CN110099622A - 用于容纳不同类型的钉的钉成形凹坑布置结构 - Google Patents
用于容纳不同类型的钉的钉成形凹坑布置结构 Download PDFInfo
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Abstract
本发明公开了一种外科缝合系统。在各种实施方案中，该系统包括钉仓附接部分，被构造成能够可操作地附接到该钉仓附接部分的第一钉仓以及被构造成能够可操作地附接到该钉仓附接部分的第二钉仓，其中该第一钉仓包括多个第一钉，该多个第一钉包括第一钉腿，其中该第二钉仓包括多个第二钉，该多个第二钉包括第二钉腿，并且其中该第一钉不同于该第二钉。该系统还包括砧座，该砧座包括组织接合表面和限定在该表面中的多个成形凹坑，其中每个凹坑包括被构造成能够接收第一钉仓的第一钉的腿的第一着陆区和被构造成能够接收第二钉仓的第二钉的腿的第二着陆区。
Description
背景技术
本发明涉及外科器械，并且在各种布置结构中，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为根据至少一个实施方案的包括柄部和可互换轴组件的外科器械的透视图，该可互换轴组件包括端部执行器；
图1A为图1的外科器械的透视图，示为已移除一些部件；
图1B为图1的外科器械的远侧部分的透视图，示为已移除一些部件；
图1C为图1的外科器械的近侧部分的透视图，示为已移除一些部件；
图1D为图1的外科器械的分解图；
图1E为图1的外科器械的远侧端部的分解图；
图1F为图1的外科器械的近侧端部的分解图；
图1G为图1的外科器械的局部剖面平面图，其示出处于非关节运动构型的端部执行器；
图1H为图1的外科器械的局部剖面平面图，其示出处于关节运动构型的端部执行器；
图1I为图1的外科器械的局部分解图；
图1J为图1的外科器械的砧座钳口的剖视图；
图2为根据至少一个实施方案的仓钳口的正视图；
图3为包括图1的砧座钳口和图2的仓钳口的端部执行器的正视图；
图4为根据至少一个实施方案的被示出处于打开构型的端部执行器的局部正视图；
图5为以完全封闭构型示出的图4中端部执行器的局部正视图；
图6为根据至少一个实施方案的击发组件的局部透视图；
图7为包括图6的击发组件的外科器械的局部剖视图；
图8为被示出处于部分打开构型的图7的外科器械的局部剖视图；
图9为根据至少一个实施方案的击发构件的联接构件的透视图；
图10为图9的击发构件的局部透视图，包括附接到联接构件的分层击发杆；
图11为图9的击发构件的端视图；
图12为根据至少一个实施方案的击发构件的联接构件的透视图；
图13为图12的击发构件的击发杆的局部透视图；
图14为图12的击发构件的局部透视图；
图15为根据至少一个实施方案的击发构件的联接构件和击发杆层的局部透视图；
图16为附接到图15的联接构件的击发杆层的局部透视图；
图17为附接到图15的联接构件的击发杆的附加层的局部透视图；
图18为图15的联接构件和击发杆的局部平面图；
图19为根据至少一个实施方案的包括联接构件、击发杆和闭锁杆的击发组件的局部透视图；
图20为包括被示为处于锁定构型的图19的击发组件的外科器械的局部剖视图；
图21为被示为处于解锁构型的图20的外科器械的局部剖视图；
图22为被示为处于锁定构型的外科器械的局部剖视图；
图23为被示为处于解锁构型的图22的外科器械的局部剖视图；
图24为被示为处于锁定构型的外科器械的局部剖视图；
图25为被示为处于解锁构型的图24的外科器械的局部剖视图；
图26为根据至少一个实施方案的外科器械的仓钳口、钉仓和击发构件的分解图；
图27为被示为处于未击发构型的图26的外科器械的正视图；
图28为被示为处于部分击发构型的图26的外科器械的正视图；
图29为被示为处于完全击发构型的图26的外科器械的正视图；
图30示出了夹在血管上的图26的外科器械；
图31为根据至少一个实施方案的仓钳口的顶部平面图；
图32为图31的仓钳口的底部平面图；
图33为沿着图31中的线33-33截取的图31所示仓钳口的剖视图；
图34为沿着图31中的线34-34截取的图31所示仓钳口的剖视图；
图35为包括击发组件的外科器械的局部剖视图，该击发组件包括被示为处于解锁状态的击发力闭锁件；
图36为图35的外科器械的局部剖视图，示出了处于锁定构型的击发力闭锁件；
图37为图35的外科器械的局部剖视图，示出了处于解锁构型的击发力闭锁件以及处于击发位置的击发组件；
图38为沿着图37的线38-38截取的图35的外科器械的剖视图；
图39为根据至少一个实施方案的包括仓闭锁件的钉仓的局部平面图；
图40为图39的钉仓的局部平面图，示出了被部分推进穿过钉仓的击发构件；
图41为图39的钉仓的局部剖视正视图，示出了处于部分推进位置的击发构件；
图42为图39的钉仓的局部平面图，示出了处于回缩位置的击发构件和处于锁定构型的仓闭锁件；
图43为根据至少一个实施方案的被示为处于解锁构型的外科器械的击发闭锁组件的局部透视图；
图44为被示为处于其解锁构型的图43的击发闭锁组件的局部剖面透视图；
图45为图43的外科器械的局部剖视正视图，示出了处于其解锁构型的击发闭锁件；
图46为图43的外科器械的局部剖视正视图，示出了处于锁定构型的击发闭锁件；
图47为图43的外科器械的局部剖视正视图，示出了返回其解锁构型的击发闭锁件；
图48为根据至少一个实施方案的包括击发闭锁件的外科器械的局部透视图；
图49为图48的外科器械的局部剖视图，示出了处于解锁构型的击发闭锁件；
图50为图48的外科器械的局部剖视图，示出了处于锁定构型的击发闭锁件；
图51为图48的外科器械的局部剖视图，示出了返回其解锁构型后的击发闭锁件；
图52为根据至少一个实施方案的包括击发构件和击发力闭锁件的外科器械的局部剖视图；
图53为图52的外科器械的局部剖视图，示出了朝远侧运动的击发构件；
图54为沿着图52的线54-54截取的图52的外科器械的端部剖视图；
图55为图52的外科器械的局部剖视图，示出了处于击发位置的击发构件；
图56为图52的外科器械的局部剖视图，示出了处于锁定状态的击发力闭锁件；
图57为根据至少一个实施方案的包括击发构件和击发力闭锁件的外科器械的局部剖视图；
图58为图57的外科器械的局部剖视图，示出了处于锁定状态的击发力闭锁件；
图59为图57的外科器械的局部剖视图，示出了重置后的击发力闭锁件和朝远侧推进以执行钉击发行程的击发构件；
图60为根据至少一个实施方案的外科器械的击发组件的局部分解图；
图61为图60的击发组件的熔断器区域的详细视图，该熔断器区域被构造成能够当通过击发组件传递的击发负载超过阈值时失效；
图62为图60的外科器械的局部剖视图，示出了处于未击发位置的击发组件以及处于完整状态的熔断器区域；
图63为图60的外科器械的局部剖视图，示出了处于失效状态的熔断器区域；
图64为图60的外科器械的局部剖视图，示出了处于塌缩状态的击发组件；
图65为根据至少一个实施方案的外科器械的局部剖视图，该外科器械包括具有可重置熔断器部分的击发组件；
图66为图65的外科器械的局部剖视图，示出了处于击发位置的击发组件；
图67为图65的外科器械的局部剖视图，示出了处于失效状态的熔断器部分；
图68为图65的外科器械的局部剖视图，示出了被回缩和重置的熔断器部分；
图69为图65的外科器械的局部剖视图，示出了处于重置状态的熔断器部分；
图70为图65的外科器械的局部剖视图，示出了处于击发位置的击发组件；
图71为根据至少一个实施方案的外科器械的局部剖视图，该外科器械包括具有熔断器部分的击发组件；
图72为图71的外科器械的局部剖视图，示出了处于击发位置的击发组件；
图73为图71的外科器械的局部剖视图，示出了在击发组件向远侧前进以执行钉击发行程之前处于失效状态的熔断器部分，其中该熔断器部分还用作防止钉击发行程的击发力闭锁件；
图74为图71的外科器械的局部剖视图，示出了在击发组件的钉击发行程期间处于第一阶段失效状态的熔断器部分；
图75为图71的外科器械的局部剖视图，示出了在击发组件的钉击发行程期间处于第二阶段失效状态的熔断器部分；
图76为图71的外科器械的局部剖视图，示出了正在重置的击发组件；
图77为图71的外科器械的局部剖视图，示出了处于重置状态的击发组件；
图77A为根据至少一个实施方案的钉仓的透视图；
图77B为图77A的钉仓和与之一起使用的砧座的局部平面图；
图77C为根据至少一个实施方案的钉仓的透视图；
图77D为图77C的钉仓和与之一起使用的砧座的局部平面图；
图77E包括处于未成形构型的图77C的钉仓的钉的正视图，处于成形构型的图77C的钉仓的钉的正视图，以及处于未成形构型的图77C的钉仓的钉的平面图；
图77F示出了被植入到患者组织中的图77E的钉；
图78为根据至少一个实施方案的包括柄部和可互换轴组件的外科器械的透视图；
图79为根据至少一个实施方案的可操作地支持多种外科工具的机器人外科系统的透视图；
图80为包括多个钉成形凹坑的外科缝合系统的砧座的平面图；
图81为图80的砧座的钉成形凹坑布置结构的平面图，其中成形凹坑布置结构被构造成能够容纳两种不同类型的钉和使其变形；
图82为图81的钉成形凹坑布置结构的剖视透视图；
图83为图80的砧座和被构造成能够与其一起使用的第一钉仓的平面图；
图84为图80的砧座和被构造成能够与其一起使用的第二钉仓的平面图；
图85为图83的第一钉仓的处于未成形构型的第一钉的正视图，处于成形构型的该第一钉的正视图，以及处于成形构型的该第一钉的平面图；
图86为图84的第二钉仓的处于未成形构型的第二钉的正视图，处于成形构型的该第二钉的正视图，以及处于成形构型的该第二钉的平面图；
图87为包括近侧成形凹坑和远侧成形凹坑的成形凹坑布置结构的剖视透视图，其中该成形凹坑布置结构被构造成能够容纳两种不同类型的钉和使其变形；
图88为图87的成形凹坑布置结构的平面图，其中每个凹坑包括第一沟槽和第二沟槽；
图89为图87的成形凹坑布置结构沿图88中的线89-89截取的剖视图；
图90为图87的成形凹坑布置结构沿图88中的线90-90截取的剖视图；
图91为图87的成形凹坑布置结构沿图88中的线91-91截取的剖视图；
图92为图87的成形凹坑布置结构沿图88中的线92-92截取的剖视图；
图93为图87的成形凹坑布置结构和被构造成能够通过其形成的第一钉和第二钉的剖视图；
图94为处于成形构型的图93的第一钉的正视图；
图95为处于成形构型的图93的第二钉的正视图；
图96为两个不同尺寸的钉的正视图，这些钉被构造成能够由经历纵向偏转的相同成形凹坑布置结构来形成；
图97为由水平层压物组成的层压成形凹坑布置结构的剖视透视图；
图98为图97的层压成形凹坑布置结构的横向剖视图；
图99为图97的层压成形凹坑布置结构的轴向剖视图；
图100为图97的层压成形凹坑布置结构的平面图；
图101为由垂直层压物组成的层压成形凹坑布置结构的横向透视图；
图102为包括面向侧面的钉尖端面的钉的正视图；
图103为外科钉仓的正视图，该外科钉仓包括驱动器，该驱动器包括倾斜的钉递送表面；
图104为图103的外科钉仓和砧座的正视图；
图105为外科缝合系统的剖视正视图，该外科缝合系统包括砧座、钉仓和包括不对称钉腿的钉；
图106为外科缝合系统的剖视正视图，该外科缝合系统包括钉仓、钉和包括弧形成形凹坑布置的砧座；
图107为包括多个成形凹坑布置结构的砧座的平面图，其中每个成形凹坑布置结构包括不对称的凹坑对；
图108为图107的砧座沿着图107的线108-108截取的剖视图；
图109为包括多个成形凹坑布置结构的砧座的剖视图，其中每个成形凹坑布置结构包括不对称的凹坑对，并且其中每个成形凹坑布置结构相对于基准平面单独地成角度；
图110为包括多个成形凹坑布置结构的砧座的平面图，其中每个成形凹坑布置结构被构造成容纳两种不同类型的钉；
图111为图110的砧座的剖视图，其中每个成形凹坑布置结构相对于基准平面单独地成角度；
图112为包括多个成形凹坑布置结构的砧座的剖视图，其中该成形凹坑布置结构相对于基准平面单独地成角度，并且其中该角度朝向砧座的远侧端部逐渐增大；
图113为外科缝合系统的剖视正视图，该外科缝合系统包括图81的成形凹坑布置结构，包括第一钉尖端的第一钉，包括第二钉尖端的第二钉，该第一钉尖端包括第一成角度构型，该第二钉尖端包括第二成角度构型；
图114为第一钉的侧视图，第二钉的侧视图，以及第三钉的侧视图，第二钉包括钉基部和相对于钉基部成角度的钉腿，第三钉包括钉基部、钉腿，以及相对于钉基部和钉腿成角度的钉尖端；
图115为包括图114的第二钉的外科缝合系统的剖视正视图；
图116为外科缝合系统的剖视正视图，该外科缝合系统包括以虚线示出的图114的第一钉和以实线示出的图114的第三钉；
图117为外科钉仓的透视图；
图118为图117的钉仓和被构造成能够与其一起使用的砧座的平面图；
图119为包括第一侧腔和第二侧腔的外科钉仓的局部透视图；
图120为图119的钉仓和被构造成能够与其一起使用的砧座的平面图；
图121为图118的砧座和图120的砧座的平面图比较；
图122为包括四个纵向和侧向偏移的钉腿的外科钉的透视图；
图123为包括四个横向偏移的钉腿的外科钉的透视图；
图124为包括四个纵向和侧向偏移的钉腿的外科钉的透视图；
图125为图124的外科钉的平面图；
图126为图124的外科钉的侧视图；
图127为图124的外科钉的正视图；以及
图128为包括四个纵向和侧向偏移的钉腿的外科钉的正视图，其中钉腿包括面向不同方向的面向侧面的钉尖端面。
在所述若干视图中，对应的参考符号指示对应的部件。本文所述的范例以一种形式示出了本发明的各种实施方案，且这种范例不应被解释为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIESTHEREOF”的美国专利申请序列号__________；代理人案卷号END7980USNP/160155；
-名称为“ARTICULATABLE SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END7981USNP/160156；
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS”的美国专利申请序列号__________；代理人案卷号END7982USNP/160157；
-名称为“SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF”的美国专利申请序列号__________；代理人案卷号END7983USNP/160158；
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS ANDREPLACEABLE TOOL ASSEMBLIES”的美国专利申请序列号__________；代理人案卷号END7984USNP/160159；以及
-名称为“SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR”的美国专利申请序列号__________；代理人案卷号END7985USNP/160160。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号__________；代理人案卷号END7986USNP/160161；
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FORSHIFTING BETWEEN CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES ANDARTICULATION AND FIRING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END7987USNP/160162；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号__________；代理人案卷号END7988USNP/160163；
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTIONFEATURES”的美国专利申请序列号__________；代理人案卷号END7989USNP/160164；
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号__________；代理人案卷号END7990USNP/160165；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号__________；代理人案卷号END7991USNP/160166；
-名称为“SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASINGA JAW OPENING DISTANCE”的美国专利申请序列号__________；代理人案卷号END7992USNP/160167；
-名称为“METHODS OF STAPLING TISSUE”的美国专利申请序列号__________；代理人案卷号END7993USNP/160168；
-名称为“FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FORSURGICAL END EFFECTORS”的美国专利申请序列号__________；代理人案卷号END7994USNP/160169；
-名称为“SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOPARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END7995USNP/160170；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号__________；代理人案卷号END7996USNP/160171；
-名称为“SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号__________；代理人案卷号END7997USNP/160172；
-名称为“SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTINGFIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT”的美国专利申请序列号__________；代理人案卷号END7998USNP/160173；以及
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号__________；代理人案卷号END7999USNP/160174。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“METHOD FOR RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT”的美国专利申请序列号__________；代理人案卷号END8013USNP/160175；
-名称为“SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL”的美国专利申请序列号__________；代理人案卷号END8016USNP/160178
-名称为“STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISINGWINDOWS DEFINED THEREIN”的美国专利申请序列号__________；代理人案卷号END8017USNP/160179；
-名称为“SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER”的美国专利申请序列号__________；代理人案卷号END8018USNP/160180；
-名称为“STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/ORSPENT CARTRIDGE LOCKOUT”的美国专利申请序列号__________；代理人案卷号END8019USNP/160181；
-名称为“FIRING ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号__________；代理人案卷号END8020USNP/160182；
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUTAND A FIRING ASSEMBLY LOCKOUT”的美国专利申请序列号__________；代理人案卷号END8021USNP/160183；
-名称为“FIRING ASSEMBLY COMPRISING A FUSE”的美国专利申请序列号__________；代理人案卷号END8022USNP/160184；以及
-名称为“FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE”的美国专利申请序列号__________；
代理人案卷号END8023USNP/160185。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END8038USNP/160186；
-名称为“ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS”的美国专利申请序列号__________；代理人案卷号END8039USNP/160187；
-名称为“METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPES OFSTAPLE CARTRIDGES WITH THE SAME SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号__________；代理人案卷号END8041USNP/160189；
-名称为“BILATERALLY ASYMMETRIC STAPLE FORMING POCKET PAIRS”的美国专利申请序列号__________；代理人案卷号END8042USNP/160190；
-名称为“CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICALINSTRUMENTS WITH SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8043USNP/160191；
-名称为“SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING ANDFIRING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8044USNP/160192；
-名称为“SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES”的美国专利申请序列号__________；代理人案卷号END8045USNP/160193；
-名称为“STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPINGBREADTHS”的美国专利申请序列号__________；代理人案卷号END8047USNP/160195；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING PRIMARYSIDEWALLS AND POCKET SIDEWALLS”的美国专利申请序列号__________；代理人案卷号END8048USNP/160196；
-名称为“NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FORSURGICAL STAPLERS”的美国专利申请序列号__________；代理人案卷号END8050USNP/160198；
-名称为“FIRING MEMBER PIN ANGLE”的美国专利申请序列号__________；代理人案卷号END8051USNP/160199；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMINGSURFACE GROOVES”的美国专利申请序列号__________；代理人案卷号END8052USNP/160200；
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES”的美国专利申请序列号__________；代理人案卷号END8053USNP/160201；
-名称为“SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS”的美国专利申请序列号__________；代理人案卷号END8054USNP/160202；
-名称为“SURGICAL INSTRUMENTS WITH JAWS THAT ARE PIVOTABLE ABOUT AFIXED AXIS AND INCLUDE SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8056USNP/160204；
-名称为“ANVIL HAVING A KNIFE SLOT WIDTH”的美国专利申请序列号__________；代理人案卷号END8057USNP/160205；
-名称为“CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8058USNP/160206；以及
-名称为“FIRING MEMBER PIN CONFIGURATIONS”的美国专利申请序列号__________；代理人案卷号END8059USNP/160207。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES”的美国专利申请序列号__________；代理人案卷号END8000USNP/160208；
-名称为“STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAPSETTING FEATURES”的美国专利申请序列号__________；代理人案卷号END8001USNP/160209；
-名称为“STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES”的美国专利申请序列号__________；代理人案卷号END8002USNP/160210；
-名称为“DURABILITY FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIESOF SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8003USNP/160211；
-名称为“SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITHPOSITIVE OPENING FEATURES”的美国专利申请序列号__________；代理人案卷号END8004USNP/160212；以及
-名称为“CONNECTION PORTIONS FOR DEPOSABLE LOADING UNITS FOR SURGICALSTAPLING INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8005USNP/160213。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“METHOD FOR ATTACHING A SHAFT ASSEMBLY TO A SURGICALINSTRUMENT AND,ALTERNATIVELY,TO A SURGICAL ROBOT”的美国专利申请序列号__________；代理人案卷号END8006USNP/160214；
-名称为“SHAFT ASSEMBLY COMPRISING A MANUALLY-OPERABLE RETRACTIONSYSTEM FOR USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号__________；代理人案卷号END8007USNP/160215；
-名称为“SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE ANDRETRACTABLE SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8008USNP/160216；
-名称为“SHAFT ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO ADAPT THEOUTPUT OF A ROTARY FIRING MEMBER TO TWO DIFFERENT SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8009USNP/160217；
-名称为“SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO ANARTICULATION STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM”的美国专利申请序列号__________；代理人案卷号END8010USNP/160218；
-名称为“SHAFT ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号__________；代理人案卷号END8011USNP/160219；以及
-名称为“SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATIONLOCKOUTS”的美国专利申请序列号__________；代理人案卷号END8012USNP/160220。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8024USNP/160221；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8025USNP/160222；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8026USNP/160223；
-名称为“SURGICAL STAPLE CARTRIDGE WITH MOVABLE CAMMING MEMBERCONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES”的美国专利申请序列号__________；代理人案卷号END8027USNP/160224；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8028USNP/160225；
-名称为“JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OFA FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN FIRED CARTRIDGE ISINSTALLED IN THE END EFFECTOR”的美国专利申请序列号__________；代理人案卷号END8029USNP/160226；
-名称为“AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYINGCLOSURE MOTIONS TO JAWS OF SURGICAL INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8030USNP/160227；
-名称为“PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN AMOVABLE JAW AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT”的美国专利申请序列号__________；代理人案卷号END8031USNP/160228；
-名称为“SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERATING OPENINGFEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS”的美国专利申请序列号__________；代理人案卷号END8032USNP/160229；
-名称为“ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFTARRANGEMENT”的美国专利申请序列号__________；代理人案卷号END8033USNP/160230；
-名称为“ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLELINKAGE DISTAL OF AN ARTICULATION LOCK”的美国专利申请序列号__________；代理人案卷号END8034USNP/160231；
-名称为“ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR INAN ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE SYSTEM”的美国专利申请序列号__________；代理人案卷号END8035USNP/160232；
-名称为“LATERALLY ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FORLOCKING AN END EFFECTOR OF A SURGICAL INSTRUMENT IN AN ARTICULATEDCONFIGURATION”的美国专利申请序列号__________；代理人案卷号END8036USNP/160233；以及
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKEAMPLIFICATION FEATURES”的美国专利申请序列号__________；代理人案卷号END8037USNP/160234。
本申请的申请人拥有2016年6月24日提交并且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“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日提交并且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,218；
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,227；
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,259；以及
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,264。
本申请的申请人拥有于2016年4月1日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM”的美国专利申请序列号15/089,325；
-名称为“MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY”的美国专利申请序列号15/089,321；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD”的美国专利申请序列号15/089,326；
-名称为“SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIPPORTION”的美国专利申请序列号15/089,263；
-名称为“ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLEBAILOUT SYSTEM”的美国专利申请序列号15/089,262；
-名称为“SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVILCONCENTRIC DRIVE MEMBER”
的美国专利申请序列号15/089,277；
-名称为“INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL ENDEFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS”的美国专利申请序列号15/089,296；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION”的美国专利申请序列号15/089,258；
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVECUTTING OF TISSUE”的美国专利申请序列号15/089,278；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT”的美国专利申请序列号15/089,284；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSIONLOCKOUT”的美国专利申请序列号15/089,295；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT”的美国专利申请序列号15/089,300；
名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT”的美国专利申请序列号15/089,196；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT”的美国专利申请序列号15/089,203；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGELOCKOUT”的美国专利申请序列号15/089,210；
-名称为“SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM”的美国专利申请序列号15/089,324；
-名称为“SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS”的美国专利申请序列号15/089,335；
-名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/089,339；
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OFSTAPLES HAVING DIFFERENT HEIGHTS”的美国专利申请序列号15/089,253；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET”的美国专利申请序列号15/089,304；
-名称为“ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS”的美国专利申请序列号15/089,331；
-名称为“STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES”的美国专利申请序列号15/089,336；
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUESUPPORT”的美国专利申请序列号15/089,312；
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM”的美国专利申请序列号15/089,309；以及
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL”的美国专利申请序列号15/089,349。
本申请的申请人还拥有于2015年12月31日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE INPOWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/984,488；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/984,525；以及
-名称为“SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROLCIRCUITS”的美国专利申请序列号14/984,552。
本申请的申请人还拥有于2016年2月9日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLYTRANSLATABLE END EFFECTOR”的美国专利申请序列号15/019,220；
-名称为“SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,228；
-名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTEDSECONDARY CONSTRAINT”的美国专利申请序列号15/019,196；
-名称为“SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLYARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY”的美国专利申请序列号15/019,206；
-名称为“SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATIONARRANGEMENTS”
的美国专利申请序列号15/019,215；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATIONLINK ARRANGEMENTS”的美国专利申请序列号15/019,227；
-名称为“SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLEDRIVEN ARTICULATION SYSTEMS”的美国专利申请序列号15/019,235；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAMARRANGEMENTS”的美国专利申请序列号15/019,230；以及
-名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTIONARRANGEMENTS”的美国专利申请序列号15/019,245。
本申请的申请人还拥有于2016年2月12日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,254；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,259；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,275；以及
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,289。
本申请的申请人拥有于2015年6月18日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL END EFFECTORS WITH POSITIVE JAW OPENINGARRANGEMENTS”的美国专利申请序列号14/742,925；
-名称为“SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSINGFEATURES”的美国专利申请序列号14/742,941；
-名称为“MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,914；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAMSTRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT”的美国专利申请序列号14/742,900；
-名称为“DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,885；以及
-名称为“PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,876。
本申请的申请人拥有于2015年3月6日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“POWERED SURGICAL INSTRUMENT”的美国专利申请序列号14/640,746，现为美国专利申请公布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于2014年12月18日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE ENDEFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER”的美国专利申请序列号14/574,478，现为美国专利申请公布2016/0174977；
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS”的美国专利申请序列号14/574,483，现为美国专利申请公布2016/0174969；
-名称为“DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS”的美国专利申请序列号14/575,139，现为美国专利申请公布2016/0174978；
-名称为“LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITHARTICULATABLE SURGICAL END EFFECTORS”的美国专利申请序列号14/575,148，现为美国专利申请公布2016/0174976；
-名称为“SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLEABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE”的美国专利申请序列号14/575,130，现为美国专利申请公布2016/0174972；
-名称为“SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS”的美国专利申请序列号14/575,143，现为美国专利申请公布2016/0174983；
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDMOVABLE FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,117，现为美国专利申请公布2016/0174975；
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDIMPROVED FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,154，现为美国专利申请公布2016/0174973；
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLEARTICULATION SYSTEM”的美国专利申请序列号14/574,493，现为美国专利申请公布2016/0174970；以及
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLEARTICULATION SYSTEM”的美国专利申请序列号14/574,500，现为美国专利申请公布2016/0174971。
本申请的申请人拥有于2013年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日提交并且其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于2014年4月9日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVESHAFTS”的美国专利申请序列号14/248,590，现为美国专利申请公布2014/0305987；
-名称为“SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRINGDRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT”的美国专利申请序列号14/248,581，现为美国专利申请公布2014/0305989；
-名称为“SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLINGTHE OPERATION OF THE SURGICAL INSTRUMENT”的美国专利申请序列号14/248,595，现为美国专利申请公布2014/0305988；
-名称为“POWERED LINEAR SURGICAL STAPLER”的美国专利申请序列号14/248,588，现为美国专利申请公布2014/0309666；
-名称为“TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT”的美国专利申请序列14/248,591，现为美国专利申请公布2014/0305991；
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENTFEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS”的美国专利申请序列号14/248,584，现为美国专利申请公布2014/0305994；
-名称为“POWERED SURGICAL STAPLER”的美国专利申请序列号14/248,587，现为美国专利申请公布2014/0309665；
-名称为“DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICALINSTRUMENT”的美国专利申请序列号14/248,586，现为美国专利申请公布2014/0305990；以及
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUSINDICATION ARRANGEMENTS”的美国专利申请序列号14/248,607，现为美国专利申请公布2014/0305992。
本申请的申请人还拥有于2013年4月16日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,365；
-名称为“LINEAR CUTTER WITH POWER”的美国临时专利申请序列号61/812,376；
-名称为“LINEAR CUTTER WITH MOTOR AND PISTOL GRIP”的美国临时专利申请序列号61/812,382；
-名称为“SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS ANDMOTORCONTROL”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”(以及“包括”的任何形式，诸如“包含”)、“具有”(以及“具有”的任何形式，诸如“带有”)、“包含”(以及“包含”的任何形式，诸如“包括”)、以及“含有”(以及“含有”的任何形式，诸如“具有”)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。钉腔被布置成六纵向排。三排钉腔定位在纵向狭槽的第一侧上且三排钉腔定位在纵向狭槽的第二侧上。钉腔和钉的其他布置也是可能的。
钉由仓体中的钉驱动装置支撑。驱动装置能够在第一或非击发位置和第二或击发位置之间运动，以从钉仓射出钉。驱动装置通过保持器保留在仓体中，所述保持器围绕仓体的底部延伸并且包括被构造成能够抓持仓体以及将保持器保持至仓体的弹性构件。驱动装置能够通过滑动件在其非击发位置与其击发位置之间运动。滑动件能够在与近侧端部相邻的近侧位置和与远侧端部相邻的远侧位置之间运动。滑动件包括多个斜坡表面，该斜坡表面被构造成能够朝向砧座在驱动装置下方滑动以及提升驱动装置，并且钉在驱动装置上受到支撑。
除上述以外，滑动件还可通过击发构件朝远侧运动。击发构件被构造成能够接触滑动件并朝向远侧端部推动滑动件。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。
图1至图1J示出了包括柄部110和可移除地附接到柄部110的轴组件1100的外科器械。轴组件1000包括：附接部分1100，该附接部分被构造成能够将轴组件1000可释放地附接到柄部110；框架组件1200，该框架组件从附接部分1100朝远侧延伸；以及端部执行器，该端部执行器围绕关节运动接头1700可旋转地联接到框架组件1200。端部执行器包括仓钳口2020-其被构造成能够在其中接收钉仓2010-以及砧座钳口2030。主要参见图1E，砧座钳口2030围绕销2025可旋转地联接到仓钳口2020。轴组件1000还包括闭合系统1300，该闭合系统被构造成能够朝仓钳口2020移动砧座钳口2030，如下文更详细地讨论。此外，轴组件1000还包括击发系统1400，该击发系统被构造成能够射出可移除地储存在钉仓2010中的钉，并且抵靠砧座钳口2030使钉变形。
主要参见图1A、图1C和图1D，附接部分1100包括下框架1110，并且此外还包括附接到下框架1110的上框架1120。上框架1120包括闩锁1130，该闩锁被构造成能够将框架1110和1120可释放地接合到柄部110的框架。附接部分1100还包括外壳部分1140和附接到外壳部分1140的喷嘴1150。外壳部分1140包括限定于其中的一个或多个凹槽和/或一个或多个壁，该凹槽和/或壁被构造成能够允许外壳部分1140和喷嘴1150相对于框架1110和1120旋转但不平移，或者至少基本上平移。此外，外壳部分1140包括限定于其中的一个或多个凹槽和/或一个或多个壁，该凹槽和/或壁被构造成能够将框架组件1200安装到其上。框架组件1200与外壳部分1140接合，使得框架组件1200、外壳部分1140和喷嘴1150能够绕轴组件1000的纵向轴线1001一起旋转。
主要参见图1D、图1E和图1F，框架组件1200包括近侧框架部分1210、中间框架部分1220和远侧框架部分1230。框架部分1210、1220和1230包括轴组件1100的刚性或至少基本上刚性的脊。近侧框架部分1210的近侧端部安装到滑动接头接口1260。滑动接头接口1260与限定在附接部分1100的下框架1110上的滑动接头接口1160协作，该滑动接头接口被构造成能够允许框架组件1200相对于框架1110和1120旋转，如上所述。此外，滑动接头接口1160和1260协作以提供电接口，该电接口可例如电耦合端部执行器中的传感器和附接部分1100。附接部分1100包括与滑动接头接口1160电连通的一个或多个电路，该一个或多个电路可被放置成与柄部110的控制模块和/或微处理器电连通，例如当轴组件1000附接到柄部110时。
除上述以外，主要参见图1D、图1E和图1F，框架组件1200还包括脊盖1250。脊盖1250与框架部分1210、1220和1230协作，以将击发系统1400包封或至少基本上包封在其中。框架组件1200还包括间隔件1280，该间隔件被构造成能够防止或至少限制框架组件1200和闭合系统1300之间的相对运动。每个间隔件1280包括从其延伸的一个或多个销，该一个或多个销延伸到闭合系统1300中限定的孔中。
主要参见图1D、图1E和图1F，闭合组件1300包括闭合致动器1310，当轴组件1000组装到柄部110时，该闭合致动器与柄部110的闭合触发器130可操作地联接。闭合组件1300还包括闭合管1330，并且此外还包括被构造成能够将闭合管1330安装到闭合致动器1310的管保持器1320。更具体地讲，管保持器1320将闭合管1330安装到闭合保持器1310，使得闭合保持器1310可将闭合管1330朝远侧推动和将闭合管1330朝近侧牵拉。主要参见图1E，闭合组件1300还包括远侧闭合管1340，该远侧闭合管经由关节运动连接件1350可旋转地联接到闭合管1330。当闭合管1330被闭合致动器1310朝远侧推动时，闭合管1330推动远侧闭合管1340与砧座钳口2030接合，并且使砧座钳口2030朝向仓钳口2020运动。当闭合管1330被闭合致动器1310朝近侧牵拉时，远侧闭合管1340可与砧座钳口2030脱离，这可允许打开砧座钳口2030。在其他情况下，当远侧闭合管1340回缩时，远侧闭合管1340可将砧座钳口2030牵拉到打开或至少部分打开的位置。
主要参见图1D、图1E和图1F，击发组件1400包括近侧击发连杆1410，当轴组件1000组装到柄部110时，该近侧击发连杆与柄部110的击发系统可操作地接合。击发组件1400还包括联接到近侧击发连杆1410的中间击发连杆1420，并且此外还包括联接到中间击发连杆1420的击发杆1430。击发杆1430由多个柔性层构成，但可包括任何合适的构型。击发组件1400还包括安装到击发杆1430的联接构件1440。当击发组件1400被柄部110的击发系统朝远侧推进时，联接构件1440朝远侧推动钉仓2010的滑动件2015，以将钉从钉仓2010射出并进入捕获在钉仓2010和砧座钳口2030之间的组织中。联接构件1440还包括切割边缘，该切割边缘在联接构件1440朝远侧推进以射出钉时切入组织。
除上述以外，参见图1F和图1I，轴组件1000还包括框架销1240。框架销1240将框架组件1200和击发组件1400联接在一起，使得当喷嘴1150围绕纵向轴线1001旋转时，它们可围绕纵向轴线1001一致地旋转，如上所述。主要参见图1I，框架销1240延伸穿过并紧密地定位在限定于中间框架部分1220中的孔1222内。框架销1240还包括突出部1242，该突出部延伸到限定于近侧框架部分1210中的孔1212中。类似于上文所述，突出部1242被紧密地定位在孔1212中。此外，框架销1240还包括限定于其中的狭槽1244。当近侧击发连杆1410朝近侧和朝远侧运动时，近侧击发连杆1410延伸穿过狭槽1244并且相对于框架销1240滑动，如上所述。狭槽1244的侧壁彼此间隔开，以便在它们之间紧密地接收近侧击发连杆1410的侧面1412。因此，如上所述，当框架组件1200围绕纵向轴线1001旋转时，框架销1240可将框架组件1200的旋转传递到击发组件1400。主要参见图1F，闭合管1330还可包括限定于其中的间隙孔1332，该间隙孔被构造成能够在其中接收框架销1240的一部分。
主要参见图1E、图1F、图1G和图1H，轴组件1000还包括关节运动系统1500，该关节运动系统被构造成能够使端部执行器围绕关节运动接头1700进行关节运动。关节运动系统1500包括安装到近侧击发连杆1410的关节运动驱动器1510，并且此外还包括能够与关节运动驱动器1510选择性地接合的关节运动杆1520。当关节运动杆1520与关节运动驱动器1510接合时，近侧击发连杆1410的运动被传递到关节运动杆1520。在此类实例中，轴组件1000处于关节运动操作模式。当关节运动杆1520不与关节运动驱动器1510接合时，近侧击发连杆1410的运动不被传递到关节运动杆1520。在此类实例中，轴组件1000处于击发操作模式。由于上述原因，击发组件1400的运动可选择性地传递到关节运动系统1500。如下文更详细讨论，轴组件1000还包括切换系统1600，该切换系统被构造成能够使轴组件1000在其关节运动操作模式和其击发操作模式之间切换。
主要参见图1C和图1F，切换系统1600包括换挡套环1610和换挡板1620。换挡套环1610可围绕轴组件1000的纵向轴线1001在未致动位置和致动位置之间旋转。闭合组件1300被构造成能够在闭合组件1300被朝远侧推进以闭合砧座钳口2030时，驱动切换系统1600并将换挡套环1610从其未致动位置旋转至其致动位置。换挡套环1610被构造成能够在换挡套环1610从其未致动位置运动到其致动位置时，将换挡板1620从第一位置纵向地驱动到第二位置。当换挡板1620处于其第一位置时，关节运动杆1520与近侧击发连杆1410可操作地接合，并且轴组件1000处于其关节运动操作模式。在此类实例中，击发组件1400的近侧运动和远侧运动被传递到关节运动组件1500。当换挡板1620运动到其第二位置时，换挡板1620将关节运动杆1520与近侧击发连杆1410可操作地脱离联接，并且轴组件1000处于其击发操作模式。在此类实例中，击发组件1400的近侧运动和远侧运动不被传递到关节运动组件1500。
除上述以外，当朝近侧牵拉闭合组件1300以使远侧闭合管1340与砧座钳口2030脱离接合时，可将换挡套环1610旋转回到其未致动位置。再次参见图1F，切换系统1600还包括偏压构件或弹簧1630，该偏压构件或弹簧被构造成能够将换挡套环1610偏压到其未致动位置中。
主要参见图1G和图1H，关节运动系统1500还包括固定地安装到远侧框架部分1230的关节运动组件1530。关节运动组件1530包括关节运动框架1540，并且此外还包括可滑动地安装到关节运动框架1540的锁定系统1550。锁定系统1550可沿远侧方向滑动，以允许端部执行器沿第一方向围绕关节运动接头1700旋转。锁定系统1550也可沿近侧方向滑动，以允许端部执行器沿第二方向围绕关节运动接头1700旋转。关节运动杆1520能够与锁定系统1550可操作地接合，使得当关节运动杆1520被近侧击发连杆1410朝远侧推动时，关节运动杆1520可朝远侧推动锁定系统1550。此外，关节运动杆1520能够与锁定系统1550可操作地接合，使得当关节运动杆1520被近侧击发连杆1410朝近侧牵拉时，关节运动杆1520可朝近侧牵拉锁定系统1550。
除上述以外，关节运动组件1530还包括关节运动连接件1560。类似于锁定系统1550，关节运动杆1520被构造成能够在朝远侧推动关节运动杆1520时朝远侧推动关节运动连接件1560，并且相应地，被构造成能够在朝近侧牵拉关节运动杆1520时朝近侧牵拉关节运动连接件1560。关节运动连接件1560的远侧端部与固定安装在仓钳口1220中的通道保持器1570接合。更具体地讲，通道保持器1570包括从其延伸的销，该销定位在限定于关节运动连接件1560中的孔内。在朝远侧推动关节运动连接件1560时，除上述以外，关节运动连接件1560以其第一方向驱动端部执行器。当将关节运动连接件1560朝近侧牵拉时，关节运动连接件1560以第二或相反方向驱动端部执行器，如图1H所示。
除上述以外，当锁定系统1550处于中性或释放状态时，关节运动组件1530被构造和布置成使得其防止端部执行器围绕关节运动接头1700旋转。当锁定系统1550被关节运动杆1520朝远侧推动或朝近侧牵拉时，关节运动组件1530被解锁，使得端部执行器可围绕关节运动接头1700旋转。为了将端部执行器重新锁定就位，关节运动杆1520可用于将锁定系统1550重新定位在其中性状态并且/或者允许偏压构件将锁定系统1550重新定位在其中性状态。
再次参见图1G和图1H，轴组件1000还包括定位在关节运动接头1700内和/或附近的刀导轨1450。刀导轨1450被构造成能够在端部执行器处于关节运动构型(如图1H所示)以及其他构型时支撑击发杆1430。刀导轨1450包括限定于其中的侧向侧壁1454，该侧壁被构造成能够支撑和/或引导击发杆1430的层-尤其是当击发杆1430朝近侧和朝远侧运动时，如上所述。刀导轨1450被构造成能够在端部执行器旋转时在关节运动接头1700内旋转。更具体地讲，当端部执行器沿第一方向旋转时，刀导轨1450沿第一方向旋转，并且相应地，当端部执行器沿第二方向旋转时，刀导轨1450沿第二方向旋转。刀导轨1450的远侧端部1456包括从其延伸的柱，该柱位于限定在通道保持器1570中的孔中，该通道保持器可用作刀导轨1450和通道保持器1570之间的枢转接头。
主要参见图1G和图1H，轴组件1000还包括与通道保持器1570接合的盖1460。在至少一个实例中，例如，盖1460以按扣配合的方式与通道保持器1570接合。盖1460被构造成能够限制击发杆1430的竖直运动并将击发杆1430保持在刀导轨1450中。
再次参见图1H，刀导轨1450包括从其延伸的侧向推动器1452。侧向推动器1452被构造成能够在端部执行器和刀导轨1450旋转时将患者的组织推出关节运动接头1700，如上所述。换句话讲，例如，侧向推动器1452被构造成能够将组织推离仓钳口2020和框架组件1200之间的夹点。此外，侧向推动器1452被构造成能够阻挡或闭合限定在仓钳口2020和框架组件1200之间的间隙。
外科器械2000示于图1至图3中。外科器械2000包括仓钳口2020和砧座钳口2030。仓钳口2020包括钉仓2010，该钉仓包括可移除地储存在其中的多个钉。钉仓2010为可替换的并且可从仓钳口2020移除；然而，可以设想到钉仓2020不可替换的其他实施方案。钉仓2010包括近侧端部2011、远侧端部2013以及在近侧端部2011和远侧端部2013之间延伸的组织压缩表面2012。钉仓2010还包括限定在组织压缩表面2012中的钉腔和可移除地储存在钉腔中的钉。砧座钳口2030包括近侧端部2031、远侧端部2033以及在近侧端部2031和远侧端部2033之间延伸的组织压缩表面2032。砧座钳口2030还包括限定在组织压缩表面2032中的钉成形凹坑。
砧座钳口2030可旋转地联接到仓钳口2020。参见图2，仓钳口2020包括限定在其相对侧上的孔2016。每个孔2016是细长的并且沿着竖直轴线2001延伸。砧座钳口2030包括沿相反方向从其侧向延伸的突出部2036。突出部2036可滑动地定位在孔2016内。孔2016和突出部2036限定接头，砧座钳口2030可围绕该接头相对于仓钳口2020在打开位置和闭合位置之间旋转。突出部2036被紧密地接收在孔2016的竖直侧壁之间，使得砧座钳口2030相对于仓钳口2020的近侧和/或远侧纵向运动被阻止或至少被抑制。也就是说，突出部2036可在孔2016内竖直地运动，如下文进一步更详细地描述。在一些实施方案中，砧座钳口可包括枢轴销，砧座钳口可围绕该枢轴销相对于仓钳口在打开位置和完全闭合位置之间旋转。
除上述以外，外科器械2000包括闭合构件或管2040，该闭合构件或管被构造成能够在闭合行程期间接触砧座钳口2030并使砧座钳口2030从其打开位置朝向其闭合位置(图3)运动。更具体地讲，闭合管2040包括远侧管端部2045，该远侧管端部被构造成能够接合限定在砧座钳口2030上的凸轮表面2035并且朝向钉仓2010的远侧端部2013旋转砧座钳口2030的远侧端部2033。闭合管2040沿着凸轮表面2035朝远侧滑动，直到远侧管端部2045与限定在砧座钳口2030上的推动肩部2037接触。在此类实例中，当砧座钳口2030相对于仓钳口2020旋转时，突出部2036在孔2016内旋转。
主要参见图3，砧座钳口2030的旋转，不需要更多，可导致钉仓2010的远侧端部2013和砧座钳口2030的远侧端部2033之间的组织间隙(DTG)大于钉仓2010的近侧端部2011和砧座钳口2030的近侧端部2031之间的组织间隙(PTG)。当远侧组织间隙DTG大于近侧组织间隙PTG时，在远侧组织间隙DTG内捕获的组织可比在近侧组织间隙PTG内捕获的组织经历更小的夹紧力或压缩。此外，在此类实例中，砧座钳口2030的组织压缩表面2032可不平行于钉仓2010的组织压缩表面2012，并且因此，由砧座钳口2030的远侧端部2033变形的钉可大于由近侧端部2031变形的钉。
除上述以外，闭合管2040还包括被构造成能够将砧座钳口2030的远侧端部2033移动得更靠近钉仓2010的远侧端部2013的一个或多个升程凸轮2046。闭合管2040的升程凸轮2046被构造成能够在闭合管2040的闭合行程期间接合砧座钳口2030的突出部2036，并在孔2016内向上推动突出部2036。在此类实例中，升程凸轮2046可以朝着钉仓2010的远侧端部2013驱动砧座钳口2030的远侧端部2033，并且增加施加到捕获在远侧组织间隙DTG内的组织的夹紧力。在各种实例中，升程凸轮2046可以相对于钉仓2010定位砧座钳口2030，使得远侧组织间隙DTG与近侧组织间隙PTG相同或至少基本上相同；然而，读者应当理解，被捕获在组织压缩表面2012和2032之间的组织的厚度可影响远侧组织间隙DTG和近侧组织间隙PTG。在任何情况下，施加到远侧组织间隙DTG中的组织的夹紧力可与施加到近侧组织间隙PTG中的组织的夹紧力相同或至少基本上相同。
在各种实例中，除上述以外，当组织正被切割构件切入时，捕获在远侧组织间隙DTG内的组织可被推出远侧组织间隙DTG。在至少一个实例中，升程凸轮2046可以相对于钉仓2010定位砧座钳口2030，使得远侧组织间隙DTG小于近侧组织间隙PTG。在此类实例中，施加到远侧组织间隙DTG中的组织的夹紧力可大于施加到近侧组织间隙PTG中的组织的夹紧力。因此，在DTG中捕获的组织不太可能被推出远侧组织间隙DTG。
在至少一种意义上，除上述以外，闭合管2040的远侧管端部2045包括第一或初始凸轮，并且闭合管2040的升程凸轮2046包括第二或后续凸轮。也就是说，升程凸轮2046可被构造成能够在闭合行程中的任何合适的点处接合突出部2036。在至少一个实例中，升程凸轮2046被构造成能够在远侧管端部2045接合推动肩部2037的同时接合突出部2036。在此类实例中，砧座钳口2030的远侧端部2033可在闭合行程结束时朝钉仓2010的远侧端部2013向下推动。在其他实例中，升程凸轮2046被构造成能够在远侧管端部2045接合推动肩部2037之前接合突出部2036。在此类实例中，砧座钳口2030的远侧端部2033可在砧座钳口2030闭合时向下成弓形。在一些实例中，升程凸轮2046被构造成能够在远侧管端部2045接合推动肩部2037之后接合突出部2036。在此类实例中，闭合管2040可在闭合行程的最末端向组织施加显著的夹紧力，该夹紧力包括，一，来自远侧管端部2045的推动至闭合力分量，以及二，来自升程凸轮2046的提升至闭合力分量。
如上所述，再次参见图3，升程凸轮2046被构造成能够在闭合管2040的闭合行程期间影响或闭合远侧组织间隙DTG。升程凸轮2046不影响或至少基本上不影响近侧组织间隙PTG。在各种实例中，定位在近侧组织间隙PTG中的组织可充当支点，当升程凸轮2046接合砧座突出部2036时，砧座钳口2030围绕该支点旋转。在某些实例中，近侧组织间隙PTG可调整以适应被捕获在砧座压缩表面2032和仓压缩表面2012之间的组织的厚度。
再次参见图1，砧座钳口2030包括纵向狭槽2038，该纵向狭槽被构造成能够在组织切割行程期间接收击发组件的一部分或击发组件的切割构件部分。如下文更详细地描述，击发组件可包括凸轮构件，该凸轮构件被构造成能够接合砧座钳口2030并且在组织切割行程期间相对于钉仓2010定位砧座钳口2030。纵向狭槽2038包括凸轮表面2039，该凸轮表面被击发组件接合以压缩组织，或者控制被捕获在仓压缩表面2012和砧座压缩表面2032之间的组织的压缩。砧座钳口2030的凸轮表面2039平行于组织压缩表面2032。在其他实施方案中，凸轮表面2039不平行于组织压缩表面2032。在至少一个此类实施方案中，凸轮表面2039沿不平行于包括组织压缩表面2032的平面的平面延伸。例如，与近侧端部2031相比，凸轮表面2039和组织压缩表面2032之间的距离在砧座钳口2030的远侧端部2033处可更大。在此类实例中，击发组件施加到组织的压缩力可随着切割构件部分前进穿过其组织切割行程而増大，这可例如防止或至少减小组织被推出远侧组织间隙DTG的可能性。
在各种实例中，除上述以外，当砧座钳口2030已经到达其完全闭合位置时，砧座钳口2030的凸轮表面2039可朝仓钳口2010的远侧端部2013向下指向。
外科器械2100示于图4和图5中。外科器械2100在许多方面类似于外科器械2000。外科器械2100包括仓钳口2120和砧座钳口2030。仓钳口2120包括钉仓2010，该钉仓包括可移除地储存在其中的多个钉。钉仓2010为可替换的并且可从仓钳口2120移除；然而，可以设想到钉仓2010不可替换的其他实施方案。类似于上文所述，砧座钳口2030可旋转地联接到仓钳口2120。仓钳口2120包括限定在其相对侧上的孔2116。每个孔2116是细长的并且沿着竖直轴线2001延伸。
同样类似于上文所述，砧座钳口2030包括沿相反方向从其侧向延伸的突出部2036。突出部2036可滑动地定位在孔2116内。孔2116和突出部2036限定接头，砧座钳口2030可围绕该接头相对于仓钳口2120在打开位置和闭合位置之间旋转。突出部2036被紧密地接收在孔2116的竖直侧壁之间，使得砧座钳口2030相对于仓钳口2120的纵向近侧和/或远侧运动被阻止或至少被抑制。也就是说，突出部2036可在孔2116内竖直地运动。如图4和图5所示，仓钳口2120还包括限定在其相对侧上的纵向狭槽2117。每个纵向狭槽2117与孔2116的底部部分相交。
除上述以外，外科器械2100包括闭合构件或管2040，该闭合构件或管被构造成能够在闭合行程期间接触砧座钳口2030并使砧座钳口2030从其打开位置(图4)朝向其闭合位置(图5)运动。更具体地讲，除上述以外，闭合管2040的远侧管端部2045被构造成能够接合限定在砧座钳口2030上的凸轮表面2035，并且朝向仓钳口2120旋转砧座钳口2030。闭合管2040沿着凸轮表面2035朝远侧滑动，直到远侧管端部2045与限定在砧座钳口2030上的推动肩部2037接触。在此类实例中，当砧座钳口2030相对于仓钳口2120旋转时，突出部2036在孔2116内旋转。
除上述以外，闭合管2040的升程凸轮2046被构造成能够在闭合管2040的闭合行程期间接合砧座钳口2030的突出部2036，并在孔2116内向上推动突出部2036。在此类实例中，升程凸轮2046可朝向仓钳口2120的远侧末端驱动砧座钳口2030的远侧末端，并增加施加到在仓钳口2120的远侧末端和砧座钳口2030之间捕获的组织的夹紧力。升程凸轮2046的运动限于由纵向狭槽2117限定的纵向路径。例如，在至少一个实例中，纵向路径包括垂直于或至少基本上垂直于竖直轴线2001的纵向轴线。当闭合管2040在其闭合行程期间朝远侧推进时，纵向狭槽2117和孔2116的相交允许升程凸轮2046接合突出部2036。
如上所述，外科器械2000和2100包括固定的仓钳口和可动的砧座钳口。然而，可设想到其他实施方案。例如，外科器械可包括固定的砧座钳口和可动的仓钳口。例如，当目标组织和体腔壁之间的空间受到限制时，此类实施方案可能是有用的。更具体地讲，在各种实例中，砧座钳口2030比钉仓钳口2020薄，并且如果砧座钳口2030为固定的，则砧座钳口2030可提供薄但刚性的钳口，该钳口可在组织后面的紧密空间中滑动。
外科器械2200示于图6至图8中。外科器械2200在许多方面类似于外科器械2000和2100。外科器械2200包括仓钳口2220和可旋转地联接到仓钳口2220的砧座钳口2230。仓钳口2220包括可替换的钉仓2210，该钉仓包括可移除地储存在其中的多个钉。在其他实施方案中，钉仓2210不能从仓钳口2220移除。仓钳口2220和砧座钳口2230分别类似于仓钳口2020和砧座钳口2030。外科器械2200还包括闭合管2240。闭合管2240在许多方面类似于闭合管2040。除此之外，闭合管2240包括远侧管端部2245，该远侧管端部被构造成能够接合砧座钳口2230上的凸轮表面2035和/或推动肩部2037，以朝向仓钳口2220旋转砧座钳口2230。
外科器械2200还包括击发组件2250。击发组件2250包括联接构件2251、安装到联接构件2251的击发杆2254，以及击发连杆2252。联接构件2251被构造成能够在击发组件2250的击发行程期间通过击发连杆2252和击发杆2254从近侧未击发位置朝远侧推进到远侧击发位置，以从钉仓2210射出钉。联接构件2251包括被构造成能够在击发行程期间接合仓钳口2220的第一凸轮和被构造成能够在击发行程期间接合砧座钳口2230的第二凸轮。除此之外，在击发行程期间，第一凸轮和第二凸轮将砧座钳口2230锁定在闭合位置。在击发行程的至少一部分已完成之后，击发组件2250可回缩，以分别使第一凸轮和第二凸轮与钳口2220和2230脱离接合。此时，闭合管2240可朝近侧回缩，以使远侧管端部2245与凸轮表面2035脱离接合。
闭合管2240还包括至少一个压接片2249(图3)。压接片2249被构造成能够正向打开砧座钳口2230。当闭合管2240朝近侧回缩时，除上述以外，远侧管端部2245朝近侧滑过凸轮表面2035，并且在闭合管2240已充分回缩之后，压接片2249接触限定在砧座钳口2230上的凸轮片2239。换句话讲，当闭合管2240被回缩时，压接片2249首先不接合凸轮片2239；相反，当闭合管2240被回缩时，压接片2249与凸轮片2239接触。一旦压接片2249与凸轮片2239接合，则闭合管2240的进一步回缩将打开砧座钳口2230。在偏压构件可打开砧座钳口2230之前，闭合管2240必须充分回缩。因此，在闭合管2240的回缩行程期间，如果不使用弹性偏压特征结构，则砧座钳口2230可能不会立即打开，该弹性偏压特征结构可在闭合管2240被回缩时将砧座钳口2230驱动到至少部分打开的位置，如下文更详细地讨论。
除上述以外，击发组件2250包括，例如，位于击发连杆2252和击发杆2254的近侧尾部2255中间的偏压构件或弹簧2256。主要参见图6，弹簧2256包括牢固地安装在限定于击发连杆2252的远侧端部中的凹陷部2257中的端部，并且此外还包括延伸到限定于击发连杆2252中的纵向开口2253中的悬臂端部2258。如图7所示，当击发组件2250回缩时，击发连杆2252经由弹簧2256向击发杆2254施加回缩力。该回缩力弹性地压缩弹簧2256，也如图7所示。当击发组件2250回缩时，联接构件2251与砧座钳口2230接触。更具体地讲，限定在联接构件2251上的肩部2259接触限定在砧座钳口2230上的凸轮片2239。此时，弹簧2256仍然处于其压缩状态，并通过联接构件2251将负载施加到砧座钳口2230。然而，该负载不打开砧座钳口2230，直到闭合管2240朝近侧运动远离推动肩部2037。然而，一旦闭合管2240开始其打开运动，负载便可快速打开或至少部分地打开砧座钳口2230，如图8所示。在各种实例中，因此，在闭合管2240的打开运动和砧座钳口2230的打开运动之间存在非常小的(如果有的话)滞后。
除上述以外，只要弹簧2256被弹性地压缩在击发连杆2252和击发杆2254之间，弹簧2256便将对砧座钳口2230施加快速打开力。一旦弹簧2256已返回至其未压缩状态，击发组件2250就可不再向砧座钳口2230施加打开力。砧座钳口2230的进一步打开可通过闭合系统的回缩来实现，使得正向钳口打开压接片2249向凸轮片2239施加力以完全打开砧座钳口2230。
联接构件2551在图9至图11中示出并且击发组件2550的一部分在图10中示出。联接构件2551包括被构造成能够接合第一钳口的第一凸轮2552和被构造成能够接合第二钳口的第二凸轮2553。联接构件2551进一步包括限定于其中的凹陷部2555。凹陷部2555被构造成能够在其中接收击发杆2554。在至少一个实例中，当击发杆2554完全就座在联接构件2551中时，击发杆2554的侧面与联接构件2551的侧面齐平。在其他实例中，击发杆2554的侧面相对于联接构件2551的侧面凹入。
除上述以外，击发杆2554包括多个柔性层。每个层安装到联接构件2551。联接构件2551包括第一或近侧安装柱或突出部2557p和第二或远侧安装柱或突出部2557d。击发杆2554的每个层包括被构造成能够紧密地接收安装柱2557p的孔2558p。在至少一个实例中，安装柱2557p压配合到孔2558p中，使得在击发杆2554和安装柱2557p之间几乎不可能发生相对运动(如果有的话)。类似地，击发杆2554的每个层包括被构造成能够紧密地接收安装柱2557d的孔2558d。在至少一个实例中，安装柱2557d压配合到孔2558d中，使得在击发杆2554和安装柱2557d之间几乎不可能发生相对运动(如果有的话)。安装柱2557p和2557d提供了：一、联接构件2551与击发杆2554的机械附接；以及，二、向外延伸到击发杆2554的外表面的表面，该表面提供了允许在联接构件2551和击发杆2554之间形成焊接连接的显著暴露表面区域。在各种实例中，安装柱2557p和2557d的周边焊接到击发杆2554的层或至少外层。在一些实例中，安装柱2557p和2557d的端部被完全焊接以在联接构件2551和击发杆2554之间建立连接。
安装柱2557p和安装柱2557d未纵向地对准。主要参见图9，安装柱2557p和2557d定位在纵向轴线2558的相对侧上。纵向轴线2558与击发组件2550的纵向路径共线和/或平行。由于上述原因，联接构件2251和击发杆2554之间的互连可承受扭矩载荷，该扭矩载荷用于向上和/或向下旋转联接构件2551。在另选的实施方案中，安装柱2557p和2557d纵向对准。在此类实例中，安装柱2557p和2557d可包括对准基准，用于使联接构件2551相对于击发杆2554适当地定向。
主要参见图10，击发组件2550包括切割部分，该切割部分被构造成能够在击发组件2550朝远侧推进穿过钉仓时切割患者的组织。联接构件2551包括切割部分的第一切割部2556’，并且击发杆2554包括切割部分的第二切割部2556”。第一切割部2556’相对于第二切割部2556”侧向地定位。然而，第一切割部2556’的面与第二切割部2556”的面对准，使得这些面包括连续的或至少基本上连续的切割边缘，如图10所示。在至少一个实例下，击发杆2554的仅一层构成第二切割部2556”；然而，设想了另选的实施方案，其中击发杆2554的多于一层构成第二切割部2556”。在某些实施方案中，联接构件2551不构成切割部分的一部分。在至少一个此类实施方案中，击发杆2554包括整个切割部分。在任何情况下，上述布置均可通过消除对联接构件2251进行打磨和珩磨的需要，并且将打磨操作转移到击发杆2554的一个平坦层来降低制造击发组件2250的成本。
图12示出了联接构件2651，图13示出了击发杆2654的一部分，并且图14示出了包括联接构件2651和击发杆2654的击发组件2650的一部分。联接构件2651包括被构造成能够接合第一钳口的第一凸轮2552和被构造成能够接合第二钳口的第二凸轮2553。参见图12，联接构件2651进一步包括限定于其中的凹陷部2655。凹陷部2655被构造成能够在其中接收击发杆2654，如图14所示。在至少一个实例中，当击发杆2654完全就座在凹陷部2655中时，击发杆2654的侧面与联接构件2651的侧面齐平。在其他实例中，击发杆2654的侧面相对于联接构件2651的侧面凹入。
主要参见图12，联接构件2651包括近侧安装柱2657p和远侧安装柱2657d。参见图13，击发杆2654包括近侧孔2658p，该近侧孔被构造成能够紧密地接收安装柱2657p。在至少一个实例中，安装柱2657p被压配合在击发杆2654的近侧孔2658p内。击发杆2654还包括远侧孔2658d，该远侧孔被构造成能够紧密地接收联接构件2651的远侧安装柱2657d。在至少一个实例中，安装柱2657d被压配合在击发杆2654的远侧孔2658d内。安装柱2657p和2657d提供了：一、联接构件2651与击发杆2654的机械附接；以及，二、向外延伸到击发杆2654的外表面的表面，该表面提供了允许在联接构件2651和击发杆2654之间形成焊接连接的显著暴露表面区域。在各种实例中，安装柱2657p和2657d的周边焊接到击发杆2654的层或至少外层。在一些实例中，安装柱2657p和2657d的端部被完全焊接以在联接构件2651和击发杆2654之间建立连接。
再次参见图13，击发杆2654还包括钩或扣件2653。现在参见图14，钩2653与联接构件2651接合。更具体地讲，钩2653至少部分地缠绕在第二凸轮2553的远侧端部周围。在各种情况下，钩2653可以用于在将击发杆2654安置到联接构件2651中的凹陷部2655中之前，使击发杆2654与联接构件2651对准。此外，钩2653在联接构件2651的切割部2556”上方延伸，并且可以被构造成能够将组织流朝向切割部2556”的切割边缘引导。击发杆2654包括单层，并且钩2653限定在该层上；然而，钩2653可以被限定在其他击发杆中的多个层上。在任何情况下，钩2653、远侧孔2658d和近侧孔2658p被构造成能够将击发杆2654保持到联接构件2651。
如上所述，击发杆2654定位在侧向凹陷部2655内。参见图12，在凹陷部2655上方延伸的第二凸轮2553比另一个第二凸轮2553长。此外，击发杆2654相对于联接构件2651的中心侧向偏移。因此，在使用中，当击发组件2650在其击发行程期间向远侧推进时，击发杆2654可以经历侧向扭转。为了解决这种扭转，在各种情况下，例如，第二凸轮2553可以紧密地接收在钳口(诸如，砧座钳口2030)内。更具体地讲，再次参见图1，狭槽2038的侧壁被构造成能够使得在侧壁和第二凸轮2553的侧面之间存在很小的(如果有的话)侧向间隙。可以使用其他装置。
现在转向图15至图18，击发组件2750包括联接构件2751和击发杆2754，该击发杆包括附接到联接构件2751的多个层。联接构件2751包括被构造成能够接合第一钳口的第一凸轮2752、被构造成能够接合第二钳口的第二凸轮2753，以及被构造成能够在击发组件2750的击发行程期间横切组织的切割边缘2756。联接构件2751包括从其向近侧延伸的安装突片2754a和限定在安装突片2754a的相对侧上的侧向凹陷部2755。参见图16，击发杆2754的中心层2754b可附接到安装突片2754a。安装突片2754a和中间层2754b之间限定孔2754c，该孔被构造成能够在其中接收焊接点2754d以将中心层2754b保持到安装突片2754a；然而，可以使用任何合适的连接方法来将中心层2754b连接到安装突片2754a。
除上述以外，现在参见图17，击发杆2754还包括侧向层2754e，该侧向层在侧向凹陷部2755中安装到联接构件2751。每个侧向层2754e经由焊接点2754f安装到联接构件2751；然而，可以使用其他连接方法。在各种情况下，焊接点2754f相对于焊接点2754d位于远侧。因此，侧向层2754e与联接构件2751的附接点相对于中心层2754b的附接点在远侧定位。由于这种纵向偏移，焊接点2754d和2754f可以承受和传递扭矩负载。此外，焊接点2754d和2754f不在同一剪切平面中，并且减小了联接构件2751从击发杆2754脱离的可能性。
如下文更详细讨论，击发组件或切割构件可以是闭锁系统的一部分和/或包括闭锁系统，该闭锁系统被构造成能够在某些情况下防止或限制击发组件的远侧推进。再次参见图9和图10，击发组件2550的联接构件2551包括远侧突起部2559。远侧突起部2559是闭锁装置的一部分，该闭锁装置被构造成能够在未耗尽的钉仓未正确地定位在击发组件2550的前面的情况下防止击发组件2550向远侧推进。在此类情况下，当击发组件2550向远侧推进时，击发组件2550可以通过偏压构件向下推动到闭锁状态，以防止击发组件2550执行钉击发行程。就未耗尽的钉仓正确地定位在击发组件2550的前面来说，远侧突起部2559可以由钉仓中的滑动件支撑，这可以允许击发组件2550完成钉击发行程。下述专利的全部公开内容据此以引用方式并入本文：
2006年5月16日公布的名称为“SURGICAL STAPLING INSTRUMENT HAVING ASINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING”的美国专利7,044,352；
2006年12月5日公布的名称为“SURGICAL STAPLING INSTRUMENT HAVING AFIRING LOCKOUT FOR AN UNCLOSED ANVIL”的美国专利7,143,923；
2006年1月24日公布的名称为“SURGICAL STAPLING INSTRUMENT HAVING A SPENTCARTRIDGE LOCKOUT”的美国专利6,988,649；
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；以及
2005年12月27日公布的名称为“SURGICAL STAPLING INSTRUMENT INCORPORATINGAN E-BEAM FIRING MECHANISM”的美国专利6,978,921。
外科器械2300的击发组件2350在图19至图21中示出。击发组件2350包括联接构件2351和安装到联接构件2351的击发杆2354。联接构件2351在许多方面类似于联接构件2551。击发杆2354包括多个层，该多个层包括中心层2354b和侧向层2354e。外科器械2300被构造成能够接收其中储存有滑动件的钉仓，该钉仓在钉击发行程期间由击发组件2350向远侧推进。钉仓2010例如包括仓体2011，并且另外还包括滑动件2014，该滑动件在钉击发行程期间可通过仓体2011从近侧未击发位置运动到远侧击发位置。当滑动件2014处于其近侧未击发位置时，钉仓2010是未耗尽的。当滑动件2014已经从其近侧未击发位置向远侧运动时，钉仓2010变成耗尽的。
击发组件2350还包括闭锁系统。闭锁系统被构造成能够如果未耗尽的钉仓诸如钉仓2010例如未正确地定位在外科器械2300中，则防止击发组件2350向远侧推进以执行钉击发行程，如图20所示。实际上，图20中的外科器械2300完全缺少钉仓。因此，闭锁系统被构造成能够如果未耗尽的钉仓诸如钉仓2010例如正确地定位在外科器械2300中，则允许击发组件2350向远侧推进以执行钉击发行程，如图21所示。
主要参见图19，击发组件2350包括可滑动地安装到击发杆2354的闭锁杆2360。闭锁杆2360包括纵向部分2364和远侧端部2366。闭锁杆2360的纵向部分2364延伸穿过限定在击发杆2354的侧向层2354e之间的纵向间隙狭槽。闭锁杆2360的远侧端部2366延伸穿过限定在联接构件2351中的孔2359并从联接构件2351向远侧突出。当未耗尽的钉仓2010正确地定位在仓钳口2020中时，闭锁杆2360可在远侧或锁定位置(图20)与近侧或解锁位置(图21)之间滑动。更具体地讲，除上述以外，未耗尽的钉仓2010包括处于其近侧未击发位置的滑动件2014，当未耗尽的钉仓2010插入到仓钳口2020中时，该滑动件接触闭锁杆2360并向近侧推动闭锁杆2360。滑动件2014可释放地保持到仓体2011，使得滑动件2014保持在其近侧未击发位置，同时向近侧推动闭锁杆2360。在至少一种情况下，仓体2011包括一个或多个棘爪，该棘爪将滑动件2014可释放地保持在其近侧未击发位置。
击发组件2350还包括击发连杆2352，该击发连杆具有限定在其中的纵向狭槽2358。击发连杆2354包括定位在纵向狭槽2358中的近侧端部2355，并且类似地，闭锁杆2360包括也定位在纵向狭槽2358中的近侧端部2365。当闭锁杆2360处于其锁定位置时，如图20所示，锁2370与击发连杆2352接合，这样防止了击发连杆2352向远侧推进。因此，在此类情况下，锁2370防止了击发连杆2352将击发杆2354和联接构件2351推进通过钉击发行程。锁2370围绕枢轴2371可旋转地安装到外科器械2300的轴2340，并且包括与限定在击发连杆2352中的锁定凹陷部或凹口2378接合的锁定肩部。锁2370通过弹簧2372偏压成与发射连杆2352接合。
在比较图20和图21时，除上述以外，可以看出，当将未耗尽的钉仓2010装载到外科器械2300中时，当闭锁杆2360在其锁定位置(图20)与其解锁位置(图21)之间运动时，闭锁杆2360相对于击发杆2354运动。击发组件2350还包括定位在击发杆2354的近侧端部2355和闭锁杆2360的近侧端部2365中间的偏压构件或弹簧2368，当闭锁杆2360向近侧运动时，该偏压构件或弹簧锁定杆在近侧端部2355与2365之间被压缩。如果在钉仓2010被击发之前将未耗尽的钉仓2010从仓钳口2020移除，则偏压构件2368将弹性地扩张并将闭锁杆2360向远侧推入其锁定位置，并且允许弹簧2372使锁2370返回其锁定位置并重新接合击发连杆2352。换句话讲，在仓钳口2020中没有未耗尽的钉仓的情况下，弹簧2368将闭锁杆2360偏压到其锁定位置。
当闭锁杆2360向近侧运动到其解锁状态时，如图21所示，闭锁杆2360的近侧端部2365接合锁2370并抵抗弹簧2372的偏压使锁2370向下旋转脱离与击发连杆2352的接合。此时，击发组件2350可以向远侧推进以执行钉击发行程。值得注意的是，击发连杆2352向远侧推动击发杆2354。更具体地讲，当击发连杆2352向远侧推进时，纵向狭槽2358的近侧壁邻接击发杆2354的近侧端部2355。而且，值得注意的是，击发杆2354经由弹簧2368向远侧推动闭锁杆2360。因此，当击发杆2354在钉击发行程期间向远侧运动时，闭锁杆2360与击发杆2354一起行进。
除上述以外，在钉击发行程期间击发杆2354和闭锁杆2360的远侧运动使闭锁杆2360的近侧端部2365远离锁2370运动。然而，在此类情况下，限定在击发连杆2352中的锁定凹陷部2378不再与锁2370对准。因此，即使闭锁杆2360已经与锁2370脱离接合，锁2370也不能重新接合击发连杆2352并将击发连杆2352锁定就位。当击发连杆2352回缩以便重置外科器械2300时，击发连杆2352可以将击发杆2354和闭锁杆2360向近侧拉动到图20所示的位置。在此类情况下，锁定凹陷部2378与锁2370重新对准，使得弹簧2372可以将锁2370与击发连杆2352重新接合并将击发组件2350重新锁定就位。在各种情况下，击发连杆2352还包括斜坡2375，该斜坡被构造成能够在击发连杆2352回缩时使锁2370向下偏转。
除上述以外，在钉击发行程之后向近侧拉动击发连杆2352，以使击发组件2350的击发杆2354、闭锁杆2360和联接构件2351回缩。值得注意的是，钉仓2010的滑动件2014不会被击发连杆2352回缩。相反，滑动件2014保持在其击发位置。因此，当击发组件2350返回到其重置位置时，闭锁杆2360被推出其锁定位置，因此，防止了击发组件2350再次向远侧推进，直到耗尽的钉仓2010从仓钳口2020中被移除并且未耗尽的钉仓2010例如正确地定位在仓钳口2020中。
此外，除上述以外，应当理解，当耗尽的钉仓2010被装载到仓钳口2020时，耗尽的钉仓2010的滑动件2014不能接触闭锁杆2360，因为滑动件2014不在其近侧端部位置，因此滑动件2014不能解锁击发组件2350。
包括击发组件2950的外科器械2900在图22和23中示出。类似于上文所述，击发组件2950包括闭锁系统，该闭锁系统被构造成能够防止击发组件2950向远侧推进以执行钉击发行程，而无需未耗尽的钉仓2910例如正确地定位在仓钳口2020中。在至少一种情况下，外科器械2900可以包括上文结合外科器械2300讨论的锁2370和锁定弹簧2372布置，例如，当未耗尽的钉仓未正确地安置在仓钳口2020中时，该布置可以阻挡击发组件2950的远侧推进，如图22所示。当未耗尽的钉仓2910正确地安置在仓钳口2020中时，如图23所示，闭锁系统可以允许击发组件2950执行钉击发行程。钉仓2910在许多方面类似于钉仓2010，并且包括仓体2912和滑动件2916，该滑动件可在钉击发行程期间由击发组件2950从近侧未击发位置(图23)运动到远侧击发位置。
击发组件2950包括击发连杆2952、击发杆2954和安装到击发杆2954的联接构件2951。联接构件2951在许多方面类似于联接构件2551。击发杆2954包括近侧部分2955，该近侧部分可滑动地定位在限定在击发连杆2952中的纵向狭槽2958中。击发组件2950还包括偏压构件或压缩弹簧2966，该偏压构件或压缩弹簧定位在纵向狭槽2958中，位于击发杆2954的近侧部分2955和击发连杆2952中间。当未耗尽的钉仓2910未定位在仓钳口2020中时，如图22所示，弹簧2966被构造成能够向前偏压击发杆2954。在击发杆2954的该向前位置，击发杆2954的键2965不与锁2370接合，因此弹簧2372将锁2370偏压到限定在击发连杆2952中的锁定凹陷部2378中，这防止了击发连杆2952向远侧推进以执行钉击发行程。
当未耗尽的钉仓2910正确地定位在仓钳口2020中时，如图23所示，滑动件2916直接接触联接构件2951并将击发杆2954向近侧推入其解锁位置。在击发杆2954的该近侧位置，击发杆2954的键2965与锁2370接合并将锁2370保持在击发连杆2952中的锁定凹口2378之外。因此，在此类情况下，击发连杆2952可以向远侧推进以推动击发杆2954、联接构件2951和滑动件2916通过钉击发行程。类似于上文所述，击发连杆2952可以回缩以向近侧拉动击发杆2954和联接构件2951以重置外科器械2900。同样类似于上文所述，滑动件2916不与击发组件2950一起回缩，因此在击发组件2950已经回缩之后击发杆2954处于其向前或锁定位置。读者应当理解，必须用未耗尽的钉仓2910替换耗尽的钉仓2910，以从击发组件2950解锁锁2370并再次使用外科器械2900。
包括轴3040和击发组件3050的外科器械3000在图24和图25中示出。类似于上文所述，击发组件3050包括闭锁系统，该闭锁系统被构造成能够防止击发组件3050向远侧推进以执行钉击发行程，而无需未耗尽的钉仓3010例如正确地定位在仓钳口2020中。外科器械3000在轴3040中包括锁3070，该锁类似于锁2370，可以阻挡击发组件3050的远侧推进，如图24所示。当未耗尽的钉仓3010正确地安置在仓钳口2020中时，如图25所示，闭锁系统可以允许击发组件3050执行钉击发行程。钉仓3010在许多方面类似于钉仓2010，并且包括仓体3012和滑动件3016，该滑动件可在钉击发行程期间由击发组件3050从近侧未击发位置(图25)运动到远侧击发位置。
击发组件3050包括击发连杆3052、击发杆3054和安装到击发杆3054的联接构件2951。击发杆3054包括近侧部分3055，该近侧部分可滑动地定位在限定在击发连杆3052中的纵向狭槽3058中。击发组件3050还包括偏压构件或压缩弹簧3066，该偏压构件或压缩弹簧定位在纵向狭槽3058中，位于击发连杆3052和击发杆3054的近侧部分3055中间。当未耗尽的钉仓3010未定位在仓钳口2020中时，如图24所示，弹簧3066被构造成能够向前偏压击发杆3054。在击发杆3054的该向前位置，片簧3072将锁3070偏压到限定在击发连杆3052中的锁定凹口2378中，这防止了击发连杆3052向远侧推进以执行钉击发行程。
当未耗尽的钉仓3010定位在仓钳口2020中时，如图25所示，滑动件3016直接接触联接构件2951并将击发杆3054向近侧推入其解锁位置。在击发杆3054的该近侧位置，击发杆3054的近侧端部3055与锁3070接合并抵抗片簧3072的偏压力将锁3070保持在击发连杆3052中的锁定凹口2378之外。因此，在此类情况下，击发连杆3052可以向远侧推进以推动击发杆3054、联接构件2951和滑动件3016通过钉击发行程。类似于上文所述，击发连杆3052可以回缩以向近侧拉动击发杆3054和联接构件2951以重置外科器械3000。同样类似于上文所述，滑动件3016不与击发组件3050一起回缩，因此在击发组件3050已经回缩之后击发杆3054处于其向前或锁定位置。读者应当理解，必须用未耗尽的钉仓3010替换耗尽的钉仓3010，以从击发组件3050解锁锁3070并再次使用外科器械3000。
如上所述，锁2370定位在外科器械2900和3000的轴中；然而，锁2370可以放置在任何合适的位置。在各种情况下，外科器械2900和/或3000例如可以包括关节运动接头，包括钳口2020和2030的端部执行器可以围绕该关节运动接头进行关节运动。在至少一种情况下，锁2370相对于关节运动接头在远侧定位。在此类情况下，闭锁系统不受关节运动接头的影响。在其他情况下，锁2370相对于关节运动接头在近侧定位。将锁2370放置在这种位置可以例如缩短外科器械在关节运动接头远侧的部分并改善外科器械进入较小手术部位的可接近性。
如上所述，外科器械的击发组件可以通过钉仓向远侧推进，以在钉击发行程期间将钉从钉仓射出。同样如上所述，钉仓可以包括滑动件，该滑动件被击发组件向远侧推动，以在钉击发行程期间将钉驱动出钉仓。然而，在各种情况下，临床医生可能无法观察到钉击发行程的过程。在没有这种信息的情况下，临床医生可能不知道在外科器械内捕获的组织是否已经被充分缝合。
现在转向图26至图30，外科器械3100包括仓钳口3120，该仓钳口被构造成能够在其中接收钉仓3110。仓钳口3120包括底部部分和从底部部分延伸的侧面壁3122。钉仓3110可定位在仓钳口3120的侧面壁3122之间。钉仓3110和仓钳口3120包括配合的特征，这些配合的特征被构造成能够将钉仓3110对准并可释放地保持在安置位置(图27至图29)。钉仓3110还包括滑动件3116，该滑动件可在钉击发行程期间由击发组件2550在近侧未击发位置(图26和图27)与远侧击发位置(图29)之间运动。
仓钳口3120包括限定在侧面壁3122中的一系列开口或窗口。仓钳口3120的窗口包括近侧窗口3127、远侧窗口3129以及定位在近侧窗口3127与远侧窗口3129中间的中间窗口3128。每个窗口3127、3128和3129包括沿着纵向轴线3121定位的细长纵向通孔；然而，窗口3127、3128和3129可以具有任何合适的布置。在至少一种情况下，中间窗口3128定位在近侧窗口3127与远侧窗口3129之间的中点处。在其他情况下，中间窗口3128可以定位在近侧窗口3127与远侧窗口3129之间的任何合适位置处。在至少一种情况下，仓钳口3120可以包括一个以上的中间窗口3128。
钉仓3110包括限定在仓体3112的侧面中的一系列开口或窗口。钉仓3110的窗口包括近侧窗口3117、远侧窗口3119以及定位在近侧窗口3117与远侧窗口3119中间的中间窗口3118。每个窗口3117、3118和3119包括沿着纵向轴线3111定位的细长纵向通孔；然而，窗口3117、3118和3119可以具有任何合适的布置。在至少一种情况下，中间窗口3118定位在近侧窗口3117与远侧窗口3119之间的中点处。在其他情况下，中间窗口3118可以定位在近侧窗口3117与远侧窗口3119之间的任何合适位置处。在至少一种情况下，钉仓3110可以包括一个以上的中间窗口3118。
当钉仓3110完全安置在仓钳口3120中时，钉仓3110中的窗口与仓3120钳口中的窗口对准。更具体地讲，近侧仓窗口3117与近侧钳口窗口3127对准，中间仓窗口3118与中间钳口窗口3128对准，并且远侧仓窗口3119与远侧钳口窗口3129对准。在此类情况下，窗口3117和3127形成第一对对准的孔，窗口3118和3128形成第二对对准的孔，并且窗口3119和3129形成第三对对准的孔。因此，临床医生可以在三个不同的位置处通过仓钳口3120观察钉仓3110。
除上述以外，当钉仓3110完全安置在仓钳口3120内时，钉仓3110以扣合连接来接合仓钳口3120。在此类情况下，钉仓3110的纵向轴线3111与仓钳口3120的纵向轴线3121对准。当轴线3111和3121完全对准时，仓窗口3118和3119的边缘不分别相对于钳口窗口3128和3129偏移。就轴线3111和3121稍微对准但未完全对准来说，仓窗口3118和3119可相对于钳口窗口3128和3129偏移。在任一种情况下，至少基本上对准的窗口可以用于在击发行程期间观察滑动件3116的位置，如下所述。
当滑动件3116处于其近侧未击发位置时，如图27所示，通过对准的仓窗口3117和钳口窗口3127可看到滑动件3116。在此类情况下，临床医生可以在视觉上观察到钉仓3110是未耗尽的。如果在钉击发行程开始之前通过对准的仓窗口3117和钳口窗口3127看不到滑动件3116，则临床医生可以假设钉仓3110已经被至少部分地耗尽，并且如果未使用未耗尽的钉仓替换耗尽的钉仓3110，则临床医生可以假设可致动缝合器械3100(诸如，本文所述的那些缝合器械)的闭锁件。此外，如果在钉击发行程期间通过对准的仓窗口3117和钳口窗口3127看不到滑动件3116，则临床医生可以假设钉击发行程正在进行中。
当滑动件3116已经运动通过钉击发行程的一半时，现在参见图28，通过对准的仓窗口3118和钳口窗口3128可看到滑动件3116。在此类情况下，临床医生可以在视觉上观察到钉仓3110已经被部分耗尽。尽管窗口3118和3128在钉击发行程的中点处对准，但是窗口3118和3128可以在任何合适的位置处对准。此外，任何合适数量的窗口对3118和3128都可以用于在钉击发行程期间观察滑动件3116。当滑动件3116处于其远侧击发位置时，如图29所示，通过对准的仓窗口3119和钳口窗口3129可看到滑动件3116。在此类情况下，临床医生可以在视觉上观察到钉仓3110已经被完全用尽。了解钉仓是否已经被完全或至少充分用尽对于临床医生确定是否回缩击发组件2550很重要。例如，参见图30，当临床医生可以观察到远侧窗口3129中的滑动件3116时，他们将知道在钉仓3010与砧座钳口2030之间捕获的血管V已经被完全缝合。
主要参见图26，滑动件3116包括分界线3115，该分界线可通过对准的仓和钳口窗口被观察到，并且可以帮助临床医生理解滑动件3116在钉仓3110内的位置。在至少一种情况下，例如，分界线3115包括与仓钳口3120和/或滑动件3116的颜色不同的颜色，诸如蓝色。在某些情况下，例如，分界线可以包括脊。
主要参见图26，仓钳口3120还包括近侧基准3123p和远侧基准3123d。当滑动件3116处于其近侧未击发位置时，分界线3115与近侧基准3123p对准。在此类情况下，近侧基准3123p可以帮助临床医生确定钉仓3110是否是未耗尽的。当滑动件3116处于其远侧完全击发位置时，分界线3115与远侧基准3123d对准。在此类情况下，近侧基准3123p可以帮助临床医生确定钉仓3110是否已经被完全用尽。基准3123p和3123d包括仓钳口3120上的狭窄线性竖直标记；然而，基准3123p和3123d可以包括任何合适的构型。在至少一种情况下，基准3123p和3123d的颜色与分界线3115相同。在其他情况下，基准3123p和3123d的颜色与分界线3115不同。
除上述以外，中间仓窗口3118的尺寸与中间钳口窗口3128相同。类似地，远侧仓窗口3119的尺寸与远侧钳口窗口3129相同。也就是说，近侧仓窗口3117的尺寸与近侧钳口窗口3127不相同。当沿着纵向轴线3111和3121测量时，近侧仓窗口3117比近侧钳口窗口3127窄。在至少一种情况下，近侧仓窗口3117的宽度与分界线3115相同。在此类情况下，临床医生可以准确地评估滑动件3116是否已经向远侧推进即使是最轻微的量。
如上所述，仓钳口3120被构造成能够在其中接收可替换的钉仓；然而，本文所公开的仓和钳口窗口可以与不包括可替换的钉仓的缝合组件一起使用。此外，本文所公开的仓和钳口窗口可以适配到缝合组件的任一侧或两侧。
参见图31至图34，仓钳口3220包括底部部分或底壁3221以及从底壁3221延伸的侧面部分或侧壁3222。类似于上文所述，仓钳口3220被构造成能够在侧壁3222之间接收可替换的钉仓。底壁3221包括限定在其中的纵向狭槽3223，该纵向狭槽被构造成能够例如接收击发组件2550的底部凸轮。
主要参见图33和图34，纵向狭槽3223包括中心部分3224。中心部分3224是T形构型的一部分，该T形构型包括从中心部分3224侧向延伸的侧向部分3225。纵向狭槽3223还在中心部分3224的相对端部处包括近侧开口或窗口3227和远侧开口或窗口3229。当钉仓的滑动件处于其近侧未击发位置时，滑动件与近侧开口3227对准。在此类情况下，临床医生可以观察到钉仓是否已经被耗尽。类似地，当滑动件处于其远侧完全击发位置时，滑动件与远侧开口3229对准。在此类情况下，临床医生可以观察到钉仓是否已经被完全用尽。
再次参见图31和图32，纵向狭槽3223还包括限定在近侧开口3227与远侧开口3229之间的底壁3221中的中间开口或窗口3228。类似于上文所述，通过开口3228可以观察到在钉击发行程期间滑动件的进展。开口3228在纵向方向上是细长的；然而，开口3228可以包括任何合适的构型。开口3228周期性地间隔开，使得底壁3221在侧面壁3222之间足够刚性。此外，可以使用任何合适数量的开口3228，但是底壁3221将更刚性并具有更少的开口3228。
主要参见图32，开口3228相对于纵向狭槽3223的中心部分3224偏移。换句话讲，每个开口3228包括不与中心部分3224的纵向轴线共线的纵向轴线。此外，开口3228以交替方式相对于中心部分3224的纵向轴线交错。在至少一种情况下，第一开口3228限定在纵向轴线的一侧，而第二开口3228限定在纵向轴线的相对侧。开口3228的这种模式沿着纵向狭槽3223的长度重复。与其中所有开口3228都沿着中心部分的纵向轴线定位的实施方案相比，这种布置可以增加开口3228之间的壁的宽度，因此增加底壁3221的刚度。然而，设想了其他实施方案。
如本文所述，外科器械可以包括击发组件，该击发组件被构造成能够在击发行程期间将击发负载或力施加到钉仓的滑动件。击发负载足以将钉推出钉仓并推入患者的组织，使钉抵抗砧变形，并切割组织。在某些情况下，击发负载可以显著增加超过被认为是安全的和/或适合于外科器械的操作的阈值。在至少一个这种情况下，例如，当击发组件邻接缺失的仓闭锁件和/或耗尽的仓闭锁件时，击发负载可以显著增加。
现在参见图35至图38，外科器械3500包括轴3540和击发组件3550。击发组件3550包括第一击发连杆3551、第二击发连杆3552和击发杆3554。击发组件3550还包括定位在第一击发连杆3551和第二击发连杆3552中间的偏压构件或弹簧3556。当第一击发连杆3551向远侧推进时，第一击发连杆3551经由弹簧3556向远侧推动第二击发连杆3552。第二击发连杆3552的远侧端部在互连件3553处连接到击发杆3554，并且当第二击发连杆3552向远侧推进时，第二击发连杆3552向远侧推动击发杆3554。换句话讲，击发负载可以通过弹簧3556从第一击发连杆3551传递到第二击发连杆3552并最终传递到击发杆3554。
除上述以外，弹簧3556响应于通过击发组件3550传递的击发负载或力而在第一击发连杆3551与第二击发连杆3552之间被压缩。当通过击发组件3550传递的击发负载低于预定的力阈值时，弹簧3556将击发负载传递到第二击发连杆3552以执行击发行程，如图35所示。当击发负载超过阈值时，弹簧3556被压缩到第二击发连杆3552的近侧端部3555致动闭锁系统的点，这防止了击发组件3550推进通过其钉击发行程，如图36所示。此时，临床医生可以关于为什么超过外科器械3500的击发力阈值的原因对外科器械3500进行评估。
除上述以外，弹簧3556在被压缩时向第二击发连杆3552施加偏压力，该偏压力抵抗第二击发连杆3552相对于第一击发连杆3551的近侧运动。击发组件3550的阈值力解释了缝合和切割组织所需的击发力，以及由弹簧3556产生的偏压力。在各种情况下，弹簧3556的偏压力抵抗通过第二击发连杆3552传递的击发力。此外，弹簧3556的偏压力响应于第二击发连杆3552与第一击发连杆3551之间的相对运动而线性地并且成比例地增加。也就是说，一旦通过击发组件3550传递的力超过阈值力，闭锁系统就在解锁构型和锁定构型之间切换，如下文更详细地讨论。
除上述以外，并且如下文还要更详细地描述，当弹簧3556的压缩超过阈值压缩或偏转时，击发组件3550的闭锁系统可以被跳闸或致动到锁定状态。换句话讲，当弹簧3556的压缩低于弹簧3556的阈值压缩时，闭锁系统不会致动到锁定状态。
除上述以外，闭锁系统包括围绕枢轴3571可旋转地安装到轴3540的框架3542上的锁3570以及安装到第一击发连杆3551的锁致动器3577。当锁致动器3577尚未被致动时，锁3570由锁致动器3577保持在解锁位置或构型。锁致动器3577可旋转地安装到第一击发连杆3551上并且可在未致动位置(图35)与致动位置(图36)之间旋转。当击发组件3550的弹簧3556未被压缩超过其阈值压缩或高于其力阈值时，如图35所示，锁致动器3577由扭转弹簧3576偏压到其未致动位置，并且锁3570保持脱离与击发组件3550的接合。
当弹簧3556被压缩超过其阈值压缩或高于其力阈值时，第二击发连杆3552的近侧端部3555接合锁致动器3577并将锁致动器3577旋转到其致动位置，如图36所示。在此类情况下，锁3570由锁致动器3577释放并结合第二击发连杆3552。更具体地讲，闭锁系统还包括偏压构件或弹簧3572，该偏压构件或弹簧被构造成能够一旦锁3570被释放就将锁3570推动成与第二击发连杆3552接合。锁3570包括锁定肩部3578，该锁定肩部被构造成能够被接收在第二击发连杆3552中限定的锁定凹陷部或凹口3558内，这防止了击发组件3550向远侧推进。
读者应当理解，当第二击发连杆3552中限定的锁定凹口3558与锁3570对准时，闭锁系统的锁3570只能止挡击发组件3550的推进。一旦击发组件3550在缝钉击发行程期间向远侧推进并且锁定凹口3558运动成不与锁定肩部3578对准，如图37所示，则锁3570在击发组件3550的整个击发行程中都被第一击发连杆3551约束在其解锁位置或构型。因此，击发组件3550的闭锁系统包括止挡击发组件3550执行钉击发行程的行程开始闭锁件。
除上述以外，当耗尽的钉仓安置在外科器械3500的端部执行器中并且/或者端部执行器完全缺失未耗尽的钉仓时，外科器械3500的端部执行器中缺失的仓闭锁件和/或耗尽的仓闭锁件例如可以阻挡击发组件3550的远侧推进。在此类情况下，通过击发组件3550传递的力将增加到阈值力以上，并且击发组件3550的闭锁系统也可以通过阻挡击发组件3550的远侧推进来作出响应。在各种情况下，击发组件闭锁件可以支撑缺失的仓和/或耗尽的仓闭锁件。因此，在此类情况下，击发组件3550不能用于在未耗尽的钉仓未正确地安置在外科器械3500的端部执行器中的情况下切割组织。
为了重置击发组件3550，除上述以外，临床医生可以操作外科器械3500以使击发组件3550向近侧回缩。在至少一种情况下，外科器械3500包括电动马达，该电动马达被构造成能够驱动击发组件3550通过其钉击发行程，该电动马达可以反向运行以使击发组件3550回缩。当击发组件3550至少部分地回缩时，弹簧3556可以重新扩张并远离第一击发连杆3551推动第二击发连杆3552，以使第二击发连杆3552与闭锁系统的锁致动器3577脱离接合。此时，击发组件3550可以向远侧推进以完成其钉击发行程，如图37所示。
包括耗尽的仓闭锁件的钉仓3610在图39至图42中示出。钉仓3610包括仓体3612，该仓体包括钉腔和限定在其中的纵向狭槽3614。主要参见图41，钉仓3610还包括滑动件3616，该滑动件可通过击发组件(诸如，击发组件2550)在近侧未击发位置(图39)与远侧击发位置之间运动，例如以在钉击发行程射出可移除地储存在钉腔中的钉。现在参见图39，滑动件3616的一部分在钉击发行程期间在纵向狭槽3614内行进。此外，参见图40，击发组件2550的一部分也在钉击发行程期间在纵向狭槽3614内行进。更具体地讲，击发组件2550包括在狭槽3614内行进的联接构件2551。
钉仓3610还包括锁3670。锁3670包括安装到仓体3612上的第一端部和延伸到纵向狭槽3614中的第二端部3672。当钉仓3610处于未击发状态并且滑动件3616处于其近侧未击发位置时，再次参见图40，锁3670的第二端部3672通过滑动件3616弯曲并保持在解锁状态。在此类情况下，锁3670不能防止击发组件2550引发钉击发行程。当滑动件3616通过击发组件2550向远侧推进时，滑动件3616被移动成不与锁3670接触。在此类情况下，击发组件2550在整个钉击发行程中继续将锁3670保持在其解锁构型中。
在钉击发行程已经至少部分完成之后，击发组件2550可以回缩。在此类情况下，滑动件3616不与击发组件2550一起回缩。相反，滑动件3616留在仓体3616内的远侧位置。因此，在击发组件2550完全回缩之后，参见图42，锁3670可以展开到锁定构型，使得第二端部3672阻挡纵向狭槽3614。换句话讲，锁3670的第二端部3672可以阻挡击发组件2550被推进通过另一个钉击发行程。
除上述以外，锁3670包括耗尽的仓闭锁件。在滑动件3616向远侧推进成不与锁3670对准之后，钉仓3610变成耗尽的钉仓，无论全部钉或任何钉是否已从钉仓3610中射出。此时，击发组件2550回缩到其未击发位置将导致钉仓3610将其自身锁定。因此，在可以再次使用外科器械之前，必须将钉仓3610从外科器械移除并用未耗尽的钉仓替换。
除上述以外，仓体3610可以包括凹口3615，该凹口被构造成能够当锁3670运动到其锁定构型时接收锁3670的一部分，如图42所示。凹口3615限定在纵向狭槽3614的侧壁中并且定位成与安装到仓体3612上的锁3670的第一部分相对。锁3670的第二端部3672与凹口3615的侧壁之间的相互作用可以加强闭锁件并减小击发组件2550被锁3670推动的可能性。除了上述内容之外或代替上述内容，击发组件2550可以包括闭锁件，当击发组件2550邻接锁3670时，该闭锁件被触发或致动。
现在转向图43至图47，外科器械3700的击发组件3750包括击发连杆3752和击发杆3754。击发连杆3752包括限定在其远侧端部中的孔3755。孔3755包括近侧端壁3756和远侧端壁3757。击发杆3754包括在界面3753处定位在孔3755中的闭锁件3770。当击发连杆3752在钉击发行程期间向远侧推进时，孔3755的近侧端壁3756接触闭锁件3770并向远侧推动击发杆3754。在击发连杆3752与击发杆3754之间传递的力超过预定的力阈值的情况下，闭锁件3770从解锁状态(图45)运动到锁定状态(图46)。类似于上文所述，例如，当击发组件3750邻接耗尽的仓闭锁件和/或缺失的仓闭锁件时，可以超过力阈值。
闭锁件3770可旋转且可滑动地安装到击发杆3754。击发杆3754包括限定在其中的纵向狭槽3775，并且闭锁件3770包括可滑动地定位在狭槽3775内的销3771。击发杆3754还包括定位在销3771和狭槽3775的远侧端部中间的弹簧3776。因此，从击发连杆3752传递的击发力可以流过闭锁件3770和闭锁销3771，流过弹簧3776并流入击发杆3754，只要击发力低于力阈值即可。在击发力超过力阈值的情况下，击发杆3752可以在纵向狭槽3775内向远侧推动闭锁件3770，如图46所示。在此类情况下，闭锁件3770还可以向上旋转成与外科器械3700的轴3740接合。更具体地讲，主要参见图44，击发杆3754包括从其侧向延伸的凸缘3772，当击发力低于阈值并且闭锁件3770定位在纵向狭槽3775的近侧端部中时，该凸缘防止闭锁件3770向上旋转；然而，一旦远离凸缘3772向远侧推动闭锁件3770，击发力就用于使闭锁件3770向上旋转，如图46所示。
除上述以外，轴3740包括框架3742，该框架包括限定在其中的锁定孔3748，该锁定孔被构造成能够当闭锁件3770向上旋转时接收闭锁件3770的一部分。闭锁件3770与锁定孔3748的侧壁之间的相互作用防止击发组件3750向远侧推进通过其钉击发行程。类似于上文所述，锁定孔3748在轴3740中限定在与钉击发行程的开始相对应的位置处。因此，闭锁件3770被构造和布置成在外科器械3700中缺失钉仓或耗尽的钉仓定位在该外科器械内的情况下帮助锁定外科器械3700。也就是说，锁定孔3748可以定位在任何合适的位置。此外，可以利用一个以上的锁定孔3748来提供一个以上的可以将击发组件3750锁定在其中的位置。
闭锁件3770在运动到其锁定构型之后可以重置(图46)。现在转向图47，击发连杆3752可以向近侧运动，直到孔3755的远侧端壁3757接触闭锁件3770，此时，端壁3757可以使闭锁件3770向下旋转，并且在击发连杆3752继续向近侧运动时使闭锁件3770正向返回到其解锁构型。此外，当击发连杆3752回缩时，击发连杆3752可以将闭锁件3770拉回到凸缘3772下方(图44)。此时，击发组件3750被重置并且可以向远侧重新推进-假设已经解决了阻挡击发组件3750的障碍。
现在转向图48至图51，外科器械3800包括轴3840和击发组件3850。轴3840包括框架3842和纵向通道，该纵向通道被构造成能够可滑动地接收击发组件3850。击发组件3850包括第一击发连杆3851、第二击发连杆3852和击发杆3854。第一击发连杆3851在互连件3853处联接到第二击发连杆3852。在使用中，参见图49，互连件3853被构造成能够在第一击发连杆3851与第二击发连杆3852之间传递力或击发负载。然而，如下文更详细地讨论，互连件3853被构造成能够当通过击发组件3850传递的击发负载超过预定的力阈值时滑动。
除上述以外，第二击发连杆3852包括近侧端部3855，该近侧端部定位在第一击发连杆3851的远侧端部中限定的腔中。第一击发连杆3851还包括与第二击发连杆3852的近侧端部3855接合的锁定臂3857，该锁定臂被构造成能够当击发负载低于力阈值时将击发负载从第一击发连杆3851传递到第二击发连杆3852。更具体地讲，锁定臂3857推动限定在第二击发连杆3852的近侧端部3855上的倾斜表面3859。当击发负载超过力阈值时，锁定臂3857沿着倾斜表面3859滑动，从而使互连件3853滑动、扩展并向外弹性张开，以破坏击发组件3850的击发行程。
除上述以外，参见图50，当锁定臂3857相对于倾斜表面3859滑动并向外张开时，锁定臂3857被构造成能够接合限定在轴框架3842上的锁定肩部3847。锁定臂3857与锁定肩部3847之间的相互作用防止击发组件3850推进通过其钉击发行程。类似于上文所述，锁定肩部3847定位在击发组件3850的钉击发行程的开始处，使得击发组件3850的闭锁特征部对行程开始闭锁件作出响应；然而，锁定肩部3847可以放置在任何合适的一个或多个位置。
除上述以外，击发组件3850在锁定后可以重置。第一击发连杆3851可以向近侧回缩，以可操作地将锁定臂3857与第二击发连杆3852的近侧端部3855重新接合。在此类情况下，锁定臂3857可以向内弹性运动以抓握近侧端部3855。击发组件3850还包括偏压构件或弹簧3856，该偏压构件或弹簧被构造成能够抵靠锁定臂3857偏压近侧端部3855的头部。一旦互连件3853被重置，参见图51，击发组件3850就可以推进通过其钉击发行程-假设再次不超过力阈值。值得注意的是，轴框架3842防止锁定臂3857在钉击发行程期间从第二发射连杆3852脱离。
现在转向图52至图56，外科器械3900包括轴3940、定位在轴3940的远侧端部处的端部执行器、被构造成能够使端部执行器相对于轴3940进行关节运动的关节运动致动器3980，以及击发组件3950。轴3940包括轴框架3942，该轴框架具有限定在其中的纵向腔3949。击发组件3950包括第一击发连杆3951、第二击发连杆3952和击发杆3954。第一击发连杆3951包括远侧端部3957，该远侧端部在界面3953处可操作地与第二击发连杆3952的近侧端部3955接合。当通过击发组件3950传递的击发负载低于预定的力阈值时，参见图52至图55，击发组件3950可以被推动通过钉击发行程。当在且仅在钉击发行程之前或开始时的闭锁区域内击发负载超过预定的阈值时，参见图56，第一击发连杆3951的远侧端部3957可以相对于第二击发连杆3952的近侧端部3955滑动并且止挡第二击发连杆3952的远侧推进。
除上述以外，在至少一个实施方案中，第一击发连杆3951的远侧端部3957包括倒钩，并且第二击发连杆3952的近侧端部3955包括倒钩扣件，该倒钩扣件被构造成能够与远侧端部3957的倒钩联接。当远侧端部3957与近侧端部3955脱离联接时，远侧端部3957的倒钩可以接合轴3940中的壁3948，并且当第一击发连杆3951相对于第二击发连杆3952滑动时止挡第一击发连杆3951和击发组件3950的远侧推进。
再次参见图52和图53，击发组件3950还包括击发套环3959，该击发套环可滑动地定位在轴3940的纵向腔3949中。击发套环3959由弹性材料构成，该弹性材料例如与纵向腔3949的侧壁摩擦接合。在比较图52和图53时，可以看出，第二击发连杆3952在击发套环3959内滑动，而击发套环3959在击发组件3950的初始远侧运动期间保持静止。击发组件3950的这种初始远侧运动不是钉击发行程的一部分。然而，例如，击发组件3950的这种初始远侧运动可以用于在端部执行器内执行不同的功能，诸如关闭端部执行器。
除上述以外，第一击发连杆3951包括限定在其上的突起部3960，该突起部被构造成能够接合击发套环3959以引发钉击发行程。此时，界面3953定位在击发套环3959内，这防止了第一击发连杆3951的远侧端部3957在钉击发行程期间相对于第二击发连杆3952的近侧端部3955滑动。作为上述的结果，界面3953可以在钉击发行程之前或开始时脱离联接，但另一方面，在整个钉击发行程中保持完整。击发套环3959包括刚性近侧端部3958，该刚性近侧端部由突起部3960接合并且在钉击发行程期间由突起部3960向远侧推动，如图56所示。击发组件3950还包括弹簧3956，该弹簧定位在击发杆3954和击发套环3959中间并在它们之间被压缩，这可以有助于控制击发杆3954与击发套环3959之间的相对位置。
现在转向图57至图59，外科器械4000包括轴4040和击发组件4050。轴4040包括框架4042，该框架包括限定在其中的纵向孔4048。击发组件4050包括击发连杆4052以及多个柔性击发杆或层4054，这些柔性击发杆或层在界面4053处可操作地联接到击发连杆4052的远侧端部4057。层4054被构造成能够当击发力低于预定的力阈值时将击发力从击发连杆4052传递到击发组件4050的联接构件4051，如图57所示。在击发力超过力阈值的情况下，层4054可以向外弯曲，如图58所示，这可以防止击发组件4050执行钉击发行程。为了重置击发组件4050，击发杆4052可以向近侧回缩，以允许层4054向内弹性弯曲到其未弯曲状态。如图59所示，击发组件4050还包括击发套环4059，该击发套环被构造成能够支撑层4054并防止层4054在缝钉击发行程期间向外弯曲。类似于上文所述，击发套环4059由柔性材料构成，该柔性材料与纵向轴孔4048的侧壁摩擦接合，并且最初不随层4054运动。换句话讲，击发套环4059不与层4054一起行进，直到击发连杆4052的远侧端部4057接触击发套环4059。
现在转向图60至图64，外科器械4100包括轴4040和击发组件4150。击发组件4150包括第一击发连杆4151、第二击发连杆4152和击发杆4154。第一击发连杆4151包括远侧端部，该远侧端部定位在第二击发连杆4152的近侧端部中限定的孔4153内。第二击发连杆4152包括远侧端部，该远侧端部包括限定在其中的纵向狭槽4155，该纵向狭槽被构造成能够接收击发杆4154的近侧端部。主要参见图60和61，第二击发连杆4152包括壁4157，该壁被构造成能够将击发力从第二击发连杆4152传递到击发杆4154。壁4157包括熔断器。当击发力低于预定的力阈值时，壁4157被构造成能够保持完整，如图62所示。在至少一种情况下，例如，力阈值为80lbf。然而，壁4157被构造成能够当击发力超过力阈值时失效，如图63所示。此时，击发杆4154可在第二击发连杆4152中限定的纵向狭槽4158内滑动，并且第二击发连杆4152的远侧运动不会传递到击发杆4154。熔断器或壁4157不可重置。
除了上述内容之外或代替上述内容，击发组件4150可以包括其他熔断器。例如，第二击发连杆4152还包括相对于壁4157定位在近侧的熔断器4156。熔断器4156包括定位在纵向狭槽4158的侧壁内并与其摩擦接合的可移位元件。在某些实施方案中，熔断器4156包括与狭槽4158的侧壁整体形成的壁。在至少一种情况下，熔断器4156各自被构造成能够在力阈值与壁4157相同(例如，为80lbf)时失效。在此类情况下，熔断器4156可以向远侧推动击发杆4154，并且可以在击发力仅超过力阈值一会儿的情况下完成钉击发行程。在击发力超过力阈值不止一会儿的情况下，熔断器4156可以顺序地失效，如图64所示。另选地，熔断器4156可以被构造成能够在大于壁4157的力阈值的一个或多个阈值下失效。例如，壁4157可以具有60lbf的力阈值，而熔断器可以具有80lbf的力阈值。在至少一个实施方案中，熔断器4156可以被构造成能够在越来越高的力阈值下失效。例如，最远侧熔断器4156可以包括最弱熔断器4156，与最远侧熔断器4156相邻的熔断器4156可以比最远侧熔断器4156更强，依次类推。在其他实施方案中，熔断器4156在比壁4157低的力阈值下失效。在至少一个这种情况下，例如，壁4157具有80lbf的力阈值，并且熔断器4156各自具有60lbf的力阈值。
除上述以外，纵向狭槽4158的长度等于或大于击发组件4150的击发行程。因此，在壁4157和熔断器4156失效之后，第二击发连杆4152可以运动通过其整个击发行程，而击发杆4154不邻接纵向狭槽4158的近侧端部。为了在壁4157和/或熔断器4156失效之后回缩击发杆4154，第二击发连杆4152可以回缩，直到纵向狭槽4158的远侧端部接合击发杆4154并向近侧拉动击发杆4154。在某些情况下，击发杆4154与纵向狭槽4158的侧壁摩擦接合，使得如果壁4157和/或熔断器4156失效，则击发杆4154可以被第二击发连杆4152回缩。
现在转向图65至图70，外科器械4200包括轴4040和击发组件4250。击发组件4250包括第一击发连杆4251、安装到第一击发连杆4251的第二击发连杆4252以及击发杆4254。第二击发连杆4252包括远侧端部肩部4257，该远侧端部肩部在界面4253处可操作地与击发杆4254的近侧端部肩部4255接合，以在击发负载低于预定的力阈值时在钉击发行程期间将击发负载传递通过击发组件4250，如图65和图66所示。第二击发连杆4252还包括从其侧向延伸的一个或多个偏压构件4256。偏压构件4256与轴框架4042中的纵向孔4048的侧壁可滑动地接合。偏压构件4256被构造成能够将第二击发连杆4252偏压成与击发杆4254接合。当击发负载超过力阈值时，如图67所示，偏压构件4256可以压缩或偏转并且允许第二击发连杆4252侧向偏转并可操作地从击发杆4254脱离接合。此时，第二击发连杆4252可以相对于击发杆4254滑动而不将击发力传递到第二击发连杆4252。
除上述以外，击发组件4250可重置。现在参见图68，第一击发连杆4251可以向近侧回缩以回缩第二击发连杆4252，使得参见图69，第二击发连杆4252的远侧端部肩部4257与击发杆4254的近侧端部肩部4255重新对准并可操作地重新联接。在此类情况下，偏压构件4256可以展开并重新扩张以使第二击发连杆4252与击发杆4254重新对准。此时，现在参见图70，击发组件4250可以再次向远侧推进以完成钉击发行程。读者应当注意，击发组件4250的界面4253可以在钉击发行程之前和/或期间的任何点处脱离联接和重新联接。因此，当击发组件4250接合缺失的仓闭锁件、耗尽的仓闭锁件时，和/或在击发力变得过大的任何其他时刻，界面4253可以脱离联接。
现在转向图71至图77，外科器械4300包括轴4340和击发组件4350。轴4340包括框架4342。框架4342包括近侧纵向孔4346和被构造成能够接收击发组件4350的远侧纵向孔4349。击发组件4350包括第一击发连杆4351、可操作地联接到第一击发连杆4351的第二击发连杆4352以及在接口4353处可操作地联接到第二击发连杆4352的击发杆4354。接口4353包括多级熔断器，如下文更详细所述。
除上述以外，击发杆4354包括近侧连接器4355，该近侧连接器包括限定在其相对侧上的驱动凹陷部4359。近侧连接器4355位于限定在第二击发连杆4352中的纵向狭槽4358中，并且经由从第二击发连杆4352的侧壁向内延伸以接合驱动凹陷部4359的突出部4356可操作地且可释放地联接到第二击发连杆4352。在使用中，当击发负载低于预定的力阈值时，击发负载从第一击发连杆4351传递通过第二击发连杆4352并进入击发杆4354，以执行钉击发行程，如图71和图72所示。
现在参见图73，当通过击发组件4350传递的击发负载超过力阈值时，第二击发连杆4352的侧壁可向外弯曲，使得突出部4356可与限定在连接器4355中的驱动凹陷部4359脱离接合。此时，击发杆4354与第二击发连杆4352可操作地脱离接合，并且钉击发行程已被中断。再次参见图73，当接口4353在钉击发行程开始处分离时，第二击发连杆4352的偏转侧壁可向外弯曲进入纵向孔4346并接合轴框架4342，以防止击发组件4350的钉击发行程。换句话讲，当击发负载超过防止第二击连发杆4352朝远侧推进的力阈值时，第二击发连杆4352的偏转侧壁不能进入纵向孔4349。
然而，当击发负载在钉击发行程期间超过力阈值时，第二击发连杆4352的侧壁不能向外或基本上向外偏转，这是因为它们非常接近纵向孔4349的侧壁。因此，如果超过了力阈值，则不会立即发生接口4353的完全分离。相反，参见图74，击发组件4350可进入第一失效状态。在击发组件4350的第一失效状态下，第二击发连杆4352的突出部4356已从限定在击发杆4354的近侧连接器4355中的驱动凹陷部4359分离，然而，突出部4356仍与近侧连接器4355接合。更具体地讲，突出部4356通过纵向孔4349的侧壁受压而贴靠近侧连接器4355的侧面，使得击发力和/或回缩力仍可从第二击发连杆4352传递到击发杆4354。在此类实例中，钉击发行程可完成并且/或者临床医生可决定回缩击发组件4350。
除上述以外，现在参见图75，第二击发连杆4352和击发杆4354之间的界面4353可完全分离并进入第二失效状态。在第二失效状态下，突出部4356不再与击发杆4354的近侧连接器4355接合，结果，第二击发连杆4352不再能够向击发杆4354传递击发运动和/或击发力。相反，随着第二击发连杆4352朝远侧运动，第二击发连杆4352将相对于击发杆4354运动。如图71所示，第二击发连杆4352包括纵向狭槽4358，该狭槽被构造成能够适应第二击发连杆4352和击发杆4354之间的相对运动。纵向狭槽4358足够长，使得击发杆4354不接触狭槽4358的近侧端部4357。
在各种实例中，除上述以外，击发组件4350进入其第一失效状态的力阈值和击发组件4350进入其第二失效状态的力阈值是相同的。在此类实例中，如果出现击发力中的瞬时脉冲或增加，则击发组件4350可切换到其第一失效状态并且仍然在第一失效状态下操作。然而，如果击发力的增加不是瞬时的，则击发组件4350随后可快速进入其第二失效状态。在至少一个实例中，例如，第一力阈值和第二力阈值为80lbf。在其他实例中，击发组件4350进入其第一失效状态的力阈值和击发组件4350进入其第二失效状态的力阈值是不同的。例如，第一力阈值为60lbf，第二力阈值为80lbf。另选地，第一力阈值为80lbf，第二力阈值为60lbf。在任一种情况下，击发组件4350都能够在高击发力条件下推进，并且仍然起作用。
在任一种情况下，现在参见图71和图72，击发组件4350可通过回缩第二击发连杆4352来重置。在至少一个实例中，击发组件4350可被重置到其第一失效状态，然后重新操作。在其他实例中，第二击发连杆4352回缩，直到突出部4356弹性地重新接合限定在击发杆4354的近侧连接器4355中的驱动凹陷部4359，以在击发组件4350重新操作之前完全重置击发组件4350的接口4353。在任一种情况下，例如，施加到第二击发连杆4352的回缩力可小于第一力阈值和/或第二力阈值。
钉仓4400如图77A和图77B所示。钉仓4400在许多方面类似于本文所公开的钉仓-为简洁起见，本文中未讨论其中的大多数钉仓。此外，钉仓4400可用于本文所公开的任何外科器械。钉仓4400包括仓体4410和在击发行程期间可通过击发构件运动穿过仓体4410的滑动件。仓体4410包括限定在其中的被构造成能够接收击发构件的纵向狭槽4415。仓体4410还包括钉腔4420的纵向排和钉腔4430的纵向排。更具体地讲，仓体4410包括定位在纵向狭槽4415的每侧上的两排内钉腔4420和定位在这两排钉腔4420的每侧上的一排外钉腔4430。也就是说，钉仓4400可包括任何合适数目和布置的钉腔4420和4430。钉腔4420和4430的纵向排彼此平行或至少基本上平行；然而，设想了其中钉腔4420和4430的纵向排彼此不平行的其他实施方案。
钉仓4400还包括可移除地储存在钉腔4420中的钉4440和储存在钉腔4430中的钉4450。钉4440包括已由一片或多片材料冲压而成的冲压钉。例如，钉4450包括已弯曲成大体V形构型的线钉。V形构型为未成形的或未击发的构型。也就是说，钉4450可具有任何合适的未击发构型。在任何情况下，钉仓4400还包括被构造成能够从钉腔4430射出钉4450的钉驱动器4480。在击发行程期间，滑动件被构造成能够接合钉驱动器4480并将钉4450向上推出钉腔4430。同时，滑动件直接接合钉4440以将钉4440从钉腔4420射出。参见图77B，当钉4440和4450从钉仓4400射出时，钉4440和4450接触砧座4490或定位成与钉仓4400相对的任何其他合适的砧座。砧座4490包括限定于其中的成形凹坑4470，该凹坑与钉4440和4450的腿对准并且被构造成能够在击发行程期间使钉4440和4450变形。在另选的实施方案中，砧座可包括与每个钉4440对准的第一类型成形凹坑和与每个钉4450对准的第二或不同类型的成形凹坑。
除上述以外，砧座4490被构造成能够使钉4440变形至第一成形高度，并使钉4450变形至第二或不同的成形高度。在至少一个此类实例中，钉4440的第一成形高度高于钉4450的第二成形高度。在另选的实施方案中，砧座4490被构造成能够使钉4440和钉4450变形至相同的成形高度。在任何情况下，砧座4490还包括限定于其中的纵向狭槽4495，该纵向狭槽被构造成能够在击发行程期间接收击发构件。纵向砧座狭槽4495沿着纵向轴线4405与纵向仓狭槽4415对准或居中。
钉仓4500如图77C和图77D所示。钉仓4500在许多方面类似于本文所公开的钉仓-为简洁起见，本文中未讨论其中的大多数钉仓。此外，钉仓4500可用于本文所公开的任何外科器械。钉仓4500包括仓体4510和在击发行程期间可通过击发构件运动穿过仓体4510的滑动件。仓体4510包括限定在其中的被构造成能够接收击发构件的纵向狭槽4415。仓体4510还包括钉腔4520’的纵向排和钉腔4520”的纵向排。更具体地讲，仓体4510包括定位在纵向狭槽4415的每侧上的一排内钉腔4520’和定位在该排钉腔4520’的每侧上的两排外钉腔4520”。也就是说，钉仓4500可包括任何合适数目和布置的钉腔4520’和4520”。钉腔4520’和4520”的纵向排彼此平行或至少基本上平行；然而，设想了其中钉腔4520’和4520”的纵向排彼此不平行的其他实施方案。
钉仓4500还包括可移除地储存在钉腔4520’中的钉4540’和储存在钉腔4520”中的钉4540”。钉4540’包括已由一片或多片材料冲压而成的冲压钉。钉4540”还包括已由一片或多片材料冲压而成的冲压钉。如图77E所示，钉4540”大于钉4540’。更具体地讲，钉4540”高于钉4540’。此外，钉4540”宽于钉4540’。在击发行程期间，滑动件直接接合钉4540’和4540”，以从钉腔4520’射出钉4540’并从钉腔4520”射出钉4540”。参见图77D，当钉4540’和4540”从钉仓4500射出时，钉4540’和4540”接触砧座4590或定位成与钉仓4500相对的任何其他合适的砧座。砧座4590包括限定于其中的与钉4540’的腿对准的成形凹坑4570’，并且此外还包括限定于其中的与钉4540”的腿对准的成形凹坑4570”。成形凹坑4570’和4570”被构造成能够在击发行程期间分别使钉4540’和4540”变形。
参见图77E和图77F，砧座4590被构造成能够使钉4540’变形至第一成形高度，并使钉4540”变形至第二或不同的成形高度。在至少一个实例中，钉4540”的第二成形高度高于钉4540’的第一成形高度。在使用中，参见图72F，钉仓4500中的最内排钉4540’被构造成能够在切入组织T中施加足够的止血密封，并且外排的较大钉4540”被构造成能够在钉线中提供一定量的柔韧性。在另选的实施方案中，钉4540’和4540”被变形至相同的成形高度。在任何情况下，砧座4590还包括限定于其中的纵向狭槽4595，该纵向狭槽被构造成能够在击发行程期间接收击发构件。纵向砧座狭槽4595沿着纵向轴线4505与纵向仓狭槽4415对准或居中。
图78示出了包括柄部110和可操作地联接到其上的可互换轴组件200的示例性外科器械100。柄部110包括被构造成能够由临床医生抓握、操纵和/或致动的柄部140。轴组件200包括轴210和端部执行器300。轴210包括轴框架(图78中未示出)，以及轴框架延伸穿过其中的中空外部套管或闭合管250。轴组件200还包括喷嘴组件290，该喷嘴组件被构造成能够与外部套管250连接并且使得临床医生能够围绕纵向轴线选择性地旋转轴210。轴组件200还包括闩锁230，该闩锁是锁定系统的一部分，该锁定系统将轴组件200可释放地锁定到柄部110。在各种情况下，例如当闩锁230与柄部110接合时，闩锁230可将柄部110中的电路闭合。2013年3月14日提交的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING ANARTICULATION LOCK”的美国专利申请13/803,086的整个公开内容以引用方式并入本文。本文所公开的所有实施方案均可用于柄部110。
图79示出了示例性外科机器人500，该示例性外科机器人被构造成能够致动多个外科工具，例如通常被标记为600。外科机器人500可与主控制器(未示出)结合使用，该主控制器被配置成允许外科医生控制和查看正由外科机器人500执行的外科手术。在各种形式中，外科机器人500包括基座510，在例示的实施方案中，例如，该基座支撑有三个外科工具600。在各种形式中，外科工具600均由一系列能够关节运动的连杆(一般称为臂520)支撑，并且可操作地联接到一个或多个驱动系统530。这些结构示出为具有护盖，这些护盖遮蔽了其可动部件的大部分。这些护盖可以是可选的，并且在一些实施方案中可以限制尺寸或者完全消除，以最小化用于操纵臂520的伺服机构所遇到的惯性。在各种形式中，外科机器人500具有轮件，该轮件允许外科机器人500由单个维护人员定位在手术台附近。图79还示出了外科机器人500的工作包壳700。工作包壳700是指外科机器人500的外科工具600的运动范围。图79所示的工作包壳700的形状和尺寸仅为例示性的。因此，工作包壳不限于图79所示的样本工作包壳的特定尺寸和形状。2015年6月23日公布的名称为“ROBOTICALLY-DRIVENSURGICAL INSTRUMENT WITH E-BEAM DRIVER”的美国专利9,060,770的完整公开内容以引用方式并入本文。本文所公开的所有实施方案均可用于外科机器人500。
图80至图86示出了与外科缝合系统一起使用的砧座5000。砧座5000包括面向组织的表面5001、被构造成能够将切割构件接收在其中的纵向狭槽5002，以及限定在面向组织的表面5001中的多个成形凹坑布置结构5100。成形凹坑布置结构5100在纵向狭槽5002的每侧上以纵向排布置在砧座5000的近侧端部5003和砧座5000的远侧端部5005之间。砧座5000包括成形凹坑布置结构5100的两个内纵向排5007和成形凹坑布置结构5100的两个外纵向排5009。每个成形凹坑布置结构5100包括近侧成形凹坑5110和远侧成形凹坑5130。成形凹坑5110、5130被构造成能够容纳不同类型的钉和使其变形。例如，在临床医生需要使用不同类型的钉的情况下，利用这种成形凹坑的器械不需要临床医生在手术期间切换器械。
如上所述，成形凹坑布置结构5100被构造成在外科缝合过程期间使钉变形。主要参见图81和图82，成形凹坑布置结构5100还包括限定在成形凹坑5110、5130之间的桥接部分5105。在这种情况下，桥接部分5105是砧座5000的面向组织的表面5001的一部分。成形凹坑布置结构5100包括限定在桥接部分5105内的中心“C”。成形凹坑布置结构5100相对于桥接部分5105双侧对称，相对于侧向凹坑轴线(垂直于轴线LA-LA并延伸通过中心“C”)双侧对称，并且相对于中心“C”不旋转对称。
参见图81和图82，每个成形凹坑5110、5130分别包括围绕其周边延伸的上部圆角边缘5114、5134。边缘5114、5134在面向组织的表面5001和凹坑5110、5130之间提供弯曲过渡。具体地，边缘5114、5134将面向组织的表面5001过渡到凹坑5110的凹坑侧壁5113A、5113B以及凹坑5130的凹坑侧壁5133A、5133B中。边缘5114、5134还使面向组织的表面5001过渡到每个凹坑5110、5130的成形表面的入口和出口部分。
侧壁5113A、5133A相对于砧座5000的纵向轴线LA-LA成角度。侧壁5113B、5133B分别包括不同的侧壁部分5121、5122、5123和5141、5142、5143。侧壁部分5121、5141相对于砧座5000的纵向轴线以与侧壁部分5113A、5133A相对于该纵向轴线成角度的角度不同的角度来成角度。侧壁部分5122、5142与纵向轴线LA-LA平行或至少基本平行。换句话讲，侧壁部分5122、5142至少基本垂直于面向组织的表面5001。侧壁部分5123、5143与侧壁5113A、5133A平行或至少基本平行。侧壁5113A、5113B、5133A、5133B被构造成能够将钉尖端和钉腿朝向凹坑5110、5130的成形表面引导，并且帮助控制钉的成形过程，如下文更详细所述。
侧壁5113A、5113B、5133A、5133B从上部过渡边缘5114、5134延伸至下部过渡边缘5116、5136。这些边缘5116、5136在侧壁5113A、5113B、5133A、5133B与每个凹坑5110、5130的成形表面之间提供圆形或平滑的过渡特征结构。下部过渡边缘5116、5136可以包括圆形和/或平坦轮廓。
凹坑5110、5130的成形表面分别包括入口区成形表面5111、5131和出口区成形表面5112、5132。凹坑5110、5130还包括分别限定在成形凹坑5110、5130中的成形或引导沟槽5115、5135。沟槽5115、5135平行于或至少基本平行于砧座5000的纵向轴线LA-LA延伸。凹坑5110、5130还包括分别围绕沟槽5115、5135的周边延伸的圆角过渡边缘，以在凹坑5110、5130的成形表面和沟槽5115、5135之间提供平滑的过渡。
如上所述，成形凹坑布置结构5100被构造成容纳不同类型的钉和使其变形。为实现这一点，成形凹坑5110、5130各自包括专用着陆或目标区LZ1、LZ2，其被构造成能够控制对应钉的形成。着陆区LZ1、LZ2相对于彼此侧向偏移。着陆区LZ1被构造成能够接收第一钉类型的钉腿，着陆区LZ2被构造成能够接收第二钉类型的钉腿。例如，不同的钉可以在尺寸、制造和/或材料方面不同。在一种情况下，一种钉类型是圆形饰面丝状钉，而另一种钉类型是平坦形钉。另选地，第一钉类型和第二钉类型可以包括相同的钉，然而，钉在它们各自的钉仓中相对于成形凹坑的位置是不同的。
着陆区LZ1分别位于沟槽5115、5135的入口部分5115N、5135N内。被构造成能够着陆在着陆区LZ1中的钉腿被构造成能够在沟槽5115、5135内形成并且分别在沟槽5115、5135的出口部分5115X、5135X处开始离开它们各自的成形凹坑5110、5130。该路径被标记为PATH1，并且是第一钉类型的成形的预期路径。在第一钉类型和成形凹坑5110、5130之间形成接触可以被限制在沟槽5115、5135中。着陆区LZ2位于凹坑5110、5130的入口区成形表面5111、5131内。被构造成能够着陆在着陆区LZ2中的钉腿被构造成能够朝向侧壁5113A、5133A成形。在成形期间，侧壁5113A、5133A被构造成能够将第二钉类型的钉腿在与侧壁5113A、5133A平行或至少基本平行的方向上朝向成形凹坑布置结构5100的中心“C”引导。第二钉类型的钉腿被构造成能够在出口区成形表面5112、5132处离开相应的成形凹坑5110、5130。该路径被标记为PATH2，并且是第二钉类型的成形的预期路径。
多个钉仓被构造成能够与外科缝合系统的砧座5000一起使用。第一钉仓5010和第二钉仓5020在图83和图84中示出。钉仓5010、5020被示出为与砧座5000相邻，以示出第一钉仓5010相对于砧座5000的对准，以及第二钉仓5020和砧座5000的对准。钉仓5010、5020分别包括纵向狭槽5012、5022，该纵向狭槽限定纵向轴线LA-LA，当钉仓5010、5020安装在外科缝合系统中时，纵向轴线与砧座5000的纵向轴线LA-LA对准。
第一钉仓5010包括面向组织的表面5011和限定在其中的多个钉腔5013。钉腔5013被布置成多个排。第一钉仓5010还包括钉腔5013的内排5017和钉腔5013的外排5019。每个钉腔5013在其中可移除地储存钉5014。每个钉5014包括一对钉腿，每个钉腿包括钉尖端5015。每一排内的钉尖端5015限定排对准轴线。存储在腔5013的内排5017内的钉5014的尖端5015限定第一排对准轴线5016，存储在腔5013的外排5019内的钉5014的尖端5015限定第二排对准轴线5018。如在图83中可见，当第一钉仓5010安装在外科器械系统中时，第一排对准轴线5016和第二排对准轴线5018与砧座5000的成形凹坑5110、5130的排5007、5009的着陆区LZ1对准，使得钉尖端5015瞄准着陆区LZ1。当被击发时，钉5014被构造成能够着陆在着陆区LZ1中并沿着路径PATH1形成(图81)。
第二钉仓5020包括面向组织的表面5021和限定在其中的多个钉腔5023。钉腔5023被布置成多个排。第二钉仓5020还包括钉腔5023的内排5027和钉腔5023的外排5029。每个钉腔5023在其中可移除地储存钉5024。每个钉5024包括一对钉腿，每个钉腿包括钉尖端5025。每一排内的钉尖端5025限定排对准轴线。存储在腔5023的内排5027内的钉5024的尖端5025限定第一排对准轴线5026，存储在腔5023的外排5029内的钉5024的尖端5025限定第二排对准轴线5028。如在图84中可见，当第二钉仓5020安装在外科器械系统中时，第一排对准轴线5026和第二排对准轴线5028与砧座5000的成形凹坑5110、5130的排5007、5009的着陆区LZ2对准，使得钉尖端5025瞄准着陆区LZ2。当被击发时，钉5024被构造成能够着陆在着陆区LZ2中并沿着路径PATH2成形(图81)。第一排对准轴线5016定位在距纵向轴线LA-LA距离d1处。第一排对准轴线5026定位在距纵向轴线LA-LA距离d2处。距离d1小于距离d2。
如上所述，成形凹坑布置结构5100被构造成能够容纳不同类型的钉并且将这些钉形成为不同的成形构型。现在参见图85和图86，示出了在由成形凹坑布置结构5100形成之后的第一钉类型和第二钉类型。图85示出了丝状钉5031，其包括钉基部5032和从钉基部5032延伸的钉腿5033。钉5031的正视图5030示出了处于未成形构型的钉5031，该钉5031的正视图5030'示出了处于成形构型的钉5031，并且钉5031的平面图5030”示出了处于成形构型的钉5031。利用成形凹坑布置结构5100中的一个成形凹坑布置结构的着陆区LZ1形成的U形钉5031被构造成能够形成为基本上平面的构型。
图88示出了冲压钉5041，其包括限定第一平面的钉基部5042和从钉基部5042延伸并限定从第一平面偏移的第二平面的钉腿5043。钉5041已经由平坦的金属片形成。钉5041的正视图5040示出了处于未成形构型的钉5041，钉5041的正视图5040'示出了处于成形构型的钉5041，并且钉5041的平面图5040”示出了处于成形构型的钉5041。利用成形凹坑布置结构5100中的一个成形凹坑布置结构的着陆区LZ2形成的U形钉5041被构造成能够形成为基本上非平面的构型。
图87至图92描绘了被构造成能够在外科缝合过程期间使钉变形的成形凹坑布置结构5200。成形凹坑布置结构5200包括限定在砧座5201的平面或组织接触表面5203中的近侧成形凹坑5210和远侧成形凹坑5230。成形凹坑5210、5230被构造成能够容纳不同类型的钉和使其变形。与上述实施方案相反，第一钉仓中的第一钉类型的钉尖端到第一钉仓的中心纵向轴线的距离与第二钉仓中的第二钉类型的钉尖端到第二钉仓的纵向轴线之间的距离相同。成形凹坑布置结构5200还包括限定在成形凹坑5210、5230之间的桥接部分5205。在这种情况下，桥接部分5205相对于砧座5201的平坦表面5203凹进。成形凹坑布置结构5200包括限定在桥接部分5205内的中心“C”。成形凹坑布置结构5200相对于桥接部分5205双侧对称，相对于凹坑轴线5203双侧对称，并且相对于中心“C”旋转对称。
成形凹坑5210包括一对凹坑侧壁5213，并且成形凹坑5230包括一对凹坑侧壁5233。凹坑侧壁5213、5233相对于平坦表面5203成角度，该平坦表面被构造成能够将钉尖端和钉腿朝向凹坑5210、5230的成形表面引导。侧壁5213、5233在砧座5201的平坦表面5203和凹坑5210、5230的成形表面之间延伸。凹坑侧壁5213、5233配合以使对应的钉尖端成漏斗形式地朝向凹坑5210、5230的侧向中心。
凹坑5210、5230分别包括入口区5211、5231和出口区5212、5232。凹坑5210、5230还包括沟槽系统，该沟槽系统被构造成能够容纳和接收不同类型的钉并将这些钉形成为不同的二维构型。凹坑5210、5230分别包括限定在其成形表面中的第一沟槽5225、5245。沟槽5225、5245包括在侧壁5213、5233和凸壁5226、5236之间延伸的凹壁5227、5247。第一沟槽5225、5245被构造成能够接收、引导和形成第一钉类型。凹坑5210、5230还包括分别限定或嵌套在第一沟槽5225、5245内的第二沟槽5215、5235。沟槽5215、5235包括在凸壁5226、5236和底部表面5216、5236之间延伸的凹壁5217、5237。第二沟槽5215、5235被构造成能够接收、引导和形成第二钉类型。第二钉类型被构造成能够绕过第一沟槽5225、5245。
参见图89，单个凹坑内的第一沟槽可包括第一入口曲率半径，其不同于第二沟槽的第二入口曲率半径。第一沟槽可包括第一出口曲率半径，其不同于第二沟槽的第二出口曲率半径。例如，参见近侧成形凹坑5210，沟槽5215的底部表面5216包括对应于入口区5211的第一入口曲率半径和对应于出口区5213的第一出口曲率半径，而沟槽5225包括对应于入口区5211的第二入口曲率半径和对应于出口区5213的第二出口曲率半径。
第一沟槽的第一入口和出口曲率半径可以包括与第二沟槽的第二入口和出口曲率半径的比率不同的比率。另一方面，第一入口和出口曲率半径的比率可以与第二入口和出口曲率半径的比率相同。在此类实施方案中，沟槽沿凹坑的长度相对于彼此垂直偏移相等的距离。除上述之外，由于沟槽壁之间的宽度不同，沟槽5215、5225、5235、5245的宽度或直径可以沿凹坑的长度变化。相反地，沟槽5215、5225、5235、5245可沿凹坑的长度包括均匀的宽度或直径。
参见图90，示出了圆形钉的轮廓S1以及冲压或平坦形钉的轮廓S2。圆形钉S1被构造成能够由沟槽5235接收，并且平坦形钉S2被构造成能够由沟槽5245接收。在某些情况下，平坦形钉S2不能进入沟槽5235，因为钉S2比沟槽5235宽。例如，在至少一种情况下，圆形钉包括约0.007英寸的直径，并且平坦形钉可包括约0.010英寸的宽度或总直径。通过利用成形凹坑装置结构5200控制哪个沟槽可以形成哪个钉，可以在沟槽5215、5225之间以及沟槽5235、5245之间改变各种特征，诸如入口和出口曲率半径，来控制形成不同的钉的钉腿的方式。
除上述之外，沟槽5215、5225、5235、5245可包括沟槽5215、5225、5235、5245本身之间以及沟槽5215、5225、5235、5245与凹坑5210、5230的边缘之间的平滑过渡特征结构。这些平滑过渡特征结构位于每个沟槽5215、5225、5235、5245的入口和/或出口部分附近，以便消除在成形期间钉在凹坑边缘上的不需要的捕获。
图93至图95示出了将通过成形凹坑布置结构5200形成的第一钉5250和第二钉5260。第一钉5250小于第二钉5260。具体地，第一钉5250的线径小于第二钉5260的线径，第一钉5250的未成形高度小于第二钉5260的未成形高度，并且第一钉5250的钉尖端之间的距离小于第二钉5260的钉尖端之间的距离。第一钉5250包括钉冠5251和从钉冠5251延伸的钉腿5253。每个钉腿5253包括钉尖端5253，钉尖端被构造成能够接触对应的成形凹坑5210、5230的第一着陆区LZ1。第二钉5260包括钉冠5261和从钉冠5261延伸的钉腿5263。每个钉腿5263包括钉尖端5263，钉尖端被构造成能够接触对应的成形凹坑5210、5230的第二着陆区LZ2。上面讨论的着陆区LZ1、LZ2之间的沟槽深度的差异可以允许第一钉5250形成为第一B形构型(图94)并且第二钉5260形成为第二B形构型(图95)，该构型的成形高度与第一钉5250的成形高度不同。
当钉从钉仓射出到组织中时，组织可以流动或运动，从而导致钉偏转或弯曲。这种组织运动可能是由刀将组织向远侧推动的前进引起的。如果组织使钉腿向远侧弯曲，则钉腿以及因此这些钉腿的钉尖端可被驱动成相对于其预期的钉成形凹坑偏离目标。图96示出了外科缝合布置结构5300。布置结构5300的砧座5301被构造成能够允许不同类型的钉的组织运动和钉腿偏转。砧座5301包括近侧成形凹坑5310和远侧成形凹坑5330。被构造成能够抵靠砧座5301形成的第一钉5350包括钉基部5351和从钉基部5351延伸的钉腿5352。每个钉腿5352包括钉尖端5353。被构造成能够抵靠砧座5301形成的第二钉5360包括钉基部5361和从钉基部5361延伸的钉腿5362。每个钉腿5362包括钉尖端5363。
例如较细直径的钉5350可以比例如较粗直径的钉5360偏转更多(参见图96中以虚线示出的腿5352'、5362'和尖端5353'、5363'的偏转表示)。这种预期的偏转可以通过增加一对成形凹坑5310、5330的纵向捕获距离，同时仍然保持钉基部的中心与成形凹坑5310、5330的中心轴线CA-CA之间的居中对准来解决。纵向捕获距离可以定义为近侧成形凹坑5310的近侧边缘或入口边缘与远侧成形凹坑5330的远侧边缘或入口边缘之间的距离。适应纵向腿部偏转的另一种解决方案可包括调节钉5350、5360和成形凹坑5310、5330的相对位置。例如，可将预期比其他钉更多地偏转的钉在其钉仓内更朝近侧定位，以允许腿的远侧偏转。将这些钉更朝近侧定位可导致钉相对于成形凹坑的中心轴线CA-CA的偏轴定位。换句话讲，钉基部的中心将不与中心轴线CA-CA对准。
图97至图100示出了包括成形凹坑5410的层压或分层砧座5400。层压砧座5400包括多个水平层5403A、5403B、5403C、5403D、5403E、5403F、5403G、5403H。层5403A、5403B、5403C、5403D、5403E、5403F、5403G、5403H可例如被激光切割，并且可通过例如焊接和/或粘合剂组装。用于组装层5403A、5403B、5403C、5403D、5403E、5403F、5403G、5403H的另一种方法可包括压配销。层5403A、5403B、5403C、5403D、5403E、5403F、5403G、5403H中的某些层可以被设计成移动或给予以赋予特定的钉成形反应。层5403A、5403B、5403C、5403D、5403E、5403F、5403G、5403H中的任何一个的边缘可以形成为光滑边缘。
图101为包括成形凹坑5411的层压或分层砧座5410的剖视图。层压砧座5410包括多个垂直层5413A、5413B、5413C、5413D、5413E、5413F、5413G、5413H、5413I、5413J、5413K、5413L、5413M、5413N、5403O。层5413A、5413B、5413C、5413D、5413E、5413F、5413G、5413H、5413I、5413J、5413K、5413L、5413M、5413N、5403O可例如被激光切割，并且可通过例如焊接和/或粘合剂组装。用于组装层5413A、5413B、5413C、5413D、5413E、5413F、5413G、5413H、5413I、5413J、5413K、5413L、5413M、5413N、5403O的另一种方法可包括压配销。层5413A、5413B、5413C、5413D、5413E、5413F、5413G、5413H、5413I、5413J、5413K、5413L、5413M、5413N、5403O中的某些层可以被设计成移动或给予以赋予特定的钉成形反应。层5413A、5413B、5413C、5413D、5413E、5413F、5413G、5413H、5413I、5413J、5413K、5413L、5413M、5413N、5403O中的任何一个的边缘可以形成为光滑边缘。某些层，例如诸如层5413G、5413H、5413I，可以被构造成能够在成形期间控制和引导钉腿。
图102示出了钉5420。钉5420包括钉冠5421和从钉冠5421延伸的钉腿5422、5424。钉腿5422包括侧向切割的钉尖端5423。钉尖端5423以第一角度切割。钉腿5424包括侧向切割的钉尖端5425。钉尖端5425以不同于第一角度的第二角度切割。两个钉尖5423、5425面向与由钉冠5421限定的轴线垂直或至少基本垂直的方向。侧向切割的钉尖端可以帮助钉对准它们各自的成形凹坑的特定区域。例如，在成形凹坑被构造成能够形成不同类型的钉的情况下，钉可以被切割有相反的侧向面向的钉尖端，例如，面向与侧向方向相反的方向，使得一个钉可以被朝凹坑的第一部分偏压并且另一个钉可以朝凹坑的不同部分偏压。如上所述，各种外科系统包括能够在打开位置和闭合位置之间运动的砧座。然而，有时，砧座可能未完全闭合或不能完全闭合。例如，捕获在砧座和钉仓之间的组织可能太厚而使砧座不能完全闭合。因此，在击发行程期间，砧座可以成角度或弧形，其影响来自钉仓的钉如何抵靠砧座形成。
图103和图104示出了外科缝合组件5500，其包括钉5505、钉仓5501，钉5505可移除地储存在该钉仓中，以及被构造成能够使钉5505变形的砧座5520。钉5505包括钉基部5506和从钉基部5506延伸的钉腿5507。每个钉腿5507包括钉尖端5508。钉5505可移除地储存在钉仓5501的钉腔5503内。钉仓5501包括钉驱动器5510，该钉驱动器包括驱动表面或支架5511，该支架被构造成能够将钉朝向砧座5520驱动。在一些情况下，砧座5520可以相对于平行于钉仓5501的面向组织的表面5502的基准成角度θ1。为了适应该角度，钉驱动器5510的驱动表面5511成角度θ1。因此，当钉5505被驱动到砧座5520的成形凹坑5522中时，钉尖端5508可以同时或最多基本同时接触凹坑5522。这可以防止一个钉腿形成得比另一个钉腿更多。
图105示出了外科缝合组件5600，其包括平坦形钉5630、钉仓5610，钉5630可移除地储存在该钉仓中，以及被构造成能够使钉5630变形的砧座5620。钉5600包括近侧钉腿5632，该近侧钉腿包括近侧钉尖端5633。近侧钉尖端5633相对于平行于钉仓5610的面向组织的表面5611的基准以角度θP切割。钉5600包括远侧钉腿5634，该远侧钉腿包括相对于远侧钉腿5634成角度θD2的远侧钉尖端5635。远侧钉尖端5635相对于平行于钉仓5610的面向组织的表面5611的基准以角度θD1切割。
钉5630可移除地储存在钉仓5610的钉腔5612内。钉5630被构造成能够被钉仓5610的滑动件5613朝向砧座5620驱动。砧座5620包括面向组织的表面5621和限定在面向组织的表面5621中的成形凹坑布置结构5623。成形凹坑布置结构5623包括近侧成形凹坑5624和远侧成形凹坑5625。在这种情况下，凹坑布置结构5623限定凹坑平面5626，其平行于砧座5620的面向组织的表面5621。凹坑平面5626由凹坑布置结构5623的每个成形凹坑5624、5625的最深部分或谷部限定。在这种情况下，砧座5520相对于钉仓5610的面向组织的表面5611以角度θ1成弧形。钉5630被构造成能够通过使一个远侧钉腿5634比近侧钉腿5632长，并且两个成特定角度的远侧钉尖5635具有成特定角度的尖端表面来适应该砧座弧度。当以角度θ1被驱动到砧座5620的成形凹坑5624、5625时，即使当砧座成弧形时，钉5630也可以形成为期望的成形构造。
图106示出了外科缝合组件5700，其包括平坦形钉5730、钉仓5710，钉5730可移除地储存在该钉仓中，以及被构造成能够使钉5730变形的砧座5720。钉5700包括钉基部5731和从钉基部5731延伸的钉腿5732。每个钉腿5732包括钉尖端5733。钉5730可移除地储存在钉仓5710的钉腔5712内。钉5730被构造成能够被钉仓5710的滑动件5713朝向砧座5720驱动。砧座5720包括面向组织的表面5721和限定在面向组织的表面5721中的成形凹坑布置结构5723。成形凹坑布置结构5723包括近侧成形凹坑5724和远侧成形凹坑5725。在这种情况下，凹坑布置结构5723限定凹坑平面5726，其平行于钉仓5710的面向组织的表面5711。凹坑平面5726由凹坑布置结构5723的每个成形凹坑5724、5725的最深部分或谷部限定。远侧凹坑5725比近侧凹坑5724浅。在这种情况下，砧座5720相对于钉仓5710的面向组织的表面5711以角度θ1成弧形。成形凹坑布置结构5723被构造成能够通过具有与钉仓5710的面向组织的表面5711平行或至少基本平行的凹坑平面5726来适应该砧座弧形。当以角度θ1被驱动到砧座5720的成形凹坑5724、5725时，即使当砧座成弧形时，钉5730也可以形成为期望的成形构型。
图107和图108示出了外科缝合系统的砧座5800，其被构造成能够在缝合过程期间使外科钉变形。砧座5800包括面向组织的表面5801，构造成能够接收击发构件的纵向狭槽5802，以及被构造成能够使被驱动到成形凹坑布置5810中的钉变形的多个成形凹坑布置结构5810。成形凹坑布置结构5810是双侧不对称的，并且每个成形凹坑布置结构5810包括近侧成形凹坑5811和远侧成形凹坑5813。近侧成形凹坑5811包括深度大于远侧成形凹坑5813的槽或谷部的槽或谷部。此类布置结构可适应砧座弧形。当不存在砧座弧形时，远侧成形凹坑5813被构造成能够提供比近侧成形凹坑5811更小的成形间隙。砧座5800包括成形凹坑布置结构5810的内纵向排5805和成形凹坑布置结构5810的外纵向排5807。
图109示出了在许多方面类似于砧座5800的砧座5800’。砧座5800'包括相对于砧座5800'的基准平面5815'单独成角度的成形凹坑布置结构5810'。成形凹坑布置结构5810'是双侧不对称的，并且包括近侧成形凹坑5811'和远侧成形凹坑5813'。近侧成形凹坑5811'包括深度大于远侧成形凹坑5813’的槽或谷部的槽或谷部。此类布置结构可适应砧座弧形。当不存在砧座弧形时，远侧成形凹坑5813'被构造成能够提供比近侧成形凹坑5811'更小的成形间隙。这种布置结构还可以容纳订卷，例如钉相对于砧座的旋转。
图110和图111示出了外科缝合系统的砧座5900，其被构造成能够在缝合过程期间使外科钉变形。砧座5900包括面向组织的表面5901，构造成能够接收击发构件的纵向狭槽5902，以及被构造成能够使被驱动到成形凹坑布置结构5910中的钉变形的多个成形凹坑布置结构5910。砧座5900还包括近侧端部5903和远侧端部5905。成形凹坑布置结构5910被构造成能够形成不同类型的钉。每个成形凹坑布置结构5910包括面向组织的表面5911，其相对于砧座5900的面向组织的表面5901单独地成角度。此类布置可适应砧座弧形。当不存在砧座弧形时，成形凹坑布置结构5910的远侧成形凹坑被构造成能够提供比成形凹坑布置结构5910的近侧成形凹坑更小的组织间隙和更小的成形间隙。砧座5900包括成形凹坑布置结构5910的内纵向排5907和成形凹坑布置结构5910的外纵向排5909。
图112示出了在许多方面类似于砧座5900的砧座5900’。砧座5900'包括多个成形凹坑布置结构5910'。每个成形凹坑布置结构5910'包括面向组织的表面5911'，该表面以渐进方式相对于砧座5900'的基准平面5915'单独成角度。砧座5900'的近侧端部5903'附近的成形凹坑布置结构5910'的角度小于砧座5900'的远侧端部附近的成形凹坑布置结构5910’的角度。此类布置可适应砧座弧形。
图113示出了缝合系统6000，其包括图80的砧座5000，包括第一钉尖端6003的第一钉腿6001，包括第二钉尖端6007的第二钉腿6005。第一钉尖端6003被侧向切割，使得第一钉腿6001可以对准并朝向钉凹坑5130的第一部分偏压。第二钉尖端6007被侧向切割，使得第二钉腿6005可以瞄准并朝向钉凹坑5130的第二部分偏压。
图114示出了第一平坦形钉6110、第二平坦形钉6120和第三平坦形钉6130，它们包括用于将钉6110、6120、6130推向其各自的成形凹坑的特定位置的特征结构。第一钉6110包括限定基部轴线BA的钉基部6111，和从钉基部6111延伸的限定腿部轴线LA的至少一个钉腿6112。钉腿6112包括钉尖端6113，其被切割成使得钉尖端6113包括面向纵向的钉尖端面。第二钉6120包括限定基部轴线BA的钉基部6121，和从钉基部6121延伸的限定腿部轴线LA的至少一个钉腿6122。钉腿6122相对于基部6121成角度θ1。钉腿6122包括钉尖端6123，其被切割成使得钉尖端6123包括面向纵向的钉尖端面。第三钉6130包括限定基部轴线BA的钉基部6131，和从钉基部6131延伸的限定腿部轴线LA的至少一个钉腿6132。钉腿6132包括钉尖端6133，其被切割成使得钉尖端6123包括面向纵向的钉尖端面。钉尖端6133相对于钉腿6132成角度θ2并且限定尖端轴线TA。
图114的钉的特定的特征可以使钉对于准它们各自的成形凹坑的某些部分。图115示出了缝合系统6200，其包括钉仓6210，该钉仓包括钉腔6212，该钉腔被构造成能够可移除地储存钉6120。缝合系统6200还包括砧座6220，该砧座被构造成能够当钉6120被钉仓6210的钉驱动器6211从钉仓6210射出时形成钉6120。当从钉仓6210射出时，钉6120的未成形构造使钉腿6122在侧向方向上偏压，以对准在砧座6220的面向组织的表面6221中限定的钉凹坑6222的着陆区6224。钉仓6222包括沟槽6223，该沟槽被构造成能够控制在钉尖端6123接触着陆区6224之后的第二成形阶段。
图116示出了缝合系统6300，其包括钉仓6310，该钉仓包括钉腔6312，该钉腔被构造成能够可移除地储存钉6130。缝合系统6300还包括砧座6320，该砧座被构造成能够当钉6130被钉仓6310的钉驱动器6311从钉仓6310射出时形成钉6130。钉6130的未成形构造使钉腿6132的钉尖端6133对准在砧座6320的面向组织的表面6321中限定的钉凹坑6322的瞄准区6324。钉仓6322包括沟槽6323，该沟槽被构造成能够控制在钉尖端6133接触瞄准区6324之后的第二成形阶段。
图117和图118示出了包括钉仓6400和砧座6420的缝合系统。钉仓6400包括仓体6401，该仓体包括纵向狭槽6402和面向组织的表面6403。钉仓6400还包括限定在仓体6401中的多个钉腔6405，这些钉腔布置成腔6405的内排6407和腔6405的外排6409。每个钉腔6405包括钉腿腔部分6406。钉腔6405被构造成能够将非平面钉可移除地储存在其中。
砧座6420包括多个成形凹坑6425，这些成形凹坑布置在成形凹坑6425的内排6427和外排6429中，这些内排和外排分别对应于腔6405的内排6407和腔6405的外排6409。内排6407的腿腔部分6406限定内排钉尖端轴线6426，成形凹坑6425的内排6427与该内排钉尖端轴线对准。相似地，外排6409的腿腔部分6406限定外排钉尖端轴线6428，成形凹坑6425的外排6429与该外排钉尖端轴线对准。
图119和图120示出了包括钉仓6500和砧座6540的缝合系统。钉仓6500包括仓体6501，该仓体包括纵向狭槽6502和面向组织的表面6503。钉仓6500还包括近侧部分6507、远侧部分6509，以及在纵向狭槽6502的每侧上限定在仓体6501中的腔6510。每个腔6510被构造成能够以钉基部到钉基部布置储存两排非平面钉。这种钉基部到钉基部布置允许钉排在钉仓中更紧密地在一起。更靠近纵向狭槽6502的排被取向成使得内排中的钉的腿面向纵向狭槽6502。另一方面，离纵向狭槽6502更远的排被取向成使得外排中的钉的腿背向纵向狭槽6502。每个钉腔6510包括被构造成能够储存内钉排6520的腿部6521的钉腿腔部分6511，和被构造成能够储存外钉排6530的腿部6531的钉腿腔部分6513。
砧座6540包括多个成形凹坑6543，该多个成形凹坑布置在成形凹坑6543的内排6545和成形凹坑6543的外排6547中，这些内排和外排分别对应于钉6520的内排和钉6530的外排。腿腔部分6511限定内排钉尖端轴线6546，成形凹坑6543的内排6545与该内排钉尖端轴线对准。相似地，腿腔部分6513限定外排钉尖端轴线6548，成形凹坑6543的外排6547与该外排钉尖端轴线对准。
现在参见图121，将砧座6420和砧座6540对比以示出总砧座宽度的差异。为了举例说明的目的，砧座6420、6540的纵向轴线LA-LA是对准的。成形凹坑6425的内排6427定位在距纵向轴线LA-LA距离6551处。成形凹坑6543的内排6545定位在距纵向轴线LA-LA距离6552处。距离6552小于距离6551。相似地，成形凹坑6425的外排6429定位在距纵向轴线LA-LA距离6553处。成形凹坑6543的外排6547定位在距纵向轴线LA-LA距离6554处。距离6554小于距离6553。因此，砧座6540的总宽度6556小于砧座6420的总宽度6555。
图122示出了非平面钉6600。钉6600可以除了钉6530之外或者代替钉6530与钉仓6500一起使用。钉6600包括近侧钉基部6601和远侧钉基部6611。近侧钉基部6601包括近侧钉腿6603和从近侧钉基部6601延伸的远侧钉腿6605。远侧钉基部6611包括近侧钉腿6613和从远侧钉基部6611延伸的远侧钉腿6615。钉基部6601、6611可彼此连接或附接，形成一个一体的钉基部。腿6603、6605、6613、6615相对于基部6601、6611向外延伸。在其他情况下，6603、6605、6613、6615可以相对于基部6601、6611向内延伸。换句话讲，钉腿6603、6605可面向钉腿6613、6615。在任一种情况下，钉腿6603、6605、6613、6615都可被砧座的成形凹坑变形。
图123示出了钉6700。钉6700包括第一基部6701和邻近第一基部6701定位的第二基部6711。钉6700相对于在基部6701、6711的附接或连接部分处限定的纵向轴线双侧对称。钉6700包括从钉基部6701延伸的近侧钉腿6703和从钉基部6711延伸的近侧钉腿6713。钉6700还包括从钉基部6701延伸的远侧钉腿6705和从钉基部6711延伸的远侧钉腿6713。钉6700可以通过单个成形凹坑布置形成，使得钉腿6703、6705形成为第一构型，并且腿6713、6715形成为与第一构型不同的第二构型。例如，第一构型可以包括这样的构型，其中当形成时，钉腿6703、6705限定至少基本平行于基部6701的平面，并且类似地，第二构型可以包括这样的构型，其中当形成时，钉腿6713、6715限定与基部6711相交的单独平面。
图124至图127示出了钉6800。钉6800包括具有驱动表面6802的钉冠6801。钉6800还包括沿第一方向从冠部6801延伸的第一近侧腿部6803和沿与第一方向相反的第二方向从冠部6801延伸的第二近侧腿部6805。钉腿6803、6805限定了相对于由基部6801限定的平面成角度的平面6804。钉6800还包括从冠部6801延伸的第一远侧腿部6807和从冠部6801延伸的第二远侧腿部6809。腿6807、6809限定了相对于基部6801成角度的平面6808。近侧钉腿6803、6805包括具有面向近侧的钉尖端面的钉尖端6810。远侧钉腿6807、6809包括具有面向远侧的钉尖端面的钉尖端6820。
图128示出了钉6900。钉6900包括具有驱动表面6902的钉冠6901。钉6900还包括从冠部6901延伸的第一近侧腿部6903和从冠部6901延伸的第二近侧腿部6905。钉6900还包括从冠部6901延伸的第一远侧腿部6913和从冠部6901延伸的第二远侧腿部6915。钉腿6903、6905、6913、6915平行或至少基本平行。近侧钉腿6903和远侧钉腿6913分别包括钉尖端6906、6916，每个钉尖端具有面向第一方向的面向侧面的钉尖端面。近侧钉腿6905和远侧钉腿6915分别包括钉尖端6904、6914，每个钉尖端具有面向第二方向的面向侧面的钉尖端面。
实施例
实施例1-一种外科器械，该外科器械包括第一钳口、第二钳口和闭合管。该第一钳口包括第一近侧端部和第一远侧端部。该第二钳口包括第二近侧端部、第二远侧端部、枢轴销和凸轮表面，第二钳口能够围绕该枢轴销相对于第一钳口在打开位置和完全关闭位置之间旋转。该闭合管能够在闭合行程期间朝第一钳口的第一远侧端部运动。闭合管包括远侧管端部，该远侧管端部被构造成能够接合凸轮表面并且在闭合行程期间使第二钳口的第二远侧端部朝向第一钳口的第一远侧端部运动。该闭合管还包括楔形件，该楔形件被构造成能够接合枢轴销并且在闭合行程期间使第二钳口的第二远侧端部朝向第一远侧端部倾斜。
实施例2-根据实施例1所述的外科器械，其中，当第二钳口处于完全闭合位置时，在第一远侧端部和第二远侧端部之间限定远侧组织间隙，其中当第二钳口处于完全闭合位置时，在第一近侧端部和第二近侧端部之间限定近侧组织间隙，并且其中第二钳口对被捕获在远侧组织间隙中的组织施加大于被捕获在近侧组织间隙中的组织的夹紧力。
实施例3-根据实施例1或2所述的外科器械，其中，该外科器械还包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例4-根据实施例3所述的外科器械，其中，该外科器械还包括被构造成能够将钉从钉仓射出的击发构件，其中该击发构件包括被构造成能够在击发行程期间接合第一钳口的第一凸轮和被构造成能够在击发行程期间接合第二钳口的第二凸轮，并且其中第一凸轮和第二凸轮被构造成能够协作地控制第一钳口和第二钳口之间的组织间隙。
实施例5-根据实施例4所述的外科器械，其中，第二钳口还包括组织压缩表面、限定在组织压缩表面中的钉成形凹坑、以及第二凸轮表面，其中第二凸轮被构造成能够在击发行程期间接合第二凸轮表面以控制位置，并且其中组织压缩表面不平行于第二凸轮表面。
实施例6-根据实施例5所述的外科器械，其中，在第二钳口的第二近侧端部处在组织压缩表面和第二凸轮表面之间限定第一距离，其中在第二钳口的第二远侧端部处在组织压缩表面和第二凸轮表面之间限定第二距离，并且其中第二距离大于第一距离。
实施例7-根据实施例1、2、3、4、5或6所述的外科器械，其中，远侧管端部被构造成能够在闭合行程期间在楔形件接合枢轴销之前接合第二钳口的凸轮表面。
实施例8-根据实施例1、2、3、4、5、6或7所述的外科器械，其中，第一钳口包括竖直狭槽，并且其中枢轴销可滑动地定位在竖直狭槽中。
实施例9-根据实施例8所述的外科器械，其中，第一钳口包括纵向狭槽，其中楔形件可滑动地定位在纵向狭槽中，并且其中该纵向狭槽与竖直狭槽连通。
实施例10-根据实施例1、2、3、4、5、6、7或8所述的外科器械，其中，楔形件不相对于第一近侧端部移动第二近侧端部。
实施例11-一种外科器械，该外科器械包括第一钳口、第二钳口和闭合管。该第一钳口包括第一近侧端部和第一远侧端部。该第二钳口包括第二近侧端部、第二远侧端部、枢轴销和凸轮表面，第二钳口能够围绕该枢轴销相对于第一钳口在打开位置和完全关闭位置之间旋转。该闭合管能够在闭合行程期间朝第一钳口的第一远侧端部运动。该闭合管包括远侧管端部和楔形件，该远侧管端部被构造成能够接合凸轮表面并且在闭合行程期间使第二钳口的第二远侧端部朝向第一钳口的第一远侧端部运动，该楔形件被构造成能够接合枢轴销并且在闭合行程期间将第二钳口的第二远侧端部朝向第一钳口的第一远侧端部推动以到达完全闭合位置。
实施例12-根据实施例11所述的外科器械，其中，该楔形件不相对于第一近侧端部移动第二近侧端部。
实施例13-一种外科器械，该外科器械包括第一钳口、第二钳口、闭合管和切割构件。第一钳口包括远侧钳口端部。第二钳口能够相对于第一钳口在打开位置和闭合位置之间运动。第二钳口包括闭合凸轮表面和打开凸轮表面。闭合管可在闭合行程期间朝远侧钳口端部运动。闭合管包括远侧管端部，该远侧管端部被构造成能够接合闭合凸轮表面并且在闭合行程期间使第二钳口运动到闭合位置。切割构件在切割行程期间可朝向远侧钳口端部运动，并且在回缩行程期间可远离远侧钳口端部运动。切割构件包括近侧部分、远侧部分和定位在近侧部分和远侧部分中间的偏压构件，其中该偏压构件被构造成能够将远侧部分偏压成与第二钳口的打开凸轮表面接合，以在回缩行程之后至少部分地打开第二钳口。
实施例14-根据实施例13所述的外科器械，其中，闭合管在打开行程期间可远离远侧钳口端部运动，并且其中闭合管抵抗偏压构件的偏压将第二钳口保持在闭合位置，直到远侧管端部与闭合凸轮表面脱离接合。
实施例15-根据实施例13或14所述的外科器械，其中，该外科器械还包括钉仓，该钉仓包括可移除地储存在其中的钉，并且其中该切割构件被构造成能够在切割行程期间从钉仓射出钉。
实施例16-根据实施例13、14或15所述的外科器械，其中，切割构件包括被构造成能够接合第一钳口的第一凸轮和被构造成能够接合第二钳口的第二凸轮，并且其中第一钳口和第二钳口在切割行程期间协作地控制第二钳口相对于第一钳口的位置。
实施例17-一种外科器械，该外科器械包括具有远侧钳口端部的第一钳口、第二钳口和切割构件。第二钳口可相对于第一钳口运动，以在第一钳口和第二钳口之间捕获患者的组织。切割构件可在切割行程期间朝远侧钳口端部运动。切割构件包括联接部分和杆，该联接部分包括被构造成能够在切割行程期间接合第一钳口的第一凸轮和被构造成能够在切割行程期间接合第二钳口的第二凸轮，该杆包括附接到联接部分的多个层，其中该杆包括被构造成能够在切割行程期间切割患者组织的切割边缘。
实施例18-根据实施例17所述的外科器械，其中，该外科器械还包括钉仓，该钉仓包括可移除地储存在其中的钉，并且其中该切割构件被构造成能够在切割行程期间从钉仓射出钉以缝合患者组织。
实施例19-根据实施例17或18所述的外科器械，其中，联接部分还包括安装凹陷部，并且其中杆包括定位在安装凹陷部中的远侧杆端部。
实施例20-根据实施例19所述的外科器械，其中，联接部分还包括安装凹陷部内的安装突出部，并且其中杆包括被构造成能够紧密地接收安装突出部的安装孔。
实施例21-根据实施例17、18、19或20所述的外科器械，其中，联接部分还包括多个安装突出部，并且其中杆包括被构造成能够紧密地接收安装突出部的多个安装孔。
实施例22-根据实施例21所述的外科器械，其中，切割构件在切割行程期间可沿着纵向轴线运动，并且其中多个安装突出部包括沿着纵向轴线定位的第一突出部和定位成与纵向轴线偏移的第二突出部。
实施例23-根据实施例21或22所述的外科器械，其中，切割构件在切割行程期间可沿着纵向轴线运动，并且其中多个安装突出部包括在纵向轴线的第一侧上定位的第一突出部和在纵向轴线的第二侧上定位的第二突出部。
实施例24-根据实施例21、22或23所述的外科器械，其中，多个安装突出部包括近侧突出部和远侧突出部，并且其中远侧突出部相对于近侧突出部朝远侧定位。
实施例25-根据实施例17、18、19、20、21、22、23或24所述的外科器械，其中，联接部分包括肩部，并且其中杆包括与肩部接合的钩。
实施例26-根据实施例17、18、19、20、21、22、23、24或25所述的外科器械，其中，所述多个层包括第一层和第二层，并且其中切割边缘限定在第一层上而不限定在第二层上。
实施例27-根据实施例17、18、19、20、21、22、23、24、25或26所述的外科器械，其中，所述多个层包括第一层和第二层，并且其中切割边缘限定在第一层和第二层上。
实施例28-根据实施例17、18、19、20、21、22、23、24、25、26或27所述的外科器械，其中，所述多个层包括第一层、第二层和位于第一层和第二层中间的中间层。联接部分包括第一侧向凹陷部、第二侧向凹陷部和安装突片。第一层在第一侧向凹陷部中安装到联接部分，第二层在第二侧向凹陷部中安装到联接部分，并且中间层附接到安装突片。
实施例29-一种外科缝合器，该外科缝合器包括：第一钳口，其包括远侧钳口端部；第二钳口；钉仓，其包括可移除地储存在其中的多个钉；以及击发构件，其在击发行程期间可朝向远侧钳口端部运动，以从钉仓射出钉。第二钳口可相对于第一钳口运动，以在第一钳口和第二钳口之间捕获患者的组织。击发构件包括联接部分和附接到联接部分的杆，该联接部分包括被构造成能够在击发行程期间接合第一钳口的第一凸轮和被构造成能够在击发行程期间接合第二钳口的第二凸轮，其中该杆包括被构造成能够在击发行程期间切割患者组织的切割边缘。
实施例30-一种外科器械，该外科器械包括：具有远侧钳口端部的第一钳口，可相对于第一钳口运动以在第一钳口和第二钳口之间捕获患者的组织的第二钳口，以及在切割行程期间朝向远侧钳口端部运动的切割构件。该切割构件包括联接部分和杆。该联接部分包括被构造成能够在切割行程期间接合第一钳口的第一凸轮、被构造成能够在切割行程期间接合第二钳口的第二凸轮、第一侧向凹陷部、第二侧向凹陷部和安装突片。该杆包括在第一侧向凹陷部中安装到联接部分的第一层、在第二侧向凹陷部中安装到联接部分的第二层、以及位于第一层和第二层中间的中间层，其中该中间层附接到安装突片。
实施例31-根据实施例30所述的外科器械，其中，该外科器械还包括钉仓，该钉仓包括可移除地储存在其中的钉，并且其中该切割构件被构造成能够在切割行程期间从钉仓射出钉以缝合患者组织。
实施例32-根据实施例30或31所述的外科器械，其中，安装突片相对于第一侧向凹陷部和第二侧向凹陷部朝远侧延伸。
实施例33-根据实施例30、31或32所述的外科器械，其中，联接部分包括被构造成能够切割患者组织的切割边缘。
实施例34-根据实施例30、31、32或33所述的外科器械，其中，杆包括被构造成能够切割患者组织的切割边缘。
实施例35-一种外科器械，该外科器械包括：具有远侧钳口端部的第一钳口，可相对于第一钳口运动以在第一钳口和第二钳口之间捕获患者的组织的第二钳口，以及在击发行程期间朝向远侧钳口端部运动的击发构件。击发构件包括联接部分和杆，该联接部分包括侧向凹陷部和安装突片，该杆包括在侧向凹陷部中安装到联接部分的第一层和附接到安装突片的第二层。
实施例36-根据实施例35所述的外科器械，其中，该外科器械还包括钉仓，该钉仓包括可移除地储存在其中的钉，并且其中该击发构件被构造成能够在击发行程期间从钉仓射出钉以缝合患者组织。
实施例37-一种外科缝合器械，该外科缝合器械包括轴、从轴延伸的端部执行器、击发组件、轴中的锁和钉仓。该端部执行器包括第一钳口和第二钳口，该第一钳口包括远侧钳口端部，该第二钳口可相对于第一钳口在打开位置与闭合位置之间运动。击发组件在击发行程期间可朝向远侧钳口端部运动，并且击发组件包括被构造成能够在击发行程期间接合第一钳口和第二钳口的联接部分，以及包括远侧闭锁端部的闭锁杆，其中闭锁杆可在远侧锁定位置和近侧解锁位置之间运动。当闭锁杆处于远侧锁定位置时，轴中的锁在击发行程之前与击发杆接合，当闭锁杆处于近侧解锁位置时，锁在击发行程之前与击发杆脱离接合。钉仓可定位在第一钳口中，并且钉仓包括仓体、可移除地储存在仓体中的多个钉，以及可在击发行程期间从近侧未击发位置和远侧击发位置运动以将钉从仓体射出的滑动件，其中该滑动件被构造成能够在钉仓被装载到第一钳口中并且滑动件处于近侧未击发位置时将闭锁杆推入近侧解锁位置。
实施例38-根据实施例37所述的外科缝合器械，其中，该联接部分包括孔，并且其中远侧闭锁端部延伸穿过该孔。
实施例39-根据实施例37或38所述的外科缝合器械，其中，闭锁杆可在击发杆内滑动。
实施例40-根据实施例37、38或39所述的外科缝合器械，其中，该外科缝合器械还包括弹簧，该弹簧被构造成能够将闭锁杆偏压到远侧锁定位置中。
实施例41-根据实施例37、38、39或40所述的外科缝合器械，其中，该外科缝合器械还包括弹簧，该弹簧被构造成能够将所述锁偏压成与击发杆接合。
实施例42-根据实施例41所述的外科缝合器械，其中，闭锁杆包括被构造成能够接合锁并且抵抗弹簧的偏压将锁与击发杆脱离接合的键。
实施例43-根据实施例37、38、39、40、41或42所述的外科缝合器械，其中，仓体包括卡位装置，该卡位装置被构造成能够在滑动件接合闭锁杆时将该滑动件可释放地保持在近侧未击发位置。
实施例44-根据实施例37、38、39、40、41、42或43所述的外科缝合器械，其中，闭锁杆在击发行程期间与击发杆一起行进。
实施例45-根据实施例44所述的外科缝合器械，其中，击发杆在击发行程之后可回缩，并且其中当击发杆回缩时，闭锁杆与击发杆一起行进。
实施例46-根据实施例45所述的外科缝合器械，其中，滑动件不与击发杆和闭锁杆一起回缩。
实施例47-根据实施例46所述的外科缝合器械，其中，闭锁杆不能重置到其近侧解锁位置，直到钉仓从第一钳口移除并且未耗尽的钉仓定位在第一钳口中。
实施例48-一种外科缝合器械，该外科缝合器械包括端部执行器、击发组件、锁和可装载到端部执行器中的钉仓。该端部执行器包括第一钳口和第二钳口，该第一钳口包括远侧钳口端部，该第二钳口可相对于第一钳口在打开位置与闭合位置之间运动。击发组件在击发行程期间可朝向远侧钳口端部运动，并且击发组件包括击发杆和闭锁杆，其中闭锁杆可相对于击发杆在远侧锁定位置和近侧解锁位置之间运动。当闭锁杆处于远侧锁定位置时，锁在击发行程之前与击发杆接合，当闭锁杆处于近侧解锁位置时，锁在击发行程之前与击发杆脱离接合。钉仓包括仓体、可移除地储存在仓体中的多个钉，以及可在击发行程期间从近侧未击发位置和远侧击发位置运动以将钉从仓体射出的滑动件，其中该滑动件被构造成能够在钉仓被装载到端部执行器中并且滑动件处于近侧未击发位置时将闭锁杆推入近侧解锁位置。
实施例49-一种外科缝合器械，该外科缝合器械包括端部执行器、击发杆、锁和可装载到端部执行器中的钉仓。该端部执行器包括第一钳口和第二钳口，该第一钳口包括远侧钳口端部，该第二钳口可相对于第一钳口在打开位置与闭合位置之间运动。击发杆可在远侧解锁位置和近侧解锁位置之间远离远侧钳口端部运动，然后击发杆可在击发行程期间朝向远侧钳口端部运动。当击发杆处于远侧锁定位置时，锁与击发杆接合以防止击发行程，并且当击发杆处于近侧解锁位置时，锁与击发杆脱离接合。钉仓包括仓体、可移除地储存在仓体中的多个钉，以及可在击发行程期间从近侧未击发位置和远侧击发位置运动以将钉从仓体射出的滑动件，其中该滑动件被构造成能够在钉仓被装载到端部执行器中并且滑动件处于近侧未击发位置时将击发杆推入近侧解锁位置。
实施例50-根据实施例49所述的外科缝合器械，其中，该外科缝合器械还包括偏压构件，该偏压构件被构造成能够将击发杆偏压到远侧锁定位置中。
实施例51-根据实施例49或50所述的外科缝合器械，其中，该外科缝合器械还包括偏压构件，该偏压构件被构造成能够将锁偏压成与击发杆接合。
实施例52-根据实施例49、50或51所述的外科缝合器械，其中，击发杆包括被构造成能够接合锁并且抵抗击发杆的偏压将锁与击发杆脱离接合的键。
实施例53-根据实施例49、50、51或52所述的外科缝合器械，其中，击发杆在击发行程之后可回缩，并且其中滑动件不与击发杆一起回缩。
实施例54-根据实施例53所述的外科缝合器械，其中，击发杆不能重置到近侧解锁位置，直到钉仓从端部执行器移除并且未耗尽的钉仓被加载到端部执行器中。
实施例55-根据实施例49、50、51、52、53或54所述的外科缝合器械，其中，仓体包括卡位装置，该卡位装置被构造成能够在滑动件接合击发杆时将该滑动件可释放地保持在近侧未击发位置，以使击发杆运动到近侧解锁位置中，并且允许击发杆使滑动件运动通过击发行程。
实施例56-根据实施例49、50、51、52、53、54或55所述的外科缝合器械，其中，该外科缝合器械还包括轴，其中端部执行器从该轴延伸，并且其中锁定位在该轴中。
实施例57-一种外科缝合组件，该外科缝合组件包括仓钳口、击发构件和可移除地定位在该仓钳口中的钉仓。该仓钳口包括近侧端部、与近侧端部相对定位的远侧端部、底壁、从底壁延伸的侧向侧壁，以及限定在侧向侧壁中的多个钳口窗口。击发构件可在击发行程期间朝远侧端部运动。钉仓包括仓体、限定在仓体中的多个仓窗口(其中当钉仓定位在仓钳口中时，仓窗口与钳口窗口对准)、可移除地储存在仓体中的钉，以及在击发行程期间可朝远侧端部运动以从仓体射出钉的滑动件，其中滑动件在击发行程期间的进展可通过仓窗口和钳口窗口被观察到。
实施例58-根据实施例57所述的外科缝合组件，其中，滑动件包括可通过仓窗口和钳口窗口观察到的基准。
实施例59-根据实施例58所述的外科缝合组件，其中，滑动件在击发行程期间沿着纵向轴线运动，并且其中基准包括正交于纵向轴线的竖直线。
实施例60-根据实施例57、58或59所述的外科缝合组件，其中，多个钳口窗口包括近侧钳口窗口和远侧钳口窗口，其中多个仓窗口包括与近侧钳口窗口对准的近侧仓窗口和与远侧钳口窗口对准的远侧仓窗口，其中滑动件在击发行程期间可在近侧未击发位置和远侧击发位置之间运动，其中当滑动件处于近侧未击发位置时，可通过近侧钳口窗口和近侧仓窗口观察到滑动件，并且其中当滑动件处于远侧击发位置时，可通过远侧钳口窗口和远侧仓窗口观察到滑动件。
实施例61-根据实施例60所述的外科缝合组件，其中，多个钳口窗口包括定位在近侧钳口窗口和远侧钳口窗口中间的中间钳口窗口，其中多个仓窗口包括定位在近侧仓窗口和远侧仓窗口中间的与该中间钳口窗口对准的中间仓窗口，并且其中滑动件可在击发行程期间通过中间钳口窗口和中间仓窗口被观察到。
实施例62-根据实施例57、58、59、60或61所述的外科缝合组件，其中，钳口窗口沿着纵向钳口窗口轴线定位，其中仓窗口沿着纵向仓窗口轴线定位，并且其中当钉仓定位在仓钳口中时，纵向钳口窗口轴线与纵向仓窗口轴线对准。
实施例63-根据实施例57、58、59、60、61或62所述的外科缝合组件，其中，底壁包括被构造成能够在击发行程期间接收击发构件的纵向狭槽。
实施例64-根据实施例63所述的外科缝合组件，其中，滑动件能够在击发行程期间在近侧未击发位置和远侧击发位置之间运动，其中纵向狭槽包括近侧底部窗口，并且其中当滑动件处于近侧未击发位置时，该滑动件可通过近侧底部窗口被观察到。
实施例65-根据实施例63或64所述的外科缝合组件，其中，滑动件能够在击发行程期间在近侧未击发位置和远侧击发位置之间运动，其中纵向狭槽包括远侧底部窗口，并且其中当滑动件处于远侧击发位置时，该滑动件可通过远侧底部窗口被观察到。
实施例66-根据实施例63、64或65所述的外科缝合组件，其中，纵向狭槽包括限定在底壁中的多个底部窗口，并且其中滑动件在击发行程期间的进展可通过底部窗口被观察到。
实施例67-根据实施例66所述的外科缝合组件，其中，纵向狭槽限定纵向轴线，并且其中底部窗口相对于纵向轴线偏移。
实施例68-根据实施例67所述的外科缝合组件，其中，底部窗口以交替方式在纵向轴线的相对侧上交错。
实施例69-一种包括击发构件的外科缝合组件，该外科缝合组件包括仓钳口和定位在仓钳口中的钉仓。该仓钳口包括近侧端部、与近侧端部相对定位的远侧端部、底部部分、从底部部分延伸的侧面部分，以及限定在侧面部分中的多个钳口窗口。钉仓包括具有钉腔的仓体、限定在仓体中的多个仓窗口(其中仓窗口与钳口窗口对准)、可移除地储存在仓体中的钉，以及可通过击发构件朝远侧端部运动以从仓体射出钉的滑动件，其中滑动件朝向远侧端部的进展可通过仓窗口和钳口窗口被观察到。
实施例70-一种外科缝合组件，该外科缝合组件包括仓钳口、击发构件和钉仓。该仓钳口包括近侧端部、与近侧端部相对定位的远侧端部、底壁、从底壁延伸的侧向侧壁，以及限定在底壁中的纵向狭槽，其中该纵向狭槽包括限定在底壁中的多个钳口窗口。击发构件可在击发行程期间通过纵向狭槽朝远侧端部运动。钉仓可定位在仓钳口中的侧向侧壁之间。钉仓包括仓体、可移除地储存在仓体中的钉，以及在击发行程期间可朝远侧端部运动以从仓体射出钉的滑动件，其中该滑动件在击发行程期间的进展可通过钳口窗口被观察到。
实施例71-根据实施例70所述的外科缝合组件，其中，滑动件能够在击发行程期间在近侧未击发位置和远侧击发位置之间运动，其中钳口窗口包括近侧底部窗口，并且其中当滑动件处于近侧未击发位置时，该滑动件可通过近侧底部窗口被观察到。
实施例72-根据实施例70或71所述的外科缝合组件，其中，滑动件能够在击发行程期间在近侧未击发位置和远侧击发位置之间运动，其中钳口窗口包括远侧底部窗口，并且其中当滑动件处于远侧击发位置时，该滑动件可通过远侧底部窗口被观察到。
实施例73-根据实施例70、71或72所述的外科缝合组件，其中，纵向狭槽限定纵向轴线，并且其中钳口窗口相对于纵向轴线偏移。
实施例74-一种外科缝合组件，该外科缝合组件包括仓钳口和钉仓。该仓钳口包括近侧端部、与所述近侧端部相对定位的远侧端部、底壁、从底壁延伸的侧向侧壁，以及限定在底壁中的纵向狭槽，其中该纵向狭槽包括限定在底壁中的多个钳口窗口。钉仓定位在仓钳口中的侧向侧壁之间。钉仓包括仓体、可移除地储存在仓体中的钉，以及在击发行程期间可朝远侧端部运动以从仓体射出钉的滑动件，其中该滑动件在击发行程期间的进展可通过钳口窗口被观察到。
实施例75-一种包括轴、端部执行器的外科器械，该端部执行器包括钉仓和击发组件。钉仓包括仓体、可移除地储存在仓体内的钉以及被构造成能够在钉击发行程期间将钉从仓体中射出的滑动件。击发组件被构造成能够在钉击发行程期间将推力施加到滑动件。击发组件包括第一部分、第二部分和推力闭锁系统，其中第二部分可相对于第一部分移位，推力闭锁系统至少部分地定位在第一部分和第二部分中间，其中该推力闭锁系统被构造成能够接合轴，并且如果推力超过阈值，则停止钉击发行程。
实施例76-根据实施例75所述的外科器械，其中，该外科器械还包括定位在第一部分和第二部分中间的偏压构件，并且其中该偏压构件被构造成能够向第二部分施加与推力相反的偏压力。
实施例77-根据实施例76所述的外科器械，其中，阈值包括推力和偏压力之间的预选差值。
实施例78-根据实施例77所述的外科器械，其中，推力闭锁系统包括安装到轴的锁、弹簧和可旋转地安装到击发组件的致动器。该锁可在解锁位置和锁定位置之间移位，并且该锁被构造成能够在锁处于锁定位置时防止击发组件执行钉击发行程。弹簧被构造成能够将锁偏压到锁定位置中。第二部分被构造成能够使致动器朝向锁旋转，并且在超过阈值时将锁移位到解锁位置。
实施例79-根据实施例78所述的外科器械，其中，致动器可旋转地安装到第一部分，并且锁被构造成能够接合第二部分。
实施例80-根据实施例78或79所述的外科器械，其中，该外科器械还包括致动器弹簧，该致动器弹簧被构造成能够将致动器偏压成与锁脱离接合，其中当第二部分朝向第一部分运动时，第二部分抵抗致动器弹簧。
实施例81-根据实施例75、76、77、78、79或80所述的外科器械，其中，钉仓包括可替换的钉仓。
实施例82-根据实施例75、76、77、78、79、80或81所述的外科器械，其中，钉仓包括被构造成能够在钉仓已至少部分地耗尽时阻挡击发组件执行钉击发行程的已空仓闭锁件。
实施例83-根据实施例75、76、77、78、79、80、81或82所述的外科器械，其中，该外科器械还包括被构造成能够驱动击发组件通过钉击发行程的电动马达。
实施例84-一种包括框架、端部执行器的外科器械，该端部执行器包括钉仓、击发组件和击发力闭锁系统。钉仓包括仓体、可移除地储存在仓体内的钉，以及被构造成能够在击发行程期间将钉从仓体中射出的滑动件。击发组件被构造成能够在击发行程期间将击发力施加到滑动件。击发组件包括第一部分和第二部分，其中第二部分可相对于第一部分移位。击发力闭锁系统被构造成能够接合框架并且如果击发力超过阈值则防止钉击发行程。
实施例85-根据实施例84所述的外科器械，其中，该外科器械还包括定位在第一部分和第二部分中间的偏压构件，其中该偏压构件被构造成能够向第二部分施加与击发力相反的偏压力。
实施例86-根据实施例85所述的外科器械，其中，阈值包括击发力和偏压力之间的预选差值。
实施例87-根据实施例86所述的外科器械，其中，击发力闭锁系统包括安装到框架的锁、弹簧和可旋转地安装到击发组件的致动器。该锁可在解锁位置和锁定位置之间移位，并且该锁被构造成能够在锁处于锁定位置时防止击发组件执行钉击发行程。弹簧被构造成能够将锁偏压到锁定位置中。第二部分被构造成能够使致动器朝向锁旋转，并且在超过阈值时将锁移位到解锁位置。
实施例88-根据实施例87所述的外科器械，其中，致动器可旋转地安装到第一部分，并且锁被构造成能够接合第二部分。
实施例89-根据实施例87或88所述的外科器械，其中，该外科器械还包括致动器弹簧，该致动器弹簧被构造成能够将致动器偏压成与锁脱离接合，并且其中当第二部分朝向第一部分运动时，第二部分抵抗致动器弹簧。
实施例90-根据实施例84、85、86、87、88或89所述的外科器械，其中，钉仓包括可替换的钉仓。
实施例91-根据实施例84、85、86、87、88、89或90所述的外科器械，其中，钉仓包括被构造成能够在钉仓已至少部分地耗尽时阻挡击发组件执行钉击发行程的已空仓闭锁件。
实施例92-一种包括端部执行器的外科器械，该端部执行器包括钉仓，其中该钉仓包括仓体、可移除地储存在仓体中的钉以及被构造成能够将钉从仓体中射出的滑动件。外科器械还包括被构造成能够在击发行程期间向滑动件施加击发力的击发组件和用于在击发力超过阈值时停止钉击发行程的装置。
实施例93-根据实施例92所述的外科器械，其中，该装置为可重置的。
实施例94-一种包括可运动通过击发行程的击发组件和端部执行器的外科器械，该端部执行器包括钉仓和击发力闭锁系统。钉仓包括仓体、可移除地储存在仓体中的钉、可在近侧未击发位置和远侧击发位置之间运动以在击发行程期间将钉从仓体射出的滑动件，以及已空仓闭锁件，该已空仓闭锁件被构造成如果滑动件在击发行程开始时不处于近侧未击发位置则能够阻挡击发组件强力执行击发。击发力闭锁系统被构造成能够有助于防止击发组件在击发组件被已空仓闭锁件阻挡时执行击发行程。
实施例95-根据实施例94所述的外科器械，其中，击发组件包括第一部分和第二部分，并且其中击发力闭锁系统至少部分地定位在击发组件的第一部分和第二部分中间。
实施例96-根据实施例95所述的外科器械，其中，第二部分可相对于第一部分运动，并且其中第二部分被构造成能够在第二部分朝向第一部分运动时将击发力闭锁系统部署成锁定构型。
实施例97-根据实施例96所述的外科器械，其中，该外科器械还包括定位在第一部分和第二部分中间的偏压构件，并且其中该偏压构件被构造成能够推动第二部分远离第一部分。
实施例98-根据实施例97所述的外科器械，其中，击发力闭锁系统被偏压成解锁构型。
实施例99-根据实施例94、95、96、97或98所述的外科器械，其中，该外科器械还包括框架，其中击发力闭锁系统安装到击发组件，并且其中该击发力闭锁系统被构造成能够响应于已空仓闭锁件阻挡击发组件而接合框架。
实施例100-根据实施例99所述的外科器械，其中，该外科器械还包括纵向轴，并且其中框架定位在该纵向轴内。
实施例101-根据实施例94、95、96、97、98、99或100所述的外科器械，其中，该外科器械还包括被构造成能够使击发组件运动通过击发行程的电动马达。
实施例102-根据实施例101所述的外科器械，其中，当击发组件被已空仓闭锁件阻挡时，击发力闭锁系统可被部署成锁定构型，并且其中电动马达能够操作以回缩击发组件从而将击发力闭锁系统重置成解锁构型。
实施例103-根据实施例94、95、96、97、98、99、100、101或102所述的外科器械，其中，仓体包括被构造成能够接收击发组件的纵向狭槽，并且其中已空仓闭锁件包括金属夹具。该金属夹具包括安装到仓体的安装部分和可在锁定构型和解锁构型之间偏转的锁定部分，其中当锁定部分处于锁定构型时，锁定部分延伸到纵向狭槽中以阻挡击发组件。
实施例104-根据实施例103所述的外科器械，其中，滑动件被构造成能够在该滑动件处于近侧未击发位置时保持锁定部分处于解锁构型。
实施例105-根据实施例104所述的外科器械，其中，锁定部分被朝向锁定构型偏压，并且其中当滑动件在击发行程期间朝远侧推进时，滑动件被构造成能够释放锁定部分。
实施例106-根据实施例94、95、96、97、98、99、100、101、102、103、104或105所述的外科器械，其中，钉仓为可替换的钉仓。
实施例107-根据实施例94、95、96、97、98、99、100、101、102、103、104或105所述的外科器械，其中，钉仓不是可替换的钉仓。
实施例108-一种包括可运动通过击发行程的击发组件和端部执行器的外科器械，该端部执行器包括钉仓和击发闭锁件。钉仓包括仓体、可移除地储存在仓体中的钉、可在近侧未击发位置和远侧击发位置之间运动以在击发行程期间将钉从仓体射出的滑动件，以及仓闭锁件，该仓闭锁件被构造成如果滑动件在击发行程开始时不处于近侧未击发位置则能够阻挡击发组件。击发闭锁件被构造成能够防止击发组件在击发组件被仓闭锁件阻挡时执行击发行程。
实施例109-一种外科器械，该外科器械包括轴、可运动通过致动行程的击发组件、端部执行器和轴中的击发闭锁件。端部执行器包括第一钳口、可相对于第一钳口运动的第二钳口，其中击发组件包括被构造成能够接合第一钳口的第一凸轮和被构造成能够接合第二钳口以在致动行程期间控制第二钳口相对于第一钳口的位置的第二凸轮，以及钉仓。钉仓包括仓体、可移除地储存在仓体中的钉、可在近侧未击发位置和远侧击发位置之间运动以将钉从仓体射出的滑动件，以及仓闭锁件，该仓闭锁件被构造成如果滑动件在致动行程开始时不处于近侧未击发位置则能够阻挡击发组件。击发闭锁件被构造成能够在击发组件被仓闭锁件阻挡时阻挡击发组件。
实施例110-一种外科器械，该外科器械包括端部执行器和被构造成能够在击发行程期间将击发负载传递到端部执行器的击发组件。击发组件包括第一部分、第二部分和熔断器部分，其中该熔断器部分被构造成能够在熔断器部分完整时将击发负载从第一部分传递到第二部分，其中熔断器部分被构造成能够在击发负载超过阈值时失效，并且其中一旦熔断器部分失效，第一部分就不能将击发负载传递到第二部分。
实施例111-根据实施例110所述的外科器械，其中，熔断器部分为可重置的。
实施例112-根据实施例111所述的外科器械，其中，端部执行器包括远侧端部，其中击发组件在击发行程期间朝向远侧端部推进，并且其中击发组件远离远侧端部推进以重置熔断器部分。
实施例113-根据实施例110、111或112所述的外科器械，其中，第一部分包括柔性第一杆，其中第二部分包括第二杆，并且其中柔性第一杆被构造成能够在击发负载超过阈值时弯曲并与第二杆脱离接合。
实施例114-根据实施例113所述的外科器械，其中，当击发负载超过阈值时，柔性杆弹性地弯曲脱离与第二杆的接合，并且其中柔性第一杆被构造成能够在柔性第一杆与第二杆重新对准时，快速回到与第二杆的接合。
实施例115-根据实施例113或114所述的外科器械，其中，击发组件还包括套环，其中第二杆可滑动地定位在套环中，其中当击发行程开始时柔性第一杆不定位在套环中，其中柔性第一杆在击发行程期间进入套环中，并且其中套环防止柔性第一杆与第二杆脱离接合。
实施例116-根据实施例113、114或115所述的外科器械，其中，该外科器械还包括框架，其中柔性第一杆被构造成能够接合框架并且当柔性第一杆与第二杆脱离接合时阻挡击发组件执行击发行程。
实施例117-根据实施例113、114、115或116所述的外科器械，其中，该外科器械还包括偏压构件，该偏压构件被构造成能够将柔性第一杆偏压成与第二杆接合。
实施例118-根据实施例110、111、112、113、114、115、116或117所述的外科器械，其中，熔断器部分包括限定在第一部分上的第一倒钩和限定在第二部分上的与第一倒钩接合的第二倒钩，并且其中当击发力超过阈值时，第一倒钩与第二倒钩脱离接合。
实施例119-根据实施例110、111、112、113、114、115、116、117或118所述的外科器械，其中，熔断器部分包括限定在第一部分上的第一脚部和限定在第二部分上的与第一脚部接合的第二脚部，并且其中当击发力超过阈值时，第一脚部相对于第二脚部滑动。
实施例120-根据实施例119所述的外科器械，其中，外科器械还包括框架，其中所述第一部分包括与框架接合的偏压构件，并且其中所述偏压构件被构造成能够将所述第一脚部偏压成与所述第二脚部接合。
实施例121-根据实施例110、111、112、113、114、115、116、117、118、119或120所述的外科器械，其中，第二部分包括多个层，其中熔断器部分包括这些层的近侧部分，该近侧部分在击发力超过阈值时向外扩展。
实施例122-根据实施例121所述的外科器械，其中，外科器械还包括框架，其中扩展的层被构造成能够接合框架并且在击发负载超过阈值时防止击发组件执行击发行程。
实施例123-根据实施例121或122所述的外科器械，其中，这些层在击发负载超过阈值时向外弹性扩展，并且其中这些层被构造成能够在击发组件回缩时向内弯曲以重置熔断器部分。
实施例124-根据实施例110、111、112、113、114、115、116、117、118、119、120、121或122所述的外科器械，其中，熔断器部分不可重置。
实施例125-根据实施例124所述的外科器械，其中，熔断器部分包括限定在第一部分中的壁，并且其中壁被构造成能够在击发负载超过阈值时脱离第一部分。
实施例126-根据实施例124或125所述的外科器械，其中，熔断器部分包括沿着第一部分中的纵向轴线布置的一系列可塌缩壁，并且其中可塌缩壁被构造成能够在击发力超过阈值时顺序地失效。
实施例127-根据实施例110、111、112、113、114、115、116、117、118、119、120、121、122、123、124、125或126所述的外科器械，其中，端部执行器包括钉仓。
实施例128-一种包括端部执行器的外科器械，端部执行器包括钉仓和击发组件。钉仓包括仓体、可移除地储存在仓体内的钉以及被构造成能够将钉从仓体中射出的滑动件。击发组件被构造成能够在钉击发行程期间将击发负载施加到滑动件。击发组件包括第一部分、第二部分和熔断器，熔断器被构造成能够在熔断器完整时将击发负载从第一部分传递到第二部分，其中熔断器被构造成能够在击发负载超过阈值时失效，并且其中一旦熔断器失效，击发组件就不能将击发行程传递到滑动件。
实施例129-一种包括端部执行器的外科器械，端部执行器包括钉仓和击发组件。钉仓包括仓体、可移除地储存在仓体内的钉以及被构造成能够将钉从仓体中射出的滑动件。击发组件被构造成能够在钉击发行程期间将击发负载施加到滑动件。击发组件包括熔断器，熔断器被构造成能够在熔断器完整时将击发负载传递到滑动件，其中熔断器被构造成能够在击发负载超过阈值时失效，并且其中一旦熔断器失效，击发组件就不能将击发负载传递到滑动件。
实施例130-一种包括端部执行器的外科器械，端部执行器包括钉仓和击发组件，击发组件包括熔断器。钉仓包括仓体、可移除地储存在仓体内的钉以及被构造成能够将钉从仓体中射出的滑动件。熔断器包括：完整状态，其中击发组件被构造成能够在熔断器处于完整状态时在击发行程期间将击发负载传递到滑动件；第一失效状态，其中击发组件被构造成能够在熔断器处于第一失效状态时将负载传递到滑动件；以及第二失效状态，其中击发组件被构造成能够在熔断器处于第二失效状态时不能将负载传递到滑动件。
实施例131-根据实施例130所述的外科器械，其中，熔断器可从第一失效状态重置成完整状态。
实施例132-根据实施例131所述的外科器械，其中，端部执行器包括远侧端部，并且其中击发组件可远离远侧端部回缩以将熔断器重置成完整状态。
实施例133-根据实施例130、131或132所述的外科器械，其中，熔断器可从第二失效状态重置成第一失效状态。
实施例134-根据实施例133所述的外科器械，其中，端部执行器包括远侧端部，并且其中击发组件可远离远侧端部回缩以将所述熔断器重置成所述完整状态。
实施例135-根据实施例130所述的外科器械，其中，熔断器不可从第一失效状态重置成完整状态。
实施例136-根据实施例130所述的外科器械，其中，熔断器不可从第二失效状态重置成第一失效状态。
实施例137-根据实施例130、131、132、133、134、135或136所述的外科器械，其中，击发组件可以用于在熔断器的第一失效状态下完成击发行程。
实施例138-根据实施例130、131、132、133、134、135或136所述的外科器械，其中，击发组件不能用于在熔断器的第一失效状态下完成击发行程。
实施例139-根据实施例130、131、132、133、134、135、136、137或138所述的外科器械，其中，熔断器被构造成能够在第二失效状态下停止击发行程。
实施例140-根据实施例139所述的外科器械，其中，外科器械还包括框架，其中熔断器被构造成能够接合框架以在第二失效状态下停止击发行程。
实施例141-根据实施例130、131、132、133、134、135、136、137、138、139或140所述的外科器械，其中，击发组件还包括第一部分和第二部分，并且其中熔断器定位在第一部分和第二部分中间。
实施例142-根据实施例141所述的外科器械，其中，当熔断器处于第一失效状态时，第二部分相对于第一部分部分塌缩。
实施例143-根据实施例141所述的外科器械，其中，当熔断器处于第二失效状态时，第二部分相对于第一部分完全塌缩。
实施例144-根据实施例130、131、132、133、134、135、136、137、138、139、140、141、142或143所述的外科器械，其中，击发负载大于该负载。
实施例145-根据实施例130、131、132、133、134、135、136、137、138、139、140、141、142或143所述的外科器械，其中，击发负载等于该负载。
实施例146-根据实施例130、131、132、133、134、135、136、137、138、139、140、141、142、143、144或145所述的外科器械，其中，熔断器包括偏压部分，偏压部分被构造成能够将熔断器偏压到完整状态。
实施例147-根据实施例130、131、132、133、134、135、136、137、138、139、140、141、142、143、144、145或146所述的外科器械，其中，偏压部分被构造成能够一旦熔断器离开完整状态就将熔断器偏压到第一失效状态。
实施例148-一种包括电动马达、端部执行器和击发组件的外科器械，端部执行器包括钉仓，击发组件包括熔断器。钉仓包括仓体、可移除地储存在仓体内的钉以及被构造成能够将钉从仓体中射出的滑动件。熔断器包括：完整状态，其中熔断器被构造成能够在熔断器处于完整状态时在击发行程期间将击发负载从电动马达传递到滑动件；下滑状态，其中熔断器被构造成能够在熔断器处于下滑状态时将负载从电动马达传递到滑动件；以及失效状态，其中熔断器被构造成能够在熔断器处于第二失效状态时不能将负载传递到滑动件。
实施例149-一种包括端部执行器的外科器械，端部执行器包括钉仓，其中钉仓包括包括远侧端部的仓体、可移除地储存在仓体中的钉以及被构造成能够将钉从仓体中射出的滑动件。外科器械还包括被构造成能够在击发行程期间将击发力施加到远侧端部并朝向远侧端部推进滑动件的击发组件；以及用于在击发力超过阈值的情况下将击发组件的功能限制在多个操作状态下的装置。
实施例150-一种用于操作包括击发组件的外科器械的方法，击发组件包括熔断器，其中该方法包括以下步骤：推进击发组件以执行钉击发行程并将击发负载施加到钉仓组件；如果击发组件中的熔断器因为过量击发负载而失效，则停止击发组件；并且回缩击发组件以重置熔断器。
实施例151-根据实施例150所述的方法，其中，该方法还包括在回缩步骤之后完成述钉击发行程的步骤。
实施例152-根据实施例150或151所述的方法，其中，该方法还包括将击发组件回缩到未击发位置而不是完成钉击发行程的步骤。
实施例153-根据实施例150、151或152所述的方法，其中，外科器械包括端部执行器，其中端部执行器包括缺失的钉仓闭锁件，并且其中当击发组件邻接缺失的钉仓闭锁件时，击发负载变为过量的击发负载。
实施例154-根据实施例150、151、152或153所述的方法，其中，外科器械包括端部执行器，其中端部执行器包括耗尽的钉仓闭锁件，并且其中当击发组件邻接耗尽的钉仓闭锁件时，击发负载变为过量的击发负载。
实施例155-根据实施例150、151、152、153或154所述的方法，其中，外科器械包括被构造成能够执行停止步骤的闭锁件。
实施例156-根据实施例150、151、152、153、154或155所述的方法，其中，该方法还包括以下步骤：用未耗尽的钉仓组件替换该钉仓组件，并且在停止步骤之后完成钉击发行程。
实施例157-一种用于操作包括击发组件的外科器械的方法，击发组件包括熔断器，其中，该方法包括以下步骤：在钉仓组件内推进击发组件以执行钉击发行程并将击发负载施加到钉仓组件；如果击发组件中的熔断器进入第一失效状态，则完成钉击发行程；并且如果击发组件中的熔断器在进入第一失效状态后进入第二失效状态，则停止钉击发行程。
实施例158-根据实施例157所述的方法，其中，该方法还包括在停止步骤之后重置熔断器的步骤。
实施例159-根据实施例158所述的方法，其中，重置步骤包括回缩击发组件的步骤。
实施例160-根据实施例157、158或159所述的方法，其中，完成步骤包括以下步骤：回缩击发组件，然后推进击发组件。
实施例161-根据实施例157、158、159或160所述的方法，其中，当击发负载超过第一力阈值时，熔断器进入第一失效状态，并且其中当击发负载超过第二力阈值时，熔断器进入第二失效状态。
实施例162-根据实施例161所述的方法，其中，第一力阈值不同于第二力阈值。
实施例163-根据实施例161或162所述的方法，其中，第二力阈值高于第一力阈值。
实施例164-根据实施例157、158、159、160、161、162或163所述的方法，其中外科器械包括被构造成能够执行停止步骤的闭锁件。
实施例165-根据实施例157、158、159、160、161、162、163或164所述的方法，其中，该方法还包括以下步骤：用未耗尽的钉仓组件替换该钉仓组件，并且在停止步骤之后完成钉击发行程。
实施例166-根据实施例157、158、159、160、161、162、163、164或165所述的方法，其中，该方法还包括在停止步骤之后将熔断器从第二失效状态重置为第一失效状态的步骤。
实施例167-根据实施例157、158、159、160、161、162、163、164、165或166所述的方法，其中，该方法还包括在停止步骤之后将熔断器从第二失效状态重置为未失效状态的步骤。
实施例168-一种用于操作包括击发组件的外科器械的方法，该击发组件包括熔断器，其中该方法包括以下步骤：推进击发组件以执行钉击发行程并将击发负载施加到钉仓组件；如果击发组件中的熔断器改变状态，则停止击发组件；并且将熔断器重置为未失效状态。
实施例169-一种外科缝合系统，包括钉仓附接部分，该钉仓附接部分被构造成能够可操作地附接到钉仓附接部分的第一钉仓，和被构造成能够可操作地附接到钉仓附接部分的第二钉仓，其中第一钉仓包括多个第一钉，该多个第一钉包括第一钉腿，其中第二钉仓包括多个第二钉，该多个第二钉包括第二钉腿，并且其中第一钉和第二钉是不同的。该外科缝合系统还包括砧座，该砧座包括组织接合表面和限定在组织接合表面中的多个成形凹坑。每个成形凹坑包括被构造成能够接收第一钉的腿部的第一着陆区，和被构造成能够接收第二钉的腿部的第二着陆区。
实施例170-根据实施例169所述的外科缝合系统，其中，砧座包括限定砧座纵向轴线的砧座狭槽，并且其中第一钉仓包括限定第一纵向仓轴线的仓狭槽以及第一钉的纵向排，当第一钉仓可操作地附接到钉仓附接部分时，第一纵向仓轴线与砧座纵向轴线对准，其中每个第一钉腿包括第一钉尖端，其中第一钉尖端限定第一纵向钉轴线，其中第一纵向钉轴线距第一纵向仓轴线第一距离。第二钉仓包括限定第二纵向仓轴线的仓狭槽以及第二钉的纵向排，当第二钉仓可操作地附接到钉仓附接部分时，第二纵向仓轴线与砧座纵向轴线对准，其中每个第二钉腿包括第二钉尖端，其中第二钉尖端限定第二纵向钉轴线，其中第二纵向钉轴线距第二纵向仓轴线第二距离，并且其中第一距离不同于第二距离。
实施例171-根据实施例169或170所述的外科缝合系统，其中，第一钉包括丝状钉，并且其中第二缝钉包括平坦形钉。
实施例172-根据实施例169、170或171所述的外科缝合系统，其中，第一钉被构造成能够形成为平面构型，并且其中第二钉被构造成能够形成为非平面构型。
实施例173-根据实施例169、170、171或172所述的外科缝合系统，其中，每个成形凹坑的第一着陆区包括第一凹坑特征结构，其被构造成能够控制将第一钉腿形成为第一构型。
实施例174-根据实施例173所述的外科缝合系统，其中，第一凹坑特征结构包括沟槽。
实施例175-根据实施例174所述的外科缝合系统，其中，每个第一钉包括第一厚度，并且其中沟槽包括大于第一厚度的总宽度。
实施例176-根据实施例175所述的外科缝合系统，其中，每个第二钉包括大于第一厚度的第二厚度，并且其中第二厚度大于沟槽的总宽度。
实施例177-根据实施例169、170、171、172、173、174、175、176或177所述的外科缝合系统，其中，成形凹坑布置在多个成形凹坑布置结构中，其中砧座限定基准平面，其中组织接合表面包括多个面向组织的表面，每个面向组织的表面包括成形凹坑布置结构，并且其中面向组织的表面相对于基准平面单独成角度。
实施例178-根据实施例177所述的外科缝合系统，其中，砧座包括近侧端部和远侧端部，并且其中每个面向组织的表面的角度从近侧端部到远侧端部逐渐增大。
实施例179-一种外科紧固系统，包括紧固件仓附接部分，被构造成能够安装到紧固件仓附接部分中的第一紧固件仓，和被构造成能够安装到紧固件仓附接部分的第二紧固件仓，其中第一紧固件仓包括多个第一紧固件，第一紧固件包括第一紧固件腿，其中第二紧固件仓包括多个第二紧固件，第二紧固件包括第二紧固件腿，并且其中第一紧固件和第二紧固件是不同的。该外科紧固系统还包括砧座，该砧座包括组织接合表面和限定在组织接合表面中的多个成形凹坑。每个成形凹坑包括第一目标区和第二目标区，第一目标区域被构造成能够接收第一紧固件的腿部并且将第一紧固件的腿部形成为第一构型，第二目标区被构造成能够接收第二紧固件的腿部并且将第二紧固件的腿部形成为第二构型，其中第一构型和第二构型是不同的。
实施例180-根据实施例179所述的外科紧固系统，其中，第一构型包括平面构型，第二构型包括非平面构型。
实施例181-根据实施例179或180所述的外科紧固系统，其中，砧座包括限定砧座纵向轴线的砧座狭槽，并且其中第一紧固件仓包括限定第一纵向仓轴线的仓狭槽以及第一紧固件的纵向排，当第一紧固件仓可操作地附接到紧固件仓附接部分时，第一纵向仓轴线与砧座纵向轴线对准，其中每个第一紧固件腿包括第一紧固件尖端，其中第一紧固件尖端限定第一纵向紧固件轴线，其中第一纵向紧固件轴线距第一纵向仓轴线第一距离。第二紧固件仓包括限定第二纵向仓轴线的仓狭槽以及第二紧固件的纵向排，当第二紧固件仓可操作地附接到紧固件仓附接部分时，第二纵向仓轴线与砧座纵向轴线对准，其中每个第二紧固件腿包括第二紧固件尖端，其中第二紧固件尖端限定第二纵向紧固件轴线，其中第二纵向紧固件轴线距第二纵向仓轴线第二距离，并且其中第一距离不同于第二距离。
实施例182-根据实施例179、180或181所述的外科紧固系统，其中，第一紧固件包括丝状紧固件，并且其中第二紧固件包括平坦形紧固件。
实施例183-根据实施例179、180、181或182所述的外科紧固系统，其中，每个成形凹坑的第一目标区包括第一凹坑特征结构，其被构造成能够控制将第一紧固件腿形成为第一构型。
实施例184-根据实施例183所述的外科紧固系统，其中，第一凹坑特征结构包括沟槽。
实施例185-根据实施例184所述的外科紧固系统，其中，每个第一紧固件包括第一厚度，并且其中沟槽包括大于第一厚度的总宽度。
实施例186-根据实施例185所述的外科紧固系统，其中，每个第二紧固件包括大于第一厚度的第二厚度，并且其中第二厚度大于沟槽的总宽度。
实施例187-一种外科缝合系统，包括钉仓附接部分，被构造成能够可操作地附接到钉仓附接部分的第一钉仓，和被构造成能够可操作地附接到钉仓附接部分的第二钉仓，其中第一钉仓包括多个第一钉，第一钉包括第一钉腿，其中第二钉仓包括多个第二钉，第二钉包括第二钉腿，并且其中第一钉和第二钉是不同的。该外科缝合系统还包括砧座，该砧座包括组织接合表面和限定在组织接合表面中的多个成形凹坑。每个成形凹坑包括被构造成能够接收第一钉的腿的第一着陆区和被构造成能够接收第二钉的腿的第二着陆区，其中第一钉被构造成能够沿第一路径形成，其中第二钉被构造成能够沿第二路径形成，并且其中第一路径和第二路径是不同的。
实施例188-根据实施例187所述的外科缝合系统，其中，砧座包括限定砧座纵向轴线的砧座狭槽，并且其中第一钉仓包括限定第一纵向仓轴线的仓狭槽以及第一钉的纵向排，当第一钉仓可操作地附接到钉仓附接部分时，第一纵向仓轴线与砧座纵向轴线对准，其中每个第一钉腿包括第一钉尖端，其中第一钉尖端限定第一纵向钉轴线，其中第一纵向钉轴线距第一纵向仓轴线第一距离。第二钉仓包括限定第二纵向仓轴线的仓狭槽以及第二钉的纵向排，当第二钉仓可操作地附接到钉仓附接部分时，第二纵向仓轴线与砧座纵向轴线对准，其中每个第二钉腿包括第二钉尖端，其中第二钉尖端限定第二纵向钉轴线，其中第二纵向钉轴线距第二纵向仓轴线第二距离，并且其中第一距离不同于第二距离。
实施例189-根据实施例187或188所述的外科缝合系统，其中，第一钉包括平面钉。
实施例190-根据实施例187或188所述的外科缝合系统，其中，第一钉包括非平面钉。
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，现为美国专利号8,733,613；
-提交于2011年2月28日的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号13/036,647，现为美国专利号8,561,870；
-名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE 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，现为美国专利申请公布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，也可使用其它材料。此外，根据多种实施方案，单个部件可被替换为多个部件，并且多个部件也可被替换为单个部件，以执行给定的一种或多种功能。上述具体实施方式和下述权利要求旨在涵盖所有此类修改和变型。
本文所公开的装置可被设计成在单次使用后废弃，或者其可被设计成多次使用。然而无论是哪种情况，该装置都可在至少使用一次后经过修整再行使用。修复可包括以下步骤的任意组合，这些步骤包括但不限于拆卸装置、之后进行装置具体部件的清洁或更换、以及随后重新组装装置。具体地，修复设施和/或外科团队可拆卸装置，并且在清洁和/或更换装置的特定部件之后，可重新组装装置以供后续使用。本领域的技术人员将会理解，修整装置可利用多种技术来进行拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修复装置均在本申请的范围内。
本文所公开的装置可在手术之前进行处理。首先，可获得新的或用过的器械，并且根据需要进行清洁。然后，可对器械进行消毒。在一种灭菌技术中，将所述器械放置在密闭且密封的容器(诸如，塑料或TYVEK袋)中。然后可将容器和器械置于可穿透容器的辐射场，诸如γ辐射、X射线和/或高能电子。辐射可杀死器械上和容器中的细菌。经消毒的器械随后可被储存在无菌容器中。密封容器可将器械保持为无菌的，直至在医疗设施中将该容器打开。还可使用本领域已知的任何其他技术对装置进行消毒，所述技术包括但不限于β辐射、γ辐射、环氧乙烷、等离子过氧化物和/或蒸汽。
尽管本发明已被描述为具有示例性设计，但可在本公开的实质和范围内进一步修改本发明。因此，本申请旨在涵盖使用本发明的一般原理的本发明的任何变型、用途或改型。
以引用方式全文或部分地并入本文的任何专利、公布或其他公开材料均仅在所并入的材料不与本发明所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。因此，并且在必要的程度下，本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其它公开材料相冲突的任何材料或其部分，将仅在所并入的材料与现有的公开材料之间不产生冲突的程度下并入。
Claims (22)
1.一种外科缝合系统，包括：
钉仓附接部分；
第一钉仓，所述第一钉仓被构造成能够可操作地附接到所述钉仓附接部分，其中所述第一钉仓包括多个第一钉，所述多个第一钉包括第一钉腿；
第二钉仓，所述第二钉仓被构造成能够可操作地附接到所述钉仓附接部分，其中所述第二钉仓包括多个第二钉，所述多个第二钉包括第二钉腿，并且其中所述第一钉和所述第二钉是不同的；和
砧座，所述砧座包括：
组织接合表面；和
多个成形凹坑，所述多个成形凹坑限定在所述组织接合表面中，其中每个所述成形凹坑包括：
第一着陆区，所述第一着陆区被构造成能够接收所述第一钉的所述腿；和
第二着陆区，所述第二着陆区被构造成能够接收所述第二钉的所述腿。
2.根据权利要求1所述的外科缝合系统，其中，所述砧座包括限定砧座纵向轴线的砧座狭槽；
其中所述第一钉仓包括：
仓狭槽，所述仓狭槽限定第一纵向仓轴线，当所述第一钉仓可操作地附接到所述钉仓附接部分时，所述第一纵向仓轴线与所述砧座纵向轴线对准；和
所述第一钉的纵向排，其中每个所述第一钉腿包括第一钉尖端，其中所述第一钉尖端限定第一纵向钉轴线，其中所述第一纵向钉轴线距所述第一纵向仓轴线第一距离；
并且其中所述第二钉仓包括：
仓狭槽，所述仓狭槽限定第二纵向仓轴线，当所述第二钉仓可操作地附接到所述钉仓附接部分时，所述第二纵向仓轴线与所述砧座纵向轴线对准；和
所述第二钉的纵向排，其中每个所述第二钉腿包括第二钉尖端，其中所述第二钉尖端限定第二纵向钉轴线，其中所述第二纵向钉轴线距所述第二纵向仓轴线第二距离，并且其中所述第一距离不同于所述第二距离。
3.根据权利要求1所述的外科缝合系统，其中，所述第一钉包括丝状钉，并且其中所述第二钉包括平坦形钉。
4.根据权利要求1所述的外科缝合系统，其中，所述第一钉被构造成能够形成为平面构型，并且其中所述第二钉被构造成能够形成为非平面构型。
5.根据权利要求1所述的外科缝合系统，其中，每个所述成形凹坑的所述第一着陆区包括第一凹坑特征结构，所述第一凹坑特征结构被构造成能够控制将所述第一钉腿形成为第一构型。
6.根据权利要求5所述的外科缝合系统，其中，所述第一凹坑特征结构包括沟槽。
7.根据权利要求6所述的外科缝合系统，其中，每个所述第一钉包括第一厚度，并且其中所述沟槽包括大于所述第一厚度的总宽度。
8.根据权利要求7所述的外科缝合系统，其中，每个所述第二钉包括大于所述第一厚度的第二厚度，并且其中所述第二厚度大于所述沟槽的所述总宽度。
9.根据权利要求1所述的外科缝合系统，其中，所述成形凹坑被布置在多个成形凹坑布置结构中，其中所述砧座限定基准平面，其中所述组织接合表面包括多个面向组织的表面，所述多个面向组织的表面各自包括所述成形凹坑布置结构，其中所述面向组织的表面相对于所述基准平面单独成角度。
10.根据权利要求9所述的外科缝合系统，其中，所述砧座包括近侧端部和远侧端部，并且其中每个所述面向组织的表面的所述角度从所述近侧端部到所述远侧端部逐渐增大。
11.一种外科紧固系统，包括：
紧固件仓附接部分；
第一紧固件仓，所述第一紧固件仓被构造成能够安装到所述紧固件仓附接部分中，其中所述第一紧固件仓包括多个第一紧固件，所述多个第一紧固件包括第一紧固件腿；
第二紧固件仓，所述第二紧固件仓被构造成能够安装到所述紧固件仓附接部分中，其中所述第二紧固件仓包括多个第二紧固件，所述多个第二紧固件包括第二紧固件腿，并且其中所述第一紧固件和所述第二紧固件是不同的；和
砧座，所述砧座包括：
组织接合表面；和
多个成形凹坑，所述多个成形凹坑限定在所述组织接合表面中，其中每个所述成形凹坑包括：
第一目标区，所述第一目标区被构造成能够接收所述第一紧固件的所述腿并将所述第一紧固件的所述腿形成为第一构型；和
第二目标区，所述第二目标区被构造成能够接收所述第二紧固件的所述腿并将所述第二紧固件的所述腿形成为第二构型，其中所述第一构型和所述第二构型是不同的。
12.根据权利要求11所述的外科紧固系统，其中，所述第一构型包括平面构型，并且所述第二构型包括非平面构型。
13.根据权利要求11所述的外科紧固系统，其中，所述砧座包括限定砧座纵向轴线的砧座狭槽；
其中所述第一紧固件仓包括：
仓狭槽，所述仓狭槽限定第一纵向仓轴线，当所述第一紧固件仓可操作地附接到所述紧固件仓附接部分时，所述第一纵向仓轴线与所述砧座纵向轴线对准；和
所述第一紧固件的纵向排，其中每个所述第一紧固件腿包括第一紧固件尖端，其中所述第一紧固件尖端限定第一纵向紧固件轴线，其中所述第一纵向紧固件轴线距所述第一纵向仓轴线第一距离；
并且其中所述第二紧固件仓包括：
仓狭槽，所述仓狭槽限定第二纵向仓轴线，当所述第二紧固件仓可操作地附接到所述紧固件仓附接部分时，所述第二纵向仓轴线与所述砧座纵向轴线对准；和
所述第二紧固件的纵向排，其中每个所述第二紧固件腿包括第二紧固件尖端，其中所述第二紧固件尖端限定第二纵向紧固件轴线，其中所述第二纵向紧固件轴线距所述第二纵向仓轴线第二距离，并且其中所述第一距离不同于所述第二距离。
14.根据权利要求11所述的外科紧固系统，其中，所述第一紧固件包括丝状紧固件，并且其中所述第二紧固件包括平坦形紧固件。
15.根据权利要求11所述的外科紧固系统，其中，每个所述成形凹坑的所述第一目标区包括第一凹坑特征结构，所述第一凹坑特征结构被构造成能够控制将所述第一紧固件腿形成为所述第一构型。
16.根据权利要求15所述的外科紧固系统，其中，所述第一凹坑特征结构包括沟槽。
17.根据权利要求16所述的外科紧固系统，其中，每个所述第一紧固件包括第一厚度，并且其中所述沟槽包括大于所述第一厚度的总宽度。
18.根据权利要求17所述的外科紧固系统，其中，每个所述第二紧固件包括大于所述第一厚度的第二厚度，并且其中所述第二厚度大于所述沟槽的所述总宽度。
19.一种外科缝合系统，包括：
钉仓附接部分；
第一钉仓，所述第一钉仓被构造成能够可操作地附接到所述钉仓附接部分，其中所述第一钉仓包括多个第一钉，所述多个
第一钉包括第一钉腿；
第二钉仓，所述第二钉仓被构造成能够可操作地附接到所述钉仓附接部分，其中所述第二钉仓包括多个第二钉，所述多个第二钉包括第二钉腿，并且其中所述第一钉和所述第二钉是不同的；和
砧座，所述砧座包括：
组织接合表面；和
多个成形凹坑，所述多个成形凹坑限定在所述组织接合表面中，其中每个所述成形凹坑包括：
第一着陆区，所述第一着陆区被构造成能够接收所述第一钉的所述腿，其中所述第一钉被构造成能够沿第一路径形成；和
第二着陆区，所述第二着陆区被构造成能够接收所述第二钉的所述腿，其中所述第二钉被构造成能够沿第二路径形成，并且其中所述第一路径和所述第二路径是不同的。
20.根据权利要求19所述的外科缝合系统，其中所述砧座包括限定砧座纵向轴线的砧座狭槽；
其中所述第一钉仓包括：
仓狭槽，所述仓狭槽限定第一纵向仓轴线，当所述第一钉仓可操作地附接到所述钉仓附接部分时，所述第一纵向仓轴线与所述砧座纵向轴线对准；和
所述第一钉的纵向排，其中每个所述第一钉腿包括第一钉尖端，其中所述第一钉尖端限定第一纵向钉轴线，其中所述第一纵向钉轴线距所述第一纵向仓轴线第一距离；
并且其中所述第二钉仓包括：
仓狭槽，所述仓狭槽限定第二纵向仓轴线，当所述第二钉仓可操作地附接到所述钉仓附接部分时，所述第二纵向仓轴线与所述砧座纵向轴线对准；和
所述第二钉的纵向排，其中每个所述第二钉腿包括第二钉尖端，其中所述第二钉尖端限定第二纵向钉轴线，其中所述第二纵向钉轴线距所述第二纵向仓轴线第二距离，并且其中所述第一距离不同于所述第二距离。
21.根据权利要求19所述的外科缝合系统，其中，所述第一钉包括平面钉。
22.根据权利要求19所述的外科缝合系统，其中，所述第一钉包括非平面钉。
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| US15/385,953 US10675026B2 (en) | 2016-12-21 | 2016-12-21 | Methods of stapling tissue |
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| PCT/US2017/065698 WO2018118500A2 (en) | 2016-12-21 | 2017-12-12 | Staple forming pocket arrangement to accommodate different types of staples |
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| CN201780079581.4A Active CN110099622B (zh) | 2016-12-21 | 2017-12-12 | 用于容纳不同类型的钉的钉成形凹坑布置结构 |
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2016
- 2016-12-21 US US15/385,953 patent/US10675026B2/en active Active
- 2016-12-21 US US15/385,898 patent/US10537325B2/en active Active
- 2016-12-21 US US15/385,896 patent/US11090048B2/en active Active
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2017
- 2017-11-06 BR BR112019012390-3A patent/BR112019012390B1/pt active IP Right Grant
- 2017-11-06 WO PCT/US2017/060155 patent/WO2018118236A2/en active Application Filing
- 2017-11-06 CN CN201780079746.8A patent/CN110099625B/zh active Active
- 2017-11-20 MX MX2019007303A patent/MX2019007303A/es unknown
- 2017-11-20 WO PCT/US2017/062580 patent/WO2018118310A1/en active Application Filing
- 2017-11-20 CN CN201780079946.3A patent/CN110430825B/zh active Active
- 2017-11-20 BR BR112019012491A patent/BR112019012491A2/pt not_active Application Discontinuation
- 2017-12-12 WO PCT/US2017/065698 patent/WO2018118500A2/en active Application Filing
- 2017-12-12 BR BR112019012456-0A patent/BR112019012456B1/pt active IP Right Grant
- 2017-12-12 CN CN201780079581.4A patent/CN110099622B/zh active Active
- 2017-12-12 MX MX2019007298A patent/MX2019007298A/es unknown
- 2017-12-21 EP EP17209447.6A patent/EP3348208A3/en active Pending
- 2017-12-21 EP EP17209637.2A patent/EP3338714B1/en active Active
- 2017-12-21 EP EP19209971.1A patent/EP3632344B1/en active Active
- 2017-12-21 EP EP17209461.7A patent/EP3348209B1/en active Active
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2018
- 2018-10-02 US US16/149,778 patent/US10905422B2/en active Active
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2020
- 2020-01-17 US US16/745,828 patent/US11350934B2/en active Active
- 2020-04-28 US US16/860,332 patent/US11701115B2/en active Active
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- 2021-03-12 US US17/199,600 patent/US11849948B2/en active Active
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