CN110099616A - 包括具有不同夹持阔度的钉的钉仓 - Google Patents

包括具有不同夹持阔度的钉的钉仓 Download PDF

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CN110099616A
CN110099616A CN201780079465.2A CN201780079465A CN110099616A CN 110099616 A CN110099616 A CN 110099616A CN 201780079465 A CN201780079465 A CN 201780079465A CN 110099616 A CN110099616 A CN 110099616A
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CN110099616B (zh
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F·E·谢尔顿四世
G·J·巴克斯
J·L·哈里斯
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Ethicon LLC
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Ethicon LLC
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00526—Methods of manufacturing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07228—Arrangement of the staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07235—Stapler heads containing different staples, e.g. staples of different shapes, sizes or materials
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Molecular Biology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Robotics (AREA)
  • Surgical Instruments (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
  • Clamps And Clips (AREA)

Abstract

本发明公开了一种钉仓组件，所述钉仓组件包括第一钉和另外的第二钉，所述第一钉包括驱动部分和从所述驱动部分偏离第一距离的咬合部分，所述第二钉包括驱动部分和从所述驱动部分偏离第二距离的咬合部分，所述第二距离不等于所述第一距离。

Description

包括具有不同夹持阔度的钉的钉仓
背景技术
本发明涉及外科器械，并且在各种布置中，涉及外科缝合和切割器械以及与其一起使用的钉仓。
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加以理解：
图1为根据至少一个实施方案的外科缝合器械的端部执行器的透视图；
图2为与图1的端部执行器一起使用的钉仓的局部透视图；
图3为可移除地储存在图2的钉仓中的线钉的透视图；
图3A为钉驱动装置的透视图，该钉驱动装置被构造成能够从图2的钉仓射出图3的钉；
图4为与图1的端部执行器一起使用的钉仓的局部透视图；
图5为可移除地储存在图4的钉仓中的钉的透视图；
图6为描绘图2的钉仓的钉和图4的钉仓的钉可与图1的端部执行器的砧座的成形凹坑对准的图示；
图7为图5的钉的正视图；
图8为图5的钉的局部侧视图；
图9为图5的钉的局部侧视图；
图10描绘了图4的钉仓的滑动件直接接合图5的钉；
图11为图4的钉仓的局部剖视图，示出了处于未击发位置的图5的钉；
图12为图4的钉仓的局部剖视图，示出了处于击发位置的图5的钉；
图13包括图5的钉的另选实施方案的透视图和正视图；
图14包括具有非平行钉腿的图5的钉的一种型式的透视图和正视图；
图15为根据至少一个实施方案的钉仓的局部平面图；
图16为与图15的钉仓一起使用的滑动件的后正视图；
图17为图16的滑动件的透视图；
图18为图15的钉仓的仓体的局部剖视图；
图19为与图15的钉仓一起使用的砧座的局部平面图；
图20为根据至少一个实施方案的钉仓的局部平面图；
图21为与图20的钉仓一起使用的滑动件的前正视端视图；
图22示出了根据至少一个实施方案的具有不同尺寸的钉；
图23包括图22的钉的透视图；
图24为被构造成能够使用图22的钉的钉仓的局部平面图；并且
图25为图24的钉仓的局部透视图。
在所述若干视图中，对应的参考符号指示对应的部件。本文所述的范例以一种形式示出了本发明的各种实施方案，且这种范例不应被解释为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIESTHEREOF”的美国专利申请序列号__________；代理人案卷号END7980USNP/160155；
-名称为“ARTICULATABLE SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END7981USNP/160156；
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS”的美国专利申请序列号__________；代理人案卷号END7982USNP/160157；
-名称为“SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF”的美国专利申请序列号__________；代理人案卷号END7983USNP/160158；
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS ANDREPLACEABLE TOOL ASSEMBLIES”的美国专利申请序列号__________；代理人案卷号END7984USNP/160159；以及
-名称为“SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR”的美国专利申请序列号__________；代理人案卷号END7985USNP/160160。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号__________；代理人案卷号END7986USNP/160161；
-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__________；代理人案卷号END7987USNP/160162；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号__________；代理人案卷号END7988USNP/160163；
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTIONFEATURES”的美国专利申请序列号__________；代理人案卷号END7989USNP/160164；
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号__________；代理人案卷号END7990USNP/160165；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号__________；代理人案卷号END7991USNP/160166；
-名称为“SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASINGA JAW OPENING DISTANCE”的美国专利申请序列号__________；代理人案卷号END7992USNP/160167；
-名称为“METHODS OF STAPLING TISSUE”的美国专利申请序列号__________；代理人案卷号END7993USNP/160168；
-名称为“FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FORSURGICAL END EFFECTORS”的美国专利申请序列号__________；代理人案卷号END7994USNP/160169；
-名称为“SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOPARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END7995USNP/160170；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号__________；代理人案卷号END7996USNP/160171；
-名称为“SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号__________；代理人案卷号END7997USNP/160172；
-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__________；代理人案卷号END7998USNP/160173；以及
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号__________；代理人案卷号END7999USNP/160174。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“METHOD FOR RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT”的美国专利申请序列号__________；代理人案卷号END8013USNP/160175；
-名称为“STAPLE FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENTTYPES OF STAPLES”的美国专利申请序列号__________；代理人案卷号END8014USNP/160176；
-名称为“SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL”的美国专利申请序列号__________；代理人案卷号END8016USNP/160178；
-名称为“STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISINGWINDOWS DEFINED THEREIN”的美国专利申请序列号__________；代理人案卷号END8017USNP/160179；
-名称为“SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER”的美国专利申请序列号__________；代理人案卷号END8018USNP/160180；
-名称为“STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/ORSPENT CARTRIDGE LOCKOUT”的美国专利申请序列号__________；代理人案卷号END8019USNP/160181；
-名称为“FIRING ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号__________；代理人案卷号END8020USNP/160182；
-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__________；代理人案卷号END8021USNP/160183；
-名称为“FIRING ASSEMBLY COMPRISING A FUSE”的美国专利申请序列号__________；代理人案卷号END8022USNP/160184；以及
-名称为“FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE”的美国专利申请序列号__________；代理人案卷号END8023USNP/160185。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END8038USNP/160186；
-名称为“ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS”的美国专利申请序列号__________；代理人案卷号END8039USNP/160187；
-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__________；代理人案卷号END8041USNP/160189；
-名称为“BILATERALLY ASYMMETRIC STAPLE FORMING POCKET PAIRS”的美国专利申请序列号__________；代理人案卷号END8042USNP/160190；
-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__________；代理人案卷号END8043USNP/160191；
-名称为“SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING ANDFIRING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8044USNP/160192；
-名称为“SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES”的美国专利申请序列号__________；代理人案卷号END8045USNP/160193；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING PRIMARYSIDEWALLS AND POCKET SIDEWALLS”的美国专利申请序列号__________；代理人案卷号END8048USNP/160196；
-名称为“NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FORSURGICAL STAPLERS”的美国专利申请序列号__________；代理人案卷号END8050USNP/160198；
-名称为“FIRING MEMBER PIN ANGLE”的美国专利申请序列号__________；代理人案卷号END8051USNP/160199；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMINGSURFACE GROOVES”的美国专利申请序列号__________；代理人案卷号END8052USNP/160200；
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES”的美国专利申请序列号__________；代理人案卷号END8053USNP/160201；
-名称为“SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS”的美国专利申请序列号__________；代理人案卷号END8054USNP/160202；
-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__________；代理人案卷号END8056USNP/160204；
-名称为“ANVIL HAVING A KNIFE SLOT WIDTH”的美国专利申请序列号__________；代理人案卷号END8057USNP/160205；
-名称为“CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8058USNP/160206；以及
-名称为“FIRING MEMBER PIN CONFIGURATIONS”的美国专利申请序列号__________；代理人案卷号END8059USNP/160207。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES”的美国专利申请序列号__________；代理人案卷号END8000USNP/160208；
-名称为“STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAPSETTING FEATURES”的美国专利申请序列号__________；代理人案卷号END8001USNP/160209；
-名称为“STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES”的美国专利申请序列号__________；代理人案卷号END8002USNP/160210；
-名称为“DURABILITY FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIESOF SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8003USNP/160211；
-名称为“SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITHPOSITIVE OPENING FEATURES”的美国专利申请序列号__________；代理人案卷号END8004USNP/160212；以及
-名称为“CONNECTION PORTIONS FOR DEPOSABLE LOADING UNITS FOR SURGICALSTAPLING INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8005USNP/160213。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“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__________；代理人案卷号END8006USNP/160214；
-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__________；代理人案卷号END8007USNP/160215；
-名称为“SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE ANDRETRACTABLE SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8008USNP/160216；
-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__________；代理人案卷号END8009USNP/160217；
-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__________；代理人案卷号END8010USNP/160218；
-名称为“SHAFT ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号__________；代理人案卷号END8011USNP/160219；以及
-名称为“SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATIONLOCKOUTS”的美国专利申请序列号__________；代理人案卷号END8012USNP/160220。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8024USNP/160221；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8025USNP/160222；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8026USNP/160223；
-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__________；代理人案卷号END8027USNP/160224；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8028USNP/160225；
-名称为“JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OFA FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN UNFIRED CARTRIDGE ISINSTALLED IN THE END EFFECTOR”的美国专利申请序列号__________；代理人案卷号END8029USNP/160226；
-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__________；代理人案卷号END8030USNP/160227；
-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__________；代理人案卷号END8031USNP/160228；
-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__________；代理人案卷号END8032USNP/160229；
-名称为“ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFTARRANGEMENT”的美国专利申请序列号__________；代理人案卷号END8033USNP/160230；
-名称为“ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLELINKAGE DISTAL OF AN ARTICULATION LOCK”的美国专利申请序列号__________；代理人案卷号END8034USNP/160231；
-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__________；代理人案卷号END8035USNP/160232；
-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__________；代理人案卷号END8036USNP/160233；以及
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKEAMPLIFICATION FEATURES”的美国专利申请序列号__________；代理人案卷号END8037USNP/160234。
本申请的申请人拥有于2016年6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6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4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12月31日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE INPOWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/984,488；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/984,525；以及
-名称为“SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROLCIRCUITS”的美国专利申请序列号14/984,552。
本申请的申请人还拥有于2016年2月9日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLYTRANSLATABLE END EFFECTOR”的美国专利申请序列号15/019,220；
-名称为“SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,228；
-名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTEDSECONDARY CONSTRAINT”的美国专利申请序列号15/019,196；
-名称为“SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLYARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY”的美国专利申请序列号15/019,206；
-名称为“SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,215；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATIONLINK ARRANGEMENTS”的美国专利申请序列号15/019,227；
-名称为“SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLEDRIVEN ARTICULATION SYSTEMS”的美国专利申请序列号15/019,235；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAMARRANGEMENTS”的美国专利申请序列号15/019,230；以及
-名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTIONARRANGEMENTS”的美国专利申请序列号15/019,245。
本申请的申请人还拥有于2016年2月12日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,254；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,259；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,275；以及
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,289。
本申请的申请人拥有于2015年6月18日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL END EFFECTORS WITH POSITIVE JAW OPENINGARRANGEMENTS”的美国专利申请序列号14/742,925；
-名称为“SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSINGFEATURES”的美国专利申请序列号14/742,941；
-名称为“MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,914；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAMSTRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT”的美国专利申请序列号14/742,900；
-名称为“DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,885；以及
-名称为“PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,876。
本申请的申请人拥有于2015年3月6日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“POWERED SURGICAL INSTRUMENT”的美国专利申请序列号14/640,746，现为美国专利申请公开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开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开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开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开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开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开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开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开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开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开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开2016/0256161。
本申请的申请人拥有于2015年2月27日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION”的美国专利申请序列号14/633,576，现为美国专利申请公开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开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开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开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开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开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开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开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开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开2016/0249917。
本申请的申请人拥有于2014年12月18日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE ENDEFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER”的美国专利申请序列号14/574,478，现为美国专利申请公开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开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开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开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开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开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开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开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开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开2016/0174971。
本申请的申请人拥有于2013年3月1日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“Articulatable Surgical Instruments With Conductive PathwaysFor Signal Communication”的美国专利申请序列号13/782,295，现为美国专利申请公布2014/0246471；
-名称为“Rotary Powered Articulation Joints For Surgical Instruments”的美国专利申请序列号13/782,323，现为美国专利申请公布2014/0246472；
-名称为“Thumbwheel Switch Arrangements For Surgical Instruments”的美国专利申请序列号13/782,338，现为美国专利申请公布2014/0249557；
-名称为“Electromechanical Surgical Device with Signal RelayArrangement”的美国专利申请序列号13/782,499，现为美国专利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3月14日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE”的美国专利申请序列号13/803,097，现为美国专利申请公布2014/0263542；
-名称为“CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICALINSTRUMENT”的美国专利申请序列号13/803,193，现为美国专利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3月7日提交且全文以引用方式并入本文的以下专利申请：
-名称为“CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/200,111，现为美国专利申请公布2014/0263539。
本申请的申请人还拥有于2014年3月26日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,106，现为美国专利申请公布2015/0272582；
-名称为“STERILIZATION VERIFICATION CIRCUIT”的美国专利申请序列号14/226,099，现为美国专利申请公布2015/0272581；
-名称为“VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT”的美国专利申请序列号14/226,094，现为美国专利申请公布2015/0272580；
-名称为“POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUITAND WAKE UP CONTROL”的美国专利申请序列号14/226,117，现为美国专利申请公布2015/0272574；
-名称为“MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFTASSEMBLIES”的美国专利申请序列号14/226,075，现为美国专利申请公布2015/0272579；
-名称为“FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICALINSTRUMENTS”的美国专利申请序列号14/226,093，现为美国专利申请公布2015/0272569；
-名称为“SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION”的美国专利申请序列号14/226,116，现为美国专利申请公布2015/0272571；
-名称为“SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETYPROCESSOR”的美国专利申请序列号14/226,071，现为美国专利申请公布2015/0272578；
-名称为“SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS”的美国专利申请序列号14/226,097，现为美国专利申请公布2015/0272570；
-名称为“INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,126，现为美国专利申请公布2015/0272572；
-名称为“MODULAR SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号14/226,133，现为美国专利申请公布2015/0272557；
-名称为“SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT”的美国专利申请序列号14/226,081，现为美国专利申请公布2015/0277471；
-名称为“POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLEVOLTAGE PROTECTION”的美国专利申请序列号14/226,076，现为美国专利申请公布2015/0280424；
-名称为“SURGICAL STAPLING INSTRUMENT SYSTEM”的美国专利申请序列号14/226,111，现为美国专利申请公布2015/0272583；以及
-名称为“SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT”的美国专利申请序列号14/226,125，现为美国专利申请公布2015/0280384。
本申请的申请人还拥有于2014年9月5日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,103，现为美国专利申请公布2016/0066912；
-名称为“ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUECOMPRESSION”的美国专利申请序列号14/479,119，现为美国专利申请公布2016/0066914；
-名称为“MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION”的美国专利申请序列号14/478,908，现为美国专利申请公布2016/0066910；
-名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'SOUTPUT OR INTERPRETATION”的美国专利申请序列号14/478,895，现为美国专利申请公布2016/0066909；
-名称为“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开2016/0066915；
-名称为“SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION”的美国专利申请序列号14/479,098，现为美国专利申请公布2016/0066911；
-名称为“MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,115，现为美国专利申请公布2016/0066916；以及
-名称为“LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION”的美国专利申请序列号14/479,108，现为美国专利申请公布2016/0066913。
本申请的申请人还拥有于2014年4月9日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVESHAFTS”的美国专利申请序列号14/248,590，现为美国专利申请公布2014/0305987；
-名称为“SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRINGDRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT”的美国专利申请序列号14/248,581，现为美国专利申请公布2014/0305989；
-名称为“SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLINGTHE OPERATION OF THE SURGICAL INSTRUMENT”的美国专利申请序列号14/248,595，现为美国专利申请公布2014/0305988；
-名称为“POWERED LINEAR SURGICAL STAPLER”的美国专利申请序列号14/248,588，现为美国专利申请公布2014/0309666；
-名称为“TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT”的美国专利申请序列14/248,591，现为美国专利申请公布2014/0305991；
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENTFEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS”的美国专利申请序列号14/248,584，现为美国专利申请公布2014/0305994；
-名称为“POWERED SURGICAL STAPLER”的美国专利申请序列号14/248,587，现为美国专利申请公布2014/0309665；
-名称为“DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICALINSTRUMENT”的美国专利申请序列号14/248,586，现为美国专利申请公布2014/0305990；以及
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUSINDICATION ARRANGEMENTS”的美国专利申请序列号14/248,607，现为美国专利申请公布2014/0305992。
本申请的申请人还拥有于2013年4月16日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,365；
-名称为“LINEAR CUTTER WITH POWER”的美国临时专利申请序列号61/812,376；
-名称为“LINEAR CUTTER WITH MOTOR AND PISTOL GRIP”的美国临时专利申请序列号61/812,382；
-名称为“SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS ANDMOTOR CONTROL”的美国临时专利申请序列号61/812,385；以及
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,372。
本申请的申请人拥有于2015年8月26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 STAPLES FOR MINIMIZING STAPLE ROLL”的美国专利申请序列号14/836,324；
-名称为“SURGICAL STAPLES COMPRISING HARDNESS VARIATIONS FOR IMPROVEDFASTENING OF TISSUE”的美国专利申请序列号14/836,411；
-名称为“SURGICAL STAPLE STRIPS FOR PERMITTING VARYING STAPLEPROPERTIES AND ENABLING EASY CARTRIDGE LOADING”的美国专利申请序列号14/836,058；
-名称为“SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULARSTAPLING INSTRUMENTS”的美国专利申请序列号14/836,110；
-名称为“STAPLE CARTRIDGE ASSEMBLY WITHOUT A BOTTOM COVER”的美国专利申请序列号14/836,036；
-名称为“STAPLE CARTRIDGE ASSEMBLY COMPRISING STAPLE CAVITIES FORPROVIDING BETTER STAPLE GUIDANCE”的美国专利申请序列号14/836,077；
-名称为“STAPLE CARTRIDGE ASSEMBLY INCLUDING STAPLE GUIDES”的美国专利申请序列号14/836,225；
-名称为“STAPLE CARTRIDGE ASSEMBLY COMPRISING STAPLE ALIGNMENTFEATURES ON A FIRING MEMBER”的美国专利申请序列号14/836,351；
-名称为“STAPLE CARTRIDGE ASSEMBLY COMPRISING VARIOUS TISSUECOMPRESSION GAPS AND STAPLE FORMING GAPS”的美国专利申请序列号14/836,163；
-名称为“STAPLES CONFIGURED TO SUPPORT AN IMPLANTABLE ADJUNCT”的美国专利申请序列号14/836,294；
-名称为“STAPLES COMPRISING A COVER”的美国专利申请序列号14/836,375；
-名称为“STAPLE CARTRIDGE ASSEMBLY INCLUDING FEATURES FOR CONTROLLINGTHE ROTATION OF STAPLES WHEN BEING EJECTED THEREFROM”的美国专利申请序列号14/836,137；以及
-名称为“SURGICAL STAPLES COMPRISING FEATURES FOR IMPROVED FASTENINGOF TISSUE”的美国专利申请序列号14/836,020。
本申请的申请人还拥有于2013年12月23日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“Surgical Instruments With Articulatable Shaft Arrangements”的美国专利申请序列号14/138,554；现为美国专利申请公开2015/0173789；
-名称为“SURGICAL STAPLES AND STAPLE CARTRIDGES”的美国专利申请序列号14/138,465；现为美国专利申请公布2015/0173744；
-名称为“Articulatable Surgical Instruments With Separate and DistinctClosing and Firing Systems”的美国专利申请序列号14/138,474；现为美国专利申请公开2015/0173745；
-名称为“Surgical Cutting and Stapling Instruments With IndependentJaw Control Features”的美国专利申请序列号14/138,485；现为美国专利申请公开2015/0173746；
-名称为“SURGICAL STAPLES AND STAPLE CARTRIDGES”的美国专利申请序列号14/138,475；现为美国专利申请公开2015/0173749；
-名称为“SURGICAL STAPLES AND METHODS FOR MAKING THE SAME”的美国专利申请序列号14/138,481；现为美国专利申请公开2015/0173750；
-名称为“SURGICAL STAPLES,STAPLE CARTRIDGES AND SURGICAL ENDEFFECTORS”的美国专利申请序列号14/138,489；现为美国专利申请公开2015/0173751；
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/477,488；
-名称为“FASTENER CARTRIDGE COMPRISING AN EXTENDABLE FIRING MEMBER”的美国专利申请序列号14/138,505；现为美国专利申请公开2015/0173760；
-名称为“FASTENER CARTRIDGE COMPRISING A FIRING MEMBER CONFIGURED TODIRECTLY ENGAGE AND EJECT FASTENERS FROM THE FASTENER CARTRIDGE”的美国专利申请序列号14/138,518；现为美国专利申请公开2015/0173761；
-名称为“FASTENER CARTRIDGE COMPRISING A FIRING MEMBER INCLUDINGFASTENER TRANSFER SURFACES”的美国专利申请序列号14/138,530；现为美国专利申请公开2015/0173762；
-名称为“Modular Surgical Instruments”的美国专利申请序列号14/138,507；现为美国专利申请公开2015/0173747；
-名称为“Surgical Cutting and Stapling Instruments With ArticulatableEnd Effectors”的美国专利申请序列号14/138,497；现为美国专利申请公开2015/0173755；以及
-名称为“SURGICAL CUTTING AND STAPLING METHODS”的美国专利申请序列号14/138,516；现为美国专利申请公布2015/0173756。
本文列出了许多具体细节，以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件，以免使说明书中描述的实施方案模糊不清。读者将会理解，本文所述和所示的实施方案为非限制性示例，从而可认识到，本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求的范围的情况下，可对这些实施方案进行变型和改变。
术语“包括(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用于执行腹腔镜式和微创外科手术操作。然而，读者将容易理解，本文所公开的各种方法和装置可用于多种外科程序和应用中，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。钉仓能够插入到第一钳口中并且能够从第一钳口移除；然而，设想到其中钉仓不能够从第一钳口移除或至少能够易于从第一钳口替换的其他实施方案。第二钳口包括被构造成能够使从钉仓射出的钉变形的砧座。第二钳口能够相对于第一钳口围绕闭合轴线枢转；然而，设想到其中第一钳口能够相对于第二钳口枢转的其他实施方案。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他实施方案。
钉仓包括仓体。仓体包括近侧端部、远侧端部和在近侧端部与远侧端部之间延伸的平台。在使用中，钉仓定位在待缝合的组织的第一侧上，并且砧座定位在组织的第二侧上。砧座朝向钉仓运动以将组织压缩并夹持抵靠平台。然后，可移除地储存在仓体中的钉可被部署到组织中。仓体包括限定于其中的钉腔，其中钉可移除地储存在钉腔中。钉腔被布置成六纵向排。三排钉腔定位在纵向狭槽的第一侧上且三排钉腔定位在纵向狭槽的第二侧上。钉腔和钉的其他布置也是可能的。
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运动，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运动。滑动件能够在与近侧端部相邻的近侧位置和与远侧端部相邻的远侧位置之间运动。滑动件包括多个斜坡表面，该斜坡表面被构造成能够朝向砧座在驱动装置下方滑动以及提升驱动装置，并且钉在驱动装置上受到支撑。
除上述以外，滑动件还可通过击发构件朝远侧运动。击发构件被构造成能够接触滑动件并朝向远侧端部推动滑动件。在一个或多个另选实施方案中，滑动件连接到击发构件。限定于仓体中的纵向狭槽被构造成能够接收击发构件。砧座还包括被构造成能够接收击发构件的狭槽。击发构件还包括接合第一钳口的第一凸轮和接合第二钳口的第二凸轮。在击发构件朝远侧推进时，第一凸轮和第二凸轮可控制钉仓的平台和砧座之间的距离或组织间隙。设想了其他实施方案，其中击发构件仅具有一个凸轮构件或不具有凸轮构件。此类实施方案可包括用于将第一钳口和第二钳口保持就位的其他合适的装置。在任何情况下，击发构件还包括被构造成能够切入捕获在钉仓和砧座中间的组织的刀。希望刀定位成至少部分接近斜坡表面，使得钉先于刀被射出。
外科缝合系统的端部执行器100示于图1中。端部执行器100包括框架190、仓钳口110和砧座120。仓钳口110从框架190固定地延伸。砧座120能够相对于仓钳口110在打开或松开位置与闭合或夹紧位置(图1)之间运动。在另选实施方案中，仓钳口110能够相对于砧座120在打开或松开位置与闭合或夹紧位置之间运动。在至少一个此类实施方案中，砧座120从框架190固定地延伸。
例如，仓钳口110被构造成能够接收钉仓，诸如钉仓130。参见图2，钉仓130包括仓体132。仓体132包括被构造成能够支撑患者的组织的平台133、纵向狭槽135、以及限定在其中的六个纵向排钉腔134。例如，纵向狭槽135被构造成能够接收击发构件，诸如击发构件270(图12)。每个钉腔134被构造成能够在其中接收并可移除地储存钉140(图3)。钉仓130还包括钉驱动装置，诸如钉驱动装置180(图3A)，例如，其被构造成能够将钉140驱动出钉腔134。参照图3和图3A，每个钉驱动装置180包括支架182，该支架被构造成能够支撑和/或接合钉140的基部或冠部142。设想了其他钉驱动装置，其中驱动装置包括例如两个支架、三个支架或四个支架，例如用于支撑和接合多于一个的钉。
除上述之外，钉仓130还包括滑动件，该滑动件被构造成能够接合钉驱动装置180。更具体地，例如，滑动件包括一个或多个斜坡，该斜坡被构造成能够接合限定在钉驱动装置180上的一个或多个凸轮，诸如凸轮185，并且当滑动件朝远侧运动穿过钉仓130时，将钉驱动装置180和钉140提升到钉腔134内。击发构件270被构造成能够在钉击发行程期间将滑动件从近侧未击发位置朝远侧运动至远侧击发位置。在至少一个实例中，当钉140处于其未击发位置时，每个钉140完全定位在仓体132的平台133下方。在此类实例中，当钉140处于其未击发位置时，钉140的钉腿144不在平台133上方延伸。在使用中，当钉140被击发时，钉腿144的尖端146在平台133上方露出。当钉仓130相对于组织移动时，此类布置可以减少钉140钩住患者组织的可能性。
在各种其他实例中，除上述之外，当钉140处于其未击发位置时，钉腿144的尖端146延伸到平台133上方。主要参见图2，仓体132还包括延伸到平台133上方的突出部136，该突出部被构造成能够当钉140处于其未击发位置时至少部分地包围尖端146。钉腿144的长度被选择成使得当钉140处于其未击发位置时，尖端146定位在突出部136的顶表面下方。突出部136还被构造成能够在钉140从钉腔134射出时引导钉腿144。在某些方面，突出部136使钉腔134延伸到平台133上方。此类布置可以允许使用更大或更高的钉，同时即使钉延伸到平台133上方，也为钉提供保护。
除上述之外，钉140由线材构成。该线材具有圆形或至少基本上圆形的横截面；然而，可以使用任何合适的横截面。例如，可以使用正方形横截面和/或具有至少一个平坦侧面的横截面。该线材由金属构成，诸如钛和/或不锈钢。也就是说，该线材可以由例如任何合适的材料(诸如塑料)构成。
每个钉140由弯曲线材构成，该弯曲线材已经成形为包括钉140的冠部142和钉腿144。如下面更详细描述的，砧座120被构造成能够使钉140在未击发构型(图3)与击发构型之间变形。如图3所示，当钉140处于其未击发构型时，钉140的腿部144彼此不平行。在此类实例中，当钉140处于其未击发构型时，钉140包括基本上V形构型。在某些实施方案中，可以利用当钉处于其未击发构型时具有平行或至少基本上平行的腿部的钉。在此类实例中，当钉处于其未击发构型时，钉包括基本U形构型。
再次参见图2，钉仓130还包括附接到仓体132的保持器160。保持器160至少部分地围绕仓132的底部延伸，并且被构造成能够防止钉140、钉驱动装置180和/或滑动件从仓体132的底部掉出。保持器160被构造成能够以按扣配合方式接合仓体132；然而，保持器160可以任何合适的方式附接到仓体132。而且，保持器160被构造成能够以按扣配合方式接合仓钳口110，以将钉仓130可释放地保持在仓钳口110中。也就是说，钉仓130可以任何合适的方式可释放地保持到仓钳口110。
除上述之外，例如，端部执行器100也被构造成能够与除钉仓130之外的钉仓一起使用，诸如钉仓230(图4)。换句话讲，钉仓230例如可以与端部执行器100一起用于代替钉仓130。在某些实例中，端部执行器100可以与钉仓130一起使用，并且在钉仓130至少部分地被击发之后，钉仓130可以从第一钳口110移除，然后用未击发的钉仓230替换。在各种实例中，外科医生可以任何合适的顺序选择性地且可互换地使用一个或多个钉仓130以及一个或多个钉仓230。
参见图4，钉仓230包括仓体232和附接到仓体232的保持器260。保持器260在许多方面类似于保持器160。保持器260被构造成能够以按扣配合方式接合仓体232；然而，保持器260可以任何合适的方式附接到仓体232。而且，保持器260被构造成能够以按扣配合方式接合仓钳口110，以将钉仓230可释放地保持在仓钳口110中。也就是说，钉仓230可以任何合适的方式可释放地被保持到仓钳口110。
仓体232包括被构造成能够支撑患者的组织的平台233、纵向狭槽135、以及限定在其中的纵向排钉腔。平台233包括位于纵向狭槽135的第一侧上的第一部分和位于纵向狭槽135的第二侧上的第二部分。平台233的第一部分和第二部分各自包括第一或内部纵向排钉腔、第二或中间纵向排钉腔、以及第三或外部纵向排钉腔。平台233的第一部分包括具有钉腔234a的第一纵向排、具有钉腔234a的第二纵向排、以及具有钉腔234a'的第三纵向排。平台233的第二部分包括具有钉腔234a'的第一纵向排、具有钉腔234a'的第二纵向排、以及具有钉腔234的第三纵向排。
除上述之外，钉腔234a和钉腔234a'在许多方面类似，不同的是它们是彼此的镜像。钉腔234a可称为“左手”钉腔，并且钉腔234a'可称为“右手”钉腔。当然，左和右是透视问题，可以利用不同的、或甚至相反的命名法。而且，可以利用左手钉腔234a和右手钉腔234a'的任何合适布置。
参见图4、图5和图14，钉240可移除地储存在每个钉腔234a中。参见图13，钉240可移除地储存在每个钉腔234a中。钉240和钉240a'在许多方面类似，不同的是它们是彼此的镜像。与上面使用的命名法一致，钉240是“左手”钉，并且钉240'是“右手”钉。
再次参见图4，平台233的第二部分是平台233的第一部分的镜像。此类布置相对于组织切割线产生对称的钉线，即，当击发构件270在击发行程期间朝远侧运动通过纵向狭槽135时，由在击发构件270上限定的切割边缘272造成的纵向切口。在其他实施方案中，平台233的第二部分不是平台233的第一部分的镜像。此类布置在相对于切割线被缝合的组织中产生不对称的钉线。
主要参见图7至图10，钉240包括冠部242、连接到冠部242的近侧钉腿244p、以及连接到冠部242的远侧腿部244d。更具体地，钉240包括将近侧钉腿244p连接到冠部242的近侧连接器248p和将远侧钉腿244d连接到冠部242的远侧连接器248d。近侧连接器248p与近侧钉腿244p和冠部242一体地形成，并且类似地，远侧连接器248d与远侧钉腿244d和冠部242一体地形成。钉240还包括与冠部242一体成形并从该冠部延伸的驱动装置246。驱动装置246包括限定在其上的凸轮表面245，该凸轮表面被构造成能够在钉击发行程期间由钉仓230的滑动件250直接接合，如图10所示。
如从图7至图10中可以看出，冠部242和驱动装置246共同限定高度，该高度高于近侧连接器248p和/或远侧连接器248d。而且，冠部242和驱动装置246的总高度限定了尺寸大于钉腿244p和244d的任何横截面宽度的尺寸。
如从图7至图10中也可以看出，近侧腿部244p、近侧连接器248p、远侧腿部244d和远侧连接器244d不在驱动装置246下方延伸。换句话讲，驱动装置246包括钉240的底部。而且，整个凸轮表面245在近侧腿部244p、近侧连接器248p、远侧腿部244d和远侧连接器244d下方。此类布置有助于确保滑动件250接触钉240的驱动装置246，而不是钉240的另一部分。
除上述之外，再次参见图13，钉240'包括冠部242'、连接到冠部242'的近侧腿部244p'、连接到冠部242'的远侧腿部244d'、以及与冠部242'一体成形并从该冠部延伸的驱动装置246'。驱动装置246'包括限定在其上的凸轮表面245'，该凸轮表面被构造成能够在钉击发行程期间由滑动件250直接接合。除非另有说明，否则本文提供的关于钉240的教导适用于钉240'。为简洁起见，本文可能未具体阐述解决这些适应性的讨论。
每个钉240由例如单一金属件构成，诸如钛和/或不锈钢。可利用其他材料诸如例如塑料。在各种实例中，钉240由一个或多个材料片冲压而成。在至少一个实例中，将连续的扁金属条送入前进模具中，该前进模具撞击或冲压材料条，并且将冠部242从钉腿244p和钉腿244d移开或移出平面。另选地，将钉腿244p和钉腿244d从冠部242移开或移出平面。在各种实例中，前进模具还被构造成能够在钉240上形成一个或多个辐射式边缘，诸如例如在钉腿244p和钉腿244d上。在某些实例中，前进模具也被构造成能够铸造钉腿244p和钉腿244d的尖端246，并从材料条上移除任何多余的材料。这些成形步骤中的每一个可以在前进模具内的一个或多个工位处和/或在前进模具内的相同的成形工位或工位内发生—该布置将最终产生附接到例如连续弹带的钉240的条。钉240与弹带分离，然后插入到钉腔234中。在某些实例中，将钉条240装入装载块中，然后从钉240中移除弹带。此后，装载块用于将钉240插入仓体232的钉腔234a中。在至少一个实例中，装载块也被构造成能够接收钉240'，使得钉240和钉240'同时被装载到仓体232中。
除上述之外，主要参见图7，每个钉240的驱动装置246在连接点249处附接到弹带，该连接点限定在驱动装置246的远侧面。此类布置减少了毛刺或标签的可能性，例如，从驱动装置246向下延伸并阻碍滑动件250的纵向前进。也就是说，可以利用任何合适的附接点或点来将钉240保持到弹带。除了上述之外或代替上述内容，可以利用线材燃烧或放电加工(EDM)、操作和/或任何其他合适的制造工艺来形成钉240。而且，钉240'可以利用本文所述的任何方法制造。
参见图8和图9，钉240的近侧钉腿244p和远侧钉腿244d限定钉腿平面241s。除上述之外，当钉240定位在钉腔234a中时，钉240的近侧钉腿244p相对于远侧钉腿244d定位在近侧。而且，钉240的近侧钉腿244p和远侧钉腿244d与击发轴线对准。当钉240定位在纵向排钉腔234a中时，该击发轴线也与其他钉240的钉腿244p和钉腿244d对准。结果，纵向排钉腔234a中的钉240的钉腿平面241s彼此对准或至少基本上对准。应当理解，钉腿244p和钉腿244d包括宽度或厚度，并且钉腿平面241s可包括钉腿244p和/或钉腿244d的宽度。
除上述之外，参见图4和图6，储存在第一内部纵向排钉腔中的左手钉240可移除地储存在其中，使得钉240的钉腿平面241s比它们的驱动平面241c更靠近纵向狭槽135。相应地，继续参见图4和图6，储存在第二内部纵向排钉腔中的右手钉240也可移除地储存在其中，使得钉240的钉腿平面241s比它们的驱动平面241c更靠近纵向狭槽135。相似地，储存在第一中间纵向排钉腔中的左手钉240可移除地储存在其中，使得钉240的钉腿平面241s比它们的驱动平面241c更靠近纵向狭槽135。同样，储存在第二中间纵向排钉腔中的右手钉240'可移除地储存在其中，使得钉240'的钉腿平面241s比它们的驱动平面241c更靠近纵向狭槽135。另一方面，再次参见图4和图6，储存在第一外部纵向排钉腔中的右手钉240可移除地储存在其中，使得钉240'的驱动平面241c比它们的钉腿平面241s更靠近纵向狭槽135。同样，储存在第二外部纵向排钉腔中的左手钉240'也可移除地储存在其中，使得钉240的驱动平面241c比它们的钉腿平面241s更靠近纵向狭槽135。
钉240的钉腿244p、钉腿244d包括钉240的组织咬合或夹紧部分，当钉240的钉腿244p、钉腿244d抵靠砧座120变形时，该钉被构造成能够在钉240内捕获患者的组织，如下面更详细地描述的。在各种实例中，近侧钉腿244p和远侧钉腿244d形成在钉腿平面241s内。然而，在其他实例中，钉腿244p和钉腿244d中的一个或两个可以从钉腿平面241s变形。
除上述之外，当钉240处于其未击发构型时，钉240的近侧钉腿244p与钉腿244d平行或至少基本上平行，如图7所示。结果，当钉240处于其未击发构型时，钉腿244p、钉腿244d和钉240的冠部242形成基本U形构型。在此类构型中，当钉240从钉腔234a射出时，钉腿244p和钉腿244d的向上运动可以比在其他构型中更容易控制。在各种另选的实施方案中，参见图14，钉240的近侧钉腿244p和远侧钉腿244d远离彼此和/或在彼此不平行的方向上向外延伸。在至少一个此类实例中，当钉240处于其未击发构型时，钉腿244p、钉腿244d和钉240的冠部242形成基本上V形构型。在此类构型中，钉240的钉腿244p和钉腿244d可以与钉腔234a的侧壁接触并且向内弹性地偏置，该钉腔的侧壁可以将钉240弹性地保持在钉腔234a中。
除上述之外，保持器260至少部分地围绕仓232的底部延伸，并且被构造成能够防止钉240、钉240'和/或滑动件250从仓体232的底部掉出。
主要参见图10，钉240的驱动装置246包括钉240的驱动部分。滑动件250的纵向斜坡255被构造成能够顺序地接合并在钉240的驱动装置246下方滑动，以将钉240在钉腔234a内朝向砧座120向上提升。每个钉240的凸轮表面245限定在驱动装置246的近侧面上，并且包括滑动件250开始与钉240接触的点。每个钉240的驱动装置246限定在驱动平面241c内，该驱动平面与纵向斜坡255对准或至少基本上对准。凸轮表面245也被限定在驱动平面241c内。应当理解，凸轮表面245和/或驱动装置246包括宽度或厚度，并且驱动平面241c可包括凸轮表面245和/或驱动装置246的宽度。
再次参见图8和图9，连接器248p和连接器248d分别使钉腿244p和钉腿244d与钉240的冠部242分离。如图8和图9所示，钉240的驱动平面241c从钉240的钉腿平面241s侧向偏置。也如图8和图9所示，钉240的驱动平面241c平行于、或至少基本上平行于钉240的钉腿平面241s。在此类实例中，纵向排钉240的驱动平面241c沿纵向驱动轴线彼此对准。纵向驱动轴线与纵向击发轴线平行且相邻，纵向击发轴线与钉腿平面241s对准，如上所述。
再次参见图8至图10，纵向斜坡255不与钉240的近侧连接器248p或远侧连接器接合。相似地，纵向斜坡255不与钉240的钉腿244p和钉腿244d接合。而且，滑动件250中没有一个部分接合钉240的近侧连接器248p、近侧钉腿244p、远侧连接器248p和远侧钉腿244d。相反，当在击发行程期间滑动件250朝远侧运动时，纵向斜坡255直接接合钉240的凸轮表面245。当滑动件250朝远侧运动时，纵向斜坡255在凸轮表面245下方滑动并且在未击发位置(图11)与击发位置(图12)之间朝向砧座120顺序地向上提升钉240。换句话讲，钉240使钉腔234a内的纵向斜坡255朝向其击发位置向上滑动，如图12所示。
除上述之外，主要参见图10，钉240的驱动表面245不延伸到近侧连接器248p中。驱动装置246包括凹口或凸起247，该凸起使驱动表面245与近侧连接器248p分离。在各种实例中，凹口247限定在驱动平面241c中。在至少一个实例中，凹口247延伸到近侧连接器248p中。凹口247被构造成能够确保滑动件250接触钉240的驱动装置246，即，在钉240的驱动平面241c内，而不是近侧连接器248p和/或近侧腿部244p。凹口247还在驱动装置246与近侧连接器248p之间形成清晰的轮廓，使得凸轮表面245不会扭曲出驱动平面241c。而且，凹口247使驱动平面241c与包括近侧钉腿244p的垂直平面分离。
与上文相似，驱动表面245不延伸到远侧连接器248d中。
除上述之外，钉240的驱动表面245以与滑动件250的纵向斜坡255的角度匹配或至少基本上匹配的角度延伸。也就是说，可使用任何合适的角度。
在至少一个实例中，除上述之外，当钉240处于其未击发位置时，每个钉240完全定位在仓体232的平台233下方。在此类实例中，当钉240处于其未击发位置时，钉240的钉腿244不会在平台233上方延伸。在使用中，当钉240被击发时，钉腿244的尖端246在平台233上方露出。当钉仓230相对于组织移动时，此类布置可以减少钉240钩住患者组织的可能性。
在各种实例中，除上述之外，当钉240处于其未击发位置时，钉腿244p和/或钉腿244d的尖端246延伸到平台233上方。主要参见图4和图6，仓体232还包括延伸到平台233上方的突出部236，该突出部被构造成能够当钉240处于其未击发位置时至少部分地包围尖端246。钉腿244p和钉腿244d的长度被选择成使得当钉240处于其未击发位置时，尖端246定位在突出部236的顶表面下方。在某些方面中，突出部236使钉腔234延伸到平台233上方。此类布置可以允许使用更大或更高的钉，同时即使钉延伸到平台233上方，也为钉提供保护。突出部236还被构造成能够在钉240从钉腔234射出时引导钉腿244。
除上述之外，当纵向斜坡255的顶表面253在钉240的底表面下方通过时，钉240达到其完全击发构型。现在转到图12，钉240几乎到达纵向斜坡255的顶表面253，并且因此几乎达到其完全击发构型。一旦顶表面253相对于变形钉240朝远侧运动并且与变形钉240脱离接合，则储存在变形钉240内的弹性反作用力和/或势能可以将变形钉240的一部分推回到钉腔234a中，变形钉从该钉腔射出。
再次参见图11和图12，砧座120包括成形凹坑，该成形凹坑被构造成能够使钉240和钉240'变形。每个成形凹坑包括例如被构造成能够接收钉240的近侧钉腿244p的近侧成形杯124p，以及被构造成能够接收钉240的远侧钉腿244d的远侧成形杯124d。近侧成形杯124p被构造成能够使近侧钉腿244p向内朝向远侧钉腿244d变形。相似地，远侧成形杯124d被构造成能够使远侧钉腿244d向内朝向近侧钉腿244p变形。设想了其他实施方案，其中钉腿244p和钉腿244d中的一个或两个彼此远离地和/或沿任何其他合适的方向向外弯曲。再次参见图12，钉240和钉240'通过砧座120变形为B形构型；然而，砧座120可以被构造成能够使钉240和钉240'变形为任何合适的构型。
如上所述，端部执行器100能够与钉仓100一起使用，或者另选地，钉仓200可使用。结果，砧座120被构造成能够使钉仓100的钉140以及另外的钉仓200的钉240、钉240'变形。换句话讲，限定在砧座120中的每个成形凹坑被构造成能够使由弯曲线材制成的钉140以及例如由扁材料条冲压而成的钉240或钉240'变形。例如，主要参见图6，成形凹坑的近侧成形杯124p被构造成能够使钉140的近侧钉腿144以及钉240的近侧钉腿244p变形。如果钉240'与成形凹坑而不是钉240对准，则成形凹坑的近侧成形杯124p还被构造成能够使近侧钉腿244p'变形。与上文相似，成形凹坑的远侧成形杯124d被构造成能够使钉140的远侧钉腿144以及钉240的远侧钉腿244d变形。同样，如果钉240'与成形凹坑而不是钉240对准，则成形凹坑的远侧成形杯124d也被构造成能够使远侧钉腿244d'变形。
除上述之外，钉仓130的钉腔134和钉仓230的钉腔234a能够与砧座120的成形凹坑对准，使得钉140的尖端146和钉240的尖端246撞击成形杯124p和成形杯124d内的相同点或目标，这取决于哪个钉仓附接到端部执行器100。应当理解，由于组织成分的变化，例如，尖端146和尖端246可能实际上并不会撞击成形杯124p和成形杯124d中的相同目标。也就是说，砧座120的成形腔被构造成能够将钉140的腿部144和钉240的腿部244p、腿部244d引导成所需的对准。为此，近侧成形杯124p包括引导壁126p，并且远侧成形杯124d包括引导壁126d，这些引导壁被构造成能够将钉140、钉240和钉240'的腿部引导并形成为期望的构型。
再次参见图7，钉240包括限定在冠部242的顶表面上的组织接合表面243。钉240的表面243被构造成能够当钉240形成为其击发构型时支撑钉240内捕获的组织和/或向其施加压力。现在参见图11，当钉240处于其未击发位置时，钉240的表面243定位在仓体232的平台233下方。当钉240运动到其击发位置时，现在转到图12，表面243至少部分地在平台233上方露出。换句话讲，滑动件250至少部分地超速驱动钉240。在此类实例中，当钉240变形时，钉240的表面243可抵接组织并向组织施加压力。在某些实例中，当钉240处于其完全击发位置时，平台233上方的表面243的仅一部分被超速驱动。在其他实例中，当钉240处于其完全击发位置时，平台233上方的整个表面243被超速驱动。此类布置可以对组织施加大量的夹紧压力，这可以减少其中的出血。
在各种实例中，除上述之外，当钉240的表面243已经在平台233上方超速驱动时，钉240的驱动装置246至少部分地保持在平台233下方。在某些实例中，钉240被构造成能够使得驱动装置246不会在平台233上方露出，而不管表面243在平台233上方被超速驱动的量。在此类实例中，在钉击发过程期间，整个驱动装置246保持在平台233下方。在至少一个实例中，当钉240被超速驱动时，钉240的凸轮表面245不会在平台233上方露出。在各种实例中，纵向斜坡255的顶表面253没有延伸到平台233上方，这意味着在钉击发过程期间，滑动件250不会在平台233上方驱动整个钉240。
除上述之外，应当理解，突出部236延伸到平台233上方。如图12所示，滑动件250被构造成能够至少部分地超速驱动突出部236上方的钉240的表面243。在此类实例中，当钉240运动到其完全击发位置时，表面243至少部分地上升到突出部236上方。在某些实例中，当钉240处于其完全击发位置时，突出部246上方的表面243的仅一部分被超速驱动。在其他实例中，当钉240处于其完全击发位置时，突出部246上方的整个表面243被超速驱动。此类布置可以对组织施加大量的夹紧压力，这可以减少其中的出血。
除上述之外，组织接合表面243可以直接接合或接触组织。在其他实例中，附属材料，诸如支撑材料片和/或组织厚度补偿件，例如，可以定位在钉仓230的平台233上，并且组织接合表面243可以直接接合或接触该附属材料。本发明公开的附属材料的参考文献在本申请的其他地方以引用的方式并入。
再次参见图7，组织接合表面243包括平坦部分、在该平坦部分的第一侧上的第一斜面部分、以及在该平坦部分的第二侧上的第二斜面部分。此类布置可以从三个方向向捕获在钉240内的组织施加压力。也就是说，组织接合表面243可包括任何合适的构型，诸如例如完全平坦的构型或圆形构型。
如上所述，再次参见图6，钉仓130和钉仓230可选择性地并且可与端部执行器100互换使用。也如上所述，钉仓130和钉仓230可移除地附接到钳口110。在各种另选的实施方案中，钉仓130和钉仓230各自包括完整的钳口，该钳口能够附接到端部执行器110的框架190并且可从其拆下。在此类实例中，临床医生可以从端部执行器110移除整个钉仓钳口并用另一整个钉仓钳口替换它—该另一钉仓钳口尚未被击发并且包括例如临床医生期望的钉的类型和/或钉的图案。
除上述之外，应当理解，图6是旨在证明端部执行器100能够与钉仓130和钉仓230一起使用的图示。尽管钉仓130和钉仓230都在图6中示出，但是应当理解，钉仓130和钉仓230在同一端部执行器100内不同时使用。也就是说，设想了各种实施方案，其中钉仓利用线材钉，以及另外的例如由一个或多个材料片形成的钉。在至少一个实施方案中，例如，钉仓包括钉140和可移除地储存在其中的钉240。设想了其他实施方案，其中钉仓包括例如钉140、钉240和钉240'。
参见图20，除上述之外，钉仓430包括仓体432，该仓体包括平台433和限定在其中的纵向狭槽135。纵向狭槽135限定了延伸穿过其中心的纵向狭槽轴线139。钉仓430还包括在纵向狭槽135的一侧上的第一或内部纵向排钉腔434a、第二或中间纵向排钉腔434b、第三或外部纵向排钉腔434c。钉仓430还包括在纵向狭槽135的另一侧上的第一或内部纵向排钉腔434a'、第二或中间纵向排钉腔434b'、第三或外部纵向排钉腔434c'。在许多方面，钉腔434a、钉腔434a'、钉腔434b和钉腔434b'类似于左手钉腔234a(图4和图6)。钉腔434c和钉腔434c'在许多方面类似于钉腔134(图2和图6)。钉240可移除地储存在钉腔434a、钉腔434a'、钉腔434b和钉腔434b'中。钉140可移除地储存在钉腔434c和钉腔434c'中。
参见图21，钉仓430还包括滑动件450，该滑动件被构造成能够从仓主体432射出钉140和钉240。滑动件450包括被构造成能够直接接合储存在钉腔434a中的钉240的纵向斜坡455a、被构造成能够直接接合储存在钉腔434a'中的钉240的纵向斜坡455a'、被构造成能够直接接合储存在钉腔434b中的钉240的纵向斜坡455b、以及被构造成能够直接接合储存在钉腔434b'中的钉240的纵向斜坡455b'。滑动件450还包括被构造成能够从钉腔434c射出钉140的纵向斜坡455c，以及被构造成能够从钉腔434c'射出钉140的纵向斜坡455c'。更具体地，钉仓430包括被构造成能够支撑和/或接合储存在钉腔434c中的钉140的一排钉驱动装置以及被构造成能够支撑和/或接合储存在钉腔434c'中的钉140的一排钉驱动装置，并且，当滑动件450朝远侧推进时，滑动件450的纵向斜坡455c和纵向斜坡455c'接合钉驱动装置，以在钉腔434c和纵向斜坡434c'内向上提升钉140，并使钉140抵靠与钉仓430相对定位的砧座变形。例如，这些钉驱动装置在许多方面可类似于图3A中所示的钉驱动装置。
除上述之外，钉腔434a沿纵向轴线437a定位，钉腔434b沿纵向轴线437b定位，并且钉腔434c沿纵向轴线437c定位。相似地，钉腔434a'沿纵向轴线437a'定位，钉腔434b'沿纵向轴线437b'定位，并且钉腔434c'沿纵向轴线437c'定位。纵向轴线437a与纵向狭槽轴线139之间的距离短于纵向轴线437a'与纵向狭槽轴线139之间的距离。结果，纵向轴线437a'与纵向轴线437a相比交错或侧向偏置。相似地，纵向排钉腔434a与纵向狭槽135之间的距离短于纵向排钉腔434a'与纵向狭槽135之间的距离。另外，纵向轴线437b与纵向狭槽轴线139之间的距离短于纵向轴线437b'与纵向狭槽轴线139之间的距离。结果，纵向轴线437b'与纵向轴线437b相比交错或侧向偏置。相似地，纵向排钉腔434b与纵向狭槽135之间的距离短于纵向排钉腔434b'与纵向狭槽135之间的距离。相比之下，纵向轴线437c和纵向轴线437c'与纵向狭槽轴线139等距。相应地，纵向排钉腔343c和钉腔343c'与纵向狭槽135等距。
限定在钉仓430中的纵向排钉腔不是均匀间隔开的。在许多方面，纵向排之间的间隔是不同的。如图20所示，在纵向狭槽135的一侧上的纵向排钉腔434a、纵向排钉腔434b和纵向排钉腔434c的间隔不等于在纵向狭槽135的另一侧上的纵向排钉腔434a'、纵向排钉腔434b'和纵向排钉腔434c'的间隔。
除上述之外，纵向轴线437a、纵向轴线437a'、纵向轴线437b、纵向轴线437b'、纵向轴线437c和纵向轴线437c'包括驱动轴线。根据具体情况，这些驱动轴线与钉240的驱动部分和钉驱动装置的凸轮表面对准，该钉驱动装置的凸轮表面支撑钉140。滑动件450的纵向斜坡与这些驱动轴线对准。例如，参见图20和图21，滑动件450的纵向斜坡455a与纵向轴线437a对准。相似地，纵向斜坡455b与纵向轴线437b对准，并且纵向斜坡455c与纵向轴线437c对准。同样，纵向斜坡455a'与纵向轴线437a'对准，纵向斜坡455b'与纵向轴线437b'对准，并且纵向斜坡455c'与纵向轴线437c'对准。为此，纵向斜坡455a和纵向轴线437a距离纵向狭槽轴线139的距离为457a，纵向斜坡455b和纵向轴线437b距离纵向狭槽轴线139的距离为457b，并且纵向斜坡455c和纵向轴线437c距离纵向狭槽轴线139的距离为457c。相似地，纵向斜坡455a'和纵向轴线437a'距离纵向狭槽轴线139的距离为457a'，纵向斜坡455b'和纵向轴线437b'距离纵向狭槽轴线139的距离为457b'，纵向斜坡455c'和纵向轴线437c'距离纵向狭槽轴线139的距离为457c'。
如从图21中可以看出，距离457a、距离457a'、距离457b和距离457b'都不相等。它们都是不同的。结果，滑动件450的导轨非对称地间隔开。
参见图21，滑动件450包括中心部分451，该中心部分被构造成能够在仓体432的纵向狭槽135内运动。中心部分451的尺寸和构造被设置成紧密地容纳在狭槽135内，使得在滑动件450与仓体432之间允许很小的(如果有的话)侧向运动，以便滑动件450的纵向斜坡保持与钉240和钉驱动装置正确对准，该钉驱动装置被构造成能够驱动钉140。
再次参见图20，由钉仓430部署的外钉排是线钉，而由钉仓430部署的内排钉和中间排钉由扁材和/或冲压形成。也就是说，设想到其他布置。在至少一个实例中，例如，由钉仓部署的中间钉排和外钉排是线钉，而由钉仓部署的内钉排是冲压钉。在其他实例中，例如，由钉仓部署的内钉排和中间钉排是线钉，而由钉仓部署的外钉排是冲压钉。当钉仓在纵向狭槽的一侧上部署两个或多个线钉排时，可以利用两个或更多个钉驱动装置排以由钉仓部署钉。在各种实例中，钉仓可以利用例如双驱动装置，这些双驱动装置被构造成能够在包括线钉的纵向排彼此相邻的同时从两个纵向排部署线钉。可以利用被构造成能够部署多于两个钉的其他驱动装置布置，诸如例如三个钉和/或四个钉。
作为上述结果，钉仓430在组织中产生非对称的钉的图案。除此之外，钉仓430在切割线的第一侧上的组织中产生第一钉图案，并且在切割线的第二侧上的组织中产生第二或不同的钉图案。
现在转向图15至图19，钉仓330包括仓体332，该仓体包括平台333和限定于其中的纵向狭槽135。纵向狭槽135限定了延伸穿过其中心的纵向狭槽轴线139。钉仓330还包括在纵向狭槽135的一侧上的第一或内部纵向排钉腔334a、第二或中间纵向排钉腔334b、第三或外部纵向排钉腔334c。钉仓330也包括在纵向狭槽135的另一侧上的第一或内部纵向排钉腔334a'、第二或中间纵向排钉腔334b'、第三或外部纵向排钉腔334c'。在许多方面，钉腔334a、钉腔334a'、钉腔334b、钉腔334b'、钉腔334c和钉腔334c'类似于左手钉腔234a(图4和图6)。钉240可移除地储存在钉腔334a、钉腔334a'、钉腔334b、钉腔334b'、钉腔334c和钉腔334c'中。
参见图16和图17，钉仓330还包括滑动件350，该滑动件被构造成能够从钉仓主体332射出钉240。滑动件350包括被构造成能够直接接合储存在钉腔334a中的钉240的纵向斜坡355a、被构造成能够直接接合储存在钉腔334a'中的钉240的纵向斜坡355a'、被构造成能够直接接合储存在钉腔334b中的钉240的纵向斜坡355b、以及被构造成能够直接接合储存在钉腔334b'中的钉240的纵向斜坡355b'。滑动件350还包括被构造成能够直接接合储存在钉腔334c中的钉240的纵向斜坡355c和被构造成能够直接接合储存在钉腔334c'中的钉240的纵向斜坡355c'。
除上述之外，钉腔334a沿纵向轴线337a定位，钉腔334b沿纵向轴线337b定位，并且钉腔334c沿纵向轴线337c定位。相似地，钉腔334a'沿纵向轴线337a'定位，第二钉腔334b'沿纵向轴线337b'定位，并且钉腔334c'沿纵向轴线337c'定位。纵向轴线337a与纵向狭槽轴线139之间的距离短于纵向轴线337a'与纵向狭槽轴线139之间的距离。结果，纵向轴线337a'与纵向轴线337a相比是交错或侧向偏置的。相似地，纵向排钉腔334a与纵向狭槽135之间的距离短于纵向排钉腔334a'与纵向狭槽135之间的距离。
另外，纵向轴线337b与纵向狭槽轴线139之间的距离短于纵向轴线337b'与纵向狭槽轴线139之间的距离。结果，纵向轴线337b'与纵向轴线337b相比交错或侧向偏置。相似地，纵向排钉腔334b与纵向狭槽135之间的距离短于纵向排钉腔334b'与纵向狭槽135之间的距离。而且，纵向轴线337c与纵向狭槽轴线139之间的距离短于纵向轴线337c'与纵向狭槽轴线139之间的距离。结果，纵向轴线337c'与纵向轴线337c相比交错或侧向偏置。相似地，纵向排钉腔334c与纵向狭槽135之间的距离短于纵向排钉腔334c'与纵向狭槽135之间的距离。
除上述之外，纵向轴线337a、纵向轴线337a'、纵向轴线337b、纵向轴线337b'、纵向轴线337c和纵向轴线337c'包括驱动轴线。这些驱动轴线与钉240的驱动部分对准。滑动件350的纵向斜坡与这些驱动轴线对准。例如，滑动件350的纵向斜坡355a与纵向轴线337a对准。相似地，纵向斜坡355b与纵向轴线337b对准，并且纵向斜坡355c与纵向轴线337c对准。同样，纵向斜坡355a'与纵向轴线337a'对准，纵向斜坡355b'与纵向轴线337b'对准，并且纵向斜坡355c'与纵向轴线337c'对准。为此，纵向斜坡355a和纵向轴线337a距离纵向狭槽轴线139的距离为357a，纵向斜坡355b和纵向轴线337b距离纵向狭槽轴线139的距离为357b，并且纵向斜坡355c和纵向轴线337c距离纵向狭槽轴线139的距离为357c。相似地，纵向斜坡355a'和纵向轴线337a'距离纵向狭槽轴线139的距离为357a'，纵向斜坡355b'和纵向轴线337b'距离纵向狭槽轴线139的距离为357b'，并且纵向斜坡355c'和纵向轴线337c'距离纵向狭槽轴线139的距离为357c'。
主要参见图17，滑动件350包括中心部分351，该中心部分被构造成能够在仓体332的纵向狭槽135内运动。中心部分351的尺寸和构造被设置成紧密地容纳在狭槽135内，使得在滑动件350与仓体332之间允许很小的(如果有的话)侧向运动，以便滑动件350的纵向斜坡保持与钉240和钉驱动装置正确对准。
再次参见图17，间隙359a限定在滑动件350的中心部分351与纵向斜坡355a之间。相似地，在纵向斜坡355a与纵向斜坡355b之间限定间隙359b，并且在纵向斜坡355b与纵向斜坡355c之间限定间隙359c。间隙359a小于间隙359b，并且相似地，间隙359b小于间隙359c。同样，间隙359a'限定在滑动件350的中心部分351与纵向斜坡355a'之间。相似地，在纵向斜坡355a'与纵向斜坡355b'之间限定间隙359b'，并且在纵向斜坡355b'与纵向斜坡355c'之间限定间隙359c'。间隙359a'小于间隙359b'，并且相似地，间隙359b'小于间隙359c'。其他布置是可能的。
图18是仓体332的剖视图，其示出了限定在其中的纵向通道，该纵向通道连接钉腔排中的钉腔，并允许滑动件350的纵向斜坡穿过仓体332。例如，通道338a纵向连接钉腔334a并且被构造成能够接收滑动件350的纵向斜坡355a。相似地，通道338b纵向连接钉腔334b并且被构造成能够接收滑动件350的纵向斜坡355b，并且另外，通道338c纵向连接钉腔334c并且被构造成能够接收滑动件350的纵向斜坡355c。而且，通道338a'纵向连接钉腔334a'并且被构造成能够接收滑动件350的纵向斜坡355a'，通道338b'纵向连接钉腔334b'并且被构造成能够接收滑动件350的纵向斜坡355b'，并且通道338c'纵向连接钉腔334c'并且被构造成能够接收滑动件350的纵向斜坡355c'。
现在转向图19，砧座320被构造成能够与钉仓330一起使用。砧座320包括成形凹坑324，该成形凹坑被构造成能够当钉240从钉仓330射出时使可移除地储存在钉仓330中的钉240变形。成形凹坑324被布置成六个纵向排，其可与限定在钉仓330中的六个纵向排钉腔配准。例如，沿着纵向砧座轴线327a限定纵向排成形凹坑324，该纵向砧座轴线能够与储存在纵向排钉腔334a中的钉240的钉腿平面对准。相似地，沿着纵向砧座轴线327b限定纵向排成形凹坑324，该纵向砧座轴线可与储存在纵向排钉腔334b中的钉240的钉腿平面对准，并且另外，沿着纵向砧座轴线327c限定纵向排成形凹坑324，该纵向砧座轴线可与储存在纵向排钉腔334c中的钉240的钉腿平面对准。而且，沿着纵向砧座轴线327a'限定纵向排成形凹坑324，该纵向砧座轴线能够与储存在纵向排钉腔334a'中的钉240的钉腿平面对准，沿着纵向砧座轴线327b'限定纵向排成形凹坑324，该纵向砧座轴线能够与储存在纵向排钉腔334b'中的钉240的钉腿平面对准，沿着纵向砧座轴线327c'限定纵向排成形凹坑324，该纵向砧座轴线能够与储存在纵向排钉腔334c'中的钉240的钉腿平面对准。
图22示出了根据至少一个实施方案的具有不同尺寸的钉。主要参考图22和图23，钉540'包括冠部542、近侧钉腿544p'和远侧钉腿544d'。钉540'还包括将近侧钉腿544p'附接到冠部542的近侧连接器548p'。钉540'还包括将远侧钉腿544d'附接到冠部542的远侧连接器548d'。近侧钉腿544p'和远侧钉腿544d'限定第一腿部平面550'。钉540'还包括与冠部542一体形成的第一凸轮表面。第一凸轮表面限定凸轮平面549。近侧连接器548p'和远侧连接器548d'限定凸轮平面549和第一腿部平面550'之间的距离543'。
还参考图22和图23，钉540”包括冠部542、近侧钉腿544p”和远侧钉腿544d”。钉540”包括将近侧钉腿544p”附接到冠部542的近侧连接器548p”。钉540”还包括将远侧钉腿544d”附接到冠部542的远侧连接器548d”。近侧钉腿544p”和远侧钉腿544d”限定第二腿部平面550”。钉540”还包括与冠部542一体形成的第二凸轮表面。第二凸轮表面限定凸轮平面549。近侧连接器548p”和远侧连接器548d”限定凸轮平面549和第二腿部平面550”之间的距离543”。
再次参考图22和图23，钉540”'包括冠部542、近侧钉腿544p”'和远侧钉腿544d”'。钉540”'包括将近侧钉腿544p”'附接到冠部542的近侧连接器548p”'。钉540”'还包括将远侧钉腿544d”附接到冠部542的远侧连接器548d”'。近侧钉腿544p”'和远侧钉腿限定第三钉腿部平面550”'。钉540”'还包括与冠部542一体形成的第三凸轮表面。第三凸轮表面限定凸轮平面549。近侧连接器548p”'和远侧连接器548d”'限定凸轮平面549和第三钉腿部平面550”'之间的距离543”'。
如上所述，钉540'的腿部548p'和548d'被定位成与钉540'的凸轮平面549等距。设想了腿部548p'和548d'不被定位成与凸轮平面549等距的其他实施方案。在至少一个实施方案中，腿部548p'被定位成比腿部548d'更远离凸轮平面549。另选地，腿部548d'被定位成比腿部548p'更远离凸轮平面549。此类布置可提供进入这些钉的流入口，该流入口增加血液到在这些钉内捕捉的组织的流动。相似地，腿部548p”和548d”可不被定位成与钉540”的凸轮平面549等距。同样，相似地，腿部548p”'和548d”'可不被定位成与钉540”'的凸轮平面549等距。
进一步参考图22和图23，钉540'、540”和540”'例如由任何合适的材料构成，诸如结合钉240公开的那些。钉540'、540”和540”'由单个/整块金属件构成。可使用其他材料，诸如塑料。例如，使用上文关于钉240描述的相同和/或等同的工艺来冲压这些钉。在其他实施方案中，钉540'、540”和540”'由与上文关于钉240描述的那些不同的材料构成。
如主要从图22和图23中看出的，钉540'、540”和540”'中的每个包括相同尺寸的冠部542。在其他实施方案中，钉540'、540”和/或540”'的冠部542是不同的。钉540'、540”和540”'包括它们的凸轮平面和它们的钉腿平面之间的不同阔度。如上所述，钉540'包括由第一距离543'隔开的凸轮平面549和第一腿部表面550'，钉540”包括由第二距离543”隔开的凸轮平面549和第二腿部表面550”，并且钉540”'包括由第三距离543”'隔开的凸轮平面549和第三腿部表面550”'。钉540'的第一距离543'小于钉540”的第二距离543”。第一距离543'也小于钉540”'的第三距离543”'。相似地，钉540”的第二距离543”小于钉540”'的第三距离543”'。
仍然参考图22和图23，限定每个钉540'、540”和540”'的阔度的距离543'、543”和543”'分别限定每个钉腿的组织接触表面的表面积。使用如上所述的外科缝合器械将夹持压力施加到正由外科钉紧固的组织上。施加到组织上的夹持压力的量与施加到组织上的夹持力成比例，并且与组织接触表面的表面积成反比例。每个钉腿的组织接触表面的表面积相对于每个距离543'、543”和543”'变化。更具体地，通过钉腿的组织接触表面施加到组织上的夹持压力随着钉540'、540”和540”'的凸轮平面和腿部平面之间的距离增大而减小。换句话讲，施加到组织上的夹持压力随着钉540'、540”和540”'的凸轮平面和腿部平面之间的距离减小而增大。
进一步参考图22和图23，钉的组织接触表面的表面积随着钉540'、540”和540”'的阔度增大而增大。因此，随着钉的阔度增大，施加到在变形钉内捕捉的组织上的压缩力被施加到组织的更大区域上。以举例的方式，钉540”的钉腿544d”和544p”以比钉540'的阔度543'更远离冠部542的更大阔度543”设置，并且因此，通过钉540”施加到组织上的压力低于通过钉540'施加的压力。相对于钉540”'，钉腿544d”'和544p”'以比钉540'和540”各自的阔度543'和543”两者都大的阔度543”'设置。因此，通过钉540”'施加到组织上的压力低于通过钉540'和540”施加到组织上的压力。
钉540'、540”和540”'的组织接触表面的表面积相对于切割线增大。在至少一个实施方案中，钉540'最靠近切割线定位，并且包括关于钉540”和540”'的组织接触表面的最小组织接触表面。在同一个实施方案中，钉540”在切割线的相对侧上相邻钉540'定位，并且钉540”包括相对于钉540'的组织接触表面更大的组织接触表面。钉540”'相邻钉540”定位，并且距离切割线最远。钉540”'包括相对于于钉540'和540”的组织接触表面最大的组织接触表面。
图24示出了用于储存图22所示的钉540'、540”和540”'的钉仓530的局部平面图。参考图24和图25，钉仓530包括仓体532。仓体532包括支撑患者组织的平台533、纵向狭槽135，以及限定在仓体532中的六个纵向排钉腔。平台533包括位于纵向狭槽135的第一侧上的第一部分和位于纵向狭槽135的第二侧上的第二部分。平台533的第一部分和第二部分各自包括第一或内部纵向排钉腔534'、第二或中间纵向排钉腔534”，以及第三或外部纵向排钉腔534”'。每个钉腔在其中接收并储存钉。钉仓530还包括多个钉驱动装置，诸如上文相对于例如图3A讨论的钉驱动装置180。钉驱动装置将钉540'、540”和540”'分别驱动出钉腔534'、534”和534”'。
除上述之外，平台533的第一部分包括第一内部纵向排钉腔534'、第二中间纵向排钉腔534”，以及第三外部纵向排钉腔534”'。平台533的第二部分包括第一内部纵向排钉腔534'、第二中间排钉腔534”，以及第三外部纵向排钉腔534”'。事实上，平台533的第一部分包括平台533的第二部分的镜像。当击发构件(诸如上文相对于图12讨论的击发构件270)例如在击发行程期间在远侧方向上移动通过仓体530时，这种布置相对于在组织中形成的切割线产生对称的钉线。另选地，在其他实施方案中，平台533的第一部分可不是平台533的第二部分的镜像。纵向排钉腔534'、534”和534”'中的每个可以任何合适的顺序布置，并且可储存钉540'、540”和540”'的任何合适的变型，等等。
纵向排钉腔支撑图22中所示的多个钉540'、540”和540”'。第一内部纵向排的钉腔534'储存钉540'。第二中间纵向排的钉腔534”储存钉540”。第三外部纵向排的钉腔534”'储存钉540”'。在一些另选的实施方案中，钉540'储存在最外部钉排中，并且钉540”'储存在最内部钉排中。在其他另选的实施方案中，钉540”储存在最内部钉排中，并且钉540”'储存在中间钉排中。在一些另选的实施方案中，钉540'储存在中间钉排中，并且钉540”储存在最外部钉排中。
钉仓530在纵向狭槽135的每侧上包括三个钉排，其中所述三个排中的每个排中具有不同尺寸的钉。另选地，钉仓可包括包含相同尺寸的钉的一些排和包含不同尺寸的钉的其他排。例如，在一些另选的实施方案中，最内部钉排和中间钉排包括钉540'。例如，在其他实施方案中，中间钉排和最外部钉排包括钉540”。例如，在一些另选的实施方案中，最内部钉排和最外部钉排包括钉540”'。另选地，最内部钉排、中间钉排和最外部钉排可包括钉540'、540”和540”'的任何合适的分类或布置。
实施例
实施例1—一种外科缝合系统，包括：轴，该轴包括近侧端部和远侧端部；以及端部执行器，该端部执行器从该轴的远侧端部延伸，其中端部执行器能够在打开构型与闭合构型之间运动。端部执行器包括框架，从框架向远侧延伸的砧座，其中砧座包括纵向排成形凹坑，以及能够附接到端部执行器的第一钉仓组件。第一钉仓组件包括第一仓体和另外的多个第一钉，该第一仓体包括第一纵向排钉腔，这些多个第一钉可移除地储存在第一纵向排钉腔中。每个第一钉由弯曲线材构成，并且当端部执行器处于闭合构型时与成形凹坑对准。外科缝合系统还包括第二钉仓组件，其能够代替第一钉仓组件附接到端部执行器。第二钉仓组件包括第二仓体和另外的多个第二钉，该第二仓体包括第二纵向排钉腔，这些多个第二钉可移除地储存在第二纵向排钉腔中。每个第二钉由扁材形成，并且当端部执行器处于闭合构型时与成形凹坑对准。
实施例2—根据实施例1所述的外科缝合系统，其中每个成形凹坑包括近侧成形杯和远侧成形杯。
实施例3—根据实施例1或2所述的外科缝合系统，其中每个第一钉包括由近侧成形杯形成的近侧腿部和由远侧成形杯形成的远侧腿部。
实施例4—根据实施例1、2或3所述的外科缝合系统，其中每个第二钉包括由近侧成形杯形成的近侧腿部和由远侧成形杯形成的远侧腿部。
实施例5—根据实施例1、2、3或4所述的外科缝合系统，其中端部执行器还包括钳口，该钳口被构造成能够接收第一钉仓组件和代替第一钉仓组件的第二钉仓组件。
实施例6—根据实施例5所述的外科缝合系统，其中钳口能够相对于砧座旋转，以将端部执行器置于闭合构型。
实施例7—根据实施例5或6所述的外科缝合系统，其中砧座能够相对于钳口旋转，以将端部执行器置于闭合构型中。
实施例8—根据实施例1所述的外科缝合系统，其中第一钉仓组件包括能够附接到框架的第一钳口，并且其中第二仓组件包括能够附接到框架的第二钳口。
实施例9—根据实施例8所述的外科缝合系统，其中砧座能够相对于框架旋转，以将端部执行器置于闭合构型。
实施例10—根据实施例8或9所述的外科缝合系统，其中当第一钳口附接到框架时，第一钳口能够相对于框架旋转以将端部执行器置于闭合构型，并且其中当第二钳口附接到框架时，第二钳口能够相对于框架旋转以将端部执行器置于闭合构型。
实施例11—根据实施例1、2、3、4、5、6、7、8、9或10所述的外科缝合系统，其中第一钉仓组件包括钉驱动装置，该钉驱动装置被构造成能够将第一钉推出第一钉腔，并且其中每个第二钉包括一体成形的钉驱动装置。
实施例12—一种外科缝合系统，包括：轴，该轴包括近侧端部和远侧端部；以及端部执行器，该端部执行器从该轴的远侧端部延伸，其中端部执行器可在松开构型与夹紧构型之间运动。端部执行器包括框架，从框架向远侧延伸的砧座，其中砧座包括纵向排成形凹坑，以及能够附接到端部执行器的第一钉仓组件。第一钉仓组件包括第一仓体和另外的多个第一钉，该第一仓体包括第一纵向排钉腔，这些多个第一钉可移除地储存在第一纵向排钉腔中。每个第一钉由弯曲线材构成，并且当端部执行器处于夹紧构型时与成形凹坑对准。外科缝合系统还包括第二钉仓组件，其能够作为第一钉仓组件的另选方案附接到端部执行器。第二钉仓组件包括第二仓体，该第二仓体包括第二纵向排钉腔和另外的多个第二钉，这些多个第二钉可移除地储存在第二纵向排钉腔中。第二钉由一个或多个扁材料片冲压而成，并且当端部执行器处于夹紧构型时与成形凹坑对准。
实施例13—根据实施例12所述的外科缝合系统，其中每个成形凹坑包括近侧成形杯和远侧成形杯。
实施例14—根据实施例12或13所述的外科缝合系统，其中每个第一钉包括由近侧成形杯形成的近侧腿部和由远侧成形杯形成的远侧腿部。
实施例15—根据实施例12、13或14所述的外科缝合系统，其中每个第二钉包括由近侧成形杯形成的近侧腿部和由远侧成形杯形成的远侧腿部。
实施例16—根据实施例12、13、14或15所述的外科缝合系统，其中端部执行器还包括钳口，该钳口被构造成能够接收第一钉仓组件和作为第一钉仓组件的替代的第二钉仓组件。
实施例17—根据实施例16所述的外科缝合系统，其中钳口能够相对于砧座旋转，以将端部执行器置于夹紧构型。
实施例18—根据实施例16或17所述的外科缝合系统，其中砧座能够相对于钳口旋转，以将端部执行器置于夹紧构型中。
实施例19—根据实施例12所述的外科缝合系统，其中第一钉仓组件包括能够附接到框架的第一钳口，并且其中第二仓组件包括能够附接到框架的第二钳口。
实施例20—根据实施例19所述的外科缝合系统，其中砧座能够相对于框架旋转，以将端部执行器置于夹紧构型。
实施例21—根据实施例19或20所述的外科缝合系统，其中当第一钳口附接到框架时，第一钳口能够相对于框架旋转以将端部执行器置于夹紧构型，并且其中当第二钳口附接到框架时，第二钳口能够相对于框架旋转以将端部执行器置于夹紧构型。
实施例22—根据实施例12、13、14、15、16、17、18、19、20或21所述的外科缝合系统，其中第一钉仓组件包括钉驱动装置，该钉驱动装置被构造成能够将第一钉推出第一钉腔，并且其中第二钉包括一体成形的钉驱动装置。
实施例23—一种外科紧固系统，包括：轴，该轴包括近侧端部和远侧端部；以及端部执行器，该端部执行器从该轴的远侧端部延伸，其中端部执行器可在打开构型与闭合构型之间运动。端部执行器包括框架和从框架朝远侧延伸的砧座，其中砧座包括成形凹坑。外科紧固系统还包括能够附接到端部执行器的第一紧固件仓组件。第一紧固件仓组件包括第一仓体和另外的多个第一紧固件，该第一仓体包括第一紧固件腔，这些多个第一紧固件可移除地储存在第一紧固件腔中。每个第一紧固件由弯曲线材构成，并且当端部执行器处于闭合构型时，第一紧固件腔与成形凹坑对准。外科紧固系统也包括第二紧固件仓组件和多个第二紧固件，该第二紧固件仓组件能够代替第一紧固件仓组件附接到端部执行器，其中第二紧固件仓组件包括第二仓体，该第二仓体包括第二紧固件腔，并且另外，这些多个第二紧固件可移除地储存在第二紧固件腔中。每个第二紧固件由扁材形成，并且当端部执行器处于闭合构型时，第二紧固件腔与成形凹坑对准。
实施例24—一种钉仓组件，该钉仓组件包括仓体和另外的钉，该仓体包括近侧端部、远侧端部以及在近侧端部和远侧端部之间延伸的钉腔，这些钉可移除地储存在钉腔中，其中每个钉由扁材形成。每个钉包括冠部、近侧腿部、远侧腿部(其中近侧腿部和远侧腿部限定钉腿平面)、以及从冠部延伸并与冠部一体成形的倾斜凸轮表面，其中倾斜凸轮表面限定了与钉腿平面不同的凸轮平面。每个钉也包括近侧连接器和远侧连接器，该近侧连接器在近侧腿部与冠部之间延伸并与近侧腿部和冠部一体成形，该远侧连接器在远侧腿部与冠部之间延伸并与远侧腿部和冠部一体成形，其中倾斜凸轮表面不从近侧连接器延伸，并且其中倾斜凸轮表面不从远侧连接器延伸。钉仓组件还包括滑动件，该滑动件被构造成能够接合钉的倾斜凸轮表面，并在钉击发行程期间将钉从钉腔射出。
实施例25—根据实施例24所述的钉仓组件，其中倾斜凸轮表面是平面的，并且其中近侧连接器和远侧连接器朝向钉腿平面从凸轮平面弯曲出。
实施例26—根据实施例24或25所述的钉仓组件，其中倾斜凸轮表面包括凸轮平面中的近侧引入端。
实施例27—根据实施例24、25或26所述的钉仓组件，其中每个钉还包括在近侧引入端与近侧连接器之间的间隙凹口，并且其中间隙凹口限定在凸轮平面中。
实施例28—根据实施例24、25、26或27所述的钉仓组件，其中当钉处于未击发构型时，每个钉的近侧腿部和远侧腿部从冠部沿非平行方向向外延伸。
实施例29—根据实施例24、25、26、27或28所述的钉仓组件，其中当钉被储存在钉腔中时，钉的近侧腿部和远侧腿部通过钉腔的侧壁向内折曲。
实施例30—根据实施例24、25、26、27、28或29所述的钉仓组件，其中在钉击发行程期间，滑动件不接合钉的近侧连接器和远侧连接器。
实施例31—根据实施例24、25、26、27、28、29或30所述的钉仓组件，其中整个倾斜凸轮表面定位在近侧钉腿和远侧钉腿下方。
实施例32—根据实施例24、25、26、27、28、29、30或31所述的钉仓组件，其中倾斜凸轮表面包括用于滑动件的初始拾取点。
实施例33—一种钉仓组件，该钉仓组件包括仓体和另外的钉，该仓体包括近侧端部、远侧端部、在近侧端部和远侧端部之间延伸的钉腔，这些钉可移除地储存在钉腔中，其中钉由一个或多个金属片形成。每个钉包括冠部、近侧腿部、远侧腿部以及从冠部延伸并与冠部一体成形的凸轮表面，其中凸轮表面限定凸轮平面，并且其中近侧腿部和远侧腿部不在凸轮平面中。每个钉也包括近侧连接器和远侧连接器，该近侧连接器在近侧腿部与冠部之间延伸并与近侧腿部和冠部一体成形，该远侧连接器在远侧腿部与冠部之间延伸并与远侧腿部和冠部一体成形，其中凸轮表面不从近侧连接器延伸。钉仓组件还包括滑动件，该滑动件被构造成能够接合钉的凸轮表面，并在钉击发行程期间将钉从钉腔射出。
实施例34—根据实施例33所述的钉仓组件，其中凸轮表面是平面的，并且其中近侧连接器和远侧连接器从凸轮平面弯曲出。
实施例35—根据实施例33或34所述的钉仓组件，其中凸轮表面包括凸轮平面中的近侧引入端。
实施例36—根据实施例33、34或35所述的钉仓组件，其中每个钉还包括在近侧引入端与近侧连接器之间的间隙凹口，并且其中间隙凹口限定在凸轮平面中。
实施例37—根据实施例33、34、35或36所述的钉仓组件，其中当钉处于未击发构型时，每个钉的近侧腿部和远侧腿部从冠部沿非平行方向向外延伸。
实施例38—根据实施例33、34、35、36或37所述的钉仓组件，其中当钉被储存在钉腔中时，钉的近侧腿部和远侧腿部通过钉腔的侧壁向内折曲。
实施例39—根据实施例33、34、35、36、37或38所述的钉仓组件，其中在钉击发行程期间，滑动件不接合钉的近侧连接器。
实施例40—根据实施例33、34、35、36、37、38或39所述的钉仓组件，其中整个凸轮表面定位在近侧钉腿和远侧钉腿下方。
实施例41—根据实施例33、34、35、36、37、38、39或40所述的钉仓组件，其中凸轮表面包括用于滑动件的初始拾取点。
实施例42—一种钉仓组件，该钉仓组件包括仓体，该仓体包括平台和纵向狭槽，该平台包括近侧端部和远侧端部，该纵向狭槽限定在该平台中，其中纵向狭槽被构造成能够接收击发构件、第一纵向排钉腔和第二纵向排钉腔。钉仓组件还包括滑动件和多个第一钉，在击发行程期间，该滑动件能够由击发构件朝向远侧端部运动，并且这些多个第一钉可移除地储存在第一纵向排钉腔中，其中每个第一钉由弯曲线材构成。钉仓组件也包括多个钉驱动装置和多个第二钉，这些多个钉驱动装置被构造成能够支撑第一钉，其中滑动件被构造成能够接合钉驱动装置，以在击发行程期间从第一纵向排钉腔射出第一钉，这些多个第二钉可移除地储存在第二纵向排钉腔中，其中每个第二钉由扁材形成并且包括一体成形的驱动装置，并且其中滑动件被构造成能够直接接合第二钉的一体成形的驱动装置，并且在击发行程期间从第二纵向排钉腔射出第二钉。
实施例43—根据实施例42所述的钉仓组件，其中第一纵向排钉腔与纵向狭槽相邻，并且其中第一纵向排钉腔在纵向狭槽和第二纵向排钉腔中间。
实施例44—根据实施例42所述的钉仓组件，其中第二纵向排钉腔与纵向狭槽相邻，并且其中第二纵向排钉腔在纵向狭槽和第一纵向排钉腔中间。
实施例45—根据实施例42、43或44所述的钉仓组件，其中仓体还包括第三纵向排钉腔，其中钉仓组件还包括多个第三钉，这些多个第三钉可移除地储存在第三纵向排钉腔中，并且其中每个第三钉由弯曲线材构成。
实施例46—根据实施例45所述的钉仓组件，其中第三纵向排钉腔与第一纵向排钉腔相邻，其中钉驱动装置被构造成能够支撑第三钉，并且其中滑动件被构造成能够在击发行程期间接合钉驱动装置，以从第三纵向排钉腔射出第三钉。
实施例47—根据实施例45所述的钉仓组件，还包括多个钉驱动装置，这些多个钉驱动装置被构造成能够支撑第三钉，并且通过滑动件接合，以在击发行程期间从第三纵向排钉腔射出第三钉。
实施例48—根据实施例42、43或44所述的钉仓组件，其中仓体还包括第三纵向排钉腔，其中钉仓组件还包括多个第三钉，这些多个第三钉可移除地储存在第三纵向排钉腔中，其中每个第三钉由扁材形成并且包括一体形成的驱动装置，并且其中滑动件被构造成能够直接接合第三钉的一体形成的驱动装置，并且在击发行程期间从第三纵向排钉腔射出第三钉。
实施例49—根据实施例48所述的钉仓组件，其中第三纵向排钉腔与纵向狭槽相邻，其中第二纵向排钉腔与第三纵向排钉腔相邻，并且其中第二纵向排钉腔在第一纵向排钉腔和第三纵向排钉腔中间。
实施例50—一种钉仓组件，该钉仓组件包括切割构件和仓体，其中仓体包括平台和纵向狭槽，该平台包括近侧端部和远侧端部，该纵向狭槽限定在该平台中，其中纵向狭槽被构造成能够接收切割构件、第一纵向排钉腔和第二纵向排钉腔。钉仓组件还包括滑动件和多个第一钉，在击发行程期间，该滑动件可由切割构件朝向远侧端部运动，并且这些多个第一钉可移除地储存在第一纵向排钉腔中，其中每个第一钉由弯曲线材构成。钉仓组件也包括多个钉驱动装置和另外的多个第二钉，这些多个钉驱动装置被构造成能够支撑第一钉，其中滑动件被构造成能够接合钉驱动装置，以在击发行程期间从第一纵向排钉腔射出第一钉，这些多个第二钉可移除地储存在第二纵向排钉腔中，其中第二钉由一个或多个金属片冲压而成，并且其中滑动件被构造成能够直接接合第二钉，并且在击发行程期间从第二纵向排钉腔射出第二钉。
实施例51—根据实施例50所述的钉仓组件，其中第一纵向排钉腔与纵向狭槽相邻，并且其中第一纵向排钉腔在纵向狭槽和第二纵向排钉腔中间。
实施例52—根据实施例50所述的钉仓组件，其中第二纵向排钉腔与纵向狭槽相邻，并且其中第二纵向排钉腔在纵向狭槽和第一纵向排钉腔中间。
实施例53—根据实施例50、51或52所述的钉仓组件，其中仓体还包括第三纵向排钉腔，其中钉仓组件还包括多个第三钉，这些多个第三钉可移除地储存在第三纵向排钉腔中，并且其中每个第三钉由弯曲线材构成。
实施例54—根据实施例53所述的钉仓组件，其中第三纵向排钉腔与第一纵向排钉腔相邻，其中钉驱动装置被构造成能够支撑第三钉，并且其中滑动件被构造成能够在击发行程期间接合钉驱动装置，以从第三纵向排钉腔射出第三钉。
实施例55—根据实施例53所述的钉仓组件，还包括多个钉驱动装置，这些多个钉驱动装置被构造成能够支撑第三钉，并且通过滑动件接合，以在击发行程期间从第三纵向排钉腔射出第三钉。
实施例56—根据实施例50、51、52、53、54或55所述的钉仓组件，其中仓体还包括第三纵向排钉腔，其中钉仓组件还包括多个第三钉，这些多个第三钉可移除地储存在第三纵向排钉腔中，其中第三钉由一个或多个金属片形成，并且其中滑动件被构造成能够直接接合第三钉，并且在击发行程期间从第三纵向排钉腔射出第三钉。
实施例57—根据实施例50、51或52所述的钉仓组件，其中第三纵向排钉腔与纵向狭槽相邻，其中第二纵向排钉腔与第三纵向排钉腔相邻，并且其中第二纵向排钉腔在第一纵向排钉腔和第三纵向排钉腔中间。
实施例58—一种钉仓组件，该钉仓组件包括仓体，该仓体包括平台和纵向狭槽，该平台包括近侧端部和远侧端部，该纵向狭槽限定在该平台中，其中纵向狭槽被构造成能够接收击发构件和多个钉腔。钉仓组件还包括滑动件、多个第一钉，在击发行程期间，该滑动件可由击发构件朝向远侧端部运动，这些多个第一钉可移除地储存在钉腔中，其中每个第一钉由弯曲线材构成，和另外的多个钉驱动装置，其中滑动件被构造成能够接合钉驱动装置，以在击发行程期间从钉腔射出第一钉。钉仓组件也包括多个第二钉，这些多个第二钉可移除地储存在钉腔中，其中每个第二钉由扁材形成并且包括一体成形的驱动装置，并且其中滑动件被构造成能够直接接合第二钉的一体成形的驱动装置，并在击发行程期间从钉腔射出第二钉。
实施例59—一种钉仓组件，该钉仓组件包括仓体，该仓体包括近侧端部、远侧端部、被构造成能够支撑患者的组织的平台、以及限定在该平台中的多个钉腔。钉仓组件也包括多个金属钉，这些多个金属钉可移除地储存在钉腔中，其中每个金属钉包括具有组织接触表面的冠部、连接到该冠部的第一腿部、连接到该冠部的第二腿部、以及与该冠部一体成形的驱动装置。另外，钉仓组件包括滑动件，该滑动件在击发行程期间能够朝向远侧端部运动，其中滑动件被构造成能够直接接合金属钉的驱动装置，并且在击发行程期间使每个金属钉在未击发位置与击发位置之间运动，其中当金属钉处于击发位置时，冠部的组织接触表面定位在平台上方，并且其中当金属钉处于击发位置时，金属钉的驱动装置至少部分地定位在该平台下方。
实施例60—根据实施例59所述的钉仓组件，其中仓体还包括引导件，这些引导件从平台延伸，这些引导件被构造成能够在金属钉运动到击发位置时在平台上方支撑和引导钉腿，并且其中当金属钉处于击发位置时，冠部的组织接触表面至少部分地定位在这些引导件上方。
实施例61—根据实施例59或60所述的钉仓组件，其中滑动件包括一个或多个驱动表面，该驱动表面被构造成能够接合金属钉的驱动装置，其中每个驱动表面包括顶表面，并且其中每个驱动表面的顶表面完全在平台下方。
实施例62—一种钉仓组件，该钉仓组件包括仓体，该仓体包括近侧端部、远侧端部、被构造成能够支撑患者的组织的平台、以及限定在该平台中的钉腔。钉仓组件还包括可移除地储存在钉腔中的钉，其中钉包括冠部，该冠部包括组织接合表面、从该冠部延伸的第一腿部、从该冠部延伸的第二腿部以及与该冠部一体成形的驱动装置。另外，钉仓组件包括滑动件，该滑动件在击发行程期间可朝向远侧端部运动，其中滑动件被构造成能够直接接合钉的驱动装置，并且在击发行程期间使钉在未击发位置与击发位置之间运动，其中当钉处于击发位置时，冠部的组织接合表面至少部分地定位在平台上方，并且其中当钉处于击发位置时，驱动装置至少部分地定位在平台下方。
实施例63—根据实施例62所述的钉仓组件，其中仓体还包括引导件，该引导件从平台延伸，该引导件被构造成能够在钉运动到击发位置时在平台上方支撑和引导第一钉腿，并且其中当钉处于击发位置时，冠部的组织接触表面至少部分地定位在该引导件上方。
实施例64—根据实施例62或63所述的钉仓组件，其中滑动件包括驱动表面，该驱动表面被构造成能够接合钉的驱动装置，其中驱动表面包括顶表面，并且其中顶表面完全在平台下方。
实施例65—一种钉仓组件，该钉仓组件包括仓体，该仓体包括近侧端部、远侧端部、被构造成能够支撑患者的组织的平台，以及限定在该平台中的钉腔。钉仓组件还包括可移除地储存在钉腔中的钉，其中钉包括冠部，该冠部包括组织接合表面、从该冠部延伸的第一腿部、从该冠部延伸的第二腿部以及与该冠部一体成形的驱动装置。钉仓组件也包括击发构件，该击发构件在击发行程期间可朝向远侧端部运动，其中击发构件被构造成能够直接接合钉的驱动装置，并且在击发行程期间使钉在未击发位置与击发位置之间运动，其中当钉处于击发位置时，冠部的组织接合表面完全定位在平台上方，并且其中当钉处于击发位置时，驱动装置完全定位在平台下方。
实施例66—根据实施例65所述的钉仓组件，其中仓体还包括引导件，该引导件从平台延伸，该引导件被构造成能够在钉运动到击发位置时在平台上方支撑和引导第一钉腿，并且其中当钉处于击发位置时，冠部的组织接触表面完全部分地定位在该引导件上方。
实施例67—根据实施例65或66所述的钉仓组件，其中击发构件包括驱动表面，该驱动表面被构造成能够接合钉的驱动装置，其中驱动表面包括顶表面，并且其中顶表面完全在平台下方。
实施例68—一种钉仓组件，该钉仓组件包括仓体，该仓体包括
被构造成能够支撑患者的组织的平台、限定在该平台中的纵向狭槽，其中纵向狭槽限定纵向狭槽轴线，其中纵向狭槽被构造成能够接收切割构件，并且其中平台包括位于纵向狭槽的第一侧上的第一平台部分和位于纵向狭槽的第二侧上的第二平台部分。该仓体还包括
限定在邻近纵向狭槽的第一平台部分中的第一排钉腔，其中第一排钉腔沿着第一纵向轴线限定，并且其中第一距离限定在第一纵向轴线与纵向狭槽轴线之间。该仓体也包括限定在邻近纵向狭槽的第二平台部分中的第二排钉腔，其中第二排钉腔沿着第二纵向轴线限定，并且其中第二距离限定在第二纵向轴线与纵向狭槽轴线之间，并且其中第二距离与第一距离不同。该钉仓组件还包括可移除地储存在第一排钉腔和第二排钉腔中的钉。
实施例69—根据实施例68所述的钉仓组件，还包括滑动件，其中滑动件包括第一纵向斜坡和第二纵向斜坡，该第一纵向斜坡被构造成能够从第一排钉腔射出钉，该第二纵向斜坡被构造成能够从第二排钉腔射出钉。
实施例70—根据实施例69所述的钉仓组件，其中第一距离限定在第一纵向斜坡与纵向狭槽轴线之间，并且其中第二距离限定在第二纵向斜坡与纵向狭槽轴线之间。
实施例71—一种紧固件仓组件，包括仓体，该仓体包括
被构造成能够支撑患者的组织的平台、以及限定在该平台中的纵向狭槽，其中纵向狭槽限定纵向狭槽轴线，其中纵向狭槽被构造成能够接收切割构件，并且其中平台包括位于纵向狭槽的第一侧上的第一平台部分和位于纵向狭槽的第二侧上的第二平台部分。该仓体还包括
限定在邻近纵向狭槽的第一平台部分中的第一排紧固件腔，其中第一排紧固件腔沿着第一纵向轴线限定，并且其中第一距离限定在第一纵向轴线与纵向狭槽轴线之间。该仓体也包括限定在邻近纵向狭槽的第二平台部分中的第二排紧固件腔，其中第二排紧固件腔沿着第二纵向轴线限定，并且其中第二距离限定在第二纵向轴线与纵向狭槽轴线之间，并且其中第二距离与第一距离不同。紧固件仓组件还包括可移除地储存在第一排紧固件腔和第二排紧固件腔中的紧固件，其中紧固件由一个或多个材料片形成。
实施例72—根据实施例71所述的紧固件仓组件，其中第一排紧固件腔比第二排紧固件腔更靠近纵向狭槽。
实施例73—根据实施例71所述的紧固件仓组件，其中第二排紧固件腔比第一排紧固件腔更靠近纵向狭槽。
实施例74—根据实施例71、72或73所述的紧固件仓组件，还包括滑动件，其中滑动件包括第一纵向斜坡和第二纵向斜坡，该第一纵向斜坡被构造成能够从第一排紧固件腔射出紧固件，该第二纵向斜坡被构造成能够从第二排紧固件腔射出紧固件。
实施例75—根据实施例74所述的紧固件仓组件，其中第一纵向斜坡被定位成比第二纵向斜坡更靠近纵向狭槽。
实施例76—根据实施例74所述的紧固件仓组件，其中第二纵向斜坡被定位成比第一纵向斜坡更靠近纵向狭槽。
实施例77—一种钉仓组件，该钉仓组件包括仓体，该仓体包括
被构造成能够支撑患者的组织的平台、以及限定在该平台中的纵向狭槽，其中纵向狭槽被构造成能够接收切割构件，并且其中平台包括位于纵向狭槽的第一侧上的第一平台部分和位于纵向狭槽的第二侧上的第二平台部分。该仓体还包括第一排钉腔，这些第一排钉腔限定在邻近纵向狭槽的第一平台部分中，并且其中在第一排钉腔与纵向狭槽之间限定第一距离。该仓体也包括第二排钉腔，这些第二排钉腔限定在邻近纵向狭槽的第二平台部分中，并且其中在第二排钉腔与纵向狭槽之间限定第二距离，并且其中第二距离与第一距离不同。该钉仓组件还包括可移除地储存在第一排钉腔和第二排钉腔中的钉。
实施例78—根据实施例77所述的钉仓组件，还包括滑动件，其中滑动件包括第一纵向斜坡和第二纵向斜坡，该第一纵向斜坡被构造成能够从第一排钉腔射出钉，该第二纵向斜坡被构造成能够从第二排钉腔射出钉。
实施例79—根据实施例78所述的钉仓组件，其中第一距离限定在第一纵向斜坡与纵向狭槽之间，并且其中第二距离限定在第二纵向斜坡与纵向狭槽之间。
实施例80—根据实施例78或79所述的钉仓组件，其中每个钉包括冠部、与冠部一体形成的凸轮部分，其中滑动件被构造成能够直接接合凸轮部分，并且组织咬合部分从凸轮部分偏移。
实施例81—根据实施例80所述的钉仓组件，其中钉的凸轮部分被定位成比组织咬合部分更靠近纵向狭槽。
实施例82—根据实施例80所述的钉仓组件，其中钉的组织咬合部分被定位成比凸轮部分更靠近纵向狭槽。
实施例83—根据实施例77、78、79、80、81或82所述的钉仓组件，其中第一距离短于第二距离。
实施例84—根据实施例77、78、79、80、81或82所述的钉仓组件，其中第二距离短于第一距离。
实施例85—一种钉仓组件，该钉仓组件包括仓体，其中该仓体包括第一纵向排钉腔和第二纵向排钉腔。该钉仓组件还包括可移除地储存在第一纵向排钉腔中的多个第一钉和可移除地储存在第二纵向排钉腔中的多个第二钉。每个第一钉包括第一冠部、第一近侧腿部和第一远侧腿部，其中第一近侧腿部和第一远侧腿部限定第一腿部平面。每个第一钉还包括第一凸轮表面，该第一凸轮表面从第一冠部延伸并与第一冠部一体形成，其中第一凸轮表面限定第一凸轮平面。每个第一钉还包括第一近侧连接器，该第一近侧连接器在第一近侧腿部和第一冠部之间延伸并与第一近侧腿部和第一冠部一体形成。每个第一钉还包括第一远侧连接器，该第一远侧连接器在第一远侧腿部和第一冠部之间延伸并与第一远侧腿部和第一冠部一体形成，其中第一近侧连接器和第一远侧连接器限定第一凸轮平面和第一腿部平面之间的第一距离。每个第二钉包括第二冠部、第二近侧腿部和第二远侧腿部，其中第二近侧腿部和第二远侧腿部限定第二腿部平面。每个第二钉还包括第二凸轮表面，该第二凸轮表面从第二冠部延伸并与第二冠部一体形成，其中第二凸轮表面限定第二凸轮平面。每个第二钉还包括第二近侧连接器，该第二近侧连接器在第二近侧腿部和第二冠部之间延伸并与第二近侧腿部和第二冠部一体形成。每个第二钉还包括第二远侧连接器，该第二远侧连接器在第二远侧腿部和第二冠部之间延伸并与第二远侧腿部和第二冠部一体形成，其中第二近侧连接器和第二远侧连接器限定第二凸轮平面和第二腿部平面之间的第二距离，并且其中第二距离不等于第一距离。
实施例86—根据实施例85所述的钉仓组件，其中仓体还包括被构造成能够接收切割构件的纵向狭槽。
实施例87—根据实施例85或86所述的钉仓组件，其中第一距离大于第二距离，其中第一纵向排钉腔与纵向狭槽相邻，并且其中第一纵向排钉腔在纵向狭槽和第二纵向排钉腔中间。
实施例88—根据实施例85或86所述的钉仓组件，其中第一距离大于第二距离，其中第二纵向排钉腔与纵向狭槽相邻，并且其中第二纵向排钉腔在纵向狭槽和第一纵向排钉腔中间。
实施例89—根据实施例85、86、87或88所述的钉仓组件，其中第一钉的第一凸轮平面比第一腿部平面更靠近纵向狭槽。
实施例90—根据实施例85、86、87、88或89所述的钉仓组件，其中第二钉的第二凸轮平面比第二腿部平面更靠近纵向狭槽。
实施例91—根据实施例85、86、87、88或89所述的钉仓组件，其中第二钉的第二腿部平面比第二凸轮平面更靠近纵向狭槽。
实施例92—根据实施例85或86所述的钉仓组件，其中第一钉的第一腿部平面比第一凸轮平面更靠近纵向狭槽。
实施例93—根据实施例85、86或92所述的钉仓组件，其中第二钉的第二凸轮平面比第二腿部平面更靠近纵向狭槽。
实施例94—根据实施例85、86或92所述的钉仓组件，其中第二钉的第二腿部平面比第二凸轮平面更靠近纵向狭槽。
实施例95—根据实施例85所述的钉仓组件，其中仓体还包括第三纵向排钉腔，并且其中钉仓组件还包括多个第三钉，这些多个第三钉可移除地储存在第三纵向排钉腔中。每个第三钉包括第三冠部、第三近侧腿部和第三远侧腿部，其中第三近侧腿部和第三远侧腿部限定第三钉腿部平面。每个第三钉还包括第三凸轮表面和第三近侧连接器，该第三凸轮表面从第三冠部延伸并与第三冠部一体形成，其中该第三凸轮表面限定第三凸轮平面，并且该第三近侧连接器在第三近侧腿部和第三冠部之间延伸并与第三近侧腿部和第三冠部一体形成。每个第三钉还包括第三远侧连接器，该第三远侧连接器在第三远侧腿部和第三冠部之间延伸并与第三远侧腿部和第三冠部一体形成，其中第三近侧连接器和第三远侧连接器限定第三凸轮平面和第三钉腿部平面之间的第三距离，并且其中第三距离不等于第二距离和第一距离。
实施例96—根据实施例95所述的钉仓组件，其中仓体还包括被构造成能够接收切割构件的纵向狭槽。
实施例97—根据实施例95或96所述的钉仓组件，其中第一钉的第一凸轮平面比第一腿部平面更靠近纵向狭槽，其中第二钉的第二凸轮平面比第二腿部平面更靠近纵向狭槽，并且其中第三钉的第三凸轮平面比第三钉腿部平面更靠近纵向狭槽。
实施例98—根据实施例95或96所述的钉仓组件，其中第一钉的第一腿部平面比第一凸轮平面更靠近纵向狭槽，其中第二钉的第二腿部平面比第二凸轮平面更靠近纵向狭槽，并且其中第三钉的第三钉腿部平面比第三凸轮平面更靠近纵向狭槽。
实施例99—根据实施例95所述的钉仓组件，其中第一钉的第一凸轮平面彼此纵向对准，并且其中第二凸轮平面彼此纵向对准。
实施例100—根据实施例95所述的钉仓组件，其中第一钉和第二钉由扁材冲压而成。
实施例101—根据实施例95所述的钉仓组件，其中第一钉和第二钉由一片或多片材料形成。
实施例102—一种钉仓组件，该钉仓组件包括仓体，其中该仓体包括第一纵向排钉腔和第二纵向排钉腔。该钉仓组件还包括可移除地储存在第一纵向排钉腔中的多个第一钉。每个第一钉包括第一冠部、第一近侧腿部和第一远侧腿部，其中第一近侧腿部和第一远侧腿部限定第一腿部平面。每个第一钉还包括第一驱动表面和第一近侧连接器，该第一驱动表面从第一冠部延伸并与第一冠部一体形成，并且该第一近侧连接器在第一近侧腿部和第一冠部之间延伸并与第一近侧腿部和第一冠部一体形成。每个第一钉还包括第一远侧连接器，该第一远侧连接器在第一远侧腿部和第一冠部之间延伸并与第一远侧腿部和第一冠部一体形成，其中第一近侧连接器和第一远侧连接器限定第一冠部和第一腿部平面之间的第一阔度。该钉仓组件还包括可移除地储存在第二纵向排钉腔中的多个第二钉。每个第二钉包括第二冠部、第二近侧腿部和第二远侧腿部，其中第二近侧腿部和第二远侧腿部限定第二腿部平面。每个第二钉还包括第二驱动表面和第二近侧连接器，该第二驱动表面从第二冠部延伸并与第二冠部一体形成，并且该第二近侧连接器在第二近侧腿部和第二冠部之间延伸并与第二近侧腿部和第二冠部一体形成。每个第二钉还包括第二远侧连接器，该第二远侧连接器在第二远侧腿部和第二冠部之间延伸并与第二远侧腿部和第二冠部一体形成，其中第二近侧连接器和第二远侧连接器限定第二冠部和第二腿部平面之间的第二阔度，并且其中第二阔度不等于第一阔度。
实施例103—一种钉仓组件，该钉仓组件包括仓体，其中该仓体包括第一纵向排钉腔和第二纵向排钉腔。该钉仓组件还包括可移除地储存在第一纵向排钉腔中的多个第一钉。每个第一钉包括第一冠部、第一近侧腿部和第一远侧腿部，其中第一近侧腿部和第一远侧腿部限定第一夹持部分。每个第一钉还包括第一凸轮和第一近侧连接器，该第一凸轮与第一冠部一体形成，并且该第一近侧连接器在第一近侧腿部和第一冠部之间延伸并与第一近侧腿部和第一冠部一体形成。每个第一钉还包括第一远侧连接器，该第一远侧连接器在第一远侧腿部和第一冠部之间延伸并与第一远侧腿部和第一冠部一体形成，其中第一近侧连接器和第一远侧连接器限定第一冠部和第一夹持部分之间的第一宽度。该钉仓组件还包括可移除地储存在第二纵向排钉腔中的多个第二钉。每个第二钉包括第二冠部、第二近侧腿部和第二远侧腿部，其中第二近侧腿部和第二远侧腿部限定第二夹持部分。每个第二钉还包括第二凸轮和第二近侧连接器，该第二凸轮与第二冠部一体形成，并且该第二近侧连接器在第二近侧腿部和第二冠部之间延伸并与第二近侧腿部和第二冠部一体形成。每个第二钉还包括第二远侧连接器，该第二远侧连接器在第二远侧腿部和第二冠部之间延伸并与第二远侧腿部和第二冠部一体形成，其中第二近侧连接器和第二远侧连接器限定第二冠部和第二夹持部分之间的第二宽度，并且其中第二宽度不等于第一宽度。
本文所述的许多外科器械系统由电动马达促动；但是本文所述的外科器械系统可以任何合适的方式促动。在各种实例中，例如，本文所述的外科器械系统可由手动操作的触发器促动。在某些实例中，本文公开的马达可包括机器人控制系统的一部分或多个部分。此外，本文公开的任何端部执行器和/或工具组件可与机器人外科器械系统一起使用。例如，名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利9,072,535)更详细地公开了机器人外科器械系统的若干示例。
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4月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312；
公布于2006年2月21日的名称为“SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利7,000,818；
公布于2008年9月9日的名称为“MOTOR-DRIVEN SURGICAL CUTTING ANDFASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK”的美国专利7,422,139；
公布于2008年12月16日的名称为“ELECTRO-MECHANICAL SURGICAL INSTRUMENTWITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”的美国专利7,464,849；
公布于2010年3月2日的名称为“SURGICAL INSTRUMENT HAVING AN ARTICULATINGEND EFFECTOR”的美国专利7,670,334；
公布于2010年7月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245；
公布于2013年3月12日的名称为“SELECTIVELY ORIENTABLE IMPLANTABLEFASTENER CARTRIDGE”的美国专利8,393,514；
名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利申请序列号11/343,803；现为美国专利7,845,537；
提交于2008年2月14日的名称为“SURGICAL CUTTING AND FASTENING INSTRUMENTHAVING RF ELECTRODES”的美国专利申请序列号12/031,573；
提交于2008年2月15日的名称为“END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT”的美国专利申请序列号12/031,873(现为美国专利7,980,443)；
名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”的美国专利申请序列号12/235,782，现为美国专利8,210,411；
名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117，现为美国专利8,608,045；
提交于2009年12月24日的名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENTWITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY”的美国专利申请序列号12/647,100；现为美国专利8,220,688；
提交于2012年9月29日的名称为“STAPLE CARTRIDGE”的美国专利申请序列号12/893,461，现为美国专利号8,733,613；
提交于2011年2月28日的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号13/036,647，现为美国专利号8,561,870；
名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利申请序列号13/118,241，现为美国专利9,072,535；
提交于2012年6月15日的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING A FIRING DRIVE”的美国专利申请序列号13/524,049；现为美国专利9,101,358；
提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,025，现为美国专利9,345,481；
提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,067，现为美国专利申请公开2014/0263552；
提交于2006年1月31日的名称为“SURGICAL CUTTING AND FASTENING INSTRUMENTWITH CLOSURE TRIGGER LOCKING MECHANISM”的美国专利申请公布2007/0175955；以及
提交于2010年4月22日的名称为“SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”的美国专利申请公布2010/0264194，现为美国专利8,308,040。
虽然本文已结合某些实施方案描述了各种装置，但也可实施对这些实施方案的许多修改和变型。在一个或多个实施方案中，具体特征、结构或特性可以任何合适的方式进行组合。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、结构或特性可全部或部分地与一个或多个其他实施方案的特征、结构或特性进行组合。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拆卸装置、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/或外科团队可拆卸装置，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拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修复装置均在本申请的范围内。
本文所公开的装置可在手术之前进行处理。首先，可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，直至在医疗设施中将该容器打开。还可使用本领域已知的任何其他技术对装置进行消毒，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、公布或其他公开材料均仅在所并入的材料不与本发明所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。因此，并且在必要的程度下，本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其它公开材料相冲突的任何材料或其部分，将仅在所并入的材料与现有的公开材料之间不产生冲突的程度下并入。

Claims (19)

1.一种钉仓组件，所述钉仓组件包括：
仓体，所述仓体包括：
第一纵向排钉腔；和
第二纵向排钉腔；
多个第一钉，所述多个第一钉可移除地储存在所述第一纵向排钉腔中，其中每个所述第一钉包括：
第一冠部；
第一近侧腿部；
第一远侧腿部，其中所述第一近侧腿部和所述第一远侧腿部限定第一腿部平面；
第一凸轮表面，所述第一凸轮表面从所述第一冠部延伸并与所述第一冠部一体形成，其中所述第一凸轮表面限定第一凸轮平面；
第一近侧连接器，所述第一近侧连接器在所述第一近侧腿部和所述第一冠部之间延伸并与所述第一近侧腿部和所述第一冠部一体形成；和
第一远侧连接器，所述第一远侧连接器在所述第一远侧腿部和所述第一冠部之间延伸并与所述第一远侧腿部和所述第一冠部一体形成，其中所述第一近侧连接器和所述第一远侧连接器限定所述第一凸轮平面和所述第一腿部平面之间的第一距离；
多个第二钉，所述多个第二钉可移除地储存在所述第二纵向排钉腔中，其中每个所述第二钉包括：
第二冠部；
第二近侧腿部；
第二远侧腿部，其中所述第二近侧腿部和所述第二远侧腿部限定第二腿部平面；
第二凸轮表面，所述第二凸轮表面从所述第二冠部延伸并与所述第二冠部一体形成，其中所述第二凸轮表面限定第二凸轮平面；
第二近侧连接器，所述第二近侧连接器在所述第二近侧腿部和所述第二冠部之间延伸并与所述第二近侧腿部和所述第二冠部一体形成；和
第二远侧连接器，所述第二远侧连接器在所述第二远侧腿部和所述第二冠部之间延伸并与所述第二远侧腿部和所述第二冠部一体形成，其中所述第二近侧连接器和所述第二远侧连接器限定所述第二凸轮平面和所述第二腿部平面之间的第二距离，并且其中所述第二距离不等于所述第一距离。
2.根据权利要求1所述的钉仓组件，其中，所述仓体还包括被构造成能够接收切割构件的纵向狭槽。
3.根据权利要求2所述的钉仓组件，其中，所述第一距离大于所述第二距离，其中所述第一纵向排钉腔与所述纵向狭槽相邻，并且其中所述第一纵向排钉腔在所述纵向狭槽和所述第二纵向排钉腔中间。
4.根据权利要求2所述的钉仓组件，其中，所述第一距离大于所述第二距离，其中所述第二纵向排钉腔与所述纵向狭槽相邻，并且其中所述第二纵向排钉腔在所述纵向狭槽和所述第一纵向排钉腔中间。
5.根据权利要求2所述的钉仓组件，其中，所述第一钉的所述第一凸轮平面比所述第一腿部平面更靠近所述纵向狭槽。
6.根据权利要求5所述的钉仓组件，其中，所述第二钉的所述第二凸轮平面比所述第二腿部平面更靠近所述纵向狭槽。
7.根据权利要求5所述的钉仓组件，其中，所述第二钉的所述第二腿部平面比所述第二凸轮平面更靠近所述纵向狭槽。
8.根据权利要求2所述的钉仓组件，其中，所述第一钉的所述第一腿部平面比所述第一凸轮平面更靠近所述纵向狭槽。
9.根据权利要求8所述的钉仓组件，其中，所述第二钉的所述第二凸轮平面比所述第二腿部平面更靠近所述纵向狭槽。
10.根据权利要求8所述的钉仓组件，其中，所述第二钉的所述第二腿部平面比所述第二凸轮平面更靠近所述纵向狭槽。
11.根据权利要求1所述的钉仓组件，其中，所述仓体还包括第三纵向排钉腔，并且其中所述钉仓组件还包括可移除地储存在所述第三纵向排钉腔中的多个第三钉，其中每个所述第三钉包括：
第三冠部；
第三近侧腿部；
第三远侧腿部，其中所述第三近侧腿部和所述第三远侧腿部限定第三钉腿部平面；
第三凸轮表面，所述第三凸轮表面从所述第三冠部延伸并与所述第三冠部一体形成，其中所述第三凸轮表面限定第三凸轮平面；
第三近侧连接器，所述第三近侧连接器在所述第三近侧腿部和所述第三冠部之间延伸并与所述第三近侧腿部和所述第三冠部一体形成；和
第三远侧连接器，所述第三远侧连接器在所述第三远侧腿部和所述第三冠部之间延伸并与所述第三远侧腿部和所述第三冠部一体形成，其中所述第三近侧连接器和所述第三远侧连接器限定所述第三凸轮平面和所述第三钉腿部平面之间的第三距离，并且其中所述第三距离不等于所述第二距离和所述第一距离。
12.根据权利要求11所述的钉仓组件，其中，所述仓体还包括被构造成能够接收切割构件的纵向狭槽。
13.根据权利要求12所述的钉仓组件，其中，所述第一钉的所述第一凸轮平面比所述第一腿部平面更靠近所述纵向狭槽，其中所述第二钉的所述第二凸轮平面比所述第二腿部平面更靠近所述纵向狭槽，并且其中所述第三钉的所述第三凸轮平面比所述第三钉腿部平面更靠近所述纵向狭槽。
14.根据权利要求12所述的钉仓组件，其中，所述第一钉的所述第一腿部平面比所述第一凸轮平面更靠近所述纵向狭槽，其中所述第二钉的所述第二腿部平面比所述第二凸轮平面更靠近所述纵向狭槽，并且其中所述第三钉的所述第三钉腿部平面比所述第三凸轮平面更靠近所述纵向狭槽。
15.根据权利要求1所述的钉仓组件，其中，所述第一钉的所述第一凸轮平面彼此纵向对准，并且其中所述第二凸轮平面彼此纵向对准。
16.根据权利要求1所述的钉仓组件，其中，所述第一钉和所述第二钉由扁材冲压而成。
17.根据权利要求1所述的钉仓组件，其中，所述第一钉和所述第二钉由一片或多片材料形成。
18.一种钉仓组件，所述钉仓组件包括：
仓体，所述仓体包括：
第一纵向排钉腔；和
第二纵向排钉腔；
多个第一钉，所述多个第一钉可移除地储存在所述第一纵向排钉腔中，其中每个所述第一钉包括：
第一冠部；
第一近侧腿部；
第一远侧腿部，其中所述第一近侧腿部和所述第一远侧腿部限定第一腿部平面；
第一驱动表面，所述第一驱动表面从所述第一冠部延伸并与所述第一冠部一体形成；
第一近侧连接器，所述第一近侧连接器在所述第一近侧腿部和所述第一冠部之间延伸并与所述第一近侧腿部和所述第一冠部一体形成；和
第一远侧连接器，所述第一远侧连接器在所述第一远侧腿部和所述第一冠部之间延伸并与所述第一远侧腿部和所述第一冠部一体形成，其中所述第一近侧连接器和所述第一远侧连接器限定所述第一冠部和所述第一腿部平面之间的第一阔度；和
多个第二钉，所述多个第二钉可移除地储存在所述第二纵向排钉腔中，其中每个所述第二钉包括：
第二冠部；
第二近侧腿部；
第二远侧腿部，其中所述第二近侧腿部和所述第二远侧腿部限定第二腿部平面；
第二驱动表面，所述第二驱动表面从所述第二冠部延伸并与所述第二冠部一体形成；
第二近侧连接器，所述第二近侧连接器在所述第二近侧腿部和所述第二冠部之间延伸并与所述第二近侧腿部和所述第二冠部一体形成；和
第二远侧连接器，所述第二远侧连接器在所述第二远侧腿部和所述第二冠部之间延伸并与所述第二远侧腿部和所述第二冠部一体形成，其中所述第二近侧连接器和所述第二远侧连接器限定所述第二冠部和所述第二腿部平面之间的第二阔度，并且其中所述第二阔度不等于所述第一阔度。
19.一种钉仓组件，所述钉仓组件包括：
仓体，所述仓体包括：
第一纵向排钉腔；和
第二纵向排钉腔；
多个第一钉，所述多个第一钉可移除地储存在所述第一纵向排钉腔中，其中每个所述第一钉包括：
第一冠部；
第一近侧腿部；
第一远侧腿部，其中所述第一近侧腿部和所述第一远侧腿部限定第一夹持部分；
第一凸轮，所述第一凸轮与所述第一冠部一体形成；
第一近侧连接器，所述第一近侧连接器在所述第一近侧腿部和所述第一冠部之间延伸并与所述第一近侧腿部和所述第一冠部一体形成；和
第一远侧连接器，所述第一远侧连接器在所述第一远侧腿部和所述第一冠部之间延伸并与所述第一远侧腿部和所述第一冠部一体形成，其中所述第一近侧连接器和所述第一远侧连接器限定所述第一冠部和所述第一夹持部分之间的第一宽度；和
多个第二钉，所述多个第二钉可移除地储存在所述第二纵向排钉腔中，其中每个所述第二钉包括：
第二冠部；
第二近侧腿部；
第二远侧腿部，其中所述第二近侧腿部和所述第二远侧腿部限定第二夹持部分；
第二凸轮，所述第二凸轮与所述第二冠部一体形成；
第二近侧连接器，所述第二近侧连接器在所述第二近侧腿部和所述第二冠部之间延伸并与所述第二近侧腿部和所述第二冠部一体形成；和
第二远侧连接器，所述第二远侧连接器在所述第二远侧腿部和所述第二冠部之间延伸并与所述第二远侧腿部和所述第二冠部一体形成，其中所述第二近侧连接器和所述第二远侧连接器限定所述第二冠部和所述第二夹持部分之间的第二宽度，并且其中所述第二宽度不等于所述第一宽度。
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US20180168617A1 (en) 2018-06-21
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