CN110099625B - 缝合组织的方法 - Google Patents
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Abstract
本发明公开了缝合组织的方法。该方法可以包括获得包括多个钉的钉仓,其中每个钉具有基部以及从基部延伸的腿部。缝合方法还可以包括从钉仓击发钉,其中沿钉线将钉击发到组织中。钉线可以包括具有第一柔性的第一部分和具有第二柔性的第二部分,其中第二柔性不同于第一柔性。缝合组织的方法还可以包括使砧座适应砧座板,砧座板具有与砧座中的钉成形凹坑不同的钉成形凹坑布置。
Description
背景技术
本发明涉及外科器械,并且在各种布置中,涉及被设计成缝合和切割组织的外科缝合和切割器械及与其一起使用的钉仓。
附图说明
本文所述的实施方案的各种特征连同其优点可结合如下附图根据以下描述来加以理解:
图1是可操作地联接到柄部组件实施方案的可互换外科工具组件实施方案的透视图;
图2是图1的柄部组件和可互换外科工具组件的部分的分解组装视图;
图3是图1和图2所示的可互换外科工具组件实施方案的远侧部分的透视图,其中为清楚起见省略了其多个部分;
图4是图1的可互换外科工具组件的远侧部分的分解组装视图;
图5是图1的可互换外科工具组件的近侧部分的部分剖视透视图;
图6是图5的可互换外科工具组件的近侧部分的分解组装视图;
图7是图1的可互换外科工具组件的脊组件实施方案的一部分的局部分解组装视图;
图8是图5的可互换外科工具组件的近侧部分的局部横截面端视图,其中离合器组件以关节运动模式示出;
图9是图5的可互换外科工具组件的近侧部分的另一局部横截面端视图,其中离合器组件以击发模式示出;
图10是图1的可互换外科工具组件的近侧部分的局部侧视图,其中离合器组件以关节运动模式示出;
图11是图1的可互换外科工具组件的部分的局部侧视图,其中离合器组件以击发模式示出;
图12A是图1的可互换外科工具组件的局部侧面剖视图,其中闭合行程减小组件实施方案处于对应于关节运动模式的回缩取向;
图12B是图12A的可互换外科工具组件的局部侧面剖视图,其中闭合行程减小组件实施方案处于对应于击发模式的延伸取向;
图13是图12A的可互换外科工具组件的一部分的透视图,示出了闭合行程减小组件实施方案处于对应于关节运动模式的回缩取向;
图14是图12B的可互换外科工具组件的一部分的透视图,示出了闭合行程减小组件实施方案处于对应于击发模式的延伸取向;
图15A是外科端部执行器实施方案的一部分的侧视图,其中钳口处于完全闭合的取向;
图15B是图15A的外科端部执行器实施方案的另一侧视图,其中其钳口处于完全打开的取向;
图16是具有正向钳口开口特征部的远侧闭合构件实施方案的透视图;
图17是被配置成与图16的远侧闭合构件结合使用的外科端部执行器实施方案的一部分的透视图;
图18是图17的外科端部执行器的部分的侧视图,其中钳口处于完全闭合位置,并且图16的远侧闭合构件以横截面示出;
图19是图18的外科端部执行器和远侧闭合构件的横截面侧视图,其钳口处于完全闭合位置;
图20是图18的外科端部执行器和远侧闭合构件的另一个横截面侧视图,其钳口处于完全打开的位置;
图21是图18的外科端部执行器和远侧闭合构件的侧视图,其钳口处于完全打开的位置;
图22是另一个外科端部执行器实施方案的一部分的透视图,为清楚起见省略了砧座,该砧座采用了正向钳口打开弹簧;
图23是图22的正向钳口打开弹簧的透视图;
图24是图22的外科端部执行器的横截面侧视图,其钳口处于完全打开的位置;
图25是图22的外科端部执行器的另一个横截面侧视图,其钳口处于完全闭合的位置;
图26是另一个外科端部执行器实施方案和远侧闭合构件实施方案的一部分的侧视图,其中外科端部执行器的钳口处于完全打开的位置;
图27是图26的外科端部执行器和远侧闭合构件在钳口闭合序列开始时的另一侧视图;
图28是图26的外科端部执行器和远侧闭合构件在钳口闭合序列期间的另一侧视图;
图29是图26的外科端部执行器和远侧闭合构件的另一侧视图,其中钳口处于完全闭合的位置;
图30是击发构件实施方案的透视图;
图31是图30的击发构件的侧正视图;
图32是图30的击发构件的正视图;
图33是图30的击发构件相对于滑动组件实施方案和击发构件锁定实施方案的透视图;
图33A是钉驱动器实施方案的顶视图;
图33B是图33A的钉驱动器实施方案的顶部透视图;
图33C是图33A和图33B的钉驱动器实施方案的底部透视图;
图34是图33的击发构件锁的底部透视图;
图35是外科端部执行器实施方案的一部分的横截面侧视图,其中钳口处于完全打开的取向,并且图33的击发构件锁定件处于解锁取向;
图36是图35的外科端部执行器的另一个横截面侧视图,其中未使用的外科钉仓被支撑在其中一个钳口中并且将击发构件锁定件保持在解锁取向;
图37是在开始击发序列之后图36的外科端部执行器的另一个横截面侧正视图;
图38是在击发构件回缩到起始位置时图36的外科端部执行器的另一横截面侧正视图;
图39是击发构件和击发构件锁定件在图38所示位置的俯视剖视图;
图40是在击发构件回缩到起始位置之后的图36的外科端部执行器的另一横截面侧正视图;
图41是击发构件和击发构件锁定件在图40所示位置的俯视剖视图;
图42是另一个外科端部执行器实施方案的一部分的横截面侧视图,其中钳口处于完全打开的取向,并且图33的另一个击发构件锁定件实施方案处于锁定取向;
图43是另一外科端部执行器实施方案和远侧闭合构件实施方案的部分的左侧透视图,其中外科端部执行器的钳口处于完全打开的位置并且在其中支撑外科钉仓,其中可扩展组织止挡件处于完全延伸的取向;
图44是图43的外科端部执行器的右侧透视图;
图45是图43和图44的钳口和外科钉仓之一的分解透视图;
图46是图43的可扩展组织止挡件之一的止挡弹簧的透视图;
图47是图42和图43的外科端部执行器的局部横截面端视图,其中钳口处于完全打开的取向,并且其可扩展组织止挡件处于其完全延伸的取向;
图48是图42和图43的外科钉仓的一部分的顶视图;
图49是图43和图44的外科端部执行器的横截面侧视图,其中钳口处于完全闭合的位置;
图50是图43和图44的外科端部执行器的另一横截面侧视图,其中钳口处于完全打开的位置;
图51是另一个外科端部执行器实施方案的局部横截面端视图,其中钳口处于完全打开的取向;
图52是图51的外科端部执行器的一部分的侧正视图,其中钳口处于完全打开的取向;
图53是图51的外科端部执行器的一部分的另一个侧正视图,其中钳口处于完全闭合的取向;
图54是其中限定有多个钉腔的钉仓体的透视图;
图55是图54的钉仓的局部透视底视图;
图56是图54的钉仓体的顶部平面图,并且示出了被定位在仓体的纵向狭槽中的切割元件;
图57是图54的钉仓体的底部平面图,并且示出了被定位在钉腔中的驱动器;
图58是植入在缝合组织中并由图54的钉仓体生成的钉线,并且示出了可能从具有虚线的钉线缺失的某些钉;
图59是图58的钉线中的钉的侧正视图;
图60是钉的侧正视图;
图61是具有限定于其中的多个钉腔的钉仓体的底部平面图,并且示出了被定位在钉腔中的驱动器;
图62是图57的近侧钉腔中的驱动器的透视图;
图63是图62的驱动器的侧正视图,并且示出了具有虚线的偏置斜坡表面;
图64是图62的驱动器的平面图;
图65是图62的驱动器的前正视图;
图66是图61的钉仓体的近侧钉腔中的驱动器的平面图;
图67是图66的驱动器的前正视图;
图68是其中限定有多个钉腔的钉仓体的顶部平面图;
图69是图68的钉仓体的底部平面图,并且示出了被定位在钉腔中的驱动器;
图70是图69的近侧钉腔中的驱动器的透视图;
图71是图70的驱动器的前正视图;
图72是图70的驱动器的平面图;
图73是图70的驱动器的侧正视图,并且示出了具有虚线的偏置斜坡表面;
图74是其中限定有多个钉腔的钉仓体的顶部平面图;
图75是图74的钉仓体的底部平面图,并且示出了被定位在钉腔中的驱动器;
图76是具有限定在其中的多个成角度取向的钉腔的钉仓体的一部分的平面图,并且示出了钉腔中的钉;
图77是具有限定在其中的多个成角度取向的钉腔的钉仓体的一部分的平面图,并且示出了钉腔中的钉;
图78是具有限定在其中的多个成角度取向的钉腔的钉仓体的一部分的平面图,并且示出了钉腔中的钉;
图79是具有限定在其中的多个成角度取向的钉腔的钉仓体的一部分的平面图,并且示出了钉腔中的钉;
图80是具有限定在其中的多个成角度取向的钉腔的钉仓体的一部分的平面图,并且示出了钉腔中的钉;
图81是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图;
图82是图81的凹坑的细部图;
图83至图84C是图82的凹坑的剖视图;
图85是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图;
图86是图85的凹坑的细部图;
图87至图88C是图86的凹坑的剖视图;
图89是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图;
图90是图89的凹坑的细部图;
图91至图92C是图90的凹坑的剖视图;
图93是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图;
图94是图93的凹坑的细部图;
图95至图96C是图94的凹坑的剖视图;
图97是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图;
图98是图97的凹坑的细部图;
图99至图100C是图98的凹坑的剖视图;
图101是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图;
图102是图101的凹坑的细部图;
图103至图104C是图102的凹坑的剖视图;
图105是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图;
图106是图105的凹坑的细部图;
图107至图108C是图106的凹坑的剖视图;
图109是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图;
图110是图109的凹坑的细部图;
图111至图112C是图110的凹坑的剖视图;
图113是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图;
图114是图113的凹坑的细部图;
图115至图116C是图114的凹坑的剖视图;
图117是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图;
图118是图117的凹坑的细部图;
图119至图120C是图118的凹坑的剖视图;
图121是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图;
图122是图121的凹坑的细部图;
图123至图125C是图122的凹坑的剖视图;
图126是端部执行器和适配器组件的分解透视图;
图127是图126的端部执行器和适配器组件的一部分的剖面透视图;
图128是图126的端部执行器和适配器组件的剖面透视图;并且
图129是具有限定于其中的多个钉成形凹坑的砧座的一部分的平面图。
在所述若干视图中,对应的参考符号指示对应的部件。本文所述的范例以一种形式示出了本发明的各种实施方案,且这种范例不应被解释为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIESTHEREOF”的美国专利申请序列号15/386,185;
-名称为“ARTICULATABLE SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,230;
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS”的美国专利申请序列号15/386,221;
-名称为“SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF”的美国专利申请序列号15/386,209;
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS ANDREPLACEABLE TOOL ASSEMBLIES”的美国专利申请序列号15/386,198;以及
-名称为“SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR”的美国专利申请序列号15/386,240。
本申请的申请人拥有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15/385,939;
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FORSHIFTING BETWEEN CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES ANDARTICULATION AND FIRING SYSTEMS”的美国专利申请序列号15/385,941;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,943;
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTIONFEATURES”的美国专利申请序列号15/385,950;
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,945;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,946;
-名称为“SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASINGA JAW OPENING DISTANCE”的美国专利申请序列号15/385,951;
-名称为“FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FORSURGICAL END EFFECTORS”的美国专利申请序列号15/385,954;
-名称为“SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOPARRANGEMENTS”的美国专利申请序列号15/385,955;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,948;
-名称为“SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号15/385,956;
-名称为“SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTINGFIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT”的美国专利申请序列号15/385,958;以及
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,947。
本申请的申请人拥有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15/385,896;
-名称为“STAPLE FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENTTYPES OF STAPLES”的美国专利申请序列号15/385,898;
-名称为“SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL”的美国专利申请序列号15/385,899;
-名称为“STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISINGWINDOWS DEFINED THEREIN”的美国专利申请序列号15/385,901;
-名称为“SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER”的美国专利申请序列号15/385,902;
-名称为“STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/ORSPENT CARTRIDGE LOCKOUT”的美国专利申请序列号15/385,904;
-名称为“FIRING ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,905;
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUTAND A FIRING ASSEMBLY LOCKOUT”的美国专利申请序列号15/385,907;
-名称为“FIRING ASSEMBLY COMPRISING A FUSE”的美国专利申请序列号15/385,908;以及
-名称为“FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE”的美国专利申请序列号15/385,909。
本申请的申请人拥有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15/385,920;
-名称为“ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS”的美国专利申请序列号15/385,913;
-名称为“METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPES OFSTAPLE CARTRIDGES WITH THE SAME SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/385,914;
-名称为“BILATERALLY ASYMMETRIC STAPLE FORMING POCKET PAIRS”的美国专利申请序列号15/385,893;
-名称为“CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICALINSTRUMENTS WITH SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号15/385,929;
-名称为“SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING ANDFIRING SYSTEMS”的美国专利申请序列号15/385,911;
-名称为“SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES”的美国专利申请序列号15/385,927;
-名称为“STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPINGBREADTHS”的美国专利申请序列号15/385,917;
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING PRIMARYSIDEWALLS AND POCKET SIDEWALLS”的美国专利申请序列号15/385,900;
-名称为“NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FORSURGICAL STAPLERS”的美国专利申请序列号15/385,931;
-名称为“FIRING MEMBER PIN ANGLE”的美国专利申请序列号15/385,915;
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMINGSURFACE GROOVES”的美国专利申请序列号15/385,897;
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES”的美国专利申请序列号15/385,922;
-名称为“SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS”的美国专利申请序列号15/385,924;
-名称为“SURGICAL INSTRUMENTS WITH JAWS THAT ARE PIVOTABLE ABOUT AFIXED AXIS AND INCLUDE SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号15/385,912;
-名称为“ANVIL HAVING A KNIFE SLOT WIDTH”的美国专利申请序列号15/385,910;
-名称为“CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号15/385,903;以及
-名称为“FIRING MEMBER PIN CONFIGURATIONS”的美国专利申请序列号15/385,906。
本申请的申请人拥有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15/386,188;
-名称为“STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAPSETTING FEATURES”的美国专利申请序列号15/386,192;
-名称为“STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES”的美国专利申请序列号15/386,206;
-名称为“DURABILITY FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIESOF SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,226;
-名称为“SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITHPOSITIVE OPENING FEATURES”的美国专利申请序列号15/386,222;以及
-名称为“CONNECTION PORTIONS FOR DEPOSABLE LOADING UNITS FOR SURGICALSTAPLING INSTRUMENTS”的美国专利申请序列号15/386,236。
本申请的申请人拥有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15/385,887;
-名称为“ASSEMBLY COMPRISING A MANUALLY-OPERABLE RETRACTION SYSTEM FORUSE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号15/385,889;
-名称为“SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE ANDRETRACTABLE SYSTEMS”的美国专利申请序列号15/385,890;
-名称为“SHAFT ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO ADAPT THEOUTPUT OF A ROTARY FIRING MEMBER TO TWO DIFFERENT SYSTEMS”的美国专利申请序列号15/385,891;
-名称为“SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO ANARTICULATION STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM”的美国专利申请序列号15/385,892;
-名称为“SHAFT ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,894;以及
-名称为“SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATIONLOCKOUTS”的美国专利申请序列号15/385,895。
本申请的申请人拥有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15/385,916;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,918;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,919;
-名称为“SURGICAL STAPLE CARTRIDGE WITH MOVABLE CAMMING MEMBERCONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES”的美国专利申请序列号15/385,921;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,923;
-名称为“JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OFA FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN UNFIRED CARTRIDGE ISINSTALLED IN THE END EFFECTOR”的美国专利申请序列号15/385,925;
-名称为“AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYINGCLOSURE MOTIONS TO JAWS OF SURGICAL INSTRUMENTS”的美国专利申请序列号15/385,926;
-名称为“PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN AMOVABLE JAW AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT”的美国专利申请序列号15/385,928;
-名称为“SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERATING OPENINGFEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS”的美国专利申请序列号15/385,930;
-名称为“ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFTARRANGEMENT”的美国专利申请序列号15/385,932;
-名称为“ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLELINKAGE DISTAL OF AN ARTICULATION LOCK”的美国专利申请序列号15/385,933;
-名称为“ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR INAN ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE SYSTEM”的美国专利申请序列号15/385,934;
-名称为“LATERALLY ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FORLOCKING AN END EFFECTOR OF A SURGICAL INSTRUMENT IN AN ARTICULATEDCONFIGURATION”的美国专利申请序列号15/385,935;以及
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKEAMPLIFICATION FEATURES”的美国专利申请序列号15/385,936。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES”的美国专利申请序列号15/191,775;
-名称为“STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPEDSTAPLES”的美国专利申请序列号15/191,807;
-名称为“STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME”的美国专利申请序列号15/191,834;
-名称为“STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES”的美国专利申请序列号15/191,788;以及
-名称为“STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL STAPLE ROWS”的美国专利申请序列号15/191,818。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,218;
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,227;
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,259;以及
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,264。
本申请的申请人拥有于2016年4月1日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM”的美国专利申请序列号15/089,325;
-名称为“MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY”的美国专利申请序列号15/089,321;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD”的美国专利申请序列号15/089,326;
-名称为“SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIPPORTION”的美国专利申请序列号15/089,263;
-名称为“ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLEBAILOUT SYSTEM”的美国专利申请序列号15/089,262;
-名称为“SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVILCONCENTRIC DRIVE MEMBER”的美国专利申请序列号15/089,277;
-名称为“INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL ENDEFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS”的美国专利申请序列号15/089,296;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION”的美国专利申请序列号15/089,258;
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVECUTTING OF TISSUE”的美国专利申请序列号15/089,278;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT”的美国专利申请序列号15/089,284;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSIONLOCKOUT”的美国专利申请序列号15/089,295;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT”的美国专利申请序列号15/089,300;
名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT”的美国专利申请序列号15/089,196;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT”的美国专利申请序列号15/089,203;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGELOCKOUT”的美国专利申请序列号15/089,210;
-名称为“SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM”的美国专利申请序列号15/089,324;
-名称为“SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS”的美国专利申请序列号15/089,335;
-名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/089,339;
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OFSTAPLES HAVING DIFFERENT HEIGHTS”的美国专利申请序列号15/089,253;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET”的美国专利申请序列号15/089,304;
-名称为“ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS”的美国专利申请序列号15/089,331;
-名称为“STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES”的美国专利申请序列号15/089,336;
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUESUPPORT”的美国专利申请序列号15/089,312;
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM”的美国专利申请序列号15/089,309;以及
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL”的美国专利申请序列号15/089,349。
本申请的申请人还拥有于2015年12月31日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE INPOWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/984,488;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/984,525;以及
-名称为“SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROLCIRCUITS”的美国专利申请序列号14/984,552。
本申请的申请人还拥有于2016年2月9日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLYTRANSLATABLE END EFFECTOR”的美国专利申请序列号15/019,220;
-名称为“SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,228;
-名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTEDSECONDARY CONSTRAINT”的美国专利申请序列号15/019,196;
-名称为“SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLYARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY”的美国专利申请序列号15/019,206;
-名称为“SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,215;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATIONLINK ARRANGEMENTS”的美国专利申请序列号15/019,227;
-名称为“SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLEDRIVEN ARTICULATION SYSTEMS”的美国专利申请序列号15/019,235;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAMARRANGEMENTS”的美国专利申请序列号15/019,230;以及
-名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTIONARRANGEMENTS”的美国专利申请序列号15/019,245。
本申请的申请人还拥有于2016年2月12日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,254;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,259;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,275;以及
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,289。
本申请的申请人拥有于2015年6月18日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL END EFFECTORS WITH POSITIVE JAW OPENINGARRANGEMENTS”的美国专利申请序列号14/742,925;
-名称为“SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSINGFEATURES”的美国专利申请序列号14/742,941;
-名称为“MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,914;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAMSTRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT”的美国专利申请序列号14/742,900;
-名称为“DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,885;以及
-名称为“PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,876。
本申请的申请人拥有于2015年3月6日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“POWERED SURGICAL INSTRUMENT”的美国专利申请序列号14/640,746,现为美国专利申请公布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,现为美国专利申请公布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,现为美国专利申请公布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,现为美国专利申请公布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,现为美国专利申请公布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,现为美国专利申请公布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,现为美国专利申请公布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,现为美国专利申请公布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,现为美国专利申请公布9,351,727;以及
-名称为“METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT”的美国专利申请序列号13/803,159,现为美国专利申请公布2014/0277017。
本申请的申请人还拥有于2014年3月7日提交且全文以引用方式并入本文的以下专利申请:
-名称为“CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/200,111,现为美国专利申请公布2014/0263539。
本申请的申请人还拥有于2014年3月26日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,106,现为美国专利申请公布2015/0272582;
-名称为“STERILIZATION VERIFICATION CIRCUIT”的美国专利申请序列号14/226,099,现为美国专利申请公布2015/0272581;
-名称为“VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT”的美国专利申请序列号14/226,094,现为美国专利申请公布2015/0272580;
-名称为“POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUITAND WAKE UP CONTROL”的美国专利申请序列号14/226,117,现为美国专利申请公布2015/0272574;
-名称为“MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFTASSEMBLIES”的美国专利申请序列号14/226,075,现为美国专利申请公布2015/0272579;
-名称为“FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICALINSTRUMENTS”的美国专利申请序列号14/226,093,现为美国专利申请公布2015/0272569;
-名称为“SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION”的美国专利申请序列号14/226,116,现为美国专利申请公布2015/0272571;
-名称为“SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETYPROCESSOR”的美国专利申请序列号14/226,071,现为美国专利申请公布2015/0272578;
-名称为“SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS”的美国专利申请序列号14/226,097,现为美国专利申请公布2015/0272570;
-名称为“INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,126,现为美国专利申请公布2015/0272572;
-名称为“MODULAR SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号14/226,133,现为美国专利申请公布2015/0272557;
-名称为“SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT”的美国专利申请序列号14/226,081,现为美国专利申请公布2015/0277471;
-名称为“POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLEVOLTAGE PROTECTION”的美国专利申请序列号14/226,076,现为美国专利申请公布2015/0280424;
-名称为“SURGICAL STAPLING INSTRUMENT SYSTEM”的美国专利申请序列号14/226,111,现为美国专利申请公布2015/0272583;以及
-名称为“SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT”的美国专利申请序列号14/226,125,现为美国专利申请公布2015/0280384。
本申请的申请人还拥有于2014年9月5日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,103,现为美国专利申请公布2016/0066912;
-名称为“ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUECOMPRESSION”的美国专利申请序列号14/479,119,现为美国专利申请公布2016/0066914;
-名称为“MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION”的美国专利申请序列号14/478,908,现为美国专利申请公布2016/0066910;
-名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'SOUTPUT OR INTERPRETATION”的美国专利申请序列号14/478,895,现为美国专利申请公布2016/0066909;
-名称为“POLARITY OF HALL MAGNET TO DETECT MISLOADED CARTRIDGE”的美国专利申请序列号14/479,110,现为美国专利申请公布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号14/248,591,现为美国专利申请公布2014/0305991;
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENTFEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS”的美国专利申请序列号14/248,584,现为美国专利申请公布2014/0305994;
-名称为“POWERED SURGICAL STAPLER”的美国专利申请序列号14/248,587,现为美国专利申请公布2014/0309665;
-名称为“DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICALINSTRUMENT”的美国专利申请序列号14/248,586,现为美国专利申请公布2014/0305990;以及
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUSINDICATION ARRANGEMENTS”的美国专利申请序列号14/248,607,现为美国专利申请公布2014/0305992。
本申请的申请人还拥有于2013年4月16日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,365;
-名称为“LINEAR CUTTER WITH POWER”的美国临时专利申请序列号61/812,376;
-名称为“LINEAR CUTTER WITH MOTOR AND PISTOL GRIP”的美国临时专利申请序列号61/812,382;
-名称为“SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS ANDMOTOR CONTROL”的美国临时专利申请序列号61/812,385;以及
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,372。
本申请的申请人还拥有于2015年9月2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 STAPLE CARTRIDGE WITH IMPROVED STAPLE DRIVERCONFIGURATIONS”的美国专利申请序列号14/843,168;
-名称为“SURGICAL STAPLE DRIVER ARRAYS”的美国专利申请序列号14/843,196;
-名称为“SURGICAL STAPLE CARTRIDGE STAPLE DRIVERS WITH CENTRAL SUPPORTFEATURES”的美国专利申请序列号14/843,216;
-名称为“SURGICAL STAPLE CONFIGURATIONS WITH CAMMING SURFACES LOCATEDBETWEEN PORTIONS SUPPORTING SURGICAL STAPLES”的美国专利申请序列号14/843,243;以及
-名称为“SURGICAL STAPLE CARTRIDGES WITH DRIVER ARRANGEMENTS FORESTABLISHING HERRINGBONE STAPLE PATTERNS”的美国专利申请序列号14/843,267。
本申请的申请人还拥有于2014年9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“CIRCULAR FASTENER CARTRIDGES FOR APPLYING RADIALLY EXPANDABLEFASTENER LINES”的美国专利申请序列号14/498,070;现为美国专利申请公布2016/0089146;
-名称为“SURGICAL STAPLE AND DRIVER ARRANGEMENTS FOR STAPLECARTRIDGES”的美国专利申请序列号14/498,087;现为美国专利申请公布2016/0089147;
-名称为“SURGICAL STAPLE AND DRIVER ARRANGEMENTS FOR STAPLECARTRIDGES”的美国专利申请序列号14/498,105;现为美国专利申请公布2016/0089148;
-名称为“FASTENER CARTRIDGE FOR CREATING A FLEXIBLE STAPLE LINE”的美国专利申请序列号14/498,121;现为美国专利申请公布2016/0089141;
-名称为“METHOD FOR CREATING A FLEXIBLE STAPLE LINE”的美国专利申请序列号14/498,145;现为美国专利申请公布2016/0089142;以及
-名称为“SURGICAL STAPLING BUTTRESSES AND ADJUNCT MATERIALS”的美国专利申请序列号14/498,107;现为美国专利申请公布2016/0089143。
本申请的申请人还拥有2013年11月26日发布的名称为“STAPLE CARTRIDGECAVITY CONFIGURATIONS”的美国专利8,590,762,该专利全文以引用方式并入本文。
本申请的申请人还拥有2014年5月20日发布的名称为“STAPLE CARTRIDGE CAVITYCONFIGURATION WITH COOPERATIVE SURGICAL STAPLE”的美国专利8,727,197,该专利全文以引用方式并入本文。
本文列出了许多具体细节,以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件,以免使说明书中描述的实施方案模糊不清。读者将会理解,本文所述和所示的实施方案为非限制性示例,从而可认识到,本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求的范围的情况下,可对这些实施方案进行变型和改变。
术语“包括(comprise)”(以及“包括(comprise)”的任何形式,诸如“包括(comprises)”和“包括(comprising)”)、“具有(have)”(以及“具有(have)”的任何形式,诸如“具有(has)”和“具有(having)”)、“包含(include)”(以及“包含(include)”的任何形式,诸如“包含(includes)”和“包含(including)”)、以及“含有(contain)”(以及“含有(contain)”的任何形式,诸如“含有(contains)”和“含有(containing)”)为开放式系动词。因此,“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件,但不限于仅具有这些一个或多个元件。同样,“包括”、“具有”、“包含”或“含有”一个或多个特征部的系统、装置、或设备的元件具有那些一个或多个特征部,但不限于仅具有那些一个或多个特征部。
术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分,术语“远侧”是指远离临床医生定位的部分。还应当理解,为简洁和清楚起见,本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而,外科器械在许多方向和位置中使用,并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以用于执行腹腔镜式和微创外科手术操作。然而,读者将容易理解,本文所公开的各种方法和装置可用于多种外科程序和应用中,包括例如与开放式外科程序结合。继续参阅本具体实施方式,读者将进一步理解,本文所公开的各种器械能够以任何方式插入体内,诸如通过自然腔道、通过成形于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可直接插入患者体内或者可通过具有工作通道的进入装置插入,外科器械的端部执行器和细长轴可通过所述工作通道推进。
外科缝合系统可包括轴和从轴延伸的端部执行器。端部执行器包括第一钳口和第二钳口。第一钳口包括钉仓。钉仓能够插入到第一钳口中并且能够从第一钳口移除;然而,设想到其中钉仓不能够从第一钳口移除或至少能够易于从第一钳口替换的其他实施方案。第二钳口包括被构造成能够使从钉仓射出的钉变形的砧座。第二钳口能够相对于第一钳口围绕闭合轴线枢转;然而,设想到其中第一钳口能够相对于第二钳口枢转的其他实施方案。外科缝合系统还包括被构造成能够允许端部执行器相对于轴旋转或进行关节运动的关节运动接头。端部执行器能够围绕延伸穿过关节运动接头的关节运动轴线旋转。设想了不包括关节运动接头的其他实施方案。
钉仓包括仓体。仓体包括近侧端部、远侧端部和在近侧端部与远侧端部之间延伸的平台。在使用中,钉仓被定位在待缝合的组织的第一侧上,并且砧座被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。三排钉腔被定位在纵向狭槽的第一侧上且三排钉腔被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示出了可操作地联接到马达驱动的柄部组件1000的可互换外科工具组件500的一种形式。工具组件1000也可有效地与机器人控制的或自动化外科系统的工具驱动组件一起使用。例如,本文所公开的外科工具组件可与各种机器人系统、器械、部件和方法诸如但不限于名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利9,072,535中公开的那些一起使用,该专利申请据此全文以引用方式并入本文。柄部组件500以及机器人系统的工具驱动组件在本文中也可称为“控制系统”或“控制单元”。
图2示出了可互换外科工具组件1000与柄部组件500的附接。柄部组件500可包括柄部壳体502,柄部壳体502包括可由临床医生抓持和操纵的手枪式抓持部分504。柄部组件500还可包括可操作地支撑多个驱动系统的框架506。例如,框架506可以可操作地支撑“第一”或闭合驱动系统(通常表示为510),其可用于将闭合和打开运动施加到可操作地附接或联接到柄部组件500的可互换外科工具组件1000。在至少一种形式中,闭合驱动系统510可包括被框架506枢转地支撑的闭合触发器512形式的致动器。这种布置使得闭合触发器512将能够由临床医生操纵,使得当临床医生抓持柄部组件500的手枪式抓持部分504时,闭合触发器512可容易从启动或“未致动”位置枢转到“致动”位置并且更具体地枢转到完全压缩或完全致动位置。在各种形式中,闭合驱动系统510还包括闭合连杆组件514,闭合连杆组件514可枢转地联接到闭合触发器512或以其他方式可操作地与闭合触发器512连接。如下面将进一步详细讨论的,在例示的示例中,闭合连杆组件514包括横向附接销516,其有利于附接到外科工具组件上的对应驱动系统。在使用中,为了致动闭合驱动系统510,临床医生将闭合触发器512朝向手枪式抓持部分504按压。如名称为“SURGICAL INSTRUMENTCOMPRISING A SENSOR SYSTEM”的美国专利申请序列号14/226,142(现为美国专利申请公布2015/0272575)(该专利申请据此全文以引用方式并入本文)中进一步详细描述的,当临床医生完全压下闭合触发器512以达到完全闭合行程时,闭合驱动系统510被构造成能够将闭合触发器512锁定到完全压下或完全致动的位置。当临床医生期望将闭合触发器512解锁以允许其被偏置到未致动位置时,临床医生只需激活闭合释放按钮组件518,这使得闭合触发器512能够返回到未致动位置。闭合释放按钮组件518还可被构造成能够与各种传感器交互,这些传感器与柄部组件500中的微控制器520通信以跟踪闭合触发器512的位置。关于闭合释放按钮组件518的构造和操作的进一步的细节可见于美国专利申请公布2015/0272575中。
在至少一种形式中,柄部组件500和框架506可以可操作地支撑在本文中被称为击发驱动系统530的另一个驱动系统,该驱动系统被构造成能够将击发动作施加到附接到其上的可互换外科工具组件的对应部分。如在美国专利申请公布2015/0272575中详细描述的,击发驱动系统530可以采用位于柄部组件500的手枪式抓持部分504中的电动马达505。在各种形式中,马达505例如可以是具有约25,000RPM的最大旋转的直流有刷驱动马达。在其他布置中,马达505可包括无刷马达、无绳马达、同步马达、步进马达或任何其它合适的电动马达。马达505可由功率源522供电,在一种形式中,该功率源可包括可移除电源组。电源组可将多个锂离子(“LI”)或其他合适的电池支撑在其中。多个电池可以串联连接,并且可用作柄部组件500的功率源522。之外,功率源522可以是可替换的和/或可再充电的。
电动马达505被构造成能够根据马达的极性在远侧和近侧方向上轴向驱动可纵向运动的驱动构件540。例如,当马达505在一个旋转方向上被驱动时,可纵向运动的驱动构件540将在远侧方向“DD”上被轴向地驱动。当马达505在相反的旋转方向上被驱动时,可纵向运动驱动构件540将在近侧方向“PD”上被轴向地驱动。柄部组件500可包括开关513,开关513可被构造成能够使通过功率源522施加到电动马达505的极性反转或以其他方式控制马达505。柄部组件500还可包括一个或多个传感器(未示出),其被构造成能够检测驱动构件540的位置和/或驱动构件540运动的方向。通过被可枢转地支撑在柄部组件500上的击发触发器532可控制马达505的致动。击发触发器532可在未致动位置和致动位置之间枢转。击发触发器532可被弹簧(未示出)或其他偏置构造偏置到未致动位置,使得当临床医生释放击发触发器532时,其可被弹簧或偏置构造枢转到或以其他方式返回到未致动位置。在至少一种形式中,击发触发器532可如上所述被定位在闭合触发器512的“外侧”。如美国专利申请公布2015/0272575中所讨论的,柄部组件500可配备有击发触发器安全按钮(未示出),以防止击发触发器532的无意致动。当闭合触发器512处于未致动位置时,安全按钮被容纳在柄部组件500中,在此情况下,临床医生不能容易地接近安全按钮并使安全按钮在防止击发触发器532的致动的安全位置和其中可击发击发触发器532的击发位置之间运动。在临床医生压下闭合触发器512时,安全按钮和击发触发器532可向下枢转,然后他们可被临床医生操纵。
在至少一种形式中,纵向可动驱动构件540可以具有形成在其上的齿条(未示出),其用于与连接到马达505的对应驱动齿轮装置(未示出)啮合。关于那些特征的进一步的细节可见于美国专利申请公布2015/0272575。至少一种形式还包括可手动致动的“救助”组件,所述组件能够允许临床医生在马达505变得停用的情况下手动地回缩可纵向运动的驱动构件540。救助组件可包括杠杆或救助柄部组件,其在可释放门550下方储存在柄部组件500内。杠杆被构造成能够被手动枢转成与驱动构件540中的齿棘轮接合。因此,临床医生可通过使用救助柄部组件手动地回缩驱动构件540,以使驱动构件540在近侧方向“PD”上做棘轮运动。名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117,现为美国专利申请公布2010/0089970(其全部公开内容据此以引用方式并入本文)公开了也可与本文公开的工具组件1000一起使用的救助装置和其他部件、装置和系统。
现在转向图4、图5和图6,可互换外科工具组件1000包括可操作地附接到细长轴组件1400的轴安装部分1300。包括细长通道1102的外科端部执行器1100可操作地附接到细长轴组件1400,细长通道1102被构造成能够将钉仓1110可操作地支撑在其中。参见图3和图4。端部执行器1100还可包括相对于细长通道1102被可枢转地支撑的砧座1130。细长通道1102钉仓组件1110和砧座1130也可以称为“钳口”。可互换外科工具组件1000还可包括关节运动接头1200和关节运动锁1210(图3和图4),其可被构造成能够将端部执行器1100围绕横向于轴轴线SA的关节运动轴线B-B可释放地保持在期望的关节运动位置。关于关节运动锁1210的构造与操作的细节可见于名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISINGAN ARTICULATION LOCK”的美国专利申请序列号13/803,086中,现为美国专利申请公布2014/0263541,其全部公开内容据此以引用方式并入本文。关于关节运动锁1210的另外细节也可见于2016年2月9日提交的名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISMWITH SLOTTED SECONDARY CONSTRAINT”的美国专利申请序列号15/019,196,其全部公开内容据此以引用方式并入本文。
如图5和6所示,轴安装部分1300包括近端外壳或喷嘴1301,该喷嘴由喷嘴部分1302、1304以及致动器轮部分1306组成,致动器轮部分被构造成能够通过按扣、凸耳、螺丝等联接到组装的喷嘴部分1302、1304。在例示的实施方案中,可互换外科工具组件1000还包括闭合组件1406,其可用于将砧座1130和端部执行器1100的细长通道1102闭合和/或打开,如将在下面进一步详述的那样。另外,例示的可互换外科工具组件1000包括可操作地支撑关节运动锁1210的脊组件1500。脊组件1500被构造成能够:第一,可滑动地支撑其中的击发构件组件1600;第二,可滑动地支撑围绕脊组件1500延伸或以换句话说由此运动地支撑的闭合组件1406。
在例示的布置中,外科端部执行器1100由关节运动接头1200可操作地联接到细长轴组件1400,该关节运动接头有助于外科端部执行器1100围绕横向于轴轴线SA的关节运动轴线B-B的选择性关节运动。参见图3。如图4所示,脊组件1500可滑动地支撑可操作地与关节运动锁1210连接的近侧关节运动驱动器1700。关节运动锁1210支撑在远侧框架段1560上,该远侧框架段也包括脊组件1500的一部分。如图4中可见,远侧框架段1560由端部执行器安装组件1230枢转地联接到细长通道1102。例如,在一种布置中,远侧框架段1560的远侧端部1562具有形成在其上的关节运动销1564。关节运动销1564适于枢转地接纳在形成于端部执行器安装组件1230的枢轴基础部分1232中的关节运动枢轴孔1234内。端部执行器安装组件1230通过一对侧向延伸的钳口附接销1235可枢转地附接到细长通道1102的近侧端部1103,所述一对侧向延伸的钳口附接销可旋转地容纳在设置在细长通道1102的近侧端部1103中的钳口枢轴孔1104内。钳口附接销1235限定基本上横向于轴轴线SA的钳口枢转轴线JA。参见图3。关节运动枢轴销1564限定横向于轴轴线SA的关节运动轴线B-B。这种布置便于端部执行器1100相对于脊组件1500围绕关节运动轴线B-B枢转地行进(即,关节运动)。
再次参见图4,在例示的实施方案中,关节运动驱动器1700具有远侧端部1702,该远侧端部被构造成能够可操作地接合关节运动锁1210。关节运动锁定件1210包括关节运动框架1212,该关节运动框架可枢转地联接到关节运动连接件1214,该关节运动连接件适于可操作地接合端部执行器安装组件1236的枢轴基座部分1232上的关节运动驱动销1230。如上所述,有关关节运动锁1210和关节运动框架1212的操作的更多细节可见于美国专利申请序列号13/803,086,美国专利申请公布2014/0263541。关于端部执行器安装组件和关节运动连接件1214的更多细节可见于2016年2月9日提交的名称为“SURGICAL INSTRUMENTSWITH CLOSURE STROKE REDUCTION ARRANGEMENTS”的美国专利申请序列号15/019,245,该专利申请的整个公开内容据此以引用方式并入本文。
在各种情况下,脊组件1500还包括近侧脊通道1510,该近侧脊通道可由压制的、弯曲的或机械加工的材料制成。如图6所示,(当从远侧端部观察时)近侧脊通道1510基本上为C形,并且被构造成能够用于在其侧壁部分1600之间可操作地支撑击发构件组件1512。如图6和图7所示,脊组件1500还包括近侧脊安装段1530,该近侧脊安装段通过脊销1514可旋转地固定到近侧脊通道1510的远侧端部1550。近侧脊安装段1530包括近端部分1532,该近端部分具有相对的凹口1535(在图7中仅可见一个),用于接收从每个喷嘴部分1302、1304向内突出的对应安装凸耳1308(如图5所示)。通过将喷嘴1301围绕轴轴线SA旋转,这种布置有利于近侧脊安装段1530围绕轴轴线SA的旋转。在例示的布置中,近侧脊安装段1530还包括朝远侧突出的下轴段1534和与下轴段1536间隔的朝远侧突出的上轴段1534。参见图7。轴段1534、轴段1536中的每一个具有弓形横截面形状。下轴段1534被容纳在近侧脊通道1514的近侧端部1510内。脊销1550延伸穿过近侧脊通道1510的近侧端部中的枢轴孔1516和下轴段1534中的枢轴孔1538。脊销1550包括形成两个直立侧壁部分1552的竖直沟槽1554。侧壁部分1554的上端被接纳在形成于近侧脊安装段1539中的对应凹坑1530内。
可互换外科工具组件1000包括可旋转地支撑轴组件1400的底座1800。近侧脊安装段的近端部分1532可旋转地支撑在形成于底座1800中的中心轴孔1801中。参见图6。在一种布置中,例如,近端部分1532可以是带螺纹的,用于附接到脊轴承(未示出)或以其他方式被支撑在安装在基础结构1800内的脊轴承中。这种布置有利于脊组件1500到底座1800的可旋转附接,使得脊组件1500可选择性地相对于底座1800围绕轴轴线SA旋转。
闭合组件1406包括细长中间闭合构件1410、远侧闭合构件1430和近侧闭合构件1480。在例示的布置中,近侧闭合构件1480包括可滑动地支撑在脊组件1500的一部分上的中空管状构件。因此,近侧闭合构件1480在本文中也可称为近侧闭合管。类似地,中间闭合构件1410在本文中也可以称为中间闭合管,并且远侧闭合构件1430也可以称为远侧闭合管。主要参见图6,可互换外科工具组件1000包括闭合梭动件1420,该闭合梭动件以可相对于底座1800轴向运动的方式可滑动地支撑在该底座内。在一种形式中,闭合梭动件1420包括一对向近侧突出的钩1421,它们被构造用于附接到附接销516(图2),该附接销附接到柄部组件500的闭合连杆组件514。因此,当钩1421钩在销516上时,闭合触发器512的致动将导致闭合梭动件1420的轴向运动,并最终导致闭合组件1406在脊组件1500上的轴向运动。闭合弹簧(未示出)也可轴颈连接在闭合构件组件1406上并且用于将闭合组件1406朝近侧方向“PD”偏压,这可在工具组件1000操作地联接到柄部组件500时用于将闭合触发器512枢转到未致动位置中。在使用中,闭合构件组件1406朝远侧(方向DD)平移,以例如响应于闭合触发器512的致动来将砧座1130闭合。
闭合连杆514在本文中也可称为“闭合致动器”,而且闭合连杆514和闭合梭动件1420在本文中可统称为“闭合致动器组件”。近侧闭合构件1480的近侧端部1482联接到闭合梭动件1420,以相对于闭合梭动件旋转。例如,将U形连接器1485插入近侧闭合构件1480的近侧端部1482中的环形狭槽1484中,使其保留在闭合梭动件1420中的竖直狭槽1422内。参见图6。此类布置用于将近侧闭合构件1480附接到闭合梭动件1420,以与闭合梭动件一起轴向行进,同时使得闭合组件1406能够围绕轴轴线SA相对于闭合梭动件1420旋转。
如上所述,例示的可互换外科工具组件1000包括关节运动接头1200。如图4所示,上柄脚1415和下柄脚1416从中间闭合构件1410的远侧端部向远侧突出,以可移动地联接到远侧闭合构件1430。如图4所示,远侧闭合构件1430包括从其近侧端部向近侧突出的上柄脚1434和下柄脚1436。中间闭合构件1410和远侧闭合构件1430由上部双枢轴连接件1220联接在一起。上部双枢轴连接件1220包括近侧销和远侧销,近侧销和远侧销分别接合近侧闭合构件1410和远侧闭合构件1430的上柄脚1415、1434中的对应孔。中间闭合构件1410和远侧闭合构件1430同样由下部双枢轴连接件1222联接在一起。下部双枢轴连接件1222包括近侧销和远侧销,近侧销和远侧销分别接合中间闭合构件1410和远侧闭合构件1430的下柄脚1416和1436中的对应孔。如下面将进一步详细讨论的,闭合组件1406的远侧和近侧轴向平移将导致砧座1130和细长通道1102的闭合和打开。
如上所述,可互换外科工具组件1000还包括击发构件组件1600,该击发构件组件被支撑以便在脊组件1500内轴向行进。在例示的实施方案中,击发构件组件1600包括近侧击发轴段1602、中间击发轴部分1610和远侧切割部分或远侧击发杆1620。击发构件组件1600在本文中也可被称为“第二轴”和/或“第二轴组件”。如图6所示,近侧击发轴段1602可形成有远侧安装凸耳1604,该远侧安装凸耳被构造成能够在中间击发轴段1610的近侧端部1612中被接纳在相应的支架或沟槽1613内。近侧附接凸耳1606从近侧击发轴段1602的近侧朝近侧突出,并且被构造成能够可操作地接纳在被支撑在柄组件500中的纵向可移动驱动构件540中的击发轴附接支架542内。参见图2。
再次参见图6,中间击发轴段1610的远侧端部1616包括纵向狭槽1618,该纵向狭槽被构造成能够接收远侧击发杆1620的近侧端部上的接片(未示出)。纵向狭槽1618和远侧击发杆1620的近侧端部可被设定尺寸并被构造成能够使得其允许它们之间的相对运动并且可包括滑动接头1622。滑动接头1622可以允许近侧击发轴段1602和近侧中间击发轴部分1610的击发构件组件1600作为一个单元在关节运动动作期间移动,而不移动或至少基本上不移动远侧击发杆1620。一旦端部执行器1100已合适地取向,近侧击发轴段1602和中间击发轴段1610便可朝远侧推进,直到纵向狭槽1618的近侧端壁与远侧击发杆1620上的插片发生接触,以便推进远侧击发杆1620并击发定位在细长通道1102内的钉仓1110。如图6进一步所示,为了便于组装,近侧击发轴段1602、中间击发轴段1610和远侧击发杆1620可作为一个单元被插入近侧脊通道1510中,并且顶部脊盖1527可与近侧脊通道1510接合,以将击发构件组件1600的那些部分包封在其中。
除上述之外,可互换外科工具组件1000包括离合器组件1640,该离合器组件可被构造成能够选择性地且可释放地将关节运动驱动器1700联接到击发构件组件1600。在一种形式中,离合器组件1640包括旋转锁定组件,在至少一个实施方案中,该旋转锁定组件包括围绕击发构件组件1650定位的锁定衬圈或锁定套筒1600。锁定套筒1650被构造为在接合位置和脱离位置之间旋转,在接合位置,锁定套筒1650将关节运动驱动器1700联接到击发构件组件1600,在脱离位置,关节运动驱动器1700未操作地联接到击发构件组件1600。当锁定套管1650处于其接合位置时,击发构件组件1600的远侧移动可以使关节运动驱动器1700朝远侧移动,相应地,击发构件组件1600的近侧移动可以使关节运动驱动器1700朝近侧移动。当锁定套管1650处于其脱离位置时,击发构件组件1600的移动不传递到关节运动驱动器1700,因此,击发构件组件1600可以独立于关节运动驱动器1700移动。在各种情况下,当击发构件组件1600未在近侧方向或远侧方向上移动关节运动驱动器1700时,关节运动驱动器1700可以由关节运动锁1210保持在适当的位置。
主要参考图8和图9,锁定套筒1650包括圆柱形或至少基本上圆柱形的主体,该主体包括限定在其中的纵向孔1652,该纵向孔被构造成能够接收击发构件组件1600的近侧击发轴段1602。锁定套筒1650还具有形成于其上的两个沿直径相对的、面向内的锁定突起部1654。在图8和图9中只能看到一个锁定突起部1654。锁定突起1654可被构造成选择性地与击发构件组件1600的近侧击发轴段1602接合。更具体地,当锁定套筒1650处于其接合位置时(图8),锁定突起部1654被定位在设置于近侧击发轴段1602中的驱动凹口1603内,使得远侧推力和/或近侧推力可从击发构件组件1600传递至锁定套筒1650。如图8和图9所示,关节运动驱动凹口1655设置在锁定套筒1650的远端部分中,以附接到近侧关节运动驱动器1704的近侧端部1700。在例示的布置中,例如,近侧端部1704包括驱动器凹口1706,该驱动器凹口被构造成能够接合锁定套筒1655中的驱动凹口1650。这种附接布置使得锁定套筒1650能够相对于近侧关节运动驱动器1700旋转,同时保持附接到其上。当锁定套筒1650处于“关节运动模式”或取向时(图8),施加到近侧击发轴段1602的远侧推动力和/或近侧拉力也被传递到锁定套筒1650和联接到其上的近侧关节运动驱动器1700。实际上,当锁定套筒1650处于关节运动模式时,击发构件组件1600、锁定套筒1650和近侧关节运动驱动器1700将一起运动。另一方面,当锁定套筒1650处于其“击发模式”时(图9),锁定突起部1654不定位在击发构件组件1603的近侧击发轴段1602中的驱动凹口1600内。当处于该位置时,施加到近侧击发轴段1602的远侧推动力和/或近侧拉力不传输到锁定套筒1650和近侧关节运动驱动器1700。在此类情况下,击发构件组件1600可相对于锁定套筒1650和近侧关节运动驱动器1700朝近侧和/或朝远侧移动。
所示的离合器组件1640还包括与锁定套筒1650接合的切换筒1660。切换筒1660包括中空轴段,该中空轴段与支撑在其中的换档板组件1680可操作地交接。换档板组件1680包括主体部分1681,该主体部分具有从其横向突出的换档销1682。换挡销1682延伸到换挡销狭槽1662中,该换挡销狭槽穿过换挡筒1660的壁部分设置。换挡板组件1680的主体部分1681具有形成在其中的滑动狭槽1683,该滑动狭槽的尺寸和构造被设置成与从滑动锁定件1650的近侧端部突出的滑动凸台1656交接。切换筒1660还可以包括开口1664,该开口允许向内延伸的安装凸耳1308从喷嘴半块1302、1304延伸以延伸穿过其中,以便座置成被接纳在近侧脊安装段1530中的对应凹口1535内。参见图5。通过旋转喷嘴1301,这种布置有利于轴组件1400围绕轴轴线SA的旋转。
同样在所示实施方案中,切换筒1660包括磁体支撑臂1665,该磁体支撑臂支撑关节运动磁体1708和其中的击发磁体1611。关节运动磁体1708和击发磁体1611被构造成能够与霍尔效应传感器1632可操作地交接,该霍尔效应传感器与可操作地安装到基础结构1630的滑环组件1800交接。例如,滑环组件1630被构造成能够将电力传导到可互换外科轴组件1000和/或从可互换外科轴组件传导电力和/或将信号传递到可互换外科轴组件1000和/或从可互换外科轴组件部件传送回柄部组件500中的微控制器520(图2)或机器人系统控制器。关于滑环组件1630和相关联的连接器的进一步细节可以在美国专利申请序列号13/803,086和美国专利申请序列号15/019,196(这两个专利申请的相应全部内容各自以引用方式并入本文)以及名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利申请序列号13/800,067(现为美国专利申请公布2014/0263552)中找到,其全部内容据此以引用方式并入本文。关节运动磁体1708和击发磁体1611与霍尔效应传感器1632或其他传感器装置配合以检测切换筒1660的旋转位置并将该信息传送到微控制器520,微控制器可用于以在上述并入的参考文献中讨论的各种方式向使用者提供一个或多个指示。也可采用其他传感器布置。
在各种情况下,柄部组件500可用于控制被构造成能够执行各种外科手术的各种不同的可互换外科工具组件。如上文简要提及的,可互换外科工具组件1000还可以有效地与机器人系统和自动外科系统结合使用,每个机器人系统和自动外科系统在本文中可以称为“控制系统”或“控制单元”。这种控制系统或控制单元可以可操作地支撑击发系统和闭合系统,所述击发系统和闭合系统被配置成在致动时移动击发致动部件或“击发致动器”(在击发系统的情况下)和闭合致动部件或“闭合致动器”(在闭合系统的情况下)对应的轴向距离,以将控制运动施加到可互换工具组件内的对应部件。在一种布置中,当柄部组件(或机器人系统)中的闭合系统被完全致动时,闭合致动器可从未致动位置轴向移动至其完全致动位置。闭合部件在其未致动位置和其完全致动位置之间移动的轴向距离在本文中可称为其“闭合行程长度”或“第一闭合距离”。相似地,当柄部组件或机器人系统中的击发系统被完全致动时,击发系统部件中的一个可从其未致动位置轴向移动至其完全致动或击发位置。击发构件部件在其未致动位置和其完全击发位置之间移动的轴向距离在本文中可称为其“击发行程长度”或“第一击发距离”。对于采用可关节运动的端部执行器布置的那些外科工具组件,柄部组件或机器人系统可采用轴向移动穿过“关节运动驱动行程长度”或“关节运动距离”的关节运动控制部件。在许多情况下,闭合行程长度、击发行程长度和关节运动驱动行程长度对于特定柄部组件或机器人系统而言是固定的。因此,被构造成能够与此类控制单元或系统结合使用的可互换外科工具组件中的每一个必须能够适应闭合、击发和/或关节运动部件/致动器穿过各自的整个行程长度的控制运动,而不会对外科工具组件施加过度的应力,过度的应力可能导致外科工具组件的损坏或重大损伤。具有用于减小致动器系统的轴向闭合行程的装置的外科工具组件的示例公开于2016年2月9日提交的名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTION ARRANGEMENTS”的美国专利申请序列号15/019,245中,该专利申请的整个公开内容据此以引用方式并入本文。名称为“SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR ANDMEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER”的美国专利申请序列号14/574,478公开了用于调节击发构件的击发行程的装置。
取决于可操作地联接到柄部组件500的可互换外科工具组件的端部执行器部分的钳口结构,柄部组件510中的闭合驱动系统500在被完全致动时,可产生对于此类钳口布置而言过长的闭合行程或第一轴向闭合距离。可互换外科工具组件1000的所示实施方案采用总体标记为1720的闭合行程减小组件,以减少当闭合驱动系统510完全致动时施加到端部执行器的闭合行程的量。例如,处于柄部组件510的一种形式的闭合驱动系统500可产生轴向闭合运动,以使闭合致动器(例如,闭合连杆514-图2)或闭合致动器组件(例如,闭合连杆514和闭合梭动件1420)轴向向前和向后移动约0.240“-0.260”。此类轴向控制行程可非常适合于外科端部执行器,该外科端部执行器配备有相对于它们所附接到的通道或钳口排布结构朝远侧移动的砧座或钳口结构。因为钳口围绕固定的钳口轴线JA枢转地联接在一起,所以它们可更适于较短的闭合行程。换句话讲,砧座1130不会相对于细长通道1102朝远侧移动。例如,这种布置可能更适合于约0.1“-0.150”的闭合行程范围。如下面将进一步详细讨论的,当闭合驱动系统510在柄部组件500中完全致动时,闭合梭动件1420和近侧闭合构件1480可在远侧方向DD上移动约0.260英寸(“第一闭合行程距离”)。然而,闭合行程减小组件1720减少施加到中间闭合构件1410并最终施加到远侧闭合构件1430的闭合行程的量(“闭合行程距离”)。在一些布置中,例如,闭合行程减小组件1720可将施加到中间闭合构件1410和远侧闭合构件1430的闭合行程的大小减小至例如约0.1”。应当理解,可设想实现其他量的闭合行程减小。
现在参考图12A和图12B,在一种形式中,闭合行程减小组件1720包括附接到闭合构件安装构件或安装环1730的闭合减小连杆1740。如图6、图12A和图12B所示,中间闭合构件1410具有在近端部分1414上形成的近侧附接凸缘1412。安装环1740的尺寸被设计成可滑动地在近侧闭合构件1480内移动,并且包括用于在其中接纳附接凸缘1742的安装沟槽1414。此类布置用于将安装环1740附接到中间闭合构件1410。在例示是实施方案中,闭合减小连杆1730包括通过致动销1736可枢转地附接在一起的近侧连接件1732和远侧连接件1734。近侧连接件1732可枢转地固定到形成在近侧脊通道1518上的直立附接壁1510。远侧连接件1734可枢转地固定到安装环1740。闭合减小连杆1730通过轴向移动近侧闭合构件1480而致动。在至少一个布置中,例如,致动器销1736可滑动地轴颈安装在设置在近侧闭合构件1480中的凸轮槽1486中。致动器销1736也向内延伸以可滑动地被接纳在形成于锁定套筒1658的近端部分上的滑动轨道1650内。因此,当近侧闭合构件1480运动到其最远侧位置时,致动器销1736在凸轮狭槽1486的近侧端部中,使得闭合减少连杆1730处于其完全延伸的位置,如图12B和图14所示。当近侧闭合构件1480处于其最近侧位置时,闭合减小连杆1730处于其回缩位置(图12A和图13)。
如上所简述,换档板组件1680包括主体部分1681,该主体部分具有从其横向突出的换档销1682。换挡销1682延伸到换挡销狭槽1662中,该换挡销狭槽穿过切换筒1660的壁部分设置。换挡销1682还延伸穿过设置在近侧闭合构件1480中的凸轮开口1490。参见图10和图11。所示布置中的凸轮开口1490包括行进部分1492,该行进部分足够长以允许近侧闭合构件组件1480相对于换挡销1682和击发部分1494的预定量的轴向行进。在至少一种布置中,换挡板1680被约束为仅绕轴轴线SA旋转短距离并且被约束为不在切换筒1660内轴向移动。可参考图8至图11观察换挡板1680和换挡销1682的这种旋转行程。
图8、图10和图12A示出处于关节运动模式的离合器组件1640,并且图9、图11和图12B示出处于击发模式的离合器组件1640。离合器组件1640通过将近侧闭合构件1480移动到其最远侧位置而从关节运动模式移动到击发模式,该最远侧位置对应于端部执行器钳口(细长通道1102和砧座1130)的“完全闭合”位置。近侧闭合构件1480通过压下柄部组件512上的闭合触发器500而朝远侧移动。如上所述,当闭合触发器512被压下时,闭合梭动件1420朝远侧推进。因为近侧闭合构件1480被支撑在闭合梭动件1420中,所以近侧闭合构件1480也朝远侧移动。当离合器组件1640处于关节运动模式时,换挡销1682围绕近侧闭合构件1492中的凸轮开口1490的行进部分1480在中间(纵向)定位。因此,近侧闭合构件1480可(通过压下和至少部分地释放闭合触发器512)轴向地来回移动一小段距离,以有效地使钳口(砧座1130和细长通道1102)在打开和关闭位置之间移动,而不将离合器组件1640移动到击发模式。因此,临床医生可使用钳口来抓握和操纵组织,而不将钳口移动至完全闭合位置,并且不将离合器组件1640移动至击发模式。然而,当临床医生想要完全闭合钳口时,临床医生将闭合触发器512完全压下至完全致动位置。此动作会引起近侧闭合构件1480移动到其最远侧轴向位置。参见图9、图11和图12B。当近侧闭合构件1480移动到该位置时,凸轮开口1491的近侧凸轮壁1490接触换挡销1682并且将换挡销1682(和换挡板1680)凸轮移动至图9和图11中所示的击发取向。在例示的实施方案中,扭转变速弹簧1667被轴颈连接在切换筒1660上并且被构造成能够将切换筒1660偏置到对应于关节运动模式的位置。参见图10。换挡销1682位于切换筒1660中的换挡销狭槽1662的底部,并且由此移动到图10所示的关节运动位置。为了将扭转偏置力施加到切换筒1660,扭转弹簧1668的一个端部1667附接到开关筒1660,并且另一个端部1669附接到喷嘴1301。下文提供了关于离合器组件1640和闭合行程减小组件1720的操作的更多细节。
图12A示出了当近侧闭合构件1730处于未致动位置时闭合行程减小组件1410和中间闭合构件1480的位置。该“未致动”位置可对应于钳口处于其各自的“完全打开”位置时外科端部执行器的钳口的取向。出于参考目的,近侧闭合构件1480的未致动位置由起始见证线SWLp表示,并且中间闭合构件1410的未致动位置由起始见证线SWLi表示。图12B示出当近侧闭合构件1480处于完全致动位置时闭合行程减小组件1730和中间闭合构件1410的位置,该完全致动位置可对应于钳口处于其各自的“完全闭合”位置时外科端部执行器的钳口的取向。如上所述,当近侧闭合构件1480处于完全致动位置时,击发触发器532的致动将导致击发构件组件1600朝远侧推进。出于参考目的,近侧闭合段1480的完全致动位置由结束见证线EWLp表示。中间闭合构件1410的完全致动位置由结束见证线EWLi表示。近侧闭合构件1480在未致动位置和完全致动位置之间行进的轴向距离由距离D1表示。在一个示例中,D1可为约0.260”。中间闭合构件1410(以及最终远侧闭合构件1430)在未致动位置和完全致动位置之间行进的轴向距离由距离D2表示。如图12A和12B所示,D1>D2。在上面引用的示例中,D2可为约0.1”。因此,中间闭合构件1410和远侧闭合构件1430行进的轴向距离比近侧闭合构件1480的轴向距离短。这种布置允许外科端部执行器1100的钳口布置更好地利用由柄部组件500中的闭合驱动系统510产生的闭合运动,并且避免当将全部闭合运动施加于端部执行器时可能导致的潜在损坏。
再次参见图2和图6,底座1800包括在其上形成的至少一个、优选地两个锥形附接部分1802,该锥形附接部分适于被接收在对应的燕尾形狭槽507内,所述燕尾形狭槽在柄部组件500的框架506的远端部分内形成。如可在图2中进一步所见,轴附接耳状物1606在近侧击发轴段1602的近侧端部上形成。如将在下文进一步详细讨论的,当可互换外科工具组件1000联接到柄部组件500时,轴附接耳状物1606被接纳在击发轴附接支架542中,该击发轴附接支架形成在纵向驱动构件540的远侧端部中。参见图2。
可互换外科工具组件1000采用闩锁系统1810,用于将可互换外科工具组件1000可拆卸地联接到柄部组件500的框架506。如可在图5中所见,例如,在至少一种形式中,闩锁系统1810包括可动地联接到底盘1800的锁构件或锁轭1812。在例示的实施方案中,例如,锁轭1812为U形,并且包括两个向下延伸的支脚1814。支脚1814各自具有在其上形成的枢轴耳状物(未示出),这些枢轴耳状物适于被接收在底座1800中形成的对应孔1816中。此类构造有利于将锁定轭1812枢转附接到底座1800。参见图6。锁定轭1812可包括两个朝近侧突起的锁定耳状物1818,这两个锁定耳状物被构造成能够与柄部组件500的框架506的远侧端部中的对应锁定棘爪或凹槽509可释放地接合。参见图2。在各种形式中,锁定轭1812被弹簧或偏置构件1819沿近侧方向偏置。锁定轭1812的致动可通过可滑动地安装在闩锁致动器组件1822上的闩锁按钮1820来实现,该闩锁致动器组件安装到底盘1800。闩锁按钮1820可相对于锁轭1812沿近侧方向偏置。可以通过在远侧方向上偏压闩锁按钮1820而使锁定轭1812移动到解锁位置,这也使锁定轭1812枢转成不再与框架506的远侧端部保持接合。当锁定轭1812与框架506的远侧端部“保持接合”时,锁定耳状物1818保持坐置在框架506的远侧端部中对应的锁定止动器或凹槽509内。
在所示的布置中,锁定轭1812包括至少一个且优选地两个锁定钩1824,这些锁定钩适于接触在闭合梭动件1420上形成的对应锁定耳状物突起1426。当闭合梭动件1420处于未致动位置时,锁定轭1812可沿远侧方向枢转以将可互换外科工具组件1000从柄部组件500解锁。当处于该位置时,锁定钩1824不接触闭合梭动件1420上的锁定耳状物部分1426。然而,当闭合梭动件1420移动到致动位置时,防止锁定轭1812枢转到解锁位置。换句话讲,如果临床医生试图将锁定轭1812枢转到解锁位置,或者例如,锁定轭1812不经意地以原本可能引起其朝远侧枢转的方式受到碰撞或发生接触,则锁定轭1812上的锁定钩1824将接触闭合梭动件1420上的锁定耳状物1426,并且防止锁定轭1812运动到解锁位置。参见图5。有关闩锁系统的更多细节可见于美国专利申请公布2014/0263541。
现在将参照图2描述可互换外科工具组件1000与柄部组件500的附接。要开始联接过程,临床医生可将可互换外科工具组件1000的底座1800定位在框架506的远侧端部上方或附近,使得底座1800上形成的锥形附接部分1802与框架506中的燕尾形狭槽507对准。然后临床医生可将外科工具组件1000沿垂直于轴轴线SA的安装轴线IA运动,以使锥形附接部分1802安置成与框架506的远侧端部中的对应燕尾形接收狭槽507“可操作地接合”。这样做时,近侧击发轴段1602上的轴附接耳状物1606也将安置在可纵向运动的驱动构件540中的支架542中,并且闭合连接件514上的销516的部分将安置在闭合梭动件1420中的对应钩1421中。如本文所用,术语“可操作地接合”在两个部件的背景下是指这两个部件彼此充分地接合,使得一旦向其施加致动运动,这些部件便可以执行其预期行动、功能和/或程序。
再次参见图4,远侧击发杆1620可包括层压梁结构,该层压梁结构包括至少两个梁层。这些梁层可包括例如不锈钢带,这些带通过例如在其近侧端部和/或沿其长度的其他位置处焊接或钉扎而互连在一起。在另选的实施方案中,这些带的远侧端部不连接在一起,以允许层压体或带在端部执行器进行关节运动时相对于彼此展开。这种布置允许远侧击发杆1620足够柔韧以适应端部执行器的关节运动。各种层压刀杆布置公开于美国专利申请序列号15/019,245中。如同样在图4中可见,中间支撑构件1614用于在远侧击发杆1620弯曲时为远侧击发杆提供侧向支撑,以适应外科端部执行器1100的关节运动。关于中间支撑构件和另选刀杆支撑布置的进一步细节在美国专利申请序列号15/019,245中公开。
在可互换外科工具组件1000已可操作地联接到柄部组件500(图1)之后,临床医生可如下操作外科工具组件10。如上所述,当闭合驱动系统510处于其未致动位置时(即,闭合触发器512未被致动),扭转弹簧1667已偏置离合器组件1640,更具体地,偏置切换销1682和锁定套筒1650进入关节运动位置。参见图8、图10和图12A。如图8所示,当处于该位置时,锁定套筒1654中的锁定突起部1650被接纳在近侧击发轴段1603中的驱动凹口1602内。如图10所示,当处于该模式时,关节运动磁体1708相对于霍尔效应传感器1632处于适当位置,以便向微控制器520指示工具组件1000处于关节运动模式。当临床医生致动击发触发器512时,马达将近侧击发轴段1602向远侧驱动。然而,如上所述,滑动接头1622有利于近侧击发轴段1602和中间击发轴部分1610的移动,而不移动或至少基本上不移动远侧击发杆1620。因为锁定套筒1650与近侧击发轴段1602可操作地接合并且近侧关节运动驱动器1700与锁定套筒1650接合,近侧击发轴段1602的致动导致关节运动驱动器1700的远侧运动。关节运动驱动器1700的远侧运动使得外科端部执行器1000围绕关节运动轴线B-B进行关节运动。在此期间,临床医生还可以通过部分地按压闭合触发器来使端部执行器1100的钳口部分地闭合。近侧闭合构件1480的这种轴向运动而不自动将离合器组件1640移位到击发模式由近侧闭合构件1492中的凸轮开口1490的行进部分1480容纳。参见图10。该特征使临床医生能够在夹紧到目标组织上之前使用钳口来抓握和操纵组织。
一旦临床医生将端部执行器1100关节运动到期望位置并且钳口已经相对于目标组织定位在期望的取向,临床医生就释放击发触发器532,这将中断近侧击发轴段1602以及近侧关节运动驱动器1700的机动运动。关节运动锁1210将近侧关节运动驱动器1700锁定在该位置,以防止端部执行器1100的进一步关节运动。临床医生可以通过将闭合触发器512按压到完全按下位置来将目标组织夹在钳口之间。这种动作使近侧闭合构件1480向远侧移动。当近侧闭合构件1480与凸轮壁1491接触时,该近侧闭合构件的这种远侧运动使得切换销1682在凸轮开口1490内向下旋转。参见图11。现在参见图11,换挡销1682在凸轮开口1490内的向下移动导致换挡板1680旋转锁定套筒1650以旋转至与近侧击发轴段1602脱离的位置。当处于该位置时,锁定突起1654已经从近侧击发轴段1602中的驱动凹口1603脱离。因此,近侧击发轴段1602可以轴向移动而不会移动锁定套筒1650和近侧关节运动驱动器1700。当近侧闭合构件1480(通过压下闭合触发器512)朝远侧运动到完全致动位置时,闭合行程减小组件1730使中间闭合构件1410朝远侧移动减小的轴向距离,如上所述。这种轴向运动被施加到远侧闭合构件1430,并且最终将钳口移动至完全闭合位置。当处于该位置时,柄部组件500中的闭合驱动系统510系统可以被锁定,并且临床医生可以释放闭合触发器512。当离合器组件1640已移动至该击发模式时,击发磁体1611与霍尔效应传感器1632连通,以指示离合器组件1640相对于微控制器520的位置。参见图11。微控制器520可以向临床医生提供远侧击发杆1620在向远侧推进穿过夹在端部执行器钳口之间的目标组织时的位置的指示。一旦远侧击发杆1620并且更具体地附接到其上的击发构件或刀构件已经前进到完全击发位置,微控制器520利用传感器布置检测击发构件组件1600的一部分的位置,然后可以使马达反转以使远侧击发杆1620回缩到其起始位置。该动作可以是自动的,或者临床医生可能必须在回缩过程中按下击发触发器532。一旦远侧击发杆1620已完全回缩到其起始位置,微控制器520可向临床医生提供远侧击发杆1620已完全回缩的指示,并且闭合扳机512可被解锁以使闭合组件1406能够返回到未致动位置,从而将钳口移动到打开位置。
在图15A和图15B所示的实施方案中,砧座组件1130包括砧座主体部分1132和砧座安装部分1134。砧座安装部分1134包括一对砧座安装壁1136,其由狭槽1138(图4)分开。砧座安装壁1136通过直立的接片部分1139互连或桥接。如上所述,端部执行器安装组件1230通过一对侧向延伸的钳口附接销1235可枢转地附接到细长通道1102的近侧端部1103,所述一对侧向延伸的钳口附接销可旋转地容纳在设置在细长通道1102的近侧端部1103中的钳口枢轴孔1104内。钳口附接销1235限定基本上横向于轴轴线SA的固定钳口枢转轴线JA。参见图4。砧座安装壁1136中的每一个具有延伸穿过其中的安装孔1140,以使砧座安装部分1134能够枢转地轴颈连接在钳口附接销1235上。因此,在这种布置中,砧座1130和细长通道1102可围绕固定钳口枢转轴线JA独立地枢转。这种布置可允许砧座1130和细长通道1102(“钳口”)打开至可比其他端部执行器装置的钳口可获得的那些打开位置更宽的位置,其中只有一个钳口相对于另一个钳口移动。
仍然参见图15A和图15B,远侧闭合构件1430包括两个向内延伸的钳口开口销1432,这两个向内延伸的钳口开口销适于延伸穿过设置在细长通道1102的近侧端部1103中的对应的通道开口凸轮狭槽1106。每个钳口开口销1432被构造成能够接合形成在每个砧座安装壁1142上的对应的砧座开口凸起表面1136。如图15A和图15B所示,砧座开口凸起表面1142与对应的通道开口凸轮狭槽1106相对或以相反的构型布置。换句话讲,通道开口凸轮狭槽1106和砧座开口凸起表面1142沿彼此相反的方向弯曲。
图15A示出砧座1130和处于完全闭合位置的细长通道1102(“钳口”)。当远侧闭合构件1430朝远侧推进时,远侧闭合构件1431的远侧端部1430向上行进至形成在砧座安装壁1137中的每一个上的闭合凸起表面1136,以及形成在细长通道1108的近侧端部1103上的闭合凸起表面1102。当远侧闭合构件1430的远侧端部1431凸轮接触闭合凸起表面1137、1108时,砧座1130以及细长通道1102都围绕钳口枢转轴线JA枢转到闭合位置,此时远侧闭合构件1430的远侧端部1431接触在砧座安装部分1134和砧座主体部分1132之间形成的凸缘部分1133以及在细长通道上的凸缘1145。参见图15A。当闭合构件组件1400被锁定就位时,远侧闭合构件1430将砧座1130和细长通道1102保持在该闭合位置。当临床医生期望将砧座1130和细长通道1102移动到打开位置时,远侧闭合构件1430沿近侧方向PD移动。当远侧闭合构件1430在近侧方向PD上移动时,钳口开口销1432接合对应的通道开口凸轮狭槽1106和砧座开口凸起表面1142,并且将砧座1130和细长通道围绕固定钳口轴线JA枢转至图15B所示的打开位置。这种使用远侧闭合构件上的特征销来实现两个钳口从完全闭合位置到完全打开位置的移动在本文中可称为“正向钳口打开”特征。其他正向钳口打开布置在名称为“SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING ARRANGEMENTS”的美国专利申请序列号14/742,925中公开,该申请全文以引用方式并入本文。
图16至图21示出了另选的远侧闭合构件1430',其采用例如可移动的钳口开口凸轮1440形式的另选的正向钳口开口特征部,该可移动的钳口开口凸轮附接到远侧闭合构件1430'以代替钳口开口销。至少一个并且优选两个钳口开口凸轮1440通过对应的可拉伸联接器1430可移动地附接到远侧闭合构件1450'。在例示的实施方案中,联接器1450包括凸轮或拉伸弹簧。在例示的布置中,拉伸弹簧1454包括平坦弹簧以节省空间。每个拉伸弹簧1450的近侧端部都具有形成于其上的钩1452,所述钩延伸穿过远侧闭合构件1442'中的开口1430。每个钩1452的端部都可以被安置在形成于远侧闭合构件1444'中的对应狭槽或沟槽1430中,如图16所示。每个拉伸弹簧1455的远侧端部1454都附接到对应的钳口开口凸轮1440。细长通道1103的近侧端部1102包括一对弹簧间隙狭槽1106'和被构造成能够由钳口开口凸轮1440接合的通道开口凸起表面1107。在另选的布置中,弹簧可包括最大延伸特征部,这些最大延伸特征部仅允许预先确定的量的顺应量,然后确保与剩余闭合触发器行进成比例的钳口开口,从而确保闭合梭动件的运动。如上所述,每个砧座安装壁1136具有形成在其上的砧座开口凸起表面1142。如图19所示,砧座开口凸起表面1142与对应的通道开口凸起表面1107相对或以相反的构型布置。换句话讲,通道开口凸起表面1107和砧座开口凸起表面1142是弧形的并且沿相反方向弯曲。
图20和图21示出砧座1130和细长通道1102处于其各自的完全打开位置。如这些附图中的每一个图所示,钳口开口凸轮1440在对应的砧座开口凸起表面1142和通道开口凸起表面1107之间取向并且处于其最近侧位置。当处于完全打开位置时,钳口开口凸轮1440位于远侧闭合构件1430'的远侧端部的远侧。如图19和图20所示,钳口开口凸轮1440可为楔形的。在至少一种布置中,楔形几何形状在近侧上具有渐变的凸起表面以防止钳口之间的偏置。当处于该完全打开位置时,拉伸弹簧1454处于其起始位置,其中拉伸弹簧1454将其最小偏置力施加到钳口开口凸轮1440中的每一个。在闭合过程开始时,远侧闭合构件1430'以本文所述的各种方式朝远侧推进。当远侧闭合构件1430'朝远侧推进时,远侧端部1431接触砧座安装部分1137上的闭合凸起表面1134和在细长通道1108的近侧端部1103上形成的闭合凸起表面1102,以围绕枢转钳口轴线JA使砧座1130和细长通道1102朝彼此枢转。当砧座1130和细长通道1102朝彼此枢转时,横跨在凸起表面1440和1142上的钳口开口凸轮1104在远侧方向上被驱动。当钳口开口凸轮1440被朝远侧驱动时,拉伸弹簧1454是细长的且“负载的”。
图18和图19示出处于其完全闭合位置的砧座1130和细长通道1102。当临床医生想要将砧座1130和细长通道1102返回至其完全打开位置(图20和图21)时,远侧闭合构件1430'在近侧方向上被抽出,这允许砧座1130和细长通道1102围绕枢转钳口轴线JA彼此远离地枢转。因为拉伸弹簧1454是细长的且是负载的,所以它们在近侧方向上拉动钳口开口凸轮1440中的每一个。当钳口开口凸轮1440在凸起表面1142和1107之间沿近侧方向PD移动时,砧座1130和细长通道1102被正向移动至完全打开的位置并且通过钳口开口凸轮1440保持在其中。远侧闭合构件朝近侧移动越多,则钳口就越远离彼此。这种顺应性的正向钳口开口布置可确保直接一对一的最终拉开以在卡住时提供更大的打开力。
图22至图25示出了采用钳口开口接片以及至少一个钳口开口弹簧1460的另选的远侧闭合构件1430”,以将砧座1130和细长通道1102'移动到其相应的完全打开的位置中。如图24和图25所示,远侧闭合构件1430”类似于如上所述的远侧闭合构件1430,不同的是远侧闭合构件1430”另外包括砧座打开突片1435和通道打开突片1437。如图24所示,当远侧闭合构件1430”已经移动到其对应于完全打开位置的最近侧位置时,砧座打开接片1435与砧座安装部分1134上的接片1139接触,并且通道开口接片与从细长通道1102的近端部分1103的下侧突出的通道接片1109接触。
图22、图24和图25中描绘的实施方案还采用了可包括钳口打开弹簧1460的正向钳口开口构件。如图23所示,在例示的布置中,钳口开口弹簧1460包括砧座开口腿部1462和通过桥接部分1464附接的通道开口腿部1463。如图22、图24和图25所示,弹簧1460可被轴颈连接在钳口附接销1235上,使得砧座开口腿部1462承载在砧座安装部分1134的底部表面上,并且通道开口腿部1464承载在细长通道1102'的近侧端部1103的底部表面上。因此,钳口打开弹簧1460用来向砧座1130和细长通道1102'施加偏置力,以使它们彼此远离打开位置枢转。图25示出砧座1130和处于完全闭合位置的细长通道1102。如图25所示,钳口开口弹簧1460处于其完全压缩状态。为了打开砧座和通道1102',远侧闭合构件1430”在近侧方向PD上以本文所公开的各种方式移动。当远侧闭合构件1430”朝近侧移动时,钳口开口弹簧1460将砧座1130和细长通道1102'围绕枢转轴线JA彼此远离地正向偏置到完全打开的位置,其中砧座开口接片1435接合砧座安装部分1139上的接片1134并且通道开口接片1437接合通道接片1109。参见图24。在至少一种布置中,钳口开口弹簧安装在击发构件停放区域(即,当击发构件处于起始位置时所在的区域)的近侧。
图26至图29示出在细长通道和闭合构件中采用狭槽布置的另选的远侧闭合构件1470,该狭槽布置被构造成能够在完全打开位置和完全闭合位置之间移动砧座1130”。在所例示的布置中,除了下面讨论的差异,远侧闭合构件1470类似于如上所述的远侧闭合构件1430。然而,在这种布置中,仅砧座1130”相对于细长通道1102”运动。如图26至图29所示,砧座1130”的砧座安装部分1134包括两个向外延伸的砧座销1150,这两个向外延伸的砧座销延伸穿过设置在细长通道1102”的近侧端部1103中的对应的通道狭槽1472。每个砧座销1150还延伸到远侧闭合构件1470中的对应的闭合狭槽1474中。在所例示的布置中,每个通道狭槽1472沿垂直轴VA延伸。砧座销1150限定枢转轴线PA,砧座1130”可围绕该枢转轴线枢转。因为砧座销1150被约束为仅在垂直延伸的通道狭槽1472内移动,因此枢转轴线PA被约束为仅沿垂直轴线VA移动。每个闭合狭槽1474都具有近端部分1476和远端部分1478。近端部分1476沿第一水平轴线HA1放置,远端部分1478沿第二水平轴线HA2放置,该第二水平轴线偏离第一水平轴线HA1。参见图26。垂直轴线VA横向于第一水平轴线HA1和第二水平轴线HA2。
图26示出处于完全打开位置时砧座1130”和细长通道1102”的位置。如图26所示,当处于该位置时,砧座销1150位于通道狭槽1472的顶端(“第一垂直位置”)以及闭合狭槽1474的远端部分1478中。图27示出闭合过程已开始之后砧座1130”和细长通道1102”的位置。如图27所示,远侧闭合构件1470已开始朝远侧移动,使得砧座销1150恰好即将进入闭合狭槽的近侧部分1476,并且销已开始在通道狭槽1472中向下移动。在图28中,远侧闭合构件1470已朝远侧移动到其中砧座销1150位于通道狭槽1472的底端处的点,并且砧座销1150现已进入闭合狭槽1474的近端部分1476。因此,砧座安装部分1134已朝细长通道1102”向下运动。图29示出处于其完全闭合位置的砧座1130”和细长通道砧座1102”。如图29所示,砧座销1150被保持在通道狭槽1472的底端(“第二竖直位置”)中,并且也被接纳在闭合狭槽1474的近端部分1476内。当远侧闭合构件1470保持在该位置时,砧座1130”和细长通道1102”保持在该完全闭合位置。从图29中可以看出,这种布置有利于砧座安装部分1134相对于通道1102”的垂直移动,从而当处于完全打开位置时,增加了砧座下侧与仓平台之间的距离。这种冗余连杆结构可允许调节砧座和邻近组织止挡件的钉仓平台之间的近侧距离。另一个仓实施方案可包括靠近滑动起始位置的金属凸轮端接特征部。这种金属特征部可以支撑或保持滑动件处于“准备使用”位置,同时防止尾部塌陷。
图30至图32示出可与可互换工具组件1000一起使用的击发构件1760的一种形式。在一个示例性形式中,击发构件1760包括主体部分1762,该主体部分包括朝近侧延伸的连接器构件1763,该连接器构件被构造成能够容纳在远侧击发杆1620的远侧端部中的相应形状的连接器开口1624(图4)中。连接器1763可通过摩擦和/或焊接或合适的粘合剂等保持在连接器开口1624内。在使用中,主体部分1762突出穿过细长通道1102中的细长狭槽1160。侧向延伸的脚部接片1764从主体部分1762的每个侧面延伸。每个脚部突片1764包括具有厚度PEf的近侧端部1765和具有厚度DEf的远侧端部1767。这种构型还限定了上脚部表面1768和下脚部表面1769。在所例示的参考中,上脚部表面1768和下脚部表面1769彼此成角度远离。在图31中,上脚部表面1768平行于上轴线UA,下脚部表面1769平行于下轴线UL,其间具有角度AF。换句话讲,远侧厚度DEf>近侧厚度PEf。因此,每个脚部接片1764的厚度从它们各自的远侧端部1767到其近侧端部1765逐渐变薄,其中近侧端部更薄。
仍然主要参见图31,所例示的击发构件1760还包括一对横向延伸的顶部接片1770。每个顶部突片1770包括具有厚度PET的近侧端部1772和具有厚度DET的远侧端部1774。这种构型还限定顶部表面1776和底部表面1778。在所例示的参考中,顶部表面1776和底部表面1778彼此成角度远离。在图31中,顶表面1776平行于上部轴线TA,底表面1778平行于底部轴线BL,其间具有角度AT。换句话讲,每个顶部突片1770的远侧厚度DET大于其近侧厚度PET。因此,每个顶部接片1770的厚度从它们各自的远侧端部1774到其近侧端部1772逐渐变薄,其中近侧端部1772更薄。在所示的布置中,角度AF可以近似等于角度AT。此外,每个顶部接片1770的顶部表面1776可以分别距远侧端部1774、1765之间的每个对应的脚部接片1764的下脚部表面1769距离HF,并且在其各自的近侧端部1772、1767处也是距彼此距离HR。在所例示的布置中,HF>HR。因此,每个顶部接片1770的顶部表面1776远离轴线SA成角度,并且每个脚部接片1764的每个下脚部表面1769远离轴线SA成角度。例示的击发构件1760还包括侧向突出的中央锁定凸耳1780,对此将在下文中进一步详细讨论。击发构件1760的主体部分1762还包括设置在朝远侧突出的底部部分1771和朝远侧突出的顶部鼻部部分1773之间的组织切割边缘或特征部1766。
在示出的示例中,仓体1111将多个钉驱动器可操作地支撑在其中,这些钉驱动器在居中设置的狭槽1114的每个侧面上成排对准。图33A至图33C示出了钉驱动器1170的一个示例,该钉驱动器可用于支撑外科钉仓的一侧上的钉。位于居中设置的狭槽1114的相对侧上的驱动器可包括驱动器1170的镜像。也可有效地采用其他钉驱动器构造。如图33A至图33C所示,钉驱动器1700的一种形式包括钉驱动器主体1172。驱动器主体1172包括被构造成能够在其上支撑钉(未示出)的第一或最内部钉支撑部分1174。第二或中心钉支撑部分1176被构造成能够在其上支撑另一个钉(未示出)并且第三支撑部分1870被构造成能够在其上支撑第三钉(未示出)。第一钉支撑部分1174、第二钉支撑部分1176和第三钉支撑部分1178都通过连接器部分1180联接在一起。在至少一种布置中,连接器部分1180形成为具有居中设置的开口或开孔1182,该开口或开孔被构造成能够可滑动地接收形成在仓体中的对应的第一驱动器引导件(未示出)。连接器部分1180包括第一凸轮部分1184,该第一凸轮部分具有形成于其上的第一凸轮表面或斜坡1186。连接器部分1180还包括第二凸轮部分1188,该第二凸轮部分具有形成于其上的第二凸轮表面1190。凸轮表面1186、1190具有相同的斜率或角度或它们可具有不同的斜率/角度。在至少一个实施方案中,每个钉驱动器1170都由例如一体地形成或模制而成,而无填充物。然而,也可使用其它材料,诸如,例如具有玻璃或矿物填充物的或者尼龙或具有玻璃锉的尼龙。在其它布置中,钉驱动器1170的各个部分可由其他材料分别制成并通过粘合剂、焊料等附接在一起。关于钉驱动器1170以及可与本文所公开的各种实施方案有效地一起使用的其他驱动器实施方案的进一步细节可见于2015年9月2日提交的名称为“SURGICAL STAPLE CONFIGURATIONS WITH CAMMINGSURFACES LOCATED BETWEEN PORTIONS SUPPORTING SURGICAL STAPLES”的美国专利申请序列号14/843,243,其全部公开内容据此以引用方式并入本文。
接下来转向图33、图36和图37,击发构件1760被构造成能够可操作地与滑动件或凸轮组件1120连接,滑动组件可操作地支撑在外科钉仓1110的主体1111内。滑动组件1120在外科钉仓主体1111内可滑动地从邻近仓体1111的近侧端部1112的近侧起始位置移动到邻近仓体1111的远侧端部1113的终止位置。参见图4。居中设置的狭槽1114使击发构件1760能够穿过其中并切割夹紧在砧座1130和钉仓1110之间的组织。驱动器1170与对应的凹坑1116相关联,凹坑穿过仓体1111的上平台表面1115打开。滑动件组件1120包括多个倾斜或楔形凸轮1122,其中每个凸轮1122对应于位于狭槽1114的每一侧上的对应驱动器1170上的特定凸起表面1186,1190。当击发构件1760被击发或朝远侧驱动时,击发构件1760也朝远侧驱动滑动组件1120。当击发构件1760朝远侧移动穿过仓1110时,组织切割特征部1766切割被夹持在砧座组件1130和仓1110之间的组织,并且滑动组件1120在仓中向上驱动驱动器1170,该驱动器驱动对应的钉或紧固件与砧座组件1130成形接触。在例示的示例中,击发构件1762的主体部分1760被构造成能够与滑动组件1120的远侧端部接合。具体地讲,在至少一个示例中,如图33所示,主体部分1762的远侧端部被取向成仅接触滑动件1120的中心部分的近侧端部。在其他击发构件布置中,击发构件主体1762可被独特地成形或被构造成能够与容纳在对应仓组件内的滑动组件的对应端部可操作地啮合、配合或可操作地交接,使得如果使用者无意地将错误的仓装载到细长通道中并且随后尝试击发仓,则击发构件和滑动件将不会正确地交接来实现其远侧推进。
在击发构件包括组织切割表面的那些实施方案中,理想的是细长轴组件可按这样的方式进行构造:除非未用完的钉仓被正确地支撑在外科端部执行器1100的细长通道1102中,否则防止击发构件意外推进。例如,如果根本不存在钉仓并且击发构件向远侧被推进穿过端部执行器,则组织将被切断,但是没有被钉住。类似地,如果在端部执行器中存在用完的钉仓(即,其中至少一些钉已经从其中击发的钉仓),并且击发构件被推进,则组织将被切断,但可能不完全被钉住。应当理解,这种情况外科手术过程中可能导致不希望的灾难性结果。名称为“SURGICAL STAPLING INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT”的美国专利6,988,649,名称为“SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOUTMECHANISM FOR PREVENTION OF FIRING”的美国专利7,044,352,名称为“SURGICALSTAPLING INSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION OFFIRING”的美国专利7,380,695,以及名称为“SURGICAL STAPLING INSTRUMENTS WITHLOCKOUT ARRANGEMENTS FOR PREVENTING FIRING SYSTEM ACTUATION WHEN A CARTRIDGEIS SPENT OR MISSING”的美国专利申请序列号14/742,933各自公开了各种击发构件闭锁布置。那些参考文献中的每一者均据此全文以引用方式并入本文。
“未击发”、“未用过”、“新鲜”或“新”的仓1110在本文中意指仓1110的所有紧固件处于其“准备好击发”位置。当处于该位置时,滑动件组件1120位于其起始位置。新的仓1110安置在细长通道1102内并且可以由仓体上的按扣特征结构保持在其中,该按扣特征结构被构造成能够保持接合细长通道1102的对应部分。图36示出了外科端部执行器1100的一部分,其中新的或未击发的外科钉仓1110安置在其中。如在图36中可见,滑动组件1120处于起始位置。在未击发或新的外科钉仓尚未正确地安置在细长通道1102内的情况下,为了防止击发系统被启动,并且更确切地讲,为了防止击发构件1760被朝远侧驱动通过端部执行器1110,例示的可互换外科工具组件1000采用通常被标记为1790的击发构件闭锁系统。
现在参见图33至图37,在一种形式中,击发构件闭锁系统1790包括可移动锁定构件1792,其被构造成能够当未用过的外科钉仓1110未正确地安置在细长通道1102内时保持接合击发构件1760。锁定构件1792包括一对侧向弹簧臂1793,这对侧向弹簧臂由中央安装突片特征1794互连。中心安装接片特征部1794具有形成于其中的安装钩1795,该安装钩被构造成能够钩住砧座安装组件1238中的保持销1230,如图35至图37所示。当安装时,安装接片1794被构造成能够向上偏置锁定构件1792。此外,锁定构件1792包括两个侧向砧座弹簧臂1796,其向上倾斜以接合砧座安装部分1134上的对应砧座安装壁1136的底表面,以在砧座1130闭合时将锁定构件1792向下偏置。击发构件对准突出部1797从侧向弹簧臂1793中的每一个向上延伸,以保持击发构件1760和锁定构件1792之间的对准。如图33最特别地示出,每个横向弹簧臂1793的远侧部分包括横向延伸的前臂1798,该横向延伸的前臂终止于滑动接片1799中,该滑动接片对应于形成在滑动件1120上的最外侧楔形凸轮1122上的滑动凸台1124。侧向弹簧臂1793中的每一个包括其中的锁定凹口1850,该锁定凹口被构造成能够锁定地接合其中的中心锁定凸耳1780中的对应的一个。本领域的普通技术人员将理解,在不同钉仓布置的滑动件中可采用不同数量和布置的滑动凸台。滑动凸台的数量和布置可被构造成能够仅与旨在使用钉仓的适当器械的锁定构件的对应滑动接片相互作用。因此,滑动凸台可起到“键”的作用,以仅致动适当装置的锁定构件。因此,当错误的外科钉仓被装入细长通道时,这种布置可防止使用者致动该装置。
图35示出端部执行器1100,其中砧座1130和细长通道1102处于其完全打开的位置,而其中没有安装有外科钉仓。如图35所示,砧座弹簧臂1796与安装壁1136的下侧接触,但它们没有“装载”。这种位置使得外科钉仓1110能够被安置到细长通道1102中。如果要在处于该位置时闭合砧座1130,则砧座弹簧臂1796将向下偏置弹簧臂1793,以使中心凸耳1780锁定地接纳在弹簧臂1850中的对应锁定凹口1793内。当处于该位置时,击发构件1760无法向远侧推进。图36示出当砧座1130处于完全闭合位置时,适当地安置在细长通道1102内的新的外科钉仓1110。如在图36中可见,滑动件1120处于其起始位置。当处于该位置时,滑动凸台1124接合滑动接片1799并将弹簧臂1793向上偏置到其中锁定凹口1850不接合中心接片1780的位置。因此,击发构件1760可以自由地向远侧推进。图37示出击发构件1760在从其起始位置朝远侧推进之后的位置。如图37所示,击发构件1760位于锁定弹簧的远侧并且与锁定弹簧脱离接合。砧座弹簧臂1796已将锁定构件向下偏置到解锁位置。
图38和图39示出击发构件1760和锁定构件1792在击发构件1760初始在近侧方向上回缩之后的位置。在例示的布置中,中心锁定凸耳1780中的每一个包括倒角近端部分1782。参见图30和图31。当击发构件1760回缩至图38和图39所示的位置时,中心锁定凸耳1782的倒角近侧端部1780接触锁定构件1798的对应向前臂1792并将弹簧臂侧向向外偏置(图39中的箭头L)。图40和图41示出击发构件1760和锁定构件1792在击发构件1760已完全回缩回其起始位置之后的位置。当处于该位置时,中心锁定凸耳1780中的每一个被锁定地接纳在对应弹簧臂1850中的锁定凹口1793内。当处于该位置时,击发构件1760无法向远侧推进。
图42示出另选的锁定构件1792'。在该实施方案中,安装接片1794向下偏置锁定构件1792'而不使用砧座弹簧臂。因此,在砧座1780和细长钳口1793打开以及外科钉仓1130在其中负载的期间,中心锁定凸耳1102保持与弹簧臂1110的锁定接合。
如上所讨论,仓体1111具有多个砧座凹坑1116,这些砧座凹坑在中心狭槽1114的两侧串行布置。容纳在这些凹坑1116内的是钉驱动器,钉驱动器可操作地将一个或多个外科钉或紧固件支撑在其上。当目标组织被夹在砧座1130和钉仓平台表面1115之间时,必须将目标组织定位成使得被切断的组织被钉在切割线的每一侧上。为了避免目标组织定位在最近侧钉或紧固件的近侧,砧座通常包含向下延伸的壁,通常被称为“组织止挡件”,其用于阻止目标组织在砧座和钉仓之间变得过于靠近。当砧座朝仓闭合时,组织止挡件向下延伸经过仓平台表面,以防止组织被定位在砧座和仓之间过远的近侧。在本文所述的端部执行器实施方案中的至少一个中,砧座1130和细长通道1102两者均可围绕枢转钳口轴线JA运动。这种布置可允许砧座1130和细长通道1102比其他端部执行器布置进一步打开,其中砧座或细长通道中的仅一者可移动或枢转。换句话讲,当砧座1132和细长通道1115均处于其相应的完全打开位置时,砧座主体1110的下表面与安置在本文所述的端部执行器1102的细长通道1110中的钉仓1130的仓平台表面1102之间的距离通常大于砧座的下侧和安置在端部执行器的细长通道中的仓的平台表面之间的距离,其中砧座和通道中的仅一者相对于另一者移动。因此,端部执行器1100的至少一种形式被构造成能够采用具有至少一个“活动”组织止挡件或“可扩展”组织止挡件的钉仓装置。在所例示的布置中,采用通常标记为1250的两个活动组织止挡件。
现在转到图45、图47和图48,如上所述,钉仓主体1111包括位于细长狭槽1114的每侧上的多个钉仓1116,所示多个钉仓被构造成能够在击发构件1760朝远侧推进穿过钉仓时容纳该击发构件。根据钉凹坑1116的构型数目和布置,一个或多个钉驱动器构型可被可操作地支撑在其中,所述一个或多个钉驱动器构型各自支撑其上的一个或多个外科钉。位于仓体的近侧端部处的一些凹坑可不包含驱动器和钉。例如,在所例示的布置中,钉凹坑1116包含驱动器(未示出)和钉(未示出)。支撑驱动器和钉的最近侧凹坑被标记为1116P。虽然有附加的“未使用”凹坑(标记为1117),但这些凹坑中没有一个包含驱动器和钉。在所例示的布置中,细长狭槽1114的两侧上与最近侧凹坑1116P相对的所有钉凹坑1116均包含驱动器和外科钉。因此,活动组织止挡件1250被构造成能够防止组织在靠近近侧钉凹坑1116P的位置处被夹持在砧座1130和钉仓1110之间,以防止组织在没有首先被缝合的情况下被切割。
在一种布置中,单独的和/或与细长通道1102组合的外科钉仓1110在本文中可以称为“第一钳口”,并且砧座1130可以称为“第二钳口”。钉仓1110的近侧端部1112可以被称为“第一近侧端部”或第一钳口的近侧端部。平台表面1115可被称为“第一钳口表面”。在所例示的布置中,砧座主体1132包括钉成形下表面1135,该钉成形下表面面向仓平台并用于在钉被驱动成与其接触时形成钉。钉成形下表面1135(图3)在本文中也可称为“第二钳口表面”。
在例示的布置中,活动组织止挡件1250可操作地附接到仓体1111。然而,可以设想其他布置,其中活动组织止挡件附接到细长通道1102的部分。
转到图45,在至少一个布置中,采用两个活动或可扩展的组织止挡件1250-在细长狭槽1114的每一侧上的一个组织止挡件。如图47所示,活动组织止挡件1250包括分叉的下部组织止挡部分1260,其包括两个凸轮壁1262,这两个凸轮壁由空间1264分开并通过连接器1265互连。上部组织止挡部分1264可移动地支撑在空间1270内。如图45所示,止挡桥接部1266设置在壁1260的远侧端部的上部之间。止挡桥接部1266与形成在上部组织止挡部分1270上的止挡接片1272配合,以防止上部组织止挡部分1270完全延伸出空间1264。安装孔1267穿过壁1260提供,以使得下部组织止挡部分1260能够枢转地轴颈连接在从仓体1118的侧面1113侧向突出的对应的止挡销1111上。如图45所示,上部止挡件1270中的每一个包括弹簧安装孔1274,该弹簧安装孔被狗造成在其中容纳偏置构件或止动弹簧1282的腿部1280。参见图46。
上部组织阻挡部分1270可滑动地容纳在对应的下部组织阻挡部分1264的空间1260内,以产生活动的或可扩展的组织止挡件1250。上部组织止挡部分1260和下部组织止挡部分1270以及对应的偏置构件或止挡弹簧1280可枢转地轴颈连接在对应的止挡销1118上。每个活动组织止挡组件1250围绕由止挡销1118限定的组织止挡轴线TSA自由枢转。如图45所示,组织止挡轴线TSA横向于仓体1114中的细长狭槽1111。止挡弹簧1280的第二腿部1284支承在仓体1111的对应的凸缘或部分1119上,使得当轴颈连接在止挡销1118上时,止动弹簧1280用于在空间1264内向上偏压上部组织止挡部分1270,直到止挡接片1272包含止挡桥接部1266。此时,偏置构件或止挡弹簧1280用于使整个活动组织止挡组件1250围绕组织止挡轴线TSA向上偏置,直到上部组织止挡部分1270接触形成在仓体1111上的对应的止挡凸缘1121。
因此,在所例示的布置中,每个活动组织止挡组件1250附接到仓体1110的对应的侧面1113。如图45所示,细长通道1102的每个侧壁1126具有形成在其中的组织止挡凹口1128,以在钳口1130、1110处于其完全闭合位置时在其中接纳活动组织止挡组件1250。图49示出砧座1130和细长通道1110和钉仓1102处于其“完全闭合”位置。当砧座1250和细长通道1130或外科仓1102处于其完全闭合位置时,活动组织止挡组件1110的取向可被称为它们的“完全压缩”取向。在某些实施方案中,砧座组件1130还可具有形成在其上的固定组织止挡件1144,该固定组织止挡件位于活动组织止挡组件1250的近侧。参见图43和图44。图47和图50示出当砧座1250和细长通道1130处于其相应的完全打开位置时活动组织止挡组件1102的取向。当砧座1250和细长通道1130或外科仓1102处于其完全打开位置时,活动组织止挡组件1110的取向可被称为它们的“完全展开”或“完全扩展”取向。当处于其完全展开位置时,活动组织止挡件1250用于防止组织显著朝近侧推进经过最近侧钉凹坑1116P。图49示出砧座1102和细长通道1130在它们各自的完全闭合位置在它们之间夹持组织。在将组织止挡组件安装在细长通道1102内之前,组织止挡组件可通过可拆卸的钉盖保持在图49所示的折叠取向,该可拆卸的钉盖可拆卸地连接到钉仓平台上。一旦将仓安装在细长通道中,就可以从钉仓中移除钉盖。
图51至图53示出另一种组织止挡装置,其包括在砧座上的配合组织止挡件以及仓。例如,在图51至图53所示的实施方案中,一对直立的仓组织止挡件1290从仓平台表面1115向上延伸。当砧座1130和细长通道1102处于其完全闭合位置时,仓组织止挡件1292的上端1290延伸到设置在砧座主体1293中的孔或腔1132中。仓组织止动件1290的上端1292成角度,使得当砧座1130和细长通道1102完全闭合时,上端1292不突出超过砧座主体1132的外表面。参见图53。此外,砧座1130包括向下延伸的远侧组织止挡件1296,当砧座1115和细长通道1130处于其完全闭合位置时不延伸到仓平台表面1102下方,以及一对近侧组织止动件1298,当砧座1130和细长通道1102处于其完全闭合位置时,所述一对近侧组织止动件向下延伸到仓1110的平台表面1115下方。参见图53。在另选的布置中,弹性带可围绕钳口的外部放置,使得带的远侧边缘位于组织止挡件的所需位置处。当钳口打开时,带可拉伸,但用作组织止挡件。带可放置在砧座中的凹槽中以及围绕砧座/通道的细长通道中,使得端部执行器可穿过标准套管针布置。
在示出的示例中,仓体1111将多个钉驱动器可操作地支撑在其中,这些钉驱动器在居中设置的狭槽1114的每个侧面上成排对准。图33A至图33C示出了钉驱动器1170的一个示例,该钉驱动器可用于支撑外科钉仓的一侧上的钉。位于居中设置的狭槽1114的相对侧上的驱动器可包括驱动器1170的镜像。也可有效地采用其他钉驱动器构造。如图33A至图33C所示,钉驱动器1700的一种形式包括钉驱动器主体1172。驱动器主体1172包括被构造成能够在其上支撑钉(未示出)的第一或最内部钉支撑部分1174。第二或中心钉支撑部分1176被构造成能够在其上支撑另一个钉(未示出)并且第三支撑部分1870被构造成能够在其上支撑第三钉(未示出)。第一钉支撑部分1174、第二钉支撑部分1176和第三钉支撑部分1178都通过连接器部分1180联接在一起。在至少一种布置中,连接器部分1180形成为具有居中设置的开口或开孔1182,该开口或开孔被构造成能够可滑动地接收形成在仓体中的对应的第一驱动器引导件(未示出)。连接器部分1180包括第一凸轮部分1184,该第一凸轮部分具有形成于其上的第一凸轮表面或斜坡1186。连接器部分1180还包括第二凸轮部分1188,该第二凸轮部分具有形成于其上的第二凸轮表面1190。凸轮表面1186、1190具有相同的斜率或角度或它们可具有不同的斜率/角度。在至少一个实施方案中,每个钉驱动器1170都由例如一体地形成或模制而成,而无填充物。然而,也可使用其它材料,诸如,例如具有玻璃或矿物填充物的或者尼龙或具有玻璃锉的尼龙。在其它布置中,钉驱动器1170的各个部分可由其他材料分别制成并通过粘合剂、焊料等附接在一起。关于钉驱动器1170以及可与本文所公开的各种实施方案有效地一起使用的其他驱动器实施方案的进一步细节可见于2015年9月2日提交的名称为“SURGICAL STAPLE CONFIGURATIONS WITH CAMMINGSURFACES LOCATED BETWEEN PORTIONS SUPPORTING SURGICAL STAPLES”的美国专利申请序列号14/843,243,其全部公开内容据此以引用方式并入本文。
钉腔1116相对于轴轴线SA成角度地取向。更具体地,钉腔1116相对于轴轴线SA以斜角取向,并且在平台表面1115中形成人字形图案。本文描述了钉仓体中的钉腔的各种另选的图案。
钉线中的钉的布置和/或几何形状的变化可影响钉线的柔性和密封特性。例如,由线性钉构成的钉线可提供有限量的柔性或拉伸,因为钉线可在线性钉之间挠曲或拉伸。因此,钉线的有限部分(例如,钉之间的部分)是柔性的。由成角度地取向的钉构成的钉线也可在钉之间挠曲或拉伸。然而,成角度取向的钉也能够旋转,这在钉线内提供附加的拉伸程度。例如,由成角度地取向的钉构成的钉线可拉伸超过60%。在某些实例中,例如,由成角度取向的钉组成的钉线可拉伸至少25%或至少50%。例如,钉的布置包括钉的相对取向和钉之间的间距。例如,钉的几何形状包括钉的尺寸和形状。基于钉的布置和/或几何形状,钉线的柔性和密封特性可在纵向和/或侧向位置处改变。在某些实例中,希望在沿钉线的一个或多个位置处改变钉线的柔性和/或密封特性。例如,可希望使钉线或其一部分的柔性最大化。除此之外或另选地,可希望使钉线或其一部分的柔性最小化。也可希望使钉线或其一部分的密封特性最大化。除此之外或另选地,可希望使钉线或其一部分的密封特性最小化。
钉仓中钉腔的布置对应于钉仓所产生的钉线中的钉的布置。例如,钉仓中的钉腔的间距和相对取向对应于由钉仓产生的钉线中的钉的间距和相对取向。在各种实例中,钉仓可包括钉腔的布置,其被选择和/或设计成优化所得钉线的柔性和/或密封特性。例如,外科医生可基于待执行的外科手术和/或外科手术期间待治疗的组织的特性来选择具有特定布置的钉腔的钉仓。
在某些实例中,可希望产生具有不同钉图案的钉线。钉线可包括用于其第一部分的第一钉图案和用于其第二部分的第二钉图案。第一图案和第二图案可纵向偏置。例如,第一图案可被定位在钉线的近侧端部或远侧端部处。在其他实例中,第一图案和第二图案可侧向偏置,并且在其他实例中,第一图案和第二图案可侧向偏置和纵向偏置。钉线可包括至少两种不同的钉图案。
在某些实例中,钉线中的大部分钉可形成主图案,并且钉线中的其他钉可形成一个或多个次图案。主图案可跨越钉线的重要部分并且可包括纵向重复的子图案。在某些实例中,次图案或不规则形状可偏离主图案。次图案可以是例如沿钉线的长度的一个或多个位置处的异常。钉线中的不同图案可被构造成能够在预定位置处产生不同的特性。例如,主图案可为高度柔性或弹性的图案,其可允许缝合的组织的广泛拉伸,并且次图案可较不柔性或较不弹性。例如,可希望大部分钉线高度柔性,并且一个或多个有限部分柔性较低。在其他实例中,次图案可比主图案更具柔性。在某些实例中,由于次图案沿钉线的较短部分延伸,因此次图案的柔性可不影响或不会显著影响整个钉线的总体柔性。
现在参见图54至57,示出了与外科端部执行器一起使用的钉仓体3000。钉仓体3000包括平台3002和狭槽3004,该狭槽从近侧端部3006朝向仓体3000的远侧端部3008延伸穿过平台3002。狭槽3004沿仓体3000的纵向轴线LA(图56)延伸。钉腔3010限定在仓体3000中,并且每个钉腔3010在平台3002中限定开口3012。
大多数钉腔3010被布置成第一图案或主图案3020。第一图案3020为成角度取向的钉腔3010的纵向重复的图案。纵向重复的图案是其中子图案或布置纵向重复的图案。例如,狭槽3004的每个侧面上的三个钉腔(内部钉腔、中间钉腔和外部钉腔)的布置可沿钉仓体3000的长度的至少一部分重复。成角度取向的钉腔的各种纵向重复的图案描述于2014年9月26日提交的名称为“METHOD FOR CREATING A FLEXIBLE STAPLE LINE”的美国专利申请号14/498,145,现为美国专利申请公布2016/0089142,该专利申请全文以引用方式并入本文。第一图案3020中的钉腔3010的开口3012形成人字形图案,其在仓平台3002中具有六排成角度取向的钉腔开口3012。钉腔3010的内排3014a、中间排3014b和外排3014c被定位在狭槽3004的每个侧面上。
每个钉腔开口3012具有近侧端部3016和远侧端部3018。第一图案3020中的钉腔3010的近侧端部3016和远侧端部3018侧向偏置。换句话说,第一图案3020中的每个钉腔3010相对于纵向轴线LA(图56)成角度地取向。腔轴线CA(图56)在每个开口3012的近侧端部3016和远侧端部3018之间延伸。腔轴线CA相对于狭槽3004倾斜地取向。更具体地,钉腔3010的内排3014a和钉腔3010的外排3014c中的开口3012以相对于纵向轴线LA的45度或约45度取向,并且钉腔3010的中间排3014b中的开口3012以相对于内排3014a和外排3014a的开口3012的90度或约90度取向。
仓体3000中的某些钉腔3010以相对于第一图案3020中的钉腔3010异常或不规则的角度取向。更具体地,近侧钉腔3010a,3010b,3010c和3010d以及远侧钉腔3010e,3010f,3010g和3010h的角度取向不符合第一图案3020中的钉腔3010的人字形布置。相反,近侧钉腔3010a-3010d和远侧钉腔3010e-3010h与第一图案3020中的钉腔3010成角度地偏置。近侧钉腔3010a,3010b,3010c和3010d相对于第一图案3020中的钉腔3010倾斜地取向,并且远侧钉腔3010e,3010f,3010g和3010h也相对于第一图案3020中的钉腔3010倾斜地取向。近侧钉腔和远侧钉腔3010a-3010h被取向成平行于狭槽3004并且平行于纵向轴线LA。
近侧钉腔3010a-3010d形成与第一图案3020不同的近侧图案3022,并且远侧钉腔3010e-3010h形成也与第一图案3020不同的远侧图案3024。在所示出的布置中,近侧图案3022包括在狭槽3004的第一侧上的第一对平行的、纵向对准的钉腔3010a,3010b以及在纵向狭槽3004的第二侧上的第二对平行的、纵向对准的钉腔3010c,3010d。远侧图案3024还包括在纵向狭槽3004的第一侧上的第一对平行的、纵向对准的钉腔3010e,3010f以及在纵向狭槽3004的第二侧上的第二对平行的、纵向对准的钉腔3010g,3010h。在其他实例中,远侧图案3024可与近侧图案3022不同。
近侧图案3022和远侧图案3024相对于纵向轴线LA对称。在其他实例中,近侧图案3022和/或远侧图案3024可相对于纵向轴线LA不对称。例如,钉腔3010e和3010f可与钉腔3010g和3010h纵向偏置和/或钉腔3010a和3010b可与钉腔3010c和3010d纵向偏置。除此之外或另选地,在某些实例中,钉仓体3000可包括近侧图案3022或远侧图案3024。在其他实例中,限定在钉仓体3000中的钉腔3010可包括钉腔3010的附加的和/或不同的图案。
主要参见图54,无创伤扩张器3030围绕第一图案3020中的钉腔3010的一部分从平台3002延伸或突出。无创伤扩张器3030分别围绕第一图案3020中的钉腔3010的开口3012的近侧端部3016和远侧端部3018。无创伤扩张器3030可被构造成能够抓持由端部执行器夹紧的组织。除此之外或另选地,在某些实例中,钉腿的尖端可从仓体3000突出。在所述实例中,无创伤扩张器3030可被构造成能够与钉腿的尖端齐平地延伸和/或延伸超出钉腿的尖端,以防止尖端过早地穿透组织。因此,较大的钉(例如具有较长腿的钉)可被定位在钉腔3010中,钉腔3010具有被定位在其周围的无创伤扩张器3030。例如,再次参见图54,较大的钉可被定位在第一图案3020中的钉腔3010中,而不是近侧图案3022和远侧图案3024中的钉腔中的钉,同时不存在由较长的钉腿过早刺穿组织的风险。在某些实例中,无创伤扩张器3030可被定位在近侧图案3022和/或远侧图案3024中的钉腔3010周围,并且较大的钉也可被定位在那些钉腔3010a-3010h中的一个或多个中。
钉仓体3000可被构造成能够产生沿其长度具有不同特性的钉线。由钉仓体3000产生并嵌入组织T中的钉线3040在图58中示出。钉线3040由钉3042组成,并且用于与本文所述的各种钉仓一起使用的示例性钉3042在图59中示出。例如,钉3042可由弯曲的线材组成。线材的直径可具有0.0079英寸或约0.0079英寸的直径。在其他实例中,线材可具有0.0089英寸或约0.0089英寸的直径。在其他实例中,线材可具有0.0094英寸或约0.0094英寸的直径。在某些实例中,线材可具有小于0.0079英寸或大于0.0094英寸的直径。读者将理解,线材的直径可决定钉的直径。钉3042是大致U形的钉,其具有基部3050,从基部3050的第一端部延伸的第一腿部3052,以及从基部3050的第二端部延伸的第二腿部3054。第一腿部3052基本上平行于第二腿部3054并且基本上垂直于基部3050。当植入组织T中时,基部3050的角度取向对应于钉3042从其被击发的钉腔开口3012的角度取向。
用于与本文所述的各种钉仓一起使用的另一个示例性钉3142在图60中示出。钉3142是大致V形的钉,其具有基部3150,从基部3050的第一端部延伸的第一腿部3152,以及从基部3150的第二端部延伸的第二腿部3154。第一腿部3152相对于第二腿部3154和基部3150倾斜地取向。当植入组织T中时,基部3150的取向对应于钉3142从其被击发的钉腔开口3012的取向。读者将理解,具有不同几何形状的钉也可从本文所述的钉仓被击发。
再次参见图58,钉线3040包括第一部分3044、近侧部分3046和远侧部分3048。第一部分3044由第一图案或主图案3020产生并且沿钉线3040的大部分延伸。由于钉3042在第一部分3044中的角度取向,第一部分3044是基本上柔性的或柔顺的。例如,因为在使对组织T的创伤最小化的同时成角度取向的钉3042可在缝合组织T内旋转,所以第一部分3044被构造成能够在缝合组织拉伸时纵向和/或侧向拉伸或延伸。
近侧部分3046从近侧图案3022产生并且形成钉线3040的近侧端部。远侧部分3048由远侧图案3024产生并且形成钉3040的远侧端部。由于钉3042在钉线3040的近侧部分3046和远侧部分3048中的平行取向,钉线3040的近侧部分3046和远侧部分3046可具有比第一部分3044更小的柔性。然而,近侧部分3046和远侧部分3048的柔性降低可不会影响或基本上不影响钉线3040的整体柔性。此外,如本文所述,近侧部分3046和远侧部分3048可不邻近切割线延伸,并且在某些实例中,近侧部分3046可不存在或从钉线3040中缺失。
击发元件诸如击发构件1760(图4)被构造成能够沿狭槽3004的至少一部分运动,以从钉腔3010击发钉3042。击发元件可包括和/或接合一个或多个楔形滑动件和/或凸轮表面,诸如具有楔形凸轮1122(图4)的滑动组件1120。例如,滑动件的凸轮被构造成能够朝向钉成形表面向上驱动钉,诸如在砧座1130(图1、图3和图4)中形成凹坑。参见图55,钉仓体3000包括沿底表面3034的多个通道3036,楔形凸轮在击发行程期间可运动通过通道3036。
在使用中,靶组织夹紧在钉仓体3000和砧座诸如砧座1130(图1、图3和图4)之间。与钉腔3010重叠的组织被缝合。如果组织未被定位在某些钉腔3010上,则从那些钉腔3010击发的钉可不接合组织。砧座通常包括通常称为“组织止挡件”的向下延伸的侧壁。组织止挡件被构造成能够阻止靶组织在砧座和钉仓之间变得过近。例如,参见图4中的端部执行器1100,砧座1130包括组织止挡件1131,其朝向钉仓1110延伸。当砧座1130朝向仓1110闭合时,砧座1130的任一侧上的组织止挡件1131向下延伸经过仓平台表面1115并且形成壁或屏障,这防止组织在砧座1130和仓1110之间定位得过近。组织止挡件1131的远侧端部限定了切割线的近侧起始点。对应于组织止挡件1131的远侧端部的近侧轴线PA在图56中示出。因为靶组织未被定位在近侧轴线PA的近侧,所以从位于近侧轴线PA近侧的钉腔(即,近侧钉腔3010a-3010d)击发的钉不会被击发到靶组织中。在所述实例中,从近侧图案3022击发的钉未形成钉线的一部分。
切割元件3028(图56)还被构造成能够沿纵向狭槽3004运动。在各种实例中,切割元件3028可以是击发元件的整体部分,诸如击发构件1760(图4)上的组织切割特征部1766。切割元件3028具有远侧切割边缘3029,远侧切割边缘3029被构造成能够切割由端部执行器夹紧并由钉3042缝合的组织。主要参见图56,切割元件3028的切割边缘3029被构造成能够在仓体3000的近侧端部部分3006附近的近侧位置和仓体3000的远侧端部部分3008附近的远侧位置之间运动。切割边缘3029的最远侧位置由切割线的远侧终止点限定。对应于切割边缘3029的远侧终止点的远侧轴线DA在图56中示出。被定位在远侧轴线DA远侧的组织在击发行程期间未被切割元件3028切开。
钉腔3010的第一图案3020在近侧轴线PA和远侧轴线DA之间延伸。此外,第一图案3020中的至少一个钉腔3010与近侧轴线PA和远侧轴线DA重叠。在其他实例中,钉腔3010的多于一个纵向重复的图案可被定位在近侧轴线PA和远侧轴线DA之间。近侧图案3022被定位在近侧轴线PA的近侧,并且远侧图案3024被定位在远侧轴线DA的远侧。在所述实例中,从远侧钉腔3010e-3010h击发的钉不被构造成能够缝合切开的组织。此外,从近侧钉腔3010a-3010d击发的钉不被构造成能够缝合靶组织。因此,这种钉可不会影响所得到的钉线的柔性和/或密封质量。
在某些实例中,可希望产生具有邻近切割线的第一柔性和在切割线近侧和/或远侧的不同柔性的钉线。例如,在切割线的每个侧面上包括至少两个平行钉并且被定位在切割线的远侧端部远侧的钉线可提供某些优点。在某些实例中,提供较小柔性的钉布置可防止和/或限制切割线的传播和/或组织的撕裂。另外,与未切割部分相邻的组织可比与切割线相邻的组织经受更小的应力和/或应变,因此可需要较小的柔性来预防和/或限制组织创伤。更具体地,与切割线相邻的组织可在切割行程期间经受更多的力,并且因此增加的柔性可防止对组织的创伤。另外,与切割线相邻的组织可在其愈合时拉伸,并且因此增加的柔性可促进愈合过程。例如,对于经受较少力的组织,诸如切割线远侧的组织,降低的柔性可增强或加强钉线并防止切割线的远侧传播。
在所示出的布置中,近侧图案3022包括在刀狭槽3004的每个侧面上与第一图案3020的近侧端部相邻的两个不规则的钉腔,并且远侧图案3024包括在刀狭槽3004的每个侧面上与第一图案3020的远侧端部相邻的两个不规则钉腔。在其他实例中,近侧图案3022和/或远侧图案3024可由刀狭槽3004的一侧或两侧上的单个不规则钉腔组成。在其他实例中,近侧图案3022和/或远侧图案3024可包括在刀狭槽3004的一侧或两侧上的三个或更多个不规则钉腔。近侧图案3022和/或远侧图案3024可包括纵向重复的子图案。例如,近侧图案3022和/或远侧图案3024可包括多列平行的钉腔开口3012。在某些实例中,钉仓体3000可具有单个不规则图案,其可被定位在第一图案3020的近侧端部或远侧端部处。
在某些实例中,近侧图案3022和/或远侧图案3024中的一个或多个钉腔可与刀狭槽3004不平行。例如,这种钉腔可垂直于刀狭槽3004进行取向或相对于刀狭槽3004以倾斜角进行取向。除此之外或另选地,近侧图案3022和/或远侧图案3024中的某些钉腔可彼此不平行。
主要参见图57,钉驱动器3060被定位在仓体3000的钉腔3010中。钉驱动器3060定位成将钉3042支撑在其中(图58和图59)并且在击发行程期间从钉腔3010驱动钉3042。由于仓体3000中的钉腔3010的不同图案,例如图案3020,3022和3024,钉驱动器3060可具有不同的几何形状和/或取向。例如,被定位在第一图案3020的钉腔3010中的钉驱动器3060可包括连接的驱动器,该连接的驱动器描述于2014年9月26日提交的名称为“METHOD FORCREATING A FLEXIBLE STAPLE LINE”的美国专利申请号14/498,145,现为美国专利申请公布2016/0089142,其全部内容以引用方式并入本文。每个连接的驱动器可包括位于内排3014a中的钉腔3010中的内部驱动器,位于中间排3014b中的钉腔3010中的中间驱动器,以及位于外排3014c中的钉腔3010中的外部驱动器。连接凸缘可将中间驱动器连接到至少一个内部驱动器和至少一个外部驱动器。在其他实例中,被定位在第一图案3020中的钉腔中的钉驱动器可包括单独的驱动器,其中每个驱动器驱动单个钉。在其他实例中,钉可以是直接驱动钉,其可通过与楔形滑动件和/或凸轮表面的直接接触来驱动,如2013年12月23日提交的名称为“SURGICAL STAPLES AND STAPLE CARTRIDGES”的美国专利申请号14/138,475(现为美国专利申请公布2015/0173749)以及美国专利申请号14/498,145中所描述的,它们各自的全部内容以引用方式并入本文。
被定位在钉腔3010中的驱动器3060的尺寸和位置设定成用于通过其滑动件和凸轮表面驱动接合。例如,驱动器3060被定位在第一图案3020的钉腔3010中。近侧驱动器3060a,3060b,3060c和3060d分别被定位在近侧图案3022的钉腔3010a,3010b,3010c和3010d中,并且远侧驱动器3060e,3060f,3060g和3060h分别定位远侧图案3024的钉腔3010e,3010f,3010g和3010h中。再次参见图4,滑动组件1120和其楔形凸轮1122可被构造成能够提升钉腔3010中的钉驱动器3060。在所述实例中,凸轮1122被构造成能够沿仓体3000的长度驱动地接合驱动器3060。更具体地,凸轮1122最初接合并驱动近侧驱动器3060a,3060b,3060c和3060d以击发近侧图案3022中的钉,然后接合并驱动驱动器3060以击发第一图案3022中的钉,并且最后接合并驱动远侧驱动器3060e,3060f,3060g和3060h以击发远侧图案3024中的钉。尽管近侧驱动器3060a,3060b,3060c和3060d和/或远侧驱动器3060e,3060f,3060g和3060h具有与钉腔3010的第一图案3020中的驱动器3060不同的几何形状,但是其滑动件和凸轮表面与仓体3000中的不同驱动器兼容。
再次参见图4,滑动组件1120包括四个凸轮表面1122。第一对凸轮表面1122定位成用于在纵向轴线LA的第一侧上与钉驱动器驱动接合,并且第二对凸轮表面1122定位成用于在纵向轴线LA的第二侧上与钉驱动器驱动接合。每对中的凸轮表面1122纵向偏置。在其他实例中,凸轮表面1122可纵向对准。每对凸轮表面1122被构造成能够提升三驱动器(参见例如图33A至图33C中的驱动器1170),即,支撑钉腔3010的内排3014a中的钉、钉腔3010的中间排3014b中的钉以及钉腔3010的外排3014c中的钉的连接的驱动器。凸轮表面1122还被构造成能够提升近侧驱动器3060a,3060b,3060c和3060d以及远侧驱动器3060e,3060f,3060g和3060h。在其他实例中,滑动组件1120可包括多于或少于四个凸轮表面。
近侧驱动器3060a-3060d和远侧驱动器3060e-3060h是连接的驱动器3058。示例性连接的驱动器3058在图62至图65中示出。连接的驱动器3058包括第一驱动器3060a和第二驱动器3060b。连接凸缘3068在两个驱动器3060a和3060b之间延伸。因为第一驱动器3060a和第二驱动器3060b连接,所以由第一驱动器3060a和第二驱动器3060b支撑的钉由滑动组件同时击发。每个驱动器3060a和3060b还包括用于支撑钉的基部的托架3070。引导件3062a和3062b分别从每个驱动器3060a和3060b侧向延伸。第一引导件3062a沿第一方向延伸并形成连接的驱动器3058的外侧部分,并且第二引导件3062b沿第二相反方向延伸并形成连接的驱动器3058的内侧部分。分别在引导件3062a和3062b上的斜坡表面3064a和3064b定位成用于与滑动组件的凸轮表面驱动接触。当通过滑动组件运动到击发位置时,引导件3062a和3062b在仓体3000的通道3036(图55)中被向上驱动。通道3036形成垂直支撑结构,引导件3062a,3062b被凸轮表面驱动通过该垂直支撑结构。如本文所述,凸轮表面可纵向偏置。
在所述实例中,斜坡表面3064a,3064b相应地偏置,如图63和图65中所示出的。在其他实例中,斜坡表面3064a和3064b可对准。
在其他实例中,钉仓中的近侧驱动器和/或远侧驱动器可不连接。例如,参见图61,示出了钉仓4800。钉仓体4800在许多方面类似于钉仓体3000。例如,钉仓体4800包括成角度取向的钉腔的第一图案4820,其以人字形图案布置。狭槽4804沿仓体4800的纵向轴线LA延伸。钉仓体4800还包括布置在近侧图案4822中的近侧钉腔和布置在远侧图案4824中的远侧钉腔。近侧图案4822包括在狭槽4804的第一侧上的第一对平行的、纵向对准的钉腔和在纵向狭槽4804的第二侧上的第二对平行的、纵向对准的钉腔。远侧图案4824还包括在狭槽4804的第一侧上的第一对平行的、纵向对准的钉腔和在纵向狭槽4804的第二侧上的第二对平行的、纵向偏置的钉腔。近侧图案4822和远侧图案4824相对于纵向轴线LA对称。在其他实例中,近侧图案4822和/或远侧图案4824可相对于纵向轴线LA不对称。
驱动器4860被定位在第一图案4820的钉腔4810中。如本文所述,第一图案4820的钉腔4810中的驱动器4860是三驱动器。近侧驱动器4860a,4860b,4860c和4860d被定位在近侧图案4822的钉腔中,并且远侧驱动器4860e,4860f,4860g和4860h被定位在远侧图案4824的钉腔中。近侧驱动器4860a-4860d和远侧驱动器4860e-4860h是单个驱动器。示例性单个驱动器4860a和4860b在图66和图67中示出。
每个驱动器4860a和4860b包括用于支撑钉的基部的托架4870。引导件4862a和4862b分别从每个驱动器4860a和4860b侧向延伸。第一引导件4862a沿第一方向延伸并形成第一驱动器4860a的外侧部分,并且第二引导件4862b沿第二相反方向延伸并形成第二驱动器4860b的外侧部分。分别在引导件4862a和4862b上的斜坡表面4864a和4864b定位成用于与滑动组件的凸轮表面驱动接触。当驱动器4860a和4860b通过滑动组件运动到击发位置时,引导件4862a和4862b在仓体4800中的通道诸如仓3000(图55)中的通道3036中被向上驱动。通道形成垂直支撑结构,引导件4862a和4862b被凸轮表面驱动通过该垂直支撑结构。这种通道可稳定引导件4862a和4862b,并且因此在部署期间分别稳定各个驱动器4860a和4860b。如本文所述,凸轮表面可纵向偏置。在所述实例中,斜坡表面4864a,4864b相应地偏置,如图67中所示。在其他实例中,斜坡表面4864a和4864b可对准。
因为第一驱动器4860a和第二驱动器4860b是分开的,所以由第一驱动器4860a和第二驱动器4860b支撑的钉可被独立地击发。在某些实例中,可顺序地击发第一驱动器4860a和第二驱动器4860b。例如,可有利地在外部钉之前击发内部钉,这可通过单独的驱动器4860a和4860b实现。在其他实例中,外部钉可在具有单独的驱动器4860a和4860b的内部钉之前被击发。例如,通过调节凸轮表面和斜坡表面3864a和4864b之间的关系可修改击发顺序。
在各种实例中,远侧图案和/或近侧图案中的钉腔可不是纵向对准的和/或可不是平行的。例如,现在参见图68和图69,示出了钉仓体4600。钉仓体4600在许多方面类似于钉仓体3000。例如,钉仓体4600包括成角度取向的钉腔4610的第一图案4620,其以人字形图案布置。狭槽4604沿仓体4600的纵向轴线LA延伸穿过钉仓体4600的平台4602。钉仓体4600还包括布置在近侧图案4622中的近侧钉腔4610a-4610d和布置在远侧图案4624中的远侧钉腔4610e-4610h。近侧图案4622包括在狭槽4604的第一侧上的第一对平行的、纵向偏置的钉腔4610a,4610b和在纵向狭槽4604的第二侧上的第二对平行的、纵向偏置的钉腔4610c,4610d。远侧图案4624还包括在狭槽4604的第一侧上的第一对平行的、纵向偏置的钉腔4610e,4610f和在纵向狭槽4604的第二侧上的第二对平行的、纵向偏置的钉腔4610g,4610h。近侧图案4622和远侧图案4624相对于纵向轴线LA对称。在其他实例中,近侧图案4622和远侧图案4624可相对于纵向轴线LA不对称。
连接的驱动器4658被定位在近侧钉腔和远侧钉腔4610a-4610h中。示例性连接的驱动器4658在图70至图73中示出。连接的驱动器4658包括第一驱动器4660a和第二驱动器4660b。连接凸缘4668在两个偏置驱动器4660a和4660b之间延伸。因为驱动器4660a和4660b连接,所以由驱动器4660a,4660b支撑的钉被滑动组件同时击发。每个驱动器4660a和4660b包括用于支撑钉的基部的托架4670。引导件4662a和4662b分别从每个驱动器4660a和4660b侧向延伸。第一引导件4662a沿第一方向延伸并形成连接的驱动器4658的外侧部分,并且第二引导件4662b沿第二相反方向延伸并形成连接的驱动器4658的内侧部分。分别在引导件4662a和4662b上的斜面4664a和4664b定位成用于与滑动组件的凸轮表面驱动接触。例如,当驱动器4660a,4660b通过滑动组件运动到击发位置时,引导件4662a和4662b在仓体4800中的通道诸如钉仓3000(图55)中的通道3036中被向上驱动。通道形成垂直支撑结构,当引导件4662a,4662b由凸轮表面驱动时,引导件4662a,4662b通过该垂直支撑结构被支撑。如本文所述,凸轮表面可纵向偏置。在所述实例中,斜坡表面4664a、4664b相应地偏置,如图71和图73中所示出的。在其他实例中,斜坡表面4664a和4664b可对准。
现在参见图74和图75,示出了钉仓体4700。钉仓体4700在许多方面类似于钉仓体3000。例如,钉仓体4700包括成角度取向的钉腔4710的第一图案4720,其以人字形图案布置。狭槽4704沿仓体4700的纵向轴线LA延伸穿过钉仓体4700的平台4702。钉仓体4700还包括布置在近侧图案4722中的近侧钉腔4710a-4710f。近侧图案4722包括内部钉腔4710c和4710d,其被取向成平行于纵向轴线LA。近侧图案4722还包括成角度取向的外部钉腔4710a和4710f,以及成角度取向的中间腔4710b和4710e。外部钉腔4710a和4710f以及中间钉腔4710b和4710e相对于纵向轴线LA以倾斜角取向。成角度取向的外部钉腔4710a和4710f也相对于第一图案4720中的钉腔4710的腔轴线以倾斜角取向。外部钉腔4710a和4710f的角度小于第一图案4720中的钉腔4710的角度。换句话说,外部钉腔4710a和4710f以比第一图案4720中的钉腔4710更接近于与纵向轴线LA平行的角度取向。在所述实例中,近侧图案4722可比第一图案4720具有更小的柔性。
中间钉腔4710b和4710e被取向成平行于第一图案4020中的某些钉腔4710。例如,中间钉腔4710b和4710e被取向成平行于第一图案4720中的内排中的钉腔4710。尽管近侧图案4722中的某些钉腔没有与第一图案4020中的钉腔成角度地偏置,但是当被视为整体时,近侧图案4722不同于第一图案4020并且不同于第一图案4020内的纵向重复的子区域。
近侧图案4722包括被定位在狭槽4704的每个侧面上的三个钉腔。在其他实例中,可在狭槽4704的一侧或两侧上的近侧图案4722中布置少于三个钉腔或多于三个钉腔。近侧图案4722不包括纵向重复的子图案。在其他实例中,近侧图案4722可以是纵向重复的。另外,近侧图案4722相对于纵向轴线LA对称。在其他实例中,近侧图案4722可相对于纵向轴线LA不对称。
驱动器4760被定位在仓体4700中的钉腔4710中。如本文所述,第一图案4720的钉腔4710中的驱动器4760是三驱动器。近侧驱动器4760a,4760b,4760c,4760d,4710e和4710f分别被定位在近侧图案4722的近侧钉腔4710a,4710b,4710c,4710d,4710e和4710f中。近侧驱动器4760a-4760f是单个驱动器。在某些实例中,内腔4710c和4710d中的近侧驱动器4760c和4760d可分别是单个驱动器,近侧驱动器4760a和4760b可以是连接的驱动器,并且近侧驱动器4760e和4760f可以是连接的驱动器。在其他实例中,近侧驱动器4760a,4760b和4760c可包括第一连接的驱动器,并且远侧驱动器4760d,4760e和4760f可包括第二连接的驱动器。
读者将理解,本文描述的钉腔的各种图案可组合和/或互换。在某些实例中,钉腔的一个或多个不规则图案可限定在钉仓体的近侧端部和/或远侧端部处。除此之外或另选地,可将一个或多个不规则图案或次图案夹在或插入主图案内。
钉线中的钉的角度取向可影响缝合组织沿钉线的柔性或顺应性。例如,当钉相对于纵向轴线和/或切割线以倾斜角取向时,钉线的柔性可增加。这种角度取向可响应于沿切割线和/或邻近切割线的力诸如张力和/或扭转而在一定限度内提供柔性或可扩展性。更具体地,钉线的柔性可允许缝合组织的拉伸、弯曲、折叠和/或扭曲。通常,当钉的角度取向相对于钉线和/或切割线的纵向轴线接近45度或135度时,缝合组织的柔性增加。例如,由成角度取向的钉构成的钉线可被认为是柔顺的或弹性的钉线。
在某些实例中,钉线的柔性可相对于切割线侧向变化。例如,钉线的第一部分中的一个或多个钉可相对于切割线以第一角度取向,并且钉线的第二部分中的一个或多个钉可相对于切割线以不同的角度取向。钉线的第一部分可具有第一柔性,并且钉线的第二部分可具有不同的柔性。在某些实例中,第一部分可与第二部分侧向偏置。例如,钉线的第一部分可包括第一钉排或第一排的一部分,并且钉线的第二部分可包括第二钉排或第二排的一部分。在所述实例中,沿第一钉排的钉线的柔性可不同于沿第二钉排的钉线的柔性。
现在参见图76,示出了钉仓体3200的一部分。钉仓体3200包括平台3202和纵向狭槽3204。纵向狭槽3204沿纵向轴线LA延伸。钉腔3210限定在钉仓体3200中,并且每个钉腔3210在平台3202中限定开口3212。钉3242被定位在每个钉腔3210中。钉3242在许多方面可类似于钉3042(图59)或钉3142(图60)。在某些实例中,每个钉3242的腿部可偏置抵靠钉腔3210的内壁。读者将理解,钉腔3210中的钉3242的布置对应于当钉3242从钉仓体3200被击发并进入组织时钉3242在钉线中的布置。更具体地,所得到的钉线中的每个钉3242的基部与腔轴线CA共线或基本上共线。
钉腔开口3212在纵向狭槽3204的第一侧上被布置成三个排3214a,3214b和3214c。内开口3212a限定内排3214a中的内腔3210a的周边,中间开口3212b限定中间排3214b中的中间腔3210b的周边,并且外开口3212c限定外排3214c中的外腔3210c的周边。内部钉3242a被定位在内腔3210a中,中间钉3242b被定位在中间腔3210b中,并且外部钉3242c被定位在外腔3210c中。尽管未在图76中示出,在至少一个实例中,狭槽3204的相对侧上的钉腔3210形成纵向狭槽3204的第一侧上的钉腔3210的镜像反射。因此,在所得到的钉线中的钉3242的布置相对于切割线对称。在其他实例中,钉线可相对于切割线不对称。
每个钉腔开口3212具有第一端部或近侧端部3216和第二端部或远侧端部3218。腔轴线CA在每个开口3212的近侧端部3216和远侧端部3218之间延伸。每个相应排中的钉腔开口3212是平行的。例如,内腔3210a相对于纵向轴线LA以角度A取向。换句话说,内开口3212a的腔轴线(例如,CAA1和CAA2)相对于纵向轴线LA以角度A取向。中间腔3210b相对于纵向轴线LA以角度B取向。换句话说,中间开口3212b的腔轴线(例如,CAB1和CAB2)相对于纵向轴线LA以角度B取向。外腔3210c相对于纵向轴线LA以角度C取向。换句话说,由外开口3212限定的腔轴线(例如,CAC1和CAC2)相对于纵向轴线LA以角度C取向。
角度A、B和C是不同的。因此,内开口3212a相对于外开口3212c倾斜地取向。因为外开口3212c的腔轴线CA(例如,轴线CAC1和CAC2)不平行于内开口3212a的腔轴线(例如,轴线CAA1和CAA2),钉仓体3200中的开口3212形成修改的或倾斜的人字形图案。中间开口3212b的腔轴线CAB1和CAB2可取向成垂直于或基本上垂直于内开口3212a或外开口3212c。例如,角度B可以是角度A或角度C的补角。在其他实例中,角度B可不是角度A或角度C的补角。
由于角度A、B和C不同,钉线中的钉排的宽度WA、WB、WC可不同。例如,内部钉3242a形成具有宽度WA的钉排,中间钉3242b形成具有宽度WB的钉排,并且外部钉3242c形成具有宽度WC的钉排。宽度WA和WC是不同的,因为角度A不同于角度C。在某些实例中,宽度WB不同于宽度WA和WC。在其他实例中,宽度WB可匹配宽度WA或WC中的一个。例如,如果角度B是角度A的补角,则宽度WB与宽度WA匹配。类似地,如果角度B是角度C的补角,则宽度WB与宽度WC匹配。
此外,由于角度A、B和C不同,钉3242a,3242b和3242c的纵向长度LA、LB和LC分别不同。例如,内部钉3242a具有纵向长度LA,中间钉3242b具有纵向长度LB,并且外部钉3242c具有纵向长度LC。纵向长度LA和LC是不同的,因为角度A不同于角度C。因为纵向长度LA和LC不同,所以内部钉3242a相对于外部钉3242c至少部分地纵向交错或偏置。换句话说,每个内部钉3242a的至少一个端部不与外部钉3242b的对应端部对准。因为端部不对准,所以相对于中间钉3242b的纵向重叠和/或间隙在内部钉3242a和外部钉3242c之间不同。在某些实例中,纵向长度LB不同于长度LA和LC。在其他实例中,纵向长度LB可与纵向长度LA或LC中的一个匹配。例如,如果角度B是角度A的补角,则纵向长度LB与纵向长度LA匹配。类似地,如果角度B是角度C的补角,则纵向长度LB与纵向长度LC匹配。
钉基部的长度也可影响宽度WA、WB和WC以及纵向长度LA、LB和LC。在钉仓体3200中,内部钉3242a、中间钉3242b和外部钉3242c具有相同长度的基部。例如,相同的钉可被定位在每个钉腔3210中。在其他实例中,如本文进一步描述的,例如,具有不同几何形状和/或尺寸诸如不同长度的基部的钉可被定位在仓体中的某些钉腔中。
仍然参见图76,钉腔3210a,3210b和3210c的角度取向以及对应的宽度WA、WB和WC以及纵向长度LA、LB和LC分别可影响钉线中的侧向和纵向重叠量。钉3242之间的纵向和侧向重叠还取决于钉腔3210的间距。通常,相邻钉之间的较大重叠对应于较不直接的流体路径,这可对应于更大的组织密封特性。更大的重叠也会降低钉线的柔性,因为组织可在重叠区域中受到更多约束。此外,更大的重叠可对应于钉之间的更小间距。在某些实例中,可希望改变钉线中的侧向和/或纵向重叠的程度。随着重叠变化,钉线的柔性和密封特性也可变化。
例如,本文描述的重叠或重叠程度可指正重叠或负重叠。当钉和/或钉排限定负重叠时,钉和/或钉排可间隔,使得他们不重叠并且在他们之间限定间隙。在其他实例中,钉或钉排可对准,使得重叠等于钉的直径。
读者将进一步理解,相对于钉仓中的钉或钉排的重叠程度对应于相对于钉仓中的钉腔或钉腔排的重叠程度。例如,钉或钉排之间的侧向和/或纵向重叠的相对差异对应于钉仓中的钉腔或钉腔排的侧向和/或纵向重叠的相对差异。在某些实例中,钉腿的至少一部分可定位成抵靠钉腔的近侧端部和远侧端部处的钉腔的内壁和/或偏置到其中。在所述实例中,相对于钉的外边缘测量的距离等于相对于对应钉腔的内边缘测量的距离。在其他实例中,这些距离之间的差异可以是最小的或无关紧要的。
在某些实例中,可使重叠程度最小化,诸如当钉的端部对准时。当钉的端部对准时,重叠与钉的直径相等或基本上相等。例如,如果钉由直径为约0.0079英寸的线材构成,则重叠可为约0.0079英寸。在其他实例中,重叠可小于钉的直径。例如,重叠可小于约0.0079英寸。在其他实例中,重叠程度可以是非重叠或负重叠,即,钉的端部之间的空间或间隙。在其他实例中,最小化的重叠可等于或小于钉长度的三分之一。例如,重叠可小于钉长度的33%。在其他实例中,重叠可小于钉长度的25%或小于钉长度的10%。在其他实例中,例如,重叠可以是钉长度的33%以上。
在某些实例中,钉线可包括内部钉排和中间钉排之间的第一重叠程度以及中间钉排和外部钉排之间的第二重叠程度。第二重叠程度可与侧向和/或纵向方向上的第一重叠程度不同。因此,钉线的内部部分可包括与钉线的外部部分不同的柔性。此外,内部部分的组织密封特性可不同于外部部分的组织密封特性。
再次参见图76,角度A小于角度C。因此,宽度WA小于宽度WC,并且长度LA大于长度LC。例如,角度A可以是35度至40度,并且角度C可以是例如43度至47度。在其他实例中,角度A可小于35度或大于40度和/或角度C可小于43度或大于47度。角度A和角度C之间的差值可在三度至十二度之间。例如,差值可以是约八度。在其他实例中,角度A和角度C之间的差值可小于三度或大于十二度。
仍然参见图76,每个相应排中的钉3242对准。更具体地,内部钉3242a的近侧端部纵向对准,内部钉3242a的远侧端部纵向对准,中间钉3242b的近侧端部纵向对准,中间钉3242b的远侧端部纵向对准,外部钉3242c的近侧端部纵向对准,并且外部钉3242c的远侧端部纵向对准。钉腔3310的每个排3214a,3214b和3214c中的对准的钉3242被构造成能够在钉线中形成多排对准的钉3242。由于钉3242的角度取向和它们之间的间距,钉排3242侧向重叠。内部钉3242a通过侧向重叠YA/B与中间钉3242b侧向重叠,并且外部钉3242c通过侧向重叠YB/C与中间钉3242b侧向重叠。内部钉3242a和中间钉3242b之间的侧向重叠YA/B大于外部钉3242c和中间钉3242b之间的侧向重叠YB/C。在所述实例中,相比于内部钉定位到中间钉,外部钉定位成更靠近中间钉。在其他实例中,侧向重叠YA/B可小于或等于侧向重叠YB/C。
中间钉3242b相对于内部钉3242a和外部钉3242c纵向交错。具体地,每个中间钉3242b在相邻的内部钉3242a之间纵向等距地定位并且在相邻的外部钉3242c之间纵向等距地定位。由于钉3242的角度取向和它们之间的间距,钉3242不纵向重叠。内部钉3242a与中间钉3242b间隔纵向间隙XA/B,并且外部钉3242c与中间钉3242b间隔纵向间隙XB/C。内部钉3242a和中间钉3242b之间的纵向间隙XA/B小于外部钉3242c和中间钉3242b之间的纵向间隙XB/C。在其他实例中,纵向间隙XA/B可大于或等于纵向间隙XB/C。在某些实例中,中间钉3242b可与内部钉3242a和/或外部钉3242c纵向地重叠。
由图76中的钉腔的布置产生的侧向重叠和纵向间隙可足以充分阻挡穿过钉线的流体通路以密封组织。在各种实例中,侧向和/或纵向重叠和/或间隙可被构造成能够选择性地优化钉线的密封特性。除此之外或另选地,侧向和/或纵向重叠和/或间隙可被构造成能够选择性地优化钉线的柔性。此外,可使重叠最小化。在某些实例中,侧向重叠可小于钉长度的三分之一,并且在至少一个实例中可约等于钉的直径。
现在参见图77,示出了钉仓体3300的一部分。钉仓体3300包括平台3302和纵向狭槽3304。纵向狭槽3304沿纵向轴线LA延伸。钉腔3310限定在钉仓体3300中,并且每个钉腔3310包括平台3302中的开口3312。钉3342被定位在每个钉腔3310中。钉3342在许多方面可类似于钉3042(图59)或钉3142(图60)。在某些实例中,每个钉3342的腿部可偏置抵靠钉腔3310的内壁。读者将理解,钉腔3310中的钉3342的布置对应于当钉3342从钉仓体3300被击发并进入组织时钉3342在钉线中的布置。更具体地,所得到的钉线中的每个钉3342的基部与腔轴线CA共线或基本上共线。
钉腔开口3312在纵向狭槽3304的第一侧上被布置成三个排3314a,3314b和3314c。内开口3312a限定内排3314a中的内腔3310a的周边,中间开口3312b限定中间排3314b中的中间腔3310b的周边,并且外开口3312c限定外排3314c中的外腔3310c的周边。内部钉3342a被定位在内腔3310a中,中间钉3342b被定位在中间腔3310b中,并且外部钉3342c被定位在外腔3310c中。尽管未在图77中示出,在至少一个实例中,狭槽3304的相对侧上的钉腔3310形成纵向狭槽3304的第一侧上的钉腔3310的镜像反射。因此,在所得到的钉线中的钉3342的布置相对于切割线对称。在其他实例中,钉线可相对于切割线不对称。
每个钉腔开口3312具有第一端部或近侧端部3316和第二端部或远侧端部3318。腔轴线CA在每个开口3312的近侧端部3316和远侧端部3318之间延伸。每个相应排中的钉腔开口3312是平行的。例如,内腔3310a相对于纵向轴线LA以角度A取向。换句话说,内开口3312a的腔轴线(例如,CAA)相对于纵向轴线LA以角度A取向。中间腔3310b相对于纵向轴线LA以角度B取向。换句话说,中间开口3312b的腔轴线(例如,CAB)相对于纵向轴线LA以角度B取向。外腔3310c相对于纵向轴线LA以角度C取向。换句话说,由外开口3312c限定的腔轴线(例如,CAC)相对于纵向轴线LA以角度C取向。
在钉仓体3300中,角度A等于角度C,并且角度B是角度A和C的补角。因此,内开口3312a平行于外开口3312c,并且中间开口3312b分别垂直于内开口3312a和外开口3312c。钉仓体3300中的钉腔开口3312形成人字形图案。此外,仍然参见图77,每个排3314a,3314b,3314c中的钉3342具有相同长度的基部BL。钉排的宽度相等,并且钉3342的纵向长度也相等。
仍然参见图77,内部钉3342a和中间钉3342b之间的纵向重叠XA/B等于外部钉3342c和中间钉3342b之间的纵向重叠XB/C。此外,内部钉3342a和中间钉3342b之间的侧向重叠YA/B等于外部钉3342c和中间钉3342b之间的侧向重叠YB/C。在所述实例中,中间钉3342b等距离地靠近内部钉3342a和外部钉3342c定位。
仍然参见图77,使仓体3300中的钉腔3310之间的间距最小化。例如,钉腔开口3312的近侧端部3316和远侧端部3318定位成邻近其他钉腔3312。在某些实例中,相邻的钉腔可邻接接触。通过最小化钉腔3310之间的间距,钉腔3310的密度和图77的布置中的钉腔3310之间的重叠程度被最大化。尽管重叠程度最大化,但由于钉腔的紧密接近,侧向重叠仍然小于钉长度的三分之一。
在其他实例中,至少一个钉腔排中的钉腔的角度取向可与其他排中的钉腔的角度取向不同。除此之外或另选地,至少一个钉腔排中的钉基部的长度可与至少另一个排中的钉基部的长度不同。除此之外或另选地,钉腔可不与每个相邻排中的相邻钉腔等距交错或偏置。钉仓和其中的钉的这种变化可相对于切割线产生侧向地具有不同特性的钉线。
在某些实例中,例如,钉线的内部部分中的钉(诸如从钉腔的内排击发的钉)可具有与钉线的外部部分中的钉不同的基部长度。例如,刀狭槽的每个侧面上的钉腔的内排中的钉可具有比钉腔的其他排中的钉更长的基部。较长的基部可提供更大的密封能力,因为例如钉可捕获更多的组织。除此之外或另选地,较长的基部可增强钉线并降低其柔性。
现在参见图78,示出了钉仓体3400的一部分。钉仓体3400包括平台3402和纵向狭槽3404。纵向狭槽3404沿纵向轴线LA延伸。钉腔3410限定在钉仓体3400中,并且每个钉腔3410在平台3402中限定开口3412。钉3442被定位在每个钉腔3410中。钉3442在许多方面可类似于钉3042(图59)或钉3142(图60)。在某些实例中,每个钉3442的腿部可偏置抵靠钉腔3410的内壁。读者将理解,钉腔3410中的钉3442的布置对应于当钉3442从仓体3400被击发并进入组织时钉3442在钉线中的布置。更具体地,所得到的钉线中的每个钉3442的基部与腔轴线CA共线或基本上共线。
钉腔开口3412在纵向狭槽3404的第一侧上被布置成三个排3414a,3414b和3414c。内开口3412a限定内排3414a中的内腔3410a的周边,中间开口3412b限定中间排3414b中的中间腔3410b的周边,并且外开口3412c限定外排3414c中的外腔3410c的周边。内部钉3442a被定位在内腔3410a中,中间钉3442b被定位在中间腔3410b中,并且外部钉3442c被定位在外腔3410c中。尽管未在图78中示出,在至少一个实例中,狭槽3404的相对侧上的钉腔3410形成纵向狭槽3404的第一侧上的钉腔3410的镜像反射。因此,在所得到的钉线中的钉3442的布置相对于切割线对称。在其他实例中,钉线可相对于切割线不对称。
每个钉腔开口3412具有第一端部或近侧端部3416和第二端部或远侧端部3418。腔轴线CA在每个开口3412的近侧端部3416和远侧端部3418之间延伸。每个排中的钉腔开口3412是平行的。例如,内腔3410a相对于纵向轴线LA以角度A取向。换句话说,内开口3412a的腔轴线(例如,CAA)相对于纵向轴线LA以角度A取向。中间腔3410b相对于纵向轴线LA以角度B取向。换句话说,中间开口3412b的腔轴线(例如,CAB)相对于纵向轴线LA以角度B取向。外腔3410c相对于纵向轴线LA以角度C取向。换句话说,由外开口3412c限定的腔轴线(例如,CAC)相对于纵向轴线LA以角度C取向。
角度A、B和C是不同的。内开口3412a相对于外开口3412c倾斜地取向。角度A小于角度C。因为外开口3412c的轴线(例如,轴线CAC)不平行于内开口3412a的轴线(例如,轴线CAA),所以钉仓体3400中的钉腔开口3412形成修改的或倾斜的人字形图案。中间开口3412b的腔轴线CAB可取向成垂直于或基本上垂直于内开口3412a或外开口3412c。例如,角度B可以是角度A或C的补角。在其他实例中,角度B可不是角度A或C的补角。
仍然参见图78,内部钉3442a具有基部长度BLA,中间钉3442b具有基部长度BLB,并且外部钉3442c具有基部长度BLC。基部长度BLA大于基部长度BLB和基部长度BLC。换句话说,内部钉3442a比中间钉3442b和外部钉3442c长。此外,容纳内部钉3442a的钉腔3410相应地更大以容纳更长的基部BLA。
钉仓3400中的钉腔3410的布置在中间钉3442b的近侧端部和远侧端部处提供内部钉3442a和中间钉3442b之间的纵向重叠XA/B。中间钉3442b在两个相邻的内部钉3442a之间等距间隔并纵向交错。中间钉3442b也在两个相邻的外部钉3442c之间等距间隔并纵向交错。每个外部钉3442c的近侧端部与中间钉3442b的远侧端部纵向对准,并且每个外部钉3442c的远侧端部与另一个中间钉3442b的近侧端部纵向对准。换句话说,这种钉纵向对准,并且纵向重叠等于钉3442的直径。钉仓3400中的钉腔3410的布置还在内排3414a和中间排3414b之间提供侧向间隙YA/B,并且在外排3414c和中间排3414b之间提供侧向重叠YB/C。在所述实例中,中间钉3442b定位成更靠近外部钉3442c而不是内部钉3442a。
仍然参见图78,由钉仓体3400产生的钉线可相对于切割线侧向地具有不同的特性。具体地,相比于从切割线侧向向外,钉线沿切割线可具有更大的密封效果。此外,相比于向内朝向切割线,钉线侧向远离切割线可具有更大的柔性。例如,因为内部钉3442a的基部BLA分别比中间钉3442b和外部钉3442c的基部BLB和BLC长,所以钉线的内部部分相比于钉线的外部部分可具有更大的密封效果和/或更小的柔性。除此之外或另选地,因为内部钉3442a以小于外部钉3442c的角度取向并且比外部钉3442c更接近平行取向,所以钉线的内部部分相比于钉线的外部部分可具有更大的密封效果和/或更小的柔性。除此之外或另选地,因为中间钉3442b与内部钉3442a纵向重叠但不与外部钉3442c纵向重叠,所以钉线的内部部分相比于钉线的外部部分可具有更大的密封效果和/或更小的柔性。可最小化重叠量。例如,重叠可小于钉长度的三分之一,并且在至少一个实例中可约等于钉的直径。
在某些实例中,例如,钉线的外部部分中的钉(诸如从钉腔的外排击发的钉)可具有与钉线的内部部分中的钉不同的基部长度。例如,刀狭槽的每个侧面上的钉腔的外排中的钉可具有比钉腔的其他排中的钉更短的基部。例如,较短的基部可提供钉线的增加的柔性。
现在参见图79,示出了钉仓体3500的一部分。钉仓体3500包括平台3502和纵向狭槽3504。纵向狭槽3504沿纵向轴线LA延伸。钉腔3510限定在钉仓体3500中,并且每个钉腔3510在平台3502中限定开口3512。钉3542被定位在每个钉腔3510中。钉3542在许多方面可类似于钉3042(图59)或钉3142(图60)。在某些实例中,每个钉3542的腿部可偏置抵靠钉腔3510的内壁。读者将理解,钉腔3510中的钉3542的布置对应于当钉3542从仓体3500被击发并进入组织时钉3542在钉线中的布置。更具体地,所得到的钉线中的每个钉3542的基部与腔轴线CA共线或基本上共线。
钉腔开口3512在纵向狭槽3504的第一侧上被布置成三个排3514a,3514b和3514c。内开口3512a限定内排3514a中的内腔3510a的周边,中间开口3512b限定中间排3514b中的中间腔3510b的周边,并且外开口3512c限定外排3514c中的外腔3510c的周边。内部钉3542a被定位在内腔3510a中,中间钉3542b被定位在中间腔3510b中,并且外部钉3542c被定位在外腔3510c中。尽管未在图79中示出,在至少一个实例中,狭槽3504的相对侧上的钉腔3510形成纵向狭槽3504的第一侧上的钉腔3510的镜像反射。因此,在所得到的钉线中的钉3542的布置相对于切割线对称。在其他实例中,钉线可相对于切割线不对称。
每个钉腔开口3512具有第一端部或近侧端部3516和第二端部或远侧端部3518。腔轴线CA在每个开口3512的近侧端部3516和远侧端部3518之间延伸。每个排中的钉腔开口3512是平行的。例如,内腔3510a相对于纵向轴线LA以角度A取向。换句话说,内开口3512a的腔轴线(例如,CAA)相对于纵向轴线LA以角度A取向。中间腔3510b相对于纵向轴线LA以角度B取向。换句话说,中间开口3512b的腔轴线(例如,CAB)相对于纵向轴线LA以角度B取向。外腔3510c相对于纵向轴线LA以角度C取向。换句话说,由外开口3512c限定的腔轴线(例如,CAC)相对于纵向轴线LA以角度C取向。
角度A、B和C可不同。内开口3512a相对于外开口3512c倾斜地取向。角度A小于角度C。因为外开口3512c的轴线(例如,轴线CAC)不平行于内开口3512a的轴线(例如,轴线CAA),所以钉仓体3500中的钉腔开口3512形成修改的或倾斜的人字形图案。中间开口3512b的腔轴线CAB可取向成垂直于或基本上垂直于内开口3512a或外开口3512c。例如,角度B可以是角度A或C的补角。在其他实例中,角度B可不是角度A或C的补角。
内部钉3542a具有基部长度BLA,中间钉3542b具有基部长度BLB,并且外部钉3542c具有基部长度BLC。基部长度BLC小于基部长度BLB和基部长度BLA。换句话说,外部钉3542c比中间钉3542b和内部钉3542a短。此外,容纳外部钉3542c的钉腔3510相应地较短以容纳较短的基部BLC。
钉仓3500中的钉腔3510的布置在中间钉3542b的近侧端部和远侧端部处提供内部钉3542a和中间钉3542b之间的纵向重叠XA/B。中间钉3542b在两个相邻的内部钉3542a之间等距间隔并纵向交错。钉仓3500中的钉腔3510的布置还在中间钉3542b的近侧端部和远侧端部处提供中间钉3542b和外部钉3542c之间的纵向重叠XB/C。中间钉3542b也在两个相邻的外部钉3542c之间等距间隔并纵向交错。由于钉3542的角度取向和间距,纵向重叠XA/B大于纵向重叠XB/C。钉仓3500中的钉腔3510的布置还在内部钉3542a和中间钉3542b之间提供侧向间隙YA/B,并且在外部钉3542c和中间钉3542b之间提供侧向重叠YB/C。在所述实例中,中间钉3542b定位成相比于内部钉3542a更靠近外部钉3542c。
仍然参见图79,由钉仓体3500产生的钉线可相对于切割线侧向地具有不同的特性。具体地,相比于从切割线侧向向外,钉线沿切割线可具有更大的密封效果。此外,相比于向内朝向切割线,钉线侧向远离切割线可具有更大的柔性。例如,因为外部钉3542c的基部BLC分别比中间钉3542b和外部钉3542c的基部BLA和BLB短,所以钉线的内部部分相比于钉线的外部部分可具有更大的密封效果和/或更小的柔性。除此之外或另选地,因为内部钉3542a以小于外部钉3542c的角度取向并且比外部钉3542c更接近平行取向,所以钉线的内部部分相比于钉线的外部部分可具有更大的密封效果和/或更小的柔性。除此之外或另选地,因为相比于中间钉3542b纵向地重叠外部钉3542c,中间钉3542b更加纵向地重叠内部钉3542a,所以钉线的内部部分可具有比钉线的外部部分更大的密封效果和/或更小的柔性。
在各种实例中,可在每个钉排中定制钉线的特性。在刀狭槽的一侧上的每个钉腔排中的钉可具有不同的基部长度。另外,刀狭槽的一侧上的每个钉腔排中的钉可相对于刀狭槽以不同的角度取向。此外,腔之间的间距可逐排变化。例如,可选择每个排中的钉的尺寸和取向,以基于从切割线朝向钉线的外边界侧向的排的位置来优化钉线的柔性和每个排中的密封特性。在某些实例中,例如,沿切割线可最大化或强调密封效果,并且例如,可沿钉线的外边界最大化或强调钉线的柔性。另选地,在某些实例中,可沿钉线的外边界最大化或强调密封效果和/或可沿切割线最大化或强调钉线的柔性。
现在参见图80,示出了钉仓体3600的一部分。钉仓体3600包括平台3602和纵向狭槽3604。纵向狭槽3604沿纵向轴线LA延伸。钉腔3610限定在钉仓体3600中,并且每个钉腔3610在平台3602中限定开口3612。钉3642被定位在每个钉腔3610中。钉3642在许多方面可类似于钉3042(图59)或钉3142(图60)。在某些实例中,每个钉3642的腿部可偏置抵靠钉腔3610的内壁。读者将理解,钉腔3610中的钉3642的布置对应于当钉3642从仓体3600被击发并进入组织时钉3642在钉线中的布置。更具体地,所得到的钉线中的每个钉3642的基部与腔轴线CA共线或基本上共线。
钉腔开口3612在纵向狭槽3604的第一侧上被布置成三个排3614a,3614b,3614c。内开口3612a限定内排3614a中的内腔3610a的周边,中间开口3612b限定中间排3614b中的中间腔3610b的周边,并且外开口3612c限定外排3614c中的外腔3610c的周边。内部钉3642a被定位在内腔3610a中,中间钉3642b被定位在中间腔3610b中,并且外部钉3642c被定位在外腔3610c中。尽管未在图80中示出,在至少一个实例中,狭槽3604的相对侧上的钉腔3610形成纵向狭槽3604的第一侧上的钉腔3610的镜像反射。因此,在所得到的钉线中的钉3642的布置相对于切割线对称。在其他实例中,钉线可相对于切割线不对称。
每个钉腔开口3612具有第一端部或近侧端部3616和第二端部或远侧端部3618。腔轴线CA在每个开口3612的近侧端部3616和远侧端部3618之间延伸。每个排中的钉腔开口3612是平行的。例如,内腔3610a相对于纵向轴线LA以角度A取向。换句话讲,内开口3612a的腔轴线(例如,CAA)相对于纵向轴线LA以角度A取向。中间腔3610b相对于纵向轴线LA以角度B取向。换句话说,中间开口3612b的腔轴线(例如,CAB)相对于纵向轴线LA以角度B取向。外腔3610c相对于纵向轴线LA以角度C取向。换句话说,由外开口3612c限定的腔轴线(例如,CAC)相对于纵向轴线LA以角度C取向。
角度A、B和C可不同。内开口3612a相对于外开口3612c倾斜地取向。角度A小于角度C。因为外开口3612c的轴线(例如,轴线CAC)不平行于内开口3612a的轴线(例如,轴线CAA),所以钉仓体3600中的钉腔开口3612形成修改的或倾斜的人字形图案。中间开口3612b的腔轴线CAB可取向成垂直于或基本上垂直于内开口3612a或外开口3612c。例如,角度B可以是角度A或C的补角。在其他实例中,角度B可不是角度A或C的补角。
内部钉3642a具有基部长度BLA,中间钉3642b具有基部长度BLB,并且外部钉3642c具有基部长度BLC。基部长度BLC小于基部长度BLB,并且基部长度BLB小于基部长度BLA。换句话说,钉3642的长度朝向纵向狭槽3604侧向增加。此外,钉腔3610的长度相应地朝向纵向狭槽3604侧向增加,以容纳较大的钉。
仓体3600中的钉腔3610的布置在中间钉3642b的近侧端部和远侧端部处提供内部钉3642a和中间钉3642b之间的纵向重叠XA/B。中间钉3642b在两个相邻的内部钉3642a之间等距间隔并纵向交错。仓体3600中的钉腔3610的布置还在中间钉3642b的近侧端部和远侧端部处在中间钉3642b和外部钉3642c之间提供纵向间隙XB/C。中间钉3642b也在两个相邻的外部钉3642c之间等距间隔并纵向交错。由于钉的角度取向、钉的间距和钉的长度的变化,纵向重叠XA/B大于纵向间隙XB/C。在其他实例中,纵向重叠XA/B可等于或小于纵向重叠XB/C。仓体3600中的钉腔3610的布置还在内排3614a和中间排3614b之间提供侧向间隙YA/B,并且在外排3614c和中间排3614b之间提供侧向重叠YB/C。
仍然参见图80,由钉仓体3600产生的钉线可相对于切割线侧向地具有不同的特性。具体地,相比于从切割线侧向向外,钉线邻近切割线可具有更大的密封效果。此外,相比于向内朝向切割线,钉线侧向远离切割线可具有更大的柔性。例如,因为钉3642a,3642b和3642c的基部BLA、BLB和BLC的长度分别朝向切割线侧向向内增加,所以钉线的内部部分可具有比钉线的外部部分更大的密封效果。除此之外或另选地,因为钉3642a,3642b和3642c的角度取向远离切割线侧向向外增加,所以钉线的外部部分可具有比钉线的内部部分更大的柔性。
如本文所述,钉可移除地被定位在钉仓中并且在使用期间从钉仓被击发。在各种实例中,钉可从钉仓中的钉腔中被驱出并与砧座成形接触。例如,击发元件可在击发行程期间平移穿过钉仓,以将钉从钉仓朝向砧座驱动。在某些实例中,钉可被钉驱动器支撑,并且击发元件可提升钉驱动器以从钉仓射出或移除钉。
砧座可包括钉成形表面,该钉成形表面具有限定在其中的钉成形凹坑。在某些实例中,钉成形凹坑可冲压在砧座中。例如,钉成形凹坑可压印在砧座的平坦表面中。读者将理解,钉成形凹坑的某些特征部可以是压印过程的有意后果。例如,在钉成形产品的拐角和/或边缘处的一定程度的倒圆可以是压印过程的有意结果。这些特征部还可设计成更好地将钉形成为其成形构造,包括在部署期间变得偏斜和/或以其他方式不对准的钉。
钉仓中的每个钉可与砧座的钉成形凹坑对准。换句话说,用于端部执行器的钉仓中的钉腔和钉的布置可对应于或匹配端部执行器的砧座中的钉成形凹坑的布置。更具体地,每个钉腔的角度取向可匹配相应的钉成形凹坑的角度取向。例如,当钉腔以人字形图案布置时,钉成形凹坑也可以人字形图案布置。
当钉从钉仓被驱动并与砧座成形接触时,钉可形成为击发构造。在各种实例中,击发构造可以是B形构造,其中钉腿的尖端朝向钉基部或冠部弯曲,以形成具有对称的上部环和下部环的大写字母B。在其他实例中,击发构造可以是改进的B形,诸如偏斜的B形构造,其中钉腿的至少一部分与钉基部扭转出平面,或者是不对称的B形构造,其中大写字母B的上部环和下部环是不对称的。可在成形的钉内捕获或夹紧组织。
钉仓中的钉和/或钉腔的布置可被构造成能够优化钉互补砧座的成形表面中的钉成形凹坑的对应布置。例如,钉仓中的钉的角度取向和间距可设计成优化砧座的成形表面。在某些实例中,砧座中的钉成形凹坑的占有面积可受到砧座的几何形状的限制。在钉成形凹坑相对于纵向轴线倾斜地取向的情况下,砧座的宽度可限制倾斜地取向的钉成形凹坑的尺寸和间距。例如,钉成形凹坑的中间排的宽度可限定中间排的一侧上的第一排(例如外排)与中间排的另一侧上的第二排(例如内排)之间的最小距离。此外,成排的钉成形凹坑被限制在砧座的内侧边缘(诸如刀狭槽)和砧座的外侧边缘之间。
在各种实例中,凹坑可沿砧座的钉成形表面相邻地嵌套。例如,中间凹坑可嵌套在内部凹坑和外部凹坑之间。凹坑的角度取向可逐排变化以便于其嵌套。例如,内排中的钉成形凹坑可以第一角度取向,中间排中的钉成形凹坑可以第二角度取向,并且外排中的钉成形凹坑可以第三角度取向。第一角度、第二角度和第三角度可以是不同的,这可促进钉成形凹坑的紧密布置。
再次参考图76至图80中所示的钉仓,可选择每个排中的钉和钉腔的变化角度,以优化钉成形凹坑在互补砧座中的嵌套。对于图76至图80中所示的每个钉仓,互补的砧座可被构造成能够具有钉成形凹坑的对应布置。此外,互补砧座中的钉成形凹坑可比图76至图80中所示的钉腔大以确保钉腿着陆或落入钉成形凹坑内。例如,钉腿可向外偏置,诸如在V形钉的情况下(参见图60),并且钉成形凹坑的较大占有面积可在击发期间捕获向外偏置的钉腿。在各种实例中,钉成形凹坑可比对应的钉腔和/或钉长0.005英寸至0.015英寸。除此之外或另选地,每个钉成形凹坑的钉接收杯可比对应的钉腔宽0.005英寸至0.015英寸。在其他实例中,长度和/或宽度的差异可小于0.005英寸或大于0.015英寸。
在钉的尺寸在钉仓内变化的实例中(参见例如图78至图80),钉成形凹坑的尺寸可在互补的砧座内相应地变化。改变钉成形凹坑的尺寸可进一步促进其嵌套。例如,在中间排中的钉成形凹坑比内排或外排中的钉成形凹坑短的情况下,可减小钉凹坑的中间排的宽度,这可最小化内排和外排之间的必要间距。
钉成形凹坑的间距也可被构造成能够优化其嵌套。例如,布置在内排中的凹坑可相对于布置在外排中的凹坑纵向交错。此外,内排中的凹坑可部分地与外排中的凹坑纵向地重叠。中间排中的凹坑可相对于内排中的凹坑和外排中的凹坑纵向交错。例如,中间排中的凹坑可与外排中的凹坑和内排中的凹坑等距地纵向偏置。
现在参见图129,示出了砧座3700。砧座3700可与钉仓3500(图79)互补。例如,砧座3700中的钉成形凹坑3706的布置可对应于钉仓3500中的钉3542和钉腔3510(图79)的布置。砧座3700包括钉成形表面3702和纵向狭槽3704。纵向狭槽3704沿砧座3700的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽3704。钉成形凹坑3706限定在钉成形表面3702中。钉成形表面3702还包括围绕凹坑3706延伸的非成形部分3708。非成形部分3708完全围绕图129中的每个凹坑3706延伸。换句话说,非成形部分3708围绕钉成形凹坑3706。在其他实例中,两个或更多个相邻凹坑3706的至少一部分可邻接接触,使得非成形部分3708不被定位在两者间。
可优化钉成形表面3702的成形比。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座3700的非成形部分3708的表面区域可相对于钉成形凹坑3706被最小化。除此之外或另选地,钉成形凹坑3706的占有面积可延伸或扩大,以最大化钉成形表面3702的被设计用于捕获和形成钉的部分。
图129中示出的凹坑3706在纵向狭槽3704的第一侧上被布置成三个排3714a,3714b,3714c。第一排3714a是内排,第二排3714b是中间排,并且第三排3714c是外排。内部凹坑3706a被定位在内排3714a中,中间凹坑3706b被定位在中间排3714b中,并且外部凹坑3706c被定位在外排3714c中。凹坑3706沿砧座3700的钉成形表面3702布置成人字形布置。尽管未在图129中示出,在至少一个实例中,狭槽3704的相对侧上的凹坑3706可形成纵向狭槽3704的第一侧上的凹坑3706的镜像反射。在其他实例中,钉成形表面3702中的凹坑3706的布置可相对于狭槽3704不对称,并且在某些实例中,砧座3700可不包括纵向狭槽3704。在各种实例中,凹坑3706可在狭槽3704的每个侧面上被布置成少于或多于三排。
每个凹坑3706包括周边3716,周边3716限定凹坑3706b的边界。每个凹坑3706还包括近侧杯3720,远侧杯3722,以及连接近侧杯3720和远侧杯3722的颈部部分3724。当钉被驱动成与钉成形表面3702成形接触时,近侧杯3720与近侧钉腿对准,并且远侧杯3722与远侧钉腿对准。钉腿的尖端被定位和被构造成能够着陆在相应的杯3720,3722中。换句话说,近侧杯3720被构造成能够接收近侧钉腿,并且远侧杯3722被构造成能够接收远侧钉腿。杯3720和3722还被构造成能够将钉腿朝向凹坑轴线PA和凹坑3806的中心部分(诸如颈部部分3724)引导或传送(funnel),并使钉腿变形成所成形的构造。
凹坑3706的几何形状、间距和/或取向可逐排变化。凹坑轴线PA从近侧杯3720延伸,穿过颈部部分3724,并且延伸到每个凹坑3706的远侧杯3722。每排中的凹坑3706是平行的。例如,内部凹坑3706a相对于纵向轴线LA以角度A取向。换句话说,内部凹坑3706a的凹坑轴线(例如,PAA)相对于纵向轴线LA以角度A取向。中间凹坑3706b相对于纵向轴线LA以角度B取向。换句话说,内部凹坑3706b的凹坑轴线(例如,PAB)相对于纵向轴线LA以角度B取向。外部凹坑3706c相对于纵向轴线LA以角度C取向。换句话说,内部凹坑3706a的凹坑轴线(例如PAC)相对于纵向轴线LA以角度C取向。
角度A、B和C可不同。内部凹坑3706a相对于外部凹坑3706c倾斜地取向。角度A小于角度C。因为外部凹坑3706c的轴线(例如,轴线PAC)不平行于内部凹坑3706a的轴线(例如,轴线PAA),所以砧座3700中的钉成形凹坑3706形成修改的或偏斜的人字形图案。中间凹坑3706b的凹坑轴线PAB相对于内部凹坑3706a和外部凹坑3706c倾斜地取向。在其他实例中,中间凹坑3706b的凹坑轴线PAB可取向成垂直于或基本上垂直于内部凹坑3706a或外部凹坑3706c。例如,角度B可以是角度A或C的补角。
内部凹坑3706a具有长度LA,中间凹坑3706b具有长度LB,并且外部凹坑3706c具有长度LC。长度LC小于长度LB和长度LA。换句话说,外部凹坑3706c比中间凹坑3706b和内部凹坑3706a短。在某些实例中,长度LA、LB和LC可以是不同的。在其他实例中,长度LA、LB和LC可以是相同的。在其他实例中,长度LB可小于长度LA和/或LB,和/或长度LA可小于长度LA和/或LC。可选择长度LA、LB和LC以优化凹坑3706的嵌套。
钉成形凹坑3706的间距也可被构造成能够优化其嵌套。例如,内部凹坑3706a可相对于外部凹坑3706c纵向交错。此外,内部凹坑3706a可部分地与外部凹坑3706c纵向重叠。参见图129,内部凹坑3706a的第一端部与外部凹坑3706c的对应端部纵向偏置距离X1A/C。此外,内部凹坑3706a的第二端部与外部凹坑3706c的对应端部纵向偏置距离X2A/C。距离X2A/C小于距离X1A/C。在其他实例中,距离X2A/C可等于或大于距离X1A/C。中间凹坑3706b相对于内部凹坑3706a和外部凹坑3706c纵向交错。更具体地,中间凹坑3706b在相邻的内部凹坑3706a之间以及相邻的外部凹坑3706c之间等距纵向地偏置。在其他实例中,中间凹坑3706b可在相邻的内部凹坑3706a之间以及相邻的外部凹坑3706c之间非等距地偏置。
凹坑3706的布置被构造成能够嵌套凹坑3706,使得凹坑3706配合在预定空间内。例如,在某些实例中,砧座的宽度可被最小化或以其他方式限制以配合在外科套管针内和/或狭窄的外科手术区域内,并且钉成形凹坑3706的布置(以及钉和/或钉腔的对应布置)可配合在狭窄的砧座内。
现在参见图81至图84C,示出了砧座3800的一部分中的钉成形凹坑3806。砧座3800包括钉成形表面3802和纵向狭槽3804。纵向狭槽3804沿砧座3800的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽3804。钉成形凹坑3806限定在钉成形表面3802中,其还包括围绕凹坑3806延伸的非成形部分3808。非成形部分3808完全围绕每个凹坑3806延伸。换句话说,非成形部分3808围绕钉成形凹坑3806。在其他实例中,两个或更多个相邻凹坑的至少一部分可邻接接触,使得非成形部分不被定位在两者间。在某些实例中,非成形部分3808可延伸越过凹坑3806中的一个或多个。
可优化钉成形表面3802的“成形比”(非成形部分3808与成形部分(即凹坑3806)的比率)。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座3800的非成形部分3808的表面区域可相对于钉成形凹坑3806被最小化。除此之外或另选地,钉成形凹坑3806的占有面积可延伸或扩大,以最大化钉成形表面3802的被设计用于捕获和形成钉的部分。例如,这种布置可防止无意的畸形钉,无论出于何种原因,钉在击发过程期间都会缺失或落在它们对应的成形凹坑之外。
图81中示出的凹坑3806在纵向狭槽3804的第一侧上被布置成三个排3814a,3814b和3814c。第一排3814a是内排,第二排3814b是中间排,并且第三排3814c是外排。内部凹坑3806a被定位在内排3814a中,中间凹坑3806b被定位在中间排3814b中,并且外部凹坑3806c被定位在外排3814c中。尽管未在图81中示出,在至少一个实例中,狭槽3804的相对侧上的凹坑3806可形成纵向狭槽3804的第一侧上的凹坑3806的镜像反射。在其他实例中,钉成形表面3802中的凹坑3806的布置可相对于狭槽3804不对称,并且在某些实例中,砧座3800可不包括纵向狭槽3804。在各种实例中,凹坑3806可在狭槽3804的每个侧面上被布置成少于或多于三排。
图81中示出的凹坑3806是相同的。限定在钉成形表面3802中的每个凹坑3806具有相同的几何形状。在其他实例中,凹坑3806的几何形状可沿砧座3800的长度逐排和/或纵向地变化。例如,在某些实例中,凹坑3806或其部分的深度可沿砧座3800的长度变化,以适应砧座和钉仓之间的间隙距离沿端部执行器和/或组织流的长度的变化,如本文所述。
示例性凹坑3806b在图82至图84C中示出。凹坑3806b具有第一端部或近侧端部3810和第二端部或远侧端部3812。凹坑轴线PA在凹坑3806b的近侧端部3810和远侧端部3814之间延伸。再次参见图81,每个相应排中的凹坑3806是平行的。例如,内部凹坑3806a的凹坑轴线(例如,PAA)彼此平行,中间凹坑3806b的凹坑轴线(例如,PAB)彼此平行,并且外部凹坑3806c的凹坑轴线(例如,PAC)彼此平行。凹坑轴线PA相对于狭槽3804倾斜地取向。此外,中间凹坑3806b的轴线PAB分别取向成垂直于内部凹坑3806a和外部凹坑3806c的轴线PAA和PAC。这样,凹坑3806沿钉成形表面3802布置成人字形布置。
凹坑3806b包括周边3816,周边3816限定凹坑3806b的边界。凹坑3806b还包括近侧杯3820,远侧杯3822,以及连接近侧杯3820和远侧杯3822的颈部部分3824。当钉被驱动成与钉成形表面3802成形接触时,近侧杯3820与近侧钉腿对准,并且远侧杯3822与远侧钉腿对准。钉腿的尖端被定位和被构造成能够着陆在相应的杯3820,3822中。换句话说,近侧杯3820被构造成能够接收近侧钉腿,并且远侧杯3822被构造成能够接收远侧钉腿。杯3820和3822还被构造成能够将钉腿朝向凹坑轴线PA和凹坑3806的中心部分(诸如颈部部分3824)引导或传送(funnel),并使钉腿变形成所成形的构造。
凹坑3806包括用于钉腿的延伸着陆区。参考图82中示出的凹坑3806b,凹坑3806b包括近侧延伸着陆区3830和远侧延伸着陆区3832。近侧延伸着陆区3830被定位在近侧杯3820的近侧部分中,并且远侧延伸着陆区3832被定位在远侧杯3822的远侧部分中。延伸着陆区3830和3832限定基本上三角形的周边。此外,延伸着陆区3830和3832沿凹坑轴线PA终止于一个点以形成凹坑3806b的拐角。
在其他实例中,延伸着陆区3830和3832可限定例如直的和/或波状周边,并且可相对于凹坑轴线PA侧向和/或纵向延伸。在钉或其一部分在击发期间偏斜的实例中,延伸着陆区3830,3832可挽救或至少试图挽救偏斜的钉的成形。
主要参见图83,凹坑3806b的每个杯3820、3822限定入口斜坡3840和出口斜坡3842。出口斜坡3842比入口斜坡3840更陡。当形成钉时,钉腿的尖端可沿入口斜坡3840进入相应的杯3820,3822并且沿出口斜坡3842离开相应的杯3820,3822。在入口斜坡3840和出口斜坡3842之间的顶点3846处,钉腿的尖端朝向钉基部变形以呈现成形的构造,例如诸如B形或修改的B形。近侧杯3820在其顶点3846处限定相对于钉成形表面3802的非成形部分3808测量的近侧深度D1,并且远侧杯3822在其顶点3846处限定相对于钉成形表面3802的非成形部分3808测量的远侧深度D2。在凹坑3806b中,近侧深度D1和远侧深度D2相等。在其他实例中,近侧深度D1和远侧深度D2可以是不同的。
凹坑3806b还在近侧杯3820和远侧杯3822之间的颈部部分3824中限定桥接件3844。桥接件3844与钉成形表面3802的非成形部分3808偏置。更具体地,桥接件3844被定位在非成形部分3808下方或相对于非成形部分3808凹入。在其他实例中,桥接件3844可与非成形部分3808对准和/或可从非成形部分3808朝向端部执行器的相对钳口突出。
主要参见图84A至图84C,凹坑3806b包括侧壁3850。侧壁3850被取向成垂直于钉成形表面3802的非成形部分3808。侧壁3850朝向每个杯3820,3822的中心区域3821变宽,并且从每个杯3820,3822的中心区域3821朝向颈部部分3824变窄。加宽的中心区域3821提供用于接收钉腿的尖端的扩大的占有面积。延伸着陆区3830,3832还扩大了用于接收钉尖端的相应杯3820,3822的占有面积。当杯3820,3822朝向颈部部分3824变窄时,杯3820,3822被构造成能够朝向和/或沿凹坑轴线PA传送和/或引导钉腿的尖端并且进入成形构造。随着杯3820和3822变宽并且然后朝向颈部部分3824变窄,凹坑3806b的周边3816限定轮廓或弧形轮廓。在其他实例中,凹坑3806b的周边3816可沿具有非圆角的线性非波状轮廓延伸。
凹坑3806b在凹坑3806b的侧壁3850和底表面之间限定圆角3852(图84A至图84C)。圆角3852被构造成能够沿凹坑3806b中的期望路径引导钉腿。例如,如果钉腿沿圆角3852着陆或者被转移到圆角3852,则圆角3852可平滑地引导钉腿朝向凹坑轴线PA。
再次参见图82,凹坑3806b关于凹坑轴线PA对称。例如,凹坑3806b的周边3816关于凹坑轴线PA对称。此外,凹坑3806b关于穿过颈部部分3824并垂直于凹坑轴线PA的中心轴线CA对称。例如,每个凹坑3806的周边3816关于中心轴线CA对称,并且近侧杯3820具有与远侧杯3822相同的几何形状。
在其他实例中,近侧杯3820可与远侧杯3822不同。例如,再次参见图83,远侧深度D2可小于近侧深度D1。在各种实例中,钉成形凹坑的深度的变化可适应砧座和钉仓之间的间隙距离在组织夹紧在两者间时沿端部执行器的长度的变化。例如,当砧座接近端部执行器的远侧端部时,砧座可从钉仓翘曲或弯曲。钉成形凹坑3806的深度的变化可被构造成能够确保考虑到砧座3800的预期或期望的翘曲或弯曲而保持适当的成形高度。
除此之外或另选地,钉成形凹坑的深度的变化可适应相对于端部执行器的组织运动或流动。更具体地,当组织被夹紧在端部执行器的钳口之间时,被夹紧的组织中的流体可朝向相邻的未夹紧组织流动或运动。组织可朝向砧座3800的纵向侧面侧向流动,朝向砧座3800的远侧端部朝远侧流动,和/或朝向砧座3800的近侧端部朝近侧流动。在某些实例中,当切割边缘被朝远侧推进穿过组织时,组织可相对于砧座3800流动。在所述实例中,组织可侧向地、朝远侧和/或朝近侧流动,但由于切割边缘的远侧运动,所以组织主要朝远侧流动。在切割边缘朝近侧运动以切开组织的实例中,组织的运动或流动在切割行程期间通常是朝近侧的。凹坑3806中的不同深度D1和D1可适应组织的远侧流动,这可使嵌入其中的钉腿朝远侧移位或偏斜。
在各种实例中,端部执行器的远侧端部处的组织运动或流动可大于端部执行器的近侧端部处的组织运动或流动。这种实例可因端部执行器内击发构件的远侧运动而出现。尽管击发构件被构造成能够随着其朝远侧运动而渐进地缝合和切入组织,但击发构件也可朝远侧推进或推动组织。此推动或推进效应可从端部执行器的近侧端部开始且可随着击发构件朝远侧运动而复合,使得在端部执行器的远侧端部处实现最大的推动或推进效应。因此,组织流动可朝向端部执行器的远侧端部增加。为了适应组织流动的这种增加,钉凹坑的几何形状可沿排的长度纵向变化。在钉仓的近侧杯和远侧杯不同以适应组织流动的实例中,凹坑不对称中的梯度可在一排凹坑内使用以补偿组织运动和钉移位中的梯度。
在某些实例中,不同的钉几何形状可与不同的凹坑几何形状一起使用。2014年6月30日提交的名称为“FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENTCONFIGURATIONS”的美国专利申请号14/318,996中描述了使用不同的钉以适应沿端部执行器的长度的组织流动,该专利申请据此全文以引用方式并入本文。在其他实例中,可沿砧座的长度使用具有不同凹坑几何形状的相同钉。
再次参见图82,颈部部分3824限定宽度WN,并且近侧杯3820和远侧杯3822限定宽度WC。宽度WN小于宽度WC。因此,凹坑3806b的中心部分比近侧杯3820和远侧杯3822窄。颈部部分3824处的凹坑3806b的变窄的周边3816在近侧杯3820的一部分和远侧杯3822的一部分之间限定接收半岛部3826。由于凹坑3806b的对称性,对称的接收半岛部3826被定位在凹坑3806b的每个侧面上。接收半岛部3826由凹坑3806b的周边3816和切线轴线(例如,TA、TB1、TB2和TC)界定,该切线轴线与凹坑3806的侧面上的近侧杯3820和远侧杯3822的最宽部分相切。第一切线轴线TB1被定位在凹坑3806b的第一侧上,并且第二切线轴线TB2被定位在凹坑3806b的相对侧上。图82中示出的第一切线轴线TB1和第二切线轴线TB2与凹坑轴线PAB平行。
再次参见图81,凹坑3806的周边3816沿钉成形表面3802嵌套或互锁。具体地,每个凹坑3806延伸到相邻凹坑3806的接收半岛部3826中。例如,中间凹坑3806b嵌套在内部凹坑3806a和外部凹坑3806c之间。换句话说,中间凹坑3806b延伸到相邻内部凹坑3806a的接收半岛部3826中并且延伸到相邻外部凹坑3806c的接收半岛部3826中。此外,内部凹坑3806a和外部凹坑3806b与中间凹坑3806b嵌套。更具体地,内部凹坑3806a延伸到相邻中间凹坑3806b的接收半岛部3826中,并且外部凹坑3806c延伸到相邻中间凹坑3806b的接收半岛部3826中。
中间凹坑3806b的远侧杯3822延伸跨过切线轴线TA并进入相邻内部凹坑3806a的接收半岛部3826。此外,中间凹坑3806b的近侧杯3820延伸跨过切线轴线TC并进入相邻外部凹坑3806c的接收半岛部3826。另外,内部凹坑3806a的远侧杯3822延伸跨过切线轴线TB1并进入相邻中间凹坑3806b的接收半岛部3826。此外,外部凹坑3806c的近侧杯3820延伸跨过切线轴线TB2并进入相邻中间凹坑3806b的接收半岛部3826。在各种实例中,中间凹坑3806b的远侧延伸着陆区3832被定位在内部凹坑3806a的接收半岛部3826中,中间凹坑3806b的近侧延伸着陆区3830被定位在外部凹坑3806c的接收半岛部3826中,内部凹坑3806a的远侧延伸着陆区3832被定位在中间凹坑3806b的接收半岛部3826中,并且外部凹坑3806c的近侧延伸着陆区3830被定位在中间凹坑3806b的接收半岛部3826中。
凹坑3806的几何形状便于凹坑3806在钉成形表面3802中的嵌套。例如,因为凹坑3806包括在两个扩大的杯3820和3822之间的变窄的颈部部分3824,所以另一个凹坑3806的扩大的杯3820,3822中的一个可定位成邻近变窄的颈部部分3824。例如,扩大的杯3820,3822中的一个可与相邻的凹坑3806的一部分对准和/或被其接收。在所述实例中,可优化由凹坑3806覆盖的钉成形表面3802的表面区域。例如,由凹坑3806覆盖的钉成形表面3802的表面区域被最大化。钉成形表面3802的“成形比”是非成形部分3808与成形部分(即,凹坑3806)的比率。成形比为约1.7:1。在其他实例中,成形比可小于1.7:1或大于1.7:1。例如,在至少一个实例中,钉成形表面3802的50%以上可用钉成形凹坑3806覆盖。
本文讨论的钉成形凹坑的嵌套可指相邻凹坑周边的嵌套。例如,在第一凹坑限定向内轮廓的情况下,即轮廓朝向凹坑轴线向内延伸,相邻的第二凹坑可突出朝向和/或进入与向内轮廓相邻的区域。除此之外或另选地,第二凹坑的一部分诸如第二凹坑的端部可与第一凹坑的变窄区域对准。因此,与第二凹坑的端部与第一凹坑的较宽区域对准相比,第二凹坑可定位成更靠近第一凹坑的凹坑轴线。
现在参见图85至图88C,描绘了砧座3900的一部分中的钉成形凹坑3906。砧座3900包括钉成形表面3902和纵向狭槽3904。纵向狭槽3904沿砧座3900的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽3904。钉成形凹坑3906限定在钉成形表面3902中。钉成形表面3902还包括围绕凹坑3906延伸的非成形部分3908。非成形部分3908完全围绕图85中的每个凹坑3906延伸。换句话说,非成形部分3908围绕钉成形凹坑3906。在其他实例中,两个或更多个相邻凹坑3906的至少一部分可邻接接触,使得非成形部分3908不被定位在两者间。
可优化钉成形表面3902的成形比。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座3900的非成形部分3908的表面区域可相对于钉成形凹坑3906被最小化。除此之外或另选地,钉成形凹坑3906的占有面积可延伸或扩大,以最大化钉成形表面3902的被设计用于捕获和形成钉的部分。
图85中示出的凹坑3906在纵向狭槽3904的第一侧上被布置成三个排3914a,3914b,3914c。第一排3914a是内排,第二排3914b是中间排,并且第三排3914c是外排。内部凹坑3906a被定位在内排3914a中,中间凹坑3906b被定位在中间排3914b中,并且外部凹坑3906c被定位在外排3914c中。类似于砧座3800,凹坑3906沿砧座3900的钉成形表面3902布置成人字形布置。尽管未在图85中示出,在至少一个实例中,狭槽3904的相对侧上的凹坑3906可形成纵向狭槽3904的第一侧上的凹坑3906的镜像反射。在其他实例中,钉成形表面3902中的凹坑3906的布置可相对于狭槽3904不对称,并且在某些实例中,砧座3900可不包括纵向狭槽3904。在各种实例中,凹坑3906可在狭槽3904的每个侧面上被布置成少于或多于三排。
图85中示出的凹坑3906是相同的。限定在钉成形表面3802中的每个凹坑3906具有相同的几何形状。在其他实例中,凹坑3906的几何形状可沿砧座3900的长度逐排和/或纵向地变化。例如,在某些实例中,凹坑3906或其部分的深度可沿砧座3900的长度变化,以适应砧座和钉仓之间的间隙距离沿端部执行器和/或组织流的长度的变化,如本文所述。
示例性凹坑3906b在图86至图88C中示出。凹坑3906b具有第一端部或近侧端部3910和第二端部或远侧端部3912。凹坑轴线PA(图86)在凹坑3906b的近侧端部3910和远侧端部3912之间延伸。凹坑3906b包括周边3916,周边3916限定凹坑3906的边界。凹坑3906b还包括近侧杯3920,远侧杯3922,以及连接近侧杯3920和远侧杯3922的颈部部分3924。当钉被驱动成与钉成形表面3902成形接触时,近侧杯3920与近侧钉腿对准,并且远侧杯3922与远侧钉腿对准。杯3920和3922被构造成能够将钉腿朝向凹坑轴线PA和凹坑3906的中心部分(诸如颈部部分3924)引导或传送,并使钉腿变形成所成形的构造。
主要参见图87,凹坑3906b的每个杯3920、3922限定入口斜坡3940和出口斜坡3942。出口斜坡3942比入口斜坡3940更陡。当形成钉时,钉腿的尖端可沿入口斜坡3940进入相应的杯3920,3922,并且沿出口斜坡3942离开相应的杯3920,3922。在入口斜坡3940和出口斜坡3942之间的顶点3946处,钉腿的尖端朝向钉基部变形以呈现成形的构造,例如诸如B形或修改的B形。近侧杯3920在其顶点3946处限定相对于钉成形表面3902的非成形部分3908测量的近侧深度D1,并且远侧杯3922在其顶点3946处限定相对于钉成形表面3902的非成形部分3908测量的远侧深度D2。在凹坑3906中,近侧深度D1和远侧深度D2相等。在其他实例中,近侧深度D1和远侧深度D2可以是不同的。凹坑3906b还在近侧杯3920和远侧杯3922之间的颈部部分3924中限定桥接件3944。桥接件3944与钉成形表面3902的非成形部分3908偏置。更具体地,桥接件3944被定位在非成形部分3908下方或相对于非成形部分3908凹入。
主要参见图88A至图88C,凹坑3906b包括侧壁3950。侧壁3950被取向成垂直于钉成形表面3902的非成形部分3908。侧壁3950从每个杯3920,3922的外端朝向颈部部分3924线性地变窄。因此,杯3920,3922的最宽部分分别位于凹坑3906b的近侧端部3910和远侧端部3912处。凹坑3906b的轮廓3916限定蝴蝶结形状周边。近侧端部和远侧端部3910,3912处的加宽区域提供了用于接收钉腿尖端的扩大的占有面积。在各种实例中,杯3920和3922的加宽部分限定用于接收钉尖端的延伸着陆区。当杯3920,3922朝向颈部部分3924变窄时,杯3920,3922被构造成能够朝向和/或沿凹坑轴线PA传送和/或引导钉腿的尖端并且进入成形构造。凹坑3906b沿凹坑3906b的侧面限定倒角边缘3954。倒角边缘3954用于扩大凹坑3906b的占有面积并引导钉腿的尖端朝向凹坑轴线PA。
再次参见图86,凹坑3906b关于凹坑轴线PA对称。例如,凹坑3906b的周边3916关于凹坑轴线PA对称。此外,凹坑3906b关于穿过颈部部分3924并垂直于凹坑轴线PA的中心轴线CA对称。例如,凹坑3906b的周边3916关于中心轴线CA对称,并且近侧杯3920具有与远侧杯3922相同的几何形状。在其他实例中,近侧杯3920可与远侧杯3922不同。例如,再次参见图87,远侧深度D2可小于近侧深度D1,以适应砧座和钉仓和/或组织流之间的间隙距离的变化,如本文所述。
再次参见图86,颈部部分3924的宽度小于杯3920和3922的宽度。因此,凹坑3906b的中心部分比近侧杯3920和远侧杯3922窄。颈部部分3924处的凹坑3906b的变窄的周边3916在近侧杯3920的一部分和远侧杯3922的一部分之间限定接收半岛部3926。由于凹坑3906b的对称性,对称的接收半岛部3926被定位在凹坑3906b的每个侧面上。接收半岛部3926由凹坑3906b的周边3916和切线轴线(例如,TB1和TB2)界定,该切线轴线与凹坑3906b的侧面上的近侧杯3920和远侧杯3922的最宽部分相切。第一切线轴线TB1被定位在凹坑3906b的第一侧上,并且第二切线轴线TB2被定位在凹坑3906b的相对侧上。第一切线轴线TB1和第二切线轴线TB2平行于凹坑轴线PA。
再次参见图85,每个凹坑3906朝向相邻凹坑3906的接收半岛部3926延伸。例如,中间凹坑3906b与内部凹坑3906a和外部凹坑3906c的颈部部分3924对准。此外,内部凹坑3906a和外部凹坑3906b朝向中间凹坑3906b中的一个的接收半岛部3926延伸。更具体地,中间凹坑3906b的凹坑轴线PA分别与相邻的内部凹坑3906a和外部凹坑3906c的颈部部分3924对准,内部凹坑3906a的凹坑轴线PA与相邻的中间凹坑3906b的颈部部分3924对准,并且外部凹坑3906c的凹坑轴线PA与相邻的中间凹坑3906b的颈部部分3924对准。在某些实例中,凹坑3906中的一个或多个的一部分可延伸到相邻凹坑3906的接收半岛部中。
凹坑3906的几何形状便于凹坑3906在钉成形表面3902中的紧密布置。例如,因为凹坑3906包括在两个扩大的杯3920和3922之间的变窄的颈部部分3924,所以另一个凹坑3906的扩大的杯3920,3922可定位成邻近变窄的颈部部分3924。例如,扩大的杯3920,3922可与相邻的凹坑3906的一部分对准和/或被其接收。因此,可优化由凹坑3906覆盖的钉成形表面3902的表面区域。例如,由凹坑3906覆盖的钉成形表面3902的表面区域被最大化。“成形比”是非成形部分3908与成形部分(即,凹坑3906)的比率。在各种实例中,例如,成形比可以是至少1:1。
在某些实例中,尽管凹坑3906定位成紧密靠近彼此,但由于颈部部分3924变窄,因此在相邻凹坑3906之间存在用于非成形部分3908的空间。例如,非成形部分3908可在内部凹坑3906a的颈部部分3924和相邻中间凹坑3906b的远侧杯3922之间延伸。相邻凹坑3906之间的非成形部分3908可在凹坑3906之间提供足够的间距,以加强和/或增强砧座3900。
现在参见图89至图92C,描绘了砧座4000的一部分中的钉成形凹坑4006。凹坑4006及其在砧座4000中的布置在许多方面类似于凹坑3906及其在砧座3900中的布置。例如,砧座4000包括钉成形表面4002和纵向狭槽4004。纵向狭槽4004沿砧座4000的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽4004。钉成形凹坑4006限定在钉成形表面4002中。钉成形表面4002还包括围绕凹坑4006延伸的非成形部分4008。非成形部分4008完全围绕图89中的每个凹坑4006延伸。换句话说,非成形部分4008围绕钉成形凹坑4006。在其他实例中,两个或更多个相邻凹坑4006的至少一部分可邻接接触,使得非成形部分4008不被定位在两者间。
可优化钉成形表面4002的成形比。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座4000的非成形部分4008的表面区域可相对于钉成形凹坑4006被最小化。除此之外或另选地,钉成形凹坑4006的占有面积可延伸或扩大,以最大化钉成形表面4002的被设计用于捕获和形成钉的部分。
凹坑4006在纵向狭槽4004的第一侧上被布置成内排4014a、中间排4014b和外排4014c。内部凹坑4006a被定位在内排4014a中,中间凹坑4006b被定位在中间排4014b中,并且外部凹坑4006c被定位在外排4014c中。类似于砧座3800,凹坑4006沿砧座4000的钉成形表面4002布置成人字形布置。尽管未在图89中示出,在至少一个实例中,狭槽4004的相对侧上的凹坑4006可形成纵向狭槽4004的第一侧上的凹坑4006的镜像反射。在其他实例中,钉成形表面4002中的凹坑4006的布置可相对于狭槽4004不对称,并且在某些实例中,砧座4000可不包括纵向狭槽4004。在各种实例中,凹坑4006可在狭槽4004的每个侧面上被布置成少于或多于三排。
图89中示出的凹坑4006是相同的。限定在钉成形表面4002中的每个凹坑4006具有相同的几何形状。在其他实例中,凹坑4006的几何形状可沿砧座4000的长度逐排和/或纵向地变化。例如,在某些实例中,凹坑4006或其部分的深度可沿砧座4000的长度变化,以适应砧座和钉仓之间的间隙距离沿端部执行器和/或组织流的长度的变化,如本文所述。
示例性凹坑4006b在图90至图92C中示出。凹坑4006b具有第一端部或近侧端部4010和第二端部或远侧端部4012。凹坑轴线PA(图90)在凹坑4006b的近侧端部4010和远侧端部4012之间延伸。凹坑4006b包括周边4016,周边4016限定凹坑4006b的边界。凹坑4006b还包括近侧杯4020,远侧杯4022,以及连接近侧杯4020和远侧杯4022的颈部部分4024。当钉被驱动成与钉成形表面4002成形接触时,近侧杯4020与近侧钉腿对准,并且远侧杯4022与远侧钉腿对准。杯4020和4022被构造成能够将钉腿朝向凹坑轴线PA和凹坑4006的中心部分(诸如颈部部分4024)引导或传送,并使钉腿变形成所成形的构造。
主要参见图91,凹坑4006b的每个杯4020、4022限定入口斜坡4040和出口斜坡4042。当形成钉时,钉腿的尖端可沿入口斜坡4040进入相应的杯4020,4022,并且沿出口斜坡4042离开相应的杯4020,4022。在入口斜坡4040和出口斜坡4042之间的顶点4046处,钉腿的尖端朝向钉基部变形以呈现成形的构造,例如诸如B形或修改的B形。凹坑4006b还在近侧杯4020和远侧杯4022之间限定桥接件4044。桥接件4044与非成形部分4008偏置。更具体地,桥接件4044被定位在非成形部分4008下方或相对于非成形部分4008凹入。
主要参见图92A至图92C,凹坑4006b包括侧壁4050,该侧壁被取向成垂直于钉成形表面4002的非成形部分4008。侧壁4050从每个杯4020,4022的外端朝向颈部部分4024变窄。因此,杯4020,4022的最宽部分分别位于凹坑4006b的近侧端部4010和远侧端部4012处。凹坑4006b的轮廓4016限定蝴蝶结形状周边。近侧端部和远侧端部4010,4012处的加宽区域提供了用于接收钉腿尖端的扩大的占有面积。在各种实例中,杯4020,4022的加宽部分限定用于接收钉尖端的延伸着陆区。当杯4020,4022朝向颈部部分4024变窄时,杯4020,4022被构造成能够朝向和/或沿凹坑轴线PA传送和/或引导钉腿的尖端并且进入成形构造。
凹坑4006b沿凹坑4006b的侧面限定倒角边缘4054。另外,凹坑4006b在其底表面4058中包括凹槽4056。凹槽4056从近侧杯4020延伸越过桥接件4024并进入远侧杯4022。凹槽4056被构造成能够在钉腿运动到变形构型时约束和引导钉腿。
在各种实例中,凹槽4056的直径可小于与凹槽4056接合的钉的直径。例如,钉可具有至少0.0079英寸的直径,并且凹槽4056的直径可小于0.0079英寸。凹槽4056的直径可为约0.007英寸、约0.005英寸或小于0.005英寸。在某些实例中,例如,钉的直径可大于0.0079英寸,诸如约0.0089英寸或约0.0094英寸。在各种实例中,U形钉的直径可小于0.0079英寸或大于0.0094英寸。在端部执行器中,其中不同的钉几何形状与相同的钉成形凹坑几何形状一起使用,凹坑中的凹槽的宽度可小于最小直径的钉。在其他实例中,凹槽4056的宽度可在排内和/或逐排改变钉-钉。
再次参见图90,凹坑4006b关于凹坑轴线PA对称。例如,凹坑4006b的周边4016关于凹坑轴线PA对称。此外,凹坑4006b关于穿过颈部部分4024并垂直于凹坑轴线PA的中心轴线CA对称。例如,凹坑4006b的周边4016关于中心轴线CA对称,并且近侧杯4020具有与远侧杯4022相同的几何形状。在其他实例中,近侧杯4020可与远侧杯4022不同。例如,再次参见图91,远侧深度D2可小于近侧深度D1,以适应砧座和钉仓和/或组织流之间的间隙距离的变化,如本文所述。
再次参见图90,凹坑4006b的颈部部分4024比近侧杯4020和远侧杯4022窄。凹坑4006b的变窄的周边4016在近侧杯4020的一部分和远侧杯4022的一部分之间限定接收半岛部4026。由于凹坑4006b的对称性,对称的接收半岛部4026被定位在凹坑4006b的每个侧面上。接收半岛部4026由凹坑4006b的周边4016和切线轴线(例如,TB1和TB2)界定,该切线轴线与凹坑4006b的侧面上的近侧杯4020和远侧杯4022的最宽部分相切。第一切线轴线TB1被定位在凹坑4006b的第一侧上,并且第二切线轴线TB2被定位在凹坑4006b的相对侧上。图90中示出的第一切线轴线TB1和第二切线轴线TB2与凹坑轴线PA平行。
再次参见图89,每个凹坑4006朝向相邻凹坑4006的接收半岛部4026延伸。例如,中间凹坑4006b与内部凹坑4006a和外部凹坑4006c的颈部部分4024对准。此外,内部凹坑4006a和外部凹坑4006b朝向中间凹坑4006b中的一个的接收半岛部4026延伸。更具体地,内部凹坑4006a与相邻中间凹坑4006b的颈部部分4024对准,并且外部凹坑4006c与相邻中间凹坑4006b的颈部部分4024对准。在某些实例中,凹坑4006的一部分可延伸到相邻凹坑4006的接收半岛部4026中。类似于砧座3900中的凹坑3906,凹坑4006的几何形状便于凹坑4006在钉成形表面4002中的紧密布置。“成形比”是非成形部分4008与成形部分(即,凹坑4006)的比率。在各种实例中,例如,成形比可以是至少1:1。
现在参见图93至图96C,描绘了砧座4100的一部分中的钉成形凹坑4106。凹坑4106及其在砧座4100中的布置在许多方面类似于凹坑4006及其在砧座4000中的布置。例如,砧座4100包括钉成形表面4102和纵向狭槽4104。纵向狭槽4104沿砧座4100的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽4104。钉成形凹坑4106限定在钉成形表面4102中。钉成形表面4102还包括围绕凹坑4106延伸的非成形部分4108。非成形部分4108完全围绕图90中的每个凹坑4106延伸。换句话说,非成形部分4108围绕钉成形凹坑4106。在其他实例中,两个或更多个相邻凹坑4106的至少一部分可邻接接触,使得非成形部分4108不被定位在两者间。
可优化钉成形表面4102的成形比。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座4100的非成形部分4108的表面区域可相对于钉成形凹坑4106被最小化。除此之外或另选地,钉成形凹坑4106的占有面积可延伸或扩大,以最大化钉成形表面4102的被设计用于捕获和形成钉的部分。
图93中示出的凹坑4106在纵向狭槽4104的第一侧上被布置成内排4114a、中间排4114b和外排4114c。内部凹坑4106a被定位在内排4114a中,中间凹坑4106b被定位在中间排4114b中,并且外部凹坑4106c被定位在外排4114c中。类似于砧座3800,凹坑4106沿砧座4100的钉成形表面4102布置成人字形布置。尽管未在图93中示出,在至少一个实例中,狭槽4104的相对侧上的凹坑4106可形成纵向狭槽4104的第一侧上的凹坑4106的镜像反射。在其他实例中,钉成形表面4102中的凹坑4106的布置可相对于狭槽4104不对称,并且在某些实例中,砧座4100可不包括纵向狭槽4104。在各种实例中,凹坑4106可在狭槽4104的每个侧面上被布置成少于或多于三排。
图93中示出的凹坑4106是相同的。限定在钉成形表面4102中的每个凹坑4106具有相同的几何形状。在其他实例中,凹坑4106的几何形状可沿砧座4100的长度逐排和/或纵向地变化。例如,在某些实例中,凹坑4106或其部分的深度可沿砧座4100的长度变化,以适应砧座和钉仓之间的间隙距离沿端部执行器和/或组织流的长度的变化,如本文所述。
示例性凹坑4106b在图94至图96C中示出。凹坑4106b具有第一端部或近侧端部4110和第二端部或远侧端部4112。凹坑轴线PA(图94)在凹坑4106b的近侧端部4110和远侧端部4112之间延伸。凹坑4106b包括周边4116,周边4116限定凹坑4106b的边界。凹坑4106b还包括近侧杯4120,远侧杯4122,以及连接近侧杯4120和远侧杯4122的颈部部分4124。当钉被驱动成与钉成形表面4102成形接触时,近侧杯4120与近侧钉腿对准,并且远侧杯4122与远侧钉腿对准。杯4120,4122被构造成能够将钉腿朝向凹坑轴线PA和凹坑4106的中心部分(诸如颈部部分4124)引导或传送,并使钉腿变形成所成形的构造。
主要参见图95,凹坑4106b的每个杯4120、4122限定入口斜坡4140和出口斜坡4142。出口斜坡4142比入口斜坡4140更陡。当形成钉时,钉腿的尖端可沿入口斜坡4140进入相应的杯4120,4122并且沿出口斜坡4142离开相应的杯4120,4122。在入口斜坡4140和出口斜坡4142之间的顶点4146处,钉腿的尖端朝向钉基部变形以呈现成形的构造,例如诸如B形或修改的B形。凹坑4106b还在近侧杯4120和远侧杯4122之间的颈部部分4124中限定桥接件4144。桥接件4144与非成形部分4108偏置。更具体地,桥接件4144被定位在非成形部分4108下方或相对于非成形部分4108凹入。
主要参见图96A至图96C,凹坑4106b包括侧壁4150,该侧壁被取向成垂直于钉成形表面4102的非成形部分4108。侧壁4150从每个杯4120,4122的外端朝向颈部部分4124变窄。因此,杯4120和4122的最宽部分分别位于凹坑4106b的近侧端部4110和远侧端部4112处。凹坑4106b的轮廓4116限定蝴蝶结形状周边。近侧端部和远侧端部4110,4112处的加宽区域提供了用于接收钉腿尖端的扩大的占有面积。在各种实例中,杯4120,4122的加宽部分限定用于接收钉尖端的延伸着陆区。当杯4120,4122朝向颈部部分4124变窄时,杯4120,4122被构造成能够朝向和/或沿凹坑轴线PA传送和/或引导钉腿的尖端并且进入成形构造。
再次参见图96A至图96C,凹坑4106b沿凹坑4106b的侧面限定倒角边缘4154。另外,凹坑4106b在其底表面4158中包括凹槽4156。凹槽4156限定在近侧杯4120和远侧杯4122中。在所示实施方案中,凹槽4156不延伸跨过凹坑4106b的桥接件4144。凹槽4156被构造成能够在钉腿运动到变形构型时约束和引导钉腿。例如,当钉沿入口斜坡4140和出口斜坡4142的至少一部分运动时,钉腿可滑过凹槽4156。在各种实例中,凹槽4156的直径可小于与凹槽4156接合的钉的直径。在端部执行器中,其中不同的钉几何形状与相同的钉成形凹坑几何形状一起使用,凹坑中的凹槽的宽度可小于最小直径的钉。在各种实例中,钉腿在到达桥接件4144之前朝向钉基部变形,并且因此不与凹坑4106b的桥接件4144接合。
再次参见图94,凹坑4106b关于凹坑轴线PA对称。例如,凹坑4106b的周边4116关于凹坑轴线PA对称。此外,凹坑4106b关于穿过颈部部分4124并垂直于凹坑轴线PA的中心轴线CA对称。例如,凹坑4106b的周边4116关于中心轴线CA对称,并且近侧杯4120具有与远侧杯4122相同的几何形状。在其他实例中,近侧杯4120可与远侧杯4122不同。例如,再次参见图91,远侧深度D2可小于近侧深度D1,以适应砧座和钉仓和/或组织流之间的间隙距离的变化,如本文所述。
再次参见图94,凹坑4106b的颈部部分4124比近侧杯4120和远侧杯4122窄。凹坑4106b的变窄的周边4116在近侧杯4120的一部分和远侧杯4122的一部分之间限定接收半岛部4126。由于凹坑4106b的对称性,对称的接收半岛部4126被定位在凹坑4106b的每个侧面上。接收半岛部4126由凹坑4106b的周边4116和切线轴线(例如,TB1和TB2)界定,该切线轴线与凹坑4106b的侧面上的近侧杯4120和远侧杯4122的最宽部分相切。第一切线轴线TB1被定位在凹坑4106b的第一侧上,并且第二切线轴线TB2被定位在凹坑4106b的相对侧上。图94中示出的第一切线轴线TB1和第二切线轴线TB2与凹坑轴线PA平行。
再次参见图93,每个凹坑4106朝向相邻凹坑4106的接收半岛部4126延伸。例如,中间凹坑4106b与内部凹坑4106a和外部凹坑4106c的颈部部分4124对准。此外,内部凹坑4106a和外部凹坑4106b朝向中间凹坑4106b中的一个的接收半岛部4126延伸。更具体地,内部凹坑4106a与相邻中间凹坑4106b的颈部部分4124对准,并且外部凹坑4106c与相邻中间凹坑4106b的颈部部分4124对准。在某些实例中,凹坑4106的一部分可延伸到相邻凹坑4106的接收半岛部4126中。类似于砧座3900中的凹坑3906,凹坑4106的几何形状便于凹坑4106在钉成形表面4102中的紧密布置。“成形比”是非成形部分4108与成形部分(即,凹坑4106)的比率。在各种实例中,例如,成形比可以是至少1:1。
现在参见图97至图100C,描绘了砧座4200的一部分中的钉成形凹坑4206。凹坑4206及其在砧座4200中的布置在许多方面类似于凹坑4106及其在砧座4100中的布置。例如,砧座4200包括钉成形表面4202和纵向狭槽4204。纵向狭槽4204沿砧座4200的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽4204。钉成形凹坑4206限定在钉成形表面4202中。钉成形表面4202还包括围绕凹坑4206延伸的非成形部分4208。非成形部分4208完全围绕图97中的每个凹坑4206延伸。换句话说,非成形部分4208围绕钉成形凹坑4206。在其他实例中,两个或更多个相邻凹坑4206的至少一部分可邻接接触,使得非成形部分4208不被定位在两者间。
可优化钉成形表面4202的成形比。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座4200的非成形部分4208的表面区域可相对于钉成形凹坑4206被最小化。除此之外或另选地,钉成形凹坑4206的占有面积可延伸或扩大,以最大化钉成形表面4202的被设计用于捕获和形成钉的部分。
图97中示出的凹坑4206在纵向狭槽4204的第一侧上被布置成内排4214a、中间排4214b和外排4214c。内部凹坑4206a被定位在内排4214a中,中间凹坑4206b被定位在中间排4214b中,并且外部凹坑4206c被定位在外排4214c中。类似于砧座3800,凹坑4206沿砧座4200的钉成形表面4202布置成人字形布置。尽管未在图97中示出,在至少一个实例中,狭槽4204的相对侧上的凹坑4206可形成纵向狭槽4204的第一侧上的凹坑4206的镜像反射。在其他实例中,钉成形表面4202中的凹坑4206的布置可相对于狭槽4204不对称,并且在某些实例中,砧座4200可不包括纵向狭槽4204。在各种实例中,凹坑4206可在狭槽4204的每个侧面上被布置成少于或多于三排。
图97中示出的凹坑4206是相同的。限定在钉成形表面4202中的每个凹坑4206具有相同的几何形状。在其他实例中,凹坑4206的几何形状可沿砧座4200的长度逐排和/或纵向地变化。例如,在某些实例中,凹坑4206或其部分的深度可沿砧座4200的长度变化,以适应砧座和钉仓之间的间隙距离沿端部执行器和/或组织流的长度的变化,如本文所述。
示例性凹坑4206b在图98至图100C中示出。凹坑4206b具有第一端部或近侧端部4210和第二端部或远侧端部4212。凹坑轴线PA(图98)在每个凹坑4206的近侧端部4210和远侧端部4212之间延伸。凹坑4206b包括周边4216,周边4216限定凹坑4206b的边界。凹坑4206b还包括近侧杯4220,远侧杯4222,以及连接近侧杯4220和远侧杯4222的颈部部分4224。当钉被驱动成与钉成形表面4202成形接触时,近侧杯4220与近侧钉腿对准,并且远侧杯4222与远侧钉腿对准。杯4220,4222被构造成能够将钉腿朝向凹坑轴线PA和凹坑4206的中心部分(诸如颈部部分4224)引导或传送,并使钉腿变形成所成形的构造。
主要参见图99,凹坑4206b的每个杯4220、4222限定入口斜坡4240和出口斜坡4242。出口斜坡4242比入口斜坡4240更陡。当形成钉时,钉腿的尖端可沿入口斜坡4240进入相应的杯4220,4222并且沿出口斜坡4242离开相应的杯4220,4222。在入口斜坡4240和出口斜坡4242之间的顶点4246处,钉腿的尖端朝向钉基部变形以呈现成形的构造,例如诸如B形或修改的B形。凹坑4206b还在近侧杯4220和远侧杯4222之间限定桥接件4244。桥接件4244与非成形部分4208偏置。更具体地,桥接件4244被定位在非成形部分4208下方或相对于非成形部分4208凹入。
主要参见图100A至图100C,凹坑4206b包括侧壁4250,该侧壁被取向成垂直于钉成形表面4202的非成形部分4208。侧壁4250朝向颈部部分4224变窄。因此,杯4220,4222的最宽部分位于侧壁4250的近侧端部和远侧端部处。加宽的区域提供用于接收钉腿的尖端的扩大的占有面积。当杯4220,4222朝向颈部部分4224变窄时,杯4220,4222被构造成能够朝向和/或沿凹坑轴线PA传送和/或引导钉腿的尖端并且进入成形构造。
杯4220,4222还分别包括延伸着陆区4230,4232,其进一步扩大了杯4220,4222的占有面积。近侧延伸着陆区4230沿凹坑轴线PA朝近侧延伸,并且远侧延伸着陆区4232沿凹坑轴线PA朝远侧延伸。在凹坑4206b中,延伸着陆区4230和4232限定基本上三角形的周边。此外,延伸着陆区4230和4232沿相应的凹坑轴线PA在拐角处终止。在其他实例中,例如,延伸着陆区4230和4232可限定直的或波状周边,并且可从杯4220和4222侧向和/或纵向延伸。
另外,凹坑4206b在其底表面中包括槽4256。槽4256被构造成能够在钉腿运动到变形构型时约束和引导钉腿。在所示实施方案中,槽4256跨越在侧壁4250之间并限定凹坑4206b的整个底表面。槽4256从近侧杯4220延伸越过桥接件4224并进入远侧杯4222。在其他实例中,槽4256可不延伸跨过凹坑4206b的桥接件4244。槽4256包括两个斜坡表面4256a和4256b,他们向下延伸远离非成形部分4208并沿凹坑形轴线PA相交(图98)。如图100A至图100C所示,槽4256沿桥接件4244限定比在杯4220、4222中更陡的梯度。在其他实例中,例如,梯度沿槽4256的长度可以是均匀的和/或可在杯4220,4222中比沿桥接件4244更陡。
仍然参见图100A至图100C,凹坑4206b还沿凹坑4206b的侧面限定倒角边缘4254。在凹坑4206b中,倒角边缘4254限定凹坑4206b的总宽度。凹坑4206b的总宽度是均匀的。例如,宽度WA(图100A)等于宽度WB(图100B)和宽度WC(图100C)。在其他实例中,宽度WA、WB和/或WC可不相等。因为侧壁4250朝向颈部部分4224变窄,所以倒角边缘4254的宽度相应地朝向颈部部分4224扩展,以保持相同的总凹坑宽度。凹坑4206b还包括突起或旋钮4258,突起或旋钮4258在凹坑4206b的颈部部分4224处朝向凹坑轴线PA延伸。旋钮4258进一步使颈部部分4224变窄至宽度WN。槽4256跨过宽度WN跨越颈部部分4224的底表面。
再次参见图98,凹坑4206b关于凹坑轴线PA对称。例如,凹坑4206b的周边4216关于凹坑轴线PA对称。此外,凹坑4206b关于穿过颈部部分4224并垂直于凹坑轴线PA的中心轴线CA对称。例如,凹坑4206b的周边4216关于中心轴线CA对称,并且近侧杯4220具有与远侧杯4222相同的几何形状。在其他实例中,近侧杯4220可与远侧杯4222不同。例如,再次参见图99,远侧深度D2可小于近侧深度D1,以适应砧座和钉仓和/或组织流之间的间隙距离的变化,如本文所述。
再次参见图97,每个凹坑4206朝向相邻凹坑4206的颈部部分4224延伸。例如,中间凹坑4206b与内部凹坑4206a和外部凹坑4206c的颈部部分4224对准。更具体地,中间凹坑4206b的近侧着陆区4230与相邻外部钉4206c的颈部部分4224对准,并且中间凹坑4206b的远侧着陆区4232与相邻内部钉4206a的颈部部分4224对准。此外,内部凹坑4206a和外部凹坑4206b朝向中间凹坑4206b中的一个的颈部部分4224延伸。更具体地,内部凹坑4206a的远侧着陆区4232与相邻中间凹坑4206b的颈部部分4224对准,并且外部凹坑4206c的近侧着陆区4230与相邻中间凹坑4206b的颈部部分4224对准。
现在参见图101至图104C,描绘了砧座4300的一部分中的钉成形凹坑4306。凹坑4306及其在砧座4300中的布置在许多方面类似于凹坑3906及其在砧座3900中的布置。例如,砧座4300包括钉成形表面4302和纵向狭槽4304。纵向狭槽4304沿砧座4300的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽4304。钉成形凹坑4306限定在钉成形表面4302中。钉成形表面4302还包括围绕凹坑4306延伸的非成形部分4308。非成形部分4308完全围绕图101中的每个凹坑4306延伸。换句话说,非成形部分4308围绕钉成形凹坑4306。在其他实例中,两个或更多个相邻凹坑4306的至少一部分可邻接接触,使得非成形部分4308不被定位在两者间。
可优化钉成形表面4302的成形比。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座4300的非成形部分4308的表面区域可相对于钉成形凹坑4306被最小化。除此之外或另选地,钉成形凹坑4306的占有面积可延伸或扩大,以最大化钉成形表面4302的被设计用于捕获和形成钉的部分。
图101中示出的凹坑4306在纵向狭槽4304的第一侧上被布置成内排4314a、中间排4314b和外排4314c。内部凹坑4306a被定位在内排4314a中,中间凹坑4306b被定位在中间排4314b中,并且外部凹坑4306c被定位在外排4314c中。类似于砧座3800,凹坑4306沿砧座4300的钉成形表面4302布置成人字形布置。尽管未在图101中示出,在至少一个实例中,狭槽4304的相对侧上的凹坑4306可形成纵向狭槽4304的第一侧上的凹坑4306的镜像反射。在其他实例中,钉成形表面4302中的凹坑4306的布置可相对于狭槽4304不对称,并且在某些实例中,砧座4300可不包括纵向狭槽4304。在各种实例中,凹坑4306可在狭槽4304的每个侧面上被布置成少于或多于三排。
图101中示出的凹坑4306是相同的。限定在钉成形表面4302中的每个凹坑4306具有相同的几何形状。在其他实例中,凹坑4306的几何形状可沿砧座4300的长度逐排和/或纵向地变化。例如,在某些实例中,凹坑4306或其部分的深度可沿砧座4300的长度变化,以适应砧座和钉仓之间的间隙距离沿端部执行器和/或组织流的长度的变化,如本文所述。
示例性凹坑4306b在图102至图104C中示出。凹坑4306b具有第一端部或近侧端部4310和第二端部或远侧端部4312。凹坑轴线PA(图102)在凹坑4306b的近侧端部4310和远侧端部4312之间延伸。凹坑4306b包括周边4316,周边4316限定凹坑4306b的边界。周边4316包括在凹坑4306的近侧端部和远侧端部处的圆角。凹坑4306b还包括近侧杯4320,远侧杯4322,以及连接近侧杯4320和远侧杯4322的颈部部分4324。当钉被驱动成与钉成形表面4302成形接触时,近侧杯4320与近侧钉腿对准,并且远侧杯4322与远侧钉腿对准。杯4320,4322被构造成能够将钉腿朝向凹坑轴线PA和凹坑4306的中心部分(诸如颈部部分4324)引导或传送,并使钉腿变形成所成形的构造。
主要参见图103,凹坑4306b的每个杯4320、4322限定入口斜坡4340和出口斜坡4342。出口斜坡4342比入口斜坡4340更陡。当形成钉时,钉腿的尖端可沿入口斜坡4340进入相应的杯4320,4322并且沿出口斜坡4342离开相应的杯4320,4322。在入口斜坡4340和出口斜坡4342之间的顶点4346处,钉腿的尖端朝向钉基部变形以呈现成形的构造,例如诸如B形或修改的B形。凹坑4306b还在近侧杯4320和远侧杯4322之间限定桥接件4344。桥接件4344与非成形部分4308偏置。更具体地,桥接件4344被定位在非成形部分4308下方或相对于非成形部分4308凹入。
主要参见图104A至图104C,凹坑4306b包括侧壁4350,该侧壁被取向成垂直于钉成形表面4302的非成形部分4308。侧壁4350在每个杯4320,4322的外端和颈部部分4324之间变窄。更具体地,侧壁4350沿向内轮廓延伸,以在凹坑4306b的周边4316中限定轮廓。杯4320,4322的最宽部分位于侧壁4350的近侧端部和远侧端部处。加宽的区域提供用于接收钉腿的尖端的扩大的占有面积。当杯4320,4322朝向颈部部分4324变窄时,杯4320,4322被构造成能够朝向和/或沿凹坑轴线PA传送和/或引导钉腿的尖端并且进入成形构造。
凹坑4306b沿凹坑4306b的侧面限定倒角边缘4354。在凹坑4306b中,倒角边缘4354限定凹坑4306b的总宽度,其朝向颈部部分4324变窄。凹坑4306b还在凹坑4306b的侧壁4350和底表面4358之间限定圆角4352(图104A至图104C)。圆角4352被构造成能够沿凹坑4306b中的期望路径引导钉腿。例如,如果钉腿沿倒角4352着陆,则圆角4352可平滑地引导钉腿朝向凹坑轴线PA。
再次参见图102,凹坑4306b关于凹坑轴线PA对称。例如,凹坑4306b的周边4316关于凹坑轴线PA对称。此外,凹坑4306b关于穿过颈部部分4324并垂直于凹坑轴线PA的中心轴线CA对称。例如,凹坑4306b的周边4316关于中心轴线CA对称,并且近侧杯4320具有与远侧杯4322相同的几何形状。在其他实例中,近侧杯4320可与远侧杯4322不同。例如,再次参见图103,远侧深度D2可小于近侧深度D1,以适应砧座和钉仓和/或组织流之间的间隙距离的变化,如本文所述。
再次参见图102,凹坑4306b的颈部部分4324比近侧杯4320和远侧杯4322窄。凹坑4306b的变窄的周边4316在近侧杯4320的一部分和远侧杯4322的一部分之间限定接收半岛部4326。由于凹坑4306b的对称性,对称的接收半岛部4326被定位在凹坑4306b的每个侧面上。接收半岛部4326由凹坑4306b的周边4316和切线轴线(例如,TB1和TB2)界定,该切线轴线与凹坑4306b的侧面上的近侧杯4320和远侧杯4322的最宽部分相切。第一切线轴线TB1被定位在凹坑4306b的第一侧上,并且第二切线轴线TB2被定位在凹坑4306b的相对侧上。图102中示出的第一切线轴线TB1和第二切线轴线TB2与凹坑轴线PA平行。
再次参见图101,每个凹坑4306朝向相邻凹坑4306的接收半岛部4326延伸。例如,中间凹坑4306b与内部凹坑4306a和外部凹坑4306c的颈部部分4324对准。此外,内部凹坑4306a和外部凹坑4306b朝向中间凹坑4306b中的一个的接收半岛部4326延伸。更具体地,内部凹坑4306a与相邻中间凹坑4306b的颈部部分4324对准,并且外部凹坑4306c与相邻中间凹坑4306b的颈部部分4324对准。在某些实例中,凹坑4306的一部分可延伸到相邻凹坑4306的接收半岛部4326中。类似于砧座3900中的凹坑3906,凹坑4306的几何形状便于凹坑4306在钉成形表面4302中的紧密布置。“成形比”是非成形部分4308与成形部分(即,凹坑4306)的比率。在至少一个实例中,例如,成形比可以是至少1:1。
现在参见图105至图108C,描绘了砧座4400的一部分中的钉成形凹坑4406。凹坑4406及其在砧座4400中的布置在许多方面类似于凹坑4306及其在砧座4300中的布置。例如,砧座4400包括钉成形表面4402和纵向狭槽4404。纵向狭槽4404沿砧座4400的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽4404。钉成形凹坑4406限定在钉成形表面4402中。钉成形表面4402还包括围绕凹坑4406延伸的非成形部分4408。非成形部分4408完全围绕图105中的每个凹坑4406延伸。换句话说,非成形部分4408围绕钉成形凹坑4406。在其他实例中,两个或更多个相邻凹坑4406的至少一部分可邻接接触,使得非成形部分4408不被定位在两者间。另外,非成形部分4406延伸穿过每个凹坑4406,如本文所述。
可优化钉成形表面4402的成形比。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座4400的非成形部分4408的表面区域可相对于钉成形凹坑4406被最小化。除此之外或另选地,钉成形凹坑4406的占有面积可延伸或扩大,以最大化钉成形表面4402的被设计用于捕获和形成钉的部分。
图105中示出的凹坑4406在纵向狭槽4404的第一侧上被布置成内排4414a、中间排4414b和外排4414c。内部凹坑4406a被定位在内排4414a中,中间凹坑4406b被定位在中间排4414b中,并且外部凹坑4406c被定位在外排4414c中。类似于砧座3800,凹坑4406沿砧座4400的钉成形表面4402布置成人字形布置。尽管未在图105中示出,在至少一个实例中,狭槽4404的相对侧上的凹坑4406可形成纵向狭槽4404的第一侧上的凹坑4406的镜像反射。在其他实例中,钉成形表面4402中的凹坑4406的布置可相对于狭槽4404不对称,并且在某些实例中,砧座4400可不包括纵向狭槽4404。在各种实例中,凹坑4406可在狭槽4404的每个侧面上被布置成少于或多于三排。
图105中示出的凹坑4406是相同的。限定在钉成形表面4402中的每个凹坑4406具有相同的几何形状。在其他实例中,凹坑4406的几何形状可沿砧座4400的长度逐排和/或纵向地变化。例如,在某些实例中,凹坑4406或其部分的深度可沿砧座4400的长度变化,以适应砧座和钉仓之间的间隙距离沿端部执行器和/或组织流的长度的变化,如本文所述。
示例性凹坑4406b在图106至图108C中示出。凹坑4406b具有第一端部或近侧端部4410和第二端部或远侧端部4412。凹坑轴线PA(图106)在凹坑4406b的近侧端部4410和远侧端部4412之间延伸。凹坑4406b包括周边4416,周边4416限定凹坑4406b的边界。周边4416包括在凹坑4406b的近侧端部4410和远侧端部4412处的圆角。凹坑4406b还包括近侧杯4420和远侧杯4422。非成形部分4408的一部分在近侧杯4420和远侧杯4422之间延伸。换句话说,凹坑4406b包括在钉成形表面4402中的两个单独且分立的杯4420和4422。当钉被驱动成与钉成形表面4402成形接触时,近侧杯4420与近侧钉腿对准,并且远侧杯4422与远侧钉腿对准。杯4420,4422被构造成能够将钉腿朝向凹坑轴线PA和凹坑4406的中心部分引导或传送,并使钉腿变形成所成形的构造。
主要参见图107,凹坑4406b的每个杯4420、4422限定入口斜坡4440和出口斜坡4442。出口斜坡4442比入口斜坡4440更陡。当形成钉时,钉腿的尖端可沿入口斜坡4440进入相应的杯4420,4422并且沿出口斜坡4442离开相应的杯4420,4422。在入口斜坡4440和出口斜坡4442之间的顶点4446处,钉腿的尖端朝向钉基部变形以呈现成形的构造,例如诸如B形或修改的B形。凹坑4406b还在近侧杯4420和远侧杯4422之间限定桥接件4444。桥接件4444与非成形部分4408对准。更具体地,桥接件4444是非成形部分4408的平面延伸部,其在近侧杯4420和远侧杯4422之间延伸。
主要参见图108A至图108C,凹坑4406b包括侧壁4450,该侧壁相对于钉成形表面4402的非成形部分4408以一定角度取向。更具体地,侧壁4450相对于非成形部分4408倾斜地取向。此外,侧壁4450的角度取向沿杯的长度是恒定的。例如,分别在图108A、图108B和图108C中示出的角度A、B和C相等。在其他实例中,角度A、B和C中的一个或多个可以是不同的。侧壁4450在每个杯4420,4422的外端和杯4420,4422的内端之间变窄。更具体地,侧壁4450沿向内轮廓延伸,以在凹坑4406b的周边4416中限定轮廓。杯4420,4422的最宽部分位于凹坑4406b的近侧端部和远侧端部处。加宽的区域提供用于接收钉腿的尖端的扩大的占有面积。当杯4420,4422朝向桥接件4444变窄时,杯4420,4422被构造成能够朝向和/或沿凹坑轴线PA传送和/或引导钉腿的尖端并且进入成形构造。
凹坑4406b在凹坑4406b的侧壁4450和底表面4458之间限定圆角4452(图108A至图108C)。圆角4452被构造成能够沿凹坑4406b中的期望路径引导钉腿。例如,如果钉腿沿圆角4452着陆,则圆角4452可平滑地引导钉腿朝向凹坑轴线PA。
再次参见图106,凹坑4406b关于凹坑轴线PA对称。例如,凹坑4406b的周边4416关于凹坑轴线PA对称。此外,凹坑4406b关于近侧杯4420和远侧杯4422之间的并且垂直于凹坑轴线PA的中心轴线CA对称。例如,凹坑4406b的周边4416关于中心轴线CA对称,并且近侧杯4420具有与远侧杯4422相同的几何形状。在其他实例中,近侧杯4420可与远侧杯4422不同。例如,再次参见图107,远侧深度D2可小于近侧深度D1,以适应砧座和钉仓和/或组织流之间的间隙距离的变化,如本文所述。
再次参见图106,凹坑4406b的中心部分分别比杯4420和4422的近侧端部4410和远侧端部4412窄。凹坑4406b的变窄的周边4416在近侧杯4420的一部分和远侧杯4422的一部分之间限定接收半岛部4426。由于凹坑4406b的对称性,对称的接收半岛部4426被定位在凹坑4406b的每个侧面上。接收半岛部4426由凹坑4406b的周边4416和切线轴线(例如,TB1和TB2)界定,该切线轴线与凹坑4406b的侧面上的近侧杯4420和远侧杯4422的最宽部分相切。第一切线轴线TB1被定位在凹坑4406b的第一侧上,并且第二切线轴线TB2被定位在凹坑4406b的相对侧上。图106中示出的第一切线轴线TB1和第二切线轴线TB2与凹坑轴线PA平行。
再次参见图105,每个凹坑4406朝向相邻凹坑4406的接收半岛部4426延伸。例如,中间凹坑4406b与内部凹坑4406a和外部凹坑4406c的中心部分对准。此外,内部凹坑4406a和外部凹坑4406b朝向中间凹坑4406b中的一个的接收半岛部4426延伸。更具体地,内部凹坑4406a与相邻中间凹坑4406b的中心部分对准,并且外部凹坑4406c与相邻中间凹坑4406b的中心部分对准。在某些实例中,凹坑4406的一部分可延伸到相邻凹坑4406的接收半岛部4426中。类似于砧座3900中的凹坑3906,凹坑4406的几何形状便于凹坑4406在钉成形表面4402中的紧密布置。钉成形表面4402的“成形比”是非成形部分4408与成形部分(即,凹坑4406)的比率。钉成形表面4402的成形比为约2.56:1。在其他实例中,成形比可小于2.56:1或大于2.56:1。例如,在至少一个实例中,钉成形表面4402的50%以上可用钉成形凹坑4406覆盖。
现在参见图109至图112C,描绘了砧座4500的一部分中的钉成形凹坑4506。凹坑4506及其在砧座4500中的布置在许多方面类似于凹坑3906及其在砧座3900中的布置。例如,砧座4500包括钉成形表面4502和纵向狭槽4504。纵向狭槽4504沿砧座4500的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽4504。钉成形凹坑4506限定在钉成形表面4502中。钉成形表面4502还包括围绕凹坑4506延伸的非成形部分4508。非成形部分4508完全围绕图109中的每个凹坑4506延伸。换句话说,非成形部分4508围绕钉成形凹坑4506。在其他实例中,两个或更多个相邻凹坑4506的至少一部分可邻接接触,使得非成形部分4508不被定位在两者间。
可优化钉成形表面4502的成形比。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座4500的非成形部分4508的表面区域可相对于钉成形凹坑4506被最小化。除此之外或另选地,钉成形凹坑4506的占有面积可延伸或扩大,以最大化钉成形表面4502的被设计用于捕获和形成钉的部分。
图109中示出的凹坑4506在纵向狭槽4504的第一侧上被布置成内排4514a、中间排4514b和外排4514c。内部凹坑4506a被定位在内排4514a中,中间凹坑4506b被定位在中间排4514b中,并且外部凹坑4506c被定位在外排4514c中。类似于砧座3800,凹坑4506沿砧座4500的钉成形表面4502布置成人字形布置。尽管未在图109中示出,在至少一个实例中,狭槽4504的相对侧上的凹坑4506可形成纵向狭槽4504的第一侧上的凹坑4506的镜像反射。在其他实例中,钉成形表面4502中的凹坑4506的布置可相对于狭槽4504不对称,并且在某些实例中,砧座4500可不包括纵向狭槽4504。在各种实例中,凹坑4506可在狭槽4504的每个侧面上被布置成少于或多于三排。
图109中示出的凹坑4506是相同的。限定在钉成形表面4502中的每个凹坑4506具有相同的几何形状。在其他实例中,凹坑4506的几何形状可沿砧座4500的长度逐排和/或纵向地变化。例如,在某些实例中,凹坑4506或其部分的深度可沿砧座4500的长度变化,以适应砧座和钉仓之间的间隙距离沿端部执行器和/或组织流的长度的变化,如本文所述。
示例性凹坑4506b在图110至图112C中示出。凹坑4506b具有第一端部或近侧端部4510和第二端部或远侧端部4512。凹坑轴线PA(图110)在凹坑4506b的近侧端部4510和远侧端部4512之间延伸。凹坑4506b包括周边4516,周边4516限定凹坑4506b的边界。类似于凹坑4306,周边4516包括在凹坑4506b的近侧端部4510和远侧端部4512处的圆角。凹坑4506b还包括近侧杯4520,远侧杯4522,以及在近侧杯4520和远侧杯4522之间延伸的颈部部分4524。当钉被驱动成与钉成形表面4502成形接触时,近侧杯4520与近侧钉腿对准,并且远侧杯4522与远侧钉腿对准。杯4520,4522被构造成能够将钉腿朝向凹坑轴线PA和凹坑4506的中心部分(诸如颈部4524)引导或传送,并使钉腿变形成所成形的构造。
主要参见图111,凹坑4506b的每个杯4520、4522限定入口斜坡4540和出口斜坡4542。入口斜坡4540比出口斜坡4542更陡。当形成钉时,钉腿的尖端可沿入口斜坡4540进入相应的杯4520,4522并且沿出口斜坡4542离开相应的杯4520,4522。在入口斜坡4540和出口斜坡4542之间的顶点4546处,钉腿的尖端朝向钉基部变形以呈现成形的构造,例如诸如B形或修改的B形。凹坑4506b还在近侧杯4520和远侧杯4522之间限定桥接件4544。桥接件4544与非成形部分4508偏置。更具体地,桥接件4544被定位在非成形部分4508下方或相对于非成形部分4508凹入。
主要参见图112A至图112C,凹坑4506b包括波状或弧形壁4550。壁4550将每个杯4520,5422形成为宽的圆形盆,用于接收和形成钉腿。另外,凹坑4506b包括沿底表面的凹槽4556。壁4550向下作弧形运动而进入非成形表面4508和凹槽4556之间的砧座4500中。例如,侧壁4550无缝地过渡到凹坑4506b的底表面。凹槽4556沿底表面从近侧杯4520延伸越过桥接件4524并进入远侧杯4522。凹槽4556被构造成能够在钉腿运动到变形构型时约束和引导钉腿。在各种实例中,凹槽4556的直径可小于与凹槽4556接合的钉的直径。在端部执行器中,其中不同的钉几何形状与相同的钉成形凹坑几何形状一起使用,凹坑中的凹槽的宽度可小于最小直径的钉。
波状壁4550在每个杯4520,4522的外端和颈部部分4524之间变窄。更具体地,壁4550沿向内轮廓延伸,以在凹坑4506b的周边4516中限定轮廓。加宽的区域提供用于接收钉腿的尖端的扩大的占有面积。当杯4520,4522朝向桥接件4544变窄时,杯4520,4522被构造成能够朝向和/或沿凹坑轴线PA传送和/或引导钉腿的尖端并且进入成形构造。
凹坑4506b还沿凹坑4506b的侧面的一部分限定倒角边缘4554。当侧壁4550朝向颈部部分4524变窄时,倒角边缘4554的宽度相应地朝向颈部部分4224扩展,以保持总凹坑宽度。
再次参见图110,凹坑4506b关于凹坑轴线PA对称。例如,凹坑4406b的周边4516关于凹坑轴线PA对称。此外,凹坑4506b关于穿过颈部部分4524并垂直于凹坑轴线PA的中心轴线CA对称。例如,凹坑4506b的周边4516关于中心轴线CA对称,并且近侧杯4520具有与远侧杯4522相同的几何形状。在其他实例中,近侧杯4520可与远侧杯4522不同。例如,再次参见图111,远侧深度D2可小于近侧深度D1,以适应砧座和钉仓和/或组织流之间的间隙距离的变化,如本文所述。
再次参见图109,每个凹坑4506朝向相邻凹坑4506的颈部部分4524延伸。例如,中间凹坑4506b与内部凹坑4506a和外部凹坑4506c的颈部部分4524对准。此外,内部凹坑4506a和外部凹坑4506b朝向中间凹坑4506b中的一个的颈部部分4524延伸。
钉成形凹坑可包括延伸着陆区,用于在钉被击发成与砧座成形接触时接收钉腿的尖端。在某些实例中,如本文所述,延伸着陆区可从钉成形凹坑的杯侧向和/或纵向延伸。钉成形凹坑的轮廓或周边可与一个或多个相邻的钉成形凹坑的轮廓或周边嵌套。例如,钉成形凹坑的周边的至少一部分可沿轮廓或路径延伸,该轮廓或路径匹配、跟踪、跟随和/或平行于一个或多个相邻的钉成形凹坑的周边的一部分。这种跟踪部分或相邻周边可限定同心轮廓。
在各种实例中,具有一个或多个延伸着陆区的钉成形凹坑的表面区域可大于没有一个或多个延伸着陆区的钉成形凹坑的表面区域。例如,延伸着陆区可使钉成形凹坑的表面区域增加至少10%。例如,延伸着陆区可使钉成形凹坑的表面区域增加15%或25%。在其他实例中,延伸着陆区可使钉成形凹坑的表面区域增加小于10%,例如诸如5%。本文所述的某些钉成形凹坑可具有比具有六排平行的钉成形凹坑的砧座中的钉成形凹坑更大的表面区域,但是其以其他方式与本文所述的具有六排成角度取向的钉成形凹坑的某些砧座相同。在其他实例中,具有延伸着陆区的钉成形凹坑还可包括变窄和/或以其他方式减小的部分,其表面区域等于或大于延伸着陆区的表面区域。
在某些实例中,钉成形凹坑可以是不对称的。例如,钉成形凹坑相对于在凹坑的近侧端部和远侧端部之间延伸的凹坑轴线可以是不对称的和/或可相对于垂直于凹坑轴线延伸并且横切凹坑的中心部分的中心轴线不对称。例如,钉成形凹坑的不对称性可促进凹坑的嵌套和/或可最大化钉成形表面中的凹坑的表面区域。
现在参见图113至图116C,描绘了砧座5000的一部分中的钉成形凹坑5006。类似于砧座3800,凹坑5006沿砧座5000的钉成形表面5002布置成人字形布置。砧座5000包括钉成形表面5002和纵向狭槽5004。纵向狭槽5004沿砧座5000的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽5004。钉成形凹坑5006限定在钉成形表面5002中。钉成形表面5002还包括围绕凹坑5006延伸的非成形部分5008。非成形部分5008完全围绕每个凹坑5006延伸。换句话说,非成形部分5008围绕钉成形凹坑5006。在其他实例中,两个或更多个相邻凹坑5006的至少一部分可邻接接触,使得非成形部分5008不被定位在两者间。
可优化钉成形表面5002的成形比。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座5000的非成形部分5008的表面区域可相对于钉成形凹坑5006被最小化。除此之外或另选地,钉成形凹坑5006的占有面积可延伸或扩大,以最大化钉成形表面5002的被设计用于捕获和形成钉的部分。
图113中示出的凹坑5006在纵向狭槽5004的第一侧上被布置成内排5014a、中间排5014b和外排5014c。内部凹坑5006a被定位在内排5014a中,中间凹坑5006b被定位在中间排5014b中,并且外部凹坑5006c被定位在外排5014c中。尽管未在图113中示出,在至少一个实例中,狭槽5004的相对侧上的凹坑5006可形成纵向狭槽5004的第一侧上的凹坑5006的镜像反射。在其他实例中,钉成形表面5002中的凹坑5006的布置可相对于狭槽5004不对称,并且在某些实例中,砧座5000可不包括纵向狭槽5004。在各种实例中,凹坑5006可在狭槽5004的每个侧面上被布置成少于或多于三排。
内部凹坑5006a相同,中间凹坑5006b相同,并且外部凹坑5006c相同;然而,内部凹坑5006a与中间凹坑5006b和外部凹坑5006c不同,并且中间凹坑5006b与外部凹坑5006c不同。换句话说,每个排5014a,5014b和5014c中的凹坑5006是不同的。本文描述的凹坑5006a,5006b和5006c的延伸着陆区5030和5032有助于其不同的几何形状。延伸着陆区5030和5032的形状和尺寸由相邻的嵌套凹坑5006的周边5016限制。
尽管每个排5014a,5014b和5014c中的凹坑5006是不同的,但是凹坑5006可被构造成能够将钉形成为相同或基本上相同的成形形状。在其他实例中,凹坑5006可被构造成能够使钉成形为不同形状的钉,诸如不同的高度和/或构造。在某些实例中,凹坑5006可在每个排5014a,5014b和5014c内纵向变化。例如,在某些实例中,凹坑5006或其部分的深度可沿砧座5000的长度变化,以适应砧座和钉仓之间的间隙距离沿端部执行器和/或组织流的长度的变化,如本文所述。
在某些实例中,凹坑5006可被构造成能够接合不同几何形状的钉。例如,具有不同的未成形高度和/或不同直径的钉可通过砧座5000中的凹坑5006形成。在某些实例中,钉的几何形状可纵向变化,并且凹坑5006可被构造成能够形成不同的几何形状的钉。例如,钉的未成形高度和/或线直径可沿砧座5000的长度变化。
示例性中间凹坑5006b在图113至图116C中示出。凹坑5006b具有第一端部或近侧端部5010和第二端部或远侧端部5012。凹坑轴线PA(图114)在凹坑5006b的近侧端部5010和远侧端部5012之间延伸。凹坑5006b包括周边5016,周边5016限定凹坑5006b的边界。周边5016包括线性部分和波状部分。更具体地,周边5016包括线性部分和在其间的波状拐角,线性部分在该拐角处改变方向。再次参见图113,每个凹坑5006的周边5016的至少一部分紧密地跟踪或平行于一个或多个相邻凹坑5006的周边的至少一部分。
凹坑5006b还包括近侧杯5020,远侧杯5022,以及在近侧杯5020和远侧杯5022之间延伸的颈部部分5024。当钉被驱动成与钉成形表面5002成形接触时,近侧杯5020与近侧钉腿对准,并且远侧杯5022与远侧钉腿对准。杯5020和5022被构造成能够将钉腿朝向凹坑轴线PA和凹坑5006的中心部分(诸如颈部部分5024)引导或传送,并使钉腿变形成所成形的构造。
主要参见图115,凹坑5006b的每个杯5020、5022限定入口斜坡5040和出口斜坡5042。当形成钉时,钉腿的尖端可沿入口斜坡5040进入相应的凹坑5020,5022并且沿出口斜坡5042离开相应的凹坑5020,5022。在入口斜坡5040和出口斜坡5042之间的顶点5046处,钉腿的尖端朝向钉基部变形以呈现成形的构造,例如诸如B形或修改的B形。凹坑5006b还在近侧杯5020和远侧杯5022之间的颈部部分5024中限定桥接件5044。桥接件5044与非成形部分5008偏置。更具体地,桥接件5044被定位在非成形部分5008下方或相对于非成形部分5008凹入。
主要参见图116A至图116C,凹坑5006b包括侧壁5050,该侧壁从非成形部分5008延伸到底表面5058。侧壁5050包括线性部分和波状部分。侧壁5050朝向每个杯5020、5022的中心区域5021(图114)变宽,并且从每个杯5020、5022的中心区域5021朝向颈部部分5024变窄。加宽的中心区域5021提供了用于接收钉腿的尖端的扩大的占有面积。当杯5020,5022朝向颈部部分5024变窄时,杯5020,5022被构造成能够朝向和/或沿凹坑轴线PA传送和/或引导其钉腿和尖端并且进入成形构造。
图116A沿图114中的平面ALL截取,其对应于钉腿的预期着陆位置(ALL)。例如,可预期钉腿的尖端在平面ALL和凹坑轴线PA的交叉处和/或附近着陆在近侧杯5020中。在平面ALL处,凹坑5006b限定宽度WA和深度DA。图116B中的横截面横跨近侧杯5020和颈部5024之间的过渡截取。图116B示出了限定宽度WB和深度DB的凹坑5006b。宽度WB小于宽度WA,并且深度DB大于深度DA。换句话说,凹坑5006b从近侧杯5020中的平面ALL朝向颈部5024变窄并加深。平面ALL处的相对大的宽度WA被构造成能够提供用于接收钉腿的宽容器或盆。图116C中的横截面横跨颈部部分5024截取。图116C示出了限定宽度WC和深度DC的凹坑5006b。宽度WC小于宽度WB,并且深度DC小于深度DB。换句话说,凹坑5006b继续变窄,并且在横跨桥接件5044的颈部5024中变得更浅。
凹坑5006b的底表面5058是平坦表面,其由其周围的弧形圆角5059界定。在某些实例中,底表面5058可具有沿其至少一部分限定的凹槽。在其他实例中,底表面5058可形成槽。在其他实例中,底表面可包括沿其至少一部分(例如诸如横跨桥接件5044)的隆起或脊。
现在主要参见图114,凹坑5006b包括近侧延伸着陆区5030和远侧延伸着陆区5032。近侧延伸着陆区5030被定位在近侧杯5020的近侧部分中,并且远侧延伸着陆区5032被定位在远侧杯5022的远侧部分中。更具体地,延伸着陆区5030和5032被定位在钉的预期着陆位置之外。例如,近侧延伸着陆区5030被定位在平面ALL的近侧,并且在钉腿的尖端着陆在平面ALL之外的实例中,近侧延伸着陆区5030可捕获钉腿并将其引导朝向凹坑轴线PA和/或朝向颈部部分5024。着陆区5030和5032限定大致多边形形状,并且更具体地,限定具有圆角的四边形。在其他实例中,着陆区5030和5032可以是三角形或基本上三角形,并且在其他实例中,例如可限定弧形或球形轮廓。
延伸着陆区5030和5032的几何形状由相邻钉成形凹坑5006的周边5016限制。例如,延伸着陆区5030和5032可朝向一个或多个相邻的钉成形凹坑延伸和/或几乎与其邻接接触。延伸着陆区5030和5032和/或凹坑5006b的其他部分可平行于相邻的钉成形凹坑5006跟踪和/或延伸。在其他实例中,延伸着陆区5030和5032可邻接一个或多个相邻的钉成形凹坑5006。
再次参见图114,凹坑5006b关于凹坑轴线PA不对称。例如,凹坑5006b的周边5016关于凹坑轴线PA不对称。此外,凹坑5006b关于穿过颈部部分5024并垂直于凹坑轴线PA的中心轴线CA不对称。例如,凹坑5006b的周边5016关于中心轴线CA不对称,并且近侧杯5020具有与远侧杯5022不同的几何形状。尽管近侧杯5020和远侧杯5022是不同的,但是凹坑5006b可被构造成能够形成对称的钉。例如,再次参见图115,远侧深度D2可小于近侧深度D1,以适应砧座和钉仓和/或组织流之间的间隙距离的变化,如本文所述。钉的近侧腿部和远侧腿部的成形高度可相等。在其他实例中,凹坑5006可被构造成能够形成不对称的钉。
再次参见图114,颈部部分5024比近侧杯5020和远侧杯5022窄。颈部部分5024处的凹坑5006b的变窄的周边5016在近侧杯5020的一部分和远侧杯5022的一部分之间限定接收半岛部5026。接收半岛部5026被定位在凹坑5006b的每个侧面上。接收半岛部5026由凹坑5006b的周边5016和切线轴线(例如,TB1和TB2)界定,该切线轴线与凹坑5006的每个侧面上的近侧杯5020和远侧杯5022的最宽部分相切。第一切线轴线TB1被定位在凹坑5006b的第一侧上,并且第二切线轴线TB2被定位在凹坑5006b的相对侧上。图114中示出的第一切线轴线TB1和第二切线轴线TB2与凹坑轴线PA平行。在其他实例中,切线轴线TB1和TB2中的一个或两个可不与凹坑轴线PA平行。
再次参见图113,凹坑5006的周边5016沿钉成形表面5002嵌套或互锁。具体地,每个凹坑5006延伸到相邻凹坑5006的接收半岛部5026中。例如,中间凹坑5006b嵌套在内部凹坑5006a和外部凹坑5006c之间。换句话说,中间凹坑5006b延伸到相邻内部凹坑5006a的接收半岛部5026中并且延伸到相邻外部凹坑5006c的接收半岛部5026中。此外,内部凹坑5006a和外部凹坑5006b与中间凹坑5006b嵌套。更具体地,内部凹坑5006a延伸到相邻中间凹坑5006b的接收半岛部5026中,并且外部凹坑5006c延伸到相邻中间凹坑5006b的接收半岛部5026中。在各种实例中,中间凹坑5006b的远侧延伸着陆区5032被定位在内部凹坑5006a的接收半岛部5026中,中间凹坑5006b的近侧延伸着陆区5030被定位在外部凹坑5006c的接收半岛部5026中,内部凹坑5006a的远侧延伸着陆区5032被定位在中间凹坑5006b的接收半岛部5026中,并且外部凹坑5006c的近侧延伸着陆区5030被定位在中间凹坑5006b的接收半岛部5026中。
凹坑5006的几何形状便于凹坑5006在钉成形表面5002中的嵌套。例如,因为凹坑5006包括在两个扩大的杯5020和5022之间的变窄的颈部部分5024,所以另一个凹坑5006的扩大的杯5020,5022中的一个可定位成邻近变窄的颈部部分5024。例如,扩大的杯5020,5022中的一个可与相邻的凹坑5006的一部分对准和/或被其接收。在所述实例中,可优化由凹坑5006覆盖的钉成形表面5002的表面区域。钉成形表面5002的“成形比”是非成形部分5008与成形部分(即,凹坑5006)的比率。钉成形表面5002的成形比为约1:1。在其他实例中,成形比可小于1:1或大于1:1。例如,在至少一个实例中,钉成形表面5002的50%以上可用钉成形凹坑5006覆盖。在另一个实例中,钉成形表面5002的60%以上或75%以上可用钉成形凹坑5006覆盖。
现在参见图117至图120C,描绘了砧座5100的一部分中的钉成形凹坑5106。类似于砧座3800,凹坑5106沿砧座5100的钉成形表面5102布置成人字形布置。砧座5100包括钉成形表面5102和纵向狭槽5104。纵向狭槽5104沿砧座5100的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽5104。钉成形凹坑5106限定在钉成形表面5102中。钉成形表面5102还包括围绕凹坑5106延伸的非成形部分5108。非成形部分5108完全围绕每个凹坑5106延伸。换句话说,非成形部分5108围绕钉成形凹坑5106。在其他实例中,两个或更多个相邻凹坑5106的至少一部分可邻接接触,使得非成形部分5108不被定位在两者间。
可优化钉成形表面5102的成形比。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座5100的非成形部分5108的表面区域可相对于钉成形凹坑5106被最小化。除此之外或另选地,钉成形凹坑5106的占有面积可延伸或扩大,以最大化钉成形表面5102的被设计用于捕获和形成钉的部分。
图117中示出的凹坑5106在纵向狭槽5104的第一侧上被布置成内排5114a、中间排5114b和外排5114c。内部凹坑5106a被定位在内排5114a中,中间凹坑5106b被定位在中间排5114b中,并且外部凹坑5106c被定位在外排5114c中。尽管未在图117中示出,在至少一个实例中,狭槽5104的相对侧上的凹坑5106可形成纵向狭槽5104的第一侧上的凹坑5106的镜像反射。在其他实例中,钉成形表面5102中的凹坑5106的布置可相对于狭槽5104不对称,并且在某些实例中,砧座5100可不包括纵向狭槽5104。在各种实例中,凹坑5106可在狭槽5104的每个侧面上被布置成少于或多于三排。
内部凹坑5106a相同,中间凹坑5106b相同,并且外部凹坑5106c相同;然而,内部凹坑5106a与中间凹坑5106b和外部凹坑5106c不同,并且中间凹坑5106b与外部凹坑5106c不同。换句话说,每个排5114a,5114b和5114c中的凹坑5106是不同的。在其他实例中,排中的两个或更多个中的凹坑5106可以是相同的。例如,内部凹坑5106a可与外部凹坑5106c相同。本文描述的凹坑5106a,5106b和5106c的延伸着陆区5130和5132可有助于其不同的几何形状。此外,延伸着陆区5130和5132的形状和尺寸由相邻的嵌套凹坑5106的周边5116限制。着陆区5130和5132限定弧形轮廓。在其他实例中,着陆区5030和5032可以是多边形的和/或包括一个或多个线性和/或波状部分。
尽管每个排5114a,5114b和5114c中的凹坑是不同的,但是凹坑5106可被构造成能够将钉形成为相同或基本上相同的成形形状。在其他实例中,凹坑5106可被构造成能够使钉成形为不同形状的钉,诸如不同的高度和/或构造。在某些实例中,凹坑5106可在每个排5114a,5114b和5114c内纵向变化。例如,在某些实例中,凹坑5106或其部分的深度可沿砧座5100的长度变化,以适应砧座和钉仓之间的间隙距离沿端部执行器和/或组织流的长度的变化,如本文所述。
示例性中间凹坑5106b在图117至图120C中示出。凹坑5106b具有第一端部或近侧端部5110和第二端部或远侧端部5112。凹坑轴线PA(图118)在凹坑5106b的近侧端部5110和远侧端部5112之间延伸。凹坑5106b包括周边5116,周边5116限定凹坑5106b的边界。周边5116包括线性部分和波状部分。更具体地,周边5116包括线性部分和在其间的波状拐角,线性部分在该拐角处改变方向。再次参见图117,每个凹坑5106的周边5116的至少一部分紧密地跟踪或平行于一个或多个相邻凹坑5106的周边的至少一部分。凹坑5106b的圆形周边5116可提供更平滑的轮廓,例如,其与具有尖角的凹坑相比可更容易地在钉成形表面5102中压印和/或冲压。
凹坑5106b包括近侧杯5120,远侧杯5122,以及在近侧杯5120和远侧杯5122之间延伸的颈部部分5124。当钉被驱动成与钉成形表面5102成形接触时,近侧杯5120与近侧钉腿对准,并且远侧杯5122与远侧钉腿对准。杯5120和5122被构造成能够将钉腿朝向凹坑轴线PA和凹坑5106的中心部分(诸如颈部部分5124)引导或传送,并使钉腿变形成所成形的构造。
主要参见图119,凹坑5106b的每个杯5120、5122限定入口斜坡5140和出口斜坡5142。当形成钉时,钉腿的尖端可沿入口斜坡5140进入相应的凹坑5120,5122并且沿出口斜坡5142离开相应的凹坑5120,5122。在入口斜坡5140和出口斜坡5142之间的顶点5146处,钉腿的尖端朝向钉基部变形以呈现成形的构造,例如诸如B形或修改的B形。凹坑5106b还在近侧杯5120和远侧杯5122之间的颈部部分5124中限定桥接件5144。桥接件5144与非成形部分5108偏置。更具体地,桥接件5144被定位在非成形部分5108下方或相对于非成形部分5108凹入。
主要参见图120A至图120C,凹坑5106b包括侧壁5150,该侧壁从非成形部分5108延伸。侧壁5150包括线性部分和波状部分。侧壁5150朝向每个杯5120、5122的中心区域5121(图118)变宽,并且从每个杯5120、5122的中心区域5121朝向颈部部分5124变窄。加宽的中心区域5121提供了用于接收钉腿的尖端的扩大的占有面积。当杯5120,5122朝向颈部部分5124变窄时,杯5120,5122被构造成能够朝向和/或沿凹坑轴线PA传送和/或引导其钉腿和尖端并且进入成形构造。
图120A沿图118中的平面ALL截取,其对应于钉腿的预期着陆位置。例如,可预期钉腿的尖端在平面ALL和凹坑轴线PA的交叉处和/或附近着陆在近侧杯5120中。在平面ALL处,凹坑5106b限定宽度WA和深度DA。图120B中的横截面横跨近侧杯5120和颈部5124之间的过渡截取。图120B示出了限定宽度WB和深度DB的凹坑5106b。宽度WB小于宽度WA,并且深度DB大于深度DA。换句话说,凹坑5106b从近侧杯5120中的平面ALL朝向颈部5124变窄并加深。平面ALL处的相对大的宽度WA被构造成能够提供用于接收钉腿的宽盆或容器。图120C中的横截面横跨颈部部分5124截取。图120C示出了限定宽度WC和深度DC的凹坑5106b。宽度WC小于宽度WB,并且深度DC小于深度DB。换句话说,凹坑5106b继续变窄,并且在横跨桥接件5144的颈部5124中变得更浅。
凹坑5106b的底表面5158是平坦表面。在其他实例中,底表面5158可具有沿其至少一部分限定的凹槽。在其他实施中,底表面5158可形成槽和/或可包括沿其至少一部分(例如诸如横跨桥接件5144)的隆起或脊。
现在主要参见图118,凹坑5106b包括近侧延伸着陆区5130和远侧延伸着陆区5132。近侧延伸着陆区5130被定位在近侧杯5120的近侧部分中,并且远侧延伸着陆区5132被定位在远侧杯5122的远侧部分中。更具体地,延伸着陆区5130和5132被定位在钉的预期着陆位置之外。例如,近侧延伸着陆区5130被定位在平面ALL的近侧,并且在钉腿的尖端着陆在平面ALL之外的实例中,近侧延伸着陆区5130可捕获钉腿并将其引导朝向凹坑轴线PA和/或朝向颈部部分5124。
延伸着陆区5130和5132的几何形状由相邻钉成形凹坑5106的周边5016限制。例如,延伸着陆区5130和5132可朝向一个或多个相邻的钉成形凹坑延伸和/或几乎与其邻接接触。延伸着陆区5130和5132和/或凹坑5106b的其他部分可平行于相邻的钉成形凹坑5106延伸。在其他实例中,延伸着陆区5130和5132可邻接一个或多个相邻的钉成形凹坑5106。
再次参见图118,凹坑5106b关于凹坑轴线PA不对称。例如,凹坑5106b的周边5116关于凹坑轴线PA不对称。此外,凹坑5106b关于穿过颈部部分5124并垂直于凹坑轴线PA的中心轴线CA不对称。例如,凹坑5106b的周边5116关于中心轴线CA不对称,并且近侧杯5120具有与远侧杯5122不同的几何形状。尽管近侧杯5120和远侧杯5122是不同的,但是凹坑5106b可被构造成能够形成对称的钉。例如,再次参见图119,远侧深度D2可小于近侧深度D1,以适应砧座和钉仓和/或组织流之间的间隙距离的变化,如本文所述。因此,钉的近侧腿部和远侧腿部的成形高度可相等。在其他实例中,凹坑5106可被构造成能够形成不对称的钉。
再次参见图118,颈部部分5124比近侧杯5120和远侧杯5122窄。颈部部分5124处的凹坑5106b的变窄的周边5116在近侧杯5120的一部分和远侧杯5122的一部分之间限定接收半岛部5126。接收半岛部5126被定位在凹坑5106b的每个侧面上。接收半岛部5126由凹坑5106b的周边5116和切线轴线(例如,TB1或TB2)界定,该切线轴线与凹坑5106的每个侧面上的近侧杯5120和远侧杯5122的最宽部分相切。第一切线轴线TB1被定位在凹坑5106b的第一侧上,并且第二切线轴线TB2被定位在凹坑5106b的相对侧上。图118中示出的第一切线轴线TB1和第二切线轴线TB2相对于凹坑轴线PA偏斜。在其他实例中,切线轴线TB1和TB2中的一个或两个可与凹坑轴线PA平行。
再次参见图117,凹坑5106的周边5116沿钉成形表面5102嵌套或互锁。具体地,每个凹坑5106延伸到相邻凹坑5106的接收半岛部5126中。例如,中间凹坑5106b嵌套在内部凹坑5106a和外部凹坑5106c之间。换句话说,中间凹坑5106b延伸到相邻内部凹坑5106a的接收半岛部5126中并且延伸到相邻外部凹坑5106c的接收半岛部5126中。此外,内部凹坑5106a和外部凹坑5106b与中间凹坑5106b嵌套。更具体地,内部凹坑5106a延伸到相邻中间凹坑5106b的接收半岛部5126中,并且外部凹坑5106c延伸到相邻中间凹坑5106b的接收半岛部5126中。在各种实例中,中间凹坑5106b的远侧延伸着陆区5132被定位在内部凹坑5106a的接收半岛部5126中,中间凹坑5106b的近侧延伸着陆区5130被定位在外部凹坑5106c的接收半岛部5126中,内部凹坑5106a的远侧延伸着陆区5132被定位在中间凹坑5106b的接收半岛部5126中,并且外部凹坑5106c的近侧延伸着陆区5130被定位在中间凹坑5106b的接收半岛部5126中。
凹坑5106的几何形状便于凹坑5106在钉成形表面5102中的嵌套。例如,因为凹坑5106包括在两个扩大的杯5120和5122之间的变窄的颈部部分5124,所以另一个凹坑5106的扩大的杯5120,5122中的一个可定位成邻近变窄的颈部部分5124。例如,扩大的杯5120,5122中的一个可与相邻的凹坑5106的一部分对准和/或被其接收。在所述实例中,可优化由凹坑5106覆盖的钉成形表面5102的表面区域。例如,由凹坑5106覆盖的钉成形表面5102的表面区域被最大化。钉成形表面5102的“成形比”是非成形部分5108与成形部分(即,凹坑5106)的比率。在至少一个实例中,例如,成形比可以是至少1:1。在某些实例中,钉成形表面5102的60%以上或75%以上可被钉成形凹坑5106覆盖。
现在参见图121至图125C,描绘了砧座5200的一部分中的钉成形凹坑5206。类似于砧座3800,凹坑5206沿砧座5200的钉成形表面5202布置成人字形布置。砧座5200包括钉成形表面5202和纵向狭槽5204。纵向狭槽5204沿砧座5200的纵向轴线LA延伸。在某些实例中,击发元件和/或切割元件可在击发行程的至少一部分期间平移穿过纵向狭槽5204。钉成形凹坑5206限定在钉成形表面5202中。钉成形表面5202还包括围绕凹坑5206延伸的非成形部分5208。非成形部分5208完全围绕每个凹坑5206延伸。换句话说,非成形部分5208围绕钉成形凹坑5206。在其他实例中,两个或更多个相邻凹坑5206的至少一部分可邻接接触,使得非成形部分5208不被定位在两者间。
可优化钉成形表面5202的成形比。通过优化成形比,更多的钉可成形和/或成形为他们期望的构造。在某些实例中,砧座5200的非成形部分5208的表面区域可相对于钉成形凹坑5206被最小化。除此之外或另选地,钉成形凹坑5206的占有面积可延伸或扩大,以最大化钉成形表面5202的被设计用于捕获和形成钉的部分。
图121中示出的凹坑5206在纵向狭槽5204的第一侧上被布置成内排5214a、中间排5214b和外排5214c。内部凹坑5206a被定位在内排5214a中,中间凹坑5206b被定位在中间排5214b中,并且外部凹坑5206c被定位在外排5214c中。尽管未在图121中示出,在至少一个实例中,狭槽5204的相对侧上的凹坑5206可形成纵向狭槽5204的第一侧上的凹坑5206的镜像反射。在其他实例中,钉成形表面5202中的凹坑5206的布置可相对于狭槽5204不对称,并且在某些实例中,砧座5200可不包括纵向狭槽5204。在各种实例中,凹坑5206可在狭槽5204的每个侧面上被布置成少于或多于三排。
图121中示出的凹坑5206是相同的。限定在钉成形表面5202中的每个凹坑5206具有相同的几何形状。在其他实例中,凹坑5206的几何形状可沿砧座5200的长度逐排和/或纵向地变化。例如,在某些实例中,凹坑5206的深度可沿砧座5200的长度变化,以适应砧座和钉仓之间的间隙距离沿端部执行器和/或组织流的长度的变化,如本文所述。
凹坑5206可被构造成能够将钉形成为相同或基本上相同的成形形状。如本文所述,凹坑5206可被构造成能够将每个钉形成为相同的不对称形状。在其他实例中,凹坑5206可被构造成能够使钉成形为不同形状的钉,诸如不同的高度和/或构造。
示例性中间凹坑5206b在图122至图125C中示出。凹坑5206b具有第一端部或近侧端部5210和第二端部或远侧端部5212。凹坑轴线PA(图121)在凹坑5206b的近侧端部5210和远侧端部5212之间延伸。凹坑5206b包括周边5216,周边5216限定凹坑5206b的边界。周边5216包括线性部分和波状部分。
凹坑5206b还包括近侧杯5220,远侧杯5222,以及在近侧杯5220和远侧杯5222之间延伸的颈部部分5224。当钉被驱动成与钉成形表面5202成形接触时,近侧杯5220与近侧钉腿对准,并且远侧杯5222与远侧钉腿对准。杯5220和5222被构造成能够将钉腿朝向凹坑轴线PA和凹坑5206的中心部分(诸如颈部部分5224)引导或传送,并使钉腿变形成所成形的构造。在其他实例中,杯5222可在杯5220的近侧。
主要参见图119,凹坑5206b的每个杯5220和5222分别限定入口斜坡5240a和5240b以及出口斜坡5242a和5242b。当形成钉时,钉腿的尖端可沿入口斜坡5240a,5240b进入相应的凹坑5220,5222并且沿出口斜坡5242a,5242b离开相应的凹坑5220,5222。在分别在入口斜坡5240a,5240b和出口斜坡5242a,5242b之间的顶点5246a,5246b处,钉腿的尖端朝向钉基部变形以呈现成形的构造,例如诸如B形或修改的B形。凹坑5206b还在近侧杯5220和远侧杯5222之间限定桥接件5244。桥接件5244与非成形部分5208偏置。更具体地,桥接件5244被定位在非成形部分5208下方或相对于非成形部分5208凹入。
再次参见图122,凹坑5206b关于凹坑轴线PA对称。例如,凹坑5206b的周边5216关于凹坑轴线PA对称。此外,凹坑5206b关于穿过颈部部分5224并垂直于凹坑轴线PA的中心轴线CA不对称。例如,凹坑5206b的周边5216关于中心轴线CA不对称,并且近侧杯5220具有与远侧杯5222不同的几何形状。杯5220和5222的不对称性被构造成能够形成不对称的钉。例如,再次参见图123,远侧深度D2小于近侧深度D1,近侧深度D1被构造成能够形成在近侧腿部处具有比在远侧腿部处更大的成形高度的钉。远侧深度D2可比近侧深度D1小约0.002英寸。在其他实例中,远侧深度D2和近侧深度D1之间的差值可大于和/或小于0.002英寸。在某些实例中,差值可以是钉直径的1%至10%。例如,差值可以是钉直径的约2%。在其他实例中,钉的成形高度在远侧腿部处可比在近侧腿部处更大。每个杯5220,5222的长度也不同。例如,远侧长度D2大于图123中的近侧长度D1。另外,凹坑5206b中的入口斜坡5240a和5240b的倾斜是不同的,并且凹坑5206b中的出口斜坡5242a和5242b的倾斜也是不同的。
在各种实例中,凹坑5206b的一部分中的减小的深度可改善砧座的刚度。例如,因为远侧深度D2小于近侧深度D1,所以砧座5200由更多材料构成,这可增加其刚度。此外,因为增加的材料位于砧座5200的远侧部分中,所以这种部分可具有增加的刚度,这可限制砧座朝向远侧端部的翘曲或变形。
近侧杯5220和远侧杯5222的几何形状的差异可适应组织运动或流动。更具体地,当组织抵靠砧座5200被夹紧时,被夹紧的组织中的流体可朝向相邻的未夹紧组织流动或运动。组织可朝向砧座5200的纵向侧面侧向流动,朝向砧座5200的远侧端部朝远侧流动,和/或朝向砧座5200的近侧端部朝近侧流动。在某些实例中,当切割边缘被朝远侧推进穿过组织时,组织可相对于砧座5200流动。在所述实例中,组织可侧向地、朝远侧和/或朝近侧流动,但由于切割边缘的远侧运动,所以组织主要朝远侧流动。在切割边缘朝近侧运动以切开组织的实例中,组织的运动或流动在切割行程期间通常是朝近侧的。近侧杯5220和远侧杯5222的不同几何形状分别可适应组织的流动,这可使嵌入其中的钉腿移位或偏斜。
主要参见图124A至图124C,凹坑5206b包括侧壁5250,该侧壁从非成形部分5208延伸。杯5220,5222被构造成能够朝向和/或沿凹坑轴线PA传送和/或引导其钉腿和尖端并且进入成形构造。由于近侧杯5220和远侧杯5222的不同几何形状,在被驱动成与凹坑5206b成形接触时,近侧钉腿的路径可与远侧钉腿的路径不同。在某些实例中,不对称的钉凹坑5206b可由对称的未成形钉形成不对称的钉。除此之外或另选地,不对称的未成形钉可通过钉凹坑5206b形成为不对称的成形钉。
图124A沿图122中的平面ALL1截取,其对应于近侧钉腿的预期着陆位置。例如,可预期近侧钉腿的尖端在平面ALL1和凹坑轴线PA的交叉处和/或附近着陆在近侧杯5220中。在平面ALL1处,近侧杯5220限定宽度W1A和深度D1A。图124B中的横截面横跨近侧杯5220和颈部5224之间的过渡截取。图124B示出了近侧杯5220,其限定宽度W1B和深度D1B。宽度W1B大于宽度W1A,并且深度D1B大于深度D1A。换句话说,近侧杯5220从近侧杯5220中的平面ALL1朝向颈部5224变宽和加深。图124C中的横截面横跨颈部部分5224的近侧端部截取。图124C示出了限定宽度W1C和深度D1C的凹坑5206b。宽度W1C小于宽度W1B,并且深度D1C小于深度D1B。换句话说,凹坑5206b继续变窄,并且在横跨桥接件5244的颈部5224中变得更浅。
图125A沿图122中的平面ALL2截取,其对应于远侧钉腿的预期着陆位置。例如,可预期远侧钉腿的尖端在平面ALL2和凹坑轴线PA的交叉处和/或附近着陆在远侧杯5222中。在平面ALL2处,远侧杯5222限定宽度W2A和深度D2A。宽度W2A与宽度W1A不同,并且深度D2A与深度D1A不同。图125B中的横截面横跨远侧杯5222和颈部5224之间的过渡截取。图125B示出了限定宽度W2B和深度D2B的远侧杯5222。宽度W2B与宽度W1B不同,并且深度D2B与深度D1B不同。宽度W2B小于宽度W2A,并且深度D2B大于深度D2A。换句话说,远侧杯5222从远侧杯5222中的平面ALL2朝向颈部5224变窄和加深。图125C中的横截面横跨颈部部分5224的远侧端部截取。图125C示出了限定宽度W2C和深度D2C的凹坑5206b。宽度W2C与宽度W1C不同,并且深度D2C与深度D1C不同。宽度W2C小于宽度W2B,并且深度D2C小于深度D2B。换句话说,凹坑5206b继续变窄,并且在横跨桥接件5244的颈部5224中变得更浅。
凹坑5206b的底表面5258是平坦表面。在其他实例中,底表面5258可具有沿其至少一部分限定的凹槽。在其他实施中,底表面5258可形成槽和/或可包括沿其至少一部分(例如诸如横跨桥接件5244)的隆起或脊。
现在主要参见图122,凹坑5206b包括近侧延伸着陆区5230和远侧延伸着陆区5232。近侧延伸着陆区5230被定位在近侧杯5220的近侧部分中,并且远侧延伸着陆区5232被定位在远侧杯5222的远侧部分中。更具体地,延伸着陆区5230和5232被定位在钉的预期着陆位置之外。例如,近侧延伸着陆区5230被定位在平面ALL1的近侧,并且在钉腿的尖端着陆在平面ALL1之外的实例中,近侧延伸着陆区5230可捕获钉腿并将其引导朝向凹坑轴线PA和/或朝向颈部部分5224。远侧延伸着陆区5232被定位在平面ALL2的远侧,并且在钉腿的尖端落在平面ALL2之外的实例中,远侧延伸着陆区5232可捕获钉腿并将其引导朝向凹坑轴线PA和/或朝向颈部部分5224。在某些实例中,延伸着陆区5230,5232的几何形状可由相邻的嵌套的钉成形凹坑5206的几何形状约束或限制。
再次参见图122,颈部部分5224比近侧杯5220和远侧杯5222窄。颈部部分5224处的凹坑5206b的变窄的周边5216在近侧杯5220的一部分和远侧杯5222的一部分之间限定接收半岛部5226。接收半岛部5226被定位在凹坑5206b的每个侧面上。接收半岛部5226由凹坑5206b的周边5216和切线轴线(例如,TB1和TB2)界定,该切线轴线与凹坑5206的每个侧面上的近侧杯5220和远侧杯5222的最宽部分相切。第一切线轴线TB1被定位在凹坑5206b的第一侧上,并且第二切线轴线TB2被定位在凹坑5206b的相对侧上。图122中示出的第一切线轴线TB1和第二切线轴线TB2相对于凹坑轴线PA偏斜。在其他实例中,切线轴线TB1和TB2中的一个或两个可与凹坑轴线PA平行。
在各种实例中,凹坑5206的几何形状可有助于凹坑5206在钉成形表面5202中的嵌套和/或闭合布置。例如,可优化由凹坑5206覆盖的钉成形表面5202的表面区域。钉成形表面5202的“成形比”是非成形部分5208与成形部分(即,凹坑5206)的比率。在至少一个实例中,例如,成形比可以是至少1:1。
如本文所述,用于端部执行器的钉仓中的钉腔和钉的布置可对应于或匹配端部执行器的砧座中的钉成形凹坑的布置。更具体地,每个钉腔的角度取向和间距可匹配相应的钉成形凹坑的角度取向和间距。例如,当钉腔以人字形图案布置时,钉成形凹坑可以对应的人字形图案布置。
在某些实例中,端部执行器可包括具有钉腔布置的钉仓和具有钉成形凹坑的非对应布置的砧座。例如,钉腔可相对于纵向轴线倾斜地取向,并且钉成形凹坑可平行于纵向轴线进行取向。在某些实例中,例如,端部执行器可被构造成能够接收具有不同的钉腔布置的不同钉仓,并且端部执行器的砧座可与所有不同的钉仓和其中的钉腔的排列不相容。在所述实例中,砧座可改装或适配成具有附件诸如砧座板,其具有合适的钉成形凹坑的布置。
外科端部执行器5500在图126至图128中示出。类似于端部执行器1100(图1-4),端部执行器5500包括细长通道1102,细长通道1102被构造成能够将钉仓5510可操作地支撑在其中。钉仓5510在许多方面类似于钉仓1110。例如,钉仓包括具有平台5515的钉仓体5511。纵向狭槽5514从主体5511的近侧端部部分5512朝向主体5511的远侧端部部分5513延伸穿过平台5515。成角度取向的钉腔5516限定在仓体5511中,并且每个钉腔5516在平台5515中限定开口。每个钉腔5516的开口相对于纵向狭槽5514以倾斜角取向。钉腔5516以人字形图案布置。钉可移除地被定位在钉腔中。
端部执行器5500还包括砧座5530,砧座5530相对于细长通道1102被可枢转地支撑。砧座5530在许多方面类似于砧座1130。例如,砧座5530包括钉成形表面5502和纵向狭槽5504。在某些实例中,例如,击发元件和/或切割元件诸如滑动组件1120和/或击发构件1760(图4)在击发行程的至少一部分期间可平移通过纵向狭槽5504。组织止挡件5531朝向钉仓5510向下延伸,以控制组织在仓体5511的近侧端部部分5512和砧座5530之间的定位。钉成形凹坑5506限定在钉成形表面5502中,其还包括围绕凹坑5506延伸的非成形部分5508。钉成形凹坑5506平行于纵向狭槽5504取向。换句话说,钉成形凹坑5506的布置与钉腔5516的布置不匹配或不对应。如果钉从钉仓5510击发成与砧座5530成形接触,则大多数这种钉可能未成形和/或畸形。
端部执行器5500包括适配器组件5540,适配器组件5540被构造成能够使砧座5530适合于钉成形凹坑的合适的布置。钉仓5510是适配器组件5540的一部分。适配器组件5540还包括砧座板5550和连接材料5570。砧座板5550的近侧部分形成弹簧5551,砧座板5550在弹簧5551处附接到钉仓5510。这样,砧座板5550被构造成能够在向砧座板5550施加闭合运动时(例如诸如通过砧座5530)在近侧弹簧5551处朝向钉仓5510向下枢转。弹簧5551可使砧座板5550朝向图126中所示的构造偏置,其可便于将适配器组件5540可释放地附接到砧座5530。
砧座板5550中的钉成形凹坑的布置对应于钉仓中的钉腔5516的布置。砧座板5550包括钉成形表面5502和纵向狭槽5554,当适配器组件5540安装在端部执行器5500中时,纵向狭槽5554与砧座5530中的纵向狭槽5504和钉仓5510中的纵向狭槽5514对准。钉成形凹坑5556限定在钉成形表面5502中,并且非成形部分5558(图126)围绕钉成形凹坑5556延伸。在所示实施方案中,钉成形凹坑5556相对于纵向狭槽5554以倾斜角取向。更具体地,钉成形凹坑5556以人字形图案布置,其对应于钉腔5516的人字形图案。砧座板5550可以是金属片,其中钉成形凹坑的布置已经被冲压。
砧座板5550中的钉成形凹坑5556的布置对应于钉仓中的钉腔5516的布置。换句话说,砧座板5550中的每个钉成形凹坑5556对应于钉腔5516的角度和位置。读者将理解,钉仓可包括各种不同的钉腔布置,并且本文描述了钉腔的各种示例性布置。例如,钉仓可包括倾斜地取向的钉腔的纵向重复的图案和/或一个或多个平行和/或成角度偏置的钉腔。除此之外或另选地,钉仓可包括多个不同图案的钉腔。在其他实例中,钉腔的布置可沿仓体侧向和/或纵向变化。无论钉仓中的钉腔的布置如何,钉成形凹坑的对应布置可由适配器组件5540的互补砧座板5550提供。
砧座板5500可连接到钉仓5510,并且连接材料5570附接到砧座板5500。在使用中,当钉仓5510插入细长通道1102时,砧座板5500和适配器组件5540的连接材料5570也设置在细长通道1102和砧座5530之间。在某些实例中,砧座5530可朝向细长通道1102向下枢转,以利用连接材料5570将砧座板5550固定或以其他方式附接到砧座5530的钉成形表面5502。除此之外或另选地,弹簧构件5551可将砧座板5550和其上的连接材料5570偏置成与砧座5530附接和/或朝向与砧座5530附接。当适配器组件5540安装在端部执行器5500中时,砧座5530已经有效地改装或适于与钉仓5510一起使用。
钉仓5510和砧座板5550可包括对准特征部,用于将钉仓5510中的钉腔5516与砧座板5500中的对应钉成形凹坑5556对准。例如,钉仓5510包括对准孔5520(图126),并且砧座板5550包括对准柱或销5562。对准销5562由对准孔5520接收,以相对于钉仓5510定位砧座板5550。例如,对准销5562可压配合到对准孔5520中。例如,对准孔5520和对准销5562之间的连接被构造成能够纵向对准钉仓5510和砧座板5550。
在某些实例中,制造商和/或分销商可提供预组装的组件5540。例如,在外科医生或其助手获得用于外科手术的组件5540之前,砧座板5550可被压配合成与钉仓5510接合。在其他实例中,外科医生和/或其助手可组装组件5540。
砧座板5550还包括用于将砧座板5550与砧座5530对准的对准特征部。例如,砧座板5550包括远侧对准凸缘5564。远侧对准凸缘5564由砧座5530中的纵向狭槽5504接收,以相对于砧座5530定位砧座板5550。例如,远侧对准凸缘5564可压配合到纵向狭槽5504中。例如,对准凸缘5564和纵向狭槽5504之间的连接被构造成能够使砧座板5550和砧座5530侧向对准。
连接材料5570是柔性材料。例如,连接材料5570可包括弹性体和/或低密度聚乙烯。在各种实例中,连接材料5570可以是砧座板5550上的包覆模制件。当粘附或以其他方式固定到砧座5530时,连接材料5570被构造成能够呈现与钉成形表面5502的轮廓匹配的变形构型。例如,连接材料5570的未成形构造在图126中示出,并且连接材料5570的成形构造在图127中示出。主要参见图127,连接材料5570流入并填充钉成形凹坑5506。换句话说,钉成形凹坑5506压印在连接材料5570中。在所述实例中,连接材料5570可在成形过程期间强化砧座板5550。例如,砧座板5550和砧座5530之间的连接材料5570可为砧座板5550提供背衬,从而当砧座板5550在使用期间受到冲击并受到其他力时,防止和/或限制砧座板5550相对于砧座5530的变形。
连接材料5570包括通道5572。通道5572沿其长度的一部分延伸。尽管未在图126中示出,类似的通道5572可沿适配器组件5540的相对侧限定在连接材料5570中。砧座板5550的唇缘5566被定位在通道5572中。唇缘5566为基本上U形的。在其他实例中,例如,唇缘5566可以是例如L形的、线性的和/或波状的。砧座板5500还包括内脊5568,其与连接材料5570中的纵向狭槽5574(图126)和砧座5530中的纵向狭槽5504对准。脊5568被构造成能够便于适配器组件5540沿端部执行器5500的长度对准。在各种实例中,连接材料5570可模制在砧座板5550上。例如,连接材料5570可围绕唇缘5566和/或脊5568模制。
端部执行器5500的一部分也在图128中示出。适配器组件5640安装在图128中的端部执行器5500中。适配器组件5640在许多方面类似于适配器组件5540。例如,适配器组件5640包括砧座板5650,砧座板5650具有钉成形表面5652和纵向狭槽5654,纵向狭槽5654与砧座5530中的纵向狭槽5504对准。钉成形凹坑5656限定在钉成形表面5652中,并且非成形部分5658围绕钉成形凹坑5656延伸。钉成形凹坑5656相对于纵向狭槽5654以倾斜角取向。更具体地,钉成形凹坑5656以人字形图案布置,其对应于钉腔5516的人字形图案(图126)。砧座板5650可以是金属片,其中钉成形凹坑的布置已经被冲压。
适配器组件5640不包括可变形材料诸如如可变形材料5570。相反,砧座板5650被构造成能够直接接合砧座5530。砧座板5650包括唇缘5666,其定位成抵靠钉成形表面5502。唇缘5666为基本上U形的。在其他实例中,例如,唇缘5666可以是例如L形的、线性的和/或波状的。砧座板5600还包括内脊5668,其与砧座5530中的纵向狭槽5504对准。脊5668被构造成能够便于适配器组件5640沿端部执行器5600的长度对准。
在其他实例中,砧座板5650可嵌入砧座5530的钉成形表面5502中。例如,砧座板5650的钉成形凹坑5656可至少部分地嵌套在砧座5530中的钉成形凹坑5506内。尽管钉成形凹坑5656的布置、数量和/或几何形状不同于钉成形凹坑5506的布置、数量和/或几何形状,但是钉成形凹坑5656的部分可被定位在钉成形凹坑5506的部分内。
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。名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利申请公布2012/0298719)更详细地公开了机器人外科器械系统的若干示例。
已结合钉的部署和变形描述了本文所述的外科器械系统;然而,本文所述的实施方案不限于此。例如,设想了部署除钉之外的紧固件诸如夹具或大头钉的各种实施方案。此外,还设想了利用用于密封组织的任何合适装置的各种实施方案。例如,根据各种实施方案的端部执行器可包括被构造成能够加热和密封组织的电极。另外,例如,根据某些实施方案的端部执行器可施加振动能量来密封组织。
下述专利的全部公开内容据此以引用方式并入本文:
-公布于1995年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8,733,613;
-提交于2011年2月28日的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号13/036,647,现为美国专利8,561,870;
-名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241,现为美国专利9,072,535;
-提交于2012年6月15日的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING A FIRING DRIVE”的美国专利申请序列号13/524,049;现为美国专利9,101,358;
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,025,现为美国专利申请公布2014/0263551;
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,067,现为美国专利申请公布2014/0263552;
-提交于2006年1月31日的名称为“SURGICAL CUTTING AND 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 (7)
1.一种将适配器组件组装到外科器械的端部执行器的方法,包括:
获得包括具有多个钉腔的钉仓和可移动地与所述钉仓连接的砧座板的适配器组件,其中所述钉腔可移除地定位有多个钉,所述砧座板包括多个第一钉成形凹坑,并且其中所述多个第一钉成形凹坑布置成与所述多个钉腔的布置对应的第一布置;以及
将所述适配器组件的所述钉仓安装在端部执行器的细长通道中,其中所述端部执行器包括砧座,所述砧座被可枢转地支撑于所述细长通道并且包括多个第二钉成形凹坑,其中所述第二钉成形凹坑布置成第二布置,并且其中所述第二布置不同于所述第一布置,
在所述适配器组件的所述钉仓安装在所述端部执行器的所述细长通道内时,所述砧座板设置在所述钉仓与所述砧座之间,与所述砧座接合,在所述砧座朝向所述钉仓运动时,所述砧座板朝向所述钉仓运动,所述多个钉腔与布置成与所述多个钉腔的所述布置对应的所述第一布置的所述多个第一钉成形凹坑相对,其中所述适配器组件包括可变形材料,并且其中安装步骤还包括将所述可变形材料成形为变形构型,所述变形构型对应于所述砧座的轮廓。
2.根据权利要求1所述的将适配器组件组装到外科器械的端部执行器的方法,其中所述第一布置包括凹坑的人字形图案。
3.根据权利要求2所述的将适配器组件组装到外科器械的端部执行器的方法,其中所述第二布置包括凹坑的平行图案。
4.根据权利要求2所述的将适配器组件组装到外科器械的端部执行器的方法,其中所述钉仓包括以对应的人字形图案布置的多个钉腔。
5.根据权利要求2所述的将适配器组件组装到外科器械的端部执行器的方法,其中所述钉仓包括以对应的人字形图案布置的多个钉。
6.根据权利要求5所述的将适配器组件组装到外科器械的端部执行器的方法,还包括驱动所述钉与所述适配器组件中的所述第一钉成形凹坑成形接触。
7.根据权利要求2所述的将适配器组件组装到外科器械的端部执行器的方法,其中安装步骤还包括将所述砧座板上的特征结构与所述砧座上的特征结构对准。
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US15/385,898 US10537325B2 (en) | 2016-12-21 | 2016-12-21 | Staple forming pocket arrangement to accommodate different types of staples |
US15/385,953 US10675026B2 (en) | 2016-12-21 | 2016-12-21 | Methods of stapling tissue |
US15/385,896 US11090048B2 (en) | 2016-12-21 | 2016-12-21 | Method for resetting a fuse of a surgical instrument shaft |
PCT/US2017/060155 WO2018118236A2 (en) | 2016-12-21 | 2017-11-06 | Methods of stapling tissue |
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CN201780079946.3A Active CN110430825B (zh) | 2016-12-21 | 2017-11-20 | 用于重置外科器械轴的熔断器的方法 |
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
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- 2017-12-12 WO PCT/US2017/065698 patent/WO2018118500A2/en active Application Filing
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