CN108472041A

CN108472041A - Round fastener cartridge for applying radially distensible fastener row

Info

Publication number: CN108472041A
Application number: CN201580064728.3A
Authority: CN
Inventors: J·L·哈里斯; J·R·摩根; M·S·齐纳; F·E·谢尔顿四世
Original assignee: Angiotech Pharmaceuticals Inc
Current assignee: Angiotech Pharmaceuticals Inc
Priority date: 2014-09-26
Filing date: 2015-09-08
Publication date: 2018-08-31
Also published as: MX2022006181A; MX2022006186A; RU2017114344A3; RU2705907C2; JP2017529184A; MX2017003962A; BR112017005979B1; BR112017006013A2; JP6657198B2; MX2017003957A; MX2022006187A; CN108472035A; RU2017114344A; JP2017528277A; MX2022006183A; BR112017005979A2; JP6657197B2; RU2703506C2; MX2022006184A; CN108472035B

Abstract

The invention discloses a kind of fastener cartridge assemblies for being used together with circular surgical clamp device.The fastener cartridge assembly includes the warehouse for having circular platform.Multiple securing member chambers are arranged in the circular platform.Each securing member chamber includes two chamber ends, one chamber end of each securing member chamber in the wherein described securing member chamber is located in the first circular axis with the first radius, and another chamber end of wherein each securing member chamber is located in the second circular axis with the second radius different from first radius.

Description

Round fastener cartridge for applying radially distensible fastener row

Technical background

The present invention relates to suture instruments, and in various embodiments, are related to one kind and being used to prepare one or more nails The surgery suturing appliance of row.

Suture instruments may include the elongated nip component of a pair of of collaborative work, suffer from wherein each jaw member may be adapted to be inserted into In person's body and relative to be stapled and/or incision tissue positioning.In various embodiments, one of jaw member can prop up Support wherein accommodates the nail bin of the staple that at least two are laterally spaced apart, and another jaw member is sustainable has 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 Blade can be slided relative to jaw member with by the cam face on push rod and/or the wedge-shaped slides by push rod pushing Cam face will be followed closely and be projected successively from nail bin.In at least one embodiment, cam face is configured to start By storehouse carrying and multiple staple drivers associated with nail, leaned against on anvil block and between being held on jaw member with pushing nail Tissue in formed lateral spacing deformation staple.In at least one embodiment, blade can follow cam face and along Route between staple cuts tissue.The example of such suture instruments is in entitled " SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING There is disclosed, the whole of the patent in the United States Patent (USP) 7,794,475 of INSTRUMENTS FOR DEPLOYING THE SAME " Disclosure is herein incorporated by reference.

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

Description of the drawings

The various features of the embodiment described herein are described in detail in the dependent claims.However, closing In the tissue of operation and the various embodiments of the various embodiments of method and its advantage in combination with following attached drawing according to following Illustrate to understand：

Fig. 1 is the perspective view according to the reuse surgical fasteners tool of at least one embodiment；

Fig. 2 is the exploded view of the end effector of the reuse surgical fasteners tool of Fig. 1；

Fig. 3 is the top plan view of the fastener cartridge of the end effector of Fig. 2；

Fig. 4 is the bottom plan view of the anvil block of the end effector of Fig. 2；

Fig. 5 is the fragmentary bottom plan view according to the anvil block of at least one embodiment；

Fig. 6 is the fragmentary bottom plan view according to the anvil block of at least one embodiment；

Fig. 7 is according to the decomposition perspective view of the end effector including nail bin of the various embodiments of the disclosure, the nail Storehouse includes the nail being angularly orientated, one group of staple drivers more than first and one group of staple drivers more than second；

Fig. 8 be Fig. 7 one more than first in staple drivers more than staple drivers perspective view；

Fig. 8 A are the plan views of the staple drivers more than first of Fig. 8；

Fig. 8 B are the perspective view of the staple drivers more than first of Fig. 8, and further show the Fig. 7 supported by more staple drivers Nail；

Fig. 8 C be Fig. 7 one more than second in staple drivers more than staple drivers perspective view；

Fig. 8 D are the plan views of the staple drivers more than second of Fig. 8 C；

Fig. 9 is the perspective view of the staple drivers more than second of Fig. 8 C, and further shows the Fig. 7 supported by more staple drivers Nail；

Figure 10 is the plan view according to the nail bin of the various embodiments of the disclosure；

Figure 11 is the plan view according to the arrangement of more staple drivers and driving wedge piece of the various embodiments of the disclosure；

Figure 12 is the plan view according to the arrangement of more staple drivers and driving wedge piece of the various embodiments of the disclosure；

Figure 13 is the plan view according to the arrangement of more staple drivers and driving wedge piece of the various embodiments of the disclosure；

Figure 14 is the plan view according to the arrangement of single staple drivers and driving wedge piece of the various embodiments of the disclosure；

Figure 15 is the front view of the driving wedge piece of Figure 14；

Figure 16 is the nail according to the various embodiments of the disclosure and drives the plan view of the arrangement of wedge piece；

Figure 17 is not formed or the perspective view of the nail of non-percussion configuration according to being shown at least one embodiment；

Figure 18 is the front view of the nail of Figure 17；

Figure 19 is the front view of the nail of Figure 17 in formation or percussion configuration；

Figure 20 is not formed or non-percussion configuration includes inflatable according to being shown at least one embodiment The front view of the nail of coating；

Figure 21 is the fragmentary bottom plan view of the nail for the Figure 20 being deployed in patient tissue；

Figure 22 is the fragmentary bottom plan view of the nail for the Figure 20 being deployed in patient tissue, shows the painting in swelling state Layer；

Figure 23 shows the tissue sutured by staple line according at least one embodiment；

Figure 24 shows the tissue sutured by staple line according at least one embodiment；

Figure 25 shows the tissue sutured by staple line according at least one embodiment；

Figure 26 is the front view according to the driving wedge piece and nail of the various embodiments of the disclosure；

Figure 27 is the perspective view of the driving wedge piece and nail of Figure 26；

Figure 28 is the plan view of the driving wedge piece and nail of Figure 26；

Figure 29 is the perspective view of circular stapling device；

Figure 29 A are a part for the sewing-end of circular stapling device and the perspective view of fastener cartridge assembly；

Figure 30 is the part of the sewing-end of circular stapling device and the perspective view of another fastener cartridge assembly；

Figure 31 is the part of the sewing-end of circular stapling device and the perspective view of another fastener cartridge assembly；

Figure 32 shows the tissue sutured by staple line according at least one embodiment, wherein in the nail in staple line at least Some nail overlappings；

Figure 33 is configured for capableing of the partial plan layout of the nail bin of the staple line of deployment diagram 32；

Figure 34 is configured for the partial plan layout of the anvil block for the nail deformation that can make to project from the nail bin of Figure 33；

Figure 35 is the partial plan layout according to the nail bin for being configured to deployment staple line of at least one embodiment；

Figure 36 is configured for the partial plan layout of the anvil block for the nail deformation that can make to project from the nail bin of Figure 35；

Figure 37 be according to the various embodiments of the disclosure include that there is the end without driver nail bin of sliding part to hold The decomposition perspective view of row device；

Figure 38 is the perspective view of the sliding part of Figure 37；

Figure 38 A are the sliding part of Figure 37 and the partial plan layout of nail, show the deployment process of nail；

Figure 38 B are the sliding part of Figure 37 and the front view of nail, show the deployment process of nail；

Figure 39 is according to the saturating of the sliding parts without driver nail bin being shown in Figure 37 of the various embodiments of the disclosure View；

Figure 39 A are to be at an angle of nail and the sliding part of Figure 39 without driver according to the having for various embodiments of the disclosure The partial plan layout of nail bin；

Figure 39 B are the local perspective views according to the nail of the sliding part and Figure 20 of Figure 39 of the various embodiments of the disclosure；

Figure 40 is the local perspective view according to the sliding part and nail of the various embodiments of the disclosure；

Figure 41 is the plan view according to the array of the nail of the various embodiments of the disclosure；

Figure 42 is the nail according to the various embodiments of the disclosure and drives the plan view of the array of wedge piece；

Figure 43 is the part according to the nail bin of the arrangement wherein with angled nail cavity of the various embodiments of the disclosure Perspective view；

Figure 44 is the partial plan layout of the nail bin of Figure 43；

Figure 45 is the perspective section partial view of the nail bin of Figure 43, shows the nail being located in nail bin and driver；

Figure 46 is the part according to the nail bin of the arrangement wherein with angled nail cavity of the various embodiments of the disclosure Perspective view；

Figure 47 is the partial plan layout of the nail bin of Figure 46；

Figure 48 is the partial perspective sectional view of the nail bin of Figure 46；

Figure 49 is the part according to the nail bin of the arrangement wherein with angled nail cavity of the various embodiments of the disclosure Perspective view；

Figure 50 is the partial plan layout of the nail bin of Figure 49；

Figure 51 is the partial perspective sectional view of the nail bin of Figure 49, shows the nail being located in nail bin and more staple drivers；

Figure 52 shows the previous nail pattern in implanting tissue；

Figure 52 A show the nail pattern by the cartridge deployment of Fig. 3；

Figure 52 B show the nail pattern of Figure 52 A in extended configuration；

Figure 53 is according to the partial plan layout of the nail bin of at least one embodiment, which includes warehouse and be located in storehouse Implantable auxiliary material on body；

Figure 54 is the partial plan layout according to the implantable auxiliary material of at least one embodiment；

Figure 55 is according to the partial plan layout of the nail bin of at least one embodiment, which includes warehouse and be located in storehouse Implantable auxiliary material on body；

Figure 56 is the partial plan layout according to the implantable auxiliary material of at least one embodiment；

Figure 57 is the partial plan layout according to the implantable auxiliary material of at least one embodiment；

Figure 58 is a part for surgery suturing appliance and the decomposition perspective view of end effector；

Figure 59 is the perspective view of the surgery nail bin with supporting member, and supporter can remove the supporting member from storehouse wherein Position in be supported on the platform of nail bin；

Figure 60 is the surgery nail bin of Figure 59 and the vertical view of supporting member；

Figure 61 is the perspective view of the surgery nail bin of Figure 59 and Figure 60 and a part for supporting member；

Figure 62 is the vertical view of the surgery nail bin of Figure 59-Figure 61 and another part of supporting member；

Figure 63 is the perspective view of the surgery nail bin of Figure 59-Figure 62 and the proximal end of supporting member；

Figure 64 is another perspective view of the surgery nail bin of Figure 59-Figure 63 and the proximal end of supporting member, wherein keeping convex Piece folds for insertion into the longitudinal slit in storehouse；

Figure 65 is another perspective view of the surgery nail bin of Figure 59-Figure 64 and the proximal end of supporting member, wherein keeping convex Piece is inserted into longitudinal slit and is remained at by nail sliding part；

Figure 66 is the decomposition assembled view of another surgery nail bin and another supporting member；

Figure 67 is the upward view of the supporting member of Figure 66；

Figure 68 is the enlarged view of a part for the supporting member of Figure 67, wherein below position of the nail cavity in nail bin with Dotted line is shown；

Figure 69 is the enlarged view of a part for another supporting member, wherein below position of the nail cavity in nail bin with Dotted line is shown；

Figure 70 is the vertical view of a part for another supporting member, wherein position of the following nail cavity in nail bin is with void Line is shown；

Figure 71 is the vertical view of a part for another supporting member；

Figure 72 is the sectional view along the supporting member of Figure 71 of the line 72-72 interceptions in Figure 71；

Figure 73 is the perspective view of another surgery nail bin；

Figure 74 is the vertical view of the surgery nail bin of Figure 73；

Figure 75 is the enlarged perspective of a part for the surgery nail bin of Figure 73 and Figure 74；

Figure 76 is the vertical view of another surgery nail bin；

Figure 77 is the side front view of a part for surgical stapling device, wherein tissue " T " is clamped in the surgery nail bin of Figure 76 Between the anvil block of device；

Figure 78 is the enlarged view of a part for the surgery nail bin of Figure 76 and Figure 77, and part of it is illustrated in cross-section；

Figure 79 is the part section front view of the nail bin and anvil block according to the various embodiments of the disclosure；And

Figure 80 is the part section front view of the nail bin and anvil block according to the various embodiments of the disclosure.

In all 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 such example is not necessarily to be construed as the model limiting the invention in any way It encloses.

Specific implementation mode

Present applicant possesses the following patent application submitted on the same day with the application, the respective full text of these patent applications It is herein incorporated by reference：

Entitled " SURGICAL STAPLE AND DRIVER ARRANGEMENTS FOR STAPLE CARTRIDGES " Attorney number be END7504USNP/140284 U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _；

Entitled " SURGICAL STAPLE AND DRIVER ARRANGEMENTS FOR STAPLE CARTRIDGES " Attorney number be END7505USNP/140285 U.S. Patent Application Serial Number _ _ _ _ _ _ _ _ _ _；

The attorney of entitled " SURGICAL STAPLING BUTTRESSES AND ADJUNCT MATERIALS " The U.S. Patent Application Serial Number that reel number is END7506USNP/140286 _ _ _ _ _ _ _ _ _ _；

The agency of entitled " FASTENER CARTRIDGE FOR CREATING A FLEXIBLE STAPLE LINE " The U.S. Patent Application Serial Number that people's file number is END7507USNP/140287 _ _ _ _ _ _ _ _ _ _；With

The attorney number of entitled " METHOD FOR CREATING A FLEXIBLE STAPLE LINE " is The U.S. Patent Application Serial Number of END7508USNP/140288 _ _ _ _ _ _ _ _ _ _.

Present applicant possesses the following patent application submitted on June 30th, 2014, these patent applications are respectively complete Text is herein incorporated by reference：

Entitled " FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENT The U.S. Patent Application Serial Number 14/318,996 of CONFIGURATIONS "；

Entitled " FASTENER CARTRIDGE COMPRISING FASTENER CAVITIES INCLUDING The U.S. Patent Application Serial Number 14/319,006 of FASTENER CONTROL FEATURES "；

Entitled " END EFFECTOR COMPRISING AN ANVIL INCLUDING PROJECTIONS The U.S. Patent Application Serial Number 14/319,014 of EXTENDING THEREFROM "；

Entitled " SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZING The U.S. Patent Application Serial Number 14/318,991 of ARRANGEMENTS "；

Entitled " SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITORING The U.S. Patent Application Serial Number 14/319,004 of ARRANGEMENTS "；

The United States Patent (USP) of entitled " FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS " Patent application serial numbers 14/319,008；

Entitled " FASTENER CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGING The U.S. Patent Application Serial Number 14/318,997 of MEMBERS "；

The U.S. of entitled " FASTENER CARTRIDGE COMPRISING TISSUE CONTROL FEATURES " is special Sharp patent application serial numbers 14/319,002；

Entitled " FASTENER CARTRIDGE ASSEMBLIES AND STAPLE RETAINER COVER The U.S. Patent Application Serial Number 14/319,013 of ARRANGEMENTS "；With

The U.S. of entitled " FASTENER CARTRIDGE INCLUDING A LAYER ATTACHED THERETO " is special Sharp patent application serial numbers 14/319,016.

Many specific details are set forth herein, so that reader is to described in specification and embodiment party shown in attached drawing Overall structure, function, manufacture and the purposes of case have thorough understanding.However, technical personnel in this field will understand that can not have Implement the embodiment in the case of these specific details.In other cases, well known operation, component are not elaborated And element, in order to avoid keep embodiment described in specification smudgy.One of ordinary skill in the art will be understood that this paper institutes It is non-limiting example to state the embodiment with shown in, to can be appreciated that, specific structural and functional details disclosed herein Can be representative and illustrative.Without departing from the scope of the claims can to these embodiments carry out modification and Change.

Term " including (comprise) " (and including any form, such as " including (comprises) " and " including (comprising) "), " have (have) " (and any form having, such as " has (has) " and " have (having) "), " include (include) " (and comprising any form, such as " include (includes) " and " include (including) " and " contain (contain) " (and any form contained such as " contains (contains) " and " contains (containing) ") it is open link-verb.Therefore, " comprising ", " having ", "comprising" or " containing " one or more elements Surgery system, device or equipment there are these one or more elements, but be not limited to that only there are these one or more members Part.Equally, the element tool of the system of " comprising ", " having ", "comprising" or " containing " one or more features, device or equipment There are these one or more features, but is not limited to that only there are these 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 the portion far from clinician Point.It is also understood that for it is succinct and clearly for the sake of, herein can in conjunction with attached drawing use space term such as " vertical ", "horizontal", "up" and "down".However, surgical instruments can use in many orientations and positions, and these terms and it is non-limiting and/or Absolutization.

Reuse surgical fasteners tool 100 is shown in Figure 1.Reuse surgical fasteners tool 100 is configured to dispose inflatable staple line.Respectively The inflatable staple line of kind has disclosed and reuse surgical fasteners tool 100 that can dispose appointing in these inflatable staple lines herein One inflatable staple line.In addition, the surgical instruments other than reuse surgical fasteners tool 100 can dispose it is disclosed herein can be swollen Any of swollen staple line may expand staple line.

Reuse surgical fasteners tool 100 includes shank 110, axis 120 and end effector 200.Shank 110 includes pistol grip 140, be configured to operation closed system closure trigger 150, be configured to operation trigger system percussion touch It sends out device 160 and is configured to operation articulation system for making end effector 200 be carried out relative to axis 120 The articulation actuator 170 of joint motions.Entitled " the SURGICAL INSTRUMENT that on December 7th, 2010 announces The disclosure of the United States Patent (USP) 7,845,537 of HAVING RECORDING CAPABILITIES ", which is incorporated by reference, to be incorporated to Herein.It is contemplated that other embodiment party of the single trigger including being configured to operation closed system and trigger system Case.It is contemplated that various embodiments, the end effector of surgical instrument cannot carry out joint motions.In August, 2013 Entitled " the FIRING MEMBER RETRACTION DEVICES FOR POWERED SURGICAL submitted for 23rd The disclosure of the U.S. Patent Application Serial Number 13/974,166 of INSTRUMENTS ", which is incorporated by reference, to be incorporated to.

Closure trigger 150 can be rotated towards pistol grip 140 to activate closed system.Referring first to Fig. 2, closed system System includes closed tube 122, and when closure trigger 150 is moved towards pistol grip 140, which promotes towards distal side.It closes Pipe 122 is closed to engage with the first jaw of the anvil block 220 including end effector 200.In at least one, anvil block 220 wraps The one or more protruding portions 228 extended from it are included, which, which is positioned in, is limited to one or more of second jaw In elongated slot 212.Protruding portion 228 and elongated slot 212 are structured and are arranged to enable anvil block 220 relative to second The static or fixed warehouse channel 210 of jaw rotates between the open and the closed positions.In various alternative embodiments In, warehouse channel can be rotated relative to static or fixed anvil block 220.No matter whether the warehouse channel or anvil block of end effector are consolidated Fixed, end effector all can be articulating or not articulating relative to axis.

Referring again to Fig. 2, anvil block 220 includes lug 226, which connects with the slit 124 being limited in closed tube 122 It closes.When closed tube 122 is moved distally by closure trigger 150, the engageable lug 226 of side wall of slit 124 and make storehouse Channel 210 is rotated towards anvil block 220.When closed tube 122 proximally moves, the engageable lug of another side wall of slit 124 226 and make anvil block 220 far from warehouse channel 210 rotate.In some cases, bias spring can be positioned in anvil block 220 and storehouse Among channel 210, which is configured to anvil block 220 being biased away from warehouse channel 210.

Referring again to Fig. 2, firing trigger 160 can be rotated towards pistol grip 140 to activate trigger system.Percussion system System includes the firing member extended in axis 120.Trigger system further includes sliding part 250, the sliding part operationally with percussion Component engages.When firing trigger 160 is rotated towards pistol grip 140, firing trigger 160 is by firing member and sliding Part 250 drives in end effector 200 towards distal side.End effector 200 further includes the nail bin being located in warehouse channel 210 230.Nail bin 230 is interchangeable, and therefore can be removed from warehouse channel 210；However, it is contemplated that other embodiments, Middle nail bin 230 is not easy to replace and/or be removed from warehouse channel 210.

Nail bin 230 includes multiple nail cavities 270.Each nail cavity 270 is configured to removedly store nail wherein, but It is possible that some nail cavities 270 may not accommodate the nail being stored therein in.Nail bin 230 further includes being movably positioned in wherein Multiple staple drivers 240.Each driver 240 is configured to three nails of support and/or terminals simultaneously or concurrently by three Nail is lifted out their corresponding nail cavities 270.Although each driver 240 of Fig. 1-embodiments shown in Fig. 4 disposes three simultaneously A nail, but it is contemplated that other embodiments, wherein driver can be disposed simultaneously less than three nails or more than three nail.Sliding part 250 include one or more ramped surfaces 252, which is configured in 240 lower slider of driver and will drive Dynamic device 240 is promoted upwardly toward the platform surface 233 of nail bin 230.Sliding part 250 can be from 231 court of proximal end of nail bin 230 Distad the movement of end 232 to promote driver 240 successively.When driver 240 is promoted by sliding part 250 towards platform, drive Dynamic device 240 promotes nail towards anvil block 220.When sliding part 250 is distally advanced, nail be located against anvil block 220 driving and by Driver 240 is projected from nail cavity 270.Nail bin 230 may also include the support plate 260 being attached to thereon, which surrounds nail bin 230 bottom extends and driver 240, nail and/or sliding part 250 is maintained in storehouse 230.

Sliding part 250 and/or by the stick member that sliding part 250 is promoted towards distal side be configured to engagement include anvil The first jaw and/or the second jaw including nail bin 230 of seat 220 and anvil block 220 and nail bin 230 is fixed relative to each other Position.In at least one, sliding part 250 includes at least one first protruding portion 256 extended from it, first protruding portion It is configured to engagement anvil block 220 and at least one second protruding portion 258, second protruding portion is configured to connect Close warehouse channel 210.Anvil block 220 and nail bin 230 can be positioned relative to each other by protruding portion 256 and 258.In sliding part 250 towards remote When side promotes, protruding portion 256 and 258 can position anvil block 220 and tissue space is arranged between anvil block 220 and platform 233.

End effector 200 may also include cutting element, which is configured to incision and is trapped in nail bin Tissue between 230 and anvil block 220.Referring again to Fig. 2, sliding part 250 includes knife 254；However, any suitable cut can be used Cut component.When sliding part 250 is promoted towards distal side and followed closely with being disposed from nail cavity 270, knife 254 is moved distally with transecting patient tissue. In certain alternative embodiments, the firing member that sliding part 250 is pushed towards distal side be may include into cutting element.Storehouse 230 includes It is configured to receive the longitudinal slit 234 of knife 254 at least partly.Anvil block 220 further includes being configured at least portion The longitudinal slit for dividing ground to receive knife 254；However, it is contemplated that such embodiment, wherein in storehouse 230 and anvil block 220 Only one includes the slit for being configured to receive cutting element.

Than that described above, referring primarily to Fig. 1, the shank 110 of surgical instruments 100 includes articulation actuator 170, works as cause When dynamic, which can make end effector 200 carry out joint motions around actuated articulation joints 180.Work as actuating When device 170 is pushed along first direction, end effector 200 can be rotated in a first direction, and work as actuator 170 in a second direction When promotion, end effector 200 can be rotated along second or opposite direction.Referring now to Fig. 2, end effector 200 includes peace It is attached to the joint motions jam plate 182 of its proximal end.In the embodiment shown in the drawing, jam plate 182 is installed to storehouse by pin 184 and leads to Road 210, the pin extend through the trepanning 214 being limited in warehouse channel 210 and jam plate 182.Axis 120 may also include can be first The lock moved between bonding station and second or disengaging configuration is locked in first bonding station and is engaged with jam plate 182, this Two or lock is disengaged with jam plate when disengaging configuration.When lock is in its bonding station, end effector 200 can be maintained at by lock Appropriate location.When lock is in its disengaging configuration, end effector 200 can surround actuated articulation joints 180 and rotate.2014 6 Entitled " the ROBOTICALLY-CONTROLLED SHAFT BASED ROTARY DRIVE SYSTEMS that the moon is submitted on the 25th The disclosure full text of the U.S. Patent Application Serial Number 14/314,788 of FOR SURGICAL INSTRUMENTS " is with the side of reference Formula is incorporated to.Entitled " the SURGICAL STAPLING INSTRUMENT WITH AN submitted on 2 26th, 2013 The disclosure full text of the U.S. Patent Application Serial Number 2013/0168435 of ARTICULATABLE END EFFECTOR " is to draw It is incorporated to mode.

Turning now to Fig. 3 and Fig. 4, the nail cavity 270 of nail bin 200 can be positioned and arranged to so that being stored in the nail in nail cavity Part deployment as extending staple line.Nail cavity 270 is disposed in nail cavity array.Nail cavity array includes removedly storing The first row nail cavity 270a of first nail.First row nail cavity 270a is along the first longitudinal direction axis adjacent with longitudinal slit 234 272a extends.Nail cavity array includes the second row nail cavity 270b for removedly storing the second nail.Second row nail cavity 270b along The second longitudinal direction axis 272b adjacent with first row nail cavity 270a extends.Nail cavity array includes removedly storing third nail Third nail chamber 270c.Third nail chamber 270c extends along second row nail cavity 270b.

Referring again to Fig. 3 and Fig. 4, first longitudinal direction axis 272a is parallel to or at least substantially parallel to second longitudinal direction axis 272b；However, other arrangements are possible, wherein first longitudinal direction axis 272a is not parallel to second longitudinal direction axis 272b.Second Longitudinal axis 272b is parallel to or at least substantially parallel to third longitudinal axis 272c；However, other arrangements are possible, Middle second longitudinal direction axis 272b is not parallel to third longitudinal axis 272c.First longitudinal direction axis 272a is parallel to or at least substantially It is parallel to third longitudinal axis 272c；However, other arrangements are possible, wherein first longitudinal direction axis 272a is not parallel to third Longitudinal axis 272c.

Referring again to Fig. 3 and Fig. 4, nail bin 230 includes the second part of the first part and the chamber array of nail cavity array, should The first part of nail cavity array includes first row 270a, second row 270b and the third on the first side of longitudinal slit 234 270c is arranged, the second part of the chamber array includes first row 270a, second row 270b in the second side of longitudinal slit 234 270c is arranged with third.First chamber array portion is mirror image of the second chamber array portion relative to cannelure；However, it is possible to use its It is arranged.

Nail bin 230 is configured to follow closely array shown in deployment diagram 52A.Nail bin 230 is configured to along One longitudinal axis 282a disposes the first nail 280a, along second longitudinal direction axis 282b the second nail 280b of deployment, and along Third longitudinal axis 282c deployment third nails 280c.In all cases, nail bin 230 is configured to the first nail 280a, the second nail 280b and third nail 280c are deployed on the first side of longitudinal cut 284, and by the first nail 280a, the second nail 280b and third nail 280c are deployed in the second side of longitudinal cut 284.First nail 280a can be determined Position at adjacent with longitudinal cut 284, and third nail 280c can be positioned so that it is farthest from longitudinal cut 284.Each second row Nail 280b can be positioned among the first nail 280a and third nail 280c.

Than that described above, the first nail 280a is removedly stored in the first nail cavity 270a, and the second nail 280b is removedly It is stored in the second nail cavity 270b, and third nail 280c is removedly stored in third nail cavity 270c.Nail cavity 270a-270c It is constructed and arranged to arrange deployment nail 280a-280c shown in Figure 52 A.First nail 280a relative to longitudinal axis 282a with First angle 274a is orientated.Second nail 280b is orientated relative to longitudinal axis 282b with second angle 274b.Third follows closely 280c phases Longitudinal axis 282c is orientated with third angle 274c.First angle 274a is different from second angle 274b；However, other In embodiment, first angle 274a and second angle 274b can be identical.Third angle 274c is different from second angle 274b；However, in other embodiments, third angle 274c and second angle 274b can be identical.First angle 274a It is identical as third angle 274c；However, in other embodiments, first angle 274a and third angle 274c can be difference 's.

Than that described above, first angle 274a can be measured relative to first longitudinal direction axis 282a, and second angle 274b can phase Second longitudinal direction axis 282b is measured, and third angle 274c can be measured relative to third longitudinal axis 282c.When first When longitudinal axis 282a, second longitudinal direction axis 282b and/or third longitudinal axis 282c parallel to each other, first angle 274a, Two angle 274b and/or third angle 274c can be vertical relative to first longitudinal direction axis 282a, second longitudinal direction axis 282b and third It is measured to any one of axis 282c.When first longitudinal direction axis 282a, second longitudinal direction axis 282b and/or third longitudinal axis When 282c is parallel to longitudinal slit 234, first angle 274a, second angle 274b and/or third angle 274c can be relative to vertical It is measured to slit 234.Correspondingly, as first longitudinal direction axis 282a, second longitudinal direction axis 282b and/or third longitudinal axis 282c When being parallel to tissue cross 284, first angle 274a, second angle 274b and/or third angle 274c can be horizontal relative to tissue Cut 284 measurements.

First nail 280a, the second nail 280b and third nail 280c can be positioned and arranged to so that they provide lateral overlap Staple line.More particularly, referring again to Figure 52 A, longitudinal longitudinal row side arranged relative to the first nail 280a of the second nail 280b To positioning so that the gap between the second nail 280b and the first nail 280a is aligned, and similarly, and third follows closely longitudinal row of 280c Longitudinal row's lateral register relative to the second nail 280b so that the gap that third is followed closely between 280c and the second nail 280b is aligned.This Sample arrangement can limit blood from tissue T to cross section 284 flowing.

In the embodiment shown in the drawing, each first nail 280a includes the distal side leg relative to adjacent second nail 280b Distal side leg 283a distally located 283b, and in addition it is located at the proximal leg 285a of nearside relative to distal side leg 283b. Similarly, each third nail 280c includes the distal side leg distally located relative to the distal side leg 283b of adjacent second nail 280b 283c, and in addition it is located at the proximal leg 285c of nearside relative to distal side leg 283b.With above-mentioned first nail 280a and third The second adjacent nail 280c nail 280b includes the near leg that 280c is followed closely relative to the proximal leg 285a and third of the first nail 280a Portion 285c is located at the proximal leg 285b of nearside.This is only an exemplary implementation scheme, and any suitable cloth can be used It sets.

Than that described above, the first nail 280a crosses over first longitudinal direction axis 282a.The distal side leg 283a quilts of first nail 280a It is located on the side of first longitudinal direction axis 282a, and proximal leg 285a is positioned in the another of first longitudinal direction axis 282a On side.In other words, the leg of the first nail 280a is biased relative to first longitudinal direction axis 282a.It is contemplated that alternative implementation Scheme, wherein the first nail 280a is aligned or collinearly with first longitudinal direction axis 282a.

Second nail 280b crosses over second longitudinal direction axis 282b.It is vertical that the distal side leg 283b of second nail 280b is positioned in second To on the side of axis 282b, and proximal leg 285b is positioned on the other side of second longitudinal direction axis 282b.In other words It says, the leg of the second nail 280b is biased relative to second longitudinal direction axis 282b.It is contemplated that alternative embodiment, wherein the Two nail 280b are aligned or collinearly with second longitudinal direction axis 282b.

Third follows closely 280c and crosses over third longitudinal axis 282c.It is vertical that the distal side leg 283c of third nail 280c is positioned in third To on the side of axis 282c, and proximal leg 285c is positioned on the other side of third longitudinal axis 282c.In other words It says, the leg that third follows closely 280c is biased relative to third longitudinal axis 282c.It is contemplated that alternative embodiment, wherein the Three nail 280c are aligned or collinearly with third longitudinal axis 282c.

In certain embodiments, the first nail 280a may include that the distal side leg 283b with adjacent second nail 280b is aligned Proximal leg 285a.Similarly, third nail 280c may include the nearside that the distal side leg 283b with adjacent second nail 280b is aligned Leg 285c.In various embodiments, the first nail 280a may include proximal leg 285a, and the proximal leg is relative to adjacent the The distal side leg 283b of two nail 280b is positioned in distal side.Similarly, third nail 280c may include proximal leg 285c, the near leg Portion is positioned relative to the distal side leg 283b of adjacent second nail 280b in distal side.

The row that the row of second nail 280b is followed closely 280c by the row and third of the first nail 280a defines.Second nail 280b is on side It is defined by the first nail 280a and is defined on another side by third nail 280c.More particularly, the first nail 280a is relative to the The proximal leg 285b of two nail 280b is positioned laterally inward, and similarly, and third follows closely 280c relative to the remote of the second nail 280b Side leg 283b is laterally outwardly positioned.Therefore, the first nail 280a can provide boundary, and third on the side of the second nail 280b Nail 280b can provide boundary on the other side of the second nail 280b.

Tradition nail array is shown in Figure 52.The nail array include on the first side of the notch 384 being located in tissue T along First nail 380a of first longitudinal direction axis 382a positioning, along the 382b positioning of second longitudinal direction axis the second nail 380b, with And the third nail 380c along the 382c positioning of third longitudinal axis.Nail 380a is aligned with first longitudinal direction axis 382a or at least base It is aligned on this；Nail 380b is aligned with second longitudinal direction axis 382b or is at least substantially aligned；And follow closely 380c and third longitudinal axis Line 382c alignment is at least substantially aligned.In other words, first 380a is followed closely not relative to first longitudinal direction axis 382a with certain Angle is orientated, and the second nail 380b is not orientated at a certain angle relative to second longitudinal direction axis 382b, and third follows closely 380c not phases Third longitudinal axis 382c is orientated at a certain angle.The nail array further includes second or the opposite side for being located in notch 384 On along the first nail 380a of first longitudinal direction axis 382a positioning, along the second nail of second longitudinal direction axis 382b positioning The 380b and third nail 380c positioned along third longitudinal axis 382c.

When being applied to longitudinal pulling force in the tissue T of nail array suture shown in Figure 52, organize extending longitudinally.This Outside, in all cases, when tissue is by extending longitudinally, nail 380a, 380b and 380c can longitudinal translations.It is such to be arranged in perhaps Can be suitable in the case of more；However, nail 380a, 380b and 380c can limit the stretching, extension and/or movement of tissue.In some cases Under, it is much lower than still unstitched adjacent tissue flexibility by following closely the tissue of 380a, 380b and 380c suture.In other words, Nail array including following closely 380a, 380b and 380c may lead to the suddenly change of the material property of tissue.In at least one situation Under, big strain gradient can within the organization be generated due to nail array, this can then generate big stress gradient within the organization.

When nail 380a-380c is projected from nail bin, the leg of nail can pierce tissue T.Therefore, nail leg generates in the tissue Hole.Various types of tissues are elastic, and can surround nail leg when nail leg passes through tissue and stretch.In all cases, group The elasticity knitted can enable tissue be stretched towards nail leg and return resiliently to existing between tissue and nail leg to reduce or eliminate Gap.Such elasticity can also enable tissue be stretched when applying stretching force to tissue；However, such elasticity can be certain Pattern is followed closely to inhibit.In at least one, the nail pattern being shown in Figure 52 can inhibit the extending longitudinally of tissue.When will longitudinally stretch When Zhan Li is applied to the tissue by the nail pattern suture of Figure 52, tissue can start between being pulled away from from nail leg and generating therebetween Gap.In some cases, especially in bariatrician excision application, such gap can cause to increase from the bleeding of gastric tissue It is more.In some cases, especially in pneumonectomy application, air leakage can lead to lung tissue.

The nail array being shown in Figure 52 A is more more flexible than the nail array being shown in Figure 52.Referring now to Figure 52 B, when will indulge When being applied in tissue T to pulling force, nail 280a, 280b and 280c can (first) tissue by extending longitudinally when longitudinal translation simultaneously And/or person (second) rotates when tissue is by extending longitudinally.The submissive nail array being shown in Figure 52 can such as be followed the usual practice along staple line Significant extensibility is such as generated by the longitudinal direction that staple line limits.This being longitudinally extended property can reduce suture tissue T and/or suture The stress and/or strain gradient in tissue T around tissue T.In addition, when extending longitudinally power is applied to tissue, Figure 52 A Shown in submissive nail array can reduce or eliminate the gap between nail leg and tissue T, and therefore reduce between nail leg and tissue Bleeding and/or air leakage.

For following closely the longitudinal translation of 280a, 280b and 280c, the first nail 280a can be moved along first longitudinal direction axis 282a, Second nail 280b can be moved along second longitudinal direction axis 282b, and third nail 280c can be moved along third longitudinal axis 282c It is dynamic.When the first nail 280a is moved along first longitudinal direction axis 282a, the first nail 280a can be on the upper berths first longitudinal direction axis 282a It opens.In other words, when by longitudinal force along and/or when being parallel to first longitudinal direction axis 282a and being applied to tissue, the first nail The distance between 280a or clearance distance can increase.Similarly, when the second nail 280b is moved along second longitudinal direction axis 282b, Second nail 280b can be spread out on second longitudinal direction axis 282b.When by longitudinal force along and/or be parallel to second longitudinal direction axis When 282b is applied to tissue, the distance between second nail 280b or clearance distance can increase.In addition, similarly, when third is followed closely When 280c is moved along third longitudinal axis 282c, third nail 280c can be spread out on third longitudinal axis 282c.When will be longitudinal Power along and/or when being parallel to third longitudinal axis 282c and being applied to tissue, third follows closely the distance between 280c or clearance gap From can increase.

As described above, when tissue T is extended, nail 280a, 280b and/or 280c can be moved with tissue T.Work as tissue T When longitudinally being pulled, than that described above, first longitudinal direction axis 282a, second longitudinal direction axis 282b and/or third longitudinal axis 282c can be remained parallel to each other.In some cases, it is such as applied to for example when by cross force (that is, transverse to power of longitudinal force) When in tissue T, the orientation of first longitudinal direction axis 282a, second longitudinal direction axis 282b and/or third longitudinal axis 282c can become It is not parallel.In some cases, when by tissue T longitudinally pull when, first longitudinal direction axis 282a, second longitudinal direction axis 282b and/ Or third longitudinal axis 282c can be moved into it is closer to each other.When extending longitudinally power is applied in tissue T, such movement It can be the result of the cross-direction shrinkage occurred in tissue T.In some cases, such as when cross force to be applied in such as tissue T When, first longitudinal direction axis 282a, second longitudinal direction axis 282b and/or third longitudinal axis 282c can be moved away from each other.

For following closely the moving in rotation of 280a, 280b and 280c, when longitudinal pulling force is applied in tissue T, the first nail 280a can be rotated relative to first longitudinal direction axis 282a.When longitudinal pulling force to be applied in tissue T, each first nail 280a can It is rotated between initial first angle 274a and another first angle 274a.In at least one, each first nail 280a can rotate between initial orientation and another orientation, and in the initial orientation, the first nail 280a is extended in transverse direction First longitudinal direction axis 282a, this another be orientated and closer be aligned with first longitudinal direction axis 282a.It in some cases, will be longitudinal Pulling force, which is applied to tissue T, can cause the first nail 280a to rotate to the orientation conllinear with first longitudinal direction axis 282a.In various situations Under, each first nail 280a can surround the axis rotation for extending through first longitudinal direction axis 282a.

As described above, when longitudinal pulling force is applied in tissue T, the first nail 280a can in initial first angle 274a and It is rotated between another first angle 274a.In various embodiments, initial or un-extended first angle 274a can be between Between for example, about 5 degree and about 85 degree.In certain embodiments, initial or un-extended first angle 274a can be between for example, about Between 30 degree and about 60 degree.In at least one embodiment, initial or un-extended first angle 274a can be for example, about 45 Degree.In at least one embodiment, initial or un-extended first angle 274a can be for example, about 10 degree, about 20 degree, about 30 It spends, about 40 degree, about 50 degree, about 60 degree, about 70 degree, and/or about 80 degree.

In all cases, the first angle 274a of stretching, extension can be between for example, about 5 degree and about 85 degree.In certain situations Under, the first angle 274a of stretching, extension can be between for example, about 30 degree and about 60 degree.In at least one, the first of stretching, extension Angle 274a can be for example, about 45 degree.In at least one, the first angle 274a of stretching, extension can be for example, about 10 degree, about 20 It spends, about 30 degree, about 40 degree, about 50 degree, about 60 degree, about 70 degree, and/or about 80 degree.

In all cases, the difference between un-extended first angle 274a and the first angle 274a of stretching, extension can be between Between for example, about 1 degree and about 45 degree.In some cases, the un-extended first angle 274a and first angle 274a of stretching, extension it Between difference can be for example, about 1 degree, about 2 degree, about 3 degree, about 4 degree, and/or about 5 degree.In some cases, un-extended first Difference between angle 274a and the first angle 274a of stretching, extension can be for example, about 5 degree, about 10 degree, about 15 degree, about 20 degree, and/ Or about 25 degree.

Than that described above, when longitudinal pulling force to be applied in tissue T, the second nail 280b can be relative to second longitudinal direction axis 282b rotates.When longitudinal pulling force to be applied in tissue T, each second nail 280b can be in initial second angle 274b and another It is rotated between a second angle 274b.In at least one, each second nail 280b can take in initial orientation with another It is rotated between, in the initial orientation, the second nail 280b extends to second longitudinal direction axis 282b in transverse direction, this another Orientation is aligned closer to second longitudinal direction axis 282b.In some cases, can be led to by longitudinal pulling force being applied to tissue T Two nail 280b rotate to the orientation conllinear with second longitudinal direction axis 282b.In all cases, each second nail 280b can be surrounded The axis for being aligned and/or extending through second longitudinal direction axis 282b with second longitudinal direction axis 282b rotates.

As described above, when longitudinal pulling force is applied in tissue T, the second nail 280b can in initial second angle 274b and It is rotated between another second angle 274b.In various embodiments, initial or un-extended second angle 274a can be between Between for example, about 5 degree and about 85 degree.In certain embodiments, initial or un-extended second angle 274b can be between for example, about Between 30 degree and about 60 degree.In at least one embodiment, initial or un-extended second angle 274b can be for example, about 45 Degree.In at least one embodiment, initial or un-extended second angle 274b can be for example, about 10 degree, about 20 degree, about 30 It spends, about 40 degree, about 50 degree, about 60 degree, about 70 degree, and/or about 80 degree.

In all cases, the second angle 274b of stretching, extension can be between for example, about 5 degree and about 85 degree.In certain situations Under, the second angle 274b of stretching, extension can be between for example, about 30 degree and about 60 degree.In at least one, the second of stretching, extension Angle 274b can be for example, about 45 degree.In at least one, the second angle 274b of stretching, extension can be for example, about 10 degree, about 20 It spends, about 30 degree, about 40 degree, about 50 degree, about 60 degree, about 70 degree, and/or about 80 degree.

In all cases, the difference between un-extended second angle 274b and the second angle 274b of stretching, extension can be between Between for example, about 1 degree and about 45 degree.In some cases, the un-extended second angle 274b and second angle 274b of stretching, extension it Between difference can be for example, about 1 degree, about 2 degree, about 3 degree, about 4 degree, and/or about 5 degree.In some cases, un-extended second Difference between angle 274b and the second angle 274b of stretching, extension can be for example, about 5 degree, about 10 degree, about 15 degree, about 20 degree, and/ Or about 25 degree.

Than that described above, when longitudinal pulling force to be applied in tissue T, third follows closely 280c can be relative to third longitudinal axis 282c rotates.When longitudinal pulling force to be applied in tissue T, each third nail 280c can be in initial third angle 274c and another It is rotated between a third angle 274c.In at least one, each third nail 280c can take in initial orientation with another It is rotated between, in the initial orientation, third nail 280c extends to third longitudinal axis 282c in transverse direction, this another It is orientated and closer is aligned with third longitudinal axis 282c.In some cases, third can be led to by longitudinal pulling force being applied to tissue T Nail 280c rotates to the orientation conllinear with third longitudinal axis 282c.In all cases, each third nail 280c can surround with Third longitudinal axis 282c alignment and/or the axis rotation for extending through third longitudinal axis 282c.

As described above, when longitudinal pulling force is applied in tissue T, third follow closely 280c can in initial third angle 274c and It is rotated between another third angle 274c.In various embodiments, initial or un-extended third angle 274c can be between Between for example, about 5 degree and about 85 degree.In certain embodiments, initial or un-extended third angle 274c can be between for example, about Between 30 degree and about 60 degree.In at least one embodiment, initial or un-extended third angle 274c can be for example, about 45 Degree.In at least one embodiment, initial or un-extended third angle 274c can be for example, about 10 degree, about 20 degree, about 30 It spends, about 40 degree, about 50 degree, about 60 degree, about 70 degree, and/or about 80 degree.

In all cases, the third angle 274c of stretching, extension can be between for example, about 5 degree and about 85 degree.In certain situations Under, the third angle 274c of stretching, extension can be between for example, about 30 degree and about 60 degree.In at least one, the third of stretching, extension Angle 274c can be for example, about 45 degree.In at least one, the third angle 274c of stretching, extension can be for example, about 10 degree, about 20 It spends, about 30 degree, about 40 degree, about 50 degree, about 60 degree, about 70 degree, and/or about 80 degree.

In all cases, the difference between un-extended third angle 274c and the third angle 274c of stretching, extension can be between Between for example, about 1 degree and about 45 degree.In some cases, the un-extended third angle 274c and third angle 274c of stretching, extension it Between difference can be for example, about 1 degree, about 2 degree, about 3 degree, about 4 degree, and/or about 5 degree.In some cases, un-extended third Difference between angle 274c and the third angle 274c of stretching, extension can be for example, about 5 degree, about 10 degree, about 15 degree, about 20 degree, and/ Or about 25 degree.

In all cases, the first nail rotatable first amounts of 280a in the first nail, and second in the second nail Follow closely rotatable second amounts different from the first amount of 280b.First amount is smaller than or is more than the second amount.In all cases, first row The first nail rotatable first amounts of 280a in nail, and third in third nail follows closely 280c rotatable different from the first amount the Three amounts.First amount is smaller than or is more than third amount.In all cases, the third in third nail follows closely the rotatable thirds of 280c Amount, and the second nail rotatable second amount different from third amount of 280b in the second nail.Third amount is smaller than or more than the Two amounts.

In at least one application, for most interior staple, i.e., near the staple of notch, it would be desirable to than other nails Row is with less flexible or not extending.For outermost staple, i.e., staple farthest from notch, it would be desirable to than other staples It is more flexible or extending.When the angle between the first nail axis and first longitudinal direction axis is less than the second nail axis and second longitudinal direction When angle between axis, the first nail must be directed towards the rotation of second longitudinal direction axis than the second nail has less direction first vertical The space rotated to axis, and therefore so that tissue is more hardened than the second nail.Similarly, when the second nail axis and second longitudinal direction When angle between axis is less than the angle between third nail axis and third longitudinal axis, the second nail must court than third nail There is the less space rotated towards second longitudinal direction axis to the rotation of third longitudinal axis, and therefore make tissue than third nail More harden.

Than that described above, it includes six longitudinal staples that pattern is followed closely disclosed in Figure 52 A.It is contemplated that other embodiment party Case, such as comprising six staples, such as four staples are less than, or are more than six staples, such as eight staples.

First nail 280a, the second nail 280 and third nail 280c may include any suitable configuration, such as V-arrangement configuration or U-shaped Configuration.Nail including V-arrangement configuration may include base portion, from the first leg that the first end of base portion extends and from the of base portion The second leg that two ends extend, wherein the first leg and the second leg extend along direction is not substantially parallel with each other.Including U-shaped configuration Nail may include base portion, from the first leg that the first end of base portion extends and extend from the second end of base portion second Leg, wherein the first leg and the second leg extend along direction parallel to each other.

For following closely pattern disclosed in such as Figure 52 A, each first nail 280a includes nearside nail leg 285a and distal side nail leg 283a.The nail bin for being configured to follow closely pattern disclosed in deployment diagram 52A may include proximal end and distal end.Nearside is followed closely Leg 285a is than distal side nail leg 283a closer to the proximal end of nail bin, and similarly, distal side nail leg 283a is followed closely than nearside Distal ends of the leg 285a closer to nail bin.The base portion of each first nail 280a can limit the first base portion axis.Nearside nail leg 285a and distal side nail leg 283a can extend from the first base portion axis.First nail 280a can be positioned and arranged to so that the first base portion Axis extends towards longitudinally cutting line 284 and towards the distal end of nail bin.

For following closely pattern disclosed in such as Figure 52 A, each second nail 280b includes nearside nail leg 285b and distal side nail leg 283b.As described above, the nail bin for being configured to follow closely pattern disclosed in deployment diagram 52A may include proximal end and distal end portion Portion.Nearside nail leg 285b is than distal side nail leg 283b closer to the proximal end of nail bin, and similarly, distal side nail leg 283b can Than nearside nail leg 285b closer to the distal end of nail bin.The base portion of each second nail 280b can limit the second base portion axis.Closely Side nail leg 285b and distal side nail leg 283b can extend from the second base portion axis.Second nail 280b can be positioned and arranged to so that the Two base portion axis extend towards longitudinally cutting line 284 and towards the proximal end of nail bin.

For following closely pattern disclosed in such as Figure 52 A, each third nail 280c includes nearside nail leg 285c and distal side nail leg 283c.As described above, the nail bin for being configured to follow closely pattern disclosed in deployment diagram 52A may include proximal end and distal end portion Portion.Nearside nail leg 285c is than distal side nail leg 283c closer to the proximal end of nail bin, and similarly, distal side nail leg 283c can Than nearside nail leg 285c closer to the distal end of nail bin.The base portion of each third nail 280c can limit third base portion axis.Closely Side nail leg 285c and distal side nail leg 283c can extend from third base portion axis.Third nail 280c can be positioned and arranged to so that the Three base portion axis extend towards longitudinally cutting line 284 and towards the distal end of nail bin.

For following closely pattern disclosed in such as Figure 52 A, the first nail 280a can follow closely 280c with third and be aligned.First nail 280a's The nearside nail leg 285c that nearside nail leg 285a can follow closely 280c with third is aligned.When nearside nail leg 285a is aligned with nearside nail leg 285c When, nearside nail leg 285a and proximal leg 285c can be along the axis locations perpendicular to cutting line 284.The distal side of first nail 280a The distal side nail leg 283c that nail leg 283a can follow closely 280c with third is aligned.When distal side nail leg 283a is aligned with distal side nail leg 283c, Distal side nail leg 283a and distal side nail leg 283c can be along the axis locations perpendicular to cutting line 284.In such cases, third is followed closely 280c can follow closely seal tissue in the case that 280a is deformed first.Similarly, the first nail 280a can follow closely 280c deformations in third In the case of tissue is kept together.In other embodiments, the first nail 280a can not follow closely 280c with third and be aligned.

Than that described above, when nail pattern is in unstretched condition, the first nail 280a can follow closely 280c with third and be aligned.Work as nail When pattern is by extending longitudinally, first nail 280a and/or third nail 280c it is translatable and/or rotation.In all cases, work as tissue When by extending longitudinally, the first nail 280a can follow closely 280c holdings with third and be aligned.In other cases, the first nail 280a can not be with the Three nail 280c keep alignment.

Again for following closely pattern disclosed in Figure 52 A, the distal side nail leg 283b of the second nail 280b can be with the first nail 280a's The proximal leg 285c alignment of nearside nail leg 285a and/or third nail 280c.Distal side nail leg 283b, the first nail of second nail 280b The nearside nail leg 285c of nearside nail leg 285a and/or third the nail 280c of 280a can be fixed along the axis perpendicular to cutting line 284 Position.The nearside nail leg 285b of second nail 280b can follow closely the distal side of 280c with the distal side nail leg 283a and/or third of the first nail 280a Nail leg 283c alignment.The nearside nail leg 285b of second nail 280b, the distal side nail leg 283a of the first nail 280a and/or third follow closely 280c Distal side nail leg 283c can be along the axis location perpendicular to cutting line 284.

Than that described above, when follow closely pattern be in unstretched condition when, second nail 280b nail leg can with first follow closely 280a and/ Or the nail leg alignment of third nail 280c.When following closely pattern by extending longitudinally, the first nail 280a, the second nail 280b and/or third nail 280c is translatable and/or rotates.In all cases, when tissue is by extending longitudinally, the leg of the second nail 280b can not be with the The leg of one nail 280a and/or third nail 280c keep alignment.In other cases, when tissue is by extending longitudinally, the second nail The leg that the leg of 280b can follow closely 280c with the first nail 280a and/or third keeps being aligned.

In various embodiments, nail pattern may be arranged so that the nail in a longitudinal staple is longitudinally followed closely with another Nail overlapping in row.For example, second nail 280b distal side nail leg 283b can relative to first nail 280a nearside nail leg 285a and/ Or the proximal leg 285c of third nail 280c is located in distal side.For example, the nearside nail leg 285b of the second nail 280b can be positioned in The distal side nail leg 283c nearsides of the distal side nail leg 283a and/or third nail 280c of first nail 280a.The nearside nail of second nail 280b The distal side nail leg 283c of leg 285b, the distal side nail leg 283a of the first nail 280a and/or third nail 280c can be along perpendicular to cuttings The axis location of line 284.

As described above, when nail pattern is in unstretched condition, the second nail 280b can be followed closely with the first nail 280a and/or third 280c is overlapped.When follow closely pattern by extending longitudinally when, first nail 280a, second nail 280b and/or third nail 280c it is translatable and/or Rotation.In all cases, when tissue is by extending longitudinally, the second nail 280b can follow closely 280c with the first nail 280a and/or third Keep overlapping.In some cases, when tissue is by extending longitudinally, the second nail 280b can no longer with the first nail 280a and/or the Three nail 280c overlappings.

Pattern is followed closely shown in Figure 52 A is shown in unstretched condition.When the tissue for following closely pattern suture shown in Figure 52 A When by extending longitudinally, nail can be vertically moved with tissue and/or be rotated within the organization, as shown in Figure 52 B.Such movement It is also depicted in Figure 24.

Surgical instruments 100 is configured to use during laparoscopic surgery.End effector 200 and axis 120 size and be dimensioned so as to across trochar or intubation it is inserted into the patient.Trochar may include inner passage, this is interior Portion channel includes internal diameter.In some cases, internal diameter can be such as about 5mm or about 12mm.End effector 200 be along Straight line applies the linear end actuator of nail.It is contemplated that other surgical instruments, applies along the line being at least partly bent Nail, such as September in 2014 entitled " the SURGICAL STAPLING DEVICE HAVING SUPPORTS FOR announced on the 9th Those of disclosed in the United States Patent (USP) 8,827,133 of A FLEXIBLE DRIVE MECHANISM ".September is announced on the 9th within 2014 Entitled " SURGICAL STAPLING DEVICE HAVING SUPPORTS FOR A FLEXIBLE DRIVE The complete disclosure of the United States Patent (USP) 8,827,133 of MECHANISM ", which is incorporated by reference, to be incorporated to.Such surgical instruments energy Enough apply the inflatable staple line of bending using principle disclosed herein.Although surgical instruments 100 can be in laparoscopic type surgery It is used during operation, but can also use surgical instruments 100 during open surgery, in open surgery China and foreign countries Section's instrument 100 is inserted through the big notch of patient's body.In addition, inflatable staple line disclosed herein can be by open surgical Stitching unstrument applies, the U.S. of entitled " the SURGICAL STAPLING INSTRUMENT " that submits such as on October 21st, 2013 Those of disclosed in patent application publication 2014/0042205.Entitled " the SURGICAL that on October 21st, 2013 submits The disclosure of the U.S. Patent Application Publication 2014/0042205 of STAPLING INSTRUMENT " is incorporated by reference simultaneously Enter herein.

Turning now to Fig. 4, anvil block 220 includes the array for being defined in forming pit 290a, 290b and 290c therein, point It is not configured to that nail 280a, 280b and 280c is made to deform.First forming pit 290a is fixed along first longitudinal direction axis 292a Position, second longitudinal direction pit 290b are positioned along second longitudinal direction axis 292b, and third forming pit 290c is along third longitudinal direction Axis 292c positioning.Longitudinal axis 292a, 292b are parallel with 292c and in the proximal end of anvil block 220 221 and distal end Extend between 222.Anvil block 220 further includes being defined in longitudinal slit 224 therein, which is configured to receive and hit Send out at least part of component.In at least one, firing member, which is included in, to be extended between anvil block 220 and nail bin 230 Cut portion.Anvil block 220 include on the side of longitudinal slit 224 one arrange the first forming pit 290a, one arrange the 2nd forming Pit 290b and one arranges the 3rd forming pit 290c, and to ranked first forming recessed by another on the other side of longitudinal slit 224 Hole 290a, another it ranked second forming pit 290b and another ranked third forming pit 290c.As it will be appreciate that, forming pit 290a, 290b and 290c are aligned and corresponding with nail cavity 270a, 270b and the 270c being each defined in nail bin 230.

Forming pit 290a, 290b and 290c are configured to that nail 280a, 280b and 280c is made to be deformed into such as B shapes structure Type.In all cases, forming pit 290a, 290b and 290c is configured to that staple and/or V-arrangement nail is made to be deformed into example Such as such B shapes configuration.Each forming pit 290a, 290b and 290c include being configured to receive the close of the proximal leg of nail Side end and the distal end for being configured to the distal side leg that reception is followed closely.That is, any suitable anvil block is available In the nail projected from nail bin is formed as any suitable shape.Each forming pit 290a, 290b and 290c may include at it The groove extended between proximal end and distal end.Groove may include side wall, which is configured to make in plane Nail leg is removed from the plane when nail deforms and prevents or be at least limited in nail leg deformation.

Turning now to Fig. 5, anvil block 320 includes the array for being defined in forming pit 390a, 390b and 390c therein.It is similar In the above, multiple first forming pit 390a are arranged along first longitudinal direction axis, multiple second forming pit 390b along Second longitudinal direction axis is arranged, and multiple third forming pit 390c are arranged along third longitudinal axis.Each forming pit 390a, 390b and 390c include nearside forming pit end and distal side forming pit end.For example, each first forming pit 390a includes being configured to receive the proximal end 393a of the proximal leg of the first nail and being configured to reception the The distal end 395a, each second forming pit 390b of the distal side leg of one nail include being configured to receive the second nail The proximal end 393b of the proximal leg and distal end 395b for being configured to the distal side leg that reception second is followed closely, and Each forming pit 390c includes being configured to receive the proximal end 393c of the proximal leg of third nail and being constructed At the distal end 395c for the distal side leg that can receive third nail.

Proximal end 393a, 393b and 393c and distal end 395a, 395b and 395c may include any suitable structure Type.Referring again to Fig. 5, proximal end 393a, 393b and 393c and distal end 395a, 395b and 395c include respectively amplification Cup.It is wider than the groove 397 of restriction therebetween to amplify cup.In some cases, the groove for amplifying cup and extending therebetween may include Such as hourglass shape.When the leg of nail enters such forming pit, leg can enter amplification cup, and when nail leg deforms, Nail leg can be directed in groove 397 by amplification cup.Each amplification cup may include the side wall for being bent and/or being at an angle of, which can It is configured to guide nail leg towards groove 397.In some cases, amplification cup can adjust the orientation of unjustified nail leg.

Nail shapes pit 390a, 390b are nested with 390c.For example, cup is amplified in the distal side of the second forming pit 390b 395b is located among amplification cup 393c, 395c of adjacent third nail shapes pit 390c, and in addition, the second forming pit The nearside amplification cup 393b of 390b is located among amplification cup 393a, 395a of the first adjacent forming pit 390a.In addition, example Such as, the first forming pit 390a nearside amplification cup 393a be located in the second adjacent forming pit 390b amplification cup 393b, Among 395b.In addition, for example, the distal side amplification cup 395c of third forming pit 390c is located in the second adjacent forming pit Among amplification cup 393b, 395b of 390b.The amplification forming cup of each nail cavity can limit rectangle perimeter, and entire forming pit can quilt It is located in the rectangle perimeter.As above-mentioned nested arrangement as a result, one nail forming cavity rectangle perimeter can with another at The rectangle perimeter of shape chamber is overlapped.For example, the rectangle perimeter of the second forming cavity 390b can be with the rectangle perimeter of the first forming cavity 390a And/or the rectangle perimeter overlapping of third forming cavity 390c.

Turning now to Fig. 6, anvil block 420 includes the array for being defined in forming pit 490a, 490b and 490c therein.It is similar In the above, multiple first forming pit 490a are arranged along first longitudinal direction axis, multiple second forming pit 490b along Second longitudinal direction axis is arranged, and multiple third forming pit 490c are arranged along third longitudinal axis.Each forming pit 490a, 490b and 490c include nearside forming pit end and distal side forming pit end.For example, each first forming pit 490a includes being configured to receive the proximal end 493a of the proximal leg of the first nail and being configured to reception the The distal end 495a, each second forming pit 490b of the distal side leg of one nail include being configured to receive the second nail The proximal end 493b of the proximal leg and distal end 495b for being configured to the distal side leg that reception second is followed closely, and Each forming pit 490c includes being configured to receive the proximal end 493c of the proximal leg of third nail and being constructed At the distal end 495c for the distal side leg that can receive third nail.

Proximal end 493a, 493b and 493c and distal end 495a, 495b and 495c may include any suitable structure Type.Referring again to Fig. 6, proximal end 493a, 493b and 493c and distal end 495a, 495b and 495c include respectively amplification Cup.It is wider than the groove 497 of restriction therebetween to amplify cup.In some cases, the groove for amplifying cup and extending therebetween may include Such as hourglass shape.When the leg of nail enters such forming pit, leg can enter amplification cup, and when nail leg deforms, Nail leg can be directed in groove 497 by amplification cup.Each amplification cup may include the side wall for being bent and/or being at an angle of, which can It is configured to guide nail leg towards groove 497.In some cases, amplification cup can adjust the orientation of unjustified nail leg.

Nail shapes pit 490a, 490b are nested with 490c.For example, cup is amplified in the distal side of the second forming pit 490b 495b is located among amplification cup 493c, 495c of adjacent third nail shapes pit 490c, and in addition, the second forming pit The nearside amplification cup 493b of 490b is located among amplification cup 493a, 495a of the first adjacent forming pit 490a.In addition, example Such as, the first forming pit 490a nearside amplification cup 493a be located in adjacent second forming pit 490b amplification cup 493b, Among 495b.In addition, for example, the distal side amplification cup 495c of third forming pit 490c is located in adjacent second forming pit 490b Amplification cup 493b, 495b among.The amplification forming cup of each nail cavity can limit rectangle perimeter, and entire forming pit can be positioned In the rectangle perimeter.As above-mentioned nested arrangement as a result, the rectangle perimeter of a nail forming cavity can be with another forming cavity Rectangle perimeter overlapping.For example, the rectangle perimeter of the second forming cavity 490b can with the rectangle perimeter of the first forming cavity 490a and/or The rectangle perimeter of third forming cavity 490c is overlapped.

Referring again to Figure 52 A, nail 280a, 280b and 280c are not overlapped.Other embodiments are contemplated that, wherein nail figure The nail overlapping of at least some of nail in case.Turning now to Figure 32, disclosed in nail pattern include that first row is longitudinally followed closely 580a and second row longitudinally follow closely 580b.As it will be appreciate that, in first row nail 580a in some nail and second row in Follow closely 580b overlappings.Base portion at least one, the second nail 580b extends below the base portion of the first nail 580a.Such In the case of, on the side for the base portion that the second distal side leg 585b for following closely 580b is positioned in the first nail 580a, and the second nail The proximal leg 583b of 580b is positioned on the other side of the base portion of the first nail 580a.Similarly, at least one, The base portion of first nail 580a extends below the base portion of the second nail 580b.In such cases, the distal side leg of the first nail 580a 585a is positioned on the side of the base portion of the second nail 580b, and the proximal leg 583a of the first nail 580a is positioned in second On the other side for following closely the base portion of 580b.As above-mentioned as a result, the first nail 580a and the second nail 580b interweave.

Referring again to Figure 32, nail pattern includes the first nail 580a and second being located on the side of longitudinal tissue's notch Nail 580b, and the first nail 580a and the second nail 580b that are located on the other side of longitudinal tissue's notch.First nail 580a is towards distal side and towards longitudinal tissue's notch orientation, and the second nail 580b is proximally and towards longitudinal tissue's notch orientation.

Referring again to Figure 32, the first nail 580a is along first longitudinal direction axis location, and the second nail 580b is along Two longitudinal axis position.Due to the overlapping between the first nail 580a and the second nail 580b, in some cases, first longitudinal direction axis It can be adjacent with second longitudinal direction axis.In some cases, the overlapping between the first nail and the second nail can make in these staples Angled nail can centreline space having the same every, the centreline space every available traditional longitudinally arranged nail pattern (example Pattern is followed closely as shown in such as Figure 52) it realizes.In some cases, the overlapping between the first nail and the second nail can make these Angled nail in staple can have than the centreline space that traditional longitudinally arranged nail pattern is realized can be used every close center Line interval.In at least one embodiment, first longitudinal direction axis can be with second longitudinal direction axis collinear.

The nail pattern being shown in Figure 32 includes repeat patterns.Repeat patterns include two first nail 580a, are followed by two Second nail 580b is followed by two first nail 580a, is followed by two second nail 580b, and so on.The repeat patterns are along close Side-distal direction is longitudinally extended.First nail 580a has the breach by following closely 580b fillings wherein, and similarly, and second Nail 580b has the breach by following closely 580a fillings wherein.Repeat patterns are present on the side of longitudinal cut, and repeat Pattern is present on the other side of longitudinal cut.These repeat patterns are mutual mirror images.It is contemplated that other repeat patterns.

Be configured to removedly to store and deployment diagram 32 disclosed in the nail bin 530 of nail pattern be shown in Figure 33 In.Nail bin 530 includes first row nail cavity 570a for removedly storing the first nail 580a and for removedly storing The second row nail cavity 570b of second nail 580b.At least some of first nail cavity 570a and the second nail cavity 570b interconnection are can be removed First nail 580a of ground storage overlapping and the second nail 580b.First row nail cavity 570a can arrange along first longitudinal direction axis, and One, which arranges the 2nd nail cavity 570b, to be arranged along second longitudinal direction axis.First longitudinal direction axis and second longitudinal direction axis can depend on the circumstances It is adjacent or conllinear, to dispose nail pattern disclosed herein.First row nail cavity 570a and second row nail cavity 570b are determined Position is on the first side of longitudinal slit 534, and first row nail cavity 570a and second row nail cavity 570b are positioned in longitudinal slit In 534 the second side.Longitudinal slit 534 is configured to receive firing member.Firing member may include cutting element, such as Knife.

The anvil block 520 for being configured to make to have the nail deformation of the nail pattern disclosed in Figure 32 is shown in Figure 34.Anvil The repeat patterns that seat 520 includes forming cavity, the forming cavity include be configured to the leg of the first nail 580a is made to deform the One forming cavity 590a and it is configured to the second forming cavity 590b for making the leg of the second nail 580b deform.First forming cavity 590a and the second forming cavity 590b are arranged with alternating pattern.Alternating pattern include be located on the side of longitudinal slit 524 along The array of the first forming cavity 590a and the second forming cavity 590b of first longitudinal direction axis location, and it is fixed along second longitudinal direction axis The array of the first forming cavity 590a and the second forming cavity 590b of position.Alternating pattern further includes be located in longitudinal slit 524 another Along the array of the first forming cavity 590a and the second forming cavity 590b of first longitudinal direction axis location on side, and along second The array of the first forming cavity 590a and the second forming cavity 590b of longitudinal axis positioning.The array of forming cavity 590a, 590b can phase Mirror image is limited for longitudinal slit 524.Longitudinal slit 524 is configured to receive firing member.Firing member may include cutting Cut element, such as knife.

The nail pattern being shown in Figure 32 includes two nails on every side of longitudinal tissue's notch；However, such Nail pattern may include that more than two rows are followed closely, such as such as three nails.Such third nail can be with the first nail 580a and/or second Nail 580b interweaves.Alternatively, such third nail can not interweave with the first nail 580a or the second nail 580b.Such In embodiment, the first nail 580a and the second nail 580b can interweave, and third nail can be with such as the first nail 580a And/or second nail 580b it is adjacent.

The nail pattern being shown in Figure 35 includes longitudinal row of the first nail 680a, longitudinal row of the second nail 680b and third nail Longitudinal row of 6870c.First nail 680a has the first base widths.Second nail 680b has the second base widths.Third is followed closely 680c has third base widths.The width of base portion can be defined as the first nail leg extended from base portion and extend from base portion The distance between second nail leg, the distance are measured along the base portion extended between the first nail leg and the second nail leg.At least one In the case of kind, base widths are measured between the cross-section center and the cross-section center of the second nail leg of the first nail leg. In any case, the first base widths are shorter than the second base widths；However, it is contemplated that other embodiments, wherein second Base widths are shorter than the first base widths.Third base widths are shorter than the first base widths and the second base widths；However, it is possible to Other embodiments are susceptible to, wherein third base widths are longer than the first base widths and/or the second base widths.

In the embodiment for being shown in Figure 35, the second nail 680b has longest base widths.Therefore, when following closely the nail in pattern When being rotated within the organization by extending longitudinally with tissue, inswept ratio first is followed closely the arc length of 680a biggers by the second nail 680b.It is similar Ground, first follows closely 680a by the inswept arc length for following closely 680c biggers than third.Therefore, in all cases, the first nail 680a will be inswept First arc length, the second nail 680b will inswept second arc length, and third follows closely 680c by inswept third arc length, wherein the first arc length, Second arc length and third arc length are different.Even if the angle of wherein nail 680a, 680b and/or 680c is identical, such arc Length also can be different.In some cases, the first arc length, the second arc length and/or third arc length can be identical.

In the embodiment in being shown in Figure 35, the first nail 680a positions in a manner of being alternately arranged and is arranged in nail bin In 630.The distal end and direction of the nail 680a of farthest side first towards nail bin 630 are limited to the longitudinal slit in nail bin 630 634 are orientated.Next first nail 680a in second longitudinal direction row towards nail bin 630 proximal end and towards longitudinal slit 634 are orientated.Then the pattern repeats in longitudinal row of the first nail 680a.

Second nail 680b is positioned and is arranged in a manner of being alternately arranged in nail bin 630.Farthest side second follows closely 680b directions The distal end and direction of nail bin 630 are limited to the longitudinal slit 634 in nail bin 630 and are orientated.It is next in second longitudinal direction row A second follows closely 680b is orientated towards the proximal end of nail bin 630 and towards longitudinal slit 634.Then the pattern is in the second nail It is repeated in longitudinal row of 680b.

Third nail 680c is positioned and is arranged in a manner of being alternately arranged in nail bin 630.Farthest side third follows closely 680c directions The distal end and direction of nail bin 630 are limited to the longitudinal slit 634 in nail bin 630 and are orientated.It is next in the row of third longitudinal direction A third is followed closely 680c and is orientated towards the proximal end of nail bin 630 and towards longitudinal slit 634.Then the pattern is followed closely in third It is repeated in longitudinal row of 680c.

With further reference to pattern is followed closely shown in Figure 35, longitudinal row of the first nail 380a is nested in longitudinal row of the second nail 380b It is interior.Similarly, longitudinal row of third nail 380c is nested in longitudinal row of the second nail 380b.

Than that described above, nail bin 630 includes being configured to removedly store the multiple of the first nail 680a wherein First nail cavity 670a.Nail bin 630 further includes being configured to removedly store multiple second nail cavities of the second nail 680b 670b, and be configured to removedly store multiple third nail cavity 670c of third nail 680c.Referring to Figure 36, anvil block 620 are configured to make them deform when following closely 680a, 680b and 680c and projecting from nail bin 630.Anvil block 620 includes and nail The nail shapes pit pattern of chamber 670a, 670b and 670c alignment.For example, anvil block 620 include be aligned with the first nail cavity 670a it is more A first forming pit 690a, the multiple second forming pit 690b being aligned with the second nail cavity 670b, and with third nail cavity Multiple third forming pit 690c of 670c alignment.

As described above, nail pattern may include several rows.Nail in often arranging can have same orientation or different orientation.Figure 23 shows Go out the embodiment for including a nail, which has first group of nail 780a being orientated with first direction, and with second direction Second group of nail 780b being orientated.First nail 780a and the second nail 780b are positioned along longitudinal axis.First nail 780a is relative to vertical It is angled to axis, and the second nail 780b is aligned with longitudinal axis.Other arrangements are possible.780a and nail 780b is followed closely to hand over It is arranged for pattern.

With continued reference to Figure 23 and referring again to Figure 24, when tissue is by extending longitudinally, the nail in staple can be within the organization It translates and rotates.In some cases, the translation and/or rotation for following closely within the organization can be generated between nail and tissue hole or Gap.This pores or gap can generate leakage.Even if various nail patterns disclosed herein can be such that such leakage minimizes, but can be right Nail itself carries out certain improvement to reduce and/or eliminate these leakages.

Turning now to Figure 17 and Figure 18, such as follow closely 280a, 280b, 280c, 380a, 380b, 380c, 580a, 580b, The nail of 680a, 680b, 680c, 780a and/or 780b are shown with non-percussion configuration.The non-percussion configuration of the nail is V-arrangement；So And principle discussed in this article can be applied to the nail of any suitable shape.Figure 19 shows Figure 17 and Figure 18 in percussion configuration Nail.The percussion configuration of the nail is B shapes；However, principle discussed in this article can be applied to the nail of any suitable shape.Figure 20 The nail 881 of Figure 17-Figure 19 including coating on it is shown；The nail will be hereinafter referred to as nail 880.Figure 21 shows to be deployed to group The nail 880 knitted and the hole being present between nail 880 and tissue or gap 882.Figure 22 shows to be in expansion shape on nail 880 The coating 881 of state.Entire gap 882 can be filled in expansion coating 881.In some cases, 881 extensible tissue of coating is expanded. In the case that various other, coating 881 can be not filled with entire gap 882.

Nail 880 can be made of any suitable material, such as such as metal.In some cases, nail 880 can be by such as titanium And/or stainless steel is constituted.

Inflatable nail coating 881 can be made of any suitable material.Follow closely coating 881 can by such as Poly-L-lactide and/or Poly- 95L/5D- lactic acid is constituted.Other copolymer compositions of PLA can be used.In all cases, once nail 880 is implanted to In tissue, nail coating 881 can initially form gel, and wherein gel is inflatable to fill or fill at least partly gap 882. In all cases, coating 881 is applied to nail 880 in one or more solution that can be by the way that staple line to be immersed to coating line. It is then immersed in the second solution at least one for example, staple line can be dipped into the first solution to apply base portion coating To apply PLA.In some cases, when nail 880 is positioned in nail bin, coating 881 can be applied to nail 880.Q.Chen Et al. ELASTOMERIC BIOMATERIALS FOR TISSUE ENGINEERING, Progress In Polymer Science (volume 38, the 584-671 pages, 2013) is hereby incorporated by reference.

Nail coating 881 can be made of such as hydrophilic material.Hydrophilic material may include for example with micro- containing RGD peptide sequence Hydrogel derived from the peptide of ball.The metal wire of nail 880 can be coated with such as natural biological copolymer, such as sodium hyaluronate or hyalomitome Acid.Other hydrogels can be used.In all cases, once nail 880 is implanted in tissue, nail coating 881 can start swollen Swollen, floating coat 881 is inflatable to fill or fill at least partly gap 882.It in all cases, can be by the way that staple line be soaked Enter in one or more solution of coating line and coating 881 is applied to nail 880.In at least one, for example, staple line can It is dipped into the first solution to apply base portion coating, is then immersed in the second solution to be loaded with the sodium hyaluronate of peptide.One In the case of a little, when nail 880 is positioned in nail bin, coating 881 can be applied to nail 880.William G.Pitt's et al. ATTACHMENT OF HYALURONAN TO METALLIC SURFACES, J.Biomed.Mater.Res. (the 68A volumes, the 95-106 pages, 2004) complete disclosure be herein incorporated by reference.

Nail coating 881 can be made of such as xerogel.Nail coating 881 can be made of such as gelatine microsphere and/or nanosphere. Gelatin includes the collagen of at least partly denaturation or complete denatured form, and cell can be coupled to the collagen and be dropped by enzymatic catalysis Solution.In all cases, gelatin can be loaded with such as fibroblast and/or platelet derived growth factor.It is dropped in coating 881 Xie Shi, coating 881 can fill at least partly and seal clearance 882 at least partly.In all cases, coating 881 can lead to It crosses following manner and is applied to nail 880：Staple line is immersed in water-in-oil emulsion, then arrives gelatine microsphere and/or nanosphere freeze-drying In staple line.The TGELATIN MICROSPHERES CROSS-LINKED WITH GENIPIN FOR of Luis Solorio et al. LOCAL DELIVERY OF GROWTH FACTORS, J.Tissue Eng.Regen.Med. (volume 4, the 514-523 pages, 2010) complete disclosure be herein incorporated by reference.

Nail 880 is made of the line with circular cross section；However, nail 880 can be by for example all with any suitable cross section As the line of polygonal crosssection is constituted.For some overall width, non-circular cross sections can have than circular cross section bigger Perimeter.The sustainable coating material more a greater amount of than circular cross section of such non-circular cross sections, the circular cross section can make coating Simultaneously packing ratio, which can be expanded, has the hole of nail bigger of circular cross section.In some cases, non-circular cross sections are formed as One or more grooves are generated in circular cross section.Such at least one, such groove can be along nail leg longitudinal direction Extend.In some cases, longitudinal groove can extend along axis.In some cases, longitudinal groove can be looped around nail leg week It encloses.In at least one, such longitudinal groove can in a spiral manner extend around leg.

The nail of nail bin can be disposed with or without the use of such as auxiliary material (such as backing material).In general, Auxiliary material can be placed on the top surface or platform of nail bin so that when nail is projected from nail bin, nail can be caught against tissue Obtain auxiliary material.Figure 55 shows be located on the platform surface 238 of nail bin 230 two pieces of auxiliary materials 239.First block of auxiliary material Material 239 is positioned on the first side of longitudinal slit 234, and second piece of auxiliary material 239 is positioned in longitudinal slit 234 In the second side.It is contemplated that alternative embodiment, wherein monolithic auxiliary material are supported by platform surface 238, the platform table Face extends on the both sides of longitudinal slit 234 and nail bin 230.Referring again to Figure 55, every piece of auxiliary material 239 is substantially rectangle And arranging the first nail cavity 270a including one, one arranging the 2nd nail cavity 270b and one and arrange and prolong above the nail pattern of the 3rd nail cavity 270c It stretches.Nail 280a, 280b and the 280c being separately stored in nail cavity 270a, 270b and 270c penetrate auxiliary when being projected from nail bin 230 Material 239 is helped, and captures a part for auxiliary material 239 at it when following closely 280a, 280b and 280c and being formed by anvil block 220 In.

In addition to or replace being located in auxiliary material on nail bin, auxiliary material can be positioned on anvil block.Penetrate tissue Nail can penetrate anvil block adminicle before contacting anvil block, then penetrate anvil block adminicle again before reentering tissue.

After nail 280a, 280b and 280c are deformed by anvil block 220, than that described above, auxiliary material 239 is against tissue By following closely 280a, 280b and 280c capture.In other words, auxiliary material 239 is planted against tissue by following closely 280a, 280b and 280c Enter.When tissue is by extending longitudinally, as described above, auxiliary material 239 can be with stretching tissue.

Auxiliary material can provide many benefits.Auxiliary material can help to seal the puncturing hole generated by nail leg.In various feelings Under condition, when nail leg passes through tissue, auxiliary material can be pushed in puncturing hole by nail leg.When tissue is by extending longitudinally, auxiliary Material may also aid in the gap for being sealed in and being generated between nail leg and tissue.Auxiliary material can supporting tissue.In all cases, auxiliary It helps material that can reinforce tissue and inhibits nail tearing tissue.

Referring again to Figure 55, it will be appreciate that, the part of dressing material 239 is not by nail 280a, 280b and 280c capture.Example Such as, the part of auxiliary material extended around nail periphery may not be captured by nail.Similarly, being located in for auxiliary material follows closely centre Part may not by nail capture.Such non-capture portion of auxiliary material 239 can not provide above-mentioned sealing benefit, and same When inhibit by it is discussed in this article nail pattern provide ductility.Such non-capture portion also can inhibit the rotation of nail within the organization Turn, as described above.The improvement of the embodiment of Figure 55 is shown in Figure 53, Figure 54, Figure 56 and Figure 57.Such embodiment includes It recessed portion, recess, notch, slit, trepanning and/or is configured to increase any other suitable of the extensibility of auxiliary material Interruption.In addition, such interruption can be conducive to follow closely rotation within the organization.

Referring to Figure 53, auxiliary material 939 includes fan-shaped edge or side 938.Fan-shaped side 938 is therein including being defined in Recessed portion or recess 937.Recess 937 includes curved configuration；However, suitable configuration can be used.Recess 937 reduces around auxiliary The perimeter for the non-capture material that the periphery of material 939 extends and the flexibility and extensibility for increasing auxiliary material 939.

Referring again to Figure 53, auxiliary material 939 further includes being defined in trepanning 936 therein.Trepanning 936 be it is oval, And including through-hole；However, it is contemplated that alternative embodiment.Trepanning 936 is located among adjacent second nail cavity 270b, with And first among nail cavity 270a and third nail cavity 270c；However, it is contemplated that alternative position.Trepanning 936 is reduced in staple line Non- capture material and increase the flexibility and extensibility of auxiliary material 939.

Referring again to Figure 53, the main body of auxiliary material 939 extends above nail cavity 270a, 270b and 270c.It is contemplated that To alternative embodiment, wherein auxiliary material 939 does not extend in nail cavity 270a, 270b and/or 270c.Turning now to figure 54, auxiliary material 939 ' includes slit or opening 935a, 935b and 935c, respectively on the tops nail cavity 270a, 270b and 270c Ground is divided to extend.935a, 935b and 935c ratio trepanning 936 that is open is big；However, opening 935a, 935b and/or 935c can be with trepannings 936 sizes are identical and/or bigger than trepanning 936.

Referring to Figure 56, auxiliary material 1039 includes notch edge or side 1038.Recess side 1038 includes being defined in it In recessed portion or recess 1037.Recess 1037 includes the configuration being at an angle of；However, suitable configuration can be used.Recess 1037 Reduce the perimeter of the non-capture material extended around auxiliary material 1039 and increases the flexibility and extensibility of auxiliary material 1039.

Referring again to Figure 56, auxiliary material 1039 further includes being defined in slit 1036 therein.Slit 1036 is ellipse , and include through-hole；However, it is contemplated that alternative embodiment.Auxiliary material 1039 includes first row slit 1036a With second row slit 1036b.Slit 1036a is located at adjacent second and follows closely the centres 1080b and the first nail 1080a and third nail Among 1080c；However, it is contemplated that alternative position.Slit 1036b is located at the adjacent third centres nail 1080c and second It follows closely among the nails of 1080b and the 4th 1080d；However, it is contemplated that alternative position.Slit 1036a is parallel to the first nail 1080a 1080c is followed closely with third, and similarly, slit 1036b is parallel to the nails of the second nail 1080b and the 4th 1080d；However, slit can With any suitable direction.Slit 1036a and 1036b reduce the non-capture material in staple line and increase auxiliary material 1039 Flexibility and extensibility.Slit 1036a and 1036b are shorter than the base portion for following closely 1080a, 1080b, 1080c and 1080d；However, it is possible to It is susceptible to such embodiment, the base of wherein slit 1036a and/or 1036b and nail 1080a, 1080b, 1080c and 1080d Minister's degree is identical and/or is longer than the base portion.

Referring to Figure 57, auxiliary material 1139 includes notch edge or side 1138.Recess side 1138 includes being defined in it In recessed portion or recess 1137.Recess 1137 includes curved configuration；However, suitable configuration can be used.Recess 1137 reduces The perimeter of the non-capture material extended around auxiliary material 1139 and the flexibility and extensibility for increasing auxiliary material 1139.

Referring again to Figure 57, auxiliary material 1139 further includes being defined in slit 1136 therein.Slit 1136 is ellipse , and include through-hole；However, it is contemplated that alternative embodiment.Auxiliary material 1139 includes first row slit 1136a With second row slit 1136b.Slit 1136a is located at adjacent second and follows closely the centres 1180b and the first nail 1180a and third nail Among 1180c；However, it is contemplated that alternative position.Slit 1136b is located at the adjacent third centres nail 1180c and second It follows closely among the nails of 1180b and the 4th 1180d；However, it is contemplated that alternative position.Slit 1136a is parallel to the first nail 1180a 1180c is followed closely with third, and similarly, slit 1136b is parallel to the nails of the second nail 1180b and the 4th 1180d；However, slit can With any suitable direction.Slit 1136a and 1136b reduce the non-capture material in staple line and increase auxiliary material 1139 Flexibility and extensibility.Slit 1136a and 1136b are shorter than the base portion for following closely 1180a, 1180b, 1180c and 1180d；However, it is possible to It is susceptible to such embodiment, the base of wherein slit 1136a and/or 1136b and nail 1180a, 1180b, 1180c and 1180d Minister's degree is identical and/or is longer than the base portion.

As described herein, firing member and/or wedge-shaped slides can traverse nail bin with percussion nail and/or will follow closely from limit The fixed nail cavity in nail bin projects.For example, firing member and/or wedge-shaped slides can be translated along the percussion path in nail bin, And firing member and/or wedge-shaped slides can engage staple drivers and/or nail itself to be driven from nail cavity along percussion path Nail.In addition as described herein, the nail arrangement for the nail including being angularly orientated can provide various benefits and advantage.For example, angulation The array for the nail that degree ground is orientated can provide increased flexible and/or longitudinal stretchability in the tissue of suture.

When nail is angularly orientated relative to percussion path, at least part of staple drivers and/or nail can not with hit It sends out path overlap and/or is covered in percussion path.For example, the base portion for the nail being angularly orientated may extend across percussion road Diameter so that nail leg is positioned on the opposite side of percussion path.In addition, the staple drivers being angularly orientated can traverse percussion road Diameter, and the end of staple drivers can be positioned on the opposite side of percussion path.In other cases, it only follows closely and/or follows closely The end of driver can be covered in percussion path, and in other situations, and nail and/or staple drivers can be completely from for example Percussion path biases.

At least part of nail and/or staple drivers is from the case that percussion path biases wherein, percussion path with it is fixed Moment arm between the part of nail and/or staple drivers of the position on the either side of percussion path can drive in nail and/or in nail Torque is generated in dynamic device.Torque can influence the inclination of nail and/or tumble during deployment.Therefore, the nail leg for reversing nail can not be with Equivalent power and/or speed engagement tissue and/or nail leg are pierced through when can be different and/or capture tissue.Because in the deployment phase Between the torsion followed closely and/or rotation may negatively affect tissue penetration and/or nail forming, so in all cases, the possible phase The torque for preventing and/or minimizing during the deployment for the nail being angularly orientated is hoped to generate.

When staple drivers are angled relative to the percussion path of wedge-shaped slides, one of the driver being only at an angle of Driving or lifting force can be received from wedge-shaped slides by dividing.For example, driving force can be applied to angled drive along diagonal path Dynamic device.In order to stablize angled driver and prevent the torsion of driver and/or rotation and be therefore supported on The torsion and/or rotation of nail, wedge-shaped slides may include multiple driving wedge pieces, and at least two driving wedge pieces are accessible Driver is to apply driving force at multiple positions on a drive.For example, the driving wedge piece of a pair of of lateral spacing can connect Merge and promote angled driver so that driving force being spaced apart with lateral spacing along the length of driver.In addition, In the case of at least one, the driving wedge piece of lateral spacing can be equidistant with the barycenter of angled driver so that driver phase For multiple driving wedge piece mass balances.

In addition to this or alternatively, in order to stablize angled driver and prevent the torsion and/or rotation of driver And the torsion and/or rotation for the angled nail being therefore supported on, multiple drivers can connect and/or connect together. Under some cases, angled more staple drivers may be integrally formed.The driver of connection and/or more staple drivers can support multiple Nail, this can reduce the quantity of the moving parts in nail bin, and can prevent the nail of each interconnection and/or integrally formed nail holder Relative movement between support surface.In addition, angled more staple drivers can be more than (be wider than and/or be longer than) singly nail driving Device.Therefore, more staple drivers can have increased aspect ratio.For example, more staple drivers can have 1:1 aspect ratio.Certain In the case of, aspect ratio can be 3:2 or 2:1.In other situations, aspect ratio can be, for example, less than 1:1 or be more than 2:1.Bigger is vertical More staple drivers of horizontal ratio can provide the stability of bigger to the nail being supported on.

In all cases, the engageable angled more staple drivers of wedge piece are individually driven, and in some cases, The driving force applied on a drive by driving wedge piece can be balanced relative to the barycenter of driver.In other cases, multiple Drive the engageable angled more staple drivers of wedge piece, angled more staple drivers that can laterally distribute drive on a drive Power.In all cases, the driving of the accumulation on angled more staple drivers is applied to by the driving wedge piece of lateral spacing Power can be balanced relative to the barycenter of driver.

In other cases, for the torsion stablizing the angled nail in nail bin and prevent it during deployment and/or Rotation, nail can be fired in the case of no driver.For example, wedge-shaped slides may include following closely engagement surface, which closes Surface directly engages the sliding part engagement surface without the nail in driver nail bin.Wedge-shaped slides can be along the base portion of nail multiple Each nail is contacted at the position of lateral spacing.For example, wedge-shaped slides may include multiple driving wedge pieces, and at least two drive The dynamic accessible angled nail of wedge piece at multiple positions to apply driving force.In all cases, the drive of a pair of of lateral spacing Dynamic wedge piece is engageable and promotes angled nail so that driving force is uniform with the interval of lateral spacing along the length of the base portion of nail Distribution.In addition, at least one, the driving wedge piece of lateral spacing can be equidistant with the barycenter of angled nail so that nail Relative to driving wedge piece mass balance.

End effector assembly 2000 has disclosed in the figure 7.As shown, end effector assembly 2000 includes first Jaw 2002, the second jaw 2004, closed tube or frame 2006 and end effector connector 2009.It holds end Row device assembly 2000 can move between first or open position and second or closed position.As shown, the first jaw 2002 include pivot pin 2008, the pivot pin movably positioning in the closure slit 2010 of the second jaw 2004.For example, pivot Pivot pin 2008 is configured in the first jaw 2002 relative to the second jaw 2004 and relative to shown end effector The frame 2006 of component 2000 is pivoted and is translated in the closure slit 2010 of the second jaw 2004 when pivoting.

In other cases, the first jaw 2002 can be fixed relative to frame 2006, and the second jaw 2004 can be opposite The jaw 2002,2004 of end effector assembly 2000 is pivoted to open and is closed in the first jaw 2002.In other cases, Jaw 2002,2004 all pivotably and/or is in other ways moved to open and/or be closed end effector assembly 2000 Jaw 2002,2004.For example, jaw 2002, at least one of 2004 can be relative to another jaw 2002,2004 simultaneously And/or person rotates relative to frame 2006, rotation, slides and/or translates to open and/or be closed end effector assembly 2000 Jaw 2002,2004.

Referring still to Fig. 7, end effector assembly 2000 is sized and configured to reception nail bin 2020, the nail bin It is configured for being removably positioned in end effector assembly 2000.For example, shown nail bin 2020 can be to be intended for single use And/or disposable storehouse, the storehouse can replaced after its percussion nail 2012 with another nail bin.Nail bin 2020 disclosed in Fig. 7 Including platform 2026, warehouse 2024 and shell 2022, warehouse 2024 is surrounded or encapsulated to the housing parts.Shown nail bin 2020 is also Including nail 2012, which is located in warehouse 2024 in which can project.Nail 2012 disclosed in Fig. 7 is followed closely for substantially " v-shaped ", nail tool There is the leg of non-parallel extension.

In all cases, nail bin (such as nail bin 2020) for example can be integrally formed simultaneously with end effector assembly 2000 And/or person can be permanently attached in a jaw in such as jaw 2002,2004.In such cases, end effector Component 2000 can be single use and/or disposable end actuator.In other cases, it is fixed to end effector assembly 2000 nail bin can reload additional nail for for example follow-up percussion.

Referring again to nail bin 2020 disclosed in Fig. 7, longitudinal slit 2032 is defined as at least partially through warehouse 2024.Shown longitudinal slit 2032 extends along longitudinal axis L, proximal end 2023 He of the longitudinal axis L in warehouse 2024 Extend between distal end 2025.Longitudinal slit 2032 shown in Figure 7 proximally is prolonged towards distal end 2025 by end 2023 Stretch and traverse a part for the length of warehouse 2024.

In some cases, longitudinal slit 2032 can traverse the whole length of warehouse 2024.In other cases, longitudinal narrow Slot 2032 can for example extend from 2023 proximally facing end 2025 of distal end.In other situations, warehouse 2024 can not wrap Include predetermined and/or preformed longitudinal slit.For example, firing member and/or cutting element can it is crosscutting during firing schedule and/ Or cutting warehouse 2024 to form slit wherein.

Nail bin 2020 disclosed in Fig. 7 is configured to the array 2011 for following closely 2012 being fired into tissue.It is shown in Fig. 7 In nail array 2011 include angled nail 2012, the angled nail is relative to longitudinal axis L and relative to driving wedge piece The percussion path of 2064a, 2064b are angled, and the driving wedge piece is described further herein.Nail bin disclosed in Fig. 7 2020 also including more staple drivers 2040a, 2040b drivingly to support the angled nail 2012 in array 2011, more nails Driver is described further herein.

Angled nail 2012 is removably positioned in angled nail cavity 2028, which is limited in Fig. 7 In disclosed warehouse 2024.For example, shown nail cavity 2028 is angularly orientated relative to longitudinal axis L.Nail cavity 2028 it is shown Arrangement corresponds to the shown nail array 2011 being located in nail bin 2020.Each nail cavity 2028 shown in Figure 7 includes platform Opening 2030 in 2026, and 2030 are each open including proximal end, distal end and in proximal end and distal end portion The nail axis extended between portion.The nail axis of opening 2030 is relative to the longitudinal axis L deflection of warehouse 2024 and/or angled. For example, in the nail bin 2020 of Fig. 7, it is limited to all nail cavities 2028 in warehouse 2024 relative to longitudinal axis L angularly It is orientated, and various nail cavities 2028 are angularly orientated relative to other nail cavities 2028.

Nail cavity 2028 disclosed in Fig. 7 is arranged in rows on every side of longitudinal slit 2032.For example, nail cavity 2028 A part is arranged on the first side 2027 of longitudinal slit 2032 in first inboard row 2033, the first outboard row 2035 and first Between in row 2037, and another part of nail cavity 2028 is arranged in the second inboard row in the second side 2029 of longitudinal slit 2032 2034, in the second outboard row 2038 and the second intermediate row 2036.In nail bin 2020 shown in Figure 7, nail cavity 2028 and its row 2033,2034,2035,2036,2037,2038 be symmetrical relative to longitudinal slit 2032.

Although shown nail cavity 2028 does not intersect or is in contact with each other in other ways, longitudinal row 2033 of nail cavity 2028, 2034,2035,2036,2037,2038 overlapping.For example, various nail cavities 2028 shown in Figure 7 are in laterally outside and/or in side The nail cavity 2028 in the nail cavity 2028 of adjacent row is extended past inwardly.In addition, nail cavities 2028 shown in various are proximally and/or court Distal side extends past the nail cavity 2028 in the nail cavity 2028 of adjacent row.Because nail 2012 is arranged in overlapping arrays 2011, Bleeding in controllable suture tissue and/or fluid flowing.The overlapping arrays of nail for example may be incorporated into herein (such as nail array 2011) In disclosed other nail bins and/or end effector assembly.

In other cases, the either side of longitudinal slit 2032 can be positioned in more or less than the nail cavity 2028 of three rows 2027, on 2029.In some cases, a side in the side 2027,2029 of nail bin 2020 may include and another side Face 2027,2029 different numbers nail cavity 2028 row.In some cases, nail cavity 2028 can not be with the nail cavity in adjacent row 2028 longitudinal directions and/or lateral overlap.In addition to this or alternatively, in some cases, nail cavity 2028 and/or its row can be relative to Longitudinal slit 2032 and/or longitudinal axis L are asymmetric.

Referring still to Fig. 7, the shown nail cavity 2028 in arranging longitudinally in each is parallel or substantially parallel.For example, such as institute's public affairs in Fig. 7 It opens, the nail cavity 2028 in the first inboard row 2033 is parallel to each other, and the nail cavity 2028 in the first outboard row 2035 is parallel to each other, and first Nail cavity 2028 in intermediate row 2037 is parallel to each other, and the nail cavity 2028 in the second inboard row 2034 is parallel to each other, the second outboard row Nail cavity 2028 in 2036 is parallel to each other, and the nail cavity 2028 in the second intermediate row 2038 is parallel to each other.

In addition as disclosed in Fig. 7, the nail cavity 2028 in arranging longitudinally in each is relative to the nail cavity 2028 in adjacent longitudinal row Angularly it is orientated.For example, on the first side 2027 of shown warehouse 2024, the nail cavity 2028 in the first intermediate row 2037 is opposite The nail cavity 2028 arranged in 2033 and outside first in row 2035 in first is angularly orientated.In addition, in shown warehouse 2024 The second side 2029 on, nail cavity 2028 in the second intermediate row 2038 is relative in row 2036 outside row 2034 and second in second Nail cavity 2028 be angularly orientated.

In other cases, longitudinally in each row 2033,2034,2035,2036,2037,2038 in nail cavity 2028 only A part can it is parallel to each other and/or all or fewer than longitudinal row 2033,2034,2035,2036,2037,2038 may include Nail cavity 2028 parallel to each other.In addition to this or alternatively, in some cases, at least part of nail cavity 2028 can take at random To.In some cases, at least one of nail cavity 2028 in longitudinal row 2033,2034,2035,2036,2037,2038 nail Chamber can be parallel at least one of the nail cavity 2028 in adjacent longitudinal row 2033,2034,2035,2036,2037,2038 nail Chamber.In some cases, nail bin 2020 may include at least one nail cavity 2028 and/or be parallel to the longitudinal axis L of warehouse 2024 An at least nail chamber.See, for example, Figure 10.

Nail bin 2020 disclosed in Fig. 7 includes driver 2040a, 2040b, and the structure snd size of the driver are designed It is interior in warehouse 2024 (Fig. 7) at movably coordinating.Include the first driver referring to Fig. 7-Fig. 9, driver 2040a, 2040b 2040a (Fig. 8-Fig. 8 B) and the second driver 2040b (Fig. 8 C- Fig. 9).First driver 2040a and the second driver 2040b quilts It is individually configured to that multiple nails 2012 can be supported.As shown in figs. 7 to 9, mostly the first driver 2040a of nail has the first geometric form Shape, and follow closely the second driver 2040b with the second geometry more.The geometry pair of more staple drivers 2040a, 2040b It should be in the array 2011 for following closely 2012 and corresponding to the arrangement for the nail cavity 2028 for being shown in Fig. 7.

As described herein, the arrangement of nail 2012 and nail cavity 2028 on the first side 2027 of longitudinal slit 2032 is nail 2012 With the mirror image of arrangement of the nail cavity 2028 in the second side 2029 of longitudinal slit 2032.In addition, the geometry of the first driver 2040a Shape is the mirror image of the geometry of the second driver 2040b.As shown in fig. 7, the first driver 2040a be positioned in it is longitudinal narrow On first side 2027 of slot 2032, and the second driver 2040b is positioned in the second side 2029 of longitudinal slit 2032.

In some cases, the driver on the side of warehouse may not be the mirror of the driver on the other side of warehouse Picture.In addition, the 2040a of staple drivers more than first and/or the 2040b of staple drivers more than second can be positioned in longitudinal slit 2032 not On homonymy and/or both sides 2027,2029.For example, more staple drivers with different geometries can be positioned in longitudinal slit On 2032 same side.In other situations, nail bin 2020 may include thering is the more of three or more different geometries Staple drivers.For example, special and/or different staple drivers can correspond to specific nail and/or the nail of specific group.Alternatively, Under some cases, all more staple drivers in nail bin 2020 can have same geometry.

The 2040a of staple drivers more than first disclosed in Fig. 7-Fig. 9 and 2040b of staple drivers more than second includes multiple slots or nail Supporting support 2042.In addition, driver 2040a, 2040b shown in each are configured to drive multiple nails 2012.For example, the One driver 2040a (Fig. 8-Fig. 8 B) includes first support 2042a, second support 2042b and third holder 2042c, the branch Frame is respective to be sized and configured to one nail 2012 of support.For example, the base portion 2014 (Fig. 8 B) of nail 2012 is positioned in In each holder 2042a, 2042b, 2042c of first driver 2040a.In addition, referring primarily to Fig. 8 C- Fig. 9, the second driver 2040b further includes first support 2042a, second support 2042b and third holder 2042c, the respective size of the holder and knot Structure is designed to support a nail 2012.For example, the base portion 2014 (Fig. 9) of nail 2012 is positioned in the second driver 2040a's In each holder 2042a, 2042b, 2042c.

As disclosed in Fig. 7, the first driver 2040a is right driver, which is positioned in nail bin 2020 right side or the first side 2027.The first support 2042a (Fig. 8-Fig. 8 B) of each first driver 2040a is adapted to The nail 2012 arranged in 2035 outside enough first with nail cavity 2028 is aligned, the second support 2042b of each first driver 2040a (Fig. 8-Fig. 8 B) is configured to the nail 2012 in the first intermediate row 2037 with nail cavity 2028 and is aligned, and each first drives The third holder 2042c (Fig. 8-Fig. 8 B) of dynamic device 2040a is configured to the nail in the first interior row 2033 with nail cavity 2028 2012 alignment.

As disclosed in Fig. 7 further, the second driver 2040b is left side drive, which is positioned in The left side of nail bin 2020 or the second side 2029.For example, the first support 2042a (Fig. 8 C- Fig. 9) of each second driver 2040b It is configured to be aligned with the nail 2012 in row 2036 outside the second of nail cavity 2028, the second of each second driver 2040b Holder 2042b (Fig. 8 C- Fig. 9) is configured to the nail 2012 in the second intermediate row 2038 with nail cavity 2028 and is aligned, and The third holder 2042c (Fig. 8 C- Fig. 9) of each second driver 2040b is configured to the second interior row with nail cavity 2028 Nail 2012 in 2034 is aligned.

Each holder 2042a, 2042b, 2042c disclosed in Fig. 8-Fig. 9 are limited to the first driver 2040a or second In the step or platform 2045 of driver 2040b.For example, shown first driver 2040a and shown second driver 2040b packets Platform 2045 is included, and holder 2042a, 2042b, 2042c are limited in each platform in platform 2045.Driver Platform 2045 disclosed in Fig. 8-Fig. 9 of 2040a, 2040b is identical height or elevation, and is configured to array 2011 Each of nail 2012 be maintained at identical height or elevation relative to other nails 2012 in array 2011.Referring still to Fig. 8-figure 9, flange connector 2048 is also disclosed, which extends between the step 2045 of each driver 2040a, 2040b.Even Relative movement between step 2045 can be limited and/or constrain by connecing flange 2048.

In other cases, step or platform 2045 can have different height and/or elevation.For example, each step 2045 Height can be varied to control the forming height of nail 2012, to control the compression of tissue of the capture in forming nail 2012. In addition to this or alternatively, the depth of each holder 2042a, 2042b, 2042c can be varied to control the height of forming nail 2012 Degree, to control the compression of tissue of the capture in forming nail 2012.

By the first driver 2040a and the second driver 2040b and its holder 2042a, 2042b, 2042c with nail bin The arrangement that the arrangement of nail cavity 2028 and nail array 2011 in 2020 is complementary is orientated.As disclosed in Fig. 8 A and Fig. 8 D, Mei Gezhi Frame 2042a, 2042b, 2042c include first end 2044 and the second end 2046, and each holder 2042a, 2042b, The first end 2044 of 2042c is in the distal side of the second end 2046 of same supports 2042a, 2042b, 2042c.In addition, axis Be limited at each holder 2042a, 2042b, 2042 first end 2044 and the second end 2046 between.For example, first axle Line A_aIt is limited by first support 2042a, second axis A_bIt is limited by second support 2042b, and third axis A_cBy third holder 2042c is limited.

In shown arrangement, first axle A_aOrientation be configured to match or correspond to by first support 2042a The orientation of the angled nail 2012 of support, second axis A_bOrientation be configured to match or correspond to by second support The orientation of the angled nail 2012 of 2042b supports, and the orientation of third axis Ac be configured to match or correspond to by The orientation of the angled nail 2012 of third holder 2042c supports.

As disclosed in Fig. 8 A and Fig. 8 D, first axle A_aParallel or substantially parallel to third axis A_c.In addition, being shown in figure Second axis A in 8A and Fig. 8 D_bTraverse first axle A simultaneously_aWith third axis A_c.For example, such as institute's public affairs in Fig. 8 A and Fig. 8 D It opens, second axis A_bIt is vertical or be approximately perpendicular to first axle A_aWith third axis A_c。

In the nail bin that driver 2040a, 2040b are used to have a case that the different arrangements of nail 2012 and nail cavity 2028 Under, the relative orientation of holder 2042a, 2042b, 2042c can be different.In some arrangements, for example, all axis A_a、A_b、A_cIt can It is parallel.In other arrangement, for example, all axis A_a、A_b、A_cIt can intersect.In some cases, an axis A_a、A_b、 A_cIt can be perpendicular at least another axis A_a、A_b、A_c.In addition to this or alternatively, in some cases, an axis A_a、A_b、A_c At least another axis A can be parallel to_a、A_b、A_c。

Referring primarily to Fig. 8-Fig. 8 C, part that the first driver 2040a and the second driver 2040b are formed as one.Example Such as, each driver 2040a, 2040b are made of integrally formed component.In other cases, at least one step 2045 and/ Or flange connector 2048 can be separately formed.In such cases, multiple parts can for example be glued, weld and/or with other Mode is adhered to each other, to form integral piece.

More staple drivers 2040a, 2040b disclosed in Fig. 7-Fig. 9 are configured to will be from the nail of nail cavity 2028 2012 are driven across multiple longitudinal rows 2033,2034,2035,2036,2037,2039.In nail bin 2020 shown in Figure 7, Nail 2012 is disposed on every side of slit 2032 in three longitudinal rows, and driver 2040a, 2040b are configured to Nail 2012 in each of capable of supporting and drive three longitudinal rows.For example, the first driver 2040a shown in each is constructed It is located in the first interior nail 2012 arranged in 2033, the nail 2012, Yi Jiding being located in the first intermediate row 2037 at that can drive Nail 2012 of the position outside the first of nail cavity 2028 in row 2035.In addition, the second driver 2040b shown in each is configured to Driving is located in the nail 2012 in row 2034, the nail 2012 being located in the second intermediate row 2038 in second, and is located in nail The nail 2012 in 2036 is arranged outside the second of chamber 2028.

In other cases, nail 2012 can be disposed on every side of slit 2032 more than three it is longitudinal arrange or less than In three longitudinal rows, and driver 2040a, 2040b are configured to engage longitudinal direction on every side of slit 2032 Nail 2012 in each of row row.For example, nail bin 2020 can have two rows of nail cavities 2028 on the either side of longitudinal axis L, And the more staple drivers being positioned in may include that two holders, the holder are configured to every in support two rows Nail in row.In some cases, more staple drivers can fire multiple nails 2012 from the nail cavity 2028 of identical row.For example, more nails Driver can fire the adjacent nail 2012 in identical row, such as such as closer to side nail 2012 and farther side nail 2012.In certain feelings Under condition, more staple drivers can not engage the nail 2012 in each row on the side of longitudinal slit 2032.For example, individually and different The engageable row of driver (such as such as outermost row and/or most interior row) in one row in nail.In addition to this or alternatively, In some cases, nail bin 2020 may include at least one more staple drivers and at least one single staple drivers.See, for example, figure 12。

End effector assembly 2000 disclosed in Fig. 7 further includes firing member 2060, which is adapted to It is enough to be moved relative to warehouse 2024.During firing schedule, firing member 2060 is configured to traverse warehouse 2024, and Sliding part 2058 is drivingly engaged so that sliding part 2058 is moved through warehouse 2024.For example, the one of shown firing member 2060 Partial size and position is designed to cooperation in longitudinal slit 2032.As disclosed in Fig. 7, firing member 2060 by structure It includes cutting edge 2061 to cause to coordinate the part in longitudinal slit 2032, which is configured to incision clamping Tissue between the first jaw 2002 and the second jaw 2004 of end effector assembly 2000.

Wedge-shaped slides 2058 disclosed in Fig. 7 are configured to engagement driver 2040a, 2040b to promote driving Device 2040a, 2040b, to which the nail 2012 being supported on to be fired into tissue.In shown end effector assembly 2000 In, the intermediate wedge part 2062 of sliding part 2058 can be slided in longitudinal slit 2032 and/or translation, and is limited to sliding part The driving wedge piece or driving guide rail 2064a, 2064b engageable staple drivers 2040a, 2040b of lateral register on 2058.Example Such as, sliding part 2058 shown in Figure 7 includes driving wedge piece or guide rail 2064a, 2064b, is configured to firing Along percussion path F during stroke₁(Fig. 8 A) and F₂(Fig. 8 D) is mobile to contact and percussion path F₁、F₂Longitudinally-aligned more nails First driver 2040a and the second driver 2040b.

As disclosed in Fig. 7, sliding part 2058 include on the either side of central part 2062 driving wedge piece 2064a, 2064b.Driving wedge piece 2064a on first side 2027 of nail bin 2020 is configured to along the first percussion path F₁ (Fig. 8 A) is mobile, and the driving wedge piece 2064b in the second side 2029 of nail bin 2020 is configured to hit along second Send out path F₂(Fig. 8 D) is mobile.

Each driven disclosed in Fig. 7 wedge piece 2064a, 2064b be configured to engage more staple drivers 2040a, Staple drivers more than one in 2040b are to promote driver 2040a, 2040b in nail cavity 2028 and be projected from warehouse 2024 Nail 2012.In shown arrangement, three steps 2045 of each first driver 2040a are held stationary relative to each other, and Three steps 2045 of each second driver 2040b are held stationary relative to each other.In other words, single driver 2040a, The step 2045 of 2040b is not moved relative to each other and/or rotates.Because of the step 2045 of single driver 2040a, 2040b It is not moved relative to each other and/or rotates, so constraining by the phase of each driver 2040a, 2040b nail 2012 supported yet To movement.In addition, each driver 2040a, 2040b have larger base portion or occupied area in warehouse 2042, this can be into One step reduces the rotation and/or torsion of driver 2040a, 2040b.Therefore, displacement and/or inclination of the nail 2012 during deployment It can be prevented, be minimized and/or be controlled by more staple drivers 2040a, 2040b.More staple drivers such as driver 2040a, 2040b Such as it may be incorporated into other nail bins disclosed herein and/or end effector assembly.

In all cases, size, structure and the position of driving wedge piece 2064a, 2064b of sliding part 2058 can be set Count into the driving surface of engagement driver 2040a, 2040b respectively.For example, driver 2040a, 2040b may include ramped surfaces And/or track, it is configured to guide respectively when firing member 2060 and sliding part 2058 move through nail bin 2020 And/or receive a part of driving wedge piece 2064a, 2064b.

Staggered relatively and driving wedge piece of driving wedge piece 2064a, 2064b arrive driver 2040a, 2040b respectively Can be selected as with correspondence percussion path F1, F2 of the nail 2012 supported by driver 2040a, 2040b prevent, reduce and/or Control the torsion of driver 2040a, 2040b and/or nail 2012 during percussion.For example, the geometry of driver 2040a, 2040b Shape and/or material, which can be selected as, is respectively placed to the barycenter (COM) of each driver 2040a, 2040b and corresponding percussion Path F1, F2 alignment.In addition to this or alternatively, drive wedge piece 2064a, 2064b and therefore percussion path F1, F2 can divide It is not positioned in storehouse 2020 to extend respectively through the barycenter (COM) of driver 2040a, 2040b.

In other cases, as further described herein, sliding part 2058 can on every side of middle section 2062 Including more than one driving wedge piece 2064a, 2064b.For example, multiple driving wedge piece 2064a, 2064b move through storehouse The either side 2027,2029 of body 2024.In addition to this or alternatively, the driving wedge piece 2064a of wedge-shaped slides 2058, 2064b is configured to directly engage and drives nail 2012, as further described herein.

Referring primarily to Fig. 8 A and Fig. 8 D, the first driver 2040a and the second driver 2040b are respectively overlay in driving wedge shape The percussion path F of part 2064a, 2064b₁、F₂On.For example, the first driver 2040a is covered on the first percussion path F1, and Second driver 2040b is covered on the second percussion path F2.In addition, the various pieces quilt of each driver 2040a, 2040b It is located on the either side of respective drive wedge piece 2064a, 2064b, and is therefore located in the either side of percussion path F1, F2 On.Referring still to Fig. 8 A and Fig. 8 D, shown driver 2040a, 2040b's is sized and configured to so that each driver The barycenter (COM) of 2040a, 2040b respectively with the corresponding percussion path F of such as driving wedge piece 2064a, 2064b₁、F₂Overlapping. In other words, each shown driver 2040a, 2040b are relative to corresponding percussion path F1, F2 mass balance.

For example, as disclosed in Fig. 8 A, the first part 2047 of the first driver 2040a is positioned in percussion path F₁'s On first side, and the second part 2049 of the first driver 2040a is positioned in percussion path F₁The second side on.First drives The first part 2047 of dynamic device 2040a has the first mass m1, and the second part 2049 of the first driver 2040a has etc. In or be substantially equal to the quality m2 of the first mass m1.In addition, as disclosed in Fig. 8 D, first of the second driver 2040b 2047 are divided to be positioned in percussion path F₂The first side on, and the second part 2049 of the second driver 2040b is positioned in Percussion path F₂The second side on.The first part 2047 of second driver 2040b has the first mass m1, and the second driving The second part 2049 of device 2040b has the quality m2 for being equal or substantially equal to the first mass m1.Because driver 2040a, 2040b is relative to corresponding percussion path F1, F2 mass balance, so driver 2040a, 2040b and the nail being supported on 2012 torsion during percussion can be minimized and/or control in other ways.In addition, by each driver 2040a, The group of the nail 2012 of 2040b deployment can synchronously be promoted relative to warehouse 2024, and driven or be fired into tissue simultaneously.Quality The driver (such as driver 2040a, 2040b) of balance for example may be incorporated into other embodiments disclosed herein.

In addition, as disclosed in Fig. 8-Fig. 9, at least one notch 2050 be limited to the 2040a of staple drivers more than first and In the 2040b of staple drivers more than second.For example, each notch 2050 is limited to the flange connector of driver 2040a, 2040b In 2048.The size of notch 2050 and position are designed to the quality of adjust drivers 2040a, 2040b, and relative to percussion Path F1, F2 balance the barycenter (COM) of each driver 2040a, 2040b.In addition, the size of notch 2050 and position are designed At the geometry for adapting to nail cavity 2028, wherein driver 2040a, 2040b is movably positioned.

In some cases, multiple nail cavities can be limited in nail bin, and at least one nail cavity can be parallel to the longitudinal direction of nail bin Axis, and at least one nail cavity can be angularly orientated relative to the longitudinal axis of nail bin.Nail bin shown in Figure 10 2120, for example, multiple nail cavities 2128 are limited in nail bin 2120, and multiple nail cavities 2128 are parallel to the longitudinal direction of nail bin 2120 Axis L.

In shown nail bin 2120, longitudinal slit 2032 is limited partially across warehouse 2124.In addition it is limited to warehouse In 2124 is the nail chamber 2128 on the either side of longitudinal slit 2032 comprising is parallel to longitudinal axis L orientation Nail cavity 2128.In shown nail bin 2120, the first row 2137 of nail cavity 2128 and the second row 2138 of nail cavity 2128 and longitudinal narrow Slot 2032 is adjacent, and the nail cavity 2128 in first row 2137 and in second row 2138 is parallel to longitudinal axis L orientation. For example, as disclosed in Figure 10, nail cavity 2128 in first row 2137 and the axis A for being parallel to longitudinal axis L_bAlignment.

Nail bin 2120 disclosed in Figure 10 includes the additional row of nail cavity 2128.For example, shown nail bin 2120 includes nail cavity 2128 third row 2135 and the 4th row 2136 of nail cavity 2128 comprising the nail being angularly orientated relative to longitudinal axis L Chamber 2128.In such cases, third row 2135 and the 4th nail cavity 2128 in row 2136 are also relative to first row 2137 and the Nail cavity 2128 in two rows 2138 is angularly orientated, and also relative to being orientated angularly in relation to one another.For example, third row 2135 In nail cavity 2128 and axis A_aAlignment, axis A_aIt traverses longitudinal axis L and traverses the axis of the first row 2137 of nail cavity 2128 Line A_b.As disclosed in Figure 10 further, the nail cavity 2128 in the 4th row 2136 is along the nail cavity traversed in third row 2135 2128 axis A_aAxis extend.First row 2137 and the third row 2135 of nail cavity 2128 is positioned in shown warehouse 2124 On first side 2127, and second row 2136 and the 4th row 2138 are positioned in the second side 2129 of shown warehouse 2124.

In all cases, nail bin 2120 disclosed in Figure 10 can be with end effector assembly 2,000 1 shown in Fig. 7 It rises and uses.For example, nail bin 2120 can be loaded into the elongated passageway of the second jaw 2004 of end effector assembly 2000.Nail Storehouse 2120 can be fired with single staple drivers, more staple drivers and/or combination thereof.For example, more staple drivers can be constructed At can on the first side 2127 of warehouse 2124 from first row 2137 and third row 2135 in 2128 percussion nail of nail cavity, and Another more staple drivers is configured in the second side 2129 of warehouse 2124 from second row 2136 and the 4th row 2128 percussion nail of nail cavity in 2138.In all cases, driver can be positioned in warehouse 2124 so that the branch of driver Frame is aligned with the nail being located in nail cavity 2128.In such cases, driver and/or the nail being supported on can be for example opposite In the percussion path mass balance of sliding part (such as sliding part 2058 (Fig. 7)), which is configured to traverse Warehouse 2124 and driver is engaged wherein.

In other cases, nail bin 2120 may not include driver.For example, firing member and/or sliding part (such as fire Component 2060 and/or sliding part 2058 (Fig. 7)) it is for example configured to be in direct contact, engage and/or drive movably The nail being located in nail cavity 2128.In such cases, nail can be relative to the percussion path mass balance of sliding part 2058.Another In the case of outer, nail can be maintained at appropriate location in warehouse 2124, and can be for example crushed in warehouse 2124 and/or It is otherwise deformed.

In all cases, more staple drivers can be balanced relative to multiple driving wedge pieces, which is disposing Period simultaneously engages with and collaboratively promotes driver.For example, more staple drivers 2240 and a pair of of driving wedge piece 2264a, 2264b It is shown in Figure 11.More staple drivers 2240 are configured for for example being used together with nail bin 2020.In addition to this or alternatively, Driver 2240 can with nail array various other nail bins be used together, the nail microwell array array 2011 (Fig. 7) and Corresponding to the arrangement for the driver 2240 being shown in Figure 11.

In all cases, the nail fired from nail bin 2120 can be formed variable forming height.For example, nail is in nail leg A height between nail leg and base portion can be more than height between another nail leg and base portion.In such cases, it follows closely The compressing force of bigger can organizationally be applied in the shorter end of nail.As described in more detail herein, when staple drivers packet When including step or difference in height (see, for example, Figure 79), and/or when the nail shapes pit in anvil block includes step or difference in height When (see, for example, Figure 80), the height of nail is changeable.

It, can be longitudinally and laterally by angled nail compressing force applied to the organization when being deformed to variable height as angle nail Ground changes.In some cases, it is leaned on for example, it may be desired to more be compressed than the tissue far from (that is, laterally outside) cutting line The closely tissue of (that is, lateral inside) cutting line.In such cases, it is carried by the angled nail for being deformed to different compression heights The lateral tissue change supplied can apply the compressing force of bigger on the lateral inboard portion of tissue, and in the laterally outside of tissue Apply the compressing force of reduction on part.

Referring again to Figure 10, in some cases, from the third of nail cavity 2128 row 2135 and from the 4th of nail cavity 2128 The nail that row 2136 projects may be deformed to variable height.For example, nail can have close to the reduction height of longitudinal axis L and separate The more big height of longitudinal axis L.In addition to this or alternatively, from the first row 2137 of nail cavity 2128 and from second row nail cavity 2138 nails projected may be deformed to even height, which is smaller than from the third of nail cavity 2128 row 2135 and the 4th row The reduction of 2136 nails projected or smaller height.In such cases, compressing force applied to the organization can be maximum close to cutting Secant, and can be gradually reduced towards the lateral side of staple line in farther outside.

Each driver 2240 disclosed in Figure 11 includes multiple slots or nail supporting support 2242a, 2242b, 2242c.Example Such as, each driver 2240 includes first support 2242a, second support 2242b and third holder 2242c, these holders are respectively Be sized and configured to support one nail, such as follow closely 2012 (Fig. 7) in one nail.For example, the base portion of nail can be determined Position is in each holder 2242a, 2242b, 2242c.Referring again to nail bin 2020 shown in Figure 7, first support 2242a can be with The nail 2012 arranged outside the first of nail cavity 2028 in 2035 is aligned, and second support 2242b can be with the first intermediate row of nail cavity 2028 Nail 2012 in 2037 is aligned, and third holder 2242c can be aligned with the nail 2012 in row 2033 in the first of nail cavity 2028. In such cases, first support 2242a corresponds to support arm, and second support 2242b corresponds to intermediate support, and third branch Frame 2242c corresponds to inner support.In all cases, another driver arrangement can be positioned on the opposite side of nail bin, and And another driver arrangement can be the mirror reflection of driver arrangement shown in Figure 11.

Holder 2242a, 2242b, the 2242c being shown in Figure 11 are limited in supporting member 2248.Supporting member 2248 It can support the nail in multiple rows of nail cavity.In addition, supporting member 2248 it is sustainable for example relative to the longitudinal axis L of nail bin and/or The nail 2012 that person is orientated relative to longitudinal percussion path of driving wedge piece 2264a, 2264b with different angle.Referring to shown branch Component 2248 is supportted, which is angularly orientated relative to the percussion path of driving wedge piece 2264a, 2264b.Separately Outside, supporting member 2248 is angled relative at least one of holder 2242a, 2242b, 2242c therein holders are defined in Ground is orientated.For example, the intermediate support 2242b disclosed in Figure 11 is angularly orientated relative to supporting member 2248.In addition, such as Disclosed in Figure 11, support arm 2242c and inner support 2242a are aligned with supporting member 2248.

In some cases, the height of supporting member 2248 can be uniform or substantially uniform so that by supporting member Each of 2248 supports nail is positioned in identical height or elevation.In other cases, supporting member 2248 may include having not With height and/or the step of elevation.For example, the height of step is changeable to control the height of forming nail, exist to control capture The compression of tissue in forming nail.In addition to this or alternatively, the depth of each holder 2242a, 2242b, 2242c can be changed To control the height of forming nail, to control the compression of tissue of the capture in forming nail.

Each holder 2242a, 2242b, 2242c include first end 2244 and the second end 2246 disclosed in Figure 11. The second end of the first end 2244 of each holder 2242a, 2242b, 2242c in same supports 2242a, 2242b, 2242c 2246 distal side.In addition, axis is limited at the first end 2244 and the second end of each holder 2242a, 2242b, 2242c Between 2246.For example, first axle A_aIt is limited by first support 2242a and third holder 2242c, and second axis Ab is by Two holder 2242b are limited.As shown in figure 11, second axis A_bTraverse first axle A_a.In some cases, second axis A_bIt can It is vertical or be approximately perpendicular to first axle A_a。

Referring still to Figure 11, more staple drivers 2240 include guide rail 2245a, the 2045b for being connected to supporting member 2248.It leads Rail 2245a, 2245b are oriented driving wedge piece 2264a, 2264b of engaged wedge sliding part.For example, shown guide rail 2245a, 2245b are aligned with percussion path F1, F2 of driving wedge piece 2264a, 2264b.In such cases, guide rail 2245a, 2245b can provide elongated surface area for receiving the driving force from driving wedge piece, and in driving wedge piece 2264a, 2264b stablize more staple drivers 2240 when being drivingly engaged guide rail 2245a, 2245b.

Driver 2240 may include multiple components being individually formed, and can be glued, welds and/or adhere in other ways Together.For example, supporting member 2248 can be joined together to form driver 2240 with guide rail 2245a, 2245b.Other In the case of, each driver 2240 can be integrally formed component comprising supporting member 2248 and guide rail 2245a, 2245b.

Driver 2240 disclosed in Figure 11 is covered in the percussion path F of driving wedge piece 2264a, 2264b₁、F₂On.This Outside, the various pieces of each shown driver 2240 are positioned on the either side of wedge piece 2264a, 2264b.Such as Figure 11 institutes Show, driver 2240 be sized and configured to so that each driver 2240 barycenter (COM) and driving axis it is equidistant, Such as the percussion path F with driving wedge piece 2264a, 2264b₁、F₂Equidistantly.For example, the percussion path F being shown in Figure 11₁、F₂ It is separated by width w, and the barycenter of each driver 2240 is positioned in percussion path F₁、F₂Between.As shown in figure 11, each The barycenter of driver 2240 is from the first percussion path F₁Strategic Lateral Offset width w/2 and from the second percussion path F₂Strategic Lateral Offset is wide Spend w/2.Therefore, each shown driver 2240 is relative to percussion path F1, F2 mass balance.Because driver 2240 relative to Percussion path F1, F2 mass balance, thus during deployment driver 2240 and nail torsion can be prevented from, minimize and/ Or it controls in other ways.The driver (such as driver 2240) of mass balance for example may be incorporated into other nail bins disclosed herein In end effector assembly.

In other cases, firing member may include the single driving wedge piece being aligned with driver 2240, and drive Device 2240 can be relative to driving wedge piece mass balance.For example, driving wedge piece can limit and extend through each driver 2240 Barycenter (COM) percussion path.In such cases, driving wedge piece can have the width of bigger to increase driver 2240 Stability.In other cases, firing member may include three or more driving wedge pieces, and be applied by driving wedge piece The accumulation driving force added can be balanced relative to the geometry of driver 2240.

Each guide rail 2245a, 2245b and percussion path F disclosed in Figure 11₁、F₂In a percussion path alignment.Tool It says to body, the first guide rail 2245a is aligned with the first percussion path F1, and F2 pairs of the second guide rail 2245b and the second percussion path Together.Driving wedge piece 2264a, 2264b are configured to contact guide rail 2245a, 2245b to promote driver 2240 and support Nail on it.Referring still to Figure 11, shown driving wedge piece 2264a, 2264b along longitudinal direction interlock distance x.For example, first wedge Shape part 2264a follows the second wedge piece 2264b with distance x shown in Figure 11.In addition, the first guide rail 2245a is relative to second Guide rail 2245b interlocks along longitudinal direction.For example, the second guide rail 2245b with distance y shown in Figure 11 from the first guide rail 2245a towards remote Side biases.In fig. 11 in disclosed arrangement, distance x is equal or substantially equal to distance y so that driving wedge piece 2264a, 2264b is contacted simultaneously respectively during firing schedule and is driven guide rail 2245a, 2245b.

Because driving wedge piece 2264a, 2264b in the either side of the barycenter (COM) of driver 2240 disclosed in Figure 11 It is upper to simultaneously engage with respectively and drivingly lift rail 2245a, 2245b and equidistant with it, so accumulation driving force is driving It is balanced in the entire deployment of device 2240.Therefore, the torsion and/or rotation of driver 2240, and the nail that is therefore supported on Torsion and/or rotation can be prevented from, minimize and/or control.The driving wedge piece biased along longitudinal direction is (such as driving wedge piece 2264a, 2264b) for example it may be incorporated into other embodiments disclosed herein.

The arrangement of more staple drivers 2340a and single staple drivers 2340b have disclosed in fig. 12.Because of driver The arrangement of 2340a, 2340b correspond to the array 2011 of nail 2012 shown in fig. 7, so driver 2340a, 2340b can be with Nail bin 2020 (Fig. 7) is used together.In addition to this or alternatively, driver 2340a, 2340b can with nail array it is various Other nail bins are used together, which corresponds to the arrangement of driver 2340a, 2340b for being shown in Figure 12.

Driver 2340a, 2340b include multiple slots or nail supporting support 2342a, 2342b, 2342c.For example, more nails drive Dynamic device 2340a includes first support 2342a and second support 2342b, and the holder is respective to be sized and configured to prop up Nail, two in nail 2012 such as shown in Figure 7.In addition, list staple drivers 2340b includes third holder 2342c, the branch Frame is sized and configured to support another nail, another nail in nail 2012 such as shown in Figure 7.For example, nail 2012 base portion can reside in each holder 2342a, 2342b, 2342c.

Referring again to nail bin 2020 shown in Figure 7, first support 2342a can be arranged with outside the first of nail cavity 2028 in 2035 Nail 2012 be aligned, second support 2342b can be aligned with the nail 2012 in the intermediate row 2037 of nail cavity 2028, and third holder 2342c can be aligned with the nail 2012 in the interior row 2033 of nail cavity 2028.In such cases, first support 2342a corresponds to outer Holder, second support 2342b corresponds to intermediate support, and third holder 2342c corresponds to inner support.In addition, another drives Dynamic device arrangement can be positioned in the opposite side of nail bin 2020, can be the mirror image of the driver arrangement disclosed in Figure 12.

Referring still to Figure 12, each holder 2342a, 2342b, 2342c are limited to step and/or support section 2345 In.In addition, each driver in driver 2340a, 2340b respectively includes base portion 2348,2349.Each more staple drivers The base portion 2348 of 2340a extends between the step 2345 of driver 2340a.In addition, the base portion of each list staple drivers 2340b 2349 extend from its step 2345.

As disclosed in fig 12, the percussion path F in each driver 2340a, 2340b and nail bin₁、F₂Alignment.Specifically It says, each first driver 2340a is aligned with the first percussion path F1, and the percussions of each second driver 2340b and second Path F2 is aligned.Shown driving wedge piece 2364a, 2364b be configured to during firing schedule along percussion path F1, F2 is moved.In addition, driving wedge piece 2364a, 2364b contact driver 2340a, 2340b respectively with promoted driver 2240a, 2340b and the nail being supported on.

Base portion 2348,2349 can be used as counterbalance to adjust and/or control the barycenter of driver 2340a, 2340b.For example, The geometry and material of each base portion 2348,2349, which can be selected as, keeps the barycenter of each driver 2340a, 2340b And/or displacement is aligned at corresponding percussion path F1, F2.As shown in figure 12, the first base portion 2348 includes at least one notch 2350.Size, placement and the geometry of notch 2350 are selected to make the first driver 2340a relative to the first percussion path F1 mass balances.For example, each first base portion 2348 is configured to the barycenter displacement by more staple drivers 2340a or protects It holds into and is aligned with the first percussion path F1, and each second base portion 2349 is configured to single staple drivers 2340b Barycenter displacement be aligned at the second percussion path F2.

In addition, base portion 2348,2349 provides elongated surface area in driving wedge piece 2364a, 2364b driving Robust driver 2340 when ground engages driver 2340a, 2340b.For example, the larger occupied area of driver 2340a, 2340b Improving stability and the torque of driver 2340a, 2340b and/or rotation during deployment can be prevented.In addition, because base portion 2348,2349 larger surface region is provided, so driving force can be assigned to that the driver of balance and nail is promoted to dispose.Example Such as, the driver with elongated surface area (such as base portion 2348,2349)

It may be incorporated into the other embodiments disclosed herein.

Referring still to Figure 12, shown driving wedge piece 2364a, 2364b is interlocked along longitudinal direction with distance x.For example, the first wedge shape Part 2364a follows the second wedge piece 2364b with distance x.As shown further in figure 12, shown driver 2340a, 2340b with away from Interlock along longitudinal direction from y.In shown arrangement, distance x is different from distance y so that is connect when driving wedge piece 2364a, 2364b difference Touch driver 2340a, 2340.For example, in shown arrangement, the first wedge piece 2364a is in the second wedge piece 2364b contacts second The first driver 2340a is contacted before driver 2340b.In such cases, the in the deployment of the second nail 2340b and therefore The deployment for causing the first driver 2340a before the movement of three holder 2342c and therefore first support 2342a and second The movement of frame 2342c.Therefore, percussion is aligned with the first driver 2340a before the nail being aligned with the second driver 2340b Nail.

In some cases, it is desired to one nail of percussion or one group of nail before firing another nail or another group of nail.For example, In order to control suture tissue in bleeding and/or fluid flowing, be located in the nail of inside, it is such as adjacent with longitudinal slit and Therefore the nail adjacent with cutting line can be fired before the nail of more lateral.

In other cases, it can be fired before the nail being aligned with the first driver 2340a and 2340b pairs of the second driver Neat nail.Alternatively, the first driver 2340a and the second driver 2340b can be fired simultaneously so that by adjacent more staple drivers It 2340a and three nails of single staple drivers 2340b supports while piercing through and capturing tissue.

The arrangement of double staple drivers 2440 is shown in Figure 13.As arranged in Figure 13, double staple drivers 2440 are configured to It can be from the nail bin percussion nail of the nail cavity of adjacent row there are four tools.For example, the driver arrangement being shown in Figure 13 can be configured to Can be on the side of the longitudinal slit in warehouse from four nail chamber percussion nails, and corresponding mirrored drive arrangement can be by structure Causing can be on the other side of longitudinal slit from four nail chamber percussion nails.

In other cases, single double staple drivers 2440 can be positioned on the first side of nail bin, and single double nails Driver 2440 can be positioned in the opposite the second side of nail bin.In such cases, double staple drivers 2440 can be arranged At on the either side of cutting line from the nail cavity percussion nail of two adjacent rows.It in other cases, can be by double staple drivers 2440 Row be added to shown in Figure 13 and arrange.For example, double staple drivers can be arranged to the nail from six or more adjacent rows Chamber percussion nail.

The double staple drivers 2440 being shown in Figure 13 include a pair of of slot or nail supporting support 2442a, 2442b.For example, each Double staple drivers 2440 include first support 2442a and second support 2442b, and the holder is sized and configured to prop up Nail such as follows closely a nail in 2012 (Fig. 7).For example, the base portion of nail can be positioned in each holder 2442a, 2442b.

The first support 2442a of a double staple drivers in double staple drivers 2440 can be with the nail pair in a nail chamber Together, and the second support 2442b of identical double staple drivers 2440 can be aligned with the nail in another nail chamber.In addition, another The first support 2442a of double staple drivers 2440 can be aligned with the nail in another nail chamber, and double staple drivers 2440 Second support 2442b can be aligned with the nail in another nail chamber.

Referring still to Figure 13, each double staple drivers 2440 include step and/or support section 2445, and each holder 2442a, 2442b are limited in a step in step 2445.In addition, each driver in driver 2440 is included in The base portion or flange connector 2448 extended between the step 2445 of double staple drivers 2440.Because step 2445 is by flange connector 2448 connections, so holder 2442a, 2442b are connected so as to coordinate and/or the deployment of synchronous nail can be by double staple drivers 2440 cause.

The step 2445 of driver 2440 can be identical height.Alternatively, in some cases, driver 2440 may include not Level step.In other situations, different driving device 2440 can such as step with different height.

As disclosed in Figure 13, each double staple drivers 2440 are covered in a pair of of percussion path.In particular, driver One in 2440 covers driver on the first percussion path F1 and the second percussion path F2, and another in driver 2440 One driver is covered on third percussion path F3 and the 4th percussion path F4.Multiple driving wedge piece 2464a, 2464b, 2464b, 2464d are also depicted in Figure 13.As shown in figure 13, driving wedge piece 2464a, 2464b, 2464c, 2464d is configured to Double staple drivers 2440 can be contacted to promote double nails staple drivers 2240 and be positioned on.

Referring still to Figure 13, each step 2445 includes barycenter (COM).In addition, every in percussion path F1, F2, F3, F4 A percussion path is aligned with the barycenter of step 2045.Therefore, each step 2445 relative to corresponding percussion path F1, F2, F3, F4 mass balances.

In all cases, the base portion 2448 extended between step 2445 also can relative to corresponding percussion path F1, F2, F3, F4 mass balance so that base portion 2448 keeps the mass balance of double staple drivers 2440.At some

In the case of, base portion 2448 can be that the mass balance contribution of double staple drivers 2440 is not notable and/or negligible Displacement and/or variation.In such cases, the mass balance of driver 2240 can be flat for example, by the quality of its step 2445 Weighing apparatus is approximate.

Referring still to Figure 13, shown driving wedge piece 2464a, 2464b is interlocked along longitudinal direction with distance x.For example, the first wedge shape Part 2464a follows the second wedge piece 2464b distances x.In addition, the barycenter (COM) of the step 2445 of each double staple drivers 2440 Interlocked along longitudinal direction with distance x.In such cases, driving wedge piece 2464a, 2464b can be moved to and driver 2440 simultaneously Engagement.Because wedge piece 2464a, 2464c contact each driver 2444 simultaneously, the nail supported by each driver 2440 To deployment can be synchronized, and follow closely can be driven via storage capacitors simultaneously or be fired into tissue.For example, the wedge piece such as wedge to interlock along longitudinal direction Shape part 2464a, 2464b may be incorporated into other embodiments disclosed herein.

In all cases, the geometry of wedge piece will be driven to select in combination with nail and arrangement of the driver in nail bin The power being applied to during deployment at balance on nail and driver.In addition, in some cases, driving the geometry of wedge piece It can be selected as the deployment for coordinating nail.

For example, driver may include the driving wedge piece biased staggeredly and/or along longitudinal direction, it is configured to simultaneously Engage the nail being angularly orientated in nail bin and/or the driver being angularly orientated.For example, driving wedge piece staggeredly can It is moved to while being engaged with second or distal end of first or proximal end of driver and identical drivers.Because of angulation Two ends of the driver of degree are simultaneously engaged with by wedge piece staggeredly, so driving wedge piece staggeredly promotes driving simultaneously Device.Therefore, during deployment driver torsion and/or rotation, and the torsion and/or rotation of the nail that are therefore supported on It can be prevented from, limit and/or control.

In the other no driver embodiments being described further herein, driving wedge piece staggeredly can be moved into together When engaged with second or distal end of first or proximal end of angled nail and identical angled nail.Because of angled nail Two ends by staggeredly wedge piece simultaneously engage with, so staggeredly driving wedge piece simultaneously promote nail.Therefore, in the deployment phase Between the torsion followed closely and/or rotation can be prevented from, limit and/or control.

In addition to this or alternatively, the geometry of driver can limit at least one percussion path, the percussion path with The nail not being orientated angularly in nail bin and/or driver alignment.For example, percussion path can be with the axis of various drivers and nail Line is conllinear, and the longitudinal axis which is parallel to nail bin is orientated.Because percussion path is conllinear with nail and/or actuator axis, institute Can be relative to driving wedge piece balance with nail and/or driver, and the torque and/or rotation of driver and/or nail can be prevented Only, it limits and/or controls.

The driver 2540 of wedge-shaped slides 2558 follows closely 2512a, 2512b and driving wedge piece 2564a, 2564b, 2564c Arrangement be shown in Figure 14 and Figure 15.Wedge piece 2564a, 2564b, 2564c is driven to be configured to disclosed in Figure 14 and Figure 15 It can be along the percussion path F for extending respectively through nail bin₁、F₂And F₃(Figure 14) is mobile.In all cases, driver 2540 Arrangement can be used in nail bin, the nail bin have nail 2512a, 2512b and nail cavity correspond to shown driver arrangement arrangement.

As disclosed in Figure 14, driver 2540 and nail 2512a, 2512b are arranged to multiple rows of 2534,2536.In addition, each Various drivers 2540 and nail 2512a in row are parallel to longitudinal axis L orientation, and each various drivers 2540 in row It is angularly orientated relative to longitudinal axis L with nail 2512b.For example, shown arrangement includes a pair of longitudinal row 2534,2536, and And each the driver 2540 in row 2534,2536 and nail 2512a, 2512b relative to longitudinal axis L is parallel-oriented and angulation Degree replaces between being orientated.For example, the driver 2540 being shown in first row 2534 includes angularly being taken relative to longitudinal axis L To the first driver 2540a, be parallel to longitudinal axis L orientation the second driver 2540b, relative to longitudinal axis L angulation The third driver 2540c that degree ground is orientated, and it is parallel to the fourth drive 2540d of longitudinal axis L orientation.

As disclosed in Figure 14, the second driver 2540b and fourth drive 2540d of first row 2534 and the first percussion Path F₁Alignment.More particularly, the proximal end 2546 and distal end portion of the second driver 2540b and fourth drive 2540d Portion 2544 is aligned with the first percussion path F1.In such cases, the first percussion path F1 extends through the second driver 2540b With the barycenter (COM) of fourth drive 2540d.Because of the first percussion path F₁With the second driver 2540b and fourth drive 2540d is aligned, so the second driver 2540b and fourth drive 2540d is relative to the first percussion path F₁Mass balance, and And the torsion and/or rotation for the second driver 2540b and fourth drive 2540d being shown in Figure 14, and be therefore supported on The torsion and/or rotation of nail thereon can be prevented from, limit and/or control.

As disclosed in Figure 14, the first driver 2540a is aligned with axis A, and axis A traverses longitudinal axis L and hits Send out path F₁、F₂And F₃.It is orientated in addition, third driver 2540c is parallel to axis A.As shown in figure 14, the first driver 2540a It is angularly orientated and is covered in multiple percussion paths relative to longitudinal axis L with third driver 2540c.For example, institute Show that the first driver 2540a and third driver 2540c are covered on the first percussion path F1 and the second percussion path F2.Such as figure Shown in 14, the first percussion path F₁The proximal end 2546 of the first driver 2540a and third driver 2540c are extended through, And the second percussion path F₂Extend through the distal end 2544 of the first driver 2540a and third driver 2540c.

The barycenter (COM) of first driver 2540a and the second driver 2540c is fired in the first percussion path F1 and second Among the F2 of path.For example, the barycenter and the first percussion path F1 and second of the first driver 2540a and the second driver 2540c Percussion path F2 is equidistant, and therefore driver 2540a, 2540c relative to the first percussion path F1 and the second percussion path F2 Mass balance.Therefore, the torsion and/or rotation of the second driver 2540b and fourth drive 2540d that are shown in Figure 14, with And the torsion and/or rotation of the nail being therefore supported on can be prevented from, limit and/or control.

In addition, driving wedge piece 2564a, 2564c, 2564c for being shown in Figure 14 and Figure 15 interlock along longitudinal direction.For example, the One driving wedge piece 2564a follows the second driving wedge piece 2564b, and the second driving wedge piece 2564b towards distal side with distance x Third driving wedge piece 2564c is followed with distance x towards distal side.As shown in figure 14, the third driver 2540c being angularly orientated Proximal end 2546 and distal end 2544 bias fore-and-aft distance y.In being arranged shown in figures 14 and 15, third driving Fore-and-aft distance y between the proximal end 2546 and distal end 2544 of device 2540c is equal to the first driving wedge piece 2564a and the Fore-and-aft distance x between two driving wedge piece 2564b, the proximal end of the first driving wedge piece and third driver 2540c 2546 alignment, and the second driving wedge piece is aligned with the distal end 2544 of third driver 2540c.

In figures 14 and 15 in disclosed arrangement, the first driving wedge piece 2564a and the second driving wedge piece 2564b It is moved to and is engaged with third driver 2540c simultaneously.For example, contacting third staple drivers in the second driving wedge piece 2564b When the distal end 2544 of 2540c, the proximal end 2546 of the first driving wedge piece 2564a contact third staple drivers 2540c. Because driving wedge piece 2564a, 2564b, 2564c for being shown in Figure 14 are configured to the end of the angled driver of engagement Portion, so lifting force is applied directly to below the leg for the nail being supported on angled third driver 2540c.Therefore, Nail leg is further stabilized, and the inclination of nail leg and/or is tumbled during deployment and can be prevented from, minimize and/or control.

The the first driving wedge piece 2564a and the second driving wedge piece 2564b being shown in Figure 14 and Figure 15 are adapted to Enough additional actuators 2540 similarly engaged in first row 2534, and can dispose successively the nail 2512a being supported on, 2512b.For example, the first driving wedge piece 2564a is configured to contact the first driver in the second driving wedge piece 2564b The proximal end 2546 of the first driver 2540a is then contacted when the distal end 2544 of 2440a.In addition, the first driving wedge shape Part 2564a is configured to engage and fire successively driven in parallel device 2540b, 2540d and nail in first row 2534 2512a。

In all cases, the proximal end 2546 and distal end 2544 of third driver 2540c can drive with third The barycenter of device 2540c is equidistant.Because driving the wedge piece 2464a and 2464b disclosed in Figure 14 and Figure 15 are configured to The opposite end for the third staple drivers 2540c being angularly orientated is contacted simultaneously and applies driving force and/or lifting force On the opposed end of the staple drivers 2540c equidistant with barycenter, so staple drivers 2540c is flat during its entire deployment Weighing apparatus.Therefore, the rotation and/or torsion of third staple drivers 2540c can be prevented from, avoid and/or control.

In other cases, driving wedge piece 2564a, 2564b can not make contact to the end of angle staple drivers 2540 2546、2544.However, in such cases, driving wedge piece 2564a, 2564b be configured to driver 2540 Barycenter equidistant position at be bonded into angle staple drivers 2540.In addition, driving wedge piece 2564a, 2564b can be by fully partially Set with while contacting and being promoted the interval location of driver 2540c.

In addition, the second driving wedge piece 2564b and third driving wedge piece 2564c that are shown in Figure 14 and Figure 15 are constructed At the driver 2540 that can similarly engage in second row 2536, and dispose successively the nail 2512a being supported on, 2512b.Such as arranged referring still to shown in Figure 14, the driver 2540 in second row 2536 is orientated at a certain angle, is made Each driver proximal end 2546 and the distance between distal end 2544 also separated by fore-and-aft distance y, the longitudinal direction away from It is equal to the fore-and-aft distance x between the second driving wedge piece 2564b and third driving wedge piece 2564c from y.

In other cases, the fore-and-aft distance between the second driving wedge piece 2564b and third driving wedge piece 2564c can It is more than and/or less than the fore-and-aft distance between the first driving wedge piece 2564a and the second driving wedge piece 2564b.In addition to this Or alternatively, the angle that the angled nail 2512b in second row 2536 can be different from the angled nail 2512b in first row 2534 Degree is orientated.In addition, in all cases, can the driver 2540 of additional row and nail 2512a, 2512b be added to institute in Figure 14 The arrangement shown, and additional drives wedge piece be configured to engagement additional actuators 2540 with fire additional nail 2512a, 2512b.In other situations, arrangement may also include for example single driver 2540 and nail 2512a, 2512b.

The arrangement of nail 2512a, 2512b for being shown in Figure 14 can also be fired from no driver nail bin.For example, with reference to Figure 16, Nail 2512a, 2512b can be disposed in no driver storehouse, all nail bins 2620 (Figure 37) as further described herein.Without driving Nail 2512a, 2512b in device nail bin directly can be engaged and/or be driven by sliding part and/or firing member.For example, nail 2512a, 2512b may include sliding part engagement surface, which is configured to directly by wedge-shaped slides 2558 Drive the nail engagement surface engagement of one or more of wedge piece 2564a, 2564b and/or 2564c.

As described herein, each nail 2512a, 2512b can relative to nail 2512a, 2512b be aligned percussion path F1, F2, F3 mass balance.For example, with reference to Figure 16, nail 2512a and percussion path F with longitudinal axis L parallel arrangement₁、F₂、F₃In One percussion path alignment.In shown arrangement, a driving wedge piece edge in wedge piece 2564a, 2564b, 2564c is driven Engage parallel nail 2512a with the length drives of the base portion of nail 2512a.In addition, barycenter and the percussion road of each parallel nail 2512a Percussion path alignment in diameter F1, F2, F3.In other words, a percussion path in percussion path F1, F2, F3 extends Across the barycenter of each parallel nail 2512a, and 2512a therefore is followed closely relative to corresponding percussion path F1, F2, F3 matter during deployment Amount balance.In such arrangement, during percussion follow closely 2512a torsion and/or rotation can be prevented from, minimize and/or control.

In addition, in the case where the nail being shown in Figure 14 is arranged in no driver storehouse, a pair of biasing driving wedge piece 2564a, 2564b, 2564c are configured to be moved to simultaneously and be engaged with each nail 2512b being angularly orientated.For example, First driving wedge piece 2564a and second driving wedge piece 2564b be configured to contact simultaneously in first row 2534 at Angle nail 2512b, and the second driving wedge piece 2564b and third driving wedge piece 2564c are configured to connect simultaneously Touch the angled nail 2512b in second row 2536.Then, wedge-shaped slides 2558 are configured to continue relative to nail 2512a, 2512b are translated, to contact successively and directly drive nail 2512a, 2512b from no driver nail bin.

As described herein, no driver nail bin can be used for keeping and fire the nail array of the nail including being angularly orientated. Including the first jaw 2002, the second jaw 2004, frame 2006, actuated articulation joints 2009 and end without driver nail bin 2620 Portion's actuator assembly 2600 has disclosed in Figure 37.Nail bin 2620, which can be single use and/or disposable storehouse, the storehouse, to be hit It is replaced with another nail bin after hair.Figure 37 discloses the nail bin 2620 including platform 2626, warehouse 2624 and shell 2622, should Surround or encapsulate to housing parts warehouse 2624.In addition, the array of such as such as nail of 2612 (Figure 39 A and Figure 39 B) of nail can be with It is removably positioned in warehouse 2624.

In some cases, nail bin 2620 can be integrally formed with end effector assembly 2600 and/or can be for good and all It is fixed in a jaw in such as jaw 2002,2004.In such cases, end effector assembly 2600 can be single Using and/or disposable end actuator.In other cases, nail bin 2620 can be fixed end effector assembly 2600, And additional nail can be reloaded for for example follow-up percussion.

Referring to nail bin 2620 shown in Figure 37, longitudinal slit 2632 is defined as at least partially through warehouse 2624. Longitudinal slit 2632 extends along longitudinal axis L, proximal end 2623 and distal end of the longitudinal axis L in warehouse 2624 Extend between 2625.Being shown in longitudinal slit 2632 in Figure 37, proximally end 2623 extends and horizontal towards distal end 2625 Pass through a part for the length of warehouse 2624.

In some cases, longitudinal slit 2632 can traverse the whole length of warehouse 2624.In other cases, longitudinal narrow Slot 2632 can for example extend from 2623 proximally facing end 2625 of distal end.In other situations, warehouse 2624 can not wrap Include predetermined and/or preformed longitudinal slit.For example, firing member and/or cutting element can be horizontal for example during firing schedule Cut and/or cut warehouse 2624.

Nail bin 2620 disclosed in Figure 37 is configured to fire the array of 2612 (Figure 38 A and Figure 38 B) of angled nail, The array can be orientated as nail array 2011 for example shown in fig. 7.Angled nail 2612 can be removably positioned in It is shown in the angled nail cavity 2628 in Figure 37, which is limited in warehouse 2624.For example, shown nail cavity 2628 relative to Longitudinal axis L is angularly orientated.In addition, the shown arrangement of nail cavity 2628 corresponds to the cloth for being located in the nail 2612 in storehouse 2620 It sets.It includes the opening 2630 in platform 2626 to be shown in each nail cavity 2628 in Figure 37, and each opening 2630 includes nearside End and distal end.The opening 2630 that nail axis can extend between proximal end and distal end, and be shown in Figure 37 Nail axis relative to the longitudinal axis L deflection of warehouse 2624 and/or angled.In the nail bin 2620 of Figure 37, all nail cavities 2628 are angularly orientated relative to longitudinal axis L, and various nail cavities 2628 angularly take relative to other nail cavities 2628 To.

It is arranged in rows on every side of longitudinal slit 2632 to be shown in the nail cavity 2628 in Figure 37.For example, nail cavity 2628 The first inboard row 2633, the first outboard row 2635 and the first intermediate row are arranged on the first side 2627 of longitudinal slit 2632 In 2637, and nail cavity 2628 is arranged in second the 2634, second outside of inboard row in the second side 2629 of longitudinal slit 2632 In row 2638 and the second intermediate row 2636.Although nail cavity 2628 does not intersect or is in contact with each other in other ways, nail cavity 2628 2633,2634,2635,2636,2637,2638 overlapping of longitudinal row.For example, nail cavity 2628 extends in laterally outside and/or inside By the nail cavity 2628 in the nail cavity 2628 of adjacent row, and nail cavity 2628 proximally and/or towards distal side extends past adjacent row Nail cavity 2628 in nail cavity 2628.Because nail cavity 2628 and the nail being positioned in are arranged in overlapping arrays, controllably Bleeding in system suture tissue and/or fluid flowing.In the nail bin 2620 in being shown in Figure 37, nail cavity 2628 and its row relative to Longitudinal slit 2632 is symmetrical.

In other cases, every side of longitudinal slit 2632 can be positioned in more or less than the nail cavity 2628 of three rows On, and in some cases, another side that may include with nail bin 2620 in the side 2627,2629 of nail bin 2620 Face 2627,2629 different numbers nail cavity 2628 row.In some cases, nail cavity 2628 can not be with the nail cavity in adjacent row 2628 longitudinal directions and/or lateral overlap.In addition to this or alternatively, in some cases, nail cavity 2628 and/or its row can be relative to Longitudinal slit 2632 and/or longitudinal axis L are asymmetric.

Referring still to Figure 37, the shown nail cavity 2628 in arranging longitudinally in each is parallel or substantially parallel.In other words, in first Nail cavity 2628 in side row 2633 is parallel to each other, and the nail cavity 2628 in the first outboard row 2635 is parallel to each other, the first intermediate row Nail cavity 2628 in 2637 is parallel to each other, and the nail cavity 2628 in the second inboard row 2634 is parallel to each other, in the second outboard row 2636 Nail cavity 2628 it is parallel to each other, and the nail cavity 2628 in the second intermediate row 2638 is parallel to each other.

In addition as shown in figure 37, the nail cavity 2628 in arranging longitudinally in each is on the same side of longitudinal slit 2632 relative to phase Nail cavity 2628 in adjacent longitudinal row is angularly orientated.For example, on the first side 2627 of warehouse 2624, the first intermediate row 2637 In nail cavity 2628 be angularly orientated relative to the nail cavity 2628 in row 2633 in first and outside first in row 2635.Separately Outside, in the second side 2629 of warehouse 2624, nail cavity 2628 in the second intermediate row 2638 relative to row 2634 in second and Nail cavity 2628 outside second in row 2636 is angularly orientated.

In other cases, longitudinally in each row 2633,2634,2635,2636,2637,2638 in nail cavity 2628 only A part can it is parallel to each other and/or all or fewer than longitudinal row 2633,2634,2635,2636,2637,2638 may include Nail cavity 2628 parallel to each other.In addition to this or alternatively, in some cases, at least part of nail cavity 2628 can take at random To.In some cases, at least one of nail cavity 2628 in longitudinal row 2633,2634,2635,2636,2637,2638 nail Chamber can be parallel at least one of the nail cavity 2628 in adjacent longitudinal row 2633,2634,2635,2636,2637,2638 nail Chamber.In some cases, nail bin 2620 may include at least one nail cavity 2628 for the longitudinal axis L for being parallel to warehouse 2624.Example Such as, referring to Figure 11.

Referring still to Figure 37, shown end effector assembly 2600 includes being hit relative to what warehouse 2624 movably positioned Send out bar 2660.Trigger shaft 2660 is configured to traverse warehouse 2624 with from 2628 percussion nail of nail cavity 2612 (Figure 38 A and figure 38B).Shown trigger shaft 2660 further includes cutting edge 2661, which is configured in trigger shaft 2660 in the first pincers Tissue is cut when being translated between mouth 2002 and the second jaw 2004.

The size of shown firing member 2660 and position are designed to cooperation in longitudinal slit 2632, and drivingly connect Close sliding part, sliding part 2658 (Figure 37-Figure 38 B), the sliding part being such as movably positioned in no driver storehouse 2620 2758 (Figure 39-Figure 39 B) or sliding part 2858 (Figure 40).When trigger shaft 2660 translates across longitudinal slit 2632, trigger shaft Sliding part 2658 (Figure 37-Figure 38 B), 2758 (Figure 39-Figure 39 B) or 2858 (Figure 40) are moved through warehouse 2624 by 2660.

Sliding part 2658 has disclosed in Figure 37-Figure 38 B.The size of sliding part 2658 and position are designed to directly connect Conjunction is located in the nail 2612 in no driver storehouse 2620 (Figure 37).Shown sliding part 2658 includes central part 2659 and driving wedge Shape part or driving guide rail 2664.It includes nail engagement surface or nail contact surface 2666 to drive wedge piece 2664, which is from cunning The distal end of moving part 2658 extends to the inclined surface and/or ramped surfaces of proximal end.As shown in Figure 37-Figure 38 B, wedge shape The inclined surface 2666 of part 2664 has gradient or angle equal or be essentially equal.

Each of Figure 37-Figure 38 B nail contact surfaces 2666 are shown in be oriented to be in direct contact and be located in nail bin 2620 Nail 2612 (Figure 38 A and Figure 38 B).More particularly, the nail contact surface 2666 of driving wedge piece 2664 is configured to Contact is each to follow closely 2612 base portion 2614 (Figure 38 B), and the base portion 2614 for following closely 2612 is lifted up to be penetrated from nail cavity 2628 Go out nail 2612.For example, will nail 2612 from falling and/or non-firing position is promoted to rising and/or firing position, it is each to tilt The base portion 2614 of 2667 jointing nail 2612 of distal end on surface 2666, and inclined surface 2666 is moved distally across nail 2612 base portion 2614.

In shown arrangement, trigger shaft 2660 and its cutting edge 2661 are configured to the sliding in longitudinal slit 2632 And/or translation.In addition, being shown in the driving wedge piece 2664 in Figure 37-Figure 38 B, it is illustrated as in trigger shaft 2660 and cutting edge 2661 laterally outside, and it is configured to nail 2612 (Figure 38 A and figure that contact is located in nail cavity 2628 (Figure 37) 38B).Multiple driving wedge pieces 2664 are positioned on the either side of central part 2659 of wedge-shaped slides 2658.For example, In shown sliding part 2658, four drivings wedge piece 2664a, 2664b, 2664c, 2664d are positioned in central part 2659 On per side.

In addition, in the arrangement disclosed in Figure 37-Figure 38 B, multiple driving wedge piece 2664a, 2664b, 2664c, 2664d is configured to single be at an angle of of engagement and follows closely 2612.For example, the first wedge piece 2664a and the second wedge piece 2664b quilts It is constructed to be permeable to engagement and is located in the nail 6212 arranged outside the first of nail cavity 2628 in 2633, the second wedge piece 2664b and third wedge Shape part 2664c is configured to the nail 2612 that engagement is located in the first intermediate row 2637, third wedge piece 2664c and the 4th Wedge piece 2664d is configured to engagement and is located in the nail 2612 arranged outside first in 2635.

In all cases, it may be desirable to support and drive from multiple positions along the base portion 2614 (Figure 38 B) of nail 2612 Nail 2612 in nail bin 2620 disclosed in Figure 37.For example, by the nail longitudinally-aligned with the percussion path of driving wedge piece 2664 2612 support along the whole length of the base portion 2614 of nail 2612.For example, the percussion road when nail 2612 relative to sliding part 2658 When diameter is at an angle of, as shown in Figure 37-Figure 38 B, 2612 can will be followed closely by using multiple driving wedge pieces 2664 along base portion supports At multiple positions.Because angled nail 2612 is drivingly supported on along its base portion 2614 at multiple positions, nail 2612 It can be balanced and/or stablize so that following closely 2612 rotation and/or torsion during deployment can be prevented from, reduces and/or control. For example, relative to multiple sliding part engagement surface mass balances directly drive nail as nail 2612 may be incorporated into it is disclosed herein other In embodiment.

Inclined surface 2666 interlocks disclosed in Figure 37-Figure 38 B.For example, shown inclined surface 2666 interlocks along longitudinal direction, make At least one other inclined surface of 2666 longitudinal guide of at least one inclined surface 2666.Second driving wedge piece 2664b and 2666 longitudinal guide first of the inclined surface driving wedge piece 2664a and third of 4th driving wedge piece 2664d drives wedge piece The inclined surface 2666 of 2664c.The inclined surface 2666 of second driving wedge piece 2664b and the 4th driving wedge piece 2664d exist Higher than the inclined surface of the first driving wedge piece 2664a and third driving wedge piece 2664c at the distal end 2667 of alignment 2666.For example, as shown in Figure 38 and Figure 38 B, the first driving wedge piece 2664a and third driving wedge piece 2664c have distal side Height y, and there is distal side height x, height x to be less than height by the second driving wedge piece 2664b and the 4th driving wedge piece 2664d Spend y.

Inclined surface 2666 staggeredly is configured to be moved to simultaneously and be engaged with angled nail 2612 along longitudinal direction.Example Such as, the nail engagement surface 2666 of the first wedge piece 2664a and the second wedge piece 2664b are configured to simultaneously engage with nail cavity The angled nail 2612 in 2633 (Figure 37) is arranged outside the first of 2628.In addition, the second wedge piece 2664b and third wedge piece The nail engagement surface 2666 of 2664c is configured to simultaneously engage with the angled nail in the first intermediate row 2637 (Figure 37) 2612.In addition, the nail engagement surface 2666 of third wedge piece 2664c and the 4th wedge piece 2664d are configured to connect simultaneously Conjunction is located in the nail 2612 in 2635 (Figure 37) of row outside first.

The deployment or percussion of nail 2612 are shown in Figure 38 A and Figure 38 B, the wherein third wedge piece 2664c of driver 2658 It is engaged with 2612 driving of nail with the 4th wedge piece 2664d.Third wedge piece 2664c can at point A initial contact stud 2612, and 4th wedge piece 2664d can at point B initial contact stud 2612.Third wedge piece 2664c and the 4th wedge piece 2664d are constructed At nail 2612 can be simultaneously engaged with so that the simultaneously or almost simultaneously contact point A and B of nail 2612.Due to third wedge piece 2664c and Difference in height between the nail engagement surface 2666 of 4th wedge piece 2664d, point A and B can be biased along longitudinal direction so that point A and B are in Identical or substantially the same elevation.

Referring still to Figure 38 A and Figure 38 B, when driver 2658 continues to be moved distally in nail bin 2620, nail 2612 Third wedge piece 2664c and the nail engagement surface 2666 of the 4th wedge piece 2664d can be made to slide up to third wedge piece respectively The 2664c and point A ' on the 4th wedge piece 2664d and B '.As shown in fig. 38b, nail 2612 is kept vertically during deployment Upright orientation.Then, nail 2612 can be such that third wedge piece 2664c and the nail engagement surface 2666 of the 4th wedge piece 2664d divides The point A " and B " on third wedge piece 2664c and the 4th wedge piece 2664d is not continued to slide up.As shown in fig. 38b, it follows closely 2612 continue to keep vertically upright orientation.In other words, this to nail engagement surface 2666 during deployment stablize and/ Or balanced nail 2612 so that the rotation or torsion for following closely 2612 can be prevented from, minimize and/or control.

In other cases, the driving wedge piece or guide rail of wedge-shaped slides can all drop to zero or substantially zero height Degree.For example, referring now to Figure 39-Figure 39 B, wedge-shaped slides 2758 are shown.Wedge-shaped slides 2758 can be used for nail bin 2620 With in end effector 2600 (Figure 37) with from nail bin 2620 (Figure 39 A) percussion nail 2612.

Similar to sliding part 2658, the appointing in central part 2759 of wedge-shaped slides 2758 disclosed in Figure 39-Figure 39 B Include four driving wedge pieces 2764 on side.Each driving wedge piece 2764 includes inclined nail engagement surface 2766, quilt It is constructed to be permeable to directly engage and follows closely 2612 from the driving of nail cavity 2628.It is also similarly to sliding part 2658, institute in Figure 39-Figure 39 B The nail engagement surface 2766 of the driving wedge piece 2764 shown interlocks along longitudinal direction so that the first driving wedge piece 2764a and third are driven Dynamic wedge piece 2764c longitudinally follows the second driving wedge piece 2764b and the 4th to drive wedge piece 2764d.

The alternating inclinations along longitudinal direction of driving wedge piece 2764a, 2764b, 2764c, 2764d disclosed in Figure 39-Figure 39 B Surface 2766 is configured to be moved into engaging with angled nail 2612 simultaneously.For example, the first wedge piece 2764a and the second wedge The nail engagement surface 2766 of shape part 2764b is configured to simultaneously engage with the angulation being located in outside first in 2635 (Figure 37) of row Degree nail 2612.In addition, the nail engagement surface 2766 of the second wedge piece 2764b and third wedge piece 2764c are configured to together When engage angled nail 2612 in the first intermediate row 2637 (Figure 37).In addition, third wedge piece 2764c and the 4th wedge piece The nail engagement surface 2766 of 2764d is configured to simultaneously engage with the angled nail being located in first in 2633 (Figure 37) of row 2612。

In addition, the friendship along longitudinal direction of driving wedge piece 2764a, 2764b, 2764c, 2764d disclosed in Figure 39-Figure 39 B Wrong inclined surface 2666 is configured to drive angled nail 2612 simultaneously.For example, the wedge shapes of the first wedge piece 2764a and second The nail engagement surface 2766 of part 2764b be configured to drive simultaneously outside the first of nail cavity 2628 (Figure 37) in row 2635 at Angle nail 2612.In addition, the nail engagement surface 2766 of the second wedge piece 2764b and third wedge piece 2764c are configured to The angled nail 2612 in the first intermediate row 2637 (Figure 37) is driven simultaneously.In addition, third wedge piece 2764c and the 4th wedge piece The nail engagement surface 2766 of 2764d is configured to drive the angled nail being located in first in 2633 (Figure 37) of row simultaneously 2612。

Referring primarily to Figure 39 A, the second wedge piece 2764b on the first side 2627 of warehouse 2624 and third wedge piece 2764c is configured to be moved to engage with the second nail 2612b, second nail for proximal nail and with the second wedge piece The percussion path of 2764b and third wedge piece 2764c are aligned.In addition, the second wedge piece 2764b and third wedge piece 2764c can It is equidistant with the barycenter (COM) of the second nail 2612b.When sliding part 2758 continues to be translated to the far side, the second wedge piece 2764b and Three wedge piece 2764c are configured to be drivingly engaged the second nail 2612b to promote simultaneously percussion nail 2612b.

In arrangement disclosed in Figure 39 A, the second nail is promoted in the second wedge piece 2764b and third wedge piece 2764c When 2612b, the first wedge piece 2764a and the second wedge piece 2764b on the first side 2627 of warehouse 2624 are configured to It is moved to and is engaged with the first nail 2612a, and the third wedge piece 2764c on the first side 2627 and the 4th wedge piece 2764d quilts It is constructed to be permeable to be moved to and be engaged with third nail 2612c.In addition, as shown in Figure 39 A, the wedge shapes of the first wedge piece 2764a and second The barycenter (COM) of the nails of part 2764b and first 2612a equidistantly, and third wedge piece 2764c and the 4th wedge piece 2764d and the The barycenter (COM) of three nail 2612c is equidistant.When sliding part 2758 continues to be translated to the far side, the first wedge piece 2764a and the second wedge Shape part 2764b is drivingly engaged the first nail 2612a to promote simultaneously percussion nail 2612b, and third wedge piece 2764c and the 4th wedge Shape part 2764d is drivingly engaged third nail 2612c to promote simultaneously percussion nail 2612c.

It is described above and be shown in the pairs of driving wedge piece in Figure 39 A and arrange and be configured in the continuation of sliding part 2758 towards remote Continue to simultaneously engage with and promoted the nail 2612 in nail bin 2620 when translating in side.Because sliding part 2758 is at multiple positions along it Base portion supports each follow closely 2612, so nail 2612 is stablized and/or balanced during deployment.In addition, because sliding part 2758 Follow closely the barycenter (COM) of engagement surface 2766 and each contact stud 2612 equidistantly, thus the rotation and/or torsion of nail 2612 can by into One step is prevented, minimizes or is controlled.In addition, because wedge piece 2764a, 2764b, 2764c, 2764 is driven to interlock along longitudinal direction, institute It is timed with the engagement of each nail 2612 with multiple driving wedge piece 2764a, 2764b, 2764c, 2764 and/or synchronous with balance The driving force being applied to during its entire deployment on each nail 2612.

Driving sliding part 2858 is shown in Figure 40.Wedge-shaped slides 2758 can be used for nail bin 2620 and end effector 2600 With from nail cavity 2620 (Figure 39 A) percussion nail 2612 in (Figure 37).Similar to sliding part 2658 and 2758, driving sliding part 2858 exists Include multiple driving wedge pieces 2864 on the either side of central part 2859.Each driving wedge piece 2864 includes inclined nail joint Surface 2866 is closed, be configured to directly engage and follows closely 2612 from the driving of nail cavity 2628.In addition, inclined nail engagement surface 2866 are laterally at an angle of or tilt.Because nail engagement surface 2866 laterally and longitudinally tilts, each surface 2866 includes The support section biased along longitudinal direction, the support section are drivingly engaged angled nail 2612 during its entire deployment and percussion.

For example, the inclined nail engagement surface 2866 disclosed in Figure 40 is configured to the base along each nail 2612 The part in portion is drivingly engaged nail 2612.In being arranged shown in Figure 40, the driving force distributed being applied on nail 2612 exists On the surface area of bigger.For example, at least the 50% of the length of the accessible base portion for following closely 2612 of nail engagement surface 2866.In other feelings Under condition, at least the 75% of the length of the base portion of Surface accessible nail 2612 is closed in nail joint.In other situations, nail engagement surface can The length of the base portion of contact stud 2612 is less than 50% or more than 75%.In addition, the driving force from sliding part 2858 relative to The barycenter balance of each nail 2612, further to stablize and balanced nail 2612 during deployment.Therefore, follow closely 2612 rotation and/ Or torsion can be prevented from, minimizes or control.

As described herein, such nail array provides various benefits：Include the longitudinal axis relative to nail bin and/or hits The nail that the percussion path of hair component is angularly orientated.For example, such nail array can provide the soft of improvement in suture tissue Property and/or extensibility.Therefore, the incidence of torn tissue can be reduced.In some cases, nail array may also include with difference The nail of length base portion.Variable-length base portion in nail array can promote to suture increased flexible and/or extensibility in tissue.Separately Outside, in some arrangements, the nail with shorter base portion can be nested in nail array.For example, the nail with shorter base portion can be determined In relatively narrow space of the position between the nail with longer base portion.Such arrangement can be such that staple line is densified, this can improve to suture The control of bleeding and/or fluid flowing in tissue.

Nail array 3011 is shown in Figure 41.Array 3011 includes spike 3012 and short nail 3013.As shown in figure 41, spike 3012 have l₁Base length, and it is short nail 3013 have l₂Base length, l₂Less than l₁.In shown array 3011, the One spike 3012a and axis A_aAlignment, and the first short nail 3013 and axis A_bAlignment, axis A_bIt is parallel to axis A_a.It is additional Spike 3012 and short nail 3013 (such as following closely 3012e, 3013b, 3013c and 3013d) are for example parallel to axis A_aAnd A_b.Such as it is shown in It is further disclosed in array 3011 in Figure 41, the second spike 3012 and axis A_cAlignment, axis A_cTraverse axis A_aWith A_b.For example, such as nail 3012c, 3012d and the 3012f of additional spike 3012 is parallel to axis A_c。

In other arrangements, axis A can be also parallel to by adding short nail 3012_c.In some cases, various nails can be along not It is parallel to axis A_a、A_bAnd A_cAxis arrangement.For example, nail array 3011 may include the longitudinal axis for being parallel to nail bin and/or put down The nail that row is orientated in the percussion path of driving sliding part.In addition, in all cases, nail array 3011 may include having and be different from The nail of the base length of l2 and l1.In some cases, nail array 3011 may include the additional and/or less nail longitudinally arranged 3012、3013.For example, can be removed with the row of the first spike 3012a spikes 3012 being aligned, and/or with the second spike The row of the spike 3012 of 3012b alignment can be removed, and/or can be moved with the row of the first short nail 3013a short nails being aligned Remove, and/or can be removed with the row of the third spike 3012c spikes 3012 being aligned, and/or with the second short nail The row of the short nail 3013 of 3013b alignment can be removed, and/or can with the row of the 4th spike 3012d spikes 3013 being aligned It is removed.

Referring again to Figure 41, short nail 3013 is embedded in the nail array 3011 among two spikes 3012.For example, array Two spikes 3012 in 3011 are such as shown in third spike 3012c in Figure 41 and the 6th spike 3012f is parallel and lateral Alignment.In such an arrangement, space is limited between third spike 3012c and the 6th spike 3012f, and the space is by structure It causes that the short nail 3013c of third can be accommodated.Therefore, the short nail 3013c of third in shown array 3011 is nested in third spike Between 3012c and the 6th spike 3012f.In such arrangement, third is short to follow closely in 3013c and array 3011 similar to the short of placement Nail 3013 can be such that staple line is densified by filling the space between spike 3012.In all cases, because staple line is in array It is densified in 3011, so bleeding and/or fluid flowing control are improved.

Densification staple line such as nail array 3011 for example may be incorporated into other embodiments disclosed herein.

In other cases, the spike 3012 for defining therebetween the space for accommodating short nail can be not parallel each other.For example, Third spike 3012c and the 6th spike 3012f can deflection and/or not parallel in other ways each other.In addition to this or alternatively, The spike 3012 for defining therebetween the space for accommodating short nail 3013 can only partially lateral overlap.For example, in certain situations Under, third spike 3012c can be relative to the 6th spike 3012f in laterally outside or lateral inside so that third follows closely 3012c and the The only a part of six nail 3012f is laterally aligned.

The array of nail, such as array 3011 can for example be positioned in no driver nail bin such as without driver nail bin 2620 In (Figure 37), and it can directly be engaged by driving sliding part and be driven from nail bin.In such cases, the nail in array 3011 3012,3013 it can be contacted relative to the driving wedge piece mass balance of sliding part, the sliding part and drive nail 3012,3013.Example Such as, percussion force can be applied to the end of the base portion equidistant with the barycenter of each nail 3012,3013 by driving wedge piece.At it In the case of it, percussion force can be applied at each interval location along the base portion of nail 3012,3013, and accumulating percussion force can Relative to 3012,3013 balance of nail.In the feelings that nail is not covered in percussion path and/or is not balanced relative to percussion path Under condition, staple drivers can be used.For example, as further described herein, more staple drivers can promote multiple nails simultaneously from nail bin.

Nail array 3111 is shown in Figure 42.Array 3111 includes spike 3112 and short nail 3113.As shown in figure 42, spike 3112 have l₁Base length, and it is short nail 3113 have l₂Base length, l₂Less than l₁.In shown array 3111, the One short nail 3113a and axis A_aAlignment, and the first spike 3112a and axis A_bAlignment, axis A_bTraverse axis A_a.It is additional Short nail 3113 is parallel to axis A_aIt is orientated, and additional spike 3112 is parallel to axis A_bIt is orientated.

In other arrangements, at least one short nail 3113 can be parallel to axis A_bOrientation and/or at least one spike 3112 can be parallel to axis A_aIt is orientated.In some cases, various nails 3112,3113 can be along being not parallel to axis A_aAnd A_b's Axis is arranged.For example, nail array 3111 may include the longitudinal axis for being parallel to nail bin and/or be parallel to driving wedge piece 3064 The nail that percussion path is orientated, is also depicted in Figure 42.In addition, in all cases, nail array 3111 may include having and be different from The nail of the base length of l2 and l1, and/or nail array 3111 may include the additional and/or less nail 3112 longitudinally arranged, 3113。

Referring still to Figure 42, short nail 3113 can be embedded in the nail array among at least two lateral overlap spike 3112 In 3111.In such an arrangement, the nested short nail 3113 in array 3111 can be by filling the sky between adjacent spike 3112 Between so that the staple line is densified.Because staple line is densified in array 3111, bleeding and/or fluid flowing can be improved.Example Such as, staple line is densified to may be incorporated into other embodiments disclosed herein (such as nail array 3111).

In other cases, the spike 3112 for defining therebetween the space for accommodating short nail can be not parallel each other.Except this Except or alternatively, define therebetween and can be only partially overlapped for accommodating the spike 3112 in space of short nail 3113.

The array of nail, such as array 3111 can for example be positioned in no driver nail bin, such as without driver nail bin 2620 In (Figure 37), and it can directly be engaged by driving sliding part, such as sliding part 2058 (Figure 37) and be driven from nail bin.In such feelings Under condition, the nail 3112,3113 in array 3111 can connect relative to 3064 mass balance of driving wedge piece of sliding part, the sliding part It touches and drives nail 3112,3113.For example, percussion force can be applied to the barycenter etc. with nail 3112,3113 by driving wedge piece 3064 Away from base portion end.

In other cases, percussion force can be applied at each interval location along the base portion of nail 3112,3113, and Accumulating percussion force can be relative to 3112,3113 balance of nail.Wherein nail 3112,3113 be not covered in percussion path and/or In the case that person does not balance relative to percussion path, staple drivers can be used.For example, as further described herein, more nail drivings Device can promote multiple nails simultaneously from nail bin.

In all cases, in the case where sliding part is configured to directly drive nail, nail may include that sliding part connects Surface is closed, and sliding part may include following closely engagement surface.Nail can be the substantially " v-shaped " of the leg with base portion and not parallel extension Nail.For example, referring again to the nail 2612 being shown in Figure 39 B and Figure 40, for example, nail 2612 includes base portion 2614, from base portion 2614 First end extend the first leg 2616 and from the second end of base portion 2614 extend the second leg 2618.Nail 2612 can be formed by the line such as line with circular cross section, and therefore, following closely 2612 outer periphery can be made of circular surface. Therefore, the sliding part engagement surface for following closely 2612 may include round and/or curved surface.

In other cases, nail 2612 can be formed by the line with polygonal crosssection, and therefore, follow closely 2612 periphery While may include edge and flat surfaces or plane surface.In such embodiment, following closely 2612 sliding part engagement surface can wrap Include for example, at least a flat surfaces and/or plane surface.In other situations, the outer periphery for following closely 2612 may include curved table Both face and plane surface.For example, nail 2612 can be formed by the line with circular cross section, the line can be flattened and/or with Other manner is deformed to form flat sliding part engagement surface.

In some cases, nail can be formed by a block of material.For example, nail can be by material piece punching press, cutting and/or molding. Various punching press nails are described in the U.S. Patent application 14/138,481 that on December 23rd, 2013 submits, and this application is complete accordingly Text is herein incorporated by reference.In all cases, nail can be for example stamped and formed out by single piece of material or be formed in other ways, And it can for example remain the material of single piece of material and/or integrated block.In all cases, such as cunning of the nail of punching press nail etc The flat surfaces or plane surface of part that moving part engagement surface may include being stamped and formed out part or be formed in other ways.Separately Outside, in some cases, sliding part engagement surface may include groove and/or notch, be configured to receive wedge-shaped cunning The driving wedge piece of moving part.When nail is angularly orientated relative to the percussion path of driving wedge piece, groove can certain angle Degree traverses the base portion of nail.

Punching press nail 2912 is shown in Figure 26-Figure 28.Nail 2912 includes base portion 2914, the first leg 2916 and the second leg 2918.As shown in Figure 26-Figure 28, the outer periphery for following closely 2912 includes flat surfaces and curved surface.In addition, nail 2912 includes groove Or track 2915 (Figure 27 and Figure 28), it has been cut into base portion 2914.Groove 2915 is configured to receive driving sliding part 2958 driving wedge piece 2964.

In all cases, the width of groove 2915 can be slightly larger than the width for receiving the wedge piece 2964 of driving wherein Degree.For example, the size of the width of groove 2915 be designed to receive driving wedge piece 2964 and anti-non-magnetic shim 2915 relative to The lateral displacement of wedge piece 2964.

Be shown in nail 2912 in Figure 26-Figure 28 relative to driving wedge piece 2964 percussion path F (Figure 28) angularly It is orientated.For example, nail 2912 extends along axis A (Figure 27), axis A traverses percussion path F.Therefore, shown groove 2915 is worn The base portion 2914 for crossing nail 2912 is angularly orientated.For example, axis A can be orientated relative to percussion path F with angle, θ.It is shown in figure Angle, θ in 28 is 45 °.

Base portion 2914 has development length l.For example, the length l of base portion 2914 is more than the length of nail leg 2916,2918.Cause It is elongated for base portion 2914, so groove 2915 includes elongated guide surface or the track for driving wedge piece 2964, Promote the stability of the nail 2912 during deployment.Nail with elongate guide or track for receiving driving wedge piece is (such as 2912) nail for example may be incorporated into other embodiments disclosed herein.

Referring primarily to Figure 28, nail 2912 has the barycenter (COM) overlapped with percussion path F.For example, percussion path F extends Across the barycenter (COM) of nail 2912 so that nail 2912 is balanced relative to driving wedge piece 2964.Therefore, it is applied on nail 2912 Driving force can promote nail leg 2916,2918 simultaneously, and follow closely 2912 torsion or rotation and can be prevented from, minimize and/or control System.

In all cases, the groove similar to groove 2915 or track can be limited in non-punching press nail.For example, tailor's tack It can be by cutting, punching press and/or grinding to generate for the track slideably received within driving wedge piece.In such cases, it follows closely Base portion can have length identical with nail leg, or in other cases, base portion can be flattened to increase or extend its length Degree.In addition, in some cases, as further described herein, multiple driving wedge pieces drivably engage nail.In such situation Under, nail may include multiple grooves or track, can respectively be configured to receive driving wedge piece.In addition, in certain situations Under, there is the longitudinal axis that the nail similar to the guide rail of groove 2915 can for example be parallel to nail bin to be orientated.For example, parallel nail It can be longitudinally-aligned with the percussion path of driving wedge piece.In such cases, the guide rail being limited in the base portion of nail can edge The base portion for the nail for being parallel to it extends.

As described herein, the nail being angularly orientated can provide increased flexible and/or extensibility to suture tissue.Example Such as, the angled nail in the array of percussion nail pivotably and/or is rotated and is aligned to the cutting line of staple line and/or longitudinal axis, In order to suture the lengthening and/or linear deformation of tissue.Because angled nail can be pivoted in the array of suture tissue and/or rotation Turn, so the tearing and/or stretching, extension of tissue can be reduced and/or be prevented.In addition, the wound of the stress and/or suture tissue in tissue Wound can be minimized.

In addition to by percussion nail can extending longitudinally array provide longitudinal flexible other than, it is also possible to it is expected to the array by following closely The tissue of processing provides lateral customization.For example, compressing force applied to the organization can be based on the opposite side organized relative to staple line Optimize to position and/or adjusts.In certain cases, it may be desirable to customize tissue before quilting and/or during suture On compressing force.In other cases, it may be desirable to customize the structural compressing force of suture.In addition, in other situations, it can It can it is expected for example before quilting, during suture, and to customize structural compressing force after stapling.

Lateral tissue compression customization and longitudinal tissue's combination flexible can provide joint management effect.For example, when suturing During and/or after compressing force applied to the organization generate smaller stress in compression organization and/or influence reduced tissue When wound, the tissue of compression is suitable for increased flexible deformation.In other words, it is extended and/or stretches in the tissue of optimal compression When long, the tissue of the optimal compression can better adapt to rotation and/or the pivot of nail therein.In addition, when suture tissue is easy Ground adapt to nail pivot and/or displacement when, can reduce suture tissue in stress, and opposite joint be combined the wound knitted can be minimum Change.Therefore, when nail pivots and/or shifts to adapt to tissue lengthening or extending longitudinally, stress to optimal compression tissue and/or Wound can be further minimized.

Nail bin 3420 is shown in Figure 43-Figure 45.Shown nail bin 3420 includes warehouse 3424 and platform 3422.Multiple nail cavities 3428 are limited in the main body 3424 of shown nail bin 3420, and each nail cavity 3428 forms opening in platform 3422 3430.In addition, the nail cavity 3428 being shown in Figure 43-Figure 45 angularly takes relative to the longitudinal axis L (Figure 44) of nail bin 3420 To.In shown nail bin 3420, longitudinal slit 3432 is limited partially across warehouse 3424, and three nail chambers 3428 are determined Position is on the either side of longitudinal slit 3432.The arrangement for the nail cavity 3428 being shown in Figure 43-Figure 45 be configured to receive at The array of angle nail.For example, multiple nails such as 3412 (Figure 45) of nail are removably positioned in nail cavity 3428.

In shown nail bin 3420, the nail cavity 3428 in outboard row on the first side of longitudinal slit 3432 is relative to longitudinal direction Axis L (Figure 44) is orientated with first angle, and the nail cavity 3428 in intermediate row on the first side of longitudinal slit 3432 is relative to vertical At a second angle to axis L, the nail cavity 3428 in interior row and on the first side of longitudinal slit 3432 is relative to longitudinal direction Axis L is orientated with third angle.In shown nail bin 3420, third angle is same or about with first angle, and the Two angles bias 90 degree or about 90 degree with first angle and with third angle.

As further shown in Figure 43-Figure 45,3428 phase of nail cavity in the outboard row in the second side of longitudinal slit 3432 Longitudinal axis L (Figure 44) is orientated with fourth angle, the nail cavity 3428 in the intermediate row in the second side of longitudinal slit 3432 It is orientated with the 5th angle relative to longitudinal axis L, and the nail cavity 3428 in the inboard row in the second side of longitudinal slit 3432 It is orientated with hexagonal degree relative to longitudinal axis L.In shown nail bin 3420, hexagonal degree is identical as fourth angle or substantially phase Together, and the 5th angle and fourth angle and with 90 degree or about 90 degree of the 6th angle offset.In addition, being shown in Figure 43-Figure 45 In arrangement in, second angle and fourth angle and hexagonal degree are same or about, and first angle and third angle It is same or about with the 5th angle.

In other cases, nail bin 3420 may include the additional and/or less row of nail cavity.In addition to this or alternatively, follow closely 3412 angle orientation in that, in each row can be adjusted and/or be changed to adapt to different arrays.For example, in some cases, at least One nail cavity can be parallel to longitudinal axis L.

In all cases, the nail bin 3420 being shown in Figure 43-Figure 45 can be with end effector 2,000 1 shown in Figure 7 It rises and uses.For example, nail bin 3420 can be loaded into the elongated passageway of the second jaw 2004.In addition, in some cases, nail bin 3420 can be fired with single staple drivers, more staple drivers and/or combination thereof.For example, single staple drivers 3440 (Figure 45) It can be positioned in each nail cavity 3428, and drivably engage the nail 3412 being supported on.The driving being shown in Figure 45 Device 3440 can be positioned in warehouse 3424 so that the holder of each driver 3440 and a nail being located in nail cavity 3428 A nail alignment in nail 3412 in chamber.

In some cases, nail bin 3420 may include more staple drivers.For example, more staple drivers be configured to from First group of 3428 percussion nail 3412 (Figure 45) of nail cavity, and another more staple drivers is configured to from second group of nail cavity 3428 percussion nails 3412.In other cases, nail bin 3420 may not include driver.For example, firing member and/or sliding part (such as firing member 2660 and sliding part 2658 (Figure 37)) is for example configured to be in direct contact, engage and/or drive Nail 3412.In all cases, such as during deployment, driver 3440 and/or nail 3412 can be (such as sliding relative to sliding part Moving part 2058 (Fig. 7) and/or sliding part 2658 (Figure 37)) percussion path carry out mass balance.

The platform 3422 being shown in Figure 43-Figure 45 includes multiple longitudinally extending portions.For example, platform 3422 is included in longitudinal direction First longitudinal direction part 3422a, second longitudinal direction part 3422b on the side of slit 3432 and third longitudinal component 3422c, and The 4th longitudinal component 3422d, the 5th longitudinal component 3422e and the 6th longitudinal component on the other side of longitudinal slit 3432 3422f.As shown in Figure 43-Figure 45, longitudinal nail chamber 3428 and extension 3422a, 3422b longitudinally in each, 3422c, 3422d, 3422e, 3422f are aligned.For example, the outboard row nail cavity 3428 on the first side of longitudinal slit 3432 and first longitudinal direction portion 3422a alignment, the intermediate row nail cavity 3428 on the first side of longitudinal slit 3432 is divided to be aligned with second longitudinal direction part 3422b, and And the inboard row nail cavity 3428 on the first side of longitudinal slit 3432 is aligned with third longitudinal component 3422c.In addition, longitudinal slit Outboard row nail cavity 3428 in 3432 the second side is aligned with the 4th longitudinal component 3422d, in the second side of longitudinal slit 3432 Intermediate row nail cavity 3428 be aligned with the 5th longitudinal component 3422e, and the inside nail in the second side of longitudinal slit 3432 Chamber 3428 is aligned with the 6th longitudinal component 3422f.

In other cases, nail bin 3420 may include additional and/or less longitudinally extending portion.For example, longitudinal component It can be adjusted and/or change to be arranged corresponding to nail cavity and the different of nail.In certain embodiments, more than one longitudinal direction nail Chamber can be overlapped at least one longitudinal component.In addition to this or alternatively, at least one longitudinal component may not include such as nail cavity An and/or nail.

In shown nail bin 3420, adjacent longitudinal portions 3422a, 3422b, 3422c, 3422d, 3422e and 3422f pass through Ridge 3423 vertically biases relative to each other.For example, ridge 3423 is between first part 3422a and second part 3422b Extend, and another ridge 3423 extends between second part 3422b vehicle Part III 3422c.In addition to this, in shown cloth In setting, ridge 3423 extends between Part IV 3422d and Part V 3422e, and another ridge 3423 is in Part V Extend between 3422e and Part VI 3422f.As shown in Figure 43-Figure 45, longitudinal slit 3432 is in Part III 3422c and Extend between four part 3422d.

Ridge 3423 disclosed in Figure 43-Figure 45 limits the elevation variation in platform 3422.For example, first part 3422a and Ridge 3423 between second part 3422b limits upward step so that second part 3422b has higher than first part 3422 Elevation.In all cases, ridge 3423 laterally adjusts the height of platform 3422.For example, ridge 3423 inwardly increases platform 3422 Height and outward reduce platform 3422 height so that maximum height is adjacent with longitudinal slit 3432, and lateral flank Part has most short height.

When the jaw of end effector, the first jaw 2002 and the second jaw of such as end effector 2000 (Fig. 7) 2004 it is clamped when, the degree of the clearance control tissue compression between platform 3422 and the staple forming surface of anvil block.Therefore, platform 3422 height can influence the tissue compression degree between clamping jaw.For example, in 3422 higher region of platform, it is adjacent Tissue can more compress relatively between clamping jaw, and in the shorter region of wherein platform 3422, adjacent tissue It can less be compressed relatively between clamping jaw.Therefore, the ridge 3423 disclosed in Figure 43-Figure 45 can influence tissue compression It laterally varies.As further described herein, tissue compression degree can be selected and/or be optimized to reduce the stress to compression organization And/or wound.In addition, because nail bin 3420 is configured to the longitudinal flexible array of percussion nail 3412, it can be further Retain the integrality of suture tissue.

Ridge 3423 disclosed in Figure 43-Figure 45 influence adjacent longitudinal component 3422a, 3422b, 3422c, 3422d, Steep and/or steep steps between 3422e and 3422f.Figure 43-Figure 45 further discloses the nail that ridge 3423 surrounds adjacent row Nail cavity 3428 in chamber 3428 is bent.For example, ridge 3423 generally along path extend, the path correspond to and/or match and its The angle of adjacent one or more nail cavities 3428 is orientated.Therefore, ridge 3423 includes multiple curved and/or bending section.In addition, ridge 3423 are included in multiple straight or substantially straight parts of curved centre.

In other cases, ridge 3423 can limit less precipitous elevation variation.For example, at least one ridge 3423 and/or Its part gradually can tilt and/or be incrementally stepped different elevations.In addition, in some cases, longitudinal component 3422a, The height of 3422b, 3422c, 3422d, 3422e, 3422f are changeable.For example, longitudinally in each part 3422a, 3422b, 3422c, The height of 3422d, 3422e, 3422f can laterally and/or longitudinally change.In such cases, platform can limit for example in ridge Inclination among 3423 and/or angled surface.

In other nail bins, ridge can extend along the different paths between staple and nail cavity.For example, being shown in Figure 46-Figure 48 In nail bin 3520 be similar to nail bin 3420 (Figure 43-Figure 45), and similar reference numeral indicates similar element.For example, Nail bin 3520 includes warehouse 3524 and platform 3522.Multiple nail cavities 3528 are limited in the main body 3524 of shown nail bin 3520, And each nail cavity 3528 forms opening 3530 in platform 3422.In addition, the matching of nail cavity 3528 being shown in Figure 46-Figure 48 is shown The array of nail cavity 3428 in Figure 43-Figure 45.For example, in shown nail bin 3520, longitudinal slit 3532 by partially across Warehouse 3524 limits, and three nail chambers 3528 are positioned on the either side of longitudinal slit 3532.It is shown in Figure 46-Figure 48 The arrangement of nail cavity 3528 is configured to receive the array of angled nail.For example, multiple nails such as 3412 (Figure 45) of nail can quilt It is removably positioned in nail cavity 3528.

Platform 3522 disclosed in Figure 46-Figure 48 includes multiple longitudinally extending portions.For example, shown platform 3522 is included in First longitudinal direction part 3522a, second longitudinal direction part 3522b on the side of longitudinal slit 3532 and third longitudinal component 3522c, And the 4th longitudinal component 3522d, the 5th longitudinal component 3522e and the 6th longitudinal direction portion on the other side of longitudinal slit 3432 Divide 3522f.As shown in Figure 46-Figure 48, longitudinal nail chamber 3528 and extension 3522a, 3522b longitudinally in each, 3522c, 3522d, 3522e, 3522f are aligned.In addition, in shown nail bin 3520, adjacent longitudinal portions 3522a, 3522b, 3522c, 3522d, 3522e and 3522f are vertically biased relative to each other by ridge 3523.

Ridge 3523 disclosed in Figure 46-Figure 48 prolongs along the path different from the ridge 3423 of platform 3422 (Figure 43-Figure 45) It stretches.For example, ridge 3423 includes for example multiple notch, and such as notch 3523a, 3523b, 3523c and 3523d (Figure 47), median ridge 3523 do not extend along and/or adjacent to nail cavity 3528.The geometry of notch 3523a, 3523b, 3523c and 3523d can be chosen It is selected to adjustment tissue compression.For example, notch can expand the region of pressure reduction and reduce the increased adjacent area of pressure.Each In the case of kind, it may be desirable to provide notch 3523a, 3523b, 3523c and 3523d to cutter slit 3532 to provide such as reduction group Knit the region of compression.

As further described herein, ridge 3523 disclosed in Figure 46-Figure 48 can influence laterally varying for tissue compression.Example Such as, tissue compression degree can be selected and/or be optimized to reduce stress and/or wound to compression organization.In addition, because nail bin 3520 are configured to the longitudinal flexible array of percussion nail 3512, so can further retain the integrality of suture tissue.

In other cases, the ridge in storehouse platform can be straight or substantially straight.For example, being shown in the nail in Figure 49-Figure 51 Storehouse 3620 is similar to nail bin 3420 (Figure 43-Figure 45), and similar reference numeral indicates similar element.For example, nail bin 3620 include warehouse 3624 and platform 3622.Multiple nail cavities 3628 are limited in the main body 3624 of shown nail bin 3620, and Each nail cavity 3628 forms opening 3630 in platform 3622.In addition, the matching of nail cavity 3628 being shown in Figure 49-Figure 51 is shown in figure The arrangement of nail cavity 3528 in 46- Figure 48.For example, in shown nail bin 3620, longitudinal slit 3632 is by partially across warehouse 3624 limit, and three nail chambers 3628 are positioned on the either side of longitudinal slit 3632.The nail cavity being shown in Figure 46-Figure 48 3628 arrangement is configured to receive the array of angled nail.For example, multiple nails such as 3612 (Figure 51) of nail can be removed Ground is located in nail cavity 3628.

Platform 3622 disclosed in Figure 49-Figure 51 includes multiple longitudinally extending portions.For example, shown platform 3622 is included in First longitudinal direction part 3622a, second longitudinal direction part 3622b on the side of longitudinal slit 3632 and third longitudinal component 3622c, And the 4th longitudinal component 3622d, the 5th longitudinal component 3622e and the 6th longitudinal direction portion on the other side of longitudinal slit 3632 Divide 3622f.As shown in Figure 49-Figure 51, longitudinal nail chamber 3628 and extension 3622a, 3622b longitudinally in each, 3622c, 3622d, 3622e, 3622f are aligned.In addition, in shown nail bin 3620, adjacent longitudinal portions 3622a, 3622b, 3622c, 3622d, 3622e and 3622f are vertically biased relative to each other by ridge 3623.

Ridge 3623 disclosed in Figure 49-Figure 51 is along ridge 3423 and the platform 3522 (figure with platform 3422 (Figure 43-Figure 45) 46- Figure 48) the different path of ridge 3523 extend.For example, ridge 3623 extends along straight line path, which is parallel to vertical Extend to slit 3632.In addition, a part for longitudinal ridge 3523 extends through the nail cavity 3628 in nail bin 3620.Therefore, nail cavity 3628 end or side are positioned in longitudinal terrace part 3622a, 3622b, 3622c, 3622d, 3622e or 3622f One of in, and another end of identical nail cavity 3628 or side be positioned in longitudinal terrace part 3622a, 3622b, In the other of 3622c, 3622d, 3622e or 3622f.

As further described herein, ridge 3623 disclosed in Figure 49-Figure 51 can influence laterally varying for tissue compression.Example Such as, tissue compression degree can be selected and/or be optimized to reduce stress and/or wound to compression organization.In addition, because nail bin 3620 are configured to the longitudinal flexible array of percussion nail 3612, so can further retain the integrality of suture tissue.

In some cases, nail bin 3620 includes more staple drivers, more staple drivers 3640 disclosed in such as Figure 51.Often A more staple drivers 3640 are configured to from one group of 3628 percussion nail 3612 of nail cavity.For example, being similar to more staple drivers 2040a, 2040b (Fig. 7-Fig. 9), more staple drivers 3640 include three steps 3645, and slot or holder 3642 are limited to In each step 3645.In addition, the step 3645 of more staple drivers 3640 is connected the connection of flange 3648.It is shown in every in Figure 51 A more staple drivers 3640 are supported on the nail 3612 in multiple rows of nail cavity 3628, and are configured to from the nail cavity in multiple rows 3628 percussion nails 3612.In Figure 51, the height of each step 3645 and the depth for being defined in each holder 3642 therein are It is identical so that the staple forming surface on nail 3612 and anvil block formed between step 3645 has identical forming height.

As further described herein, it may be desirable to which customization and/or Optimize the forming scheme staple height are to influence the change in forming nail Tissue compression.Therefore, at least one of more staple drivers 3640 can be modified to form the nail 3612 of differing formed height.Example Such as, following closely the step 3645 of more staple drivers 3640 and/or holder 3642 can be modified to have different sizes so that by what is changed At least two nails in the nail 3612 that more staple drivers 3640 are formed have differing formed height.In other cases, different nails The step 3645 and/or holder 3642 of driver 3640 can be changed so that the first driver 3640 is configured to be formed Nail 3612 with the first forming height and the second driver 3640 are configured to be formed with the second different formings The nail 3612 of height.

In other situations, nail bin 3620 may include single staple drivers.Alternatively, nail bin 3620 may not include driver. For example, firing member and/or sliding part (such as firing member 2660 and sliding part 2658 (Figure 37)) are for example configured to Enough it is in direct contact, engages and/or drives nail 3612.In all cases, driver 3640 and/or nail 3612 can for example relative to The percussion path of sliding part (such as sliding part 2058 (Fig. 7) and/or sliding part 2658 (Figure 37)) carries out mass balance.

As described herein, in order to customize and/or be optimized to the tissue compression in staple, the nail followed closely in array can be formed Differing formed height.For example, in all cases, it may be desirable to tissue compression is laterally changed, to change forming nail size. In the case of such, for example, the tissue close to cutting line is more compressed than the tissue far from cutting line.With it is different not at The various nail arrays of shape height and/or differing formed height are described in following patent：The name that on January 1st, 2011 announces The referred to as United States Patent (USP) 7,866,528 of " STAPLE DRIVE ASSEMBLY "；On June 1st, 2010 announces entitled The United States Patent (USP) of " SURGICAL STAPLER WITH UNIVERSAL ARTICULATION AND TISSUE PRE-CLAMP " 7,726,537；The United States Patent (USP) 7,641,091 for entitled " the STAPLE DRIVE ASSEMBLY " that on January 5th, 2010 announces； The United States Patent (USP) 7,635,074 for entitled " the STAPLE DRIVE ASSEMBLY " that on December 22nd, 2009 announces；And 2011 The United States Patent (USP) 7 on August 16, entitled " STAPLE DRIVE ASSEMBLY " announced, 997,469, the patent is accordingly It is incorporated by reference and is incorporated herein.

Referring again to Figure 49-Figure 51, in all cases, nail bin 3620 can be used together with end effector, the end Actuator is configured to that nail 3612 is made to be deformed into differing formed height.Angled nail cavity 3628 in nail bin 3620 is arranged At multiple rows.For example, angled nail cavity 3628 is arranged in row outside first, the first intermediate row and the on the first side of nail bin 3620 In one in row, and angled nail cavity 3628 is arranged in row outside second, the second intermediate row and the in the second side of nail bin 3620 In two in row.In all cases, the nail 3612 that the nail cavity 3628 in being arranged outside first fires is than from the first intermediate row Higher forming height is presented in the nail 2612 that nail cavity 3628 fires, and/or is fired from the nail cavity 3628 in the first intermediate row The nail 2612 that is fired than the nail cavity 3628 in the row out of first of nail 3612 higher forming height is presented.In addition to this or separately Selection of land, the nail 3612 that the nail cavity 3628 in being arranged outside second fires is than the nail fired from the nail cavity 3628 in the second intermediate row 2612 are presented higher forming heights, and/or the nail 3612 fired from the nail cavity 3628 in the second intermediate row is than from the Higher forming height is presented in the nail 2612 that nail cavity 3628 in two in row fires.

In some cases, the nail 3612 fired from nail bin 3620 can have different unshaped height.For example, outside first The nail 3612 that nail cavity 3628 in row fires has bigger than the nail 2612 fired from the nail cavity 3628 in the first intermediate row Unshaped height, and/or from the nail 3612 that the nail cavity 3628 in the first intermediate row fires than the nail in the row out of first The nail 2612 that chamber 3628 fires has the unshaped height of bigger.In addition to this or alternatively, the nail cavity in being arranged outside second The nail 3612 of 3628 percussions has the unshaped height of bigger than the nail 2612 fired from the nail cavity 3628 in the second intermediate row, And/or what the nail 3612 fired from the nail cavity 3628 in the second intermediate row was fired than the nail cavity 3628 in the row out of second Unshaped height of the nail 2612 with bigger.

In all cases, the nail array with different unshaped height and/or differing formed height can be incorporated into that herein In the various nail bins.For example, nail bin 3420 (Figure 43-Figure 45) and nail bin 3520 (Figure 46-Figure 48) may include thering is difference It the nail of unshaped height and/or is configured to follow closely and is fired into differing formed height.In such cases, step Shape storehouse platform 3422 (Figure 43-Figure 45), 3522 (Figure 46-Figure 48) and 3622 (Figure 49-Figure 51) can influence the preshot that for example can be changed Tissue compression is sent out, and different forming nail heights can influence the rear percussion tissue compression that for example can be changed.

As described herein, it is at an angle of nail array and provides improved flexibility for suture tissue.Relative to nail bin cutting line and/ Or the angled nail of longitudinal axis can have than another nail leg closer to a nail leg of cutting line.In such an arrangement, In order to laterally customize and/or optimizing tissue compression, nail can be formed differing formed height.For example, an end of nail can shape As the first height, and another end followed closely is formed as the second different height.In such cases, by the nail of identical row The tissue of processing can be subjected to different compressing forces.

Nail bin 3720 and anvil block 3703 are shown in Figure 79.Nail bin 3720 is similar to nail bin 3620 (Figure 49-Figure 51), and class As reference numeral indicate similar element.For example, nail bin 3720 includes warehouse 3724 and platform 3722.Platform 3722 includes more A longitudinally extending portion 3722a, 3722b, 3722c, and adjacent longitudinal portions 3722a, 3722b, 3722c are divided by ridge 3723 It opens.Ridge 3723 is longitudinally extended along at least part of the length of warehouse 3722.Angled nail cavity 3728 is limited to warehouse In 3724, and ridge 3723 extends through nail cavity 3728.Therefore, the first end of shown nail cavity 3728 is positioned in first longitudinal direction In the 3722a of part, and the second end of shown nail bin 3728 is positioned in the 3722b of second longitudinal direction part.In addition, longitudinal narrow Slot 3732 is defined as partially across shown warehouse 3724.

In all cases, nail bin 3720 may include multiple nail cavities 3728, be configured to receive angled nail 3712 array.For example, nail bin 3720 may include the arrangement of nail cavity 3728, which corresponds to follows closely shown in Figure 49-Figure 51 The arrangement of chamber 3628.In some cases, three nail chambers 3728 can be positioned on such as both sides of longitudinal slit 3732.

Unshaped nail 3712 and change staple 3712 ' are shown in Figure 79.Nail 3712 includes base portion 3714, extends from base portion 3714 The first leg 3716 and from base portion 3714 extend the second leg 3718.Driver 3740 is also depicted in Figure 79.Driver 3740 include slot or holder 3742, and the slot or holder are configured to the base portion 3714 of support nail 3712.3740 He of driver Be defined in holder 3742 therein has variable height between the first end 3741 and the second end 3743 of driver 3740. For example, the first end 3741 of driver 3740 limits the first height, and the second end 3743 of driver 3740 limits the Two height, second height are less than the first height.

In driver 3740 in the nail cavity 3728 by percussion and rise when, nail 3712 rides over upwards promotes driver 3740 On, and deformed by the nail shapes pit of anvil block 3,703 3705.Forming nail 3712 ' is also depicted in Figure 79.The forming of nail 3712 ' is high Degree is the distance between the driver 3740 promoted and the nail shapes pit 3705 of anvil block 3703 or the function in gap.Because being promoted Driver 3740 nail the distance between support surface 3742 and nail shapes pit 3705 in the nail bin disclosed in Figure 79 Change in 3720, so forming nail 3712 ' has variable height.For example, the height of forming nail 3712 ' is in the first leg 3716 ' Between base portion 3714 ' than between the second leg 3718 ' and base portion 3714 ' bigger.In all cases, the angle of nail 3712 ' Degree, which is orientated, can be positioned to the first leg 3716 ' than the second leg 3718 ' further from longitudinal slit 3732.In such cases, First leg 3716 ' can be the outer leg of nail 3712 ', and the second leg 3718 ' can be the interior leg of nail 3712 '.In such cloth In setting, tissue compression is big than between outer leg 3716 ' and base portion 3714 ' between interior leg 3718 ' and base portion 3714 '.

It is configured to the nail bin for making angled nail be deformed into differing formed height and anvil block arrangement (such as 3720 He of nail bin Anvil block 3705) for example it may be incorporated into other embodiments disclosed herein.For example, the driving with variable height nail supporting support Device (such as driver 2740) for example may be incorporated into other nail bins disclosed herein and/or end effector assembly.

The unshaped nail 3712 being shown in Figure 79 also has variable height.For example, nail 3712 limits at the first leg 3716 Fixed first height and the second height of restriction at the second leg 3718, second height are less than the first height.In addition, nail 3712 Base portion 3714 limit bending section or step 3715, promote the second leg 3718 relative to the first leg 3716.

In other cases, unshaped nail 3712 can have even height.In addition to this or alternatively, unshaped nail 3712 Base portion 3714 can be straight or substantially straight between the first leg 3716 and the second leg 3718.In such cases, when When the distance between the nail support surface 3742 of the driver 3740 of promotion and nail shapes pit 3705 are variable, nail 3712 can be still It so presents and can be changed forming height.For example, a nail leg in nail leg 3716,3718 is more than another nail leg 3716,3718 Deformation and/or compacting are to adapt to additional leg length.In addition, because nail support surface 3742 and nail shapes pit 3705 between away from From change, so base portion 3714 can be bent and/or be otherwise deformed to adapt to difference in height during percussion.

Nail bin 3820 and anvil block 3803 are shown in Figure 80.Nail bin 3820 is similar to nail bin 3620 (Figure 49-Figure 51), and class As reference numeral indicate similar element.For example, nail bin 3820 includes warehouse 3824 and platform 3822.With (the figure of platform 3622 49- Figure 51) it is different, platform 3822 has flat or general planar non-stepped surface.Angled nail cavity 3828 is limited to In warehouse 3824.In addition, longitudinal slit 3832 is limited partially across shown warehouse 3824.

In all cases, nail bin 3820 may include multiple nail cavities 3828, be configured to receive angled nail Array.For example, nail bin 3820 may include the arrangement of nail cavity, which corresponds to the cloth of nail cavity 3628 shown in Figure 49-Figure 51 It sets.In some cases, three nail chambers 3828 can be positioned on such as either side of longitudinal slit 3832.

Unshaped nail 3812 is shown in Figure 80.Nail 3812 include base portion 3814, from base portion 3814 extend the first leg 3816 and from base portion 3814 extend the second leg 3818.Driver 3840 is also depicted in Figure 80.Driver 3840 includes slot Or holder 3842, it is configured to the base portion 3814 of support nail 3812.

Anvil block 3803 includes the lateral step shape surface 3801 towards storehouse.First nail shapes pit 3805a and second nail at Shape pit 3805b is limited in stepped surface 3801.As shown in Figure 80, the first nail shapes pit 3805a is in step In the first step 3801a on surface 3801, and the second nail shapes pit 3805b is in the second step of stepped surface 3801 In 3801b.

In driver 3840 in nail cavity 3828 by percussion and when being promoted, nail 3812 rides over upwards promotes driver 3840 On, and deformed by nail shapes pit 3805a, 3805b of anvil block 3803.Forming nail 3812 ' is also depicted in Figure 80.Nail 3812 ' Forming height be the distance between nail shapes pit 3805a, 3805b of the driver 3840 and the anvil block 3803 that are promoted or gap Function.Because between the nail support surface 3842 of the driver 3840 promoted and each nail shapes pit 3805a, 3805b It is different in distance nail bin 3720 shown in Figure 79, so variable height is presented in forming nail 3812 '.For example, forming nail 3812 ' Height bigger than between the second leg 3818 ' and base portion 3814 ' between the first leg 3816 ' and base portion 3814 '.Various In the case of, the first leg 3816 ' can be positioned to than the second leg 3818 ' further from longitudinal slit by the angle orientation of nail 3812 ' 3832.In such cases, the first leg 3816 ' can be the outer leg of nail 3812 ', and the second leg 3818 ' can be nail 3812 ' Interior leg.In such an arrangement, tissue compression is comparable in outer leg 3816 ' and base portion between interior leg 3818 ' and base portion 3814 ' Bigger between 3814 '.

In other cases, nail 3812 ' can be deformed into smaller height at outer leg 3816 '.Therefore, tissue compression is outside Than the bigger between interior leg 3818 ' and base portion 3814 ' between leg 3816 ' and base portion 3814 '.

It is configured to the nail bin for making angled nail be deformed into differing formed height and anvil block arrangement (such as 3820 He of nail bin Anvil block 3805a, 3805b) for example it may be incorporated into other embodiments disclosed herein.For example, variable depth pit (such as pit 3805a, 3805b) for example it may be incorporated into other embodiments disclosed herein.

The unshaped nail 3812 being shown in Figure 80 has variable height.For example, nail 3812 limits at the first leg 3816 First height and the second height of restriction at the second leg 3818, second height are less than the first height.

In other cases, unshaped nail 3812 can have even height.In such cases, when the driver of promotion When the distance between 3840 nail support surface 3842 and nail shapes pit 3805 are variable, nail 3812, which can be still presented, to be become Shape height.For example, one in nail leg 3816,3818 more deforms and/or is compacted with suitable than another nail leg 3816,3818 Answer additional length.

In certain form of surgical operation, the use of surgical staples or surgical fastener has become the preferred side of engagement tissue Method, and developed specifically-built surgical stapling device or circular surgical clamp device for these applications.For example, intracavitary Or circular stapler has been developed that for being used in the surgical operation for being used to form " identical ".It can be used for executing anastomosis Circular stapler for example has in following patent disclosed：Entitled " INTRALUMINAL ANASTOMOTIC SURGICAL The United States Patent (USP) 5 of STAPLER WITH DETACHED ANVIL ", 104,025, entitled " CIRCULAR STAPLER The United States Patent (USP) 5 of TISSUE RETENTION SPRING METHOD ", 309,927, entitled " SURGICAL CUTTING AND STAPLING DEVICE WITH CLOSURE APPARATUS FOR LIMITING MAXIMUM TISSUE The United States Patent (USP) 7 of COMPRESSION FORCE ", 665,647, entitled " SURGICAL STAPLING SYSTEMS AND STAPLE CARTRIDGES FOR DEPLOYING SURGICAL STAPLES WITH TISSUE COMPRESSION The United States Patent (USP) 8 of FEATURES ", 668,130, the complete disclosure of each patent is hereby incorporated by reference.

A form of " anastomosis " includes first cutting off linkage section (being usually illness section) and then each section of connection by intestines To surgical operation together.Operation needs connect together the end of two tubular sections, to form continuous tubular conduit. In the past, this surgical operation was time-consuming and laborious operation.Surgeon accurately must cut and be aligned the end of intestines, and logical It crosses and keeps aligned condition when repeatedly suture connects end.The exploitation of round clamp device enormously simplifies anastomosis journey Sequence, and also shorten the time executed needed for anastomosis.

In general, conventional circular stitching unstrument or clamp device are made of elongated shaft, which includes nearside actuator Structure and distal side suturing mechanism mounted on the shaft.Distal side suturing mechanism is usually made of fixed nail bin, the cartridge cloth It is set to multiple nails of circular concentric array.Round cutter is also concentrically attached in storehouse so that it is in the inside of nail.Knife can It is moved axially along distal direction.What it is from the central axial extension in storehouse is trocar shaft.Trocar shaft also can be in elongated shaft inner shaft To movement.Trocar shaft is configured to be removably attached to anvil member.Anvil member includes nail shaped lower face, It is arranged in face of nail bin to form the end of nail when nail is advanced to and is in contact with it.The distal face of nail bin and the nail of anvil block at The distance between shape lower surface is usually controlled by the regulating mechanism for being installed to the nearside of stapler shaft.When surgeon activates When mechanism, while suturing and cutting the tissue being accommodated between nail bin and nail anvil.

When executing anastomosis using circular stapler, intestines initially are sutured usually using conventional surgical stitching unstrument, this is outer Section's stitching unstrument disposes two rows of staples on the either side of the target phase (that is, illness section or sample) of intestines.Usually while suture Cut target phase.Next, after removing sample, anvil block is usually inserted into the close of tube chamber (i.e. intestines) by surgeon in staple line nearside Side end.This is completed by the way that anvil head is inserted into the entrance that surgeon cuts in nearside tube chamber (intestines).Sometimes, anvil block can Per anum is placed, i.e., by the way that anvil head to be placed in the distal end of stitching unstrument and by rectal insert tool.Then it uses The proximal end of intestines is sewn onto anvil shaft by suture or other conventional fastening devices.Next, surgeon's excision is neighbouring The excess tissue of tying, and anvil block is attached to the trocar shaft of stitching unstrument.Surgeon then by by anvil block towards nail bin It pulls and comes the gap between closed anvil and storehouse.When anvil block is moved towards storehouse, the proximal end and distal end of intestines are clamped in Therebetween.Then stitching unstrument is activated, passes through two ends of intestines to be driven to and anvil block shaping contact so as to cause staple.Meanwhile When driving is followed closely and nail is made to shape, driving circular shear blade passes through intestinal tissue end, to the end of the neighbouring interior nail of cutting.It connects It, surgeon takes out stitching unstrument from intestines, and completes anastomosis.

Effective healing of coloproctosomy can be challenged by a number of factors and condition.For example, healing can be kissed Close the existing influence of bacterial pollutant in region.In general practice, the success rate of anastomosis is often as patient restores to move It moves property and improves.Desirably patient restores content transmission as early as possible.The restraining factors that content transmits are " narrow " Risk.If colonic contents cannot be by staple line, or if they significantly compress staple line, tearing, rupture may occur Or leakage.For the organ (such as lung) of high level expansion, develop can linear expansion staple line.However, such nail configuration is uncomfortable It is used in combining circular stapler.

Figure 29 shows to be generally termed as 5000 a form of circular stapler or stitching devices.Various circular seams attach together It sets and is well-known and for installing operation nail or fastener.Therefore, in addition to possible it should be understood that being disclosed herein and attached It innovates and arranges shown in figure, will not be begged in detail herein about the construction of circular stapling device and the various details of operation By.More details about round fastener and stitching devices are found in entitled " SURGICAL CUTTING AND STAPLING DEVICE WITH CLOSURE APPARATUS FOR LIMITING MAXIMUM TISSUE The United States Patent (USP) 7,665,647 (full patent texts are herein incorporated by reference) of COMPRESSION FORCE " and with reference Other United States Patent (USP)s that mode is incorporated herein.In general, be suitable for Figure 29 in circular stapling device 5000 include head 5002, Anvil block 5004, adjustment knob assembly 5006 and the shank 5010 for being supported on trigger 5008.Handle assembly 5010 is logical It crosses arch shaft assembly 5012 and is connected to head 5002.In shown arrangement, trigger 5008 by handle assembly 5010 pivotly Support, and for operating stitching unstrument 5000 when release mechanism (not shown) is released.When trigger 5008 is activated, hit Hair mechanism movably promotes in shaft assembly 5012 so that follows closely or fastener is discharged or is deployed to from head 5002 and anvil block The shaping contact of 5004 anvil block shaped lower face 5005.Meanwhile being operatively supported at circular knife (Figure 29 in head 5002 In it is invisible) promoted towards anvil block 5004 towards distal side, and be clamped in 5002 He of head for cutting in a known way Tissue between anvil block 5004.Then stitching devices 5000 are removed from operative site, appropriate location is stayed in which tissue will be sutured.

Such as from Figure 29 it can also be seen that anvil block 5004 include annular body portion 5014, the annular body portion have from Its anvil shaft 5016 outstanding.Anvil shaft 5016 is configured to be removably attached to be operatively supported at shaft assembly Trocar shaft 5050 in 5012.Referring to Figure 29 A.It is well known that trocar shaft 5050 is movably supported with shaft assembly 5012, And it is operativelyd interface with adjustment knob assembly 5006, which is pivotally supported at handle assembly 5010 On.Anvil shaft 5016 can be removably attached to trocar shaft 5050 or other releasable clamp devices by geometrical clamp 5052 It can also be used for anvil shaft 5016 being removably secured to trocar shaft 5050.Once anvil shaft 5016 has been attached to trocar shaft 5050, clinician can by will adjust knob 5006 along the rotation of appropriate direction of rotation by anvil block 5004 toward and away from head 5002 movements.

Figure 29 A show head 5002, which has the unique and novel fastener cartridge being operably mounted therein Component 5020.As seen from the figure, fastener cartridge assembly 5020 includes warehouse 5022, which includes circular platform 5030.Circle Shape platform 5030 can form plane surface 5032, which is arranged to when anvil shaft 5016 is attached to trocar shaft 5050 When in face of anvil block 5004 nail shaped lower face 5005.Multiple securing member chambers 5040 are arranged in circular platform 5030 and by structure It causes at least one surgical staples or surgical fastener be received (not shown) wherein, the surgical staples or surgical fastener can It is operatively supported on actuator assembly 5060, which is movably supported at the main body of fastener cartridge assembly 5020 In 5022.It is corresponding that actuator assembly 5060 is operably linked to being operativelyd interface with trigger 5008 for shaft assembly 5012 Moveable part.The enabling of trigger 5008 for example will cause actuator assembly 5060 along the axial movement of distal direction " DD ". Actuator assembly 5060 will lead to surgical staples being supported in each securing member chamber 5040 or tight along the movement of distal direction " DD " Firmware is mobile or is discharged, thus with 5005 shaping contact of nail shaped lower face on anvil block 5004.

Referring still to Figure 29 A, for example, each securing member chamber 5040 includes two chamber ends 5042,5044.In shown arrangement In, each chamber end 5042 (its also can referred to herein as " the first chamber end ") be positioned in the with the first radius " FR " In one circular axis " FCA ".First radius " FR " can be measured from apparatus axis axis " SA ".In addition in shown arrangement, chamber end 5044 (its also can referred to herein as " the second chamber end " be positioned in the second circular axis with the second radius " SR " On " SCA ", which is different from the first radius " FR ".In the shown embodiment, it is also measured from axis axis " SA " Second radius " SR " is more than the first radius " FR ".In addition in the embodiment shown in the drawing, each securing member chamber 5040 includes chamber axis Line " CA ".In the embodiment shown in the drawing, each securing member chamber 5040 is relative to the first circular axis " FCA " and the second circular shaft Line " SCA " is disposed in circular platform 5030 so that each cavity axis " CA " and the first circular axis " FCA " and second are round Axis " SCA " forms acute angle.In other words, the chamber end 5042 of adjacent fastener chamber 5040 is adjacent to each other, and identical fastening The end 5044 of part chamber 5040 is separated from each other.Such arrangement can referred to herein as " zigzag " be orientated.However, other In arrangement, cavity axis " CA " can be perpendicular to the first circular axis " FCA " and the second circular axis " SCA ".

In the arrangement in being shown in Figure 29 A, each chamber end 5042,5044 can be V-arrangement so that they are commonly terminated in A bit.For example, each chamber end 5042 can be commonly terminated in a little 5043 and each end 5044 may terminate at a little 5045.Point 5043 can be positioned in the first circular axis " FCA " or intersect with it, and point 5045 can be positioned in the second circular axis Intersect on " SCA " or with it.Such chamber arrangement leads to surgical staples or fastener to apply with similar pattern is organized.In shown cloth In setting, securing member chamber 5040 respectively supports a surgical staples or surgical fastener wherein.However, in other arrangements, no Only a nail or fastener can be supported in each chamber.Fastener cartridge assembly 5020 uses class in each securing member chamber 5040 Like the nail of size.In other arrangements, different size of surgical staples or fastener can be used in fastener cartridge assembly.It is adoptable Surgical staples for example include two nail legs extended from center body portion or bizet.Leg can be received in the V of securing member chamber 5040 In shape end 5042,5044 so that when they are projected from chamber 5040, leg extends through the first circular axis or the second circle Axis, this under any circumstance can.These nails, which are orientated, can solve the problems, such as that some are narrow associated with above-mentioned nail.Specifically It says, the nail configuration formed when using fastener cartridge assembly 5020 can enable staple line more like original colon more swollen than conventional staple line Swollen and bending.For example, nail or fastener can be distorted when it is radially pulled, to allow them to make the stress on healing area It minimizes and makes flexible and maximum intensity.

Another Focus Area associated with coloproctosomy journey regulation is related to letting out by the radial direction of attachment area Leakage.Above-mentioned fastener cartridge assembly 5020 can also solve the problems, such as the field.Another fastener cartridge assembly 5120 is shown in Figure 30 And it can also solve the problems, such as above-mentioned various and misgivings.As seen from the figure, securing member chamber be with the arrangement of " asymmetric pattern ", Those of outer shroud or outer circular the array application of nail and transit chamber that the inner ring or inner circular array of middle transit chamber apply nail Or the function of fastener is different.

More particularly and with reference to Figure 30, fastener cartridge assembly 5120 includes warehouse 5122, which includes circular flat Platform 5130.Circular platform 5130 can form plane surface 5132, which is arranged to when anvil shaft 5016 is attached to set In face of the nail shaped lower face 5005 of anvil block 5004 when pipe needle shaft 5050.First ring 5036 of the first chamber 5040 is arranged in circular flat In platform 5130, and the second ring 5160 of the second chamber 5170 is arranged across storehouse platform 5130, as shown in the figure.First chamber 5040 and Each of two chambers 5170 are configured at least one surgical staples or surgical fastener receiving (not shown) wherein, should Surgical staples or surgical fastener are operatively supported on actuator assembly 5060, which is movably supported at tightly In the main body 5122 of firmware storehouse component 5120.

Each securing member chamber 5040 includes two chamber ends 5042,5044.Each chamber end 5042 is positioned in the In the first circular axis " FCA " of Radius " FR ".First radius " FR " can be measured from apparatus axis axis " SA ".Each chamber end 5044 are positioned in the second circular axis " SCA " with the second radius " SR ", which is different from the first half Diameter " FR ".In the shown embodiment, the second radius " SR " also measured from axis axis " SA " is more than the first radius " FR ".It is each tight Firmware chamber 5040 includes cavity axis " CA ".In the embodiment shown in the drawing, each securing member chamber 5040 is relative to the first circular shaft Line " FCA " and the second circular axis " SCA " are disposed in circular platform 5130 so that each cavity axis " CA " and the first circle Axis " FCA " and the second circular axis " SCA " form acute angle.In other words, the chamber end 5042 of adjacent fastener chamber 5040 that This is adjacent, and the end 5044 of same fasteners chamber 5040 is separated from each other.Such arrangement can be referred to herein as " sawtooth Shape " is orientated.However, in other arrangements, cavity axis " CA " can be perpendicular to the first circular axis " FCA " and the second circular axis “SCA”。

In addition in the arrangement in being shown in Figure 30, each chamber end 5042,5044 can be V-arrangement so that they are usually eventually It terminates in a bit.For example, each chamber end 5042 can be commonly terminated in a little 5043 and each end 5044 can be commonly terminated in a little 5045.Point 5043 can be positioned in the first circular axis " FCA " or intersect with it, and point 5045 can be positioned in the second circle Intersect on shape axis " SCA " or with it.Such chamber arrangement leads to surgical staples or fastener to apply with similar pattern is organized.Separately In arrangement shown in external, the second ring 5160 includes multiple second securing member chambers 5170, and second securing member chamber is in third circular shaft It is aligned on line " TCA ", which is arranged in from axis axis " SA " at third radius " TR ".In shown arrangement, the Three radiuses " TR " are less than the first radius and the second radius.However, in other arrangements, third radius " TR " is more than the first radius. However, in other arrangement, third radius " TR " is more than the first radius and the second radius.

Unique and novel fastener cartridge assembly 5120 is used to make nail or fastener in tissue to be oriented such that their phases The amount of expansion for being applied to staple line will be " adjustable ".Adoptable surgical staples for example include from center body portion or Two nail legs that bizet extends.Leg can be received in the V-arrangement end of securing member chamber so that when they are projected from chamber, leg The first circular axis " FCA ", the second circular axis " SCA " or third circular axis " TCA " are extended through, this is under any circumstance It can.These nails, which are orientated, can cause and the improvement of the narrow associated problem of above-mentioned nail.For example, a ring of nail or fastener (for example, second ring 5160) provides standard seal feature structure, and the first ring 5036 can be with the radial direction and flexibility aspect of staple line It is more consistent.Therefore, it is such arrangement can also provide with discussed above for fastener cartridge assembly 5020 it is same or analogous excellent Point.

Figure 31 shows that another unique and novel fastener cartridge assembly 5220, the fastener cartridge assembly can also solve above-mentioned Various problems and misgivings.As seen from the figure, securing member chamber is with the arrangement of " asymmetric pattern ", and the inner ring of wherein transit chamber is applied The outer shroud of the nail added and transit chamber those of applies nail or the function of fastener is different.

More particularly and with reference to Figure 31, fastener cartridge assembly 5220 includes warehouse 5222, which includes circular flat Platform 5230.Circular platform 5230 can form plane surface 5232, which is arranged to when anvil shaft 5016 is attached to set In face of the nail shaped lower face 5005 of anvil block 5004 when pipe needle shaft 5050.First ring 5236 of the first chamber 5240 is arranged in circular flat In platform 5230, and the second ring 5260 of the second chamber 5270 is arranged by storehouse platform 5230, as shown in the figure.First chamber 5240 and Each of two chambers 5270 are configured at least one surgical staples or surgical fastener receiving (not shown) wherein, should Surgical staples or surgical fastener are operatively supported on actuator assembly 5060, which is movably supported at tightly In the main body 5222 of firmware storehouse component 5220.

Each securing member chamber 5240 includes two chamber ends 5242,5244.Each chamber end 5242 is positioned in the In the first circular axis " FCA " of Radius " FR ".First radius " FR " can be measured from apparatus axis axis " SA ".Each chamber end 5244 are positioned in the second circular axis " SCA " with the second radius " SR ", which is different from the first half Diameter " FR ".In the shown embodiment, the second radius " SR " also measured from axis axis " SA " is more than the first radius " FR ".It is each tight Firmware chamber 5240 includes cavity axis " CA ".In the embodiment shown in the drawing, each securing member chamber 5240 is relative to the first circular shaft Line " FCA " and the second circular axis " SCA " are disposed in circular platform 5230 so that each cavity axis " CA " and the first circle Axis " FCA " and the second circular axis " SCA " form acute angle.

In addition in the arrangement in being shown in Figure 31, each chamber end 5242,5244 can be V-arrangement so that they are usually eventually It terminates in a bit.For example, each chamber end 5242 can be commonly terminated in a little 5243 and each end 5244 can be commonly terminated in a little 5245.Point 5243 can be positioned in the first circular axis " FCA " or intersect with it, and point 5245 can be positioned in the second circle Intersect on shape axis " SCA " or with it.Such chamber arrangement leads to surgical staples or fastener to apply with similar pattern is organized.Separately In arrangement shown in external, the second ring 5260 includes multiple second securing member chambers 5270, and second securing member chamber is in third circular shaft It is aligned on line " TCA ", which is arranged in from axis axis " SA " at third radius " TR ".In shown arrangement, the Three radiuses " TR " are less than the first radius and the second radius.However, in other arrangements, third radius " TR " is more than the first radius. However, in other arrangement, third radius " TR " is more than the first radius and the second radius.These nail be orientated can cause with it is above-mentioned The improvement of the associated problem of pin structure.In particular, the nail configuration formed when using fastener cartridge assembly 5220 can make nail Line more like original colon can expand and be bent than conventional staple line.For example, nail or fastener can be turned round when it is radially pulled Song, to allow them that the stress on healing area is made to minimize and make flexible and maximum intensity.

It has been proved that auxiliary film/backing material can improve hemostasis and wind-puff by being sealed in around nail end.Permitted In applying, backing material is for hardening and/or reinforcing soft tissue more.Various backing material arrangements have been developed that and are configured to Surgery nail bin for being arranged in surgical stapling device or anvil block.Supporting member is attached to storehouse or anvil block, is then released from it Putting backing material may be challenging.Figure 58 shows surgical end-effector 5300 and surgery cuts and fastening instrument 5400 part.Supporting member 5500 is attached to surgical staples by end effector 5300 using unique and novel arrangement Storehouse 5320 simultaneously therefrom discharges it.The surgery cuts of the type in Figure 58 and the example of fastening instrument are shown in June 30 in 2014 Entitled " the SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZING that day submits There is disclosed, the complete disclosure evidence of this application in the U.S. Patent Application Serial Number 14/318,991 of ARRANGEMENTS " This is herein incorporated by reference.In addition to understand end effector 5300 construction and purposes needed for other than other details can be with It is collected with reference to the document and many other documents being herein incorporated by reference.

As in Figure 58 as it can be seen that be shown in end effector 5300 therein include elongate staple channel 5302, the elongate staple channel It is configured to be operably supported nail bin 5320 wherein.Elongate staple channel 5302 is connected to ridge part 5404, the spine Divide and is operatively supported in the elongated shaft assembly 5402 of surgery suturing appliance 5400.Nail bin 5320 includes warehouse 5322, the storehouse Body can be made of polymer material.In the embodiment shown in the drawing, metal chassis 5324 is attached to warehouse 5322.Warehouse 5322 wraps Platform 5330 is included, which, which has, is defined in multiple nail cavities 5332 therein.Each nail cavity 5332 is configured to will to follow closely can It is stored therein in removing.Warehouse 5322 further includes longitudinal slit, which is configured to firing member 5410 It is removably received in wherein.Warehouse 5320 may also include distal end 5326, proximal end 5328 and in distal end The opposite longitudinal direction side 5329 extended between 5326 and proximal end 5328.In all cases, side 5329 may include longitudinally in each It is defined in adjoining or the continuous boundary of no interruption therein.

It is nail 5342 to be located in each nail cavity 5332, which is supported on corresponding staple drivers 5340, nail driving Device is movably supported in warehouse 5322.When firing member 5410 drives across nail bin 5320 towards distal side, staple drivers 5340 are moving upward.It is such as discussed in more detail in U.S. Patent Application Serial Number 14/318,991,5410 quilt of firing member It is constructed to be permeable to promote nail sliding part 5350 towards distal side to be lifted up staple drivers 5340 and nail 5342 and be lifted out nail Chamber 5332.End effector 5300 further includes the anvil block 5360 for being installed to elongate staple channel 5302.In the embodiment shown in the drawing, Anvil block 5360 includes a pair of of the lug 5362 being movably received in the lug slit 5304 in elongate staple channel 5302.Such as exist Furthermore, it can be seen that anvil block 5360 includes anvil block lug 5364 in Figure 58, which interacts with pipeline section 5420 is closed.It closes Anvil block 5360 can be moved along the movement of distal direction " DD " along the direction towards nail bin 5320 by closing pipeline section 5420.5420 edge of closed tube The movement of proximal direction " PD " causes anvil block to move away from nail bin 5320.Storehouse and anvil block arrangement can be used in other embodiments, Middle anvil block is static (for example, the elongated shaft for the surgical device that is immovably secured to), and elongated passageway and/or nail bin energy It is enough to be moved toward and away from anvil block.

As in Figure 58 and Figure 59 as it can be seen that supporting member 5500 be configured to receive in surgery nail bin 5320 and anvil block Between 5360.More precisely, supporting member 5500 is configured to receive the nail shaped lower face 5366 in anvil block 5360 Between the platform 5330 of nail bin 5320.In the embodiment shown in the drawing, supporting member 5500 is configured to be tensioned ground On the platform 5330 of nail bin 5320.The backing material for constituting supporting member 5500 may include such as Gore SeamGuard Material, Synovis Peri-Strips materials and/or polyurethane.Other suitable backing materials or auxiliary material were at 2014 6 Entitled " the SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZING that the moon is submitted on the 30th Disclosed in having in the U.S. Patent Application Serial Number 14/318,991 of ARRANGEMENTS ", in the entire disclosure of the patent application Appearance is previously hereby incorporated herein by.Various other suitable backing materials and auxiliary material are also on 2 28th, 2013 The U.S. Patent application of entitled " the LAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES " that submits Disclosed in having in sequence number 13/763,095, the complete disclosure of the patent application is hereby incorporated herein by accordingly. The complete disclosure of following application is also incorporated herein by reference：Entitled " the TISSUE that on June 25th, 2012 submits STAPLER HAVING A THICKNESS COMPENSATOR COMPRISING INCORPORATING A HEMOSTATIC Entitled " the TISSUE STAPLER that the U.S. Patent Application Serial Number of AGENT " is submitted on June 25th, 13/531,619,2012 U.S. of HAVING A THICKNESS COMPENSATOR INCORPORATING AN OXYGEN GENERATING AGENT " Entitled " the TISSUE STAPLER HAVING A that state's patent application serial number is submitted on June 25th, 13/531,623,2012 The U.S. Patent application sequence of THICKNESS COMPENSATOR INCORPORATING AN ANTI-MICROBIAL AGENT " Entitled " the TISSUE STAPLER HAVING A THICKNESS submitted in row number 13/531,627 and on June 25th, 2012 The U.S. Patent Application Serial Number 13/ of COMPENSATOR INCORPORATING AN ANTI-INFLAMMATORY AGENT " 531,630。

In the embodiment shown in the drawing, nail bin 5320 includes protruding portion 5336, and the protruding portion is with U.S. Patent Application Serial The various modes and arrangement being described in detail in number 14/318,991 are upwardly extended from the platform 5330 of neighbouring each nail cavity 5332. In other embodiments, nail bin does not have such protruding portion.In the embodiment shown in the drawing, supporting member 5500 includes wherein Hole 5502, the hole correspond to protruding portion 5336.See, for example, Figure 61 and Figure 62.However, as it can be seen that hole 5502 only holds in such as those figures Receive protruding portion 5336 so that backing material crosses over at least part of region for corresponding to the bizet for being supported on the nail in chamber.Branch Those of crown part part that corresponds to of timbering material is usually identified as 5504 in Figure 61 and Figure 62.

Supporting member 5500 includes the device for supporting member 5500 to be releasably secured to warehouse 5322 so that branch Support component 5500 is kept on it with being tensioned before the actuating of surgical instruments, is then activated or " percussion " in surgical instruments When from warehouse 5322 discharge.For example, as, as it can be seen that supporting member 5500 includes distal end 5503, which exists in Figure 58 Wherein there is at least one distal side to keep feature structure 5506.In shown arrangement, two distal apertures 5506 are arranged on distal side In end 5503 and it is configured to receive from the distal end 5326 of warehouse 5322 corresponding holding member 5338 outstanding. As shown in Figure 59 and Figure 60, holding member 5338 is configured to receive the distal end portion 5503 in supporting member 5500 In distal aperture 5506 in, the distal end of supporting member 5500 is releasably held in the distal end portion in storehouse 5320 On 5326.When tension is applied to supporting member 5500 along proximal direction and/or distal direction, other forms also can be used Supporting member 5500 is releasably held in nail bin by releasable holding member (shape, quantity, size, configuration) and arrangement On 5320.

Figure 63-Figure 65 is gone to, supporting member 5500 includes proximal end part 5510, which has on it There is nearside to keep feature structure 5511.In the embodiment shown in the drawing, nearside keep feature structure 5511 include from it proximally At least one holding lug 5512 outstanding.Lug 5512 is kept to be positioned such that when hole 5506 is inserted on warehouse 5322 Above holding member 5338 and when supporting member 5500 is received in storehouse platform 5330, lug 5512 and warehouse 5322 are kept In elongated slot 5334 be aligned.Referring to Figure 64.When nail sliding part 5350 is in its nearside initial position in storehouse 5320, protect It holds lug 5512 to be folded in the proximal end of warehouse, and is maintained in elongated slot 5334 by nail sliding part 5350.Nail Sliding part 5350 can be type and construction disclosed in U.S. Patents Serial numbers 14/318,991 comprising stabilizing member 5352, The stabilizing member extends with Stable sliding part 5350 towards distal side and prevents and/or inhibit to follow closely the shake or rotation of sliding part 5350 Turn.As in Figure 65 as it can be seen that keep lug 5512 by stabilizing member 5352 and/or follow closely sliding part 5350 other parts be maintained at thin In long slit 5534.Such arrangement is tightly retained in nail platform 5330 for opening supporting member 5500.In other words, it props up Support component 5500 can stretch between holding member 5338 and the proximal end 5328 of nail bin 5320.When clinician activates surgery When instrument is to start percussion process, firing member 5410 is promoted along distal direction " DD " towards distal side.Firing member 5410 is slided with nail Moving part 5350 joins, and such as U.S. Patent Application Serial Number 14/318, and discussed in 991, firing member 5410 slides nail Part 5350 is moved distally across nail bin 5320 to drive up staple drivers 5340 so that the nail 5342 being supported on is driven Move with 5366 shaping contact of the downside of anvil block 5360, and the tissue being clamped between anvil block 5360 and nail bin 5320 is cut Component 5410 is cut off.Remained engaged with once nail sliding part 5350 has disengaged from lug 5512 is kept, holding lug 5512 just by Release, so that backing material 5500 can be removed with suture tissue from nail bin 5320.Such arrangement was for firing The tension in backing material 5500 is discharged when journey starts.In addition, such support arrangement need not add releasing parts or configuration.

Existing suturing skill is not particularly well-suited for undergoing the tissue of stretching, extension during agglutination.For example, in chest thin-walled In tissue suture, staple line is fired on the lung in collapsed configuration.After the completion of operation, atelectasis, this frequently results in the table of lung Area doubles.Existing suturing skill does not have the expansion service with lung tissue same degree usually.This may cause close to nail The notable strain gradient of line, this may lead to the high stress in staple line, especially in the staple farthest from cutting edge.Therefore, In order to mitigate strain gradient and related stress to eliminate or at least reduce potential leaking source, need to allow staple line stretch and/or Increase the technology of length.

It has been proved that auxiliary film/backing material can improve hemostasis and wind-puff by being sealed in around nail end.Permitted In applying, backing material is for hardening and/or reinforcing soft tissue more.However, existing backing material may not have enough Elasticity, to not interfere the compliance of elastic nail line.Figure 66-Figure 68 shows a form of backing material 6100, the fid Material can solve this problem.As in these figures as it can be seen that backing material 6100 include supportive body 6102, the supportive body It is sized to operationally receive on the platform 6004 of surgery nail bin 6000.In the shown embodiment, surgery nail bin 6000 include the warehouse 6002 for limiting platform 6004.Warehouse 6002 includes the elongated slot 6006 being centrally located, the elongated slot It is configured to receive tissue cutting element (not shown) across it.Multiple nail pits or nail cavity are in the every of elongated slot 6006 It is arranged on side in platform 6004.As shown, the first row 6010 of the first chamber 6012 is arranged on elongated slot 6006 Every side on.The first chamber 6012 in each first row 6010 is parallel to each other.Each of first chamber 6012 is arranged to phase It is angled and adjacent thereto for elongated slot 6006.Shown warehouse 6002 further includes being arranged to relative to the first nail cavity The two rows 6020 of 6012 the second angled nail cavities 6022.The two rows 6030 of third nail cavity 6032 are also disposed in warehouse 6002 In, as shown in the figure.In at least one form, third nail cavity 6032 is parallel with corresponding first nail cavity 6012.However, it can be used It is followed closely or securing member chamber arrangement.In addition, staple cartridge body 6002 can have the lateral lip 6008 projected laterally therefrom.In addition such as Figure 66 In as it can be seen that the proximal end 6003 of warehouse 6002 is more narrower than the remainder of warehouse 6002.

In the embodiment shown in the drawing, supportive body 6102 includes four edges 6110,6140,6150,6160 and center Part 6152.At least two in edge 6110,6140,6150,6160 include various edge notches configurations.In the implementation of diagram In scheme, edge 6110,6160 includes edge notches wherein.More particularly, as in Figure 67 as it can be seen that first group of first edge Recess 6114 is formed in the first part 6112 of first edge 6110.In the embodiment shown in the drawing, first edge recess 6114 are extended internally with the first acute angle 6115 (" recess angle ") from first edge part 6112 and parallel to each other.Such as Figure 66 and figure Furthermore, it can be seen that second edge recess 6118 extends internally from the second part 6116 of first edge part 6112 in 67.One In kind arrangement, for example, second edge recess 6118 extends (" recess angle ") from second part 6116 perpendicularly inward.Such as Figure 66 and Furthermore, it can be seen that third edge notches 6122 extend internally from the Part III 6120 of first edge part 6110 in Figure 67. In a kind of arrangement, for example, third edge notches 6122 extend (" recess angle ") from Part III 6120 perpendicularly inward.Such as Figure 66 With in Figure 67 furthermore, it can be seen that the 4th edge notches 6126 extend internally from the Part IV 6124 of first edge part 6110. In one arrangement, for example, the 4th edge notches 6126 are extended internally with acute angle (" recess angle ") from Part IV 6124.Such as figure Furthermore, it can be seen that the 5th edge notches 6130 are inwardly prolonged from the Part V 6128 of first edge part 6110 in 66 and Figure 67 It stretches.In one arrangement, for example, the 5th edge notches 6130 are extended internally with acute angle (" recess angle ") from Part V 6128.

Referring still to Figure 66 and Figure 67, a series of primary part of primary edge notches 6164 from second edge portion 6160 6162 extend internally.In shown arrangement, primary edge notches 6164 extend perpendicularly inward from primary marginal portion 6162 (" recess angle ").As in Figure 66 and Figure 67 furthermore, it can be seen that secondary edge notches 6168 are from the sub-section of second edge 6160 6166 extend internally.In one arrangement, for example, secondary edge notches 6168 with acute angle (" recess angle ") from secondary marginal portion 6166 extend internally.As in Figure 66 and Figure 67 furthermore, it can be seen that three-level edge notches 6172 are from the three-level portion of second edge 6160 6170 are divided to extend internally.In one arrangement, for example, three-level edge notches 6172 with acute angle (" recess angle ") from three-level part 6170 extend internally.As in Figure 66 and Figure 67 furthermore, it can be seen that level Four edge notches 6176 are from the level Four portion of second edge 6160 6174 are divided to extend internally.In one arrangement, for example, level Four edge notches 6176 extend perpendicularly inward from level Four part 6174 (" recess angle ").As in Figure 66 and Figure 67 furthermore, it can be seen that Pyatyi edge notches 6180 are from the Pyatyi of second edge portion 6160 Part 6178 extends internally.In one arrangement, for example, Pyatyi edge notches 6180 are prolonged perpendicularly inward from Pyatyi part 6178 It stretches at (" recess angle ").

Being shown in backing material 6100 in Figure 66 and Figure 67, there are five types of different width also along the total length tool of supporter 6100 Spend W1, W2, W3, W4, W5.W1 corresponds to marginal portion 6112,6162.W2 corresponds to marginal portion 6116,6166.W3 corresponds to Marginal portion 6120,6170.W4 corresponds to marginal portion 6124,6174.W5 corresponds to marginal portion 6128,6178.Other Support material embodiments can with the width of constant width or different number, contribute to surgery suturing appliance nail bin and/ Or the operable support on anvil block.In addition, the quantity of edge notches, shape, size and arrangement can change according to embodiment.

In the embodiment in being shown in Figure 66 and Figure 67, backing material 6100 includes multiple cutouts wherein.Such as As it can be seen that notch is arranged to parallel in those figures.In particular, the notch 6204 in row 6200 includes slit, the slit It is angularly arranged relative to marginal portion so that the notch 6204 often arranged in 6200 is parallel to each other.Notch 6204 can with or can Not extend completely through backing material 6100.Similarly, the notch 6206 in row 6202 includes slit, and the slit is vertically horizontal To in the marginal portion of backing material 6100.Notch 6206 may or may not extend fully through backing material 6100.At it In its embodiment, quantity, shape, size, orientation, spacing, depth and the position of such notch can change.

Figure 68 shows a kind of notch arrangement, and wherein nail cavity position 6012,6022 and 6032 are shown in dotted line.It such as can from the figure See, when backing material 6100 is positioned to be registered on the platform 6004 of surgery nail bin 6000, do not have in any notch 6204,6206 There are one parts to be positioned in nail cavity 6012,6022, any one of 6032.Figure 69 shows that similar backing material is arranged, Wherein nail cavity 6012,6022 and 6032 are shown in dotted line.Wherein nail/fastener legs of backing material 6100 ' will be penetrated finally Part 6103 is also shown in dotted line.Alternatively referred to as " follow closely penetrating region " herein in part 6103.As seen from the figure, notch 6208, no one of any of 6209 parts are located at any or 6103 top of nail penetrating region.Notch 6208 and 6209 exists It is arranged to longitudinal row in backing material 6100 '.Notch 6208 in often arranging is substantially parallel to one another, and relative to backing material 6100 ' edge is arranged with acute angle.Similarly, the notch 6209 in often arranging is substantially parallel to one another, and is arranged such that it Notch 6208 in adjacent row.Notch 6208 may or may not extend fully through backing material 6100 '.In addition As in Figure 69 as it can be seen that an entire row notch 6208 is located between the position and the edge of backing material 6100 ' of securing member chamber 6032, with Contribute to the further flexibility of backing material 6100 '.It is the quantity of such notch, shape, big as other embodiments Small, orientation, spacing, depth and position can change.

Figure 70 shows another supporting member embodiment 6100 ".In this embodiment, backing material includes multiple sides Emargination mouth 6300, the edge notches include the wavy curve for the fluctuating to form snakelike edge.Such edge notches/snakelike edge permits Xu Ding rotates while reducing the material stress during expansion.

Figure 71 and Figure 72 shows another supporting member 6400, and the supporting member is by that can be bioabsorbable or can be with It is not made of bioabsorbable weaving material.In addition, backing material may include any one of backing material as described herein, And including unique and novel attribute described below.For example, supporting member 6400 may include the hole across it or opening 6402, for coordinating with the part (for example, column, protrusion etc.) of surgery nail bin or the corresponding forming of anvil block, by supporting member 6400 are supported relative to nail/fastener in nail bin with required orientation/registration.In shown arrangement, supporting member 6400 wraps The multiple nail areas 6404,6406,6408 being located therein are included, for when supporting member 6400 is supported in storehouse platform and outer Correspondence securing member chamber 6012,6022,6032 in section's nail bin is registrated.Nail area can be heated by compression material and to it to promote material Material is for good and all presented compressive state and is formed.As having than support as it can be seen that compressing and following closely region (being typically expressed as 6410) in Figure 72 The smaller tranverse sectional thickness of adjacent uncompressed part (being typically expressed as 6412) of component 6400.In addition, supporting member 6400 can With linear edge 6420,6422,6424 and/or snakelike edge 6426.Supporting member can have the surgical staples with surgical instruments The corresponding shape of the shape of storehouse and/or anvil block.

All foregoing supporting member embodiments can be used on the platform of surgery nail bin, or the anvil with surgical stapling device Seat is used in combination.All supporting members can have shape corresponding with the shape of surgery nail bin and/or anvil block, and can have straight The combination of line or linear edge or marginal portion and/or waveform, zigzag and/or snakelike edge or such edge configuration.Branch Support component can with constant width or they can be with multiple width.Across the notch of backing material remove extra material with Promote or allow the more shape changeable of supporter, distortion etc., wherein the stress during longitudinal dilatation in entire backing material compared with It is small.In other words, notch enables supporter " folding " in a manner of identical with when nail itself is moving.It is snakelike or not Regular edge allows nail to rotate while reducing the material stress during expansion.Above-mentioned support configuration includes " softening structure ", this is soft Changing structure allows increased extensibility, while still sealing relevant range.In addition, above-mentioned supporting member does not inhibit not only nail to distort, But also nail and adminicle (supporter) is allowed to be moved in an identical manner in stretching, extension.Such supporting member arrangement includes support Component, the supporting member consist essentially of the region of the various mechanical behaviors for the optimum performance for allowing staple line.

Figure 73-Figure 78 shows another nail bin 6500 for being similar in construction to above-mentioned nail bin 6000, the difference is that nail bin 6500 include additionally multiple protruding portion.In the shown embodiment, surgery nail bin 6500 includes limiting the warehouse 6502 of platform 6504. Warehouse 6502 is installed in chassis 6524 and includes the elongated slot 6506 being centrally located, which is adapted to It is enough to receive tissue cutting element (not shown) across it.Multiple nail pits of nail cavity are set on every side of elongated slot 6506 It sets in platform 6504.As shown, the first row 6510 of the first chamber 6512 is arranged on every side of elongated slot 6506. The first chamber 6512 in each first row 6510 is parallel to each other.Each of first chamber 6512 is arranged to relative to elongated slot 6506 is angled and adjacent thereto.Shown warehouse 6502 further includes being arranged to the be at an angle of relative to the first nail cavity 6512 The two rows 6520 of two nail cavities 6522.The two rows 6530 of third nail cavity 6532 are also disposed in warehouse, as shown in the figure.At least one In kind form, third nail cavity 6532 is parallel with corresponding first nail cavity 6512.Warehouse 6502 also has there are two longitudinal direction side 6508.

Warehouse 6502 may also include the multiple protruding portion 6550 extended from platform surface 6504.Protruding portion 6550 can be constructed At the tissue being located among anvil block 5360 and storehouse 6500 can be engaged, and control movement of the tissue relative to storehouse 6500.Group Knit to move relative to storehouse 6500 in all cases.In at least one, when anvil block is in open position and closed position When being moved between (wherein tissue is compressed between anvil block and storehouse 6500), tissue can be flowed relative to storehouse 6500.In such feelings Under condition, tissue can towards 6508 lateral flow of longitudinal direction side, towards distal end 6503 towards distal side flow and/or it is proximally facing It proximally flows end 6505.In the case that at least one other, when cutting element be advanced through towards distal side be trapped in anvil block and When tissue between storehouse 6500, tissue can be flowed relative to storehouse 6500.In such cases, tissue can laterally, towards distal side and/ Or proximally flow, but since cutting edge is moved distally, so tissue is mainly flowed towards distal side.In all cases, prominent Portion 6550 is configured to the flowing that tissue is restricted or prevented relative to nail bin.Protruding portion 6550 can be positioned on nail cavity 6512, at 6522,6532 proximal end and/or distal end.In all cases, each protruding portion 6550 may include surrounding The set that the end of corresponding nail cavity 6512,6522 and 6532 extends.In some cases, each protruding portion 6550 may include around pair The arcuate ridge for answering nail cavity 6512,6522 and 6532 to extend.

Figure 76-Figure 78 show include protruding portion 6550 storehouse arrangement.The storehouse arrangement being shown in Figure 73-Figure 75 is similar to figure The storehouse of 76- Figure 78, but also include the row for the protrusion column 6560 being formed on platform surface 6504.In the arrangement of Figure 73-Figure 75 In, for example, between each nail cavity 6512,6522 and 6532 that prominent column 6560 is arranged in every nail chamber.Prominent column 6560 Flowing for further controlling tissue during clamping and percussion process.

Referring primarily to Figure 73, warehouse 6502, which is included in, to be extended between the distal end of warehouse 6502 and platform surface 6504 Angled transition 6570.When by storehouse 6500 and anvil positioning in operative site, it is opposite that angled transition 6570 is conducive to storehouse 6500 In histokinesis.In this case, tissue can slide on inclined surface 6570.In other arrangements, inclined surface 6570 Including radiused surface.In shown arrangement, inclined surface 6570 includes angled surface.In other arrangement, inclined surface 6570 include concave surface and/or nonreentrant surface.

The nail cavity 6512,6522 and 6532 in warehouse 6502 is limited on every side of longitudinal slit 6506 with longitudinal row Arrangement.Each protruding portion 6550 is configured to the nail that support is removedly stored in nail cavity 6512,6522 and 6532 6542 at least part.In all cases, each protruding portion 6550 can make the end wall of nail cavity 6512,6522 and 6532 6513,6515 extend above platform 6504.In some cases, referring generally to Figure 78, be located in nail cavity 6512,6522, Nail 6542 in 6532 is including base portion 6543, the first leg 6545 extended from base portion 6543 with first angle and with second jiao Spend the second leg 6547 extended from base portion 6543.First leg 6545 can be contacted with the first end wall 6513 of nail cavity 6532, and And second leg 6547 can be contacted with the second end wall 6515 of nail cavity 6512,6522,6532.In some cases, 6542 are followed closely The distance between first leg 6545 and the second leg 6547 or extension can be wider than end wall 6513, the distance between 6515 so that When nail 6542 is located in nail cavity 6512,6522,6532, leg 6545,6547 is inwardly biased by end wall 6513,6515.Work as nail 6542 are not fired or when non-raised position is stored in nail cavity 6512,6522,6532, the end of nail leg 6545,6547 can with it It is located in protruding portion 6550.In this case, the nail leg end of sustainable 6504 top of simultaneously protecting platform of protruding portion 6550 6545、6547.In some cases, when following closely 6542 in its non-firing position, the end of nail leg 6545,6547 can be positioned on 6550 lower section of protruding portion, and therefore, when following closely 6542 in its non-firing position, protruding portion 6550 can not support nail leg 6545、6547.When such nail 6542 is fired or be lifted out nail cavity 6512,6522,6532, nail leg 6545,6547 can It touches protruding portion 6550 and is supported by it.Under any circumstance, protruding portion 6550 can continue to prop up in deployment nail 6542 Nail leg 6545,6547 is until nail 6542 is fully fired and/or be lifted out nail cavity 6512,6522,6532 so that nail leg 6545, it 6547 is no longer contacted with protruding portion 6550.

Layer (such as backing material) can for example be made of any biocompatible materials.Backing material can be by natural material And/or synthetic material is formed.Backing material can be bioabsorbable and/or not bioabsorbable.It should be appreciated that can be used Naturally, synthesis, bioabsorbable and not bioabsorbable material arbitrary combine form backing material.It can be made into backing material Some non-limiting examples of material include but not limited to for example poly- (lactic acid), poly- (glycolic), poly- (butyric ester), poly- (phosphine piperazine), polyester, polyethylene glycol, polyethylene oxide, polyacrylamide, poly-hydroxyethyl methyl acrylate, polyvinylpyrrolidone, Polyvinyl alcohol, polyacrylic acid, poly- acetic acid esters, polycaprolactone, polypropylene, aliphatic polyester, glycerine, poly- (amino acid), copolymerization (ether Ester), polyalkylenes oxalates, polyamide, poly- (iminocarbonic ester), polyalkylenes oxalates, polyoxaesters, polyorthoester, Polyphosphazene and its copolymer, block copolymer, homopolymer, blend and/or combination thereof.

Natural biological copolymer can be used to form support material.Suitable natural biological copolymer includes but not limited to example As collagen, gelatin, fibrin, fibrinogen, elastin laminin, keratin, albumin, hydroxyethyl cellulose, cellulose, Oxycellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose, chitin, chitosan, and/or it Combination.Natural biological copolymer can be combined with other polymer materials as described herein to prepare backing material.People and/or The collagen of animal origin, such as I types pig or bovine collagen, I types people's collagen or type III people's collagen, can be used to form backing material.Branch The collagen that timbering material can lose its helical structure at least partly by denatured collagen or by heating or any other method is made, The collagen is mainly made of the non-hydrated a chains of molecular weight close to such as 100kDa.Term " denatured collagen " refers to losing its spiral The collagen of structure.For porous layer as described herein collagen can be for example especially such as by pepsin digestion and/or The natural collagen or Atelocollagen (atellocollagen) obtained later such as the appropriate heating of previous definition.Collagen may be first It is preceding by aoxidizing, methylating, succinylation, ethylization and/or any other known procedure carry out chemical modification.

In the case where backing material is fiber, fiber can be that or can be suitable for being knitted or woven filament or line Staple fiber is such as usually used in preparing those of non-woven material.Fiber can be made of any biocompatible materials.Fiber can be by Natural material or synthetic material are formed.The material for forming fiber can be biological absorptive material or non-bioabsorbable materials.It answers Work as understanding, natural material, synthetic material, bioabsorbable material and non-bioabsorbable material any combinations can be used in shape At fiber.It can be made into some non-limiting examples including but not limited to poly- (lactic acid) of the material of fiber, poly- (glycolic), gather (butyric ester), poly- (phosphine piperazine), polyester, polyethylene glycol, polyethylene oxide, polyacrylamide, poly-hydroxyethyl methyl acrylate, Polyvinylpyrrolidone, polyvinyl alcohol, polyacrylic acid, poly- acetic acid esters, polycaprolactone, polypropylene, aliphatic polyester, glycerine, poly- (ammonia Base acid), copolymerization (ether-ether), polyalkylenes oxalates, polyamide, poly- (iminocarbonic ester), polyalkylenes oxalates, polyoxy it is miscellaneous Ester, polyorthoester, polyphosphazene and its copolymer, block copolymer, homopolymer, blend and/or combination thereof.In fid In the case that material is fiber, backing material, which can be used, to be suitable for forming any method of fibre structure to be formed, the method packet It includes but is not limited to such as knitting, woven, nonwoven techniques.In the case where backing material is foam, porous layer can be used suitable It is formed in any method for forming foam or sponge, the including but not limited to freeze-drying and freeze-drying of such as composition.

Backing material can have hemostatic properties.It can be used to provide and stop bleeding or the fid of the ability of bleeding with auxiliary The material of material illustrates that example includes but not limited to for example poly- (lactic acid), poly- (glycolic), poly- (butyric ester), poly- (in oneself Ester), poly- (dioxanone), polyalkylene oxide, copolymerization (ether-ether), collagen, gelatin, fibrin ferment, fibrin, fibrin Original, fibronectin splicing variants, elastin, albumin, hemoglobin, ovalbumin, polysaccharide, hyaluronic acid, chondroitin sulfate, hydroxyl Hydroxyethyl starch, hydroxyethyl cellulose, cellulose, oxycellulose, hydroxypropyl cellulose, carboxyethyl cellulose, carboxymethyl cellulose Element, chitosan, chitosan, agarose, maltose, maltodextrin, alginates, coagulation factor, methyl acrylate, polyamine group first Acid esters, cyanoacrylate, platelet agonist, vasoconstrictor, alum, calcium, RGD peptide, albumen, protamine sulfate, ε- Aminocaproic acid, ferric sulfate, iron sulfite, iron chloride, zinc, zinc chloride, aluminium chloride, aluminum sulfate, aluminium acetate, permanganate, tannin, Bone wax, polyethylene glycol, fucosan and/or combination thereof.The use of natural biological copolymer and especially albumen can be fitted It is used to form the backing material with hemostatic properties.Suitable natural biological copolymer include but not limited to for example collagen, gelatin, Fibrin, fibrinogen, elastin laminin, keratin, albumin and/or combination thereof.Natural biological copolymer can It is combined with any other hemostat to prepare the porous layer of supporter.Entitled " the BUTTRESS that on July 30th, 2013 announces The entire disclosure of the United States Patent (USP) 8,496,683 of AND SURGICAL STAPLING APPARATUS " is by reference simultaneously Enter herein.

The entire disclosure of following patent is hereby incorporated by reference：

The United States Patent (USP) for entitled " the ELECTROSURGICAL HEMOSTATIC DEVICE " that April 4 nineteen ninety-five announces 5,403,312；

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

Entitled " the MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING announced on the 9th of September in 2008 The United States Patent (USP) 7,422,139 of INSTRUMENT WITH TACTILE POSITION FEEDBACK "；

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

Entitled " the SURGICAL INSTRUMENT HAVING AN ARTICULATING that on March 2nd, 2010 announces The United States Patent (USP) 7,670,334 of END EFFECTOR "；

The United States Patent (USP) 7 for entitled " the SURGICAL STAPLING INSTRUMENTS " that on July 13rd, 2010 announces, 753,245；

Entitled " the SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER that on March 12nd, 2013 announces The United States Patent (USP) 8,393,514 of CARTRIDGE "；

Entitled " surgical instruments (the SURGICAL INSTRUMENT HAVING RECORDING with registering capacity CAPABILITIES U.S. Patent Application Serial Number 11/343,803 (being now United States Patent (USP) 7,845,537)) "；

It is filed on 2 14th, 2008 entitled " surgery cuts and fastening instrument (SURGICAL with RF electrodes CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES) " U.S. Patent Application Serial Number 12/031,573；

It is filed on 2 15th, the 2008 entitled " end effector (END for surgery cuts and suture instruments EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT) " U.S. Patent Application Serial Number 12/031,873 (being now United States Patent (USP) 7,980,443)；

It is entitled that " motor drives surgical cutting instrument (MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT U.S. Patent Application Serial Number 12/235,782 (being now United States Patent (USP) 8,210,411)) "；

It is entitled " have can manual refraction trigger system band electrosurgical cut and robotic suturing device (POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM U.S. Patent Application Serial Number 12/249,117 (being now United States Patent (USP) 8,608,045)) "；

Being filed in the entitled of on December 24th, 2009 " there is the motor driving surgery of electric actuator Direction Control Unit to cut Cutter tool (MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY) " U.S. Patent Application Serial Number 12/647,100 (be now United States Patent (USP) 8, 220,688)；

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

It is filed on 2 28th, 2011 entitled " surgery suturing appliance (SURGICAL STAPLING INSTRUMENT U.S. Patent Application Serial Number 13/036,647 (being now United States Patent (USP) 8,561,870)) "；

Entitled " SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT The U.S. Patent Application Serial Number 13/118,241 of ARRANGEMENTS " (is now U.S. Patent Application Publication 2012/ 0298719)；

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 " (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 "；

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 "；

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 ARTICULATABLE END EFFECTOR " U.S. Patent Application Publication 2010/0264194 (be now United States Patent (USP) 8,308, 040)。

Although certain disclosed embodiments has been combined to elaborate the various embodiments of device herein, can implement to this Many modifications and variations of a little embodiments.In addition, in the case of the open material for being used for certain components, other materials can be used Material.In addition, according to multiple embodiments, single component can be replaced by multiple components, and multiple components can be also replaced by Single component, to execute given one or more functions.Above description and following the claims are intended to cover all such repair Change and modification.

Apparatus as disclosed herein is designed to be dropped after a single use or it is designed to using more It is secondary.However, in either case, can prosthetic device to be reused after use at least once.Reparation may include following The arbitrary combination of step：Then provision for disengagement is cleaned or is replaced specific component and then re-assemblied.In particular, Detachable apparatus, and optionally replace or remove in any combination any number of specific component or the portion of device Part.After cleaning and/or replacing particular elements, device is can be reassembled for then at the repair facility or outside it will carry out It is used by operating team before section's operation.It will be understood by those of skill in the art that the reparation again of device can utilize a variety of use In the technology of dismounting, cleaning/replace and re-assembly.The purposes and gained prosthetic device of these technologies are entirely in the model of the application In enclosing.

Preferably, invention as described herein will the processing before surgical operation.First, it obtains and if necessary clear Clean new or used instrument.Then it can sterilize to instrument.In a kind of sterilization technology, by instrument be placed on closure and it is close In the container of envelope, in such as plastics or TYVEK bag.Then container and instrument are placed on can penetrate the container radiation field it is (all Such as γ radiation, X-ray or high energy electron) in.The bacterium in instrument and in container is killed in radiation.It then can be by sterilized instrument It is stored in sterile chamber.Sealing container makes instrument keep sterile, until it is opened in medical facilities.

It, can be in the spirit and scope of the disclosure further although the present invention has been described as having illustrative design The modification present invention.Therefore, this application is intended to cover any modification, purposes or the remodeling using general principles.In addition, this Application is intended to cover belong to known or usual practice such deviation relative to the disclosure in technology belonging to the present invention.

Any patent, announcement or other public materials incorporated herein by reference in its entirety or in part 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. Similarly and at the necessary level, the disclosure being expressly recited herein is any instead of what is be herein incorporated by reference Conflict material.It is any to be herein incorporated by reference but mutually rushed with existing definitions, statements, or other disclosure materials as described herein Prominent material or part thereof does not only generate and is incorporated to this under the degree of conflict between the incorporated material and the existing public material Text.

Claims

1. a kind of fastener cartridge assembly for being used together with circular surgical clamp device, wherein the fastener cartridge assembly packet It includes：

Warehouse, the warehouse include circular platform；With

Multiple securing member chambers, the multiple securing member chamber pass through the circular platform, each securing member chamber with opening mode A chamber end including two chamber ends, and each securing member chamber in wherein the multiple securing member chamber, which is located in, to be had In first circular axis of the first radius, and another chamber end of wherein each securing member chamber be located in with it is described In second circular axis of the second different radius of the first radius.

2. fastener cartridge assembly according to claim 1, wherein the securing member chamber is arranged to circular array, wherein institute It includes at least a line securing member chamber of the orientation arrangement of zigzag to state circular array.

3. fastener cartridge assembly according to claim 1, wherein the one chamber end of each of described securing member chamber and Each of the securing member chamber another chamber end is V-arrangement and terminates at a bit, and wherein one chamber end The point location is in first circular axis, and the point location of another chamber end is in second circular shaft On line.

4. fastener cartridge assembly according to claim 1 further includes other a number of other securing member chambers, described in addition multiple Other securing member chambers pass through the circular platform with opening mode, wherein the other fasteners of each of described other securing member chambers Chamber is aligned in the third circular axis with third radius, and the third radius is different from first radius and described second Radius.

5. fastener cartridge assembly according to claim 1 further includes other a number of other securing member chambers, described in addition multiple Other securing member chambers pass through the circular platform with opening mode, wherein the other fasteners of each of described other securing member chambers Chamber is aligned in the third circular axis with third radius, and the third radius is different from first radius and described second Radius.

6. fastener cartridge assembly according to claim 5, wherein the other fasteners of each of described other securing member chambers Chamber is in the upper alignment of one of first circular axis and second circular axis.

7. fastener cartridge assembly according to claim 4, wherein the other fasteners of each of described other securing member chambers Chamber has another size different from the size of each securing member chamber in the securing member chamber.

8. fastener cartridge assembly according to claim 1, wherein each securing member chamber support wherein it is at least one Surgical fastener.

9. fastener cartridge assembly according to claim 2, wherein each securing member chamber support wherein it is at least one Surgical fastener.

10. fastener cartridge assembly according to claim 4, wherein each securing member chamber support wherein it is at least one Surgical fastener, and the other securing member chambers of each of wherein described other securing member chambers support wherein it is at least one other Surgical fastener.

11. fastener cartridge assembly according to claim 10, wherein each surgical fastener has fastener sizes, And wherein each other surgical fasteners have another fastener sizes different from the fastener sizes.

12. a kind of fastener cartridge assembly for being used together with circular surgical fastener, wherein the fastener cartridge assembly packet It includes：

Warehouse, the warehouse include circular platform；With

Multiple securing member chambers, the multiple securing member chamber pass through the circular platform, the multiple securing member chamber with opening mode It is arranged to circular array, wherein the circular array includes at least a line securing member chamber of the orientation arrangement of zigzag.

13. fastener cartridge assembly according to claim 12 further includes other a number of other securing member chambers, described in addition more A other securing member chambers pass through the circular platform with opening mode, wherein the other fastenings of each of described other securing member chambers Part chamber is aligned in circular axis.

14. fastener cartridge assembly according to claim 12, wherein each securing member chamber supports at least one wherein A surgical fastener.

15. fastener cartridge assembly according to claim 13, wherein each securing member chamber supports at least one wherein A surgical fastener, and the other securing member chambers of each of wherein described other securing member chambers support wherein it is at least one its Its surgical fastener.

16. fastener cartridge assembly according to claim 15, wherein each surgical fastener has surgical fastener Size, and each other surgical fasteners have another surgical fastener ruler different from the surgical fastener size It is very little.

17. a kind of fastener cartridge assembly for being used together with circular surgical fastener, wherein the fastener cartridge assembly packet It includes：

Round warehouse；

Multiple surgical fasteners, the multiple surgical fastener are operatively supported in the round warehouse；With

The device of the multiple surgical fastener is guided when in the round warehouse so that be applied to movement will be fired When described device, the multiple surgical fastener is driven out the round warehouse in the form of circular array so that the surgery Fastener is orientated with the orientation of zigzag relative to each other.

18. fastener cartridge assembly according to claim 17, wherein the multiple surgical fastener includes outside multiple first Section's fastener and multiple second surgical fasteners, and the described device for being wherein used for guiding is configured in the circle The multiple first surgical fastener is guided when in warehouse so that will fire movement be applied to described device when, it is the multiple First surgical fastener is driven out the round warehouse in the form of circular array so that the multiple first surgical fastener phase Orientation each other with zigzag is orientated, and the multiple second surgical fastener is orientated with another circular array.

19. fastener cartridge assembly according to claim 18, wherein each of the multiple first surgical fastener is outer Section's fastener has the first fastener sizes, and each surgical fastener tool in wherein the multiple second surgical fastener There are second fastener sizes different from first fastener sizes.

20. a kind of fastener cartridge assembly for being used together with circular surgical fastener, wherein the fastener cartridge assembly packet It includes：

Round warehouse；

Multiple surgical fasteners, the multiple surgical fastener are operatively supported in the round warehouse, each described outer Section's fastener includes a pair of of fastener leg；With

The device of the multiple surgical fastener is guided when in the round warehouse so that be applied to movement will be fired When described device, the multiple surgical fastener is driven out the round warehouse in the form of circular array so that the surgery One leg extension of each surgical fastener in fastener passes through the first circular axis with the first radius, and wherein Another leg extension of each surgical fastener passes through second with second radius different from first radius Circular axis.