CN109310427A - 用于操作外科器械的方法 - Google Patents

用于操作外科器械的方法 Download PDF

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CN109310427A
CN109310427A CN201780036320.4A CN201780036320A CN109310427A CN 109310427 A CN109310427 A CN 109310427A CN 201780036320 A CN201780036320 A CN 201780036320A CN 109310427 A CN109310427 A CN 109310427A
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surgical instruments
motor
driving
processor
patent application
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CN109310427B (zh
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F·E·谢尔顿四世
M·D·奥尔梅亚
D·C·耶茨
J·L·哈里斯
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Angiotech Pharmaceuticals Inc
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Angiotech Pharmaceuticals Inc
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Abstract

本发明公开了一种外科器械，所述外科器械被构造成能够补偿电池组和驱动系故障。一种方法包括：生成击发序列，确定可再充电电池单元的子集在所述击发序列期间是否被损坏，以及响应于确定所述可再充电电池单元的子集被损坏而逐渐升高所述电池组的输出电压以完成所述击发序列。另一种方法包括：生成机械输出以促动驱动系将运动传输到所述外科器械的钳口组件，响应于所述驱动系的紧急故障而激活安全模式，以及响应于所述驱动系的灾难性故障而激活救助模式。另一种方法包括：驱动驱动系，感测并记录来自所述驱动系的振动信息，基于所述振动信息来生成输出信号，以及基于所述输出信号来确定所述外科器械的状态。

Description

用于操作外科器械的方法
背景技术
本发明涉及外科器械，并且在各种布置中，涉及被设计成缝合和切割组织的外科缝合和切割器械及与其一起使用的钉仓。
附图说明
各个方面的特征在所附权利要求书中进行了具体描述。然而，通过结合如下附图参考以下说明可最好地理解关于操作的组织和方法的各个方面及其优点：
图1是根据本公开的包括外科器械、适配器和端部执行器的机电外科系统的透视拆卸图；
图2是根据本公开的至少一个方面的图1的外科器械的透视图；
图3是根据本公开的至少一个方面的图1的外科器械的透视分解图；
图4是根据本公开的至少一个方面的图1的外科器械的电池的透视图；
图5是根据本公开的至少一个方面的图1的外科器械的顶部部分拆卸图；
图6是根据本公开的至少一个方面的图1的外科器械的前部透视图，其中适配器与其分离；
图7是根据本公开的至少一个方面的通过图2的7-7截取的图1的外科器械的侧面剖视图；
图8是根据本公开的至少一个方面的通过图2的8-8截取的图1的外科器械的顶部剖视图；
图9是根据本公开的至少一个方面的图1的端部执行器的透视分解图；
图10A是根据本公开的至少一个方面的锁定构件的顶视图；
图10B是根据本公开的至少一个方面的图10A的锁定构件的透视图；
图11是根据本公开的至少一个方面的图1的外科器械的示意图；
图12是根据本公开的至少一个方面的机电外科系统的透视图，其中零部件分离；
图13是根据本公开的至少一个方面的图12的机电外科系统的轴组件和电动外科器械的后部透视图，其中示出了它们之间的连接；
图14是根据本公开的至少一个方面的图13的轴组件的透视图，其中零部件分离；
图15是根据本公开的至少一个方面的图13的轴组件的传动外壳的透视图，其中零部件分离；
图16是根据本公开的至少一个方面的支撑在图15的传动外壳中的第一齿轮系系统的透视图；
图17是根据本公开的至少一个方面的支撑在图15的传动外壳中的第二齿轮系系统的透视图；
图18是根据本公开的至少一个方面的支撑在图15的传动外壳中的第三驱动轴的透视图；
图19是根据本公开的至少一个方面的外科器械的透视图；
图19A是根据本公开的至少一个方面的图19的外科器械的顶视图；
图20是根据本公开的至少一个方面的图20的外科器械的各个部件的电路图；
图21是根据本公开的至少一个方面的包括用于响应于图19的外科器械的驱动系故障的步骤的逻辑图；
图22是根据本公开的至少一个方面的图19的外科器械的安全模式的逻辑图；
图22A是根据本公开的至少一个方面的包括用于响应于图19的外科器械的驱动系故障的步骤的逻辑图；
图23是根据本公开的至少一个方面的概述图22的安全模式下的马达调制的曲线图；
图23A是根据本公开的至少一个方面的概述图22的安全模式下的马达调制的曲线图；
图24是根据本公开的至少一个方面的包括用于响应图19的外科器械的驱动系故障的步骤的逻辑图；
图25是根据本公开的至少一个方面的图19的外科器械的救助模式的逻辑图；
图26A是根据本公开的至少一个方面的外科器械的局部透视图；
图26B是根据本公开的至少一个方面的图26A的外科器械的电源组的透视图；
图27是根据本公开的至少一个方面的概述评估图26B的电源组的健康状况以及响应于所检测到的电源组健康状况下降的方法的逻辑图；
图28是根据本公开的至少一个方面的图26A的外科器械的模块的逻辑图；
图29是根据本公开的至少一个方面的图27的方法的步骤的逻辑图；
图30是根据本公开的至少一个方面的图27的方法的步骤的逻辑图；
图31是根据本公开的至少一个方面的图27的方法的步骤的逻辑图；
图32是根据本公开的至少一个方面的图26A的外科器械的模块的电路图；
图33是根据本公开的至少一个方面的惠斯通电桥电路；
图34是根据本公开的至少一个方面的耦合到串联布置的多个电池单元的电子控制电路；
图35是根据本公开的至少一个方面的用于基于传感器读数来评估电源组的健康状况的逻辑图；
图36是根据本公开的至少一个方面的外科器械的透视图；
图36A是根据本公开的至少一个方面的图36的外科器械的顶视图；
图36B是根据本公开的至少一个方面的图36的外科器械的局部分解图；
图37是根据本公开的至少一个方面的马达仓的透视图；
图38是根据本公开的至少一个方面的图37的外科器械的各个部件的电路图；
图39是根据本公开的至少一个方面的概述监测马达仓的健康状况的方法的逻辑图；
图40是根据本公开的至少一个方面的概述采用电流传感器来监测马达仓的健康状况的方法的逻辑图；
图41是根据本公开的至少一个方面的概述图37的外科器械的模块的逻辑图；
图42是根据本公开的至少一个方面的概述图37的外科器械的模块的逻辑图；
图43是根据本公开的至少一个方面的外科器械的透视图；
图44是根据本公开的至少一个方面的图43的外科器械的各个部件的电路图；
图45是根据本公开的至少一个方面的包括麦克风的电路图，该麦克风与耦合到多个逻辑门的多个滤波器通信；
图46是根据本公开的至少一个方面的以伏特为单位的麦克风输出与以秒为单位的时间的曲线图，该曲线图表示在外科器械的操作期间由麦克风记录的正常运转的图43的外科器械的振动响应；
图46A是根据本公开的至少一个方面的图46的麦克风输出的滤波信号；
图47是根据本公开的至少一个方面的以伏特为单位的麦克风输出与以秒为单位的时间的曲线图，该曲线图表示在外科器械的操作期间由麦克风记录的出现故障的图43的外科器械的振动响应；
图47A是根据本公开的至少一个方面的图47的麦克风输出的滤波信号；
图48是根据本公开的至少一个方面的包括图43的外科器械的传感器的电路图，该传感器耦合到经由多路复用器和模数转换器与微控制器通信的多个滤波器；
图48A是根据本公开的至少一个方面的包括图43的外科器械的传感器的电路图，该传感器耦合到经由多路复用器和模数转换器与微控制器通信的多个滤波器；
图48B至图48D示出了根据本公开的至少一个方面的图43的外科器械的带通滤波器的结构和操作特性；
图49是根据本公开的至少一个方面的表示图43的外科器械的传感器输出的滤波信号的曲线图；
图50是根据本公开的至少一个方面的表示图43的外科器械的传感器输出的处理信号的曲线图；
图51是根据本公开的至少一个方面的表示与图43的外科器械的驱动组件距离起始位置的位移位置有关的击发该外科器械所需的力(FTF)的曲线图；
图52是根据本公开的至少一个方面的表示在击发冲程期间与驱动组件距离起始位置的位移位置有关的图43的外科器械的驱动组件的速度的曲线图；
图53是根据本公开的至少一个方面的表示图43的外科器械的击发冲程期间基于冲程位置的区域的容许限值修改的曲线图；
图54是根据本公开的至少一个方面的表示图43的外科器械的传感器的输出的处理信号的曲线图，其中示出了由于在击发冲程期间驱动组件经历的负载和速度变化而引起的处理信号的频率响应的变化；
图55是根据本公开的至少一个方面的表示在操作区域期间由图43的外科器械的传感器捕获的振动的处理信号的曲线图，该曲线图示出了操作区域的容许限值、边际限值和临界限值；
图56是根据本公开的至少一个方面的图43的外科器械的逻辑图；
图57是根据本公开的至少一个方面的表示由图43的外科器械的传感器捕获的振动的处理信号的曲线图；
图58是根据本公开的至少一个方面的表示由图43的外科器械的传感器捕获的振动的处理信号的曲线图；
图59是根据本公开的至少一个方面的表示由图43的外科器械的传感器捕获的振动的处理信号的曲线图；
图60是根据至少一个实施方案的外科器械系统的透视图；
图61是根据至少一个实施方案的旋转驱动击发组件的一部分和外科钉仓的滑动件的透视图，其中滑动件处于起始位置并且击发组件处于第一“解锁”位置；
图62是图61的旋转驱动击发组件实施方案的处于第二“锁定”位置的部分的另一透视图，其中滑动件不在起始位置；
图63是根据至少一个实施方案的最初安装在外科端部执行器中的外科钉仓的侧正视图，该外科端部执行器被构造成能够切割和缝合组织；
图64是安置在图63的外科端部执行器的通道中的外科钉仓的另一侧正视图，其中该外科钉仓的滑动件处于起始位置并且与外科器械的击发构件接合；
图65是安置在图63的外科端部执行器的通道中的部分使用的外科钉仓的另一侧正视图，其中外科钉仓的滑动件不在起始位置；
图66是根据至少一个实施方案的旋转驱动击发组件的一部分以及外科切割和缝合端部执行器的通道的透视图，其中击发组件处于“锁定”位置；
图67是图66的旋转驱动击发组件的一部分和外科钉仓的滑动件的另一透视图，其中滑动件处于起始位置并且击发组件处于“解锁”位置；
图68是根据至少一个实施方案的螺母部分的透视图；
图69是以剖面示出的安装到相应通道实施方案中的图68的螺母部分的透视图；
图70是图69的通道和螺母部分的剖面正视图，其中螺母部分处于锁定位置；
图71是图69和图70的通道和螺母部分的另一剖面正视图，其中螺母部分处于解锁位置；
图72是图69至图71的通道和螺母部分的另一剖面正视图，其中螺母部分处于锁定位置并且示出了外科钉仓的滑动件最初安装到通道中，为清楚起见省略了仓体；
图73是图72的通道、螺母部分和滑动件的另一剖面正视图，其中滑动件被安装成以便将螺母部分移动到解锁位置；
图74是根据至少一个实施方案的外科切割和缝合端部执行器的剖面侧正视图；
图75是图74的外科端部执行器的砧座组件的分解透视组装图；
图76是图75的砧座组件的剖视图；
图77是图74的外科端部执行器的剖视图，其中其击发构件组件处于锁定位置；
图78是图77的外科端部执行器在其近侧端部处截取的另一剖视图，其中击发构件组件处于解锁位置；
图79是图77的外科端部执行器在图78的视图远侧的位置处截取的另一剖视图；
图80是根据至少一个实施方案的包括柄部和可替换装载单元的外科缝合器械的透视图；
图81是图80的装载单元的透视图，该装载单元被示为具有从该装载单元拆下的钉仓钳口；
图82是根据至少一个实施方案的包括柄部和可替换装载单元的外科缝合器械的透视图；
图83是图82的装载单元的透视图；
图84示出了图82的柄部和装载单元的连接部分；
图85是图80的装载单元的端部执行器的剖视图；
图86是图80的钉仓钳口与钉装载单元的框架之间的附接的详细视图；
图87是根据至少一个实施方案的装载单元的端部执行器的剖视图；
图88是图87的钉仓钳口与装载单元的框架之间的附接的详细视图；
图89是图87的装载单元的框架的透视图；
图90是图87的钉仓钳口的近侧端部的详细视图；
图91是示出图87的框架与钉仓钳口之间的连接的详细视图；
图92是根据至少一个实施方案的钉仓钳口的分解图；
图93是根据至少一个实施方案的装载单元的局部透视图；
图94是根据至少一个实施方案的装载单元的框架的局部正视图，该装载单元被示为没有附接到其上的钉仓钳口；
图95是附接到图94的装载单元的框架的钉仓钳口的局部正视图；
图96是被示为处于夹持构型的图94的装载单元的局部正视图；
图97是被示为处于部分击发构型的图94的装载单元的局部正视图；
图98是根据至少一个实施方案的装载单元的框架的局部正视图，该装载单元被示为没有附接到其上的钉仓钳口；
图99是附接到图98的装载单元的框架的钉仓钳口的局部正视图；
图100是被示为处于夹持构型的图98的装载单元的局部正视图；
图101是被示为处于部分击发构型的图98的装载单元的局部正视图；
图102是图98的装载单元的局部透视图，该装载单元被示为具有附接到框架的钉仓钳口；
图103是根据至少一个实施方案的附接到装载单元的框架的钉仓钳口的局部透视图；
图104是将图103的钉仓钳口附接到被构造成能够接收不同钉仓钳口的装载单元的试件的局部正视图；
图105是附接到图103的装载单元的框架的图103的钉仓钳口的局部正视图；
图106是根据至少一个实施方案的钉仓钳口与装载单元的框架之间的连接的局部正视图；
图107是图106的装载单元的局部正视图；
图108是被构造成能够与附接到图106的装载单元的除了图106的装载单元之外的不同装载单元一起使用的钉仓钳口的局部正视图；
图109是外科器械系统的局部正视图，该外科器械系统包括被示为处于锁定构型的可偏转闭锁布置；
图110是图109的外科器械系统的局部正视图，其中闭锁布置被示为处于解锁构型；
图111是外科器械系统的局部正视图，该外科器械系统包括被示为处于锁定构型的磁性闭锁布置；
图112是图111的外科器械系统的局部正视图，其中磁性闭锁布置被示为处于解锁构型；
图113是被示为处于部分击发构型的图111的外科器械系统的局部正视图；
图114是用于外科器械系统的钉仓的局部透视图，其中钉仓包括被构造成能够控制外科器械系统的闭锁布置的驱动器；
图115是与图114的钉仓一起使用的滑动件的透视图；
图116是图114的钉仓的假驱动器的透视图；
图117是利用图114的钉仓的外科器械系统的局部正视图，其中外科器械系统包括闭锁布置，该闭锁布置被构造成能够限制击发构件的运动，直到钉仓被装载到外科器械系统中；
图118是图117的外科器械系统的局部正视图，其中闭锁布置被示为处于解锁构型；
图119是被示为处于部分击发构型的图117的外科器械系统的局部正视图；
图120是与外科器械系统一起使用的钉仓的局部透视图，其中外科器械系统包括闭锁电路，该闭锁电路包括可断开构件；
图121是图120的外科器械系统的剖视平面图，其中外科器械系统还包括电磁体和闭锁构件，其中闭锁构件被示为处于解锁位置，并且其中闭锁电路处于闭合构型；
图122是图120的外科器械系统的剖视平面图，其中闭锁构件被示为处于锁定位置，并且其中闭锁电路处于打开构型；
图123是外科器械系统的透视图，其中外科器械系统包括电路闭锁布置，该电路闭锁布置包括定位在滑动件上与钉仓一起使用的电接触件；
图124是图123的外科器械系统的局部正视图；
图125是击发构件闭锁件的局部剖视图，其中示出了处于锁定构型的击发构件闭锁件；
图126是沿着图125的线126-126截取的图125的击发构件闭锁件的剖视图；
图127是图125的击发构件闭锁件的局部剖视图，其中示出了处于解锁构型的击发构件闭锁件；
图128是沿着图127的线128-128截取的图125的击发构件闭锁件的剖视图；
图129是沿着图127的线129-129截取的图125的击发构件闭锁件的剖视平面图；
图130是根据至少一个实施方案的包括未用过钉仓的缝合组件的局部正视图；
图131是图130的缝合组件的局部平面图；
图132是被示为处于用过状态的图130的缝合组件的局部正视图；
图133是被示为处于图132的状态的图130的缝合组件的局部平面图；
图134是根据至少一个实施方案的包括未用过钉仓的缝合组件的局部透视图；
图135是被示为处于用过状态的图134的缝合组件的局部透视图；
图136是出于图示目的以移除部件而示出的缝合组件的局部透视图；
图137示出了图136的缝合组件的销，该销被构造成能够影响缝合组件的检测电路；
图138是图136的缝合组件的某些部件的局部透视图；
图139是图136的缝合组件的轴外壳的局部透视图；
图140是根据至少一个实施方案的钉仓的局部平面图；
图140A示出了在至少一个实施方案中击发钉仓时所经历的击发力分布曲线；
图141是根据至少一个实施方案的包括闭锁件的缝合组件的局部剖视图；
图142是被示为处于锁定构型的图141的缝合组件的局部剖视图；
图143是根据至少一个实施方案的包括闭锁件的缝合组件的局部剖视图；
图144是根据至少一个实施方案的包括闭锁件的缝合组件的局部剖视图；
图145是根据至少一个实施方案的包括制动器的缝合组件的局部剖视图；
图146是根据至少一个实施方案的包括阻尼系统的缝合组件的局部剖视图；
图147是示出根据至少一个实施方案的包括电磁制动器的缝合组件的示意图；
图148是根据至少一个实施方案的包括阻尼系统的缝合组件的局部剖视图；
图149是被构造成能够检测钉击发构件的位置和行进的电路，其中示出了处于完全击发位置的钉击发构件；
图150示出了处于完全回缩位置的图149的钉击发构件；
图151是根据至少一个实施方案的包括闭锁件的缝合组件的剖视图，该缝合组件被示为处于解锁构型；
图152是被示为处于其解锁构型的图151的缝合组件的剖面端视图；
图153是被示为处于锁定构型的图151的缝合组件的剖视图；并且
图154是被示为处于其锁定构型的图151的缝合组件的剖面端视图。
具体实施方式
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL INSTRUMENT COMPRISING A LOCKOUT”的美国专利申请序列号________，代理人案卷号END7828USNP/150542；
-名称为“SURGICAL INSTRUMENT COMPRISING A PRIMARY FIRING LOCKOUT AND ASECONDARY FIRING LOCKOUT”的美国专利申请序列号________；代理人案卷号END7787USNP/150522；
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING A MAGNETIC LOCKOUT”的美国专利申请序列号________，代理人案卷号END7789USNP/150503；
-名称为“SURGICAL INSTRUMENT COMPRISING A REPLACEABLE CARTRIDGE JAW”的美国专利申请序列号________，代理人案卷号END7790USNP/150504；以及
-名称为“CARTRIDGE LOCKOUT ARRANGEMENTS FOR ROTARY POWERED SURGICALCUTTING AND STAPLING INSTRUMENTS”的美国专利申请序列号________，代理人案卷号END7791USNP/150505。
本申请的申请人拥有于2016年4月15日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“STAPLE FORMATION DETECTION MECHANISMS”的美国专利申请序列号15/130,575；
-名称为“SURGICAL INSTRUMENT WITH DETECTION SENSORS”的美国专利申请序列号15/130,582；
-名称为“SURGICAL INSTRUMENT WITH IMPROVED STOP/START CONTROL DURING AFIRING MOTION”的美国专利申请序列号15/130,588；
-名称为“SURGICAL INSTRUMENT WITH ADJUSTABLE STOP/START CONTROL DURINGA FIRING MOTION”的美国专利申请序列号15/130,595；
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE PROGRAM RESPONSES DURING AFIRING MOTION”的美国专利申请序列号15/130,566；
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE PROGRAM RESPONSES DURING AFIRING MOTION”的美国专利申请序列号15/130,571；
-名称为“MODULAR SURGICAL INSTRUMENT WITH CONFIGURABLE OPERATING MODE”的美国专利申请序列号15/130,581；
-名称为“SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING ANDCUTTING INSTRUMENT”的美国专利申请序列号15/130,590；以及
-名称为“SYSTEMS AND METHODS FOR CONTROLLING A SURGICAL STAPLING ANDCUTTING INSTRUMENT”的美国专利申请序列号15/130,596。
本申请的申请人拥有于2016年4月1日提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM”的美国专利申请序列号15/089,325；
-名称为“MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY”的美国专利申请序列号15/089,321；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD”的美国专利申请序列号15/089,326；
-名称为“SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIPPORTION”的美国专利申请序列号15/089,263；
-名称为“ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLEBAILOUT SYSTEM”的美国专利申请序列号15/089,262；
-名称为“SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVILCONCENTRIC DRIVE MEMBER”的美国专利申请序列号15/089,277；
-名称为“CLOSURE SYSTEM ARRANGEMENTS FOR SURGICAL CUTTING AND STAPLINGDEVICES WITH SEPARATE AND DISTINCT FIRING SHAFTS”的美国专利申请序列号15/089,283；
-名称为“INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL ENDEFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS”的美国专利申请序列号15/089,296；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION”的美国专利申请序列号15/089,258；
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVECUTTING OF TISSUE”的美国专利申请序列号15/089,278；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT”的美国专利申请序列号15/089,284；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSIONLOCKOUT”的美国专利申请序列号15/089,295；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT”的美国专利申请序列号15/089,300；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT”的美国专利申请序列号15/089,196；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT”的美国专利申请序列号15/089,203；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGELOCKOUT”的美国专利申请序列号15/089,210；
-名称为“SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM”的美国专利申请序列号15/089,324；
-名称为“SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS”的美国专利申请序列号15/089,335；
-名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/089,339；
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OFSTAPLES HAVING DIFFERENT HEIGHTS”的美国专利申请序列号15/089,253；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET”的美国专利申请序列号15/089,304；
-名称为“ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS”的美国专利申请序列号15/089,331；
-名称为“STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES”的美国专利申请序列号15/089,336；
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUESUPPORT”的美国专利申请序列号15/089,312；
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM”的美国专利申请序列号15/089,309；以及
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL”的美国专利申请序列号15/089,349。
本申请的申请人还拥有于2015年12月31日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE INPOWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/984,488；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/984,525；以及
-名称为“SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROLCIRCUITS”的美国专利申请序列号14/984,552。
本申请的申请人还拥有于2016年2月9日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLYTRANSLATABLE END EFFECTOR”的美国专利申请序列号15/019,220；
-名称为“SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,228；
-名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTEDSECONDARY CONSTRAINT”的美国专利申请序列号15/019,196；
-名称为“SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLYARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY”的美国专利申请序列号15/019,206；
-名称为“SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,215；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATIONLINK ARRANGEMENTS”的美国专利申请序列号15/019,227；
-名称为“SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLEDRIVEN ARTICULATION SYSTEMS”的美国专利申请序列号15/019,235；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAMARRANGEMENTS”的美国专利申请序列号15/019,230；以及
-名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTIONARRANGEMENTS”的美国专利申请序列号15/019,245。
本申请的申请人还拥有于2016年2月12日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,254；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,259；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,275；以及
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,289。
本申请的申请人拥有于2015年6月18日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL END EFFECTORS WITH POSITIVE JAW OPENINGARRANGEMENTS”的美国专利申请序列号14/742,925；
-名称为“SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSINGFEATURES”的美国专利申请序列号14/742,941；
-名称为“MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,914；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAMSTRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT”的美国专利申请序列号14/742,900；
-名称为“DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,885；以及
-名称为“PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,876。
本申请的申请人拥有于2015年3月6日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“POWERED SURGICAL INSTRUMENT”的美国专利申请序列号14/640,746；
-名称为“MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/640,795；
-名称为“ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURERATES FOR MULTIPLE TISSUE TYPES”的美国专利申请序列号14/640,832，代理人案卷号END7557USNP/140482；
-名称为“OVERLAID MULTI SENSOR RADIO FREQUENCY(RF)ELECTRODE SYSTEM TOMEASURE TISSUE COMPRESSION”的美国专利申请序列号14/640,935；
-名称为“MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTORFOR POWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/640,831；
-名称为“TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINESTABILITY,CREEP,AND VISCOELASTIC ELEMENTS OF MEASURES”的美国专利申请序列号14/640,859；
-名称为“INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/640,817；
-名称为“CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULARSHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE”的美国专利申请序列号14/640,844；
-名称为“SMART SENSORS WITH LOCAL SIGNAL PROCESSING”的美国专利申请序列号14/640,837；
-名称为“SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGEINTO A SURGICAL STAPLER”的美国专利申请序列号14/640,765；
-名称为“SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON AROTATABLE SHAFT”的美国专利申请序列号14/640,799；以及
名称为“SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING”的美国专利申请序列号14/640,780。
本申请的申请人拥有于2015年2月27日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION”的美国专利申请序列号14/633,576；
-名称为“SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCEPARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND”的美国专利申请序列号14/633,546；
-名称为“SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONEOR MORE BATTERIES”的美国专利申请序列号14/633,576；
-名称为“CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FORCHARGING A BATTERY”的美国专利申请序列号14/633,566；
-名称为“SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TOBE SERVICED”的美国专利申请序列号14/633,555；
-名称为“REINFORCED BATTERY FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,542；
-名称为“POWER ADAPTER FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,548；
-名称为“ADAPTABLE SURGICAL INSTRUMENT HANDLE”的美国专利申请序列号14/633,526；
-名称为“MODULAR STAPLING ASSEMBLY”的美国专利申请序列号14/633,541；以及
-名称为“SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFEPARAMETER”的美国专利申请序列号14/633,562。
本申请的申请人拥有于2014年12月18日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE ENDEFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING”的美国专利申请序列号14/574,478；
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS”的美国专利申请序列号14/574,483；
-名称为“DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS”的美国专利申请序列号14/575,139；
-名称为“LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITHARTICULATABLE SURGICAL END EFFECTORS”的美国专利申请序列号14/575,148；
-名称为“SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLEABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE”的美国专利申请序列号14/575,130；
-名称为“SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS”的美国专利申请序列号14/575,143；
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDMOVABLE FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,117；
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDIMPROVED FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,154；
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLEARTICULATION SYSTEM”的美国专利申请序列号14/574,493；以及
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLEARTICULATION SYSTEM”的美国专利申请序列号14/574,500。
本申请的申请人拥有于2013年3月1日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“Articulatable Surgical Instruments With Conductive PathwaysFor Signal Communication”的美国专利申请序列号13/782,295，现为美国专利申请公布2014/0246471；
-名称为“Rotary Powered Articulation Joints For Surgical Instruments”的美国专利申请序列号13/782,323，现为美国专利申请公布2014/0246472；
-名称为“Thumbwheel Switch Arrangements For Surgical Instruments”的美国专利申请序列号13/782,338，现为美国专利申请公布2014/0249557；
-名称为“Electromechanical Surgical Device with Signal RelayArrangement”的美国专利申请序列号13/782,499，现为美国专利申请公布2014/0246474；
-名称为“Multiple Processor Motor Control for Modular SurgicalInstruments”的美国专利申请序列号13/782,460，现为美国专利申请公布2014/0246478；
-名称为“Joystick Switch Assemblies For Surgical Instruments”的美国专利申请序列号13/782,358，现为美国专利申请公布2014/0246477；
-名称为“Sensor Straightened End Effector During Removal ThroughTrocar”的美国专利申请序列号13/782,481，现为美国专利申请公布2014/0246479；
-名称为“Control Methods for Surgical Instruments with RemovableImplement Portions”的美国专利申请序列号13/782,518，现为美国专利申请公布2014/0246475；
-名称为“Rotary Powered Surgical Instruments With Multiple Degrees ofFreedom”的美国专利申请序列号13/782,375，现为美国专利申请公布2014/0246473；以及
-名称为“SURGICAL INSTRUMENT SOFT STOP”的美国专利申请序列号13/782,536，现为美国专利申请公布2014/0246476。
本申请的申请人还拥有于2013年3月14日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE”的美国专利申请序列号13/803,097，现为美国专利申请公布2014/0263542；
-名称为“CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICALINSTRUMENT”的美国专利申请序列号13/803,193，现为美国专利申请公布2014/0263537；
-名称为“INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICALINSTRUMENT”的美国专利申请序列号13/803,053，现为美国专利申请公布2014/0263564；
-名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATIONLOCK”的美国专利申请序列号13/803,086，现为美国专利申请公布2014/0263541；
-名称为“SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FORSURGICAL INSTRUMENTS”的美国专利申请序列号13/803,210，现为美国专利申请公布2014/0263538；
-名称为“MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT”的美国专利申请序列号13/803,148，现为美国专利申请公布2014/0263554；
-名称为“DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/803,066，现为美国专利申请公布2014/0263565；
-名称为“ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICALINSTRUMENTS”的美国专利申请序列号13/803,117，现为美国专利申请公布2014/0263553；
-名称为“DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/803,130，现为美国专利申请公布2014/0263543；以及
-名称为“METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT”的美国专利申请序列号13/803,159，现为美国专利申请公布2014/0277017。
本申请的申请人还拥有于2014年3月7日提交且全文以引用方式并入本文的以下专利申请：
-名称为“CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/200,111，现为美国专利申请公布2014/0263539。
本申请的申请人还拥有于2014年3月26日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,106，现为美国专利申请公布2015/0272582；
-名称为“STERILIZATION VERIFICATION CIRCUIT”的美国专利申请序列号14/226,099，现为美国专利申请公布2015/0272581；
-名称为“VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT”的美国专利申请序列号14/226,094，现为美国专利申请公布2015/0272580；
-名称为“POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUITAND WAKE UP CONTROL”的美国专利申请序列号14/226,117，现为美国专利申请公布2015/0272574；
-名称为“MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFTASSEMBLIES”的美国专利申请序列号14/226,075，现为美国专利申请公布2015/0272579；
-名称为“FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICALINSTRUMENTS”的美国专利申请序列号14/226,093，现为美国专利申请公布2015/0272569；
名称为“SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION”的美国专利申请序列号14/226,116，现为美国专利申请公布2015/0272571；
-名称为“SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETYPROCESSOR”的美国专利申请序列号14/226,071，现为美国专利申请公布2015/0272578；
-名称为“SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS”的美国专利申请序列号14/226,097，现为美国专利申请公布2015/0272570；
-名称为“INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,126，现为美国专利申请公布2015/0272572；
-名称为“MODULAR SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号14/226,133，现为美国专利申请公布2015/0272557；
-名称为“SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT”的美国专利申请序列号14/226,081，现为美国专利申请公布2015/0277471；
-名称为“POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLEVOLTAGE PROTECTION”的美国专利申请序列号14/226,076，现为美国专利申请公布2015/0280424；
-名称为“SURGICAL STAPLING INSTRUMENT SYSTEM”的美国专利申请序列号14/226,111，现为美国专利申请公布2015/0272583；以及
-名称为“SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT”的美国专利申请序列号14/226,125，现为美国专利申请公布2015/0280384。
本申请的申请人还拥有于2014年9月5日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,103，现为美国专利申请公布2016/0066912；
-名称为“ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUECOMPRESSION”的美国专利申请序列号14/479,119，现为美国专利申请公布2016/0066914；
-名称为“MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION”的美国专利申请序列号14/478,908，现为美国专利申请公布2016/0066910；
-名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'SOUTPUT OR INTERPRETATION”的美国专利申请序列号14/478,895，现为美国专利申请公布2016/0066909；
-名称为“USE OF POLARITY OF HALL MAGNET DETECTION TO DETECT MISLOADEDCARTRIDGE”的美国专利申请序列号14/479,110，现为美国专利申请公布2016/0066915；
-名称为“SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION”的美国专利申请序列号14/479,098，现为美国专利申请公布2016/0066911；
-名称为“MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,115，现为美国专利申请公布2016/0066916；以及
-名称为“LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION”的美国专利申请序列号14/479,108，现为美国专利申请公布2016/0066913。
本申请的申请人还拥有于2014年4月9日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVESHAFTS”的美国专利申请序列号14/248,590，现为美国专利申请公布2014/0305987；
-名称为“SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRINGDRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT”的美国专利申请序列号14/248,581，现为美国专利申请公布2014/0305989；
-名称为“SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLINGTHE OPERATION OF THE SURGICAL INSTRUMENT”的美国专利申请序列号14/248,595，现为美国专利申请公布2014/0305988；
-名称为“POWERED LINEAR SURGICAL STAPLER”的美国专利申请序列号14/248,588，现为美国专利申请公布2014/0309666；
-名称为“TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/248,591，现为美国专利申请公布2014/0305991；
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENTFEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS”的美国专利申请序列号14/248,584，现为美国专利申请公布2014/0305994；
-名称为“POWERED SURGICAL STAPLER”的美国专利申请序列号14/248,587，现为美国专利申请公布2014/0309665；
-名称为“DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICALINSTRUMENT”的美国专利申请序列号14/248,586，现为美国专利申请公布2014/0305990；以及
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUSINDICATION ARRANGEMENTS”的美国专利申请序列号14/248,607，现为美国专利申请公布2014/0305992。
本申请的申请人还拥有于2013年4月16日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,365；
-名称为“LINEAR CUTTER WITH POWER”的美国临时专利申请序列号61/812,376；
-名称为“LINEAR CUTTER WITH MOTOR AND PISTOL GRIP”的美国临时专利申请序列号61/812,382；
-名称为“SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS ANDMOTOR CONTROL”的美国临时专利申请序列号61/812,385；以及
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,372。
本文列出了许多具体细节，以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件，以免使说明书中描述的实施方案模糊不清。读者将会理解，本文所述和所示的实施方案为非限制性示例，从而可认识到，本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求的范围的情况下，可对这些实施方案进行变型和改变。
术语“包括(comprise)”(以及“包括(comprise)”的任何形式，诸如“包括(comprises)”和“包括(comprising)”)、“具有(have)”(以及“具有(have)”的任何形式，诸如“具有(has)”和“具有(having)”)、“包含(include)”(以及“包含(include)”的任何形式，诸如“包含(includes)”和“包含(including)”)、以及“含有(contain)”(以及“含有(contain)”的任何形式，诸如“含有(contains)”和“含有(containing)”)为开放式系动词。因此，“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件，但不限于仅具有这些一个或多个元件。同样，“包括”、“具有”、“包含”或“含有”一个或多个特征的系统、装置、或设备的元件具有那些一个或多个特征，但不限于仅具有那些一个或多个特征。
术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分，术语“远侧”是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而，外科器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以用于执行腹腔镜式和微创外科程序操作。然而，读者将容易理解，本文所公开的各种方法和装置可用于多种外科程序和应用中，包括例如与开放式外科程序结合。继续参阅本具体实施方式，读者将进一步理解，本文所公开的各种器械能够以任何方式插入体内，诸如通过自然腔道、通过形成于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可直接插入患者体内或者可通过具有工作通道的进入装置插入，外科器械的端部执行器和细长轴可通过所述工作通道推进。
外科缝合系统可包括轴和从轴延伸的端部执行器。端部执行器包括第一钳口和第二钳口。第一钳口包括钉仓。钉仓能够插入到第一钳口中并且能够从第一钳口移除；然而，设想到其中钉仓不能够从第一钳口移除或至少能够易于从第一钳口替换的其他实施方案。第二钳口包括被构造成能够使从钉仓射出的钉变形的砧座。第二钳口能够相对于第一钳口围绕闭合轴线枢转；然而，可设想到其中第一钳口能够相对于第二钳口枢转的其它实施方案。外科缝合系统还包括被构造成能够允许端部执行器相对于轴旋转或进行关节运动的关节运动接头。端部执行器能够围绕延伸穿过关节运动接头的关节运动轴线旋转。设想了不包括关节运动接头的其它实施方案。
钉仓包括仓体。仓体包括近侧端部、远侧端部和在近侧端部与远侧端部之间延伸的平台。在使用中，钉仓定位在待缝合的组织的第一侧上，并且砧座定位在组织的第二侧上。砧座朝向钉仓运动以将组织压缩并夹持抵靠平台。然后，可移除地储存在仓体中的钉可部署到组织中。仓体包括限定于其中的钉腔，其中钉可移除地储存在钉腔中。钉腔被布置成六纵向排。三排钉腔定位在纵向狭槽的第一侧上且三排钉腔定位在纵向狭槽的第二侧上。钉腔和钉的其它构造也是可以的。
钉由仓体中的钉驱动器支撑。驱动器能够在第一或非击发位置和第二或击发位置之间运动，以从钉仓射出钉。驱动器通过保持器保留在仓体中，保持器围绕仓体的底部延伸并且包括被构造成能够抓持仓体以及将保持器保持至仓体的弹性构件。驱动器能够通过滑动件在其非击发位置和击发位置之间运动。滑动件能够在与近侧端部相邻的近侧位置和与远侧端部相邻的远侧位置之间运动。滑动件包括多个斜坡表面，该斜坡表面被构造成能够朝向砧座在驱动器下方滑动以及提升驱动器，并且钉在驱动器上受到支撑。
除上述以外，滑动件还可通过击发构件朝远侧运动。击发构件被构造成能够接触滑动件并朝朝远侧端部推动滑动件。限定于仓体中的纵向狭槽被构造成能够接收击发构件。砧座还包括被构造成能够接收击发构件的狭槽。击发构件还包括接合第一钳口的第一凸轮和接合第二钳口的第二凸轮。在击发构件朝远侧推进时，第一凸轮和第二凸轮可控制钉仓的平台和砧座之间的距离或组织间隙。击发构件还包括被构造成能够切入在钉仓和砧座中间捕集的组织的刀。希望刀定位成至少部分接近斜坡表面，使得钉先于刀被射出。
在详细说明用于补偿电动外科器械中的驱动系故障的各种形式的机构之前，应该指出的是，例示性形式的应用或使用并不局限于附图和具体实施方式中所示出的零部件的构型和布置的细节。示例性形式可以单独实施，也可以与其它形式、变型和修改结合在一起实施，并可以通过多种方式实践或执行。此外，除非另外指明，否则本文所用的术语和表达是为了方便读者而对示例性形式进行描述目的所选的，并非为了限制性的目的。
此外，应当理解，下述形式、形式表达、示例中的任何一个或多个可与下述其它形式、形式表达和示例中的任何一个或多个组合。
各种形式涉及用于补偿电动外科器械中的驱动系故障的机构。在一种形式中，用于补偿电动外科器械中的驱动系故障的机构可被构造成用于开放式外科程序中，但也可应用于其他类型的手术中，诸如腹腔镜式、内窥镜式和机器人辅助程序。
图1至图18描绘了外科系统的各个方面，该外科系统通常被标记为100并且为电动手持式机电器械的形式，该电动手持式机电器械被构造成用于将多个不同的端部执行器选择性地附接到其上，每个端部执行器被构造成用于通过电动手持式机电外科器械致动和操纵。图1至图18的方面公开于以下文献中：于2012年10月23日提交且名称为“SURGICALINSTRUMENT WITH RAPID POST EVENT DETECTION”的美国专利申请公布2014/0110453、于2013年6月19日提交且名称为“APPARATUS FOR ENDOSCOPIC PROCEDURES”的美国专利申请公布2013/0282052，以及于2013年5月10日提交且名称为“APPARATUS FOR ENDOSCOPICPROCEDURES”的美国专利申请公布2013/0274722。
参见图1至图3，外科器械100被构造成用于与适配器200选择性地连接，并且适配器200又被构造成用于与端部执行器或单次使用的装载单元或再装载件300选择性地连接。如图1至图3所示，外科器械100包括柄部外壳102，该柄部外壳具有下部外壳部分104、从下部外壳部分104延伸和/或支撑在下部外壳部分上的中间外壳部分106，以及从中间外壳部分106延伸和/或支撑在中间外壳部分上的上部外壳部分108。中间外壳部分106和上部外壳部分108被分成与下部部分104一体形成并从下部部分延伸的远侧半节段110a，以及可通过多个紧固件连接到远侧半节段110a的近侧半节段110b。当结合时，远侧半节段110a和近侧半节段110b限定其中具有腔102a的柄部外壳102，电路板150和驱动机构160位于该腔中。
远侧半节段110a和近侧半节段110b沿着横穿上部外壳部分108的纵向轴线“X”的平面分开，如图2和图3所示。柄部外壳102包括垫圈112，该垫圈完全围绕远侧半节段110a和/或近侧半节段110b的边缘延伸并且插置在远侧半节段110a和近侧半节段110b之间。垫圈112密封远侧半节段110a和近侧半节段110b的周边。垫圈112用于在远侧半节段110a和近侧半节段110b之间建立气密密封，使得电路板150和驱动机构160免受消毒和/或清洁程序的影响。
这样，柄部外壳102的腔102a沿着远侧半节段110a和近侧半节段110b的周边密封，但仍被构造成使得电路板150和驱动机构160更容易、更有效地组装在柄部外壳102中。
柄部外壳102的中间外壳部分106提供了电路板150位于其中的外壳。电路板150被构造成能够控制外科器械100的各种操作。
外科器械100的下部外壳部分104限定形成在其上表面中的孔(未示出)，该孔位于中间外壳部分106下方或内部。下部外壳部分104的孔提供了通路，线152穿过该通路以将位于下部外壳部分104中的电气部件(如图4所示的电池156、如图3所示的电路板154等)与位于中间外壳部分106和/或上部外壳部分108中的电气部件(电路板150、驱动机构160等)电气互连。
柄部外壳102包括设置在下部外壳部分104的孔(未示出)内的垫圈103，由此堵塞或密封下部外壳部分104的孔，同时允许线152穿过其中。垫圈103用于在下部外壳部分106和中间外壳部分108之间建立气密密封，使得电路板150和驱动机构160免受消毒和/或清洁程序的影响。
如图所示，柄部外壳102的下部外壳部分104提供了可再充电电池156可移除地位于其中的外壳。电池156被构造成能够向外科器械100的任何电气部件供电。下部外壳部分104限定腔(未示出)，电池156插入该腔中。下部外壳部分104包括可枢转地连接到其上的门105，用于闭合下部外壳部分104的腔并将电池156保持在其中。
参考图3和图5，上部外壳部分108的远侧半节段110a限定鼻部或连接部分108a。鼻锥114支撑在上部外壳部分108的鼻部部分108a上。鼻锥114由透明材料制成。反馈指示器诸如照明构件116设置在鼻锥114内，使得通过其可看见照明构件116。照明构件116可以是发光二极管印刷电路板(LED PCB)。照明构件116被构造成能够照亮多种颜色，其中特定颜色图案与唯一的离散事件相关联。
柄部外壳102的上部外壳部分108提供了驱动机构160位于其中的外壳。如图5所示，驱动机构160被构造成能够驱动轴和/或齿轮部件，以便执行外科器械100的各种操作。具体地讲，驱动机构160被构造成能够驱动轴和/或齿轮部件，以便相对于端部执行器300的近侧主体部分302选择性地移动端部执行器300的工具组件304(参见图1和图9)，相对于柄部外壳102围绕纵向轴线“X”(参见图2)旋转端部执行器300，相对于端部执行器300的仓组件308移动砧座组件306，并且/或者击发端部执行器300的仓组件308内的缝合和切割仓。
驱动机构160包括相对于适配器200紧邻近侧定位的选择器齿轮箱组件162。在选择器齿轮箱组件162近侧的是具有第一马达164的功能选择模块163，该功能选择模块用于择性地将选择器齿轮箱组件162内的齿轮元件移动成与具有第二马达166的输入驱动部件165接合。
如图1至图4所示且如上所述，上部外壳部分108的远侧半节段110a限定连接部分108a，该连接部分被构造成能够接纳适配器200的相应驱动联接组件210。
如图6至图8所示，外科器械100的连接部分108a具有圆柱形凹陷部108b，当适配器200与外科器械100配合时，该凹口接收适配器200的驱动联接组件210。连接部分108a容纳三个可旋转驱动连接器118、120、122。
当适配器200与外科器械100配合时，外科器械100的可旋转驱动连接器118、120、122中的每一者与适配器200的相应可旋转连接器套管218、220、222联接，如图6所示。就这一点而言，相应的第一驱动连接器118和第一连接器套管218之间的接口、相应的第二驱动连接器120和第二连接器套管220之间的接口以及相应的第三驱动连接器122和第三连接器套管222之间的接口是键控的，使得外科器械100的驱动连接器118、120、122中每一者的旋转引起适配器200的相应连接器套管218、220、222的相应旋转。
外科器械100的驱动连接器118、120、122与适配器200的连接器套管218、220、222的配合允许经由三个相应的连接器接口中的每一者独立地传输旋转力。外科器械100的驱动连接器118、120、122被构造成能够通过驱动机构160独立地旋转。就这一点而言，驱动机构160的功能选择模块163选择由驱动机构160的输入驱动部件165驱动外科器械100的哪个或哪些驱动连接器118、120、122。
由于外科器械100的驱动连接器118、120、122中的每一者具有与适配器200的相应连接器套管218、220、222的键控和/或基本上不可旋转的接口，因此当适配器200联接到外科器械100时，一个或多个旋转力从外科器械100的驱动机构160选择性地转移到适配器200。
外科器械100的驱动连接器118、120和/或122的选择性旋转允许外科器械100选择性地致动端部执行器300的不同功能。外科器械100的第一驱动连接器118的选择性和独立旋转对应于端部执行器300的工具组件304的选择性和独立打开和闭合，以及端部执行器300的工具组件304的缝合/切割部件的驱动。而且，外科器械100的第二驱动连接器120的选择性和独立旋转对应于端部执行器300的工具组件304横向于纵向轴线“X”(参见图2)的选择性和独立关节运动。另外，外科器械100的第三驱动连接器122的选择性和独立旋转对应于端部执行器300相对于外科器械100的柄部外壳102围绕纵向轴线“X”(参见图2)的选择性和独立旋转。
如上所述且如图5和图8所示，驱动机构160包括选择器齿轮箱组件162；以及位于选择器齿轮箱组件162近侧的功能选择模块163，该功能选择模块用于选择性地将选择器齿轮箱组件162内的齿轮元件移动成与第二马达166接合。因此，驱动机构160在给定时间选择性地驱动外科器械100的驱动连接器118、120、122中的一者。
如图1至图3所示，柄部外壳102将控制组件107支撑在中间外壳部分108的远侧表面或侧面上。控制组件107是全功能机械子组件，其可在联接到器械100之前与器械的其余部分分开组装和测试。
控制组件107与中间外壳部分108配合，将一对手指致动的控制按钮124、126和一对摇杆装置128、130支撑在外壳107a内。控制按钮124、126分别联接到延伸轴125、127。具体地讲，控制组件107限定用于可滑动地接收延伸轴125的上部孔124a，以及用于可滑动地接收延伸轴127的下部孔126a。
控制组件107及其部件(例如，控制按钮124、126和摇杆装置128、130)可由低摩擦、自润滑、润滑的塑料或材料或者覆盖移动部件的涂层形成，以减小致动力和关键部件磨损，消除磨伤，实现平稳一致的致动，改进部件和组件的可靠性，并且减小间隙以实现更紧密的配合和手感一致性。这包括在衬套、摇杆轴颈、柱塞衬套、弹簧套座、保持环和滑块部件中使用塑料材料。用塑料模塑部件还提供了具有所有这些性能属性的网状或网眼状部件。塑料部件消除了电解条件(诸如，高压灭菌、蒸汽消毒和清洁)下的腐蚀和双金属阳极反应。与类似的金属部件相比，用润滑塑料和材料进行压配合还消除了间隙，同时使对部件的应变或功能损失最小。
用于形成控制组件107的部件的合适材料包括但不限于多胺、聚苯硫醚、聚邻苯二甲酰胺、聚苯砜、聚醚酮、聚四氟乙烯及其组合。这些部件可在存在或不存在润滑剂的情况下使用，并且还可包括用于减少磨损和摩擦力的添加剂。
可参考美国专利申请序列号13/331,047(现为美国专利8,968,276，其全部内容以引用方式并入本文)了解外科器械100的构造和操作的详细讨论。
外科器械100包括击发组件，该击发组件被构造成能够将多个钉部署或弹射到由端部执行器300捕获的组织中。击发组件包括驱动组件360，如图9所示。驱动组件360包括柔性驱动梁364和近端接合节段368，该柔性驱动梁的远侧端部固定到动态夹紧构件365。接合节段368包括限定肩部370的阶梯式部分。接合节段368的近侧端部包括沿直径相对的向内延伸的指状物372。指状物372接合中空驱动构件374，以将驱动构件374牢固地固定到梁364的近侧端部。驱动构件374限定近侧孔口376a，当端部执行器300附接到适配器200的远侧联接件230时，该近侧孔口接收适配器200的驱动管246(图1)的连接构件。
当驱动组件360在工具组件304内朝远侧推进时，夹紧构件365的上部梁365a在砧座板312和砧座盖310之间限定的通道内移动，并且下部梁365b在托架316的外表面上方移动以闭合工具组件304并击发其中的钉。
端部执行器300的近侧主体部分302包括包封上部外壳部分301a和下部外壳部分301b的护套或外管301。外壳部分301a和301b包封关节运动连接件366，该关节运动连接件具有从端部执行器300的近侧端部延伸的钩状近侧端部366a。当端部执行器300固定到适配器200的远侧外壳232时，关节运动连接件366的钩状近侧端部366a接合适配器200的联接钩(未示出)。当适配器200的驱动杆258如上所述推进或回缩时，端部执行器300的关节运动连接件366在端部执行器300内推进或回缩，以使工具组件304相对于近侧主体部分302的远侧端部枢转。
如上述图9所示，工具组件304的仓组件308包括可支撑在托架316中的钉仓305。仓可以永久地安装在端部执行器300中，或者可以被布置成可移除和可替换。钉仓305限定中央纵向狭槽305a，以及定位在纵向狭槽305a的每侧上的三排线性钉保持狭槽305b。钉保持狭槽305b中的每一者接收单个钉307以及钉推动器309的一部分。在器械100的操作期间，驱动组件360抵接致动滑动件并推动致动滑动件通过仓305。随着致动滑动件移动通过仓305，致动滑动件的凸轮楔形件顺序地接合钉推动器309以在钉保持狭槽305b内垂直地移动钉推动器309并顺序地从其中弹射出钉307以便抵靠砧座板312形成。
中空驱动构件374包括闭锁机构373，该闭锁机构防止先前击发的端部执行器300的击发。闭锁机构373包括锁定构件371，该锁定构件经由销377可枢转地联接在远侧孔口376b内，使得锁定构件371相对于驱动构件374绕销377枢转。
参考图10A和图10B，锁定构件371限定形成在细长滑件381和383之间的通道379。腹板385结合滑件381和383的上表面的一部分。腹板385的构造和尺寸被设计成配合在驱动构件374的孔口376b内。水平凸缘389和391分别从滑件381和383延伸。如图9最佳所示，弹簧393设置在驱动构件374内，并且接合水平凸缘389和/或水平凸缘391以向下偏置锁定构件371。
在操作中，锁定构件371最初设置在外壳部分301a和301b的近侧端部处的预击发位置，其中水平凸缘389和391搁置在形成于外壳部分301b的侧壁中的突出部303a、303b的顶部上。在该位置中，锁定构件371被保持向上并与形成于外壳部分301b的底表面中的突出部303c(位于突出部303a、303b的远侧)脱离对齐，并且腹板385与驱动梁364中限定的肩部370纵向并置。这种构型允许打开砧座306并将其重新定位到待缝合的组织上，直到外科医生对该位置感到满意，而无需激活锁定构件371来使一次性端部执行器300失效。
在驱动管246朝远侧移动驱动梁364时，锁定构件371从突出部303a、303b上移开，并且通过突出部303c远侧的弹簧393被偏置成与外壳部分301b接合。在击发装置的整个过程中，锁定构件371都保持在该构型中。
在驱动梁364回缩时，在至少部分击发之后，锁定构件371穿过突出部303a、303b下方并且骑在外壳部分301b的突出部303c上方，直到锁定构件371的最远侧部分在突出部303c近侧。弹簧393将锁定构件371偏置成与突出部303c并置对齐，从而有效地使一次性端部执行器失效。如果试图重新致动装载有现有端部执行器300的装置，则锁定构件371将抵接外壳部分301b的突出部303c并且将阻止驱动梁364朝远侧移动。
器械100的另一方面在图11中示出。器械100包括马达164。马达164可以是被构造成能够致动一个或多个驱动器(例如，图6的可旋转驱动连接器118、120、122)的任何电动马达。马达164联接到电池156，该电池可以是DC电池(例如，可再充电的铅基、镍基、锂离子基电池等)、AC/DC变压器或适合向马达164提供电能的任何其他电源。
电池156和马达164联接到设置在电路板154上的马达驱动器电路404，该马达驱动器电路控制马达164的操作，包括电能从电池156到马达164的流动。驱动器电路404包括多个传感器408a、408b……408n，这些传感器被构造成能够测量马达164和电池156的操作状态。传感器408a-n可包括电压传感器、电流传感器、温度传感器、压力传感器、遥测传感器、光学传感器及其组合。传感器408a-408n可测量电池156所提供的电能的电压、电流和其他电特性。传感器408a-408n还可测量旋转速度如每分钟转数(RPM)、扭矩、温度、电流消耗和马达164的其他操作特性。RPM可通过测量马达164的旋转来确定。各种驱动轴(例如，图6的可旋转驱动连接器118、120、122)的位置可通过使用设置在轴中或轴附近的各种线性传感器来确定，或者由RPM测量值进行推断。在某些方面，扭矩可基于在恒定RPM下马达164的所调节电流消耗来计算。在其他方面，驱动器电路404和/或控制器406可测量时间并且将上述值处理成其函数，包括积分和/或微分，例如以确定所测量值的变化率等。
驱动器电路404还联接到控制器406，该控制器可以是适于执行计算和/或根据一组指令进行操作的任何合适的逻辑控制电路。控制器406可包括可操作地连接到存储器的中央处理单元，该存储器可包括暂态型存储器(例如，RAM)和/或非暂态型存储器(例如，闪存介质、磁盘介质等)。控制器406包括用于与驱动器电路404接口的多个输入和输出。具体地讲，控制器406从驱动器电路404接收关于马达164和电池156的操作状态的所测量传感器信号，继而将控制信号输出到驱动器电路404，以基于传感器读数和特定算法指令来控制马达164的操作。控制器406还被构造成能够从用户界面(例如，联接到控制器406的控制组件107的开关、按钮、触摸屏等)接受多个用户输入。可提供可移除存储器或芯片，或者可以无线下载数据。
参见图12至图18，描绘了外科系统10'。外科系统10'在许多方面类似于外科系统10。例如，外科系统10’包括外科器械100。器械外壳102的上部外壳部分108限定鼻部或连接部分108a，该鼻部或连接部分被构造成能够接纳轴组件500(其在许多方面类似于轴组件200)的传动外壳512的相应轴联接组件514。
轴组件500具有力传输组件，用于将外科器械的至少一个驱动构件互连到端部执行器的至少一个旋转接收构件。力传输组件具有可连接到至少一个可旋转驱动构件的第一端部以及可连接到端部执行器的至少一个旋转接收构件的第二端部。当轴组件500与外科器械100配合时，外科器械100的可旋转驱动构件或连接器118、120、122中的每一者与轴组件500的相应可旋转连接器套管518、520、522联接(参见图13和图15)。就这一点而言，相应的第一驱动构件或连接器118和第一连接器套管518之间的接口、相应的第二驱动构件或连接器120和第二连接器套管520之间的接口以及相应的第三驱动构件或连接器122和第三连接器套管522之间的接口是键控的，使得外科器械100的驱动构件或连接器118、120、122中每一者的旋转引起轴组件500的相应连接器套管518、520、522的相应旋转。
外科器械100的驱动构件或连接器118、120和/或122的选择性旋转允许外科器械100选择性地致动端部执行器400的不同功能。
参见图12和图14，轴组件500包括细长的、基本上刚性的外部管状主体510和传动外壳512，该外部管状主体具有近侧端部510a和远侧端部510b，该传动外壳连接到管状主体510的近侧端部210a并且被构造成用于选择性地连接到外科器械100。另外，轴组件500还包括连接到细长主体部分510的远侧端部510b的关节运动颈部组件530。
传动外壳512被构造成能够在其中容纳一对齿轮系系统，用于在将外科器械100的第一可旋转驱动构件或连接器118、第二可旋转驱动构件或连接器120和/或第三可旋转驱动构件或连接器122的旋转速度/力传输到端部执行器501之前，改变(例如，增大或减小)这种旋转速度/力。如图15所示，传动外壳512和轴联接组件514可旋转地支撑第一近侧或输入驱动轴524a、第二近侧或输入驱动轴526a和第三驱动轴528。
轴驱动联接组件514包括设置在相应的第一连接器套管518、第二连接器套管520和第三连接器套管522远侧的第一偏置构件518a、第二偏置构件520a和第三偏置构件522a。偏置构件518a、520a和522a中的每一者设置在相应的第一近侧驱动轴524a、第二近侧驱动轴526a和第三驱动轴228周围。偏置构件518a、520a和522a作用在相应的连接器套管518、520和522上，以在轴组件500连接到外科器械100时帮助保持连接器套管218、220和222与外科器械100的相应驱动可旋转驱动构件或连接器118、120、122的远侧端部接合。
轴组件500包括分别设置在传动外壳512和管状主体510内的第一齿轮系系统540和第二齿轮系系统550，以及相邻的联接组件514。如上所述，每个齿轮系系统540、550被构造成并适于在将外科器械100的第一可旋转驱动连接器118和第二可旋转驱动连接器120的旋转速度/力传输到端部执行器501之前，改变(例如，增大或减小)这种旋转速度/力。
如图15和图16所示，第一齿轮系系统540包括第一输入驱动轴524a，以及键接到第一输入驱动轴524a的第一输入驱动轴正齿轮542a。第一齿轮系系统540还包括可旋转地支撑在传动外壳512中的第一传动轴544、键接到第一传动轴544并与第一输入驱动轴正齿轮542a接合的第一输入传动正齿轮544a，以及键接到第一传动轴544的第一输出传动正齿轮544b。第一齿轮系系统540还包括可旋转地支撑在传动外壳512和管状主体510中的第一输出驱动轴546a，以及键接到第一输出驱动轴546a并与第一输出传动正齿轮544b接合的第一输出驱动轴正齿轮546b。
在至少一个实例中，第一输入驱动轴正齿轮542a包括10个齿；第一输入传动正齿轮544a包括18个齿；第一输出传动正齿轮544b包括13个齿；并且第一输出驱动轴正齿轮546b包括15齿。如此构造，第一输入驱动轴524a的输入旋转以1:2.08的比率被转换为第一输出驱动轴546a的输出旋转。
在操作中，当由于外科器械100的第一相应驱动连接器118的旋转引起第一连接器套管558和第一输入驱动轴524a的旋转，从而使第一输入驱动轴正齿轮542a旋转时，第一输入驱动轴正齿轮542a接合第一输入传动正齿轮544a，从而使得第一输入传动正齿轮544a旋转。当第一输入传动正齿轮544a旋转时，第一传动轴544旋转并因此使得键接到第一传动轴544的第一输出驱动轴正齿轮546b旋转。当第一输出驱动轴正齿轮546b旋转时，由于第一输出驱动轴正齿轮546b与其接合，所以第一输出驱动轴正齿轮546b也旋转。当第一输出驱动轴正齿轮546b旋转时，由于第一输出驱动轴正齿轮546b键接到第一输出驱动轴546a，所以第一输出驱动轴546a旋转。
包括第一齿轮系统540的轴组件500用于将操作力从外科器械100传输到端部执行器501，以便操作、致动和/或击发端部执行器501。
如图15和图17所示，第二齿轮系系统550包括第二输入驱动轴526a，以及键接到第二输入驱动轴526a的第二输入驱动轴正齿轮552a。第二齿轮系系统550还包括可旋转地支撑在传动外壳512中的第一传动轴554、键接到第一传动轴554并与第二输入驱动轴正齿轮552a接合的第一输入传动正齿轮554a，以及键接到第一传动轴554的第一输出传动正齿轮554b。
第二齿轮系系统550还包括可旋转地支撑在传动外壳512中的第二传动轴556、键接到第二传动轴556并与键接到第一传动轴554的第一输出传动正齿轮554b接合的第二输入传动正齿轮556a，以及键接到第二传动轴556的第二输出传动正齿轮556b。
第二齿轮系系统550另外包括可旋转地支撑在传动外壳512和管状主体510中的第二输出驱动轴558a，以及键接到第二输出驱动轴558a并与第二输出传动正齿轮556b接合的第二输出驱动轴正齿轮558b。
在至少一个实例中，第二输入驱动轴正齿轮552a包括10个齿；第一输入传动正齿轮554a包括20个齿；第一输出传动正齿轮554b包括10个齿；第二输入传动正齿轮556a包括20个齿；第二输出传动正齿轮556b包括10个齿；并且第二输出驱动轴正齿轮558b包括15齿。如此构造，第二输入驱动轴526a的输入旋转以1:6的比率被转换为第二输出驱动轴558a的输出旋转。
在操作中，当由于外科器械100的第二相应驱动连接器120的旋转引起第二连接器套管560和第二输入驱动轴526a的旋转，从而使第二输入驱动轴正齿轮552a旋转时，第二输入驱动轴正齿轮552a接合第一输入传动正齿轮554a，从而使得第一输入传动正齿轮554a旋转。当第一输入传动正齿轮554a旋转时，第一传动轴554旋转并因此使得键接到第一传动轴554的第一输出传动正齿轮554b旋转。当第一输出传动正齿轮554b旋转时，由于第二输入传动正齿轮556a与其接合，所以第二输入传动正齿轮556a也旋转。当第二输入传动正齿轮556a旋转时，第二传动轴256旋转并因此使得键接到第二传动轴556的第二输出传动正齿轮256b旋转。当第二输出传动正齿轮556b旋转时，由于第二输出驱动轴正齿轮558b与其接合，所以第二输出驱动轴正齿轮558b旋转。当第二输出驱动轴正齿轮558b旋转时，由于第二输出驱动轴正齿轮558b键接到第二输出驱动轴558a，所以第二输出驱动轴558a旋转。
包括第二齿轮系系统550的轴组件500用于将操作力从外科器械100传输到端部执行器501，以便使轴组件500和/或端部执行器501相对于外科器械100旋转。
如图15和图18所示，传动外壳512和轴联接组件514可旋转地支撑第三驱动轴528。第三驱动轴528包括被构造成能够支撑第三连接器套管522的近侧端部528a，以及延伸到关节运动组件570并与其可操作地连接的远侧端部528b。
如图14所示，轴组件500的细长外部管状主体510包括第一半节段511a和第二半节段511b，当半节段511a、511b彼此配合时，这两个半节段限定穿过外部管状主体510的至少三个纵向延伸的通道。通道的构造和尺寸被设计成当第一输出驱动轴546a、第二输出驱动轴558a和第三驱动轴528从传动外壳512延伸到关节运动颈部组件530时，可旋转地接收和支撑第一输出驱动轴546a、第二输出驱动轴558a和第三驱动轴528。第一输出驱动轴546a、第二输出驱动轴558a和第三驱动轴528中的每一者都是细长的并且足够刚性以将旋转力从传动外壳520传输到关节运动颈部组件530。
转到图14，轴组件500还包括关节运动颈部组件530。关节运动颈部组件530包括近侧颈部外壳532、连接到近侧颈部外壳532并从其串联延伸的多个连接件534；以及连接到多个连接件534中的最远侧连接件并从其延伸的远侧颈部外壳536。可以设想，在本文公开的任何方面，轴组件可具有单个连接件或枢轴构件，以允许端部执行器进行关节运动。可以设想，在本文公开的任何方面，远侧颈部外壳可以与最远侧连接件合并。
以下专利的全部公开内容据此以引用方式并入本文：
于2012年10月23日提交且名称为“SURGICAL INSTRUMENT WITH RAPID POSTEVENT DETECTION”的美国专利申请公布2014/0110453；
于2013年6月19日提交且名称为“APPARATUS FOR ENDOSCOPIC PROCEDURES”的美国专利申请公布2013/0282052；以及
于2013年5月10日提交且名称为“APPARATUS FOR ENDOSCOPIC PROCEDURES”的美国专利申请公布2013/0274722。
参见图19至图20，描绘了外科器械1010。外科器械1010在许多方面类似于外科器械100。例如，外科器械1010被构造成用于经由适配器200与端部执行器或单次使用的装载单元或再装载件300选择性地连接。而且，外科器械1010包括柄部外壳102，该柄部外壳包括下部外壳部分104、中间外壳部分106和上部外壳部分108。
与外科器械100类似，外科器械1010包括驱动机构160，该驱动机构被构造成能够驱动轴和/或齿轮部件，以便执行外科器械1010的各种操作。在至少一个实例中，驱动机构160包括旋转驱动系1012(参见图20)，该旋转驱动系被构造成能够使端部执行器300相对于柄部外壳102围绕纵向轴线“X”(参见图2)旋转。驱动机构160还包括闭合驱动系1014(参见图20)，该闭合驱动系被构造成能够使砧座组件306相对于端部执行器300的仓组件308移动以捕获其间的组织。另外，驱动机构160包括击发驱动系1016(参见图20)，该击发驱动系被构造成能够击发端部执行器300的仓组件308内的缝合和切割仓。
如上所述，主要参见图7、图8和图20，驱动机构160包括可以相对于适配器200紧邻近侧定位的选择器齿轮箱组件162。在选择器齿轮箱组件162近侧的是包括第一马达164的功能选择模块163，该功能选择模块用于择性地移动选择器齿轮箱组件162内的齿轮元件以选择性地定位驱动系1012、1014和1016中的一者，并将其移动成与第二马达166的输入驱动部件165接合。
参见图20，马达164和166分别联接到马达控制电路1018和1018'，所述马达控制电路被构造成能够控制马达164和166的操作，包括电能从电源156到马达164和166的流动。电源156可以是DC电池(例如，可再充电的铅基、镍基、锂离子基电池等)、AC/DC变压器或适合向外科器械1010提供电能的任何其他电源。
外科器械1010还包括微控制器1020(“控制器”)。在某些实例中，控制器1020可包括微处理器1036(“处理器”)和一个或多个计算机可读介质或存储单元1038(“存储器”)。在某些实例中，存储器1038可存储各种程序指令，所述各种程序指令在被执行时可使处理器1036执行本文所述的多个功能和/或计算。电源156可被构造成能够例如向控制器1020供电。
处理器1036可与马达控制电路1018通信。另外，存储器1038可存储程序指令，所述程序指令在由处理器103639于用户输入1034执行时，可使马达控制电路1018促动马达164产生至少一个旋转运动，从而选择性地移动选择器齿轮箱组件162内的齿轮元件以选择性地定位驱动系1012、1014和1016中的一者，并将其移动成与第二马达166的输入驱动部件165接合。此外，处理器1036可与马达控制电路1018'通信。存储器1038还可存储程序指令，所述程序指令在由处理器1036响应于用户输入1034执行时，可使马达控制电路1018'促动马达166产生至少一个旋转运动，从而驱动例如与第二马达166的输入驱动部件165接合的驱动系。
控制器1020和/或本公开的其他控制器可使用集成的和/或分立的硬件元件、软件元件和/或两者的组合来实现。集成硬件元件的示例可包括处理器、微处理器、微控制器、集成电路、ASIC、PLD、DSP、FPGA、逻辑门、寄存器、半导体器件、芯片、微芯片、芯片组、微控制器、SoC、和/或SIP。分立硬件元件的示例可包括电路和/或电路元件，诸如逻辑门、场效应晶体管、双极型晶体管、电阻器、电容器、电感器和/或继电器。在某些实例中，例如，控制器1020可包括混合电路，该混合电路在一个或多个基板上包括分立的和集成的电路元件或部件。
在某些实例中，控制器1020和/或本公开的其他控制器可以是例如购自TexasInstruments的LM 4F230H5QR。在某些实例中，Texas Instruments LM4F230H5QR为ARMCortex-M4F处理器芯，其包括：256KB的单循环闪速存储器或其他非易失性存储器(最多至40MHZ)的片上存储器、用于使性能改善超过40MHz的预取缓冲器、32KB的单循环SRAM、装载有软件的内部ROM、2KB的EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入通道的一个或多个12位ADC，以及易得的其他特征。可以很方便地换用其他微控制器，来与本公开联合使用。因此，本公开不应限于这一上下文。
在各种实例中，本文所述的各种步骤中的一个或多个可由包括组合逻辑电路或顺序逻辑电路的有限状态机执行，其中组合逻辑电路或顺序逻辑电路耦合到至少一个存储电路。至少一个存储电路存储有限状态机的当前状态。组合或顺序逻辑电路被构造成能够使有限状态机到达这些步骤。顺序逻辑电路可以是同步的或异步的。在其他实例中，例如，本文所述的各种步骤中的一个或多个可通过包括处理器1036和有限状态机的组合的电路来执行。
再次参见图20，外科器械1010还包括驱动系故障检测模块1040。处理器1036可与模块1040通信或以其他方式控制该模块。模块1040可体现为各种装置，诸如电路、硬件、计算机程序产品(其包括存储可由处理设备(例如，处理器1036)执行的计算机可读程序指令的计算机可读介质(例如，存储器1038))或其某种组合。在一些方面，处理器1036可包括模块1040或以其他方式控制该模块。
参见图20，模块1040还包括一个或多个传感器(未示出)，这些传感器可被构造成能够检测驱动系1012、1014和1016中的一者或多者中的紧急驱动系故障。
参见图20，模块1040可被构造成能够检测外科器械1010的有效驱动系中的紧急故障。如本文结合驱动系1012、1014和1016所用的术语“有效”是指与输入驱动部件165接合并由第二马达166驱动的选定驱动系。本文所用的术语“紧急故障”是指可使驱动系1012、1014和1016中的一者或多者例如以低于最佳性能水平操作的故障。紧急驱动系故障的一个示例可涉及对有效驱动系的一个或多个齿轮造成齿损坏和/或有效驱动系中发生过度倾斜。
在发生紧急驱动系故障的情况下，仍然可操作有效驱动系以完成手术步骤或重置外科器械1010；然而，如下面更详细地描述，可采取某些预防和/或安全步骤以避免或最小化对有效驱动系和/或外科器械1010的其他部件造成额外损坏。或者，在发生灾难性故障的情况下，使有效驱动系不可操作，并且采取某些救助步骤以确保外科器械1010与被治疗组织安全分离等。
再次参见图21，逻辑图1021表示可由外科器械1010响应于有效驱动系故障而实施的可能操作。存储器1038可包括程序指令，所述程序指令在由处理器1036执行时，可使处理器1036使用模块1040来连续地检测1023有效驱动系故障。存储器1038可包括程序指令，所述程序指令在由处理器1036执行时，可使处理器1036例如通过激活操作的安全模式1022来响应所检测到的紧急驱动系故障。另外，存储器1038可包括程序指令，所述程序指令在由处理器1036执行时，可使处理器1036通过激活恢复或救助模式1022来响应所检测到的灾难性驱动系故障。如果没有检测到驱动系故障，则处理器1036可允许外科器械1010继续1027正常操作，直到检测到有效驱动系故障。
参见图22，安全模式1022可包括一个或多个步骤，诸如马达调制步骤1026，处理器1036可采用该步骤来限制有效驱动系的速度。例如，如果在击发序列期间由马达166有效地驱动击发驱动系1016，则模块1040检测到紧急驱动系故障可使处理器1036与马达驱动电路1018'指令通信，以使马达166的机械输出减小。马达166的机械输出减小降低了有效驱动系1016的速度，这确保了安全完成击发序列和/或将有效驱动系1016重置为原始或起始位置。
同样，如果在闭合运动期间由马达166有效地驱动闭合驱动系1014以通过端部执行器300捕获组织，则模块1040检测到紧急驱动系故障可使处理器1036与马达驱动电路1018'指令通信，以使马达166的机械输出减小。马达166的机械输出减小降低了有效驱动系1014的速度，这确保了安全完成闭合运动和/或将有效驱动系1014重置为原始或起始位置。而且，如果由马达166有效地驱动旋转驱动系1012，则模块1040检测到紧急驱动系故障可使处理器1036与马达驱动电路1018'指令通信，以使马达166的机械输出减小。马达166的机械输出减小降低了有效驱动系1012的速度，这确保了安全完成旋转和/或将有效驱动系1012重置到原始或起始位置。
参见图23，马达调制步骤1026可由存储在存储器1038中的程序指令实施，所述程序指令在由处理器1036执行时，可使处理器1036与马达驱动电路1018'通信，例如以调制马达166的马达输入电压(Vm)，例如从而降低可操作地连接到马达166的有效驱动系的速度。在至少一个实例中，如图23所示，马达调制1026可包括不利用马达输入电压(Vm)或利用零马达输入电压(Vm)以彼此间隔开时间段(t1)的脉冲形式传输马达输入电压(Vm)。或者，如图23A所示，马达调制1026可包括将马达输入电压(Vm)从第一电压(V1)降低到第二电压(V2)。传输马达输入电压(Vm)有节制地减小了马达166的机械输出，继而降低或限制了有效驱动系的速度。如上所述降低有效驱动系的速度可减慢驱动系围绕损坏节段的旋转并且/或者限制与损坏齿或缺失齿后面的齿的接合力。
马达输入电压(Vm)脉冲可各自包括时间段(t2)。在至少一个实例中，时间段(t2)与时间段(t1)的比率可以是选自例如约1/100至约1的范围的任何值。在至少一个实例中，时间段(t2)与时间段(t1)的比率可以是选自例如约1/20至约1/80的范围的任何值。在至少一个实例中，时间段(t2)与时间段(t1)的比率可以是选自例如约1/30至约1/60的范围的任何值。本公开设想了时间段(t2)与时间段(t1)的比率的其他值。
参见图22A，在某些实例中，可针对驱动系1012、1014和/或1016中的每一者实施不同的或专用的马达调制1026。在这类实例中，逻辑图1041表示可由外科器械1010实施的可能操作。如上所述，存储器1038可包括程序指令，所述程序指令在由处理器1036执行时，可使处理器1036使用模块1040来连续地检测1023有效驱动系故障。存储器1038还可包括程序指令，所述程序指令在由处理器1036执行时，可使处理器1036通过实施击发驱动系调制算法1043、闭合驱动系调制算法1045和旋转驱动系调制算法1049中的一者来响应所检测到1027的紧急驱动系故障，具体取决于当检测到紧急故障时有效驱动系的类型或性质。击发驱动系调制算法1043、闭合驱动系调制算法1045和/或旋转驱动系调制算法1049可例如存储在存储器1038中。
再次参见图22，安全模式1022还可包括传感器绕过步骤1028。外科器械1010可包括各种传感器，诸如被构造成能够向处理器1036提供关于外科器械1010的操作的各种数据的闭环传感器。在发生紧急驱动系故障的情况下，这些传感器提供的数据可能不准确。作为响应，存储器1038可包括程序指令，所述程序指令在由处理器1036执行时，可使处理器1036通过绕过来自这些传感器的输入并且/或者停用或暂停响应于来自这些传感器的输入而触发的功能来响应所检测到的紧急驱动系故障。
存储器1038可包括在发生紧急驱动系故障的情况下将被停用或忽略的传感器子集的传感器绕过数据库。在至少一个实例中，处理器1036可利用传感器绕过数据库来在发生紧急驱动系故障的情况下实施传感器绕过步骤。
安全模式1022还可包括步骤1029，警告外科器械1010的用户已经检测到紧急驱动系故障并且外科器械1010将继续以安全模式1022运行，这可能会例如限制或减少用户可用的功能。处理器1036可使用反馈系统1035来向外科器械1010的用户发出这种警告。反馈系统1035可包括例如一个或多个反馈元件1034和/或一个或多个用户输入元件1037。在某些实例中，反馈系统1035可包括例如一个或多个视觉反馈元件，包括显示屏、背光源和/或LED。在某些实例中，反馈系统1035可包括例如一个或多个音频反馈系统，诸如扬声器和/或蜂鸣器。在某些实例中，反馈系统1035可包括例如一个或多个触觉反馈系统。在某些实例中，反馈系统1035可包括例如视觉、音频和/或触觉反馈系统的组合。
参见图24，在许多方面类似于逻辑图1021的逻辑图1021'表示可由外科器械1010响应于有效驱动系故障而实施的可能操作。在至少一个实例中，如图24所示，以安全模式1022操作外科器械1010可以获得来自外科器械1010的用户的批准为条件，如图24所示。例如，在检测到紧急驱动系故障之后，可暂停1033马达166。存储器1038可包括程序指令，所述程序指令在由处理器1036执行时，可使处理器1036例如通过暂停马达166的操作来响应于紧急驱动系故障而暂停有效驱动系的操作。例如，可通过将电源156与马达166断开来停止和/或禁用马达166。在各种实例中，例如处理器1036可使用马达超驰电路来停止向马达166进行电力传输。
在禁用马达166之后，处理器1036可经由一个或多个反馈元件1037请求用户批准以安全模式1022进行。操作者的决定可经由用户输入1034传送到处理器1036。如果操作者选择以安全模式1022进行，则处理器1036可通过重新激活向马达166进行电力传输来重新激活损坏驱动系，并且以安全模式1022进行。或者，如果操作者选择不以安全模式1022进行，则处理器1036可激活救助模式1024。
再次参见图22，安全模式1022还可包括服务请求步骤1042，用于在有效驱动系发生紧急故障的情况下发起服务请求。存储器1038可包括程序指令，所述程序指令在由处理器1036执行时，可使处理器1036通过发起服务请求来响应所检测到的紧急驱动系故障。该请求可通过任何合适的通信模式传送到服务单元，该服务单元例如可以是外部服务器的形式。
在至少一个实例中，可采用无线通信模式来发起服务请求。无线通信模式可包括专用短程通信(DSRC)、蓝牙、WiFi、ZigBee、射频识别(RFID)和近场通信(NFC)中的一者或多者。
服务请求通信还可包括与所检测到的驱动系故障有关的任何保存数据，诸如故障的时间和日期、有效驱动系的类型和/或故障发生的手术步骤。此外，反馈系统1035可包括一个或多个视觉反馈元件，诸如屏幕1046，其可用于提供例如可服务性选项和/或重建步骤的交互式演练。
再次参见图22，安全模式1022还可包括有限的功能性步骤1044。存储器1038可包括程序指令，所述程序指令在由处理器1036执行时，可使处理器1036通过限制用户可用的外科器械1010的功能来响应所检测到的紧急驱动系故障。在至少一个实例中，处理器1036可将可用功能限制为将外科器械1010重置或返回到原始或起始位置的功能。例如，在击发驱动系1016中检测到紧急故障的情况下，处理器1036可被构造成能够暂停击发驱动系1016的进一步推进，并且仅允许击发驱动系1016回缩到原始或起始位置。同样，在端部执行器300的闭合运动期间在闭合驱动系1014中检测到紧急故障的情况下，处理器1036可被构造成能够暂停闭合驱动系1014的进一步推进，并且仅允许闭合驱动系1014回缩到原始或起始位置，从而释放任何捕获的组织。否则，不受所检测到的故障影响的功能可能仍然可用。
如果检测到灾难性驱动系故障而不是紧急驱动系故障，则可激活救助模式1024。存储器1038可包括程序指令，所述程序指令在由处理器1036执行时，可使处理器1036通过激活救助模式1024来响应紧急驱动系故障。在至少一个实例中，如图25所示，救助模式1024可包括机械救助步骤1046。在有效驱动系(诸如，击发驱动系1016)发生灾难性故障的情况下，处理器1036可通过停止马达166来暂停击发驱动系1016。另外，处理器1036可使用一个或多个反馈元件1037来向用户警告1029所检测到的故障并向外科器械1010的用户提供指令，以机械地完成击发序列和/或重置击发驱动系1016。
在有效闭合驱动系1014发生灾难性故障的情况下，处理器1036可通过停止马达166来暂停闭合驱动系1014。另外，处理器1036可使用一个或多个反馈元件1037来向外科器械1010的用户提供指令，以机械地完成闭合运动和/或重置闭合驱动系1014。
参见图19，外科器械1010可包括救助门1013，该救助门可使用救助柄部1047打开。救助门1013可由外科器械1010的用户打开以进入救助组件，该救助组件可用于机械地完成例如击发序列和/或重置外科器械1010的击发驱动系1016。名称为“SURGICAL INSTRUMENTCOMPRISING A SENSOR SYSTEM”且于2014年3月26日提交的美国专利申请序列号14/226,142(现为美国专利申请公布2015/0272575和美国专利申请公布2010/0089970)公开了救助布置以及也可与本文公开的各种器械一起使用的其他部件、布置和系统。名称为“SURGICALINSTRUMENT COMPRISING A SENSOR SYSTEM”且于2014年3月26日提交的美国专利申请序列号14/226,142(现为美国专利申请公布2015/0272575)据此全文以引用方式并入。而且，名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117(现为美国专利申请公布2010/0089970)据此全文以引用方式并入。
再次参见图25，救助模式1024还可包括上面结合安全模式1022所述的一个或多个步骤。例如，救助模式1024可包括传感器绕过步骤1028。存储器1038可包括程序指令，所述程序指令在由处理器1036执行时，可使处理器1036通过绕过来自各个传感器的输入并且/或者停用或暂停响应于来自这些传感器的输入而触发的功能来响应灾难性驱动系故障。
存储器1038可包括在发生灾难性驱动系故障的情况下将被停用或忽略的传感器子集的传感器绕过数据库。在至少一个实例中，处理器1036可利用传感器绕过数据库来在发生灾难性驱动系故障的情况下实施传感器绕过步骤。救助模式1024还可包括服务请求步骤1042，用于在有效驱动系发生灾难性故障的情况下发起服务请求。
参见图26A，描绘了外科器械2010。外科器械2010在许多方面类似于外科器械100。例如，外科器械2010被构造成用于经由适配器200与端部执行器或单次使用的装载单元或再装载件300选择性地连接。而且，外科器械2010包括柄部外壳102，该柄部外壳包括下部外壳部分104、中间外壳部分106和上部外壳部分108。另外，外科器械2010包括保持在下部外壳部分104中的电源组2012。与电池156类似，电源组2012可分离地联接到外科器械2010。一个或多个连接器2019可被构造成能够在电源组2012附接到外科器械2010时将电源组2012电联接到外科器械2010，如图28所示。连接器2019便于电源组2012和外科器械2010之间的通信和电力交换。
如图26B所示，下部外壳部分104包括弹性构件2017和2018，这些弹性构件被构造成能够提供与中间外壳部分106的扣合接合。本公开设想了用于将下部外壳部分104附接到中间外壳部分106的其他机构。在图26A所示的方面，可通过在远离中间外壳部分106的方向上回缩或拉动下部外壳部分104来将电源组2012与外科器械2010分离。
参见图26B和图28，电源组2012包括多个电池单元(B1……Bn)2014和电子控制电路2016。电池单元2014串联布置并且电联接到电子控制电路2016。本公开设想了电池单元2014的其他布置。在图26B所示的方面，电源组2012包括四个电池单元(B1-B4)。在其他方面，如图28所示，电源组2012可包括多于或少于四个电池单元。在各种实例中，电池单元2014是可替换的和/或可再充电的。
参见图27，描绘了在外科器械2010的击发序列期间监测电源组2012的健康状况的方法2009。方法2009包括用于响应所检测到的电源组2012的健康状况下降到预定阈值以下的步骤。方法2009包括检测击发序列的激活的步骤2011。方法2009还包括在检测到击发序列的激活之后监测电源组的健康状况的步骤2013。监测电源组2012的健康状况的步骤可包括监测与电源组2012相关联的一个或多个参数，诸如温度、输出电流和/或输出电压。在检测到电源组2012的健康状况部分受损的情况下，方法2009还包括至少一个检测后安全和/或操作措施。例如，方法2009还包括警告外科器械2010的用户并且/或者记录受损电源组2012的损坏状态。
在至少一个实例中，方法2009还包括确定是否可以完成击发序列。在确定不能完成击发序列的情况下，方法2009还包括警告外科器械2010的用户并且/或者重置击发序列。重置击发序列的步骤可包括将驱动组件360回缩到原始或起始位置等。在确定可以完成击发序列的情况下，方法2009还包括警告外科器械2010的用户继续击发序列。另外，方法2009还可包括增加和/或优先化电源组2012的电力输出以促进击发序列的完成。在完成击发序列后，方法9还可包括停用外科器械2010的步骤。
可采用方法2009的安全和/或操作措施来解决已经开始击发序列但由于电源组2012的故障而仅部分完成的情况。这种情况通常会产生仅部分缝合和/或切除的组织区域。在电源组2012的故障是部分故障的情况下，方法2009允许完成组织区域的吻合和/或切除。
参见图28，电源组2012可使用电子控制电路2016来监测外科器械2010的击发序列期间电源组2012的健康状况，并且响应所检测到的电源组2012的健康状况下降到预定阈值以下。电子控制电路2016可包括一个或多个传感器(S1……Sn)2015，用于监测电源组2012的健康状况。在图34所示的方面，电子控制电路2016包括电压传感器2022、温度传感器2024和电流传感器2026，这些传感器协作监测电源组2012的健康状况，如下面更详细地描述。电子控制电路2016也可使用其他传感器来监测电源组2012的健康状况。
除上述之外，电子控制电路2016包括可操作地联接到传感器2015的微控制器2028(“控制器”)，如图28所示。在某些实例中，控制器2028可包括微处理器2030(“处理器”)和一个或多个计算机可读介质或存储单元2032(“存储器”)。在某些实例中，存储器2032可存储各种程序指令，所述各种程序指令在被执行时可使处理器2030执行本文所述的多个功能和/或计算，诸如图27中所描绘的方法2009的一个或多个步骤。在某些实例中，存储器2032可联接到例如处理器2030。例如，电池单元2014可被构造成能够向例如控制器2028、传感器2015和/或电子控制电路2016的其他部件供电。此外，控制器2028可与外科器械2010中的主控制器2029通信，如图28所示，该主控制器也可通过连接器2019由电池单元2014供电。
控制器2028和/或本公开的其他控制器可使用集成的和/或分立的硬件元件、软件元件和/或两者的组合来实现。集成硬件元件的示例可包括处理器、微处理器、微控制器、集成电路、ASIC、PLD、DSP、FPGA、逻辑门、寄存器、半导体器件、芯片、微芯片、芯片组、微控制器、SoC、和/或SIP。分立硬件元件的示例可包括电路和/或电路元件，诸如逻辑门、场效应晶体管、双极型晶体管、电阻器、电容器、电感器和/或继电器。在某些实例中，例如，控制器2028可包括混合电路，该混合电路在一个或多个基板上包括分立的和集成的电路元件或部件。
在某些实例中，控制器2028和/或本公开的其他控制器可以是例如购自TexasInstruments的LM 4F230H5QR。在某些实例中，Texas Instruments LM4F230H5QR为ARMCortex-M4F处理器芯，其包括：256KB的单循环闪速存储器或其他非易失性存储器(最多至40MHZ)的片上存储器、用于使性能改善超过40MHz的预取缓冲器、32KB的单循环SRAM、装载有软件的内部ROM、2KB的EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入通道的一个或多个12位ADC，以及易得的其他特征。可以很方便地换用其他微控制器，来与本公开联合使用。因此，本公开不应限于这一上下文。
在各种实例中，本文所述的各种步骤中的一个或多个可由包括组合逻辑电路或顺序逻辑电路的有限状态机执行，其中组合逻辑电路或顺序逻辑电路耦合到至少一个存储电路。至少一个存储电路存储有限状态机的当前状态。组合或顺序逻辑电路被构造成能够使有限状态机到达这些步骤。顺序逻辑电路可以是同步的或异步的。在其他实例中，例如，本文所述的各种步骤中的一个或多个可通过包括处理器2030和有限状态机的组合的电路来执行。
参见图28，电子控制电路2016还可包括升压转换器2036。如图28所示，电池单元2014联接到电压转换器或升压转换器2036。处理器2030可被构造成能够在确定一个或多个电池单元2014在外科器械2010的操作期间损坏或受损是的情况下，使用升压转换器2036来提供升高电压或者逐渐升高电压，以维持足以完成击发序列的最小电压。
在至少一个实例中，如图28所示，处理器2030可被构造成能够通过使用反馈系统2034向外科器械100的用户发出警报来响应一个或多个电池单元2014受损的确定。在某些实例中，反馈系统2034可包括例如一个或多个视觉反馈系统，诸如显示屏、背光源和/或LED。在某些实例中，反馈系统2034可包括例如一个或多个音频反馈系统，诸如扬声器和/或蜂鸣器。在某些实例中，反馈系统2034可包括例如一个或多个触觉反馈系统。在某些实例中，反馈系统2034可包括例如视觉、音频和/或触觉反馈系统的组合。
在至少一个实例中，处理器2030被构造成能够通过将电源组2012的损坏状态存储或记录在存储器2032中来响应一个或多个电池单元2014受损的确定。电源组2012的损坏状态也可存储在外科器械2040内的主控制器2029的存储器2054中。电源组2012的控制器2028的处理器2030可与主控制器2029的处理器2052通信，以向主控制器2029报告电源组2012的损坏状态。响应于确定一个或多个电池单元2014受损，主控制器2029的处理器2052可被构造成能够例如通过使驱动组件360返回到原始或起始位置来重置击发序列。或者，在某些实例中，处理器2052可被构造成能够从外科器械2040的非必要系统重新路由电力，以确保在确定一个或多个电池单元2014在击发序列期间受损的情况下完成击发序列。非必要系统的示例可包括背光液晶显示器(LCD)和/或发光二极管(LED)指示器。在完成击发序列之后，主控制器2029的处理器2052可被构造成能够使外科器械2040停用，直到例如用未损坏的电源组替换损坏的电源组2012。
参见图29，监测电源组2012的健康状况的步骤2013可包括监测电池单元2014的输出电压。在这类实例中，传感器2015可包括可与电池单元2014并联布置的电压传感器。电压传感器可被构造成能够在外科器械2010的击发序列期间对电池单元2014的输出电压进行采样。可在激活击发序列之前和/或在完成击发序列之后获得额外的电压读数。处理器2030可被构造成能够接收电压传感器的电压读数，并将所述读数与可存储在存储器2032中的预定电压阈值(vt)进行比较。在电压读数或多个电压读数的平均值达到和/或低于预定电压阈值(vt)的情况下，处理器2030可断定一个或多个电池单元2014受损或损坏。作为响应，处理器2030可被构造成激活上述一个或多个安全和/或操作措施。
参见图30，监测电源组2012的健康状况的步骤2013可包括监测来自电池单元2014的电流消耗。在这类实例中，传感器2015可包括可与电池单元2014串联布置的电流传感器。电流传感器可被构造成能够在外科器械2010的击发序列期间对来自电池单元2014的电流消耗进行采样。可在激活击发序列之前和/或在完成击发序列之后获得额外的电流读数。处理器2030可被构造成能够接收电流传感器的电流读数，并将所述读数与可存储在存储器2032中的预定电流阈值(It)进行比较。在电流读数或多个电流读数的平均值达到和/或低于预定电流阈值(It)的情况下，处理器2030可断定一个或多个电池单元2014受损或损坏。作为响应，处理器2030可被构造成能够激活上述一个或多个安全和/或操作措施。
参见图31，监测电源组2012的健康状况的步骤2013可包括监测电池单元2014的温度。在这类实例中，传感器2015可包括可紧邻电池单元2014定位在电源组2012内的一个或多个温度传感器。温度传感器可被构造成能够在外科器械100的击发序列期间对电池单元2014的温度进行采样。可在激活击发序列之前和/或在完成击发序列之后获得额外的温度读数。处理器2030可被构造成能够接收温度传感器的温度读数，并将所述读数与可存储在存储器2032中的预定温度阈值(Tt)进行比较。在温度读数或多个温度读数的平均值达到和/或超过预定温度阈值(Tt)的情况下，处理器2030可断定一个或多个电池单元2014受损或损坏。作为响应，处理器2030可被构造成能够激活上述一个或多个安全和/或操作措施。
参见图32，外科器械2040在许多方面类似于外科器械2010和100。外科器械2040包括在许多方面类似于电源组2012的电源组2042。另外，电源组2042包括容纳电池单元2014的绝缘室2044。绝缘室2044包括绝缘壁2046，该绝缘壁被构造成能够抵抗绝缘室2044的内部和外部之间的热传递。绝缘室2044还容纳一个或多个温度传感器2024，这些温度传感器被构造成能够在外科器械2040的击发序列期间对绝缘室2044内的内部温度进行采样。附加温度传感器2024'定位在绝缘室2044外，以在外科器械2040的击发序列期间对绝缘室2044外的外部温度进行采样。
处理器2030被构造成能够分别接收温度传感器2024'和2024的外部和内部温度读数。另外，处理器30被构造成能够应用可存储在存储器2032中的算法来对所接收的外部和内部温度读数进行定量比较。在内部温度读数或多个内部温度读数的平均值超过同时取得的外部温度读数或多个外部温度读数的平均值预定温度阈值(Tt)(可存储在存储器2032中)的情况下，处理器2030可断定一个或多个电池单元2014受损或损坏。作为响应，处理器2030可被构造成能够激活上述一个或多个安全和/或操作措施。
在某些实例中，外科器械2040的内部温度传感器2024和外部温度传感器2024'可布置在惠斯通电桥电路2048中，如图33所示。可使用电压传感器2022来测量惠斯通电桥电路2048两端的电压。处理器2030可被构造成能够接收电压传感器2022的电压读数。在电压读数或多个电压读数的平均值达到和/或超过预定电压阈值(vt)的情况下，处理器2030可断定一个或多个电池单元2014受损或损坏。作为响应，处理器2030可被构造成激活上述一个或多个安全和/或操作措施。
在图34所示的方面，电子控制电路2016包括电压传感器2022、温度传感器2024和电流传感器2026，这些传感器协作监测电源组2012的健康状况。电压传感器2022可被构造成能够监测电池单元2014的输出电压，而电流传感器2026和温度传感器2024分别同时测量来自电池单元2014的电流消耗和电池单元2014的温度。在至少一个实例中，处理器30被构造成能够在外科器械2010的击发序列期间从电压传感器2022、温度传感器2024和电流传感器2026接收读数。还可在激活击发序列之前和/或在完成击发序列之后获得额外读数。
图35是根据本公开的至少一个方面的用于基于传感器读数来评估电源组的健康状况的逻辑图。参见图35，除上述之外，处理器2030被构造成能够应用可存储在存储器2032中的算法2050来基于从电压传感器2022、温度传感器2024和电流传感器2026获得的读数来评估电源组2012的健康状况。首先，处理器2030被构造成能够确定从电压传感器2022接收的电压读数是否达到或低于存储在存储器2032中的预定电压阈值(Vt)。其次，如果处理器2030确定电压读数达到或低于预定电压阈值(Vt)，则处理器2030被构造成能够进一步确定从电流传感器2026接收的电流读数是否达到或低于存储在存储器2032中的预定电流阈值(It)。再次，如果处理器2030确定电流读数达到或低于预定电流阈值(It)，则处理器2030进一步被构造成能够确定从温度传感器2024接收的温度读数是否达到或超过存储在存储器2032中的预定温度阈值(Tt)。如果不满足三个条件中的任何一个，则处理器2030可继续监测电源组2012的健康状况。然而，如果满足所有三个条件，则处理器2030可断定一个或多个电池单元2014受损或损坏。作为响应，处理器2030可被构造成能够激活上述一个或多个安全和/或操作措施。在至少一个实例中，如果满足三个条件中的两个，则处理器2030可断定一个或多个电池单元2014受损或损坏。
参见图36至图36B，描绘了外科器械3010。外科器械3010在许多方面类似于外科器械100。例如，外科器械3010被构造成用于经由适配器200与端部执行器或单次使用的装载单元或再装载件300选择性地连接。而且，外科器械3010包括柄部外壳102，该柄部外壳包括下部外壳部分104、中间外壳部分106和上部外壳部分108。另外，外科器械3010还包括可替换的马达仓3012，如图37所示。马达仓3012可分离地联接到外科器械3010。可打开马达进入门3013(图36)以获得通向马达仓3012的入口。一旦打开马达进入门3013，便可移除马达仓3012并用另一个马达仓进行替换。
如下面稍后描述，外科器械3010被构造成能够检测损坏的马达仓3012，并且在某些实例中，指示外科器械3010的操作者用未损坏的马达仓3012替换损坏的马达仓3012。替换马达仓3012的能力是相当有用的，至少因为其允许改进修理能力，因为可用未损坏的马达仓3012容易地替换损坏的马达仓3012。在不具有替换损坏的马达仓3012的能力的情况下，即使外科器械3010的大部分部件处于良好的操作状态，也可能使外科器械3010不可操作。替换马达仓3012的能力对于允许新产品设计中的模块化以及作为生命周期改进的一部分简化硬件升级的安装也是有用的。例如，可用升级的第二代马达仓容易地替换第一代马达仓。例如，也可在采用相同类型的马达仓的外科器械之间交换马达仓。
马达仓3012包括外壳3014，该外壳包括外科器械3010的高电流部件，诸如至少一个马达3016和至少一个马达电路板3018。由于外科器械3010的高电流部件比低电流部件诸如主控制电路板3019和各种反馈系统更容易损坏，因此希望能够通过替换马达仓3012来容易地替换高电流部件。
如图38所示，马达仓3012可释放地联接到外科器械3010。马达仓3012和外科器械3010之间的接口3021包括由机械连接器3022、3023、3024和3025表示的机械部件，由电连接器3026、3028、3030和3032表示的电力/通信传输部件。在至少一个实例中，主控制电路板3019包括接收器3053，该接收器可以是插口的形式，如图36B所示。接收器3053可被构造成能够接收连接器3028和3032，例如以将主控制电路板3019电联接到电路板3018和3018'。在某些实例中，接口3021还包括一个或多个开关，所述开关可在马达仓3012和外科器械3010的联接接合之后被激活。于2013年4月16日提交且名称为“DRIVE SYSTEM DECOUPLINGARRANGEMENT FOR A SURGICAL INSTRUMENT”的美国专利申请公布2014/0305990中描述了各种合适的连接器，该公布据此全文以引用方式并入本文。
在图38所示的方面，马达仓3012包括两个马达3016和3016'，这两个马达由单独的马达控制电路板3018和3018'控制。或者，马达3016和3016'可由一个马达控制电路板控制。在某些实例中，两个或更多个单独的马达仓可与外科器械3010一起使用，其中每个马达仓包括例如至少一个马达以及用于控制至少一个马达的至少一个马达控制电路板。为简洁起见，下面的讨论将集中在马达3016和控制电路板3018上；但是下面的讨论也适用于马达3016'和控制电路板3018'。
马达3016可以是被构造成能够致动一个或多个驱动器(例如，图36B的可旋转驱动连接器3024)的任何电动马达。马达3016由外科器械3010中的电源3034供电。电能通过接口3021传输到马达3016。电源3034可以是DC电池(例如，可再充电的铅基、镍基、锂离子基电池等)、AC/DC变压器或适合向马达3016提供电能的任何其他电源。当马达仓3012联接到外科器械3010时，电源3034和马达3016联接到马达控制电路3018，该马达控制电路控制马达3016的操作，包括电能从电源3034到马达3016的流动。
参见图38，主控制电路板3019包括微控制器3020(“控制器”)。在某些实例中，控制器3020可包括微处理器3036(“处理器”)和一个或多个计算机可读介质或存储单元3038(“存储器”)。在某些实例中，存储器3038可存储各种程序指令，所述各种程序指令在被执行时可使处理器3036执行本文所述的多个功能和/或计算。电源3034可被构造成能够向例如控制器3020和/或主控制电路板3019的其他部件供电。
控制器3020和/或本公开的其他控制器可使用集成的和/或分立的硬件元件、软件元件和/或两者的组合来实现。集成硬件元件的示例可包括处理器、微处理器、微控制器、集成电路、ASIC、PLD、DSP、FPGA、逻辑门、寄存器、半导体器件、芯片、微芯片、芯片组、微控制器、SoC、和/或SIP。分立硬件元件的示例可包括电路和/或电路元件，诸如逻辑门、场效应晶体管、双极型晶体管、电阻器、电容器、电感器和/或继电器。在某些实例中，例如，控制器3020可包括混合电路，该混合电路在一个或多个基板上包括分立的和集成的电路元件或部件。
在某些实例中，控制器3020和/或本公开的其他控制器可以是例如购自TexasInstruments的LM 4F230H5QR。在某些实例中，Texas Instruments LM4F230H5QR为ARMCortex-M4F处理器芯，其包括：256KB的单循环闪速存储器或其他非易失性存储器(最多至40MHZ)的片上存储器、用于使性能改善超过40MHz的预取缓冲器、32KB的单循环SRAM、装载有软件的内部ROM、2KB的EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入通道的一个或多个12位ADC，以及易得的其他特征。可以很方便地换用其他微控制器，来与本公开联合使用。因此，本公开不应限于这一上下文。
在各种实例中，本文所述的各种步骤中的一个或多个可由包括组合逻辑电路或顺序逻辑电路的有限状态机执行，其中组合逻辑电路或顺序逻辑电路耦合到至少一个存储电路。至少一个存储电路存储有限状态机的当前状态。组合或顺序逻辑电路被构造成能够使有限状态机到达这些步骤。顺序逻辑电路可以是同步的或异步的。在其他实例中，例如，本文所述的各种步骤中的一个或多个可通过包括处理器3036和有限状态机的组合的电路来执行。
图39描绘了表示可由外科器械3010实施例如以监测马达仓3012的健康状况并响应所检测到的马达仓故障的可能操作的逻辑图3070。处理器3036可从外科器械3010的致动器3042接收3072马达激活信号。致动器3042可以是开关，其被构造成能够在致动器3042致动时闭合或断开电路。电路的闭合或断开可发信号通知处理器3036致动器3042已被致动。在至少一个实例中，致动器3042可以是击发触发器的形式，其可由操作者致动以激活例如外科器械3010的击发序列。在另一个实例中，致动器3042可以是闭合触发器的形式，其可由操作者致动以闭合例如外科器械3010的端部执行器300。在另一个实例中，致动器3042可以是旋转触发器的形式，其可由操作者致动以旋转例如外科器械3010的端部执行器300。
在接收到激活信号时，处理器3036可发信号通知3074马达控制电路板3018激活马达3016。在致动器3042被致动时，可连续监测3076马达仓3012的健康状况。在正常操作条件下，如图38所示，马达3016从电源3034汲取电流并产生旋转运动，该旋转运动响应于致动器3042的致动而通过接口3021被传输到驱动机构160。然而，如果检测到3078马达仓3012中的故障，则可激活3079一个或多个安全和/或操作措施，如下面更详细地描述。否则，在致动器3042被致动时，连续监测3076马达仓健康状况，直到检测到3078故障。
图40描绘了表示可由外科器械3010实施例如以监测马达仓3012的健康状况并响应所检测到的马达仓故障的可能操作的逻辑图3080。处理器3036可从外科器械3010的致动器3042接收3082马达激活信号。在接收到激活信号时，处理器3036可发信号通知3084马达控制电路板3018激活马达3016。在3086处，在致动器3042被致动时，可通过监测马达仓3012的电流消耗来连续监测马达仓3012的健康状况。如图38所示，马达仓3012的电流消耗可由一个或多个电流传感器3040来监测。所感测的电流读数可由电流传感器3040传送到处理器3036。在3088处，如果在致动器3042被致动时，马达仓3012的电流消耗变得超出预定值或范围，则处理器3036可断定检测到3088马达仓3012的故障。如果检测到3088马达仓3012中的故障，则可激活3089一个或多个安全和/或操作措施，如下面更详细地描述。否则，在致动器3042被致动时，连续监测3086马达仓健康状况，直到检测到3088故障。
例如，预定值或范围可存储在存储器3038中。在预定范围存储在存储器3038中的情况下，处理器3036可访问存储器3038以将电流传感器3040的电流读数或多个电流读数的平均值与预定范围进行比较。如果电流读数大于或等于预定范围的最大值，则处理器3036可断定检测到3088马达仓3012的故障。而且，如果电流读数小于或等于预定范围的最小值，则处理器3036可断定检测到3088马达仓3012的故障。
同样，在存储值存储在存储器3038中的情况下，处理器3036可访问存储器3038以将电流传感器3040的电流读数或多个电流读数的平均值与预定值进行比较。如果电流读数例如大于或等于预定值，或者例如小于或等于预定值，则处理器3036可断定检测到3088马达仓3012的故障。
在至少一个实例中，如果在致动器4302被激活时，马达仓3012的电流消耗小于或等于预定值的10％，则处理器3036可断定检测到马达仓3012的故障。在至少一个实例中，如果在致动器3042被激活时，马达仓3012的电流消耗小于或等于预定值的20％，则处理器3036可断定检测到马达仓3012的故障。在至少一个实例中，如果在致动器3042被致动时，马达仓3012的电流消耗大于或等于预定值的150％，则处理器3036可断定检测到马达仓3012的故障。在至少一个实例中，如果在致动器3042被致动时，马达仓3012的电流消耗大于或等于预定值的200％，则处理器3036可断定检测到马达仓3012的故障。
如上所述，处理器3036可被构造成能够通过激活(79和89)一个或多个安全和/或操作措施来响应所检测到的马达仓3012的故障。例如，处理器3036可使用一个或多个反馈元件3044来向外科器械3010的操作者发出警告。在某些实例中，反馈元件3044可包括例如一个或多个视觉反馈系统，诸如显示屏、背光源和/或LED。在某些实例中，反馈元件3044可包括例如一个或多个音频反馈系统，诸如扬声器和/或蜂鸣器。在某些实例中，反馈元件3044可包括例如一个或多个触觉反馈系统。在某些实例中，反馈元件3044可包括例如视觉、音频和/或触觉反馈系统的组合。
除上述之外，处理器3036可使用外科器械3010的反馈屏幕3046(图36B)来向操作者提供例如如何替换马达仓3012的指令。另外，处理器3036可通过将马达仓3012的损坏状态存储或记录在存储器3038中来响应所检测到的马达仓3012的故障。
在至少一个实例中，处理器3036可禁用外科器械3010，直到用未损坏的马达仓替换损坏的马达仓3012。例如，存储器3038可包括程序指令，所述程序指令在由处理器3036响应于所检测到的马达仓3012的故障而执行时，可使处理器3036忽略来自致动器3042的输入，直到损坏的马达仓3012被替换。可使用马达仓替换反馈元件3058来警告处理器3036何时替换马达仓3012，如下面更详细地描述。
主要参见图36A和图38，外科器械3010可包括马达进入门3013。马达进入门3013可以可释放地锁定到柄部外壳102，以控制通向马达仓3012的入口。如图36A所示，马达进入门3013可包括锁定机构，诸如用于与柄部外壳102锁定接合的按扣型锁定机构3047。本公开设想了用于将马达进入门3013锁定到柄部外壳102的其他锁定机构。在使用中，临床医生可通过解锁锁定机构3047并打开马达进入门3013来获得通向马达仓3012的入口。在至少一个示例中，马达进入门3013可以可分离地联接到柄部外壳102，并且可从柄部外壳102拆下，以提供例如通向马达进入门3013的入口。在另一个示例中，马达进入门3013可经由铰链(未示出)可枢转地联接到柄部外壳102，并且可相对于柄部外壳102枢转，以提供例如通向马达进入门3013的入口。在又一个示例中，马达进入门3013可以是滑动门，其可相对于柄部外壳102可滑动地移动，以提供通向马达进入门3013的入口。
再次参见图38，在某些实例中，马达门反馈元件3048可被构造成能够警告处理器3036锁定机构3047被解锁。在至少一个示例中，马达门反馈元件3048可包括可操作地联接到处理器3036的开关电路(未示出)；开关电路可被构造成能够例如当锁定机构3047被临床医生解锁时转换到打开构型，并且/或者当锁定机构3047被临床医生锁定时转换到闭合构型。在至少一个示例中，马达门反馈元件3048可包括可操作地联接到处理器3036的至少一个传感器(未示出)；传感器可被构造成能够例如当锁定机构3047被临床医生转换到解锁和/或锁定构型时被触发。马达门反馈元件3048可包括用于检测锁定机构3047被临床医生锁定和/或解锁的其他装置。
参见图38和图41，控制器3020可包括实施为固件、软件、硬件或其任何组合的一个或多个嵌入式应用程序。在某些实例中，控制器3020可例如包括各种可执行模块，诸如软件、程序、数据、驱动器和/或应用程序接口(API)。图41描绘了可存储在例如存储器3038中的示例性模块3050。模块3050可由处理器3036执行，例如以向外科器械3010的用户警告、指导和/或提供关于替换马达仓3012的反馈。
如图41所示，模块3050由处理器3036执行，以向用户提供例如关于如何替换马达仓3012的指令。在各种实例中，模块3050可包括一个或多个决策步骤，例如关于检测需要替换马达仓3012的一个或多个错误的决策步骤3052。在至少一个实例中，如上面更详细地描述，处理器3036被构造成能够例如当马达仓3012的电流消耗在致动器3042被致动时超出预定范围时，检测需要替换马达仓3012的错误。
当处理器3036在决策步骤52中检测到错误时，处理器3036可通过例如停止和/或禁用马达3016来进行响应。另外，在某些实例中，处理器3036还可在检测到马达仓错误之后将马达仓3012的损坏状态存储在存储器3038中，如图42所示。如上所述，存储器3038可以是非易失性存储器，其可在例如用户重置外科器械3010时保存所存储的状态。在各种实例中，可通过例如将电源3034与马达3016断开来停止和/或禁用马达3016。在各种实例中，主控制电路板3019可包括马达超驰电路，例如处理器3036可使用该电路来停止向马达仓3012进行电力传输。停止马达3016和/或停止向马达仓3012进行电力传输的步骤可有利于例如防止出现或至少降低进一步损坏外科器械3010的可能性。
除上述之外，仍参见图41，模块3050可包括用于检测马达进入门3013是否被移除的决策步骤3054。如上所述，处理器3036可以可操作地联接到马达门反馈元件3048，该马达门反馈元件可被构造成能够警告处理器3036马达进入门3013是否被移除。在某些实例中，处理器3036可被编程为例如当马达门反馈元件3048报告锁定机构3047被解锁时，检测马达进入门3013是否被移除。在某些实例中，处理器3036可被编程为例如当马达门反馈元件3048报告马达进入门3013被打开时，检测马达进入门3013是否被移除。在某些实例中，处理器3036可被编程为例如当马达门反馈元件3048报告锁定机构3047被解锁并且马达进入门3013被打开时，检测马达进入门3013是否被移除。
仍参见图41，当处理器3036在决策步骤3052中未检测到马达仓错误并且在决策步骤3054中未检测到马达进入门3013被移除时，处理器3036可不中断外科器械3010的正常操作，并且可继续进行各种临床算法。然而，处理器3036可继续检测需要替换马达仓3012的错误。
在某些实例中，当处理器3036在决策步骤3052中未检测到马达仓错误但是在决策步骤3054中检测到马达进入门3013被移除时，处理器3036可如上所述通过停止和/或禁用马达3016来进行响应。另外，处理器3036还可向用户提供重新安装马达进入门3013的指令。在某些实例中，当处理器3036检测到马达进入门3013被重新安装，同时未检测到马达仓错误时，处理器3036可被构造成能够将电源重新连接到马达3016并允许用户继续进行临床算法，如图41所示。
除上述之外，当处理器3036检测到马达仓错误并且进一步检测到马达进入门3013的移除时，处理器3036可例如通过向用户提供视觉、音频和/或触觉反馈来发信号通知用户替换马达仓3012。在某些实例中，处理器3036可通过使反馈屏幕3046的背光源闪烁来发信号通知外科器械3010的用户替换马达仓3012。在任何情况下，处理器3036可向用户提供替换马达仓3012的指令，如图41所示。
再次参见图41，在各种实例中，由处理器3036向用户提供的移除马达进入门3013和/或替换马达仓3012的指令可包括一个或多个步骤；这些步骤可按时间顺序呈现给用户。这些步骤可包括由用户执行的动作。在这类实例中，用户可通过执行每个步骤中呈现的动作来继续进行这些步骤。在某些实例中，可将一个或多个步骤中所需的动作例如以显示在反馈屏幕3046(图36B)上的动画图像的形式呈现给用户。在某些实例中，可将一个或多个步骤作为消息呈现给用户，该消息可包括单词、符号和/或图像。
除上述之外，仍参见图41，模块3050可包括用于检测马达仓3012是否已被替换的决策步骤3056。在至少一个实例中，当马达仓3012已被替换时，请求外科器械3010的用户例如使用一个或多个用户反馈元件3044来警告处理器3036。或者如图38所示，处理器3036可以可操作地联接到马达仓替换反馈元件3058，该马达仓替换反馈元件可被构造成能够在马达仓3012被替换时警告处理器3036。在至少一个实例中，马达仓替换反馈元件3058包括一个或多个传感器和/或开关，当马达仓3012被移除和/或替换时，所述传感器和/或开关可被触发，以在马达仓3012已被移除和/或替换时警告处理器36。
在至少一个实例中，马达仓替换反馈元件3058包括定位在外科器械3010和马达仓3012之间的接口3021处的压力传感器。处理器3036可被构造成能够使用马达仓替换反馈元件3058的压力传感器来检测马达仓3012何时被移除和/或替换。在至少一个实例中，处理器3036可被构造成能够使用马达仓替换反馈元件3058的压力传感器来检测当马达仓3012与外科器械3010一起安装时的阈值设定压力读数。可使用阈值设定压力读数来设定可存储在存储器3038中的预定阈值。或者，可计算预定阈值并将其存储在存储器3036中，而与压力传感器获得的任何读数无关。
除上述之外，处理器3036可被构造成能够在由马达仓替换反馈元件3058的压力传感器检测到的一个或多个压力读数小于或等于预定阈值时断定安装的马达仓3012已被移除。当由马达仓替换反馈元件3058的压力传感器检测到的后续压力读数变得例如大于或等于预定阈值时，处理器3036还可被构造成能够断定替换马达仓3012已被安装。
除上述之外，仍参见图41，一旦确定马达仓3012已被替换，处理器3036便可被构造成能够指示用户重新安装马达进入门3013。在随后检测到马达进入门3013已被安装时，处理器3036可被构造成能够允许向安装的替换马达仓3012进行电力传输。在某些实例中，处理器3036进一步被构造成能够使用一个或多个用户反馈元件3044来向用户警告替换马达仓3012的成功安装和/或外科器械3010现在准备好继续进行各种临床算法。
在各种实例中，马达进入门3013可用被构造成能够将马达仓3012固定到柄部外壳102的马达进入构件或马达固定构件代替。或者，马达进入门3013可被完全移除或集成到马达仓3012的外壳3014中，使得可通过例如远离柄部外壳102拉动或回缩马达仓3012来容易地从外科器械3010移除或分离马达仓3012。在至少一个实例中，在没有马达进入门的情况下，马达仓3012的外壳3014的外壁3059(图37)可被构造成能够在马达仓3012与外科器械3010一起安装时形成外科器械3010的柄部外壳102的外壁的一部分。在这类实例中，外壁3059可包括附接部分(未示出)，该附接部分可被外科器械的用户抓住并被拉动以便于例如将马达仓3012与柄部外壳102分离。
图42描绘了可存储在例如存储器38中的示例性模块3060。模块3060在许多方面类似于模块3050。例如，模块3060也可由处理器3036执行，例如以向外科器械3010的用户警告、指导和/或提供关于替换马达仓3012的反馈；但是，模块3060在不使用马达进入门特征结构时实施。
如图41所示，模块3050由处理器3036执行，以向用户提供例如关于如何替换马达仓3012的指令。在各种实例中，模块3050可包括一个或多个决策步骤，例如关于检测需要替换马达仓3012的一个或多个错误的决策步骤3052。在至少一个实例中，如上面更详细地描述，处理器3036被构造成能够例如当马达仓3012的电流消耗在致动器3042被激活时超出预定范围时，检测需要替换马达仓3012的错误。
与模块3050类似，模块3060也可包括一个或多个决策步骤，例如关于检测需要替换马达仓3012的一个或多个错误的决策步骤3052。当处理器3036在决策步骤3052中检测到错误时，处理器3036可通过例如停止和/或禁用马达3016来进行响应。另外，在某些实例中，处理器3036还可在检测到马达仓错误之后将马达仓3012的损坏状态存储在存储器3038中，如图42所示。
除上述之外，当处理器3036检测到马达仓错误时，处理器3036可例如通过向用户提供视觉、音频和/或触觉反馈来发信号通知用户替换马达仓3012。在某些实例中，处理器3036可通过使反馈屏幕3046的背光源闪烁来发信号通知外科器械3010的用户替换马达仓3012。在任何情况下，处理器36可向用户提供替换马达仓3012的指令，如图42所示。此外，模块3060包括决策步骤3056，用于检测马达仓3012是否已被替换，如上面更详细地描述。另外，一旦确定马达仓3012已被替换，处理器3036便可被构造成能够允许向安装的替换马达仓3012进行电力传输。处理器3036可进一步被构造成能够使用一个或多个用户反馈元件3044来向用户警告替换马达仓3012的成功安装。
参见图43至图44，描绘了外科器械4010。外科器械4010在许多方面类似于外科器械100。例如，外科器械4010被构造成用于经由适配器200与端部执行器或单次使用的装载单元或再装载件300选择性地连接。而且，外科器械4010包括柄部外壳102，该柄部外壳包括下部外壳部分104、中间外壳部分106和上部外壳部分108。
与外科器械100类似，外科器械4010包括驱动机构160，该驱动机构被构造成能够驱动轴和/或齿轮部件，以便执行外科器械4010的各种操作。在至少一个实例中，驱动机构160包括旋转驱动系4012(参见图44)，该旋转驱动系被构造成能够使端部执行器300相对于柄部外壳102围绕纵向轴线“X”(参见图2)旋转。驱动机构160还包括闭合驱动系4014(参见图44)，该闭合驱动系被构造成能够使砧座组件306相对于端部执行器300的仓组件308移动以捕获其间的组织。另外，驱动机构160包括击发驱动系4016(参见图44)，该击发驱动系被构造成能够击发端部执行器300的仓组件308内的缝合和切割仓。
如上所述，主要参见图7、图8和图44，驱动机构160包括可以相对于适配器200紧邻近侧定位的选择器齿轮箱组件162。在选择器齿轮箱组件162近侧的是包括第一马达164的功能选择模块163，该功能选择模块用于择性地移动选择器齿轮箱组件162内的齿轮元件以选择性地定位驱动系4012、4014和4016中的一者，并将其移动成与第二马达166的输入驱动部件165接合。
参见图44，马达164和166分别联接到马达控制电路4018和4018'，所述马达控制电路被构造成能够控制马达164和166的操作，包括电能从电源156到马达164和166的流动。电源156可以是DC电池(例如，可再充电的铅基、镍基、锂离子基电池等)、AC/DC变压器或适合向外科器械4010提供电能的任何其他电源。
外科器械4010还包括微控制器4020(“控制器”)。在某些实例中，控制器4020可包括微处理器4036(“处理器”)和一个或多个计算机可读介质或存储单元4038(“存储器”)。在某些实例中，存储器4038可存储各种程序指令，所述各种程序指令在被执行时可使处理器4036执行本文所述的多个功能和/或计算。电源156可被构造成能够例如向控制器4020供电。
处理器4036可与马达控制电路4018通信。另外，存储器4038可存储程序指令，所述程序指令在由处理器4036响应于用户输入4034执行时，可使马达控制电路4018促动马达164产生至少一个旋转运动，从而选择性地移动选择器齿轮箱组件162内的齿轮元件以选择性地定位驱动系4012、4014和4016中的一者，并将其移动成与第二马达166的输入驱动部件165接合。此外，处理器4036可与马达控制电路4018'通信。存储器4038还可存储程序指令，所述程序指令在由处理器4036响应于用户输入4034执行时，可使马达控制电路4018'促动马达166产生至少一个旋转运动，从而驱动例如与第二马达166的输入驱动部件165接合的驱动系。
控制器4020和/或本公开的其他控制器可使用集成的和/或分立的硬件元件、软件元件和/或两者的组合来实现。集成硬件元件的示例可包括处理器、微处理器、微控制器、集成电路、ASIC、PLD、DSP、FPGA、逻辑门、寄存器、半导体器件、芯片、微芯片、芯片组、微控制器、SoC、和/或SIP。分立硬件元件的示例可包括电路和/或电路元件，诸如逻辑门、场效应晶体管、双极型晶体管、电阻器、电容器、电感器和/或继电器。在某些实例中，例如，控制器4020可包括混合电路，该混合电路在一个或多个基板上包括分立的和集成的电路元件或部件。
在某些实例中，控制器4020和/或本公开的其他控制器可以是例如购自TexasInstruments的LM 4F230H5QR。在某些实例中，Texas Instruments LM4F230H5QR为ARMCortex-M4F处理器芯，其包括：256KB的单循环闪速存储器或其他非易失性存储器(最多至40MHZ)的片上存储器、用于使性能改善超过40MHz的预取缓冲器、32KB的单循环SRAM、装载有软件的内部ROM、2KB的EEPROM、一个或多个PWM模块、一个或多个QEI模拟、具有12个模拟输入通道的一个或多个12位ADC，以及易得的其他特征。可以很方便地换用其他微控制器，来与本公开联合使用。因此，本公开不应限于这一上下文。
在各种实例中，本文所述的各种步骤中的一个或多个可由包括组合逻辑电路或顺序逻辑电路的有限状态机执行，其中组合逻辑电路或顺序逻辑电路耦合到至少一个存储电路。至少一个存储电路存储有限状态机的当前状态。组合或顺序逻辑电路被构造成能够使有限状态机到达这些步骤。顺序逻辑电路可以是同步的或异步的。在其他实例中，例如，本文所述的各种步骤中的一个或多个可通过包括处理器4036和有限状态机的组合的电路来执行。
在各种实例中，能够评估外科器械的功能性状态以确保其功能正常可能是有利的。例如，如上所述的驱动机构(被构造成能够包括各种马达、驱动系和/或齿轮部件，以便执行外科器械4010的各种操作)可能随着时间的推移而磨损。这可在正常使用中发生，并且在一些情况下，驱动机构由于滥用情况可能磨损得更快。在某些实例中，外科器械4010可被构造成能够执行自我评估以确定驱动机构及其各种部件的状态(例如，健康状况)。
例如，自我评估可用于确定外科器械4010在再次消毒之前何时能够执行其功能或何时应替换和/或修理一些部件。可以各种方式实现对驱动机构及其部件(包括但不限于旋转驱动系4012、闭合驱动系4014和/或击发驱动系4016)的评估。与预测性能的偏差幅度可用于确定所感测的故障的可能性和这种故障的严重性。可以使用多个度量，包括：可重复预测事件的周期性分析、超出预期阈值的峰值或下降，以及故障的宽度。
在各种实例中，可使用正常运行的驱动机构或其一个或多个部件的特征波形来评估驱动机构或其一个或多个部件的状态。一个或多个振动传感器可相对于正常运行的驱动机构或其一个或多个部件布置，以记录在正常运行的驱动机构或其一个或多个部件的操作期间发生的各种振动。记录的振动可用于创建特征波形。可将未来波形与特征波形进行比较，以评估驱动机构及其部件的状态。
在至少一个方面，可采用声学原理来评估驱动机构及其部件的状态。如本文所用，术语“声学”通常是指气体、液体和固体中的所有机械波，包括振动、声音、超声(频率高于人类听觉的可听上限的声波)和次声(低频声音，频率低于20Hz[赫兹]或每秒周数，因此低于人类听觉的“正常”限值)。因此，可利用声学传感器(包括振动、声音、超声和次声传感器)来检测来自驱动机构及其部件的声发射。在一个方面，可分析驱动机构160的振动频率特征以确定驱动系4012、4014和/或4016中的一者或多者的状态。一个或多个振动传感器可联接到驱动系4012、4014和/或4016中的一者或多者，以便在使用时记录驱动系的声学输出。
再次参见图44，外科器械4010包括驱动系故障检测模块4040，其被构造成能够记录和分析驱动系4012、4014和/或4016中的一者或多者的一个或多个声学输出。处理器4036可与模块4040通信或以其他方式控制该模块。如下面更详细地描述，模块4040可体现为各种装置，诸如电路、硬件、计算机程序产品(其包括存储可由处理设备(例如，处理器4036)执行的计算机可读程序指令的计算机可读介质(例如，存储器4038))或其某种组合。在一些方面，处理器4036可包括模块4040或以其他方式控制该模块。
模块4040可包括一个或多个传感器4042，模块4040可使用这些传感器来检测外科器械4010的驱动系故障。在至少一个实例中，如图45所示，传感器4042可包括例如一个或多个声学传感器或麦克风。在至少一个实例中，如图48所示，传感器4042可包括一个或多个加速度计。
可在传感器4042的输出上使用各种类型的滤波器和变换，以生成表示例如外科器械4010的驱动系的操作状态的波形。如图45所示，多个带通滤波器可被构造成能够与传感器4042通信以便处理其输出。在图45所示的示例中，有四个带通滤波器BPF1、BPF2、BPF3和BPF4，用于对传感器4042的输出滤波。这些滤波器用于确定用来评估外科器械4010的健康状况的各种阈值，包括例如容许限值、边际限值和临界限值。在一个示例中，如图48所示的一系列低通滤波器可在传感器4042的输出上使用。
在一个方面，如图45所示，逻辑门可与滤波器一起使用以处理传感器4042的输出。或者，处理器(诸如处理器4036)可与滤波器一起使用以处理传感器4042的输出，如图48和图48A所示。图48B、图48C和图48D描绘了用于对传感器4042的输出滤波的带通滤波器的示例性结构和操作细节。在至少一个实例中，用于对传感器4042的输出滤波的一个或多个滤波器是双低噪声JFET输入通用运算放大器。
虽然可使用各种频率，但是图45中所示的滤波器的示例性频率为5kHz、1kHz、200Hz和50Hz。每个滤波器的输出在图49中示出，该图示出了每个滤波器的频率处的电压振幅。每个滤波器的输出的峰值振幅在图50中示出。例如，通过与存储在存储器4038中的阈值进行比较，这些值可用于确定外科器械4010的健康状况。如图48所示，可采用多路复用器4044和模数转换器4046来将滤波器的输出传送到处理器4036。
在至少一个实例中，当马达在具有可重复运动的已知功能期间运行时，可记录传感器4042的输出。例如，当马达166运行以将驱动系(诸如，击发驱动系4016)回缩或重置到原始或起始位置时，可记录该输出。所记录的传感器4042的输出可用于产生该运动的特征波形。在一个示例中，所记录的传感器4402的输出通过快速傅立叶变换运行以产生特征波形。
除上述之外，可将得到的特征波形的关键区域的振幅与例如存储在存储器4038中的预定值进行比较。在至少一个实例中，存储器4038可包括程序指令，所述程序指令在由处理器4036执行时，可使处理器4036将关键区域的振幅与存储在存储器4038中的预定值进行比较。当振幅超过那些存储值时，处理器4036确定外科器械4010的一个或多个部件不再正常运行并且/或者外科器械4010已达到其使用寿命的终点。
图46示出了来自正常运行的驱动系的振动响应。随着时间的推移记录来自定位在驱动系上或紧邻驱动系定位的麦克风的以伏特为单位的输出。使用快速傅立叶变换确定该输出的频率响应，如图46A所示，以产生正常运行的驱动系的特征波形。正常运行的驱动系的特征波形可用于检测同一驱动系或其他类似驱动系中的任何故障。例如，图47示出了来自正常运行的驱动系的振动响应。麦克风输出用于确定故障驱动系的频率响应，如图47A所示。故障驱动的频率响应与正常运行的驱动系的特征波形的偏差表示驱动系中的故障。
在至少一个实例中，将如图47A所示的正常运行的驱动系的频率响应的关键区域的存储值与如图48A所示的所检查驱动系的频率响应的相应区域的记录值进行比较。在记录值超过存储值的情况下，可断定在所检查驱动系中检测到故障。作为响应，可采取各种安全和补救步骤，如在名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE INPOWERED SURGICAL INSTRUMENTS”且于2015年12月30日提交的共同拥有的美国专利申请序列号14/984,525中更详细地描述，该申请全文以引用方式并入本文。
当部件被移动以在外科器械4010的端部执行器处实现功能(诸如，捕获组织、将钉击发到所捕获的组织中和/或切割所捕获的组织)时，外科器械4010可以有各种操作阶段。由外科器械4010的驱动机构160产生的振动可根据外科器械4010的操作阶段而变化。某些振动可与外科器械4010的某些操作阶段唯一地相关联。因此，要考虑外科器械4010的操作阶段或区域允许选择性地分析与该操作阶段或区域相关联的振动，同时忽略与该操作阶段或区域不相关的其他振动。处理器4036可采用各种传感器(诸如，位置传感器)来确定外科器械4010的操作阶段。
在一个示例中，器械4010的各个操作阶段在图51的曲线图中表示，该图示出了在外科程序器械4010的击发序列或冲程期间与驱动组件360距离起始或原始位置的位移位置有关的击发外科器械4010所需的力(FTF)。在区域1中，外科器械4010的端部执行器300已被夹持在组织上，如上所述，但是没有影响组织。在区域2中，施加负载以移动外科器械4010的致动滑动件，以允许端部执行器300通过例如切割和缝合组织来影响组织。在区域3中，组织已被外科器械4010的端部执行器300切割和缝合。取决于在捕获和处理由各种驱动系产生的振动期间外科器械4010处于哪个区域，可将所述振动与阈值频率值进行比较，或者可忽略或不考虑所述振动。对于图51的框4048和框4050中由传感器4042捕获的振动，为了确定外科器械4010的健康状况，可忽略或不考虑所捕获的振动的某些部分。
在至少一个实例中，可忽略或不考虑阈值线4052以下的任何所捕获的振动。在至少一个实例中，在外科器械4010的击发序列或冲程期间，最小阈值4052与最大FTF的比率为选自例如约0.001至约0.30的任何值。在至少一个实例中，该比率为选自例如约0.01至约0.20的任何值。在至少一个实例中，该比率为选自例如约0.01至约0.10的任何值。
另外，也可忽略或不考虑框4048和框4050内所捕获的任何振动，只要这些框内的事件不是灾难性事件即可。在发生灾难性故障的情况下，使驱动机构160不可操作，并且采取某些救助步骤以确保外科器械4010与被治疗组织安全分离等。或者，在发生驱动系故障的情况下，仍然可操作有效驱动系以完成手术步骤或重置外科器械4010；然而，可采取某些预防和/或安全步骤以避免或最小化对驱动系和/或外科器械4010的其他部件造成额外损坏。
再次参见图51，在至少一个实例中，为了评估外科器械4010的损坏/功能状态，要忽略或不考虑在外科器械4010的击发冲程开始和/或结束时检测到的振动。在一个示例中，为了评估外科器械4010的损坏/功能状态，要考虑在外科器械4010的击发冲程的中心区段处检测到的振动。在至少一个实例中，为了评估外科器械4010的损坏/功能状态，要忽略或不考虑如图51所示的在外科器械4010的击发冲程的区域1开始和/或区域2结束时检测到的振动。
噪声有限增加可能表明例如齿轮的零部件的磨损或非灾难性故障增加。噪声幅度以慢性方式显著增加可能表明传输的持续侵蚀，但可用于预测器械4010的寿命，并且其性能降低例如允许完成某些工作。例如，峰值幅度或数量急剧大幅增加可能表明例如重大或灾难性故障导致器械启动更多直接和最终反应选项。
图52示出了与驱动组件360距离起始或原始位置的位移位置有关的外科器械4010的驱动组件360的速度。点A(图51和图52所示)表示与组织的初始接触，其增加了推进外科器械4010的驱动组件360的力，如图51所示，并且降低了驱动组件360的速度，如图52所示。点B(同样在图51和图52中所示)表示在缝合和切割期间与组织的最厚部分的接触。因此，点B处的FTF最大，如图51所示，并且点B的速度处于其最低点，如图52所示。一个或多个传感器(诸如，力传感器)可被构造成能够在推进驱动组件360时测量FTF。另外，一个或多个位置传感器可被构造成能够在外科器械4010的击发序列期间检测驱动组件360的位置。
在至少一个实例中，存储器4038包括程序指令，所述程序指令在由处理器4036执行时，使处理器4036采用定位在外科器械4010的驱动机构160的一个或多个部件附近的一个或多个传感器4042来选择性地捕获或记录在击发序列的预定节段期间由驱动机构160的一个或多个部件产生的振动。在至少一个实例中，传感器4042由处理器4036在预定节段的起始点处激活并且在击发序列或冲程的预定节段的结束点处停用，使得传感器4042可仅捕获或记录在预定节段期间产生的振动。
预定节段可具有击发序列开始之后的起始点以及击发序列完成之前的终点。换句话讲，处理器4036被构造成能够使传感器4042仅在击发序列的中心节段处记录振动。如图52所示，处理器4036可被构造成能够使传感器4042在驱动组件360的速度向下倾斜期间开始捕获或记录振动，并且在驱动组件360的速度向上倾斜期间停止记录振动。或者，传感器4042可在外科器械4010的整个击发序列期间都是有效的，而处理器4036忽略或排除在击发序列或冲程的预定节段之外记录的振动。
图53示出了基于冲程位置的区域的容许限值修改。示出了区域1和区域2的限值分布曲线。由于具有组织对外科器械4010的负载，区域2的阈值限值高于区域1。随着器械从区域1移动到区域2，器械的速度降低，功率谱的频率将下移。如图54(其表示图51和图52的点A和B在由图48所示的滤波器表示的各种带宽处的电压幅值与频率的关系)所示，每个滤波器带宽的与点B相关联的频率线低于与点A相关联的频率线，这是由于在点B处具有组织对器械4010的负载并且由于冲程区域引起速度变化。
因此，这些限值可用于评估对外科器械4010的潜在损坏。使用从外科器械4010的各种驱动系捕获的振动，可使用图45所示的处理器4036来处理振动，以确定振动的频率何时高于存储在与处理器4036相关联的存储器4038中的某些阈值，同时在捕获振动期间考虑外科器械4010的操作区域。当以某种方式确定外科器械4010有缺陷时，可在消毒或随后使用之前修理或替换器械4010。还可采取各种其他安全和/或补救步骤。
在另一方面，可将由外科器械4010产生的噪声幅度与预定义的系统谐波进行比较，以评估对外科器械4010的潜在损坏以及该损坏的严重性。如图55所示，将来自外科器械4010的一个或多个驱动系的传感器4042的输出呈现为例如区域1的电压信号。在通过滤波器处理信号期间捕获的每个频率(诸如，图48所示的那些频率)可具有其自己的阈值分布曲线。
例如，如图55所示，对于外科器械4010的每个操作区域，每个频率可具有其自己的容许限值4054、边际限值4056和临界限值4058。基于图55所示的示例，除了由A'表示的频率之外，所有频率都是容许的并且代表正常运行的外科器械4010。在至少一个实例中，这使得处理器(诸如，图48所示的处理器4036)断定发生了紧急而非灾难性驱动系故障。
除上述之外，在至少一个实例中，处理器4036被构造成能够在任何一个频率等于或超过临界限值4058时断定发生了灾难性驱动系故障。或者，处理器4036可被构造成能够例如仅当多个频率等于或超过临界限值4058时，断定发生了灾难性驱动系故障。或者，处理器4036可被构造成能够例如仅当在通过滤波器处理信号期间捕获的所有频率等于或超过临界限值4058时，断定发生了灾难性驱动系故障。
除上述之外，在至少一个实例中，处理器4036被构造成能够在任何一个频率等于或超过边际限值4056但是低于临界限值4058时断定发生了紧急驱动系故障，如图55所示。或者，处理器4036可被构造成能够例如仅当多个频率等于或超过边际限值4056但是低于临界限值4058时，断定发生了紧急驱动系故障。或者，处理器4036可被构造成能够例如仅当在通过滤波器处理信号期间捕获的所有频率等于或超过边际限值4056但是低于临界限值4058时，断定发生了紧急驱动系故障。
参见图56，逻辑图4021表示可由外科器械4010响应于所检测到的驱动系故障而实施的可能操作。存储器4038可包括程序指令，所述程序指令在由处理器4036执行时，可使处理器4036基于来自传感器4042的输入来评估驱动系故障的严重性，并且根据所确定的严重性来激活适当的响应。存储器4038可包括程序指令，所述程序指令在由处理器4036执行时，可使处理器4036例如通过激活操作的安全模式4022来响应所检测到4023的紧急驱动系故障。另外，存储器4038可包括程序指令，所述程序指令在由处理器4036执行时，可使处理器4036通过激活恢复或救助模式4022来响应所检测到的灾难性驱动系故障。当没有检测到驱动系故障时，处理器4036可允许外科器械4010继续4027正常操作，直到检测到驱动系故障。
再次参见图56，安全模式4022可包括一个或多个步骤，诸如马达调制步骤，处理器4036可采用该步骤来限制有效驱动系的速度。例如，当在击发序列期间由马达166有效地驱动击发驱动系4016时，模块4040检测到紧急驱动系故障可使处理器4036与马达驱动电路4018'(图44)指令通信，以使马达166的机械输出减小。马达166的机械输出减小降低了有效驱动系4016的速度，这确保了安全完成击发序列和/或将有效驱动系4016重置为原始或起始位置。
在另一方面，使用累积噪声幅度相对于预定最小和/或最大阈值的频率比较来评估对外科器械4010的潜在损坏。在至少一个实例中，最小阈值限定容许限值4054。低于最小阈值的累积噪声幅度被处理器4036解释为容许限值4054。另外，可采用最大阈值来限定临界限值4058。高于最小阈值的累积噪声幅度被处理器4036解释为临界限值4058。边际限值4056可由最小和最大阈值限定。在一个示例中，高于最小阈值但低于最大阈值的累积噪声幅度被处理器4036解释为边际限值4056。
图57是由四个带通滤波器BPF1、BPF2、BPF3和BPF4滤波的传感器4042的输出的处理信号的表示。处理信号在频率带宽a1、a2、a3和a4内表示，这些频率带宽对应于四个带通滤波器BPF1、BPF2、BPF3和BPF4的带宽。
图57示出了处理信号的电压幅值与频率的曲线图。带通滤波器BPF1、BPF2、BPF3和BPF4的中心频率处的处理信号的峰值电压幅值分别由实心竖直线A、A'、A”和A”'表示。另外，基线阈值4060用于允许忽略或不考虑可预测量的噪声。可考虑或忽略附加噪声，这取决于其在频谱中的位置。
在图57所示的示例中，忽视电压幅值Z2，因为其低于表示容许噪声水平的基线阈值4060，并且忽视Z4，因为其落在预定带宽a1、a2、a3和a4之外。因为Z、Z1和Z3落在基线阈值4060之上并且在预定带宽a1、a2、a3和a4内，所以在定义累积噪声幅度进而确定对器械4010的潜在损坏时要考虑具有A、A'、A”和A”'的这些电压幅值。
在至少一个实例中，对中心频率处的电压幅值A、A'、A”和A”'求和以产生由电压幅值表示的累积噪声幅度，然后采用该电压幅值来评估是否发生故障，以及(当发生时)该故障的严重性。在另一个实例中，对中心频率处的电压幅值A、A'、A”和A”'和预定带宽a1、a2、a3和a4内的任何电压幅值求和以产生由电压幅值表示的累积噪声幅度，然后采用该电压幅值来评估是否发生故障，以及(当发生时)该故障的严重性。在另一个实例中，对中心频率处的电压幅值A、A'、A”和A”'和大于基线阈值4060且在预定带宽a1、a2、a3和a4内的任何电压幅值求和以产生由电压幅值表示的累积噪声幅度，然后采用该电压幅值来评估是否发生故障，以及(当发生时)该故障的严重性。
在各种实例中，处理器4036可采用当前噪声信号和可存储在存储器4038中的先前记录的噪声信号之间的比较来确定外科器械4010的损坏/功能状态。在外科器械4010的正常操作期间由传感器4042记录的噪声信号可由处理器4036滤波和处理，以产生存储在存储器4038中的正常处理信号。由传感器4042记录的任何新噪声信号可以与正常噪声信号相同的方式进行滤波和处理，以产生当前处理信号，可将该当前处理信号与存储在存储器4038中的正常处理信号进行比较。
当前处理特征和正常处理信号之间的偏差超过预定阈值可被解释为对外科器械4010具有潜在损坏。例如，可在第一次使用器械时设定正常处理信号。或者，当前处理信号成为针对下一个当前处理信号的正常处理信号。
图58是由四个带通滤波器BPF1、BPF2、BPF3和BPF4滤波的传感器4042的输出的两个处理信号的表示。所述处理信号在频率带宽a1、a2、a3和a4内表示，这些频率带宽对应于四个带通滤波器BPF1、BPF2、BPF3和BPF4的带宽。图58示出了处理信号的电压幅值与频率的曲线图。
正常和当前处理信号的电压幅值由实心竖直线表示。正常处理信号为实线，而当前处理信号为虚线，表示当前/目前处理信号，如上所述。存在基线阈值4060，其类似于图57的基线阈值4060，用于允许忽略可预测量的噪声。计算两次迭代之间的差值，并且该差值被示为图58中的δ1、δ2和δ3。存在各种阈值，可将这些阈值与各种δ值进行比较以确定外科器械4010的损坏，所述各种δ值表示容许δ、边缘δ或临界δ，将指示替换或修理器械4010的需要。
在至少一个实例中，将一个或多个电压幅值与先前记录的噪声模式中的对应电压幅值进行比较，以评估外科器械4010的任何损坏。可将当前电压幅值与先前存储的电压幅值之间的差值与可存储在存储器4038中的一个或多个预定阈值进行比较，以选择容许、边际或临界状态的输出。
在至少一个实例中，对当前电压幅值与先前存储的电压幅值之间的差值求和并将其与存储在存储器4038中的一个或多个预定阈值进行比较，例如以选择容许、边际或临界状态的输出。偏差的幅度可在范围与范围之间进行比较，以指示局部事件中的剪切变化。
在各种实例中，处理器4036可采用可存储在存储器4038中的一个或多个算法来基于传感器4042的输出的处理信号来确定外科器械4010的损坏/功能状态。由传感器4042记录的不同噪声信号可被解释为表示外科器械4010的不同损坏/功能状态。在正常操作期间，传感器4042记录正常或预期的噪声信号。当传感器4042记录异常噪声信号时，处理器4036可使用存储在存储器4038中的一个或多个算法来对其进行进一步评估，以确定外科器械4010的损坏/功能状态。异常信号可包括可用于评估对外科器械4010的损坏性质的唯一特征。例如，异常信号的唯一特征可指示对外科器械4010的可容易地替换的特定部件的损坏。
在某些实例中，一个或多个算法被构造成能够基于传感器4042的输出的处理信号来评估外科器械4010的一个或多个部件中的正常磨损。可通过例如识别指示潜在碎片的噪声信号来检测正常磨损。例如，当通过其记录的噪声符号测量的碎片达到或超过存储在存储器4038中的预定阈值时，处理器4036可被构造成能够发出外科器械4010接近其寿命终点或需要维护的警告。
此外，一个或多个算法可被构造成能够基于传感器4042的输出的处理信号来确定对一个或多个齿轮机构(诸如，驱动机构160内的行星齿轮机构)的潜在损坏。在正常操作期间，行星齿轮可产生由传感器4042记录的正常噪声信号。例如，当行星齿轮由于断齿而被损坏时，传感器4042记录异常噪声信号。异常信号可包括例如指示损坏的行星齿轮的唯一特征。
图59是由四个带通滤波器BPF1、BPF2、BPF3和BPF4滤波的传感器4042的输出的处理信号的表示。处理信号在频率带宽a1、a2、a3和a4内表示，这些频率带宽对应于四个带通滤波器BPF1、BPF2、BPF3和BPF4的带宽。如上所述的各种算法可应用于图59的处理信号，以确定外科器械4010的损坏/功能状态。
与图57类似，图59示出了处理信号的电压幅值与频率的曲线图。处理信号的电压幅值由实心竖直线表示。在带宽a1、a2、a3和a4中的每一者内，在由幅值阈值和子带宽阈值限定的预期范围内评估处理信号。预期范围E1、E2、E3和E4分别对应于带宽a1、a2、a3和a4。
在图59所示的示例中，观察到指示潜在行星损坏的第一事件。所观察到的第一事件包括处理信号，该处理信号包括指示潜在行星损坏的两个电压幅值读数。两个电压幅值读数是在带宽a1的中心频率处超过预期范围E1的第一电压幅值读数，以及在带宽a1和a2之间但在其之外的频率处的第二电压幅值读数。第一算法可被构造成能够将所观察到的事件识别为指示潜在的行星损坏。处理器4036可采用第一算法来断定检测到潜在的行星损坏。
而且，在图59所示的示例中，观察到指示与外科器械4010的毂相关的唯一潜在损坏的第二事件。第二事件包括处理信号，该处理信号包括在带宽a2的中心频率处低于预期电压幅值阈值的电压幅值读数。另外，该处理信号包括电压幅值读数Z1和Z2，这两个读数超过基线阈值4060，并且在带宽a2内，但是落在预期范围E2的子带宽阈值之外。第二算法可被构造成能够将所观察到的第二事件识别为指示唯一的潜在损害。处理器4036可采用第二算法来断定检测到与外科器械4010的毂相关的潜在损坏。
而且，在图59所示的示例中，观察到指示与外科器械4010的一个或多个部件相关联的指示磨损的潜在碎片的第三事件。第三事件包括处理信号，该处理信号包括在带宽a4的中心频率处超过预期电压幅值阈值的电压幅值读数。第三算法可被构造成能够将所观察到的第三事件识别为指示潜在的碎片。例如，处理器4036可采用第三算法来基于所观察到的电压幅值和预期电压幅值阈值之间的差值来评估潜在碎片的严重性。
本文所述的某些外科缝合和切割端部执行器包括细长通道，该细长通道被构造成能够可移除地接收其中存储有外科钉的钉仓。钉仓包括可移动地支撑在钉仓的仓体内的弹射器或驱动器，所述弹射器或驱动器各自被构造成能够支撑其上的一个或多个钉。钉支撑驱动器在仓体内以纵排布置，位于仓体中限定的纵向延伸狭槽的每一侧。狭槽被构造成能够可移动地容纳击发构件，该击发构件上可具有组织切割边缘，用于切割已经夹持在砧座和钉仓之间的组织。当驱动器与滑动件(该滑动件被构造成能够由击发构件纵向地驱动通过仓体)接触时，驱动器在仓体中被向上推动，即朝向仓体的平台被推动。滑动件可移动地支撑在仓中，并且包括多个成角度的或楔形的凸轮，所述凸轮对应于仓体内成排的钉驱动器。在未击发或“新鲜”的钉仓中，滑动件定位在每条线中靠近第一驱动器或最近侧钉驱动器的起始位置。在击发冲程期间，滑动件被击发构件朝远侧推进，以从仓体中弹射出钉。一旦钉仓至少部分地被击发，即从仓体中弹射出，击发构件就回缩到开始或未击发位置，并且滑动件保持在现在用过的钉仓的远侧端部处。一旦击发构件已经返回到开始或未击发位置，就可将用过的钉仓从端部执行器的通道中移除。
除上述之外，外科器械系统19010在图60中示出。外科器械系统19010包括柄部19014和可移除地附接到柄部19014的轴组件19200。轴组件19200包括端部执行器19300，该端部执行器包括仓通道19302和可相对于仓通道19302移动的砧座19306。钉仓19304可移除地定位在仓通道19302中。
这类切割和缝合端部执行器安装到细长轴组件的远侧端部，该细长轴组件可操作地支撑被构造成能够将各种控制运动施加到端部执行器的各种驱动轴和部件。在各种实例中，轴组件可包括关节运动接头，或可以其他方式被构造成能够在关节运动被施加到端部执行器时便于端部执行器相对于细长轴的一部分进行关节运动。轴组件联接到支撑各种驱动系统的外壳，所述各种驱动系统可操作地与细长轴组件中的各种部件接口。在某些布置中，外壳可包括手持式外壳或柄部。在其他布置中，外壳可包括一部分的机器人或自动化外科系统。外壳的各种驱动系统可被构造成能够将轴向驱动运动、旋转驱动运动和/或轴向和旋转驱动运动的组合施加到细长轴组件。在手持式布置中，轴向运动可由一个或多个手动致动的手动曲柄产生和/或由一个或多个电动马达产生。机器人系统可采用电动马达和/或其他自动化驱动布置，其被构造成能够产生必要的控制运动并将其施加到细长轴组件，并且在一些实例中，最终施加到端部执行器中的击发构件。
对于需要旋转控制运动的外科端部执行器，细长轴组件可包括“近侧”旋转驱动轴部分，其由相应的马达或支撑在外壳中的其他旋转运动源来旋转。近侧旋转驱动轴被构造成能够将旋转控制运动施加到支撑在端部执行器中的端部执行器驱动轴。在这类布置中，击发构件与端部执行器驱动轴接口，使得击发构件可被纵向推进通过端部执行器，然后返回到未击发位置。
当使用被构造成能够切割和缝合组织的外科器械时，应采取措施以确保在致动外科器械的击发驱动系统之前已将未用过的外科钉仓正确地安装在外科器械的端部执行器中。例如，如果临床医生无意中致动了击发驱动系统的组织切割构件而没有首先将未用过的钉仓安装在端部执行器中，则组织切割构件可切断组织而不缝合组织。如果临床医生无意中将部分用过的钉仓安装到端部执行器中，也会出现类似的问题。当在先前的程序中或在程序中的先前步骤中使用钉仓时，可产生部分用过的钉仓，然后在所有钉从其中弹射出之前将其从端部执行器中移除。如果要在外科器械中重复使用这种部分用过的仓，则组织切割构件可在组织中产生比施加到组织的钉线更长的切口。因此，当使用被构造成能够切割和缝合组织的外科端部执行器时，希望外科端部执行器被构造成能够防止组织切割构件的致动，除非已将未用过的“新鲜”钉仓正确地安装在端部执行器中。
图61和图62描绘了可解决这些问题的外科切割和缝合端部执行器20000的各部分。如图61和图62所示，端部执行器20000包括旋转端部执行器驱动轴20010。虽然未示出，但是旋转端部执行器驱动轴20010可旋转地支撑在细长通道内，该细长通道被构造成能够在其中可移除地支撑外科钉仓。旋转端部执行器驱动轴20010被构造成能够从近侧旋转驱动轴接收旋转驱动运动，该近侧旋转驱动轴附接到通道或以其他方式可操作地与旋转端部执行器驱动轴20010接口。可通过相应的驱动布置将旋转控制运动施加到近侧旋转驱动轴，该驱动布置可包括由机器人控制系统或其他旋转控制运动源手动致动或控制的一个或多个马达。在替代布置中，可手动产生旋转控制运动。仍参见图61和图62，外科端部执行器20000包括击发组件20020，该击发组件被构造成用于在通道内纵向行进。在所示的实施方案中，击发组件20020包括上部击发主体20022，该上部击发主体具有远侧发射凸耳20024和近侧击发凸耳20026。远侧击发凸耳20024中具有无螺纹孔(未示出)，该无螺纹孔被构造成能够接收穿过其中的旋转端部执行器驱动轴20010。近侧击发凸耳20026与远侧击发凸耳20024间隔开，以在其间限定螺母腔20028。近侧击发凸耳20026具有穿过其中的无螺纹孔20027，该无螺纹孔被构造成能够接收穿过其中的旋转端部执行器驱动轴20010。
如图61和图62所示，旋转端部执行器驱动轴20010是螺纹的。击发组件20020包括行进螺母20030，该行进螺母以螺纹方式轴颈连接在旋转端部执行器驱动轴20010上并且位于远侧击发凸耳20026和近侧击发凸耳20027之间的螺母腔20028中。行进螺母20040可在螺母腔20028内在第一位置(图61)和第二位置(图62)之间移动。行进螺母20040包括上部凹口部分20042，该上部凹口部分具有从其中突出的朝远侧延伸的保持器凸片20044。当行进螺母20040处于第一位置时，凹口上部部分20042与击发组件20020的上部击发主体20022竖直对齐。如图61和图62进一步所示，远侧击发凸耳20024可包括一对侧向突出的远侧翼片20025(图中仅可看到一个)，并且近侧击发凸耳20026可包括一对侧向突出的近侧翼片20027。同样，行进螺母20040可包括一对螺母翼片20046，该对螺母翼片被构造成能够在行进螺母20040处于第一位置时与远侧翼片20025和近侧翼片20027对齐。参见图61。当处于该对齐位置时，翼片20025、20027和20046可在设置在钉仓主体中的通道内自由通过。同样在所示的布置中，击发组件20020的上部主体部分20022包括一对侧向突出的上部翼片20030，该对上部翼片被构造成能够在击发组件朝远侧驱动通过端部执行器时可滑动地接收在砧座中的相应通道中或以其他方式可滑动地接合砧座。因此，翼片20025、20027、20046和上部翼片20030用于在击发过程中将砧座保持在距钉仓所需的距离处。击发组件20020还包括组织切割表面或组织切割刀片20032，用于切割已经夹持在砧座和钉仓之间的组织。
外科端部执行器20000的通道被构造成能够在其中可操作地且可移除地支撑包括滑动件20050的外科钉仓。滑动件20050可从位于钉仓的近侧端部中的起始位置移动到仓内的结束位置。滑动件20050包括中心滑动件主体20052，该中心滑动件主体具有形成在其中的一组凸轮楔形件20054。在所示的示例中，滑动件20050包括四个凸轮楔形件20054，其中两个凸轮楔形件20054位于中心滑动件主体20052的每一侧上。每个凸轮楔形件20054将对应于位于仓体中的一排钉支撑驱动器。当滑动件20050朝远侧驱动通过仓体时，凸轮楔形件20054将在仓体内向上顺序地驱动相应排中的钉驱动器，从而驱动钉与砧座的下侧形成接触。
在所示的示例中，滑动件20050包括形成在中心滑动件主体20052中的保持腔20056，该保持腔被构造成能够在行进螺母处于第一位置并且滑动件20050处于起始(预击发)位置时保持地接合行进螺母20040上的朝远侧延伸的保持器凸片20044。参见图61。在某些布置中，一个或多个偏置构件20060可设置在击发组件20020中，以将行进螺母20040偏置到第一位置。例如，扭力弹簧可支撑在近侧击发凸耳20024和远侧击发凸耳20026中的一者或两者中，以在未致动螺纹端部执行器驱动轴20020时将行进螺母20040偏置到第一位置(方向D1)。然而，当螺纹端部执行器驱动轴20020在击发方向(D2)上旋转时，旋转驱动轴20020克服偏置构件20060的偏置并且将行进螺母20030移动到图62所示的第二位置。当行进螺母20030处于第二位置时，保持凸片20044与仓体中可滑动地容纳中心滑动件主体20052的狭槽脱离对齐，并且螺母翼片20046与仓体中的通道脱离对齐。因此，旋转端部执行器驱动杆20010的进一步旋转将不会朝远侧驱动击发组件20020，因为凸片20044和翼片20046不与仓体的相应部分对齐。但是，如果仓是未用过的(从未击发的)，则仓将使滑动件20050处于起始位置。当将仓正确地安置在端部执行器通道中时，保持器凸片20044将被接收在滑动件20050中的保持腔20056中，当旋转端部执行器驱动轴20010在击发方向上旋转时，该保持腔将行进螺母20030保持在第一位置。因此，当未将未用过的仓正确地安置在通道中时，这种布置将防止临床医生无意中推进击发组件20020(和组织切割表面20044)。如果将用过的或甚至部分用过的仓安置在通道中，则滑动件将不会处于起始位置，并且临床医生将无法击发击发组件。如果通道中存在未用过的仓，但是尚未将其正确地安置在其中，使得保持凸片被接收在滑动件中的保持腔内，则临床医生将无法推进击发组件。
接下来转到图63至图65，示出了另一个外科切割和吻合端部执行器20100的各部分。端部执行器20100包括通道20110，该通道被构造成能够在其中可移除地接收外科钉仓20200。在至少一个实施方案中，端部执行器20100包括旋转端部执行器驱动轴20120，其可在第一“锁定”位置和第二“驱动”位置之间选择性地移动或偏转。旋转端部执行器驱动轴20120被构造成能够从近侧旋转驱动轴(未示出)接收旋转驱动运动。可通过相应的驱动布置将旋转控制运动施加到近侧旋转驱动轴，该驱动布置可包括由机器人控制系统手动致动或控制的一个或多个马达。在替代布置中，可手动产生旋转控制运动。可通过相应的旋转轴承布置或支架将旋转端部执行器驱动轴20120可旋转地支撑在其近侧端部和远侧端部上，所述旋转轴承布置或支架便于旋转端部执行器驱动轴20120的操作旋转，但使旋转端部执行器驱动轴的一部分能够在第一位置和第二位置之间偏转，同时保持与近侧旋转驱动轴或其他旋转运动源的旋转操作接合。
如图63至图67所示，外科端部执行器20100包括击发组件20130，该击发组件被构造成用于在通道20110内纵向行进。在所示的实施方案中，击发组件20130包括击发主体20132，该击发主体以螺纹方式轴颈连接在旋转端部执行器驱动轴20120上。击发主体20132包括一对侧向突出的翼片20134，该对翼片被构造成能够在通道20110中的通路20112内通过。通路20112可由两个向内延伸的间隔开的通道凸片20114(图66和图67中仅可看到一个凸片)限定，所述两个通道凸片间具有槽20116，用于容纳旋转端部执行器驱动轴20120以及其间的击发主体20132的通路。参见图66和图67。同样在所示的布置中，击发组件20130的上部主体部分20136包括一对侧向突出的上部翼片20138，该对上部翼片被构造成能够在击发组件20130朝远侧驱动通过端部执行器20100时可滑动地接收在砧座20150中的相应通道20152中。因此，翼片20134和20138用于在击发过程中将砧座20150保持在距钉仓20200所需的距离处。击发组件20130还包括组织切割表面或组织切割刀片20139，该组织切割表面或组织切割刀片被构造成能够切割已经夹持在砧座和钉仓之间的组织。
图63示出了将未用过的钉仓20200安装到外科端部执行器20100中。如图63所示，未用过的钉仓20200包括位于起始位置的滑动件20210。滑动件20210可从位于钉仓20200的近侧端部中的起始位置移动到仓20200内的结束位置。如图67所示，滑动件20210包括中心滑动件主体20212，该中心滑动件主体具有形成在其中的一组凸轮楔形件20214。在所示的示例中，滑动件20210包括四个凸轮楔形件20214，其中两个凸轮楔形件20214位于中心滑动件主体20212的每一侧上。每个凸轮楔形件20214对应于支撑在仓20200中的一排钉支撑驱动器。当滑动件20210朝远侧驱动通过仓20200时，凸轮楔形件20214在仓20200内向上顺序地驱动相应排中的钉驱动器，从而驱动钉与砧座2015的下侧形成接触。在将未用过的钉仓20200安置在通道20110中之前，旋转驱动轴20120位于第一位置或向上位置(由箭头“U”表示)。图66示出了在将钉仓安装在端部执行器内之前处于锁定位置的旋转驱动轴20120和击发组件20130的位置。如图66所示，翼片20134与通道20110的通道凸片20144对齐，使得如果临床医生致动旋转驱动轴20120以便朝远侧驱动击发组件通过通道20110，则因为翼片20134和通道凸片20114之间的接触而将阻止击发组件20130朝远侧移动。旋转驱动轴20120以及击发组件20130可向下偏转的距离在图66中表示为距离Df。
在所示的示例中，击发组件接合凹口20216设置在滑动件主体20212中，其被构造成能够接合击发组件20130的上部主体部分20136中的对应接合凹口20137。由于滑动件20210的击发组件接合凹口20216最初接合击发组件20130的上部主体部分20136中的接合凹口20137，因此滑动件20120将击发组件20130和端部执行器旋转驱动轴20120向下偏置或偏转到通道20110中(由图67中的箭头“D”表示)。这种运动使击发组件20130的翼片20134与通道20110中的通路20112对齐。外科钉仓20220可被构造成能够按扣到通道20100中并以正确安装的取向保持在其中。图64和图67示出了处于“驱动位置”或“第二位置”的旋转驱动轴20120，其中击发组件20130与通道20110竖直对齐，以便在旋转驱动轴20120在击发方向上旋转时允许击发组件20130朝远侧驱动通过钉仓20200。
图65示出了用过的或部分用过的钉仓20200'安装到外科端部执行器20100中。如图65所示，滑动件20210已从钉仓20200'内的起始位置朝远侧移动。因此，当将钉仓20200'正确地安装在通道20110内时，滑动件20210并且更具体地讲滑动件20210中的击发组件接合凹口20126与击发组件20130中的接合凹口20137脱离接合。因此，击发组件20130保持在第一或锁定位置。因此，如果临床医生无意中致动了旋转端部执行器驱动轴20120，则击发组件20130不会朝远侧推进到仓20200'中。
图68至图73示出了另一个可锁定击发组件20300的各部分，该可锁定击发组件被阻止朝远侧推进，除非已将未使用的外科钉仓正确地安置在端部执行器通道20400内。图68示出了击发组件20300的螺纹螺母部分20302，该螺纹螺母部分以本文所述的方式以螺纹方式轴颈连接在旋转端部执行器驱动轴上。为清楚起见，在图68至图73中省略了旋转端部执行器驱动轴。在所示的实施方案中，锁定凸耳20304和致动器凸耳20306从螺纹螺母部分20302侧向突出。虽然未示出，但是击发组件20300包括具有组织切割边缘的上部击发主体，该组织切割边缘可类似于本文公开的那些。图69至图73示出了与通道20400连接的螺纹螺母部分20302。应当理解，通道20400被构造成能够在其中可操作地且可移除地支撑外科钉仓。首先转到图69，通道20400包括居中设置的纵向狭槽20402，该纵向狭槽被构造成能够可操作地支撑旋转端部执行器驱动轴以及允许螺纹螺母20302纵向行进通过通道20400。另外，第一纵向凸缘20404和第二纵向凸缘20406设置在纵向狭槽20402的每一侧上。凸缘20404、20406用于限定纵向通路20408，当击发组件20300朝远侧击发通过通道20400时，该纵向通路允许凸耳20304和20306在其中通过。另外，通道20400包括纵向腔20410，用于在其中接收仓体。应当理解，仓体可被构造成能够按扣地且可移除地保持在腔20410内。
在所示的实施方案中，锁定凹口20412设置在凸缘20404中。当击发组件20300在击发之前处于第一或开始位置时，锁定凹口20412的尺寸被设计成将锁定凸耳20304的至少一部分接收在其中。锁定弹簧或偏置构件20414设置在凸缘20406上并且被构造成能够在锁定方向“L”上接合并偏置致动器凸耳20306。致动器凸耳20306的这种旋转使锁定凸耳20304进入锁定凹口20412中。当处于该位置时，当旋转端部执行器驱动轴在击发方向上旋转时，击发组件20300不能朝远侧推进。
图71示出了当击发组件已经移动到第二或解锁位置时击发组件20300的螺纹螺母部分20302的位置。图72示出了当外科钉仓最初被引入通道20400时发生的情况。在图72和图73中，为清楚起见省略了仓体。然而，应当理解，外科钉仓包括滑动件20500。滑动件20500可从位于钉仓的近侧端部中的起始位置移动到仓内的结束位置。如图72和图73所示，滑动件20500包括中心滑动件主体20502，该中心滑动件主体具有形成在其中的一组凸轮楔形件20504。在所示的示例中，滑动件20500包括四个凸轮楔形件20504，其中两个凸轮楔形件20504位于中心滑动件主体20502的每一侧上。每个凸轮楔形件20504对应于位于仓20500中的一排钉支撑驱动器。当滑动件20500朝远侧驱动通过仓时，凸轮楔形件20504在仓内向上顺序地驱动相应排中的钉驱动器，从而将钉弹射成与砧座的下侧形成接触。
仍参见图72，滑动件20500被构造成能够在将仓正确地安装在通道20400内并且滑动件处于起始位置时接触致动器凸耳20306。在所示的实施方案中，例如向下延伸的致动器构件20506形成在滑动件20500上或以其他方式附接到该滑动件。当将仓安装在通道20400中时，滑动件20500上的致动器构件20506接触致动器凸耳20306并将击发组件在解锁方向“UL”(图72)上偏置到图73所示的位置。如图73所示，锁定凸耳20304脱离锁定凹口20412，并且击发组件20300现在可纵向推进通过通道和钉仓。因此，这种布置将防止临床医生无意中推进击发组件，除非已将具有处于起始位置的滑动件的仓一起正确地安装在通道中。如在本上下文中所用，术语“正确地安装”意味着已将钉仓以预期的方式保持地安置在通道中，以便允许滑动件及其其他部分以本文所述的方式与击发组件相互作用。
图74至图76示出了端部执行器20500的各部分，该端部执行器被构造成能够切割和缝合组织。端部执行器20500包括细长通道20510，该细长通道被构造成能够在其中可操作地支撑外科钉仓20600。端部执行器包括砧座组件20700，该砧座组件可操作地支撑砧座同心驱动构件20710，该砧座同心驱动构件用于可操作地驱动击发构件20720通过端部执行器20500。砧座同心驱动构件20710可例如居中设置在砧座框架20712内并且基本上延伸其长度。所示的实施方案中的砧座同心驱动构件20710包括砧座驱动轴，该砧座驱动轴包括远侧轴承凸耳20714和近侧轴承凸耳20716。远侧轴承凸耳20714可旋转地容纳在远侧轴承外壳20718中，该远侧轴承外壳支撑在砧座框架20712中的轴承凹坑中。近侧轴承凸耳20716通过浮动轴承外壳20720可旋转地支撑在砧座组件20700中，该浮动轴承外壳可移动地支撑在形成于近侧砧座部分20724中的轴承凹坑20722中。参见图75。近侧和远侧轴承外壳布置可用于防止或至少最小化在砧座驱动轴20710上产生压缩力，产生压缩力可能会导致砧座驱动轴20710在高力条件下弯曲。砧座驱动轴20710还包括从动击发齿轮20726、近侧螺纹或螺旋节段20728以及远侧螺纹或螺旋节段20730。在所示的布置中，近侧螺纹节段20728具有第一长度，并且远侧螺纹节段20730具有大于第一长度的远侧长度。在所示的布置中，远侧螺纹节段20730的节距大于近侧螺纹节段20728的节距。换句话讲，远侧螺纹节段20730的导程大于近侧螺纹节段20728的导程。在一种布置中，远侧螺纹节段20730的导程可以是近侧螺纹节段20728的导程的大约两倍大。另外，可在近侧螺纹节段20728和远侧螺纹节段20730之间提供死空间20731。在至少一个示例中，砧座驱动轴20710可由挤出齿轮原件一体式制成。
为了便于组装各种砧座部件，砧座组件20700包括砧座帽20740，该砧座帽可通过焊接、按扣特征结构等附接到砧座框架20712。另外，砧座组件20700包括一对砧座板或钉成形板20742，该板可在其底表面上包含各种图案的钉成形凹坑，所述钉成形凹坑对应于支撑在细长通道20510中的外科钉仓20600中的钉布置。钉成形板20742可由金属或类似材料制成并且焊接到或以其他方式附接到砧座框架20712。在其他布置中，也可采用单个砧板，该单个砧板中具有狭槽以容纳击发构件。这种砧板或板的组合可用于改善砧座组件的整体刚度。例如，砧板可以是平坦的并且具有在其中“铸造”的钉成形凹坑。
如图74以及图77至图79所示，外科端部执行器20500包括击发构件20800，该击发构件具有主体部分20802，该主体部分具有形成在其上或以其他方式附接到其上的刀具螺母部分20804。刀具螺母部分20804被构造成能够接收在砧座驱动轴20710上。在刀具螺母部分20804中形成远侧螺纹结节20806和近侧螺纹结节20808，它们被构造成能够接合近侧螺纹节段20728和远侧螺纹节段20730。远侧螺纹结节20806相对于死空间20731的长度与近侧螺纹结节20808间隔开，使得当刀具螺母部分20804跨越死空间20731时，远侧螺纹结节20806与远侧螺纹节段20730螺纹接合，并且近侧螺纹结节20808与近侧螺纹节段20728螺纹接合。另外，砧座接合凸片20810从刀具螺母20804的相对侧向部分侧向突出，并且各自被取向成与附接到砧座框架20712的相应钉成形板20742接合。击发构件20800还包括从主体部分20800的每个侧面突出的通道接合凸片20820。击发构件20800还包括组织切割表面20822。
砧座驱动轴20710在第一旋转方向上旋转将导致击发构件20800从第一位置轴向移动到第二位置。类似地，砧座驱动轴20710在第二旋转方向上旋转将导致击发构件20800从第二位置轴向回缩到第一位置。砧座驱动轴20710最终从可操作地与远侧动力轴20830接口的近侧驱动轴(未示出)获得旋转运动。在所示的布置中，远侧动力轴20830具有远侧驱动齿轮20832，该远侧驱动齿轮被构造成用于在砧座组件20710处于闭合位置时与砧座驱动轴20710上的从动击发齿轮20726啮合接合。砧座驱动轴20710被称为与远侧动力轴20830“分离且不同”。也就是说，至少在所示的布置中，例如砧座驱动轴20710不与远侧动力轴20830同轴对齐，并且不形成远侧动力轴20830的一部分。另外，例如当砧座组件20700在打开位置和闭合位置之间移动时，砧座驱动轴20710可相对于远侧动力轴20830移动。可通过支撑在外壳中的马达来最终旋转近侧驱动轴，该马达附接到联接到外科端部执行器20500的轴组件。外壳可包括手持式组件或机器人控制系统的一部分。
在所示的布置中，通过朝远侧推进闭合管20900来闭合砧座组件20700。如图74所示，闭合管20900包括内螺纹闭合螺母20902，该内螺纹闭合螺母被构造成用于与形成在远侧动力轴20830上的闭合螺纹区段20834螺纹接合。远侧动力轴20830初始旋转将朝远侧驱动闭合管20900，以将砧座组件20700凸轮移动到闭合位置。远侧动力轴20830在相反方向上旋转将在近侧方向上驱动闭合管20900，以允许砧座组件20700移动到打开位置。
转到图77至图79，通道包括一对向内延伸的纵向保持凸片20512，该对凸片之间具有狭槽空间20514，用于容纳击发构件20800的纵向移动。另外，通道20510包括保持凸片20512近侧的锁定腔20516。锁定腔20516转变为远侧击发腔，该远侧击发腔与凸片20512和其间的空间20514共同延伸。锁定腔20516大于远侧击发腔，以允许击发构件20800枢转到图77所示的位置。当处于该位置时，击发构件主体20802与狭槽空间脱离对齐，并且凸片20820与远侧击发腔20518脱离对齐。当处于该位置时，从击发构件20800突出的凸片20820中的一个与保持凸片20512中的一个对齐，因此防止击发构件20800被纵向推进通过通道20510。当最初旋转砧座驱动轴20710并且尚未将具有处于起始位置的滑动件的外科钉仓安装在通道20510中时，击发构件20800将枢转到该“锁定”位置。然而，当已将具有处于起始位置的滑动件的仓安装在通道20510中时，滑动件将用于接触击发构件20800或以其他方式与该击发构件接口，以定位击发构件20800并保持其与保持凸片20512之间的空间20514对齐。参见图78。因此，继续旋转砧座驱动轴20710将朝远侧驱动击发构件20800通过通道20510，如图79所示。因此，这种布置将防止临床医生无意中致动砧座驱动轴20710以朝远侧驱动击发构件20800通过通道20510，除非已将具有处于起始位置的滑动件的未使用的外科钉仓安装在通道中。
在其他布置中，可以电的方式确定对已经正确地安置在外科切割和缝合端部执行器的通道中的未使用的钉仓内的正确位置中的滑动件的检测。例如，这可通过滑动件上的接触件来实现，当滑动件在已经正确地安置在通道中的仓中处于起始位置时，所述接触件形成完整的电路。在击发时，电路被断开并且不允许进一步击发，直到电路再次被闭合。
如上所述，用于第一次抓持、夹持、缝合和/或切割组织的缝合组件在本领域中是公知的。先前的缝合组件(诸如，美国专利5,865,361中公开的那些)例如包括可操作地连接到柄部组件的装载单元。发布于1999年2月2日的名称为“SURGICAL STAPLING APPARATUS”的美国专利5,865,361的公开内容全文以引用方式并入。虽然这些先前的缝合组件的柄部组件被构造成用于多次使用，但是装载单元被构造成用于单次使用。在每个装载单元被用过或至少部分被用过之后，将装载单元从柄部组件中移除，然后如果需要则用新的或未用过的装载单元替换。这些先前的装载单元的构造不允许替换装载单元的仓部分，因此可以再次使用用过的装载单元。
美国专利申请公布2012/0286021公开了一种替代缝合组件，其具有包括砧座的第一钳口和包括钉仓的第二钳口。公布于2012年11月15日的名称为“REPLACEABLE STAPLECARTRIDGE”的美国专利申请公布2012/0286021的全部公开内容以引用方式并入本文。与先前的装载单元不同，大概在先前的第二钳口被用过之后，可从装载单元完全移除这些缝合组件的第二钳口，然后用另一个第二钳口进行替换。值得注意的是，这些缝合组件的整个第二钳口都被替换，而不仅仅是第二钳口的一部分，如发布于2006年1月24日的名称为“SURGICAL STAPLING INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT”的美国专利6,988,649中所公开的，该专利的全部公开内容以引用方式并入本文。
但是在美国专利申请公布2012/0286021中公开的缝合组件是有缺陷的。例如，美国专利申请公布2012/0286021中公开的缝合组件包括切割构件，该切割构件即使在第二钳口未附接到缝合组件时也可朝远侧推进。因此，切割构件可能无意地暴露于患者的组织中。下面进一步讨论了对这些缝合组件的各种改进。
现在转到图80，外科器械系统21000包括柄部21010以及附接到柄部21010的轴21020的缝合组件或装载单元21030。主要参见图81，装载单元21030包括近侧端部或卡口连接器21032，该近侧端部或卡口连接器被构造成能够将装载单元21030可释放地附接到轴21020。与美国专利申请公布2012/0286021中公开的缝合组件类似，装载单元21030包括砧座21040和可附接的仓钳口21050。仓钳口21050一旦附接到装载单元21030，就可在打开位置(图80)和闭合或夹持位置之间枢转。
柄部21010包括致动器或触发器21014，该致动器或触发器可朝向柄部21010的手枪式握持部21012旋转，以朝远侧驱动装载单元21030的击发杆。在触发器21014的第一冲程期间，击发杆接合仓钳口21050并将仓钳口21050移动到其闭合位置。在触发器21014的一个或多个后续冲程期间，击发杆被推进通过仓钳口21050。仓钳口21050包括可移除地存储在其中的多个钉，当击发杆被朝远侧推进通过仓钳口21050时，所述多个钉从仓钳口21050中弹射出。更具体地讲，如本文在其他地方更详细地讨论，击发杆进入仓钳口21050中并朝远侧推动存储在仓钳口21060中的滑动件，继而将钉从仓钳口21050中驱动出来。
主要参见图81，装载单元21030还包括关节运动接头21036，砧座21040和仓钳口21050可围绕该关节运动接头进行关节运动。装载单元21030包括关节运动驱动器，该关节运动驱动器被构造成能够使砧座21040和仓钳口21050围绕关节运动接头21036进行关节运动。关节运动驱动器与关节运动致动器21016可操作地联接，该关节运动致动器可旋转以推动或拉动关节运动驱动器，具体取决于关节运动致动器21016的旋转方向。
替代外科器械系统21100在图82和图83中示出。系统21100包括柄部21110和可附接的装载单元21130。与上述类似，装载单元21130包括砧座钳口21040和可移除地附接的仓钳口21050。装载单元21130还包括关节运动接头21138和挠性接头21136，它们被构造成能够允许端部执行器相对于装载单元21130的轴部分21120进行关节运动。轴部分21120包括近侧连接器21122，该近侧连接器被构造成能够将装载单元21130附接到柄部21110。主要参见图84，近侧连接器21122包括可旋转输入件21128，该可旋转输入件可与柄部21110的可旋转输出件21118可操作地接合。每个可旋转输入件21128都是驱动系统的一部分，该驱动系统例如使装载单元21130围绕挠性接头21136和/或关节运动接头21128进行关节运动、闭合仓钳口21050和/或从仓钳口21050击发钉。柄部21110包括控件21114和21116，这些控件可用于操作装载单元21130的驱动系统。公布于2013年10月24日的名称为“APPARATUS FORENDOSCOPIC PROCEDURES”的美国专利申请公布2013/0282052的公开内容全文以引用方式并入。
除上述之外，钉仓钳口21050可移除地附接到装载单元21030的砧座钳口21040。主要参见图85和图86，砧座钳口21040的近侧端部包括从其相对侧延伸的附接突出部21042。钉仓钳口21050的近侧端部包括限定于其中的凹陷部21052，该凹陷部被构造成能够接收附接突出部21042。砧座钳口21040固定地附接到装载单元21030的框架，并且附接突出部21042从砧座钳口21040固定地延伸。在至少一个实例中，砧座钳口21040和/或附接突出部21042与砧座部分21030的框架一体形成。
钉仓钳口21050还包括夹具21056，所述夹具被构造成能够接合并抓持附接突出部21042。每个夹具21056定位在限定于仓钳口21050中的狭槽21055内。当仓钳口21050附接到装载单元21030时，夹具21056围绕附接突出部21042弯曲。当仓钳口21050完全附接到装载单元21030时，夹具21056弹性地按扣或朝向其未弯曲构型返回并且将附接突出部21042保持在凹陷部21052中。
除上述之外，当夹具21056与附接突出部21042接合并且附接突出部21042完全安置在凹陷部21052中时，仓钳口21050正确地附接到装载单元21030。也就是说，装载单元21030不包括被构造成能够检测仓钳口21050是否正确地附接到装载单元21030的感测系统。现在转到图87至图91，装载单元21130包括被构造成能够检测钉仓钳口21150是否正确地附接到装载单元21130的砧座钳口21140的系统，如下面更详细地描述。
装载单元21130包括当钉仓钳口21150正确地附接到装载单元21130时完成或闭合的电路。电路与外科器械系统的微处理器或控制器通信。控制器在外科器械系统的柄部中；然而，控制器可在外科器械系统的任何合适的部分中，诸如在装载单元21130中。或者，控制器可在外科器械组件的附接到机器人外科系统和/或在机器人外科系统本身中的外壳中。在任何情况下，控制器与驱动外科器械系统的钉击发系统的电动马达通信。
当控制器检测到未将钉仓正确地附接到装载单元21130时，除上述之外，控制器可防止电动马达驱动钉击发系统通过钉击发冲程。在至少一个这种实例中，控制器可断开电源(诸如，电池)和电动马达之间的开关，以防止向电动马达供电。当控制器检测到将钉仓21150正确地附接到装载单元21130时，控制器可允许电动马达从电池接收电力并且在由外科器械系统的用户致动时驱动钉击发系统通过钉击发冲程。在至少一个这种实例中，控制器可例如闭合电池和电动马达之间的开关。
装载单元21130的电路包括延伸穿过装载单元21130的轴部分的导体21147(图89和图91)，以及定位在每个附接突出部21142周围的接触件21146。每个导体21147电联接到微处理器和接触件21146。钉仓21150包括电路的一部分，当钉仓21150与附接突出部21142完全接合时，该部分使得形成完整的电路。参见图90，钉仓21150中电路的该部分包括定位在每个凹陷部21052中的接触件21159以及在接触件21159之间延伸并与接触件电联接的导体或迹线21157。夹具21056被构造成能够将钉仓钳口21150的接触件21159保持在围绕附接部分21142延伸的接触件21146上。在至少一个实例中，夹具21056由导电材料构成并与迹线21157连通。在这类实例中，夹具21056是钉仓21150中的电路的一部分。在任何情况下，当将钉仓钳口21150从装载单元21130拆下时，电路切断或断开，并且微处理器可检测到钉仓钳口21150不再附接到装载单元21130。
除上述之外，如果仅一个接触件21159与其相应的接触件21146接合，则控制器可确定钉仓钳口21150不正确地附接到装载单元21130。在这类实例中，电路将处于断开状态，因此微处理器将不正确组装的钉仓钳口21150视为缺失的仓钳口21150，并防止电动马达被致动以执行钉击发冲程。在各种实例中，外科器械系统可包括向外科器械系统的用户传达钉仓钳口检测电路尚未闭合的指示灯和/或反馈系统。响应于此，用户可调查该状况并正确地安置钉仓钳口21150以闭合检测电路。
如图90所示，导体21157横向延伸跨过仓钳口21150。当击发构件朝远侧推进通过仓钳口21150时，击发构件可横切和/或切断导体21157并断开钳口检测电路。此时，控制器可允许操作电动马达以朝远侧推进击发构件，直到击发构件回缩到其未击发位置。在击发构件回缩到其未击发位置之后，控制器随后可阻止重新操作电动马达，直到将未用过的仓钳口21150正确地附接到装载单元21130。因此，装载单元21130的电路可用作缺失的仓闭锁件、不正确地附接的仓闭锁件和用过的仓闭锁件。
除了或代替上述内容，滑动件21170可包括导电部分，当滑动件21170处于其未击发位置时，该导电部分电连接侧向钳口接触件21159和/或导电夹具21056。在至少一个实例中，滑动件21170包括从滑动件21170的一个侧面延伸到另一个的导体和/或迹线。当滑动件21170朝远侧推进时，滑动件21170的导电部分不再与接触件21159和/或夹具21056电连通，并且钳口检测电路断开。就钳口组件还包括导体21157来说，导体21157可被切割或切断以如上所述断开钳口检测电路。在各种实例中，例如在导体21157被切割或切断的同时，滑动件21170可从钳口检测电路移位。在任何情况下，导电滑动件21170可提供用过的仓闭锁件。
在各种替代实施方案中，当击发构件朝远侧推进时，装载单元的电路闭锁件不被横切。现在转到图93，装载单元21230的钉仓钳口21250包括仓体21251、限定在仓体21251中的多个钉腔21258，以及限定在仓体21251中的纵向狭槽21259，该狭槽被构造成能够接收击发构件的一部分。与钉仓钳口21150类似，钉仓钳口21250包括装载单元电路的一部分。钉仓钳口21250中电路的该部分包括限定在凹陷部21052中的电接触件(诸如，接触件21159)以及设置在纵向狭槽21251的相对侧上的柔顺电接触件21257。每个柔顺接触件21257经由例如延伸穿过仓体21251的导体或迹线与接触件21052电连通。
柔顺接触件21257被构造成能够在钉仓钳口21250组装到装载单元21250时接合装载单元21230的砧座钳口21240。更具体地讲，柔顺接触件21257接合限定在砧座钳口21240中的导电通路21247(其电连接柔顺接触件21257)，并且此时电路已被闭合。柔顺接触件21257保持恒定地与导电通路21247接合，即当仓钳口21250处于打开位置时，当仓钳口21250处于闭合位置时，以及当仓钳口21250在其打开位置和闭合位置之间移动时都是如此。当击发构件朝远侧推进时，击发构件穿过限定在接触件21257之间的间隙，因此电钳口检测电路不被横切。这种布置可提供缺失的仓钳口闭锁件和/或不正确地附接的仓钳口闭锁件。
除上述之外，柔顺接触件21257可包括弹簧，所述弹簧被构造成能够将钉仓钳口21250偏置到打开位置。当钉仓钳口21250移动到其闭合位置时，柔顺接触件21257在钉仓钳口21250和砧座21240之间被压缩。柔顺接触件21257连同电钳口检测电路的其他部分与缝合组件的金属或导电部分电绝缘，以便保持钳口检测电路的完整性并防止钳口检测电路发生短路。
除了或代替电闭锁件或电子闭锁件(诸如，上述闭锁件)，装载单元可包括机械闭锁件，如果未将钉仓钳口正确地附接到装载单元，则该机械闭锁件可防止击发系统执行钉击发冲程。现在转到图92，钉仓钳口21150包括滑动件21170，当击发构件21160(图89)在钉击发冲程期间朝远侧推进时，该滑动件被击发构件21160朝远侧推动。钉仓钳口21150还包括闭锁构件21172，该闭锁构件可枢转地与仓钳口21150的仓体21151接合。如美国专利申请公布2012/0286021中所述，在滑动件21170在击发冲程期间已被至少部分地朝远侧推进之后，闭锁构件21172被向内偏置到闭锁位置，这防止了仓钳口21150被重新击发。
虽然闭锁构件21172可阻挡击发构件21160朝远侧推进，如上所述，但是在某些实例中，击发构件21160可能能够推动穿过闭锁构件21172并在它们之间滑动。作为改进，一个或两个闭锁构件21172可包括朝向击发构件21160向内延伸的闩锁或钩。当闭锁构件21172在滑动件21170已被朝远侧推进之后被向内偏置时，闩锁或钩可在击发构件21160回缩到其未击发位置时接合在击发构件21160中限定的孔。一旦闩锁或钩定位在击发构件孔中，它们就可防止击发构件21160朝远侧推进通过已用过的仓。此时，必须替换钉仓才能解锁击发构件21160。
如上所述，可附接的钉仓钳口可在打开位置和闭合位置之间移动，以将组织夹持在其间。设想了其他实施方案，其中钉仓钳口可移除地附接到缝合器械，但是砧座钳口可在打开位置和闭合位置之间移动。现在转到图94至图97，缝合组件21530包括可附接的钉仓钳口21550(其包括仓体21551)，并且另外包括可枢转的砧座钳口21540。缝合组件21530还包括击发构件，诸如击发构件21160，该击发构件可朝远侧移动以接合砧座钳口21540并将砧座钳口21540移动到闭合位置。更具体地讲，击发构件21160包括第一凸轮构件21162和第二凸轮构件21164，该第一凸轮构件被构造成能够接合仓钳口21550，并且该第二凸轮构件被构造成能够接合砧座钳口21540并使砧座钳口21540朝向仓钳口21550移动。
缝合组件21530还包括机械闭锁件21572。闭锁件21572在框架枢轴21232处安装到缝合组件21530的框架。闭锁件21572朝远侧延伸并且由框架销21533支撑。闭锁件21572包括金属线；但是闭锁件21572可由任何合适的材料构成。闭锁件21572还包括限定于其中的细长凹陷轨道21576，该细长凹陷轨道被构造成能够接收从击发构件21160延伸的闭锁销21166。主要参见图94，当闭锁件21572处于其锁定位置时，细长凹陷轨道21276约束或限制击发构件21160的纵向位移。更具体地讲，凹陷轨道21576被构造成能够允许击发构件21160朝远侧推进以使砧座钳口21540在其打开位置和闭合位置之间移动，但是防止击发构件21160朝远侧推进以执行击发冲程，除非闭锁件21572移动到其解锁位置，如下所述。
当钉仓钳口21550附接到缝合组件21530时，如图95所示，仓钳口21550的滑动件21270接触闭锁件21572的远侧臂21574并使闭锁件21572向下偏转到其解锁位置。此时，闭锁件21572已经移位到击发构件21160的闭锁销21166下方，因此击发构件21160可朝远侧推进以执行钉击发冲程，如图96所示。在钉击发冲程期间，击发构件21160将滑动件21270从闭锁臂21574朝远侧推离，并且闭锁件21572可返回到其未弯曲或锁定构型。当击发构件21160回缩时，如图97所示，闭锁销21166可接合闭锁件21572并使闭锁件21572向下弯曲，以允许击发构件21160返回到其未击发位置。值得注意的是，滑动件21270不与击发构件21160一起回缩，因此即使击发构件21160已经回缩也不能重新解锁闭锁件21572。由于以上原因，闭锁件21572可用作缺失的仓闭锁件和用过的仓闭锁件。
现在转到图98至图102，缝合组件21330包括可附接的钉仓钳口21350(其包括仓体21351)，并且另外包括砧座钳口21340。缝合组件21330还包括击发构件，诸如击发构件21160，该击发构件可朝远侧移动以接合砧座钳口21340和仓钳口21350。更具体地讲，击发构件21160包括第一凸轮构件21162和第二凸轮构件21164，该第一凸轮构件被构造成能够接合仓钳口21350，并且该第二凸轮构件被构造成能够接合砧座钳口21340，这样当击发构件21160朝远侧推进时可闭合钳口21340和21350。
缝合组件21330还包括机械闭锁件21372。闭锁件21372在框架枢轴21232处安装到缝合组件21330的框架。闭锁件21372朝远侧延伸并且被框架销21333约束。闭锁件21372包括金属线；但是闭锁件21372可由任何合适的材料构成。闭锁件21372还包括限定于其中的细长凹陷轨道21376，该细长凹陷轨道被构造成能够接收从击发构件21160延伸的闭锁销21166。主要参见图98，当闭锁件21372处于其锁定位置时，细长凹陷轨道21376约束或限制击发构件21160的纵向位移。更具体地讲，凹陷轨道21376被构造成能够允许击发构件21160朝远侧推进以闭合缝合组件21330，但是防止击发构件21160朝远侧推进以执行击发冲程。
当钉仓钳口21550附接到缝合组件21530时，如图99所示，仓钳口21350的滑动件21370接触闭锁件21372的远侧臂21374并使闭锁件21372向上偏转到解锁位置。此时，闭锁件21372已经移位到击发构件21160的闭锁销21166上方，因此击发构件21160可朝远侧推进以执行钉击发冲程，如图100所示。在钉击发冲程期间，击发构件21160将滑动件21370从闭锁臂21374下方朝远侧推出，并且闭锁件21372可返回到其未弯曲或锁定构型。当击发构件21160回缩时，如图101所示，闭锁销21166可接合闭锁件21372并使闭锁件21372向上弯曲，以允许击发构件21160返回到其未击发位置。值得注意的是，滑动件21370不与击发构件21160一起返回。由于以上原因，闭锁件21372可用作缺失的仓闭锁件和用过的仓闭锁件。
参见图102，闭锁件21372的臂21374在纵向狭槽21359的相对侧上横向间隔开，使得击发构件21160可在臂21374之间滑动。在这类实例中，臂不被击发构件21160横切。
在外科程序过程中，多个装载单元可与外科缝合系统的柄部一起使用。在至少一个实例中，例如可使用被构造成能够施加30mm钉线的第一装载单元，可使用被构造成能够施加45mm钉线的第二装载单元，并且可使用被构造成能够施加60mm钉线的第三装载单元。在这些装载单元中的每一个都包括可替换的仓钳口的情况下，可能将错误的钉仓钳口附接到装载单元。例如，临床医生可尝试将60mm钉仓钳口附接到被构造成能够施加30mm钉线的装载单元。因此，砧座可能不会使从60mm钉仓钳口弹射出的一些钉变形并且/或者组织切口线可能比钉线更长。本文公开的缝合组件和/或装载单元可包括用于防止将错误的钉仓钳口附接到其上的装置，如下面更详细地讨论。
参见图103和图105，除上述之外，限定在仓钳口21250中的凹陷部21052被构造成能够紧密地接收装载单元21130的附接突出部21142，使得它们之间存在贴合配合。在至少一个实例中，第二装载单元21130'的附接突出部21242'(图104)小于附接突出部21142，并且相应地，与第二装载单元21130'一起使用的第二仓钳口的凹陷部小于凹陷部21052。为了提供防错形式，第二仓钳口的凹陷部太小以致于不能接收装载单元21130的附接突出部21142，因此第二仓钳口不能附接到装载单元21130。类似地，现在转到图104，仓钳口21250的凹陷部21052大于第二装载单元21130'的附接突出部21242'，使得仓钳口21250的夹具21056不能将附接突出部21242'保持在凹陷部21052中，因此不能将仓钳口21250保持在装载单元21130'上。在这类实例中，仓钳口21250和装载单元21130'之间的互连将太松，以致于使仓钳口21250不能与装载单元21130'一起使用。
在上述实例中，装载单元的附接突出部、钉仓钳口的凹陷部以及将钉仓钳口保持到装载单元上的弹簧夹具在缝合组件的两侧上具有相同的构型。在其他实例中，缝合组件的一侧上的附接突出部、凹陷部和/或弹簧夹具不同于缝合组件的另一侧上的附接突出部、凹陷部和/或弹簧夹具。例如，较大的附接突出部、凹陷部和弹簧夹具设置在缝合组件的一侧上，而较小的附接突出部、凹陷部和弹簧夹具设置在另一侧上。这类布置可增加可用的排列，以防止将不正确的钉仓钳口附接到装载单元。
在上述实例中，装载单元的附接突出部、钉仓钳口的凹陷部以及弹簧夹具相对于共同的横向轴线对齐。在其他实例中，缝合组件的一侧上的附接突出部、凹陷部和/或弹簧夹具不与另一侧上的附接突出部、凹陷部和/或弹簧夹具对齐。换句话讲，一侧与另一侧偏置。这类布置也可增加可用的排列，以防止将不正确的钉仓钳口附接到装载单元。
除上述之外，可以设想可提供一种装载单元的套件，其中该套件的每个装载单元可被构造成使得可将仅旨在与该装载单元一起使用的仓钳口正确地附接到该装载单元。
现在转到图106和图107，钉仓钳口21050包括近侧肩部21058，当仓钳口21050附接到装载单元21030时，该近侧肩部紧邻装载单元21030的框架定位。由于突出部21042、凹陷部21052和夹具21056之间的贴合配合，仓钳口21050被保持就位，例如使得仓钳口21050的肩部21058不会干扰击发构件21160朝远侧前进。更具体地讲，肩部21058不会干扰击发构件21160的第一凸轮构件21162。在将不正确的钉仓附接到钉仓21050的情况下，在某些实例中，不正确的钉仓钳口的近侧肩部可能会干扰第一凸轮构件朝远侧前进，因此防止击发构件21160利用不正确的钉仓执行击发冲程。现在转到图108，钉仓钳口21450是与装载单元21030一起使用的不正确的钉仓钳口。即使已将钉仓钳口21450附接到装载单元21030，近侧肩部21458也能防止击发构件21060朝远侧推进。
除上述之外，钉仓钳口的近侧肩部可包括尖锐或急剧的拐角。在至少一个这种实例中，近侧肩部不包括例如倒角或引入端。
在各种实例中，钉仓钳口的近侧肩部可被构造成如果夹持在钉仓钳口和相对的砧座钳口之间的组织太厚，则能够阻挡钉击发构件朝远侧推进。在这类实例中，钉仓钳口将不会完全闭合，并且钉仓钳口的近侧肩部将定位在钉击发构件的前方。这种布置将包括组织厚度闭锁件；但是在尚未将钉仓钳口移动到其夹持位置的情况下，这种布置也可用作组织夹持闭锁件。
除了或代替上述内容，可利用外科器械系统的电子或软件闭锁件来在将不正确的钉仓钳口附接到外科器械系统的情况下防止击发驱动件执行钉击发冲程。在各种实例中，如上所述，钳口检测电路的一部分可延伸穿过钉仓钳口，并且在至少一个实例中，外科器械系统的控制器可被构造成能够对钳口检测电路的延伸穿过钉仓钳口的该部分进行评估，以确定附接到外科器械系统的钉仓钳口是否是与外科器械系统一起使用的适当钉仓钳口。在至少一个实例中，第一钉仓钳口的夹具21056具有与第二钉仓钳口的夹具21056不同的可检测电特性，诸如电阻或阻抗。
再次参见图81、图85和图87，仓钳口移除工具21090可用于将仓钳口从装载单元拆下。美国专利申请公布2012/0286021更详细地讨论了仓移除工具。
希望采用外科缝合器械具有可替换钉仓组件的闭锁系统。例如，在用户忘记将钉仓安装到没有这种闭锁系统的器械中的情况下，外科器械的击发构件可用于切割患者的组织而不缝合该组织。这种情况是不希望的。在又一个示例中，在用户将用过或部分用过的钉仓安装到没有闭锁系统的器械中的情况下，外科器械的击发构件将类似地切割但不缝合或仅部分缝合患者的组织。这种情况也是不希望的。因此，可自动锁定击发构件以防止击发构件在端部执行器内推进的外科器械是希望的。
现在转到图109和图110，描绘了包括缺失的仓和用过的仓闭锁系统的外科器械系统25100。系统25100包括击发构件25110、钉仓组件25120和砧座钳口25130。击发构件25110包括在远侧呈现的切割部分25111，该切割部分被构造成能够在推进通过外科器械系统25100的端部执行器部分时切割组织。击发构件25110被构造成能够通过将滑动件25121纵向推进通过钉仓组件25120来朝向砧座钳口25130部署来自钉仓组件25120的多个钉。在钉击发冲程期间，滑动件25121可从近侧未击发位置移动到远侧完全击发位置。在钉击发冲程完成之后，击发构件25110回缩。滑动件25121不与击发构件25110一起回缩。然而，设想了其中滑动件25121至少部分地回缩的实施方案。
外科器械系统25100还包括闭锁构件25140。闭锁构件25140被构造成能够在外科器械系统25100中不存在仓或者外科器械系统25100中存在用过或部分用过的仓时防止击发构件25110推进通过钉击发冲程。闭锁构件25140包括近侧部分25141，该近侧部分可枢转地安装到系统25100的框架部分的脊销25101。闭锁构件25140还包括锁定面或肩部25142，该锁定面或肩部被构造成能够捕捉击发构件25110和可偏转部分25143。当将钉仓组件安装在系统25100内时，闭锁构件25140可在锁定位置(图109)和解锁位置(图110)之间移动或偏转。当未将钉仓组件安装在系统25100内时，闭锁构件25140被弹簧偏置到锁定位置，如下面更详细地讨论。当将用过或部分用过的钉仓组件安装在系统25100内时，闭锁构件25140也被弹簧偏置到锁定位置，同样如下面更详细地讨论。
当闭锁构件25140处于其锁定位置时，如图109所示，安装在击发构件25110上的击发构件销25113被构造成能够抵接闭锁构件25140的锁定面25142，这样可防止击发构件25110朝远侧推进。要将闭锁构件25140从锁定位置移动到解锁位置，必须将未用过的准备好击发的钉仓组件正确地安装在系统25100内。更具体地讲，未用过的准备好击发的钉仓组件的滑动件25121处于其近侧未击发位置，并且当将这种钉仓组件安装到系统25100中时，滑动件25121使可偏转部分25143向下偏转或弯曲到其解锁位置。当闭锁构件25140处于其解锁位置时，参见图110，击发构件销25113轻松地推进超过锁定面25142，从而允许击发构件25110朝远侧推进以在击发冲程期间部署钉并切割组织。
如图109和图110所示，当闭锁构件25140处于其锁定位置时，允许击发构件25110的一些纵向移动。当闭锁构件25140处于其锁定位置时，这种纵向移动的自由度允许击发构件25110朝远侧推进以闭合系统25100的钳口并朝近侧移动以防止钳口被重新打开。操纵系统25100的钳口可能是例如装载和/或卸载钉仓所必需的。
如上所述，当击发构件25110在击发冲程之后回缩时，滑动件25121不与击发构件25110一起返回。当击发构件25110回缩时，击发构件销25113使可偏转部分25143偏转或弯曲到其解锁位置，从而允许销25113通过锁定面25142并返回到原始位置。一旦销25113回缩通过锁定面25142，闭锁构件25140就弹回或返回到其锁定位置，以防止用安装在系统25100内的用过的钉仓来重复击发。击发构件25110可甚至进一步回缩，使得系统25100的钳口可随后从被缝合的组织松开。
现在参见图111至图113，描绘了另一外科器械系统25200。系统25200包括另一种类型的缺失的仓和用过的仓闭锁布置。系统25200包括击发构件25210和钉仓组件25220。击发构件25210包括在远侧呈现的切割部分25211，该切割部分被构造成能够在推进通过系统25200时切割组织。该击发构件被构造成能够通过将滑动件25221纵向推进通过钉仓组件25220来部署来自钉仓组件25220的多个钉。在钉击发冲程期间，滑动件25221可从近侧未击发位置移动到远侧完全击发位置。滑动件25221不与击发构件25210一起回缩；然而，设想了其中滑动件25221至少部分地回缩的实施方案。
外科器械系统25200还包括闭锁构件25240。闭锁构件25240被构造成能够在系统25200内不存在仓或者系统25200内存在用过或部分用过的仓时防止击发构件25210推进通过其钉击发冲程。闭锁构件25240包括第一或近侧部分25241，该第一或近侧部分可旋转地安装到系统25200的第一脊销25201。脊销25201可例如从系统25200的轴框架或脊延伸。闭锁构件25240还包括第二部分25242、第三或捕捉部分25243，以及第四或远侧部分25245。闭锁构件25240可在锁定位置(图111和图113)和解锁位置(图112)之间移动。当未将钉仓组件正确地安装在系统25200内时，闭锁构件25240被弹簧偏置到锁定位置。当将用过或部分用过的钉仓组件安装在系统25200内时，闭锁构件25240也被偏置到锁定位置。
当闭锁构件25240处于其锁定位置时，如图111所示，安装在击发构件25210上的击发构件销25213被构造成能够抵接闭锁构件25240的锁定面或肩部25244。由于存在锁定面25244，击发构件25210的远侧推进被阻挡超过该位置。要将闭锁构件25240从其锁定位置移动到其解锁位置，必须将未用过的准备好击发的钉仓组件安装在系统25200内。未用过的准备好击发的钉仓组件包括处于近侧未击发位置的滑动件25221。
滑动件25221包括磁体25226，该磁体被取向成一个极“P1”面向闭锁构件25240的远侧部分25245，另一个极“P2”背向闭锁构件25240的远侧部分25245。闭锁构件25240的远侧部分25245包括设置在其上的磁体25246。磁体25246被取向成极“P1”面向滑动件磁体25226的相同极“P1”，另一个极“P2”背向滑动件磁体25226。磁体25226的极1和磁体25246的极1彼此互相排斥。该关系在滑动件25221处于其近侧未击发位置(图112)时产生悬浮效应，这将闭锁构件25240向上推动或排斥到其解锁位置，从而将锁定面25244提升离开击发构件25210的销25213，以允许销25213推进超过锁定面25142。击发构件25210随后可朝远侧推进以在击发冲程期间部署钉并切割组织。
当击发构件25210在其击发冲程之后回缩时，销25213被构造成能够接触远侧部分25245的成角面以将远侧部分25245以及因此闭锁构件25240朝向其解锁位置推动，从而允许销25213在返回到原始位置时通过锁定面25244。一旦销25213通过锁定面25244，闭锁构件25240就弹回或返回到其锁定位置，以防止用安装在系统25100内的用过或部分用过的钉仓来重复击发冲程。
与图109和图110所示的系统25100类似，闭锁构件25240被构造成能够允许击发构件25210在距离“y”内移动，以在击发构件25210被用于夹持和松开功能时允许钳口夹持和松开。即使钉仓从系统25100中缺失并且/或者用过的钉仓定位在该系统内，销25213以及因此击发构件25210也可在闭锁构件25240的捕捉部分25243内朝近侧和朝远侧移动。
另一外科器械系统25300在图114至图119中描绘。系统25300包括另一种类型的闭锁布置，其中系统25300被构造成能够在未将仓安装在系统25300内时被锁定。该系统还被构造成能够在将用过或部分用过的仓安装在系统25300内时被锁定。系统25300包括击发构件25310和钉仓组件25320。击发构件25310包括在远侧呈现的切割部分25311，该切割部分被构造成能够在推进通过系统25300时切割组织。击发构件25310被构造成能够通过将滑动件25330(图115)纵向推进通过钉仓组件25320来部署来自钉仓组件25320的多个钉。在击发冲程期间，滑动件25330可在近侧未击发位置到远侧完全击发位置之间移动。在各种实例中，滑动件25230不与击发构件25310一起回缩；然而，设想了其中滑动件25230至少部分地回缩的实施方案。
外科器械系统25300还包括闭锁构件25340。闭锁构件25340被构造成能够在系统25300内不存在仓或者系统25300内存在用过或部分用过的仓时防止击发构件25310推进通过钉击发冲程。闭锁构件25340在许多方面类似于闭锁构件25140、25240。参见图117至图119，闭锁构件25340包括第一或近侧部分25341，该第一或近侧部分可旋转地安装到系统25300的第一脊销25301。或者，近侧部分25341可固定地安装到系统25300的脊25301。闭锁构件25340还包括第二部分25342、第三或捕捉部分25343，以及第四或远侧部分25345。闭锁构件25340可在锁定位置(图117和图119)和解锁位置(图118)之间移动。当未将钉仓组件安装在系统25300内时，闭锁构件25340被弹簧偏置到其锁定位置。当将用过或部分用过的钉仓组件安装在系统25300内时，闭锁构件25340也被偏置到其锁定位置。
钉仓组件25320包括滑动件25330和多个驱动器25328，所述多个驱动器被构造成能够在钉击发冲程期间在由滑动件25330的斜面25330A、25330B、25330C和25330D驱动时弹射出钉。钉仓组件25320还包括控制构件，当滑动件25330在其钉击发冲程期间朝远侧推进时，该控制构件可通过滑动件25330在未用过位置和用过位置之间移动。该控制构件在钉仓25320被装载到外科器械系统25300中时处于其未用过位置，并且被构造成能够在未用过的钉仓组件25320被装载到外科器械系统25300中时将闭锁构件25340从其锁定位置移动到其解锁位置。近侧驱动器25325的第一构型在图114和图116中示出。近侧驱动器25325包括驱动器楔形部分25326和磁性部分25327。当近侧驱动器25325处于其未用过位置并且滑动件25330处于其未击发位置时(图118)，驱动器楔形部分25326定位在滑动件凹口25331内，并且磁性部分25327足够紧邻远侧部分25327以吸引远侧部分25327，从而将闭锁构件25340移动或提升到其解锁位置。
类似的近侧驱动器构型在图118和图119中描绘。近侧驱动器25325'包括驱动器楔形部分25326'和磁性部分25327'。近侧驱动器25325'的楔形部分25326'定位在近侧驱动器25325'的侧面上。当近侧驱动器25325'处于其未用过位置并且滑动件25330处于其未击发位置时(图118)，驱动器楔形部分25326'定位在滑动件凹口25331内，并且磁性部分25327'足够紧邻远侧部分25327'以吸引远侧部分25327'，从而将闭锁构件25340移动到其解锁位置。当驱动器楔形部分25326'定位在滑动件凹口25331内时，磁性部分25327'被构造成能够将闭锁构件25340保持在其解锁位置。当滑动件25330从其未击发位置朝远侧推进时，滑动件25330驱动近侧驱动器25325'，使得驱动器楔形部分25326'被驱动出滑动件凹口25331。因此，磁性部分25327'不再足够紧邻闭锁构件25340以将闭锁构件保持在其解锁位置，因此闭锁构件被弹簧偏置到其锁定位置(图119)。基准“D”被定义为滑动件25330的顶表面，并且当楔形部分25326'的底部与基准D对齐或在基准D上方时，远侧部分25345和磁性部分25327'之间的磁性关系不足以将闭锁构件25340保持在其解锁位置，从而释放闭锁构件25340。
一旦闭锁构件25340已被释放到其锁定位置(图119)并且安装的仓组件25320已被至少部分用过(图119)，就可以防止系统25300重新击发同一仓组件25320。当击发构件25310回缩时，闭锁销25312骑在远侧部分下方，以使闭锁构件25340暂时移开，直到闭锁销25312到达捕捉部分25343。当闭锁销25312到达捕捉部分25343时，闭锁构件25340弹回或返回到其锁定位置。当处于其用过位置时，磁性部分25327'不会将闭锁构件25340拉动到其解锁位置。在各种实例中，当近侧驱动器25325'被滑动件25330移动到其用过位置时，近侧驱动器25325'可以压配合方式接合钉仓组件25320，以防止近侧驱动器25325'朝向其未用过位置下落。这种布置可防止闭锁构件25340被错误地解锁。除了用过的仓组件之外，在系统25300内未安装仓将闭锁构件推到其锁定位置。仅仅没有近侧驱动器就完全阻止了闭锁构件25340移动到其解锁位置。
控制构件25325、25325'由滑动件25330驱动，并且可被称为驱动器；但是它们不驱动钉。这样，控制构件25325、25325'构成“假”驱动器。也就是说，可以设想钉仓组件的最近侧钉驱动器可用作控制构件。
另一外科器械系统在图120至图122中描绘。系统25400包括钉仓组件25410、闭锁电路系统25420和闭锁构件25430。闭锁构件25440固定地附接到系统25400的脊部分25401。闭锁构件25430还包括例如弹簧构件，并且朝向其锁定位置偏置(图122)。当闭锁构件25430处于其锁定位置时，闭锁构件25430的钩部分25431被构造成能够在外科器械或临床医生试图将击发构件推进超过闭锁构件25440而没有将未用过的钉仓组件安装在系统25400内的情况下捕捉击发构件。
要将闭锁构件25440移动到其解锁位置，使得击发构件可在钉击发冲程期间推进通过钉仓组件25410，采用电磁体25421。电磁体25421设置在系统25400的脊部分25401上，但是也可设置在系统25400内的任何合适的位置。导体沿脊部分25401定位在系统25400内，例如以为电磁体25421供电。包围电磁体25421的闭锁电路系统25420及其电源延伸穿过钉仓组件25410。如下所述，当电路25420完成或闭合时，电磁体25421通电。当电路未完成或断开时，电磁体25421不通电。同样如下所述，系统25400中存在用过或部分用过的仓是电路25420断开的情况。系统25400中不存在仓是电路25420断开的另一种情况。
闭锁电路系统25420包括导体25422，所述导体从电磁体25421延伸到定位在系统25400内的一对电接触件25423。电接触件25423定位在系统25400的钳口内，诸如接收钉仓组件25410的通道部分内。钉仓组件25410还包括导体支柱25425，所述导体支柱被构造成能够在钉仓组件25410完全安置在钳口的通道部分中时接合接触件25423。导体支柱25425是限定在钉仓组件25410内的电迹线25424的一部分。导体支柱25425设置在仓组件25410的近侧面25412上。同样设置在近侧面25412上的是电迹线25424的可断开部分25426，该部分延伸跨过钉仓组件25410的狭槽25411。击发构件的切削边缘被构造成能够在击发构件的钉击发冲程期间切断或切割可断开部分25426。
当仓组件被安装并且是未用过的时，除上述之外，可断开部分25426不被切断并且闭锁电路25420完成或闭合。当闭锁电路25420完成时(图121)，电磁体25421接收电力，从而将闭锁构件25430推到其解锁位置，进而允许击发构件通过。在击发构件的击发冲程期间可断开部分25426被切断或切割之后，外科器械检测到不完整的电路。不完整或断开的电路表示钉仓组件25410处于错误构型。这可能是由于在系统25400内安装了用过或部分用过的仓或没有安装仓。当电路25420不完整(图122)例如处于错误构型时，电磁体25421断电并将闭锁构件25430释放到其锁定位置(图122)。
当将用过的钉仓组件25410从外科器械系统25400移除时，闭锁电路25420保持断开状态，并且电磁体25421保持不通电。当将未用过的钉仓组件25410完全安置在系统25400中时，闭锁电路25420再次闭合，并且电磁体25421重新通电以解锁闭锁构件25430。值得注意的是，如果未将钉仓组件25410完全安置在系统25400中，则支柱25425将不与接触件25423接合，并且闭锁电路25420将保持断开的不通电状态。
另一外科器械系统25500在图123和图124中描绘。系统25500包括钉仓25501，该钉仓包括可在未击发位置和击发位置之间移动的滑动件25510。击发构件25503被构造成能够将滑动件25510从其未击发位置移动到其击发位置，以经由斜面25511部署存储在仓25501内的多个钉(未示出)。系统25500还包括电路25520，该电路被构造成能够向外科器械和/或系统25500的用户指示安装在系统25500内的仓是否用过或部分用过，或者安装在系统25500内的仓是否未用过并准备好击发。当滑动件25510处于其未击发位置时，滑动件25510完成电路25520，并且当滑动件25510处于其击发或部分击发位置时，滑动件25510未完成电路25520并且电路25520断开。
闭锁电路25520包括例如与外科器械柄部电连通的一对导体25521，以及定位在外科器械系统25500的钳口部分内的一对电接触件25522，该对电接触件被构造成能够支撑钉仓25501。电接触件25522被定位成使得当将钉仓25501完全安置在系统25500中并且滑动件25510处于其未击发位置(图124)时，设置在滑动件25510的近侧面25512上的相应垫或接触件25523接触电接触件25522。系绳部分或导体25524连接或电联接接触件25523并且附接到滑动件25510的近侧中间面25513。接触件25522除了延伸到近侧面25512之外，还延伸到滑动件的底面。当滑动件25510处于其未击发位置时，接触件25523与闭锁电路25520接合，并且闭锁电路25520完成，表明钉仓未击发、准备好击发。当闭锁电路25520不完整时，可使用例如软件和/或机械特征结构(诸如，本文公开的那些)来锁定外科器械。在至少一个实例中，闭锁电路25520与外科器械系统255500的控制器进行信号通信，该控制器在闭锁电路25520处于闭合状态时向击发驱动件的电动马达供电，并且在闭锁电路25520断开时防止向电动马达供电。
系统25600的击发构件闭锁布置在图125至图129中描绘。系统25600包括击发构件25610、闭锁件25620和轴脊25601。轴脊25601容纳闭锁件25620和击发构件25610。击发构件25610包括在远侧呈现的切割边缘25611，该切割边缘被构造成能够在击发构件25610的钉击发冲程期间切割组织。闭锁件25620被构造成能够在闭锁件25620被激活时捕捉击发构件25610，并且允许击发构件25610穿过。除上述之外，当未将未用过的钉仓定位在系统25600中时，闭锁件25620可由系统25600的控制器来激活。
闭锁件25620包括螺线管25621以及包括第一连接件25623和第二连接件25624的机械连杆。连接件25623、25624在枢轴25622处附接。螺线管25621定位在脊25601内，使得螺线管25621可向枢轴25622附近的连杆施加力。闭锁件25620以其偏置的锁定位置在图125和图126中示出。闭锁件25620还包括锁定主体或凸轮板25625，该锁定主体或凸轮板可枢转地与第二连接件25624的端部连接。当螺线管25621处于其未致动构型时，如图125和图126所示，凸轮板25625被偏置到刀束缚窗口25612中以捕捉击发构件25610。
在各种实例中，多个窗口设置在击发构件25610中。另一窗口诸如窗口25614可包括另一近侧表面。窗口25614将用作中间闭锁件以将击发构件25610锁定在操作中。诸如刀束缚的事件可触发螺线管25621以将闭锁件25620释放到其锁定位置，从而防止击发构件25610的进一步致动。在各种实例中，击发构件25610中窗口的远侧表面可被构造成使得当击发构件25610朝近侧回缩时，凸轮板25625可在远侧表面上方滑行，以在击发构件25610朝近侧移动时防止击发构件25610的锁定。在其他实例中，可能希望在击发构件25610朝近侧移动时将其锁定。
在一些实例中，闭锁件可被构造成能够允许在一个方向上移动，但防止在另一个方向上移动。例如，当击发构件25610的远侧移动已被锁定时，击发构件25610的轻微回缩可能是希望的。当在这类实例中朝近侧回缩时，导致击发构件25610束缚起来的区域中的组织可自然地减压，并且在等待组织减压的限定时间段之后，螺线管25621可被激活以将闭锁件25620移动到其解锁位置(图127和图128)，从而允许击发构件25610再次朝远侧推进。
图127至图129示出了处于其解锁位置的闭锁件25620。在比较图125和图126与图127至图129时，可以看出，当被致动时，螺线管25621将机械连杆移动成共线构型，以将凸轮板25625从窗口25612滑出或推出，从而解锁击发构件25610。滑块支撑件25603设置在脊25601内，以在螺线管25621移动机械连杆时引导凸轮板25625。在至少一个实例中，滑块支撑件25603将凸轮板25625的移动控制成例如线性路径。
本文公开了各种实施方案，这些实施方案包括被构造成能够在某些实例中防止击发构件朝远侧推进的闭锁件。在许多实例中，闭锁件远远足以阻挡击发构件朝远侧推进。在一些实例中，可能希望具有一个以上的被构造成能够阻挡击发构件朝远侧推进的闭锁件。在这类实例中，主闭锁件和辅闭锁件可阻挡击发构件朝远侧推进。如下面更详细地描述，由于主闭锁件被致动，辅闭锁件可被致动。例如，主闭锁件可阻挡击发构件朝远侧推进，原因是装载单元缺失了钉仓钳口，将钉仓钳口不正确地附接到装载单元，并且/或者钉仓钳口先前已被至少部分地击发，并且当击发构件朝远侧移位受到主闭锁件的阻碍时，辅闭锁件可被致动以辅助主闭锁件阻挡击发构件朝远侧推进。
现在转到图141和图142，装载单元包括轴21730和延伸穿过轴21730的击发构件系统。该击发构件系统包括第一或近侧击发构件21760和第二或远侧击发构件21762。在该击发构件系统的钉击发冲程期间，近侧击发构件21760例如由电动马达和/或手动曲柄朝远侧推动。同样，远侧击发构件21762由近侧击发构件21760朝远侧推进。该击发构件系统还包括闭锁件21780，该闭锁件定位在近侧击发构件21760和远侧击发构件21762中间。闭锁件21780被构造成能够在钉击发冲程期间将击发力从近侧击发构件21760传输到远侧击发构件21762。在通过闭锁件21780传输的力超过在钉击发冲程期间预期的击发力和/或超过预定阈值力的情况下，闭锁件21780移动到锁定构型，如图142所示并且如下面进一步更详细地描述。
闭锁件21780包括锁定臂21782，该锁定臂在枢轴21784处可枢转地安装到近侧击发构件21760。锁定臂21782被构造成能够抵接限定在击发构件21762的近侧端部上的驱动表面21768并朝远侧推动击发构件21762。在至少一个实例中，驱动表面21768形成例如锥形表面。闭锁件21780还包括偏置构件或弹簧21785，该偏置构件或弹簧被构造成能够抵靠驱动表面21768朝向解锁构型向内偏置锁定臂21782，如图141所示。每个锁定臂21782包括从其延伸的销21783，该销被构造成能够将弹簧21785的端部安装到其上。当闭锁件21780移动到锁定构型时，除上述之外，锁定臂21782相对于驱动表面21768滑动并向外张开或旋转成与轴21730接合。轴21730包括限定在其中的一个或多个齿条21781，所述齿条被锁定臂21782接合并防止近侧击发构件21760朝远侧推进。
除上述之外，当锁定臂21782向外移位时，弹簧21785弹性地伸展。弹簧21785的刚度被选择成使得弹簧21785可在从近侧击发构件21760传输到远侧击发构件21762的力低于阈值力时，将锁定臂21782抵靠驱动表面21768保持在其解锁构型中，但在从近侧击发构件21760传输到远侧击发构件21762的力超过阈值力时，允许锁定臂21782向外移位。例如，在近侧击发构件21760和远侧击发构件21762之间传输的力在击发系统从钉仓击发钉时低于阈值力，在远侧击发构件21760被缺失的仓和/或用过的仓闭锁件阻挡时高于阈值力。在这类实例中，闭锁件21780响应于另一闭锁件阻挡钉击发系统的推进而部署。换句话讲，闭锁件21780可包括辅闭锁件，其与主闭锁件合作以阻挡钉击发系统的推进。
在各种实例中，除上述之外，闭锁件21780可为钉击发系统提供过载保护。例如，钉击发系统可在击发冲程期间堵塞，并且闭锁件21780可部署以停止钉击发冲程。在这类实例中，闭锁件21780可将击发力或至少一部分击发力传递到轴21730而不是钉仓。因此，闭锁件21780可防止击发系统和/或钉仓被损坏或至少进一步损坏。在这类实例中，闭锁件21780响应于除了预定义的闭锁件之外的缝合组件的条件而部署。再次参见图141和图142，齿条21781与钉击发系统的击发冲程的长度相同或比其更长，使得闭锁件21780可在击发冲程期间的任何点处接合齿条21781。
当从近侧击发构件21760传输到远侧击发构件21762的力下降到力阈值以下时，弹簧21785可弹性地将锁定臂21782返回到其解锁构型并使其与远侧击发构件21762的驱动表面21768接合。此时，如果导致第二闭锁件21780致动的条件已减弱，则可完成击发冲程。否则，近侧击发构件21760可回缩。
现在转到图151至图154，装载单元包括轴24530和延伸穿过轴24530的钉击发系统。该钉击发系统包括近侧击发构件24560和远侧击发构件24562。在该钉击发系统的钉击发冲程期间，近侧击发构件24560例如由电动马达和/或手动曲柄朝远侧推动。同样，远侧击发构件24562由近侧击发构件24560朝远侧推进。该钉击发系统还包括闭锁件24580，该闭锁件定位在近侧击发构件24560和远侧击发构件24562中间。闭锁件24580被构造成能够在钉击发冲程期间将击发力从近侧击发构件24560传输到远侧击发构件24562。在通过闭锁件24580传输的力超过在钉击发冲程期间预期的击发力和/或超过预定阈值力的情况下，闭锁件24580移动到锁定构型，如图153和图154所示。
主要参见图152和图154，闭锁件24580包括大致C形的构型，例如其围绕远侧击发构件24562的一部分延伸。闭锁件24580包括锁定臂24584，当闭锁件24580处于其未致动或解锁构型时，如图151和图152所示，所述锁定臂抓持远侧击发构件24562。闭锁件24580还包括驱动凸片24582，当近侧击发构件24560在钉击发系统的钉击发冲程期间朝远侧驱动时，该驱动凸片与近侧击发构件24560接触。当闭锁件24580被近侧击发构件24560朝远侧推动时，闭锁件24580抵接限定在远侧击发构件24562上的驱动表面24564并朝远侧推动远侧击发构件24562。因此，闭锁件24580将来自近侧击发构件24560的推力通过锁定臂24584传输到驱动表面24564中。
主要参见图151，驱动凸片24582与锁定臂24584不共平面；相反，驱动凸片24582从由锁定臂24584限定的平面横向延伸。更具体地讲，驱动凸片24582包括升高部分，至少在闭锁件24580处于其未致动构型时，该升高部分从锁定臂24584镦粗。闭锁件24580被构造成能够只要通过闭锁件24580传输的推力低于阈值力，就保持在其未致动构型中。完成击发冲程所需的推力低于该阈值力。当通过闭锁件24580传输的推力超过阈值力时，闭锁件24580塌缩成其致动构型，如图153和图154所示。例如，当远侧击发构件24562抵接钉仓中缺失的仓和/或用过的仓闭锁件时，推力可超过阈值力。
再次参见图153和图154，当闭锁件24580移动到其致动构型时，锁定臂24584径向向外张开以接合轴24530。在至少一个实例中，轴24530可包括限定在其中的凹陷部24534，该凹陷部被构造成能够接收锁定臂24584。凹陷部24534限定在轴24530中，使得当击发系统的远侧前进被缺失的仓和/或用过的仓闭锁件阻挡时，锁定臂24584与凹陷部24534对齐。一旦锁定臂24584在凹陷部24534中，闭锁件24580也可阻挡击发系统朝远侧推进。在各种实例中，凹陷部24534被定位和布置成在击发驱动件的切割构件切割组织之前停止击发构件24560。当近侧击发构件24560回缩并且施加到闭锁件24580的推动负载下降到阈值力以下时，闭锁件24580可弹性地返回到其未致动构型。此时，可将未用过的仓置于装载单元中以击败缺失的仓和/或用过的仓闭锁件，使得击发系统可朝远侧推进通过其钉击发冲程。然而在任何时候，近侧击发构件24560都可回缩以使远侧击发构件24562回缩。
如果钉击发系统被加速太快，则上述闭锁件的阈值力可被致动。换句话讲，钉击发系统中的加速度峰值可导致力峰值超过闭锁件的阈值力，从而导致闭锁件停止钉击发系统。例如，当机械地联接到钉击发系统的击发触发器被挤压太快并且/或者突然将电源施加到钉击发系统的电动马达时，会出现这类情况。在至少一个实例中，例如，当施加到电动马达的电力被不正确地调制时并且/或者当在马达控制器中发生软件故障时，会产生加速度峰值。这类加速度峰值和力峰值通常是瞬态的，并且一旦通过钉击发系统传输的力下降回阈值力以下，就可完成击发冲程。
现在转到图143，缝合组件包括轴21830和延伸穿过其中的击发构件21860。该缝合组件还包括闭锁系统21880。闭锁系统21880包括锁定臂21882，该锁定臂围绕枢轴21884可旋转地安装到钉击发构件21860。每个锁定臂21882可在未致动位置(在图143中以实线示出)和致动位置(在图143中以虚线示出)之间旋转。闭锁系统21880还包括安装到钉击发构件21860的悬臂弹簧21885，该悬臂弹簧被构造成能够将锁定臂21882偏置到其未致动位置。该缝合组件还包括安装到击发构件21860的致动器21862，该致动器被构造成能够在击发构件21860朝远侧移动时抵靠轴21830的外壳滑动或拖动。当击发构件21860被加速太快或被加速到阈值水平以上时，致动器21862和轴21830之间的拖曳力将减缓或抓持致动器21862并且允许击发构件21860相对于致动器21862滑动。在这类实例中，致动器21862和击发构件21860之间的相对移动将锁定臂21882向外驱动成与限定在轴21830中的齿条21881接合，以停止、阻碍或减缓钉击发系统朝远侧前进。
现在转到图144，缝合组件包括轴21930和击发构件21960，该击发构件被构造成能够在轴21930内平移。该缝合组件还包括闭锁系统21980，该闭锁系统包括围绕枢轴21984可旋转地安装到钉击发构件21960的锁定臂21982。锁定臂21982可在未致动位置(在图144中以实线示出)和致动位置(在图144中以虚线示出)之间旋转。闭锁系统21980还包括安装到钉击发构件21960和锁定臂21982的螺旋弹簧21985，该螺旋弹簧被构造成能够将锁定臂21982偏置到其未致动位置。闭锁系统21980还包括安装到锁定臂21982的致动器或砝码21989，该致动器或砝码被构造成能够在击发构件21960朝远侧加速时惯性地旋转锁定臂21982。当击发构件21960被加速太快或被加速到阈值水平以上时，由砝码21989产生的惯性力足以克服弹簧21985的偏置力并使锁定臂21982旋转成与限定在轴21930中的齿条21981接合。在这类实例中，闭锁系统21890将停止、阻碍或减缓钉击发系统朝远侧前进，直到击发构件21960的加速度下降到阈值以下并且弹簧21985可将锁定臂21982拉动成与齿条21981脱离接合。
除了或代替上述内容，缝合组件可包括用于调节钉击发系统的速度的装置，所述装置在各种实例中可减小或缓和在钉击发系统内产生的加速度峰值。现在转到图145，缝合组件可包括轴22030和钉击发构件22060，该钉击发构件被构造成能够在轴22030内平移。缝合组件还包括阻尼系统22080，该阻尼系统包括被构造成能够减缓钉击发构件22060朝远侧平移和/或朝近侧平移的阻尼构件或缓冲器22081。阻尼构件22081由柔顺和/或弹性体材料(诸如，橡胶)构成，该柔顺和/或弹性体材料被构造成能够在击发构件22060接触阻尼构件22081时产生与施加到击发构件22060的推力相反的阻尼力。击发构件22060延伸穿过限定在阻尼构件22081中的孔，并且包括被构造成能够接合阻尼构件22081的环形脊部22082。虽然图145中仅示出了一个阻尼构件22081和轴脊部22082，但是缝合组件可包括例如任何合适数量的阻尼构件22081和/或轴脊部22082。
除上述之外，缓冲器22081定位在轴22030内，使得脊部22082恰好在击发构件22060到达缺失的仓和/或用过的仓闭锁件之前接触缓冲器22081。在这类实例中，阻尼系统22080可在击发构件22060到达闭锁件之前减小击发构件22060的速度，因此降低击发构件22060撞击或无意地击败闭锁件的可能性。
现在转到图146，缝合组件可包括轴22130和钉击发构件22160，该钉击发构件被构造成能够在轴22130内平移。该缝合组件还包括液压阻尼系统22180，该液压阻尼系统包括被构造成能够在其钉击发冲程期间减缓击发构件22160的汽缸组件。该汽缸组件包括可滑动地定位在室22183中的输入活塞22181，该输入活塞与室22183的侧壁密封地接合。该汽缸组件还包括可滑动地定位在室22185中的输出活塞22184，该输出活塞与室22185的侧壁密封地接合。如图146所示，室22183的一部分经由限流孔口22189与室22185的一部分流体连通。不可压缩或基本上不可压缩的流体22182容纳在输入活塞22181和输出活塞22184之间的室22183和22185中。在至少一个实例中，流体22182包括例如液压流体。在某些实例中，流体22182包括例如盐水。当击发构件22160朝远侧推进时，击发构件22160或限定在击发构件22160上的肩部接触限定在输入活塞22181上的凸轮或成角表面，并将输入活塞向下驱动到室22183中。在这类实例中，输入活塞22181将流体22182移位到室22185中，继而使输出活塞22184在室22185内移位。输出活塞22184、流体22182和输入活塞22181的移动受到定位在室22185中的弹簧22186的抵抗。由于以上原因，阻尼系统22180向击发构件22160施加阻力，该阻力随着击发构件22160的速度的增加而成比例地增加，并且可限制击发构件22160的最大速度。与上述类似，阻尼系统22180可定位在轴22130中，使得击发构件22160恰好或至少在击发构件22160到达闭锁件之前接触阻尼系统22180。
现在转到图148，缝合组件可包括轴22330和可在轴22330内滑动的击发构件22360。该缝合组件还包括气动活塞布置22380，该气动活塞布置被构造成能够向击发构件22360施加阻力。击发构件22360包括延伸穿过限定在轴22330中的支撑件的圆柱形或至少大致圆柱形的杆，以及可滑动地定位在限定在轴22330中的汽缸22383中的一体形成的活塞22362。活塞布置22380包括一个或多个活塞密封件22382，所述活塞密封件安置在围绕活塞22362延伸的密封沟槽内。活塞密封件22382与活塞22362以及汽缸22383的汽缸壁22381密封地接合。活塞布置22380还包括一个或多个密封件22361，所述密封件安置在限定在轴支撑件中的密封沟槽中，并且与轴22330和击发构件22360密封地接合。在各种实例中，密封件22361和22383包括例如柔顺O环。在任何情况下，击发构件22360朝远侧移位压缩气缸22383中的空气，并迫使压缩空气通过限定在轴22330中的通风口22363。这种布置向击发构件22360施加阻力，该阻力与击发构件22360的速度成比例地增加。
除上述之外，可将通风口22363的直径和/或长度选择成以期望的方式限制击发构件22360的速度。此外，当击发构件22360朝远侧推进并朝近侧回缩时，密封件22382与轴22330密封地接合，因此当击发构件22360朝远侧推进并朝近侧回缩时，活塞布置22380向击发构件22360施加阻力。在至少一个实施方案中，阀(诸如，单向阀)可相对于通风口22363定位和布置。该阀可在击发构件22360朝远侧推进时提供具有较小直径的孔口，并且在击发构件22360朝近侧回缩时提供具有较大直径的孔口。在这类实例中，与当击发构件22360以给定速度朝近侧回缩时相比，当击发构件22360朝远侧推进时，通风口可向击发构件22360施加更大的阻力。因此，阀可提供不同的方向速度限制。
现在转到图147，缝合组件可包括钉击发轴22060，该钉击发轴朝远侧移位以从钉仓击发钉。该缝合组件还包括用于向钉击发轴22260施加电磁阻力和/或磁阻力的装置。在至少一个实例中，该缝合组件包括缠绕的导体线圈22280，该导体线圈由电源(诸如，电池)供电，使得电流流过线圈22280。缠绕的导体线圈22280一旦通电就产生磁场，该磁场与限定在轴22260中和/或附接到该轴的磁性元件22282相互作用。在至少一个实例中，磁性元件22282包括例如永磁体。电源的极性被施加到线圈22280，使得线圈22280产生磁场，该磁场在击发构件22260接近线圈22280时向铁磁元件22282施加排斥力，因此在钉击发冲程期间向击发构件22360施加阻力。由线圈22280产生的磁场的强度在线圈22280附近更强，因此施加到击发构件22360的阻力在线圈22280附近将更大。
鉴于上述情况，线圈22280在通电时可用作制动器，并且在某些实例中例如可在钉击发冲程结束时停止或至少有助于停止击发构件22360的纵向移动。在某些实例中，在击发构件22360的回缩冲程期间，可反转施加到线圈22280的电压极性以反转通过线圈22280的电流。在这类实例中，当击发构件22360远离线圈22280回缩时，线圈22280可向击发构件22360施加制动力。虽然图147中仅示出了一个线圈22280，但是缝合组件可包括任何合适数量的可通电线圈。除了或代替上述内容，缝合组件可包括安装到缝合组件的轴的一个或多个永磁体，所述永磁体可向钉击发构件施加磁制动力。
在至少一个实施方案中，再次参见图147，未将电源施加到线圈22280，并且线圈22280可用作电/感应制动器。在这类实施方案中，磁性元件22282通过线圈22280的移动在线圈22280中产生电流，该电流继而产生与磁性元件22282的移动相反的磁场。当磁性元件22282相对于线圈22280缓慢移动时，相反的磁场在击发构件22260上施加可忽略的制动力。当磁性元件22282相对于线圈22280快速移动时，相反的磁场强得多并且向击发构件22260施加更强的制动力。线圈22280和磁性元件22282可被定位和布置成使得恰好或至少在击发构件22260到达缺失的仓和/或用过的仓闭锁件之前向击发构件22260施加制动力。
如上所述，钉击发系统的击发构件可由电动马达驱动。马达控制器(其可包括处理器并且可实施为微控制器)可用于控制供应给电动马达的电压，因此控制钉击发构件的速度。在某些实例中，马达控制器可利用例如脉宽调制(PWM)和/或频率调制(FM)来控制电动马达的速度。在其他实例中，马达控制器可能不调制供应给电动马达的电力。在任一种情况下，缝合组件可包括与马达控制器通信的传感器系统，该传感器系统被构造成能够检测未用过的钉仓或未用过的钉仓钳口是否已附接到缝合组件。在传感器系统检测到未用过的钉仓附接到缝合组件的情况下，马达控制器可识别来自传感器系统的指示未用过的钉仓的存在的信号，并且在缝合组件的用户致动钉击发系统时操作钉击发系统的电动马达。在传感器系统未检测到附接到缝合组件的未用过的钉仓的情况下，马达控制器接收来自传感器系统的指示未用过的仓未附接到缝合组件的信号，并且防止电动马达操作钉击发系统。这种布置可包括电子或软件闭锁件。
除了或代替上述内容，缝合系统可包括被构造成能够跟踪钉击发构件的位移的传感器系统。参见图149，缝合组件22400的钉击发构件22460可沿着钉击发路径22463在近侧未击发位置和远侧击发位置之间移动。可检测的磁性元件22461例如安装到钉击发构件22460，该钉击发构件沿着或至少大致沿着钉击发路径22463移动。在至少一个实例中，磁性元件22461是例如由铁、镍和/或任何其他合适的材料构成的永磁体。传感器系统包括第一或近侧传感器22401'和第二或远侧传感器22401，这两个传感器被构造成能够在磁性元件22461与可平移构件22460一起沿着钉击发路径22463移动时检测该磁性元件。第一传感器22401'和第二传感器22401各自包括霍尔效应传感器；但是传感器22401’和22401可包括任何合适的传感器。传感器22401'和22401输出电压的根据它们与磁性元件22461的相应距离而变化(当距离较小时输出较高电压，当距离较大时输出较小电压)。
除上述之外，传感器系统包括传感器电路，该传感器电路包括例如与传感器22401'和22401通信并向传感器22401'和22401供电的电压源22403等。该传感器电路还包括与第一传感器22401'通信的第一开关22405'和与第二传感器22401通信的第二开关22405。在至少一个实例中，开关22405'和22405各自包括晶体管，诸如FET。传感器22401'、22401的输出分别连接到开关22405'、22405的中央(门极)端子。在钉击发构件22460的击发冲程之前，来自传感器22401'、22401的输出电压较高，使得第一开关22405'和第二开关22405处于闭合状态。
当磁性元件22461经过第一传感器22401'时，第一传感器22401'的电压输出足以在闭合状态和断开状态之间改变第一开关。类似地，当磁性元件22461经过第二传感器22401时，第二传感器22401的电压输出足以在闭合状态和断开状态之间改变第二开关22405。当开关22405'和22405都处于断开状态时，接地电位被施加到运算放大器电路22406。运算放大器电路22406与马达控制器的微控制器22490的输入通道进行信号通信，并且当接地电位被施加到运算放大器电路22406时，微控制器22490从电路22406接收接地信号。
当微控制器22490从电路22406接收接地信号时，微控制器22490可确定钉击发冲程已经完成并且定位在缝合组件22400中的钉仓已经完全用尽。设想了其他实施方案，其中传感器系统被构造成能够检测钉击发构件22460的部分击发冲程并向微控制器22490提供指示钉仓已经至少部分用过的信号。在任一种情况下，马达控制器可被构造成能够防止击发构件22460执行另一击发冲程，直到钉仓已用未用过的钉仓进行替换。在至少一个实例中，除上述之外，传感器系统包括传感器，该传感器被构造成能够检测是否已将用过的仓从缝合组件拆下和/或是否已将未用过的仓组装到缝合组件。
除上述之外，传感器系统可被构造成能够检测击发构件22460是否已沿着回缩路径22462回缩。在至少一个实例中，当磁性元件22461沿着路径22462回缩并将第二开关22405改变回闭合状态时，传感器22401可检测磁性元件22461。类似地，当磁性元件22461沿着路径22463回缩并将第一开关22405改变回闭合状态时，传感器22401可检测磁性元件22461。通过闭合开关22405和22405'，来自电池22403的电压极性被施加到电路22406，因此微处理器22490在其输入通道上从电路22406接收Vcc信号。在各种实例中，马达控制器可被构造成能够防止操作电动马达以执行另一钉击发冲程，直到击发构件22460已经完全回缩。
包括钉仓25730、击发构件25760和锁定件25780的缝合组件25700在图130至图133中示出。钉仓25730包括滑动件25770，该滑动件在击发构件25760的钉击发冲程期间被击发构件25760朝远侧推动。在钉击发冲程期间，击发构件25760将滑动件25770从近侧未击发位置(图130和图131)朝远侧推朝远侧击发位置(图132和图133)。滑动件25770被构造成能够在可移除地存储在钉腔(限定在钉仓25730中)中的钉下方滑动，并且从钉腔中弹射出钉。在各种实例中，钉仓25730包括钉驱动器，所述钉驱动器(一)支撑钉仓中的钉，并且(二)被滑动件25770驱动以从钉腔中弹射出钉。在击发构件25760的钉击发冲程完成之后，击发构件25760朝近侧回缩。值得注意的是，滑动件25770不与击发构件25760一起朝近侧回缩。
除上述之外，闭锁件25780包括锁定臂25782。每个锁定臂25782包括悬臂梁，该悬臂梁包括安装到缝合组件25700的轴的第一端部和被构造成能够接合击发构件25760的可移动第二端部。击发构件25760包括限定在其中的锁定孔25762，所述锁定孔被构造成能够接收锁定臂25782的第二端部。然而，当滑动件25770处于其近侧未击发位置(图130和图131)时，滑动件25770使锁定臂25782横向偏离击发构件25760并将锁定臂25782保持在锁定孔25762之外。因此，当钉仓25730定位在缝合组件25700中并且钉仓25730的滑动件25770处于其未击发位置时，闭锁件25780不会阻止击发构件25760执行钉击发冲程。当击发构件25760在其钉击发冲程期间朝远侧推进时，限定在击发构件25760中的锁定孔25762不再与锁定臂25782对齐，因此一旦缝合击发冲程开始，锁定臂25782便不会干扰该缝合击发冲程。在击发构件25760的钉击发冲程之后，击发构件25760朝近侧回缩到其未击发位置，如图132和图133所示。此时，锁定孔25762与锁定臂25782重新对齐，并且当滑动件25770未返回到其未击发位置时，锁定臂25782可进入锁定孔25762中并锁定击发构件25760。
由于以上原因，闭锁件25780包括缺失的仓闭锁件和用过的仓闭锁件。设想了其中钉仓25730不可从缝合组件25700移除的替代实施方案。在这类实施方案中，闭锁件25780将包括用过的仓闭锁件。
参见图134和图135，缝合组件25800包括钉仓25830，该钉仓包括仓体25831、可在仓体25831内朝远侧移动的滑动件25870以及钉驱动器25880。仓体包括限定在其中的钉腔25832和可移除地存储在钉腔25832中的钉。在钉击发冲程期间，滑动件25870可在近侧未击发位置(图134)和远侧击发位置之间朝远侧平移。在钉击发冲程期间，滑动件25870接触钉驱动器25880并在钉腔25832内向上驱动钉驱动器25880，如图135所示。值得注意的是，仓体25831包括限定在其中的多个纵排钉腔25832，并且钉驱动器25880以纵排布置，与纵排钉腔25832对齐。在滑动件25870的钉击发冲程期间，当滑动件25870朝远侧推进时，钉驱动器25880和钉被顺序地驱动。换句话讲，在最远侧驱动器25880和钉之前被击发，最近侧钉驱动器25880和钉被击发。在各种实例中，最近侧钉驱动器25880的击发标志着钉击发冲程的开始。
再次参见图134和图135，钉仓25830包括闭锁电路，该闭锁电路被构造成能够检测钉仓25830何时已被至少部分地击发。闭锁电路的一部分延伸穿过仓体25831并且包括电接触件25834。闭锁电路的另一部分延伸穿过最近侧钉驱动器25880并且包括与电接触件25834对齐的电接触件25884。当钉仓25830处于其未击发状态(图134)时，驱动器接触件25884抵接仓体接触件25834，因此闭锁电路处于闭合状态。当最近侧钉驱动器25880被滑动件25870向上提升时，驱动器接触件25884与仓体接触件25834脱离接合并且闭锁电路断开。闭锁电路与缝合组件25800的控制器进行信号通信，该控制器被构造成能够解释闭锁电路的断开意味着缝合组件25800中的钉仓25830已被至少部分地击发，并且在没有用未用过的钉仓25830替换钉仓25830的情况下，不应第二次或再一次操作钉击发系统。一旦已将未用过的钉仓25830定位在缝合组件25800中并且未用过的钉仓25830将闭锁电路闭合，控制器就可允许再次操作钉击发系统。
在各种实例中，再次参见图135，最近侧钉驱动器25880与钉腔25832的侧壁略带摩擦地配合接合。因此，最近侧钉驱动器25880在被滑动件25870向上提升之后保持在其击发位置，因此，一旦闭锁电路断开，驱动器接触件25884就与仓体接触件25834保持不接触，并且闭锁电路重新闭合的可能性降低。
如上所述，钉仓25830的钉击发冲程断开闭锁电路。在替代实施方案中，钉仓的钉击发冲程可闭合闭锁电路。在这类实施方案中，缝合组件的控制器可解释闭锁电路的闭合意味着钉仓已被至少部分地击发，并且在没有用未用过的钉仓替换钉仓的情况下，不应第二次或再一次操作钉击发系统。
除了或代替上述内容，缝合组件可包括检测电路，该检测电路被构造成能够检测最远侧钉驱动器25880和钉何时已被击发。在至少一个这种实例中，最远侧钉驱动器25880可具有上述接触布置，和/或改变检测电路的状态的任何其他合适的布置。缝合组件的控制器可解释例如检测电路的状态变化意味着钉仓已被完全击发并且钉击发系统应回缩。
现在转到图136和图137，缝合组件25900包括轴25910、砧座钳口25920和钉仓钳口，该钉仓钳口可移除地附接到轴25910的框架。缝合组件25900还包括关节运动接头25940，该关节运动接头被构造成能够允许砧座钳口25920和钉仓钳口相对于轴25910进行关节运动。与本文所述的实施方案类似，钉仓钳口可在打开位置和闭合位置之间移动，以抵靠砧座钳口25920夹持患者的组织。
缝合组件25900还包括闭锁电路25980，该闭锁电路被构造成能够检测钉仓钳口何时处于其闭合位置。闭锁电路25980包括延伸穿过轴25910的导体25984和定位在砧座钳口25920中的电极垫25982。导体25984将电极垫25982放置成与缝合组件25900的控制器连通，并且在各种实例中，控制器可在导体25984两端施加电压电势以在闭锁电路25980内产生监测电流。如下面更详细地描述，控制器被构造成能够评估闭锁电路25980的阻抗和/或电阻率，并且经由监测电流监测闭锁电路25980的阻抗和/或电阻率的变化。
除上述之外，主要参见图137，钉仓钳口包括销25932，该销被构造成能够在钉仓钳口移动到其闭合位置时刺穿电极垫25982和/或使该电极垫变形。销25932由例如不锈钢构成，并且会破坏闭锁电路25980的由控制器检测的阻抗和/或电阻率。这种破坏可向控制器通知(一)钉仓钳口已附接到缝合组件25900，并且(二)钉仓钳口已闭合。此时，控制器可电子地解锁钉击发系统并允许钉击发系统执行其钉击发冲程。在至少一个这种实例中，钉击发系统包括电动马达和电池，其中控制器包括电子或软件闭锁件，所述电子或软件闭锁件防止电池向电动马达供应足够的电力以执行钉击发冲程，直到控制器检测到闭锁电路25980的参数已经发生足够的变化。因此，在钉仓钳口闭合之前，不能操作缝合组件25900的钉击发系统。
再次参见图136，闭锁电路25980延伸穿过轴25910和砧座钳口25920，但不延伸穿过钉仓钳口。虽然钉仓钳口的销25932破坏了闭锁电路25980，如上所述，但是销25932在钉仓钳口内电绝缘并且不会闭合或断开闭锁电路25980。
或者，参见图136和图137，销25932是闭锁电路25980的一部分，并且电极垫25982包括被销25932刺穿的接触件。在这类实施方案中，当销25932接合电极垫25982时，销25932闭合闭锁电路，使得感测电流可在销25932和电极垫25982之间流动。在至少一个实例中，电极垫25982可由自修复材料诸如导电凝胶构成。在各种实例中，销25932可在进入电极垫25982之前刺穿组织。再次参见图136，电极垫25982可包括擦拭垫25983，该擦拭垫被构造成能够在销25932进入电极垫25982之前至少部分地清洁销25932。
参见图138和图139，轴25910包括外部外壳25911，该外部外壳包括限定在其中的纵向狭槽25912，该纵向狭槽被构造成能够可滑动地接收击发构件25960。纵向狭槽25912延伸穿过关节运动接头25940并进入砧座钳口25920和钉仓钳口。当砧座钳口25920和钉仓钳口处于非关节运动取向时，纵向狭槽25912是直的，或不包括方向上的变化。当砧座钳口25920和钉仓钳口处于关节运动取向时，纵向狭槽25912包括方向上的变化。因此，击发构件25960需要足够柔性以穿过关节运动接头25940。然而，击发构件25960的这种柔韧性可导致击发构件25960在钉击发冲程期间弯曲。为了防止或减少这种弯曲，缝合组件25900还包括定位在击发构件25960的相对侧上的防弯曲或防喷出板25944，所述板被构造成能够将击发构件25960支撑在关节运动接头25940内和/或其附近。在至少一个实例中，防弯曲板25944相对于关节运动接头25940朝近侧定位在轴25910中。
除上述之外，轴25910和关节运动接头25940包括限定在其中的路由通道，所述路由通道被构造成能够接收闭锁电路25980的导体25984。例如，轴25910包括限定在轴25910的外部外壳25911中的通道25915。在至少一个这种实例中，第一导体25984延伸穿过第一通道25915，并且第二导体25984延伸穿过第二通道25915。此外，每个防弯曲板25984包括限定在其中的通道25945，该通道被构造成能够接收导体25984。通道25945与通道25915对齐或至少大致对齐。
参见图140，钉仓26230包括纵向狭槽26231和限定在其中的纵排钉腔26232。在钉击发冲程期间，击发构件诸如击发构件25960被构造成能够在纵向狭槽26231内滑动，以将滑动件诸如滑动件25770朝远侧推动以从钉腔26232中弹射出钉。与上述类似，击发构件25960和滑动件25770顺序地从钉腔26232中弹射出钉，因此例如抵靠砧座诸如砧座25920顺序地使钉变形。通过击发构件25960传输以顺序地使钉变形的推力很少(如果有的话)是恒定的。相反，推力通常包括一系列峰值，这些峰值与抵靠砧座变形的钉一致。图141A示出了这类力峰值。更具体地讲，图141A示出了击发构件25960在钉击发冲程的长度(L)上经历的推力(F)的典型力分布曲线26260。力分布曲线26260包括峰26261以及峰26261之间的谷26262。
在各种实例中，除上述之外，缝合组件的控制器可被构造成能够监测施加到击发构件25960的推力。在至少一个实例中，钉击发系统包括被构造成能够驱动击发构件25960的电动马达，并且在这类实例中，可监测在钉击发冲程期间由电动马达消耗的电流，作为施加到击发构件25960的推力的代表。事实上，比较在钉击发冲程内由电动马达消耗的电流的图表看起来可能与图140A所示的力分布曲线26260非常类似。在某些实施方案中，可利用力换能器来监测推力。在任何情况下，控制器可在击发冲程期间对力分布曲线26260的峰26261进行计数，并且在达到预定计数阈值之后停止钉击发冲程。在至少一个这种实例中，钉仓可包括可移除地存储在其中的100个钉，并且例如在控制器已经对100个力和/或电流峰值进行计数之后，控制器可中断向电动马达供电，因为可以假设钉击发冲程已经完成。
在各种实例中，除上述之外，缝合组件可被构造成用于与具有不同长度和/或其中储存有不同数量的钉的钉仓一起使用。例如，缝合组件可与被构造成能够施加大约45mm钉线的第一钉仓和被构造成能够施加大约60mm钉线的第二钉仓一起使用。第一钉仓包括可移除地存储在其中的第一数量的钉，并且第二钉仓包括可移除地存储在其中的第二数量的钉，第二数量大于第一数量。当第一钉仓与缝合组件一起使用时，控制器被构造成能够在控制器识别第一数量的力峰值之后停止钉击发冲程，并且类似地，当第二钉仓与缝合组件一起使用时，控制器被构造成能够在控制器识别第二数量的力峰值之后停止钉击发冲程。换句话讲，控制器可被构造成能够评估第一仓的力分布曲线，诸如力分布曲线26260，以及第二仓的力分布曲线，诸如力分布曲线26260'。此外，控制器可被构造成能够监测任何合适数量的钉仓的力分布曲线。
除上述之外，可与缝合组件一起使用的钉仓可包括唯一的标识符，所述标识符可帮助缝合组件的控制器识别附接到缝合组件的钉仓的类型。在至少一个实例中，钉仓具有唯一的RFID标签，所述RFID标签例如可与缝合组件的控制器通信。在某些实例中，钉仓上具有条形码，例如在所述条形码与缝合组件一起使用之前可对它们进行扫描。一旦控制器识别附接到缝合组件的钉仓的类型，控制器就可确定钉击发冲程的适当长度。在至少一个实例中，关于钉仓的适当击发冲程长度的信息可存储在例如与控制器的微处理器通信的存储设备中。
除了或代替上述内容，钉仓诸如钉仓26230可被构造成能够产生推力中的可检测力峰值和/或由电动马达在钉击发冲程结束时消耗的电流峰值。参见图140，钉仓26230包括一个或多个桥接件26233，所述桥接件在纵向狭槽26231的远侧端部附近(即，在钉击发冲程的远侧端部附近)延伸跨过纵向狭槽26231。当击发构件26260朝远侧推进时，击发构件26260接触桥接件26233并且切断和/或切割桥接件26233，这样便产生推力和/或供应电流的峰值，所述峰值与钉变形时产生的峰值不同。在至少一个实例中，通过击败桥接件26233而产生的峰值比通过使钉变形而产生的尖峰大得多，并且控制器被构造成能够识别这类峰值的差异。一旦控制器识别桥接件已产生某些峰值，控制器就可停止钉击发冲程。读者应当理解，这种布置将允许控制器在适当的时刻停止钉击发系统，而例如不管附接到缝合组件的钉仓的长度如何并且/或者不管存储在钉仓中的钉的数量如何。
虽然在上述具体实施方式中列出了各种细节，但是应当理解，可在没有这些具体细节的情况下实践用于补偿电动外科器械中的驱动系故障的机构的各个方面。例如，为简洁和清楚起见，以框图的形式示出了选择的方面，而不是详细地示出。本文提供的详细描述的某些部分可以呈现为对存储在计算机存储器中的数据进行操作的指令。本领域的技术人员用此类描述和表达向本领域的其它技术人员描述和传达他们的工作要旨。通常，算法是指导致所需结果的步骤的自相容序列，其中“步骤”是指物理量的操纵，物理量可以(但不一定)采用能被存储、转移、组合、比较和以其它方式操纵的电或磁信号的形式。常用于指这些信号，如位、值、元素、符号、字符、术语、数字等。这些和类似的术语可与适当的物理量相关联并且仅仅是应用于这些量的方便的标签。
除非上述讨论中另外明确指明，否则可以理解的是，在上述描述中，使用术语如“处理”或“估算”或“计算”或“确定”或“显示”的讨论是指计算机系统或类似的电子计算设备的动作和处理，其操纵表示为计算机系统的寄存器和存储器内的物理(电子)量的数据并将其转换成相似地表示为计算机系统存储器或寄存器或其它此类信息存储、传输或显示设备内的物理量的其它数据。
值得注意的是，任何对“一个方面”或“方面”的提及均意指结合方面所述的特定特征、结构或特性包括在至少一个方面中。因此，在整个说明书中各处出现的短语“在一个方面”、“在某一方面”不一定都指同一方面。此外，具体特征、结构或特性可在一个或多个方面中以任何合适的方式组合。
尽管本文描述了各个方面，但是可实施这些方面的许多修改形式、变型形式、替换形式、改变形式和等效形式，并且本领域的技术人员将会想到这些形式。另外，在公开了用于某些部件的材料的情况下，也可使用其它材料。因此，应当理解，上述具体实施方式和所附权利要求旨在涵盖落入所公开方面的范围内的所有此类修改形式和变型形式。以下权利要求旨在涵盖所有此类修改形式和变型形式。
本文所述的一些或所有方面通常可包括用于补偿电动外科器械中的驱动系故障的机构的技术，或以其他方式根据本文所述的技术。在一般意义上，本领域的技术人员将会认识到，可以用多种硬件、软件、固件或它们的任何组合单独和/或共同实施的本文所述的多个方面可以被看作是由多种类型的“电子电路”组成。因此，如本文所用，“电子电路”包括但不限于具有至少一个离散电路的电子电路、具有至少一个集成电路的电子电路、具有至少一个专用集成电路的电子电路、形成由计算机程序配置的通用计算设备的电子电路(如，至少部分地实施本文所述的方法和/或设备的由计算机程序配置的通用计算机，或至少部分地实施本文所述的方法和/或设备的由计算机程序配置的微处理器)、形成存储器设备(如，形成随机存取存储器)的电子电路，和/或形成通信设备(如，调制解调器、通信开关或光电设备)的电子电路。本领域的技术人员将会认识到，可以模拟或数字方式或它们的一些组合实施本文所述的主题。
上述具体实施方式已通过使用框图、流程图和/或示例阐述了装置和/或方法的各种方面。只要此类框图、流程图和/或示例包含一个或多个功能和/或操作，本领域的技术人员就要将其理解为此类框图、流程图或示例中的每个功能和/或操作都可以单独和/或共同地通过多种硬件、软件、固件或实际上它们的任何组合来实施。在一个方面，本文所述的主题的若干部分可通过专用集成电路(ASIC)、现场可编程门阵列(FPGA)、数字信号处理器(DSP)或其他集成格式来实施。然而，本领域的技术人员将会认识到，本文公开的方面中的一些方面可作为在一台或多台计算机上运行的一个或多个计算机程序(如，作为在一个或多个计算机系统上运行的一个或多个程序)，作为在一个或多个处理器上运行的一个或多个程序(如，作为在一个或多个微处理器上运行的一个或多个程序)，作为固件，或作为实际上它们的任何组合全部或部分地在集成电路中等效地实现，并且根据本发明，设计电子电路和/或编写软件和/或硬件的代码将在本领域技术人员的技术范围内。另外，本领域的技术人员将会认识到，本文所述主题的机制能够作为多种形式的程序产品进行分布，并且本文所述主题的示例性方面适用，而不管用于实际进行分布的信号承载介质的具体类型是什么。信号承载介质的示例包括但不限于如下：可录式媒体，诸如软盘、硬盘驱动器、光盘(CD)、数字视频光盘(DVD)、数字磁带、计算机存储器等；和传输式介质，诸如数字和/或模拟通信介质(例如，光纤缆线、波导、有线通信链路、无线通信链路(例如，发射器、接收器、传输逻辑、接收逻辑等)等)。
本文所述的许多外科器械系统由电动马达促动；但是本文所述的外科器械系统可以任何合适的方式促动。在各种实例中，例如，本文所述的外科器械系统可由手动操作的触发器促动。在某些实例中，本文公开的马达可包括机器人控制系统的一部分或多个部分。此外，本文公开的任何端部执行器和/或工具组件可与机器人外科器械系统一起使用。例如，名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利9,072,535)更详细地公开了机器人外科器械系统的若干示例。名称为“SURGICAL STAPLING INSTRUMENTS WITHROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利9,072,535)的全部公开内容以引用方式并入本文。
以下专利的全部公开内容据此以引用方式并入本文：
提交于1997年3月12日的名称为“LINEAR STAPLER WITH IMPROVED FIRINGSTROKE”的欧洲专利申请EP 795298；
发布于1997年2月25日的名称为“TRIGGER MECHANISM FOR SURGICALINSTRUMENTS”的美国专利5,605,272；
发布于1997年12月16日的名称为“LINEAR STAPLER WITH IMPROVED FIRINGSTROKE”的美国专利5,697,543；
公布于2005年11月10日的名称为“METHOD FOR MAKING A SURGICAL STAPLER”的美国专利申请公布2005/0246881；
公布于2007年9月6日的名称为“METHOD FOR STAPLING TISSUE”的美国专利申请公布2007/0208359；
发布于1985年7月9日的名称为“DISPOSABLE LINEAR SURGICAL STAPLINGINSTRUMENT”的美国专利4,527,724；
发布于1992年8月11日的名称为“FAST CLOSURE DEVICE FOR LINEAR SURGICALSTAPLING INSTRUMENT”的美国专利5,137,198；
发布于1995年4月11日的名称为“FLEXIBLE SUPPORT SHAFT ASSEMBLY”的美国专利5,405,073；
发布于2013年1月29日的名称为“SURGICAL CUTTING AND STAPLING INSTRUMENTWITH SELF ADJUSTING ANVIL”的美国专利8,360,297；
提交于2015年7月30日的名称为“SURGICAL INSTRUMENT COMPRISING SYSTEMSFOR ASSURING THE PROPER SEQUENTIAL OPERATION OF THE SURGICAL INSTRUMENT”的美国专利申请序列号14/813,242；
提交于2015年7月30日的名称为“SURGICAL INSTRUMENT COMPRISING SEPARATETISSUE SECURING AND TISSUE CUTTING SYSTEMS”的美国专利申请序列号14/813,259；
提交于2015年7月30日的名称为“SURGICAL INSTRUMENT COMPRISING SYSTEMSFOR PERMITTING THE OPTIONAL TRANSECTION OF TISSUE”的美国专利申请序列号14/813,266；
提交于2015年7月30日的名称为“SURGICAL INSTRUMENT COMPRISING A SYSTEMFOR BYPASSING AN OPERATIONAL STEP OF THE SURGICAL INSTRUMENT”的美国专利申请序列号14/813,274；
发布于1995年4月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312；
发布于2006年2月21日的名称为“SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利7,000,818；
发布于2008年9月9日的名称为“MOTOR-DRIVEN SURGICAL CUTTING ANDFASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK”的美国专利7,422,139；
发布于2008年12月16日的名称为“ELECTRO-MECHANICAL SURGICAL INSTRUMENTWITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”的美国专利7,464,849；
发布于2010年3月2日的名称为“SURGICAL INSTRUMENT HAVING AN ARTICULATINGEND EFFECTOR”的美国专利7,670,334；
发布于2010年7月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245；
发布于2013年3月12日的名称为“SELECTIVELY ORIENTABLE IMPLANTABLEFASTENER CARTRIDGE”的美国专利8,393,514；
名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利申请序列号11/343,803，现为美国专利7,845,537；
提交于2008年2月14日的名称为“SURGICAL CUTTING AND FASTENING INSTRUMENTHAVING RF ELECTRODES”的美国专利申请序列号12/031,573；
提交于2008年2月15日的名称为“END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT”的美国专利申请序列号12/031,873，现为美国专利7,980,443；
名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”的美国专利申请序列号12/235,782，现为美国专利8,210,411；
名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117，现为美国专利8,608,045；
提交于2009年12月24日的名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENTWITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY”的美国专利申请序列号12/647,100，现为美国专利8,220,688；
提交于2012年9月29日的名称为“STAPLE CARTRIDGE”的美国专利申请序列号12/893,461，现为美国专利号8,733,613；
提交于2011年2月28日的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号13/036,647，现为美国专利号8,561,870；
名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利申请序列号13/118,241，现为美国专利9,072,535；
提交于2012年6月15日的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING A FIRING DRIVE”的美国专利申请序列号13/524,049，现为美国专利9,101,358；
提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,025，现为美国专利申请公布2014/0263551；
提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,067，现为美国专利申请公布2014/0263552；
提交于2006年1月31日的名称为“SURGICAL CUTTING AND FASTENING INSTRUMENTWITH CLOSURE TRIGGER LOCKING MECHANISM”的美国专利申请公布2007/0175955；以及
提交于2010年4月22日的名称为“SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”的美国专利申请公布2010/0264194，现为美国专利8,308,040。
已结合钉的部署和变形描述了本文所述的外科器械系统；然而，本文所述的实施方案不限于此。例如，可以设想部署除钉之外的紧固件诸如夹具或大头钉的各种实施方案。此外，还可设想利用用于密封组织的任何合适装置的各种实施方案。例如，根据各种实施方案的端部执行器可包括被构造成能够加热和密封组织的电极。另外，例如，根据某些实施方案的端部执行器可施加振动能量来密封组织。
上述美国专利、美国专利申请公开、美国专利申请、国外专利、国外专利申请、本说明书中所提及和/或任何应用数据表中所列出的非专利申请或任何其它公开材料均在不与其相抵触的程度上以引用方式并入本文。因此，并且在必要的程度下，本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其它公开材料相冲突的任何材料或其部分，将仅在所并入的材料与现有的公开材料之间不产生冲突的程度下并入。
本领域技术人员将会认识到，本文所述的组成部分(例如，操作)、装置、对象和它们随附的论述是为了概念清楚起见而用作示例，并且可以设想多种构型修改形式。因此，如本文所用，阐述的具体示例和随附的论述旨在代表它们更一般的类别。通常，任何具体示例的使用旨在代表其类别，并且具体组成部分(例如，操作)、装置和对象的未纳入部分不应采取限制。
对于本文中使用的基本上任何复数和/或单数术语，本领域技术人员可从复数转换成单数和/或从单数转换成复数，只要适合于上下文和/或应用即可。为清楚起见，各种单数/复数置换在本文中没有明确表述。
本文所述的主题有时阐述了包含在其它不同部件中的不同部件或与其它不同部件连接的不同部件。应当理解，这样描述的结构仅是示例性的，并且事实上可以实现获得相同功能性的多种其它结构。在概念意义上，获得相同功能性的组件的任何布置结构方式都是有效“相关联的”，从而获得所需的功能性。因此，本文中为获得特定功能性而结合在一起的任何两个组件都可被视为彼此“相关联”，从而获得所需的功能性，而不论结构或中间组件如何。同样，如此相关联的任何两个组件也可被视为彼此“以可操作的方式连接”或“以可操作的方式联接”，以获得所需的功能性，并且能够如此相关联的任何两个组件都可被视为彼此“以可操作的方式联接”，以获得所需的功能性。以可操作的方式联接的具体示例包括但不限于可物理匹配的和/或物理交互组件，和/或无线交互式，和/或无线交互式组件，和/或逻辑交互式，和/或逻辑交互式组件。
一些方面可使用表达“联接”和“连接”连同其衍生词来描述。应当理解，并不希望这些术语彼此同义。例如，某些方面可使用术语“连接”来描述，以表示两个或更多个元件彼此直接物理接触或电接触。在另一个示例中，一些方面可使用术语“联接”来描述，以表示两个或更多个元件直接物理接触或电接触。然而，术语“联接”还可指两个或更多个元件彼此不是直接接触，而是彼此配合或相互作用。
在一些情况下，一个或多个部件在本文中可被称为“被构造成能够”、“可被构造成能够”、“可操作/可操作地”、“适于/可适于”、“能够”、“可适形/适形于”等。本领域的技术人员将会认识到，除非上下文另有所指，否则“被构造成能够”通常可涵盖活动状态的部件和/或未活动状态的部件和/或待机状态的部件。
虽然已经示出并描述了本文所述的本发明主题的特定方面，但是对本领域的技术人员将显而易见的是，基于本文的教导，可在不脱离本文所述的主题的情况下作出改变和变型，并且如在本文所述的主题的真实实质和范围内，其更广泛的方面并因此所附权利要求将所有此类改变和变型包括在其范围内。本领域的技术人员应当理解，一般而言，本文、以及特别是所附权利要求(例如，所附权利要求的正文)中所使用的术语通常旨在为“开放”术语(例如，术语“包括”应解释为“包括但不限于”，术语“具有”应解释为“至少具有”，术语“包含”应解释为“包含但不限于”等)。本领域的技术人员还应当理解，如果所引入权利要求叙述的具体数目为预期的，则这样的意图将在权利要求中明确叙述，并且在不存在这样的叙述的情况下，不存在这样的意图。例如，为有助于理解，下述所附权利要求可含有对介绍性短语“至少一个”和“一个或多个”的使用以引入权利要求。然而，对此类短语的使用不应视为暗示通过不定冠词“一个”或“一种”引入权利要求表述将含有此类引入权利要求表述的任何特定权利要求限制在含有仅一个这样的表述的权利要求中，甚至当同一权利要求包括介绍性短语“一个或多个”或“至少一个”和诸如“一个”或“一种”(例如，“一个”和/或“一种”通常应解释为意指“至少一个”或“一个或多个”)的不定冠词时；这也适用于对用于引入权利要求表述的定冠词的使用。
另外，即使明确叙述引入权利要求叙述的特定数目，本领域的技术人员应当认识到，此种叙述通常应解释为意指至少所叙述的数目(例如，在没有其它修饰语的情况下，对“两个叙述”的裸叙述通常意指至少两个叙述、或两个或更多个叙述)。此外，在其中使用类似于“A、B和C中的至少一者等”的惯例的那些情况下，一般而言，这种结构意在具有本领域的技术人员将理解所述惯例的意义(例如，“具有A、B和C中的至少一者的系统”将包括但不限于具有仅A、仅B、仅C、A和B一起、A和C一起、B和C一起和/或A、B和C一起等的系统)。在其中使用类似于“A、B或C中的至少一者等”的惯例的那些情况下，一般而言，这种结构意在具有本领域的技术人员将理解所述惯例的意义(例如，“具有A、B或C中的至少一者的系统”应当包括但不限于具有仅A、仅B、仅C、A和B一起、A和C一起、B和C一起和/或A、B和C一起等的系统)。本领域的技术人员还应当理解，通常，除非上下文另有指示，否则无论在具体实施方式、权利要求或附图中呈现两个或更多个替代术语的转折性词语和/或短语应理解为涵盖包括所述术语中的一者、所述术语中的任一个或这两个术语的可能性。例如，短语“A或B”通常将被理解为包括“A”或“B”或“A和B”的可能性。
对于所附的权利要求，本领域的技术人员将会理解，其中表述的操作通常可以任何顺序进行。另外，尽管以一定顺序列出了多个操作流程，但应当理解，可以不同于所示顺序的其它顺序进行所述多个操作，或者可以同时进行所述多个操作。除非上下文另有规定，否则此类替代排序的示例可包括重叠、交错、中断、重新排序、增量、预备、补充、同时、反向，或其它改变的排序。此外，除非上下文另有规定，否则像“响应于”、“相关”这样的术语或其它过去式的形容词通常不旨在排除此类变体。
在某些情况下，对系统或方法的使用可发生在一个地区中，即使部件位于所述地区外部。例如，在分布式计算上下文中，对分布式计算系统的使用可发生在一个地区中，即使所述系统的部件可能位于所述地区外部(例如，位于所述地区外部的继电器、服务器、处理器、信号承载介质、传输计算机、接收计算机等)。
系统或方法的销售同样可发生一个地区中，即使所述系统或方法的部件位于和/或用于所述地区外部。此外，在一个地区中实施用于执行方法的系统的至少一部分不排除在另一个地区中使用所述系统。
尽管本文描述了各个方面，但是可实施这些方面的许多修改形式、变型形式、替换形式、改变形式和等效形式，并且本领域的技术人员将会想到这些形式。另外，在公开了用于某些部件的材料的情况下，也可使用其它材料。因此，应当理解，上述具体实施方式和所附权利要求旨在涵盖落入所公开方面的范围内的所有此类修改形式和变型形式。以下权利要求旨在涵盖所有此类修改形式和变型形式。

Claims (20)

1.一种补偿电动外科器械中的电池组故障的方法，所述方法包括：
由电动马达生成旋转运动，以促动击发组件在击发序列期间将钉部署到所捕获的组织中；
基于由电池单元健康状况指示器执行的测量，由控制电路确定可再充电电池单元的子集在所述击发序列期间是否被损坏；以及响应于确定所述可再充电电池单元的子集被损坏，由联接到电压转换器的所述控制电路逐渐升高所述电池组的输出电压以完成所述击发序列。
2.根据权利要求1所述的方法，还包括响应于确定所述可再充电电池单元的子集被损坏，由联接到存储器的所述控制电路将所述电源组的损坏状态存储在所述存储器中。
3.根据权利要求2所述的方法，还包括在用未损坏的电池单元替换所述可再充电电池单元的所述损坏的子集之后，由所述控制电路清除所述损坏状态。
4.根据权利要求1所述的方法，还包括响应于确定所述可再充电电池单元的子集被损坏，由所述控制电路在完成所述击发序列之后停用所述外科器械。
5.一种补偿电动外科器械中的驱动系故障的方法，所述方法包括：
由电动马达生成机械输出，以促动驱动系将运动传输到所述外科器械的钳口组件；
响应于所述驱动系的紧急故障，由控制电路激活安全模式；以及
响应于所述驱动系的灾难性故障，由所述控制电路激活救助模式。
6.根据权利要求5所述的方法，还包括响应于所述紧急故障，由所述控制电路调制所述电动马达的所述机械输出。
7.根据权利要求6所述的方法，其中调制所述电动马达的所述机械输出包括减慢所述机械输出。
8.根据权利要求5所述的方法，还包括由电源生成马达输入电压。
9.根据权利要求8所述的方法，还包括响应于所述紧急故障，由所述控制电路调制所述马达输入电压。
10.根据权利要求9所述的方法，其中调制所述马达输入电压包括以脉冲形式传输所述马达输入电压。
11.根据权利要求9所述的方法，其中调制所述马达输入电压包括减小所述马达输入电压。
12.根据权利要求5所述的方法，还包括响应于所述灾难性故障，由所述控制电路禁用所述电动马达。
13.根据权利要求8所述的方法，还包括响应于所述灾难性故障，由所述控制电路采用反馈元件来提供救助指令。
14.一种补偿电动外科器械中的驱动系故障的方法，所述方法包括：
由电动马达驱动包括齿轮部件的驱动系，以执行所述外科器械的操作；
由相对于所述驱动系定位的振动传感器感测来自所述驱动系的振动信息；
由联接到存储器的处理器记录由所述振动传感器感测的所述振动信息；
基于所述振动信息，由所述振动传感器生成输出信号；以及基于所述输出信号，确定所述外科器械的状态。
15.根据权利要求14所述的方法，还包括：
由滤波器对所述振动传感器的所述输出信号滤波；以及
基于所接收的输出信号，由所述滤波器生成滤波信号。
16.根据权利要求14所述的装置的方法，还包括基于所述滤波信号，由所述处理器生成处理信号。
17.根据权利要求16所述的方法，还包括由所述处理器将预定阈值与所述处理信号的对应值进行比较。
18.根据权利要求17所述的方法，还包括当所述预定阈值等于或小于所述处理信号的所述对应值时，由所述处理器检测所述外科器械的故障。
19.根据权利要求16所述的方法，还包括根据所述振动传感器的测试输出信号或先前处理的信号生成所述预定阈值。
20.根据权利要求19所述的方法，还包括：
在所述外科器械的测试程序期间，由所述振动传感器感测测试振动信息；以及
基于由所述振动传感器感测的所述测试振动信息，由所述存储器记录测试输出信号。
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