CN108135602A - Including the surgical instruments of the system of correct sequence operation for being used to ensure surgical instruments - Google Patents

Abstract

The invention discloses a kind of surgical instruments, the surgical instruments includes tissue grasping system, nail trigger system and tissue diced system.The system of the surgical instruments can be fitted to each other that the system is prevented to be operated and/or prevented the system to be operated with worthless sequence with reverse sequence.

Description

Including the surgical instruments of the system of correct sequence operation for being used to ensure surgical instruments

Background technology

The present invention relates to surgical instruments, and in various embodiments, be related to surgical stapling and cutting device and with Its nail bin being used together.

Suture instruments may include the elongated nip component of a pair of of collaborative work, wherein each jaw member is adapted for insertion into patient It positions in vivo and relative to be stapled and/or incision tissue.In various embodiments, one of jaw member can prop up Support wherein accommodates the nail bins of at least two staples laterally separated, and another jaw member can support and have and nail bin In staple alignment nail shapes pit anvil block.In general, suture instruments may also include push rod and blade, the push rod and knife Piece can be slided relative to jaw member with via on the cam face on push rod and/or the wedge-shaped slides by push rod promotion Cam face will be followed closely and continuously be projected from nail bin.In at least one embodiment, cam face is configured to start By storehouse carrying and multiple staple drivers associated with nail, so that nail is pushed to be resisted against on anvil block and is being held on jaw member Between tissue in form the deformation staple laterally separated.In at least one embodiment, blade can follow cam face And cut tissue along the route between staple.

The current various aspects of the relevant technologies in the field of the invention only for the purpose of illustration discussed above, without should It is considered as the negative to right.

Description of the drawings

The various feature structures and its advantage of the embodiment described herein can with reference to drawings described below according to be described below come Understood：

Fig. 1 is the perspective view according to the surgery suturing appliance of at least one embodiment；

Fig. 2 is the perspective view of the surgery suturing appliance of Fig. 1, and the component of wherein surgery suturing appliance is removed for diagram Purpose；

Fig. 3 is point according to the surgery suturing appliance including shank, axis and end effector of at least one embodiment Solve perspective view；

Fig. 4 be shown at not clamping, the broken section front view of the shank of Fig. 3 of non-percussion configuration；

Fig. 5 be shown at clamping, non-percussion configuration Fig. 3 shank broken section front view；

Fig. 6 be shown at clamping, part percussion configuration Fig. 3 shank broken section front view；

Fig. 7 be shown at clamping, complete firing configuration Fig. 3 shank broken section front view；

Fig. 8 is the broken section front view back to the shank of Fig. 3 before non-clamp configuration；

Fig. 9 be according to the surgery suturing appliance including shank, axis and end effector of at least one embodiment just View；

Figure 10 is the decomposition perspective view of nail bin being used together with the surgery suturing appliance of Fig. 9；

Figure 11 is the perspective view for showing just to be assembled to the nail bin of Figure 10 of the surgery suturing appliance of Fig. 9；

Figure 12 is the nail bin for the Figure 10 for showing to be located in the end effector of the surgical instruments of Fig. 9 and shows in folder Hold the sectional view of the end effector of configuration；

Figure 13 is the nail bin for the Figure 10 for showing to be located in the end effector of the surgical instruments of Fig. 9 and shows to pass through Trigger system moves to the sectional view of the staple drivers of the end effector of percussion configuration；

Figure 14 is the nail bin for the Figure 10 for showing to be located in the end effector of the surgical instruments of Fig. 9 and show can be with The sectional view for the staple drivers that trigger system is operatively disengaged；

Figure 15 is the nail bin for the Figure 10 for showing to be located in the end effector of the surgical instruments of Fig. 9 and shows to pass through The sectional view of the cutting element of trigger system actuating；

Figure 16 is according to the exploded view of the surgery suturing appliance of at least one embodiment, which is shown Component has been removed to illustrate purpose；

Figure 17 is the detail drawing of the progress indicator of the surgery suturing appliance of Figure 16；

Figure 18 is the sectional view for being shown at clamping but the end effector of the surgery suturing appliance of non-percussion configuration；

Figure 19 is the sectional view of the end effector for the Figure 18 for being shown at nail percussion pattern；

Figure 20 is the sectional view of the end effector of Figure 18, shows that the end effector follows closely percussion pattern and tissue at it Conversion between cut mode.

Figure 21 is the sectional view for the end effector for being shown at its Figure 18 for organizing cut mode；

Figure 22 is according to the exploded view of the surgery suturing appliance of at least one embodiment, which is shown Component has been removed to illustrate purpose；

Figure 23 be shown at not clamping, the partial sectional view of the surgery suturing appliance of Figure 22 of non-percussion configuration；

Figure 23 A are the detail drawing of the transmitting device of the surgery suturing appliance of Figure 22；

Figure 24 is the broken section of the surgery suturing appliance of Figure 22 of the clamp configuration before being shown at firing schedule Figure；

Figure 25 is the broken section of the surgery suturing appliance for the Figure 22 for being shown at the clamp configuration after firing schedule Figure；

Figure 26 be clamping before being shown at cross-section stroke, percussion configuration Figure 22 surgery suturing appliance part Sectional view；

Figure 27 be shown at clamping after cross-section stroke, percussion configuration Figure 22 surgery suturing appliance part Sectional view；

Figure 28 is the perspective view of the transmitting device of the surgery suturing appliance of Figure 22；

Figure 28 A are another perspective view of the transmitting device of Figure 28；

Figure 29 is according to the exploded view of the surgery suturing appliance of at least one embodiment, which is shown Component has been removed to illustrate purpose；

Figure 30 be shown at not clamping, the partial sectional view of the surgery suturing appliance of Figure 29 of non-percussion configuration；

Figure 30 A be shown at corresponding to not clamping shown in Figure 30, Figure 29 of the configuration of non-percussion configuration it is outer The detail drawing of the transmitting device of section's suture instruments；

Figure 31 be shown at clamping, non-percussion configuration Figure 29 surgery suturing appliance partial sectional view；

Figure 31 A be shown at correspond to Figure 31 shown in clamping, non-percussion configuration configuration Figure 29 surgery The detail drawing of the transmitting device of suture instruments；

Figure 32 is the surgery suturing appliance for being shown at wherein following closely the Figure 29 for the clamp configuration just disposed from surgical instruments Partial sectional view；

Figure 32 A be shown at correspond to Figure 32 shown in clamping, percussion configuration configuration Figure 29 surgery seam The detail drawing of the transmitting device of clutch tool；

Figure 33 is to be shown at wherein organizing just by the surgical stapling device of Figure 29 of the cross-section clamp configuration of surgical instruments The partial sectional view of tool；

Figure 33 A be shown at correspond to Figure 33 shown in clamping, percussion configuration configuration Figure 29 surgery seam The detail drawing of the transmitting device of clutch tool；

Figure 34 is according to the exploded view of the surgery suturing appliance of at least one embodiment, which is shown Component has been removed to illustrate purpose；

Figure 35 be in do not clamp, the partial sectional view of the surgery suturing appliance of Figure 34 of non-percussion configuration；

Figure 36 is the partial sectional view of the surgery suturing appliance of Figure 34 of the clamp configuration before firing schedule；

Figure 37 be clamping before cross-section stroke, percussion configuration Figure 34 surgery suturing appliance broken section Figure；

Figure 38 be clamping after cross-section stroke, percussion configuration Figure 34 surgery suturing appliance broken section Figure；

Figure 39 is according to the exploded view of the surgery suturing appliance of at least one embodiment, which is shown Component has been removed to illustrate purpose；

Figure 40 is the partial sectional view of the shank of the surgery suturing appliance for the Figure 39 for being shown at non-clamp configuration；

Figure 41 is the partial sectional view of the shank for the Figure 40 for being shown at tissue suture operation mode；

Figure 42 is the partial sectional view of the shank for the Figure 40 for being shown at percussion configuration；

Figure 43 is the partial sectional view of the shank of Figure 40, shows the shank just in its tissue suture operation mode and tissue Switch between cross-section operation mode；

Partial sectional views of the Figure 44 for the shank of Figure 40 after the cross-section stroke of tissue；

Figure 45 is according to the partial sectional view of the surgery suturing appliance of at least some embodiments, the surgery suturing appliance packet Nail trigger shaft, blade bar and locking piece, the locking piece is included to be configured to hit when blade bar is promoted relative to trigger shaft Hair bar is held in place；

The locking piece that Figure 46 shows the trigger shaft of Figure 45 in firing position and is located in behind nail trigger shaft；

Figure 47 shows the blade bar of Figure 45 in firing position；

Figure 48 shows the locking piece of Figure 45, which is disengaged such that trigger shaft can be retracted with nail trigger shaft；

Figure 49 is the surgical stapling device for including being capable of the locking piece of manual releasing according at least one optionally embodiment The partial sectional view of tool；

Figure 50 is according at least one optionally surgery suturing appliance for being shown at non-clamp configuration of embodiment Partial sectional view；

Figure 51 is the partial sectional view of the surgery suturing appliance for the Figure 50 for being shown at clamp configuration；

Figure 52 is the partial sectional view of the surgery suturing appliance for the Figure 50 for being shown at nail percussion configuration；

Figure 53 is the partial sectional view of the surgery suturing appliance for the Figure 50 for being shown at tissue cutting configuration；

Figure 54 is to be configured to continuously percussion nail and cut capture holding according at least one embodiment The local perspective view of the end effector of tissue in portion's actuator, the end effector be shown component be removed for Illustrate purpose；

Figure 55 is the local perspective view of the end effector for the Figure 54 for being shown at nail percussion operation mode；

Figure 56 is the local perspective view of the end effector for the Figure 54 for being shown at the cross-section operation mode of tissue；

Figure 57 is the partial cut-away perspective view according to the end effector of at least one embodiment；

Figure 58 is the partial cut-away perspective view of the end effector for the Figure 57 for being shown at nail percussion operation mode；

Figure 59 is the local perspective view of the end effector for the Figure 57 for being shown at the cross-section operation mode of tissue；

Figure 60 is the partial sectional view according to the surgery suturing appliance of at least one embodiment；

Figure 61 is the partial sectional view of the surgery suturing appliance for the Figure 60 for being shown at nail percussion operation mode；

Figure 62 is the surgery suturing appliance of Figure 60 changed between nail percussion operation mode and the cross-section operation mode of tissue Partial sectional view；

Figure 63 is the partial sectional view of the surgery suturing appliance of Figure 60 in its cross-section operation mode of tissue；

Figure 64 is the office according to the surgery suturing appliance for being shown at part cock of at least one embodiment Portion's sectional perspective view；And

Figure 65 is the broken section front view of the surgery suturing appliance for the Figure 64 for being shown at part cock.

In several views, corresponding reference mark indicates corresponding component.Exemplifications set out herein is with a kind of shape Formula shows various embodiments of the present invention, and this example is not necessarily to be construed as the model limiting the invention in any way It encloses.

Specific embodiment

Present applicant possesses following patent application, and the patent application is submitted and each with the application in same date From being incorporated by reference being incorporated herein：

Entitled " SURGICAL INSTRUMENT COMPRISING SEPARATE TISSUE SECURING AND The U.S. Patent Application Serial Number of TISSUE CUTTING SYSTEMS " _ _ _ _ _ _ _ _ _ _ (attorney number END7668USNP/150103)；

Entitled " SURGICAL INSTRUMENT COMPRISING SYSTEMS FOR PERMITTING THE The U.S. Patent Application Serial Number of OPTIONAL TRANSECTION OF TISSUE " _ _ _ _ _ _ _ _ _ _ (attorney number END7669USNP/150104)；And

Entitled " SURGICAL INSTRUMENT COMPRISING A SYSTEM FOR BYPASSING AN The U.S. Patent Application Serial Number of OPERATIONAL STEP OF THE SURGICAL INSTRUMENT " _ _ _ _ _ _ _ _ _ _ (generation Manage people file number END7670USNP/150105).

Many details are listed herein, to provide to whole with attached embodiment shown in figure described in specification Body structure, function, the thorough understanding of manufacture and purposes.Well known operation, component and element are not described in, in order to avoid make explanation Embodiment described in book is smudgy.Reader will appreciate that embodiment described and illustrated herein is shown to be nonrestrictive Example, so as to can be appreciated that, specific structural and functional details disclosed herein can be representative and illustrative.Power is not being departed from In the case of the range of profit requirement, variations and modifications can be carried out to these embodiments.

Term " comprising " (and any form of " comprising ", such as " including (comprises) " and " including (comprising) "), " with " (and any form of " with ", such as " with (has) " and " with (having) "), " packet Containing " (and any form of "comprising", such as " include (includes) " and " comprising (including) ") and " containing " (and Any form of " containing ", such as " contain (contains) " and " containing (containing) ") for open link-verb.Cause This, " comprising ", " with ", "comprising" or " containing " one or more elements surgery system, device or equipment with these one A or multiple element, but it is not limited to that only there are these one or more elements.Equally, " comprising ", " having ", "comprising" or " contain Having " element of the systems of one or more features, device or equipment has those one or more features, but be not limited to only have There are those one or more features.

Term " nearside " and " distal side " are herein defined as coming relative to the clinician for the handle portions for manipulating surgical instruments It uses.Term " nearside " refers near the part of clinician, and term " distal side " refers to position far from clinician Part.It is also understood that for the sake of succinct and be clear, can be used herein with reference to attached drawing such as " vertical ", " level ", " on " and " under " etc. spatial terminologies.However, surgical instruments uses in many directions and position, and these terms and unrestricted And/or absolute.

Various exemplary means and method are provided for performing laparoscopic type and minimally invasive surgical procedures.However, it reads Person it will be readily understood that various method and apparatus disclosed herein can be used for a variety of surgical operations and application in, including for example with Open surgery combines.With continued reference to present embodiment, reader will be further understood that, various devices disclosed herein Tool can be inserted into body in any way, by natural cavity, pass through the notch being formed in tissue or puncturing hole etc..Device The working portion or end effector portion of tool can be inserted directly into patient body or can be filled by entering with service aisle Insertion is put, the end effector and elongated shaft of surgical instruments may pass through service aisle propulsion.

Certain previous surgery suturing appliances are disclosed in following patents：

It is filed in entitled " the LINEAR STAPLER WITH IMPROVED FIRING on March 12nd, 1997 The European Patent Application No. 795298 of STROKE "；

It is published in entitled " the TRIGGER MECHANISM FOR SURGICAL of on 2 25th, 1997 The United States Patent (USP) 5,605,272 of INSTRUMENTS "；

It is published in entitled " the LINEAR STAPLER WITH IMPROVED FIRING on December 16th, 1997 The United States Patent (USP) 5,697,543 of STROKE "；

It is published in entitled " the METHOD FOR MAKING A SURGICAL STAPLER's " on November 10th, 2005 U.S. Patent Application Publication 2005/0246881；

It is published in the U.S. Patent application of in September, 2007 entitled " the METHOD FOR STAPLING TISSUE " of 6 days Announce 2007/0208359；

It is published in entitled " the DISPOSABLE LINEAR SURGICAL STAPLING on July 9th, 1985 The United States Patent (USP) 4,527,724 of INSTRUMENT "；

It is published in August, 1992 entitled " the FAST CLOSURE DEVICE FOR LINEAR SURGICAL of 11 days The United States Patent (USP) 5,137,198 of STAPLING INSTRUMENT "；And it is published in the entitled of 11 days April nineteen ninety-five The United States Patent (USP) 5 of " FLEXIBLE SUPPORT SHAFT ASSEMBLY ", 405,073, the complete disclosures of these patents with Way of reference is incorporated herein.

Surgery suturing appliance 100 is disclosed in Fig. 1 and Fig. 2.Instrument 100 includes shank 110, the axis extended from shank 110 140 and end effector 150.Shank 110 include shell 111, the frame 114 for extending through axis 140, closure trigger 120, With firing trigger 130.The operation of closure trigger 120 make end effector 150 open configuration (Fig. 1) and closed configuration it Between move.Referring primarily to Fig. 2, closure trigger 120 can be pivotally mounted to shank shell 111 and wrap around pivot 121 Drive part 122 is included, the drive part 122 is in closure trigger 120 when open position (Fig. 1) is moved between closed position It is rotated towards distal side.Closure trigger 120 is the part for being closed driver, which further includes connector 123 and close Close bar 126.Connector 123 can rotatably be pinned to the drive part 122 of closure trigger 120, and couple around pin 124 Part 123 can rotatably be pinned to closed rod 126 around pin 125.When the drive part 122 of closure trigger 120 is revolved towards distal side When turning, drive part 122 drive closed rod 126 so that end effector 150 nail bin 160 towards end effector 150 anvil block 170 movements, so that tissue is clamped between nail bin 160 and anvil block 170 during the closing stroke for being closed driver.Driving portion 122 are divided to include being defined in locked groove 127 therein, which is configured to reach its folder completely in closure trigger 120 The distal end 117 of closed-lock part 112 is received when holding position.Closed-lock part 112 can rotatably pacify around pivot pin 113 It is attached to shank shell 111 and the drive part of closure trigger 120 is biased against by biasing member such as spring 122。

The operation of firing trigger 130 fires the nail being removedly stored in nail bin 160 towards anvil block 170.Referring primarily to Fig. 2, firing trigger 130 can be pivotally mounted to shank shell 111 and including drive part, the drive around pivot 131 Dynamic part is rotated in firing trigger 130 when unactuated position (Fig. 1) is moved between actuated position towards distal side.Percussion triggering Device 130 is the part for firing driver, which further includes trigger shaft 136, and the trigger shaft 136 is in firing trigger 130 are driven when being moved towards its actuated position towards distal side.Percussion driver further includes staple drivers and cutting element, nail driving Device and cutting element are promoted during the firing schedule of percussion driver by trigger shaft 136 towards distal side.Frame 114, closed rod 126 and trigger shaft 136 surrounded or at least substantially surrounded by shaft housing 144.

Shank 110 may also include percussion return spring, which is configured to complete in firing schedule Into, and firing trigger 130 has been made firing trigger 130 back to its unactuated position to incite somebody to action after clinician's release Trigger system resets.Similarly, shank 110 may also include closure return spring, which is configured to Closed-lock part 112 has been depressed by clinician so that closed-lock part 112 triggers closure after being disengaged with locked groove 127 Device 120 back to its open position and resets closed system.

Embodiment with reference to being disclosed in Fig. 1 and Fig. 2, firing trigger 130 are activated in firing trigger 130 It is sutured in single stroke and cuts the tissue being clamped in end effector 150.In addition, it is disclosed in the implementation in Fig. 1 and Fig. 2 Scheme does not provide what is suspended between the nail percussion function of trigger system and tissue cutting function to the clinician of operation instrument Ability.In addition, instrument is not just performing nail forming function to clinician's offer about instrument still organizes any of cutting function Feedback.Provided hereinafter the various improvement to the instrument.

Surgery suturing appliance 200 is shown in Fig. 3-Fig. 8 and is similar to instrument 100 and/or herein institute's public affairs in many aspects The other surgical instruments opened.For example, referring primarily to Fig. 4, instrument 200 includes closure trigger 120, which exists Closed rod 126 is driven to be closed the end effector of instrument 200 towards distal side when activateding.The actuating of closure trigger 120 will also The trigger shaft 236 of trigger system is advanced to preset position towards distal side at least partly, and wherein firing trigger 130 then can be caused The dynamic nail bin percussion nail with from positioning in the end effector.Firing trigger 130 includes drive part 132, the drive part 132 are aligned in trigger shaft 236 once its preset position is had been moved to the proximal end of trigger shaft 236 133.At this point, now Referring to Fig. 5, firing trigger 130 can be activated so that trigger shaft 236 moves toward the far side and from nail bin percussion nail.However, it hits It sends out the actuating of trigger 130 and the distal side of trigger shaft 236 is promoted by 280 limitation of retainer or switch.Switch 280 is in trigger shaft 236 cross-section captures stop trigger shaft 236 distal side before the tissue in end effector promotes.For transected tissue, switch 280 activated to discharge trigger shaft 236, as shown in Figure 6 so that the firing schedule of percussion actuator 130 can be completed, such as Fig. 7 institutes Show.By this method, the percussion of nail and the cross-section of tissue may include the independent and discrete operating procedure of instrument 200.In such feelings Under condition, clinician may be selected when to cut tissue and/or whether cut tissue.

It is as discussed above, and referring primarily to Fig. 5, stop hitting by switch 280 during the distal side of trigger shaft 236 promotes Send out bar 236.Trigger shaft 236 includes being defined in slit 285 therein, and switchs 280 and be removably positioned in slit 285. Switch 280 can be pivotally mounted to shank shell 111 and the locking including being located in slit 285 around pivot pin 281 Arm 282.Trigger shaft 236 can be promoted by firing trigger 130 towards distal side, until the proximal end of slit 285 contacts lock arm 282.It is prevented at this point, the further distal movement of trigger shaft 236 is locked arm 282.Spring 284 is located in lock arm 282 and handle Lock arm 282 is biased in slit 285 and is held in place lock arm 282, Zhi Daokai between portion's shell 111 It closes 280 to activated, as shown in Figure 6.When switch 280 is activated, lock arm 282 rotates out of slit 285 and trigger shaft 236 can It is then promoted again towards distal side, as shown in Figure 7.When the terminal of trigger shaft 236 towards its firing schedule promotes, lock arm 282 is not It is aligned again with slit 285, and lock arm 282 is biased against the bottom surface of trigger shaft 236 by spring 284.When trigger shaft 236 exists When organizing to bounce back towards its non-firing position after being cut, lock arm 282 can be aligned with slit 285 again, and spring 284 Lock arm 282 can be biased in slit 285.

Apart from the above, it follows closely and has been fully formed when trigger shaft 236 is switched on and off 280 stopping.In such cases, it is firing The cut portion of bar 236 is pushed into so that before cutting tissue, tissue can be fixed by nail completely.It is susceptible to wherein follow closely in trigger shaft 236 are switched on and off the alternative embodiment only partly shaped during 280 stopping.In such embodiment, organize to have shaped in nail Into while be cut.In either case, the pause after the first step in providing the operation of instrument 200, this Need the intervention of clinician with selectively decide whether perform second step, even if the two steps pass through trigger one It is secondary to activate to perform.In other words, switch 280 stops firing trigger 130 during the actuation stroke of firing trigger 130, And switching 280 locking function must fail before actuation stroke can be completed.It can be when clinician thinks suitable Between carry out Operation switch 280.In some cases, it can immediately operate after 280 stopping trigger shaft 236 of switch or alternatively exist Operation switch 280 after a period of time.In some cases, can before trigger shaft 236 is stopped Operation switch 280, thus permit Perhaps first step and second step are selectively combined.

Apart from the above, clinician can remove or not in the intervals provided by switch 280 from firing trigger 130 Remove their hand.In either case, it is desirable to trigger shaft 236 be prevented suddenly and/or unexpectedly to bounce back.For this purpose, device Tool 200 further includes locking piece 290, which is configured to trigger shaft 236 being releasably retained in appropriate location. Locking piece 290 includes ratchet system；However, any suitable locking piece can be used.Locking piece 290 can around pivot pin 291 Shell 111, and the pawl 292 including extending from it are rotatably mounted to, which is configured to engagement and is defined in Hook tooth 295 in trigger shaft 236.Locking piece 290 is further included among proximal arm 293 and proximally positioned arm 293 and shell 111 Spring 294, which is configured to be biased to engage with tooth 295 by pawl 292.When pawl 292 and tooth 295 connect During conjunction, locking piece 290 is configured to that trigger shaft 236 is allowed to move toward the far side but trigger shaft 236 is prevented proximally to move.Device The shank 210 of tool 200 further includes switch 296, the switch 296 be configured to the proximal arm 293 of engagement latch 290 and Pawl 292 is made to be pivoted away from trigger shaft 236 and pawl 292 is made to be disengaged with tooth 295.At this point, trigger shaft 236 can be retracted.

For the trigger shaft 236 that bounces back, clinician can push closed-lock part 112 so that closed-lock part 112 is with being closed Trigger 120 is disengaged and closure trigger 120 is made to move to its unactuated position (Fig. 4) and/or shank 210 It may include being configured to being biased to closure trigger 120 return spring of its unactuated position.In either case Under, the movement of closure trigger 120 towards its unactuated position can proximally pull connector 123, this then can proximally be pulled Closed rod 126 and trigger shaft 236.More specifically, the pin 125 of connection connector 123 extends also through and is defined in 126 He of closed rod Longitudinal hole in trigger shaft 236, the longitudinal hole 129 being such as defined in trigger shaft 236, and when connector 123 be closed it is tactile Hair device 120 is when proximally pulling, pin 125 can contact hole 129 proximal end and the longitudinal hole being defined in closed rod 126 it is near Side end, and proximally pull trigger shaft 236 and closed rod 126.The proximal movement of trigger shaft 236 can also push percussion to activate Device 120 can not activate position by return spring back to its unactuated position and/or percussion actuator 120 back to it It puts.In either case, once trigger shaft 236 has returned to its unactuated position, so that it may by towards distal side pull switch 296 are resetted locking piece 290 so that pawl 292 is allowed to be re-engaged with tooth 295.

Apart from the above, pawl 292 is configured to generate when pawl 292 slides in the tooth 295 of trigger shaft 236 Audible sound, such as click sound.Such audible sound can provide trigger shaft 236 for surgeon and just move toward the far side Feedback.Such audible sound can also provide the feedback of the speed about trigger shaft 236 for surgeon, because with very fast The sound that sends out of rhythm will indicate that trigger shaft 236 will just referred to the sound that faster speed moves and is being sent out with slower rhythm Show trigger shaft 236 and just moved with slower speed.

Surgery suturing appliance 300 is shown in Fig. 9-Figure 15 and is similar to instrument 100,200 and/or this paper in many aspects Disclosed other surgical instruments.Instrument 300 includes end effector 350, which includes nail bin 360 and anvil Seat 170.In use, tissue, which is located between nail bin 360 and anvil block 170 and then by the tissue pin 379 that can be disposed, catches It obtains in end effector 350.Tissue pin 379 is stored in the pin chamber 378 of nail bin 360 and is moved towards distal side to anvil block 170. When nail bin 360 moves to closed position, tissue pin 379 can be pushed towards distal side, following article further discusses in more detail.Tissue Pin 379 includes lateral clamping member 377, which is configured to that clinician is allowed to push away towards anvil block 170 It moves pin 379 and/or retracts to pin 379 in nail bin 360.Nail bin 360 includes being defined in lateral slit 375 therein, should Lateral slit 375 is configured to guiding clamping components 377 and organizes the longitudinal movement of pin 379.Organize pin 379 movement by Anvil block 170 and proximal end plate 376 limit.

Referring primarily to Fig. 9, instrument 300 further includes closure trigger 120, and the closure trigger 120 is when activateding towards remote Side drive closed rod 126 with the end effector 350 that is closed instrument 300 and by tissue be clamped in nail bin 360 and anvil block 170 it Between.Instrument 300 further includes firing trigger 130, the firing trigger 130 when activateding towards distal side push trigger shaft 336 with Nail is projected from the nail bin 360 being located in end effector 350.Referring to Figure 10-Figure 15, nail bin 360 includes warehouse 361, should Warehouse 361 includes multiple nail cavity 361a, 361b and is defined in blade slots 366 therein.Nail cavity 361a is located in blade slots 366 the first side, and nail cavity 361b is located in the second side of blade slots 366.Although being not shown, nail is stored in nail cavity It is penetrated in 361a, 361b and when staple drivers 362 are moved by trigger shaft 336 towards anvil block 170 by nail from nail cavity 361a, 361b Go out.Staple drivers 362 include the multiple nail support elements or stent that are configured to the nail that driving is stored in nail cavity 361a 362a and it is configured to the multiple nail support elements of the nail that is stored in nail cavity 361b of driving or stent 362b.Staple drivers 362 Further include be configured to by the motion control of staple drivers 362 and/or be tied to longitudinal path longitudinal rail 368a and 368b。

Apart from the above, nail bin 360 includes the cutting element or blade that can be slidably positioned in blade slots 366 367.Staple drivers 362 include the first blade latch 364a and the second blade latch 364b, the first blade latch 364a and the Two blade latch 364b are configured to blade 366 and staple drivers 362 being releasably retained in together, and following article is more detailed Described in ground.Staple drivers 362 include the first pivot fitting 363a and the second pivot fitting 363b.First blade latch 364a can It is rotatably located in the first pivot fitting 363a, and the second blade latch 364b can rotatably be located in the second pivot and connect In head 363b.First blade latch 364a and the second blade latch 364b being capable of they are engaged with blade 367 wherein clamping It is rotated between position (Figure 12 and Figure 13) and the non-clip position (Figure 14 and Figure 15) that wherein they are disengaged with blade 367. When the first blade latch 364a and the second blade latch 364b are in its clip position, staple drivers 362 and blade 367 are together Movement.In use, staple drivers 362 and blade 367 are pushed towards distal side by trigger shaft 336 so that nail is in non-firing position It is moved between (Figure 12) and firing position (Figure 13).Such as it is appreciated that from Figure 13 when staple drivers 362 move to its firing position When, the cutting edge of blade 367 does not expose to cut tissue of the capture between warehouse 361 and anvil block 170 from warehouse 361.Phase Instead, blade 367 is in the stage position below the platform surface of warehouse 361.

As it can be seen that trigger shaft 336 contacts the first blade latch 364a and the second blade latch 364b such as in Figure 12 and Figure 13 To push staple drivers 362 towards distal side.Referring to Figure 11-Figure 13, the first blade latch 364a can be discharged with blade support member 369 Ground engages so that the action of staple drivers 362 can be transferred to blade 367.More specifically, the first blade latch 364a includes determining Ridge 365a of the position in the groove 369a in being defined in blade support member 369, and similarly, the second blade latch 364b includes The ridge 365b being located in the groove 369b being defined in blade support member 369.It is corresponding that ridge 365a, 365b are fixedly accommodated in it Groove 369a, 369b in so that the driving force delivered by trigger shaft 336 be transferred to staple drivers 362 and blade 367 so that Nail is deformed against anvil block 170.Ridge 365a, 365b and groove 369a, 369b be configured to so that ridge 365a, 365b keep with Groove 369a, 369b are engaged, until reaching threshold force, wherein blade latch 364a, 364b are moved outwardly away from blade branch at this time Support member 369, as shown in Figure 14 and Figure 15.Threshold force may include nail is for example made to be fully formed required power.At this point, trigger shaft 336 It is no longer able to operatively engage with staple drivers 362, and trigger shaft 336 can be moved toward the far side relative to staple drivers 362.It hits Hair bar 336 then can be in direct contact blade support member 369 to drive blade 367 and transected tissue towards anvil block 170.Such as in Figure 15 In as it can be seen that blade 367 moves after staple drivers 362 detach with blade 367 relative to staple drivers 362.

Apart from the above, the trigger system of instrument 300 includes two independent and discrete steps：First or nail the percussion stage With second or tissue-cutting phase.The operation of blade latch 364a, 364b limit the boundary between the two stages.When blade is fastened with a bolt or latch When lock 364a, 364b are clamped to blade 367, trigger system is in it and follows closely cock.When blade latch 364a, 364b are not clamped During blade 367, trigger system is in it and organizes cut state.The two stages are independent and discrete and are not present between the two Overlapping；It is envisaged however that the embodiment of at least some overlappings wherein may be present between the two stages.

Surgery suturing appliance 400 be shown in Figure 16 and Figure 17 and in many aspects be similar to instrument 100,200,300 and/ Or surgical instruments disclosed herein.For example, instrument 400 includes shank 410, which includes shell 411, the shell 411 It is similar to shell 111 in many aspects.Instrument 400 further includes closed rod 126, which also makes nail bin apart from the above It moves to organize to be clamped between the two towards anvil block.As discussed above, closure trigger 120 is activated so that closed rod 126 It moves toward the far side.Additionally as discussed above, closure trigger 120 also pushes away trigger shaft 136 when closure trigger 120 is activated Enter preset position.Firing trigger 130 then can be activated so that trigger shaft 136 is moved toward the far side and fired from nail bin Nail, and it is then cut into tissue.Accordingly, it can be said that trigger shaft 136 is in all three modes of operation, (closed operation state, nail are hit Hair mode of operation and tissue incision mode of operation) during move toward the far side.Instrument 400 further includes the operation shape of display apparatus 400 The progress indicator of state, as discussed in more detail below.

Apart from the above, referring primarily to Figure 17, progress indicator includes the line of demarcation 418 on trigger shaft 136.Line of demarcation 418 include the protrusion laterally extended from trigger shaft 136；However, in the case that various other, line of demarcation 418 may include for example The label being printed on trigger shaft 136.Progress indicator, which further includes, to be located in the window 414 being defined in shank shell 411 Progress bar 415.Progress bar 415 includes the label 416 of three modes of operation corresponding to instrument 400.For example, label 416 wraps Include the first label " clamping " corresponding to tissue clipping operation state, the second label " seam corresponding to nail percussion mode of operation Conjunction " and the third label " cutting " corresponding to tissue incision mode of operation.Progress bar 415 is further included corresponding to mode of operation Three lines 417 completed.In use, the line of demarcation 418 on trigger shaft 136 when closing stroke has been completed with First Line 417 Alignment as shown in figure 17, is aligned when nail is fired completely with the second line 417, and when cutting stroke and having completed and the Three lines 417 are aligned.In other words, when trigger shaft 136 is promoted towards distal side, line of demarcation 418 is moved toward the far side along progress bar 415 To indicate the progress of trigger shaft 136.The operator of surgical instruments 400 can be by the window 414 that is defined in shank shell 411 Observe this type games in line of demarcation 418.In at least one embodiment, progress bar associated with clipping operation state 415 parts can be that the first color is such as green, and 415 part of progress bar associated with nail percussion mode of operation can be the second color Such as yellow, and 415 part of progress bar associated with tissue incision mode of operation can be that third color is such as red.Another In the embodiment of choosing, progress bar 415 may be mounted to trigger shaft 136, and line of demarcation 418 can extend from shank shell 411.

Surgery suturing appliance 500 is shown in Figure 18-Figure 21.Instrument 500 in many aspects be similar to instrument 100,200, 300, and/or 400.Instrument 500 includes end effector 550, which includes nail bin 560 and anvil block 170.Nail Storehouse 560 includes warehouse 561, which includes being defined in nail cavity 561a therein.Nail is removedly stored in nail cavity 561a In.Nail bin 560 further includes staple drivers 562, which includes pusher 562a, and pusher 562a is configured to Nail can be made to be moved towards anvil block 170 and project nail from nail cavity 561a.Instrument 500 further includes trigger shaft 536, the trigger shaft 536 are configured to push staple drivers 562 towards distal side to anvil block 170.Staple drivers 562 include nearside stretch flange formability 564, The nearside stretch flange formability 564 is engaged when trigger shaft 536 is promoted towards distal side by trigger shaft 536.When end effector 550 is in not When clamping but non-percussion configuration, as shown in figure 18, flange 564 is located in the channel 568 being defined in storehouse 561.In fact, Flange 564 is inwardly bent or biases and slided along side wall when staple drivers 562 are moved toward the far side by the side wall of channel 568 It is dynamic.Flange 564 engages with channel side wall in the entire firing schedule of nail and is maintained at its inwardly flexure position by channel side wall It puts.The terminal of nail firing schedule is shown in Figure 19.

Nail bin 560 further includes the cutting element being located in can moving in the blade slots 566 being defined in warehouse 561 567.Cutting element 567 includes base portion 569, which is clamped between flange 564 so that when staple drivers 562 are fired Bar 563 towards distal side drive when, cutting element 567 moves together with staple drivers 562.Referring again to Figure 19, it illustrates nails to hit Issue the terminal of journey, it should be understood that cutting element 567 does not expose also from warehouse 561.Therefore, instrument 500 nail percussion operation with The tissue incision operation of instrument 500 is independent and discrete.When flange 564 discharges cutting element 567, instrument 500 is followed closely at it Percussion operates and it organizes incision to change between operating.By comparing Figure 19 and Figure 20, it should be understood that when the nearside of flange 564 When end is no longer inwardly biased by the side wall of channel 568,564 outside lateral bending of flange.More specifically, flange 564 once leave it is logical The just flexure outward of the distal end 565 in road 568.At this point, flange 564 is no longer engaged with cutting element 567.In addition, at this point, flange 564 no longer engage with trigger shaft 536, therefore trigger shaft 536 no longer can push staple drivers 562 towards distal side.On the contrary, work as trigger shaft 536 towards distal side promote when, trigger shaft 536 can directly be contacted with the base portion of cutting element 567 569 and towards distal side promote cutting structure Part 567, as shown in figure 21, with tissue of the cross-section capture between anvil block 170 and nail bin 560.

Apart from the above, the point that instrument 500 is converted between nail percussion operation mode and tissue cutting actions pattern depends on In the distance that trigger shaft 536 has moved.Other instruments disclosed herein for example pass through the trigger shaft of instrument depending on transmitting Power and nail percussion operation mode and tissue cutting actions pattern between convert.Both conversion sides can be used in certain embodiments The combination of formula.

Surgery suturing appliance 600 is shown in Figure 22-Figure 28 A.Instrument 600 in many aspects be similar to instrument 100,200, 300th, 400,500, and/or other surgical instruments disclosed herein.Instrument 600 includes shank 610, which includes quilt It is constructed to be permeable to operation closed system or organizes the closure trigger 620 of grasping system and be configured to operation trigger system Firing trigger 630.Closure trigger 620 can rotate between unactuated position (Figure 24) and actuated position (Figure 25). The closed system of instrument 600 is similar to the closed system of instrument 100 in many aspects, and no longer superfluous herein for brevity It states.In all cases, instrument 600 includes locking system, which prevents firing trigger 630 in closure trigger Actuating before 620 actuatings.

Apart from the above, closure trigger 620 includes drive part 622, which pushes connector towards distal side 123 by the end effector of surgical instruments 600 to be clamped to tissue.Drive part 622 is narrow including being defined in gap therein Slot 628 so that drive part 622 can be moved relative to the axis 634 for extending through clearance slot 628.

The trigger system of instrument 600 is independent and discrete with closed system.There are two independent and discrete for trigger system tool Operating function, that is, nail percussion function and tissue incision function.Nail percussion function appears in the first cause of firing trigger 630 During dynamic, and incision function is organized to appear in the second activating of firing trigger 630.It is similarly as described above, percussion Trigger 630 can be rotationally coupled to shell 111 around pivot 131.Referring primarily to Figure 23, Figure 23 A, Figure 28 and Figure 28 A, hit Hair trigger 630 includes the gear parts 632 being engaged with pinion gear 633.Pinion gear 633 is installed to axis 634, the axis 634 It can be rotatably mounted to shank shell 111.More specifically, pinion gear 633 is installed to the first part 634a of axis 634 so that Pinion gear 633 and shaft portion 634a rotate together.Therefore, firing trigger 630 actuating or rotation make pinion gear 633 and first Shaft portion 634a rotates.

Referring again to Figure 28 and Figure 28 A, axis 634 further includes second part 634b, and the second part 634b can be in spine It is selectively engaged at wheel interface 639 with first part 634a.When the second shaft portion divides 634b that can be operated with first part 634a When ground engages, the rotation of first part 634a is transferred to second part 634b and first axle part 634a and the second shaft portion divide 634b rotates together.Output pinion 635 is installed to the second shaft portion and divides 634b so that pinion gear 635 divides 634b with the second shaft portion It rotates together.Pinion gear 635 is engaged with the rack 637 being defined in the proximal end of trigger shaft 636.In use, it is existing Referring to Figure 25, ratchet interface 639 is configured to that spinning movement is transferred to percussion when firing trigger 630 is activated Bar 636 and towards distal side driving trigger shaft 636 (the direction D in Figure 28).

Apart from the above, referring again to Figure 25, the first actuating of firing trigger 630 towards distal side push trigger shaft 636 with Percussion nail.First actuating after, the releasable firing trigger 630 of surgeon and allow return spring can with fire touch Hair device 630 operatively couples so that firing trigger 630 returns to its non-firing position, as shown in figure 26.Alternatively, surgery is cured Life can manually make firing trigger 630 return to its unactuated position.In either case, ratchet interface 639 is by structure Cause when firing trigger 630 returns to its non-firing position to allow first axle part 634a relative to the second shaft portion point 634b rotates.More specifically, first axle part 634a includes hook tooth, which returns to it not in firing trigger 630 It is slided during actuated position relative to being defined in the correspondence hook tooth that the second shaft portion divides on 634b.In order to adapt to such relative motion, First axle part 634a, which is allowed to move away from the second shaft portion, divides 634b.Shank 610 further includes biasing member such as spring, this is partially Put component be configured to make once its unactuated position has been returned in firing trigger 630 first axle part 634a with The second shaft portion divides 634b to be re-engaged.

Referring again to Figure 26, reader should be appreciated that trigger shaft 636 during the first stroke of firing trigger 630 only Partly promoted.Such part of the trigger shaft 630 during the first stroke of firing trigger 630, which promotes, to be made to be stored in instrument Nail in 600 end effector is fired or is fully formed, but its tissue of not cross-section capture in end effector.Ginseng now See Figure 27, firing trigger 630 can be activated to be fully advanced trigger shaft 630 and transected tissue for the second time.As above it is general It states, actuating or rotation driving pinion 633, the axis 634 and output pinion 635 of firing trigger 630 are hit with being promoted towards distal side Send out bar 636.In all cases, surgeon may be selected not transected tissue and can unclamp tissue after percussion nail on the contrary. In such cases, surgeon will not second of actuating firing trigger 630.In all cases, above in association with instrument 600 The teachings can be used with reference to such as instrument 400 and/or 500.

Surgery suturing appliance 700 is shown in Figure 29-Figure 33 A.Instrument 700 in many aspects be similar to instrument 100,200, 300th, 400,500,600, and/or other surgical instruments disclosed herein.Instrument 700 includes shank 710, which wraps It includes and is configured to operation closed system or organizes the closure trigger 620 of grasping system and be configured to operation percussion The firing trigger 630 of system.Closure trigger 620 can revolve between unactuated position (Figure 30) and actuated position (Figure 31) Turn.The closed system of instrument 700 is similar to the closed system of instrument 100 in many aspects, and for brevity herein no longer It repeats.In all cases, instrument 700 includes locking system, which prevents firing trigger 630 in closure trigger Actuating before 620 actuatings.

The trigger system of instrument 700 is independent and discrete with closed system.There are two independent and discrete for trigger system tool Operating function, that is, nail percussion function and tissue incision function.Following article is further described in more detail, firing trigger 630 Actuating perform two functions.Firing trigger 630 can be rotatably mounted to shank 710 around pivot 131, and fire and touch It sends out device 630 and includes gear parts 632.The tooth of gear parts 632 is engaged with pinion gear 733, which surrounds axis 734 can be rotationally mounted in shank 710.Axis 734, which further includes, is installed to its two cam protrusions, that is, the first cam Protruding portion 735a and the second cam protrusion 735b.First cam protrusion 735a is configured to engage and nail is promoted to fire Bar 736a, and the second cam protrusion 735b is configured to engage and promotes tissue cutter bar 736b.Cam protrusion 735a, 735b are installed to axis 734 so that they are rotated together with axis 734.

Before firing trigger 630 is activated, referring to Figure 31, the first cam protrusion 735a is with being defined in nail trigger shaft The first cam face 737a alignments in the proximal end of 736a, and the second cam protrusion 735b is with being defined in tissue cutting The second cam face 737b alignments in the proximal end of bar 736b.First cam protrusion 735a and the second cam protrusion 735b is installed to axis 734 with false relation.When firing trigger 630 is in its unactuated position, as shown in figure 31, first is convex Wheel protruding portion 735a is positioned adjacent to the first cam face 737a, and the second cam protrusion 735b and the second cam face 737b is spaced apart.

Apart from the above, firing trigger 630 activated nail to be driven to hit during the single stroke of firing trigger 630 Send out bar 736a and tissue cutter bar 736b.The first part of firing trigger actuating drives nail trigger shaft 736a towards distal side, and The second part of firing trigger actuating drives tissue cutter bar 736b towards distal side.The first part and the of firing trigger actuating Two parts are not overlapped.In other words, nail percussion process has been completed before tissue cutting process starts.In use, first is convex The slope 738a of wheel protruding portion 735a is moved distally nail trigger shaft 736a, until slope 738a passes through the first cam face 737a.At this point, the pressurize portion 739a of the first cam protrusion 735a is aligned, and follow closely trigger shaft with the first cam face 737a 736a is no longer promoted by the first cam protrusion 735a towards distal side.In various other embodiments, the first cam protrusion The pressurize portion 739a of 735a can complete nail forming process.In such cases, the slope 738a of the first cam protrusion 735a is opened The nail forming process that begins and pressurize portion 739a complete nail forming process.In at least one, slope 738a is than pressurize portion 739a completes more nail forming processes.In such cases, nail promptly grasps tissue and is then slowly closed to incite somebody to action Tissue is completely fixed wherein.Alternatively, pressurize portion 739a completes more nail forming processes than slope 738a.In such feelings Under condition, the squeeze pressure applied by nail can be applied in longer period, this preferably can allow fluid to be shaped in nail Tissue is flowed out during journey.In either case, the second cam protrusion 735b passes through between pressurize portion 739a and slope 738a It separates.When axis 734 is rotated by percussion actuator 630, as shown in Figure 32 and Figure 32 A, the second cam protrusion 735b is rotated to It is contacted with the second cam face 737b and completes nail cutting process, as shown in Figure 33 and Figure 33 A.

In all cases, apart from the above, instrument 700 may include retainer, the retainer define nail percussion process with Organize the transformation between cutting process.Retainer can for example be cut after nail trigger shaft 736a has been fully advanced and in tissue Cut the movement that percussion actuator 630 is prevented or prevented before bar 736b is pushed into.Shank 710 may include retainer release device, The retainer release device allows surgeon to complete to fire the firing schedule of actuator 630 once activateding.Such reality The scheme of applying allows surgeon to choose whether to carry out the tissue cutting function of instrument 700.In some cases, instrument 700 can Sensory feedback is generated when firing transition point of the actuator 630 across nail percussion function and tissue cutting function, is such as listened Feel and/or touch feedback.

In various alternative embodiments, apart from the above, tissue cutting process can be with nail forming process at least partly Ground is overlapped.In such embodiment, the first cam protrusion 735a and the second cam protrusion 735b position and are arranged in axis On 734 so that the first cam protrusion 735a can drive while the second cam protrusion 735b drives tissue cutter bar 736b Dynamic nail trigger shaft 736a.

Apart from the above, percussion actuator 630 can return to after it has been activated with percussion nail and/or incision tissue Its unactuated position.Shank 710 may include with the return spring that engages of percussion actuator 630, the return spring biased so that It fires actuator 630 and returns to its unactuated position.In addition to or replace it is described above, instrument 700 may include and bar 736a, 736b One or more biasing members of engagement, the one or more biasing member are configured to return to bar 736a, 736b Its non-firing position.When firing actuator 630 back to its unactuated position, gear parts 632 make pinion gear 733, axis 734 Rotated with cam protrusion 735a, 735b along opposite direction so that cam protrusion 735a, 735b respectively with bar 736a, 736b is disengaged.

Surgery suturing appliance 800 is shown in Figure 34-Figure 38.Instrument 800 in many aspects be similar to instrument 100,200, 300th, 400,500,600, and/or 700 and/or other surgical instruments disclosed herein.Instrument 800 includes shank 810, the handle Portion 810 includes being configured to operation closed system or organizes the closure trigger 620 of grasping system.Instrument 800 further includes It is configured to the firing trigger 830a of operation nail trigger system and is configured to cutting for operation tissue diced system Cut trigger 830b.Closure trigger 620 can rotate between unactuated position (Figure 35) and actuated position (Figure 36).Instrument 800 closed system is similar to the closed system of instrument 100 in many aspects, and repeats no more herein for brevity. In the case of various, instrument 800 includes locking system, which prevents firing trigger 830a and/or cutting trigger Actuatings of the 830b before the actuating of closure trigger 620.

The trigger system of instrument 800 is independent and discrete with closed system.The actuating operation nail of firing trigger 830a Trigger system is so that the nail deformation being removedly stored in the end effector of instrument 800.Firing trigger 830a surrounds pivot Axis 131 can be rotatably mounted to shank 810 between non-firing position (Figure 36) and firing position (Figure 37).Firing trigger 830a includes the curved cam component 832a from its extension, and the curved cam component 832a is when firing trigger 830a is activated It moves toward the far side, as shown in figure 36.When cam member 832a is promoted towards distal side, cam member 832a contact stud trigger shafts 836a Proximal end 837a, to drive the nail being removedly stored in the end effector of instrument 800 and to make its deformation.

The diced system of instrument 800 is independent and discrete with trigger system and closed system.Cut trigger 830b's Actuating operates tissue diced system to cut tissue of the capture in the end effector of instrument 800.Cutting trigger 830b encloses Shank 810 can be rotatably mounted between unactuated position (Figure 37) and actuated position (Figure 38) around pivot 131.Cutting is touched It sends out device 830b and includes the curved cam component 832b extended from it, which is caused in cutting trigger 830b It is moved toward the far side when dynamic, as shown in figure 38.When cam member 832b is promoted towards distal side, cam member 832b contact tissue cuttings The proximal end 837b of bar 836b is to cut tissue.

Percussion actuator 830a is rotated through the first motion range to complete the firing schedule of trigger shaft 836a, and cut It cuts actuator 830b and is rotated through the second motion range to complete the cutting stroke of cutter bar 836b.Firing schedule is gone with cutting Journey has identical length or at least substantially identical length；It is envisaged however that wherein the length of firing schedule is different from cutting Cut other embodiments of the length of stroke.In addition, the first motion range of percussion actuator 830a and cutting actuator 830b The second motion range it is identical or at least substantially identical；It is envisaged however that wherein the first motion range is different from the second movement Other embodiments of range.

Referring again to Figure 37 and Figure 38, percussion actuator 830a includes being defined in groove 839 therein.Groove 839 is by structure It causes to receive wherein or receives cutting actuator 830b at least partly.As shown in figure 36, as percussion actuator 830a When being in its unactuated position with cutting actuator 830b, cutting actuator 830b is nested together with percussion actuator 830a. When percussion actuator 830a moves to its actuated position, as shown in figure 37, actuator 830a, 830b can be because cutting actuator 830b is positively retained at its unactuated position and becomes non-nested.Then, the actuating of cutting actuator 830b can make actuator 830b is nested together again with percussion actuator 830a, as shown in figure 38.

Apart from the above, independent and discrete actuator 830a, 830b allow the nail trigger system and tissue of instrument 800 Diced system is selectively operated in a manner of independent and is discrete.Nonetheless, surgeon has activates instrument 800 simultaneously The selection of actuator 830a, 830b.In such cases, instrument 800 will suture and cut simultaneously capture in the end effector Tissue.Alternatively, at least one embodiment, instrument 800 may include latching member, which is configured to hinder Only cutting actuator 830b percussion actuator 830a it is fully actuated before activated.In such embodiment, surgery doctor It is raw by without the selection for activating actuator 830a and 830b simultaneously, but still with selectively actuating cutting actuator 830b's Selection.In another alternative embodiment, cutting actuator 830b can be in certain for firing the activating of actuator 830a It is unlocked at a point so that actuator 830a, 830b then can be if necessary to be activated simultaneously by surgeon.Such embodiment It can ensure that follow closely before tissue is cut and fired or at least fully fired at least partly.

Surgery suturing appliance 900 is shown in Figure 39-Figure 44.Instrument 900 in many aspects be similar to instrument 100,200, 300th, 400,500,600,700,800 and/or other surgical instruments disclosed herein.Instrument 900 includes shank 910, the handle Portion 910 include shell 911, be configured to operation closed system or organize grasping system system closure trigger 620, with And it is configured to operate：First, the firing trigger 930a of trigger system and two, tissue diced system is followed closely.Closure trigger 620 can rotate between unactuated position (Figure 40) and actuated position (Figure 41).The closed system of instrument 900 is in many aspects Similar to the closed system of instrument 100, and repeat no more herein for brevity.In all cases, instrument 900 includes closing Lock system, the locking system prevent actuating of the firing trigger 930 before the actuating of closure trigger 620.

Apart from the above, firing trigger 930 surrounds pivot 131 in unactuated position (Figure 41) and actuated position (Figure 42) Between can be rotatably mounted to shank shell 911.Following article is described in more detail, and firing trigger 930 is in firing trigger 930 the first activating operation follows closely trigger system (Figure 42) and in the second activating operational group of firing trigger 930 Knit diced system (Figure 43).Firing trigger 930 includes curved cam part 932, which triggers in percussion Device 930 moves toward the far side when activateding.When cam portion 932 is rotated towards distal side, cam portion 932 contacts lobe plate 985.It is convex Wheel plate 985 can be slidably mounted in shank shell 911.The energy when it is pushed by cam portion 932 towards distal side of lobe plate 985 It is enough longitudinally to slide.Lobe plate 985 includes being defined in the drive between the arm 986,987 of the distal end extension of lobe plate 985 Dynamic slot.Driver slot is configured to receive the proximal end of nail trigger shaft 936a so that when lobe plate 985 is pushed towards distal side When, lobe plate 985 is removedly stored in firing in the end effector of instrument 900 towards distal side driving trigger shaft 936a Nail.More specifically, the proximal end 987a of 986 contact stud trigger shaft 936a of distal side adjutage with towards distal side push trigger shaft 936a。

Apart from the above, lobe plate 985 also is able to laterally slide.More specifically, lobe plate 985 can be in first position Slided between the second position, in the first position lobe plate 985 can with nail trigger shaft 936a operatively engage (Figure 41 and Figure 42), lobe plate 985 can operatively engage (Figure 43 and Figure 44) with tissue cutter bar 936b in the second position.Shank 910 further include the pushing block 980 engaged with lobe plate 985.Pushing block 980 includes extending through shank shell 911 from its extension Push pin 981.Pushing block 980 may include extending through another promotion pin 981 of shank shell 911 along opposite direction. In any case, the user of surgical instruments 900 can push one in pin 981 to make pushing block 980 at it by exerting a force to It is converted between first position and its second position.When pushing block 980 is in its second position, tissue cutter bar 936b is located in limit Due in the driver slot between arm 986 and 987.At this point, lobe plate 985 can with tissue cutter bar 936b operatively couple and The follow-up of firing trigger 930 is activated activating tissue diced system.

In use, instrument 900 is located in the end effector of patient's body and instrument 900 relative to be treated group It knits and is positioned.Closure trigger 620 then activated end effector being clamped to tissue.At this point, pushing block 980 positions It can be engaged with nail trigger shaft 936a in its first position and operatively.The actuating of firing trigger 930 is then pushed away towards distal side Into nail trigger shaft 936a；However, when cam slider 985 not with tissue cutter bar 936b engage when, firing trigger 930 this Kind actuating does not promote tissue cutter bar 936b.After firing trigger 930 has been activated, firing trigger 930 can be released It puts and returns to its unactuated position, as shown in figure 43.Similarly as described above, shank 910 may include being configured to Firing trigger 930 is made to return to the return spring of its unactuated position.In addition as shown in figure 43, when firing trigger 930 is returned When returning to its unactuated position, trigger shaft 936a is maintained at its firing position.Turning now to Figure 44, pushing block 980 is moveable to it The second position, so that pushing block 980 is disengaged with nail trigger shaft 936a and pushing block 980 is made to be engaged with tissue cutter bar 936b. The actuating of firing trigger 930 then can promote tissue cutter bar 936b to cut tissue towards distal side；However, surgeon has The selection of tissue is not cut and tissue can be discharged from end effector without second of actuating firing trigger 930.Shank 910 It may include being configured to that closure trigger 620 and closed system is made to return to the relieving mechanism of its non-firing position.It is in office In the case of what, instrument 900 may include one or more return springs for bar 936a, 936b to be reset to its unactuated position And/or gigback.In at least one, bar 936a, 936b can be reset when end effector reopens.

As discussed above, when firing trigger 930 is activated again to drive tissue cutter bar 936b towards distal side, nail is hit Hair bar 936a is maintained at its distal side firing position.In all cases, trigger shaft 936a can be because of such as trigger shaft 936a and instrument Frictional force between 900 frame and be maintained at its firing position；However, such frictional force can be overcome and trigger shaft 936a It can proximally be pushed.In some cases, turning now to Figure 45, following closely trigger shaft and/or tissue cutter bar may include being used to incite somebody to action Bar is definitely maintained at actuating or at least partly device of actuated position.

In at least one exemplary implementation, apart from the above, surgical instruments 1000 includes shank 1010, the shank 1010 include shank shell 1011.Instrument 1000, which further includes, follows closely trigger shaft 1036a, and nail trigger shaft 1036a is configured to When trigger shaft 1036a is pushed towards distal side by the nail being removedly stored in the end effector of instrument 1000 project and Deformation.Instrument 1000 further includes tissue cutter bar 1036b, and tissue cutter bar 1036b is configured to incision capture in device Tissue in the end effector of tool 1000.Shank 1010 includes such as locking piece 1090, which is adapted to It is enough to be held in place trigger shaft 1036a when cutter bar 1036b is just activated.Locking piece 1090 includes being installed to shank The first end of shell 1011 and second or the cantilever end 1092 engaged with the rack 1093a of trigger shaft 1036a.Rack 1093a includes longitudinal array of tooth, and longitudinal array of the tooth is configured to allow trigger shaft 1036a relative to locking piece 1090 move toward the far side, and as shown in figure 46, and trigger shaft 1036a are prevented proximally to be moved relative to locking piece 1090, until Locking piece 1090 is discharged from trigger shaft 1036a.

Apart from the above, when trigger shaft 1036a passes through locking piece 1090, locking piece 1090 itself is continuously located in tooth Behind each tooth of 1093a.If surgeon will suspend at some point during the firing schedule of trigger shaft 1036a The propulsion of trigger shaft 1036a, then locking piece 1090 trigger shaft 1036a can be held in place, until firing schedule again Start.After nail firing schedule has been completed, locking piece 1090 is located in behind the recent side tooth of trigger shaft 1036a.At this point, Locking piece 1090 is kept by tissue cutter bar 1036b and is engaged with trigger shaft 1036a.Cutter bar 1036b includes limiting thereon Rack 1093b, rack 1093b is similarly as described above, and longitudinal array including tooth, longitudinal array of the tooth is constructed Into cutter bar 1036b can allow for be moved toward the far side relative to locking piece 1090, as shown in figure 47, and cutter bar is prevented 1036b is proximally moved relative to locking piece 1090, cuts stroke until cutter bar 1036b has completed it, as shown in figure 48.This When, locking piece 1090 can slip away trigger shaft 1036a and cutter bar 1036b end and with bar 1036a and 1036b disengaging connect It closes.

Apart from the above, locking piece 1090 is maintained at flexure configuration by bar 1036a and 1036b so that in rack 1093a and After 1093b has been subjected to locking piece 1090, locking piece 1090 can flexibly stretch and make itself to take off with bar 1036a and 1036b From engagement.Rack 1093a is defined in from the flexible cantilever 1094a that trigger shaft 1036a is extended proximally, and rack 1093b It is defined in from the flexible cantilever 1094b that cutter bar 1036b is extended proximally.Rack 1093a and 1093b be configured to Locking piece 1090 is cooperative bent.Under any circumstance, it has been disengaged with rack 1093a and 1093b in locking piece 1090 Afterwards, bar 1036a and 1036b can return to its unactuated position respectively.In all cases, one or more return springs can be with Bar 1036a and 1036b are associated so that bar 1036a and 1036b return to its unactuated position.

Turning now to Figure 49, instrument 1000 may include return actuator such as actuator 1190, which can make Locking piece 1090 instrument 1000 firing schedule and/or cutting stroke complete before with trigger shaft 1036a and/or cutter bar 1036b is disengaged.Actuator 1190 includes the first end that shank shell can be rotatably mounted to via pivot pin 1193 1191 and in addition it is configured to the second end 1192 of engagement latch 1090.Button 1194 can be with actuator 1190 First end 1191 operatively engage and be configured to make the second of actuator 1190 when button 1194 is depressed End 1192 is rotated into be engaged with locking piece 1090, as shown in figure 49.In such cases, actuator 1190 makes locking piece 1090 The second end 1092 bend far from bar 1036a and 1036b and connect locking piece 1090 and rack 1093a and 1093b disengaging It closes.At this point, bar 1036a and 1036b can retract to its unactuated position.Such release actuating system allows instrument 1000 in device It is quickly opened at any appropriate point during the operation of tool 1000 and is unclamped from tissue.Button 1194 can be in firing schedule After period, firing schedule, cutting stroke during and/or cutting stroke after be depressed to discharge locking piece 1090.

Referring to Figure 50-Figure 53, surgical instruments 1200 includes end effector 1250 and is held with closure end is configured to The closed system of row device 1250.End effector 1250 includes nail bin 1260 and anvil block 170.Nail bin 1260 includes warehouse 161, limit Due to multiple nail cavities in warehouse and the nail being removedly stored in nail cavity.Nail bin 1260 can be at open position (Figure 50) Between closed position (Figure 51) towards anvil block 170 move with by tissue compression between warehouse 161 and anvil block 170.Instrument 1200 Further include the closed rod 126 for being installed to warehouse 161.Closed rod 126 can be promoted towards distal side so that nail bin 1260 moves toward the far side simultaneously And it can proximally bounce back so that nail bin 1260 proximally moves.End effector 1250 further includes guide rail 168,168 quilt of guide rail It is constructed to be permeable to proximally guide nail bin 1260 along longitudinal axis with when moving toward the far side in nail bin 1260.

Referring primarily to Figure 50 and Figure 51, the distal side of closed rod 126 promotes also promotes tissue pin 379 that will organize to catch towards distal side It obtains in end effector 1250.More specifically, closed rod 126 includes the drive pin 128a extended laterally therefrom, the driving Pin 128a is configured to engage one or more tissue pin actuators 372 when closed rod 126 moves toward the far side.Tissue pin Actuator 372 can be rotatably mounted to axis frame 114 around pivot pin 118 and can be at unactuated position (Figure 50) with causing It is moved between dynamic position (Figure 51).Each tissue pin actuator 372 includes drive part 373, which is configured to It can engage and push the base portion 374 of tissue pin 379.Tissue pin 379, which can be maintained slidably retained in, is defined in end effector In chamber 378 in 1250 so that the movement of tissue pin 379 is constrained to longitudinal path.Anvil block 170 includes being defined in pin therein Hole 179, the pin hole 179 are configured to receive tissue pin 379 when pin 379 is organized to reach its complete deployed position.

Apart from the above, nail bin 1260 is moved in the previous dynasty anvil block 170 that tissue pin 379 is disposed.In such cases, group It knits and is continuously clamped and then captured in end effector 1250；It is envisaged however that wherein tissue is simultaneously by storehouse 1260 It clamps and the alternative embodiment in end effector 1250 is captured by tissue pin 379.It is susceptible to wherein organize pin 379 The other embodiments disposed before nail bin 1260 is moved toward the far side with compression organization.

Apart from the above, nail bin 1260 further includes the staple drivers 162 being configured to towards the driving nail of anvil block 170.Anvil Seat 170 includes being defined in the forming pit 171 therein for being configured to deform nail.Following article is described in more detail, nail Driver 162 is pushed by trigger shaft 1236 towards distal side.Referring again to Figure 50 and Figure 51, closed rod 126 further includes laterally therefrom Second drive pin 128b of extension, second drive pin 128b are configured to move toward the far side to clamp tissue in storehouse 1260 When engagement trigger shaft 1236 and trigger shaft 1236 is made to be moved toward the far side together with storehouse 1260.By this method, it can be performed in end The relative position of trigger shaft 1236 and nail bin 1260 is kept or at least substantially kept during the closure of device 1250.

Trigger shaft 1236 does not push directly on staple drivers 162；On the contrary, trigger shaft 1236 pushes directly on medium drive 1263, the medium drive 1263 is by the motion transmission of trigger shaft 1236 to staple drivers 162.More specifically, medium drive 1263 include the multiple actuating arms 1264 extended from it towards distal side, and multiple actuating arm 1264 is with being defined in staple drivers 162 Driving surface 1265 on proximal side contacts.When trigger shaft 1236 is just promoted towards distal side so that nail is deformed against anvil block 170, As shown in figure 52, actuating arm 1264 transmits power between trigger shaft 1236 and staple drivers 162.

In actuating arm 1264 each medium drive 1263 can be rotationally connected to around pivot pin 1266.It is each to drive Swing arm 1264 is constructed and arranged to enable to it that power of specific quantity can be transferred to staple drivers 162, and when transmission is worn Overdrive arm 1264 power be more than threshold force when, actuating arm 1264 can be rotated to collapsed position, as shown in figure 53.Threshold force is chosen Be selected to so that its with make nail be deformed into its forming or percussion configuration needed for power it is consistent；It will be appreciated, however, that a certain range of power It is suitably adapted for making nail to be deformed into suitable forming height, and threshold force any power in OK range or can be more than thus This range.Under any circumstance, collapsing for actuating arm 1264 allows medium drive 1263 to be transported relative to or towards staple drivers 162 It is dynamic, and at this point, staple drivers 162 can be moved no longer towards anvil block 170.In addition, at this point, nail percussion process has been completed, and existing May be between medium drive 1263 and staple drivers 162 relative motion be used for towards anvil block 170 dispose cutting element or Blade is to cut tissue.The cutting stroke of blade starts and contacts in actuating arm 1264 to limit when actuating arm 1264 starts to collapse Terminate when support surface 1239 on medium drive 1263.Due to described above, tissue cutting actions and nail percussion behaviour As independent and discrete.In addition, nail percussion operation does not occur continuously and overlappingly with tissue cutting actions.Such arrangement Prevent tissue in nail by cross-section before being fully formed.

Reader should be appreciated that the operator of surgical instruments 1200 can be in any point during the nail percussion operation of instrument 1200 Trigger shaft 1236 is retracted to its non-firing position by place.More specifically, trigger shaft 1236 can be returned proximally, until itself and closure The second drive pin 128b contacts of bar 126.Reader is also understood that the operator of surgical instruments can fire in the nail of instrument 1200 End effector 1250 is opened at any point during operation and nail bin 1260 is made to be moved far from anvil block 170.Nonetheless, device Tool 1200 includes locking system, which is configured to prevent end effector 1250 during tissue cutting actions It is opened.In addition, blade members must tissue pin 379 can be retracted and/or end effector 1250 can be opened before quilt Trigger shaft 1236 is fully retracted.Such locking system is shown in Figure 51-Figure 53.

Referring to Figure 51, each actuating arm 1264 for following closely trigger system includes the lock pin 1267 extended from it.Each lock pin 1267 are located in the locked groove being defined in warehouse 161, wherein each locked groove includes first part 1268 and second part 1269. As discussed in more detail below, lock pin 1267 is located in first part 1268 during shaping operation is followed closely and is cut in tissue It is located in during operation in second part 1269.During the nail shaping operation of instrument 1200, lock pin 1267 is the first of locked groove It is slided in part 1268 towards distal side, as shown in figure 52.In fact, lock pin 1267 can be in first part 1268 proximally and towards remote Side moves, and thus trigger shaft 1236 is allowed to selectively propel and bounce back during shaping operation is followed closely, as described above.In addition, pin 1267 anvil block 170 of such permission nail bin 1261 far from instrument 1200 in first part 1268 is selectively proximally transported It is dynamic, it is also as described above, to open end effector 1250.However, during tissue cutting actions, lock pin 1267 enters lock In the second part 1269 of slot.At this point, the side wall of second part 1269 prevents warehouse 161 from bouncing back relative to trigger shaft 1236.With This mode, nail bin 1260 lock in place when cutting element exposes or may expose.In such cases, end performs Device 1250 cannot be opened, until cutting element is retracted or is at least fully bounced back.Cutting element is in trigger shaft 1236 by court Nearside is retracted when pulling.When firing member 1236 is proximally pulled, lock pin 1267 is transported from the second part 1269 of locked groove It moves in first part 1268 and unlocks warehouse 161.At this point, lock pin 379 can be retracted and/or end effector 1250 It can be opened.

The tissue suture of surgical instruments 1300 and the alternative embodiment of cutting mechanism are shown in Figure 54-Figure 56.Instrument 1300 include cartridge jaw 1360, which includes：First, it is configured to project to stitch from nail bin 1360 by nail It is combined the multiple staple drivers 1362 knitted；With two, it is configured to the blade members 1367 of incision tissue.Staple drivers 1362 It is disposed with blade members 1367 by firing member 1336；However, as discussed below, staple drivers 1362 and blade members 1367 It is deployed as staggeredly.Firing member 1336 includes the rack 1369 of tooth, which moves toward the far side or translate along direction D To dispose staple drivers 1362 and blade members 1367.Instrument 1300, which further includes, operatively to be engaged or engage with rack 1369 Gear train 1366, the gear train 1366 include multiple gears that can be rotated.Rack 1369 and gear train 1366 are configured to The translation motion of firing member 1336 can be converted into the spinning movement of gear train 1366.

Gear train 1366 includes the first and second output gears 1368.Each output gear 1368 is installed to axis 1363, makes It obtains axis 1363 and gear 1368 rotates together.It is convex that gear train 1366 further includes each nail percussion output being installed in axis 1363 Take turns 1364a, 1364b.In the embodiment of illustration, each axis 1363 include being installed to it rotated together with axis 1383 the One and second follows closely deployment cam 1364a.Each cam 1364a is included into contour surface, this is configured into contour surface Engagement is defined in the driving surface 1365a on the bottom of staple drivers 1362.When cam 1364a is rotated by axis 1363, cam Shape is in first orientation (Figure 54) associated with the non-firing position of staple drivers 1362 and percussion with staple drivers 1362 It is rotated between the associated second orientation in position (Figure 55).First orientation and second orientation are spaced apart such as about 180 degree.Cam This type games of 1364a and staple drivers 1362 form the firing schedule of instrument 1300, and when staple drivers 1362 have reached During the terminal of firing schedule, the peak of cam 1364a is contacted with driving surface 1365a, as shown in figure 55.

Apart from the above, instrument 1300 includes four nail percussion cam 1364a；However, it can be used any appropriate number of Cam 1364a.Four nail percussion cam 1364a are positioned and are arranged relative to driving surface 1365a, to be carried to staple drivers 1362 For balance or symmetrical percussion load.By comparing Figure 54 and Figure 55, reader should be appreciated that nail percussion cam 1364a makes nail Driver 1362 is moved relative to blade members 1367.Blade members 1367 are disposed in a manner of independently of staple drivers 1362, As discussed below.

Gear train 1366 further includes each tissue cutting output cam 1364b being installed in axis 1363.Cam 1364b It is configured to deployment blade members 1367.Similarly as described above, cam 1364b is following closely percussion process as discussed above Period rotates between first orientation (Figure 54) and second orientation (Figure 55)；However, cam 1364b rotate herein during not towards remote Side pushes staple drivers 1362 or blade members 1367.Referring now to Figure 56, the follow-up rotation of axis 1363 and cam 1364b will be convex Wheel 1364b is positioned to engage with the driving surface 1365b of blade members 1367, thus blade members 1367 is pushed to cut towards distal side The tissue that slot closes.The peak for following closely percussion cam 1364a is also rotated by such follow-up rotation to be connect with driving surface 1365a disengagings It closes.In such cases, when tissue is just cut, staple drivers 1362 floating can return to or permissible retraction returns to nail In storehouse 1360.

As discussed above, cam 1364a and 1364b are positioned and are arranged on axis 1363 so that nail percussion operation and tissue Occur during cutting operation difference.In some cases, cam 1364a and 1364b, which can be arranged to, enables in nail percussion behaviour Make the presence of interval between tissue cutting actions.In the case that at least one such, cam 1364a and/or cam 1364b can be wrapped Pressurize portion is included, which generates the pause between nail percussion operation and tissue cutting actions.Such pause can be in nail percussion row The chance for the operation for stopping instrument 1300 is provided between journey and tissue cutting stroke for surgeon.In alternative embodiment In, cam 1364a and 1365b can be positioned and are arranged on axis 1363 so that between nail percussion operation and tissue cutting actions There are overlappings.Such overlapping allows the fast actuating of instrument.

The tissue suture of surgical instruments 1400 and the alternative embodiment of cutting mechanism are shown in Figure 57-Figure 59.Instrument 1400 include cartridge jaw 1460, which includes warehouse 1461, is configured to penetrate nail from warehouse 1461 Go out multiple staple drivers 1462 to suture tissue and be configured to the blade members 1467 of incision tissue.Staple drivers 1462 and blade members 1467 disposed by firing member 1436；However, as discussed below, staple drivers 1462 and blade members 1467 are deployed as staggeredly.Staple drivers 1462 and blade members 1467 are in first or unactuated position (Figure 57) with corresponding to It is moved toward the far side between the second position (Figure 58) of the terminal of nail percussion process.Blade members 1467 are then able to drive relative to nail Dynamic device 1462 moves to the third place, as shown in figure 59.

Apart from the above, firing member 1436 includes limiting slope driving surface 1464 thereon.In use, nail drives Dynamic device 1462 and blade members 1467 are pushed towards distal side with from 1461 percussion nail of warehouse by driving surface 1464.More specifically, it drives Dynamic surface 1464 pushes blade members 1467 towards distal side, this then pushes staple drivers at least during percussion process is followed closely towards distal side 1462.Blade members 1467 include the roller 1465a and 1465b that are contacted with ramped surfaces 1464.Roller 1465a and 1465b enclose respectively Blade members 1467 can be rotatably mounted to around drive pin 1469a and 1469b.Drive pin 1469a and 1469b are respectively positioned at It is defined in the driver slot 1463a and 1463b in the frame 1468 of connection staple drivers 1462.Drive pin 1469a, 1469b quilt It is constructed to be permeable to bear against driver slot 1463a, 1463b when blade members 1467 are pushed by firing member 1436 towards distal side Distal side side wall.By this method, percussion force is followed closely from trigger shaft 1436 via driver slope 1464, roller 1465a, roller 1465b, driving Pin 1469a, drive pin 1469b and driver slot 1463a, driver slot 1463b are transferred to staple drivers 1462.Staple drivers 1462 Distal movement is limited by the stop surfaces 1466 being for example defined in warehouse 1461.When staple drivers frame 1468 contacts stop table During face 1466, referring to Figure 58, the firing schedule of instrument 1400 is completed.At this point, only one of the cutting surfaces of blade members 1467 Divide and expose from warehouse 1461；However, tissue is not exposed to cutting surfaces also.More specifically, the jaw opposite with nail bin 1460 Or anvil block may include being configured to the chamber for the exposed portion for receiving cutting surfaces, therefore can reduce at this time in instrument 1400 Blade members 1467 cut the possibility of tissue in operation.

As discussed above, the distal movement of staple drivers 1462 and blade members 1467 is stopped by the terminal point of firing schedule Dynamic surface 1466 constrains, therefore the additional distal side of trigger shaft 1436 or longitudinal direction action will no longer be converted into staple drivers 1462 and knife The distal side of sheet element 1467 or longitudinal direction action.On the contrary, referring to Figure 59, the additional distal movement of trigger shaft 1436 is converted into blade The lateral movement of component 1467.More specifically, the additional distal movement of ramped surfaces 1464 blade members 1467 at present it is quiet Reaction force is generated between driver frame 1468 only, the reaction force makes slope table of the blade members 1467 along decline It laterally moves in face 1464.Roller 1465a, 1465b are conducive to the lateral movement of blade members 1467；However, in no roller In the case that 1465a, 1465b are assisted, blade members 1467 can slide to cope with firing member 1436 along driving slope 1464 Continuation distal movement.

Apart from the above, blade members 1467 cut the tissue of suture when it laterally moves across nail bin 1460.Knife Sheet element 1467 is moved along cutting shaft line, which fires transverse to by the longitudinal direction that the action of firing member 1436 limits Axis.Cutting shaft line and percussion axis are vertical or at least substantially vertical；However, any suitable arrangement can be used.In addition it removes Except above-mentioned, the cutting stroke of blade members 1467 starts at the end of the firing schedule of driver 1462；It it is envisaged however that can Delay is provided between cutting stroke and firing schedule.

Single trigger shaft can be used to be cut for actuating nail deployment system and tissue for many surgical instruments disclosed herein Cut system.Such instrument can benefit from the sense of hearing and/or the use of touch feedback, and the sense of hearing and/or touch feedback can be to surgery devices Certain information of the user's transmission of tool about the present operating state of surgical instruments.In at least one example, surgical instruments Trigger shaft may include the first array of tooth and the second array of tooth, and the first array of the tooth and the second array of tooth can be relative to outer One or more of the shank of section's instrument buckle element slides.During the nail percussion operation of surgical instruments, first gust of tooth Interaction between row and buckle element can generate click sound and/or vibration.First array of tooth may be arranged on trigger shaft, So that feedback is generated for example when close to the terminal of firing schedule.In the case of with such feedback, if surgeon's phase Hope the operation for for example at least suspending surgical instruments between nail percussion operation mode and tissue cutting actions pattern, then they can subtract The advance of slow trigger shaft.Alternatively, surgeon may be selected not cut tissue.The second array of tooth may be arranged on cutter bar, So that for example feedback is generated when close to the terminal of cutting stroke.In certain embodiments, the array of tooth may be arranged at percussion On bar so that generate feedback between nail percussion operation mode and tissue cutting actions pattern.Above-mentioned feedback can be with hitting including nail Hair bar is used together with the instrument of individually tissue cutter bar.

Surgical instruments 1500 is disclosed in Figure 61-Figure 64.Instrument 1500 include axis 1540 and for for example suture with it is cross-section The rounded ends actuator 1550 of inner cavity.It [is incorporated by reference.] end effector 1550 include nail bin 1560, the nail bin 1560 include round warehouse 1561 and the multiple nails being removedly stored in circular array in warehouse 1561.Nail bin 1560 also wraps It includes and is configured to that the staple drivers 1562 projected from warehouse 1561 will be followed closely.Staple drivers 1562 are also arranged simultaneously with circular array And it is connected to common driver frame；However, any suitable arrangement can be used.For example, staple drivers 1562 can be not connected to each other. End effector 1550 further includes circular anvil 1570, which is configured to compress against warehouse 1561 interior A part for chamber.Anvil block 1570 is attached to the closing actuator 1526 for extending through axis 1540.Closing actuator 1526 is constructed It is moved between clip position and non-clip position toward and away from nail bin 1560 into anvil block 1570 can be made.Figure 61-Figure 64 is complete Portion shows the anvil block 1570 in clip position.Anvil block 1570 further includes the circular array of forming pit 1571, and the forming is recessed Hole 1571 is configured to deform nail when that will follow closely and project from nail bin 1560.

Surgical instruments 1500 further includes cutting element 1567, which is configured to incision capture in anvil Tissue between seat 1570 and nail bin 1560.In use, staple drivers 1562 during forming process is followed closely against anvil block 1570 Driving nail (Figure 61), and cutting element 1567 cuts tissue (Figure 63) during cutting process is organized.As discussed below, it follows closely into Shape process and tissue cutting process are continuously present and overlapping are not present between the two；It is envisaged however that wherein nail forming Process and tissue cutting process can occur simultaneously or at least partly simultaneously appearance embodiment.

Apart from the above, and referring primarily to Figure 60, when anvil block 1570 moves to its clip position, staple drivers 1562 It is stored in the unactuated position in end nail bin 1560 with cutting element 1567.Staple drivers 1562 and cutting element 1567 with It is moved toward the far side during forming process is followed closely by firing member 1536 so as to follow closely deformation, as shown in Figure 61 afterwards.More specifically, it hits The engagement of distal end 1538 of hair component 1536 be located in firing member 1536 and driver 1562 and cutting element 1567 it Between washer 1539, this then engages driver 1562 and cutting element 1567.When driver 1562 contacts the near of warehouse 1561 During the side of side, the firing schedule of staple drivers 1562 terminates.It is worth noting that, cutting element 1567 is during forming process is followed closely Do not expose from warehouse 1561；On the contrary, cutting element 1567 is remained positioned in during forming process is followed closely in warehouse 1561, although its It is moved towards anvil block 1570.

Once staple drivers 1562 see the bottom against warehouse 1561, surgeon can be understood from nail forming process and complete. At this point, surgeon then can bounce back firing member 1536 and skip over tissue cutting step (if what they selected in this way Words).Alternatively, surgeon can apply firing member 1536 motive force to wear out washer 1539, as shown in Figure 62.This is pushed Power is more than the power needed for percussion nail.Therefore, after the terminal of nail firing schedule, surgeon will be subjected to dramatically increasing required Power is to promote firing member 1536.If firing member 1536 is driven by the actuator being manually operated, cut to start tissue Stroke is cut, surgeon will have to independently select to increase the power for being applied to firing member 1536.Washer 1539 can be constructed Into enabling to it that can bear the power of at most threshold force, once wherein threshold force has met or has been more than, firing member 1536 it is remote Side end 1538 can be pushed across washer 1539.

In some cases, apart from the above, washer 1539 is configured to so that it is once applied to washer 1539 threshold force has met just fracture or catastrophic failure.In the case that at least one such, washer 1539 may include weakenings Point, which promotes failure of the washer 1539 in predetermined region such as ring-shaped groove 1537.In some cases, it hits The distal end 1538 of hair component 1536 may include the cut portion of cross-section washer 1539.Under any circumstance, washer 1539 can Fuse is served as, which must fail before cutting stroke can start.

Once washer 1539 is broken off or cross-section or fail in other ways, referring to Figure 63, washer 1539 will just wrap Include two unitary parts：It can the first part 1539a that pushed by firing member 1536 towards distal side and the second part remained stationary as 1539b.Groove 1537 is located among the first part 1539a of washer 1539 and second part 1539b.Groove 1537 generates significantly The washer 1539 of easy fracture so that once the power of proper level has been applied to washer 1539, washer 1539 is just broken.At least one In the case of kind, washer 1539 is made of such as plastics.First gasket portion 1539a is pushed by firing member 1536 towards distal side, with Cutting element 1567 is moved toward the far side to complete the cutting stroke of instrument 1500.

In addition to or replace the actuator of manual operation, instrument 1500 may include being configured to driving firing member 1536 Electro-motor.At least one sensing for being configured to detect the load being subjected to by firing member also can be used in such system Device and the controller in addition to communicate with load sensor and electro-motor, the controller can be received according to from load sensor Data control the operation of electro-motor.Such system can be appreciated that staple drivers 1562 seen the bottom and in response to this, temporarily Stop electro-motor.Such permissible surgeon of pause chooses whether to open anvil block 1570 or instruction control after percussion process is followed closely Device processed is to perform tissue cutting process.Instrument 1500 may include for example being activated by surgeon with open anvil block 1570 first It button and can for example be activated to perform the second button of tissue cutting process by surgeon.

Apart from the above, each surgical instruments disclosed herein may include or can be modified to include operating instrument One or more manual operations triggers and/or one or more electro-motors.Surgical instruments 100,200,300,400, 500th, 600,700,800,900,1000,1200,1300,1400 and 1500 may include the closed system being manually operated, this is manually The closed system of operation transmits power between the closure trigger and end effector of surgical instruments.For example, instrument 100 includes hand The closed system of dynamic operation, the closed system of the manual operation are configured to arrive the rotary transfer of closure trigger 120 End effector 150.In alternative embodiment, any one in instrument disclosed herein may include being configured to Operate the electro-motor of the closed system of instrument.Similarly as described above, instrument may also include control system, the control system quilt It is constructed to be permeable in response to being received from surgical one or more inputs and/or from the one or more sensors of instrument Data operate electro-motor.

In addition to or replace it is described above, surgical instruments 100,200,300,400,500,600,700,800,900,1000, 1200th, 1300,1400 and 1500 may include the trigger system being manually operated, and the trigger system of the manual operation is united in surgery device Power is transmitted between the firing trigger and end effector of tool.For example, instrument 100 includes the trigger system of manual operation, the hand The trigger system of dynamic operation is configured to the rotary transfer of firing trigger 130 to end effector 150.Alternative In embodiment, any one electricity that may include being configured to the trigger system of operation instrument in instrument disclosed herein Dynamic motor.Similarly as described above, instrument may also include control system, which is configured to outer in response to coming from One or more inputs of section doctor and/or the data that are received from the one or more sensors of instrument operate electro-motor.

Reader should be appreciated that surgical instruments 100,200,300,400,500,600,700,800,900,1000,1200, 1300 and 1400 are commonly used in following surgical technics, wherein manufacturing one or more big notch in patient's body to provide entrance The entrance of the surgical site of patient's body.These surgical technics are commonly known as " open " surgical technic.Provided herein is religion It leads content and is suitable for the surgical technic that wherein instrument is inserted by one or more trochars or intubation, the surgical technic is for example logical It crosses and provides the entrance into patient's body compared with small notch.Open surgical technology is usually that clinician provides preferable surgery The position visual field, and laparoscopic type surgical technic usually generates smaller scar with patient.Instrument 1500 can pass through patient Natural aperture such as anus be inserted into.Provided herein is teachings be suitable for wherein instrument pass through patient it is one or more from The surgical technic that right aperture is inserted into.

Reader should be appreciated that surgical instruments 100,200,300,400,500,600,700,800,900,1000,1200, 1300th, 1400 and 1500 nail is longitudinally disposed, that is, along, be parallel to or be arranged essentially parallel to by surgical instruments axis limit Fixed longitudinal axis deployment.It is susceptible to wherein follow closely other implementations along one or more axis deployment transverse to longitudinal axis Scheme.Figure 64 and Figure 65 discloses such exemplary surgical instrument, that is, surgical instruments 1600.Surgical instruments 1600 includes Cartridge jaw 1660 and anvil jaw 1670.Cartridge jaw 1660 and/or anvil jaw 1670 can move that clamping will be organized Between the two.Cartridge jaw 1660 includes warehouse 1661, which includes being defined in multiple nail cavities therein.Storehouse jaw 1660 further include the multiple nails 1669 being removedly stored in nail cavity and are configured to project nail 1669 from nail cavity Multiple staple drivers 1662.Instrument 1600 further includes trigger shaft 1636, which can move toward the far side with towards anvil block Jaw 1670 promotes staple drivers 1662 and nail 1669.Anvil jaw 1670 includes nail shapes pit 1671, the nail shapes pit 1671 are configured to deform nail 1669, as shown in Figure 64 and Figure 65.Provided herein is teachings be suitable for surgery device Tool 1600 etc..

Surgical stapling system may include axis and the end effector extended from axis.End effector includes the first jaw and the Two jaws.First jaw includes nail bin.Nail bin is inserted into the first jaw and can be removed from the first jaw；However, it sets Expect that wherein nail bin can not remove from the first jaw or at least be not easy to the other embodiments replaced from the first jaw.Second Jaw includes the anvil block of nail deformation for being configured to make to project from nail bin.Second jaw can surround be closed axis relative to First jaw pivots；It is envisaged however that other embodiment party that wherein the first jaw can be pivoted or be moved relative to the second jaw Case.Surgical stapling system further includes the pass for being configured to allow end effector that joint motions are rotated or carried out relative to axis Save kinematic joint.End effector can surround the joint motions axis rotation for extending through actuated articulation joints.It contemplates not Other embodiments including actuated articulation joints.

Nail bin includes warehouse.Warehouse includes proximal end, distal end and extends between proximal end and distal end Platform.In use, nail bin is located on the first side of tissue to be stapled, and anvil positioning is in the second side of tissue On.Anvil block is towards cartridge movement by tissue compression and to clamp against platform.Then, the nail being removedly stored in warehouse can portion It affixes one's name in tissue.Warehouse includes being defined in nail cavity therein, is removedly stored in nail cavity wherein following closely.Nail cavity is arranged to six Longitudinal direction row.Three nail chambers are located on the first side of longitudinal slit and three nail chambers are located in the second side of longitudinal slit.Nail Other arrangements of chamber and nail are also possible.

Nail is supported by the staple drivers in warehouse.Driver can be in the first or non-firing position and second or firing position Between move, will follow closely from nail bin project.Driver is maintained at by retainer in warehouse, and retainer prolongs around the bottom of warehouse It stretches and including being configured to clamping warehouse and keeping retainer to the elastic component of warehouse.Driver can pass through Sliding part moves between its non-firing position and firing position.Sliding part can in the proximal position adjacent with proximal end and It is moved between the distal position adjacent with distal end.Sliding part includes multiple ramped surfaces, which is adapted to It is enough to slide and promoted driver below driver towards anvil block, and follow closely and be supported on a drive.

Than that described above, sliding part can also be moved toward the far side by firing member.Firing member is configured to contact Sliding part simultaneously pushes sliding part towards distal end.The longitudinal slit being defined in warehouse is configured to receive firing member. Anvil block further includes the slit for being configured to receive firing member.Firing member further includes the first cam of the first jaw of engagement With the second cam of the second jaw of engagement.When firing member is promoted towards distal side, first cam and the second cam can control nail bin Platform and the distance between anvil block or tissue space.Firing member, which further includes, is configured to incision in nail bin and anvil block Between the blade of tissue that captures.Wish blade positioning at least part close to ramped surfaces so as to follow closely and projected prior to blade.

The deployment and deformation for having combined nail describe surgical instrument system as described herein；However, implementation as described herein Scheme is without being limited thereto.For example, it is envisioned that the various embodiments of fastener such as fixture or tack of the deployment in addition to nail. In addition, it is also contemplated that utilize the various embodiments of any appropriate device for seal tissue.For example, according to various embodiment party The end effector of case may include being configured to the electrode of heating and seal tissue.In addition, for example, according to certain embodiment party The end effector of case can apply vibrational energy with seal tissue.

Embodiment

Embodiment 1- it is a kind of for treat patient tissue surgical stapling device, the surgical stapling device include shank, from The axis of the shank extension and the end effector extended from the axis, are in wherein the end effector can be constructed Open configuration and closed configuration.The end effector includes the first jaw；Second jaw, wherein second jaw being capable of court First jaw moves the end effector being placed in the closed configuration；Warehouse including nail cavity；Removedly store up There are the nails in the nail cavity；And it is configured to the anvil block for making the nail deformation.The surgical stapling device further include by It is constructed to be permeable to the closed system that second jaw is made to be moved towards first jaw；Trigger system, the trigger system packet Include be configured to during firing schedule by it is described follow closely the percussion driver that is projected from the nail cavity towards the anvil block and by It is constructed to be permeable to cut the cutting element of the tissue, and be configured to during retract stroke during stroke is cut Bounce back the cutting element；And device, described device is for preventing the end effector from returning to the open configuration, directly After having been completed to the retract stroke.

Embodiment 2- allows the end effector to exist according to surgical stapling device described in embodiment 1, wherein described device The open configuration is returned to during the firing schedule.

Surgical stapling devices of the embodiment 3- according to embodiment 1 or 2, wherein described device allow the end effector Back to the open configuration after firing schedule completion and before the cutting stroke starts.

Surgical stapling devices of the embodiment 4- according to embodiment 1,2 or 3, the surgical stapling device further includes can be The tissue pin moved between non-deployed position and deployed position, wherein the tissue pin is configured to capture in the tissue In the end effector；And tissue pin actuator, the tissue pin actuator were configured in the deployment stroke phase Between extend the tissue pin between the non-deployed position and the deployed position, and towards described non-during stroke is recalled Deployed position recalls the tissue pin, and wherein described device prevents the tissue pin during the cutting stroke towards the non-portion Administration recalls position.

Surgical stapling devices of the embodiment 5- according to embodiment 1,2 or 3, the surgical stapling device further includes can be The tissue pin moved between non-deployed position and deployed position, wherein the tissue pin is configured to capture in the tissue In the end effector；And tissue pin actuator, the tissue pin actuator were configured in the deployment stroke phase Between extend the tissue pin between the non-deployed position and the deployed position, and towards described non-during stroke is recalled Deployed position recalls the tissue pin, and wherein described device prevents the tissue pin during the firing schedule towards the non-portion Administration recalls position.

Embodiment 6- it is a kind of for treat patient tissue surgical stapling device, the surgical stapling device include shank, from The axis of the shank extension and the end effector extended from the axis, are in wherein the end effector can be constructed Open configuration and closed configuration.The end effector includes the first jaw；Second jaw, wherein second jaw being capable of court First jaw moves the end effector being placed in the closed configuration；Warehouse including nail cavity；Removedly store up There are the nails in the nail cavity；And it is configured to the anvil block for making the nail deformation.The surgical stapling device further include by It is constructed to be permeable to the closed system that second jaw is made to be moved towards first jaw；Trigger system, the trigger system packet It includes and is configured to follow closely the driver projected from the nail cavity towards the anvil block by described during firing schedule and be constructed Into the cutting element that the tissue can be cut during stroke is cut, wherein the cutting element is included in the cutting stroke The cutting edge that period exposes from the warehouse；And device, described device are used to prevent the closed system in the cutting structure The open configuration is returned to when part exposes.

Surgical stapling devices of the embodiment 7- according to embodiment 6, wherein described device allow the end effector to exist The open configuration is returned to during the firing schedule.

Surgical stapling devices of the embodiment 8- according to embodiment 6 or 7, wherein described device allow the end effector Back to the open configuration after firing schedule completion and before the cutting stroke starts.

Surgical stapling devices of the embodiment 9- according to embodiment 6,7 or 8, wherein described device allow the end to hold Row device returns to the open configuration after firing schedule completion and before cutting element exposing.

Surgical stapling devices of the embodiment 10- according to embodiment 6,7,8 or 9, the surgical stapling device further includes can The tissue pin moved between non-deployed position and deployed position, wherein the tissue pin is configured to catch in the tissue It obtains in the end effector；And tissue pin actuator, the tissue pin actuator are configured in deployment stroke Period extends the tissue pin between the non-deployed position and the deployed position, and towards described during stroke is recalled Non-deployed position recalls the tissue pin, and wherein described device prevents the tissue pin when the cutting element exposes towards described Non-deployed position is recalled.

Surgical stapling devices of the embodiment 11- according to embodiment 6,7,8 or 9, the surgical stapling device further includes can The tissue pin moved between non-deployed position and deployed position, wherein the tissue pin is configured to catch in the tissue It obtains in the end effector；And tissue pin actuator, the tissue pin actuator are configured in deployment stroke Period extends the tissue pin between the non-deployed position and the deployed position, and towards described during stroke is recalled Non-deployed position recalls the tissue pin, and wherein described device prevents the tissue pin during the firing schedule towards described non- Deployed position is recalled.

Embodiment 12- it is a kind of for treat patient tissue surgical stapling device, the surgical stapling device include shank, from The axis of the shank extension and the end effector extended from the axis, are in wherein the end effector can be constructed Open configuration and closed configuration.The end effector includes the first jaw；Second jaw, wherein second jaw being capable of court First jaw moves the end effector being placed in the closed configuration；Warehouse including nail cavity；Removedly store up There are the nails in the nail cavity；And it is configured to the anvil block for making the nail deformation.The surgical stapling device further include by It is constructed to be permeable to the closed system that second jaw is made to be moved towards first jaw；Trigger system, the trigger system packet Staple drivers are included, wherein the trigger system is configured to push the nail driving towards the anvil block during firing schedule Device and bounce back during the retract stroke staple drivers and cutting element, the cutting element are configured to The tissue is cut during cutting stroke, wherein the cutting element includes from the warehouse exposing during the cutting stroke Cutting edge；And device, described device are used to that the staple drivers to be prevented to bounce back when the cutting element exposes.

Surgical stapling devices of the embodiment 13- according to embodiment 12, wherein described device allow the end effector The open configuration is returned to during the firing schedule.

Surgical stapling devices of the embodiment 14- according to embodiment 12 or 13, wherein described device allow the end to hold Row device is after firing schedule completion and before the cutting stroke starts back to the open configuration.

Surgical stapling devices of the embodiment 15- according to embodiment 12,13 or 14, wherein described device allow the end Portion's actuator returns to the open configuration after firing schedule completion and before cutting element exposing.

Surgical stapling devices of the embodiment 16- according to embodiment 12,13,14 or 15, the surgical stapling device further include The tissue pin that can be moved between non-deployed position and deployed position, wherein the tissue pin is configured to described group Capture is knitted in the end effector；And tissue pin actuator, the tissue pin actuator are configured to disposing Extend the tissue pin, and the court during stroke is recalled during stroke between the non-deployed position and the deployed position The non-deployed position recalls the tissue pin, and wherein described device prevents the tissue pin during the cutting stroke towards institute Non-deployed position is stated to recall.

Surgical stapling devices of the embodiment 17- according to embodiment 12,13,14 or 15, the surgical stapling device further include The tissue pin that can be moved between non-deployed position and deployed position, wherein the tissue pin is configured to described group Capture is knitted in the end effector；And tissue pin actuator, the tissue pin actuator are configured to disposing Extend the tissue pin, and the court during stroke is recalled during stroke between the non-deployed position and the deployed position The non-deployed position recalls the tissue pin, and wherein described device prevents the tissue pin during the firing schedule towards institute Non-deployed position is stated to recall.

Embodiment 18- it is a kind of for treat patient tissue surgical stapling device, the surgical stapling device include shank, from The axis of the shank extension, the end effector extended from the axis, beat wherein the end effector can be constructed to be in Open configuration and closed configuration.The end effector includes the first jaw；Second jaw, wherein second jaw can be towards institute The movement of the first jaw is stated so that the end effector is placed in the closed configuration；Warehouse including nail cavity；Removedly store Nail in the nail cavity；It is configured to the anvil block for making the nail deformation；It and can be in non-deployed position and deployment position The tissue pin moved between putting, wherein the tissue pin is configured to the tissue capture in the end effector It is interior.The surgical stapling device further includes the closed system for being configured to that second jaw is made to be moved towards first jaw System；Tissue pin actuator, the tissue pin actuator are configured to make during stroke is disposed the tissue pin described It moves between non-deployed position and the deployed position and bounces back described group towards the non-deployed position during retract stroke Knit pin；Trigger system, the trigger system includes staple drivers, wherein the trigger system is configured in firing schedule Period pushes the staple drivers and cutting element towards the anvil block, and the cutting element is configured to go in cutting The tissue is cut during journey, wherein the cutting element includes the cutting exposed during the cutting stroke from the warehouse Sword；And device, described device are used to that the pin to be prevented to bounce back when the cutting element exposes.

Surgical stapling devices of the embodiment 19- according to embodiment 18, wherein described device allow the end effector The open configuration is returned to during the firing schedule.

Surgical stapling devices of the embodiment 20- according to embodiment 18 or 19, wherein described device allow the end to hold Row device is after firing schedule completion and before the cutting stroke starts back to the open configuration.

Surgical stapling devices of the embodiment 21- according to embodiment 18,19 or 20, wherein described device allow the end Portion's actuator returns to the open configuration after firing schedule completion and before cutting element exposing.

Embodiment 22- is a kind of for treating the surgical stapling device of the tissue of patient, and the surgical stapling device includes shank；From The axis of the shank extension；And from the axis extend end effector, the end effector include the first jaw, second Jaw, wherein one of first jaw and second jaw can be transported relative to the another one of first jaw Dynamic, the warehouse including nail cavity and is configured to make the nail deformation nail being removedly stored in the nail cavity Anvil block.The surgical stapling device further includes trigger system, and the trigger system is configured to institute during firing schedule Nail is stated to project from the nail cavity towards the anvil block and cut institute during the cutting stroke after the firing schedule has been completed State tissue.

Surgical stapling devices of the embodiment 23- according to embodiment 22, wherein the trigger system includes trigger shaft, and Wherein described trigger shaft can move to perform the firing schedule and the cutting stroke towards the end effector.

Surgical stapling devices of the embodiment 24- according to embodiment 22 or 23, the surgical stapling device, which further includes, to be constructed Into the retainer that can stop the trigger shaft after the firing schedule.

Surgical stapling devices of the embodiment 25- according to embodiment 24, wherein the retainer can be actuated manually, with Discharge the firing member so that the firing member is able to carry out the cutting stroke.

Surgical stapling devices of the embodiment 26- according to embodiment 22,23,24 or 25, wherein the trigger system is also wrapped Include be configured to by the staple drivers that the nail is projected from the nail cavity be configured to cut cutting for the tissue Component is cut, wherein the cutting element moves during the firing schedule with together with the staple drivers, and wherein described Cutting element does not cut the tissue during the firing schedule.

Surgical stapling devices of the embodiment 27- according to embodiment 26, wherein the cutting element is in the firing schedule Period is connected to the staple drivers, and wherein described cutting element divides during the cutting stroke with the staple drivers From.

Surgical stapling devices of the embodiment 28- according to embodiment 26 or 27, the surgical stapling device further include fixture, institute Stating fixture can remain to the cutting element during the firing schedule of the firing member nail drive with discharging Dynamic device, wherein the fixture is configured to drive from the nail when the power transmitted by the firing member is more than threshold force Dynamic device discharges the cutting element.

Surgical stapling devices of the embodiment 29- according to embodiment 26 or 27, the surgical stapling device further include fixture, institute The cutting can be remained to discharging during the firing schedule of the firing member by the staple drivers by stating fixture Component；And fixture limiter, the fixture limiter is configured to can be by the folder during the firing schedule Tool is releasably retained in clamp position and the Clamping Off-set is allowed to open so that the percussion during the cutting stroke Component is disengaged with the trigger shaft.

Surgical stapling devices of the embodiment 30- according to embodiment 22,23,24,25,26,27,28 or 29, wherein described Shank includes the firing trigger that can operatively couple with the firing member, wherein the firing trigger can rotate it is logical The first motion range and the second motion range are crossed, wherein when firing trigger movement is by first motion range, The firing trigger makes the firing member movement by the firing schedule, and wherein when the firing trigger moves During by second motion range, the trigger makes the firing member movement by the cutting stroke.

Surgical stapling devices of the embodiment 31- according to embodiment 30, wherein first motion range is relative to described Second motion range is discrete.

Surgical stapling devices of the embodiment 32- according to embodiment 30 or 31, wherein first motion range and described During second motion range appears in the single actuation of the firing trigger.

Surgical staplings of the embodiment 33- according to embodiment 22,23,24,25,26,27,28,29,30,31 or 32 Device, the surgical stapling device further include indicator, and the indicator is configured to provide when the firing schedule is completed First instruction simultaneously provides the second instruction when the cutting stroke is completed, and wherein described first instruction is different from described second Instruction.

Surgical stapling devices of the embodiment 34- according to embodiment 33, wherein first instruction includes visually indicating, listening Feel instruction and one of haptic indication, and wherein described second instruction includes visually indicating, audible indication and haptic indication One of.

Surgical stapling devices of the embodiment 35- according to embodiment 30, wherein first motion range appear in it is described Activating of firing trigger, and wherein described second motion range appears in another time of the firing trigger Activating.

Surgical stapling devices of the embodiment 36- according to embodiment 30, the surgical stapling device further includes indicator, described Indicator is configured to provide the first instruction when the primary actuating of the firing trigger is completed and be touched in the percussion The second instruction is provided during another actuating completion for sending out device, and wherein described first instruction is different from described second and indicates.

Embodiment 37- is according to embodiment 22,23,24,25,26,27,28,29,30,31,32,33,34,35 or 36 Surgical stapling device, wherein the trigger system includes being configured to during the firing schedule by the nail from described The trigger shaft of nail cavity injection and the blade bar for being configured to cut the tissue during the cutting stroke.

Surgical stapling devices of the embodiment 38- according to embodiment 37, wherein the trigger system further includes percussion triggering Device, wherein the trigger shaft is driven, and wherein institute in the activating of the firing trigger towards the end effector The activating that blade bar is stated in the firing trigger is driven towards the end effector.

Surgical stapling devices of the embodiment 39- according to embodiment 38, wherein the firing trigger being capable of institute wherein It states first position that firing trigger can operatively engage with the trigger shaft and wherein described firing trigger can be with institute It states and converts between the second position that trigger shaft operatively engages.

Surgical stapling devices of the embodiment 40- according to embodiment 38 or 39, the surgical stapling device further include switching machine Structure, the switching mechanism be configured to after the firing schedule by the firing trigger be automatically converted into not with The trigger shaft is engaged and is engaged with the blade bar.

Surgical stapling devices of the embodiment 41- according to embodiment 38,39 or 40, the surgical stapling device, which further includes, to be cut Converting mechanism, the switching mechanism are configured to allow manually to turn the firing trigger after the firing schedule It changes into and does not engage with the trigger shaft and engaged with the blade bar.

Surgical stapling devices of the embodiment 42- according to embodiment 37, wherein the trigger system further includes percussion triggering Device, wherein the trigger shaft is driven in the first activating of the firing trigger towards the end effector, and its Described in blade bar the firing trigger the second activating by towards the end effector drive.

Surgical stapling devices of the embodiment 43- according to embodiment 37, wherein further include can be with institute for the trigger system The firing trigger that trigger shaft operatively engages is stated, wherein the actuating of the firing trigger makes the trigger shaft movement pass through institute State firing schedule；And the cutting trigger that can be operatively engaged with the blade bar, wherein the cause of the cutting trigger It is dynamic to make the blade bar movement by the cutting stroke.

Embodiment 44- according to embodiment 22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37, 38th, the surgical stapling device described in 39,40,41,42 or 43, wherein the trigger system is further configured in the percussion Stroke suspends the operation of the surgical stapling device after completing, be so that the user of the surgical stapling device is allowed optionally to select It is no to perform the cutting stroke using the surgical stapling device.

Embodiment 45- is a kind of for treating the surgical stapling device of the tissue of patient, and the surgical stapling device includes shank；From The axis of the shank extension；And from the axis extend end effector, the end effector include the first jaw, second Jaw, wherein one of first jaw and second jaw can be transported relative to the another one of first jaw Dynamic, the warehouse including nail cavity and is configured to make the nail deformation nail being removedly stored in the nail cavity Anvil block.The surgical stapling device, which further includes, to be configured to hit the nail from what the nail cavity projected during firing schedule Send out bar；It is configured to cut the blade bar of the tissue during stroke is cut；It can operatively be connect with the trigger shaft The firing trigger of conjunction, wherein the actuating of the firing trigger makes the trigger shaft movement by the firing schedule；And The cutting trigger that can be operatively engaged with the blade bar, wherein the actuating of the cutting trigger transports the blade bar It is dynamic to pass through the cutting stroke.

Embodiment 46- is a kind of for treating the surgical stapling device of the tissue of patient, and the surgical stapling device includes shank；From The axis of the shank extension；And from the axis extend end effector, the end effector include the first jaw, second Jaw, wherein one of first jaw and second jaw can be transported relative to the another one of first jaw Dynamic, the warehouse including nail cavity and is configured to make the nail deformation nail being removedly stored in the nail cavity Anvil block.The surgical stapling device, which further includes, to be configured to the nail during firing schedule from the nail cavity towards the anvil The trigger system that seat projects；It is configured to cut the diced system of the tissue during stroke is cut；And device, institute Device is stated for the diced system to be prevented to perform the cutting stroke, until the trigger system has completed the percussion row Journey.

Embodiment 47- it is a kind of for treat patient tissue surgical stapling device, the surgical stapling device include shank, from The axis of the shank extension and the end effector extended from the axis.The end effector includes the first jaw；Second Jaw, wherein one of first jaw and second jaw can be transported relative to the another one of first jaw It is dynamic；Warehouse including nail cavity；The nail being removedly stored in the nail cavity；And it is configured to make the nail deformation Anvil block.The surgical stapling device further includes trigger system, and the trigger system is configured to institute during firing schedule Nail is stated to project from the nail cavity towards the anvil block and cut institute during the cutting stroke after the firing schedule has been completed State tissue；And device, user of the described device for the permission surgical instruments after the firing schedule choose whether to utilize The surgical stapling device performs the cutting stroke.

Surgical stapling devices of the embodiment 48- according to embodiment 47, the surgical stapling device are further included for described The feedback device that firing schedule indicates when completing.

Surgical stapling devices of the embodiment 49- according to embodiment 47 or 48, the surgical stapling device further include for The trigger system close to the firing schedule terminal when the feedback device that indicates.

Surgical stapling devices of the embodiment 50- according to embodiment 47,48 or 49, the surgical stapling device further include use In the feedback device indicated when the cutting stroke is completed.

Surgical stapling devices of the embodiment 51- according to embodiment 47,48,49 or 50, the surgical stapling device further include For the feedback device indicated in terminal of the trigger system close to the cutting stroke.

Surgical stapling devices of the embodiment 52- according to embodiment 47,48,49,50 or 51, the surgical stapling device is also Including visually indicating item, the item that visually indicates includes the first range and the second range, wherein first range show it is described The progress of firing schedule and second range show the progress of the cutting stroke.

Surgical stapling devices of the embodiment 53- according to embodiment 47,48,49,50,51 or 52, wherein described device packet Include the retainer for being configured to stop the trigger system after the firing schedule, and wherein described retainer energy It is enough selectively to be discharged by the user of the surgical stapling device.

Embodiment 54- is a kind of for treating the surgical stapling device of the tissue of patient, and the surgical stapling device includes shank；From The axis of the shank extension；And from the axis extend end effector, the end effector include the first jaw, second Jaw, wherein one of first jaw and second jaw can be transported relative to the another one of first jaw Dynamic, the warehouse including nail cavity and is configured to make the nail deformation nail being removedly stored in the nail cavity Anvil block.The surgical stapling device further includes trigger system, and the trigger system is configured to institute during firing schedule Nail is stated to project from the nail cavity towards the anvil block；Diced system, the diced system are configured in the firing schedule The tissue is cut during cutting stroke after having completed；And device, described device are used to allow the surgical stapling device User choose whether to perform the cutting stroke using the surgical stapling device.

Surgical stapling devices of the embodiment 55- according to embodiment 54, the surgical stapling device are further included for described The feedback device that firing schedule indicates when completing.

Surgical stapling devices of the embodiment 56- according to embodiment 54 or 55, the surgical stapling device further include for The trigger system close to the firing schedule terminal when the feedback device that indicates.

Surgical stapling devices of the embodiment 57- according to embodiment 54,55 or 56, the surgical stapling device further include use In the feedback device indicated when the cutting stroke is completed.

Surgical stapling devices of the embodiment 58- according to embodiment 54,55,56 or 57, the surgical stapling device further include For the feedback device indicated in terminal of the diced system close to the cutting stroke.

Surgical stapling devices of the embodiment 59- according to embodiment 54,55,56,57 or 58, the surgical stapling device is also Including visually indicating item, the item that visually indicates includes the first range and the second range, wherein first range show it is described The progress of firing schedule and second range show the progress of the cutting stroke.

Surgical stapling devices of the embodiment 60- according to embodiment 54,55,56,57,58 or 59, wherein the percussion system System includes firing trigger；The trigger shaft that can be operatively engaged with the firing trigger, wherein in the firing schedule phase Between the actuating of the firing trigger promote the firing member towards the end effector；And engaged with the trigger shaft Tactile feedback generator.

Surgical stapling devices of the embodiment 61- according to embodiment 60, wherein the tactile feedback generator is configured to A series of sound can be generated, a series of sound become increasing as the firing schedule carries out.

Surgical stapling devices of the embodiment 62- according to embodiment 60 or 61, wherein the tactile feedback generator is in institute It is noiseless during the first part for stating firing schedule and is audible during the second part of the firing schedule.

Surgical stapling devices of the embodiment 63- according to embodiment 60,61 or 62, wherein the tactile feedback generator It is configured to generate a series of sound with following rates, the rate increases as the firing schedule carries out.

Surgical stapling devices of the embodiment 64- according to embodiment 60,61,62 or 63, wherein the touch feedback occurs Device generates touch feedback when the trigger shaft reaches the terminal of its firing schedule.

Surgical staplings of the embodiment 65- according to embodiment 54,55,56,57,58,59,60,61,62,63 or 64 Device, wherein described device include the retainer for being configured to stop after the firing schedule trigger system, and And wherein described retainer can selectively be discharged by the user of the surgical stapling device.

Embodiment 66- is a kind of for treating the surgical stapling device of the tissue of patient, and the surgical stapling device includes shank；From The axis of the shank extension；And from the axis extend end effector, the end effector include the first jaw, second Jaw, wherein one of first jaw and second jaw can be transported relative to the another one of first jaw Dynamic, the warehouse including nail cavity and is configured to make the nail deformation nail being removedly stored in the nail cavity Anvil block.The surgical stapling device further includes trigger system, and the trigger system is configured to institute during firing schedule Nail is stated to project from the nail cavity towards the anvil block；Diced system, the diced system are configured in the firing schedule The tissue is cut during cutting stroke after having completed；And feedback generator, the feedback generator are adapted to Enough indicate the conversion between the firing schedule and the cutting stroke.

Embodiment 67- it is a kind of for treat patient tissue surgical stapling device, the surgical stapling device include shank, from The axis of the shank extension and the end effector extended from the axis, are in wherein the end effector can be constructed Open configuration and closed configuration.The end effector includes the first jaw；Second jaw, wherein second jaw being capable of court First jaw moves the end effector being placed in the closed configuration；Warehouse including nail cavity；Removedly store up There are the nails in the nail cavity；And it is configured to the anvil block for making the nail deformation.The surgical stapling device further include by It is constructed to be permeable to the closed system that second jaw is made to be moved towards first jaw；And trigger system, the percussion system System includes staple drivers, wherein the trigger system is configured to push the nail towards the anvil block during firing schedule Driver and bounce back during the retract stroke staple drivers and cutting element, the cutting element are adapted to It is enough to cut the tissue during stroke is cut, wherein the cutting element is included during the cutting stroke from the warehouse The cutting edge of exposing.The surgical stapling device further includes latching member, and the latching member is configured to prevent the nail driving Device is retracted during the firing schedule；It is described to be configured to overcome the locking around device and around device Part so that the staple drivers can be retracted during the firing schedule.

Embodiment 68- it is a kind of for treat patient tissue surgical stapling device, the surgical stapling device include shank, from The axis of the shank extension and the end effector extended from the axis, are in wherein the end effector can be constructed Open configuration and closed configuration.The end effector includes the first jaw；Second jaw, wherein second jaw being capable of court First jaw moves the end effector being placed in the closed configuration；Warehouse including nail cavity；Removedly store up There are the nails in the nail cavity；And it is configured to the anvil block for making the nail deformation.The surgical stapling device further include by It is constructed to be permeable to the closed system that second jaw is made to be moved towards first jaw；And trigger system, the percussion system System includes staple drivers, wherein the trigger system is configured to push the nail towards the anvil block during firing schedule Driver and bounce back during the retract stroke staple drivers and cutting element, the cutting element are adapted to It is enough to cut the tissue during stroke is cut, wherein the cutting element is included during the cutting stroke from the warehouse The cutting edge of exposing.The surgical stapling device further includes locking piece, and the locking piece is configured to prevent the nail driving Device is retracted before the cutting stroke is completed；And around device, it is described be configured to overcome around device it is described Locking piece so that the staple drivers can be retracted before the cutting stroke is completed.

Embodiment 69- it is a kind of for treat patient tissue surgical stapling device, the surgical stapling device include shank, from The axis of the shank extension and the end effector extended from the axis, are in wherein the end effector can be constructed Open configuration and closed configuration.The end effector includes the first jaw；Second jaw, wherein second jaw being capable of court First jaw moves the end effector being placed in the closed configuration；Warehouse including nail cavity；Removedly store up There are the nails in the nail cavity；And it is configured to the anvil block for making the nail deformation.The surgical stapling device further include by It is constructed to be permeable to the closed system that second jaw is made to be moved towards first jaw；And trigger system, the percussion system System includes staple drivers, wherein the trigger system is configured to push the nail towards the anvil block during firing schedule Driver and bounce back during the retract stroke staple drivers and cutting element, the cutting element are adapted to It is enough to cut the tissue during stroke is cut, wherein the cutting element is included during the cutting stroke from the warehouse The cutting edge of exposing.The surgical stapling device further includes latching member, and the latching member is configured to prevent the cutting structure Part is retracted during the cutting stroke；It is described to be configured to overcome the locking around device and around device Part so that the cutting element can be retracted during the cutting stroke.

The complete disclosure of following patents is hereby incorporated by reference：

The U.S. for being published in entitled " the ELECTROSURGICAL HEMOSTATIC DEVICE " on April nineteen ninety-five 4 is special Profit 5,403,312；

It is published in entitled " the SURGICAL STAPLING INSTRUMENT HAVING of on 2 21st, 2006 The United States Patent (USP) 7,000,818 of SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS "；

It is published in September, 2008 entitled " the MOTOR-DRIVEN SURGICAL CUTTING AND of 9 days The United States Patent (USP) 7,422,139 of FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK "；

It is published in entitled " the ELECTRO-MECHANICAL SURGICAL INSTRUMENT on December 16th, 2008 The United States Patent (USP) 7,464,849 of WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS "；

It is published in entitled " the SURGICAL INSTRUMENT HAVING AN ARTICULATING on March 2nd, 2010 The United States Patent (USP) 7,670,334 of END EFFECTOR "；

It is published in the United States Patent (USP) of entitled " the SURGICAL STAPLING INSTRUMENTS " on July 13rd, 2010 7,753,245；

It is published in entitled " the SELECTIVELY ORIENTABLE IMPLANTABLE on March 12nd, 2013 The United States Patent (USP) 8,393,514 of FASTENER CARTRIDGE "；

The United States Patent (USP) Shen of entitled " SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES " It please sequence number 11/343,803；It is now United States Patent (USP) 7,845,537；

It is filed in entitled " the SURGICAL CUTTING AND FASTENING INSTRUMENT of on 2 14th, 2008 The U.S. Patent Application Serial Number 12/031,573 of HAVING RF ELECTRODES "；

It is filed in entitled " the END EFFECTORS FOR A SURGICAL CUTTING AND of on 2 15th, 2008 The U.S. Patent Application Serial Number 12/031,873 of STAPLING INSTRUMENT " is now United States Patent (USP) 7,980,443；

The U.S. Patent Application Serial Number of entitled " MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT " 12/235,782, it is now United States Patent (USP) 8,210,411；

Entitled " POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY The U.S. Patent Application Serial Number 12/249,117 of RETRACTABLE FIRING SYSTEM " is now United States Patent (USP) 8,608, 045；

It is filed in entitled " the MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT on December 24th, 2009 The U.S. Patent Application Serial Number 12/ of WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY " 647,100；It is now United States Patent (USP) 8,220,688；

It is filed in the U.S. Patent Application Serial Number 12/ of in September, 2012 entitled " the STAPLE CARTRIDGE " of 29 days 893,461, it is now United States Patent (USP) 8,733,613；

It is filed in the United States Patent (USP) Shen of entitled " the SURGICAL STAPLING INSTRUMENT " of on 2 28th, 2011 Please sequence number 13/036,647, be now United States Patent (USP) 8,561,870；

Entitled " SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT The U.S. Patent Application Serial Number 13/118,241 of ARRANGEMENTS " is now United States Patent (USP) 9,072,535；

It is filed in entitled " the ARTICULATABLE SURGICAL INSTRUMENT on June 15th, 2012 The U.S. Patent Application Serial Number 13/524,049 of COMPRISING A FIRING DRIVE "；It is now U.S. Patent Application Publication 2013/0334278；

It is filed in entitled " the STAPLE CARTRIDGE TISSUE THICKNESS SENSOR on March 13rd, 2013 The U.S. Patent Application Serial Number 13/800,025 of SYSTEM " is now U.S. Patent Application Publication 2014/0263551；

It is filed in entitled " the STAPLE CARTRIDGE TISSUE THICKNESS SENSOR on March 13rd, 2013 The U.S. Patent Application Serial Number 13/800,067 of SYSTEM " is now U.S. Patent Application Publication 2014/0263552；

It is filed in entitled " the SURGICAL CUTTING AND FASTENING INSTRUMENT on January 31st, 2006 The U.S. Patent Application Publication 2007/0175955 of WITH CLOSURE TRIGGER LOCKING MECHANISM "；And

It is filed in entitled " the SURGICAL STAPLING INSTRUMENT WITH AN on April 22nd, 2010 The U.S. Patent Application Publication 2010/0264194 of ARTICULATABLE END EFFECTOR " is now United States Patent (USP) 8,308, 040。

Although having combined the various embodiments that certain disclosed embodiments describe device herein, can also implement pair Many modifications and variations of these embodiments.In addition, when materials for certain parts are disclosed, it is possible to use Other materials.In addition, according to multiple embodiments, single component can be replaced by multiple components, and multiple components also can quilt Single component is replaced with, to perform given one or more functions.Above-mentioned specific embodiment and the claims below are intended to Cover all such modifications and variations.

Apparatus as disclosed herein be designed to discard after a single use or its be designed to use it is more It is secondary.However no matter what kind of situation it is, which all can be at least using exercising use after primary again by repairing.Reparation may include tearing open Handler, cleaning or the combination of wherein arbitrary several steps replaced specific component and subsequently re-assemblied.Specifically, it is described Device is detachable, and selectively can replace or remove in any combination any number of specific component or the portion of described device Part.After cleaning and/or replacing particular elements, described device can be re-assemblied, then to make at the repair facility With or just used by operating team before surgical protocols.It will be appreciated by those skilled in the art that prosthetic device can utilize respectively Kind of technology is dismantled, cleans/replace and re-assembly.The use of such technology and the prosthetic device of gained are in this Shen Please in the range of.

Only by way of example, herein described aspects can be handled before surgical operation.It is possible, firstly, to it obtains New or used instrument, and cleaned as needed.Then, it can carry out disinfection to instrument.In a kind of sterilization technology, The instrument is placed in the container (such as, plastics or TYVEK bag) of closure and sealing.Then container and instrument can be placed in can Penetrate the radiation field of the container, such as γ radiation, x-ray or high energy electron.Radiation can kill thin on instrument and in container Bacterium.Instrument after disinfection can be then stored in sterile chamber.Sealing container can keep instrument in germ-free condition, until The container is opened in medical facilities.Any other technology known in the art also can be used to carry out disinfection device, it is described Technology includes but not limited to β or γ radiation, ethylene oxide or steam.

Although the present invention has been described as having exemplary design, but it is further repaiied in the spirit and scope of the disclosure Change the present invention.Therefore, present patent application be intended to cover using the present invention General Principle the present invention any modification, purposes or Remodeling.

Any patent incorporated herein by reference in its entirety or in part, announcement or other public materials only simultaneously It is incorporated herein in the conflicting range of existing definitions, statements, or other disclosure materials that the material entered is not proposed with the disclosure. Therefore, and at the necessary level, disclosure specifically listed herein replaces any punching being herein incorporated by reference Prominent material.It is said that being herein incorporated by reference but the existing definitions, statements, or other disclosure materials with listing herein mutually conflict Any material or part thereof, will only not generated between incorporated material and existing public material under the degree that conflicts simultaneously Enter.

Claims (21)

1. a kind of for treating the surgical stapling device of the tissue of patient, the surgical stapling device includes：

Shank；

Axis, the axis extend from the shank；

End effector, the end effector extend from the axis, are beaten wherein the end effector can be constructed to be in Configuration and closed configuration are opened, and wherein described end effector includes：

First jaw；

Second jaw, wherein second jaw can be described the end effector to be placed in towards first jaw movement Closed configuration；

Warehouse, the warehouse include nail cavity；

Nail, the nail are removedly stored in the nail cavity；And

Anvil block, the anvil block are configured to make the nail deformation；

Closed system, the closed system are configured to that second jaw is made to move towards first jaw；

Trigger system, the trigger system include：

Driver is fired, the percussion driver is configured to the nail during firing schedule from the nail cavity towards institute State anvil block injection；And

Cutting element, the cutting element are configured to cut the tissue during stroke is cut and in retract stroke The period retraction cutting element；And

Device, described device for preventing the end effector back to the open configuration, until the retract stroke After completion.

2. surgical stapling device according to claim 1, wherein described device allow the end effector in the percussion The open configuration is returned to during stroke.

3. surgical stapling device according to claim 1, wherein described device allow the end effector in the percussion The open configuration is returned to after stroke is completed and before the cutting stroke starts.

4. surgical stapling device according to claim 1, the surgical stapling device further includes：

Tissue pin, the tissue pin can move between non-deployed position and deployed position, wherein the tissue pin is constructed Into can by it is described tissue capture in the end effector；And

Tissue pin actuator, the tissue pin actuator be configured to during stroke dispose in the non-deployed position and Extend the tissue pin between the deployed position, and the tissue is recalled towards the non-deployed position during stroke is recalled Pin, wherein described device prevent the tissue pin from being recalled during the cutting stroke towards the non-deployed position.

5. surgical stapling device according to claim 1, the surgical stapling device further includes：

Tissue pin, the tissue pin can move between non-deployed position and deployed position, wherein the tissue pin is constructed Into can by it is described tissue capture in the end effector；And

Tissue pin actuator, the tissue pin actuator be configured to during stroke dispose in the non-deployed position and Extend the tissue pin between the deployed position, and the tissue is recalled towards the non-deployed position during stroke is recalled Pin, wherein described device prevent the tissue pin from being recalled during the firing schedule towards the non-deployed position.

6. a kind of for treating the surgical stapling device of the tissue of patient, the surgical stapling device includes：

Shank；

Axis, the axis extend from the shank；

End effector, the end effector extend from the axis, are beaten wherein the end effector can be constructed to be in Configuration and closed configuration are opened, and wherein described end effector includes：

First jaw；

Second jaw, wherein second jaw can be described the end effector to be placed in towards first jaw movement Closed configuration；

Warehouse, the warehouse include nail cavity；

Nail, the nail are removedly stored in the nail cavity；And

Anvil block, the anvil block are configured to make the nail deformation；

Closed system, the closed system are configured to that second jaw is made to move towards first jaw；

Trigger system, the trigger system include：

Driver, the driver are configured to penetrate the nail from the nail cavity towards the anvil block during firing schedule Go out；And

Cutting element, the cutting element is configured to cut the tissue during stroke is cut, wherein the cutting Component includes the cutting edge exposed during the cutting stroke from the warehouse；And

Device, described device are used to that the closed system to be prevented to return to the open configuration when the cutting element exposes.

7. surgical stapling device according to claim 6, wherein described device allow the end effector in the percussion The open configuration is returned to during stroke.

8. surgical stapling device according to claim 6, wherein described device allow the end effector in the percussion The open configuration is returned to after stroke is completed and before the cutting stroke starts.

9. surgical stapling device according to claim 6, wherein described device allow the end effector in the percussion The open configuration is returned to after stroke is completed and before cutting element exposing.

10. surgical stapling device according to claim 6, the surgical stapling device further includes：

Tissue pin, the tissue pin can move between non-deployed position and deployed position, wherein the tissue pin is constructed Into can by it is described tissue capture in the end effector；And

Tissue pin actuator, the tissue pin actuator be configured to during stroke dispose in the non-deployed position and Extend the tissue pin between the deployed position, and the tissue is recalled towards the non-deployed position during stroke is recalled Pin, wherein described device prevent the tissue pin from being recalled when the cutting element exposes towards the non-deployed position.

11. surgical stapling device according to claim 6, the surgical stapling device further includes：

Tissue pin, the tissue pin can move between non-deployed position and deployed position, wherein the tissue pin is constructed Into can by it is described tissue capture in the end effector；And

Tissue pin actuator, the tissue pin actuator be configured to during stroke dispose in the non-deployed position and Extend the tissue pin between the deployed position, and the tissue is recalled towards the non-deployed position during stroke is recalled Pin, wherein described device prevent the tissue pin from being recalled during the firing schedule towards the non-deployed position.

12. a kind of for treating the surgical stapling device of the tissue of patient, the surgical stapling device includes：

Shank；

Axis, the axis extend from the shank；

End effector, the end effector extend from the axis, are beaten wherein the end effector can be constructed to be in Configuration and closed configuration are opened, and wherein described end effector includes：

First jaw；

Second jaw, wherein second jaw can be described the end effector to be placed in towards first jaw movement Closed configuration；

Warehouse, the warehouse include nail cavity；

Nail, the nail are removedly stored in the nail cavity；And

Anvil block, the anvil block are configured to make the nail deformation；

Closed system, the closed system are configured to that second jaw is made to move towards first jaw；

Trigger system, the trigger system include：

Staple drivers, wherein the trigger system is configured to the nail be pushed to drive towards the anvil block during firing schedule Dynamic device and the staple drivers that bounce back during retract stroke；And

Cutting element, the cutting element is configured to cut the tissue during stroke is cut, wherein the cutting Component includes the cutting edge exposed during the cutting stroke from the warehouse；And

Device, described device are used to that the staple drivers to be prevented to bounce back when the cutting element exposes.

13. surgical stapling device according to claim 12, wherein described device allow the end effector to be hit described The open configuration is returned to during issuing journey.

14. surgical stapling device according to claim 12, wherein described device allow the end effector to be hit described The open configuration is returned to after distribution journey is completed and before the cutting stroke starts.

15. surgical stapling device according to claim 12, wherein described device allow the end effector to be hit described It issues after journey is completed and returns to the open configuration before cutting element exposing.

16. surgical stapling device according to claim 12, the surgical stapling device further includes：

Tissue pin, the tissue pin can move between non-deployed position and deployed position, wherein the tissue pin is constructed Into can by it is described tissue capture in the end effector；And

Tissue pin actuator, the tissue pin actuator be configured to during stroke dispose in the non-deployed position and Extend the tissue pin between the deployed position, and the tissue is recalled towards the non-deployed position during stroke is recalled Pin, wherein described device prevent the tissue pin from being recalled during the cutting stroke towards the non-deployed position.

17. surgical stapling device according to claim 12, the surgical stapling device further includes：

Tissue pin, the tissue pin can move between non-deployed position and deployed position, wherein the tissue pin is constructed Into can by it is described tissue capture in the end effector；And

Tissue pin actuator, the tissue pin actuator be configured to during stroke dispose in the non-deployed position and Extend the tissue pin between the deployed position, and the tissue is recalled towards the non-deployed position during stroke is recalled Pin, wherein described device prevent the tissue pin from being recalled during the firing schedule towards the non-deployed position.

18. a kind of for treating the surgical stapling device of the tissue of patient, the surgical stapling device includes：

Shank；

Axis, the axis extend from the shank；

End effector, the end effector extend from the axis, are beaten wherein the end effector can be constructed to be in Configuration and closed configuration are opened, and wherein described end effector includes：

First jaw；

Second jaw, wherein second jaw can be described the end effector to be placed in towards first jaw movement Closed configuration；

Warehouse, the warehouse include nail cavity；

Nail, the nail are removedly stored in the nail cavity；

Anvil block, the anvil block are configured to make the nail deformation；And

Tissue pin, the tissue pin can move between non-deployed position and deployed position, wherein the tissue pin is constructed Into can by it is described tissue capture in the end effector；

Closed system, the closed system are configured to that second jaw is made to move towards first jaw；

Tissue pin actuator, the tissue pin actuator are configured to make during stroke is disposed the tissue pin described It moves between non-deployed position and the deployed position, and bounces back described group towards the non-deployed position during retract stroke Knit pin；

Trigger system, the trigger system include：

Staple drivers, wherein the trigger system is configured to the nail be pushed to drive towards the anvil block during firing schedule Dynamic device；And

Cutting element, the cutting element is configured to cut the tissue during stroke is cut, wherein the cutting Component includes the cutting edge exposed during the cutting stroke from the warehouse；And

Device, described device bounce back for the tissue to be prevented to sell when the cutting element exposes.

19. surgical stapling device according to claim 18, wherein described device allow the end effector to be hit described The open configuration is returned to during issuing journey.

20. surgical stapling device according to claim 18, wherein described device allow the end effector to be hit described The open configuration is returned to after distribution journey is completed and before the cutting stroke starts.

21. surgical stapling device according to claim 18, wherein described device allow the end effector to be hit described It issues after journey is completed and returns to the open configuration before cutting element exposing.