CN109310413A - Anvil block for surgical stapling device modifies component - Google Patents

Anvil block for surgical stapling device modifies component Download PDF

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Publication number
CN109310413A
CN109310413A CN201780033809.6A CN201780033809A CN109310413A CN 109310413 A CN109310413 A CN 109310413A CN 201780033809 A CN201780033809 A CN 201780033809A CN 109310413 A CN109310413 A CN 109310413A
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CN
China
Prior art keywords
nail
anvil block
shaft
anvil
assembly
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
CN201780033809.6A
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Chinese (zh)
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CN109310413B (en
Inventor
J·R·摩根
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 US15/089,331 external-priority patent/US10376263B2/en
Application filed by Angiotech Pharmaceuticals Inc filed Critical Angiotech Pharmaceuticals Inc
Publication of CN109310413A publication Critical patent/CN109310413A/en
Application granted granted Critical
Publication of CN109310413B publication Critical patent/CN109310413B/en
Active legal-status Critical Current
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Abstract

The present invention provides a kind of surgery system, the surgery system includes anvil block, and the anvil block has (1) elongated slot, and the elongated slot longitudinally extends along the length of the anvil block, and (2) multiple first nail shapes pits.The surgery system further includes the anvil block modification component for being releasably attached to the anvil block, wherein anvil block modification component includes multiple second nail shapes pits.Furthermore, the surgery system further includes the nail bin with multiple nails, when anvil block modification component is not attached to the anvil block, the multiple nail can be shaped by the multiple first nail shapes pit, and wherein when anvil block modification component is attached to the anvil block, the nail can be shaped by the multiple second nail shapes pit.

Description

Anvil block for surgical stapling device modifies component
Background technique
The present invention relates to surgical instruments, and in various arragement constructions, 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 are managed in combination with following attached drawing according to being described below together with its advantage Solution:
Fig. 1 is the perspective view according to the surgical instruments including interchangeable surgical tool component of at least one embodiment；
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 with sudden and violent Dew is contained in component therein；
Fig. 3 is the decomposition component view of the part 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, and wherein the retained part of handle assembly is relative to master It wants to be shown in solid in a position of casing part, and in another position of the main enclosure portion relative to handle assembly It is shown in dotted line in setting；
Fig. 6 is the cross-sectional end view along the handle assembly of Fig. 2 to Fig. 5 of the line 6-6 interception in Fig. 5；
Fig. 7 is another cross-sectional end view along the handle assembly of Fig. 2 to Fig. 6 of the line 7-7 interception in Fig. 5；
Fig. 8 is another cross-sectional end view of the handle assembly of Fig. 2 to Fig. 7, is shown and the sliding tooth on rotation driving pod Take turns the switch gear being engaged；
Fig. 9 is another cross-sectional end view of the handle assembly of Fig. 2 to Fig. 8, is shown when switch gear and rotation driving are held Switch solenoidal position when driving gear on nest is engaged；
Figure 10 is another perspective view of the handle assembly of Fig. 2 to Fig. 9, and wherein its certain part is shown and its access with section Plate part is shown in dotted line；
Figure 11 is the top view of the handle assembly of Fig. 2 to Figure 11, and wherein emergency system is illustrated at actuatable position；
Figure 12 is the perspective view of the emergency shank of emergency system shown in Fig. 2 to Figure 11；
Figure 13 is the decomposition component view of the part of the emergency shank of Figure 12, and part is shown with section；
Figure 14 is the cross-section front view of the handle assembly of Figure 11；
Figure 15 is the perspective view of surgical stapling attachment comprising attachment part, shaft assembly, actuated articulation joints and end execute Device assembly；
Figure 16 be the part of the nail bin groupware of the surgical stapling attachment of Figure 15, end effector assembly and actuated articulation joints thoroughly View；
Figure 17 is the end effector assembly of the surgical stapling attachment of Figure 15, the exploded of actuated articulation joints and shaft assembly Figure；
Figure 18 is the attachment part of the surgical stapling attachment of Figure 15 and the local perspective view of shaft assembly；
Figure 19 is the end effector assembly of the surgical stapling attachment of Figure 15, the partial perspective of actuated articulation joints and shaft assembly Figure, wherein the shaft assembly includes changeover module, which is configured in closure driving device and percussion driving dress Switch between the driveability set, and wherein the changeover module is shown at the position for driving percussion driving device It sets；
Figure 20 is the end effector assembly of the surgical stapling attachment of Figure 15, the partial perspective of actuated articulation joints and shaft assembly Figure, wherein the changeover module is shown at the position for driving closure driving device；
Figure 21 is the perspective view of the closure frame of the end effector assembly of the surgical stapling attachment of Figure 15, wherein the closure frame Frame includes corresponding slit keeps pin mechanism and corresponding driving lug to engage with the tissue of engagement end portion actuator assembly Nail bin groupware；
Figure 22 is the bottom view of closure frame shown in Figure 21；
Figure 23 is the side view of closure frame shown in Figure 21；
Figure 24 is the end effector assembly of the surgical stapling attachment of Figure 15, the partial perspective of actuated articulation joints and shaft assembly Figure, wherein the changeover module is shown at the position for driving closure driving device；
Figure 25 is the longitudinal profile of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Figure, wherein the changeover module is in the first position for driving closure driving device, and end effector assembly is in and beats Open configuration；
Figure 26 is the longitudinal profile of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Figure, wherein the changeover module is in first position, and end effector assembly is in part closed configuration；
Figure 27 is the longitudinal profile of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Figure, wherein the changeover module is in first position, and end effector assembly is in complete clamping configuration；
Figure 28 is the longitudinal profile of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Figure, wherein the changeover module has been switched to the second position from first position to drive percussion driving device, and end effector Component is in complete clamping configuration；
Figure 29 is the longitudinal profile of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Figure, wherein the changeover module is in the second position, and surgical stapling attachment is in complete firing configuration；
Figure 30 is the longitudinal profile of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Figure, wherein the changeover module from the second position be switched to the third place with and meanwhile drive percussion driving device and closure driving fill It sets, and wherein surgical stapling attachment is in complete firing configuration；
Figure 30 A be include perspective view according to the shaft assembly of the nail bin of at least one embodiment；
Figure 30 B is the local perspective view of the shaft assembly of Figure 30 A, shows the nail bin dismantled from shaft assembly；
Figure 30 C is the partial exploded view of the shaft assembly of Figure 30 A；
Figure 30 D is the partial sectional view of the shaft assembly of Figure 30 A, is shown as in configuration opening, not clamping；
Figure 30 E is the partial sectional view of the shaft assembly of Figure 30 A, is shown as configuration in closure, clamping；
Figure 30 F is the partial sectional view of the shaft assembly of Figure 30 A, is shown as the configuration in percussion；
Figure 30 G is the partial sectional view of the shaft assembly of Figure 30 A, and it illustrates harvested to be according to the power of at least one embodiment System；
Figure 31 is the perspective view of surgical stapling attachment or instrument comprising attachment part, shaft assembly, actuated articulation joints and end Portion's actuator assembly；
Figure 32 is the actuated articulation joints of the instrument of Figure 31 and the local perspective view of end effector assembly, end effector Component includes end effector frame, closure frame and nail bin groupware；
Figure 33 is the local perspective view of the shaft assembly of the instrument of Figure 31, actuated articulation joints and end effector assembly, is shown The nail bin groupware being mounted in end effector assembly；
Figure 34 is the attachment part of the instrument of Figure 31 and the sectional perspective view of shaft assembly, wherein attachment part include attachment interface and Transmission device, the transmission device are configured to that the master of shaft assembly will be transmitted to by the received rotational control motion of tool interface system Drive shaft；
Figure 35 is the end effector assembly of the instrument of Figure 31 and the exploded view of shaft assembly；
Figure 36 is the local perspective view of the end effector assembly of the instrument of Figure 31；
Figure 37 is the end effector assembly of the instrument of Figure 31 and the local perspective view of shaft assembly, wherein the end effector assembly Part completely or partially removed, with the drive system of exposed end actuator assembly, multiple Lock structures and tissue keep Pin mechanism；
Figure 38 is the local perspective view of the part of closure frame and end effector frame, wherein having removed part with exposure Drive system, Lock structure and the tissue of the instrument of Figure 31 keep pin mechanism；
Figure 39 is the part section front view of the end effector assembly of the instrument of Figure 31, is shown as in not capturing, do not clamp, not The configuration of percussion, unlock；
Figure 40 is the part section front view of the end effector assembly of the instrument of Figure 31, is shown as not capturing, not in Figure 39 The configuration for clamping, not firing, unlocking；
Figure 41 is the cross-section front view of the end effector assembly of the instrument of Figure 31, is shown as cutting in the line 41-41 in Figure 40 The configuration of the Figure 39 taken do not capture, do not clamp, do not fire, unlocked；
Figure 42 is the part section front view of the end effector assembly of the instrument of Figure 31, is shown as in capture, grips, not The configuration of percussion；
Figure 43 is the part section front view of the end effector assembly of the instrument of Figure 31, is shown as being in capture, the part of Figure 42 The configuration clamp, not fired；
Figure 44 is the part section front view of the end effector assembly of the instrument of Figure 31, is shown as in clamping completely, does not fire Configuration；
Figure 45 is the part section front view of the end effector assembly of the instrument of Figure 31, is shown as in clamping completely, has fired Configuration；
Figure 46 is the part section front view of the end effector assembly of the instrument of Figure 31, is shown as in portion rebounds, has fired Configuration；
Figure 47 is the part section front view of the end effector assembly of the instrument of Figure 31, is shown as in being fully retracted, lock Configuration, wherein used nail bin groupware is removed from end effector assembly；
Figure 48 is the part section front view of the end effector assembly of the instrument of Figure 31, be shown as in being fully retracted of Figure 46, The configuration of locking, wherein unexhausted nail bin groupware is ready to be mounted in end effector assembly；
Figure 49 is the part section front view of the end effector assembly of the instrument of Figure 31, is shown as in clamping completely, partially hits The configuration of hair, wherein nail bin groupware includes cock indicator system, and cock indicator system indicates the instrument In the complete configuration for clamping, partially firing；
Figure 50 is the part section front view of the end effector assembly of the instrument of Figure 31, is shown as in clamping completely, hits completely The configuration of hair, wherein cock indicator system indicates that the instrument is in the configuration for clamping, firing completely completely；
Figure 51 is the perspective view of surgical stapling attachment or instrument comprising attachment part, shaft assembly, actuated articulation joints and end Portion's actuator assembly；
Figure 52 is the local perspective view of the joint motions transmission device of the attachment part of the instrument of Figure 51；
Figure 53 is the perspective sectional view of the end effector assembly of the instrument of Figure 51, and wherein some parts of instrument are removed with sudden and violent Reveal the interior section of instrument；
Figure 54 is the partial exploded view of the instrument of Figure 51；
Figure 55 is the local perspective view of the storehouse support jaw of the instrument of Figure 51 comprising limits the pivot pin of pivotal line, storehouse support Jaw can be rotated around the pivotal line；
Figure 56 is the attachment part of the instrument of Figure 51, the partial exploded view of shaft assembly and actuated articulation joints；
Figure 57 is the partial perspective cutaway view of the actuated articulation joints of the instrument of Figure 51；
Figure 58 is the actuated articulation joints of the instrument of Figure 51 and the perspective view of end effector assembly, wherein end effector assembly Including a pair of of moveable jaws, nail bin and drive system；
Figure 59 is the cross-section front view of the instrument of Figure 51, is shown as in the configuration for clamping, not firing；
Figure 60 is the cross-section front view of the end effector assembly of the instrument of Figure 51, is shown as in the configuration for clamping, suturing completely；
Figure 61 is the cross-section front view of the end effector assembly of the instrument of Figure 51, is shown as in retracted configuration；
Figure 62 is the cross-section front view of the end effector assembly of the instrument of Figure 51 of the line 62-62 interception in Figure 61；
Figure 63 is the cross-section front view of the end effector assembly of the instrument of Figure 51, is shown as suturing in clamping, completely, partially cut The configuration cut；
Figure 64 is the part section front view of the end effector assembly of the instrument of Figure 51, is shown as in the structure for not clamping or opening Type；
Figure 65 is the end effector assembly of the instrument of Figure 51, the partial top view of actuated articulation joints and shaft assembly, is shown as locating In the configuration of clamping, non-joint motions；
Figure 66 is the end effector assembly of the instrument of Figure 51, the partial top view of actuated articulation joints and shaft assembly, is shown as locating In configurations do not clamp, joint motions；
Figure 67 is the end effector assembly of the instrument of Figure 51, the partial top view of actuated articulation joints and shaft assembly, is shown as locating In clamping, joint motions configuration；
Figure 68 is the cross-section front view of the closure frame of the end effector assembly of the instrument of Figure 51；
Figure 69 is the cross-section front view of the end effector frame of the instrument of Figure 51；
Figure 70 is a part according to the surgery nail bin of at least one embodiment being used together with circular surgical staplers tool Perspective view；
Figure 71 shows a pair of of nail in unshaped and shaped configuration according at least one embodiment；
Figure 72 is the section view of a part of anvil block relative to a part of the surgery nail bin of Figure 70 before forming process is followed closely in actuating Figure；
Figure 73 is another cross-sectional view of the nail bin of the anvil block and Figure 70 of Figure 72 after nail is formed；
Figure 74 is a part according to the surgery nail bin of at least one embodiment being used together with circular surgical staplers tool Perspective view；
Figure 75 is the section view of a part of anvil block relative to a part of the surgery nail bin of Figure 74 before forming process is followed closely in actuating Figure；
Figure 76 is the anvil block of Figure 75 and another cross-sectional view of nail bin after nail is formed；
Figure 77 is the top view according to the nail bin of at least one embodiment；
Figure 78 is the bottom view according to the anvil block of at least one embodiment；
Figure 79 is the cross-sectional view of a part of the anvil block of a part relative to surgery nail bin；
Figure 80 shows three unfashioned surgical staples；
Figure 81 is the perspective view according to a part of the surgical stapling device of at least one embodiment；
Figure 82 is the top view of the surgery nail bin of the stitching devices of Figure 81；
Figure 83 is the perspective view of a part of the surgical stapling device of Figure 81；
Figure 84 is the side front view according to the staple drivers component of at least one embodiment；
Figure 85 is the bottom view according to the anvil block of at least one embodiment；
Figure 86 is the side elevational cross-sectional view using a part of the surgical stapling device of the anvil block of Figure 85；
Figure 87 is the enlarged view of the nail shapes pit of the anvil block of Figure 85, which has corresponding forming nail；
Figure 88 shows the nail in unshaped and shaped configuration according at least one embodiment；
Figure 89 is the side elevational cross-sectional view according to a part of the surgical stapling device of at least one embodiment；
Figure 90 shows the nail in unshaped and shaped configuration according at least one embodiment；
Figure 91 is the side elevational cross-sectional view according to a part of the surgical stapling device of at least one embodiment；
Figure 92 is the top view according to a part of the surgical stapling device of at least one embodiment；
Figure 93 is the bottom view according to the anvil block that can be used in combination with the surgical stapling device of Figure 92 of at least one embodiment；
Figure 94 is the top view of the nail cavity and corresponding nail according at least one embodiment；
Figure 95 is shown to be followed closely according to the unshaped of at least one embodiment；
Figure 96 is the top view according to the surgical stapling device of at least one embodiment；
Figure 97 is the top view of the nail cavity and corresponding nail according at least one embodiment；
Figure 98 is the bottom view according to the anvil block that can be used in combination with the surgical stapling device of Figure 96 of at least one embodiment；
Figure 99 is the enlarged view of the nail shapes pit of the anvil block of Figure 98, which has corresponding forming nail；
Figure 100 is the partial sectional view according to the surgical stapling device of at least one embodiment；
Figure 101 is shown to be followed closely according to the unshaped of at least one embodiment；
Figure 102 is the top plan view according to the nail bin of at least one embodiment；
Figure 103 is the top view of the nail cavity and corresponding nail according at least one embodiment；
Figure 104 is the bottom view according to the surgical stapling device anvil block of at least one embodiment；
Figure 105 is the top view of a pair of of the nail cavity and corresponding nail according at least one embodiment；
Figure 106 is the cross-sectional view according to the anvil assembly of the surgical stapling device of at least one embodiment；
Figure 107 is the cross-sectional view of the anvil block modification component of the anvil assembly of Figure 106；
Figure 108 is the top view of the anvil block modification component of the anvil assembly of Figure 106；
Figure 109 is the top view according to the anvil assembly of the surgical stapling device of at least one embodiment；
Figure 110 is the top view of the nail bin of the surgical stapling device of Figure 109；
The nail that Figure 111 shows the forming pit of anvil block modification component and shaped by the forming pit；
Figure 112 shows the nail cavity and unshaped nail of the surgical stapling device of Figure 109；
Figure 113 is the perspective view for supporting the staple drivers of three nails of surgical stapling device of Figure 109；
Figure 114 is the top view of the staple drivers of Figure 113；
Figure 115 shows the cross-sectional view for selecting the end effector of embodiment else according at least one, which includes Nail bin, anvil block and anvil block modify component；And
Figure 116 shows three nails in unshaped configuration and shaped configuration according at least one embodiment.
In several views, corresponding reference symbol indicates corresponding component.Exemplifications set out herein is shown in one form Various embodiments of the present invention are gone out, and this example is not necessarily to be construed as limiting the scope of the invention in any way.
Specific embodiment
Present applicant possesses following patent application, the patent application and the application and submits in same date and respectively complete Text is herein incorporated by reference:
The U.S. Patent application sequence of entitled " METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM " Row number _ _ _ _ _ _ _ _；Attorney number END7821USNP/150535；
The United States Patent (USP) of entitled " MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY " Patent application serial numbers _ _ _ _ _ _ _；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 CONCENTRIC The U.S. Patent Application Serial Number of 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 THATIS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS " Number _ _ _ _ _ _ _；Attorney number END7827USNP/150541；
The beauty of entitled " SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION " State's patent application serial number _ _ _ _ _ _ _；Attorney number END7829USNP/150543；
Entitled " SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVE CUTTING The U.S. Patent Application Serial Number of OF TISSUE " _ _ _ _ _ _ _；Attorney number END7830USNP/150544；
The U.S. of entitled " SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT " is special Sharp patent application serial numbers _ _ _ _ _ _ _；Attorney number END7831USNP/150545；
Entitled " SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSION LOCKOUT " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7832USNP/150546；
The U.S. of entitled " SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT " Patent application serial number _ _ _ _ _ _ _；Attorney number END7833USNP/150547；
The U.S. of entitled " SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT " Patent application serial number _ _ _ _ _ _ _；Attorney number END7834USNP/150548；
The beauty of entitled " SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT " State's patent application serial number _ _ _ _ _ _ _；Attorney number END7835USNP/150549；
Entitled " SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGE LOCKOUT's " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7836USNP/150550；
The United States Patent (USP) Shen of entitled " SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM " Please sequence number _ _ _ _ _ _ _；Attorney number END7837USNP/150551；
The U.S. of entitled " SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS " Patent application serial number _ _ _ _ _ _ _；Attorney number END7838USNP/150552；
The U.S. Patent Application Serial Number of entitled " SURGICAL STAPLING INSTRUMENT " _ _ _ _ _ _ _；Attorney Reel 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；
The beauty of entitled " SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET " State's patent application serial number _ _ _ _ _ _ _；Attorney number END7841USNP/150555；
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 SUPPORT " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7844USNP/150558；
The U.S. of entitled " CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM " is special Sharp patent application serial numbers _ _ _ _ _ _ _；Attorney number END7845USNP/150559；And
The U.S. Patent application sequence of entitled " CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL " Row number _ _ _ _ _ _ _；Attorney number END7845USNP1/150559-1.
Present applicant also possesses U.S. Patent application below, these patent applications were submitted on December 31st, 2015, Each is respectively entirely incorporated into herein by reference:
Entitled " MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE IN POWERED The U.S. Patent Application Serial Number 14/984,488 of SURGICAL INSTRUMENTS "；
Entitled " MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED The U.S. Patent Application Serial Number 14/984,525 of SURGICAL INSTRUMENTS "；With
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 U.S. Patent application below, these patent applications were submitted on 2 9th, 2016, often It is a to be all respectively entirely incorporated by reference herein:
Entitled " SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLY TRANSLATABLE The U.S. Patent Application Serial Number 15/019,220 of 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 The U.S. Patent Application Serial Number 15/019,196 of CONSTRAINT "；
Entitled " SURGICAL INSTRUMENTS WITH AN END EFFECTOR THATIS 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 LINK The U.S. Patent Application Serial Number 15/019,227 of 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 "；With
Entitled " SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTION ARRANGEMENTS " U.S. Patent Application Serial Number 15/019,245.
Present applicant also possesses U.S. Patent application below, these patent applications were submitted on 2 12nd, 2016, often It is a to be all respectively entirely incorporated by reference 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 "；With
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 it is following specially Benefit application:
Entitled " SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING ARRANGEMENTS's " U.S. Patent Application Serial Number 14/742,925；
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 "；With
Entitled " PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLE SURGICAL The U.S. Patent Application Serial Number 14/742,876 of INSTRUMENTS ".
Present applicant possess on March 6th, 2015 submit and be respectively incorporated by reference be incorporated herein it is following specially Benefit 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 SURGICAL The U.S. Patent Application Serial Number 14/640,795 of INSTRUMENTS "；
Entitled " ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATES The U.S. Patent Application Serial Number 14/640,832 of 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 FOR The U.S. Patent Application Serial Number 14/640,831 of POWERED SURGICAL INSTRUMENTS "；
Entitled " TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE STABILITY, The U.S. Patent Application Serial Number 14/640,859 of CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES "；
The beauty of entitled " INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS " State'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 Number of entitled " SMART SENSORS WITH LOCAL SIGNAL PROCESSING " 14/640,837；
Entitled " SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGE INTO The U.S. Patent Application Serial Number 14/640,765 of A SURGICAL STAPLER "；
Entitled " SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A ROTATABLE The U.S. Patent Application Serial Number 14/640,799 of SHAFT "；With
The U.S. of entitled " SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING " Patent application serial number 14/640,780.
Present applicant possesses submission on 2 27th, 2015 and is respectively hereby incorporated herein by full following Patent application:
The beauty of entitled " SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION " State'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 OR The U.S. Patent Application Serial Number 14/633,576 of MORE BATTERIES "；
Entitled " CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR CHARGING A The U.S. Patent Application Serial Number 14/633,566 of BATTERY "；
Entitled " SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TO BE The U.S. Patent Application Serial Number 14/633,555 of SERVICED "；
The U.S. Patent Application Serial Number of entitled " REINFORCED BATTERY FOR A SURGICAL INSTRUMENT " 14/633,542；
The U.S. Patent Application Serial Number 14/ of entitled " POWER ADAPTER FOR A SURGICAL INSTRUMENT " 633,548；
The U.S. Patent Application Serial Number 14/633 of entitled " ADAPTABLE SURGICAL INSTRUMENT HANDLE ", 526；
The U.S. Patent Application Serial Number 14/633,541 of entitled " MODULAR STAPLING ASSEMBLY "；With
Entitled " SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFE PARAMETER " U.S. Patent Application Serial Number 14/633,562；
Present applicant possess on December 18th, 2014 submit and full text be respectively hereby incorporated herein by with Lower 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 U.S. of entitled " SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS " is special Sharp patent application serial numbers 14/574,483；
The U.S. of entitled " DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS " 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 THATIS 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 U.S. of entitled " SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS " is special Sharp patent application serial numbers 14/575,143；
Entitled " SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE The U.S. Patent Application Serial Number 14/575,117 of 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 ARTICULATION The U.S. Patent Application Serial Number 14/574,493 of SYSTEM "；With
Entitled " SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION The U.S. Patent Application Serial Number 14/574,500 of SYSTEM ".
Present applicant possesses to be submitted and is respectively hereby incorporated herein by full following on March 1st, 2013 Patent application:
Entitled " ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS FOR The U.S. Patent Application Serial Number 13/782,295 of SIGNAL COMMUNICATION " is now U.S. Patent Application Publication 2014/ 0246471；
The beauty of entitled " ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS " State's patent application serial number 13/782,323 is now U.S. Patent Application Publication 2014/0246472；
The U.S. of entitled " THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS " is special Sharp patent application serial numbers 13/782,338 are now U.S. Patent Application Publication 2014/0249557；
Entitled " ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAY ARRANGEMENT " U.S. Patent Application Serial Number 13/782,499, be 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 United States Patent (USP) Shen of entitled " JOYSTICK SWITCH ASSEMBLIES FOR SURGICAL INSTRUMENTS " Please sequence number 13/782,358, be now U.S. Patent Application Publication 2014/0246477；
Entitled " SENSOR STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGH TROCAR's " U.S. Patent Application Serial Number 13/782,481 is now U.S. Patent Application Publication 2014/0246479；
Entitled " CONTROL METHODS FOR SURGICAL INSTRUMENTS WITH REMOVABLE IMPLEMENT The U.S. Patent Application Serial Number 13/782,518 of 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；With
The U.S. Patent Application Serial Number 13/782,536 of entitled " SURGICAL INSTRUMENT SOFT STOP ", now for U.S. Patent Application Publication 2014/0246476.
Present applicant also possess on March 14th, 2013 submit and full text be respectively hereby incorporated herein by with Lower patent application:
The beauty of entitled " ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE " State's patent application serial number 13/803,097 is now U.S. Patent Application Publication 2014/0263542；
Entitled " CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT " U.S. Patent Application Serial Number 13/803,193, be 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 SURGICAL The U.S. Patent Application Serial Number 13/803,210 of INSTRUMENTS " is now U.S. Patent Application Publication 2014/0263538；
The U.S. Patent Application Serial of entitled " MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT " Number 13/803,148, it 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； With
The United States Patent (USP) of entitled " METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT " Patent application serial numbers 13/803,159 are now U.S. Patent Application Publication 2014/0277017.
Present applicant also possesses to be submitted and is incorporated by reference the following patent being incorporated herein on March 7th, 2014 Application:
The U.S. Patent Application Serial Number 14/ of entitled " CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS " 200,111, it is now U.S. Patent Application Publication 2014/0263539.
Present applicant also possess submit on March 26th, 2014 and be respectively incorporated by reference be incorporated herein it is following Patent application:
The U.S. of entitled " POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS " Patent application serial number 14/226,106 is now U.S. Patent Application Publication 2015/0272582；
The U.S. Patent Application Serial Number 14/226 of entitled " STERILIZATION VERIFICATION CIRCUIT ", 099, it is now U.S. Patent Application Publication 2015/0272581；
The beauty of entitled " VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT " State's patent application serial number 14/226,094 is now U.S. Patent Application Publication 2015/0272580；
Entitled " POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND The U.S. Patent Application Serial Number 14/226,117 of 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 U.S. Patent Application Serial of entitled " SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION " Number 14/226,116, it is now U.S. Patent Application Publication 2015/0272571；
Entitled " SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR's " U.S. Patent Application Serial Number 14/226,071 is now U.S. Patent Application Publication 2015/0272578；
The U.S. Patent application of entitled " SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS " Sequence number 14/226,097 is now U.S. Patent Application Publication 2015/0272570；
The United States Patent (USP) Shen of entitled " INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS " Please sequence number 14/226,126, be now U.S. Patent Application Publication 2015/0272572；
The U.S. Patent Application Serial Number 14/226 of entitled " MODULAR SURGICAL INSTRUMENT SYSTEM ", 133, it is now U.S. Patent Application Publication 2015/0272557；
The U.S. of entitled " SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT " is special Sharp patent application serial numbers 14/226,081 are now U.S. Patent Application Publication 2015/0277471；
Entitled " POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE The U.S. Patent Application Serial Number 14/226,076 of PROTECTION " is now U.S. Patent Application Publication 2015/0280424；
The U.S. Patent Application Serial Number 14/226 of entitled " SURGICAL STAPLING INSTRUMENT SYSTEM ", 111, it is now U.S. Patent Application Publication 2015/0272583；With
The U.S. Patent application sequence of entitled " SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT " Row number 14/226,125 is now U.S. Patent Application Publication 2015/0280384.
Present applicant also possess on September 5th, 2014 submit and full text be respectively hereby incorporated herein by with Lower patent application:
The U.S. Patent application sequence of entitled " CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE " Row number 14/479,103 is now U.S. Patent Application Publication 2016/0066912；
Entitled " ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION's " U.S. Patent Application Serial Number 14/479,119 is now U.S. Patent Application Publication 2016/0066914；
The beauty of entitled " MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION " State's patent application serial number 14/478,908 is 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 United States Patent (USP) Shen of entitled " SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION " Please sequence number 14/479,098, be now U.S. Patent Application Publication 2016/0066911；
The U.S. Patent application of entitled " MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE " Sequence number 14/479,115 is now U.S. Patent Application Publication 2016/0066916；With
The U.S. Patent application sequence of entitled " LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION " Row number 14/479,108 is now U.S. Patent Application Publication 2016/0066913.
Present applicant also possess on April 9th, 2014 submit and full text be respectively hereby incorporated herein by with Lower 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 DRIVE The U.S. Patent Application Serial Number 14/248,581 of OPERATED FROM THE SAME ROTATABLE OUTPUT ", is now beauty State's patent application publication 2014/0305989；
Entitled " SURGICAL INSTRUMENT SHAFTINCLUDING SWITCHES FOR CONTROLLING THE The U.S. Patent Application Serial Number 14/248,595 of OPERATION OF THE SURGICAL INSTRUMENT ", is now the U.S. Patent application publication 2014/0305988；
The U.S. Patent Application Serial Number 14/248,588 of entitled " POWERED LINEAR SURGICAL STAPLER ", it is existing For U.S. Patent Application Publication 2014/0309666；
The U.S. Patent application of entitled " TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT " Sequence number 14/248,591 is now U.S. Patent Application Publication 2014/0305991；
Entitled " MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES The United States Patent (USP) of FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS " Patent application serial numbers 14/248,584 are now U.S. Patent Application Publication 2014/0305994；
The U.S. Patent Application Serial Number 14/248,587 of entitled " POWERED SURGICAL STAPLER ", is now the U.S. Patent application publication 2014/0309665；
Entitled " DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT's " U.S. Patent Application Serial Number 14/248,586 is now U.S. Patent Application Publication 2014/0305990；With
Entitled " MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION
The U.S. Patent Application Serial Number 14/248,607 of ARRANGEMENTS " is now U.S. Patent Application Publication 2014/ 0305992。
Present applicant also possess on April 16th, 2013 submit and full text be respectively hereby incorporated herein by with Lower patent application:
Entitled " SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE The U.S. Provisional Patent Application Serial No. 61/812,365 of MOTOR "；
The U.S. Provisional Patent Application Serial No. 61/812,376 of entitled " LINEAR CUTTER WITH POWER "；
The U.S. Provisional Patent Application Serial No. of entitled " LINEAR CUTTER WITH MOTOR AND PISTOL GRIP " 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 "；With
Entitled " SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE The U.S. Provisional Patent Application Serial No. 61/812,372 of MOTOR ".
Many details are listed herein, are tied to described in specification with the whole of embodiment shown in the drawings with providing 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 in specification The embodiment of description is smudgy.Reader will appreciate that embodiment described and illustrated herein is non-limiting example, from And can be appreciated that, specific structural and functional details disclosed herein can be representative and illustrative.It is wanted not departing from right In the case where the range asked, variations and modifications can be carried out to these embodiments.
Term " includes " (and any form of " comprising ", such as "comprising"), " having " (and any form of " having ", Such as " have "), "comprising" (and any form of "comprising", such as " comprising ") and " containing ", (and " containing " appointed What form, such as "comprising") it is open link-verb.Therefore, " comprising ", " having ", "comprising" or " containing " one or more Surgery system, device or the equipment of element have these one or more elements, but are not limited to only have these one or more Element.Equally, the element of the system of " comprising ", " having ", "comprising" or " containing " one or more features, device or equipment With those one or more features, but it is not limited to that only there are those one or more features.
Term " nearside " and " distal side " be herein defined as relative to manipulation surgical instruments handle portions clinician come using 's.Term " nearside " refers to that near the part of clinician, term " distal side " refers to the part far from clinician's positioning.Also It should be appreciated that using the skies such as "vertical", "horizontal", "up" and "down" in combination with attached drawing herein for the sake of succinct and is clear Between term.However, surgical instruments uses in many directions and position, and these terms and unrestricted and/or absolute 's.
Various exemplary means and method are provided for executing laparoscopic type and minimally invasive surgical procedures.However, reader will Be readily appreciated that, various method and apparatus disclosed herein can be used for a variety of surgical operations and application in, including for example with opening Formula surgical operation combines.With continued reference to present embodiment, reader be will be further understood that, various instrument energy disclosed herein In enough insertion bodies in any way, by natural cavity, pass through the notch being formed in tissue or puncturing hole etc..Instrument Working portion or end effector portion can be inserted directly into patient's body or can be inserted by the device that enters with service aisle Enter, 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 second pincers Mouthful.First jaw includes nail bin.The nail bin is inserted into the first jaw and can remove from the first jaw；It is contemplated, however, that Other embodiments replaced from the first jaw can not be removed or are at least readily able to from the first jaw 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 surrounded relative to the first jaw Axis is closed to pivot；It is contemplated, however, that the other embodiments that can be pivoted to wherein the first jaw relative to the second jaw.Outside Section's sewing system further includes that the joint for being configured to allow end effector that joint motions are rotated or carried out relative to axis is transported Dynamic connector.End effector can be around the joint motions axis rotation for extending through actuated articulation joints.It contemplates and does not include Other embodiments of actuated articulation joints.
Nail bin includes warehouse.Warehouse includes proximal end, distal end and extends between proximal end and distal end flat 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.Anvil Seat is towards cartridge movement by tissue compression and to grip against platform.Then, the nail being removedly stored in warehouse can be by portion It affixes one's name in tissue.Warehouse includes being defined in nail cavity therein, is removedly stored in nail cavity wherein following closely.Nail cavity is arranged to six Longitudinal row.Three nail chambers are located on the first side of longitudinal slit and three nail chambers are located in second side of longitudinal slit.Nail Other arragement constructions of chamber and nail are also possible.
Nail is supported by the staple drivers in warehouse.Driver can be between first or non-firing position and second or firing position Movement is followed closely with projecting from nail bin.Driver is retained in warehouse by retainer, which extends simultaneously around the bottom of warehouse Including being configured to grasping warehouse and keeping the retainer to the elastic component of warehouse.Driver can pass through sliding Part moves between its non-firing position and firing position.Sliding part can the proximal position adjacent with proximal end and with it is remote It is moved between the adjacent distal position in side end.Sliding part includes multiple ramped surfaces, which is configured to court Driver is slided and promoted below driver to anvil block, and follows closely and is 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 slide Part simultaneously pushes sliding part towards distal end.The longitudinal slit being defined in warehouse is configured to receive firing member.Anvil Seat further includes the slit for being configured to receive firing member.Firing member further include engage the first jaw the first cam and Engage the second cam of the second jaw.When firing member is promoted towards distal side, first cam and the second cam can control nail bin The distance between platform and anvil block or tissue space.Firing member further includes being configured to incision among nail bin and anvil block The knife of the tissue of trapping.Wish that knife is positioned at least partly close to ramped surfaces, so that nail is emitted prior to knife.
Fig. 1 shows the surgery system 10 that can be used for executing the motor driving of various different surgical operations.In shown embodiment In, the surgery system 10 of motor driving includes the alternative shell reconfigured or handle assembly 20, is attached to interchangeable A kind of form of surgical tool component 1000.For example, system 10 shown in Fig. 1 includes interchangeable surgical tool component 1000 comprising surgery cuts and fastening instrument, the instrument are referred to alternatively as endoscopic stapler.It is discussed in detail as discussed further below , interchangeable surgical tool component may include end effector, can support the nail bin of different sizes and type, and have There are different shaft lengths, size and type etc..Such construction, for example, using any suitable one or more fasteners Carry out fastening tissue.E.g., including the fastener cartridge for being removedly stored in multiple fasteners therein can be inserted removedly Enter in the end effector of surgical tool component and/or be attached to the end effector of surgical tool component.Other surgical tools Component can be interchangeably used with handle assembly 20.For example, interchangeable surgical tool component 1000 can be torn open from handle assembly 20 It unloads and is replaced with different surgical tool components, which is configured to execute other surgical operations.At other In arragement construction, surgical tool component can not be exchanged with other surgical tool components, and be consisted essentially of for example non-removable Ground fixation or the special axis for being connected to handle assembly 20.Surgical tool component is alternatively referred to as elongated shaft assembly.Surgical tool component It can be reusable, or in other configurations, surgical tool component is designed to abandon after a single use.
With continued reference to present embodiment, it will be understood that various forms of interchangeable surgical tool components disclosed herein The surgery system that can also effectively control with robot is used in combination.Therefore, term " shell " and " casing assembly " can also be covered The receiving of robot system or the shell or similar portions for being otherwise operably supported at least one drive system, wherein At least one described drive system be configured to generate and apply can be used for activating elongated shaft assembly disclosed herein and At least one control movement of its corresponding equivalent.Term " frame " can refer to a part of hand-held surgical instrument.Term " frame Frame " can also indicate the surgical instruments of robot control a part and/or robot system can be used for being operatively controlled it is outer A part of section's instrument.For example, surgical tool component disclosed herein can be with various robot systems, instrument, component and side Method, such as, but not limited in entitled " SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE The U.S. Patent Application Serial Number 13/118,241 of DEPLOYMENT ARRANGEMENTS " (is now U.S. Patent Application Publication 2012/0298719) it is used together those of disclosed in, which is incorporated by reference accordingly is incorporated herein.
Referring now to Fig. 1 and Fig. 2, casing assembly or handle assembly 20 include main enclosure portion 30, which can It is formed by a pair of of shell segments 40,70, shell segments can be made in this of plastics, polymer material, metal etc., and by appropriate tight Firmware configuration adhesive, screw, pressure cooperation feature structure, snap-fitted feature structure, latch etc. link together.Such as It hereafter will be discussed in further detail, main enclosure portion 30 is operably supported multiple drive systems therein, the multiple Drive system is configured to generate various control movements and various controls movement is applied to interchangeable surgical tool group The corresponding part of part being operably attached to thereon.Handle assembly 20 further includes retained part 100, retained part activity connection It is connected to main enclosure portion 30 and is configured to by clinician in the various positions relative to main enclosure portion 30 Clamping and manipulation.Retained part 100 can be made of a pair of of gripping section 110,120, this can be by plastics, polymeric material to gripping section Material, metal etc. are made, and by fastener arragement construction appropriate such as adhesive, screw, pressure cooperation feature structure, take Snap fit closes feature structure, latch etc. and links together, and is used for I& M purpose.
As in fig. 2 it can be seen that retained part 100 includes clamping shell 130, which limits cavity 132, the cavity It is configured to be operably supported drive motor and gear-box, this will be discussed in further detail below.Clamping shell 130 Top 134 be configured to extend through the opening 80 in main enclosure portion 30 and pivotly axle journal is connected to pivot In shaft 180.Pivotal axis 180 limits the pivot axis for being expressed as " PA ".Referring to Fig. 3.For reference purposes, handle assembly 20 limits Determine the shank axis for being expressed as " HA ", the axis axis " SA " of the elongated shaft assembly of interchangeable surgical tool can be parallel to, It is operably attached to handle assembly 20.Pivot axis P A is transverse to shank axis HA.Referring to Fig. 1.Such arragement construction makes Retained part 100 can be pivoted to around pivot axis P A relative to main enclosure portion 30 and be best suited for being connected to handle assembly The position of 20 interchangeable surgical tool component type.Clamping shell 130 limits clamping axis, is typically expressed as " GA ".Referring to Fig. 2.When the interchangeable surgical tool component for being connected to handle assembly 20 includes such as endoscopic stapler, clinician may think Retained part 100 is positioned relative to main enclosure portion 30 so that clamping axis GA perpendicular to or substantially vertical (angle " H1 ") in shank axis HA (referred to herein as " the first clip position ").Referring to Fig. 5.However, if handle assembly 20 is for controlling Interchangeable surgical tool component for example including circular stapler, then clinician may want to by retained part 100 relative to Main enclosure portion 30 be pivoted to wherein clamping axis GA relative to shank axis HA at 45 degree or about 45 degree of angles or other close The position of suitable acute angle (angle " H2 ").This position is referred to herein as " the second clip position ".Fig. 5 is shown in second Retained part 100 shown in dotted line in clip position.
Referring now to Fig. 3 to Fig. 5, handle assembly 20 further includes the clamping locking system for being typically expressed as 150, for relative to master Want casing part 30 that retained part 100 is selectively locked in desired orientation.In a kind of arragement construction, clamping locking system System 150 includes the arch series 152 of pointed tooth 154.Tooth 154 is separated from each other and forms locking groove 156 between them.Each Lock the special angle latched position that groove 156 corresponds to retained part 100.For example, at least one arragement construction, tooth 154 are arranged to permission retained part 100 with locking groove or " locking position " 156 with the spaced lock of 10-15 degree first Between clip position and the second clip position.Two stop positions can be used in the arragement construction, the two stop positions are directed to institute The instrument type (axis arragement construction) of use customizes.For example, for endoscopic stapler axis arragement construction, can with axis about at 90 degree or so, and circular stapler is constructed, which can be with axis about at 45 degree, forward simultaneously towards surgeon It scans.Clamping locking system 150 further includes locking press button 160, which has lock part 162, the lock part quilt Engage locking groove 156 with being constructed to be permeable to locking.For example, locking press button 160 is pivotably mounted on the master on pivot pin 131 It wants in handle portions 30, is engaged with allowing locking press button 160 to be pivoted into corresponding locking groove 156.Lock spring 164 is used for Locking press button 160 is biased into the position with corresponding locking groove 156 engagement or locking.When clinician presses locking press button When 160, lock part 162 and tooth configuration are for enabling tooth 154 to slip over lock part 162.Therefore, in order to adjust retained part 100 angle position relative to main enclosure portion 30, clinician press locking press button 160, then by 100 pivot of retained part Go to desired angle position.Once retained part 100 is moved into desired locations, clinician just discharges locking press button 160.Then, Lock spring 164 by locking press button 160 towards 154 bias of tooth of the series so that lock part 162 enters pair The locking groove 156 answered, during use to keep retained part 100 in the position.
Handle assembly 20 is operably supported the first rotary drive system 300, the second rotary drive system 320 and third and axially drives Dynamic system 400.Each free motor 200 of rotary drive system 300,320 provides power, which is operatively supported at clamping part Divide in 100.As in fig. 2 it can be seen that for example, motor 200 is supported in the chamber 132 in retained part 100, and there is tooth Box assembly 202 is taken turns, which has the output driving shaft 204 from its protrusion.In various forms, motor 200 is for example The DC that can be the maximum rotation with about 25,000RPM has brush drive motor.In other arragement constructions, motor may include nothing Brush motor, wireless motor, syncmotor, stepper motor or any other suitable electric motor.Motor 200 can be by power source 210 power supplies, in one form, which may include removable power source group 212.Power source 210 may include, for example, in name The referred to as U.S. Patent Application Publication 2015/ of " SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM " Any one of various power supply arragement constructions being further disclosed in detail in 0272575, the entire disclosure of the patent application publication Content is hereby incorporated by reference.In the arragement construction shown in, for example, power supply group 212 may include nearside shell Divide 214, which is configured to be attached to distal side casing part 216.Nearside casing part 214 and distal side shell Part 216 is configured to be operably supported multiple batteries 218 therein.Battery 218 can respectively include such as lithium ion (" LI ") or other suitable batteries.Distal side casing part 216 is configured to removably be operably attached to same Sample is operably linked to the shank circuit board assemblies 220 of motor 200.Shank circuit board assemblies 220 generally also may be used herein Referred to as " control system or CPU 224 ".The multiple batteries 218 that can be connected in series can be used as the power source of handle assembly 20.Except this Except, power source 210 can be interchangeable and/or rechargeable.In other embodiments, surgical instruments 10 can be by example As alternating current (AC) powers.Motor 200 can be controlled by the rocker switch 206 for being installed to retained part 100.
As described above, motor 200 is operably linked to gear case assembly 202, which includes output driving shaft 204.Drive bevel gear 230 is attached to output driving shaft 204.Motor 200, gear case assembly 202, output driving shaft 204 and master Dynamic bevel gear 230 also can be collectively referred to as " motor sub-assembly 231 " herein.Drive bevel gear 230 and driven wheel of differential 234 join, The driven wheel of differential is attached to system drive axis 232 and pivot bevel gear 238, which is connected to pivotal axis On 180.Driven wheel of differential 234 can be axially moved between bonding station and disengaging configuration on system drive axis 232, engaged In position, driven wheel of differential 234 and drive bevel gear 230 are engaged (Fig. 5), and in disengaging configuration, driven wheel of differential 234 It is disengaged from drive bevel gear 230 and engages (Figure 14).Drive system spring 235 is connected to 234 He of driven wheel of differential by axle journal Between proximal end flange 236, which is formed on the proximal end part of system drive axis 232.Referring to fig. 4 And Figure 14.Drive system spring 235 is disengaged from it with drive bevel gear 230 to engage for bias driven wheel of differential 234, such as Hereafter it will be discussed in further detail.Pivot bevel gear 238 passes through clamping convenient for output driving shaft 204 and drive bevel gear 230 It advances relative to the pivot of main handle portions 30 part 100.
In the example shown in the series of figures, system drive axis 232 and rotation driving selector system handover, the rotation drive selector system It is typically expressed as 240.In at least one form, for example, rotation driving selector system 240 includes can be in the first rotation driving Selectively moved switch gear 250 between system 300 and the second rotary drive system 320.It such as can into Fig. 9 in Fig. 6 To find out, for example, driving selector system 240 includes the switch installation not being movably mounted in main handle portions 30 Plate 242.For example, switch mounting plate 242 can be frictionally held in the installation lug being formed in shell segments 40,70 (not Show) between, or otherwise remained at by screw, adhesive etc..Referring still to Fig. 6 to Fig. 9, system drive Axis 232 extends through the hole in switch mounting plate 242, and has center or the system drive being non-rotatably attached to thereon Moving gear 237.For example, central drive gear 237, which can construct 233 by keyway, is attached to system drive axis 232.Extremely referring to Fig. 6 Fig. 9.In other arragement constructions, system drive axis 232 can be by corresponding shaft bearing (not shown) mounted thereto rotatably It is supported in switch mounting plate 242.Under any circumstance, the rotation of system drive axis 232 will cause central drive gear 234 Rotation.
As can be seen in Figure 3, the first drive system 300 includes the first driving pod 302, and the first driving pod is rotatable Ground is supported in the distal walls 32 being formed in main handle portions 30.First driving pod 302 may include the first main part 304, which has strip pod formed therein.First driven gear 306 is formed in the first main part It is not attached on 304 or movably first main part.It is remote that first main part 304 can be pivotally supported at offer In the corresponding aperture of side wall 32 or channel or it can be pivotally supported at the corresponding shaft bearing being mounted in distal walls 32 (not Show) in.Similarly, the second rotary drive system 320 includes the second driving pod 322, and the second driving pod is also rotatable Ground is supported in the distal walls 32 of main handle portions 30.Second driving pod 322 may include the second main part 324, this Two main parts 324 have strip pod formed therein.Second driven gear 326 is formed in the second main part 324 Or it is non-rotatably mounted to second main part.Second main part 324 can be pivotally supported at offer distal walls In 32 corresponding aperture or channel or it can be pivotally supported at the corresponding shaft bearing (not shown) being mounted in distal walls 32 In.First driving pod and the second driving pod 302,322 are separated from each other on each cross side of shank axis HA.Example Such as, referring to fig. 4.
As described above, in the example shown in the series of figures, rotation driving selector system 240 includes switch gear 250.Such as Fig. 6 extremely As can be seen that switch gear 250 is rotatably installed on idler shaft 252 in Fig. 9, which, which is movably supported at, is cut In arcuate slot 244 in parallel operation mounting plate 242.Switch gear 250 is installed into rotate freely on idler shaft 252 And it keeps being engaged with central drive gear 234.Idler shaft 252 is connected to one end of the axis 262 of switch solenoid 260. Switch solenoid 260 is pinned or is otherwise installed together with main shank shell 30, so that working as switch helical When pipe 260 is activated, switch gear 250 is moved into and one in the first driven gear 306 or the second driven gear 326 It is engaged.For example, in a kind of arragement construction, when solenoid shaft 262 bounces back (Fig. 6 and Fig. 7), switch gear 250 with Centre-driven gear 234 and the first driven gear 306 are engaged, so that the actuating of motor 200 will cause the first driving pod 302 rotation.As can be used in figure 6 and figure 7 switch spring 266 by switch gear 250 be biased into this In one actuated position.Therefore, if surgical instruments 10 loses electric power, switch spring 266 will be automatically by switch gear 250 are biased into the first position.When switch gear 250 is in the position, the subsequent actuating of motor 200 will cause first The rotation of first driving pod 302 of rotary drive system 300.When switch solenoid is activated, 250 quilt of switch gear It is moved into being engaged with the second driven gear 326 on the second driving pod 322.Then, the actuating of motor 200 will cause The actuating or rotation of second driving pod 322 of two rotary drive systems 320.
It is discussed in detail as discussed further below, the first and second rotary drive systems 300,320 can be used for being interchangeable outer The various parts part of section's tool assembly being coupled provides power.As described above, at least one arragement construction, if In the activating of interchangeable surgical tool component, motor loses electric power, then switch spring 266 is inclined by switch gear 250 It is pressed onto first position.Which operated according to component part of interchangeable surgical tool component, it may be necessary to drive rotation The dynamic reversing of motion is applied to the first drive system 300, so that interchangeable surgical tool component can be removed from patient.Diagram Exemplary handle assembly 20 uses manually actuable " emergency " system, is typically expressed as 330, for for example in above-mentioned scene Rotating drive movements are manually applied to the first rotary drive system 300.
Referring now to Fig. 3, Figure 10 and Figure 11, shown in emergency system 330 include emergency power train 332 comprising planetary gear Component 334.In at least one form, planetary gear set 334 includes planetary gear shell 336, which holds Receive the planetary gear arragement construction (not shown) including bevel planet gear 338.Planetary gear set 334 includes emergency driving axis 340, the planetary gear arragement construction being operably linked in planetary gear shell 336.The rotation of bevel planet gear 338 makes The rotation of planetary gear arragement construction, the planetary gear arragement construction finally rotate emergency driving axis 340.By emergency driving gear 342 axle journals are connected on emergency driving axis 340, so that emergency driving gear 342 can move axially on emergency driving axis 340, Then it rotates with.Emergency driving gear 342 can be in the spring stop flange 344 and formation being formed on emergency driving axis 340 It is moved between the shaft end retainer 346 in the distal end of emergency driving axis 340.Emergency 348 axle journal of axis spring, which is connected to, answers On emergency driving axis 340 between anxious driving gear 342 and spring stop flange 344.Axis spring 348 of meeting an urgent need is in emergency driving axis Towards distal side bias emergency driving gear 342 on 340.When emergency driving gear 342 is in its farthest side on emergency driving axis 340 When position, it is engaged with emergency driven gear 350, which is non-rotatably mounted to system drive axis 232.Referring to Figure 14.
Referring now to Figure 12 and Figure 13, emergency system 330 includes emergency actuator or emergency handle assembly 360, is helped It is applied to emergency power train 332 manually in moving emergency driving.As in these figures as can be seen that emergency handle assembly 360 Including bevel gear assembly 362 of meeting an urgent need comprising emergency bevel gear 364 and ratchet gear 366.Emergency handle assembly 360 further include Emergency shank 370 is movably coupled to emergency bevel gear assembly 362 by pivotal yoke 372, which is pivotably mounted on On ratchet gear 366.Emergency shank 370 is pivotally coupled to pivotal yoke 372 by pin 374, at storage location " SP " It selectively pivots and advances between actuated position " AP ".Referring to Figure 12.Shank spring 376 is for 370 bias of shank that will meet an urgent need Into actuated position AP.In at least one arragement construction, for example, in the axis SP for indicating storage location and indicating actuated position Axis AP between angle can be about 30 degree.Referring to Figure 13.It can also be seen that emergency handle assembly such as in Figure 13 360 further include the click 378 in the chamber being rotatably installed in pivotal yoke 372 or hole 377.Click 378 is by structure It causes engagingly engage ratchet gear 366 when along direction of actuation " AD " rotation, the then rotation when rotating in mutually opposite directions Turn to be disengaged from engagement.In the chamber 379 that ratchet spring 384 and spherical component 386 are movably supported in pivotal yoke 372, and For the detent 380,382 when shank 370 of meeting an urgent need is activated (ratcheting motion) in locking ground engagement click 378.
Referring now to Fig. 3 and Figure 10, emergency system 330 further includes the emergency that can be manipulated between the open and the closed positions Access panels 390.In the arragement construction shown in, emergency route plate 390 is configured to be removably coupled to major capsid The shell segments 70 of part 30.Therefore, in at least embodiment, when emergency route plate 390 is removed from main enclosure portion 30 Or when disassembly, it, which is referred to as, is in " opening " position, and as shown in the figure when emergency route plate 390 is attached to main enclosure portion When 30, it, which is referred to as, is in " closed " position.It is contemplated, however, that other embodiments, wherein access panels are movably coupled to mainly Casing part, so that access panels remain attached to thereon when access panels are in an open position.For example, in such embodiment In, access panels are pivotably attached to main enclosure portion or are attached slidably to main enclosure portion, and can open It is manipulated between position and closed position.In the example shown in the series of figures, emergency route plate 390 is configured to engagingly engage shell The corresponding part of section 70, is removably retained in " closed " position.The machanical fastener of other forms can also be used, it is all Such as screw, pin.
No matter emergency route plate 390 is can to dismantle also to be to maintain from main enclosure portion 30 to be actively attached to main enclosure portion 30, emergency route plate 390 includes drive system locking component or yoke 392 and emergency locking component or yoke 396, each from its Back side protrusion is otherwise formed on.It includes drive shaft recess 394 that drive system, which locks yoke 392, is configured to A part of system drive axis 232 can be received wherein when emergency route plate 390 is mounted in main enclosure portion 30 (that is, emergency route plate is in " closed " position).When emergency route plate 390 is positioned or mounted in closed position, driving System lock yoke 392, which is used to be biased into driven wheel of differential 234 to be engaged with drive bevel gear 230, (resists drive system bullet The bias of spring 235).In addition, emergency locking yoke 396 includes emergency driving axis recess 397, it is configured in emergency route A part of emergency driving axis 340 is received wherein when plate 390 is mounted or located in closed position.Such as in Fig. 5 and Figure 10 In as can be seen that emergency locking yoke 396 is also used to for emergency driving gear 342 to be biased into disengaging and driven gear 350 of meeting an urgent need It is engaged (bias for resisting emergency axis spring 348).Therefore, when emergency route plate 390 is mounted or is in the close position, Emergency locking yoke 396 prevents the rotation of 342 interference system drive shaft 232 of emergency driving gear.In addition, emergency locking yoke 396 wraps Shank recess 398 is included, for engaging emergency shank 370 and holding it in storage location SP.
Fig. 4, Fig. 5 and Figure 10 show the drive component when emergency route plate 390 is mounted or is in the close position and answer The configuration of anxious system unit.As can be seen that drive system locking component 392 in these figures for 234 bias of driven wheel of differential It is engaged at drive bevel gear 230.Therefore, when emergency route plate 390 is mounted or is in the close position, motor 200 Actuating will cause drive bevel gear 230 rotate and finally cause system drive axis 232 to rotate.Moreover, when at that position, The emergency driven gear that emergency locking yoke 396 is used to be biased into emergency driving gear 342 on disengaging and system drive axis 232 350 are engaged.Therefore, when emergency route plate 390 is mounted or is in the close position, drive system can be by motor 200 Actuating, and emergency system 330 is disconnected or is prevented from that any actuating movement is applied to system drive axis 232.In order to activate Emergency system 330, clinician remove emergency route plate 390 first or are otherwise moved to emergency route plate 390 and beat Open position.The movement removes drive system locking component 392 from the engagement with driven wheel of differential 234, to allow to drive system Driven wheel of differential 234 is biased into being engaged for disengaging and drive bevel gear 230 by system spring 235.In addition, removing emergency route Emergency route plate is moved to open position also and causes emergency locking yoke 396 and emergency driving gear 342 is detached from and connects by plate 390 It closes, so that emergency driving gear 342 is biased into and the emergency driven tooth on system drive axis 232 by the axis spring 348 that allows to meet an urgent need Wheel 350 is engaged.Therefore, the rotation of emergency driving gear 342 will cause meet an urgent need driven gear 350 and system drive axis 232 Rotation.Removing emergency route plate 390 or emergency route plate 390 is otherwise moved to open position also allows shank Emergency shank 370 is biased into actuated position shown in Figure 11 and Figure 14 by spring 376.When at that position, clinician The ratcheting motion on the RD of ratchet direction of shank 370 of meeting an urgent need can manually be made, this causes the rotation of ratchet bevel gear 364 (for example, edge Clockwise direction in Figure 14), this finally causes to apply retraction rotation fortune to system drive axis 232 by emergency power train 332 It is dynamic.Clinician can repeatedly make meet an urgent need 370 ratcheting motion of shank, until system drive axis 232 be fully rotatable repeatedly with Retraction is attached to the component of the surgical end-effector part of the surgical tool component of handle assembly 20.Once emergency system 330 It is fully activated manually, then emergency route plate 390 can be replaced (that is, returning emergency route plate 390 in clinician To closed position), to make drive system locking component 392 that driven wheel of differential 234 is biased into and drive bevel gear 230 and be answered Anxious locking yoke 396 is engaged, and emergency driving gear 342 is biased into being engaged for disengaging and emergency driven gear 350. As described above, switch solenoid 260 is biased into the first actuating position by switch spring 266 if power loss or interruption In setting.Therefore, the actuating of emergency system 330 will cause to apply reversed or retracting motion to the first rotary drive system 300.
As described above, surgery suturing appliance may include the emergency system activated manually, which is configured to for example bounce back Nail percussion driving device.In many cases, which may need to be operated and/or shaken more than once with complete Retraction nail percussion driving device.In such cases, the user of suture instruments may forget them by the emergency system It has shaken how many times and/or percussion driving device needs has been retracted due to other reasons and how far felt to obscure.It contemplates Various embodiments, wherein suture instruments include system, which is configured to detect the firing member of percussion driving device Position determines the distance that firing member needs to be retracted, and is shown to the distance of the user of surgical instruments.
In at least one embodiment, surgery suturing appliance includes one or more sensors, is configured to detect percussion The position of component.In at least one situation, sensor can be positioned in stitching unstrument for example including hall effect sensor In the axis and/or end effector of tool.Sensor is communicated with the controller signals of surgery suturing appliance, the controller and and surgery Monitor signal communication on suture instruments.The controller includes microprocessor, which is configured to firing member Physical location be compared with benchmark or reference position (it includes the fully retracted position of firing member), and calculate percussion structure The distance between the physical location of part and reference position, i.e. Distance Remaining.
Apart from the above, display is for example including electronic console, and controller is configured to exist in any suitable manner Distance Remaining is shown on electronic console.In at least one situation, controller shows progress bar over the display.In such feelings Under condition, for example, empty progress bar can indicate that firing member is in the end of its firing schedule, and complete progress bar can be indicated Firing member has been fully retracted.In at least one situation, for example, 0% can indicate that firing member is in its firing schedule End, and 100% can indicate that firing member has been fully retracted.In some cases, controller is display configured to need Firing member is retracted to its fully retracted position over the display by the actuating of how many times emergency organization.
Apart from the above, the actuating of emergency organization can operationally drive the battery or power of surgery suturing appliance and percussion The electric motor of device disconnects.In at least one embodiment, the actuating toggle switch of emergency organization, this by battery with it is electronic Motor is electrically separated.The manual retrieving that this system will prevent electric motor from resisting firing member.
Shown in handle assembly 20 also support be typically expressed as 400 third axial drive system.As in figs. 3 and 4 can be with Find out, third axial drive system 400 includes solenoid 402 in the form of at least one, which has the from its protrusion Three driving actuating components or bar 410.Third drives the distal end 412 of actuating component 410 that there is third formed therein to drive Dynamic bracket or pod 414, for receiving the drive component for being operably attached to interchangeable surgical tool component thereon Corresponding part.Solenoid 402 be wired to shank circuit board assemblies 220 and control system or CPU 224 or otherwise with It is connected to.In at least one arragement construction, solenoid 402 is " spring-loaded ", so that when solenoid 402 is not activated When, third driving 410 bias of actuator is returned 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 surgical tools Component.For this purpose, handle assembly 20 includes the tool mounting portion for being typically expressed as 500, it is used for interchangeable surgical tool group Part is operatively connected thereto.In the example shown in the series of figures, tool mounting portion 500 faces interior swallow-tail form including two and receives Slit 502 is configured to engage the corresponding part of the tool attachment module part of interchangeable surgical tool component.Each Or in other words swallow-tail form receives slit 502 and can be tapered, and, can be slightly V-arrangement.Swallow-tail form receives slit 502 It is configured to releasedly receive corresponding conical attachment or ear portions, the conical attachment or lug portion Divide in a part for the tool attachment nozzle segment for being formed in interchangeable surgical tool component.Each interchangeable surgical tool group Part can also be equipped with latch system, which is configured to be releasably engaged the tool for being formed in handle assembly 20 Corresponding holding pit 504 in installation section 500.
Various interchangeable surgical tool components can have " main " rotary drive system, be configured to operationally join It is connected to the first rotary drive system 310 or joins with it, and " auxiliary " rotary drive system, be configured to operate Ground is connected to the second rotary drive system 320 or joins with it.Main and auxiliary rotary drive system be configured to The part of certain types of surgical end-effector provides various rotary motions, and the part includes interchangeable surgical tool group A part of part.For the ease of main rotary drive system is operably linked to the first rotary drive system and drives auxiliary Dynamic system is operably linked to the second rotary drive system 320, and the tool mounting portion 500 of handle assembly 20 further includes a pair It is inserted into inclined-plane 506, is configured to rotate the main of interchangeable surgical tool component and auxiliary during connection process The part of drive system is towards distal side bias, to promote the first rotation driving system on main rotary drive system and handle assembly 20 The alignment and operable connection of system 300, and the second rotation on auxiliary rotary drive system and handle assembly 20 is promoted to drive The alignment and operable connection of dynamic system 320.
Interchangeable surgical tool component may also include " third " axial drive system, for will be axially moved be applied to it is interchangeable The corresponding part of the surgical end-effector of surgical tool component.For the ease of third axial drive system is operatively coupled Third axial drive system 400 on to handle assembly 20, third driving actuating component 410 are provided with pod 414, the pod quilt It is constructed to be permeable to operationally receive the lug of third axial drive system or other parts wherein.
Surgical stapling tool assembly or attachment 11100 are shown in Figure 15 into Figure 30.Tool assembly 11100 is configured to Tissue is captured, clamps, sutures and cut during surgical operation.Referring primarily to Figure 15, tool assembly 11100 includes attachment part 11200, shaft assembly 11300, actuated articulation joints 11400 and end effector assembly 11500.Tool assembly 11100 is constructed At instrument interface can be attached to by attachment part 11200.Instrument interface may include surgical instruments shank, and such as institute is public herein Those of open.Other embodiments are contemplated, wherein tool assembly 11100 is not easy to be attached to instrument interface and connect from instrument Mouth disassembly, and it is on the contrary a part of integrated instrument.Attachment part 11200, which is configured to receive from instrument interface, to be rotated Control movement, tool assembly 11100 are attached to the instrument interface and rotational control motion are transmitted to shaft assembly 11300.Axis These rotational control motions are transmitted to end effector assembly 11500 by actuated articulation joints 11400 by component 11300.
It is illustrated in greater detail in Figure 18, attachment part 11200 is configured to be attached to instrument interface, will be connect by instrument The rotational control motion that mouth generates is provided to shaft assembly 11300.Attachment part 11200 include primary attachment interface 11210 and by The auxiliary attachment interface 11220 that attachment part shell 11201 supports.Attachment interface 11210,11220 is configured to and device The correspondence attachment interface of tool interface cooperates or connection.For example, the correspondence attachment interface of surgical instruments shank may include gear train, it should Gear train is configured to when being activated by user by one or more motor rotations, and when, upon rotating, which makes to lead Attachment interface 11210 and auxiliary attachment interface 11220 is wanted to rotate.
Rotatable interface 11210,11220 simultaneously may be selected in user, or alternatively, rotates independently interface 11210,11220. Primary attachment interface 11210 is configured to rotation input drive shaft 11211 and input driven gear mounted thereto 11213.Input drive shaft 11211 includes shell bearing 11212, which is configured to latch housing 11201 simultaneously Axis 11211 is prevented to be translated to the far side.Input driven gear 11213 operationally with 11313 phase of transmission gear of shaft assembly 11300 Mutually engagement, the transmission gear are mounted on main drive shaft 11311.As a result, the rotation of interface 11210 is transmitted to axis 11311.It is similar Arragement construction for assisting attachment interface 11220.Auxiliary attachment interface 11220 is configured to make input drive shaft 11221 and input driven gear 11223 mounted thereto rotate.Input drive shaft 11221 includes shell bearing 11222, should Shell bearing is configured to latch housing 11201 and axis 11221 is prevented to be translated to the far side.Input driven gear 11223 can It is operatively intermeshed with the transmission gear 11323 of shaft assembly 11300, which is mounted in time drive shaft 11321.Knot Fruit, the rotation of interface 11220 are transmitted to axis 11321.Main drive shaft 11311 is contained in shaft assembly shell 11301.Drive shaft Rotational control motion is transmitted to end effector assembly from attachment interface 11210 by actuated articulation joints 11400 by 11311 11500.Secondary drive shaft 11321 is also accommodated in shaft assembly shell 11301.Secondary drive shaft 11321 passes through actuated articulation joints Rotational control motion is transmitted to end effector assembly 11500 from attachment interface 11220 by 11400.
Actuated articulation joints 11400 allow end effector assembly 11500 to connect relative to 11301 passive joint of shaft assembly shell It connects.Referring primarily to Figure 19 and Figure 20, actuated articulation joints 11400 include the nearside yoke 11410, attached for being attached to shaft housing 11301 It is connected to the distal side yoke 11430 of end effector assembly 11500 and is pivotally coupled nearside yoke 11410 and distal side yoke 11430 Joint motions pin 11420.Joint motions pin 11420, which is rotatably received in, is each defined in nearside yoke 11410 and distal side In nearside yoke aperture 11411 and distal side yoke aperture 11431 in yoke 11430.End effector assembly 11500 is configured to Around the joint motions axis AA limited by joint motions pin 11420 transverse to by tool assembly 11100 (more particularly, Shaft housing 11301) limit longitudinal tool axis LT direction upper joint movement.Nearside yoke 11410 includes prolonging across its longitudinal direction The aperture 11419 stretched allows concentric main drive shaft 11311 and time drive shaft 11321 to extend through.Joint motions pin 11420 Further include the aperture 11421 longitudinally extended across it, time drive shaft 11321 is allowed to extend through joint motions pin 11420.
Actuated articulation joints 11400 connect system using passive joint comprising joint motions lock 11440 and detent 11413.Make User can manually be such that end effector assembly 11500 pivots around joint motions pin 11420, so that distal side yoke 11430 be made to move Movable joint movement lock 11440.When joint motions lock 11440 is mobile relative to nearside yoke 11410 and surrounds joint motions pin 11420 When rotation, joint motions lock 11440 is configured to clamping or is incremented by with the detent 11413 being limited in nearside yoke 11410 Ground locking, distal side yoke 11430 is locked in place, and is therefore locked end effector assembly 11500 in place.It changes Word is said, when rotating end effector assembly 11500 around joint motions pin 11420, passive joint connection system is convenient for End effector assembly 11500 surrounds the increment joint motions of joint motions axis AA.
Actuated articulation joints 11400 are further configured to the rotation transmitting by main drive shaft 11311 or are transmitted to end execution Device assembly 11500.In order to pass through or transmit across actuated articulation joints 11400 rotary motion of main drive shaft 11311, joint fortune Dynamic connector 11400 further includes pitch wheel system, which includes being attached to the input bevel gear of main drive shaft 11311 11415, the idle pulley bevel gear 11416 that can be rotated around joint motions pin 11420, and it is attached to input drive shaft 11518 Output bevel gear wheel 11417.When main drive shaft 11311 rotates, input bevel gear 11415 rotates, this makes idle pulley bevel gear 11416 Rotation.The rotation of idle pulley bevel gear 11416 rotates output bevel gear wheel 11417, so that output bevel gear wheel 11417 be made to be connected to Input drive shaft 11518 rotates.When 11500 joint motions of end effector assembly, this construction allows output bevel gear wheel 11417 rotate around joint motions pin 11420, while keeping engaging with the driving of primary input drive shaft 11518.
Primary input driving gear 11519 is attached in primary input drive shaft 11518, and when primary input drive shaft 11518 rotates Rotation.Primary input driving gear 11519 is configured to the single rotation as drive system 11510 and inputs, this will be under Text discusses in more detail.
Actuated articulation joints 11400 are further configured to that time drive shaft 11321 is allowed to extend there through, so that secondary drive shaft The changeover module 11550 of the 11321 engageable drive system 11510 discussed in greater detail below of driving screw rod 11325.Input cone Gear 11415, output bevel gear wheel 11417 and primary input drive shaft 11518 respectively include being configured to allow time drive shaft 11321 apertures extended through.Secondary drive shaft 11321 can be flexible, for example, when end effector assembly 11500 is enclosed It is bent when around joint motions axis AA joint motions.Thrust bearing 11326 is installed to time drive shaft 11321, to prevent time driving Axis 11321 is pulled through primary input drive shaft 11518 in 11500 joint motions of end effector assembly.Bearing 11326 and master are defeated Enter to drive gear 11519 adjacent or is defined by it.
Actuated articulation joints 11400 are by being attached to distal side yoke for the proximal jaw 11610 of end effector frame 11600 11430 carry out supporting base end portion actuator frame 11600.Distal side yoke 11430 includes the sleeve portion with outer surface and inner surface 11433, wherein outer surface is engaged by end effector frame 11600, and inner surface is configured to slidingly support Changeover module 11550.
Referring primarily to Figure 17 and Figure 19, end effector assembly 11500 includes drive system 11510, end effector frame 11600, the closure frame 11700 movable relative to end effector frame 11600, and be configured to be installed to end Replaceable nail bin groupware 11800 in actuator frame 11600.Drive system 11510 includes single rotation input device, quilt It is constructed to be permeable to receive rotational control motion from shaft assembly 11300 and actuated articulation joints 11400, selectively to drive driving The closure driving device 11530 and percussion driving device 11540 of system 11510.Closure driving device 11530 is configured to It interacts with the part of closure frame 11700 and nail bin groupware 11800, by closure frame 11700 and nail bin groupware 11800 It is moved to capturing table position relative to end effector frame 11600, so that capture will be organized in end effector assembly 11500 It is interior.Capturing table includes that there is Automatic-expanding the tissue of tissue retaining pin 11871 to keep pin mechanism 11870.Then closure can be used Closure frame 11700 is moved to clamping fixture table position by driving device, to utilize 11800 grip tissue of nail bin groupware.Once tool Component 11100 is in complete clamping configuration, and it is multiple to project from nail bin groupware 11800 can to operate percussion driving device 11540 It follows closely 11880 and knife 11840 is deployed to nail and cut from the staple cartridge body 11810 of nail bin groupware and captured by nail bin groupware 11800 With the tissue of clamping.Changeover module 11550 is provided for user and is driven in the driveability of closure driving device 11530, percussion While the driveability and closure driving device 11530 of device 11540 and percussion driving device 11540 between driveability The ability of switching.
Nail bin groupware 11800 is configured to replaceable.Nail bin groupware 11800 is mountable in end effector frame 11600, So that during installation, nail bin groupware 11800 can operatively be engaged with closure frame 11700 and drive system 11510.It is now main It to include proximal jaw 11610, distal jaw 11630 and connection proximal jaw referring to Figure 16, end effector frame 11600 11610 and distal jaw 11630 coupling part 11620.Proximal jaw 11610 is operably supported 11510 He of drive system Closure frame 11700, and be configured to slideably received within and move ground support nail warehouse 11810.Distal jaw 11630 are configured to slideably received within and are fixedly supported the anvil portion 11830 of nail bin groupware 11800.Anvil block Part 11830 includes staple forming surface 11831 and cutter slit 11835, the staple forming surface be configured to make nail 11880 at Shape, and the cutter slit is configured at least partly receive knife 11840 wherein.Coupling part 11620 is configured to The anvil block frame 11820 of the nail bin groupware 11800 with layout of pins structure 11821 can be received and supported.Positioning pin cloth Structure 11821 is set to allow that faster and/or more easily nail bin groupware 11800 is loaded into end effector assembly 11500. Locater pin feature structure 11821 corresponds to the positioning pin recess portion in the coupling part 11620 of end effector frame 11600.Nail Storehouse component 11800 further includes guide pin 11823.Warehouse 11810 is configured to using knife and storehouse guide pin 11823 relative to end Actuator frame 11600 is mobile, to be used to support and guide purpose.
Warehouse 11810 includes storehouse platform 11811, has the multiple nail cavities for being configured to removedly store nail 11880 11818, knife 11840 is movably positioned in the cutter slit 11815 in it, and is configured to receive pin 11823 wherein With 11871 a pair of pin slit 11812.Storehouse platform 11811 further includes closure retainer 11813, which is constructed At can when warehouse 11810 is promoted towards staple forming surface 11831 adjacent anvil portion 11830.When closure retainer is tight When by staple forming surface 11831, closure retainer 11813 is defined can be real between platform 11811 and staple forming surface 11831 Existing minimum range.That is, it is contemplated that for example, closure retainer 11813 can not contact when suturing thick tissue Staple forming surface 11831.
Closure frame 11700 includes storehouse driving lug 11701 and storehouse grasping recess portion or feature structure 11703, is adapted to It enough engages warehouse 11810 and allows closure frame 11700 to push warehouse 11810 towards distal jaw 11630 and make warehouse 11810 bounce back far from distal jaw 11630.Storehouse drives the driving surface 11801 of the engagement staple cartridge body 11810 of lug 11701, so that When closure frame 11700, which is closed driver 11530, to be moved distally, closure frame 11700 warehouse 11810 can be pushed to or It is driven towards anvil portion 11830.Storehouse grasps feature structure 11703 and is used as hook or arm, and is configured in closure frame Frame 11700 proximally pulls storehouse 11810 when proximally moving by being closed driving device 11530.
Turning now to Figure 17, nail bin groupware 11800 further includes the multiple drivers 11851 supported by staple drivers base portion 11850. Driver 11851 is configured to support nail 11880 and nail 11880 is released its corresponding nail cavity 11818.Staple drivers base Portion 11850 and knife 11840 are driven by master driver 11860,11560 phase of trigger shaft of the master driver and drive system 11510 Interaction.Knife 11840 is attached to master driver 11860 by knife supporting element 11843.Fire driving device 11540 and main driving Device 11860 interacts, so that trigger shaft 11560 pushes master driver towards distal side when percussion driving device 11540 is activated 11860 and nail finally is projected from nail bin groupware 11,800 11880 and dispose knife 11840.Percussion driving device 11540 can be operated to return Contracting trigger shaft 11560, the trigger shaft use the knife retraction arm 11561 engaged with trigger shaft 11560 and master driver 11860, return Contracting master driver 11860.Master driver 11860 includes slit 11863, is configured to receive knife retraction arm 11561, remove There are also trigger shaft guide pin 11865 except this, it is configured to be used as between trigger shaft 11560 and master driver 11860 It is directed at interface.
As described above, the drive system 11510 of end effector assembly 11500 and single rotation input or primary input drive gear 11519 engagements, with the multiple functions of implementation tool component 11100.Referring now to Figure 24, drive system 11510 includes that closure is driven Dynamic device 11530, percussion driving device 11540 and changeover module 11550, selectively in closure driving device 11530 Driveability, the driveability for firing driving device 11540 and closure driving device 11530 and percussion driving device 11540 While driveability between switch.As described above, 11220 property of can choose of interface rotate with operating shaft 11321.Axis 11321 include threaded portion or driving screw rod 11325, is threadedly engaged with changeover module 11550.Changeover module 11550 can make With the driving screw rod 11325 of secondary drive shaft 11321, tool axis LT is vertically moved along longitudinal direction.When auxiliary attachment interface 11220 is revolved When turning, changeover module 11550 is mobile relative to distal side yoke 11430.It is contemplated that motor and/or solenoid are fixed instead of axis 11321 Position is in end effector assembly 11500, so that changeover module 11550 moves between the position.
Being closed driving device 11530 includes input drive shaft, which has input driven gear 11539 and input length Item part 11538.Input driven gear 11539 is operationally intermeshed with primary input driving gear 11519.Closure driving dress Setting 11530 further includes output shaft, which has output strip part 11537 and threaded portion 11536.It is closed driving device 11530 output shaft is aligned with the input drive shaft of closure driving device 11530.When primary input driving gear 11519 rotates, Only when strip part 11538,11537 by changeover module 11550 couple when, be closed driving device 11530 output shaft with close The input drive shaft for closing driving device 11530 consistently rotates.It is closed the threaded portion of the output shaft of driving device 11530 11536 are threadably received by the threaded hole 11736 of closure frame 11700.When being closed the output shaft rotation of driving device 11530, Closure frame 11700 is mobile relative to end effector frame 11600, so that staple cartridge body 11810 is towards 11830 court of anvil portion Distal side promotes, by clamp tissue in end effector assembly 11500.
Firing driving device 11540 further includes input drive shaft, which has input driven gear 11549 and input Strip part 11548.Input driven gear 11549 is also operable to drive gear 11519 to be intermeshed with primary input.Percussion is driven Dynamic device 11540 further includes output shaft, which has output strip part 11547 and input strip part 11546.Percussion The output shaft of driving device 11540 further includes tubulose beating shaft 11545, receives the input strip parts in percussion axis hole 11545B Divide 11546.Tubulose beating shaft 11545 is rotatably engaged with the rib 11546S of input strip part 11546, so that tubulose fires Axis 11545 can relative to input strip part 11546 vertically move, while keep with input strip part 11546 rotation, can Driving relationship.The output shaft for firing driving device 11540 is aligned with the input drive shaft of percussion driving device 11540.When master is defeated When entering to drive gear 11519 to rotate, only when strip part 11548,11547 is coupled by changeover module 11550, percussion driving The output shaft of device 11540 and the input drive shaft of percussion driving device 11540 consistently rotate.
Tubulose beating shaft 11545 further includes beating shaft earthing member 11544, and additionally includes and connect by 11560 screw thread of trigger shaft The threaded output shaft 11543 of receipts.When closure frame 11700 is promoted by closure driving device 11530 towards distal side, closure frame 11700 push trigger shaft 11560 towards distal side.When trigger shaft is promoted by closure frame 11700 towards distal side, since screw thread is defeated Shaft 11543 and trigger shaft 11560 are at least threadedly engaged, and tubulose beating shaft 11545 is grown by trigger shaft 11560 relative to input Item part 11546 is pulled towards distal side.Tubulose beating shaft 11545 can axis by the percussion hole 11745 being limited in closure frame 11700 It receives to neck, to allow tubulose beating shaft 11545 to rotate in closure frame 11700.When strip part 11548,11547 couples When, the tubulose beating shaft 11545 of percussion driving device 11540 is rotated by input strip part 11546, and tubulose beating shaft 11545 beating shaft earthing member 11544 also pushes the percussion flange 11744 of closure frame 11700.Using flange 11744 as Movable earthing mechanism, tubulose beating shaft 11545 drives trigger shaft 11560 towards distal side by threaded output shaft 11543, to dispose Knife 11840 simultaneously projects nail 11880 from nail cavity 11818.
Changeover module 11550 allows user by connection and separates the group 11537,11538 and 11547,11548 of strip part To switch between driveability option discussed above.Changeover module 11550 includes threaded hole 11555, tapped receptor The driving screw rod 11325 of drive shaft 11321, so that switching device assembly 11550 relative to length when driving screw rod 11325 to rotate The group 11537,11538 and 11547,11548 of item part vertically moves.Changeover module 11550 further includes corresponding to closure driving The strip closure shaft coupling or clutch ring 11553 of device 11530 and the strip corresponding to percussion driving device 11540 fire Shaft coupling or clutch ring 11554.Strip shaft coupling 11553,11554 is cylindrical tubulose shaft coupling, can axle journal twelve Earthly Branches Support is in changeover module 11550 and allows to rotate in changeover module 11550.Strip shaft coupling 11553,11554 respectively has There is the inner casing including strip configuration, so that shaft coupling 11553,11554 can couple or cooperate respectively the group of strip shaft portion 11537,11538 and 11547,11548.When changeover module 11550 switches so that end effector assembly 11500 is placed in tissue folder When in tight configuration, closure shaft coupling 11553 is engaged with strip part 11537,11538.Shaft coupling 11553 is closed by strip axle portion 11538 rotation is divided to be transmitted to strip shaft portion 11537, thus the output shaft of rotating closed driving device 11530.Work as switch groups When part 11550 is switched to be placed in end effector assembly 11500 in tissue cutting and suture configuration, shaft coupling is fired 11554 engage with strip part 11547,11548.The rotation for inputting strip part 11548 is transmitted to by percussion shaft coupling 11554 Strip part 11547 is exported, to rotate the output shaft of percussion driving device 11540.Changeover module 11550 further includes cylinder Recess portion 11556 allows changeover module 11550 against the thrust axis of secondary drive shaft 11321 when being proximally moved to the second position Hold 11326 nestings.
The user of tool assembly 11100 can pass through controller and/or tool assembly 11100 onboard on tool assembly 11100 Attached instrument interface wishes the function of executing according to them, makes tool assembly 11100 in clamped condition and nail forming shape Switch between state.Controller will be communicated with motor to activate primary attachment interface 11210, auxiliary attachment interface 11220 simultaneously, or Both person's primary attachment interface 11210 and auxiliary attachment interface 11220.It, now will be about tool referring now to Figure 25 to Figure 30 The ability function (including capture, clamping, suture and cutting tissue) of component 11100 discusses that drive system 11510 and end execute Interaction and engagement between device assembly 11500.
Figure 25 shows the tool assembly 11100 in opening or initial configuration.Changeover module 11550 is in first position, The strip shaft portion 11538,11537 of middle closure shaft coupling 11553 connection closure driving device 11530, so that closure driving dress Setting 11530 output shaft can drive gear 11519 to be driven when rotating in primary input.Fire shaft coupling 11554 be in only with Fire the position of the output shaft cooperation of driving device 11540.In this case, percussion shaft coupling 11554 is not constructed to The position that can cooperate with strip shaft portion 11538,11537.In this position, percussion shaft coupling 11554 is not in changeover module Rotation in 11550, because the output shaft of percussion driving device 11540 is not driven when primary input driving gear 11519 rotates.
The actuating for being closed driving device 11530 executes two kinds of functions；Pin joint (capture) tissue in end effector assembly 11500 And the tissue is clipped in end effector assembly 11500.In order to capture tissue with tissue retaining pin 11871, in changeover module 11550 activate primary attachment interface 11210 when being in first position.Primary input driving gear 11519 is driven, and due to closing It closes shaft coupling and is engaged with the two strip parts 11538,11537 for being closed driving device 11530, closure driving device 11530 Output shaft promotes closure frame 11700 towards distal side by rotation.This initial automatic land productivity of distal movement of closure frame 11700 Tissue, which is disposed, with lever 11770 keeps pin mechanism 11870.Connector part 11873 with connector recess portion 11876 is constructed At that can receive from the lever tip 11774 that a pair of lever arms 11772 extends, pin mechanism 11870 and thick stick are kept to couple tissue Bar 11770.Lever 11770 is allowed to engage nail bin groupware 11800 with the warehouse lid 11878 of lid window 11877 and lid base portion 11875 To interact with pin mechanism 11870.Lid base portion 11875 limits earthing position, for pin joint connector part 11873, and from And pin joint pin mechanism 11870.In order to dispose pin 11871, lever 11770 and end effector frame 11600, closure frame 11700 keep pin mechanism 11870 to join with tissue.Lever 11770 is opened including being supported on the frame of end effector frame 11600 The frame slot 11741 of ground pin 11771 and closure frame 11700 in hole 11671.Ground pin 11771 limits lever rotation Axis.Lever 11770 further includes lever arm 11772, which has actuating pointed tooth 11773, which is constructed use It is engaged in the closure frame cam path 11743 with closure frame 11700.The lever further includes lever tip 11774, lever point End is configured to engage with the connector part 11873 of pin mechanism 11870.
If Figure 21 is best shown into Figure 23, the closure frame cam path 11743 of closure frame 11700 includes initial cam path Part 11743A is configured to drive actuating pointed tooth 11773 towards distal side, so that lever 11770 is around lever rotation axis Rotation, so that lift lever tip 11774 is stretched out from its corresponding cotter way 11812 with drive pin 11871 and clamped towards distal side Mouth 11630.Closure frame cam path 11743 further includes final cam slot portion 11743B, to allow to discuss in more detail below Clamping phase during for activating the gap in the closure frame 11700 of pointed tooth 11773.It activates pointed tooth 11773 and is clamping rank Adjacent final cam slot portion 11743B during section, to prevent tissue retaining pin 11871 in clamping and/or percussion/suture stage Period retraction is opened.Frame slot 11741 provides gap also during clamping phase for ground pin 11771.Closure driving dress The initial activation stage for setting 11530 completes initial acquisition, wherein tissue retaining pin 11871 is deployed to and nail bin groupware 11800 distal jaw 11630 and/or anvil portion 11830 engagement.The initial acquisition can be enough to use as shown in figure 26 Tool assembly 11100 captures tissue.
During initial acquisition, also being partially toward nail bin groupware 11800 and trigger shaft 11560 of closure frame 11700 Distal jaw 11630 promotes.Storehouse drives lug 11701 to drive storehouse main body 11810, and closure frame 11700 drives tubulose to hit Send out axis 11545 and trigger shaft 11560.It can be between closure frame 11700, percussion driving device 11540 and nail bin groupware 11800 Other and/or other contact point are provided, to help to promote certain parts of end effector assembly 11500.As described above, pipe It the input strip part 11546 of shape beating shaft 11545 and the output shaft of percussion driving device 11540 can be longitudinal relative to each other It is mobile, while keeping rotatable driving relationship.This is conducive to the extension for firing the output shaft of driving device 11540, so that working as Tubulose beating shaft 11545 can be driven at driving input strip part 11546 after closure frame 11700 is pushed into.
Figure 27 shows the tool assembly that complete clamping configuration is in after the final actuation phase of closure driving device 11530 11100.Closure retainer 11813 is defined by anvil portion 11830, and organizes that pin mechanism 11870 is kept to be fully deployed.In order to It is fully deployed tissue and keeps pin mechanism 11870, closure frame cam path 11743 includes final cam path end 11743C, will Actuating pointed tooth 11773 is advanced to final position.This configuration of tool assembly 11100 considered to be in fully clamped position.Make User can determine that activating closure driving device in opposite direction is closed driving device and therefore release and taking-up tissue to bounce back, or Person user can determine for changeover module to be switched to the second position, as shown in figure 28, to fire tool assembly 11100.
Changeover module is moved to the second position shown in Figure 28, the actuatable auxiliary attachment interface 11220 of user, to revolve Turn driving screw rod 11325, so that changeover module 11550 is proximally moved to the second position.Changeover module 11550 is adapted to It is enough nested against thrust bearing 11326 when being moved to the second position.In the second position, the percussion connection of changeover module 11550 The strip shaft portion 11548,11547 of the connection percussion driving device 11540 of axis device 11554, so that percussion driving device 11540 Output shaft can drive gear 11519 to be driven when rotating in primary input.Changeover module 11550, which is moved to the second position also, to be made The strip shaft portion 11538,11537 for being closed driving device 11530 separates.When primary input driving gear 11519 is driven, close Close shaft coupling 11553 rotated in changeover module 11550, but due to closure shaft coupling 11553 only with input strip part 11548 The output shaft of cooperation, closure driving device 11530 will not rotate.
User can activate percussion driving device 11540 by driving primary attachment interface 11210 now to drive main driving Axis 11311.The actuating of percussion driving device 11540 makes to export the rotation of strip part 11546, to make tubulose beating shaft 11545 Rotation.Tubulose beating shaft 11545 rotates in the percussion hole 11745 of closure frame 11700.When tubulose beating shaft 11545 rotates When, the beating shaft earthing member 11544 of tubulose beating shaft 11545 is released or is connect from the percussion flange 11744 of closure frame 11700 Ground.The rotation of tubulose beating shaft 11545 rotates threaded output shaft 11543, to drive trigger shaft 11560 towards distal side.Percussion Knife 11840 is disposed export main body 11810 and utilizes staple drivers 11851 and driver base portion by the distal movement of bar 11560 Nail 11880 is driven out nail cavity 11818 by 11850.The tissue that the cutting of knife 11840 is clamped with end effector assembly 11500, and Nail 11880 pegs the tissue clamped with end effector assembly.
The stage shown in Figure 29, user can be by activating primary attachment interface 11210 in opposite direction come the trigger shaft that bounces back 11560, to proximally pull drive rod 11560 and knife 11840.Trigger shaft 11560 includes hole 11565, which is configured to Trigger shaft guide pin 11865 can be supported to axle journal, to keep during the movement of trigger shaft 11560 and master driver 11860 The alignment of trigger shaft 11560 and master driver 11860.Trigger shaft 11560 further includes slit 11563, which is adapted to Enough receive knife retraction arm 11561 so that when trigger shaft 11560 proximally moves, trigger shaft 11560 can proximally pull or Bounce back knife 11840.Another selection of user may include being cut changeover module 11550 by actuating auxiliary attachment interface 11220 The third place is changed to, the third place is between the first position and the second position.The third place, as shown in figure 30, by two Shaft coupling 11553,11554 is engaged with the respective sets 11538,11537 and 11548,11547 of its strip part.Then, make User can activate primary attachment interface 11210 along inverse direction and be closed with activating primary input driving gear 11519 and driving simultaneously Close the output shaft of driving device 11530 and the output shaft of percussion driving device 11540.During using tool assembly 11100 Any moment, user may want to this while driveability and want in user from operative site extraction tool component Snapback method is provided in the case where 11100.Controller on instrument interface can be programmed to by and meanwhile actuating two it is attached Connection interface 11210,11220 come changeover module 11550 is automatically switched to the third place and make primary input drive gear 11519 is reversed.
Tool assembly 11100 ' is shown in Figure 30 A to Figure 30 G.Tool assembly 11100 ' is similar to tool assembly in many aspects 11100.Referring primarily to Figure 30 A, tool assembly 11100' include attachment part 11200, from attachment part 11200 extend axis 11300, end effector 11500', and end effector 11500' is connected to the actuated articulation joints of axis 11300 11400'.Referring primarily to Figure 30 B, end effector 11500' includes end effector frame 11600', can be inserted into end execution Device frame 11600' and the nail bin 11800' and anvil jaw 11630' removed from it.Nail bin 11800' includes warehouse 11810', the warehouse can be relative to anvil jaw 11630' in open unclamped position (Figure 30 D) and the clamped position being closed It is slided between (Figure 30 E).As described in more detail below, tool assembly 11100' includes closure driving device 11530', quilt It is constructed to be permeable to move warehouse 11810' between its unclamped position and clamped position.Referring primarily to Figure 30 F, tool assembly 11100' further includes percussion driving device 11540', is configured to be moved into its clamped position in warehouse 11810' The nail being removedly stored in nail bin 11800' is projected later, this is also described more fully hereinafter in.
As described above, actuated articulation joints 11400 include nearside yoke 11410 and distal side yoke 11430, they can by pin 11420 Rotatably connect.Actuated articulation joints 11400' includes similar construction, including nearside yoke 11410' and distal side yoke 11430'.This Outside, also as described above, actuated articulation joints 11400 include bevel gear 11415,11416 and 11417, are operationally mutually nibbled It closes so that the rotation of drive shaft 11311 is transmitted to drive system 11510.Actuated articulation joints 11400' includes similar bevel gear Construction, is configured to the rotary motion of axis 11311 being transmitted to drive system 11510'.In addition, actuated articulation joints 11400' include the second group intermeshing bevel gear 11495' nested with bevel gear 11415,11416 and 11417 and 11496' is configured to that end effector 11500' is made to carry out joint motions relative to axis 11300.Bevel gear 11495' It is pivotably supported by nearside yoke 11410', and can be with joint motions input shaft 11391'(Figure 30 D) and bevel gear 11496' is operatively engaged.Bevel gear 11496 ' is fixedly secured to distal side yoke 11430'.A part of bevel gear 11496' is prolonged In the recess 11439' for reaching distal side yoke 11430'.Input shaft 11391' makes end effector 11500' along the rotation of first direction It is rotated in a first direction, and similarly, input shaft 11391' is in a second direction or the rotation of opposite direction makes end effector 11500' is in a second direction or opposite direction rotates.Tool assembly 11100' can be activated by the electric motor of instrument interface, component 11100' is attached to the electric motor so that input shaft 11391' rotates；However, tool assembly 11100' can be by any suitable Mode activate.
Similar to the drive system 11510 of end effector 11500, the drive system 11510' of end effector 11500' includes Input gear 11519, can operatively be engaged with bevel gear 11417 and can with closure driving device 11530' driving The driving gear 11549 of gear 11539 and percussion driving device 11540' are operatively intermeshed.It is also similarly to drive system 11510, drive system 11510' include that can move between first position (Figure 30 D and Figure 30 E) and the second position (Figure 30 F) Switch block or component 11550', by shaft assembly 11100 ' respectively in closure or clamp operation mode and percussion operation mode Between switch.Driving gear 11539 is installed to elongated shaft 11538', and when switch block 11550' is in its first position (Figure 30 D and Figure 30 E), elongated shaft 11538' are rotationally coupled to the elongated shaft 11537' of closure driving device 11530'.It is long Axis 11537' includes the screw thread distal end 11536 being threadedly engaged with closure frame 11700', and works as elongated shaft 11537' When being rotated in a first direction by elongated shaft 11538', closure frame 11700' and warehouse 11810 ' are as shown in Figure 30 E towards distal side Displacement is to be closed end effector 11500'.It is worth noting that, when switch block 11550' is in its first position, percussion The rotation of the driving gear 11549 of driving device 11540' does not pass through switch block 11550' and is transmitted to percussion driving device The distal part of 11540'.Therefore, closure driving device 11530' is operated independently of percussion driving device 11540', and this Outside, percussion driving device 11540' could be operated when switch block 11550' is moved in its second position.
In addition to this, driving gear 11549 is installed to elongated shaft 11548', and when switch block 11550' is in its second When setting (Figure 30 F), elongated shaft 11548' is rotationally coupled to the length of percussion driving device 11540' by switch block 11550' Axis 11547'.Elongated shaft 11547' includes distal end 11546, which is keyed to percussion driving device 11540''s Rotatable drive shaft 11545, so that elongated shaft 11547' and drive shaft 11545 rotate together.Drive shaft 11545 includes that screw thread is remote Side end 11543, which is threadedly engaged with percussion block 11560', wherein when elongated shaft 11547' passes through elongated shaft When 11548' is rotated in a first direction, percussion block 11560' fires the nail from nail bin 11800' towards distal side displacement and cutting is caught Obtain the tissue between staple cartridge body 11810' and anvil jaw 11630'.Driving device 11540 is fired similar to as described above, Percussion driving device 11540' includes staple drivers 11850', cutter block 11860' and knife 11840', in percussion driving device It is pushed by percussion block 11560' towards distal side during the firing schedule of 11540'.It is worth noting that, at switch block 11550' When its second position, the rotation for being closed the driving gear 11539 of driving device 11530' will not pass through switch block 11550' It is transmitted to the distal part of closure driving device 11530'.Therefore, percussion driving device 11540' is independently of closure driving device 11530' operation.
In relatively Figure 30 D and Figure 30 E, apart from the above, reader be should be appreciated that when closure driving device 11530' is operable to When being closed end effector 11550', percussion driving device 11540' extends or stretches.Therefore, the distal end portion of elongated shaft 11547' Portion 11546 keeps being rotatably engaged with drive shaft 11545.Referring primarily to Figure 30 C, closure frame 11700' includes being configured to The hook 11744' for the lining ring 11544 being limited in drive shaft 11545 can be abutted, and when closure frame 11700' is by towards distal side Drive shaft 11545 is pulled towards distal side when driving is to be closed end effector 11550'.When closure driving device 11530' is operated When reopening end effector 11500', as described below, drive shaft 11545 is proximally pushed so as to fire driving device 11540' collapses.
After the firing schedule of percussion driving device 11540', elongated shaft 11548' is rotated along second or opposite direction, with Proximally pull percussion block 11560', cutter block 11860' and knife 11840'.It is worth noting that, staple drivers 11850' not with hit Hair block 11560' bounces back together；However, in other embodiments, staple drivers 11850' can be retracted.Once knife 11840' It fully having been retracted to below the platform of warehouse 11810', then switch block 11550' switches back to its first position, with Percussion driving device 11540' is operationally separated with drive shaft 11311, and will also closure driving device 11530' and drive Moving axis 11311 operationally couples again.At this point, elongated shaft 11538' can be rotated along second or opposite direction, with proximally It pulls warehouse 11810' and closed frame 11700' and reopens end effector 11500'.
End effector 11500' includes motor 11322', the motor be configured to make switch block 11550' its first It is moved between position and the second position, as described above.Motor 11322' includes positioned at the horse being mounted in closure frame 11700' Shell up in supporting element 11329'.The shell of motor 11322 ' is fixedly mounted in motor support 11329', so that outside Shell is not mobile relative to motor support 11329'.Motor 11322' further includes rotatable output shaft 11325', and is being cut The threaded hole 11555 limited in parallel operation block 11550' is threadedly engaged.When motor 11322' is operated along first direction, screw thread output Switch block 11550' is moved in its first position by axis 11325'.When motor 11322' is operated in a second direction, screw thread Switch block 11550' is moved in its second position by output shaft 11325'.
Referring primarily to Figure 30 G, battery and controller system 11324' are configured to communicate with motor 11322' and power for it.Example Such as, the user of the surgical instruments interface attached by the instrument 11100' and/or computer are wanted to cut handoff block 11550' When changing, signal is wirelessly sent to battery and controller system 11324.In other cases, signal can be transmitted by conductor To system 11324'.Then motor 11322' is transferred the signal to the to activate motor 11322'.In at least one optionally implementation In scheme, solenoid can be used for switching switch block 11550'.
As reader it should be understood that as, the battery life for extending this system may be critically important.Instrument 11100' is configured Kinetic energy is harvested at during each stage of operation.Instrument 11100' includes energy harvesting system, which can incite somebody to action The movement of drive system 11510' be converted into electric energy and by the energy storage in the battery.Energy harvesting system includes coil 11327', the coil accommodate distal side yoke 11430' and are located near the portions of proximal of closure driving device 11530'.Line It encloses 11327' and is electrically coupled to battery and controller system 11324' via conductor 11326'.Proximally prolong from driving gear 11539 The axis stretched includes disk 11328' mounted thereto.When being closed driving device 11530' rotation, disk 11328' is close to line 11327' rotation is enclosed, to generate electric current in energy harvesting system.
As switch block 11550' (Figure 30 G) in an intermediate position, energy harvesting system can be used as generator.In the interposition In setting, strip shaft coupling 11554 is only engaged with elongated shaft 11547', and similarly, strip shaft coupling 11553 only with elongated shaft 11537' engagement.Therefore, when driving input unit 11519 to rotate, energy harvesting system is configured to generate energy to electricity Battery recharge, but any appliance function is not executed.It is worth noting that, when switch block 11550' is in its first position and its When the second position, energy harvesting system also is used as generator.In clamping and/or percussion, in this case, whichever Appliance function is activated, and disk 11328' passes through 11539 rotation of input.End effector 11500' clamping and/or hit It, can be by the energy supply of harvest to battery and/or motor 11322' during hair operation.
Surgical stapling attachment or tool assembly 12100 are shown in Figure 31 into Figure 50.Tool assembly or instrument 12100 are configured to Tissue can be captured, clamps and sutured during surgery.Referring primarily to Figure 31 to Figure 33, tool assembly 12100 includes attached Socket part point 12200, shaft assembly 12300, actuated articulation joints 12400 and end effector assembly 12500.Tool assembly 12100 It is configured to be attached to instrument interface by attachment part 12200.Instrument interface may include surgical instruments shank, such as originally Those of disclosed in literary.Contemplate other embodiments, wherein tool assembly 12100 be not easy to be attached to instrument interface and from Instrument interface disassembly, and it is on the contrary a part of integrated instrument.Attachment part 12200 is configured to connect from instrument interface Rotational control motion is received, tool assembly 12100 is attached to the instrument interface and rotational control motion is transmitted to shaft assembly 12300.These rotational control motions are transmitted to end effector assembly by actuated articulation joints 12400 by shaft assembly 12300 12500。
Attachment part 12200 includes transmission system 12210.As shown in figure 34, the transmission being contained in attachment part shell 12201 System 12210 includes attachment interface 12220, which includes connector part 12223.Connector part 12223 is by structure It causes that instrument interface can be operably linked to.Transmission device further includes shell bearing 12221, is connected to connector part 12223 input shaft 12211, and it is attached to the input driven gear 12213 of input shaft 12211.It is caused by instrument interface When dynamic connector part 12223, input driven gear 12213 drives main drive shaft gear 12313 to be attached to main driving to drive The main drive shaft 12311 of shaft gear 12313.
Referring primarily to Figure 35 to Figure 38, end effector assembly 12500 includes drive system 12510, end effector frame 12600, the closure frame 12700 that can be moved relative to end effector frame 12600, and be configured to be installed to Replaceable nail bin groupware 12800 in end effector frame 12600.Drive system 12510 includes single rotation input device, It is configured to receive rotational control motion from shaft assembly 12300 and drives main drive 12520 to utilize tool 12100 grip tissue of component.Main drive 12520 be configured to end effector assembly 12500 interact with Mobile closure frame 12700, and therefore it is moved distally nail bin groupware 12800.The distal movement of closure frame 12700 also results in The automatic deployment of the tissue retaining pin 12860 of nail bin groupware 12800 is to capture tissue.Main drive 12520 is further configured to Tool assembly 12100 can be just fired when obtaining complete clamping configuration in tool assembly 12100.Fire tool assembly 12100 include that multiple nails are deployed to the nail tissue for being captured and being clamped by tool assembly 12100 from nail bin groupware 12800.
The various parts of the receiving end effector assembly 12500 of end effector frame 12600.End effector frame 12600 Accommodate closure frame 12700 and nail bin groupware 12800.Allow closure frame 12700 and nail bin groupware 12800 in end effector Relative motion in frame 12600.End effector frame 12600 includes proximal neck part 12610, the first side frame 12620A and the second side frame 12620B.Proximal neck part 12610 is attached or coupled to actuated articulation joints 12400.Joint Kinematic joint 12400 includes flexible neck 12401, which is configured to allow the use of tool assembly 12100 Relative to shaft housing 12301, passively joint connects end effector assembly 12500 to person.Scheme is implemented as follows in imagination, wherein work Having component 12100 does not include actuated articulation joints, and proximal neck part 12610 is directly attached to the axis of shaft assembly 12300 Shell 12301.
It includes drive system that proximal neck part 12610 and the first side frame 12620A and the second side frame 12620B, which are accommodated, Certain components of 12510 end effector assembly 12500.First side frame 12620A and the second side frame 12620B respectively divide Not Bao Kuo proximal jaw part 12621A, 12621B, intermediate associated jaw portion 12622A, 12622B and distal jaw portion 12623A,12623B.Distal jaw portion 12623A, 12623B are at least through the anvil block 12640 with staple forming surface 12641 It keeps together.For example, bolt, screw rod and/or rivet configuration can be used for for side frame 12620A, 12620B being attached to each other.End Portion's actuator frame 12600 further includes the spacer parts 12630 being centrally positioned between associated jaw portion 12622A, 12622B, To provide gap for one or more parts of nail bin groupware 12800, thus mobile relative to end effector frame 12600 When slided between middle section 12622A, 12622B of side frame 12620A, 12620B.
Closure frame 12700 is configured to push nail bin group towards anvil block 12640 towards distal side when activating main drive 12510 Part 12800.Closure frame 12700 includes warehouse driving surface 12708, to contact and drive the staple cartridge body of nail bin groupware 12800 12810.Staple cartridge body 12810 includes platform 12811, multiple nail cavities 12813 and multiple closure retainers 12815.Nail bin groupware 12800 further include the multiple nails 12830 being removedly stored in nail cavity 12813.It is multiple nail 12830 be configured to against Staple forming surface 12641 shapes.It is defined in when being closed the adjacent staple forming surface 12641 of retainer 12815 and/or being placed in When in the recess portion in anvil block 12640, it is assumed that tool assembly 12100 has reached complete clamping configuration.Also contemplate such implementation Scheme, wherein closure retainer 12815 never reaches anvil block 12640 or staple forming surface 12641, but in nail bin groupware It is located near staple forming surface 12641 when 12800 its fully clamped position of arrival.Use the driving system discussed in greater detail below System 12510 can be realized the control of the distance between platform 12811 and staple forming surface 12641 in complete clamping configuration.
Referring to Figure 36 to Figure 38, end effector assembly 12500 is shown before actuator drive system 12510 with unlocked configuration. End effector assembly 12500 is configured to use tool assembly using the rotary motion provided by main drive shaft 12311 12100 captures clamp and suture tissue.In order to using tool assembly 12100 capture tissue, closure frame 12700 be pushed into or Actuating sells actuating mechanism 12560 with actuating.Sell the tissue retaining pin of the actuating deployment nail bin groupware 12800 of actuating mechanism 12560 12860.Pin actuating mechanism 12560 includes pin lever 12561 and the ground connection fixedly extended from end effector frame 12600 Pin 12565.Ground pin 12565 defines that holding pin axis, pin lever 12561 are rotated around the axis.Closure frame 12700 wraps A pair of of the ground connection cotter way 12706 limited on opposite sides thereof is included, gap is provided for ground pin 12565, so that closure frame 12700 It can be mobile relative to ground pin 12565.Selling lever 12561 includes a pair of lever arms 12562, this includes a pair of of actuating to lever arm Protruding portion or pointed tooth 12563, are received in a pair of cams slot 12702 being limited in closure frame 12700.Cam path 12702 are configured to be vertically moved in end effector frame 12600 with closure frame 12700 so as to sell actuator Structure 12560 is around keeping pin axis rotation and towards distal side and laterally displacement actuator tab 12563.Selling lever 12561 further includes From the lever tip 12564 that lever arm 12562 extends.Lever tip 12564 extends to the coupling portion of tissue retaining pin 12860 Divide in 12861, actuating mechanism 12560 will be sold and be connected to pin 12860.Organizing retaining pin 12860 further includes pin shaft or bar 12863 With manual override knob 12865.When pin actuating mechanism 12560 is activated by closure frame 12700, lever tip 12564 is by pin Axis 12863 is promoted towards anvil block 12640.
The manual override knob 12865 of pin 12860 is configured to that the user of tool assembly 12100 is allowed for example to drive System 12510 manually retracts to pin shaft 12863 in nail bin groupware 12800 in the case where blocking or losing electric power.Actuating is prominent Portion 12563 may include the material and/or geometry more fragile than lever arm 12562 out, to provide for user from lever Arm 12562 shears the ability of protruding portion 12563, so that pin lever 12561 be allowed to rotate freely around ground pin 12565.Due to It is this to rotate freely, allow connector part 12861 proximally to move relative to staple cartridge body 12810 without very big resistance (if any), to allow pin shaft 12863 by manual retrieving.Additionally or alternatively, actuator tab 12563 May include substantially thin configuration or profile, allow lever arm 12562 when proximally pulling manual override knob 12865 to It inside collapses or is bent, so that actuator tab 12563 is inwardly pushed and is released from cam path 12702, it is above-mentioned to provide It rotates freely.
When storehouse that is unexhausted or not firing is mounted in end effector assembly 12500, main drive 12520 may be actuated. As discussed in more detail below, end effector assembly 12500 includes one or more latching members, is inserted when by unexhausted nail bin When entering end effector assembly 12500, one or more of latching members are released from.Under any circumstance, main drive 12520 are responsible for closure frame 12700 and nail bin groupware 12800 towards the movement of anvil block 12640, to utilize end effector assembly 12500 captures are fired with grip tissue and by tool assembly 12100 to suture tissue.Main drive 12520 includes and master The driveably intermeshing input driven gear 12521 of input gear 12310.Input driven gear 12521 is installed to main drive Moving axis 12523, the main drive shaft include driving screw portion 12525.Main drive 12520 further includes being configured to prop up Support the thrust bearing configuration 12524 of axis 12523.Driving screw portion 12525 can be threadedly received in closure nut pipe or closure In the threaded hole 12531 of driving device 12530.Closure nut pipe 12530 is movably supported at internal framework 12650 In frame aperture 12653, and including receiving multiple longitudinal multiple tabs extended in slit 12653S in frame aperture 12653 In 12533, prevent closure nut pipe 12530 from rotating together with screw portion 12525 is driven.Although shown embodiment includes Four tabs 12533, but only one tab 12533 and corresponding slit 12653S may be sufficient.When driving threaded shank Points 12525 when being rotated in a first direction, and closure nut pipe 12530 is longitudinally moved or slided in frame aperture 12653, but is not existed Rotation in frame aperture 12653.Due to the distal movement, the flange 12537 for being closed nut pipe 12530 pushes closure frame 12700, It is moved distally closure frame 12700.When driving screw portion 12525 to rotate in a second direction, screw portion is driven 12525 proximally pull closure nut pipe 12530.
When closed tube 12530 reaches the farthest position associated with the fully clamped position of nail bin 12800, tab 12533 Into the distal annual recess portion 12653AD being limited in closed tube 12530.Annular recess 12653AD is between tab 12533 provides Gap.When tab 12533 is aligned with annular recess 12653AD, tab 12533 is no longer prevented from the rotation of closure nut pipe 12530. Therefore, when being closed the arrival the farthest position of nut pipe 12530, the rotation of driving screw portion 12525 causes to be closed nut Pipe 12530 and driving screw portion 12525 rotate simultaneously.
In this stage, the further actuating of drive system 12510 in same direction leads to the percussion of tool assembly 12100.Each In the case of kind, drive system 12510 can be continuously carried out in unbroken situation from this transition for being clamped to percussion.? In various other situations, tool assembly 12100 is configured to when being closed its farthest position of arrival of nut pipe 12530 The actuating of interrupt-driven system 12510.In any case, tool assembly 12100 is configured in drive system 12510 It is fired after storehouse component 12800 is moved in fully clamped position.Closure nut pipe 12530 further includes percussion threaded shank Divide or fire driving device 12535, is threadably received by the percussion nut portion 12555 of drive rod 12550.Due to being closed nut Pipe 12530 is freely rotatable now, so percussion screw portion 12535 will rotate now with the rotation of driving screw rod 12525 And drive rod 12550 is driven towards distal side.Drive rod 12550 pushes nail bin driver 12820 towards distal side, thus from nail bin groupware 12800 project nail 12830.The multiple staple drivers 12823 of staple drivers 12820 support multiple nails 12830, each staple drivers With supporting support 12824.Staple drivers 12820 are moved distally in staple cartridge body 12810 towards anvil block 12640, will be followed closely 12830 project from nail cavity 12813 towards staple forming surface 12641.Although illustrating only two staples, any conjunction can be used The staple of suitable quantity.Drive rod 12550 is guided by closure frame 12700 using guide pin 12553 and corresponding guide pin slot 12703.
As described above, main drive 12520 is activated to capture simultaneously gripping end by promoting closure frame 12700 and execute Tissue in device assembly 12500, then by promoting drive rod 12550 to suture tissue towards distal side.However, as described above, straight To when being mounted on unexhausted nail bin groupware in end effector assembly 12500, main drive 12520 could be activated.It mentions For blocking drive 12540 to provide such locked configuration.As discussed in more detail below, blocking drive 12540 utilize input identical with main drive 12520, and if blocking drive 12540 is in locked configuration, Prevent main drive 12520 from being driven.If blocking drive 12540 is in unlocked configuration, allow to drive main driving Device 12520.
Referring to Figure 38 and Figure 41, blocking drive 12540 includes and the operationally intermeshing external drive of primary input gear Moving gear 12541, or it is attached to the common driver input unit 12310 of main drive shaft 12311.Blocking drive 12540 Further include axis 12542, against end effector frame 12600 internal framework 12650 be grounded spring-loaded interference Gear 12545, and it is configured to the distal side lock part engaged by the key-lock part 12817 of nail bin groupware 12800 12547.Closure frame 12700 includes window 12707 (Figure 35), to allow closure frame 12700 and distal side lock part 12547 Between relative motion.External drive gear 12541 includes internal strip or dentate part 12541S, and being configured to can It is slidably supported the internal drive gear 12543 for being attached to axis 12542 and engages.The configuration allows axis 12542 and outside The relative longitudinal motion between gear 12541 is driven, while keeping internal drive gear 12543 and external drive gear 12541 Between driving relationship.For example, with axis 12542 have press fit relation interference gear 12545 by spring 12544 against 12650 spring loads of internal framework of end effector frame 12600.Spring 12544 can be made of such as compressed spring. Axis 12542 is always pushed by spring 12544 towards distal side, pushes interference gear 12545 to latch-up window in closure frame 12700 12704 locking groove 12704S.When interfering gear 12545 to be in locking groove 12704S, axis 12542 is in locked configuration. The locked configuration prevents axis 12542 from rotating, to prevent external drive gear 12541 from being driven.Prevent external drive gear 12541 prevent drive system 12510 to be activated by driving.In locked configuration, drive system 12510 be can be at for example in conjunction with shape State.The controller of instrument shank and/or onboard controller can sense marriage relation for example, by measurement energy spikes, then exist When reaching energy threshold, obtains and conveyed to the power of motor.
In order to which blocking drive 12540 is placed in unlocked configuration, it is necessary to which nail bin groupware is mounted on end effector assembly In 12500.The key-lock part 12817 of nail bin groupware 12800 is configured to the inclined-plane of contact distal side lock part 12547 12548 proximally to push distal side lock part 12547.Proximally distal side lock part 12547 is pushed to make axis 12542 by court Nearside pushes.Proximally impeller-hub 12542 makes that gear 12545 is interfered to remove locking groove 12704S and enters latch-up window 12704 Interior freely rotatable position.When allowing that gear 12545 is interfered to rotate freely, axis 12542 is allowed to rotate.When permission axis 12542 When rotation, blocking drive 12540 is in unlocked configuration, and input gear 12310 is allowed to drive main drive 12520 simultaneously With blocking drive 12540.In unlocked configuration, drive system 12510 is no longer on bonding state.
Distal side lock part 12547 is pinned to axis 12542 by pin 12547P.Pin 12547P is received in the axis hole of axis 12542 In 12549P, so that axis 12542 and pin 12547P are due to interference fit (for example, when blocking drive 12540 is driven) It rotates together.Therefore, pin 12547P can rotate in distal side lock part 12547.Therefore, in addition to when being switched to locked configuration Towards except the spring-loaded interference gear 12545 of distal side push shaft 12542, distal side lock part 12547 will push pin towards distal side The plunger of 12547P causes distal side lock part 12547 also to pull axis 12542 (referring to fig. 4 1) towards distal side.Distal side lock part 12547 are sandwiched in or are nested between lever arm 12562.Drive rod 12550 includes the gap for distal side lock part 12547 Slit 12557.
Another blocking device is provided to prevent the driving when the nail bin groupware used up is mounted in end effector assembly 12500 System 12510 is activated.The storehouse latch members or storehouse driver engagement arm 12660 used up be located in side frame 12620A, Between 12620B.Latch members 12660 include spring member 12661 and drive rod snap features or hook 12663.It is latched structure Part 12660 is shown in Figure 35 into Figure 38 with unlocked configuration.The nail bin groupware being mounted in end effector assembly 12500 12800 is unexhausted into Figure 37 in Figure 35.Unexhausted storehouse include staple drivers 12820, the staple drivers do not fired and In its nearest side position.Since in various embodiments, staple drivers such as staple drivers 12820 do not return after being fired Contracting, therefore the farthest position that it is reached when the staple drivers in the storehouse used up are maintained at percussion.Therefore, latch members 12660 are pushed by spring member 12661 to block drive rod 12550 in the case where staple drivers are not present, regardless of this There is no be due to being completely absent nail bin groupware or due to there is the storehouse used up.Anyway, it is buckled when by storehouse driver When feature structure 12663 is blocked, drive system 12510 is prevented to be activated.Drive system 12510 is also placed in knot by the locking configuration Conjunction state.
Referring primarily to Figure 39 to Figure 46, the operation of description instrument component 12100 will be carried out about surgical stapling regulation or operation now. The configuration that tool assembly 12100 do not capture into Figure 41 in Figure 39, does not clamp, does not fire, unlocks is shown.Due to unexhausted Nail bin groupware 12800 is mounted in end effector assembly 12500, so tool assembly 12100 is unlocked.Interfere gear 12545 are pushed out locking groove 12704S and in the latch-up window of internal framework 12,650 12704 and latch-up window or chamber It is rotated freely in 12655.Latch members 12660 push away drive rod by the staple drivers 12820 of unexhausted nail bin groupware 12800 12550, to provide without hindrance path for the traveling of drive rod 12550.Actuating pointed tooth 12563 for selling actuating mechanism 12560 In the first part of cam path 12702.Now, tissue can be placed on 12811 He of storehouse platform of instrument by the user of instrument Between anvil block 12640, to prepare to capture tissue.
Referring now to Figure 42 and Figure 43, drive system 12510 has been activated to capture tissue using tool assembly 12100.Closure Frame 12700 automatic deployment pin actuating mechanism 12560 and pin and being jacked up actuator tab 12563 with cam path 12702 12860.The contact of pin 12860 limits the anvil block 12640 of complete tissue acquisition phase.Closure frame 12700 also makes nail bin groupware 12800 promote towards anvil block towards distal side.At this point, tool assembly 12100 can activate main drive 12520 continuously to have continued Full grip tissue.However, if a user desire that taking out the tissue (tissue is not shown) currently captured, then user can be along opposite Direction actuator drive system 12510 is to be driven reverse system 12510, so that pin actuating mechanism 12560 be made to keep axis around pin Rotation is with the pin shaft 12863 that bounces back.For example, instrument can be equipped with sensor to detect when pin shaft 12863 reaches complete deployed position. The complete deployment of test pin can lead to the pause in actuating, whether to allow the determining tissue captured at this stage of user It is tissue that is to be clamped and being finally sewn.Once user determines that captured tissue is group that is to be clamped and being finally sewn It knits, then user can trigger the further actuating of main drive system 12510 to enter clamping phase.
In Figure 42 and Figure 43, the axis 12542 of blocking drive 12540 with its biasing member (key-lock of staple cartridge body 12810 Part 12817) its initial position is bounce back into when losing contact.In other words, spring 12544 is in in-between or uncompressed shape State.Due to 1) latch-up window 12655 of internal framework 12650 and 2) distal movement of closure frame 12700, interference Gear 12545 is still in freely rotatable position.Internal drive gear 12543 vertically moves in interior minister's item part 12541S But the meshing relation with it is kept, to allow the rotation when drive system 12510 is activated of blocking drive 12540.It closes The tab 12533 for closing nut pipe 12530 is located in slit 12653S, so that closure nut pipe 12530 is in driving screw portion It is translated in frame aperture 12653 when 12525 rotation.
Turning now to Figure 44, tool assembly 12100 is shown with complete clamping configuration.It is closed the tab 12533 of nut pipe 12530 Its farthest position is reached, allows to be closed nut pipe 12530 now and rotates.Tool assembly 12100 can be further configured to energy Enough actuatings for temporarily suspending main drive 12510 when reaching fully clamped position, so that the user of tool assembly 12100 Whether tissue that is can checking capture and being clamped now is target tissue to be stapled.In the user of tool assembly 12100 Want in the case where unclamping tissue, system 12510 can be driven reverse so that the tab 12533 for being closed nut pipe 12530 to be put back into In the slot 12653S in hole 12653, so that driving screw portion 12525 can pull closure nut pipe 12530, and it therefore will be closed frame Frame 12700 proximally pulls.If user determines that capture and now clamped tissue is target tissue to be stapled, User can trigger the further actuating of main drive 12510 to fire tool assembly 12100.
Figure 45 shows the tool assembly 12100 in complete firing configuration.Percussion screw portion 12535 has been rotated will drive Lever 12550 is promoted towards anvil block 12640, to push staple drivers 12820 towards distal side in staple cartridge body 12810.Nail driving This distal side of device 12820, which promotes, to cause to follow closely 12830 deployment from nail cavity 12813.Guide pin 12553 is by partly from closure frame It is released in its corresponding guide pin slot 12703 in frame 12700.In percussion tool assembly 12100 completely, tool assembly 12100 can It is driven reverse system 12510 automatically with the nail bin groupware 12800 that bounces back, unclamps and take out the tissue being just sewn.For example, this Automatic retracted may be due to following closely the 12830 any suitable sensor configurations fired completely for identification.In a kind of feelings Under condition, the fully actuated of drive rod 12550 can detect.In another case, percussion screw portion 12535 is configured to The rotation of enough rotation setting quantity is to promote set distance for staple drivers；When completing the rotation of setting quantity, tool assembly 12100 and/or tool assembly 12100 attached by instrument interface can initialize automatic retracted.For example, different when using When nail bin groupware and drive rod 12550 need the distance advanced change to adapt to different staple heights, this can be advantageous.
Referring now to Figure 46, tool assembly 12100 is shown with the configuration for not capturing, not clamping, fire completely.Locking component 12660 are pushed out by drive rod 12550.Its snap features 12663 is also directly touched and is being followed closely by locking component 12660 12820 lower section of driver.Snap features 12663 can individually prevent the staple drivers for the nail bin groupware 12800 used up now 12820 are proximally moved due to any.The tab 12533 of closure nut pipe 12530 is in its nearest side position.This is most Tab 12533 is placed in the nearside annular recess 12653AP in percussion hole 12653 by proximal position.Annular recess 12653AP permits Perhaps closed tube rotates simultaneously with driving screw portion 12525, with the drive rod 12550 that bounces back.
Figure 47 shows tool assembly 12100, and wherein nail bin groupware 12800 is unloaded out of end effector assembly 12500.It is unloading Before screw position component 12800, the snap features 12663 of locking component 12660 inwardly pushed by spring member 12661 with Block drive rod 12550.In this position, drive system 12510 is in bonding state, because drive rod 12550 cannot be pushed away Into.When the nail bin groupware 12800 used up is removed from tool assembly 12100, locking component 12660 is kept in the position.Locking Driving device 12540 starts its lock function when removing nail bin groupware 12800.Since distal side lock part 12547 is not by storehouse Body key-lock component proximally pushes, so spring 12544 actuates interference gear 12545, and therefore makes axis 12542 that will interfere gear In the 12545 locking groove 12704S for being placed in latch-up window 12704 towards distal side.It is being not installed on end effector assembly 12500 In the case where interior nail bin groupware, latch members 12660 and blocking drive 12540 provide two anti-actuation means or machine Structure, to prevent drive system 12510 to be activated.
Referring now to Figure 48, unexhausted nail bin groupware 12800 is shown as being not installed in end effector assembly 12500.Nail The base portion 12821 of driver 12820 is configured to by contact snap features 12663 and by snap features 12663 push away drive rod 12550 to unlock locking component 12660.As described above, key-lock part 12817 is configured to connect The inclined-plane 12548 for closing distal side lock part 12547 will interfere gear 12545 to release locking groove 12704S and freedom of entry rotation Indexing is set.
Nail bin groupware 12800 further includes state indicator system, visually to indicate to follow closely to the user of tool assembly 12100 12830 state.Referring now to Figure 49 and Figure 50, nail bin groupware 12800 to clamp completely, the configuration of part percussion is shown, The staple drivers 12823 of middle staple drivers 12820 partly extend above the platform 12811 of warehouse 12810.Storehouse window 12853 are arranged in staple cartridge body 12810, for showing the movement of staple drivers 12823.View on staple drivers 12823 itself Feel the movement of label 12823A, 12823B instruction staple drivers.For example, visual indicia 12823A, 12823B may include for example strong Degree or the solid color of shade variation, to show progress of the nail bin driver 12823 in warehouse 12810.Bigger intensity can Instruction staple drivers 12823 are close or arrived complete firing position.In other cases, staple drivers 12823 may include two Kind color；For example, the first color 12823A (such as blue) indicates that staple drivers 12823 are in intermediate progress, and the second face Color 12823B (such as red) indicates that staple drivers 12823 arrived complete firing position.
Surgical stapling attachment or tool assembly 13100 are shown in Figure 51 into Figure 69.Tool assembly or instrument 13100 are configured to Tissue can be clamped, sutures and cut during surgery.Referring primarily to Figure 51 to Figure 55, tool assembly 13100 includes attached Socket part point 13200, shaft assembly 13300, actuated articulation joints 13400 and end effector assembly 13500.Attachment part 13200 It is configured to be attached to the interface of surgical instruments.Instrument interface may include shank, all shanks as disclosed herein.Imagine Other embodiments, wherein tool assembly 13100 is not easy to be attached to instrument interface and dismantle from instrument interface, and opposite Ground is a part of integrated instrument.Attachment part 13200 is configured to receive rotational control motion, tool from instrument interface Component 13100 is attached to the instrument interface and rotational control motion is transmitted to shaft assembly 13300.It is as follows to be discussed more fully , these rotational control motions are transmitted to end effector assembly by actuated articulation joints 13400 by shaft assembly 13300 13500。
Attachment part 13200 includes shell 13201 and transmission device 13205, which includes joint motions transmission device, And end effector transmission device.Referring to Figure 56, joint motions transmission device includes joint motions driving connector 13210 (Figure 52) is configured to receive the rotary motion from instrument, input shaft 13212 and shell bearing 13211.Bearing 13211 are pivotably supported input shaft 13212.Input shaft 13212 includes the worm-drive part engaged with worm gear 13214 13213.Worm gear 13214 couples with traverse gear or pinion gear 13215, with the articulating shaft or bar of actuator shaft component 13300 13320.Gear 13215 rotates together with worm gear 13214.Articulating shaft 13320 includes the tooth being arranged in its portions of proximal Item 13325, the rack gear are engaged with pinion gear 13215, so that when pinion gear 13215 is entered axis 13212 and rotates, joint motions Axis or the longitudinal movement of connector 13320 are so that 13500 joint motions of end effector assembly.
End effector assembly 13500 is shown with the configuration of joint motions non-in Figure 65 or centre.As shown in Figure 66, joint motions Axis 13320 can be pushed towards distal side so that end effector 13500 is along first direction joint motions.Similarly, as shown in Figure 67, Articulating shaft 13320 can be pulled proximally so that end effector 13500 carries out joint fortune along second or opposite direction It is dynamic.As shown in Figure 65 to Figure 67, articulating shaft 13320 is not attached directly to end effector 13500；On the contrary, joint motions Axis 13320 is attached to end effector 13500 via joint movement connector 13324.End effector 13500 centre or In non-joint motions configuration, as shown in figure 55, joint movement connector 13324 prolongs from the region of joint motions axis A-A nearside Reach the region in the distal side joint motions axis A-A.Moreover, in the neutral configuration of end effector 13500, joint motions connection Part 13324 is merely positioned the side of the longitudinal axis L A limited by tool assembly 13100 and/or shaft housing 13301.Joint motions Connector 13324 includes curved configuration, which is configured to pass through in articulating shaft or driving device 13320 Joint motions transmission device promotes end effector assembly 13500 around articulating shaft proximally and/or when being translated to the far side Line A-A carries out joint motions.
End effector assembly 13500 includes the frame or ridge 13501 extended from actuated articulation joints 13400 towards distal side.Joint Kinematic joint 13400 includes the nearside yoke 13401 for being securely attached to shaft housing 13301, is securely attached to end effector The lower distal yoke arm 13402 of ridge 13501, and also it is securely attached to the top distal side yoke arm of end effector ridge 13501 13403.Yoke arm 13402,13403 is configured to rotate relative to yoke 13401 around joint motions axis A-A.Although not It shows, but pin or bar can be positioned along joint motions axis A-A, so that nearside yoke 13401 and yoke arm 13402,13403 surround It is pivoted.Joint movement connector 13324 is connected to top distal side yoke arm 13403 by pin 13404, so that working as articulating shaft 13320 relative to shaft housing 13301 vertically move when, articulating shaft 13320 can push or pull on top yoke arm 13403 so that End effector assembly 13500 carries out joint motions around joint motions axis A-A.
The end effector transmission device of transmission device 13205 includes driving input unit or mainly drives connector 13220, It is configured to receive rotary motion from instrument interface.End effector transmission device further includes input shaft 13222 and shell Bearing 13221, the shell bearing are pivotably supported input shaft 13222.Input shaft 13222 includes being supported on to axle journal Closed drive gear 13223, can be supported on to axle journal percussion driving gear 13224, and setting closure drive Strip shaft portion 13225 between gear 13223 and percussion driving gear 13224.Closed drive gear 13223 and shaft assembly 13300 corresponding output closed drive gear 13333 engages, and it is corresponding with shaft assembly 13300 defeated to fire driving gear 13224 Percussion sliding tooth wheel 13344 engages out.
The switch mechanism 13230 of end effector transmission device can closed drive gear 13223 driveability and hit Switch between the driveability of hair driving gear 13224.Unless engaged by switch mechanism 13230, otherwise closed drive gear 13223 do not rotate with percussion driving gear 13224.Closed drive gear 13223 includes one group of tooth or protruding portion 13226, is set It sets on the side towards percussion driving gear 13224 of closed drive gear 13223.Percussion driving gear 13224 includes one Group tooth or protruding portion 13227 are arranged on the side towards closed drive gear 13223 of percussion driving gear 13224.It cuts Exchanger body or disk 13235 include the tooth or protrusion being arranged on the first side towards closed drive gear 13223 of disk 13235 Portion 13236, and the tooth or protruding portion 13237 that are arranged in second side towards percussion driving gear 13224 of disk 13235. Switch plate 13235 is engaged with strip shaft portion 13225 and can be slided relative to the strip shaft portion.Switch plate 13235 is by switching Device arm 13233 is kept, which can be activated by switching solenoid 13231 so that switch arm 13233 in first position and It is moved between the second position, in first position, disk 13235 is engaged with closed drive gear 13223, in the second position In, disk 13235 is engaged with percussion driving gear 13224.When disk 13235 is engaged with closed drive gear 13223, driving The rotation of connector 13220 causes closed drive gear 13223 and is closed the rotation of axis 13330 in turn.Similarly, work as disk 13235 with percussion driving gear 13224 engage when, driving connector 13220 rotation cause percussion drive gear 13224 and And then the rotation of beating shaft 13340.Activation switching solenoid 13231, the onboard control can be realized by onboard controller 13203 Device processed is configured to receive signal from instrument interface and these signals is transferred to switching solenoid 13231.
Turning now to Figure 57, rotated as described above, actuated articulation joints 13400 are configured to receive from shaft assembly 13300 Control movement, and end effector assembly 13500 is transmitted or is transmitted in these rotational control motions.In order to by shaft assembly The rotary motion of 13300 closure axis 13330 is transmitted to the closure axis or driving device 13530 of end effector assembly 13500, And in addition the rotary motion of beating shaft 13340 is transmitted to the beating shaft or driving device of end effector assembly 13500 13540, while keeping the ability for making end effector assembly 13500 carry out joint motions relative to shaft assembly 13300, the joint Kinematic joint 13400 includes the construction of bevel gear.Beating shaft 13340 include be attached to beating shaft 13340 distal end it is defeated Enter bevel gear 13441, and the idle pulley bevel gear 13442 that engages of input bevel gear 13441, and output bevel gear wheel 13443 with it is lazy Wheel bevel gear 13442 engages and is attached to the beating shaft 13540 of the drive system of end effector assembly 13500.Idle pulley bores tooth Wheel 13442 has the rotation axis shared with joint motions axis A-A.Apart from the above, closure axis 13330 further includes being attached to Be closed axis 13330 distal end input bevel gear 13431, with joint motions axis A-A share rotation axis simultaneously The idle pulley bevel gear 13432 engaged with input bevel gear 13431, and engaged with idle pulley bevel gear 13432 and be attached to end The output bevel gear wheel 13433 of the closure axis 13530 of the drive system of portion's actuator assembly 13500.Bevel gear 13441,13442, 13443 be in nested configuration in bevel gear 13431,13432,13433 so that (inside) fire bevel gear 13441,13442, 13443, which can be closed bevel gear 13431,13432,13433 relative to (outside), rotates, and vice versa.
Output bevel gear wheel 13433,13443 can be rotated around joint motions axis A-A.When 13500 joint of end effector assembly When movement, output bevel gear wheel 13433,13443 is configured to make two idle pulley bevel gears 13432,13442 to convolution Turn.Being rotated back for idle pulley bevel gear 13432,13442 will cause to input being rotated back for bevel gear 13431,13441, and because This causes the rotation for being closed axis 13330 and beating shaft 13340.In order to avoid in 13500 joint motions of end effector assembly It is incorporated in end effector transmission device, the onboard controller 13203 of attachment part 13200 can be to switching solenoid 13231 Transmission signal is being placed in switch plate 13235 when user's actuated articulation moves driving connector 13210, switch plate 13235 The middle position not engaged with the driving gear 13223,13224 that can support to axle journal.As a result, driving gear 13223,13224 It will be rotated freely relative to input shaft, therefore propagate the rotation of bevel gear assembly due to joint motions.
End effector assembly 13500 further includes the first jaw 13510 and the second jaw that can be movable with respect to each other 13520.Turning now to Figure 58, end effector assembly 13500 includes closed system, which is configured to make to clamp Mouth 13510,13520 moves between the open and the closed positions.Closed system includes closure frame 13535, the closure frame Frame has the closure nut 13536 being threadedly engaged with the closure screw portion 13531 of closure axis 13530.It is closed activating or rotating When sympodium 13530, closure frame 13535 can be moved relative to end effector frame 13501.Axis 13530 is closed along first The rotation of direction of rotation causes the distal movement of frame 13501.Axis 13530 is closed along second rotation opposite with the first direction of rotation The rotation for turning direction causes the proximal movement of frame 13501.The thrust bearing being located at the distal end of closure axis 13530 13533 are supported in the frame support 13503 of end effector frame 13501.It is discussed in greater detail below, end effector Component 13500 further includes the trigger system 13550 activated by the percussion driving gear 13541 of beating shaft 13540.It is closed axis 13530 and beating shaft 13540 be configured to be independently of one another.
Figure 64 is the partial view of the end effector assembly 13500 in opening or non-clamping configuration.In order to utilize tool group 13100 grip tissue of part is closed driving device 13530 by actuating, and two jaws 13510,13520 are moved to from open position Closed position.The rotation of closure driving device 13530 makes to be closed the rotation of screw portion 13531.It is closed the rotation of screw portion 13531 Closure nut 13536 is quoted and closure frame 13535 is therefore caused to translate relative to end effector frame 13501.Complete When full retraction closure frame 13535, closure nut 13536 is configured to receive and limit between yoke arm 13402,13403 Recess portion in.
End effector frame 13501 is positioned at least partially in closure frame 13535, so that end effector frame 13501 two sides receive in the respective slots of closure frame 13535.This construction allows end effector frame 13501 extend through closure frame 13535 and allow closure frame 13535 mobile relative to end effector frame 13501.End Portion's actuator assembly 13500 further includes the anvil portion 13521 being arranged on jaw 13520, is configured to make to follow closely 13575 formings.Jaw 13520 is positioned at least partially in end effector frame 13501.Jaw 13520 includes a pair of causes Dynamic pin 13527 in a pair of of the closure frame slit 13537 being limited in closure frame 13535 and can be limited to end execution It is moved in a pair of end portions actuator frame slot 13507 in device frame 13501.Jaw 13520 further includes nearside hook portion 13522, which includes a pair of of the slit 13522S being positioned in.Nearside hook portion 13522 is configured to It is hooked on or is latched in the frame pin 13502 of end effector frame 13501.Jaw 13520 can surround 13502 pivot of frame pin Turn.In the case where user wants replacement jaw 13520 for any reason, the open slot configuration of hook portion 13522 is permitted Perhaps jaw 13520 is removed from end effector assembly 13500.
By promoting closure frame 13535 towards distal side, so that the jaw 13520 that is grounded by pin 13502 and can be rotated around the pin Closed position is rotated to, causes a pair of of closing cam surface 13537C of closure frame slit 13537 by the pin of jaw 13520 13527 jack up towards jaw 13510.The jaw that is grounded by pin 13515 and can be rotated around the pin axis limited by pin 13515 13510 are moved to rotation position and promoting closure frame 13535 towards distal side, cause the closing cam of closure frame 13535 Surface 13532 jacks up the bottom surface 13512 of jaw 13510 towards jaw 13520.Similarly, it is closed by proximally mobile Frame 13535 makes jaw 13520 be moved to open position, causes a pair of openings cam face of closure frame slit 13537 13537O (see Figure 68) jacks up the pin 13527 of jaw 13520 upwards.When pin 13527 by relative to frame 13501 upwards and to When lower jack-up, end effector frame slit 13507 is the clearance slot of pin 13527.By proximally moving closure frame 13535 make jaw 13510 be moved to open position, and closing cam surface 13532 is caused proximally to be moved, to allow jaw 13510 open downwards relative to frame 13501.Jaw 13510 includes a pair of curved recess portion 13517, between providing for pin 13527 Gap.
Apart from the above, as can be seen that jaw 13510 encloses the axis rotated about and jaw 13520 around it such as in Figure 69 The axis of rotation is not identical.It is offset from one another perpendicularly to the axis and horizontally.Jaw 13510 encloses the axis rotated about relative to pincers It is distally located that mouth 13520 encloses the axis rotated about.Vertical range between axis can limit storehouse 13570 and anvil block 13521 it Between predetermined tissue space distance and/or clamping distance.
When tool assembly 13100 is in non-clamping configuration (Figure 66), apart from the above, closure nut 13536 is in it recently Side position, the position are the recess portions being limited between yoke arm 13402,13403.In non-clamping configuration, the top table of jaw 13520 Face is completely exposed, and the user of tool assembly 13100 is allowed to remove jaw 13520 from instrument.This, which is provided, is readily able to replace Anvil block configuration.
End effector frame 13501 supports trigger system 13550, which is configured to suture and/or cut The tissue clamped with tool assembly 13100.The trigger system 13550 discussed in greater detail below is configured to by beating shaft 13540 percussion driving gear 13541 activates.Jaw or storehouse support channel 13510 include a pair of pivot pin 13515, this is to pivot Pivot pin extends outwardly relative to jaw 13510, and is configured to receive in a pair of corresponding frame aperture 13505, from And allow jaw 13510 and nail bin 13570 therefore allowed to surround the pivot axis limited by pin 13515 to execute relative to end Device frame 13501 pivots.
Trigger system 13550 includes the driving gear 13551 engaged with percussion driving gear 13541.Gear 13551 is driven to position On nearside beating shaft 13552, the nearside beating shaft is rotatable by the frame support 13504 of end effector frame 13501 Ground support.Trigger system 13550 further includes percussion screw shaft 13555, which includes being supported on pushing away for jaw 13510 Nearside thrust bearing 13554 in power bearing supports 13514 and the distal side being supported in the bush assembly 13573 of top and bottom Thrust bearing 13556.Bush assembly 13573 is located in distal side storehouse chamber 13572.Trigger system 13550 further includes U-joint 13553, which is operatively coupled beating shaft 13552 and percussion screw shaft 13555.U-joint 13553 allows jaw 13510 rotate around the pivot axis limited by pin 13515, while keeping nearside beating shaft 13552 and percussion screw shaft 13555 Between driving relationship.In all cases, U-joint 13553 is located at the axis limited by pivot pin 13515；However, U-joint 13553 can be located at any suitable location.
Trigger system 13550 further includes firing member or sliding part 13560.Sliding part 13560 includes the screw thread extended through Hole, the threaded hole are threadedly engaged with percussion screw shaft 13555.Sliding part 13560 is limited to be revolved together with percussion screw shaft 13555 Turn or at least substantially rotate, and therefore, when firing screw shaft 13555 around the rotation of its longitudinal axis, fires screw shaft 13555 make 13560 vertical shift of sliding part.In use, when percussion screw shaft 13555 is rotated in a first direction, sliding part 13560 shift towards distal side, and when percussion screw shaft 13555 rotates in a second direction, which is proximally shifted.
As described in more detail below, during following closely firing schedule, sliding part 13560 is in non-firing position (Figure 59) and percussion position It sets and is shifted between (Figure 60) towards distal side, to project nail 13575 from nail bin 13570 and suture capture in anvil portion 13521 and nail Tissue between storehouse 13570.Reader should will be seen that group is woven in when being sewn and is not cut from Figure 59 and Figure 60.More It says to body, sliding part 13560 includes knife or cutting element 13561, is maintained at during following closely firing schedule and does not dispose or reduce Position.After completing to follow closely firing schedule, referring now to Figure 61, sliding part 13560 proximally bounces back.13560 court of sliding part Proximal retraction, until cutting element 13561 contacts the pin or cam 13516 that extend from the frame of nail bin 13570.Cutting element 13561 are rotatably mounted to sliding part 13560, and when 13561 contact plug 13516 of cutting element, cutting element 13561 It is rotated upwardly in deployed position.At this point, sliding part 13560 can be promoted again towards distal side to cut and stitch during cutting stroke The tissue of conjunction, as shown in Figure 63.
Cutting element 13561 slides in the longitudinal slit 13571 being defined in nail bin 13570.Pin 13516 is from thrust bearing branch Support member 13514 extends and is aligned with longitudinal slit 13571.When sliding part 13560 is in its non-firing position (Figure 59), cutting Component 13561 is not contacted with pin 13516；However, when sliding part 13560 proximally bounces back relative to its non-firing position, such as Shown in Figure 61,13561 contact plug 13516 of cutting element is simultaneously rotated in its deployed position.More particularly, cutting element 13561 13566 engaging pin 13516 of cam arm is simultaneously rotated upwardly to its cutting position from its non-cutting position.
As described above, Figure 59 is shown in not firing or the tool assembly 13100 of initial configuration.In tool assembly 13100 In this non-percussion configuration, also as described above, sliding part 13560 is in its non-firing position and cutting element 13561 is in Its non-cutting position.Tool assembly 13100 can be configured to detection sliding part 13560 whether in its non-firing position and/ Or whether cutting element 13561 is in its non-cutting position.In at least one situation, nail bin 13570 may include the first biography Sensor, the first sensor are configured to be able to detect sliding part 13560 if sliding part 13560 is in its non-firing position Presence.Similarly, nail bin 13570 may include second sensor, if the second sensor is configured to cutting element 13561 The presence of cutting element 13561 is then able to detect in its cutting position.First sensor and second sensor may include for example Proximity sensor, and can be communicated with the controller signals of tool assembly 13100.
When sliding part 13560 reach its firing schedule its farthest position when, as shown in figure 60, it is all nail 13575 by from Nail bin 13570 is disposed.In all cases, sensor is arranged at the distal end of end effector assembly, the sensor quilt It is configured to whether detection sliding part 13560 arrived its farthest position.Sensor may include for example, with tool assembly 13100 Controller carry out signal communication proximity sensor.Once all nails 13575 are fired, instrument controller can be to using Person sends the signal that firing schedule is completed.At this point, user can operational instrument component 13100 with the sliding part 13560 that bounces back, with It just is the cut portion preparation tool component 13100 of the regulation.Alternatively, tool assembly 13100 is configured to hitting Issue automatic retracted sliding part 13560 after journey is completed.
As described above, Figure 61 shows the tool assembly 13100 in such configuration, wherein all nails fired and Firing member has been retracted into recent side or mode switch positions.Also as described above, which allows pin 13516 to connect It closes the cam arm 13566 of cutting element 13561 and cutting element 13561 is rotated into its cutting position.In all cases, may be used Prevent sliding part 13560 from reaching the mode switch positions, until instrument controller has received the nail completed letter of firing schedule Number.In the example as at least one, does not terminate sensor from firing schedule in instrument controller and receive confirmation percussion In the case where the completed signal of stroke, once sliding part 13560 arrived its non-firing position, then instrument controller can be interrupted Power supply to the motor of percussion driving device.The case where instrument controller receives nail firing schedule completed signal Under, instrument controller allows sliding part 13560 proximally to bounce back and crosses its non-firing position into its mode switch positions.
Once sliding part 13560 is moved into mode switch positions, instrument controller just allows sliding part 13560 by again It is secondary to be promoted towards distal side.In all cases, instrument may include tissue cutting switch, which when depressed, can Actuating percussion driving device 13540 again, to drive sliding part 13560 to pass through nail bin 13570 by second or cutting stroke.When When cutting element 13561 has been increased in its cutting position now, cutting element 13561 will cut the tissue of suture.
Apart from the above, tool assembly 13100 is configured to complete to incite somebody to action after its tissue cutting stroke in sliding part 13560 Cutting element 13561 is reduced to its non-cutting position.More particularly, referring primarily to Figure 63, the cam part of cutting element 13561 13566 are divided to be configured to contact distal pin or cam 13574 at the end of tissue cutting stroke, wherein this phase interaction With making cutting element 13561 be rotated downwardly to its non-cutting position.Therefore, sliding part 13560 can be in no cutting element 13561 It bounces back in the case where being exposed to tissue.Moreover, therefore, jaw 13510,13520 can be unclamped from tissue after cutting stroke, and Cutting element 13561 does not expose.Reader should understand that cutting element 13561 at the end of firing schedule not with distal pin 13574 Interaction, because cutting element 13561 has been in it during firing schedule reduces position.
As described above, tool assembly 13100 is configured to forbid cutting the tissue clamped by tool assembly 13100, until Until all nails 13575 are fired or are fully formed.Similarly, as described above, since cutting element 13561 can be non-cutting It is pivoted between position and cutting position, therefore the bifurcated of this function is possible.
Figure 70 is the perspective view according to the nail bin 4410 of at least one embodiment being used together with circular surgical staplers tool. A variety of circular surgical staplers tools are known.For example, on August 26th, 2015 entitled " the SURGICAL STAPLING submitted The U.S. Patent application sequence of CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS " Row number 14/836,110 discloses various circular surgical staplers tool constructions, which is incorporated by reference simultaneously accordingly Enter.Entitled " the CIRCULAR FASTENER CARTRIDGES FOR APPLYING submitted on September 26th, 2014 The U.S. Patent Application Serial Number 14/498,070 of RADIALLY EXPANDING FASTENER LINES " also discloses various Circular surgical staplers construction, the entire disclosure are hereby incorporated by reference.Such as institute in these references It discusses, circular surgical staplers generally include frame assembly, which includes being configured to that anvil block can be operated Ground is connected to the attachment part of circular surgical staplers.
In general, anvil block includes anvil head, which supports one or more toroid of nail shapes pit.Anvil stem or Trochar part is attached to anvil head and is configured to be removably coupled to the anvil block attachment of circular stapler instrument Part.Various circular surgical staplers tools include for selectively toward and away from the device of the mobile anvil block of surgery nail bin, making Obtaining destination organization can be sandwiched between anvil block and the platform of surgery nail bin.Multiple surgical staples are removedly stored in by surgery nail bin Wherein, the multiple surgical staples are arranged with one or more annular arrays, and one or more of annular arrays correspond to setting The arragement construction of nail shapes pit in anvil block.Nail is removedly stored in corresponding nail cavity, and the nail cavity is in nail bin It shapes and is supported on the corresponding part of alternative mobile promotion device assembly, which is operationally received In circular stapler.Circular stapler further includes endless knife or cutting element, is configured to incision and is sandwiched in anvil block Tissue between nail bin.
Referring again to Figure 70, nail bin 4410 includes warehouse 4411, which limits annular bin platform surface 4412.Warehouse 4411 wraps Include the inner annular row 4420 of inside nail cavity 4422 spaced apart and the outer annular row 4440 of external nail cavity 4442 spaced apart. Internal nail cavity 4422 is interlocked relative to the nail cavity 4442 that space outside is opened, and can be seen that such as in Figure 70.In each internal nail cavity Surgical staples 4430 and the surgical staples 4450 on the outside of 4442 inner support of each external nail cavity on the inside of 4422 inner supports.Outer annular row Outside nail 4450 in 4440, which can have, follows closely 4430 different features from the inside in inner annular row 4420.For example, such as Figure 71 Embodiment shown in, outside nail 4450 have unfashioned " gull wing type " configuration.In particular, each 4450 packet of outside nail Include a pair of of the leg 4454,4464 extended from crown 4452.Each leg 4454,4464 includes respectively from the vertical of the extension of bizet 4452 Part 4456,4466.In one embodiment, vertical portion 4456,4466 can be parallel to each other.However, the cloth shown in It sets in structure, vertical portion 4456,4466 is not parallel each other.For example, in the arragement construction shown in, bizet 4452 and vertical portion Divide the angle A between 4456,44661Greater than 90 degree.Referring to Figure 71.Other details about nail configuration is found in June, 2014 The U.S. of entitled " the FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS " that submits for 30th is special Sharp patent application serial numbers 14/319,008 are now U.S. Patent Application Publication 2015/0297232, the entire disclosure accordingly with Way of reference is incorporated herein.However, other vertical portions 4456,4466 can arrange at other angles relative to bizet 4452. Make vertical leg 4456,4466 relative to bizet 4452 with greater than 90 degree angle orientation an advantage be this arragement construction It can help to follow closely and be temporarily retained in its corresponding nail cavity.
At least one leg 4454,4464 includes the end to extend internally.In the embodiment shown in Figure 71, for example, each leg 4454,4464 include the leg to extend internally.In the arragement construction shown in, leg 4458 is inwardly prolonged from vertical leg 4456 It stretches, and leg 4468 extends internally from vertical leg 4466.As can be seen that leg 4458 is than leg 4468 such as in Figure 71 It is short.In other words, the distance between the point that crown 4452 and leg 4458 are inwardly at an angle of from vertical leg 4456 HAGreater than nail The distance between the point that hat 4452 is inwardly at an angle of with leg 4468 from vertical leg 4466 HC.Therefore, at least one embodiment party Distance H in caseBShorter than length HD.Leg 4458 is relative to vertical 4556 angulation A of leg2It can be equal to 4468 phase of leg For vertical 4466 angulation A of leg3Or angle A2, and angle A3It can be different from each other.About the other thin of nail configuration Section is found in entitled " the FASTENER CARTRIDGE COMPRISING NON-UNIFORM submitted on June 30th, 2014 The U.S. Patent Application Serial Number 14/319,008 of FASTENERS " is now U.S. Patent Application Publication 2015/0297232, It has been herein incorporated by reference.
In at least one embodiment, each inside surgical staples 4430 can have configuration shown in Figure 71.Such as in Figure 71 As can be seen that inside surgical staples 4430 have bizet 4432 and two vertical legs 4434,4436 extending therefrom.Vertical leg 4434,4436 can relatively orthogonally extend or they can be greater than 90 degree of angle A from bizet 44324Extend.This cloth It sets structure and can help to that 4430 will be followed closely and be temporarily retained in its corresponding nail cavity 4422.However, vertical leg 4434,4436 can be from hat Portion 4432 is extended with different angle.In some embodiments, angle A4It is equal to each other.In other embodiments, angle A4That This is different.In the illustrated embodiment, 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 traditional surgical staples 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 be formed by the line with other diameters.In some arragement constructions, inside nail and outer Side nail can be formed by the staple line of same type.Therefore, in this arragement construction, the linear diameter of inside nail and outside nail will be phase With.However, in yet another embodiment, inside nail and outside nail can unshaped shape/configuration having the same, but by Two different staple lines with different linear diameters are formed.Equally at least one arragement construction, each outside nail 4450 Bizet width C WOGreater than the bizet width C W of each inside nail 4430I.Other details about nail configuration is found in June, 2014 The U.S. of entitled " the FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS " that submits for 30th is special Sharp patent application serial numbers 14/319,008 are now U.S. Patent Application Publication 2015/0297232, have been incorporated by reference this Text.
Figure 70 is returned to, nail bin 4410 includes the outer rim 4414 extended above platform surface 4412.During operation, clinician Adjustable position of the anvil block relative to the storehouse of circular stapler.In at least one such embodiment, nail bin 4410 further includes The platform features structure 4416 and 4418 extended from platform surface 4412.As can be seen that a series of internal platforms such as in Figure 70 Feature structure 4416 is arranged between the interior row 4420 of nail cavity 4422 and the knife opening 4413 of center setting, and knife or cutting element will The knife is passed through during percussion to be open.Platform features structure 4416 can shape and determine relative to internal nail cavity and opening 4413 Position, as shown in Figure 70, Figure 72 and Figure 73.For example, each internal platform feature structure 4416 can have the wall with knife opening 4413 Coextensive flat wall part 4415 and the conical or inclined main part adjacent with the row of the inside nail cavity 4422 4417.Referring to Figure 72 and Figure 73.In the embodiment shown in Figure 70, platform features structure 4416 is in two adjacent internal nails It is orientated in gap between chamber 4422, and interlocks between pairs of nail cavity 4422 as shown in the figure.Chamber in the system extends Arragement construction or platform features structure can be used for reducing the pressure typically encountered in flat platform storehouse.The arragement construction of the disclosure is also It can help to mitigate tissue movement and sliding.Since the sliding of tissue is usually undesirable, outer diameter keeps feature structure It can be bigger and more.When blade passes through internal internal diameter, internal diameter feature structure can be used for increasing tissue tension/shearing force, this System can be made to cut more preferably.However, platform features structure 4416 can have different shape and configuration, and platform can be located at At different location on surface 4412.
It can also be seen that nail cavity 4442 includes related to each of which end outside one such as in Figure 70, Figure 72 and Figure 73 The external platform feature structure 4418 of connection.External platform feature structure 4418 extends above platform surface 4412, and when nail 4450 guide outside nail 4450 towards anvil block when being projected from nail bin 4410.In such embodiment, until firing member Keep outside nail 4450 mobile towards anvil block, outside nail can just extend above external platform features structure 4418.Referring primarily to figure 70, at least one embodiment, external platform feature structure 4418 does not extend around entire corresponding external nail cavity 4442. First external platform feature structure 4418 is oriented, and second exterior flat adjacent with the first end of corresponding external cavity 4442 Platform feature structure 4418 is oriented adjacent with the second end of external cavity 4442.As can be seen that external platform such as in Figure 70 Feature structure 4418 is associated every one in external nail cavity 4442.This arragement construction can be used for reducing gross pressure and make Tissue stretches and movement minimizes.However, in other embodiments, the first and second external platform feature structures 4418 can be with Each of external nail cavity 4442 is associated.In other embodiments, external platform feature structure can be around corresponding external The entire periphery of chamber extends.As can be seen that internal platform feature structure 4416 is than external platform feature structure such as in Figure 72 4418 is short.In other words, each internal platform feature structure distance of protrusion above platform surface 4412 is less than each outside The distance of protrusion above platform surface 4412 of platform features structure 4418.Each external platform feature structure can be in platform surface 4412 top protrusions identical distance of the distance of protrusion above platform surface 4412 with outer rim 4414.In addition, such as in Figure 72 It can also be seen that each external platform feature structure 4418 has the outer profile of conical shaped or taper, can help to Prevent tissue hook in platform features structure during colon and rectum that stapler head is inserted through patient.
Above-mentioned platform features structure arragement construction can provide one or more advantages.For example, upright outer rim can help to prevent Tissue slips over storehouse platform.The vertical edge may also include the repeat patterns of spikes/low- points, rather than a continuous antelabium shape State.Internal upright nature structure, which can also aid in, is maintained at cutting near blade and improved for tissue.Internal platform is special Levying structure can be between each chamber, or in alternative arragement construction, platform features structure may include one continuous straight Vertical antelabium.The quantity of balance platform feature structure may be needed so that high-tensile strength/constricted zone quantity minimizes, while obtaining institute The tissue immobilization of requirement.Chamber concentric character structure can be used for minimizing the attached of tissue flowing from its region outstanding in nail leg Add purpose.When nail leg ejects and is transitioned into reception anvil block pit, this arragement construction is also convenient for required nail forming, described to connect Receiving anvil block pit can be made of corresponding forming pit.Such part pit feature structure increases low constricted zone, simultaneously It is convenient for when nail leaves storehouse from storehouse supporting leg.Therefore, this arragement construction jump nail must " before it meets with anvil block pit The distance minimization of jump ".Tissue flowing tends to radially increasing outward from storehouse.
Figure 72 and Figure 73 shows the use that surgery nail bin 4410 is combined with anvil block 4480.Anvil block 4480 includes anvil head part 4482, nail shaping insert or part 4484 and edge bearing circle 4490 can be operatively supported.Edge bearing circle 4490 with be supported on The relationship that knife 4492 in stapler head faces is supported.In the illustrated embodiment, nail shaping insert 4484 is by for example Steel, stainless steel etc. are made, and include the inside nail shapes pit 4486 of interior row and the external nail shapes pit 4488 of outlet.Often A internal nail shapes pit 4486 corresponds to one in internal nail cavity 4422, and each external nail shapes pit 4488 is corresponding One in external nail cavity 4442.In the arragement construction shown in, when anvil block 4480 is mobile relative to storehouse platform surface 4412 When to its firing position, internal nail shapes pit 4486 is than external nail shapes pit 4488 closer to storehouse platform surface 4412.It changes Word says that first follows closely the first gap g between shaped portion 4485 and storehouse platform surface 44121Or first nail forming distance be less than The second gap g between second nail shaped portion 4487 and storehouse platform surface 44122Or second nail forming distance.
Such as in Figure 72 and Figure 73 can with it is further seen that, inside nail 4430 respectively is supported on be located at push device assembly 4500 pair Its for answering on inner drive part 4502 corresponds in internal nail cavity 4422, and each of outside nail 4450 is supported on pair It answers in the external nail cavity 4442 of its correspondence on peripheral driver part 4504.Push propulsion of the device assembly 4500 towards anvil block 4480 Inside nail 4430 and outside nail 4450 will be made to be driven into the forming of nail shapes pit 4486,4488 corresponding with each to connect Touching, as shown in Figure 73.In addition, knife 4492 is advanced through the group being clipped between anvil block 4480 and platform surface 4412 towards distal side It knits, and passes through the frangible bottom 4491 of edge bearing circle 4490.This arragement construction is used to provide the height of forming for outside nail 4450 Spend FHO, this is highly 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, to generate bigger trapping volume and/or higher nail forming height to mitigate near outer staple 4440 High tissue compression.Bigger B form can also improve the blood flow moved towards drainage in these.In all cases, outside is followed closely 4450 outlet 4440 passes through using bigger crown, nail leg width and/or nail leg thickness, and has bigger mounted resistance.
The quantity of nail used in every nail can change.In one embodiment, for example, in the presence of more than inside nail 4430 Outside nail 4450.Another embodiment is used than the more inside nails 4430 of outside nail 4450.In all cases, outside The linear diameter of nail 4450 is greater than the linear diameter of inside nail 4430.Inside nail 4430 and outside nail 4450 can unshapeds having the same Height UFH.Bizet width C W in the outlet 4440 of outside nail 4450OGreater than the bizet width of the interior row 4420 of inside nail 4430 CWI.The gull wing type configuration of outside nail 4450, which uses, to be located at away from the bending section at its corresponding bizet different distance.Using with flat The staged anvil block configuration on (non-staged) storehouse platform surface 4412, the configuration have uniform driver or pusher stroke, To generate the nail with differing formed height.
Figure 74 shows another nail bin embodiment 4610.As can be seen that nail bin 4610 includes storehouse platform such as in Figure 74 4612 comprising the annular row 4620 of inside nail cavity 4622 spaced apart and the outer ring row of external nail cavity 4642 spaced apart 4640.Internal nail cavity 4622 is interlocked relative to the nail cavity 4642 that space outside is opened, and can be seen that such as in Figure 74.In each inside Surgical staples 4630 and the surgical staples 4650 on the outside of 4642 inner support of each external nail cavity on the inside of 4622 inner support of nail cavity.In addition, Outer rim 4614 extends above platform surface 4612.In various embodiments, than that described above, until firing member makes to follow closely 4630, it 4650 is moved towards anvil block, nail just projects into 4612 top of platform surface.Such embodiment often using relative to Lesser nail for the depth for the corresponding nail cavity that they are stored therein in.In other embodiments, when nail is in its non-percussion When position, the leg of nail projects into 4612 top of platform surface.In at least one such embodiment, nail bin 4610 further include from The platform features structure 4616 and 4618 that platform surface 4612 extends.
It can also be seen that nail cavity 4622 includes internal platform associated with each of which end inside one such as in Figure 74 Feature structure 4616.Internal platform feature structure 4616 extends above platform surface 4612, and when corresponding inside is followed closely 4630 guide corresponding inside nail 4630 towards anvil block when being projected from nail bin 4610.In such embodiment, until hitting Hair component keeps inside nail 4630 mobile towards anvil block, and inside nail can just extend above internal platform features structure 4616.Scheming In the example shown, internal platform feature structure 4616 does not extend around entire corresponding internal nail cavity 4622.First internal platform Feature structure 4616 is oriented, and second internal platform feature structure adjacent with the first end of corresponding inner chamber 4622 4616 be oriented it is adjacent with the second end of inner chamber 4622.However, in other embodiments, internal platform feature structure 4416 can be associated with each of internal nail cavity 4622.In other embodiments, internal platform feature structure can surround The entire periphery of corresponding internal nail cavity extends.By using the platform features structure in concentric pat with different height, at this They are associated with every a chamber in concentric pat, it is possible to provide the tissue space region of more lower pressures, while by they It is balanced with by nail leg as much as possible guidance expectation as prolonged as possible.In other words, this arragement construction can make flow of tissue Momentum minimizes, to reduce the stagnation pressure strength for being applied to destination organization.
Referring still to Figure 74, each external nail cavity 4642 includes external platform feature structure associated with each of which end 4618.External platform feature structure 4618 extends above platform surface 4612, and when nail 4650 is projected from nail bin 4610 When by outside nail 4650 towards anvil block guide.In such embodiment, until firing member makes outside nail 4650 towards anvil block Mobile, outside nail can just extend above external platform features structure 4618.Such as the example in Figure 74 as can be seen that shown in In, external platform feature structure 4618 does not extend around entire corresponding external nail cavity 4642.First external platform feature structure 4618 are oriented adjacent with the first end of corresponding external cavity 4642, and the second external platform feature structure 4618 is positioned At adjacent with the second end of external cavity 4642.As can be seen that external platform feature structure 4618 and external nail such as in Figure 74 Each of chamber 4642 is associated.However, in other embodiments, the first and second external platform feature structures 4618 can It is associated every one in external nail cavity 4642.In other embodiments, external platform feature structure can be around correspondence The entire periphery of external cavity extends.As can be seen that internal platform feature structure 4616 and external platform such as in Figure 75 and Figure 76 Feature structure 4618 extends identical distance above platform surface 4612.In other words, their height having the same.Separately Outside, it can also be seen that each internal platform feature structure 4416 and each external platform feature structure such as in Figure 75 and Figure 76 4618 outer profiles with conical shaped or taper can help to be inserted through the colon of patient and straight in stapler head Prevent tissue hook in platform features structure between intestinal phase.
Figure 75 and Figure 76 shows the use that surgery nail bin 4610 is combined with anvil block 4680.Anvil block 4680 includes anvil head part 4682, nail shaping insert or part 4684 and edge bearing circle 4690 can be operatively supported.Edge bearing circle 4690 with be supported on The relationship that knife 4692 in stapler head faces is supported.In the illustrated embodiment, nail shaping insert 4684 is by for example Steel, stainless steel etc. are made, and include the inside nail shapes pit 4686 of interior row and the external nail shapes pit 4688 of outlet.Often A internal nail shapes pit 4686 corresponds to one in internal nail cavity 4622, and each external nail shapes pit 4688 is corresponding One in external nail cavity 4642.In the arragement construction shown in, internal nail shapes pit 4686 and platform surface 4612 Distance g1It is identical as at a distance from external nail shapes pit 4688 and the platform surface.
Such as in Figure 75 and Figure 76 can with it is further seen that, inside nail 4630, which is supported on, pushes the corresponding internal of device assembly 4700 to drive In corresponding internal nail cavity 4622 on dynamic device part 4702.Outside nail 4650 is supported on corresponding peripheral driver part 4704 In corresponding external nail cavity 4642.Push the propulsion of device assembly 4700 towards anvil block 4680 that will make inside nail 4630 and outside nail 4650 It is driven into nail shapes pit 4686 corresponding with each, 4688 shaping contacts, as shown in Figure 76.In addition, 4692 quilt of knife It is advanced through the tissue being clipped between anvil block 4680 and platform surface 4612 towards distal side, and passes through the frangible bottom of edge bearing circle 4690 Portion 4691.In the embodiment shown in Figure 75 and Figure 76, each inside follows closely 4630 by having the first linear diameter D1And have first Unshaped height L1The first staple line formed.For example, the first linear diameter D1It can be about 0.0079 inch to 0.015 inch (to increase Amount is usually 0.0089 inch, 0.0094 inch and 0.00145 inch), and the first unshaped height L1It can be about 0.198 inch to 0.250 inch.Each outside nail 4650 is formed by the second staple line, which has the second linear diameter D2 And there is the second unshaped height L2.In the discribed embodiment of Figure 75 and Figure 76, D1<D2And L1<L2.However, such as As can be seen that inside nail 4630 and outside nail 4650 are formed with identical forming height FH in Figure 76.It is smaller with inboard row The nail of diameter is compared, and the thicker tailor's tack in outside tends to provide high tearing and bursting strength, these nails tend to preferably keep hemostasis. In other words, closer inside staple can be better maintained hemostasis, and the staple of external less compression can promote more preferably Healing and blood flow.In addition, the nail with longer leg, even if being shaped at height identical as the nail with shorter leg When, also ensure that more bending sections B, this may make that the nail of longer leg is stronger and is more likely to suitably shape to be enough to protect It holds under high loading conditions.The quantity of nail used in every nail can change.In one embodiment, for example, interior row 4620 have the inside nail 4630 that 4650 identical quantity are followed closely with the outside of outlet 4640.In various arragement constructions, 4650 are followed closely Bizet width is greater than the bizet width of inside nail 4630.In other embodiments, nail 4630,4650 can bizet having the same Width.In other arragement constructions, nail 4630,4650 can be above-mentioned gull wing type design.For example, at least one leg of nail can wrap It includes aduncate end or two legs may include end aduncate toward each other.This nail can be used in interior ring row Or in outer ring row, or arranges used in annular and arranged in the two with outer ring.
Figure 77 shows another round nail bin embodiment 4810 comprising storehouse platform 4812, the storehouse platform include being spaced apart Nail cavity three ring rows 4820,4840,4860.Interior row or first row 4820 include more than first a inner cavities or the first nail cavity 4822, respectively arranged with first angle.Each internal nail cavity 4822 operationally supports corresponding inside to follow closely or the wherein One nail 4830.Inner chamber 4822 makes the first nail 4830 with the identical uniform angle orientation relative to tangential direction.In showing for diagram In example, each inside nail 4830 is by having the first nail diameter D1The first staple line formed.In one example, the first staple line diameter D1Can be about 0.0079 inch to 0.015 inch, (increment is usually 0.0089 inch, 0.0094 inch and 0.00145 English It is very little).Referring to Figure 80, each inside nail 4830 includes the first bizet 4832 and two the first legs 4834.First bizet has first Bizet width C1, and each first leg 4834 has the first unshaped leg length L1.In one example, the first bizet width C1It can be about 0.100 inch to 0.300 inch, and the first unshaped leg length L1It can be about 0.198 inch extremely 0.250 inch.First leg 4834 can be respectively relative to the first crown 4832 with angle A1Arrangement.Angle A1Can be about 90 ° or It can be slightly larger than 90 ° to person, so that the first leg 4834 opens slightly outwards, to help the first nail 4830 being maintained at its corresponding In first nail cavity 4822.
Figure 78 and Figure 79 are gone to, nail bin 4810 is intended to be used in combination with anvil block 4900, which includes the first nail shapes pit Row or first row 4902 in two of 4904 first pair 4903 for interlocking or being at an angle of.Each of first nail shapes pit 4904 Correspond to one first nail 4830 for first pair 4903.One first nail is corresponded to 4,903 first nail shapes pit 4904 Leg 4834, and another first nail shapes pit 4904 corresponds to another first nail leg 4834.This arragement construction is for building The nail configuration of vertical forming, wherein the first bizet 4832 of the first nail leg 4834 of the first nail 4830 and specific first nail 4830 It is shaped outside plane, so that first leg 4834 shapes on the side of the first bizet 4832, and another first leg 4834 It is shaped on the other side of the first bizet 4832.The nail configuration of this " three-dimensional " forming is relative to the first nail shapes pit in Figure 78 Some in 4904 show.
It is constructed as can be seen that storehouse platform 4812 especially in Figure 79 with " staged ".Storehouse platform 4812 includes internal or the One storehouse platform part 4814 corresponds to internal or the first nail cavity 4822 inside or first annular row 4820.Such as in Figure 79 Can with it is further seen that, when anvil block 4900 is moved to closure or clamped position, anvil block 4900 include the first nail shapes pit 4904 part is spaced apart the first clearance distance g with terrace part 48141。
Referring again to Figure 77, Figure 79 and Figure 80, intermediate or second row 4840 includes more than second intermediate or the second nail cavities 4842, Respectively arranged with second angle.Each intermediate nail cavity 4842 operationally supports corresponding centre or the second nail 4850 wherein. Intermediate cavity 4842 makes intermediate or the second nail 4850 with the identical uniform second angle orientation relative to tangential direction.But the Two angles are different from first angle.In other words, when the first nail and the second nail are supported on their corresponding first chambers and second When in chamber, the axis of the first bizet of each first nail 4830 is in extension by final the second hat with the second adjacent nail 4850 The extension axis in portion intersects.Such as in Figure 79 and Figure 80 as can be seen that each second or intermediate nail 4850 include the second crown or Base portion 4852 and two the second legs 4854.Base portion 4852 can have the slightly cross-sectional shape of rectangle and by flat material Piece is formed.For example, the second nail leg 4854 can have circular cross-sectional profile.Second or intermediate nail may include at such as 2015 8 Entitled " the SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR that the moon is submitted on the 26th Various nail configurations disclosed in the U.S. Patent Application Serial Number 14/836,110 of STAPLING INSTRUMENTS " are complete Text is herein incorporated by reference.Possessing can provide not from the round nail leg that the base portion with rectangular cross-sectional facial contour point extends There are the base portion point and nail leg of priority bending plane.Second nail 4850 includes bending part 4856, the nail leg in the bending part 4854 extend from base portion point 4852.Bending part 4856 may include substantially square cross-sectional profiles.Bending part 4856 and the square profiles respectively of base portion points 4852 and rectangular profile to round nail leg 4854 provide rigid connection portion and bone It is dry.Round nail leg 4854 eliminate cross section be square, the nail leg of rectangle or any shape with vertex or non-uniform shapes The priority bending plane that can have.Each second nail leg 4854 has second diameter D2.In at least one embodiment, D2> D1.Second base portion or bizet 4852 have the second bizet width C2.In a kind of arragement construction, C2>C1.Second leg 4854 can be each From with the angle A relative to the second base portion or bizet 48522Arrangement.Angle A2Can be about 90 ° or its can be slightly larger than 90 °, so that the second leg 4854 opens slightly outwards, to help the second nail 4850 being maintained at its corresponding second nail cavity 4842 In.
Figure 78 and Figure 79 are gone to, anvil block 4900 further includes second pair 4913 for interlocking or being at an angle of of the second nail shapes pit 4914 Two intermediate rows or second row 4912.Second pair 4913 of each of second nail shapes pit 4914 corresponds to one second nail 4850.One the second nail shapes pit 4914 corresponds to second nail leg 4854, and this is to 4913 another second nail Forming pit 4914 corresponds to another second nail leg 4854.This arragement construction is used to establish the nail configuration of forming, wherein the Second base portion 4852 of two legs 4854 and specific second nail 4850 is formed in outside plane.Should " three-dimensional " forming nail configuration relative to Some second nail shapes pits 4914 in Figure 78 are shown.
As can be seen that storehouse platform 4812 further includes the second storehouse platform part 4816, correspond to especially in Figure 79 it is intermediate or The centre of second nail cavity 4842 or the second ring row 4840.Such as in Figure 79 can with it is further seen that, when anvil block 4900 is moved to Closure or when clamped position, the part comprising the second nail shapes pit 4914 of anvil block 4900 are spaced apart the with terrace part 4816 Two clearance distance g2.In the example shown in the series of figures, g2>g1。
Referring again to Figure 77, Figure 79 and Figure 80, outside or third row 4860 include the multiple outsides of third or third nail cavity 4862, Size is determined relative to the second nail cavity 4842, so that each outside or third nail cavity 4862 cross over two adjacent second chambers 4842 The distance between.Each external nail cavity 4862 operationally supports corresponding outside or third to follow closely 4870 wherein.External cavity 4862 by outside follow closely or third nail 4870 be orientated to it is tangent with circumferential direction.As can be seen that each the such as in Figure 79 and Figure 80 Three or outside nail 4870 include third crown or base portion 4872 and two third legs 4874.Base portion 4872 can have slightly rectangle Cross-sectional shape and formed by flat material piece.For example, third nail leg 4874 can have circular cross-sectional profile.Third Or outside nail 4870 may include in such as on August 26th, 2015 entitled " the SURGICAL STAPLING submitted The U.S. Patent application sequence of CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS " Various nail configurations, have been incorporated by reference and have been incorporated herein disclosed in row number 14/836,110.Possess from rectangle cross The round nail leg that the base portion of cross section profile point extends can provide the base portion point and nail leg of no priority bending plane.Third nail 4870 include bending part 4876, and nail leg 4874 extends from base portion point 4872 in the bending part.Bending part 4876 can Including substantially square cross-sectional profiles.The square profiles and rectangle of bending part 4876 and base portion point 4872 respectively Profile provides rigid connection portion and backbone to round nail leg 4874.Round nail leg 4874 eliminate cross section be square, rectangle, Or the priority bending plane that any shape with vertex or the nail leg of non-uniform shapes can have.In at least one embodiment In, D3>D2.Third base portion or bizet 4872 have third bizet width C3, and each third leg 4874 has third unshaped Leg length L3.In a kind of arragement construction, C3>C2And L3>L2.Third leg 4874 can be respectively relative to third base portion or bizet 4872 angle A3Arrangement.Angle A3It can be about 90 ° or it can be slightly larger than 90 °, so that third leg 4874 is slightly outwards It opens, to help for third nail 4870 to be maintained in its corresponding third nail cavity 4862.
Figure 78 and Figure 79 are gone to, anvil block 4900 further includes external or third nail shapes pit 4918 outlet 4916.Each third Nail shapes pit 4918 corresponds to a third nail 4870.As especially in Figure 79 as can be seen that storehouse platform 4812 further includes the Three storehouse platform parts 4818 correspond to external or third nail cavity 4862 outlet or third row 4860.It can be with such as in Figure 79 It is further seen that anvil block 4900 includes third nail shapes pit 4918 when anvil block 4900 is moved to closure or clamped position Part third space distance g is spaced apart with terrace part 48183.In the example shown in the series of figures, g3>g2.It can be into such as in Figure 79 One step finds out that at least one embodiment, tissue thickness compensation part 4920 is followed closely with each outside or third nail 4870 is combined It uses.Tissue thickness compensation part may include the weaving material for being embedded with oxidized regenerated cellulose (ORC) to promote hemostasis.Tissue is thick Degree compensating part 4920 may include the beauty of entitled " the IMPLANTABLE LAYER ASSEMBLIES " that submits on 2 24th, 2014 State's patent application serial number 14/187,389 is now the thickness of various tissues disclosed in U.S. Patent Application Publication 2015/0238187 Any one of compensating part arragement construction is spent, the entire disclosure is hereby incorporated by reference.It can such as in Figure 79 To find out, tissue thickness compensation part 4920 has the thickness labeled as " a ".In one embodiment, tissue thickness compensation part Thickness be about 0.015 inch to 0.045 inch.However, other thickness can be used.
Therefore, at least one discribed embodiment of Figure 77 to Figure 80, nail bin 4810 can be in each of three staples The middle nail using different number.In a kind of arragement construction, interior staple includes having minimum linear diameter and most short unshaped leg long The tradition nail of degree.Each first nail has shortest bizet width, and each first follows closely relative to tangential direction with uniform angle Degree orientation.Centre nail has the configuration different from the first nail configuration.Each leg of centre nail include medium linear diameter and not at The leg length of shape.Each intermediate nail has the bizet width more slightly larger than the bizet width that inside is followed closely, and each intermediate nail is with phase The angle uniform for tangential direction is still orientated with the different angle of the interior row followed closely relative to inside.Each outside nail have with The similar configuration of the configuration of centre nail.Compared with the linear diameter of inside nail and the leg of intermediate nail, each third of each outside nail Leg includes maximum linear diameter.The bizet width of each outside nail is significantly greater than the bizet width of inside nail and intermediate nail.Each Outside is followed closely tangentially to be orientated with the circumferential direction in storehouse.Outer staple uses woven tissue thickness compensation part (space fabric), embedding Enter to have ORC to promote to stop blooding.Staged anvil block and staged storehouse platform generate different forming nail heights, wherein have it is most short at The nail of shape height is located in interior row, and the nail with longest forming height is located in outlet.Corresponding to interior staple and intermediate staple Anvil block pit arranged and formed in intermediate row by " inclination " three-dimensional follow closely inside." bathtub formula " anvil block pit corresponds to outer staple. In at least one embodiment, nail can be sequentially fired.For example, the nail in interior row and intermediate row can be fired first, then hit Send out the nail in outlet.Endless knife cuts the tissue of clamping during percussion.
Figure 81 to Figure 84, which is shown, is configured to the curved of capture, incision and suture tissue according at least one embodiment The part of bent suture instruments 5000.It is bent suture instruments 5000 and includes frame assembly 5010, nail bin 5020 and anvil block (not shown), The anvil block is configured to be supported with the relationship of the flat surface pair with nail bin.It is discussed in detail as discussed further below, When receiving the first actuating power, nail bin 5020 is driven towards anvil block and is captured tissue therebetween.It is bent suture instruments 5000 also Including knife assembly, which includes the cutting structure for being configured to tissue of the incision capture between nail bin 5020 and anvil block Part (not shown).Nail bin 5020 includes platform 5022, which includes the cutting slit for being configured to receive cutting element 5024, multiple nail cavity 5030A and 5030B, the and (figure of multiple nails 5040 being removedly stored in nail cavity 5030A, 5030B 84).Bending suture instruments 5000 further include actuator assembly 5100, which includes being configured in frame assembly Axially displaced master driver 5102 in 5010.When activating trigger system, master driver 5102 is on the direction towards anvil block Axial movement.In at least one arragement construction, cutting element is also released cutting slit by the axial movement of master driver 5102 5024, to cut the tissue being clipped between storehouse 5020 and anvil block.
In the example shown in the series of figures, storehouse 5020 is divided longitudinally into three parts: "high" part 5030, " in " part 5050 and " low " part 5070.Cutting slit 5024 makes each of high part 5030, middle part 5050 and lower part 5070 bifurcated, so that two nails Chamber is located on every side of cutting slit 5024.As can be seen that for example, nail bin 5020 includes internal nail cavity 5082 such as in Figure 82 Two in arrange two outlets 5090A, 5090B of 5080A, 5080B and external nail cavity 5092.Nail bin 5020 further includes from platform The 5022 multiple platform features structures extended.For example, with reference to Figure 81 and Figure 82, outlet 5090A, 5090B of nail cavity 5092 has Group platform feature structure associated there.In the example shown in the series of figures, those nail cavities 5092 associated with high part 5030 It is included in 5022 top extended characteristics height H of platform surfacehPlatform features structure 5032.It is associated with middle part 5050 that A little nail cavities 5092 are included in 5022 top extended characteristics height H of platform surfacemPlatform features structure 5052.With lower part 5070 Those associated nail cavities 5092 are included in 5022 top extended characteristics height H of platform surfaceLPlatform features structure 5072.Hh> Hm>HL.In at least one embodiment, for example, HhIt can be about 0.020 inch, HmIt can be about 0.015 inch, and And HLIt can be about 0.010 inch.Platform features structure 5032,5052 and 5072 can be molded into platform surface 5022. It is contemplated that platform features structure 5032,5052 and 5072 is configured for that the independent portion of platform surface 5022 can be attached to The embodiment divided.Platform features structure 5032,5052 and 5072 can be the extension of nail cavity 5092, to be loaded into will follow closely When in storehouse 5020, accommodated before projecting nail 5112 or when support nail 5112, and/or projected from storehouse 5020 follow closely when, support, draw Lead and/or control nail.Two different nail legs of the neighbouring nail 5112 of the support of single platform feature structure 5032,5052,5072.Platform Feature structure 5032,5052 and 5072 may include being configured to support one or more sides, face and/or the side of each nail leg Multiple supporting walls of edge.It is contemplated that the platform features structure 5032,5052,5072 in staple 5090A, 5090B of outside is only With in each outlet 5090A, 5090B every the associated embodiment of nail cavity 5092.The embodiment party shown in Figure 83 In case, the nail cavity 5082 (only it can be seen that row 5080B in Figure 83) of interior row 5080A, 5080B respectively have associated there flat Platform feature structure.For example, those nail cavities 5082 associated with high part 5030, which are included in above platform surface 5022, extends spy Levy height HhPlatform features structure 5034.Those nail cavities 5082 associated with middle part 5050 are included in platform surface 5022 Top extended characteristics height HmPlatform features structure 5054.Those nail cavities 5082 associated with lower part 5070 are included in flat 5022 top extended characteristics height H of platform surfaceLPlatform features structure 5074.
Nail bin 5020 includes actuator assembly 5100, which is configured to be supported on when applying actuating power Nail in nail cavity 5082,5092 drives towards anvil block.In the arragement construction shown in Figure 83 and Figure 84, for example, actuator assembly 5100 include master driver 5102, which is configured to mobile simultaneously towards anvil block when applying actuating movement to it And it is mobile far from anvil block when applying retracting motion to it.Actuator assembly 5100 further includes a pair of high driver portion 5104 (one on every side of a cutting slit 5024), centering driver portion 5106 (one on every side of cutting slit 5024) and one To low driver portion 5108 (one on every side of cutting slit 5024).It is each in driver portion 5104,5106,5108 It is a that there are multiple nail supporting drivers 5110 associated there.Nail supporting driver 5110 is supported on nail cavity 5082,5092 Support nail 5112 in each and on it.See, for example, Figure 84.Therefore, when stitching devices are fired, nail 5112 can be at Shape is different forming nail height.For example, it is associated with high part 5030 nail 5112 forming height can have than with middle part The short forming height of the forming height of points 5050 those associated nails, and nail 5112 associated with middle part 5050 at Shape height can be shorter than the forming height of nail 5112 associated with lower part 5070.In addition, can by the way that driving different distance will be followed closely Help to adapt to anvil block deflection.However, this arragement construction provides to have to be become with region in the case where the deflection of no anvil block The nail of the forming height of change.The actuating of actuator assembly 5100 also will lead to the tissue that cutting element is driven through clamping.It reads Person will be understood that, can use in different parts 5030,5050,5070 straight with different legs and/or bizet configuration and/or line The different nails of diameter and/or unshaped height, to realize desired forming nail height and arrangement knot on every side of tissue cut line Structure.
Figure 85 to Figure 88, which is shown, is configured to the another of capture, incision and suture tissue according at least one embodiment The various pieces of one bending suture instruments 5200.Referring first to Figure 86, be bent suture instruments 5200 include frame assembly 5210, Nail bin 5220 and anvil block 5260, the anvil block are configured to be supported with the relationship that the platform 5222 with nail bin 5220 faces. Being bent suture instruments 5200 further includes knife assembly, which includes being configured to incision capture in nail bin 5220 and anvil block The cutting element (not shown) of tissue between 5260.In the embodiment shown in Figure 86, platform 5222 includes " staged " Platform, being somebody's turn to do " staged " platform includes the cutting slit 5228 for being configured to receive the center setting of cutting element.Platform 5222 further include the high platform part 5224 and low platform part 5226 of center setting, and cutting slit 5228 extends through the Gao Ping Platform part.The interior row of internal nail cavity 5230A is arranged in the high platform part 5224 on every side of cutting slit 5228.Each Low platform part 5226 has corresponding exclusive portion's nail cavity 5230B.As can be seen that various structures disclosed herein such as in Figure 86 The platform features structure 5231 of type can in each of external nail cavity 5230B or the external nail cavity 5230B of each outlet It is associated every an external nail cavity 5230B.In other arragement constructions, platform features structure can in addition with internal nail cavity It is associated every an internal nail cavity 5230A in each of 5230A or every row inside nail cavity 5230A.In other arrangements In structure, platform features structure can not be used in combination with any of internal nail cavity 5230A and external nail cavity 5230B.
Referring now to Figure 86 and Figure 88, at least one arragement construction, each nail cavity 5230A is in wherein removedly storing Side nail 5240, and removedly storage outside follows closely 5250 to each nail cavity 5230B wherein.Each inside nail 5240 is supported on pair It answers on driver 5214, and each outside nail 5250 is supported in respective drivers 5216.The formation of driver 5214,5216 can A part of dynamic actuator assembly 5218, is operatively supported in suture instruments 5200.It should be appreciated that actuating movement is applied Be added to actuator assembly 5218 will lead to it is each nail 5240,5250 be advanced to anvil block 5260 formation contact.
The inside nail 5240 of interior row may include following closely 5250 different features from the outside of outlet.For example, such as the embodiment of Figure 88 Shown in, the leg of inside nail 5240 has " gull wing type " configuration.In particular, each inside nail 5240 includes prolonging from crown 5242 A pair of of the leg 5244,5246 stretched.Each leg 5244,5246 includes the vertical portion 5245,5247 extended from bizet 5242.One In a embodiment, vertical portion 5245,5247 can be parallel to each other.However, in the arragement construction shown in, vertical portion 5245,5247 is not parallel each other.Referring to Figure 88.However, vertical leg 5245,5247 can be relative to bizet 5242 with other angles Degree arrangement.Other details about nail configuration is found in entitled " the FASTENER CARTRIDGE submitted on June 30th, 2014 The U.S. Patent Application Serial Number 14/319,008 of COMPRISING NON-UNIFORM FASTENERS ", is now United States Patent (USP) Shen Qing Publication 2015/0297232, is incorporated by reference is incorporated herein accordingly.Make vertical leg 5245,5247 relative to hat Portion 5242 is that this arragement construction can help to follow closely that be temporarily retained in its right with an advantage of the angle orientation greater than 90 degree In the nail cavity answered.Referring still to Figure 88, each leg 5244,5246 further includes the leg to extend internally.The arragement construction shown in In, leg 5248 extends internally from vertical leg 5244, and leg 5249 extends internally from vertical leg 5246.Such as in the figure In as can be seen that leg 5248 it is shorter than leg 5244.Each inside nail 5240 has unshaped height L1。
It can also be seen that the leg of outside nail 5250 also has " gull wing type " configuration such as in Figure 88.In particular, each outside nail 5250 include a pair of of the leg 5254,5256 extended from crown 5252.Each leg 5254,5256 includes from the perpendicular of the extension of bizet 5252 Straight part 5255,5257.In one embodiment, vertical portion 5255,5257 can be parallel to each other.However, shown in In arragement construction, vertical portion 5255,5257 is not parallel each other.Referring to Figure 88.Other details about nail configuration is found in Entitled " the FASTENER CARTRIDGE COMPRISING NON-UNIFORM submitted on June 30th, 2014 The U.S. Patent Application Serial Number 14/319,008 of FASTENERS " is now U.S. Patent Application Publication 2015/0297232, It is incorporated by reference and is incorporated herein accordingly.However, vertical leg 5245,5247 can be relative to bizet 5242 at other angles Arrangement.Make vertical leg 5255,5257 relative to bizet 5252 with greater than 90 degree angle orientation an advantage be this cloth It sets structure and can help to follow closely and be temporarily retained in its corresponding nail cavity.Referring still to Figure 88, each leg 5254,5256 further includes The leg to extend internally.In the arragement construction shown in, leg 5258 extends internally from vertical leg 5254, and leg 5259 It extends internally from vertical leg 5256.As in the figure, it can be seen that leg 5258 is shorter than leg 5254.Each outside nail 5250 With unshaped height L2.In the arragement construction shown in, L2>L1.In the illustrated embodiment, inside nail 5240 and outside nail 5250 linear diameter D having the same1.However, in other embodiments, inside nail 5240 and outside nail 5250 are with different Linear diameter.In other embodiments, nail 5240 may be provided in nail cavity 5230B, and nail 5250 may be provided in nail cavity 5230A, So that longer unshaped nail is located in the interior lines of nail cavity, and shorter nail is located in the outside line of nail cavity.
Anvil block 5260 can be used in suture instruments 5200, as shown in Figure 85 and Figure 86.Referring first to Figure 85, anvil block 5260 may include two A insertion piece 5264, is supported in anvil body 5260, so that an insertion piece 5264 corresponds to cutting slit Nail on 5228 side, and another insertion piece 5264 corresponds to the nail on the other side of cutting slit 5228.Such as exist As can be seen that insertion piece 5264 is that anvil block 5260 provides the staged nail to form bottom surface 5261 in Figure 86.Each insertion piece 5264 Including interior section 5265 and exterior section 5267.When anvil block 5260 is located in the closed orientation for grip tissue, inserting Enter and provides clearance G between the interior section 5265 of part 5264 and corresponding terrace part 52241, and in the outer of insertion piece 5264 Clearance G is formed between portion part 5267 and corresponding terrace part 52262.In the arragement construction shown in, G2>G1.Interior section 5265 include the interior row 5266A to 5268A of internal nail forming cavity 5270.The exterior section 5267 of each insertion piece 5264 includes The outlet 5266B of the external pit 5258B of external nail shapes pit 5270.
Turning now to Figure 87, at least one embodiment, each nail of each pair of 5268A, 5268B of nail shapes pit 5270 Forming pit 5270 has triangular shaped.Forming pit 5270 in single pair 5268A, 5268B is separated from each other and by structure It causes the correspondence leg that can receive specific nail and makes its forming.This arragement construction is used to provide 3-d modelling for the nail of forming. That is, during each leg of forming nail is not generally aligned in the same plane with crown.Referring to Figure 87.In a kind of arragement construction, each The forming height F of outside nail 52502Greater than the forming height F of each inside nail 52401, as shown in Figure 88.In alternative arrangement knot In structure, for example, anvil block insertion piece can not have stair-stepped configuration, and it can basically comprise and various types disclosed herein Similar nail shapes pit line, the corresponding part of these pits and storehouse platform is away from identical distance.In this arragement construction, Storehouse platform can not be it is stepped, and may include or can not include type disclosed herein platform features structure.Extremely In a kind of few modification, interior tailor's tack can have the unshaped length more shorter than the nail in outside line, and (distance accommodates the slit of cutting element Farthest), vice versa.Staple in interior and exterior lines can have gull wing type configuration disclosed herein or they can have mark Quasi- U-shaped design.Nail in every line can linear diameter having the same, which can be with the linear diameter of the nail in adjacent lines not With or it is identical.
Figure 89 and Figure 90, which is shown, is configured to the another of capture, incision and suture tissue according at least one embodiment The various pieces of one suture instruments 5300.Referring first to Figure 89, suture instruments 5300 include frame assembly 5310, nail bin 5320 With anvil block 5360, which is configured to be supported with the relationship that the platform 5322 with nail bin 5320 faces.Nail bin 5320 It can be that curved or they can be straight with anvil block 5360.Suture instruments 5300 further include knife assembly, the knife assembly packet Include the cutting element 5312 for being configured to tissue of the incision capture between nail bin 5320 and anvil block 5360.Nail bin 5320 wraps Platform 5322 is included, which includes the cutting slit 5328 being centrally located for being configured to receive cutting element 5312.Between The interior row of the inside nail cavity 5330A separated is arranged on every side of cutting slit 5228.External nail cavity 5330B's spaced apart Outlet is adjacent to the interior row's setting of each of internal nail cavity 5330A.As can be seen that various configurations disclosed herein are put down such as in Figure 89 Platform feature structure 5331 can be associated with each of internal nail cavity 5330A and external nail cavity 5330B.In other embodiments In, having in the inside nail cavity 5330A and/or external nail cavity 5330B in each corresponding row every one is associated there Platform features structure 5331.It, can not be with any in internal nail cavity 5330A and external nail cavity 5330B in other arragement constructions A combined use platform features structure.
In at least one arragement construction, removedly storage inside follows closely 5340 to each internal nail cavity 5330A wherein, and every Removedly storage outside follows closely 5350 to a external nail cavity 5330B wherein.Each inside nail 5340 is supported on respective drivers On 5314, and each outside nail 5350 is supported in respective drivers 5316.Driver 5314,5316 forms movable driver A part of component 5318 is operatively supported in suture instruments 5300.It should be appreciated that actuating movement is applied to driving Device assembly 5318 will lead to it is each nail 5340,5350 be advanced to anvil block 5260 formation contact.It is interior in the arragement construction shown in Side nail 5340 may include the leg of gull wing type design and have unshaped height L1.Outside nail 5350 can also have gull wing type design Leg and have unshaped height L2.In the arragement construction shown in, L1>L2.However, can also be used it is disclosed herein other Follow closely configuration.
Anvil block 5360 can be used in suture instruments 5300, as shown in Figure 89.As can be seen that anvil block 5360 may include two such as in Figure 89 A insertion piece 5364, is supported in anvil body 5362, so that an insertion piece 5364 corresponds to cutting slit Nail on 5328 side, and another insertion piece 5364 corresponds to the nail on the other side of cutting slit 5328.Such as exist As can be seen that insertion piece 5364 is located at the uniform distance G with storehouse platform 5322 when anvil block 5360 is closed in Figure 891Place.Each Insertion piece 5364 includes the interior row of internal nail shapes pit 5368A and the outlet of external nail shapes pit 5368B.Nail shapes pit 5368A, 5368B can be provided with any one of various nail shapes pit configurations disclosed herein.When device 5300 is fired, The forming height F of each outside nail 53502Greater than the forming height F of each inside nail 52401, as shown in Figure 90.
Figure 91 shows another seam for being configured to capture, incision and suture tissue according at least one embodiment The various pieces of clutch tool 5400.Suture instruments 5400 include frame assembly 5410, nail bin 5420 and anvil block 5470, the anvil block quilt It is constructed to be permeable to be supported with the relationship that the platform 5422 with nail bin 5420 faces.Nail bin 5420 and anvil block 5470 can be bending Or they can be straight.Suture instruments 5400 further include knife assembly, which includes being configured to incision to catch Obtain the cutting element 5412 of the tissue between nail bin 5420 and anvil block 5470.Nail bin 5420 includes platform 5422, the platform packet Include the cutting slit 5428 being centrally located for being configured to receive cutting element 5412.Inside nail cavity 5430A spaced apart Interior row be arranged on every side of cutting slit 5428.The intermediate row of intermediate nail cavity 5430B spaced apart is adjacent to cutting slit The interior row's setting of each of the inside nail cavity 5430A being spaced apart on 5428 every side.The outlet of external nail cavity 5430C spaced apart is adjacent Each of nearly intermediate nail cavity 5430B intermediate row setting spaced apart.Platform features structure is not shown in conjunction with the embodiment.So And other embodiments use the platform features structure of various configurations disclosed herein in conjunction with some or all of internal nail cavities And/or in conjunction with some or all of intermediate nail cavities and/or in conjunction with some or all of external nail cavities.
In at least one arragement construction, removedly storage inside follows closely 5440 to each internal nail cavity 5430A wherein.In each Between the nail cavity 5430B removedly intermediate nail 5450 of storage wherein.Removedly storage is outer wherein by each external nail cavity 5430C Side nail 5460.Each inside nail 5440 is supported in respective drivers 5414.Each intermediate nail 5450 is supported on corresponding centre On staple drivers 5416.Each outside nail 5460 is supported on corresponding peripheral driver 5418.Driver 5414,5416, 5418 form a part of movable actuator assembly 5419, are operatively supported in suture instruments 5400.It should be appreciated that will Actuating movement be applied to actuator assembly 5419 will lead to it is each nail 5440,5450,5460 be advanced to anvil block 5470 formation connect Touching.In the arragement construction shown in, inside nail 5440, intermediate nail 5450 and outside nail 5460 construction having the same and can have There is identical unshaped height.
Anvil block 5470 can be used in suture instruments 5400, as shown in Figure 91.As can be seen that anvil block 5470 may include two such as in Figure 91 A insertion piece 5474, is supported in anvil body 5472, so that an insertion piece 5474 corresponds to cutting slit Nail on 5428 side, and another insertion piece 5474 corresponds to the nail on the other side of cutting slit 5428.Such as exist As can be seen that insertion piece 5474 is located at the uniform distance G with storehouse platform 5422 when anvil block 5470 is closed in Figure 891Place.Each Insertion piece 5474 includes the inside nail forming cavity 5478A, the intermediate nail forming cavity 5478B of intermediate row and the external nail of outlet of interior row Forming cavity 5478C.Following closely forming cavity 5478A, 5478B and 5478C may include in various nail shapes pit configurations disclosed herein It is any.When device 5400 is fired, each of nail 5440,5450,5460 forming height and configuration having the same. However, other nail configurations and nail shapes pit configuration disclosed herein can also be used, to generate with differing formed height and The nail of configuration.
Figure 92 shows another seam for being configured to capture, incision and suture tissue according at least one embodiment Clutch tool 5500.Suture instruments 5500 include that frame assembly 5510, nail bin 5520 and anvil block 5570 (Figure 93), the anvil block are constructed At can be supported with the relationship that the platform 5522 with nail bin 5520 faces.Suture instruments 5500 further include knife assembly, the knife group Part includes the cutting element 5512 for being configured to tissue of the incision capture between nail bin 5520 and anvil block 5570.Nail bin 5520 include platform 5522, which includes the cutting slit being centrally located for being configured to receive cutting element 5512 5528.The interior row of inside nail cavity 5530A spaced apart is arranged on every side of cutting slit 5528.Intermediate nail cavity spaced apart The interior row's setting of each of the inside nail cavity 5530A that the intermediate row of 5530B is spaced apart on every side of cutting slit 5528.Interval The outlet of the external nail cavity 5530C opened is arranged adjacent to each intermediate row of intermediate nail cavity 5530B.Do not show in conjunction with the embodiment Platform features structure out.However, other embodiments using various configurations disclosed herein platform features structure and it is some or All internal nail cavities combine and/or in conjunction with some or all of intermediate nail cavities and/or in conjunction with some or all of external nail cavities.? In other arragement constructions, there can be platform features structure associated there positioned at every the nail cavity in a row.
In at least one arragement construction, removedly storage inside follows closely 5540 to each internal nail cavity 5530A wherein.In each Between the nail cavity 5530B removedly intermediate nail 5550 of storage wherein.Removedly storage is outer wherein by each external nail cavity 5530C Side nail 5560.Each nail 5540,5550,5560 is supported on corresponding driver, which forms movable actuator assembly A part, which is operatively supported in suture instruments 5500.It should be appreciated that actuating movement is applied To actuator assembly will lead to it is each nail 5540,5550,5560 be advanced to anvil block 5570 formation contact.Knot is arranged shown in In structure, inside nail 5440, intermediate nail 5450 and outside nail 5460 having the same can construct and have identical as shown in Figure 95 Unshaped height.In a kind of arragement construction, for example, nail 5540,5550 and 5560 can be and submit on August 26th, 2015 Entitled " SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING Type and configuration disclosed in the U.S. Patent Application Serial Number 14/836,110 of INSTRUMENTS ", the entire disclosure of the patent Content is hereby incorporated by reference.
Than that described above, the nail of nail bin disclosed herein may include one or more features structure, one or more of spies Sign structure, which is configured to follow closely, to be maintained in the nail cavity of nail bin.Turning now to Figure 94 and Figure 95, nail 5540,5550,5560 Respectively including base portion 5542 and the nail leg 5544,5546 extended from base portion 5542.Base portion 5542 includes protrusion extending therefrom 5543, the protrusion in the side wall of corresponding nail cavity 5530A, 5530B and 5530C corresponding detent or groove 5531 engage.It is prominent The interaction risen between 5543 and the detent in nail cavity side wall or groove 5531 prevents nail 5540,5550,5560 from storehouse 5520 Bottom drop out.Interaction between protrusion 5543 and nail cavity side wall includes interference fit；However, this interference fit will not Nail 5540,5550,5560 is prevented to project from corresponding chamber 5530A, 5530B and 5530C.Protrusion 5543 can be for example in presser It is formed in during skill in base portion 5542.Sheet Metal Forming Technology can be by generating detent in the opposite side of base portion 5542, to form protrusion 5543.It is contemplated that not including the alternative embodiment of groove or detent 5531.
Anvil block 5570 can be used in suture instruments 5500, as shown in Figure 93.As can be seen that anvil block 5570 may include interior such as in Figure 93 It is arranged in two to 5578A of portion's nail shapes pit 5579, two intermediate rows to 5578B of intermediate nail shapes pit 5579 Two outlet 5577C to 5578C of 5577B and external nail shapes pit 5579.In single pair 5578A, 5578B and 5578C Nail shapes pit 5579 is separated from each other and is configured to receive the correspondence leg of specific nail 5540,5550 and 5560 5544,5546 and make its forming.However, nail shapes pit 5579 can be with appointing in various nail shapes pit configurations disclosed herein One kind provides.
Figure 96 shows another seam for being configured to capture, incision and suture tissue according at least one embodiment Clutch tool 5600.Suture instruments 5600 include that frame assembly 5610, nail bin 5620 and anvil block 5670 (Figure 97), the anvil block are constructed At can be supported with the relationship that the platform 5622 with nail bin 5620 faces.Suture instruments 5600 further include knife assembly, the knife group Part includes the cutting element 5612 for being configured to tissue of the incision capture between nail bin 5620 and anvil block 5670.Nail bin 5620 include platform 5622, which includes the cutting slit being centrally located for being configured to receive cutting element 5612 5628.The interior row 5630A of nail cavity 5632 spaced apart is arranged on every side of cutting slit 5528.Nail cavity 5632 spaced apart Outlet 5630B adjacent to the interior row 5630A setting of each of nail cavity 5632.Platform features knot is not shown in conjunction with the embodiment Structure.However, platform features structure and some or all of internal nail cavity of other embodiments using various configurations disclosed herein In conjunction with and/or in conjunction with some or all of external nail cavities.
In at least one arragement construction, removedly storage follows closely 5640 to each nail cavity 5632 wherein.Each 5640 support of nail On corresponding driver 5650, which forms a part of movable actuator assembly, which can grasp It is supported in suture instruments 5600 with making.It should be appreciated that actuating movement, which is applied to actuator assembly, will lead to each nail 5640 It is advanced to and is contacted with the formation of anvil block 5670.In the arragement construction shown in, each nail 5640 includes bizet 5642 and two intervals The leg 5644,5646 opened.As discussed herein, leg 5644,5646 can perpendicular to bizet 5642 or they can be not orthogonal to Bizet 5642.As can be seen that each staple drivers 5650 include central part 5652 and two end sections such as in Figure 97 5644, the central part has the first width W1, each end sections are with relatively narrow width W2.End sections 5654 support Each end of corresponding nail 5642.Each chamber 5632 and central part 5634 and two end sections 5636 are similarly shaped.When When nail 5642 is projected from chamber 5632, narrow end sections 5636 are that nail leg 5644,5646 provides lateral support.
Anvil block 5670 can be used in suture instruments 5600, as shown in Figure 98.As in the figure, it can be seen that anvil block 5670 include nail at Two to 5679B that 5678A and nail shapes pit 5680,5690 are arranged in two to 5679A of shape pit 5680,5690 are outer Arrange 5678B.Nail shapes pit 5680,5690 in single pair 5679A, 5679B is separated from each other and is configured to receive The correspondence leg 5544,5546 of specific nail 5640 simultaneously makes its forming.As can be seen that each nail pit 5680 includes outer such as in Figure 99 Portion's pit portion 5682, which is configured to initial with the end of corresponding leg 5644 and internal pit part Points 5684 contacts, to capture leg when leg 5644 is to internal shaping to complete forming process.Similarly, each nail pit 5690 wraps External pit 5692 is included, which is configured to initial be connect with internal pit portion 5694 with the end of corresponding leg 5646 Touching, to capture leg when leg 5646 is to internal shaping to complete forming process.External pit portion 5682 has width S1And it is interior Portion's pit portion 5684 has width S2.In the embodiment illustrated, S1>S2.This arragement construction is wider for providing for leg Initial contact area, and in forming process by leg keep with crown planar registration, to 5640 provide Figure 99 for nail Shown in shaping form.
Figure 100 shows another for being configured to capture, incision and suture tissue according at least one embodiment A part of suture instruments 5700.Suture instruments 5700 include elongated passageway 5710, nail bin 5720 and anvil block 5770, the anvil block quilt It is constructed to be permeable to be supported with the relationship that the platform 5722 with nail bin 5720 faces.Suture instruments 5700 further include knife assembly 5780, which includes the cutting element for being configured to tissue of the incision capture between nail bin 5720 and anvil block 5770 5782.In the arragement construction shown in, knife assembly 5780 is suspended in rotation drive shaft 5772, and the rotation drive shaft is operationally It is supported in anvil block 5770.The rotation of rotation drive shaft 5772 along the first direction of rotation will drive knife assembly 5780 to pass through towards distal side Nail bin 5720.Drive shaft 5772 will cause knife assembly 5780 to bounce back along proximal direction along the rotation of second opposite direction.Knife assembly 5780 for driving wedge-shaped slides (not shown) towards distal side, which joins with staple drivers with suitable from nail bin 5720 Project to sequence nail.
Nail bin 5720 include platform 5722, the platform include be configured to receive cutting element 5782 be centrally located cut Cut slit 5728.The interior row of inside nail cavity 5730A spaced apart is arranged on every side of cutting slit 5728.In spaced apart Between the interior row of each of inside nail cavity 5730A that is spaced apart on every side of cutting slit 5728 of intermediate row of nail cavity 5730B set It sets.The outlet of external nail cavity 5730C spaced apart is arranged adjacent to each intermediate row of intermediate nail cavity 5730B.It can such as in Figure 100 To find out, the platform features structures 5731 of various configurations disclosed herein can with it is each in nail cavity 5730A, 5730B, 5730C It is a associated.In other embodiments, in internal nail cavity 5730A every one and/or in intermediate nail cavity 5730B every There is platform features structure 5731 associated there every one in one and/or external nail cavity 5730C.In other arrangements In structure, platform features structure can not be used in combination with any of nail cavity 5730A, 5730B and 5730C.
As can be seen that anvil block 5770 may include two insertion pieces 5774 such as in Figure 100, it is supported on anvil body 5771 In, so that an insertion piece 5774 corresponds to the nail on the side of cutting slit 5728, and another insertion piece 5774 is right Ying Yu is located at the nail on the other side of cutting slit 5728.Such as in Figure 100 as can be seen that when anvil block 5770 is closed, insertion Part 5774 is located at the uniform distance G with storehouse platform 57221Place.Each insertion piece 5774 includes that forming cavity is followed closely in the inside of interior row 5778A, the intermediate nail forming cavity 5778B of intermediate row and the external of outlet follow closely forming cavity 5778C.Follow closely forming cavity 5778A, 5778B It may include any one of various nail shapes pit configurations disclosed herein with 5778C.When device 5700 is fired, nail 5740 Each of obtain identical forming height and configuration.However, other nail configurations disclosed herein and nail forming can also be used Pit configuration, to generate the nail with differing formed height and configuration.
Referring now to Figure 101, nail 5740 includes base portion 5742 and the nail leg 5744,5548 from the extension of base portion 5542.Shown Arragement construction in, leg 5744 can have gull wing type configuration.That is, leg 5744 is with vertical extension 5745 and inwardly Angled end sections 5746.On August 26th, the 2015 entitled " SURGICAL submitted can be used in other embodiments The U.S. of STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS " is special Type disclosed in sharp patent application serial numbers 14/836,110 and nail configuration, are incorporated by reference are incorporated herein accordingly.
Figure 102 shows surgery nail bin 5820, can for example be used in combination with above-mentioned stitching devices 5700, or by reference One of similar stitching devices arragement construction disclosed in the various bibliography being incorporated herein is used in combination.Nail bin 5820 includes flat Platform 5822, the platform include being configured to receive the cutting slit 5828 being centrally located that cutting element passes through.Between The interior row 5830A of the nail cavity 5832 separated is arranged on every side of cutting slit 5828.The centre of nail cavity 5832 spaced apart Arrange 5830B interior row 5830A setting each of on every side of cutting slit 5828.The outlet of chamber 5832 spaced apart 5832C is arranged adjacent to each intermediate row 5830B of nail cavity 5832.Platform features structure is not shown in conjunction with the embodiment.So And other embodiments use the platform features structure of various configurations disclosed herein in conjunction with some or all of internal nail cavities And/or in conjunction with some or all of intermediate nail cavities and/or in conjunction with some or all of external nail cavities.
In at least one arragement construction, removedly storage follows closely 5840 to each nail cavity 5832 wherein.In a kind of arragement construction In, for example, nail 5840 can have on August 26th, 2015 entitled " the SURGICAL STAPLING submitted The U.S. Patent application sequence of CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS " Type and configuration disclosed in row number 14/836,110, are incorporated by reference are incorporated herein accordingly.Than that described above, herein The nail of disclosed nail bin may include one or more features structure, one or more of feature structures be configured to by Nail is maintained in the nail cavity of nail bin.Turning now to Figure 103, nail 5840 includes base portion 5842 and the nail leg from the extension of base portion 5842 5844,5846.Base portion 5842 includes protrusion 5843 extending therefrom, which blocks with corresponding in the side wall of corresponding nail cavity 5832 Position or groove 5833 engage.Protrusion 5843 and the detent in nail cavity side wall or the interaction between groove 5833 prevent nail 5840 It is dropped out from the bottom in storehouse 5820.Interaction between protrusion 5843 and nail cavity side wall includes interference fit；However, this interference Cooperation cannot prevent from projecting nail 5840 from respective chamber 5832.Protrusion 5843 can for example be formed in base portion 5842 during Sheet Metal Forming Technology In.Sheet Metal Forming Technology can be by generating detent in the opposite side of base portion 5842, to form protrusion 5843.It is contemplated that not including The alternative embodiment of groove or detent 5833.
Figure 104 shows anvil block 5970 comprising for driving the rotation drive shaft 5972 of knife assembly in the above described manner.Anvil block 5970 may include two insertion pieces 5974, be supported in anvil body 5971, so that an insertion piece 5974 corresponds to position Nail on the side of cutting slit in corresponding nail bin (not shown), and another insertion piece 5974 correspond to cut it is narrow Nail on the other side of slot.Each insertion piece 5974 includes the interior row 5978A to 5979A of nail forming cavity 5980, nail forming cavity The 5980 intermediate row 5978B to the 5979B and outlet 5978C to 5979C of nail forming cavity 5980.Single pair 5979A, 5979B, Nail shapes pit 5980 in 5979C be separated from each other and be configured to receive the correspondence leg 5944 of corresponding nail 5940, 5946 and make its forming.
Various nail bins disclosed herein and nail configuration can be used in combination with various pharmacological eluting arrangements.Below with reference to every in document One accordingly its be hereby incorporated herein by full accordingly: on August 31st, the 2015 entitled " DRUG submitted The U.S. Patent application sequence of ELUTING ADJUNCTS AND METHODS OF USING DRUG ELUTING ADJUNCTS " Row number 14/840,613；Entitled " the MALLEABLE BIOABSORBABLE POLYMER submitted on March 25th, 2015 ADHESIVE FOR RELEASABLY ATTACHING A STAPLE BUTTRESS TO A SURGICAL STAPLER's " U.S. Patent Application Serial Number 14/667,874；Entitled " the TISSUE STAPLER HAVING submitted on June 25th, 2012 The U.S. of A THICKNESS COMPENSATOR COMPRISING INCORPORATING A HEMOSTATIC AGENT " is special Sharp patent application serial numbers 13/531,619 (being now U.S. Patent Publication 2012/0318842)；On June 25th, 2012 title submitted For " TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORATING AN OXYGEN The U.S. Patent Application Serial Number 13/531,623 of GENERATING AGENT " (is now U.S. Patent Publication 2012/ 0318843)；Entitled " the TISSUE STAPLER HAVING A THICKNESS submitted on June 25th, 2012 The U.S. Patent Application Serial Number 13/531 of COMPENSATOR INCORPORATING AN ANTI-MICROBIAL AGENT ", 627 (being now U.S. Patent Publication 2012/0312860)；Entitled " the TISSUE STAPLER that on June 25th, 2012 submits The beauty of HAVING A THICKNESS COMPENSATOR INCORPORATING AN ANTI-INFLAMMATORY AGENT " State's patent application serial number 13/531,630 (being now U.S. Patent Publication 2012/0318844)；On 2 8th, 2013 names submitted Referred to as " RELEASABLE LAYER OF MATERIAL AND SURGICAL END EFFECTOR HAVING THE SAME " U.S. Patent Application Serial Number 13/763,161 (being now U.S. Patent Application Publication 2013/0153641)；On 2 8th, 2013 Entitled " the ACTUATOR FOR RELEASING A LAYER OF MATERIAL FROM A SURGICAL END submitted The U.S. Patent Application Serial Number 13/763,177 (being now U.S. Patent Application Publication 2013/0146641) of EFFECTOR "； Entitled " the MULTIPLE THICKNESSIMPLANTABLE LAYERS FOR SURGICAL submitted on 2 8th, 2013 The U.S. Patent Application Serial Number 13/763,192 of STAPLING DEVICES " (is now U.S. Patent Application Publication 2013/ 0146642)；The U.S. Patent Application Serial Number of entitled " the ADHESIVE FILM LAMINATE " that submits on 2 8th, 2013 13/763,028 (being now U.S. Patent Application Publication 2013/0146643)；It submits on 2 8th, 2013 entitled “ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM A FASTENER The U.S. Patent Application Serial Number 13/763,035 (being now U.S. Patent Application Publication 2013/0214030) of CARTRIDGE "； Entitled " the RELEASABLE TISSUE THICKNESS COMPENSATOR AND FASTENER submitted on 2 8th, 2013 The U.S. Patent Application Serial Number 13/763,042 of CARTRIDGE HAVING THE SAME " (is now U.S. Patent Application Publication 2013/0221063)；Entitled " the FASTENER CARTRIDGE COMPRISING A submitted on 2 8th, 2013 The U.S. Patent Application Serial Number 13/763,048 of RELEASABLE TISSUE THICKNESS COMPENSATOR " (is now beauty State's patent application publication 2013/0221064)；On 2 8th, 2013 entitled " the FASTENER CARTRIDGE submitted The beauty of COMPRISING A CUTTING MEMBER FOR RELEASING A TISSUE THICKNESS COMPENSATOR " State's patent application serial number 13/763,054 (being now U.S. Patent Application Publication 2014/0097227)；It submits on 2 8th, 2013 Entitled " FASTENER CARTRIDGE COMPRISING A RELEASABLY ATTACHED TISSUE THICKNESS The U.S. Patent Application Serial Number 13/763,065 (being now U.S. Patent Application Publication 2013/0221065) of COMPENSATOR "； Entitled " the ANVIL LAYER ATTACHED TO A PROXIMAL END OF AN END submitted on 2 8th, 2013 The U.S. Patent Application Serial Number 13/763,078 (being now U.S. Patent Application Publication 2013/0256383) of EFFECTOR "； The beauty of entitled " the LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS " that submits on 2 8th, 2013 State's patent application serial number 13/763,094 (being now U.S. Patent Application Publication 2013/0256377)；It submits on 2 8th, 2013 Entitled " END EFFECTOR COMPRISING A DISTAL TISSUE ABUTMENT MEMBER " United States Patent (USP) Shen It please sequence number 13/763,106 (being now U.S. Patent Application Publication 2013/0256378)；On June 26th, 2012 title submitted For the U.S. Patent Application Serial of " TISSUE THICKNESS COMPENSATOR HAVING IMPROVED VISIBILITY " Number 13/532,825 (being now U.S. Patent Application Publication 2013/0256376)；On June 10th, 2014 submits entitled “ADJUNCT MATERIALS AND METHODS OF USING SAME IN SURGICAL METHODS FOR TISSUE The U.S. Patent Application Serial Number 14/300,954 (being now U.S. Patent Application Publication 2015/0351758) of SEALING "；2015 Entitled " the SURGICAL STAPLER BUTTRESS ASSEMBLY WITH GEL ADHESIVE that on October 29, in submits The U.S. Patent Application Serial Number 14/926,027 of RETAINER "；Entitled " the FLUID that on October 29th, 2015 submits The U.S. Patent Application Serial Number 14/ of PENETRABLE BUTTRESS ASSEMBLY FOR A SURGICAL STAPLER " 926,029；Entitled " the SURGICAL STAPLER BUTTRESS ASSEMBLY WITH submitted on October 29th, 2015 The U.S. Patent Application Serial of FEATURES TO INTERACT WITH MOVABLE END EFFECTOR COMPONENTS " Number 14/926,072；Entitled " the EXTENSIBLE BUTTRESS ASSEMBLY FOR submitted on October 29th, 2015 The U.S. Patent Application Serial Number 14/926,090 of SURGICAL STAPLER "；And the title submitted on October 29th, 2015 For the U.S. Patent Application Serial Number 14/926 of " MULTI-LAYER SURGICAL STAPLER BUTTRESS ASSEMBLY ", 160。
The shaping insert of relatively flat can be used in various anvil block constructions disclosed herein comprising in the nail forming wherein shaped Pit or they can have " staged " shape surface, have in the correspondence nail shapes pit wherein shaped.This paper's is each It is stepped (including in Different Plane that kind nail bin construction can have flat platform surface or platform surface can be Platform surface part).In some embodiments, platform features structure can be associated with all nail cavities in nail bin.At other In construction, platform features structure is used in combination with every all nail cavities in a nail chamber.Other embodiments are also contemplated, Middle platform features structure is associated every a nail cavity in given row, and every row's chamber be also so to construct.It is contemplated that Other embodiments, wherein do not use platform features structure.
Various embodiments disclosed herein can be used the nail with " u "-shaped unshaped configuration, or nail can have it is different not Shaping form, wherein for example, base portion or bizet have rectangular cross-sectional shape.Various nails can by with circular cross sectional shape, The line of the combination of square cross-sectional shape, circle and square cross-sectional shape etc. shapes.Nail may be provided with one or more Leg with gull wing type or conical configuration.Nail can have different linear diameters and different cross-sectional dimensions.Nail leg can be with It is symmetrical or they can be asymmetric (with and without bent tip).The leg of specific nail can it is parallel to each other or They can be not parallel each other.Nail in particular bin can unshaped height having the same or they can have it is different not Forming height.Nail in particular bin or region can bizet width having the same or they can have different bizet width. Nail and its corresponding nail pit can be configured so that leg is located in plane identical with crown or base portion when following closely forming, or Person they can be configured so that when follow closely forming when, leg is not located in plane identical with crown or base portion.All above-mentioned nails are special Sign structure can change between nail region and between the selection of storehouse from being pinned to.
In circular stapler anvil block arragement construction, nail shapes pit can be tangent with the circumference of anvil block.In other arragement constructions Or other than the nail shapes pit of arranged tangential, other nail shapes pits can be set with tangential direction angulation.Nail This modification in forming pit orientation may be provided in the nail shapes pit of given row or in the nail shapes pit of different rows.Also A variety of different nail shapes pit geometries can be used.Traditional symmetrical nail shapes pit geometry can be used.Except this it Outside or alternatively, asymmetric nail shapes pit geometry can be used.Other nail shapes pits can have bow-tie shape, In each nail leg have big touch-down zone, corresponding leg is collected to relatively narrow outlet pit portion.All above-mentioned nails at Shape pit feature structure can change between the region or line of pit and between the selection of specific anvil block between pit.
Various stitching devices disclosed herein are also configured to be capable of providing different amounts of driver stroke, are modulated to Desired forming nail height is realized relative to the correspondence gap provided between anvil block and storehouse.For example, in some arragement constructions, Staple drivers can be driven just above storehouse platform or considerably beyond storehouse platform to control forming nail height.By by driver row The amount of journey matches with the specific nail with desired unshaped length or height, can get with desired forming height Nail.
As described in the various embodiments in the disclosure, surgical stapling and cutting device include anvil block and are configured to Receive the warehouse channel of nail bin.One or both of anvil block and nail bin can be relative to another in open configuration and closed configuration Between move, to capture tissue therebetween.Nail is from the tissue that the nail cavity in nail bin is deployed to capture.Nail in anvil block at The forming of shape pit.After nail is disposed, nail bin can be replaced.
In order to shape nail correctly, nail cavity and forming pit needs are closely aligned in closed configuration.The limitation of appearance is one The anvil block of seed type can only be used to a type of nail bin.Different nail bins with the nail cavity being arranged differently cannot with it is identical Anvil block is used together, because nail cavity cannot be correctly aligned with the forming pit of anvil block.The disclosure includes various embodiments, is repaired Change anvil block so as to be used together from different nail bins.When anvil block includes being configured to be changed or use during following closely deployment When the one or more components crossed, there is another limitation.The disclosure includes various embodiments, modifies anvil block to replenish It is changed during nail deployment or used component or feature structure, and/or new feature structure and/or component is provided.
Referring to Figure 106, anvil assembly 15000 includes the anvil block modification component 15004 for being attached to anvil block 15002.Anvil block modifies structure Part 15004 includes tissue contacting surface 15006 and anvil block contact surface 15008.Tissue contacting surface 15006 includes and anvil block The different pit 15010 of 15002 forming pit 15012.When anvil block modification component 15004 is not attached to anvil block 15002, at Shape pit 15012 can be aligned with the nail cavity of the first nail bin.However, when anvil block modification component 15004 is attached to anvil block 15002, Forming pit 15010 can be aligned with the nail cavity of the second nail bin, while be different from the nail cavity of the first nail bin.
As shown in Figure 106, anvil block 15002 includes staged platform 15013, and anvil block modification component 15004 includes non-staged Platform 15015.Alternatively, anvil block may include non-staged platform, can be by including that the anvil block modification component of staged platform is repaired Change.The outlet of staged platform 15013 including forming pit 15012', the outlet from the interior row of forming pit 15012 upwards by It is cumulative to add.Non- staged platform 15015 includes the forming pit 15010 being limited in planar tissue contact surface 15006.Extremely In a kind of few situation, it may include a row or multi-row of forming pit 15010 that anvil block, which modifies component, described a row or multi-row from forming Other rows of recess 15010 gradually increase upwards.
In at least one situation, when anvil block one or more components or feature structure anvil block previously used period by Change or with out-of-date, anvil block modification component 15004 can be used.In this case, anvil block modification component, which is used, has new component Or used or change the tissue contacting surface of the new tissue contacting surface replacement anvil block of feature structure.For example, anvil block 15002 Forming pit 15012 may include the circuit element that can be severed during following closely deployment.It is not to repair cutting when using anvil block every time Circuit element, but anvil block modification component can be used, the replacement group including having the anvil block pit of complete circuit element is provided Knit contact surface.For another example, anvil block may include the implantable layer positioned against the tissue contacting surface of anvil block.Anvil block is used every time When, new implantable layer is not attached to anvil block, anvil block modification component can be used, replacement tissue contacting surface is provided, It has the implantable layer for being attached to replacement tissue contacting surface.
In at least one situation, anvil block modification component 15004 can be used for introducing in anvil block one or more new components or Feature structure.As shown in Figure 107, it includes implantable layer 15014 that anvil block, which modifies component 15004,.Although anvil block 15002 initially may Do not include implantable layer, but can be added to implantable layer and anvil block modification component 15004 is attached to anvil block 15002 Anvil block 15002, as shown in Figure 106.Implantable layer 15014 can be used various attachment means (for example, biocompatible glue and/or Band) it is attached to anvil block modification component 15004.During the deployment of nail, implantable layer 15014 is released from anvil block modification component 15004 It puts.In some cases, the nail of forming define may include a part of tissue and implantable layer 15014 retention area.? In this case, the retention part that can plant layer 15014 can be used as tissue thickness compensation part.Implantable layer 15014 may include gathering Polymer composition.Polymer composition may include one or more synthetic polymers and/or one or more non-synthetic polymers. Synthetic polymer may include the absorbable polymer of synthesis and/or the non-absorbable polymer of synthesis.
In nail forming process, effect of the anvil block by significant power.Gap between anvil block and anvil block modification component can lead to Stability reduces and/or collapses risk increase during following closely forming process.As shown in Figure 106 and Figure 107, anvil block modifies component 15004 include the gap fillers 15016 extended from the anvil block contact surface 15008 of anvil block modification component 15004.Gap filling Object 15016 is configured to provide additional support between anvil block 15002 and anvil block modification component 15004, and in anvil Seat is including particularly useful in the case where staged platform.
As shown in Figure 106, the staged platform 15013 of anvil block 15002 is between anvil block 15002 and anvil block modification component 15004 With one or more gaps.Gap fillers 15016 are strategically positioned at the forming pit of staged platform 15013 In the outlet of 15012', to make anvil block modification component 15004 and anvil when anvil block modification component 15004 is attached to anvil block 15002 Gap between seat 15002 minimizes.In at least one situation, anvil block modifies the anvil block contact surface 15008 of component 15004 Including protrusion, which is configured to filling or at least substantially fills the anvil block for being attached to anvil block modification component 15004 Correspondence anvil block pit.
It includes one or more attachment features structures 15018 that anvil block, which modifies component 15004,.In at least one situation, attachment is special Sign structure 15018 is configured to anvil block modification component 15004 being releasably attached to anvil block 15002.Such as Figure 106 and figure Shown in 107, anvil block modify component 15004 attachment features structure 15018 include side wall, the side wall be spaced sufficiently apart each other with Closely clamp the outer wall 15020 of anvil block 15002.Attachment features structure 15018 include it is inclined, curved, fillet and/or The edge 15022 of scraping, be configured to anvil block modify component 15004 be attached to anvil block 15002 when with anvil block 15002 Form surface that is continuous or flushing.The flush surfaces of generation, which are intended to reduce or prevent, causes wound to tissue.
In at least one situation, anvil block modification component can be designed to and anvil block snap engagement.For example, anvil block may include one Item or a plurality of slit, one or more slit are configured to frictionally receive the anvil block contact from anvil block modification component The upright tab of one or more that surface extends.It can utilize other attachment means (for example, biocompatible glue and/or screw) will Anvil block modifies component against anvil positioning.
Referring again to Figure 106 and Figure 107, anvil block modification component 15004 includes in two sides of anvil block modification component 15004 What is longitudinally extended between 15028 and 15030 can transverse portions 15024.When anvil block modification component 15004 is attached to anvil block 15002 When, as shown in Figure 106, can transverse portions 15024 with anvil block 15002 staged platform 15013 two sides 15032 and The longitudinal slit 15026 extended between 15034 is aligned.Can transverse portions 15024 be distally advanced by slit 15026 along longitudinal direction Cutting element cutting.When anvil block modification component 15004 be attached to anvil block 15002 when, can transverse portions 15024 make anvil block modify structure Part 15004 is stablized.In at least one situation, when cutting element is promoted along longitudinal slit 15026 towards distal side, anvil block is repaired The side 15028 and 15030 for changing component 15004 is completely cut through and is separated by cutting element.In other cases, work as cutting element When being promoted along longitudinal slit 15026 towards distal side, anvil block modifies the side 15028 and 15030 of component 15004 only by cutting structure Part partial cut.
Referring to Figure 108, anvil block modification component 15104 is shown.Anvil block modification component 15104 is repaired similar to anvil block in many aspects Change component 15004.For example, anvil block modification component 15104 is releasably attached to anvil block 15002.Component 15004 is modified with anvil block Difference, anvil block modification component 15104 lacks can transverse portions.On the contrary, anvil block modification component 15104 is included in anvil block modification component The elongated slot 15124 extended between 15104 two sides 15128 and 15130.However, in other cases, anvil block modification Component 15104 can equipped with can transverse portions replace elongated slot 15124.
It includes proximal end 15136 and distal end 15138 that anvil block, which modifies component 15104,.Elongated slot 15124 can pass through nearside End 15136 and/or distal end 15138 limit.In addition, elongated slot 15124 is defined in two 15128 Hes of side The longitudinal axis 15140 extended between 15130.As shown in Figure 109, when anvil block modification component 15104 is attached to anvil block 15002 When, elongated slot 15124 is aligned with the elongated slot 15026 of anvil block 15002.For example, in alignment, 15124 He of elongated slot 15026 are configured to receive the cutting element for being suitable for cutting off soft tissue.
Anvil block modify component 15104 in each of side 15128 and 15130 include three row's forming pit 15110a, 15110b and 15110c.As shown in Figure 109, multiple first forming pit 15110a can be parallel to each other or be at least substantially put down Row.Similarly, multiple second forming pit 15110b can be parallel to each other or at least substantially parallel and/or multiple the Three forming pit 15110c can be parallel to each other or at least substantially parallel.In at least one situation, for the purposes herein, " substantially parallel " can indicate in either direction in parallel about 15 degree.
In some cases, at least one first forming pit 15110a, at least one second forming pit 15110b and at least One third forming pit 15110c is limited in the tissue contacting surface 15108 of anvil block modification component 15004.First forming is recessed Hole 15110a, the second forming pit 15110b and third forming pit 15110c can be located at side 15128 and/or side 15130 On.As shown in Figure 109, the first forming pit 15110a limits first axle 15142, which extends through the first forming The proximal end and distal end of pit 15110a.Similarly, the second forming pit 15110b limits second axis 15144, should Second axis extends through the proximal end and distal end of the second forming pit 15110b.Moreover, third forming pit 15110c limits the third axis 15146 of the proximal end and distal end that extend through third forming pit 15110c.Second Axis 15144 is transverse to first axle 15142, so that axis 15144 and 15142 forms acute angle or obtuse angle between them.Separately Outside, second axis 15144 is transverse to third axis 15146, such as axis 15144 and 15146, formed between them acute angle or Obtuse angle.
As shown in Figure 109, first axle 15142 is parallel with third axis 15146 or at least substantially parallel, and second axis 15144 is vertical or at least substantially vertical with first axle 15142 and/or third axis 15146.In at least one situation, For the purposes herein, " substantially vertical " can indicate in either direction in vertical about 15 degree.
Referring to Figure 109 to Figure 112, anvil block modifies the first forming pit 15110a, the second forming pit 15110b of component 15104 It is configured to make difference can be from the first nail cavity 15210a of nail bin 15200, the second nail cavity with third forming pit 15110c The nail forming or bending of 15210b and third nail cavity 15210c deployment.For example, the first forming pit 15110a includes two formings Recess 15152 is configured to receive the nail leg 15254 of nail 15256 when following closely 15256 from the first nail cavity 15210a deployment And make its forming.
In closed configuration, anvil block 15002 is aligned with nail bin 15200 or is at least substantially aligned, so that tissue is trapped in anvil Between the tissue contacting surface 15108 of seat modification component 15104 and the tissue contacting surface 15208 of nail bin 15200.In addition, anvil The first forming pit 15110a, the second forming pit 15110b and third forming pit 15110c points of seat modification component 15104 It is not aligned with the first nail cavity 15210a, the second nail cavity 15210b and third nail cavity 15210c or is at least substantially aligned, so that portion The nail leg 15254 of the nail 15256 of administration is captured and is shaped.
Nail bin 15200 includes first side 15228 and second side 15230.Elongated slot 15224 is in 15228 He of first side Extend between second side 15230.Elongated slot 15224 can be in the proximal end 15236 and distal end of nail bin 15200 Extend between 15238 and/or extends through.It includes three rows that nail bin 15200 is upper in each of side 15228 and 15230 Nail cavity 15210a, 15210b and 15210c.In closed configuration, the elongated slot of elongated slot 15224 and anvil block 15002 15026 and anvil block modification component 15104 elongated slot 15124 alignment or be at least substantially aligned.For example, in alignment, carefully Long slit 15224,15124 and 15026 is configured to receive the cutting element for being suitable for cutting off soft tissue.
As shown in Figure 110, multiple first nail cavity 15210a are parallel to each other or at least substantially parallel.Similarly, multiple second nails Chamber 15210b is parallel to each other or at least substantially parallel and/or multiple third nail cavity 15210c are parallel to each other or at least base It is parallel in sheet.
In some cases, at least one first nail cavity 15210a, at least one the second nail cavity 15210b and at least one third Nail cavity 15210c is limited in the tissue contacting surface 15208 of nail bin 15200.First nail cavity 15210a, the second nail cavity 15210b It can be located on side 15228 and/or side 15230 with third nail cavity 15210c.As shown in Figure 110, the first nail cavity 15210a is limited Determine first axle 15242, which extends through the proximal end and distal end of the first nail cavity 15210a.Similarly, Second nail cavity 15210b limit second axis 15244, the second axis extend through the second nail cavity 15210b proximal end and Distal end.Moreover, third nail cavity 15210c limits the proximal end and distal end for extending through third nail cavity 15210c Third axis 15246.Second axis 15244 is transverse to first axle 15242, so that axis 15244 and 15242 is between them Form acute angle or obtuse angle.In addition, second axis 15244 is transverse to third axis 15246, such as axis 15244 and 15246, Acute angle or obtuse angle are formed between them.For example, as shown in Figure 110, first axle 15242 is parallel with third axis 15246 or extremely It is few substantially parallel, and second axis 15244 is vertical with first axle 15242 and/or third axis 15246 or at least substantially Vertically.
In all cases, than that described above, anvil block may include multiple rows of nail shapes pit along the alignment of first group of longitudinal axis.It can Be attached to anvil block anvil block modification component may include along second group of longitudinal axis alignment multiple rows of nail shapes pit, described second group Longitudinal axis is not aligned with first group of longitudinal axis.As a result, anvil block modification component on nail shapes pit not with the nail on anvil block Forming pit is longitudinally aligned.In some cases, on some longitudinal rows and anvil block of the forming pit on anvil block modification component Longitudinal row's alignment of forming pit, and other longitudinal directions row of the forming pit on anvil block modification component is not recessed with the forming on anvil block Longitudinal row's alignment in hole.
Referring to Figure 113 and Figure 114, at least one first nail 15256a from least one the first nail cavity 15210a, from extremely At least one second nail 15256b of a few second nail cavity 15210b and from least one third nail cavity 15210c extremely Few third nail 15256c can be deployed to simultaneously to be modified in the tissue captured between component 15104 and nail bin 15200 in anvil block. Triple staple drivers 15260 are configured to cooperate with the cam slider of nail bin 15200, with corresponding from it simultaneously Nail cavity 15210a, 15210b and 15210c dispose three nails 15256a, 15256b and 15256c.Staple drivers 15260 can pass through Cam slider is lifted up or slides in nail cavity 15210a, 15210b and 15210c, so that staple drivers 15260 is upward Nail 15256a, 15256b and 15256c can be projected or be disposed to movement.
As shown in Figure 113 and Figure 114, each of three nails 15256a, 15256b and 15256c include driving against nail The base portion 15253 of the bracket 15255 of dynamic device 15260.Staple drivers 15260 include two inclined-planes 15257, are configured to Cooperate with the cam slider of nail bin 15200, to dispose three from its corresponding nail cavity 15210a, 15210b and 15210c simultaneously Follow closely 15256a, 15256b and 15256c.
Three nails 15256a, 15256b and 15256c limit common plane 15272,15274 and 15276 respectively.Three nails 15256a, 15256b and 15256c are orientated relative to staple drivers 15260, so that the second common plane 15274 is transverse to first Common plane 15272, so that common plane 15274 and 15272 forms acute angle or obtuse angle between them.In addition, second is common Plane 15274 transverse to third common plane 15276 so that common plane 15274 and 15276 formed between them acute angle or Obtuse angle.As shown in Figure 114, the first common plane 15272 is parallel with third common plane 15276 or at least substantially parallel, and Second common plane 15274 is vertical or at least substantially vertical with the first common plane 15272 and third common plane 15276.
Referring to Figure 115, end effector 15300 includes with nail bin shown in the closed configuration with anvil assembly 15303 15301, which includes the anvil block modification component 15304 for being attached to anvil block 15002.Anvil block is modified component 15304 and is being permitted Various aspects are similar to anvil block and modify component 15004.For example, anvil block modification component 15304 includes can transverse portions 15024 and setting Forming pit 15010 on the two sides 15028 and 15030 of anvil block modification component 15304.Implantable 15314 abutment side surface of layer 15028 forming pit 15010 is arranged, and the forming pit 15010 of implantable 15315 abutment side surface 15030 of layer is arranged.It can Implant layer 15314 and 15315 is spaced apart, and limits gap 15317 between them.Gap 15317 with can transverse portions 15024 it is flat Row ground or at least substantially longitudinally parallel extension.Staged platform of the implantable layer 15318 and 15319 against nail bin 15301 15321 settings.Nail 15323 is supported by the bracket 15355 in the nail cavity 15325 of nail bin 15301.When anvil block modifies component 15304 When being attached to anvil block 15002, nail 15323 is configured to shape against forming pit 15010, as shown in Figure 114.Optionally Ground, when anvil block modification component 15304 is not attached to anvil block 15002, nail 15323 is configured to against anvil block 15002 Forming pit 15012 and 15012' forming.
Figure 116 shows three unshaped nail 15323a, 15323b and 15323c similar to each other, and is similarly disposed at nail bin In 15301 nail cavity 15325.Nail 15323a, 15323b and 15323c include that identical or at least substantially identical unshaped is high Spend H, about 0.150 inch.In all cases, unshaped height H can be selected from for example, about 0.100 inch to about 0.200 inch Range.As shown in Figure 116, nail 15323a, 15323b and 15323c respectively include different forming height H1, H2 and H3.Nail 15323a, 15323b and 15323c shape in the interior row of nail bin 15301, intermediate row and outlet respectively.The forming height of nail takes Certainly in the forming distance limited between forming pit and corresponding bracket, bracket support nail in corresponding nail cavity.It can pass through Forming pit is positioned closer to or changes forming distance further from corresponding bracket.Anvil block modification component can be used to change Become forming distance.For example, as shown in Figure 115, the first forming distance D1 is limited to the forming pit of anvil block modification component 15304 Between 15010 and shaped bracket 15355, and the second forming distance D2 greater than the first forming distance D1 is limited to anvil block 15002 Forming pit 15012' and identical bracket 15355 between.
Referring to Figure 116, since the second forming distance D2 is greater than the first forming distance D1, nail 15323b includes being greater than nail The forming height H2 of the forming height H1 of 15323a.In other words, forming pit 15012' of the nail 15323b against anvil block 15002 Forming, and the forming pit 15010 for following closely 15323a against anvil block modification component 15304 shapes.As shown in Figure 116, nail bin 15301 The forming height H3 of nail 15323c of outer staple be the forming height for following closely the first nail leg of 15323c, be less than nail 15323c The forming height of second nail leg.Nail such as nail 15323c may include the nail leg for being configured to different staple heights, as shown in Figure 116.
In all cases, anvil block modification component may include staged tissue contacting surface, wherein for example, at least one to line up shape recessed Hole gradually increases upwards relative to other row's forming pits or gradually decreases downwards.In some cases, anvil block modification component can Specific part against anvil block is positioned to modify the part.For example, anvil block modification component can be positioned against the portions of proximal of anvil block To modify portions of proximal, while distal part and central part remain unchanged.For another example, anvil block modification component can be in anvil block Center portion point positioning is to modify central part, while distal part and portions of proximal remain unchanged.In yet another example, anvil block is repaired Changing component can position against the distal part of anvil block, and to modify distal part, while portions of proximal and central part remain unchanged.
In all cases, anvil block modification component is configured to the subset of the forming pit of modification anvil block.For example, anvil block Modifying component can position against a row or multi-row forming pit of anvil block to modify a row or multi-row forming pit, while anvil The forming pit of remaining row of seat remains unchanged.In at least one situation, anvil block modifies component (for example, anvil block modifies component 15304) group captured between nail bin such as nail bin 15301 and anvil block such as anvil block 15002 can be applied to modifications or changes The compression knitted.Anvil block modifies component 15304 can be by reducing the tissue compression gap between nail bin 15301 and anvil block 15002 To increase the structural compression for being applied to capture.It is positioned, is organized against anvil block 15002 by the way that anvil block is modified component 15304 The size of compression clearance efficiently reduces the size of anvil block modification component 15304, and which increase the tissues for being applied to capture Compression.Tissue compression gap includes about 0.045 inch of height.In all cases, tissue compression gap may include selected from example The height of such as from about 0.03 inch to about 0.10 inch of range.The disclosure contemplates the other values of the height in tissue compression gap.
Many surgical instrument systems as described herein are actuated by electric motor；However, surgical instrument system as described herein can be with It actuates in any suitable manner.In all cases, for example, surgical instrument system as described herein can be by the touching that is manually operated Hair device actuates.In some cases, motor disclosed herein may include one or more parts of robot control system.This Outside, any end effector and/or tool assembly disclosed herein can be used together with robotic surgical Instrument system.For example, Entitled " SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT The U.S. Patent Application Serial Number 13/118,241 (being now U.S. Patent Application Publication 2012/0298719) of ARRANGEMENTS " Several examples of robotic surgical Instrument system are disclosed in more detail.
The deployment and deformation for having combined nail describe surgical instrument system as described herein；However, the embodiment described herein It 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.This Outside, it is also contemplated that utilize the various embodiments of any appropriate device for seal tissue.For example, according to various embodiments End effector may include be configured to heating and seal tissue electrode.In addition, for example, according to certain embodiment End effector can apply vibrational energy and carry out seal tissue.
The complete disclosure of following patents is hereby incorporated by reference:
It is filed in entitled " the LINEAR STAPLER WITH IMPROVED FIRING STROKE " on March 12nd, 1997 European Patent Application No. EP 795298；
It is published on 2 25th, 1997 entitled " TRIGGER MECHANISM FOR SURGICAL INSTRUMENTS " United States Patent (USP) 5,605,272；
It is published in entitled " the LINEAR STAPLER WITH IMPROVED FIRING STROKE " on December 16th, 1997 United States Patent (USP) 5,697,543；
It is published in the U.S. of entitled " the METHOD FOR MAKING A SURGICAL STAPLER " on November 10th, 2005 Patent application publication 2005/0246881；
It is published in the U.S. Patent Application Publication of on September 6th, 2007 entitled " METHOD FOR STAPLING TISSUE " 2007/0208359；
It is published in entitled " the DISPOSABLE LINEAR SURGICAL STAPLING on July 9th, 1985 The United States Patent (USP) 4,527,724 of INSTRUMENT "；
It is published on August 11st, 1992 entitled " FAST CLOSURE DEVICE FOR LINEAR SURGICAL The United States Patent (USP) 5,137,198 of STAPLING INSTRUMENT "；
It is published in the United States Patent (USP) 5 of entitled " the FLEXIBLE SUPPORT SHAFT ASSEMBLY " on April nineteen ninety-five 11, 405,073；
It is published in entitled " the SURGICAL CUTTING AND STAPLING INSTRUMENT on January 29th, 2013 The United States Patent (USP) 8,360,297 of WITH SELF ADJUSTING ANVIL "；
It is filed in entitled " the SURGICAL INSTRUMENT COMPRISING SYSTEMS FOR 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；
It is filed in entitled " the SURGICAL INSTRUMENT COMPRISING SEPARATE on July 30th, 2015 The U.S. Patent Application Serial Number 14/813,259 of TISSUE SECURING AND TISSUE CUTTING SYSTEMS "；
It is filed in entitled " the SURGICAL INSTRUMENT COMPRISING SYSTEMS FOR on July 30th, 2015 The U.S. Patent Application Serial Number 14/813,266 of PERMITTING THE OPTIONAL TRANSECTION OF TISSUE "；
Entitled " SURGICAL INSTRUMENT COMPRISING A SYSTEM FOR BYPASSING AN The U.S. Patent Application Serial Number 14/813,274 of OPERATIONAL STEP OF THE SURGICAL INSTRUMENT ".；
It is published in the United States Patent (USP) of entitled " the ELECTROSURGICAL HEMOSTATIC DEVICE " on April nineteen ninety-five 4 5,403,312；
It is published on 2 21st, 2006 entitled " SURGICAL STAPLING INSTRUMENT HAVING SEPARATE The United States Patent (USP) 7,000,818 of DISTINCT CLOSING AND FIRING SYSTEMS "；
It is published on September 9th, 2008 entitled " MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING The United States Patent (USP) 7,422,139 of INSTRUMENT WITH TACTILE POSITION FEEDBACK "；
It is published in entitled " the ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH on December 16th, 2008 The United States Patent (USP) 7,464,849 of CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS "；
It is published in entitled " the SURGICAL INSTRUMENT HAVING AN ARTICULATING on March 2nd, 2010 The United States Patent (USP) 7,670,334 of END EFFECTOR "；
It is published in the United States Patent (USP) 7 of entitled " the SURGICAL STAPLING INSTRUMENTS " on July 13rd, 2010, 753,245；
It is published in entitled " the SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER on March 12nd, 2013 The United States Patent (USP) 8,393,514 of CARTRIDGE "；
The U.S. Patent application of entitled " SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES " Sequence number 11/343,803；It is now United States Patent (USP) 7,845,537；
It is filed on 2 14th, 2008 entitled " SURGICAL CUTTING AND FASTENING INSTRUMENT The U.S. Patent Application Serial Number 12/031,573 of HAVING RF ELECTRODES "；
It is filed on 2 15th, 2008 entitled " END EFFECTORS FOR A SURGICAL CUTTING AND The U.S. Patent Application Serial Number 12/031,873 (being now United States Patent (USP) 7,980,443) of STAPLING INSTRUMENT "；
The U.S. Patent Application Serial Number 12/ of entitled " MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT " 235,782, it is now United States Patent (USP) 8,210,411；
Entitled " POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY The U.S. Patent Application Serial Number 12/249,117 of RETRACTABLE FIRING SYSTEM " is now United States Patent (USP) 8,608, 045；
It is filed in entitled " the MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT on December 24th, 2009 The U.S. Patent Application Serial Number 12/ of WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY " 647,100；It is now United States Patent (USP) 8,220,688；
It is filed in the U.S. Patent Application Serial Number 12/893 of on September 29th, 2012 entitled " STAPLE CARTRIDGE ", 461, it is now United States Patent (USP) 8,733,613；
It is filed in the U.S. Patent application of on 2 28th, 2011 entitled " SURGICAL STAPLING INSTRUMENT " Sequence number 13/036,647 is now United States Patent (USP) 8,561,870；
Entitled " SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT The U.S. Patent Application Serial Number 13/118,241 of ARRANGEMENTS " is now United States Patent (USP) 9,072,535；
It is filed in entitled " the ARTICULATABLE SURGICAL INSTRUMENT COMPRISING on June 15th, 2012 The U.S. Patent Application Serial Number 13/524,049 of A FIRING DRIVE "；It is now United States Patent (USP) 9,101,358；
It is filed in entitled " the STAPLE CARTRIDGE TISSUE THICKNESS SENSOR on March 13rd, 2013 The U.S. Patent Application Serial Number 13/800,025 of SYSTEM " is now U.S. Patent Application Publication 2014/0263551；
It is filed in entitled " the STAPLE CARTRIDGE TISSUE THICKNESS SENSOR on March 13rd, 2013 The U.S. Patent Application Serial Number 13/800,067 of SYSTEM " is now U.S. Patent Application Publication 2014/0263552；
It is filed in entitled " the SURGICAL CUTTING AND FASTENING INSTRUMENT on January 31st, 2006 The U.S. Patent Application Publication 2007/0175955 of WITH CLOSURE TRIGGER LOCKING MECHANISM "；And
It is filed in entitled " the SURGICAL STAPLING INSTRUMENT WITH AN on April 22nd, 2010 The U.S. Patent Application Publication 2010/0264194 of ARTICULATABLE ENDEFFECTOR " is now United States Patent (USP) 8,308, 040, all patents are hereby incorporated by reference.
Although certain embodiments has been combined to describe various devices herein, also the implementable modification to these embodiments and Modification.In addition, when materials for certain parts are disclosed, it is possible to use other materials.In addition, according to a variety of realities Scheme is applied, single component can be replaced by multiple components, and multiple components can also be replaced by single component, given to execute One or more functions.Above-mentioned specific embodiment and following the claims are intended to cover all such modifications and variations.
Apparatus as disclosed herein is designed to discard after a single use or it is designed to be used for multiple times.However No matter what kind of situation it is, which all can be at least using exercising use by finishing after primary again.Finishing may include following steps Any combination, the step includes but is not limited to provision for disengagement, later cleaning or the specific component of alternative and subsequent Re-assembly device.In particular, restoration facilities and/or surgical team can be with provisions for disengagement, and in cleaning and/or more After the specific part of changing device, the device can be re-assemblied for subsequent use.It will be appreciated by those skilled in the art that Trimming device can be dismantled using various technologies, clean/replace and re-assembly.Such technology use and it is resulting Prosthetic device is within the scope of application.
Apparatus as disclosed herein can be handled before the surgery.It is possible, firstly, to obtain new or used instrument, and root According to being cleaned.Then, it can carry out disinfection to instrument.In a kind of sterilization technology, by the instrument be placed on it is 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, this can be further modified in the spirit and scope of the disclosure Invention.Therefore, this application is intended to cover any modification, purposes or the remodeling of the invention for using General Principle of the invention.
Any patent, announcement or other public materials incorporated in this article in full or in part by reference are only being incorporated to Material is not incorporated herein in existing definition of the present invention, statement or the conflicting range of other public materials.Therefore, and And at the necessary level, disclosure specifically listed herein replaces any conflict material being herein incorporated by reference. It is said that be herein incorporated by reference but with the conflicting any material of existing definitions, statements, or other disclosure materials listed herein Material or part thereof will not generated only between incorporated material and existing public material and is incorporated under the degree that conflicts.

Claims (21)

1. a kind of surgical stapling device, comprising:
Anvil assembly, the anvil assembly include:
Anvil block, the anvil block include:
Elongated slot, the elongated slot longitudinally extend along the length of the anvil block；
First anvil portion, first anvil portion is located on the first side of the elongated slot, wherein first anvil block Part includes multiple first nail shapes pits；With
Second anvil portion, the second anvil portion is located in second side of the elongated slot, wherein second anvil portion Including multiple second nail shapes pits；
Anvil block modifies component, and the anvil block modification component is attached to the anvil block, wherein anvil block modification component includes:
First part, the first part position against first anvil portion, wherein the first part includes multiple Three nail shapes pits；With
Second part, the second part are positioned against second anvil portion, wherein the second part includes multiple Four nail shapes pits.
2. surgical stapling device according to claim 1, wherein first nail shapes pit includes the first pit arrangement knot Structure, wherein the third nail shapes pit includes the second dimple arragement construction different from the first pit arragement construction.
3. surgical stapling device according to claim 2, wherein second nail shapes pit includes the first pit cloth Structure is set, wherein the 4th nail shapes pit includes the second dimple arragement construction.
4. surgical stapling device according to claim 1, wherein the anvil block modification component further includes being located at described first Point between the second part can transverse portions.
5. surgical stapling device according to claim 4, wherein it is described can transverse portions positioned against the elongated slot.
6. surgical stapling device according to claim 1, wherein the anvil block modification component includes being releasably attached to it On implantable layer.
7. surgical stapling device according to claim 1, wherein the anvil block modification component includes at least one gap filling Object, at least one described gap fillers, which are configured to modify when component is attached to the anvil block in the anvil block, occupies institute State at least one gap between anvil block modification component and the anvil block.
8. surgical stapling device according to claim 1, wherein the anvil block modification component includes at least one attachment features Structure, at least one described attachment features structure are configured to anvil block modification component being attached to the anvil block.
9. surgical stapling device according to claim 8, wherein at least one described attachment features structure includes beveled edge, Wherein the anvil block includes outer wall, and wherein the beveled edge is configured to be attached to institute in anvil block modification component It is flushed when stating anvil block with the outer wall.
10. surgical stapling device according to claim 1, wherein first nail shapes pit is along first longitudinal direction axis cloth It sets, wherein second nail shapes pit is arranged along second longitudinal direction axis, wherein the third nail shapes pit is along third longitudinal direction Axis arrangement, wherein the third longitudinal axis is not aligned with the first longitudinal direction axis, wherein the 4th nail shapes pit It is arranged along the 4th longitudinal axis, and wherein the 4th longitudinal axis is not aligned with the second longitudinal direction axis.
11. a kind of anvil block modification component being used together with the anvil block of surgical stapling device, wherein anvil block modification component includes:
Main body；
Anvil block contact surface, the anvil block contact surface are configured to against the anvil positioning；
Tissue contacting surface, the tissue contacting surface include multiple nail shapes pits；With
At least one attachment features structure, at least one described attachment features structure are configured to the main body is releasable Ground is fixed to the anvil block.
12. anvil block according to claim 11 modifies component, wherein the main body includes elongated slot.
13. anvil block according to claim 11 modifies component, further including can transverse portions.
14. anvil block according to claim 13 modifies component, wherein it is described can transverse portions can be against the anvil block Elongated slot positioning.
It further include being releasably attached to the tissue contacting surface 15. anvil block according to claim 11 modifies component Implantable layer.
Further include at least one gap fillers 16. anvil block according to claim 11 modifies component, it is described at least one Gap fillers, which are configured to modify in the anvil block, occupies the anvil block modification component when component is attached to the anvil block At least one gap between the anvil block.
17. anvil block according to claim 11 modifies component, wherein at least one described attachment features structure includes bevel edge Edge, wherein the anvil block includes outer wall, and wherein the beveled edge is configured to modify component attachment in the anvil block It is flushed when to the anvil block with the outer wall.
18. a kind of surgery system, comprising:
Anvil block, the anvil block include:
Elongated slot, the elongated slot longitudinally extend along the length of the anvil block；With
Multiple first nail shapes pits；
Anvil block modifies component, and the anvil block modification component can be releasably attached to the anvil block, wherein the anvil block is modified Component includes multiple second nail shapes pits；With
Nail bin, the nail bin includes can be by the multiple first when anvil block modification component is not attached to the anvil block Multiple nails of nail shapes pit forming, and wherein when anvil block modification component is attached to the anvil block, the nail can It is shaped by the multiple second nail shapes pit.
19. surgery system according to claim 18, further include be releasably attached to the anvil block modification component can Implant layer.
20. surgery system according to claim 18, wherein the anvil block modification component includes at least one gap filling Object, at least one described gap fillers, which are configured to modify when component is attached to the anvil block in the anvil block, occupies institute State at least one gap between anvil block modification component and the anvil block.
21. surgery system according to claim 18, wherein the anvil block modification component includes at least one attachment features Structure, at least one described attachment features structure are configured to anvil block modification component being attached to the anvil block.
CN201780033809.6A 2016-04-01 2017-03-28 Anvil modifying member for a surgical stapler Active CN109310413B (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US15/089,331 US10376263B2 (en) 2016-04-01 2016-04-01 Anvil modification members for surgical staplers
US15/089,331 2016-04-01
PCT/US2017/024514 WO2017172750A1 (en) 2016-04-01 2017-03-28 Anvil modification members for surgical staplers

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CN109310413B CN109310413B (en) 2021-07-16

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1923147A (en) * 2005-08-31 2007-03-07 伊西康内外科公司 Staple cartridges for forming staples having differing formed staple heights
CN101254123A (en) * 2007-02-28 2008-09-03 伊西康内外科公司 Surgical stapling device with staple drivers of different height
US20090020584A1 (en) * 2007-07-11 2009-01-22 Michael Soltz Surgical staple with augmented compression area
CN101534728A (en) * 2006-09-29 2009-09-16 伊西康内外科公司 Surgical cutting and stapling device with closure apparatus for limiting maximum tissue compression force
CN101873834A (en) * 2007-06-29 2010-10-27 伊西康内外科公司 Washer for use with a surgical stapling instrument
US20120080340A1 (en) * 2010-09-30 2012-04-05 Ethicon Endo-Surgery, Inc. Staple cartridge comprising a variable thickness compressible portion

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9795384B2 (en) * 2013-03-27 2017-10-24 Ethicon Llc Fastener cartridge comprising a tissue thickness compensator and a gap setting element

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1923147A (en) * 2005-08-31 2007-03-07 伊西康内外科公司 Staple cartridges for forming staples having differing formed staple heights
CN101534728A (en) * 2006-09-29 2009-09-16 伊西康内外科公司 Surgical cutting and stapling device with closure apparatus for limiting maximum tissue compression force
CN101254123A (en) * 2007-02-28 2008-09-03 伊西康内外科公司 Surgical stapling device with staple drivers of different height
CN101873834A (en) * 2007-06-29 2010-10-27 伊西康内外科公司 Washer for use with a surgical stapling instrument
US20090020584A1 (en) * 2007-07-11 2009-01-22 Michael Soltz Surgical staple with augmented compression area
US20120080340A1 (en) * 2010-09-30 2012-04-05 Ethicon Endo-Surgery, Inc. Staple cartridge comprising a variable thickness compressible portion

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JP6938531B2 (en) 2021-09-22
JP2019513055A (en) 2019-05-23
CN109310413B (en) 2021-07-16
BR112018070101A2 (en) 2019-02-12

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