CN109310415A - Surgery suturing appliance including multiple latching members - Google Patents

Abstract

The invention discloses a kind of surgical stapling attachments.The surgical stapling attachment includes attachment part, shaft assembly, actuated articulation joints and end effector assembly.The end effector assembly includes drive system, and the drive system includes main drive and the blocking drive by individually rotating input component driving.The main drive is configured to capture, clamping and suture tissue.The blocking drive is configured to prevent the main drive from being driven in the case where nail bin is not installed in the end effector assembly.Another blocking device is provided to prevent the drive system when the nail bin used up is mounted in the end effector assembly to be activated.

Description

Surgery suturing appliance including multiple latching members

Background technique

The present invention relates to surgical instruments, and in various arragement constructions, are related to being designed to suture and cutting tissue Surgical stapling and cutting device and the nail bin being used therewith.

Detailed description of the invention

The various features of the embodiment described herein add in combination with following attached drawing according to being described below together with its advantage To understand:

Fig. 1 is the perspective according to the surgical instruments including interchangeable surgical tool component of at least one embodiment Figure；

Fig. 2 is another perspective view of the handle assembly of the surgical instruments of Fig. 1, and wherein a part of shank shell is omitted Component therein is contained in exposure；

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 opposite It is shown in solid in a position of main enclosure portion, and in the another of the main enclosure portion relative to handle assembly It is shown in dotted line in a position；

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 drive on rotation driving pod The switch gear that moving gear is 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 drive Switch solenoidal position when driving gear on dynamic pod is engaged；

Figure 10 is another perspective view of the handle assembly of Fig. 2 to Fig. 9, wherein its certain part shown with section and its Access panels 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 Actuator assembly；

Figure 16 is the office of the nail bin groupware of the surgical stapling attachment of Figure 15, end effector assembly and actuated articulation joints Portion's perspective view；

Figure 17 is the part of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Exploded view；

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 part of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Perspective view, wherein the shaft assembly includes changeover module, which is configured to drive in closure driving device and percussion Switch between the driveability of dynamic device, and wherein the changeover module is shown at for driving percussion driving device Position；

Figure 20 is the part of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Perspective view, 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, and wherein this is closed Close frame include corresponding slit with the tissue of engagement end portion actuator assembly keep pin mechanism and corresponding driving lug with Engage 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 part of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Perspective view, wherein the changeover module is shown at the position for driving closure driving device；

Figure 25 is the longitudinal direction of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Sectional view, wherein the changeover module is in the first position for driving closure driving device, and at end effector assembly In open configuration；

Figure 26 is the longitudinal direction of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Sectional view, wherein the changeover module is in first position, and end effector assembly is in part closed configuration；

Figure 27 is the longitudinal direction of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Sectional view, wherein the changeover module is in first position, and end effector assembly is in complete clamping configuration；

Figure 28 is the longitudinal direction of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Sectional view, wherein the changeover module is switched to the second position from first position to drive percussion driving device, and end is held Row device assembly is in complete clamping configuration；

Figure 29 is the longitudinal direction of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Sectional view, wherein the changeover module is in the second position, and surgical stapling attachment is in complete firing configuration；

Figure 30 is the longitudinal direction of the end effector assembly of the surgical stapling attachment of Figure 15, actuated articulation joints and shaft assembly Sectional view, wherein the changeover module from the second position be switched to the third place with and meanwhile drive percussion driving device and closure drive Dynamic device, 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 received according to the power of at least one embodiment Obtain system；

Figure 31 is the perspective view of surgical stapling attachment or instrument comprising attachment part, shaft assembly, actuated articulation joints And end effector assembly；

Figure 32 is the actuated articulation joints of the instrument of Figure 31 and the local perspective view of end effector assembly, and medial end portions are held Row device assembly 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, Show 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, and wherein attachment part includes connecing Mouth and transmission device, the transmission device are configured to that shaft assembly will be transmitted to by the received rotational control motion of tool interface system Main 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 The part of component is 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 removed part with Drive system, Lock structure and the tissue of the instrument of exposure 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 press from both sides Tightly, the configuration of non-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 catching in Figure 39 It obtains, clamp, the configuration of non-percussion, unlock；

Figure 41 is the cross-section front view of the end effector assembly of the instrument of Figure 31, is shown as in the line 41- in Figure 40 Not the capturing, do not clamp of Figure 39 of 41 interceptions, non-percussion, unlock configuration；

Figure 42 is the part section front view of the end effector assembly of the instrument of Figure 31, is shown as pressing from both sides in capture, part Tightly, the configuration of non-percussion；

Figure 43 is the part section front view of the end effector assembly of the instrument of Figure 31, be shown as in Figure 42 capture, Grips, non-percussion configuration；

Figure 44 is the part section front view of the end effector assembly of the instrument of Figure 31, be shown as in completely clamp, it is non- The configuration of percussion；

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, The configuration of percussion；

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, The configuration of percussion；

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 Fixed 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, is shown as returning completely in Figure 46 The configuration of contracting, 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, portion completely Divide the configuration of percussion, wherein nail bin groupware includes cock indicator system, and the instruction of cock indicator system should Instrument is in the configuration for clamping, partially firing completely；

Figure 50 is the part section front view of the end effector assembly of the instrument of Figure 31, be shown as in completely clamp, it is complete The configuration fired entirely, 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 effector 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 To expose 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 that can rotate 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, end effector Component includes 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 the configuration in clamping, non-percussion；

Figure 60 is the cross-section front view of the end effector assembly of the instrument of Figure 51, is shown as in clamping, suture completely Configuration；

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 in clamping, completely suture, portion 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 not clamping or open Configuration；

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 For the configuration in 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 For 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 For configuration in clamping, joint motions；

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 one according to the surgery nail bin being used together with circular surgical staplers tool of at least one embodiment Partial perspective view；

Figure 71 shows a pair of of nail in unshaped and shaped configuration according at least one embodiment；

Figure 72 is a part of a part of anvil block relative to the surgery nail bin of Figure 70 before forming process is followed closely in actuating Cross-sectional view；

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 one according to the surgery nail bin being used together with circular surgical staplers tool of at least one embodiment Partial perspective view；

Figure 75 is a part of a part of anvil block relative to the surgery nail bin of Figure 74 before forming process is followed closely in actuating Cross-sectional view；

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 according to the anvil block that can be used in combination with the surgical stapling device of Figure 92 of at least one embodiment View；

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 according to the anvil block that can be used in combination with the surgical stapling device of Figure 96 of at least one embodiment View；

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, the end effector Component is modified including nail bin, anvil block and anvil block；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 with a kind of shape Formula shows various embodiments of the present invention, and this example is not necessarily to be construed as the model limiting the invention in any way It encloses.

Specific embodiment

Present applicant possesses following patent application, the patent application and the application and submits in same date and each It is incorporated herein from being incorporated by reference:

The United States Patent (USP) Shen of entitled " METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM " Please sequence number _ _ _ _ _ _ _ _；Attorney number END7821USNP/150535；

The U.S. of entitled " MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY " Patent application serial number _ _ _ _ _ _ _；Attorney number END7822USNP/150536；

Entitled " SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE- The U.S. Patent Application Serial Number of ORIENTABLE DISPLAY FIELD " _ _ _ _ _ _ _；Attorney number END7822USNP1/150536-1；

Entitled " SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIP The U.S. Patent Application Serial Number of PORTION " _ _ _ _ _ _ _；Attorney number END7823USNP/150537；

Entitled " ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLE The U.S. Patent Application Serial Number of BAILOUT SYSTEM " _ _ _ _ _ _ _；Attorney number END7824USNP/150538；

Entitled " SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVIL The U.S. Patent Application Serial Number of CONCENTRIC DRIVE MEMBER " _ _ _ _ _ _ _；Attorney number END7825USNP/ 150539；

Entitled " CLOSURE SYSTEM ARRANGEMENTS FOR SURGICAL CUTTING AND STAPLING The U.S. Patent Application Serial Number of DEVICES WITH SEPARATE AND DISTINCT FIRING SHAFTS " _ _ _ _ _ _ _； Attorney number END7826USNP/150540；

Entitled " INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL END The U.S. Patent Application Serial of EFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS " Number _ _ _ _ _ _ _；Attorney number END7827USNP/150541；

Entitled " SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7829USNP/150543；

Entitled " SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVE The U.S. Patent Application Serial Number of CUTTING OF TISSUE " _ _ _ _ _ _ _；Attorney number END7830USNP/150544；

The beauty of entitled " SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT " State's patent application serial number _ _ _ _ _ _ _；Attorney number END7831USNP/150545；

Entitled " SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSION The U.S. Patent Application Serial Number of LOCKOUT " _ _ _ _ _ _ _；Attorney number END7832USNP/150546；

Entitled " SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT's " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7833USNP/150547；

Entitled " SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT's " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7834USNP/150548；

Entitled " SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7835USNP/150549；

Entitled " SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGE The U.S. Patent Application Serial Number of LOCKOUT " _ _ _ _ _ _ _；Attorney number END7836USNP/150550；

The U.S. of entitled " SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM " is special Sharp patent application serial numbers _ _ _ _ _ _ _；Attorney number END7837USNP/150551；

The U.S. Patent Application Serial Number of entitled " SURGICAL STAPLING INSTRUMENT " _ _ _ _ _ _ _；Agency People's file number END7839USNP/150553；

Entitled " SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OF The U.S. Patent Application Serial Number of STAPLES HAVING DIFFERENT HEIGHTS " _ _ _ _ _ _ _；Attorney number END7840USNP/150554；

Entitled " SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET " U.S. Patent Application Serial Number _ _ _ _ _ _ _；Attorney number END7841USNP/150555；

The United States Patent (USP) Shen of entitled " ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS " Please sequence number _ _ _ _ _ _ _；Attorney number END7842USNP/150556；

The U.S. Patent Application Serial of entitled " STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES " Number _ _ _ _ _ _ _；Attorney number END7843USNP/150557；

Entitled " CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUE The U.S. Patent Application Serial Number of SUPPORT " _ _ _ _ _ _ _；Attorney number END7844USNP/150558；

The beauty of entitled " CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM " State's patent application serial number _ _ _ _ _ _ _；Attorney number END7845USNP/150559；And

The United States Patent (USP) Shen of entitled " CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL " Please sequence number _ _ _ _ _ _ _；Attorney number END7845USNP1/150559-1.

Present applicant also possesses U.S. Patent application below, these patent applications were mentioned on December 31st, 2015 It hands over, each is respectively entirely incorporated into herein by reference:

Entitled " MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE IN The U.S. Patent Application Serial Number 14/984,488 of POWERED SURGICAL INSTRUMENTS "；

Entitled " MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED The U.S. Patent Application Serial Number 14/984,525 of SURGICAL INSTRUMENTS "；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 mentioned on 2 9th, 2016 It hands over, each is respectively entirely incorporated into herein by reference:

Entitled " SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLY The U.S. Patent Application Serial Number 15/019,220 of TRANSLATABLE END EFFECTOR "；

Entitled " SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATION The U.S. Patent Application Serial Number 15/019,228 of ARRANGEMENTS "；

Entitled " SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTED The U.S. Patent Application Serial Number 15/019,196 of SECONDARY CONSTRAINT "；

Entitled " SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLY The U.S. Patent Application Serial Number 15/ of ARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY " 019,206；

Entitled " SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATION The U.S. Patent Application Serial Number 15/019,215 of ARRANGEMENTS "；

Entitled " ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATION The U.S. Patent Application Serial Number 15/019,227 of LINK ARRANGEMENTS "；

Entitled " SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLE The U.S. Patent Application Serial Number 15/019,235 of DRIVEN ARTICULATION SYSTEMS "；

Entitled " ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAM The U.S. Patent Application Serial Number 15/019,230 of ARRANGEMENTS "；With

Entitled " SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTION The U.S. Patent Application Serial Number 15/019,245 of ARRANGEMENTS ".

Present applicant also possesses U.S. Patent application below, these patent applications were mentioned on 2 12nd, 2016 It hands over, each is respectively entirely incorporated into herein by reference:

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 with Lower patent application:

Entitled " SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING The U.S. Patent Application Serial Number 14/742,925 of ARRANGEMENTS "；

Entitled " SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSING The U.S. Patent Application Serial Number 14/742,941 of FEATURES "；

Entitled " MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLE The U.S. Patent Application Serial Number 14/742,914 of SURGICAL INSTRUMENTS "；

Entitled " ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAM The U.S. of STRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT " Patent application serial number 14/742,900；

Entitled " DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLE The U.S. Patent Application Serial Number 14/742,885 of SURGICAL INSTRUMENTS "；With

Entitled " PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLE The U.S. Patent Application Serial Number 14/742,876 of SURGICAL INSTRUMENTS ".

Present applicant possess on March 6th, 2015 submit and be respectively incorporated by reference be incorporated herein with Lower patent application:

The U.S. Patent Application Serial Number 14/640,746 of entitled " POWERED SURGICAL INSTRUMENT "；

Entitled " MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWERED The U.S. Patent Application Serial Number 14/640,795 of SURGICAL INSTRUMENTS "；

Entitled " ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE The U.S. Patent Application Serial Number 14/640,832 of RATES FOR MULTIPLE TISSUE TYPES "；Attorney number END7557USNP/140482；

Entitled " OVERLAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO The U.S. Patent Application Serial Number 14/640,935 of MEASURE TISSUE COMPRESSION "；

Entitled " MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTOR The U.S. Patent Application Serial Number 14/640,831 of FOR POWERED SURGICAL INSTRUMENTS "；

Entitled " TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE The U.S. Patent Application Serial Number 14/ of STABILITY, CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES " 640,859；

Entitled " INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS " U.S. Patent Application Serial Number 14/640,817；

Entitled " CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULAR The U.S. Patent Application Serial Number 14/640 of SHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE ", 844；

The U.S. Patent Application Serial of entitled " SMART SENSORS WITH LOCAL SIGNAL PROCESSING " Number 14/640,837；

Entitled " SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGE The U.S. Patent Application Serial Number 14/640,765 of INTO A SURGICAL STAPLER "；

Entitled " SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A The U.S. Patent Application Serial Number 14/640,799 of ROTATABLE SHAFT "；With

Entitled " SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING's " U.S. Patent Application Serial Number 14/640,780.

Present applicant possesses to be submitted and full text is respectively hereby incorporated herein by on 2 27th, 2015 Following patent application:

Entitled " SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION " U.S. Patent Application Serial Number 14/633,576；

Entitled " SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCE PARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND” U.S. Patent Application Serial Number 14/633,546；

Entitled " SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONE The U.S. Patent Application Serial Number 14/633,576 of OR MORE BATTERIES "；

Entitled " CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR The U.S. Patent Application Serial Number 14/633,566 of CHARGING A BATTERY "；

Entitled " SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TO The U.S. Patent Application Serial Number 14/633,555 of BE SERVICED "；

The U.S. Patent application sequence of entitled " REINFORCED BATTERY FOR A SURGICAL INSTRUMENT " Row number 14/633,542；

The U.S. Patent Application Serial Number of entitled " POWER ADAPTER FOR A SURGICAL INSTRUMENT " 14/633,548；

The U.S. Patent Application Serial Number 14/ of entitled " ADAPTABLE SURGICAL INSTRUMENT HANDLE " 633,526；

The U.S. Patent Application Serial Number 14/633,541 of entitled " MODULAR STAPLING ASSEMBLY "；With

Entitled " SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFE The U.S. Patent Application Serial Number 14/633,562 of PARAMETER "；

Present applicant possesses to be submitted and is respectively hereby incorporated herein by full on December 18th, 2014 Following patent application:

Entitled " SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END The U.S. Patent application of EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING " Sequence number 14/574,478；

The beauty of entitled " SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS " State's patent application serial number 14/574,483；

Entitled " DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS's " U.S. Patent Application Serial Number 14/575,139；

Entitled " LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH The U.S. Patent Application Serial Number 14/575,148 of ARTICULATABLE SURGICAL END EFFECTORS "；

Entitled " SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE The United States Patent (USP) Shen of ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE " It please sequence number 14/575,130；

The beauty of entitled " SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS " State's patent application serial number 14/575,143；

Entitled " SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND The U.S. Patent Application Serial Number 14/575,117 of MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS "；

Entitled " SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND The U.S. Patent Application Serial Number 14/575,154 of IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS "；

Entitled " SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE The U.S. Patent Application Serial Number 14/574,493 of ARTICULATION SYSTEM "；With

Entitled " SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE The U.S. Patent Application Serial Number 14/574,500 of ARTICULATION SYSTEM ".

Present applicant, which possesses, to be submitted on March 1st, 2013 and full text is respectively hereby incorporated herein by Following patent application:

Entitled " ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS The U.S. Patent Application Serial Number 13/782,295 of FOR SIGNAL COMMUNICATION ", is now U.S. Patent Application Publication 2014/0246471；

Entitled " ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS " U.S. Patent Application Serial Number 13/782,323, be now U.S. Patent Application Publication 2014/0246472；

The beauty of entitled " THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS " State's patent application serial number 13/782,338 is now U.S. Patent Application Publication 2014/0249557；

Entitled ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAY The U.S. Patent Application Serial Number 13/782,499 of ARRANGEMENT " is now U.S. Patent Application Publication 2014/0246474；

Entitled " MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICAL The U.S. Patent Application Serial Number 13/782,460 of INSTRUMENTS " is now U.S. Patent Application Publication 2014/0246478；

Entitled " MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICAL The U.S. Patent Application Serial Number 13/782,358 of INSTRUMENTS " is now U.S. Patent Application Publication 2014/0246477；

Entitled SENSOR STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGH The U.S. Patent Application Serial Number 13/782,481 of TROCAR " is now U.S. Patent Application Publication 2014/0246479；

Entitled " CONTROL METHODS FOR SURGICAL INSTRUMENTS WITH REMOVABLE The U.S. Patent Application Serial Number 13/782,518 of IMPLEMENT PORTIONS " is now U.S. Patent Application Publication 2014/ 0246475；

Entitled " ROTARY POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OF The U.S. Patent Application Serial Number 13/782,375 of FREEDOM " is now U.S. Patent Application Publication 2014/0246473；With

The U.S. Patent Application Serial Number 13/782,536 of entitled " SURGICAL INSTRUMENT SOFT STOP ", It is now U.S. Patent Application Publication 2014/0246476.

Present applicant also possesses to be submitted and is respectively hereby incorporated herein by full on March 14th, 2013 Following patent application:

Entitled " ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE " U.S. Patent Application Serial Number 13/803,097, be now U.S. Patent Application Publication 2014/0263542；

Entitled " CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL The U.S. Patent Application Serial Number 13/803,193 of INSTRUMENT " is now U.S. Patent Application Publication 2014/0263537；

Entitled " INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL The U.S. Patent Application Serial Number 13/803,053 of INSTRUMENT " is now U.S. Patent Application Publication 2014/0263564；

Entitled " ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION The U.S. Patent Application Serial Number 13/803,086 of LOCK " is now U.S. Patent Application Publication 2014/0263541；

Entitled " SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR The U.S. Patent Application Serial Number 13/803,210 of SURGICAL INSTRUMENTS " is now U.S. Patent Application Publication 2014/ 0263538；

The U.S. Patent application of entitled " MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT " Sequence number 13/803,148 is now U.S. Patent Application Publication 2014/0263554；

Entitled " DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL The U.S. Patent Application Serial Number 13/803,066 of INSTRUMENTS " is now U.S. Patent Application Publication 2014/0263565；

Entitled " ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL The U.S. Patent Application Serial Number 13/803,117 of INSTRUMENTS " is now U.S. Patent Application Publication 2014/0263553；

Entitled " DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL The U.S. Patent Application Serial Number 13/803,130 of INSTRUMENTS " is now U.S. Patent Application Publication 2014/0263543； With

The U.S. of entitled " METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT " Patent application serial number 13/803,159 is now U.S. Patent Application Publication 2014/0277017.

Present applicant also possess submit on March 7th, 2014 and be incorporated by reference be incorporated herein it is following Patent application:

The U.S. Patent Application Serial Number of entitled " CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS " 14/200,111, it is now U.S. Patent Application Publication 2014/0263539.

Present applicant, which also possesses on March 26th, 2014 to submit and be respectively incorporated by reference, to be incorporated herein Following patent application:

Entitled " POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS's " U.S. Patent Application Serial Number 14/226,106 is now U.S. Patent Application Publication 2015/0272582；

The U.S. Patent Application Serial Number 14/ of entitled " STERILIZATION VERIFICATION CIRCUIT " 226,099, it is now U.S. Patent Application Publication 2015/0272581；

Entitled " VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT " U.S. Patent Application Serial Number 14/226,094, be now U.S. Patent Application Publication 2015/0272580；

Entitled " POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT The U.S. Patent Application Serial Number 14/226,117 of AND WAKE UP CONTROL " is now U.S. Patent Application Publication 2015/ 0272574；

Entitled " MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT The U.S. Patent Application Serial Number 14/226,075 of ASSEMBLIES " is now U.S. Patent Application Publication 2015/0272579；

Entitled " FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL The U.S. Patent Application Serial Number 14/226,093 of INSTRUMENTS " is now U.S. Patent Application Publication 2015/0272569；

The United States Patent (USP) Shen of entitled " SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION " Please sequence number 14/226,116, be now U.S. Patent Application Publication 2015/0272571；

Entitled " SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY The U.S. Patent Application Serial Number 14/226,071 of PROCESSOR " is now U.S. Patent Application Publication 2015/0272578；

The United States Patent (USP) of entitled " SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS " Patent application serial numbers 14/226,097 are now U.S. Patent Application Publication 2015/0272570；

The U.S. of entitled " INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS " is special Sharp patent application serial numbers 14/226,126 are now U.S. Patent Application Publication 2015/0272572；

The U.S. Patent Application Serial Number 14/ of entitled " MODULAR SURGICAL INSTRUMENT SYSTEM " 226,133, it is now U.S. Patent Application Publication 2015/0272557；

The beauty of entitled " SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT " State's patent application serial number 14/226,081 is now U.S. Patent Application Publication 2015/0277471；

Entitled " POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE The U.S. Patent Application Serial Number 14/226,076 of VOLTAGE PROTECTION " is now U.S. Patent Application Publication 2015/ 0280424；

The U.S. Patent Application Serial Number 14/ of entitled " SURGICAL STAPLING INSTRUMENT SYSTEM " 226,111, it is now U.S. Patent Application Publication 2015/0272583；With

The United States Patent (USP) Shen of entitled " SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT " Please sequence number 14/226,125, be now U.S. Patent Application Publication 2015/0280384.

Present applicant, which also possesses on September 5th, 2014, to be submitted and is respectively hereby incorporated herein by full Following patent application:

The United States Patent (USP) Shen of entitled " CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE " Please sequence number 14/479,103, be now U.S. Patent Application Publication 2016/0066912；

Entitled " ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE The U.S. Patent Application Serial Number 14/479,119 of COMPRESSION " is now U.S. Patent Application Publication 2016/0066914；

Entitled " MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION " U.S. Patent Application Serial Number 14/478,908, be now U.S. Patent Application Publication 2016/0066910；

Entitled " MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S The U.S. Patent Application Serial Number 14/478,895 of OUTPUT OR INTERPRETATION ", is now U.S. Patent Application Publication 2016/0066909；

Entitled " USE OF POLARITY OF HALL MAGNET DETECTION TO DETECT MISLOADED The U.S. Patent Application Serial Number 14/479,110 of CARTRIDGE " is now U.S. Patent Application Publication 2016/0066915；

The U.S. of entitled " SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION " is special Sharp patent application serial numbers 14/479,098 are now U.S. Patent Application Publication 2016/0066911；

The United States Patent (USP) of entitled " MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE " Patent application serial numbers 14/479,115 are now U.S. Patent Application Publication 2016/0066916；With

The United States Patent (USP) Shen of entitled " LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION " Please sequence number 14/479,108,

It is now U.S. Patent Application Publication 2016/0066913.

Present applicant also possesses to be submitted and is respectively hereby incorporated herein by full on April 9th, 2014 Following patent application:

Entitled " MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE The U.S. Patent Application Serial Number 14/248,590 of SHAFTS " is now U.S. Patent Application Publication 2014/0305987；

Entitled " SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRING The U.S. Patent Application Serial Number 14/248,581 of DRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT ", It is now U.S. Patent Application Publication 2014/0305989；

Entitled " SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING The U.S. Patent Application Serial Number 14/248,595 of THE OPERATION OF THE SURGICAL INSTRUMENT ", now for U.S. Patent Application Publication 2014/0305988；

The U.S. Patent Application Serial Number 14/248 of entitled " POWERED LINEAR SURGICAL STAPLER ", 588, it is now U.S. Patent Application Publication 2014/0309666；

The United States Patent (USP) of entitled " TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT " Patent application serial numbers 14/248,591 are now U.S. Patent Application Publication 2014/0305991；

Entitled " MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS” U.S. Patent Application Serial Number 14/248,584, be now U.S. Patent Application Publication 2014/0305994；

The U.S. Patent Application Serial Number 14/248,587 of entitled " POWERED SURGICAL STAPLER ", now for U.S. Patent Application Publication 2014/0309665；

Entitled " DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL The U.S. Patent Application Serial Number 14/248,586 of INSTRUMENT " is now U.S. Patent Application Publication 2014/0305990；With

Entitled " MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS The U.S. Patent Application Serial Number 14/248,607 of INDICATION ARRANGEMENTS ", is now U.S. Patent Application Publication 2014/0305992。

Present applicant also possesses to be submitted and is respectively hereby incorporated herein by full on April 16th, 2013 Following patent application:

Entitled " SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A The U.S. Provisional Patent Application Serial No. 61/812,365 of SINGLE MOTOR "；

The U.S. Provisional Patent Application Serial No. 61/812,376 of entitled " LINEAR CUTTER WITH POWER "；

The U.S. Provisional Patent Application sequence of entitled " LINEAR CUTTER WITH MOTOR AND PISTOL GRIP " Row number 61/812,382；

Entitled " SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS AND The U.S. Provisional Patent Application Serial No. 61/812,385 of MOTOR CONTROL "；With

Entitled " SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A The U.S. Provisional Patent Application Serial No. 61/812,372 of SINGLE MOTOR ".

Many details are listed, herein to provide to whole with embodiment shown in the drawings described in specification Body structure, function, the thorough understanding of manufacture and purposes.It is not described in well known operation, component and element, in order to avoid make to illustrate Embodiment described in book is smudgy.Reader will appreciate that embodiment described and illustrated herein is non-limiting shows Example, thus it can be appreciated that, specific structural and functional details disclosed herein can be representative and illustrative.Power is not being departed from In the case where the range that benefit requires, variations and modifications can be carried out to these embodiments.

Term " includes " (and any form of " comprising ", such as "comprising"), " having " (and any shape of " having " Formula such as " has "), "comprising" (and any form of "comprising", such as " comprising ") and " containing " (and " containing " Any form, such as "comprising") be open link-verb.Therefore, " comprising ", " having ", "comprising" or " containing " one or Surgery system, device or the equipment of multiple element have these one or more elements, but be not limited to only to have these or Multiple element.Equally, the system of " comprising ", " having ", "comprising" or " containing " one or more features, device or equipment Element has those one or more features, but is not limited to only have those one or more features.

Term " nearside " and " distal side " are herein defined as coming relative to the clinician of the handle portions of manipulation surgical instruments It uses.Term " nearside " refers to that near the part of clinician, term " distal side " refers to the portion far from clinician's positioning Point.It is also understood that using such as "vertical", "horizontal", "up" and "down" in combination with attached drawing herein for the sake of succinct and is clear Etc. spatial terminologies.However, surgical instruments uses in many directions and position, and these terms and it is unrestricted and/or Absolute.

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

Surgical stapling system may include axis and the end effector from axis extension.End effector includes the first jaw and the Two jaws.First jaw includes nail bin.The nail bin is inserted into the first jaw and can remove from the first jaw；However, Other embodiments replaced from the first jaw can not be removed from the first jaw or at least be readily able to by being susceptible to wherein nail bin. Second jaw includes the anvil block for being configured to the nail deformation for making to project from nail bin.Second jaw can be relative to the first jaw It is pivoted around closure axis；It is contemplated, however, that the other embodiment party that can be pivoted to wherein the first jaw relative to the second jaw Case.Surgical stapling system further includes the pass for being configured to allow end effector that joint motions are rotated or carried out relative to axis Save kinematic joint.End effector can be around the joint motions axis rotation for extending through actuated articulation joints.It contemplates not Other embodiments including actuated articulation joints.

Nail bin includes warehouse.Warehouse includes proximal end, distal end and extends between proximal end and distal end Platform.In use, nail bin is located on the first side of tissue to be stapled, and anvil positioning is in second side of tissue On.Anvil block is towards cartridge movement by tissue compression and to grip against platform.Then, the nail being removedly stored in warehouse can It is deployed in tissue.Warehouse includes being defined in nail cavity therein, is removedly stored in nail cavity wherein following closely.Nail cavity is arranged At six longitudinal rows.Three nail chambers are located on the first side of longitudinal slit and three nail chambers are located in second side of longitudinal slit On.Nail cavity and other arragement constructions of nail are also possible.

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

Than that described above, sliding part can also be moved toward the far side by firing member.Firing member is configured to contact Sliding part simultaneously pushes sliding part towards distal end.The longitudinal slit being defined in warehouse is configured to receive percussion structure Part.Anvil block further includes the slit for being configured to receive firing member.Firing member further includes engage the first jaw first Second cam of the second jaw of cam and engagement.When firing member is promoted towards distal side, first cam and the second cam is controllable The distance between platform and anvil block of nail bin or tissue space.Firing member further includes being configured to incision in nail bin and anvil The knife of the intermediate tissue trapped of seat.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 implementation In scheme, the surgery system 10 of motor driving includes the alternative shell reconfigured or handle assembly 20, and being attached to can Exchange 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 tools disclosed herein The surgery system that component can also be controlled effectively with robot is used in combination.Therefore, term " shell " and " casing assembly " can also Cover the receiving of robot system or be otherwise operably supported the shell or similar portions of at least one drive system, Wherein at least one described drive system is configured to generate and apply to can be used for activating elongated shaft group disclosed herein At least one of part and its corresponding equivalent control movement.Term " frame " can refer to a part of hand-held surgical instrument.Art Language " frame " can also indicate that a part of the surgical instruments of robot control and/or robot system can be used for operationally controlling A part of surgical instruments processed.For example, surgical tool component disclosed herein can be with various robot systems, instrument, component And method, such as, but not limited in entitled " SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE The U.S. Patent Application Serial Number 13/118,241 of STAPLE DEPLOYMENT ARRANGEMENTS " (is now United States Patent (USP) Shen Please announce 2012/0298719) disclosed in those of be used together, which is incorporated by reference accordingly is incorporated to this Text.

Referring now to Fig. 1 and Fig. 2, casing assembly or handle assembly 20 include main enclosure portion 30, the major capsid portion Dividing can be formed by a pair of of shell segments 40,70, and shell segments can be made in this of plastics, polymer material, metal etc., and by appropriate Fastener construction adhesive, screw, pressure cooperation feature structure, snap-fitted feature structure, latch etc. be connected to one It rises.It is discussed in detail as discussed further below, main enclosure portion 30 is operably supported multiple drive systems therein, described Multiple drive systems are configured to generate various control movements and various controls movement are applied to interchangeable surgery work Has the corresponding part of component being operably attached to thereon.Handle assembly 20 further includes retained part 100, and the retained part is living It is dynamic to be connected to main enclosure portion 30 and be configured to by clinician in the various positions relative to main enclosure portion 30 Set middle clamping and manipulation.Retained part 100 can be made of a pair of of gripping section 110,120, this can be by plastics, polymer to gripping section Material, metal etc. are made, and by fastener arragement construction appropriate such as adhesive, screw, pressure cooperation feature structure, Snap-fitted feature structure, latch etc. link together, and are 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, should Cavity is configured to be operably supported drive motor and gear-box, this will be discussed in further detail below.Clamping is outer The top 134 of shell 130 is configured to extend through the opening 80 in main enclosure portion 30 and pivotly axle journal connects It connects on pivotal axis 180.Pivotal axis 180 limits the pivot axis for being expressed as " PA ".Referring to Fig. 3.For reference purposes, shank group Part 20 defines the shank axis for being expressed as " HA ", can be parallel to the axis axis of the elongated shaft assembly of interchangeable surgical tool " SA " is operably attached to handle assembly 20.Pivot axis P A is transverse to shank axis HA.Referring to Fig. 1.Such arrangement Structure retained part 100 to be pivoted to relative to main enclosure portion 30 around pivot axis P A to be best suited for being connected to handle The position of the interchangeable surgical tool component type of parts 20.Clamping shell 130 limits clamping axis, is typically expressed as "GA".Referring to fig. 2.It is clinical when the interchangeable surgical tool component for being connected to handle assembly 20 includes such as endoscopic stapler Doctor may wish to position retained part 100 relative to main enclosure portion 30 so that clamping axis GA perpendicular to or substantially Vertically (angle " H1 ") is in shank axis HA (referred to herein as " the first clip position ").Referring to Fig. 5.However, if handle assembly 20 for controlling the interchangeable surgical tool component for example including circular stapler, then clinician may want to 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 the position of other suitable acute angles (angle " H2 ").This position is referred to herein as " the second clip position ".Fig. 5 is shown Retained part 100 shown in dotted line in the second 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 opposite Retained part 100 is selectively locked in desired orientation in main enclosure portion 30.In a kind of arragement construction, clamping lock Determine the arch series 152 that system 150 includes pointed tooth 154.Tooth 154 is separated from each other and forms locking groove 156 between them. Each locking groove 156 corresponds to the special angle latched position of retained part 100.For example, at least one arragement construction, Tooth 154 and locking groove or " locking position " 156, which are arranged to, allows retained part 100 with the spaced lock of 10-15 degree the Between one clip position and the second clip position.Two stop positions can be used in the arragement construction, the two stop positions are directed to Used instrument type (axis arragement construction) customization.For example, for endoscopic stapler axis arragement construction, it can be with axis about At 90 degree or so, and for circular stapler arragement construction, which can be cured with axis about at 45 degree simultaneously towards surgery Life is scanned forward.Clamping locking system 150 further includes locking press button 160, which has lock part 162, the locking Part engages locking groove 156 with being configured to locking.For example, locking press button 160 is pivotably mounted on pivot pin 131 On main handle portions 30 in, with allow locking press button 160 be pivoted into and corresponding locking groove 156 engage.Lock spring 164 for locking press button 160 to be biased into the position with corresponding locking groove 156 engagement or locking.When clinician presses When locking press button 160, lock part 162 and tooth configuration are for enabling tooth 154 to slip over lock part 162.Therefore, in order to adjust Angle position of the retained part 100 relative to main enclosure portion 30, clinician press locking press button 160, then will clamping Part 100 is pivoted 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 enter corresponding locking groove 156, 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 axis To drive system 400.Each free motor 200 of rotary drive system 300,320 provides power, which is operatively supported at folder It holds in part 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 have There is gear case assembly 202, which has the output driving shaft 204 from its protrusion.In various forms, motor 200 Such as the DC that can be the maximum rotation with about 25,000RPM has brush drive motor.In other arragement constructions, motor can be wrapped Include brushless motor, wireless motor, syncmotor, stepper motor or any other suitable electric motor.Motor 200 can be by function Rate source 210 powers, and in one form, which may include removable power source group 212.Power source 210 may include, for example, In the U.S. Patent Application Publication of entitled " SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM " Any one of various power supply arragement constructions being further disclosed in detail in 2015/0272575, the whole of the patent application publication Disclosure is hereby incorporated by reference.In the arragement construction shown in, for example, power supply group 212 may include outside nearside Shell parts 214, the nearside casing part are configured to be attached to distal side casing part 216.Nearside casing part 214 and distal side Casing 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 operationally be attached To the shank circuit board assemblies 220 for being equally operably linked to motor 200.Shank circuit board assemblies 220 are usual herein Alternatively 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. In addition to this, power source 210 can be interchangeable and/or rechargeable.In other embodiments, surgical instruments 10 can It is powered by such as alternating current (AC).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 Axis 204.Drive bevel gear 230 is attached to output driving shaft 204.Motor 200, gear case assembly 202,204 and of output driving shaft Drive 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 are handed over It connects, which is attached to system drive axis 232 and pivot bevel gear 238, which is connected to pivot In shaft 180.Driven wheel of differential 234 can be axially moved between bonding station and disengaging configuration on system drive axis 232, In bonding station, driven wheel of differential 234 and drive bevel gear 230 are engaged (Fig. 5), and in disengaging configuration, from mantle tooth Wheel 234 is disengaged from drive bevel gear 230 engages (Figure 14).Drive system spring 235 is connected to driven wheel of differential by axle journal Between 234 and proximal end flange 236, which is formed on the proximal end part of system drive axis 232.Ginseng See Fig. 4 and Figure 14.Drive system spring 235 is disengaged from it with drive bevel gear 230 to connect for bias driven wheel of differential 234 It closes, is discussed in detail as discussed further below.Pivot bevel gear 238 passes through convenient for output driving shaft 204 and drive bevel gear 230 Retained part 100 is advanced relative to the pivot of main handle portions 30.

In the example shown in the series of figures, system drive axis 232 and rotation driving selector system handover, the rotation drive selector System is typically expressed as 240.In at least one form, for example, rotation driving selector system 240 includes can be in the first rotation Selectively moved switch gear 250 between drive system 300 and the second rotary drive system 320.Such as in Fig. 6 to Fig. 9 In as can be seen that for example, driving selector system 240 includes the switch that is not movably mounted in main handle portions 30 Mounting plate 242.For example, switch mounting plate 242 can be frictionally held in the installation lug being formed in shell segments 40,70 Between (not shown), or otherwise remained at by screw, adhesive etc..Referring still to Fig. 6 to Fig. 9, system Drive shaft 232 extends through the hole in switch mounting plate 242, and has and be non-rotatably attached to center thereon or be System driving gear 237.For example, central drive gear 237, which can construct 233 by keyway, is attached to system drive axis 232.Referring to figure 6 to Fig. 9.In other arragement constructions, system drive axis 232 can be rotatable by corresponding shaft bearing (not shown) mounted thereto Ground 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, which can It is rotationally supported in the distal walls 32 being formed in main handle portions 30.First driving pod 302 may include the first main body Part 304, first main part have strip pod formed therein.First driven gear 306 is formed in the first main body It is not attached on part 304 or movably first main part.First main part 304, which can be pivotally supported at, to be mentioned In corresponding aperture or channel for distal walls 32 or it can be pivotally supported at the corresponding shaft bearing being mounted in distal walls 32 In (not shown).Similarly, the second rotary drive system 320 includes the second driving pod 322, which can also revolve It is supported in the distal walls 32 of main handle portions 30 with turning.Second driving pod 322 may include the second main part 324, should Second main part 324 has strip pod formed therein.Second driven gear 326 is formed in the second main part 324 Go up or be non-rotatably mounted to second main part.Second main part 324, which can be pivotally supported at, provides distal side In the corresponding aperture of wall 32 or channel or it can be pivotally supported at the corresponding shaft bearing being mounted in distal walls 32 and (not show In out).First driving pod and the second driving pod 302,322 are separated from each other on each cross side of shank axis HA. For example, with reference 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 scheming 6, which can be seen that switch gear 250 into Fig. 9, is rotatably installed on idler shaft 252, which is actively supported In the arcuate slot 244 in switch mounting plate 242.Switch gear 250 is installed into convenient for free on idler shaft 252 It rotates and keeps being engaged with central drive gear 234.Idler shaft 252 is connected to the one of the axis 262 of switch solenoid 260 End.Switch solenoid 260 is pinned or is otherwise installed together with main shank shell 30, so that working as switch spiral shell When spool 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 a to be engaged.For example, in a kind of arragement construction, when solenoid shaft 262 bounces back (Fig. 6 and Fig. 7), switch gear 250 It is engaged with centre-driven gear 234 and the first driven gear 306, so that the actuating of motor 200 will cause the first driving to be held The rotation of nest 302.Switch gear 250 is biased into this as switch spring 266 can be used in figure 6 and figure 7 In first actuated position.Therefore, if surgical instruments 10 loses electric power, switch spring 266 will be automatically by switch tooth Wheel 250 is biased into the first position.When switch gear 250 is in the position, the subsequent actuating of motor 200 will cause The rotation of first driving pod 302 of one rotary drive system 300.When switch solenoid is activated, switch gear 250 It is moved into and is 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 the second rotary drive system 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 The various parts part that is coupled of surgical tool component power is provided.As described above, at least one arragement construction, If motor loses electric power in the activating of interchangeable surgical tool component, then switch spring 266 is by switch gear 250 are biased into first position.Which operated according to component part of interchangeable surgical tool component, it may be necessary to will revolve Turn the driving reversing of motion and be applied to the first drive system 300, so that interchangeable surgical tool component can be removed from patient.Figure The exemplary handle assembly 20 shown uses manually actuable " emergency " system, is typically expressed as 330, for for example in above-mentioned field Rotating drive movements are manually applied to the first rotary drive system 300 in scape.

Referring now to Fig. 3, Figure 10 and Figure 11, shown in emergency system 330 include emergency power train 332 comprising planet Gear assembly 334.In at least one form, planetary gear set 334 includes planetary gear shell 336, outside the planetary gear Shell accommodates 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 Rotate planetary gear arragement construction, which finally rotate emergency driving axis 340.By emergency driving tooth It takes turns 342 axle journals to be connected on emergency driving axis 340, so that emergency driving gear 342 can axially move on emergency driving axis 340 It is dynamic, then rotate with.Emergency driving gear 342 can be in the spring stop flange 344 and shape 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 is connected to On emergency driving axis 340 between emergency driving gear 342 and spring stop flange 344.Axis spring 348 of meeting an urgent need is in emergency driving Towards distal side bias emergency driving gear 342 on axis 340.When emergency driving gear 342 is farthest in it on emergency driving axis 340 When side 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, Help to move emergency driving and is applied to emergency power train 332 manually.As in these figures as can be seen that emergency handle assembly 360 include emergency bevel gear assembly 362 comprising emergency bevel gear 364 and ratchet gear 366.Emergency handle assembly 360 is also wrapped Emergency shank 370 is included, emergency bevel gear assembly 362 is movably coupled to by pivotal yoke 372, which is pivotably mounted On ratchet gear 366.Emergency shank 370 is pivotally coupled to pivotal yoke 372 by pin 374, in storage location It selectively pivots and advances between " SP " and actuated position " AP ".Referring to Figure 12.Shank spring 376 is for the shank 370 that will meet an urgent need It is biased into actuated position AP.In at least one arragement construction, for example, in the axis SP for indicating storage location and indicating actuating Angle between the axis AP of position can be about 30 degree.Referring to Figure 13.It can also be seen that emergency shank group such as in Figure 13 Part 360 further includes the click 378 in the chamber being rotatably installed in pivotal yoke 372 or hole 377.378 quilt of click It is constructed to be permeable to engagingly engage ratchet gear 366 when along direction of actuation " AD " rotation, then when rotating in mutually opposite directions It rotationally disengages and is engaged.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 manipulating between the open and the closed positions Emergency route plate 390.In the arragement construction shown in, emergency route plate 390 is configured to be removably coupled to main The shell segments 70 of casing part 30.Therefore, in at least embodiment, when emergency route plate 390 is from main enclosure portion 30 When removing or dismantling, it, which is referred to as, is in " opening " position, and as shown in the figure when emergency route plate 390 is attached to major capsid When part 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 Main enclosure portion, so that access panels remain attached to thereon when access panels are in an open position.For example, in such implementation In scheme, access panels are pivotably attached to main enclosure portion or are attached slidably to main enclosure portion, and can be It is manipulated between open position and closed position.In the example shown in the series of figures, emergency route plate 390 is configured to engagingly engage The corresponding part of shell segments 70, is removably retained in " closed " position.The mechanical fasteners of other forms can also be used Part, screw, pin etc..

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 major capsid Part 30, emergency route plate 390 include drive system locking component or yoke 392 and emergency locking component or yoke 396, each From its back side protrusion or otherwise it is formed on.It includes drive shaft recess 394 that drive system, which locks yoke 392, by structure It causes to receive a part of system drive axis 232 when emergency route plate 390 is mounted in main enclosure portion 30 Wherein (that is, emergency route plate is in " closed " position).When emergency route plate 390 is positioned or mounted in closed position, Drive system locking yoke 392, which is used to for driven wheel of differential 234 being biased into be engaged with drive bevel gear 230, (resists driving system The bias of system spring 235).In addition, emergency locking yoke 396 includes emergency driving axis recess 397, it is configured to meeting an urgent need A part of emergency driving axis 340 is received wherein when access panels 390 are mounted or located in closed position.Such as in Fig. 5 and As can be seen that emergency locking yoke 396 is also used to for emergency driving gear 342 being biased into disengaging and emergency driven gear in Figure 10 350 be engaged (bias for resisting emergency axis spring 348).Therefore, when emergency route plate 390 is mounted or is in closure position When setting, emergency locking yoke 396 prevents the rotation of 342 interference system drive shaft 232 of emergency driving gear.In addition, emergency locking yoke 396 include shank recess 398, 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 With the configuration of emergency system component.As can be seen that drive system locking component 392 in these figures for driven wheel of differential 234 It is biased into and is engaged with 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 to rotate and system drive axis 232 is finally caused to rotate.Moreover, when being in the position When, emergency locking yoke 396 is used to for emergency driving gear 342 to be biased into disengaging and the emergency driven tooth on system drive axis 232 Wheel 350 is engaged.Therefore, when emergency route plate 390 is mounted or is in the close position, drive system can be by motor 200 actuatings, and emergency system 330 is disconnected or is prevented from that any actuating movement is applied to system drive axis 232.In order to swash Emergency system 330 living, clinician remove emergency route plate 390 first or are otherwise moved to emergency route plate 390 Open position.The movement removes drive system locking component 392 from the engagement with driven wheel of differential 234, to allow to drive Driven wheel of differential 234 is biased into being engaged for disengaging and drive bevel gear 230 by system spring 235.In addition, it is logical to remove emergency 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 road 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 Retraction nail percussion driving device.In many cases, the emergency system may need to be operated and/or shaken more than once with It is fully retracted nail percussion driving device.In such cases, the user of suture instruments may forget them by the emergency System has shaken how many times and/or has been retracted due to other reasons to percussion driving device needs how far feel to obscure.If Various embodiments are thought, wherein suture instruments include system, which is configured to detect the percussion structure of percussion driving device The position of part 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 The position of firing member.In at least one situation, sensor can be positioned in seam for example including hall effect sensor In the axis and/or end effector of clutch tool.Sensor is communicated with the controller signals of surgery suturing appliance, the controller again with Monitor signal communication on surgery suturing appliance.The controller includes microprocessor, which is configured to fire The physical location of component is compared with benchmark or reference position (it includes the fully retracted position of firing member), and is calculated and hit Send out the distance between physical location and the reference position of component, i.e. Distance Remaining.

Apart from the above, display is for example including electronic console, and controller is configured to any suitable side Formula shows Distance Remaining on an electronic display.In at least one situation, controller shows progress bar over the display.Herein In the case of class, for example, empty progress bar can indicate that firing member is in the end of its firing schedule, and complete progress bar can Indicate that firing member has been fully retracted.In at least one situation, for example, 0% can indicate that firing member is in its percussion row The end of journey, and 100% can indicate that firing member has been fully retracted.In some cases, controller is display configured to Need the actuating of how many times emergency organization that firing member is retracted to its fully retracted position over the display.

Apart from the above, the actuating of emergency organization can be operationally by the battery or power of surgery suturing appliance and percussion The electric motor of driving device disconnects.In at least one embodiment, the actuating toggle switch of emergency organization, this by battery with Electric 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 As can be seen that third axial drive system 400 includes solenoid 402 in the form of at least one, which has from its protrusion Third driving actuating component or bar 410.Third drives the distal end 412 of actuating component 410 to have formed therein the Three driving arms or pod 414, for receiving the drive system for being operably attached to interchangeable surgical tool component thereon The corresponding part of component.Solenoid 402 is wired to shank circuit board assemblies 220 and control system or CPU 224 or with its other party Formula communicates therewith.In at least one arragement construction, solenoid 402 is " spring-loaded ", so that when solenoid 402 is not caused When dynamic, 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 surgeries Tool assembly.For this purpose, handle assembly 20 includes the tool mounting portion for being typically expressed as 500, it is used for interchangeable surgery work Tool component is operatively connected thereto.In the example shown in the series of figures, tool mounting portion 500 faces interior swallow-tail form including two Slit 502 is received, is configured to engage the corresponding part of the tool attachment module part of interchangeable surgical tool component. Each swallow-tail form receives slit 502 and can be tapered, or in other words, can be slightly V-arrangement.Swallow-tail form receives slit 502 are configured to releasedly receive corresponding conical attachment or ear portions, the conical attachment or ear Object part is formed in a part of tool attachment nozzle segment of interchangeable surgical tool component.Each interchangeable surgery work Having component can also be equipped with latch system, which, which is configured to be releasably engaged, is formed in handle assembly 20 Corresponding holding pit 504 in tool mounting portion 500.

Various interchangeable surgical tool components can have " main " rotary drive system, be configured to operate Ground is connected to the first rotary drive system 310 or joins with it, and " auxiliary " rotary drive system, and being configured to can It is operably coupled to the second rotary drive system 320 or joins with it.Main and auxiliary rotary drive system is configured to Enough to provide various rotary motions to the part of certain types of surgical end-effector, the part includes interchangeable surgery work Has a part of component.For the ease of main rotary drive system being operably linked to the first rotary drive system and will be auxiliary Drive system is helped to be operably linked to the second rotary drive system 320, the tool mounting portion 500 of handle assembly 20 further includes A pair of insertion inclined-plane 506 is configured to the main of interchangeable surgical tool component and auxiliary during connection process The part of rotary drive system is towards distal side bias, to promote the first rotation on main rotary drive system and handle assembly 20 to drive The alignment and operable connection of dynamic system 300, and promote the second rotation on auxiliary rotary drive system and handle assembly 20 Turn the alignment and operable connection of drive system 320.

Interchangeable surgical tool component may also include " third " axial drive system, and for that will be axially moved, be applied to can Exchange the corresponding part of the surgical end-effector of surgical tool component.For the ease of by third axial drive system operationally The third axial drive system 400 being connected in handle assembly 20, third driving actuating component 410 are provided with pod 414, this holds Nest is configured 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 adapted to It is enough to capture, clamp, suture and cut tissue during surgery.Referring primarily to Figure 15, tool assembly 11100 includes attachment Divide 11200, shaft assembly 11300, actuated articulation joints 11400 and end effector assembly 11500.Tool assembly 11100 is by structure It causes that instrument interface can be attached to by attachment part 11200.Instrument interface may include surgical instruments shank, such as this paper institute Those disclosed.Other embodiments are contemplated, wherein tool assembly 11100 is 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 11200, which is configured to receive from instrument interface, revolves Turn control movement, tool assembly 11100 is attached to the instrument interface and rotational control motion is transmitted to shaft assembly 11300. These rotational control motions are transmitted to end effector assembly 11500 by actuated articulation joints 11400 by shaft assembly 11300.

It is illustrated in greater detail in Figure 18, attachment part 11200 is configured to be attached to instrument interface, will be by device The rotational control motion that tool interface generates is provided to shaft assembly 11300.Attachment part 11200 includes primary attachment interface 11210 With the auxiliary attachment interface 11220 supported by attachment part shell 11201.Attachment interface 11210,11220 is configured to With the cooperation of the corresponding attachment interface of instrument interface or connection.For example, the correspondence attachment interface of surgical instruments shank may include gear System, the gear train are configured to when being activated by user by one or more motor rotations, when, upon rotating, the gear train Rotate primary attachment interface 11210 and auxiliary attachment interface 11220.

Rotatable interface 11210,11220 simultaneously may be selected in user, or alternatively, rotate independently interface 11210, 11220.Primary attachment interface 11210 is configured to rotation input drive shaft 11211 and input driving mounted thereto Gear 11213.Input drive shaft 11211 includes shell bearing 11212, which is configured to latch housing 11201 and axis 11211 is prevented to be translated to the far side.The operationally transmission gear with shaft assembly 11300 of input driven gear 11213 11313 intermeshings, the transmission gear are mounted on main drive shaft 11311.As a result, the rotation of interface 11210 is transmitted to axis 11311.Similar arragement construction is for assisting attachment interface 11220.Auxiliary attachment interface 11220 is configured to make to input Drive shaft 11221 and input driven gear 11223 mounted thereto rotation.Input drive shaft 11221 includes shell bearing 11222, which is configured to latch housing 11201 and axis 11221 is prevented to be translated to the far side.Input driven gear 11223 are operationally intermeshed with the transmission gear 11323 of shaft assembly 11300, which is mounted on time drive shaft On 11321.As a result, the rotation of interface 11220 is transmitted to axis 11321.Main drive shaft 11311 is contained in shaft assembly shell 11301 It is interior.Rotational control motion is transmitted to end from attachment interface 11210 by actuated articulation joints 11400 and held by drive shaft 11311 Row device assembly 11500.Secondary drive shaft 11321 is also accommodated in shaft assembly shell 11301.Secondary drive shaft 11321 is transported by joint Rotational control motion is transmitted to end effector assembly 11500 from attachment interface 11220 by dynamic connector 11400.

Actuated articulation joints 11400 allow end effector assembly 11500 relative to 11301 passive joint of shaft assembly shell Connection.Referring primarily to Figure 19 and Figure 20, actuated articulation joints 11400 include be attached to shaft housing 11301 nearside yoke 11410, It is attached 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 11410 He of nearside yoke In nearside yoke aperture 11411 and distal side yoke aperture 11431 in distal side yoke 11430.End effector assembly 11500 is configured to Can around the joint motions axis AA that is limited by joint motions pin 11420 transverse to by tool assembly 11100 (more specifically Say, shaft housing 11301) limit longitudinal tool axis LT direction upper joint movement.Nearside yoke 11410 includes across its longitudinal direction The aperture 11419 of extension 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, and 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.User can manually be such that end effector assembly 11500 pivots around joint motions pin 11420, to make distal side yoke 11430 linear joints movement lock 11440.When joint motions lock 11440 is mobile relative to nearside yoke 11410 and surrounds joint motions When pin 11420 rotates, joint motions lock 11440 is configured to clamping or with the detent being limited in nearside yoke 11410 11413 incrementally lock, and distal side yoke 11430 are locked in place, and therefore lock end effector assembly 11500 It is fixed in place.In other words, when rotating end effector assembly 11500 around joint motions pin 11420, passive joint connection System surrounds the increment joint motions of joint motions axis AA convenient for end effector assembly 11500.

Actuated articulation joints 11400 are further configured to the rotation transmitting by main drive shaft 11311 or are transmitted to end Actuator assembly 11500.In order to pass through or transmit across actuated articulation joints 11400 rotary motion of main drive shaft 11311, close Section kinematic joint 11400 further includes pitch wheel system, which includes the input cone for being attached to main drive shaft 11311 Gear 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 bore tooth 11416 rotation of wheel.The rotation of idle pulley bevel gear 11416 rotates output bevel gear wheel 11417, to make output bevel gear wheel 11417 The input drive shaft 11518 being connected to rotates.When 11500 joint motions of end effector assembly, this construction allows to export Bevel gear 11417 rotates 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 is revolved in primary input drive shaft 11518 Rotation when turning.Primary input driving gear 11519 is configured to the single rotation input component as drive system 11510, this It will be discussed in more detail below.

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 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 portion's actuator frame 11600.Drive system 11510 includes single rotation input component, 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 In 11600, so that during installation, nail bin groupware 11800 can operatively connect with closure frame 11700 and drive system 11510 It closes.Referring now primarily to Figure 16, end effector frame 11600 includes proximal jaw 11610, distal jaw 11630 and connects Connect the coupling part 11620 of proximal jaw 11610 and distal jaw 11630.Proximal jaw 11610 is operably supported driving system System 11510 and closure frame 11700, and be configured to slideably received within and move ground support nail warehouse 11810. Distal jaw 11630 is configured to slideably received within and is fixedly supported the anvil portion of nail bin groupware 11800 11830.Anvil portion 11830 includes staple forming surface 11831 and cutter slit 11835, which is configured to Make 11880 forming of nail, and the cutter slit is configured at least partly receive knife 11840 wherein.Coupling part 11620 are configured to receive and support the anvil block frame of the nail bin groupware 11800 with layout of pins structure 11821 11820.Layout of pins structure 11821 allows that nail bin groupware 11800 faster and/or is more easily loaded into end execution In device assembly 11500.Locater pin feature structure 11821 corresponds in the coupling part 11620 of end effector frame 11600 Positioning pin recess portion.Nail bin groupware 11800 further includes guide pin 11823.Warehouse 11810 is configured to using knife and storehouse guide pin 11823 is mobile relative to end effector frame 11600, to be used to support and guide purpose.

Warehouse 11810 includes storehouse platform 11811, has and is configured to removedly store the multiple of nail 11880 Nail cavity 11818, knife 11840 are movably positioned in the cutter slit 11815 in it, and are configured to receive pin wherein 11823 and 11871 a pair of pin slit 11812.Storehouse platform 11811 further includes closure retainer 11813, the closure retainer quilt It is constructed to be permeable to the adjacent anvil portion 11830 when warehouse 11810 is promoted towards staple forming surface 11831.When closure stop When part abuts staple forming surface 11831, closure retainer 11813 is defined between platform 11811 and staple forming surface 11831 Achievable minimum range.That is, it is contemplated that for example, closure retainer 11813 can not when suturing thick tissue Contact staple forming surface 11831.

Closure frame 11700 includes storehouse driving lug 11701 and storehouse grasping recess portion or feature structure 11703, is constructed At can engage warehouse 11810 and allow closure frame 11700 by warehouse 11810 towards distal jaw 11630 push and make storehouse Body 11810 bounces back far from distal jaw 11630.Storehouse drives lug 11701 to engage the driving surface 11801 of staple cartridge body 11810, makes When proper closure frame 11700 is closed driver 11530 and is moved distally, closure frame 11700 can push warehouse 11810 to Or it is driven towards anvil portion 11830.Storehouse grasps feature structure 11703 and is used as hook or arm, and is configured to be closed 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 supported by staple drivers base portion 11850 11851.Driver 11851 is configured to support nail 11880 and nail 11880 is released its corresponding nail cavity 11818.Nail drives Dynamic device base portion 11850 and knife 11840 are driven by master driver 11860, the trigger shaft of the master driver and drive system 11510 11560 interactions.Knife 11840 is attached to master driver 11860 by knife supporting element 11843.Fire driving device 11540 with Master driver 11860 interacts, so that trigger shaft 11560 is pushed towards distal side and led when percussion driving device 11540 is activated Driver 11860 simultaneously finally projects nail 11880 from nail bin groupware 11800 and disposes knife 11840.Percussion driving device can be operated 11540 retraction trigger shafts 11560, the trigger shaft use the knife retraction arm engaged with trigger shaft 11560 and master driver 11860 11561, bounce back master driver 11860.Master driver 11860 includes slit 11863, is configured to receive knife retraction arm 11561, in addition to this there are also trigger shaft guide pin 11865, it is configured to be used as trigger shaft 11560 and master driver Alignment interface between 11860.

As described above, the drive system 11510 of end effector assembly 11500 and single rotation input component or primary input are driven Moving gear 11519 engages, with the multiple functions of implementation tool component 11100.Referring now to Figure 24, drive system 11510 includes It is closed driving 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 dress Switch between driveability while setting 11540.As described above, 11220 property of can choose of interface rotate with operating shaft 11321.Axis 11321 includes threaded portion or driving screw rod 11325, is threadedly engaged with changeover module 11550.Changeover module 11550 can be used the tool axis LT longitudinal movement along longitudinal direction of driving screw rod 11325 of time drive shaft 11321.When auxiliary connects When mouth 11220 rotates, changeover module 11550 is mobile relative to distal side yoke 11430.It is contemplated that motor and/or solenoid replace Axis 11321 is located 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 defeated Enter strip part 11538.Input driven gear 11539 is operationally intermeshed with primary input driving gear 11519.Closure is driven Dynamic device 11530 further includes output shaft, which has output strip part 11537 and threaded portion 11536.Closure driving The output shaft of device 11530 is aligned with the input drive shaft of closure driving device 11530.When primary input driving gear 11519 revolves When turning, only when strip part 11538,11537 is coupled by changeover module 11550, it is closed the output shaft of driving device 11530 It is consistently rotated with the input drive shaft of closure driving device 11530.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 11549 He of input driven gear Input strip part 11548.Input driven gear 11549 is also operable to drive gear 11519 to be intermeshed with primary input.It hits Sending out driving device 11540 further includes output shaft, which has output strip part 11547 and input strip part 11546. The output shaft for firing driving device 11540 further includes tubulose beating shaft 11545, and the input received in percussion axis hole 11545B is long Item part 11546.Tubulose beating shaft 11545 is rotatably engaged with the rib 11546S of input strip part 11546, so that tubulose Beating shaft 11545 can be vertically moved relative to input strip part 11546, while keep the rotation with input strip part 11546 Turn, can driving relationship.The output shaft for firing driving device 11540 is aligned with the input drive shaft of percussion driving device 11540.When When primary input drives gear 11519 to rotate, only when strip part 11548,11547 is coupled by changeover module 11550, percussion The output shaft of driving 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 is additionally included by 11560 spiral shell of trigger shaft The received threaded output shaft 11543 of line.When closure frame 11700 is promoted by closure driving device 11530 towards distal side, closure Frame 11700 pushes trigger shaft 11560 towards distal side.When trigger shaft is promoted by closure frame 11700 towards distal side, due to spiral shell Line output shaft 11543 and trigger shaft 11560 are at least threadedly engaged, and tubulose beating shaft 11545 is by trigger shaft 11560 relative to defeated Enter strip part 11546 to pull towards distal side.Tubulose beating shaft 11545 is by the percussion hole 11745 that is limited in closure frame 11700 It can receive to axle journal, to allow tubulose beating shaft 11545 to rotate in closure frame 11700.When strip part 11548,11547 When connection, the tubulose beating shaft 11545 of percussion driving device 11540 is rotated by input strip part 11546, and tubulose is hit The beating shaft earthing member 11544 of hair axis 11545 also pushes the percussion flange 11744 of closure frame 11700.Utilize flange 11744 As movable earthing mechanism, tubulose beating shaft 11545 drives trigger shaft 11560 towards distal side by threaded output shaft 11543, thus It disposes knife 11840 and projects nail 11880 from nail cavity 11818.

Changeover module 11550 allow user by couple and separate strip part group 11537,11538 and 11547, 11548 switch between driveability option discussed above.Changeover module 11550 includes threaded hole 11555, and screw thread connects The driving screw rod 11325 of time drive shaft 11321 is received, so that switching device assembly 11550 is opposite when driving screw rod 11325 to rotate Group 11537,11538 and 11547,11548 in strip part vertically moves.Changeover module 11550 further includes corresponding to closure The strip of driving device 11530 is closed shaft coupling or clutch ring 11553 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 Ground is supported in changeover module 11550 and allows to rotate in changeover module 11550.Strip shaft coupling 11553,11554 is each From having 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 onboard on tool assembly 11100 Instrument interface attached by 11100 wishes the function of executing according to them, makes tool assembly 11100 in clamped condition and nail Switch between shaped state.Controller will be communicated with motor to activate primary attachment interface 11210, auxiliary attachment interface simultaneously 11220 or both primary attachment interface 11210 and auxiliary attachment interface 11220.Referring now to Figure 25 to Figure 30, now will Ability function (including capture, clamping, suture and cutting tissue) about tool assembly 11100 discusses 11510 He of drive system Interaction and engagement between end effector assembly 11500.

Figure 25 shows the tool assembly 11100 in opening or initial configuration.Changeover module 11550 is in first It sets, wherein the strip shaft portion 11538,11537 of the closure connection closure driving device 11530 of shaft coupling 11553, so that closure is driven The output shaft of dynamic device 11530 can drive gear 11519 to be driven when rotating in primary input.Percussion shaft coupling 11554 is in The position only cooperated with the output shaft of percussion driving device 11540.In this case, percussion shaft coupling 11554 is not by structure Cause the position that can cooperate with strip shaft portion 11538,11537.In this position, percussion shaft coupling 11554 is not switching Rotation in component 11550 because the output shaft of percussion driving device 11540 when primary input driving gear 11519 rotates not by Driving.

The actuating for being closed driving device 11530 executes two kinds of functions；Pin joint (capture) in end effector assembly 11500 It organizes and the tissue is clipped in end effector assembly 11500.In order to capture tissue with tissue retaining pin 11871, switching Component 11550 activates primary attachment interface 11210 when being in first position.Primary input driving gear 11519 is driven, and by It is engaged in closure shaft coupling with the two strip parts 11538,11537 for being closed driving device 11530, is closed driving device 11530 output shaft promotes closure frame 11700 towards distal side by rotation.This initial distal movement of closure frame 11700 Tissue automatically, which is disposed, using lever 11770 keeps pin mechanism 11870.Connector part with connector recess portion 11876 11873 are configured to receive from the lever tip 11774 that a pair of lever arms 11772 extends, to couple tissue retaining pin machine Structure 11870 and lever 11770.Allow 11770 jointing nail of lever with the warehouse lid 11878 of lid window 11877 and lid base portion 11875 Storehouse component 11800 with pin mechanism 11870 to interact.Lid base portion 11875 limits earthing position, is used for pin joint connector part 11873, and thereby pin joint pin mechanism 11870.In order to dispose pin 11871, lever 11770 and end effector frame 11600 are closed It closes frame 11700 and tissue keeps pin mechanism 11870 to join.Lever 11770 includes being supported on end effector frame 11600 The frame slot 11741 of ground pin 11771 and closure frame 11700 in frame aperture 11671.Ground pin 11771 limits thick stick Bar rotation axis.Lever 11770 further includes lever arm 11772, which has actuating pointed tooth 11773, the actuating pointed tooth quilt It is configured to engage with the closure frame cam path 11743 of closure frame 11700.The lever further includes lever tip 11774, should Lever tip 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 convex Slot part 11743A is taken turns, is configured to drive actuating pointed tooth 11773 towards distal side, so that lever 11770 is rotated around lever Axis rotation, so that lift lever tip 11774 is stretched out from its corresponding cotter way 11812 with drive pin 11871 and towards remote Side jaw 11630.Closure frame cam path 11743 further includes final cam slot portion 11743B, to allow in more detail below The gap in closure frame 11700 during the clamping phase of discussion for activating pointed tooth 11773.Actuating pointed tooth 11773 is pressing from both sides Adjacent final cam slot portion 11743B during the tight stage, to prevent tissue retaining pin 11871 in clamping and/or percussion/suture It bounces back or opens during stage.Frame slot 11741 provides gap also during clamping phase for ground pin 11771.Closure is driven The initial activation stage of dynamic device 11530 completes initial acquisition, wherein tissue retaining pin 11871 is deployed to and nail bin group The distal jaw 11630 and/or anvil portion 11830 of part 11800 engage.The initial acquisition can be enough as shown in figure 26 Tissue is captured with tool assembly 11100.

During initial acquisition, closure frame 11700 is also by the part of nail bin groupware 11800 and trigger shaft 11560 It is promoted towards distal jaw 11630.Storehouse drives lug 11701 to drive storehouse main body 11810, and 11700 driving tube of closure frame Shape beating shaft 11545 and trigger shaft 11560.It can be in closure frame 11700, percussion driving device 11540 and nail bin groupware 11800 Between other and/or other contact point are provided, to help to promote certain parts of end effector assembly 11500.Institute as above It states, the input strip part 11546 of the output shaft of tubulose beating shaft 11545 and percussion driving device 11540 can be relative to that This longitudinal movement, while keeping rotatable driving relationship.This is conducive to the extension for firing the output shaft of driving device 11540, Allow when after closure frame 11700 is pushed into driving input strip part 11546 when drive tubulose beating shaft 11545。

Figure 27 shows the tool that complete clamping configuration is in after the final actuation phase of closure driving device 11530 Component 11100.Closure retainer 11813 is defined by anvil portion 11830, and organizes that pin mechanism 11870 is kept to be fully deployed. Pin mechanism 11870 is kept in order to be fully deployed tissue, closure frame cam path 11743 includes final cam path end 11743C, Final position is advanced to so that pointed tooth 11773 will be activated.This configuration of tool assembly 11100 considered to be in complete clamping position It sets.User can determine that activating closure driving device in opposite direction is closed driving device and therefore release and taking-up group to bounce back It knits or 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, user is actuatable to assist attachment interface 11220, from And drive screw 11325, so that changeover module 11550 is proximally moved to the second position.Changeover module 11550 is constructed At can when being moved to the second position it is nested against thrust bearing 11326.In the second position, changeover module 11550 is hit The strip shaft portion 11548,11547 of the connection percussion driving device 11540 of shaft coupling 11554 is sent out, so that percussion driving device 11540 output shaft can drive gear 11519 to be driven when rotating in primary input.Changeover module 11550 is moved to second Position also separates the strip shaft portion 11538,11537 for being closed driving device 11530.When primary input drives 11519 quilt of gear When driving, closure shaft coupling 11553 rotated in changeover module 11550, but due to closure shaft coupling 11553 only with input strip Part 11548 cooperates, and the output shaft of closure driving device 11530 will not rotate.

User can activate percussion driving device 11540 by driving primary attachment interface 11210 now to drive master Drive shaft 11311.The actuating of percussion driving device 11540 makes to export the rotation of strip part 11546, to make tubulose beating shaft 11545 rotations.Tubulose beating shaft 11545 rotates in the percussion hole 11745 of closure frame 11700.When tubulose beating shaft 11545 When rotation, the beating shaft earthing member 11544 of tubulose beating shaft 11545 released from the percussion flange 11744 of closure frame 11700 or Ground connection.The rotation of tubulose beating shaft 11545 rotates threaded output shaft 11543, to drive trigger shaft 11560 towards distal side.It hits Knife 11840 is disposed export main body 11810 and utilizes staple drivers 11851 and driver base portion by the distal movement for sending out 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 hit by activating primary attachment interface 11210 in opposite direction to bounce back Bar 11560 is sent out, to proximally pull drive rod 11560 and knife 11840.Trigger shaft 11560 includes hole 11565, and the hole is by structure It causes can support to axle journal trigger shaft guide pin 11865, during the movement of trigger shaft 11560 and master driver 11860 Keep the alignment of trigger shaft 11560 and master driver 11860.Trigger shaft 11560 further includes slit 11563, which is constructed At knife retraction arm 11561 can be received, so that trigger shaft 11560 can proximally be drawn when trigger shaft 11560 proximally moves Dynamic or retraction knife 11840.Another selection of user may include assisting attachment interface 11220 by changeover module by actuating 11550 are switched to the third place, and the third place is between the first position and the second position.The third place, as shown in figure 30, Two shaft couplings 11553,11554 are engaged with the respective sets 11538,11537 and 11548,11547 of its strip part. Then, user can activate primary attachment interface 11210 along inverse direction to activate primary input driving gear 11519 and simultaneously The output shaft of driving closure driving device 11530 and the output shaft of percussion driving device 11540.Using tool assembly 11100 Any moment of period, user may want to this while driveability and want in user from operative site extraction tool group Snapback method is provided in the case where part 11100.Controller on instrument interface can be programmed to by while activate two Attachment 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 in many aspects Component 11100.Referring primarily to Figure 30 A, tool assembly 11100' includes attachment part 11200, extends from attachment part 11200 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 pass through pin 11420 are rotatably attached.Actuated articulation joints 11400' includes similar construction, including nearside yoke 11410' and distal side yoke 11430'.In addition, also as described above, actuated articulation joints 11400 include bevel gear 11415,11416 and 11417, can operate Ground is intermeshed so that the rotation of drive shaft 11311 is transmitted to drive system 11510.Actuated articulation joints 11400' includes similar Bevel gear construction, be configured to the rotary motion of axis 11311 being transmitted to drive system 11510'.In addition, joint Kinematic joint 11400' includes the second group intermeshing bevel gear nested with bevel gear 11415,11416 and 11417 11495' and 11496' is configured to that end effector 11500' is made to carry out joint motions relative to axis 11300.Bore tooth Wheel 11495' is pivotably supported by nearside yoke 11410', and can be with joint motions input shaft 11391'(Figure 30 D) and cone Gear 11496' is operatively engaged.Bevel gear 11496 ' is fixedly secured to distal side yoke 11430'.One of bevel gear 11496' Divide and extends in the recess 11439' of distal side yoke 11430'.Input shaft 11391' makes end effector along the rotation of first direction 11500' is rotated in a first direction, and similarly, and input shaft 11391' is in a second direction or the rotation of opposite direction makes end Actuator 11500' is in a second direction or opposite direction rotates.Tool assembly 11100' can be caused by the electric motor of instrument interface Dynamic, component 11100' is attached to the electric motor so that input shaft 11391' rotates；However, tool assembly 11100' can be by appointing What suitable mode activates.

Similar to the drive system 11510 of end effector 11500, the drive system 11510' of end effector 11500' Including input gear 11519, can operatively be engaged with bevel gear 11417 and can be with closure driving device 11530' Driving gear 11539 and the driving gear 11549 for firing driving device 11540' are operatively intermeshed.It is also similarly to drive System 11510, drive system 11510' includes can be between first position (Figure 30 D and Figure 30 E) and the second position (Figure 30 F) Mobile switch block or component 11550' operates shaft assembly 11100 ' in closure or clamp operation mode and percussion respectively Switch between mode.Driving gear 11539 is installed to elongated shaft 11538', and when switch block 11550' is in its first When setting (Figure 30 D and Figure 30 E), elongated shaft 11538' is rotationally coupled to the elongated shaft of closure driving device 11530' 11537'.Elongated shaft 11537' includes the screw thread distal end 11536 being threadedly engaged with closure frame 11700', and works as strip When axis 11537' is rotated in a first direction by elongated shaft 11538', closure frame 11700' and such as Figure 30 E institute of warehouse 11810 ' Show towards distal side and shifts to be closed end effector 11500'.It is worth noting that, when switch block 11550' is in its first When setting, the rotation for firing the driving gear 11549 of driving device 11540' does not pass through switch block 11550' and is transmitted to percussion drive The distal part of dynamic device 11540'.Therefore, closure driving device 11530' is operated independently of percussion driving device 11540', and And in addition, 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' be in its When two positions (Figure 30 F), elongated shaft 11548' is rotationally coupled to percussion driving device 11540' by switch block 11550' Elongated shaft 11547'.Elongated shaft 11547' includes distal end 11546, which is keyed to percussion driving device The rotatable drive shaft 11545 of 11540', so that elongated shaft 11547' and drive shaft 11545 rotate together.Drive shaft 11545 is wrapped Screw thread distal end 11543 is included, which is threadedly engaged with percussion block 11560', wherein when elongated shaft 11547' is logical When crossing elongated shaft 11548' and being rotated in a first direction, percussion block 11560' is shifted towards distal side to fire the nail from nail bin 11800' And cut the tissue captured between staple cartridge body 11810' and anvil jaw 11630'.Similar to percussion driving dress as described above 11540 are set, percussion driving device 11540' includes staple drivers 11850', cutter block 11860' and knife 11840', is driven in percussion It is pushed by percussion block 11560' towards distal side during the firing schedule of dynamic device 11540'.It is worth noting that, working as switch block When 11550' is in its second position, the rotation for being closed the driving gear 11539 of driving device 11530' will not pass through switch Block 11550' 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 grasped When making to be closed end effector 11550', percussion driving device 11540' extends or stretches.Therefore, elongated shaft 11547''s is remote Side end 11546 keeps being rotatably engaged with drive shaft 11545.Referring primarily to Figure 30 C, closure frame 11700' includes by structure Cause can to abut the hook 11744' for the lining ring 11544 being limited in drive shaft 11545, and when closure frame 11700' is by court Drive shaft 11545 is pulled towards distal side when distal side driving is to be closed end effector 11550'.When closure driving device 11530' quilt When operation is to reopen 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 revolved along second or opposite direction Turn, proximally to pull percussion block 11560', cutter block 11860' and knife 11840'.It is worth noting that, staple drivers 11850' It does not bounce back together with percussion block 11560'；However, in other embodiments, staple drivers 11850' can be retracted.Once knife 11840' has fully been retracted to below the platform of warehouse 11810', then switch block 11550' switches back to its first It sets, driving device 11540' will be fired and operationally separated with drive shaft 11311, and will also be closed driving device 11530' Operationally couple again with drive shaft 11311.At this point, elongated shaft 11538' can be rotated along second or opposite direction, with court Nearside pulls warehouse 11810' and closed frame 11700' and reopens end effector 11500'.

End effector 11500' includes motor 11322', which is configured to make switch block 11550' at it It is moved between first position and the second position, as described above.Motor 11322' includes being located to be mounted in closure frame 11700' Motor support 11329' in shell.The shell of motor 11322 ' is fixedly mounted in motor support 11329', makes It is not mobile relative to motor support 11329' to obtain shell.Motor 11322' further includes rotatable output shaft 11325', with The threaded hole 11555 limited in switch block 11550' is threadedly engaged.When motor 11322' is operated along first direction, screw thread Switch block 11550' is moved in its first position by output shaft 11325'.When motor 11322' is operated in a second direction, Switch block 11550' is moved in its second position by threaded output shaft 11325'.

Referring primarily to Figure 30 G, battery and controller system 11324' are configured to communicate with motor 11322' and supply for it Electricity.For example, the user of the surgical instruments interface attached by the instrument 11100' and/or computer are wanted handoff block When 11550' switches, signal is wirelessly sent to battery and controller system 11324.In other cases, signal can pass through Conductor is transmitted to system 11324'.Then motor 11322' is transferred the signal to the to activate motor 11322'.At at least one Optionally in embodiment, 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' quilt It is configured to harvest kinetic energy during each stage of operation.Instrument 11100' includes energy harvesting system, the energy harvesting system The movement of drive system 11510' can be converted into electric energy and by the energy storage in the battery.Energy harvesting system includes line 11327' is enclosed, which accommodates distal side yoke 11430' and be located near the portions of proximal of closure driving device 11530'. Coil 11327' is electrically coupled to battery and controller system 11324' via conductor 11326'.Proximally from driving gear 11539 The axis of extension includes disk 11328' mounted thereto.When be closed driving device 11530' rotation when, disk 11328' close to Coil 11327' rotation, 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 this Between in position, strip shaft coupling 11554 is only engaged with elongated shaft 11547', and similarly, strip shaft coupling 11553 only with length Axis 11537' engagement.Therefore, when drive input unit 11519 rotate when, energy harvesting system be configured to generate energy with Battery is recharged, but does not execute any appliance function.It is worth noting that, when switch block 11550' is in its first position When with its second position, energy harvesting system also is used as generator.In clamping and/or percussion, in this case, no matter Which appliance function is activated, and disk 11328' passes through 11539 rotation of input.End effector 11500' clamping and/ It, can be by the energy supply of harvest to battery and/or motor 11322' or during percussion operation.

Surgical stapling attachment or tool assembly 12100 are shown in Figure 31 into Figure 50.Tool assembly or instrument 12100 are by structure It causes to capture, clamp and suture tissue during surgery.Referring primarily to Figure 31 to Figure 33, tool assembly 12100 is wrapped Include attachment part 12200, shaft assembly 12300, actuated articulation joints 12400 and end effector assembly 12500.Tool assembly 12100 are configured to be attached to instrument interface by attachment part 12200.Instrument interface may include surgical instruments shank, It is all as disclosed herein those.Other embodiments are contemplated, wherein tool assembly 12100 is not easy to be attached to instrument interface And dismantled from instrument interface, and it is on the contrary a part of integrated instrument.Attachment part 12200 is configured to from instrument Interface rotational control motion, tool assembly 12100 are attached to the instrument interface and rotational control motion are transmitted to axis Component 12300.These rotational control motions are transmitted to end effector by actuated articulation joints 12400 by shaft assembly 12300 Component 12500.

Attachment part 12200 includes transmission system 12210.As shown in figure 34, it is contained in attachment part shell 12201 Transmission system 12210 includes attachment interface 12220, which includes connector part 12223.Connector part 12223 It is configured to be operably linked to instrument interface.Transmission device further includes shell bearing 12221, is connected to coupling portion Divide 12223 input shaft 12211, and is attached to the input driven gear 12213 of input shaft 12211.Passing through instrument interface When actuation linkages device part 12223, input driven gear 12213 drives main drive shaft gear 12313 to be attached to main drive to drive The main drive shaft 12311 of moving axis gear 12313.

Referring primarily to Figure 35 to Figure 38, end effector assembly 12500 includes drive system 12510, end effector frame Frame 12600, the closure frame 12700 that can be moved relative to end effector frame 12600, and be configured to install Replaceable nail bin groupware 12800 into end effector frame 12600.Drive system 12510 includes single rotation input component, 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 Relative motion in actuator frame 12600.End effector frame 12600 includes proximal neck part 12610, the first side frame Frame 12620A and the second side frame 12620B.Proximal neck part 12610 is attached or coupled to actuated articulation joints 12400.It closes Saving kinematic joint 12400 includes flexible neck 12401, which is configured to allow making for tool assembly 12100 Relative to shaft housing 12301, passively joint connects end effector assembly 12500 to user.Scheme is implemented as follows in imagination, wherein Tool assembly 12100 does not include actuated articulation joints, and proximal neck part 12610 is directly attached to shaft assembly 12300 Shaft housing 12301.

It includes driving system that proximal neck part 12610 and the first side frame 12620A and the second side frame 12620B, which are accommodated, Certain components of the end effector assembly 12500 of system 12510.First side frame 12620A and the second side frame 12620B are respectively Respectively include 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 when activating main drive 12510 towards anvil block 12640 towards distal side and follow closely Storehouse component 12800.Closure frame 12700 includes warehouse driving surface 12708, to contact and drive the nail of nail bin groupware 12800 Warehouse 12810.Staple cartridge body 12810 includes platform 12811, multiple nail cavities 12813 and multiple closure retainers 12815.Nail bin group Part 12800 further includes the multiple nails 12830 being removedly stored in nail cavity 12813.It is multiple nail 12830 be configured to It is shaped by staple forming surface 12641.When the adjacent staple forming surface 12641 of closure retainer 12815 and/or it is placed in restriction When in the recess portion in anvil block 12640, it is assumed that tool assembly 12100 has reached complete clamping configuration.Also contemplate such reality Scheme is applied, wherein closure retainer 12815 never reaches anvil block 12640 or staple forming surface 12641, but in nail bin group Part 12800 is located near staple forming surface 12641 when reaching its fully clamped position.Use the driving 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 Out.End effector assembly 12500 is configured to use tool group using the rotary motion provided by main drive shaft 12311 The capture of part 12100 clamps and sutures tissue.In order to capture tissue using tool assembly 12100, closure frame 12700 is pushed into Or actuating, actuating mechanism 12560 is sold with actuating.The tissue for selling the actuating deployment nail bin groupware 12800 of actuating mechanism 12560 is kept Pin 12860.Pin actuating mechanism 12560 includes pin lever 12561 and connects from what end effector frame 12600 fixedly extended Ground pin 12565.Ground pin 12565 defines that holding pin axis, pin lever 12561 are rotated around the axis.Closure frame 12700 Including a pair of of the ground connection cotter way 12706 limited on its opposite side, gap is provided for ground pin 12565, so that closure frame 12700 can be mobile relative to ground pin 12565.Selling lever 12561 includes a pair of lever arms 12562, this includes one to lever arm To actuator tab or pointed tooth 12563, it is received in a pair of cams slot 12702 being limited in closure frame 12700.It is convex Race 12702 is configured to be vertically moved in end effector frame 12600 with closure frame 12700 so as to sell cause Motivation structure 12560 is around keeping pin axis rotation and towards distal side and laterally displacement actuator tab 12563.Sell lever 12561 also Including from the lever tip 12564 that lever arm 12562 extends.Lever tip 12564 extends to the connection of tissue retaining pin 12860 In device part 12861, actuating mechanism 12560 will be sold and be connected to pin 12860.Organizing retaining pin 12860 further includes pin shaft or bar 12863 and manual override knob 12865.When pin actuating mechanism 12560 is activated by closure frame 12700, lever tip 12564 Pin shaft 12863 is promoted towards anvil block 12640.

The manual override knob 12865 of pin 12860 is configured to allow the user of tool assembly 12100 for example Drive system 12510 manually retracts to pin shaft 12863 in nail bin groupware 12800 in the case where blocking or losing electric power.It causes Dynamic protruding portion 12563 may include the material and/or geometry more fragile than lever arm 12562, so as to for user provide 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. It is rotated freely due to this, connector part 12861 is allowed proximally to move relative to staple cartridge body 12810 without very big resistance Power (if any), to allow pin shaft 12863 by manual retrieving.Additionally or alternatively, actuator tab 12563 may include substantially thin configuration or profile, and lever arm 12562 is allowed proximally to pull manual override knob It inwardly collapses or is bent when 12865, so that actuator tab 12563 inwardly be pushed and released from cam path 12702, to mention It is rotated freely for above-mentioned.

When the storehouse of unexhausted or non-percussion is mounted in end effector assembly 12500, main drive may be actuated 12520.As discussed in more detail below, end effector assembly 12500 includes one or more latching members, when will be unexhausted When nail bin is inserted into end effector assembly 12500, one or more of latching members are released from.Under any circumstance, main driving Device 12520 is responsible for closure frame 12700 and nail bin groupware 12800 towards the movement of anvil block 12640, to utilize end effector The capture of component 12500 is fired with grip tissue and by tool assembly 12100 to suture tissue.Main drive 12520 includes With the driveably intermeshing input driven gear 12521 of primary input gear 12310.Input driven gear 12521 is installed to Main drive shaft 12523, the main drive shaft include driving screw portion 12525.Main drive 12520 further includes being adapted to The thrust bearing configuration 12524 of enough support shafts 12523.Driving screw portion 12525 can be threadedly received closure nut pipe or It is closed in the threaded hole 12531 of driving device 12530.Closure nut pipe 12530 is movably supported at internal framework In 12650 frame aperture 12653, and including receiving in multiple longitudinal extension slit 12653S in frame aperture 12653 In multiple tabs 12533, prevent closure nut pipe 12530 from rotating together with screw portion 12525 is driven.Although shown implementation Scheme includes four tabs 12533, but only one tab 12533 and corresponding slit 12653S may be sufficient.Work as drive When dynamic screw portion 12525 is rotated in a first direction, closure nut pipe 12530 is longitudinally moved or is slided in frame aperture 12653 It is dynamic, but do not rotated in frame aperture 12653.Due to the distal movement, the flange 12537 for being closed nut pipe 12530 pushes closure Frame 12700 is moved distally closure frame 12700.When driving screw portion 12525 to rotate in a second direction, driving Screw portion 12525 proximally pulls closure nut pipe 12530.

When closed tube 12530 reaches the farthest position associated with the fully clamped position of nail bin 12800, tab 12533 enter the distal annual recess portion 12653AD being limited in closed tube 12530.Annular recess 12653AD is tab 12533 Gap is provided.When tab 12533 is aligned with annular recess 12653AD, tab 12533 is no longer prevented from closure nut pipe 12530 Rotation.Therefore, when being closed the arrival the farthest position of nut pipe 12530, the rotation of driving screw portion 12525 causes to close It closes nut pipe 12530 and driving screw portion 12525 rotates simultaneously.

In this stage, the further actuating of drive system 12510 in same direction leads to the percussion of tool assembly 12100. In all cases, drive system 12510 can be continuously carried out in unbroken situation from this mistake for being clamped to percussion It crosses.In various other situations, tool assembly 12100 is configured to reach its farthest side in closure nut pipe 12530 The actuating of interrupt-driven system 12510 when position.In any case, tool assembly 12100 is configured in driving system System 12510 is fired after storehouse component 12800 is moved in fully clamped position.Being closed nut pipe 12530 further includes hitting Screw portion or percussion driving device 12535 are sent out, is threadably received by the percussion nut portion 12555 of drive rod 12550.Due to Closure nut pipe 12530 is freely rotatable now, so percussion screw portion 12535 will revolve now with driving screw rod 12525 Then it rotates and drives drive rod 12550 towards distal side.Drive rod 12550 pushes nail bin driver 12820 towards distal side, thus from Nail bin groupware 12800 projects nail 12830.The multiple staple drivers 12823 of staple drivers 12820 support multiple nails 12830, each Staple drivers have supporting support 12824.Staple drivers 12820 move in staple cartridge body 12810 towards anvil block 12640 towards distal side It is dynamic, 12830 will be followed closely and projected from nail cavity 12813 towards staple forming surface 12641.It, can although illustrating only two staples Using any appropriate number of staple.Drive rod 12550 uses guide pin 12553 and corresponding guide pin slot by closure frame 12700 12703 guidance.

As described above, main drive 12520 is activated to capture simultaneously gripping end by promoting closure frame 12700 Tissue in actuator assembly 12500, then by promoting drive rod 12550 to suture tissue towards distal side.However, institute as above It states, when unexhausted nail bin groupware is mounted in end effector assembly 12500, main drive could be activated 12520.Blocking drive 12540 is provided to provide such locked configuration.As discussed in more detail below, locking is driven Dynamic device 12540 utilizes input identical with main drive 12520, and if blocking drive 12540 is in locking Configuration then prevents main drive 12520 from being driven.If blocking drive 12540 is in unlocked configuration, allow to drive Main drive 12520.

Referring to Figure 38 and Figure 41, blocking drive 12540 includes operationally intermeshing outer with primary input gear Portion drives gear 12541, or 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 it is spring-loaded Interfere gear 12545, and is configured to the distal side sticking department engaged by the key-lock part 12817 of nail bin groupware 12800 Divide 12547.Closure frame 12700 includes window 12707 (Figure 35), to allow closure frame 12700 and distal side lock part Relative motion between 12547.External drive gear 12541 includes internal strip or dentate part 12541S, is configured to The internal drive gear 12543 for being attached to axis 12542 can be slidingly supported and engaged.The configuration allows axis 12542 Relative longitudinal motion between external drive gear 12541, while keeping internal drive gear 12543 and external drive gear Driving relationship between 12541.For example, with axis 12542 there is the interference gear 12545 of press fit relation to pass through spring 12544 against end effector frame 12600 12650 spring loads of internal framework.Spring 12544 can be by for example compressing Spring is constituted.Axis 12542 is always pushed by spring 12544 towards distal side, and interference gear 12545 is pushed in closure frame 12700 Latch-up window 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 Moving gear 12541 prevents drive system 12510 to be activated by driving.In locked configuration, drive system 12510 be can be at for example Bonding state.The controller of instrument shank and/or onboard controller can sense marriage relation for example, by measurement energy spikes, Then it when reaching energy threshold, obtains and is 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 group In part 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 axis 12542 In axis hole 12549P, so that axis 12542 and pin 12547P are since interference fit is (for example, when blocking drive 12540 is driven When) rotate together.Therefore, pin 12547P can rotate in distal side lock part 12547.Therefore, in addition to being switched to locking structure Towards except the spring-loaded interference gear 12545 of distal side push shaft 12542 when type, distal side lock part 12547 will be pushed away towards distal side The plunger of dynamic pin 12547P, causes distal side lock part 12547 also to pull axis 12542 (referring to fig. 4 1) towards distal side.Distal side locking Part 12547 is sandwiched in or is nested between lever arm 12562.Drive rod 12550 includes for distal side lock part 12547 Clearance slot 12557.

Another blocking device is provided to prevent when the nail bin groupware used up is mounted in end effector assembly 12500 Drive 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, description instrument component 12100 will be carried out about surgical stapling regulation or operation now Operation.Tool assembly 12100 do not capture in Figure 39 into Figure 41, do not clamp, non-percussion, unlock configuration show.Due to not The nail bin groupware 12800 used up is mounted in end effector assembly 12500, so tool assembly 12100 is unlocked.Interfere tooth Wheel 12545 is 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. The automatic deployment pin actuating mechanism 12560 and being jacked up actuator tab 12563 with cam path 12702 of closure frame 12700 With pin 12860.The contact of pin 12860 limits the anvil block 12640 of complete tissue acquisition phase.Closure frame 12700 also makes nail bin Component 12800 is promoted towards anvil block towards distal side.At this point, tool assembly 12100 can continuously activate main drive 12520 with after Continue complete grip tissue.However, if a user desire that taking out the tissue (tissue is not shown) currently captured, then user can edge Opposite direction actuator drive system 12510 is to be driven reverse system 12510, so that pin actuating mechanism 12560 be made to keep around pin Axis is rotated with the pin shaft 12863 that bounces back.For example, instrument can be equipped with sensor to detect when pin shaft 12863 reaches complete deployment Position.The complete deployment of test pin can lead to the pause in actuating, the group captured at this stage to allow user to determine Whether knit is tissue that is to be clamped and being finally sewn.Once user determines that captured tissue is to be clamped and is finally stitched The tissue of conjunction, 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 (staple cartridge body 12810 Key-lock part 12817) its initial position is bounce back into when losing contact.In other words, spring 12544 is in in-between or uncompressed State.Due to 1) latch-up window 12655 of internal framework 12650 and 2) distal movement of closure frame 12700, do Gear 12545 is related to still in freely rotatable position.Internal drive gear 12543 longitudinally moves in interior minister's item part 12541S Dynamic but holding and its meshing relation, to allow the rotation when drive system 12510 is activated of blocking drive 12540. The tab 12533 of closure nut pipe 12530 is located in slit 12653S, so that closure nut pipe 12530 is in driving threaded shank It is translated in frame aperture 12653 when dividing 12525 rotation.

Turning now to Figure 44, tool assembly 12100 is shown with complete clamping configuration.It is closed the tab of nut pipe 12530 12533 arrived its farthest position, allow to be closed nut pipe 12530 now and rotate.Tool assembly 12100 can be further by structure Cause can temporarily to suspend when reaching fully clamped position the actuating of main drive 12510, so that tool assembly 12100 User can check whether capture and now clamped tissue is target tissue to be stapled.In tool assembly 12100 User wants in the case where unclamping tissue, can be driven reverse system 12510 will be closed the tab 12533 of nut pipe 12530 It is put back into the slot 12653S in hole 12653, so that driving screw portion 12525 can pull closure nut pipe 12530, and therefore will Closure frame 12700 proximally pulls.If user determines that capture and now clamped tissue is target to be stapled Tissue, then 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 rotated with Drive rod 12550 is promoted towards anvil block 12640, to push staple drivers 12820 towards distal side in staple cartridge body 12810.Nail This distal side of driver 12820, which promotes, to cause to follow closely 12830 deployment from nail cavity 12813.Guide pin 12553 is by partly from closing It closes and is released in its corresponding guide pin slot 12703 in frame 12700.In percussion tool assembly 12100 completely, tool assembly 12100 can be driven reverse system 12510 automatically with the nail bin groupware 12800 that bounces back, and unclamp and take out the tissue being just sewn.Example Such as, this automatic retracted may be due to following closely the 12830 any suitable sensor configurations fired completely for identification.? In a kind of situation, the fully actuated of drive rod 12550 can detect.In another case, percussion screw portion 12535 can be by structure Cause the rotation that can rotate setting quantity staple drivers are promoted set distance；When completing the rotation of setting quantity, work Instrument interface attached by tool component 12100 and/or tool assembly 12100 can initialize automatic retracted.For example, when using When different nail bin groupwares and drive rod 12550 needs the distance advanced to change to adapt to different staple heights, this can be to have Benefit.

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. Before unloading nail bin groupware 12800, the snap features 12663 of locking component 12660 are inwardly pushed away by spring member 12661 Pressure is to block drive rod 12550.In this position, drive system 12510 is in bonding state, because drive rod 12550 cannot It is pushed into.When the nail bin groupware 12800 used up is removed from tool assembly 12100, locking component 12660 is kept in the position. Blocking drive 12540 starts its lock function when removing nail bin groupware 12800.Not due to distal side lock part 12547 It is proximally pushed by warehouse key-lock component, so spring 12544 actuates interference gear 12545, and interfere axis 12542 will In the locking groove 12704S that gear 12545 is placed in latch-up window 12704 towards distal side.It is being not installed on end effector assembly In the case where nail bin groupware in 12500, latch members 12660 and blocking drive 12540 provide two anti-actuation means Or mechanism, to prevent drive system 12510 to be activated.

Referring now to Figure 48, unexhausted nail bin groupware 12800 is shown as being not installed at end effector assembly 12500 It is interior.The base portion 12821 of staple drivers 12820 is configured to by contact snap features 12663 and by snap features Structure 12663 pushes away drive rod 12550 to unlock locking component 12660.As described above, key-lock part 12817 is adapted to The inclined-plane 12548 for enough engaging distal side lock part 12547 will interfere gear 12545 to release locking groove 12704S and enter certainly By rotation position.

Nail bin groupware 12800 further includes state indicator system, visually to refer to the user of tool assembly 12100 Show the state of nail 12830.Referring now to Figure 49 and Figure 50, nail bin groupware 12800 to clamp completely, the configuration of part percussion shows Out, wherein the staple drivers 12823 of staple drivers 12820 partly extend above the platform 12811 of warehouse 12810.Storehouse window Mouth 12853 is arranged in staple cartridge body 12810, for showing the movement of staple drivers 12823.On staple drivers 12823 itself The movement of visual indicia 12823A, 12823B instruction staple drivers.For example, visual indicia 12823A, 12823B may include for example Intensity or the solid color of shade variation, to show progress of the nail bin driver 12823 in warehouse 12810.Bigger intensity It can indicate that staple drivers 12823 are close or arrived complete firing position.In other cases, staple drivers 12823 may include Two kinds of colors；For example, the first color 12823A (such as blue) indicates that staple drivers 12823 are in intermediate progress, and second 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 by structure It causes to clamp, suture and cut tissue during surgery.Referring primarily to Figure 51 to Figure 55, tool assembly 13100 is wrapped Include attachment part 13200, shaft assembly 13300, actuated articulation joints 13400 and end effector assembly 13500.Attachment part 13200 are configured to be attached to the interface of surgical instruments.Instrument interface may include shank, all handles as disclosed herein Portion.Other embodiments are contemplated, wherein tool assembly 13100 is not easy to be attached to instrument interface and tear open from instrument interface It unloads, and is on the contrary a part of integrated instrument.Attachment part 13200 is configured to receive rotation control from instrument interface Movement, tool assembly 13100 are attached to the instrument interface and rotational control motion are transmitted to shaft assembly 13300.It is as follows Discussed in detail, these rotational control motions are transmitted to end by actuated articulation joints 13400 and executed by shaft assembly 13300 Device assembly 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) are configured to receive the rotary motion from instrument, input shaft 13212 and shell bearing 13211. Bearing 13211 is 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 Kinematic axis 13320 can be pushed towards distal side so that end effector 13500 is along first direction joint motions.Similarly, such as Figure 67 Shown, articulating shaft 13320 can proximally be pulled so that end effector 13500 is closed along second or opposite direction Section movement.As shown in Figure 65 to Figure 67, articulating shaft 13320 is not attached directly to end effector 13500；On the contrary, joint Kinematic axis 13320 is attached to end effector 13500 via joint movement connector 13324.In end effector 13500 Between or non-joint motions configuration in, as shown in figure 55, joint movement connector 13324 is from the area of joint motions axis A-A nearside Domain extends to the region in the distal side joint motions axis A-A.Moreover, in the neutral configuration of end effector 13500, joint motions Connector 13324 is merely positioned the side of the longitudinal axis L A limited by tool assembly 13100 and/or shaft housing 13301.Joint Motion couplings 13324 include curved configuration, which is configured in articulating shaft or driving device 13320 By joint motions transmission device proximally and/or when being translated to the far side, end effector assembly 13500 is promoted to transport around joint Shaft 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. Actuated articulation joints 13400 are held including being securely attached to the nearside yoke 13401 of shaft housing 13301, being securely attached to end The lower distal yoke arm 13402 of row device ridge 13501, and also it is securely attached to the top distal side of end effector ridge 13501 Yoke arm 13403.Yoke arm 13402,13403 is configured to rotate relative to yoke 13401 around joint motions axis A-A.To the greatest extent Pipe is not shown, but pin or bar can be positioned along joint motions axis A-A, so that nearside yoke 13401 and yoke arm 13402,13403 It encloses and pivots about.Joint movement connector 13324 is connected to top distal side yoke arm 13403 by pin 13404, so that when joint is transported When moving axis 13320 is vertically moved relative to shaft housing 13301, 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 is including 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 be pivotably supported input shaft 13222.Input shaft 13222 includes can axle journal Closed drive gear 13223 that ground is supported on, the percussion that can be supported on to axle journal driving gear 13224, Yi Jishe Set the strip shaft portion 13225 between closed drive gear 13223 and percussion driving gear 13224.Closed drive gear 13223 output closed drive gears 13333 corresponding with shaft assembly 13300 engage, and fire driving gear 13224 and shaft assembly 13300 corresponding output percussion driving gear 13344 engages.

The switch mechanism 13230 of end effector transmission device can be in the driveability of closed drive gear 13223 Switch between the driveability of percussion driving gear 13224.Unless being engaged by switch mechanism 13230, otherwise closure driving Gear 13223 and percussion driving gear 13224 do not rotate.Closed drive gear 13223 includes one group of tooth or protruding portion 13226, It is arranged on the side towards percussion driving gear 13224 of closed drive gear 13223.Percussion driving gear 13224 wraps One group of tooth or protruding portion 13227 are included, the side towards closed drive gear 13223 of percussion driving gear 13224 is set On.Switch main body or disk 13235 include the tooth being arranged on the first side towards closed drive gear 13223 of disk 13235 Or protruding portion 13236, and the tooth or protruding portion that are arranged in second side towards percussion driving gear 13224 of disk 13235 13237.Switch plate 13235 is engaged with strip shaft portion 13225 and can be slided relative to the strip shaft portion.Switch plate 13235 It is kept by switch arm 13233, which can be activated by switching solenoid 13231, so that switch arm 13233 is first It is moved between position and the second position, in first position, disk 13235 is engaged with closed drive gear 13223, second In position, disk 13235 is engaged with percussion driving gear 13224.When disk 13235 is engaged with closed drive gear 13223, The rotation of driving connector 13220 causes closed drive gear 13223 and is closed the rotation of axis 13330 in turn.Similarly, when Disk 13235 with percussion driving gear 13224 engage when, driving connector 13220 rotation cause percussion drive gear 13224 with And the rotation of beating shaft 13340 in turn.Activation switching solenoid 13231 can be realized by onboard controller 13203, this is onboard Controller is configured to receive signal from instrument interface and these signals is transferred to switching solenoid 13231.

Turning now to Figure 57, as described above, actuated articulation joints 13400 are configured to receive from shaft assembly 13300 Rotational control motion, 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 end effector assembly 13500 When joint motions, output bevel gear wheel 13433,13443 is configured to make two idle pulley bevel gears 13432,13442 to returning Rotation.Being rotated back for idle pulley bevel gear 13432,13442 will cause to input being rotated back for bevel gear 13431,13441, and Therefore cause the rotation for being closed axis 13330 and beating shaft 13340.In order to avoid in 13500 joint motions of end effector assembly When be incorporated in end effector transmission device, the onboard controller 13203 of attachment part 13200 can be to switching solenoid 13231 transmission signals are being placed in switch plate 13235 when user's actuated articulation moves driving connector 13210, switch plate 13235 middle positions not engaged with the driving gear 13223,13224 that can support to axle journal.As a result, driving gear 13223, 13224 will rotate freely relative to input shaft, therefore the rotation of bevel gear assembly is propagated 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 work Have 13100 grip tissue of component, driving device 13530 is closed by actuating, two jaws 13510,13520 are moved from open position Move closed position.The rotation of closure driving device 13530 makes to be closed the rotation of screw portion 13531.It is closed screw portion 13531 Rotation cause be closed nut 13536 and therefore cause closure frame 13535 relative to end effector frame 13501 translate. When being fully retracted closure frame 13535, closure nut 13536 is configured to receive between yoke arm 13402,13403 In the recess portion of restriction.

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 that is grounded by pin 13502 and can be rotated around the pin 13520 rotate to closed position, cause a pair of of closing cam surface 13537C of closure frame slit 13537 by jaw 13520 Pin 13527 towards jaw 13510 jack up.It is grounded by pin 13515 and the pin axis rotation limited by pin 13515 can be surrounded Jaw 13510 is moved to rotation position and promoting closure frame 13535 towards distal side, causes the closure of closure frame 13535 Cam face 13532 jacks up the bottom surface 13512 of jaw 13510 towards jaw 13520.Similarly, by proximally moving Closure frame 13535 makes jaw 13520 be moved to open position, causes a pair of openings CAM table of closure frame slit 13537 Face 13537O (see Figure 68) jacks up the pin 13527 of jaw 13520 upwards.When pin 13527 by relative to frame 13501 upwards and When jacking up downwards, 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 encloses such as in Figure 69 The axis rotated about is not identical.It is offset from one another perpendicularly to the axis and horizontally.It is opposite that jaw 13510 encloses the axis rotated about It is distally located that the axis that rotates about is enclosed in jaw 13520.Vertical range between axis can limit storehouse 13570 and anvil block Predetermined tissue space distance and/or clamping distance between 13521.

When tool assembly 13100 is in non-clamping configuration (Figure 66), apart from the above, closure nut 13536 is in it Nearest side position, the position are the recess portions being limited between yoke arm 13402,13403.In non-clamping configuration, jaw 13520 Top surface 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 The anvil block configuration of replacement.

End effector frame 13501 support trigger system 13550, the trigger system be configured to suture and/or The tissue that cutting is clamped with tool assembly 13100.The trigger system 13550 discussed in greater detail below is configured to by firing The percussion driving gear 13541 of axis 13540 activates.Jaw or storehouse support channel 13510 include a pair of pivot pin 13515, this is right Pivot pin extends outwardly relative to jaw 13510, and is configured to receive in a pair of corresponding frame aperture 13505, It is held by the pivot axis that pin 13515 limits relative to end to allow jaw 13510 and therefore nail bin 13570 be allowed to surround Row device frame 13501 pivots.

Trigger system 13550 includes the driving gear 13551 engaged with percussion driving gear 13541.Drive gear 13551 On proximally positioned beating shaft 13552, which can by the frame support 13504 of end effector frame 13501 It pivotally supports.Trigger system 13550 further includes percussion screw shaft 13555, which includes being supported on jaw 13510 Thrust bearing supporting element 13514 in nearside thrust bearing 13554 and be supported on top and bottom bush assembly 13573 in Distal side thrust bearing 13556.Bush assembly 13573 is located in distal side storehouse chamber 13572.Trigger system 13550 further includes that U-shaped connects First 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 extending through Threaded hole, the threaded hole are threadedly engaged with percussion screw shaft 13555.Sliding part 13560 is by limitation and percussion screw shaft 13,555 1 It plays rotation or at least substantially rotates, and therefore, when firing screw shaft 13555 around the rotation of its longitudinal axis, fire spiral shell Bar axis 13555 makes 13560 vertical shift of sliding part.In use, sliding when percussion screw shaft 13555 is rotated in a first direction Moving part 13560 is shifted 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 hits It sends out and is shifted between position (Figure 60) towards distal side, to project nail 13575 from nail bin 13570 and suture capture in anvil portion 13521 Tissue between nail bin 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 particularly, sliding part 13560 include knife or cutting element 13561, be maintained at during following closely firing schedule do not dispose or Reduced position.After completing to follow closely firing schedule, referring now to Figure 61, sliding part 13560 proximally bounces back.Sliding part 13560 proximally bounce back, until cutting element 13561 contacts the pin or cam 13516 that extend from the frame of nail bin 13570.It cuts It cuts component 13561 and is rotatably mounted to sliding part 13560, and when 13561 contact plug 13516 of cutting element, cut structure Part 13561 is rotated upwardly in deployed position.At this point, sliding part 13560 can be promoted towards distal side in the cutting stroke phase again Between cut the tissue of suture, 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 axis Supporting element 13514 is held to extend and be aligned with longitudinal slit 13571.When sliding part 13560 is in its non-firing position (Figure 59), Cutting element 13561 is not contacted with pin 13516；However, when sliding part 13560 proximally bounces back relative to its non-firing position When, as shown in Figure 61,13561 contact plug 13516 of cutting element simultaneously rotates in its deployed position.More particularly, structure is cut 13566 engaging pin 13516 of cam arm of part 13561 is simultaneously rotated upwardly to its cutting position from its non-cutting position.

As described above, Figure 59 shows the tool assembly 13100 in non-percussion or initial configuration.In tool assembly In 13100 this non-percussion configuration, also as described above, sliding part 13560 is in its non-firing position and cutting element 13561 are in its non-cutting position.Whether tool assembly 13100 can be configured to detection sliding part 13560 in its non-percussion Whether position and/or cutting element 13561 are in its non-cutting position.In at least one situation, nail bin 13570 can be wrapped First sensor is included, which is configured to be able to detect cunning if sliding part 13560 is in its non-firing position The presence of moving part 13560.Similarly, nail bin 13570 may include second sensor, if the second sensor is configured to cutting Component 13561 is in the presence that its cutting position is then able to detect cutting element 13561.First sensor and second sensor can Including such as proximity sensor, and can be communicated with the controller signals of tool assembly 13100.

When sliding part 13560 reaches its farthest position of its firing schedule, as shown in figure 60, all nails 13575 will It is disposed from nail bin 13570.In all cases, sensor is arranged at the distal end of end effector assembly, the sensing Device is configured to detect whether sliding part 13560 arrived its farthest position.Sensor may include for example, and tool assembly 13100 controller carries out the proximity sensor of signal communication.Once all nails 13575 are fired, instrument controller can The signal that firing schedule is completed is sent to user.At this point, user can operational instrument component 13100 with the sliding part that bounces back 13560, so as to the cut portion preparation tool component 13100 for the regulation.Alternatively, tool assembly 13100 can be configured to Can firing schedule completion after automatic retracted sliding part 13560.

As described above, Figure 61 shows the tool assembly 13100 in such configuration, wherein all nails are fired And firing member has been retracted into recent side or mode switch positions.Also as described above, which allows pin Cutting element 13561 is simultaneously rotated to its cutting position by the cam arm 13566 of 13516 engagement cutting elements 13561.In various feelings Under condition, can prevent sliding part 13560 reach the mode switch positions, until instrument controller have received nail firing schedule it is complete At signal.In the example as at least one, does not terminate sensor from firing schedule in instrument controller and receive really In the case where recognizing the completed signal of firing schedule, once sliding part 13560 arrived its non-firing position, then instrument controller The power supply of the motor to percussion driving device can be interrupted.The nail completed signal of firing schedule is received in instrument controller In the case where, instrument controller allows sliding part 13560 proximally to bounce back and crosses its non-firing position into its pattern switching Position.

Once sliding part 13560 is moved into mode switch positions, instrument controller just allows sliding part 13560 It is promoted again towards distal side.In all cases, instrument may include tissue cutting switch, which, which works as, is pressed When, percussion driving device 13540 can be activated, again to drive sliding part 13560 to pass through nail bin by second or cutting stroke 13570.When cutting element 13561 has been increased in its cutting position now, cutting element 13561 will cut the group of suture It knits.

Apart from the above, tool assembly 13100 be configured to sliding part 13560 complete its tissue cutting stroke it Cutting element 13561 is reduced to its non-cutting position afterwards.More particularly, referring primarily to Figure 63, cutting element 13561 it is convex Wheel part 13566 is configured to contact distal pin or cam 13574 at the end of tissue cuts stroke, wherein this phase Interaction makes cutting element 13561 be rotated downwardly to its non-cutting position.Therefore, sliding part 13560 can be in no cutting element 13561 be exposed to tissue in the case where bounce back.Moreover, therefore, jaw 13510,13520 can be from tissue pine after cutting stroke It opens, 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 interactions, 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 all nails 13575 are fired or are fully formed.Similarly, as described above, since cutting element 13561 can be non- It is pivoted between cutting position and cutting position, therefore the bifurcated of this function is possible.

Figure 70 is according to the saturating of the nail bin 4410 being used together with circular surgical staplers tool of at least one embodiment View.A variety of circular surgical staplers tools are known.For example, on August 26th, the 2015 entitled " SURGICAL submitted The U.S. of STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS " is special Sharp patent application serial numbers 14/836,110 disclose various circular surgical staplers tool constructions, and the patent application is accordingly in full to quote Mode is incorporated to.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 block Bar or trochar part are attached to anvil head and are configured to be removably coupled to the anvil block of circular stapler instrument Attachment part.Various circular surgical staplers tools include for selectively toward and away from the dress of the mobile anvil block of surgery nail bin It sets, so that destination organization can be sandwiched between anvil block and the platform of surgery nail bin.Surgery nail bin by multiple surgical staples removedly It is stored therein in, the multiple surgical staples are arranged with one or more annular arrays, and one or more of annular arrays are corresponding In the layout for the nail shapes pit being arranged in anvil block.Nail is removedly stored in corresponding nail cavity, and the nail cavity is in nail bin Middle to shape and be supported on the corresponding part of alternative mobile promotion device assembly, which is operationally connect It is received in circular stapler.Circular stapler further includes endless knife or cutting element, is configured to incision and is sandwiched in anvil Tissue between seat and nail bin.

Referring again to Figure 70, nail bin 4410 includes warehouse 4411, which limits annular bin platform surface 4412.Warehouse 4411 include inner annular row 4420 and the outer annular of external nail cavity 4442 spaced apart of inside nail cavity 4422 spaced apart Row 4440.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.Each interior 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 support of portion's nail cavity.It is external Outside nail 4450 in ring row 4440, which can have, follows closely 4430 different features from the inside in inner annular row 4420.For example, As shown in the embodiment of Figure 71, outside nail 4450 has unfashioned " gull wing type " configuration.In particular, each outside nail 4450 include a pair of of the leg 4454,4464 extended from crown 4452.Each leg 4454,4464 includes extending respectively from bizet 4452 Vertical portion 4456,4466.In one embodiment, vertical portion 4456,4466 can be parallel to each other.However, institute In the layout shown, vertical portion 4456,4466 is not parallel each other.For example, in the layout shown in, bizet 4452 and vertical portion 4456, the angle A between 4466₁Greater than 90 degree.Referring to Figure 71.Other details about nail configuration is found in June 30 in 2014 The United States Patent (USP) of entitled " FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS " that day submits Patent application serial numbers 14/319,008 are now U.S. Patent Application Publication 2015/0297232, and the entire disclosure is accordingly to draw It is incorporated herein with mode.However, other vertical portions 4456,4466 can arrange at other angles relative to bizet 4452.Make Vertical leg 4456,4466 is that this layout can help with the advantage that the angle greater than 90 degree is orientated relative to bizet 4452 It is temporarily retained in its corresponding nail cavity in that will follow closely.

At least one leg 4454,4464 includes the end to extend internally.In the embodiment shown in Figure 71, for example, often A leg 4454,4464 includes the leg to extend internally.In the layout 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 H_AGreater than nail The distance between the point that hat 4452 is inwardly at an angle of with leg 4468 from vertical leg 4466 H_C.Therefore, at least one embodiment party Distance H in case_BShorter than length H_D.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 scheming In 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 Office, which can help to that 4430 will be followed closely, to be temporarily retained in its corresponding nail cavity 4422.However, vertical leg 4434,4436 can be from bizet 4432 are extended with different angle.In some embodiments, angle A₄It is equal to each other.In other embodiments, angle A₄Each other It is different.In the illustrated embodiment, 4450 respective unshaped height UFH having the same are followed closely in inside nail 4430 and outside.Inside 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 layouts, inside nail and outside nail It can be formed by the staple line of same type.Therefore, in this layout, the linear diameter of inside nail and outside nail will be identical.So And in yet another embodiment, inside nail and outside nail can unshaped shape/configuration having the same, but by have not Two different staple lines with linear diameter are formed.Equally at least one layout, the bizet width C W of each outside nail 4450_O Greater than the bizet width C W of each inside nail 4430_I.Other details about nail configuration is found in what on June 30th, 2014 submitted The U.S. Patent Application Serial of entitled " FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS " Number 14/319,008, it is now U.S. Patent Application Publication 2015/0297232, has been herein incorporated by reference.

Figure 70 is returned to, nail bin 4410 includes the outer rim 4414 extended above platform surface 4412.During operation, clinical Doctor can adjust position of the anvil block relative to the storehouse of circular stapler.In at least one such embodiment, nail bin 4410 is also Including the platform features structure 4416 and 4418 extended from platform surface 4412.As can be seen that a series of inside such as in Figure 70 Platform features structure 4416 is arranged between the interior row 4420 of nail cavity 4422 and the knife opening 4413 of center setting, knife or cutting structure Part will pass through the knife during percussion and be open.Platform features structure 4416 can relative to internal nail cavity and opening 4413 forming and Positioning, as shown in Figure 70, Figure 72 and Figure 73.For example, each internal platform feature structure 4416 can have and knife opening 4413 The coextensive flat wall part 4415 of wall 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 Layout or platform features structure can be used for reducing the pressure typically encountered in flat platform storehouse.The layout of the disclosure may also help in Mitigate tissue movement and sliding.Since the sliding of tissue is usually undesirable, outer diameter keeps feature structure bigger And it is more.When blade passes through internal internal diameter, internal diameter feature structure can be used for increasing tissue tension/shearing force, this can make system Cut more preferably.However, platform features structure 4416 can have different shape and configuration, and platform surface 4412 can be located at On different location at.

It can also be seen that including and each of which end every an external nail cavity 4442 such as in Figure 70, Figure 72 and Figure 73 Associated external platform feature structure 4418.External platform feature structure 4418 extends above platform surface 4412, and Outside nail 4450 is guided towards anvil block when following closely 4450 and being projected from nail bin 4410.In such embodiment, until percussion Component keeps outside nail 4450 mobile towards anvil block, and outside nail can just extend above external platform features structure 4418.Main ginseng See Figure 70, at least one embodiment, external platform feature structure 4418 is not around entire corresponding external nail cavity 4442 Extend.First external platform feature structure 4418 be oriented it is adjacent with the first end of corresponding external cavity 4442, and second External platform feature structure 4418 is oriented adjacent with the second end of external cavity 4442.It is such as in Figure 70 as can be seen that outer Portion's platform features structure 4418 is associated every one in external nail cavity 4442.This layout can be used for reducing gross pressure simultaneously Make tissue stretch and move to minimize.However, in other embodiments, the first and second external platform feature structures 4418 can It is associated with each of external nail cavity 4442.In other embodiments, external platform feature structure can be around corresponding outer The entire periphery of portion's 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 topology layout 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 layout, platform features structure may include a continuous upright lip Edge.The quantity of balance platform feature structure may be needed so that high-tensile strength/constricted zone quantity minimizes, while obtaining aequum Tissue immobilization.Chamber concentric character structure can be used for minimizing the additional mesh of tissue flowing from its region outstanding in nail leg 's.When nail leg ejects and is transitioned into reception anvil block pit, this layout is also convenient for required nail forming, and the reception anvil block is recessed Hole can be made of corresponding forming pit.Such part pit feature structure increases low constricted zone, while leaving in nail It is convenient for when storehouse from storehouse supporting leg.Therefore, this layout makes to follow closely at a distance from necessary before it meets with anvil block pit " jump " most Smallization.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 can be operatively supported nail shaping insert or part 4484 and edge bearing circle 4490.Edge bearing circle 4490 with branch The relationship that the knife 4492 in stapler head faces is supportted to be supported.In the illustrated embodiment, nail shaping insert 4484 by Such as steel, stainless steel etc. are made, and include the inside nail shapes pit 4486 of interior row and the external nail shapes pit of outlet 4488.Each internal nail shapes pit 4486 corresponds to one in internal nail cavity 4422, and each external nail shapes pit 4488 correspond to one in external nail cavity 4442.In the layout shown in, when anvil block 4480 is relative to storehouse platform surface 4412 When being moved to its firing position, internal nail shapes pit 4486 is than external nail shapes pit 4488 closer to storehouse platform surface 4412.In other words, the first gap g between the first nail shaped portion 4485 and storehouse platform surface 4412₁Or first nail forming Distance is less than the second gap g between the 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 are supported on be located at push device assembly 4500 Correspondence inner drive part 4502 on its correspond in internal nail cavity 4422, and each of outside nail 4450 support Its on corresponding peripheral driver part 4504 corresponds in external nail cavity 4442.Push device assembly 4500 towards anvil block 4480 Propulsion will make inside nail 4430 and outside nail 4450 be driven into the forming of nail shapes pit 4486,4488 corresponding with each Contact, 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 layout is for providing the height of forming for outside nail 4450 FH_O, this is highly greater than the forming height FH of inside nail 4430_I.In other words, the outlet 4440 of outside nail 4450 is shaped as more Big " 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 nail 4450 Outlet 4440 pass through using bigger crown, nail leg width and/or nail leg thickness, and there is bigger mounted resistance.

The quantity of nail used in every nail can change.In one embodiment, for example, in the presence of than inside nail 4430 More outside nails 4450.Another embodiment is used than the more inside nails 4430 of outside nail 4450.In all cases, The linear diameter of outside nail 4450 is greater than the linear diameter of inside nail 4430.Inside nail 4430 and outside nail 4450 can it is having the same not Forming height UFH.Bizet width C W in the outlet 4440 of outside nail 4450_OGreater than the bizet of the interior row 4420 of inside nail 4430 Width C W_I.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 having The staged anvil block configuration on flat (non-staged) storehouse platform surface 4412, the configuration have uniform driver or pusher row Journey, to generate the nail with differing formed height.

Figure 74 shows another nail bin embodiment 4610.As can be seen that nail bin 4610 is flat including storehouse such as in Figure 74 Platform 4612 comprising the annular row 4620 of inside nail cavity 4622 spaced apart and the outer ring of external nail cavity 4642 spaced apart Row 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.Each interior 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 portion's nail cavity.Separately Outside, outer rim 4614 extends above platform surface 4612.In various embodiments, than that described above, until firing member makes Nail 4630,4650 is moved towards anvil block, and nail just projects into 4612 top of platform surface.Such embodiment is often using opposite The lesser nail for the depth for the corresponding nail cavity that they are stored therein in.In other embodiments, when nail non-is hit in its When sending out position, the leg of nail projects into 4612 top of platform surface.In at least one such embodiment, nail bin 4610 further includes The platform features structure 4616 and 4618 extended from platform surface 4612.

It can also be seen that nail cavity 4622 includes inside associated with each of which end inside one such as in Figure 74 Platform features structure 4616.Internal platform feature structure 4616 extends above platform surface 4612, and works as corresponding inside Corresponding inside nail 4630 is guided towards anvil block when nail 4630 is projected from nail bin 4610.In such embodiment, until Firing member keeps inside nail 4630 mobile towards anvil block, and inside nail can just extend above internal platform features structure 4616.? In the example of diagram, internal platform feature structure 4616 does not extend around entire corresponding internal nail cavity 4622.First inside is flat 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 layout can make tissue amount of flow It 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 can be operatively supported nail shaping insert or part 4684 and edge bearing circle 4690.Edge bearing circle 4690 with branch The relationship that the knife 4692 in stapler head faces is supportted to be supported.In the illustrated embodiment, nail shaping insert 4684 by Such as steel, stainless steel etc. are made, and include the inside nail shapes pit 4686 of interior row and the external nail shapes pit of outlet 4688.Each internal nail shapes pit 4686 corresponds to one in internal nail cavity 4622, and each external nail shapes pit 4688 correspond to one in external nail cavity 4642.In the layout 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 be supported on push device assembly 4700 correspondence in In corresponding internal nail cavity 4622 in portion's driver portion 4702.Outside nail 4650 is supported on corresponding peripheral driver part 4704 On corresponding external nail cavity 4642 in.Push the propulsion of device assembly 4700 towards anvil block 4680 that will make inside nail 4630 and outside nail 4650 are driven into nail shapes pit 4686 corresponding with each, 4688 shaping contacts, as shown in Figure 76.In addition, knife 4692 are advanced through the tissue being clipped between anvil block 4680 and platform surface 4612 towards distal side, and pass through edge bearing circle 4690 Frangible bottom 4691.In the embodiment shown in Figure 75 and Figure 76, each inside follows closely 4630 by having the first linear diameter D₁And have There is the 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 (increment 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 line straight Diameter D₂And there is the second unshaped height L₂.In the discribed embodiment of Figure 75 and Figure 76, D₁<D₂And L₁<L₂.So And as can be seen that inside nail 4630 and outside nail 4650 are formed with identical forming height FH such as in Figure 76.With inboard row The nail of small 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 Preferably healing and blood flow.In addition, with longer leg nail, even if at height identical as the nail with shorter leg at When shape, more bending sections B are also ensured that, this may make that the nail of longer leg is stronger and is more likely to suitably shape to be enough It keeps 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 layouts, 4650 bizet is followed closely Width is greater than the bizet width of inside nail 4630.In other embodiments, nail 4630,4650 can bizet having the same it is wide Degree.In other layouts, nail 4630,4650 can be above-mentioned gull wing type design.For example, at least one leg of nail may include inside Curved end or two legs may include end aduncate toward each other.This nail can be used in interior ring row or outer ring In shape 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, between which includes Three ring rows 4820,4840,4860 of the nail cavity separated.Interior row or first row 4820 include more than first a inner cavities or the first nail Chamber 4822, is respectively arranged with first angle.Each internal nail cavity 4822 operationally support wherein corresponding inside follow closely or First nail 4830.Inner chamber 4822 makes the first nail 4830 with the identical uniform angle orientation relative to tangential direction.In 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 is straight Diameter D₁Can be about 0.0079 inch to 0.015 inch, (increment is usually 0.0089 inch, 0.0094 inch and 0.00145 Inch).Referring to Figure 80, each inside nail 4830 includes the first bizet 4832 and two the first legs 4834.First bizet has the One bizet width C₁, and each first leg 4834 has the first unshaped leg length L₁.In one example, the first bizet is wide Spend 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 that the first nail forming is recessed Row or first row 4902 in two of first pair 4903 for interlocking or being at an angle of in hole 4904.First nail shapes pit 4904 it is every A first pair 4903 corresponds to one first nail 4830.One first is corresponded to 4,903 first nail shapes pit 4904 Nail leg 4834, and another first nail shapes pit 4904 corresponds to another first nail leg 4834.This layout is for establishing The nail configuration of forming, wherein the first nail leg 4834 of the first nail 4830 and the first bizet 4832 of specific first nail 4830 exist It is shaped outside plane, so that first leg 4834 shapes on the side of the first bizet 4832, and another first leg 4834 exists It is shaped on the other side of 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 inside Or the first storehouse platform part 4814, correspond to internal or the first nail cavity 4822 inside or first annular row 4820.Such as scheming In 79 can with it is further seen that, when anvil block 4900 is moved to closure or clamped position, anvil block 4900 comprising first nail forming The part of pit 4904 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 second wherein Nail 4850.Intermediate cavity 4842 makes intermediate or the second nail 4850 with the identical uniform second angle orientation relative to tangential direction. But second angle is different from first angle.In other words, when the first nail and the second nail are supported on their corresponding first chambers When in the second chamber, the axis of the first bizet of each first nail 4830 follows closely 4850 with adjacent second for final in extension The extension axis of second bizet intersects.Can be seen that each second or intermediate such as in Figure 79 and Figure 80 and follow closely 4850 includes 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 formed.For example, the second nail leg 4854 can have circular cross-sectional profile.Second or intermediate nail may include for example Entitled " the SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND submitted on August 26th, 2015 Various nail structures disclosed in the U.S. Patent Application Serial Number 14/836,110 of CIRCULAR STAPLING INSTRUMENTS " Type has been incorporated by reference and has been incorporated herein.Possess the circular staple extended from the base portion with rectangular cross-sectional facial contour point Leg can provide the base portion point and nail leg of no priority bending plane.Second nail 4850 includes bending part 4856, in the bending Nail leg 4854 extends from base portion point 4852 in part.Bending part 4856 may include substantially square cross-sectional profiles. Bending part 4856 and 4852 square profiles and rectangular profile respectively of base portion point provide rigidity to round nail leg 4854 and connect Socket part and backbone.Round nail leg 4854 eliminate cross section be square, rectangle or any shape with vertex or non-homogeneous shape The priority bending plane that the nail leg of shape can have.Each second nail leg 4854 has second diameter D₂.In at least one embodiment party In case, D₂>D₁.Second base portion or bizet 4852 have the second bizet width C₂.In a kind of layout, C₂>C₁.Second leg 4854 can Respectively 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 for interlocking or being at an angle of of the second nail shapes pit 4914 4913 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 to 4913 another second Nail shapes pit 4914 corresponds to another second nail leg 4854.This layout is for establishing the nail configuration of forming, wherein second Second base portion 4852 of leg 4854 and specific second nail 4850 is formed in outside plane." three-dimensional " forming nail configuration is somebody's turn to do relative to figure Some second nail shapes pits 4914 in 78 are shown.

As can be seen that storehouse platform 4812 further includes the second storehouse platform part 4816, corresponded to especially in Figure 79 Between or the second nail cavity 4842 centre or the second ring row 4840.Such as in Figure 79 can with it is further seen that, when anvil block 4900 move When moving closure or clamped position, the part comprising the second nail shapes pit 4914 and the terrace part 4816 of anvil block 4900 are spaced Open the second 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 are across two adjacent the The distance between two chambers 4842.Each external nail cavity 4862 operationally supports corresponding outside or third to follow closely 4870 wherein. Outside nail or third nail 4870 are orientated to tangent with circumferential direction by external cavity 4862.It can be seen that such as in Figure 79 and Figure 80 Each third or outside nail 4870 include third crown or base portion 4872 and two third legs 4874.Base portion 4872 can have summary It the cross-sectional shape of micro- rectangle and is formed by flat material piece.For example, third nail leg 4874 can have circular cross section wheel It is wide.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 layout, 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 opened 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.It is also wrapped as can be seen that storehouse platform 4812 especially in Figure 79 Third storehouse platform part 4818 is included, external or third nail cavity 4862 outlet or third row 4860 is corresponded to.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 third nail shapes pit 4918 part is spaced apart third space distance g with terrace part 4818₃.In the example shown in the series of figures, g₃>g₂.It can such as in Figure 79 With it is further seen that, at least one embodiment, tissue thickness compensation part 4920 and each outside are followed closely or third nail 4870 It is used in combination.Tissue thickness compensation part may include the weaving material for being embedded with oxidized regenerated cellulose (ORC) to promote hemostasis.Group Knitting thickness compensation part 4920 may include entitled " the IMPLANTABLE LAYER ASSEMBLIES " submitted on 2 24th, 2014 U.S. Patent Application Serial Number 14/187,389, now for various groups disclosed in U.S. Patent Application Publication 2015/0238187 Any one of thickness compensation part layout is knitted, 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 the every of three staples The nail of different number is used in one.In a kind of layout, 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 capture, incision and suture tissue according at least one embodiment Bending suture instruments 5000 part.Bending suture instruments 5000 include that frame assembly 5010, nail bin 5020 and anvil block (do not show Out), which 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 further include knife assembly, which includes the tissue for being configured to incision capture between nail bin 5020 and anvil block Cutting element (not shown).Nail bin 5020 includes platform 5022, which includes being configured to receive cutting for cutting element Cut slit 5024, multiple nail cavity 5030A and 5030B, and the multiple nails being removedly stored in nail cavity 5030A, 5030B 5040 (Figure 84).Bending suture instruments 5000 further include actuator assembly 5100, which includes being configured for Axially displaced master driver 5102 in frame assembly 5010.When activating trigger system, master driver 5102 is towards anvil block Direction on move axially.In at least one layout, cutting element is also released and is cut by the axial movement of master driver 5102 Slit 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 Nail chamber is located on every side of cutting slit 5024.As can be seen that for example, nail bin 5020 includes internal nail cavity such as in Figure 82 Two outlets 5090A, 5090B of 5080A, 5080B and external nail cavity 5092 are arranged in two of 5082.Nail bin 5020 further include from Multiple platform features structures that platform 5022 extends.For example, with reference to Figure 81 and Figure 82, outlet 5090A, 5090B of nail cavity 5092 With group platform feature structure associated there.In the example shown in the series of figures, those nail cavities associated with high part 5030 5092 are included in 5022 top extended characteristics height H of platform surface_hPlatform features structure 5032.It is associated with middle part 5050 Those of nail cavity 5092 be included in 5022 top extended characteristics height H of platform surface_mPlatform features structure 5052.With lower part 5070 those associated nail cavities 5092 are included in 5022 top extended characteristics height H of platform surface_LPlatform features structure 5072。H_h>H_m>H_L.In at least one embodiment, for example, H_hIt can be about 0.020 inch, H_mIt can be about 0.015 Inch, and H_LIt can be about 0.010 inch.Platform features structure 5032,5052 and 5072 can be molded into platform surface In 5022.It is contemplated that platform features structure 5032,5052 and 5072 is configured for that platform surface 5022 can be attached to Unitary part embodiment.Platform features structure 5032,5052 and 5072 can be the extension of nail cavity 5092, to incite somebody to action Nail is when being loaded into storehouse 5020, accommodates before projecting nail 5112 or when support nail 5112, and/or follows closely projecting from storehouse 5020 When, support, guidance and/or control nail.Two of the neighbouring nail 5112 of the support of single platform feature structure 5032,5052,5072 are not Same nail leg.Platform features structure 5032,5052 and 5072 may include the one or more for being configured to support each nail leg Multiple supporting walls of side, face and/or edge.It is contemplated that outside staple 5090A, 5090B on platform features structure 5032, 5052,5072 only in each outlet 5090A, 5090B every the associated embodiment of nail cavity 5092.In Figure 83 institute In the embodiment shown, the nail cavity 5082 (only it can be seen that row 5080B in Figure 83) of interior row 5080A, 5080B respectively have and it Associated platform features structure.For example, those nail cavities 5082 associated with high part 5030 are included in platform surface 5022 Top extended characteristics height H_hPlatform features structure 5034.Those nail cavities 5082 associated with middle part 5050 are included in flat 5022 top extended characteristics height H of platform surface_mPlatform features structure 5054.Those nail cavities associated with lower part 5070 5082 are included in 5022 top extended characteristics height H of platform surface_LPlatform features structure 5074.

Nail bin 5020 includes actuator assembly 5100, which is configured to will branch when applying actuating power The nail supportted in nail cavity 5082,5092 drives towards anvil block.In the layout 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 layout, which provides, to be had with regional change in the case where the deflection of no anvil block The nail of forming height.The actuating of actuator assembly 5100 also will lead to the tissue that cutting element is driven through clamping.Reader will Understand, it can be in different parts 5030,5050,5070 using with different legs and/or bizet configuration and/or linear diameter And/or the different nails of unshaped height, to realize desired forming nail height and layout on every side of tissue cut line.

Figure 85 to Figure 88, which is shown, is configured to capture, incision and suture tissue according at least one embodiment Another bending suture instruments 5200 various pieces.Referring first to Figure 86, being bent suture instruments 5200 includes frame assembly 5210, nail bin 5220 and anvil block 5260, the anvil block are configured to the relationship quilt faced with the platform 5222 with nail bin 5220 Support.Being bent suture instruments 5200 further includes knife assembly, which includes being configured to incision capture in nail bin 5220 The cutting element (not shown) of tissue between anvil block 5260.In the embodiment shown in Figure 86, platform 5222 includes " rank Ladder type " 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 includes the high platform part 5224 and low platform part 5226 of center setting, and cutting slit 5228 extends through this High 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.It is such as in Figure 86 as can be seen that disclosed herein each The platform features structure 5231 of kind of configuration can be with the external nail cavity 5230B of each of external nail cavity 5230B or each outlet In it is associated every an external nail cavity 5230B.In other layouts, 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 layouts In, 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 layout, 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 implementation of Figure 88 Shown in scheme, the leg of inside nail 5240 has " gull wing type " configuration.In particular, each inside nail 5240 includes from crown 5242 a pair of of the legs 5244,5246 extended.Each leg 5244,5246 include from bizet 5242 extend vertical portion 5245, 5247.In one embodiment, vertical portion 5245,5247 can be parallel to each other.However, in the layout shown in, vertically Part 5245,5247 is not parallel each other.Referring to Figure 88.However, vertical leg 5245,5247 can be relative to bizet 5242 with it He arranges at angle.Other details about nail configuration is found in the entitled " FASTENER submitted on June 30th, 2014 The U.S. Patent Application Serial Number 14/319,008 of CARTRIDGE COMPRISING NON-UNIFORM FASTENERS ", it is existing For U.S. Patent Application Publication 2015/0297232, it is incorporated by reference is incorporated herein accordingly.Make vertical leg 5245, 5247 relative to bizet 5242 be that this layout can help to follow closely temporary protect with the advantage that the angle greater than 90 degree is orientated It holds in its corresponding nail cavity.Referring still to Figure 88, each leg 5244,5246 further includes the leg to extend internally.Shown in In layout, leg 5248 extends internally from vertical leg 5244, and leg 5249 extends internally from vertical leg 5246.Such as exist In the figure as can be seen that leg 5248 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 outer Side nail 5250 includes a pair of of the leg 5254,5256 extended from crown 5252.Each leg 5254,5256 includes extending from bizet 5252 Vertical portion 5255,5257.In one embodiment, vertical portion 5255,5257 can be parallel to each other.However, institute In the layout shown, 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 Office, which can help to follow closely, to be temporarily retained in its corresponding nail cavity.Referring still to Figure 88, each leg 5254,5256 further includes inside The leg of extension.In the layout shown in, leg 5258 extends internally from vertical leg 5254, and leg 5259 is from vertical leg Portion 5256 extends internally.As in the figure, it can be seen that leg 5258 is shorter than leg 5254.Each outside nail 5250 have not at Shape height L₂.In the layout shown in, L₂>L₁.In the illustrated embodiment, inside nail 5240 and outside nail 5250 have identical Linear diameter D₁.However, in other embodiments, inside nail 5240 and outside nail 5250 have different linear diameters.At it In his embodiment, nail 5240 be may be provided in nail cavity 5230B, and nail 5250 may be provided in nail cavity 5230A so that it is longer not Forming 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 can be wrapped Include two insertion pieces 5264, be supported in anvil body 5260 so that an insertion piece 5264 correspond to cut it is narrow Nail on the side of slot 5228, and another insertion piece 5264 corresponds to the nail on the other side of cutting slit 5228.Such as 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 include interior section 5265 and exterior section 5267.When anvil block 5260 is located in the closed orientation for grip tissue, Clearance G is provided between the interior section 5265 and corresponding terrace part 5224 of insertion piece 5264₁, and in insertion piece 5264 Exterior section 5267 and corresponding terrace part 5226 between form clearance G₂.In the layout 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 pair of 5268A, 5268B's of nail shapes pit 5270 is every A nail shapes pit 5270 has triangular shaped.Forming pit 5270 in single pair 5268A, 5268B be separated from each other and It is configured to receive the correspondence leg of specific nail and makes its forming.This layout is for providing 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 layout, each outside The forming height F of nail 5250₂Greater than the forming height F of each inside nail 5240₁, as shown in Figure 88.In alternative layout, example Such as, anvil block insertion piece can not have stair-stepped configuration, and can basically comprise with it is disclosed herein various types of similar The corresponding part of the line of nail shapes pit, these pits and storehouse platform is away from identical distance.In this layout, storehouse platform can be with Stepped, and may include or can not include type disclosed herein platform features structure.In at least one modification In, interior tailor's tack can have the unshaped length (slit that distance accommodate cutting element farthest) more shorter than the nail in outside line, on the contrary ?.Staple in interior and exterior lines can have gull wing type configuration disclosed herein or they can have the U-shaped of standard to set Meter.Nail in every line can linear diameter having the same, which can be similar and different with the linear diameter of the nail in adjacent lines.

Figure 89 and Figure 90, which is shown, is configured to capture, incision and suture tissue according at least one embodiment Another suture instruments 5300 various pieces.Referring first to Figure 89, suture instruments 5300 include frame assembly 5310, nail bin 5320 and anvil block 5360, the anvil block be configured to be supported with the relationship that the platform 5322 with nail bin 5320 faces.Nail bin 5320 and anvil block 5360 can be that curved or they can be straight.Suture instruments 5300 further include knife assembly, the knife group Part includes the cutting element 5312 for being configured to tissue of the incision capture between nail bin 5320 and anvil block 5360.Nail bin 5320 include platform 5322, which includes the cutting slit being centrally located for being configured to receive cutting element 5312 5328.The interior row of inside nail cavity 5330A spaced apart is arranged on every side of cutting slit 5228.External nail cavity spaced apart The outlet of 5330B is adjacent to the interior row's setting of each of internal nail cavity 5330A.It is such as in Figure 89 as can be seen that disclosed herein various The platform features structure 5331 of configuration can be associated with each of internal nail cavity 5330A and external nail cavity 5330B.At other In embodiment, having in the inside nail cavity 5330A and/or external nail cavity 5330B in each corresponding row every one and its Associated platform features structure 5331.In other layouts, can not in internal nail cavity 5330A and external nail cavity 5330B Platform features structure is used in combination in any one.

In at least one layout, each internal nail cavity 5330A removedly stores inside nail 5340 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.In the layout shown in, inside nail 5340 may include the leg of gull wing type design and have unshaped height L₁.The leg that outside nail 5350 can also have gull wing type to design And there is unshaped height L₂.In the layout shown in, L₁>L₂.However, other nail configurations disclosed herein can also be used.

Anvil block 5360 can be used in suture instruments 5300, as shown in Figure 89.As can be seen that anvil block 5360 can wrap such as in Figure 89 Include two insertion pieces 5364, be supported in anvil body 5362 so that an insertion piece 5364 correspond to cut it is narrow Nail on the side of slot 5328, and another insertion piece 5364 corresponds to the nail on the other side of cutting slit 5328.Such as 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.Often A insertion piece 5364 includes the interior row of internal nail shapes pit 5368A and the outlet of external nail shapes pit 5368B.Nail forming is recessed 5368A, 5368B can be provided with any one of various nail shapes pit configurations disclosed herein in hole.When device 5300 is fired When, 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, which is shown, is configured to the another of capture, incision and suture tissue according at least one embodiment The various pieces of a suture instruments 5400.Suture instruments 5400 include frame assembly 5410, nail bin 5420 and anvil block 5470, the anvil Seat is configured to be supported with the relationship that the platform 5422 with nail bin 5420 faces.Nail bin 5420 and anvil block 5470 can be It is curved or they can be straight.Suture instruments 5400 further include knife assembly, which includes being configured to cut Enter the cutting element 5412 of tissue of the capture between nail bin 5420 and anvil block 5470.Nail bin 5420 includes platform 5422, this is flat Platform includes the cutting slit 5428 being centrally located for being configured to receive cutting element 5412.Inside nail cavity spaced apart The interior row of 5430A is arranged on every side of cutting slit 5428.The neighbouring cutting of the intermediate row of intermediate nail cavity 5430B spaced apart The interior row's setting of each of the inside nail cavity 5430A being spaced apart on every side of slit 5428.External nail cavity 5430C's spaced apart is outer Arrange each of neighbouring intermediate nail cavity 5430B intermediate row setting spaced apart.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 intermediate nail cavities and/or in conjunction with some or all of external nail cavities.

In at least one layout, each internal nail cavity 5430A removedly stores inside nail 5440 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 being laid out shown in, inside nail 5440, intermediate nail 5450 and outside nail 5460 having the same can construct and have phase Same 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 can wrap such as in Figure 91 Include two insertion pieces 5474, be supported in anvil body 5472 so that an insertion piece 5474 correspond to cut it is narrow Nail on the side of slot 5428, and another insertion piece 5474 corresponds to the nail on the other side of cutting slit 5428.Such as 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.Often A insertion piece 5474 includes the intermediate outside for following closely forming cavity 5478B and outlet of the inside nail forming cavity 5478A of interior row, intermediate row Follow closely 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 structure having the same Type.However, other nail configurations and nail shapes pit configuration disclosed herein can also be used, to generate with differing formed height With the nail of configuration.

Figure 92, which is shown, is configured to the another of capture, incision and suture tissue according at least one embodiment A suture instruments 5500.Suture instruments 5500 include frame assembly 5510, nail bin 5520 and anvil block 5570 (Figure 93), the anvil block quilt It is constructed to be permeable to be supported with the relationship that the platform 5522 with nail bin 5520 faces.Suture instruments 5500 further include knife assembly, should Knife assembly includes the cutting element 5512 for being configured to tissue of the incision capture between nail bin 5520 and anvil block 5570.Nail Storehouse 5520 includes 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 layouts, there can be platform features structure associated there positioned at every the nail cavity in a row.

In at least one layout, each internal nail cavity 5530A removedly stores inside nail 5540 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.It is laid out shown in In, 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 layout, for example, nail 5540,5550 and 5560 can be submit on August 26th, 2015 it is 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 A feature structure is configured to follow closely and 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 extending therefrom Protrusion 5543, the protrusion in the side wall of corresponding nail cavity 5530A, 5530B and 5530C corresponding detent or groove 5531 connect It closes.Protrusion 5543 and the detent in nail cavity side wall or the interaction between groove 5531 prevent nail 5540,5550,5560 from storehouse 5520 bottom drops out.Interaction between protrusion 5543 and nail cavity side wall includes interference fit；However, this interference fit Nail 5540,5550,5560 will not be prevented to project from corresponding chamber 5530A, 5530B and 5530C.Protrusion 5543 can rushed for example It is formed in base portion 5542 during pressure technique.Sheet Metal Forming Technology can be by generating detent in the opposite side of base portion 5542, to be formed 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 can wrap such as in Figure 93 Include two centres to 5578B of row in two to 5578A of internal nail shapes pit 5579, intermediate nail shapes pit 5579 Arrange two outlet 5577C to 5578C of 5577B and external nail shapes pit 5579.In single pair 5578A, 5578B and 5578C Nail shapes pit 5579 be separated from each other and be 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, which is shown, is configured to the another of capture, incision and suture tissue according at least one embodiment A suture instruments 5600.Suture instruments 5600 include frame assembly 5610, nail bin 5620 and anvil block 5670 (Figure 97), the anvil block quilt It is constructed to be permeable to be supported with the relationship that the platform 5622 with nail bin 5620 faces.Suture instruments 5600 further include knife assembly, should Knife assembly includes the cutting element 5612 for being configured to tissue of the incision capture between nail bin 5620 and anvil block 5670.Nail Storehouse 5620 includes 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 layout, 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 layout shown in, each nail 5640 includes that bizet 5642 and two are spaced apart Leg 5644,5646.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 5644, institute such as in Figure 97 Central part is stated with the first width W₁, each end sections are with relatively narrow width W₂.The corresponding nail of the support of end sections 5654 5642 each end.Each chamber 5632 and central part 5634 and two end sections 5636 are similarly shaped.When nail 5642 When projecting 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 includes Arranged in two to 5679A of nail shapes pit 5680,5690 5678A and nail shapes pit 5680,5690 to the two of 5679B A outlet 5678B.Nail shapes pit 5680,5690 in single pair 5679A, 5679B is separated from each other and is configured to It receives the correspondence leg 5544,5546 of specific nail 5640 and makes its forming.As can be seen that each nail pit 5680 wraps such as in Figure 99 External pit portion 5682 is included, which is configured to initial with the end of corresponding leg 5644 and inner-concave It cheats part 5684 to contact, to capture leg when leg 5644 is to internal shaping to complete forming process.Similarly, each nail pit 5690 include external pit 5692, which is configured to initial with the end of corresponding leg 5646 and inside pit portion 5694 contacts, to capture leg when leg 5646 is to internal shaping to complete forming process.External pit portion 5682 has width S₁ And internal pit portion 5684 has width S₂.In the embodiment illustrated, S₁>S₂.This layout for leg for providing more Wide initial contact area, and be used for leg holding and crown planar registration in forming process, to provide figure for nail 5640 Shaping form shown in 99.

Figure 100, which is shown, is configured to the another of capture, incision and suture tissue according at least one embodiment A part of one suture instruments 5700.Suture instruments 5700 include elongated passageway 5710, nail bin 5720 and anvil block 5770, the anvil Seat is configured 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 layout shown in, knife assembly 5780 is suspended in rotation drive shaft 5772, which is operably supported In anvil block 5770.Rotating the rotation of drive shaft 5772 along the first direction of rotation will drive knife assembly 5780 to pass through nail bin towards distal side 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, the wedge-shaped slides and staple drivers join with from nail bin 5720 sequentially Project nail.

Nail bin 5720 includes platform 5722, which includes being configured to receive being centrally located for cutting element 5782 Cutting slit 5728.The interior row of inside nail cavity 5730A spaced apart is arranged on every side of cutting slit 5728.It is spaced apart Intermediate nail cavity 5730B each of the inside nail cavity 5730A that is spaced apart on every side of cutting slit 5728 of intermediate row in Row's setting.The outlet of external nail cavity 5730C spaced apart is arranged adjacent to each intermediate row of intermediate nail cavity 5730B.Such as in Figure 100 In as can be seen that various configurations disclosed herein platform features structure 5731 can in nail cavity 5730A, 5730B, 5730C Each is associated.In other embodiments, in internal nail cavity 5730A every one and/or in intermediate nail cavity 5730B There is platform features structure 5731 associated there every one every one and/or in external nail cavity 5730C.At other In layout, 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 In 5771, so that an insertion piece 5774 corresponds to the nail on the side of cutting slit 5728, and another insertion piece 5774 correspond to 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 When, insertion piece 5774 is located at the uniform distance G with storehouse platform 5722₁Place.The inside nail of each insertion piece 5774 including interior row at Shape chamber 5778A, the intermediate nail forming cavity 5778B of intermediate row and the external of outlet follow closely forming cavity 5778C.Nail forming cavity 5778A, 5778B and 5778C may include any one of various nail shapes pit configurations disclosed herein.When device 5700 is fired, Each of nail 5740 obtains identical forming height and configuration.However, can also be used it is disclosed herein other nail configurations and Nail shapes 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 in layout 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 with reference One of similar stitching devices layout disclosed in the various bibliography that mode is 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 layout, removedly storage follows closely 5840 to each nail cavity 5832 wherein.In a kind of layout, example Such as, entitled " the SURGICAL STAPLING CONFIGURATIONS FOR that nail 5840 can have submit on August 26th, 2015 It is disclosed in the U.S. Patent Application Serial Number 14/836,110 of CURVED AND CIRCULAR STAPLING INSTRUMENTS " Type and configuration, be incorporated by reference be incorporated herein accordingly.Than that described above, the nail of nail bin disclosed herein can wrap One or more features structure is included, one or more of feature structures are configured to that the nail cavity for being maintained at nail bin will be followed closely In.Turning now to Figure 103, nail 5840 includes base portion 5842 and the nail leg 5844,5846 from the extension of base portion 5842.Base portion 5842 Including protrusion 5843 extending therefrom, the protrusion in the side wall of corresponding nail cavity 5832 correspondence detent or groove 5833 engage. Protrusion 5843 and the detent in nail cavity side wall or the interaction between groove 5833 prevent nail 5840 from falling from the bottom in storehouse 5820 Out.Interaction between protrusion 5843 and nail cavity side wall includes interference fit；However, this interference fit cannot be prevented from phase Chamber 5832 is answered to project nail 5840.Protrusion 5843 can be for example formed in during Sheet Metal Forming Technology in base portion 5842.Sheet Metal Forming Technology can lead to It crosses the opposite side in base portion 5842 and generates detent, to form protrusion 5843.It is contemplated that not including groove or detent 5833 Alternative embodiment.

Figure 104 shows anvil block 5970 comprising for driving the rotation drive shaft 5972 of knife assembly in the above described manner.Anvil Seat 5970 may include two insertion pieces 5974, be supported in anvil body 5971, so that an insertion piece 5974 corresponds to Nail on the side of cutting slit in corresponding nail bin (not shown), and another insertion piece 5974 corresponds to cut Nail on the other side of slit.Each insertion piece 5974 includes shaping to interior row 5978A, the nail of 5979A for nail forming cavity 5980 The intermediate row 5978B to 5979B of the chamber 5980 and outlet 5978C to 5979C of nail forming cavity 5980.Single pair 5979A, Nail shapes pit 5980 in 5979B, 5979C is separated from each other and is configured to receive the correspondence leg of corresponding nail 5940 5944,5946 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 in document Each it is hereby incorporated herein by full accordingly 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 THICKNESS IMPLANTABLE 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 wherein shaped Forming pit or they can have " staged " shape surface, have in the correspondence nail shapes pit wherein shaped.Herein Various nail bins construction can have flat platform surface or platform surface can be stepped (to be included in Different Plane On platform surface part).In some embodiments, platform features structure can be associated with all nail cavities in nail bin.? In other constructions, platform features structure is used in combination with every all nail cavities in a nail chamber.Also contemplate other embodiment party Case, wherein platform features structure is associated every a nail cavity in given row, and every row's chamber be also so to construct.Also Other embodiments are contemplated, wherein not using platform features structure.

The nail with " u "-shaped unshaped configuration can be used in various embodiments disclosed herein, or nail can have difference Unshaped shape, wherein for example, base portion or bizet have rectangular cross-sectional shape.Various nails can be by with circular cross section shape Shape, square cross-sectional shape, circle and square cross-sectional shape combination etc. line forming.Nail may be provided with one or more A leg with gull wing type or conical configuration.Nail can have different linear diameters and different cross-sectional dimensions.Nail leg can To be symmetrical or they can be asymmetric (with and without bent tip).The leg of specific nail can it is parallel to each other or Person they can be not parallel each other.Nail in particular bin can unshaped height having the same or they can have it is different Unshaped height.Nail in particular bin or region can bizet width having the same or they can have different bizets wide Degree.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 they can be configured so that leg is not located in plane identical with crown or base portion when following closely forming.All above-mentioned nails Feature structure can change between nail region and between the selection of storehouse from being pinned to.

In circular stapler anvil block layout, nail shapes pit can be tangent with the circumference of anvil block.In other layouts or remove Except the nail shapes pit of arranged tangential, other nail shapes pits can be set with tangential direction angulation.Nail forming This modification in pit orientation may be provided in the nail shapes pit of given row or in the nail shapes pit of different rows.It can also adopt With a variety of different nail shapes pit geometries.Traditional symmetrical nail shapes pit geometry can be used.In addition to this or Alternatively, asymmetric nail shapes pit geometry can be used.Other nail shapes pits can have bow-tie shape, wherein often A nail leg has big touch-down zone, and corresponding leg is collected to relatively narrow outlet pit portion.All above-mentioned nail formings are recessed Cheating 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 adjusted It is made as realizing desired forming nail height relative to the correspondence gap provided between anvil block and storehouse.For example, in some layouts, 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 The warehouse channel of nail bin can be received.One or both of anvil block and nail bin can be relative to another in open configuration and closure It is moved between configuration, to capture tissue therebetween.Nail is from the tissue that the nail cavity in nail bin is deployed to capture.Nail is in anvil block Forming pit forming.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 It is that a type of anvil block can only be used to a type of nail bin.Different nail bins with the nail cavity being arranged differently cannot be with 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, It modifies anvil block so as to be used together from different nail bins.When anvil block includes being configured to be changed during following closely deployment Or when used one or more components, there is another limitation.The disclosure includes various embodiments, modifies anvil block to mend It fills and is changed during following closely deployment or used component or feature structure, and/or new feature structure and/or portion are provided Part.

Referring to Figure 106, anvil assembly 15000 includes the anvil block modification component 15004 for being attached to anvil block 15002.Anvil block is repaired Changing component 15004 includes tissue contacting surface 15006 and anvil block contact surface 15008.Tissue contacting surface 15006 includes and anvil The different pit 15010 of the forming pit 15012 of seat 15002.When anvil block modification component 15004 is not attached to anvil block 15002, Forming 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 When, 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-rank Ladder type platform 15015.Alternatively, anvil block may include non-staged platform, can be by including that the anvil block of staged platform modifies structure Part modification.The outlet of staged platform 15013 including forming pit 15012', the outlet from the interior row of forming pit 15012 to On gradually increase.Non- staged platform 15015 includes the forming pit 15010 being limited in planar tissue contact surface 15006. In at least one situation, anvil block modify component may include a row or multi-row of forming pit 15010, it is described it is a row or multi-row from Other rows of profiled 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 It has been changed or with out-of-date, anvil block can be used to modify component 15004.In this case, anvil block modification component is used and is had newly The tissue contacting surface that the new tissue contacting surface of component or feature structure is replaced the used of anvil block or changed.For example, anvil block 15002 forming pit 15012 may include the circuit element that can be severed during following closely deployment.When using anvil block every time, it is not The circuit element of cutting is repaired, but anvil block modification component can be used to provide the anvil block pit including having complete circuit element Replacement tissue contacting surface.For another example, anvil block may include the implantable layer positioned against the tissue contacting surface of anvil block.Make every time When with anvil block, new implantable layer is not attached to anvil block, anvil block modification component can be used and connect to provide replacement tissue Surface is touched, there is 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 one or more new portions in anvil block Part or feature structure.As shown in Figure 107, it includes implantable layer 15014 that anvil block, which modifies component 15004,.Although anvil block 15002 is initial It may not include implantable layer, but can be added implantable layer and anvil block modification component 15004 is attached to anvil block 15002 It is added to 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, it can plant layer 15014 from anvil block and modify component 15004 releases.In some cases, the nail of forming define may include a part of tissue and implantable layer 15014 retention Region.In this case, the retention part that can plant layer 15014 can be used as tissue thickness compensation part.Implantable layer 15014 can Including polymer composition.Polymer composition may include one or more synthetic polymers and/or one or more non-synthetic Polymer.Synthetic polymer may include the absorbable polymer of synthesis and/or the non-absorbable polymer of synthesis.

In nail forming process, anvil block is subjected to significant forces.Gap between anvil block and anvil block modification component can lead to Stability reduces and/or collapses risk increase during nail 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 modifies component 15004 in anvil block 15002 and anvil block Between there are 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,.It is attached at least one situation Feature structure 15018 is connect to be configured to anvil block modification component 15004 being releasably attached to anvil block 15002.Such as Figure 106 With shown in Figure 107, the attachment features structure 15018 that anvil block modifies component 15004 includes side wall, and the side wall is spaced apart sufficiently from each other It opens closely to clamp the outer wall 15020 of anvil block 15002.Attachment features structure 15018 includes 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 and 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 can wrap One or more slit is included, one or more slit is configured to frictionally receive the anvil block from anvil block modification component The upright tab of one or more that contact surface extends.It can be using other attachment means (for example, biocompatible glue and/or spiral shell Follow closely) anvil block is modified into 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 face 15028 and 15030 can transverse portions 15024.When anvil block modification component 15004 is attached to anvil block When 15002, as shown in Figure 106, can transverse portions 15024 with anvil block 15002 staged platform 15013 two sides The longitudinal slit 15026 extended between 15032 and 15034 is aligned.Can transverse portions 15024 by slit 15026 along longitudinal direction towards remote Skidding into cutting element cutting.When anvil block modification component 15004 be attached to anvil block 15002 when, can transverse portions 15024 make anvil Seat modification component 15004 is stablized.In at least one situation, when cutting element is promoted along longitudinal slit 15026 towards distal side When, the side 15028 and 15030 of anvil block modification component 15004 is completely cut through and is separated by cutting element.In other cases, When cutting element is promoted along longitudinal slit 15026 towards distal side, anvil block modifies the side 15028 and 15030 of component 15004 Only by cutting element partial cut.

Referring to Figure 108, anvil block modification component 15104 is shown.Anvil block modifies component 15104 and is similar to anvil in many aspects Seat modification component 15004.For example, anvil block modification component 15104 is releasably attached to anvil block 15002.Component is modified with anvil block 15004 is different, and anvil block modification component 15104 lacks can transverse portions.On the contrary, anvil block modification component 15104 is included in anvil block and repairs Change the elongated slot 15124 extended between two sides 15128 and 15130 of component 15104.However, in other cases, anvil Seat 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 Proximal 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 at Shape pit 15110a, the second forming pit 15110b and third forming pit 15110c can be located at side 15128 and/or side On 15130.As shown in Figure 109, the first forming pit 15110a limits first axle 15142, which extends through the The proximal end and distal end of one forming pit 15110a.Similarly, the second forming pit 15110b limits second axis 15144, which extends through the proximal end and distal end of the second forming pit 15110b.Moreover, third shapes 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 blunt between them Angle.In addition, second axis 15144 is formed between them transverse to third axis 15146, such as axis 15144 and 15146 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 the second axis Line 15144 is vertical or at least substantially vertical with first axle 15142 and/or third axis 15146.In at least one situation Under, 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 of component 15104, the second forming pit 15110b and third forming pit 15110c is configured to make respectively can be from the first nail cavity 15210a of nail bin 15200, the The nail forming or bending of two nail cavity 15210b and third nail cavity 15210c deployment.For example, the first forming pit 15110a includes two A profiled recess 15152 is configured to receive the nail of nail 15256 when following closely 15256 from the first nail cavity 15210a deployment Leg 15254 simultaneously makes its forming.

In closed configuration, anvil block 15002 is aligned with nail bin 15200 or is at least substantially aligned, so that tissue is captured Between the tissue contacting surface 15108 of anvil block modification component 15104 and the tissue contacting surface 15208 of nail bin 15200.Separately Outside, the first forming pit 15110a, the second forming pit 15110b and the third forming pit of anvil block modification component 15104 15110c is aligned with the first nail cavity 15210a, the second nail cavity 15210b and third nail cavity 15210c or at least substantially right respectively Standard, so that the nail leg 15254 of the nail 15256 of deployment is captured and shaped.

Nail bin 15200 includes first side 15228 and second side 15230.Elongated slot 15224 is in first side Extend between 15228 and second side 15230.Elongated slot 15224 can be in the proximal end 15236 of nail bin 15200 and distal side Extend and/or extend through between end 15238.Nail bin 15200 includes on each of side 15228 and 15230 Three nail chamber 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, Duo Ge Two nail cavity 15210b are parallel to each other or at least substantially parallel and/or multiple third nail cavity 15210c are parallel to each other or extremely It is few substantially parallel.

In some cases, at least one first nail cavity 15210a, at least one 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 and third nail cavity 15210c can be located on side 15228 and/or side 15230.As shown in Figure 110, the first nail cavity 15210a limits first axle 15242, which extends through the proximal end and distal end of the first nail cavity 15210a. Similarly, the second nail cavity 15210b limits second axis 15244, which extends through the nearside of the second nail cavity 15210b End and distal end.Moreover, third nail cavity 15210c limits proximal end and the distal side for extending through third nail cavity 15210c The third axis 15246 of end.Second axis 15244 is transverse to first axle 15242, so that axis 15244 and 15242 is at it Between form acute angle or obtuse angle.In addition, second axis 15244 is transverse to third axis 15246, such as 15244 He of axis 15246, acute angle or obtuse angle are formed between them.For example, as shown in Figure 110, first axle 15242 and third axis 15246 It is in parallel or at least substantially parallel, and second axis 15244 is vertical with first axle 15242 and/or third axis 15246 or extremely It is few substantially vertical.

In all cases, than that described above, anvil block may include along the alignment of first group of longitudinal axis the forming of multiple rows of nail it is recessed Hole.The anvil block modification component that could attach to anvil block may include the multiple rows of nail shapes pit being aligned along second group of longitudinal axis, described Second group of longitudinal axis is not aligned with first group of longitudinal axis.As a result, anvil block modification component on nail shapes pit not with anvil block On nail shapes pit it is longitudinally aligned.In some cases, some longitudinal rows of the forming pit on anvil block modification component and anvil Longitudinal row's alignment of forming pit on seat, and other longitudinal directions row of the forming pit on anvil block modification component is not and on anvil block Longitudinal row's alignment of forming pit.

Referring to Figure 113 and Figure 114, from least one the first nail cavity 15210a at least one first nail 15256a, come From at least one second nail 15256b of at least one the second nail cavity 15210b and from least one third nail cavity 15210c At least one third nail 15256c can be deployed to simultaneously and modify the group captured between component 15104 and nail bin 15200 in anvil block In knitting.Triple staple drivers 15260 are configured to cooperate with the cam slider of nail bin 15200, simultaneously from it Corresponding nail cavity 15210a, 15210b and 15210c dispose three nails 15256a, 15256b and 15256c.Staple drivers 15260 It can be lifted up or slide in nail cavity 15210a, 15210b and 15210c by cam slider, so that staple drivers 15260 Move upwards can project or dispose nail 15256a, 15256b and 15256c.

As shown in Figure 113 and Figure 114, each of three nails 15256a, 15256b and 15256c include driving against nail The base portion 15253 that the bracket 15255 of dynamic device 15260 positions.Staple drivers 15260 include two inclined-planes 15257, are configured to It can cooperate with the cam slider of nail bin 15200, to be disposed simultaneously from its corresponding nail cavity 15210a, 15210b and 15210c Three nails 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 the nail bin 15301 shown in closed configuration, which has anvil block Component 15303, the anvil assembly include the anvil block modification component 15304 for being attached to anvil block 15002.Anvil block modifies component 15304 It is similar to anvil block in many aspects and modifies component 15004.For example, anvil block modification component 15304 includes can 15024 He of transverse portions Forming pit 15010 on the two sides 15028 and 15030 of anvil block modification component 15304 is set.Implantable layer 15314 against The forming pit 15010 of side 15028 is arranged, and the forming pit 15010 of implantable 15315 abutment side surface 15030 of layer is set It sets.Implantable layer 15314 and 15315 is spaced apart, and limits gap 15317 between them.Gap 15317 with can transverse portions 15024 in parallel or at least substantially longitudinally parallel extension.Ladder of the implantable layer 15318 and 15319 against nail bin 15301 Formula platform 15321 is arranged.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, and nail 15323 is configured to shape against forming pit 15010, as shown in Figure 114. Alternatively, 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 In the nail cavity 15325 of nail bin 15301.Nail 15323a, 15323b and 15323c include it is identical or it is at least substantially identical not at Shape height 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 The range of inch.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 of nail is high Degree depends on the forming distance limited between forming pit and corresponding bracket, bracket support nail in corresponding nail cavity.It can By the way that forming pit is positioned closer to or changes forming distance further from corresponding bracket.Anvil block modification component can be used To change forming distance.For example, as shown in Figure 115, the forming that the first forming distance D1 is limited to anvil block modification component 15304 is recessed Between hole 15010 and shaped bracket 15355, and the second forming distance D2 greater than the first forming distance D1 is limited to anvil block Between 15002 forming pit 15012' and identical bracket 15355.

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 lines up Shape pit is gradually increased upwards relative to other row's forming pits or is gradually decreased downwards.In some cases, anvil block modifies structure Part can be positioned against the specific part of anvil block to modify the part.For example, anvil block modification component can be against the portions of proximal of anvil block Positioning is to modify portions of proximal, while distal part and central part remain unchanged.For another example, anvil block modification component can be against anvil block Central part position to modify central part, while distal part and portions of proximal remain unchanged.In yet another example, anvil Seat modification component can be positioned against the distal part of anvil block, and to modify distal part, while portions of proximal and central part are kept It is constant.

In all cases, anvil block modification component is configured to the subset of the forming pit of modification anvil block.For example, Anvil block is modified component and can be positioned to modify a row or multi-row forming pit, together against a row or multi-row forming pit of anvil block When anvil block remaining row forming pit remain unchanged.In at least one situation, anvil block modifies component (for example, anvil block is modified Component 15304) it can be applied to modifications or changes and captured between nail bin such as nail bin 15301 and anvil block such as anvil block 15002 Structural compression.Anvil block modifies component 15304 can be by reducing the tissue compression between nail bin 15301 and anvil block 15002 Gap is applied to the structural compression of capture to increase.It is positioned by the way that anvil block is modified component 15304 against anvil block 15002, The size in tissue compression gap efficiently reduces the size of anvil block modification component 15304, and which increase the groups for being applied to capture The compression knitted.Tissue compression gap includes about 0.045 inch of height.In all cases, tissue compression gap may include choosing From the height of for example, about 0.03 inch to about 0.10 inch of range.The disclosure contemplates other of the height in tissue compression gap Value.

Many surgical instrument systems as described herein are actuated by electric motor；However, surgical instrument system as described herein It can actuate in any suitable manner.In all cases, for example, surgical instrument system as described herein can be by being manually operated Trigger actuate.In some cases, motor disclosed herein may include one or more parts of robot control system. In addition, any end effector disclosed herein and/or tool assembly can be used together with robotic surgical Instrument system.Example Such as, 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, implementation as described herein Scheme is without being limited thereto.For example, it is envisioned that the various embodiments of fastener such as fixture or tack of the deployment in addition to nail. Furthermore, it is also contemplated that utilize the various embodiments of any appropriate device for seal tissue.For example, according to various embodiment party The end effector of case may include the electrode for being configured to heating and seal tissue.In addition, for example, according to certain embodiment party The end effector of case can apply vibrational energy and carry out seal tissue.

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

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

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

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

Entitled " the ARTICULATABLE SURGICAL INSTRUMENT submitted on November 10th, 2005 The U.S. Patent Application Publication 2005/0246881 of COMPRISING A FIRING DRIVE "；

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

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

It is published on August 11st, 1992 entitled " FAST CLOSURE DEVICE FOR LINEAR SURGICAL The United States Patent (USP) 5,137,198 of STAPLING INSTRUMENT "；

The U.S. for being published in entitled " the FLEXIBLE SUPPORT SHAFT ASSEMBLY " on April nineteen ninety-five 11 is special Benefit 5,405,073；

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 on July 30th, 2015 The beauty of FOR ASSURING THE PROPER SEQUENTIAL OPERATION OF THE SURGICAL INSTRUMENT " State's patent application serial number 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 on July 30th, 2015 The U.S. Patent Application Serial Number 14/813 of FOR PERMITTING THE OPTIONAL TRANSECTION OF TISSUE ", 266；

It is filed in entitled " the SURGICAL INSTRUMENT COMPRISING A SYSTEM on July 30th, 2015 The U.S. Patent application sequence of FOR BYPASSING AN OPERATIONAL STEP OF THE SURGICAL INSTRUMENT " Row number 14/813,274；

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

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

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

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

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

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

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

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

It is filed 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 of STAPLING INSTRUMENT " (is now United States Patent (USP) No.7,980,443)；

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

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

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

It is filed in the U.S. Patent Application Serial Number 12/ of on September 29th, 2012 entitled " STAPLE CARTRIDGE " 893,461, it is now U.S. Patent number 8,733,613；

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

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

It is filed in entitled " the ARTICULATABLE SURGICAL INSTRUMENT on June 15th, 2012 The U.S. Patent Application Serial Number 13/524,049 of COMPRISING A FIRING DRIVE "；It is now 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 END EFFECTOR " is now United States Patent (USP) 8,308, 040。

It is also implementable that these embodiments are repaired although certain embodiments has been combined to describe various devices herein Change and modification.In addition, when materials for certain parts are disclosed, it is possible to use other materials.In addition, according to more Kind embodiment, single component can be replaced by multiple components, and multiple components can also be replaced by single component, to execute Given one or more functions.Above-mentioned specific embodiment and following the claims are intended to cover all such modifications and change Type.

Apparatus as disclosed herein is designed to discard after a single use or it is designed to be used for multiple times. However 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 Any combination of step, the step include but is not limited to provision for disengagement, later cleaning or alternative specific component and It is subsequent to re-assembly device.In particular, restoration facilities and/or surgical team can with provision for disengagement, and cleaning and/ Or after the specific part of more changing device, the device can be re-assemblied for subsequent use.Those skilled in the art will Understand, trimming device can be dismantled using various technologies, clean/replace and re-assembly.Such technology use and Resulting prosthetic device is within the scope of application.

Apparatus as disclosed herein can be handled before the surgery.It is possible, firstly, to new or used instrument is obtained, and And it is cleaned as needed.Then, it can carry out disinfection to instrument.In a kind of sterilization technology, the instrument is placed on close It closes and in the container (such as, plastics or TYVEK bag) that seals.Then container and instrument can be placed in the spoke that can penetrate the container Penetrate field, such as γ radiation, X-ray and/or high energy electron.Radiation can kill the bacterium on instrument and in container.Device after disinfection Tool can be then stored in sterile chamber.Sealing container can keep instrument to be in germ-free condition, until 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 not It is limited to β radiation, γ radiation, ethylene oxide, plasma peroxide and/or steam.

Although the present invention has been described as having exemplary design, can further be repaired in the spirit and scope of the disclosure Change the present invention.Therefore, this application is intended to cover use any modification of the invention of General Principle of the invention, purposes or change Type.

Any patent, announcement or other public materials incorporated in this article in full or in part by reference only simultaneously The material entered is not incorporated herein in existing definition of the present invention, statement or the conflicting range of other public materials.Cause This, and at the necessary level, disclosure specifically listed herein replaces any conflict being herein incorporated by reference Material.It is said that being herein incorporated by reference but conflicting with the existing definitions, statements, or other disclosure materials listed herein Any material or part thereof will not generated only between incorporated material and existing public material under the degree that conflicts simultaneously Enter.

Claims (20)

1. a kind of surgery suturing appliance, comprising:

Axis；

Actuated articulation joints；With

End effector assembly, the end effector assembly include:

First jaw；

Second jaw, second jaw can be mobile relative to first jaw；

Anvil block, the anvil block are configured to deform nail；

Drive system, the drive system include:

Rotate input component；

It is closed driving device, the closure driving device is configured to move second jaw；

Driving device is fired, the percussion driving device is configured to from nail bin percussion nail；With

First latching member, first latching member include the unlocked configuration when nail bin is mounted in the end effector assembly With the locked configuration when nail bin is not installed in the end effector assembly, wherein when be in the unlocked configuration when, institute The first latching member is stated to be configured to allow the actuating of the closure driving device and the percussion driving device, and its In, when being in the locked configuration, first latching member is configured to prevent the closure driving device and described Percussion driving device is activated；With

Second latching member, second latching member include locked configuration and are mounted on the end execution in the nail bin of non-percussion Unlocked configuration in the case where in device assembly, wherein second latching member is adapted to when being in the unlocked configuration Enough allow the actuating of the closure driving device and the percussion driving device, and wherein, when being in the locked configuration, Second latching member is configured to prevent the actuating of the closure driving device and the percussion driving device.

2. surgery suturing appliance according to claim 1, wherein first latching member further includes latch shaft, the locking Axis can operatively be engaged with the rotation input component, so that when first latching member is in the locked configuration, it is described First latching member prevents the rotation input component from rotating.

3. surgery suturing appliance according to claim 2, wherein the latch shaft includes spring-loaded interference gear, institute Spring-loaded interference gear is stated to be configured to engage described when first latching member is in the locked configuration Two jaws.

4. surgery suturing appliance according to claim 1 further includes storehouse driver, wherein second latching member further includes Storehouse driver engagement arm, the storehouse driver engagement arm are configured to be driven in the storehouse driver engagement arm by the nail of nail bin Second latching member is moved to the unlocked configuration from the locked configuration when dynamic device engagement.

5. surgery suturing appliance according to claim 4, wherein second latching member is configured in the storehouse Driver prevents the retraction of the staple drivers when bouncing back from firing position.

6. surgery suturing appliance according to claim 1, wherein the closure driving device and the percussion driving device Shared common driver axis.

7. surgery suturing appliance according to claim 1 further includes nail bin.

8. surgery suturing appliance according to claim 7, wherein the nail bin includes positioning indicator, the state instruction Device is configured to show cock during surgical stapling operates.

9. surgery suturing appliance according to claim 8, wherein the nail bin includes window, and wherein the state refers to Show that device includes the visible visual indicia in the window.

10. surgery suturing appliance according to claim 7, wherein the end effector assembly further includes tissue retaining pin Mechanism, the tissue keep pin mechanism to be configured to activating automatic deployment and retraction in the closure driving device The tissue retaining pin of the nail bin.

11. surgery suturing appliance according to claim 10, wherein it includes manual override system that the tissue, which keeps pin mechanism, System, the manual override system are configured to provide the ability for organizing retaining pin described in manual retrieving to user.

12. surgery suturing appliance according to claim 11, wherein it includes a pair of lever arms that the tissue, which keeps pin mechanism, The pair of lever arm respectively includes the actuator tab engaged with second jaw, and the wherein manual override system It is configured to be detached from each actuator tab and second jaw.

13. surgery suturing appliance according to claim 12, wherein second jaw includes closure frame, the closure Frame includes the respective slots engaged with the actuator tab, is automatically controlled with the activating in the closure driving device The tissue keeps pin mechanism.

14. a kind of surgery suturing appliance, comprising:

Axis；

Actuated articulation joints；With

End effector assembly, the end effector assembly include:

First jaw；

Second jaw, second jaw can be mobile relative to first jaw；

Anvil block, the anvil block are configured to deform nail；

Drive system, the drive system include:

Rotate input component；

Main drive, the main drive include the first input tooth being configured to by the rotation input component driving Wheel, wherein the main drive is configured to move second jaw and fires multiple nails from nail bin；With

Blocking drive, the blocking drive include:

Second input gear, second input gear are configured to be driven by the rotation input component；

Unlocked configuration when nail bin is mounted in the end effector assembly, wherein the blocking drive is configured to The main drive can be allowed to be driven when the blocking drive is in the unlocked configuration；With

When nail bin is not installed in the end effector assembly and the blocking drive prevents the main drive Locked configuration when being driven；With

Second latching member, second latching member include locked configuration and Dang Fei percussion nail bin be mounted on the end effector Unlocked configuration when in component, wherein second latching member is configured to allow institute when being in the unlocked configuration The actuating of main drive is stated, and wherein, when being in the locked configuration, second latching member is configured to prevent The only actuating of the main drive.

15. surgery suturing appliance according to claim 14 further includes the nail bin.

16. surgery suturing appliance according to claim 14, wherein the blocking drive includes being configured to The interference gear locked by second jaw.

17. surgery suturing appliance according to claim 14, wherein the main drive and the blocking drive It is inputted including common driver.

18. a kind of surgical stapling attachment for being configured to be attached to surgical instruments shank, the surgical stapling attachment Include:

Attachment part；

Axis；With

End effector assembly, the end effector assembly include:

Non- clamping configuration and clamping configuration；

Replaceable nail bin, the replaceable nail bin include warehouse and are removedly stored in the intracorporal multiple nails in the storehouse, wherein The replaceable nail bin is configured to be mounted in the end effector assembly；

Anvil block, the anvil block are configured to deform the nail；

Drive system, the drive system include:

Rotate input component；

Main drive, the main drive is engaged with rotation input component driving, wherein the main drive is by structure It causes that the warehouse and the anvil block can be made to approach and fires the nail；With

Blocking drive, the blocking drive are engaged with rotation input component driving, wherein the latch actuation fills It sets non-clamping configuration described in being configured to be in when the end effector assembly and the replaceable nail bin is not installed When in the end effector assembly, prevent the main drive from being driven；With

Latch members, the latch members are configured to be in the non-clamping configuration simultaneously when the end effector assembly And the replaceable nail bin prevents the actuating of the main drive when being fired.

19. surgical stapling attachment according to claim 18, further includes closure frame, wherein the blocking drive Including interfering gear, and wherein, the closure frame is configured to be not installed at the end effector when the nail bin Prevent the interference gear from rotating when in component.

20. surgical stapling attachment according to claim 18, wherein the main drive includes first axle, and The blocking drive includes second axis, and wherein the first axle with the second axis is parallel.