CN110167463A - 包括被构造成能够将旋转击发构件的输出适配到两种不同系统的离合器的轴组件 - Google Patents
包括被构造成能够将旋转击发构件的输出适配到两种不同系统的离合器的轴组件 Download PDFInfo
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- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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Abstract
本发明公开了一种轴组件，其可与外科系统，诸如例如外科机器人和/或外科器械的柄部一起使用。该轴组件被构造成能够接收来自外科系统的旋转输入运动，以及传输装置或离合器，该传输装置或离合器可在第一操作模式与第二操作模式之间移位，以选择性地将该旋转输入运动传递到第一驱动系统和第二驱动系统。
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为根据至少一个实施方案的轴组件的透视图；
图2为被示出移除一些部件的图1的轴组件的透视图；
图3为图1的轴组件的脊组件的透视图；
图4为图1的轴组件的局部剖视图；
图5为被示出移除一些部件的图1的轴组件的分解图；
图6为图3的脊组件的分解图；
图7为图1的轴组件的远侧端部的分解图；
图8为图1的轴组件的中间部分的分解图；
图9为被示出移除一些部件的图1的轴组件的近侧端部的分解图；
图10为图1的轴组件的远侧端部的局部剖视图，其以打开的未击发构型示出并且包括处于未空状态的钉仓；
图11为在轴组件的击发构件朝远侧被推进之前示出的图1的轴组件的远侧端部的局部剖视图；
图12为在击发构件已经朝远侧被推进通过闭合行程之后但在击发构件被推进通过击发行程之前示出的图1的轴组件的远侧端部的局部剖视图；
图13为在击发构件的击发行程已经开始之后示出的图1的轴组件的远侧端部的局部剖视图；
图14为图1的轴组件的远侧端部的局部剖视图，其示出了击发行程之后处于回缩位置的击发构件；
图15为图1的轴组件的远侧端部的局部剖视图，其示出了处于空状态的钉仓和处于锁定状态的击发构件；
图16为被示出处于关节运动操作模式的图1的轴组件的局部剖视图；
图17为被示出处于击发操作模式的图1的轴组件的局部剖视图；
图18为被示出处于图16的关节运动操作模式的图1的轴组件的近侧端部的局部剖视图；
图19为被示出处于图17的击发操作模式的图1的轴组件的近侧端部的局部剖视图；
图20为沿图18中的线20-20截取的图1的轴组件的近侧端部的局部剖视图；
图21为沿图18中的线21-21截取的图1的轴组件的近侧端部的局部剖视图；
图22为沿图19中的线22-22截取的图1的轴组件的近侧端部的局部剖视图；
图23为沿图19中的线23-23截取的图1的轴组件的近侧端部的局部剖视图；
图24为图1的轴组件的局部分解图，其示出了轴组件的击发系统中的可移位离合器；
图25为图24的击发系统的中间击发连杆的剖视图；
图26为图1的轴组件的局部剖视图，其示出了处于击发构型的图24的可移位离合器；
图27为图1的轴组件的局部剖视图，其示出了图24的可移位离合器即将从图26的击发构型转变到关节运动构型；
图28为图1的轴组件的局部剖视图，其示出了图24的可移位离合器正在从图26的击发构型转变到关节运动构型；
图29为图1的轴组件的局部剖视图，其示出了处于关节运动构型的图24的可移位离合器；
图30为被示出处于非关节运动构型的图1的轴组件的局部剖视图；
图31为被示出处于关节运动构型的图1的轴组件的局部剖视图；
图32为图1的轴组件的局部剖视图，其示出了处于解锁状态的轴组件的关节运动系统；
图33为图1的轴组件的局部剖视图，其示出了处于锁定状态的轴组件的关节运动系统；
图34为图1的轴组件的近侧端部的剖视图，其示出了处于未展开状态的轴组件的回缩系统；
图35为被示出图34的回缩系统处于展开状态的图1的轴组件的近侧端部的剖视图；
图36为图1的轴组件的近侧端部的剖视图，其示出了处于致动状态的图34的回缩系统；
图37为根据至少一个实施方案的轴组件的透视图；
图38为被示出移除一些部件的图37的轴组件的部分透视图；
图39为被示出移除附加部件的图37的轴组件的部分透视图；
图40为图37的轴组件的局部剖视图；
图41为图37的轴组件的局部剖视图；
图42为被示出移除一些部件的图37的轴组件的分解图；
图43为图37的轴组件的远侧端部的分解图；
图44为被示出移除一些部件的图37的轴组件的近侧端部的分解图；
图45为被示出处于闭合或夹紧构型的图37的轴组件的局部剖视图；
图46为被示出处于打开构型的图37的轴组件的局部剖视图；
图47为被示出移除一些部件的根据至少一个实施方案的轴组件的透视图；
图48为图47的轴组件的移位组件的透视图；
图49为被示出移除一些部件的图47的轴组件的分解图；
图50为被示出处于关节运动操作模式的图47的轴组件的局部剖视图；
图51为被示出处于击发操作模式的图47的轴组件的局部剖视图；
图52为根据至少一个另选的实施方案的包括移位组件的轴组件的透视图；
图53为被示出处于关节运动操作模式的图52的轴组件的局部剖视图；
图54为被示出处于击发操作模式的图52的轴组件的局部剖视图；
图55为根据至少一个实施方案的轴组件的附接部分的透视图；
图56为被示出处于打开构型的图55的附接部分的透视图；
图57为图55的附接部分的分解图；
图58为被示出处于图56的打开构型的并且被示出移除一些部件的图55的附接部分的透视图；
图59为被示出处于图56的打开构型的并且被示出移除附加部件的图55的附接部分的透视图；
图60为被示出处于击发操作模式的图55的附接部分的传动系的平面图；
图61为沿图60中的线61-61截取的并且被示出处于图60的击发操作模式的图60的传动系的剖视图；
图62为沿图60中的线62-62截取的并且被示出处于图60的击发操作模式的图60的传动系的剖视图；
图63为沿图60中的线63-63截取的并且被示出处于图60的击发操作模式的图60的传动系的剖视图；
图64为沿图60中的线62-62截取的并且被示出处于第二操作模式的图60的传动系的剖视图；
图65为沿图60中的线63-63截取的并且被示出处于回缩操作模式的图60的传动系的剖视图；
图66为被示出处于图65的回缩操作模式的图55的附接部分的局部剖视图；
图67为包括端部执行器、第一关节运动锁和第二关节运动锁的轴组件的局部剖视图，其被示出第一关节运动锁处于锁定状态，并且第二关节运动锁处于解锁状态；
图68为被示出第一关节运动锁和第二关节运动锁处于锁定状态的图67的轴组件的局部剖视图；
图69为被示出第一关节运动锁和第二关节运动锁处于锁定状态的图67的轴组件的局部剖视图；
图70为图67的轴组件的局部剖视图，其被示出第一关节运动锁处于锁定状态，并且第二关节运动锁处于解锁状态；
图71为被示出第一关节运动锁和第二关节运动锁处于解锁状态的图67的轴组件的局部剖视图；
图72为包括柄部和可互换轴组件的外科器械的透视图；以及
图73为可操作地支撑多个外科工具的机器人外科系统的透视图。
在所述若干视图中，对应的参考符号指示对应的部件。本文所述的范例以一种形式示出了本发明的各种实施方案，且这种范例不应被解释为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIESTHEREOF”的美国专利申请序列号__________；代理人案卷号END7980USNP/160155；
-名称为“ARTICULATABLE SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END7981USNP/160156；
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS”的美国专利申请序列号__________；代理人案卷号END7982USNP/160157；
-名称为“SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF”的美国专利申请序列号__________；代理人案卷号END7983USNP/160158；
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS ANDREPLACEABLE TOOL ASSEMBLIES”的美国专利申请序列号__________；代理人案卷号END7984USNP/160159；以及
-名称为“SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR”的美国专利申请序列号__________；代理人案卷号END7985USNP/160160。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号__________；代理人案卷号END7986USNP/160161；
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FORSHIFTING BETWEEN CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES ANDARTICULATION AND FIRING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END7987USNP/160162；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号__________；代理人案卷号END7988USNP/160163；
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTIONFEATURES”的美国专利申请序列号__________；代理人案卷号END7989USNP/160164；
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号__________；代理人案卷号END7990USNP/160165；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号__________；代理人案卷号END7991USNP/160166；
-名称为“SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASINGA JAW OPENING DISTANCE”的美国专利申请序列号__________；代理人案卷号END7992USNP/160167；
-名称为“METHODS OF STAPLING TISSUE”的美国专利申请序列号__________；代理人案卷号END7993USNP/160168；
-名称为“FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FORSURGICAL END EFFECTORS”的美国专利申请序列号__________；代理人案卷号END7994USNP/160169；
-名称为“SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOPARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END7995USNP/160170；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号__________；代理人案卷号END7996USNP/160171；
-名称为“SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号__________；代理人案卷号END7997USNP/160172；
-名称为“SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTINGFIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT”的美国专利申请序列号__________；代理人案卷号END7998USNP/160173；以及
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号__________；代理人案卷号END7999USNP/160174。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“METHOD FOR RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT”的美国专利申请序列号__________；代理人案卷号END8013USNP/160175；
-名称为“STAPLE FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENTTYPES OF STAPLES”的美国专利申请序列号__________；代理人案卷号END8014USNP/160176；
-名称为“SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL”的美国专利申请序列号__________；代理人案卷号END8016USNP/160178；
-名称为“STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISINGWINDOWS DEFINED THEREIN”的美国专利申请序列号__________；代理人案卷号END8017USNP/160179；
-名称为“SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER”的美国专利申请序列号__________；代理人案卷号END8018USNP/160180；
-名称为“STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/ORSPENT CARTRIDGE LOCKOUT”的美国专利申请序列号__________；代理人案卷号END8019USNP/160181；
-名称为“FIRING ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号__________；代理人案卷号END8020USNP/160182；
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUTAND A FIRING ASSEMBLY LOCKOUT”的美国专利申请序列号__________；代理人案卷号END8021USNP/160183；
-名称为“FIRING ASSEMBLY COMPRISING A FUSE”的美国专利申请序列号__________；代理人案卷号END8022USNP/160184；以及
-名称为“FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE”美国专利申请序列号__________；代理人案卷号END8023USNP/160185。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END8038USNP/160186；
-名称为“ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS”的美国专利申请序列号__________；代理人案卷号END8039USNP/160187；
-名称为“METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPES OFSTAPLE CARTRIDGES WITH THE SAME SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号__________；代理人案卷号END8041USNP/160189；
-名称为“BILATERALLY ASYMMETRIC STAPLE FORMING POCKET PAIRS”的美国专利申请序列号__________；代理人案卷号END8042USNP/160190；
-名称为“CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICALINSTRUMENTS WITH SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8043USNP/160191；
-名称为“SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING ANDFIRING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8044USNP/160192；
-名称为“SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES”的美国专利申请序列号__________；代理人案卷号END8045USNP/160193；
-名称为“STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPINGBREADTHS”的美国专利申请序列号__________；代理人案卷号END8047USNP/160195；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING PRIMARYSIDEWALLS AND POCKET SIDEWALLS”的美国专利申请序列号__________；代理人案卷号END8048USNP/160196；
-名称为“NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FORSURGICAL STAPLERS”的美国专利申请序列号__________；代理人案卷号END8050USNP/160198；
-名称为“FIRING MEMBER PIN ANGLE”的美国专利申请序列号__________；代理人案卷号END8051USNP/160199；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMINGSURFACE GROOVES”的美国专利申请序列号__________；代理人案卷号END8052USNP/160200；
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES”的美国专利申请序列号__________；代理人案卷号END8053USNP/160201；
-名称为“SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS”的美国专利申请序列号__________；代理人案卷号END8054USNP/160202；
-名称为“SURGICAL INSTRUMENTS WITH JAWS THAT ARE PIVOTABLE ABOUT AFIXED AXIS AND INCLUDE SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8056USNP/160204；
-名称为“ANVIL HAVING A KNIFE SLOT WIDTH”的美国专利申请序列号__________；代理人案卷号END8057USNP/160205；
-名称为“CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8058USNP/160206；以及
-名称为“FIRING MEMBER PIN CONFIGURATIONS”的美国专利申请序列号__________；代理人案卷号END8059USNP/160207。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES”的美国专利申请序列号__________；代理人案卷号END8000USNP/160208；
-名称为“STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAPSETTING FEATURES”的美国专利申请序列号__________；代理人案卷号END8001USNP/160209；
-名称为“STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES”的美国专利申请序列号__________；代理人案卷号END8002USNP/160210；
-名称为“DURABILITY FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIESOF SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8003USNP/160211；
-名称为“SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITHPOSITIVE OPENING FEATURES”的美国专利申请序列号__________；代理人案卷号END8004USNP/160212；以及
-名称为“CONNECTION PORTIONS FOR DISPOSABLE LOADING UNITS FOR SURGICALSTAPLING INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8005USNP/160213。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“METHOD FOR ATTACHING A SHAFT ASSEMBLY TO A SURGICALINSTRUMENT AND,ALTERNATIVELY,TO A SURGICAL ROBOT”的美国专利申请序列号__________；代理人案卷号END8006USNP/160214；
-名称为“SHAFT ASSEMBLY COMPRISING A MANUALLY-OPERABLE RETRACTIONSYSTEM FOR USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号__________；代理人案卷号END8007USNP/160215；
-名称为“SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE ANDRETRACTABLE SYSTEMS的美国专利申请序列号__________；代理人案卷号END8008USNP/160216；
-名称为“SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO ANARTICULATION STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM”的美国专利申请序列号__________；代理人案卷号END8010USNP/160218；
-名称为“SHAFT ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号__________；代理人案卷号END8011USNP/160219；以及
-名称为“SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATIONLOCKOUTS”的美国专利申请序列号__________；代理人案卷号END8012USNP/160220。
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8024USNP/160221；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8025USNP/160222；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8026USNP/160223；
-名称为“SURGICAL STAPLE CARTRIDGE WITH MOVABLE CAMMING MEMBERCONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES”的美国专利申请序列号__________；代理人案卷号END8027USNP/160224；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号__________；代理人案卷号END8028USNP/160225；
-名称为“JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OFA FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN UNFIRED CARTRIDGE ISINSTALLED IN THE END EFFECTOR”的美国专利申请序列号__________；代理人案卷号END8029USNP/160226；
-名称为“AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYINGCLOSURE MOTIONS TO JAWS OF SURGICAL INSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8030USNP/160227；
-名称为“PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN AMOVABLE JAW AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT”的美国专利申请序列号__________；代理人案卷号END8031USNP/160228；
-名称为“SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERATING OPENINGFEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS”的美国专利申请序列号__________；代理人案卷号END8032USNP/160229；
-名称为“ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFTARRANGEMENT”的美国专利申请序列号__________；代理人案卷号END8033USNP/160230；
-名称为“ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLELINKAGE DISTAL OF AN ARTICULATION LOCK”的美国专利申请序列号__________；代理人案卷号END8034USNP/160231；
-名称为“ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR INAN ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE SYSTEM”的美国专利申请序列号__________；代理人案卷号END8035USNP/160232；
-名称为“LATERALLY ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FORLOCKING AN END EFFECTOR OF A SURGICAL INSTRUMENT IN AN ARTICULATEDCONFIGURATION”的美国专利申请序列号__________；代理人案卷号END8036USNP/160233；以及
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKEAMPLIFICATION FEATURES”的美国专利申请序列号__________。代理人案卷号END8037USNP/160234。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES”的美国专利申请序列号15/191,775；
-名称为“STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPEDSTAPLES”的美国专利申请序列号15/191,807；
-名称为“STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME”的美国专利申请序列号15/191,834；
-名称为“STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES”的美国专利申请序列号15/191,788；以及
-名称为“STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL STAPLE ROWS”的美国专利申请序列号15/191,818。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,218；
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,227；
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,259；以及
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,264。
本申请的申请人拥有于2016年4月1日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM”的美国专利申请序列号15/089,325；
-名称为“MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY”的美国专利申请序列号15/089,321；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD”的美国专利申请序列号15/089,326；
-名称为“SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIPPORTION”的美国专利申请序列号15/089,263；
-名称为“ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLEBAILOUT SYSTEM”的美国专利申请序列号15/089,262；
-名称为“SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVILCONCENTRIC DRIVE MEMBER”的美国专利申请序列号15/089,277；
-名称为“INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL ENDEFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS”的美国专利申请序列号15/089,296；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION”的美国专利申请序列号15/089,258；
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVECUTTING OF TISSUE”的美国专利申请序列号15/089,278；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT”的美国专利申请序列号15/089,284；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSIONLOCKOUT”的美国专利申请序列号15/089,295；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT”的美国专利申请序列号15/089,300；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT”的美国专利申请序列号15/089,196；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT”的美国专利申请序列号15/089,203；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGELOCKOUT”的美国专利申请序列号15/089,210；
-名称为“SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM”的美国专利申请序列号15/089,324；
-名称为“SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS”的美国专利申请序列号15/089,335；
-名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/089,339；
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OFSTAPLES HAVING DIFFERENT HEIGHTS”的美国专利申请序列号15/089,253；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET”的美国专利申请序列号15/089,304；
-名称为“ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS”的美国专利申请序列号15/089,331；
-名称为“STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES”的美国专利申请序列号15/089,336；
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUESUPPORT”的美国专利申请序列号15/089,312；
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM”的美国专利申请序列号15/089,309；以及
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL”的美国专利申请序列号15/089,349。
本申请的申请人还拥有于2015年12月31日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE INPOWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/984,488；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/984,525；以及
-名称为“SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROLCIRCUITS”的美国专利申请序列号14/984,552。
本申请的申请人还拥有于2016年2月9日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLYTRANSLATABLE END EFFECTOR”的美国专利申请序列号15/019,220；
-名称为“SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,228；
-名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTEDSECONDARY CONSTRAINT”的美国专利申请序列号15/019,196；
-名称为“SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLYARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY”的美国专利申请序列号15/019,206；
-名称为“SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,215；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATIONLINK ARRANGEMENTS”的美国专利申请序列号15/019,227；
-名称为“SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLEDRIVEN ARTICULATION SYSTEMS”的美国专利申请序列号15/019,235；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAMARRANGEMENTS”的美国专利申请序列号15/019,230；以及
-名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTIONARRANGEMENTS”的美国专利申请序列号15/019,245。
本申请的申请人还拥有于2016年2月12日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,254；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,259；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,275；以及
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,289。
本申请的申请人拥有于2015年6月18日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL END EFFECTORS WITH POSITIVE JAW OPENINGARRANGEMENTS”的美国专利申请序列号14/742,925；
-名称为“SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSINGFEATURES”的美国专利申请序列号14/742,941；
-名称为“MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,914；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAMSTRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT”的美国专利申请序列号14/742,900；
-名称为“DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,885；以及
-名称为“PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,876。
本申请的申请人拥有于2015年3月6日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“POWERED SURGICAL INSTRUMENT”的美国专利申请序列号14/640,746，现为美国专利申请公布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2014年9月5日提交并且其各自全文以引用方式并入本文的以下专利申请：
-名称为“CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,103，现为美国专利申请公布2016/0066912；
-名称为“ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUECOMPRESSION”的美国专利申请序列号14/479,119，现为美国专利申请公布2016/0066914；
-名称为“MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION”的美国专利申请序列号14/478,908，现为美国专利申请公布2016/0066910；
-名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'SOUTPUT OR INTERPRETATION”的美国专利申请序列号14/478,895，现为美国专利申请公布2016/0066909；
-名称为“POLARITY OF HALL MAGNET TO DETECT MISLOADED CARTRIDGE”的美国专利申请序列号14/479,110，现为美国专利申请公布2016/0066915；
-名称为“SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION”的美国专利申请序列号14/479,098，现为美国专利申请公布2016/0066911；
-名称为“MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,115，现为美国专利申请公布2016/0066916；以及
-名称为“LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION”的美国专利申请序列号14/479,108，现为美国专利申请公布2016/0066913。
本申请的申请人还拥有于2014年4月9日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVESHAFTS”的美国专利申请序列号14/248,590，现为美国专利申请公布2014/0305987；
-名称为“SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRINGDRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT”的美国专利申请序列号14/248,581，现为美国专利申请公布2014/0305989；
-名称为“SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLINGTHE OPERATION OF THE SURGICAL INSTRUMENT”的美国专利申请序列号14/248,595，现为美国专利申请公布2014/0305988；
-名称为“POWERED LINEAR SURGICAL STAPLER”的美国专利申请序列号14/248,588，现为美国专利申请公布2014/0309666；
-名称为“TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT”的美国专利申请序列14/248,591，现为美国专利申请公布2014/0305991；
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENTFEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS”的美国专利申请序列号14/248,584，现为美国专利申请公布2014/0305994；
-名称为“POWERED SURGICAL STAPLER”的美国专利申请序列号14/248,587，现为美国专利申请公布2014/0309665；
-名称为“DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICALINSTRUMENT”的美国专利申请序列号14/248,586，现为美国专利申请公布2014/0305990；以及
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUSINDICATION ARRANGEMENTS”的美国专利申请序列号14/248,607，现为美国专利申请公布2014/0305992。
本申请的申请人还拥有于2013年4月16日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,365；
-名称为“LINEAR CUTTER WITH POWER”的美国临时专利申请序列号61/812,376；
-名称为“LINEAR CUTTER WITH MOTOR AND PISTOL GRIP”的美国临时专利申请序列号61/812,382；
-名称为“SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS ANDMOTOR CONTROL”的美国临时专利申请序列号61/812,385；以及
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,372。
本文列出了许多具体细节，以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件，以免使说明书中描述的实施方案模糊不清。读者将会理解，本文所述和所示的实施方案为非限制性示例，从而可认识到，本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求的范围的情况下，可对这些实施方案进行变型和改变。
术语“包括(comprise)”(以及“包括(comprise)”的任何形式，诸如“包括(comprises)”和“包括(comprising)”)、“具有(have)”(以及“具有(have)”的任何形式，诸如“具有(has)”和“具有(having)”)、“包含(include)”(以及“包含(include)”的任何形式，诸如“包含(includes)”和“包含(including)”)、以及“含有(contain)”(以及“含有(contain)”的任何形式，诸如“含有(contains)”和“含有(containing)”)为开放式系动词。因此，“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件，但不限于仅具有这些一个或多个元件。同样，“包括”、“具有”、“包含”或“含有”一个或多个特征部的系统、装置、或设备的元件具有那些一个或多个特征部，但不限于仅具有那些一个或多个特征部。
术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分，术语“远侧”是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而，外科器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以用于执行腹腔镜式和微创外科手术操作。然而，读者将容易理解，本文所公开的各种方法和装置可用于多种外科程序和应用中，包括例如与开放式外科程序结合。继续参阅本具体实施方式，读者将进一步理解，本文所公开的各种器械能够以任何方式插入体内，诸如通过自然腔道、通过成形于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可直接插入患者体内或者可通过具有工作通道的进入装置插入，外科器械的端部执行器和细长轴可通过所述工作通道推进。
外科缝合系统可包括轴和从轴延伸的端部执行器。端部执行器包括第一钳口和第二钳口。第一钳口包括钉仓。钉仓能够插入到第一钳口中并且能够从第一钳口移除；然而，设想到其中钉仓不能够从第一钳口移除或至少能够易于从第一钳口替换的其他实施方案。第二钳口包括被构造成能够使从钉仓射出的钉变形的砧座。第二钳口能够相对于第一钳口围绕闭合轴线枢转；然而，可设想到其中第一钳口能够相对于第二钳口枢转的其他实施方案。外科缝合系统还包括被构造成能够允许端部执行器相对于轴旋转或进行关节运动的关节运动接头。端部执行器能够围绕延伸穿过关节运动接头的关节运动轴线旋转。设想了不包括关节运动接头的其他实施方案。
钉仓包括仓体。仓体包括近侧端部、远侧端部和在近侧端部与远侧端部之间延伸的平台。在使用中，钉仓定位在待缝合的组织的第一侧上，并且砧座定位在组织的第二侧上。砧座朝向钉仓运动以将组织压缩并夹持抵靠平台。然后，可移除地储存在仓体中的钉可被部署到组织中。仓体包括限定于其中的钉腔，其中钉可移除地储存在钉腔中。钉腔被布置成六纵向排。三排钉腔定位在纵向狭槽的第一侧上且三排钉腔定位在纵向狭槽的第二侧上。钉腔和钉的其他布置也是可能的。
钉由仓体中的钉驱动装置支撑。驱动装置能够在第一或未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未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。
轴组件1000示于图1中。轴组件1000包括附接部分1100、从附接部分1100朝远侧延伸的轴1200以及附接到轴1200的端部执行器1300。参见图1和图2，附接部分1100包括框架1110、壳体1120和闩锁1130。框架1110被构造成能够接合外科系统的框架，例如诸如外科器械的柄部和/或外科机器人的臂。在至少一个实例中，例如，框架1110和外科系统的框架包括互锁燕尾形装置。闩锁1130包括被构造成能够将轴组件1000可释放地保持到外科系统的锁。由于上述原因，轴组件1000可选择性地与手持式外科器械一起使用，另选地，与远程控制的机器人外科系统一起使用。
参见图3-6，轴1200包括附接到附接部分1110的框架1100的框架或脊。脊包括近侧脊部分1210，该近侧脊部分能够围绕延伸穿过脊的纵向轴轴线1001与框架1110旋转地接合。主要参见图6，近侧脊部分1210包括限定于其中的孔1211，该孔被构造成能够接收驱动器盖1220的近侧端部1221。驱动器盖1220还包括远侧端部1222，该远侧端部被构造成能够定位在中间脊部分1230的近侧端部1232内。脊还包括上远侧部分1250和与脊部分1230的远侧端部1231接合的下远侧部分1260。更具体地，远侧部分1250和1260分别包括近侧端部1251和1261，它们横向插入或滑动到限定在中间脊部分1230的远侧端部1231中的燕尾形狭槽中。脊还包括覆盖件1240，该覆盖件被构造成能够封闭限定在脊部分1230中的开口并且/或者将远侧部分1250和1260锁定在适当位置。
主要参见图7，端部执行器1300包括通道钳口1310和可旋转地安装到通道钳口1310的砧座钳口1330。通道钳口1310被构造成能够将钉仓1320或任何其他合适的钉仓接收在其中。通道钳口1310和钉仓1320包括共同操作的对齐特征结构，其被构造成能够允许钉仓1320仅在通道钳口1310内的一个适当位置和取向上安置。一旦未空的钉仓1320正确地安置在通道钳口1310中，钉击发构件就可被推进穿过钉仓1320以从钉仓1320射出钉，并且切割定位在钉仓1320与砧座钳口1330中间的患者的组织，如下文更详细地描述。除上述以外，砧座钳口1330包括限定于其中的成形凹坑，该成形凹坑被构造成在钉从钉仓1320射出时能够使钉变形。
主要参见图7，端部执行器1300的通道钳口1310围绕关节运动接头1660可旋转地联接到轴1200的脊。通道钳口1310包括附接到其上的关节运动框架1270，该关节运动框架包括从其侧向延伸的销1271，该销定位在限定于仓通道1310中的孔1311内。销1271和孔1311的尺寸和构造被设置成将关节运动框架1270牢固地安装到仓通道1310。关节运动框架1270包括限定在其中的关节运动孔，并且脊的远侧端部包括定位在关节运动孔内的关节运动柱1262。关节运动柱1262的尺寸和构造被设置成使得其被紧密地接收在关节运动孔内，并且使得关节运动框架1270和轴1200的脊之间的相对运动限于围绕与轴轴线1001正交的轴线的旋转运动。
除上述以外，再次参见图1，轴组件1000还包括外框架1600。现在参见图2，外框架1600能够围绕滑动接头相对于附接部分1100的框架1110旋转。滑动接头包括近侧凸缘1610，该近侧凸缘平行于或至少基本上平行于限定在框架1110上的对应凸缘1111。除了提供可旋转的机械接口之外，滑动接头还提供可旋转的电接口。更具体地，滑动接头包括限定在凸缘1111上的电迹线1190，以及另外的附接到凸缘1610的电连接器1690，其包括与迹线1190接合的电触头。在各种实例中，电迹线1190包括彼此电隔离并且各自为分立电路的一部分的导电环形环。当外框架1600相对于框架1110旋转时，电连接器1690的触头保持与迹线1190电接触。参见图5，附接部分1100的闩锁1130还包括与迹线1190电连通的电连接器1192，当闩锁1130将轴组件1000联接到外科系统时，迹线1190可被放置成与外科系统电连通。由于上述原因，轴组件1000中的传感器可通过滑动接头与外科器械的柄部中的控制器和/或微处理器通信，并且另选地与外科机器人通信。
外框架1600还包括从近侧凸缘1610朝远侧延伸的管1620，并且除上述以外，附接部分1100的壳体1120安装到管1620。壳体1120包括限定于其中的指状物夹持件1128，该指状物夹持件被构造成能够帮助临床医生围绕纵向轴轴线1001旋转壳体1120和管1620。外框架1600还包括可旋转地安装到管1620的远侧管部分1630。更具体地，主要参见图7，外框架1600还包括将远侧管部分1630连接到管1620并且在远侧管部分1630与管1620之间提供一个或多个自由度的联接件1640。远侧管部分1630与管1620之间的这种一个或多个自由度允许端部执行器1300围绕关节运动接头1660相对于轴1200进行关节运动。由于上述原因，外框架1600能够围绕纵向轴轴线旋转并且能够围绕关节运动接头1660旋转。也就是说，外框架1600不能相对于附接部分1100的框架1110纵向平移。
主要参见图5，轴组件1000还包括被构造成能够使端部执行器1300相对于轴1200进行关节运动的关节运动系统1400。此外，轴组件1000还包括击发系统1500，该击发系统被构造成能够首先闭合端部执行器1330的砧座钳口1300，然后击发储存在钉仓1320中的钉，如上所述。如下文更详细地讨论，关节运动系统1400能够选择性地与击发系统1500接合，使得关节运动系统1400可由击发系统1500驱动以使端部执行器1300进行关节运动。一旦端部执行器1300已经充分进行关节运动，关节运动系统1400就可与击发系统1500可操作地脱离接合。此时，击发系统1500可独立于关节运动系统1400操作。如下文还更详细地讨论，轴组件1000还包括关节运动锁定系统，该关节运动锁定系统首先将端部执行器1300锁定就位，然后使轴组件1000在关节运动操作模式与击发操作模式之间切换。
主要参见图9，击发系统1500包括击发连杆1510，该击发连杆能够在轴组件1000的关节运动操作模式和/或击发操作模式期间朝近侧和远侧平移。例如，击发连杆1510包括近侧端部1511，该近侧端部能够与外科系统的驱动系统诸如外科器械的柄部和/或外科机器人的臂可操作地接合。击发系统1500还包括齿条1520，齿条1520固定地安装到击发连杆1510，使得齿条1520能够与击发连杆1510一起平移。击发连杆1510延伸穿过限定在齿条1520中的纵向孔1521。此外，齿条1520固定地安装到击发连杆1510，使得齿条1520和击发连杆1510能够围绕纵向轴轴线一起旋转。关节运动系统1400还包括关节运动驱动器1420，关节运动驱动器1420安装到齿条1520，使得齿条1520能够相对于关节运动驱动器1420平移或纵向滑动。这就是说，关节运动驱动器1420安装到齿条1520，使得关节运动驱动器1420、齿条1520和击发连杆1510围绕纵向轴轴线1001一起旋转。
除上述以外，主要参见图9、图21和图23，齿条1520包括限定在其相对侧上的纵向狭槽1522，并且关节运动驱动器1420包括定位在纵向狭槽1522中的突起部1422。狭槽1522和突起部1422被构造成能够允许齿条1520相对于关节运动驱动器1420朝近侧和朝远侧移动。更具体地，关节运动驱动器1420安装在轴组件1000的附接部分1100内，使得防止关节运动驱动器1420相对于附接部分1100的框架1110纵向平移或至少基本上平移，并且当齿条1520纵向移动以驱动轴组件1000的关节运动系统1400和/或击发系统1500时，齿条1520可相对于关节运动驱动器1420纵向移动。也就是说，如下文更详细所述，狭槽1522和突起部1422被构造成能够将旋转运动从关节运动驱动器1420传递到齿条1520。
主要参见图8，关节运动系统1400还包括安装到击发连杆1510的移位器1430以及关节运动驱动器1440。移位器1430固定地安装到击发连杆1510，使得移位器1430与击发连杆1510纵向地平移。此外，移位器1430固定地安装到击发连杆1510，使得移位器1430能够与击发连杆1510一起旋转。移位器1430包括纵向齿条齿(rack of teeth)1431，并且类似地，关节运动驱动器1440包括纵向齿条齿1441。当轴组件1000处于其关节运动操作模式时，参见图16、图18、图20和图21，关节运动驱动器1440的齿1441与移位器1430的齿1431啮合接合。在这种构型中，击发连杆1510的纵向运动可被传递到关节运动驱动器1440。
主要参见图30，关节运动驱动器1440还包括远侧端部1443，远侧端部1443具有限定于其中的细长孔。安装到通道钳口1310的端部执行器1300的关节运动框架1270包括从其延伸的关节运动销1444，关节运动销1444定位在限定于远侧端部1443中的孔中。当轴组件1000处于其关节运动操作模式并且击发连杆1510朝远侧被推进时，击发连杆1510朝远侧推动关节运动驱动器1440和关节运动销1444，以使端部执行器1300在第一方向上进行关节运动，如图31所示。当击发连杆1510朝近侧被牵拉时，击发连杆朝近侧牵拉关节运动驱动器1440和关节运动销1444，以使端部执行器1300在与第一方向相反的第二方向上进行关节运动。在使用中，临床医生可操作外科系统以推动和/或牵拉关节运动驱动器1440，以将端部执行器1300旋转成期望的取向。
再次参见图30，关节运动系统1400还包括第二关节运动驱动器1450和传动齿轮1470。传动齿轮1470安装到轴1200的脊并且可围绕固定轴线旋转。此外，传动齿轮1470与限定在关节运动驱动器1440上的纵向齿条齿1442啮合接合。类似地，第二关节运动驱动器1450包括与传动齿轮1470啮合接合的纵向齿条齿1452。第二关节运动驱动器1450还包括远侧端部1453，该远侧端部具有限定于其中的细长孔。端部执行器1300的关节运动框架1270还包括从其延伸的关节运动销1454，该关节运动销定位在限定于远侧端部1453中的孔中。当关节运动驱动器1440被击发连杆1510朝远侧推进时，如图31所示，关节运动驱动器1440旋转传动齿轮1470，传动齿轮1470继而朝近侧驱动关节运动驱动器1450和关节运动销1454。因此，关节运动驱动器1440和1450协同操作以在相同方向上旋转端部执行器1300。当关节运动驱动器1440被击发连杆1510朝近侧牵拉时，关节运动驱动器1440在相反方向上旋转传动齿轮1470，这相应地将关节运动驱动器1450和关节运动销1454朝远侧推动。
一旦端部执行器1300处于期望的取向时，端部执行器1300可锁定就位。主要参见图5和图7-9，轴组件1000还包括关节运动锁杆1480和关节运动锁致动器1410。关节运动锁杆1480包括安装到关节运动锁致动器1410的近侧端部1481。当关节运动锁致动器1410从近侧位置(图32)移动到远侧位置(图33)时，关节运动锁致动器1410朝远侧推动锁杆1480。当关节运动锁致动器1410从远侧位置(图33)移动到近侧位置(图32)时，关节运动锁致动器1410朝近侧牵拉锁杆1480。主要参见图9，关节运动锁致动器1410包括近侧驱动钩1411，该近侧驱动钩1411能够与外科系统的致动器可操作地接合，该致动器可如上所述朝近侧和远侧移动关节运动锁致动器1410。
参见图32和图33，轴组件1000还包括安装到轴1200的脊的关节运动锁1494。关节运动锁1494包括从其延伸的第一锁臂和第二锁臂1495。参见图32，当关节运动锁致动器1410处于其近侧位置时，关节运动锁杆1480的远侧端部1482不与锁臂1495接合。在所述实例中，端部执行器1300处于解锁构型并且能够相对于轴1200的脊旋转。当关节运动锁杆1480被关节运动锁致动器1410朝远侧推进时，参见图33，关节运动锁杆1480的远侧端部1482接合锁臂1495并且将锁臂1495移位成与关节运动驱动器1440和1450接合。主要参见图7，关节运动驱动器1440包括纵向齿条齿1445，当锁臂1495被关节运动锁杆1480向外移位时，纵向齿条1445被锁臂1495接合。类似地，关节运动驱动器1450包括纵向齿条齿1455，当锁臂1495被关节运动锁杆1480向外移位时，纵向齿条齿1445被另一个锁臂1495接合。在所述实例中，端部执行器1300处于锁定构型并且不能够相对于轴1200的脊旋转。
关节运动锁致动器1410从其近侧位置(图32)到其远侧位置(图33)的运动不仅将端部执行器1300锁定就位—其还将轴组件1000从其关节运动操作模式(图16、图18、图20和图21)移位到其击发操作模式(图17、图19、图22和图23)。主要参见图9，关节运动锁致动器1410包括一个或多个驱动突起部1415，一个或多个驱动突起部1415向内延伸到限定于关节运动锁致动器1410中的纵向孔1414中。纵向孔1414围绕或至少基本上围绕关节运动驱动器1420，并且驱动突起部1415定位在限定于关节运动驱动器1420的外表面中的凸轮凹槽1425内。除上述以外，当关节运动锁致动器1410朝远侧被推进时，驱动突起部1415使关节运动驱动器1420、齿条1520和击发连杆1510从它们在图16中所示的取向旋转到它们在图17中所示的取向。在所述实例中，移位器1430的齿1431被旋转离开与关节运动驱动器1440的齿1441的可操作接合，并且因此，关节运动系统1400与击发系统1500可操作地脱离联接。因此，关节运动锁致动器1410的远侧运动将端部执行器1300锁定就位，并且将轴组件1000转变到其击发操作模式中。在各种实例中，关节运动锁致动器1410可朝近侧被牵拉，以将轴组件1000移位回到其关节运动操作模式。
一旦关节运动系统1400已与击发系统1500可操作地脱离联接，如上所述，击发系统1500就可朝远侧被推进以执行闭合行程以闭合砧座钳口1330，此外，执行击发行程，该击发行程将钉从钉仓1320射出并切割在钉仓1320与砧座钳口1330之间捕获的组织。参见图7-9，击发系统1500还包括中间击发连杆1530和击发杆1550。如下文更详细所述，击发连杆1510能够与中间击发连杆1530可操作地接合，使得击发连杆1510的纵向运动能够转移到中间击发连杆1530。击发杆1550包括近侧端部1552，近侧端部1552定位在限定于远侧击发连杆1510的远侧端部中的纵向孔1532中。
当中间击发连杆1530被击发连杆1510朝远侧推动时，参见图11，中间击发连杆1530朝远侧推动击发杆1550以接合砧座钳口1330并使砧座钳口1330朝向其闭合或夹紧位置移动，如图12所示。击发杆1550的这种远侧运动表示闭合行程。如果临床医生对组织在钉仓1320与夹紧的砧座钳口1330之间的定位不满意，则临床医生可操作外科系统以回缩击发杆1550。在所述实例中，压缩在钉仓1320与夹紧的砧座钳口1330之间的弹簧可用于打开钳口1330。
如果临床医生对组织在钉仓1320与夹紧的砧座钳口1330之间的定位感到满意，除上述以外，临床医生可操作外科系统以推进击发杆1550穿过钉仓1320，以从其射出钉并横切组织。击发杆1550的这种远侧运动表示击发行程，并且击发行程的开始在图13中示出。在本实例中，闭合行程和击发行程是分开的且不同的。用于操作击发系统1500的外科系统在闭合行程与击发行程之间暂停或被暂停，这使临床医生有机会回缩击发杆1550，并且如果他们如此选择的话就重新打开砧座钳口1330。在其他实例中，闭合行程和击发行程不是分开的和不同的。相反，外科系统立即从闭合行程转变到击发行程。在任一种情况下，参见图14，外科系统可操作以将击发杆1550回缩至其未击发位置并且使弹簧重新打开砧座钳口1330。
如上文所述，击发连杆1510用于驱动关节运动系统1400和击发系统1500。此外，看起来击发连杆1510在击发连杆1510用于操作关节运动系统1400的同时移动击发杆1550；然而，参见图24-29，轴组件1000还包括离合器1540，离合器1540被构造成当离合器1540处于击发构型(图26)时能够将击发连杆1510与中间击发连杆1530可操作地联接，并且在离合器1540处于关节运动构型(图29)时将击发连杆1510与中间击发连杆1530可操作地脱离联接。离合器1540被构造成能够使得在轴组件1000处于其关节运动操作模式时其处于其关节运动构型(图29)，并且相应地，在轴组件1000处于其击发操作模式时其处于其击发构型(图26)。
主要参见图24，击发连杆1510包括可滑动地定位在限定于中间击发连杆1530中的圆柱体1535中的远侧活塞1515。离合器1540包括固定地安装到中间击发连杆1530的悬臂梁1543，并且此外还包括可滑动地定位在限定于中间击发连杆1530中的侧向狭槽1534中的凸轮头部1544。凸轮头部1544包括限定于其中的孔1545，孔1545被构造成能够将击发连杆1510的远侧活塞1515接收在其中。
当轴组件1000处于其关节运动操作模式并且离合器1540处于其关节运动构型时，参见图29，远侧活塞1515的至少一部分定位在限定于中间击发连杆1530中的圆柱体1535的近侧部分1531中。在所述实例中，远侧活塞1515的另一部分定位在限定于离合器1540的凸轮头部1544中的孔1545中。虽然孔1545的侧壁可接触远侧活塞1515的侧面，但在所述实例中，活塞1515能够相对于离合器1540和中间击发连杆1530移动，而不将击发连杆1510的运动传递或至少基本上传递到中间击发连杆1530。因此，当击发连杆1510用于驱动关节运动系统1400时，击发连杆1510不使击发杆1550朝远侧移位。在某些实例中，间隙可存在于击发杆1550的近侧端部1552与孔1532的纵向端壁之间，以适应中间击发连杆1530在轴组件1000处于其关节运动操作模式时可经历的一定量的运动。
除上述以外，再次参见图29，当离合器1540处于其关节运动构型时，离合器1540的悬臂梁1543侧向偏转或弹性弯曲。这是因为限定在凸轮头部1544中的孔1545不自然地与远侧活塞1515对齐，并且当远侧活塞1515定位在孔1545中时，凸轮头部1544侧向移位，并且梁1543侧向偏转，以便适应这种强制对齐。当轴组件1000被置于其击发操作模式并且击发连杆1510朝远侧被推进时，远侧活塞1515相对于凸轮头部1544朝远侧移动，直到远侧活塞1515完全穿过孔1545。此时，参见图26，离合器1540弹性地返回到未挠曲状态，并且将离合器1540放置在其击发构型中。值得注意的是，在所述实例中，凸轮头部1544侧向移位并且锁定在远侧活塞1515的近侧肩部后面，以将远侧活塞1515保持在圆柱体1535中。因此，在击发组件1500的整个操作期间，离合器1540将击发连杆1510锁定到中间击发连杆1530，使得击发连杆1510的纵向运动在击发行程期间被传递到中间击发连杆1530。
除上述以外，在击发行程已完成或至少部分完成之后，离合器1540继续将击发连杆1510和中间击发连杆1530保持在一起。因此，击发连杆1510可朝近侧移动以朝近侧回缩中间击发连杆1530和击发杆1550。在各种实例中，可将已空钉仓1320从端部执行器1300移除，并且未空的钉仓1320例如可被安置在通道钳口1310中。如果临床医生仍然对端部执行器1300的取向感到满意，则临床医生可再次操作击发组件1500。然而，如果临床医生想要改变端部执行器1300的取向，则临床医生可操作外科系统以进一步朝近侧回缩击发连杆1510，并且使击发连杆1510与中间击发连杆1530脱离联接，以重新进入轴组件1000的关节运动操作模式。下面将更详细地描述这种转变。
参见图27和图28，轴组件1000的脊包括凸轮1234，凸轮1234被构造成能够随着中间击发连杆1530朝近侧回缩，在凸轮头部1544接触凸轮1234时侧向偏转离合器1540的凸轮头部1544。一旦凸轮头部1544被侧向偏转，则限定在凸轮头部1544中的孔1545与远侧活塞1515重新对齐，因此远侧活塞1515从离合器1540释放并且可相对于凸轮1540朝近侧移动进入其关节运动构型(图29)。此时，击发连杆1510可用于操作关节运动系统1400以重新取向端部执行器1300。一旦临床医生对端部执行器1300的取向感到满意，临床医生就可使用外科系统将远侧活塞1515朝远侧推进，以将离合器1540再次移位进入其击发构型。此外，应当理解，每当临床医生想要在轴组件1000的击发操作模式与关节运动操作模式之间切换时，离合器1540可从其击发构型和其关节运动构型移位。
如上所述，现在参见图10-12，击发杆1550能够朝远侧移动以在击发组件1500的闭合行程期间将砧座钳口1330从打开位置(图11)移动到闭合位置(图12)或至少朝向闭合位置(图12)移动。击发杆1550包括被构造成能够接合砧座钳口1330的砧座凸轮1564，以及另外的被构造成能够接合通道钳口1310的仓凸轮1563。砧座钳口1330包括限定于其中的包括底部凸轮表面的纵向狭槽1334。类似地，通道钳口1310包括限定于其中的包括上凸轮表面的纵向狭槽1313。当击发杆1550朝远侧被推进时，砧座凸轮1564可接合纵向狭槽1334的底部凸轮表面，并且仓凸轮1563可接合纵向狭槽1313的上凸轮表面以协作地控制砧座钳口1330相对于钉仓1320的位置。
如上所述，砧座钳口1330可旋转地联接到通道钳口1310。在至少一个实例中，砧座钳口1330通过一个或多个销安装到通道钳口1310并且能够围绕固定轴线枢转。在其他实例中，砧座钳口1330不围绕固定轴线安装到通道钳口1310。在至少一个所述实例中，当砧座钳口1330相对于通道钳口1310旋转时，砧座钳口1330能够相对于通道钳口1310平移。在任一种情况下，即使仓钳口1310能够围绕关节运动接头1660旋转或进行关节运动，也可将仓钳口1310称为固定钳口。在这种情况下，术语“固定的”意指外科系统1000不在打开位置与闭合位置之间旋转通道钳口1310。设想到其中仓钳口1310能够相对于砧座钳口1330旋转的另选的实施方案。在所述实例中，砧座钳口1330可以是固定钳口。
参见图7，砧座钳口1330由已组装在一起的若干部件构成。更具体地，砧座钳口1330包括已附接到其上的一个或多个侧向侧板1333。在至少一个实例中，例如，砧座钳口1330和侧板1333由钢构成并且已经焊接在一起。除其他外，此类布置可简化用于产生限定在砧座钳口1330中的纵向狭槽1334的制造过程。在至少一个实例中，纵向狭槽1334的一部分可在侧板1333附接到砧座钳口1330之前形成为侧板1333。在各种实例中，纵向狭槽1334的底部凸轮表面包括弯曲轮廓，该弯曲轮廓可例如使用磨削工艺形成在侧板1333中。此外，在某些实例中，侧板1333可经受与砧座钳口1330的其余部分不同的热处理工艺。如上所述，砧座钳口1330可使用任何合适的制造方法形成。
除上述以外，钉仓1320包括仓体1322和可移动地定位在仓体1322中的滑动件1360。滑动件1360能够通过击发杆1550在近侧未击发位置(图10、图11和图12)与远侧击发位置之间移动。更具体地，击发杆1550包括安装到其远侧端部的联接构件1560，联接构件1560被构造成能够邻接滑动件1360并且在击发行程期间朝远侧移动滑动件1360。然而，值得注意的是，在击发构件1550的闭合行程期间，联接构件1560不邻接滑动件1360。因此，击发构件1550可朝近侧和远侧移动以打开和闭合砧座钳口1330，而不使滑动件1360朝远侧移位。因此，无论在执行击发行程之前砧座钳口1330打开和闭合的次数如何，钉仓1320都保持未空状态。
除上述以外，钉仓1320是可替换的。因此，当钉仓未定位在通道钳口1310中时，可出现各种实例。此外，当已空钉仓定位在通道钳口1310中时，可出现各种实例。现在参见图10-15，轴组件1000包括闭锁件，该闭锁件被构造成当任一条件存在时能够防止击发行程开始。闭锁件包括锁1570，锁1570可旋转地安装到击发杆1550并且能够在解锁位置(图10-14)与锁定位置(图15)之间移动。锁1570包括可枢转地安装到联接构件1560的相对的侧向侧的侧向凸缘1572，侧向凸缘1572提供旋转轴线，锁1570围绕该旋转轴线旋转。当击发杆1550纵向移动以打开和闭合砧座钳口1330时，参见图10-12，通道钳口1310将锁1570保持在解锁位置。
当击发杆1550的击发行程开始时，参见图13，滑动件1360被构造成当滑动件1360处于其近侧未击发位置时能够将锁1570支撑在其解锁位置。更具体地，滑动件1360包括近侧凸缘1365，近侧凸缘1365被构造成在锁1570接近限定在通道钳口1310中的锁定凹槽1315时能够支撑锁1570的远侧肩部1575。换句话说，滑动件1360可防止锁1570进入锁定凹槽1315，但是仅在滑动件1360处于其近侧未击发位置时。一旦远侧肩部1575在击发行程开始时被滑动件1360的近侧凸缘1365支撑，近侧凸缘1365就可在整个击发行程期间继续支撑远侧肩部1575。也就是说，一旦锁1570已经相对于锁定凹槽1315朝远侧移动，则锁1570就不能进入锁定凹槽1315中，并且在击发行程的剩余部分中不需要凸缘1365来支撑肩部1575。
再次参见图10-13，闭锁件还包括锁定弹簧1370，锁定弹簧1370被构造成能够将锁1570偏压到锁定凹槽1315中。锁定弹簧1370包括固定地安装到关节运动框架1270的近侧端部1371，以及另外的与近侧端部1371相对定位的远侧端部1375。当击发杆1550用于在闭合行程期间打开和闭合砧座钳口1330时，参见图10-12，凸缘1572可相对于锁定弹簧1370滑动。当击发杆1550朝远侧被推进以执行击发行程并且滑动件1360处于其近侧未击发位置时，如图13所示，凸缘1572可向上挠曲锁定弹簧1370的远侧端部1375以允许凸缘1572在其下方滑动。当击发杆1550朝远侧被推进并且凸缘1572移动经过锁定弹簧1370的远侧端部1375时，锁定弹簧1370可弹性地返回到其未挠曲状态。
在击发行程已经完成或至少充分完成之后，击发杆1550可回缩回到其近侧未击发位置，如图14所示。值得注意的是，滑动件1360不与击发杆1550一起朝近侧回缩。相反，滑动件1360保持在远侧击发位置。因此，如果击发杆1550要朝远侧被推进以执行第二击发行程，则已空仓1320的滑动件1360不能将锁1570保持在其解锁位置。相反，参见图15，锁定弹簧1370将锁1570的侧向凸缘1572偏压到锁定凹槽1315中，这将防止击发杆1550执行第二击发行程，即，在通道钳口1310中具有已空钉仓的击发行程。如图15所示，锁定弹簧1370的远侧端部1375在旋转接头的远侧的位置处与锁1570的凸缘1572接合，该旋转接头将锁1570连接到联接构件1560。因此，锁定弹簧1370被构造成能够向锁1570施加向下的偏压扭矩，该向下的偏压扭矩将锁1570向下旋转到其锁定位置并进入锁定凹槽1315中。为了将锁1570复位到其解锁位置，击发杆1550可朝近侧被牵拉以将锁1570从锁定凹槽1315拉出，直到锁1570再次由通道钳口1310支撑。
尽管在将已空钉仓定位在通道钳口1310中时不能执行击发行程，但是即使已空钉仓定位在通道钳口1310中，击发系统1500也可用于打开和闭合砧座钳口1330。此外，即使已空钉仓定位在通道钳口1310中，击发系统1500也可用于操作关节运动系统1400。类似地，当钉仓从通道钳口1310中缺失时，击发系统1500可用于打开和闭合砧座钳口1330和/或操作关节运动系统1400。然而，为了重复使用轴组件1000来击发另一个钉仓，例如，必须将已空钉仓1320从通道钳口1310移除并用未空的钉仓诸如另一个钉仓1320替换。此类未空的钉仓将必须包括处于其近侧未击发位置的滑动件1360，该滑动件1360将允许击发杆1550被推进通过另一个击发行程。
再次参见图10-15，击发杆1550的联接构件1560包括切割刃1565，该切割刃1565被构造成能够横切在钉仓1320与砧座钳口1330之间捕获的组织。值得注意的是，联接构件1560不被锁定弹簧1370向下移位到限定在通道钳口1310中的锁定凹槽1315中。相反，仅锁1570被锁定弹簧1370向下移位。因此，在击发杆1550的击发行程期间，切割刃1565不相对于在钉仓1320与砧座钳口1330之间捕获的组织移位并保持与其对齐。
如上文所述，击发系统1500被构造成能够执行闭合行程以闭合端部执行器1300并且执行击发行程以缝合并切割在端部执行器1300内捕获的组织。还如上所述，击发系统1500可操作地联接到外科系统的驱动系统并且由其驱动。在各种实例中，一旦执行了闭合行程和/或击发行程，外科系统的驱动系统可失效并且可不能够推进和/或回缩击发系统1500。此类实例可相当有问题的，因为端部执行器1300将被击发杆1550锁定关闭。更具体地，如上所述，击发杆1550包括凸轮1563和1564(图10-15)，凸轮1563和1564被构造成能够在闭合行程和击发行程期间将砧座钳口1330和通道钳口1310相对于彼此保持就位，并且如果击发杆1550不可回缩，则凸轮1563和1564将不再有效地将钳口1310和1330锁定在一起。下文描述了回缩系统，该回缩系统被构造成能够朝近侧牵拉击发杆1550，使得砧座钳口1330可被重新打开。
现在转向图34-36，轴组件1000包括回缩或应急系统1700，其被构造成能够选择性地展开以接合击发系统1500并且朝近侧回缩击发杆1500。主要参见图34，回缩系统1700包括柄部或致动器1702，该柄部或致动器1702围绕枢轴销1704可旋转地安装到附接部分1100的壳体1120。枢轴销1704限定固定的旋转轴线，柄部1702可围绕该旋转轴线旋转。回缩系统1700还包括棘爪1706，棘爪1706围绕枢轴销1708可旋转地安装到柄部1702，枢轴销1708限定棘爪1706可围绕其相对于柄部1702旋转的固定旋转轴线。棘爪1706包括限定于其上的齿，该齿被构造成能够接合限定在齿条1520上的纵向齿条齿1526。当柄部1702处于储存的或未展开的位置时，如图34所示，棘爪1706的齿未与齿条齿1526接合。
再次参见图34，壳体1120包括限定于其中的进入窗口1129，进入窗口1129的尺寸和构造被设置成允许临床医生抓住柄部1702并将柄部1702旋转到展开位置—其在图35中示出。除上述以外，外框架1600的管1620包括窗口1629，并且类似地，轴1200的脊包括限定在其中的窗口1229，这些窗口与限定于壳体1120中的窗口1129对齐或至少基本上对齐。窗口1629和1229被构造成能够允许棘爪1706进入限定在齿条1520上的齿条齿1526。当柄部1702升高到其展开位置时，如图35中所示，棘爪1706的齿接合齿条齿1526。此时，柄部1702可被旋转以朝近侧驱动齿条1520、击发连杆1510、中间击发连杆1530和击发杆1550。
除上述以外，柄部1702和棘爪1706包括棘轮组件，如果需要，该棘轮组件可被致动若干次以朝近侧驱动击发系统1500至击发杆1550已与砧座钳口1330充分脱离接合以允许打开砧座钳口1330的位置。当柄部1702处于图35中的其展开位置时，柄部1702可朝远侧旋转大约45度，例如旋转至图36中所示的位置，以便朝近侧牵拉击发系统1500。柄部1702的这种45度旋转可或可不足以使击发杆1550与砧座钳口1330脱离接合。如果不足，则柄部1702可朝近侧旋转并返回到图35中所示的位置，使得柄部1702可再次被致动以进一步回缩击发杆1550。该过程可根据需要重复多次，直到砧座钳口1330可被打开以将端部执行器1300从组织松开并且将轴组件1000从手术部位移除。
除上述以外，可出现这样的情况，即在击发杆1550回缩或至少完全回缩之前，需要将轴组件1000从外科系统拆下。在所述实例中，类似于上文所述，轴组件1000将不会由外科系统提供动力-然而，即使轴组件1000未附接到外科系统，也可使用回缩系统1700来快速地从组织释放端部执行器1300。此类布置与其中回缩系统为外科系统的一部分而非可附接轴组件的其他布置相比是一种改进。在此类其他布置中，轴组件可必须保持附接到外科系统，以便使回缩系统用于重新打开端部执行器。
在已经执行了闭合行程的一部分之后，在已经执行了整个闭合行程之后，在已经执行了击发行程的一部分之后，和/或在已经执行整个闭合行程之后，回缩系统1700可用于回缩击发组件1500。当已经完全执行击发行程并且回缩系统1700用于回缩击发组件1500时，临床医生可必须使回缩系统1700启动若干次，以便使击发杆1550回缩通过整个击发行程以及另外的整个闭合行程以打开端部执行器1300。这种情况是完全合适的，但是可采用回缩系统1700的许多致动来充分回缩击发杆1550。下面讨论的是包括另选的应急系统的轴组件。
轴组件2000在图37-46中示出并且在许多方面类似于轴组件1000-为简洁起见，本文未讨论其中的若干方面。主要参见图37，轴组件2000包括附接部分2100，附接部分2100被构造成能够将轴组件2000可释放地附接到外科系统，诸如例如外科器械的柄部以及另选的外科机器人的臂。轴组件2000还包括端部执行器2300，被构造成能够使端部执行器2300围绕关节运动接头1660进行关节运动的关节运动系统1400，以及被构造成能够从定位在端部执行器2300中的钉仓击发钉的击发系统1500。主要参见图38和图39，轴组件2000还包括外框架1600，外框架1600安装到附接部分2100的框架2110并且能够围绕纵向轴轴线2001相对于框架2110旋转。此类布置可允许端部执行器2300相对于患者组织重新取向。例如，在将砧座钳口1330夹紧到组织上之前，端部执行器2300的砧座钳口1330可从患者组织的一侧旋转到另一侧。如上所述，外框架1600安装到附接部分2100的框架2110，使得外框架1660相对于框架2110不能够平移或至少基本上能够平移。
类似于轴组件1000，轴组件2000包括回缩系统1700，回缩系统1700被构造成能够使击发系统1500回缩。除上述以外，回缩系统1700能够操作以朝近侧回缩击发杆1550并且允许端部执行器2300从闭合或夹紧构型(图45)重新打开至打开构型(图46)。主要参见图42-44，轴组件2000还包括可平移脊2200和应急系统2800，其被构造成能够将端部执行器2300从其闭合或夹紧构型(图45)驱动至其打开构型(图46)以重新打开端部执行器2300。如下面更详细描述的，应急系统2800被构造成能够将脊2200从近侧未致动位置(图45)朝远侧移动到远侧致动位置(图46)，以相对于击发杆1550朝远侧移动端部执行器2300的通道钳口2310。
可平移脊2200在许多方面类似于脊1200。主要参见图42-44，脊2200包括近侧脊部分2210，其能够相对于框架2110围绕纵向轴轴线2001旋转。近侧脊部分2210包括限定在其中的孔，该孔被构造成能够接收驱动器盖2220的近侧端部。驱动器盖2220还包括远侧端部，该远侧端部被构造成能够定位在脊2200的中间脊部分2230的近侧端部内。脊2200还包括上远侧部分2250和与脊部分2230的远侧端部接合的下远侧部分2260。远侧部分2250和2260包括近侧端部，这些近侧端部侧向插入或滑动到限定在中间脊部分2230的远侧端部中的燕尾形狭槽中。脊2200还包括覆盖件2240，该覆盖件被构造成能够封闭限定在脊部分2230中的开口并且/或者将远侧部分2250和2260锁定在适当位置。下远侧部分2260包括从其延伸的关节运动突起部1262，该关节运动突起部紧密地定位在限定在安装在通道钳口2210内的关节运动框架2270中的关节运动孔内。
与安装到框架1110以防止脊1200相对于框架1110平移的脊1200不同，脊2200可滑动地定位在框架2110中并且能够通过应急系统2800相对于框架2110朝近侧和远侧移动。主要参见图38和图39，应急系统2800包括应急杠杆2802，应急杠杆2802围绕固定轴线枢轴2804可旋转地安装到框架2110。实际上，参见图41，应急系统2800包括在其相对侧上可旋转地安装到框架2110的两个应急杠杆2802，它们通过横杆2807彼此连接，如图42所示，使得应急杠杆2802一起旋转。应急系统2800还包括可旋转地安装到应急杠杆2802中每一个的驱动联接件2806。参见图41，每个应急杠杆2802包括驱动销2803，驱动销2803延伸到限定在驱动联接件2806中的驱动孔中并且将驱动联接件2806可操作地联接到应急杠杆2802。
除上述以外，参见图40和图41，每个驱动联接件2806包括从其延伸的驱动销2808，驱动销2808定位在限定于近侧脊部分2210中的环形狭槽2218中。当应急杠杆2802朝远侧旋转到其致动位置时，如图46所示，应急杠杆2802朝远侧牵拉驱动联接件2806和脊2200，以使通道钳口2310相对于击发杆1550朝远侧平移。此外，由于砧座钳口1330可旋转地安装到通道钳口2310的事实，通道钳口2310的远侧运动还使砧座钳口1330朝远侧平移。钳口2310和1330的这种远侧运动包括应急打开行程，其可使砧座钳口1330与击发杆1550的砧座凸轮1564脱离接合并且允许砧座钳口1330移动到打开位置。除上述以外，端部执行器2300包括压缩的偏压构件诸如例如弹簧，一旦砧座钳口1330已经与砧座凸轮1564充分脱离接合，该压缩的偏压构件可将砧座钳口1330偏压到其打开位置。
如读者应该理解的，应急系统2800是独立的并且与回缩系统1700不同。因此，应急系统2800和回缩系统1700可彼此独立地操作。在至少一个实例中，如果需要，应急系统2800可用于在闭合行程期间打开端部执行器2300，并且如果需要，回缩系统1700可用于在击发行程期间打开端部执行器2300。在各种实例中，回缩系统1700可用于在闭合行程期间和/或击发行程期间的任何点处打开端部执行器2300。在某些实例中，应急系统2800可用于在闭合行程和/或击发行程期间打开端部执行器2300。在至少一个所述实例中，由应急系统2800产生的应急打开行程足以在闭合行程期间的任何点处和/或在击发行程期间的任何点处打开端部执行器2300。然而，在一些实例中，由应急系统2800产生的应急打开行程可不足以在击发行程期间打开端部执行器2300。在所述实例中，除了应急系统2800之外或代替应急系统2800，临床医生可使用回缩系统1700来打开端部执行器2300。
除上述以外，应急系统2800能够致动以快速打开端部执行器2300。相比之下，回缩系统1700可必须被启动若干次以打开端部执行器2300，而应急系统2800可用一个行程打开端部执行器2300。在应急系统2800不能自己打开端部执行器2300的实例中，可致动应急系统2800以减少回缩系统1700必须启动以打开端部执行器2300的次数。此外，在所述实例中，通道钳口2310被朝远侧推动而远离击发杆1550并且击发杆1550被朝近侧牵拉而远离砧座钳口1330。在应急系统2800可自己打开端部执行器2300的实例中，击发系统1500的击发杆1550不需要回缩以打开端部执行器2300。
在各种实例中，除上述以外，应急系统2800的应急杠杆2802可从其近侧未致动位置(图45)旋转至其远侧致动位置(图46)以打开端部执行器2300并且将端部执行器2300从患者组织释放。然后可使端部执行器2300移动远离患者组织。然后，应急杠杆2802可从其远侧致动位置(图46)旋转到其近侧未致动位置(图45)，以朝近侧牵拉脊2200和通道钳口2310并且闭合端部执行器2300。当从手术部位移除端部执行器2300时，这种特征可特别有用，因为在各种实例中，当端部执行器2300处于其闭合构型时，从手术部位移除端部执行器2300可更容易。在任何情况下，应急系统2800可被致动和退动以根据需要多次打开和闭合端部执行器2300。
如上所述，再次参见图32和图33，轴组件1000包括关节运动锁杆1480，关节运动锁杆1480被构造成能够接合轴组件1000的关节运动锁1494并且使关节运动锁1494的臂1495移位成与关节运动系统1400的关节运动驱动器1440和1450接合，以便将端部执行器1300锁定就位并且防止端部执行器1300通过关节运动系统1400进行关节运动。此类布置包括单级关节运动锁定系统，因为两个臂1495同时或至少基本上同时与关节运动驱动器1440和1450接合。在一个另选的实施方案中，图67-71中所示的轴组件6000包括两级关节运动锁定系统6490，其被构造成能够将端部执行器诸如例如端部执行器1300锁定就位。
轴组件6000在许多方面类似于轴组件1000和2000-为简洁起见，本文未讨论其中的若干方面。尽管未必如图67-71所示，轴组件6000包括轴1200、端部执行器1300、关节运动系统1400、击发系统1500和外框架1600。轴组件6000还包括关节运动锁致动器，其被构造成能够使锁杆6480相对于端部执行器1300移动并且使锁杆6480与关节运动锁定系统6490接合。如下面更详细描述的，锁定系统6490被构造成能够首先直接接合第一锁与端部执行器1300，然后接合第二锁与关节运动系统1400的关节运动驱动器1440和1450。在所述实例中，关节运动锁定系统6490的第一锁和第二锁可协作地将端部执行器1300保持就位。
主要参见图67，两级关节运动锁定系统6490包括框架6491，框架6491定位在外框架1600的外管1620中并固定地安装到轴1200的脊。关节运动锁定系统6490还包括：第一锁6496，其可滑动地定位在限定于框架6491中的腔6492内；以及偏压弹簧6499，其被构造成能够将第一锁6496偏压成与安装在端部执行器1300中的关节运动框架1270接合。第一锁6496包括从其延伸的凸缘6498，并且偏压弹簧6499在凸缘6498和限定在框架6491中的腔6492的近侧端壁之间被压缩。因此，偏压弹簧6499被构造成能够使第一锁6496从近侧解锁位置(图66)(在该位置第一锁6496未与关节运动框架1270接合)移动到远侧锁定位置(图67-70)(在该位置第一锁6496与关节运动框架1270接合)。
除上述以外，关节运动框架1270包括周向齿阵列1277，其各自被构造成当第一锁6496朝远侧被推进到其锁定位置时能够被限定在第一锁6496的远侧端部中的齿凹陷部6497接合。齿阵列1277围绕关节运动框架1270的近侧周边延伸，使得齿1277与第一锁6496对齐或至少基本上对齐，而不管端部执行器1300的取向如何。因此，齿1277总是出现在第一锁6496的远侧端部的前面，使得当第一锁6496被偏压弹簧6499偏压到其锁定位置时，第一锁6496可将端部执行器1300锁定就位。
关节运动锁定系统6490还包括第二关节运动锁6494，其被构造成能够选择性地与关节运动系统1400的关节运动驱动器1440和1450接合。关节运动锁6494固定地安装到轴组件6490的脊，并且包括从其延伸的锁臂6495。锁臂6495能够在未挠曲构型(图67)与挠曲构型(图68)之间移动，在该未挠曲构型中，它们不与关节运动驱动器1440和1450接合，在该挠曲构型中，它们与关节运动驱动器1440和1450接合。换句话说，锁臂6495从解锁构型侧向或向外挠曲成锁定构型，以接合关节运动驱动器1440和1450。
每个锁臂6495包括限定在其上的齿，所述齿被构造成当锁臂6495向外偏转成与关节运动驱动器1440和1450接合时能够接合关节运动驱动器1440和1450。更具体地，第一锁臂6495的齿被构造成能够接合限定在关节运动驱动器1440上的齿1445，并且第二锁臂6495的齿被构造成能够接合限定在关节运动驱动器1450上的齿1455。锁臂6495和关节运动驱动器1440之间的这种相互作用和1450防止关节运动驱动器1440和1450朝近侧和远侧移动以使端部执行器1330进行关节运动，并且因此将端部执行器1330锁定就位。锁臂6495还被构造成当扭矩施加到端部执行器1330时能够防止关节运动驱动器1440和1450被端部执行器1330反向驱动。
图67和图68示出了两级关节运动锁定系统6490的锁定序列。如图67所示，第一关节运动锁6496通过偏压弹簧6499被偏压到其锁定状态，如上所述。因此，第一关节运动锁6496不需要被致动以将关节运动锁定系统6490置于第一锁定状态。然而，值得注意的是，当关节运动锁定系统6490处于其第一锁定状态时，第二关节运动锁6494未与关节运动驱动器1640和1650接合，因为关节运动锁6494的锁臂6495尚未被偏压成与关节运动驱动器1640和1650接合。相反，参见图68，锁杆6480必须朝远侧被推进以接合锁臂6495并且使锁臂6495移位成与关节运动驱动器1640和1650接合。因此，第二关节运动锁6494必须被致动以将关节运动锁定系统6490置于第二锁定状态。
再次参见图67，锁杆6480包括轴部分6481，轴部分6481被构造成能够在锁臂6495之间滑动而不会使锁臂6495侧向移位成与关节运动驱动器1440和1450接合。这就是说，现在参见图68，锁杆6480包括限定在轴部分6481上的扩大部6485，该扩大部被构造成当锁杆6480朝远侧被推进时能够接合锁臂6495并且将锁臂6495偏转到其锁定构型。此时，关节运动锁定系统6490处于其第二锁定状态。值得注意的是，当关节运动锁定系统6490处于其第二锁定状态时，第一关节运动锁6496与端部执行器1300接合，并且第二关节运动锁6494与关节运动驱动器1440和1450接合。而且，值得注意的是，在关节运动锁定系统6490的两阶段锁定序列期间，第一关节运动锁6496在第二关节运动锁6494接合关节运动驱动器1440和1450之前接合端部执行器1300。
图69-71示出了两级关节运动锁定系统6490的解锁序列。图69示出了处于其第二锁定状态的关节运动锁定系统6490，并且为了解锁端部执行器1300使得其可如上所述进行关节运动，关节运动锁定系统6490被顺序地置于其第一锁定状态，如图70所示，然后置于其解锁状态，如图71所示。参见图70，锁杆6480朝近侧回缩以使扩大部6485与锁臂6495脱离接合，使得锁臂6495可弹性地向内挠曲并与关节运动驱动器1440和1450脱离接合。此时，关节运动锁定系统6490已经返回到其第一锁定状态。值得注意的是，锁杆6480包括远侧端部6482，其可滑动地定位在限定在第一关节运动锁6496中的细长孔6493中，并且当锁杆6480朝近侧移动以将关节运动锁定系统从其第二锁定状态转变到其第一锁定状态，如上所述，远侧端部6482可在细长孔6493内滑动，而不会使第一关节运动锁6496移出其锁定状态。
一旦关节运动锁定系统6490已经返回到其第一锁定状态，如上所述，锁杆6480可进一步朝近侧回缩以将第一关节运动锁6496拉出与关节运动框架1270的接合。更具体地，当锁杆6480朝近侧回缩以便向第一关节运动锁6494施加回缩力时，锁杆6480的远侧端部6482可邻接孔6483的近侧端壁。这种近侧回缩力必须能够克服弹簧6499施加到第一关节运动锁6496的远侧偏压力，以便朝近侧移动第一关节运动锁6496。在任何情况下，一旦第一关节运动锁6496已经与关节运动框架1270脱离接合，关节运动锁定系统6490就处于解锁状态。此时，端部执行器1300可以是关节运动的。为了将端部执行器1300重新锁定就位，可释放锁杆6480以允许偏压弹簧6499再次将第一关节运动锁6496置于其锁定状态。另选地，可朝远侧驱动锁杆6480以将端部执行器1300重新锁定就位。
如上所述，两级关节运动锁定系统6490被构造成能够顺序地锁定第一关节运动锁6496并且然后锁定第二关节运动锁6494。设想到另选的实施方案，其中关节运动锁定系统被构造成能够顺序地锁定第二关节运动锁6494并且然后锁定第一关节运动锁6496。此外，设想到另选的实施方案，其被构造成能够同时锁定第一关节运动锁6494和第二关节运动锁6494。
还如上所述，两级关节运动锁定系统6490被构造成能够顺序地解锁第二关节运动锁6494并且然后解锁第一关节运动锁6496。设想到另选的实施方案，其中关节运动锁定系统被构造成能够顺序地解锁第一关节运动锁6496并且然后解锁第二关节运动锁6494。此外，设想到另选的实施方案，其被构造成能够同时解锁第一关节运动锁6494和第二关节运动锁6494。
轴组件3000示于图47-51中。轴组件3000在许多方面类似于轴组件1000-为简洁起见，本文未讨论其中的若干方面。虽然未必如图47-51所示，但是轴组件3000包括附接部分3100和安装到附接部分3100的脊，其能够相对于附接部分3100的框架3110旋转但不能够平移。轴组件3000还包括端部执行器1300，被构造成能够使端部执行器1300进行关节运动的关节运动系统1400，以及击发系统1500。如上所述，端部执行器1300包括砧座钳口1330，砧座钳口1330能够相对于通道钳口1310在打开位置与闭合位置之间旋转。轴组件3000还包括外轴部分3600，外轴部分3600被构造成能够接合砧座钳口1330并且使砧座钳口1330朝向其闭合位置移动，如下面更详细描述的。
主要参见图47和图49，外轴组件3600包括近侧部分3610，联接到近侧部分3610的中间部分3620，以及联接到中间部分3620的远侧部分3630。近侧部分3610安装到附接部分3100的框架3110，使得近侧部分3610能够相对于框架3110旋转但不能够平移。近侧部分3610包括延伸穿过其中的纵向通路3615，并且类似地，中间部分3620包括延伸穿过其中的纵向通路3625。纵向通路3615和3625彼此对齐或至少基本上对齐，并且围绕脊、关节运动系统1400和轴组件3600的击发系统1500。除上述以外，远侧部分3630包括延伸穿过其中的纵向通路3635，纵向通路3635与限定在中间部分3620中的纵向通路3625对齐。远侧部分3630的近侧端部定位在纵向通路3625中并且以压配合方式与中间部分3620接合，使得在中间部分3620与远侧部分3630之间几乎没有(如果有的话)相对运动。
再次参见图49，外轴组件3600的近侧部分3610包括远侧凸缘3611。另外，外轴组件3600的中间部分3620包括邻近远侧凸缘3611定位的近侧凸缘3621。远侧凸缘3611和近侧凸缘3621彼此平行或至少基本上平行。主要参见图48和图49，外轴组件3600还包括延伸组件3700，延伸组件3700将近侧部分3610的远侧凸缘3611连接到中间部分3620的近侧凸缘3621。延伸组件3700被构造成能够允许外轴组件3600在收缩构型(图50)与扩张构型(图51)之间移位，如下面更详细地讨论的。
参见图48和图49，延伸组件3700包括第一连杆和另外的第二连杆，该第一连杆包括近侧联接件3710和远侧联接件3720，该第二连杆包括近侧联接件3730和远侧联接件3740。近侧联接件3710可旋转地安装到外轴组件3600的近侧部分3610。近侧部分3610包括从其延伸的安装柱3612，安装柱3612定位在限定在近侧联接件3710中的柱孔3712中。类似地，远侧联接件3720可旋转地安装到外轴组件3600的中间部分3620。中间部分3620包括限定在其中的安装孔3622，安装孔3622被构造成能够接收从远侧联接件3720延伸的柱3722。此外，近侧联接件3710可旋转地联接到远侧联接件3720。更具体地，近侧联接件3710包括从其延伸的连接器柱3724，连接器柱3724可旋转地定位在限定于远侧联接件3720中的连接器孔3724中。
除上述以外，延伸组件3700的近侧联接件3730可旋转地安装到外轴组件3600的近侧部分3610。近侧部分3610包括从其延伸的安装柱3616，该安装柱定位在限定在近侧联接件3730中的柱孔3736中。类似地，延伸组件3700的远侧联接件3740可旋转地安装到外轴组件3600的中间部分3620。中间部分3620包括限定在其中的安装孔，该安装孔被构造成能够接收从远侧联接件3740延伸的柱3746。此外，近侧联接件3730可旋转地联接到远侧联接件3740。更具体地，每个近侧联接件3730包括从其延伸的连接器柱3734，其可旋转地定位在限定于远侧联接件3740中的连接器孔3744中。
现在参见图50，在齿条1520被击发连杆1510朝远侧推进以执行闭合行程和/或击发行程之前，外轴组件3600的延伸组件3700相对于击发系统1500的齿条1520定位在远侧。当齿条1520朝远侧被推进时，参见图51，齿条1520接合延伸组件3700并将外轴组件3600从其收缩构型(图50)移位到其扩张构型(图51)。更具体地，齿条1520邻接延伸组件3700的联接件3710和3720并且侧向地或向外地旋转它们，因此，其朝远侧或纵向推动联接件3730和3740。主要参见图49，联接件3710和3720可包括限定在其中的凸轮表面3715，凸轮表面3715由齿条1520接合和驱动。由于上述原因，当外轴组件3600从其收缩构型(图50)切换到其扩张构型(图51)时，外轴组件3600的中间部分3620和远侧部分3630相对于近侧部分3610朝远侧被推动。
除上述以外，主要参见图51，当远侧部分3630朝远侧被推进并且因此使砧座钳口1330旋转到其闭合位置时，外轴组件3600的远侧部分3630接合砧座钳口1330。换句话说，击发系统1500的齿条1520的远侧运动产生闭合行程，该闭合行程闭合端部执行器1300。然后，击发系统1500可用于驱动击发连杆1510、齿条1520、中间击发连杆1530和击发杆1550通过击发行程-这在上面更详细地讨论。因此，击发系统1500分别经由外轴组件1600和击发杆1550将分离且不同的闭合行程和击发行程传递到端部执行器1300。值得注意的是，当关节运动锁致动器1410朝远侧被推进以将端部执行器1300锁定就位时，击发系统1500能够在轴组件3000已经从其关节运动操作模式切换到其击发操作模式之后产生闭合行程-其再次在上面更详细地讨论。
如上所述，击发系统1500的齿条1520在闭合行程期间接合延伸组件3700，以将外轴组件3600置于其扩张构型。在整个闭合行程和击发行程中，齿条1520保持与延伸组件3700接合，并且因此在整个闭合行程和击发行程中将外轴组件3600保持在其扩张构型。在闭合行程和/或击发行程已经完成或至少充分完成之后，击发系统1500可操作以使击发连杆1510和齿条1520朝近侧回缩。当齿条1520朝近侧回缩时，齿条1520与延伸组件3700脱离接合，因此，外轴组件3600将不再由齿条1520保持在其延伸构型。
再次参见图49，外轴组件3600还包括弹簧3750，弹簧3750被构造成能够朝向近侧部分3610偏压或牵拉中间部分3620并使外轴组件3600返回到其收缩构型。近侧部分3610的远侧凸缘3611包括限定在其中的孔3619，孔3619被构造成能够将弹簧3750安装到近侧部分3610，并且类似地，中间部分3620的近侧凸缘3621包括限定在其中的孔3629，孔3629被构造成能够将弹簧3750安装到中间部分3620。当外轴组件3600的中间部分3620被齿条1520朝远侧移位时，齿条1520必须向延伸组件3700施加远侧延伸力，这克服了弹簧3750的近侧偏压力。
在图52-54中示出了另选的轴组件4000。轴组件4000在许多方面类似于轴组件3000-为简洁起见，本文未讨论其中的大部分方面。轴组件4000包括外轴组件，该外轴组件包括近侧部分4610和中间部分4620，其通过围绕延伸组件3700延伸的拉伸弹簧4750连接。类似于上述，当中间部分4620通过齿条1520朝远侧移位远离近侧部分4610时，拉伸弹簧4750将近侧偏压力施加到中间部分4620。同样类似于上述，拉伸弹簧4750在齿条1520已经与延伸组件3700脱离接合之后朝向近侧部分4610回缩中间部分4620。
如上所述，再次参见图34-36，轴组件1000包括回缩系统1700，其被构造成能够手动回缩击发系统1500。现在转向图55-66，轴组件5000还包括手动致动的回缩系统，这将在下面进一步更详细地讨论。轴组件5000在许多方面类似于轴组件1000-为简洁起见，本文未讨论其中的大部分方面。
参见图55，轴组件5000包括附接部分5100，附接部分5100包括外部壳体5120。主要参见图57，外部壳体5120包括第一壳体部分和第二壳体部分5121，它们彼此附接以构成壳体框架。例如，壳体部分5121可通过一个或多个按扣配合特征部、一个或多个压配合特征部和/或一个或多个紧固件联接在一起。外部壳体5120还包括一个或多个特征部，其被构造成能够将附接部分5100可释放地连接到外科系统的框架，例如诸如外科器械的柄部以及另选的外科机器人的臂。例如，壳体部分5121还包括一个或多个支承表面，这些支承表面被构造成能够可滑动地支撑驱动组件5500的可平移部件，并且另外包括一个或多个支承孔，这些支承孔被构造成能够可旋转地支撑驱动组件5500的可旋转部件。
主要参见图57-59，驱动组件5500包括可平移的击发连杆5510，其被构造成能够与外科系统的驱动系统可操作地联接。驱动组件5500还包括输入齿条5520，输入齿条5520固定地安装到击发连杆5510，使得输入齿条5520能够与击发连杆5510一起平移。驱动组件5500被构造成能够将输入齿条5520的平移传递到第一驱动系统的第一齿条5560以及另选的第二驱动系统的第二齿条5580。为实现此目的，驱动组件5500包括可移位轴5540，其可在第一位置(图64)(在该位置输入齿条5520在第一操作模式期间可操作地联接到第一齿条5560)与第二位置(图60-62)(在该位置输入齿条5520在第二操作模式期间可操作地联接到第二齿条5580)之间移位。轴5540包括从第一壳体部分5121延伸的第一端部5542和从第二壳体部分5121延伸的第二端部5542。轴5540的第一端部和第二端部5542各自包括可推动表面，其可移位以使轴5540在其第一位置(图64)与其第二位置(图60-62)之间滑动或切换。
再次参见图57-59，驱动组件5500还包括可滑动地安装到轴5540的齿轮5530，与轴5540可操作地接合的第一输出齿轮5550，以及与轴5540可操作地接合的第二输出齿轮5570。参见图62，齿轮5530包括围绕其周边延伸的齿阵列5536，以及另外的延伸穿过其中的花键孔5534。齿5536与限定在输入齿条5520上的纵向齿阵列5526可操作地相互啮合。当输入齿条5520朝远侧移位时，输入齿条5520使齿轮5530在第一方向上旋转，并且当输入齿条5520朝近侧移位时，输入齿条5520使齿轮5530在第二或相反方向上旋转。齿轮5530的花键孔5534与限定在轴5540上的花键部分5544可操作地相互啮合。因此，当齿轮5530在第一方向上旋转时，齿轮5530使轴5540在第一方向上旋转。同样，当齿轮5530在第二方向上旋转时，齿轮5530使轴5540在第二方向上旋转。
除上述以外，齿轮5530被约束在壳体5120内，使得齿轮5530不会相对于第一输出齿轮5550和第二输出齿轮5570侧向地移动或至少基本上移动。然而，当轴5540在其第一位置(图64)(以将轴组件5000置于其第一操作模式)与其第二位置(图62)(以将轴组件5000置于其第二操作模式)之间移动时，轴5540可相对于齿轮5530、第一输出齿轮5550和第二输出齿轮5570侧向移动。值得注意的是，轴5540的花键部分5544具有足以将齿轮5530可操作地联接到轴5540的长度，而不管轴5540是处于其第一位置(图64)还是其第二位置(图62)。由于上述原因，齿轮5530保持与输入齿条5520和轴5540可操作地接合，而不管轴5540的位置如何，并且不管轴组件5000放置的操作模式如何。
当轴5540处于其第一位置时，参见图64，轴5540的花键部分5544与第一输出齿轮5550可操作地接合。更具体地，当轴5540处于其第一位置时，轴5540的花键部分5544定位在限定在第一输出齿轮5550中的花键孔5554中，使得轴5540的旋转被传递到第一输出齿轮5550。因此，当轴5540在第一方向上旋转时，轴5540使第一输出齿轮5550在第一方向上旋转，并且相应地，当轴5540在第二方向上旋转时，轴5540使第一输出齿轮5550在第二方向上旋转。第一输出齿轮5550包括围绕其周边延伸的齿阵列5556，其与限定在第一齿条5560上的纵向齿阵列5566可操作地相互啮合。因此，当输入齿条5520朝远侧移位时，第一齿条5560朝远侧移位，并且相应地，当输入齿条5520朝近侧移位时，第一齿条5560朝近侧移位。类似于齿轮5530，第一输出齿轮5550被约束在壳体5520内，使得第一输出齿轮5550不会相对于第一齿条5560侧向移动或至少基本上移动。因此，无论轴组件5000的操作模式如何，第一输出齿轮5550都保持与第一齿条5560可操作地接合。
当轴5540处于其第二位置时，参见图62，轴5540的花键部分5544与第二输出齿轮5570可操作地接合。更具体地，当轴5540处于其第二位置时，轴5540的花键部分5544定位在限定在第二输出齿轮5570中的花键孔5574中，使得轴5540的旋转被传递到第二输出齿轮5570。因此，当轴5540在第一方向上旋转时，轴5540使第二输出齿轮5570在第一方向上旋转，并且相应地，当轴5540在第二方向上旋转时，轴5540使第二输出齿轮5570在第二方向上旋转。第二输出齿轮5570包括围绕其周边延伸的齿阵列5576，其与限定在第二齿条5580上的纵向齿阵列5586可操作地相互啮合。因此，当输入齿条5520朝远侧移位时，第二齿条5580朝远侧移位，并且相应地，当输入齿条5520朝近侧移位时，第二齿条5580朝近侧移位。类似于齿轮5530和第一输出齿轮5550，第二输出齿轮5570被约束在壳体5520内，使得第二输出齿轮5570不会相对于第二齿条5580侧向移动或至少基本上移动。因此，无论轴组件5000的操作模式如何，第二输出齿轮5570都保持与第二齿条5580可操作地接合。
此外，除上述以外，轴5540的花键部分5544具有防止轴5540同时驱动第一驱动系统和第二驱动系统的长度。更具体地，当花键部分5544与第一输出齿轮5550可操作地接合时，花键部分5544不与第二输出齿轮5570可操作地接合。相应地，当花键部分5544与第二输出齿轮5570可操作地接合时，花键部分5544不与第一输出齿轮5550可操作地接合。因此，击发连杆1510能够与第一齿条5560和第二齿条5580接合，但不能够同时与两者接合。设想到另选的实施方案，其中花键部分5544可选择性地定位在中间位置，在该中间位置，花键部分5544同时与第一输出齿轮5550和第二输出齿轮5570可操作地接合。在所述实例中，击发连杆1510可同时驱动第一齿条5560和第二齿条5580。
驱动系统5500可用于选择性地驱动包括第一齿条5560的第一驱动系统或包括第二齿条5580的第二驱动系统。第一驱动系统和第二驱动系统可被构造成能够执行轴组件5000的任何合适的功能。例如，第一驱动系统可用于产生闭合行程，该闭合行程闭合轴组件5000的端部执行器，并且第二驱动系统可用于产生击发行程，该击发行程从例如定位在端部执行器中的钉仓射出钉。在所述实例中，轴组件5000能够执行单独且不同的闭合行程和击发行程。另选地，第一驱动系统可用于使轴组件5000的端部执行器进行关节运动，并且第二驱动系统可用于产生一个或多个行程，这些行程闭合端部执行器并且例如从钉仓射出钉。在任一种情况下，驱动系统5500被构造成能够选择性地将施加到击发连杆5510的线性输入运动传递到两个单独的驱动系统。
主要参见图60，驱动系统5500还包括输出轴组件5590。输出轴组件5590包括花键部分5594，可滑动地安装到花键部分5594的齿轮5596，以及固定地安装到其上的锥齿轮5598。齿轮5596能够在驱动位置(图60、图61和图63)与回缩位置(图65)之间滑动。当齿轮5596处于其驱动位置时，参见图60、图61和图63，齿轮5596与限定在第二齿条5580上的纵向齿阵列5586可操作地相互啮合。在所述实例中，当第二齿条5580被击发连杆1510朝近侧和远侧驱动时，第二齿条5580可通过齿轮5596旋转轴组件5590，如上所述。当齿轮5596处于其回缩位置时，参见图65，齿轮5596与第二齿条5580可操作地脱离联接。相反，在所述实例中，齿轮5596与回缩系统5700可操作地联接，如下面更详细地描述的。
参见图56，回缩系统5700被储存或存放在附接部分5100的壳体5120中。壳体5120包括可旋转地安装到壳体部分5121中的一个的覆盖件或舱口5125，壳体部分5121可打开以进入回缩系统5700。参见图57，覆盖件5125包括限定在其中的销孔5128，销孔5128与限定在壳体部分5121中的销孔5123对齐。每组销孔5123,5128被构造成能够将销5127接收在其中，销5127可将覆盖件5125可旋转地联接到壳体部分5121。可使用用于将覆盖件5125连接到壳体部分5121的其他装置。壳体5120还包括限定在其中的开口5122，当覆盖件5125从闭合位置(图55)旋转到打开位置(图56)时，通过开口5122可进入回缩系统5700。值得注意的是，覆盖件5125包括从其延伸的臂5126，其被构造成能够在覆盖件5125从其闭合位置(图55)旋转到其打开位置(图56)时接合轴组件5590的齿轮5596，如下面更详细地描述。
除上述以外，覆盖件5125被构造成当覆盖件5125打开时能够将齿轮5596从其驱动位置(图63)推入其回缩位置(图65)。参见图63，当齿轮5596处于其驱动位置时，齿轮5596与齿条5580可操作地接合并且与回缩系统5700可操作地脱离接合。参见图65，当齿轮5596处于其回缩位置时，齿轮5596与第二齿条5580可操作地脱离接合并且与回缩系统5700可操作地接合。因此，当覆盖件5125打开以进入回缩系统5700时，覆盖件5125自动地将轴组件5000从其第二操作模式移位到回缩操作模式(图65和图66)。因此，在临床医生甚至可抓住回缩系统5700的曲柄5702之前，回缩系统5700与轴组件5590可操作地联接，并且第二齿条5580与轴组件5590可操作地脱离联接。此外，只要覆盖件5125处于其打开位置，覆盖件5125就将齿轮5596保持在其回缩位置。
鉴于上述情况，轴组件5590可由第二齿条5580或回缩系统5700驱动，这取决于轴组件5000处于哪种操作模式。在第二操作模式或回缩操作模式中，主要参见图60，轴组件5590的锥齿轮5598与输出系统5600可操作地接合。输出系统5600包括与锥齿轮5598可操作地相互啮合的锥齿轮5608。输出系统5600还包括可旋转的输出齿轮5606。锥齿轮5608固定地安装到输出轴5606，使得当轴组件5590旋转时，输出轴5606旋转。输出系统5600还包括可旋转的击发轴5602和齿轮减速箱5604，齿轮减速箱5604可操作地联接可旋转的击发轴5602和可旋转的输出轴5606。除上述以外，当轴组件5000处于其第二操作模式并且齿轮5596与第二齿条5580可操作地联接时，根据第二齿条5580移位的方向，击发轴5602可通过第二齿条5580在第一方向或相反方向上旋转。当轴组件5000处于其回缩操作模式时，回缩系统5700仅能够使击发轴5602在其相反方向上旋转，如下面更详细地描述。
参见图58、图59和图66，回缩系统5700的曲柄5702能够相对于轴5710旋转，轴5710由壳体5120可旋转地支撑。值得注意的是，当曲柄5702旋转时，曲柄5702不会直接驱动轴5710。相反，曲柄5702包括可旋转地安装到其上的棘爪5706，棘爪5706驱动固定地安装到轴5710的棘轮齿轮5716。主要参见图59，棘爪5706围绕安装到曲柄5702的销5704可旋转地联接到曲柄5702。在使用中，棘爪5706被构造成当曲柄5702在第一方向上旋转时能够驱动棘轮齿轮5716并使击发轴5602在其相反方向上旋转。另一方面，棘爪5706被构造成当曲柄5702在第二或相反方向上旋转时能够相对于棘轮齿轮5716滑动。回缩系统5700还包括固定地安装到轴5710的齿轮5712，当轴5710被棘爪5706旋转时，齿轮5712与轴5710一起旋转。主要参见图66，齿轮5712与可旋转地安装到轴5724的齿轮5722可操作地相互啮合，使得齿轮5712的旋转被传递到齿轮5722。当齿轮5596处于其回缩位置时，除上述以外，齿轮5596与齿轮5722可操作地相互啮合。因此，曲柄5702在其第一方向上的旋转(其在图66中示出)被传递到轴组件5690，以使击发轴5602在其相反方向上旋转。在各种实例中，例如，击发轴5602在其相反方向上的旋转使击发构件朝近侧回缩远离轴组件5000的端部执行器。
覆盖件5125的打开将齿轮5596与第二齿条5580永久地脱离联接，并且相应地，使击发轴5602与输入轴5510永久地脱离联接。更具体地，在齿轮5596移动到其回缩位置(图65)之后，齿轮5596不可复位或者至少不可容易地复位到其驱动位置(图63)。因此，轴组件5000在其被置于其回缩操作模式之后不能返回到其第二操作模式。例如，在覆盖件5125被打开然后重新闭合的情况下，覆盖件5125的臂5126将与齿轮5596脱离接合，但齿轮5596将不会移回而与第二齿条5580的接合。然而，在所述实例中，回缩系统5700仍可用于使击发杆5602在其相反方向上旋转。此外，在所述实例中，驱动系统5500仍可用于使第一齿条5560与击发连杆5510接合并操作第一驱动系统。此类布置将防止临床医生重新使用可有缺陷的轴组件5000-因为打开覆盖件5125的动作可表明轴组件5000可能有问题。
设想到各种另选的实施方案，其中轴组件5000在被置于其回缩操作模式之后可复位为其第二操作模式。例如，轴组件5000可包括定位在齿轮5596与锥齿轮5598中间的弹簧，当覆盖件5125被打开并且齿轮5596沿轴组件5590的花键部分5594滑动到其回缩位置时，该弹簧被齿轮5596压缩。在所述实例中，当覆盖件5125被闭合时，弹簧可将齿轮5596偏压回其驱动位置并且将齿轮5596与第二齿条5580可操作地重新接合。此类布置将允许轴组件5000在使用期间被修复然后用来完成外科技术。
图72示出了示例性外科器械100，其包括柄部110和可操作地联接到其的可互换轴组件200。柄部110包括壳体140，壳体140被构造成能够由临床医生抓握、操纵和/或致动。轴组件200包括轴210和端部执行器300。轴210包括轴框架(图78中未示出)，以及轴框架延伸穿过其的中空外部套管或闭合管250。轴组件200还包括喷嘴组件290，喷嘴组件290被构造成能够与外部套管250接合并使临床医生能够选择性地使轴210围绕纵向轴线旋转。轴组件200还包括作为锁定系统的一部分的闩锁230，其将轴组件200可释放地锁定到柄部110。在各种情况下，例如当闩锁230与柄部110接合时，闩锁230可闭合柄部110中的电路。2013年3月14日提交的名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING ANARTICULATION LOCK”的美国专利申请号13/803,086的整个公开内容以引用方式并入本文。本文公开的所有实施方案均可与柄部110一起使用。
图73示出了示例性外科机器人500，其被构造成能够致动多个外科工具(例如通常标记为600)。外科机器人500可与未示出的主控制器结合使用，该主控制器被构造成能够允许外科医生控制和观察由外科机器人500执行的外科规程。在各种形式中，外科机器人500包括基部510，在所示实施方案中，例如从基部510支撑三个外科工具600。在各种形式中，外科工具600各自由一系列可关节运动的连杆支撑(通常称为臂520)，并且与一个或多个驱动系统530可操作地联接。这些结构被示出具有护盖，该护盖使其大部分可移动部件模糊。这些护盖可以是任选的，并且可在一些实施方案中限制尺寸或完全消除，以最小化用于操纵臂520的伺服机构所遇到的惯性。在各种形式中，外科机器人500具有轮子，该轮子允许外科机器人500被单个服务员定位在手术台附近。图73进一步示出了外科机器人500的工作区域(work envelope)700。工作区域700指的是外科机器人500的外科工具600的运动范围。图73中示出的工作区域700的形状和尺寸仅仅是说明性的。因此，工作区域不限于图73中示出的样本工作区域的特定尺寸和形状。2015年6月23日公布的名称为“ROBOTICALLY-DRIVENSURGICAL INSTRUMENT WITH E-BEAM DRIVER”的美国专利9,060,770的全部公开内容以引用方式并入本文。本文公开的所有实施方案均可与外科机器人500一起使用。
实施例
实施例1-一种方法，包括以下步骤：获得包括端部执行器的轴组件，将轴组件附接到外科器械的柄部，以及将所述轴组件从所述柄部移除。该方法还包括将所述轴组件附接到外科机器人的臂，以及从所述臂移除所述轴组件的步骤。
实施例2-根据实施例1所述的方法，其中从所述外科器械柄部移除所述轴组件的步骤在将所述轴组件附接到所述外科机器人臂的步骤之前发生，并且其中所述方法还包括在从所述外科器械柄部移除所述轴组件之后对所述轴组件进行灭菌的步骤。
实施例3-根据实施例1所述的方法，其中从所述外科机器人臂移除所述轴组件的步骤在将所述轴组件附接到所述外科器械柄部的步骤之前发生，并且其中所述方法还包括在从所述外科机器人臂移除所述轴组件之后对所述轴组件进行灭菌的步骤。
实施例4-根据实施例1、2或3所述的方法，其中所述轴组件包括击发构件，其中所述外科器械柄部包括电动马达，所述电动马达在将所述轴组件附接到所述外科器械柄部的步骤期间能够与所述击发构件可操作地联接，并且其中所述外科机器人臂包括电动马达，所述电动马达在将所述轴组件附接到所述外科机器人臂的步骤期间能够与所述击发构件可操作地联接。
实施例5-根据实施例1、2、3或4所述的方法，其中所述轴组件包括闩锁，所述闩锁被构造成能够接合所述外科器械的所述柄部以及另选的所述外科机器人的所述臂。
实施例6-根据实施例1、2、3、4或5所述的方法，其中所述轴组件包括轴微处理器和轴电连接器，其中所述柄部包括柄部微处理器和柄部电连接器，并且其中所述外科机器人包括机器人微处理器和机器人连接器。
实施例7-根据实施例6所述的方法，其中将所述轴组件附接到所述外科器械的所述柄部的步骤包括将所述轴电连接器与所述柄部电连接器电联接。
实施例8-根据实施例6所述的方法，其中将所述轴组件附接到所述外科器械的所述柄部的步骤包括将所述轴微处理器放置成与所述柄部微处理器进行信号通信。
实施例9-根据实施例6所述的方法，其中将所述轴组件附接到所述外科机器人的所述臂的步骤包括将所述轴电连接器与所述机器人电连接器电联接。
实施例10-根据实施例6所述的方法，其中将所述轴组件附接到所述外科机器人的所述臂的步骤包括将所述轴微处理器放置成与所述机器人微处理器进行信号通信。
实施例11-根据实施例1、2、3、4、5、6、7、8、9或10所述的方法，还包括在将所述轴组件附接到所述外科器械柄部的步骤之前将钉仓附接到所述轴组件的步骤。
实施例12-根据实施例1、2、3、4、5、6、7、8、9或10所述的方法，还包括在将所述轴组件附接到所述外科器械柄部的步骤之后将钉仓附接到所述轴组件的步骤。
实施例13-根据实施例1、2、3、4、5、6、7、8、9或10所述的方法，还包括在将所述轴组件附接到所述外科机器人臂的步骤之前将钉仓附接到所述轴组件的步骤。
实施例14-根据实施例1、2、3、4、5、6、7、8、9或10所述的方法，还包括在将所述轴组件附接到所述外科机器人臂的步骤之后将钉仓附接到所述轴组件的步骤。
实施例15-根据实施例1、2、3、4、5、6、7、8、9、10、11、12、13或14所述的方法，还包括将所述端部执行器组装到所述轴组件的步骤。
实施例16-一种方法，包括以下步骤：获得轴组件，将所述轴组件附接到外科器械的柄部，以及在替代形式将所述轴组件附接到外科机器人的臂。
实施例17-根据实施例16所述的方法，还包括将端部执行器附接到所述轴组件的步骤。
实施例18-根据实施例17所述的方法，还包括将钉仓附接到所述端部执行器的步骤。
实施例19-一种方法，包括以下步骤：获得轴组件，以及选择性地将所述轴组件附接到外科器械的柄部或外科机器人的臂。
实施例20-一种与机动化外科系统一起使用的轴组件，其中所述轴组件包括可选择性地安装到所述机动化外科系统的框架，从所述框架延伸的轴，以及联接到所述轴的端部执行器。
所述轴组件还包括能够与所述机动化外科系统可操作地接合的击发构件，其中所述击发构件在击发行程期间能够朝向所述端部执行器移动。所述轴组件还包括可旋转地安装到所述框架的回缩曲柄，其中所述回缩曲柄能够选择性地与所述击发构件接合，并且其中在所述轴组件未安装到所述机动化外科系统的情况下，所述回缩曲柄可选择性地操作以使所述击发构件回缩远离所述端部执行器。
实施例21-根据实施例20所述的轴组件，其中所述端部执行器包括能够在打开位置与闭合位置之间移动的钳口，并且其中所述击发构件被构造成能够在所述击发行程期间使所述钳口从所述打开位置朝向所述闭合位置移动。
实施例22-根据实施例20或21所述的轴组件，其中所述端部执行器包括第一钳口和第二钳口，其中所述第一钳口能够在打开位置与闭合位置之间移动，并且其中所述轴组件还包括闭合构件，所述闭合构件被构造成能够使所述第一钳口朝向所述闭合位置移动。
实施例23-根据实施例20、21或22所述的轴组件，其中所述轴包括能够相对于所述框架滑动的轴框架，其中所述第二钳口安装到所述轴框架，并且其中所述第二钳口能够被所述轴框架移动以使所述第一钳口朝向所述打开位置移动。
实施例24-根据实施例20、21、22或23所述的轴组件，还包括可枢转地安装到所述回缩曲柄的回缩棘爪，并且其中所述回缩棘爪被构造成当所述回缩曲柄相对于所述框架旋转时能够接合所述击发构件。
实施例25-根据实施例20、21、22、23或24所述的轴组件，其中所述机动化外科系统包括第一机动化外科系统，其中所述框架被构造成能够安装到第二机动化外科系统，并且其中所述击发构件被构造成能够可操作地联接到所述第二机动化外科系统。
实施例26-根据实施例25所述的轴组件，其中所述第一机动化外科系统包括外科器械的柄部，并且其中所述第二机动化外科系统包括外科机器人。
实施例27-根据实施例20、21、22、23、24、25或26所述的轴组件，其中所述端部执行器包括钉仓。
实施例28-根据实施例27所述的轴组件，其中所述钉仓是可替换的。
实施例29-一种外科系统，包含包括第一电动马达的第一机动化外科系统，包括第二电动马达的第二机动化外科系统，以及轴组件。所述轴组件包括框架，所述框架可选择性地安装到所述第一机动化外科系统和所述第二机动化外科系统。所述轴组件还包括从所述框架延伸的轴，联接到所述轴的端部执行器，以及能够与所述第一电动马达和所述第二电动马达可操作地接合的击发构件，其中所述击发构件在击发行程期间能够朝向所述端部执行器移动。所述轴组件还包括可旋转地安装到所述框架的回缩曲柄，其中所述回缩曲柄能够选择性地与所述击发构件接合，并且其中在所述轴组件安装到所述第一机动化外科系统，安装到所述第二机动化外科系统，并且未安装到所述第一机动化外科系统或所述第二机动化外科系统的情况下，所述回缩曲柄能够选择性地操作以使所述击发构件回缩远离所述端部执行器。
实施例30-根据实施例29所述的外科系统，其中所述端部执行器包括能够在打开位置与闭合位置之间移动的钳口，并且其中所述击发构件被构造成能够在所述击发行程期间使所述钳口从所述打开位置朝向所述闭合位置移动。
实施例31-根据实施例29或30所述的外科系统，其中所述端部执行器包括第一钳口和第二钳口，其中所述第一钳口能够在打开位置与闭合位置之间移动，并且其中所述轴组件还包括闭合构件，所述闭合构件被构造成能够使所述第一钳口朝向所述闭合位置移动。
实施例32-根据实施例29、30或31所述的外科系统，其中所述轴包括能够相对于所述框架滑动的轴框架，其中所述第二钳口安装到所述轴框架，并且其中所述第二钳口能够被所述轴框架移动以使所述第一钳口朝向所述打开位置移动。
实施例33-根据实施例29、30、31或32所述的外科系统，还包括可枢转地安装到所述回缩曲柄的回缩棘爪，并且其中所述回缩棘爪被构造成当所述回缩曲柄相对于所述框架旋转时能够接合所述击发构件。
实施例34-根据实施例29、30、31、32或33所述的外科系统，其中所述第一机动化外科系统包括外科器械的柄部，并且其中所述第二机动化外科系统包括外科机器人。
实施例35-根据实施例29、30、31、32、33或34所述的轴组件，其中所述端部执行器包括钉仓。
实施例36-根据实施例35所述的轴组件，其中所述钉仓是可替换的。
实施例37-一种与第一外科器械系统和第二外科器械系统一起使用的轴组件，其中所述轴组件包括可选择性地安装到所述第一外科器械系统和所述第二外科器械系统的框架。所述轴组件还包括从所述框架延伸的轴，联接到所述轴的端部执行器，以及能够与所述第一外科器械系统和所述第二外科器械系统可操作地接合的击发构件，其中所述击发构件在击发行程期间能够朝向所述端部执行器移动。所述轴组件还包括可手动操作的回缩装置，以用于选择性地接合所述击发构件并且将所述击发构件回缩远离所述端部执行器。
实施例38-根据实施例37所述的轴组件，其中所述端部执行器包括钉仓。
实施例39-根据实施例38所述的轴组件，其中所述钉仓是可替换的。
实施例40-一种与外科系统一起使用的轴组件，其中所述轴组件包括框架，其中所述框架包括被构造成能够安装到所述外科系统的近侧部分，以及从所述近侧部分朝远侧延伸的管。所述轴组件还包括脊，其中所述脊延伸穿过所述管，并且其中所述脊可滑动地安装到所述近侧部分。所述轴组件还包括端部执行器，其中所述端部执行器包括从所述脊朝远侧延伸的第一钳口，以及可旋转地安装到所述第一钳口的第二钳口，其中所述第二钳口能够在打开位置与闭合位置之间旋转。所述轴组件还包括能够与所述外科系统的驱动系统可操作地接合的击发构件，其中所述击发构件在击发行程期间能够相对于所述脊朝远侧移动。所述轴组件还包括被构造成能够朝近侧牵拉所述击发构件的击发构件回缩系统，以及被构造成能够使所述脊朝远侧滑动并且允许所述第二钳口旋转到所述打开位置的端部执行器打开系统。
实施例41-根据实施例40所述的轴组件，其中所述击发构件回缩系统包括可手动致动的杠杆。
实施例42-根据实施例40或41所述的轴组件，其中所述端部执行器打开系统包括可手动致动的杠杆。
实施例43-根据实施例40、41或42所述的轴组件，其中所述端部执行器还包括钉仓。
实施例44-根据实施例43所述的轴组件，其中所述钉仓能够可替换地安置在所述第一钳口中。
实施例45-根据实施例43所述的轴组件，其中所述钉仓能够可替换地安置在所述第二钳口中。
实施例46-根据实施例40、41、42、43、44或45所述的轴组件，还包括被构造成能够将所述第二钳口偏压到所述打开位置的弹簧。
实施例47-根据实施例40、41、42、43、44、45或46所述的轴组件，其中所述端部执行器打开系统和所述击发构件可彼此独立地操作。
实施例48-根据实施例40、41、42、43、44、45、46、或47所述的轴组件，其中所述击发构件包括被构造成能够在所述击发行程期间接合所述第一钳口的第一凸轮以及被构造成能够在所述击发行程期间接合所述第二钳口的第二凸轮构件。
实施例49-根据实施例43、44、45、46、47或48所述的轴组件，其中所述钉仓包括可移除地储存在其中的钉，并且其中所述击发构件被构造成能够从所述钉仓射出所述钉。
实施例50-根据实施例40、41、42、43、44、45、46、47、48或49所述的轴组件，其中所述端部执行器还包含包括可移除地储存在其中的钉的钉仓，并且其中所述击发构件被构造成能够从所述钉仓射出所述钉。
实施例51-根据实施例40、41、42、43、44、45、46、47、48、49或50所述的轴组件，还包括闭合构件，所述闭合构件被构造成能够在闭合行程期间使所述第二钳口从所述打开位置朝向所述闭合位置移动。
实施例52-根据实施例51所述的轴组件，其中所述击发构件被构造成能够接合所述闭合构件并且使所述闭合构件移动通过闭合行程。
实施例53-根据实施例51或52所述的轴组件，其中所述闭合构件可被构造成能够处于收缩构型和扩张构型，并且其中所述闭合构件被构造成当所述闭合构件在所述收缩构型与所述扩张构型之间转变时能够执行所述闭合行程。
实施例54-根据实施例51、52或53所述的轴组件，其中所述闭合构件包括闩锁，所述闩锁被构造成能够将所述闭合构件可释放地保持在所述收缩构型中。
实施例55-根据实施例51、52、53或54所述的轴组件，其中所述击发构件被构造成能够在执行击发行程之前接合所述闭合构件并释放所述闩锁。
实施例56-根据实施例51、52、53、54或55所述的轴组件，其中所述闭合构件包括近侧部分和远侧部分，其中所述闭合构件的所述近侧部分安装到所述框架的所述近侧部分，并且其中所述远侧部分在闭合行程期间能够移动远离所述闭合构件的所述近侧部分。
实施例57-根据实施例51、52、53、54、55或56所述的轴组件，其中所述闭合构件还包括被构造成能够将所述远侧部分朝向所述闭合构件的所述近侧部分偏压的弹簧。
实施例58-根据实施例53所述的轴组件，还包括被构造成能够将所述闭合构件偏压到所述收缩构型的弹簧。
实施例59-一种与外科系统一起使用的轴组件，其中所述轴组件包括可安装到所述外科系统的框架，和端部执行器，其中所述端部执行器包括第一钳口；以及可旋转地安装到所述第一钳口的第二钳口，其中所述第二钳口能够在打开位置与闭合位置之间旋转。所述轴组件还包括可被构造成能够处于收缩构型和扩张构型的闭合构件，其中所述闭合构件被构造成当所述闭合构件在闭合行程期间从所述收缩构型转变到所述扩张构型时能够使所述第二钳口朝向所述闭合位置移动。
实施例60-根据实施例59所述的轴组件，还包括能够与所述外科系统的驱动系统可操作地接合的击发构件，其中所述击发构件能够通过所述驱动系统移动通过击发行程。
实施例61-根据实施例60所述的轴组件，其中所述击发构件被构造成能够接合所述闭合构件并且使所述闭合构件从所述收缩构型转变到所述扩张构型。
实施例62-根据实施例60或61所述的轴组件，其中所述闭合构件包括闩锁，所述闩锁被构造成能够将所述闭合构件可释放地保持在所述收缩构型中。
实施例63-根据实施例60、61或62所述的轴组件，其中所述击发构件被构造成能够在执行所述击发行程之前释放所述闩锁。
实施例64-根据实施例59、60、61、62或63所述的轴组件，其中所述闭合构件包括近侧部分和远侧部分，其中所述闭合构件的所述近侧部分安装到所述框架，并且其中所述远侧部分在闭合行程期间能够移动远离所述近侧部分。
实施例65-根据实施例64所述的轴组件，其中所述闭合构件还包括被构造成能够使所述闭合构件的所述远侧部分朝向所述近侧部分偏压的弹簧。
实施例66-根据实施例59、60、61、62、63、64或65所述的轴组件，还包括被构造成能够将所述闭合构件偏压到所述收缩构型的弹簧。
实施例67-根据实施例59、60、61、62、63、64、65或66所述的轴组件，其中所述端部执行器还包括钉仓。
实施例68-根据实施例67所述的轴组件，其中所述钉仓是可替换的。
实施例69-根据实施例67或68所述的轴组件，其中所述钉仓可安置在所述第一钳口中。
实施例70-根据实施例67或68所述的轴组件，其中所述钉仓可安置在所述第二钳口中。
实施例71-一种与外科系统一起使用的轴组件，包括端部执行器和附接部分。所述端部执行器包括第一钳口，第二钳口，被构造成能够使所述第一钳口相对于所述第二钳口在打开位置与闭合位置之间移动的闭合构件，以及能够移动通过击发行程的击发构件。所述附接部分包括被构造成能够接合所述外科系统的框架的轴框架，被构造成能够接收来自所述外科系统的旋转运动的可旋转输入部，以及与闭合构件可操作地联接的闭合系统。所述附接部分还包括与所述击发构件可操作地联接的击发系统、和离合器，其中所述离合器可被构造成能够处于闭合模式和击发模式。当所述离合器处于所述闭合模式时，所述离合器将所述可旋转输入部与所述闭合系统可操作地联接，并且当离合器被置于所述闭合模式时，所述离合器将所述击发系统与所述可旋转输入部可操作地脱离联接。当所述离合器处于击发模式时，所述离合器将所述可旋转输入部与所述击发系统可操作地联接，并且其中当所述离合器被置于所述击发模式时，所述离合器将所述闭合系统与所述可旋转输入部可操作地脱离联接。
实施例72-根据实施例71所述的轴组件，其中所述离合器包括拨动件，所述拨动件可定位在闭合位置以将所述离合器置于所述闭合模式，并且可定位在击发位置以将所述离合器置于击发模式。
实施例73-根据实施例71或72所述的轴组件，其中所述拨动件包括第一可推动端部和第二可推动端部。
实施例74-根据实施例71、72或73所述的轴组件，还包括被构造成能够使所述击发构件回缩的可手动操作的回缩系统。
实施例75-根据实施例74所述的轴组件，其中所述回缩系统可被构造成能够处于停用构型和启用构型，并且其中所述回缩系统被构造成当所述回缩系统被置于所述启用构型时能够将所述可旋转输入部与所述击发系统脱离联接。
实施例76-根据实施例74或75所述的轴组件，其中当所述回缩系统处于所述启用构型时，所述闭合系统能够与所述可旋转输入部可操作地接合。
实施例77-根据实施例74、75或76所述的轴组件，其中当所述回缩系统被置于所述启用构型时，所述击发系统与所述可旋转输入部永久地脱离联接。
实施例78-根据实施例75所述的轴组件，其中在所述回缩系统已返回到所述停用构型之后，所述击发系统能够与所述可旋转输入部可操作地联接。
实施例79-根据实施例74、75、76、77或78所述的轴组件，其中所述附接部分包括壳体，并且其中所述壳体包括能够在闭合位置与打开位置之间移动以暴露所述回缩系统的杠杆的覆盖件。
实施例80-根据实施例79所述的轴组件，其中当所述覆盖件从所述闭合位置移动到所述打开位置时，所述覆盖件被构造成能够将所述击发系统与所述可旋转输入部可操作地脱离接合。
实施例81-根据实施例79或80所述的轴组件，其中当所述覆盖件从所述闭合位置移动到所述打开位置时，所述覆盖件不将所述闭合系统与所述可旋转输入部可操作地脱离接合。
实施例82-根据实施例80所述的轴组件，其中当所述覆盖件移动回到所述闭合位置时，所述击发系统能够与所述可旋转输入部可操作地重新接合。
实施例83-根据实施例71、72、73、74、75、76、77、78、79、80、81或82所述的轴组件，其中所述击发构件包括可旋转的输出轴。
实施例84-根据实施例80、81、82或83所述的轴组件，其中所述击发系统包括第一齿轮和第二齿轮，其中当所述覆盖件处于所述闭合位置时，所述第一齿轮与所述第二齿轮可操作地相互啮合，并且其中当所述覆盖件处于所述打开位置时，所述第一齿轮与所述第二齿轮脱离啮合。
实施例85-根据实施例84所述的轴组件，还包括被构造成能够将所述第一齿轮偏压成与所述第二齿轮操作性地相互啮合的弹簧。
实施例86-根据实施例71、72、73、74、75、76、77、78、79、80所述的轴组件，其中所述端部执行器还包括钉仓。
实施例87-根据实施例86所述的轴组件，其中所述钉仓是可替换的。
实施例88-根据实施例71、72、73、74、75、76、77、78、79、80、81、82、83、84、85、86或87所述的轴组件，其中所述击发构件能够旋转并且所述闭合构件能够平移。
实施例89-一种与外科系统一起使用的轴组件，包括端部执行器、第一驱动系统和第二驱动系统。轴组件还包括附接部分，其中所述附接部分包括被构造成能够接合所述外科系统的框架的轴框架，以及被构造成能够接收来自所述外科系统的旋转运动的可旋转输入轴。所述附接部分还包括可被构造成能够处于第一操作模式和第二操作模式的离合器。当所述离合器处于所述第一操作模式时，所述离合器将所述可旋转输入轴与所述第一驱动系统可操作地联接，并且当所述离合器处于所述第一操作模式时，所述离合器将所述第二驱动系统与所述可旋转输入轴可操作地脱离联接。当所述离合器处于所述第二操作模式时，所述离合器将所述可旋转输入轴与所述第二驱动系统可操作地联接，并且其中当所述离合器被置于所述第二操作模式时，所述离合器将所述第一驱动系统与所述可旋转输入轴可操作地脱离联接。
实施例90-一种与外科系统一起使用的轴组件，包括第一驱动系统、第二驱动系统以及被构造成能够接合所述外科系统的框架的轴框架。所述轴组件还包括被构造成能够接收来自所述外科系统的旋转运动的可旋转输入轴，以及可被构造成能够处于第一操作模式和第二操作模式的传输装置。当所述传输装置处于所述第一操作模式时，所述传输装置将所述可旋转输入轴与所述第一驱动系统可操作地联接，并且当所述传输装置处于所述第一操作模式时，所述传输装置将所述第二驱动系统与所述可旋转输入轴可操作地脱离联接。当所述传输装置处于所述第二操作模式时，所述传输装置将所述可旋转输入轴与所述第二驱动系统可操作地联接，并且当所述传输装置被置于所述第二操作模式时，所述传输装置将所述第一驱动系统与所述可旋转输入轴可操作地脱离联接，并且可手动操作的回缩系统被构造成能够在致动时可操作地停用所述第一操作模式并且回缩所述第二驱动系统。
实施例91-一种与外科系统一起使用的轴组件，其中所述轴组件包括可附接到所述外科系统的框架，以及包括第一钳口、第二钳口的端部执行器，其中所述第一钳口能够相对于所述第二钳口旋转，以及包括可移除地储存在其中的钉的钉仓。所述轴组件还包括关节运动接头，其中所述端部执行器围绕所述关节运动接头可旋转地连接到所述框架。所述轴组件还包括击发构件，所述击发构件在击发行程期间能够在未击发位置与击发位置之间平移以从所述钉仓射出钉，其中所述击发构件能够在第一取向与第二取向之间旋转。所述轴组件还包括关节运动驱动器，所述关节运动驱动器被构造成能够使所述端部执行器围绕所述关节运动接头旋转，其中当所述击发构件处于所述第一取向时，所述击发构件与所述关节运动驱动器可操作地联接，其中当所述击发构件处于所述第一取向时，所述击发构件的所述平移运动被传递到所述关节运动驱动器，并且其中当所述击发构件处于所述第二取向时，所述击发构件与所述关节运动驱动器可操作地脱离联接。
实施例92-根据实施例91所述的轴组件，还包括能够在解锁构型与锁定构型之间移动的关节运动锁，其中当所述关节运动锁处于所述解锁构型时，所述端部执行器能够相对于所述框架旋转，并且其中当所述关节运动锁处于所述锁定构型时，所述关节运动锁被构造成能够防止所述端部执行器相对于所述框架旋转。
实施例93-根据实施例92所述的轴组件，其中所述关节运动锁被构造成能够接合所述关节运动驱动器并且当所述关节运动锁处于所述锁定构型时将所述关节运动驱动器保持在适当位置。
实施例94-根据实施例92或93所述的轴组件，其中所述关节运动锁被构造成能够接合所述端部执行器并且当所述关节运动锁处于所述锁定构型时将所述端部执行器保持在适当位置。
实施例95-根据实施例92、93或94所述的轴组件，还包括关节运动锁致动器，所述关节运动锁致动器被构造成能够使所述关节运动锁在所述解锁构型与所述锁定构型之间移动。
实施例96-根据实施例95所述的轴组件，其中所述关节运动锁致动器被构造成当所述关节运动锁致动器使所述关节运动锁移动到所述解锁构型时，能够将所述击发构件旋转到所述第一取向并且将所述击发构件与所述关节运动驱动器可操作地联接。
实施例97-根据实施例95或96所述的轴组件，其中所述关节运动锁致动器被构造成当所述关节运动锁致动器使所述关节运动锁移动到所述锁定构型时，能够将所述击发构件旋转到所述第二取向，并且将所述击发构件与所述关节运动驱动器可操作地脱离联接。
实施例98-根据实施例91、92、93、94、95、96或97所述的轴组件，其中所述击发构件被构造成能够接合所述第一钳口并且在闭合行程期间使所述第一钳口朝向所述第二钳口移动，并且其中所述击发构件被构造成能够在所述击发行程之前执行所述闭合行程。
实施例99-根据实施例91、92、93、94、95、96、97或98所述的轴组件，还包括回缩致动器，其中所述回缩致动器能够选择性地与所述击发构件接合并且可手动致动以将所述击发构件回缩到所述未击发位置。
实施例100-根据实施例91、92、93、94、95、96、97、98或99所述的轴组件，还包括闭合构件，所述闭合构件被构造成能够接合所述第一钳口并且在闭合行程期间使所述第一钳口朝向所述第二钳口移动。
实施例101-根据实施例91、92、93、94、95、96、97、98、99或100所述的轴组件，其中所述击发构件包括第一部分、第二部分和离合器，其中所述离合器被构造成能够使所述击发构件在关节运动模式构型与击发模式构型之间切换，其中当所述击发构件处于所述关节运动模式构型时，所述第一部分能够相对于所述第二部分移动，并且其中当所述击发构件处于所述击发模式构型时，所述第一部分与所述第二部分接合以朝远侧驱动所述第二部分。
实施例102-根据实施例101所述的轴组件，其中所述离合器包括锁，所述锁被构造成能够将所述击发构件可释放地保持在所述击发模式构型。
实施例103-根据实施例101或102所述的轴组件，其中所述锁安装到所述击发构件的所述第二部分。
实施例104-根据实施例101、102或103所述的轴组件，其中当所述离合器使所述击发构件在所述关节运动模式构型与所述击发模式构型之间转变时，所述击发构件的所述第一部分能够朝向所述击发位置移动，以允许所述锁将所述第一部分可释放地捕获成与所述第二部分操作性地接合。
实施例105-根据实施例101、102、103或104所述的轴组件，其中所述框架还包括键，其中所述锁被构造成当所述击发构件朝向所述未击发位置回缩时能够接合所述键，并且其中所述键被构造成能够解锁所述锁并且允许所述击发构件从所述击发模式构型转变到所述关节运动模式构型。
实施例106-根据实施例91所述的轴组件，其中所述框架包括第一旋转止动件和第二旋转止动件，其中所述第一旋转止动件被构造成能够使所述击发构件停止在所述第一取向，并且其中所述第二旋转止动件被构造成能够使所述击发构件停止在所述第二取向。
实施例107-根据实施例91、92、93、94、95、96、97、98、99、100、101、102、103、104、105或106所述的轴组件，其中所述钉仓是可替换的。
实施例108-一种与外科系统一起使用的轴组件，其中所述轴组件包括可附接到所述外科系统的框架，以及包括第一钳口和第二钳口的端部执行器，其中所述第一钳口能够相对于所述第二钳口旋转。所述轴组件还包括关节运动接头，其中所述端部执行器围绕所述关节运动接头可旋转地连接到所述框架，以及被构造成能够使所述端部执行器围绕所述关节运动接头旋转的关节运动驱动器。所述轴组件还包括击发组件，所述击发组件在击发行程期间能够在未击发位置与击发位置之间平移，其中所述击发组件包括第一部分和第二部分。所述第一部分能够相对于所述第二部分在关节运动模式取向与击发模式取向之间旋转，其中当所述第一部分处于所述关节运动模式取向时，所述第一部分与所述关节运动驱动器可操作地联接。当所述第一部分处于所述关节运动模式取向时，所述击发组件的平移运动被传递到所述关节运动驱动器，并且其中当所述第一部分处于所述击发模式取向时，所述击发组件与所述关节运动驱动器可操作地脱离联接。
实施例109-根据实施例108所述的轴组件，其中所述端部执行器还包括钉仓。
实施例110-一种与外科系统一起使用的轴组件，包括可附接到所述外科系统的框架，以及端部执行器，其中所述端部执行器包括第一钳口和第二钳口，其中所述第一钳口能够相对于所述第二钳口旋转。所述轴组件还包括关节运动接头，其中所述端部执行器围绕所述关节运动接头可旋转地连接到所述框架，以及被构造成能够使所述端部执行器围绕所述关节运动接头旋转的关节运动驱动器。所述轴组件还包括击发组件，所述击发组件在击发行程期间能够在未击发位置与击发位置之间平移，其中所述击发组件包括第一部分和第二部分。所述轴组件还包括用于选择性地旋转所述击发组件的所述第一部分使其与所述关节运动驱动器可操作地接合和脱离接合的装置，以及用于在所述第一部分与所述关节运动驱动器可操作地接合时将所述击发组件的所述第二部分与所述第一部分可操作地脱离联接的装置。
实施例111-一种与外科系统一起使用的轴组件，所述轴组件包括钉仓、端部执行器和击发构件。所述钉仓包括包含多个钉腔的仓体，可移除地储存在所述钉腔中的钉，以及在击发行程期间能够在未击发位置与击发位置之间移动以从所述钉腔射出钉的滑动件。所述端部执行器包括被构造成能够接收所述钉仓的仓通道，其中所述仓通道包括锁定凹槽。所述端部执行器还包括被构造成能够使所述钉变形的砧座，以及锁定弹簧。所述击发构件包括击发杆，所述击发杆包括被构造成能够在击发行程期间切割患者的组织的切割刃。所述击发构件还包括可旋转地安装到所述击发杆的锁，其中所述锁能够在解锁位置与锁定位置之间旋转，其中所述滑动件被构造成，当所述钉仓安置在所述仓通道中并且所述滑动件处于所述未击发位置时，所述滑动件能够将所述锁保持在所述解锁位置，并且其中当所述钉仓不在所述仓通道中或所述滑动件不处于所述未击发位置时，所述锁能够通过所述锁定弹簧从所述解锁位置旋转到所述锁定位置。
实施例112-根据实施例111所述的轴组件，还包括钉驱动器，其中所述滑动件被构造成能够接合所述钉驱动器以在击发行程期间从所述钉腔射出钉。
实施例113-根据实施例112所述的轴组件，其中所述钉驱动器与所述钉一体形成。
实施例114-根据实施例111、112或113所述的轴组件，其中所述击发杆还包括联接构件，其中所述联接构件包括所述切割刃，并且其中所述联接构件包括被构造成能够在击发行程期间接合所述仓通道的仓凸轮以及被构造成能够接合所述砧座的砧座凸轮。
实施例115-根据实施例114所述的轴组件，其中所述砧座能够相对于所述仓通道在打开位置与闭合位置之间旋转，并且其中所述联接构件被构造成能够控制所述砧座相对于所述钉仓的位置。
实施例116-根据实施例114所述的轴组件，其中所述仓通道能够相对于所述砧座在打开位置与闭合位置之间旋转，并且其中所述联接构件被构造成能够控制所述钉仓相对于所述砧座的位置。
实施例117-根据实施例111、112、113、114、115或116所述的轴组件，其中所述砧座能够相对于所述仓通道在打开位置与闭合位置之间旋转，并且其中所述轴组件还包括被构造成能够使所述砧座朝向所述闭合位置的闭合构件。
实施例118-根据实施例111、112、113、114、115、116或117所述的轴组件，其中所述仓通道能够相对于所述砧座在打开位置与闭合位置之间旋转，并且其中所述轴组件还包括被构造成能够使所述仓通道朝向所述闭合位置移动的闭合构件。
实施例119-根据实施例111、112、113、114、115、116、117或118所述的轴组件，其中所述端部执行器包括近侧端部和远侧端部，并且其中所述锁相对于所述切割刃朝远侧延伸。
实施例120-根据实施例111、112、113、114、115、116、117、118或119所述的轴组件，其中当所述击发行程开始并且所述钉仓不在所述仓通道中或所述滑动件不处于所述未击发位置时，所述锁被所述锁定弹簧偏压到所述锁定凹槽中，并且其中在所述钉从所述钉腔射出之前，所述击发行程被所述锁和所述锁定凹槽停止。
实施例121-根据实施例111、112、113、114、115、116、117、118、119或120所述的轴组件，其中所述击发杆不被所述锁定弹簧朝向所述锁定凹槽偏压。
实施例122-根据实施例111、112、113、114、115、116、117、118、119、120或121所述的轴组件，其中所述锁被构造成，如果在击发行程开始时所述钉仓安置在所述仓通道中并且所述滑动件处于所述未击发位置，则所述锁能够推动所述滑动件通过所述击发行程。
实施例123-根据实施例122所述的轴组件，其中所述击发构件在所述击发行程的至少一部分已经完成之后可回缩，并且其中所述滑动件不可与所述击发构件一起回缩。
实施例124-根据实施例122或123所述的轴组件，其中所述击发构件在所述击发行程的至少一部分已经完成之后可回缩，并且其中所述锁被构造成能够在所述锁回缩经过所述锁定弹簧时保持在所述解锁位置。
实施例125-根据实施例111、112、113、114、115、116、117、118、119、120、121、122、123或124所述的轴组件，其中所述锁包括悬臂梁，所述悬臂梁包括固定地安装到所述仓通道的近侧端部和能够相对于所述近侧端部移动的远侧端部。
实施例126-根据实施例111、112、113、114、115、116、117、118、119、120、121、122、123、124或125所述的轴组件，其中所述仓通道能够可移除地附接到所述端部执行器。
实施例127-根据实施例111、112、113、114、115、116、117、118、119、120、121、122、123、124或125所述的轴组件，其中所述仓通道不能够可移除地附接到所述端部执行器。
实施例128-一种与外科系统一起使用的轴组件，其中所述轴组件包括钉仓、端部执行器和击发组件。所述钉仓包括仓体和钉，其中每个钉至少部分地储存在所述仓体中。所述钉仓还包括滑动件，所述滑动件在击发行程期间能够在未击发位置与击发位置之间移动以从所述仓体射出钉。所述端部执行器包括被构造成能够接收所述钉仓的仓通道，其中所述仓通道包括闭锁件。所述端部执行器还包括被构造成能够使所述钉变形的砧座、以及偏压构件。所述击发组件包括击发构件和可旋转地安装到所述击发构件的锁，其中所述锁能够在解锁位置与锁定位置之间旋转，其中所述滑动件被构造成，当所述钉仓安置在所述仓通道中并且所述滑动件处于所述未击发位置时，所述滑动件能够将所述锁保持在所述解锁位置，并且其中当所述钉仓不在所述仓通道中或所述滑动件不处于所述未击发位置时，所述锁能够通过所述偏压构件从所述解锁位置旋转到所述锁定位置。
实施例129-一种与外科系统一起使用的端部执行器，所述端部执行器包括钉仓，其中所述钉仓包括仓体和钉，其中每个钉至少部分地储存在所述仓体中。所述钉仓还包括滑动件，所述滑动件在击发行程期间能够在未击发位置与击发位置之间移动以从所述仓体射出钉。所述端部执行器还包括被构造成能够接收所述钉仓的仓通道，其中所述仓通道包括闭锁件，被构造成能够使所述钉变形的砧座，以及偏压构件。所述端部执行器还包括击发组件，其中所述击发组件包括击发构件和可旋转地安装到所述击发构件的锁，其中所述锁能够在解锁位置与锁定位置之间旋转，其中所述滑动件被构造成，当所述钉仓安置在所述仓通道中并且所述滑动件处于所述未击发位置时，所述滑动件能够将所述锁保持在所述解锁位置，并且其中当所述钉仓不在所述仓通道中或所述滑动件不处于所述未击发位置时，所述锁能够通过所述偏压构件从所述解锁位置旋转到所述锁定位置。
实施例130-一种轴组件，包括轴框架，包括端部执行器框架的端部执行器，以及关节运动接头，其中所述关节运动接头将所述端部执行器框架可旋转地连接到所述轴框架。所述轴组件还包括关节运动驱动器，所述关节运动驱动器被构造成能够使所述端部执行器围绕所述关节运动接头旋转。所述轴组件还包括能够选择性地致动以接合所述端部执行器框架并且防止所述端部执行器框架相对于所述轴框架旋转的第一关节运动锁，以及能够选择性地致动以接合所述关节运动驱动器并且防止所述端部执行器框架相对于所述轴框架旋转的第二关节运动锁。
实施例131-根据实施例130所述的轴组件，其中所述第一关节运动锁和所述第二关节运动锁在锁定运动期间均被锁致动器致动到锁定状态。
实施例132-根据实施例130或131所述的轴组件，其中所述第一关节运动锁被构造成能够在所述锁定运动期间在所述第二关节运动锁接合所述关节运动驱动器之前接合所述端部执行器框架。
实施例133-根据实施例130或131所述的轴组件，其中所述第二关节运动锁被构造成能够在所述锁致动器的解锁运动期间在所述第一关节运动锁与所述端部执行器框架脱离接合之前与所述关节运动驱动器脱离接合。
实施例134-根据实施例130或131所述的轴组件，其中所述第一关节运动锁被构造成能够在所述锁定行程期间在所述第二关节运动锁接合所述关节运动驱动器之后接合所述端部执行器框架。
实施例135-根据实施例130或131所述的轴组件，其中所述第二关节运动锁被构造成能够在所述锁致动器的解锁运动期间在所述第一关节运动锁与所述端部执行器框架脱离接合之后与所述关节运动驱动器脱离接合。
实施例136-根据实施例130或131所述的轴组件，其中所述第一关节运动锁被构造成能够在所述锁定行程期间在所述第二关节运动锁接合所述关节运动驱动器的同时接合所述端部执行器框架。
实施例137-根据实施例130或131所述的轴组件，其中所述第二关节运动锁被构造成能够在所述锁致动器的解锁运动期间在所述第一关节运动锁与所述端部执行器框架脱离接合的同时与所述关节运动驱动器脱离接合。
实施例138-根据实施例130所述的轴组件，其中所述第一关节运动锁和所述第二关节运动锁能够被分别地致动。
实施例139-根据实施例130、131、132、133、134、135、136、137或138所述的轴组件，其中所述关节运动驱动器包括被构造成能够使所述端部执行器在第一方向上旋转的第一关节运动驱动器，其中所述轴组件还包括被构造成能够使所述端部执行器在第二方向上围绕所述关节运动接头旋转的第二关节运动驱动器，并且其中所述第二方向与所述第一方向相反。
实施例140-根据实施例139所述的轴组件，其中所述关节运动锁被构造成当所述第二关节运动锁被致动时能够接合所述第二关节运动驱动器并且防止所述端部执行器框架相对于所述轴框架旋转。
实施例141-根据实施例139所述的轴组件，其中所述第二关节运动锁被构造成能够在致动所述第二关节运动锁的同时接合所述第一关节运动驱动器和所述第二关节运动驱动器。
实施例142-根据实施例139所述的轴组件，其中所述第二关节运动锁被构造成能够在与致动所述第二关节运动锁的不同时间接合所述第一关节运动驱动器和所述第二关节运动驱动器。
实施例143-根据实施例139、140、141或142所述的轴组件，其中所述第二关节运动锁包括被构造成能够接合所述第一关节运动驱动器的第一臂和被构造成能够接合所述第二关节运动驱动器的第二臂，并且其中所述第一关节运动锁被构造成能够在所述第一关节运动锁的锁定运动期间使所述第一臂与所述第一关节运动驱动器接合并且使所述第二臂与所述第二关节运动驱动器接合。
实施例144-根据实施例130、131、132、133、134、135、136、137、138、139、140、141、142或143所述的轴组件，其中所述端部执行器还包括钉仓。
实施例145-根据实施例144所述的轴组件，其中所述钉仓是可替换的。
实施例146-一种轴组件，包括轴框架，以及包括端部执行器框架的端部执行器。所述轴组件还包括关节运动接头，其中所述关节运动接头将所述端部执行器框架可旋转地连接到所述轴框架，以及被构造成能够使所述端部执行器围绕所述关节运动接头旋转的关节运动驱动器。所述轴组件还包括锁定系统，所述锁定系统被构造成能够接合所述端部执行器框架并且防止所述端部执行器框架相对于所述轴框架旋转，并且接合所述关节运动驱动器并防止所述端部执行器框架相对于所述轴框架旋转。
实施例147-根据实施例146所述的轴组件，其中所述端部执行器还包括钉仓。
实施例148-一种轴组件，包括轴框架，以及包括端部执行器框架的端部执行器。所述轴组件还包括关节运动接头，其中所述关节运动接头将所述端部执行器框架可旋转地连接到所述轴框架，以及可移位使所述端部执行器围绕所述关节运动接头旋转的关节运动驱动器。所述轴组件还包括用于选择性地防止所述旋转端部执行器围绕所述关节运动接头旋转的第一锁定装置，以及用于选择性地防止所述关节运动驱动器的移位的第二锁定装置。
实施例149-根据实施例148所述的轴组件，其中所述端部执行器还包括钉仓。
本文所述的许多外科器械系统由电动马达促动；但是本文所述的外科器械系统可以任何合适的方式促动。在各种实例中，例如，本文所述的外科器械系统可由手动操作的触发器促动。在某些实例中，本文公开的马达可包括机器人控制系统的一部分或多个部分。此外，本文公开的任何端部执行器和/或工具组件可与机器人外科器械系统一起使用。例如，名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利9,072,535)更详细地公开了机器人外科器械系统的若干示例。
已结合钉的部署和变形描述了本文所述的外科器械系统；然而，本文所述的实施方案不限于此。例如，设想了部署除钉之外的紧固件诸如夹具或大头钉的各种实施方案。此外，还设想了利用用于密封组织的任何合适装置的各种实施方案。例如，根据各种实施方案的端部执行器可包括被构造成能够加热和密封组织的电极。另外，例如，根据某些实施方案的端部执行器可施加振动能量来密封组织。
下述专利的全部公开内容据此以引用方式并入本文：
-公布于1995年4月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312；
-公布于2006年2月21日的名称为“SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利7,000,818；
-公布于2008年9月9日的名称为“MOTOR-DRIVEN SURGICAL CUTTING ANDFASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK”的美国专利7,422,139；
-公布于2008年12月16日的名称为“ELECTRO-MECHANICAL SURGICAL INSTRUMENTWITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”的美国专利7,464,849；
-公布于2010年3月2日的名称为“SURGICAL INSTRUMENT HAVING ANARTICULATING END EFFECTOR”的美国专利7,670,334；
-公布于2010年7月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245；
-公布于2013年3月12日的名称为“SELECTIVELY ORIENTABLE IMPLANTABLEFASTENER CARTRIDGE”的美国专利8,393,514；
-名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利申请序列号11/343,803；现为美国专利7,845,537；
-提交于2008年2月14日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT HAVING RF ELECTRODES”的美国专利申请序列号12/031,573；
-提交于2008年2月15日的名称为“END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT”的美国专利申请序列号12/031,873(现为美国专利7,980,443)；
-名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”的美国专利申请序列号12/235,782，现为美国专利8,210,411；
-名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117，现为美国专利8,608,045；
-提交于2009年12月24日的名称为“MOTOR-DRIVEN SURGICAL CUTTINGINSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY”的美国专利申请序列号12/647,100；现为美国专利8,220,688；
-提交于2012年9月29日的名称为“STAPLE CARTRIDGE”的美国专利申请序列号12/893,461，现为美国专利号8,733,613；
-提交于2011年2月28日的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号13/036,647，现为美国专利号8,561,870；
-名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241，现为美国专利9,072,535；
-提交于2012年6月15日的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING A FIRING DRIVE”的美国专利申请序列号13/524,049；现为美国专利9,101,358；
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,025，现为美国专利9,345,481；
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,067，
现为美国专利申请公布2014/0263552；
-提交于2006年1月31日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM”的美国专利申请公布2007/0175955；以及
-提交于2010年4月22日的名称为“SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”的美国专利申请公布2010/0264194，现为美国专利8,308,040。
虽然本文已结合某些实施方案描述了各种装置，但也可实施对这些实施方案的许多修改和变型。在一个或多个实施方案中，具体特征、结构或特性可任何合适的方式进行组合。因此，在无限制的情况下，结合一个实施方案示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其他实施方案的特征、结构或特性组合。另外，在公开了用于某些部件的材料的情况下，也可使用其它材料。此外，根据多种实施方案，单个部件可被替换为多个部件，并且多个部件也可被替换为单个部件，以执行给定的一种或多种功能。上述具体实施方式和下述权利要求旨在涵盖所有此类修改和变型。
本文所公开的装置可被设计成在单次使用后废弃，或者其可被设计成多次使用。然而无论是哪种情况，该装置都可在至少使用一次后经过修整再行使用。修复可包括以下步骤的任意组合，这些步骤包括但不限于拆卸装置、之后进行装置具体部件的清洁或更换、以及随后重新组装装置。具体地，修复设施和/或外科团队可拆卸装置，并且在清洁和/或更换装置的特定部件之后，可重新组装装置以供后续使用。本领域的技术人员将会理解，修整装置可利用多种技术来进行拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修复装置均在本申请的范围内。
本文所公开的装置可在手术之前进行处理。首先，可获得新的或用过的器械，并且根据需要进行清洁。然后，可对器械进行消毒。在一种灭菌技术中，将所述器械放置在密闭且密封的容器(诸如，塑料或TYVEK袋)中。然后可将容器和器械置于可穿透容器的辐射场，诸如γ辐射、X射线和/或高能电子。辐射可杀死器械上和容器中的细菌。经消毒的器械随后可被储存在无菌容器中。密封容器可将器械保持为无菌的，直至在医疗设施中将该容器打开。还可使用本领域已知的任何其他技术对装置进行消毒，所述技术包括但不限于β辐射、γ辐射、环氧乙烷、等离子过氧化物和/或蒸汽。
尽管本发明已被描述为具有示例性设计，但可在本公开的实质和范围内进一步修改本发明。因此，本申请旨在涵盖使用本发明的一般原理的本发明的任何变型、用途或改型。
以引用方式全文或部分地并入本文的任何专利、公布或其他公开材料均仅在所并入的材料不与本发明所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。因此，并且在必要的程度下，本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其它公开材料相冲突的任何材料或其部分，将仅在所并入的材料与现有的公开材料之间不产生冲突的程度下并入。
Claims (20)
1.一种与外科系统一起使用的轴组件，所述轴组件包括：
端部执行器，所述端部执行器包括：
第一钳口；
第二钳口；
闭合构件，所述闭合构件被构造成能够使所述第一钳口相对于所述第二钳口在打开位置与闭合位置之间移动；以及
击发构件，所述击发构件能够移动通过击发行程；以及
附接部分，所述附接部分包括：
轴框架，所述轴框架被构造成能够接合所述外科系统的框架；
可旋转输入部，所述可旋转输入部被构造成能够接收来自所述外科系统的旋转运动；
闭合系统，所述闭合系统与所述闭合构件能够操作地联接；
击发系统，所述击发系统与所述击发构件能够操作地联接；以及
离合器，所述离合器能够被构造成能够处于：
闭合模式，其中当所述离合器处于所述闭合模式时，所述离合器将所述可旋转输入部与所述闭合系统能够操作地联接，并且其中当所述离合器被置于所述闭合模式时，所述离合器将所述击发系统与所述可旋转输入部能够操作地脱离联接；以及
击发模式，其中当所述离合器处于所述击发模式时，所述离合器将所述可旋转输入部与所述击发系统能够操作地联接，
并且其中当所述离合器被置于所述击发模式时，所述离合器将所述闭合系统与所述可旋转输入部能够操作地脱离联接。
2.根据权利要求1所述的轴组件，其中，所述离合器包括拨动件，所述拨动件能够定位在闭合位置以将所述离合器置于所述闭合模式，并且能够定位在击发位置以将所述离合器置于击发模式。
3.根据权利要求2所述的轴组件，其中，所述拨动件包括第一可推动端部和第二可推动端部。
4.根据权利要求1所述的轴组件，还包括被构造成能够使所述击发构件回缩的可手动操作的回缩系统。
5.根据权利要求4所述的轴组件，其中，所述回缩系统能够被构造成能够处于停用构型和启用构型，并且其中所述回缩系统被构造成当所述回缩系统被置于所述启用构型时能够将所述可旋转输入部与所述击发系统脱离联接。
6.根据权利要求5所述的轴组件，其中，当所述回缩系统处于所述启用构型时，所述闭合系统能够与所述可旋转输入部可操作地接合。
7.根据权利要求5所述的轴组件，其中，当所述回缩系统被置于所述启用构型时，所述击发系统与所述可旋转输入部永久地脱离联接。
8.根据权利要求5所述的轴组件，其中，在所述回缩系统已返回到所述停用构型之后，所述击发系统能够与所述可旋转输入部可操作地联接。
9.根据权利要求4所述的轴组件，其中，所述附接部分包括壳体，并且其中所述壳体包括覆盖件，所述覆盖件能够在闭合位置与打开位置之间移动以暴露所述回缩系统的杠杆。
10.根据权利要求9所述的轴组件，其中，当所述覆盖件从所述闭合位置移动到所述打开位置时，所述覆盖件被构造成能够将所述击发系统与所述可旋转输入部能够操作地脱离接合。
11.根据权利要求10所述的轴组件，其中，当所述覆盖件从所述闭合位置移动到所述打开位置时，所述覆盖件不将所述闭合系统与所述可旋转输入部能够操作地脱离接合。
12.根据权利要求10所述的轴组件，其中，当所述覆盖件移动回到所述闭合位置时，所述击发系统能够与所述可旋转输入部可操作地重新接合。
13.根据权利要求1所述的轴组件，其中，所述击发构件包括可旋转输出轴。
14.根据权利要求10所述的轴组件，其中，所述击发系统包括第一齿轮和第二齿轮，其中当所述覆盖件处于所述闭合位置时，所述第一齿轮与所述第二齿轮能够操作地相互啮合，并且其中当所述覆盖件处于所述打开位置时，所述第一齿轮与所述第二齿轮脱离啮合。
15.根据权利要求14所述的轴组件，还包括被构造成能够将所述第一齿轮偏压成与所述第二齿轮操作性地相互啮合的弹簧。
16.根据权利要求1所述的轴组件，其中，所述端部执行器还包括钉仓。
17.根据权利要求16所述的轴组件，其中，所述钉仓为能够替换的。
18.根据权利要求1所述的轴组件，其中，所述击发构件是能够旋转的，并且所述闭合构件是能够平移的。
19.一种与外科系统一起使用的轴组件，所述轴组件包括：
端部执行器；
第一驱动系统；
第二驱动系统：以及
附接部分，所述附接部分包括：
轴框架，所述轴框架被构造成能够接合所述外科系统的框架；
可旋转输入轴，所述可旋转输入轴被构造成能够接收来自所述外科系统的旋转运动；以及
离合器，所述离合器能够被构造成能够处于：
第一操作模式，其中当所述离合器处于所述第一操作模式时，所述离合器将所述可旋转输入轴与所述第一驱动系统能够操作地联接，并且其中当所述离合器被置于所述第一操作模式时，所述离合器将所述第二驱动系统与所述可旋转输入轴能够操作地脱离联接；以及
第二操作模式，其中当所述离合器处于所述第二操作模式时，所述离合器将所述可旋转输入轴与所述第二驱动系统能够操作地联接，并且其中当所述离合器被置于所述第二操作模式时，所述离合器将所述第一驱动系统与所述可旋转输入轴能够操作地脱离联接。
20.一种与外科系统一起使用的轴组件，所述轴组件包括：
第一驱动系统；
第二驱动系统；
轴框架，所述轴框架被构造成能够接合所述外科系统的框架；
可旋转输入轴，所述可旋转输入轴被构造成能够接收来自所述外科系统的旋转运动；
传输装置，所述传输装置能够被构造成能够处于：
第一操作模式，其中当所述传输装置处于所述第一操作模式时，所述传输装置将所述可旋转输入轴与所述第一驱动系统能够操作地联接，并且其中当所述传输装置被置于所述第一操作模式时，所述传输装置将所述第二驱动系统与所述可旋转输入轴能够操作地脱离联接；以及
第二操作模式，其中当所述传输装置处于所述第二操作模式时，所述传输装置将所述可旋转输入轴与所述第二驱动系统能够操作地联接，并且其中当所述传输装置被置于所述第二操作模式时，所述传输装置将所述第一驱动系统与所述可旋转输入轴能够操作地脱离联接；以及
可手动操作的回缩系统，所述可手动操作的回缩系统被构造成能够在致动时能够操作地停用所述第一操作模式并回缩所述第二驱动系统。
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| US15/385,891 | 2016-12-21 | ||
| PCT/IB2017/056665 WO2018115996A2 (en) | 2016-12-21 | 2017-10-26 | Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems |
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| EP3348211A3 (en) | 2018-10-17 |
| WO2018115996A9 (en) | 2018-08-30 |
| JP2020501762A (ja) | 2020-01-23 |
| BR112019012420A2 (pt) | 2020-02-27 |
| US20180168592A1 (en) | 2018-06-21 |
| MX2019007307A (es) | 2019-11-18 |
| EP3348211A2 (en) | 2018-07-18 |
| WO2018115996A2 (en) | 2018-06-28 |
| JP7013468B2 (ja) | 2022-01-31 |
| CN110167463B (zh) | 2022-08-09 |
| US11419606B2 (en) | 2022-08-23 |
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