CN108348233B - 用于允许改变钉特性并实现轻松仓加载的外科钉条 - Google Patents

用于允许改变钉特性并实现轻松仓加载的外科钉条 Download PDF

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CN108348233B
CN108348233B CN201680062522.1A CN201680062522A CN108348233B CN 108348233 B CN108348233 B CN 108348233B CN 201680062522 A CN201680062522 A CN 201680062522A CN 108348233 B CN108348233 B CN 108348233B
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staple
staples
staple cartridge
surgical
cartridge
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CN108348233A (zh
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C·O·巴克斯特三世
F·E·谢尔顿四世
J·S·斯韦兹
J·R·摩根
J·L·哈里斯
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Ethicon LLC
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Abstract

本发明公开了一种外科钉仓，所述外科钉仓包括能够移除地储存在所述外科钉仓内的钉条。所述钉条包括多个钉、基部条以及将所述钉连结到所述基部条的多个连接器部分。

Description

用于允许改变钉特性并实现轻松仓加载的外科钉条
背景技术
本发明涉及外科器械，并且在各种实施方案中，涉及外科缝合和切割器械以及与其一起使用的钉仓。
缝合器械可包括一对协同工作的细长钳口构件，其中每个钳口构件可适于插入患者体内并且相对于待缝合和/或切入的组织定位。在各种实施方案中，钳口构件中的一个可支撑其中容纳有至少两个侧向地隔开的钉排的钉仓，并且另一个钳口构件可支撑具有与钉仓中的钉排对准的钉成形凹坑的砧座。一般来讲，缝合器械还可包括推杆和刀片，该推杆和刀片能够相对于钳口构件滑动以经由推杆上的凸轮表面和/或由推杆推动的楔形滑动件上的凸轮表面将钉从钉仓中连续射出。在至少一个实施方案中，凸轮表面可被构造成能够致动由仓承载并与钉相关联的多个钉驱动器，以便推动钉抵靠在砧座上并且在夹持于钳口构件之间的组织中形成侧向地隔开的变形钉排。在至少一个实施方案中，刀片可跟随凸轮表面并且沿着钉排之间的线切割组织。
上述讨论仅是为了举例说明本发明的领域中相关技术目前的各个方面，而不应当视为对权利要求范围的否定。
附图说明
本文所述的实施方案的各种特征在所附权利要求书中进行了具体描述。然而，关于操作的组织和方法的各种实施方案以及其优点的各种实施方案可结合如下附图根据以下描述来加以理解：
图1为根据至少一个实施方案的与外科缝合器械一起使用的钉的透视图；
图2为图1的钉的侧正视图；
图3为图1的钉的顶视图；
图4为沿着图3的线4-4截取的图1的钉的剖视图；
图5为根据至少一个实施方案的与外科缝合器械一起使用的钉的透视图；
图6为图5的钉的侧正视图；
图7为根据至少一个实施方案的与外科缝合器械一起使用的钉的侧正视图；
图8为处于成形构型的图7的钉的侧正视图；
图9为处于图8的成形构型的图7的钉的顶视图；
图10为处于成形构型的图7的钉的侧正视图以及外科缝合器械的砧座的局部剖视图；
图11为根据至少一个实施方案的与外科缝合器械一起使用的钉的透视图；
图11A-11C为图11的钉的部分的横截面；
图12为根据至少一个实施方案的与外科缝合器械一起使用的钉的透视图；
图13为根据至少一个实施方案的与外科缝合器械一起使用的钉的侧正视图；
图14为根据至少一个实施方案的包括多个钉的成形钉构型的局部顶视图；
图15为根据至少一个实施方案的与外科缝合器械一起使用的钉的透视图；
图16为砧座的局部剖视图，示出了从未成形构型成形为成形构型的图 15的钉的一部分；
图17为处于成形构型的图15的钉的正视图；
图18包括根据至少一个实施方案的多个钉尖端的侧视图；
图19为根据至少一个实施方案的钉和根据第一布置的砧座的成形凹坑的底视图；
图20为沿着图19的线20-20截取的图19的砧座凹坑的局部剖视图；
图21为根据第二布置的图19的钉和成形凹坑的底视图；
图22为根据第三布置的图19的钉和成形凹坑的底视图；
图23为根据至少一个实施方案的图19的钉和成形凹坑的底视图；
图24为沿着图23的线24-24截取的图23的砧座凹坑的局部剖视图；
图25为根据至少一个实施方案的图19的钉和成形凹坑的底视图；
图26为根据至少一个实施方案的图19的钉和成形凹坑的底视图；
图27为根据至少一个实施方案的钉腿的局部透视图；
图27A为图27的钉腿的局部剖面端视图；
图27B为图27的钉腿的局部纵截面；
图28为使用级进模冲压制造的钉条的一部分的透视图；
图28A为沿着图28的线28A-28A截取的图28的钉条部分的局部剖视图；
图28B为沿着图28的线28B-28B截取的图28的钉条部分的局部剖视图；
图28C为滑动件的局部透视图，该滑动件被构造成能够接合图28的钉条；
图29为根据至少一个实施方案的使用级进模冲压制造的钉条的一部分的透视图；
图30为图29的钉条的底部透视图；
图31为根据至少一个实施方案的钉仓和钉的局部剖视图；
图32为根据至少一个实施方案的钉仓组件的透视图；
图33为图32的钉仓组件的顶部平面图；
图34为图32的钉仓组件的远侧端部的细部图；
图35为根据至少一个实施方案的钉仓组件的局部剖面透视图，示出了通过击发构件从钉仓组件射出的钉；
图36为图35的钉仓组件的局部分解图；
图37为图35的钉仓组件的局部剖视图，示出了通过击发构件使之抵靠在砧座上变形的钉；
图38为定位在图35的钉仓组件的钉腔中的钉的局部平面图；
图39为通过图35的钉仓的击发构件提升的钉的局部透视图；
图40为图39的钉的底部透视图；
图41为示出了处于水平位置的图39的钉的示意图；
图42为示出了处于弯曲位置的图39的钉的示意图；
图43为根据至少一个实施方案的钉腔的剖视平面图，该钉腔被构造成能够引导钉；
图44为根据至少一个实施方案的定位在外科缝合器械的钳口中的钉仓组件的剖面透视图，示出了定位在钉仓组件的仓体中的击发构件；
图45为图44的钉仓组件的局部剖面透视图，示出了保持特征结构，该保持特征结构被构造成能够在钉仓组件不定位在外科缝合器械的钳口中时将击发构件保持在仓体中；
图46为图44的钉仓组件的局部剖面分解图；
图47为图44的钉仓组件的局部剖面端视图；
图48为图44的钉仓组件的局部剖面透视图，示出了保持特征结构，该保持特征结构被构造成能够将钉仓组件可释放地保持在外科缝合器械的钳口中；
图49为根据至少一个实施方案的定位在钉仓组件的钉腔中的钉的局部平面图；
图50为保持特征结构的细部图，该保持特征结构被构造成能够将钉可释放地保持在图49的钉仓组件中；
图51为根据至少一个实施方案的钉仓组件的局部剖面正视图；
图52为根据至少一个实施方案的钉的透视图；
图53为图52的钉的底部透视图；
图54为图52的钉的前正视图；
图55为图52的钉的侧正视图；
图56为图52的钉的底视图；
图57为根据至少一个实施方案的钉仓组件的击发构件的透视图，该击发构件包括对准通道；
图58为示出了图57的击发构件和定位在钉仓组件的钉腔中的钉的示意图；
图59为示出了与图58的钉腔内的图58的钉对准的图57的击发构件的示意图；
图60为图57的击发构件和被布置成两个纵向排的钉的透视图；
图61为图57的击发构件的对准通道和图58的钉的一部分的局部剖视图；
图62为图58的钉仓组件的局部剖面透视图；
图63为图58的钉仓组件的局部分解图；
图64为图58的钉仓组件的局部底部剖面透视图；
图65为根据至少一个另选的实施方案的从钉仓组件的甲板表面延伸的突出部的局部透视图；
图66为根据至少一个另选的实施方案的从钉仓组件的甲板表面延伸的突出部的局部透视图；
图67为钉仓组件的仓体的底部透视图；
图68为图67的仓体的底视图；
图69为图32的钉仓组件的仓体的底部透视图；
图70为图32的仓体的底视图；
图71为示出了图67的仓体与仓体的另选实施方案的示意图；
图72为根据至少一个实施方案的钉仓组件的局部顶部平面图；
图73为图32的钉仓的局部透视图；
图74为图32的钉仓和图37的砧座的剖视图，示出了处于未击发位置的某些钉和处于击发位置的某些钉；
图75示出了变形为三种不同高度的图32的钉仓的钉；
图76示出了植入患者组织中的图32的钉仓的钉；
图77示出了发生变形的图32的钉仓的钉；
图78为根据至少一个实施方案的钉的透视图；
图79为图78的钉的剖视图；
图80为根据至少一个实施方案的钉组件的透视图；
图81为图80的钉组件的正视图；
图82为可植入钉辅助件的透视图；
图83为图82的钉辅助件的剖视图；
图84为包括图82的钉辅助件在内的钉组件的局部透视图；
图85示出了植入到组织中的图84的钉组件；
图86为根据至少一个实施方案的被示出为处于变形构型的钉的透视图；
图87为根据至少一个实施方案的包括图84的多个钉组件在内的圆形仓体的平面图；
图88示出了未拉伸组织中的图35的钉的间距；
图89示出了拉伸组织中的图35的钉的间距；
图90为根据至少一个实施方案的钉的透视图；
图91示出了植入到组织中的图90的钉；
图92示出了在部分溶解之后的图90的钉；
图93为根据至少一个实施方案的圆形外科缝合器的一部分的剖面透视图；
图94为图93的圆形外科缝合器的局部剖面透视图；
图95为图93的圆形外科缝合器的局部透视图；
图96为根据至少一个实施方案的圆形外科缝合器的局部分解透视图；
图97为图96的圆形外科缝合器的局部透视图，示出了处于预加载位置的钉；
图98为图96的圆形外科缝合器的局部透视图；
图99为根据至少一个实施方案的圆形外科缝合构型的端视图；
图100为根据至少一个实施方案的圆形外科缝合构型的端视图；
图101为使用本文所公开的圆形缝合器械缝合的结肠的局部剖视图；
图102为根据至少一个实施方案的弯曲缝合器的局部透视图；
图103为图102的弯曲缝合器的局部分解图；
图104为图102的弯曲缝合器的局部透视图；
图105为根据至少一个实施方案的弯曲缝合器的局部透视图；并且
图106为图105的弯曲缝合器的局部透视图。
在所述若干视图中，对应的参考符号指示对应的部件。本文所述的范例以一种形式示出了本发明的各种实施方案，并且这种范例不应被解释为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL STAPLES FOR MINIMIZING STAPLE ROLL”的美国专利申请序列号14/836,324；美国专利申请公开号2017/0056005；
-名称为“SURGICAL STAPLES COMPRISING FEATURES FOR IMPROVED FASTENINGOF TISSUE”的美国专利申请序列号 14/836,020；美国专利申请公开号2017/0055996；
-名称为“SURGICAL STAPLES COMPRISING HARDNESS VARIATIONS FOR IMPROVEDFASTENING OF TISSUE”的美国专利申请序列号14/836,411；美国专利申请公开号2017/0056008；
-名称为“SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULARSTAPLING INSTRUMENTS”的美国专利申请序列号14/836,110；美国专利申请公开号2017/0056000；
-名称为“STAPLE CARTRIDGE ASSEMBLY WITHOUT A BOTTOM COVER”的美国专利申请序列号14/836,036；美国专利申请公开号 2017/0055997；
-名称为“STAPLE CARTRIDGE ASSEMBLY COMPRISING STAPLE CAVITIES FORPROVIDING BETTER STAPLE GUIDANCE”的美国专利申请序列号14/836,077；美国专利申请公开号2017/0055999；
-名称为“STAPLE CARTRIDGE ASSEMBLY INCLUDING STAPLE GUIDES”的美国专利申请序列号14/836,225；美国专利申请公开号 2017/0056003；
-名称为“STAPLE CARTRIDGE ASSEMBLY COMPRISING STAPLE ALIGNMENTFEATURES ON A FIRING MEMBER”的美国专利申请序列号14/836,351；美国专利申请公开号2017/0056006；
-名称为“STAPLE CARTRIDGE ASSEMBLY COMPRISING VARIOUS TISSUECOMPRESSION GAPS AND STAPLE FORMING GAPS”的美国专利申请序列号14/836,163；美国专利申请公开号 2017/0056002；
-名称为“STAPLES CONFIGURED TO SUPPORT AN IMPLANTABLE ADJUNCT”的美国专利申请序列号14/836,294；美国专利申请公开号2017/0056004；
-名称为“STAPLES COMPRISING A COVER”的美国专利申请序列号14/836,375；美国专利申请公开号2017/0056007；以及
-名称为“STAPLE CARTRIDGE ASSEMBLY INCLUDING FEATURES FOR CONTROLLINGTHE ROTATION OF STAPLES WHEN BEING EJECTED THEREFROM”的美国专利申请序列号14/836,137；美国专利申请公开号2017/0056001。
本申请的申请人还拥有于2013年12月23日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE SHAFT ARRANGEMENTS”的美国专利申请序列号14/138,554；
-名称为“SURGICAL STAPLES AND STAPLE CARTRIDGES”的美国专利申请序列号14/138,465；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SEPARATE AND DISTINCTCLOSING and FIRING SYSTEMS”的美国专利申请序列号14/138,474；
-名称为“SURGICAL CUTTING AND STAPLING INSTRUMENTS WITH INDEPENDENTJAW CONTROL FEATURES”的美国专利申请序列号14/138,485；
-名称为“SURGICAL STAPLES AND STAPLE CARTRIDGES”的美国专利申请序列号14/138,475；
-名称为“SURGICAL STAPLES AND METHODS FOR MAKING THE SAME”的美国专利申请序列号14/138,481；
-名称为“SURGICAL STAPLES,STAPLE CARTRIDGES AND SURGICAL ENDEFFECTORS”的美国专利申请序列号14/138,489；
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号 29/477,488；
-名称为“FASTENER CARTRIDGE COMPRISING AN EXTENDABLE FIRING MEMBER”的美国专利申请序列号14/138,505；
-名称为“FASTENER CARTRIDGE COMPRISING A FIRING MEMBER CONFIGURED TODIRECTLY ENGAGE AND EJECT FASTENERS FROM THE FASTENER CARTRIDGE”的美国专利申请序列号14/138,518；
-名称为“FASTENER CARTRIDGE COMPRISING A FIRING MEMBER INCLUDINGFASTENER TRANSFER SURFACES”的美国专利申请序列号14/138,530；
-名称为“MODULAR SURGICAL INSTRUMENTS”的美国专利申请序列号14/138,507；
-名称为“SURGICAL CUTTING AND STAPLING INSTRUMENTS WITH ARTICULATABLEEND EFFECTORS”的美国专利申请序列号14/138,497；以及
-名称为“SURGICAL CUTTING AND STAPLING METHODS”的美国专利申请序列号14/138,516。
本文列出了许多具体细节，以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件，以免使说明书中描述的实施方案模糊不清。读者将会理解，本文所述和所示的实施方案为非限制性示例，从而可认识到，本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求书范围的情况下，可对这些实施方案进行变型和改变。
术语“包括(comprise)”(及“包括(comprise)”的任何形式，诸如“包括(comprises)”和“包括(comprising)”)、“具有(have)” (及“具有(have)”的任何形式，诸如“具有(has)”和“具有(having)”)、“包含(include)”(及“包含(include)”的任何形式，诸如“包含(includes)”和“包含(including)”)、以及“含有(contain)”(及“含有(contain)”的任何形式，诸如“含有(contains)”和“含有(containing)”)为开放式系动词。因此，“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置或设备具有那些一个或多个元件，但不限于仅具有那些一个或多个元件。同样，“包括”、“具有”、“包含”或“含有”一个或多个特征的系统、装置或设备的元件具有那些一个或多个特征，但不限于仅具有那些一个或多个特征。
术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分，并且术语“远侧”是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而，外科器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以用于执行腹腔镜式和微创外科手术操作。然而，读者将容易理解，本文所公开的各种方法和装置可用于多种外科手术和应用中，包括例如与开放式外科手术结合。继续参阅本具体实施方式，读者将进一步理解，本文所公开的各种器械可以任何方式插入身体中，诸如通过自然腔道、通过形成于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可直接插入患者身体中或可通过具有工作通道的进入装置插入，外科器械的端部执行器和细长轴可穿过该工作通道推进。
本文所公开的钉或紧固件被构造成能够与外科缝合器械一起使用。如下文更详细地讨论，钉能够移除地储存在钉仓的钉腔中。钉仓包括滑动件，该滑动件被构造成能够从外科缝合器械接收击发致动，该击发致动对钉施加力而将钉从钉腔射出。当通过滑动件将钉从钉腔中射出或驱动出时，钉经历变形过程，在该变形过程中，钉从未击发构型成形为击发构型。当钉接触外科缝合器械的砧座的对应成形凹坑时，钉成形为击发构型。
本文所公开的各种钉包括平坦成形钉，该平坦成形钉可例如由材料片切割和/或冲压而成。例如，材料片可为金属的，并且可包括不锈钢和/或钛。在至少一种情况下，可将轮廓描画、蚀刻和/或切割到材料片中，对该材料片进行加工和/或激光切割以使钉成形为制造的形状。
钉包括一对钉腿以及钉腿从其延伸的钉基部分或冠部。每个钉腿包括钉尖端或穿刺部分，该钉尖端或穿刺部分被构造成能够穿刺组织并且接触外科缝合器械的砧座的对应成形凹坑。钉腿被构造成能够改变形状以实现成形构型，从而紧固组织。钉基部分限定第一平面，并且钉腿限定第二平面，该第二平面从该第一平面侧向地偏移，但至少基本上平行于该第一平面。可以设想到第一平面和第二平面不平行的实施方案。
图1-4所示的平坦成形钉100包括近侧钉腿110、远侧钉腿120和钉基部分130。钉100还包括竖直过渡部分或弯曲部118,128和侧向过渡部分或弯曲部116,126。竖直过渡部分118,128从钉基部分130竖直地或向上弯曲或延伸腿部110,120。侧向过渡部分116,126相对于钉基部分130侧向向外或至少基本上垂直地延伸钉腿110,120。钉腿110,120限定第一平面，并且钉基部分130限定第二平面。竖直过渡部分118,128和侧向过渡部分116, 126一起允许钉腿110,120相对于钉基部分130侧向地偏移和平行。换句话说，第一平面从第二平面偏移并且至少基本上平行于第二平面。在图1-4中，第一平面在负Y方向上偏移。其他钉可与多个钉100结合使用，其中其他钉包括在正Y方向上偏移的第一平面。这两种类型的钉的使用允许钉排嵌套或交织，其中邻近排的钉腿可至少基本上对准和/或共享公共纵向轴线。在各种情况下，钉排可嵌套以提供更密集的钉排。
近侧钉腿110和远侧钉腿120分别包括钉尖端112,122和拐角114,124。尖端112,122被构造成能够穿刺组织并且接触外科缝合器械的砧座的成形凹坑。当钉100接收驱动力以从钉仓中的对应钉腔射出钉100时，尖端112, 122接触砧座。钉100的尖端112,122和/或腿部110,120随后将开始从未击发构型成形为击发构型。近侧钉腿120还包括具有倒角表面或边缘119的前导接合脚部117。随着在滑动件朝远侧平移时滑动件接触钉100，滑动件的特征结构可接合前导接合脚部117以有助于防止例如纵向钉转动或旋转。接合脚部117可包括推动点，该推动点被构造成能够被推动以将钉100加载到钉仓中。
由于钉100是平坦成形钉，因此在从平坦或至少基本上平坦的原料冲压之后，可进一步制作或加工钉100的钉腿110,120、尖端112,122和/或其他部分。进一步制作钉100可提供形成和/或改变例如优先弯曲平面、韧性和/ 或弹性的具体特性。传统线材成形钉具有有利于外科紧固的期望特性，并且可用钉100实施。用于构造拐角114,124和/或尖端112,122的方法例如可包括任何合适的工艺，包括例如冷加工。具体工艺可包括通过以下方式进行的精压：将拐角114,124加工成例如倒圆的、成角的、倾斜的和/或抛物线的外形。也可使用相似方法加工钉尖端112,122以提供适宜尖端，该适宜尖端被构造成能够穿刺组织并且抵靠在砧座的对应成形凹坑上成形。
钉基部分130包括倾斜驱动表面132、最终驱动表面131和远侧壁133。在各种实施方案中，通过盘将钉100支撑在钉仓中，其中最终驱动表面131 被构造成能够搁置在盘上。在钉仓没有盘的各种其他实施方案中，最终驱动表面并未搁置在盘上，相反，最终驱动表面具有位于无盘钉仓的底部表面上方的初始位置。当滑动件平移经过仓时，这将允许滑动件的底部表面和无盘钉仓的底部表面至少基本上齐平。每个钉基部分130的驱动表面132被构造成能够从外科缝合器械的滑动件接收驱动力Fs。当滑动件朝远侧平移经过钉仓时，滑动件接触驱动表面132以将钉100提升出仓，另外还接触最终驱动表面131以使钉100成形为其击发构型。
远侧壁133充当钉基部分130的最远侧壁并且定位在远侧钉腿120的近侧，从而缺少远侧钉腿120下面的钉基部分130的任何部分。钉100的基部部分130中具有更大量的质量增强了钉100抵抗由滑动件施加的力矩MS所引起的旋转运动的能力。增大钉基部分130的惯性力矩增强了抵抗旋转运动的能力。因此，将需要更大的转矩或更大的力矩才能引起纵向钉转动。
钉基部分130还包括顶部表面或压缩表面136，该顶部表面或压缩表面包括近侧表面139、中间表面138和远侧表面137。近侧表面139朝近侧腿部110向上成角或倾斜。远侧表面137朝远侧腿部120向上成角或倾斜。中间表面138至少基本上平行于最终驱动表面131。该谷状构型限制在过渡部分118,128,116,126附近捕获的组织的应力集中，在这些过渡部分处腿部 110,120从钉基部分130延伸。在各种实施方案中，这些表面137,138,139 可弯曲而形成凹表面。在传统钉中，当成形时，腿部与钉基相交的连接部产生会引起较高局部组织应力的位置。在这种传统钉扭曲、或被压变形、或被压扁而不是成形为真正的“B”构型的情况下，尤其是如此。
在各种实施方案中，当从钉仓射出时，钉100的动力学是可预测的。当钉100从其对应钉腔射出时，来自滑动件的驱动力FS产生力矩Ms。用于防止钉转动的一种预防措施包括增大上面讨论的钉100的惯性力矩，该惯性力矩被构造成能够防止(如图2所示)钉的纵向转动或旋转。如果钉100 在远侧方向上纵向地转动，或换句话讲，以逆时针方向围绕Y轴旋转，则钉100的外部纵向钉腿表面115,125将接触钉仓的引导表面或侧壁。该接触产生对应反作用力FC1和FC2。更具体地，当钉100被驱动出钉腔并且围绕Y轴旋转时，近侧钉腿110的壁115接触钉仓的近侧侧壁，从而产生在质心下方作用于钉腿110上的反作用力FC2。远侧钉腿120的壁125接触钉仓的远侧侧壁，从而产生在质心上方作用于钉腿120上的反作用力FC1。这两种反作用力FC1和FC2都会引起反作用力矩MRC，从而抵消或平衡作用于钉100上的所施加的力矩MS。本文所讨论的反作用力可为作用于钉腿110, 120每一个的表面积上的分布负载。
钉100的惯性力矩也被构造成能够防止(如图4所示)钉100的侧向转动或旋转。钉基部分130包括在离腿部110,120最近的钉基部分130一侧上的顶部表面136中限定的凹口134。凹口134有助于在成形之前及在从钉仓射出时成形之后钉100的动力学的可预测性。例如，主要参见图4，凹口134 被构造成能够引起钉100朝特定腔体侧壁的旋转。如果钉100侧向地转动，或换句话讲，在所施加的力矩MS的方向上旋转，则钉100的外侧向钉腿壁 111,121将接触钉仓的引导表面或侧壁，从而产生对应反作用力FC1和FC2。例如，当钉100被驱动出钉腔并且在所施加的力矩MS的方向上旋转时，钉腿110,120的壁111,121接触钉仓的对应侧壁，从而产生在质心上方作用于钉腿110,120上的反作用力FC1。钉基部分130的外侧向壁135接触钉仓的另一个对应侧壁，从而产生在质心下方作用于钉基部分130上的反作用力FC2。反作用力FC1和FC2产生反作用力矩MRC，从而抵消或平衡从滑动件作用于钉100上的所施加的力矩MS。本文所讨论的反作用力可为作用于钉腿110,120和钉基部分130每一个的表面积上的分布负载。在各种实施方案中，钉100被促使在所施加的力矩MS的方向上侧向地转动，以便在钉 100从钉100的对应钉腔射出时控制钉腔的哪个壁将要被接触以用于钉引导。
图5和图6示出了包括钉腿210和钉基部分230的线材成形钉200。钉腿210以基本上九十度的角度从钉基部分230偏移和弯曲。钉腿210位于第一平面中，该第一平面至少基本上垂直于由钉基部分230和钉腿210的弯曲部分220限定的第二平面。
图7-10示出了钉300，该钉包括近侧钉腿310、远侧钉腿320以及具有驱动表面332的钉基部分或冠部330。钉腿310,320从钉基部分330延伸，并且每个钉腿310,320包括侧向向外弯曲部分和向上弯曲部分。钉腿的侧向向外弯曲部分相对于钉基部分侧向向外弯曲钉腿。钉腿的向上弯曲部分相对于钉基部分竖直地弯曲钉腿。钉300包括具有第一硬度的第一区331、具有第二硬度的第二区311,321以及具有第三硬度的第三区312,322。可以设想到钉300包括比所示的更多或更少的区的实施方案。改变钉300的不同部分的某些特性(诸如硬度)可例如在使钉抵靠在对应成形凹坑(诸如砧座340 的成形凹坑341)上成形时提供更大的控制和可预测性。第一区331的第一硬度可大于第二区311,321的第二硬度。在许多情况下，希望拥有能够永久改变形状而不断裂的可延展的钉腿310,320，或换句话讲，拥有例如具有高塑性的钉腿310,320，同时拥有支撑钉腿310,320且具有比钉腿310,320更大的硬度的钉基部分330。更大的硬度将增强钉基部分330抵抗外力和/或内力(诸如在抵靠在砧座上压缩时来自钉腿的力)施加时的变形的能力。
金属加工本文所公开的钉的不同部分可具有若干优点。这些优点之一可包括能够在成形期间防止钉腿被压变形或扭曲，相反，由于与对应成形凹坑接触，能够促使钉腿以期望构型变形。
钉300可成形为任何期望的形态。在未成形构型中，钉腿310,320限定第一平面P1，并且钉基部分330限定第二平面P2。图9和图10中示出了钉300的成形的示例，其中钉腿310,320朝第二平面P2侧向地成形。钉300 的某些区和/或部分的硬度的变化可在接触成形凹坑341时起到提供定向支持的作用。可以设想到钉腿310,320在侧向地远离第二平面P2的方向上成形的实施方案。
图11-11C示出了由平坦材料片形成的钉400，该钉包括钉腿410和钉基部分430。钉基部分430具有矩形横截面外形431，并且钉腿具有圆形横截面外形411。拥有从具有矩形横截面外形431的钉基部分430延伸的圆形钉腿410可提供没有优先弯曲平面的钉基部分和钉腿。钉400包括弯曲部分 420，在该弯曲部分处钉腿410从钉基部分430延伸。弯曲部分420具有基本上正方形的横截面外形421。弯曲部分420和钉基部分430分别的正方形外形421和矩形外形431向圆形钉腿410提供刚性连接部和骨干。圆形钉腿 410消除了横截面为正方形、矩形、或任何带顶点的形状或非均匀形状的钉腿可具有的优先弯曲平面。
图12示出了根据至少一个实施方案的钉500，该钉包括近侧钉腿510、远侧钉腿520以及钉腿510,520从其延伸的钉基部分530。近侧钉腿510在第一方向上从钉基部分530侧向向外弯曲。远侧钉腿520在第二方向上从钉基部分侧向向外弯曲。第一方向与第二方向相反。钉基部分530限定第一平面，并且钉腿510,520限定第二平面，该第二平面与该第一平面相交。使钉腿510,520在相反方向上弯曲的一个优点可抵消钉基部分530的每一侧上所施加的滑动件力矩，从而有助于防止侧向转动。这得到了S形构型并且需要互补成形凹坑。
图13中示出了钉600，该钉包括近侧腿部610、远侧腿部620以及具有驱动表面632的钉基部分630。远侧腿部620长于近侧腿部610，从而引起钉腿610,620的尖端611,621抵靠在砧座的成形凹坑上的接触时间偏移。在各种实施方案中，远侧腿部可包括具有初始预弯曲构型的尖端，以有助于在初始接触砧座时的成形过程。该预成形尖端621将需要比钉尖端611更小的压缩力以开始抵靠在砧座上变形。使较长钉腿(在这种情况下为远侧钉腿 620)在较短或近侧钉腿610之前接触砧座可能需要较长腿部620的钉尖端 621在尖端611变形之前在一定程度上具有预成形尖端。
图14示出了成形钉711,721的布置700。钉711被布置成第一排710，并且钉721被布置成与第一排710相邻的第二排720。钉711,712可与上文所讨论的图13所示的钉600相似。钉711包括侧向相对的腿部713,715。钉721包括侧向相对的腿部723,725。侧向相对的腿部713,715各自包括尖端，这些尖端被构造成能够分别在接触点713c,715c处接触砧座的成形凹坑。侧向相对的腿部723,725也各自包括尖端，这些尖端被构造成能够分别在接触点723c,725c处接触砧座的成形凹坑。侧向相对的腿部713,715各自朝它们从其延伸的钉基部分向内成形。侧向相对的腿部723,725也各自朝它们从其延伸的钉基部分向内成形。
钉排710,720发生交织，使得接触点723c,713c基本上对准。这种布置允许钉仓中更密集布置的钉排构型和/或砧座上更密集布置的成形凹坑构型。另外，相交的扩力平面可提供较高质量的扩力和较大面积的组织扩力覆盖度。相交的扩力平面可保证钉排与成形凹坑之间捕获的任何东西必定被充分紧固。这在缝合较小的血管和/或不易看见的血管时可有所帮助，而在常规钉布置中，可能要操纵钉排间距，从而导致不太充分的紧固。
图15-17示出了钉800，该钉包括钉腿810,820以及具有驱动表面832 的钉基部分830。钉腿810,820包括尖端842，这些尖端被构造成能够接触砧座的成形凹坑，诸如砧座860的成形凹坑861。钉尖端842包括穿刺尖端或部分842T、卷曲表面842S以及凹形切口部分842C。穿刺尖端842T被构造成能够在从钉仓射出时穿刺组织T，并且一旦与砧座860的成形凹坑861 接触，就在成形凹坑861内变形。通过利用凹形切口部分842C的可预测变形性，促使钉尖端842变形为特定形态。钉尖端842的卷曲表面842S被构造成能够从穿刺位置812A到中间成形位置812B再到非穿刺位置812C发生卷曲或变形。一旦钉尖端842已完全变形，就通过卷曲表面842S将穿刺尖端842T与组织T隔开或隔离。这防止在尖端842在射出时穿刺组织之后进一步穿刺组织T。该布置还防止初始穿刺后暴露的穿刺尖端可能造成的进一步损伤和/或有害刺激。防止在腿部成形后进一步穿刺组织也减少了钉800 被拉动穿过组织T的机会。卷曲表面842S充当屏障，该屏障被构造成能够将穿刺尖端842T与组织T隔开。
图18示出了可与任何合适的外科钉(诸如本文所公开的钉)一起使用的不同类型的钉尖端871、872、873、874和875的多个示例。钉尖端871 具有三角形形状，其具有至少基本上平坦的面。钉尖端872包括具有变化轮廓的面。钉尖端873具有火箭状形状。钉尖端874具有凸块状外形。该凸块状外形可例如为基本上钝的。钉尖端875具有铅笔削尖外形。
在各种实施方案中，本文所公开的钉尖端可包括不同于钉尖端与之相连的钉的材料，以便更易以期望方式进行变形，但是钉尖端材料仍可足够牢固以防止在紧固组织之后钉尖端展开。
可通过改变被构造成能够使钉成形的成形凹坑的形状、尺寸、构型和/ 或其他方面，促使外科钉成形为期望构型。图19示出了被构造成能够使钉 900成形的成形凹坑911,921。钉900包括钉腿901,902、钉尖端910,920 以及钉基930，其中钉腿901,902从钉基930延伸。钉900被构造成能够接触对应成形凹坑911,921并且抵靠在这些成形凹坑上成形。成形凹坑911 包括成形通道表面917，该成形通道表面被构造成能够接收对应尖端910并且促使尖端910在方向P1上成形。如图20所示，成形凹坑911包括侧向谷状表面915和纵向谷状表面913，它们被构造成能够在接触时轻微不对准的情况下汇集或捕获钉的尖端910。在从仓射出时，钉900、钉腿901和/或钉尖端910可相对于成形通道表面917被驱动偏离目标。谷状表面允许钉的纵向和侧向转动。虽然被示出为凹表面，但谷表面可为例如凸形的或平坦的。
成形凹坑921包括成形通道表面927，该成形通道表面被构造成能够接收钉900的对应尖端920并且促使尖端920在方向D1上成形。方向D1与方向P1相反，并且如图19所示，示出了钉腿朝彼此成形且至少基本上平行于钉基930的情况。可以设想到方向D1,P1将对应钉腿以相反方向但相对于彼此向外导向的其他实施方案。成形凹坑921还包括侧向谷状表面925 和纵向谷状表面923，它们被构造成能够在接触时轻微不对准的情况下汇集或捕获钉900的尖端920。在从仓射出时，钉900、钉腿902和/或钉尖端920 可相对于成形通道表面927被驱动偏离目标。
在各种实施方案中，纵向谷状表面可包括两个单独的谷表面。这两个单独的谷表面可包括离对应钉尖端的预期接触点最近的初始谷表面。初始谷表面可具有比单独谷表面中的另一个谷表面更大的不对准保护范围。初始谷表面可具有例如比单独谷表面中的另一个谷表面更大的宽度和/或高度。
图21示出了上文所讨论的钉凹坑911,921的另一种布置。然而，处于所示布置的钉凹坑911,921被构造成能够将钉尖端朝钉基130向内导向。腿部901和尖端910被构造成能够在方向P2上成形。腿部902和尖端920被构造成能够在方向D2上成形。方向P2,D2是横向的。可以设想到方向P2,D2 将对应钉腿和尖端远离钉基或向外导向的其他实施方案。
图22示出了上文所讨论的钉凹坑911,921的又一种布置。处于所示布置的钉凹坑911,921被构造成能够使对应钉腿901,902和尖端910,920以相反方向成形，其中钉腿902中的一个朝钉基930导向，并且钉腿901中的一个远离钉基930导向。腿部901和尖端910被构造成能够在方向P3上成形。腿部902和尖端920被构造成能够在方向D3上成形。方向P3,D3至少基本上平行。可以设想到方向P3,D3不平行的其他实施方案。
图23和图24示出了成形凹坑的另一个实施方案，这些成形凹坑包括被构造成能够使钉900变形的成形凹坑1011,1021。成形凹坑1011,1021具有提供嵌套凹坑的耳状形状。这种类型的布置可节省砧座的钉成形表面上的空间，从而允许在更少量的空间中有更多的钉凹坑及因此钉仓中的更多钉。成形凹坑1011包括成形通道表面1017，该成形通道表面被构造成能够接收对应尖端910并且促使尖端910在弯曲方向P4上成形。如图24所示，成形凹坑1011包括第一谷状、弯曲表面1015A和第二谷状、弯曲表面1015B，它们被构造成能够在接触期间轻微不对准的情况下汇集或捕获钉的尖端910。在从其钉腔射出时，钉900、钉腿901和/或钉尖端910可相对于成形通道表面917被驱动偏离目标。谷状表面允许钉的一些纵向和侧向转动。虽然被示出为凹表面，但谷表面可为例如凸形的或平坦的。
成形凹坑1021包括成形通道表面1027，该成形通道表面被构造成能够接收钉900的对应尖端920并且促使尖端920在方向D4上成形。图23示出了钉腿901,902朝彼此成形的情况，其中一个钉腿901远离钉基930成形，另一个钉腿902朝钉基930成形。可以设想到方向P4,D4将对应钉腿901, 902以相反方向但相对于彼此向外导向的其他实施方案。成形凹坑1021包括第一谷状、弯曲表面1025A和第二谷状、弯曲表面1025B，它们被构造成能够在接触之前和/或期间轻微不对准的情况下汇集或捕获钉900的尖端 920。
图25示出了成形凹坑的又一个实施方案，这些成形凹坑包括被构造成能够使对应钉腿901,902和尖端910,920朝钉基930变形的砧座成形凹坑 1111,1121。成形凹坑1111,1121为梯形的形状，并且可与其他相似成形凹坑嵌套，从而在砧座的成形表面上使用更少空间。成形凹坑1111,1121被构造成能够分别使钉腿901,902和尖端910,920在方向P5,D5上成形。
图26示出了成形凹坑的又一个实施方案，这些成形凹坑包括被构造成能够分别使对应钉腿901,902和尖端910,920在方向P6,D6上变形的砧座成形凹坑1211,1221。成形凹坑1111,1121为三角形的形状并且可彼此嵌套，从而在外科缝合器械的砧座上具有甚至更紧凑的成形凹坑布置。
现在参见图27-27B，示出了钉腿1300。钉腿1300包括基本上圆形的钉尖端，且具有基本上正方形的钉腿和钉腿主体部分1301。钉腿1300包括使用精压工艺形成的硬化拐角，例如，在该精压工艺中，拐角1303A、1303B、 1303C和1303D被倒圆以便形成优先弯曲平面。换句话说，钉腿1300具有一定横截面外形，该横截面外形被构造成能够在与砧座接触时因拐角硬化而促使钉腿1300在特定方向上弯曲。拐角1303A、1303B、1303C和1303D 的硬度可在一个拐角与下一个拐角之间变化，或它们可包括具有第一硬度的两个拐角以及具有第二硬度的另两个拐角。拐角1303A、1303B、1303C和 1303D可被精压以在相同钉腿上提供不同径向外形。例如，拐角1303A包括一定径向外形，该径向外形的半径RA大于图27B所示的拐角1303B的径向外形的半径RB。
可使用任何合适的装置在制造工艺的各个时间对本文所公开的钉的部分进行硬化。例如，硬化工艺可包括例如烫金、化学气相沉积、物理气相沉积、激光表面处理、热氧化、离子渗氮和/或固态扩散。可防止钉的其他部分通过这些工艺进行硬化。可对钉的其他部分进行局部退火，诸如钉尖端。增加某些区域的硬度可增大在钉已呈现击发构型之后使钉不成形所需的力。
图28-28C示出了根据至少一个实施方案的钉1400和滑动件1460。钉 1400包括钉腿1410,1420、钉腿1410,1420从其延伸的钉基部分1430、驱动表面1432以及底部表面1431。钉腿1410,1420在特定平面中从钉基部分 1430延伸，该平面相对于由钉基部分1430限定的平面平行且偏移。利用基部条1450和连接器部分1451，通过级进模冲压制成钉1400。虽然仅示出了单个钉1400，但多个钉1400附接到基部条1450。连接器部分1451将钉1400 (具体地，钉基部分1430)连结到基部条1450。连接器部分1451包括不连续部或凹口1453，该不连续部或凹口被构造成能够允许钉1400与条1450 分离。在至少一种情况下，滑动件1460包括释放部分或击打部分1461。滑动件1460的释放部分1461被构造成能够接合不连续部1453或连接器部分 1451，以从基部条1450分开、断开和/或剪切钉1400并且允许通过滑动件 1460将钉从其钉腔射出。
可以设想到基部条1450包括例如接合钉仓上的对应对准特征结构的对准特征结构(诸如孔)的实施方案。此类对准特征结构可包括例如与基部条 1450的对准特征结构对准的突起。在各种情况下，将钉加载到仓中的人员可将钉与钉腔对准和/或在将钉推入钉腔中之前对准这些对准特征结构。可以设想到钉仓包括接合特征结构的某些实施方案，这些接合特征结构被构造成能够在条组件加载到钉仓中时接合不连续部1453。当钉1400被加载到钉仓中时，而非当钉1400被击发时，这些接合特征结构允许钉1400与条1450 分开。使用级进模冲压来制造钉可允许钉具有不同的冠部尺寸、形状和/或构型以及钉腿尺寸、形状和/或构型。使用级进模冲压技术的另一个优点可包括能够改变钉所排列的钉排的间距。
图29和图30示出了使用级进模冲压制成的钉1501的条1500的另一个实施方案。钉1501的条1500包括基部条1550、连接器部分1551和钉1501。每个钉1501首先包括具有底部表面1531的钉基部分1530，其次包括从钉基部分1530延伸的钉腿1510。连接器部分1551将钉基部分1530的底部表面1531附接到基部条1550。钉腿从钉基部分1530向上弯曲，使得腿部1510 位于特定平面中，该平面与由钉基部分1530限定的平面偏移且至少基本上平行。在图示实施方案中，钉腿1510在与连接器部分1551相反的方向上弯曲。使腿部1510和连接器部分1551以这种方式弯曲可允许更密集的钉排布置。连接器部分1551可包括不连续部，从而能够在将钉1501加载到钉仓中和/或从钉仓击发钉1501时将钉1501从基部条1550释放，如前述实施方案中所讨论。
图31示出了根据至少一个实施方案的多个钉1601以及钉仓1650的一部分的剖视图。钉1601能够移除地储存在钉仓1650的对应钉腔1651内。钉仓1650包括甲板表面1653和钉腿支撑件1655。钉1601首先包括各自具有钉尖端1611的钉腿1610，其次包括钉腿1610从其延伸的钉基部分1630。每个钉1601具有预加载构型、加载构型和击发构型，在击发构型中，钉1601 从钉仓1650射出并且抵靠在砧座的对应成形凹坑上成形。在预加载构型中钉腿1610相对于钉基部分1630向外弯曲。在加载构型中钉腿1610偏压抵靠对应钉腔1651的侧壁，并且限定钉腿1610的尖端1611之间的第一距离 X。在预加载构型中，钉腿1610的钉尖端1611之间的距离大于X。该偏压力有助于支撑钉仓1650中的钉1601。
图32-34中示出了钉仓2000。钉仓组件2000包括仓体2010。仓体2010 可定位在外科缝合器械的钳口中并且可从该钳口移除。因此，钉仓2000可替换；然而，可以设想到钉仓2000不可替换的其他实施方案。仓体2010 包括近侧端部2011、远侧端部2012以及在近侧端部2011和远侧端部2012 之间延伸的甲板2014。甲板2014被构造成能够在患者的组织压靠在甲板 2014上时支撑该组织。
仓体2010还包括限定于其中的多个钉腔2020。钉腔2020被布置成在近侧端部2011与远侧端部2012之间延伸的六个纵向排；然而，可利用钉腔 2020的任何合适的布置。诸如钉2130(图40)的钉例如能够移除地储存在每个钉腔2020中。如下文更详细地讨论，当击发构件从仓体2010的近侧端部2011朝远侧端部2012运动时，击发构件从钉腔2020射出钉。
除上述以外，击发构件使钉从未击发位置运动到击发位置。击发构件朝诸如砧座2190(图37)的砧座提升钉，例如以使钉在未击发、未变形构型与击发、变形构型之间变形。仓体2010还包括限定于其中的纵向狭槽2013。狭槽2013被构造成能够在从钉腔2020射出钉时在其中接收钉击发构件和/ 或组织切割构件。
在各种实施方案中，除上述以外，直到击发构件使钉朝砧座运动，钉才突出到甲板2014上方。此类实施方案可能常常要利用较小的钉。在其他实施方案中，当钉处于其未击发位置时，钉的腿部突出到甲板2014上方。在至少一个此类实施方案中，仓体2010还包括从甲板2014延伸的突出部 2050。突出部2050使钉腔2020在甲板2014上方延伸，并且在从钉仓2000 射出钉时朝砧座引导钉。在此类实施方案中，直到击发构件使钉朝砧座运动，钉才可在突出部2050上方延伸。
主要参见图34，突出部2050不围绕完整的钉腔2020延伸。第一突出部2050被定位成与每个腔体2020的第一端部相邻，并且第二突出部2050 被定位成与每个腔体2020的第二端部相邻。每个第一突出部2050围绕钉腔 2020的第一钉腿引导件2022延伸，并且每个第二突出部2050围绕钉腔2020 的第二钉腿引导件2023延伸。每个第一突出部2050提供可控制和引导钉的近侧腿部的近侧托架，并且每个第二突出部2050提供可控制和引导钉的远侧腿部的远侧托架。每个钉腔2020的第一突出部2050不相对于钉腔2020 的第一端部对称，并且不围绕腔体2020的完整第一端部延伸。相似地，每个钉腔2020的第二突出部2050不相对于钉腔2020的第二端部对称，并且不围绕腔体2020的完整第二端部延伸。第一突出部2050和第二突出部2050 构成彼此的镜像，并且相对于每个钉腔2020的中心对称地布置；然而，可利用突出部的任何合适的布置。
如图32-34所示，仓体2010包括从甲板2014向上延伸的台阶2014’和台阶2014”。更具体地，台阶2014’从甲板2014向上延伸，并且台阶2014”从台阶2014’向上延伸。因此，台阶2014”对组织施加的压缩压力可大于台阶2014’，并且相似地，台阶2014’对组织施加的压缩压力可大于甲板2014。台阶2014’和2014”包括交错的纵向台地；然而，台阶2014’和2014”可具有任何合适的构型。此外，除上述以外，从台阶2014”延伸的突出部2050在从台阶2014’延伸的突出部2050上方延伸，并且相似地，从台阶2014’延伸的突出部2050在从甲板2014延伸的突出部2050上方延伸。换句话说，从甲板2014、台阶2014’和台阶2014”延伸的突出部2050是交错的。
图35-38中示出了钉仓2100。钉仓组件2100包括仓体2110，并且在很多方面与钉仓组件2000和/或本文所公开的其他钉仓相似。仓体2110包括甲板2114、多个钉腔2120a和多个钉腔2120b。钉腔2120a在很多方面与钉腔2120b相似。例如，钉腔2120a和2120b均包括具有近侧端部和远侧端部的中心狭槽2121、从中心狭槽2121的近侧端部侧向地延伸的近侧钉腿引导件2122以及从中心狭槽2121的远侧端部侧向地延伸的远侧钉腿引导件 2123。也就是说，钉腔2120a和钉腔2120b在不同方向上取向。更具体地，钉腔2120a的钉腿引导件2122,2123朝钉腔2120b延伸，并且相似地，钉腔 2120b的钉腿引导件2122,2123朝钉腔2120a延伸；然而，可利用任何合适的布置。
钉2130a定位在每个钉腔2120a中，并且钉2130b定位在每个钉腔2120b 中。钉2130a和钉2130b在很多方面是相似的。例如，每个钉2130a包括基部或冠部2131、从基部2131的近侧端部延伸的近侧腿部2132以及从基部 2131的远侧端部延伸的远侧腿部2133。也就是说，钉2130a,2130b能够以一定方式分别适配在钉腔2120a,2120b内。例如，当钉2130a定位在钉腔 2120a中并且钉2130b定位在钉腔2120b中时，钉2130a的腿部2132,2133朝钉2130b延伸，并且钉2130b的腿部2132,2133朝钉2130a延伸；然而，其他布置是可能的。
除上述以外，当钉2130a,2130b分别储存在钉腔2120a,2120b中时，钉 2130a,2130b的近侧腿部2132定位在钉腿引导件2122内。相似地，当钉 2130a,2130b分别储存在钉腔2120a,2120b中时，钉2130a,2130b的远侧腿部2133定位在钉腿引导件2123内。此外，当钉2130a,2130b分别储存在钉腔2120a,2120b中时，钉2130a,2130b的基部2131定位在钉腔2120的中心狭槽2121中。主要参见图35，当钉2130a,2130b处于其未击发位置时，钉腿2132,2133的尖端在仓体2110的甲板2114上方延伸。也就是说，钉腿 2132的尖端由从甲板2114延伸的近侧突出部2152至少部分地围绕，并且钉腿2133的尖端由从甲板2114延伸的远侧突出部2153至少部分地围绕。近侧突出部2152围绕近侧钉腿引导件2122延伸，但它们不围绕中心狭槽 2121的近侧端部延伸。相似地，远侧突出部2153围绕远侧钉腿引导件2123 延伸，但它们不围绕中心狭槽2121的远侧端部延伸。
现在转到图38，每个近侧突出部2152包括围绕近侧引导狭槽2122的近侧延伸的第一部分2154以及围绕近侧引导狭槽2122的侧面延伸的第二部分2155。近侧突出部2152不围绕近侧引导狭槽2122的远侧延伸；然而，可以设想到在另选实施方案中，近侧突出部2152可围绕近侧引导狭槽的远侧延伸。相似地，每个远侧突出部2153包括围绕远侧引导狭槽2123的远侧延伸的第一部分以及围绕远侧引导狭槽2123的侧面延伸的第二部分。远侧突出部2153不围绕远侧引导狭槽2123的近侧延伸；然而，可以设想到在另选实施方案中，远侧突出部2153可围绕远侧引导狭槽的近侧延伸。在任何情况下，图38所示的布置在钉2130a,2130b处于其未击发位置时保护钉腿 2132,2133，另外在钉被击发时引导钉2130a,2130b。这种布置也适当地控制组织相对于仓体2110的甲板2114的流动。
再次参见图38，钉腔2120a和钉2130a的尺寸和构造使得在钉2130a 与钉腔2120a之间提供余隙间隙。例如，在钉2130b的近侧腿部2132与近侧引导狭槽2122的近侧侧壁之间存在余隙间隙2156，并且相似地，在钉 2130b的近侧腿部2132与近侧引导狭槽2122的远侧侧壁之间存在余隙间隙 2158。另外，在近侧腿部2132的侧面与近侧引导狭槽2122的侧向侧壁之间存在余隙间隙2157。可以在远侧腿部2133与远侧引导狭槽2123之间发现相似的间隙。还可在钉2130b的基部2131与中心狭槽2121的侧面之间提供侧向余隙间隙2126,2127。尽管如此，此类余隙间隙可较短暂并且钉可接触这些侧壁中的一个或多个。
图43中示出了钉仓2200。钉仓2200在很多方面与钉仓2000,2100和本文所公开的其他钉仓相似。钉仓2200包括仓体2210，该仓体包括限定于其中的钉腔2220。每个钉腔2220具有例如能够移除地储存在其中的钉，诸如钉2130。每个钉腔2220包括被构造成能够引导钉2130的腿部2132的第一引导狭槽2222、被构造成能够引导钉2130的腿部2133的第二引导狭槽 2223以及中心狭槽2221。引导狭槽2222和2223从中心狭槽2221侧向地延伸，并且中心狭槽2221包括中间引导件2225，该中间引导件被构造成能够引导钉2130的基部2131。第一引导狭槽2222的尺寸和构造使得钉腿2132 被紧密接收在第一引导狭槽2222的拐角中。相似地，第二引导狭槽2223 的尺寸和构造使得钉腿2133被紧密接收在第二引导狭槽2223的拐角中。中间引导件2225的尺寸和构造使得其限制钉2130在钉腔2220内的侧向运动。此外，中间引导件2225的尺寸和构造使得其将钉腿2132和2133分别保持在钉腿引导狭槽2222和2223中。
如上所讨论，中间引导件2225的尺寸和构造使得其将钉腿2132和2133 分别抵靠在引导狭槽2222和2223的侧壁上。这种布置在腔体2220的侧向侧壁与钉2130之间产生侧向反作用力(在图43中指示为力向量LT)。当从腔体2220射出钉2130时，此类侧向反作用力在腔体2220的侧壁与钉2130 之间产生摩擦力。应当理解，摩擦力随着施加摩擦力的表面积而变化，因此，中间引导件2225不沿着中心狭槽2221的整个长度延伸。也就是说，中间引导件2225具有一定纵向长度，该纵向长度足以控制钉2130在腔体2220内的取向。此外，中间引导件2225具有足够的竖直长度，该竖直长度足以在钉2130的击发冲程期间控制钉2130的取向。在至少一种情况下，引导件 2225沿着腔体2220的整个竖直深度延伸。
中间引导件2225为平坦的，并且被构造成能够与钉2130的基部2131 的侧面上限定的平坦表面交接；然而，可利用任何合适的布置。在某些另选的实施方案中，中间引导件2225包括弹性偏压构件，该弹性偏压构件被构造成能够例如对钉2130的基部2131施加侧向偏压力。在至少一种情况下，弹性偏压构件可包括例如悬臂弹簧。
钉腔2220不包括被定位成与侧向中间引导件2225相背对的侧向引导件。事实上，在侧向侧壁2228与钉2130之间存在余隙间隙2229。
除上述以外，再次参见图43，钉2130不定位在中心狭槽2221的端部中。更具体地，腔体2220的中心狭槽2221包括近侧端部2226和远侧端部 2227，并且钉2130不延伸到近侧端部2226或远侧端部2227中。相反，在端部2226,2227与钉2130之间存在余隙间隙。此类余隙间隙在端部2226, 2227与中间引导件2225之间延伸。因此，钉腔2220的端部2226,2227不控制钉2130的纵向位置。相反，钉腿引导件2222,2223控制钉2130的纵向位置。事实上，钉2130的腿部2132和2133可分别由钉腿引导件2222和 2223向内偏压。这种布置产生纵向反作用力(在图43中指示为力向量LG)。
作为以上的结果，钉腔2220包括三个控制点或位置，在这三个控制点或位置中，钉腔2220控制钉2130的取向。这些控制点包括其间限定有余隙间隙的离散控制位置。换句话说，引导件2222、2223和2225使钉2130的控制呈三角划分。可以设想到包括超过三个控制点的另选实施方案。在任何情况下，由钉腿引导件2222和2223提供的控制点在第一控制平面中限定。由中间引导件2225提供的中间控制点在第二控制平面中限定。第一控制平面与第二控制平面平行；然而，可以设想到第一控制平面与第二控制平面不平行的另选实施方案。此外，第一控制平面与钉2130的钉腿2132和2133 对准或相邻，并且第二控制平面与钉2130的基部2131对准或相邻。
图65中示出了钉仓2700。钉仓2700包括仓体2710，该仓体包括甲板 2714以及限定于甲板2714中的多个钉腔2220。与仓体2110相似，仓体2710 包括在甲板2714上方延伸的突出部2752和2753。突出部2752至少部分地围绕钉腔2220的钉腿引导件2222，并且突出部2753至少部分地围绕钉腔 2220的钉腿引导件2223。与突出部2152,2153相似，突出部2752,2753各自包括外部部分2754和侧向部分2755。外部部分2754相对于钉腿引导件 2222和2223纵向地定位，而侧向部分2755相对于钉腿引导件2222和2223 侧向地定位。与突出部2152,2153不同，突出部2752,2753各自包括相对于钉腿引导件2222和2223纵向地定位的内部部分2756。内部部分2756连结到侧向部分2755，并且侧向部分2755连结到外部部分2754。与上述相似，突出部2752,2753在甲板2714上方延伸钉腔2220。
图66中示出了钉仓2800。钉仓2800包括仓体2810，该仓体包括甲板 2814以及限定于甲板2814中的多个钉腔2220。与仓体2110相似，仓体2810 包括在甲板2114上方延伸的突出部2152,2153。如上所概述，突出部2152 至少部分地围绕钉腔2220的钉腿引导件2222，并且突出部2753至少部分地围绕钉腔2220的钉腿引导件2223。此外，仓体2810包括相对于钉腿引导件2222和2223纵向地定位的内部突出部2856。内部突出部2856不连结到突出部2152,2153。
再次参见图35，通过诸如滑动件2140的击发构件在未击发位置与击发位置之间驱动钉2130。滑动件2140包括楔形件2145，这些楔形件被构造成能够直接接合钉2130并且将钉2130朝诸如砧座2190的砧座提升，例如如图37所示。滑动件2140包括用于每个纵向排钉2130的楔形件2145；然而，滑动件2140可具有任何合适数量的楔形件2145。每个楔形件2145包括成角的驱动表面2141，当滑动件2140从钉仓2100的近侧端部朝钉仓2100的远侧端部推进时，该成角的驱动表面在钉2130下方滑动。每个钉2130的基部2131包括与驱动表面2141直接接触的成角的驱动表面2135。换句话说，每个钉2130包括具有驱动表面2135的其自身一体形成的驱动器。钉2130 由金属构成，因此，一体形成的驱动器也由金属构成。也就是说，本文所公开的钉可由任何合适的材料构成。
除上述以外，每个驱动表面2141包括初始或远侧部分2142、第二或中间部分2143以及第三或顶点部分2144。初始部分2142以第一角度延伸，并且在滑动件2140朝远侧运动时提供滑动件2140抵靠钉2130的初始接触点。当初始部分2142在钉2130下方滑动时，钉2130在钉腔2120内向上提升。当滑动件2140继续朝远侧运动时，中间部分2143与钉2130形成接触。中间部分2143以与第一角度不同的第二角度延伸。当希望存在钉2130的快速初始向上位移时，第一角度可陡于第二角度，而当希望提供钉2130的逐渐初始向上位移时，第一角度可浅于第二角度。在任一情况下，当钉2130 由中间部分2143向上提升时，钉2130接触砧座2190，如图37所示；然而，可以设想到在钉2130由初始部分2142向上提升时钉2130接触砧座2190 的另选实施方案。在任一情况下，钉2130的近侧腿部2132接触限定于砧座 2190中的近侧成形凹坑2192，并且远侧腿部2133接触限定于砧座2190中的远侧成形凹坑2193。成形凹坑2192和2193被构造成能够使腿部2132和 2133向内弯曲，从而使钉2130变形并且将患者的组织捕获在钉2130内。驱动表面2141的顶点2144在钉2130下方滑动以完成成形过程。顶点2144 可包括驱动表面2141、平坦表面和/或以与第一角度和/或第二角度不同的第三角度延伸的表面的最高点。
在各种情况下，每个驱动表面2141可包括尾随驱动表面2141的顶点 2144或定位在该顶点近侧的部分。这个尾随部分可例如低于顶点2144。此外，这个尾随部分可提供例如钉2130中的成形压力的逐渐降低。
现在转到图39，钉2130还包括从近侧腿部2132向下延伸的脚部2134。当钉2130在其钉腔2120中处于其正确取向时，如图41所示，脚部2134 不与滑动件2140接触。在此类情况下，滑动件2140的对准台地2146在脚部2134下方穿过。当钉2130未在其钉腔2120中处于其正确取向时，如图 42所示，滑动件2140可接触钉2130并且使钉2130重新取向。为了比较的目的，图42中示出了不正确取向的钉2130和正确取向的钉2130’。滑动件 2140包括成角的对准滑道2148，该成角的对准滑道被构造成能够接触脚部 2134并且将钉2130旋转到正确取向。在对准滑道2148已使钉2130正确取向之后，对准台地2146可在脚部2134下面滑动。从图39可以理解，对准滑道2148、对准台地2146和脚部2134被布置在对准平面中，该对准平面与钉2130的腿部2132和2133的成形平面对准。对准平面与提升平面相邻，该提升平面包括滑动件2140的成形表面2141和钉2130的基部2131。
图44-48中示出了钉仓组件2300。钉仓组件2300在很多方面与钉仓 2000,2100,2200和本文所公开的其他钉仓相似。钉仓2300包括仓体2310 和滑动件2340，这些滑动件被构造成能够射出能够移除地储存在仓体2310 中的钉。与滑动件2140相似，滑动件2340包括钉成形滑道2145。滑道2145 可滑动地定位在限定于仓体2110中的纵向狭槽2115中，这些纵向狭槽与钉的提升部分或平面对准。值得注意的是，如下文更详细地讨论，狭槽2115 具有限定于仓体2310的底部2316中的开口端。
除上述以外，钉仓组件2300不包括围绕仓体2310的底部2316延伸的覆盖件。主要参见图48，仓体2310直接抵靠在缝合器械的钳口2180上。在钉仓不易从缝合器械的钳口移除且不易替换为另一个钉仓的实施方案中，缺少底部覆盖件不一定有问题，因为钳口2180可防止钉从钉腔2120的底部落出和/或可防止滑动件2340从纵向狭槽2115的底部落出。然而，钉仓组件2300可替换，并且即使其不包括底部覆盖件，钉仓组件2300也包括阻止钉和滑动件2340从仓体2310的底部2316落出的特征结构，这将在下文进一步更详细描述。此类特征结构可适于本文所公开的任何钉仓。
主要参见图45-47，仓体2310包括保持特征结构，这些保持特征结构被构造成能够将滑动件2340保持在其中。例如，仓体2310包括近侧保持特征结构2317，这些近侧保持特征结构被构造成能够在滑动件2340处于其近侧或未击发位置时将滑动件2340保持在纵向狭槽2115中。当钉仓组件2300 插入或加载到钳口2180中时，滑动件2340处于其未击发位置，因此当临床医生在操作仓组件2300时，近侧保持特征结构2317将滑动件2340保持在仓体2310中。每个保持特征结构2317包括成角表面2318和肩部2319。每个滑动件2340包括被构造成能够接收成角表面2318的对应凹陷部2348，另外还包括可与保持特征结构2317的肩部2319对准和/或接触的对应肩部 2349。当滑动件2340插入到狭槽2115中时，参见图46，滑道2145和/或仓 2310的侧壁可屈曲以允许滑动件2340相对于成角表面滑动，然后一旦滑动件2340的肩部2349已变得与仓体2310的肩部2319对准，就弹性地迅速恢复到其初始位置，如图45所示。保持特征结构2317也被构造成能够防止滑动件2340朝近侧滑动出纵向狭槽2115。
作为以上的结果，当临床医生在操作钉仓组件2300时，近侧保持特征结构2317防止滑动件2340从仓体2310落出。当朝远侧推进滑动件2340 以击发钉时，滑动件2340不再与近侧保持特征结构2317对准。然而，此时钉仓组件2300已处于钳口2180中，并且不再需要滑动件保持特征结构。也就是说，仓体2310可包括附加保持特征结构，这些附加保持特征结构可将滑动件2340保持在仓体2310中，而不论滑动件2340的位置如何。此类保持特征结构可被构造成能够例如在滑动件2340处于其远侧或完全击发位置时将滑动件2340保持在仓体2310中。
除上述以外，本文所公开的钉仓的钉可包括一个或多个特征结构，所述一个或多个特征结构被构造成能够将钉保持在钉仓的钉腔中。现在转到图 49和图50，钉2330包括基部2331以及从基部2331延伸的一个或多个钉腿 2332。例如，钉2330能够移除地储存在仓体2310中的钉腔2320中。基部 2331包括从其延伸的突起2338，该突起与钉腔2320的侧壁接合。突起2338 与钉腔侧壁之间的相互作用阻止钉2330从仓体2310的底部2316落出。突起2338与钉腔侧壁之间的相互作用包括过盈配合；然而，这种过盈配合不能防止滑动件2340从钉腔2320射出钉2330。突起2338可例如在冲压工艺期间形成于基部2331中。冲压工艺可通过在基部2331的相对侧产生凹痕 2337，从而形成突起2338。钉腔2320包括与突起2338对准的竖直沟槽2328。沟槽2328增大了钉腔2320的侧壁与突起2338之间的接触面积。另外，沟槽2328可控制钉2330在钉腔2320内的取向。可以设想到不包括沟槽2328 的另选实施方案。
作为上述的补充或替代，储存在本文所公开的钉仓中的钉可包括钉腿，这些钉腿与其钉腔的侧壁弹性地接合。现在转到图51，钉2430可包括基部 2431以及从基部2431延伸的钉腿2432和2433。钉2430在很多方面与钉 2130,2330和/或本文所公开的其他钉相似。钉仓体2410例如可包括限定于其中的多个钉腔2120以及定位在每个钉腔2120中的钉2430。图51示出了定位在腔体2120内部的钉2430以及定位在仓体2430的钉腔2120外部的钉 2430。当钉2430不定位在钉腔2120中时，钉腿2432,2433不在平行方向上延伸；相反，它们远离彼此向外延伸。当钉2430定位在钉腔2120中时，它们在钉腔2120的侧壁的作用下向内屈曲。换句话说，钉腿2432,2433弹性地偏压抵靠钉腔的侧壁，并且由于该偏压接合，钉2430被阻止从仓体2410 的底部2436落出。如图51所示，当钉2130定位在钉腔2120中时钉腿2432, 2433之间的距离为X，而当钉2130不定位在钉腔中时钉腿2432,2433之间的距离大于X。
在各种实施方案中，仓体可包括一个或多个肩部，所述一个或多个肩部被构造成能够阻止其中储存的钉从仓体的底部落出。这些肩部可至少部分地在钉的下面延伸。
在某些实施方案中，钉仓组件的仓体可由塑料构成，并且可例如在注塑工艺期间形成。注塑模具可包括能够朝向和远离彼此运动的两个半部。注塑模具半部之间的接合部通常称为分型线，并且经常可在分型线处出现飞边或塑料在模具半部之间的渗流。在至少一个实施方案中，可在钉仓的甲板与限定于甲板中的钉腔之间的接合部处限定注塑模具的分型线。作为以上的结果，可在钉腔的周边周围出现塑料飞边。这种飞边可将钉可释放地保持在钉仓中。
再次参见图48，仓体2310被构造成能够直接接合钳口2180。钳口2180 包括限定于其中的一个或多个保持肩部2315。仓体2310包括对应保持肩部 2187，其与保持肩部2315协作以将仓体2310可释放地保持在钳口2180中。仓体2310和/或钳口2180还包括滑道表面2314，这些滑道表面被构造成能够有利于仓体2310插入到钳口2180中。作为以上的结果，仓体2310可与钳口2180具有按扣配合关系。可通过将仓体2310撬动出钳口2180来克服该按扣配合关系，使得可替换钉仓组件2300。
图52-56中示出了钉2530。钉2530在很多方面与钉2130,2330,2340 和/或本文所公开的其他钉相似。钉2530包括基部2531以及从基部2531延伸的腿部2532和2533。钉2530还包括从基部2531向上延伸的突出部2538。突出部2538与包括基部2531的钉驱动平面对准，并且不与包括钉腿2532 和2533的组织捕获平面对准。突出部2538可在钉捕获平面外部压缩组织。
图57-64中示出了钉仓组件2600。钉仓2600包括仓体2610，该仓体包括限定于其中的多个钉腔2220。钉仓2600还包括定位在每个钉腔2220中的钉2530以及被构造成能够从钉腔2220射出钉2530的滑动件2640。滑动件2640在很多方面与滑动件2140相似。每个滑动件2640包括多个滑道 2645，其中每个滑道2645包括驱动表面2641，该驱动表面被构造成能够在钉2530下方滑动并且提升钉腔2220内的钉2530。每个驱动表面2641包括由侧向侧壁2649界定的倾斜表面2643，这些侧向侧壁限定使钉2530相对于驱动表面2641和/或钉腔2220对准的引导通道。引导通道被构造成能够在侧壁2649之间接收钉2530的基部2531，并且在滑动件2640朝远侧推进时使钉2530侧向地取向。在比较图58和图59时，这种侧向重新对准是显而易见的。再次参见图52-56，每个钉2530包括限定于其基部2531上的引导特征结构2139。每个钉2530的引导特征结构2139包括例如弯曲端部，该弯曲端部被构造成能够与引导通道的侧向侧壁2649相互作用并且调节钉2530的侧向位置。在各种其他实施方案中，引导特征结构2139可包括任何合适的构型。
作为上述的补充或替代，主要参见图60，滑动件2640包括引导通道 2646，这些引导通道被构造成能够接收钉2530的向下悬垂的脚部2134并且使钉2530相对于驱动表面2641和/或钉腔2220取向。每个引导通道2646 包括滑道部分2648和侧向侧壁。引导通道2646被构造成能够在通道2646 的侧壁之间接收钉2530的基部2531，并且在滑动件2640朝远侧推进时使钉2530侧向地取向。主要参见图61，每个脚部2134包括引入端或斜切表面2137，该引入端或斜切表面被构造成能够与通道2646的侧壁相互作用以将钉2530引导到通道2646中。也就是说，脚部2134可具有有利于钉2530 进入通道2646中的任何合适的几何形状。读者应当理解，当驱动表面2641 将钉2530在钉腔2220内向下驱动时，钉2530的脚部2134提升出通道2646。到驱动表面2641的顶点2644使钉2530成形的时候，脚部2134不再定位在通道2646中。
主要参见图58、图59和图64，通道2646也可使滑动件2640相对于仓体2610对准。更具体地，仓体2610还包括向下延伸到通道2646中的纵向导轨2616。导轨2616紧密接收在通道2646中以限制或防止滑动件2640与仓体2610之间的侧向运动，同时允许击发钉2530所需的滑动件2640的纵向运动，如上所概述。每个钉2530的脚部2134被构造成能够在钉2530在钉腔2220内错误取向的情况下使钉2530在其钉腔2220内正确取向。
本文所公开的布置允许钉仓比先前的钉仓更紧凑。除了别的以外，在击发构件与钉之间不利用钉驱动器的本文所公开的钉仓(即，无驱动器的钉仓) 允许钉仓具有更矮的总高度。相似地，不包括底部覆盖件的钉仓也允许钉仓具有更矮的总高度。无驱动器的钉仓也可允许利用更小的钉腔。现在转到图 67和图68，仓体2910包括限定于其中的钉腔2920和纵向狭槽2013。图67 和图68示出了仓体2910的底部2916以及钉腔2920的底部开口。读者应当理解，钉腔2920的尺寸和构造使得其接收钉驱动器以便将钉驱动出仓体 2910。现在转到图69和图70，其示出了仓体2010的底部2016，仓体2010 的钉腔2020小于钉腔2920。读者可以回忆，驱动器不定位在钉腔2020中，因此钉腔2020的尺寸可减小。图71将仓体2910的底部2916与仓体3010 的另选实施方案的底部3016进行比较。从图71中可以看出，仓体3010包括比纵向排钉腔2920窄得多的纵向排钉腔3020。在各种情况下，此类更窄的钉腔可允许纵向排钉腔的中心线彼此更靠近。现在转到图72，钉仓体3110 包括限定于仓体3110的甲板3114中的纵向排钉腔3120a、3120b和3120c，与使用钉驱动器提升仓体内的钉的实施方案中将允许的相比，这些纵向排钉腔一起定位得更近。
本文所公开的钉仓组件的各种实施方案可具有任何合适数量的钉和/或任何合适尺寸的钉。在某些情况下，储存在钉仓组件2000(图73)中的所有钉具有相同或至少基本上相同的尺寸。参见图77，钉仓2000中的每个钉 2130包括限定于基部2131的底部与钉腿2132,2133的尖端之间的未成形或未击发总高度H1。相似地，每个钉2130包括限定于基部2131的顶部与钉腿2132,2133的尖端之间的组织捕获区域，当钉2130处于其未成形高度时，该组织捕获区域具有相同高度H2。
与上述相反，储存在钉仓2000中的第一组钉可具有第一未成形高度 H1，并且第二组钉可具有与第一未成形高度H1不同的第二未成形高度H1。也与上述相反，储存在钉仓2000中的第一组钉可具有第一组织捕获高度 H2，并且第二组钉可具有与第一组织捕获高度H2不同的第二组织捕获高度 H2。
第一组钉可定位在第一纵向排钉腔2120中，而第二组钉可定位在第二纵向排钉腔2120中。在至少一种情况下，第一排钉腔2120可与仓体2010 的台阶2014”中的刀狭槽2013相邻，而第二排钉腔2120可与仓体2010的台阶2014’中的第一排钉腔2120相邻。在至少一种此类情况下，第一未成形高度H1例如矮于第二未成形高度H1。
除上述以外，储存在钉仓2000中的第三组钉可具有与第一未成形高度 H1和/或第二未成形高度H1不同的第三未成形高度H1。第三组钉可定位在第三纵向排钉腔2120中。在至少一种情况下，第三排钉腔2120可与仓体 2010的甲板2014中的第二排钉腔2120相邻。在至少一种此类情况下，第二未成形高度H1例如矮于第三未成形高度H1。作为上述的补充或替代，第三组钉可具有大于第二组织捕获高度H2的第三组织捕获高度H2。
在各种实施方案中，第一组钉、第二组钉和/或第三组钉可变形到相同的总成形高度。另选地，第一组钉可变形到第一成形高度，第二组钉可变形到第二成形高度，和/或第三组钉可变形到第三成形高度。在此类情况下，第一组钉对组织施加的压力可大于第二组钉，并且相似地，第二组钉对组织施加的压力可大于第三组钉。
现在转到图74-76，具有相同未成形高度的钉可变形到不同成形高度。例如，第一纵向排钉(由钉2130”表示)可变形到第一成形高度，第二纵向排钉(由钉2130’表示)可变形到第二成形高度，和/或第三排钉(由钉2130 表示)可变形到第三成形高度。例如，第一成形高度矮于第二成形高度，并且第二成形高度矮于第三成形高度。在此类情况下，第一组钉对组织施加的压力可大于第二组钉，并且相似地，第二组钉施加的压力可大于第三组钉。
图78和图79中示出了钉3230。钉3230包括基部或冠部3231、从基部 3231延伸的第一腿部3232以及从基部3231延伸的第二腿部3233。与钉2130 的基部2131相似，钉3230的基部3231包括限定于驱动平面中的倾斜驱动表面。然而，与钉2130不同，第一腿部3232和第二腿部3233限定横向于或不平行于驱动平面的钉成形平面。
钉3230还包括从基部3231延伸的平台3238。平台3238与基部3231 一体形成并且已折叠，使得平台3238从基部3231侧向地延伸。平台3238 不直接连结到腿部3232,3233。相反，在平台3238与腿部3232,3233之间存在间隙3237。在各种其他实施方案中，平台3238直接连结到第一腿部3232 和/或第二腿部3233。平台3238在横向于驱动平面和钉成形平面的平面(即，支撑平面)中延伸；然而，平台3238可在任何合适的方向上延伸。平台3238 是平坦的或至少基本上平坦的；然而，平台3238可具有任何合适的形状。
在某些实施方案中，当钉3230植入组织中时，钉3230的平台3238可接触所缝合的组织。更宽的平台3238可降低钉3230在组织中撕扯的可能性。
在各种实施方案中，钉仓组件包括仓体，该仓体包括甲板以及限定于甲板中的钉腔。钉仓组件还包括能够移除地储存在钉腔中的钉3230，另外还包括定位在甲板上方的可植入层。可植入层可包括任何合适的辅助件，诸如组织厚度补偿件和/或支撑物材料。组织厚度补偿件可补偿所缝合的组织的厚度的变化。可植入层可由例如织造材料和/或非织造材料构成。
除上述以外，当钉3230植入组织中时，钉3230的平台3238可邻接该层。在此类情况下，平台3238支撑该层。与上述相似，平台3238也可降低钉3230在层中撕扯的可能性。钉3230的平台3238和该层可形成协作系统，该协作系统将施加到组织的力、应力和/或应变分布在更大区域内。
利用冲压工艺由平坦材料片形成钉3230。在冲压工艺期间，从该片中移除材料以形成钉3230的大致形状。第一腿部3232在第一方向上弯曲，并且第二腿部3233在第二方向上弯曲；然而，第一腿部3232和第二腿部3233 均可通过模具利用单个作用线在任何合适的方向上弯曲。在该冲压工艺和/ 或不同冲压工艺期间，平台3238在与第一腿部3232相同的方向上弯曲。在某些情况下，可利用形成腿部3232和3233的相同单个作用线来形成平台3238。在其他情况下，可利用横向或正交于第一作用线的第二作用线来形成平台3238。
现在转到图86，钉3630包括基部或冠部3631以及从基部3631延伸的腿部3632和3633。与钉3230相似，钉3630还包括从基部3631延伸的平台3638。读者应当理解，钉3230的平台3238和钉3630的平台3638可增大钉的惯性力矩或刚度。钉3630包括基部3631中的卸压或屈曲狭槽3637，该卸压或屈曲狭槽例如减小了钉3630的刚度。除此之外或另选地，可在平台3638中提供卸压狭槽。在任何情况下，可利用超过一个卸压狭槽来提供钉3630的所需刚度。此外，此类卸压狭槽可适于本文所公开的任何钉。
作为上述的补充或替代，现在转到图80和图81，钉组件3330包括钉 3230以及附接到钉3230的可植入辅助件3370。辅助件3370包括第一端部，该第一端部包括被构造成能够接收钉3230的第一腿部3232的第一孔口 3372，以及被构造成能够接收第二腿部3233的第二孔口3373。因此，辅助件3370拴系到钉腿3232,3233，并且辅助件3370相对于钉3230的运动受到约束。
除上述以外，辅助件3370包括在钉3230的平台3238上方延伸的弹性部分3371。当钉组件3330储存在钉仓中时，在辅助件3370的弹性部分3371 与钉3230的平台3238之间存在间隙3377。当从钉仓射出钉组件3330时，钉3230的钉腿3232,3233穿透所缝合的组织，并且辅助件3370的弹性部分 3371与组织形成接触。弹性部分3371被构造成能够在辅助件3370与组织形成接触时朝平台3238向下屈曲、偏转和/或位移。当组织捕获在钉3230 内时，弹性部分3371可对组织施加偏压力。弹性部分3371的运动至少部分地受到平台3238约束。
作为上述的补充或替代，现在转到图84，钉组件3430包括钉3630以及附接到钉3230的可植入辅助件3470。辅助件3470包括第一端部，该第一端部包括被构造成能够接收钉3630的第一腿部3632的第一孔口3472，以及被构造成能够接收第二腿部3633的第二孔口3473。因此，辅助件3470 拴系到钉腿3632,3633，并且辅助件3470相对于钉3630的运动受到约束。
除上述以外，辅助件3470包括在钉3630的平台3638上方延伸的弹性部分3471。当钉组件3430储存在钉仓中时，在辅助件3470的弹性部分3471 与钉3630的平台3638之间存在极少(如果有的话)间隙。当从钉仓射出钉组件3430时，钉3630的钉腿3632,3633穿透所缝合的组织，并且辅助件 3470的弹性部分3471与组织形成接触。参见图85，弹性部分3471被构造成能够在辅助件3470与组织形成接触时朝平台3638向下屈曲、偏转和/或位移。当组织捕获在钉3630内时，弹性部分3471可对组织施加偏压力。弹性部分3471的运动至少部分地受到平台3638约束。
主要参见图82和83，辅助件3470的弹性部分3471包括封装件。封装件被密封并且其中包括至少一种材料。在各种情况下，该材料包括药物。当封装件破裂时，该药物从封装件释放。封装件可在钉组件3430植入组织中时或在一段时间之后破裂。辅助件3470由任何合适的生物相容性材料构成，并且当生物相容性材料包括可生物吸收的材料时，辅助件3470可被原位吸收。在足够量的辅助件3470已被吸收之后，药物可从辅助件3470释放。在各种另选实施方案中，辅助件包括两个单独的封装件。在至少一个此类实施方案中，第一封装件可容纳第一药物，并且第二封装件可容纳第二药物。当封装件已破裂时，第一药物可与第二药物混合。
除上述以外，弹性部分3471的室中的材料可针对诸如其弹性的其机械特性来选择，并且可为弹性部分3471提供期望特性以对组织施加足够的偏压力。在至少一种情况下，可能希望弹性部分3471具有与患者组织的机械特性非常类似的机械特性。在其他情况下，可能希望弹性部分3471例如具有小于患者组织的刚度的刚度。此类实施方案可提供组织内的血流的适当收缩。在一些情况下，可能希望弹性部分3471例如具有小于基部3631的刚度但大于患者组织的刚度的刚度。此类实施方案可向组织提供应变消除。
辅助件3370,3470可由织造材料和/或非织造材料构成。在至少一种情况下，辅助件3370,3470包括由织造材料和/或非织造材料构成的壳体。辅助件3370,3470可由例如PGA和/或PLA构成。在至少一种情况下，辅助件3370,3470包括由例如PGA和/或PLA构成的壳体。
辅助件3370,3470被构造成能够附接到单个钉。换句话说，每个辅助件 3370,3470仅附接到一个钉。此类辅助件可称为脱脂棉。可以设想到由辅助件连接两个或更多个钉的另选实施方案。
现在转到图88和图89，本文所公开的各个钉(诸如钉2130)可按纵向排植入到患者的组织中。图88和图89中示出了两个纵向排钉2130。在各种情况下，组织可在各种方向上(诸如纵向地)拉伸。图89中示出了组织 T的纵向拉伸。从图89中可以看出，排钉2130可与组织T一起拉伸。在此类情况下，钉2130之间的间隙可增加。当将未拉伸间隙距离X1(图88) 与拉伸间隙距离X2(图89)进行比较时，该间隙增加是显而易见的。第三纵向排中的钉2130可被定位和布置成使得它们与间隙对准或共同延伸，而不论间隙是被拉伸的(X2)还是未被拉伸的(X1)。此类概念可易于适于例如圆形和/或弯曲钉排。
现在转到图87，圆形仓体3510例如可利用钉组件3430。仓体3510包括被布置成圆形同心排的多个钉腔3520。如图87所示，每个钉腔包括定位在其中的钉组件3430；然而，可利用任何合适的钉。
本文所公开的钉可由任何合适的材料构成。在各种情况下，钉由例如不锈钢和/或钛构成。在某些情况下，本文所公开的钉由镁构成。下述文献的全部公开内容以引用方式并入本文：Yan等人发表的COMPARISON OF THE EFFECTS OF Mg-6Zn AND Ti-3Al-2.5VALLOYS ON TGF-β/TNF-α/VEGF/b-FGF IN THE HEALING OF THE INTESTINAL TRACT INVIVO,Biomed.Mater.9(2014)025011；Yan等人于2013年3月 20日在线发表的COMPARISONOF THE EFFECTS OF Mg-6Zn AND TITANIUM ON INTESTINAL TRACT IN VIVO,J.Mater.Sci.:Mater.Med.； Erdmann等人发表的EVALUATION OF THE SOFT TISSUEBIOCOMPATIBILITY OF MgCa0.8 AND SURGICAL STEEL 316L IN VIVO: A COMPARATIVESTUDY IN RABBITS,Biomed.Eng.OnLine 2010 9:63； Brar等人发表的INVESTIGATION OFTHE MECHANICAL AND DEGRADATION PROPERTIES OF Mg-Sr AND Mg-Zn-Sr ALLOYS FORUSE AS POTENTIAL BIODEGRADABLE IMPLANT MATERIALS,J.Mech. Behavior ofBiomed.Mat.7(2012)87-95；Li等人发表的Mg-Zr-Sr ALLOYS AS BIODEGRADABLE IMPLANTMATERIALS,Acta Biomaterialia 8(2012) 3177-3188；Pellicer等人于2012年8月28日在线发表的ON THE BIODEGRADABILITY,MECHANICAL BEHAVIOR,AND CYTOCOMPATABILITY OFAMORPHOUS Mg72Zn23Ca5 AND CRYSTALLINE Mg70Zn23Ca5Pd2 ALLOYS AS TEMPORARYIMPLANT MATERIALS,Soc.Biomat.。在至少一种情况下，钉由例如包含锌和/或银的镁合金构成。包含镁和锌合金的钉增强组织的愈合性能。包含银的钉提供抗微生物有益效果。包含所有三种合金的钉提供协同增效动力学。
可对由镁构成的钉(包括由镁合金构成的那些)进行处理以改善钉的硬度。在各种情况下，将氮化镁涂层施加到镁钉。在某些情况下，将氮化镁涂层施加到全部镁钉，而在其他情况下，仅将氮化镁涂层施加到镁钉的部分。例如，当钉腿需要足以穿透组织的硬度时，可能希望仅将钉腿和/或钉腿的尖端在氮化镁中涂布。在至少一种此类情况下，当将氮化镁涂层施加到钉腿时，可将掩模施加到镁钉的其余部分。可例如通过在升高的温度和/或压力下将镁钉引入到富氮环境来形成氮化镁涂层。
作为上述的补充或替代，镁钉的一个或多个表面可包括含碳的涂层。
作为上述的补充或替代，可利用其他表面硬化技术。例如，可使用激光硬化工艺和/或等离子体放电硬化工艺将镁钉硬化。在至少一种情况下，可对钉施加KeroniteInternational的KERONITE陶瓷表面处理。
如上所讨论，镁钉的某些部分可经历硬化工艺，而镁钉的其他部分可不经历硬化工艺。在一些情况下，镁钉的某些部分可硬化到第一硬度，而镁钉的其他部分可硬化到与第一硬度不同的第二硬度。具有更低硬度的镁钉部分例如将比具有更高硬度的镁钉部分更快地析出镁、锌和/或银离子。
作为上述的补充或替代，镁钉(包括由镁合金构成的那些)可至少部分地覆盖在包含银的涂层中。在至少一种情况下，银涂层可包含例如电离的银。在某些情况下，可利用电镀工艺将银涂层施加到镁钉。在各种情况下，全部镁钉覆盖在银涂层中。在至少一种情况下，在电镀工艺期间掩蔽镁钉的一部分或多部分，使得所掩蔽的部分不在银中涂布或至少基本上涂布。
作为上述的补充或替代，本文所公开的钉可在抗微生物涂层中涂布或至少部分地涂布。这种涂层可包含例如三氯生。在至少一种情况下，三氯生混合于可吸收聚合物涂层中。在某些情况下，涂层可包含例如与硬脂酸钠相互混合的LAE。Gaffar等人的名称为“Composition for coating medical devices containing lae and a polycationicamphoteric polymer”的WO 2012013577A1 的全部公开内容以引用方式并入本文。
现在转到图90-92，钉3730包括金属框架以及少于全部金属框架上的涂层3739。金属框架包括钉2130，并且由例如镁和/或镁合金构成。涂层3739 包含可生物吸收的聚合物；然而，涂层3739可包含任何合适的材料。涂层3739围绕金属框架2130的腿部2132,2133延伸。更具体地，涂层3739围绕腿部2132,2133每一个盘旋；然而，可利用涂层3739的任何合适的布置。涂层3739还覆盖金属框架2130的腿部2132,2133与基部或冠部2131之间的过渡部或拐角。涂层3739还可覆盖基部2131的一部分。在各种情况下，可将涂层3739策略性地施加到固有地易被更快生物吸收的金属框架2130 的区域，诸如金属框架2130的弯曲部、边缘和/或拐角。在任何情况下，金属框架2130的一部分被涂层3739覆盖，而金属框架2130的另一部分被暴露。
镁或镁合金金属框架2130是可生物吸收的。主要参见图91，金属框架 2130的未被涂层3739覆盖的部分在植入时直接暴露于身体，因此立即经受身体的天然吸收过程。金属框架2130的被涂层3739覆盖的部分在植入时不直接暴露于身体，或至少最初不直接暴露于身体。涂层3739保护或至少在一定程度上保护金属框架2130的被其覆盖的部分并且延迟这些部分的生物吸收。随着时间推移，主要参见图92，金属框架2130的未受保护的部分将被生物吸收，留下金属框架2130的受涂层3739保护的部分。涂层3739可基本上包封金属框架2130的被其覆盖的部分，至少直到涂层3739自身被生物吸收和/或直到金属框架2130已被充分分解。此时，金属框架2130的曾受涂层3739保护的部分被暴露，并且可由身体进行生物吸收。
涂层3739的可生物吸收的聚合物可由例如PGA和/或PLA构成；然而，涂层3739可由任何合适的材料构成，包括但不限于可生物吸收的聚合物和不可生物吸收的聚合物。在某些情况下，涂层3739包含例如非交联聚合物。这种聚合物可使涂层3739溶胀并包封在金属框架2130劣化时形成的金属框架2130的任何尖锐边缘。
在各种实施方案中，涂层3739可按网格、网眼和/或晶格布置的形式布置在金属框架2130上。在这种实施方案中，金属框架2130可在网格的开口中暴露，从而可允许金属框架2130在这些开口中被生物吸收。当金属框架 2130开始劣化时，晶格状涂层3739可充当网或笼并且将金属框架2130的片段保持在一起，例如至少直到涂层3739被生物吸收。
可以以任何合适的方式将涂层3739施加到金属框架2130。在至少一种情况下，可将涂层3739喷涂到金属框架2130上，使得以随机方式施加涂层 3739，从而形成随机开口，金属框架2130可通过这些随机开口被生物吸收。在某些其他情况下，可以以一定图案将涂层3739施加到金属框架2130。在至少一种此类情况下，该图案可包括点阵图案，该点阵图案具有由金属框架 2130的暴露部分围绕的涂层岛。
在某些另选的实施方案中，钉可包括两个或更多个涂层。在至少一种此类情况下，第一涂层可在第一速率下被生物吸收，并且第二涂层可在第二速率下被生物吸收，从而在例如愈合过程的不同时间暴露金属框架2130的不同部分。此类钉仍可具有未被覆盖的部分；然而，可以设想到钉的每一部分可被至少一个或多个涂层覆盖。
由本文所公开的材料提供的治疗有益效果随暴露于患者身体的钉的表面积而变化。具有更大表面积的钉可比具有更小表面积的钉更快递送此类治疗有益效果。也就是说，具有更小表面积的钉可在更长时间段内提供此类治疗有益效果。尽管如此，可通过向钉中引入孔口来增加本文所公开的钉的表面积。例如，可例如在钉2130的基部或冠部2131中形成一个或多个孔口或通孔。这些通孔可允许组织从钉2130中长出并且改善钉2130向身体的同化。
在至少一个实施方案中，除上述以外，当涂层3739会减少钉2130的可用表面吸收面积时，涂层3739不定位在孔口中。然而，如果需要延迟这些钉部分的生物吸收，则可在钉2130的孔口中填充或至少部分地填充涂层 3739。如上所讨论，涂层3739可被构造成能够延迟下层金属框架的吸收；然而，可利用任何合适的涂层。例如，金属框架上的涂层可促进组织向内生长到钉结构中。在至少一种此类情况下，涂层包括与组织产生多孔和/或多刺相互作用的较小微柱。
在各种实施方案中，除上述以外，缝合线或线可延伸穿过钉中限定的孔口。这种缝合线可将钉拴系在一起。在各种情况下，当钉定位在钉仓中时，缝合线被穿线经过孔口。在其他情况下，在钉已植入组织中之后，缝合线被穿线经过孔口。在至少一个实施方案中，缝合线定位在钉仓的甲板中限定的沟槽中，并且钉各自包括限定于其中的狭槽或钩，该狭槽或钩被构造成能够在钉被部署时抓住缝合线。在任何情况下，可拉动缝合线以将缝合的组织收拢在一起，诸如采用荷包组织收拢技术。
在各种实施方案中，本文所公开的钉可包括倒钩。在至少一种情况下，倒钩限定于钉腿上，使得倒钩将所植入的层与组织接合。此类倒钩可减少该层与钉之间的相对运动。在某些实施方案中，倒钩限定于钉的基部上。此类倒钩可夹持定位在所植入的钉附近的一层组织。
图93-95中示出了圆形外科缝合器5000。圆形外科缝合器5000包括框架组件5020，该框架组件包括被构造成能够将砧座可操作地耦接到圆形外科缝合器5000的附接部分5021。圆形外科缝合器5000还包括被构造成能够切入由圆形外科缝合器5000捕获的组织的刀构件5040、在其中能够移除地储存多个钉5051的外科钉仓5010、以及被构造成能够从钉仓5010射出钉5051的推动器组件或驱动器5030。外科钉仓5010包括仓甲板5013以及限定于仓甲板5013中且能够移除地储存钉5051的多个钉腔5011。钉5051 与本文更详细讨论的钉相似，但是可使用任何合适的钉。钉5051在从钉基部分所限定的平面偏移的平面中包括钉腿。
主要参见图95，钉仓5010的钉腔5011包括内排钉腔5011A、中间排钉腔5011B和外排钉腔5011C。钉排间距可包括任何合适的间距；然而，与非嵌套排相比，嵌套排可靠得更近。中间排钉腔5011B相对于内排钉腔 5011A径向向外定位。外排钉腔5011C相对于中间排钉腔5011B径向向外定位。内排中的钉腔5011A具有一定取向，其使钉腔中储存的钉5051的钉腿取向成使得钉腿相对于钉基径向向外延伸。中间排钉腔5011B和外排钉腔5011C具有一定取向，其使钉腔中储存的钉5051的钉腿取向成使得钉腿相对于钉基径向向内延伸。
内排中的钉腔5011A在其间限定具有距离A的多个第一间隙。中间排钉腔5011B限定具有距离B的多个第二间隙。外排钉腔5011C限定具有距离C的多个第三间隙。距离A小于距离B和C。距离B大于距离A但小于距离C。距离C大于距离A和B。腔体5011被布置成使得第一间隙的距离大于第二间隙和/或第三间隙的距离。腔体5011被布置成使得第三间隙的距离小于第一间隙和/或第二间隙的距离。可以设想到没有与一排或多排钉腔相关联的间隙的实施方案。
中间排钉腔5011B被布置成使得腔体5011B与由内排钉腔5011A限定的第一间隙重叠，以便补偿第一间隙中组织结扎的缺少。外排钉腔5011C 被布置成使得腔体5011C与由中间排钉腔5011B限定的第二间隙重叠，以便补偿第二间隙中组织结扎的缺少。利用这种布置重叠这些紧固间隙增强了圆形外科缝合器5000的结扎能力。该布置还允许紧固的组织在紧固时屈曲。常规布置在中间排和/或外排中利用更大数量的钉以便提高结扎效率；然而，此类常规布置在紧固之后可限制组织柔性。
图96-98示出了根据至少一个实施方案的圆形外科缝合器5100。圆形外科缝合器5100包括框架组件5120，该框架组件包括被构造成能够将砧座可操作地耦接到圆形外科缝合器5100的附接部分。圆形外科缝合器5100 还包括被构造成能够切入由圆形外科缝合器5100捕获的组织的刀构件 5140、在其中能够移除地储存多个钉5151的外科钉仓5110、以及被构造成能够从钉仓5110射出钉5151的推动器组件或驱动器5130。推动器组件5130 包括内排钉驱动器5130A、中间排钉驱动器5130B和外排钉驱动器5130C。外科钉仓5110包括仓甲板5113以及限定于仓甲板5113中且在其中能够移除地储存钉5151的多个钉腔5111。外科钉仓5110还包括多个甲板特征结构或钉支撑件或引导件5115，它们被构造成能够在从钉仓5110射出钉5151 时支撑、引导和/或控制钉5151。甲板特征结构或腔体延伸部5115可具有多种用途，诸如有助于将组织夹持在砧座和钉仓5110的中间，和/或储存药物、将药物释放并递送到用缝合器5100捕获的组织。
钉仓5110的钉腔5111在很多方面与钉腔5011相似。钉腔5111包括内排钉腔5111A、中间排钉腔5111B和外排钉腔5111C。甲板特征结构5115 包括多个第一甲板特征结构5115A、多个第二甲板特征结构5115B和多个第三甲板特征结构5115C。每个第一甲板特征结构5115A包括中间部分5116 和两个外部部分5117以限定T构型。中间部分5116位于两个钉腔5111A 之间，并且从甲板5113延伸以引导和/或支撑邻近钉腿。外部部分5117在至少基本上相反的方向上从中间部分5116分支，并且从甲板5113延伸以引导和/或支撑钉基的一部分。以这种方式组合超过一个腔体的甲板特征结构可节省仓甲板5113上的空间。
每个第二甲板特征结构5115B和每个第三甲板特征结构5115C包括中间部分5118和两个外部部分5119以限定围绕腔体的构型。中间部分5118 从甲板5113延伸，以引导和/或支撑能够移除地储存在中间排钉腔5111B和外排钉腔5111C中的钉的钉基。这两个外部部分5119从中间部分5118分支以支撑从钉基延伸的钉腿，中间部分5118引导和/或支撑钉基。
图99示出了根据至少一个实施方案的与圆形外科缝合器一起使用的圆形缝合构型5200。圆形缝合构型5200是可与圆形钉仓一起采用的钉的布置。采用圆形缝合构型5200的圆形钉仓包括对应钉腔以能够移除地储存本文所讨论的钉。圆形缝合构型5200包括具有内排钉5213、中间排钉5215和外排钉5217的多个钉5210。每个钉5213被取向成使得其钉腿向外面向这些外排钉5217。每个钉5215被取向成使得其钉腿向内面向这些内排钉5113。每个钉5217被取向成使得其钉腿远离内排钉5213和中间排钉5215面向外。每个钉排可位于离每个其他钉排和/或切割构件的一定距离处，以便在所缝合的组织内的某些点处更好地控制血流和/或预测组织行为。
外排钉5217具有与内排钉和/或中间排钉5213,5215不同的特性。例如，在各种情况下，外排钉5217被成形为更大的“B”形态，从而产生更大的捕获体积和/或更高的钉成形高度以减轻外排钉5217附近的高组织压缩。更大的B形态也可改善朝向这些内排流动的血流。在各种情况下，外排钉5217 通过利用更大的钉冠、钉腿宽度和/或钉腿厚度，而具有更大的展开阻力。
每排钉中使用的钉的数量在圆形和/或线性外科钉仓中可有所不同。外排钉5217具有第一数量，中间排钉5215具有第二数量，并且内排钉5213 具有第三数量。图99示出了第一数量等于第二数量但大于第三数量的情形。在各种实施方案中，第一数量、第二数量和第三数量是不同的。在各种实施方案中，第一数量大于第二数量，并且第二数量大于第三数量。
钉排之间不同的钉冠宽度可提供高效和/或有效的缝合布置。例如，每个外排钉5217包括宽度大于每个内排钉5213和每个中间排钉5215的冠部宽度的钉冠。每个外排钉5217的钉冠侧向地弯曲以便具有更大冠部宽度的钉，同时保持紧凑圆形缝合布置。可以设想到每个外排钉5217的冠部呈弯曲形的一些实施方案。弯曲或弯折外排钉5217的冠部的一个优点可包括能够例如使外排钉5217更靠近中间排钉5215和内排钉5213进行嵌套。每个外排钉5217跨越内排钉5213和/或中间排钉5215之间限定的多个间隙。每个中间排钉5215跨越、重叠或覆盖内排钉5213之间限定的每个间隙。
在各种实施方案中，可基于内侧钉排的径向位置来改变由内排钉5213 限定的间隙。例如，直径远小于所缝合的肠的直径的一排内侧钉可包括内排钉之间大得多的间隙以提供径向柔性和/或伸展。直径小于但更接近所缝合的肠的直径的一排内侧钉可包括内排钉之间更小的间隙，因为在这种情况下，可能不需要巨大的伸展和/或柔性。
图100示出了根据至少一个实施方案的与圆形外科缝合器一起使用的圆形缝合构型5300。圆形缝合构型5300是可与圆形钉仓一起采用的钉的布置。采用圆形缝合构型5300的圆形钉仓包括对应钉腔以能够移除地储存本文所讨论的钉。圆形缝合构型5300包括具有内排钉5313A,5313B、中间排钉5315C,5315D和外排钉5317E,5317F的多个钉5310。每个钉5313A, 5313B被取向成使得其钉腿向外面向这些外排钉5317E,5317F。每个钉 5315C,5315D被取向成使得其钉腿向内面向这些内排钉5313A,5313B。每个钉5317E,5317F被取向成使得其钉腿远离内排钉5313A,5313B和中间排钉5315C,5315D面向外。可以设想到同一排内的各个钉面向相反方向的实施方案。可以设想到每一排中的每一个钉面向相同方向的实施方案。可以设想到例如内排钉面向内、中间排钉面向外且外排钉面向内的实施方案。
钉排之间和之内不同的钉冠宽度也可提供高效和/或有效的缝合布置。例如，内排钉5313A,5313B各自具有不同冠部宽度，中间排钉5315C,5315D 各自具有不同冠部宽度，并且外排钉5317E,5317F各自具有不同冠部宽度。在各种实施方案中，每个钉5313A、5313B、5315C、5315D、5317E和5317F 的冠部宽度全都不同。可以设想到一排中的某些钉的冠部宽度等于另一排中的某些钉的冠部宽度的实施方案。内排钉限定标记为SZ的拉伸区。拉伸区SZ可包括例如限定在钉5313A之间的间隙。拉伸区SZ允许缝合的组织屈曲。
圆形外科缝合器、圆形钉仓和/或圆形缝合构型可用于例如结肠切除术。图101示出了结肠切除术的一部分的示例，其中将肠的两个部分连接，从而为消化系统提供新通路或通道5400。肠T1的一部分包括内壁5410，并且肠T2的第二部分包括内壁5420。使用内侧钉5401、中间钉5403和外侧钉 5405缝合肠部分T1和T2。切入肠部分T1和T2，从而形成供消化物质通过的新通道P-P。该切入形成了肠部分T1和T2的切口部分5411和5421。肠部分T1和T2的内壁5410,5420与切口部分5411,5421之间的直径变化在一些情况下可使通道P-P收缩或变窄，造成消化物质难以通过。可能希望从内侧钉5401开始的钉部分具有柔性。一种用于提供柔性的方法利用在布置钉的各个排中的钉之间限定的钉间隙。另一种用于提供柔性的方法利用具有更大钉冠的更大尺寸钉。在各种情况下，钉与钉排之间的间隙容许缝合部分有柔性，从而更易让消化物质通过。在各种情况下，不同尺寸的钉容许组织柔性。
图102-104示出了根据至少一个实施方案的被构造成能够捕获、切入和缝合组织的弯曲缝合器械5500。弯曲缝合器械5500包括框架组件5510、钉仓5520和砧座5530。在接收第一致动力时，钉仓5520朝砧座5530驱动而将组织捕获在其间。弯曲缝合器械5500还包括刀组件5540，该刀组件包括被构造成能够切入捕获在钉仓5520与砧座5530之间的组织的切割构件5541。钉仓5520包括甲板5527，该甲板包括被构造成能够接收切割构件5541 的切割狭槽5521、多个钉腔5523A和5523B、以及能够移除地储存在钉腔 5523A,5523B内的多个钉5560。弯曲缝合器械5500还包括驱动器组件5550，该驱动器组件包括被构造成能够在施加第二致动力时使钉5560朝砧座5530 驱动的多个钉驱动器5551。第二致动力起到相对于弯曲缝合器械5500竖直地提升驱动器组件5550和刀组件5540的作用以便切入并缝合组织。
钉仓5520还包括从甲板5527延伸的多个甲板特征结构5525。可以设想到甲板特征结构5525是被构造成能够附接到甲板5527的单独部分的实施方案。甲板特征结构5525可为钉腔5523A,5523B的伸出部，以便在将钉 5560加载到仓5520中时，在射出钉5560之前容纳或支撑钉5560时，和/ 或在从仓5520射出钉5560时，支撑、引导和/或控制钉5560。单个甲板特征结构5525支撑邻近钉的两个不同钉腿。甲板特征结构5525可包括被构造成能够支撑每个钉腿的一个或多个侧、面和/或边缘的多个支撑壁。可以设想到外侧钉排(离狭槽最远的排)上的甲板特征结构5525仅与每个外排中的每隔一个钉腔相关的实施方案。钉特征结构离切口的位置越近，钉特征结构的密度可随之增大。
图105和图106示出了根据至少一个实施方案的被构造成能够捕获、切入和缝合组织的弯曲缝合器械5600。弯曲缝合器械5600包括框架组件5610、钉仓5620和砧座5630。在接收第一致动力时，钉仓5620朝砧座5630驱动而将组织捕获在其间。弯曲缝合器械5600还包括刀组件，该刀组件包括被构造成能够切入捕获在钉仓5620与砧座5630之间的组织的切割构件。钉仓 5620包括甲板5627，该甲板包括被构造成能够接收切割构件的切割狭槽 5621、多个钉腔5623、以及能够移除地储存在钉腔5623内的多个钉5660。弯曲缝合器械5600还包括驱动器组件5650，该驱动器组件包括被构造成能够在施加第二致动力时使钉5660朝砧座5630驱动的多个钉驱动器5651。第二致动力起到相对于弯曲缝合器械5600竖直地提升驱动器组件5650和刀组件的作用以便切入并缝合组织。
钉仓5620还包括从甲板5627延伸的多个甲板特征结构5625。可以设想到甲板特征结构5625是被构造成能够附接到甲板5627的单独部分的实施方案。甲板特征结构5625可为钉腔5623的伸出部，以便在将钉5660加载到仓5620中时，在射出钉5660之前容纳或支撑钉5660时，和/或在从仓5620 射出钉5660时，支撑、引导和/或控制钉5660。甲板特征结构5625可包括被构造成能够支撑每个钉腿的一个或多个侧、面和/或边缘的多个支撑壁。甲板特征结构5625从钉腔的钉腿壁中的至少一个和钉基壁中的至少一个延伸。
钉驱动器5651具有与钉5660的底部外形至少基本上相同的平坦外形。具有相似或相同的外形容许钉驱动器5651在钉5660的钉基部分内的适宜力分布。当抵靠在砧座5630上成形时，驱动器5651与钉5660之间相似的外形防止钉5660变得不对准。
实施例
实施例1：一种与外科缝合器一起使用的钉仓组件，其中所述钉仓组件包括仓体，所述仓体包括近侧端部、远侧端部、甲板、限定于所述甲板中且从所述近侧端部朝所述远侧端部延伸的纵向狭槽以及钉腔，其中所述钉腔被布置成纵向排。每个钉腔包括限定于所述甲板中的顶部开口、底部开口、近侧端部、远侧端部以及在所述近侧端部与所述远侧端部之间延伸的钉腔侧壁。所述钉仓组件还包括能够移除地储存在所述钉腔中的钉，其中每个钉包括近侧腿部、远侧腿部、在所述近侧腿部与所述远侧腿部之间延伸的基部以及从所述基部延伸的保持突出部，其中所述钉的所述保持突出部与所述钉腔侧壁接合以防止所述钉从所述钉腔的所述底部开口落出。
实施例2：根据实施例1所述的钉仓组件，还包括滑动件，所述滑动件能够从所述近侧端部朝所述远侧端部运动以通过所述钉腔的所述顶部开口射出所述钉。
实施例3：根据实施例2所述的钉仓组件，其中所述仓体还包括与所述甲板相背对限定的底部表面；限定于所述底部表面中的纵向通道，其中所述滑动件的至少一部分可滑动地定位在所述纵向通道中；以及保持部分，所述保持部分被构造成能够防止所述滑动件通过所述底部表面从所述纵向通道落出。
实施例4：根据实施例3所述的钉仓组件，其中所述滑动件能够在击发冲程期间在近侧位置与远侧位置之间运动，其中当所述滑动件处于所述近侧位置时，所述保持部分与所述滑动件接合，并且其中当所述滑动件处于所述远侧位置时，所述保持部分不与所述滑动件接合。
实施例5：根据实施例1、2、3或4所述的钉仓组件，其中所述钉仓组件不包括围绕所述仓体的所述底部表面延伸的覆盖件。
实施例6：根据实施例1、2、3、4或5所述的钉仓组件，其中所述仓体包括被构造成能够直接接合所述外科缝合器的至少一个按扣配合特征结构。
实施例7：根据实施例3、4或5所述的钉仓组件，其中所述滑动件直接接合所述钉，并且其中所述钉仓组件不包括定位在所述滑动件和所述钉的中间的驱动器。
实施例8：根据实施例1、2、3、4、5、6或7所述的钉仓组件，其中每个钉由材料片冲压而成，其中每个所述钉的所述近侧腿部、所述远侧腿部和所述基部在钉平面中成形，并且其中所述保持突出部从所述钉平面侧向地延伸。
实施例9：一种与外科缝合器一起使用的钉仓组件，其中所述钉仓组件包括仓体，所述仓体包括近侧端部、远侧端部、甲板、底部部分、限定于所述甲板中且从所述近侧端部朝所述远侧端部延伸的纵向狭槽、限定于所述底部部分中的纵向通道以及钉腔，其中每个钉腔包括限定于所述甲板中的顶部开口以及限定于所述底部部分中的底部开口。所述钉仓组件还包括能够移除地储存在所述钉腔中的钉；可滑动地定位在所述纵向通道中的滑动件，其中所述滑动件能够从所述近侧端部朝所述远侧端部运动以通过所述钉腔的所述顶部开口射出所述钉；以及保持部分，所述保持部分被构造成能够防止所述滑动件通过所述底部部分从所述纵向通道落出。
实施例10：根据实施例9所述的钉仓组件，其中所述滑动件能够在击发冲程期间在近侧位置与远侧位置之间运动，其中当所述滑动件处于所述近侧位置时，所述保持部分与所述滑动件接合，并且其中当所述滑动件处于所述远侧位置时，所述保持部分不与所述滑动件接合。
实施例11：根据实施例9或10所述的钉仓组件，其中所述钉仓组件不包括围绕所述仓体的所述底部部分延伸的覆盖件。
实施例12：根据实施例9、10或11所述的钉仓组件，其中所述滑动件直接接合所述钉，并且其中所述钉仓组件不包括定位在所述滑动件和所述钉的中间的驱动器。
实施例13：一种与外科缝合器一起使用的钉仓组件，其中所述外科缝合器包括被构造成能够接收所述钉仓组件的钳口，并且其中所述钉仓组件包括仓体，所述仓体包括近侧端部；远侧端部；甲板；底部部分，其中所述钉仓组件不包括围绕所述底部部分延伸的封装件；限定于所述甲板中且从所述近侧端部朝所述远侧端部延伸的纵向狭槽；限定于所述底部部分中的纵向通道；以及钉腔，其中每个所述钉腔包括限定于所述甲板中的顶部开口以及限定于所述底部部分中的底部开口。所述钉仓组件还包括能够移除地储存在所述钉腔中的钉；可滑动地定位在所述纵向通道中的滑动件，其中所述滑动件能够从所述近侧端部朝所述远侧端部运动以在击发冲程期间通过所述钉腔的所述顶部开口射出所述钉；以及用于防止所述滑动件通过所述底部部分从所述纵向通道落出的装置。
实施例14：根据实施例13所述的钉仓组件，其中所述滑动件在所述击发冲程期间直接接合所述钉。
实施例15：根据实施例13或14所述的钉仓组件，还包括用于防止所述钉通过所述底部开口从所述钉腔落出的装置。
实施例16：一种与外科缝合器一起使用的钉仓组件，其中所述外科缝合器包括被构造成能够接收所述钉仓组件的钳口，并且其中所述钉仓组件包括仓体，所述仓体包括近侧端部；远侧端部；甲板；底部部分，其中所述钉仓组件不包括围绕所述底部部分延伸的封装件；以及钉腔，其中每个所述钉腔包括限定于所述甲板中的顶部开口以及限定于所述底部部分中的底部开口。所述钉仓组件还包括能够移除地储存在所述钉腔中的钉，其中所述仓体包括与所述仓体一体形成的搁架，所述搁架防止所述钉通过所述底部开口从所述钉腔落出。
实施例17：一种与外科缝合器一起使用的钉仓组件，其中所述钉仓组件包括仓体，所述仓体包括近侧端部、远侧端部、甲板、限定于所述甲板中且从所述近侧端部朝所述远侧端部延伸的纵向狭槽以及钉腔。所述钉腔包括限定于所述甲板中的顶部开口、底部开口、近侧引导件、远侧引导件、在所述近侧引导件与所述远侧引导件之间延伸的侧壁以及从所述侧壁向内延伸的中间引导件。所述钉仓组件还包括能够移除地储存在所述钉腔中的钉，所述钉包括定位在所述近侧引导件内的近侧腿部、定位在所述远侧引导件内的远侧腿部以及在所述近侧腿部与所述远侧腿部之间延伸的基部，其中所述中间引导件被定位成引导所述基部并且将所述近侧腿部保持在所述近侧引导件中并将所述远侧腿部保持在所述远侧引导件中。
实施例18：根据实施例17所述的钉仓组件，其中所述钉腔还包括在所述近侧引导件近侧的近侧腔体端部以及在所述远侧引导件远侧的远侧腔体端部。
实施例19：根据实施例18所述的钉仓组件，其中所述钉不定位在所述近侧腔体端部和所述远侧腔体端部中。
实施例20：根据实施例18或19所述的钉仓组件，其中在所述钉基、所述中间引导件和所述远侧腔体端部之间存在第一余隙间隙，并且其中在所述钉基、所述中间引导件和所述近侧腔体端部之间存在第二余隙间隙。
实施例21：根据实施例17、18、19或20所述的钉仓组件，其中所述基部包括与所述中间引导件交接的平坦引导表面。
实施例22：根据实施例17、18、19、20或21所述的钉仓组件，其中所述仓体还包括多个所述钉腔，并且其中所述钉仓组件还包括定位在所述钉腔中的多个所述钉。
实施例23：根据实施例17、18、19、20、21或22所述的钉仓组件，其中当从所述钉腔射出所述钉时，所述近侧引导件、所述远侧引导件和所述中间引导件使所述钉的控制呈三角划分。
实施例24：根据实施例17、18、19、20、21、22或23所述的钉仓组件，其中所述近侧引导件和所述远侧引导件在所述甲板上方延伸。
实施例25：根据实施例17、18、19、20、21、22、23或24所述的钉仓组件，其中所述中间引导件在所述甲板上方延伸。
实施例26：根据实施例17、18、19、20、21、22、23、24或25所述的钉仓组件，其中所述钉的所述近侧腿部和所述远侧腿部限定腿部平面，其中所述基部包括驱动平面中的驱动表面，并且其中所述驱动平面从所述腿部平面偏移。
实施例27：根据实施例17、18、19、20、21、22、23、24、25或26 所述的钉仓组件，其中所述近侧腿部和所述远侧腿部通过所述近侧引导件和所述远侧引导件朝彼此夹紧。
实施例28：根据实施例17、18、19、20、21、22、23、24、25、26或 27所述的钉仓组件，其中所述中间引导件包括与所述基部接合的弹性偏压构件，所述弹性偏压构件被构造成能够将所述近侧腿部推动到所述近侧引导件中并将所述远侧腿部推动到所述远侧引导件中。
实施例29：根据实施例17、18、19、20、21、22、23、24、25、26、 27或28所述的钉仓组件，其中所述中间引导件比所述近侧引导件更靠近所述远侧引导件定位。
实施例30：根据实施例17、18、19、20、21、22、23、24、25、26、 27或28所述的钉仓组件，其中所述中间引导件定位在所述远侧引导件与所述近侧引导件之间的等距离处。
实施例31：一种与外科缝合器一起使用的钉仓组件，其中所述钉仓组件包括仓体，所述仓体包括近侧端部、远侧端部、甲板、限定于所述甲板中且从所述近侧端部朝所述远侧端部延伸的纵向狭槽以及钉腔。所述钉腔包括限定于所述甲板中的顶部开口、底部开口、近侧引导件、远侧引导件以及在所述近侧引导件与所述远侧引导件之间延伸的侧壁。所述钉仓组件还包括能够移除地储存在所述钉腔中的钉，所述钉包括定位在所述近侧引导件内的近侧腿部；定位在所述远侧引导件内的远侧腿部，其中所述近侧腿部和所述远侧腿部限定腿部平面，并且其中所述近侧腿部和所述远侧腿部通过所述近侧引导件和所述远侧引导件朝彼此夹紧；以及在所述近侧腿部与所述远侧腿部之间延伸的基部，其中所述基部包括驱动平面中的驱动表面，并且其中所述驱动平面从所述腿部平面偏移。
实施例32：根据实施例31所述的钉仓组件，其中所述腿部平面平行于所述驱动平面。
实施例33：根据实施例31或32所述的钉仓组件，其中所述仓体还包括多个所述钉腔，并且其中所述钉仓组件还包括定位在所述钉腔中的多个所述钉。
实施例34：一种与外科缝合器一起使用的钉仓组件，其中所述钉仓组件包括仓体，所述仓体包括近侧端部、远侧端部、甲板、限定于所述甲板中且从所述近侧端部朝所述远侧端部延伸的纵向狭槽以及钉腔。所述钉腔包括限定于所述甲板中的顶部开口、底部开口、近侧引导件、远侧引导件、在所述近侧引导件与所述远侧端部引导件之间延伸的侧壁以及从所述钉腔侧壁向内延伸的中间引导件。所述钉仓组件还包括能够移除地储存在所述钉腔中的钉，所述钉包括定位在所述近侧引导件内的近侧腿部、定位在所述远侧引导件内的远侧腿部以及在所述近侧腿部与所述远侧腿部之间延伸的基部，其中当从所述钉腔射出所述钉时，所述近侧引导件、所述远侧引导件和所述中间引导件使所述钉的控制呈三角划分。
实施例35：根据实施例34所述的钉仓组件，其中所述仓体还包括多个所述钉腔，并且其中所述钉仓组件还包括定位在所述钉腔中的多个所述钉。
实施例36：一种与外科缝合器一起使用的钉仓组件，其中所述钉仓组件包括仓体，所述仓体包括近侧仓端部、远侧仓端部、甲板、限定于所述甲板中且从所述近侧仓端部朝所述远侧仓端部延伸的纵向刀狭槽以及钉腔。所述钉腔包括限定于所述甲板中的顶部开口；近侧腔体端部；远侧腔体端部；近侧引导件；远侧引导件，其中所述近侧引导件和所述远侧引导件在所述甲板上方延伸；以及在所述近侧腔体端部与所述远侧腔体端部之间延伸的腔体狭槽，其中所述近侧引导件和所述远侧引导件相对于所述腔体狭槽侧向地延伸。所述钉仓组件还包括能够移除地储存在所述钉腔中的钉，所述钉包括定位在所述近侧引导件内的近侧腿部、定位在所述远侧引导件内的远侧腿部以及在所述近侧腿部与所述远侧腿部之间延伸的基部，其中所述基部定位在所述腔体狭槽中。
实施例37：根据实施例36所述的钉仓组件，其中所述近侧引导件和所述远侧引导件朝所述刀狭槽延伸。
实施例38：根据实施例36所述的钉仓组件，其中所述近侧引导件和所述远侧引导件远离所述刀狭槽延伸。
实施例39：根据实施例36、37或38所述的钉仓组件，其中所述近侧引导件包括近侧托架。
实施例40：根据实施例39所述的钉仓组件，其中所述近侧托架不围绕所述近侧腔体端部延伸。
实施例41：根据实施例39或40所述的钉仓组件，其中所述腔体狭槽由纵向轴线限定，并且其中所述近侧托架不与所述纵向轴线对准。
实施例42：根据实施例36、37、38、39、40或41所述的钉仓组件，其中所述远侧引导件包括远侧托架。
实施例43：根据实施例42所述的钉仓组件，其中所述远侧托架不围绕所述远侧腔体端部延伸。
实施例44：根据实施例42或43所述的钉仓组件，其中所述腔体狭槽由纵向轴线限定，并且其中所述远侧托架不与所述纵向轴线对准。
实施例45：根据实施例36、37、38、39、40、41、42、43或44所述的钉仓组件，其中所述近侧腿部和所述远侧腿部限定钉腿平面，其中所述基部包括从所述钉腿平面偏移的驱动平面中的驱动表面，其中所述近侧引导件和所述远侧引导件与所述钉平面对准，并且其中所述近侧引导件和所述远侧引导件不与所述驱动平面对准。
实施例46：根据实施例36、37、38、39、40、41、42、43或44所述的钉仓组件，其中所述近侧腿部和所述远侧腿部限定钉腿平面，其中所述基部包括从所述钉腿平面偏移的驱动平面中的驱动表面，并且其中所述近侧引导件和所述远侧引导件限定与所述钉腿平面对准的托架平面。
实施例47：根据实施例36、37、38、39、40、41、42、43、44、45或 46所述的钉仓组件，其中所述仓体还包括多个所述钉腔，并且其中所述钉仓组件还包括定位在所述钉腔中的多个所述钉。
实施例48：根据实施例36、37、38、39、40、41、42、43、44、45、 46或47所述的钉仓组件，其中所述近侧引导件的在所述甲板上方延伸的部分包括钉腔延伸部，并且其中所述远侧引导件的在所述甲板上方延伸的部分包括钉腔延伸部。
实施例49：一种与外科缝合器一起使用的钉仓组件，其中所述钉仓组件包括仓体，所述仓体包括近侧仓端部、远侧仓端部、甲板以及钉腔。所述钉腔包括近侧腔体端部、远侧腔体端部、在所述甲板上方和下方延伸的近侧引导件、在所述甲板上方和下方延伸的远侧引导件以及在所述近侧腔体端部与所述远侧腔体端部之间延伸的连接狭槽，其中所述近侧引导件和所述远侧引导件相对于所述连接狭槽侧向地延伸。所述钉仓组件还包括能够移除地储存在所述钉腔中的钉，所述钉包括定位在所述近侧引导件内的近侧腿部、定位在所述远侧引导件内的远侧腿部以及在所述近侧腿部与所述远侧腿部之间延伸的基部，其中所述基部定位在所述腔体狭槽中。
实施例50：根据实施例49所述的钉仓组件，其中所述仓体还包括多个所述钉腔，并且其中所述钉仓组件还包括定位在所述钉腔中的多个所述钉。
实施例51：根据实施例49或50所述的钉仓组件，其中所述近侧引导件的在所述甲板上方延伸的所述部分包括钉腔延伸部，并且其中所述远侧引导件的在所述甲板上方延伸的所述部分包括钉腔延伸部。
实施例52：一种与外科紧固器械一起使用的紧固件仓组件，其中所述紧固件仓组件包括仓体，所述仓体包括近侧仓端部、远侧仓端部、甲板和紧固件凹坑。所述紧固件凹坑包括近侧凹坑端部；远侧凹坑端部；近侧引导件；远侧引导件；近侧凹坑延伸部，其中所述近侧凹坑延伸部在所述甲板上方延伸；远侧凹坑延伸部，其中所述近侧凹坑延伸部在所述甲板上方延伸；以及在所述近侧凹坑端部与所述远侧凹坑端部之间延伸的凹坑开口，其中所述近侧引导件和所述远侧引导件相对于所述凹坑开口侧向地延伸。所述紧固件仓组件还包括能够移除地储存在所述紧固件凹坑中的紧固件，所述紧固件包括定位在所述近侧引导件内的近侧腿部、定位在所述远侧引导件内的远侧腿部以及在所述近侧腿部与所述远侧腿部之间延伸的基部，其中所述基部定位在所述凹坑开口中。
实施例53：根据实施例52所述的紧固件仓组件，其中所述仓体还包括多个所述紧固件凹坑，并且其中所述紧固件仓组件还包括定位在所述紧固件凹坑中的多个所述紧固件。
实施例54：一种与外科器械一起使用的钉仓组件，所述钉仓组件包括仓体，所述仓体包括近侧端部、远侧端部、甲板以及限定于所述甲板中的钉腔。所述钉仓组件还包括能够移除地定位在所述钉腔中的钉以及具有与所述钉对准的通道的击发构件，其中所述通道包括第一侧向侧壁和第二侧向侧壁，并且其中所述通道被构造成能够在所述第一侧向侧壁与所述第二侧向侧壁之间接收所述钉。
实施例55：根据实施例54所述的钉仓组件，其中所述通道限定在所述击发构件的倾斜表面上。
实施例56：根据实施例54或55所述的钉仓组件，其中所述通道包括滑道部分和顶点部分，所述滑道部分被构造成能够在所述击发构件的击发冲程期间提升所述钉腔内的所述钉，所述顶点部分被构造成能够使所述钉抵靠在所述外科器械的砧座上成形到最终成形高度。
实施例57：根据实施例56所述的钉仓组件，其中所述通道包括相对于所述顶点部分朝近侧定位的尾随部分，并且其中所述顶点部分定位在所述尾随部分上方。
实施例58：根据实施例54、55、56或57所述的钉仓组件，其中所述击发构件包括具有多个楔形件的滑动件，并且其中所述通道限定在所述楔形件中的一个上。
实施例59：根据实施例54、55、56、57或58所述的钉仓组件，其中所述击发构件还包括滑道，所述滑道被构造成能够初始提升所述钉腔内的所述钉并且将所述钉引导到所述通道中。
实施例60：根据实施例54、55、56、57、58或59所述的钉仓组件，其中所述通道包括口部部分和纵向部分，其中所述口部部分向所述纵向部分提供引入端，并且其中所述口部部分宽于所述纵向部分。
实施例61：根据实施例54、55、56、57、58、59或60所述的钉仓组件，其中所述钉接收在所述通道内，而没有定位在所述钉与所述通道之间的钉驱动器。
实施例62：根据实施例54、55、56、57、58、59、60或61所述的钉仓组件，其中所述第一侧向侧壁平行于所述第二侧向侧壁。
实施例63：根据实施例54、55、56、57、58、59、60或61所述的钉仓组件，其中所述第一侧向侧壁不平行于所述第二侧向侧壁。
实施例64：根据实施例54、55、56、57、58、59、60或61所述的钉仓组件，其中所述第一侧向侧壁和所述第二侧向侧壁相对于彼此成角以形成钉进入引入端。
实施例65：根据实施例54、55、56、57、58、59、60、61、62、63或 64所述的钉仓组件，其中所述通道包括第一通道，并且其中所述击发构件还包括被构造成能够接收所述钉的第二通道。
实施例66：根据实施例65所述的钉仓组件，其中每个钉包括被构造成能够进入所述第一通道的驱动部分以及被构造成能够进入所述第二通道的成形部分。
实施例67：根据实施例65或66所述的钉仓组件，其中所述第一通道以相对于所述第二通道成角度延伸。
实施例68：根据实施例65、66或67所述的钉仓组件，其中所述第一通道和所述第二通道在第一区域中彼此平行并且在第二区域中彼此不平行。
实施例69：根据实施例65、66、67或68所述的钉仓组件，其中所述第二通道被构造成能够在所述击发构件朝所述远侧端部推进时在所述第一通道前接收所述钉。
实施例70：一种与外科器械一起使用的钉仓组件，所述钉仓组件包括：仓体，所述仓体包括甲板以及限定于所述甲板中的钉腔；能够移除地定位在所述钉腔中的钉；以及击发构件，所述击发构件包括被构造成能够直接接合所述钉的滑道以及从所述滑道延伸且被构造成能够使所述钉相对于所述滑道取向的导轨。
实施例71：根据实施例70所述的钉仓组件，其中所述导轨包括第一导轨，并且其中所述击发构件还包括从所述滑道延伸且被构造成能够使所述钉相对于所述滑道取向的第二导轨。
实施例72：根据实施例71所述的钉仓组件，其中所述第一导轨平行于所述第二导轨。
实施例73：一种与包括砧座的外科缝合器械一起使用的钉仓组件，其中所述砧座包括成形凹坑，并且其中所述钉仓组件包括仓体，所述仓体包括近侧端部、远侧端部、甲板以及限定于所述甲板中的钉腔。所述钉仓组件包括：能够移除地定位在所述钉腔中的钉，其中每个钉包括钉驱动部分和钉成形部分；以及击发构件，所述击发构件包括与所述钉的所述钉驱动部分对准的第一引导通道以及与所述钉的所述钉成形部分对准的第二引导通道，其中所述第一引导通道和所述第二引导通道被构造成能够在所述击发构件朝所述远侧端部运动时协同使所述钉与所述砧座的所述钉成形凹坑对准。
实施例74：一种钉仓组件，所述钉仓组件包括仓体，所述仓体包括甲板、第一纵向排钉腔和第二纵向排钉腔。所述钉仓组件还包括多个第一钉，其中每个第一钉能够移除地储存在所述第一纵向排钉腔中，并且其中每个第一钉具有一体式结构，所述一体式结构包括具有第一驱动表面的第一基部以及从所述第一基部延伸且具有第一尖端的第一钉腿，其中在所述第一驱动表面与所述第一尖端之间限定第一未成形距离；多个第二钉，其中每个第二钉能够移除地储存在所述第二纵向排钉腔中，并且其中每个第二钉具有一体式结构，所述一体式结构包括具有第二驱动表面的第二基部以及从所述第二基部延伸且具有第二尖端的第二钉腿，其中在所述第二驱动表面与所述第二尖端之间限定第二未成形距离，所述第二未成形距离与所述第一未成形距离不同；以及击发构件，所述击发构件被构造成能够直接接合所述第一钉和所述第二钉。
实施例75：根据实施例74所述的钉仓组件，其中所述第一钉和所述第二钉由金属片形成。
实施例76：根据实施例74或75所述的钉仓组件，其中每个第一基部包括第一组织支撑表面，其中在所述第一组织支撑表面与所述第一尖端之间限定第一组织捕获距离，其中每个第二基部包括第二组织支撑表面，其中在所述第二组织支撑表面与所述第二尖端之间限定第二组织捕获距离，并且其中所述第一组织捕获距离与所述第二组织捕获距离不同。
实施例77：根据实施例74、75或76所述的钉仓组件，其中所述甲板具有沿着所述第一纵向排钉腔的第一甲板高度以及沿着第二所述纵向排钉腔的第二甲板高度，所述第二甲板高度与所述第一甲板高度不同。
实施例78：根据实施例77所述的钉仓组件，其中所述仓体还包括被构造成能够接收切割构件的纵向狭槽，其中所述第一纵向排钉腔与所述纵向狭槽相邻，其中所述第二纵向排钉腔与所述第一纵向排钉腔相邻，并且其中所述第二甲板高度矮于所述第一甲板高度。
实施例79：根据实施例74、75、76、77或78所述的钉仓组件，其中所述仓体还包括被构造成能够接收切割构件的纵向狭槽，其中所述第一纵向排钉腔与所述纵向狭槽相邻，并且其中所述第二纵向排钉腔与所述第一纵向排钉腔相邻。
实施例80：根据实施例74、75、76、77、78或79所述的钉仓组件，其中所述第一未成形距离短于所述第二未成形距离。
实施例81：根据实施例74、75、76、77、78、79或80所述的钉仓组件，还包括被构造成能够使所述钉变形的砧座。
实施例82：根据实施例81所述的钉仓组件，其中所述砧座被构造成能够使所述第一钉变形到第一变形高度并且使所述第二钉变形到第二变形高度，所述第二变形高度与所述第一变形高度不同。
实施例83：根据实施例81或82所述的钉仓组件，其中所述仓体能够朝所述砧座运动以将组织夹持在所述砧座与所述仓体的所述甲板之间。
实施例84：根据实施例81、82或83所述的钉仓组件，其中所述砧座能够朝所述仓体运动以将组织夹持在所述砧座与所述仓体的所述甲板之间。
实施例85：根据实施例74、75、76、77、78、79、80、81、82、83或 84所述的钉仓组件，还包括从所述甲板延伸的钉腔延伸部。
实施例86：根据实施例74、75、76、77、78、79、80、81、82、83、 84或85所述的钉仓组件，还包括定位在所述甲板上方的可植入层。
实施例87：一种钉仓组件，所述钉仓组件包括仓体，所述仓体包括甲板、第一纵向排钉腔和第二纵向排钉腔。所述钉仓组件还包括多个第一钉，其中每个第一钉能够移除地储存在所述第一纵向排钉腔中，并且其中每个第一钉具有一体式结构，所述一体式结构包括具有第一驱动表面和第一组织支撑表面的第一基部以及从所述第一基部延伸且具有第一尖端的第一钉腿，其中在所述第一组织支撑表面与所述第一尖端之间限定第一组织捕获距离；多个第二钉，其中每个第二钉能够移除地储存在所述第二纵向排钉腔中，并且其中每个第二钉具有一体式结构，所述一体式结构包括具有第二驱动表面和第二组织支撑表面的第二基部以及从所述第二基部延伸且具有第二尖端的第二钉腿，其中在所述第二组织支撑表面与所述第二尖端之间限定第二组织捕获距离，所述第二组织捕获距离与所述第一组织捕获距离不同；以及击发构件，所述击发构件被构造成能够直接接合所述第一钉和所述第二钉。
实施例88：根据实施例87所述的钉仓组件，其中所述甲板具有沿着所述第一纵向排钉腔的第一甲板高度以及沿着第二所述纵向排钉腔的第二甲板高度，所述第二甲板高度与所述第一甲板高度不同。
实施例89：根据实施例88所述的钉仓组件，其中所述仓体还包括被构造成能够接收切割构件的纵向狭槽，其中所述第一纵向排钉腔与所述纵向狭槽相邻，其中所述第二纵向排钉腔与所述第一纵向排钉腔相邻，并且其中所述第二甲板高度矮于所述第一甲板高度。
实施例90：根据实施例87、88或89所述的钉仓组件，还包括被构造成能够使所述钉变形的砧座。
实施例91：根据实施例90所述的钉仓组件，其中所述砧座被构造成能够使所述第一钉变形到第一变形高度并且使所述第二钉变形到第二变形高度，所述第二变形高度与所述第一变形高度不同。
实施例92：根据实施例90或91所述的钉仓组件，其中所述仓体能够朝所述砧座运动以将组织夹持在所述砧座与所述仓体的所述甲板之间。
实施例93：一种钉仓组件，所述钉仓组件包括：仓体，所述仓体包括第一纵向排钉腔和第二纵向排钉腔；能够移除地储存在所述第一纵向排钉腔中的多个第一钉，其中每个第一钉由冲压金属构成并且包括一体形成的金属驱动器；能够移除地储存在所述第二纵向排钉腔中的多个第二钉，其中每个第二钉由冲压金属构成并且包括一体形成的金属驱动器；以及用于使所述第一钉成形到第一变形高度并且使所述第二钉成形到第二变形高度的装置，其中所述第一变形高度与所述第二变形高度不同。
实施例94：一种钉仓组件，所述钉仓组件包括：钉仓体，所述钉仓体包括甲板以及限定于所述甲板中的钉腔；能够移除地储存在所述钉腔中的钉，其中每个钉包括基部、从所述基部延伸的腿部以及从所述基部侧向地延伸的平台；以及定位在所述甲板上方的可植入层，其中所述钉的所述平台被构造成能够在所述钉植入到患者的组织中时邻接所述层。
实施例95：根据实施例94所述的钉仓组件，其中每个钉由材料片冲压而成，其中所述基部限定基部平面，并且其中所述平台从所述基部平面折出。
实施例96：根据实施例94或95所述的钉仓组件，其中所述可植入层包含织造材料。
实施例97：根据实施例94、95或96所述的钉仓组件，其中所述可植入层包含非织造材料。
实施例98：根据实施例94、95、96或97所述的钉仓组件，还包括从所述腿部延伸且与所述基部相邻的保持构件，其中所述保持构件被构造成能够在钉植入到患者的所述组织中时接合所述可植入层。
实施例99：根据实施例94、95、96、97或98所述的钉仓组件，其中所述平台为平坦的。
实施例100：根据实施例94、95、96、97、98或99所述的钉仓组件，其中所述平台不直接附接到所述腿部。
实施例101：一种钉仓组件，所述钉仓组件包括：钉仓体，所述钉仓体包括甲板以及限定于所述甲板中的钉腔；能够移除地储存在所述钉腔中的钉，其中每个钉包括冠部、从所述冠部延伸的第一腿部和第二腿部以及从所述冠部侧向地延伸的平台；以及定位在所述甲板上方的可植入层，其中所述钉的所述平台被构造成能够在所述钉植入到患者的组织中时支撑所述层。
实施例102：根据实施例101所述的钉仓组件，其中每个钉由材料片冲压而成，其中所述冠部限定冠部平面，并且其中所述平台从所述冠部平面折出。
实施例103：根据实施例101或102所述的钉仓组件，其中所述可植入层包含织造材料。
实施例104：根据实施例101、102或103所述的钉仓组件，其中所述可植入层包含非织造材料。
实施例105：根据实施例101、102、103或104所述的钉仓组件，还包括从所述腿部延伸且与所述冠部相邻的保持构件，其中所述保持构件被构造成能够在钉植入到患者的所述组织中时接合所述可植入层。
实施例106：根据实施例101、102、103、104或105所述的钉仓组件，其中所述平台为平坦的。
实施例107：根据实施例101、102、103、104、105或106所述的钉仓组件，其中每个钉包括与所述冠部相邻定位的顺应性辅助件。
实施例108：根据实施例107所述的钉仓组件，其中所述顺应性辅助件在所述第一腿部与所述第二腿部之间延伸。
实施例109：根据实施例107或108所述的钉仓组件，其中所述顺应性辅助件附接到所述第一腿部和所述第二腿部。
实施例110：根据实施例107、108或109所述的钉仓组件，其中所述顺应性辅助件包括第一孔口和第二孔口，其中所述第一腿部延伸穿过所述第一孔口，并且其中所述第二腿部延伸穿过所述第二孔口。
实施例111：根据实施例107、108、109或110所述的钉仓组件，其中所述顺应性辅助件包括腔体以及定位在所述腔体中的至少一种药物。
实施例112：根据实施例107、108、109、110或111所述的钉仓组件，其中所述顺应性辅助件包括可压缩封装件。
实施例113：一种钉仓组件，所述钉仓组件包括：钉仓体，所述钉仓体包括甲板以及限定于所述甲板中的钉腔；以及能够移除地储存在所述钉腔中的钉，其中每个钉包括冠部、从所述冠部延伸的第一腿部和第二腿部、从所述冠部侧向地延伸的平台以及与所述冠部相邻定位的顺应性辅助件。
实施例114：根据实施例113所述的钉仓组件，其中所述顺应性辅助件在所述第一腿部与所述第二腿部之间延伸。
实施例115：根据实施例113或114所述的钉仓组件，其中所述顺应性辅助件附接到所述第一腿部和所述第二腿部。
实施例116：根据实施例113、114或115所述的钉仓组件，其中所述顺应性辅助件包括第一孔口和第二孔口，其中所述第一腿部延伸穿过所述第一孔口，并且其中所述第二腿部延伸穿过所述第二孔口。
实施例117：根据实施例113、114、115或116所述的钉仓组件，其中所述顺应性辅助件包括腔体以及定位在所述腔体中的至少一种药物。
实施例118：根据实施例113、114、115、116或117所述的钉仓组件，其中所述顺应性辅助件包括可压缩封装件。
实施例119：一种钉仓组件，所述钉仓组件包括：仓体，所述仓体包括甲板以及限定于所述甲板中的多个钉腔；以及储存在所述钉腔中的多个钉，其中每个钉包括由包含锌和镁的合金构成的第一部分以及由可吸收聚合物构成的第二部分，其中所述第二部分设置在所述第一部分上，并且其中所述第二部分覆盖少于全部所述第一部分。
实施例120：根据实施例119所述的钉仓组件，其中所述第一部分包括基部以及从所述基部延伸的钉腿，并且其中所述第二部分以螺旋图案围绕所述钉腿延伸。
实施例121：根据实施例119或120所述的钉仓组件，其中将所述第二部分以点阵图案涂布在所述第一部分上。
实施例122：根据实施例119、120或121所述的钉仓组件，其中所述第一部分包括基部以及从所述基部延伸的钉腿，其中在所述基部与所述钉腿之间限定拐角，并且其中所述第二部分覆盖所述拐角。
实施例123：根据实施例119、120、121或122所述的钉仓组件，其中所述可吸收聚合物包括非交联聚合物。
实施例124：根据实施例119、120、121、122或123所述的钉仓组件，其中将所述第二部分以网眼图案涂布在所述第一部分上。
实施例125：根据实施例119、120、121、122、123或124所述的钉仓组件，其中所述第一部分包括基部以及从所述基部延伸的钉腿，其中所述钉腿包括组织穿透尖端，并且其中所述钉还包括设置在所述尖端上的氮化镁。
实施例126：根据实施例119、120、121、122、123、124或125所述的钉仓组件，其中所述钉还包括在所述第一部分的至少未被所述第二部分涂布的部分上的电离银的涂层。
实施例127：根据实施例119、120、121、122、123、124、125或126 所述的钉仓组件，还包括在所述第一部分中的至少一个孔口。
实施例128：一种钉仓组件，所述钉仓组件包括：仓体，所述仓体包括甲板以及限定于所述甲板中的多个钉腔；以及储存在所述钉腔中的多个钉，其中每个钉包括由镁合金构成的金属框架以及涂布在所述金属框架上的可吸收聚合物，其中所述可吸收聚合物不覆盖所述金属框架的每一部分。
实施例129：一种钉仓组件，所述钉仓组件包括：仓体，所述仓体包括甲板以及限定于所述甲板中的多个钉腔；以及储存在所述钉腔中的多个钉，其中每个钉包括由镁合金构成的金属框架，其中所述金属框架包括基部以及从所述基部延伸的腿部，并且其中所述腿部包括组织穿透尖端以及在所述尖端上的氮化镁涂层。
实施例130：根据实施例129所述的钉仓组件，其中每个钉还包括涂布在所述金属框架上的可吸收聚合物，并且其中所述可吸收聚合物不覆盖所述金属框架的每一部分。
实施例131：根据实施例129或130所述的钉仓组件，其中每个钉还包括在所述金属框架的至少一部分上的包含银的涂层。
实施例132：一种钉仓组件，所述钉仓组件包括：仓体，所述仓体包括甲板以及限定于所述甲板中的多个钉腔；以及储存在所述钉腔中的多个钉，其中每个钉包括由镁合金构成的金属框架以及在所述金属框架的至少一部分上的包含银的涂层，其中所述金属框架包括基部以及从所述基部延伸的腿部，并且其中所述腿部包括组织穿透尖端。
实施例133：根据实施例132所述的钉仓组件，其中每个钉还包括涂布在所述金属框架上的可吸收聚合物，并且其中所述可吸收聚合物不覆盖所述金属框架的每一部分。
实施例134：根据实施例132或133所述的钉仓组件，还包括在所述尖端上的氮化镁涂层。
实施例135：一种钉仓组件，所述钉仓组件包括：仓体，所述仓体包括甲板以及限定于所述甲板中的多个钉腔；以及储存在所述钉腔中的多个钉，其中每个钉包括由镁合金构成的金属框架以及限定于所述金属框架中的孔口，其中所述金属框架包括基部以及从所述基部延伸的腿部，并且其中所述腿部包括组织穿透尖端。
实施例136：根据实施例135所述的钉仓组件，其中每个钉还包括涂布在所述金属框架上的可吸收聚合物，并且其中所述可吸收聚合物不覆盖所述金属框架的每一部分。
实施例137：根据实施例135所述的钉仓组件，其中每个钉还包括涂布在所述金属框架上的可吸收聚合物，并且其中所述可吸收聚合物不定位在所述孔口中。
实施例138：根据实施例135所述的钉仓组件，其中每个钉还包括涂布在所述金属框架上的可吸收聚合物，并且其中所述可吸收聚合物定位在所述孔口中。
实施例139：根据实施例135所述的钉仓组件，其中每个钉还包括涂布在所述金属框架上的可吸收聚合物，并且其中所述孔口填充有所述可吸收聚合物。
实施例140：一种用于缝合组织的钉仓组件，所述钉仓组件包括：仓体，所述仓体包括近侧端部、远侧端部和多个钉腔；定位在所述钉腔中的多个钉，其中每个钉包括基部、从所述基部延伸的腿部以及从所述基部延伸的脚部，其中所述腿部包括被构造成能够穿透所述组织的尖端；以及被构造成能够将所述钉从所述钉腔射出的击发构件，其中所述击发构件被构造成能够在将任一其钉腔内错误取向的钉从其钉腔射出之前接触所述错误取向的钉的所述脚部。
实施例141：根据实施例140所述的钉仓组件，其中所述击发构件包括击发滑道和对准滑道，所述击发滑道被构造成能够接触所述钉的所述基部以将所述钉驱动出所述钉腔，并且所述对准滑道被构造成能够在所述钉错误取向的情况下接触所述钉的所述脚部。
实施例142：根据实施例140或141所述的钉仓组件，其中所述击发构件还包括与所述击发滑道对准的击发通道，其中所述击发通道被构造成能够接收所述钉的所述基部；以及与所述对准滑道对准的对准通道，其中所述对准通道被构造成能够一旦所述钉正确取向就接收所述钉的所述脚部。
实施例143：根据实施例141或142所述的钉仓组件，其中所述对准滑道相对于所述击发滑道朝远侧延伸，使得在所述击发滑道接触所述钉的所述基部之前所述对准滑道能够接触所述钉的所述脚部。
实施例144：根据实施例140、141、142或143所述的钉仓组件，其中所述钉的所述脚部相对于所述钉的所述基部朝近侧定位。
实施例145：根据实施例140、141、142、143或144所述的钉仓组件，其中所述击发构件未被构造成能够在所述钉在所述钉腔内正确取向的情况下接触所述钉的所述脚部。
实施例146：一种用于缝合组织的钉仓组件，所述钉仓组件包括：仓体，所述仓体包括近侧端部和远侧端部；以及多个钉腔，其中每个钉腔包括顶部开口、近侧壁和远侧壁。所述钉仓组件还包括击发构件以及定位在所述钉腔中的多个钉，其中每个钉包括基部、从所述基部延伸的近侧腿部、从所述基部延伸的远侧腿部以及限定于所述基部中的质心，其中所述远侧壁在所述质心上方向所述钉提供远侧反作用力，并且所述近侧壁在所述质心下方向所述钉提供近侧反作用力，其中所述钉由所述击发构件朝所述顶部开口提升。所述钉仓组件还包括被构造成能够将所述钉从所述钉腔射出的击发构件，其中所述击发构件被构造成能够在将任一其钉腔内错误取向的钉从其钉腔射出之前接触所述错误取向的钉的所述脚部。
实施例147：根据实施例146所述的钉仓组件，其中所述基部限定驱动平面，并且其中所述近侧腿部和所述远侧腿部不在所述驱动平面中。
实施例148：根据实施例146或147所述的钉仓组件，其中所述近侧腿部和所述远侧腿部从所述钉的所述质心侧向地偏移。
实施例149：根据实施例146、147或148所述的钉仓组件，其中所述远侧壁向所述远侧腿部施加所述远侧反作用力，并且所述近侧壁向所述近侧腿部施加所述近侧反作用力。
实施例150：根据实施例147所述的钉仓组件，其中所述近侧腿部延伸到所述驱动平面的第一侧，并且所述远侧腿部延伸到所述驱动平面的第二侧。
实施例151：根据实施例146、147、148、149或150所述的钉仓组件，其中所述基部包括限定于其中的凹口，所述凹口被构造成能够将所述钉的所述质心朝所述钉腔的一侧转移。
实施例152：一种用于缝合组织的钉仓组件，所述钉仓组件包括仓体，所述仓体包括近侧端部、远侧端部和多个钉腔。所述钉仓组件还包括定位在所述钉腔中的多个钉，其中每个钉包括限定驱动平面的基部以及从所述基部延伸的腿部，其中所述腿部延伸到所述驱动平面的一侧；被构造成能够将所述钉从所述钉腔射出的击发构件；以及用于在所述击发构件将所述钉驱动出所述钉腔时减少所述钉在所述钉腔内的旋转的装置。
实施例153：一种与外科缝合器械一起使用的外科钉仓，所述外科钉仓包括仓体、多个钉腔以及能够移除地储存在所述钉腔中的多个钉，其中每个钉包括限定第一平面的钉基部分、位于所述钉基部分内的质心、从所述钉基部分延伸的第一钉腿以及从所述钉基部分延伸的第二钉腿，其中所述第一钉腿和所述第二钉腿限定第二平面，所述第二平面与所述第一平面偏移且至少基本上平行。
实施例154：根据实施例153所述的外科钉仓，其中所述第一钉腿和所述第二钉腿被构造成能够朝所述钉基部分成形。
实施例155：根据实施例153或154所述的外科钉仓，其中所述钉基部分包括压缩表面，所述压缩表面包括被构造成能够限制组织压缩的轮廓。
实施例156：根据实施例153、154或155所述的外科钉仓，其中所述钉基部分包括底部表面，并且其中所述第一钉腿还包括升高到所述底部表面上方的接合脚部。
实施例157：根据实施例153、154、155或156所述的外科钉仓，其中所述钉基部分包括内壁和顶部表面，其中所述内壁和所述顶部表面包括切口，所述切口被构造成能够使所述钉基部分偏向所述钉腿。
实施例158：根据实施例153、154、155、156或157所述的外科钉仓，其中所述第一钉腿延伸高于所述第二钉腿。
实施例159：根据实施例153、154、155、156、157或158所述的外科钉仓，其中所述钉基部分具有矩形横截面外形。
实施例160：根据实施例153、154、155、156、157、158或159所述的外科钉仓，其中所述第一钉腿和所述第二钉腿具有基本上圆形的横截面外形。
实施例161：根据实施例153、154、155、156、157、158、159或160 所述的外科钉仓，其中所述第一钉腿和所述第二钉腿包括精压拐角。
实施例162：根据实施例153、154、155、156、157、158、159、160 或161所述的外科钉仓，其中所述第一钉腿在所述第二钉腿近侧，其中所述钉基部分包括远侧壁，并且其中所述远侧壁在所述第二钉腿近侧。
实施例163：根据实施例153、154、155、156、157、158、159、160、 161或162所述的外科钉仓，其中所述第一钉腿具有第一高度，并且所述第二钉腿具有与所述第一高度不同的第二高度。
实施例164：根据实施例153、154、155、156、157、158、159、160、 161、162或163所述的外科钉仓，其中所述第一钉腿和所述第二钉腿各自包括被构造成能够抵靠在砧座的对应成形凹坑上成形的钉尖端，其中所述对应成形凹坑包括谷和成形表面，并且其中所述谷被构造成能够使所述钉尖端朝所述成形表面汇集。
实施例165：根据实施例153、154、155、156、157、158、159、160、 161、162、163或164所述的外科钉仓，其中所述第一钉腿和所述第二钉腿被构造成能够抵靠在对应成形凹坑上成形，其中所述对应成形凹坑被构造成能够使所述第一钉腿在第一方向上成形并且使所述第二钉腿在第二方向上成形，并且其中所述第一方向与所述第二方向相反且至少基本上平行。
实施例166：根据实施例165所述的外科钉仓，其中所述第一方向背向所述钉基部分，并且其中所述第二方向指向所述钉基部分。
实施例167：根据实施例153、154、155、156、157、158、159、160、 161、162、163、164、165或166所述的外科钉仓，其中所述第一钉腿和所述第二钉腿被构造成能够抵靠在对应成形凹坑上成形，其中所述对应成形凹坑被构造成能够使所述第一钉腿在第一弯曲方向上成形并且使所述第二钉腿在第二弯曲方向上成形。
实施例168：一种外科钉，所述外科钉包括限定第一平面的钉基部分、从所述钉基部分至少基本上垂直地延伸的第一钉腿以及从所述钉基部分至少基本上垂直地延伸的第二钉腿，其中所述第一钉腿和所述第二钉腿限定第二平面，其中所述第一平面和所述第二平面相交。
实施例169：一种外科钉仓，所述外科钉仓包括根据实施例152、153、 154、155、156、157、158、159、160、161、162、163、164、165、166、 167或168所述的多个外科钉，其中所述外科钉被布置成多个织造排。
实施例170：根据实施例168或169所述的外科钉，其中所述钉被构造成能够成形为S形构型。
实施例171：一种外科钉，所述外科钉包括具有限定底部平面的底部表面的钉基部分、位于所述钉基部分内的质心以及从所述钉基部分延伸且限定钉腿平面的第一钉腿和第二钉腿，所述钉腿平面与所述钉基部分偏移且至少基本上平行，其中所述第一钉腿包括升高到所述底部平面上方的接合脚部。
实施例172：根据实施例171所述的外科钉，其中所述接合脚部相对于所述钉基部分侧向地偏移。
实施例173：一种与包括砧座的外科缝合器一起使用以缝合组织的外科钉仓，其中所述砧座包括多个成形凹坑，所述外科钉仓包括仓体、多个钉腔以及能够移除地储存在所述钉腔内的多个钉，其中每个钉包括基部以及从所述基部延伸的钉腿，其中所述钉腿包括具有穿刺部分的钉尖端，其中所述穿刺部分被构造成能够穿刺组织并且抵靠在所述砧座的所述成形凹坑上变形，并且其中所述穿刺部分被构造成能够变形为嵌套构型，使得所述穿刺尖端与所述组织隔离。
实施例174：根据实施例173所述的外科钉仓，其中所述嵌套构型包括钩构型，所述钩构型被构造成能够防止所述外科钉拉动穿过所述组织。
实施例175：根据实施例173或174所述的外科钉仓，其中所述钉尖端还包括切口部分，所述切口部分被构造成能够在所述穿刺部分变形时接收所述穿刺部分。
实施例176：根据实施例175所述的外科钉仓，其中所述切口部分为凹形的。
实施例177：根据实施例175或176所述的外科钉仓，其中每个钉包括从所述基部延伸的另一个钉腿，其中所述另一个钉腿包括具有另一个切口部分的另一个钉尖端，并且其中所述切口部分和所述另一个切口部分彼此面对。
实施例178：根据实施例173、174、175、176或177所述的外科钉仓，其中所述钉尖端还包括卷曲表面，所述卷曲表面被构造成能够骑靠在所述砧座的对应成形凹坑上。
实施例179：根据实施例173、174、175、176、177或178所述的外科钉仓，其中每个钉包括另一个钉腿，其中所述钉腿和所述另一个钉腿限定第一平面，其中所述钉基限定第二平面，并且其中所述第一平面和所述第二平面彼此侧向地偏移。
实施例180：一种与包括砧座的外科缝合器一起使用的外科钉，其中所述砧座包括成形凹坑，所述外科钉包括钉基部分以及从所述钉基部分延伸的钉腿，其中所述钉腿包括钉尖端，并且其中所述钉尖端包括被构造成能够接触所述成形凹坑以使所述钉腿变形的穿刺尖端以及切口部分，其中所述穿刺尖端被构造成能够在与所述成形凹坑接触时朝所述切口部分卷曲，使得所述钉尖端呈现非穿刺构型。
实施例181：根据实施例180所述的外科钉，其中所述非穿刺构型包括钩构型，所述钩构型被构造成能够防止所述外科钉拉动穿过所述组织。
实施例182：根据实施例180或181所述的外科钉，其中所述切口部分被构造成能够在所述钉尖端变形时接收所述穿刺尖端。
实施例183：根据实施例180、181或182所述的外科钉，其中所述切口部分为凹形的。
实施例184：根据实施例180、181、182或183所述的外科钉，其中所述钉尖端还包括可变形表面，所述可变形表面被构造成能够抵靠在所述砧座的所述成形凹坑上成形。
实施例185：一种与包括砧座的外科缝合器一起使用的外科钉仓，所述外科钉仓包括仓体、多个钉腔以及能够移除地储存在所述钉腔内的多个平坦成形钉，其中每个钉包括钉基部分以及从所述基部部分延伸的钉腿，其中所述钉腿包括具有倒圆外形和穿刺部分的钉尖端。
实施例186：根据实施例185所述的外科钉仓，其中所述倒圆外形通过冷加工工艺实现。
实施例187：根据实施例185或186所述的外科钉仓，其中所述钉尖端包括精压部分。
实施例188：根据实施例185、186或187所述的外科钉仓，其中所述钉尖端还包括可变形表面，所述可变形表面被构造成能够抵靠在所述砧座的成形凹坑上成形。
实施例189：根据实施例185、186、187或188所述的外科钉仓，其中所述钉尖端具有第一硬度，并且其中所述钉腿具有与所述第一硬度不同的第二硬度。
实施例190：根据实施例189所述的外科钉仓，其中所述第一硬度大于所述第二硬度。
实施例191：一种与外科缝合器械一起使用的外科钉仓，所述外科钉仓包括仓体、多个钉腔以及能够移除地储存在所述钉腔内的多个钉，其中每个钉包括钉基以及从所述钉基延伸的一对钉腿，其中每个钉腿包括钉尖端，其中所述钉腿包括具有第一硬度的第一区，并且其中所述钉尖端包括具有第二硬度的第二区，所述第二硬度与所述第一硬度不同。
实施例192：根据实施例191所述的外科钉仓，其中所述第二硬度大于所述第一硬度。
实施例193：根据实施例191所述的外科钉仓，其中所述第二硬度小于所述第一硬度。
实施例194：根据实施例191、192或193所述的外科钉仓，其中所述钉基包括具有第三硬度的第三区，所述第三硬度与所述第一硬度和所述第二硬度不同。
实施例195：根据实施例191、192、193或194所述的外科钉仓，其中所述钉腿包括被精压为所述第一硬度的拐角部分。
实施例196：根据实施例195所述的外科钉仓，其中所述拐角部分提供优先弯曲平面。
实施例197：根据实施例191、192、193、194、195或196所述的外科钉仓，其中所述第一区具有第一延展性，并且其中所述第二区具有小于所述第一延展性的第二延展性。
实施例198：一种与外科缝合器械一起使用的外科钉仓，所述外科钉仓包括仓体、多个钉腔以及
能够移除地储存在所述钉腔内的多个钉，其中每个钉包括钉基、从所述钉基延伸的一对钉腿、具有第一硬度的第一区以及具有第二硬度的第二区，所述第二硬度与所述第一硬度不同。
实施例199：根据实施例198所述的外科钉仓，其中所述第一区使用第一方法硬化，并且所述第二区使用第二方法硬化，所述第二方法与所述第一方法不同。
实施例200：根据实施例198所述的外科钉仓，其中所述第一区和所述第二区中的仅一个通过硬化方法硬化。
实施例201：根据实施例198、199或200所述的外科钉仓，其中每个钉还包括位于所述钉腿和所述钉基的中间的弯曲部分，并且其中所述弯曲部分包括所述第一区，并且所述钉基包括所述第二区。
实施例202：根据实施例198、199、200或201所述的外科钉仓，其中所述钉基包括所述第一区，并且所述钉腿包括所述第二区。
实施例203：根据实施例198、199、200、201或202所述的外科钉仓，其中所述钉腿未被硬化并且所述钉基被硬化，使得促使所述钉腿呈现成形构型并且使得所述钉基被构造成能够避免塑性变形。
实施例204：根据实施例198、199、200、201、202或203所述的外科钉仓，其中每个钉腿包括从所述钉基延伸的过渡部分以及从所述过渡部分延伸的竖直腿部部分，并且其中所述钉基包括所述第一区，并且所述竖直腿部部分包括所述第二区。
实施例205：一种被构造成能够以未击发构型能够移除地储存在外科钉仓内的外科钉，所述外科钉具有非均匀硬度分布，其中所述钉包括具有第一硬度的第一区和具有第二硬度的第二区，其中当所述钉处于预加载构型时，所述第一区被硬化到所述第一硬度，并且其中当所述钉处于所述预加载构型时，所述第二区被硬化到所述第二硬度。
实施例206：一种与外科缝合器械一起使用的外科钉仓，所述外科钉仓包括仓体、多个钉腔以及能够移除地储存在所述钉腔内的多个钉，其中每个钉包括钉基，其中所述钉基限定具有第一硬度的第一区；从所述钉基延伸的多个弯曲部分，其中所述弯曲部分限定具有第二硬度的第二区；以及从所述弯曲部分延伸的钉腿，其中每个钉腿限定具有第三硬度的第三区，所述第三硬度与所述第一硬度不同。
实施例207：根据实施例206所述的外科钉仓，其中所述第一硬度大于所述第三硬度。
实施例208：根据实施例206所述的外科钉仓，其中所述第一硬度大于所述第二硬度和所述第三硬度。
实施例209：根据实施例206、207或208所述的外科钉仓，其中每个钉腿包括钉尖端，所述钉尖端限定具有第四硬度的第四区，所述第四硬度小于所述第三硬度。
实施例210：一种与外科缝合器械一起使用的外科钉仓，所述外科钉仓包括滑动件、仓体、多个钉腔以及能够移除地储存在所述钉腔内的钉条，其中所述钉条包括多个钉、条以及将所述钉连结到所述条的多个连接器部分，其中所述连接器部分被构造成能够将所述钉从所述条释放。
实施例211：根据实施例210所述的外科钉仓，其中每个连接器部分包括不连续部，所述不连续部被构造成能够促使所述钉与所述条分离。
实施例212：根据实施例210所述的外科钉仓，其中每个连接器部分包括不连续部，所述不连续部被构造成能够在所述钉条加载到所述仓体中时促使所述钉与所述条分离。
实施例213：根据实施例210或211所述的外科钉仓，其中所述滑动件被构造成能够在所述滑动件平移经过所述钉仓时通过破坏所述连接器部分来使所述多个钉与所述条分离。
实施例214：根据实施例210、211、212或213所述的外科钉仓，其中每个钉包括一对向外偏压的钉腿，所述一对向外偏压的钉腿被构造成能够接合所述仓体并且将所述钉条保持在所述外科钉仓中。
实施例215：根据实施例210、211、212、213或214所述的外科钉仓，其中所述仓体包括底部，并且其中所述钉条被构造成能够加载到所述仓体的所述底部中。
实施例216：根据实施例210、211、212、213、214或215所述的外科钉仓，其中所述多个钉被布置成第一排和第二排，并且其中所述条连结到所述第一排和所述第二排中的所述钉。
实施例217：根据实施例210、211、212、213、214、215或216所述的外科钉仓，其中所述多个钉包括具有第一构型的第一组钉以及具有第二构型的第二组钉，所述第二构型与所述第一构型不同。
实施例218：根据实施例210、211、212、213、214、215、216或217 所述的外科钉仓，其中所述连接器部分包括喷丸处理的部分。
实施例219：根据实施例210、211、212、213、214、215、216、217 或218所述的外科钉仓，其中所述滑动件包括击打部分，所述击打部分被构造成能够破坏所述连接器部分。
实施例220：根据实施例210、211、212、213、214、215、216、217、 218或219所述的外科钉仓，其中所述钉包括倒角表面，所述倒角表面被构造成能够在所述滑动件平移经过所述仓体时接合所述滑动件。
实施例221：根据实施例210、211、212、213、214、215、216、217、 218、219或220所述的外科钉仓，其中所述条包括对准特征结构，所述对准特征结构被构造成能够接合所述仓体上的对应对准特征结构。
实施例222：一种与外科缝合器械一起使用的外科钉仓，所述外科钉仓包括仓体、多个钉腔以及能够移除地储存在所述仓体内的钉条，所述钉条包括多个钉、条以及将所述钉连结到所述条的多个连接器部分，其中所述连接器部分是能够接合的以将所述钉从所述条释放，并且其中所述钉、所述条和所述连接器部分是金属。
实施例223：根据实施例222所述的外科钉仓，其中所述多个钉包括具有第一冠部宽度的多个第一钉以及具有第二冠部宽度的多个第二钉，所述第二冠部宽度与所述第一冠部宽度不同。
实施例224：根据实施例222或223所述的外科钉仓，其中所述多个钉包括具有限定第一高度的钉腿的第一组钉以及具有限定第二高度的钉腿的第二组钉，所述第二高度与所述第一高度不同。
实施例225：根据实施例222所述的外科钉仓，其中所述钉条包含均匀构成。
实施例226：根据实施例222、223、224或225所述的外科钉仓，其中所述条包括对准特征结构，所述对准特征结构被构造成能够接合所述仓体上的对应对准特征结构。
实施例227：实施例222、223、224、225或226所述的外科钉仓，还包括第二钉条，所述第二钉条包括多个第二钉、第二条以及将所述第二钉连结到所述第二条的多个第二连接器部分，其中所述多个钉被布置成限定第一排间距的多个排，其中所述多个第二钉被布置成限定第二排间距的多个第二排，并且其中所述第一排间距和所述第二排间距是不同的。
实施例228：一种被构造成能够与外科钉仓一起使用的金属外科钉，所述金属外科钉包括多个钉、带以及将所述钉连结到所述带的多个连接器部分。
实施例229：根据实施例228所述的金属外科钉，其中所述连接器部分包括不连续凹口。
实施例230：一种与圆形缝合器一起使用的外科钉仓，所述外科钉仓包括仓体、限定于所述仓体中的多个钉腔以及能够移除地储存在所述钉腔内的多个钉，所述多个钉包括具有一定数量的第一钉的内排钉，其中每个第一钉包括限定第一钉冠宽度的第一钉冠；相对于所述内排钉径向向外定位的中间排钉，其中所述中间排钉包括一定数量的第二钉，并且其中每个第二钉包括限定第二钉冠宽度的第二钉冠；以及相对于所述中间排钉径向向外定位的外排钉，其中所述外排钉包括一定数量的第三钉，其中每个第三钉包括限定第三钉冠宽度的第三钉冠，并且其中所述第一钉冠宽度、所述第二钉冠宽度和所述第三钉冠宽度中的一个不同于所述第一钉冠宽度、所述第二钉冠宽度和所述第三钉冠宽度中的另一个。
实施例231：根据实施例230所述的外科钉仓，其中所述内排钉限定所述第一钉之间的多个第一间隙，并且其中所述中间排钉的所述第二钉与所述第一间隙重叠。
实施例232：根据实施例231所述的外科钉仓，其中所述中间排钉限定所述第二钉之间的多个第二间隙，其中所述第二间隙大于所述第一间隙，并且其中所述外排钉的所述第三钉与所述第二间隙重叠。
实施例233：根据实施例231或232所述的外科钉仓，其中所述外排钉的所述第三钉也与所述第一间隙重叠。
实施例234：根据实施例230所述的外科钉仓，其中所述内排钉限定所述第一钉之间的多个第一间隙，其中所述中间排钉限定所述第二钉之间的多个第二间隙，其中所述第二钉与所述第一间隙重叠，并且其中所述第一间隙和所述第二间隙至少基本上相等。
实施例235：根据实施例230所述的外科钉仓，其中所述内排钉限定所述第一钉之间的多个第一间隙，其中所述中间排钉限定所述第二钉之间的多个第二间隙，其中每个第一间隙限定第一距离，并且其中每个第二间隙限定小于所述第一距离的第二距离。
实施例236：根据实施例230、231、232、233、234或235所述的外科钉仓，其中所述第一钉冠宽度小于所述第二钉冠宽度。
实施例237：根据实施例230、231、232、233、234或235所述的外科钉仓，其中所述第一钉冠宽度至少基本上等于所述第二钉冠宽度。
实施例238：根据实施例230、231、232、233、234、235、236或237 所述的外科钉仓，其中所述第三钉冠宽度大于所述第一钉冠宽度和所述第二钉冠宽度。
实施例239：一种与圆形缝合器一起使用的外科钉仓，所述外科钉仓包括仓体、限定于所述仓体中的多个钉腔以及能够移除地储存在所述钉腔内的多个钉，所述多个钉包括具有第一数量的第一钉的内排钉，其中每个第一钉包括限定第一钉冠宽度的第一钉冠；相对于所述内排钉径向向外定位的中间排钉，其中所述中间排钉包括第二数量的第二钉，并且其中每个第二钉包括限定第二钉冠宽度的第二钉冠；以及相对于所述中间排钉径向向外定位的外排钉，其中所述外排钉包括第三数量的第三钉，其中每个第三钉包括限定第三钉冠宽度的第三钉冠，其中所述第一钉冠宽度、所述第二钉冠宽度和所述第三钉冠宽度中的一个不同于所述第一钉冠宽度、所述第二钉冠宽度和所述第三钉冠宽度中的另一个，并且其中所述第一数量、所述第二数量和所述第三数量中的一个不同于所述第一数量、所述第二数量和所述第三数量中的另一个。
实施例240：根据实施例239所述的外科钉仓，其中所述第二数量小于所述第一数量。
实施例241：根据实施例239或240所述的外科钉仓，其中所述第二数量小于所述第三数量。
实施例242：根据实施例239、240或241所述的外科钉仓，其中所述多个钉腔包括多个非均匀腔体延伸部。
实施例243：根据实施例239、240、241或242所述的外科钉仓，其中所述内排钉的每个第一钉包括从每个第一钉冠径向向外延伸的一对钉腿。
实施例244：根据实施例239、240、241、242或243所述的外科钉仓，其中所述中间排钉的每个第二钉包括从每个第二钉冠径向向内延伸的一对钉腿。
实施例245：根据实施例239、240、241、242、243或244所述的外科钉仓，其中所述外排钉的每个第三钉包括从每个第三钉冠径向向内延伸的一对钉腿。
实施例246：一种与外科缝合器一起使用的外科钉仓，所述外科钉仓包括仓体、限定于所述仓体中的多个钉腔以及能够移除地储存在所述钉腔内的多个钉，所述多个钉包括具有第一数量的第一钉的内排钉，其中每个第一钉包括限定第一钉冠宽度的第一钉冠；相对于所述内排钉向外定位的中间排钉，其中所述中间排钉包括第二数量的第二钉，并且其中每个第二钉包括限定第二钉冠宽度的第二钉冠；以及相对于所述中间排钉向外定位的外排钉，其中所述外排钉包括第三数量的第三钉，其中每个第三钉包括限定第三钉冠宽度的第三钉冠，并且其中所述第一钉冠宽度、所述第二钉冠宽度和所述第三钉冠宽度中的一个不同于所述第一钉冠宽度、所述第二钉冠宽度和所述第三钉冠宽度中的另一个。
实施例247：根据实施例246所述的外科钉仓，其中所述第一数量、所述第二数量和所述第三数量中的一个不同于所述第一数量、所述第二数量和所述第三数量中的另一个。
实施例248：根据实施例246所述的外科钉仓，其中所述第一数量和所述第二数量相等。
实施例249：根据实施例246、247或248所述的外科钉仓，其中所述内排钉限定所述第一钉之间的多个第一间隙，其中所述中间排钉限定所述第二钉之间的多个第二间隙，其中每个第一间隙限定第一距离，并且其中每个第二间隙限定小于所述第一距离的第二距离。
以下专利的全部公开内容据此以引用方式并入本文：
公布于1995年4月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312；
公布于2006年2月21日的名称为“SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利7,000,818；
公布于2008年9月9日的名称为“MOTOR-DRIVEN SURGICAL CUTTING ANDFASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK”的美国专利7,422,139；
公布于2008年12月16日的名称为“ELECTRO-MECHANICAL SURGICAL INSTRUMENTWITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”的美国专利7,464,849；
公布于2010年3月2日的名称为“SURGICAL INSTRUMENT HAVING AN ARTICULATINGEND EFFECTOR”的美国专利7,670,334；
公布于2010年7月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245；
公布于2013年3月12日的名称为“SELECTIVELY ORIENTABLE IMPLANTABLEFASTENER CARTRIDGE”的美国专利8,393,514；
名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利申请序列号11/343,803；现为美国专利 7,845,537；
提交于2008年2月14日的名称为“SURGICAL CUTTING AND FASTENING INSTRUMENTHAVING RF ELECTRODES”的美国专利申请序列号12/031,573；
提交于2008年2月15日的名称为“END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT”的美国专利申请序列号12/031,873，现为美国专利7,980,443；
名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”的美国专利申请序列号12/235,782，现为美国专利8,210,411；
名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117，现为美国专利8,608,045；
提交于2009年12月24日的名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENTWITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY”的美国专利申请序列号12/647,100；现为美国专利 8,220,688；
提交于2012年9月29日的名称为“STAPLE CARTRIDGE”的美国专利申请序列号12/893,461，现为美国专利8,733,613；
提交于2011年2月28日的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号13/036,647，现为美国专利 8,561,870；
名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利申请序列号 13/118,241，现为美国专利9,072,535；
提交于2012年6月15日的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING A FIRING DRIVE”的美国专利申请序列号 13/524,049；现为美国专利9,101,358；
提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,025，现为美国专利申请公布2014/0263551；
提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,067，现为美国专利申请公布2014/0263552；
提交于2006年1月31日的名称为“SURGICAL CUTTING AND FASTENING INSTRUMENTWITH CLOSURE TRIGGER LOCKING MECHANISM”的美国专利申请公布2007/0175955；以及
提交于2010年4月22日的名称为“SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”的美国专利申请公布2010/0264194，现为美国专利8,308,040。
虽然本文已结合某些公开的实施方案描述了装置的各种实施方案，但也可实施对这些实施方案的许多修改和变型。另外，在公开了用于某些部件的材料的情况下，也可使用其它材料。此外，根据各种实施方案，单个部件可被替换为多个部件，并且多个部件也可被替换为单个部件，以执行给定的一种或多种功能。上述说明和下述权利要求书旨在涵盖所有此类修改和变型。
本文所公开的装置可被设计成在单次使用后废弃，或者其可被设计成能够使用多次。然而无论是哪种情况，该装置都可在至少一次使用后经过修整再行使用。修整可包括拆卸装置、之后清洁或替换特定零件以及后续重新组装步骤的任意组合。具体地，所述装置可拆卸，并且可以任意组合选择性地替换或移除所述装置的任意数目的特定零件或部件。在清洁和/或替换特定部件后，可对所述装置进行重新组装，以便随后在修整设施处使用或者在外科手术之前由手术团队使用。本领域的技术人员将会理解，修整装置可利用各种技术来进行拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修整装置均在本申请的范围内。
仅以举例的方式，可在外科手术之前对本文所述的方面进行处理。首先，可以获得新的或使用过的器械，并且根据需要进行清洁。然后，可对器械进行灭菌。在一种灭菌技术中，将该器械置于闭合且密封的容器(诸如，塑料或TYVEK袋)中。然后可将容器和器械置于可穿透该容器的辐射场，例如γ辐射、X射线或高能电子。辐射可以杀死器械上和容器中的细菌。灭菌后的器械随后可被存放在无菌容器中。密封容器可保持器械无菌，直至在医疗设施中打开该容器。还可使用本领域已知的任何其它技术对装置进行灭菌，包括但不限于β或γ辐射、环氧乙烷、等离子体过氧化物或蒸汽。
尽管本发明已被描述为具有示例性设计，但可在本公开的实质和范围内进一步修改本发明。因此，本申请旨在涵盖使用本发明一般原理的本发明的任何变型、用途或改型。
以引用方式全文或部分地并入本文的任何专利、公布或其它公开材料均仅在所并入的材料不与本公开列出的现有定义、陈述或其它公开材料相冲突的程度下并入本文。因此，并且在必要的程度下，本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其它公开材料相冲突的任何材料或其部分，将仅在所并入的材料与现有的公开材料之间不产生冲突的程度下并入。

Claims (17)

1.一种与外科缝合器械一起使用的外科钉仓，所述外科钉仓包括：
滑动件；
仓体；
多个钉腔；以及
能够移除地储存在所述钉腔内的钉条，其中所述钉条包括：
多个钉；
条；以及
将所述钉连结到所述条的多个连接器部分，其中所述连接器部分被构造成能够将所述钉从所述条释放，
其中每个所述钉包括一对向外偏压的钉腿，所述一对向外偏压的钉腿被构造成能够接合所述仓体并且将所述钉条保持在所述外科钉仓中。
2.根据权利要求1所述的外科钉仓，其中每个所述连接器部分包括不连续部，所述不连续部被构造成能够促使所述钉与所述条分离。
3.根据权利要求1所述的外科钉仓，其中每个所述连接器部分包括不连续部，所述不连续部被构造成能够在所述钉条加载到所述仓体中时促使所述钉与所述条分离。
4.根据权利要求1所述的外科钉仓，其中所述滑动件被构造成能够在所述滑动件平移经过所述钉仓时通过破坏所述连接器部分来使所述多个钉与所述条分离。
5.根据权利要求1所述的外科钉仓，其中所述仓体包括底部，并且其中所述钉条被构造成能够加载到所述仓体的所述底部中。
6.根据权利要求1所述的外科钉仓，其中所述多个钉被布置成第一排和第二排，并且其中所述条连结到所述第一排和所述第二排中的所述钉。
7.根据权利要求1所述的外科钉仓，其中所述多个钉包括具有第一构型的第一组钉以及具有第二构型的第二组钉，所述第二构型与所述第一构型不同。
8.根据权利要求1所述的外科钉仓，其中所述连接器部分包括喷丸处理的部分。
9.根据权利要求1所述的外科钉仓，其中所述滑动件包括击打部分，所述击打部分被构造成能够破坏所述连接器部分。
10.根据权利要求1所述的外科钉仓，其中所述钉包括倒角表面，所述倒角表面被构造成能够在所述滑动件平移经过所述仓体时接合所述滑动件。
11.根据权利要求1所述的外科钉仓，其中所述钉、所述条和所述连接器部分是金属。
12.根据权利要求11所述的外科钉仓，其中所述多个钉包括具有第一冠部宽度的多个第一钉以及具有第二冠部宽度的多个第二钉，所述第二冠部宽度与所述第一冠部宽度不同。
13.根据权利要求11所述的外科钉仓，其中所述多个钉包括具有限定第一高度的钉腿的第一组钉以及具有限定第二高度的钉腿的第二组钉，所述第二高度与所述第一高度不同。
14.根据权利要求11所述的外科钉仓，其中所述钉条包含均匀构成。
15.根据权利要求11所述的外科钉仓，其中所述条包括对准特征结构，所述对准特征结构被构造成能够接合所述仓体上的对应对准特征结构。
16.根据权利要求11所述的外科钉仓，还包括第二钉条，所述第二钉条包括：
多个第二钉；
第二条；以及
将所述第二钉连结到所述第二条的多个第二连接器部分，其中所述多个钉被布置成限定第一排间距的多个排，其中所述多个第二钉被布置成限定第二排间距的多个第二排，并且其中所述第一排间距和所述第二排间距是不同的。
17.根据权利要求1所述的外科钉仓，其中所述连接器部分包括不连续凹口。
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US20200046356A1 (en) 2020-02-13
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