CN110087565A - 外科缝合系统 - Google Patents

外科缝合系统 Download PDF

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Publication number
CN110087565A
CN110087565A CN201780079993.8A CN201780079993A CN110087565A CN 110087565 A CN110087565 A CN 110087565A CN 201780079993 A CN201780079993 A CN 201780079993A CN 110087565 A CN110087565 A CN 110087565A
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CN
China
Prior art keywords
patent application
nail bin
distal
locking
surgical
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
CN201780079993.8A
Other languages
English (en)
Inventor
G·G·斯科特
D·V·拉巴塞瓦
J·M·纳思
R·J·劳伦特
M·E·塞瑟
黄志凡
C·A·麦克兹卡
R·J·西姆斯
J·L·哈里斯
F·E·谢尔顿四世
G·J·巴克斯
N·Y·科维
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ethicon LLC
Original Assignee
Ethicon LLC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US15/385,919 external-priority patent/US20180168619A1/en
Application filed by Ethicon LLC filed Critical Ethicon LLC
Publication of CN110087565A publication Critical patent/CN110087565A/zh
Pending legal-status Critical Current

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    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0807—Indication means
    • A61B2090/0811—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08—Accessories or related features not otherwise provided for
    • A61B2090/0814—Preventing re-use
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/90—Identification means for patients or instruments, e.g. tags
    • A61B90/92—Identification means for patients or instruments, e.g. tags coded with colour

Abstract

本公开公开了一种系统。该系统可以包括可替换的钉仓，该可替换的钉仓包括多个钉、侧向突出的近侧凸耳和侧向突出的远侧凸耳。该系统可以还包括通道，该通道被构造成能够接纳可替换的钉仓，其中，该通道包括侧壁，该侧壁包括近侧容座和远侧容座，近侧容座的位置和尺寸被设计成接纳侧向突出的近侧凸耳，远侧容座的位置和尺寸被设计成接纳侧向突出的远侧凸耳。

Description

外科缝合系统
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
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理解：
图1为可操作地联接到柄部组件实施方案的可互换外科工具组件实施方案的透视图。
图2为图1的柄部组件和可互换外科工具组件的部分的分解组装视图；
图3为图1和2中所示的可互换外科工具组件实施方案的透视图，其中为清楚起见省略了其一些部分；
图4为图1至3的可互换外科工具组件实施方案的近侧部分的透视图，其中为清楚起见省略了其一些部分；
图5为图1至4的可互换外科工具组件的近侧部分的分解组装视图；
图6为图1至5的可互换外科工具组件的远侧部分的分解组装视图；
图7示出了将可互换外科工具组件实施方案用于执行被称为人类骨盆区域内的下前切除的医疗规程；
图8为图7中所示的可互换外科工具组件的一部分的顶视图；
图9为图8中示出的可互换外科工具组件的另一顶视图，其中其部分以横截面示出；
图10为图9的可互换外科工具组件的远侧部分的局部透视图；
图11为沿图10中的线11-11截取的图10的可互换外科工具组件的剖视图；
图12为另一可互换外科工具组件的一部分的局部透视图；
图13为另一可互换外科工具实施方案的轴组件部分的横截面端视图；
图14为另一可互换外科工具实施方案的轴组件部分的横截面端视图；
图15为处于关节运动构型的可互换外科工具实施方案的一部分的顶部剖视图；
图15A为另一外科端部执行器和细长轴组件布置的部分的顶视图，其中外科端部执行器处于非关节运动位置(实线)和关节运动位置(虚线)；
图16为可互换外科工具端部执行器的一部分的透视图，其采用砧座盖来覆盖其端部执行器内的击发构件停放区域的一部分；
图17为图16的外科端部执行器的一部分的另一透视图，其中为了清楚起见省略了砧座盖；
图18为图16的外科端部执行器的侧正视图，其中其砧座处于打开构型；
图18A为图18的外科端部执行器的横截面侧视图；
图19为图18的外科端部执行器在砧座闭合过程开始时的横截面侧视图；
图20为图18和图19的外科端部执行器的另一横截面侧视图，其中其砧座处于完全打开位置；
图20A为图20的外科端部执行器在其击发构件已向远侧推出击发构件停放区域之后的另一横截面侧视图；
图21为远侧闭合构件实施方案的透视图；
图22为采用图21的远侧闭合构件的可互换外科工具组件的一部分的侧视图，其中其外科端部执行器部分的砧座处于完全闭合位置；
图23为图22的可互换外科工具组件的一部分的另一侧正视图，其中远侧闭合件处于初始打开位置；
图24为图22的可互换外科工具组件的一部分的另一侧正视图，其中远侧闭合件处于另一打开位置；
图25为图22的可互换外科工具组件的一部分的另一侧正视图，其中其砧座处于完全打开位置；
图26为另一远侧闭合构件实施方案的透视图；
图27为另一砧座实施方案的侧视图；
图28为另一可互换外科工具组件的局部横截面侧视图，其采用图26的远侧闭合构件和图27的砧座实施方案，其中砧座处于完全闭合位置；
图29为图28的可互换外科工具组件的另一局部横截面侧视图，其中其砧座处于完全打开位置；
图30为另一远侧闭合构件实施方案的透视图；
图31为另一可互换外科工具组件的局部横截面侧视图，其采用图30的远侧闭合构件实施方案并且其中砧其座处于完全打开位置；
图32为另一可互换外科工具组件的局部横截面侧视图，其中其砧座处于完全闭合位置；
图33为图32的可互换外科工具组件的另一局部横截面侧视图，其中其砧座处于完全打开位置；
图34为另一可互换外科工具组件的一部分的侧正视图，其中其砧座处于完全闭合位置；
图35为图34的可互换外科工具组件的一部分的另一侧正视图，其中其砧座处于完全打开位置；
图36为另一可互换外科工具组件的一部分的侧正视图，其中其砧座处于完全闭合位置；
图37为图36的可互换外科工具组件的一部分的另一侧正视图，其中其砧座处于部分打开位置；
图38为另一可互换外科工具组件的一部分的侧正视图，其中其砧座处于完全闭合位置；
图39为图38的可互换外科工具组件的一部分的另一侧正视图，其中其砧座处于部分打开位置；
图40为凸轮传动或滑动件组件实施方案的底部透视图；
图41为外科端部执行器实施方案的一部分的顶视图，其中未击发的外科钉仓安装在其中并且其凸轮传动组件处于起始位置并且与击发构件锁定构件解锁接合；
图42为图41的外科端部执行器实施方案的一部分的顶视图，其具有安装在其中的不适当的未击发外科钉仓，其凸轮传动组件处于起始位置并且击发构件锁与击发构件锁定接合；
图43为另一可互换外科工具组件实施方案的砧座、击发构件、滑动件组件和击发构件锁实施方案的部分的分解透视图；
图44为图43的可互换外科工具组件的远侧部分的局部剖视图，为清楚起见省略了其击发构件；
图45为图44的可互换外科工具组件的远侧部分的另一局部剖视图，其中未击发的外科钉仓适当地安置在其外科端部执行器内，其砧座处于打开位置并且击发构件处于起始位置；
图46为图45的可互换外科工具组件的远侧部分的另一局部剖视图，其中砧座处于完全闭合位置并且击发构件处于初始击发位置；
图47为图45的可互换外科工具组件的远侧部分的另一局部剖视图，其中砧座处于完全闭合位置并且击发构件在外科端部执行器内进一步向远侧推进；
图48为图47的可互换外科工具组件的远侧部分的另一局部剖视图，其中砧座处于完全闭合位置并且击发构件在就快接触击发构件锁之前回缩到起始位置；
图49为图48的可互换外科工具组件的远侧部分的另一局部剖视图，其中砧座处于完全闭合位置并且击发构件在初始接触击发构件锁之后回缩到起始位置；
图50为图49的可互换外科工具组件的远侧部分的另一局部剖视图，其中砧座处于完全闭合位置并且击发构件回缩到起始位置；
图51为另一可互换外科工具组件实施方案的一部分的侧剖视图，其中未击发的外科钉仓装载在其外科端部执行器中，并且击发构件处于起始位置或构型；
图52为图51的可互换外科工具组件实施方案在击发构件开始向远侧穿过外科端部执行器推进之后的另一侧剖视图；
图53为图51和图52的可互换外科工具组件实施方案在击发构件回缩到起始位置期间的另一侧剖视图；
图54为图51至53的可互换外科工具组件实施方案在击发构件进一步向起始位置回缩之后的另一侧剖视图；
图55为图51至54的可互换外科工具组件实施方案在击发构件已经完全回缩到起始位置之后的另一侧剖视图；
图56为另一可互换外科工具组件实施方案的击发构件、滑动组件、击发构件和击发构件锁定构件的部分的分解透视图；
图57为图56的可互换外科工具组件实施方案的一部分的侧剖视图，其中在外科端部执行器内安装未击发的外科钉仓之前其外科端部执行器的砧座处于打开位置，并且击发构件处于起始位置；
图58为图57的可互换外科工具组件实施方案的一部分的另一侧剖视图，其中未击发的外科钉仓安装在外科端部执行器内并且砧座处于闭合位置；
图59为图58的可互换外科工具组件实施方案的一部分的顶部剖视图，其中击发构件锁定在相对于击发构件的脱离构型中；
图60为图58和图59的可互换外科工具组件实施方案的一部分在击发构件向远侧初始推进之后的另一侧剖视图；
图61为图58至60的可互换外科工具组件实施方案的一部分在回缩到起始位置期间的另一侧剖视图；
图62为图61的可互换外科工具组件实施方案的部分的顶视图；
图63为图58至62的可互换外科工具组件实施方案的一部分在击发构件已经完全回缩到起始位置并且与击发构件锁锁定接合之后的另一侧剖视图；
图64为另一可互换外科工具组件实施方案的关节运动接头和关节运动锁实施方案的部分的分解透视图；
图65为图64的关节运动锁实施方案的锁弹簧组件实施方案的透视图；
图66为图64的可互换外科工具组件的端部执行器安装组件实施方案的顶视图；
图67为图64的可互换外科工具组件实施方案的部分的顶视图，其中其外科端部执行器处于非关节运动构型；
图68为图67的可互换外科工具组件实施方案的部分在将关节运动动作初始施加到关节运动接头时的另一顶视图；
图69为图68的可互换外科工具组件实施方案的部分的底视图；
图70为图69的可互换外科工具组件实施方案的部分的另一底视图，其中外科端部执行器处于关节运动构型；
图71为另一可互换外科工具组件实施方案的关节运动接头和关节运动锁实施方案的部分的分解透视图；
图72为图71的可互换外科工具组件的端部执行器安装组件实施方案的顶视图；
图73为图71的可互换外科工具组件实施方案的部分的顶视图，其中其外科端部执行器处于非关节运动构型；
图74为沿图73中的线74-74截取的图73的关节运动锁实施方案的部分的局部剖视图；
图75为图73的可互换外科工具组件实施方案的部分在将关节运动动作初始施加到关节运动接头时的另一顶视图；
图76为图75的可互换外科工具组件实施方案的部分的另一顶视图，其中其外科端部执行器处于关节运动构型，并且关节运动锁处于解锁构型；
图77为图75的可互换外科工具组件实施方案的部分的另一顶视图，其中其外科端部执行器处于关节运动构型，并且关节运动锁处于锁定构型；
图78为另一可互换外科工具组件实施方案的关节运动接头和关节运动锁实施方案的部分的分解透视图；
图79为图78的可互换外科工具组件实施方案的部分的顶视图，其中其外科端部执行器处于非关节运动构型；
图80为沿图79中的线80-80截取的图79的可互换外科工具组件的部分的侧剖视图；
图81为图80的可互换外科工具组件的部分在将关节运动动作初始施加到其关节运动锁时的另一侧剖视图；
图82为图81的可互换外科工具组件的部分的另一侧剖视图，其中关节运动接头由关节运动锁锁定在位；
图83为另一可互换外科工具组件实施方案的脊组件、关节运动接头和关节运动锁实施方案的部分的分解透视图；
图84为图83的可互换外科工具组件实施方案的脊组件的远侧端部和关节运动锁定布置的一部分的顶视图；
图85为另一可互换外科工具组件实施方案的脊组件、关节运动接头和关节运动锁实施方案的部分的分解透视图；
图86为图85的可互换外科工具组件的脊组件和关节运动接头和关节运动锁的部分的另一分解透视图；
图87为图85的可互换外科工具组件的顶部剖视图，其中其外科端部执行器处于非关节运动构型；
图88为图87的可互换外科工具组件的另一顶部剖视图，其中其外科端部执行器处于关节运动构型，并且关节运动锁处于解锁构型；
图89为图88的可互换外科工具组件的另一顶部剖视图，其中其外科端部执行器处于关节运动构型，并且关节运动锁处于锁定构型；
图90为另一可互换外科工具组件实施方案的脊组件、关节运动接头和关节运动锁实施方案的部分的分解透视图；
图91为图90的可互换外科工具组件的顶部剖视图，其中其外科端部执行器处于非关节运动构型；
图92为图91的可互换外科工具组件的另一顶部剖视图，其中其外科端部执行器处于关节运动构型，并且关节运动锁处于解锁构型；
图93为沿图92中的线93-93截取的图92的关节运动锁的局部剖视图；
图94为图91的可互换外科工具组件的另一顶部剖视图，其中其外科端部执行器处于关节运动构型，并且关节运动锁处于锁定构型；
图95为沿图94中的线95-95截取的图94的关节运动锁的局部剖视图；
图96为关节运动行程倍增器实施方案的部分的透视图；
图97为具有图96的关节运动行程倍增器实施方案的可互换外科工具组件实施方案的轴组件的横截面端视图；
图98A为处于未致动构型的图96的关节运动行程倍增器实施方案的部分的顶视图；
图98B为图98A的关节运动行程倍增器的部分在沿第一轴向向其施加轴向关节运动动作之后的另一顶视图；
图98C为图98A的关节运动行程倍增器的部分在沿第二轴向向其施加另一轴向关节运动动作之后的另一顶视图；
图99A为可互换外科工具组件实施方案的轴组件的部分的顶部剖视图，其中另一关节运动行程倍增器实施方案处于未致动构型；
图99B为图99A的轴组件和关节运动行程倍增器在沿第一轴向向其施加轴向关节运动动作之后的另一顶部剖视图；
图99C为另一可互换外科工具组件实施方案的轴组件的部分的顶部剖视图，其中另一关节运动行程倍增器实施方案处于未致动构型；
图99D为图99C的轴组件和关节运动行程倍增器在沿第一轴向向其施加轴向关节运动动作之后的另一顶部剖视图；
图100为通道和钉仓的分解透视图；
图101为图100的通道和钉仓的正视图；
图102为沿图101中所示的平面截取的图100的通道和钉仓的剖视正视图；
图103为通道和钉仓的分解透视图；
图104为图103的钉仓的正视图；
图105为沿图104中所示的平面截取的图103的通道和钉仓的剖视正视图；
图106为通道和钉仓的分解正视图；
图107为图106的通道和钉仓的正视图，示出了完全安装在通道中的钉仓；
图108为通道和钉仓的分解正视图；
图109为图108的通道和钉仓的正视图，示出了完全安装在通道中的钉仓；
图110为图106的钉仓和图108的通道的正视图，示出了未完全安装在通道中的钉仓；
图111为钉仓的一部分的透视图；
图112为钉仓的一部分的透视图；
图113为端部执行器的透视图；并且
图114和115示出了用于不同类型的端部执行器的标识的表。
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，并且此类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于2016年十二月21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“SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIESTHEREOF”的美国专利申请序列号15/386,185；
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS”的美国专利申请序列号15/386,221；
-名称为“SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF”的美国专利申请序列号15/386,209；
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS ANDREPLACEABLE TOOL ASSEMBLIES”的美国专利申请序列号15/386,198；以及
-名称为“SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR”的美国专利申请序列号15/386,240；
本申请的申请人拥有于2016年十二月21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“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,939；
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FORSHIFTING BETWEEN CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES ANDARTICULATION AND FIRING SYSTEMS”的美国专利申请序列号15/385,941；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,943；
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTIONFEATURES”的美国专利申请序列号15/385,950；
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,945；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,946；
-名称为“SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASINGA JAW OPENING DISTANCE”的美国专利申请序列号15/385,951；
-名称为“METHODS OF STAPLING TISSUE”的美国专利申请序列号15/385,953；
-名称为“FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FORSURGICAL END EFFECTORS”的美国专利申请序列号15/385,954；
-名称为“SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOPARRANGEMENTS”的美国专利申请序列号15/385,955；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,948；
-名称为“SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号15/385,956；
-名称为“SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTINGFIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT”的美国专利申请序列号15/385,958；以及
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,947；
本申请的申请人拥有于2016年十二月21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 RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT”的美国专利申请序列号15/385,896；
-名称为“STAPLE FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENTTYPES OF STAPLES”的美国专利申请序列号15/385,898；
-名称为“SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL”的美国专利申请序列号15/385,899；
-名称为“STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISINGWINDOWS DEFINED THEREIN”的美国专利申请序列号15/385,901；
-名称为“SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER”的美国专利申请序列号15/385,902；
-名称为“STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/ORSPENT CARTRIDGE LOCKOUT”的美国专利申请序列号15/385,904；
-名称为“FIRING ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,905,；
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUTAND A FIRING ASSEMBLY LOCKOUT”的美国专利申请序列号15/385,907；
-名称为“FIRING ASSEMBLY COMPRISING A FUSE”的美国专利申请序列号15/385,908；以及
-名称为“FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE”的美国专利申请序列号15/385,909；
本申请的申请人拥有于2016年十二月21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“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列号15/385,920；
-名称为“ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS”的美国专利申请序列号15/385,913；
-名称为“METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPES OFSTAPLE CARTRIDGES WITH THE SAME SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/385,914；
-名称为“BILATERALLY ASYMMETRIC STAPLE FORMING POCKET PAIRS”的美国专利申请序列号15/385,893；
-名称为“CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICALINSTRUMENTS WITH SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号15/385,929；
-名称为“SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING ANDFIRING SYSTEMS”的美国专利申请序列号15/385,911；
-名称为“SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES”的美国专利申请序列号15/385,927；
-名称为“STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPINGBREADTHS”的美国专利申请序列号15/385,917；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING PRIMARYSIDEWALLS AND POCKET SIDEWALLS”的美国专利申请序列号15/385,900；
-名称为“NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FORSURGICAL STAPLERS”的美国专利申请序列号15/385,931；
-名称为“FIRING MEMBER PIN ANGLE”的美国专利申请序列号15/385,915；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMINGSURFACE GROOVES”的美国专利申请序列号15/385,897；
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES”的美国专利申请序列号15/385,922；
-名称为“SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS”的美国专利申请序列号15/385,924；
-名称为“SURGICAL INSTRUMENTS WITH JAWS THAT ARE PIVOTABLE ABOUT AFIXED AXIS AND INCLUDE SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号15/385,912；
-名称为“ANVIL HAVING A KNIFE SLOT WIDTH”的美国专利申请序列号15/385,910；
-名称为“CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号15/385,903；以及
-名称为“FIRING MEMBER PIN CONFIGURATIONS”的美国专利申请序列号15/385,906；
本申请的申请人拥有于2016年十二月21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“STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES”的美国专利申请序列号15/386,188；
-名称为“STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAPSETTING FEATURES”的美国专利申请序列号15/386,192；
-名称为“STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES”的美国专利申请序列号15,386,206；
-名称为“DURABILITY FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIESOF SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,226；
-名称为“SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITHPOSITIVE OPENING FEATURES”的美国专利申请序列号15/386,222；以及
-名称为“CONNECTION PORTIONS FOR DISPOSABLE LOADING UNITS FOR SURGICALSTAPLING INSTRUMENTS”的美国专利申请序列号15/386,236；
本申请的申请人拥有于2016年十二月21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 ATTACHING A SHAFT ASSEMBLY TO A SURGICALINSTRUMENT AND,ALTERNATIVELY,TO A SURGICAL ROBOT”的美国专利申请序列号15/385,887；
-名称为“SHAFT ASSEMBLY COMPRISING A MANUALLY-OPERABLE RETRACTIONSYSTEM FOR USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号15/385,889；
-名称为“SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE ANDRETRACTABLE SYSTEMS”的美国专利申请序列号15/385,890；
-名称为“SHAFT ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO ADAPT THEOUTPUT OF A ROTARY FIRING MEMBER TO TWO DIFFERENT SYSTEMS”的美国专利申请序列号15/385,891；
-名称为“SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO ANARTICULATION STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM”的美国专利申请序列号15/385,892；
-名称为“SHAFT ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,894；以及
-名称为“SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATIONLOCKOUTS”的美国专利申请序列号15/385,895；
本申请的申请人拥有于2016年十二月21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“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,916；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,918；
-名称为“SURGICAL STAPLE CARTRIDGE WITH MOVABLE CAMMING MEMBERCONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES”的美国专利申请序列号15/385,921；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,923；
-名称为“JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OFA FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN FIRED CARTRIDGE ISINSTALLED IN THE END EFFECTOR”的美国专利申请序列号15/385,925；
-名称为“AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYINGCLOSURE MOTIONS TO JAWS OF SURGICAL INSTRUMENTS”的美国专利申请序列号15/385,926；
-名称为“PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN AMOVABLE JAW AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT”的美国专利申请序列号15/385,928；
-名称为“SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERATING OPENINGFEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS”的美国专利申请序列号15/385,930；
-名称为“ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFTARRANGEMENT”的美国专利申请序列号15/385,932；
-名称为“ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLELINKAGE DISTAL OF AN ARTICULATION LOCK”的美国专利申请序列号15/385,933；
-名称为“ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR INAN ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE SYSTEM”的美国专利申请序列号15/385,934；
-名称为“LATERALLY ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FORLOCKING AN END EFFECTOR OF A SURGICAL INSTRUMENT IN AN ARTICULATEDCONFIGURATION”的美国专利申请序列号15/385,935；以及
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKEAMPLIFICATION FEATURES”的美国专利申请序列号15/385,936；
本申请的申请人拥有于2016年六月24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“STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES”的美国专利申请序列号15/191,775；
-名称为“STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPEDSTAPLES”的美国专利申请序列号15/191,807；
-名称为“STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME”的美国专利申请序列号15/191,834；
-名称为“STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES”的美国专利申请序列号15/191,788；以及
-名称为“STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL STAPLE ROWS”的美国专利申请序列号15/191,818；
本申请的申请人拥有于2016年六月24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“SURGICAL FASTENER”的美国设计专利申请序列号29/569,218；
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,227；
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,259；以及
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,264。
本申请的申请人拥有于2016年四月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“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“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年十二月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年二月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年二月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年六月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年三月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，现为美国专利申请公布2016/0256184；
-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；现为美国专利申请公布2016/02561185；
-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，现为美国专利申请公布2016/0256154；
-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，现为美国专利申请公布2016/0256071；
-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，现为美国专利申请公布2016/0256153；
-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，现为美国专利申请公布2016/0256187；
-名称为“INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/640,817，现为美国专利申请公布2016/0256186；
-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，现为美国专利申请公布2016/0256155；
-名称为“SMART SENSORS WITH LOCAL SIGNAL PROCESSING”的美国专利申请序列号14/640,837，现为美国专利申请公布2016/0256163；
-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，现为美国专利申请公布2016/0256160；
-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，现为美国专利申请公布2016/0256162；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，现为美国专利申请公布2016/0256161；
本申请的申请人拥有于2015年二月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，现为美国专利申请公布2016/0249919；
-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，现为美国专利申请公布2016/0249915；
-名称为“SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONEOR MORE BATTERIES”的美国专利申请序列号14/633,560，现为美国专利申请公布2016/0249910；
-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，现为美国专利申请公布2016/0249918；
-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，现为美国专利申请公布2016/0249916；
-名称为“REINFORCED BATTERY FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,542，现为美国专利申请公布2016/0249908；
-名称为“POWER ADAPTER FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,548，现为美国专利申请公布2016/0249909；
-名称为“ADAPTABLE SURGICAL INSTRUMENT HANDLE”的美国专利申请序列号14/633,526，现为美国专利申请公布2016/0249945；
-名称为“MODULAR STAPLING ASSEMBLY”的美国专利申请序列号14/633,541，现为美国专利申请公布2016/0249927；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，现为美国专利申请公布2016/0249917；
本申请的申请人拥有于2014年十二月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 MEMBER”的美国专利申请序列号14/574,478，现为美国专利申请公布2016/0174977；
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS”的美国专利申请序列号14/574,483，现为美国专利申请公布2016/0174969；
-名称为“DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS”的美国专利申请序列号14/575,139，现为美国专利申请公布2016/0174978；
-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，现为美国专利申请公布2016/0174976；
-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，现为美国专利申请公布2016/0174972；
-名称为“SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS”的美国专利申请序列号14/575,143，现为美国专利申请公布2016/0174983；
-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，现为美国专利申请公布2016/0174975；
-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，现为美国专利申请公布2016/0174973；
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLEARTICULATION SYSTEM”的美国专利申请序列号14/574,493，现为美国专利申请公布2016/0174970；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，现为美国专利申请公布2016/0174971。
本申请的申请人拥有于2013年三月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9,358,003；
-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9,326,767；
-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9,468,438；
-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9,398,911；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9,307,986。
本申请的申请人还拥有于2013年三月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9,332,987；
-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9,351,726；
-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9,351,727；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年三月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年三月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2014年九月5日提交并且全文各自以引用的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“POLARITY OF HALL MAGNET TO DETECT MISLOADED CARTRIDGE”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2014年四月9日提交并且全文各自以引用的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2013年四月16日提交并且全文各自以引用的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一体结构、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”一个或多个特征部的系统、装置、或设备的元件具有那些一个或多个特征部，但不限于仅具有那些一个或多个特征部。
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执行腹腔镜式和微创外科规程。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、通过成形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它实施方案。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，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。砧座朝向钉仓移动以将组织压缩并夹紧抵靠平台。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也是可能的。
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移动，以从钉仓射出钉。驱动装置通过保持器保留在仓体中，所述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。驱动装置能够通过滑动件在其非击发位置与其击发位置之间移动。滑动件能够在邻近近侧端部的近侧位置和邻近远侧端部的远侧位置之间移动。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向远侧移动。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。限定于仓体中的纵向狭槽被构造成能够接纳击发构件。砧座还包括被构造成能够接纳击发构件的狭槽。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。在击发构件向远侧推进时，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地在斜坡表面的近侧，使得钉先于刀被射出。
图1示出了可操作地联接到马达驱动柄部组件500的可互换外科工具组件1000的一种形式。可互换外科工具组件1000可还有效地与机器人控制或自动化外科系统的工具驱动组件一起采用。例如，本文所公开的外科工具组件可与(诸如但不限于)名称为“SURGICALSTAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利9,072,535中公开的各种机器人系统、器械、部件和方法一起采用，该专利申请据此全文以引用方式并入本文。柄部组件500以及机器人系统的工具驱动组件在本文中也可称为“控制系统”或“控制单元”。
图2示出了可互换外科工具组件1000到柄部组件500的附接。柄部组件500可包括柄部外壳502，柄部外壳包括可由临床医生抓握和操纵的手枪式握把部504。柄部组件500还可包括操作地支撑多个驱动系统的框架506。例如，框架506可操作地支撑通常被标记为510的“第一”或闭合驱动系统，可采用该“第一”或闭合驱动系统以将闭合动作和打开动作操作地施加到附接或联接到柄部组件500的可互换外科工具组件1000。在至少一种形式中，闭合驱动系统510可包括被框架506枢转地支撑的闭合触发器512形式的致动器。此类构造使得闭合触发器512将能够由临床医生操纵，使得当临床医生握持柄部组件500的手枪式握持部部504时，闭合触发器512可容易从启动或“未致动”位置枢转到“致动”位置并且更具体地枢转到完全压缩或完全致动位置。在各种形式中，闭合驱动系统510还包括枢转地联接到闭合触发器512或以其它方式操作地与其连接的闭合连杆组件514。如下面将进一步详细讨论的，在例示的示例中，闭合连杆组件514包括横向附接销516，其促进附接到外科工具组件上的对应驱动系统。在使用中，为了致动闭合驱动系统510，临床医生将闭合触发器512朝向手枪式握把部504压下。如在名称为“SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM”的美国专利申请序列号14/226,142即现在的美国专利申请公布2015/0272575(该专利据此全文以引用方式并入本文)中进一步详细描述的，当临床医生完全压下闭合触发器512以获得“完全”闭合行程时，闭合驱动系统510被构造成能够将闭合触发器512锁定在完全压下或完全致动位置。当临床医生期望将闭合触发器512解锁以允许其被偏置到未致动位置时，临床医生只需激活闭合释放按钮组件518，这使得闭合触发器512能够返回到未致动位置。闭合释放按钮组件518可还被构造成能够与各种传感器交互，这些传感器与柄部组件500中的微控制器520通信以跟踪闭合触发器512的位置。有关闭合触发器518的构型和操作的进一步细节可见于美国专利申请公布2015/0272575中。
在至少一种形式中，柄部组件500和框架506可以可操作地支撑在本文中被称为击发驱动系统530的另一个驱动系统，该驱动系统被构造成能够将轴向或击发动作施加到附接到其上的可互换外科工具组件的对应部分。如在美国专利申请公布2015/0272575中详细描述的，击发驱动系统530可采用位于柄部组件500的手枪式握把部504中的电动马达505。在各种形式中，马达505例如可为具有约25,000RPM的最大旋转的直流有刷驱动马达。在其它构造中，马达505可包括无刷马达、无绳马达、同步马达、步进马达或任何其它合适的电动马达。马达505可由功率源522供电，在一种形式中，该功率源可包括可移除电源组。电源组可在其中支撑多个锂离子(“LI”)或其它合适的电池。串联连接的多个电池可用作柄部组件500的功率源522。除此之外，功率源522可为可替换的和/或可再充电的。
电动马达505被构造成能够根据马达的极性在远侧和近侧方向上轴向驱动纵向可移动的驱动构件540。例如，当马达505在一个旋转方向上被驱动时，能够纵向移动的驱动构件540将在远侧方向“DD”上轴向驱动。当马达505在相反的旋转方向上被驱动时，能够纵向移动的驱动构件540将在近侧方向“PD”上轴向驱动。柄部组件500可包括开关513，该开关可被构造成能够使由功率源522施加到电动马达505的极性反转或以其它方式控制马达505。柄部组件500还可包括被构造成能够检测驱动构件540的位置和/或驱动构件540移动的方向的一个或多个传感器(未示出)。马达505的致动可由被枢转地支撑在柄部组件500上的击发触发器532控制。击发触发器532可在未致动位置和致动位置之间枢转。击发触发器532可被弹簧(未示出)或其它偏置构造偏置到未致动位置，使得当临床医生释放击发触发器532时，其可被弹簧或偏置结构枢转到或以其它方式返回未致动位置。在至少一种形式中，击发触发器532可如上所述被定位在闭合触发器512的“外侧”。如美国专利申请公布2015/0272575中所讨论的，柄部组件500可配备有击发触发器安全按钮(未示出)，以防止击发触发器532的不经意致动。当闭合触发器512处于未致动位置时，安全按钮被容纳在柄部组件500中，在此情况下，临床医生不能容易地接近安全按钮并使安全按钮在防止击发触发器532的致动的安全位置和其中可击发击发触发器532的击发位置之间移动。临床医生按压闭合触发器512时，安全按钮和击发触发器532可向下枢转，随后可被临床医生操纵。
在至少一种形式中，能够纵向移动的驱动构件540可具有形成于其上的齿条(未示出)，其用于与连接到马达505的对应驱动齿轮装置(未示出)啮合接合。有关这些特征部的更多细节可见于美国专利申请公布2015/0272575中。至少一种形式还包括可手动致动的被构造成能够使得临床医生能够在马达505变得失效情况下手动地回缩能够纵向移动的驱动构件540的“救助”组件。救助组件可包括杠杆或救助柄部组件，其存放在释放门550下方的柄部组件500内。杠杆被构造成能够手动枢转到与驱动构件540中的齿棘轮接合。因此，临床医生可通过使用救助柄部组件来手动地回缩驱动构件540，以在近侧方向PD上啮合驱动构件540。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，其据此全部公开内容以引用方式并入本文)公开了救助布置和也可与工具组件1000一起采用的其它部件、布置和系统。
现在转向图5和图6，可互换外科工具组件1000包括可操作地附接到细长轴组件1400的轴安装部分1300。包括细长通道1102的外科端部执行器1100可操作地附接到细长轴组件1400，其中细长通道被构造成能够将外科钉仓1150可操作地支撑在其中。参见图3和图6。外科端部执行器1100还可包括相对于细长通道1102被枢转地支撑的砧座1130。其中安装有钉仓1150的细长通道1102和砧座1130也可称为端部执行器“钳口”。可互换外科工具组件1000还可包括关节运动接头1200和关节运动锁1210(图3和图6)，该关节运动锁可被构造成能够可释放地将外科端部执行器1100关于关节运动轴线B-B(横向于轴轴线SA)保持在期望的关节运动位置。有关于关节运动锁1210的构造和操作的许多细节可见于名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803,086中，现为美国专利申请公布2014/0263541，其全部公开内容据此以引用方式并入本文。关于关节运动锁1210的其它细节也可见于2016年二月9日提交的名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTED SECONDARYCONSTRAINT”的美国专利申请序列号15/019,196中，其全部公开内容据此以引用方式并入本文。
如图5和图6中所示，轴安装部分1300包括近端外壳或喷嘴1301，该喷嘴由喷嘴部分1302、1304以及致动器轮部分1306构成，致动器轮部分被构造成能够通过按扣、凸耳、螺丝等联接到组装的喷嘴部分1302、1304。在例示的实施方案中，可互换外科工具组件1000还包括闭合组件1406，其可用于将砧座1130相对于外科端部执行器1100的细长通道1102闭合和/或打开，如将在下面所进一步详述。此外，例示的可互换外科工具组件1000包括可操作地支撑关节运动锁1210的脊组件1500。脊组件1500被构造成能够：第一，可滑动地支撑其中的击发构件组件1600；第二，可滑动地支撑围绕脊组件1500延伸或以换句话说由此可移动地支撑的闭合组件1406。
在例示的布置中，外科端部执行器1100由关节运动接头1200可操作地联接到细长轴组件1400，该关节运动接头有助于外科端部执行器1100围绕横向于轴轴线SA的关节运动轴线B-B的选择性关节运动。参见图1。如图5和图6中所示，脊组件1500可滑动地支撑可操作地与关节运动锁1210连接的近侧关节运动驱动器1700。关节运动锁1210支撑在远侧框架段1560上，该远侧框架段也包括脊组件1500的一部分。如在图6中可见，远侧框架段1560包括远侧脊延伸部1562，远侧脊延伸部由端部执行器安装组件1230枢转地联接到细长通道1102。例如，在一种布置中，远侧框架段1560的远侧端部1563具有形成在其上的脊附接销1564。脊附接销1564适于枢转地接纳在脊附接孔1234内，脊附接孔形成在端部执行器安装组件1230中。参见图6。
再次参见图6，在例示的实施方案中，近侧关节运动驱动器1700具有远侧端部1702，该远侧端部被构造成能够可操作地接合关节运动锁1210。关节运动锁1210包括关节运动框架1212，关节运动框架枢转地联接或销接在远侧关节运动连接件1710上，远侧关节运动连接件还被构造成能够枢转地附接到端部执行器安装组件1230。具体地，如图6中所示，远侧关节运动连接件1710的远侧端部1712包括关节运动销1714，该关节运动销被构造成能够枢转地接纳在端部执行器安装组件1230中的对应关节运动孔1236内。远侧关节运动连接件1710由远侧脊延伸部1562可滑动地支撑。端部执行器安装组件1230由弹簧销连接器1235附接到细长通道1102的近侧端部1103，弹簧销连接器延伸穿过端部执行器安装组件1230中的横向安装孔1231，以接纳在设置在细长通道1102的近侧端部1103中的通道或钳口安装孔1106内。脊附接销1564限定横向于轴轴线SA的关节运动轴线B-B。此类布置便于外科端部执行器1100相对于脊组件1500围绕关节运动轴线B-B枢转行进(即，关节运动)。如上所述，有关关节运动锁1210和关节运动框架1212的操作的更多细节可见于美国专利申请序列号13/803,086中，现为美国专利申请公布2014/0263541。
在各种情况下，脊组件1500还包括附接到关节运动锁1210的远侧框架段1560的中间脊段1510。脊组件1500还包括近侧脊安装段1530，近侧脊安装段包括近端部分1532，该近端部分具有相对的凹口1535(在图5中仅可见一个)，用于接纳从每个喷嘴部分1302、1304向内突出的对应安装凸耳1308(如图4中所示)。通过将喷嘴1301围绕轴轴线SA旋转，此类布置促进近侧脊组件1500围绕轴轴线SA的旋转。可互换外科工具组件1000包括可旋转地支撑轴组件1400的底座1800。近侧脊安装段的近端部分1532可旋转地支撑在形成于底座1800中的中心轴孔1801中。参见图5。例如，在一种布置中，近端部分1532上具有螺纹1533，便于附接到脊轴承(未示出)或者其它方式支撑在安装在底座1800内的脊轴承中。此类布置促进脊组件1500到底座1800的可旋转附接，使得脊组件1500可选择性地相对于底座1800围绕轴轴线SA旋转。
封闭组件1406包括细长近侧闭合构件1410和远侧闭合构件1430。在例示的布置中，近侧闭合构件1410包括可滑动地支撑在脊组件1500上的中空管状构件。因此，近侧闭合构件1410在本文中也可称为“近侧闭合管”。类似地，远侧闭合构件1430也可称为“远侧闭合管”。主要参见图5，可互换外科工具组件1000包括闭合梭动件1420，该闭合梭动件以可相对于底座1800轴向移动的方式可滑动地支撑在该底座内。在一种形式中，闭合梭动件1420包括一对向近侧突出的钩1421，它们被构造用于附接到横向附接销516(图2)，该横向附接销附接到柄部组件500的闭合连杆组件514。因此，当钩1421钩在横向附接销516上时，闭合触发器512的致动将导致闭合梭动件1420的轴向移动，并最终导致闭合组件1406在脊组件1500上的轴向移动。闭合弹簧(未示出)也可轴颈连接在闭合组件1406上并且用于将闭合组件1406向近侧方向“PD”偏压，这可在外科工具组件1000操作地联接到柄部组件500时用于将闭合触发器512枢转到未致动位置中。在使用中，闭合组件1406向远侧(方向DD)平移，以(例如)响应于闭合触发器512的致动而闭合钳口1130、1102。
闭合连杆组件514在本文中也可称为“闭合致动器”，而且闭合连杆组件514和闭合梭动件1420在本文中可统称为“闭合致动器组件”。近侧闭合构件1410的近侧端部1412联接到闭合梭动件1420，以相对于闭合梭动件旋转。例如，将U形连接器1424插入近侧闭合构件1410的近侧端部1412中的环形狭槽1414中，使其保留在闭合梭动件1420中的竖直狭槽1422内。参见图5。此类布置用于将近侧闭合构件1410附接到闭合梭动件1420，以与闭合梭动件一起轴向行进，同时使得闭合组件1406能够围绕轴轴线SA相对于闭合梭动件1420旋转。
如上所述，例示的可互换外科工具组件1000包括关节运动接头1200。如在图6中可见，上柄脚1415和下柄脚1416从近侧闭合构件1410的远侧端部向远侧突出，以可移动地联接到远侧闭合构件1430。同样如在图6中可见，远侧闭合构件1430包括从其近侧端部向近侧突出的上柄脚1434和下柄脚1436。近侧闭合构件1410和远侧闭合构件1430由上部双枢转连接件1220联接在一起。上部双枢转连接件1220包括近侧销和远侧销，近侧销和远侧销分别接合近侧闭合构件1410和远侧闭合构件1430的上柄脚1415、1434中的对应孔。近侧闭合构件1410和远侧闭合构件1430同样由下部双枢转连接件1222联接在一起。下部双枢转连接件1222包括近侧销和远侧销，近侧销和远侧销分别接合近侧闭合构件1410和远侧闭合构件1430的下柄脚1416和1436中的对应孔。如下面将进一步详细讨论的，闭合组件1406的远侧和近侧轴向平移将导致砧座1130的闭合和打开。
图1至6中示出的可互换外科工具组件1000包括外科端部执行器1100，其能够在一个方向上围绕关节运动轴线B-B进行关节运动。如上所述，关节运动轴线B-B由脊附接销1564限定，脊附接销可旋转地接纳在形成于端部执行器安装组件1230中的脊附接孔1234内。在所示的布置中，脊附接孔1234可横向地与轴轴线SA轴向对准。在其它布置中，脊附接孔1234可从轴轴线略微侧向偏离。在例示的示例中，关节运动轴线B-B横向于轴轴线SA并与轴线轴线SA相交。所示的示例仅采用近侧关节运动驱动器1700，该近侧关节运动驱动器与单个远侧关节运动连接件1710(通过关节运动锁1210)连接，该远侧关节运动连接件可操作地与端部执行器安装组件1230连接以向其施加关节运动动作。例如，将远侧关节运动连接件1710向远侧推进将使外科端部执行器1100在单个“第一”关节运动方向上进行关节运动。例如，在一种布置中，外科端部执行器1100能够从第一非关节运动位置选择性地关节运动，在该位置，外科端部执行器1100与轴组件1400轴向对准(用于插入穿过套管针或其它进入开口)通过大约110°的关节角度(在外科端部执行器1100已经将套管针退出到患者体内之后)。可实现其它关节运动角度布置。
例如，如图7中可看到，可互换外科工具组件1000可非常适合与称为下前切除术“LAR”的医疗规程结合使用。此类规程通常涉及去除结肠的患病部分。例如，该规程可包括去除与该部分肠相关的血管和淋巴结。外科医生随后重新连接剩余的结肠和直肠的剩余部分(这可称为吻合术)。在此规程中外科医生通常面临的一个挑战为将端部执行器放入骨盆区域中足够远来完成规程。图7示出了在患者的结肠410切除期间，外科端部执行器1100在患者的骨盆400内的期望位置。图7中的线BTL可示出通常由患者的骨盆骨结构和相关组织产生的行进限制。在所示的布置中，外科工具组件1000采用“不对称的”近侧闭合构件1410，该近侧闭合构件被构造成能够为该区域内的外科工具组件1000提供附加的间隙和可操纵性。
在一个示例中，如图7中所示，轴组件1400的近侧闭合构件1410包括细长近端部分1417和从近端部分1417延伸的细长远端部分1411。如在图7至9中可见，为了促进轴组件1400和例如骨盆结构之间的更多间隙，在近侧闭合构件1410的远端部分1411中设置不对称切口或凹口区域1418。在至少一个示例中，凹口区域1418延伸用于整个远端部分1411。在此类布置中，远端部分的轴向长度小于近端部分1417的轴向长度。
现在参见图11，在例示的示例中，近端部分1417具有不间断的或“连续的”“近侧”外周边或周边形状1417P。远端部分1411的至少一部分具有不连续或间断的“远侧”外周边或外周边形状1411P。例如，同样可见于图9中，远侧脊延伸部1562在其中具有类似的凹口区域1568。而且，中间脊段1510可还在其中具有与凹口区域1418和1568匹配的不对称凹口1516。参见图10和图11。此类布置可允许临床医生将轴组件1400和外科端部执行器1100定位在图7中所示的骨盆区域内的位置。例如，在所示的布置中，关节运动角AA可为大约110°。因此，与其它工具和端部执行器布置相比，此类布置可使临床医生能够将外科端部执行器1100定位在骨盆区域内的更深处。在所示的布置中，凹口区域1418、1516、1568位于轴轴线SA的相对侧，端部执行器1100从该侧进行关节运动(例如，关节运动方向DA)。然而，在其它布置中，能够想到凹口区域1418、1516、1568设置在轴轴线SA的同一侧上，外科端部执行器从该侧进行关节运动。
在一个示例中，为了当近侧闭合构件1410在脊组件1500上轴向移动时将该近侧闭合构件在该脊组件上保持轴向对准并且为了在端部执行器钳口1130、1102的关节运动和闭合期间延迟或防止轴部件的屈曲，采用了相对的闭合对准构件1413。例如，在一种布置中，一对沿直径相对的对准销1413附接到近侧闭合构件1410并从近侧闭合构件向内延伸，以可滑动地接纳分别在中间脊段1510和远侧脊延伸部1562中的对应对准狭槽1514、1566内。参见图10和图11。在图11中也可见，远侧脊延伸部1562可具有凹进区域1567，用于接纳形成在中间脊段1510的下侧上的向下突出的凸耳部分1518。此类布置可用于将中间脊段1510和远侧脊延伸部1562在一定程度上侧向地互锁在一起，从而抵抗在这些部件之间发生的任何侧向偏转。图12示出了另选的近侧闭合构件1410'，其与上述近侧闭合构件1410相同，不同的是近侧闭合构件1410'包括在上柄脚1415和下柄脚1416之间延伸的连接器桥1419，该连接器桥可用于限制上柄脚1415和下柄脚1416在使用过程中展开的任何趋势。
图13示出了另一种布置，其被构造成能够当侧向载荷LL在凹口区域中侧向地施加到轴组件1400时防止或限制近侧闭合构件1410”在OD方向上打开。除了本文所述的不同之外，近侧闭合构件1410”可与近侧闭合构件1410相同。如图13中可看到，近侧闭合构件1410”还包括一对向内突出的略微沿直径相对的挠曲片1425。一个挠曲片1425可滑动地接纳在对应的轴向延伸狭槽1519内，另一个挠曲片1425可滑动地接纳在远侧脊延伸部1562中的对应的轴向狭槽1569内。此类布置用于将近侧闭合构件1410”可滑动地互锁在脊组件1500'上，从而当向侧向载荷LL施加到其上时使近侧闭合构件1410”抵抗打开(在OD方向上)。图14示出了采用挠曲片1425’的一种另选布置，该挠曲片略微呈L形并且可滑动地接纳在对应的L形狭槽1514'和1569'内。
如上所述，可互换外科工具组件1000还包括击发构件组件1600，该击发构件组件被支撑以便在脊组件1500内轴向行进。在例示的实施方案中，击发构件组件1600包括近侧击发轴段1602和远侧切割部分或远侧击发杆1620。击发构件组件1600在本文中也可被称为“第二轴”和/或“第二轴组件”。如图5中可见，近侧击发轴段1602包括近侧附接凸耳1604，该近侧附接凸耳从其近侧端部向近侧突出，该近侧端部被构造成能够可操作地接纳在能够纵向移动的驱动构件540中的击发轴附接支架542内，该能够纵向移动的驱动构件被支撑在柄部组件中500。参见图2。
再次参见图5，近侧击发轴段1602的远侧端部1606包括纵向狭槽1608，该纵向狭槽被构造成能够接纳远侧击发杆1620的近侧端部上的接片(未示出)。纵向狭槽1608和远侧击发杆1620的近侧端部可被设计尺寸并被构造成能够允许它们之间的相对移动并且可包括滑动接头1622。滑动接头1622可以允许近侧击发轴段1602在关节运动致动期间移动，而不移动或至少基本上不移动远侧击发杆1620。一旦端部执行器1100已合适地取向，近侧击发轴段1602便可向远侧推进，直到狭槽1608的近侧端壁与远侧击发杆1620上的插片发生接触，以便推进远侧击发杆1620并击发定位在细长通道1102内的外科钉仓1150。如在图5中可进一步看出，中间脊段1510包括用于将近侧击发轴段1602可滑动地支撑在其中的通道1512。为了便于组装近侧击发轴段1602和脊组件1500，顶部脊盖1527可与中间脊段1510接合，以将击发构件组件1600的那些部分封闭在其中。
图15示出了处于关节运动位置的外科端部执行器1100。如在图15以及图6中可见，采用中间支撑构件1614以在远侧击发杆1620弯曲时为远侧击发杆提供侧向支撑，以适应外科端部执行器1100的关节运动。在一个示例中，远侧枢转销1615从中间支撑构件1614的远侧端部突出并且被接纳在端部执行器安装组件1230中的脊附接孔1234内。近侧枢转销1616被接纳在远侧脊延伸部1562中的细长狭槽1569内。此外，中间支撑构件1614包括其中的通道1618，当外科端部执行器1100进行关节运动时，该通道为远侧击发杆1620提供侧向支撑。关于中间支撑构件和另选刀杆支撑布置的进一步细节在美国专利申请序列号15/019,245中公开，该专利申请全文以引用方式并入本文。
图15A示出了另选关节运动接头1200'，其促进外科端部执行器1100围绕关节运动轴线B-B的关节运动，关节轴线B-B横向于轴轴线SA，轴轴线SA由细长轴组件1400'限定，该细长轴组件可操作地附接到外科端部执行器。在例示的示例中，外科端部执行器1100能够选择性地关节运动到轴轴线SA的一侧。此类关节运动方向由箭头LD表示。类似于上述实施方案，端部执行器安装组件1230枢转地附接到外科端部执行器1100的细长通道1102的近侧端部1103。端部执行器安装组件1230枢转地附接到细长轴组件1400'的远侧框架段1560的远侧脊延伸部1562。类似于上述实施方案，远侧框架段1560可以可操作地支撑关节运动锁1210(图6)，该关节运动锁由近侧关节运动驱动器1700(图6)致动，该近侧关节运动驱动器可操作地与关节运动和回缩动作源连接，如本文详细描述。在图15A中所示的示例中，端部执行器安装组件1230由远侧支撑连接件1570枢转地连接到远侧脊延伸部1562。例如，在一种布置中，端部执行器安装组件1230由限定关节运动轴线B-B的关节运动销1580销接到远侧支撑连接件1570的远侧端部1572。远侧支撑连接件1570的近侧端部1574附接到远侧脊延伸部1562的远侧端部1563，以相对于其进行轴向行进和枢转行进。
如图15A中可以进一步看到的，远侧支撑连接件1570的近侧端部1574包括轴向狭槽1576，该轴向狭槽的尺寸被设计成可滑动地且枢转地在其中接纳附接到远侧脊延伸部1562的近侧附接销1578。此类布置用于将外科端部执行器1100联接到远侧框架段1560，用于围绕关节运动轴线B-B的选择性枢转行进(关节运动)以及相对于该轴线的一些有限的轴向行进。在所示的布置中，关节运动由远侧关节运动连接件1710施加到外科端部执行器1100，远侧关节运动连接件枢转地联接到关节运动锁1210或以其它方式可操作地与关节运动锁连接。远侧关节运动连接件1710在近侧方向PD上的轴向移动(其被约束为沿轴轴线SA的一侧轴向移动)将使外科端部执行器1100从非关节运动位置在向左方向LD进行关节运动，其中外科端部执行器1100在轴轴线SA上轴向对准到轴轴线SA的左侧上的关节运动位置(在图15A中以虚线表示)。远侧关节运动连接件1710在远侧方向DD上的轴向移动将使外科端部执行器1100从关节运动位置朝向未致动位置移动(箭头RD)。在一种布置中，止动构件或止动形成物1232形成或以其它方式附接到端部执行器安装组件1230，以在外科端部执行器1100已经到达未致动位置时接触远侧脊延伸部的远侧端部1563，以防止外科端部执行器在向右方向RD的任何进一步行进。此类关节运动接头布置可提供改进的关节运动行进和闭合稳定性。
除上述之外，可互换外科工具组件1000包括离合器组件1640，该离合器组件可被构造成能够选择性地且可释放地将近侧关节运动驱动器1700联接到击发构件组件1600。在一种形式中，离合器组件1640包括旋转锁定组件，在至少一个实施方案中，该旋转锁定组件包括围绕击发构件组件1650定位的锁定衬圈或锁定套筒1600。锁定套筒1650被构造成能够在接合位置和脱离位置之间旋转，在接合位置，锁定套筒1650将近侧关节运动驱动器1700联接到击发构件组件1600，在脱离位置，近侧关节运动驱动器1700未操作地联接到击发构件组件1600。当锁定套筒1650处于其接合位置时，击发构件组件1600的远侧移动可使近侧关节运动驱动器1700向远侧移动，对应地，击发构件组件1600的近侧移动可使近侧关节运动驱动器1700向近侧移动。当锁定套筒1650处于其脱离位置时，击发构件组件1600的移动不传递到近侧关节运动驱动器1700，因此，击发构件组件1600可独立于近侧关节运动驱动器1700移动。在各种情况下，当击发构件组件1600没有使近侧关节运动驱动器1700在近侧或远侧方向上移动时，近侧关节运动驱动器1700可被关节运动锁1210保持就位。
主要参考图4和图5，锁定套筒1650包括圆柱形或至少基本上圆柱形的主体，该主体包括纵向孔1652，纵向孔被构造成能够接纳击发构件组件1600的近侧击发轴段1602。锁定套筒1650还具有两个沿直径相对的、面向内的锁定突出部1654和形成于其上的向外突出的第二锁定构件1656。锁定突出部1654可被构造成能够选择性地与击发构件组件1600的近侧击发轴段1602接合。更具体地，当锁定套筒1650处于其接合位置时，锁定突出部1654被定位在设置于近侧击发轴段1602中的驱动凹口1603内，使得远侧推力和/或近侧推力可从击发构件组件1600传递至锁定套筒1650。当锁定套筒1650处于其接合位置时，第二锁定构件1656被接纳在近侧关节运动驱动器1700中限定的驱动凹口1704内，使得施加到锁定套筒1650的远侧推力和/或近侧拉力可传递到关节运动驱动器1700。实际上，当锁定套筒1650处于其接合位置时，击发构件组件1600、锁定套筒1650和近侧关节运动驱动器1700将一起移动。另一方面，当锁定套筒1650处于其脱离位置时，锁定突出部1654可不定位在击发构件组件1600的近侧击发轴段1602的驱动凹口1603内；并且因此，远侧推力和/或近侧推力可不从击发构件组件1600传递至锁定套筒1650。对应地，远侧推力和/或近侧拉力可不传递至近侧关节运动驱动器1700。在此类情况下，击发构件组件1600可相对于锁定套筒1650和近侧关节运动驱动器1700向近侧和/或向远侧滑动。
离合器组件1640还包括与锁定套筒1650接合的切换筒1630。关于切换筒1630和锁定套筒1650的操作的进一步细节可见于美国专利申请序列号13/803,086和美国专利申请序列号15/019,196中，这两个申请各自全文以引用方式并入本文。切换筒1630还可包括限定于其中的至少部分周向延伸的开口1632，所述开口可以接纳从喷嘴部分1302、1304延伸的周边安装座1305，并且允许切换筒1630和近侧喷嘴1301之间的相对旋转而不是相对平移。参见图6。喷嘴1301至其中安装座到达其在切换筒1630中的相应开口1632的端部的点的旋转将导致切换筒1630围绕轴轴线SA的旋转。切换筒1630的旋转最终将导致锁定套筒1650在其接合位置和脱离位置之间移动。在另选的实施方案中，可采用喷嘴1301以使关节运动驱动系统与击发驱动系统可操作地接合和脱离。如上所述，离合器组件1640可以美国专利申请序列号13/803,086和美国专利申请序列号15/019,196中进一步详细描述的各种方式操作。
在所示的布置中，切换筒1630包括L形狭槽1636，该狭槽延伸到切换筒1630中的远侧开口1637中。远侧开口1637接纳移动板1638的横向切换销1639。在一个示例中，移动板1638接纳在设置在锁定套筒1650中的纵向狭槽(未示出)内，以当锁定套筒1650与近侧关节运动驱动器1700接合时促进该锁定套筒的轴向移动。关于移动板和移动鼓布置的操作的进一步细节可见于2015年九月28日提交的名称为“SURGICAL STAPLING INSTRUMENT WITHSHAFT RELEASE,POWERED FIRING AND POWERED ARTICULATION”的美国专利申请序列号14/868,718中，该申请的整个公开内容据此以引入方式并入本文。
另外在例示的实施方案中，切换筒1630包括磁体支撑臂1665，该磁体支撑臂支撑磁体或被构造成能够与霍尔效应传感器1662可操作地交接的其它传感器布置，该霍尔效应传感器与可操作地安装到底座1660的滑环组件1800交接。例如，滑环组件1660被构造成能够将电力传导到可互换外科工具组件1000和/或从可互换外科工具组件传导电力和/或将信号传递到可互换外科工具组件1000和/或从可互换外科工具组件部件传送回柄部组件500中的微控制器520(图2)或机器人系统控制器。关于滑环组件1660和相关联的连接器的进一步细节可见于美国专利申请序列号13/803,806和美国专利申请序列号15/019,196(这两个专利申请的相应全部内容各自以引用方式并入本文)以及名称为“STAPLE CARTRIDGETISSUE THICKNESS SENSOR SYSTEM”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)中，其全部内容据此以引用方式并入本文。支撑在磁体支撑臂1665上的一个或多个磁体与霍尔效应传感器1662或其它传感器装置配合以检测切换筒1630的旋转位置并将该信息传送到微控制器520，微控制器可用于以在上述并入的参考文献中讨论的各种方式向使用者提供一个或多个指示。也可采用其它传感器布置。
再次参见图2和图5，底座1800包括其上形成的至少一个、优选地两个锥形附接部分1802，该锥形附接部分适于被接纳在对应的燕尾形狭槽507内，所述燕尾形狭槽在柄部组件500的框架506的远端部分内形成。如可在图2中进一步所见，轴附接凸耳1607在近侧击发轴段1602的近侧端部上形成。如将在下文进一步详细地讨论，当可互换外科工具组件1000联接到柄部组件500时，轴附接凸耳1607被接纳在击发轴附接支架542中，该击发轴附接支架在能够纵向移动的驱动构件540的远侧端部中形成。参见图2。
可互换外科工具组件1000采用闩锁系统1810，用于将可互换外科工具组件1000可移除地联接到柄部组件500的框架506。如可在图5中所见，例如，在至少一种形式中，闩锁系统1810包括可移动地联接到底盘1800的锁构件或锁轭1812。在例示的实施方案中，例如，锁轭1812为U形，并且包括两个向下延伸的支脚1814。支脚1814各自具有在其上形成的枢转凸耳(未示出)，这些枢转凸耳适于被接纳在底座1800中形成的对应孔1816中。此类构造促进将锁定轭1812枢转附接到底座1800。锁定轭1812可包括两个向近侧突出的锁定凸耳1818，这两个锁定凸耳被构造成能够与柄部组件500的框架506的远侧端部中的对应锁定棘爪或凹槽509可释放地接合。参见图2。在各种形式中，锁定轭1812被弹簧或偏置构件1819沿近侧方向偏置。锁定轭1812的致动可通过可滑动地安装在闩锁致动器组件1822上的闩锁按钮1820来实现，该闩锁致动器组件安装到底盘1800。闩锁按钮1820可相对于锁定轭1812沿近侧方向偏置。锁定轭1812可通过沿远侧方向偏置闩锁按钮1820而移动到解锁位置，这也使锁定轭1812枢转成不再与框架506的远侧端部保持接合。当锁定轭1812与框架506的远侧端部“保持接合”时，锁定凸耳1818保持坐置在框架506的远侧端部中对应的锁定止动器或凹槽509内。
在所示的布置中，锁定轭1812包括至少一个且优选两个锁定钩1824，这些锁定钩适于接触在闭合梭动件1420上形成的对应锁定凸耳部分1426。当闭合梭动件1420处于未致动位置时，锁定轭1812可沿远侧方向枢转以将可互换外科工具组件1000从柄部组件500解锁。当处于该位置时，锁定钩1824不接触闭合梭动件1420上的锁定凸耳部分1426。然而，当闭合梭动件1420移动到致动位置时，防止锁定轭1812枢转到解锁位置。换句话讲，如果临床医生试图将锁定轭1812枢转到解锁位置，或者例如，锁定轭1812不经意地以原本可能引起其向远侧枢转的方式受到碰撞或发生接触，则锁定轭1812上的锁定钩1824将接触闭合梭动件1420上的锁定凸耳1426，并且防止锁定轭1812移动到解锁位置。参见图5。有关闩锁系统的更多细节可见于美国专利申请公布2014/0263541中。
现在将参照图2描述可互换外科工具组件1000与柄部组件500的附接。要开始联接过程，临床医生可将可互换外科工具组件1000的底座1800定位在框架506的远侧端部上方或附近，使得底座1800上形成的锥形附接部分1802与框架506中的燕尾形狭槽507对准。然后临床医生可将外科工具组件1000沿垂直于轴轴线SA的安装轴线IA移动，以使锥形附接部分1802安置成与框架506的远侧端部中的对应燕尾形接纳狭槽507“可操作地接合”。这样做时，近侧击发轴段1602上的轴附接凸耳1606也将安置在能够纵向移动的驱动构件540中的支架542中，并且闭合连杆组件514上的横向附接销516的部分将安置在闭合梭动件1420中的对应钩1421中。如本文所用，术语“可操作地接合”在两个部件的背景下是指这两个部件彼此充分地接合，使得一旦向其施加致动动作，这些部件便可执行其预期行动、功能和/或程序。
再次参见图11和15，远侧击发杆1620可包括层压梁结构，该层压梁结构包括至少两个梁层。这些梁层可包括例如不锈钢带，这些带通过例如在其近侧端部和/或沿其长度的其它位置处焊接或钉扎而互连在一起。在另选的实施方案中，这些带的远侧端部不连接在一起，以允许层压体或带在端部执行器进行关节运动时相对于彼此展开。此类布置允许远侧击发杆1620足够柔韧以适应端部执行器的关节运动。各种其它合适的层压刀杆布置在美国专利申请序列号15/019,245中公开。如同样在图4中可见，采用中间支撑构件1614以在远侧击发杆1620弯曲时为远侧击发杆提供侧向支撑，以适应外科端部执行器1100的关节运动。关于中间支撑构件和另选刀杆支撑布置的进一步细节在美国专利申请序列号15/019,245中公开。
在可互换外科工具组件1000已可操作地联接到柄部组件500(图1)之后，临床医生可如下操作外科工具组件1000。如上所述，当闭合驱动系统510处于其未致动位置时(即，闭合触发器512未被致动)，扭转弹簧1642已偏置离合器组件1640，更具体地，偏置切换销1639和锁定套筒1650进入关节运动位置。当处于该模式时，磁体支撑臂1665中的一个或多个磁体可与霍尔效应传感器1662或其它传感器布置协作，以向微控制器520指示外科工具组件1000处于关节运动模式。当临床医生致动击发触发器532时，马达将近侧击发轴段1602向远侧驱动。然而，如上所述，滑动接头1622促进近侧击发轴段1602的移动，而不移动或至少基本上不移动远侧击发杆1620。因为锁定套筒1650与近侧击发轴段1602可操作地接合并且近侧关节运动驱动器1700与锁定套筒1650接合，近侧击发轴段1602的致动导致近侧关节运动驱动器1700的远侧移动。近侧关节运动驱动器1700的远侧移动使得外科端部执行器1100围绕关节运动轴线B-B进行关节运动。在此期间，临床医生可以还通过部分地按压闭合触发器来使外科端部执行器1100的钳口部分地闭合。此类布置促进近侧闭合构件1410的轴向移动，而不会使离合器组件1640自动地切换到击发模式。该特征可使临床医生能够在夹紧到目标组织上之前使用钳口来抓握和操纵组织。
一旦临床医生将外科端部执行器1100关节运动到期望位置并且钳口已经相对于目标组织定位在期望的取向，临床医生就释放击发触发器532，这将中断近侧击发轴段1602以及近侧关节运动驱动器1700的机动移动。关节运动锁1210将近侧关节运动驱动器1700锁定在该位置，以防止外科端部执行器1100的进一步关节运动。临床医生可通过将闭合触发器512按压到完全按下位置来将目标组织夹在钳口之间。此类动作使近侧闭合构件1410向远侧移动。近侧闭合构件1410的此类远侧移动使得移动板1638旋转锁定套筒1650以旋转到与近侧击发轴段1602脱离的位置。当处于该位置时，锁定突出部1654已经从近侧击发轴段1602中的驱动凹口1603脱离。因此，近侧击发轴段1602可以轴向移动而不会移动锁定套筒1650和近侧关节运动驱动器1700。随着近侧闭合构件1410向远侧移动到完全致动位置(通过按压闭合触发器512)，近侧闭合构件1410和远侧闭合构件1430向远侧移动以使钳口1130、1102闭合。当处于该位置时，柄部组件500中的闭合驱动系统510可被锁定，并且临床医生可以释放闭合触发器512。当离合器组件1640已经移动到该击发模式时，磁体支撑臂1665或其它部分中的磁体或其它传感器与霍尔效应传感器1662连通，以向微控制器520指示离合器组件1640的位置。
微控制器520可向临床医生提供远侧击发杆1620在向远侧推进穿过夹在端部执行器钳口之间的目标组织时的位置的指示。一旦远侧击发杆1620并且更具体地附接到其上的击发构件或刀构件已经推进到完全击发位置，微控制器520利用传感器布置检测击发构件组件1600的一部分的位置，然后可使马达反转以使远侧击发杆1620回缩到其起始位置。该动作可为自动的，或者临床医生可能必须在回缩过程中按下击发触发器532。一旦远侧击发杆1620已完全回缩到其起始位置，微控制器520可向临床医生提供远侧击发杆1620已完全回缩的指示，并且闭合扳机512可被解锁以使闭合组件1406能够返回到未致动位置，从而将钳口移动到打开位置。
在一个示例中，细长通道1102大致为C形，具有两个直立侧壁部分1104。砧座1130包括砧座主体部分1132和砧座安装部分1134。砧座安装部分1134包括一对砧座安装壁1136，其由狭槽1138(图6)分开。如上所述，端部执行器安装组件1230由弹簧销连接器1235枢转地附接到细长通道1102的近侧端部1103，弹簧销连接器延伸穿过端部执行器安装组件1230中的横向安装孔1231，以接纳在设置在细长通道1102的侧壁1104中的通道安装孔1106内。每个砧座安装壁1136具有从其突出的砧座凸耳1137，每个砧座耳轴适于可旋转地接纳在细长通道1102的近侧端部1103中的对应砧座安装孔1107内。如在图16和图17中可见，每个通道侧壁1104可具有竖直狭槽或释放区域1108，其对应于每个砧座安装孔1107，砧座安装孔使得砧座凸耳1137能够竖直地落入每个狭槽1108中以便于组装。砧座凸耳限定枢转轴线PA，砧座1130可围绕该枢转轴线PA相对于细长通道1102选择性地枢转。在各种示例中，枢转轴线PA横向于轴轴线SA。参见图16。
细长通道1102被构造成能够可移除地将外科钉仓1150支撑在其中。外科钉仓1150包括仓体1151，仓体限定平台表面1152，平台表面面向砧座主体部分1132的钉成形下表面1133。仓体1151具有延伸穿过其中的细长狭槽1154，以允许击发构件1670通过，该击发构件附接到远侧击发杆1620的远侧端部。仓体1151具有多个砧座凹坑1156，这些砧座凹坑在细长狭槽1154的两侧串行布置。参见图6。容纳在这些凹坑1156内的是钉驱动器，钉驱动器将一个或多个外科钉或紧固件可操作地支撑在其上。当目标组织被夹在砧座主体部分1132的钉成形下表面1133和钉仓平台表面1152之间时，必须将目标组织定位成使得被切断的组织被钉在切割线的每一侧上。为了避免目标组织定位在最近侧钉或紧固件的近侧，砧座1130可包括两个向下延伸的组织止挡件1140。参见图18。当向下延伸超过钉仓平台表面1152时，组织止挡件1140用于阻止目标组织在砧座1130和外科钉仓1150之间变得过于靠近。
仍然参考图18和图19，在例示的示例中，砧座安装壁1136略微伸长并向近侧延伸。在一个示例中，砧座安装壁1136中的一个或两个包括形成在其上的开口限制器1139(图18)，该开口限制器被构造成能够接触端部执行器安装组件1230以防止砧座1130打开得太大。参见图18。此类砧座打开限制器1139可防止砧座1130在细长通道1102上过于松散。此外，开口限制器1139防止砧座1130打开到组织止挡件1140在钉仓平台表面1152上方延伸的位置。如果发生这种情况，则可以允许组织在砧座1130和外科钉仓1150之间向近侧延伸太远并且可能被切断但不被钉合。此类布置可还用于防止砧座被认为相对于细长通道过于松散。
再次参见图17，砧座安装部分1134限定击发构件“停放区域”1141，当击发构件1670处于起始(未击发)位置时，该击发构件“停放区域”将击发构件1670容纳在其中。在所示的布置中，停放区域1141的至少一部分在枢转轴线近侧。参见例如图19。此类布置可减少从夹在砧座1130和被支撑在细长通道1102中的外科钉仓1150之间的组织产生的负力矩臂。在一个示例中，砧座帽或盖1142附接到砧座安装部分1134，以提供预闭合表面1143，其用于由形成在远侧闭合构件1430的远侧端部1431上的远侧凸轮传动斜面或表面1440接触。参见图20。在一种布置中，砧座帽1142包括一对向下延伸的腿1144，所述腿被构造成能够卡扣地接合在砧座安装壁1136上形成的附接凸耳1145。例如，如在图16中可见，砧座帽1142包括向远侧延伸的过渡部分1146，该过渡部分在砧座安装壁1136之间延伸并且当击发构件1670处于击发构件停放区域1141中时覆盖该击发构件。过渡部分1146在砧座安装壁1136之间延伸，并形成从预闭合表面1143和形成在砧座安装部分1134上的砧座凸轮表面1147的过渡。此外，当砧座1130处于其完全打开位置时，砧座帽1142可尽量减少在砧座安装部分1134和远侧闭合构件1430的远侧端部1431之间可能存在的夹紧点。
现在将参考图18A、19和20A描述在该示例中采用的闭合过程的操作。在图示的布置中，砧座主体部分1132限定上砧面1135。如在图18A中可见，形成在砧座安装部分1134上的凸轮区域或凸轮表面1147逐渐过渡到上砧面1135。更具体地，在所示的布置中，凸轮表面1147包括两个表面部分：近侧凸轮表面部分1147P和远侧凸轮表面部分1147D。在至少一个示例中，近侧凸轮表面部分1147P从砧座主体部分1132的近侧端部延伸到远侧凸轮表面部分1147D。远侧凸轮表面部分1147D从近侧凸轮表面部分1147P延伸到上砧面1135。在一种布置中，近侧凸轮表面部分1147P可具有比远侧凸轮表面部分1147D略微更陡的角度。在其它布置中，砧座安装部分上的凸轮表面可包括一个连续的凸轮表面，该凸轮表面被取向为相对于外表面成单个凸轮角度。
如图19中可见，远侧闭合构件1430具有形成在其远侧端部上的远端表面1431。远侧凸轮传动表面1440相对于远端表面1431以钝角凸轮角度CA延伸。在所示的布置中，远侧闭合构件1430包括远侧闭合管，远侧闭合管具有外表面1433和内表面1435，它们限定其间的横截面厚度CT。远端表面1431包括横截面厚度CT的一部分。远侧凸轮传动表面1440从远端表面1431延伸到远侧闭合构件1430的内表面1435。初始凸轮区域1437包括远端表面1431和远侧凸轮传动表面1440之间的交叉线或交叉点。
图18A示出了处于起始位置的远侧闭合构件1430，其中砧座1130处于打开位置。如在图18A中可见，远侧凸轮传动表面1440与砧座帽1142上的预闭合表面1143接触。为了开始闭合过程，远侧闭合构件1430沿远侧方向DD轴向推进。当初始凸轮区域1437和/或远端表面1431初始接触凸轮表面1147(近侧凸轮表面部分1147P)时，向其施加初始闭合动作或初始闭合力ICF。参见图19。该初始闭合力ICF法向于或垂直于近侧凸轮表面部分1147P。远侧闭合构件1430的持续轴向推进带动远侧凸轮传动表面1440与凸轮表面1147(远侧凸轮表面1147D)凸轮传动接合并且实质上施加基本平行于轴轴线SA的闭合力CF。参见图20A。
在上述示例中，砧座安装壁1136的长度可比其它砧座布置采用的砧座安装构型稍长。此类细长的砧座安装壁1136用于使枢转轴线能够相对靠近由关节运动接头1200限定的关节运动轴线定位。该布置有助于在枢转轴线PA和初始闭合力ICF之间建立更长的初始力矩臂MAI(图19)。与其它砧座/通道安装布置相比，此类布置还促进将枢转轴线PA定位在稍微更靠近细长通道1102的底部的位置。因此，在所示的布置中，枢转轴线PA与施加闭合力CF所沿的轴线之间的距离略大于其它布置(更大的力矩臂)。与其它砧座安装布置相比，该布置可还导致建立更大的闭合力CF。因此，所示示例的砧座安装布置可提供比其它砧座安装布置通常可获得的更大的机械闭合优势。通过前述示例可获得的另一个优点是，将击发构件停放区域1141的至少一部分定位在枢转轴线PA的近侧可有助于减少由夹在砧座和钉仓之间的组织施加到砧座的“负”力矩臂。
现在转到图21至25，远侧闭合构件1430形成有至少一个且优选地两个正向钳口打开钩或突片1442。突片1442在本文中也可称为“主要正向钳口打开突片”。在一个示例中，正向钳口打开突片一体形成在远侧闭合构件1430中。例如，正向钳口打开突片1442从包括远侧闭合构件1430的管状结构的壁切出。每个正向钳口打开突片1442包括向上突出的钩部分1444，钩部分上形成有圆形凸轮传动端部1445，圆形凸轮传动端部被构造成能够与从砧座主体部分1132向下延伸的对应砧座开口斜面1148凸轮传动接合。图22示出了当砧座组件1130处于闭合位置时的砧座1130和远侧闭合构件1430的位置。图23示出了打开过程的开始，其中远侧闭合构件1430已经开始在近侧方向PD上回缩。如图23中可见，凸轮传动端部1445初始接触砧座开口斜面1148。图24示出了处于部分打开位置的砧座1130，而图25示出了处于完全打开位置的砧座1130。如图25中可见，凸轮传动端部1445位于砧座开口斜面的底端1149上，以将砧座1130保持在完全打开位置。此类使用远侧闭合构件上的特征部来实现砧座从完全闭合位置到完全打开位置的打开在本文中可称为“正向钳口打开”特征。其它合适的正向钳口打开布置在名称为“SURGICAL END EFFECTORS WITH POSITIVE JAWOPENING ARRANGEMENTS”的美国专利申请序列号14/742,925中公开，该申请全文以引用方式并入本文。
图26至29示出了另选的远侧闭合构件1430'，其采用辅助正向钳口打开突片1448，这些打开突片被构造成能够与形成在砧座安装壁1136上的辅助钳口打开特征部1160配合。参见图16、图17和图27。如图26中可见，辅助正向钳口打开突片1448可被切入远侧闭合管或构件1430'的壁中并向内弯曲，以便能够在远侧闭合管或构件1430'沿近侧方向PD移动时接触砧座1130上的辅助钳口打开特征部1160。
图29示出了处于完全打开位置的砧座1130。当远侧闭合构件1430'向近侧移动时，主要正向钳口打开突片1442向上移动到砧座1130上的对应砧座开口斜面1148并开始使砧座枢转打开。然后，在闭合过程期间，远侧闭合构件1430'中的辅助正向钳口打开突片1448接触形成在砧座安装壁1136上的辅助钳口打开特征部1160，以进一步帮助将砧座1130移动到完全打开位置。如图26中可见，辅助正向钳口打开突片1448通常遵循远侧闭合管1430'的轮廓。
图30示出了另选的远侧闭合构件1430'，其中辅助正向钳口打开突片1448'一体地形成在远侧闭合管1430'的壁中，但是当远端闭合管或构件1430'沿近侧方向PD移动时，这些打开突片向近侧向内延伸以接触砧座1130上的辅助钳口打开特征部1160。图31示出了处于完全打开位置的砧座1130。因此，这些主要和辅助砧座打开或钳口打开特征部可用于当远侧闭合构件从对应于砧座的完全闭合位置的完全致动位置移动到对应于砧座的完全打开位置的未致动位置时顺序地将打开动作施加到砧座。在此类布置中，当远侧闭合管1430'沿近侧方向移动时，主要正向钳口打开突片1442使砧座移动到“大部分打开”位置。辅助正向钳口打开突片1448用于确保当远侧闭合构件移回到未致动位置时砧座移动到其完全打开位置。
图32和33示出了另选的辅助正向钳口打开布置，其中砧座安装壁1136包括近侧砧座延伸部1162，该近侧砧座延伸部与对应的辅助砧座偏置弹簧1164配合以将砧座偏置到打开位置。当远侧闭合构件1430向近侧移动时，主要正向钳口打开突片1442向上移动到砧座1130上的对应砧座开口斜面1148并开始使砧座枢转打开。此外，辅助砧座偏置弹簧1164向近侧砧座延伸部1162施加偏置力，以进一步帮助将砧座1130移动到完全打开位置。在先前的钳口打开布置中，在钳口打开系统(例如，击发触发器)的致动和钳口的主动打开之间通常存在“滞后时间”。在上文所述的示例中，辅助砧座偏置弹簧1164位于枢转轴线PA的近侧，砧座围绕该枢转轴线PA相对于细长通道枢转。此类布置可用于增加对砧座的偏置(打开)动作以及尽量减少在闭合构件的初始回缩和闭合构件实际开始施加足够量的打开动作到砧座来使砧座移动到打开位置的点之间可能发生的任何“死区”的发生。
图34和图35示出了另选的远侧闭合构件1430”，该远侧闭合构件在每个正向钳口打开突片1442上采用正向钳口偏置构件1450。正向钳口偏置构件1450可形成由金属等形成的叶片型弹簧布置，并且用于当远侧闭合构件1430”沿近侧方向PD移动时向砧座1130上的砧座开口斜面1148施加附加的打开力。图34示出了处于完全闭合位置的砧座1130，而图35示出了处于完全打开位置的砧座1130。图36和图37示出了另选的远侧闭合构件1430”，该远侧闭合构件在每个正向钳口打开突片1442上采用另一形式的正向钳口偏置构件1452。正向钳口偏置构件1452可具有略微V形的构型并且由弹簧钢等形成。图36示出了处于完全闭合位置的砧座1130，图37示出了当远侧闭合构件1430”沿近侧方向初始移动时处于部分打开位置的砧座1130。正向钳口偏置构件1452用于确保砧座1130从打开过程开始时抵靠远侧闭合构件1430”升高。
图38和图39示出了另选的远侧闭合构件1430”，其中每个正向钳口打开突片1442上具有柔顺部分1454，其用于确保砧座1130从打开过程开始时抵靠远侧闭合构件1430”升高。柔顺部分1454可包括形成在正向钳口打开突片1442的钩部分1444上的橡胶或类似材料。在其它布置中，部分1454可不由柔顺材料形成，而是可由硬化材料形成，以防止在正向钳口打开突片1442上的磨损。图38示出了处于完全闭合位置的砧座1130，而图39示出了处于部分打开位置的砧座1130。此类柔顺布置和偏置构件布置可用于在闭合构件凸轮特征部保持与砧座上的凸轮斜面凸轮传动接合时促使砧座打开，以尽量减少在闭合系统的致动(打开砧座)和砧座的实际打开之间发生的任何死区滞后。此类构型可还用于建立固体凸轮传动表面，该凸轮传动表面将使使用者能够通过操作闭合触发器来压缩砧座堵塞。
接下来转向图40至42，击发构件1670被构造成能够可操作地与滑动件或凸轮组件1120连接，滑动件或凸轮组件可操作地支撑在外科钉仓1150的主体1151内。凸轮组件1120在外科钉仓主体1151内可滑动地从邻近仓体1151的近侧端部1153的近侧起始位置移动到邻近仓体1151的远侧端部1155的终止位置。仓体1151可操作地在其中支撑多个钉驱动器(未示出)，所述钉驱动器在居中设置的狭槽1154的每侧上成排对准。居中设置的狭槽1154使击发构件1670能够从中通过，并切割夹在砧座1130和外科钉仓1150之间的组织。驱动器与对应的凹坑1156相关联，凹坑穿过仓体1151的上平台表面1152。每个钉驱动器在其上支撑一个或多个外科钉或紧固件(未示出)。因此，多个外科钉被布置在位于狭槽1154的两侧的排或行中。凸轮组件1120包括多个倾斜或楔形凸轮1122，其中每个凸轮1122对应于位于槽1154一侧的特定一排紧固件或驱动器。当击发构件1670被击发或向远侧驱动时，击发构件1670也将凸轮组件1120向远侧驱动。当击发构件1670向远侧移动通过外科钉仓1150时，组织切割特征部1676切割夹在砧座1130和外科钉仓1150之间的组织，并且凸轮组件1120将钉仓中的驱动器向上驱动，驱动器驱动对应的钉或紧固件与砧座1130形成接触。
在击发构件包括组织切割表面或组织切割特征部的那些实施方案中，理想的是细长轴组件被构造成能够防止击发构件意外推进，除非未击发的或新的钉仓被正确地支撑在外科端部执行器1100的细长通道1102中。例如，如果根本不存在钉仓并且击发构件向远侧被推进穿过端部执行器，则组织将被切断，但是没有被钉住。类似地，如果在端部执行器中存在用完的钉仓(即，其中至少一些钉已经从其中击发的钉仓)，并且击发构件被推进，则组织可被切断，但可能不完全被钉住。应当理解，此类情况可能导致外科规程期间不希望的灾难性结果。名称为“SURGICAL STAPLING INSTRUMENT HAVING A SPENT CARTRIDGELOCKOUT”的美国专利6,988,649，名称为“SURGICAL STAPLING INSTRUMENT HAVING ASINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING”的美国专利7,044,352，名称为“SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FORPREVENTION OF FIRING”的美国专利7,380,695，以及名称为“SURGICAL STAPLINGINSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTING FIRING SYSTEM ACTUATIONWHEN A CARTRIDGE IS SPENT OR MISSING”的美国专利申请序列号14/742,933各自公开了可采用的各种击发构件闭锁布置。这些美国专利中的每一者均以引用方式全文并入本文中。
“未击发”、“未用过”、“新鲜”或“新”的外科钉仓1150在本文中表示外科钉仓1150在其正确加载到端部执行器中时其所有紧固件处于其“准备好发射”位置。当处于该位置时，凸轮组件1120位于其起始位置。新的外科钉仓1150安置于细长通道1102内并且可由仓体上的按扣特征部保持在其中，该按扣特征部被构造成能够保持地接合细长通道1102的对应部分。图41示出了外科端部执行器1100的部分，其中新的或未击发的外科钉仓1150安置在其中。如在图41中可见，凸轮组件1120处于起始位置。为了防止击发系统被激活，并且更确切地说，为了防止击发构件1670向远侧驱动通过端部执行器1100，除非未击发或新的外科钉仓已经正确地安置在细长通道1102内，否则所示的可互换外科工具组件1000采用通常标记为1730的击发构件闭锁系统，在某些方面，其可类似于2016年十二月21日提交的名称为“SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTING FIRINGSYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT”的美国专利申请序列号15/385,958中公开的闭锁系统，其整个公开内容据此以引用的方式全文并入本文。
在例示的示例中，击发构件闭锁系统1730包括可移动的锁定构件1732，其被构造成能够当未用过或未击发的外科钉仓1150未正确地安置在细长通道1102内时保持地接合击发构件1670。锁定构件1732包括一对侧向弹簧臂1733，这对侧向弹簧臂由中央安装突片特征部1734互连。如在图41中可见，侧向弹簧臂1733中的每个从轴轴线SA侧向偏离。当安装锁定构件1732时，安装突片特征部1734被构造成能够将锁定构件1732向上偏置。此外，锁定构件1732包括两个侧向砧座弹簧臂1736，其向上倾斜以接合砧座安装部分1134上的对应砧座安装壁1136的底表面，以在砧座1130闭合时将锁定构件1732向下偏置。每个侧向弹簧臂1733的远侧部分终止于滑动突片1738，每个滑动突片进一步侧向偏离轴轴线SA。每个滑动突片1738被取向成接触形成在凸轮组件1120的近侧部分1121上的对应解锁特征部或滑动凸台1124。例如，如在图40中可见，在所示的布置中，凸轮组件1120具有中心轴线CA。当滑动件组件1120处于未被适当支撑在细长通道中的未击发钉仓内的其起始位置时，中心轴线CA与轴轴线SA侧向对准。如在图40中可见，滑板凸台从中心轴线CA(并且最终从轴轴线SA)侧向偏移，以便限定它们之间的中心区域1123。当击发构件向远侧推进穿过端部执行器时，击发构件接触中心区域中的凸轮组件1120，以将凸轮组件1120向远侧驱动穿过仓体。在另选的布置中，可采用仅一个侧向弹簧臂1733，因此仅提供一个侧向滑动突片1738。在此类布置中，在凸轮组件1120上仅形成一个对应的滑动凸台1124。在其它布置中，锁定构件1732可具有两个侧向弹簧臂1733，但是其中只有一个侧向弹簧臂可设置有滑动突片1738。在所示的布置中，每个面向近侧的滑动凸台1124包括斜面1127，以便在将钉仓安装在细长通道期间促进滑动凸台1124和侧滑动突片1738之间更容易的接合。
每个侧向弹簧臂1733在其中包括锁定凹口，该锁定凹口被构造成能够锁定接合从击发构件主体部分1672侧向延伸的对应中央锁定凸耳1674。图41示出了处于起始位置的凸轮组件1120，其中滑动凸台1124已将锁定构件1732抬起而不与锁定凸耳1674锁定接合。图42示出了相对于锁定构件1732安装的不适当的外科钉仓1150W。如在图42中可见，尽管钉仓1150W具有凸轮组件1120W，其向近侧延伸的特征部1124W从凸轮组件的中心轴线侧向偏移，但是特征部1124W未与锁定构件1732的滑动突片1738解锁接合。因此，即使在其起始位置，凸轮组件1120W也不会使锁定构件1732移动成不与击发构件1670锁定接合。
在另选的布置中，锁定构件可被构造成能够在其向下移动以与正确装载的未击发钉仓的滑动件的对应部分接触时(当滑动件处于其正确击发位置时)完成电路。在此类布置中，例如，当电路开路时，马达是不可操作的。在一种布置中，锁定构件还能够以上述方式机械地接合击发构件，从而促进以机械方式和电的方式闭锁的特征/能力。
图43至50示出了可与本文所公开的各种端部执行器实施方案结合采用的另一击发构件闭锁系统1740。在该实施方案中，击发构件闭锁系统1740包括击发构件锁1742，该击发构件锁被支撑用于在锁定位置和解锁位置之间枢转行进，在锁定位置，击发构件锁1742与击发构件1670锁定接合，在解锁位置，击发构件1670可自由地向远侧推进穿过外科钉仓1150。如在图43中可见，击发构件锁1742包括安装部分1743，该安装部分具有从其每一侧侧向突出的枢转构件1744。枢转构件1744枢转地被捕获在设置在端部执行器安装组件1230的下侧中的枢转凹口1238内。参见图44。如在图44中可见，枢转构件1744由下部双枢转连接件1222可旋转地捕获在枢转凹口1238中。如在图中43也可见，一对钩臂1746从安装部分1743向远侧延伸。每个钩臂1746包括形成在其下侧的锁定凹口1748，该锁定凹口被构造成能够接合击发构件1670上的对应的一个中央锁定凸耳1674。击发构件闭锁系统1740还包括一对片簧等形式的偏置构件1749，其与砧座1130上的对应砧座安装壁1136和击发构件锁1742接合，以将击发构件锁1742向下偏置。
图45示出了外科端部执行器1100，其中砧座1130和细长通道1102处于其完全打开位置，这在将未使用或未击发的外科钉仓1150装载在其中期间发生。当处于打开位置时，击发构件1670至少由于击发构件的部分与砧座1130内的对应通道未对准而无法而向远侧推进。此外，该器械可采用各种传感器布置，其被构造成能够检测砧座的位置和/或砧座闭合系统的用以防止击发系统部件的致动(除非砧座处于完全闭合位置)的其它部分的构型。如在图45中可见，当处于打开位置时，钩臂1746被取向在未致动位置，其中每个钩臂1746的一部分被接纳在击发构件1670的对应中央锁定凸耳1674上，使得锁定凹口1748不在与对应中央锁定凸耳1674接合的位置。
图46示出了在具有滑动件组件或凸轮组件1120的未击发的外科钉仓1150已经正确地安装在细长通道1102中并且砧座1130已经闭合之后的端部执行器。当处于此类构型时，偏置构件1749向击发构件锁1742施加向下偏置动作，该击发构件锁现在与滑动凸台1124以及击发构件1670上的中央锁定凸耳1674接触。如在图46中可进一步看到的，滑动件组件1120上的滑动凸台1124用于向上提升击发构件锁1742，使得其中的锁定凹口148与击发构件1670上的中央锁定凸耳1674脱离锁定接合。因此，击发构件1670可自由地向远侧推进，如图47中所示。如在图47中可见，击发构件锁1742与击发构件1670以及滑动件组件1120脱离接合，并且偏置构件1749使击发构件锁1742向下枢转。
图48至50示出了击发构件1670的回缩。图48示出了在回缩过程开始时击发构件1670和击发构件锁1742的位置。图49示出了在中央锁定凸耳1674的渐缩的近侧端部1675已经接触钩臂1746的远侧端部上的成角表面并使钩臂1746向上枢转(箭头U)之后击发构件1670的位置。图50示出了击发构件1670处于其完全回缩或起始位置。如在图50中可见，钩臂1746已向下枢转到“预锁定”位置。当锁定构件处于预锁定位置时，击发构件1670可向远侧移动，直到其上的中央锁定凸耳1674锁定地接合钩臂1746，这用于防止击发构件1670进一步向远侧推进。因此，在例示的示例中，除非砧座首先移动到闭合位置，否则击发构件锁1742将不会从解锁或未致动位置移动到致动位置。例如，在该语境中，术语“闭合位置”表示砧座被移动到相对于钉仓和击发构件的位置，该位置原本将使击发构件能够向远侧推进但是用于击发构件闭锁系统。
图51至55示出了可以与本文所公开的各种端部执行器实施方案结合使用的另一击发构件闭锁系统1750。在该实施方案中，击发构件闭锁系统1750包括至少一个击发构件锁1752，其被支撑以实现沿横向于轴轴线SA的锁定轴线LA的竖直行进。在一个示例中，击发构件锁1752对应于每个砧座安装壁1136。在其它示例中，可以仅采用一个击发构件锁1752。为清楚起见，在图中仅示出了一个击发构件锁1752。在例示的示例中，每个击发构件锁1752具有L形和闩锁部分1754。击发构件锁1752可移动地轴颈连接在对应的安装杆1751上，该安装杆附接到对应的砧座安装壁1136或砧座的其它部分。对应的锁定弹簧或偏置构件1756将击发构件锁1752向下偏置(图52和53中的箭头D)。图51示出了外科端部执行器1100，其中砧座1130和细长通道1102处于其完全闭合位置，未用过或未击发的外科钉仓1150被适当地支撑在其中。如在图51中可见，每个闩锁部分1754的渐缩端部1755已经由滑动件组件1120上的对应的解锁特征部1125接合。解锁特征部1125用于竖直移动闩锁部分1754，使得击发构件1670上的中央锁定凸耳1674可以从其下方通过。因此，击发构件1670可以自由地向远侧推进。图52示出了击发构件1670在击发过程开始时的位置，其中击发构件已从其起始位置向远侧推进。如在图52中可见，解锁特征部1125不再与闩锁部分1754接触。
图53至55示出了击发构件1670的回缩。图53示出了在回缩过程开始时击发构件1670和击发构件锁1752的位置。图54示出了在中央锁定凸耳1674的渐缩的近侧端部1675已经接触闩锁部分1754的成角表面或渐缩端部1755以使击发构件锁1752沿向上方向(箭头U-图54和55)竖直移动之后，击发构件1670的位置。图55示出了击发构件1670处于其完全回缩或起始位置。如在图55中可见，击发构件锁1752处于锁定位置或底部位置，其中，如果击发构件1670将向远侧移动，击发构件1670上的中央锁定凸耳1674将接触对应的击发构件锁1752的闩锁部分1754。当处于该位置时，击发构件1670无法向远侧推进。因为击发构件锁1752附接到砧座，所以当砧座处于打开位置时，击发构件锁1752不处于锁定位置，在锁定位置，它们可以防止击发构件1670的轴向推进。因此，为了致动击发构件闭锁系统1750，必须首先将砧座1130移动到闭合位置。例如，在该语境中，术语“闭合位置”表示砧座被移动到相对于钉仓和击发构件的位置，该位置原本将使击发构件能够向远侧推进但是用于击发构件闭锁系统。
图56至63示出了另一个击发构件闭锁系统1760，其包括可移动的锁定构件1762，该可移动的锁定构件被构造成能够当外科钉仓1150未正确地安置在细长通道1102内时保持地接合击发构件1670。锁定构件1762包括至少一个侧向移动的锁定部分1764，该部分被构造成能够当滑动件组件1120在其起始位置不存在于外科钉仓1150内时保持地接合击发构件的对应部分。在所示的布置中，锁定构件1762采用两个侧向移动的锁定部分1764，其中每个锁定部分1764接合击发构件1670的侧向延伸部分。
在例示的实施方案中，锁定构件1762包括大致U形的弹簧构件，其中每个能够侧向移动的腿部或锁定部分1764从中心弹簧部分1763延伸并且被构造成能够在图56、59和62中用箭头“L”表示的侧向方向上移动。应当理解，术语“侧向”是指横向于轴轴线SA的方向。弹簧或锁定构件1762可由高强度弹簧钢或类似材料制成。中心弹簧部分1763可包括向近侧延伸的弹簧突片1767，该弹簧片保持在端部执行器安装组件1230中的凹口1240内。参见图57。在例示的示例中，弹簧突片1767用于在砧座1130处于打开位置时将锁定构件1762偏置成解锁构型。图57示出了处于打开位置的砧座1130，其准备好将未击发的或新的钉仓安装在细长通道1102中。如在图57中可见，安装突片1767将锁定构件1762沿向上方向(箭头U)偏置。当处于该解锁位置时，锁定构件1762不处于防止击发构件1762的远侧推进的位置。然而，该器械可以采用其它传感器和闭锁布置来检测砧座的位置并且换句话说防止击发系统的致动，除非砧座已经移动到闭合位置。
图58示出了外科端部执行器1100的一部分，其中未击发的钉仓1150装载或适当地支撑在细长通道1102内并且在砧座1130已经移动到闭合位置之后。随着砧座1130移动到闭合位置，砧座安装壁1136接触形成在锁定构件1762上的对应的侧向延伸砧座突片1766。参见图56。因此，砧座安装壁1136用于将锁定构件1762从脱离位置移动到锁定位置，在锁定位置，锁定构件1762与击发构件1670锁定接合。在一个示例中，锁定构件1762的每个能够侧向移动的腿部或锁定部分1764在其中包括锁定窗口1768。当锁定构件1762处于锁定位置时，击发构件1670的每个侧面上的中央锁定凸耳1674延伸到对应的锁定窗口1768中，以保持防止击发构件1670向远侧轴向推进。
如在图56中可见，滑动件或凸轮组件1120包括解锁特征部1125，该特征部对应于每个能够侧向移动的锁定部分1764。在所示的布置中，解锁特征部1125设置在每个中央楔形凸轮1122上或从每个中央楔形凸轮向近侧延伸。在另选的布置中，解锁特征部1125可包括对应的楔形凸轮1122的近侧突出部分。如在图59中可见，当滑动件组件1120处于其起始位置时，解锁特征部1125在横向于轴轴线SA的方向上(箭头L)侧向接合并偏置对应的锁定部分1764。当锁定部分1764处于那些解锁取向时，中央锁定凸耳1674不与其对应的锁定窗口1768保持接合。当处于那些取向时，击发构件1670可以向远侧轴向推进(击发)。然而，当未击发的外科钉仓1150不存在于细长通道1102中或者滑动件组件1120已经移出其起始位置(这可能意味着钉仓至少部分地或完全地被击发)时，锁定部分1764侧向弹性地保持与击发构件1670接合。当处于如图58中所示的那个位置时，中央锁定凸耳1674被接纳在它们各自的锁定窗口1768内并且被闭锁止动件1769防止向远侧移动。当处于此类位置时，击发构件1670无法向远侧移动。
图61示出了击发构件1670在回缩到其起始或未击发位置时的情况。当中央锁定凸耳1674的渐缩或渐缩近侧端部1675接触可移动的锁定部分1764的弧形远侧端部1765时，可移动的锁定部分1764被侧向向外偏置，如图62中所示，直到每个中央锁定凸耳1674再次完全被接纳在锁定部分1764中的锁定窗口部分1768内(图63)。当击发构件1670已经完全回缩到图63中所示的起始位置时，击发构件1670再次被锁定构件1762锁定就位并被阻止向远侧推进，直到另一个新钉仓已经如上所述正确地装载到细长通道1102中。当砧座1130打开时，弹簧突片1767再次将锁定构件1762偏置回到解锁或预致动位置。因此，为了致动击发构件闭锁系统1760，使用者必须首先将砧座移动到闭合位置。例如，在该语境中，术语“闭合位置”表示砧座被移动到相对于钉仓和击发构件的位置，该位置原本将使击发构件能够向远侧推进但是用于击发构件闭锁系统。
图64至70示出了另选的关节运动锁定布置1910，其用于将外科端部执行器1100'相对于轴轴线SA围绕关节运动轴线B-B锁定在关节运动位置。在例示的示例中，外科端部执行器1100'枢转地联接到脊组件1500'。脊组件1500'可以以上述方式附接到底座1800(图4)。脊组件1500'的远端部分1540形成有向下突出的关节运动销1542，该关节运动销限定关节运动轴线B-B。关节运动销1542被构造成能够可旋转地或枢转地被接纳在脊附接孔1254内，该脊附接孔设置在端部执行器安装组件1250的安装基部1252中。端部执行器安装组件1250由弹簧销连接器1235(图6)附接到细长通道1102的近侧端部1103，弹簧销连接器延伸穿过安装组件1250中的横向安装孔1251，以接纳在设置在细长通道1102的近侧端部1103中的通道安装孔1106(图6)内。
参见图64和图65，在一个示例中，关节运动锁定布置1910包括锁定弹簧组件1920，该锁定弹簧组件包括中心弹簧主体部分1922，该中心弹簧主体部分限定中心销孔1924并且包括底部释放环片段1930和1932以及顶部释放环片段1940和1942。锁定弹簧组件1920的尺寸被设计成可旋转地接纳在安装基部1252中的脊附接孔1254内。在一个示例中，上部释放止动件1256和下部释放止动件1258各自在脊附接孔1254内向内突出。关节运动锁定布置1910还包括释放销组件1950，该组件包括上部释放臂1952和下部释放臂1954。释放销组件1950附接到远侧关节运动连接件1960，该远侧关节运动连接件由连接件销1962固定到远侧关节运动连接件1710'的远侧端部。远侧关节运动连接件1710'可以与本文所述的关节运动系统连接，用于根据期望的关节运动方向在远侧和近侧方向上轴向移动远侧关节运动连接件1710'。释放销组件1950的底部(未示出)被构造成能够可枢转且可滑动地支撑在下部弓形释放销狭槽1260内，该狭槽形成在端部执行器安装组件1250中。第二上部释放臂狭槽1270也形成在端部执行器安装组件中，并且被构造成能够可移动地容纳上部释放臂1952和下部释放臂1954。如在图67中可见，上部平衡形成物1272突出到第二上部释放臂狭槽1270中并且被构造成能够可操作地与上部释放臂1952连接。同样地，下部平衡形成物1274突出到第二上部释放臂狭槽1270中并且被构造成能够可操作地与下部释放臂1954连接。
在例示的示例中，关节运动销1542可旋转地接纳在锁定弹簧组件1920中的中心销孔1924内。锁定弹簧组件1920被接纳在端部执行器安装组件1250中的脊附接孔1254内，使得上部释放止动件1256被接纳在上部锁定空间1941内，该上部锁定空间形成在顶部释放环片段1940和1942之间，并且下部释放止动件1258位于下部锁定空间1931内，该下部锁定空间形成在底部释放环片段1930和1932之间。图67示出了处于非关节运动位置的外科端部执行器1100。如在图67中可见，上部释放止动件1256与顶部释放环片段1940邻接接合。下部释放止动件1258也可以与底部释放环片段1932邻接接合。此类构型保持锁定弹簧组件1920与关节运动销1542摩擦接合，以将外科端部执行器1100保持在非关节运动位置。
图68为在外科端部执行器关于关节运动轴线向右(箭头RD)的关节运动开始时关节运动锁定布置1910的顶视图。如在图68中可见，通过沿远侧方向DD轴向推进远侧关节运动连接件1710'来启动向右关节运动过程。远侧关节运动连接件1710'的远侧推进导致远侧关节运动连接件1960将释放销组件1950向远侧移动，使得上部释放臂1952与端部执行器安装组件1250上的上部平衡形成物1272邻接接合。上部平衡形成物1272和上部释放臂1952之间的此类接触使得上部释放臂1952接触顶部释放环片段1942并向其施加向右关节运动力RAF。此类移动导致顶部释放环片段1942逆时针逆时针CCW移动，从而使锁定弹簧组件1920打开或扩张以脱离与关节运动销1542的摩擦接合。图69为如图68中所示的关节运动锁定布置1910的底视图。如在图69中可见，下部释放止动件1258与底部释放环片段1930邻接接合，这防止底部释放环片段1930移动。因此，锁定弹簧组件1920扩张以释放关节运动销1542。远侧关节运动连接件1710'的进一步远侧推进使得释放销组件1950在向右方向RD上将关节运动动作施加到外科端部执行器安装组件1250，同时还使锁定弹簧组件1920脱离与关节运动销1542的锁定接合。参见图70。为了使外科端部执行器1100沿向左方向关节运动，远侧关节运动连接件1710'沿近侧方向移动，这使得释放销组件使锁定弹簧组件1920扩张并使外科端部执行器安装组件1250在向左方向以相反但相似的方式移动。因此，如从前面的描述可以理解的，锁定弹簧组件基本上包括弹簧组件，该弹簧组件可从第一锁定或保持构型扩张，其中锁定弹簧组件1920与关节运动销1542摩擦保持接合，在第二解锁位置，锁定弹簧组件1920和外科端部执行器安装组件1250一起因为施加在其上的关节运动动作而自由地围绕关节运动销1542枢转。
图71至77示出了另选的关节运动锁定布置2010，其用于将外科端部执行器1100相对于轴轴线SA围绕关节运动轴线B-B锁定在关节运动位置。在例示的示例中，外科端部执行器1100枢转地联接到脊组件1500'。脊组件1500'可以以上述方式附接到底座1800(图4)。脊组件1500'的远端部分1540形成有向下突出的关节运动销1542，该关节运动销限定关节运动轴线B-B。关节运动销1542被构造成能够可旋转地或枢转地被接纳在脊附接孔1254内，该脊附接孔设置在端部执行器安装组件1250'的安装基部1252'中。端部执行器安装组件1250’由弹簧销连接器1235(图6)附接到细长通道1102的近侧端部1103，弹簧销连接器延伸穿过安装组件1250’中的横向安装孔1251，以接纳在设置在细长通道1102的近侧端部1103中的通道安装孔1106(图6)内。
参见图71和73，在一个示例中，关节运动锁定布置2010包括球锁组件2020，该球锁组件包括球形保持器基部2022，该球形保持器基部中具有中心枢转孔2024，该中心枢转孔被构造成能够接纳穿过其中的关节运动销1542。球形保持器基部2022由关节运动销2023附接到关节运动锁定连接件1960，该关节运动销延伸穿过球形保持器基部2022中的销孔2025进入外科端部执行器安装组件1250'的安装基部1252’中的关节运动狭槽1264中。关节运动锁定连接件1960通过连接件销1962固定到远侧关节运动连接件1710'的远侧端部。远侧关节运动连接件1710'可以与本文所述的关节运动系统连接，用于根据期望的关节运动方向在远侧和近侧方向上轴向移动远侧关节运动连接件1710'。球形保持器基部2022还包括两个直立的球形止动构件2026和2028，它们用于将两个锁定球2030和2032保持在形成于外科端部执行器安装组件1250'上的锁定支架1262上的远侧锁定表面1263与形成在脊组件1500'的远端部分1540上的近侧锁定表面1541之间。球形保持器基部2022还包括两个定心弹簧2034和2036，它们分别用于支撑锁定球2030、2032。
图73示出了处于非关节运动位置的外科端部执行器1100。如在图73中可见，锁定球2030、2032被捕获为锁定接合在锁定支架1262上的远侧锁定表面1263和脊组件1500'的远端部分1540上的近侧锁定表面1541之间，以将外科端部执行器1100保持在非关节运动位置。
图74示出了锁定平面LP，其延伸穿过锁定球2030和锁定支架1262上的远侧锁定表面1263与近侧锁定表面1541之间的接触点。图75为在外科端部执行器关于关节运动轴线向右(箭头RD)的关节运动开始时关节运动锁定布置2010的顶视图。如在图75中可见，通过沿远侧方向DD轴向推进远侧关节运动连接件1710'来启动向右关节运动过程。远侧关节运动连接件1710'的远侧推进导致关节运动锁定连接件1960使关节运动销2023在端部执行器安装组件1250'的安装基部1252'中的关节运动狭槽1264内向远侧移动，同时还向球形保持器底部2022施加释放载荷RL。球形保持器基部2022沿向右方向RD的运动使得球形止动件2026使锁定球2032移动为脱离与锁定支架1262上的远侧锁定表面1263锁定接合。尽管球形止动件2026已经移动为脱离与锁定球2030接合，锁定球2030初始保持与锁定支架1262上的远侧锁定表面1263和近侧锁定表面1541临时接合。远侧关节运动连接件1710'的进一步远侧推进使得关节运动销2023在向右方向RD上将关节运动动作施加到外科端部执行器安装组件1250'，同时还使球形保持器基部2022沿向右方向RD移动。关节运动角度AA表示外科端部执行器1100经历的关节运动的量。随着球形保持器基部2022沿向右方向RD移动，锁定球2030也移动成脱离与远侧锁定表面1263和近侧锁定表面1541锁定接合。球形止动件2028还使锁定球2032在关节运动期间保持脱离与远侧锁定表面1263和近侧锁定表面1541锁定接合。一旦外科端部执行器1100已经关节运动到期望位置，远侧关节运动连接件1710'的远侧推进就停止。此后，定心弹簧2034和2036推动锁定球2030和2032与远侧锁定表面1263和近侧锁定表面1541锁定接合，以将外科端部执行器1100保持在关节运动位置。如在图76中可见，当处于锁定关节运动位置时，定心弹簧的使锁定球2030、2032偏置成与远侧锁定表面1263和近侧锁定表面1541保持接合的动作也导致关节运动销2023移动到关节运动狭槽1264内的中间位置。为了外科端部执行器1100沿向左方向关节运动，远侧关节运动连接件1710'沿近侧方向移动，这使得球锁组件2020和外科端部执行器1100沿向左方向枢转并以类似方式操作。
图78至82示出了另选的关节运动锁定布置2110，其用于将外科端部执行器1100相对于轴轴线SA围绕关节运动轴线B-B锁定在关节运动位置。在例示的示例中，外科端部执行器1100枢转地联接到脊组件1500”。脊组件1500”可以以上述方式附接到底座1800(图4)。脊组件1500”的远端部分1540'包括限定关节运动轴线B-B的枢转孔1543。端部执行器安装组件1250”由弹簧销连接器1235(图80至82)附接到细长通道1102的近侧端部1103，弹簧销连接器延伸穿过安装组件1250”中的横向安装孔1251，以被接纳在设置在细长通道1102的近侧端部1103中的通道安装孔1106(图6)内。在例示的示例中，外科端部执行器安装组件1250”包括渐缩安装柱1253，该安装柱从安装基部1252向上延伸以被接纳在脊组件1500”中的枢转孔1543内。在一种布置中，渐缩安装柱1253远离安装基部1252逐渐变细。换句话说，渐缩安装柱1253的端部1255的横截面积小于渐缩安装柱1253的邻近安装基部1252的部分的横截面积。
关节运动锁定布置2110包括至少一个锁定构件或锁定滑块，其可移动地支撑在安装柱1253和枢转孔1543的内壁1545之间。在所示的布置中，安装柱1253具有三角形横截面形状，其限定三个柱侧面1280、1282、1284。因此，(在例示的示例中)采用三个锁定构件或锁定滑块2112、2114、2116，其中锁定滑块2112被布置为邻近柱壁1282，锁定滑块2114被布置为邻近柱壁1284，锁定滑块2116邻近柱壁1280。也可以采用具有其它形状和其它数量的锁定滑块的安装柱。每个锁定滑块2112、2114、2116被接纳在波形垫圈2120上，该波形垫圈安装在端部执行器安装组件1250”的安装基部1252上。例如，所示的布置包括近侧闭合构件2410，该近侧闭合构件可以相对于近侧闭合构件1410以本文所述的各种方式轴向推进和回缩。近侧闭合构件2410枢转地联接到远侧闭合构件2430，远侧闭合构件在结构和操作上类似于远侧闭合构件1430。如在图80至图82中可见，远侧闭合构件2430由上部双枢转连接件1220和下部双枢转连接件1222'联接到近侧闭合构件2410。在一个实施方案中，下部双枢转连接件1222'在其上表面1224上形成有渐缩形斜坡1226。参见图78。所示的布置采用两个关节运动连接件1710R和1710L以将向左和向右关节运动动作施加到外科端部执行器1100。参见图79。为了使外科端部执行器1100向右进行关节运动，关节运动连接件1710R沿近侧方向PD轴向回缩，并且关节运动连接件1710L沿远侧方向DD轴向推进。相反，为了使外科端部执行器1100沿向左方向进行关节运动，关节运动连接件1710L沿近侧方向PD轴向回缩，并且关节运动连接件1710R沿远侧方向DD轴向推进。可以由各种已知的关节运动系统布置和本文所公开的其它关节运动系统布置来生成关节运动控制动作并将其施加到关节运动连接件1710R、1710L。关节运动连接件1710R具有开槽端部1711R，该端部被接纳在右关节运动销1266R上，该右关节运动销附接到端部执行器安装组件1250”。同样，关节运动连接件1710L具有开槽端部1711L，该端部被接纳在左关节运动销1266L上，该左关节运动销附接到端部执行器安装组件1250”。
现在转到图80，在所示的布置中，当闭合系统处于未致动状态时，波形垫圈2120将端部执行器安装组件1250”的安装基部1252向下(箭头D)偏置。在图80中，近侧闭合构件2410处于近侧位置。同样，下部双枢转连接件1222'也处于近侧位置，这允许将安装基部1252向下驱动。因为安装基部1252处于其最下部或解锁位置，所以渐缩安装柱1253已经释放锁定滑块2112、2114、2116，使其不与脊组件1500”的远端部分1540'保持接合(第一解锁位置)。因此，当处于该位置时，外科端部执行器1100可以由关节运动连接件1710R、1710L围绕关节运动轴线B-B做关节运动。一旦外科端部执行器1100已经关节运动到期望位置，关节运动锁定布置2110可以通过向远侧推进近侧闭合构件2410而被重新激活。
图81示出了锁定过程的开始。如在该图中可见，近侧闭合构件2410以及下部双枢转连接件1222'已经在远侧方向DD上初始移动。当下部双枢转连接件1222'向远侧移动时，其上的斜坡1226向上驱动端部执行器安装组件1250”的安装基部1252以使波形垫圈2120塌缩。随着安装基部1252向上移动(箭头U)，渐缩安装柱1253将锁定滑块2112、2114、2116从第一解锁位置推动到与脊组件1500”的远端部分1540'保持锁定接合(第二锁定位置)，以将外科端部执行器1100锁定在关节运动位置。外科端部执行器1100的该锁定在外科端部执行器的钳口完全闭合之前发生。图82示出了当闭合系统部件已经移动到完全闭合位置时(这时端部执行器已经完全闭合)近侧闭合构件2410、下部双枢转连接件1222'和关节运动锁定布置2110的位置。因此，通过少量致动闭合系统，可以使关节运动锁定布置2110在锁定状态和解锁状态之间致动或移动。可以想到其它布置，其中安装柱附接到脊组件的远侧端部，并且枢转孔设置在外科端部执行器的近侧部分中。
图83和84示出了另选的关节运动锁定布置2110’，其用于将外科端部执行器1100相对于轴轴线SA围绕关节运动轴线B-B锁定在关节运动位置。在例示的示例中，外科端部执行器1100枢转地联接到脊组件1500”。脊组件1500”可以以上述方式附接到底座1800(图4)。脊组件1500”的远端部分1540'包括限定关节运动轴线B-B的枢转孔1543。端部执行器安装组件1250”由弹簧销连接器1235(图6)附接到细长通道1102的近侧端部1103，弹簧销连接器延伸穿过安装组件1250”中的横向安装孔1251，以被接纳在设置在细长通道1102的近侧端部1103中的通道安装孔1106(图6)内。外科端部执行器安装组件1250”包括安装柱1253’，该安装柱从安装基部1252向上延伸以被接纳在脊组件1500”中的枢转孔1543内。在该实施方案中，安装柱1253'可以不是渐缩的。
该实施方案还包括多个锁定滑块2112'、2114'、2116'，每个锁定滑块由电活化聚合物材料(EAP)制成。例如，此类材料在电激励时可以膨胀。例如，可以由从外壳或柄部布置或机器人控制系统等延伸的导体(未示出)将电流施加到锁定滑块2112'、2114'、2116'中的一个或多个。因此，一旦外科端部执行器1100已关节运动到期望位置，锁定滑块2112'、2114'、2116'中的一个或多个通过向其施加电流而膨胀。在其它布置中，锁定滑块2112'、2114'、2116'中的一个或多个可被构造成能够气动或液压膨胀。在其它布置中，锁定滑块2112'、2114'、2116'可以不是可膨胀的。在此类布置中，安装柱1253可以从EAP制造并且可以通过向其施加电流而选择性地膨胀。在其它布置中，安装柱1253可以选择性地气动或液压膨胀。
图85至89示出了另选的关节运动锁定布置2210，其用于将外科端部执行器1100相对于轴轴线SA围绕关节运动轴线B-B锁定在关节运动位置。在例示的示例中，外科端部执行器1100枢转地联接到脊组件1500'。脊组件1500'可以以上述方式附接到底座1800(图4)。脊组件1500'的上部部分1539的远端部分1540形成有向下突出的关节运动销1542，该关节运动销限定关节运动轴线B-B。关节运动销1542被构造成能够可旋转地或枢转地被接纳在脊附接孔1254内，该脊附接孔设置在端部执行器安装组件1250”的安装基部1252中。端部执行器安装组件1250”由弹簧销连接器1235(图6)附接到细长通道1102的近侧端部1103，弹簧销连接器延伸穿过安装组件1250”中的横向安装孔1251，以接纳在设置在细长通道1102的近侧端部1103中的通道安装孔1106(图6)内。
参见图85，所示的布置采用两个关节运动连接件1710R’和1710L’以将向左和向右关节运动动作施加到外科端部执行器1100。然而，在其它示例中，可以仅采用一个关节运动连接件。在所示的布置中，为了使外科端部执行器1100向右进行关节运动，关节运动连接件1710R’沿近侧方向PD轴向回缩，并且关节运动连接件1710L’沿远侧方向DD轴向推进。相反，为了使外科端部执行器1100沿向左方向进行关节运动，关节运动连接件1710L’沿近侧方向PD轴向回缩，并且关节运动连接件1710R’沿远侧方向DD轴向推进。关节运动连接件1710R’具有开槽端部1711R，该端部被接纳在右关节运动销1266R上，该右关节运动销附接到端部执行器安装组件1250”。同样，关节运动连接件1710L’具有开槽端部1711L，该端部被接纳在左关节运动销1266L上，该左关节运动销附接到端部执行器安装组件1250”。
仍参见图85，所示实施方案中的关节运动锁定布置2210包括锁定组件2220，该锁定组件包括远侧端部2222，该远侧端部具有从其突出的右锁定构件或叉2224以及左锁定构件或叉2228。右锁定构件2224包括右锁定齿条2226，该右锁定齿条侧向邻近在右关节运动连接件1710R'的向下延伸部分上形成的对应右关节运动齿条1720且与其成面对面关系。相似地，左锁定构件2228包括左锁定齿条2230，该左锁定齿条侧向邻近在左关节运动连接件1710L'的向下延伸部分1722上形成的对应左关节运动齿条1723且与其成面对关系。在未致动状态下，右锁定构件2224和左锁定构件2228居中地位于右关节运动连接件1710R'和左关节运动连接件1710L'之间并且不与其接合。如在图85中也可见，锁定组件2220支撑在下部远侧脊部分1550和上部脊部分1539之间。下部远侧脊部分1550包括向上延伸的远侧支撑销1554，该远侧支撑销延伸穿过锁定组件2220的远侧端部2222中的安装孔2223，以被接纳在形成于上部脊部分1539的下侧上的远侧凸台1544中。参见图86。下部远侧脊部分1550还包括向上延伸的近侧支撑销1556，该近侧支撑销延伸穿过右锁定构件2224和左锁定构件2228之间的锁定开口2225，以被接纳在形成于上部脊部分1539的下侧上的近侧凸台1546中。
在所示的布置中，关节运动锁定布置2210还包括轴向可移动的锁定杆组件2240，其可操作地与关节运动传动装置2250连接，关节运动传动装置可操作地支撑在轴组件1400'内。锁定杆组件2240包括形成在其远侧端部2242上的锁定楔形件2244。关节运动传动装置2250被构造成能够可操作地与远侧击发杆1620接合，该远侧击发杆可操作地支撑在轴组件1400'中。在该语境下，远侧击发杆1620可包括击发致动器。
现在转到图85至87，在所示的布置中，关节运动传动装置2250的一种形式包括击发齿条1624，该击发齿条形成在远侧击发杆1620的一部分上并且被构造成能够可操作地接合形成在换档器2252上的换档器驱动齿条2254。换档器2252的近侧端部2253被构造成能够可操作地与形成在锁定杆组件2240上的锁定杆联接器2246连接。如也可在图85至87中可见，换档器2252还包括换档器从动齿条2256，其与附接到关节运动链轮齿轮2260的关节运动小齿轮2262啮合接合。关节运动链轮齿轮2260可旋转地支撑在轴组件1400'内并且与形成在右远侧关节运动连接件1710R'上或附接到该右远侧关节运动连接件的右关节运动驱动齿条1724啮合接合，还与形成在左远侧关节运动连接件1710L'上或以其它方式附接到该左远侧关节运动连接件的左关节运动驱动齿条1726'啮合接合。
将参考图87至89说明关节运动传动装置2250以及关节运动锁定布置2210的操作。图87示出了处于非关节运动位置的外科端部执行器1100。锁定杆组件2240处于其最远侧“解锁位置”，这时锁定楔形件2244被接纳在位于右锁定构件2224和左锁定构件2228之间的锁定开口2225内。右锁定构件2224和左锁定构件2228处于其未致动状态并且不与右关节运动连接件1710R’和左关节运动连接件1710L'接合。因此，右锁定构件2224上的右锁定齿条2226脱离与右远侧关节运动连接件1710R'上的右关节运动齿条1720接合，并且左锁定齿条2230脱离与左远侧关节运动连接件1710L'上的左关节运动齿条1723的啮合接合。因此，关节运动锁定布置2210处于“解锁”构型。然而，各种部件之间的摩擦可以使外科端部执行器1100不会围绕关节运动轴线B-B翻转或旋转。
图88示出了关节运动过程的开始。如在图88中可见，换档器2252的近侧端部2253可操作地与锁定杆联接器2246接合，并且锁定杆组件2240处于解锁取向。当换档器2252以该方式与锁定杆组件2240接合时，换档器驱动齿条2254与远侧击发杆1620上的击发齿条1624啮合接合。然后通过轴向移动远侧击发杆1620来启动关节运动过程。在图88中所示的示例中，端部执行器1100通过沿近侧方向PD轴向移动远侧击发杆1620而在向右方向RD上围绕关节运动轴线做关节运动。本文已经详细讨论了远侧击发杆1620在近侧方向和远侧方向上的轴向致动。因为锁定杆联接器2246保持换档器驱动齿条2254与远侧击发杆1620上的击发齿条1624啮合接合，所以换档器2252与远侧击发杆1620一起向近侧移动。利用换档器从动齿条2256与关节运动小齿轮2262的啮合接合，换档器2252在近侧方向PD上的移动使得关节运动小齿轮2262和关节运动链轮齿轮2260沿顺时针方向旋转通过关节运动致动角度AAA。当关节运动链轮齿轮2260旋转时，右远侧关节运动连接件1710R’沿近侧方向PD被驱动，左侧远侧关节运动连接件1710L'沿远侧方向DD被驱动，这最终导致外科端部执行器沿向右方向RD围绕关节运动轴线枢转。一旦外科端部执行器1100已关节运动到期望位置，使用者可通过将锁定杆组件2240沿近侧方向PD轴向推进，以使锁定楔形件2244向近侧移动到驱动与分别形成在右锁定构件2224和左锁定构件2228上的两个致动止动器2227、2229接触，使右锁定构件2224和左锁定构件2228侧向向外侧向偏置成分别与左关节运动齿条1720和右关节运动齿条1723锁定接合，来将端部执行器1100锁定在该关节运动位置。锁定杆组件2240的此类近侧移动还用于将锁定杆联接器2246与换档器2252脱离，如图89中所示。
如在图89中可见，当换档器2252已经与锁定杆组件2240脱离时，换档器驱动齿条2254不再与远侧击发杆1620上的击发齿条1624啮合接合，并且换档器从动齿条2256不再与关节运动小齿轮2262啮合接合。因此，远侧击发杆1620现在可以向远侧推进以将击发动作施加到外科端部执行器，然后沿近侧方向回缩到图87中所示的起始位置。一旦远侧击发杆1620已经返回到起始位置，使用者随后可以将锁定杆组件2240向远侧推进，以使锁杆联接器2246变得与换档器2252的近侧端部2253可操作地接合，并将锁定楔形件2244移回其起始或解锁位置，这时右锁定构件2224和左锁定构件2228可以弹回或以其它方式返回到其解锁位置。然后，使用者可以沿适当的轴向方向向远侧击发杆1620施加轴向动作，以使外科端部执行器1100返回到其非关节运动位置。
图90至95示出了另选的关节运动锁定布置2310，其用于将外科端部执行器1100相对于轴轴线SA围绕关节运动轴线B-B锁定在关节运动位置。在例示的示例中，外科端部执行器1100枢转地联接到脊组件1500'。脊组件1500’可以以上述方式附接到底座1800(图4)。脊组件1500'的上部脊部分1539的远端部分1540形成有向下突出的关节运动销1542，该关节运动销限定关节运动轴线B-B。关节运动销1542被构造成能够可旋转地或枢转地被接纳在脊附接孔1254内，该脊附接孔设置在端部执行器安装组件1250”的安装基部1252中。端部执行器安装组件1250”由弹簧销连接器1235(图6)附接到细长通道1102的近侧端部1103，弹簧销连接器延伸穿过安装组件1250”中的横向安装孔1251，以接纳在设置在细长通道1102的近侧端部1103中的通道安装孔1106(图6)内。
参见图90，所示的布置采用两个关节运动连接件1710R”和1710L”以将向左和向右关节运动动作施加到外科端部执行器1100。为了使外科端部执行器1100向右进行关节运动，关节运动连接件1710R”沿近侧方向PD轴向回缩，并且关节运动连接件1710L”沿远侧方向DD轴向推进。相反，为了使外科端部执行器1100沿向左方向进行关节运动，关节运动连接件1710L”沿近侧方向PD轴向回缩，并且关节运动连接件1710R”沿远侧方向DD轴向推进。右远侧关节运动连接件1710R”具有开槽端部1711R，该端部被接纳在右关节运动销1266R上，该右关节运动销附接到端部执行器安装组件1250”。同样，左远侧关节运动连接件1710L”具有开槽端部1711L，该端部被接纳在左关节运动销1266L上，该左关节运动销附接到端部执行器安装组件1250”。
仍然参见图90，右制动片2312形成在右远侧关节运动连接件1710R”上，左制动片2320形成在左远侧关节运动连接件1710L”上。如在图90中也可见，右制动片2312和左制动片2320被支撑在下部远侧脊部分1552'和上部脊部分1539之间。下部远侧脊部分1552'包括向上延伸的远侧支撑销1554，该远侧支撑销被构造成能够被接纳在形成在上部脊部分1539的下侧上的远侧凸台(未示出)中。在所示的布置中，关节运动锁定布置2310还包括能够轴向移动且可锁定的锁定杆组件2340，其可与本文所述类型的关节运动传动装置可操作地接合，或以其它方式与被构造成能够在远侧方向DD和近侧方向PD上施加轴向控制动作的锁定杆控制布置(未示出)接合。锁定杆组件2340包括形成在其远侧端部2342上的锁定夹具2344。锁定夹具2344延伸穿过右制动片2312中的右制动狭槽2314和左制动片2320中的左制动狭槽2322，并且穿过被设置为穿过楔形板2350的轴向狭槽2352以接合夹板2360。
将参考图91至95说明关节运动锁定布置2310的操作。图91示出了处于非关节运动位置的外科端部执行器1100。锁定杆组件2340处于解锁位置，其中夹具部分2344不向右制动片2312和左制动片2320施加任何夹紧力。因此，当向其施加关节运动动作时，右远侧关节运动连接件1710R”和左远侧关节运动连接件1710L”可自由地轴向移动。各个部件之间的摩擦可以防止外科端部执行器1100围绕关节运动轴线B-B翻转或旋转。图92示出了通过将右远侧关节运动连接件1710R”沿远侧方向DD轴向移动并将左远侧关节运动连接件1710L”沿近侧方向PD移动，外科端部执行器1100沿向左方向LD的关节运动。图93示出了处于解锁构型的关节运动锁定布置2310。图94和95示出了处于锁定构型的关节运动锁定布置2310。通过沿近侧方向向锁定杆组件2340施加致动动作来锁定关节运动锁定布置2310。此类动作使其夹紧部分夹紧左制动片2312和右制动片2320，以便保持夹在楔形板2350和下部远侧脊部分1552'之间。此类布置用于在夹板2360和下部远侧脊部分1552'之间施加夹紧力CF，从而防止右远侧关节运动连接件1710R”和左远侧关节运动连接件1710L”的任何进一步轴向移动。
图96和97示出了可与本文所公开的各种关节运动连接件布置一起使用的关节运动行程倍增器传动布置2410的示例。首先转到图97，示出了轴组件1400”的一部分的剖视图，该轴组件包括近侧闭合构件1410以及上部中间脊段1510”和远侧脊延伸部1562”。中间脊段1510”和远侧脊延伸部1562”用于以本文所公开的各种方式可操作地支撑远侧击发杆1620以及近侧击发轴段1602。该实施方案包括中间关节运动连接件段1706和远侧关节运动连接件段1707，它们可以以本文所公开的各种方式中的任何一种与端部执行器安装组件连接。中间关节运动连接件1706可以以本文所公开的各种方式可操作地与关节运动锁1210连接。如在图96中可见，中间关节运动连接件段1706包括形成在其上的中间或第一齿条1708，远侧关节运动连接件段1707包括第二或远侧齿条1709。齿条1708和1709与至少一个并且优选地至少两个倍增器小齿轮组2412啮合接合，所述小齿轮组可旋转地支撑在上部中间脊部分1510”和远侧脊延伸部1562”之间。参见图97。例如，在所示的布置中，每个倍增器齿轮组2412包括被支撑为与第一齿条1708啮合接合的较小驱动齿轮2414，以及被支撑为与远侧齿条1709啮合接合的较大倍增器齿轮2416。
图98A至98C示出了关节运动行程倍增器传动布置2410的操作。图98A示出了处于中间或非关节运动位置时中间关节运动连接件段1706和远侧关节运动连接件段1707的位置。图98B示出了在中间关节运动连接件段1706已经从图98A中的中间位置在远侧方向上轴向推进距离D1R之后中间关节运动连接件段1706和远侧关节运动连接件段1707的位置。如在图98B中也可见，远侧关节运动连接件1707移动轴向距离D2R。在例示的示例中，D2R>D1R。图98C示出了在中间关节运动连接件段1706已经从图98A中所示的中间位置在近侧方向PD上轴向推进距离D1L之后中间关节运动连接件段1706和远侧关节运动连接件段1707的位置。如在图98C中也可见，远侧关节运动连接件1707移动轴向距离D2L。在例示的示例中，D2L>D1L。因此，此类布置使得能够获得附加的轴向关节运动行程并且用于使端部执行器围绕关节运动轴线通过更大范围的关节运动来进行关节运动。
图99A至99B示出了可与本文所公开的各种关节运动连接件布置一起使用的关节运动行程倍增器传动装置2510的示例。关节运动行程倍增器2510可操作地与近侧关节运动驱动器1700”接合，该近侧关节运动驱动器可以与近侧关节运动驱动器1700相同，除了所提到的差异。具体地讲，近侧关节运动驱动器1700”包括形成在其远侧端部上的驱动齿条1701。该驱动齿条被构造成能够啮合接合齿轮段2522，该齿轮段形成在枢转地销接到脊组件的对应部分的摆动齿轮2520上。在所示的布置中，摆动齿轮2520可围绕横向于轴向方向的摆动齿轮轴线枢转，近侧关节运动驱动器1700”被构造成能够沿所述轴向方向行进。摆动齿轮2520还包括转移狭槽2524，该转移狭槽被构造成能够接纳附接到中间关节运动连接件段1706”的近侧端部1716的转移销1713。如在图99A至99B中可见，中间关节运动连接件段1706”的远侧端部被构造成能够以本文所公开的各种方式可操作地与关节运动锁1210连接。
图99A示出了处于中间位置的关节运动行程倍增器传动装置2510，其中没有向近侧关节运动驱动器1700”施加关节运动动作。图99B示出了在近侧关节运动驱动器1700”已经沿远侧方向DD轴向推进第一轴向距离D1之后关节运动行程倍增器传动装置2510的位置。近侧关节运动驱动器1700”沿远侧方向的此类运动使得摆动齿轮2520沿顺时针方向CW围绕摆动齿轮轴线枢转。摆动齿轮2520的此类移动驱动中间关节运动连接件段1706”沿近侧方向行进第二轴向距离D2。在此类示例中，D2>D1。图99C至99D示出了类似的布置，不同的是转移狭槽2524设置在中间关节运动连接件段1706”的近侧端部1716中并且转移销1713设置在摆动齿轮2520中。
实施例
实施例1-一种外科工具组件，该外科工具组件包括由关节运动接头可移动地联接到轴组件的外科端部执行器。该关节运动接头被构造成能够选择性地促进外科端部执行器相对于轴组件围绕关节运动轴线的选择性关节运动。关节运动轴线横向于由轴组件限定的轴轴线。轴组件包括近侧端部，可操作地连接到关节运动接头的远侧端部，以及轴组件中的细长凹口。细长凹口位于轴轴线的一个侧向侧上并且位于远侧端部附近。
实施例2-实施例1的外科工具组件，其中，关节运动接头被构造成能够将外科端部执行器围绕关节运动轴线的关节运动限制在轴轴线的一个侧向侧。
实施例3-实施例1或2的外科工具组件，其中，轴组件包括脊组件和近侧闭合构件。脊组件包括可操作地联接到关节运动接头的远侧脊端部。近侧闭合构件被支撑在脊组件上，用于相对于脊组件选择性地轴向行进。细长凹口还包括位于轴轴线的一个侧向侧上的远侧脊端部中的细长脊凹口，和位于轴轴线的一个侧向侧上的近侧闭合构件中并且与细长脊凹口对应的细长闭合构件凹口。
实施例4-实施例3的外科工具组件，其中，外科端部执行器包括可操作地联接到关节运动接头的第一钳口，和第二钳口，第二钳口被支撑用于响应于施加到其上的闭合动作而相对于第一钳口进行选择性的可移动行进。
实施例5-实施例4的外科工具组件，其中，轴组件还包括远侧闭合构件，该远侧闭合构件可移动地联接到近侧闭合构件，用于与其一起选择性地轴向行进，远侧闭合构件可操作地与第二钳口连接以向其施加闭合动作。
实施例6-实施例1或2的外科工具组件，其中，外科工具组件还包括用于当轴向致动动作被施加到轴组件的近侧端部时防止轴组件的远侧端部屈曲的装置。
实施例7-实施例3、4或5的外科工具组件，其中，外科工具组件还包括用于当轴向致动动作被施加到轴组件的近侧端部时防止轴组件的远侧端部屈曲的装置。
实施例8-实施例7的外科工具组件，其中，用于防止屈曲的装置包括至少一个对准构件，该对准构件从近侧闭合构件突出并且延伸到脊组件中的对应的轴向狭槽中。
实施例9-实施例8的外科工具组件，其中，所述至少一个对准构件包括至少一个第一对准构件和至少一个第二对准构件，第一对准构件在第一位置处从近侧闭合构件突出并且延伸到脊组件中的对应的第一轴向狭槽中以在其中进行轴向行进，第二对准构件在与第一位置沿直径相对的第二位置处从近侧闭合构件突出。第二对准构件延伸到脊组件中的对应的第二轴向狭槽中。
实施例10-实施例8或9的外科工具组件，其中，所述至少一个对准构件中的至少一个具有L形横截面形状。
实施例11-一种外科工具组件，该外科工具组件包括由关节运动接头可移动地联接到轴组件的外科端部执行器。关节运动接头被构造成能够促进外科端部执行器相对于轴组件围绕关节运动轴线的选择性关节运动。关节运动轴线横向于由轴组件限定的轴轴线。轴组件包括近侧部分和远侧部分，近侧部分包括不间断的近侧外周边，远侧部分从近侧部分延伸并且可操作地联接到关节运动接头。远侧部分包括远侧外周边，该远侧外周边包括位于轴轴线的一个侧向侧上的不连续远侧部分。
实施例12-实施例11的外科工具组件，其中，关节运动接头被构造成能够将外科端部执行器围绕关节运动轴线的关节运动限制在轴轴线的一个侧向侧。
实施例13-实施例11或12的外科工具组件，其中，轴组件包括脊组件，该脊组件包括可操作地联接到关节运动接头的远侧脊端部和支撑在脊组件上以相对于其选择性地轴向行进的近侧闭合构件。不连续的远侧部分包括在轴轴线的一个侧向侧上的近侧闭合构件中的细长闭合构件凹口。
实施例14-实施例13的外科工具组件，其中，外科工具组件还包括细长闭合构件凹口。
实施例15-实施例13或14的外科工具组件，其中，外科工具组件还包括用于当轴向致动动作被施加到轴组件的近侧部分时防止轴组件的远侧端部屈曲的装置。
实施例16-实施例15的外科工具组件，其中，用于防止屈曲的装置包括至少一个对准构件，该对准构件从近侧闭合构件突出并且延伸到脊组件中的对应的轴向狭槽中。
实施例17-实施例16的外科工具组件，其中，所述至少一个对准构件包括至少一个第一对准构件和至少一个第二对准构件，第一对准构件在第一位置处从近侧闭合构件突出并且延伸到脊组件中的对应的第一轴向狭槽中以在其中进行轴向行进，第二对准构件在与第一位置沿直径相对的第二位置处从近侧闭合构件突出。第二对准构件延伸到脊组件中的对应的第二轴向狭槽中。
实施例18-实施例16或17的外科工具组件，其中，所述至少一个对准构件中的至少一个具有L形横截面形状。
实施例19-实施例11、12、13、14、15、16、17或18的外科工具组件，其中，远侧部分包括远侧轴向长度。近侧部分包括近侧轴向长度，并且近侧轴向长度大于远侧轴向长度。
实施例20-一种外科工具组件，该外科工具组件包括由关节运动接头可移动地联接到轴组件的外科端部执行器。关节运动接头被构造成能够促进外科端部执行器相对于轴组件围绕关节运动轴线的选择性关节运动。关节运动轴线横向于由轴组件限定的轴轴线。轴组件包括近侧端部、可操作地联接到关节运动接头的远侧端部、细长凹口、以及与轴轴线轴向对准的可轴向移位的击发构件。细长凹口在轴组件的轴轴线的一个侧向侧上并且位于远侧端部附近。
实施例21-一种外科工具组件，该外科工具组件包括轴组件、外科端部执行器和保护性顶盖构件。轴组件包括能够轴向移动的闭合构件，以及能够在未击发位置和击发位置之间选择性地轴向移动的能够轴向移动的击发构件。外科端部执行器包括第一钳口和第二钳口，第二钳口包括安装部分，该安装部分包括一对安装壁。安装壁被构造成能够可移动地接合第一钳口的一部分，以将第二钳口可移动地支撑在第一钳口上。安装部分限定凸轮区域，该凸轮区域被构造成能够由能够轴向移动的闭合构件接合，以使第二钳口相对于第一钳口从打开位置移动到闭合位置。安装壁在其间限定顶部打开的停放区域，用于在击发构件处于未击发位置时将击发构件容纳在其中。保护性顶盖构件附接到安装壁并且覆盖顶部打开的停放区域的至少一部分。
实施例22-实施例21的外科工具组件，其中，每个安装壁被构造成能够枢转地接合第一钳口的对应部分，以促进第二钳口相对于第一钳口围绕枢转轴线的枢转行进。
实施例23-实施例22的外科工具组件，其中，每个安装壁从凸轮区域向近侧突出。保护性顶盖包括过渡部分，该过渡部分构被造成覆盖顶部打开的停放区域的靠近凸轮区域的至少一部分并形成靠近凸轮区域的预闭合凸轮表面，以及从过渡部分延伸以将保护性顶盖联接到至少一个安装壁上的至少一个附接部分。
实施例24-实施例23的外科工具组件，其中，所述至少一个附接构件包括第一腿部和第二腿部，第一腿部从过渡部分向下延伸并且被构造成能够保持地接合安装壁中的对应一个，第二腿部从过渡部分向下延伸并且被构造成能够保持地接合安装壁中的对应另一个。
实施例25-实施例24的外科工具组件，其中，第一腿部和第二腿部可移除地附接到安装壁。
实施例26-实施例25的外科工具组件，其中，第一腿部包括第一附接开口，该第一附接开口被构造成能够将形成在安装壁中的对应一个上的第一附接凸耳保持地接纳在其中。第二腿部包括第二附接开口，该第二附接开口被构造成能够将形成在安装壁中的对应另一个上的第二附接凸耳保持地接纳在其中。
实施例27-实施例23、24、25或26的外科工具组件，其中，闭合构件包括远侧凸轮传动表面，该远侧凸轮传动表面被构造成能够以凸轮传动方式接合保护性顶盖上的预闭合凸轮表面以及安装部分上的凸轮区域，以将第二钳口从打开位置移动到闭合位置。
实施例28-实施例22、23、24、25、26或27的外科工具组件，其中，外科工具组件还包括用于将第二钳口偏置到打开位置的装置。
实施例29-实施例28的外科工具组件，其中，外科工具组件还包括用于防止第二钳口打开超过最大打开位置的装置。
实施例30-实施例22、23、24、25、26、27、28或29的外科工具组件，其中，第二钳口被构造成能够相对于第一钳口围绕枢转轴线选择性地枢转，并且其中顶部打开的停放区域的至少一部分靠近枢转线。
实施例31-实施例22、23、24、25、26、27、28、29或30的外科工具组件，其中，第二钳口包括枢转地支撑在安装壁中的一对凸耳。
实施例32-实施例31的外科工具组件，其中，所述一对耳轴包括第一凸耳和第二凸耳，第一凸耳被构造成能够枢转地支撑在安装壁中的第一个中的第一横向枢转孔中，第二凸耳被构造成能够枢转地支撑在安装壁中的第二个中的第二横向枢转孔中。第一凸耳和第二凸耳限定枢转轴线，第二钳口可围绕该枢转轴线枢转。
实施例33-实施例32的外科工具组件，其中，外科工具组件还包括在安装壁中的第一个中的第一安装狭槽和在安装壁中的第二个中的第二安装狭槽。第一安装狭槽从安装壁中的第一个的第一顶部边缘横向于第一横向枢转孔延伸到第一横向枢转孔。第二安装狭槽从所述安装壁中的所述第二个的第二顶部边缘横向于第二横向枢转孔延伸到所述第二横向枢转孔。
实施例34-一种外科工具组件，该外科工具组件包括轴组件、外科端部执行器和保护性顶盖构件。轴组件包括能够轴向移动的闭合构件，以及能够在未击发位置和击发位置之间选择性地轴向移动的能够轴向移动的击发构件。外科端部执行器包括细长通道和砧座，细长通道被构造成能够将外科钉仓可操作地支撑在其中，砧座包括砧座安装部分。砧座安装部分包括一对砧座安装壁，砧座安装壁枢转地支撑在细长通道上以相对于细长通道围绕枢转轴线进行选择性的枢转行进。砧座安装部分限定凸轮区域，该凸轮区域被构造成能够由能够轴向移动的闭合构件接合，以使砧座相对于细长通道从打开位置移动到闭合位置。砧座安装壁在其间限定顶部打开的停放区域，用于在击发构件处于未击发位置时将击发构件容纳在其中。保护性顶盖构件附接到砧座安装壁并且覆盖顶部打开的停放区域的至少一部分。
实施例35-实施例34的外科工具组件，其中，顶部打开的停放区域的至少一部分靠近枢转轴线。
实施例36-实施例34或35的外科工具组件，其中，击发构件包括竖直延伸的击发主体，该击发主体包括组织切割边缘、顶部砧座接合突片和底部通道接合突片。顶部砧座接合突片从击发主体的顶端侧向延伸，并且被构造成能够在击发构件从未击发位置轴向推进到击发位置时接合砧座。底部通道接合突片从击发主体的底部部分侧向延伸，并且被构造成能够在击发构件从未击发位置轴向推进到击发位置时接合通道，以将砧座的下侧保持在距离支撑在细长通道中的外科钉仓的钉仓平台的所需距离处。
实施例37-实施例34、35或36的外科工具组件，其中，每个安装壁从凸轮区域向近侧突出。保护性顶盖包括过渡部分，该过渡部分构被造成覆盖顶部打开的停放区域的靠近凸轮区域的至少一部分并形成靠近凸轮区域的预闭合凸轮表面，以及从过渡部分延伸以将保护性顶盖联接到至少一个砧座安装壁上的至少一个附接部分。
实施例38-实施例37的外科工具组件，其中，所述至少一个附接部分包括第一腿部和第二腿部，第一腿部从过渡部分向下延伸并且被构造成能够保持地接合砧座安装壁中的对应一个，第二腿部从过渡部分向下延伸并且被构造成能够保持地接合砧座安装壁中的对应另一个。
实施例39-实施例34、35、36、37或38的外科工具组件，其中，外科工具组件还包括用于在闭合构件处于起始位置时将砧座偏置到打开位置的装置。
实施例40-一种外科工具组件，该外科工具组件包括轴组件和外科端部执行器。轴组件包括能够轴向移动的闭合构件，以及能够在未击发位置和击发位置之间选择性地轴向移动的能够轴向移动的击发构件。外科端部执行器包括第一钳口和第二钳口，第二钳口包括安装部分。安装部分包括一对安装壁，其被构造成能够可移动地接合第一钳口的一部分，以将第二钳口可移动地支撑在第一钳口上。安装部分限定凸轮区域，该凸轮区域被构造成能够由能够轴向移动的闭合构件接合，以使第二钳口相对于第一钳口从打开位置移动到闭合位置。安装壁在其间限定顶部打开的停放区域，用于在击发构件处于未击发位置时将击发构件容纳在其中。该外科工具组件还包括用于至少部分地覆盖顶部打开的停放区域的至少一部分并且限定靠近凸轮区域的预闭合凸轮表面的装置。
实施例41-一种外科工具组件，该外科工具组件包括第一钳口、第二钳口和轴组件。第二钳口可移动地支撑在第一钳口上，用于相对于第一钳口在打开位置和闭合位置之间围绕固定的枢转轴线进行选择性的移动。轴组件被构造成能够当闭合构件在凸轮表面上轴向推进时在法向于凸轮表面的第一闭合方向上对第二钳口上的凸轮表面施加初始闭合动作，并且在平行于轴轴线的第二闭合方向上向凸轮表面施加附加的闭合动作。
实施例42-实施例41的外科工具组件，其中，凸轮表面形成在第二钳口安装部分上，并且其中第二钳口还包括第一安装壁和第二安装壁，该第一安装壁和第二安装壁各自枢转地附接到第一钳口以围绕枢转轴线进行选择性的枢转行进。
实施例43-实施例41或42的外科工具组件，其中，能够轴向移动的闭合构件包括远侧闭合管，该远侧闭合管包括远端表面和远侧凸轮传动表面，远侧凸轮传动表面被构造成能够以凸轮传动方式接合第二钳口上的凸轮表面。
实施例44-实施例43的外科工具组件，其中，远端表面被构造成能够将初始闭合动作施加到凸轮表面，并且远侧凸轮传动表面被构造成能够将附加闭合动作施加到凸轮表面。
实施例45-实施例44的外科工具组件，其中，远端表面包括闭合管的横截面厚度的一部分，并且其中凸轮传动表面从远端表面延伸并且包括闭合管的横截面厚度的另一部分。
实施例46-实施例45的外科工具组件，其中，闭合管包括外表面、内表面和限定远端表面的远侧端部。远侧凸轮传动表面相对于远端表面以钝角从远端表面延伸到内表面。
实施例47-实施例42的外科工具组件，其中，轴组件还包括能够轴向移动的击发构件，其能够在第一安装壁和第二安装壁之间在起始位置和终止位置之间选择性地轴向移动。
实施例48-实施例47的外科工具组件，其中，当击发构件处于起始位置时，击发构件的至少一部分靠近凸轮表面。
实施例49-一种外科工具组件，该外科工具组件包括端部执行器和轴组件。端部执行器包括细长通道和砧座，该细长通道被构造成能够将外科钉仓可操作地支撑在其中。砧座包括可移动地支撑在细长通道上的砧座安装部分，用于相对于细长通道围绕固定枢转轴线在打开位置和闭合位置之间进行选择性的移动。轴组件限定轴轴线并且包括能够轴向移动的闭合构件，该闭合构件被构造成能够当闭合构件在凸轮表面上轴向推进时在法向于凸轮表面的第一闭合方向上将初始闭合动作施加到砧座安装部分上的凸轮表面，并且在平行于轴轴线的第二闭合方向上向凸轮表面施加附加的闭合动作。
实施例50-实施例49的外科工具组件，其中，砧座还包括第一砧座安装壁和第二砧座安装壁，该第一砧座安装壁和第二砧座安装壁各自枢转地附接到细长通道，以围绕枢转轴线进行选择性的枢转行进。
实施例51-实施例49或50的外科工具组件，其中，能够轴向移动的闭合构件包括远侧闭合管，该远侧闭合管包括远端表面和远侧凸轮传动表面，远侧凸轮传动表面被构造成能够以凸轮传动方式接合砧座安装部分上的凸轮表面。
实施例52-实施例51的外科工具组件，其中，远端表面被构造成能够将初始闭合动作施加到凸轮表面，并且远侧凸轮传动表面被构造成能够将附加闭合动作施加到凸轮表面。
实施例53-实施例52的外科工具组件，其中，远端表面包括闭合管的横截面厚度的一部分，并且其中凸轮传动表面从远端表面延伸并且包括闭合管的横截面厚度的另一部分。
实施例54-实施例50的外科工具组件，其中，轴组件还包括能够轴向移动的击发构件，其能够在第一砧座安装壁和第二砧座安装壁之间在起始位置和终止位置之间选择性地轴向移动。
实施例55-实施例54的外科工具组件，其中，当击发构件处于起始位置时，击发构件的至少一部分靠近凸轮表面。
实施例56-一种外科工具组件，该外科工具组件包括端部执行器和轴组件，轴组件限定轴轴线并且包括能够轴向移动的闭合构件。端部执行器包括：细长通道，其被构造成能够将外科钉仓可操作地支撑在其中；以及砧座，其可移动地包括支撑在细长通道上的砧座安装部分以相对于细长通道在打开位置和闭合位置之间进行选择性的移动。该外科工具组件还包括位于闭合构件上的第一闭合装置，其用于在法向于凸轮表面的第一闭合方向上将初始闭合动作施加到砧座安装部分上的凸轮表面，以及位于闭合构件上的第二闭合装置，其用于当闭合构件在凸轮表面上轴向推进时在平行于轴轴线的第二闭合方向上向凸轮表面施加附加的闭合动作。
实施例57-实施例56的外科工具组件，其中，第一闭合装置包括在闭合构件的远侧端部的一部分上的远侧凸轮表面，并且其中第二闭合装置包括在远侧端部的另一部分上并从远侧凸轮表面相对于其以钝角延伸的远侧凸轮传动表面。
实施例58-实施例56或57的外科工具组件，其中，凸轮表面形成在砧座安装部分上，并且其中砧座还包括第一安装壁和第二安装壁，该第一安装壁和第二安装壁各自枢转地附接到细长通道，以围绕枢转轴线进行选择性的枢转行进。
实施例59-实施例58的外科工具组件，其中，轴组件还包括能够轴向移动的击发构件，其能够在第一安装壁和第二安装壁之间在起始位置和终止位置之间选择性地轴向移动。
实施例60-实施例59的外科工具组件，其中，当击发构件处于起始位置时，击发构件的至少一部分靠近凸轮表面。
实施例61-一种外科工具组件，该外科工具组件包括外科端部执行器和闭合构件，该闭合构件能够响应于施加到其上的闭合动作和打开动作而轴向移动。外科端部执行器包括第一钳口和第二钳口，第二钳口包括第二钳口主体部分和第二钳口安装部分。第二钳口安装部分可移动地联接到第一钳口，用于相对于第一钳口在打开位置和闭合位置之间选择性地移动。闭合构件包括形成在其上的至少一个开口凸轮，并且所述至少一个开口凸轮被构造成能够可移动地接合形成在第二钳口主体部分上的对应的凸轮表面，使得在将打开动作施加到闭合构件时，所述至少一个开口凸轮可移动地接合该对应的凸轮表面以使第二钳口移动到打开位置。在将闭合动作施加到闭合构件上时，闭合构件接合第二钳口以使第二钳口移动到闭合位置中的一个。
实施例62-实施例61的外科工具组件，其中，所述至少一个开口凸轮包括第一钩部分和第二钩部分，第一钩部分从闭合构件的远侧端部向远侧延伸并且被构造成能够以凸轮传动方式接合形成在第二钳口主体部分上的凸轮表面中的第一个，第二钩部分从闭合构件的远侧端部向远侧延伸并且被构造成能够以凸轮传动方式接合形成在第二钳口主体部分上的凸轮表面中的第二个。
实施例63-实施例61或62的外科工具组件，其中，凸轮表面包括形成在第二钳口主体部分上的向下延伸的斜坡表面。
实施例64-实施例63的外科工具组件，其中，所述至少一个开口凸轮中的每个包括形成在其上的凸轮传动端部，凸轮传动端部被构造成能够在向闭合构件施加打开动作时以凸轮传动方式接合对应的斜坡表面。
实施例65-实施例64的外科工具组件，其中，每个斜坡表面包括斜坡表面端部，并且其中每个凸轮传动端部被构造成能够接合对应的斜坡表面的斜坡表面端部以将第二钳口相对于第一钳口保持在完全打开位置。
实施例66-实施例61、62、63、64或65的外科工具组件，其中，外科工具组件还包括用于将附加的打开动作施加到第二钳口的辅助钳口打开装置。
实施例67-实施例66的外科工具组件，其中，辅助钳口打开装置包括闭合构件上的至少一个辅助钳口打开构件，其被构造成能够接合第二钳口上的对应的钳口打开特征部，以在将打开动作施加到闭合构件时将附加的打开动作施加到第二钳口。
实施例68-实施例67的外科工具组件，其中，辅助钳口打开特征部包括至少一个第一钳口打开突片和至少一个第二钳口打开突片，第一钳口打开突片一体地形成在闭合构件中并且被构造成能够接触对应的钳口打开特征部中的对应一个，第二钳口打开突片一体地形成在闭合构件中并且被构造成能够接触对应的钳口打开特征部中的另一对应一个。
实施例69-实施例66、67或68的外科工具组件，其中，辅助钳口打开装置包括至少一个偏置构件，该偏置构件被构造成能够将附加的打开动作施加到第二钳口。
实施例70-实施例62、63、64、65、66、67、68或69的外科工具组件，其中，第一和第二钩部分各自包括其上的柔顺部分。
实施例71-实施例70的外科工具组件，其中，柔顺部分包括附接到第一和第二钩部分中的每个的柔顺材料。
实施例72-实施例70或71的外科工具组件，其中，所述至少一个偏置构件包括与第一和第二钩部分中的每个相对应并且附接到其上的弹簧。
实施例73-一种外科工具组件，该外科工具组件包括外科端部执行器和闭合构件，该闭合构件能够响应于施加到其上的闭合动作和打开动作而轴向移动。外科端部执行器包括：细长通道，其被构造成能够将外科钉仓可操作地支撑在其中；以及砧座，其包括砧座主体和砧座安装部分，砧座安装部分枢转地支撑在细长通道上，以相对于细长通道在打开位置和闭合位置之间进行选择性的移动。闭合构件包括形成在其上的至少一个开口凸轮，其中所述至少一个开口凸轮被构造成能够可移动地接合形成在砧座主体部分上的对应的凸轮表面，使得在将打开动作施加到闭合构件时，所述至少一个开口凸轮可移动地接合该对应的凸轮表面以使砧座移动到打开位置，并且在将闭合动作施加到闭合构件上时，闭合构件接合砧座以使砧座移动到闭合位置中的一个。
实施例74-实施例73的外科工具组件，其中，外科工具组件还包括形成在砧座主体上的至少一个组织止挡件，并且其中至少一个凸轮表面位于所述至少一个组织止挡件的近侧。
实施例75-实施例73或74的外科工具组件，其中，所述至少一个开口凸轮包括第一钩部分和第二钩部分，第一钩部分从闭合构件的远侧端部向远侧延伸并且被构造成能够以凸轮传动方式接合形成在砧座主体上的凸轮表面中的第一个，第二钩部分从闭合构件的远侧端部向远侧延伸并且被构造成能够以凸轮传动方式接合形成在砧座主体上的凸轮表面中的第二个。
实施例76-实施例75的外科工具组件，其中，第一和第二钩部分各自包括其上的柔顺部分。
实施例77-实施例73或74的外科工具组件，其中，第一和第二钩部分各自包括其上的柔顺部分。
实施例78-实施例73、74、75、76或77的外科工具组件，其中，外科工具组件还包括用于将附加的打开动作施加到第二钳口的辅助砧座打开装置。
实施例79-实施例78的外科工具组件，其中，砧座枢转地联接到细长通道，以围绕枢转轴线在打开位置和闭合位置之间选择性地枢转行进。辅助砧座打开装置位于枢转轴线的近侧。
实施例80-一种外科工具组件，该外科工具组件包括外科端部执行器和闭合构件。外科端部执行器包括细长通道和砧座，细长通道被构造成能够将外科钉仓可操作地支撑在其中，砧座包括砧座主体和砧座安装部分。砧座安装部分被枢转地支撑在细长通道上，以便相对于细长通道在打开位置与闭合位置之间移动。闭合构件能够在对应于闭合位置中的完全闭合位置的完全致动位置和对应于打开位置的未致动位置之间轴向移动。闭合构件包括闭合系统，该闭合系统被构造成能够随着闭合构件从完全致动位置移动到未致动位置而顺序地将初始打开动作施加到砧座然后将附加的辅助动作施加到砧座。
实施例81-一种外科端部执行器，该外科端部执行器包括：第一钳口，其被构造成能够将外科钉仓可操作地支撑在其中；第二钳口，其相对于第一钳口可移动地支撑以在打开位置和闭合位置之间选择性地移动；击发构件；以及击发构件闭锁系统。击发构件被支撑以在向击发构件施加击发和回缩动作时，在第一钳口内沿轴轴线在起始位置和终止位置之间轴向移动。击发构件闭锁系统能够由第二钳口在未致动位置和锁定位置之间移动，其中当击发构件从起始位置向远侧初始推进时，击发构件锁定地接合击发构件闭锁系统以防止击发的进一步远侧推进，除非包括位于未击发位置的凸轮组件的未击发外科钉仓被支撑在第一钳口内。
实施例82-实施例81的外科端部执行器，其中，击发构件闭锁系统包括安装到第一钳口的锁定构件。
实施例83-实施例82的外科端部执行器，其中，锁定构件还包括弹簧突片，该弹簧突片被构造成能够将锁定构件支撑在第一钳口上并将锁定构件偏置到解锁位置。
实施例84-实施例82或83的外科端部执行器，其中，锁定构件包括至少一个能够侧向移动的锁定部分，该锁定部分被构造成能够在第二钳口处于闭合位置时在击发构件的初始远侧推进时锁定地接合击发构件的一部分，除非未击发的外科钉仓被支撑在第一钳口内。
实施例85-实施例84的外科端部执行器，其中，击发构件包括击发构件主体，击发构件主体包括锁定突出部，该锁定突出部对应于能够侧向移动的锁定部分中的每个，每个锁定突出部被取向成用于在第二钳口处于闭合位置时在击发构件的初始远侧推进时与对应的能够侧向移动的锁定部分锁定接合，除非未击发的外科钉仓被支撑在第一钳口内。
实施例86-实施例85的外科端部执行器，其中，凸轮组件包括对应于每个能够侧向移动的锁定部分的解锁特征部，以在未击发的外科钉仓被支撑在第一钳口中并且其凸轮组件处于未击发位置时，使对应的能够侧向移动的锁定部分中的每个侧向偏置成脱离与对应的锁定突出部锁定接合。
实施例87-实施例85或86的外科端部执行器，其中，每个能够侧向移动的锁定部分包括锁定窗口，该锁定窗口被构造成能够当能够侧向移动的锁定部分与对应的锁定突出部锁定接合时锁定地接纳对应的锁定突出部的一部分。
实施例88-实施例81、82、83、84、85、86或87的外科端部执行器，其中，击发构件闭锁系统包括至少一个锁定构件，该锁定构件可移动地联接到所述第二钳口，以当所述砧座处于所述闭合位置时沿横向于所述轴轴线的对应锁定轴线行进。
实施例89-实施例81、82、83、84、85、86、87或88的外科端部执行器，其中，击发构件闭锁系统包括可移动地支撑以在解锁位置和锁定位置之间行进的锁定构件，其中，在击发构件的初始远侧推进时，锁定构件的至少一部分被构造成能够钩住地接合击发构件的对应部分，以防止击发构件从起始位置推进到终止位置。
实施例90-一种外科端部执行器，该外科端部执行器包括：细长通道，该细长通道被构造成能够将外科钉仓可操作地支撑在其中；相对于细长通道支撑的砧座，使得砧座能够相对于细长通道在打开位置和闭合位置之间选择性地移动；击发构件；和击发构件闭锁系统。击发构件被支撑以在向击发构件施加击发和回缩动作时，在细长通道内沿轴轴线在起始位置和终止位置之间轴向移动。击发构件闭锁系统能够由砧座在未致动位置和锁定位置之间移动，其中当击发构件从起始位置向远侧初始推进时，击发构件锁定地接合击发构件闭锁系统以防止击发的进一步远侧推进，除非包括位于未击发位置的凸轮组件的未击发外科钉仓被支撑在细长通道内。击发构件闭锁系统被构造成能够当砧座移动到闭合位置时从未致动位置移动到锁定位置。
实施例91-实施例90的外科端部执行器，其中，击发构件闭锁系统包括锁定构件。锁定构件包括：一对能够侧向移动的锁定部分；安装部分，其被构造成能够将锁定构件支撑在外科端部执行器上并将锁定构件偏置到未致动位置；以及锁定构件上的至少一个砧座突片，其用于当砧座移动到闭合位置时接触砧座的对应部分。
实施例92-实施例91的外科端部执行器，其中，每个能够侧向移动的锁定部分包括锁定窗口，该锁定窗口被构造成能够当锁定构件处于锁定位置时保持地接合击发构件的对应部分，除非未击发的外科钉仓被支撑在细长通道内。
实施例93-实施例92的外科端部执行器，其中，击发构件的每个对应部分包括侧向突出的锁定凸耳，该锁定凸耳对应于对应的能够侧向移动的锁定部分的每个锁定窗口并且尺寸被设计成当锁定构件处于锁定位置时保持地接纳在其中，与其锁定接合，除非包括位于未击发位置的凸轮组件的未击发外科钉仓被支撑在细长通道内。
实施例94-实施例93的外科端部执行器，其中，凸轮组件包括对应于每个能够侧向移动的锁定部分的解锁特征部，以在未击发的外科钉仓被支撑在细长通道中并且其凸轮组件处于未击发位置时，使对应的能够侧向移动的锁定部分中的每个侧向偏置成脱离与对应的锁定凸耳锁定接合。
实施例95-实施例90、91、92、93或94的外科端部执行器，其中，击发构件闭锁系统包括至少一个锁定构件，并且其中砧座包括砧座主体和砧座安装部分，砧座安装部分包括一对间隔开的砧座安装壁，该砧座安装壁各自枢转地支撑在细长通道上，并且其中每个砧座安装壁可移动地将对应的一个锁定构件支撑在其中。
实施例96-实施例90、91、92、93、94或95的外科端部执行器，其中，击发构件闭锁系统包括至少一个锁定构件，该锁定构件可移动地联接到砧座，以当砧座处于闭合位置时沿横向于轴轴线的对应锁定轴线行进。
实施例97-实施例90、91、92、93、94、95或96的外科端部执行器，其中，外科端部执行器还包括击发构件上的组织切割表面。
实施例98-一种外科器械，该外科器械包括：限定轴轴线的细长轴；细长通道，其可操作地联接到细长轴并且被构造成能够将外科钉仓可操作地支撑在其中；以及砧座，其相对于细长通道支撑，使得砧座能够相对于细长通道在打开位置和闭合位置之间选择性地移动。该外科器械还包括击发构件，其被支撑用于在向其施加击发和回缩动作时在细长通道内在起始位置和结束位置之间轴向行进，以及用于防止击发构件从起始位置移动到终止位置的装置，除非砧座处于闭合位置并且包括位于未击发位置的凸轮组件的未击发外科钉仓被支撑在细长通道内。
实施例99-实施例98的外科器械，其中，砧座包括砧座主体和从砧座主体部分延伸的一对砧座安装壁。每个砧座安装壁枢转地联接到细长通道，使得在由细长轴组件的闭合部分向砧座施加闭合动作和打开动作时，砧座能够相对于细长通道在打开位置和闭合位置之间选择性地移动。
实施例100-实施例98或99的外科器械，其中，用于防止的装置包括可移动地支撑以在解锁位置和锁定位置之间行进的锁定构件，其中至少一部分被构造成能够钩住地接合击发构件的对应部分，以防止击发构件从起始位置推进到终止位置，以及用于将击发构件偏置到解锁位置的装置。
实施例101-一种外科器械，该外科器械包括外科端部执行器，限定轴轴线的细长轴，闭合构件和关节运动接头。外科端部执行器包括第一钳口和第二钳口，第二钳口可移动地支撑在第一钳口上，以相对于第一钳口在打开位置和闭合位置之间进行选择性的行进。闭合构件可移动地支撑在细长轴上并且被构造成能够选择性地在闭合方向上从打开位置移动到闭合位置以及沿打开方向从闭合位置移动到打开位置。关节运动接头将外科端部执行器联接到细长轴，使得外科端部执行器能够相对于细长轴围绕横向于轴轴线的关节运动轴线进行选择性的关节运动。关节运动接头包括关节运动锁定布置，其被构造成能够从锁定构型以及解锁构型移动，在锁定构型，外科端部执行器被阻止围绕关节运动轴线做关节运动，在解锁构型，外科端部执行器能够围绕关节运动轴线做关节运动。当闭合构件在闭合方向上从打开位置移动时，关节运动锁定布置从锁定构型移动到解锁构型。该外科器械还包括用于在关节运动锁定布置处于解锁构型时将关节运动动作施加到外科端部执行器的装置。
实施例102-实施例101的外科器械，其中，关节运动锁定布置包括至少一个锁定构件，该锁定构件能够在对应于解锁构型的第一位置和第二位置之间移动，在第二位置，所述至少一个锁定构件与外科端部执行器的安装部分和细长轴的远端部分摩擦接合。所述至少一个锁定构件可操作地与闭合构件连接，使得闭合构件在闭合方向上的初始移动导致至少一个锁定构件从第一位置移动到第二位置。
实施例103-实施例102的外科器械，其中，外科端部执行器的安装部分包括直立安装柱，该直立安装柱包括多个柱侧面，并且其中所述至少一个锁定构件包括与每个柱侧面对应的锁定构件。
实施例104-实施例103的外科器械，其中，细长轴的远端部分包括限定关节运动轴线的枢转孔，并且其中直立安装柱延伸到枢转孔中，使得每个锁定构件可移动地在对应的柱侧面和枢转孔的内壁之间被支撑在枢转孔内。
实施例105-实施例104的外科器械，其中，直立安装柱被构造成能够当闭合构件在闭合方向上移动时，使多个锁定构件移动成与枢转孔的内壁和对应的柱侧面摩擦接合。
实施例106-实施例105的外科器械，其中，闭合构件包括近侧闭合构件，其与闭合动作和打开动作的源连接以使近侧闭合构件在闭合方向和打开方向上移动；远侧闭合构件，其由连杆布置枢转地联接到近侧闭合构件，其中连杆布置的一部分被构造成能够与直立安装柱连接，以便当闭合构件在闭合方向上初始移动时，使直立安装柱将多个锁定构件移动成与枢转孔的内壁和对应的柱侧壁摩擦接合。
实施例107-实施例106的外科器械，其中，连杆布置包括枢转地联接到近侧闭合构件和远侧闭合构件并在其间延伸的上部双枢转连接件，以及枢转地联接到近侧闭合构件和远侧闭合构件并在它们之间延伸的下部双枢转连接件。下部双枢转连接件被构造成能够可操作地与直立安装柱连接，以在下部双枢转连接件在闭合方向上初始移动时向直立安装柱施加锁定动作。
实施例108-实施例107的外科器械，其中，直立安装柱包括第一端部，该第一端部附接到邻近下部双枢转连接件的安装基部，直立柱逐渐渐缩到自由端，其中自由端的横截面积小于柱的第一端部的另一横截面积。
实施例109-实施例101、102、103、104、105、106、107、或108的外科器械，其中，第一钳口包括细长通道，该细长通道被构造成能够将外科钉仓可操作地支撑在其中，并且其中第二钳口包括砧座。
实施例110-实施例101、102、103、104、105、106、107、108或109的外科器械，其中，用于将关节运动动作施加到外科端部执行器的装置包括用于将第一关节运动动作施加到外科端部执行器以使外科端部执行器沿第一关节运动方向围绕关节运动轴线进行关节运动的装置，以及用于将第二关节运动动作施加到外科端部执行器以使外科端部执行器在第二关节运动方向上围绕关节运动轴线进行关节运动的装置。
实施例111-一种外科器械，该外科器械包括：细长轴，其包括远端部分并限定轴轴线；外科端部执行器；关节运动锁定布置；和关节运动构件。外科端部执行器包括端部执行器安装部分，其中细长轴的远端部分和端部执行器安装部分中的一个包括枢转孔，并且细长轴的远端部分和端部执行器安装部分中的另一个包括枢转孔限定关节运动销，该关节运动销被枢转地接纳在枢转孔内并且限定横向于轴轴线的关节运动轴线，在对外科端部执行器施加关节运动动作时，外科端部执行器能够相对于细长轴围绕该关节运动轴线做关节运动。关节运动锁定布置在关节运动销和枢转孔的内壁之间被支撑在枢转孔内。关节运动锁定布置能够从第一锁定构型和解锁构型移动，当处于第一锁定构型时，关节运动锁定布置与关节运动销和枢转孔的内壁摩擦接合，以防止关节运动销和细长轴的远端部分的相对枢转行进，当处于解锁构型时，关节运动销和远端部分可相对于彼此枢转。关节运动构件与外科端部执行器连接，使得关节运动构件的致动导致关节运动构件将关节运动动作施加到外科端部执行器。关节运动构件与关节运动锁定装置连接，使得关节运动构件的初始致动导致关节运动锁定布置从锁定构型移动到解锁构型，并且在关节构件去激活时，关节运动锁定布置从解锁构型移动到锁定构型。
实施例112-实施例111的外科器械，其中，关节运动锁定布置包括支撑在关节运动销和枢转孔的内壁之间的扭转弹簧。
实施例113-实施例112的外科器械，其中，扭转弹簧可从第一位置旋转，在第一位置，扭转弹簧摩擦地接合关节运动销和枢转孔的内壁，以防止细长轴的远端部分和外科端部执行器的相对枢转行进，还可从扭转弹簧不阻止该相对枢转行进的位置旋转。
实施例114-实施例111、112或113的外科器械，其中，关节运动锁定布置包括至少一个锁定球，该锁定球可移动地在关节运动销和枢转孔的内壁之间被支撑在第一位置和每个所述锁定球不阻止细长轴的远端部分和外科端部执行器的相对枢转行进的位置之间，在第一位置，每个锁定球摩擦地接合关节运动销和枢转孔的内壁以防止所述相对枢转行进。
实施例115-实施例111、112、113或114的外科器械，其中，外科端部执行器包括第一钳口和第二钳口，第二钳口被支撑以相对于第一钳口可移动地行进。
实施例116-实施例115的外科器械，其中，第一钳口包括细长通道，该细长通道被构造成能够将外科钉仓可操作地支撑在其中，并且其中第二钳口包括砧座。
实施例117-实施例111、112、113、114、115或116的外科器械，其中，关节运动构件包括能够轴向移动的关节运动构件，该能够轴向移动的关节运动构件枢转地连接到外科端部执行器，使得其沿第一轴向方向的轴向移动导致外科端部执行器沿第一关节运动方向围绕关节运动轴线进行关节运动，并且能够轴向移动的关节运动部件在第二轴向方向上的移动导致外科端部执行器在第二关节运动方向上围绕关节运动轴线进行关节运动。
实施例118-一种外科器械，该外科器械包括外科端部执行器，限定轴轴线的细长轴，闭合装置和关节运动接头。外科端部执行器包括第一钳口和第二钳口，第一钳口可移动地联接到细长轴的以围绕横向于轴轴线的关节运动轴线选择性地做关节运动，第二钳口可移动地支撑在第一钳口上以相对于第一钳口在打开位置和闭合位置之间进行选择性的行进。闭合装置选择性地将第二钳口从打开位置移动到闭合位置，闭合装置还被构造成能够选择性地将第二钳口从闭合位置移动到打开位置。关节运动接头将外科端部执行器联接到细长轴，使得外科端部执行器能够相对于细长轴围绕横向于轴轴线的关节运动轴线选择性地做关节运动。关节运动接头包括关节运动锁定布置，其被构造成能够从锁定构型以及解锁构型移动，在锁定构型，外科端部执行器被阻止围绕关节运动轴线做关节运动，在解锁构型，外科端部执行器能够围绕关节运动轴线做关节运动。当闭合装置将第二钳口从打开位置朝向闭合位置移动时，关节运动锁定布置从锁定构型移动到解锁构型。该外科器械还包括用于在关节运动锁定布置处于解锁构型时将关节运动动作施加到外科端部执行器的装置。
实施例119-实施例118的外科器械，其中，第一钳口包括细长通道，该细长通道被构造成能够将外科钉仓可操作地支撑在其中，并且其中第二钳口包括砧座。
实施例120-实施例119或120的外科器械，其中，关节运动锁定布置包括至少一个锁定构件，该锁定构件能够在对应于解锁构型的第一位置和第二位置之间移动，在第二位置，所述至少一个锁定构件与第一钳口的安装部分和细长轴的远端部分摩擦接合。所述至少一个锁定构件可操作地与闭合构件连接，使得闭合构件在闭合方向上的初始移动导致至少一个锁定构件从第一位置移动到第二位置。
实施例121-一种外科器械，该外科器械包括限定轴轴线的细长轴，外科端部执行器，至少一个关节运动连接件和关节运动锁定布置。外科端部执行器联接到细长轴以相对于细长轴围绕横向于轴轴线的关节运动轴线进行选择性的关节运动。至少一个关节运动连接件可操作地与关节运动动作源连接，并且联接到外科端部执行器以向其施加关节运动动作。关节运动锁定布置包括与每个关节运动连接件相对应的关节运动锁定构件，每个关节运动锁定构件被构造成能够从侧向邻近对应的关节运动连接件的解锁位置侧向移动成与对应的关节运动连接件锁定接合。该外科器械还包括致动装置，其可操作地与每个关节运动锁定构件连接，以选择性地将每个关节运动锁定构件从解锁位置侧向移动成与对应的关节运动连接件锁定接合。
实施例122-实施例121的外科器械，其中，至少一个关节运动连接件各自包括关节运动齿条，并且其中与其对应的关节运动锁定构件包括与每个关节运动齿条相对应的锁定齿条，并且被取向成相对于每个关节运动齿条成侧向面对关系，以当对应的关节运动锁定构件朝向关节运动连接件侧向推进时与关节运动齿条啮合接合。
实施例123-实施例121或122的外科器械，其中，所述至少一个关节运动连接件包括能够轴向移动的右关节运动连接件和能够轴向移动的左关节运动连接件，右关节运动连接件在其上包括右关节运动齿条，左关节运动连接件在其上包括左关节运动齿条。关节运动锁定构件包括右关节运动锁定构件和左关节运动锁定构件，右关节运动锁定构件包括右锁定齿条，右锁定齿条与右关节运动齿条成侧向面对关系以当右关节运动锁定构件朝向右关节运动连接件侧向推进时与右关节运动齿条啮合接合，左关节运动锁定构件包括左锁定齿条，左锁定齿条与左关节运动齿条成侧向面对关系以当左关节运动锁定构件朝向左关节运动连接件侧向推进时与左关节运动齿条啮合接合。
实施例124-实施例123的外科器械，其中，致动装置包括相对于右关节运动锁定构件和左关节运动锁定构件可移动地定位的锁定致动器，使得锁定致动器沿第一轴向方向的轴向移动导致右关节运动锁定构件朝向右关节运动连接件侧向移动，以带动右锁定齿条与右关节运动齿条锁定接合，并且左关节运动锁定构件朝向左关节运动连接件侧向移动，以带动左锁定齿条与左关节运动齿条锁定接合。
实施例125-实施例121、122、123或124的外科器械，其中，关节运动动作源包括能够轴向移动的击发致动器和关节运动传动装置，能够轴向移动的击发致动器被构造成能够选择性地将击发动作施加到外科端部执行器的对应部分，关节运动传动装置可操作地与能够轴向移动的击发致动器和至少一个关节运动连接件连接，使得能够轴向移动的击发致动器沿第一轴向击发方向的致动使所述至少一个关节运动连接件沿第一轴向关节运动方向移动，并且能够轴向移动的击发致动器在第二轴向回缩方向上的移动使所述至少一个关节运动连接件沿第二轴向关节运动方向移动。
实施例126-实施例123或124的外科器械，其中，关节运动动作源包括能够轴向移动的击发致动器和关节运动传动装置，能够轴向移动的击发致动器被构造成能够选择性地将击发动作施加到外科端部执行器的对应部分，关节运动传动装置可操作地与左关节运动连接件、右关节运动连接件和能够轴向移动的击发构件连接，使得能够轴向移动的击发致动器沿第一轴向击发方向的致动使右关节运动连接件在第一轴向方向上移动并且左关节运动连接件在第二轴向方向上移动，并且能够轴向移动的击发致动器沿第二轴向方向的移动使右关节运动连接件在第二轴向方向上移动并且左关节运动连接件在第一轴向方向上移动。
实施例127-实施例126的外科器械，其中，关节运动锁定布置还包括相对于右关节运动锁定构件和左关节运动锁定构件可移动地定位的锁定致动器，使得锁定致动器沿第一轴向方向的轴向移动导致右关节运动锁定构件朝向右关节运动连接件侧向移动，以带动右锁定齿条与右关节运动齿条锁定接合，并且左关节运动锁定构件朝向左关节运动连接件侧向移动，以带动左锁定齿条与左关节运动齿条锁定接合。
实施例128-实施例127的外科器械，其中，关节运动传动装置包括与左关节运动连接件和右关节运动连接件啮合接合的齿轮组件，以及被构造用于与齿轮组件和能够轴向移动的击发致动器选择性啮合接合的换档器。换档器被构造用于与锁定致动器选择性地可操作地接合，使得当换档器与锁定致动器可操作地接合时，换档器移动成与能够轴向移动的击发致动器和齿轮组件啮合接合，并且换档器脱离与锁定致动器可操作地接合的移动还使换档器移动成脱离与齿轮组件和能够轴向移动的击发致动器啮合接合。
实施例129-实施例125的外科器械，其中，外科端部执行器的对应部分包括附接到能够轴向移动的击发致动器的击发构件。击发构件被支撑用于在外科端部执行器中的起始位置和结束位置之间轴向行进通过外科端部执行器。
实施例130-一种外科器械，该外科器械包括限定轴轴线的细长轴，外科端部执行器，击发致动器，被构造用于与击发致动器选择性地可操作地接合的至少一个关节运动连接件，以及关节运动锁定布置。外科端部执行器联接到细长轴以相对于细长轴围绕横向于轴轴线的关节运动轴线进行选择性的关节运动。击发致动器可在第一轴向方向和第二轴向方向上选择性地轴向移动，以将击发动作施加到可操作地支撑在外科端部执行器中的击发构件。击发致动器的轴向移动被传递到所述至少一个关节运动连接件中的每个。关节运动锁定布置被构造成能够在锁定构型和解锁构型之间侧向移动，在锁定构型，所述至少一个关节运动连接件中的每个不可移动地锁定在位，在解锁构型，所述至少一个关节运动连接件中的每个能够响应于击发致动器的移动而移动。关节运动锁定布置与击发致动器连接，使得当关节运动锁定布置处于解锁构型时，击发致动器与所述至少一个关节运动连接件中的每个可操作地接合，并且当关节运动锁定布置处于锁定构型时，防止所述至少一个关节运动连接件中的每个与击发致动器可操作地接合。
实施例131-实施例130的外科器械，其中，关节运动锁定布置包括与每个关节运动连接件相对应的关节运动锁定构件。每个关节运动锁定构件被构造成能够从解锁位置侧向移动成与对应的关节运动连接件锁定接合，解锁位置侧向地邻近对应的关节运动连接件。
实施例132-实施例131的外科器械，其中，所述至少一个关节运动连接件中的每个包括关节运动齿条，并且其中每个对应的关节运动锁定构件包括锁定齿条，该锁定齿条被取向为相对于对应的关节运动连接件的关节运动齿条成侧向面对关系，以当关节运动锁定构件朝向对应的关节运动连接件侧向推进时与关节运动齿条啮合接合。
实施例133-实施例132的外科器械，其中，所述至少一个关节运动连接件包括能够轴向移动的右关节运动连接件和能够轴向移动的左关节运动连接件，右关节运动连接件在其上包括右关节运动齿条，左关节运动连接件在其上包括左关节运动齿条。关节运动锁定构件包括右关节运动锁定构件和左关节运动锁定构件，右关节运动锁定构件包括右锁定齿条，右锁定齿条与右关节运动齿条成侧向面对关系以当右关节运动锁定构件朝向右关节运动连接件侧向推进时与右关节运动齿条啮合接合，左关节运动锁定构件包括左锁定齿条，左锁定齿条与左关节运动齿条成侧向面对关系以当左关节运动锁定构件朝向左关节运动连接件侧向推进时与左关节运动齿条啮合接合。
实施例134-实施例130、131、132或133的外科器械，其中，外科端部执行器包括击发构件，该击发构件联接到击发致动器并且被支撑用于轴向行进通过外科端部执行器。
实施例135-实施例134的外科器械，其中，外科端部执行器包括细长通道和砧座，细长通道被构造成能够将外科钉仓可操作地支撑在其中，砧座可移动地被支撑在细长通道上，以在打开位置和闭合位置之间进行选择性的移动。细长通道联接到细长轴，以相对于细长轴围绕关节运动轴线进行选择性的关节运动。击发构件包括组织切割特征部。
实施例136-实施例133的外科器械，其中，外科器械还包括关节运动传动装置，其可操作地与左关节运动连接件、右关节运动连接件和能够轴向移动的击发致动器连接，使得能够轴向移动的击发致动器沿第一轴向击发方向的致动使右关节运动连接件在第一轴向方向上移动并且左关节运动连接件在第二轴向方向上移动，并且能够轴向移动的击发致动器沿第二轴向方向的移动使右关节运动连接件在第二轴向方向上移动并且左关节运动连接件在第一轴向方向上移动。
实施例137-实施例133或136的外科器械，其中，关节运动锁定布置还包括相对于右关节运动锁定构件和左关节运动锁定构件可移动地定位的锁定致动器，使得锁定致动器沿第一轴向方向的轴向移动导致右关节运动锁定构件朝向右关节运动连接件侧向移动，以带动右锁定齿条与右关节运动齿条锁定接合，并且左关节运动锁定构件朝向左关节运动连接件侧向移动，以带动左锁定齿条与左关节运动齿条锁定接合。
实施例138-实施例136的外科器械，其中，关节运动传动装置包括与左关节运动连接件和右关节运动连接件啮合接合的齿轮组件，以及被构造用于与齿轮组件和能够轴向移动的击发致动器选择性啮合接合的换档器。换档器被构造用于选择性地与锁定致动器可操作地接合，使得当换档器与锁定致动器可操作地接合时，换档器移动成与能够轴向移动的击发致动器和齿轮组件啮合接合。当换档器脱离与锁定致动器可操作地接合时，换档器移动成脱离与齿轮组件和能够轴向移动的击发致动器啮合接合。
实施例139-一种外科器械，该外科器械包括：限定轴轴线的细长轴；外科端部执行器，其联接到细长轴以相对于细长轴围绕横向于轴轴线的关节运动轴线进行选择性的关节运动；用于产生轴向击发动作的装置；和关节运动装置。关节运动装置与用于产生轴向击发动作的装置连接，并且关节运动装置被构造成能够响应于由用于产生轴向击发动作的装置产生的轴向击发动作而将关节运动动作施加到外科端部执行器。该外科器械还包括装置，该装置用于选择性地将关节运动装置锁定在不可移动构型中，以及解锁关节运动装置并且将关节运动装置与用于产生轴向击发动作的装置可操作地联接，使得用于产生轴向击发动作的装置可以将轴向击发动作施加到关节运动装置。
实施例140-实施例139的外科器械，其中，外科端部执行器包括细长通道和砧座，细长通道被构造成能够将外科钉仓可操作地支撑在其中，砧座可移动地被支撑在细长通道上，以在打开位置和闭合位置之间进行选择性的移动。细长通道联接到细长轴，以相对于细长轴围绕关节运动轴线进行选择性的关节运动。击发构件包括组织切割特征部。
实施例141-一种外科工具组件，该外科工具组件包括：限定轴轴线的细长轴；外科端部执行器，其联接到细长轴以相对于细长轴围绕横向于轴轴线的关节运动轴线进行选择性的关节运动；第一关节运动连接件；第二关节运动连接件；和关节运动行程倍增器。第一关节运动连接件可操作地与关节运动动作源连接，以选择性地使第一关节运动连接件沿第一关节运动方向轴向移动第一轴向距离。第二关节运动连接件可操作地与外科端部执行器连接，以将关节运动动作施加到外科端部执行器。关节运动行程倍增器可操作地与第一关节运动连接件和第二关节运动连接件连接，使得当第一关节运动连接件在第一轴向方向上轴向移动第一轴向距离时，关节运动行程倍增器使第二关节运动连接件在第一轴向方向上移动大于第一轴向距离的另一第一轴向距离。
实施例142-实施例141的外科工具组件，其中，关节运动动作源被构造成能够附加地使第一关节运动连接件沿第二轴向方向轴向移动第二轴向距离，并且其中当第一关节运动连接件在第二轴向方向上移动第二轴向距离时，关节运动行程倍增器使第二关节运动连接件在第二轴向方向上移动大于第二轴向距离的另一第二轴向距离。
实施例143-实施例141或142的外科工具组件，其中，第一关节运动连接件包括第一关节运动齿条，其中第二关节运动连接件包括第二关节运动齿条，并且其中关节运动行程倍增器包括与第一关节运动齿条和第二关节运动齿条啮合接合的至少一个齿轮组。
实施例144-实施例143的外科工具组件，其中，所述至少一个齿轮组中的每个包括可旋转地支撑成与第一关节运动齿条啮合接合的第一齿轮，和可旋转地支撑成与第一关节运动齿条啮合接合的第一齿轮。
实施例145-实施例141、142、143或144的外科工具组件，其中，第二关节运动连接件可操作地与关节运动锁定组件连接，该关节运动锁定组件可操作地联接到外科端部执行器。
实施例146-实施例141、142、143、144或145的外科工具组件，其中，第一关节运动连接件包括第一关节运动齿条，并且其中关节运动行程倍增器包括与第一关节运动齿条啮合接合并且可滑动地联接到第二关节运动连接件的摆动齿轮。
实施例147-实施例141、142、143、144、145或146的外科工具组件，其中，摆动齿轮被支撑以围绕摆动齿轮安装轴线旋转行进，该摆动齿轮安装轴线横向于第一关节运动连接件和第二关节运动连接件。
实施例148-实施例146或147的外科工具组件，其中，第二关节运动连接件包括开槽的远侧端部，其可滑动地将摆动齿轮的一部分接合在其中。
实施例149-实施例146、147或148的外科工具组件，其中，在摆动齿轮中具有狭槽，该狭槽被构造成能够可滑动地接合第二关节运动连接件的远端部分。
实施例150-一种外科工具组件，该外科工具组件包括限定轴轴线的细长轴，外科端部执行器，第一关节运动连接件，第二关节运动连接件和关节运动行程倍增器。外科端部执行器包括细长通道和砧座，细长通道被构造成能够将外科钉仓可操作地支撑在其中并且联接到细长轴，以相对于细长轴围绕横向于轴轴线的关节运动轴线选择性地做关节运动，砧座可移动地支撑在细长通道上。第一关节运动连接件可操作地与关节运动动作源连接，以选择性地使第一关节运动连接件沿第一关节运动方向轴向移动第一轴向距离。第二关节运动连接件可操作地与外科端部执行器连接，以将关节运动动作施加到外科端部执行器。关节运动行程倍增器可操作地与第一关节运动连接件和第二关节运动连接件连接，使得当第一关节运动连接件在第一轴向方向上轴向移动第一轴向距离时，关节运动行程倍增器使第二关节运动连接件在第一轴向方向上移动大于第一轴向距离的另一第一轴向距离。
实施例151-实施例150的外科工具组件，其中，关节运动动作源包括击发构件组件和离合器组件，击发构件组件可操作地与被支撑以在细长通道内轴向行进的击发构件连接，离合器组件可操作地与第一关节运动连接件和击发构件组件连接并且能够在激发模式和关节运动模式之间选择性地配置，在击发模式下，击发构件组件的轴向移动被施加到击发构件，在关节运动模式下，击发构件组件的轴向移动被施加到第一关节运动连接件。
实施例152-实施例151的外科工具组件，其中，当离合器组件处于关节运动模式时，击发构件组件被构造成能够附加地使第一关节运动连接件沿第二轴向方向轴向移动第二轴向距离，并且其中当第一关节运动连接件在第二轴向方向上移动第二轴向距离时，关节运动行程倍增器使第二关节运动连接件在第二轴向方向上移动大于第二轴向距离的另一第二轴向距离。
实施例153-实施例151或152的外科工具组件，其中，第一关节运动连接件包括第一关节运动齿条，其中第二关节运动连接件包括第二关节运动齿条，并且其中关节运动行程倍增器包括与第一关节运动齿条和第二关节运动齿条啮合接合的至少一个齿轮组。
实施例154-实施例153的外科工具组件，其中，所述至少一个齿轮组中的每个包括可旋转地支撑成与第一关节运动齿条啮合接合的第一齿轮，和附接到第一齿轮以与其一起旋转的第二齿轮。第二齿轮的直径大于第一齿轮的直径，第二齿轮与第二关节运动齿条啮合接合。
实施例155-实施例151、152、153或154的外科工具组件，其中，第二关节运动连接件可操作地与关节运动锁定组件连接，该关节运动锁定组件可操作地联接到外科端部执行器。
实施例156-实施例151、152、153、154或155的外科工具组件，其中，第一关节运动连接件包括第一关节运动齿条，并且其中关节运动行程倍增器包括与第一关节运动齿条啮合接合并且可滑动地联接到第二关节运动连接件的摆动齿轮。
实施例157-实施例156的外科工具组件，其中，摆动齿轮被支撑以围绕摆动齿轮安装轴线旋转行进，该摆动齿轮安装轴线横向于第一关节运动连接件和第二关节运动连接件。
实施例158-实施例156或157的外科工具组件，其中，第二关节运动连接件包括开槽的远侧端部，其可滑动地将摆动齿轮的一部分接合在其中。
实施例159-实施例156、157或158的外科工具组件，其中，在摆动齿轮中具有狭槽，该狭槽被构造成能够可滑动地接合第二关节运动连接件的远端部分。
实施例160-一种外科工具组件，该外科工具组件包括限定轴轴线的细长轴，外科端部执行器，第一关节运动连接件，第二关节运动连接件和关节运动行程倍增装置。外科端部执行器联接到细长轴以相对于细长轴围绕横向于轴轴线的关节运动轴线进行选择性的关节运动。第一关节运动连接件可操作地与关节运动动作源连接，以选择性地使第一关节运动连接件沿第一关节运动方向轴向移动第一轴向距离。第二关节运动连接件可操作地与外科端部执行器连接，以将关节运动动作施加到外科端部执行器。关节运动行程倍增装置可操作地与第一关节运动连接件和第二关节运动连接件连接，以响应于第一关节运动连接件在小于第二轴向距离的第一轴向距离上的移动而使第二关节运动移动第二轴向距离。
实施例161-一种外科工具组件，该外科工具组件包括限定轴轴线的细长轴组件，外科端部执行器和远侧关节运动构件。外科端部执行器由远侧支撑连接件可移动地联接到细长轴组件，该远侧支撑连接件枢转地联接到外科端部执行器以限定横向于轴轴线的关节运动轴线。远侧支撑连接件枢转地且能够轴向移动地联接到细长轴组件，以促进外科端部执行器相对于细长轴组件围绕关节运动轴线在第一非关节运动位置和关节运动位置之间进行选择性的关节运动，其中外科端部执行器与细长轴对准，关节运动位置位于轴轴线的一侧上。远侧关节运动构件可操作地与关节运动动作源连接，并且枢转地联接到外科端部执行器以向其施加关节运动动作。
实施例162-实施例161的外科工具组件，其中，远侧关节运动构件被构造成能够响应于施加到其上的关节运动动作而在轴轴线的一侧上轴向移动，并且其中远侧支撑连接件被构造成能够相对于细长轴组件沿轴轴线轴向移动。
实施例163-实施例161或162的外科工具组件，其中，远侧支撑连接件包括远侧端部和近侧端部，远侧端部枢转地联接到外科端部执行器以围绕关节运动轴线枢转行进，近侧端部包括近侧轴向狭槽，该近侧轴向狭槽被构造成能够将附接到细长轴组件的远侧端部的对应关节运动销接纳在其中。
实施例164-实施例161、162或163的外科工具组件，其中，外科工具组件还包括近侧关节运动构件和关节运动锁定组件，近侧关节运动构件可操作地与关节运动动作源连接，关节运动锁定组件可操作地联接到近侧关节运动构件和远侧关节运动构件的近侧端部以选择性地将远侧关节运动构件锁定在轴向位置。
实施例165-实施例164的外科工具组件，其中，远侧关节运动构件的近侧端部枢转地联接到关节运动锁定组件。
实施例166-实施例161、162、163、164或165的外科工具组件，其中，远侧支撑连接件枢转地且能够轴向移动地联接到细长轴组件的远侧脊构件。
实施例167-实施例161、162、163、164、165或166的外科工具组件，其中，外科端部执行器包括细长通道和砧座，细长通道被构造成能够将外科钉仓可操作地支撑在其中，砧座可移动地被支撑在细长通道上，以相对于细长通道在打开位置和闭合位置之间进行选择性的移动。
实施例168-实施例167的外科工具组件，其中，细长通道由联接到细长通道的端部执行器安装组件枢转地联接到远侧支撑连接件。
实施例169-实施例161、162、163、164、165、166、167或168的外科工具组件，其中，远侧关节运动构件被构造成能够沿第一轴向方向和第二轴向方向轴向移动，使得当远侧关节运动构件在第一轴向方向上移动时，外科端部执行器在第一关节运动方向上从第一非关节运动位置关节运动到关节运动位置中的任何一个，并且当远侧关节运动构件沿第二轴向方向轴向移动时，外科端部执行器在第二关节运动方向上从关节运动位置中的任何一个移动到第一非关节运动位置。
实施例170-实施例169的外科工具组件，其中，外科工具组件还包括用于当远侧关节运动构件在第二轴向方向上移动时防止外科端部执行器在第二关节运动方向上移动超过第一非关节运动位置的装置。
实施例171-一种外科工具组件，该外科工具组件包括限定轴轴线的细长轴组件，外科端部执行器，远侧支撑连接件，和远侧关节运动构件。外科端部执行器包括细长通道和砧座，细长通道被构造成能够将外科钉仓可操作地支撑在其中，砧座被支撑以相对于外科钉仓可移动地行进。远侧支撑连接件枢转地连接到细长通道，以限定横向于轴轴线的关节运动轴线，细长通道可围绕该关节运动轴线相对于细长轴组件做关节运动。远侧支撑连接件附接到细长轴组件的远侧端部，以相对于细长轴组件沿轴轴线进行轴向行进和枢转行进。远侧关节运动构件被支撑以在轴轴线的一侧上轴向行进，远侧关节运动构件枢转地联接到细长通道并且可操作地与关节运动动作源连接。
实施例172-实施例171的外科工具组件，其中，远侧支撑连接件的近侧端部包括近侧轴向狭槽，该近侧轴向狭槽被构造成能够将附接到所述细长轴组件的远侧端部的对应关节运动销接纳在其中。
实施例173-实施例171或172的外科工具组件，其中，外科工具组件还包括近侧关节运动构件和关节运动锁定组件，近侧关节运动构件可操作地与关节运动动作源连接，关节运动锁定组件可操作地联接到近侧关节运动构件和远侧关节运动构件的近侧端部以选择性地将远侧关节运动构件锁定在轴向位置。
实施例174-实施例173的外科工具组件，其中，远侧关节运动构件的近侧端部枢转地联接到关节运动锁定组件。
实施例175-实施例171、172、173或174的外科工具组件，其中，远侧支撑连接件枢转地且能够轴向移动地联接到细长轴组件的远侧脊构件。
实施例176-实施例171、172、173、174或175的外科工具组件，其中，远侧关节运动构件被构造成能够在第一轴向方向和第二轴向方向上移动，使得当远侧关节运动构件在第一轴向方向上移动时，外科端部执行器在第一关节运动方向上从第一非关节运动位置关节运动到关节运动位置中的任何一个，并且当远侧关节运动构件在第二轴向方向上移动时，外科端部执行器在第二关节运动方向上从关节运动位置中的任何一个移动到第一非关节运动位置。
实施例177-实施例176的外科工具组件，其中，外科工具组件还包括用于当远侧关节运动构件在第二轴向方向上移动时防止外科端部执行器在第二关节运动方向上移动超过第一非关节运动位置的装置。
实施例178-一种外科工具组件，该外科工具组件包括：限定轴轴线的细长轴组件；用于将外科端部执行器联接到细长轴组件的远侧端部的装置，使得外科端部执行器可围绕横向于轴轴线的关节运动轴线在非关节运动位置和关节运动位置之间进行选择性的关节运动，其中外科端部执行器沿轴轴线与细长轴对准，关节运动位置位于轴轴线的一侧上；以及用于将关节运动动作施加到外科端部执行器的装置。用于联接的装置联接到细长轴组件，以相对于细长轴组件轴向行进和枢转进行。
实施例179-实施例178的外科工具组件，其中，用于施加的装置在侧向偏离轴轴线的位置处枢转地联接到外科端部执行器。
实施例180-实施例178或179的外科工具组件，其中，用于施加的装置还包括用于选择性地将外科端部执行器锁定在关节运动位置中的任何一个的装置。
实施例181-一种被构造成能够支撑在外科端部执行器的钳口内的外科钉仓，其中，外科端部执行器的至少一个钳口可相对于外科端部执行器的第二钳口在打开位置和闭合位置之间移动。外科端部执行器包括锁定构件，当至少一个钳口移动到闭合位置时，该锁定构件从解锁构型移动到锁定构型以防止击发构件轴向行进通过外科端部执行器。外科端部执行器包括尺寸适于安置在外科端部执行器内的仓体和凸轮组件，仓体将布置在钉线中的多个外科钉可操作地支撑在其中。凸轮组件可在仓体内的起始位置和终止位置之间移动，凸轮组件限定中心轴线和其上的多个凸轮特征部，其中每个凸轮特征部对应于钉线中的至少一个。凸轮组件还包括其上的至少一个解锁特征部，该解锁特征部从中心轴线侧向偏移并且被构造成能够当仓体安置在外科端部执行器内并且凸轮组件处于锁定位置时，解锁地接合锁定构件的对应部分，从而当至少一个钳口移动到闭合位置时防止锁定构件达到锁定构型。
实施例182-实施例181的外科钉仓，其中，所述至少一个解锁特征部包括第一解锁斜坡和第二解锁斜坡，第一解锁斜坡形成在凸轮组件的近侧端部上的侧向偏移到中心轴线的一侧上的位置，第二解锁斜坡形成在凸轮组件的近侧端部上的在中心轴线的相对侧上的另一个侧向偏移位置。
实施例183-实施例181或182的外科钉仓，其中，每个解锁特征部被构造成能够将锁定构件偏置成解锁构型。
实施例184-实施例182的外科钉仓，其中，凸轮组件的近侧端部限定位于第一解锁斜坡和第二解锁斜坡之间的中央接触区域，该中央接触区域被构造成能够当击发构件轴向推进通过外科端部执行器时由击发构件接合。
实施例185-一种外科端部执行器，该外科端部执行器包括第一钳口、砧座、击发构件、锁定构件和外科钉仓。砧座相对于第一钳口被支撑，以相对于第一钳口在打开位置和闭合位置之间进行选择性的移动。击发构件被支撑以在向击发构件施加击发动作和回缩动作时，在端部执行器内的起始位置和终止位置之间轴向移动。锁定构件可在锁定构型和解锁构型之间移动，在锁定构型，防止击发构件轴向行进通过外科端部执行器，在解锁构型，击发构件能够轴向推进通过外科端部执行器。外科钉仓包括仓体和凸轮组件。仓体的尺寸被设计成安置于第一钳口内，仓体将布置在钉线中的多个外科钉可操作地支撑在其中。凸轮组件可在仓体内的起始位置和终止位置之间移动，凸轮组件限定中心轴线并且包括其上的多个凸轮特征部，其中每个凸轮特征部对应于钉线中的至少一个。凸轮组件还包括其上的至少一个解锁特征部，该解锁特征部从中心轴线侧向偏移并且被构造成能够当仓体安置在第一钳口内并且凸轮组件处于锁定位置时，解锁地接合锁定构件的对应部分，从而当砧座移动到闭合位置时防止锁定构件达到锁定构型。
实施例186-实施例185的外科端部执行器，其中，所述至少一个解锁特征部包括第一解锁斜坡和第二解锁斜坡，第一解锁斜坡形成在凸轮组件的近侧端部上的侧向偏移到中心轴线的一侧上的位置，第二解锁斜坡形成在凸轮组件的近侧端部上的在中心轴线的相对侧上的另一个侧向偏移位置。
实施例187-实施例185或186的外科端部执行器，其中，砧座被构造成能够当砧座移动到闭合位置时使锁定构件沿第一方向移动成与击发构件锁定接合，并且其中每个解锁特征部被构造成能够使锁定构件的对应部分沿与第一方向相反的第二方向偏置。
实施例188-实施例186的外科端部执行器，其中，凸轮组件的近侧端部限定位于第一解锁斜坡和第二解锁斜坡之间的中央接触区域，该中央接触区域被构造成能够当击发构件轴向推进通过外科端部执行器时由击发构件接合。
实施例189-实施例181、182、183或184的外科端部执行器，其中，外科钉仓包括细长狭槽，该细长狭槽被构造成能够当击发构件在起始位置和终止位置之间移动时可滑动地将击发构件接纳在其中，并且其中锁定构件被构造成能够使击发构件与细长狭槽轴向对准。
实施例190-实施例185、186、187或188的外科端部执行器，其中，击发构件包括两个侧面，并且其中锁定构件被构造成能够当锁定构件处于锁定构型时保持地接合击发构件的每个侧面。
实施例191-实施例190的外科端部执行器，其中，锁定构件包括对应于击发构件的每个侧面的弹簧臂，以及每个弹簧臂中的锁定凹口，其被构造成能够可释放地接合击发构件的每个侧面上的对应锁定凸耳。
实施例192-实施例185、186、187、188、190或191的外科端部执行器，其中，外科端部执行器还包括击发构件上的组织切割表面。
实施例193-实施例185、186、187、188、190、191或192的外科端部执行器，其中，砧座包括：砧座主体；砧座主体中的轴向狭槽，其允许击发构件的一部分轴向从中通过；以及在轴向狭槽的每一侧上砧座主体内的轴向通道。
实施例194-实施例193的外科端部执行器，其中，击发构件包括脚部和砧座接合特征部，脚部被构造成能够在第一钳口内的对应通道内可滑动地通过，砧座接合特征部从击发构件主体的顶部侧向延伸并且被构造成能够通过砧座主体内的对应的一个轴向通道，并且其中第一和第二接合特征部位于脚部和砧座接合特征部之间。
实施例195-一种被构造成能够支撑在限定轴轴线的外科端部执行器的钳口内的外科钉仓，其中，外科端部执行器的至少一个钳口可相对于外科端部执行器的第二钳口在打开位置和闭合位置之间移动。外科端部执行器包括可在锁定构型和解锁构型之间移动的锁定构件，在锁定构型，防止击发构件轴向行进通过外科端部执行器，在解锁构型，击发构件能够轴向推进通过外科端部执行器。外科钉仓包括尺寸适于安置在外科端部执行器的一个钳口内的仓体，该仓体将布置在钉排中的多个外科钉可操作地支撑在其中；以及钉凸轮传动装置，其用于当凸轮传动装置在仓体内从起始位置轴向移动到终止位置时将钉从仓体中凸轮传动出来。钉凸轮传动装置被构造成能够当仓体安置在外科端部执行器的钳口内并且钉凸轮传动装置处于起始位置时，解锁地接合锁定构件的侧向偏离轴轴线的至少一个对应部分，从而防止锁定构件在所述至少一个钳口移动到闭合位置时达到锁定构型。
实施例196-一种方法，该方法包括获得具有第一排钉的第一钉仓，以及获得具有第二排钉的第二钉仓，其中第一排钉和第二排钉包括相同的长度。该方法还包括将第一钉仓插入包括带键轮廓的通道中以及将第二钉仓插入该通道中，其中由带键轮廓和通道之间的干涉来防止第一钉仓完全插入该通道中，其中由带键轮廓允许第二钉仓完全插入该通道中。
实施例197-实施例196的方法，其中，将第二钉仓插入通道中还包括使第二钉仓上的键特征部与通道上的带键轮廓对准。
实施例198-实施例196或197的方法，其中，该方法还包括当将第一钉仓插入通道中时，使第一钉仓的底部表面与通道间隔开。
实施例199-实施例198的方法，其中，该方法还包括当将第二钉仓插入通道中时，使第二钉仓的底部表面抵靠通道定位。
实施例200-实施例196、197、198或199的方法，其中，该方法还包括当将第一钉仓插入通道中时，使第一钉仓的近侧部分阻止砧座抵靠第一钉仓的远侧部分夹紧。
实施例201-实施例196、197、198、199或200的方法，其中，该方法还包括当将第一钉仓插入通道中时，使第一钉仓的击发闭锁件阻止击发行程。
实施例202-一种方法，该方法包括获得包括第一数量的钉的第一钉仓，以及获得包括第一数量的钉的第二钉仓。该方法还包括将第一钉仓插入包括带键轮廓的通道中，其中由带键轮廓防止第一钉仓完全插入该通道中，以及将第一钉仓插入包括带键轮廓的通道中，其中由带键轮廓防止第一钉仓完全插入该通道中。
实施例203-实施例202的方法，其中，将第二钉仓插入通道中还包括使第二钉仓上的键特征部与通道上的带键轮廓对准。
实施例204-实施例202或203的方法，其中，该方法还包括当将第一钉仓插入通道中时，使第一钉仓的底部表面与通道间隔开。
实施例205-实施例204的方法，其中，该方法还包括当将第一钉仓插入通道中时，使第一钉仓的底部表面与通道间隔开。
实施例206-实施例202、203、204或205的方法，其中，该方法还包括当将第一钉仓插入通道中时，使第一钉仓阻止砧座抵靠第一钉仓夹紧。
实施例207-实施例202、203、204、205或206的方法，其中，该方法还包括当将第一钉仓插入通道中时，使第一钉仓的击发闭锁件阻止击发行程。
实施例208-一种方法，该方法包括：获得通道；获得包括近侧对准突出部和远侧对准突出部的兼容的钉仓；以及使近侧对准突出部与通道中的对应的近侧对准特征部对准。该方法还包括使远侧对准突出部与通道中的对应远侧对准特征部对准，以及将兼容的钉仓插入通道中，使得近侧对准突出部与对应的近侧对准特征部互锁，并且远侧对准突出部与对应的远侧对准特征部互锁。
实施例209-实施例208的方法，其中，该方法还包括当将兼容的钉仓插入通道中时，使兼容的钉仓的底部表面抵靠通道定位。
实施例210-实施例208或209的方法，其中，该方法还包括使兼容的钉仓的击发闭锁件阻止击发行程，直到将兼容的钉仓插入通道中。
实施例211-实施例208、209或210的方法，其中，该方法还包括尝试将不兼容的钉仓插入通道中，其中，不兼容的钉仓还包括相对于通道上的对应的近侧对准特征部的干涉特征部。
实施例212-实施例211的方法，其中，该方法还包括当将不兼容的钉仓插入通道中时，使不兼容的钉仓的底部表面与通道间隔开。
实施例213-实施例212的方法，其中，该方法还包括当将不兼容的钉仓插入通道中时，使不兼容的钉仓的近侧部分阻止砧座抵靠不兼容的钉仓的远侧部分夹紧。
实施例214-实施例211、212或213的方法，其中，该方法还包括当将不兼容的钉仓定位在通道中时，使闭锁件阻止至少一个外科功能。
实施例215-实施例208、209、210、211、212、213或214的方法，其中，所述通道包括端部执行器的钳口，并且所述方法还包括将端部执行器上的分类指示与兼容的钉仓上的分类指示进行匹配。
实施例216-一种系统，该系统包括可替换的钉仓和被构造成能够接纳可替换的钉仓的通道。可替换的钉仓包括多个钉、向下突出的第一突片和向下突出的第二突片。通道包括第一容座和第二容座，第一容座的位置和尺寸被设计成接纳向下突出的第一突片，第二容座的位置和尺寸被设计成接纳向下突出的第二突片。
实施例217-实施例216的系统，其中，可替换的钉仓还包括仓体和围绕仓体的一部分定位的平底件，其中平底件还包括基部，并且其中向下突出的第一突片和向下突出的第二突片从基部突出。
实施例218-实施例217的系统，其中，向下突出的第一突片和向下突出的第二突片由金属构成。
实施例219-实施例216、217或218的系统，其中，可替换的钉仓还包括侧向延伸的第一凸耳和侧向延伸的第二凸耳。
实施例220-实施例219的系统，其中，可替换的钉仓还包括第一侧壁和第二侧壁，第一侧壁包括第一切口，其中第一切口的位置和尺寸被设计成接纳侧向延伸的第一凸耳，第二侧壁包括第二切口，其中第二切口的位置和尺寸被设计成接纳侧向延伸的第二凸耳。
实施例221-实施例220的系统，其中，可替换的钉仓还包括模制的仓体，并且其中侧向延伸的第一凸耳和侧向延伸的第二凸耳为该模制的仓体的模制的特征部。
实施例222-实施例221的系统，其中，仓体由塑料材料构成。
实施例223-实施例219、220、221或222的系统，其中，侧向延伸的第一凸耳和侧向延伸的第二凸耳位于向下突出的第一突片和向下突出的第二突片的远侧。
实施例224一种系统，该系统包括可替换的钉仓和被构造成能够接纳可替换的钉仓的通道。可替换的钉仓包括多个钉，以及包括多个肋的外表面。通道包括多个狭槽，其中每个狭槽被构造成能够接纳肋中的一个。
实施例225-实施例224的系统，其中，所述多个肋包括第一肋和第二肋。
实施例226-实施例225的系统，其中，所述多个狭槽包括第一狭槽和第二狭槽，并且其中所述通道还包括第一侧壁和第二侧壁，第一侧壁包括第一狭槽，第二侧壁包括第二狭槽。
实施例227-实施例224、225或226的系统，其中，可替换的钉仓还包括模制的仓体，并且其中肋为该模制的仓体的模制的特征部。
实施例228-实施例224、225、226或227的系统，其中，可替换的钉仓还包括侧向延伸的第一凸耳和侧向延伸的第二凸耳。
实施例229-实施例224、225、226、227或228的系统，其中，通道还包括第一侧壁和第二侧壁，第一侧壁包括第一切口，其中第一切口的位置和尺寸被设计成接纳侧向延伸的第一凸耳，第二侧壁包括第二切口，其中第二切口的位置和尺寸被设计成接纳侧向延伸的第二凸耳。
实施例230-实施例229的系统，其中，可替换的钉仓还包括模制的仓体，并且其中侧向延伸的第一凸耳和侧向延伸的第二凸耳在该模制的仓体中模制。
实施例231-实施例230的系统，其中，模制的仓体由塑料材料构成。
实施例232-实施例231的系统，其中，侧向延伸的第一凸耳和侧向延伸的第二凸耳位于肋的远侧。
实施例233-一种系统，该系统包括兼容的钉仓和通道，该钉仓包括多个钉。该系统还包括用于允许将兼容的钉仓完全插入和用于防止不兼容的钉仓被完全插入通道中的装置，其中不兼容的钉仓和兼容的钉仓包括相同的长度和相同的宽度。
实施例234-实施例233的系统，其中，所述装置包括近侧对准键和远侧对准键。
实施例235-实施例233或234的系统，其中，该系统还包括第二通道，并且其中不兼容的钉仓与第二通道兼容。
实施例236一种系统，该系统包括可替换的钉仓和被构造成能够接纳可替换的钉仓的通道。可替换的钉仓包括多个钉、侧向突出的近侧凸耳和侧向突出的远侧凸耳。所述通道包括侧壁，该侧壁包括近侧容座和远侧容座，近侧容座的位置和尺寸被设计成接纳侧向突出的近侧凸耳，远侧容座的位置和尺寸被设计成接纳侧向突出的远侧凸耳。
实施例237-实施例236的系统，其中，通道还包括障碍物，并且其中可替换的钉仓还包括互补的抗障碍物，该互补的抗障碍物的位置和尺寸被设计成克服所述障碍物。
实施例238-实施例237的系统，其中，所述系统还包括第二可替换的钉仓，其包括非互补的抗障碍物，该非互补的抗障碍物的位置和尺寸被设计成与所述障碍物干涉。
实施例239-实施例236、237或238的系统，其中，近侧容座限定侧壁中的切口，并且其中该切口包括凹入部和突起部。
实施例240-实施例239的系统，其中，突起部位于凹入部内。
实施例241-实施例236、237、238、239或240的系统，其中，该系统还包括第二可替换的钉仓，该第二可替换的钉仓包括第二多个钉、侧向突出的第二近侧凸耳和侧向突出的第二远侧凸耳。
实施例242-实施例241的系统，其中，侧向突出的第二远侧凸耳与侧向突出的第二近侧凸耳间隔开一距离，并且其中该距离不同于可替换的钉仓的近侧侧向突出的凸耳和侧向突出的远侧凸耳之间的第一距离。
实施例243-实施例241或242的系统，其中，侧向突出的第二远侧凸耳与侧向突出的远侧凸耳匹配，并且其中侧向突出的第二近侧凸耳不同于近侧侧向突出的凸耳。
实施例244-实施例241、242或243的系统，其中，第二可替换的钉仓还包括平台，其中通道还包括底部表面，并且其中当第二可替换的钉仓位于通道中时，该平台被取向为相对于底部表面倾斜。
实施例245-实施例241、242、243或244的系统，其中，可替换的钉仓和第二可替换的钉仓包括相同的宽度和相同的长度。
实施例246-实施例241、242、243、244或245的系统，其中，所述多个钉和第二多个钉包括相同数量的钉。
实施例247-实施例236、237、238、239、240、241、242、243、244、245或246的系统，其中，侧向突出的远侧凸耳包括不同于近侧侧向突出的凸耳的几何结构。
实施例248-实施例247的系统，其中，近侧侧向突出的凸耳包括楔形件。
实施例249-实施例247或248的系统，其中，近侧侧向突出的凸耳包括与近侧容座中的突起部匹配的切口。
实施例250-实施例236、237、238、239、240、241、242、243、244、245、246、247、248或249的系统，其中，近侧侧向突出的凸耳从可替换的钉仓的第一侧突出，并且其中侧向突出的远侧凸耳从可替换的钉仓的第二侧突出。
实施例251-实施例236、237、238、239、240、241、242、243、244、245、246、247、248、249或250的系统，其中，可替换的钉仓还包括平台，其中，通道还包括底部表面，并且其中当可替换的钉仓定位在通道中时，平台平行于底部表面。
实施例252-一种系统，该系统包括：通道，其包括障碍物；兼容的钉仓，其包括互补的抗障碍物，该互补的抗障碍物的位置和尺寸被设计成当兼容的钉仓被接纳在通道中时与障碍物互补；以及不兼容的钉仓，其包括非互补的抗障碍物，非互补的抗障碍物的位置和尺寸被设计成当不兼容的钉仓被接纳在通道中时与障碍物干涉。
实施例253-实施例252的系统，其中，兼容的钉仓和不兼容的钉仓包括相同长度的钉排。
实施例254-实施例252或253的系统，其中，兼容的钉仓和不兼容的钉仓包括相同数量的钉。
实施例255-实施例252、253或254的系统，其中，障碍物还包括切口，该切口包括凹入部和突起部。
实施例256-一种系统，该系统包括：兼容的钉仓，其包括第一数量的钉；不兼容的钉仓，其包括第一数量的钉；以及通道，其包括用于允许将兼容的钉仓完全插入和用于防止不兼容的钉仓被完全插入通道中的装置。
实施例257-一种系统，该系统包括端部执行器，该端部执行器被构造成能够接纳兼容的可替换钉仓，其中端部执行器包括第一外表面，并且其中端部执行器的分类标识刻在第一外表面上，并且兼容的可替换钉仓包括第二外表面，其中兼容的可替换钉仓的分类标识刻在第二外表面上，并且其中兼容的可替换钉仓的分类标识对应于端部执行器的分类标识。
实施例258-实施例257的系统，其中，该系统还包括不兼容的可替换钉仓，其中不兼容的可替换钉仓包括第三外表面，其中不兼容的可替换钉仓的分类标识位于第三外表面上，并且其中兼容的可替换钉仓的分类标识不同于端部执行器的分类标识。
实施例259-实施例257或258的系统，其中，端部执行器还包括远侧部分，并且其中端部执行器的分类标识位于该远侧部分上。
实施例260-实施例259的系统，其中，端部执行器还包括砧座，并且其中端部执行器的分类标识位于砧座的远侧端部。
实施例261-实施例257、258、259或260的系统，其中，端部执行器还包括砧座，该砧座包括一对组织止挡件，并且其中端部执行器的辅助分类标识位于每个组织止挡件上。
实施例262-实施例257、258、259、260或261的系统，其中，兼容的可替换钉仓还包括楔形远侧鼻部，并且其中兼容的可替换钉仓的分类标识位于该楔形远侧鼻部上。
实施例263-实施例257、258、259、260、261或262的系统，其中，端部执行器的分类标识和兼容的可替换钉仓的分类标识包括相同的字母数字字符。
实施例264-实施例263的系统，其中，相同的字母数字字符表示从兼容的可替换钉仓击发的所得钉线的长度。
实施例265-实施例264的系统，其中，相同的字母数字字符表示一种类型的端部执行器。
实施例266-实施例257、258、259、260、261、262、263、264或265的系统，其中，端部执行器的分类标识和兼容的可替换钉仓的分类标识包括相同的形状。
实施例267-实施例257、258、259、260、261、262、263、264、265或266的系统，其中，端部执行器的分类标识和兼容的可替换钉仓的分类标识包括相同的颜色。
实施例268-实施例257、258、259、260、261、262、263、264、265、266或267的系统，其中，该系统还包括闭锁件，该闭锁件被构造成能够防止至少一个外科功能，除非兼容的可替换钉仓位于端部执行器中。
实施例269-一种系统，该系统包括端部执行器，该端部执行器被构造成能够接纳兼容的可替换钉仓，其中该端部执行器包括第一远侧端部，第一远侧端部包括钉仓兼容性指示器，并且兼容的可替换钉仓包括多个钉，其中兼容的可替换钉仓包括第二远侧端部，第二远侧端部包括端部执行器兼容性指示器。
实施例270-实施例269的系统，其中，钉仓兼容性指示器压印在端部执行器的外表面上。
实施例271-实施例270的系统，其中，端部执行器兼容性指示器压印在兼容的可替换钉仓的外表面上。
实施例272-实施例269、270或271的系统，其中，当兼容的可替换钉仓定位在端部执行器中时，钉仓兼容性指示器纵向地重叠在端部执行器兼容性指示器上。
实施例273-一种系统，该系统包括端部执行器，该端部执行器被构造成能够接纳兼容的可替换钉仓，其中该端部执行器包括第一外表面，第一外表面包括第一代码，并且兼容的可替换钉仓包括多个钉和第二外表面，其中第二外表面包括第二代码，并且其中第二代码与第一代码匹配。
实施例274-实施例273的系统，其中，第一代码被压印在第一外表面上，并且其中第二代码被压印在第二外表面上。
实施例275-实施例273或274的系统，其中，第一代码和第二代码指示兼容的可替换钉仓的长度。
实施例276-实施例273、274或275的系统，其中，第一代码和第二代码包括至少一个数字和至少一个字母。
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利用。名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利申请公布2012/0298719)更详细地公开了机器人外科器械系统的若干示例。
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，设想了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，还设想了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：
-公布于1995年四月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312；
-公布于2006年二月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年九月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年十二月16日的名称为“ELECTRO-MECHANICAL SURGICALINSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”的美国专利7,464,849；
-公布于2010年三月2日的名称为“SURGICAL INSTRUMENT HAVING ANARTICULATING END EFFECTOR”的美国专利7,670,334；
-公布于2010年七月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245；
-公布于2013年三月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年二月14日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT HAVING RF ELECTRODES”的美国专利申请序列号12/031,573；
-提交于2008年二月15日的名称为“END EFFECTORS FOR A SURGICAL CUTTINGAND STAPLING 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年十二月24日的名称为“MOTOR-DRIVEN SURGICAL CUTTINGINSTRUMENT WITH 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年九月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8,733,613；
-提交于2011年二月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8,561,870；
-名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS”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年六月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年三月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESSSENSOR SYSTEM”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年三月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESSSENSOR SYSTEM”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年一月31日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM”的美国专利申请公布2007/0175955；以及
-提交于2010年四月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许多修改和变型。在一个或多个实施方案中，具体特征部、结构或特性可以任何合适的方式组合。因此，在无限制的情况下，结合一个实施方案示出或描述的具体特征部、结构或特性可全部或部分地与一个或多个其它实施方案的特征部、结构或特性组合。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。修复可包括以下步骤的任意组合，这些步骤包括但不限于移除装置、之后进行装置具体部件的清洁或更换、以及随后重新组装装置。具体地，修复设施和/或外科团队可移除装置，并且在清洁和/或更换装置的特定部件之后，可重新组装装置以供后续使用。本领域的技术人员将会理解，修整装置可利用多种技术来进行移除、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推进行处理。首先，可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。经消毒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为无菌的，直到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它技术对装置进行消毒，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、公布或其它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、陈述或其它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 (21)

1.一种系统，所述系统包括：
可替换的钉仓，所述可替换的钉仓包括：
多个钉；
侧向突出的近侧凸耳；以及
侧向突出的远侧凸耳；以及
通道，所述通道被构造成能够接纳所述可替换的钉仓，其中所述通道包括侧壁，所述侧壁包括：
近侧容座，所述近侧容座的位置和尺寸被设计成接纳所述侧向突出的近侧凸耳；以及
远侧容座，所述远侧容座的位置和尺寸被设计成接纳所述侧向突出的远侧凸耳。
2.根据权利要求1所述的系统，其中，所述通道还包括障碍物，并且其中所述可替换的钉仓还包括互补的抗障碍物，所述互补的抗障碍物的位置和尺寸被设计成克服所述障碍物。
3.根据权利要求2所述的系统，还包括可替换的第二钉仓，所述可替换的第二钉仓包括非互补的抗障碍物，所述非互补的抗障碍物的位置和尺寸被设计成与所述障碍物干涉。
4.根据权利要求1所述的系统，其中，所述近侧容座限定所述侧壁中的切口，并且其中所述切口包括凹入部和突起部。
5.根据权利要求4所述的系统，其中，所述突起部定位在所述凹入部内。
6.根据权利要求1所述的系统，还包括可替换的第二钉仓，所述可替换的第二钉仓包括：
第二多个钉，
侧向突出的第二近侧凸耳；以及
侧向突出的第二远侧凸耳。
7.根据权利要求6所述的系统，其中，所述侧向突出的第二远侧凸耳与所述侧向突出的第二近侧凸耳间隔开一距离，并且其中所述距离不同于所述可替换的钉仓的所述侧向突出的近侧凸耳和所述侧向突出的远侧凸耳之间的第一距离。
8.根据权利要求6所述的系统，其中，所述侧向突出的第二远侧凸耳与所述侧向突出的远侧凸耳匹配，并且其中所述侧向突出的第二近侧凸耳不同于所述侧向突出的近侧凸耳。
9.根据权利要求6所述的系统，其中，所述可替换的第二钉仓还包括平台，其中所述通道还包括底部表面，并且其中当所述可替换的第二钉仓定位在所述通道中时，所述平台被取向为相对于所述底部表面倾斜。
10.根据权利要求6所述的系统，其中，所述可替换的钉仓和所述可替换的第二钉仓包括相同的宽度和相同的长度。
11.根据权利要求6所述的系统，其中，所述多个钉和所述第二多个钉包括相同数量的钉。
12.根据权利要求1所述的系统，其中，所述侧向突出的远侧凸耳包括不同于所述侧向突出的近侧凸耳的几何结构。
13.根据权利要求12所述的系统，其中，所述侧向突出的近侧凸耳包括楔形件。
14.根据权利要求12所述的系统，其中，所述侧向突出的近侧凸耳包括与所述近侧容座中的突起部匹配的切口。
15.根据权利要求1所述的系统，其中，所述侧向突出的近侧凸耳从所述可替换的钉仓的第一侧突出，并且其中所述侧向突出的远侧凸耳从所述可替换的钉仓的第二侧突出。
16.根据权利要求1所述的系统，其中，所述可替换的钉仓还包括平台，其中所述通道还包括底部表面，并且其中当所述可替换的钉仓定位在所述通道中时，所述平台平行于所述底部表面。
17.一种系统，所述系统包括：
通道，所述通道包括障碍物；
兼容的钉仓，所述兼容的钉仓包括互补的抗障碍物，所述互补的抗障碍物的位置和尺寸被设计成当所述兼容的钉仓被接纳在所述通道中时与所述障碍物互补；以及
不兼容的钉仓，所述不兼容的钉仓包括非互补的抗障碍物，所述非互补的抗障碍物的位置和尺寸被设计成当所述不兼容的钉仓被接纳在所述通道中时与所述障碍物干涉。
18.根据权利要求17所述的系统，其中，所述兼容的钉仓和所述不兼容的钉仓包括相同长度的钉排。
19.根据权利要求17所述的系统，其中，所述兼容的钉仓和所述不兼容的钉仓包括相同数量的钉。
20.根据权利要求17所述的系统，其中，所述障碍物还包括切口，所述切口包括凹入部和突起部。
21.一种系统，所述系统包括：
兼容的钉仓，所述兼容的钉仓包括第一数量的钉；
不兼容的钉仓，所述不兼容的钉仓包括所述第一数量的钉；以及
通道，所述通道包括用于允许将所述兼容的钉仓完全插入和用于防止所述不兼容的钉仓被完全插入所述通道中的装置。
CN201780079993.8A 2016-12-21 2017-10-26 外科缝合系统 Pending CN110087565A (zh)

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US11224428B2 (en) 2022-01-18
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Application publication date: 20190802