distance 2712 apart from 2712' " and second distance 2712 " be shorter than the 3rd distance 2712 " '.Each In the case of kind, first can limit the first tissue gap, second distance apart from 2712' between the first ladder 2711' and anvil block 20 2712 " can be in the second ladder 2711 " minor microstructure gap, and the 3rd distance 2712 are limited and anvil block 20 between " ' can be the 3rd Ladder 2711 " ' the 3rd tissue space is limited and anvil block 20 between.It is positioned at the first tissue gap of the most top of interior nail chamber 2750 It is smaller than being positioned at the 3rd tissue space of the top of outermost nail chamber 2750.It is centrally positioned second group of the top of nail chamber 2750 Knitting gap can be more than the first tissue gap but less than the 3rd tissue space.
Than that described above, Figure 49 and Figure 49 A are referred again to and, first longitudinal direction row's protuberance 2751' can be from the first ladder 2711' extends, second longitudinal direction row protuberance 2751 " can be from the second ladder 2711 " extend, and protuberance 2751 is arranged in the 3rd longitudinal direction " ' Can be from the 3rd ladder 2711 " ' extend.First protuberance 2751' can be limited by the first height 2755', the second protuberance 2751 " can By the second height 2755 " limit, and the 3rd protuberance 2751 " ' can be 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 less than the second height 2755 " and the Two height 2755 " can be less than third height 2755 " '.In all cases, minimum longitudinal direction row's protuberance (that is, protuberance 2751') Can extend along most interior nail chamber 2750, the longitudinal row's protuberance of highest (that is, protuberance 2751 " ') can be along outermost nail chamber 2750 extend, and the protuberance (that is, protuberance 2751 ") with intermediate altitude can extend along intermediate row nail cavity 2750.Figure 76 The longitudinal row's protuberance of the embodiment for showing alternative, wherein highest (that is, protuberance 2751 " ') along most interior nail chamber 2750 Extend, minimum longitudinal direction row's protuberance (that is, protuberance 2751') extends along outermost nail chamber 2750, and with intermediate altitude Protuberance (that is, protuberance 2751 ") can extend along intermediate row nail cavity 2750.
Figure 76 is referred again to, nail bin 4000 can in many aspects similar to nail bin 2700 as discussed above.Similar to nail Storehouse 2700, nail bin 4000 may include longitudinal nail chamber 2750, and longitudinal nail chamber includes first row nail cavity 2750, the second nail The nail chamber 2750 of chamber 2750 and the 3rd, the first row nail cavity includes the first nail 2730' being stored therein with can removing, institute Stating second row nail cavity includes the second nail 2730 being stored therein with can removing ", the 3rd nail chamber includes removing Be stored therein the 3rd nail 2730 " '.With nail bin 2700 conversely, the first nail 2730' includes outermost nail and the 3rd nail 2730 " ' include most interior nail.Nail bin 4000 may include driver 4040 and 4042, and the driver is configured to driving Dynamic device 4040 and 4042 is in and does not fire or follow closely 2730 by the 3rd during non-raised position " ' support into and be separated by the three one-tenth with anvil block 20 Shape distance 2732 " ', by second follow closely 2730 " support into be separated by the second forming distance 2732 with anvil block 20 ", and by first nail 2730' is supported 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, follows closely 2730 " ') the 3rd forming height is deformed into, middle nail (that is, nail 2730 ") is deformed into the second forming height, and make outermost Nail (that is, following closely 2730') is deformed into the first forming height.For example, the 3rd forming height can be higher than the second forming height and second Forming height can be higher than the first forming height.Similar to nail bin 2700, nail bin 4000 may include staged platform surface;However, 3rd ladder 2711 " ' can extend along most interior nail chamber 2750 and the first ladder 2711' can prolong along outermost nail chamber 2750 Stretch.The first tissue gap limited by the first clearance distance 2712' can be relative to by the second clearance distance 2712 " limit second Tissue space is positioned towards laterally outside, the second clearance distance 2712 " can be relative to by third space distance 2712 " ' limit the Three tissue spaces are 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 relative side 3612.Warehouse 3610 may also include such as platform 3611, be defined in it is flat The longitudinal slit 3615 of multiple nail cavities 3650 in platform 3611 and the edge of a knife for being configured to receive firing member.Warehouse 3610 may also include the protuberance 2051 and 2053 extended from storehouse platform 3611.Warehouse 3610 may also include and prolong from storehouse platform 3611 The protuberance 3651 stretched.Similar to protuberance 2051, protuberance 3651 is configured to engagement and is positioned at anvil block and storehouse Organizing and controlling tissue relative to the motion in storehouse 3600 in the middle of 3600.In all cases, protuberance 3651 can be constructed Into flowing of the tissue relative to nail bin can be restricted or prevented.Protuberance 3651 can be positioned on nail cavity 3650 proximal end and/ Or at distal end.In all cases, each protuberance 3651 may include the hoop extended around the end of nail cavity 3650.At certain In the case of a little, each protuberance 3651 may include the arch spine extended around the end of nail cavity 3650.In all cases, dash forward Going out portion 3651 may not be high as protuberance 2051 and/or protuberance 2053.Compared with relatively low protuberance 3651, protrusion higher Portion 2051 can apply bigger local pressure to tissue.In all cases, protuberance 2051 can provide enough controls to tissue System is held in place tissue with during percussion.In this case, except protection and guiding are positioned in nail cavity 3650 Beyond nail, protuberance 3651 can also provide some other controls to tissue.
Than that described above, platform 3611 may include ladder 2711', 2711 " and 2711 " ', the ladder is configured to Tissue of the compression set in the middle of warehouse 3610 and anvil block.In all cases, the 3rd ladder 2711 " ' may include along outermost The lowest deck surface that nail chamber 3650 and the distal end 3613 around warehouse 2610 extend.Second ladder 2711 " can be from most Low platform surface 2711 " ' upwardly extend and the first ladder 2711' can be from the second ladder 2711 " upwardly extend.When the phase of warehouse 3610 When being slided for tissue, 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 2711' and 2711 " is slided.Also as discussed above, using ladder 2711', 2711 " and 2711 " ' come control tissue relative to The flowing of nail bin 3600.Referring primarily to Figure 71, compared in ladder 2711 " and anvil block between limit tissue space and/or Ladder 2711 " ' between the anvil block limit tissue space, ladder 2711' can in all cases storehouse 3600 with it is described Smaller tissue space, the anvil block and the relative positioning of storehouse 3600 are limited between anvil block.In ladder 2711' and minimum tissue space In the case of adjacent with longitudinal slit 3615, with compared with the tissue of ladder 2711' lateral registers, with longitudinal slit 3615 Adjacent tissue can undergo more compressions and more controls.This embodiment can be for various reasons favourable. For example, can attempt making the displacement of tissue being trapped in nail bin 3600 and anvil block through 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.
Discussed as explained above with embodiment shown in Figure 76, nail bin may include wherein minimum tissue space and outermost longitudinal direction The coextensive staged platform surface in 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, mitigates or reduce the displacement of tissue, the lateral displacement especially organized.In some feelings Under condition, Figure 70 to Figure 72 is referred again to, can prevent, mitigate or reduce being trapped in nail bin 3600 and anvil by lateral side wall 3617 The lateral displacement of the tissue between seat.Each lateral side wall 3617 can extend from the side 3612 of warehouse 3610 and hinder tissue Lateral movement.Side wall 3617 may include any suitable configuration.In the case of at least one, 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 is included from warehouse 3710 The lateral side wall 3717 that side 3712 extends.In the case of at least one, 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 to be located at the protuberance 2053 at the distal end of farthest side nail cavity 3850.Also class It is similar to above-mentioned, warehouse 3810 may include the prominent of at least some of proximal end that can be surround in nail cavity 3850 and/or distal end Go out portion 2051.Except or replace protuberance 2051 and 2053, staple cartridge body 3810 may also include the protuberance 3851 extended from it.Often Individual protuberance 3851 can extend around the end of more than one nail cavity 3850.In the case of at least one, each protuberance 3851 The end of the nail cavity 3850 in end, the outermost nail chamber 3850 of nail cavity 3850 that can be for example in most interior nail chamber 3850 And/or the end of the nail cavity 3850 in intermediate row nail cavity extends.In the case of at least one is such, first of protuberance 3851 Dividing can make the first nail cavity 3850 extend beyond storehouse platform surface, and the Part II of protuberance 3851 can extend the second nail cavity 3850 The 3rd nail cavity 3850 can be made to extend beyond storehouse platform surface more than the Part III of storehouse platform surface, and protuberance 3851.It is prominent The Part I in portion 3851 can protect, guide and/or keep first to follow closely, and Part II can protect, guide and/or keep second Nail, and the 3rd nail can be protected, guide and/or kept to Part III.In all cases, protuberance 3851 can be defined in warehouse Extend between longitudinal slit 3615 in 3810 and the lateral side wall 3717 extended from warehouse 3810.In at least one such situation Under, protuberance 3851 can extend across the first ladder 2711', the second ladder 2711 " and/or the 3rd ladder 2711 " '.In other words Say, protuberance 3851 can extend across the change of the height of the platform of warehouse 3810.In some cases, although storehouse platform surface Height change, the top of protuberance 3851 or tissue engagement surface still can be flat.In other cases, protuberance 3851 top or tissue engagement surface can also change in height.In the case of at least one is such, the top of protuberance 3851 Portion surface can in height be raised for example when platform surface is raised in height and when platform surface is reduced in height Reduced on height.In other cases, the top surface of protuberance 3851 can for example when platform surface is raised in height Reduced on height and raised in height when platform surface is reduced in height.
In all cases, Figure 74 is referred again to, warehouse 3810 may include laterally projecting portion or the rib 3817 extended from it. Laterally projecting portion 3817 can extend transverse to longitudinal slit 3615 and/or lateral side wall 3717.In the case of at least one, laterally Protuberance 3817 can extend along the direction for being transversely to the machine direction slit 3615 and/or lateral side wall 3717.In the case of at least one, Laterally projecting portion 3817 can extend between protuberance 3851 and side wall 3717.Laterally projecting portion 3817 can also be in protuberance 2051 Extend between side wall 3717, and similarly, extend between protuberance 2053 and side wall 3717.In some cases, it is prominent Portion 3817 and side wall 3717 can be identical height.In other cases, protuberance 3817 and side wall 3717 can be different height.Ginseng See Figure 74, side wall 3717 is for example higher than protuberance 3817.Under any circumstance, laterally projecting portion 3817 is configured to limit Make or prevent for example to organize relative to nail bin 3800, particularly along the flowing of distally 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 further feature structure In addition, warehouse 4510 may also include angled transition 2014, the protuberance 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 Structure can be combined with the organizational controls feature structure of the other embodiments disclosed herein various embodiments.Additionally, Disclosed herein is the nail cavity being wherein defined in nail bin whole may include at least partly about nail cavity protuberance it is various Embodiment.Other embodiment party for dreaming up the protuberance all including at least partly about nail cavity for being wherein less than nail cavity Case.Turning now to Figure 82, nail bin 4600 may include warehouse 4610, and the warehouse includes platform 4611, proximal end 4616, distally End 4613 and the longitudinal knife slot 4615 extended between proximal end 4616 and distal end 4613.Warehouse 4610 can Including the protuberance 2051 and 2053 of some extended from platform 4611 and at least partly about nail cavity 4650.For example, The proximal end and/or distal end of the nail cavity 4650 being defined in the distal end 4613 of nail bin 4600 can at least in part by Protuberance 2051 surround, and similarly, the proximal end of the nail cavity 4650 being defined in the proximal end 4616 of nail bin 4600 and/ Or distal end can be surround by protuberance 2051 at least in part.In such embodiment, the middle part of warehouse 4610 is defined in The nail cavity 4650 of (that is, between the proximal end 4616 and distal end 4613 of nail bin) can not by such as protuberance 2051 and/or Any other protuberance 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 may also include and be defined in multiple nail cavities 4750 therein.Farthest side nail cavity 4750 may include by the circular distal end of protuberance 2053 and by the circular proximal end of protuberance 2051.Other nail cavities 4750 May include by the circular distal end of protuberance 2051 and not by proximal end that protuberance is circular.Some nail cavities 4750 may include By the circular proximal end of protuberance 2051 and not by distal end that protuberance is circular.
As discussed above, the protuberance extended from platform surface is configured to protect, support and/or guide fixed 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 protuberance 4151 from the extension of platform 4111.Nail bin 4100 may also include can be removed Be positioned at nail 4130 in nail cavity 4150.Protuberance 4151 may include to be defined in slit therein 4154, and the slit can quilt It is constructed to be permeable to when 4130 storages are followed closely in nail cavity 4150 and/or the support nail 4130 when following closely 4130 and just being ejected from nail cavity 4150 Leg 4132.Slit 4154 may include the extension of nail cavity end wall 4152.When following closely 4130 in non-firing position, nail cavity end Wall 4152 and/or slit 4154 can operate to support nail leg 4132 altogether.When following closely 4130 and being ejected from chamber 4150, leg 4132 can be from Protuberance 4151 is ejected, 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, protuberance 4151 can not provide lateral support to nail leg 4132.More Body ground, referring to Figure 77, slit 4154 may include relative side 4155, and the relative side can be between the side of nail leg 4132 Separate, and do not contact the side of nail leg 4132.In all cases, in nail 4130 is still positioned at least partially at nail cavity 4150 When, nail 4130 may be deformed to its configuration that is badly deformed.In the case of at least one is such, end wall 4152 and/or slit 4154 can The support nail 4130 in the whole forming process of nail 4130.In other cases, nail 4130 can its it is elevated go out slit 4154 and more than reaching its configuration that is badly deformed after protuberance 4151.In this case, end wall 4152 and slit 4154 can Not support nail 4130 in its whole 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 protuberance 4251.Nail bin 4200 may also include and be positioned at can removing Nail 4130 in nail cavity 4250.Protuberance 4251 may include to be defined in slit therein 4254, and the slit is configured to The leg of enough support nails 4130 when 4130 storages are followed closely 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 following closely 4130 in non-firing position, nail cavity end wall 4252 And/or slit 4254 can operate to support nail leg 4132 altogether.When nail 4130 is ejected from chamber 4250, leg 4132 can be from protuberance 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 of the ejection of chamber 4250.In some cases, protuberance 4251 can provide lateral support to nail leg 4132.More specifically, ginseng See Figure 78, slit 4254 may include relative side 4255, the side of the accessible nail leg 4132 in the relative side.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. It is at least one it is such in the case of, end wall 4252 and/or slit 4254 can in the whole forming process of nail 4130 support nail 4130. In other cases, nail 4130 elevated can go out slit 4254 and lifted complete higher than its is reached after protuberance 4251 at it Full deformed configuration.In this case, end wall 4252 and slit 4254 can in its whole 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 protuberance 4351.Nail bin 4300 may also include and be positioned at can removing Nail 4130 in nail cavity 4350.Each protuberance 4351 may include to be defined in tapered slit 4354 therein, the tapered slit It is configured to when 4130 storages are followed closely in nail cavity 4350 and/or the support nail when following closely 4130 and just being ejected 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 in non-firing position when, the side wall 4355 of each slit 4354 can altogether operation supporting nail leg 4132.As reader will be from Figure 79 recognizes that nail leg 4132 can not be supported by end wall 4352.When nail 4130 is ejected from 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 protuberance 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 the case of kind such, slit 4354 can in the whole forming process of nail 4130 support nail 4130.In other cases, 4130 are followed closely Elevated can go out slit 4354 and lifted higher than reaching its configuration that is badly deformed after protuberance 4351 at it.In this feelings Under condition, slit 4354 can in its whole 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 protuberance 4451a and 4451b.Nail bin 4400 may also include for example can The nail 4130 being positioned in nail cavity 4450 with removing.Nail cavity 4450 may include the first end wall 4452a and the second end wall 4452b, institute The first leg that the first end wall is configured to support and guide nail 4130 is stated, second end wall is configured to support With the second leg of guiding nail 4130.Protuberance 4451a can extend first apart from 4455a and protuberance 4451b from platform 4411 The second distance 4455b of protuberance 4451a can be extended beyond from platform 4411.Therefore, in all cases, protuberance 4451a Sustainable and the first nail leg first of guiding apart from and protuberance 4451b is sustainable and the second nail leg second distance of guiding, wherein the Two distances can be longer than the first distance.In some cases, protuberance 4451b can be positioned at the distal end of nail cavity 4450 and prominent Going out 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 The distally motion of knife be when being promoted towards distally it is favourable, it is as discussed above.Alternatively, protuberance 4451b can be positioned on nail cavity At 4450 proximal end and protuberance 4451a can be positioned at the distal end of nail cavity 4450.Under any circumstance, protuberance 4451b may include such as stair-stepped configuration.In the case of at least one, protuberance 4451b may include for example to be limited by height 4455a Fixed Part I and the Part II limited by height 4455b.
Figure 85 A to Figure 85 C show the nail bin 4900 including the warehouse 4910 with platform 4911.In various embodiments In, warehouse 4910 can be made up of flexible material.In certain embodiments, warehouse 4910 can be by rigid material and flexible material structure Into wherein at least platform 4911 can be made up of flexible material.Flexible material may include such as some 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 up of pliable material.Under any circumstance, platform 4911 may include the protuberance 4951 extended from it.Similar to upper State, nail 4130 can be protected, support and/or guided to protuberance 4951.It is also similar to above-mentioned, protuberance 4951 can be prevented or at least limited Motion of the system tissue relative to nail bin 4900.When anvil block is moved to closing position, or alternatively nail bin with respect to nail bin 4900 4900 relative to anvil block when being moved to closing position, and protuberance 4951 can be positioned in the tissue in the middle of anvil block and nail bin 4900 Compression.Figure 85 A to Figure 85 C are shown in which that protuberance 4951 undergoes the sequence of events of increased compression stress.Figure 85 A show place In the protuberance 4951 of uncompressed configuration.In this configuration, can there is compression between the nail leg of protuberance 4951 and nail 4130 Or interference fit.Figure 85 B show the protuberance 4951 that compressed configuration is in response to applying compression stress to it.In comparison diagram After 85A and Figure 85 B, it is possible to understand that the top surface 4956 of protuberance 4951 downwardly toward the actuating length 4955 of platform 4911 and is dashed forward Going out the shape in portion 4951 has become distortion.In this configuration, protuberance 4951 can clamp the nail leg of nail 4130 and/or protect nail leg Hold in place.Figure 85 C show the bigger compression stress for being applied to protuberance 4951.After comparison diagram 85B and Figure 85 C, it is possible to understand that The top surface 4956 of protuberance 4951 further promoted downwardly toward platform 4911 and protuberance 4951 shape become into One step is distorted.Additionally, in this configuration, protuberance 4951 can increase the chucking power for being applied to nail leg.
Figure 86 A and Figure 86 B show the nail bin 5000 including the warehouse 5010 with platform 5011.Warehouse 5010 can also be wrapped The multiple protruding portion 5051 for being defined in multiple nail cavities 5050 therein and extending from platform 5011 is included, the protuberance is configured to Can protect, support and/or guide the nail 5030 being positioned at can removing in nail cavity 5050.Similar to above-mentioned, nail bin 5000 Staple drivers 5040 and 5042 are may also include, the staple drivers are configured between non-firing position and firing position Support and lifting nail 5030.Figure 86 A and Figure 86 B show that the end in wherein nail 5030 is partly pushed up from protuberance 5051 The nail 5030 of the part firing position for going out.Similar to above-mentioned, warehouse 5010 can be made up of flexible material.Flexible material may include example As some plastic materials (such as polypropylene) and/or for example elastomeric material (such as rubber, thermoplastic elastomer (TPE) and/or mountain are all It is flat).In all cases, warehouse 5010 can be made up of pliable material.When compression stress is applied to warehouse 5010, warehouse 5010 can Bent as shown in Figure 86 B.When the platform 5011 of warehouse 5010 is bent downwardly as shown in Figure 86 B, protuberance 5051 can downward bias Torque is from 5055.By this way, protuberance 5051 can be moved.
Dream up the various embodiments that the protuberance for wherein extending from nail bin platform can be moved relative to platform.At least In the case of one kind, protuberance protuberance can make nail cavity extend beyond the first position of platform and wherein protuberance can both to make wherein Also nail cavity can not be made to extend beyond the second of platform or reduce motion between position.In all cases, for extending from platform Individual or multiple protruding portion can collapse.The protuberance that can collapse can make nail cavity extend beyond the first of platform by protuberance wherein Position and wherein protuberance can both not be such that nail cavity extends beyond between second or collapsed position of platform to move.At least In the case of one kind, can collapse protuberance can elasticity return to its non-collapsed configuration, and in some cases, protuberance may not It is completely recovered to its non-collapsed configuration.In all cases, one or more protuberances for extending from platform can be squeezable. Squeezable protuberance can wherein protuberance make nail cavity extend beyond the first position of platform can both make with wherein protuberance or Nail cavity can not be made to extend beyond between second or extrusion position of platform move.Squeezable protuberance may not return to it Non- conquassation configuration.
As discussed above, when nail is stored in nail bin in which can remove, the nail of nail bin can be supported by staple drivers.Also As discussed above, staple drivers for example can be lifted up by firing member (such as firing member 2760).In all cases, Turning now to Figure 53 and Figure 54, firing member be configured to will such as nail sliding part (such as follow closely sliding part 2870) towards remote Side is advanced, and staple drivers and nail are lifted towards anvil block.Nail sliding part 2870 may include main body 2871 and shoulder 2876, the shoulder Portion is configured to be engaged by firing member 2760 and supports firing member 2760.Sliding part 2870 may also include for example oblique 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 are slided below staple drivers and be lifted up staple drivers.In various situations Under, than that described above, for example, during first slope surface 2872 is configured to contact and lifted first row staple drivers Staple drivers, the second ramped surfaces 2873 are configured to contact and lifted the staple drivers in second row staple drivers, 3rd ramped surfaces 2874 are configured to contact and lifted the staple drivers in the 3rd nail driver, and the 4th slope Surface 2875 is configured to contact and lifted the staple drivers in the 4th nail driver.
In all cases, than that described above, sliding part 2870 is configured to lift four nail drivers simultaneously In staple drivers.In some cases, the staple drivers that sliding part 2870 can be 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 while contacting this Four staple drivers and by them along four parallel lifting surfaced lifts so that it is high that these staple drivers reach identical simultaneously Degree.In addition, in this case, ramped surfaces 2872,2873,2874 and 2875 can have identical length.In other feelings Under condition, sliding part 2870 can simultaneously lift the staple drivers in the often row in four nail drivers, 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.Additionally, first slope 2872 can limit with by the 4th slope 2875 the 4th slope length identical first slope length for limiting.The distal end 2873a on the second slope 2873 can be relative to The distal end 2872a of the first slope 2872 and distal end 2875a on the 4th slope 2875 is reached by distance towards distally positioning The distance that 2879a is represented.Second slope 2873 can be not parallel to the slope 2875 of first slope 2872 and/or the 4th.Additionally, second Slope 2873 can limit the second slope length for being longer than first slope length and/or the 4th slope length.3rd slope 2874 Distal end 2874a can be relative to the distal end 2873a on the second slope 2873 towards distally positioning up to by being represented apart from 2878a Distance.3rd slope 2874 can be not parallel to first slope 2872, the second slope 2873 and/or the 4th slope 2875.Additionally, the Three slopes 2874 can limit the 3rd 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 moment of torsion, and this can be such that sliding part and/or staple drivers are rotated in response to the reaction force and/or moment of torsion.Figure 53 Can prevent from or at least limit to be slided when sliding part 2870 is contacted and lifts staple drivers with the arrangement on the slope shown in Figure 54 The rotation of moving part 2870.Additionally, sliding part 2870 may include stabilizing member 2877, the stabilizing member extends with stabilization towards distally 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 on slope 2872,2873,2874 and 2875,2874a and 2875a extend towards distally.
Turning now to Figure 54 A to Figure 54 D, sliding part 2870 is configured to for example when sliding part 2870 from nail bin 2000 proximal end 2016 is disposed from nail bin 2000 when being moved towards the distal end 2013 of nail bin 2000 and followed closely.Nail bin 2000 and/ Or sliding part 2870 may include the feature in the proximal end 2016 that sliding part 2870 can be made to be releasably held in nail bin 2000 Structure.In all cases, the warehouse 2010 of nail bin 2000 may include screens 2019, and the screens is configured to engagement and slides Moving part 2870 and sliding part 2870 is set 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 screens 2019 may include to extend inward into the rib in 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 be connect with screens 2019 when sliding part 2870 is in its nearside, non-firing position Close, as shown in Figure 54 A.In all cases, screens 2019 can limit the gap of the width less than main body 2871 therebetween.At this In the case of kind, can there is interference fit between the main body 2871 of screens 2019 and sliding part 2870 so that screens 2019 can be pressed from both sides Hold sliding part 2870 and be held in place.When firing member promotes sliding part 2870 towards distally, main body 2871 can be pushed away Move into be disengaged with screens 2019 and sliding part 2870 can by towards distally propulsion to fire nail of the storage in nail bin 2000. In the case of various, referring now to Figure 54 D, the main body 2871 of sliding part 2870 may include to be defined in groove therein 2018, described Groove is configured to releasedly receive screens 2019.Groove 2018 and screens 2019 can limit sliding part in alignment 2870 nearside, non-firing position.Although there is two groups of grooves 2018 and screens 2019 in the illustrated embodiment, also can profit 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, screens 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 protuberance extended from the platform, the protrusion Portion is configured to flowing of (one) control 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 guiding nail cavity.In all cases, warehouse and protuberance can be by Single piece of material is constituted.In the case of at least one, protuberance can be integrally formed with warehouse.Warehouse and protuberance can be by plastic materials Constitute and can be formed for example during injection molding.In some cases, protuberance may fitted to warehouse.In at least one feelings Under condition, protuberance may be affixed to such as warehouse.Warehouse and protuberance can be made up of identical material or different materials.At least In the case of one kind, for example, warehouse can be molded of plastic material and protuberance can be by elastomeric material (such as rubber, thermoplastic elastomehc Gonosome and/or santoprene) formed.In all cases, protuberance can be made up of pliable material and may not injure and be highlighted The tissue of portion's compression.For example, protuberance 3051 (Figure 60) and/or protuberance 3151 (Figure 61) for example can be (all by elastomeric material Such as rubber, thermoplastic elastomer (TPE) and/or santoprene) constitute.In the case of at least one, warehouse can during injection molding shape Into and protuberance can be used the material more flexible than the material including warehouse during the second injection molding on warehouse formed. In the case of various, protuberance 3051 and/or 3151 for example may include to texture platform surface.In some cases, protuberance 3051 and/or 3151 can be for example made up of the material with the coefficient of friction higher than warehouse.This embodiment can improve warehouse Chucking power between tissue.
In all cases, the protuberance for extending from warehouse can be static and it can be moved not with respect to warehouse.At certain As discussed above in the case of a little, protuberance 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 can allow protuberance to be moved when warehouse is deflected.Nail bin may include can be relative to storehouse The protuberance that body extends.Turning now to Figure 75, nail bin 3900 may include there is the warehouse for being defined in multiple chambers 3950 therein 3910.In all cases, chamber 3950 may include the tissue engaging member disposed 3940 being positioned in.Each component 3940 Never deployed position deployed position can be moved to.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 extend beyond platform 3911 when its non-deployed position at which.In at least one such embodiment, tissue The engageable tissue in its non-deployed position He its deployed position of engagement member 3940.Under any circumstance, component 3940 can Including the protuberance 3951 extended from it, the protuberance is configured to engage, stabilization and/or compression set are in anvil block 20 with storehouse 3900 in the middle of tissue.
Figure 75 is referred again to, component 3940 can longitudinally traverse warehouse 3910 by 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 the case of at least one, each component 3940 may include the inclined-plane or angled faces 3942 that can be contacted by slope 3972.Slope 3972 can be slided simultaneously below component 3940 Component 3940 is lifted onto surface 3979.Surface 3979 (can such as fire structure with sliding part 3970 by such as firing member Part 2760) advanced towards distally and component 3940 is maintained at its deployed position.As shown in Figure 75, surface 3979 can long enough with Some components 3940 are supported thereon.Additionally, surface 3979 can long enough with performed by firing member 2760 nail shaping and group Knit supporting member 3940 in cutting process.In the case of at least one, surface 3979 can be leading, or relative to firing member 2760 edge of a knife 2761 is positioned towards distally.In this case, component 3940 can move across group with the edge of a knife 2761 towards distally Knit and tissue is positioned towards distally relative to the edge of a knife 2761.In other words, tissue engaging member 3940 can be deployed will organize A part be clamped in before the tissue part for being sewn and/or cutting.Chamber 3950 is configured to support and guides Component 3940 and forbid component 3940 lateral translation or rotation in chamber 3950.The construction and cloth of the proximal end on surface 3979 Putting can be set so that once the edge of a knife 2761 has passed through component 3940, sliding part 3970 can release component 3940.At least It is a kind of it is such in the case of, once the edge of a knife 2761 is slipped over from by component 3940, surface 3979 may no longer supporting member 3940.
Than that described above, Figure 75 is referred again to, chamber 3950 can be arranged to longitudinal row.For example, chamber 3950 can be arranged to Six longitudinal direction rows including two most interior rows, two outermost rows and the row being positioned in the middle of each most interior row and outermost.Dream up Its lumen 3950 is arranged to less than six rows or more than six other embodiments of row.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 can contain the nail (such as following closely 2630) being for example stored therein with can removing.Sliding part 3970 can be constructed Into component 3940 and in addition percussion nail can be disposed.In the case of at least one is such, sliding part 3970 may also include at least One slope 2873, at least one slope includes ramped surfaces 3971, and the ramped surfaces are configured to for example Staple drivers 2640 are lifted towards anvil block 20, so that as discussed above can percussion nail 2630.In all cases, slope 3972 can Leading slope 2873.In this case, slope 3972 can be complete to its by the nail lifting adjacent with component 3940 on slope 2873 Component 3940 is deployed to its deployed position before full shaping position.Dreaming up wherein outermost row chamber 3950 includes being stored therein Tissue engaging member 3940 and most interior row and intermediate row chamber 3950 include the various realities of the nail being stored therein with can removing Apply scheme.This embodiment can include two nails and row tissue engagement on every side of the longitudinal cutter groove being defined in warehouse Component 3940.Dream up wherein using component 3940 and other embodiments of any suitably-arranged structure of nail.
It is as discussed above, it is contemplated that going out wherein nail bin may include many nails 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 to go out and wherein deposited using nail cavity The embodiment that storage can dispose tissue engaging member.Wherein tissue engaging member is dreamed up to be not stored in nail cavity but be storable in Some embodiments in one row chamber of neighbouring nail cavity.
Figure 90 to Figure 93 shows the another embodiment that protuberance is engaged including that can dispose tissue.Nail bin 5300 for example may be used Including warehouse 5310, the warehouse includes being defined in platform therein 5311 and multiple nail cavities 5350.Nail bin 5310 may include energy It is enough to remove nail 5330 of the ground storage in nail cavity 5350 and be configured to be driven from the multiple of the ejection of nail cavity 5350 nail 5330 Device 5340.Nail bin 5310 may also include one or more protuberances disposed stored with can removing in nail cavity 5350 5351, will such as discuss in more detail further below.Each driver 5340 may include base 5341 and in addition driving table Face 5342, the base is configured to support nail 5330, and the driving surface is for example configured to (all by sliding part Such as sliding part 5370) engagement.Similar to above-mentioned, sliding part 5370 be configured to non-deployed position and deployed position it Between lifted driver 5340.Figure 92 shows driver 5340 and the nail in its non-deployed position 5330.Referring primarily to Figure 93, Driver 5340 is configured to the lifting between non-deployed position and deployed position and can dispose protuberance 5351.At least In the case of one kind is such, referring primarily to Figure 90 and Figure 91, each driver 5340 may be mounted at the nearside around driver 5340 The first of end positioning can dispose protuberance 5351 and can dispose protrusion with second of the distal end positioning around driver 5340 Between portion 5351, the upward motion of wherein driver 5340 may pass to that protuberance 5351 can be disposed, so that protuberance 5351 Move to its deployed position.In the case of at least one, protuberance 5351 can be frictionally engaged with driver 5340.Work as driver 5340 when being moving upward, and can be lifted up for protuberance 5351 by the frictional fit between driver 5340 and protuberance 5351. Each protuberance 5351 may include tissue engagement portion 5352, and the tissue engagement portion is configured to contact tissue and to group Knit applying compression stress.In all cases, protuberance 5351 can apply compression stress to tissue, until compression stress exceedes protuberance Stiction between 5351 and the driver 5340 of upward motion protuberance 5351.At such moment, driver 5340 can Move or slide relative to protuberance 5351.In other words, driver 5340 can depart from protuberance associated there 5341 Connection.
In all cases, Figure 93 is referred again to, when protuberance 5351 is in its non-deployed position, protuberance can be disposed 5351 tissue engagement portion 5352 can be not extended past platform 5311.In other cases, when protuberance 5351 is in its non-portion During administration position, the tissue engagement portion 5352 that can dispose protuberance 5351 can extend over platform 5311.In either case, when When protuberance 5351 is in its deployed position, the tissue engagement portion 5352 that can dispose protuberance 5351 can extend over platform 5311.Than that described above, the frictional fit between each protuberance 5351 and driver 5340 can be identical so that driver 5340 The power (that is, sliding force) that will be slided relative to protuberance 5351 can be identical for each protuberance 5351.Dream up some of which Frictional fit between protuberance 5351 and some drivers 5340 may differ from other protuberances 5351 and other drivers 5340 other embodiments.In such an implementation, the sliding force between protuberance 5351 and driver 5340 can be different. In at least one embodiment, being positioned at the first protuberance 5351 at the distal end of driver 5340 can start with first The second protuberance 5351 that sliding force is slided and is positioned at the proximal end of driver 5340 can start to be slided with different from first Second sliding force of power is slided.In all cases, due to above-mentioned, the compression stress that protuberance 5351 can apply to tissue can be received To limitation.Further, since above-mentioned, the distance that protuberance 5351 can extend from the platform 5311 of warehouse 5310 can be restricted. In the case of various, protuberance 5351 may include the organization type and/or the variable response of tissue thickness to being sewn.For example, phase Than in when organizing thicker and/or more rigid, when organizing thinner and/or more flexible, protuberance 5351 can be further from platform 5311 deployment.Under any circumstance, being slidably matched between driver 5340 and protuberance 5351 can prevent tissue by protuberance 5351 overcompression.
Than that described above, protuberance 5351 can float relative to storehouse platform 5311.In all cases, protuberance 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 advanced towards distally.When Anvil block 20 towards nail bin 5300 move when, tissue can be compressed by anvil block 20, wherein in response to this, protuberance 5351 can be transported for example downwards It is dynamic or retract to warehouse 5310.
In all cases, nail bin may include the protuberance rigidly extended from the platform of warehouse.In the case of at least one, Platform and protuberance can be not with respect to moving each other.In other cases, platform can be moved relative to protuberance.In at least one In the case of such, protuberance can rigidly extend from warehouse and platform may include the surface that can move.When tissue is compressed in When between anvil block and this nail bin, platform can be moved downward relative to protuberance.Platform can be in first position and the second place Between move.When platform is in its first position, protuberance can be not extended past the top surface of platform.In such case Under, when platform is in its first position, protuberance can be recessed less than the top surface of platform.When platform moves to its second When putting, protuberance can expose and extend beyond the top surface of platform.Alternatively, when platform is in its first position and Qi During two positions, protuberance can extend over top platform surface.In either case, platform relative to protuberance move away from From the pressure that may depend on applying extremely tissue.For example, platform can move relatively large distance when larger compression pressure is applied to tissue And move small distance when smaller compression pressure is applied to tissue.Top platform surface may be in response to apply to its compression Pressure and float.Dreaming up wherein platform includes some embodiments of single piece of material.Dreaming up wherein platform includes multiple portion Other embodiments divided.In at least one such embodiment, each part can work independently of other parts.Each In the case of kind, platform can be made up of the elastomeric material that may be in response to apply to be deflected to its compression pressure.In at least one feelings Under condition, platform can be made up of such as foam.In some cases, platform can be made up of such as oxidized regenerated cellulose.Platform can It is made up of implantable material or implantable material.Platform had both been implanted into or can not be implanted in patient's body.In all cases, Platform may include to be defined in the hole of the relative motion allowed between platform and protuberance therein.In at least one such situation Under, hole may include through hole and protuberance can be positioned in the through hole.In some cases, hole may include what is extended around nail cavity Clearance groove and one or more protuberances extended around the nail cavity.When nail is ejected from nail cavity, nail may pass through by clearance groove The opening of offer.In some cases, at least a portion of platform can be implanted into platform by nail capture with against the tissue being sewn.
In all cases, nail bin disclosed herein can include auxiliary material.Auxiliary material can be included and is for example positioned at The platform top of nail bin and at least one of which material by being implanted to from the nail of cartridge deployment in patient's body.In all cases, At least one of which material can include such as backing material and/or tissue thickness compensation part.At least one of which material can be by example As Gore SeamGuard materials, Synovis Peri-Strips materials and/or polyurethane are constituted.The multiple of this layer is disclosed Bibliography has been incorporated by reference.Be filed on 2 28th, 2013 it is entitled " for surgery nail bin layer arrangement knot The U.S. Patent Application Serial Number 13/ of structure (LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES) " The entire disclosure of 763,095 (now for United States Patent (USP) discloses 2013/0161374) is herein incorporated by reference.It is special below The entire disclosure of profit 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 U.S. State's patent disclosure 2012/0312860);And it is filed in the entitled " with the thickness comprising antiinflammatory 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 up of bioabsorbable material and/or non-bioabsorbable material.One In the case of a little, material layer could attach to platform.In the case of at least one, 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 to be defined in hole therein.At least It is a kind of it is such in the case of, layer can be used together with such as nail bin 2000, and may include for example to be defined in it is therein with from nail bin Protuberance 2051 and/or the hole of the alignment of protuberance 2053, slit and/or slit that 2010 platform 2011 extends.In some feelings Under condition, hole may include to extend fully through the through hole of layer or window.Hole, slit and/or slit are for example using such as band blade Cutting element incision layer in.In some cases, hole, slit or/or slit can for example be formed in such as moulding layer.At certain In the case of a little, hole, slit or/or slit are for example formed using such as laser cutting process in layer.In some cases, hole May include the groove for not extending completely through layer being defined in layer.In all cases, protuberance can be closely received in hole It is interior so that can to prevent or the relative motion at least between limitation warehouse 2010 and layer.In the case of at least one is such, can be prominent Go out between portion and the side wall in hole and there is interference fit.
Than that described above, auxiliary layer can be made up of such as weaving layer and/or non-woven layer.Layer can be made up of such as film. In the case of various, layer may include the stream for being configured to prevent from or at least limit to organize relative to nail bin for for example extending from it Dynamic texturizing surfaces, protuberance and/or projection.Layer may include first group of region and second group of region, first group of region Closed and/or captured in the nail by the nail joint ejected from nail bin, second group of region is not closed or captured by the nail joint In the nail.In all cases, second group of region can be changed.In the case of at least one, layer can be made up of film and film Two groups of regions can be modified to include such as hole, slit and/or slit.In the case of at least one, the periphery Ke Bao of this layer Include the otch for being defined in the edge for softening layer therein.In some cases, cut-out pattern can be made in layer.At least one In the case of kind is such, cut-out pattern may include the otch for for example extending with 45 degree of angles relative to each other.In some cases, otch Depth, width and/or interval can be random.Above-mentioned otch can make film layer more flexible, draftability and/or compliance.On Stating otch can be fabricated into such as weaving or non-woven material.Above-mentioned otch can be used for example any suitable process, such as all Such as made by mechanical blades system and/or laser cutting system.In all cases, can not modifying layer as discussed above First group of region.
As discussed above, the layer being made up of solid material piece can be modified to make layer more flexible, draftability and/or soft It is pliable.Layer can be assembled by some material pieces being bonded together.In the case of at least one, can be between binding material piece In the presence of such as hole, slit and/or slit.In some cases, highly non-resilient absorbable polymer band may be welded to it is thinner, In more flexible film, to provide stretching and limiting along the stretching in other directions along some anticipated orientations.This band may be used also High stress portion for strengthening film allows the other parts of film to keep soft and submissive simultaneously.One kind realizes this mesh calibration method To make some thin strips being made up 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 total length of such as staple line.Six bands can be arranged with the staple line with six longitudinal staples Laterally expand correspondence.Then, can be by for example by polymer (the such as Monocryl or 36/64PGA/ of such as soft and elastic PCL) the thick thin continuous film layer of about 0.003 " to 0.005 " for constituting is welded to this six bands.In some cases, can profit Use compression molded operation.Result will be with soft-side and be easy to the highly reinforcing of the lateral ability rather than longitudinal stretching Staple line.The band extended from film can even produce the towed guarantor that the tissue flowing on the film that will make along desired direction is minimized Hold feature structure.In some cases, the layer being made up of weaving and/or non-woven material can be changed so that some districts of such as layer Domain (such as first group region) solidifies.Can be by flat extrusion fiber weaving into band, then by using felting and/or another The technology based on heat is planted, for example can be by first group of area fusing together so that they solidify.In some cases, can be by layer All fuse together.
As discussed above, nail bin may include the protuberance extended from warehouse.Except or instead of these protuberances, anvil block can Including the protuberance extended from it, the protuberance is configured to (one) control tissue relative to anvil block and the stream of warehouse Dynamic, (two) make nail cavity extend from the opposite side of tissue and/or (three) support and/or guiding nail when nail is ejected from nail cavity.
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 Rotated between closing position.Anvil block 3320 may also include and be defined in longitudinal slit therein 3325, and the longitudinal slit is constructed Into the part that can wherein receive firing member and/or cutting element.Anvil block 3320 may also include side, and the side can Including the longitudinally projecting portion extended from it 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 for example to organize the lateral flow relative to anvil block 3320.
Than that described above, anvil block 3320 may include to be defined in multiple nail shapes pits 3322 therein, and the nail shaping is recessed Hole can be arranged to the longitudinal direction 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, outermost row 3328c and the row 3328b in the middle of most interior row 3328a and outermost row 3328c.In at least one situation Under, each nail shapes pit 3322 may include first or distally 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 Into the second leg that can receive nail and deform it.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 protuberance 3324.Protuberance 3324 can be positioned on the first forming cup In the middle of 3322a and the second forming cup 3322b.First protuberance 3324 can be positioned in the first side of plane 3322c and second Protuberance 3324 can be positioned in the second side of plane 3322c.The protuberance 3324 extended from anvil block 3320 can with from nail bin The protuberance of extension is operated to guide and supports the nail from nail bin ejection altogether.In the case of at least one, anvil block protuberance 3324 It is interlockable with nail bin protuberance.In all cases, storehouse protuberance can extend from the end of nail cavity and anvil block protuberance 3324 can It is positioned in the middle of the supermedial storehouse protuberance of such as nail cavity.When nail is formed against anvil block 3320, the He of anvil block protuberance 3324 Storehouse protuberance can be operated so that nail cavity extends and supports and guide nail altogether.When nail leg is ejected from nail cavity and contacts anvil block 3320 When, the storehouse protuberance 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 guided by the protuberance 3324 extended from anvil block.In all cases, nail leg can be simultaneously by storehouse protuberance Support and guide with anvil block protuberance 3324.In some cases, nail leg can be supported by storehouse protuberance and anvil block protuberance 3324 And guide, but be not simultaneously.
In all cases, forming cup 3322a, 3322b is configured to receive wherein from dashing forward that nail bin extends At least a portion gone out in portion.In the case of at least one is such, each forming cup 3322a, 3322b may include to be adapted to Enough outer ends wide and narrow the inner for receiving the protuberance extended from nail bin.The outer end wide of forming cup 3322a, 3322b can also be constructed Into 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 of forming cup 3322a, 3322b.Nail leg then can from narrow the inner exit forming cup 3322a, 3322b, wherein protuberance 3324 are configured to support and guide nail leg.Each forming cup 3322a, 3322b may include outside width Hold and narrow inner middle angled faces.Nail leg in bootable forming cup 3322a, 3322b of angled faces, limits the side of nail leg To motion, and improve nail leg with narrow inner alignment.
Than that described above, protuberance 3324 is configured to be engaged in suture and/or transecting patient tissue and organizes and make Tissue is held in place.In some cases, each protuberance 3324 may include from the extension of tissue engagement surface 3321 including flat The platform part on smooth surface.Figure 89 is shown including with tissue engagement for being defined in forming pit therein 3322 and extend from it The alternative embodiment of the anvil block 5220 of protuberance 5224.Similar to protuberance 3224, each protuberance 5224 may include platform The portion part 5224a and flat surfaces 5224b for being configured to engagement tissue.In addition, each protuberance 5224 may include Transitional surface 5224c in the middle of platform part part 5224a and flat surfaces 5224c.In all cases, transitional surface 5224c 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 between the open position and the closed position rotate around the pivot.Anvil block 5120 may also include and be defined in longitudinal slit therein 5125, and the longitudinal slit is configured to receive percussion structure wherein A part for 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 for extending or wall.In all cases, the second ladder 5121 higher " 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 compression stress to tissue.In various alternative embodiments, the second ladder 5121 higher " 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 in the first ladder 5121' and the second ladder 5121 " between prolong The ramped surfaces 5128 stretched ", the ramped surfaces can be conducive to anvil block 5120 relative to the positioning of tissue.
Than that described above, anvil block 5120 may include to be defined in multiple nail shapes pits 5122 therein, and the nail shaping is recessed Hole can be arranged to the longitudinal direction row that can be aligned with the nail cavity being defined in nail bin.In all cases, outermost row 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 Such as the second ladder 5121 " in.Dream up other implementations during wherein intermediate row forming pit 5122 is defined in the first ladder 5121' Scheme.Under any circumstance, anvil block 5120 may include that the tissue extended from it engages protuberance 5124.In all cases, often Individual protuberance 5124 may include such as H-shaped configuration.Protuberance 5124 can extend between for example adjacent forming pit 5122.It is prominent Extend between the adjacent forming cup that portion 5124 can be in such as forming pit 5122.In all cases, protuberance 5124 can enclose Around the end of forming cup supporting and guide the nail leg formed by forming cup.Protuberance 5124 can be along such as forming pit 5122 Side extend.Protuberance 5124 can extend along the side of such as 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 protuberance 5124 And limit the lateral movement of nail leg.Figure 88 shows the protuberance 5124 on each side of forming pit 5122.Figure 88 also shows The protuberance 5124 gone out on each side of the forming cup of forming pit 5122.In various other embodiments, protuberance Can with the forming pit 5122 of anvil block 5120 more only and/or in the forming cup of forming pit 5122 only some are adjacent fixed Position.
In all cases, the protuberance for extending from anvil block can have identical highly.In other cases, prolong from anvil block The protuberance 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 the part for being configured to and receiving firing member and/or cutting element therein.Anvil block 3520 Side is may also include, the side may include longitudinally projecting portion or the wall 3323 extended from it.Similar to above-mentioned, anvil block 3520 can Including being arranged to most interior row 3328a, outermost row 3328c and the row 3328b in the middle of most interior row 3328a and outermost row 3328c Forming pit.In all cases, anvil block 3520 may include that longitudinal direction for example adjacent with most interior row 3328a ranked first protuberance Longitudinal direction 3551a adjacent with intermediate row 3328b ranked second protuberance 3551b and the longitudinal direction row adjacent with outermost row 3228c 3rd protuberance 3551c.First protuberance 3551a can extend the first distance and the second protuberance from tissue engagement surface 3221 3551b can extend the second distance different from the first distance from tissue engagement surface 3221.3rd protuberance 3551c can be from tissue Composition surface 3221 extends the 3rd distance that may differ from the first distance and/or second distance.In all cases, the 3rd protrude Portion 3551c can be higher than the second protuberance 3551b and the second protuberance 3551b can be higher than the first protuberance 3551a.In various alternatives In embodiment, protuberance 3551a can be with such as intermediate row 3328b and/or outermost row's 3328c adjacent positioneds, protuberance 3551b Can be with for example most interior row 3328a and/or outermost row's 3328c adjacent positioneds, and/or protuberance 3551c can be with for example most interior row 3328a and/or intermediate row 3328b adjacent positioneds.
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 closing position it Between rotate.Anvil block 3420 be may also include and be defined in longitudinal slit therein 3325, and the longitudinal slit is configured at it The middle part for receiving firing member and/or cutting element.Anvil block 3420 may also include side, and the side may include to prolong from it The longitudinally projecting portion stretched or wall 3323.Anvil block 3420 may include to be defined in multiple nail shapes pits 3322 therein, described to follow closely into Shape pit can be arranged to the longitudinal direction 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 the protuberance extended from it.For example, anvil block 3420 may include the conical projections 3051 extended from it and/or Dome-shaped protuberance 3151.Protuberance 3051 and/or protuberance 3151 can improve the chucking power that can apply to tissue.
In all cases, anvil block and the protuberance extended from anvil block can be made up of single piece of material.In at least one situation Under, protuberance can be integrally formed with anvil block.Anvil block and protuberance can be made up of such as metal material (such as stainless steel), and can be For example in processing and/or punching course formed.In some cases, protuberance may fitted to anvil block.In the case of at least one, Protuberance may be affixed to such as anvil block.Anvil block and protuberance can be made up of identical material or different materials.In at least one In the case of, anvil block can be made up of metal material and protuberance can for example by elastomeric material (such as rubber, thermoplastic elastomer (TPE) And/or santoprene) formed.In all cases, protuberance can be made up of pliable material and may not injure by protuberance pressure The tissue of contracting.Protuberance 3051 and/or protuberance 3151 for example can be by such as elastomeric material (such as rubber, thermoplastic elastic Body and/or santoprene) constitute.In the case of at least one, anvil block can be formed in processing and/or punching course and protuberance can Formed on anvil block in molding process using the material more flexible than the material including anvil block.In all cases, protuberance 3051 and/or 3151 for example may include to texture anvil faces.In some cases, protuberance 3051 and/or 3151 for example may be used It is made up 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 the uniform protuberance array extended from it.In other cases, the array can For uneven.Figure 68 is referred again to, protuberance 3051 can prolong on the first side of longitudinal slit 3325 from anvil faces 3321 Stretch and protuberance 3151 can extend on the second side of longitudinal slit 3325 from anvil faces 3321.In all cases, it is prominent Portion can position relative to such as forming pit 3322 towards distally.In some cases, protuberance can be interspersed in forming pit 3322 In.Protuberance can from the surface 3429a being for example defined in the middle of most internal shaping pit 3322 and slit 3325, be defined in it is most interior into Surface 3429b in the middle of shape pit 3322 and middle forming pit 3322, it is defined in middle forming pit 3322 and is shaped with outermost The surface 3429c of the centre of the pit 3322 and/or surface 3429d being defined in the middle of outermost forming pit 3322 and lateral sidewall 3323 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 Cause to be prevented from or limit flowing of the tissue relative to anvil block 5920.In the case of at least one, anvil block 5920 may include example Such as protuberance 5924' and protuberance 5924 ".Protuberance 5924 " can be higher than protuberance 5924'.This difference in height is by dimension 5925 Represent.As shown in Figure 98, protuberance 5924 " can position relative to protuberance 5924' towards distally.In all cases, protuberance 5924 " and protuberance 5924' can be longitudinal direction row protuberance a part.In some cases, protuberance 5924 " and protuberance 5924' can be a part for different longitudinal direction row protuberances.In some cases, although not shown, protuberance 5924' can be relative In protuberance 5924 " positioned towards distally.
In all cases, anvil block disclosed herein may include auxiliary material.Auxiliary material can be included and is for example positioned at The tissue engagement surface top of anvil block and at least one of which material by being implanted to from the nail of cartridge deployment in patient's body.Various In the case of, at least one of which material can include such as backing material and/or tissue thickness compensation part.At least one of which material Can be made up of such as Gore SeamGuard materials, Synovis Peri-Strips materials and/or polyurethane.This layer is disclosed Multiple bibliography be incorporated by reference.Be filed on 2 28th, 2013 it is entitled " for surgery nail bin layer The U.S. Patent application sequence of arrangement (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 the thickness compensation part comprising styptic 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 bag of on June 25th, 2012 Tissue stitching instrument (the TISSUE STAPLER HAVING A THICKNESS of the thickness compensation part containing antiinflammatory 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 the case of at least one, 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 the protuberance extended from it, and the protuberance may extend into and be defined in In forming pit in anvil block.Protuberance can be arranged to the array or figure being aligned with forming pit array or pattern in anvil block Case.In the case of at least one, protuberance can be snugly fit against in forming pit.Protuberance is configured to limiting layer Relative to the lateral movement and/or lengthwise movement of anvil block.
In some cases, layer may include solid material piece.In some cases, layer may include to be defined in hole therein. In the case of at least one is such, layer can be used together with such as anvil block 3320, and may include for example to be defined in it is therein with from Hole, slit and/or slit that the protuberance that the tissue engagement surface 3321 of anvil block 3320 extends is aligned.In some cases, hole May include to extend fully through the through hole or window of layer.Hole, slit and/or slit are for example using the cutting structure of such as band blade In part incision layer.In some cases, hole, slit or/or slit can for example be formed in such as moulding layer.In some situations Under, hole, slit or/or slit are for example formed using such as laser cutting process in layer.In some cases, hole may include It is defined in the groove for not extending completely through layer in layer.In all cases, protuberance can be closely received in hole so that Can prevent or the relative motion at least between limitation anvil block 3320 and layer.At least one it is such in the case of, can protuberance with There is interference fit between the side wall in hole.
Than that described above, auxiliary layer can be made up of such as weaving layer and/or non-woven layer.Layer can be made up of such as film. In the case of various, layer may include for example to be configured to prevent or at least limit tissue relative to anvil block from what it extended The texturizing surfaces of flowing, protuberance and/or projection.Layer may include first group of region and second group of region, first group of area Domain is closed and/or is captured in the nail by the nail joint ejected from nail bin, and second group of region is not closed or captured by the nail joint In the nail.In all cases, second group of region can be changed.In the case of at least one, layer can be made up of and film film Second group of region can be modified to include such as hole, slit and/or slit.In the case of at least one, the periphery of this layer can Otch including being defined in the edge for softening layer therein.In some cases, cut-out pattern can be made in layer.At least In the case of one kind is such, cut-out pattern may include the otch for for example extending with 45 degree of angles relative to each other.In some cases, cut Mouthful depth, width and/or interval can be random.Above-mentioned otch can make film layer more flexible, draftability and/or compliance. Above-mentioned otch can be fabricated into such as weaving or non-woven material.Above-mentioned otch can be used for example any suitable process, for example Such as made by mechanical blades system and/or laser cutting system.In all cases, can not modifying layer as discussed above First group of region.
As discussed above, the layer being made up of solid material piece can be modified to make layer more flexible, draftability and/or soft It is pliable.Layer can be assembled by some material pieces being bonded together.In the case of at least one, can be between binding material piece In the presence of such as hole, slit and/or slit.In some cases, highly non-resilient absorbable polymer band may be welded to it is thinner, In more flexible film, to provide stretching and limiting along the stretching in other directions along some anticipated orientations.This band may be used also High stress portion for strengthening film allows the other parts of film to keep soft and submissive simultaneously.One kind realizes this mesh calibration method To make some thin strips being made up 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 total length of such as nail shapes pit line.Can arrange that six bands are followed closely with six longitudinal directions The staple line of row laterally expands correspondence.Then, can be by for example by such as soft and elastomeric polymer (such as Monocryl or 36/ 64PGA/PCL) the thick thin continuous film layer of about 0.003 " to 0.005 " for constituting is welded to this six bands.In certain situation Under, using compression molded operation.Result will be with soft-side and the height for being easy to the lateral ability rather than longitudinal stretching Spend enhanced staple line.The band extended from film can even produce what the tissue flowing on the film that will make along desired direction was minimized Towed holding feature structure.In some cases, the layer being made up of weaving and/or non-woven material can be changed so that such as layer Some regions (such as first group region) solidification.Can be by flat extrusion fiber weaving into band, then by using felting And/or another technology based on heat, for example can be by first group of area fusing together so that they solidify.In certain situation Under, the whole of layer can be fused together.
Interior storing with can removing in end-to-end arrangement are longitudinally arranged disclosed herein is one or more are included in The various embodiments of the nail in nail bin.Similarly, disclosed herein is including with being arranged to corresponding end-to-end arrangement Nail shapes pit anvil block various embodiments.Dream up other nails and arrangement of nail-forming pit structure and the arrangement knot Structure is applicable to embodiments disclosed herein.This arrangement both may include or may not include end-to-end arrangement. It is published in entitled " the surgical stapling system for disposing the surgical staples with tissue compression feature structure on May 29th, 2012 System and nail bin (SURGICAL STAPLING SYSTEMS AND STAPLE CARTRIDGES FOR DEPLOYING SURGICAL STAPLES WITH TISSUE COMPRESSION FEATURES) " United States Patent (USP) 8,186,560 it is complete Disclosure is herein incorporated by reference.Be published on 2 5th, 2013 it is entitled " have it is dissolvable, bioabsorbable or Surgical staples of biodegradable moieties and for disposing its suture instruments (SURGICAL STAPLES HAVING DISSOLVABLE,BIOABSORBABLE OR BIOFRAGMENTABLE PORTIONS AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME) " United States Patent (USP) 8,365,976 entire disclosure with the side of reference Formula is incorporated herein.
Figure 19 to Figure 22 shows that motor that is both recycling or can not recycling drives surgery cuts and fastening instrument 1010.In the illustrated embodiment, apparatus 1010 includes shell 1012, and the shell includes shank 1014, and the shank is by structure Causing can be by clinician's grasping, manipulation and actuating.Shell 1012 is configured to be operatively attached to interchangeable shaft assembly 1200, the interchangeable shaft assembly with its surgical end-effector 1300 is operably linked to, hold by the surgical end Row device is configured to perform one or more surgical tasks or operation.With continued reference to this specific embodiment, it will be appreciated that Various unique and new arrangement of various forms of interchangeable shaft assemblies disclosed herein can also be effectively combined machine The surgery system of device people control is used.Therefore, term " shell " can also cover the receiving or otherwise of robot system The shell or similar portions of at least one drive system are operably supported, wherein at least one drive system is configured to Can generate and apply to can be used at least one control for activating interchangeable shaft assembly disclosed herein and its corresponding equivalent System motion.Term " framework " can refer to a part for hand-held surgical apparatus.Term " framework " can also represent the outer of robot control A part for section's apparatus and/or the part that can be used to be operatively controlled surgical instruments of robot system.For example, this paper institutes Disclosed interchangeable shaft assembly " can have the surgery suturing appliance that rotatable nail disposes arrangement 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, apparatus, part 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 arrangement STAPLE DEPLOYMENT ARRANGEMENTS) " U.S. Patent Application Serial Number 13/118,241 (be now United States Patent (USP) Shen Please announce and 2012/0298719) be incorporated by reference in its entirety herein.
Shell 1012 shown in Figure 19 to Figure 21 shows that the interchangeable shaft assembly includes with reference to interchangeable shaft assembly 1200 End effector 1300, the end effector includes being configured to be operably supported surgery nail bin 1304 wherein Surgery cuts and fastener.Shell 1012 can be configured to be used with reference to interchangeable shaft assembly, the interchangeable shaft assembly Including end effector, the end effector can support the nail bin of different size and type, with different shaft lengths, chi Very little and type etc..Additionally, shell 1012 effectively can also be used together with various other interchangeable shaft assemblies, it is described it is various its Its interchangeable shaft assembly includes being configured to the end effector cloth to being suitable to be used with reference to various surgery applications and operation Put structure and apply such as energy (such as radio frequency (RF) energy, ultrasonic energy and/or motion) of other motions and form Those components.Additionally, end effector, shaft assembly, shank, surgical instruments and/or surgical instrument system can utilize any conjunction One or more suitable fasteners are fastened with by tissue.For example, the fastener being stored therein with can removing including multiple Fastener cartridge inserts and/or is attached to the end effector of shaft assembly in which can remove.
Figure 19 is shown with the surgical instruments 1010 for being operably linked to its interchangeable shaft assembly 1200.Figure 20 and Figure 21 shows the attachment of interchangeable shaft assembly 1200 to shell 1012 or shank 1014.Such as can finding, shank in figure 21 1014 can interconnect shank shell section 1016 and 1018 including a pair, and this pair of shank shell section can be by screw, snap in features Structure, adhesive etc. are interconnected.In shown arrangement, operation can be cured shank shell section 1016,1018 with being formed by clinic altogether The raw pistol grip portion 1019 for grasping and manipulating.To such as discuss in further detail below, shank 1014 can be grasped wherein Make the multiple drive systems of ground support, the drive system is configured to generate various controls moves and apply it to grasp It is attached to the appropriate section of its interchangeable shaft assembly with making.
Referring now to Figure 21, shank 1014 may also include the framework 1020 for being operably supported multiple drive systems.For example, Framework 1020 can be operably supported " first " or closure drive system, " first " or closure for being typically expressed as 1030 Drive system can be used to be closed and open motion to the applying of interchangeable shaft assembly 1200 for being operationally attached or coupled to it. In at least one form, closure drive system 1030 may include the form of closure trigger 1032 being pivotally supported by framework 1020 Actuator.More specifically, as shown in figure 21, closure trigger 1032 is pivotally coupled to shell 1014 by pin 1033. This arrangement enables that closure trigger 1032 is manipulated by clinician so that when clinician grasps shank 1014 During pistol grip portion 1019, closure trigger 1032 easily can be pivoted to " actuating " position from starting or " actuating " position Put, and more specifically, be pivoted to compression or fully actuated position completely.Closure trigger 1032 can be by spring or other biasings Arrangement (not shown) is biased to unactuated position.In various forms, closure drive system 1030 is also included pivotly It is connected to the closed connecting rod component 1034 of closure trigger 1032.Such as can finding in figure 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 including horizontal attachment pin 1037 herein.
Referring also to Figure 21, it can be observed that the first closed connecting rod 1036 can have latch wall disposed thereon or end 1039, the closure release component 1060 that the latch wall or end were configured to and were pivotally coupled to framework 1020 is total to Operation.In at least one form, closure release component 1060 can include thering is the lock towards distally projection being formed on Determine the release button component 1062 of ratchet 1064.Release button component 1062 can be released spring (not shown) along side counterclockwise To pivot.Pistol grip portion 1019 as clinician by closure trigger 1032 from its unactuated position towards shank 1014 is pressed During 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 remain engaged with point so as to prevent closure trigger 1032 from returning to unactuated position.Therefore, closure release component 1060 help for closure trigger 1032 to be 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's simply pivoted closed release button component 1062 so that lock Determine ratchet 1064 and move into be disengaged with the latch wall 1039 in the first closed connecting rod 1036.When locking pawl 1064 has been moved When being disengaged with closed connecting rod 1036, closure trigger 1032 can be pivoted back to unactuated position.Also other can be used Closure trigger is locked and release arrangement.
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 place from its first position, magnetic element 1063 can be towards circuit board 1100 motions.Circuit board 1100 may include at least one sensor, and at least one sensor is configured to detection magnetic The motion of property element 1063.In at least one embodiment, " Hall effect " sensor (not shown) can be for example installed to The lower surface of circuit board 1100.Hall effect transducer is configured to detection to be caused by the motion 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 that closure release button 1062 in being held with the unactuated position and end of closure trigger 1032 Its associated first position of the open configuration of row device and the actuated position and the closure of end effector of closure trigger 1032 Its associated second place of configuration, and/or any position between first position and the second place.
In at least one form, shank 1014 and framework 1020 can be operably supported at and herein referred to as fire Another drive system of drive system 1080, the drive system is configured to being attached to its interchangeable shaft assembly Appropriate section apply percussion motion.Percussion drive system 1080 is also referred herein as " the second drive system ".Percussion is driven Dynamic system 1080 can be used the electro-motor 1082 in the pistol grip portion 1019 of shank 1014.In various forms, Motor 1082 can be the DC brush drive motor of such as maximum (top) speed with about 25,000RPM.In other arrangements In, motor may include brushless motor, wireless motor, syncmotor, stepper motor or any other suitable electro-motor.Motor 1082 can be by may include that the power supply 1090 of removable power source group 1092 is powered in one form.Such as can finding, example in figure 21 Such as, power supply group 1092 may include nearside casing part 1094, and the nearside casing part is configured to be attached to distally shell Part 1096.Nearside casing part 1094 and distally casing part 1096 are configured to be operably supported multiple wherein Battery 1098.Battery 1098 can each include such as lithium ion (" LI ") battery or other suitable batteries.Distally casing part 1096 are configured to remove and can be operatively attached to circuit board assemblies 1100, and the circuit board assemblies are also operable to It is connected to motor 1082.The multiple batteries 1098 that can be connected in series can be used as the power supply of surgical instruments 1010.Additionally, power supply 1090 can be replaceable and/or chargeable.
As summarized above with respect to other various forms, electro-motor 1082 may include operationally with gear reduction unit The rotatable shaft (not shown) of the handing-over of component 1084, the The gear deceleration device assembly is nibbled with the sliding tooth 1122 of a group or a tooth bar Splice grafting closes to be arranged on is capable of in the drive member 1120 of lengthwise movement.In use, the polarity of voltage that power supply 1090 is provided can Electro-motor 1082 is operated along clockwise direction, wherein can be inverted by the polarity of voltage that battery is applied to electro-motor, so as to Electro-motor 1082 is operated in the counterclockwise direction.When electro-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 near Side is axially driven to " PD ".Shank 1014 may include switch, and the switch is configured to make applied by power supply 1090 It is added to the polarity inversion of electro-motor 1082.As other forms as herein described, shank 1014 may also include sensor, institute State sensor and be configured to detect the position of drive member 1120 and/or the direction of the motion of drive member 1120.
The actuating of motor 1082 can be controlled by the firing trigger 1130 being pivotally supported on shank 1014. Firing trigger 1130 can be pivoted between unactuated position and actuated position.Firing trigger 1130 can by spring 1132 or its Its offset placement configuration biases is to unactuated position so that when clinician discharges firing trigger 1130, it can be by spring 1132 or offset placement structure be pivoted to or otherwise return 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 with the pivotal arm 1136 from its projection.Referring to Figure 21.When closure is touched When hair device 1032 is in unactuated position, safety switch 1134 is accommodated in shank 1014, and now clinician is possibly cannot The button is touched easily and it is being prevented home and wherein firing trigger to the actuating of firing trigger 1130 Moved between 1130 firing positions that can be fired.When clinician presses closure trigger 1032, the He of safety switch 1134 Firing trigger 1130 is pivoted downwards, and wherein they can then be manipulated by clinician.
As described above, at least one form, the drive member 1120 for being capable of lengthwise movement has what is be formed on The tooth 1122 of one tooth bar, engagement is engaged for the respective drive gear 1086 with The gear deceleration device assembly 1084.At least one shape Formula may also include " relief " component 1140 of manually actuable, and " relief " component is configured to make clinician in horse Manually retracted in the case of may being disabled up to 1082 and be capable of the drive member 1120 of lengthwise movement.Relief component 1140 can be wrapped Include lever that the ratchet of tooth 1124 for being configured to manually be pivoted into be also disposed in drive member 1120 engages or Relief shank assembly 1142.Therefore, clinician can by using relief shank assembly 1142 and driving structure of manually retracting 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 arrangement and can be also used together with various apparatuses disclosed herein Other parts, arrangement 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 in full 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 being configured to be operably supported wherein the elongated passageway 1302 of 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 be wrapped Include actuated articulation joints 1270 and be configured to make end effector 1300 be releasably held relative to axial line SA-SA In the articulation lock of desired position.Structure on end effector 1300, actuated articulation joints 1270 and articulation lock The detailed content made and operate be set forth in be filed on March 14th, 2013 it is entitled " including articulation lock being capable of joint Surgical instruments (the ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION of motion 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 being capable 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 finding in fig. 22, interchangeable shaft assembly 1200 may also include be made up of spray nozzle part 1202 and 1203 near Side shell or nozzle 1201.Interchangeable shaft assembly 1200 may also include closed tube 1260, the closed tube can be used to closing 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.Joint motions driver has that be configured to can The distal end that operatively connecting joints motion is locked.Articulation lock with can be operatively engaged on end effector frame The articulation frame handing-over of drive pin.As described above, the operation on articulation lock and articulation frame is more detailed Thin content is found in U.S. Patent Application Serial Number 13/803,086.In all cases, ridge 1210 may include to rotate Be supported in proximal end 1211 in chassis 1240.In an arrangement, for example, the proximal end 1211 of ridge 1210 has There is the screw thread 1214 being formed on for being threadedly attached to the ridge bearing 1216 for being configured to be supported in chassis 1240. Referring to Figure 22.This arrangement is conducive to ridge 1210 to the rotatable attachment on chassis 1240 so that ridge 1210 is optionally Rotated around axial line SA relative to chassis 1240.
Referring primarily to Figure 22, interchangeable shaft assembly 1200 includes closure spindle moving part 1250, and the closure spindle moving part is slidably Be supported in chassis 1240 so that it can be axially movable relative to the chassis.Closure spindle moving part 1250 includes a pair of courts The hook 1252 of nearside projection, the hook is 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.For example, in the proximal end 1261 of the insertion closed tube 1260 of U-shaped connector 1263 Narrow annular slot 1262 and be maintained at closure spindle moving part 1250 in vertical slit 1253 in.This arrangement is used for closing Pipe 1260 is closed to be attached to closure spindle moving part 1250 therewith axially to advance while enabling closed tube 1260 around axle center Line SA rotates relative to closure spindle moving part 1250.The axle journal of closing spring 1268 is connected in closed tube 1260 and for that will close Proximally direction " PD " biasing of pipe 1260, 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 cannot carry out joint motions.Such as can finding in fig. 22, for example, actuated articulation joints 1270 include double pivots Axle closes thimble assembly 1271.According to various forms, double pivot closure sleeve assembly 1271 includes having towards the upper of distally protrusion The end effector closure thimble assembly 1272 of tang 1273 and lower tang 1274.End effector closure thimble assembly 1272 is wrapped Shape of a hoof hole 1275 and fin 1276 are included, the shape of a hoof hole and fin are used for each with what is illustrated in following patent application The mode of kind engages the opening fins on anvil block 1306:What is be herein incorporated by reference is filed in the name on March 14 in 2013 Referred to as " including it is hinged surgical instruments (the ARTICULATABLE SURGICAL INSTRUMENT for being capable of joint motions of lock COMPRISING AN ARTICULATION LOCK) " U.S. Patent Application Serial Number 13/803,086.As in further detail herein Illustrate, when anvil block 1306 is opened, the fin on shape of a hoof hole 1275 and the engagement anvil block of fin 1276.The double pivot links in top 1277 include the distally and proximally pivot pin for projecting upwards, and the pivot pin engages proximally protruding in closed tube 1260 respectively Upper tang 1273 in top distal pin hole and towards distally protrude upper tang 1264 in top proximal pin hole.Under The double pivot links 1278 in portion include the distally and proximally pivot pin for projecting upwards, and the pivot pin engages what is proximally protruded respectively Lower distal pin-and-hole cave in lower tang 1274 and the bottom proximal pin hole in the lower tang 1265 protruded towards distally.Also join See Figure 22.
In use, closed tube 1260 is translated towards distally (direction " DD "), with for example in response to closure trigger 1032 Activate and close anvil block 1306.Anvil block 1306 is closed by following manner:Towards distal translation closed tube 1260 and therefore axle is closed Trap tube assembly 1272, so as to the references to U.S. patent patent application serial numbers 13/803 for causing it to be previously mentioned, in 086 The mode for being illustrated clashes into the proximal face on anvil block 1360.Also elaborated in bibliography as described, anvil block 1306 passes through Following manner and open:Proximally translation closed tube 1260 and axle close thimble assembly 1272, so as to cause fin 1276 and horse Ungulate hole 1275 contacts and pushes anvil block fin to lift anvil block 1306.In anvil block open position, the passive movement of axle closed tube 1260 To its proximal position.
As also described above, interchangeable shaft assembly 1200 also includes the percussion for being supported for axially being advanced in axle ridge 1210 Component.Firing member includes the middle percussion shaft portion 1222 for being configured to be attached to distal incision part or knife bar.It is middle Percussion shaft portion 1222 may include the wing being configured in the proximal end of reception distally 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 May include slip joint.Slip joint can allow the middle percussion shaft portion 1222 for firing driver to be moved into holds end Row device 1300 carries out joint motions, and moves without motion or at least substantially knife bar.Once end effector 1300 is suitable Ground orientation, centre percussion shaft portion 1222 just can be advanced towards distally, until proximal sidewall and the fin of longitudinal slit come in contact, To advance knife bar and to fire the nail bin being positioned in passage 1302.Being expanded on further for operation to firing member is found in U.S. In state's patent application serial number 13/803,086.
Such as can finding in fig. 22, shaft assembly 1200 also includes rotatably receiving the switch drum 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 process.In all cases, actuating pin extends through longitudinal slit, and the longitudinal slit is arranged on Being conducive to axial movement of the lock tube when it is engaged with joint motions driver in lock tube.Rotary torsion spring 1420 is constructed Apply bias force with to switch drum 1500 into the boss and a part for nozzle housing 1203 that can be engaged on switch drum 1500.Open Drum 1500 is closed to may also include and be defined at least part of peripheral openings 1506 therein, the opening be configured to receive from The periphery mounting seat that nozzle half 1202,1203 extends, and allow relative between switch drum 1500 and nearside nozzle 1201 Rotation is rather than relative translation.Mounting seat is extended also through in the closed tube 1260 in the groove in axle ridge 1210 to be positioned Opening 1266.However, nozzle 1201 to mounting seat reaches the point of the end of its respective slots 1506 in drum 1500 is switched Rotation will cause to switch rotation of the drum 1500 around axial line SA.Switch the rotation of drum 1500 most causes actuating to be sold and lock tube at last Rotation between its bonding station and disengaged position.Therefore, substantially, nozzle 1201 can be used for in following patent Shen Please in the various modes that are explained in more detail joint motions drive system is operatively engaged and is departed from percussion drive system Engagement:It is filed in entitled " including surgical instruments (the SURGICAL INSTRUMENT of 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, its 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 For example 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 sending signal.Slip ring assembly 1600 may include proximal connector flange 1604 and distal connector flange, institute State proximal connector flange and be installed to the chassis flange 1242 extended from chassis 1240, the distal connector flange is positioned at limit Due in the slit in shaft housing.Proximal connector flange 1604 may include the first face and distal connector flange may include it is neighbouring The second face that first face positions and can be moved relative to the first face.Distal connector flange can be around axial line SA relative near Side-connector flange 1604 rotates.Proximal connector flange 1604 may include to be defined in its first face it is multiple with one heart or at least Substantially concentric conductor.Connector can be arranged on the nearside of connector flange and can have multiple contacts, and wherein each is touched Point is corresponding with one of the conductor and makes electrical contact with.This arrangement allows proximal connector flange 1604 to be connected with distally The electrical contact for keeping simultaneously therebetween is rotated against between device flange.Proximal connector flange 1604 may include electric connector 1606, conductor can be positioned to carry out signal with the axle circuit board 1610 for being for example installed to axle chassis 1240 lead to by the electric connector Letter.In the case of at least one, including the wire harness of multiple conductors can extend between electric connector 1606 and axle circuit board 1610. Electric connector 1606 can proximally extend through 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 in its entirety 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 in its entirety this Text.Further detailed content on slip ring assembly 1600 is found in U.S. Patent Application Serial Number 13/803,086.
It is as discussed above, shaft assembly 1200 may include to be fixedly secured to shank 1014 portions of proximal and can be around The distal part of longitudinal axis rotation.Rotatable distal shaft part can it is as discussed above around slip ring assembly 1600 relative near Side part rotates.The distal connector flange of slip ring assembly 1600 can be positioned in rotatable distal shaft part.Additionally, except above-mentioned In addition, switch drum 1500 is alternatively positioned in rotatable distal shaft part.When rotatable distal shaft part rotates, distally connection Device flange and switch drum 1500 can rotate synchronously with one another.Additionally, switch drum 1500 can be relative to distal connector flange the Rotated between one position and the second place.When switch drum 1500 be in its first position when, joint motions drive system can with hit Hair drive system is operatively disengaged from engagement, and therefore, the operation for firing drive system can not hold the end of shaft assembly 1200 Row device 1300 carries out joint motions.When drum 1500 is switched in its second place, joint motions drive system can drive with percussion Dynamic system is operatively engaged, and therefore, the operation for firing drive system can enter the end effector 1300 of shaft assembly 1200 Row joint motions.When switch drum 1500 is moved between its first position and its second place, switch drum 1500 is relative to remote Side-connector flange is moved.In all cases, shaft assembly 1200 may include to be configured to the position of detection switch drum 1500 At least one sensor put.
Figure 22 is referred again to, chassis 1240 includes at least one and the preferably two tapered attachment parts that are formed on 1244, the tapered attachment part can be received in the corresponding swallow formed in the distally of framework 1020 attachment flange portion 1700 In tail slit 1702.Referring to Figure 21.Each dovetail slot 1702 can for tapered, or, in other words, slightly V-arrangement with it Middle resettlement receives attachment part 1244.Such as can further finding in fig. 22, axle means of attachment lugs 1226 is in middle beating shaft Formed in 1222 proximal end.To such as discuss in further detail below, when interchangeable shaft assembly 1200 is connected to shank When 1014, axle means of attachment lugs 1226 receives the beating shaft attachment in the distal end 1125 for being formed at zigzag tread patterns component 1120 In base 1126.Referring to Figure 21.
Shaft assembly 1200 is connected to shell with can removing by various shaft assembly embodiments using latch system 1710 1012 and more specifically it is connected to framework 1020.Such as can finding in fig. 22, for example, at least one form, latch system 1710 locking components for including being movably coupled to chassis 1240 or lock yoke 1712.In the illustrated embodiment, for example, lock yoke 1712 in two U-shapeds of the leg 1714 for extending downwardly spaced apart.Leg 1714 each has the energy being formed on Enough receive the pivot lug 1715 in the corresponding hole 1245 being formed in chassis 1240.This arrangement is conducive to locking yoke The pivotal attachment on 1712 to chassis 1240.Lock yoke 1712 may include two lock lugs 1716 of proximally projection, the lock lug The corresponding locking screens or groove 1704 being configured in the distally attachment flange 1700 to framework 1020 are releasably engaged. Referring to Figure 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 breech lock 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.Such as will below Discussed in further detail, lock yoke 1712 can be by making latched press-button not remote with framework 1020 along being also pivoted into lock yoke 1712 The distal direction for remaining engaged with of side attachment flange 1700 is biased and moves to unlocked position.When lock yoke 1712 and framework 1020 During attachment flange 1700 " the remaining engaged with " of distally, lock lug 1716 is retentively placed in the corresponding lock in distally attachment flange 1700 Determine in screens or groove 1704.
When using including cutting and the end effector of type described herein of fastening tissue and other types of During the interchangeable shaft assembly of end effector, it may be desirable to prevent the interchangeable shaft assembly of activating in end effector with it is outer Shell undesirably falls off.For example, in use, clinician may be actuated closure trigger 32 to grasp destination organization and manipulated Into desired position.Once destination organization is oriented to desired orientation in end effector 1300, clinician just can be complete It is complete to activate closure trigger 1032 to close anvil block 1306 and clamp 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 falling off.
Such as can finding most specifically in fig. 22, lock yoke 1712 includes at least one and preferably two latch hooks 1718, institute Stating latch hook can contact the corresponding lock ledge portion 1256 formed on closure spindle moving part 1250.When closure spindle moving part 1250 is in During unactuated position (that is, the first drive system 1030 is not activated and anvil block 1306 is opened), lock yoke 1712 can be along distal direction pivot Turn to be unlocked with shell 1012 with by interchangeable shaft assembly 1200.When in this positions, latch hook 1718 does not contact closure shuttle and moves Lock ledge portion 1256 on part 1250.However, when closure spindle moving part 1250 is moved to actuated position (that is, the first drivetrain System 1030 is activated and anvil block 1306 is in the close position) when, lock yoke 1712 is prevented from being pivoted to unlocked position.In other words, it is 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 Pivotably collided towards distally or contacted, then the lock that the latch hook 1718 on lock yoke 1712 will be contacted on closure spindle moving part 1250 is convex Ear 1256 and prevent lock yoke 1712 to unlocked position motion.
The attachment of interchangeable shaft assembly 1200 to shank 1014 will be illustrated now.It is clinical to start connection process Doctor can by the chassis 1240 of interchangeable shaft assembly 1200 be positioned at the distally of framework 1020 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 framework 1020.Clinician Then can along the mounting axis perpendicular to axial line SA move shaft assembly 1200 with by attachment part 1244 be positioned to accordingly Dovetail receives slit 1702 " being operatively engaged ".Therefore, the axle means of attachment lugs 1226 on middle beating shaft 1222 also will placement The part of the pin 1037 in the base 1126 in the drive member 1120 for being capable of lengthwise movement and in the second closed connecting rod 1038 To be placed in the respective hook 1252 in closed yoke 1250.As used herein, term " being operatively engaged " is in two parts Refer to that described two parts are fully engaged each other under background so that once applying actuating movement to it, the part just can be with Perform its expection action, function and/or program.
At least five systems of interchangeable shaft assembly 1200 can be operable with least five corresponding systems of shank 1014 Ground connection.The first system may include that the framework or ridge of shaft assembly 1200 are coupled and/or be aligned with the framework 1020 of shank 1014 Frame system.Another system may include to close 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.It is 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 Middle beating shaft 1222.As outlined above, axle means of attachment lugs 1226 be able to can be grasped with the base 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 to the controller (such as microcontroller) in such as shank 1014 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 is operably mounted into axle circuit board 1610.Electric connector 1810 is configured to and handle Corresponding electric connector 1800 on portion's control panel 1100 coordinates engagement.Further detailed content on 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 up of so that shaft assembly 1200 is releasable locking system Lock onto shank 1014.
Surgical stapling device is used 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 otch.This apparatus generally includes the jaw member of a pair of collaborative works, if be intended to the apparatus 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 has 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.Apparatus includes multiple reciprocating wedges, the multiple reciprocal when present dynasty distally drives Formula wedge passes through the opening in nail bin and engages the driver of support nail, to realize nail towards the percussion of anvil block.
Tissue is cut off simultaneously when forming staple on otch is per side, can be reduced and be bled and simplify surgical operation.It is more and more Ground, endoscopic procedure and laparoscopic type operation are better than abdominal, because they reduce post-operative recovery time and further advantage. Endoscope type is sutured and cutting off apparatus use the elongated nip component for often being upward deflected when being clamped in thick tissue.In thickness Tissue, freedom (distally) end of jaw this upward deflect can because the distant gap between anvil block and storehouse be more than nearside gap And cause the difference in height of forming nail.To ensure that nearside evenly follows closely shaping to distally, anvil block usually inward towards nail bin flare or Bending.This flare is that can preferably cause when being used on thin tissue tighter at distal end for thick tissue Nail form.To overcome this tight distally to close, sell 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 injury Or bump.
Various arrangements have been developed to tackle this challenge.One arrangement for example includes being configured to really Anvil block is spaced apart with the elongated passageway of support nail bin " E masts " cutting head or trigger shaft on the spot.This E masts cutting head and Trigger shaft arrangement is disclosed in for example following patent:Entitled " including the surgery suturing appliance of E mast firing locks U.S. of (SURGICAL STAPLING INSTRUMENT INCORPORATING AN E-BEAM FIRING MECHANISM) " State's patent 6, in 978,921, the entire disclosure of the patent is hereby incorporated by reference.
For example, as shown in Fig. 2 and Fig. 3 herein, tissue cutting head includes the E posts that can be translated in end effector 16 Bar 50.As described above, E masts 50 may include vertical portion 52, the vertical portion can be worked as when E masts 50 are advanced towards distally and pass through Extend through the narrow vertical slit in narrow longitudinal anvil slot 58, the nail bin 42 of the tissue contacting surface 60 in anvil block 20 62 and elongate staple channel 40 in narrow longitudinal channel 64.Anvil slot 58 can extend up in anvil block 20 and May include to be passed through the end of the lateral vertical passage 66 widened, the size and construction of the lateral vertical passage widened are set Into the upper pin 54 that reception is extended laterally from vertical portion 52.Similarly, passage slot 64 can be extended downwardly into passage 40 simultaneously And may include the end being passed through in the lateral vertical passage 68 widened, the size and configuration quilt of the lateral vertical passage widened It is set to one or more the lower pins 70 for receiving and being extended laterally from vertical portion 52.E masts 50 may also include one or more Intermediate pin 72, the intermediate pin can extend laterally from vertical portion 52 and be configured to be held in the palm along the bottom of nail bin 42 The top surface of disk 74 is slided.In certain embodiments, intermediate pin 72 is configured to for nail bin 42 to be placed in passage 40 In or ensure that nail bin 42 remains disposed at passage 40.The longitudinal direction percussion formed in the nail bin 42 of the top of bottom tray 74 is recessed The permission intermediate pin 72 that is sized to of groove 75 translates across nail bin 42.
Various elongated passageway arrangements include elongated or longitudinal slit, and described elongated or longitudinal slit is cut in E masts Head prolongs between the starting position and the end position adjacent with the distal end of elongated passageway in the portions of proximal of elongated passageway Stretch.The vertical portion of E mast cutting heads extends through the lower pin portions of the longitudinal slit and E masts along elongated passageway Lower surface is run.Pin portions can help to positively make anvil block be spaced apart 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 distally When cutting head pin position, clinician will know exactly cutting head be located at storehouse in position.It is used to be spaced apart when providing Anvil block and during for the efficient apparatus of position for monitoring cutting head, not in elongated passageway, use can reduce logical to this arrangement The longitudinal slit of the warp resistance and resistance to autgmentability of road rigidity and passage.
To avoid this extension of elongated passageway, it may be desirable to which it is resistance to when thick tissue is sutured to improve to eliminate longitudinal slit Warping property and resistance to autgmentability.However, this arrangement can eliminate surgeon understands seam by observing the position of knife pin Conjunction has proceeded to the ability of which kind of degree.Figure 32 show be can be similar in addition to following differences it is disclosed herein including for example The elongated passageway 6022 of the various elongated passageways of elongated passageway 22 and 302.Elongated passageway 6022 can be by suitable polymeric material It is molded and/or processes and/or otherwise formed 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 for extending internally limit.The chimb part 6028 for extending internally further defines Elongated interior path 6030 between chimb part 6028 and solid bottom part 6024.Although elongated interior slit 6026 Most of length of elongated passageway 6022 is extended up to, but it does not extend across the lower surface 6024 of elongated passageway 6022.It is internal Being sized to be slidably received within cutting head of path 6030 forms or is otherwise affixed to cutting head One or more pins.
Figure 42 shows can for example combine the E masts cutting head 6050 that elongated passageway 6022 is used.However, will such as become aobvious And be clear to, elongated passageway 6022 may also be incorporated in and cut using the various differences of single pin or multiple pins on the bottom of cutting head An arrangement is cut to use.Referring to Figure 42, cutting head 6050 includes perpendicular with what two lower pins 6070 for extending laterally were terminated Straight part 6052.Vertical portion 6052 is configured to through elongated slot 6026 so that lower pin 6070 is received corresponding The lower section of chimb part 6028.
Refer again to Figure 32, elongated passageway 6022 may also include the near of the base section 6024 that is arranged on elongated passageway 6022 Proximal channel opening 6040 in side end.Proximal channel opening 6040 can provide to clinician and be opened when cutting head 6050 is in The view of at least one of the pin 6070 of cutting head 6050 or one or more of the other part when beginning or non-firing position.This " starting position " also can 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 correspondences.Similarly, distal channel opening 6042 be arranged in the distal end of base section 6024 with to Clinician provide when cutting head 6050 is in its " completely percussion " or " end position " pin 6070 of cutting head 6050 or The view of at least one of one or more of the other part.This arrangement is provided for finding out cutting head to clinician It is to be in its end position in its starting position to provide compared to the bottom for extending longitudinally through elongated passageway simultaneously The method of the relatively harder elongated passageway of other passages of the longitudinal slit in portion.Proximal channel opening 6040 and distal channel opening 6042 can shape to be conducive to the light installation in such as cutting head 6050 to elongated passageway 6022 (to pass through in mode shown in Figure 32 Proximal channel opening 6040) and cutting head 6050 from the removal (by distal channel opening 6042) of elongated passageway 6022.Therefore, Elongated passageway 6022 has the closure for including opening 6040,6042 corresponding with the beginning and end of cutting head firing schedule respectively Bottom.This arrangement is allowed to see the beginning and end of percussion and allows cutting head to such as will in further detail below The latched position that ground is discussed is moved downward.
Elongated passageway 6022 can effectively with the cutting head assembly that manually advances or use motor power supplying formula trigger system The cutting head assembly of propulsion is used together.For example, surgical instruments 10 mentioned above is included by actuating trigger 32 manually The cutting head 50 of propulsion.In various arrangements, cutting head 50 can be by three actuating firing triggers 32 since it Position is advanced to its end position.Thus, for example, one-shot trigger 32 can be such that cutting head is transported towards distally in elongated passageway / 3rd (" the first firing positions ") of dynamic the distance between starting position and end position.Second startup trigger can be led 2/3rds (" second firing positions ") and third time of the distance between the cause traveling starting position of cutting head 50 and end position Startup trigger 32 can cause propulsion of the cutting head 50 from the second firing position to end position.Therefore, when the energy of cutting head 6050 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 Road 6022 can also be used with reference to operated type surgical instruments 1010 (Figure 19 to Figure 22).
Figure 33 to Figure 35 shows another elongated passageway cloth similar to elongated passageway 6022 in addition to the difference being previously mentioned Put structure 6122.Those parts for being same as the elongated passageway arrangement 6122 of the part of elongated passageway arrangement 6022 will Shared identical element number.Specifically, such as can finding in fig. 33, a series of indicator openings 6144 spaced apart set Put in base section 6124.Indicator opening 6144 can be different on quantity, size and interval, but at least one cloth Put 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 path 6030.As can be seen in those figures, indicator opening 6144 be for round-shaped.Also such as can finding, light in fig. 33 Source 6160 can be arranged in the proximal end of elongated passageway 6122 so that light source 6160 is projected light onto in internal path 6030 (being represented by the dotted line " L " in Figure 33 and Figure 34).Light source 6160 may include such as one or more light emitting diodes (" LED ") or Other light source arrangements 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 would be projected to inside In path 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 no light " L " is 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 distally, light " L " will be mapped to cutting It is on first 6050 and visible at least through the unobstructed indicator opening 6144 close to cutting head 6050, as shown in figure 34.Cause This, this arrangement allow the clinician to monitoring cutting head 6050 with its in elongated passageway 6122 from its start bit Put the process that its end position is moved to towards distally.This elongated passageway arrangement is also elongated more logical than with extending fully through Those elongated passageway arrangements of the most elongated slot of the lower surface in road are harder and more rigid.In an arrangement knot In structure, the light of the indicator opening that cutting head is located therein is shone through due to there will be no, clinician can determine that cutting head Position.All other indicator opening will have shine through its light.Therefore, in an arrangement, " 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 observing the position of pin 6070 through indicator opening 6144 Put.
Figure 36 shows another elongated passageway arrangement similar to elongated passageway 6122 in addition to the difference being previously mentioned 6222.Those parts of elongated passageway arrangement 6222 of the part of elongated passageway arrangement 6122 are same as by shared phase Same element number.Such as can finding in the drawings, a series of indicator openings 6144 spaced apart are arranged through lower surface 6224.In shown arrangement, indicator opening 6144 is of the same size with shape but interval sets at different intervals Put through lower surface 6224.For example, recent side indicator opening 6144P can be spaced apart such that with proximal open 6040 being capable of example Such as when cutting head 6050 be in starting position when by its observe cutting head 6050 pin 6070 or other parts at least First spacing distance " FSD " of one.Equally, farthest side indicator opening 6144D can be spaced with adjacent indicator opening 6144 Open the second spacing distance " SSD " different from the first spacing distance FSD.As can seen in Figure 36, for example, SSD be more than FSD. Farthest side indicator opening 6144D can be corresponding with the position of the cutting head 6050 in its end position.Therefore, elongated passageway cloth Putting structure 6222 is shown in which open amount at you by the variable interval indicator opening closely reduced when remote motion.
Figure 37 shows another elongated passageway arrangement similar to elongated passageway 6122 in addition to the difference being previously mentioned 6322.Those parts of elongated passageway arrangement 6322 of the part of elongated passageway arrangement 6122 are same as by shared phase Same element number.Such as can finding in the drawings, elongated passageway arrangement 6322 includes a series of elongated independent indicators Opening 6144'.In shown arrangement, indicator opening 6144' is of the same size with shape and with interval at equal intervals Arrangement.
Figure 38 shows another elongated passageway arrangement similar to elongated passageway 6222 in addition to the difference being previously mentioned 6422.Those parts of elongated passageway arrangement 6422 of the part of elongated passageway arrangement 6222 are same as by shared phase Same element number.Such as can finding, only two " independence " indicator openings 6144 spaced apart in the drawings " it is arranged through bottom Portion surface 6424.In shown arrangement, indicator opening 6144 " is of the same size and shape but at different intervals Interval is arranged through lower surface 6424.For example, recent side indicator opening 6144P " can be spaced apart with proximal open 6040 One spacing distance " FSD " and farthest side indicator opening 6144D " can be with recent side indicator opening 6144 " it is spaced apart and is different from Second spacing distance " SSD " of the first spacing distance FSD.In at least one arrangement, for example, when elongated passageway 6422 with When the cutting head assembly manually advanced by activating firing trigger is used together, cut head assembly at least one pin or Other parts are indicated when can be advanced through " the first stroke " or first actuating of firing trigger head assembly is cut by nearside Device opening 6144P " is observed.Equally, at least one pin or other parts of cutting head assembly can be the second of firing trigger Opening 6144D is indicated by farthest side during stroke or the second actuation sequences " observation.Therefore, elongated passageway 6422 includes elongated Slit shape indicator opening and when you when remote motion by closely providing the circular indicators opening of more closures/less opening.
Figure 39 shows another elongated passageway arrangement similar to elongated passageway 6422 in addition to the difference being previously mentioned 6522.Those parts of elongated passageway arrangement 6522 of the part of elongated passageway arrangement 6422 are same as by shared phase Same element number.Such as can finding in the drawings, elongated passageway 6522 includes allowing the clinician in firing trigger The first stroke or actuation sequences during observe cutting head assembly at least one pin or other parts recent side dolichostenomelia Show device opening 6144P " combination and circle indicator opening 6144 at equal intervals combination.Therefore, elongated passageway 6522 is used The combination of open flume type slit and elongated slot.Any one in above-mentioned elongated passageway arrangement can be combined herein in conjunction with Figure 33 Light source 6160 that shown embodiment is specifically described or its can be used in the case of no light source.
Other cutting heads monitoring arrangement may include the opening for example in passage or the slit along channel interior One or more light source arrangements or light emitting diode (" LED ") arrangement 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 arrangements, example Such as, LED may include with cutting head along the further discriminating between cutting head propulsion of passage from green to many of blueness Color LED (or other color placement structures).
In various end effector arrangements, it may be desirable to be using for prevent the propulsion of cutting head or percussion System, unless untapped 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 the storehouse latching member for having used that way of reference is incorporated herein INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT) " United States Patent (USP) 6,988,649 and entitled " have Surgery suturing appliance (SURGICAL STAPLING INSTRUMENT HAVING for preventing the single blocking mechanism of percussion A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING) " the disclosure of United States Patent (USP) 7,044,352 Various block sytems.In this locking arrangement, cutting head or " trigger shaft " are generally biased to by spring arrangement Latched position.Before untapped storehouse has been arranged in elongated passageway, cutting head cannot otherwise by surgical instruments Percussion drive system propulsion.
Referring to Figure 40 to Figure 42, the cutting head 6050 for being attached to trigger shaft 6080 is shown.As illustrated, trigger shaft 6080 It is laminar construction.However, trigger shaft 6080 can be solid construction.In either case, trigger shaft 6080 with it is as described herein Or the percussion drive system of surgical instruments as known to otherwise operationally joins.The actuating for firing drive system will hit Send out bar 6080 and be attached to its cutting head 6050 and be axially advanced the surgery nail bin being passed through in elongated passageway 6122.Cut Cutting first 6050 vertical portion 6052 includes the tissue cutting table being located between upper end part 6054 and center hook portion 6056 Face 6053.Referring to Figure 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 of passage.
Figure 41 shows cutting head 6050 and trigger shaft 6080 when in the elongated passageway 6122 in the absence of surgery nail bin Position.When in this positions, trigger shaft 6080 and cutting head 6050 are by " D " biasing, institute in a downwardly direction of spring arm 6090 State the axle ridge (not shown) support that spring arm is coupled to elongated passageway 6122.Such as can finding, spring arm 6090 in the drawings It is slidably engaged with the spring afterbody 6082 formed in the distal end of trigger shaft 6080.When cutting head 6050 is in such as Figure 41 institutes During the latched position shown, the base section of spring afterbody 6082 is biased to the inclined surface formed on elongated passageway 6122 In 6123.Such as can in Figure 41 further finding, when cutting head 6050 is in the locked position, if clinician is not intended to pilot scale Cutting head 6050 is advanced towards distally for figure or " percussion " passes through elongated passageway 6122, then a multiple or lower pin 6070 may connect Touch the bottom of elongated passageway 6122.In other words, when cutting head 6050 is in the locked position, pin 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 observing position of the pin 6070 in proximal open 6040.
Figure 40 shows the cutting head when untapped surgery nail bin has been operably supported in elongated passageway 6122 6050 and the position of trigger shaft 6080.Although the main body of the not shown surgery nail bins of Figure 40, shows wedge-shaped slides component 6078.It should be appreciated that wedge-shaped slides component 6078 by do not fire or untapped nail bin in position shown in Figure 40. When in this positions, wedge-shaped slides component 6078 is engaged so that cutting head with the hook portion 6056 on cutting head 6050 6050 in upward direction (arrow " U " in Figure 40) be increased to the pin wherein when cutting head 6050 is advanced towards distally thereon The point of 6070 internal paths 6030 that will enter in elongated passageway 6122.When using with closing bottom or substantially closed bottom During portion (all as those described herein), it is envisaged that ground occurs dimension storehouse situation, in this case, is held when using end When row device is to cut and suture very thin tissue, the interference between channel bottom and one or more knife pins can occur.If Tissue is too thin, for example, tissue crushing resistance may be not enough to promote anvil block away from elongated passageway and loaded against cutting head fin Both parts.In the event of such case, one or more knife pins can be extended far enough in the bottom part down of elongated passageway To cause that cutting head can not be advanced towards distally.Cutting head assembly 6050 and elongated passageway arrangement 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 pin 6070 can have being formed on Inclined-plane 6072.Inclined-plane 6072 is configured to be advanced into towards distally in cutting head 6050 makes pin 6070 enter internal path The appropriate section of elongated passageway 6122 is engaged when 6030.Therefore, inclined-plane 6072 helps to for pin 6070 to be directed to path Small " introducing " slope in 6030.Also as can seen in Figure 40 and Figure 41, limit internal path 6030 proximal end 6131 The part of elongated passageway 6122 can thereon have and inclined-plane 6133 or otherwise incline as shown in the figure.In alternative arrangement knot In structure, multiple pins 6070 (or single pin) can be provided with the close end part 6131 of inclined-plane 6072 or internal path 6030 Inclined-plane 6133 can be provided with or the two inclined-plane arrangements can be provided as shown in Figure 40 and Figure 41.
Figure 43 and Figure 44 show can for example similar to end effector disclosed herein 16 or 300 or other end devices End effector 7016.In this arrangement, closed tube or sleeve pipe 7028 have allow the clinician to lead to wherein It is crossed to observe a series of indicator openings 7144 of trigger shaft 6080.Trigger shaft 6080 can be provided with thereon can be in trigger shaft 6080 status indications 6084 observed by indicator opening 7144 by clinician when being advanced towards distally.Status indication 6084 can Simply include as the printing mark of reference marker or further feature structure.In an arrangement, status indication 6084 include one or more hairs that the surgical instruments as attached by end effector 7016 or the power supply in surgery system are powered Optical diode (LED) or other light sources.
Figure 45 is shown in which that whether closure casing section 7030 includes allowing the clinician to determine cutting head in it The other end actuator 7016 of the indicator window 7032 of latched position.In this arrangement, if clinician Ke Tong Cross indicator window 7032 and see spring afterbody 6082, then cutting head is not at its latched position.If clinician cannot lead to Cross indicator window 7032 and see spring afterbody 6082, then cutting head is in its latched position.In alternative arrangement structure, indicate Device window 7032 may be provided on such a position (for example, relatively low in casing section is closed) if to cause spring afterbody 6082 is visible by indicator window 7032, then cutting head is in its latched position, and if spring afterbody 6082 is by indicating Device opening is invisible, then cutting head is not at latched position.For auxiliary clinician determines the position of cutting head, cutting head can be with Especially bright color or fluorescence color are provided.These color placements may, for example, be based on radium.Additionally, the color of cutting head can Along its length change allowing the clinician to easily find out its position.
Figure 47 shows the path 7022 entered axially into including the upper end part 6054 provided to cutting head 6050 In observation multiple or a series of indicator openings 7044 anvil block 7020.In embodiment shown in Figure 47, indicator is opened Mouth 7044 is spaced apart with having round-shaped and along anvil block 7020 equal length.In embodiment shown in Figure 48, indicate Device opening 7044 is closer to be spaced apart together at the proximal end of anvil block 7020.Interval between indicator opening 7044 with And moved towards distally and gradually increased in anvil block 7020.However, the size of indicator opening 7044, shape and variable spaced Change.Referring to Figure 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 that one of electric power can be obtained from surgical instruments by through the conductor 6081 of trigger shaft 6080 Or multiple light emitting diodes or other light sources.This arrangement 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 during 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 be improved visual color or the fluorescence labeling offer that the instruction in anvil block is open are provided.For example, color can be Based on radium.Cutting head can alternatively be provided with laser scribe numeral to provide for determining cutting head in passage 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, indicate 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 wavy spring 7202.Wavy spring 7202 extend anvil block 7020 length and with the indicator through it The part of the anvil block 7020 of opening 7044 is at least coextensive.Such as can finding in figures 4-6 can, a series of indicating elements 7206 are attached to Flexible strip 7202 so that each indicating element 7206 is slidably supported in respective indicator opening 7044.Each refers to Show the initial support of device component 7206 in its respective indicator opening 7044 so that it is not from indicator opening projection.Change Sentence is talked about, and wavy spring 7202 is constructed such that indicating element 7206 is biased to wherein described indicating element not from it The initial position that respective indicator opening 7044 protrudes.However, when cutting head 6050 is advanced through end effector towards distally, The top section 6054 of cutting head 6050 along wavy spring 7202 basal sliding and for wavy spring 7202 is upward Biasing so that when cutting head is slided below a part for the wavy spring 7202 attached by indicating element 7206, make finger Show that device component 7206 is protruded from indicator opening 7044, as shown in figure 46.Therefore, which indicator clinician can be by noting Position of the component 7206 from the outstanding monitoring cutting head 6050 in its indicator opening 7044 in end effector.
Therefore, some offers in elongated passageway arrangement disclosed herein are better than existing elongated passageway arrangement Vast improvement.For example, at least some in the elongated passageway arrangement do not use the lower surface for extending through passage Elongated slot.Therefore, this elongated passageway arrangement is often harder and anti-extension during operation.Carried when to clinician For the process for monitoring cutting head device when, also realize these advantages.For example, some elongated passageway arrangements provide edge The cycle for the length of passage is visual to notify clinician's cutting head location in firing cycle.It is described elongated logical At least some in road arrangement are allowed the clinician to when cutting head is in complete deployed position and at cutting head At least a portion of cutting head is seen when fully retracted position.Additionally, in the passage and/or anvil block arrangement at least Some provide at least a portion of cutting heads from the visuality at the side of end effector or top or otherwise provide use In the device of the position that cutting head is found out from the side or top of end effector.
As described above, surgery nail bin is operably supported wherein each supports the one of one or more surgical staples thereon Serial staple drivers.Staple drivers are supported in the nail pit for being arranged to the respective shapes of linear orientation in warehouse.Surgery Nail is supported on driver in which can move so that when driver is driven upwardly in storehouse, and nail is driven through and is clamped in Tissue between storehouse and anvil block and formed with the bottom side of anvil block and contacted.When anvil block is opened, nail is maintained at one with suture tissue Rise.In its respective dimple ' loosely ' being supported on its staple drivers due to nail, therefore nail is it is envisioned that ground makes in nail bin With it is preceding unexpectedly overturned in the case of dropped out from nail bin.To avoid such case from occurring, Cang Gai generally can before using It is attached to nail bin with removing.When storehouse is attached to, storehouse lid covering nail pit is remained at by nail, but regardless of storehouse position such as What.When clinician expects to be installed to storehouse in end effector, lid can be in a pre-installation removed.
Such as discussed further above, staple drivers are sliding by the wedge shape driven towards distally together with cutting head assembly in storehouse Moving part drives up successively.In at least some arrangements, wedge-shaped slides therefore the before firing quilt in untapped storehouse It is orientated to recent side " beginning " position.It is actually also as discussed above, at least some arrangements need wedge-shaped slides (when During in its starting position) interacting to cutting head removal lock and cutting head (when in its latched position) between Positioning puts to make it ready for percussion.However, at least some existing arrangements, storehouse lacks for ensuring wedge-shaped slides Using the device or structure for being preceding maintained at its starting position.Storehouse lid 7250 shown in Figure 64 and Figure 65 can solve such asking Topic.
Figure 64 shows surgery nail bin 7220, and the surgery nail bin has warehouse 7222, and the warehouse is operable wherein Multiple staple drivers (not shown) on each side of the slit 7224 of ground support Longitudinal extending.The slit 7224 of Longitudinal extending It is configured to be conducive to cutting head to be longitudinally travelled through 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 show storehouse lid 7250, The Cang Gai includes top section 7252, and the top section is configured to be covered when storehouse lid 7250 is arranged 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 chamber openings in the platform 7226 of warehouse 7222.Storehouse lid 7250 can be by being configured to retentively connect A pair of flexible attachment arms 7254 for closing warehouse 7222 are attached to nail bin 7220 with can removing.Clinician can be easily by will be soft Property attachment arm 7254 pry open into not remained engaged with warehouse 7222 and remove storehouse lid 7250.Storehouse lid 7250 may also include for positioning The side panel 7255 that a pair of the storehouse lid 7250 in desired locations are extended downwardly on storehouse 7220.For example, side panel 7255 can The antelabium 7227 for extending laterally formed on the every side for being oriented to be bonded on storehouse platform 7226.Storehouse lid 7250 may also include between two parties The positioning flaps 7256 of setting, the positioning flaps are oriented to be received in Longitudinal extending when storehouse lid 7250 is attached to storehouse 7220 Slit 7224 in, as shown in Figure 65.Positioning flaps 7256 include being configured to be retentively engaged wedge-shaped slides 7230 A part and wedge-shaped slides 7230 is maintained at the engagement recesses 7258 of its starting position or one or more of the other shaping Portion.Therefore, when storehouse lid 7250 is installed on nail bin 7220, nail is maintained in its respective dimple, but regardless of the orientation in storehouse 7220 How.Additionally, wedge-shaped slides 7230 are maintained at its starting position.In various arrangements, the size of positioning flaps can phase It is set to for the slit 7224 of Longitudinal extending and set up frictional fit with it.In this arrangement, frictional fit can be used To make lid 7250 be held in place on storehouse 7220, without attachment arm 7254.In other arrangements, positioning is usable in The frictional fit set up between fin 7256 and warehouse 7222 and attachment arm 7254 keeps the lid 7250 on warehouse 7222 In covering position.Additionally, holding rib 7257 can be formed on positioning flaps 7256 being matched somebody with somebody with further setting up friction with warehouse 7222 Close.In addition, as can be seen in Figure 65, the distal end 7221 of surgery nail bin 7220 can have relative to the angulation of storehouse platform 7226 The nose surface 7223 of degree ground orientation.In various arrangements, storehouse lid 7250 may also include and be configured to retentively connect Close 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 of galenic 7220 and including be arranged in the form of hook engage storehouse 7220 distal end 7221 it is remote Side retention tab 7253.Additionally, disengaging fin or projection 7259 can be formed on nose part 7251 to be conducive to retention tab 7253 with the disengaging in storehouse 7220.Therefore, in some arrangements, the distal end of storehouse lid 7250 is configured to allow it Absorb and dive all one's effort for declining and the power is transferred directly to storehouse 7220, and almost not lid 7250 relative to warehouse 7222 Lengthwise movement.This arrangement is used for preventing proximally move sliders 7230 under these conditions of lid 7250.When clinic is cured It is raw to expect during using storehouse 7220, to remove storehouse lid 7250.In at least some arrangements, storehouse lid 7250 can be with reception in nail bin The corresponding particular color of size of the nail in 7220 is provided.
As being discussed in detail above, in various embodiments, surgical staples are supported on and are 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 warehouse and is arranged on receiving Through its cutting element or cutting head path the elongated slot being centrally located each side on Longitudinal extending row In.As being previously discussed as herein, cutting head include wedge-shaped slides or with its common operation, the wedge-shaped slides are adapted to Enough drivers of contact successively are so that driver drives up in its respective dimple.When driver motion upwards in nail bin, One or more surgical staples being supported on are driven upwardly through 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 shaping " surface, " nail shaping " surface generally include to be arranged to by A series of nail shapes pits of the ends contact of nail leg.Pit is set and is shaped so that when being contacted by nail leg, forces leg Portion bends and ultimately forms the closure nail for being approximately similar to " B shapes " around pit.Misalignment of the nail leg in forming process can be led Nail is caused to become deformity, and this can cause undesirable seepage in severe cases.Staple drivers structure shown in Figure 94 and Figure 95 Type can help to keep nail alignment during percussion.If additionally, during percussion, driver in its respective dimple not Holding is properly aligned with, then must produce percussion force higher to fire the nail being supported on.
Figure 94 and Figure 95 show " double " staple drivers 7300.Such as can finding in these figures, staple drivers 7300 include First driver portion 7310 and the second driver portion of " staggeredly " orientation are separated into 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 for the first driver 7310 being divided into the first nearside upright support portion 7320 and the first distally 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 a upper end part 7322, and the upper end part has for being formed wherein One proximal base sections 7324.Similarly, the first distally 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 first for being formed wherein remote Wing base sections 7334.First nearside bottom segment 7324 and the first distally base sections 7334 are aligned and are configured to Wherein support the base portion of surgical staples.Such as can in Figure 94 further finding, when viewed from above, the first nearside upright support portion Dividing 7320 has 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 distally upright support portion 7330 has 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 arrangement, 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 distally 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 the second proximal base sections 7364 for being formed wherein.Similarly, second Distally upright support portion 7370 has the second distal body portion 7371, and second distal body portion has the second distally End 7372, second distal end has the second distally base sections 7374 for being formed wherein.Second proximal base section The distally base sections 7374 of section 7364 and second is aligned and is configured to support wherein the base portion of 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 near less than second The width " PW " of the center width " CW " of side main part 7361.Equally, the second distally upright support portion 7370 has distally End 7376, the distal end has 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.
It is to provide bigger stability, the first driver portion 7310 and second 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.First that the first distally upright support portion 7330 can be also shown in is remote 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 Dividing 7350 can have second nearside group of support column 7368,7369 of the lateral protrusion formed in its second proximal end 7366 7367.Can also be shown in providing lateral protrusion in the second distal end 7376 of the second distally upright support portion 7370 Second distally group 7377 of support column 7378,7379.
As described above, staple drivers 7300 can be supported with moving by the nail pit of the complementary shape in nail bin.Work as wedge shape When sliding part is driven towards distally, its appropriate section drivingly contacts the partition part 7340 that is centrally located and by driver 7300 drive up.It is each in the support column 7328,7329,7338,7339,7368,7369,7378 and 7379 of lateral protrusion In the groove of respective shapes of person's reception in cartridge body and for keeping the alignment of driver 7300 and preventing the drive Dynamic device is distorted during it is advanced towards anvil block.In an arrangement, driver 7300 be molded by solid material or with Other manner is formed.However, in other arrangements, the first driver portion 7310 and the second driver portion 7350 can be Hollow these parts to enable driver 7300 are for slightly flexible and submissive further keeping the driving Alignment of the device in its respective dimple, so as to further reduce required driving force.In any one arrangement, by providing Alignment post on two the two of driver portion ends, further enhances alignment of the driver in its respective dimple.
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 be included by the partition board portion that is 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 is integral type construction, 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 put, first chamber being centrally located 7420 and the first distally 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 first for being formed wherein near Wing base sections 7424.Similarly, the first distally 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 the first distally bottom for being formed wherein Seat sections 7434.First proximal base sections 7424 and the first distally base sections 7434 are aligned and are configured to wherein Support the base portion of surgical staples.Such as can in Figure 96 further finding, the first nearside upright support portion 7420 and the first distally are straight Vertical support section each 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 distally 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 the second proximal base sections 7464 for being formed wherein.Similarly, second Distally upright support portion 7470 has the second distal body portion 7471, and second distal body portion has the second distally End 7472, second distal end has the second distally base sections 7474 for wherein being formed.Second proximal base sections 7464 and second distally base sections 7474 be aligned and be configured to support wherein the base portion of another surgical staples.
It is to provide bigger stability, the first driver portion 7410 and second 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 of formation in the first proximal body portion 7421 First nearside group 7427 of support column 7428,7429.The first of the first distally upright support portion 7430 can be also shown in 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.The second distal body portion 7471 that the second distally upright support portion 7470 can be also shown in above is carried For the second distally group 7477 of the support column 7478,7479 of lateral protrusion.
As described above, staple drivers 7400 can be supported with moving by the nail pit of the complementary shape in nail bin.Work as wedge shape When sliding part is driven towards distally, its appropriate section drivingly contacts the partition part 7440 that is centrally located and by driver 7400 drive up.It is each in the support column 7428,7429,7438,7439,7468,7469,7478 and 7479 of lateral protrusion In the groove of the respective shapes that person is received in cartridge body and for keeping the alignment of driver 7400 and preventing the drive Dynamic device is distorted during it is advanced towards anvil block.In an arrangement, driver 7400 be molded by solid material or with Other manner is formed.However, in other arrangements, the first driver portion 7410 and the second driver portion 7450 can be Hollow these parts to enable driver 7400 are for slightly flexible and submissive further keeping the driving Alignment of the device in its respective dimple, so as to further reduce required driving force.In any one arrangement, by providing Alignment post on two the two of driver portion ends, further enhances alignment of the driver in its respective dimple.
Figure 97 shows the nail or driver pit 7510 formed in the main part 7502 of nail bin 7500.This nail drives Device pit 7510 is configured to be operably supported wherein " list " staple drivers of complementary shape.Such as can be in the drawings Finding, nail pit 7510 is formed with two nearly jamb members 7512,7514 for extending internally and two distally posts for extending internally 7516、7518.Post 7512,7514,7516 and 7518 is configured to slideably extend to and is arranged in staple drivers In respective lateral groove.This driver pit configuration be used for providing further stabilization of the driver when it drives from pit with Alignment.Although Figure 97 shows that the nail or driver that are configured to be operably supported wherein single staple drivers are recessed Hole, but identical concept is applicable to be configured to those driver pits of supporting driver, and the driver is by structure Cause for supporting multiple surgical staples.For example, the support column used in driver embodiment shown in Figure 94 to Figure 96 can quilt The groove of the corresponding post formed in the side for replacing with the nail pit for being configured to be slidably received in warehouse.
As shown in Figure 94 to Figure 96, various driver arrangements substantially may include with outer surface and forward position with after The drive body on edge or drive body part.In various arrangements, the size and dimension of outer surface can be configured to Avoid being supported with outer surface motion any part of the inwall for following closely pit wherein (lateral except what is formed on nail pit Feature structure/the support column of extension) contact.For example, the double staple drivers 7400 shown in Figure 96 include the first driver portion 7410 and second driver portion 7450.The size of the first driver portion 7410 and the second driver portion 7450 can be relative to Nail pit is set such that the part for only being contacted with the inwall of nail pit is the feature structure for extending laterally being formed on, example Such as element 7428,7429,7438,7439,7468,7469.The nearest side end of the first driver portion 7410 may include " front end The farthest side end of portion " and the second driver portion 7450 may include " rearward end ".In another arrangement, for example, preceding The size of end and rearward end can relative to wherein its received into and caused sky between these ends and its respective dimple part Appropriate section setting of the gap less than the nail pit in the space between the other parts of other driver portions and nail pit.This sky The size of gap amount can be configured to improve lateral stability of the driver in activating without in the outer surface of driver and nail Frictional fit is set up between the inwall of pit.In another arrangement, the configuration (for example, size and dimension) 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 for nail pit One or more on leading section and/or rearward end form part (support column) composition.Conversely, can be in leading section and/or rearward end Middle one or more grooves of 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 only one between the activating driver of driver and the inwall of nail pit or Multiple contact points.As described above, driver can generally be supported in warehouse and being arranged on receiving through its cutting element or cutting In Longitudinal extending nail pit on each side for the elongated slot being centrally located for cutting the path of head.In some arrangements In, can be used for using the disclosed herein various drivers of the feature structure of one or more support columns/extend laterally elongated In one or more longitudinal nail pits (or part of longitudinal direction row) on the one or both sides of slit.For example, elongated slot is each This nail pit on side near warehouse edge may include the driver using the forming section of support column/extend laterally, but its Its nail pit can be used legacy drive.This arrangement can also be used together with nail pit 7510.That is, pit 7510 is followed closely In some the longitudinal nail pits (or part of longitudinal direction row) that can be used on the one or both sides of elongated slot.
Tissue flowing can be to cause to follow closely one of problem of deformity.During suturing, tissue not only flowed towards distally but also laterally, Wherein lateral movement is more harmful than lengthwise movement.Using tissue flowing and high compression forces, will nail from its respective dimple laterally and Towards distal guide.By tightening up the cooperation between driver and the storehouse part of neighbouring driver, nail during firing to side or The reduced capability for above waving, because the ability that driver is waved also weakens.Various drivers disclosed herein and nail pit Arrangement is used for making this to wave minimum.The feature structure of support column disclosed herein/extend laterally may be provided at institute There is on driver or is simply to set the driver (for example, the driver in outer row in storehouse) in specific region.This branch The feature structure of dagger/extend laterally can be located on end of the side of such as driver, driver or both.For illustrating this The term " support column " of the driver stabilization arrangement disclosed in text cover 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 for extending laterally of different shapes, described to extend laterally Feature structure be configured to motion be received in be arranged on nail pit inwall in respective shapes groove in (at it In the feature structure of middle support column/extend laterally arrangement on a drive) or in being received in various driver portions ( Wherein the feature structure of support column/extend laterally is from the arrangement of the inwall projection of nail pit), no matter which kind of feelings belonged to Condition.Support column can for example include the single feature structure for extending laterally or its feature for extending laterally that may include multiple alignments Structure.For example, support column can be made up of post fragment or alignment portion/forming section.In other arrangements, other can be used to dash forward Play shape.
For various embodiments disclosed herein, fastener cartridge may include the material layer in implantable patient's body. Such layer may include such as one or more fid tablets and/or one or more tissue thickness compensation parts.It is filed in Entitled " including nail bin (the STAPLE CARTRIDGE of the nail being positioned in its compressible portion in April 29 in 2011 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 includes proximal end 8012, distal end 8014 and in the and of proximal end 8012 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 also includes being defined in securing member chamber therein, and the securing member chamber is each configured to Such as fastener (such as following closely) can wherein be stored.Each securing member chamber includes proximal end and distal end.It is tight with each The distal end in firmware chamber is compared, the proximal end of each securing member chamber closer to warehouse 8010 proximal end 8012, 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 protuberance extended from platform 8016.In all cases, protuberance can be with Any suitable arrangement arrangement.For example, distal projections 8017 can with the distal end adjacent positioned of securing member chamber and it is near Side protuberance 8019 can be with the proximal end adjacent positioned of securing member chamber.Similar to above-mentioned, distal projections 8017 and/or nearside Protuberance 8019 is configured to guide fastener of the storage 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 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 8026 proximal end 8022 it is neighbouring or positioned relative to the proximal end 8012 of warehouse 8010 and distal end 8024 it is neighbouring or 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 one or more securing member chambers being defined in warehouse 8010.In the case of at least one is such, layer Main body 8026 is included in 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 as to layer 8020 is remained into 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 to be defined in the hole being aligned with protuberance that is extending from platform 8016 therein.For example, layer Main body 8026 may include the distal aperture 8027 being aligned with least some distal projections 8017 and/or be protruded with least some distally The proximal aperture 8029 of the alignment of portion 8019.In all cases, the size and configuration quilt of distal aperture 8027 and distal projections 8017 It is set such that there is space therebetween.Similarly, the size and configuration of proximal aperture 8029 and proximal projections 8019 can be set Into so that there is space therebetween.In some cases, the size and configuration of distal aperture 8027 and distal projections 8017 can be set Determine into and cause there is interference fit therebetween.In addition, similarly, the size and configuration of proximal aperture 8029 and proximal projections 8019 can It is set so that there is interference fit therebetween.In the case of at least one is such, the interference fit between protuberance and hole can Layer 8020 is releasably held into warehouse 8010.In use, fastener of the storage in warehouse 8010 can fastener from Contact layer 8020 when warehouse 8010 is ejected and lifts away from platform 8016 and make hole be disengaged with protuberance layer 8020 Part 8025.
Layer main body 8026 may include each to be configured to receive distal projections 8017 and proximal projections wherein 8019 hole 8028.Each hole 8028 may include to have and be configured to the proximal end and quilt that receive distal projections 8017 It is constructed to be permeable to the elongated slot of the distal end of reception proximal projections 8019.In some cases, can hole 8028 with it is prominent Go out between portion 8017 and 8019 to exist space cooperation.In some cases, can be between hole 8028 and protuberance 8017 and 8019 There is interference fit and releasably hold warehouse 8010 with by layer 8020.In the case of at least one, the size in hole 8028 and Configuration can be configured to stretching to accommodate distal projections 8017 and proximal projections 8019 wherein.
Layer 8020 is attached to warehouse 8010 with can removing.In some cases, the distal end 8024 of layer 8020 It is attached to the distal end 8014 of warehouse 8010 with can removing.In some cases, the proximal end 8022 of layer 8020 It is attached to the proximal end 8012 of warehouse 8010 with can removing.In at least one example, using attachment part Layer 8020 is releasably held warehouse 8010 by 8021.
For example layer (such as backing material) can be made up 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.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, PEO, polyacrylamide, poly-hydroxyethyl methyl acrylate, polyvinylpyrrolidone, Polyvinyl alcohol, polyacrylic acid, poly- acetic acid esters, polycaprolactone, polypropylene, aliphatic polyester, glycerine, poly- (amino acid), copolymerization (ether Ester), polyalkylenes oxalates, polyamide, poly- (iminocarbonic ester), polyalkylenes oxalates, polyoxaesters, poe, Polyphosphazene and its copolymer, block copolymer, homopolymers, blend and/or combinations thereof.
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, carboxymethylcellulose calcium, shitosan, chitosan and/ Or combinations thereof.Natural biological copolymer can combine to prepare backing material with other polymeric materials as herein described.Can Formed using the collagen (for example, I types pig or bovine collagen, I types people's collagen or type III people's collagen) of the mankind and/or animal origin Backing material.What backing material can be made up of by such as denatured collagen or mainly the non-hydrated a chains of the molecular weight close to 100kDa Heating is passed through or any other method has lost the collagen of its helical structure and has been made at least in part.Term " denatured collagen " refers to The collagen of its helical structure is lost.For porous layer as herein described collagen can as a example by particular such as such as pass through pepsin Digestion and/or the native collagen or Atelocollagen that are obtained after the appropriate heating of such as previous definition (atellocollagen).Collagen may previously pass through to aoxidize, methylate, 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 to be suitable to knitting or braiding long filament or line, or can be short Fiber, for example, be usually used in preparing the chopped fiber of non-woven material.Fiber can be made up of any biocompatible materials.Fiber can be by Natural material or synthetic material are formed.It can be bioabsorbable or not bioabsorbable to form the material of fiber.Should manage Solution, can be used natural, synthesis, bioabsorbable and not bioabsorbable material any combination to form fiber.Can be made into fibre Some non-limiting examples including but not limited to poly- (lactic acid) of the material of dimension, poly- (glycolic), poly- (butyric ester), poly- (phosphine piperazine), polyester, polyethylene glycol, PEO, polyacrylamide, poly-hydroxyethyl methyl acrylate, polyvinylpyrrolidone, Polyvinyl alcohol, polyacrylic acid, poly- acetic acid esters, polycaprolactone, polypropylene, aliphatic polyester, glycerine, poly- (amino acid), copolymerization (ether Ester), polyalkylenes oxalates, polyamide, poly- (iminocarbonic ester), polyalkylenes oxalates, polyoxaesters, poe, Polyphosphazene and its copolymer, block copolymer, homopolymers, blend and/or combinations thereof.It is the feelings of fiber in backing material Under condition, backing material can be used and suitably form any method of fibre structure and formed, including but not limited to for example knitting, compile Knit, nonwoven techniques etc..In the case where backing material is foam, porous layer can be used and suitably form any of foam or sponge Method is formed, it may for example comprise but it is not limited to the lyophilized and freeze-drying of such as composition.
Backing material can have hemostatic properties.Can be used to provide with auxiliary stop bleed or bleeding ability fid 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, FN, elastin laminin, albumin, hemoglobin, ovalbumin, polysaccharide, hyaluronic acid, chondroitin sulfate, hydroxyl second Base starch, hydroxyethyl cellulose, cellulose, oxycellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethylcellulose calcium, Shitosan, chitosan, agarose, maltose, maltodextrin, alginates, clotting 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 combinations thereof.Use to natural biological copolymer and particularly albumen is applicable In backing material of the formation with hemostatic properties.Suitable natural biological copolymer includes but is not limited to such as collagen, gelatin, blood Fibrin, fibrinogen, elastin laminin, keratin, albumin and/or combinations thereof.Natural biological copolymer can Combine to prepare the porous layer of supporter with any other styptic.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 in the entitled " surgical stapling device with individually different closures and trigger system of on 2 21st, 2006 Tool (SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS United States Patent (USP) 7,000,818) ";
It is published in September, 2008 entitled " motor driving surgery cuts and the fastener with tactile position feedback of 9 days Tool (MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK) " United States Patent (USP) 7,422,139;
Being published in the entitled of on December 16th, 2008 " has the electromechanical surgical apparatus of closed-system and anvil block aligning parts (ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS) " United States Patent (USP) 7,464,849;
Being published in the entitled of on March 2nd, 2010 " has the surgical instruments (SURGICAL of articulating end effector 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;
It is entitled " to there is surgical instruments (the SURGICAL INSTRUMENT HAVING RECORDING of registering capacity CAPABILITIES U.S. Patent Application Serial Number 11/343,803 (being now United States Patent (USP) 7,845,537)) ";
It is filed in entitled " surgery cuts and fastening instrument (SURGICAL with RF electrodes of on 2 14th, 2008 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 the end effector (END of surgery cuts and 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)) ";
Be filed on December 24th, 2009 it is entitled " have electric actuator Direction Control Unit motor drive surgery 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 in September, 2012 entitled " nail bin (the STAPLE CARTRIDGE) " of 29 days Number 12/893,461 (being now United States Patent (USP) 8,733,613);
It is filed in entitled " surgery suturing appliance (the SURGICAL STAPLING of on 2 28th, 2011 INSTRUMENT U.S. Patent Application Serial Number 13/036,647 (being now United States Patent (USP) 8,561,870)) ";
It is entitled " to there is surgery suturing appliance (the SURGICAL STAPLING that rotatable nail disposes arrangement INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS) " U.S. Patent Application Serial Number 13/118,241 (being now U.S. Patent Application Publication 2012/0298719);
Be filed on June 15th, 2012 it is entitled " including percussion drive device joint motions surgical instruments 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;
Being filed in the entitled of on January 31st, 2006 " has the surgery cuts and fastener of closure trigger locking mechanism Tool (SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM U.S. Patent Application Publication 2007/0175955) ";And
Being filed in the entitled of on April 22nd, 2010 " has the surgery suturing appliance of articulating end effector 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).
Although elaborating the various embodiments of device with reference to some disclosed embodiments herein, can implement to this Many modifications of a little embodiments and modification.In addition, in the case of the open material for being used for some parts, other materials can be used Material.Additionally, according to multiple embodiments, single part can be replaced by multiple parts, and multiple parts can also be replaced by Single part, to perform one or more given function.Described above and the claims below are intended to all these repairing Change and modification.
Apparatus as disclosed herein is designed to be dropped after a single use, or it is designed to using many It is secondary.However, in either case, can prosthetic device reused with after use at least one times.Reparation may include following Any combination of step:Provision for disengagement, then cleans or replaces specific component and then re-assemblied.Specifically, Detachable apparatus, and any number of specific component or the portion of device are optionally replaced or removed in any combination Part.After cleaning and/or replacing particular elements, device can be re-assemblied for then at restoration facilities or just in surgical operation Used by operating team before.Those skilled in the art will be appreciated that the reparation of device can utilize it is various for dismantling, clean/ The technology replaced and re-assembly.The use of such technology and gained prosthetic device are within the scope of application.
Preferably, invention as herein described will be processed before surgical operation.First, obtain and if necessary clear Clean new or used apparatus.Then can be to sterilization of instruments.In a kind of disinfection technology, by apparatus be placed on such as polybag or In the closing and sealing container of TYVEK bag.Then being placed on apparatus and container can penetrate such as γ radiation, the x-ray of container Or in the radiation field of high energy electron.Bacterium in radiation kill apparatus and in container.Then sterilized apparatus storage can be existed In sterile chamber.Sealing container makes apparatus keep aseptic, until it is opened in medical facilities.
Although the present invention has been described as with exemplary design, the present invention can enter in the spirit and scope of the disclosure One step is modified.Therefore, the application be intended to use its General Principle of the invention any modification, using or modification. Additionally, the application be intended to belong to it is known or usual practice such relative to the disclosure in art of the present invention Deviate.
By reference in full or partly any patent, announcement or other open materials for being incorporated herein only simultaneously It is incorporated herein in existing definition, statement or the afoul scope of other open materials that the material for entering is not proposed with the disclosure. Similarly and under necessary degree, the disclosure being expressly recited herein instead of be herein incorporated by reference any Conflict material.It is any to be herein incorporated by reference but mutually rushed with existing definition as herein described, statement or other open materials Prominent material or part thereof, is incorporated to this under the degree for not producing conflict only between the material being incorporated to and existing open material Text.

Claims (18)

1. a kind of end effector, including:
First jaw, first jaw includes fastener cartridge, wherein the fastener cartridge includes:
Warehouse, the warehouse includes being configured to the platform of supporting tissue;
Securing member chamber, the securing member chamber is defined in the warehouse;With
Fastener, the fastener is positioned in the securing member chamber in which can remove;And second jaw, second jaw Including anvil block, wherein the anvil block includes:
Tissue scaffold surface, the tissue scaffold surface is configured to supporting tissue;
Forming pit, the forming pit is configured to deform the fastener;With
Anvil block protuberance, the anvil block protuberance extends from the tissue scaffold surface, and the anvil block protuberance is adapted to Flowing of enough control tissues relative to the tissue scaffold surface and the platform.
2. end effector according to claim 1, wherein second jaw can be rotationally coupled to described first Jaw.
3. end effector according to claim 1, wherein the securing member chamber is arranged to first longitudinal direction chamber row and the Two longitudinal chambers are arranged, wherein the anvil block protuberance is arranged to first longitudinal direction anvil block row and second longitudinal direction anvil block row, wherein described First longitudinal direction anvil block is arranged and is aligned with first longitudinal direction chamber row, and wherein described second longitudinal direction anvil block row and the second longitudinal direction Chamber row's alignment.
4. end effector according to claim 3, wherein the anvil block protuberance in first longitudinal direction anvil block row By the first High definition, wherein the anvil block protuberance in second longitudinal direction anvil block row is by the second High definition, and its Described in the first height be different from described second height.
5. end effector according to claim 1, wherein the fastener cartridge also includes the storehouse extended from the platform Protuberance.
6. end effector according to claim 5, wherein the storehouse protuberance is aligned with the anvil block protuberance.
7. end effector according to claim 1, wherein the anvil block protuberance extends between the securing member chamber.
8. a kind of end effector, including:
First jaw, first jaw includes fastener cartridge, wherein the fastener cartridge includes:
Warehouse, the warehouse includes being configured to the platform of supporting tissue;
Securing member chamber, the securing member chamber is defined in the warehouse;With
Fastener, the fastener is positioned in the securing member chamber in which can remove;And second jaw, second jaw Including anvil block, wherein the anvil block includes:
Tissue compression surface, the tissue compression surface is configured to supporting tissue;
Forming pit, the forming pit is configured to deform the fastener;With
Organizational controls device, the organizational controls device extends from the tissue compression surface, and the organizational controls device is used for Flowing of the control tissue relative to the tissue compression surface and the platform.
9. end effector according to claim 8, wherein second jaw can be rotationally coupled to described first Jaw.
10. end effector according to claim 8, wherein the securing member chamber is arranged to first longitudinal direction chamber row and the Two longitudinal chambers are arranged, wherein the organizational controls device includes that being arranged to first longitudinal direction anvil block arranges prominent with second longitudinal direction anvil block row Go out portion, wherein first longitudinal direction anvil block row is aligned with first longitudinal direction chamber row, and wherein described second longitudinal direction anvil block row Row is aligned with the second longitudinal direction chamber.
11. end effectors according to claim 10, wherein the anvil block in first longitudinal direction anvil block row is protruded Portion is by the first High definition, wherein the anvil block protuberance in second longitudinal direction anvil block row is by the second High definition, and Wherein described first height is different from the described second height.
12. end effectors according to claim 8, wherein the fastener cartridge also includes the storehouse extended from the platform Protuberance.
13. end effectors according to claim 12, wherein the storehouse protuberance and the tissue flow control apparatus Alignment.
14. end effectors according to claim 8, wherein the dynamic control device of the flow of tissue the securing member chamber it Between extend.
A kind of 15. end effectors, including:
First jaw, first jaw includes fastener cartridge, wherein the fastener cartridge includes:
Warehouse, the warehouse includes being configured to the platform of supporting tissue;
Securing member chamber, the securing member chamber is defined in the warehouse;
Fastener, the fastener is positioned in the securing member chamber in which can remove;With
First expander, first expander extends from the platform, wherein when the fastener from the securing member chamber top When going out, first expander supports the fastener at least in part;And
Second jaw, second jaw includes anvil block, wherein the anvil block includes:
Tissue scaffold surface, the tissue scaffold surface is configured to supporting tissue;
Forming pit, the forming pit is configured to deform the fastener;
With
Second expander, second expander extends from the tissue scaffold surface, wherein when the fastener is from described tight When firmware chamber ejects, second expander supports the fastener at least in part.
16. end effectors according to claim 15, wherein each described first expander are at least partly about tight Firmware chamber, and wherein each described at least partly about forming pit of second expander.
17. end effectors according to claim 15, wherein when the fastener is ejected from the securing member chamber, institute State the first expander and second expander operates to support the fastener altogether.
A kind of 18. end effectors, including:
First jaw, first jaw includes fastener cartridge, wherein the fastener cartridge includes:
Warehouse, the warehouse includes being configured to the platform of supporting tissue;
Securing member chamber, the securing member chamber is defined in the warehouse;
Fastener, the fastener is positioned in the securing member chamber in which can remove;With
First securing member chamber expander, the first securing member chamber expander extends from the platform, wherein when the fastener When being ejected from the securing member chamber, the first securing member chamber expander supports the fastener at least in part;And
Second jaw, second jaw includes anvil block, wherein the anvil block includes:
Tissue scaffold surface, the tissue scaffold surface is configured to supporting tissue;
Forming pit, the forming pit is configured to deform the fastener;With
Second securing member chamber expander, the second securing member chamber expander extends from the tissue scaffold surface, wherein working as institute State fastener from the securing member chamber eject when, the second securing member chamber expander supports the fastener at least in part.
CN201580032322.7A 2014-04-16 2015-04-14 End effector including anvil having projections extending therefrom Active CN106714705B (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US201461980339P 2014-04-16 2014-04-16
US61/980,339 2014-04-16
US14/319,014 2014-06-30
US14/319,014 US10542988B2 (en) 2014-04-16 2014-06-30 End effector comprising an anvil including projections extending therefrom
PCT/US2015/025642 WO2015160730A2 (en) 2014-04-16 2015-04-14 End effector comprising an anvil including projections extending therefrom

Publications (2)

Publication Number Publication Date
CN106714705A true CN106714705A (en) 2017-05-24
CN106714705B CN106714705B (en) 2020-01-17

Family

ID=58551670

Family Applications (1)

Application Number Title Priority Date Filing Date
CN201580032322.7A Active CN106714705B (en) 2014-04-16 2015-04-14 End effector including anvil having projections extending therefrom

Country Status (3)

Country Link
JP (1) JP6605497B2 (en)
CN (1) CN106714705B (en)
BR (1) BR112016023849B1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109199496A (en) * 2017-07-05 2019-01-15 柯惠Lp公司 Operation stapling instrument

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5452837A (en) * 1994-01-21 1995-09-26 Ethicon Endo-Surgery, Inc. Surgical stapler with tissue gripping ridge
EP1316290A2 (en) * 2001-11-28 2003-06-04 Ethicon Endo-Surgery (Europe) GmbH Surgical stapling instrument
US20070034667A1 (en) * 2005-08-15 2007-02-15 Holsten Henry E Surgical stapling instruments including a cartridge having multiple staple sizes
EP1917918A2 (en) * 2006-11-03 2008-05-07 Tyco Healthcare Group, LP Surgical stapling instuments including a cartridge having multiple staple sizes
US7604151B2 (en) * 2007-03-15 2009-10-20 Ethicon Endo-Surgery, Inc. Surgical stapling systems and staple cartridges for deploying surgical staples with tissue compression features
WO2012050798A1 (en) * 2010-09-29 2012-04-19 Ethicon Endo-Surgery, Inc. Staple cartridge
CN102525585A (en) * 2007-11-06 2012-07-04 Tyco医疗健康集团 Coated surgical staples and an illuminated staple cartridge for a surgical stapling instrument

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5480089A (en) * 1994-08-19 1996-01-02 United States Surgical Corporation Surgical stapler apparatus with improved staple pockets
US6953138B1 (en) * 2004-02-18 2005-10-11 Frank W. Dworak Surgical stapler anvil with nested staple forming pockets

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5452837A (en) * 1994-01-21 1995-09-26 Ethicon Endo-Surgery, Inc. Surgical stapler with tissue gripping ridge
EP1316290A2 (en) * 2001-11-28 2003-06-04 Ethicon Endo-Surgery (Europe) GmbH Surgical stapling instrument
US20070034667A1 (en) * 2005-08-15 2007-02-15 Holsten Henry E Surgical stapling instruments including a cartridge having multiple staple sizes
EP1917918A2 (en) * 2006-11-03 2008-05-07 Tyco Healthcare Group, LP Surgical stapling instuments including a cartridge having multiple staple sizes
US7604151B2 (en) * 2007-03-15 2009-10-20 Ethicon Endo-Surgery, Inc. Surgical stapling systems and staple cartridges for deploying surgical staples with tissue compression features
CN102525585A (en) * 2007-11-06 2012-07-04 Tyco医疗健康集团 Coated surgical staples and an illuminated staple cartridge for a surgical stapling instrument
WO2012050798A1 (en) * 2010-09-29 2012-04-19 Ethicon Endo-Surgery, Inc. Staple cartridge

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109199496A (en) * 2017-07-05 2019-01-15 柯惠Lp公司 Operation stapling instrument
CN109199496B (en) * 2017-07-05 2023-08-29 柯惠Lp公司 surgical stapling device

Also Published As

Publication number Publication date
BR112016023849A2 (en) 2017-08-15
BR112016023849B1 (en) 2022-09-27
JP6605497B2 (en) 2019-11-13
JP2017511221A (en) 2017-04-20
CN106714705B (en) 2020-01-17

Similar Documents

Publication Publication Date Title
CN106456158B (en) Fastener cartridge including non-uniform fastener
CN106456176B (en) Fastener cartridge including the extension with various configuration
CN106456159B (en) Fastener cartridge assembly and nail retainer lid arragement construction
BR112016023694B1 (en) FASTENER CARTRIDGE
CN107106170B (en) Fastener cartridge including the tissue engaging member that can be disposed
CN106456161B (en) Stablize the surgical fastener storehouse of arrangement with driver
CN106456160B (en) Surgical end-effector with percussion element monitoring arragement construction
RU2692973C2 (en) Cassette of surgical stapling instrument comprising recesses for fasteners, including control elements
CN106714705A (en) End effector comprising an anvil including projections extending therefrom
CN106413576B (en) Fastener cartridge including being attached to layer thereon
CN106456175B (en) Fastener cartridge including organizational controls feature structure

Legal Events

Date Code Title Description
PB01 Publication
PB01 Publication
SE01 Entry into force of request for substantive examination
GR01 Patent grant
GR01 Patent grant