CN110381852B - 用于圆形钉合器设备的末端执行器组合件 - Google Patents

用于圆形钉合器设备的末端执行器组合件 Download PDF

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CN110381852B
CN110381852B CN201780087863.9A CN201780087863A CN110381852B CN 110381852 B CN110381852 B CN 110381852B CN 201780087863 A CN201780087863 A CN 201780087863A CN 110381852 B CN110381852 B CN 110381852B
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沈冬明
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A61B17/1155—Circular staplers comprising a plurality of staples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00473—Distal part, e.g. tip or head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07257—Stapler heads characterised by its anvil
    • A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07271—Stapler heads characterised by its cartridge
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07278—Stapler heads characterised by its sled or its staple holder
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B2017/07214—Stapler heads
    • A61B2017/07285—Stapler heads characterised by its cutter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1132—End-to-end connections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B17/115—Staplers for performing anastomosis in a single operation
    • A61B2017/1157—Staplers for performing anastomosis in a single operation applying the staples radially

Abstract

一种用于与圆形钉合器设备(10)一起使用的末端执行器组合件(300)准许在不考虑组件的相对定向的情况下将砧座组合件的钉形成凹座(356)与钉筒组合件的钉(312)对准。所述末端执行器组合件(300)包含：筒壳体(306)；钉固持器(310)，具有以圆形阵列布置的多个钉(312)；钉推动器(308)，其至少部分地安置于所述筒壳体(306)内且配置成用于移动通过击发行程以从所述钉固持器(310)弹射所述钉(312)；砧座杆(348)，其配置成用于相对于所述筒壳体(306)联接；以及砧座头(350)，其包含至少一个连续圆形钉形成凹座(356)。所述钉形成凹座(356)与所述钉(312)对齐以用于在所述击发行程期间至少部分地接纳所述钉(312)。所述钉形成凹座(356)配置成用于至少部分地使所述钉(312)变形。

Description

用于圆形钉合器设备的末端执行器组合件
技术领域
本公开涉及一种手术钉合器设备，且更具体地说涉及一种用于圆形钉合器设备的末端执行器组合件。本公开进一步涉及包含钉筒和砧座机构的末端执行器组合件，所述砧座机构并有在不需要使砧座机构与钉筒机构一起转位的情况下准许击发钉的特征。
背景技术
圆形钉合器器械被临床医生用以向主体组织施用一个或多个手术紧固件，例如钉或两件式钉，以便将主体组织的段接合在一起和/或以创建吻合。圆形钉合器器械大体上包含：环形钉筒组合件，其支撑多个环形钉排；环形砧座组合件，其与钉筒组合件可操作地相关联且具有个别钉形成凹座，以提供抵靠形成钉的表面；以及环形刀片，其用于切割组织。
在典型紧固过程期间，砧座组合件与钉合器器械分离且定位于主体组织的一个段内。钉合器器械定位于主体组织的邻近段中。接着将砧座组合件附接到仓组合件，且操纵钉合器器械以使砧座组合件与筒组合件接近，从而将主体组织的段夹持在一起。通常，砧座组合件的砧座杆和筒组合件的筒外壳或壳体相应地并有例如外栓槽和内栓槽等结构，以确保砧座组合件的个别钉形成凹座与筒组合件的钉正对准，以在击发序列期间进行适当的钉形成。不利的是，栓槽的未对准可能尤其在高速自动夹持过程中发生。此种未对准有可能损坏栓槽，这常常导致离轴钉形成和伴随的组织连接或吻合中的缺陷。
发明内容
因此，本公开涉及一种用于圆形钉合器器械的末端执行器组合件，其不考虑组件的相对定向的情况下准许砧座组合件的钉形成凹座与钉筒组合件的钉的自动对准。在一个实施例中，公开一种与圆形钉合器设备一起使用的末端执行器组合件。末端执行器组合件包含：筒壳体，其限定中心壳体轴线；钉固持器，其安置于所述筒壳体内且具有围绕中心壳体轴线以圆形阵列布置的多个钉；钉推动器，其至少部分地安置于筒壳体内且配置成用于移动通过击发行程以从钉固持器弹射钉；砧座杆，其配置成用于相对于筒壳体联接；以及砧座头，其包含至少一个连续圆形钉形成凹座。所述钉形成凹座与所述钉对齐以用于在所述击发行程期间至少部分地接纳所述钉。所述钉形成凹座配置成用于至少部分地使所述钉变形。
在实施例中，筒壳体包含内砧座接收座，其配置成接纳砧座杆以相对于筒壳体安装砧座杆。在一些实施例中，内砧座接收座限定圆柱形部分，其具有不含栓槽的连续内表面。在某些实施例中，砧座杆也不含栓槽。
在实施例中，钉推动器包含多个推动器指状物。每个推动器指状物配置成接合个别钉以从钉固持器弹射个别钉，以使钉形成凹座内的个别钉变形。在一些实施例中，所述推动器指状物以对应于所述钉的所述圆形阵列的圆形阵列布置。
在某些实施例中，钉固持器包含相对于中心壳体轴线布置的第一组多个钉和第二组多个钉，且砧座头包含相对于中心壳体轴线同心地布置的第一连续圆形钉形成凹座和第二连续圆形钉形成凹座。所述第一连续钉形成凹座和所述第二连续钉形成凹座与相应第一组钉和相应第二组钉中的钉对齐，以用于在击发行程期间至少部分地接纳和变形。在实施例中，所述钉固持器包含相对于所述中心壳体轴线同心地布置的第三组多个钉，且所述砧座头包含相对于中心壳体轴线同心地布置的第三连续圆形钉形成凹座，且与所述第三组所述钉中的所述钉对齐，以用于在所述击发行程期间至少部分地接纳和变形。
在一些实施例中，每个推动器指状物配置成沿着与所述中心壳体轴线呈平行关系的中心推动器轴线延伸。在某些实施例中，每个推动器指状物包含中心推动器轴线的相对侧上的两个凹部。在某些实施例中，每个钉包含钉后跨部和从钉后跨部悬垂的相对支腿。每个钉限定沿着钉的长度延伸的钉轴线。每个钉的钉后跨部具有在钉轴线的相对侧上的两个凸部。每个推动器指状物的凹部配置成在钉推动器的击发行程期间接合钉的相应凸部。在一些实施例中，钉的每个相对支腿具有倾斜远端段。倾斜远端段相对于钉轴线朝内径向延伸且配置成在击发行程期间促进相对支腿的变形。
本公开提供优于已知圆形钉合器器械的显著优点。末端执行器组合件的钉筒机构包含筒壳体，其并有钉推动器，所述钉推动器能够移动通过击发行程以抵靠砧座头弹射和形成钉，而不考虑砧座头相对于钉推动器的定向。具体来说，砧座头包含至少一个连续圆形钉形成凹座，其与钉对齐且与钉推动器的个别推动器指状物的圆形阵列对齐。因此，消除了在砧座杆上和筒壳体内并有例如转位栓槽等对准特征以对准钉形成凹座与钉的需要，连同上文所描述的相关联缺点。
通过以下描述将更好地了解本公开的其它特征和优点。
附图说明
下文参考图式描述本公开的各种方面，所述图式并入本说明书中并且构成本说明书的一部分，在图式中：
图1是根据本公开的示例性圆形钉合器设备的透视图，其说明包含钉筒机构和砧座机构的末端执行器组合件；
图2是说明与钉筒机构分离的砧座机构的末端执行器组合件的透视图；
图3是末端执行器组合件的分解透视图；
图4是钉筒机构的筒壳体的顶部透视图；
图5是钉筒机构的钉推动器的顶部平面图；
图6是钉推动器的个别推动器指状物的透视图；
图7是沿着图6的线7-7截取的截面视图，其说明推动器指状物的双凹部；
图8是钉固持器的透视图；
图9是图8中识别的细节区域的放大隔离视图；
图10是钉筒机构的个别手术钉的侧面视图；
图11是末端执行器组合件的砧座机构的透视图；
图12是砧座机构的砧座头的顶部透视图，其说明砧座头的连续钉形成凹座；
图13是沿着图12的线13-13截取的放大截面视图；且
图14到图16是说明具有单个连续钉形成凹座的钉的形成序列的视图。
具体实施方式
现在参考图式详细描述本公开的实施例，其中在若干视图中的每一个中，相同附图标号指定相同或对应元件。如本文中所使用，术语“临床医生”是指医生、护士或任何其它医护人员且可以包含辅助人员。贯穿本说明书，术语“近侧”是指组合件或其组件最靠近临床医生的部分，且术语“远侧”是指装置或其组件最远离临床医生的部分。
先参看图1，说明圆形或端对端钉合器设备，且一般将其指定为附图标号10。圆形钉合器器械10可适用于重复使用或替代地，可在单次使用之后丢弃。圆形钉合器器械10包含手柄组合件100、从手柄组合件100延伸的伸长主体200和末端执行器组合件300。末端执行器组合件300可用作相对于伸长主体200可释放地固定的可拆卸的和可更换的组合件。替代地，末端执行器组合件300可永久地紧固到伸长主体200。手柄组合件100包含可旋转推进接近器102和可枢转的触发构件104，所述可枢转的触发构件可操作地联接到支撑在伸长主体200内的机构以相应地实现圆形钉合器器械10的接近和击发。在一些实施例中，伸长主体200沿着其长度的至少部分具有直线形状，且在其它实施例中，伸长主体200沿着其长度的至少部分具有弯曲形状。
为了详细论述示例性圆形钉合器设备的构造和操作，可以参考Milliman的第20150014393号共同转让的美国专利公开，其全部内容以引入的方式并入本文中。
参看图2到3，末端执行器组合件300包含钉筒机构302和可释放地安装到钉筒机构302的砧座机构304。钉筒机构302包含筒壳体306、推动器308、钉固持器310和含于钉固持器310内的多个钉312。钉筒机构302可装纳多个额外组件，其不形成本公开的部分且不在本文中进一步示出和描述。在实施例中，末端执行器组合件300的钉筒机构302和/或砧座机构304可以被替换且圆形钉合器器械10可以重复使用。在实施例中，末端执行器组合件300包含适于切割组织的刀具组合件(未示出)。
现参看图4，结合图3，筒壳体306是容纳钉筒机构302的其余组件的外部外壳。筒壳体306限定中心纵向壳体轴线“k”。一般来说，安置于筒壳体306的内部内，与中心壳体轴线“k”对准的是内砧座接收座314。内砧座接收座314的配置是大体上圆柱形的且限定内表面316，所述内表面不含不规律体，例如栓槽等等，其通常存在于常规圆形钉合器设备中。在实施例中，内表面316是平滑且连续的。内砧座接收座314通过从内接收座314朝外延伸且联接到筒壳体306的壁的内肋材318安装在筒壳体306内。内砧座接收座314可容纳套管针400(图2)，其延伸通过砧座接收座314且可操作地联接到手柄组合件100的可旋转推进接近器102。套管针400帮助相对于钉筒机构302安装砧座机构304。包含内砧座接收座314和肋材318的筒壳体306可由合适的聚合材料整体形成。
现参看图3和图5，推动器308至少部分地接纳在筒壳体306内。推动器308联接到可枢转触发构件104，由此使触发构件104的致动引起推动器308经历击发行程。推动器308包含相对于中心壳体轴线“k”同轴地布置的个别推动器指状物320(图5)的至少一个环形阵列，例如圆形阵列。在实施例中，推动器组合件包含围绕中心壳体轴线“k”同心地或同轴地布置的个别推动器指状物320的第一(内)圆形阵列320a、第二(中间)圆形阵列320b和第三(外)圆形阵列320c。
图6到图7说明圆形阵列320a、320b、320c的个别推动器指状物320。每个个别推动器指状物320沿着与中心壳体轴线“k”呈平行关系的中心推动器轴线“m”延伸。个别推动器指状物320各自包含远侧推动器端322，其限定用于至少部分地接纳个别钉312的凹槽324。每个凹槽324内的是推动器面326，其具有以中心推动器轴线“m”对准的伸出部328和在伸出部326的相对侧上并与其邻接的两个凹部330。凹部330延伸到推动器指状物320的外边缘332。每个推动器指状物320的伸出部326、凹部330和外边缘332配合以使个别钉312变形。
参看图8到图9，钉固持器310的配置大体上是环形的且至少部分地接纳在筒壳体306内。钉固持器310包含钉接纳开口334的至少一个环形阵列，例如圆形阵列。在实施例中，钉固持器310包含围绕中心壳体轴线“k”同心地或同轴地布置且与推动器指状物320的第一阵列320a、第二阵列320b和第三阵列320c对齐的个别开口334的第一(内)圆形阵列334a、第二(中间)圆形阵列334b和第三(外)圆形阵列334c。(图5)钉接纳开口334各自容纳个别钉312，由此呈现钉312的第一(内)圆形阵列312a、第二(中间)圆形阵列312b和第三(外)圆形阵列312c，其还与推动器指状物320的第一圆形阵列320a、第二圆形阵列320b和第三圆形阵列320c对齐。
现参看图10，将论述圆形钉阵列312的每个个别钉312。每个钉312包含钉后跨部336和从钉后跨部336悬垂的相对支腿338。钉312各自限定沿着钉312的长度延伸且与中心推动器轴线“m”平行或对准的钉轴线“f”。每个钉312的钉后跨部336限定与钉轴线“f”对准的倒置顶点或伸出部340和在倒置顶点340的相对侧上且与其邻接的两个凸部342。钉312的每个相对338支腿具有从后跨部336连续地延伸的直线段344和从直线段344延伸且相对于钉轴线“f”朝内径向悬垂的倾斜远端段346。倾斜远端段346配置成在击发行程期间促进相对支腿338的变形。
现参看图11到图13，将论述末端执行器组合件300的砧座机构304。砧座机构304包含中心砧座杆348和联接到中心砧座杆348的砧座头350。在实施例中，砧座头350可以可枢转地安装到砧座杆348。砧座杆348可包含多个相交平坦表面352，其配置成促进通过镊子器械等进行抓握接合。然而，不同于常规砧座组合件，砧座杆348不含通常用于对准砧座头的个别钉形成凹座与钉固持器的任何栓槽结构。实际上，砧座杆348完全不含原本可旋转地对准砧座头350与钉固持器310的任何结构。在实施例中，当联接组件时，砧座杆348可能能够在筒壳体306的内砧座接收座314内旋转。砧座杆348包含用于接纳套管针400(图2)的开口354，且包含配合结构，以相对于套管针400和钉筒机构302可释放地紧固砧座机构304。
砧座头350包含当砧座机构安装到筒壳体306时围绕中心壳体轴线“k”同轴地布置的至少一个连续环形钉形成凹座356，例如圆形钉形成凹座。在击发行程期间，钉接纳器凹座356与钉312的圆形阵列312a、312b、312c中的一个对齐，以用于至少部分地接纳钉312，以至少使钉312的相对支腿338变形。在实施例中，砧座头350包含相对于中心壳体轴线“k”同心地布置的第一(内)连续圆形钉形成凹座356a、第二(中间)连续圆形钉形成凹座356b和第三(外)连续圆形钉形成凹座356c(图13)。第一钉形成凹座356a、第二钉形成凹座356b和第三钉形成凹座356c与钉固持器310内的钉312的相应第一圆形阵列312a、第二圆形阵列312b和第三圆形阵列312c的相应钉312对齐。在实施例中，每个钉形成凹座356a、356b、356c包含相对倒角或凸轮表面358，以辅助将钉312的相对支腿338导引到或保持在钉形成凹座356中。
将结合用圆形钉合器器械10执行的吻合程序论述末端执行器组合件300的使用。砧座机构304定位于第一管状器官内且可利用荷包缝合线等将器官围绕砧座头350固定。安装有钉筒机构302的圆形钉合器器械10定位于第二管状器官内。通过将砧座杆348插入到内砧座接收座314内来将砧座杆348安装到筒壳体306的内砧座接收座314。在实施例中，砧座杆348的开口354还可接纳套管针400(图2)，且可以通过两个组件之间的配合结构可释放地紧固到套管针400。如上文所论述，至少部分地由于推动器指状物320的圆形阵列320a、320b、320c和连续圆形钉形成凹座356a、356b、356c，因此不存在与砧座杆348或筒壳体306相关联的转位栓槽。具体来说，砧座杆348位于内砧座接收座314内，不受旋转移动的限制。通过操纵手柄组合件100的接近器102相对于筒壳体306接近砧座头350。致动触发器104以使得推动器308经历击发行程。在推动器308的推进期间，推动器指状物320的第一圆形阵列320a、第二圆形阵列320b和第三圆形阵列320c横穿钉固持器310的对应第一阵列334a、第二阵列334b和第三阵列334c，以从钉固持器310弹射钉312的第一圆形阵列312a、第二圆形阵列312b和第三圆形阵列312c。弹射的钉312的第一阵列312a、第二阵列312b和第三阵列312c配合地接纳在第一连续钉形成凹座356a、第二连续钉形成凹座356b和第三连续钉形成凹座356c内，其中所述钉变形以与管状器官的端接合在一起。
图14到图16说明在击发行程期间钉形成凹座356内的个别钉的变形序列。如所示出，个别推动器308接合钉312的钉后跨部336与接纳在推动器面326的凹部330内的凸部342和接纳在钉312的倒置顶点340的内部内的推动器面326的伸出部328。在如图14到15所描绘进一步推进个别推动器通过击发行程后，倾斜远端段346接合钉形成凹座356并变形(例如，在与直线段344相交点处)，以形成与管状器官接合在一起的一般的“B”形状。
虽然已在图式中示出本公开的若干实施例，但是并不意图将本公开限于这些实施例，因为希望本公开具有如本领域将允许的广泛的范围且对说明书的理解也是如此。还设想以上实施例的任何组合，且所述组合在所附权利要求书的范围内。因此，上文的描述不应解释为限制性的，而仅仅是作为特定实施例的例证。本领域的技术人员将设想在本文所附的权利要求书的范围内的其它修改。

Claims (12)

1.一种用于与圆形钉合器设备一起使用的末端执行器组合件，其包括：
筒壳体，其限定中心壳体轴线；
钉固持器，其安置于所述筒壳体内，所述钉固持器包含围绕所述中心壳体轴线以至少一个圆形阵列布置的多个钉；
钉推动器，其至少部分地安置于所述筒壳体内，所述钉推动器配置成用于移动通过击发行程，以从所述钉固持器弹射所述钉；
砧座杆，其配置成用于相对于所述筒壳体联接；以及
砧座头，其包含至少一个连续圆形钉形成凹座，所述钉形成凹座与所述至少一个圆形阵列中的一个圆形阵列中的多个钉对齐，以用于在所述击发行程期间至少部分地接纳所述一个圆形阵列中的多个钉，所述钉形成凹座配置成用于至少部分地使所述钉变形。
2.根据权利要求1所述的末端执行器组合件，其中所述筒壳体包含内砧座接收座，其配置成接纳所述砧座杆以相对于所述筒壳体安装所述砧座杆。
3.根据权利要求2所述的末端执行器组合件，其中所述内砧座接收座限定圆柱形部分，其具有不含栓槽的连续内表面。
4.根据权利要求3所述的末端执行器组合件，其中所述砧座杆不含栓槽。
5.根据权利要求1所述的末端执行器组合件，其中所述钉推动器包含多个推动器指状物，每个推动器指状物配置成接合个别钉，以从所述钉固持器弹射所述个别钉，以使所述个别钉在所述钉形成凹座内变形。
6.根据权利要求5所述的末端执行器组合件，其中所述推动器指状物以对应于所述钉的所述圆形阵列的圆形阵列布置。
7.根据权利要求5所述的末端执行器组合件，其中所述钉固持器包含相对于所述中心壳体轴线同心地布置的第一组多个钉和第二组多个钉，且其中包含第一连续圆形钉形成凹座和第二连续圆形钉形成凹座的所述砧座头相对于所述中心壳体轴线同心地布置，所述第一连续圆形钉形成凹座和所述第二连续圆形钉形成凹座与相应第一组所述钉和第二组所述钉中的所述钉对齐，以用于在所述击发行程期间至少部分地接纳和变形。
8.根据权利要求7所述的末端执行器组合件，其中所述钉固持器包含相对于所述中心壳体轴线同心地布置的第三组多个钉，且其中包含第三连续圆形钉形成凹座的所述砧座头相对于所述中心壳体轴线同心地布置，且与所述第三组所述钉中的所述钉对齐，以用于在所述击发行程期间至少部分地接纳和变形。
9.根据权利要求6所述的末端执行器组合件，其中每个推动器指状物配置成沿着与所述中心壳体轴线呈平行关系的中心推动器轴线延伸。
10.根据权利要求9所述的末端执行器组合件，其中每个推动器指状物包含所述中心推动器轴线的相对侧上的两个凹部。
11.根据权利要求10所述的末端执行器组合件，其中每个钉包含钉后跨部和从所述钉后跨部悬垂的相对支腿，每个钉限定沿着所述钉的长度延伸的钉轴线，每个钉的所述钉后跨部具有在所述钉轴线的相对侧上的两个凸部，每个推动器指状物的所述凹部配置成在所述钉推动器的所述击发行程期间接合所述钉的相应凸部。
12.根据权利要求11所述的末端执行器组合件，其中所述钉的每个相对支腿具有倾斜远端段，所述倾斜远端段相对于所述钉轴线朝内径向延伸且配置成在所述击发行程期间促进所述相对支腿的变形。
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