CN109310431B - 包括线材钉和冲压钉的钉仓 - Google Patents

包括线材钉和冲压钉的钉仓 Download PDF

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CN109310431B
CN109310431B CN201780039378.4A CN201780039378A CN109310431B CN 109310431 B CN109310431 B CN 109310431B CN 201780039378 A CN201780039378 A CN 201780039378A CN 109310431 B CN109310431 B CN 109310431B
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staple
staples
longitudinal
cavities
staple cavities
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CN109310431A (zh
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F·E·谢尔顿四世
J·L·哈里斯
G·J·巴克斯
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Ethicon Endo Surgery LLC
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
    • A61B17/105—Wound clamp magazines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00526—Methods of manufacturing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0645—Surgical staples, i.e. penetrating the tissue being elastically deformed for insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07228—Arrangement of the staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07235—Stapler heads containing different staples, e.g. staples of different shapes, sizes or materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07285—Stapler heads characterised by its cutter

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Abstract

本发明公开了一种钉仓组件，该钉仓组件包括一个或多个线材钉和由材料片形成的一个或多个钉。

Description

包括线材钉和冲压钉的钉仓
背景技术
本发明涉及外科器械，并且在各种布置中涉及外科缝合和切割器械以及与它们一起使用的钉仓。
附图说明
本文所述的实施方案的各种特征连同其优点可结合如下附图根据以下描述来加以理解：
图1是根据至少一个实施方案的外科缝合器械的端部执行器的透视图；
图2是与图1的端部执行器一起使用的钉仓的局部透视图；
图3是可移除地储存在图2的钉仓中的线材钉的透视图；
图3A是被构造成能够从图2的钉仓射出图3的钉的钉驱动装置的透视图；
图4是与图1的端部执行器一起使用的钉仓的局部透视图；
图5是可移除地储存在图4的钉仓中的钉的透视图；
图6是示出图2的钉仓的钉和图4的钉仓的钉能够与图1的端部执行器的砧座的成形凹坑对齐的图解；
图7是图5的钉的正视图；
图8是图5的钉的局部侧视图；
图9是图5的钉的局部侧视图；
图10示出了直接接合图5的钉的图4的钉仓的滑动件；
图11是图4的钉仓的局部剖视图，示出了处于未击发位置的图5的钉；
图12是图4的钉仓的局部剖视图，示出了处于击发位置的图5的钉；
图13包括图5的钉的另选实施方案的透视图和正视图；
图14包括具有非平行钉腿的图5的钉的型式的透视图和正视图；
图15是根据至少一个实施方案的钉仓的局部平面图；
图16是与图15的钉仓一起使用的滑动件的后正视端视图；
图17是图16的滑动件的透视图；
图18是图15的钉仓的仓体的局部剖视图；
图19是与图15的钉仓一起使用的砧座的局部平面图；
图20是根据至少一个实施方案的钉仓的局部平面图；以及
图21是与图20的钉仓一起使用的滑动件的前正视端视图。
在所述若干视图中，对应的参考符号指示对应的部件。本文所述的范例以一种形式示出了本发明的各种实施方案，且这种范例不应被解释为以任何方式限制本发明的范围。
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“STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPEDSTAPLES”的美国专利申请序列号__________；代理人案卷号END8046USNP/160194；
-名称为“STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME”的美国专利申请序列号__________；代理人案卷号END8055USNP/160203；
-名称为“STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES”的美国专利申请序列号__________；代理人案卷号END8040USNP/160188；以及
-名称为“STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL STAPLE ROWS”的美国专利申请序列号__________；代理人案卷号END8049USNP/160197。
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设计专利申请：
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号__________；代理人案卷号END8055USDP/160203D；
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号__________；代理人案卷号END8055USDP1/160203D-1；
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号__________；代理人案卷号END8055USDP2/160203D-2；以及
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号__________；代理人案卷号END8055USDP3/160203D-3。
本申请的申请人拥有2015年8月26日提交并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 STAPLES FOR MINIMIZING STAPLE ROLL”的美国专利申请序列号14/836,324；
-名称为“SURGICAL STAPLES COMPRISING HARDNESS VARIATIONS FOR IMPROVEDFASTENING OF TISSUE”的美国专利申请序列号14/836,411；
-名称为“SURGICAL STAPLE STRIPS FOR PERMITTING VARYING STAPLEPROPERTIES AND ENABLING EASY CARTRIDGE LOADING”的美国专利申请序列号14/836,058；
-名称为“SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULARSTAPLING INSTRUMENTS”的美国专利申请序列号14/836,110；
-名称为“STAPLE CARTRIDGE ASSEMBLY WITHOUT A BOTTOM COVER”的美国专利申请序列号14/836,036；
-名称为“STAPLE CARTRIDGE ASSEMBLY COMPRISING STAPLE CAVITIES FORPROVIDING BETTER STAPLE GUIDANCE”的美国专利申请序列号14/836,077；
-名称为“STAPLE CARTRIDGE ASSEMBLY INCLUDING STAPLE GUIDES”的美国专利申请序列号14/836,225；
-名称为“STAPLE CARTRIDGE ASSEMBLY COMPRISING STAPLE ALIGNMENTFEATURES ON A FIRING MEMBER”的美国专利申请序列号14/836,351；
-名称为“STAPLE CARTRIDGE ASSEMBLY COMPRISING VARIOUS TISSUECOMPRESSION GAPS AND STAPLE FORMING GAPS”的美国专利申请序列号14/836,163；
-名称为“STAPLES CONFIGURED TO SUPPORT AN IMPLANTABLE ADJUNCT”的美国专利申请序列号14/836,294；
-名称为“STAPLES COMPRISING A COVER”的美国专利申请序列号14/836,375；
-名称为“STAPLE CARTRIDGE ASSEMBLY INCLUDING FEATURES FOR CONTROLLINGTHE ROTATION OF STAPLES WHEN BEING EJECTED THEREFROM”的美国专利申请序列号14/836,137；以及
-名称为“SURGICAL STAPLES COMPRISING FEATURES FOR IMPROVED FASTENINGOF TISSUE”的美国专利申请序列号14/836,020。
本申请的申请人还拥有于2013年12月23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 INSTRUMENTS WITH ARTICULATABLE SHAFT ARRANGEMENTS”的美国专利申请序列号14/138,554；现为美国专利申请公布2015/0173789；
-名称为“SURGICAL STAPLES AND STAPLE CARTRIDGES”的美国专利申请序列号14/138,465；现为美国专利申请公布2015/0173744；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SEPARATE AND DISTINCTCLOSING AND FIRING SYSTEMS”的美国专利申请序列号14/138,474；现为美国专利申请公布2015/0173745；
-名称为“SURGICAL CUTTING AND STAPLING INSTRUMENTS WITH INDEPENDENTJAW CONTROL FEATURES”的美国专利申请序列号14/138,485；现为美国专利申请公布2015/0173746；
-名称为“SURGICAL STAPLES AND STAPLE CARTRIDGES”的美国专利申请序列号14/138,475；现为美国专利申请公布2015/0173749；
-名称为“SURGICAL STAPLES AND METHODS FOR MAKING THE SAME”的美国专利申请序列号14/138,481；现为美国专利申请公布2015/0173750；
-名称为“SURGICAL STAPLES,STAPLE CARTRIDGES AND SURGICAL ENDEFFECTORS”的美国专利申请序列号14/138,489；现为美国专利申请公布2015/0173751；
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/477,488；
-名称为“FASTENER CARTRIDGE COMPRISING AN EXTENDABLE FIRING MEMBER”的美国专利申请序列号14/138,505；现为美国专利申请公布2015/0173760；
-名称为“FASTENER CARTRIDGE COMPRISING A FIRING MEMBER CONFIGURED TODIRECTLY ENGAGE AND EJECT FASTENERS FROM THE FASTENER CARTRIDGE”的美国专利申请序列号14/138,518；现为美国专利申请公布2015/0173761；
-名称为“FASTENER CARTRIDGE COMPRISING A FIRING MEMBER INCLUDINGFASTENER TRANSFER SURFACES”的美国专利申请序列号14/138,530；现为美国专利申请公布2015/0173762；
-名称为“MODULAR SURGICAL INSTRUMENTS”的美国专利申请序列号14/138,507；现为美国专利申请公布2015/0173747；
-名称为“SURGICAL CUTTING AND STAPLING INSTRUMENTS WITH ArticulatableEND EFFECTORS”的美国专利申请序列号14/138,497；现为美国专利申请公布2015/0173755；以及
-名称为“SURGICAL CUTTING AND STAPLING METHODS”的美国专利申请序列号14/138,516；现为美国专利申请公布2015/0173756。
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”(以及“包括”的任何形式，诸如“包含”)、“具有”(以及“具有”的任何形式，诸如“带有”)、“包含”(以及“包含”的任何形式，诸如“包括”)、以及“含有”(以及“含有”的任何形式，诸如“包含”)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手术操作。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手术和应用中，包括例如与开放式外科手术结合。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。该钉仓能够插入到第一钳口中并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被部署到组织中。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。钉腔和钉的其它布置结构也是可以的。
钉由仓体中的钉驱动装置支撑。驱动装置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。驱动装置通过保持器保留在仓体中，该保持器围绕仓体的底部延伸并包括被构造成能够抓持仓体以及将该保持器保持至仓体的弹性构件。驱动装置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装置下方滑动以及提升驱动装置，并且钉在驱动装置上受到支撑。
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向远侧端部推动滑动件。在一个或多个另选实施方案中，滑动件连接到击发构件。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。设想了其它实施方案，其中击发构件仅具有一个凸轮构件或不具有凸轮构件。此类实施方案可包括用于将第一钳口和第二钳口保持在适当的位置的其它合适的装置。在任何情况下，击发构件还包括被构造成能够切入捕集在钉仓和砧座中间的组织的刀。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。
在图1中示出了外科缝合系统的端部执行器100。端部执行器100包括框架190、仓钳口110和砧座120。仓钳口110从框架190固定地延伸。砧座120能够相对于仓钳口110在打开或未夹紧位置和闭合或夹紧位置(图1)之间移动。在另选的实施方案中，仓钳口110能够相对于砧座120在打开或未夹紧位置和闭合或夹紧位置之间移动。在至少一个此类实施方案中，砧座120从框架190固定地延伸。
仓钳口110被构造成能够接收钉仓，诸如例如钉仓130。参见图2，钉仓130包括仓体132。仓体132包括被构造成能够支撑患者的组织的平台133、纵向狭槽135以及限定于其中的六个纵向排钉腔134。纵向狭槽135被构造成能够接收击发构件，诸如例如击发构件270(图12)。每个钉腔134被构造成能够接收钉140(图3)并且将钉140可移除地储存在其中。钉仓130还包括诸如钉驱动装置180(图3A)的钉驱动装置，该钉驱动装置例如被构造成能够将钉140驱动离开钉腔134。参见图3和图3A，每个钉驱动装置180包括支架182，该支架182被构造成能够支撑和/或接合钉140的基部或冠部142。设想了其它钉驱动装置，其中驱动装置包括例如用于支撑和接合多于一个钉的两个支架、三个支架或四个支架。
除上述之外，钉仓130还包括被构造成能够接合钉驱动装置180的滑动件。更具体地，滑动件包括一个或多个斜坡，一个或多个斜坡被构造成能够在滑动件朝远侧移动通过钉仓130时接合限定于钉驱动装置180上的诸如例如凸轮185的一个或多个凸轮并且提升钉驱动装置180和钉腔134内的钉140。击发构件270被构造成能够在钉击发行程期间将滑动件从近侧、未击发位置朝向远侧、击发位置向远侧移动。在至少一种情况下，当钉140处于它们的未击发位置时，每个钉140完全定位在仓体132的平台133的下方。在此类情况下，当钉140处于它们的未击发位置时，钉140的钉腿144未延伸到平台133的上方。在使用时，当钉140被击发时，钉腿144的尖端146出现在平台133的上方。此类布置可降低钉140在钉仓130相对于组织移动时钩在患者的组织上的可能性。
在各种其它情况下，除上述之外，当钉140处于它们的未击发位置时，钉腿144的尖端146延伸到平台133的上方。主要参见图2，仓体132还包括在平台133的上方延伸的突出部136，该突出部136被构造成能够在钉140处于它们的未击发位置时至少部分地围绕尖端146。钉腿144的长度可被选定成使得尖端146在钉140处于它们的未击发位置时定位在突出部136的顶表面的下方。突出部136还被构造成能够在钉140从钉腔134射出时引导钉腿144。在某些方面，突出部136使钉腔134在平台133的上方延伸。此类布置可允许使用较大或较高的钉，并且同时提供对钉的保护，即使钉延伸到平台133的上方。
除上述之外，钉140由线材制成。线材具有圆形的或至少基本上圆形的横截面；然而，可使用任何合适的横截面。例如，可使用正方形的横截面和/或具有至少一个平整的侧面的横截面。线材由诸如例如钛和/或不锈钢的金属制成。即便如此，线材可由诸如例如塑料的任何合适的材料制成。
每个钉140均由弯曲线材制成，该弯曲线材已被形成为包括钉140的冠部142和钉腿144。如下文更详细地描述的，砧座120被构造成能够使钉140在未击发构型(图3)和击发构型之间变形。如图3所示，当钉140处于它的未击发构型时，钉140的腿部144彼此不平行。在此类情况下，当钉140处于它们的未击发构型时，钉140包括基本V形的构型。在某些实施方案中，可使用在钉处于它们的未击发构型时具有平行的或至少基本上平行的腿部的钉。在此类情况下，当钉处于它们的未击发构型时，钉包括基本U形的构型。
再次参见图2，钉仓130还包括附接到仓体132的保持器160。保持器160至少部分地围绕仓132的底部延伸并且被构造成能够防止钉140、钉驱动装置180和/或滑动件从仓体132的底部掉出。保持器160被构造成能够以扣合的方式接合仓体132；然而，保持器160可以任何合适的方式附接到仓体132。此外，保持器160被构造成能够以扣合的方式接合仓钳口110，以将钉仓130可释放地保持在仓钳口110中。即便如此，钉仓130可以任何合适的方式可释放地保持到仓钳口110。
除上述之外，端部执行器100还被构造成能够与除了钉仓130之外的钉仓(诸如例如钉仓230(图4))一起使用。换句话说，钉仓230例如可代替钉仓130与端部执行器100一起使用。在某些情况下，端部执行器100可与钉仓130一起使用，并且在钉仓130已至少部分地击发之后，钉仓130可从第一钳口110移除，并且然后用未击发的钉仓230替换。在各种情况下，外科医生可以任何合适的顺序选择性地且可互换地使用一个或多个钉仓130和一个或多个钉仓230。
参见图4，钉仓230包括仓体232和附接到仓体232的保持器260。保持器260在许多方面与保持器160类似。保持器260被构造成能够以扣合的方式接合仓体232；然而，保持器260可以任何合适的方式附接到仓体232。此外，保持器260被构造成能够以扣合的方式接合仓钳口110，以将钉仓230可释放地保持在仓钳口110中。即便如此，钉仓230可以任何合适的方式可释放地保持到仓钳口110。
仓体232包括被构造成能够支撑患者的组织的平台233、纵向狭槽135以及限定于其中的纵向排钉腔。平台233包括纵向狭槽135的第一侧上的第一部分和纵向狭槽135的第二侧上的第二部分。平台233的第一部分和第二部分各自包括第一或内纵向排钉腔、第二或中间纵向排钉腔以及第三或外纵向排钉腔。平台233的第一部分包含包括钉腔234a的第一纵向排、包括钉腔234a的第二纵向排和包括钉腔234a’的第三纵向排。平台233的第二部分包含包括钉腔234a’的第一纵向排、包括钉腔234a’的第二纵向排和包括钉腔234的第三纵向排。
除上述之外，钉腔234a和钉腔234a’在许多方面类似，不同的是它们是彼此的镜像。钉腔234a可称为“左转”钉腔并且钉腔234a’可称为“右转”钉腔。当然，左和右是透视图方面的问题，并且可以使用不同或甚至相反的命名。此外，可使用左转钉腔234a和右转钉腔234a’的任何合适的布置。
参见图4、图5和图14，钉240可移除地储存在每个钉腔234a中。参见图13，钉240’可移除地储存在每个钉腔234a’中。钉240a和钉240a’在许多方面类似，不同的是它们是彼此的镜像。为符合上文使用的命名，钉240是“左转”钉并且钉240’是“右转”钉。
再次参见图4，平台233的第二部分是平台233的第一部分的镜像。这种布置产生相对于组织切割线(即，由限定于击发构件270上的切割边缘272在击发构件270在击发行程期间朝远侧移动通过纵向狭槽135时形成的纵向切口)对称的钉线。在其它实施方案中，平台233的第二部分不是平台233的第一部分的镜像。此类布置在被缝合的组织中产生相对于切割线非对称的钉线。
主要参见图7至图10，钉240包括冠部242、连接到冠部242的近侧钉腿244p和连接到冠部242的远侧腿部244d。更具体地，钉240包括将近侧钉腿244p连接到冠部242的近侧连接器248p和将远侧钉腿244d连接到冠部242的远侧连接器248d。近侧连接器248p与近侧钉腿244p和冠部242一体成形，并且类似地，远侧连接器248d与远侧钉腿244d和冠部242一体成形。钉240还包括与冠部242一体成形且从冠部242延伸的驱动装置246。驱动装置246包括限定于其上的凸轮表面245，该凸轮表面245被构造成能够在钉击发行程期间由钉仓230的滑动件250直接接合，如图10所示。
如图7至图10可见，冠部242和驱动装置246共同限定高于近侧连接器248p和/或远侧连接器248d的高度。此外，冠部242和驱动装置246的共同高度限定大于钉腿244p和244d的任何横截面宽度的尺寸。
如图7至图10还可见，近侧腿部244p、近侧连接器248p、远侧腿部244d和远侧连接器244d未延伸到驱动装置246的下方。换句话说，驱动装置246包括钉240的底部。此外，整个凸轮表面245在近侧腿部244p、近侧连接器248p、远侧腿部244d和远侧连接器244d的下方。这种布置有助于确保滑动件250接触钉240的驱动装置246，而不接触钉240的另一部分。
除上述之外，再次参见图13，钉240’包括冠部242’、连接到冠部242’的近侧腿部244p’、连接到冠部242’的远侧腿部244d’以及与冠部242’一体成形并且从冠部242’延伸的驱动装置246’。驱动装置246’包括限定于其上的凸轮表面245’，该凸轮表面245’被构造成能够在钉击发行程期间由滑动件250直接接合。除非另行指出，否则本文相对于钉240所提供的教导内容可适应于钉240’。为了简明起见，可不在本文中具体地阐明针对这些改型的论述。
每个钉240由诸如例如钛和/或不锈钢的单一金属件制成。可使用诸如例如塑料的其它材料。在各种情况下，钉240由一个或多个材料片冲压。在至少一种情况下，将连续平整的金属原料条带馈送到行进模具中，该行进模具冲击或压模材料条带，并且使冠部242远离钉腿244p和244d移位或移位到钉腿244p和244d的平面外。另选地，钉腿244p和244d远离冠部242移位或者移位到冠部242的平面外。在各种情况下，行进模具还被构造成能够在钉240上(诸如例如在钉腿244p和244d上)形成一个或多个倒圆边缘。行进模具也被构造成能够在某些情况下精压钉腿244p和244d的尖端246，并且从材料条带移除任何多余的材料。这些成形步骤中的每一个都可发生在行进模具内的一个或多个工位处和/或在行进模具内的同样的一个或多个成形工位内-该成形步骤的布置例如将最终产生附接到连续的料带的钉240的条带。钉240从料带拆下，并且然后插入到钉腔234中。在某些情况中，钉240的条带被加载到加载块中，在该加载块处料带然后被从钉240移除。然后，加载块用于将钉240插入到仓体232的钉腔234a中。在至少一种情况下，加载块还被构造成能够接收钉240’，使得钉240和240’被同时加载到仓体232中。
除上述之外，主要参见图7，每个钉240的驱动装置246在限定于驱动装置246的远侧上的连接点249处附接到料带。这种布置降低了毛刺或附接件例如从驱动装置246向下延伸以及阻碍滑动件250的纵向行进的可能性。即便如此，可使用任何合适的附接点或点来将钉240保持到料带。除了或代替上文，线材燃烧或放电机加工(EDM)操作和/或任何其它合适的制造方法可用于形成钉240。此外，钉240’可利用本文所述的任何方法等进行制造。
参见图8和图9，钉240的近侧钉腿244p和远侧钉腿244d限定钉腿平面241s。当钉240定位在钉腔234a中，除上述之外，钉240的近侧钉腿244p相对于远侧钉腿244d定位在近侧。此外，钉240的近侧钉腿244p和远侧钉腿244d与击发轴线对齐。当钉240定位在纵向排钉腔234a中时，此击发轴线也与其它钉240的钉腿244p和244d对齐。因此，纵向排钉腔234a中的钉240的钉腿平面241s彼此对齐或至少基本上对齐。应了解，钉腿244p和244d包括宽度或厚度，并且钉腿平面241s可包括钉腿244p和/或244d的宽度。
除上述之外，参见图4和图6，储存在第一内纵向排钉腔中的左转钉240可移除地储存在其中，使得钉240的钉腿平面241s比它们的驱动平面241c更接近纵向狭槽135。对应地，继续参考图4和图6，储存在第二内纵向排钉腔中的右转钉240’也可移除地储存在其中，使得钉240’的钉腿平面241s比它们的驱动平面241c更接近纵向狭槽135。类似地，储存在第一中间纵向排钉腔中的左转钉240可移除地储存在其中，使得钉240的钉腿平面241s比它们的驱动平面241c更接近纵向狭槽135。同样，储存在第二中间纵向排钉腔中的右转钉240’可移除地储存在其中，使得钉240’的钉腿平面241s比它们的驱动平面241c更接近纵向狭槽135。在另一方面，再次参见图4和图6，储存在第一外纵向排钉腔中的右转钉240’可移除地储存在其中，使得钉240’的驱动平面241c比它们的钉腿平面241s更接近纵向狭槽135。同样，储存在第二外纵向排钉腔中的左转钉240也可移除地储存在其中，使得钉240的驱动平面241c比它们的钉腿平面241s更接近纵向狭槽135。
钉240的钉腿244p、244d包括钉240的组织握紧或夹紧部分，钉240的组织握紧或夹紧部分被构造成能够在钉240的钉腿244p、244d抵靠着砧座240变形时将患者的组织捕集在钉240内，如下文更详细地描述的。在各种情况下，近侧钉腿244p和远侧钉腿244d在钉腿平面241s内形成。然而，在其它情况下，钉腿244p和244d中的一者或两者可变形到钉腿平面241s外。
除上述之外，当钉240处于它的未击发构型时，钉240的近侧钉腿244p平行于或至少基本上平行于钉腿244d，如图7所示。因此，当钉240处于它的未击发构型时，钉240的钉腿244p、244d和冠部242形成基本U形的构型。相较于在其它构型中，在这种构型中，可更易于控制在钉240从钉腔234a射出时的钉腿244p和244d的向上移动。在各种另选的实施方案中，参见图14，钉240的近侧钉腿244p和远侧钉腿244d远离彼此向外延伸和/或在彼此不平行的方向上延伸。在至少一个此类情况下，当钉240处于它的未击发构型时，钉240的钉腿244p、244d和冠部242形成基本V形的构型。在这种构型中，钉240的钉腿244p和244d可与钉腔234a的侧壁接触并被该侧壁向内弹性偏压，该钉腔234a的侧壁可将钉240弹性地保持在钉腔234a中。
除上述之外，保持器260至少部分地围绕仓232的底部延伸并且被构造成能够防止钉240、钉240’和/或滑动件250从仓体232的底部掉出。
主要参见图10，钉240的驱动装置246包括钉240的驱动部分。滑动件250的纵向斜坡255被构造成能够顺序地接合钉240的驱动装置246并在钉240的驱动装置246的下方滑动，以在钉腔234a内朝向砧座120向上提升钉240。每个钉240的凸轮表面245限定于驱动装置246的近侧上并且包括滑动件250开始与钉240接触的点。每个钉240的驱动装置246限定在驱动平面241c内，该驱动平面241c与纵向斜坡255对齐或至少基本上对齐。凸轮表面245也限定在驱动平面241c内。应了解，凸轮表面245和/或驱动装置246包括宽度或厚度，并且驱动平面241c可包括凸轮表面245和/或驱动装置246的宽度。
再次参见图8和图9，连接器248p和248d分别将钉腿244p和244d与钉240的冠部242分离。如图8和图9所示，钉240的驱动平面241c从钉240的钉腿平面241s侧向偏移。还如图8和图9所示，钉240的驱动平面241c平行于或至少基本上平行于钉240的钉腿平面241s。在此类情况下，纵向排钉240的驱动平面241c沿纵向驱动轴线彼此对齐。纵向驱动轴线平行于且邻近已在上文论述的与钉腿平面241s对齐的纵向击发轴线。
再次参见图8至图10，纵向斜坡255不接合钉240的近侧连接器248p或远侧连接器。类似地，纵向斜坡255不接合钉240的钉腿244p和244d。此外，滑动件250中没有一个部分接合钉240的近侧连接器248p、近侧钉腿244p、远侧连接器248p和远侧钉腿244d。相反，当滑动件250在击发行程期间朝远侧移动时，纵向斜坡255直接接合钉240的凸轮表面245。当滑动件250朝远侧移动时，纵向斜坡255在未击发位置(图11)和击发位置(图12)之间在凸轮表面245的下方滑动，并且朝向砧座120顺序向上提升钉240。换句话说，钉240在钉腔234a内的纵向斜坡255之上朝向它们的击发位置(如图12所示)滑动。
除上述之外，主要参见图10，钉240的驱动表面245未延伸到近侧连接器248p中。驱动装置246包括凹口或离隙部247，该凹口或离隙部247将驱动表面245与近侧连接器248p分离。在各种情况下，凹口247限定于驱动平面241c中。在至少一种情况下，凹口247延伸到近侧连接器248p中。凹口247被构造成能够确保滑动件250接触钉240的驱动装置246(即，在钉240的驱动平面241c内)，而不接触近侧连接器248p和/或近侧腿部244p。凹口247还在驱动装置246和近侧连接器248p之间形成清晰的描绘，使得凸轮表面245不被扭曲到驱动平面241c外。此外，凹口247将驱动平面241c与包括近侧钉腿244p的垂直平面分离。
类似于上文，驱动表面245未延伸到远侧连接器248d中。
除上述之外，钉240的驱动表面245以与滑动件250的纵向斜坡255的角度匹配或至少基本上匹配的角度延伸。即便如此，可使用任何合适的角度。
在至少一种情况下，除上述之外，当钉240处于它们的未击发位置时，每个钉240完全定位在仓体232的平台233的下方。在此类情况下，当钉240处于它们的未击发位置时，钉240的钉腿244未延伸到平台233的上方。在使用时，当钉240被击发时，钉腿244的尖端246出现在平台233的上方。此类布置可降低钉240在钉仓230相对于组织移动时钩在患者的组织上的可能性。
在各种情况下，除上述之外，当钉240处于它们的未击发位置时，钉腿244p和/或244d的尖端246延伸到平台233的上方。主要参见图4和图6，仓体232还包括在平台233的上方延伸的突出部236，该突出部236被构造成能够在钉240处于它们的未击发位置时至少部分地围绕尖端246。钉腿244p和/或244d的长度可被选定成使得尖端246在钉240处于它们的未击发位置时定位在突出部236的顶表面的下方。在某些方面，突出部236使钉腔234在平台233的上方延伸。此类布置可允许使用较大或较高的钉，并且同时提供对钉的保护，即使钉延伸到平台233的上方。突出部236还被构造成能够在钉240从钉腔234射出时引导钉腿244。
除上述之外，当纵向斜坡255的顶表面253在钉240的底表面的下方穿过时，钉240达到它们的完全击发构型。现转到图12，钉240已几乎到达纵向斜坡255的顶表面253，并因此已几乎达到它的完全击发构型。当顶表面253相对于变形钉240朝远侧移动并且与变形钉240脱离接合时，储存在变形钉240内的弹性反应力和/或势能可将变形钉240的一部分推回到它被射出的钉腔234a中。
再次参见图11和图12，砧座120包括被构造成能够使钉240和240’变形的成形凹坑。每个成形凹坑包括例如被构造成能够接收钉240的近侧钉腿244p的近侧成形杯124p和被构造成能够接收钉240的远侧钉腿244d的远侧成形杯124d。近侧成形杯124p被构造成能够使近侧钉腿244p朝向远侧钉腿244d向内变形。类似地，远侧成形杯124d被构造成能够使远侧钉腿244d朝向近侧钉腿244p向内变形。设想了其它实施方案，其中钉腿244p和244d中的一者或两者远离彼此向外弯曲和/或在任何其它合适的方向上弯曲。再次参见图12，钉240和240’通过砧座120变形成B形的构型；然而，砧座120可被构造成能够使钉240和240’变形成任何合适的构型。
如上所述，端部执行器100可与钉仓100一起使用或在另选方案中可与钉仓200一起使用。因此，砧座120被构造成能够使钉仓100的钉140变形，并且另外使钉仓200的钉240、240’变形。换句话说，例如，限定于砧座120中的每个成形凹坑被构造成能够使已由弯曲线材制成的钉140变形，并且使已由平整的材料片冲压成的钉240或钉240’变形。例如，主要参见图6，成形凹坑的近侧成形杯124p被构造成能够使钉140的近侧钉腿144和钉240的近侧钉腿244p变形。成形凹坑的近侧成形杯124p还被构造成能够在钉240’代替钉240与成形凹坑对齐时使近侧钉腿244p’变形。类似于上文，成形凹坑的远侧成形杯124d被构造成能够使钉140的远侧钉腿144和钉240的远侧钉腿244d变形。同样，成形凹坑的远侧成形杯124d还被构造成能够在钉240’代替钉240与成形凹坑对齐时使远侧钉腿244d’变形。
除上述之外，钉仓130的钉腔134和钉仓230的钉腔234a能够与砧座120的成形凹坑对齐，使得钉140的尖端146和钉240的尖端246冲击成形杯124p和124d内的相同的点或目标-这取决于哪一个钉仓被附接到端部执行器100。应理解，由于组织成分的变化，例如，尖端146和尖端246可实际上不冲击成形杯124p和124d中的相同的目标。即便如此，砧座120的成形腔被构造成能够将钉140的腿部144和钉240的腿部244p、244d引导成期望的对齐。为此，近侧成形杯124p包括导向壁126p，并且远侧成形杯124d包括导向壁126d，这些导向壁126p和126d被构造成能够将钉140、240和240’的腿部引导并形成为期望的构型。
再次参见图7，钉240包括限定于冠部242的顶表面上的组织接合表面243。钉240的表面243被构造成能够在钉240被形成为它的击发构型时支撑捕集在钉240内的组织和/或向该组织施加压力。现参见图11，当钉240处于它的未击发位置时，钉240的表面243被定位成远低于仓体232的平台233。现转到图12，当钉240移动到它的击发位置时，表面243至少部分地出现在平台233的上方。换句话说，滑动件250至少部分地过度驱动钉240。在这种情况下，当钉240正在变形时，钉240的表面243可邻接组织并向组织施加压力。在某些情况下，当钉240处于它的完全击发位置时，只有一部分的表面243被过度驱动到平台233的上方。在其它情况下，当钉240处于它的完全击发位置时，整个表面243被过度驱动到平台233的上方。这种布置可向组织施加显著量的夹紧压力，该夹紧压力可减少由此产生的出血。
在各种情况下，除上述之外，当钉240的表面243被过度驱动到平台233的上方时，钉240的驱动装置246至少部分地保持在平台233的下方。在某些情况下，无论表面243被过度驱动到平台233的上方的量如何，钉240被构造成能够使得驱动装置246不出现在平台233的上方。在此类情况下，在钉击发过程期间，整个驱动装置246保持在平台233的下方。在至少一种情况下，当钉240被过度驱动时，钉240的凸轮表面245不出现在平台233的上方。在各种情况下，在钉击发过程期间，纵向斜坡255的顶表面253不延伸到平台233的上方，这意味着滑动件250将不会将整个钉240驱动到平台233的上方。
应了解，除上述之外，突出部236延伸在平台233的上方。如图12所示，滑动件250被构造成能够将钉240的表面243至少部分地过度驱动到突出部236的上方。在此类情况下，当钉240移动到它的完全击发位置时，表面243至少部分地上升到突出部236的上方。在某些情况下，当钉240处于它的完全击发位置时，只有一部分的表面243被过度驱动到突出部246的上方。在其它情况下，当钉240处于它的完全击发位置时，整个表面243被过度驱动到突出部246的上方。这种布置可向组织施加显著量的夹紧压力，该夹紧压力可减少由此产生的出血。
除上述之外，组织接合表面243可直接接合或接触组织。在其它情况下，诸如支撑物材料片和/或组织厚度补偿件的辅助材料例如可定位在钉仓230的平台233上，并且组织接合表面243可直接接合或接触辅助材料。公开辅助材料的参考文献以引用方式并入本申请中的其它地方。
再次参见图7，组织接合表面243包括平整部分、平整部分的第一侧上的第一倾斜部分以及平整部分的第二侧上的第二倾斜部分。这种布置可从三个方向向捕集在钉240内的组织施加压力。即便如此，组织接合表面243可包括任何合适的构型，诸如例如完全平整的构型或圆形的构型。
如上所述，再次参见图6，钉仓130和230能够可选择地且可互换地与端部执行器100一起使用。还如上所述，钉仓130和230能够可移除地附接到钳口110。在各种另选的实施方案中，钉仓130和230各自包括完整的钳口，该钳口能够附接到端部执行器110的框架190并且能够从该框架拆下。在这类情况下，临床医生可以从端部执行器110移除整个钉仓钳口并用另一个整个钉仓钳口-例如尚未击发且包括临床医生期望的钉的类型和/或钉的模式的整个钉仓钳口-替换它。
除上述之外，应了解，图6是旨在展示端部执行器100能够与钉仓130和钉仓230一起使用的图解。尽管图6中示出钉仓130和钉仓230，但是应理解，钉仓130和钉仓230不会同时在同一端部执行器100内使用。即便如此，设想了各种实施方案，例如，其中钉仓利用线材钉，并且另外利用由一个或多个材料片形成的钉。在至少一个实施方案中，例如，钉仓包括可移除地储存在其中的钉140和钉240。设想了其它实施方案，例如其中钉仓包括钉140、钉240和钉240’。
参见图20，除上述之外，钉仓430包括仓体432，仓体432包括平台433和限定于其中的纵向狭槽135。纵向狭槽135限定了延伸通过它的中心的纵向狭槽轴线139。钉仓430还包括纵向狭槽135的一侧上的第一或内纵向排钉腔434a、第二或中间纵向排钉腔434b和第三或外纵向排钉腔434c。钉仓430还包括纵向狭槽135的另一侧上的第一或内纵向排钉腔434a’、第二或中间纵向排钉腔434b’和第三或外纵向排钉腔434c’。钉腔434a、434a’、434b和434b’在许多方面类似于左转钉腔234a(图4和图6)。钉腔434c和434c’在许多方面类似于钉腔134(图2和图6)。钉240可移除地储存在钉腔434a、434a’、434b和434b’中。钉140可移除地储存在钉腔434c和434c’中。
参见图21，钉仓430还包括被构造成能够从仓体432射出钉140和240的滑动件450。滑动件450包括被构造成能够直接接合储存在钉腔434a中的钉240的纵向斜坡455a、被构造成能够直接接合储存在钉腔434a’中的钉240的纵向斜坡455a’、被构造成能够直接接合储存在钉腔434b中的钉240的纵向斜坡455b以及被构造成能够直接接合储存在钉腔434b'中的钉240的纵向斜坡455b’。滑动件450还包括被构造成能够从钉腔434c射出钉140的纵向斜坡455c和被构造成能够从钉腔434c’射出钉140的纵向斜坡455c’。更具体地，钉仓430包括被构造成能够支撑和/或接合储存在钉腔434c中的钉140的一排钉驱动装置以及被构造成能够支撑和/或接合储存在钉腔434c’中的钉140的一排钉驱动装置，并且当滑动件450朝远侧推进时，滑动件450的纵向斜坡455c和455c’接合钉驱动装置以在钉腔434c和434c’内向上提升钉140，从而抵靠着定位在钉仓430对面的砧座使钉140变形。例如，这些钉驱动装置可在许多方面类似于图3A所示的钉驱动装置。
除上述之外，钉腔434a沿着纵向轴线437a定位，钉腔434b沿着纵向轴线437b定位，并且钉腔434c沿着纵向轴线437c定位。类似地，钉腔434a’沿着纵向轴线437a’定位，钉腔434b’沿着纵向轴线437b’定位，并且钉腔434c’沿着纵向轴线437c’定位。纵向轴线437a和纵向狭槽轴线139之间的距离短于纵向轴线437a’和纵向狭槽轴线139之间的距离。因此，与纵向轴线437a相比，纵向轴线437a’是侧向错开或偏移的。类似地，纵向排钉腔434a和纵向狭槽135之间的距离短于纵向排钉腔434a’和纵向狭槽135之间的距离。此外，纵向轴线437b和纵向狭槽轴线139之间的距离短于纵向轴线437b’和纵向狭槽轴线139之间的距离。因此，与纵向轴线437b相比，纵向轴线437b’是侧向错开或偏移的。类似地，纵向排钉腔434b和纵向狭槽135之间的距离短于纵向排钉腔434b’和纵向狭槽135之间的距离。相对地，纵向轴线437c和纵向轴线437c’距纵向狭槽轴线139是等距的。对应地，纵向排钉腔343c和纵向排钉腔343c’距纵向狭槽135是等距的。
限定在钉仓430中的纵向排钉腔不是均匀间隔开的。在许多方面中，纵向排之间的间距是不同的。如图20可见，纵向狭槽135的一侧上的纵向排钉腔434a、434b和434c的间距不同于纵向狭槽135的另一侧上的纵向排钉腔434a’、434b’和434c’的间距。
除上述之外，纵向轴线437a、437a’、437b、437b’、437c和437c’包括驱动轴线。这些驱动轴线与钉240的驱动部分和支撑钉140的钉驱动装置的凸轮表面对齐，这视情况而定。滑动件450的纵向斜坡与这些驱动轴线对齐。例如，参见图20和图21，滑动件450的纵向斜坡455a与纵向轴线437a对齐。类似地，纵向斜坡455b与纵向轴线437b对齐，并且纵向斜坡455c与纵向轴线437c对齐。另外，纵向斜坡455a’与纵向轴线437a’对齐，纵向斜坡455b’与纵向轴线437b’对齐，并且纵向斜坡455c’与纵向轴线437c’对齐。为此，纵向斜坡455a和纵向轴线437a距纵向狭槽轴线139的距离为457a，纵向斜坡455b和纵向轴线437b距纵向狭槽轴线139的距离为457b，并且纵向斜坡455c和纵向轴线437c距纵向狭槽轴线139的距离为457c。类似地，纵向斜坡455a’和纵向轴线437a’距纵向狭槽轴线139的距离为457a’，纵向斜坡455b’和纵向轴线437b’距纵向狭槽轴线139的距离为457b’，并且纵向斜坡455c’和纵向轴线437c’距纵向狭槽轴线139的距离为457c’。
如图21所示，距离457a、457a’、457b和457b’均不相等。它们都是不同的。因此，滑动件450的导轨非对称地间隔开。
参见图21，滑动件450包括被构造成能够在仓体432的纵向狭槽135内移动的中心部分451。中心部分451的尺寸和构造被设置成紧密地接收在狭槽135内，使得在滑动件450和仓体432之间允许很小的(如果有的话)侧向移动，从而使得滑动件450的纵向斜坡与钉240和被构造成能够驱动钉140的钉驱动装置保持正确的对齐。
再次参见图20，由钉仓430部署的外排钉是线材钉，而由钉仓430部署的内排钉和中间排钉是由平整的原料形成的和/或冲压成的。即便如此，设想了其它布置。在至少一种情况下，例如，由钉仓部署的中间排钉和外排钉是线材钉，而由钉仓部署的内排钉是冲压钉。在其它情况下，例如，由钉仓部署的内排钉和中间排钉是线材钉，而由钉仓部署的外排钉是冲压钉。当钉仓在纵向狭槽的一侧上部署两排或更多排的线材钉时，两排或更多排的钉驱动装置可用于从钉仓部署钉。在各种情况下，钉仓可利用双驱动装置，双驱动装置例如被构造成能够在包括线材钉的纵向排彼此邻近时同时从两个纵向排部署线材钉。可利用被构造成能够部署多于两个钉(诸如例如三个钉和/或四个钉)的其它驱动装置布置。
作为上文的结果，钉仓430在组织中产生非对称图案的钉。除其它之外，钉仓430在切割线的第一侧上的组织中产生第一图案的钉，并且在切割线的第二侧上的组织中产生第二或不同的图案的钉。
现转到图15至图19，钉仓330包括仓体332，该仓体332包括平台333和限定于其中的纵向狭槽135。纵向狭槽135限定了延伸通过它的中心的纵向狭槽轴线139。钉仓330还包括纵向狭槽135的一侧上的第一或内纵向排钉腔334a、第二或中间纵向排钉腔334b和第三或外纵向排钉腔334c。钉仓330还包括纵向狭槽135的另一侧上的第一或内纵向排钉腔334a’、第二或中间纵向排钉腔334b’和第三或外纵向排钉腔334c’。钉腔334a、334a’、334b、334b’、334c和334c’在许多方面类似于左转钉腔234a(图4和图6)。钉240可移除地储存在钉腔334a、334a’、334b、334b’、334c和334c’中。
参见图16和图17，钉仓330还包括被构造成能够从仓体332射出钉240的滑动件350。滑动件350包括被构造成能够直接接合储存在钉腔334a中的钉240的纵向斜坡355a、被构造成能够直接接合储存在钉腔334a’中的钉240的纵向斜坡355a’、被构造成能够直接接合储存在钉腔334b中的钉240的纵向斜坡355b以及被构造成能够直接接合储存在钉腔334b'中的钉240的纵向斜坡355b’。滑动件350还包括被构造成能够直接接合储存在钉腔334c中的钉240的纵向斜坡355c和被构造成能够直接接合储存在钉腔334c’中的钉240的纵向斜坡355c’。
除上述之外，钉腔334a沿着纵向轴线337a定位，钉腔334b沿着纵向轴线337b定位，并且钉腔334c沿着纵向轴线337c定位。类似地，钉腔334a’沿着纵向轴线337a’定位，钉腔334b’沿着纵向轴线337b’定位，并且钉腔334c’沿着纵向轴线337c’定位。纵向轴线337a和纵向狭槽轴线139之间的距离短于纵向轴线337a’和纵向狭槽轴线139之间的距离。因此，与纵向轴线337a相比，纵向轴线337a’是侧向错开或偏移的。类似地，纵向排钉腔334a和纵向狭槽135之间的距离短于纵向排钉腔334a’和纵向狭槽135之间的距离。
此外，纵向轴线337b和纵向狭槽轴线139之间的距离短于纵向轴线337b’和纵向狭槽轴线139之间的距离。因此，与纵向轴线337b相比，纵向轴线337b’是侧向错开或偏移的。类似地，纵向排钉腔334b和纵向狭槽135之间的距离短于纵向排钉腔334b’和纵向狭槽135之间的距离。此外，纵向轴线337c和纵向狭槽轴线139之间的距离短于纵向轴线337c’和纵向狭槽轴线139之间的距离。因此，与纵向轴线337c相比，纵向轴线337c’是侧向错开或偏移的。类似地，纵向排钉腔334c和纵向狭槽135之间的距离短于纵向排钉腔334c’和纵向狭槽135之间的距离。
除上述之外，纵向轴线337a、337a’、337b、337b’、337c和337c’包括驱动轴线。这些驱动轴线与钉240的驱动部分对齐。滑动件350的纵向斜坡与这些驱动轴线对齐。例如，滑动件350的纵向斜坡355a与纵向轴线337a对齐。类似地，纵向斜坡355b与纵向轴线337b对齐，并且纵向斜坡355c与纵向轴线337c对齐。另外，纵向斜坡355a’与纵向轴线337a’对齐，纵向斜坡355b’与纵向轴线337b’对齐，并且纵向斜坡355c’与纵向轴线337c’对齐。为此，纵向斜坡355a和纵向轴线337a距纵向狭槽轴线139的距离为357a，纵向斜坡355b和纵向轴线337b距纵向狭槽轴线139的距离为357b，并且纵向斜坡355c和纵向轴线337c距纵向狭槽轴线139的距离为357c。类似地，纵向斜坡355a’和纵向轴线337a’距纵向狭槽轴线139的距离为357a’，纵向斜坡355b’和纵向轴线337b’距纵向狭槽轴线139的距离为357b’，并且纵向斜坡355c’和纵向轴线337c’距纵向狭槽轴线139的距离为357c’。
主要参见图17，滑动件350包括被构造成能够在仓体332的纵向狭槽135内移动的中心部分351。中心部分351的尺寸和构造被设置成紧密地接收在狭槽135内，使得在滑动件350和仓体332之间允许很小的(如果有的话)侧向移动，从而使得滑动件350的纵向斜坡与钉240保持正确的对齐。
再次参见图17，间隙359a限定在滑动件350的中心部分351和纵向斜坡355a之间。类似地，间隙359b限定在纵向斜坡355a和纵向斜坡355b之间，并且间隙359c限定在纵向斜坡355b和纵向斜坡355c之间。间隙359a小于间隙359b，并且类似地，间隙359b小于间隙359c。同样，间隙359a’限定在滑动件350的中心部分351和纵向斜坡355a’之间。类似地，间隙359b’限定在纵向斜坡355a’和纵向斜坡355b’之间，并且间隙359c’限定在纵向斜坡355b’和纵向斜坡355c’之间。间隙359a’小于间隙359b’，并且类似地，间隙359b’小于间隙359c’。其它布置是可能的。
图18是仓体332的剖视图，该剖视图示出了限定于其中的纵向通道，该纵向通道连接钉腔排中的钉腔并允许滑动件350的纵向斜坡穿过仓体332。例如，通道338a纵向地连接钉腔334a并且被构造成能够接收滑动件350的纵向斜坡355a。类似地，通道338b纵向地连接钉腔334b并且被构造成能够接收滑动件350的纵向斜坡355b，并且此外，通道338c纵向地连接钉腔334c并且被构造成能够接收滑动件350的纵向斜坡355c。另外，通道338a’纵向地连接钉腔334a’并且被构造成能够接收滑动件350的纵向斜坡355a’，通道338b’纵向地连接钉腔334b’并且被构造成能够接收滑动件350的纵向斜坡355b’，并且通道338c’纵向地连接钉腔334c’并且被构造成能够接收滑动件350的纵向斜坡355c’。
现转到图19，砧座320被构造成能够与钉仓330一起使用。砧座320包括成形凹坑324，该成形凹坑324被构造成能够在钉240从钉仓330射出时使可移除地储存在钉仓330中的钉240变形。成形凹坑324被布置成六个纵向排，这些纵向排可与限定于钉仓330中的六个纵向排钉腔对齐。例如，纵向排成形凹坑324沿着纵向砧座轴线327a进行限定，该纵向砧座轴线327a能够与储存在纵向排钉腔334a中的钉240的钉腿平面对齐。类似地，纵向排成形凹坑324沿着纵向砧座轴线327b进行限定，该纵向砧座轴线327b能够与储存在纵向排钉腔334b中的钉240的钉腿平面对齐，并且此外，纵向排成形凹坑324沿着纵向砧座轴线327c进行限定，该纵向砧座轴线327c能够与储存在纵向排钉腔334c中的钉240的钉腿平面对齐。此外，纵向排成形凹坑324沿着纵向砧座轴线327a’进行限定，该纵向砧座轴线327a’能够与储存在纵向排钉腔334a’中的钉240的钉腿平面对齐，纵向排成形凹坑324沿着纵向砧座轴线327b’进行限定，该纵向砧座轴线327b’能够与储存在纵向排钉腔334b’中的钉240的钉腿平面对齐，并且纵向排成形凹坑324沿着纵向砧座轴线327c’进行限定，该纵向砧座轴线327c’能够与储存在纵向排钉腔334c’中的钉240的钉腿平面对齐。
实施例
实施例1-一种外科缝合系统，包括：轴，该轴包括近侧端部和远侧端部；以及端部执行器，该端部执行器从该轴的该远侧端部延伸，其中该端部执行器能够在打开构型和闭合构型之间移动。该端部执行器包括：框架；砧座，该砧座从该框架朝远侧延伸，其中该砧座包括纵向排成形凹坑；以及第一钉仓组件，该第一钉仓组件能够附接到该端部执行器。该第一钉仓组件包括第一仓体，该第一仓体包括第一纵向排钉腔，并且此外包括可移除地储存在该第一纵向排钉腔中的多个第一钉。每个第一钉均由弯曲线材制成并且在该端部执行器处于该闭合构型时与成形凹坑对齐。该外科缝合系统还包括能够附接到该端部执行器的第二钉仓组件，以代替该第一钉仓组件。该第二钉仓组件包括第二仓体，该第二仓体包括第二纵向排钉腔，并且此外包括可移除地储存在该第二纵向排钉腔中的多个第二钉。每个第二钉均由平整的原料形成并且在该端部执行器处于该闭合构型时与成形凹坑对齐。
实施例2-根据实施例1所述的外科缝合系统，其中每个成形凹坑包括近侧成形杯和远侧成形杯。
实施例3-根据实施例1和2所述的外科缝合系统，其中每个第一钉包括由该近侧成形杯形成的近侧腿部和由该远侧成形杯形成的远侧腿部。
实施例4-根据实施例1、2和3所述的外科缝合系统，其中每个第二钉包括由该近侧成形杯形成的近侧腿部和由该远侧成形杯形成的远侧腿部。
实施例5-根据实施例1、2、3和4所述的外科缝合系统，其中该端部执行器还包括钳口，该钳口被构造成能够接收该第一钉仓组件以及接收该第二钉仓组件以代替该第一钉仓组件。
实施例6-根据实施例5所述的外科缝合系统，其中该钳口能够相对于该砧座旋转以使该端部执行器处于该闭合构型中。
实施例7-根据实施例5和6所述的外科缝合系统，其中该砧座能够相对于该钳口旋转以使该端部执行器处于该闭合构型中。
实施例8-根据实施例1所述的外科缝合系统，其中该第一钉仓组件包括能够附接到该框架的第一钳口，并且其中第二钉仓组件包括能够附接到该框架的第二钳口。
实施例9-根据实施例8所述的外科缝合系统，其中该砧座能够相对于该框架旋转以使该端部执行器处于该闭合构型中。
实施例10-根据实施例8和9所述的外科缝合系统，其中当该第一钳口附接到该框架时，该第一钳口能够相对于该框架旋转以使该端部执行器处于该闭合构型中，并且其中当该第二钳口附接到该框架时，该第二钳口能够相对于该框架旋转以使该端部执行器处于该闭合构型中。
实施例11-根据实施例1、2、3、4、5、6、7、8、9和10所述的外科缝合系统，其中该第一钉仓组件包括钉驱动装置，该钉驱动装置被构造成能够将该第一钉推出该第一钉腔，并且其中每个第二钉包括一体成形的钉驱动装置。
实施例12-一种外科缝合系统，包括：轴，该轴包括近侧端部和远侧端部；以及端部执行器，该端部执行器从该轴的该远侧端部延伸，其中该端部执行器能够在未夹紧构型和夹紧构型之间移动。该端部执行器包括：框架；砧座，该砧座从该框架朝远侧延伸，其中该砧座包括纵向排成形凹坑；以及第一钉仓组件，该第一钉仓组件能够附接到该端部执行器。该第一钉仓组件包括第一仓体，该第一仓体包括第一纵向排钉腔，并且此外包括可移除地储存在该第一纵向排钉腔中的多个第一钉。每个第一钉均由弯曲线材制成并且在该端部执行器处于该夹紧构型时与成形凹坑对齐。该外科缝合系统还包括能够附接到该端部执行器的第二钉仓组件，以作为该第一钉仓组件的替代方案。该第二钉仓组件包括第二仓体，该第二仓体包括第二纵向排钉腔，并且此外包括可移除地储存在该第二纵向排钉腔中的多个第二钉。该第二钉由一个或多个平整的材料片冲压成并且在该端部执行器处于该夹紧构型时与这些成形凹坑对齐。
实施例13-根据实施例12所述的外科缝合系统，其中每个成形凹坑包括近侧成形杯和远侧成形杯。
实施例14-根据实施例12和13所述的外科缝合系统，其中每个第一钉包括由该近侧成形杯形成的近侧腿部和由该远侧成形杯形成的远侧腿部。
实施例15-根据实施例12、13和14所述的外科缝合系统，其中每个第二钉包括由该近侧成形杯形成的近侧腿部和由该远侧成形杯形成的远侧腿部。
实施例16-根据实施例12、13、14和15所述的外科缝合系统，其中该端部执行器还包括钳口，该钳口被构造成能够接收该第一钉仓组件以及接收该第二钉仓组件以作为该第一钉仓组件的替代方案。
实施例17-根据实施例16所述的外科缝合系统，其中该钳口能够相对于该砧座旋转以使该端部执行器处于该夹紧构型中。
实施例18-根据实施例16和17所述的外科缝合系统，其中该砧座能够相对于该钳口旋转以使该端部执行器处于该夹紧构型中。
实施例19-根据实施例12所述的外科缝合系统，其中该第一钉仓组件包括可附接至框架的第一钳口，并且其中第二仓组件包括可附接至框架的第二钳口。
实施例20-根据实施例19所述的外科缝合系统，其中该砧座能够相对于该框架旋转以使该端部执行器处于该夹紧构型中。
实施例21-根据实施例19和20所述的外科缝合系统，其中当该第一钳口附接到该框架时，该第一钳口能够相对于该框架旋转以使该端部执行器处于该夹紧构型中，并且其中当该第二钳口附接到该框架时，该第二钳口能够相对于该框架旋转以使该端部执行器处于该夹紧构型中。
实施例22-根据实施例12、13、14、15、16、17、18、19、20和21所述的外科缝合系统，其中该第一钉仓组件包括钉驱动装置，该钉驱动装置被构造成能够将该第一钉推出该第一钉腔，并且其中该第二钉包括一体成形的钉驱动装置。
实施例23-一种外科紧固系统，包括：轴，该轴包括近侧端部和远侧端部；以及端部执行器，该端部执行器从该轴的该远侧端部延伸，其中该端部执行器能够在打开构型和闭合构型之间移动。该端部执行器包括：框架；以及砧座，该砧座从该框架朝远侧延伸，其中该砧座包括成形凹坑。该外科紧固系统还包括能够附接到该端部执行器的第一紧固件仓组件。该第一紧固件仓组件包括第一仓体，该第一仓体包括第一紧固件腔，并且此外包括可移除地储存在这些第一紧固件腔中的多个第一紧固件。每个第一紧固件均由弯曲线材制成，并且这些第一紧固件腔在该端部执行器处于该闭合构型时与这些成形凹坑对齐。该外科紧固系统还包括能够附接到该端部执行器的第二紧固件仓组件，以代替该第一紧固件仓组件，其中该第二紧固件仓组件包括第二仓体，该第二仓体包括第二紧固件腔，并且另外包括可移除地储存在这些第二紧固件腔中的多个第二紧固件。每个第二紧固件均由平整的原料形成，并且这些第二紧固件腔在该端部执行器处于该闭合构型时与这些成形凹坑对齐。
实施例24-一种钉仓组件，该钉仓组件包括仓体，该仓体包括近侧端部、远侧端部和在该近侧端部和该远侧端部之间延伸的钉腔，并且此外包括可移除地储存在这些钉腔中的钉，其中该钉各自由平整的原料形成。每个钉包括：冠部；近侧腿部、远侧腿部，其中该近侧腿部和该远侧腿部限定钉腿平面；以及倾斜凸轮表面，该倾斜凸轮表面从该冠部延伸并与之一体成形，其中该倾斜凸轮表面限定与该钉腿平面不同的凸轮平面。每个钉还包括：近侧连接器，该近侧连接器在该近侧腿部和该冠部之间延伸并且与该近侧腿部和该冠部一体成形；以及远侧连接器，该远侧连接器在该远侧腿部和该冠部之间延伸并且与该远侧腿部和该冠部一体成形，其中该倾斜凸轮表面不从该近侧连接器延伸，并且其中该倾斜凸轮表面不从该远侧连接器延伸。该钉仓组件还包括滑动件，该滑动件被构造成能够在钉击发行程期间接合这些钉的这些倾斜凸轮表面并从这些钉腔射出这些钉。
实施例25-根据实施例24所述的钉仓组件，其中该倾斜凸轮表面是平面的，并且其中该近侧连接器和该远侧连接器朝向该钉腿平面弯曲到该凸轮平面外。
实施例26-根据实施例24和25所述的钉仓组件，其中该倾斜凸轮表面包括该凸轮平面中的近侧引入端。
实施例27-根据实施例24、25和26所述的钉仓组件，其中每个钉还包括该近侧引入端和该近侧连接器之间的间隙凹口，并且其中该间隙凹口限定在该凸轮平面中。
实施例28-根据实施例24、25、26和27所述的钉仓组件，其中当这些钉处于未击发构型时，每个钉的该近侧腿部和该远侧腿部沿着非平行的方向从该冠部向外延伸。
实施例29-根据实施例24、25、26、27和28所述的钉仓组件，其中当这些钉被储存在这些钉腔中时，这些钉的这些近侧腿部和这些远侧腿部通过这些钉腔的侧壁向内弯曲。
实施例30-根据实施例24、25、26、27、28和29所述的钉仓组件，其中该滑动件在该钉击发行程期间不接合这些钉的这些近侧连接器和这些远侧连接器。
实施例31-根据实施例24、25、26、27、28、29和30所述的钉仓组件，其中该整个倾斜凸轮表面定位在该近侧钉腿和该远侧钉腿的下方。
实施例32-根据实施例24、25、26、27、28、29、30和31所述的钉仓组件，其中该倾斜凸轮表面包括用于该滑动件的初始接取点。
实施例33-一种钉仓组件，该钉仓组件包括仓体，该仓体包括近侧端部、远侧端部、在该近侧端部和该远侧端部之间延伸的钉腔，并且此外包括可移除地储存在这些钉腔中的钉，其中这些钉由一个或多个金属片形成。每个钉包括冠部、近侧腿部、远侧腿部和从该冠部延伸且与之一体成形的凸轮表面，其中该凸轮表面限定凸轮平面，并且其中该近侧腿部和该远侧腿部不在该凸轮平面中。每个钉还包括：近侧连接器，该近侧连接器在该近侧腿部和该冠部之间延伸并且与该近侧腿部和该冠部一体成形；以及远侧连接器，该远侧连接器在该远侧腿部和该冠部之间延伸并且与该远侧腿部和该冠部一体成形，其中该凸轮表面不从该近侧连接器延伸。该钉仓组件还包括滑动件，该滑动件被构造成能够在钉击发行程期间接合这些钉的这些凸轮表面并从这些钉腔射出这些钉。
实施例34-根据实施例33所述的钉仓组件，其中该凸轮表面是平面的，并且其中该近侧连接器和该远侧连接器弯曲到该凸轮平面外。
实施例35-根据实施例33和34所述的钉仓组件，其中该凸轮表面包括该凸轮平面中的近侧引入端。
实施例36-根据实施例33、34和35所述的钉仓组件，其中每个钉还包括该近侧引入端和该近侧连接器之间的间隙凹口，并且其中该间隙凹口限定在该凸轮平面中。
实施例37-根据实施例33、34、35和36所述的钉仓组件，其中当这些钉处于未击发构型时，每个钉的该近侧腿部和该远侧腿部沿着非平行的方向从该冠部向外延伸。
实施例38-根据实施例33、34、35、36和37所述的钉仓组件，其中当这些钉被储存在这些钉腔中时，这些钉的这些近侧腿部和这些远侧腿部通过这些钉腔的侧壁向内弯曲。
实施例39-根据实施例33、34、35、36、37和38所述的钉仓组件，其中该滑动件在该钉击发行程期间不接合这些钉的这些近侧连接器。
实施例40-根据实施例33、34、35、36、37、38和39所述的钉仓组件，其中该整个凸轮表面定位在该近侧钉腿和该远侧钉腿的下方。
实施例41-根据实施例33、34、35、36、37、38、39和40所述的钉仓组件，其中该凸轮表面包括用于该滑动件的初始接取点。
实施例42-一种钉仓组件，该钉仓组件包括仓体，该仓体包括：平台，该平台包括近侧端部和远侧端部；限定在该平台中的纵向狭槽，其中该纵向狭槽被构造成能够接收击发构件；第一纵向排钉腔；和第二纵向排钉腔。该钉仓组件还包括：滑动件，该滑动件能够在击发行程期间通过该击发构件朝向该远侧端部移动；以及多个第一钉，这些多个第一钉可移除地储存在该第一纵向排钉腔中，其中每个第一钉均由弯曲线材制成。该钉仓组件还包括：多个钉驱动装置，这些多个钉驱动装置被构造成能够支撑这些第一钉，其中该滑动件被构造成能够在该击发行程期间接合这些钉驱动装置以从该第一纵向排钉腔射出这些第一钉；以及多个第二钉，这些多个第二钉可移除地储存在该第二纵向排钉腔中，其中每个第二钉均由平整的原料形成并且包括一体成形的驱动装置，并且其中该滑动件被构造成能够在该击发行程期间直接接合这些第二钉的这些一体成形的驱动装置并且从该第二纵向排钉腔射出这些第二钉。
实施例43-根据实施例42所述的钉仓组件，其中该第一纵向排钉腔邻近该纵向狭槽，并且其中该第一纵向排钉腔介于该纵向狭槽和该第二纵向排钉腔之间。
实施例44-根据实施例42所述的钉仓组件，其中该第二纵向排钉腔邻近该纵向狭槽，并且其中该第二纵向排钉腔介于该纵向狭槽和该第一纵向排钉腔之间。
实施例45-根据实施例42、43和44所述的钉仓组件，其中该仓体还包括第三纵向排钉腔，其中该钉仓组件还包括可移除地储存在该第三纵向排钉腔中的多个第三钉，并且其中每个第三钉均由弯曲线材制成。
实施例46-根据实施例45所述的钉仓组件，其中该第三纵向排钉腔邻近该第一纵向排钉腔，其中这些钉驱动装置被构造成能够支撑这些第三钉，并且其中该滑动件被构造成能够在该击发行程期间接合这些钉驱动装置以从该第三纵向排钉腔射出这些第三钉。
实施例47-根据实施例45所述的钉仓组件，该钉仓组件还包括多个钉驱动装置，这些多个钉驱动装置被构造成能够支撑这些第三钉并且在该击发行程期间由该滑动件接合以从该第三纵向排钉腔射出这些第三钉。
实施例48-根据实施例42、43和44所述的钉仓组件，其中该仓体还包括第三纵向排钉腔，其中该钉仓组件还包括可移除地储存在该第三纵向排钉腔中的多个第三钉，其中每个第三钉均由平整的原料形成并且包括一体成形的驱动装置，并且其中该滑动件被构造成能够在该击发行程期间直接接合这些第三钉的这些一体成形的驱动装置并且从该第三纵向排钉腔射出这些第三钉。
实施例49-根据实施例48所述的钉仓组件，其中该第三纵向排钉腔邻近该纵向狭槽，其中该第二纵向排钉腔邻近该第三纵向排钉腔，并且其中该第二纵向排钉腔介于该第一纵向排钉腔和该第三纵向排钉腔之间。
实施例50-一种钉仓组件，该钉仓组件包括切割构件和仓体，其中该仓体包括：平台，该平台包括近侧端部和远侧端部；限定在该平台中的纵向狭槽，其中该纵向狭槽被构造成能够接收切割构件；第一纵向排钉腔；和第二纵向排钉腔。该钉仓组件还包括：滑动件，该滑动件能够在击发行程期间通过该切割构件朝向该远侧端部移动；以及多个第一钉，这些多个第一钉可移除地储存在该第一纵向排钉腔中，其中每个第一钉均由弯曲线材制成。该钉仓组件还包括：多个钉驱动装置，这些多个钉驱动装置被构造成能够支撑这些第一钉，其中该滑动件被构造成能够在该击发行程期间接合这些钉驱动装置以从该第一纵向排钉腔射出这些第一钉；以及此外多个第二钉，这些多个第二钉可移除地储存在该第二纵向排钉腔中，其中这些第二钉由一个或多个金属片冲压而成，并且其中该滑动件被构造成能够在该击发行程期间直接接合这些第二钉并且从该第二纵向排钉腔射出这些第二钉。
实施例51-根据实施例50所述的钉仓组件，其中该第一纵向排钉腔邻近该纵向狭槽，并且其中该第一纵向排钉腔介于该纵向狭槽和该第二纵向排钉腔之间。
实施例52-根据实施例50所述的钉仓组件，其中该第二纵向排钉腔邻近该纵向狭槽，并且其中该第二纵向排钉腔介于该纵向狭槽和该第一纵向排钉腔之间。
实施例53-根据实施例50、51和52所述的钉仓组件，其中该仓体还包括第三纵向排钉腔，其中该钉仓组件还包括可移除地储存在该第三纵向排钉腔中的多个第三钉，并且其中每个第三钉均由弯曲线材制成。
实施例54-根据实施例53所述的钉仓组件，其中该第三纵向排钉腔邻近该第一纵向排钉腔，其中这些钉驱动装置被构造成能够支撑这些第三钉，并且其中该滑动件被构造成能够在该击发行程期间接合这些钉驱动装置以从该第三纵向排钉腔射出这些第三钉。
实施例55-根据实施例53所述的钉仓组件，该钉仓组件还包括多个钉驱动装置，这些多个钉驱动装置被构造成能够支撑这些第三钉并且在该击发行程期间由该滑动件接合以从该第三纵向排钉腔射出这些第三钉。
实施例56-根据实施例50、51、52、53、54和55所述的钉仓组件，其中该仓体还包括第三纵向排钉腔，其中该钉仓组件还包括可移除地储存在该第三纵向排钉腔中的多个第三钉，其中这些第三钉由一个或多个金属片形成，并且其中该滑动件被构造成能够在该击发行程期间直接接合这些第三钉并且从该第三纵向排钉腔射出这些第三钉。
实施例57-根据实施例50、51和52所述的钉仓组件，其中该第三纵向排钉腔邻近该纵向狭槽，其中该第二纵向排钉腔邻近该第三纵向排钉腔，并且其中该第二纵向排钉腔介于该第一纵向排钉腔和该第三纵向排钉腔之间。
实施例58-一种钉仓组件，该钉仓组件包括仓体，该仓体包括：平台，该平台包括近侧端部和远侧端部；限定在该平台中的纵向狭槽，其中该纵向狭槽被构造成能够接收击发构件；以及多个钉腔。该钉仓组件还包括：滑动件，该滑动件能够在击发行程期间通过该击发构件朝向该远侧端部移动；多个第一钉，这些多个第一钉可移除地储存在这些钉腔中，其中每个第一钉均由弯曲线材制成；以及此外多个钉驱动装置，其中该滑动件被构造成能够在该击发行程期间接合这些钉驱动装置以从这些钉腔射出这些第一钉。该钉仓组件还包括多个第二钉，这些多个第二钉可移除地储存在这些钉腔中，其中每个第二钉均由平整的原料形成并且包括一体成形的驱动装置，并且其中该滑动件被构造成能够在该击发行程期间直接接合这些第二钉的这些一体成形的驱动装置并且从这些钉腔射出这些第二钉。
实施例59-一种钉仓组件，该钉仓组件包括仓体，该仓体包括：近侧端部、远侧端部、被构造成能够支撑患者组织的平台以及限定于该平台中的多个钉腔。该钉仓组件还包括多个金属钉，这些多个金属钉可移除地储存在这些钉腔中，其中每个金属钉包括：包含组织接触表面的冠部、连接到该冠部的第一腿部、连接到该冠部的第二腿部以及与该冠部一体成形的驱动装置。此外，该钉仓组件包括：滑动件，该滑动件能够在击发行程期间朝向该远侧端部移动，其中该滑动件被构造成能够在该击发行程期间直接接合这些金属钉的这些驱动装置并且使每个金属钉在未击发位置和击发位置之间移动，其中当这些金属钉处于该击发位置时，这些冠部的这些组织接触表面定位在该平台的上方，并且其中当这些金属钉处于该击发位置时，这些金属钉的这些驱动装置至少部分地定位在该平台的下方。
实施例60-根据实施例59所述的钉仓组件，其中该仓体还包括从该平台延伸的导向件，这些导向件被构造成能够在这些金属钉被移动到该击发位置时在该平台的上方支撑和引导这些钉腿，并且其中当这些金属钉处于该击发位置时，这些冠部的这些组织接触表面至少部分地定位在这些导向件的上方。
实施例61-根据实施例59和60所述的钉仓组件，其中该滑动件包括一个或多个驱动表面，该一个或多个驱动表面被构造成能够接合这些金属钉的这些驱动装置，其中每个驱动表面包括顶表面，并且其中每个驱动表面的该顶表面完全位于该平台的下方。
实施例62-一种钉仓组件，该钉仓组件包括仓体，该仓体包括：近侧端部、远侧端部、被构造成能够支撑患者组织的平台以及限定于该平台中的钉腔。该钉仓组件还包括可移除地储存在该钉腔中的钉，其中该钉包括：包含组织接合表面的冠部、从该冠部延伸的第一腿部、从该冠部延伸的第二腿部以及与该冠部一体成形的驱动装置。此外，该钉仓组件包括：滑动件，该滑动件能够在击发行程期间朝向该远侧端部移动，其中该滑动件被构造成能够在该击发行程期间直接接合该钉的该驱动装置并且使该钉在未击发位置和击发位置之间移动，其中当该钉处于该击发位置时，该冠部的该组织接合表面至少部分地定位在该平台的上方，并且其中当该钉处于该击发位置时，该驱动装置至少部分地定位在该平台的下方。
实施例63-根据实施例62所述的钉仓组件，其中该仓体还包括从该平台延伸的导向件，该导向件被构造成能够在该钉被移动到该击发位置时在该平台的上方支撑和引导该第一钉腿，并且其中当该钉处于该击发位置时，该冠部的该组织接触表面至少部分地定位在该导向件的上方。
实施例64-根据实施例62和63所述的钉仓组件，其中该滑动件包括驱动表面，该驱动表面被构造成能够接合该钉的该驱动装置，其中该驱动表面包括顶表面，并且其中该顶表面完全位于该平台的下方。
实施例65-一种钉仓组件，该钉仓组件包括仓体，该仓体包括：近侧端部、远侧端部、被构造成能够支撑患者组织的平台以及限定于该平台中的钉腔。该钉仓组件还包括可移除地储存在该钉腔中的钉，其中该钉包括：包含组织接合表面的冠部、从该冠部延伸的第一腿部、从该冠部延伸的第二腿部以及与该冠部一体成形的驱动装置。该钉仓组件还包括：击发构件，该击发构件能够在击发行程期间朝向该远侧端部移动，其中该击发构件被构造成能够在该击发行程期间直接接合该钉的该驱动装置并且使该钉在未击发位置和击发位置之间移动，其中当该钉处于该击发位置时，该冠部的该组织接合表面完全定位在该平台的上方，并且其中当该钉处于该击发位置时，该驱动装置完全定位在该平台的下方。
实施例66-根据实施例65所述的钉仓组件，其中该仓体还包括从该平台延伸的导向件，该导向件被构造成能够在该钉被移动到该击发位置时在该平台的上方支撑和引导该第一钉腿，并且其中当该钉处于该击发位置时，该冠部的该组织接触表面完全部分地定位在该导向件的上方。
实施例67-根据实施例65和66所述的钉仓组件，其中该击发构件包括驱动表面，该驱动表面被构造成能够接合该钉的该驱动装置，其中该驱动表面包括顶表面，并且其中该顶表面完全位于该平台的下方。
实施例68-一种钉仓组件，该钉仓组件包括仓体，该仓体包括
被构造成能够支撑该患者的组织的平台、限定于该平台中的纵向狭槽，其中该纵向狭槽限定纵向狭槽轴线，其中该纵向狭槽被构造成能够接收切割构件，并且其中该平台包括该纵向狭槽的第一侧上的第一平台部分和该纵向狭槽的第二侧上的第二平台部分。该仓体还包括
第一排钉腔，该第一排钉腔限定于邻近该纵向狭槽的该第一平台部分中，其中该第一排钉腔沿第一纵向轴线进行限定，并且其中第一距离限定在该第一纵向轴线和该纵向狭槽轴线之间。该仓体还包括第二排钉腔，该第二排钉腔限定于邻近该纵向狭槽的该第二平台部分中，其中该第二排钉腔沿第二纵向轴线进行限定，其中第二距离限定在该第二纵向轴线和该纵向狭槽轴线之间，并且其中该第二距离不同于该第一距离。该钉仓组件还包括可移除地储存在该第一排钉腔和该第二排钉腔中的钉。
实施例69-根据实施例68所述的钉仓组件，该钉仓组件还包括滑动件，其中该滑动件包括被构造成能够从该第一排钉腔射出这些钉的第一纵向斜坡和被构造成能够从该第二排钉腔射出这些钉的第二纵向斜坡。
实施例70-根据实施例69所述的钉仓组件，其中该第一距离限定在该第一纵向斜坡和该纵向狭槽轴线之间，并且其中该第二距离限定在该第二纵向斜坡和该纵向狭槽轴线之间。
实施例71-一种紧固件仓组件，该紧固件仓组件包括仓体，该仓体包括
被构造成能够支撑该患者的组织的平台以及限定于该平台中的纵向狭槽，其中该纵向狭槽限定纵向狭槽轴线，其中该纵向狭槽被构造成能够接收切割构件，并且其中该平台包括该纵向狭槽的第一侧上的第一平台部分和该纵向狭槽的第二侧上的第二平台部分。该仓体还包括
第一排紧固件腔，该第一排紧固件腔限定于邻近该纵向狭槽的该第一平台部分中，其中该第一排紧固件腔沿第一纵向轴线进行限定，并且其中第一距离限定在该第一纵向轴线和该纵向狭槽轴线之间。该仓体还包括第二排紧固件腔，该第二排紧固件腔限定于邻近该纵向狭槽的该第二平台部分中，其中该第二排紧固件腔沿第二纵向轴线进行限定，其中第二距离限定在该第二纵向轴线和该纵向狭槽轴线之间，并且其中该第二距离不同于该第一距离。该紧固件仓组件还包括可移除地储存在该第一排紧固件腔和该第二排紧固件腔中的紧固件，其中这些紧固件由一个或多个材料片形成。
实施例72-根据实施例71所述的紧固件仓组件，其中该第一排紧固件腔比该第二排紧固件腔更靠近该纵向狭槽。
实施例73-根据实施例71所述的紧固件仓组件，其中该第二排紧固件腔比该第一排紧固件腔更靠近该纵向狭槽。
实施例74-根据实施例71、72和73所述的紧固件仓组件，该紧固件仓组件还包括滑动件，其中该滑动件包括被构造成能够从该第一排紧固件腔射出这些紧固件的第一纵向斜坡和被构造成能够从该第二排紧固件腔射出这些紧固件的第二纵向斜坡。
实施例75-根据实施例74所述的紧固件仓组件，其中该第一纵向斜坡被定位成比该第二纵向斜坡更靠近该纵向狭槽。
实施例76-根据实施例74所述的紧固件仓组件，其中该第二纵向斜坡被定位成比该第一纵向斜坡更靠近该纵向狭槽。
实施例77-一种钉仓组件，该钉仓组件包括仓体，该仓体包括
被构造成能够支撑该患者的组织的平台以及限定于该平台中的纵向狭槽，其中该纵向狭槽被构造成能够接收切割构件，并且其中该平台包括该纵向狭槽的第一侧上的第一平台部分和该纵向狭槽的第二侧上的第二平台部分。该仓体还包括限定于邻近该纵向狭槽的该第一平台部分中的第一排钉腔，并且其中第一距离限定在该第一排钉腔和该纵向狭槽之间。该仓体还包括限定于邻近该纵向狭槽的该第二平台部分中的第二排钉腔，并且其中第二距离限定在该第二排钉腔和该纵向狭槽之间，并且其中该第二距离不同于该第一距离。该钉仓组件还包括可移除地储存在该第一排钉腔和该第二排钉腔中的钉。
实施例78-根据实施例77所述的钉仓组件，该钉仓组件还包括滑动件，其中该滑动件包括被构造成能够从该第一排钉腔射出这些钉的第一纵向斜坡和被构造成能够从该第二排钉腔射出这些钉的第二纵向斜坡。
实施例79-根据实施例78所述的钉仓组件，其中该第一距离限定在该第一纵向斜坡和该纵向狭槽之间，并且其中该第二距离限定在第二纵向斜坡和该纵向狭槽之间。
实施例80-根据实施例78和79所述的钉仓组件，其中每个钉包括冠部；与该冠部一体成形的凸轮部分，其中该滑动件被构造成能够直接接合该凸轮部分；以及从该凸轮部分偏移的组织握紧部分。
实施例81-根据实施例80所述的钉仓组件，其中这些钉的这些凸轮部分被定位成比这些组织握紧部分更靠近该纵向狭槽。
实施例82-根据实施例80所述的钉仓组件，其中这些钉的这些组织握紧部分被定位成比这些凸轮部分更靠近该纵向狭槽。
实施例83-根据实施例77、78、79、80、81或82所述的钉仓组件，其中该第一距离短于该第二距离。
实施例84-根据实施例77、78、79、80、81或82所述的钉仓组件，其中该第二距离短于该第一距离。
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。
下述专利的全部公开内容据此以引用方式并入本文：
提交于2015年8月11日的名称为“ADAPTER ASSEMBLY FOR INTERCONNECTINGELECTROMECHANICAL SURGICAL DEVICES AND SURGICAL LOADING UNITS,AND SURGICALSYSTEMS THEREOF”的美国专利申请序列号14/822,970，现为美国专利申请公布2015/0342603；
提交于2013年6月19日的名称为“APPARATUS FOR ENDOSCOPIC PROCEDURES”的美国专利申请序列号13/921,890，现为美国专利申请公布2013/0282052；
提交于2013年6月21日的名称为“SURGICAL STAPLING APPARATUS”的美国专利申请序列号13/924,054，现为美国专利申请公布2014/0263545；
提交于2014年4月21日的名称为“ADAPTER ASSEMBLY WITH GIMBAL FORINTERCONNECTING ELECTROMECHANICAL SURGICAL DEVICES AND SURGICAL LOADINGUNITS,AND SURGICAL SYSTEMS THEREOF”的美国专利申请序列号14/257,063，现为美国专利申请公布2015/0297199；
提交于2015年3月31日的名称为“DISPOSABLE HOUSINGS FOR ENCASING HANDLEASSEMBLIES AND METHODS OF USE”的美国专利申请序列号14/674,152，现为美国专利申请公布2015/0366560；
提交于2015年3月30日的名称为“ADAPTER ASSEMBLY FOR INTERCONNECTINGELECTROMECHANICAL SURGICAL DEVICES AND SURGICAL LOADING UNITS,AND SURGICALSYSTEMS THEREOF”的美国专利申请序列号14/672,973，现为美国专利申请公布2015/0374366；
提交于2015年3月30日的名称为“ADAPTER ASSEMBLIES FOR INTERCONNECTINGELECTROMECHANICAL HANDLE ASSEMBLIES AND SURGICAL LOADING UNITS”的美国专利申请序列号14/672,731，现为美国专利申请2015/0374449；以及
公布于2016年4月13日的名称为“STAPLE CARTRIDGE WITH SHIPPING WEDGE”的欧洲专利申请公布EP 3005956A1；以及
公布于2016年4月14日的名称为“HANDHELD ELECTROMECHANICAL SURGICALSYSTEM”的PCT公开WO2016/057225A1。
下述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”的欧洲专利申请号12/795298；
公布于1997年2月25日的名称为“TRIGGER MECHANISM FOR SURGICALINSTRUMENTS”的美国专利5,605,272；
公布于1997年12月16日的名称为“LINEAR STAPLER WITH IMPROVED FIRINGSTROKE”的美国专利5,697,543；
2005年11月10日提交的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING A FIRING DRIVE”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；
公布于1985年7月9日的名称为“DISPOSABLE LINEAR SURGICAL STAPLINGINSTRUMENT”的美国专利4,527,724；
公布于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；
公布于1995年4月11日的名称为“FLEXIBLE SUPPORT SHAFT ASSEMBLY”的美国专利5,405,073；
公布于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；
公布于1995年4月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312；
公布于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；
公布于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；
公布于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；
公布于2010年3月2日的名称为“SURGICAL INSTRUMENT HAVING AN ARTICULATINGEND EFFECTOR”的美国专利7,670,334；
公布于2010年7月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245；
公布于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No.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。
虽然本文已结合某些实施方案描述了各种装置，但也可实施对这些实施方案的修改和变型。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。此外，根据多种实施方案，单个部件可被替换为多个部件，并且多个部件也可被替换为单个部件，以执行给定的一种或多种功能。上述具体实施方式和下述权利要求旨在涵盖所有此类修改和变型。
本文所公开的装置可被设计成在单次使用后废弃，或者其可被设计成多次使用。然而无论是哪种情况，该装置都可在至少使用一次后经过修整再行使用。修整可包括以下步骤的任意组合，所述步骤包括但不限于拆卸装置、之后清洁或替换装置的特定零件以及后续重新组装装置。具体地讲，修复设施和/或外科手术团队可以拆卸装置，并且在清洁和/或更换装置的特定部分之后，可以重新组装该装置以供后续使用。本领域的技术人员将会理解，修整装置可利用各种技术来进行拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修复装置均在本申请的范围内。
本文所公开的装置可在手术之前进行处理。首先，可以获得新的或用过的器械，并且根据需要进行清洁。然后，可对器械进行消毒。在一种灭菌技术中，将所述器械放置在密闭且密封的容器(诸如，塑料或TYVEK袋)中。然后可将容器和器械置于可穿透所述容器的辐射场，诸如γ辐射、X射线和/或高能电子。辐射可杀死器械上和容器中的细菌。消毒后的器械随后可被储存在无菌容器中。密封容器可将器械保持处于无菌状态，直至在医疗设施中将该容器打开。还可使用本领域已知的任何其他技术对装置进行灭菌，所述技术包括但不限于β辐射、γ辐射、环氧乙烷、等离子过氧化物和/或蒸汽。
尽管本发明已被描述为具有示例性设计，但可在本公开的实质和范围内进一步修改本发明。因此，本申请旨在涵盖使用本发明的一般原理的本发明的任何变型、用途或改型。
以引用方式全文或部分地并入本文的任何专利、公布或其他公开材料均仅在所并入的材料不与本发明所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。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。

Claims (9)

1.一种钉仓组件，包括：
仓体，所述仓体包括：
平台，所述平台包括近侧端部和远侧端部；
所述平台中限定的纵向狭槽，其中所述纵向狭槽被构造成能够接收击发构件；
第一纵向排钉腔；以及
第二纵向排钉腔，其中所述第一纵向排钉腔和所述第二纵向排钉腔侧向偏移并且沿纵向保持一致；
滑动件，所述滑动件能够在击发行程期间通过所述击发构件朝向所述远侧端部移动；
多个第一钉，其中所述多个第一钉中的一个可移除地储存在所述第一纵向排钉腔的每个钉腔中，其中每个所述第一钉均由弯曲线材制成；
多个钉驱动装置，所述多个钉驱动装置被构造成能够支撑所述第一钉，其中所述滑动件被构造成能够在所述击发行程期间接合所述钉驱动装置以从所述第一纵向排钉腔射出所述第一钉；以及
由平整的原料形成的多个第二钉，其中所述多个第二钉中的一个可移除地储存在所述第二纵向排钉腔的每个钉腔中，其中每个所述第二钉均包括一体成形的驱动装置，并且其中所述滑动件被构造成能够在所述击发行程期间直接接合所述第二钉的所述一体成形的驱动装置并且从所述第二纵向排钉腔射出所述第二钉。
2.根据权利要求1所述的钉仓组件，其中所述第一纵向排钉腔邻近所述纵向狭槽，并且其中所述第一纵向排钉腔介于所述纵向狭槽和所述第二纵向排钉腔之间。
3.根据权利要求1所述的钉仓组件，其中所述第二纵向排钉腔邻近所述纵向狭槽，并且其中所述第二纵向排钉腔介于所述纵向狭槽和所述第一纵向排钉腔之间。
4.根据权利要求1所述的钉仓组件，其中所述仓体还包括第三纵向排钉腔，其中所述钉仓组件还包括多个第三钉，其中所述多个第三钉中的一个可移除地储存在所述第三纵向排钉腔中的每个钉腔中，并且其中每个所述第三钉均由弯曲线材制成。
5.根据权利要求4所述的钉仓组件，其中所述第三纵向排钉腔邻近所述第一纵向排钉腔，其中所述钉驱动装置被构造成能够支撑所述第三钉，并且其中所述滑动件被构造成能够在所述击发行程期间接合所述钉驱动装置以从所述第三纵向排钉腔射出所述第三钉。
6.根据权利要求4所述的钉仓组件，还包括多个钉驱动装置，所述多个钉驱动装置被构造成能够支撑所述第三钉并且在所述击发行程期间由所述滑动件接合以从所述第三纵向排钉腔射出所述第三钉。
7.根据权利要求1所述的钉仓组件，其中所述仓体还包括第三纵向排钉腔，其中所述钉仓组件还包括多个第三钉，其中所述多个第三钉中的一个可移除地储存在所述第三纵向排钉腔中的每个钉腔中，其中每个所述第三钉均由平整的原料形成并且包括一体成形的驱动装置，并且其中所述滑动件被构造成能够在所述击发行程期间直接接合所述第三钉的所述一体成形的驱动装置并且从所述第三纵向排钉腔射出所述第三钉。
8.根据权利要求7所述的钉仓组件，其中所述第三纵向排钉腔邻近所述纵向狭槽，其中所述第二纵向排钉腔邻近所述第三纵向排钉腔，并且其中所述第二纵向排钉腔介于所述第一纵向排钉腔和所述第三纵向排钉腔之间。
9.如前述任一项权利要求所述的钉仓组件，其中所述第二钉由一个或多个金属片冲压而成。
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CN109310431A (zh) 2019-02-05
BR112018076768A2 (pt) 2019-04-02
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