CN110099619B - 用于外科端部执行器和可替换工具组件的闭锁装置 - Google Patents

用于外科端部执行器和可替换工具组件的闭锁装置 Download PDF

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CN110099619B
CN110099619B CN201780079494.9A CN201780079494A CN110099619B CN 110099619 B CN110099619 B CN 110099619B CN 201780079494 A CN201780079494 A CN 201780079494A CN 110099619 B CN110099619 B CN 110099619B
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firing
anvil
patent application
firing member
end effector
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CN110099619A (zh
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F·E·谢尔顿四世
J·L·哈里斯
G·J·巴克斯
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Ethicon LLC
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Ethicon LLC
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Abstract

本发明公开了外科端部执行器。外科端部执行器可包括第一钳口、可旋转地联接到第一钳口的第二钳口、以及闭锁装置，该闭锁装置被构造成能够防止第二钳口朝第一钳口的旋转运动，除非未击发的钉仓被定位在第一钳口中。该锁定装置可包括可枢转锁、可转移锁定杆和/或弹簧加载的闭锁杠杆，该可枢转锁被构造成能够在锁定取向和解锁取向之间枢转。

Description

用于外科端部执行器和可替换工具组件的闭锁装置
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加以理解：
图1是可操作地联接到柄部组件的可互换外科工具组件的透视图；
图1A是图1的柄部组件及其多个可互换外科工具组件的正视分解组装视图；
图2是图1的柄部组件和可互换外科工具组件的一些部分的分解透视组装视图；
图3是图1的可互换外科工具组件的远侧部分的透视图，其中为清楚起见省略了其一些部分；
图4是图1所示的可互换外科工具组件的远侧部分沿其纵向轴线截取的透视剖视图，其中为清楚起见省略了其一些部分；
图5是图1的可互换外科工具组件的远侧部分的分解组装视图；
图6是图1所示的可互换外科工具组件的砧座的透视图；
图7是图1所示的可互换外科工具组件的细长通道的透视图；
图8是图1的可互换外科工具组件的枢转接头的透视图；
图9是图8的枢转接头的平面图；
图10是图1的可互换外科工具组件的远侧部分的正视剖视图，示出了图8的枢转接头处的处于初始位置的击发构件；
图11是图1的可互换外科工具组件的远侧部分的正视剖视图，示出了图8的枢转接头处的处于从初始位置朝近侧回缩的位置的击发构件；
图12是图1的可互换外科工具组件的远侧部分的正视剖视图，示出了图8的枢转接头处的处于从初始位置朝远侧推进的位置的击发构件；
图13是可互换外科工具组件的远侧部分的透视图，示出了处于初始构型的远侧鼻状部分；
图14是图13的可互换外科工具组件的远侧部分的正视图，示出了处于初始构型的远侧鼻状部分；
图15是图13的可互换外科工具组件的远侧部分的正视图，示出了处于枢转构型的远侧鼻状部分；
图16是图13的可互换外科工具组件的远侧部分的正视图，示出了处于枢转构型的远侧鼻状部分；
图17是图13的端部执行器的正视剖视图，其示出了处于枢转构型的远侧鼻状部分；
图18是击发构件的上部部分的透视图；
图18A是图18的击发构件的上部凸缘的透视图；
图19是图18的击发构件的上部部分的正视图，示出了处于第一构型的击发构件；
图20是图18的击发构件的上部部分的正视图，示出了处于压力构型的击发构件；
图21是图18的击发构件的上部部分的正视图，示出了处于适应构型的击发构件；
图21A是图18的击发构件的上部部分的正视图，示出了处于加载构型的击发构件；
图22是击发构件的上部部分的正视图，示出了处于第一构型的击发构件；
图23是图22的击发构件的上部部分的正视图，示出了处于适应构型的击发构件；
图24是可互换外科工具组件的一部分的正视局部剖视图，示出了从原始位置朝远侧移位到第一中间位置的击发构件并且该击发构件的上部凸缘被施加第一负载；
图25是图24的可互换外科工具组件的一部分的正视局部剖视图，示出了从第一中间位置朝远侧移位到第二中间位置的击发构件并且上部凸缘被施加减小的负载；
图26是图24的可互换外科工具组件的一部分的正视局部剖视图，示出了从第二中间位置朝远侧移位到第三中间位置的击发构件并且上部凸缘被施加增大的负载；
图27是可互换外科工具组件的远侧部分的透视局部剖视图，其中为清楚起见省略了其一些部分；
图28是图27的可互换外科工具组件的一部分的正视局部剖视图，其中该可更换外科工具组件中缺少钉仓；
图29是图27的可互换外科工具组件的一部分的正视局部剖视图，其中钉仓定位在该可更换外科工具组件中；
图30是具有闭锁件的可互换外科工具组件的一部分的正视局部剖视图，其中闭锁装置处于锁定构型；
图31是图30的具有定位在其中的钉仓的可互换外科工具组件的一部分的正视局部剖视图，其中闭锁装置处于解锁构型并且钉仓处于击发前状态；
图32是图31的钉仓的近侧部分的透视图，示出了钉仓的击发前状态；
图33是图30的具有定位在其中的图31的钉仓的可互换外科工具组件的一部分的正视局部剖视图，并且示出了该可更换外科工具组件的击发组件在击发冲程的初始部分期间推进到中间位置，其中钉仓处于击发后状态；
图34是图31的钉仓的近侧部分的透视图，示出了钉仓的击发后状态；
图35是图30的可互换外科工具组件的一部分在完成击发冲程之后并且使图31的钉仓定位在其中的正视局部剖视图；
图36是砧座的透视分解组装视图；
图37是可互换外科工具组件的一部分沿该可互换外科工具组件的中心线截取的透视剖视图，并且示出了图36的砧座的一部分、细长通道的一部分以及闭锁弹簧；
图38是图37的可互换外科工具组件的一部分沿该可互换外科工具组件的中心线截取的透视局部剖视图；
图39是图37的可互换外科工具组件的一部分沿该可互换外科工具组件的中心线截取的正视局部剖视图，并且示出了处于打开位置的砧座；
图40是图37的可互换外科工具组件的一部分沿图36所示的平面截取的正视局部剖视图，并且示出了处于打开位置的砧座；
图41是图37的可互换外科工具组件的一部分沿该可互换外科工具组件的中心线截取的正视局部剖视图，并且示出了安装在细长通道中的钉仓和处于打开位置的砧座；
图42是图37的可互换外科工具组件的一部分沿图36所示的平面截取的正视局部剖视图，并且示出了安装在细长通道中的钉仓和处于打开位置的砧座；
图43是图37的可互换外科工具组件的一部分沿该可互换外科工具组件的中心线截取的正视局部剖视图，并且示出了安装在细长通道中的钉仓和由击发构件移动到闭合位置的砧座；
图44是图37的可互换外科工具组件的近侧部分沿图36所示的平面截取的正视局部剖视图，并且示出了安装在细长通道中的钉仓和由击发构件移动到闭合位置的砧座；
图45是可互换外科工具组件的一部分的透视局部剖视图，示出了安装在其中的未击发钉仓和处于近侧位置的击发构件；
图46是图45的可互换外科工具组件的一部分的另一透视局部剖视图，示出了安装在其中的未击发钉仓和处于近侧位置的击发构件；
图47是图45的可互换外科工具组件中的闭锁装置的透视分解组装视图；
图48是图45的可互换外科工具组件的一部分的正视局部剖视图，示出了安装在其中的未击发钉仓和处于近侧原始位置的击发构件；
图49是图45的可互换外科工具组件的一部分的正视局部剖视图，示出了击发构件在击发冲程的初始部分期间从近侧原位置朝远侧移位；
图50是图45的可互换外科工具组件的一部分的正视局部剖视图，示出了击发构件在击发冲程完成时返回到近侧原始位置；
图51是图45的可互换外科工具组件的一部分的正视局部剖视图，示出了已返回到近侧原始位置的击发构件；
图52是图45的可互换外科工具组件的一部分的正视局部剖视图，示出了在后续尝试的击发冲程期间从近侧原位置朝远侧移位的击发构件；
图53是图47的闭锁装置的透视图；
图54是图8的枢转接头的正视局部剖视细部图，示出了枢转接头处的处于推进位置的击发构件并且还示出了弹簧组件；
图55是可互换外科工具组件的远侧部分的透视分解组装视图；
图56是可互换外科工具组件的远侧部分的正视剖视图；
图57是图56的可互换外科工具组件的一部分的平面图；
图58为图56的可互换外科工具组件沿图56所示的平面截取的正视剖视图；
图59是图56的可互换外科工具组件的推板和击发连杆的正视分解组装视图；
图60为图59的推板和击发连杆沿图59所示的平面截取的平面剖视图；
图61是图59的推板的正视图；
图62是图56的可互换外科工具组件的远侧部分在第一击发冲程开始时的正视剖视图；
图63是图56的可互换外科工具组件沿图62所示的平面截取的在第一击发冲程开始时的正视剖视图；
图64是图56的可互换外科工具组件的远侧部分在第一击发冲程完成时的正视剖视图；
图65是图56的可互换外科工具组件的远侧部分在第二击发冲程完成时的正视剖视图；
图66是图56的可互换外科工具组件的一部分在第二击发冲程完成时的平面图；
图67是图56的可互换外科工具组件的远侧部分在第三击发冲程完成时的正视剖视图；
图68是图56的可互换外科工具组件的一部分在第三击发冲程完成时的平面图；
图69是图56的可互换外科工具组件沿图67所示的平面截取的在第三击发冲程完成时正视剖视图；
图70是图56的可互换外科工具组件的远侧部分在第四击发冲程完成时的正视剖视图；
图71是可互换外科工具组件的远侧部分的透视图；
图72是图71的可互换外科工具组件的远侧部分的透视分解组装视图；
图73是图71的可互换外科工具组件的一部分的平面剖视图；
图74是图71的可互换外科工具组件的一部分的正视剖视图；
图75是另一外科器械实施方案的一部分的透视图；
图76是图75的外科器械部分的透视分解组装视图；
图77是图75和图76的外科器械的另一分解组装视图，其通道部分与其轴组件分离；
图78是图75至77的外科器械的通道和轴组件的一些部分的另一分解组装视图；
图79是图75至78的外科器械的一些部分的局部剖视正视图，其中其通道将外科钉仓支撑在其中并且附接到轴组件，其中其砧座处于闭合位置，并且击发构件朝远侧推进以击发外科钉仓内的钉；
图80是另一外科器械实施方案的一部分的局部透视图；
图81是图75至79的外科器械的一些部分的剖视正视图；
图82是图81所示的外科器械的一些部分的另一剖视正视图；
图83是图75至79的外科器械的局部侧正视图，其中其端部执行器相对于轴组件在第一关节运动平面内进行关节运动；
图84是图83的外科器械的局部透视图，其中其端部执行器相对于轴组件在第二关节运动平面中进行关节运动；
图85是图83和图84的外科器械的另一透视图，示出了在第一关节运动平面和第二关节运动平面中进行关节运动的端部执行器；
图86是另一外科器械实施方案的一部分的透视图；
图87是图86的外科器械部分的透视分解组装视图；
图88是用于将端部执行器部分可移除地联接到图86和图87的外科器械的轴组件部分的联接器装置的透视图；
图89是附接到图86至88的轴组件的端部执行器的顶视图，其中为清楚起见，该端部执行器和轴组件的一些部分以横截面示出；
图90是可互换外科工具组件的一部分的正视剖视图，示出了其砧座处于打开位置；
图91是图90的可互换外科工具组件的一部分的正视剖视图，示出了安装在细长通道中的钉仓和处于打开位置的砧座；以及
图92是图90的可互换外科工具组件的一部分的正视剖视图，示出了安装在细长通道中的钉仓和移动到闭合位置的砧座。
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2016年12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“ARTICULATABLE SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,230；
-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；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2016年12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2016年12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2016年12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2016年12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2016年12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2016年12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 STAPLING SYSTEMS”的美国专利申请序列号15/385,919；
-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2015年12月31日提交且各自全文以引用方式并入本文的以下所识别的专利申请：
-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2016年2月9日提交且各自全文以引用方式并入本文的以下所识别的专利申请：
-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2016年2月12日提交且各自全文以引用方式并入本文的以下所识别的专利申请：
-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2013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2013年4月16日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,365；
-名称为“LINEAR CUTTER WITH POWER”的美国临时专利申请序列号61/812,376；
-名称为“LINEAR CUTTER WITH MOTOR AND PISTOL GRIP”的美国临时专利申请序列号61/812,382；
-名称为“SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS ANDMOTOR CONTROL”的美国临时专利申请序列号61/812,385；以及
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,372。
本文列出了许多具体细节，以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件，以免使说明书中描述的实施方案模糊不清。读者将会理解，本文所述和所示的实施方案为非限制性示例，从而可认识到，本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求的范围的情况下，可对这些实施方案进行变型和改变。
术语“包括(comprise)”(以及“包括(comprise)”的任何形式，诸如“包括(comprises)”和“包括(comprising)”)、“具有(have)”(以及“具有(have)”的任何形式，诸如“具有(has)”和“具有(having)”)、“包含(include)”(以及“包含(include)”的任何形式，诸如“包含(includes)”和“包含(including)”)、以及“含有(contain)”(以及“含有(contain)”的任何形式，诸如“含有(contains)”和“含有(containing)”)为开放式系动词。因此，“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件，但不限于仅具有这些一个或多个元件。同样，“包括”、“具有”、“包含”或“含有”一个或多个特征部的系统、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，可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。钉腔被布置成四个纵向排。两排钉腔定位在纵向狭槽的第一侧上且两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。
钉通过滑动件组件能够在其非击发位置与其击发位置之间移动。滑动件组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移动。滑动件组件包括多个斜坡表面，这些斜坡表面被构造成能够在钉下方滑动并将钉朝砧座提升。其他布置可包括将钉支撑在钉腔中的钉驱动器，并且在这种布置中，滑动件组件可在驱动器下方滑动并将驱动器以及支撑在其上的钉朝砧座提升。
除上述以外，滑动件组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组件并朝远侧端部推动滑动件组件。限定于仓体中的纵向狭槽被构造成能够接收击发构件。砧座还包括被构造成能够接收击发构件的狭槽。击发构件还包括接合第一钳口的第一凸轮和接合第二钳口的第二凸轮。在击发构件朝远侧推进时，第一凸轮和第二凸轮可控制钉仓的平台和砧座之间的距离或组织间隙。击发构件还包括被构造成能够切入在钉仓和砧座中间捕集的组织的刀。希望刀定位成至少部分接近斜坡表面，使得钉先于刀被射出。
在某些实例中，本文所述的端部执行器可以限定等于或小于8mm的宽度以及等于或小于8mm的高度。例如，本文所述的端部执行器可以是5mm宽×8mm高。在其他实例中，端部执行器可以是例如5mm宽×5mm高。本文所述的紧凑型端部执行器可包括有助于其较小占地面积的各种特征部。例如，此类端部执行器可包括直接驱动的钉，诸如2015年8月26日提交的名称为“SURGICAL STAPLES FOR MINIMIZING STAPLE ROLL”的美国专利申请序列号14/836,324中描述的钉，该专利申请全文以引用方式并入本文。因为当钉由滑动件组件直接驱动时消除了驱动器，所以钉仓的高度以及因此被构造成能够接纳钉仓的端部执行器的高度可以减小。附加地或另选地，此类端部执行器可包括多功能击发构件。例如，击发构件可以驱动滑动件以从钉仓击发钉，切割夹在钳口之间的组织，将钳口凸轮移动成夹紧构型，并将钳口凸轮移动成打开构型。这种夹紧-击发-打开击发构件可以实现外科功能与单个致动系统的组合，这可以减少端部执行器中的独立致动系统，并且因此可以减小端部执行器的尺寸。例如，在某些实例中，可以消除围绕端部执行器的至少一部分移动以实现闭合动作的平移闭合管。
本文所述的紧凑型端部执行器对于各种外科手术是有利的，包括其中可以重视小的手术足迹的外科手术。例如，在某些胸腔手术中，端部执行器可用于切割和密封血管，例如肺血管，这种血管具有小直径和高流量。紧凑型端部执行器可能需要较小的插入孔，并且可以为外科医生提供外科手术部位周围的增强可视性。
图1和图2示出了外科器械10的一种形式，其包括可互换外科工具组件1000，该可互换外科工具组件可操作地联接到马达驱动的柄部组件500。参见图1A，除了可互换外科工具组件1000之外，柄部组件500还可与多个不同的可互换外科工具组件兼容。例如，柄部组件500可与图1中A所示的可互换外科工具组件1000'、1000”、1000”'和1000””兼容。可互换外科工具组件1000还可以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使用。例如，本文所公开的可互换外科工具组件可与(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、部件和方法一起使用，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1和图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，该柄部外壳包括可由临床医生握持和操纵的手枪式握持部504。柄部组件500还可包括可操作地支撑至少一个驱动系统的框架506。
在至少一种形式中，柄部组件500和框架506可以可操作地支撑驱动系统530，该驱动系统被构造成能够将闭合动作和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。如在名称为“SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM”的美国专利申请序列号14/226,142(现为美国专利申请公布2015/0272575，其据此全文以引用方式并入本文)中详细描述的那样，驱动系统530可以采用位于柄部组件500的手枪式握持部分504中的电动马达505。在各种形式中，马达505例如可为具有大约25,000RPM的最大旋转的DC有刷驱动马达。在其他布置中，马达505可包括无刷马达、无绳马达、同步马达、步进马达、或任何其他合适的电动马达。马达505可由功率源522供电，在一种形式中，功率源522可包括可移除功率源组。功率源组可以在其中支撑多个锂离子(“LI”)或其他合适的电池。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可以是可替换的和/或可再充电的。
主要参见图2，电动马达505被构造成能够根据马达505的极性在远侧方向和近侧方向上轴向地驱动能够纵向的移动驱动构件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”上被轴向地驱动。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”上被轴向地驱动。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的极性反转或以其他方式控制马达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)。当可互换外科工具组件1000安装到柄部组件500时，柄部驱动系统530的驱动构件540联接到可互换外科工具组件1000中的工具驱动系统1600的驱动构件1602，并且驱动构件1602通过柔性击发杆1770连接到端部执行器1100中的击发构件1760(参见图3至5)。
在击发冲程期间，驱动构件540经由驱动构件1602将击发动作传递到击发杆1770以击发该击发构件1760。例如，驱动构件540的致动被构造成能够使击发杆1770和击发构件1760朝远侧移位以切割组织并实现将钉从钉仓击发。然后，驱动构件540可朝近侧回缩以使击发杆1770和击发构件1760朝近侧回缩。击发杆1770可以包括有至少两层的层压梁结构。击发杆1770可被构造成能够在关节运动接头1200内弯曲。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/或沿其长度的其他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。这种布置允许击发杆1770足够柔韧以适应端部执行器1100的关节运动。在名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTIONARRANGEMENTS”的美国专利申请序列号15/019,245中公开了各种层压刀杆布置，该专利申请全文以引用方式并入本文。读者将容易理解，在某些示例下，本文所述的各种击发构件可以联接到击发杆1770。
在各种实例下，柄部组件500可被构造成能够检测安装或附接到其上的可互换外科工具组件1000的类型。例如，柄部组件500可以包括霍尔效应传感器，其可以被配置成能够检测例如在可互换外科工具组件(诸如可互换外科工具组件1000)上的可检测元件，诸如磁性元件。不同的可互换外科工具组件可具有不同的可检测元件和/或其布置。用于检测不同的可互换外科工具组件的各种传感器在名称为“INTERCHANGEABLE SHAFT ASSEMBLIESFOR USE WITH A SURGICAL INSTRUMENT”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)中描述，该专利申请据此全文以引用方式并入本文。
基于检测到的可互换外科工具组件1000的类型，柄部组件500可以实现某些外科功能和/或可以闭锁某些外科功能。例如，柄部组件500可包括一个或多个分立驱动系统(例如，闭合驱动系统和击发驱动系统)，然而，在检测到可互换外科工具组件1000时，柄部组件500可以解除或停用某些驱动系统(例如，可以停用闭合驱动系统并使用击发驱动系统来闭合和击发端部执行器)。例如，在同时提交的名称为“SURGICAL TOOL ASSEMBLIES WITHCLUTCHING ARRANGEMENTS FOR SHIFTING BETWEEN CLOSURE SYSTEMS WITH CLOSURESTROKE REDUCTION FEATURES AND ARTICULATION AND FIRING SYSTEMS”的美国专利申请序列号15/385,941中描述了一种包括多个驱动系统的柄部组件，该专利申请据此全文以引用方式并入本文。
在至少一种形式中，能够纵向移动的驱动构件540可以具有形成在其上的齿条(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。关于这些特征的另外细节可见于名称为“SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM”的美国专利申请序列号14/226,142(现为美国专利申请公布2015/0272575)，该专利申请据此全文以引用方式并入本文。至少一种形式还包括能够被手动致动的“救助”组件，其被构造成能够使得临床医生能够在马达505变得停用情况下手动地回缩能够纵向移动的驱动构件540。救助组件可包括杠杆或救助柄部组件，其存放在柄部组件500内处于释放门550下方。杠杆被构造成能够手动地枢转到与驱动构件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 MANUALLY RETRACTABLEFIRING SYSTEM”的美国专利申请序列号12/249,117(现为美国专利8,608,045，其据此全文以引用方式并入本文)公开了救助装置和也可以与可互换外科工具组件1000一起使用的其他部件、装置和系统。
仍然参见图2，用于驱动系统505的马达530的致动可由一个或多个致动器控制。在至少一种形式中，驱动系统530可包括被框架506可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。闭合触发器512可用于将闭合动作和任选地打开动作施加到可操作地附接到或联接到柄部组件500的可互换外科工具组件1000。
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，驱动系统530(或柄部组件500中的另一驱动系统)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还可被构造成能够与各种传感器交接，这些传感器与柄部组件500中的微控制器520(参见图2)通信以用于跟踪闭合触发器512的位置。关于闭合释放按钮组件518的另外细节可见于名称为“SURGICAL INSTRUMENT COMPRISING ASENSOR SYSTEM”的美国专利申请序列号14/226,142(现为美国专利申请公布2015/0272575)，该专利申请据此全文以引用方式并入本文。
在至少一种形式中，驱动系统530还可包括被框架506可枢转地支撑的击发触发器532形式的致动器。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)或其他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他方式返回未致动位置。在至少一种形式中，击发触发器532可被定位在闭合触发器512的“外侧”。如在名称为“SURGICAL INSTRUMENTCOMPRISING A SENSOR SYSTEM”的美国专利申请序列号14/226,142(现为美国专利申请公布2015/0272575，其据此全文以引用方式并入本文)中所述，柄部组件500可以配备有击发触发器安全按钮(未示出)，以防止击发触发器532的无意间致动。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该击发触发器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。
如本文进一步所述，闭合触发器512可被构造成能够致动马达505以将驱动系统530驱动第一度数和/或通过第一系列动作，并且击发触发器532可被构造成能够致动马达505以将驱动系统530驱动第二度数和/或通过第二系列动作。在其他实例中，柄部组件500可包括用于闭合和击发端部执行器的单个致动器。
主要参见图2，可互换外科工具组件1000包括工具驱动系统1600，其被支撑以在脊组件1500内轴向行进。在例示的实施方案中，工具驱动系统1600包括近侧驱动轴段1602。近侧驱动轴段1602可以联接到中间驱动构件，诸如驱动构件3540(参见图30、31、33和35)，并且中间驱动构件可以联接到终止于击发构件中的击发杆，诸如击发杆3770和击发构件1760(参见图30、31、33和35)。如图2中可见，近侧附接凸耳1606从近侧驱动轴段1602的近侧端部朝近侧突出，并且被构造成能够可操作地接纳在支撑于柄部组件500中的纵向可移动的驱动构件540中的击发轴附接支架542内。当组装时，柄部驱动构件540被构造成能够经由中间驱动构件和击发杆将动作传递到近侧驱动轴段1602并最终传递到击发构件1760。
仍参见图1和图2，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在其中可操作地支撑钉仓1110。端部执行器1100还可包括相对于细长通道1102被可枢转地支撑的砧座1130。细长通道1102/钉仓组件1110和砧座1130也可称为“钳口”。可互换外科工具组件1000还可包括关节运动接头1200(图1)和关节运动锁，该关节运动锁可被构造成能够能够将端部执行器1100围绕关节运动轴线B-B(横向于轴轴线SA)释放地保持在期望的关节运动位置。关于该关节运动锁的构造和操作的许多细节可见于名称为“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，其全部公开内容据此以引用方式并入本文。关于该关节运动锁的其他细节也可以在2016年2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中找到，其全部公开内容据此以引用方式并入本文。
主要参见图3至图5，击发构件1760被构造成能够与滑动件组件1120可操作地交接，该滑动件组件可操作地支撑在外科钉仓1110的仓体1111内。滑动件组件1120在外科钉仓主体1111内可滑动地从邻近仓体1111的近侧端部1112的近侧原始位置移位到邻近仓体1111的远侧端部1113的终止位置。
钉凹坑或腔1116在居中设置的狭槽1114的每一侧上成排对准。腔1116穿过仓体1111的上平台表面1115。居中设置的狭槽1114使击发构件1760能够从其中通过，并切割夹持在砧座1130与钉仓1110之间的组织。直接驱动的外科钉或紧固件1126(参见图5)定位在每个钉腔1116中。主要参见图5，钉1126是平坦形的钉，其可以例如从材料片切割和/或冲压而成。例如，材料片可为金属的，并且可包括不锈钢和/或钛。在至少一个实例中，可将轮廓描画、蚀刻和/或切割到材料片中，对该材料片进行加工和/或激光切割以使直接驱动钉1126成形为制造的形状。
钉1126包括一对钉腿以及钉腿从其延伸的钉基部部分或冠部。每个钉腿包括钉尖端或穿刺部分，该钉尖端或穿刺部分被构造成能够穿刺组织并且接触外科缝合器械的砧座的对应成形凹坑1128(参见图6)。钉腿被构造成能够改变形状以实现成形构型，从而紧固组织。钉基部分限定第一平面，并且钉腿限定第二平面，该第二平面从该第一平面侧向地偏移，但至少基本上平行于该第一平面。在其他实例中，第一平面和第二平面可以不平行。
钉1126包括基部部分或冠部上的驱动表面。驱动表面构造成从滑动件组件1120接纳驱动力。当滑动件组件1120朝远侧平移穿过钉仓1110时，滑动件组件1120接触驱动表面以将钉1126提升到钉仓1110之外并将钉1126形成为其击发构型。诸如钉1126的直接驱动钉在2015年8月26日提交的名称为“SURGICAL STAPLES FOR MINIMIZING STAPLE ROLL”的美国专利申请序列号14/836,324中进一步描述，该专利申请全文以引用方式并入本文。
滑动件组件1120包括多个倾斜或楔形凸轮1122，其中每个凸轮1122与位于居中设置的狭槽1114一侧上的特定一排钉1126。当击发构件1760被击发或朝远侧驱动时，击发构件1760也将滑动件组件1120朝远侧驱动。当击发构件1760朝远侧移动穿过钉仓1110时，组织切割特征部1766切割夹持在砧座组件1130与钉仓1110之间的组织，并且滑动件组件1120在钉仓1110中将钉1126向上驱动并使其与砧座组件1130形成接触。
击发构件1760限定I形梁结构，该I形梁结构包括下凸缘1764、上凸缘1762和在凸缘1762和1764之间延伸的支撑部分1763。上凸缘1762由从支撑部分1763延伸的水平销构成。下凸缘1764由在支撑部分1763的基部处的扩大或加宽的脚部构成。组织切割特征部1766由凸缘1762和1764之间的支撑部分1763支撑。支撑部分1763被构造成能够穿过细长通道1102、钉仓1110和砧座1130中的对准的狭槽行进。例如，支撑部分1763延伸穿过细长通道1102中的居中设置的纵向通道狭槽1104，使得下凸缘1764可移动地定位在由细长通道1102限定的通路1106(参见图10和11)内。例如，通路1106可以限定在细长通道1102的仓支撑基部1101下方。
支撑部分1763还延伸穿过砧座1130中的居中设置的砧座狭槽1132，使得上凸缘1762可移动地定位在由砧座1130限定的通路1136(参见图10和11)内。例如，通路1136可以被限定为穿过砧座1130。I形梁凸缘1762和1764提供凸轮传动表面，其分别与细长通道1102和砧座1130交接，以打开和夹紧或闭合钳口，如本文进一步所述。此外，击发构件1760被构造成能够沿端部执行器1100的长度在细长通道1102和砧座1130之间保持恒定距离，以确保适当的组织间隙。
现在主要参见图6，砧座1130包括向下延伸的侧壁1133，通常称为“组织止挡件”。组织止挡件1133被构造成能够阻止目标组织在砧座1130和钉仓1110之间过于靠近(参见图3至图5)。例如，组织止挡件1133朝钉仓1110延伸(参见图3)。当砧座1130朝钉仓1110闭合时，砧座1130的任一侧上的组织止挡件1133向下延伸经过仓平台表面1115并形成壁或屏障，这防止组织定位成在砧座1130和钉仓1110之间过于靠近。附加地或另选地，细长通道1102可包括向上延伸的组织止挡件，用于阻挡近侧组织。
砧座1130还包括内导轨1135，该内导轨朝钉仓1110向下延伸。内导轨1135平行于组织止挡件1133延伸并且定位在组织止挡件1133的侧向内侧。内导轨1135被构造成能够在砧座1130相对于细长通道1102枢转时相对于细长通道1102引导砧座1130。例如，内导轨1135可以嵌套在细长通道1102的侧壁1103内，并且当砧座1130朝闭合位置枢转时，组织止挡件1133可以定位在细长通道1102的侧壁1103的外侧。在各种情况下，当砧座1130接近钉仓1110时，内导轨1135可以在细长通道1102的侧壁1103的内表面附近滑动或移动，以确保砧座1130保持与细长通道1102和安装在其中的钉仓1110正确对准。
砧座1130中的狭槽1132从砧座1130的近侧端部延伸到远侧端部。主要参见图6，狭槽1132和通路1136延伸到砧座1130的远侧端部处的t形开口1129，其可以为击发构件1760提供组装路径。例如，击发构件1760可以在t形开口1129处从远侧端部插入砧座1130中，并且在钉仓1110插入细长通道1102之前朝近侧回缩到原始位置。
现在主要参见图7，细长通道1102包括侧壁1103和限定在每个侧壁1103的近侧部分中的销孔1108。细长通道1102还包括板1105，该板附接到细长通道1102的仓支撑基部1101的下侧。例如，板1105可以被激光焊接到细长通道1102，并且可以增加细长通道1102的结构完整性。例如，板1105可被构造成能够在缝合操作期间防止和/或限制细长通道1102的弯曲、扭转和/或变形。板1105定位在纵向通道狭槽1104的一部分上方，并且可以限定穿过细长通道1102的通路1106。例如，用于下凸缘1764的通路1106可由板1105和仓支撑基部1101限定。板1105中的开口1107沿其长度定位，以在击发冲程期间击发构件1760横穿纵向通道狭槽1104时提供对击发构件的观察。例如，操作者可以在整个击发冲程中通过开口1107观察击发构件1760的进程。
现在主要参见图8至图12，示出了用于端部执行器1100的枢转接头1150。枢转接头1150包括枢轴销1152(参见图8)，砧座1130在该枢轴销处相对于细长通道1102枢转。尽管图8中仅示出了单个枢轴销1152，读者将容易理解，对称的枢轴销1152位于端部执行器1100的相对侧上。对称枢轴销1152在图5中示出。枢轴销1152延伸穿过砧座1130的每一侧上的孔1131并且延伸到细长通道1102的每个相应侧上的销孔1108中。例如，枢轴销1152可以被压入开孔1131中。在击发冲程开始时，击发构件1760被构造成能够从初始位置或原始位置朝远侧移动(图10)。当击发构件1760朝远侧移动时，砧座1130由击发构件1760的I形梁结构朝夹紧构造枢转。更具体地，击发构件1760的下凸缘1764移动穿过由细长通道1102限定的通路1106，并且上凸缘1762沿砧座1130的斜坡表面1134移动，然后穿过由砧座1130限定的通路1136。
主要参见图10和图11，斜坡表面1134在砧座1130中限定开闭腔1148，击发构件1760的一部分在击发冲程的一部分期间延伸穿过该腔。例如，上凸缘1762在击发冲程的一部分期间经由开闭腔1148从砧座1130突出。斜坡表面1134沿近侧开放表面1142向下倾斜，沿中间部分1138延伸，并沿远侧闭合斜坡1140向上倾斜。当击发构件1760处于初始位置或原始位置时(参见图10)，上凸缘1762与中间部分1138间隔开。换句话讲，上凸缘1762不与开闭腔1148经凸轮接合。在原始位置，击发构件1760可相对于开闭腔1148停留或悬停，使得击发构件1760既不会向砧座1130施加打开力，也不会向其施加闭合力。
从原始位置(参见图10)，击发构件1760可朝近侧回缩。击发构件1760的回缩位置在图11中示出。随着击发构件1760继续朝近侧移动，击发构件1760的与近侧开放表面1142接合的上凸缘1762被构造成能够在近侧开放表面1142上施加打开力。随着上凸缘1762抵靠近侧开放表面1142移动，近侧开放表面1142枢转，这引起砧座1130的枢转打开动作。近侧开放表面1142定位在枢转接头1150的近侧。因此，当上凸缘1762在近侧开放表面1142上施加向下的力时，砧座1130由近侧开放表面1142上的杠杆作用被向上推动。
斜坡表面1134还包括在中间部分1138和近侧开放表面1142之间的圆角1144。在某些实例中，开闭腔1148的近侧端部可包括开放斜坡，其可延伸到突出的尾部。击发构件1760的上凸缘1762可被构造成能够经凸轮接合开放斜坡和/或突出的尾部，以产生用于端部执行器1100的打开动作。在某些实例中，上凸缘1762还可以包括朝近侧延伸的凸台，该凸台可被构造成能够产生额外的打开动作，如本文进一步所述。
从回缩位置(参见图11)，击发构件1760可朝远侧推进以返回到原始位置(参见图10)。为了闭合端部执行器，击发构件1760可以进一步从原始位置推进到图12中所示的推进位置。对于在回缩位置和推进位置中间的击发动作的一部分，上凸缘1762与斜坡表面1134间隔开。例如，当击发构件1760在闭合动作(参见图12)和打开动作(参见图11)之间转移时，上凸缘1762悬停或停留在中间部分1138上方。例如，击发动作的停留部分可被构造成能够防止打开动作和/或闭合动作的卡住。
击发构件1760移动成与斜坡表面1134及其远侧闭合斜坡1140接触，处于图12所示的推进位置。随着击发构件1760朝远侧推进，上凸缘1762沿远侧闭合斜坡1140移动，以相对于细长通道1102夹紧砧座1130。远侧闭合斜坡1140定位在枢转接头1150的远侧。因此，当上凸缘1762在远侧闭合斜坡1140上施加向下的力时，砧座1130被向下推动。
随着击发构件1760继续朝远侧推进，上凸缘1762移动穿过通路1136以确保砧座1130和细长通道1102之间沿端部执行器1100长度的恒定距离。例如，通路1136包括下凸缘1137和上盖1139，它们限定通路1136的下限和上限。在击发冲程期间，上凸缘1762被约束在这些下限和上限内。上凸缘1762的尺寸可被设计为紧密配合在通路1136的边界内。在其他实例中，如本文进一步描述的，上凸缘1762可被构造成能够在由通路1136或其一部分提供的间隙内垂直浮动和/或调节。
击发构件1760是多功能击发构件。例如，击发构件1760被构造成能够驱动滑动件组件1120，以便将直接驱动钉1126从钉仓1110击发，切割夹在钳口1102和1130之间的组织，在击发冲程开始时使钳口1102和1130凸轮运动成夹紧构型，以及在击发冲程完成时使钳口1102和1130凸轮运动成打开构型。换句话讲，击发构件1760被构造实现外科功能与单个致动系统的组合。因此，多功能击发构件1760可以使配合在端部执行器1100的占地面积内所需的独立致动系统最小化。
在其他实例中，可互换外科工具组件可包括用于打开和闭合端部执行器的钳口的闭合管。闭合管可以被构造成能够相对于端部执行器平移。例如，当闭合管在端部执行器上平移时，闭合管可被构造成能够使端部执行器的钳口偏置成闭合。在某些实例中，弹簧可被构造成能够将端部执行器的钳口朝打开构型偏置，并且闭合管可以克服弹簧偏置以使钳口闭合。
包括端部执行器7100和远侧闭合管7430的可互换外科工具组件7000在图13至图17中示出。端部执行器7100包括砧座7130和细长通道7102，它们分别类似于砧座1130和细长通道1102。闭合组件7406用于闭合和/或打开端部执行器7100的砧座7130和细长通道7102。闭合组件7406包括中间闭合构件7410和远侧闭合构件7430。中间闭合构件7410和远侧闭合构件7430由上部双枢轴连接件7220联接在一起。
在例示的布置中，远侧闭合构件7430包括相对于端部执行器7100可滑动地支撑的中空管状构件。因此，远侧闭合构件7430在本文中也可称为远侧闭合管。致动外科器械柄部组件500上的闭合触发器512(参见图1和图2)可导致包括远侧闭合管7430的闭合组件7406的轴向移动。闭合弹簧(未示出)也可轴颈连接在闭合组件7406上并且用于将闭合组件7406朝近侧方向“PD”偏置，这可在可互换外科工具组件7000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7406被构造成能够朝远侧(方向DD)平移，以(例如)响应于闭合触发器512的致动而闭合砧座7130。
图13和图14示出了处于闭合位置的砧座7130和细长通道7102(“钳口”)。随着远侧闭合构件7430沿远侧方向DD推进，远侧闭合构件7430的远侧端部7431可被构造能够在形成在砧座安装壁上的闭合凸轮表面和形成在细长通道7102近侧端部上的闭合凸轮表面上行进。当临床医生期望将砧座7130和细长通道7102移动到打开位置时，远侧闭合构件7430沿近侧方向PD移动。包括其远侧闭合管的闭合触发器和闭合组件的致动在同时提交的名称为“SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号15/385,956中有所描述，该专利申请据此全文以引用方式并入本文。
现在主要参见图17，击发构件7760定位在端部执行器7100中。击发构件7760被构造成能够在击发冲程期间平移穿过端部执行器7100，以使滑动件组件7120移动穿过端部执行器7100并切割夹在端部执行器7100的钳口之间的组织。砧座7130包括通路7136，该通路被构造成能够在击发冲程期间接纳击发构件7760的一部分。例如，击发构件7760上的上凸缘可以可移动地定位在通路7136中。
砧座7130还包括通道7138(参见图13和15)，杆7140延伸穿过该通道。主要参见图17，杆7140包括近侧端部7142和远侧端部7144。远侧端部7144被可操作地定位成接合砧座7130的远侧鼻部7150，如本文进一步所述。近侧端部7142可操作地定位成与远侧闭合管7430的远侧端部7431邻接接触。当远侧闭合管7430朝远侧移动以完成砧座7130的闭合时，远侧闭合管7430的远侧端部7431可移动成与杆7140的近侧端部7142邻接接触。因此，在闭合动作完成时，杆7140朝远侧延伸或推动，这导致远侧鼻部7150枢转。主要参见图15至图17，在砧座7130已被远侧闭合管7430移动成闭合构型之后，杆7140被闭合管7430朝远侧推动以使远侧鼻部7150枢转。
再次参见图13和15，通道7138从砧座7130的近侧部分延伸到远侧鼻部7150。远侧鼻部7150在枢转接头7152处可枢转地连接到砧座7130的主体。弹性支撑件7154被构造成能够将远侧鼻部7150保持在线性或非枢转位置(参见图13和图14)。弹性支撑件7154可以是弹性构件或弹簧，诸如片簧或发夹式弹簧。当杆7140朝远侧延伸时，其远侧端部7144接合远侧鼻部7150并克服弹性支撑件7154。例如，杆7140在图15至图17中已延伸以使远侧鼻部7150枢转到枢转位置。在枢转位置时，远侧鼻部7150被构造成能够将组织抵靠钉仓的远侧鼻状部分夹紧。这种夹紧特征部被构造成能够捕获或保持组织的远侧部分并且在击发冲程期间限制组织流动。例如，可以由端部执行器7100在其远侧端部部分施加增加的夹紧压力。
如上所述，在某些实例中，对于击发动作的一部分(参见图10)，击发构件的上凸缘1762可以悬停而不与斜坡表面1134接触。例如，斜坡表面1134可包括在远侧闭合斜坡1140和近侧闭合表面1142之间延伸的中间表面1138。中间表面1124可以将远侧闭合斜坡1140与近侧闭合表面1142分开，使得表面1140和1142是分开且不同的。
例如，尽管闭合触发器512(参见图1和图2)可以在一系列动作内枢转以使击发构件1760移位，但是枢转动作不被构造成能够引起砧座1130的对应枢转动作。换句话讲，在闭合触发器512的一系列动作期间，闭合触发器512的致动与砧座1130的闭合动作和打开动作不成比例。在某些实例中，期望在整个击发动作中向砧座1130提供反馈，即，实现其枢转，包括当上凸缘1762在与远侧闭合斜坡1140接合并与近侧闭合表面1142接合之间悬停在中间表面1138上方时。例如，弹簧组件可被构造成能够在击发冲程的停留部分期间在砧座1130上施加偏置力。
现在参见图54，弹簧组件1160定位在击发构件1760的上凸缘1762的近侧。弹簧组件1160包括管状构件1162和部分地定位在管状构件1162内的压缩弹簧1164。管状构件1162定位在砧座1130中的近侧凹口或凹陷部1149中。例如，砧座1130包括从开闭腔1148朝近侧延伸的近侧凹口1149。弹簧组件1160保持在凹陷部1149中并定位成可操作地接合击发构件1760。
弹簧组件1160被构造成能够在上凸缘1762悬停在中间表面1138上方时实现砧座1130的打开动作。上凸缘1762可被构造成能够当砧座1130处于闭合构型并且击发构件1760处于原始位置时移动成与压缩弹簧1164接触。随着击发构件1760继续朝近侧回缩，击发构件1760可被构造成能够将压缩弹簧1164压缩到管状构件1162中。压缩弹簧1164的压缩被构造成能够在砧座1130上施加力，该力可以对应于砧座1130上的打开力。例如，弹簧组件1160可被构造成能够在凹口1149的面向远侧的表面上施加近侧和向下的力，以实现砧座1130朝打开构型向上枢转。
在各种情况下，压缩弹簧1164可被击发构件1760压缩，直到上凸缘1762移动成与近侧闭合表面1142接合。压缩弹簧1164可以限定弹簧力，该弹簧力足以在上凸缘1762移动成与近侧闭合表面1142邻接接合之前启动砧座1130的打开。在各种情况下，可以调节弹簧力以在击发冲程的停留部分期间提供足够的反馈。在某些实例中，压缩弹簧1164可以被压缩到管状构件1162的高度。当压缩弹簧1164完全压缩在管状构件1162内时，打开动作可以与击发构件1760的近侧位移和闭合触发器512的对应致动动作成比例。
在各种情况下，当砧座1130相对于细长通道1102完全打开时，组织孔口可以限定在砧座1130的形成表面和定位在细长通道1102中的钉仓1110的平台1115之间。当砧座1130完全打开时，组织孔口可以被量化为砧座形成表面与端部执行器1100的远侧端部处的平台1115之间的垂直高度。在某些实例中，可能需要增大组织孔口而不增加砧座1130和细长通道1102之间的角度。在此类情况下，砧座1130的近侧端部可被构造成能够远离细长通道1102移动，以增大远侧端部处的组织孔口。
例如，现在参见图55，细长通道11102包括用于允许砧座1130相对于细长通道11102垂直移动的垂直狭槽11108。细长通道11102在许多方面类似于细长通道1102；然而，细长通道11102包括垂直狭槽11108而不是销孔1108(参见图5)。细长通道11102可以与端部执行器11100一起使用，该端部执行器还包括砧座1130并且被构造成能够接纳钉仓1110。砧座1130由枢轴销11152可枢转地连接到细长通道11102，枢轴销由弹簧11154可操作地接合。弹簧11154被构造成能够使垂直狭槽11108中的枢轴销11152向下偏置。图55中示出的弹簧11154是片簧；然而，读者将容易理解，可以使用另选的弹簧几何形状和构造。当枢轴销11152定位在垂直狭槽11108的底部时，端部执行器11100限定第一组织孔口。当枢轴销11152被允许向上移动到垂直狭槽11108的顶部时，端部执行器11100限定第二较大的组织孔口。
在各种情况下，当击发构件朝近侧回缩成不与砧座1130上的远侧闭合斜坡1140接合时，可允许枢轴销11152克服弹簧11154并在垂直狭槽11108中向上“弹出”或弹起。例如，枢轴销11152被构造成能够当击发构件移动成停留或悬停在砧座1130上的中间表面1138上方时，在垂直狭槽11108中向上转移。仍参见图55，击发构件11760被构造成能够将枢轴销11152向上提升。例如，击发构件11760在许多方面类似于击发构件1760；然而，击发构件11760包括楔形突起部11770，这些突起部具有斜坡表面11772，用于在垂直狭槽11108中接合和向上提升枢轴销11152。尽管在图55中仅示出了单个楔形突起部11170，读者将容易理解，一对对称的楔形物11170定位在击发构件11760的相对侧上。
当击发构件11760朝近侧回缩以在砧座1130上施加打开动作时，砧座1130被构造成能够远离细长通道11102垂直地转移以增大组织孔口。此外，当击发构件11760在随后的闭合动作期间朝远侧推进时，楔形突起部11770被构造成能够移动成不与枢轴销11152接合，使得弹簧11154可使枢轴销11152返回其在垂直狭槽11108底部的初始位置。在各种情况下，枢轴销11152被构造成能够在击发构件11760的上凸缘接合砧座1130的远侧闭合斜坡1140之前返回到垂直狭槽11108的底部，以影响其闭合。
在某些实例中，端部执行器可被构造成能够在一定厚度范围内夹紧和缝合组织。端部执行器可以在第一外科功能期间夹持具有第一厚度的组织，并且可以在第二外科功能期间夹持具有不同厚度的组织。在某些外科功能中，夹在端部执行器钳口之间的组织厚度可以是恒定的或基本上恒定的。在其他实例中，端部执行器可以被构造成能够夹紧和缝合具有改变或变化的厚度的组织。例如，夹在端部执行器钳口之间的组织厚度可沿端部执行器的长度纵向变化。
如本文所述，击发构件可包括用于设定端部执行器钳口之间的组织间隙的凸缘。例如，上凸缘可被构造成能够沿砧座中的通道移动，并且下凸缘可被构造成能够在击发冲程期间沿细长通道中的一个通道移动。击发构件的凸缘包括凸轮传动表面，这些凸轮传动表面被构造成能够接合相应通道的内表面以限制钳口之间的组织间隙。例如，凸缘可以限定钳口之间的最大和/或最小间距，这等于限制安装在端部执行器中的钉仓上的组织接触平台与端部执行器的面向组织的砧座之间的间距。在某些实例中，由击发构件凸缘限定的最大和最小间距可以是固定的。在其他实例中，凸缘中的一个或两个可以被构造成能够浮动或转移以适应组织厚度的变化。例如，凸缘可在击发冲程或其一部分期间转移。
现在参见图18至图21，示出了击发构件8760的上部部分。击发构件8760在许多方面类似于击发构件1760(参见图4和图5)。例如，击发构件8760限定I形梁结构，该I形梁结构包括下凸缘(未示出)、上凸缘8762和在下凸缘和上凸缘8764之间延伸的支撑部分8763。上凸缘8762由从支撑部分8763延伸的水平销构成。例如，下凸缘可以与下凸缘1764(参见图4和5)相同。组织切割特征部8766由凸缘之间的支撑部分8763支撑。
支撑部分8763被构造成能够穿过细长通道、钉仓和砧座中的对准的狭槽行进。例如，击发构件8760可以与端部执行器1100(参见图1至图5)兼容，使得支撑部分8763穿过细长通道1102、钉仓1110和砧座1130中的对准的狭槽行进。类似于击发构件1760，当击发构件8760被朝远侧击发或驱动时，击发构件8760被构造成能够也朝远侧驱动滑动件组件。并且，当击发构件8760朝远侧移动穿过钉仓时，组织切割特征部8766被构造成能够随着滑动件组件在钉仓1110中向上驱动钉并形成与砧座1130接触而切割由端部执行器1100夹持的组织。
击发构件8760包括沿支撑部分8763的上部部分延伸的狭槽8761。狭槽8761为楔形狭槽，并且狭槽8761的高度沿击发构件8760的长度纵向变化。更具体地，狭槽8761在近侧端部8765处的高度大于在远侧端部8767处的高度。在其他实例中，狭槽8761的高度可为恒定的，但狭槽8761可沿击发构件8760的长度倾斜取向、倾斜和/或非水平。狭槽8761包括上边缘8768，该上边缘限定最大组织间隙。如本文所述，上凸缘或销8762被构造成能够在狭槽8761中移动以调节组织间隙。此外，当负载被施加到上部销8762时，上部销8762被构造成能够随着上部销8762在狭槽8761中移动而沿上边缘8768滑动。
主要参见图18A，上部销8762包括中心沟槽8770，其引导狭槽8761内的上部销8762。例如，上边缘8768被构造成能够当上部销8762定位在狭槽8761中时延伸到沟槽8770中。在其他实施方案中，上部销8762可包括引导块，其可在支撑部分8763的一侧或两侧上固定到销8762上。中心沟槽8770和/或引导块可被构造成能够防止在击发冲程期间以及上部销8762在狭槽8761中移动时上部销8762的扭转或扭结。例如，引导块可以焊接到销8762上。在其他实例中，一个或多个引导块可以固定到支撑部分8763。
击发构件8760的第一或初始构型在图19中示出。上部销8762在第一构型中凭借摩擦保持就位。例如，上部销8762可以被压缩和压配合在狭槽8761内。处于第一构型时，上部销8762定位在狭槽8761的远侧端部8767附近。第一高度H1限定在当击发构件8760处于第一构型时的上部销8762和下凸缘之间。更具体地，第一高度H1限定在下凸缘的上表面和上部销8762的下表面之间。第一高度H1对应于由击发构件8760限定的最小组织间隙。
仍参见图19，狭槽8761的上边缘8768沿向内轮廓延伸。换句话讲，上边缘8768限定压缩半径R。上边缘8768的向内轮廓向上部销8762施加压缩力，该压缩力试图将上部销8762抵靠远侧端部8767保持在狭槽8761中的最远侧位置。
现在参见图20，在击发冲程期间，力F可以被施加到上部销8762。例如，当组织夹在端部执行器的钳口之间时，组织可被钳口压缩。因此，压缩的组织被构造成能够在钳口上施加打开力，并且这种力被施加到击发构件8760的上部销8762和下凸缘。当被夹紧的组织经历增大的压缩时，诸如当较厚的组织被夹在钳口之间时，力F更大。图20中的力F足以使上边缘8768的向内轮廓偏转，这使得击发构件8760的上边界偏转并且减轻了在狭槽8761中的上部销8762上的压缩。力F等于或大于使上边缘8768偏转并释放上部销8762所需的阈值力。在图20中，上部销8762上的力F使击发构件8760移动到压力构型。
因为上部销8762已经被力F释放，所以上部销8762在狭槽8761内沿近侧方向(PD)自由滑动(参见图20)。例如，上部销8762已经移动到图21中的近侧上部位置。在图21的近侧上部位置，第二高度H2限定在上部销8762和下凸缘之间。更具体地，第二高度H2限定在下凸缘的上表面和上部销8762的下表面之间。第二高度H2对应于最大组织间隙或当击发构件8760处于适应构型时的组织间隙。在此类情况下，击发构件8760被构造成能够在击发冲程的第二部分期间允许更大的组织间隙。如本文所述，在某些实例中，可能期望在击发冲程的初始部分期间进一步限制最大组织间隙，此时负载可以是最高的以防止击发构件8760卡住。
上部销8762被构造成能够当等于或大于阈值力的力施加到上部销8762时转移到图21中所示的近侧上部位置。因为力F在上部销8762上向上施加，力F使上部销8762沿狭槽8761的上边缘8768偏置并保持沟槽8770和上边缘8768的对准。因此，击发构件8760被构造成能够调节或适应组织厚度的变化。
在其他实例中，击发构件8760可被构造成能够限定在击发冲程的远侧部分期间减小的组织间隙。在此类情况下，可以增大端部执行器远侧端部处的压缩。例如，狭槽8761的上表面8768可朝击发构件8760的近侧端部向下倾斜，使得狭槽8761的高度在狭槽8761的远侧端部8767处最大，而不是如图19至图23所示。
现在参见图21A，上部销8762以加载构型示出。为了将上部销8762装载到狭槽8761中，上部销8762可以与狭槽8761的最大或最高部分对准，该部分位于近侧端部8765处。上部销8762可以从近侧端部8765朝远侧端部8767滑动，使得上边缘8768突出到上部销8762中的中心沟槽8770中并且将上部销8762限制在狭槽8761中。例如，当击发构件8760朝远侧推进时，上部销8762被构造成能够朝远侧端部8767滑动并成为图19所示的构型。上部销8762上的第一负载可以使上部销8762朝远侧偏置并且在远侧端部8767处进入压缩状态，并且上部销8762上的第二较大负载可以使击发构件8760变形以释放上部销8762中的压缩并允许其朝近侧滑动，如本文所述。
尽管已经描述击发构件8760具有单个浮动凸缘，即上凸缘8762，但在其他实例中，下凸缘也可以被构造成能够当其被施加有等于或大于第二阈值力的力时浮动和/或转移。例如，上凸缘8762可被构造成能够在由压缩组织施加第一力时转移，并且下凸缘可被构造成能够在由压缩组织施加第二较大力时转移。在其他实例中，只有下凸缘可以被构造成能够转移和/或浮动。
现在参见图22至图23，示出了击发构件9760的上部部分。击发构件9760在许多方面类似于击发构件1760(参见图4和图5)。例如，击发构件9760限定I形梁结构，该I形梁结构包括下凸缘、上凸缘9762和在下凸缘和上凸缘9764之间延伸的支撑部分9763。上凸缘9762由从支撑部分9763延伸的水平销构成。例如，下凸缘可以与下凸缘1764(参见图4和5)相同。组织切割特征部9766由凸缘之间的支撑部分9763支撑。
支撑部分9763被构造成能够穿过细长通道、钉仓和砧座中的对准的狭槽行进。例如，击发构件9760可以与端部执行器1100(参见图1至图5)兼容，使得支撑部分9763穿过细长通道1102、钉仓1110和砧座1130中的对准的狭槽行进。类似于击发构件1760，当击发构件9760被朝远侧击发或驱动时，击发构件9760被构造成能够也朝远侧驱动滑动件组件。并且，当击发构件9760朝远侧移动穿过钉仓时，组织切割特征部9766被构造成能够随着滑动件组件在钉仓中向上驱动钉并与砧座形成接触而切割由端部执行器夹持的组织。
击发构件9760包括沿支撑部分9763的上部部分延伸的狭槽9761。狭槽9761为楔形狭槽，并且狭槽9761的高度沿击发构件9760的长度纵向变化。更具体地，狭槽9761在近侧端部9765处的高度大于在远侧端部9767处的高度。附加地或另选地，狭槽9761可以倾斜地取向、倾斜和/或非水平，使得远侧端部9767高于近侧端部9765。狭槽9761包括上边缘9768，该上边缘限定最大组织间隙。如本文所述，上凸缘或销9762被构造成能够在狭槽9761中移动以调节组织间隙，并且当上部销9762在狭槽9761中移动时上部销9762沿上边缘9768滑动。击发构件9760还包括弹簧9769，该弹簧被构造成能够在上部销9762上施加偏置力。
上部销9762包括中心沟槽9770，其引导狭槽9761内的上部销9762。例如，上边缘9768被构造成能够当上部销9762定位在狭槽9761中时延伸到沟槽9770中。在所示的实施方案中，上部销9762包括固定到支撑部分9763的两侧的引导块9780。引导块9780可被构造成能够防止在击发冲程期间以及上部销9762在狭槽9761中移动时上部销9762的扭转或扭结。在其他实例中，一个或多个引导块可以被固定到上部销9762，并且在其他实例中，击发构件9760可以不包括引导块。
击发构件9760的第一或初始构型在图22中示出。上部销9762被弹簧9769保持就位。例如，弹簧9769被构造成能够将上部销9762朝狭槽9761的远侧端部9767偏置。第一高度H1限定在当击发构件9760处于第一构型时的上部销9762和下凸缘之间。更具体地，第一高度H1限定在下凸缘的上表面和上部销9762的下表面之间。第一高度H1对应于最小组织间隙。
仍参见图22，当组织夹在端部执行器的钳口之间时，组织可被钳口压缩。因此，压缩的组织可在钳口上施加打开力，并且这种力被施加到击发构件9760的上部销9762和下凸缘。当被夹紧的组织经历增大的压缩时，诸如当较厚的组织被夹在钳口之间时，力F更大。当力F等于或大于阈值力时，该力F可以构造成克服弹簧9769的偏置，如图23所示。例如，力F足以使弹簧9769变形为压缩构型并允许上部销9762沿狭槽9761朝其近侧端部9765移动。
上部销9762已经移动到图23中的近侧上部位置。在图23的近侧上部位置，第二高度H2限定在上部销9762和下凸缘之间。更具体地，第二高度H2限定在下凸缘的上表面和上部销9762的下表面之间。第二高度H2对应于最大组织间隙或当击发构件9760处于适应构型时的组织间隙。因为力F(图22)在上部销9762上向上施加，力F使上部销9762沿狭槽9761的上边缘9768偏置并保持沟槽9770和上边缘9768的对准。因此，击发构件9760被构造成能够调节或适应组织厚度的变化。
尽管已经描述击发构件9760具有单个浮动凸缘，即上凸缘9762，但在其他实例中，下凸缘也可以被构造成能够当其被施加有等于或大于第二阈值力的力时浮动和/或转移。例如，上凸缘9762可被构造成能够在由压缩组织施加第一力时转移，并且下凸缘可被构造成能够在由压缩组织施加第二较大力时转移。在其他实例中，只有下凸缘可以被构造成能够转移和/或浮动。
如本文所述，击发构件可包括至少一个浮动凸缘，其可被构造成能够在阈值力施加到其时转移或移动以适应组织厚度的变化。在某些实例中，该浮动凸缘可以定位在狭槽中并且可以被偏置和/或保持在初始构型，直到阈值力施加到其。在其他实例中，击发构件的一部分可包括可变形或柔顺材料，其可被构造成能够在阈值力施加到其时弯曲或以其他方式变形。在某些实例中，击发构件的柔顺芯可以支撑被构造成能够在被施加有阈值力时转移或移动的至少一个凸缘。
现在参见图24至图26，示出了包括端部执行器10100的可互换外科工具组件10000的一部分。端部执行器10100包括细长通道1102和砧座1130，并且钉仓1110安装在细长通道1102中。端部执行器10100还包括击发构件10760，该击发构件在许多方面类似于击发构件1760(参见图4和图5)。例如，击发构件10760限定I形梁结构，该I形梁结构包括下凸缘10764、上凸缘10762和在下凸缘和上凸缘10762之间延伸的支撑部分10763。上凸缘10762由从支撑部分10763延伸的水平销构成。下凸缘10764由在支撑部分10763的基部处的扩大或加宽的脚部构成。组织切割特征部10766由凸缘10762和10764之间的支撑部分10763支撑。
支撑部分10763被构造成能够穿过细长通道1102、钉仓1110和砧座1130中的对准的狭槽行进。类似于击发构件1760，当击发构件10760被朝远侧击发或驱动时，击发构件10760被构造成能够也朝远侧驱动滑动件组件1120。并且，当击发构件10760朝远侧移动穿过钉仓时，组织切割特征部10766被构造成能够随着滑动件组件1120在钉仓1110中向上驱动钉1126(参见图5)并形成与砧座1130接触而切割由端部执行器10100夹持的组织。
仍参见图24至图26，击发构件10760包括主体10772和嵌入在主体10772中的柔顺部分或芯10770。例如，主体10772包括切口或腔10774，柔顺部分10770定位在切口10774中。柔顺部分10770包括上凸缘10762。如本文进一步描述，上凸缘10762被构造成能够随着柔顺部分10770变形而转移或移动。
主体10772的弹性可以小于柔顺芯10770的弹性。在某些实例中，柔顺芯10770可以由形状记忆材料形成，诸如镍钛合金，其可以在其整个垂直弯曲范围内提供恒定的弹性比率。此外，击发构件10760的主体10772可以由非柔顺或基本上不太柔顺的材料形成，诸如不锈钢或钛。
柔顺部分10770包括第一端部10776和第二端部10778。第一端部10776保持或固定在主体10772中的切口10774中。例如，切口10774可以牢固地包封第一端部10776，以防止第一端部10776在主体10772内移动。第二端部10778支撑上凸缘10762。例如，上凸缘10762可以与第二端部10778一体形成和/或可以牢固地连接到该第二端部。第二端部10778在切口10774内设有间隙10780，以允许第二端部10778在其中受控偏转。例如，第二端部10778和支撑在其上的上凸缘10762被构造成能够响应于施加到上凸缘10762的力而相对于第一端部10776和相对于下凸缘10764转移。上凸缘10762的移动受到切口10774和限定在砧座1130中的通路1136的几何结构的限制。
如关于击发构件1760(参见图4和图5)所描述的，击发构件10760被构造成能够接合砧座1130的开闭腔1148以使砧座1130移动到夹紧位置。例如，击发构件10760的上凸缘10762被构造成能够沿砧座1130的远侧闭合斜坡1140(参见图8至图12)移动并进入通路1136。通路1136包括下凸缘1137和上盖1139，它们限定通路1136的下限和上限。
在图24中，击发构件10760已经从原始位置朝远侧移位到第一中间位置。在原始位置和第一中间位置之间，上凸缘10762已经沿远侧闭合斜坡1140移动，以使砧座1130朝钉仓1110枢转并将组织夹在其间。仍参见图24，第一负载被施加到击发构件10760的上凸缘10762。第一负载可对应于由端部执行器10100夹紧的组织的第一厚度、密度和/或韧性。
当第一负载被施加到上凸缘10762时，柔顺部分10770被构造成能够呈现图24中所示的构型。具体地，柔顺部分10770的第二端部10778在通路1136的下凸缘1137和上盖1139之间分开。间隙10780的一部分在第二端部10778上方，间隙10780的另一部分在第二端部10778下方。在此类情况下，上凸缘10762限定中间组织间隙，该中间组织间隙在可互换外科工具组件10000处于第一中间位置时允许的最小和最大组织间隙之间。
在图25中，击发构件10760已经从第一中间位置(参见图24)朝远侧推进到第二中间位置，并且第二负载被施加到击发构件10760的上凸缘10762。第二负载小于第一负载并且可以对应于由端部执行器10100夹紧的组织的第二厚度、密度和/或韧性，其分别小于第一厚度、密度和/或韧性。例如，第二负载可以小于第一负载，因为组织更薄。
当第二负载被施加到上凸缘10762时，柔顺部分10770被构造成能够呈现图25中所示的构型。具体地，柔顺部分10770的第二端部10778被定位成抵靠通路1136的下凸缘1137，而间隙10780位于第二端部10778上方。在此类情况下，上凸缘10762限定最小组织间隙。为了呈现图25的构型，柔顺部分10770已经收缩以将第二端部10778拉向固定的第一端部10776。柔顺部分10770的收缩可受到其材料、下凸缘1137的位置和/或限位销10768的限制，这将在本文中进一步描述。
在图26中，击发构件10760已经从第二中间位置(参见图25)朝远侧移位到第三中间位置，并且第三负载被施加到击发构件10760的上凸缘10762。第三负载大于第一负载和第二负载，并且可以对应于由端部执行器10100夹紧的组织的第三厚度、密度和/或韧性，其分别大于第一厚度、密度和/或韧性并且分别大于第二厚度、密度和/或韧性。例如，第三负载可以大于第一负载和第二负载，因为组织更厚、更密和/或更柔韧。
当第三负载被施加到上凸缘10762时，柔顺部分10770被构造成能够呈现图26中所示的构型。具体地，柔顺部分10770的第二端部10778被定位成抵靠通路1136的上盖1139，而间隙10780位于第二端部10778下方。在此类情况下，上凸缘10762限定最大组织间隙。为了呈现图26的构型，柔顺部分10770已经被拉伸或延长以将第二端部10778拉离固定的第一端部10776。柔顺部分10770的延伸可受到其材料、上盖1139的位置和/或限位销10768的限制，这将在本文中进一步描述。
击发构件10670还包括第一侧向突出的凸耳或限位销10768，其被构造成能够在砧座1130的通路1136中移动。限位销10768被构造成能够在击发冲程的一部分期间限制组织间隙。限位销10768相对于支撑部分10763固定，并且被构造成能够在击发冲程的至少一部分期间在通路1136中移动。当限位销10768沿砧座凸部1137(参见图24)行进时，限位销10768被构造成能够限制最大组织间隙。当限位销10768沿上盖1139行进时，限位销10768被构造成能够限制最小组织间隙。例如，尽管上凸缘10762可相对于支撑部分10763移动，但上凸缘10762的位移受到限位销10768在通路1136内的固定位置的限制。
在各种情况下，限位销10768可以侧向突出第一距离，该第一距离可以小于上凸缘10762的侧向突出距离。换句话讲，限位销10768可以比上凸缘10762窄。另外，砧座1130中的狭槽1132(其提供到通路1136的入口)可以在砧座1130的一部分中更宽。在此类情况下，较短的限位销10768可以在砧座凸部1137下方延伸，而不限制击发冲程的一部分期间的最大组织间隙。
在所示的实施方案中，限位销10768在击发冲程的初始近侧部分期间定位在通路1136内(参见图24)，并且在击发冲程的稍后的远侧部分期间在砧座凸部1037下方突出(参见图26)。更具体地，在击发冲程的近侧部分和击发冲程的远侧部分之间，狭槽1132加宽，使得固定销不被限制在通路1136内，然而，较宽的上凸缘1762可以保持限制在通路1136内。在各种情况下，狭槽1132可以在距近侧起始点的距离的三分之一处或约三分之一处加宽到比限位销10768更大。在其他实例中，狭槽1132可以在距近侧起始点的距离的三分之一之前或之后加宽到比限位销10768更大。
在各种情况下，可能希望在击发冲程的初始部分期间限制最大组织间隙。例如，在通过厚的、致密的和/或柔韧的组织的击发冲程开始时，击发构件10760上的负载可以较大并且可以使上凸缘10762偏置离开下凸缘10764最大距离。在此类情况下，为了在击发冲程的初始部分期间确保击发构件10760在最高负载被施加在击发构件10760上时不会卡住或以其他方式禁用，可以通过固定限位销10769和下凸缘10764之间的距离来控制最大组织间隙。此后，当击发构件10760上的负载随着组织被切割刃10766切割而减小时，限位销10768可以脱离接合通路1136及其砧座凸部1137，以允许额外的或增大的最大组织间隙，这可以通过浮动的上凸缘10762来控制。
击发构件10760还包括第二侧向突出的凸耳10769，其可操作地被构造成能够接合细长通道1102。例如，侧向突出的凸耳10769被构造成能够沿细长通道1102中的内表面(例如，沿仓支撑基部1101)行进以进一步控制组织间隙。附加地或另选地，侧向突出的凸耳10769可以被构造成能够接合闭锁装置，诸如闭锁装置6180(参见图45至图53)，这将在本文中进一步描述。
在击发冲程期间，钉可被击发到组织中，并且组织可被切割元件切割。在击发冲程完成时，钉排可以被定位在切割线的两侧，并且钉排可以在切割线的两侧提供组织密封。为了使出血最小化，可以在切割元件切割组织之前击发钉。在此类情况下，钉可以提供组织密封直到密封件之间的组织被切割元件切断。
在某些实例中，防止外科器械实施击发冲程是有利的。例如，如果端部执行器缺少钉仓，则防止击发冲程可能是有利的，因为这样的击发冲程可导致组织被切割元件切割但不被钉密封。相似地，当空的或用过的钉仓被安装在端部执行器中时，防止击发冲程可能是有利的，因为这样的击发冲程也会导致组织被切割元件切割但不被钉密封。
可以为外科器械提供各种特征部来在某些实例中防止击发冲程。这些特征部通常被称为“闭锁件”并且可以定位在例如柄部、轴、可互换外科工具组件、端部执行器和/或钉仓中。参见图27至图29，示出了具有闭锁装置2180的端部执行器2100。端部执行器2100包括细长通道2102，其在许多方面类似于细长通道1102(参见图3至图5)。例如，细长通道2102包括从仓支撑表面或基部2101延伸的一对侧壁2103。细长通道2102被构造成能够在其中可操作地支撑钉仓诸如钉仓1110(参见图3至图5)。端部执行器2100还可包括砧座1130和击发构件1760。
闭锁装置2180包括锁2182，该锁具有第一腿部或插针2181、第二腿部或插针2183，以及第三腿部或插针2185。第一腿部2181和第二腿部2183形成锁2182的V形主体。第三腿部2185从V形主体朝近侧延伸。闭锁枢轴2184被定位在腿部2181、2183和2185中间的中心部。锁2182被构造成能够围绕闭锁枢轴2184在锁定位置(参见图27和图28)和解锁位置(参见图29)之间枢转。闭锁枢轴2184可枢转地安装到细长通道2102的侧壁2103。闭锁装置2180还包括闭锁弹簧2186，该闭锁弹簧被构造成能够作用在锁2182上。尽管在图27至图29中仅示出了一个锁2182和一个闭锁弹簧2186，读者将容易理解，闭锁装置2180可包括对称的锁2182和闭锁弹簧2186。例如，每个锁2182-闭锁弹簧2186对可以定位在击发构件1760的一侧上。在其他实例中，闭锁装置2180可包括单个锁2182和单个闭锁弹簧2186。
第一腿部2181构成砧座接合腿部，当锁2182处于第一取向时，该砧座接合腿部用作用于砧座1130的支撑凸部。第二腿部2183构成钉仓接合腿部，其可由钉仓偏置以将锁2182枢转到解锁位置。第三腿部2185构成弹簧接合腿部或凸块，闭锁弹簧2186将锁2182抵靠该弹簧接合腿部或凸块朝锁定位置偏置。更具体地，闭锁装置2180包括闭锁弹簧2186，其在第三腿部2185上施加向下的力。第三腿部2185上的力被构造成能够将第一腿部2181向上朝砧座1130并朝近侧偏置。闭锁弹簧2186的近侧部分牢固地固定到细长通道2102，并且闭锁弹簧2186的远侧部分被构造成能够相对于其固定的近侧部分偏转。闭锁弹簧2186是片簧；然而，读者将容易理解，可采用另选弹簧将锁2182朝锁定位置偏置。
主要参见图28，锁2182最初被闭锁弹簧2186偏置到锁定位置。当处于锁定位置时，第一腿部2181邻接砧座1130。具体地，第一腿部2181的端部2181a被定位成抵靠砧座1130的内导轨1135。由于第一腿部2181和内导轨2135之间的接合，砧座1130相对于细长通道2102保持在打开取向。即使将闭合动作施加到砧座1130(例如，通过使击发构件1760朝远侧推进)，第一腿部2181和内导轨1135的接合也会防止砧座1130闭合。
锁2182被构造成能够保持在锁定位置，直到未击发的钉仓被安装在细长通道2102中。当钉仓1110定位在细长通道2102中时，如图29所示，钉仓1110的一部分邻接第二腿部2183。更具体地，当钉仓1110未击发时，滑动件组件1120处于近侧位置，并且未击发的滑动件组件1120的近侧端部被定位成抵靠锁2182的第二腿部2183。滑动件组件1120将力F(参见图29)施加到第二腿部2183，这使第二腿部2183向下移位并进入细长通道2102的仓支撑基部2101中的闭锁凹口2109。因为第二腿部2183嵌套在闭锁凹口2109中，所以安装的钉仓1110可以被定位成与细长通道2102的仓支撑基部2101齐平。由滑动件组件1120施加在第二腿部2183上的力F足以克服闭锁弹簧2186的弹簧偏置。
在其他实例中，钉仓1110的另一部分，诸如仓体1111，可以与锁2182邻接。在此类情况下，闭锁装置1280可以是缺少钉仓或无钉仓的闭锁件，其防止端部执行器2100的夹紧直到钉仓安装在其中。然而，当钉仓被安装在端部执行器2100中时，即使钉仓已经被击发，也可以克服闭锁装置。例如，这种缺少钉仓的闭锁件可以与空的或用过的钉仓闭锁件结合。例如，空钉仓闭锁件可以是传感器(例如电子接触传感器)，其检测滑动件组件1120在钉仓1110内的适当位置，并且仅在滑动件组件1120处于适当的击发前位置时才允许击发冲程。
仍参见图29，当第二腿部2183旋转到闭锁凹口2109中时，锁2182枢转到解锁位置。因此，第一腿部2181移动成脱离与内导轨1135的接合。当将闭合动作施加到砧座1130时(例如，通过使击发构件1760朝远侧推进)，砧座1130闭合以向下朝钉仓1110枢转。换句话讲，当未击发的钉仓定位在细长通道2102中时，允许砧座1130闭合。例如，击发构件1760可朝远侧推进，并且上凸缘1762可沿开闭腔1148的远侧闭合斜坡1140移动，以使砧座1130朝闭合位置进行凸轮运动。
当滑动件组件1120定位在图29所示的近侧位置时，滑动件组件1120将锁2182保持在解锁位置。当滑动件组件1120在击发冲程期间朝远侧推进时，锁2182被释放；然而，当砧座1130相对于钉仓1110被夹紧时，内导轨1135防止锁2182旋转回到锁定位置。此后，当砧座1130返回到打开位置时(例如，通过使击发构件1760朝近侧回缩)，闭锁弹簧2186被构造成能够将锁2182往回朝锁定位置偏置(参见图27和28)，这防止随后的闭合和击发冲程，直到将钉仓1110从细长通道2102移除并用具有定位成克服闭锁装置1280的朝近侧定位的滑动件组件的新钉仓替换。
闭锁装置1280防止砧座1130相对于细长通道2102枢转，除非未击发的钉仓1110安装在端部执行器1000中。在各种情况下，砧座1130可以是固定的或静止的，并且细长通道2102可以被构造成能够相对于固定砧座1130枢转。在此类情况下，读者将容易理解，闭锁装置1280可被构造成能够防止细长通道2102相对于砧座1130枢转，除非未击发的钉仓1110安装在端部执行器2100中。
在某些实例中，闭锁件可定位在端部执行器中。例如，闭锁装置2180的锁2182被定位在端部执行器2100的细长通道2102中。在其他实例中，闭锁件可定位在外科器械的轴部分。例如，可互换外科工具组件可包括轴部分和端部执行器部分，并且闭锁件可定位在轴部分中。
图30示出了可互换外科工具组件3000，其在许多方面类似于可互换外科工具组件1000。可互换外科工具组件包括端部执行器3100和轴部分3400。闭锁装置3480被定位在轴部分3400中。可互换外科工具组件3000还包括联接到击发杆3770的击发构件3760。
击发构件3760在许多方面类似于击发构件1760(参见图4和图5)。例如，击发构件3760限定I形梁结构，该I形梁结构包括下凸缘3764、上凸缘3762和在凸缘3762和3764之间延伸的支撑部分3763。上凸缘3762由从支撑部分3763延伸的水平销构成。下凸缘3764由在支撑部分3763的基部处的扩大或加宽的脚部构成。组织切割特征部3766由凸缘3762和3764之间的支撑部分3763支撑。支撑部分3763穿过细长通道3102、钉仓和砧座3130中的对准的狭槽行进。
与砧座1130不同，砧座3130不包括可由击发构件接合以使端部执行器3100的钳口打开和闭合的开闭腔1148。相反，为了将砧座3130打开和闭合，闭合管3430被构造成能够围绕端部执行器3100的一部分平移。闭合管3430的远侧平移被构造成能够使钳口朝夹紧构型进行凸轮运动，并且闭合管3430的近侧位移被构造成能够使钳口朝打开构型进行凸轮运动。闭合管的用于将端部执行器的钳口打开和闭合的操作在本文中进一步描述。
轴部分3400包括可纵向移动的驱动构件3540，其在许多方面类似于驱动构件1602。在击发冲程期间，驱动构件3540将击发动作传递到击发杆3770以将击发构件3760击发。例如，驱动构件3540的致动被构造成能够使击发杆3770和击发构件3760朝远侧移位以切割组织并实现将钉从钉仓击发。然后，驱动构件3540可朝近侧回缩以使击发杆3770和击发构件3760朝近侧回缩。
在某些实例中，驱动构件3540可以直接联接到击发杆3770。其他时间，如图30所示，偏置弹簧3560被定位在驱动构件3540和击发杆3770之间。例如，偏置弹簧3560从击发杆3770朝近侧朝驱动构件3540延伸。在各种情况下，偏置弹簧3560的一端可以联接到击发杆3770，并且偏置弹簧3560的另一端可以联接到驱动构件3540。驱动构件3540包括在其远侧端部处的弹簧孔口3544。弹簧孔口3544被构造成能够接纳和约束偏置弹簧3560的一部分。偏置弹簧3560为卷簧，但读者将容易理解，另选的弹簧几何形状可被构造成能够在驱动构件3540上施加近侧偏置力和在击发杆3770上施加对应的远侧偏置力。
轴部分3400中的闭锁装置3480包括闭锁杠杆3482，该闭锁杠杆具有止动器3484(参见图33和35)和远侧鼻部3486。闭锁杠杆3482的止动器3484被定位成可操作地接合驱动构件3540，并且闭锁杠杆3482的远侧鼻部3486被定位成可操作地接合击发杆3770。具体地，击发杆3770包括具有近侧鼻部3774的近侧复位棘爪3772。近侧复位棘爪3772从击发杆3770的近侧端部朝闭锁装置3480延伸。闭锁杠杆3482上的远侧鼻部3486的倾斜表面和近侧鼻部3774的倾斜表面滑动接合，如本文进一步所述。
闭锁装置3480还包括复位弹簧3450，其可操作地接合闭锁杠杆3482。复位弹簧3450定位成在闭锁杠杆3482上施加力F(参见图30)，以将闭锁杠杆3482朝图30中所示的锁定位置偏置。如本文进一步所述，闭锁杠杆3482被构造成能够围绕枢轴3488旋转以从锁定位置移动到解锁位置(参见图31)。当处于锁定位置时，闭锁杠杆3482的止动器3484(参见图33和35)与驱动构件3540接合。更具体地，止动器3484定位在驱动构件3540中的闭锁凹陷部3542中，使得止动器3484防止驱动构件3540的纵向位移。
仍参见图30，端部执行器3100中缺少钉仓。当钉仓没有定位在端部执行器3100中时，来自复位弹簧3450的力F将闭锁杠杆3482枢转到锁定位置，使得止动器3484(参见图33和35)定位在闭锁凹陷部3542中。因此，防止了驱动构件3540的远侧位移。尽管可以从外科器械的柄部中的致动器(例如，图1和图2中的柄部组件500)向击发构件3540施加击发动作，但是驱动构件3540不会移位并且不会将击发动作传递给击发杆3770和击发构件3760，因为止动器3484保持和/或约束驱动构件3540以防止其远侧位移。
参见图31，钉仓3110被定位在端部执行器3100中。钉仓3110在许多方面类似于钉仓1110。然而，钉仓3110还包括近侧门3120，该近侧门可操作地被构造成能够邻接击发构件3760。参见图32，钉仓3110包括仓体3111和限定在仓体3111中的纵向狭槽3114。纵向狭槽3114从钉仓3110的近侧端部3112延伸。在钉仓3110的近侧端部3112处，近侧门3120延伸跨过纵向狭槽3114。因此，近侧门3120形成用于击发构件3760的易碎或易破裂的阻隔物。
仍参见图32，近侧门3120由纵向狭槽3114的第一侧上的铰链3122连接到仓体3111。近侧门3120在纵向狭槽3114的相对侧上邻接仓体3111。具体地，仓体3111包括切口3124，该切口的尺寸被设计为配合和接纳门3120的一部分。在各种情况下，门3120可以压配合或摩擦配合到切口3124中。附加地或另选地，切口3124可以限定止挡件3126。止挡件3126构成用于门3120的远侧邻接表面或搁架。在各种情况下，仓体3111可以由塑料材料模制而成，切口3124和/或止挡件3126可以是仓体3111的模制特征部。
再次参见图31，当钉仓3110定位在端部执行器3100中时，近侧门3120被定位成抵靠击发构件3760的远侧端部部分。因此，近侧门3120被构造成能够使击发构件3760和击发杆3770朝近侧转移。如图31所示，偏置弹簧3560被构造成能够压缩或以其他方式变形以允许击发构件3760朝驱动构件3540的近侧位移。尽管近侧门3120是易碎的，但近侧门3120被构造成能够承受由压缩的偏置弹簧3560产生的偏置力。
仍参见图31，击发构件3760的近侧位移驱动复位棘爪3772上的近侧鼻部3774朝近侧抵靠闭锁杠杆3482。近侧鼻部3774被构造成能够克服复位弹簧3450，使得闭锁杠杆3482可朝图31中所示的解锁位置枢转。当处于解锁位置时，复位弹簧3450被压缩成与轴部分3400的内表面齐平，并且闭锁杠杆3482上的止动器3484(参见图33和35)从闭锁凹陷部3542脱离。因此，闭锁装置3480允许驱动构件3540的远侧位移。此外，驱动构件3540的传递到击发杆3770和击发构件3760的击发力被构造成能够使钉仓3110上的近侧门3120破裂。
现在参见图33，驱动构件3540已将击发杆3770朝远侧推动，导致击发构件3760破坏或以其他方式释放近侧门3120。破坏或以其他方式释放近侧门3120所需的阈值力可小于由外科器械产生的用于实施击发冲程的力。换句话讲，击发冲程可以被设计成破坏或以其他方式克服近侧门3120。如图34所示，当击发构件3760利用击发冲程的力推压近侧门3120时，近侧门3120可被构造成能够在铰链3122处枢转。在各种情况下，切口3124的止挡件3126可以变形或破裂以释放近侧门3120。例如，如图34所示，止挡件3126的拐角被打破以容纳远侧枢转门3120。
随着在击发冲程期间驱动构件3540朝远侧移动，再次参见图33，击发杆3770及其复位棘爪3772也朝远侧移动。复位棘爪3772的远侧位移使复位棘爪3772移动成脱离与闭锁杠杆3482接合。因此，复位弹簧3450在闭锁杠杆3482上的力被构造成能够将脱离的闭锁杠杆3482偏置回到锁定位置。尽管闭锁杠杆3482已经返回到图33中的锁定位置，但允许完成击发冲程，因为驱动构件3540中的闭锁凹陷部3542从闭锁杠杆3482上的止动器3484纵向地偏移。
在击发冲程完成时，击发构件3760可朝近侧回缩。随着击发构件3760、击发杆3770和驱动构件3540朝近侧移动，驱动构件3540上的斜坡表面3546接合闭锁杠杆3482。例如，斜坡表面3546可以沿闭锁杠杆3482的远侧鼻部3486滑动，以暂时压缩复位弹簧3450并使闭锁杠杆3482抵靠复位弹簧3450枢转。随着驱动构件3540继续朝近侧回缩并且斜坡表面3546移动经过闭锁杠杆3482上的止动器3484，止动器3484可弹性地与驱动构件3540中的闭锁凹陷部3542接合，如图35所示。复位弹簧3450将弹簧力施加在闭锁杠杆3482上以使闭锁装置3480复位。因为止动器3484与闭锁凹陷部3542重新接合并且被复位弹簧3450偏置到这样的位置，所以闭锁装置3480在图35中被复位。换句话讲，闭锁装置3480防止随后的击发冲程。
尽管击发构件3760已经回缩到图35中的原始位置，但击发构件3760略微远离图31中所示的位置。因为近侧门3120在击发冲程期间被克服，所以门3120不再将击发构件3760朝近侧偏置，因此不再使击发杆3770朝近侧偏置。因此，轴部分3400中的闭锁装置3480不能被图35中所示的用过的钉仓3110克服。
虽然已经相对于端部执行器3100描述了闭锁装置3480，但是读者将容易理解，闭锁装置3480也可以与其他端部执行器一起使用，诸如端部执行器1100，该端部执行器利用多功能击发构件来打开和闭合端部执行器钳口、击发钉以及切割组织。
在某些实例中，可互换外科工具组件可包括弹簧，该弹簧被构造成能够将端部执行器的钳口推向闭合位置。例如，这种弹簧可以定位在端部执行器的枢转接头的远侧。在某些实例中，该弹簧可以与闭锁装置相互作用，该闭锁装置在钉仓没有安装在端部执行器中时(即缺少钉仓或无钉仓的闭锁件)防止击发冲程。
参见图36，示出了砧座4130。砧座4130在许多方面类似于砧座1130(参见图3至图6)，然而，砧座4130还包括弹簧狭槽4146和释放凹口4136。弹簧狭槽4146限定在砧座4130的外近侧表面4147中。例如，砧座4130包括斜坡表面4134，该斜坡表面限定分别类似于斜坡表面1134和开闭腔1148(参见图8至图12)的开闭腔4148。例如，开闭腔4148包括远侧闭合斜坡4140和近侧开放表面4142。弹簧狭槽4146位于砧座4130的近侧端部处，靠近开闭腔4148。砧座4130还包括位于侧壁组织止挡件4133的侧向内侧的内导轨4135。
内导轨4135类似于内导轨1135(参见图4和图6)并且在其中包括释放凹口4136。释放凹口4136由闭锁特征接合，如本文进一步所述。图36至图44的闭锁装置包括一对闭锁弹簧4450和一对锁定杆4180。闭锁弹簧4450和锁定杆4180相对于砧座4130的纵向轴线对称。在其他实例中，闭锁装置可包括单个闭锁弹簧4450和单个锁定杆4180。
主要参见图33至图40，可互换外科工具组件4000包括具有砧座4130和细长通道4102的端部执行器4100，以及在砧座4130和细长通道4102之间延伸的闭锁弹簧4450。砧座4130被构造成能够在枢轴销4152处的枢转接头4150处相对于细长通道4102枢转。例如，细长通道4102在许多方面类似于细长通道1102(参见图3至图5和图7)，然而，细长通道4102还包括用于弹簧4450的孔口4107(参见图24、图26和图28)，以及用于锁定杆4180的凹陷部4109。例如，砧座4130在许多方面类似于砧座1130(参见图3至图6)，然而，砧座4130还包括用于容纳闭锁弹簧4450的一部分的弹簧狭槽4146。
闭锁弹簧4450延伸穿过细长通道4102和砧座4130之间的弹簧狭槽4146。每个弹簧4450包括第一端部4452和第二端部4454，第一端部保持在细长通道4102中的孔口4107中，第二端部接合砧座4130。弹簧4450的第一端部4452可以嵌入或以其他方式固定到细长通道4102。例如，弹簧4450的第一端部4452可以保持在细长通道4102中的相应孔口4107内。弹簧4450的第二端部4454可被定位成抵靠砧座4130的外近侧表面4147上的相应邻接表面4149。例如，邻接表面4149与紧邻开闭腔4148的弹簧狭槽4146对准。
击发构件4760(参见图38至图40)定位在端部执行器4100中。击发构件4760在许多方面类似于击发构件1760(参见图4和图5)。例如，击发构件4760限定I形梁结构，该I形梁结构包括下凸缘4764、上凸缘4762和在凸缘4762和4764之间延伸的支撑部分4763。上凸缘4762由从支撑部分4763延伸的水平销构成。下凸缘4764由在支撑部分4763的基部处的扩大或加宽的脚部构成。组织切割特征部4766由凸缘4762和4764之间的支撑部分4763支撑。支撑部分4763行进通过细长通道4102、钉仓(诸如钉仓1110(参见图3至图5))和砧座4130中的对准的狭槽。
击发构件4760还包括近侧凸台4768，其从击发构件4760的顶部部分朝近侧延伸。近侧凸台4768可操作地被构造成能够接合砧座4130以促进砧座4130的打开动作。更具体地，近侧凸台4768被定位成接合砧座4130的中心交叉表面4145。中心交叉表面4145定位在弹簧狭槽4146的中间并且靠近端部执行器4100的开闭腔4148和枢转接头4150。当击发构件4760朝近侧回缩超过枢转接头4150时，近侧凸台4768被构造成能够滑动地接合中心交叉表面4145，它将中心交叉表面4145向下偏置以使砧座4130朝打开位置枢转。
端部执行器4100包括可滑动地定位在细长通道4102中的凹陷部4109中的锁定杆4180。每个锁定杆4180包括近侧端部4182和远侧端部4184。近侧端部4182可操作地定位在释放凹口4136中。远侧端部4184定位成当钉仓插入细长通道4102中时接合该钉仓。锁定杆4180的近侧端部4182处的接合表面和凹口4136被构造成能够将锁定杆4180朝远侧偏置。例如，凹口4136限定将锁定杆4180的近侧端部4182朝远侧推动的斜坡表面。附加地或另选地，闭锁装置可包括用于将锁定杆4180朝远侧位置偏置的偏置弹簧4186(参见图40)。偏置弹簧4186被定位成与锁定杆4180的近侧端部4182邻接接触。在各种情况下，细长通道4102中的凹陷部可以被构造成能够接纳和支撑偏置弹簧4186。
主要参见图39和图40，端部执行器4100被示出为处于未夹紧或打开构型。此外，钉仓尚未安装在细长通道4102中。尽管砧座4130未相对于钉仓夹紧，但闭锁弹簧4450被构造成能够在砧座4130上施加闭合力。例如，闭锁弹簧4450被构造成能够将砧座4130向下和向前偏置。主要参见图40，该弹簧4450的第二端部4454被定位成抵靠外侧近侧表面4147上的邻接表面4149，并且弹簧4450被构造成能够在邻接表面4149上施加力f(参见图40)；力f使砧座4130朝闭合位置偏置。
来自闭锁弹簧4450的力f还被构造成能够将砧座销4152偏置到细长通道4102中的闭锁凹口4105中。更具体地，细长通道4102包括限定在每个侧壁的近侧部分中的一对成型狭槽4108。成型狭槽4108由于其几何形状通常被称为“肾形狭槽”或“香蕉形狭槽”。闭锁凹口4105从成型狭槽4108的下近侧部分延伸。当砧座销4152定位在闭锁凹口4105中时，防止砧座4130从打开位置(参见图39至图42)旋转到闭合位置(参见图43和图44)。例如，其中锁定杆4180的近侧端部4182定位在释放凹口4136中，近侧端部4182处的斜坡表面可以定位成与释放凹口4136中的斜坡表面齐平，使得砧座4130的移动受限。
现在参见图41和42，钉仓1110已被安装在细长通道4102中。当钉仓1110插入端部执行器4100中时，钉仓1110的近侧端部1112被定位成抵靠锁定杆4180的远侧端部4184并且使锁定杆4180在凹陷部4109中朝近侧转移。例如，锁定杆4180的远侧端部4184可包括面向钉仓的表面，钉仓的近侧端部1112抵靠该表面。锁定杆4180的近侧位移还使锁定杆的近侧端部4182在释放凹口4136内移动。近侧端部4182包括斜坡表面，该斜坡表面接合释放凹口4136的斜坡表面以将砧座4130向上提升远离细长通道4102。随着砧座4130向上移动，砧座销4152也向上移出闭锁凹口4105并进入成型狭槽4108。尽管弹簧4450继续将砧座4130向下偏置并因此将砧座销4152偏置到闭锁凹口4105中，但是安装的钉仓1110对锁定杆4180造成的近侧位移足以克服闭锁弹簧4450的偏置。当砧座销4152定位在成型狭槽4108内时，如图42所示，砧座4130可操作地被构造成能够在砧座销4152处围绕枢转接头4150朝闭合位置枢转。
现在参见图43和图44，击发构件4760已朝远侧推进以使砧座4130闭合。例如，随着击发构件4760朝远侧移动，砧座4130的上凸缘4762被构造成能够抵靠例如砧座4130上的远侧闭合斜坡进行凸轮运动，类似于砧座1130上的远侧闭合斜坡1140(参见图8至图12)。由击发构件4760产生的凸轮运动力足以使砧座4130朝闭合位置枢转，并且砧座销4152被构造成能够随着砧座4130相对于细长通道4102枢转而沿成型狭槽4108移动。然后，击发构件4760可以继续沿端部执行器4100中的击发路径朝远侧移动以完成击发冲程。
在击发冲程完成时，击发构件4760朝用过的钉仓1110的近侧端部1112回缩。尽管击发构件4760朝近侧回缩，但是滑动件组件1120被构造成能够保持在用过的钉仓1110的远侧端部1113处。在此类情况下，用过的钉仓1110的近侧端部1112可以继续将锁定杆4180朝近侧偏置，使得砧座销4152保持在成型狭槽4108中。
在其他实例中，滑动件组件1120可以可操作地接合锁定杆4180，使得只有当滑动件组件1120处于钉仓1110中的近侧击发前位置时，锁定杆4180才朝近侧偏置。在这种情况下，在击发冲程开始时，可以允许锁定杆4180朝远侧转移并且重新接合闭锁装置，使得防止随后的击发冲程，直到新的钉仓被安装在端部执行器4100中。
如本文所述，在某些实例中，端部执行器的细长通道可包括成型狭槽(例如“肾”或“香蕉”形狭槽)，以有利于砧座的打开和闭合。在其他实例中，细长通道可包括用于促进砧座的打开和闭合的销孔。在此类情况下，砧座被构造成能够围绕枢转接头处的单个枢转轴线枢转。包括锁定杆4180的闭锁装置可被修改用于砧座的单个枢转轴线闭合。
例如，现在参见图90-92，可互换外科工具组件5000包括具有砧座5130和细长通道5102的端部执行器5100。砧座5130被构造成能够围绕枢轴销5152处的枢转接头5150相对于细长通道5102枢转。细长通道5102在许多方面类似于细长通道4102(参见图37至图44)，然而，细长通道5102包括用于接纳枢轴销5152而不是成型狭槽的销孔5108。砧座5130在许多方面类似于砧座4130(参见图36至图44)，然而，砧座5130在内导轨5135中不包括用于与锁定杆接合的凹口。
例如，尽管击发构件未在图90至图92中示出，读者将容易理解，端部执行器5100中的击发构件可与击发构件4760(参见图38)相同。用于端部执行器5100的击发构件可被构造成能够接合斜坡表面，该倾斜表面限定分别类似于斜坡表面1134和开闭腔1148(参见图8至图12)的开闭腔。例如，开闭腔包括远侧闭合斜坡和近侧开放表面。在某些实例中，闭锁弹簧可延伸穿过细长通道5102和砧座5130之间的弹簧狭槽5146。例如，这种闭锁弹簧可以与闭锁弹簧4450相同。在其他实例中，端部执行器5100可以不包括在砧座5130和细长通道5102之间延伸的闭锁弹簧。
端部执行器5100包括锁定杆5180，该锁定杆可滑动地定位在细长通道5102中的凹限部5109中。每个锁定杆5180包括近侧端部5182和远侧端部5184。近侧端部5182被定位成与压缩弹簧5190邻接接触，该压缩弹簧也定位在凹陷部5109中。远侧端部5184定位成当钉仓插入细长通道5102中时接合该钉仓。尽管图90至图92中仅示出了单个锁定杆5180，但读者将容易理解，对称锁定杆5180可定位在端部执行器5100的每个侧面上。例如，在其他实例中，端部执行器5100的闭锁装置可以相对于击发构件不对称，并且可以仅包括单个锁定杆5180。
主要参见图90，端部执行器5100被示出为处于未夹紧或打开构型。此外，钉仓尚未安装在细长通道5102中。尽管砧座5130未相对于钉仓夹紧，但在某些实例中，闭锁弹簧可被构造成能够在砧座5130上施加闭合力。例如，闭锁弹簧可被构造成能够将砧座5130向下和向前偏置。尽管砧座5130可以朝夹紧构型偏置，但是枢轴销5152可被构造成能够防止砧座5130的枢转。
枢轴销5152具有半圆的周边或横截面，包括圆形、圆化或其他成型部分5154和平坦或线性部分5156。当砧座5130处于未夹紧构型时，枢轴销5152被取向成使得平坦部分5156定位成与锁定杆5180的顶部表面5186齐平。当平坦部分5156与顶部表面5186齐平时，枢轴销5152的旋转以及因此砧座5130从打开位置到闭合位置(参见图92)的旋转受到限制或被完全阻止。例如，当击发构件从开闭腔中的原始位置朝远侧闭合斜坡朝远侧推进时，击发构件尝试的远侧位移可能不足以克服枢轴销5152的平坦表面5156和锁定杆5180的顶部表面5186之间的旋转阻力。因此，可以防止砧座5130朝闭合构型移动，直到钉仓被定位在细长通道5102中，并且因此克服闭锁装置。
现在参见图91，钉仓1110已被安装在细长通道5102中。当钉仓1110插入端部执行器5100中时，钉仓1110的近侧端部1112被定位成抵靠锁定杆5180的远侧端部5184并且使锁定杆5180在凹陷部5109中朝近侧转移。例如，锁定杆5180的远侧端部5184可包括面向钉仓的表面，钉仓的近侧端部1112抵靠该表面。
锁定杆5180的近侧位移还使锁定杆5180中的凹口5188朝近侧移动。凹口5188被限定成从近侧端部5182和远侧端部5184中间的顶部表面5186向下。当压缩弹簧5190压缩以允许锁定杆5180在凹陷部5109内朝近侧转移时，凹口5188被构造成能够移动成与枢轴销5152纵向对准。如图91所示，当凹口5188与枢轴销5152对准时，枢轴销5152的平坦部分5156可与锁定杆5180间隔开。因此，砧座5130可操作地被允许在枢转接头5150处围绕砧座销5152朝闭合位置枢转。
现在参见图92，闭合动作已被施加到砧座5130。例如，击发构件可朝远侧推进以使砧座5130闭合。击发构件的远侧推进被构造成能够使其上凸缘抵靠砧座5130上的远侧闭合斜坡进行凸轮运动。由击发构件产生的凸轮运动力足以使销5152在销孔5108内枢转。然后，击发构件可以继续沿端部执行器5100中的击发路径朝远侧移动以完成击发冲程。
在击发冲程完成时，击发构件可朝用过的钉仓1110的近侧端部1112回缩。尽管击发构件朝近侧回缩，但是滑动件组件1120被构造成能够保持在用过的钉仓1110的远侧端部1113处。在此类情况下，用过的钉仓1110的近侧端部1112可以继续将锁定杆5180朝近侧偏置，使得砧座销5152保持与凹口5188对准。
在其他实例中，滑动件组件1120可以可操作地接合锁定杆5180，使得只有当滑动件组件1120处于钉仓1110中的近侧击发前位置时，锁定杆5180才朝近侧偏置。在这种情况下，在击发冲程开始时，可以允许锁定杆5180朝远侧转移并且重新接合闭锁装置，使得防止随后的击发冲程，直到新的钉仓被安装在端部执行器5100中。
现在参见图45至图53，示出了外科端部执行器6100。外科端部执行器6100包括细长通道6102和砧座1130。细长通道6102在许多方面类似于细长通道1102(参见图3至图5和图7)，然而，细长通道6102还包括尺寸和位置被设计成可操作地接纳闭锁弹簧6182的一部分的凹陷部6109。在其他实例中，外科端部执行器6100可包括细长通道1102来代替细长通道6102，如本文进一步所述。
击发构件6760被定位在端部执行器6100中。击发构件6760在许多方面类似于击发构件1760(参见图4和图5)。例如，击发构件6760限定I形梁结构，该I形梁结构包括下凸缘6764、上凸缘6762和在凸缘6762和6764之间延伸的支撑部分6763。上凸缘6762由从支撑部分6763延伸的水平销构成。下凸缘6764由在支撑部分6763的基部处的扩大或加宽的脚部构成。组织切割特征部6766由凸缘6762和6764之间的支撑部分6763支撑。支撑部分6763穿过细长通道6102、钉仓6110和砧座1130中的对准的狭槽行进。
类似于击发构件1760，击发构件6760被构造成能够在端部执行器6100上施加闭合凸轮运动力以在击发冲程的一部分期间相对于细长通道6102夹紧砧座1130，并且被构造成能够在端部执行器6100上施加开放凸轮运动力以在击发冲程完成时使砧座1130远离细长通道6102枢转。例如，击发构件6730定位成可操作地接合砧座1130中的开闭腔1148，以有利于砧座1130的枢转。
外科端部执行器6100包括闭锁装置6180，其可操作地防止击发冲程和/或防止砧座1130朝细长通道6102的旋转运动，除非未击发的钉仓被定位在第一钳口中。换句话讲，闭锁装置6180是缺少的和空钉仓闭锁件，并且也可被认为是夹紧闭锁件。因为击发构件6760是多功能击发构件，所以击发构件被构造成能够实现外科功能与单个致动系统的组合。因此，当闭锁装置6180阻止击发构件6760的致动时，闭锁装置6180有效地防止由击发构件6760实现的外科功能的组合，包括端部执行器6100的夹紧和切割刃6766的推进。
在其他实例中，闭锁装置6180可被构造成能够在击发构件6760已经使端部执行器钳口闭合之后接合击发构件6760。例如，闭锁装置6180可被定位成在远侧更远，使得击发构件6760在接合开闭腔1148的远侧闭合斜坡1140之后接合闭锁装置6180。在此类情况下，击发构件6760可被构造成能够在闭锁装置6180可能被接合之前相对于细长通道6102夹紧砧座1130。
闭锁装置6180包括闭锁弹簧6182以及击发构件6760上的闭锁凸耳6770。闭锁弹簧6182定位在细长通道6102中的凹陷部6109中。闭锁弹簧6182限定U形构件，该U形构件具有固定端和一对可偏转端。闭锁弹簧6182是片簧，然而，读者将容易理解，可以构造各种另选弹簧来可操作地接合闭锁凸耳6770。例如，闭锁弹簧6182可由击发构件6760的任一侧上的两个独立的片簧构成。
闭锁弹簧6182的固定端是固定到细长通道6102的近侧端部6184。例如，近侧端部6184可以在点焊6196处焊接到细长通道6102(参见图47)。闭锁弹簧6182的可偏转或自由端限定其远侧端部6186。弹簧臂6188在锁闭弹簧6182的近侧端部6184和每个自由远侧端部6186之间延伸。
主要参见图47，一对侧向延伸的突片或钩6190从远侧端部6186向内朝闭锁弹簧6182的中心线延伸。钩6190位于弹簧臂6188的侧向内侧。钩可操作地被构造成能够捕获或接合闭锁凸耳6770，如本文进一步所述。仍然参见图47，闭锁弹簧6182被示出为处于非压力或非弯曲的默认构型。在非压力构型中，弹簧臂6188限定弯曲或轮廓，使得远侧端部6186从近侧端部6184向上偏移。虽然闭锁弹簧6182被构造成能够在端部执行器6100的操作期间弯曲或以其他方式变形，但是闭锁弹簧6182被构造成能够寻求恢复图47的非压力构型。
闭锁凸耳6770在击发构件6760的支撑部分6763上限定侧向突出的凸耳。锁定或凹口6772限定在每个侧向突出的凸耳6770中。锁6772是矩形切口，其尺寸被设计并对准以在闭锁弹簧6182处于图47的非压力构型并且击发构件6760朝远侧推进成与闭锁弹簧6182上的钩6190接合时接纳钩6190。例如，每个锁6772包括面向远侧的开口，该开口被构造成能够当钩6190与面向远侧的开口对准并且击发构件6760朝远侧推进时接纳钩6190。当钩6190保持在锁6772中时，防止了击发构件6760的远侧推进。因此，闭锁装置6180防止砧座1130的夹紧和刀刃6766的推进。
在使用中，闭锁弹簧6182最初可以在细长通道6102中处于图47的非压力构型。在非压力构型中，闭锁弹簧6182的远侧端部6186上的钩6190向上偏置并变成与击发构件6760中的锁6772对准。因此，当击发构件6760朝远侧推进时，钩6190滑动到推进的击发构件6760上的锁6772中，使得防止击发构件6760经过钩6190的远侧位移。
现在参见图48，当钉仓6110安装在端部执行器6100中时，钉仓6110的一部分被构造成能够接合闭锁弹簧6182。钉仓6110在许多方面类似于钉仓1110(参见图3至图5)。钉仓6110包括滑动件组件6120，该滑动件组件在许多方面类似于滑动件组件1120(参见图4和图5)，然而，滑动件组件6120在钉仓6110的近侧端部6112处具有切口或凹陷部6122。切口6122限定在滑动件组件6120的面向通道的表面中，并且被构造成能够当滑动件组件6120在钉仓6110中处于近侧原始位置时(参见图48)接纳闭锁弹簧6182的远侧端部6186，包括其钩6190。滑动件组件6120接合闭锁弹簧6182的远侧端部6186，以使钩6190偏转到切口6122中并且变得不与锁6772对准。
在其他实例中，钉仓1110(参见图3至图5)可以安装在细长通道6102中，并且其滑动件组件1120可被构造成能够将钩6190向下偏转到细长通道6102中的闭锁凹陷部6109中。在此类情况下，闭锁凹陷部6109的尺寸可被设计成适应闭锁弹簧6182的高度，使得钉仓1110可以定位成与细长通道6102的仓支撑表面齐平。在另外的其他情况下，细长通道6102可以不包括闭锁凹陷部6109，类似于细长通道1102(参见图3至图5)。在此类情况下，滑动件组件6120中的切口6122的尺寸可被设计成适应闭锁弹簧6182的高度，使得钉仓6110可以定位成与细长通道6102的仓支撑表面齐平。
在击发冲程期间，滑动件组件6120由击发构件6760朝远侧推进通过仓体6111。当击发构件6760在击发冲程之后朝近侧回缩时，滑动件组件6120留在钉仓6110的远侧部分中。例如，现在参见图49，击发构件6760在击发冲程的初始部分期间从近侧原始位置朝远侧推进。随着击发构件6760远离闭锁弹簧6182朝远侧移动，闭锁弹簧6182被构造成能够恢复图47的非压力取向，其中钩6190相对于闭锁弹簧6182的固定的近侧端部6184向上偏转。
现在参见图50，在击发冲程完成时，击发构件6760朝近侧原始位置朝近侧回缩。当击发构件6760朝近侧移动经过闭锁弹簧6182的远侧端部6186时，闭锁弹簧6182上的钩6190被构造成能够沿侧向突出的凸耳6770上的斜坡表面6774跨置或滑动。钩6190与图50中的斜坡表面6774接合，使得斜坡表面6774使钩6190和闭锁弹簧6182的远侧端部6186向上凸轮运动或提升越过锁6772并沿着侧向突出的凸耳6770的顶表面。当钩6190绕过锁6772时，闭锁装置6180被有效地复位。
现在参见图51，击发构件6760已返回到近侧原始位置，并且闭锁弹簧6182已返回到非应力构型。因此，闭锁弹簧6182上的钩6190与击发构件6760上的锁6772对准。例如，锁6772被构造成能够在击发构件6760朝远侧推进时沿着端部执行器6100中的相应锁定路径移动，并且每个钩6190在对应锁6772的锁定路径中。尽管钉仓6110保持在图51中的细长通道6102中，但是由于钉仓6110已经被击发或用尽，滑动件6120(参见图33和图34)保持在钉仓6110的远侧端部部分中。朝远侧移位的滑动件6120没有定位成接合闭锁弹簧6182的远侧端部6186以克服闭锁装置6180，如图45所示。
击发构件6170经过复位闭锁装置6180的远侧位移被阻止，如图52所示。具体地，击发构件6760在后续尝试的击发冲程期间已从近侧原始位置朝远侧移位。然而，当击发构件6760朝远侧移动时，锁6772沿其相应的锁定路径移动成与钩6190接合。钩6190滑入锁6772中以防止击发构件6760的进一步远侧运动。
闭锁装置6180包括对称锁6772和对称钩6190。例如，锁6772和钩6190围绕端部执行器6100的纵向轴线对称，使得由击发构件产生的击发力由闭锁装置6180以平衡和对称的方式约束。在其他实例中，闭锁装置6180可以是非对称的，并且可包括例如，单个锁6772和单个钩6190。
在各种情况下，如本文所述，用于外科器械的可互换外科工具组件可在致动其柄部组件上的击发触发器时被击发。在某些实例中，击发触发器的多次致动可被构造成能够击发可互换外科工具组件。例如，击发触发器的每次致动可实现击发冲程的一部分。在其他实例中，击发冲程的单次致动可被构造成能够实现一系列连续击发冲程。在某些实例中，每个连续的击发冲程可有助于击发构件、切割刃和/或滑动件组件的远侧推进和/或近侧回缩。例如，可互换外科工具组件中的击发连杆可在一系列连续击发冲程中多次伸出和回缩，以完成端部执行器的击发。
在某些实例中，可能希望将击发构件朝远侧推进到端部执行器的中间部分。击发构件可将滑动件组件和/或切割元件击发到端部执行器的中间部分。此外，在各种情况下，推板可朝远侧推进以完成滑动件组件和/或切割元件的击发。如本文所述，击发构件可包括上凸缘，该上凸缘被构造成能够行进穿过可互换外科工具组件的砧座。在击发构件的远侧推进终止于端部执行器的中间部分的情况下，砧座的远侧部分可以是无通路的。例如，砧座的远侧部分可为实心的，使得击发构件的上凸缘不能行进穿过其中。当砧座的远侧部分为实心时，砧座的刚度可大于具有延伸到其远侧端部的通路的砧座。砧座的增加刚度可被构造成能够限制砧座的变形和/或翘曲。
被构造成能够执行一系列连续击发冲程的可互换外科工具组件12000在图56至图70中示出。可互换外科工具组件12000可安装到柄部组件500(参见图1和图2)。在某些实例中，该系列连续击发冲程中的每个击发冲程可受到击发触发器532的单次致动的影响(参见图1和图2)。在其他实例中，击发触发器532的单次致动可影响一个或多个击发冲程。例如，击发触发器532的单次致动可影响完整系列的连续击发冲程，以击发钉并切入夹持在端部执行器钳口之间的目标组织。
可互换外科工具组件12000包括端部执行器12100、轴部分12400、击发构件12760和击发杆12770。端部执行器12100包括细长通道12102，该细长通道被构造成能够在其中可操作地支撑钉仓11210。细长通道12102可操作地附接到轴部分12400。端部执行器12100还包括相对于细长通道12102被可枢转地支撑的砧座12130。
击发构件12760被构造成能够与滑动件组件12120可操作地交接，该滑动件组件可操作地支撑在外科钉仓12110的主体12111内。滑动件组件12120在外科钉仓主体12111内可滑动地从邻近仓体12111的近侧端部12112的近侧原始位置移位到邻近仓体12111的远侧端部12113的终止位置。滑动件组件12120包括多个倾斜或楔形凸轮12122，其中每个凸轮12122与特定一排钉1126对应。滑动件组件12120还包括切割刃12124。切割刃12124被构造成能够与滑动件组件12120一起行进穿过端部执行器12100。例如，切割刃12124一体地形成在滑动件组件12120上。
直接驱动的外科钉1126(也参见图5)定位在主体12111中的钉腔中。当滑动件组件12120朝远侧驱动时，组织切割刃12124被构造成能够切割夹持在砧座组件12130和钉仓12110之间的组织，并且滑动件组件12120在钉仓12110中向上驱动钉1126并使其与砧座组件12130形成接触。如本文进一步所述，滑动件组件12120可通过击发构件12760和/或通过推板12780朝远侧驱动。例如，击发构件12760被构造成能够将滑动件组件12120朝远侧推动到端部执行器12100中的中间位置，并且推板12780被构造成能够绕过击发构件12760以进一步朝远侧推进滑动件组件12120至端部执行器12100中的远侧位置。
在击发冲程期间，例如，轴部分12400中的驱动构件诸如驱动构件1602(参见图2)被构造成能够将击发动作传递到击发杆12770。例如，驱动构件1602的移位被构造成能够移位击发杆12770。如本文所述，击发杆12770可以可操作被地构造成能够击发该击发构件12760。例如，击发杆12770可在击发序列的至少一部分期间朝远侧推动击发构件12760。
击发构件12760在许多方面类似于击发构件1760(参见图4和图5)。例如，击发构件12760限定I形梁结构，该I形梁结构包括下凸缘12764、上凸缘12762和在下凸缘12764和上凸缘12762之间延伸的支撑部分12763。上凸缘12762由从支撑部分12763延伸的水平销构成。下凸缘12764由在支撑部分12763的基部处的扩大或加宽的脚部构成。击发构件12760可被构造成能够接合砧座12130上的开闭腔，诸如开闭腔1148(参见图8至图12)，以实现砧座12130相对于钉仓12110的打开和闭合。另外，上凸缘12762可被构造成能够行进穿过砧座12130中的通路12136，并且下凸缘12764可被构造成能够行进穿过细长通道12102中的通路12106。与击发构件1760不同，击发构件12760不包括切割刃。相反，击发构件12760被构造成能够选择性地接合滑动件组件12120，该滑动件组件包括切割刃12124。
可互换外科工具组件12000还包括具有推板12780和弹簧12782的推杆组件12778。主要参见图56至图58，当可互换外科工具组件12000处于未击发构型时，弹簧12782被构造成能够将推板12780朝击发杆12770侧向地偏置。例如，弹簧12782定位在推板12780和轴组件12400的侧壁中间。推板12780抵靠击发杆12770偏置，该击发杆被定位成抵靠轴部分12400中的止动板12784。弹簧12782为线性波形弹簧，然而，读者将容易理解，另选的弹簧设计可被构造成能够将推板12780朝击发杆12770侧向地偏置。如本文进一步所述，推板12780保持在可互换外科工具组件12000的轴部分12400中，直到击发杆12770回缩至更近侧的位置，这允许推板12780侧向弹性地与击发杆12770接合。
现在参见图59至图61，推板12780包括具有沿着主体12786的多个片簧12788的线性主体12786。片簧12788在图60和图61中被描绘成非应力或未变形构型，其描绘了从线性主体12786侧向向外偏置的片簧12788。线性主体12786在近侧端部12788和远侧端部12790之间延伸。T形狭槽12792限定在近侧端部12788中。T形狭槽12792被构造成能够可操作地接纳击发杆12770上的远侧键或凸块12771。远侧键12771可包括例如从击发杆12770突出的盘形键(参见图63)。当键12771位于T形槽12792中时，击发杆12770的近侧和远侧平移被传递到推板12780。读者将容易理解，可采用另选的互补狭槽和键几何形状来在击发杆12770和推板12780之间传递击发动作。
在第一击发冲程开始时，主要参见图62和图63，击发杆12770的远侧端部被定位成与击发构件12760邻接并驱动接触。此外，击发杆12770被构造成能够限制推板12780及其片簧12788。在此类情况下，击发杆12770可朝远侧推进以朝远侧推动击发构件12760。当击发构件12760朝远侧移动时，击发构件12760也将滑动件组件12120朝远侧推动。在图62中，滑动件组件12120的斜坡表面12122已接合所描绘的排中最近侧的钉1126，并且开始朝砧座12130提升钉1126。
尽管击发杆12770已在图62中朝远侧移动，但推板12780被构造成能够保持在可互换外科工具组件12000的轴部分12400中的近侧位置。主要参见图63，击发构件12760包括凹口12766，该凹口的尺寸被设计为允许推板12780在击发冲程序列的稍后阶段绕过击发构件12760，如本文进一步所述。
可互换外科工具组件12000在图64中的第一击发冲程完成时示出。通过比较图58和图64，读者将容易理解击发构件12760已由击发杆12770朝远侧移动从点A到点B的距离V。点B大约为钉仓12110的近侧端部12112和远侧端部12113之间的距离的三分之一。在其他实例中，点B可小于或大于近侧端部12112和远侧端部12113之间的距离的三分之一。例如，点B可大约为近侧端部12112和远侧端部12113之间的距离的四分之一或六分之一。在其他实例中，点B可比近侧端部12112和远侧端部12113之间的中间位置更远。
在到达点B时，滑动件组件12120已将所描绘的排中的两个钉1126移动到成形位置中，并且已将所描绘的排中的第三钉朝成形位置移动。然后，击发杆12770被构造成能够在第二击发冲程期间朝近侧回缩。因为击发杆12770仅与击发构件12760邻接、驱动接触并且不与其联接，所以当击发杆12770朝近侧回缩时，击发构件12770被构造成能够保持在端部执行器12100中的中间位置(点B)。
主要参见图65和图66，可互换外科工具组件12000在第二击发冲程完成时示出。通过比较图64和图66，读者将容易理解，击发杆12770已朝近侧移动从点B到点C的距离W。点C在点A的近侧。换句话讲，距离W大于距离V(参见图64)。此外，点C在推杆组件12778的近侧。更具体地，当击发杆12770回缩到点C时，击发杆12770朝近侧回缩，使得推板12780的近侧端部12788中的T形狭槽12792与击发杆12770上的远侧键12771对准。当远侧键12771与T形狭槽12792对准时，T形狭槽12792被构造成能够在其中接纳远侧键12771。例如，主要参见图66，弹簧12782被构造成能够将推板12780侧向地偏置成与击发杆12770接合。此外，当击发杆12770已朝其近侧回缩时，允许片簧12788恢复非应力构型(参见图60和图61)。
可互换外科工具组件12000在图67至图69中的第三击发冲程完成时示出。通过比较图66和图67，读者将容易理解，击发杆12770已朝远侧移动从点C到点D的距离X。点D也在点B的远侧(参见图64)。击发杆12770的远侧位移距离X被构造成能够将击发构件12760移动距离Y并将滑动件组件12120移动到钉仓12110的远侧端部12113。在第三击发冲程期间，推板12780通过击发杆12770朝远侧推进。
在第三击发冲程期间，推板12780朝远侧推动击发构件12760，直到击发构件12760到达通路12136的端部。当击发构件12760的上凸缘12762邻接通路12136的远侧端部(或者击发构件12760以另外的方式被阻止朝远侧行进得更远)时，推板12780被构造成能够绕过击发构件12760。例如，片簧12788被构造成能够朝主体12786偏转，这允许推板12780配合在击发构件12760中的凹口12766内。当推板12780定位在凹口12766内时，推板12780被构造成能够朝远侧行进经过击发构件12760。在某些实例中，推板12780在第三击发冲程期间不会朝远侧移位击发构件。例如，点B可与通路12136的远侧端部对准。
在第三击发冲程完成时，滑动件组件12120定位在钉仓12110的远侧端部12113处，并且所描绘的排中的所有钉1126已随着砧座12130移动到成形位置。此外，滑动件组件12120被构造成能够在第三击发冲程完成时朝细长通道12102的仓支撑表面12101下沉或向下移动。图67所示的下沉的滑动件组件12120被构造成能够使切割刃12124向下转移。例如，切割刃12124可被定位在钉仓12110的平台下方。在此类情况下，当击发构件12760回缩并且砧座12130枢转到打开构型时，切割刃12124可被隐藏在仓体12111内或被该仓体遮挡，这可防止切割刃12124的意外切割和/或伤害。在某些实例中，钉仓12110的主体12111包括远侧腔，滑动件组件12120被构造成能够在第三击发冲程完成时下落或转移到该远侧腔中。
仍然参见图67至图69，片簧12788处于非应力构型，使得它们在主体12786的侧向外侧延伸。当处于非应力构型时，片簧12788中的一个的近侧向外定位的端部12789在击发构件12760的支撑部分12763的前面延伸(参见图69)。换句话讲，片簧12788的端部12789延伸超过凹口12766并且与击发构件12760的支撑部分12763侧向重叠。因此，端部12789充当通过弹簧加载的倒钩，当推板12780随后朝近侧回缩时，该倒钩捕获击发构件12760。
在第四击发冲程期间，推板12780朝近侧回缩。通过比较图67和图70，读者将容易理解，击发杆12770已朝近侧移动从点D到点E的距离Z。击发杆12770经由锁12771和T形槽12792与推板12780接合，因此推板12780也与击发杆12770朝近侧回缩。此外，由于片簧12788中的一个的端部12789被捕获或以其他方式与击发构件12760接合，因此推板12780的回缩也使击发构件12760回缩。图70中的击发构件12760已被回缩，使得上凸缘12762从砧座12130中的通路12136回缩。在某些实例中，上凸缘12762可被构造成能够接合开闭腔以在回缩到点E时朝打开构型打开砧座12130。此外，包括其切割刃12124的滑动件组件12120保持被遮挡在钉仓12110的远侧端部12113处的下降腔中。
在某些实例中，可互换外科工具组件可包括柔性脊，该柔性脊可允许轴的至少一部分远离线性构型弯曲。柔性脊被构造成能够相对于轴的纵向轴线垂直地和/或水平地移动可互换外科工具组件的端部执行器。附加地或另选地，在某些实例中，可互换外科工具组件的端部执行器和/或远侧部分可被构造成能够相对于轴的纵向轴线旋转。可互换外科工具组件的柔性和可旋转性被构造成能够增加该系列动作，使得端部执行器可被操纵以相对于目标组织呈现不同的位置。另外，柔性和可旋转性可被构造成能够增加操作者在手术部位处的可视性。
可互换外科工具组件14000示于图71至图74中。可互换外科工具组件14000包括端部执行器1100，该端部执行器包括细长通道1102、砧座1130和击发构件1760。钉仓1110(参见图72和图74)可移除地定位在细长通道1102中。可互换外科工具组件14000还包括轴部分14400，该轴部分包括柔性脊14402。外科器械的柔性脊进一步描述于2013年12月23日提交的名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE SHAFT ARRANGEMENTS”的美国专利申请序列号14/138,554(现为美国专利申请公布2015/0173789)中，该专利申请据此全文以引用方式并入本文。
柔性脊14402包括椎体14404和安装到椎体14404的远侧管段14440(参见图74)。椎体14404包括中心部分14408和从中心部分14408延伸的侧向对称的椎骨14406对。椎骨14406沿椎体14404的每个侧面14410、14412定位。沿着椎体14404的长度的椎骨14406是嵌套的。例如，每个椎骨14406包括突起部，并且相邻椎骨14406包括突起部突出到其中的对应凹陷部。互锁突起部和凹陷部被构造成能够限制椎体14404的扭转或扭曲。
当椎体14404处于线性取向时，椎体14404中的相邻椎骨14406由间隙14405隔开。例如，间隙14405可在互锁突起部和凹陷部之间延伸。相邻椎骨14406之间的间隙14405被构造成能够允许椎体14404在关节运动平面中关节运动。
主要参见图72和图73，为了使柔性脊14402和安装在其上的远侧管段14440关节运动，通过使关节运动带14420沿椎体14404的每个相应侧面14410、14412纵向穿过通道的选择性运动，椎体14404的相应侧面14410、14412同时被压缩和膨胀。关节运动带14420的远侧端部锚定到关节运动头部14430，该关节运动头部安装或以其他方式固定到远侧管段14440。例如，关节运动带14420终止于远侧套环14422处，该远侧套环围绕关节运动头部14430上的附接突片14432定位。因此，关节运动带14420的往复运动动作被构造成能够使关节运动头部14430和远侧管段14440相对于柔性脊14402进行关节运动。关节运动带14420可由金属带组成，例如，该金属带可至少部分地被包围或包封在塑料中。在各种情况下，关节运动带可通过柄部组件上的杠杆或其他致动器(诸如，外科器械的柄部组件500(参见图1和图2))致动(即，朝近侧或朝远侧移位)。
当椎体14404弯曲并且远侧管段14440进行关节运动时，端部执行器1100也被构造成能够进行关节运动。更具体地，端部执行器1100包括近侧安装部分14450。主要参见图74，近侧安装部分14450安装到细长通道1102。例如，近侧安装部分14450可固定到细长通道1102和/或与细长通道1102一体形成。近侧安装部分14450邻近远侧管段14440和其中的关节运动头部14430定位。如本文进一步所述，推力轴承14460定位在近侧安装部分14450和远侧管段14440中间，使得近侧安装部分14450可相对于远侧管段14440旋转。当远侧管段14440进行关节运动时，近侧安装部分14450和从其延伸的端部执行器1100也被构造成能够进行关节运动。
在各种情况下，端部执行器1100还可被构造成能够围绕轴部分14000的纵向轴线旋转。例如，端部执行器1100可相对于柔性脊14402旋转。可互换外科工具组件14000包括旋转轴14470，该旋转轴从近侧安装部分14450朝近侧延伸。旋转轴14470可朝近侧延伸穿过远侧管段14440和柔性脊14402，并且可固定在柄部组件中的旋转联接件处。旋转轴14470和近侧安装部分14450可被连接成使得旋转轴14470的旋转引起近侧安装部分14450的旋转，从而也引起端部执行器1100的旋转。例如，旋转轴14470可与近侧安装部分14450固定和/或一体形成。在其他实例中，旋转传递特征部(诸如齿轮齿)，例如可被构造成能够将旋转轴14470的旋转传递到近侧安装部分14450。
旋转轴14470延伸穿过柔性脊14402。例如，旋转轴14470可与柔性脊14402及其椎体14404同心。虽然旋转轴14470延伸穿过柔性脊14402并且在其中旋转，但旋转轴14470的旋转不传递到柔性脊14402。例如，在近侧安装部分14450和关节运动头部1430中间的推力轴承14460被构造成能够允许近侧安装部分14450相对于关节运动头部1430旋转。在其他实例中，柔性脊14402可被构造成能够与旋转轴14470一起旋转，并且推力轴承14460可定位在柔性脊14402和轴14400的不可旋转部分中间。
主要参见图73，旋转轴14470可以是锯齿状或凹口状的。锯齿和/或凹口被构造成能够允许旋转轴14470在柔性脊14402内弯曲。尽管允许旋转轴14470弯曲，但锯齿可以被构造成能够限制旋转轴14470的扭曲或扭转，使得在其近侧端部处产生的旋转运动可以有效地传递到旋转轴14470的远侧端部，并因此传递到近侧安装部分14450。
主要参见图73和图74，轴部分14400包括可纵向移动的击发杆14770，该击发杆在许多方面类似于击发杆1770(参见图3至图5)。在击发冲程期间，柄部组件中的驱动构件(例如，柄部组件500中的驱动构件540，见图1和图2)经由驱动构件(例如，驱动构件1602，见图2)将到击发杆1770的击发动作传递到击发构件1760。例如，驱动构件540的致动可被构造成能够使击发杆14770和击发构件1760朝远侧移位以切割组织并实现将钉从钉仓1110击发。然后，驱动构件540可朝近侧回缩以使击发杆14770和击发构件1760朝近侧回缩。击发杆14770被构造成能够在柔性脊14402内弯曲。
击发杆14770与旋转轴14470同心。此外，当旋转轴14470在柔性脊14402内旋转时，击发杆14770被构造成能够也旋转。例如，击发杆14770朝远侧延伸到击发构件1760，该击发构件具有由砧座1130约束的上凸缘1462和由细长通道1102约束的下凸缘1464。当端部执行器1100随着旋转轴14470旋转时，如本文所述，定位在端部执行器1100中的击发构件1760也被构造成能够旋转。
如本文所述，近侧安装部分14450和远侧管段14440之间的旋转接头位于进行关节运动的椎体14404的远侧。因此，端部执行器1100的旋转发生在轴部分14400的关节运动区域的远侧。在其他实例中，可互换外科工具组件14000可以包括另选和/或附加关节运动接头和/或区域。例如，本文进一步描述了各种附加关节运动接头。在此类情况下，近侧安装部分14450和远侧管段14440之间的旋转接头可以定位在最远侧关节运动接头的远侧。
在各种情况下，可以防止击发构件1760和/或击发杆14770的平移，直到未击发的钉仓定位在端部执行器1100中。例如，本文所公开的各种闭锁装置可以结合到端部执行器1100和/或可互换外科工具组件14000中。尽管可以在此类情况下防止击发构件1760和/或击发杆14770的平移，但可以通过此类闭锁装置允许击发构件和击发杆14770与旋转轴14470和端部执行器1100一起旋转。
接下来转向图75至图81，示出了本发明的另一个外科器械实施方案15010的一部分。在所示的布置中，外科器械15010包括轴组件15100，该轴组件可以可操作地联接到柄部组件或机器人系统的一部分形式的外壳(未示出)。例如，轴组件15100可以可操作地联接到上文所公开的柄部组件和其他驱动装置和/或以下文献中所公开的各种柄部组件、击发和关节运动驱动系统，或者以其他方式被构造用于与上文所公开的柄部组件和其他驱动装置结合使用和/或与以下文献中所公开的各种柄部组件、击发和关节运动驱动系统结合使用：标题为“ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS FOR SIGNALCOMMUNICATION”的美国专利申请公开No.2014/0246471，其全部公开内容据此以引用方式并入本文。
如图75中可见，轴组件15100包括脊构件15110，该脊构件可操作地支撑近侧旋转驱动轴15120，该近侧旋转驱动轴与旋转动作源(例如，支撑在柄部组件或机器人系统中的马达或马达装置)可操作地交接。在所示的布置中，近侧旋转驱动轴15120是柔性的，以适应轴组件15100的一部分的关节运动。例如，旋转驱动轴可包括稍微柔性的缆线。脊构件15110限定轴轴线SA，并且可例如以各种已知的方式联接到柄部组件或机器人系统，以便于脊构件15110相对于柄部组件或机器人系统围绕轴轴线SA选择性旋转。在所示的实施方案中，轴组件15100包括近侧或“第一”关节运动接头15130，其限定横向于轴轴线SA的第一关节运动轴线AA1；以及远侧或“第二”关节运动接头15150，其限定也横向于轴轴线SA以及第一关节运动轴线AA1的第二关节运动轴线AA2。
现在参见图76，近侧或第一关节运动接头15130包括第一通道安装组件15132，该第一通道安装组件通过第一关节运动销15134可枢转地联接到脊构件15110的远侧端部15112。第一关节运动销15134限定第一关节运动轴线AA1，第一通道安装组件15132可围绕该第一关节运动轴线枢转。所示的轴组件15100包括第一关节运动系统15136，该第一关节运动系统包括第一轴向可移动关节运动致动器15138，该致动器与柄部组件或机器人系统中的第一轴向关节运动动作源可操作地交接。这种第一轴向关节运动动作由图76中的箭头AD1和AD2表示。如图76中可见，第一轴向可移动关节运动构件15138的远侧端部15139通过附接销15135可枢转地销接到第一通道安装组件15132。第一关节运动致动器15138在第一关节运动方向AD1和第二关节运动方向AD2上的轴向移动将导致第一通道安装组件15132相对于脊构件15110围绕第一关节运动轴线AA1枢转行进。
仍然参见图76，远侧或第二关节运动接头15150包括第二通道安装构件15152，该第二通道安装构件通过第二关节运动销15154可枢转地联接到第一通道安装组件15132。第二关节运动销15154限定第二关节运动轴线AA2，第二通道安装构件15152可相对于第一通道安装组件15132围绕该第二关节运动轴线枢转。参见图75。所示的轴组件15100还包括第二关节运动系统15160，该第二关节运动系统包括第二环状关节运动构件15162，该第二环状关节运动构件轴颈连接在近侧惰轮15164上，该近侧惰轮可旋转地支撑在滑轮轴15165上，该滑轮轴附接到脊构件15110。第二环状关节运动构件15162也附接到关节运动滑轮15156，该关节运动滑轮不可移动地附接到或形成在第二通道安装构件15152上，使得第二环状关节运动构件15162在惰轮15164上的旋转将引起第二通道安装构件15152围绕第二关节运动轴线AA2相对于第一通道安装组件15132枢转。第二关节运动系统15160还包括第二轴向可移动关节运动致动器15166，该致动器与柄部组件或机器人系统中的第二轴向关节运动动作源可操作地交接。这种第二轴向关节运动由图76中的箭头AD3和AD4表示。如图76中可见，第二轴向可移动关节运动构件15166的远侧端部15167通过夹持构件15168夹持到第二环状关节运动构件15162的一部分。夹持构件15168包括穿过其中的缆线引导孔15169，用于在向其施加第二关节运动动作期间可滑动地支撑第二环状关节运动构件15162的另一部分。
在所示的实施方案中，砧座构件15200可移动地联接到轴组件15100。砧座15200可类似于上述砧座1130。例如，砧座15200可枢转地联接到第二通道安装构件15162，以相对于其选择性枢转行进。如图76中可见，砧座15200包括砧座主体15202，该砧座主体包括钉成形部分15204和砧座安装部分15210。砧座安装部分15210包括向下延伸的侧壁15212，该侧壁通常被称为组织止动件，其目的先前在本文中进行了描述。
在所示的示例中，第二通道安装构件15152包括两个朝远侧突出的砧座安装部分15190，每个砧座安装部分中具有销孔15192，该销孔适于在其中容纳对应的砧座附接销15193。砧座附接销15193被容纳在销孔15192中并且容纳在砧座15200的侧壁15212中的对应开孔15213中。如上所述，销可被压入开孔15213中。这种布置形成枢转接头15191，该枢转接头有助于砧座15200在保持附接到第二通道安装构件15152的同时相对于其枢转行进。在这种布置中，在正常使用期间，砧座15200并不旨在与轴组件15100或更具体与第二通道安装构件15152分离。因此，如在描述砧座15200附接到轴组件15100的上下文中所用，术语“不可移动地附接”意味着砧座15200在外科器械的操作期间以及在可操作地安装其他外科钉仓时保持附接到轴组件15100，如下文将进一步详细地讨论。
如图76和图77可见，外科器械15010还包括通道15300，该通道被构造成能够在其中可操作地支撑外科钉仓15400。在所示的实施方案中，通道15300包括近侧附接部分15302，该近侧附接部分被构造成能够可移动地附接到第二通道安装构件15152。例如，第二通道安装构件15152包括安装主体或安装毂部分15194，该安装主体或安装毂部分具有形成在其中的两个通道附接狭槽15196，这两个狭槽被构造成能够容纳形成在通道15300的近侧附接部分15302上的对应通道轨道15304。如图77中可见，通道15300通过将通道轨道15304沿横向于轴轴线SA的安装方向ID插入第二通道安装构件15152中的对应通道附接狭槽15196中而可移动地附接到轴组件15100。在所示的示例中，通道15300通过锁定构件15350可移除地锁定到轴组件15100。
仍然参见图76和图77，在所示的示例中，锁定构件15350包括远侧管段15352，该远侧管段轴向可移动地支撑在第二通道安装构件15152的安装毂部分15194上。远侧管段15352可以可枢转地附接到轴组件15100的柔性近侧管段(未示出)，以便于围绕第一关节运动轴线和第二关节运动轴线进行关节运动。远侧管段15352被构造成能够在最远侧“锁定”位置和近侧“解锁”位置之间轴向移动，在最远侧“锁定”位置，远侧管段15352防止通道15300沿移除方向RD与轴组件15100分离，在近侧“解锁”位置，远侧管段15352位于通道附接狭槽15196的近侧，以使通道15300能够与轴组件15100分离。因此，远侧管段15352联接到近侧管段以便于相对于其进行轴向移动，或者整个组件(远侧管段15352和近侧管段)可轴向移动。如图76至图79中可见，间隙狭槽15309设置在细长通道15300的直立侧壁15308中，以容纳将砧座15200附接到第二通道安装构件15152的砧座附接销15193。当砧座15200闭合并且细长通道15300附接到第二通道安装构件15152时，砧座侧壁15212与每个对应的砧座安装部分15190间隔开以容纳细长通道15300的对应侧壁15308。
在一种布置中，外科钉仓15400包括仓体15402，该仓体被构造成能够卡扣或以其他方式可移除地保持在通道15200内，以便于在使用后容易替换。仓体15402包括居中设置的细长狭槽15404，该细长狭槽被构造成能够适应击发构件15500穿过其中轴向行进。仓体15402还包括其中的多个钉凹坑15406。在所示的示例中，钉凹坑15406在细长狭槽15404的每侧上布置成两行。一行中的钉凹坑15406相对于相邻钉凹坑行中的钉凹坑15406交错排列。在所示的示例中，每个钉凹坑15406在其中包含“直接驱动”外科钉1126。在图79中描绘的布置中，外科钉1126可移动地支撑在钉凹坑15406内，并且被构造成能够使得不使用单独的可移动钉驱动器。图80示出了另选的布置，其中常规的外科钉1126'各自支撑在钉驱动器15412上，而不是支撑在仓体15402'中的钉凹坑15406'内。当击发构件15500'通过外科钉仓15400'朝远侧驱动时，钉驱动器15412在该外科钉仓中向上驱动。关于击发构件15500'和钉驱动器15412的操作的进一步细节可在标题为“SURGICAL CUTTING AND STAPLINGINSTRUMENTS AND OPERATING SYSTEMS THEREFOR”的美国专利申请序列号14/308,240(现在为美国专利申请公开No.2014/0299648)中找到，其全部公开内容据此以引用方式并入本文。
接下来转向图78和图81，在所示的示例中，近侧旋转驱动轴15120延伸穿过第二通道安装构件15152并且由轴承组件15122可旋转地支撑在其中。近侧旋转驱动轴15120的远侧端部15124具有附接到其上的击发构件驱动齿轮15126，该击发构件驱动齿轮被构造用于可操作地与安装在细长通道15300内的远侧旋转驱动轴组件15310接合。远侧旋转驱动轴组件15310包括近侧轴端部15312，该近侧轴端部具有附接到其上的击发构件从动齿轮15314。近侧轴端部15312可旋转地支撑在近侧轴轴承15316中，该近侧轴轴承安装在通道15300的近侧附接部分15302中。参见图77和图81。远侧旋转驱动轴组件15310还包括远侧轴端部15320，该远侧轴端部可旋转地支撑在远侧轴轴承15322中，该远侧轴轴承支撑在通道15300的远侧端部15306中。参见图78。远侧旋转驱动轴组件15310的中心部分15330带有螺纹，用于与击发构件15500的螺纹驱动螺母部分15502螺纹驱动接合。
在一个示例中，击发构件15500包括直立主体15504，该直立主体从螺纹驱动螺母部分15502向上延伸并且具有形成在其上或附接到其上的组织切割表面15506。在至少一个实施方案中，击发构件主体15504具有形成在其上或附接到其上的滑动件组件15540。在其他布置中，滑动件组件可不附接到击发构件15500，而是被构造成能够在击发构件15500通过外科钉仓15400朝远侧驱动时通过该外科钉仓朝远侧驱动。滑动件组件15540包括一系列楔形凸轮15542，这些凸轮被构造成能够经凸轮接合钉1126或驱动器15412，以将钉凸轮地向上驱动成与砧座15200上的钉成形下表面15220形成接触。参见图79。如图77中可见，例如，钉成形下表面15220包括与外科钉仓15400内的每个钉相对应的一系列钉成形凹坑15222。当钉腿接触成形凹坑时，钉形成或闭合。参见例如图80所示的钉1126'。在所示的实施方案中，击发构件从动齿轮15314被构造成能够在通道15300附接到轴组件15100的第二通道安装构件15152时啮合地接合近侧驱动轴15120上的击发构件驱动齿轮15126。因此，近侧驱动轴15120的旋转将导致远侧驱动轴组件15310的旋转。近侧驱动轴15120沿第一旋转方向的旋转将引起击发构件15500在通道15300内朝远侧驱动，并且近侧驱动轴15120沿第二旋转方向的旋转将引起击发构件15500在通道15300内沿近侧方向驱动。
击发构件15500限定I形梁状结构并且包括下凸缘部分15560，该下凸缘部分由从螺纹驱动螺母部分15502延伸的两个侧向延伸的凸缘15562形成。另外，击发构件包括上凸缘部分15564，该上凸缘部分由两个侧向延伸的凸缘15566形成。击发构件主体15504延伸穿过细长通道15300中的细长通道狭槽15301、外科钉仓15400中的细长狭槽15404以及砧座15200中的砧座狭槽15230。例如，击发构件主体15504延伸穿过细长通道15300中的居中设置的通道狭槽15301，使得下凸缘15562可移动地定位在由细长通道15300限定的通路15303内。在图77所示的实施方案中，通道15300的底部是打开的。板15305附接到其上以向其提供增加的刚度。板15305在其中具有一系列窗口15307，以使外科医生能够在击发和回缩期间通过这些窗口观察击发构件15500的位置。
在所示的实施方案中，砧座构件15200通过击发构件15500在打开位置和闭合位置之间移动。如上所述，击发构件主体15504延伸穿过仓体中的细长狭槽15404。击发构件主体15504的顶端15505被构造成能够延伸到砧座主体15202的钉成形部分15204中的砧座狭槽15230中。参见图77。顶端15505延伸穿过砧座狭槽15230，使得上凸缘15566可移动地定位在由砧座15200限定的通路15232(参见图79)内。例如，通路15232可以通过砧座15200限定。I形梁凸缘15562和15566提供凸轮表面，这些凸轮表面分别与细长通道15300和砧座15200相互作用，以打开并夹持或闭合钳口，如本文进一步描述。此外，击发构件15500被构造成能够沿端部执行器1100的长度在细长通道15300和砧座15200之间保持恒定距离。
在击发冲程开始时，击发构件15500被构造成能够从初始位置朝远侧移动。当击发构件15500朝远侧移动时，砧座15200由击发构件15500的I形梁结构朝夹持构型枢转。更具体地，击发构件15500的下凸缘15562移动穿过由细长通道15300限定的通路15303，上凸缘15566沿砧座15200的斜坡表面15234移动，然后通过由砧座15200限定的通路15232。
主要参见图79和图81，斜坡表面15234在砧座15200中限定开闭腔15236，击发构件15500的一部分在击发冲程的一部分期间延伸穿过该腔。例如，上凸缘15566经由开闭腔15236从砧座15200突出。斜坡表面15234沿近侧开放表面15238向下倾斜，沿中间部分15239延伸，并沿远侧闭合斜坡15234向上倾斜。当击发构件15500处于初始位置或原始位置时，上凸缘15566与中间部分15239间隔开。换句话讲，上凸缘15566不与开闭腔15236经凸轮接合。在原始位置，击发构件15500可相对于开闭腔15234停留，使得击发构件15500既不会向砧座15200施加打开力，也不会向其施加闭合力。
从原始位置，击发构件15500可朝近侧回缩。随着击发构件15500继续朝近侧移动，击发构件15500的与近侧开放表面15238接合的上凸缘15566被构造成能够在近侧开放表面15238上施加打开力。随着上凸缘15566抵靠近侧开放表面15238移动，近侧开放表面15238枢转，这引起砧座15200枢转打开。当上凸缘15566在近侧开放表面15238上施加向下的力时，砧座15200由近侧开放表面15238上的杠杆作用被向上推动。
从回缩位置，击发构件15500可朝远侧推进以返回到原始位置。为了闭合端部执行器，击发构件15500可以进一步从原始位置推进到推进位置。对于在原始位置和推进位置中间的击发动作的一部分，上凸缘15566与斜坡表面15234间隔开。例如，当击发构件15500在闭合动作和打开动作之间转移时，上凸缘15566悬停或停留在中间部分15239上方。例如，击发动作的停留部分可被构造成能够防止打开动作和/或闭合动作的卡住。
随着击发构件15500朝远侧移动，凸缘15566接触斜坡表面15234，以在砧座15200上施加向下的力以使其枢转闭合。随着击发构件15500继续沿远侧方向移动，上凸缘15566移动穿过通路15232以确保砧座15200和细长通道15300之间沿端部执行器长度的恒定距离。例如，通路15232包括下凸部和上盖，它们限定通路15232的下限和上限。在击发冲程期间，上凸缘15566被约束在这些下限和上限内。上凸缘15566的尺寸可被设计为紧密配合在通路15232的边界内。在其他实例中，如本文进一步描述的，上凸缘15566可被构造成能够在通路15232内垂直浮动和/或调节。
击发构件15500是多功能击发构件。例如，击发构件15500被构造成能够驱动滑动件组件15540，以将钉1126从外科钉仓15400击发，切割夹持在钳口15200和15300之间的组织，在击发冲程开始时使钳口15200凸轮运动成夹持构型，以及在击发冲程完成时使钳口15200凸轮运动成打开构型。击发构件15500可以利用单个致动系统实现组合外科功能。因此，多功能击发构件15500可使配合在端部执行器的占地面积内所需的独立致动系统最小化。另外，可以在不分离或替换砧座15200的情况下将细长通道和外科钉仓15400作为一个单元进行替换。在另选的布置中，可在不替换细长通道15300的情况下替换外科钉仓15400，无论细长通道15300是保持附接到轴组件15100还是已经与该轴组件分离。另外，如图83至图85中可见，细长通道15300以及外科钉仓15400和砧座15200可选择性地在彼此垂直的多个关节运动平面AP1、AP2中枢转。
图86至图89示出了本发明的另一个外科器械实施方案16010的部分。在所示的布置中，外科器械16010包括轴组件16100，该轴组件可以可操作地联接到柄部组件或机器人系统的一部分形式的外壳(未示出)。例如，轴组件16100可以可操作地联接到本文所公开的各种驱动装置和/或以下文献中所公开的各种柄部组件、击发和关节运动驱动系统，或者以其他方式被构造用于与本文所公开的各种驱动装置结合使用和/或与以下文献中所公开的各种柄部组件、击发和关节运动驱动系统结合使用：标题为“SURGICAL INSTRUMENTS WITHARTICULATABLE SHAFT ARRANGEMENTS”的美国专利申请公开No.2015/0173789，其全部公开内容据此以引用方式并入本文。
如图86至图89所示，所示的轴组件包括柔性轴部分16110。柔性轴部分16110可以是在美国专利申请公开No.2015/0173789中更详细公开的类型和构造。因此，为了简洁起见，除了理解外科器械16010的构造和操作所必需的内容之外，本文将不讨论柔性轴部分16110的具体细节。在各种布置中，柔性轴部分16110可包括轴组件16100的段并且附接到例如附接杆部分(未示出)，该附接杆部分联接到外壳(柄部、机器人系统等)，如在上述美国专利申请或本文所公开的那些可互换轴装置中所述。柔性轴部分16110可由例如作为ISOPLAST等级2510购自Dow Chemical Company的刚性热塑性聚氨酯制成，并且包括居中设置的、竖直延伸的关节运动脊16112。关节运动脊16112包括居中设置的部件或刀狭槽16114，以便于各种控制部件从中穿过。参见图87。在所示的布置中，刀狭槽16114在其中可移动地支撑中心击发梁或杆16200。柔性轴部分16110还包括可与关节运动脊16112一体形成并且从其侧向突出的多个右肋16116和多个左肋16118。右肋16116和左肋16118具有弓形形状，以为柔性轴部分16110提供大致圆形的横截面形状。这种形状可有利于柔性轴部分16110穿过圆形通道，诸如适当尺寸的套管针。
在各种布置中，每一个右肋16116用于限定右关节运动通道，以便可移动地容纳穿过其中的右关节运动带16120。右关节运动带16120可延伸穿过右关节运动通道并且联接到连接器组件16150。例如，右关节运动带16120的远侧端部16122可具有右钩部分16124，该右钩部分适于联接到连接器组件16150的右附接部分16152。参见图89。相似地，每一个左肋16118用于限定左关节运动通道，以便可移动地容纳穿过其中的左关节运动带16130。左关节运动带16130可延伸穿过左关节运动通道并且联接到连接器组件16150。例如，左关节运动带16130的远侧端部16132可具有左钩部分16134，该左钩部分适于联接到连接器组件16150的左附接部分16154。在所示的示例中，右关节运动带16120和左关节运动带16130能够与柄部或外壳中的关节运动系统(诸如，例如美国专利申请公开No.2015/0173789中所公开的关节运动系统或本文所公开的可互换轴布置的关节运动系统)可操作地交接。
现在参见图87，在所示的示例中，连接器组件16150具有安装在其上的近侧外管构件16160。如图89中可见，近侧外管构件16160可具有与柔性轴部分16110的外径相同的外径，以便于通过套管针套管或其他通道将其插入。开放近侧端部16162的尺寸被设定成不可移动地容纳在柔性轴部分16110的远侧端部16111上的远侧安装毂16119上。近侧外管构件16160具有开放远侧端部16163和形成在其中的内凸缘16164。如图89中可见，右关节运动带16120和左关节运动带16130自由地在近侧外管构件16160内轴向移动。连接器组件16150被构造成能够有利于外科端部执行器16300与轴组件16100的快速附接和分离。
在所示的示例中，端部执行器16300包括细长通道16310，该细长通道被构造成能够在其中可操作地支撑外科钉仓1110。细长通道16310可基本上类似于上文详细描述的细长通道1102，除了细长通道16310包括近侧端部部分16312，该近侧端部部分具有不可移动地附接到其上的远侧管连接器16314。远侧管连接器16314从通道16310的近侧端部部分16312朝近侧突出，并且包括近侧安装毂部分16316，该近侧安装毂部分的尺寸被设定成容纳在近侧外管构件16160的开放远侧端部16163内。参见图89。另外，远侧管连接器16314包括一对沿直径相对的向内延伸的卡口销16318和16320。卡口销16318被构造成能够容纳在连接器组件16150的远侧端部16155中的对应狭槽16156内，并且卡口销16320构造成容纳在连接器组件16150的远侧端部16155中的对应狭槽16158内。参见图88。另外，偏置构件16170容纳在近侧外管构件16160的开放远侧端部16163内，与内凸缘16164对接接合。在所示的布置中，例如偏置构件16170包括波形弹簧。参见图87和图89。为了将外科端部执行器16300附接到轴组件16100，将远侧连接器管的近侧安装毂部分16316插入近侧外管构件16160的开放远侧端部16163中，使得卡口销16318与连接器组件16150中的狭槽16156对准，并且卡口销16320与狭槽16158对准。然后，端部执行器16300沿近侧方向PD移动并围绕轴轴线旋转，直到卡口销16318安置在连接器组件16150中的保持沟槽16157中，并且卡口销16320安置在保持沟槽16159中。参见图88。偏置构件16170朝远侧管连接器16314施加偏置动作，以将卡口销16318、16320保持安置在其各自的保持沟槽16157、16159中。为了将端部执行器16300与轴组件16100分离，用户沿近侧方向向外科端部执行器16300施加力以压缩偏置构件16170，然后沿相反方向旋转外科端部执行器16300以将卡口销16318、16320从其各自的保持沟槽16157、16159中取出，然后将外科端部执行器16300沿远侧方向DD拉离连接器组件16150。
在至少一个实施方案中，外科端部执行器16300包括砧座1130，如上文详细描述的。细长通道16310包括直立侧壁16330，每个直立侧壁中具有销孔16332。参见图87。砧座1130通过枢轴销1152可枢转地附接到细长通道16310，该枢轴销以上文详细讨论的方式延伸穿过砧座1130的每侧上的开孔1131并进入销孔16332。
如图87中可见，细长通道16310被构造成能够在其中可操作地支撑钉仓1110。外科器械16010还包括类似于上述击发构件1760的击发构件16210，除了击发构件16210被构造成能够用于快速轴向附接到击发梁16200和与该击发梁快速分离。击发梁16200可由多个层压板构成并且被构造成能够充分弯曲以适应端部执行器相对于轴组件的关节运动。在所示的示例中，击发构件16210包括朝近侧突出的联接器16212，该联接器被构造成能够可移动地插入形成在击发梁16200的远侧端部16202上的对应保持腔16204中。在一种布置中，联接器16212包括稍微箭头形的构件，并且保持腔16204相应地成形，以便在外科器械16010的正常操作(例如，击发和回缩)期间将击发构件保持在联接接合中，但是在外科端部执行器16300与轴组件16100分离时便于击发构件16210与击发梁16200分离。击发构件16210的致动以其他方式便于以本文所公开的各种方式打开和闭合砧座1130。这种布置有利于外科端部执行器与轴组件的容易附接和分离。因此，当更换整个端部执行器时，这种布置可以用于为用户提供新的(未使用的)击发构件和组织切割表面以及新的砧座和钉仓。然而，如果需要，用户可仅仅更换仓而不需要更换整个端部执行器。击发构件16210以与上文所述的击发构件1760类似的方式操作，并且用于以本文所述的方式与滑动件1120相互作用以从钉仓1110射出钉。
实施例
实施例1-一种可互换的外科工具组件，包括端部执行器，其中该端部执行器包括滑动件和切割刃。该可互换工具组件还包括击发杆，该击发杆可操作地被构造成能够击发滑动件和切割刃，其中击发杆包括远侧接合部分，并且其中击发杆能够从第一近侧位置移动到第一远侧位置，从第二近侧位置移动到第二远侧位置。该可互换工具组件还包括推杆组件，其中推杆组件包括板，该板包括近侧接合部分，其中该近侧接合部分选择性地联接到远侧接合部分，并且弹簧被构造成能够当击发杆从第一远侧位置移动到第二近侧位置时将近侧接合部分侧向地偏置成与远侧接合部分接合。
实施例2-根据实施例1所述的可互换外科工具组件，还包括击发构件，其中，该击发杆被构造成能够当击发杆从第一近侧位置移动到第一远侧位置时朝远侧推动击发构件。
实施例3-根据实施例2所述的可互换外科工具组件，其中，该击发构件包括被构造成能够接合端部执行器的第一钳口的第一凸缘、被构造成能够接合端部执行器的第二钳口的第二凸缘以及在第一凸缘和第二凸缘之间延伸的支撑部分。凹口限定在支撑部分中，并且板被构造成能够当击发杆从第二近侧位置移动到第二远侧位置时朝远侧滑动穿过凹口。
实施例4-根据实施例3所述的可互换外科工具组件，其中，板包括通过弹簧加载的扣件，该通过弹簧加载的扣件被构造成能够当板被击发杆朝近侧回缩时接合支撑部分。
实施例5-根据实施例1、2、3或4所述的可互换外科工具组件，其中，第一近侧位置在第二近侧位置的远侧。
实施例6-根据实施例1、2、3、4或5所述的可互换外科工具组件，其中，第一远侧位置在第二远侧位置的近侧。
实施例7-根据实施例1、2、3、4、5或6所述的可互换外科工具组件，其中，切割刃与滑动件一体形成。
实施例8-根据实施例1、2、3、4、5、6或7所述的可互换外科工具组件，其中，近侧接合部分包括t形狭槽，并且其中远侧接合部分包括键。
实施例9-一种可互换外科工具组件，包括端部执行器，其中该端部执行器包括第一钳口、可旋转地联接到第一钳口的第二钳口；以及滑动件，该滑动件被构造成能够相对于第一钳口和第二钳口平移。该可互换外科工具组件还包括击发构件，其中该击发构件包括被构造成能够接合第一钳口的第一凸缘以及被构造成能够接合第二钳口的第二凸缘。该可互换外科工具组件还包括推板和选择性地联接到推板的击发杆，其中该击发杆被构造成能够移动穿过多个连续的击发冲程。该多个连续的击发冲程包括：第一远侧击发冲程，在第一远侧击发冲程中，击发杆被构造成能够朝远侧推动击发构件；以及第一近侧击发冲程，在第一近侧击发冲程中，击发杆被构造成能够朝近侧回缩成与推板接合。该多个连续的击发冲程还包括：第二远侧击发冲程，在第二远侧击发冲程中，击发杆被构造成能够使推板朝远侧推进经过击发构件，以及第二近侧击发冲程，在第二近侧击发冲程中，击发杆被构造成能够使推板和击发构件朝近侧回缩。
实施例10-根据实施例9所述的可互换外科工具组件，其中，击发构件被构造成能够在第一远侧击发冲程期间朝远侧推动滑动件。
实施例11-根据实施例9或10所述的可互换外科工具组件，其中，推板被构造成能够在第二远侧击发冲程期间朝远侧推动滑动件。
实施例12-根据实施例9、10或11所述的可互换外科工具组件，其中，推板包括具有端部的片簧，并且其中该端部被构造成能够当推板在第二近侧击发冲程期间朝近侧回缩时接合击发构件。
实施例13-根据实施例9、10、11或12的可互换外科工具组件，其中，滑动件包括切割刃。
实施例14-根据实施例13所述的可互换外科工具组件，还包括可移除地定位在第一钳口中的钉仓，其中该第一钳口包括远侧腔，该远侧腔被构造成能够在第二远侧击发冲程完成时接纳切割刃。
实施例15-根据实施例9所述的可互换外科工具组件，还包括弹簧，该弹簧被构造成能够在第一近侧击发冲程期间将推板侧向地偏置成与击发杆接合。
实施例16-一种可互换外科工具组件，包括端部执行器，其中该端部执行器包括第一钳口和第二钳口，该第一钳口包括近侧端部，该第二钳口可旋转地联接到第一钳口。该可互换外科工具组件还包括固定地附接到近侧端部的远侧安装部分和可旋转地附接到远侧安装部分的近侧安装部分。该可互换外科工具组件还包括在近侧安装部分和远侧安装部分中间的旋转轴承以及从远侧安装部分延伸穿过近侧安装部分的旋转轴，其中该旋转轴的旋转被构造成能够使远侧安装部分旋转。该可互换外科工具组件还包括从近侧安装部分延伸的柔性脊，其中该柔性脊包括多个侧向对称的椎骨。
实施例17-根据实施例16所述的可互换外科工具组件，还包括击发构件，该击发构件被构造成能够与旋转轴一起平移，其中该击发构件包括第一凸缘和第二凸缘，该第一凸缘被构造成能够经凸轮接合第一钳口中的开闭腔，该第二凸缘被构造成能够经凸轮接合第二钳口。
实施例18-根据实施例16或17所述的可互换外科工具组件，其中，旋转轴包括多个穿孔，用于允许旋转轴在柔性脊内弯曲。
实施例19-根据实施例16、17或18所述的可互换外科工具组件，其中，柔性脊包括与侧向对称的椎骨相邻地中间定位的多个间隙。
实施例20-根据实施例16、17、18或19所述的可互换外科工具组件，其中，柔性脊柱包括安装到近侧安装部分的关节运动头部，其中该关节运动头部包括一对附接突片以及朝远侧延伸到相应的附接突片的一对柔性附接带。
实施例21-一种外科器械，包括限定轴轴线的轴组件，其中该轴组件包括近侧关节运动接头和远侧关节运动接头，该近侧关节运动接头限定横向于轴轴线的第一关节运动轴线，该远侧关节运动接头限定横向于轴轴线和第一关节运动轴线的第二关节运动轴线。该外科器械还包括驱动轴和可移动砧座，该驱动轴被构造成能够从旋转驱动动作源传输旋转驱动动作。该外科器械还包括通道，该通道被构造成能够在其中可操作地支撑外科钉仓，该通道被构造成能够可移除地附接到轴组件。该外科器械还包括击发构件，该击发构件可移动地支撑在通道中，并且被构造成能够当通道可操作地联接到轴组件时与驱动轴可操作地交接，其中击发构件能够在第一近侧位置和闭合位置之间可操作地移动，在第一近侧位置中，击发构件向砧座施加打开动作，在闭合位置中，击发构件向砧座施加闭合动作。
实施例22-根据实施例21所述的外科器械，其中，通道被构造成能够在横向于轴轴线的安装方向上附接到轴组件。
实施例23-根据实施例21或22所述的外科器械，其中，轴组件还包括脊构件，并且其中近侧关节运动接头包括第一通道安装组件，该第一通道安装组件可枢转地联接到脊构件，用于相对于脊构件围绕第一关节运动轴线进行选择性关节运动，并且其中远侧关节运动接头包括第二通道安装构件，该第二通道安装构件可枢转地联接到第一通道安装组件，用于相对于第一通道安装组件围绕第二关节运动轴线选择性枢转行进。
实施例24-根据实施例21、22或23所述的外科器械，还包括第一关节运动系统和第二关节运动系统，该第一关节运动系统与第一通道安装组件可操作地交接，用于向其选择性地施加第一关节运动动作，该第二关节运动系统与第二通道安装构件可操作地交接，用于向其选择性地施加第二关节运动动作。
实施例25-根据实施例24所述的外科器械，其中，该第一关节运动系统包括可操作地联接到第一通道安装组件的第一可轴向移动的关节运动致动器，并且其中该第二关节运动系统包括第二环状关节运动构件以及用于旋转第二关节运动构件的装置，该第二环状关节运动构件与第二通道安装构件可操作地交接，并且被构造成能够当第二环状关节运动构件旋转时向其施加第二关节运动动作。
实施例26-根据实施例25所述的外科器械，其中，用于旋转的装置包括与第二环状关节运动构件可操作地交接的第二可轴向移动的关节运动致动器。
实施例27-根据实施例21、22、23、24、25或26所述的外科器械，其中，通道的部分被构造成能够可滑动地接纳在第二通道安装构件中的对应狭槽内。
实施例28-根据实施例21、22、23、24、25、26或27所述的外科器械，其中，通道的部分被构造成能够在横向于轴轴线的安装方向上可滑动地插入第二通道安装构件中的对应狭槽中。
实施例29-根据实施例21、22、23、24、25、26、27或28所述的外科器械，还包括用于将通道的部分可释放地保持在对应狭槽中的装置。
实施例30-根据实施例29所述的外科器械，其中，用于可释放地保持的装置包括锁定构件，该锁定构件能够在锁定位置和解锁位置之间选择性地轴向移动，在锁定位置中，通道的部分被保持在对应狭槽内，在解锁位置中，通道的部分可在与安装方向相反的移除方向上从对应狭槽中移除。
实施例31-根据实施例30所述的外科器械，其中，锁定构件可在横向于安装方向和移除方向的锁定方向上轴向移动。
实施例32-一种外科器械，包括：轴组件，其中轴组件包括限定轴轴线的脊构件；可移动地联接到脊构件的第一通道安装组件，用于在第一关节运动平面中相对于脊构件进行选择性关节运动；以及可移动地联接到第一通道安装组件的第二通道安装构件，用于在与第一关节运动平面垂直的第二关节运动平面中相对于第一通道安装组件进行选择性关节运动。该外科器械还包括柔性旋转驱动轴和可枢转地联接到第二通道安装构件的砧座。该外科器械还包括通道，该通道被构造成能够在其中可操作地支撑外科钉仓，其中该通道被构造成能够与第二通道安装构件可移除地分离以与砧座隔开。该外科器械还包括击发构件，该击发构件可移动地支撑在通道中，并且被构造成能够当通道可操作地联接到第二通道安装构件时与柔性旋转驱动轴可操作地交接，该击发构件能够在第一近侧位置和闭合位置之间可操作地移动，在第一近侧位置中，击发构件向砧座施加打开动作，在闭合位置中，击发构件向砧座施加闭合动作。
实施例33-根据实施例32所述的外科器械，其中，击发构件包括组织切割部分，以及用于当击发构件在通道内的第一近侧位置和终止位置之间被驱动时从支撑在通道中的外科钉仓中射出外科钉的装置。
实施例34-根据实施例32或33所述的外科器械，其中，通道被构造成能够在横向于轴轴线的安装方向上附接到第二通道安装构件。
实施例35-根据实施例32、33或34所述的外科器械，其中，轴组件还包括锁定构件，该锁定构件可移动地支撑在脊构件上并且在其上能够在锁定位置和解锁位置之间选择性地轴向移动，在锁定位置中，通道被锁定到第二通道安装构件，在解锁位置中，通道能够与第二通道安装构件分离。
实施例36-一种外科器械，包括轴组件，其中该轴组件包括脊组件和可轴向移动的击发杆。该外科器械还包括外科端部执行器，该外科端部执行器包括通道，该通道被构造成能够在其中可操作地支撑外科钉仓，其中该通道被构造成能够通过连接器组件可移除地联接到脊组件。该外科器械还包括击发构件，该击发构件被支撑以在支撑于通道内的外科钉仓内轴向行进。该击发构件包括朝近侧突出的联接器，该联接器的尺寸被设计成可移除地插入形成在可轴向移动的击发杆的远侧端部中的对应保持腔中。该对应保持腔的尺寸相对于朝近侧突出的联接器设定，以当通道可移除地联接到脊组件时在其中卡扣地接纳朝近侧突出的联接器。
实施例37-根据实施例36所述的外科器械，其中，该连接器组件包括可操作地联接到脊组件的通道保持器，以及包括一对向内延伸的沿直径相对的附接销的远侧通道联接器，该附接销被构造成能够轴向插入通道保持器中的横向于轴轴线的对应联接狭槽中。
实施例38-根据实施例36或37所述的外科器械，其中，脊组件包括可移动地联接到通道保持器的柔性关节运动节段。
实施例39-根据实施例38所述的外科器械，其中，通道保持器通过至少一个可轴向移动的关节运动杆可移动地联接到柔性关节运动节段，该至少一个可轴向移动的关节运动杆由柔性关节运动节段可移动地支撑。
实施例40-根据实施例36、37、38或39所述的外科器械，其中，轴向移动的击发杆包括多个层压板。
实施例41-一种外科端部执行器，包括第一钳口、可旋转地联接到第一钳口的第二钳口以及被构造成能够在击发冲程期间平移的击发构件，其中该击发构件包括凹口。该外科端部执行器还包括闭锁弹簧，该闭锁弹簧包括钩，其中凹口被对准以在击发冲程期间接纳钩，除非未击发的钉仓被定位在第一钳口中，并且其中未击发的钉仓的滑动件组件被定位成使钩偏转脱离与凹口的对准。
实施例42-根据实施例41所述的外科端部执行器，其中，闭锁弹簧包括片簧。该片簧包括固定到第一钳口的近侧部分和包括钩的远侧部分。
实施例43-根据实施例41或42所述的外科端部执行器，其中，该击发构件包括切割刃、支撑切割刃的中间部分以及从中间部分侧向突出的凸耳，其中凹口限定在凸耳中。
实施例44-根据实施例41、42或43所述的外科端部执行器，其中，该击发构件还包括第一凸缘和第二凸缘，该第一凸缘被构造成能够经凸轮接合第一钳口，该第二凸缘被构造成能够经凸轮接合第二钳口。
实施例45-根据实施例41、42、43或44所述的外科端部执行器，其中，闭锁弹簧被构造成能够防止击发构件朝远侧平移经过钩，除非未击发的钉仓被定位在第一钳口中。
实施例46-根据实施例41、42、43、44或45所述的外科端部执行器，其中，第一钳口包括仓支撑表面，其中凹陷部限定在仓支撑表面中，并且其中当未击发的钉仓被定位在第一钳口中时，钩至少部分地偏转到凹陷部中。
实施例47-根据实施例41、42、43、44、45或46所述的外科端部执行器，其中，闭锁弹簧包括支撑钩的弹簧臂，并且其中弹簧臂从击发构件侧向地偏移。
实施例48-根据实施例41、42、43、44、45、46或47所述的外科端部执行器，其中，闭锁弹簧包括第二钩，并且其中击发构件包括第二凹口，该第二凹口被对准以在击发冲程期间接纳第二钩，除非未击发的钉仓被定位在第一钳口中。
实施例49-一种外科端部执行器，包括第一钳口、可旋转地联接到第一钳口的第二钳口以及被构造成能够在击发冲程期间平移的击发构件。该击发构件包括侧向突出的凸耳以及限定在侧向突出的凸耳中的锁。该外科端部执行器还包括闭锁弹簧，该闭锁弹簧包括侧向突出的突片，其中锁被定位成在击发冲程期间接纳侧向突出的突片，除非未击发的钉仓被定位在第一钳口中。
实施例50-根据实施例49所述的外科端部执行器，还包括未击发的钉仓，其包括滑动件组件，该滑动件组件被构造成能够在击发冲程期间朝远侧平移。
实施例51-根据实施例50所述的外科端部执行器，其中，锁被构造成能够在击发冲程期间沿锁定路径平移，并且其中未击发钉仓中的滑动件组件被构造成能够使侧向突出的突片偏转脱离锁定路径。
实施例52-根据实施例49、50或51所述的外科端部执行器，其中，第一钳口包括仓支撑表面，其中凹陷部限定在仓支撑表面中，并且其中当未击发的钉仓被定位在第一钳口中时侧向突出的突片偏转到凹陷部中。
实施例53-根据实施例49、50、51或52所述的外科端部执行器，其中，闭锁弹簧包括片簧。该片簧包括固定到第一钳口的第一部分、支撑侧向突出的突片的第二部分以及在第一部分和第二部分中间延伸的弹簧臂，其中该弹簧臂从击发构件侧向地偏移。
实施例54-根据实施例49、50、51、52或53所述的外科端部执行器，其中，击发构件还包括支撑件，该支撑件包括切割刃。该击发构件还包括从支撑件延伸的第一凸缘和从支撑件延伸的第二凸缘，其中该第一凸缘被构造成能够经凸轮接合第一钳口，其中该第二凸缘被构造成能够经凸轮接合第二钳口。
实施例55-根据实施例49、50、51、52、53或54所述的外科端部执行器，其中，该击发构件还包括第二侧向突出的凸耳和限定在第二侧向突出的凸耳中的第二锁，其中闭锁弹簧还包括第二侧向突出的突片，并且其中第二锁被定位成在击发冲程期间接纳第二侧向突出的突片，除非未击发的钉仓被定位在第一钳口中。
实施例56-一种外科端部执行器，包括第一钳口、可旋转地联接到第一钳口的第二钳口以及闭锁装置。该闭锁装置包括锁，该锁被构造成能够在击发冲程期间沿锁定路径平移；和闭锁弹簧，该闭锁弹簧包括向内突出的突片，其中锁被定位成在击发冲程期间接纳向内突出的突片，除非未击发的钉仓被定位在第一钳口中。
实施例57-根据实施例56所述的外科端部执行器，还包括未击发的钉仓，其中该未击发的钉仓包括被构造成能够在击发冲程期间朝远侧平移的滑动件组件，其中锁被构造成能够在击发冲程期间沿锁定路径平移，并且其中未击发的钉仓中的滑动件组件被构造成能够使向内突出的突片偏转脱离锁定路径。
实施例58-根据实施例56或57所述的外科端部执行器，其中，第一钳口包括仓支撑表面，其中凹陷部限定在仓支撑表面中，并且其中当未击发的钉仓被定位在第一钳口中时向内突出的突片偏转到凹陷部中。
实施例59-根据实施例56、57或58所述的外科端部执行器，其中，闭锁弹簧包括片簧。该片簧包括固定到第一钳口的第一部分和支撑侧向突出的突片的第二部分。片簧还包括在第一部分和第二部分中间延伸的弹簧臂，其中该弹簧臂从击发构件侧向地偏移。
实施例60-根据实施例56、57、58或59所述的外科端部执行器，还包括击发构件，其中该击发构件包括支撑件，该支撑件包括切割刃和锁。该击发构件还包括从支撑件延伸的第一凸缘和从支撑件延伸的第二凸缘，其中该第一凸缘被构造成能够经凸轮接合第一钳口，其中该第二凸缘被构造成能够经凸轮接合第二钳口。
实施例61-一种外科端部执行器，包括第一钳口、包括闭合表面和开放表面的第二钳口以及枢转接头，其中该第二钳口被构造成能够在枢转接头处相对于第一钳口枢转，其中该闭合表面被定位在枢轴接头的远侧，并且其中该开放表面被定位在枢轴接头的近侧。该外科端部执行器还包括击发构件，该击发构件被构造成能够在击发冲程期间朝远侧移动。该击发构件包括被定位成接合第一钳口的第一凸缘以及被定位成接合第二钳口的第二凸缘，其中该第二凸缘被构造成能够接合闭合表面以使第二钳口朝闭合位置枢转，并且其中该第二凸缘被构造成能够接合开放表面以使第二钳口朝打开位置枢转。
实施例62-根据实施例61所述的外科端部执行器，其中，该击发构件能够从原始位置朝远侧移动以使第二钳口朝闭合位置枢转，并且其中该击发构件能够从原始位置朝近侧移动以使第二钳口朝打开位置枢转。
实施例63-根据实施例61或62所述的外科端部执行器，其中，该第二钳口包括在闭合表面和开放表面之间的中间表面，并且其中当击发构件处于原始位置时，第二凸缘与中间表面间隔开。
实施例64-根据实施例61、62或63所述的外科端部执行器，其中，该击发构件还包括在第一凸缘和第二凸缘中间的刀。
实施例65-根据实施例61、62、63或64所述的外科端部执行器，其中，该第一钳口被构造成能够接纳钉仓。
实施例66-根据实施例61、62、63、64或65所述的外科端部执行器，其中，该第二钳口包括钉成形砧座。
实施例67-根据实施例61、62、63、64、65或66所述的外科端部执行器，其中，该第一钳口包括用于第一凸缘的第一通路，并且其中该第二钳口包括用于第二凸缘的第二通路。
实施例68-根据实施例61、62、63、64、65、66或67所述的外科端部执行器，还包括弹簧，该弹簧被构造成能够当击发构件在原始位置的近侧时将第二钳口朝打开位置偏置。
实施例69-一种外科端部执行器，包括第一钳口、包括闭合表面和开放表面的第二钳口以及枢转接头，其中该第二钳口被构造成能够在枢转接头处相对于第一钳口枢转。该外科端部执行器还包括击发构件，该击发构件被构造成能够在击发冲程期间从原始位置朝远侧移动。该击发构件包括被定位成接合第一钳口的第一凸缘以及被定位成接合第二钳口的第二凸缘，其中该第二凸缘被构造成能够当击发构件从原始位置朝远侧移动时接合闭合表面，并且其中该第二凸缘被构造成能够当击发构件从原始位置朝近侧移动时接合开放表面。
实施例70-根据实施例69所述的外科端部执行器，其中，该第二凸缘被构造成能够接合闭合表面以使第二钳口朝闭合位置枢转，并且其中该第二凸缘被构造成能够接合开放表面以使第二钳口朝打开位置枢转。
实施例71-根据实施例69或70所述的外科端部执行器，其中，该第二钳口包括在闭合表面和开放表面之间的中间表面，并且其中当击发构件处于原始位置时，第二凸缘与中间表面间隔开。
实施例72-根据实施例69、70或71所述的外科端部执行器，其中，该击发构件还包括在第一凸缘和第二凸缘中间的刀。
实施例73-根据实施例69、70、71或72所述的外科端部执行器，其中，该第一钳口被构造成能够接纳钉仓。
实施例74-根据实施例69、70、71、72或73的外科端部执行器，其中，第二钳口包括砧座。
实施例75-根据实施例69、70、71、72、73或74所述的外科端部执行器，其中，该第一钳口包括用于第一凸缘的第一通路，并且其中该第二钳口包括用于第二凸缘的第二通路。
实施例76-根据实施例69、70、71、72、73、74或75所述的外科端部执行器，还包括弹簧，该弹簧被构造成能够当击发构件处于原始位置时将第二钳口远离第一钳口偏置。
实施例77-一种外科端部执行器，包括第一钳口、包括第一凸轮装置和第二凸轮装置的第二钳口以及枢转接头，其中该第二钳口被构造成能够在枢转接头处相对于第一钳口枢转。该外科端部执行器还包括击发构件，该击发构件被构造成能够在击发冲程期间从原始位置朝远侧移动。该击发构件包括被定位成与第一钳口接合的第一凸缘以及被定位成与第二钳口接合的第二凸缘，其中该第二凸缘被构造成能够当击发构件从原始位置朝远侧移动时接合第一凸轮装置，并且其中该第二凸缘被构造成能够当击发构件从原始位置朝近侧移动时接合第二凸轮装置。
实施例78-根据实施例77所述的外科端部执行器，其中，该第一凸轮装置被构造成能够使第二钳口朝闭合位置进行凸轮运动，并且其中该第二凸轮装置被构造成能够使第二钳口朝打开位置进行凸轮运动。
实施例79-根据实施例77或78所述的外科端部执行器，其中，该第一凸轮装置包括从中间表面向上延伸到第二钳口中的通路中的远侧闭合斜坡，并且其中该第二凸轮装置包括从中间表面向上延伸的近侧闭合表面。
实施例80-根据实施例77、78或79所述的外科端部执行器，其中，原始位置包括一系列位置。
实施例81-一种外科端部执行器，包括第一钳口、可旋转地联接到第一钳口的第二钳口以及闭锁装置，该闭锁装置被构造成能够防止第二钳口朝第一钳口的旋转运动，除非未击发的钉仓被定位在第一钳口中，其中该闭锁装置包括可枢转锁，该可枢转锁被构造成能够在锁定取向和解锁取向之间枢转。该可枢转锁包括第一腿部和第二腿部，该第一腿部被构造成能够当可枢转锁处于锁定取向时接合第二钳口，该第二腿部被构造成能够当未击发的钉仓被定位在第一钳口中时接合未击发的钉仓。
实施例82-根据实施例81所述的外科端部执行器，还包括弹簧，该弹簧包括远侧端部，其中该远侧端部与可枢转锁接合，并且其中该弹簧被构造成能够将可枢转锁朝锁定取向偏置。
实施例83-根据实施例82所述的外科端部执行器，其中，弹簧包括片簧。
实施例84-根据实施例81、82或83所述的外科端部执行器，其中，该可枢转锁包括第三腿部，并且其中该远侧端部被定位成抵靠第三腿部。
实施例85-根据实施例81、82、83或84所述的外科端部执行器，其中，该闭锁凹口限定在第一钳口中，并且其中当可枢转锁处于解锁取向时，第二腿部至少部分地定位在闭锁凹口中。
实施例86-根据实施例81、82、83、84或85所述的外科端部执行器，其中，该第一钳口包括细长通道，其中该第二钳口包括砧座，该砧座包括延伸到细长通道中的内轨道，并且其中当可枢转锁处于锁定取向时，第一腿部的端部部分邻接内轨道。
实施例87-根据实施例81、82、83、84、85或86所述的外科端部执行器，其中，闭锁装置包括第二可枢转锁。
实施例88-根据实施例81、82、83、84、85、86或87所述的外科端部执行器，还包括未击发的钉仓，该未击发的钉仓包括滑动件组件，其中该滑动件组件被构造成能够当滑动件组件处于击发前位置时接合第二腿部。
实施例89-一种可互换的外科工具组件，包括被构造成能够接纳钉仓的端部执行器和轴。该轴包括击发组件，其中该击发组件包括远侧部分、包括凹口的近侧部分以及在近侧部分和远侧部分中间的弹簧。该轴还包括能够在解锁取向和锁定取向之间移动的闭锁杠杆，其中当闭锁杠杆处于锁定取向时，闭锁杠杆延伸到凹口中，并且其中击发组件的远侧部分的位移被构造成能够将闭锁杠杆移动到解锁取向。
实施例90-根据实施例89所述的可互换外科工具组件，还包括钉仓，其中该钉仓包括近侧端部，
从近侧端部朝远侧延伸的纵向狭槽以及在近侧端部处延伸跨过纵向狭槽的易碎门。该易碎门被构造成能够当钉仓被安装在端部执行器中时使击发组件的远侧部分朝近侧转移。
实施例91-根据实施例89或90所述的可互换外科工具组件，其中，弹簧被构造成能够当钉仓被安装在端部执行器中时在近侧部分和远侧部分之间压缩。
实施例92-根据实施例89、90或91所述的可互换外科工具组件，其中，该远侧部分包括朝近侧延伸的楔形件，该楔形件被构造成能够当远侧部分朝近侧转移时将闭锁杠杆移动到解锁取向。
实施例93-根据实施例90、91或92所述的可互换外科工具组件，其中，钉仓包括仓体，该仓体包括切口，并且其中易碎门包括可枢转地联接到仓体的第一端部以及摩擦配合在切口中的第二端部。
实施例94-根据实施例90、91、92或93所述的可互换外科工具组件，其中，击发组件被构造成能够在击发冲程期间破开易碎门。
实施例95-根据实施例89、90、91、92、93或94所述的可互换外科工具组件，其中，轴还包括复位弹簧，该复位弹簧被构造成能够将闭锁杠杆朝锁定取向偏置。
实施例96-根据实施例89、90、91、92、93、94或95所述的可互换外科工具组件，其中，击发组件的远侧部分在击发冲程期间从击发前近侧位置推进到远侧位置，并且在击发冲程之后从远侧位置回缩到击发后近侧位置，并且其中击发后近侧位置在击发前近侧位置的远侧。
实施例97-一种外科端部执行器，包括第一钳口和可旋转地联接到第一钳口的第二钳口，其中该第二钳口包括能够在锁定构型和解锁构型之间移动的销。该外科端部执行器还包括闭锁装置，该闭锁装置被构造成能够防止第二钳口朝第一钳口的旋转运动，除非钉仓被定位在第一钳口中，其中该闭锁装置包括锁定杆，该锁定杆被构造成能够当钉仓被定位在第一钳口中时在第一钳口内从远侧位置平移到近侧位置，并且其中锁定杆被构造成能够当锁定杆移动到近侧位置时将销移动到解锁构型。
实施例98-根据实施例97所述的外科端部执行器，还包括在第一钳口和第二钳口之间延伸的弹簧，其中该弹簧被构造成能够将第二钳口朝第一钳口偏置。
实施例99-根据实施例98所述的外科端部执行器，其中，第一钳口包括成型狭槽，其中销被构造成能够当第二钳口朝第一钳口旋转时沿成型狭槽移动，其中第一钳口还包括从成型狭槽延伸的闭锁凹口，并且其中弹簧将销偏置到闭锁凹口中。
实施例100-根据实施例97、98或99所述的外科端部执行器，其中，销包括半圆的周边。
实施例101-一种外科端部执行器，包括第一钳口、第二钳口和击发构件，该击发构件被构造成能够在击发冲程期间相对于第一钳口和第二钳口平移。该击发构件包括具有狭槽的支撑部分、从支撑部分延伸的第一凸缘，其中该第一凸缘被构造成能够在击发冲程期间接合第一钳口。该击发构件还包括定位在狭槽中的第二凸缘，其中该第二凸缘被构造成能够在击发冲程期间接合第二钳口，并且其中该第二凸缘被构造成能够在阈值力施加到第二凸缘时在狭槽中远离第一凸缘移动。
实施例102-根据实施例101所述的外科端部执行器，其中，狭槽包括楔形狭槽。
实施例103-根据实施例101或102所述的外科端部执行器，其中，该狭槽包括近侧端部和远侧端部，并且其中第二凸缘摩擦配合在狭槽的远侧端部中。
实施例104-根据实施例103所述的外科端部执行器，其中，阈值力被配置成能够克服将第二凸缘固定在远侧端部中的摩擦力。
实施例105-根据实施例101、102、103或104所述的外科端部执行器，其中，狭槽包括成型上边缘，并且其中第二凸缘被构造成能够在阈值力施加到第二凸缘时沿成型上边缘滑动。
实施例106-根据实施例101、102、103、104或105所述的外科端部执行器，其中，第二凸缘包括与狭槽对准的沟槽。
实施例107-根据实施例101、102、103、104、105或106所述的外科器械，其中，击发构件还包括固定到第二凸缘的引导件。
实施例108-根据实施例101、102、103、104、105、106或107所述的外科端部执行器，其中，第二钳口可旋转地联接到第一钳口。
实施例109-一种外科端部执行器，包括第一钳口、第二钳口和击发构件，该击发构件被构造成能够在击发冲程期间相对于第一钳口和第二钳口平移。该击发构件包括固定凸缘，该固定凸缘被构造成能够在击发冲程期间接合第一钳口；浮动凸缘，该浮动凸缘被构造成能够在击发冲程期间接合第二钳口；弹簧，该弹簧被构造成能够将浮动凸缘朝第一位置偏置。
实施例110-根据实施例109所述的外科端部执行器，其中，狭槽限定在击发构件中，并且其中浮动凸缘被构造成能够在阈值力施加到浮动凸缘时沿狭槽滑动。
实施例111-根据实施例110所述的外科端部执行器，其中，狭槽包括近侧端部、远侧端部，其中远侧端部比近侧端部更靠近固定凸缘，以及从近侧端部延伸到远侧端部的上边缘。
实施例112-根据实施例111所述的外科端部执行器，其中，第一位置与远侧端部相邻。
实施例113-根据实施例111或112所述的外科端部执行器，其中，弹簧包括在浮动凸缘和狭槽的近侧端部之间延伸的螺旋弹簧。
实施例114-根据实施例110、111、112或113所述的外科端部执行器，其中，浮动凸缘包括与狭槽对准的沟槽。
实施例115-根据实施例109、110、111、112、113或114所述的外科器械，其中，击发构件还包括引导件。
实施例116-一种外科端部执行器，包括第一钳口、第二钳口和击发构件，该击发构件被构造成能够在击发冲程期间相对于第一钳口和第二钳口平移。该击发构件包括被构造成能够在击发冲程期间接合第一钳口的固定凸缘以及具有浮动凸缘的柔顺部分，其中浮动凸缘被构造成能够在击发冲程期间接合第二钳口。
实施例117-根据实施例116所述的外科端部执行器，其中，柔顺部分由镍钛诺构成。
实施例118-根据实施例116或117所述的外科端部执行器，其中，切口限定在击发构件中，并且其中柔顺部分被嵌入在切口中。
实施例119-根据实施例118所述的外科端部执行器，其中，切口包括下部，并且其中柔顺部分包括定位在下部中的脚部。
实施例120-根据实施例116、117、118或119所述的外科端部执行器，其中，浮动凸缘被构造成能够在阈值力施加到浮动凸缘时远离固定凸缘移动。
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 ANARTICULATING END 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 FASTENINGINSTRUMENT HAVING RF ELECTRODES”的美国专利申请序列号12/031,573；
-提交于2008年2月15日的名称为“END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT”的美国专利申请序列号12/031,873(现为美国专利No.7,980,443)；
-名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”的美国专利申请序列号12/235,782，现为美国专利8,210,411；
-名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117，现为美国专利8,608,045；
-提交于2009年12月24日的名称为“MOTOR-DRIVEN SURGICAL 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布2014/0263552；
-提交于2006年1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，也可使用其他材料。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，在任何一种情况下，可以在至少一次使用之后修复设备以便重复使用。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，修整装置可利用各种技术来进行拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修复装置均在本申请的范围内。
本文所公开的装置可在手术之前进行处理。首先，可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、陈述或其他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 (8)

1.一种外科端部执行器，包括：
第一钳口；
第二钳口，所述第二钳口可旋转地联接到所述第一钳口；以及
闭锁装置，所述闭锁装置被构造成能够防止所述第二钳口朝所述第一钳口的旋转运动，除非未击发的钉仓被定位在所述第一钳口中，其中所述闭锁装置包括被构造成能够在锁定取向和解锁取向之间枢转的可枢转锁，并且其中所述可枢转锁包括：
第一腿部，所述第一腿部被构造成能够当所述可枢转锁处于所述锁定取向时接合所述第二钳口，使得由于所述第一腿部与所述第二钳口之间的接合，所述第二钳口相对于所述第一钳口保持在打开构型；以及
第二腿部，所述第二腿部被构造成能够当所述未击发的钉仓被定位在所述第一钳口中时接合所述未击发的钉仓，
其中，所述可枢转锁被构造成在所述钉仓安装到所述第一钳口中时通过驱动第二腿部被运动到所述解锁取向。
2.根据权利要求1所述的外科端部执行器，还包括弹簧，所述弹簧包括远侧端部，其中所述远侧端部与所述可枢转锁接合，并且其中所述弹簧被构造成能够将所述可枢转锁朝所述锁定取向偏置。
3.根据权利要求2所述的外科端部执行器，其中，所述弹簧包括片簧。
4.根据权利要求3所述的外科端部执行器，其中，所述可枢转锁包括第三腿部，并且其中所述远侧端部被定位成抵靠所述第三腿部。
5.根据权利要求1所述的外科端部执行器，其中，闭锁凹口限定在所述第一钳口中，并且其中当所述可枢转锁处于所述解锁取向时，所述第二腿部至少部分地定位在所述闭锁凹口中。
6.根据权利要求1所述的外科端部执行器，其中，所述第一钳口包括细长通道，其中所述第二钳口包括砧座，所述砧座包括延伸到所述细长通道中的内轨道，并且其中当所述可枢转锁处于所述锁定取向时，所述第一腿部的端部部分邻接所述内轨道。
7.根据权利要求1所述的外科端部执行器，其中，所述闭锁装置包括第二可枢转锁。
8.根据权利要求1所述的外科端部执行器，还包括所述未击发的钉仓，所述未击发的钉仓包括滑动件组件，其中所述滑动件组件被构造成能够当所述滑动件组件处于击发前位置时接合所述第二腿部。
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US20190099181A1 (en) 2019-04-04
US11317913B2 (en) 2022-05-03

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