CN109219401A - Circular stapler system including loading control - Google Patents

Circular stapler system including loading control Download PDF

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Publication number
CN109219401A
CN109219401A CN201780034400.6A CN201780034400A CN109219401A CN 109219401 A CN109219401 A CN 109219401A CN 201780034400 A CN201780034400 A CN 201780034400A CN 109219401 A CN109219401 A CN 109219401A
Authority
CN
China
Prior art keywords
nail
end effector
anvil block
cavity
longitudinal axis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CN201780034400.6A
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Chinese (zh)
Other versions
CN109219401B (en
Inventor
J·L·哈里斯
F·E·谢尔顿四世
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Angiotech Pharmaceuticals Inc
Original Assignee
Angiotech Pharmaceuticals Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US15/089,349 external-priority patent/US10682136B2/en
Application filed by Angiotech Pharmaceuticals Inc filed Critical Angiotech Pharmaceuticals Inc
Publication of CN109219401A publication Critical patent/CN109219401A/en
Application granted granted Critical
Publication of CN109219401B publication Critical patent/CN109219401B/en
Active legal-status Critical Current
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Abstract

The invention discloses a kind of end effector being used together with surgical stapling device, which includes the warehouse with longitudinal axis and the multiple nail cavities being limited in warehouse.Nail cavity includes the first annular row of the nail cavity extended around longitudinal axis, and the second ring row of the nail cavity extended around longitudinal axis.End effector further includes the nail being removedly stored in nail cavity and ramp, which can be rotated about longitudinal axes, sequentially to project nail from nail cavity.End effector further includes cutting element, which is disposed after projecting nail from nail cavity.

Description

Circular stapler system including loading control
Background technique
The present invention relates to surgical instruments, and in various arrangements, are related to the surgery for being designed to suture and cut tissue Suture and cutting device and the nail bin being used therewith.
Detailed description of the invention
The various features of the embodiment described herein add in combination with following attached drawing according to being described below together with its advantage To understand:
The perspective view of the surgical instruments including interchangeable surgical tool component of at least one embodiment according to Fig. 1；
Fig. 2 is another perspective view of the handle assembly of the surgical instruments of Fig. 1, and wherein a part of shank shell is omitted Component therein is contained in expose；
Fig. 3 is the decomposition assembly drawing of each section of the handle assembly of the surgical instruments of Fig. 1 and Fig. 2；
Fig. 4 is the sectional perspective view of the handle assembly of Fig. 2 and Fig. 3；
Fig. 5 is the partial cut away side views of the handle assembly of Fig. 2 to Fig. 4, wherein the handle assembly being shown in solid is held The main shell that part is held relative to handle assembly is partially in a position, and the grip portions of handle assembly shown in dotted line Then another location is partially in relative to the main shell of handle assembly；
The cross-sectional end view that the handle assembly that Fig. 6 is Fig. 2 to Fig. 5 is intercepted along the line 6-6 of Fig. 5；
The other end cross-sectional view that the handle assembly that Fig. 7 is Fig. 2 to Fig. 6 is intercepted along the line 7-7 of Fig. 5；
Fig. 8 is the other end cross-sectional view of the handle assembly of Fig. 2 to Fig. 7, is shown and the driving on rotation driving pod The shifter gear that gear is engaged；
Fig. 9 is the other end cross-sectional view of the handle assembly of Fig. 2 to Fig. 8, is shown when shifter gear and rotation drive Driving gear on pod is engaged the solenoidal position of shift device；
Figure 10 is another perspective view of the handle assembly of Fig. 2 to Fig. 9, and wherein its certain part is shown with section, and its It is shown in dotted line to access faceplate part；
Figure 11 is the top view of the handle assembly of Fig. 2 to Figure 11, and wherein emergency system is shown at actuatable position；
Figure 12 is the perspective view of the emergency shank of emergency system shown in Fig. 2 to Figure 11；
The decomposition assembly drawing of each section for the emergency shank that Figure 13 is Figure 12, wherein its each section is shown with section；
Figure 14 is the cross-section front view of the handle assembly of Figure 11；
Figure 15 shows the exploded view of the interchangeable tools component according at least one embodiment；
Figure 16 is the perspective view of the interchangeable tools component of Figure 15；
Figure 17 is the sectional perspective view of the interchangeable tools component of Figure 15；
Figure 18 is the sectional exploded view of the interchangeable tools component of Figure 15；
Figure 19 is the perspective view of the articulation block of the interchangeable tools component of Figure 15；
Figure 20 be include Figure 19 articulation block Figure 15 interchangeable tools component actuated articulation joints section Perspective view；
Figure 21 is another sectional perspective view of the actuated articulation joints of Figure 20；
Figure 22 is the partial exploded view of the interchangeable tools component of Figure 15；
Figure 23 is another partial exploded view of the interchangeable tools component of Figure 15；
Figure 24 is the partial exploded view of the actuated articulation joints of Figure 20；
Figure 25 is the sectional perspective view of the proximal end of the interchangeable tools component of Figure 15；
Figure 26 is the end view of the interchangeable tools component of Figure 15；
Figure 27 is the cross-sectional view that the end effector of the interchangeable tools component of Figure 15 is intercepted along the line 27-27 of Figure 26, End effector in clamping but non-cock is shown；
Figure 28 is the cross-sectional view that the end effector of the interchangeable tools component of Figure 15 is intercepted along the line 28-28 of Figure 26, End effector in clamping but non-cock is shown；
Figure 29 is the cross-sectional view that the end effector of the interchangeable tools component of Figure 15 is intercepted along the line 29-29 of Figure 26, End effector in clamping but non-cock is shown；
Figure 30 is the cross-sectional view for being shown at the end effector of interchangeable tools component of Figure 15 of disassembly status；
Figure 31 shows the end effector that the interchangeable tools component of Figure 15 of joint motions is carried out along first direction；
Figure 32 shows the end effector for carrying out the interchangeable tools component of Figure 15 of joint motions in a second direction；
Figure 33 is the perspective view of the warehouse of the interchangeable tools component of Figure 15；
The perspective view of the warehouse of at least one alternative embodiment according to Figure 34；
The exploded view of the end effector of the interchangeable tools component of at least one alternative embodiment according to Figure 35；
Figure 36 is the disassembly diagram of the end effector of Figure 35；
The disassembly diagram of the end effector of the interchangeable tools component of at least one alternative embodiment according to Figure 37；
The disassembly diagram of the end effector of the interchangeable tools component of at least one alternative embodiment according to Figure 38；
Figure 39 is the perspective view for showing nail bin and axis according to the surgery suturing appliance of at least one embodiment；
Figure 40 is the partial sectional view for the nail bin being assembled on the suture instruments of Figure 39；
Figure 41 be surgery suturing appliance partial sectional view, the surgery suturing appliance include closure driving device, anvil block and Latching member, the latching member are configured to prevent from anvil block to be assembled to closing when being closed driving device and being not in fully extended position Close driving device；
Figure 42 is the partial sectional view of the surgery suturing appliance of Figure 41, shows the anvil block for being attached to closure driving device；
Figure 43 is the local perspective view of surgery suturing appliance, which includes nail bin and be configured to phase The closure driving device of anvil block mobile for nail bin；
Figure 44 is the partial sectional view of the suture instruments of Figure 43, shows and is configured to be not attached to closure in anvil block The latching member of closure driving device retraction is prevented when driving device；
Figure 45 be Figure 44 suture instruments partial sectional view, show be attached to closure driving device anvil block and with close Close the latching member that driving device is disengaged；
Figure 46 is the partial sectional view of surgery suturing appliance, which includes having removedly to be stored in it In the nail bin of nail, anvil block, be configured to closure driving device relative to the mobile anvil block of nail bin, and be adapted to Enough percussion driving devices that nail is projected from nail bin；
Figure 47 is the detail drawing of latching member, which is configured to prevent before anvil block is moved to closed position Percussion driving device is activated；
Figure 48 is the detail drawing of the latching member for the Figure 47 being disengaged with percussion driving device；
Figure 49 is the local perspective view of surgery suturing appliance, which includes having removedly to be stored in it In the nail bin of nail, anvil block, be configured to closure driving device relative to the mobile anvil block of nail bin, and be adapted to Enough percussion driving devices that nail is projected from nail bin；
Figure 50 be Figure 49 surgery suturing appliance latching member detail drawing, the latching member be configured to anvil block to Being trapped in front of the tissue between anvil block and nail bin applies enough pressure prevents percussion driving device to be activated；
Figure 51 is the detail drawing of the latching member for the Figure 50 being disengaged with percussion driving device；
Figure 52 is the local perspective view of surgery suturing appliance, which includes having removedly to be stored in it In the nail bin of nail, anvil block, be configured to closure driving device relative to the mobile anvil block of nail bin, and be adapted to Enough percussion driving devices that nail is projected from nail bin；
Figure 53 is the detail drawing of the latching member of the surgery suturing appliance of Figure 52, which is configured to drive in percussion The cutting element of dynamic device prevents anvil block from separating with closure driving device when being exposed to above nail bin；
Figure 54 is the detail drawing of the latching member of Figure 53, which sufficiently returns after firing schedule in percussion driving device It is disengaged after contracting with anvil block；
Figure 55 is the partial sectional view of surgery suturing appliance, which includes having removedly to be stored in it In the nail bin of nail, anvil block, be configured to closure driving device relative to the mobile anvil block of nail bin, and be adapted to Enough percussion driving devices that nail is projected from nail bin；
Figure 56 is the partial sectional view of the surgery suturing appliance of Figure 55, shows the closure driving device in clamping configuration And the percussion driving device in non-percussion configuration, wherein latching member is remained and does not discharge configuration by percussion driving device；
Figure 57 is the partial sectional view of the surgery suturing appliance of Figure 55, shows the percussion at least partly percussion configuration The latching member of driving device and Figure 56 in release configuration；
Figure 58 is the partial sectional view of the surgery suturing appliance of Figure 55, shows the closure in stretching, extension or open configuration and drives Dynamic device and the latching member that Figure 56 to prevent closure driving device from being clamped again is engaged with closure driving device；
Figure 59 is the cross-sectional view of surgery suturing appliance, which includes having removedly to be stored therein in The nail bin of nail, anvil block are configured to closure driving device relative to the mobile anvil block of nail bin, and be configured to from The nail bin for being shown as disabling or being latched configuration projects the percussion driving device followed closely；
The section end view that the surgery suturing appliance that Figure 59 A is Figure 59 is intercepted along the line 59A-59A of Figure 59；
Figure 60 is the cross-sectional view of the surgery suturing appliance of Figure 59, clamping configuration is shown at, in the clamping structure Driving device is fired in type to be activated；
Figure 60 A is the section end view of line 60A-60A interception of the surgery suturing appliance of Figure 59 in Figure 60；
Figure 61 is the partial sectional view of surgery suturing appliance, which includes having removedly to be stored in it In the nail bin of nail, anvil block, be configured to closure driving device relative to the mobile anvil block of nail bin, and be adapted to Enough percussion driving devices that nail is projected from nail bin wherein closure driving device is shown at non-clamping configuration, and fire Driving device is shown at inoperable configuration；
Figure 62 is the partial sectional view of the surgery suturing appliance of Figure 61, wherein closure driving device is shown at clamping Configuration, and fire driving device and be shown at operable configuration；
Figure 63 is the perspective view of the rotatable intermediate drive member of the percussion driving device of the surgical instruments of Figure 61；
Figure 64 is the local perspective view of the rotatable beating shaft of the percussion driving device of the surgical instruments of Figure 61；
Figure 65 is the front view of spring system, which is configured to that the beating shaft of Figure 64 is biased to and schemed 63 intermediate drive member is disengaged；
The decomposition of the end effector of the surgery suturing appliance including nail bin of at least one embodiment according to Figure 66 Figure；
Figure 67 is the partial sectional view of the end effector of Figure 66, shows and is configured to not assemble completely in nail bin The latching member for preventing end effector from being operated when to suture instruments；
Figure 68 is the partial sectional view of the end effector of Figure 66, shows the latching member in unlocked configuration；
The decomposition of the end effector of the surgery suturing appliance including nail bin of at least one embodiment according to Figure 69 Figure；
Figure 70 is the partial sectional view of the end effector of Figure 69, shows and is configured to releasedly protect nail bin Hold the lock of suture instruments；
Figure 71 is the partial sectional view of the end effector of Figure 69, shows the lock in unlocked configuration；
Figure 72 shows the axis of surgery suturing appliance, which is configured to together with the nail bin selected from multiple round nail bins It uses；
Figure 73 is the cross-sectional view of the distal end of the suture instruments of Figure 72；
Figure 74 is the partial sectional view of surgery suturing appliance, which includes not firing nail bin and closed line System, the locking system are configured in the percussion driving device percussion rear defence non-magnetic shim storehouse for previously having passed through surgical instruments by again Secondary percussion；
Figure 75 is the partial sectional view for being shown at the suture instruments of Figure 74 of clamping configuration, and fires driving dress It sets in percussion configuration；
Figure 76 is the partial sectional view for being shown at the suture instruments of Figure 74 of non-clamping configuration, and fires driving Device is in retracted configuration；
Figure 77 is the percussion driving device of the suture instruments of Figure 74 and the end-view of frame, is shown in non-percussion configuration Percussion driving device；
Figure 78 is the percussion driving device of the suture instruments of Figure 74 and the end-view of frame, is shown in retracted configuration Fire driving device；
Figure 79 is the end-view for the alternative nail bin design that can be used together with the suture instruments of Figure 74；
Figure 80 is the end-view for the alternative nail bin design that can be used together with the suture instruments of Figure 74；
The perspective view of the surgery suturing appliance including flexible shaft of at least one embodiment according to Figure 81；
The schematic diagram of the surgical kit including multiple end effectors of at least one embodiment according to Figure 82；
The robotic surgery device including multiple attachable end effectors of at least one embodiment according to Figure 82 A The schematic diagram of tool system；
Figure 83 is the perspective view of several end effectors shown in Figure 82；
The perspective view of the anvil block of at least one embodiment according to Figure 84；
Figure 85 is the cross-sectional view of the anvil block of Figure 84；
Figure 86 is the partial sectional view of the end effector including anvil block of Figure 84, is shown at percussion configuration；
The perspective view of the anvil block of at least one embodiment according to Figure 87；
Figure 88 is the plan view of the anvil block of Figure 87；
The cross-sectional view of the end effector of at least one embodiment according to Figure 89 is shown at clamping, not Percussion configuration；
Figure 90 is the cross-sectional view for being shown at the end effector of Figure 89 of percussion configuration；
The cross-sectional view of the end effector of at least one alternative embodiment, is shown at folder according to Figure 91 Tightly, non-percussion configuration；
Figure 92 is the cross-sectional view for being shown at the end effector of Figure 91 of percussion configuration；
The cross-sectional view of the end effector of at least one alternative embodiment, is shown at folder according to Figure 93 Tightly, non-percussion configuration；
Figure 94 is the cross-sectional view for being shown at the end effector of Figure 91 of percussion configuration；
The perspective view of the nail shapes pit of at least one embodiment according to Figure 95；
Figure 96 is the cross-sectional view of the nail shapes pit of Figure 95；
The exploded view of the end effector of at least one embodiment according to Figure 97, the end effector are adapted to It is enough that the nail of first annular row and the nail of the second ring row is sequentially unfolded；
Figure 98 is the partial sectional view of the end effector of Figure 97, shows the percussion driving that nail is unfolded in the first nail Device；
Figure 99 is the partial sectional view of the end effector of Figure 97, shows hitting for Figure 98 that nail is unfolded in the second nail Send out driving device；
Figure 100 is the local perspective view for firing driving device, which is configured to be sequentially driven For firing the first driver of the first nail, for firing the second driver of the second nail, followed by for driving cutting The third driver of component；
Figure 101 is the local perspective view of the percussion driving device of Figure 100, shows the first driving in firing position Device；
Figure 102 is the local perspective view of the percussion driving device of Figure 100, shows the second driving in firing position Device；
Figure 103 is the local perspective view of the percussion driving device of Figure 100, shows the third driving in firing position Device；
Figure 104 is the exploded view of the percussion driving device of Figure 100；
Figure 105 is the local perspective view of the percussion driving device of Figure 100 of the configuration in Figure 103；
The exploded view of the percussion driving device of at least one alternative embodiment according to Figure 106；
The one of the surgery nail bin of at least one embodiment being used together with circular surgical staplers tool according to Figure 107 Partial perspective view；
Figure 108 shows a pair of of nail in unshaped and shaped configuration according at least one embodiment；
Figure 109 is one relative to the anvil block of a part of the surgery nail bin of Figure 107 before forming process is followed closely in actuating The cross-sectional view divided；
Figure 110 is another cross-sectional view of the nail bin of the anvil block and Figure 107 of Figure 109 after forming nail；
The one of the surgery nail bin of at least one embodiment being used together with circular surgical staplers tool according to Figure 111 Partial perspective view；
Figure 112 is one relative to the anvil block of a part of the surgery nail bin of Figure 111 before forming process is followed closely in actuating The cross-sectional view divided；
Figure 113 is the anvil block of Figure 112 and another cross-sectional view of nail bin after forming nail；
The top view of the nail bin of at least one embodiment according to Figure 114；
The bottom view of the anvil block of at least one embodiment according to Figure 115；
Figure 116 is the cross-sectional view of a part of the anvil block of a part relative to surgery nail bin；
Figure 117 shows three unfashioned surgical staples；
Figure 118 shows the partial sectional view of the nail bin of the circular stapler according at least one embodiment；And
Figure 119 shows the local perspective view of the nail bin of the circular stapler according at least one embodiment.
In several views, corresponding reference symbol indicates corresponding component.Exemplifications set out herein is with a kind of shape Formula shows various embodiments of the present invention, and this example is not necessarily to be construed as the model limiting the invention in any way It encloses.
Specific embodiment
Present applicant possesses following patent application, the patent application and the application and submits in same date and each It is incorporated herein from being incorporated by reference:
The United States Patent (USP) Shen of entitled " METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM " Please sequence number _ _ _ _ _ _ _ _；Attorney number END7821USNP/150535；
The U.S. of entitled " MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY " Patent application serial number _ _ _ _ _ _ _；Attorney number END7822USNP/150536；
Entitled " SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE- The U.S. Patent Application Serial Number of ORIENTABLE DISPLAY FIELD " _ _ _ _ _ _ _；Attorney number END7822USNP1/150536-1；
Entitled " SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIP The U.S. Patent Application Serial Number of PORTION " _ _ _ _ _ _ _；Attorney number END7823USNP/150537；
Entitled " ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLE The U.S. Patent Application Serial Number of BAILOUT SYSTEM " _ _ _ _ _ _ _；Attorney number END7824USNP/150538；
Entitled " SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVIL The U.S. Patent Application Serial Number of CONCENTRIC DRIVE MEMBER " _ _ _ _ _ _ _；Attorney number END7825USNP/ 150539；
Entitled " CLOSURE SYSTEM ARRANGEMENTS FOR SURGICAL CUTTING AND STAPLING The U.S. Patent Application Serial Number of DEVICES WITH SEPARATE AND DISTINCT FIRING SHAFTS " _ _ _ _ _ _ _； Attorney number END7826USNP/150540；
Entitled " INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL END The U.S. Patent Application Serial of EFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS " Number _ _ _ _ _ _ _；Attorney number END7827USNP/150541；
Entitled " SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7829USNP/150543；
Entitled " SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVE The U.S. Patent Application Serial Number of CUTTING OF TISSUE " _ _ _ _ _ _ _；Attorney number END7830USNP/150544；
The beauty of entitled " SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT " State's patent application serial number _ _ _ _ _ _ _；Attorney number END7831USNP/150545；
Entitled " SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSION The U.S. Patent Application Serial Number of LOCKOUT " _ _ _ _ _ _ _；Attorney number END7832USNP/150546；
Entitled " SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT's " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7833USNP/150547；
Entitled " SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT's " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7834USNP/150548；
Entitled " SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7835USNP/150549；
Entitled " SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGE The U.S. Patent Application Serial Number of LOCKOUT " _ _ _ _ _ _ _；Attorney number END7836USNP/150550；
The U.S. of entitled " SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM " is special Sharp patent application serial numbers _ _ _ _ _ _ _；Attorney number END7837USNP/150551；
Entitled " SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS's " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7838USNP/150552；
The U.S. Patent Application Serial Number of entitled " SURGICAL STAPLING INSTRUMENT " _ _ _ _ _ _ _；Agency People's file number END7839USNP/150553；
Entitled " SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OF The U.S. Patent Application Serial Number of STAPLES HAVING DIFFERENT HEIGHTS " _ _ _ _ _ _ _；Attorney number END7840USNP/150554；
Entitled " SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7841USNP/150555；
The United States Patent (USP) Shen of entitled " ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS " Please sequence number _ _ _ _ _ _ _；Attorney number END7842USNP/150556；
The U.S. Patent Application Serial of entitled " STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES " Number _ _ _ _ _ _ _；Attorney number END7843USNP/150557；
Entitled " CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUE The U.S. Patent Application Serial Number of SUPPORT " _ _ _ _ _ _ _；Attorney number END7844USNP/150558；And
The beauty of entitled " CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM " State's patent application serial number _ _ _ _ _ _ _；Attorney number END7845USNP/150559.
Present applicant also possesses following U.S. Patent application, these patent applications were submitted on December 31st, 2015 And it is respectively incorporated by reference and is incorporated herein:
Entitled " MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE IN The U.S. Patent Application Serial Number 14/984,488 of POWERED SURGICAL INSTRUMENTS "；
Entitled " MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED The U.S. Patent Application Serial Number 14/984,525 of SURGICAL INSTRUMENTS "；And
Entitled " SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROL The U.S. Patent Application Serial Number 14/984,552 of CIRCUITS ".
Present applicant also possesses following U.S. Patent application, these patent applications on 2 9th, 2016 submit and It is respectively incorporated by reference and is incorporated herein:
Entitled " SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLY The U.S. Patent Application Serial Number 15/019,220 of TRANSLATABLE END EFFECTOR "；
Entitled " SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATION The U.S. Patent Application Serial Number 15/019,228 of ARRANGEMENTS "；
Entitled " SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTED SECONDARY CONSTRAINT”
U.S. Patent Application Serial Number 15/019,196；
Entitled " SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLY The U.S. Patent Application Serial Number 15/ of ARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY " 019,206；
Entitled " SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATION The U.S. Patent Application Serial Number 15/019,215 of ARRANGEMENTS "；
Entitled " ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATION The U.S. Patent Application Serial Number 15/019,227 of LINK ARRANGEMENTS "；
Entitled " SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLE The U.S. Patent Application Serial Number 15/019,235 of DRIVEN ARTICULATION SYSTEMS "；
Entitled " ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAM The U.S. Patent Application Serial Number 15/019,230 of ARRANGEMENTS "；And
Entitled " SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTION The U.S. Patent Application Serial Number 15/019,245 of ARRANGEMENTS ".
Present applicant also possesses following U.S. Patent application, these patent applications were submitted on 2 12nd, 2016 And it is respectively incorporated by reference and is incorporated herein:
Entitled " MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED The U.S. Patent Application Serial Number 15/043,254 of SURGICAL INSTRUMENTS "；
Entitled " MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED The U.S. Patent Application Serial Number 15/043,259 of SURGICAL INSTRUMENTS "；
Entitled " MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED The U.S. Patent Application Serial Number 15/043,275 of SURGICAL INSTRUMENTS "；And
Entitled " MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED The U.S. Patent Application Serial Number 15/043,289 of SURGICAL INSTRUMENTS ".
Present applicant possess on June 18th, 2015 submit and be respectively incorporated by reference be incorporated herein with Lower patent application:
Entitled " SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING The U.S. Patent Application Serial Number 14/742,925 of ARRANGEMENTS "；
Entitled " SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSING The U.S. Patent Application Serial Number 14/742,941 of FEATURES "；
Entitled " MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLE The U.S. Patent Application Serial Number 14/742,914 of SURGICAL INSTRUMENTS "；
Entitled " ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAM The U.S. of STRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT " Patent application serial number 14/742,900；
Entitled " DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLE The U.S. Patent Application Serial Number 14/742,885 of SURGICAL INSTRUMENTS "；And
Entitled " PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLE The U.S. Patent Application Serial Number 14/742,876 of SURGICAL INSTRUMENTS ".
Present applicant possess on March 6th, 2015 submit and be respectively incorporated by reference be incorporated herein with Lower patent application:
The U.S. Patent Application Serial Number 14/640,746 of entitled " POWERED SURGICAL INSTRUMENT "；
Entitled " MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWERED The U.S. Patent Application Serial Number 14/640,795 of SURGICAL INSTRUMENTS "；
Entitled " ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE The U.S. Patent Application Serial Number 14/640,832 of RATES FOR MULTIPLE TISSUE TYPES "；Attorney number END7557USNP/140482；
Entitled " OVERLAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO The U.S. Patent Application Serial Number 14/640,935 of MEASURE TISSUE COMPRESSION "；
Entitled " MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTOR The U.S. Patent Application Serial Number 14/640,831 of FOR POWERED SURGICAL INSTRUMENTS "；
Entitled " TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE The U.S. Patent Application Serial Number 14/ of STABILITY, CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES " 640,859；
Entitled " INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS " U.S. Patent Application Serial Number 14/640,817；
Entitled " CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULAR The U.S. Patent Application Serial Number 14/640 of SHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE ", 844；
The U.S. Patent Application Serial of entitled " SMART SENSORS WITH LOCAL SIGNAL PROCESSING " Number 14/640,837；
Entitled " SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGE The U.S. Patent Application Serial Number 14/640,765 of INTO A SURGICAL STAPLER "；
Entitled " SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A The U.S. Patent Application Serial Number 14/640,799 of ROTATABLE SHAFT "；And
Entitled " SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING's " U.S. Patent Application Serial Number 14/640,780.
Present applicant, which possesses on 2 27th, 2015, to be submitted and is respectively hereby incorporated herein by full Following patent application:
Entitled " SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION " U.S. Patent Application Serial Number 14/633,576；
Entitled " SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCE PARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND” U.S. Patent Application Serial Number 14/633,546；
Entitled " SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONE The U.S. Patent Application Serial Number 14/633,576 of OR MORE BATTERIES "；
Entitled " CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR The U.S. Patent Application Serial Number 14/633,566 of CHARGING A BATTERY "；
Entitled " SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TO The U.S. Patent Application Serial Number 14/633,555 of BE SERVICED "；
The U.S. Patent application sequence of entitled " REINFORCED BATTERY FOR A SURGICAL INSTRUMENT " Row number 14/633,542；
The U.S. Patent Application Serial Number of entitled " POWER ADAPTER FOR A SURGICAL INSTRUMENT " 14/633,548；
The U.S. Patent Application Serial Number 14/ of entitled " ADAPTABLE SURGICAL INSTRUMENT HANDLE " 633,526；
The U.S. Patent Application Serial Number 14/633,541 of entitled " MODULAR STAPLING ASSEMBLY "；And
Entitled " SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFE The U.S. Patent Application Serial Number 14/633,562 of PARAMETER "；
Present applicant, which possesses on December 18th, 2014 to submit and be respectively incorporated by reference, to be incorporated herein Following patent application:
Entitled " SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END The U.S. Patent application of EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING " Sequence number 14/574,478；
The beauty of entitled " SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS " State's patent application serial number 14/574,483；
Entitled " DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS's " U.S. Patent Application Serial Number 14/575,139；
Entitled " LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH The U.S. Patent Application Serial Number 14/575,148 of ARTICULATABLE SURGICAL END EFFECTORS "；
Entitled " SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE The United States Patent (USP) Shen of ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE " It please sequence number 14/575,130；
The beauty of entitled " SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS " State's patent application serial number 14/575,143；
Entitled " SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND The U.S. Patent Application Serial Number 14/575,117 of MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS "；
Entitled " SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND The U.S. Patent Application Serial Number 14/575,154 of IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS "；
Entitled " SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE The U.S. Patent Application Serial Number 14/574,493 of ARTICULATION SYSTEM "；And
Entitled " SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE The U.S. Patent Application Serial Number 14/574,500 of ARTICULATION SYSTEM ".
Present applicant possess on March 1st, 2013 submit and be respectively incorporated by reference be incorporated herein with Lower patent application:
Entitled " Articulatable Surgical Instruments With Conductive Pathways The U.S. Patent Application Serial Number 13/782,295 of For Signal Communication ", is now U.S. Patent Application Publication 2014/0246471；
Entitled " Rotary Powered Articulation Joints For Surgical Instruments " U.S. Patent Application Serial Number 13/782,323, be now U.S. Patent Application Publication 2014/0246472；
The beauty of entitled " Thumbwheel Switch Arrangements For Surgical Instruments " State's patent application serial number 13/782,338 is now U.S. Patent Application Publication 2014/0249557；
Entitled " Electromechanical Surgical Device with Signal Relay The U.S. Patent Application Serial Number 13/782,499 of Arrangement " is now U.S. Patent Application Publication 2014/0246474；
Entitled " Multiple Processor Motor Control for Modular Surgical The U.S. Patent Application Serial Number 13/782,460 of Instruments " is now U.S. Patent Application Publication 2014/0246478；
The U.S. of entitled " Joystick Switch Assemblies For Surgical Instruments " is special Sharp patent application serial numbers 13/782,358 are now U.S. Patent Application Publication 2014/0246477；
Entitled " Sensor Straightened End Effector During Removal Through The U.S. Patent Application Serial Number 13/782,481 of Trocar " is now U.S. Patent Application Publication 2014/0246479；
Entitled " Control Methods for Surgical Instruments with Removable The U.S. Patent Application Serial Number 13/782,518 of Implement Portions " is now U.S. Patent Application Publication 2014/ 0246475；
Entitled " Rotary Powered Surgical Instruments With Multiple Degrees of The U.S. Patent Application Serial Number 13/782,375 of Freedom " is now U.S. Patent Application Publication 2014/0246473；And
The U.S. Patent Application Serial Number 13/782,536 of entitled " Surgical Instrument Soft Stop ", It is now U.S. Patent Application Publication 2014/0246476.
Present applicant, which also possesses on March 14th, 2013 to submit and be respectively incorporated by reference, to be incorporated herein Following patent application:
Entitled " ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE " U.S. Patent Application Serial Number 13/803,097, be now U.S. Patent Application Publication 2014/0263542；
Entitled " CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL The U.S. Patent Application Serial Number 13/803,193 of INSTRUMENT " is now U.S. Patent Application Publication 2014/0263537；
Entitled " INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL The U.S. Patent Application Serial Number 13/803,053 of INSTRUMENT " is now U.S. Patent Application Publication 2014/0263564；
Entitled " ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION The U.S. Patent Application Serial Number 13/803,086 of LOCK " is now U.S. Patent Application Publication 2014/0263541；
Entitled " SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR The U.S. Patent Application Serial Number 13/803,210 of SURGICAL INSTRUMENTS " is now U.S. Patent Application Publication 2014/ 0263538；
The U.S. Patent application of entitled " MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT " Sequence number 13/803,148 is now U.S. Patent Application Publication 2014/0263554；
Entitled " DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL The U.S. Patent Application Serial Number 13/803,066 of INSTRUMENTS " is now U.S. Patent Application Publication 2014/0263565；
Entitled " ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL The U.S. Patent Application Serial Number 13/803,117 of INSTRUMENTS " is now U.S. Patent Application Publication 2014/0263553；
Entitled " DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL The U.S. Patent Application Serial Number 13/803,130 of INSTRUMENTS " is now U.S. Patent Application Publication 2014/0263543； And
The U.S. of entitled " METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT " Patent application serial number 13/803,159 is now U.S. Patent Application Publication 2014/0277017.
Present applicant also possess submit on March 7th, 2014 and be incorporated by reference be incorporated herein it is following Patent application:
The U.S. Patent Application Serial Number of entitled " CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS " 14/200,111, it is now U.S. Patent Application Publication 2014/0263539.
Present applicant, which also possesses on March 26th, 2014 to submit and be respectively incorporated by reference, to be incorporated herein Following patent application:
Entitled " POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS's " U.S. Patent Application Serial Number 14/226,106 is now U.S. Patent Application Publication 2015/0272582；
The U.S. Patent Application Serial Number 14/ of entitled " STERILIZATION VERIFICATION CIRCUIT " 226,099, it is now U.S. Patent Application Publication 2015/0272581；
Entitled " VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT " U.S. Patent Application Serial Number 14/226,094, be now U.S. Patent Application Publication 2015/0272580；
Entitled " POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT The U.S. Patent Application Serial Number 14/226,117 of AND WAKE UP CONTROL " is now U.S. Patent Application Publication 2015/ 0272574；
Entitled " MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT The U.S. Patent Application Serial Number 14/226,075 of ASSEMBLIES " is now U.S. Patent Application Publication 2015/0272579；
Entitled " FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL The U.S. Patent Application Serial Number 14/226,093 of INSTRUMENTS " is now U.S. Patent Application Publication 2015/0272569；
The United States Patent (USP) Shen of entitled " SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION " Please sequence number 14/226,116, be now U.S. Patent Application Publication 2015/0272571；
Entitled " SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY The U.S. Patent Application Serial Number 14/226,071 of PROCESSOR " is now U.S. Patent Application Publication 2015/0272578；
The United States Patent (USP) of entitled " SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS " Patent application serial numbers 14/226,097 are now U.S. Patent Application Publication 2015/0272570；
The U.S. of entitled " INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS " is special Sharp patent application serial numbers 14/226,126 are now U.S. Patent Application Publication 2015/0272572；
The U.S. Patent Application Serial Number 14/ of entitled " MODULAR SURGICAL INSTRUMENT SYSTEM " 226,133, it is now U.S. Patent Application Publication 2015/0272557；
The beauty of entitled " SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT " State's patent application serial number 14/226,081 is now U.S. Patent Application Publication 2015/0277471；
Entitled " POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE The U.S. Patent Application Serial Number 14/226,076 of VOLTAGE PROTECTION " is now U.S. Patent Application Publication 2015/ 0280424；
The U.S. Patent Application Serial Number 14/ of entitled " SURGICAL STAPLING INSTRUMENT SYSTEM " 226,111, it is now U.S. Patent Application Publication 2015/0272583；And
The United States Patent (USP) Shen of entitled " SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT " Please sequence number 14/226,125, be now U.S. Patent Application Publication 2015/0280384.
Present applicant, which also possesses to submit and be respectively incorporated by reference on September 5th, 2014, to be incorporated herein Following patent application:
The United States Patent (USP) Shen of entitled " CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE " Please sequence number 14/479,103, be now U.S. Patent Application Publication 2016/0066912；
Entitled " ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE The U.S. Patent Application Serial Number 14/479,119 of COMPRESSION " is now U.S. Patent Application Publication 2016/0066914；
Entitled " MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION " U.S. Patent Application Serial Number 14/478,908, be now U.S. Patent Application Publication 2016/0066910；
Entitled " MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S The U.S. Patent Application Serial Number 14/478,895 of OUTPUT OR INTERPRETATION ", is now U.S. Patent Application Publication 2016/0066909；
Entitled " USE OF POLARITY OF HALL MAGNET DETECTION TO DETECT MISLOADED The U.S. Patent Application Serial Number 14/479,110 of CARTRIDGE " is now U.S. Patent Application Publication 2016/0066915；
The U.S. of entitled " SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION " is special Sharp patent application serial numbers 14/479,098 are now U.S. Patent Application Publication 2016/0066911；
The United States Patent (USP) of entitled " MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE " Patent application serial numbers 14/479,115 are now U.S. Patent Application Publication 2016/0066916；And
The United States Patent (USP) Shen of entitled " LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION " Please sequence number 14/479,108, be now U.S. Patent Application Publication 2016/0066913.
Present applicant, which also possesses on April 9th, 2014 to submit and be respectively incorporated by reference, to be incorporated herein Following patent application:
Entitled " MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE The U.S. Patent Application Serial Number 14/248,590 of SHAFTS " is now U.S. Patent Application Publication 2014/0305987；
Entitled " SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRING The U.S. Patent Application Serial Number 14/248,581 of DRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT ", It is now U.S. Patent Application Publication 2014/0305989；
Entitled " SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING The U.S. Patent Application Serial Number 14/248,595 of THE OPERATION OF THE SURGICAL INSTRUMENT ", now for U.S. Patent Application Publication 2014/0305988；
The U.S. Patent Application Serial Number 14/248 of entitled " POWERED LINEAR SURGICAL STAPLER ", 588, it is now U.S. Patent Application Publication 2014/0309666；
The United States Patent (USP) of entitled " TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT " Patent application serial numbers 14/248,591 are now U.S. Patent Application Publication 2014/0305991；
Entitled " MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS” U.S. Patent Application Serial Number 14/248,584, be now U.S. Patent Application Publication 2014/0305994；
The U.S. Patent Application Serial Number 14/248,587 of entitled " POWERED SURGICAL STAPLER ", now for U.S. Patent Application Publication 2014/0309665；
Entitled " DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL The U.S. Patent Application Serial Number 14/248,586 of INSTRUMENT " is now U.S. Patent Application Publication 2014/0305990；With And
Entitled " MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS The U.S. Patent Application Serial Number 14/248,607 of INDICATION ARRANGEMENTS ", is now U.S. Patent Application Publication 2014/0305992。
Present applicant, which also possesses on April 16th, 2013 to submit and be respectively incorporated by reference, to be incorporated herein Following patent application:
Entitled " SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A The U.S. Provisional Patent Application Serial No. 61/812,365 of SINGLE MOTOR "；
The U.S. Provisional Patent Application Serial No. 61/812,376 of entitled " LINEAR CUTTER WITH POWER "；
The U.S. Provisional Patent Application sequence of entitled " LINEAR CUTTER WITH MOTOR AND PISTOL GRIP " Row number 61/812,382；
Entitled " SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS AND The U.S. Provisional Patent Application Serial No. 61/812,385 of MOTOR CONTROL "；And
Entitled " SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A The U.S. Provisional Patent Application Serial No. 61/812,372 of SINGLE MOTOR ".
Many details are listed, herein to provide to whole with embodiment shown in the drawings described in specification Body structure, function, the thorough understanding of manufacture and purposes.It is not described in well known operation, component and element, in order to avoid make to illustrate Embodiment described in book is smudgy.Reader will appreciate that embodiment described and illustrated herein is non-limiting shows Example, thus it can be appreciated that, specific structural and functional details disclosed herein can be representative and illustrative.Power is not being departed from In the case where the range that benefit requires, variations and modifications can be carried out to these embodiments.
Term " including (comprise) " (and any form of " including (comprise) ", such as " including (comprises) " and " including (comprising) "), " with (have) " (and any form of " with (have) ", it is all Such as " with (has) " and " with (having) "), " comprising (include) " (and any form of " comprising (include) ", Such as " include (includes) " and " including (including) ") and " containing (contain) " (and " contain (contain) " any form, such as " contain (contains) " and " containing (containing) ") for open link-verb. Therefore, the surgery system, device or equipment of " comprising ", " having ", "comprising" or " containing " one or more elements have these One or more elements, but it is not limited to that only there are these one or more elements.Equally, " comprising ", " having ", "comprising" or The element of the system of " containing " one or more features, device or equipment has those one or more features, but is not limited to only With those one or more features.
Term " nearside " and " distal side " are herein defined as coming relative to the clinician of the handle portions of manipulation surgical instruments It uses.Term " nearside " refers to that near the part of clinician, term " distal side " refers to the portion far from clinician's positioning Point.It is also understood that using such as "vertical", "horizontal", "up" and "down" in combination with attached drawing herein for the sake of succinct and is clear Etc. spatial terminologies.It is used however, surgical instruments is middle in many orientations and positions, and these terms are not intended to be limiting And/or absolute.
Various exemplary means and method are provided for executing laparoscopic type and minimally invasive surgical procedures.However, reading Person it will be readily understood that various method and apparatus disclosed herein can be used for a variety of surgical operations and application in, including for example with Open surgery combines.With continued reference to present embodiment, reader be will be further understood that, various devices disclosed herein Tool in any way in insertion body, by natural cavity, can pass through the notch being formed in tissue or puncturing hole etc..Device The working portion or end effector portion of tool can be inserted directly into patient's body or can be filled by entering with service aisle Insertion is set, the end effector and elongated shaft of surgical instruments can be promoted by the service aisle.
Surgical stapling system may include axis and the end effector from axis extension.End effector includes the first jaw and the Two jaws.First jaw includes nail bin.Nail bin is inserted into the first jaw and can remove from the first jaw；However, Other embodiments replaced from the first jaw can not be removed from the first jaw or at least be readily able to by being susceptible to wherein nail bin. Second jaw includes the anvil block for being configured to the nail deformation for making to project from nail bin.Second jaw can be relative to the first jaw It is pivoted around closure axis；It is contemplated, however, that the other embodiment party that can be pivoted to wherein the first jaw relative to the second jaw Case.Surgical stapling system further includes the pass for being configured to allow end effector that joint motions are rotated or carried out relative to axis Save kinematic joint.End effector can be around the joint motions axis rotation for extending through actuated articulation joints.It contemplates not Other embodiments including actuated articulation joints.
Nail bin includes warehouse.Warehouse includes proximal end, distal end and extends between proximal end and distal end Platform.In use, nail bin is located on the first side of tissue to be stapled, and anvil positioning is in second side of tissue On.Anvil block is towards cartridge movement by tissue compression and to grip against platform.Then, the nail being removedly stored in warehouse can It is deployed in tissue.Warehouse includes being defined in nail cavity therein, is removedly stored in nail cavity wherein following closely.Nail cavity is arranged to Six longitudinal rows.Three nail chambers are located on the first side of longitudinal slit and three nail chambers are located in second side of longitudinal slit. Other constructions of nail cavity and nail are also possible.
Nail is supported by the staple drivers in warehouse.Driver can be first or non-firing position and second or firing position Between move, with from nail bin project follow closely.Driver is retained in warehouse by retainer, and retainer extends around the bottom of warehouse And including being configured to grasping warehouse and keeping retainer to the elastic component of warehouse.Driver can pass through cunning Moving part moves between its non-firing position and its firing position.Sliding part can in the proximal position adjacent with proximal end and It is moved between the distal position adjacent with distal end.Sliding part includes multiple ramped surfaces, which is adapted to It is enough to slide and promoted driver below driver towards anvil block, and follow closely and be supported on a drive.
Than that described above, sliding part can also be moved toward the far side by firing member.Firing member is configured to contact Sliding part simultaneously pushes sliding part towards distal end.The longitudinal slit being defined in warehouse is configured to receive percussion structure Part.Anvil block further includes the slit for being configured to receive firing member.Firing member further includes engage the first jaw first Second cam of the second jaw of cam and engagement.When firing member is promoted towards distal side, first cam and the second cam is controllable The distance between platform and anvil block of nail bin or tissue space.Firing member further includes being configured to incision capture in nail bin With the knife of the tissue among anvil block.Wish that knife is positioned at least partly close to ramped surfaces, so that nail is emitted prior to knife.
Fig. 1 shows the motor driving surgery system 10 that can be used for executing a variety of different surgical operations.In the embodiment party of illustration In case, motor driving surgery system 10 includes the shell or handle assembly 20, the shell or shank optionally reconfigured Component is attached to a form of interchangeable surgical tool component 1000.For example, system 10 shown in FIG. 1 includes interchangeable surgery Tool assembly 1000, the interchangeable surgical tool component include the surgery cuts and fastening instrument for being referred to alternatively as linear cutter. It is discussed in detail as discussed further below, interchangeable surgical tool component may include end effector, which is suitable for branch Support the nail bin of different sizes and type and there is different shaft lengths, size and type etc..Appoint for example, this construction is available What suitable one or more fastener carrys out fastening tissue.E.g., including the multiple fasteners being removedly stored therein in Fastener cartridge can be removably inserted into the end effector of surgical tool component and/or be attached to the end of surgical tool component Portion's actuator.Other surgical tool components can be interchangeably used with handle assembly 20.For example, interchangeable surgical tool component 1000 can separate with handle assembly 20, and with being configured to execute the different surgical tool component generations of other surgical operations It replaces.In other constructions, surgical tool component can not be interchangeable with other surgical tool components and be for example consisted essentially of Attach or be connected to non-removablely the special axis of handle assembly 20.Surgical tool component is alternatively referred to as elongated shaft assembly.Surgery Tool assembly can be reusable, or in other configurations, surgical tool component is designed to be intended for single use It discards later.
With continued reference to present embodiment, it should be understood that various forms of interchangeable surgical tools disclosed herein The surgery system that component can also be controlled effectively with robot is used in combination.Therefore, term " shell " and " casing assembly " can also To cover the receiving of robot system or in other ways be operably supported the shell or similar department of at least one drive system Point, at least one described drive system is configured to generate and application can be used for activating elongated shaft assembly disclosed herein And its at least one control action of corresponding equivalent.Term " frame " can refer to a part of hand-held surgical instrument.Term " frame " can also indicate that a part of the surgical instruments of robot control and/or robot system can be used for being operatively controlled A part of surgical instruments.For example, surgical tool component disclosed herein can with various robot systems, instrument, component and Method is used together, such as, but not limited to entitled " SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE The U.S. Patent Application Serial Number 13/118,241 of STAPLE DEPLOYMENT ARRANGEMENTS " (is now United States Patent (USP) Shen Those disclosed in 2012/0298719) please be announce, which is incorporated by reference accordingly is incorporated herein.
Referring now to Fig. 1 and Fig. 2, casing assembly or handle assembly 20 include that can be formed by a pair of of shell segment 40,70 Main shell part 30, a pair of shell segment can be made of plastics, polymer material, metal etc. and by fasteners appropriate Construction (for example, adhesive, screw, pressure cooperation features, snap fit features, latch etc.) is bonded together.It is as follows It will be discussed in further detail, main shell part 30 is operably supported multiple drive systems therein, these drive systems are by structure It causes that various control movements can be generated and these control movements is applied to the interchangeable surgery being operably attached to thereon The corresponding part of tool assembly.Handle assembly 20 further includes grip portions 100, which is operatively coupled to main shell portion Divide 30 and is configured to be held and manipulated by clinician in each position relative to main shell part 30.Grip part Divide 100 can hold segment 110,120 by a pair be made, which holds segment can be by plastics, polymer material, metal etc. It is made and by fastener appropriate construction (for example, adhesive, screw, pressure cooperation features, snap fit features, door bolt Lock etc.) it is bonded together for I& M purpose.
As seen in Figure 2, grip portions 100 include the gripping shell 130 for limiting hollow cavity 132, the hollow cavity It is configured to be operably supported the drive motor that will be discussed in further detail below and gear-box.Hold shell 130 upper part 134 is configured to extend through the opening 80 in main shell part 30 and pivotally axle journal connects On pivotal axis 180.Pivotal axis 180 limits the pivot axis for being marked as " PA ".Referring to Fig. 3.For reference purposes, shank group Part 20, which limits, is marked as the shank axis of " HA ", the shank axis can be parallel to be operably attached to handle assembly 20 can Exchange the axial line " SA " of the elongated shaft assembly of surgical tool.Pivot axis P A is transverse to shank axis HA.Referring to Fig. 1.It is this Constructing, which enables grip portions 100 to be pivoted to around pivot axis P A relative to main shell part 30, is most suitable for being connected to shank group The position of the interchangeable surgical tool component type of part 20.It holds shell 130 and limits the gripping axis for being commonly labeled as " GA ". Referring to fig. 2.When the interchangeable surgical tool component for being connected to handle assembly 20 includes such as linear cutter, clinician can It can wish to position grip portions 100 relative to main shell part 30, so that holding axis GA is perpendicular or substantially perpendicular to (angle Spend " H1 ") shank axis HA (referred to herein as " the first grip position position ").Referring to Fig. 5.However, if handle assembly 20 For controlling the interchangeable surgical tool component including such as circular stapler, clinician may want to make grip portions 100 It is pivoted to relative to main shell part 30 and wherein holds axis GA relative to shank axis HA in 45 degree or about 45 degree Angle or the position of other suitable acute angles (angle " H2 ").This position is referred to herein as " the second grip position ".Fig. 5 is with dotted line Grip portions 100 in the second grip position are shown.
Referring now to Fig. 3 to Fig. 5, handle assembly 20 further includes the gripping locking system for being commonly labeled as 150, will be held Part 100 is held to be selectively locked in desired orientation relative to main shell part 30.In a kind of construction, locking system is held System 150 includes the arc sequence 152 of pointed tooth 154.Tooth 154 is separated from each other, and forms locking groove 156 therebetween.Each Lock the special angle latched position that groove 156 corresponds to grip portions 100.For example, at least one construction, 154 He of tooth Locking groove or " latched position " 156 be arranged to allow grip portions 100 the first grip position and the second grip position it Between with 10-15 degree spaced lock.Two stop positions can be used in the construction, for used instrument type (axis construction) into Row modulation.It can be in substantially about 90 degree with axis, and for circular stapler structure for example, being constructed for linear cutter axis It makes, which can scan forward to be in about 45 degree with axis simultaneously towards surgeon.Holding locking system 150 further includes Locking press button 160, the locking press button have engage locking groove 156 lock part with being configured to locking.For example, lock Determine button 160 to be pivotally mounted in main handle part part 30 on pivot pin 131, with allow locking press button 160 be switched to it is right The locking groove 156 answered engages.Lock spring 164, which is used to bias to locking press button 160, locks connecing for groove 156 with corresponding Conjunction or latched position.Lock part and tooth configuration when clinician pressure-locks button 160 for enabling tooth 154 slip over lock Determine part.Therefore, in order to adjust angle position of the grip portions 100 relative to main shell part 30, clinician is pressure-locked Then grip portions 100 are pivoted to desired angle position by button 160.Once grip portions 100 are moved to desired position It sets, clinician discharges locking press button 160.Lock spring 164 then biases the sequence of locking press button 160 towards tooth 154, makes It obtains lock part and enters corresponding locking groove 156 during use to keep grip portions 100 in the position.
Handle assembly 20 is operably supported the first rotary drive system 300, the second rotary drive system 320 and third axis To drive system 400.Each motor 200 being freely operatively supported in grip portions 100 of rotary drive system 300,320 supplies Electricity.As seen in Figure 2, for example, motor 200 is supported on the cavity 132 in grip portions 100 Nei and has gear-box group Part 202, the gear case assembly have from its output driving shaft 204 outstanding.In various forms, motor 200 for example can be The DC of maximum rotation with about 25,000RPM has brush drive motor.In other constructions, motor may include brushless motor, nothing Rope motor, syncmotor, stepper motor or any other suitable electric motor.Motor 200 can be powered by power source 210, In a kind of form, which may include removable power source group 212.Power source 210 may include for example in entitled " SURGICAL In the U.S. Patent Application Publication 2015/0272575 of INSTRUMENT COMPRISING A SENSOR SYSTEM " further Any one of the various power source structures of detailed disclosure, the complete disclosure of the patent application is incorporated by reference accordingly Herein.In the construction of illustration, for example, power supply group 212 may include nearside casing part 214, which is constructed For being attached to distal side casing part 216.Nearside casing part 214 and distal side casing part 216 are configured to operate Ground supports multiple batteries 218 therein.Battery 218 can respectively include such as lithium ion (" LI ") or other suitable batteries.Far Side casing part 216 is configured for removably being operably attached to equally be operably linked to motor 200 Shank circuit board assemblies 220.Shank circuit board assemblies 220 generally also can referred to herein as " control system or CPU 224 ". The multiple batteries 218 being connected in series can be used as the power source of handle assembly 20.In addition, power source 210 can be alternatively and/ Or it is rechargeable.In other embodiments, surgical instruments 10 can power for example, by alternating current (AC).Motor 200 can be with Rocker switch 206 by being installed to grip portions 100 controls.
As described above, motor 200 be operably linked to include output driving shaft 204 gear case assembly 202.Driving Bevel gear 230 is attached to output driving shaft 204.Motor 200, gear case assembly 202, output driving shaft 204 and driving bevel gear 230 can also collectively referred to herein as " motor sub-assembly 231 ".Driving bevel gear 230 and the slave mantle for being attached to system drive axis 232 Gear 234 and axle journal are connected to the handover of the pivot bevel gear 238 on pivotal axis 180.Driven wheel of differential 234 bonding station with It can be axially moved on system drive axis 232 between disengaging configuration, in bonding station driven wheel of differential 234 and driving bevel gear 230 be engaged (Fig. 5), is detached from disengaging configuration driven wheel of differential 234 and is engaged (Figure 14) with driving bevel gear 230. Proximal end flange of the drive system spring 235 on driven wheel of differential 234 and the portions of proximal for being formed in system drive axis 232 Axle journal connects between 236.Referring to fig. 4 and Figure 14.Drive system spring 235 be used for by driven wheel of differential 234 bias to disengaging with Being engaged for driving bevel gear 230, is discussed in detail as discussed further below.It pivots bevel gear 238 and is conducive to output driving shaft 204 and driving bevel gear 230 with grip portions 100 relative to main handle part part 30 pivot advance.
In the example shown, system drive axis 232 and the rotation driving selector system handover for being commonly labeled as 240. For example, at least one form, rotation driving selector system 240 includes can be in the first rotary drive system 300 and the The shifter gear 250 selectively moved between two rotary drive systems 320.Such as in Fig. 6 into Fig. 9 it is seen, for example, driving Selector system 240 includes the shift unit mounting plate 242 being mounted in main handle part part 30 non-movablely.For example, shift unit Mounting plate 242 can be frictionally held between the mounting lug (not shown) being formed in shell segment 40,70, or be passed through Screw, adhesive etc. are otherwise held in wherein.Referring still to Fig. 6 to Fig. 9, system drive axis 232 extends through displacement Hole in device mounting plate 242 and there is center or the system drive gear 237 being non-rotatably attached to thereon.In for example, Heart driving gear 237 can construct 233 by keyway and be attached to system drive axis 232.Referring to Fig. 6 to Fig. 9.In other constructions, System drive axis 232 can be pivotally supported at shift unit mounting plate 242 by the corresponding shaft bearing (not shown) being mounted thereto In.Under any circumstance, the rotation of system drive axis 232 will lead to the rotation of centre-driven gear 234.
As seen in Figure 3, the first drive system 300 includes that the first driving being pivotally supported in distal walls 32 is held Nest 302, the distal walls are formed in main handle part part 30.First driving pod 302 may include the first main part 304, this One main part has spline pod formed therein.First driven gear 306 is formed in the first main part 304 or not Movably it is attached to first main part.First main part 304, which can be pivotally supported at, to be arranged in distal walls 32 In corresponding aperture or channel in or its can be pivotally supported at the corresponding shaft bearing (not shown) being mounted in distal walls 32 In.Similarly, the second rotary drive system 320 includes equally being pivotally supported in the distal walls 32 of main handle part part 30 Second driving pod 322.Second driving pod 322 may include the second main part 324, which, which has, is formed in Spline pod therein.Second driven gear 326 be formed in the second main part 324 or be non-rotatably mounted to this second Main part.Second main part 324 can be pivotally supported in the corresponding aperture being arranged in distal walls 32 or channel, or Person it can be pivotally supported in the corresponding shaft bearing (not shown) being mounted in distal walls 32.First driving 302 He of pod Second driving pod 322 is separated from each other on each side of shank axis HA.For example, with reference to Fig. 4.
As described above, in the example shown, rotation driving selector system 240 includes shifter gear 250.Such as in Fig. 6 Into Fig. 9 as it can be seen that shifter gear 250 is rotatably installed on idler shaft 252, which is movably supported at displacement In arcuate slot 244 in device mounting plate 242.Shifter gear 250 is installed into rotate freely simultaneously on idler shaft 252 Holding is engaged with centre-driven gear 234.Idler shaft 252 is connected to the end of the axis 262 of shifter solenoid 260.It moves Position device solenoid 260 and 30 pin joint of main handle part shell are otherwise mounted to together, so that working as 260 quilt of shifter solenoid When actuating, shifter gear 250 is moved to be engaged with one of the first driven gear 306 or the second driven gear 326. For example, in a kind of construction, when solenoid shaft 262 bounces back (Fig. 6 and Fig. 7), shifter gear 250 and centre-driven gear 234 and first driven gear 306 be engaged so that the actuating of motor 200 will lead to the rotation of the first driving pod 302.Such as Shifter gear 250 is biased into the first actuated position as it can be seen that shift unit spring 266 can be used in figure 6 and figure 7.Therefore, such as The power loss of fruit surgical instruments 10, shift unit spring 266 can be by 250 automatic bias of shifter gear to first position.Work as shifting When position device gear 250 is in the position, the subsequent actuating of motor 200 will lead to the first driving of the first rotary drive system 300 The rotation of pod 302.When shifter solenoid is activated, shifter gear 250 is moved to be driven on pod 322 with second Second driven gear 326 is engaged.Hereafter, the actuating of motor 200 will lead to the second driving of the second rotary drive system 320 The actuating or rotation of pod 322.
It is discussed in detail as discussed further below, the first rotary drive system 300 and the second rotary drive system 320 can be used for For the various component parts power supply for being connected to interchangeable surgical tool component thereon.As described above, at least one construction, If the power loss of the activating motor in interchangeable surgical tool component, shift unit spring 266 can be by shift unit tooth Wheel 250 is biased to first position.According to the component part of interchangeable surgical tool component operated, it may be necessary to drive rotation The application of dynamic movement is reversed to the first drive system 300, so that interchangeable surgical tool component can be removed from patient's body.Institute Show that the exemplary use of handle assembly 20 is commonly labeled as 330 manually actuable " emergency " system, such as in above-mentioned feelings Rotating drive movements are manually applied to the first rotary drive system 300 in condition.
Referring now to Fig. 3, Figure 10 and Figure 11, shown in emergency system 330 include emergency driving system 332, the emergency driving System includes planetary gear set 334.In at least one form, planetary gear set 334 includes planetary gear shell 336, should Planetary gear shell accommodates the planetary gear structure (not shown) including bevel planet gear 338.Planetary gear set 334 includes answering Anxious drive shaft 340, the emergency driving axis are operably linked to the planetary gear structure in planetary gear shell 336.Planet cone The rotation of gear 338 rotates planetary gear structure, which finally rotate emergency driving axis 340.Emergency is driven 342 axle journal of moving gear is connected on emergency driving axis 340, so that emergency driving gear 342 can be axial on emergency driving axis 340 Movement, also rotates with it.Emergency driving gear 342 can be in the spring stop flange 344 being formed on emergency driving axis 340 Be formed in emergency driving axis 340 distal end on axis end stop 346 between move.Emergency 348 axle journal of axis spring It is connected on emergency driving axis 340 between emergency driving gear 342 and spring stop flange 344.Axis spring 348 of meeting an urgent need will Emergency driving gear 342 is biased on emergency driving axis 340 towards distal side.When emergency driving gear 342 is in it in emergency driving When the farthest position on axis 340, engaged with the emergency driven gear 350 for being non-rotatably mounted to system drive axis 232 Engagement.Referring to Figure 14.
Referring now to Figure 12 and Figure 13, emergency system 330 includes being conducive to move emergency driving to be applied to emergency manually Driving is 332 emergency actuator or emergency handle assembly 360.As in the drawings as it can be seen that emergency handle assembly 360 Including bevel gear assembly 362 of meeting an urgent need, which includes emergency bevel gear 364 and ratchet gear 366.Emergency shank Component 360 further includes that emergency bevel gear set is operatively coupled to by the pivotal yoke 372 being pivotally mounted on ratchet gear 366 The emergency shank 370 of part 362.Emergency shank 370 is pivotally coupled to pivotal yoke 372 by pin 374, so as in storage location It selectively pivots and advances between " SP " and actuated position " AP ".Referring to Figure 12.Shank spring 376 is inclined for the shank 370 that will meet an urgent need Set actuated position AP.In at least one construction, for example, indicating the axis SP of storage location and indicating the axis of actuated position Angle between AP can be about 30 degree.Referring to Figure 13.Such as it can be seen that emergency handle assembly 360 further includes spine equally in Figure 13 Tire 378, the ratchet pawl are rotatably installed in the cavity in pivotal yoke 372 or hole 377.Ratchet pawl 378 is adapted to It is enough engagingly to engage ratchet gear 366 when along direction of actuation " AD " rotation, then rotate when rotating in mutually opposite directions with de- From being engaged.Ratchet spring 384 and spherical component 386 are movably supported in the cavity 379 in pivotal yoke 372, and are used In the detent 380,382 when shank 370 of meeting an urgent need is activated and (carries out ratcheting motion) in locking ground engagement ratchet pawl 378.
Referring now to Fig. 3 and Figure 10, emergency system 330 further includes answering of can manipulating between the open position and the closed position Anxious access panel 390.In shown construction, emergency access panel 390 is configured to be removably coupled to main shell portion Divide 30 shell segment 70.Therefore, in at least embodiment, when emergency access panel 390 is removed from main shell part 30 Or when being partially separated with main shell, then it is assumed that be in " opening " position, and when emergency access panel 390 is attached to as shown in the figure When main shell part 30, then it is assumed that be in " closed " position.It is contemplated, however, that other embodiments, wherein access panel activity Ground is connected to main shell part, so that it is remained attached to thereon when access panel is in an open position.For example, such In embodiment, access panel is pivotably attached to main shell part or is attached slidably to main shell part, and can It is manipulated between the open position and the closed position.In the example shown, emergency access panel 390 is configured to buckle Ground engages the corresponding part of shell segment 70 to be removably retained in " closed " position.The machine of other forms can also be used Tool fastener, screw, pin etc..
No matter emergency access panel 390 is can to separate also to be to maintain with main shell part 30 to be actively attached to main shell portion Divide 30, emergency access panel 390 includes respectively since the drive system that its back side is prominent or is otherwise formed upon thereon locks Component or yoke 392 and emergency locking component or yoke 396.It includes drive shaft recess 394, the drive shaft that drive system, which locks yoke 392, Recess is configured to be mounted in main shell part 30 in emergency access panel 390 (that is, emergency access panel is in and " closes Close " position) when by system drive axis 232 a part receive wherein.It is closed when emergency access panel 390 is positioned or mounted at When coincidence is set, drive system locking yoke 392 be used for by driven wheel of differential 234 bias to driving bevel gear 230 be engaged (with The biasing of drive system spring 235 is opposite).In addition, emergency locking yoke 396 includes emergency driving axis recess 397, the emergency driving Axis recess is configured to emergency driving axis 340 when emergency access panel 390 is mounted or is located in closed position A part is received wherein.As it can be seen that emergency locking yoke 396 is also used to bias emergency driving gear 342 such as in Fig. 5 and Figure 10 To being detached from and emergency being engaged of driven gear 350 (biasing of axis spring 348 is opposite with meeting an urgent need).Therefore, when emergency accesses When panel 390 is mounted or is in the close position, emergency locking yoke 396 prevents 342 interference system drive shaft of emergency driving gear 232 rotation.In addition, emergency locking yoke 396 includes shank recess 398, to engage emergency shank 370 and to hold it in storage It deposits in the SP of position.
Fig. 4, Fig. 5 and Figure 10 show the drive component when emergency access panel 390 is mounted or is in the close position With the construction of emergency system component.As in the drawings as it can be seen that drive system locking component 392 is inclined by driven wheel of differential 234 It sets to driving bevel gear 230 and is engaged.Therefore, when emergency access panel 390 is mounted or is in the close position, motor 200 actuating will lead to the rotation of driving bevel gear 230 and the rotation of final system drive shaft 232.In addition, when being in the position When setting, emergency locking yoke 396 is used to emergency driving gear 342 biasing to disengaging and the emergency on system drive axis 232 is driven Gear 350 is engaged.Therefore, when emergency access panel 390 is mounted or is in the close position, drive system can be by horse Up to 200 actuatings, and disconnect or prevent it that any actuating movement is applied to system drive axis 232 emergency system 330. In order to activate emergency system 330, clinician removes emergency access panel 390 first or emergency is accessed panel in other ways 390 are moved to open position.The movement engages drive system locking component 392 with driven wheel of differential 234, to allow to drive Driven wheel of differential 234 is biased to being engaged for disengaging and driving bevel gear 230 by dynamic system spring 235.In addition, removing emergency Access panel 390 or the access panel that will meet an urgent need are moved to open position and also result in emergency locking yoke 396 and emergency driving gear 342 are disengaged, so that the axis spring 348 that allows to meet an urgent need biases to emergency driving gear 342 and answering on system drive axis 232 Anxious driven gear 350 is engaged.The rotation of emergency driving gear 342 will lead to emergency driven gear 350 and system drive axis 232 rotation.It removes emergency access panel 390 or emergency access panel 390 is moved to open position in other ways and also permit Perhaps emergency shank 370 is biased to actuated position shown in Figure 11 and Figure 14 by shank spring 376.When at that position, clinical Emergency shank 370 manually can be carried out ratcheting motion on the RD of ratchet direction by doctor, this will lead to the rotation of ratchet bevel gear 364 Turn (for example, along clockwise direction of Figure 14), eventually leads to and retraction rotary motion is applied to system by emergency driving system 332 Drive shaft 232.Emergency shank 370 can be carried out multiple ratcheting motion by clinician, until system drive axis 232 fully rotates Repeatedly with the component for being attached to handle assembly 20 of the surgical end-effector part for the surgical tool component that bounces back.Once emergency system System 330 is fully activated manually, and clinician then can put back to emergency access panel 390 in situ (that is, by the access face of emergency Plate 390 is back to closed position), so that drive system locking component 392 be made to bias to driven wheel of differential 234 and drive cone tooth Wheel 230 is engaged, and makes emergency locking yoke 396 that emergency driving gear 342 is biased to disengaging and emergency driven gear 350 Be engaged.As described above, shift unit spring 266 can bias to shifter solenoid 260 if power loss or interruption First actuated position.It reverses or bounces back in this way, the actuating of emergency system 330 will lead to apply to the first rotary drive system 300 Movement.
As described above, for example, surgery suturing appliance may include being configured to retraction nail to fire the manual of driving device The emergency system of actuating.In many instances, emergency system may need to operate and/or rotating crank more than once to return completely Contracting nail percussion driving device.In the illustration being described, the user of suture instruments may forget that they have been that emergency set rotation is more Few crank and/or the distance that in other words unclear percussion driving device needs to bounce back.Various embodiments can be envisaged, wherein Suture instruments include the position for being configured to the firing member of detection percussion driving device, determine that firing member needs to bounce back Distance, and be user's system for showing the distance of surgical instruments.
In at least one embodiment, surgery suturing appliance includes the position for being configured to detection firing member One or more sensors.In at least one example, sensor includes such as hall effect sensor, and can be positioned on seam In the axis and/or end effector of clutch tool.The controller of sensor and surgery suturing appliance carries out signal communication, the controller Then signal communication is carried out with the display on surgery suturing appliance.Controller includes microprocessor, which is constructed At the physical location of firing member and benchmark or reference position (it includes the fully retracted position of firing member) can be carried out The distance between physical location and the reference position compared, and calculate firing member, i.e. Distance Remaining.
Than that described above, display includes such as electronic console, and controller is configured to any suitable Mode show Distance Remaining on an electronic display.In at least one example, controller shows progress bar over the display. In the illustration being described, for example, empty progress bar can indicate that firing member is at the end of its firing schedule, and expiring progress bar can Indicate that firing member has been fully retracted.In at least one example, for example, 0% can indicate that firing member is in its firing schedule End at, and 100% can indicate that firing member has been fully retracted.In some instances, controller is configured to Show that firing member, which is bounced back to its fully retracted position, needs to activate how many times emergency organization on display.
Than that described above, the actuating of emergency organization can be by the battery of surgery suturing appliance or power source and percussion driving device Electric motor operationally disconnect.In at least one embodiment, the actuating of emergency organization switchs switching, which makes Battery is electrically separated with electric motor.The manual retrieving that this system will prevent electric motor from resisting firing member.
Shown handle assembly 20 also support be commonly labeled as 400 third axial drive system.As in figs. 3 and 4 As it can be seen that at least one form, third axial drive system 400 includes solenoid 402, which has outstanding from its Third drives actuator means or bar 410.It is formed therein that third drives the distal end 412 of actuator means 410 to have Third driving arm or pod 414, to receive the drive component of interchangeable surgical tool component to be operably attached to Corresponding part thereon.Solenoid 402 is wiredly connected to shank circuit board assemblies 220 and control system or CPU 224 or with it Its mode communicates.In at least one construction, solenoid 402 is " spring loads ", so that when solenoid 402 does not cause When dynamic, third driving actuator 410 is biased back to the initial position not activated by spring members.
As described above, reconfigurable handle assembly 20 is advantageously used for activating a variety of different interchangeable surgery works Has component.For this purpose, handle assembly 20 includes the tool mounting portion for being commonly labeled as 500, by interchangeable surgical tool group Part is operatively connected thereto.In the example shown, tool mounting portion 500 includes that two inward-facing swallow-tail forms receivings are narrow Slot 502, the slit are configured to engage the corresponding part of the tool attachment module part of interchangeable surgical tool component.Often A swallow-tail form receives slit 502 that can be tapered, or in other words, can omit forming V-shape.Swallow-tail form receives 502 quilt of slit It is constructed to be permeable in a part for releasably accepting the tool for being formed in interchangeable surgical tool component attachment nozzle segment Corresponding taper attachment or ledge portion.Each interchangeable surgical tool component can also be equipped with latch system, the latch system quilt It is constructed to be permeable to be releasably engaged the corresponding holding pit 504 in the tool mounting portion 500 for being formed in handle assembly 20.
Various interchangeable surgical tool components, which can have, is configured to be operably linked to the first rotation driving system System 310 or " master " rotary drive system joined with it, and be configured to be operably linked to the second rotation driving System 320 or " second level " rotary drive system joined with it.Main rotary drive system and second level rotary drive system can be by structures It causes to provide for the part of the certain types of surgical end-effector of a part for constituting interchangeable surgical tool component Various rotary motions.For the ease of main rotary drive system is operably linked to the first rotary drive system and by second level Rotary drive system is operably linked to the second rotary drive system 320, and the tool mounting portion 500 of handle assembly 20 also wraps A pair of of insertion ramp 506 is included, is configured to bias interchangeable surgical tool component towards distal side during connection process The part of main rotary drive system and second level rotary drive system, in order to be aligned main rotary drive system and operationally join The first rotary drive system 300 being connected in handle assembly 20, and second level rotary drive system is aligned and is operationally joined The second rotary drive system 320 being connected in handle assembly 20.
Interchangeable surgical tool component may also include for the surgical end-effector to interchangeable surgical tool component Corresponding part applies " three-level " axial drive system being axially moved.For the ease of three-level axial drive system is operationally joined The third axial drive system 400 being connected in handle assembly 20, third driving actuator means 410 are provided with pod 414, this holds Nest is configured in the lug or other parts for wherein operationally receiving three-level axial drive system.
Interchangeable tools component 2000 is shown in Figure 15.Interchangeable tools component 2000 is similar to interchangeable in many aspects Tool assembly 1000, but it is different from interchangeable tools component 1000 in certain other aspects.For example, interchangeable components 2000 are round Shape suturing assembly.Referring primarily to Figure 15 and Figure 16, circular stapler component 2000 includes shaft portion 2100 and end effector 2200. Shaft portion 2100 includes the portions of proximal for being for example releasably attached to handle assembly 20.End effector 2200 includes around pass Section kinematic joint 2300 is rotatably attached to the first part 2210 of shaft portion 2100.End effector 2200 further includes that can release It is attached to the second part 2220 of first part 2210 with putting.Second part 2220 includes storehouse part 2222, which includes It is defined in the annular array of nail cavity 2224 therein and the nail being stored in each nail cavity 2224.Second part 2220 further includes anvil Seat 2230, which includes tissue compression surface 2232 and the forming pit annular array or forming pit that are aligned with nail cavity 2224 2234 (Figure 27), these forming pit annular arrays or forming pit are configured to make to follow closely when nail is projected from nail cavity 2224 Deformation.
Than that described above, referring again to Figure 15 and Figure 16, the second part 2220 of end effector 2200 is optionally It is attached to the first part 2210 of end effector 2200 and selectively separated.Second part 2220 includes outer enclosure 2227, which includes proximal connector 2229, which, which is configured to be received in, is defined in first Divide in hole or room 2218 in 2210 shell 2217.The connector 2229 of shell 2227 and the shell 2217 of first part 2210 Between cooperation be close.Compressed fit between connector 2229 and shell 2217 can prevent second part 2220 relative to First part 2210 unexpectedly longitudinal direction and/or rotation displacement.In various examples, detent component can be used for second part 2220 It is releasably secured to the first part 2210 of end effector 2200.
Referring to Figure 15 and Figure 35 to Figure 38, the second part 2220 of end effector 2200 can be with other second parts such as Second part 2220 ', second part 2220 ", second part 2220 " ' and/or the exchange of another second part 2220.Second part 2220 ', 2220 " and 2220 " ' it is similar to second part 2220 in many aspects.For example, each second part 2220,2220 ', It 2220 " and 2220 " ' include being defined in centre bore 2226 therein.That is, second part 2220 ', 2220 " and 2220 " ' It is different from second part 2220 in other aspects.For example, second part 2220 ' has the diameter bigger than second part 2220.This Outside, the annular array for the nail cavity 2224 being defined in second part 2220 ' has the nail cavity than being defined in second part 2220 The big circumference of 2224 annular array.Similarly, second part 2220 " has the diameter bigger than second part 2220 ', and limits Annular array due to the nail cavity 2224 in second part 2220 " has the nail cavity 2224 than being defined in second part 2220 ' The big circumference of annular array.Equally, similarly, second part 2220 " ' there is the diameter bigger than second part 2220 ", and Be defined in second part 2220 " ' in the annular array of nail cavity 2224 have than the nail cavity that is defined in second part 2220 " The big circumference of 2224 annular array.
Than that described above, anvil block 2230 can be with other anvil blocks such as anvil block 2230 ', anvil block 2230 ", anvil block 2230 " ' and/ Or another anvil block 2230 exchanges.Anvil block 2230 ', 2230 " and 2230 " ' is similar to anvil block 2230 in many aspects.For example, each Anvil block 2230,2230 ', 2230 " and 2230 " ' includes longitudinal axis 2236, which includes flange connector 2238.That is, Anvil block 2230 ', 2230 " and 2230 " ' is different from anvil block 2230 in other aspects.For example, anvil block 2230 ' has than anvil block 2230 Big diameter.In addition, the annular array for the forming pit 2234 being defined in anvil block 2230 ' has than being defined in anvil block 2230 Forming pit 2234 the big circumference of annular array so that forming pit 2234 keeps and is defined in second part 2220 ' Nail cavity 2224 be aligned.Similarly, anvil block 2230 " has the diameter bigger than anvil block 2230 ', and is defined in anvil block 2230 " Forming pit 2234 annular array have the circle bigger than the annular array for the forming pit 2234 being defined in anvil block 2230 ' Week, so that the holding of forming pit 2234 is aligned with the nail cavity 2224 being defined in second part 2220 ".Equally, similarly, anvil block 2230 " ' have the diameter bigger than anvil block 2230 ", and be defined in second part 2220 " ' in forming pit 2234 annular Array has the circumference bigger than the annular array for the forming pit 2234 being defined in anvil block 2230 ", so that forming pit 2234 Keep and be defined in second part 2220 " ' in nail cavity 2224 be aligned.
Referring primarily to Figure 17, shaft portion 2100 includes proximal connector 2120 and proximally connector 2120 extends towards distal side Elongate shaft portion 2110.Proximal connector 2120 includes the first input 2318 and the second input 2418.First input 2318 can It is operatively coupled to end effector system, and the second input 2418 is operably connected to end effector folder Hold and follow closely trigger system.First input 2318 and the second input 2418 can operate in any suitable order.For example, the first input 2318 can be rotated in a first direction, so that end effector 2200 carries out joint motions along first direction, and correspondingly along the Two directions rotate, so that end effector 2200 carries out joint motions in a second direction.Once end effector 2200 is suitably Ground carries out joint motions, so that it may rotate the second input 2428 with closed anvil 2230 and against the storehouse part of end effector 2200 2222 clamping tissues.As follows to be further discussed in more detail, the second input 2428 can then be operated to fire from nail cavity 2224 Follow closely and cut the tissue captured in end effector 2200.In various alternative embodiments, the first input 2318 and the Two inputs 2328 can operate in any suitable order and/or simultaneously.
First input 2318 is mounted to the proximal end of articulating shaft 2310, which is rotatably mounted In shaft portion 2010.Referring primarily to Figure 20 and Figure 21, rotatable articulating shaft 2310 includes distal end and is installed to The worm gear 2312 of distal end.Worm gear 2312 is threadably engaged with joint motions sliding part 2320.More particularly, joint Move sliders 2320 include being defined in threaded hole 2322 therein, and worm gear 2312 is threadably matched with threaded hole 2322 It closes.When articulating shaft 2310 is rotated in a first direction, worm gear 2312 pushes the (figure of joint motions sliding part 2320 towards distal side 32).When articulating shaft 2310 in a second direction or opposite direction rotate when, worm gear 2312 proximally pulls joint motions sliding Part 2320 (Figure 31).Joint in distal end of the joint motions sliding part 2320 by being fixedly mounted in elongate shaft portion 2110 Moving mass 2112 slidingly supports.The movement of joint motions sliding part 2320 is by being defined in leading in articulation block 2112 Slot 2315 and the nearside and distal movement for being limited to articulation block 2112.Joint motions sliding part 2320 further includes from its extension Longitudinal key 2326, which is snugly received in longitudinal keyway 2116 in the bottom for being defined in guide groove 2315, this Relative motion between joint motions sliding part 2320 and articulation block 2112 is limited to longitudinal path.
Referring again to Figure 20, Figure 21 and Figure 24, joint motions sliding part 2320 is connected to joint movement connector 2330.It closes Saving move sliders 2320 includes drive pin 2324 extending therefrom, which, which is located in, is defined in joint movement connector In proximal aperture 2334 in 2330.Drive pin 2324 is snugly received in hole 2334, so that drive pin 2324 and hole 2334 Side wall cooperates to define the rotation axis between joint motions sliding part 2320 and joint movement connector 2330.Joint motions connect Fitting 2330 is also coupled to the shell 2217 of end effector 2200.More particularly, joint movement connector 2330 further includes It is positioned at distal aperture 2335 therein, and including shell 2217 includes the pin 2215 being positioned in distal aperture 2335.Pin 2215 is tight It is thickly received in hole 2335, so that pin 2215 and the side wall in hole 2335 cooperate to define joint movement connector 2330 and shell Rotation axis between 2217.
Than that described above, referring to Figure 18 to Figure 21 and Figure 24, end effector 2200 can around actuated articulation joints 2300 It is rotationally coupled to the articulation block 2112 of axis 2100.The shell 2217 of end effector 2200 includes being defined in its opposite side In hole 2213, and articulation block 2112 includes the protruding portion 2113 extended from its opposite side, and the protruding portion is positioned at In hole 2213.Protruding portion 2113 is snugly received in hole 2213, so that protruding portion 2113 and the cooperation of the side wall in hole 2213 are to limit The joint motions axis of joint motions can be carried out around it by determining end effector 2200.When articulating shaft 2310 is rotated with towards remote When side drives joint motions sliding part 2320, joint motions sliding part 2320 is close towards distal side driving joint movement connector 2330 Side end.In response to the distal movement of the proximal end of joint movement connector 2330, joint movement connector 2330 is around drive Dynamic pin 2324 rotates, which surrounds 2300 rotary end effector 2200 of actuated articulation joints.It is filled when joint motions input When setting 2310 rotations proximally to drive joint motions sliding part 2320, it is similar to above-mentioned, joint motions sliding part 2320 is towards close The proximal end of layback movable joint motion couplings 2330.In response to the nearside fortune of the proximal end of joint movement connector 2330 Dynamic, joint movement connector 2330 is rotated around drive pin 2324, which rotates end around actuated articulation joints 2300 Actuator 2200.Joint movement connector 2330 provides at least one certainly between joint motions sliding part 2320 and shell 2217 By spending.Therefore, joint movement connector 2330 allows end effector 2200 to be closed by the articulation angle of wide scope Section movement.
As described above, the proximal connector 2120 of interchangeable tools component 2000 includes second defeated referring to Figure 17 and Figure 25 Enter 2418.Second input 2418 includes driving gear 2417, the driving gear and is mounted in the proximal end of drive shaft 2410 Driving gear 2416 engagingly engage.Drive shaft 2410 extends through shaft portion 2110 and is defined in articulation block 2112 Hole 2114, as shown in figure 19.Hole 2114 includes bearing and is pivotably supported drive shaft 2410.Alternatively, hole 2114 can Including mesopore.In either case, referring primarily to Figure 22, drive shaft 2410 extend through actuated articulation joints 2300 and Into in the room 2218 being defined in end effector shell 2217.Drive shaft 2410 is by being installed to the bearing of drive shaft 2410 2414 are pivotably supported, which is trapped in the recessed portion 2214 in the shell 2217 for being defined in end effector 2200 It is interior.Drive shaft 2410 further includes the output gear 2412 for being installed to its distal end, so that the rotation of drive shaft 2410 is transmitted To output gear 2412.
Referring primarily to Figure 18, Figure 22 and Figure 23, the output gear 2412 of drive shaft 2410 operationally with transmitting device 2420 engagements.As follows to be discussed in more detail, transmitting device 2420 is configured in first operator scheme and the second operation Shift end effector 2200 between mode, in the first mode of operation, drive shaft 2410 makes anvil block 2230 relative to warehouse 2222 is mobile, in this second mode of operation, drive shaft 2410 from 2224 percussion nail of nail cavity and cutting be trapped in anvil block 2230 with Tissue between warehouse 2222.Transmitting device 2420 includes rail driving device, which includes planet plate 2421 With four planetary gears 2424 for being rotatably mounted to planet plate 2421.Planet plate 2421 includes between extending through its center Lyriform pore, and drive shaft 2410 extends through mesopore.Planet plate 2421 and planetary gear 2424, which are located in, to be defined in end and holds In room 2219 in row device shell 2217.Each planetary gear 2424 can be revolved around the gear pin 2423 extended from planet plate 2421 Turn.Gear pin 2423 is along the circumferential registration for surrounding mesopore.Output gear 2412 is engagingly engaged with planetary gear 2424, and As described in greater detail below, drive shaft 2410 drives planetary gear 2424.
Than that described above, drive shaft 2410 extends through actuated articulation joints 2300.In order to hold output gear 2412 Portion's actuator 2200 carries out keeping correct engagement planetary gear 2424 when joint motions, and drive shaft 2410 is flexible.At least In one example, drive shaft 2410 is made of such as plastics.
As described above, transmitting device 2420 includes first operator scheme and second operator scheme.Referring primarily to Figure 23 and figure 28, interchangeable tools component 2000 further includes the shift unit 2600 that can be moved between the first location and the second location, will be passed Defeated device 2420 switches between its first operator scheme and second operator scheme.When shift unit 2600 is in its first position When, as shown in Figure 28 to Figure 30, shift unit 2600 is not engaged with the planet plate 2421 of transmitting device 2420, and therefore, planet Plate 2421 and planetary gear 2424 are rotated by drive shaft 2410.More particularly, drive shaft 2410 encloses planetary gear 2424 It is rotated around its respective gears pin 2423, and planetary gear 2424 extends due to planetary gear 2424 and around planetary gear 2424 Annular gear ring 2534 between reaction force and revolving planet plate 2421, it is as follows to be further more fully described.Planet plate 2421 operationally couple with output connector 2430, so that the rotation of planet plate 2421 is transferred to output connector 2430. Referring primarily to Figure 23, exporting connector 2430 includes 2433 array of hole extended around its outer periphery, wherein from planet plate 2421 The gear pin 2423 of extension extends to the hole 2433 being defined in output connector 2430 and by its close receiving, so that planet plate Any relative motion between 2421 and output connector 2430 is seldom.
Referring primarily to Figure 18 and Figure 23, exporting connector 2430 includes driving pod 2432.Driving pod 2432 includes example Such as the hole of substantially hexagon；However, using any suitable construction.Driving pod 2432 is configured to receive and extend through Cross the closure axis 2440 of the second part 2220 of end effector 2200.Being closed axis 2440 includes that nearside drives end 2442, should Nearside driving end has the shape for the substantially hexagon being closely received in driving pod 2432, so that drive shaft 2410 Rotation can transmit closure axis 2440.Closure axis 2440 is pivotally supported at the shell of second part 2220 by bearing 2444 In 2227.Bearing 2444 includes such as thrust bearing；However, bearing 2444 may include any suitable bearing.
Referring primarily to Figure 23 and Figure 28 to Figure 30, being closed axis 2440 includes threaded portion 2446, the threaded portion and restriction Threaded hole 2456 in trochar 2450 is threadably engaged.As follows to be further discussed in more detail, anvil block 2230 can It is attached to trochar 2450, the trochar is translatable with direction and/or far from the mobile anvil block 2230 of warehouse 2222.Referring again to figure 18, trochar 2450 includes being defined at least one longitudinal keyway 2459 therein, the longitudinal direction keyway be configured to and from At least one longitudinal key cooperation that the inner surface 2546 of drive sleeve 2540 extends.Drive sleeve 2540 is follow closely trigger system one Part, as further discussed below, and reader should be appreciated that trochar 2450 and drive sleeve 2540 are opposite in one aspect In sliding over each other, and collaboratively inhibit relative rotary motion therebetween on the other hand.Due to closure axis 2440 and trochar Being threadedly engaged between 2450, closure axis 2440 can make trochar 2450 towards distal side when being closed axis 2440 and being rotated in a first direction Displacement or translation, and correspondingly, trochar 2450 is moved proximally when being closed axis 2440 and rotating along second or opposite direction Position or translation.
As described above, anvil block 2230 could attach to trochar 2450.Anvil block 2230 includes flange connector 2238, and the connection is convex Edge is configured to engagement and grip sleeve needle 2450.Flange connector 2238 includes the shaft portion 2236 for being connected to anvil block 2230 Cantilever beam.Referring primarily to Figure 23, trochar 2450 includes keeping recess or recessed portion 2458, is configured in anvil block 2230 releasably accept flange connector 2238 when being assembled to trochar 2450.Keep recess 2458 and flange connector 2238 by structure Cause the disengaging unintentionally that can resist anvil block 2230 with trochar 2450.Flange connector 2238 is spaced apart by longitudinal slit 2237. Longitudinal slit 2237 is configured to receive what is extended from trochar 2450 to indulge when anvil block 2230 is assembled to trochar 2450 To rib 2457.Rib 2457 is snugly received in slit 2237, and therefore, inhibits anvil block 2230 relative to trochar 2450 Rotation.
Once anvil block 2230 is suitably positioned relative to storehouse part 2222, as described above, tool assembly 2000 is displaceable Into its second operator scheme.Shift unit 2600 includes what the transmitting device 2420 for example for making end effector 2200 shifted Electric power driven motor.In various other embodiments, shift unit 2600 may include times electrically and/or manually activated What appropriate device.Shift unit 2600 is communicated with the processor signal of surgery suturing appliance, and the battery with surgery suturing appliance Power communication.In various examples, insulated electric conductor for example extends between shift unit 2600 and the shank of surgical instruments, so that place Reason device can be communicated with shift unit 2600, and battery can provide electric power to shift unit 2600.In various other examples, move Position device 2600 may include wireless signal receiver, and processor can be wirelessly communicated with shift unit 2600.In some instances, Power for example can wirelessly be supplied to shift unit 2600 by sensor circuit.In various examples, shift unit 2600 can be wrapped Include the power supply of its own.
Shift unit 2600 includes shell, which is mounted on the room being defined in the proximal end of end effector 2200 In 2218.Shift unit 2600 includes clutch key or striking gear 2602 and output shaft 2604, the output shaft can be relative to displacement Device shell moves between the first location and the second location.Clutch key 2602 includes the first lock tooth 2608 and the second lock tooth 2609, and when clutch key 2602 is in its first position, the first lock tooth 2608 and the firing tube 2530 for following closely trigger system Engagement, and at the same time, the second lock tooth 2609 is disengaged with the planet plate 2421 of transmitting device 2420.More particularly, first Lock tooth 2608 is located in hole 2538, which is a part of the annular array around the hole 2538 that firing tube 2530 limits, and And second locks 2609 delocalization of tooth in hole 2429, which is one of the annular array around the hole 2429 that planet plate 2421 limits Part.Shift unit 2600 prevents firing tube 2530 from rotating due to the above reasons, and therefore clutch key 2602 be in its Locking nail trigger system when one position.Although nail trigger system is shifted device when clutch key 2602 is in its first position 2600 lockings, but the rotatable planet plate 2421 of drive shaft 2410 and anvil block closed system is operated, as described above.
As shown in figure 23, firing tube 2530 includes the annular rack gear 2534 being defined in its inner sidewall 2532.Planet tooth Wheel 2424 is operationally intermeshed with rack gear 2534.When shift unit 2600 is in its first position, as shown in figure 28, percussion Pipe 2530 is shifted device 2600 and is held in place, and planetary gear 2424 can be by drive shaft 2410 relative to firing tube 2530 and rack gear 2534 rotate.In the illustration being described, planetary gear 2424 surrounds the zigzag tread patterns axis limited by drive shaft 2410 Line rotation, and at the same time being rotated around the axis limited by its respective gears 2423.Reader should be appreciated that planetary gear 2424 by Drive shaft 2410 directly drives, and the reaction force due to generating between planetary gear 2424 and firing tube 2530, planet tooth 2424 driving of wheel and revolving planet plate 2421.When actuated displacement device 2600 is to be moved to its second position for clutch key 2602 When, the first lock tooth 2608 is disengaged with firing tube 2530, and at the same time, the second lock tooth 2609 is engaged with planet plate 2421.When When clutch key 2602 is in its second position, planet plate 2421 is shifted device 2600 and is held in place, and therefore closes Driving device is closed to be locked and cannot operate to move anvil block 2230.It is defeated when drive shaft 2410 rotates in the illustration being described Gear 2412 drives planetary gear 2424 and rotates it relative to planet plate 2421 around its respective gears pin 2423 out.Planet Gear 2424 drives firing tube 2530 via rack gear 2534, and rotates firing tube 2530 around its longitudinal axis.
Than that described above, and referring again to Figure 23, the operationally drive sleeve with nail trigger system of firing tube 2530 2540 connections.More particularly, the inner sidewall 2532 of firing tube 2530 includes being defined in longitudinal slit 2535 therein, described vertical It is configured to closely receive the longitudinal rib 2545 being defined in drive sleeve 2540 to slit, so that drive sleeve 2540 It is rotated together with firing tube 2530.Drive sleeve 2540 further includes screw thread distal end 2542, the screw thread distal end and driving Lining ring 2550 is threadably engaged.More particularly, driving lining ring 2550 includes threaded hole 2552, and the threaded hole is remote with screw thread Side end 2542 is threadably engaged.Driving lining ring 2550 is located in the hole being defined in the shell of end effector 2200 In 2228, and it is prevented from for example rotating in hole 2228 by longitudinal rib and channel layout.Drive sleeve due to the above reasons, 2540 rotation makes to drive 2550 longitudinal translation of lining ring.For example, driving lining ring 2550 is revolved in drive sleeve 2540 along first direction It promotes when turning towards distal side, and proximally bounces back when drive sleeve 2540 is rotated along second or opposite direction.
When driving lining ring 2550 to push towards distal side, as described above, driving lining ring 2550 such as hitting in nail trigger system Nail drive block 2560 and such as knife of cutting element 2570 are pushed towards distal side during issuing journey.More particularly, lining ring 2550 is driven It will not be fired between nail drive block 2560 and the non-firing position of the push-in nearside of cutting element 2570 and distal side firing position in nearside In position, nail is located in the nail cavity 2224 being defined in warehouse part 2222, and cutting element 2570 is recessed to warehouse portion Divide below 2222 platform surface, in the firing position of distal side, nail is deformed against anvil block 2230, and is trapped in anvil block 2230 Tissue between warehouse part 2222 is crosscutting by cutting element 2570.Driving lining ring 2550 includes drive recess 2554, should Drive recess is configured to adjacent nail drive block 2560 and cutting element when driving lining ring 2550 to promote towards distal side 2570.Nail drive block 2560 includes being defined in multiple nail brackets therein, wherein each nail bracket is configured to support nail Base portion.Nail bracket is aligned with the nail cavity 2224 being defined in warehouse part 2222 and is arranged at least two concentric rows.
Nail drive block 2560 and cutting element 2570 are attached to driving lining ring 2550, so that when driving lining ring 2550 is far from anvil When seat 2230 proximally moves, follows closely drive block 2560 and cutting element 2570 is proximally pulled by driving lining ring 2550.At least In one example, follows closely drive block 2560 and cutting element 2570 includes extending in the hole 2557 being defined in driving lining ring 2550 One or more hooks.In various examples, following closely drive block 2560 and cutting element 2570 can bounce back, so that they are fully retracted To below the platform surface of warehouse part 2222.
Than that described above, end effector 2200 can operate in a third operating mode, wherein shift unit 2600 from Clutch key 2602 is simultaneously and operably engaged with anvil block closed system and nail trigger system.In the operation mode, the first lock tooth 2608 engage with the firing tube 2530 of nail trigger system, and the second lock tooth 2609 and the planet plate 2421 of transmitting device 2420 connect It closes.In the illustration being described, the first lock tooth 2608 is located in the hole 2538 being defined in firing tube 2530, and the second lock tooth 2609 are located in the hole 2429 being defined in planet plate 2421.Drive shaft 2410 is relative to warehouse 2222 due to the above reasons, Mobile anvil block 2230, nail drive block 2560 and cutting element 2570 simultaneously.
Referring again to Figure 15, the user of interchangeable tools component 2000 can from second part 2220,2220 ', 2220 ", 2220 " ' it and/or in the external member of any other suitable second part is selected, and selected second part is assembled to end In the first part 2210 of actuator 2200.Referring primarily to Figure 18, when second part is assembled to first part 2210, each Second part includes cage adapter 2229, which engages the shell 2217 of first part 2210.In addition, when by the Two when being partially fitted to first part 2210, and each second part includes closure axis 2440, which is operatively engaged the The driving pod 2432 of a part 2210.In addition, when second part is assembled to first part 2210, each second part packet Drive sleeve 2540 is included, which is operatively engaged the firing tube 2530 of first part 2210.
Than that described above, referring to Figure 35 and Figure 36, tool assembly 2000 ' can be exchanged with tool assembly 2000.Tool assembly 2000 are similar to tool assembly 2000 in many aspects；However, tool assembly 2000 ', which is configured to application diameter, compares tool The big circular staple line of the circular staple line that component 2000 is applied.Tool assembly 2000 ' further includes wider second in addition to other Part 2220 ', staple drivers 2560 ', knife assembly 2570 ', warehouse 2222 ' and anvil block 2230 '.Referring to Figure 37, tool assembly 2000 " can exchange with tool assembly 2000.Tool assembly 2000 " is similar to tool assembly 2000 and 2000 ' in many aspects；So And tool assembly 2000 " is configured to apply the diameter circular staple bigger than the circular staple line that tool assembly 2000 ' is applied Line.Tool assembly 2000 " further includes wider second part 2220 ", staple drivers 2560 ", knife assembly in addition to other 2570 ", warehouse 2222 " and anvil block 2230 ".Referring to Figure 38, tool assembly 2000 " ' it can be exchanged with tool assembly 2000.Tool group Part 2000 " ' it is similar to tool assembly 2000,2000 ' and 2000 " in many aspects；However, tool assembly 2000 " ' it is configured to The diameter circular staple line bigger than the circular staple line that tool assembly 2000 " is applied can be applied.Tool assembly 2000 " ' except other Except further include wider second part 2220 " ', staple drivers 2560 " ', knife assembly 2570 " ', warehouse 2222 " ' and anvil block 2230”’。
In various embodiments, than that described above, surgical instruments can have any appropriate number of operation mode.Extremely In a few embodiment, surgery suturing appliance includes transmitting device, the transmitting device include percussion nail first operator scheme, The second operator scheme of deployment cutting element and simultaneously percussion nail and the third operation mode for disposing cutting element.In the first behaviour In operation mode, cutting element is not disposed.In addition, the processor of such surgical instruments can be programmed so that instrument cannot be not first It first completes to be placed in second operator scheme in the case where first operator scheme.The user of surgical instruments can determine due to the above reasons, It is fixed whether tissue to be cut after percussion nail.
The alternative embodiment for the staple cartridge body being used together with surgical stapling device is shown in Figure 34.Warehouse 2222 ' includes nail Row in the annular outlet of chamber 2224 and the annular of nail cavity 2224 '.Nail cavity 2224 is defined in the first step of warehouse platform, and And nail cavity 2224 ' is defined in the second step of warehouse platform.Second step extends above the first step.In other words, First step has the first podium level, and the second step has the second podium level, which is higher than first Podium level.Platform wall separates the first step and the second step.In various embodiments, platform wall is inclined.At certain In a little embodiments, platform wall is orthogonal to the first step and/or the second step.
Warehouse 2222 ' further includes the cavity extension 2229 ' extended from the first step of platform.Cavity extension 2229 ' Around the end of nail cavity 2224, and extend nail cavity 2224 above the first step.Cavity extension 2229 ' can be from nail cavity 2224 at least partly control nail above the first step when projecting nail.Cavity extension 2229 ' is further configured to connect It touches captured tissue and compresses the tissue against warehouse 2222 '.The also controllable tissue of cavity extension 2229 ' is relative to warehouse 2222 ' flowing.For example, cavity extension 2229 ' can limit the Radial Flow of tissue.Cavity extension 2229 ', which can have, appoints What suitable configuration, and any suitable height can be extended from the first step.In at least one example, cavity extension 2229 ' top surface is aligned with such as the second step or has height identical with the second step.In other examples, cavity prolongs Extending portion 2229 ' can extend above or below the second step.
Than that described above, nail cavity 2224 respectively includes being positioned at the first nail therein, which has the first unshaped Highly.Nail cavity 2224 ' respectively includes being positioned at the second nail therein, which has the different from the first unshaped height Two unshaped height.For example, the first unshaped height is higher than the second unshaped height；However, the second unshaped height can be higher than First unshaped height.In alternative embodiment, the first unshaped staple height and the second unshaped staple height are identical.
First nail is deformed into the first Deformation Height, and the second nail is deformed into the second deformation different from the first Deformation Height Highly.For example, the first Deformation Height is higher than the second Deformation Height.This construction can improve the blood flow into sutured tissue. Alternatively, the second Deformation Height can be higher than the first Deformation Height.Tissue can be improved along interior transversal flexibility in this construction.? In certain alternative embodiments, the first Deformation Height is identical with the second Deformation Height.
As described above, interchangeable tools component may also include axis, end effector and replaceable nail bin in addition to other.It can Replacing nail bin includes: closure driving device, which is configured to movement to open and close end execution Device will be will organize capture in end effector, and percussion driving device, the percussion driving device are configured to suture With tissue of the cutting capture in end effector.When replaceable nail bin is assembled to axis, the closure of end effector drives dress Set and fire driving device operationally closure driving device corresponding with axis and percussion driving device connection.In replaceable nail bin In the case where not correctly being assembled to axis, replaceable nail bin may not be operated in a manner of its expection.As described in greater detail below, Replaceable nail bin and/or axis may include latching member, which prevents replaceable nail bin from being operated, unless replaceable nail bin is just Really it is attached to axis.
Turning now to Figure 39, interchangeable tools component 3000 includes axis 3010 and replaceable nail bin 3020.Similar to above-mentioned, Replaceable nail bin 3020 includes closure driving input unit and percussion driving input unit, when nail bin 3020 is arranged to axis completely When on 3010, the closure driving input unit and percussion driving input unit respectively operably drive output device with closure With percussion driving output device connection.For simplicity, the operation of such closure and trigger system repeats no more herein.
Interchangeable tools component 3000 further includes exclusive circuit 3090.Exclusive circuit 3090 includes conductor 3096 and contact 3092.First contact 3092 is electrically coupled to the first conductor 3096, and the second contact 3092 is electrically coupled to the second conductor 3096.? Before nail bin 3020 is arranged to completely on axis 3010, the first contact 3092 is not electrically coupled to the second contact 3092.Nail bin 3020 Including contact carriage 3094, when nail bin 3020 is arranged to completely on axis 3010, which merges Electricity Federation contact point 3092.Touching Point 3092 and contact carriage 3094 are constructed and arranged to so that when nail bin 3020 is only partially arranged on axis 3010, contact carriage 3094 not Electricity Federation contact points 3092.
Interchangeable tools component 3000 can be used together with surgical instrument system, which includes for example can hand The shank and/or robot system of dynamic operation.In various embodiments, surgical instrument system includes electric motor, this is electronic Motor is configured to the nail trigger system of driving instrument component 3000, additionally includes controller, which is constructed At electric motor can be operated.The exclusive circuit of tool assembly 3000 is communicated with controller.When controller detects contact carriage 3094 do not engage with contact 3092 or when exclusive circuit is in an off state, controller prevents electric motor operation nail percussion System.In various examples, controller is configured to so that when exclusive circuit is in an off state, not to electronic horse Up to offer electric power.In certain other examples, controller is configured to provide electric power to electric motor, so that when locking electricity When road is in an off state, closed system can be operated rather than trigger system.In at least one described example, controller behaviour It is connected to the transmitting device of electric motor, so that the output of electric motor is only directed to closed system.When controller detects Engaged to contact carriage 3094 with contact 3092 or exclusive circuit in the closure state, controller allow electric motor operate Follow closely trigger system.
When surgical instrument system includes shank, than that described above, detects that exclusive circuit is in controller and disconnect structure When type, trigger lock is may be actuated in controller, which prevents the firing trigger of shank to be activated.When nail bin 3020 is complete It is arranged on axis 3010 entirely and when exclusive circuit is closed, controller can bounce back and trigger lock and firing trigger be allowed to be caused It is dynamic.Such system can be used together with motorization and/or non-motorised percussion driving device.For example, non-motorised percussion driving Device can be driven by hand-crank.
As described above, anvil block 2230 may fitted to the trocar shaft 2450 of the closure driving device of tool assembly 2000.Anvil The flange connector 2238 of seat 2230 is configured to the recessed portion 2458 that is defined in trocar shaft 2450 of engagement with by anvil block 2230 are connected thereto.Once anvil block 2230 is assembled to trocar shaft 2450, trocar shaft 2450 and anvil block 2230 can be by closing It closes driving device to bounce back or pull towards nail bin 2222, to compress tissue against nail bin 2222.However, in some instances, anvil Seat 2230 may not be accurately fitted to trocar shaft 2450.When clinician attempts anvil block 2230 being assembled to trocar shaft When 2450, if trocar shaft 2450 does not extend substantially into above the platform of nail bin 2222, can it occur frequently that anvil block 2230 with The mistake assembly of trocar shaft 2450.In general, in the illustration being described, anvil block 2230 is fully attached to trocar shaft 2450, make Tissue can be compressed towards the mobile anvil block 2230 of nail bin 2222, but when anvil block 2230 starts to abut against nail bin 2222 by obtaining trocar shaft 2450 When, anvil block 2230 can be separated with trocar shaft 2450.
Turning now to Figure 39 and Figure 40, interchangeable tools component 3100 is shown, is similar to articles and opinions in many aspects The interchangeable tools component 2000 stated.Tool assembly 2000 includes warehouse 3120, which includes platform 3121, and the platform is by structure Cause can tissue by anvil block 2130 against warehouse 3120 compress when supporting tissue.Tool assembly 3100 further includes being configured to It can be relative to the closure driving device of the mobile anvil block 2130 of warehouse 3120.Being closed driving device includes trocar shaft 3150, class Be similar to it is above-mentioned, the trocar shaft include be defined in recessed portion therein.Recessed portion includes distal shoulder 3158, the distal shoulder quilt It is constructed to be permeable to anvil block 2130 remaining to trocar shaft 3150.In addition, tool assembly 3100 further include be configured to from Warehouse 3120 projects the percussion driving device of nail.Percussion driving device include rotatable shaft 3162 and with rotatable shaft 3162 with spiral shell The translatable lining ring 3160 that line mode engages, the translatable lining ring are configured to project from warehouse 3120 and follow closely.Rotatable shaft 3162 include being defined in longitudinal hole 3164 therein, and trocar shaft 3150 extends through via hole 3164.
Than that described above, closure driving device further includes the fixture 3190 for being installed to trocar shaft 3150.Fixture 3190 wraps Include the base portion 3192 in the slit for being mounted on and being defined in trocar shaft 3150.Fixture 3190 further includes extending from base portion 3192 Submissive arm or additives 3198.Arm 3198 can move between extended position (Figure 39) and deflected position (Figure 40).Work as arm 3198 be in its deflected position when, as shown in figure 40, anvil block 2130 can be locked into trocar shaft 3150.When trocar shaft 3150 When extending substantially into 3121 top of platform of warehouse 3120, as shown in figure 40, arm 3198 is put down by percussion driving device It moves lining ring 3160 and is maintained at its deflected position.Translatable lining ring 3160 includes annular shoulder 3168, which is configured to Can when arm 3198 and shoulder 3168 contact inside spring-biased arm 3198.
When trocar shaft 3150 is not in enough extended positions of 3121 top of storehouse platform, arm 3198 is not by shoulder 3168 inwardly biasings.In the illustration being described, arm 3198 is in its extended position, as shown in figure 39.When arm 3198 is in its stretching When position, arm 3198 prevents anvil block 2130 to be attached to trocar shaft 3150.More particularly, arm 3198 prevents the company of anvil block 2130 Flange 2138 is connect to be placed in behind the shoulder 3158 being defined in trocar shaft 3150.In the illustration being described, arm 3198 prevents Anvil block 2130 is partly attached to trocar shaft 3150, and therefore, attempts anvil block 2130 being assembled to trocar shaft 3150 Anvil block 2130 partly cannot be assembled to trocar shaft 3150 by clinician, and can be to avoid the above problem.Reader should Understand, usually in situ or patient's body is assembled in trocar shaft 3150, and anvil block 2130 is correctly assembled to anvil block 2130 The completion of surgical technic used by accelerating in trocar shaft 3150.Above system provides latching member, which prevents The anvil block of part assembly is compressed against tissue.
Turning now to Figure 41 to Figure 43, interchangeable tools component 3200 includes being configured to prevent closure driving device The latching member to bounce back when no anvil block is attached to thereon, it is as follows to be discussed in more detail.Tool assembly 3200 includes axis 3210 With end effector 3220.End effector 3220 includes outer enclosure 3227, warehouse 3222 and the longitudinal hole limited across it 3226.Tool assembly 3200 further includes closure driving device, which includes trocar shaft 3250 and could attach to The anvil block 3230 of trocar shaft 3250.Similar to above-mentioned, closure driving device is configured to toward and away from warehouse 3222 Mobile anvil block 3230.Trocar shaft 3250 can move between extended position and retraction position.Figure 42 and Figure 43 shows place In the trocar shaft 3250 of its extended position.
Than that described above, tool assembly 3200 further includes retraction lock 3290, and retraction lock is configured to prevent casing Needle shaft 3250 anvil block 3230 without when being fitted on trocar shaft 3250 from its extended position (Figure 42 and Figure 43) towards its bounce back position Set movement.Retraction lock 3290 includes the hammerlock 3292 that shell 3227 is rotatably mounted to around protruding portion or pin 3294.Retraction Lock 3290 further includes the spring 3296 engaged with hammerlock 3292, which is configured to hammerlock 3292 towards trocar shaft 3250 biasings.Trocar shaft 3250 includes lock shoulder 3258, and when anvil block 3230 is without trocar shaft 3250 is fitted on, such as Figure 42 Shown, hammerlock 3292 is configured to capture lock shoulder 3258 and prevents trocar shaft 3250 from proximally moving.More particularly, Hammerlock 3292 includes the capture pieces 3298 for being configured to slide below lock shoulder 3258.When anvil block 3230 is assembled to trochar When axis 3250, as shown in figure 43, anvil block 3230 contacts hammerlock 3292 and shifts hammerlock 3292 far from lock shoulder 3258.At this point, set Pipe needle shaft 3250 has unlocked and can be moved to its retraction position towards warehouse 3222.
Turning now to Figure 44 to Figure 46, interchangeable tools component 3300 includes closure driving device, nail percussion driving device And latching member, the latching member are configured to anti-non-magnetic shim percussion driving device and are operated until the anvil block of closure driving is set It is as follows to be discussed in more detail for correct tissue space.Tool assembly 3300 includes axis 3310 and end effector 3320.End Portion's actuator 3320 includes inner frame 3329, outer enclosure 3327 and warehouse 3322.Similar to above-mentioned, closure driving device packet It includes trocar shaft 3350 and could attach to the anvil block 2230 of trocar shaft 3350.It is also similarly to above-mentioned, 3350 energy of trocar shaft It reaches and moves (Figure 46) between extended position (Figure 45) and retraction position, to move anvil block 2230 toward and away from warehouse 3322. Percussion driving device includes rotatable shaft 3360, which is configured to shift percussion driving device towards distal side, To project the nail being stored in warehouse 3322.
Than that described above, end effector 3320 includes the percussion driving lock for being movably installed to inner frame 3329 3390.Percussion driving lock 3390 includes lock pin 3394 and the Lock spring 3398 around the positioning of lock pin 3394.Lock pin 3394 includes Head 3392 and retainer 3396.The cavity that Lock spring 3398 is located in retainer 3396 and is defined in inner frame 3329 The centre of 3328 side wall.When trocar shaft 3350 is in extended position, as shown in figure 45, Lock spring 3398 is by lock pin 3394 are biased in the lockhole 3364 being defined in the rotatable shaft 3360 of nail percussion driving device.In the illustration being described, lock pin Interaction between 3394 and the side wall of lockhole 3364 prevents axis 3360 to be rotated to from 3322 percussion nail of warehouse.Work as trochar When axis 3350 sufficiently bounces back, trocar shaft 3350 engages the head 3392 of lock pin 3394.Head 3392 includes limiting thereon Cam face, the cam face are configured to be engaged by trocar shaft 3350, so that percussion driving lock 3390 is in locking structure It is moved between type (Figure 45) and unlocked configuration (Figure 46).When driving lock 3390 is in its unlocked configuration, driving device is fired Axis 3360 is rotatable.
The percussion driving latching member of tool assembly 3300 needs anvil block 2230 that can be moved to pre-determined bit before firing in nail It sets or is moved in the range of predetermined position.In addition, the percussion driving latching member of tool assembly 3300 requires anvil block 2230 and storehouse Tissue space between body 3322 can be less than certain distance in nail before firing.Therefore, anvil block 2230 and/or closed system Deactivated nail is fired latching member by position.This construction can help to the deformity of anti-non-magnetic shim and/or the insufficient compression of tissue etc..
Turning now to Figure 47 to Figure 49, interchangeable tools component 3400 includes the closure drive for being configured to clamping tissue Dynamic device, nail percussion driving device and percussion driving latching member 3490, percussion driving latching member are configured to anti-non-magnetic shim Percussion driving device operates before closure driving device applies enough clamp pressures to tissue.Being closed driving device includes set Pipe needle shaft 3450 and the anvil block for being attached to trocar shaft 3450, such as anvil block 2230.Similar to above-mentioned, trocar shaft 3450 can Retraction position (Figure 49) is moved to from extended position (Figure 48), to compress tissue against the warehouse of tool assembly 3400.Percussion is driven Dynamic device includes rotatable shaft 3460, which is configured to that staple drivers is made to shift towards distal side and project from warehouse Nail.
Percussion driving latching member 3490 be located in closure driving device trocar shaft 3450 and percussion driving device can The centre of rotary shaft 3460.Percussion driving latching member 3490 is including distal side plate 3492, proximal panel 3494 and is located in distal side plate 3492 with the spring 3493 among proximal panel 3494.Percussion driving latching member 3490 further include can locked configuration (Figure 48) with The lock pin 3498 moved between unlocked configuration (Figure 49), lock pin 3498 is engaged with axis 3460 in locked configuration, in unlocked configuration Middle lock pin 3498 is disengaged with axis 3460.Lock pin 3498 is located in the pin being defined between distal side plate 3492 and proximal panel 3494 In room 3496.More particularly, lock pin 3498 includes being positioned in the cam 3495 being defined on distal side plate 3492 and being defined in The angled head of the centre of cam 3495 on proximal panel 3494.When trocar shaft 3450 proximally bounces back, trocar shaft 3450 cams 3495 for proximally pushing distal side plate 3492, and being defined on distal side plate 3492 engage the head of lock pin 3498. In the illustration being described, the cam 3495 being defined on distal side plate 3492 cooperates with the cam 3495 being defined on proximal panel 3494, Lock pin 3498 is set to be displaced to its unlocked configuration, as shown in figure 49.
As described above, when the proximally facing plate 3494 of 3492 sleeve needle shaft of distal side plate 3450 is mobile, percussion driving locking The cam 3495 of part 3490 squeezes the head of lock pin 3498.More particularly, cam 3495 inwardly drives lock pin 3498 and makes to lock Pin is detached from the engagement with rotatable shaft 3460.When lock pin 3498 is in its locked configuration, lock pin 3498, which is located in, is defined in axis In lockhole 3468 in 3460, and due to the interaction between lock pin 3498 and the side wall of lockhole 3468, lock pin 3498 is anti- Only axis 3460 rotates.Therefore, nail cannot be fired by percussion driving device from warehouse.When lock pin 3498 is moved to unlocked configuration, As described above, lock pin 3498 is moved out of lockhole, and axis 3460 can be rotated by percussion driving device with from warehouse percussion nail.Each In kind embodiment, axis 3460 may include the circumferential array for the lockhole 3468 being defined in axis 3460, and each lockhole is configured to Lock pin 3498 can be received and lock percussion driving device.Referring again to Figure 49 to Figure 51, percussion driving latching member 3490 is also wrapped Include the biasing member for being configured to lock pin 3498 is biased in lockhole 3468, such as spring 3499.
Than that described above, the spring 3493 of percussion driving latching member 3490 is configured to resist trocar shaft 3450 Proximal movement.Spring 3493 is linear coil springs；However, any suitable spring can be used.Furthermore, it is possible to use be more than one A spring.Under any circumstance, spring 3493 or spring system have when trocar shaft 3450 bounces back to percussion driving locking The distal side plate 3492 of part 3490 applies the rigidity of spring force.In other words, the power of distal side plate 3492 is applied to by spring 3493 With trocar shaft 3450 proximally shift at a distance from proportional increase.Spring force caused by spring 3493 and anvil block 2230 apply Chucking power to tissue is opposite.Therefore, chucking power must overcome certain or scheduled spring force caused by spring 3493, so as to It shifts distal side plate 3492 sufficiently and unlocks percussion driving device.In the illustration being described, tissue chucking power must drive in percussion Latching member 3490 reaches predetermined threshold, and actuatable nail percussion driving device before may deactivating.
As combined various embodiments disclosed herein to be discussed, nail percussion driving device drives against anvil block is followed closely, with Nail is set to be deformed into desired forming height.In various examples, nail percussion driving device is further configured to cutting element Such as knife is pushed towards distal side to cut the tissue captured between warehouse and anvil block.In the illustration being described, knife is exposed on warehouse Platform above.That is, anvil block is closely positioned relative to warehouse when anvil block is in its closure or clamped position, and Even if knife is exposed to above warehouse, knife is largely also covered by anvil block.Anvil block will be moved into its open position and/or When separating before below the platform that knife retracts to warehouse with closure driving device, knife will be exposed and expose.Tool assembly 3500 as shown in Figure 52 to Figure 54 comprising latching member 3590, the latching member are configured to be exposed in storehouse platform in knife Anvil block is prevented to be moved to its open position when square.
Tool assembly 3500 includes closure driving device and percussion driving device.Being closed driving device includes trocar shaft 3550 and it is releasably attached to the anvil block 3530 of trocar shaft 3550.Similar to above-mentioned, trocar shaft 3550 can by with set The rotatable closure axis 2440 that pipe needle shaft 3550 is threadably engaged proximally and is translated to the far side.Firing driving device includes Rotatable shaft 3562 and the translatable lining ring 3560 being threadably engaged with rotatable shaft 3562.Similar to above-mentioned, work as axis 3562 along first direction and second direction when rotating respectively, and lining ring 3560 can proximally and be translated to the far side.It is also similarly to Above-mentioned, the lining ring 3560 for firing driving device is configured to the staple drivers battle array that promotes and bounce back toward and away from anvil block 3530 Column and knife assembly 2570.
Than that described above, latching member 3590 includes the axis that percussion driving device is rotatably mounted to around pivot 3594 3562 hammerlock 3592.Latching member 3590 further includes the biasing member engaged with hammerlock 3592 or spring 3599, the biasing member Or spring is configured to bias to hammerlock 3592 and contact with anvil block 3530.In use, anvil block 3530 is assembled to set Then pipe needle shaft 3550 makes trocar shaft 3550 bounce back, anvil block 3530 is located in its closure or clamping position relative to warehouse In setting.When anvil block 3530 bounces back, the hammerlock 3592 of latching member 3590 is slided against the outer surface of anvil block 3530, until hammerlock 3592 are aligned with the lock recessed portion 3532 being defined in anvil block 3530.At this point, hammerlock 3592 is biased to lock recess by spring 3599 In portion 3532, as shown in figure 53.More particularly, hammerlock 3592 is located in behind the lock shoulder for limiting lock recessed portion 3532.Then Percussion driving device can be operated with percussion nail and cut tissue.In the illustration being described, the cutting edge of knife assembly 2570 is exposed to storehouse Above body, and due to latching member 3590, it is closed driving device and is locked or is prevented from opening, until the cutting of knife assembly 2570 Sword no longer exposes.
Referring primarily to Figure 52, hammerlock 3592 further includes reset tab 3593 extending therefrom.Fire the lining ring of driving device 3560 further include cam 3563, which is configured in lining ring 3560 and knife assembly 2570 by percussion driving device towards close Engagement resets tab 3593 when side bounces back.Cam 3563 is configured to be rotated down hammerlock 3592 to be detached from and be defined in The engagement of lock shoulder in lock recessed portion 3532 simultaneously unlocks closure driving device.Cam 3563 is configured in knife assembly 2570 Cutting edge unlock closure driving device when having retracted to below storehouse platform；However, in other embodiments, when cutting edge with When storehouse platform is flushed or at least substantially flushed, cam 3563 can unlock closure driving device.In some embodiments, it is closed Driving device may not unlock before knife assembly 2570 is fully retracted.Once being closed driving device unlock, closure can be operated Driving device is to be moved to opening or unclamped position for anvil block 3530 again.
Once the nail of interchangeable tools component is fired, according to various embodiments, tool assembly may not used.Such as It more fully hereinafter discusses, tool assembly may include being configured to prevent tool assembly quilt after it be used to suture tissue Again it is clamped to structural latching member.
Referring now to Figure 53 to Figure 56, at least one embodiment, interchangeable tools component 3600 includes: that closure is driven Dynamic device, closure driving are configured to for example position anvil block, such as anvil block 2230 relative to nail bin；And percussion driving Device, the percussion driving device are configured to drive from nail bin and follow closely.Similar to above-mentioned, anvil block 2230 could attach to closure and drive The translatable trocar shaft 3650 of dynamic device.Be also similarly to it is above-mentioned, percussion driving device include rotatable shaft 3660, with can revolve The translatable lining ring 2550 and can be filled by the nail percussion driving that rotatable shaft 3660 shifts that shaft 3660 is threadably engaged Set 2560.In use, anvil block 2230 is located in clamped position relative to nail bin, then closure driving device can operate Percussion driving device can be operated will follow closely in the tissue being fired into Bu Huo between anvil block 2230 and nail bin.Then, operation is closed Driving device is closed to open anvil block 2230 and discharge tissue.
Than that described above, tool assembly 3600 include be configured to anvil block 2230 is prevented to be clamped to again it is structural Latching member 3690.Latching member 3690 includes the hammerlock 3692 for being rotatably mounted to rotatable shaft 3660, when closure driving device Between the clamped position (Figure 54) of open unclamped position (Figure 53) and closure when mobile anvil block 2230, which is fired Driving device is maintained in unlocked configuration.It is mobile with opposite relative to percussion driving device in trocar shaft 3650 and anvil block 2230 When nail bin positions anvil block 2230, hammerlock 3692 with its unlocked configuration be maintained at rotatable shaft 3660 and translatable lining ring 2550 it Between.Arm 3692 is maintained in its unlocked configuration, until operation percussion driving device, as shown in figure 55.When axis 3460 is along first party To when rotation, lining ring 2550 is shifted towards distal side, and the spring 3699 of latching member 3690 can be biased against trocar shaft 3650 and be locked Arm 3692.It shifts in lining ring 2550 towards distal side with percussion nail, when then proximally bouncing back, trocar shaft 3650 is relative to hammerlock 3692 rotations.Then closure driving device can be operated to reopen anvil block 2230, to unclamp tissue and/or by anvil block 2230 It is separated with trocar shaft 3650.When anvil block 2230 reopens, hammerlock 3692 is biased to and is defined in trochar by spring 3699 In lock recessed portion 3652 in axis 3650 and/or anvil block 2230.Once hammerlock 3692 is located in lock recessed portion 3652, hammerlock 3692 prevent trocar shaft 3650 from proximally bouncing back.When attempting to bounce back trocar shaft 3650 the case where operation closure driving device Under, hammerlock 3692 will abut against the lock shoulder being defined in lock recessed portion 3652 and prevent time of trocar shaft 3650 and anvil block 2230 Contracting.Therefore, after latching member 3690 prevents anvil block 2230 from undergoing in tool assembly 3600 or at least partly undergoes the percussion period Again it is clamped to tissue, and tool assembly 3600 can not be used again.In addition, latching member 3690 can be used as it is used Storehouse latching member.
Turning now to Figure 59 and Figure 60, tool assembly 3700 includes nail bin 3720 and anvil block 3730.Tool assembly 3700 is also It including being configured to the closed system towards the mobile anvil block 3730 of nail bin 3720, and further include being configured to project Or fire the trigger system for the nail being removedly stored in nail bin 3720.Anvil block 3730 includes longitudinal axis part 3736 and from axis The attachment arm 3738 that part 3736 extends, the attachment arm be configured to flexibly to clamp the closing actuator of closed system or Trochar 3734.Closing actuator 3734 can proximally be bounced back by being closed driving device, and trochar 3734 is being opened Unclamped position (Figure 59) and closure clamped position (Figure 60) between move.When closed system is in its open configuration, As shown in figure 59, nail trigger system is disabled and cannot be activated to fire the nail that is stored in nail bin 3720, it is as follows more It describes in detail.
Than that described above, nail trigger system includes the rotatable beating shaft 3750 with screw thread distal end, and is also wrapped Translatable percussion nut 2550 is included, which includes the screw thread distal side for being configured to receive beating shaft 3750 The threaded hole of end.It is worth noting that, referring to Figure 59, when anvil block 3730 is in its open position, the spiral shell of beating shaft 3750 There are gaps between line distal end and the threaded hole being defined in percussion nut 2550.Therefore, beating shaft 3750 cannot make to hit Fat nut 2550 is shifted towards distal side, until beating shaft 3750 and percussion nut 2550 are threadably engaged.
As shown in figure 60, the attachment arm 3738 of anvil block 3730 is configured to engagement beating shaft 3750 and in anvil block 3730 are deflected outward beating shaft 3750 when being moved to its closed position.Referring primarily to Figure 59 A and Figure 60 A, arm 3738 is attached by structure It causes that the protruding portion 3758 to extend internally being defined on beating shaft 3750 can be engaged, and pushes out protruding portion 3758 and hit Send out the periphery of axis 3750.In the illustration being described, the screw thread distal end of beating shaft 3750 be pushed to at thread interface 3790 The threaded hole of percussion nut 2550 operatively engages, and at this point, beating shaft 3750 can be driven in beating shaft 3750 by percussion Device makes to fire nut 2550 towards distal side displacement when rotating to project nail from nail bin 3720.When anvil block 3730 is again turned on, hit Hair axis 3750 will be returned to its initial configuration and operationally be disengaged with percussion nut 2550.
Tool assembly 3700 includes latching member due to the above reasons, which is not attached to closed system in anvil block 3730 It is prevented when system, when anvil block 3730 is improperly attached to closed system and/or in 3730 non-adequate closure of anvil block Nail is fired.
Turning now to Figure 61 and Figure 62, tool assembly 3800 includes: replaceable nail bin, which includes that can be removed The nail that ground is stored therein in；It is configured to the anvil block for deforming nail；It is configured to relative to the mobile anvil block of nail bin It is closed drive system；And it is configured to project the trigger system of nail from nail bin.As described below, tool assembly 3800 also wraps Latching member is included, which is configured to prevent trigger system from being operated, unless nail bin is arranged to tool assembly completely On 3800.
Nail bin includes the Hatch Coaming frame 3820 for being configured to the axis frame 3810 of bonding tool component 3800.Nail bin also wraps Drive shaft 3830 is included, when nail bin is mounted to tool assembly 3800, which is inserted into axis frame 3810.More specifically It says, referring primarily to Figure 64, drive shaft 3830 includes proximal end 3832, which includes annular gear portions 3833, should Annular gear portions are configured to that the transmission of trigger system is engaged and compressed when nail bin is mounted to tool assembly 3800 Device 3860.Referring primarily to Figure 62, transmitting device 3860 includes first part 3862, second part 3864 and Part III 3868, rotary input motion can be transferred to drive shaft 3830 when being pushed to and operatively engaging each other by these parts.
Referring primarily to Figure 63 and Figure 64, the annular gear portions 3833 of drive shaft 3830 are configured to engagement and are defined in Corresponding gear part 3863 on the distal side of first hop 3862, and when 3862 driven shaft 3830 of the first hop When proximally pushing, the first hop 3862 can be operatively engaged the second hop 3864.More particularly, first Hop 3862 includes proximal gear part 3865, which engages the distal side gear of the second hop 3864 Part 3866, and the second hop is proximally pushed when 3862 driven shaft 3830 of the first hop proximally pushes 3864.When the second hop 3864 is proximally pushed by the first hop 3862, it is similar to above-mentioned, the second hop 3864 can be operatively engaged third hop 3868.More particularly, the second hop 3862 includes proximal gear Part 3867, when the first hop 3862 and 3864 driven shaft 3830 of the second hop proximally push, the nearside The distal side gear parts 3869 of gear parts engagement third hop 3864.Third hop 3868 is operably linked to Input shaft, and axis and/or the support of shaft housing 3810 are entered proximally to shift.
Referring primarily to Figure 61, transmitting device 3860 further includes being located in the first hop 3862 and the second hop At least one spring member 3870 among 3864.In at least one example, spring member 3870 may include such as one or Multiple waveform springs.Spring member 3870 is configured to the first hop 3862 of biasing and the second hop 3864, So that them is separated from each other.Additionally or alternatively, transmitting device 3860 further includes being located in 3864 He of the second hop At least one spring member 3870 among third hop 3868, is similar to above-mentioned, and spring member is configured to partially The second hop 3864 and third hop 3868 are set, them is made to be separated from each other.Referring primarily to Figure 65, each spring member 3870 include two disc springs 3872, and disc spring is configured to flexure when to compressing force is applied thereon；However, bullet Spring component 3870 may include any suitable configuration.
Than that described above, and referring again to Figure 61, the rotatable third hop of the input shaft of tool assembly 3800 3868；However, unless the spring member 3870 being located among the second hop 3864 and third hop 3868 by Sufficiently compression is with by the distal side gear part of the proximal gear part 3867 of the second hop 3864 and third hop 3868 Divide 3869 connections, otherwise the rotation of third hop 3868 cannot be transferred to the second hop 3864.Similarly, unless The spring member 3870 among the first hop 3862 and the second hop 3864 is located in be sufficiently compressed with by the The proximal gear part 3865 of one hop 3862 is connect with the distal side gear parts 3866 of the second hop 3864, otherwise Second hop 3864 cannot be by rotary motion transmission to the first hop 3862.As described above, when nail bin disposes completely When on to axis frame 3810, drive shaft 3830 engages the first hop 3862 with the second hop 3864, and by Two hops 3864 are engaged with third hop 3868, as shown in Figure 62.In the illustration being described, the rotation of input shaft can pass It is defeated to arrive drive shaft 3830.However, if nail bin is not arranged on axis frame 3810 completely, hop 3862,3864 and One or more of 3868 cannot operationally be engaged with each other, and the rotation of input shaft cannot be transferred to drive shaft 3830.Therefore, tool assembly 3800 ensures to be stored in the nail in nail bin and cannot project from nail bin, unless nail bin is arranged to axis completely On frame 3810.
Turning now to Figure 66 to Figure 68, tool assembly 3900 includes axis 3910 and replaceable nail bin 3920.Replaceable nail bin 3920 include the closure driving device being configured to relative to the mobile anvil block of nail bin 3920, and further includes percussion driving dress It sets, which includes the rotatable percussion for being configured to project the nail being removedly stored in nail bin 3920 Axis 3930.Similar to above-mentioned, tool assembly 3900 includes latching member, which is configured to prevent percussion driving device It projects and follows closely from nail bin 3920, unless nail bin 3920 is fully or substantially arranged on axis 3910.More particularly, latching member prevents Beating shaft 3930 rotates in nail bin 3920, unless nail bin 3920 is fully or substantially arranged on axis 3910.In various examples In, referring to Figure 67, beating shaft 3930 includes the annular array for the lockhole 3939 being defined in its outer periphery, and nail bin 3920 wraps Include at least one lock 3929 for being configured to be releasably engaged the lockhole 3939 being defined in axis 3930.Locking 3929 includes The cantilever beam extended proximally；However, using any suitable construction.Lock 3929 further includes locking protruding portion, and the locking is prominent Portion extends in lockhole 3939 and prevents beating shaft 3930 relative to the main body rotation of nail bin 3920 or at least substantially rotate out. Lock 3929 is configured to so that it is biased to engages with the lockhole 3939 being defined in beating shaft 3930, until working as nail bin 3920 when being fully or substantially assembled to axis 3910, and lockhole 3929 is elevated out lockhole 3939, as shown in Figure 68.Referring to Figure 68, The outer enclosure of axis 3910 includes wedge piece 3919, which is configured to promote lock 3929 simultaneously far from beating shaft 3930 And it is disengaged lock 3929 with lockhole 3939.Wedge piece 3919 is configured to so that it will not make lock 3929 and beating shaft 3930 are disengaged, unless nail bin 3920 is fully or substantially arranged on axis 3910, as shown in Figure 68.Figure 67 shows nail bin 3920 are not arranged to the scene on axis 3910 fully or substantially.
Turning now to Figure 69 to Figure 71, tool assembly 4000 includes axis 4010 and replaceable nail bin 4020.Replaceable nail bin 4020 include the closure driving device being configured to relative to the mobile anvil block of nail bin 4020, and further includes percussion driving dress It sets, which includes the rotatable percussion for being configured to project the nail being removedly stored in nail bin 4020 Axis 3930.Nail bin 4020 includes lock 4029, which is configured to nail bin 4020 being releasably connected to axis 4010.Lock 4029 include the cantilever extended proximally and lock shoulder extending therefrom 4028.Lock 4029 is configured to be filled in nail bin 4020 It is inwardly bent in axis 4010 when being fitted on axis 4010, is then locking 4029 lock shoulder 4028 and be defined in the outer enclosure of axis 4010 In window 4019 be aligned when, return resiliently to its non-deflected or at least towards its non-deflected.In the illustration being described, When nail bin 4020 is fully or substantially placed on axis 4010, lock shoulder 4028 enters in window 4019, as shown in Figure 70.For Understand pinning storehouse 4020, tool or its finger can be for example inserted into window by clinician, and will lock 4029 far from window 4019 Pressing.At this point, nail bin 4020 can be removed from axis 4010, and if clinician so it is expected, new nail bin can be attached to Axis 4010.
Additionally or alternatively, surgical stapling system may include electric locking part, which is configured to Prevent the closure driving device of sewing system by anvil block be clamped to tissue and/or prevent percussion driving device nail bin still Its firing schedule is executed when not being arranged to fully or substantially on the axis of sewing system.In various examples, sewing system can be wrapped It includes and is configured to the sensor whether detection nail bin has fully or substantially been arranged on axis, and further include being configured to The electric motor of percussion driving device can be operated.Detect that nail bin is not yet fully or substantially attached to the feelings of axis in sensor Under condition, motor can be deactivated by electricity.In various examples, sewing system includes the controller communicated with sensor and electric motor, Such as microprocessor.In at least one example, controller is configured to execute following operation: first, it allows sensing Device detects allows electric motor to be operated when the nail bin correctly disposed on axis, secondly, preventing from detecting on axis not in sensor Electric motor is operated when the nail bin correctly disposed.
Turning now to Figure 72, tool assembly external member 4100 include axis 4110 and multiple nail bins, such as 4120,4120 ', 4120 " and 4120 " '.Each nail bin 4120,4120 ', 4120 " and 4120 " ', which is configured to apply, has different-diameter Round nail row.For example, nail bin 4120 " ' it is configured to apply with larger-diameter pattern and follow closely, and nail bin 4120 is by structure It causes to apply with the pattern with minor diameter and follow closely.In various examples, different nail bins can be disposed with different unshapeds The nail of height.In at least one example, there is the nail of larger undeformed height with the cartridge deployment that larger pattern applies nail, and There is the nail of smaller undeformed height with the cartridge deployment that smaller pattern applies nail.In some instances, nail bin can be disposed and have The nail of two or more unshaped height.Under any circumstance, the nail bin selected from multiple nail bins may fitted to axis 4110.
Referring to Figure 72 and Figure 73, whether tool assembly 4100 is fully or substantially attached including being configured to detection nail bin It is connected to the detection circuit 4190 of axis 4110.Detection circuit 4190 is not fully accommodated in axis 4110；On the contrary, nail bin must be filled correctly Axis 4110 is fitted on to complete detection circuit 4190.Detection circuit 4190 includes conductor 4193, and the conductor, which extends through, to be defined in The channel 4192 of outer enclosure restriction in the frame of axis 4110 and/or along axis 4110.Referring primarily to Figure 73, each conductor 4193 are electrically coupled to the electric contact 4194 in the distal end for being defined in shell.Nail bin 4120 is for example including corresponding electric contact 4195, which is positioned and is arranged in the main body 4122 of nail bin 4120, so that contact 4195 engages the touching on axis 4110 Point 4194.Nail bin 4120 further includes the conductor 4196 for extending through warehouse 4122 and/or extending along warehouse.Each conductor 4196 It is electrically connected with contact 4195.In some instances, conductor 4196 is directly coupled with each other, and in the illustration being described, once nail bin 4120 are correctly assembled to axis 4110, with regard to occlusion detection circuit 4190.
In some instances, than that described above, the detection circuit 4190 of tool assembly 4100 extends through nail bin 4120 Terrace part 4124.In at least one example, terrace part 4124 is actively attached to warehouse 4122.More particularly, exist In at least one described example, spring member 4198 is located among warehouse 4122 and terrace part 4124 and is adapted to Enough be located against when terrace part 4124 compresses in tissue allows terrace part 4124 relative to the movement of warehouse 4122 or floating.Extremely In a few example, spring member 4198 includes for example one or more waveform springs.Spring member 4198 is also in warehouse 4122 Conductive path is formed between terrace part 4124.More particularly, spring member 4198 is located in is defined in warehouse respectively 4122 and terrace part 4124 on electric contact 4197 and 4199 among.Conductor 4196, which is electrically coupled to, is defined in the remote of warehouse 4122 Electric contact 4197 on side end, and electric contact 4199 is electrically connected each other by the conductor in terrace part 4125.Institute as above It states, once nail bin 4120 is correctly assembled to axis 4110, with regard to occlusion detection circuit 4190.
Turning now to Figure 74 to Figure 76, tool assembly 4200 includes being configured to prevent alternatively round nail bin quilt More than one latching member is fired, it is as follows to be further more fully described.It in use, will interchangeable round nail bin 4220 It is assembled to the axis 4210 of tool assembly 4200.Then tool assembly 4200 is located in operative site, and by anvil block 2230 It is assembled to the trochar 2450 of closure driving device.Then anvil block 2230 is moved towards nail bin 4220 using closure driving device It is dynamic, to clamp the tissue of patient against nail bin 4220, until anvil block 2230 reaches closure or clamped position.The position of anvil block 2230 It sets as shown in Figure 74.At this point, percussion driving device can be operated to dispose the nail being removedly stored in nail bin 4220.Percussion is driven Dynamic device further includes the rotatable drive shaft 4230 being threadably engaged with driving lining ring 4240 in addition to other, and is also wrapped Include nail percussion driver 2560.Driving lining ring 4240 and percussion driver 2560 includes individual component；However, in alternative reality It applies in scheme, driving lining ring 4240 and percussion driver 2560 may be integrally formed.Firing driving device can be in the firing schedule phase Between be rotated in a first direction, between non-firing position (Figure 74) and firing position (Figure 75) will driving lining ring 4240 and nail hit It sends out driver 2560 to push towards distal side, be followed closely with being projected from nail bin 4220.Driving lining ring 4240 and staple drivers 2560 are prevented from Rotation in nail bin 4220, and therefore, drive shaft 4230 is rotated relative to driving lining ring 4240 and staple drivers 2560.
Than that described above, driving lining ring 4240 includes the one or more latching members 4290 extended proximally from it.Each Latching member 4290 includes locking pin 4292, which is slidably located in the pin hole 4293 being defined in driving lining ring 4240 It is interior.Each latching member 4290 further includes the biasing member for being configured to proximally offset pins 4292, such as spring 4294.When Percussion driving device is when being in its non-percussion configuration, as shown in Figure 74, latching member 4290 not with rotatable drive shaft 4230 and/or The frame 4222 of nail bin 4220 engages.When driving lining ring 4240 and 2560 driven shaft 4230 of staple drivers to push towards distal side, Locking pin 4292 is mobile far from drive shaft 4230, as shown in Figure 75.It is completed and is followed closely against anvil block 2230 in firing schedule After fully deformed, drive shaft 4230 is rotated in mutually opposite directions proximally to pull driving 4240 He of lining ring during retract stroke Staple drivers 4260.In the illustration being described, latching member 4290 is mobile towards drive shaft 4230.It is worth noting that, retract stroke It is longer than firing schedule, therefore, lining ring 4240 is driven proximally to be moved to retraction position relative to its first beginning and end firing position, such as schemed Shown in 76.In the retraction position of driving lining ring 4240, the frame with drive shaft 4230 and nail bin 4220 of latching member 4290 4222 engagements.More particularly, each latching member 4290 has entered the lock being defined between drive shaft 4230 and Hatch Coaming frame 4222 Determine in hole.Referring now to Figure 78, each lock hole is by the hole wall 4296 in the hole wall 4295 and frame 4222 in drive shaft 4230 It limits.Once locking pin 4292 enters lock hole, driving lining ring 4240 is unable to driven shaft 4230 and rotates, and nail bin 4220 Trigger system has been locked.Therefore, specific nail bin 4220 can not be used again, and must be replaced with new nail bin, so as to again It is secondary to use tool assembly 4200.
Reader should be appreciated that than that described above, when percussion driving device is in its non-percussion configuration, locking pin 4292 can With or can not be partially positioned in lock hole, as shown in Figure 74.However, to a certain extent, locking pin 4292 is partly It is located in lock hole, in the illustration being described, when firing the rotation of drive shaft 4230, pin 4292 can be defined in driving lining ring It is shifted in pin hole 4293 in 4240 towards distal side.Reader should also be understood that when driving lining ring 4240 to be moved to its retraction position, lock Rationed marketing 4292 is sufficiently deep arranged in the lock hole being defined in drive shaft 4230, so as to percussion drive shaft 4230 along its When one direction rotates again, anti-shotpin 4292 removes lock hole towards distal side.
Referring again to Figure 78, when driving lining ring 4240 to be in its retraction position, the side wall 4295 and 4296 of lock hole that This alignment.However, the side wall 4295 being defined in drive shaft 4230 will rotate to disengaging and limit when drive shaft 4230 rotates The alignment of side wall 4296 in warehouse 4222.In some instances, when firing the rotation of driving device 4230, side wall 4295 can Temporarily rotation is extremely realigned with side wall 4296.Referring now to Figure 77, under any circumstance, do not hit when trigger system is in it When sending out configuration, side wall 4295 is not aligned with side wall 4296.Therefore, when trigger system is in its non-percussion configuration and nail bin 4220 When cannot unintentionally lock, locking pin 4292 not can enter in lock hole.
Referring now to Figure 80, selected else in embodiment at least one, one or more lock holes 4295 " can be only defined in In the drive shaft 4230 " of tool assembly 4200 ".In such embodiment, once locking pin 4292 enters lock hole 4295 ", Driving lining ring 4240 cannot be rotated relative to drive shaft 4230 ".In fact, driving lining ring 4240 and drive shaft 4230 " will be by It synchronously locks together, but is not necessarily locked in the frame of tool assembly 4200 ", this will prevent drive shaft 4230 " opposite It is rotated in driving lining ring 2440 and makes that lining ring 2440 is driven to shift towards distal side.
Referring now to Figure 79, selected else in embodiment at least one, each percussion driving latching member has different structures Type, so that the corresponding lock hole of each locking pin uniquely matches.For example, tool assembly 4200 ' includes being adapted to Enough the first locking pins for entering the first lock hole limited by side wall 4295 and 4296, and be configured to enter by side wall Second locking pin of 4295 ' and 4296 ' the second lock holes limited.However, the size of the first locking pin of tool assembly 4200 ' With construction so that it can not into the second lock hole, and accordingly, the second locking pin is sized and configured so that it cannot be into Enter the first lock hole.It is formed in addition, the first locking pin or the second locking pin can not enter by the combination of side wall 4295 and 4296 ' Hole or the hole that is formed by the combination of side wall 4295 ' and 4296.
As described above, the suture instruments for being configured to deployment round nail row may include actuated articulation joints.The joint Kinematic joint is configured to that the end effector of suture instruments is allowed to carry out joint motions relative to the axis of suture instruments.This Plant rectum and/or colon that suture instruments can help surgeon that end effector is located in patient.In various embodiment party In case, referring to Figure 81, be configured to deployment round nail row suture instruments such as suture instruments 9000 for example may include can Form profile or adjustable frame 9010.Frame 9010 is configured to be permanently deformed during use.For example, extremely In few such embodiment, frame 9010 is made of ductile metal such as silver, platinum, palladium, nickel, gold and/or copper.For example, In certain embodiments, frame 9010 is made of ductility plastics.For example, at least one embodiment, frame is by wrapping Polymer containing the metal ion in conjunction with polymer chain is constituted, such as ion polymer-metal composite material (IPMC).It can incite somebody to action Voltage potential or potential are applied to IPMC material, to make shaft flexing in the desired manner.In some instances, axis can be along one Radius of curvature forms profile, and in other examples, axis can form profile along more than one radius of curvature.For example, when axis is being suffered from When in person's body, voltage potential or potential can be modified so that axis forms profile.In certain embodiments, frame forms profile Part include multiple pivotable connectors.In at least one embodiment, frame forms outline portion by viscoelastic Property material constitute.
Than that described above, suture instruments, which may also include, is configured to releasedly being formed suture instruments frame Outline portion is maintained at the lock in its profile configuration.In at least one example, suture instruments frame includes articulating Framework connecting piece and the one or more longitudinal direction that can proximally pull framework connecting piece and lock together framework connecting piece Tension cable.In some instances, each framework connecting piece may include the longitudinal hole for extending through it, which is configured to The bar that can be moved distally can be received.Bar is sufficiently flexible to pass through longitudinal hole, when the part that can form profile has formed profile And it is sufficiently rigid suture instruments to be maintained in its profile configuration when, the longitudinal hole may not be in alignment with each other completely.
As described herein, surgical instruments can be by multiple module compositions for being assembled together each other.For example, at least one In embodiment, surgical instruments includes first module with shank and the second module with shaft assembly.Shaft assembly includes quilt It is constructed to be permeable to the end effector of tissue for suturing and/or cutting patient；However, shaft assembly may include any suitable end Actuator.In various examples, end effector includes the third module that could attach to shaft assembly.Referring now to Figure 82 and figure 83, shank such as shank 20 is for example including controller and the display communicated with controller 10000.Controller is adapted to Enough data that the operation about surgical instruments is shown on display 10000.Being shown in data on display 10000 will be about The information association of at least one operating parameter of at least one operating parameter and/or the second module of the first module to surgery is cured It is raw.For example, controller can show the data of the progress about nail firing schedule on display 10000.
Than that described above, shaft assembly further includes second display.For example, shaft assembly 2000 includes display 10100；So And any shaft assembly disclosed herein may include display, such as display 10100.Second module includes the control of their own Device processed, the controller are configured to show the data of the operation about surgical instruments on display 10100.Similar to upper It states, the data being shown on display 10100 are related at least one operating parameter and/or second module about the first module The information of at least one operating parameter.The controller of second module is communicated with the controller signals of the first module；However, other In embodiment, the second module controller can be operated independently of the first module controller.In certain alternative embodiments, the Two modules do not include controller.In such embodiment, the controller of the first module and the first display 10000 and second are aobvious Show 10100 signal communication of device, and controls the data being shown on the first display 10000 and second display 10100.
As described above, tool assembly 2000 includes anvil block and nail bin.Shank 20 includes actuating system, the actuating system quilt It is constructed to be permeable to relative to the mobile anvil block of nail bin.Anvil block can be positioned in a certain position range relative to nail bin, to control anvil The distance between seat and nail bin or gap, thus the forming height that control is followed closely when nail is projected from nail bin.For example, anvil block is positioned At closer to nail bin, so that nail is deformed into lesser forming height, and positioned further away from nail bin so that nail be deformed into compared with Big forming height.Under any circumstance, the second display 10100 of tool assembly 2000 is configured to display anvil block phase Position and/or display for nail bin are followed closely will forming or formed height.In various embodiments, shaft assembly can wrap The actuator for being configured to the function of control end effector is included, and shows the end effector about adjacent actuator The display of the data of function.
Referring to Fig. 1, tool assembly 1500 includes axis and the end effector from axis extension.Axis includes axis frame and longitudinal axis Axis.End effector includes end effector frame and longitudinal end actuator axis.End effector further includes distal side head Portion and rotary joint, the rotary joint allow distal head to surround longitudinal end actuator axis relative to end effector frame Rotation.Distal head includes the first jaw and the second jaw.First jaw includes with the nail being removedly stored therein in Nail bin is configured to receive the channel of this nail bin, and the second jaw includes being configured to deform nail Anvil block.Second jaw can move between the open position and the closed position relative to the first jaw；However it is also contemplated that other Embodiment, wherein the first jaw can be moved relative to the second jaw and/or both the first jaw and the second jaw energy Enough it is movable with respect to each other.
In certain embodiments, other than rotary joint, tool assembly may also include actuated articulation joints.At least In one such embodiment, rotary joint is distally located relative to actuated articulation joints.In such embodiments, distal side The rotation on head does not influence the angle that end effector has carried out joint motions.That is, contemplated in which that joint motions connect The head other embodiments distally located relative to rotary joint.The width that such embodiment can provide distal head scans.? Under any case, longitudinal end actuator axis can be relative to longitudinal axis axial-movement.It is longitudinal at least one example End effector axis can be transported between the position of longitudinal axis axis with it at it with the position of longitudinal axis axis collinear It is dynamic.
Than that described above, the distal head of tool assembly 1500 can rotate between initial position and rotation position.? In at least one example, distal head can rotate between zero or upper dead center position and the second position.In some instances, far Side head can rotate the motion range by least 360 degree.In other examples, distal head can be rotated by being less than 360 degree of rotating range.In either case, tool assembly 1500 and/or shank 20 are configured to tracking distal side head The rotation position in portion.In various examples, tool assembly 1500 and/or shank 20 include operationally remote with end effector The electric motor of side head connection, and further include encoder, which is configured to directly track the rotation of distal head And/or for example track the rotation of distal head indirectly by the rotation position of the axis of assessment electric motor.The control of shank 20 Device is communicated with code device signal, and is configured to for example show the rotation position of distal head on display 10000.
In at least one embodiment, it in the distal head rotation of end effector, is shown on display 10000 Data orientation and arrangement be static.Certainly, in such embodiments, the data being shown on display 10000 It will be updated by surgical instruments controller；However, show will not be as distal head rotates and redirect and/or cloth again for data It sets.This embodiment can provide for surgeon correctly utilizes information necessary to surgical instruments in static field.Extremely In a few alternative embodiment, the data field on display 10000 is dynamic.In this context, term dynamic not Mean only that data are updated on display 10000；Term dynamic also means that data are being shown as distal head rotates Show and redirects and/or rearrange on device 10000.In at least one example, the orientation tracking distal head of data is taken To.For example, the data field on display 10000 also rotates 30 degree if distal head rotates 30 degree.In various examples In, distal head can be rotated by 360 °, and data field can be rotated by 360 °.
Than that described above, data field is oriented at and the matched any orientation of the orientation of distal head.This implementation Scheme can provide the accurate and intuitive sensing to the orientation of distal head for surgeon.In certain embodiments, it controls Data field is oriented the orientation selected from the independent position array of the orientation most tight fit of distal head by device processed.Example Such as, if distal head has rotated 27 degree, and selectable independent data field location separates 15 degree, then controller can be again Directional data field is to be orientated to 30 degree with benchmark.Similarly, it for example, if distal head has rotated 17 degree, and may be selected Independent data field location separate 5 degree, then controller can redirect data field to be orientated to 15 degree with benchmark.At least In one embodiment, benchmark orientation is aligned with the features of surgical instruments itself.For example, the benchmark orientation of shank 20 and extension Across the axis alignment of the handle of shank 20.In such embodiments, shank 20 can be ignored relative to its environment in controller Orientation.However, for example, benchmark orientation is aligned relative to gravity axis at least one alternative embodiment.
Than that described above, controller, which is configured to redirect relative to the orientation of distal head, is shown in display Entire data field on 10000.In other embodiments, controller is configured to the orientation relative to distal head Redirect the only a part of the data field shifted on display 10000.In such embodiments, data field A part is orientated relative to benchmark keeps static, and another part of data field is orientated relative to benchmark and rotates.In certain realities It applies in scheme, first part's rotation the first rotation angle of data field, and the second part of data field is in same direction Rotation the second rotation angle.For example, second part rotates more low-angle than first part.In various embodiments, data The first part of field is rotated in a first direction, and the second part of data field is rotated along second or opposite direction.
Than that described above, data field is by real time or at least substantially with the rotation of distal head and again fixed in real time To and/or rearrange.The data that such embodiment provides great responsiveness are shown.In other embodiments, data The reorientation of field and/or rearrange the rotation that can postpone distal head.It is less that such embodiment can provide shake Data are shown.In various embodiments, the first part of data field is redirected and/or is rearranged with First Speed, And the second part of data field is redirected and/or is rearranged with second or friction speed.For example, second part can be with Slower speed rotation.
As described above, the data field on display 10000 is rotated as the distal head of end effector rotates.So And in other embodiments, a part of data field or data field is translated as distal tip rotates.It is same as above Described, the controller of surgical instruments is configured to redirect and/or rearrange data field in shank display On 10000.However, data field can be redirected and/or be rearranged on the second display by the controller of surgical instruments, Such as axis display.
Referring again to Figure 15 and Figure 83, tool assembly 2000 includes actuator 10200, which is configured to cause The joint motion drive system of power driven tools component 2000.Actuator 10200 can be rotated about longitudinal axes, the longitudinal axis example Such as be parallel to or at least substantially parallel to axis 2100 longitudinal axis.Actuator 10200 be operably linked to for example with handle The rheostat of the controller signals communication in portion 20.When actuator 10200 is rotated in a first direction around its longitudinal axis, variable resistance Device detect actuator 10200 rotation, and controller operation electric motor so that end effector 2200 along first direction into Row joint motions.Similarly, when actuator 10200 is rotated around its longitudinal axis along second or opposite direction, rheostat inspection Survey the rotation of actuator 10200, and controller operation electric motor so that end effector 2200 along second or opposite direction Carry out joint motions.In various examples, end effector 2200 for example can along first direction from longitudinal axis joint motions about 30 degree, and/or along second or opposite direction from about 30 degree of longitudinal axis joint motions.
Such as reader it should be understood that as, than that described above, tool assembly 2000 do not have is configured to operation close Save the onboard electric motor of motion driving system；But the electric motor of joint motion drive system is located in shank, such as handle Portion 20, tool assembly 2000 are attached to the shank.Therefore, the operation of the actuator control shank on dismountable shaft assembly.? In other embodiments, the electric motor of joint motion drive system can be located in tool assembly 2000.In either case, Display 10100 is configured to show the joint motions of end effector 2200 in a manner of at least some.As reader should As understanding, 10100 adjacent actuator 10200 of display, and therefore, surgeon can easily check joint simultaneously Motion driving system is output and input.
Than that described above, it may for example comprise the surgical tool component that can form the axis of profile can be advantageously shaped to fit in The rectum or colon of patient.However, this axis for forming profile cannot bear stretching and/or the compressive load of significant quantity. In order to compensate for such case, in various embodiments, what only rotatable drive system can extend across axis forms profile portion Point.In the illustration being described, axis only needs to resist the rotating reactive force generated by rotatable drive system.In such embodiment In, if it is desired, the rotary motion of drive system can be converted to relative to the shaft portion of profile can be formed towards the linear of distal side Movement.This longitudinal movement can produce drawing force and/or compressing force；However, such power can in end effector i.e. relative to The shaft portion that profile can be formed is decomposed or is balanced towards distal side.Such embodiment also can use relative to the axis that can form profile The actuated articulation joints that part is positioned towards distal side.In such embodiment, available cross can not form profile to tool assembly Shaft portion push-pull type drive system.
The anvil block 6020 of circular stapler instrument is as shown in Figure 84 and Figure 85.Anvil block 6020 includes 6022 He of tissue compression surface It is defined in the annular array of the nail shapes pit 6024 in tissue compression surface 6022.Anvil block 6020 further includes frame 6028, attached The shaft for connecing installation part 6026 and extending from attachment installation part 6026.The shaft is configured to be releasably attached to The closure driving device of circular stapler instrument, so that anvil block 6020 can be mobile toward and away from the nail bin of circular stapler instrument.Pressure Contracting surface 6022, attachment installation part 6026 and frame 6028 are made of such as stainless steel；However, any suitable one kind can be used Or multiple material.
Than that described above, anvil block 6020 further includes tissue support 6030.Tissue support 6030, which is located in, is defined in group It knits in the looping pit in support surface 6022.Tissue support 6030 is tightly secured in anvil block 6020, so that therebetween There are seldom (if any) relative motions.Tissue support 6030 includes annular tissue support surface 6032, the annular Tissue scaffold surface is adjacent with the annular tissue compressive surfaces 6022 of anvil block 6020.Tissue support 6030 further includes being defined in it In inner annular wall 6036, and further include the bottom wall 6038 that positions of anvil block frame 6028 of neighbouring anvil block 6020.
Referring now to Figure 86, circular stapler instrument includes nail bin 6040, which includes first annular staple 6070, second Annular staple 6080, and percussion driving device, the percussion driving device are configured to the percussion in percussion driving device Nail 6070 and 6080 is projected from nail bin 6040 during stroke.As shown in Figure 86, nail 6070 and 6080 from nail bin 6040 when projecting It is deformed by forming pit 6024.In various examples, nail 6070 and nail 6080 are deformed into identical height, and in other examples In, nail 6070 and nail 6080 are deformed into different height.For example, nail 6070 can be deformed to than following closely 6080 smaller Deformation Heights.? In other examples, nail 6080 is deformed into than following closely 6070 smaller height.
Additionally or alternatively, nail 6070 and nail 6080 can have different unshaped height.For example, nail 6070 can With than following closely 6080 smaller unshaped height.In other examples, nail 6080 has than following closely 6070 smaller unshaped height. In some instances, 6080 unshaped height having the same of nail 6070 and nail.
Than that described above, it is deformed in nail 6070 and 6080 against anvil block 6020 and is trapped in anvil block 6020 and nail bin to suture When tissue T between 6040, suture instruments can cut into tissue T.The percussion driving device that nail is projected from its nail cavity will be cut Component 6050 drives towards tissue T and anvil block 6020.The distal side edge transecting patient tissue T of cutting element 6050, then along tissue The inner sidewall 6036 of supporting element 6030 slides, without crosscutting inner sidewall 6036.The cutting edge of cutting element 6050 is annular, and And it is aligned with the annular inner wall 6036 of tissue support 6030.Cutting element 6050 is advanced in anvil block 6020, until cutting The crosscutting bottom wall 6038 of component 6050 is cut, as shown in Figure 86.
When against the driving of anvil block 6020 nail 6070 and 6080 and/or cutting tissue, percussion driving device experience is various negative It carries.For example, percussion driving device can undergo increased negative when the crosscutting tissue previously for example sutured with 6090 (Figure 86) of nail It carries.However, the sudden change of the power by percussion driving device transmission can be generated by the crosscutting bottom wall 6038 of cutting element 6050 Or pulse.Clinician can be used surgical stapling device and/or be configured as the electronics of the load variation of detection percussion driving device Sensing system carrys out this sudden change of sensing power.Tissue support 6030 can be by that can apply load in cutting element 6050 The material grabbed when being added to bottom wall 6038 is constituted.In at least one example, tissue support 6030 is made of such as plastics.? In any case, it can detect the crosscutting of bottom wall 6038, and once detect, clinician and/or electronic sensor systems can Determine that cutting process is completed.
Percussion driving device makes the deformation of nail 6070,6080 and while cutting tissue using cutting element 6050；However, it is possible to Imagine, nail forming step and tissue cutting step can interlock.In at least one example, until nail forming step completion just starts Organize cutting step.
From Figure 86 it should be appreciated that when surface 6032 can partly supporting tissue T when, cutting element 6050 can be in cutting element 6050 are defined in tissue T push-in when mobile towards bottom wall 6038 inner wall 6036 and attachment installation part of tissue support 6030 In cavity between 6026.In other words, cutting element 6050 can drag tissue T in the forward position wall 6036 of finally cutting tissue T. In the illustration being described, the notch made of cutting element 6050 may not be accurate.Reality disclosed in Figure 86 is discussed below Apply the improvement of scheme.
Turning now to Figure 87 and Figure 88, the tissue support 6030 of anvil block 6020 is replaced by tissue support 6130.Group Knitting supporting element 6130 includes first annular wall or annular wall 6131 and the second annular wall or inner annular wall 6133.Inner wall 6133 limits Determine hole 6136, which is configured to closely receive attachment installation part 6026.Outer wall 6131 and inner wall 6133 pass through lateral Wall 6132 connects.Lateral sidewall 6132 radially prolongs between inner wall 6133 and outer wall 6131 around the center of tissue support 6130 It stretches.Lateral sidewall 6132 is uniformly spaced apart from each other；It is contemplated, however, that alternative embodiment, wherein lateral sidewall 6132 is not each other It is evenly spaced apart.In either case, the annular array of cavity 6134 is defined in tissue support by lateral sidewall 6132 In 6130.In various examples, each cavity 6134 can be for example closed on every side in addition to the side towards tissue. In other examples, the side towards tissue of cavity can be closed.
The outer wall 6131 and inner wall 6133 of tissue support 6130 are configured to horizontal by cutting element 6050 in tissue Supporting tissue when cutting.Lateral sidewall 6132 goes back supporting tissue, and in addition, prevented when tissue is crosscut or resisted organize relative to Outer wall 6131 and inner wall 6133 slide.It should be appreciated that tissue can enter cavity 6134 when tissue is crosscut；However, can be significantly Reduce the relative motion between tissue and side wall.According to desired amount of support, can composition to lateral sidewall 6132 and arrangement carry out Selection, to provide more supports to tissue or provide less support to tissue.For example, thicker lateral sidewall 6132 can provide Than the relatively thin more tissue scaffolds of lateral sidewall 6132.Similarly, more lateral sidewalls 6132 can provide than relatively thin lateral sidewall 6132 more tissue scaffolds.
When the movement of cutting element 6050 cuts stroke by it, cutting element 6050 cuts tissue and crosscutting lateral sidewall 6132.Cutting element 6050 is annular the and crosscutting lateral sidewall 6132 adjacent with outer wall 6131；However, cutting element can be Any suitable position transverse wall 6132.Under any circumstance, lateral sidewall 6132 is propped up before and after, during cutting in tissue Tissue is supportted, and prevents from dragging tissue along outer wall 6131 and/or inner wall 6133 or at least reduces its possibility.Similar to tissue branch Support member 6030, tissue support 6130 include the bottom wall 6138 being crosscut at the end of cutting stroke.
Surgical stapling device including nail bin 6240 and anvil block 6220 is disclosed in Figure 89 and Figure 90.Nail bin 6240 is in many sides Noodles are similar to nail bin 6040.Anvil block 6220 is similar to anvil block 6020 and anvil block 6120 in many aspects.Anvil block 6220 includes attachment Shaft 6226 and the annular tissue supporting element 6230 positioned around attachment shaft 6226.Tissue support 6230 includes by structure Cause closely to receive the centre bore of shaft 6226.Tissue support 6230 further includes the tissue pressure of neighbouring anvil block 6220 The annular outer wall 6231 of contracting surface positioning, and further include the lateral sidewall 6232 radially extended from outer wall 6231.Tissue support 6230 do not include inner annular wall, and the inner end of lateral sidewall 6232 is freely bent.Tissue support 6230 further includes bottom wall 6238, The bottom wall is cut by cutting element 6050, is similar to above-mentioned.
Surgical stapling device including nail bin 6240 and anvil block 6220 is molten as shown in Figure 91 and Figure 92.However, reader should manage Solution, the tissue support 6230 of anvil block 6220 are replaced by tissue support 6330.Tissue support 6330 includes being configured to The annular center hole of shaft 6226 can closely be received.Tissue support 6330 further include roof 6332, bottom wall 6338 with And the side wall 6336 extended between roof 6332 and bottom wall 6338.Roof 6332 is parallel with bottom wall 6338 or at least substantially puts down Row；However it is also contemplated that the embodiment that its mesospore 6332 and 6338 is not parallel.Side wall 6336 is parallel or at least substantially puts down Row；However it is also contemplated that the wherein not parallel embodiment of side wall 6336.
Wall 6332,6336 and 6338 limits annular housing 6334 therebetween.Cavity 6334 is closed or extremely on all sides It is few substantially closed.Cavity 6334 extends incessantly around shaft 6226；However, for example, it is also contemplated that wherein cavity 6334 by other embodiments that side wall is interrupted and/or geometry changes.
Similar to above-mentioned, tissue support 6330 is configured to the support group when organizing crosscutting by cutting element 6050 It knits.Tissue support 6330 is snugly received in anvil block 6220 so that tissue support 6330 relative to anvil block 6220 not Movement is not moved at least substantially.In addition, tissue support 6330 includes the box-like section of rigidity, so that in cutting element 6050 When transecting patient tissue, the flexure minimum of tissue support 6330 or not significant.As shown in Figure 91, bottom wall 6338 and inner sidewall 6336 Between there are gaps.This gap can provide some flexibilities in tissue support 6330；However it is also contemplated that this is not present Other embodiments in kind gap.Tissue support 6330 is made of such as plastics；However, in various embodiments, tissue Supporting element 6330 can be for example made of flexible and/or elastomer plastic.
The transecting patient tissue supporting element 6330 during it cuts stroke of cutting element 6050.As shown in Figure 92, cutting element 6050 after transecting patient tissue crosscutting roof 6332, subsequently into cavity 6334.Roof 6332 includes being defined in annular therein Recess 6333, the annular notch are aligned with the annular cutting edge of cutting element 6050.Recess 6333 reduces cuing open for roof 6332 Face and be conducive to cut roof 6332.Cutting element 6050 can also its cut stroke during crosscutting bottom wall 6338.Such as reader As it should be understood that, the roof 6332 of tissue support 6330 and the crosscutting of bottom wall 6338 can drive in the percussion of suture instruments Power pulse is generated in device.Roof 6332 and bottom wall 6338 can be configured to provide different pulses in structure, so that The electronic sensor systems of clinician and/or surgical instruments can distinguish the difference between pulse, and will not be by roof 6332 Incision be mistakenly read as the end of percussion/cutting stroke.
Referring again to Figure 91 and Figure 92, the roof 6332 of tissue support 6330 and the tissue compression surface of anvil block 6220 6022 alignment are at least substantially aligned.Additionally or alternatively, roof 6332 can be relative to tissue compression surface 6022 It is recessed and/or extends above tissue compression surface 6022.The roof 6332 of tissue support is on the forming surface of anvil block 6220 6024 tops extend.Additionally or alternatively, roof 6332 can relative to forming surface 6024 recess and/or with forming table Face 6024 is aligned.
Surgical stapling device including nail bin 6240 and anvil block 6220 is molten as shown in Figure 93 and Figure 94.However, reader should manage Solution, the tissue support 6230 of anvil block 6220 are replaced by tissue support 6430.Tissue support 6430 includes being configured to The annular center hole of shaft 6226 can closely be received.Tissue support 6430 further include roof 6432, bottom wall 6438 with And the side wall 6436 extended between roof 6432 and bottom wall 6438.Wall 6432,6436 and 6438 limits annular housing therebetween 6434.Cavity 6434 is closed on all sides or at least substantially closes.Cavity 6434 surrounds shaft 6226 incessantly Extend；However, for example, it is also contemplated that other embodiments that wherein cavity 6434 is changed by side wall interruption and/or geometry.
Similar to above-mentioned, tissue support 6430 is configured to the support group when organizing crosscutting by cutting element 6050 It knits.Tissue support 6430 is snugly received in anvil block 6220 so that tissue support 6430 relative to anvil block 6220 not Movement is not moved at least substantially.In addition, tissue support 6430 includes rigid polygonal cross-section, so that in cutting element When 6050 transecting patient tissue, the flexure minimum of tissue support 6430 or not significant.As shown in Figure 93, bottom wall 6438 and inner sidewall There are gaps between 6436.This gap can provide some flexibilities in tissue support 6430；However it is also contemplated that not depositing Other embodiments in this gap.Tissue support 6430 is made of such as plastics；However, in various embodiments, Tissue support 6430 can be for example made of flexible and/or elastomer plastic.
As shown in Figure 93 and Figure 94, inner sidewall 6436 is short in lateral wall 3436；However it is also contemplated that wherein lateral wall 6436 The other embodiments shorter than inner sidewall 6436.In addition, roof 6432 is not parallel to bottom wall 6438.More particularly, roof 6432 include sloping portion, the other parts of the crosscutting bottom wall 6438 of the sloping portion and/or roof 6432 and extend.
The transecting patient tissue supporting element 6430 during it cuts stroke of cutting element 6050.As shown in Figure 94, cutting element 6050 after transecting patient tissue crosscutting roof 6432, subsequently into cavity 6434.Cutting element 6050 can also cut stroke at it Period crosscutting bottom wall 6438.
As described above, tissue support disclosed herein is configured to the support group when cutting element cuts tissue It knits.For example, in general, being previously sewn by the tissue that cutting element is cut, that is, stitched during the previous steps in surgical operation It closes.In various examples, such nail can also be cut by cutting element, even if they are by metal such as titanium and/or stainless steel structure At.In other examples, such nail may not be cut by cutting element；But they can be pushed into composition tissue support Material in.No matter follow closely and whether cut by cutting element, tissue support disclosed herein has enough in various examples Intensity and/or rigidity, be more than to prevent from being generated in tissue support by cutting element against the nail that tissue support captures The deformation of local plastic.In at least one described example, local plastic deformation is restricted in any direction relative to nail A upper characteristic length (CL) less than nail.In at least one example, the material of tissue support can be selected, so that Nail against tissue support capture can for example only form plastically deforming area of the diameter less than 2 × CL in tissue support. In other examples, can select the material of tissue support, allow against tissue support capture nail for example Plastically deforming area of the diameter less than 1.5 × CL is only formed in tissue support.The characteristic length of nail may be, for example, the width of crown The forming height of degree or rear span and/or nail leg in its deformed configuration.In addition, tissue support disclosed herein can be by It is constituted firmly with the material of the support nail when nail is cut by cutting element enough.In at least one example, tissue support is constituted Material hardness be equal to or more than constitute be located against tissue support incision nail material hardness.In some instances, The hardness for constituting the material of tissue support is less than the hardness for constituting the material for the nail being cut into；However, the knot of tissue support Structure design is enough to prevent tissue support by plastic elongation more than acceptable plastically deforming area.In some instances, incision group Energy needed for energy needed for forming nail in knitting and organizing is less than incision tissue support.In various examples, composition group The material for knitting supporting element can resist nail chisel.In at least one example, biocompatible lubricant can be placed in tissue support In upper and/or immersion tissue support, to prevent non-magnetic shim capture on tissue support.
In various examples, the tissue compression surface of anvil block and the tissue contacting surface of tissue support are flat or extremely It is few substantially flat.The power applied by anvil block can be distributed to the tissue of large area by this construction.It contemplated in which anvil block Tissue compression surface and/or tissue support the uneven other embodiments of tissue contacting surface.In some instances, The tissue compression surface of anvil block and/or the tissue contacting surface of tissue support include extending therefrom being configured to engage Component or spike are firmly grasped with the tissue of clamping tissue.This class loading clamping components can for example reduce opposite between tissue and anvil block Movement or sliding.In at least one example, on the tissue compression surface of anvil block and the tissue contacting surface of tissue support It is identical for organizing clamping components density.In other examples, the tissue in the tissue contacting surface of tissue support clamps structure Part density is higher than the tissue clamping components density on the compressive surfaces of anvil block.In such an example, when tissue support is opposite When the compressive surfaces of anvil block radially-inwardly position, tissue clamping components can prevent tissue inward flow or sliding.
Anvil block 6520 is disclosed in Figure 95.Anvil block 6520 includes tissue compression surface 6522, and further includes being defined in group The forming pit in compressive surfaces 6522 is knitted, which is configured to be deformed into nail when nail is projected from its nail bin Desired configuration.Each forming pit includes a pair of of cup, wherein each pair of cup is configured to make the leg deformation of nail.For example, A pair of of forming cup may include the first forming cup 6530a of the first leg deformation for being configured to make nail and be configured to Make the second forming cup 6530b of the second leg deformation of nail.First forming cup 6530a and the second forming cup 6530b relative to The axis 6531 extended between first forming cup 6530a and the second forming cup 6530b is mirrored into each other；However, it can also be used It is constructed.
First forming cup 6530a includes first end or outer end 6532 and the second end or inner end 6534.First forming cup 6530a further includes the bottom extended between outer end 6532 and inner end 6534 or bath tub surface 6536.First end 6532 is by structure The forming process for causing the leg that can receive nail and starting leg.First end 6532 includes being configured to towards second The curved surface of the flexure of end 6534 nail leg.Bottom surface 6536 includes being configured at least partly by nail leg towards nail bin The curved surface or concave surface gone back to.The second end 6534 includes being configured to guidance nail leg portion to be detached from forming cup 6530a Curved surface.
Second forming cup 6530b includes the construction similar with the construction of the first forming cup 6530a, and is configured to Make the second leg deformation of nail.The first leg the second leg of direction of first forming cup 6530a guidance nail due to the above reasons, And the second leg the first leg of direction of the second forming cup 6530b guidance nail.In various examples, for example, the first forming cup 6530a and the second forming cup 6530b cooperates so that nail is deformed into B shape configuration；However, forming cup is configured to become nail Form any suitable configuration.
Referring primarily to Figure 96, each forming cup 6530 (6530a and 6530b) is including the first lateral side wall 6537 and first The second lateral side wall 6539 extended between end 6532 and the second end 6534.In various examples, the first lateral side wall 6537 and second lateral side wall 6539 be mirrored into each other relative to the longitudinal axis 6533 at the center for extending through forming cup 6530. In other examples, the first lateral side wall 6537 and the second lateral side wall 6539 are not mutual mirror images.In either case, For example, side wall 6537,6539 is inclined or inclined-plane, towards the center of forming cup, i.e., to guide and follow closely towards axis 6533 Leg.
Each forming cup 6530 includes groove or the channel 6538 being defined in its bottom surface 6536.Groove 6538 is shaping Longitudinally extend between the first end 6532 and the second end 6534 of cup 6530.Groove 6538 is parallel to the center of forming cup 6530 Longitudinal axis 6535 extends and relative to the central longitudinal axis laterally offset.Groove 6538 by forming cup 6530 than being deformed Nail leg it is wide；However it is also contemplated that wherein other embodiments narrower than the leg of nail of groove 6538.In any case Under, groove 6538 is configured to the guidance nail leg of the predefined paths in forming cup 6530.
In various examples, the groove of forming cup 6530 is configured to reverse leg when the leg for making nail deforms. In at least one example, nail is plane or at least substantially plane before deformation.In at least one described example, When nail is projected from nail bin, the leg of nail and base portion are located in the same plane being aligned with longitudinal axis 6535.When nail leg enters When in forming cup 6530, first end 6532 and bottom surface 6536 are tilted and/or are configured in other ways towards ditch Slot 6538 guides leg.Once nail leg enters in groove 6538, it is coplanar to the base portion not with nail that groove 6538 will reverse nail leg.By In above-mentioned reason, it is plane that unshaped, which follows closely configuration, but forming nail configuration is nonplanar.However it is also contemplated that wherein following closely Other embodiments with non-planar configurations before and after it is deformed.
The groove 6538 (for one group of given forming cup 6530) of forming cup 6530 is located in the same of longitudinal axis 6535 On side, and it is configured to for both nail legs to be torqued into the same side of base portion.However it is also contemplated that wherein first following closely Leg is rotated to the side of base portion and the second nail leg be rotated to base portion the other side other embodiments.At least In one such embodiment, first groove 6538 is located on the first side of longitudinal axis 6535, which is configured to First nail leg can be torqued into the first side of base portion, and second groove 6538 is located in second side of longitudinal axis 6535 On, which is configured to for the second nail leg to be torqued into second side of base portion.
For one group of given forming cup 6530, the groove 6538 of forming cup 6530 is conllinear or at least substantially conllinear 's.However it is also contemplated that other embodiments, wherein groove 6538 is located on the same side of longitudinal axis 6535, but not that This is conllinear.In at least one described example, groove 6538 is parallel to each other, and in other such examples, groove 6538 is each other It is not parallel.
Referring primarily to Figure 96, groove 6538 is deeper than the bottom surface 6536 of forming cup 6530.However it is also contemplated that wherein groove There are other embodiments of same depth with the bottom surface of forming cup.
In various examples, when anvil block 6520 is configured for that the one of the longitudinal end actuator of longitudinal staple can be applied When part, forming cup 6530 is arranged to longitudinal row.In at least one described example, the groove 6538 of forming cup is arranged to So that being bent out plane in the same direction by all nails that end effector is disposed.In other examples, groove 6538 is by cloth It sets in the first longitudinal direction row of forming cup 6530 to be bent nail leg in a first direction, and is disposed in the of forming cup 6530 To be bent nail leg on second or different directions in two longitudinal rows.In some instances, groove 6538 is arranged in first party It is bent upwards the leg of the first nail in staple and is bent the second leg followed closely in staple on second or opposite direction.
In various examples, when anvil block 6520 is configured for that the one of the annular end actuator of annular staple can be applied When part, forming cup 6530 is arranged to ring row.In at least one described example, groove 6538 is relative to forming cup 6530 Central longitudinal axis 6535 be located radially outward.In other examples, groove 6538 is vertical relative to the center of forming cup 6530 It is radially-inwardly positioned to axis 6535.In some instances, groove 6538 is located radially outward the first ring in forming cup 6530 In shape row, and radially-inwardly it is located in the second ring row of forming cup 6530.
Than that described above, the forming pit of anvil block may include any suitable configuration.In at least one example, shape recessed Hole may include two forming cups, and the forming cup is relative to central axis two forming cups mirroring each other.Each forming Cup includes the triangle configuration with outer end and inner end.The inner end of a pair of of forming cup is adjacent to each other.Compare inner end in the outer end of forming cup Width, and be configured to receive the leg of nail.Each forming cup further include the bottom extended between outer end and inner end or Bath tub surface, and further include the longitudinal groove being defined in bottom surface, which is configured in forming cup Guide nail leg.In at least one example, longitudinal groove is placed in the middle in the bottom surface of forming cup.
The end effector 7000 of circular stapler component is disclosed in Figure 97 into Figure 99.End effector 7000 includes nail Storehouse, the nail bin include platform 7030 and warehouse 7040.Platform 7030 includes tissue compression surface 7031 and is defined in compressive surfaces Nail cavity 7032 in 7031.Nail cavity 7032 is arranged to first annular row or annular row and the second ring row or outer ring is arranged. Each nail cavity 7032 in interior row includes that first be removedly stored therein in follows closely 7070a, and each nail cavity in outlet 7032 include the second nail 7070b being removedly stored therein in.
End effector 7000 further includes being configured to that the staple drivers for releasing nail bin will be followed closely.For example, nail bin includes It is configured to project the first annular nail driver 7060a of the first staple 7070a, and is configured to from warehouse 7040 project the second ring row staple drivers 7060b of the second staple 7070b.Staple drivers 7060a and 7060b are located in restriction It is aligned in nail cavity 7032 in platform 7030 and/or with the nail cavity.Staple drivers 7060a and 7060b can be in nail cavities 7032 Interior sliding is to project nail 7070a and 7070b from nail cavity 7032 respectively.
End effector 7000 further includes anvil block 7020.Anvil block 7020 includes tissue compression surface 7021 and is defined in compression Nail shapes pit 7022 in surface 7021.Nail shapes pit 7022 is arranged to first annular row or annular row and the second ring Shape row or outer ring row.Nail shapes pit 7022 is aligned with nail cavity 7032, so that when nail 7070a, 7070b is projected from nail cavity 7032 When, nail 7070a, 7070b are contacted with nail shapes pit 7022.
End effector 7000 further includes firing member 7056, which is configured to staple drivers 7060a and 7060b is promoted into nail cavity 7032 to project nail 7070a and 7070b from nail cavity 7032 respectively.Firing member 7056 wraps Include base portion 7054 and ramp 7055.Base portion 7054 is slidably located in the recessed portion being defined in percussion driving device 7050 In 7052.Ramp 7055 is slidably located in the slit 7041 being defined in warehouse 7040.It is as follows to retouch in more detail It states, ramp 7055 is configured to slide and come into contact in slit 7041 staple drivers 7060a, 7060b with from nail cavity 7032 project nail 7070a, 7070b.
Than that described above, firing member 7056 may move through firing schedule with from nail cavity 7032 project nail 7070a, 7070b.During firing schedule, firing member 7056 is moved along bending or bow-shaped route, and the bending or bow-shaped route are by slit 7041 limit.Referring primarily to Figure 97, slit 7041 includes first end 7042 and the second end 7049 and the company between them Continuous path.The ramp 7055 of firing member 7056 is located in first end 7042 when firing schedule starts, and is being fired It is located at the end of stroke in the second end 7049.The first end 7042 of slit 7041 is aligned with interior nail chamber 7032, and The second end 7049 of slit 7041 is aligned with outlet nail cavity 7032.Slit 7041 further includes prolonging around central longitudinal axis 7090 The first peripheral portion 7043 stretched, the central longitudinal axis extend through end effector 7000.First periphery of slit 7041 Part 7043 is aligned with the staple drivers 7060a in interior nail chamber 7032 and extends below the staple drivers.Firing member Ramp 7055 sequentially engage staple drivers 7060a, to move through the first periphery of slit 7041 in firing member 7056 Sequentially percussion nail 7070a when part 7043.
First peripheral portion 7043 around the consistent of longitudinal axis 7090 or at least substantially consistent radius of curvature by limiting It is fixed；However it is also contemplated that wherein inconsistent other embodiments of the radius of curvature of the first peripheral portion 7043.At at least one In the example, the first peripheral portion 7043 includes spiral.In other words, in the illustration being described, longitudinal axis 7090 is being surrounded When extension, the first peripheral portion 7043 is retreated far from longitudinal axis 7090.
Second peripheral portion 7045 of slit 7041 is aligned and with the staple drivers 7060b in outlet nail cavity 7032 at this Extend below staple drivers.The ramp 7055 of firing member sequentially engages staple drivers 7060b, to move in firing member 7056 Move sequentially percussion nail 7070b when across the second peripheral portion 7045 of slit 7041.Second peripheral portion 7045 is by around vertical To the consistent of axis 7090 or at least substantially consistent radius of curvature limits；However it is also contemplated that wherein the second peripheral portion The inconsistent other embodiments of 7045 radius of curvature.In at least one described example, the second peripheral portion 7045 includes Spiral.In other words, in the illustration being described, when extending around longitudinal axis 7090, the second peripheral portion 7045 is far from longitudinal Axis 7090 retreats.
Than that described above, slit 7041 includes the transition among the first peripheral portion 7043 and the second peripheral portion 7045 Part 7044.During firing schedule, ramp 7055 sequentially slides through the first peripheral portion 7043, transition portion 7044, Then pass through the second peripheral portion 7045.Transition portion 7044 allows firing member 7056 in the first curvature radius of the first staple It is deviated between the second curvature radius of the second staple.In certain embodiments, the first peripheral portion 7043 and the second periphery Transition portion 7044 between part 7045 may be unnecessary.In at least one described example, the first peripheral portion 7043 may include the first helical configuration, and the second peripheral portion 7045 may include the second helical configuration, second helical configuration Such as it is aligned so that the end of the first helical configuration is aligned with the starting of the second helical configuration.
Firing member 7056 is driven by percussion driving device 7050 along its percussion path.For example, percussion driving device 7050 It is driven by hand-crank and/or electric motor around longitudinal axis 7090.Percussion driving device 7050 is therein including being defined in Drive recess 7052.The base portion 7054 of firing member 7056 is located in drive recess 7052.Drive recess 7052 is big In the base portion 7054 of firing member 7056, so that base portion 7054 can be moved or be floated in drive recess 7052.Driving recess Portion 7052 is limited by the side wall that the movement of base portion 7054 is limited in recessed portion 7052.When percussion driving device 7050 is around vertical When rotating to axis 7090, the side wall of drive recess 7052 contacts with base portion 7054 and is forced through drive member 7056 Slit 7051.As described above, the radius of curvature of slit 7051 has one or more variations, and when firing member 7056 moves When moving through such variation, the base portion 7054 of firing member 7056 can slide in drive recess.
As described above, sequentially disposing the nail in the first staple or interior staple, the second staple or outer is then sequentially disposed Nail in staple.Such embodiment can for example control the inner periphery of colon before outside suture.In other embodiments In, the nail in outer staple is sequentially disposed, the nail in interior staple is then sequentially disposed.Such embodiment for example can to Boundary is formed before interior suture in colonic tissue.
In various examples, than that described above, the first nail 7070a and the second nail 7070b unshaped height having the same. In at least one described example, the first nail 7070a and the second nail 7070b are shaped as identical forming height.It is other this In class example, the first nail 7070a is shaped as the first forming height, and the second nail 7070b can be shaped as different from first Second forming height of forming height.In at least one described example, of the first forming height than outer staple of interior staple Two forming heights are short.For example, this construction can provide suture tissue and not suture the more progressive transition between tissue.Other In example, the first forming height of interior staple is higher than the second forming height of outer staple.For example, this construction can make to suture The innermost layer tissue of intestines is for example more flexible.
In some instances, than that described above, the first nail 7070a has the first unshaped height, and the second nail 7070b With the second unshaped height for being different from the first unshaped height.In at least one described example, the first nail 7070a and the Two nail 7070b are shaped as identical forming height.In other such examples, the first nail 7070a is shaped as the first forming Highly, and the second nail 7070b is shaped as the second forming height different from the first forming height.
There are two annular staples for the tool of end effector 7000；However, end effector can have any appropriate number of ring Staple row.For example, end effector can have, there are three annular staples.In at least one described example, in first annular row Nail can have the first unshaped staple height, and the nail in the second ring row can have the second unshaped staple height, and third annular Third nail in row can have third unshaped staple height.In addition, the nail at least one described example, in first annular row There can be the first deformation staple height, the nail in the second ring row there can be the second deformation staple height, and in third ring row Third nail can have third to deform staple height.
Percussion driving device 7150 is shown in Figure 100 into Figure 105.Percussion driving device 7150 includes that can surround longitudinal axis The rotatable drive shaft 7152 of rotation.Percussion driving device 7150 further includes three-level sequence actuator assembly, and three-level sequence is driven Dynamic device assembly includes the first driver or inner driver 7154a, the second driver or medium drive 7154b and third driving Device or outer driver 7154c.Drive shaft 7152 includes drive pin 7151 extending therefrom.Drive pin 7151 driver 7154a, Driving slit is extended through in each of 7154b and 7154c.For example, the first driver 7154a is therein including being defined in First driving slit 7153a, the second driver 7154b includes being defined in the second driving slit 7153b therein, and third is driven Dynamic device 7154c includes being defined in third driving slit 7153c therein.Slit 7153a, 7153b and 7153c is driven not to have phase Same configuration；However, driving slit 7153a, 7153b and 7153c have and are in alignment with each other at drive pin 7151 or at least basic The juxtaposed configuration of upper alignment.For example, drive pin 7151 is in the non-firing position in Figure 100, and drive slit 7153a, 7153b and 7153c is aligned with drive pin 7151.
Than that described above, Figure 100 shows driver 7154a, 7154b and 7154c in non-firing position.Work as drive shaft When 7152 rotations pass through the first part of its firing schedule, referring now to Figure 101, the rotation of drive pin 7151 passes through perimeter path, In the perimeter path, drive pin 7151 engagement driving slit 7153a side wall and towards distal side push the first driver 7154a or The first driver is set to carry out cam movement towards distal side.It is worth noting that, drive pin 7151 is not in the first part of firing schedule Period drives driver 7154b and 7154c towards distal side.As it can be seen that driving slit 7153b and 7153c goes in percussion such as in Figure 100 It is aligned in the entire first part of journey with the perimeter path of drive pin 7151.First driver 7154a is configured to One driver 7154a fires first annular staple when shifting towards distal side.
When the rotation of drive shaft 7152 passes through the second part of its firing schedule, referring now to Figure 102, drive pin 7151 revolves Turn through perimeter path, in the perimeter path, the side wall of the engagement driving of drive pin 7151 slit 7153b simultaneously pushes the towards distal side Two driver 7154b make the second driver carry out cam movement towards distal side.It is worth noting that, drive pin 7151 is not firing Driver 7154c is driven towards distal side during the second part of stroke.Similar to above-mentioned, driving slit 7153a and 7153c is being fired It is aligned on the entire second part of stroke with the perimeter path of drive pin 7151.Second driver 7154b is configured to The annular staple of percussion second when second driver 7154b is shifted towards distal side.
When the rotation of drive shaft 7152 passes through the Part III of its firing schedule, referring now to Figure 103, drive pin 7151 revolves Turn through perimeter path, in the perimeter path, the side wall of the engagement driving of drive pin 7151 slit 7153c simultaneously pushes the towards distal side Three driver 7154c make third driver carry out cam movement towards distal side.Similar to above-mentioned, driving slit 7153a and 7153b It is aligned on the entire Part III of firing schedule with the perimeter path of drive pin 7151.Third driver 7154c is configured to Cutting element can be disposed when third driver 7154c is shifted towards distal side；However, in certain embodiments, third driving Device 7154c can for example dispose third staple.
It follows closely between percussion stage, the second nail percussion stage and tissue-cutting phase first without weight due to the above reasons, It is folded.Their timings in order.Therefore, deform nail and cut tissue required power to be unfolded in entire firing schedule.In addition, hitting Hair driving device 7150 cannot cut tissue before tissue suture.It contemplated in which and hit in the first nail percussion stage, the second nail There are the various optionally embodiments of some overlappings between hair stage and/or tissue-cutting phase.In at least one such implementation In scheme, drive slit 7153a, 7153b and 7153c configuration it is adaptable at make the first driver 7154a and second drive The movement presence of device 7154b partly overlaps and/or the movement of the second driver 7154b and third driver 7154c exist It partly overlaps.
Referring primarily to Figure 103 and Figure 104, driver 7154a, 7154b and 7154c include preventing or at least inhibiting driver The mating features that 7154a, 7154b and 7154c rotate relative to each other.For example, the first driver 7154a includes longitudinal key 7155a, the longitudinal key are located in the longitudinal slit 7156b being defined in the second driver 7154b.Key 7155a and slit 7156b is configured to allow the first driver 7154a relative to the second driver 7154b longitudinal sliding motion, but stops first Rotary motion between driver 7154a and the second driver 7154b.Similarly, the second driver 7154b includes longitudinal key 7155b, the longitudinal key are located in the longitudinal slit 7156c being defined in third driver 7154c.Key 7155b and slit 7156c is configured to allow the second driver 7154b relative to third driver 7154c longitudinal sliding motion, but stops second Rotary motion between driver 7154b and third driver 7154c.
For driver 7154a, 7154b and the 7154c of bouncing back, drive shaft 7152 is rotated in mutually opposite directions.In the example In, drive shaft 7152 sequentially engages the side wall of driving slit 7153c, drives the side wall of slit 7153b, and then engagement driving is narrow The side wall of slot 7153a, so that third driver 7154c, the second driver 7154b and the first driver 7154a return to it and do not hit It sends out position (Figure 100).
Driving device 7250 is fired as shown in Figure 106.Driving device 7250 is fired with similar to percussion driving device 7150 Mode operate.Percussion driving device 7250 includes the drive shaft 7252 that can be rotated about longitudinal axes.Drive shaft 7252 includes Cam face or ramp 7256 of the rotation by several stages of firing schedule.Firing driving device 7250 further includes the first driving Device 7254a, the second driver 7254b and third driver 7254c, these drivers are logical when firing driving device 7250 and rotating Overdrive axis 7252 cam 7256 engage.In the first stage of firing schedule, the engagement of cam 7256 is defined in the first driving Cam face 7255a on device 7254a simultaneously drives the first driver 7254a towards distal side.It is convex in the second stage of firing schedule Wheel 7256 engages the cam face 7255b being defined on the second driver 7254b and drives the second driver 7254b towards distal side, And in the phase III of firing schedule, cam 7256 engages the cam face 7255c being limited on third driver 7254c And third driver 7254c is driven towards distal side.
First cam face 7255a is shorter than the second cam face 7255b, and therefore, the first driver 7254a have than Second driver 7254b short firing schedule.Similarly, the second cam face 7255b is shorter than third cam face 7255c, and And therefore, the second driver 7254b has the firing schedule shorter than third driver 7254c.For example, it is this construction can be used for by Different staples is formed to different forming heights.In other embodiments, driver 7254a, 7254b and 7254c can have There is any suitable firing schedule.In at least one embodiment, driver 7254a, 7254b and 7254c has such as phase Same firing schedule.For example, this construction can be used for forming different staples to identical forming height.
The one of the nail bin 4410 of at least one embodiment being used together with circular surgical staplers tool according to Figure 107 Partial perspective view.A variety of circular surgical staplers tools are known.For example, submitting on August 26th, 2015 entitled “SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING The U.S. Patent Application Serial Number 14/836,110 of INSTRUMENTS " discloses various circular surgical staplers tool constructions, this is specially Benefit application full text is hereby incorporated by reference.On September 26th, 2014 entitled " the CIRCULAR FASTENER submitted The U.S. Patent Application Serial of CARTRIDGES FOR APPLYING RADIALLY EXPANDING FASTENER LINES " Number 14/498,070 discloses various circular surgical staplers constructions, and the complete disclosure of the patent application is accordingly with reference side Formula is incorporated herein.As described in these bibliography, circular surgical staplers generally include frame assembly, which includes It is configured to for anvil block to be operably linked to the attachment part of circular surgical staplers.
In general, anvil block includes the one or more toroidal anvil head for supporting nail shapes pit.Anvil block is rod-shaped Object or trochar part are attached to anvil head, and are configured to be removably coupled to the anvil block of circular stapler instrument Attachment part.Various circular surgical staplers tools include for dress selectively that anvil block is mobile toward and away from surgery nail bin It sets, so that destination organization can be clamped between anvil block and the platform of surgery nail bin.Surgery nail bin removedly stores wherein Multiple surgical staples, the multiple surgical staples are arranged to one corresponding with the construction of the nail shapes pit provided in anvil block Or multiple annular arrays.Nail is removedly stored in the correspondence nail cavity being formed in nail bin, and is supported on operationally On the corresponding part of the mobile promotion device assembly of the alternative being received in circular stapler.Circular stapler further includes annular Knife or cutting element, the endless knife or cutting element are configured to the tissue that incision is clamped between anvil block and nail bin.
Referring again to Figure 107, nail bin 4410 includes the warehouse 4411 for limiting annular bin platform surface 4412.Warehouse 4411 wraps Include the annular row 4420 of interior nail cavity 4422 spaced apart and the outer ring row 4440 of outer nail cavity 4442 spaced apart.Interior nail cavity 4422 interlock relative to outer nail cavity 4442 spaced apart, visible such as in Figure 107.Inside surgical staples 4430 are supported on each interior nail In chamber 4422, and outside surgical staples 4450 are supported in each outer nail cavity 4442.Outside nail 4450 in outer ring row 4440 Can have and follow closely 4430 different features from the inside in annular row 4420.For example, as shown in the embodiment of Figure 108, outside Nail 4450 has unfashioned " the gull wing " configuration.In particular, each outside nail 4450 includes a pair extended from crown 4452 Leg 4454,4464.Each leg 4454,4464 respectively includes the vertical portion 4456,4466 extended from crown 4452.One In a embodiment, vertical portion 4456,4466 can be parallel to each other.However, in shown construction, vertical portion 4456,4466 It is not parallel each other.For example, the angle A between the crown 4452 in shown construction and vertical portion 4456,44661Greater than 90 Degree.Referring to Figure 108.Other details about nail configuration is found in the entitled " FASTENER submitted on June 30th, 2014 The U.S. Patent Application Serial Number 14/319,008 of CARTRIDGE COMPRISING NON-UNIFORM FASTENERS ", it is existing For U.S. Patent Application Publication No.2015/0297232, the entire disclosure is hereby incorporated by reference.However, Other vertical portions 4456,4466 can be relative to crown 4452 with other angles arrangement.Make vertical leg 4456,4466 relative to Crown 4452 is that this construct can help to follow closely that be temporarily retained in its right with the advantage that the angle greater than 90 degree orients It answers in nail cavity.
At least one leg 4454,4464 includes the end sections to extend internally.For example, the embodiment party shown in Figure 108 In case, each leg 4454,4464 includes the Leg portion to extend internally.In shown construction, Leg portion 4458 is from vertical Leg portion 4456 extends internally, and Leg portion 4468 extends internally from vertical Leg portion 4466.It can such as in Figure 108 See, Leg portion 4458 is shorter than Leg portion 4468.In other words, crown 4452 and Leg portion 4458 are from vertical Leg portion The distance between 4456 intilted points HAIt is inside from vertical Leg portion 4466 greater than crown 4452 and Leg portion 4468 The distance between inclined point HC.Therefore, at least one embodiment, distance HBLess than length HD.4458 phase of Leg portion For the inclined angle A of vertical Leg portion 45562Leg portion 4468 can be equal to incline relative to vertical Leg portion 4466 Oblique angle A3Or angle A2And A3It can be different from each other.Other details about nail configuration is found on June 30th, 2014 The United States Patent (USP) Shen of entitled " the FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS " that submits Please sequence number 14/319,008, be now U.S. Patent Application Publication No.2015/0297232, be herein incorporated by reference.
In at least one embodiment, each inside surgical staples 4430 can have configuration shown in Figure 108.Such as scheming In 108 as it can be seen that inside surgical staples 4430 have crown 4432 and two vertical legs 4434,4436 extending therefrom.Vertical leg Portion 4434,4436 can relatively orthogonally extend from crown 4432 or they can be greater than 90 degree of angle A4Extend.This Class construction can help to nail 4430 and be temporarily retained in its corresponding nail cavity 4422.However, vertical leg 4434,4436 is with difference Angle extends from crown 4432.In some embodiments, angle A4It is equal to each other.In other embodiments, angle A4Each other It is different.In the embodiment of illustration, 4450 respective unshaped height UFH having the same are followed closely in inside nail 4430 and outside.It is interior Side nail 4430 and outside nail 4450 are formed by conventional surgical staple line.In at least one embodiment, it is used to form outside nail The diameter of 4450 staple line is greater than the diameter for being used to form the staple line of inside nail 4430.In other embodiments, inside nail and Outside nail can have the same diameter, and can be formed by the line with other diameters.In some constructions, inside nail and outside Nail can be formed by the staple line of same type.Therefore, in such construct, the linear diameter of inside nail and outside nail will be identical. However, in another embodiment, inside nail and outside nail can unshaped shape/configuration having the same, but by having not With two kinds of linear diameter, different staple lines are formed.Equally, at least one construction, the crown width C W of each outside nail 4450O Greater than the crown width C W of each inside nail 4430I.Other details about nail configuration is found in what on June 30th, 2014 submitted The U.S. Patent Application Serial of entitled " FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS " Number 14/319,008, it is now U.S. Patent Application Publication No.2015/0297232, is herein incorporated by reference.
Back to Figure 107, nail bin 4410 includes the outer edge 4414 extended above platform surface 4412.In surgical operation Period, clinician can adjust the position of anvil block relative to the storehouse of circular stapler.In at least one such embodiment, Nail bin 4410 further includes from the platform features portion 4416 and 4418 that platform surface 4412 extends.It is such as in Figure 107 as it can be seen that a series of The knife that inner platform features 4416 are arranged in the interior row 4420 of nail cavity 4422 and are centrally located is open between 4413, knife or cutting structure Part will pass through the knife during percussion process and be open.Platform features portion 4416 can relative to interior nail cavity and opening 4413 forming and Positioning, as shown in Figure 107, Figure 109 and Figure 110.For example, each inner platform features 4416 can have the wall with knife opening 4413 Coextensive flat wall part 4415 and the taper or inclined main part 4417 adjacent with the row of interior nail cavity 4422.Referring to figure 109 and Figure 110.In the embodiment shown in Figure 107, platform features portion 4416 is oriented at two adjacent interior nail cavities 4422 Between gap in, and as shown in the figure between 4422 pairs of nail cavity staggeredly.Cavity extended configuration or platform in the system is special Sign portion can be used for the lower pressure being frequently run onto flat platform storehouse.Construction disclosed in this invention can also contribute to mitigation group Knit movement and sliding.Since the sliding of tissue is usually undesirable, outer diameter keeps features bigger and more. Augmenting tissue tension/shearing when inside diameter features can be used for passing through beside internal internal diameter when blade, this can make system more It cuts well.However, platform features portion 4416 can have different shape and configuration, and can be located on platform surface 4412 Different location.
Equally as it can be seen that each other outer nail cavities 4442 include related to its every one end such as in Figure 107, Figure 109 and Figure 110 The outer platform features 4418 of connection.When following closely 4450 from the injection of nail bin 4410, outer platform features 4418 are in platform surface 4412 Top extends and guides outside nail 4450 towards anvil block.In such embodiment, until firing member makes outside follow closely 4450 courts It is moved to anvil block, outside nail can just extend above outer platform features portion 4418.Referring primarily to Figure 107, at least one implementation In scheme, outer platform features 4418 do not extend around entire corresponding outer nail cavity 4442.First outer platform features 4418 are determined Position is at adjacent with the first end of corresponding exocoel 4442, and the second outer platform features 4418 are oriented and exocoel 4442 The second end is adjacent.As it can be seen that outer platform features 4418 are associated with the outer nail cavity 4442 every one such as in Figure 107.This Class construction, which can be used for reducing total pressure and minimize tissue, to be stretched and moves.However, in other embodiments, it is flat outside first Platform features and the second outer platform features 4418 can be associated with each outer nail cavity 4442.In other embodiments, outside Platform features portion can extend around the entire periphery of corresponding exocoel.As it can be seen that inner platform features 4416 are more flat than outer such as in Figure 109 Platform features 4418 are short.In other words, each inner platform features prominent certain distance, distance above platform surface 4412 Less than each outer platform features 4418 above platform surface 4412 distance outstanding.Each outer platform features can be in platform 4412 top distance outstanding of surface is outstanding apart from identical above platform surface 4412 with outer edge 4414.In addition, same As it can be seen that each outer platform features 4418 have general conical or tapered exterior contour such as in Figure 109, can help to prevent Only organize to hang in platform features portion during the colon and rectum of stapler head insertion patient.
Above-mentioned platform features construction can provide one or more advantages.For example, upright outer edge can help to prevent tissue It is slided in storehouse platform.The vertical edge may also include the repeat patterns of spikes/low- points, rather than form a continuous lip Edge.Internal upright nature portion can also contribute to keep tissue adjacent to blade and lead to improved cutting.Internal platform features can Between each cavity or in alternative construction, platform features portion may include a continuous upright antelabium.It may expect Be the quantity of balance platform features to minimize high-tensile strength/compressional zone quantity, while reaching desired tissue fixed amount.Chamber Body concentric character portion can be used for minimizing the additional purpose of tissue flowing from its region outstanding in nail leg.Such construct is also Form desired nail conducive to when nail leg projects and is transitioned into and receives anvil block pit, the receiving anvil block pit can by it is corresponding at Shape pit composition.Such part pit features increase low compressional zone, while being conducive to when nail leaves storehouse from storehouse supporting leg Portion.The construction is to make the distance minimization for following closely necessary before meeting with anvil block pit " jump ".Tissue flow tends to from storehouse Radially outward increase.Referring to Figure 118, improved upright outboard row extension have when being inserted upwardly into colon due to It hangs histozoic trend for tubulose.
Figure 109 and Figure 110 shows the use of the surgery nail bin 4410 combined with anvil block 4480.Anvil block 4480 includes anvil head Portion part 4482, the anvil head part are operably supported nail shaping insert or part 4484 and edge bearing circle 4490.Edge bearing The knife 4492 that circle 4490 is supported for and is supported in stapler head is in facing relationship.In the embodiment of illustration, nail at Shape insertion piece 4484 is made of such as steel, stainless steel etc., and include inside nail shapes pit 4486 interior row and outside nail at The outlet of shape pit 4488.Each inside nail shapes pit 4486 corresponds to one in interior nail cavity 4422, and each outside Nail shapes pit 4488 corresponds to one in outer nail cavity 4442.In shown construction, when anvil block 4480 is relative to storehouse platform table When face 4412 is moved to its firing position, inside nail shapes pit 4486 compares outside nail shapes pit 4488 closer to storehouse platform table Face 4412.In other words, the first gap g between the first nail shaped portion 4485 and storehouse platform surface 44121Or first nail at Shape distance is less than the second gap g between the second nail shaped portion 4487 and storehouse platform surface 44122Or second nail forming distance.
Furthermore, it can be seen that inside nail 4430 is respectively supported on its corresponding interior nail cavity 4422 such as in Figure 109 and Figure 110 Inherence pushes on the correspondence inner driver part 4502 of device assembly 4500, and to be supported on its corresponding for each outside nail 4450 In outer nail cavity 4442 on corresponding outer driver part 4504.Promoting towards anvil block 4480 pushes device assembly 4500 to will lead to inside Nail 4430 and outside nail 4450 are driven to its corresponding corresponding nail shapes pit 4486,4488 shaping contacts, such as Figure 110 institute Show.In addition, knife 4492 is across the tissue being clamped in anvil block 4480 and platform surface 4412 and passes through edge bearing circle 4490 Frangible bottom 4491 is promoted towards distal side.Such construct is used to provide forming height FH for outside nail 4450O, which is greater than The forming height FH of inside nail 4430I.In other words, the outlet 4440 of outside nail 4450 is shaped as bigger " B " form, from And bigger trapping volume and/or higher nail forming height are generated to mitigate the high tissue compression near outer staple 4440.More Big B form can also improve the blood flow moved towards drainage in these.In various examples, the outlet 4440 of outside nail 4450 passes through Using bigger crown, nail leg width and/or nail leg thickness, and there is bigger mounted resistance.
Nail quantity used in every nail can change.In one embodiment, for example, in the presence of more than inside nail 4430 More outside nails 4450.Another embodiment is used than the more inside nails 4430 of outside nail 4450.In various examples, outside The linear diameter of side nail 4450 is greater than the linear diameter of inside nail 4430.Inside nail 4430 and outside nail 4450 can it is having the same not at Shape height UFH.Crown width C W in the outlet 4440 of outside nail 4450OCrown greater than the interior row 4420 of inside nail 4430 is wide Spend CWI.The gull wing configuration of outside nail 4450, which uses, is located at the bending section of crown corresponding to its at different distances.It is flat using having The staged anvil block configuration on the storehouse platform surface 4412 of smooth (no ladder) is generated by uniform driver or pusher stroke Nail with differing formed height.
Figure 111 shows another nail bin embodiment 4610.As it can be seen that nail bin 4610 includes storehouse platform such as in Figure 111 4612, which includes annular row 4620 and the outer ring of outer nail cavity 4642 spaced apart of interior nail cavity 4622 spaced apart Row 4640.Interior nail cavity 4622 is interlocked relative to outer nail cavity 4642 spaced apart, visible such as in Figure 111.Inside surgical staples 4630 It is supported in each interior nail cavity 4622, and outside surgical staples 4650 are supported in each outer nail cavity 4642.In addition, outer edge 4614 extend above platform surface 4612.In various embodiments, than that described above, until firing member make nail 4630, 4650 move towards anvil block, and nail is just projected into 4612 top of platform surface.The depth of its corresponding nail cavity relative to storage nail, this Class embodiment can be frequently utilized that tingle.In other embodiments, when nail is in its non-firing position, the leg of nail is prominent To 4612 top of platform surface.In at least one such embodiment, nail bin 4610 further includes extending from platform surface 4612 Platform features portion 4616 and 4618.
Equally as it can be seen that each other interior nail cavities 4622 include inner platform spy associated with its every one end such as in Figure 111 Sign portion 4616.When corresponding inside nail 4630 is projected from nail bin 4610, inner platform features 4616 are above platform surface 4612 Extend and guides corresponding inside nail 4630 towards anvil block.In such embodiment, until firing member makes inside follow closely 4630 courts It is moved to anvil block, inside nail can just extend above interior platform features portion 4616.In the example shown, inner platform features 4616 Do not extend around entire corresponding interior nail cavity 4622.First inner platform features 4616 are oriented first with corresponding inner cavity 4622 End is adjacent, and the second inner platform features 4616 be oriented it is adjacent with the second end of inner cavity 4622.However other In embodiment, inner platform features 4416 can be associated with nail cavity 4622 in each.In other embodiments, inner platform Features can extend around the entire periphery of corresponding interior nail cavity.It is special by using the platform in concentric pattern with different height Sign portion, wherein they are associated with the cavity every one, it is possible to provide lower pressure tissue space region, while balancing them To guide nail leg as much as possible as long as possible.In other words, such construct can minimize tissue amount of flow, and reduction is applied to The stagnation pressure strength of destination organization.
Referring still to Figure 111, each outer nail cavity 4642 includes outer platform features associated with their each end 4618.When following closely 4650 and projecting from nail bin 4610, outer platform features 4618 extend above platform surface 4612 and towards anvils Seat guidance outside nail 4650.In such embodiment, until firing member moves outside nail 4650 towards anvil block, outside is followed closely It can just extend above outer platform features portion 4618.As it can be seen that in the example shown such as in Figure 111, outer platform features 4618 Do not extend around entire corresponding outer nail cavity 4642.First outer platform features 4618 are oriented first with corresponding exocoel 4642 End is adjacent, and the second outer platform features 4618 be oriented it is adjacent with the second end of the exocoel 4642.Such as in Figure 111 In as it can be seen that outer platform features 4618 are associated with each outer nail cavity 4642.However, in other embodiments, the first He Second outer platform features 4618 can be associated with the outer nail cavity 4642 every one.In other embodiments, outer platform is special Sign portion can extend around the entire periphery of corresponding exocoel.As it can be seen that inner platform features 4616 and outer such as in Figure 112 and Figure 113 Platform features portion 4618 extends same distance above platform surface 4612.In other words, their height having the same.This Outside, equally such as in Figure 112 and Figure 113 as it can be seen that each inner platform features 4416 and each outer platform features 4618 have General conical or tapered exterior contour can help to prevent the group during the colon and rectum that stapler head is inserted into patient It knits and hangs in platform features portion.
Figure 112 and Figure 113 shows the use for the surgery nail bin 4610 connecting with anvil block 4680.Anvil block 4680 includes anvil head Portion part 4682, the anvil head part are operably supported nail shaping insert or part 4684 and edge bearing circle 4690.Edge bearing The knife 4692 that circle 4690 is supported for and is supported in stapler head is in facing relationship.In the embodiment of illustration, nail at Shape insertion piece 4684 is made of such as steel, stainless steel etc., and include inside nail shapes pit 4686 interior row and outside nail at The outlet of shape pit 4688.Each inside nail shapes pit 4686 corresponds to one in interior nail cavity 4622, and each outside Nail shapes pit 4688 corresponds to one in outer nail cavity 4642.In shown construction, 4686 anomaly platform of inside nail shapes pit The distance g on surface 46121It is identical as outside nail shapes pit 4688.
Furthermore, it can be seen that inside nail 4630 is supported in the correspondence for pushing device assembly 4700 such as in Figure 112 and Figure 113 In correspondence in driver portion 4702 in nail cavity 4622.Outside nail 4650 is supported on corresponding outer driver part 4704 In corresponding outer nail cavity 4642.It is promoted towards anvil block 4680 and device assembly 4700 is pushed to will lead to inside nail 4630 and outside 4650 quilts of nail Driving is to its corresponding corresponding nail shapes pit 4686,4688 shaping contacts, as shown in Figure 113.In addition, knife 4692 passes through quilt The tissue that is clamped between the anvil block 4680 and platform surface 4612 and frangible bottom 4691 for passing through edge bearing circle 4690 is pushed away towards distal side Into.In the example shown in Figure 112 and Figure 113, each inside follows closely 4630 by having the first linear diameter D1And not with first Forming height L1The first staple line formed.For example, the first linear diameter D1Can be about 0.0079 " -0.015 " (increment is usually , and the first unshaped height L 0.0089 ", 0.0094 " and 0.00145 ")1It can be about 0.198 " -0.250 ".Each outside nail 4650 by having the second linear diameter D2And there is the second unshaped height L2The second staple line formed.In Figure 112 and Figure 113 institute In the embodiment shown, D1<D2, and L1<L2.However, as it can be seen that inside nail 4630 and outside nail 4650 are by shape such as in Figure 113 As forming height FH having the same.With often preferably keep hemostasis small diameter follow closely interior row compared with, on outside compared with Thick tailor's tack often provides high tearing and bursting strength.In other words, inside staple is closer, can more keep stopping blooding well, And the compression of outer staple is fewer, then can promote preferably healing and blood flow.Even if in addition, the nail shape with longer leg portion At height identical with the nail with shorter leg portion, more B bendings are also ensured that, this may make that the nail in longer leg portion is stronger simultaneously And it is more likely to be suitably shaped into and is enough to keep under high loading conditions.Nail quantity used in every nail can change.One In a embodiment, for example, the quantity for the inside nail 4630 that interior row 4620 has is identical as the outlet 4640 of outside nail 4650.? In various constructions, the crown width for following closely 4650 is greater than the crown width that inside follows closely 4630.In other embodiments, nail 4630, 4650 can crown width having the same.In other constructions, nail 4630,4650 can have the above-mentioned gull wing to design.For example, nail At least one leg may include aduncate end sections or two legs may include end aduncate toward each other Part.Such nail can be used in annular row or outer ring row or both annular row and outer belt row.
Figure 114 shows another round nail bin embodiment 4810 comprising storehouse platform 4812, the storehouse platform include interval Three ring rows 4820,4840,4860 for the nail cavity opened.Interior row or first row 4820 include nail cavity or the first nail in more than first Chamber 4822, each is arranged with first angle.In each nail cavity 4822 be operably supported wherein corresponding inside nail or First nail 4830.Inner cavity 4822 orients the first nail 4830 relative to tangential direction with identical homogeneous angular.In shown example In, each inside nail 4830 is by having the first nail diameter D1The first staple line formed.In one example, the first staple line diameter D1 Can be about 0.0079 " -0.015 " (increment is usually 0.0089 ", 0.0094 " and 0.00145 ").Referring to Figure 117, each inside Nail 4830 includes the first crown 4832 and two the first legs 4834.First crown has the first crown width C1, and it is each First leg 4834 has the first unshaped leg length L1.In one example, the first crown width C1It can be about 0.100 "- 0.300 ", and the first unshaped leg length L1It can be about 0.198 " -0.250 ".It first leg 4834 can be respectively relative to One crown 4832 is with angle A1Arrangement.Angle A1It can be about 90 ° or it can be slightly larger than 90 °, so that the first leg 4834 is slightly It is flared out, to help for the first nail 4830 to be maintained in its corresponding first nail cavity 4822.
Figure 115 and Figure 116 are gone to, nail bin 4810 is intended to be used in combination with anvil block 4900, which includes the first nail forming Row or first row 4902 in two of first pair 4903 for interlocking or being at an angle of of pit 4904.First nail shapes pit 4904 Each first pair 4903 corresponds to one first nail 4830.One the first nail shapes pit 4904 corresponds to first nail leg 4834, and the pair of 4903 another first nail shapes pit 4904 corresponds to another first nail leg 4834.It is such Be configured to establish forming nail configuration, wherein first nail 4830 the first nail leg 4834 be formed not with this it is specific first nail 4830 the first crown 4832 is coplanar, so that first leg 4834 is formed on the side of the first crown 4832, and another One the first leg 4834 is formed on the other side of the first crown 4832.This " three-dimensional " forming nail configuration is relative to some One nail shapes pit 4904 is shown in Figure 115.
Can most specifically it see such as in Figure 116, storehouse platform 4812 is constructed with " staged ".Storehouse platform 4812 include with The annular of interior nail cavity or the first nail cavity 4822 row or the corresponding interior storehouse platform part of first annular row 4820 or the first storehouse platform Part 4814.Such as in Figure 116 furthermore, it can be seen that when anvil block 4900 is moved to closure or clamped position, the packet of anvil block 4900 Part containing the first nail shapes pit 4904 is spaced apart the first clearance distance g with terrace part 48141。
Referring again to Figure 114, Figure 116 and Figure 117, intermediate row or second row 4840 include more than second intermediate nail cavities or the Two nail cavities 4842, each is arranged with second angle.Each intermediate nail cavity 4842 is wherein being operably supported in corresponding Between follow closely or second nail 4850.Centre nail or second are followed closely 4850 relative to tangential direction with identical uniform second by intermediate cavity 4842 Angle orientation.However, second angle is different from first angle.In other words, when the first nail and the second nail are supported on them respectively From the first chamber and the second chamber in when, the axis of the first crown of each first nail 4830 is in extension by final with adjacent the The extension axis intersection of second crown of two nails 4850.As it can be seen that each second nail or intermediate nail such as in Figure 116 and Figure 117 4850 include the second crown or base portion 4852 and two the second legs 4854.Base portion 4852 can have the section shape of slightly rectangle It shape and is formed by planarization material piece.Second nail leg 4854 can have such as circular section profile.Second nail or intermediate nail can wrap Include entitled " the SURGICAL STAPLING CONFIGURATIONS FOR CURVED submitted at such as on August 26th, 2015 It is various disclosed in the U.S. Patent Application Serial Number 14/836,110 of AND CIRCULAR STAPLING INSTRUMENTS " Configuration is followed closely, which, which is incorporated by reference, is incorporated herein.Possess and prolongs from the base portion part with rectangular cross sectional profile The round nail leg stretched can provide base portion part and the nail leg of no priority bending plane.Second nail 4850 includes bending part 4856, nail leg 4854 extends from base portion part 4852 at the bending part.Bending part 4856 can have generally square Section profile.The square profiles and rectangular profile of bending part 4856 and base portion part 4852 are respectively to round nail leg 4854 provide rigid connection portion and pillar.Round nail leg 4854 eliminate section be square, rectangle or any shape with vertex The priority bending plane that the nail leg of shape or non-uniform shapes can have.Each second nail leg 4854 has second diameter D2.Extremely In a few embodiment, D2>D1.Second base portion or crown 4852 have the second crown width C2.In a kind of construction, C2>C1。 It second leg 4854 can be respectively relative to the second base portion or crown 4852 with angle A2Arrangement.Angle A2It can be about 90 ° or it can To be slightly larger than 90 ° so that the second leg 4854 is opened slightly outwards, with help for the second nail 4850 to be maintained at its corresponding second In nail cavity 4842.
Figure 115 and Figure 116 are gone to, anvil block 4900 further includes second for interlocking or being at an angle of of the second nail shapes pit 4914 To 4,913 two intermediate rows or second row 4912.Second pair 4913 of each of second nail shapes pit 4914 corresponds to one the Two nails 4850.One the second nail shapes pit 4914 corresponds to second nail leg 4854, and the pair of 4913 it is another A second nail shapes pit 4914 corresponds to another second nail leg 4854.Such construct is used to establish forming nail configuration, wherein Second leg 4854 is shaped as non-coplanar with the second base portion 4852 of specific second nail 4850.This " three-dimensional " forming nail configuration It is shown in Figure 115 relative to some second nail shapes pits 4914.
Can most specifically it see such as in Figure 116, storehouse platform 4812 further includes and intermediate nail cavity or the second nail cavity 4842 Intermediate annular row or 4840 corresponding second storehouse platform part 4816 of the second ring row.Furthermore, it can be seen that working as anvil such as in Figure 116 When seat 4900 is moved to closure or clamped position, the part comprising the second nail shapes pit 4914 of anvil block 4900 and terrace part 4816 are spaced apart the second clearance distance g2.In the example shown, g2>g1。
Referring again to Figure 114, Figure 116 and Figure 117, outboard row or third row 4860 relative to the second nail cavity 4842 comprising setting The multiple outside nail cavities of third or third nail cavity 4862 of scale cun, so that each outer nail cavity or third nail cavity 4862 are adjacent at two The second chamber 4842 between cross over certain distance.Each outer nail cavity 4862 is operably supported corresponding outside wherein and follows closely or the Three nails 4870.Outside nail or third nail 4870 are oriented tangent with peripheral direction by exocoel 4862.Such as in Figure 116 and Figure 117 As it can be seen that each third nail or outside nail 4870 include third crown or base portion 4872 and two third legs 4874.Base portion 4872 can have the slightly section shape of rectangle and be formed by planarization material piece.Third nail leg 4874 can have such as circle to cut open Facial contour.Third nail or outside nail 4870 may include in such as on August 26th, the 2015 entitled " SURGICAL submitted The U.S. of STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS " is special Various nail configurations disclosed in sharp patent application serial numbers 14/836,110, which, which is incorporated by reference, is incorporated herein.It gathers around There is the round nail leg extended from the base portion part with rectangular cross sectional profile to can provide the base portion of no priority bending plane Part and nail leg.Third nail 4870 includes bending part 4876, and nail leg 4874 is from base portion part 4872 at the bending part Extend.Bending part 4876 can have generally square section profile.Bending part 4876 and base portion part 4872 are just Square contour and rectangular profile provide rigid connection portion and pillar to round nail leg 4874 respectively.Round nail leg 4874, which eliminates, to be cutd open The priority bending plane that face is square, rectangle or any shape with vertex or the nail leg of non-uniform shapes can have.Extremely In a few embodiment, D3>D2.Third base portion or crown 4872 have third crown width C3, and each third leg 4874 have third unshaped leg length L3.In a kind of construction, C3>C2And L3>L2.It third leg 4874 can be respectively opposite In third base portion or crown 4872 with angle A3Arrangement.Angle A3It can be about 90 ° or it can be slightly larger than 90 °, so that third leg Portion 4874 is opened slightly outwards, to help for third nail 4870 to be maintained in its corresponding third nail cavity 4862.
Go to Figure 115 and Figure 116, anvil block 4900 further includes the outer of outside nail shapes pit or third nail shapes pit 4918 Row 4916.Each third nail shapes pit 4918 corresponds to a third nail 4870.Can most specifically it see such as in Figure 116, Storehouse platform 4812 further includes arranging 4860 corresponding third storehouse platform parts with the outlet or third of outer nail cavity or third nail cavity 4862 4818.Such as in Figure 116 furthermore, it can be seen that when anvil block 4900 is moved to closure or clamped position, anvil block 4900 includes the The part of three nail shapes pits 4918 is spaced apart third space distance g with terrace part 48183.In the example shown, g3>g2.Such as Furthermore, it can be seen that at least one embodiment, tissue thickness compensation part 4920 is followed closely with each outside or third in Figure 116 Nail 4870 is used in combination.Tissue thickness compensation part may include being embedded with the weaving material of oxidized regenerated cellulose (ORC) to promote Hemostasis.Tissue thickness compensation part 4920 may include entitled " the IMPLANTABLE LAYER submitted on 2 24th, 2014 In the U.S. Patent Application Serial Number 14/187,389 (U.S. Patent Application Publication No.2015/0238187) of ASSEMBLIES " Any one of disclosed various tissue thickness compensation parts construction, the complete disclosure of the patent application is accordingly with reference side Formula is incorporated herein.As it can be seen that tissue thickness compensation part 4920 has the thickness for being marked as " a " such as in Figure 116.Implement at one In scheme, tissue thickness compensation part have about 0.015 " -0.045 " thickness.However, other thickness can be used.
Therefore, at least one embodiment shown in Figure 114 to Figure 117, nail bin 4810 can be in three nails The nail of different number is used in each row.In a kind of construction, interior staple includes having minimum linear diameter and most short unshaped leg The conventional nail of minister's degree.Each first nail has shortest crown width, and each first follows closely relative to tangential direction with equal Even angle orientation.The configuration of centre nail is different from the first nail configuration.Centre nail each leg have appropriateness linear diameter and Unshaped leg length.Each intermediate nail has the crown width more slightly larger than the crown width that inside is followed closely, and each intermediate nail It is oriented relative to tangential direction with uniform angle, but the interior row relative to inside nail orients at different angles.Each outside The configuration of nail is similar to the configuration of intermediate nail.Each of the third leg of each outside nail has and inside nail and intermediate nail Leg linear diameter compare maximum linear diameter.The crown width of each outside nail is noticeably greater than the nail of inside nail and intermediate nail It is preced with width.Each outside nail is oriented to tangent with the peripheral direction in storehouse.Outer staple is using the weave thickness for being embedded with ORC Compensating part (space fabric) is to promote to stop blooding.Staged anvil block and staged storehouse platform generate different forming nail heights, wherein Nail with most short forming height is located in interior row, and the nail with longest forming height is located in outlet.Corresponding to interior staple It is arranged inside with the anvil block pit of intermediate staple by " inclination " and forms three-dimensional nail in intermediate row." bathtub shaped " anvil block pit is corresponding In outer staple.In at least one embodiment, nail can be fired sequentially.For example, the nail in interior row and intermediate row can be first It is fired, and then fires the nail in outlet.Endless knife cuts the tissue of clamping during percussion process.
As described in the various embodiments of the disclosure, circular stapler instrument includes anvil block and nail bin.In anvil block and nail bin One of or both can relative to other persons between open configuration and closed configuration move to capture tissue therebetween.Nail bin exists Interior receiving nail is arranged in round nail cavity row or at least partly in round nail cavity.Nail is deployed to capture from its corresponding nail cavity with circular row Tissue in, and the forming pit in anvil block correspondence circular row forming.Percussion driving device is configured to It projects and follows closely from nail bin during firing the firing schedule of driving device.
The nail forming that the anvil block of circular stapler instrument generally includes tissue compression surface and is defined in tissue compression surface The annular array of pit.Anvil block further includes the shaft for being attached installation part and extending from attachment installation part.The shaft is constructed At the closure driving device that can be releasably attached to circular stapler instrument, so that anvil block can be toward and away from circular stapler The nail bin of tool is mobile.
Nail bin and anvil block can individually advance in patient's body, and combine at operative region.In various examples, nail bin Such as travel across the narrow tubular body of patient, such as colon.Nail bin may include several tissue contact characteristic portions, such as ladder Formula platform and pit extension.In order to avoid when nail bin is advanced towards destination organization, unintentionally patient harm, the disclosure are removed other Except also propose to it is several tissue contact characteristic portions various modifications.
Referring to Figure 118, broken section is illustrated and is pressed when advancing in patient body when nail bin 15500 against tissue (T) Circular surgical apparatus nail bin 15500.Multiple structure feature portions of nail bin 15500 are modified to form the outline border of specific profile Frame 15502 is with protective tissue.Nail bin 15500 includes the nail cavity of multiple ring rows.In at least one example, nail cavity 15510 Outlet 15504 at least partly around nail cavity 15512 interior row 15506, as shown in Figure 118.Nail cavity 15510 and 15512 is by structure It causes that nail 15530 and 15531 can be accommodated respectively.
Relationship of the inner and outer description of term relative to central axis 15533.For example, inner tissue's contact surface 15518 is than outer Tissue contacting surface 15516 is closer to central axis 15533.
As shown in Figure 119, nail bin 15500 includes staged storehouse platform 15508.It is flat that outlet 15504 is defined in staged storehouse In the outer tissue contacting surface 15516 of platform 15508, and interior row 15506 is defined in inner tissue's contact of staged storehouse platform 15508 In surface 15518.Outer tissue contacting surface 15516 declines from 15518 staged of inner tissue's contact surface, which contacts table Face generates the gradient for reducing friction when pressing nail bin 15500 against tissue.
In some instances, outer tissue contacting surface 15516 is parallel to or at least substantially parallel to inner tissue's contact table Face 15518.In other examples, outer tissue contacting surface 15516 is inclined to so that being limited by outer tissue contacting surface 15516 The first plane transverse to the second plane limited by inner tissue's contact surface 15518.Between the first plane and the second plane Limit angle.The angle can be acute angle.In at least one example, for example, the angle can for selected from greater than about 0 ° and be less than or Equal to any angle in the range of about 30 °.In at least one example, for example, the angle can be selected from greater than about 5 ° and small In or equal to any angle in the range of about 25 °.In at least one example, for example, the angle can be for selected from greater than about 10 ° And less than or equal to about 20 ° in the range of any angle.Inclined outer tissue contacting surface 15516 can be in 15500 phase of nail bin Friction or obstruction to tissue is reduced when mobile for tissue.In at least one example, outer tissue contacting surface 15516 is tilted Also decline from 15518 staged of inner tissue's contact surface.
In at least one example, the interior section of outer tissue contacting surface 15516 is flat or at least substantially puts down Smooth, and the outer edge 15548 of outer tissue contacting surface 15516 is inclined by, is bent and/or chamfers, with opposite in nail bin 15500 The friction or obstruction to tissue are reduced when organizing mobile.For example, nail cavity 15510 resides in outer tissue contacting surface 15516 In flat internal part.The outer edge 15550 of inner tissue's contact surface 15518 can also be inclined by, chamfers and/or be bent, with Nail bin 15500 reduces the friction or obstruction to tissue relative to tissue when mobile.
In order to accommodated in the nail cavity 15510 of outlet 15504 and the nail cavity 15512 of interior row 15504 have it is identical or at least The nail of substantially the same unshaped height, the nail cavity 15510 of outlet 15504 include pit extension 15514.Pit extension 15514 are configured to control when following closely 15530 from the injection of its corresponding nail cavity 15510 and guide nail.In some instances, example Such as, pit extension 15514, which is configured to accommodate, has the unshaped bigger than the nail of inner tissue contact surface 15518 The nail of height.
As shown in Figure 119, nail cavity 15510 in outlet 15504 and two adjacent nail cavities 15512 in interior row 15506 it Between gap 15520 be laterally aligned or be at least substantially aligned.Nail cavity 15510 includes first end 15522 and the second end 15524.One first end 15526 in the second end 15524 and two continuous nail cavities 15512 is stacked, so that being located in Nail leg 15530a at the second end 15524 and the nail leg 15531a radially aligned being located at first end 15526 or at least Substantial alignment, as shown in Figure 118.Equally, the first end 15522 of nail cavity 15510 with it is another in two continuous nail cavities 15512 One the second end 15528 is stacked.
Pit extension 15514 includes from outer tissue contacting surface 15,516 first collet 15532 outstanding, with concealed nailing The tip 15536 for extending beyond outer tissue contacting surface 15516 of leg 15530a.First collet 15532 includes from first end 15522 ends 15538 outstanding extend far from end 15538 to form inner sidewall 15540 and the outside of the first collet 15532 Wall 15542.In at least one example, the first collet 15532 is limited or is at least substantially limited to including first end 15522 Nail cavity 15510 periphery 15535 a part on " C " shape wall for extending.
In order to reduce the friction to tissue, inner sidewall 15540 is projected to from outer tissue contacting surface 15516 compares lateral wall 15542 bigger height.In other words, the height of lateral wall 15542 is lower than inner sidewall 15540.This construction generate for from Inner sidewall 15540 arrives the gradient of the smooth transition of outer tissue contacting surface 15516 to lateral wall 15542 again.Show at least one In example, inner sidewall 15540 and inner tissue's contact surface 15518 have identical or extremely relative to outer tissue contacting surface 15516 Few substantially the same height.Alternatively, inner sidewall 15540 and inner tissue's contact surface 15518 have connects relative to outer tissue Touch the different height in surface 15516.In some instances, referring to outer tissue contacting surface 15516, inner sidewall 15540 relative to The height of inner tissue's contact surface 15518 is lower.This construction is generated for from inner tissue's contact surface 15518 to inner sidewall 15540 arrive the gradient of the smooth transition of outer tissue contacting surface 15516 to lateral wall 15542 again.
Inner tissue's contact surface 15518, inner sidewall 15540, lateral wall 15542 and/or outer tissue contacting surface 15516 limit It is shaped as the independent sector of the outer framework 15502 of profile；However, such part keeps sufficiently closing to each other as shown in Figure 118, So that tissue cannot capture therebetween when nail bin 15500 is against tissue pressing.In addition, one or more of these parts can Including outer surface inclined, that form profile, curved, arc and/or beveling to reduce the friction to tissue.Such as figure Shown in 118, the upper surface 15544 of lateral wall 15542 and the upper surface 15546 of inner sidewall 15540 are inclined by, form profile, is curved Bent, arc-shaped and/or beveling is to limit the outer framework 15502 to form profile.
In at least one example, upper surface 15544 and upper surface 15546 limit clinoplain, and the clinoplain is lateral In the first plane limited by outer tissue contacting surface 15516 and the second plane limited by inner tissue's contact surface 15518.? In at least one example, first angle is limited between clinoplain and the first plane.It can also be in clinoplain and the second plane Between limit second angle.First angle and second angle can having the same or at least substantially identical values.Alternatively, The value of one angle may differ from second angle.In at least one example, first angle and/or second angle are acute angle.Extremely In a few example, for example, first angle be selected from greater than about 0 ° and less than or equal to about 30 ° in the range of any angle. In at least one example, for example, first angle be selected from greater than about 5 ° and less than or equal to about 25 ° in the range of any angle Degree.In at least one example, for example, first angle be selected from greater than about 10 ° and less than or equal to about 20 ° in the range of appoint What angle.In at least one example, for example, second angle be selected from greater than about 0 ° and less than or equal to about 30 ° in the range of Any angle.In at least one example, for example, second angle is the model selected from greater than about 5 ° and less than or equal to about 25 ° Enclose interior any angle.In at least one example, for example, second angle is selected from greater than about 10 ° and less than or equal to about 20 ° In the range of any angle.
Than that described above, pit extension 15514 includes the second collet 15534, and second collet is similar in many aspects In the first collet 15532.Similar to the first collet 15532, the second collet 15534 is prominent from outer tissue contacting surface 15516, with Hide the tip for extending beyond outer tissue contacting surface 15516 of nail leg.Second collet 15534 includes from the second end 15524 End 15538 outstanding extends from end 15538 to form the inner sidewall 15540 and lateral wall 15542 of the second collet 15534.
Although a pit extension 15514 as shown in Figure 119, it is to be understood that, for example, one or more of the other pit Extension 15514 can be prominent from outer tissue contacting surface 15516.In at least one example, for example, 15532 He of the first collet Second collet 15534 is connected via side wall to limit the pit extension entirely around nail cavity.
Many surgical instrument systems as described herein are actuated by electric motor；However, surgical instrument system as described herein It can actuate in any suitable manner.In all cases, for example, surgical instrument system as described herein can be by being manually operated Trigger actuate.In all cases, motor disclosed herein may include one or more portions of robot control system Point.In addition, any one of end effector disclosed herein and/or tool assembly can be with robotic surgical Instrument systems one It rises and uses.Figure 82 A schematically shows robotic surgical Instrument system 20 '；However, entitled " SURGICAL STAPLING The U.S. Patent Application Serial of INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS " Number 13/118,241 (is now for example disclosed in more detail robotic surgery for U.S. Patent Application Publication No.2012/0298719) Several examples of device system.
The deployment and deformation for having combined nail describe surgical instrument system as described herein；However, implementation as described herein Scheme is without being limited thereto.For example, it is envisioned that the various embodiments of fastener such as fixture or tack of the deployment in addition to nail. Furthermore, it is also contemplated that utilize the various embodiments of any appropriate device for seal tissue.For example, according to various embodiment party The end effector of case may include the electrode for being configured to heating and seal tissue.In addition, for example, according to certain embodiment party The end effector of case can apply vibrational energy and carry out seal tissue.
The complete disclosure of following patents is hereby incorporated by reference:
Entitled " the LINEAR STAPLER WITH IMPROVED FIRING STROKE " submitted on March 12nd, 1997 European patent application No.EP 795298；
On 2 25th, 1997 entitled " the TRIGGER MECHANISM FOR SURGICAL INSTRUMENTS " announced United States Patent (USP) No.5,605,272；
Entitled " the LINEAR STAPLER WITH IMPROVED FIRING that on December 16th, 1997 announces The United States Patent (USP) No.5,697,543 of STROKE "；
The beauty of entitled " METHOD FOR MAKING A SURGICAL STAPLER " that on November 10th, 2005 announces State patent application publication No.2005/0246881；
The U.S. Patent application of on September 6th, 2007 entitled " the METHOD FOR STAPLING TISSUE " announced is public Cloth No.2007/0208359；
Entitled " the DISPOSABLE LINEAR SURGICAL STAPLING that on July 9th, 1985 announces The United States Patent (USP) No.4,527,724 of INSTRUMENT "；
On August 11st, 1992 entitled " the FAST CLOSURE DEVICE FOR LINEAR SURGICAL announced The United States Patent (USP) No.5,137,198 of STAPLING INSTRUMENT "；
The United States Patent (USP) of entitled " FLEXIBLE SUPPORT SHAFT ASSEMBLY " that April 11 nineteen ninety-five announces No.5,405,073；
Entitled " the SURGICAL CUTTING AND STAPLING INSTRUMENT that on January 29th, 2013 announces The United States Patent (USP) No.8,360,297 of WITH SELF ADJUSTING ANVIL "；
Entitled " the SURGICAL INSTRUMENT COMPRISING SYSTEMS FOR submitted on July 30th, 2015 The U.S. of ASSURING THE PROPER SEQUENTIAL OPERATION OF THE SURGICAL INSTRUMENT " is special Sharp patent application serial numbers 14/813,242；
Entitled " the SURGICAL INSTRUMENT COMPRISING SEPARATE submitted on July 30th, 2015 The U.S. Patent Application Serial Number 14/813,259 of TISSUE SECURING AND TISSUE CUTTING SYSTEMS "；
Entitled " the SURGICAL INSTRUMENT COMPRISING SYSTEMS FOR submitted on July 30th, 2015 The U.S. Patent Application Serial Number 14/813,266 of PERMITTING THE OPTIONAL TRANSECTION OF TISSUE "；
Entitled " the SURGICAL INSTRUMENT COMPRISING A SYSTEM FOR submitted on July 30th, 2015 The U.S. Patent Application Serial Number of BYPASSING AN OPERATIONAL STEP OF THE SURGICAL INSTRUMENT " 14/813,274；
The United States Patent (USP) of entitled " ELECTROSURGICAL HEMOSTATIC DEVICE " that April 4 nineteen ninety-five announces No.5,403,312；
On 2 21st, 2006 entitled " the SURGICAL STAPLING INSTRUMENT HAVING announced The United States Patent (USP) No.7,000,818 of SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS "；
On September 9th, 2008 entitled " the MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING announced The United States Patent (USP) No.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) No.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) No.7,670,334 of END EFFECTOR "；
The United States Patent (USP) of entitled " SURGICAL STAPLING INSTRUMENTS " that on July 13rd, 2010 announces No.7,753,245；
Entitled " the SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER that on March 12nd, 2013 announces The United States Patent (USP) No.8,393,514 of CARTRIDGE "；
The United States Patent (USP) Shen of entitled " SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES " It please sequence number 11/343,803；It is now United States Patent (USP) 7,845,537；
Entitled " the SURGICAL CUTTING AND FASTENING INSTRUMENT submitted on 2 14th, 2008 The U.S. Patent Application Serial Number 12/031,573 of HAVING RF ELECTRODES "；
Entitled " the END EFFECTORS FOR A SURGICAL CUTTING AND submitted on 2 15th, 2008 The U.S. Patent Application Serial Number 12/031,873 of STAPLING INSTRUMENT " is now United States Patent (USP) No.7,980,443；
The U.S. Patent Application Serial Number of entitled " MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT " 12/235,782, it is now United States Patent (USP) No.8,210,411；
Entitled " POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY The U.S. Patent Application Serial Number 12/249,117 of RETRACTABLE FIRING SYSTEM " is now United States Patent (USP) No.8, 608,045；
Entitled " the MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT submitted on December 24th, 2009 The U.S. Patent Application Serial Number 12/ of WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY " 647,100；It is now United States Patent (USP) No.8,220,688；
The U.S. Patent Application Serial Number 12/ of entitled " the STAPLE CARTRIDGE " that submits on September 29th, 2012 893,461, it is now United States Patent (USP) No.8,733,613；
The U.S. Patent application of entitled " the SURGICAL STAPLING INSTRUMENT " that submits on 2 28th, 2011 Sequence number 13/036,647 is now United States Patent (USP) No.8,561,870；
Entitled " SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT The U.S. Patent Application Serial Number 13/118,241 of ARRANGEMENTS " is now United States Patent (USP) No.9,072,535；
Entitled " the ARTICULATABLE SURGICAL INSTRUMENT submitted on June 15th, 2012 The U.S. Patent Application Serial Number 13/524,049 of COMPRISING A FIRING DRIVE "；It is now United States Patent (USP) No.9, 101,358；
Entitled " the STAPLE CARTRIDGE TISSUE THICKNESS SENSOR submitted on March 13rd, 2013 The U.S. Patent Application Serial Number 13/800,025 of SYSTEM " is now U.S. Patent Application Publication No.2014/0263551；
Entitled " the STAPLE CARTRIDGE TISSUE THICKNESS SENSOR submitted on March 13rd, 2013 The U.S. Patent Application Serial Number 13/800,067 of SYSTEM " is now U.S. Patent Application Publication No.2014/0263552；
Entitled " the SURGICAL CUTTING AND FASTENING INSTRUMENT submitted on January 31st, 2006 The U.S. Patent Application Publication No.2007/0175955 of WITH CLOSURE TRIGGER LOCKING MECHANISM "；And
Entitled " the SURGICAL STAPLING INSTRUMENT WITH AN submitted on April 22nd, 2010 The U.S. Patent Application Publication No.2010/0264194 of ARTICULATABLE END EFFECTOR " is now United States Patent (USP) No.8,308,040。
It is also implementable that these embodiments are repaired although certain embodiments has been combined to describe various devices herein Change and modification.In addition, when materials for certain parts are disclosed, it is possible to use other materials.In addition, according to more Kind embodiment, single component can be replaced by multiple components, and multiple components can also be replaced by single component, to execute Given one or more functions.Above-mentioned specific embodiment and following the claims are intended to cover all such modifications and change Type.
Apparatus as disclosed herein is designed to discard after a single use or it is designed to be used for multiple times. However, in either case, device can exercise again use by finishing after use at least once.Finishing may include step Any combination, the step includes but is not limited to provision for disengagement, later cleaning or the specific component of alternative and subsequent Ressemble device.In particular, finishing facility and/or operating team's detachable apparatus, and in cleaning and/or alternative Particular elements after, device can be ressembled for subsequent use.It will be appreciated by those skilled in the art that trimming device can It uses various techniques to be dismantled, clean/replace and re-assembly.The use of such technology and resulting prosthetic device are equal Within the scope of application.
Apparatus as disclosed herein can be handled before the surgery.Firstly, can get new or used instrument, and It is cleaned as needed.Then, it can carry out disinfection to instrument.In a kind of sterilization technology, the instrument is placed on closed And in the container (such as, plastics or TYVEK bag) of sealing.Then container and instrument can be placed in the radiation that can penetrate the container , such as γ radiation, X-ray and/or high energy electron.Radiation can kill the bacterium on instrument and in container.Instrument after disinfection It can then be stored in sterile chamber.Sealing container can keep instrument to be in germ-free condition, until will in medical facilities The container is opened.Any other technology known in the art also can be used to sterilize device, the technology includes but unlimited In β radiation, γ radiation, ethylene oxide, plasma peroxide and/or steam.
Although the present invention has been described as having exemplary design, can further be repaired in the spirit and scope of the disclosure Change the present invention.Therefore, this application is intended to cover use any modification of the invention of General Principle of the invention, purposes or change Type.
Any patent, announcement or other public materials incorporated in this article in full or in part by reference only simultaneously The material entered is not incorporated herein in existing definition of the present invention, statement or the conflicting range of other public materials.Cause This, and at the necessary level, disclosure specifically listed herein replaces any conflict being herein incorporated by reference Material.It is said that being herein incorporated by reference but conflicting with the existing definitions, statements, or other disclosure materials listed herein Any material or part thereof will not generated only between incorporated material and existing public material under the degree that conflicts simultaneously Enter.

Claims (19)

1. a kind of end effector being used together with surgical stapling device, wherein the end effector includes:
Warehouse, the warehouse include longitudinal axis；
Multiple nail cavities, the multiple nail cavity are limited in the warehouse, and the multiple nail cavity includes:
First annular nail chamber, the first annular nail chamber extend around the longitudinal axis；And
Second ring row nail cavity, the second ring row nail cavity extend around the longitudinal axis；
Nail, the nail can be stored in the nail cavity with removing；
Anvil block, the anvil block are configured to deform the nail；And
Cutting element；And
Ramp, the ramp can be rotated around the longitudinal axis to project the nail from the nail cavity, then described in deployment Cutting element is to cut the tissue captured between the warehouse and the anvil block.
2. end effector according to claim 1 further includes staple drivers, wherein the ramp be configured to it is suitable Engage the staple drivers sequence sequentially to project the nail from the nail cavity.
3. end effector according to claim 2, wherein the ramp is stored in the second row in sequentially injection The nail being stored in the first row nail cavity is sequentially projected before the nail in nail cavity.
4. end effector according to claim 1, wherein the warehouse includes being configured to guide the ramp Helical slot, and wherein the helical slot extends around the longitudinal axis, while constantly close to the longitudinal axis Line.
5. end effector according to claim 1, wherein the warehouse includes being configured to guide the ramp Helical slot, and wherein the helical slot extends around the longitudinal axis, while constantly from the longitudinal axis It retreats.
6. end effector according to claim 1, wherein the warehouse includes being configured to receive the ramp Bending slit, and wherein the bending slit extends around the longitudinal axis, while close to the longitudinal axis.
7. end effector according to claim 1, wherein the warehouse includes being configured to receive the ramp Bending slit, and wherein the bending slit extends around the longitudinal axis, while constantly from the longitudinal axis It retreats.
8. end effector according to claim 1, wherein the nail includes:
Multiple first nails, wherein each first nail is located in the first annular nail chamber, and wherein each described First nail is by the first unshaped High definition；And
Multiple second nails, wherein each second nail is located in the second ring row nail cavity, and wherein each described Second nail is by the second unshaped High definition different from the first unshaped height.
9. end effector according to claim 8, wherein the anvil block is configured to make the first nail deformation To the first forming height and second nail is made to be deformed into the second forming height, and wherein first forming height is different In second forming height.
10. a kind of end effector of surgical stapling device, wherein the end effector includes:
Warehouse, the warehouse include platform and longitudinal axis；
Multiple nail cavities, the multiple nail cavity are limited in the warehouse；
Nail, the nail can be stored in the nail cavity with removing；
Cutting element；And
Firing member, the firing member can be rotated around the longitudinal axis, described in sequentially projecting from the nail cavity Then the cutting element is sequentially deployed in above the platform by nail.
11. end effector according to claim 10 further includes staple drivers, wherein the firing member is configured to The staple drivers can be engaged sequentially sequentially to project the nail from the nail cavity.
12. end effector according to claim 10, wherein the multiple nail cavity includes:
First annular nail chamber, the first annular nail chamber extend around the longitudinal axis；And
Second ring row nail cavity, the second ring row nail cavity extends around the longitudinal axis, wherein the firing member exists It sequentially projects and is stored in the first row nail cavity before sequentially projecting the nail being stored in the second row nail cavity The nail.
13. end effector according to claim 10, wherein the warehouse includes being configured to hit described in guidance The helical slot of component is sent out, and wherein the helical slot extends around the longitudinal axis, while constantly close to described Longitudinal axis.
14. end effector according to claim 10, wherein the warehouse includes being configured to hit described in guidance The helical slot of component is sent out, and wherein the helical slot extends around the longitudinal axis, while constantly from described vertical It is retreated to axis.
15. end effector according to claim 10, wherein the warehouse includes being configured to hit described in receiving The bending slit of component is sent out, and wherein the bending slit is around longitudinal axis extension, while close to the longitudinal axis Line.
16. end effector according to claim 10, wherein the warehouse includes being configured to hit described in receiving The bending slit of component is sent out, and wherein the bending slit extends around the longitudinal axis, while constantly from described vertical It is retreated to axis.
17. end effector according to claim 12, wherein the nail includes:
Multiple first nails, wherein each first nail is located in the first annular nail chamber, and wherein each described First nail is by the first unshaped High definition；And
Multiple second nails, wherein each second nail is located in the second ring row nail cavity, and wherein each described Second nail is by the second unshaped High definition different from the first unshaped height.
18. end effector according to claim 17 further includes the anvil block for being configured to make the nail deformation, Described in anvil block be configured to make first nail to be deformed into the first forming height and second nail made to be deformed into the Two forming heights, and wherein first forming height is different from second forming height.
19. a kind of with end effector that is being configured to apply the surgical stapling device of annular nail and be used together, the end Portion's actuator includes:
Warehouse；
Multiple nail cavities, the multiple nail cavity are limited in the warehouse, and the multiple nail cavity includes:
First annular nail chamber；
Second ring row nail cavity；
First group of nail, first group of nail can be stored in the first annular nail chamber with removing；
Second group of nail, second group of nail can be stored in the second ring row nail cavity with removing；
Multiple staple drivers, wherein each staple drivers are configured to project the nail from the nail cavity；
Cutting element；
Slit is driven, the driving slit is limited along bow-shaped route, wherein the bow-shaped route includes:
The first part extended below the first annular nail chamber；
Second part after the first part, the second part extend below the second ring row nail cavity；With And
Part III after the second part, the Part III extend below the cutting element；And
Ramp, the ramp can be slided in the driving slit, wherein the ramp is configured to engage the nail Driver is to project the nail from the nail cavity and dispose the cutting element.
CN201780034400.6A 2016-04-01 2017-03-27 Circular stitching system including load control Active CN109219401B (en)

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US15/089,349 US10682136B2 (en) 2016-04-01 2016-04-01 Circular stapling system comprising load control
US15/089,349 2016-04-01
PCT/US2017/024255 WO2017172585A1 (en) 2016-04-01 2017-03-27 Circular stapling system comprising load control

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Cited By (3)

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WO2021083143A1 (en) * 2019-10-28 2021-05-06 苏州英途康医疗科技有限公司 Clip cartridge apparatus and surgical instrument
CN114259270A (en) * 2021-12-23 2022-04-01 苏州贝诺医疗器械有限公司 Electric anastomat with percussion degree display function
CN116138830A (en) * 2023-03-24 2023-05-23 苏州卡夫思曼医疗科技有限公司 Circular tissue suturing device

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