CN110868940B - 外科砧座布置 - Google Patents
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Abstract
本发明公开了一种外科缝合砧座，所述外科缝合砧座包括砧座主体，所述砧座主体包括面向组织的表面、多个钉成形凹坑和纵向狭槽。所述纵向狭槽包括第一部分和第二部分，所述第一部分被构造成能够在其中接收击发构件的切割边缘，所述第二部分被构造成能够在其中接收所述击发构件的砧座凸轮部分。所述砧座还包括焊接到所述砧座主体的砧座帽，其中所述砧座帽包括焊接部分和非焊接部分，其中所述非焊接部分具有非焊接宽度，并且其中所述非焊接宽度小于或等于所述第二部分的宽度的约105％。
Description
背景技术
本发明涉及外科器械，并且在各种布置中，涉及被设计成缝合和切割组织的外科缝合和切割器械及与其一起使用的钉仓。
附图说明
本文所述的实施方案的各种特征连同其优点可结合如下附图根据以下描述来加以理解：
图1是外科系统的侧正视图，该外科系统包括柄部组件以及可与其一起使用的多个可互换外科工具组件；
图2是图1的可互换外科工具组件中的一者的透视图，该可互换外科工具组件可操作地联接到图1的柄部组件；
图3是图1和图2的柄部组件和可互换外科工具组件的部分的分解组装视图；
图4是图1中所描绘的可互换外科工具组件中的另一者的透视图；
图5是图4的可互换外科工具组件的局部横截面透视图；
图6是图4和图5的可互换外科工具组件的一部分的另一局部横截面视图；
图7是图4至图6的可互换外科工具组件的一部分的分解组装视图；
图7A是图7的可互换外科工具组件的弹性脊组件的一部分的放大顶视图；
图8是图4至图7的可互换外科工具组件的一部分的分解组装视图；
图9是图4至图8的可互换外科工具组件的外科端部执行器部分的横截面透视图；
图10是图9中所描绘的可互换外科工具组件的外科端部执行器部分的分解组装视图；
图11是可在图4至图10的可互换外科工具组件中采用的击发构件的透视图、侧正视图和前正视图；
图12是可在图4至图11的可互换外科工具组件中采用的砧座的透视图；
图13是图12的砧座的横截面侧正视图；
图14是图12和图13的砧座的底视图；
图15是图4的可互换外科工具组件的外科端部执行器和轴部分的一部分的横截面侧正视图，其中未用过的外科钉仓在外科端部执行器的细长通道内正确就位；
图16是图15的外科端部执行器和轴部分的横截面侧正视图，其中外科钉仓已经在钉击发行程期间被击发，并且击发构件在钉击发行程之后回缩到起始位置；
图17是图16的外科端部执行器和轴部分的另一横截面侧正视图，其中击发构件已经完全回缩到其起始位置；
图18是图15中描绘的外科端部执行器和轴部分的俯视横截面视图，其中未用过的外科钉仓与外科端部执行器的细长通道正确就位；
图19是其中安装有被击发的外科钉仓的图15的外科端部执行器的另一俯视横截面视图，示出了保持在锁定位置的击发构件；
图20是图4的可互换工具组件的砧座和细长通道的部分的局部横截面视图；
图21是图20的砧座和细长通道的部分的分解侧正视图；
图22是根据至少一个实施方案的砧座的砧座安装部分的后透视图；
图23是根据至少一个实施方案的另一个砧座的砧座安装部分的后透视图；
图24是根据至少一个实施方案的另一个砧座的砧座安装部分的后透视图；
图25是根据至少一个实施方案的砧座的透视图；
图26是图25的砧座的分解透视图；
图27是图25的砧座的横截面端视图；
图28是根据至少一个实施方案的另一个砧座的透视图；
图29是图28的砧座实施方案的分解透视图；
图30是图28的砧座的砧座主体部分的远侧端部部分的顶视图；
图31是根据至少一个实施方案的另一个砧座的砧座主体部分的远侧端部部分的顶视图；
图32是图31的砧座的横截面端部透视图；
图33是根据至少一个实施方案的砧座的横截面端透视图；
图34提供了砧座的第一实施方案与砧座的第二实施方案之间的比较；
图35是包括图34的第二砧座实施方案的端部执行器的横截面视图；
图36是图34的第一砧座实施方案和被构造成能够与第一砧座实施方案接合的击发构件的局部横截面视图；
图37是图36的击发构件的局部正视图；
图38是描绘图34的第一砧座实施方案和图36的击发构件中的应力集中的图示；
图39是描绘图36的击发构件中的应力集中的另一图示；
图40是根据至少一个实施方案的击发构件的透视图；
图41是图40的击发构件的侧正视图；
图42是图40的击发构件的前正视图；
图43是根据至少一个实施方案的击发构件的局部透视图；
图44是图43的击发构件的局部侧正视图；
图45是图43的击发构件的局部前正视图；
图46是根据至少一个实施方案的击发构件的局部透视图；
图47是图46的击发构件的局部侧正视图；
图48是图46的击发构件的局部前正视图；
图49是根据至少一个实施方案的击发构件的局部透视图；
图50是图49的击发构件的局部侧正视图；
图51是图49的击发构件的局部前正视图；
图52是根据至少一个实施方案的击发构件的局部透视图；
图53是图52的击发构件的局部侧正视图；
图54是图52的击发构件的局部前正视图；
图55是根据至少一个实施方案的击发构件的局部透视图；
图56是图55的击发构件的局部侧正视图；
图57是图55的击发构件的局部前正视图；
图58是根据至少一个实施方案的击发构件的局部透视图；
图59是图58的击发构件的局部侧正视图；
图60是图58的击发构件的局部前正视图；
图61是根据至少一个实施方案的击发构件的局部透视图；
图62是图61的击发构件的局部侧正视图；
图63是图61的击发构件的局部前正视图；
图64是根据至少一个实施方案的击发构件的局部透视图；
图65是图64的击发构件的局部侧正视图；
图66是图64的击发构件的另一局部透视图；
图67是图64的击发构件的局部前正视图；
图68是描绘推进本文所公开的击发构件通过钉击发行程所需的能量的示意图；
图69是从图43的击发构件延伸的侧向突出部的详细视图，其示意性地示出了弯曲状态下侧向突出部与砧座之间的相互作用；
图70是从图58的击发构件延伸的侧向突出部的详细视图，其示意性地示出了弯曲状态下侧向突出部与砧座之间的相互作用；
图71是从图58的击发构件延伸的侧向突出部的详细视图，其示意性地示出了另一弯曲状态下侧向突出部与砧座之间的相互作用；
图72是包括砧座主体和砧座帽的外科缝合器械的砧座的透视图；
图73是图72的砧座的分解图；
图74是包括竖直焊接表面的焊接砧座的局部横截面视图；
图75是包括水平焊接表面的焊接砧座的局部横截面视图；
图76是包括角焊接表面的焊接砧座的局部横截面视图；
图77是包括砧座主体和砧座帽的砧座的横截面视图，其中砧座主体和砧座帽彼此焊接；
图78是包括第一砧座构件和第二砧座构件的外科缝合砧座的显微照片，其中第一砧座构件和第二砧座构件彼此焊接；
图79是包括砧座主体和砧座帽的外科缝合砧座的横截面视图；
图80是表示经受两种不同载荷情况的四种不同外科缝合砧座布置的图表，包括第一情况的偏转和应力数据以及第二情况的应力数据；
图81是包括第一砧座构件和第二砧座构件的砧座的透视图，其中砧座构件包括被构造成能够增加总焊接深度的焊接构型；
图82为沿图81中的线82-82截取的在焊接之前的图81的外科缝合砧座的横截面视图；
图83为沿图81中的线83-83截取的在焊接之后的图81的外科缝合砧座的横截面视图；
图84是包括彼此焊接的第一砧座构件和第二砧座构件的外科缝合砧座的横截面视图；
图85为图84的外科缝合砧座的局部横截面视图、局部分解图；
图86是包括彼此焊接的第一砧座构件和第二砧座构件的外科缝合砧座的横截面视图，其中砧座构件包括互锁特征结构；
图87是包括彼此焊接的第一砧座构件和第二砧座构件的外科缝合砧座的横截面视图，其中砧座构件包括互锁特征结构；
图88是被示为处于打开构型的端部执行器组件的透视图；
图89是被示为处于封闭构型的图88所示的端部执行器组件的透视图；
图90是沿图88中的线90-90截取的图88的端部执行器组件的局部横截面视图；
图91是沿图88中的线91-91截取的图89的端部执行器组件的局部横截面视图；
图92是沿图88中的线92-92截取的图89的端部执行器组件的横截面视图；
图93是钉仓通道的透视图，该钉仓通道包括通道主体和焊接到其的通道帽；
图94为图93的钉仓通道的分解图；
图95是包括彼此焊接的第一通道构件和第二通道构件的钉仓通道的横截面视图；
图96是用于与外科器械一起使用的击发构件的透视图，其中击发构件包括第一钳口联接构件和第二钳口联接构件；
图97是用于与外科器械一起使用的另一个击发构件的透视图，其中击发构件包括第一钳口联接构件和第二钳口联接构件；
图98是图96的击发构件的前视图；
图99是图96的击发构件的正视图；
图100是图97的击发构件的前视图；
图101是图97的击发构件的正视图；
图102是图96的击发构件的局部正视图；
图103是图97的击发构件的局部正视图；
图104是包括图97的击发构件的缝合系统的横截面视图；
图105是包括图96的击发构件的缝合系统的横截面视图；
图106是图105的缝合系统的砧座和击发构件的局部横截面视图；
图107是图104的缝合系统的砧座和击发构件的局部横截面视图；并且
图108是图105的缝合系统的砧座的应力分析；
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 ANVIL MANUFACTURING METHODS”的美国专利申请序列号________；代理人案卷号END8165USNP/170079M；
-名称为“SURGICAL ANVIL ARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END8168USNP/170080；
-名称为“SURGICAL ANVIL ARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END8164USNP/170082；
-名称为“SURGICAL FIRING MEMBER ARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END8169USNP/170083；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END8167USNP/170085；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END8232USNP/170086；
-名称为“SURGICAL END EFFECTORS AND ANVILS”的美国专利申请序列号__________；代理人案卷号END8166USNP/170087；和
-名称为“ARTICULATION SYSTEMS FOR SURGICALINSTRUMENTS”的美国专利申请序列号__________；代理人案卷号END8171USNP/170088。
本申请的申请人拥有于2016年12月21日提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIESTHEREOF”的美国专利申请序列号15/386,185；
-名称为“ARTICULATABLE SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,230；
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS”的美国专利申请序列号15/386,221；
-名称为“SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF”的美国专利申请序列号15/386,209；
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS ANDREPLACEABLE TOOL ASSEMBLIES”的美国专利申请序列号15/386,198；
-名称为“SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR”的美国专利申请序列号15/386,240；
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,939；
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FORSHIFTING BETWEEN CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES ANDARTICULATION AND FIRING SYSTEMS”的美国专利申请序列号15/385,941；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,943；
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTIONFEATURES”的美国专利申请序列号15/385,950；
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,945；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,946；
-名称为“SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASINGA JAW OPENING DISTANCE”的美国专利申请序列号15/385,951；
-名称为“METHODS OF STAPLING TISSUE”的美国专利申请序列号15/385,953；
-名称为“FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FORSURGICAL END EFFECTORS”的美国专利申请序列号15/385,954；
-名称为“SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOPARRANGEMENTS”的美国专利申请序列号15/385,955；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,948；
-名称为“SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号15/385,956；
-名称为“SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTINGFIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT”的美国专利申请序列号15/385,958；
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,947；
-名称为“METHOD FOR RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT”的美国专利申请序列号15/385,896；
-名称为“STAPLE FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENTTYPES OF STAPLES”的美国专利申请序列号15/385,898；
-名称为“SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL”的美国专利申请序列号15/385,899；
-名称为“STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISINGWINDOWS DEFINED THEREIN”的美国专利申请序列号15/385,901；
-名称为“SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER”的美国专利申请序列号15/385,902；
-名称为“STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/ORSPENT CARTRIDGE LOCKOUT”的美国专利申请序列号15/385,904；
-名称为“FIRING ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,905；
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUTAND A FIRING ASSEMBLY LOCKOUT”的美国专利申请序列号15/385,907；
-名称为“FIRING ASSEMBLY COMPRISING A FUSE”的美国专利申请序列号15/385,908；
-名称为“FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE”的美国专利申请序列号15/385,909；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列号15/385,920；
-名称为“ANVIL ARRANGEMENTS FOR SURGICAL STAPLE/FASTENERS”的美国专利申请序列号15/385,913；
-名称为“METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPES OFSTAPLE CARTRIDGES WITH THE SAME SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/385,914；
-名称为“BILATERALLY ASYMMETRIC STAPLE FORMING POCKET PAIRS”的美国专利申请序列号15/385,893；
-名称为“CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICALINSTRUMENTS WITH SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号15/385,929；
-名称为“SURGICAL STAPLE/FASTENERS WITH INDEPENDENTLY ACTUATABLECLOSING AND FIRING SYSTEMS”的美国专利申请序列号15/385,911；
-名称为“SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES”的美国专利申请序列号15/385,927；
-名称为“STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPINGBREADTHS”的美国专利申请序列号15/385,917；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING PRIMARYSIDEWALLS AND POCKET SIDEWALLS”的美国专利申请序列号15/385,900；
-名称为“NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FORSURGICAL STAPLE/FASTENERS”的美国专利申请序列号15/385,931；
-名称为“FIRING MEMBER PIN ANGLE”的美国专利申请序列号15/385,915；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMINGSURFACE GROOVES”的美国专利申请序列号15/385,897；
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES”的美国专利申请序列号15/385,922；
-名称为“SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS”的美国专利申请序列号15/385,924；
-名称为“SURGICAL INSTRUMENTS WITH JAWS THAT ARE PIVOTABLE ABOUT AFIXED AXIS AND INCLUDE SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号15/385,912；
-名称为“ANVIL HAVING A KNIFE SLOT WIDTH”的美国专利申请序列号15/385,910；
-名称为“FIRING MEMBER PIN CONFIGURATIONS”的美国专利申请序列号15/385,906；
-名称为“STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES”的美国专利申请序列号15/386,188；
-名称为“STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAPSETTING FEATURES”的美国专利申请序列号15/386,192；
-名称为“STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES”的美国专利申请序列号15/386,206；
-名称为“DURABILITY FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIESOF SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,226；
-名称为“SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITHPOSITIVE OPENING FEATURES”的美国专利申请序列号15/386,222；
-名称为“CONNECTION PORTIONS FOR DEPOSABLE LOADING UNITS FOR SURGICALSTAPLING INSTRUMENTS”的美国专利申请序列号15/386,236；
-名称为“METHOD FOR ATTACHING A SHAFT ASSEMBLY TO A SURGICALINSTRUMENT AND,ALTERNATIVELY,TO A SURGICAL ROBOT”的美国专利申请序列号15/385,887；
-名称为“SHAFT ASSEMBLY COMPRISING A MANUALLY-OPERABLE RETRACTIONSYSTEM FOR USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号15/385,889；
-名称为“SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE ANDRETRACTABLE SYSTEMS”的美国专利申请序列号15/385,890；
-名称为“SHAFT ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO ADAPT THEOUTPUT OF A ROTARY FIRING MEMBER TO TWO DIFFERENT SYSTEMS”的美国专利申请序列号15/385,891；
-名称为“SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO ANARTICULATION STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM”的美国专利申请序列号15/385,892；
-名称为“SHAFT ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,894；
-名称为“SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATIONLOCKOUTS”的美国专利申请序列号15/385,895；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,916；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,918；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,919；
-名称为“SURGICAL STAPLE/FASTENER CARTRIDGE WITH MOVABLE CAMMINGMEMBER CONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES”的美国专利申请序列号15/385,921；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,923；
-名称为“JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OFA FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN FIRED CARTRIDGE ISINSTALLED IN THE END EFFECTOR”的美国专利申请序列号15/385,925；
-名称为“AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYINGCLOSURE MOTIONS TO JAWS OF SURGICAL INSTRUMENTS”的美国专利申请序列号15/385,926；
-名称为“PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN AMOVABLE JAW AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT”的美国专利申请序列号15/385,928；
-名称为“SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERATING OPENINGFEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS”的美国专利申请序列号15/385,930；
-名称为“ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFTARRANGEMENT”的美国专利申请序列号15/385,932；
-名称为“ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLELINKAGE DISTAL OF AN ARTICULATION LOCK”的美国专利申请序列号15/385,933；
-名称为“ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR INAN ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE SYSTEM”的美国专利申请序列号15/385,934；
-名称为“LATERALLY ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FORLOCKING AN END EFFECTOR OF A SURGICAL INSTRUMENT IN AN ARTICULATEDCONFIGURATION”的美国专利申请序列号15/385,935；和
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKEAMPLIFICATION FEATURES”的美国专利申请序列号15/385,936。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES”的美国专利申请序列号15/191,775；
-名称为“STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPEDSTAPLES”的美国专利申请序列号15/191,807；
-名称为“STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME”的美国专利申请序列号15/191,834；
-名称为“STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES”的美国专利申请序列号15/191,788；和
-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；和
-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 STAPLE/FASTENERS”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；和
-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；和
-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年二月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；和
-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；和
-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，现为美国专利申请公布2016/0367256；
-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，现为美国专利申请公布2016/0367248；
-名称为“MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,914，现为美国专利申请公布2016/0367255；
-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，现为美国专利申请公布2016/0367254；
-名称为“DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,885，现为美国专利申请公布2016/0367246；和
-名称为“PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,876，现为美国专利申请公布2016/0367245。
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 STAPLE/FASTENER”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；和
-名称为“SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING”的美国专利申请序列号14/640,780，现为美国专利申请公布2016/0256161。
本申请的申请人拥有于2015年2月27日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION”的美国专利申请序列号14/633,576，现为美国专利申请公布2016/0249919；
-名称为“SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCEPARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND”的美国专利申请序列号14/633,546，现为美国专利申请公布2016/0249915；
-名称为“SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONEOR MORE BATTERIES”的美国专利申请序列号14/633,560，现为美国专利申请公布2016/0249910；
-名称为“CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FORCHARGING A BATTERY”的美国专利申请序列号14/633,566，现为美国专利申请公布2016/0249918；
-名称为“SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TOBE SERVICED”的美国专利申请序列号14/633,555，现为美国专利申请公布2016/0249916；
-名称为“REINFORCED BATTERY FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,542，现为美国专利申请公布2016/0249908；
-名称为“POWER ADAPTER FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,548，现为美国专利申请公布2016/0249909；
-名称为“ADAPTABLE SURGICAL INSTRUMENT HANDLE”的美国专利申请序列号14/633,526，现为美国专利申请公布2016/0249945；
-名称为“MODULAR STAPLING ASSEMBLY”的美国专利申请序列号14/633,541，现为美国专利申请公布2016/0249927；和
-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；和
-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，现为美国专利号9,554,794；
-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；和
-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9,629,623；
-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；和
-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9,629,629。
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；和
-名称为“SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT”的美国专利申请序列号14/226,125，现为美国专利申请公布2015/0280384。
本申请的申请人还拥有于2014年9月5日提交并且各自全文以引用方式并入本文的以下专利申请：
-名称为“CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,103，现为美国专利申请公布2016/0066912；
-名称为“ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUECOMPRESSION”的美国专利申请序列号14/479,119，现为美国专利申请公布2016/0066914；
-名称为“MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION”的美国专利申请序列号14/478,908，现为美国专利申请公布2016/0066910；
-名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'SOUTPUT OR INTERPRETATION”的美国专利申请序列号14/478,895，现为美国专利申请公布2016/0066909；
-名称为“POLARITY OF HALL MAGNET TO DETECT MISLOADED CARTRIDGE”的美国专利申请序列号14/479,110，现为美国专利申请公布2016/0066915；
-名称为“SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION”的美国专利申请序列号14/479,098，现为美国专利申请公布2016/0066911；
-名称为“MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,115，现为美国专利申请公布2016/0066916；和
-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9,649,110；
-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 STAPLE/FASTENER”的美国专利申请序列号14/248,588，现为美国专利申请公布2014/0309666；
-名称为“TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/248,591，现为美国专利申请公布2014/0305991；
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENTFEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS”的美国专利申请序列号14/248,584，现为美国专利申请公布2014/0305994；
-名称为“POWERED SURGICAL STAPLE/FASTENER”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；和
-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；和
-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”一个或多个特征结构的系统、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结构。
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，钉仓被定位在待缝合的组织的第一侧上，并且砧座被定位在组织的第二侧上。砧座朝向钉仓运动以将组织压缩并夹持抵靠平台。然后，可移除地储存在仓体中的钉可被部署到组织中。仓体包括限定于其中的钉腔，其中钉可移除地储存在钉腔中。钉腔被布置成六纵向排。三排钉腔被定位在纵向狭槽的第一侧上且三排钉腔被定位在纵向狭槽的第二侧上。钉腔和钉的其他布置也是可能的。
钉由仓体中的钉驱动装置支撑。驱动装置能够在第一或非击发位置和第二或击发位置之间运动，以从钉仓射出钉。驱动装置通过保持器保留在仓体中，所述保持器围绕仓体的底部延伸并且包括被构造成能够抓持仓体以及将保持器保持至仓体的弹性构件。驱动装置能够通过滑动件在其非击发位置与其击发位置之间运动。滑动件能够在与近侧端部相邻的近侧位置和与远侧端部相邻的远侧位置之间运动。滑动件包括多个斜坡表面，该斜坡表面被构造成能够朝向砧座在驱动装置下方滑动以及提升驱动装置，并且钉在驱动装置上受到支撑。
除上述以外，滑动件还可通过击发构件朝远侧运动。击发构件被构造成能够接触滑动件并朝向远侧端部推动滑动件。限定于仓体中的纵向狭槽被构造成能够接收击发构件。砧座还包括被构造成能够接收击发构件的狭槽。击发构件还包括接合第一钳口的第一凸轮和接合第二钳口的第二凸轮。在击发构件朝远侧推进时，第一凸轮和第二凸轮可控制钉仓的平台和砧座之间的距离或组织间隙。击发构件还包括被构造成能够切入在钉仓和砧座中间捕集的组织的刀。希望刀定位成至少部分接近斜坡表面，使得钉先于刀被射出。
图1示出了可用于执行多种不同外科手术的马达驱动外科系统10。如该图中可见，外科系统10的一个示例包括四个可互换外科工具组件100、200、300和1000，这四个可互换外科工具组件各自适于可互换地与柄部组件500一起使用。每个可互换外科工具组件100、200、300和1000可以被设计成用于与一种或多种特定外科手术的执行结合使用。在另一外科系统实施方案中，可互换外科工具组件可以有效地与机器人控制的外科系统或自动外科系统的工具驱动组件一起使用。例如，本文所公开的外科工具组件可与各种机器人系统、器械、部件和方法诸如但不限于名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLESTAPLE DEPLOYMENT ARRANGEMENTS”的美国专利9,072,535中公开的那些一起使用，该专利申请据此全文以引用方式并入本文。
图2示出了可操作地联接到柄部组件500的可互换外科工具组件100的一种形式。图3示出了可互换外科工具组件100到柄部组件500的附接。图3中描绘的附接布置和方法也可以与可互换外科工具组件100、200、300和1000中任一者到机器人系统的工具驱动部分或工具驱动器壳体的附接结合使用。柄部组件500可包括柄部壳体502，该柄部壳体包括可由临床医生抓持和操纵的手枪式握持部504。如将在下文简要讨论的，柄部组件500可操作地支撑多个驱动系统，该多个驱动系统被构造成能够生成各种控制运动并将各种控制运动施加到可操作地附接到其上的可互换外科工具组件100、200、300和/或1000的对应部分。
现在参见图3，柄部组件500还可以包括可操作地支撑多个驱动系统的框架506。例如，框架506可以可操作地支撑通常被标记为510的“第一”或闭合驱动系统，该“第一”或闭合驱动系统可以用于将闭合和打开运动施加到可操作地附接或联接到柄部组件500的可互换外科工具组件100、200、300和/或1000。在至少一种形式中，闭合驱动系统510可包括被框架506枢转地支撑的闭合触发器512形式的致动器。此类构造使得闭合触发器512将能够由临床医生操纵，使得当临床医生握持柄部组件500的手枪式握持部504时，闭合触发器512可从启动或“未致动”位置枢转到“致动”位置并且更具体地枢转到完全压缩或完全致动位置。在各种形式中，闭合驱动系统510还包括闭合连杆组件514，该闭合连杆组件可枢转地联接到闭合触发器512或以其他方式可操作地与该闭合触发器连接。如下面将进一步详细讨论的，闭合连杆组件514包括横向附接销516，其有利于附接到外科工具组件上的对应驱动系统。为了致动闭合驱动系统，临床医生朝向手枪式握持部504压下闭合触发器512。如以引用方式全文并入本文中的名称为“SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM”的美国专利申请序列号14/226,142，现为美国专利申请公布2015/0272575中进一步详细描述的，当临床医生完全按下闭合触发器512以达到完全闭合冲程时，闭合驱动系统被构造成能够将闭合触发器512锁定到完全按下或完全致动的位置中。当临床医生期望将闭合触发器512解锁以允许闭合触发器512被偏压到未致动位置时，临床医生简单地启动使闭合触发器能够返回到未致动位置的闭合释放按钮组件518。闭合释放按钮518还可以被构造成能够与各种传感器进行交互，这些传感器与柄部组件500中的微控制器520进行通信，以用于跟踪闭合触发器512的位置。关于闭合释放按钮组件518的构造和操作的进一步的细节可见于美国专利申请公布2015/0272575中。
在至少一种形式中，柄部组件500和框架506可以可操作地支撑在本文中被称为击发驱动系统530的另一个驱动系统，该驱动系统被构造成能够将击发动作施加到附接到其上的可互换外科工具组件的对应部分。如在美国专利申请公布2015/0272575中详细地描述的，击发驱动系统530可以采用位于柄部组件500的手枪式握持部504中的电动马达(图1至图3中未示出)。在各种形式中，马达可以为例如具有约25,000RPM的最大速度的DC有刷驱动马达。在其它构造中，马达可包括无刷马达、无绳马达、同步马达、步进马达、或任何其它合适的电动马达。马达可以由功率源522供电，在一种形式中，该功率源可以包括可移除电源组。电源组可将多个锂离子(“LI”)或其他合适的电池支撑在其中。可以使用可串联连接的多个电池作为外科系统10的功率源522。之外，功率源522可以是可替换的和/或可再充电的。
电动马达被构造成能够根据施加到马达的电压的极性在远侧和近侧方向上轴向地驱动可纵向移动的驱动构件540。例如，当马达在一个旋转方向上被驱动时，可纵向移动的驱动构件540将在远侧方向“DD”上被轴向地驱动。当马达在相反的旋转方向上被驱动时，可纵向移动的驱动构件540将在近侧方向“PD”上被轴向地驱动。柄部组件500可以包括开关513，该开关可以被构造成能够使由功率源522施加到电动马达的极性反转或以其他方式控制马达。柄部组件500还可包括被构造成能够检测驱动构件540的位置和/或驱动构件540移动的方向的一个或多个传感器。马达的致动可以由被枢转地支撑在柄部组件500上的击发触发器532(图1)控制。击发触发器532可在未致动位置和致动位置之间枢转。击发触发器532可以由弹簧或其他偏压布置偏压到未致动位置中，使得当临床医生释放击发触发器532时，该击发触发器532可以由弹簧或偏压布置枢转或以其他方式返回到未致动位置。在至少一种形式中，击发触发器532可如上所述被定位在闭合触发器512的“外侧”。如美国专利申请公布2015/0272575中所讨论的，柄部组件500可配备有击发触发器安全按钮，以防止击发触发器532的无意致动。当闭合触发器512处于未致动位置时，安全按钮被容纳在柄部组件500中，在此情况下，临床医生不能容易地接近安全按钮并使安全按钮在防止击发触发器532的致动的安全位置和其中可击发击发触发器532的击发位置之间运动。当临床医生压下闭合触发器512时，安全按钮和击发触发器532向下枢转，其中随后其可由临床医生操纵。
在至少一种形式中，可纵向移动的驱动构件540可以具有形成在其上的齿条，以用于与和马达相接的对应驱动齿轮布置啮合接合。关于那些特征的进一步的细节可见于美国专利申请公布2015/0272575。在至少一种形式中，柄部组件500还包括可手动致动的“救助”组件，该组件被构造成能够使得临床医生能够在马达被禁用的情况下手动地使可纵向移动的驱动构件540回缩。救助组件可包括杠杆或救助柄部组件，其在可释放门550下方储存在柄部组件500内。杠杆被构造成能够被手动枢转成与驱动构件540中的齿棘轮接合。因此，临床医生可通过使用救助柄部组件手动地回缩驱动构件540，以使驱动构件5400在近侧方向“PD”上做棘轮运动。名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITHMANUALLY RETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117(现为美国专利8,608,045，该专利的全部公开内容据此以引用方式并入本文)公开了救助布置以及也可与本文所公开的各种外科工具组件一起采用的救助布置。
现在转向图2，可互换外科工具组件100包括外科端部执行器110，该外科端部执行器包括第一钳口和第二钳口。在一个布置中，第一钳口包括细长通道112，该细长通道被构造成能够在其中可操作地支撑外科钉仓116。第二钳口包括相对于细长通道112被枢转地支撑的砧座114。可互换外科工具组件100还包括可锁定关节运动接头120，该可锁定关节运动接头可以被构造成能够相对于轴轴线SA将端部执行器110可释放地保持在期望位置。有关端部执行器110、关节运动接头120和关节运动锁的各种构造和操作的细节阐述于名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK”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，该美国专利据此全文以引用方式并入本文)中。如在图2和图3中可进一步看出，可互换外科工具组件100可以包括近侧外壳或喷嘴130和闭合管组件140，该闭合管组件可以用于闭合和/或打开端部执行器110的砧座114。如美国专利申请公布2015/0272575中所讨论的，闭合管组件140可移动地支撑在脊145上，该脊支撑关节运动驱动器布置147，其被构造成能够将关节运动动作施加到外科端部执行器110。脊145被构造成能够：第一，可滑动地支撑其中的击发杆170；第二，可滑动地支撑围绕脊145延伸的闭合管组件140。在各种情况下，脊145包括可旋转地支撑在底座150中的近侧端部。参见图3。在一个布置中，例如，脊145的近侧端部附接到脊轴承，该脊轴承被构造成能够被支撑在底座150内。这种布置有利于脊145到底座150的可旋转附接，使得脊145可以选择性地相对于底座150围绕轴轴线SA旋转。
仍参见图3，可互换外科工具组件100包括闭合梭动件160，该闭合梭动件被可滑动地支撑在底座150内，使得闭合梭动件160可以相对于该底座150轴向地移动。如图3中可见，闭合梭动件160包括被构造成能够附接到附接销516的一对朝近侧突出的钩162，该附接销附接到柄部组件500中的闭合连杆组件514。闭合管组件140的近侧闭合管段146可旋转地联接到闭合梭动件160。因此，当钩162钩在销516上时，闭合触发器512的致动将使得闭合梭动件160轴向地移动，并最终使得脊145上的闭合管组件140轴向地移动。闭合弹簧还可以轴颈连接在闭合管组件140上并且用于在近侧方向“PD”上偏压闭合管组件140，这可以在轴组件100可操作地联接到柄部组件500时用于使闭合触发器512枢转到未致动位置中。在使用中，闭合管组件140朝远侧(方向DD)平移，以响应于闭合触发器512的致动而闭合砧座114。闭合管组件140包括远侧闭合管段142，该远侧闭合管段枢转地销接到近侧闭合管段146的远侧端部。远侧闭合管段142被构造成能够随近侧闭合管段146相对于外科端部执行器110轴向地移动。当远侧闭合管段142的远侧端部撞击砧座114上的近侧表面或凸部115时，砧座114枢转成闭合。有关砧座114的闭合的进一步细节可以在上述美国专利申请公布2014/0263541中找到，并且将在下文中进一步详细讨论。如在美国专利申请公布2014/0263541中同样详细描述的，通过朝近侧平移远侧闭合管段142来打开砧座114。远侧闭合管段142其中具有限定向下延伸的返回突片的马蹄形孔143，该返回突片与形成在砧座114的近侧端部上的砧座突片117配合以使砧座114枢转回到打开位置。在完全打开位置，闭合管组件140处于其最近侧或未致动位置。
同样如上所述，可互换外科工具组件100还包括击发杆170，该击发杆被支撑以便在轴脊145内轴向地行进。击发杆170包括中间击发轴部分，该中间击发轴部分被构造成能够附接到远侧切割部分或刀杆，该远侧切割部分或刀杆被构造用于轴向地行进通过外科端部执行器110。在至少一个布置中，可互换外科工具组件100包括离合器组件，该离合器组件可以被构造成能够选择性地且可释放地将关节运动驱动器联接到击发杆170。有关离合器组件特征和操作的更多细节可以在美国专利申请公布2014/0263541中找到。如在美国专利申请公布2014/0263541中所讨论的，当离合器组件处于其接合位置时，击发杆170的远侧移动可以使关节运动驱动器布置147朝远侧移动，并且相应地，击发杆170的近侧移动可以使关节运动驱动器布置147朝近侧移动。当离合器组件处于其脱离位置时，击发杆170的移动未被传送至关节运动驱动器布置147，并且因此，击发杆170可以独立于关节运动驱动器布置147移动。可互换外科工具组件100还可以包括滑环组件，该滑环组件可以被构造成能够将电力传导到端部执行器110和/或从该端部执行器传导电力并且/或者将信号传送到端部执行器110和/或从该端部执行器传送信号。有关滑环组件的更多细节可以在美国专利申请公布2014/0263541中找到。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，全文以引用方式并入。名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利9,345,481同样据此全文以引入方式并入。
仍参见图3，底座150其上形成有一个或更多锥形附接部分152，该锥形附接部分适于被接收在框架506的远侧端部内形成的对应燕尾形狭槽507内。每个燕尾形狭槽507可以是锥形，或换句话讲，可以略成V形，从而以坐置方式将锥形附接部分152接收在其中。如可在图3中进一步所见的，轴附接耳状物172形成在击发轴170的近侧端部上。当可互换外科工具组件100联接到柄部组件500时，轴附接耳状物172被接收在形成在可纵向移动驱动构件540的远侧端部中的击发轴附接支架542中。可互换外科工具组件100还采用闩锁系统180，以用于将轴组件100可释放地锁定到柄部组件500的框架506。在至少一种形式中，例如，闩锁系统180包括可移动地联接到底座150的锁定构件或锁定轭182。锁定轭182包括两个朝近侧突出的锁定耳状物184，这两个锁定耳状物被构造用于与框架506的远侧附接凸缘中的对应锁定棘爪或凹槽509可释放地接合。在各种形式中，锁定轭182由弹簧或偏压构件在近侧方向上偏压。锁定轭182的致动可以通过可滑动地安装在安装到底座150的闩锁致动器组件上的闩锁按钮186来实现。闩锁按钮186可相对于锁定轭182沿近侧方向偏压。如将在下文进一步详细讨论的，可以通过在远侧方向DD上偏压闩锁按钮186来使锁定轭182移动到解锁位置，这也使锁定轭182枢转成不再与框架506的远侧附接凸缘保持接合。当锁定轭182与框架506的远侧附接凸缘“保持接合”时，锁定凸耳184保持安置在框架506的远侧端部中的对应锁定棘爪或凹槽509内。有关闩锁系统的更多细节可见于美国专利申请公布2014/0263541中。
为了将可互换外科工具组件100附接到柄部组件500A，临床医生可将可互换外科工具组件100的底座150定位在框架506的远侧端部上方或附近，使得底座150上形成的锥形附接部分152与框架506中的燕尾形狭槽507对准。然后临床医生可将外科工具组件100沿垂直于轴轴线SA的安装轴线IA运动，以使锥形附接部分152安置成与框架506的远侧端部中的对应燕尾形接纳狭槽507可操作地接合。这样做时，击发轴170上的轴附接耳状物172同样将安置在可纵向移动的驱动构件540中的支架542中，并且闭合连接件514上的销516的部分将安置在闭合梭动件160中的对应钩162中。如本文所用，术语“可操作地接合”在两个部件的背景下是指这两个部件彼此充分地接合，使得一旦向其施加致动运动，这些部件便执行其预期行动、功能和/或程序。
现在返回到图1，外科系统10包括四个可互换外科工具组件100、200、300和1000，这四个可互换外科工具组件各自可以有效地与同一柄部组件500一起使用以执行不同的外科手术。可互换外科工具组件100的示例性形式的构造在上文中简要地进行了讨论，并且在美国专利申请公布2014/0263541中进行了进一步的详细讨论。有关可互换外科工具组件200和300的各种细节可以在已以引用方式并入本文的各种美国专利申请中找到。有关可互换外科工具组件1000的各种细节将在下文中进一步详细地讨论。
如图1所示，外科工具组件100、200、300和1000中的每个包括一对钳口，其中至少一个钳口可移动以在两个钳口之间捕获、操纵和/或夹持组织。在通过柄部组件或者外科工具组件可操作地联接到的机器人或自动外科系统对其施加闭合动作和打开动作时，可移动钳口在打开位置和闭合位置之间移动。此外，所示的可互换外科工具组件中的每一者包括击发构件，该击发构件被构造成能够切割组织并从钉仓击发钉，该钉仓响应于由柄部组件或机器人系统对其施加的击发动作而被支撑在一个钳口中。每个外科工具组件可以被独特地设计成执行特定手术，例如，用于在身体的特定区域内切割和紧固特定类型和厚度的组织。柄部组件500或机器人系统中的闭合、击发和关节运动控制系统可以被构造成能够根据外科工具组件中采用的闭合、击发和关节运动系统构型的类型来生成轴向控制动作和/或旋转控制动作。在一种布置中，当柄部组件或机器人系统中的闭合控制系统被完全致动时，闭合系统控制部件中的一个从未致动位置轴向移动至其完全致动位置。在本文中可以将闭合管组件在从其未致动位置移动到其完全致动位置时移动的轴向距离称为其“闭合行程长度”。类似地，当柄部组件或机器人系统中的击发系统被完全致动时，击发系统控制部件中的一个从其未致动位置轴向移动至其完全致动或击发位置。在本文中可以将可纵向移动驱动构件在从其未致动位置移动到其完全击发位置时移动的轴向距离称为其“击发行程长度”。对于采用可关节运动端部执行器布置的那些外科工具组件，柄部组件或机器人系统可以采用轴向地移动通过“关节运动驱动行程长度”的关节运动控制部件。在许多情况下，闭合行程长度、击发行程长度和关节运动驱动行程长度对于特定柄部组件或机器人系统是固定的。因此，外科工具组件中的每一者必须能够通过其所有行程长度中的每一者来适应闭合、击发和/或关节运动部件的控制移动，而不会对外科工具部件施加过度的应力，因为这可能导致外科工具部件损坏。
现在转向图4至图10，可互换外科工具组件1000包括外科端部执行器1100，该外科端部执行器包括被构造成能够可操作地支撑其中的钉仓1110的细长通道1102。端部执行器1100还可包括相对于细长通道1102被可枢转地支撑的砧座1130。可互换外科工具组件1000还可以包括关节运动接头1200和关节运动锁1210(图5以及图8至图10)，该关节运动锁可以被构造成能够将端部执行器1100相对于轴轴线SA可释放地保持在期望关节运动的位置。关于关节运动锁1210的构造与操作的细节可见于名称为“ARTICULATABLE SURGICALINSTRUMENT COMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803,086中，现为美国专利申请公布2014/0263541，其全部公开内容据此以引用方式并入本文。关于该关节运动锁的其他细节也可以在2016年2月9日提交的名称为“SURGICAL INSTRUMENTARTICULATION MECHANISM WITH SLOTTED SECONDARY CONSTRAINT”的美国专利申请序列号15/019,196中找到，其全部公开内容据此以引用方式并入本文。从图7中可见，可互换外科工具组件1000还可以包括由喷嘴部分1302、1304以及致动器轮部分1306组成的近侧壳体或喷嘴1300，其被构造成能够例如通过按扣、凸耳和/或螺钉来联接到已组装喷嘴部分1302、1304。可互换外科工具组件1000还可包括闭合管组件1400，该闭合管组件可用于闭合和/或打开端部执行器1100的砧座1130，如将在下面进一步详细讨论的。现在主要参见图8和图9，可互换外科工具组件1000可以包括脊组件1500，该脊组件可以被构造成能够支撑关节运动锁1210。脊组件1500包括将在下文进一步详细描述的“弹性”脊或框架构件1510。弹性脊构件1510的远侧端部部分1522附接到远侧框架段1560，该远侧框架段可操作地支撑其中的关节运动锁1210。如图7和图8中可见，脊组件1500被构造成能够：第一，可滑动地支撑其中的击发构件组件1600；第二，可滑动地支撑围绕脊组件1500延伸的闭合管组件1400。脊组件1500还可以被构造成能够可滑动地支撑近侧关节运动驱动器1700。
如图10所示，远侧框架段1560通过端部执行器安装组件1230枢转地联接到细长通道1102。例如，在一个布置中，远侧框架段1560的远侧端部1562具有形成在其上的枢轴销1564。枢轴销1564适于枢转地接收在形成于端部执行器安装组件1230的枢轴基础部分1232中的枢轴孔1234内。端部执行器安装组件1230通过弹簧销1108或其他合适的构件附接到细长通道1102的近侧端部1103。枢轴销1564限定横向于轴轴线SA的关节运动轴线B-B。参见图4。这种布置便于端部执行器1100相对于脊组件1500围绕关节运动轴线B-B枢转行进(即，关节运动)。
仍参见图10，关节运动驱动器1700具有远侧端部1702，该远侧端部被构造成能够可操作地接合关节运动锁1210。关节运动锁1210包括关节运动框架1212，该关节运动框架适于可操作地接合端部执行器安装组件1230的枢轴基础部分1232上的驱动销1238。此外，交叉连接件1237可以连接到驱动销1238和关节运动框架1212，以辅助端部执行器1100的关节运动。如上所述，有关关节运动锁1210和关节运动框架1212的操作的更多细节可见于美国专利申请序列号13/803,086中，现为美国专利申请公布2014/0263541。有关端部执行器安装组件和交叉连接件的其他细节可以在于2016年2月9日提交的名称为“SURGICALINSTRUMENTS WITH CLOSURE STROKE REDUCTION ARRANGEMENTS”的美国专利申请序列号15/019,245中找到，该美国专利的全部公开内容据此以引用方式并入本文。在各种情况下，弹性脊构件1510包括可旋转地支撑在底座1800中的近侧端部1514。在一个布置中，例如，弹性脊构件1510的近侧端部1514具有在其上形成的用于螺纹附接到被构造成能够支撑在底座1800内的脊轴承的螺纹1516。此类布置有利于弹性脊构件1510到底座1800的可旋转附接，使得脊组件1500可以选择性地相对于底座1800围绕轴轴线SA旋转。
主要参见图7，可互换外科工具组件1000包括闭合梭动件1420，该闭合梭动件可滑动地支撑在该底座1800内，使得闭合梭动件1420可以相对于底座1800周向移动。在一种形式中，闭合梭动件1420包括一对朝近侧突出的钩1421，这对朝近侧突出的钩被构造成能够附接到附接销516，该附接销附接到柄部组件500的闭合连杆组件514，如上文所讨论的。近侧闭合管段1410的近侧端部1412可旋转地联接到闭合梭动件1420。例如，将U形连接器1424插入到近侧闭合管段1410的近侧端部1412中的环形狭槽1414中，并使其保持在闭合梭动件1420中的竖直狭槽1422内。参见图7。此类布置用于将近侧闭合管段1410附接到闭合梭动件1420，以与闭合梭动件一起轴向地行进，同时使得闭合管组件1400能够相对于闭合梭动件1420围绕轴轴线SA旋转。闭合弹簧轴颈连接在近侧闭合管段1410的近侧端部1412上，并且用于在近侧方向PD上偏压闭合管组件1400，这可以用于在可互换外科工具组件1000可操作地联接到柄部组件500时，使柄部组件500(图3)上的闭合触发器512枢转到未致动位置。
如上所述，例示的可互换外科工具组件1000包括关节运动接头1200。然而，其他可互换外科工具组件可能无法进行关节运动。如图10中可见，上柄脚1415和下柄脚1416从近侧闭合管段1410的远侧端部朝远侧突出，以可移动地联接到闭合管组件1400的端部执行器闭合套管或远侧闭合管段1430。如图10中可见，远侧闭合管段1430包括从其近侧端部朝近侧突出的上柄脚1434和下柄脚1436。上部双枢轴连接件1220包括近侧销和远侧销，该近侧销和远侧销分别接合近侧闭合管段1410和远侧闭合管段1430的上柄脚1415、1434中的对应孔。类似地，下部双枢轴连接件1222包括近侧销和远侧销，该近侧销和远侧销分别接合近侧闭合管段1410和远侧闭合管段1430的下柄脚1416和1436中的对应孔。如下文将进一步详细讨论的，闭合管组件1400的远侧和近侧轴向平移将使得砧座1130相对于细长通道1102闭合和打开。
如上所述，可互换外科工具组件1000还包括击发构件组件1600，该击发构件组件被支撑以便在脊组件1500内轴向行进。击发构件组件1600包括被构造成能够附接到远侧切割部分或刀杆1610的中间击发轴部分1602。击发构件组件1600在本文中也可被称为“第二轴”和/或“第二轴组件”。如图7至图10中可见，中间击发轴部分1602可以在其远侧端部中包括纵向狭槽1604，该纵向狭槽可以被构造成能够接收刀杆1610的近侧端部上的突片。纵向狭槽1604和刀杆1610的近侧端部可以被设定尺寸并被构造成能够使得其允许它们之间的相对移动并且可以包括滑动接头1612。滑动接头1612可以允许击发构件组件1600的中间击发轴部分1602移动，以在不移动或至少基本上不移动刀杆1610的情况下，使端部执行器1100做关节运动。一旦端部执行器1100已合适地取向，则中间击发轴部分1602可以朝远侧推进，直到纵向狭槽1604的近侧侧壁与刀杆1610上的突片发生接触，以便推进刀杆1610并击发定位在细长通道1102内的钉仓1110。如图8和图9中可进一步所见，弹性脊构件1520其中具有细长的开口或窗口1525，以便于将中间击发轴部分1602组装和插入到弹性脊构件1520中。一旦中间击发轴部分1602已经插入到弹性脊构件1520中，则顶部框架段1527可以与该弹性脊构件接合，以封闭其中的中间击发轴部分1602和刀杆1610。有关击发构件组件1600的操作的进一步描述可以在美国专利申请序列号13/803,086(现为美国专利申请公布2014/0263541)中找到。
除上述之外，可互换工具组件1000可以包括离合器组件1620，该离合器组件可以被构造成能够选择性地且可释放地将关节运动驱动器1700联接到击发构件组件1600。在一种形式中，离合器组件1620包括围绕击发构件组件1600定位的锁定衬圈或锁定套管1622，其中锁定套管1622可以在接合位置与脱离位置之间旋转，在接合位置处，锁定套管1622将关节运动驱动器1700联接到击发构件组件1600，在脱离位置处，关节运动驱动器1700未可操作地联接到击发构件组件1600。当锁定套筒1622处于其接合位置时，击发构件组件1600的远侧运动可使关节运动驱动器1700朝远侧运动，相应地，击发构件组件1600的近侧运动可使关节运动驱动器1700朝近侧运动。当锁定套筒1622处于其脱离位置时，击发构件组件1600的运动不传递到关节运动驱动器1700，因此，击发构件组件1600可独立于关节运动驱动器1700运动。在各种情况下，当关节运动驱动器1700未由击发构件组件1600朝近侧方向或远侧方向运动时，关节运动驱动器1700可由关节运动锁1210保持在适当的位置。
主要参见图7，锁定套管1622可以包括圆柱形或至少基本上呈圆柱形的主体，该主体包括限定于其中并且被构造成能够接收击发构件组件1600的纵向孔1624。锁定套管1622可以包括沿直径相对的面朝内锁定突出部1626、1628以及面朝外锁定构件1629。锁定突出部1626、1628可以被构造成能够选择性地与击发构件组件1600的中间击发轴部分1602接合。更具体地讲，当锁定套管1622处于其接合位置时，锁定突出部1626、1628定位在限定于中间击发轴部分1602中的驱动凹口1605内，使得远侧推力和/或近侧拉力可以从击发构件组件1600传递到锁定套管1622。当锁定套管1622处于其接合位置时，第二锁定构件1629被接收在关节运动驱动器1700中限定的驱动凹口1704内，使得施加到锁定套管1622的远侧推力和/或近侧拉力可以传递到关节运动驱动器1700。实际上，当锁定套管1622处于其接合位置时，击发构件组件1600、锁定套管1622和关节运动驱动器1700将一起移动。另一方面，当锁定套管1622处于其脱离位置时，锁定突出部1626、1628可以不定位在击发构件组件1600的中间击发轴部分1602的驱动凹口1605内；并且因此，远侧推力和/或近侧拉力可以不从击发构件组件1600传递到锁定套管1622。相应地，远侧推力和/或近侧拉力可以不传递到关节运动驱动器1700。在此类情况下，击发构件组件1600可相对于锁定套筒1622和近侧关节运动驱动器1700向近侧和/或向远侧滑动。离合组件1620还包括与锁定套管1622接合的切换筒1630。有关切换筒和锁定套管1622的操作的其他细节可以在美国专利申请序列号13/803,086(现为美国专利申请公布2014/0263541和序列号15/019,196)中找到。切换筒1630还可以包括限定于其中的至少部分地沿周边的开口1632、1634，该开口可以接收从喷嘴半块1302、1304延伸的周边安装架1305，并且允许切换筒1630和近侧喷嘴1300之间的相对旋转但不是相对平移。参见图6。喷嘴1300到其中安装架到达其在切换筒1630中的相应狭槽1632、1634的端部的点的旋转将使得切换筒1630围绕轴轴线SA旋转。切换筒1630的旋转最终将导致锁定套筒1622在其接合位置和脱离位置之间移动。因此，实质上，喷嘴1300可以用于以在以下专利申请中更详细地描述的各种方式使关节运动驱动系统与击发驱动系统可操作地接合和脱离接合：美国专利申请序列号13/803,086，现为美国专利申请公布2014/0263541；以及美国专利申请序列号15/019,196；这些专利各自全文以引用方式并入本文。
在例示的布置中，切换筒1630包括L形狭槽1636，该L形狭槽延伸到切换筒1630中的远侧开口1637中。远侧开口1637接收移动板1638的横向销1639。在一个示例中，移动板1638被接收在设置在锁定套筒1622中的纵向狭槽内，以在锁定套筒1622与关节运动驱动器1700接合时便于该锁定套筒轴向地移动。关于移动板和移动鼓布置的操作的进一步细节可见于2015年九月28日提交的名称为“SURGICAL STAPLING INSTRUMENT WITH SHAFTRELEASE,POWERED FIRING AND POWERED ARTICULATION”的美国专利申请序列号14/868,718(现在为美国专利公布2017/0086823)中，该申请的整个公开内容据此以引入方式并入本文。
同样如图7和图8所示，可互换工具组件1000可以包括滑环组件1640，该滑环组件可以被构造成能够将电力传导至端部执行器1100和/或从该端部执行器传导电力，并且/或者将信号传送至端部执行器1100和/或从该端部执行器将信号传送回例如柄部组件中的微控制器或机器人系统控制器。有关滑环组件1640和相关联的连接器的其他细节可以在美国专利申请序列号13/803,086(现为美国专利申请公布2014/0263541)和美国专利申请序列号15/019,196(这两个专利申请各自全文以引用方式并入本文)以及名称为“STAPLECARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利申请序列号13/800,067(现为美国专利申请公布2014/0263552，该美国专利据此全文以引用方式并入本文)中找到。同样如在已经以引用方式并入本文的前述专利申请中进一步详细描述的，可互换外科工具组件1000还可以包括被构造成能够检测切换筒1630的位置的至少一个传感器。
再次参见图7，底座1800包括在其上形成的一个或多个锥形附接部分1802，该锥形附接部分适于被接收在对应燕尾形狭槽507内，该燕尾形狭槽形成在柄部组件500的框架506的远侧端部部分内，如上文所讨论的。如可在图7中进一步所见，轴附接耳状物1605形成在中间击发轴1602的近侧端部上。如将在下面进一步详细讨论的，当可互换外科工具组件1000联接到柄部组件500时，轴附接凸耳1605被接收在击发轴附接支架542中，该击发轴附接支架形成在纵向驱动构件540的远侧端部中。参见图3。
各种可互换外科工具组件采用闩锁系统1810，以用于将可互换外科工具组件1000可移除地联接到柄部组件500的框架506。在至少一种形式中，如图7中可见的，闩锁系统1810包括可移动地联接到底座1800的锁定构件或锁定轭1812。锁定轭1812为U形，有两个隔开并向下延伸的腿部1814。腿部1814各自具有在其上形成的能够容纳在形成于底座1800中的相应孔1816中的枢轴凸耳。此类构造有利于将锁定轭1812枢转附接到底座1800。锁定轭1812可包括两个向近侧突出的锁定凸耳1818，这两个锁定凸耳被构造成能够与柄部组件500的框架506的远侧端部中的对应锁定棘爪或凹槽509可释放地接合。参见图3。在各种形式中，锁定轭1812被弹簧或偏压构件1819沿近侧方向偏压。锁定轭1812的致动可通过可滑动地安装在闩锁致动器组件1822上的闩锁按钮1820来实现，该闩锁致动器组件安装到底盘1800。闩锁按钮1820可相对于锁定轭1812沿近侧方向偏压。锁定轭1812可通过沿远侧方向偏置闩锁按钮1820而运动到解锁位置，这也使锁定轭1812枢转成不再与框架506的远侧端部保持接合。当锁定轭1812与框架506的远侧端部保持接合时，锁定凸耳1818保持坐置在框架506的远侧端部中对应的锁定止动器或凹槽509内。
在所示的布置中，锁定轭1812包括至少一个且优选两个锁定钩1824，这些锁定钩适于接触在闭合梭动件1420上形成的对应锁定凸耳部分1426。当闭合梭动件1420处于未致动位置时，锁定轭1812可沿远侧方向枢转以将可互换外科工具组件1000从柄部组件500解锁。当处于该位置时，锁定钩1824不接触闭合梭动件1420上的锁定凸耳部分1426。然而，当闭合梭动件1420移动到致动位置时，防止锁定轭1812枢转到解锁位置。换句话讲，如果临床医生试图将锁定轭1812枢转到解锁位置，或者例如，锁定轭1812不经意地以原本可能引起其朝远侧枢转的方式受到碰撞或发生接触，则锁定轭1812上的锁定钩1824将接触闭合梭动件1420上的锁定凸耳1426，并且防止锁定轭1812运动到解锁位置。
仍然参见图10，刀杆1610可以包括层压梁结构，该层压梁结构包括至少两个梁层。这些梁层可以包括例如不锈钢带，这些不锈钢带在其近侧端部和/或沿着带长度的其他位置处通过例如焊接和/或销而互连。在另选的实施方案中，这些带的远侧端部不连接在一起，以允许层压体或带在端部执行器进行关节运动时相对于彼此地展开。此类布置允许刀杆1610足够柔性以适应端部执行器的关节运动。各种层压刀杆布置在美国专利申请序列号15/019,245中公开。同样如图10中可见，中间支撑构件1614用于在刀杆1610弯曲以适应外科端部执行器1100的关节运动时为该刀杆提供侧向支撑。关于中间支撑构件和另选刀杆支撑布置的进一步细节在美国专利申请序列号15/019,245中公开。同样如图10中所见，击发构件或刀构件1620附接到刀杆1610的远侧端部。
图11示出了可与可互换工具组件1000一起使用的击发构件1660的一种形式。击发构件1660包括主体部分1662，该主体部分包括朝近侧延伸的连接器构件1663，该连接器构件被构造成能够被接收在刀杆1610的远侧端部中的对应成形的连接器开口1614中。参见图10。例如，连接器1663可以通过摩擦、焊接和/或合适的粘合剂保持在连接器开口1614内。参考图15至图17，主体部分1662突出穿过细长通道1102中的细长狭槽1104，并终止于在主体部分1662的每一侧上侧向延伸的脚部构件1664中。当通过外科钉仓1110朝远侧驱动击发构件1660时，脚部构件1664跨置在细长通道1102中定位在外科钉仓1110下方的通路内。如图11中可见，击发构件1660还可以包括侧向突出的中央突片、销或保持器特征结构1680。当通过外科钉仓1110朝远侧驱动击发构件1660时，中央保持器特征结构1680跨置在细长通道1102的内表面1106上。击发构件1660的主体部分1662还包括设置在朝远侧突出的肩部1665与朝远侧突出的顶部鼻状部分1670之间的组织切割刃或特征结构1666。如可在图11中进一步所见，击发构件1660还可以包括两个侧向延伸的顶部突片、销或砧座接合特征结构1665。参见图13和图14。当朝远侧驱动击发构件1660时，主体1662的顶部部分延伸穿过居中设置的砧座狭槽1138(图14)，并且顶部砧座接合特征结构1672跨置在形成于砧座狭槽1134的每一侧上的对应凸部1136上。
返回到图10，击发构件1660被构造成能够与滑动件1120可操作地连接，该滑动件支撑在外科钉仓1110的主体1111内。滑动件1120在外科钉仓体1111内从邻近仓体1111的近侧端部1112的近侧端部起始位置可滑动地移位到邻近仓体1111的远侧端部1113的结束位置。仓体1111可操作地在其中支撑多个钉驱动器(图10中未示出)，所述钉驱动器在居中设置的狭槽1114的每侧上成排对准。居中设置的狭槽1114使击发构件1660能够穿过其中并切割夹持在砧座1130和钉仓1110之间的组织。驱动器与对应的凹坑1115相关联，该凹坑穿过仓体的上平台表面。钉驱动器中的每一个在其上支撑一个或多个外科钉或紧固件。滑动件1120包括多个倾斜的或楔形凸轮1122，其中每个凸轮1122对应于位于狭槽1114的侧面上的紧固件或驱动器的特定线。在例示的示例中，一个凸轮1122与一排“双”驱动器对准，这排“双”驱动器各自在其上支撑两个钉或紧固件，另一个凸轮1122与在狭槽1114的同一侧上的另一排“单个”驱动器对准，这排“单个”驱动器各自在其上支撑单个外科钉或紧固件。因此，在例示的示例中，当外科钉仓1110被“击发”时，组织切割线的每个侧面上将存在三排钉。然而，也可以采用其他仓和驱动器构型来击发其他钉/紧固件布置。滑动件1120具有中央主体部分1124，该中央主体部分被构造成能够由击发构件1660的肩部1665接合。当击发构件1660被击发或朝远侧驱动时，击发构件1660也朝远侧驱动滑动件1120。当击发构件1660朝远侧移动通过仓1110时，组织切割特征结构1666切割夹持在砧座组件1130与仓1110之间的组织，并且还有滑动件1120将仓中的驱动器向上驱动，该驱动器驱动对应的钉或紧固件以与砧座组件1130形成接触。
在击发构件包括组织切割表面的实施方案中，理想的是细长轴组件可按这样的方式进行构造：除非未用完的钉仓被正确地支撑在外科端部执行器1100的细长通道1102中，否则防止击发构件意外推进。例如，如果根本不存在钉仓并且击发构件向远侧被推进穿过端部执行器，则组织将被切断，但是没有被钉住。类似地，如果在端部执行器中存在用完的钉仓(即，其中至少一些钉已经从其中击发的钉仓)，并且击发构件被推进，则组织将被切断，但可能不完全被钉住。应当理解，此类情况可能导致外科规程期间不期望的结果。名称为“SURGICAL STAPLING INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT”的美国专利6,988,649，名称为“SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOUT MECHANISMFOR PREVENTION OF FIRING”的美国专利7,044,352，名称为“SURGICAL STAPLINGINSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING”的美国专利7,380,695，以及名称为“SURGICAL STAPLING INSTRUMENTS WITH LOCKOUTARRANGEMENTS FOR PREVENTING FIRING SYSTEM ACTUATION WHEN A CARTRIDGE IS SPENTOR MISSING”的美国专利申请序列号14/742,933各自公开了各种击发构件闭锁布置。这些美国专利中的每一者均以引用方式全文并入本文中。
“未击发”、“未用过”、“新鲜”或“新”的紧固件仓1110表示紧固件仓1110使其所有紧固件处于其“准备好击发”位置。新的仓1110安置于细长通道1102内并且可以由仓体上的按扣特征结构保持在其中，该按扣特征结构被构造成能够保持接合细长通道1102的对应部分。图15和图18示出了外科端部执行器1100的一部分，其中新的或未击发的外科钉仓1110安置在其中。如在图15和图18中可见，滑动件1120处于其起始位置。为了防止击发系统被激活，并且更精确地讲，为了防止击发构件1660朝远侧驱动穿过端部执行器1110，除非未击发的或新的外科钉仓已正确地安置在细长通道1102内，否则可互换外科工具组件1000采用通常命名为1650的击发构件锁定系统。
现在参见图10以及图15至图19，击发构件闭锁系统1650包括可移动的锁定构件1652，该可移动的锁定构件被构造成能够在新外科钉仓1110未正确地安置在细长通道1102内时保持接合击发构件1660。更具体地，锁定构件1652包括至少一个侧向移动的锁定部分1654，该部分被构造成能够在滑动件1120在其起始位置不存在于仓1110内时保持接合击发构件1660的对应部分。实际上，锁定构件1652采用两个侧向移动的锁定部分1654，其各自接合击发构件1660的侧向延伸部分。可以使用其他闭锁布置。
锁定构件1652包括大致呈U形的弹簧构件，其中每个可侧向移动的腿部或锁定部分1654从中心弹簧部分1653延伸并且被构造成能够在图18和图19中由“L”表示的侧向方向上移动。应当理解，术语“侧向”是指横向于轴轴线SA(图2)的方向。例如，弹簧或锁定构件1652可由高强度弹簧钢和/或类似材料制成。中心弹簧部分1653安置在端部执行器安装组件1230中的狭槽1236内。参见图10。如图15至图17中可见，可侧向移动的腿部或锁定部分1654中的每一者均具有远侧端部1656，该远侧端部其中具有锁定窗口1658。当锁定构件1652处于锁定位置时，击发构件1660的每个侧面上的中心保持器特征结构1680延伸到在锁定部分1654中限定的对应锁定窗口1658中，以保持防止击发构件被朝远侧或轴向地推进。
将参考图15至图19说明击发构件闭锁系统的操作。图15和图18示出了外科端部执行器1100的一部分，其中新的未击发仓1110正确地安装在该部分中。如图15和图18中可见，滑动件1120包括解锁特征结构1126，该特征结构与可侧向移动的锁定部分1654中的每一者对应。解锁特征结构1126设置在每个中央楔形凸轮1122上或从该每个中央楔形凸轮朝近侧延伸。在另选的布置中，解锁特征结构1126可包括对应的楔形凸轮1122的近侧突出部分。从图18中可以看出，当滑动件1120处于其起始位置时，解锁特征结构1124接合对应锁定部分1654并使其在横向于轴轴线SA(图2)的方向上侧向偏置。当锁定部分1654处于此类解锁取向时，中央保持器特征结构1680不与锁定窗口1658保持接合。在此类情况下中，击发构件1660可以向远侧或轴向推进(击发)。然而，当仓不存在于细长通道1102中或者滑动件1120已经移出其起始位置(这意味着仓部分地或完全地被击发)时，锁定部分1654侧向弹性地保持与击发构件1660接合。在此类情况下，参考图19，击发构件1660无法向远侧移动。
图16和图17示出了在如上所讨论的那样执行钉击发行程之后，击发构件1660回缩到其起始位置或未击发位置。图16描绘了保持特征结构1680与其对应的锁定窗口1658的初始重新接合。图17示出了当击发构件1660已完全回缩到其起始位置时处于其锁定位置的保持特征结构。为了在锁定部分1654与朝近侧移动的保持特征结构1680接触时辅助锁定该部分的侧向移位，保持特征结构1680中的每一者均可以设置有面向近侧的、侧向渐缩的端部部分。当不存在新的未击发仓时或者当存在新的未击发仓但其未正确地安置在细长通道1102中时，此类闭锁系统防止击发构件1660被致动。另外，闭锁系统可以防止临床医生在用过或部分击发的仓已经在无意中正确地安置在细长通道内的情况下朝远侧推进击发构件。闭锁系统1650可以提供的另一个优点是，与需要移动击发构件以与钉仓中的对应狭槽/通路对准和不对准的其他击发构件闭锁布置不同，击发构件1660在处于锁定和解锁位置时保持与仓通路对准。锁定部分1654被设计成可侧向移动以与击发构件的对应侧面接合和脱离接合。一个或多个锁定部分的此类侧向移动可使其与在竖直方向上移动以接合和脱离击发构件的部分的其他锁定布置区分开。
返回到图13和图14，砧座1130包括细长砧座主体部分1132和近侧砧座安装部分1150。细长砧座主体部分1132包括外表面1134，该外表面限定两个向下延伸的组织止动构件1136，这两个组织止动构件邻近近侧砧座安装部分1150。细长砧座主体部分1132还包括下侧1135，该下侧限定细长砧座狭槽1138。在图14中所示的例示布置中，砧座狭槽1138居中设置在下侧1135中。下侧1135包括定位在砧座狭槽1138的每侧上的三排1140、1141、1142的钉成形凹坑1143、1144和1145。与砧座狭槽1138的每一侧相邻的是两个细长的砧座通路1146。每个通路1146具有近侧斜坡部分1148。参见图13。当朝远侧推进击发构件1660时，顶部砧座接合特征结构1632最初进入对应的近侧斜坡部分1148并且进入对应的细长砧座通路1146。
转到图12和图13，砧座狭槽1138以及近侧斜坡部分1148延伸到砧座安装部分1150中。换句话讲，砧座狭槽1138将砧座安装部分1150划分为或分成两个砧座附接凸缘1151。砧座附接凸缘1151在其近侧端部处通过连接桥接件1153联接在一起。连接桥接件1153支撑砧座附接凸缘1151，并且可以用于使砧座安装部分1150比在其近侧端部处未连接在一起的其他砧座布置的安装部分更具刚性。同样如图12和图14中可见，砧座狭槽1138具有较宽部分1139，以在击发构件1660处于其近侧未击发位置时容纳击发构件1660的包括顶部砧座接合特征结构1632的顶部部分。
如图13以及图20至图24中可见，砧座附接凸缘1151中的每一者均包括横向安装孔1156，该横向安装孔被构造成能够接收穿过其中的枢轴销1158(图10和图20)。砧座安装部分1150通过枢轴销1158枢转地销接到细长通道1102的近侧端部1103，该枢轴销延伸穿过细长通道1102的近侧端部1103中的安装孔1107以及砧座安装部分1150中的安装孔1156。这种布置将砧座1130枢转地附连到细长通道1102s，使得砧座1130可绕横向于轴轴线SA的固定砧座轴线A-A枢转。参见图5。砧座安装部分1150还包括凸轮表面1152，该凸轮表面从集中的击发构件停放区域1154延伸到砧座主体部分1132的外表面1134。
除上述之外，砧座1130可通过轴向推进和缩回远侧闭合管段1430而在打开位置和闭合位置之间移动，如下文进一步讨论的。远侧闭合管段1430的远侧端部部分具有形成在其上的内侧凸轮表面，该内侧凸轮表面被构造成能够接合凸轮表面1552或形成在砧座安装部分1150上的凸轮表面并且移动砧座1130。图22示出了凸轮表面1152a，该凸轮表面形成在砧座安装部分1150上以便与例如在远侧闭合管段1430上的内侧凸轮表面1444建立单个接触路径1155a。图23示出了凸轮表面1152b，该凸轮表面相对于远侧闭合管段上的内侧凸轮表面1444构造，以在砧座安装部分1150上的凸轮表面1152与远侧闭合管段1430上的内侧凸轮表面1444之间建立两个分开的且不同的弓形接触路径1155b。除本文所讨论的其他潜在优点之外，这种布置可以将闭合力从远侧闭合管段1430更好地分布到砧座1130。图24示出了凸轮表面1152c，该凸轮表面相对于远侧闭合管段1430的内侧凸轮表面1444构造，以在砧座安装部分1150和远侧闭合管段1430上的凸轮表面之间建立三个不同的接触区1155c和1155d。区1155c、1155d在远侧闭合管段1430与砧座安装部分1150上的一个或多个凸轮表面之间建立更大的凸轮接触区域，并且可以将闭合力更好地分布到砧座1130。
当远侧闭合管段1430凸轮接合砧座1130的砧座安装部分1150时，砧座1130围绕砧座轴线AA(图5)枢转，这使得细长砧座主体部分1132的端部1133的远侧端部朝向外科钉仓1110和细长通道1102的远侧端部1105枢转地移动。随着砧座主体部分1132开始枢转，该砧座主体部分接触待切割和缝合的组织，该组织现在定位在细长砧座主体部分1132的下侧1135与外科钉仓1110的平台1116之间。随着砧座主体部分1132被压缩到组织上，砧座1130可能例如遭遇相当大的阻力和/或弯曲负载。随着远侧闭合管1430继续其远侧推进，这些阻力得到克服。然而，根据这些阻力的大小以及其对砧座主体部分1132的施加点，这些阻力可能倾向于使得砧座1130的一部分弯曲远离钉仓1110，这通常可能是非期望的。例如，此类弯曲可能导致击发构件1660与砧座1130内的通路1148、1146未对准。在弯曲过度的情况下，这种弯曲可以显著增大击发器械所需的击发力的量(即，穿过组织将击发构件1660从其起始位置驱动到终止位置)。这种过大击发力可导致例如损坏端部执行器、击发构件、刀杆和/或击发驱动系统部件。因此，将砧座构造成抵抗这种挠曲可以是有利的。
图25至图27示出了砧座1130'，其包括改善砧座主体的刚度及其对在闭合和/或击发过程期间可能产生的弯曲力的抵抗力的特征结构。除本文所讨论的差异之外，砧座1130'在构造上可以与上文所述的砧座1130相同。如在图25至图27中可见，砧座1130’具有细长砧座主体1132’，该细长砧座主体具有上主体部分1165和与其附接的砧座帽1170。砧座帽1170的形状大致为矩形并且具有外帽周边1172，但砧座帽1170可具有任何合适的形状。砧座帽1170的周边1172被构造成能够插入形成在上部主体部分1165中的对应成形开口1137中，并且能够被定位抵靠形成于其中的轴向延伸的内侧凸部部分1139。参见图27。内侧凸部部分1139被构造成能够支撑砧座帽1170的对应长边1177。在另选的实施方案中，砧座帽1170可以穿过砧座主体1132'的远侧端部1133中的开口滑动到内侧凸部1139上。在又一个实施方案中，不提供内侧凸部部分。砧座主体1132'和砧座帽1170可以由便于焊接的合适金属制成。第一焊接部1178可以围绕砧座帽1170的整个帽周边1172延伸，或者它可以仅沿砧座帽1170的长边1177定位并且不沿其远侧端部1173和/或其近侧端部1175定位。第一焊接部1178可以是连续的，或者其可以是不连续的或间断的。在第一焊接部1178是不连续或间断的那些实施方案中，焊接部段可以沿砧座帽1170的长边1177均匀分布，更靠近长边1177的远侧端部更密集地间隔开，和/或更靠近长边1177的近侧端部更密集地间隔开。在某些布置中，焊接部段可以在砧座帽1170的长边1177的中心区域中更密集地间隔开。
图28至图30示出了砧座帽1170'，该砧座帽被构造成能够与砧座主体1132'机械性互锁并且能够焊接到上部主体部分1165。在该实施方案中，多个保持结构1182限定在上部主体部分1165的壁1180中，该壁限定开口1137。如在该上下文中所使用的，术语“机械性互锁”意指，无论细长砧座主体的取向如何，砧座帽将保持附连到细长砧座主体，并且不需要任何附加的保持或紧固，诸如焊接和/或粘合剂。尽管可以使用任何合适的布置，保持结构1182可以从开口壁1180向内突出到开口1137中。保持结构1182可以整体地形成在壁1180中或以其他方式附接到其上。保持结构1182被设计成当该砧座帽1170'安装在开口1137中以将砧座帽1170'摩擦地保持在其中时摩擦接合砧座帽1170'的对应部分。保持结构1182向内突出到开口1137中，并且被构造成能够被摩擦接收在形成在砧座帽1170'的外周边1172'中的对应成形接合区域1184内。保持结构1182仅与砧座帽1170'的长边1177'对应，并且未设置在壁1180中与砧座帽1170'的远侧端部1173或近侧端部1175对应的部分中。在另选的布置中，保持结构1182也可以设置在壁1180中与砧座帽1170'以及其长边1177'的远侧端部1173和近侧端部1175对应的部分中。在另外的布置中，保持结构1182可以仅设置在壁1180中与砧座帽1170'的远侧端部1173和近侧端部1175中的一者或两者对应的部分中。在另外的布置中，保持结构1182可以设置在壁1180中与长边1177'对应并且仅与砧座盖1170'的近侧端部1173和远侧端部1175中的一者对应的部分中。还应当理解，所有前述实施方案中的保持突出部可以替代地形成在砧座帽上，其中接合区域形成在细长砧座主体中。
在图28至图30中所示的实施方案中，保持结构1182沿砧座帽1170'的壁部分1180等距间隔开或均匀分布。在另选的实施方案中，保持结构1182更靠近长边1177'的远侧端部则可以更密集地间隔开，或者更靠近长边1177'的近侧端部则可以更密集地间隔开。换句话讲，邻近远侧端部、邻近近侧端部或者邻近远侧端部和近侧端部两者的那些保持结构之间的间隔可以小于定位在砧座盖1170'的中心部分中的结构之间的间隔。在另外的布置中，保持结构1182可以在砧座帽1170'的长边1177'的中心区域中更密集地间隔开。在一些另选的实施方案中，对应成形的接合区域1184可以不设置在外周边1172'中或者可以不设置在砧座帽1170'的外周边1172'的一部分中。在其他实施方案中，保持结构以及对应成形的接合区域可以设置有不同的形状和尺寸。在另选的布置中，保持结构可以相对于接合区域来确定尺寸，使得保持结构与接合区域之间不存在过盈配合。在此类布置中，砧座帽可以例如通过焊接和/或粘合剂保持在适当位置。
在所示的示例中，焊接部1178'围绕砧座帽1170'的整个周边1172'延伸。替代地，焊接部1178'沿着砧座帽1170'的长边1177'而不是其远侧端部1173和/或近侧端部1175定位。焊接部1178'可以是连续的，或者其可以是不连续的或间断的。在焊接部1178'是不连续或间断的那些实施方案中，焊接部段可以沿砧座盖1170'的长边1177'均匀分布，或者焊接部段更靠近长边1177'的远侧端部则可以更密集地间隔开，或更靠近长边1177'的近侧端部则可以更密集地间隔开。在另外的布置中，焊接部段可以在砧座帽1170'的长边1177'的中心区域中更密集地间隔开。
图31和图32示出了其上附接有砧座帽1170”的另一个砧座布置1130”。砧座帽1170”的形状大致为矩形，并且具有外帽周边1172”；然而，砧座帽1170”可包括任何合适的构型。外帽周边1172”被构造成能够插入到砧座主体1132”的上部主体部分1165中的对应成形的开口1137”中，并且能够被接收在形成于其中的轴向延伸的内侧凸部部分1139”和1190”上。参见图32。凸部部分1139”和1190”被构造成能够支撑砧座帽1170”的对应长边1177”。在另选的实施方案中，砧座帽1170”穿过砧座主体1132'的远侧端部1133”中的开口滑动到内侧凸部1139”和1190”上。砧座主体1132”和砧座帽1170”可以由便于焊接的金属材料制成。第一焊接部1178”可以围绕砧座帽1170”的整个周边1172”延伸，或者它可以仅沿砧座帽1170”的长边1177”定位并且不沿其远侧端部1173”和/或其近侧端部定位。焊接部1178”可以是连续的，或者其可以是不连续的或间断的。应当理解，与具有笔直周边侧的实施方案(诸如，图26中所示的砧座盖)相比，由于砧座盖1170”具有不规则形状周边，连续焊接部实施方案具有更大的焊接部表面积。在焊接部1178”是不连续或间断的那些实施方案中，焊接部段可以沿砧座盖1170”的长边1177”均匀分布，或者焊接部段更靠近长边1177”的远侧端部则可以更密集地间隔开，或更靠近长边1177”的近侧端部则可以更密集地间隔开。在另外的布置中，焊接部段可以在砧座帽1170”的长边1177”的中心区域中更密集地间隔开。
仍参见图31和图32，砧座盖1170”可以通过多个第二离散“深”焊接部1192”附加地焊接到砧座主体1132”。例如，每个焊接部1192”可以置于穿过砧座盖1170”设置的对应孔或开口1194”的底部处，使得可以沿砧座主体1132”中在凸部1190”和1139”之间的部分形成离散的焊接部1192”。参见图32。焊接部1192”可以沿砧座盖1170”的长边1177”均匀分布，或者焊接部1192”更靠近长边1177”的远侧端部则可以更密集地间隔开，或更靠近长边1177”的近侧端部则可以更密集地间隔开。在另外的布置中，焊接部1192”可以在砧座帽1170”的长边1177”的中心区域中更密集地间隔开。
图33示出了另一个砧座帽1170”'，该砧座帽被构造成能够与砧座主体1132”'机械性互锁并且能够焊接到上部主体部分1165。在该实施方案中，沿砧座帽1170”'的每个长边1177”'采用榫舌嵌入凹槽布置。具体地讲，侧向延伸的连续或间断突片1195”'从砧座盖1170”'的每个长边1177”'突出。每个突片1195”与形成在砧座主体1132”'中的轴向狭槽1197”'对应。砧座帽1170”'从砧座主体1132”'的远侧端部中的开口滑入，以将砧座帽“机械地”附连到砧座主体1132”'。突片1195”'和狭槽1197”'可以相对于彼此来确定尺寸，以在它们之间建立滑动摩擦配合。另外，砧座帽1170”'可以焊接到砧座主体1132”'。砧座主体1132”'和砧座帽1170”'可以由便于焊接的金属制成。焊接部1178”'可以围绕砧座帽1170”'的整个周边1172”'延伸，或者它可以仅沿砧座帽1170”'的长边1177”'定位。焊接部1178”'可以是连续的，或者其可以是不连续的或间断的。在焊接部1178”'是不连续或间断的那些实施方案中，焊接部段可以沿砧座盖1170”'的长边1177”'均匀分布，或者焊接部段更靠近长边1177”'的远侧端部则可以更密集地间隔开，或更靠近长边1177”'的近侧端部则可以更密集地间隔开。在另外的布置中，焊接部段可以在砧座帽1170”'的长边1177”'的中心区域中更密集地间隔开。
本文所述的具有砧座帽的砧座实施方案可以提供几种优点。例如，一个优点可以使砧座和击发构件组装过程更容易。也就是说，当砧座附接到细长通道时，击发构件可以穿过砧座主体中的开口来安装。另一个优点是，上盖可以改善砧座的刚度以及其对夹持组织时可能遭遇的上述弯曲力的抵抗力。通过抵抗此类弯曲，可以减小击发构件1660正常遭遇到的摩擦力。因此，还可以减少将击发构件从其在外科钉仓中的起始位置驱动到终止位置所需的击发力的量。
图34提供了对两个砧座的并列比较。图34的右半部分中描绘了端部执行器2000的第一砧座2030的一部分，并且图34的左半部分中描绘了端部执行器2000'的第二砧座2030'的一部分。砧座2030包括第一纵向排的成形凹坑2032a、第二纵向排的成形凹坑2032b、及第三纵向排的成形凹坑2032c。砧座2030还包括纵向狭槽2033，该纵向狭槽被构造成能够例如在推进击发构件通过钉击发行程时接收击发构件诸如击发构件2040。第一纵向排的成形凹坑2032a定位在纵向狭槽2033和第二纵向排的成形凹坑2032b的中间，并且第二纵向排的成形凹坑2032b定位在第一纵向排的成形凹坑2032a和第三纵向排的成形凹坑2032c的中间。因此，第一纵向排的成形凹坑2032a包括内排，第三纵向排的成形凹坑2032c包括外排，并且第二纵向排的成形凹坑2032b包括中排。
类似于上文，砧座2030'包括第一纵向排的成形凹坑2032a、第二纵向排的成形凹坑2032b、及第三纵向排的成形凹坑2032c。砧座2030'还包括纵向狭槽2033'，该纵向狭槽被构造成能够例如在推进击发构件通过钉击发行程时接收击发构件诸如击发构件2040'。第一纵向排的成形凹坑2032a定位在纵向狭槽2033'和第二纵向排的成形凹坑2032b的中间，并且第二纵向排的成形凹坑2032b定位在第一纵向排的成形凹坑2032a和第三纵向排的成形凹坑2032c的中间。因此，第一纵向排的成形凹坑2032a包括内排，第三纵向排的成形凹坑2032c包括外排，并且第二纵向排的成形凹坑2032b包括中排。
砧座2030包括平坦或至少基本上平坦的组织接合表面2031。成形凹坑2032a、2032b和2032c限定在平坦表面2031中。平坦表面2031其中未限定有台阶；然而，设想了其中砧座2030可以包括阶梯式组织接合表面的实施方案。例如，砧座2030'包括阶梯式组织接合表面2031'。在该实施方案中，成形凹坑2032a和2032b限定在下台阶中，并且成形凹坑2032c限定在上台阶中。
击发构件2040'包括包含切割部分2041的联接构件2042'。例如，切割部分2041被构造和布置成切入捕获在砧座2030'和钉仓2010(图35)之间的组织。击发构件2040'被构造成能够在钉击发行程期间朝远侧推动具有倾斜表面的滑动件。倾斜表面被构造成能够提升钉仓2010内的钉驱动器以抵靠砧座2030'形成钉2020并从钉仓2010射出钉2020。联接构件2042'包括从其侧向延伸的突出部或凸轮2043'，该突出部或凸轮被构造成能够在钉击发行程期间接合砧座2030'。参见图37，突出部2043'由从联接构件2042'延伸的纵向细长肩部构成。在其他实施方案中，突出部2043'包括延伸穿过联接构件2042'的筒销。在任何情况下，突出部2043'具有平坦的侧面或端部2047'。
纵向狭槽2033'包括从中心部分2033c'侧向延伸的侧向部分2033l'，该侧向部分被构造成能够接收突出部2043'。如图34所示，纵向狭槽2033'的侧向部分2033l'具有呈矩形或至少基本上呈矩形的构型，该构型具有尖角。狭槽2033'的每个侧向部分2033l'包括纵向凸轮表面2035'，该纵向凸轮表面被构造成能够在钉击发行程期间与突出部2043'接合。每个纵向凸轮表面2035'限定在凸部2037'的上侧上，该凸部沿狭槽2033'纵向延伸。每个纵向凸部2037'包括梁，该梁包括附接到砧座2030'的主体部分的固定端以及被构造成能够相对于固定端移动的自由端。因此，每个纵向凸部2037'可以包括悬臂梁。
联接构件2042'还包括脚部或凸轮2044(图35)，该脚部或凸轮被构造成能够在钉击发行程期间接合钉仓2010或支撑钉仓2010的钳口。此外，突出部2043'和脚部2044配合以使砧座2030'和钉仓2010相对于彼此定位。当砧座2030'可相对于钉仓2010移动时，联接构件2042'可以将砧座2030'相对于钉仓2010凸轮传动到合适位置。当钉仓2010或支撑钉仓2010的钳口可相对于砧座2030'移动时，联接构件2042'可以将钉仓2010相对于砧座2030'凸轮传动到合适位置。
除上述之外，击发构件2040包括包含切割部分2041的联接构件2042。切割部分2041被构造和布置成切入捕获在砧座2030和钉仓2010(图35)之间的组织。击发构件2040被构造成能够在钉击发行程期间朝远侧推动具有倾斜表面的滑动件。倾斜表面被构造成能够提升钉仓2010内的钉驱动器以抵靠砧座2030成形钉2020并从钉仓2010射出钉2020。联接构件2042包括从其侧向延伸的突出部或凸轮2043，该突出部或凸轮被构造成能够在钉击发行程期间接合砧座2030。突出部2043具有弯曲或圆化的侧面或端部2047。突出部2043的侧向端部2047完全弯曲或完全圆化。每个侧向端部2047包括在突出部2043的顶表面与突出部2043的底表面之间延伸的弓形轮廓。在其他实施方案中，突出部2043的侧向端部2047仅部分地弯曲。
纵向狭槽2033包括从中心部分2033c侧向延伸的侧向部分2033l，该侧向部分被构造成能够接收突出部2043。狭槽2033的每个侧向部分2033l包括纵向凸轮表面2035，该纵向凸轮表面被构造成能够在钉击发行程期间与突出部2043接合。每个纵向凸轮表面2035限定在凸部2037的上侧上，该凸部沿狭槽2033纵向延伸。每个纵向凸部2037包括梁，该梁包括附接到砧座2030的主体部分的固定端以及被构造成能够相对于固定端移动的自由端。因此，每个纵向凸部2037可以包括悬臂梁。如图34所示，纵向狭槽2033的侧向部分包括弯曲或圆化的轮廓，该轮廓与突出部2043的弯曲端部2047匹配或至少基本匹配。
联接构件2042还包括脚部或凸轮2044(图35)，该脚部或凸轮被构造成能够在钉击发行程期间接合钉仓2010或支撑钉仓2010的钳口。此外，突出部2043和脚部2044配合以使砧座2030和钉仓2010相对于彼此定位。当砧座2030可相对于钉仓2010移动时，联接构件2042可以将砧座2030相对于钉仓2010凸轮传动到合适位置。当钉仓2010或支撑钉仓2010的钳口可相对于砧座2030移动时，联接构件2042可以将钉仓2010相对于砧座2030凸轮传动到合适位置。
再次参见图34，纵向狭槽2033'的侧向部分2033l'从砧座2030'的中心线CL延伸距离2034'。侧向部分2033l'在砧座2030'中的成形凹坑2032a的上方或后方延伸。如图34所示，侧向部分2033l'的侧向端部与成形凹坑2032a的外边缘对准。设想了其中例如侧向部分2033l'侧向延伸超过成形凹坑2032a的其他实施方案。也就是说，参见图36，砧座2030'的凸部2037'很长，并且在某些情况下，凸部2037'在负载下可以显著地偏转。在一些情况下，凸部2037'可以向下偏转，使得限定在突出部2043'的底部上的驱动表面2045'的大部分不与凸轮表面2035'接触。在这种情况下，突出部2043'和凸轮表面2035'之间的接触可以减小为一个点，诸如点2047'。在一些情况下，突出部2043'与凸轮表面2035'之间的接触可以减小为纵向延伸的线，当从端部执行器的远侧端部观察时，该纵向延伸的线看起来可以是一个点，如图36所示。
此外，再次参见图34，突出部2043'在砧座2030'中的成形凹坑2032a上方或后方延伸。突出部2043'的侧向端部在成形凹坑2032a的纵向中心线2062a上方延伸。设想了其中突出部2043'的侧向端部与成形凹坑2032a的纵向中心线2062a对准的其他实施方案。设想了其中突出部2043'的侧向端部不延伸到成形凹坑2032a的纵向中心线2062a的某些实施方案。在任何情况下，再次参见图36，突出部2043'可以向上偏转(尤其是当突出部2043'较长时)，使得突出部2043'的驱动表面2045'的大部分不与凸轮表面2035'接触。这种情况可能进一步加剧上文结合凸部2037'所讨论的情况。也就是说，例如，当突出部2043'延伸到成形凹坑2032a的外边缘或延伸超出该外边缘时，突出部2043'能够更好地控制在成形凹坑2032a和/或成形凹坑2032b和2032c中发生的钉成形过程。
除上述之外，凸部2037'和突出部2043'可以以使得在击发构件2040'和砧座2030'之间流动的负载施加在凸部2037'的内端处的方式偏转。如图36所示，接触点2048'定位在凸部2037'的内端处或附近。凸部2037'和突出部2043'的偏转与悬臂梁的偏转相同或类似。如读者应当理解的，当在悬臂梁的端部处施加负载时，悬臂梁的偏转与梁长度的立方成比例。在任何情况下，当凸部2037'和/或突出部2043'偏转时，凸部2037'与突出部2043'之间可以形成间隙。凸部2037'和突出部2043'的部分之间的这种间隙意味着，在它们之间流动的力将流过非常小的区域，这从而将增大凸部2037'和突出部2043'所经受的应力和应变。这种相互作用由图38和图39中的应力上升部或应力集中部2039'和2049'表示，其中应力上升部2039'存在于凸部2037'中，并且应力上升部2049'存在于突出部2043'与联接构件2042'之间的互连部处。可以存在其他应力上升部或集中部，但如下文所讨论的，期望减少或消除此类应力上升部。
再次参见图34和图35，纵向狭槽2033的侧向部分2033l各自从砧座2030的中心线CL延伸距离2034。距离2034比距离2034'短。尽管如此，侧向部分2033l在砧座2030中的成形凹坑2032a的上方或后方延伸。如图34所示，侧向部分2033l的侧向端部不与成形凹坑2032a的外边缘对准。此外，侧向部分2033l的侧向端部不延伸超出成形凹坑2032a的外边缘。然而，侧向部分2033l在成形凹坑2032a的纵向中心线2062a上方延伸。除上述之外，凸部2037比凸部2037'短。因此，针对施加到其上的给定力，凸部2037将比凸部2037'经历更小的偏转、应力和应变。
设想了其中狭槽2033的侧向部分2033l不延伸到成形凹坑2032a的纵向中心线2062a的其他实施方案。在某些实施方案中，侧向部分2033l不在成形凹坑2032a上方侧向延伸或不与该成形凹坑重叠。除上述之外，此类较短的侧向部分2033l可以减小凸部2037中的偏转、应力和应变。由于凸部2037的偏转减小，限定在突出部2043的底部上的驱动表面2045可以与凸部2037的凸轮表面2035保持接触。在这种情况下，与突出部2043'和凸轮表面2035'之间的接触区域相比，突出部2043和凸轮表面2035之间的接触区域可以增大。
除上述之外，与具有恒定横截面厚度的凸部2037'不同，凸部2037的横截面厚度不是恒定的。凸部2037具有逐渐减小的横截面厚度，其中每个凸部2037的基部比其内端更宽，这要归因于侧向狭槽部分2033l的圆化侧向端部。这种构型可以用于加强或强化凸部2037，并且相比于凸部2037'，减小凸部2037的偏转、应力和应变。在至少一种情况下，凸部2037的一部分是锥形的，而凸部2037的另一部分具有恒定的横截面厚度。在至少一种其他情况下，整个凸部2037可以是锥形的，使得无一处的横截面厚度是恒定的。
此外，再次参见图34和图35，突出部2043在砧座2030中的成形凹坑2032a上方或后方延伸。突出部2043的侧向端部不在成形凹坑2032a的纵向中心线2062a上方延伸。设想了其中突出部2043的侧向端部与成形凹坑2032a的纵向中心线2062a对准的其他实施方案。设想了其中突出部2043的侧向端部根本不在成形凹坑2032a上方延伸的某些实施方案。在任何情况下，突出部2043的向上偏转可以小于突出部2043'的偏转，因此，在驱动表面2045和凸轮表面2035之间可以存在更大的接触区域。
除上述之外，凸部2037和突出部2043可以以使得在击发构件2040和砧座2030之间流动的负载沿凸部2037的长度侧向地施加而不是在单个点和/或在凸部2037的端部处施加的方式偏转。因此，在其间流动的力将流过更大的区域，这从而将减小凸部2037和突出部2043所经历的应力和应变，这又可以减少或消除例如上文结合凸部2037'和突出部2043'所讨论的应力上升部。
再次参见图35，联接构件2042的脚部2044比突出部2033更宽。换句话讲，脚部2044的侧向宽度比突出部2033的侧向端部之间的宽度更宽。在这种情况下，脚部2044可以比突出部更多地偏转或拉紧，从而可以减小突出部2033的偏转。设想了其中脚部2044的侧向宽度等于或小于突出部2033的侧向端部之间的宽度的另选实施方案；然而，这些实施方案可以以其他方式被构造成能够在突出部2033内提供期望的偏转和/或应变。
如上所述，端部执行器可以包括例如砧座，该砧座可在打开位置和闭合位置之间移动。在一些情况下，例如，当击发构件诸如击发构件2040或2040'朝远侧移动时，该击发构件使砧座朝向其闭合位置移动。在其他情况下，在朝远侧推进击发构件以执行钉击发行程之前，砧座朝向其闭合位置移动。在任何情况下，砧座可能不会移动到其完全闭合位置，直到击发构件接近或到达其钉击发行程的终点。因此，砧座由击发构件渐进式地闭合。在至少一个这种情况下，由于砧座和钉仓之间捕获较厚组织，砧座可以渐进式地闭合。在一些情况下，砧座实际上可以在击发构件的钉击发行程期间偏转或变形。然而，这种情况通常由击发构件的上突出部和底脚控制。
现在转向图37，限定在突出部2043'上的驱动表面2045'是平坦的或至少基本平坦的。此外，驱动表面2045'被构造成能够在砧座2030'处于完全闭合位置时冲压式地接合限定在砧座2030'上的平坦或至少基本平坦的凸轮表面2035'。换句话讲，当砧座2030'处于完全平坦的取向时，驱动表面2045'以面对面关系与凸轮表面2035'接合。图37中以虚线描绘了砧座2030'的平坦取向。在这种情况下，在钉击发行程期间，驱动表面2045'平行于或至少基本上平行于击发构件2040'的纵向路径。然而，如上所述，在击发行程期间砧座2030'可以渐进式地闭合，因此，砧座2030'可能并不总是处于完全闭合位置。因此，驱动表面2045'可能并不总是与凸轮表面2035'对准，并且在这种情况下，突出部2043'可能会凿入到砧座2030的凸部2037'中。图37用实线描绘了此类实例。
除上述之外，如果击发构件2040'必须使砧座2030'渐进式地闭合到其完全闭合位置，则突出部2043'的驱动表面2045'和/或限定在凸部2037'上的凸轮表面2035'可以塑性地变形。在某些情况下，凸轮表面2035'例如可以磨损，这可增大完成钉击发行程所需的力。更具体地，当金属变形超出塑性极限时，突出部2043'和/或砧座凸部2037'的塑性应变可能造成能量损失。此时，发生磨损，并且联接件的摩擦系数显著增大。例如，能量损失可以是约10％至30％，这可以使击发击发构件所需的力增大约10％至30％。此外，在这种情况下，如果再次使用端部执行器2000'，则用端部执行器2000'完成随后的钉击发行程所需的力可能会增大。
现在转向图40至图42，击发构件2140包括击发杆以及附接到击发杆的联接构件2142。联接构件2142包括将联接构件2142连接到击发杆的连接器2148。联接构件2142还包括切割构件2041，该切割构件被构造成能够在钉击发行程期间切入患者的组织。联接构件2142还包括：突出部2143，该突出部被构造成能够接合砧座诸如砧座2030或2030'；以及脚部2144，该脚部被构造成能够在钉击发行程期间接合钉仓钳口。每个突出部2143包括限定在其底侧上的驱动表面2145。每个突出部2143还包括朝近侧延伸的凸轮过渡部2147和围绕突出部2143的周边延伸的圆角过渡部2149。联接构件2142还包括从其侧向延伸的中间突出部2146，该中间突出部被构造成能够在钉击发行程开始时未使用钉仓未定位在击发构件2140前方时防止击发构件2140执行钉击发行程。
除上述之外，突出部2143的驱动表面2145不平行于击发构件2140的纵向路径2160。而是，驱动表面2145横向于纵向路径2160延伸。在至少一种情况下，每个驱动表面2145的远端定位成比近端更加远离纵向路径2160。这种布置可以减少或消除上文结合砧座2130的渐进式闭合描述的问题。更具体地，在至少一种情况下，如果砧座2130在渐进式闭合期间将相对于纵向路径2160成介于约4度至约0度之间的角度移动通过运动范围，则驱动表面2145可以例如相对于纵向路径2160成约2度定向，这表示渐进式闭合范围的中点。其他实施方案也是可能的。例如，如果砧座2130在渐进式闭合期间将相对于纵向路径2160成介于约1度至约0度之间的角度移动通过运动范围，则驱动表面2145可以例如相对于纵向路径2160成约1度定向，这表示渐进式闭合范围的上限。在各种情况下，例如，可能需要击发构件2140使砧座2130渐进式地闭合通过5度的运动范围。在其他情况下，例如，可能需要击发构件2140使砧座2130渐进式地闭合通过10度的运动范围。在一些情况下，砧座2130可能未到达其完全闭合位置，因此，砧座2130的渐进式闭合可能不会达到0度。
除上述之外，突出部2143的驱动表面2145不平行于脚部2144的驱动表面。主要参见图41，驱动表面2145沿轴线2183延伸，并且脚部2144的驱动表面沿轴线2184延伸。在至少一种情况下，例如，驱动表面2145相对于脚部2144的驱动表面成约0.5度的角度定向。设想了其中例如驱动表面2145相对于脚部2144的驱动表面成约1度的角度定向的实例。设想了其中例如驱动表面2145相对于脚部2144的驱动表面成介于约0.5度至约5度之间的角度定向的某些实例。脚部2144的驱动表面平行于纵向路径2160；然而，还设想了其中脚部2144的驱动表面不平行于纵向路径2160的其他实施方案。
结合可移动砧座讨论了上文提供的示例；然而，应当理解，这些示例的教导内容可以适用于任何合适的可移动钳口，诸如可移动钉仓钳口。类似地，本申请中其他地方提供的示例可以适用于任何可移动钳口。
现在转向图43至图45，击发构件2240包括击发杆以及附接到击发杆的联接构件2242。联接构件2242包括将联接构件2242连接到击发杆的连接器2148。联接构件2242还包括切割构件2041，该切割构件被构造成能够在钉击发行程期间切入患者的组织。联接构件2242还包括：突出部2243，该突出部被构造成能够接合砧座诸如砧座2030或2030'；以及脚部2144，该脚部被构造成能够在钉击发行程期间接合钉仓钳口。每个突出部2243包括限定在其底侧上的驱动表面2245。每个突出部2243还包括围绕其周边延伸的圆角过渡部2249。联接构件2242还包括从其侧向延伸的中间突出部2146，该中间突出部被构造成能够在钉击发行程开始时未使用钉仓未定位在击发构件2240前方时防止击发构件2240执行钉击发行程。
除上述之外，每个突出部2243包括被构造成能够接合砧座的前端或近侧端部2251以及尾端。每个突出部2243的前端与突出部2243的后端或尾端不同。前端2251包括从突出部2243的底部驱动表面2245延伸到定位在突出部2243的纵向中心线2250上方的位置的半径。前端2251包括单个曲率半径；然而，前端2251可以包括多于一个的曲率半径。每个突出部2243还包括在圆角前端2251与突出部2243的顶表面之间的圆角边缘2259。边缘2259的曲率半径小于前端2251的曲率半径。还设想了其中整个前端2251或其至少一部分呈线性的其他实施方案。在任何情况下，前端2251的构型可以使在击发构件2240和砧座之间传递的力或负载远离前端2251朝向突出部2243的尾端偏移。换句话讲，前端2251的构型可以防止前端2251成为在击发构件2240和砧座之间传递的力的焦点。这种布置可以防止或减少击发构件2240粘连砧座的可能性，并且可以减小朝远侧移动击发构件2240所需的力。
现在转向图46至图48，击发构件2340包括击发杆以及附接到击发杆的联接构件2342。联接构件2342包括将联接构件2342连接到击发杆的连接器2148。联接构件2342还包括切割构件2041，该切割构件被构造成能够在钉击发行程期间切入患者的组织。联接构件2342还包括：突出部2343，该突出部被构造成能够接合砧座诸如砧座2030或2030'；以及脚部2144，该脚部被构造成能够在钉击发行程期间接合钉仓钳口。每个突出部2343包括限定在其底侧上的驱动表面。每个突出部2343还包括围绕其周边延伸的圆角过渡部2349。联接构件2342还包括从其侧向延伸的中间突出部2146，该中间突出部被构造成能够在钉击发行程开始时未使用钉仓未定位在击发构件2340前方时防止击发构件2340执行钉击发行程。
除上述之外，每个突出部2343包括圆角前端2351。前端2351类似于前端2251并且包括弯曲表面，该弯曲表面跨突出部2343的中心线2350延伸。前端2251具有与突出部2243的尾端不同的构型。每个突出部2343还包括侧面或侧向端部2352。每个侧向端部2352包括平坦表面，该平坦表面定位在圆角或弯曲边缘2347中间。第一圆角边缘2347定位在突出部2343的顶表面和侧向端部2352的中间，并且另外，第二圆角边缘2347定位在突出部2343的底表面和侧向端部2352的中间。
现在转向图49至图51，击发构件2440包括击发杆以及附接到击发杆的联接构件2442。联接构件2442包括将联接构件2442连接到击发杆的连接器2148。联接构件2442还包括切割构件2041，该切割构件被构造成能够在钉击发行程期间切入患者的组织。联接构件2442还包括：突出部2443，该突出部被构造成能够接合砧座诸如砧座2030或2030'；以及脚部2144，该脚部被构造成能够在钉击发行程期间接合钉仓钳口。每个突出部2443包括限定在其底侧上的驱动表面2445。每个突出部2443还包括围绕其周边延伸的圆角过渡部。联接构件2442还包括从其侧向延伸的中间突出部2146，该中间突出部被构造成能够在钉击发行程开始时未使用钉仓未定位在击发构件2440前方时防止击发构件2440执行钉击发行程。
除上述之外，每个突出部2443的侧面或侧向端部由多于一个的曲率半径限定。每个突出部2443包括从底部驱动表面2445延伸的第一曲率半径2447a以及从突出部2443的顶表面延伸的第二曲率半径2447b。第一曲率半径2447a与第二曲率半径2447b不同。例如，第一曲率半径2447a大于第二曲率半径2447b。然而，曲率2447a和2447b可以包括任何合适的配置。主要参见图51，第一曲率半径2447a向上延伸经过突出部2443的中心线2450。
现在转向图52至图54，击发构件2540包括击发杆以及附接到击发杆的联接构件2542。联接构件2542包括将联接构件2542连接到击发杆的连接器2148。联接构件2542还包括切割构件2041，该切割构件被构造成能够在钉击发行程期间切入患者的组织。联接构件2542还包括：突出部2543，该突出部被构造成能够接合砧座诸如砧座2030或2030'；以及脚部2144，该脚部被构造成能够在钉击发行程期间接合钉仓钳口。每个突出部2543包括限定在其底侧上的驱动表面。每个突出部2543还包括围绕其周边延伸的圆角过渡部。联接构件2542还包括从其侧向延伸的中间突出部2146，该中间突出部被构造成能够在钉击发行程开始时未使用钉仓未定位在击发构件2540前方时防止击发构件2540执行钉击发行程。
除上述之外，每个突出部2543包括侧面或侧向端部2552，该侧面或侧向端部是平坦的或至少基本上是平坦的。每个突出部2543还包括围绕侧向端部2552延伸的圆角过渡部2547。每个突出部2543关于延伸穿过侧向端部2552的纵向中心线对称或至少基本上对称。此外，每个突出部2543的顶表面和底表面彼此平行。
主要参见图53，每个突出部2543的前端2551相对于切割部分2041的切割边缘2042定位在远侧。每个突出部2543的尾端2559相对于切割边缘2042定位在近侧。因此，突出部2043纵向跨越切割边缘2042。在这种情况下，击发构件2540可以将砧座和钉仓一起直接保持在组织被切割的位置处。
现在转向图55至图57，击发构件2640包括击发杆以及附接到击发杆的联接构件2642。联接构件2642包括将联接构件2642连接到击发杆的连接器2148。联接构件2642还包括切割构件2041，该切割构件被构造成能够在钉击发行程期间切入患者的组织。联接构件2642还包括：突出部2643，该突出部被构造成能够接合砧座诸如砧座2030或2030'；以及脚部2144，该脚部被构造成能够在钉击发行程期间接合钉仓钳口。每个突出部2643包括限定在其底侧上的驱动表面2645。每个突出部2643还包括围绕其周边延伸的圆角过渡部2649。联接构件2642还包括从其侧向延伸的中间突出部2146，该中间突出部被构造成能够在钉击发行程开始时未使用钉仓未定位在击发构件2640前方时防止击发构件2640执行钉击发行程。
除上述之外，每个突出部2643还包括侧向端部2652、底部驱动表面2645和顶表面2647。底部驱动表面2645是平坦的，并且平行于击发构件2640的纵向击发路径2660。主要参见图57，顶表面2647是平坦的，但不平行于纵向击发路径2660。此外，顶表面2647不平行于底表面2645。因此，每个突出部2643均是不对称的。实际上，顶表面2647的取向使突出部2643的惯性矩在侧向端部2652上方偏移。这种布置可以增大突出部2643的抗弯刚度，从而可以减小突出部2643的偏转。
现在转向图58至图60，击发构件2740包括击发杆以及附接到击发杆的联接构件2742。联接构件2742包括将联接构件2742连接到击发杆的连接器2148。联接构件2742还包括切割构件2041，该切割构件被构造成能够在钉击发行程期间切入患者的组织。联接构件2742还包括：突出部2743，该突出部被构造成能够接合砧座诸如砧座2030或2030'；以及脚部2144，该脚部被构造成能够在钉击发行程期间接合钉仓钳口。每个突出部2743包括限定在其底侧上的驱动表面。联接构件2742还包括从其侧向延伸的中间突出部2146，该中间突出部被构造成能够在钉击发行程开始时未使用钉仓未定位在击发构件2740前方时防止击发构件2740执行钉击发行程。
除上述之外，每个突出部2743包括第一部分或前部2753a以及定位在前部2753a后方远侧的第二部分或后部2753b。前部2753a包括限定在其远端上的弯曲引入表面2751，该引入表面被构造成能够最初接合砧座。前部2753a还包括限定在其底侧上的第一驱动表面或前驱动表面2745a。类似地，后部2753b包括限定在其底侧上的第二驱动表面或后驱动表面2745b。每个突出部2743还包括限定在前部2753a和后部2753b之间的过渡部2752。
随着击发构件2740朝远侧推进，除上述之外，驱动表面2745a和2745b还可以配合以接合和定位砧座。在某些实施方案中，在钉击发行程期间，驱动表面2745a和2745b限定平行于或至少基本上平行于击发构件2740的纵向路径2760的驱动平面。然而，在一些情况下，仅前驱动表面2745a可以接合限定在砧座上的凸轮表面。例如，当击发构件2740渐进式地闭合砧座时，可能会出现这种情况。
在其他实施方案中，参见图69和图71，前驱动表面2745a定位在后驱动表面2745b上方。换句话讲，前驱动表面2745a定位成比后驱动表面2745b更加远离纵向路径2760，使得驱动表面2745a和2745b两者在钉击发行程期间均保持与砧座接触。在至少一种情况下，驱动表面2745a和2745b可以限定横向于纵向路径2760的驱动平面。在某些情况下，可以在驱动平面和纵向路径2760之间限定例如1度的角度。在各种情况下，前驱动表面2745a以例如大约0.001”的距离竖直地定位在后驱动表面2745b上方。在其他实施方案中，前驱动表面2745a以例如大约0.002”的距离竖直地定位在后驱动表面2745b上方。在某些情况下，前驱动表面2745a以介于约0.001”至约0.002”之间的距离定位在后驱动表面2745b上方。
在某些情况下，再次参见图70，当击发构件2740渐进式地闭合砧座时，仅后驱动表面2745b可以与砧座的凸轮表面接触。在这种情况下，前驱动表面2745a不与砧座的凸轮表面接触。与仅前驱动表面2745a与砧座的凸轮表面接触时相比，这种布置可以减小突出部2743的塑性变形并且可以减小朝远侧推进击发构件2740所需的力。当砧座因施加到砧座的钉成形负载而开始弯曲时，在一些情况下，砧座可以向上弯曲以与前驱动表面2745a接触，如图71所示。
前部2753a比后部2753b厚。换句话讲，前部2753a具有比后部2753b更大的弯曲惯性矩，其可以抵抗突出部2743的向上弯曲。因此，后部2753b可以比前部2753a更多地向上偏转。在这种情况下，即使击发构件2740用于渐进式地闭合砧座，突出部2743的两个部分2753a和2753b也更可能在钉击发行程期间保持与砧座接触。此外，前部2753a还具有比后部2753b更大的剪切厚度，这可以更好地抵抗通过突出部2743传递的剪切力。相比于后部2753b，前部2753a往往暴露于更大的剪切力下，并且因此可以受益于增大的剪切厚度。如果据信，相比于前突出部2753a，后部2753b可以经受更大的剪切力，则例如后部2753b可以具有比前部2753a更大的剪切厚度。
现在转向图61至图63，击发构件2840包括击发杆以及附接到击发杆的联接构件2842。联接构件2842包括将联接构件2842连接到击发杆的连接器2148。联接构件2842还包括切割构件2041，该切割构件被构造成能够在钉击发行程期间切入患者的组织。联接构件2842还包括：突出部，该突出部被构造成能够接合砧座诸如砧座2030或2030'；以及脚部2144，该脚部被构造成能够在钉击发行程期间接合钉仓钳口。如下文更详细地描述的，每个突出部包括限定在其底侧上的驱动表面。联接构件2842还包括从其侧向延伸的中间突出部2146，该中间突出部被构造成能够在钉击发行程开始时未使用钉仓未定位在击发构件2840前方时防止击发构件2840执行钉击发行程。
除上述之外，联接构件的每一侧均包括第一突出部或前突出部2843d以及定位在前突出部2843d后方的第二突出部或后突出部2843p。前突出部2843d包括限定在其远端上的弯曲引入表面2851d，该引入表面被构造成能够最初接合砧座。前突出部2843d还包括限定在其底侧上的第一驱动表面或前驱动表面2845d。类似地，后突出部2843p包括限定在其远端上的弯曲引入表面2851p，该引入表面被构造成能够接合砧座。后突出部2843p还包括限定在其底侧上的第二驱动表面或后驱动表面2845p。
随着击发构件2840朝远侧推进，除上述之外，驱动表面2845d和2845p还可以配合以接合和定位砧座。在某些实施方案中，在钉击发行程期间，驱动表面2845d和2845p限定平行于或至少基本上平行于击发构件2840的纵向路径2860的驱动平面。在其他实施方案中，前驱动表面2845d定位在后驱动表面2845p上方。换句话讲，前驱动表面2845d定位成比后驱动表面2845p更加远离纵向路径2860。在至少一种情况下，驱动表面2845d和2845p可以限定横向于纵向路径2860的驱动平面。在某些情况下，可以在驱动平面和纵向路径2860之间限定例如1度的角度。
除上述之外，前突出部2843d和后突出部2843p可以相对于彼此移动。在各种情况下，在联接构件2842的一侧上的前突出部2843d和后突出部2843p可以彼此独立地移动。尤其是当击发构件2840用于渐进式地闭合砧座时，这种布置可以允许突出部2843d和2843p独立地适应砧座的取向。因此，突出部2843d和2843p两者均可以保持与砧座接合，使得力在多个位置处在击发构件2840和砧座之间流动，并且使得突出部的塑性变形减小。
图68描绘了第一击发构件完成标记为2090'的击发行程所需的能量以及第二击发构件完成标记为3090的击发行程所需的能量。击发行程2090'表示发生显著塑性变形和磨损的状态。击发行程3090表示对击发行程2090'的改进，其中，击发构件和砧座凸部的变形大部分是弹性的。据信，在某些情况下，例如，通过采用本文所公开的教导内容，击发构件和/或砧座经历的塑性应变可以减小约40％至60％。
本文所述的各种实施方案可以用于平衡在击发构件和砧座之间传递的负载。这些实施方案也可以用于平衡在击发构件和钉仓钳口之间传递的负载。在任何情况下，击发构件可以被设计成提供期望结果，但应当理解，由于例如缝合器械存在制造公差并且/或者端部执行器内所捕获的组织的厚度存在可变性，在一些情况下可能无法实现这种期望结果。在至少一种情况下，击发构件的上突出部和/或底脚例如可以包括可穿戴特征结构，该可穿戴特征结构被构造成能够允许击发构件限定与砧座的平衡连接。
除上述之外，现在参见图64至图67，击发构件2940包括侧向突出部2943。每个突出部2943包括从其底部延伸的纵向脊2945。脊2945被构造成能够在击发构件2940朝远侧推进以与砧座接合时塑性地变形和/或涂抹。脊2945被构造成能够快速磨合或建立一个过弯姿势，以便增大突出部2943与砧座之间的接触区域，并在击发构件2940和砧座之间提供更好的负载平衡。当端部执行器用于执行几个钉击发行程时，这种布置可能特别有用。除了或代替上述内容，一个或多个可穿戴垫可以附接到可被构造成能够塑性地变形的击发构件的突出部。
图72和图73描绘了用于与外科缝合器械一起使用的外科缝合砧座或砧座钳口3100。砧座3100被构造成能够在外科缝合手术期间使钉变形。砧座3100包括砧座主体3101和砧座帽3110。砧座主体3101和砧座帽3110焊接在一起。砧座主体3101包括近侧部分3102，该近侧部分包括联接部分3103。联接部分3103被构造成能够组装至外科缝合器械的端部执行器，以允许砧座钳口3000相对于对应钳口(例如，钉仓钳口)旋转。设想了这样的实施方案，其中砧座钳口相对于钉仓钳口固定，并且在此类情况下，钉仓钳口可以相对于砧座钳口旋转。砧座主体3101还包括远侧尖端部分3104、外边缘3107和平面的面向组织的表面3106。面向组织的表面3106包括限定在其中的钉成形凹坑，其被构造成能够在外科缝合规程期间使钉变形。砧座主体3101还包括被构造成能够在其中接收砧座帽3110的纵向腔或孔3105。如下面更详细地讨论的，纵向腔3105可以包括被构造成能够在组装期间与砧座帽3110的对应表面配合的对应表面。某些表面可以被构造用于焊接，而其他表面可以仅被构造用于在组装期间进行对准。
砧座帽3110包括近侧端部3111、远侧端部3112和连续的周边或边缘3113。当砧座主体3101和砧座帽3110组装和/或焊接在一起时，边缘3113可以与砧座主体3101的顶表面3108齐平或基本齐平以便提供外科缝合砧座3100的光滑上表面，尽管在其间的接缝中的阶梯可以是可能的。除上述之外，砧座帽3110还包括圆化上表面3114。可以对上表面3114进行成型和/或圆化，例如以便在砧座主体3101和砧座帽3110焊接在一起时提供外科缝合砧座3100的连续弯曲上表面。在各种情况下，连续边缘3113是被构造用于焊接的特征结构，如以下所讨论的。
两件式外科缝合砧座3100可允许在制造期间抛光砧座3100内的内表面。制造这些零件可以包括导致砧座内的各种表面的表面光洁度低于期望的过程。改善各种内表面的光洁度可以减小砧座和穿过其中的钉击发构件之间的内侧摩擦力。减小内侧摩擦力可以减小使击发构件移动通过其钉击发行程所需的力。减小使击发构件移动通过其钉击发行程所需的力可以导致某些部件的尺寸减小，从而导致期望的整体器械尺寸减小。这种布置还可以减小器械故障的次数。也就是说，两件式焊接砧座面临挑战。例如，在一些情况下，两件式焊接砧座可能比一体砧座偏转更大。换句话说，两件式砧座的硬度可能小于一体砧座的硬度，并且抗弯曲性也更小。此外，砧座侧面的远离击发构件或纵向器械轴线的侧向偏转或旋转可致使钉不适当地变形。这种偏转可导致整个系统的竖直扩展，从而导致成形钉的成形高度不是预期的成形高度。此外，这种偏转可允许击发构件竖直地撕裂通过其凸轮的砧座。同样，横向偏转或旋转可能需要将更多击发力施加到击发构件以完成其击发行程。例如，由于组织引起的压力的作用，砧座的远侧部分可能偏转远离钉仓。最小化这种偏转对于创建正确成形钉很重要。上面说过，横向和侧向偏转的存在可具有复合作用。实际上，横向偏转可引起砧座的侧向偏转。
图74描绘了外科缝合砧座3200的一部分，该外科缝合砧座包括砧座主体3210和通过焊接部3201焊接到砧座主体3210的砧座帽3220。尽管仅示出了外科缝合砧座3200的一部分，但应当理解，存在示出部分的镜像部分以完成外科缝合砧座3200。示出部分和镜像部分将同时进行讨论。砧座主体3210包括：面向组织的表面3211，其包括限定在其中的多个钉成形凹坑3212；凸部3215，该凸部包括凸轮表面3216，这些凸轮表面被构造成能够由外科缝合器械的击发构件的砧座凸轮特征结构接触，以及纵向狭槽3213，该纵向狭槽被构造成能够在其中接收击发构件。砧座主体3210还包括外边缘3214。凸部3215被构造成能够在击发构件移动通过钉击发行程时承受或支撑由击发构件施加的分布式负载力3231。砧座主体3210还包括凸部3217，该凸部被构造成能够在焊接期间保持砧座帽3220。凸部3217可以帮助组装并且可以确保砧座帽3220和砧座主体3210的正确对准。凸部3217还可以用作改善总体砧座刚度的特征结构。砧座帽3220包括上部分3223、下部分3221和被构造成能够在焊接之前、期间和之后搁置在凸部3217上的凸部3224。
砧座帽3220的上部分3223和砧座主体3210通过焊接部3201焊接在一起。在砧座主体3210和砧座帽3220中的一者或两者上的斜切边缘提供了焊接通道。在这种情况下，砧座主体3210和砧座帽3220的焊接部表面是竖直的，并且因此，焊接部3201是竖直的。焊接部3201包括由3202标记的焊接部长度或深度。例如，焊接深度3202为约0.030英寸。值得注意的是，焊接部3201没有穿透砧座3200以到达凸部3217、3224的水平表面。通过这种布置，由于击发构件和组织施加到砧座主体3210上的力的组合，砧座主体3210将趋于围绕枢转轴线P旋转地偏转。当击发构件通过在凸部3215上按压而使表面3216凸轮倾斜时(由分布式负载力3231表示)，并且组织和仓在面向组织的表面3211上推动时(由分布负载力3232表示)，因此砧座主体3210的两侧(图74中仅示出一侧)可能趋于围绕枢转轴线P旋转并且相对于击发构件和砧座帽3220竖直和/或向外偏转。由于缺乏所提供的焊接装置的焊接部熔深，因此允许这种偏转(由偏转3233表示)。在一些情况下，砧座主体3210和砧座帽3220可以在具有长度3203的非焊接部分或接缝3204处散开。
图75描绘了外科缝合砧座3300的一部分，该外科缝合砧座包括砧座主体3310和通过焊接部3301焊接到砧座主体3310的砧座帽3320。尽管仅示出了外科缝合砧座3300的一部分，但应当理解，存在示出部分的镜像部分以完成外科缝合砧座3300。示出部分和镜像部分将同时进行讨论。砧座主体3310包括：面向组织的表面3311，其包括限定在其中的多个钉成形凹坑3312；凸部3315，该凸部包括凸轮表面3316，这些凸轮表面被构造成能够由外科缝合器械的击发构件的砧座凸轮特征结构接触，以及纵向狭槽3313，该纵向狭槽被构造成能够在其中接收击发构件。砧座主体3310还包括外边缘3314。凸部3315被构造成能够在击发构件移动通过钉击发行程时承受或支撑由击发构件施加的分布式负载力3331。砧座主体3310还包括从狭槽3313延伸到外边缘3314的上部分3317。砧座帽3320包括上部分3323、下部分3321和被构造成能够在焊接之前、期间和之后搁置在上部分3317上的凸部3224。
砧座帽3320的凸部3324和砧座主体3310的上部分3317通过焊接部3301焊接在一起。砧座帽3320的斜切边缘提供了焊接通道。在这种情况下，砧座主体3310和砧座帽3320的焊接部表面是水平的，并且因此，焊接部3301是水平的。焊接部3301包括由3302标记的焊接部长度或深度。例如，焊接深度3302为约0.030英寸。然而，这种焊接深度3302产生具有非焊接宽度3303的非焊接部分3304。例如，非焊接宽度约为0.080英寸。通过这种布置，砧座主体3310将趋于围绕枢转轴线P旋转地偏转，并且上部分3317和凸部3324将趋于在偏转期间压缩。然而，非焊接宽度3303在狭槽3313之间延伸并超出第二排钉成形凹坑3312。在各种情况下，由击发构件和组织施加到砧座主体3310上的力的组合可生成由偏转3333指示的偏转。当击发构件通过在凸部3315上按压而使砧座3300朝着相对钉仓凸轮倾斜时(由分布式负载力3331表示)，并且当组织和定仓在面向组织的表面3311上推动时(由分布负载力3332表示)，砧座主体3310的两侧(图75中仅示出一侧)可能趋于旋转并且相对于击发构件竖直和/或向外偏转。由于缺少焊接熔深、显著的非焊接宽度3304、以及水平焊接布置3301而发生这种偏转3333。
图76描绘了外科缝合砧座3400的一部分，该外科缝合砧座包括砧座主体3410和通过焊接部3401焊接到砧座主体3410的砧座帽3420。尽管仅示出了外科缝合砧座3400的一部分，但应当理解，存在示出部分的镜像部分以完成外科缝合砧座3400。示出部分和镜像部分将同时进行讨论。砧座主体3410包括：面向组织的表面3411，其包括限定在其中的多个钉成形凹坑3412；凸部3415，该凸部包括凸轮表面3416，这些凸轮表面被构造成能够由外科缝合器械的击发构件的砧座凸轮特征结构接触；以及纵向狭槽3413，该纵向狭槽被构造成能够在其中接收击发构件。砧座主体3410还包括外边缘3414。凸部3415被构造成能够在击发构件移动通过钉击发行程时承受或支撑由击发构件施加的分布式负载力3431。砧座主体3410还包括凸部3417，该凸部被构造成能够在焊接期间保持砧座帽3420。凸部3417可以帮助组装帽3420和主体3410并且可以确保砧座帽3420和砧座主体3410的正确对准。凸部3417还可以改善砧座3400的整体砧座刚度。砧座帽3420包括上部分3423、下部分3421和被构造成能够在焊接之前、期间和之后搁置在凸部3417上的凸部3424。
砧座帽3420的上部分3423和砧座主体3410通过焊接部3401焊接在一起。由砧座主体3410和砧座帽3420中的一者或两者的斜切边缘提供了焊接通道。在这种情况下，砧座主体3410和砧座帽3420的焊接部表面是成角度的，并且因此，焊接部3401是成角度的。焊接部3401包括由3402标记的焊接部长度或深度。例如，焊接深度3402为约0.030英寸。值得注意的是，焊接部3401没有穿透砧座3400以到达凸部3417、3424的水平表面，并且通过这种布置，砧座主体3410将趋于围绕枢转轴线P旋转偏转。具体地，由击发构件和组织施加到砧座主体3410上的力的组合可生成由偏转3433表示的偏转。当击发构件通过在凸部3415上按压而使砧座3400朝着相对钉仓凸轮倾斜时(由分布式负载力3431表示)，并且当组织和定仓在面向组织的表面3411上推动时(由分布负载力3432表示)，砧座主体3410的两侧(在图76中仅示出了一侧)可能趋于围绕枢轴P旋转。然而，当砧座主体3410的两侧旋转时，成角度的焊接部表面将趋于压缩，这可能会限制砧座3400经历的偏转量。砧座主体3410和砧座帽3420可能趋于在具有长度3403的非焊接部分3404处压缩，从而导致帽3420和主体3410之间的非常牢固的互连。
图77描述了用于与外科缝合器械一起使用的外科缝合砧座3500。砧座3500包括砧座主体3510和砧座帽3520。砧座主体3510包括：面向组织的表面3511，该面向组织的表面包括限定在其中的多个钉成形凹坑3512；凸部3515，该凸部包括凸轮表面3516，这些凸轮表面被构造成能够由外科缝合器械的击发构件的砧座凸轮特征结构接合；以及纵向狭槽3513，该纵向狭槽被构造成能够在其中接收击发构件。凸部3415被构造成能够在击发构件移动通过钉击发行程时承受或支撑由击发构件施加的分布式负载力。砧座主体3510还包括凸部3517，该凸部被构造成能够在焊接期间保持砧座帽3520就位。凸部3517可以帮助组装帽3520和砧座主体3510并且可以确保砧座帽3520和砧座主体3510的正确对准。凸部3517还可以改善砧座3500的整体刚度。砧座帽3520包括上部分3523、下部分3521和被构造成能够在焊接之前、期间和之后搁置在凸部3517上的凸部3524。
砧座帽3520的上部分3523和砧座主体3510通过焊接部3501焊接在一起。仅示出了一个焊接部3501以提供在焊接之前和之后的砧座主体3510和砧座帽3520的关系的清楚性。在这种情况下，砧座主体3510和砧座帽3520的焊接部表面是成角度的，并且因此，焊接部3501是成角度的。焊接部3501包括由3502标记的焊接部长度或深度。焊接深度或熔深3502可以在约0.015英寸至约0.040英寸之间。在某些情况下，焊接深度为例如0.030英寸。值得注意的是，焊接部3501穿透砧座3500以到达凸部3517、3524的水平表面。提供被构造成能够与焊接部熔深相匹配的成角度焊接部表面可有助于旋转以及竖直方向上防止砧座偏转。换句话说，具有焊接部熔深等于或大于成角度焊接部表面长度的焊接部可以增加砧座3500的惯性矩和整体刚度。在其他情况下，焊接深度3502可以小于成角度焊接部表面的长度或配合的长度。合适焊接技术用于焊接本文公开的任何砧座。在一些情况下，在相邻焊接部表面之间存在间隙，该间隙被构造成能够接收焊接材料。在一些情况下，没有提供间隙。在至少一种这样的情况下，成角度焊接部表面被激光焊接。
图78是包括砧座主体部分3610和上砧座部分3620的砧座3600的显微照片。砧座主体部分3610包括：面向组织的表面3611，其包括限定在其中的多个钉成形凹坑3612；纵向腔3613，其被构造成能够在其中接收外科器械的击发构件；以及凸部3615，该凸部被构造成能够在钉击发行程期间与击发构件接合。砧座主体部分3610和上砧座部分3620通过焊接部3601彼此焊接，每个焊接部包括焊接部熔深长度3602。值得注意的是，焊接部3601未穿透砧座3600以到达砧座主体部分3610的上凸部3616的水平表面3617。
砧座3600具有较大非焊接宽度3606，以及还有较大狭槽腔宽度3605。非焊接宽度3606为腔宽度3605的约125％。实际上，非焊接宽度3606的宽度使得中间成形凹坑排3612B和内侧成形凹坑排3612A被限定在非焊接宽度3606内。类似地，内侧成形凹坑3612A和中间成形凹坑3612B的一部分被限定具有狭槽腔宽度3605。此外，在非焊接宽度3606和槽腔宽度3605两者内限定成形凹坑3612B的中间排的内边界轴线3619。当夹持组织和/或当击发构件移动通过其钉击发行程时，这种布置可以使砧座3600显著偏转。此类偏转可能是由于焊接部熔深的缺乏以及相对于狭槽宽度3606的相对较大的非焊接宽度3605引起的。
图79描绘了包括砧座主体部分3710和砧座帽3720的砧座3700。砧座主体部分3710包括平面的面向组织的表面3711，其包括多个成形钉凹坑，这些凹坑包括内钉成形凹坑3712A、中间钉成形凹坑3712B和外钉成形凹坑3712C。主体部分3710还包括：纵向腔或狭槽3713，其被构造成能够在其中接收击发构件；砧座凸部3715，其限定径向凸轮表面3714，这些径向凸轮表面被构造成能够在击发构件移动通过其钉击发行程时被击发构件接合；以及凸部3716，其被构造成能够保持砧座帽3730。狭槽3713包括：第一部分3713A，其被构造成能够从中接收击发构件的切割构件；以及第二部分3713B，其被构造成能够从中接收击发构件的上凸轮部分。第一部分3713A的宽度小于第二部分3713B的宽度。
砧座帽3720包括Y形横截面。砧座帽3720包括；下部分3721，其被构造成能够接收在限定第一配合区域的狭槽3713内；以及上部分3723，其被构造成能够焊接到砧座主体3710。上部分3723包括凸部或肩部3724，其包括水平对准表面，这些水平对准表面被构造成能够搁置在凸部3716的对应水平对准表面上。该界面限定垂直于或至少基本垂直于第一配合区域的第二配合区域。水平对准表面至少基本平行于面向组织的表面3711。上部分3723相对于下部分3721张开并且包括成角度焊接部表面3725，该成角度焊接部表面被构造成能够被焊接到限定第三配合区域的砧座主体3710的对应成角度焊接部表面3717。焊接部的焊接部熔深长度等于成角度焊接部表面3725、3717的长度。
砧座3700具有非焊接宽度3706和狭槽宽度3705。非焊接宽度3706不大于狭槽宽度3705的约105％。中心平面轴线“CA”被限定为砧座3700的几何中心。非焊接宽度3706(即焊接部之间的宽度)限定外边界轴线3731，该外边界轴线是与中心轴线CA相距的第一距离3731D。内钉成形凹坑3712A限定排轴线3732，该排轴线是与中心轴线CA相距的第二距离3732D。第二距离3732D小于第一距离3731D。因此，全部或至少一部分的内钉成形凹坑3712A被限定在非焊接宽度3706内。在其他情况下，内钉成形凹坑3712A完全位于非焊接宽度3706的外侧。在此类情况下，第一宽度3731D小于第二宽度3732D。在某些情况下，外边界轴线3731不延伸超过内钉成形凹坑3712A的内边界轴线。内钉成形凹坑3712A还限定外边界轴线3733，该外边界轴线是与中心轴线CA相距的第三距离3733D。第三距离3733D大于第一距离3731D和第二距离3732D。在其他情况下，内钉成形凹坑3712A完全位于非焊接宽度3706内。在此类情况下，第二距离3732D和第三距离3733D小于第一距离3731D。
中间钉成形凹坑3712B限定内边界轴线3734，该内边界轴线是与中心轴线相距的第四距离3734D。第四距离3734D大于第一距离3731D、第二距离3732D和第三距离3733D。换句话说，非焊接宽度3706不延伸到中间钉成形凹坑3712B。使第一距离3731D或外边界轴3731D从中心轴线CA延伸的距离最小化可以增加砧座3700的整体刚度以减小砧座3700的纵向和旋转、或扭转、弯曲或偏转。
图80是表示经受两种不同负载情况的四种不同外科缝合砧座布置的图表3800。模型A是一件式或整体式砧座。模型B是两件式砧座，包括砧座主体和焊接到砧座主体的砧座帽。砧座帽包括上焊接部分，该上焊接部分具有比狭槽宽度的105％更宽的非焊接宽度。类似模型B，模型C是两件式砧座，包括砧座主体和焊接到砧座主体的砧座帽。砧座帽的非焊接宽度为狭槽宽度的约105％。然而，模型C的在砧座帽和砧座主体之间限定的成角度焊接部表面的角度阻止形成沿成角度焊接部表面的整个长度延伸的焊接深度。在至少一种情况下，焊接深度例如小于0.03英寸。模型D表示砧座3700。砧座帽具有狭槽宽度的约105％的非焊接宽度，并且模型D的成角度焊接部表面的角度允许创建焊接深度，该深度融合成角度焊接部表面的整个长度。在至少一种情况下，焊接深度为例如至少0.03英寸。因此，砧座3700的远侧尖端偏转小于模型A、模型B和模型C的砧座的远侧尖端偏转。同样，模型B、模型C和模型D的凸部中的总应力小于模型A的凸部。
图81至图83描绘了用于与外科缝合器械一起使用的砧座3900。砧座3900被构造成能够在外科缝合手术期间使钉变形。砧座3900包括砧座主体3910和砧座帽3920。砧座主体3910和砧座帽3920焊接在一起。砧座主体3910包括近侧部分3912，该近侧部分包括联接部分，该联接部分被构造成能够组装至外科缝合器械的端部执行器以允许砧座钳口3900相对于对应钳口(例如，钉仓钳口)旋转。设想了这样的实施方案，其中砧座钳口相对于钉仓钳口固定，并且在这种情况下，钉仓钳口可以相对于砧座钳口旋转。砧座主体3910还包括远侧尖端部分3914和平面的面向组织的表面3911。面向组织的表面3911包括限定在其中的钉成形凹坑3912，其被构造成能够在外科缝合规程期间使钉变形。砧座主体3910包括纵向狭槽3913，其被构造成能够在其中接收外科器械的击发构件。砧座主体3910还包括凸轮特征结构3914，该凸轮特征结构包括径向凸轮表面3915，该径向凸轮表面被构造成能够在击发构件的钉击发行程期间由击发构件的砧座凸轮部分接合。
参考图81，砧座帽3920包括各自包括区长度3930L的多个浅焊区3930，以及各自包括区长度3940L的多个深焊区3940。区长度3930L、3940L相等；然而，在其他情况下，区长度3930L、3940L不同。帽3920的每个浅焊区3930包括上部分3933和下部分3931。上部分3933包括带有焊接表面3935的喇叭形主体部分3934。喇叭形主体部分3934被构造成能够搁置在砧座主体3910的对准凸部3916上，而焊接表面3935被构造成能够与砧座主体3910的对应成角度焊接表面3917接合或配合(图82)。每个深焊区3940包括上部分3943和下部分3941。下部分3941可经由延伸通过深焊区3940的上部分3943的窗口3945进入。上部分3942包括可经由焊接进入区3945进入的对准凸部3944，这些对准凸部被构造成能够搁置在砧座主体3910的对应对准凸部3418上。对准凸部3916与面向组织的表面3911相距第一距离，并且对准凸部3944与面向组织的表面3911相距第二距离。第一距离大于第二距离。在其他情况下，第一距离和第二距离相等。
上面讨论的焊接表面3935、3917被构造成能够焊接在一起，以通过包括焊根3937的焊接部3936将浅焊区3930焊接到砧座主体3910(图83)。焊根3937被构造成能够至少穿透到凸部3916的水平表面。深焊区3940被构造成能够通过包括焊根3947的焊接部3946来焊接到砧座主体3910上(图83)。焊接部进入区域3945允许深焊接部，从而将下部分3941焊接到砧座主体3910。在焊接期间，整个凸部3946可以与砧座主体3910熔合。尽管焊接部长度3938、3948可以是类似的，但如果不相等，则砧座帽3920与砧座主体3910之间的有效焊接深度或净焊接深度可以通过提供浅焊区3930和深焊区3940而增加。焊接深度可以被限定为砧座的上表面3901的边缘3921到相应焊接部的焊根之间的距离。使浅焊区3930和深焊区3940交替可以允许沿着砧座3900的纵向长度在砧座3900的两侧上存在浅焊接部和深焊接部，并且在砧座帽3920和砧座主体3910之间建立牢固的连接。
浅焊区3930和深焊区3940被构造成能够沿着砧座3900的长度增加总焊接深度。浅焊区3930和深焊区3940的位置、纵向长度和数量可以改变以沿砧座的长度改变或调整砧座3900的刚度。例如，浅焊区3930具有第一刚度，并且深焊区3940具有与第一刚度不同的第二刚度。这种布置还可以允许使用单深度焊接机来制造焊接部3936、3946，这可以简化制造。除了这些焊接部之外，可以在已经形成焊接部3946之后施加填料焊接部以填充进入区域3945，以便增加砧座3900的刚度并减小砧座3900内的旋转偏转的可能性。设想了这样的实施方案，其中代替具有纵向交替的在砧座两侧上具有深焊接部的区和在砧座两侧上具有浅焊接部的区(图81)，砧座包括沿长度L延伸的多个区，其中每个区在砧座相对侧上包括浅焊接部和深焊接部。例如，每个区包括在砧座的一侧上沿着区的长度L延伸的浅焊接部以及在砧座的另一侧上沿着区的长度L延伸的深焊接部。此外，除了具有不同长度之外，多个区可以使形成浅焊接部和深焊接部的侧面交替。因此，这种砧座将沿砧座的整个长度包括浅焊接部和深焊接部。
可以使用多种过程来制造本文公开的各种外科缝合砧座。例如，砧座主体部分和/或砧座帽部分可以使用金属注射模制过程来制造。砧座主体部分和/或砧座帽部分也可以使用机加工过程来制造。在至少一种情况下，砧座主体部分和砧座帽中的一个使用金属注射模制过程来制造，并且砧座主体部分和砧座帽中的另一个完全使用机加工过程来制造。在某些情况下，可以使用电化学机械加工过程来形成砧座主体部分、砧座帽部分、或砧座主体部分和砧座帽部分两者。模制过程可以允许圆角容易地结合到砧座帽和/或砧座主体的几何形状中。此类圆角可以减小在原本可能存在不同顶点或拐角的位置处的应力集中。
用于制造外科缝合砧座(诸如本文所公开那些)的方法可以包括各种步骤。制造砧座的一个步骤包括制造砧座主体部分和砧座帽构件。制造砧座的另一个步骤包括抛光砧座主体部分的砧座凸轮表面。在各种情况下，可接触击发构件的任何部分的任何内表面可以被抛光。制造砧座的另一步骤包括将砧座主体部分和砧座帽构件焊接在一起。焊接步骤可以包括例如激光焊接过程。制造砧座的又一个步骤包括将钉成形凹坑或紧固件成形凹坑冲压到砧座主体部分的面向组织的表面中。
除上述之外，抛光步骤可包括抛光砧座凸轮表面或凸部的各个区。凸部可包括第一区和第二区，其中第一区被构造成能够由击发构件的砧座凸轮接触，并且第二区侧向地延伸超过第一区。在正常击发情况下，击发构件将仅接触第一凸部区而不接触第二凸部区。然而，在异常击发情况下，击发构件的一部分可接触第二区。因此，有利的可以是，确保凸部的第一区和第二区都被抛光以减少当由击发构件接触时凸部上发生磨损的可能性。
图84和图85描绘了包括砧座主体4010和砧座帽4020的砧座4000。砧座主体4010包括面向组织的表面4011和限定在面向组织的表面4011中的多个钉成形凹坑4012。砧座4000包括纵向腔4013，其被构造成能够在其中接收外科器械的击发构件。腔4013包括由砧座主体4010的凸部4014限定的砧座凸轮表面4015。击发构件被构造成能够当击发构件移动通过击发行程时使凸部4014凸轮倾斜。砧座帽4020焊接到砧座主体4010。允许焊接机(诸如激光焊接机)经由焊接机进入区域4005进入砧座主体4010和砧座帽4020。焊接机进入区域4005包括开口或斜切边缘以为焊工提供进入要焊接位置的空间。较大的焊接机进入区域可以确保较深的焊接部熔深。
砧座4000包括主要焊接部4001和辅助填料焊接部4003。尽管仅示出了一个辅助填料焊接部4003，但砧座4000可包括在所有的现有主要焊接部的顶部上或上方的辅助填料焊接部。填料焊接部4003在砧座4000的纵向长度上为砧座4000提供附加刚度，并且还有助于防止砧座侧面的旋转偏斜或扭转弯曲或扭曲。此外，填料焊接部4003增加到砧座4000中的总焊接熔深，这增加了砧座4000的刚度。主要焊接部4001熔合砧座主体4010和砧座帽4020的对应斜面。更具体地，砧座主体4010包括：第一斜面4019，其被构造成能够与砧座帽4020的第一斜面4029配合；第一水平表面4018，其被构造成能够与砧座帽4020的第一水平表面4028配合；第二斜面4017，其被构造成能够与砧座帽4020的第二斜面4027配合；以及第二水平表面4016，其被构造成能够与砧座帽4020的第二水平表面或底表面4026配合。在制造期间，可以选择焊接机并将其被构造成能够将第一斜面4019、4029熔合在一起。
附加斜面4017、4027和水平表面4016、4018、4026、4028被构造成能够在制造期间在焊接之前辅助砧座主体4010和砧座帽4020的组装。例如，当准备砧座主体4010和砧座帽4020以用于焊接时，附加表面可以帮助对准砧座主体4010和砧座4020以用于焊接。第二水平表面4016为砧座帽4020提供限定的深度。换句话说，第二水平表面4016限定底表面4026可相对于砧座主体4010坐置的最低可坐置位置。
图86描绘了砧座4100，其包括第一砧座构件或砧座主体部分4110和第二砧座构件或砧座帽4130。第一砧座构件4110包括面向组织的表面4111，该面向组织的表面包括限定在其中的多个钉成形凹坑4112。第一砧座构件4110还包括纵向腔4113，其被构造成能够在其中接收外科器械的击发构件。第一砧座构件4110还包括砧座凸轮凸部4114，其限定砧座凸轮表面4115，该砧座凸轮表面被构造成能够当击发构件移动通过击发行程时被击发构件接合。
第一砧座构件4110和第二砧座构件4130包括互锁特征结构，其被构造成能够增加砧座4100的整体刚度并当砧座4100抵靠钉仓夹持时减小砧座4100远离相对钉仓的横向组织引起的弯曲。第一砧座构件4110包括水平延伸的互锁特征结构4117，该互锁特征结构被接收在第二砧座构件4130的对应互锁孔4137内。第一砧座构件4110还包括竖直延伸的互锁特征结构4116，该互锁特征结构被接收在第二砧座构件4130的对应孔4136内。在各种情况下，互锁特征结构4116、4117可能要求砧座4100在被焊接在一起之前仅在纵向方向上被组装。例如，第二砧座构件4130可以相对于第一砧座构件在纵向方向上纵向滑动以组装第一砧座构件4110和第二砧座构件4130。
第一砧座构件4110和第二砧座构件4130通过外侧焊接部4101和内侧焊接部4103彼此焊接。焊接部4101、4103可以包括例如激光焊接部。外侧焊接部4101位于砧座4100的外侧部分4105中。内侧焊接部4103位于由第一砧座构件4110和第二砧座构件4130限定的纵向腔4113中。例如，激光焊接机可以通过在凸轮凸部4114之间限定的开口或孔进入纵向腔4113以形成内侧焊接部4103。在各种情况下，由凸轮凸部4114限定的开口的尺寸被设置成允许专用于内侧焊接部4103的焊接机进入。具有内侧焊接部、外侧焊接部和互锁特征结构的这种布置可以增加砧座的总强度并且减小横向偏转和/或扭转偏转。互锁特征结构还可以提供固的保持表面，使得当第一砧座构件和第二砧座构件中的一个在焊接准备过程中接地时，第一砧座构件和第二砧座构件中的另一个被限制于一个运动平面。这种布置可以确保第一砧座构件和第二砧座构件在焊接过程之前和/或期间不会相对于彼此移动。
现在参考图87，砧座4200包括砧座主体4210和砧座帽4220。砧座主体4210包括平面的组织接触表面4211，其包括限定在其中的多个钉成形凹坑4212。砧座主体4210还包括纵向腔4213，其被构造成能够在其中接收外科器械的击发构件。砧座主体4210还包括砧座凸轮凸部4214，其限定砧座凸轮表面4215，该砧座凸轮表面被构造成能够当击发构件移动通过击发行程时被击发构件接合。
砧座帽4220定位在纵向腔4213内并通过焊接部4201焊接到砧座主体4210。焊接部4201可以包括例如激光焊接部。砧座帽4220包括被构造成能够接收在砧座主体4210的孔4216内的侧向突出部或互锁特征结构4221。焊接部4201包括不渗透到突出部4221中的焊接深度，然而设想了其中焊接部4201延伸到突出部4221或延伸到突出部4221中的实施方案。
图88至图92示出了包括焊接砧座的外科缝合组件4300，其采用另一种布置来帮助防止和/或限制焊接砧座的纵向弯曲。外科缝合组件4300包括：砧座钳口4340，其包括砧座主体4350和砧座帽4360；仓通道钳口4330，其被构造成能够将钉仓接收在其仓接收孔4333中；以及闭合机构4310，其被构造成能够通过凸轮机构使砧座钳口4340相对于仓通道钳口4330枢转。就是说，设想了其中仓通道钳口4330相对于砧座钳口4340枢转的实施方案。砧座主体4350包括面向组织的表面4351，该面向组织的表面包括限定在其中的多个钉成形凹坑，这些钉成形凹坑被构造成能够使从外科钉仓中弹出的钉变形。缝合组件4300还包括击发构件4370，其被构造成能够在砧座钳口4340的狭槽4357内和仓通道钳口4330的狭槽4331内纵向移动以部署储存在钉仓内的多个钉，并且被构造成能够在击发行程期间切割捕获在砧座钳口4340和仓通道钳口4330之间的组织。
外科缝合组件4300包括用于通过减小仓通道钳口4330的刚度来改善砧座钳口4340的整体刚度和强度的装置。仓通道包括通道壁4334，其包括近侧壁部分4335和远侧壁部分4337。砧座钳口4340被构造成能够当砧座钳口4340朝向仓通道钳口4330枢转时紧贴或围绕仓通道钳口4330，特别是近侧壁部分4335。砧座主体4350包括近侧围绕部分4352，其被构造成能够当砧座钳口4340通过闭合机构4310从打开构型(图88)枢转到闭合构型(图89)时津贴或围绕近侧壁部分4335。近侧围绕部分4352还包括组织止挡件4359，其被构造成能够限制组织到外科缝合组件4300中的近侧移动。
近侧围绕部分4352包括下部分4354、上部分4353和在它们之间限定的凸部4356。当缝合组件4300处于闭合构型时(例如，图91)，下部分4354被构造成能够与近侧壁部分4335重叠。上部分4353比下部分4354更厚或更大；然而，上部分4353和下部分4354可以具有任何合适的构型。总体上，较厚的上部分4353和下部分4354被构造成能够增加砧座钳口4340的整体刚度和惯性矩。当缝合组件4300处于闭合构型时，通道钳口4330的凸部4336面对近侧围绕部分4352的对应凸部4356。
主要参考图92，近侧壁部分4335包括切口，该切口的壁厚小于远侧壁部分4337的壁厚。近侧壁部分4335还包括比远侧壁部分4337(图91)更小的高度。在仓通道钳口4330的近侧部分中提供更薄和更小的壁允许砧座钳口4340的近侧周围部分4352具有更大空间以便为更厚且总体上更大，从而增加了砧座钳口4340的刚度。在先前的设计中，缝合组件的仓通道钳口具有比缝合组件的砧座实质上更大的刚度。本布置牺牲了仓通道钳口的一些刚度以通过从仓通道钳口移除材料并将材料添加到砧座钳口且同时保持期望的器械直径使砧座钳口变硬。在各种情况下，期望器械直径可以是例如5mm、8mm或12mm。由于上述，近侧围绕部分4352包括一定体积的材料，该材料被构造成能够占据被限定为超出近侧壁部分4335但在器械直径内的空间的空隙。
除上述之外，砧座钳口4340具有第一刚度，并且仓通道钳口4330具有第二刚度。缝合组件4300包括用于减小第二刚度以增加第一刚度的结构装置。在各种情况下，第一刚度和第二刚度的比率在约1:3至约1:1之间。在一些情况下，第一刚度和第二刚度的比率为约1:3。在其他情况下，第一刚度和第二刚度的比率为约1:1。
现在参考图93至图95，仓通道钳口4400包括主体部分4410和帽部分4430。主体部分4410包括被构造成能够接收帽部分4430的纵向腔4415(图94)。这种布置可以允许在制造过程中抛光通道钳口4400的各种内表面以减小用于将击发构件推进或击发通过外科器械的力。仓通道钳口4400包括由主体部分4410的通道壁4411限定的钉仓接收腔4401(其被构造成能够在其中接收钉仓)、被构造成能够联接至器械轴的近侧部分4405、以及远侧部分4407。可替换钉仓被构造成能够插入或安装到仓通道钳口4400中。参考图95，主体部分4410还包括纵向孔4413，该纵向孔被构造成能够当击发构件移动通过钉击发行程时在其中接收外科器械的击发构件的一部分。
主体部分4410的纵向腔4415限定凸部4413(图95)，其被构造成能够将帽部分4430相对于主体部分4410保持就位以用于焊接。帽部分4430包括帽壁4433，并且通过焊接部4409焊接到主体部分4410。焊接部4409可以包括例如激光焊接部。帽部分4430和主体部分4410的凸部4413限定纵向狭槽4403，该纵向狭槽被构造成能够可滑动地接收击发构件的一部分。在将帽部分4430焊接到主体部分4410之前，抛光纵向狭槽4403。在各种情况下，纵向狭槽4403的整体被抛光。例如，帽部分4430的内表面以及凸部4413被抛光。抛光凸部4413可以是有利的，使得当击发构件移动通过其钉击发行程时，抛光的凸部4413可减小仓通道钳口4400与击发构件之间的摩擦并因此减小表面的磨损，表面的磨损将会增加用于击发外科器械的力。在其他情况下，仅帽部分4430的某些表面被抛光。在此类情况下，仅帽部分4430的水平表面4435和凸部4413可以被抛光。
图96至图107分别比较了用于与外科缝合系统4800、4700一切使用的两个不同击发构件4500、4600。击发构件4500(图96)包括：主体4510，该主体包括近侧连接部分4512；以及切割构件4511，该切割构件被构造成能够在钉击发行程期间切割组织。击发构件4500还包括通道钳口联接构件4520和砧座钳口联接构件4530，该通道钳口联接构件和砧座钳口联接构件被构造成能够在击发构件4500的钉击发行程期间使砧座钳口和通道钳口相对于彼此保持。类似地，击发构件4600(图97)包括：主体4610，该主体包括近侧连接部分4612；切割构件4611，该切割构件被构造成能够在钉击发行程期间切割组织；以及闭锁特征结构4615。击发构件4600还包括通道钳口联接构件4620和砧座钳口联接构件4630，该通道钳口联接构件和砧座钳口联接构件被构造成能够在击发构件4600的钉击发行程期间使砧座钳口和通道钳口相对于彼此保持。
现在参考图98和图99，击发构件4500的砧座钳口联接构件4530包括从主体4510的侧面延伸的侧向突出部或砧座凸轮特征结构4531。相对于主体4510，用圆角4532来使突出部圆角化。突出部4531还包括外圆化拐角4533。砧座钳口联接部件4530限定上平坦表面4534。每个突出部4531包括侧向宽度或厚度4545和竖直厚度4541。侧向宽度4545被限定为主体4510与突出部4531的外边缘4536之间的距离。侧向突出部4531限定突出部轴线4543，该突出部轴线相对于击发构件4500的水平表面(例如，通道钳口联接构件4520的上凸轮表面4521)成约一度角。使突出部4531成角度可以减少接触表面的磨损。侧向突出部4531还包括纵向长度4542(图102)，该纵向长度被限定为突出部4531的前边缘4535与突出部4531的后边缘4537之间的距离。
侧向突出部4531的纵向长度4542和竖直厚度4541例如具有约2.5:1至约20:1的比率。在某些情况下，纵向长度4542和竖直厚度4541的比率在约5:1和约10:1之间。在一些情况下，纵向长度4542和竖直厚度4541的比率为约5:1。在各种情况下，竖直厚度4541和侧向宽度4545的比率例如在约1:2与约1:1之间。在某些情况下，竖直厚度4541和侧向宽度4545的比率为约1:1。这些布置减小凸部偏转并继而减小击发构件4500的突出部4531的偏转。这些布置还鼓励纯剪切作为偏转的主要来源，这增加了突出部抵抗变形的能力。其中突出部的弯曲是偏转的主要来源的布置可能导致突出部的塑性变形的更大可能性。
现在参考图100和图101，砧座钳口联接构件4630包括从主体4610的侧面延伸的侧向突出部或砧座凸轮特征结构4631。每个突出部4631包括侧向宽度或厚度4645和竖直厚度4641。侧向宽度4645被限定为主体4610与突出部4631的外边缘4636之间的距离。侧向突出部4631还包括纵向长度4642(图103)，该纵向长度被限定为突出部4631的前边缘4635与突出部4631的后边缘4637之间的距离。纵向长度4542大于纵向长度4642。
现在转到图104，缝合系统4700包括用于与外科器械一起使用的端部执行器，该端部执行器包括砧座钳口4750、仓通道钳口4780和安装在仓通道钳口4780内的钉仓4710。缝合系统4700还包括击发构件4600，如上所讨论的。钉仓4710包括：多个钉，所述多个钉可移动地储存在钉仓4710的钉腔4712中，被构造成能够由击发构件4600、仓平台、或面向组织的表面4711击发；以及纵向狭槽4713，该纵向狭槽被构造成能够在其中接收击发构件4600。砧座钳口4750包括：面向组织的表面4751，其包括被构造成能够使钉变形的多个钉成形凹坑4752；砧座狭槽4753，其被构造成能够在其中接收击发构件4600的钳口联接构件4630；以及凸轮凸部4755，其被构造成能够当击发构件4600移动通过其钉击发行程时由击发构件4600的突出部4631接合。通道4780包括：通道壁4781；纵向狭槽或腔4785，其被构造成能够在其中接收钳口联接构件4620；以及凸轮凸部4783，其被构造成能够在击发构件4600移动通过其钉击发行程时由钳口联接构件4620接合。在这种情况下，突出部4631用作悬臂梁，与下面描述的系统相比，导致弯曲突出部4631所需的力小得多。
现在转到图105，缝合系统4800包括用于与外科器械一起使用的端部执行器，该端部执行器包括砧座钳口3700、仓通道钳口4400和安装在仓通道钳口4400内的钉仓4810。系统4800还包括击发构件4500。钉仓4810包括：多个钉，所述多个钉可移动地储存在钉仓4810的钉腔4812中，被构造成能够由击发构件4500、仓平台、或面向组织的表面4811击发；以及纵向狭槽4813，该纵向狭槽被构造成能够在其中接收击发构件4500。砧座狭槽3713被构造成能够在其中接收击发构件4500的钳口联接构件4530，并且凸轮凸部3715被构造成能够当击发构件4500移动通过其钉击发行程时与突出部4531接合。在此类情况下，突出部4531的圆形边缘4533被构造成能够接合凸轮凸部3715的圆化部分3714。通道钳口4400的纵向狭槽4403被构造成能够在其中接收钳口联接构件4520，并且凸轮凸部4413被构造成能够在击发构件4500移动通过其钉击发行程时由钳口联接构件4520接合。在这种情况下，突出部4531的主要偏转源是由剪切应力引起的，该剪切应力需要比使图104所示的系统4700的突出部4631变形所需的力大得多的力来使突出部4531变形。
现在转到图106和图107，示出了每个缝合系统4700、4800的凸部的偏转的比较。相同击发负载被施加到图106和图107所示的缝合系统4700、4800。在图106中，示出了具有偏转4801的系统4800。在图107中，系统4700被示出为具有大于偏转4801的偏转4701。这种差异可能部分是由于突出部4631的刚度缺乏、凸部4755的几何形状及其抗弯曲能力的缺乏、突出部4531的增加的刚度、和/或凸部3715的几何形状及其抗弯曲的能力等。例如，缝合系统4800主要以剪切方式放置突出部4531和凸部3715，从而增加其抵抗变形的能力。此外，由于允许砧座的更多材料的事实，使击发构件的突出部圆化并缩短击发构件的突出部的宽度增加了对应钳口联接构件以及砧座的刚度。
在某些情况下，在击发构件的击发行程期间，平衡凸部3715和突出部4531的刚度将平衡凸部3715的偏转大小和突出部4531的偏转大小。由于此类平衡的偏转，在偏转方面，凸部和突出部都不会相互支配，并且从而在击发行程期间，凸部和突出部都不会导致一者的塑性变形明显大于另一者并且可能根本不会塑性变形。在各种情况下，凸部的刚度等于、基本上等于或小于突出部的刚度。在某些情况下，凸部的高度或竖直厚度基本上类似于突出部的高度或竖直厚度。除了或代替提供凸部和突出部的平衡几何形状，例如，可以基于屈服强度和/或硬度值来选择凸部和突出部的材料。具有带有类似的材料屈服强度和/或硬度值的材料可以促进凸部和突出部的相等或平衡的偏转。
图108是在击发构件4500的推进期间的包括焊接部3701的砧座3700的应力和应变分析4900。从图108中可以看出，由击发构件4500向凸部3715施加分布式负载4903和由组织和仓4810向面向组织法人表面3711施加分布式负载4905的组合导致如图所示的偏转4901和应力分布。应力分析示出了低应力区域4907、中应力区域4908和高应力区域4909。值得注意的是，焊接部3701处和附近的应力均匀分布，并且不会定位或集中在焊接部3701处或附近。
在各种设计中，T形刀头用于机加工砧座和/或通道中的狭槽，该狭槽接收击发构件的钳口联接构件。这种机加工方法可引起刀头震颤，这可使用T形刀头切割的狭槽的表面变粗糙。在两件式砧座和槽道设计中，可以使用标准刀头来消除此问题以提供更好的表面光洁度并减小用于对击发构件进行击发的力。
减小击发力的另一种方法可以包括用材料至少涂覆砧座的抛光表面以减小那些表面的摩擦系数。这种涂层可包含例如Medcoat 2000。
在制造本文公开的各种焊接砧座设计期间，可以采用X射线技术来验证焊接深度和/或焊接完整性以减小有缺陷的所得焊接部通过缺少X射线步骤的质量控制测试。另一个质量控制步骤可能包括批量破坏性测试，其中将砧座切片并且然后对其进行分析以确保适当的焊接深度和/或焊接完整性。
在本文中公开的各种两件式砧座设计的制造中可以使用各种材料来增加强度和/或提供期望的焊接材料。例如，钨-合金可以用于砧座帽材料。在各种情况下，W-3、W-5、W-25或W-26钨-合金可以用于砧座帽材料。在一些情况下，例如，银镍包层可以用于砧座帽，并且416不锈钢或17-4不锈钢可以用于砧座主体。
如上所讨论，砧座主体和砧座帽可以包括不同的材料。例如，可以基于可焊接性和/或强度来选择这些材料。除了可焊接性和强度之外，另一种材料选择过程可能会影响硬度。这对于砧座主体的砧座凸轮凸部是尤其重要的。在一些情况下，被选择用于砧座主体的材料的硬度值可以大于砧座帽的硬度值。与砧座主体和砧座帽均使用较软材料来制造相比，砧座凸轮凸部的抗磨损性可能更低。
在某些情况下，可以将成形凹坑排冲压到砧座的面向组织的表面中。在此类情况下，可以将狭缝或切口切割到面向组织的表面中以在冲压过程期间为材料提供朝向其或移动到其中的空间。这可以允许所有的成形凹坑排包括具有相同凹坑深度的成形凹坑，其中在没有预切缝的情况下冲压凹坑可能使排之间的相等凹坑深度变得困难。
实施例
实施例1—一种用于与外科器械一起使用的外科缝合砧座，其中该外科缝合砧座包括砧座主体，该砧座主体包括面向组织的表面，该面向组织的表面包括限定于其中的多个钉成形凹坑和限定于其中的纵向腔。纵向腔包括具有第一宽度的第一腔部分、具有大于第一宽度的第二宽度的第二腔部分，以及具有大于第二宽度的第三宽度的第三腔部分，其中第一腔部分被构造成能够在其中接收外科器械的击发构件的切割边缘的至少一部分，其中第二腔部分被构造成能够在其中接收击发构件的砧座接合部分，其中第三腔部分还包括相对于第二腔部分向外呈喇叭形张开的第一斜面。砧座还包括砧座帽，该砧座帽包括定位在第二腔部分的一部分内的第一节段和定位在第三腔部分内的第二节段，其中第二节段包括对应于第一斜面的第二斜面，并且其中第一斜面和第二斜面的配合节段限定配合深度。砧座还包括将第一斜面和第二斜面焊接在一起的焊接部，其中焊接部包括基本上等于配合深度的焊接深度。
实施例2—根据实施例1所述的外科缝合砧座，其中砧座帽包括Y形横截面。
实施例3—根据实施例1或2所述的外科缝合砧座，其中焊接深度介于约0.015英寸和约0.040英寸之间。
实施例4—根据实施例3所述的外科缝合砧座，其中焊接深度为0.030英寸。
实施例5—根据实施例1、2、3或4所述的外科缝合砧座，其中第三腔部分包括第一凸部表面，其中第二节段包括对应于第一凸部表面的第二凸部表面，并且其中第一凸部表面和第二凸部表面至少基本上平行于面向组织的表面。
实施例6—根据实施例5所述的外科缝合砧座，其中焊接部延伸到凸部表面中。
实施例7—根据实施例1、2、3、4、5或6所述的外科缝合砧座，其中焊接部包括激光焊接部。
实施例8—根据实施例1、2、3、4、5、6或7所述的外科缝合砧座，其中焊接深度小于配合深度。
实施例9—根据实施例1、2、3、4、5、6或7所述的外科缝合砧座，其中焊接深度大于配合深度。
实施例10—一种用于与外科器械一起使用的外科缝合砧座，其中该外科缝合砧座包括第一砧座构件，该第一砧座构件包括面向组织的表面，该面向组织的表面包括限定于其中的多个钉成形凹坑和纵向腔。纵向腔包括具有第一宽度的第一腔部分、具有大于第一宽度的第二宽度的第二腔部分，以及具有大于第二宽度的第三宽度的第三腔部分，其中第一腔部分被构造成能够在其中接收外科器械的击发构件的切割边缘的至少一部分，其中第二腔部分被构造成能够在其中接收击发构件的砧座接合部分。砧座还包括第二砧座构件，该第二砧座构件包括定位在第二腔部分内的第一节段、定位在第三腔部分内的第二节段，其中第二节段包括大于第二宽度的第四宽度和过渡边缘，其中第一节段和第二节段在过渡边缘处过渡。砧座还包括将第二节段和第一砧座构件连接在一起的焊接部，其中该焊接部至少延伸到过渡边缘。
实施例11—根据实施例10所述的外科缝合砧座，其中第二节段相对于第一节段向外呈喇叭形张开。
实施例12—根据实施例10或11所述的外科缝合砧座，其中第二砧座构件包括Y形横截面。
实施例13—根据实施例10、11或12所述的外科缝合砧座，其中焊接部包括介于约0.015英寸和约0.040英寸之间的焊接深度。
实施例14—根据实施例10、11、12或13所述的外科缝合砧座，其中过渡边缘包括至少基本上平行于面向组织的表面的凸部表面。
实施例15—根据实施例14所述的外科缝合砧座，其中焊接部延伸到凸部表面中。
实施例16—根据实施例10、11、12、13、14或15所述的外科缝合砧座，其中焊接部包括激光焊接部。
实施例17—一种外科缝合砧座，该外科缝合砧座包括第一砧座构件，该第一砧座构件包括纵向狭槽和面向组织的表面，该纵向狭槽被构造成能够在其中接收外科器械的击发构件，并且该面向组织的表面包括限定于其中的多个钉成形凹坑。砧座还包括第二砧座构件和将第一砧座构件和第二砧座构件焊接在一起的焊接部，其中第一砧座构件和第二砧座构件包括至少基本上垂直于面向组织的表面的第一配合表面和相对于面向组织的表面成角度的第二配合表面，其中焊接部将至少第二配合表面连接在一起。
实施例18—根据实施例17所述的外科缝合砧座，其中焊接部还将第一配合表面的至少一部分连接在一起。
实施例19—根据实施例17或18所述的外科缝合砧座，其中第一砧座构件和第二砧座构件还包括至少基本上平行于面向组织的表面的第三配合表面。
实施例20—根据实施例19所述的外科缝合砧座，其中第二配合表面和第三配合表面被构造成能够帮助相对于第一砧座构件保持第二砧座构件以用于焊接。
实施例21—根据实施例19或20所述的外科缝合砧座，其中焊接部还将第三配合表面的至少一部分焊接在一起。
实施例22—根据实施例17、18、19、或20或21所述的外科缝合砧座，其中第二配合表面包括配合深度，该配合深度与用于将第二配合表面焊接在一起的焊接机的预先确定的焊接深度至少基本上匹配。
实施例23—根据实施例17、18、19、20、21或22所述的外科缝合砧座，其中焊接部包括介于约0.015英寸和约0.040英寸之间的焊接深度。
实施例24—一种外科缝合砧座，该外科缝合砧座包括砧座主体，该砧座主体包括面向组织的表面、限定在面向组织的表面中的多个钉成形凹坑和纵向狭槽。纵向狭槽包括具有第一宽度的第一部分和具有大于第一宽度的第二宽度的第二部分，其中第一部分被构造成能够在其中接收击发构件的切割边缘，其中第二部分被构造成能够在其中接收击发构件的砧座凸轮部分。砧座还包括焊接到砧座主体的砧座帽，其中该砧座帽包括焊接部分和非焊接部分，其中非焊接部分具有非焊接宽度，并且其中非焊接宽度小于或等于第二宽度的约105％。
实施例25—根据实施例24所述的外科缝合砧座，其中非焊接部分包括第一非焊接部分和第二非焊接部分，第一非焊接部分被构造成能够被接收在纵向狭槽的第二部分内，第二非焊接部分包括被构造成能够将砧座帽和砧座主体对准以用于焊接的对准表面。
实施例26—根据实施例25所述的外科缝合砧座，其中面向组织的表面限定第一平面，并且其中对准表面限定至少基本上平行于第一平面的第二平面。
实施例27—根据实施例24、25或26所述的外科缝合砧座，其中焊接部分相对于非焊接部分呈喇叭形张开。
实施例28—根据实施例24、25、26或27所述的外科缝合砧座，其中焊接部分包括对应于砧座主体的斜面的焊接斜面。
实施例29—根据实施例24、25、26、27或28所述的外科缝合砧座，其中砧座帽包括Y形横截面。
实施例30—一种外科缝合砧座，包括砧座主体，该砧座主体包括限定狭槽轴线的纵向狭槽，其中该纵向狭槽包括面向彼此的狭槽表面，以及
面向组织的表面。面向组织的表面包括由纵向狭槽限定的第一侧和第二侧，以及布置成多个纵向排的多个钉成形凹坑，其中钉成形凹坑的所述多个纵向排包括最靠近纵向狭槽的钉成形凹坑的最内侧排，其中钉成形凹坑的最内侧排限定排轴线距狭槽轴线第一距离，并且限定第一外边界轴线距狭槽第二距离，第二距离大于第一距离。砧座还包括焊接到砧座主体的砧座帽。砧座帽包括焊接部分和非焊接部分，非焊接部分包括最外侧非焊接区域，该最外侧非焊接区域限定定位在距狭槽轴线第三距离的第二外边界轴线，其中第三距离小于第二距离。
实施例31—根据实施例30所述的外科缝合砧座，其中第三距离大于第一距离。
实施例32—根据实施例30所述的外科缝合砧座，其中第三距离小于第一距离。
实施例33—根据实施例30、31或32所述的外科缝合砧座，其中砧座帽还包括被构造成能够将砧座帽和砧座主体对准以用于焊接的对准表面。
实施例34—根据实施例33所述的外科缝合砧座，其中面向组织的表面限定第一平面，并且其中对准表面限定至少基本上平行于第一平面的第二平面。
实施例35—根据实施例30、31、32、33或34所述的外科缝合砧座，其中焊接部分相对于非焊接部分呈喇叭形张开。
实施例36—根据实施例30、31、32、33、34或35所述的外科缝合砧座，其中焊接部分包括对应于砧座主体的斜面的焊接斜面。
实施例37—根据实施例30、31、32、33、34、35或36所述的外科缝合砧座，其中砧座帽包括Y形横截面。
实施例38—一种用于与外科器械一起使用的砧座，其中该砧座包括第一砧座构件，该第一砧座构件包括限定基准平面的面向组织的表面和限定在面向组织的表面中的多个钉成形凹坑。砧座还包括由至少一个焊接部焊接到第一砧座构件的第二砧座构件。第一砧座构件和第二砧座构件包括第一配合区域、第二配合区域和第三配合区域，第一配合区域限定至少基本上平行于基准平面的第一平面，第二配合区域限定至少基本上垂直于基准平面的第二平面，第三配合区域限定相对于基准平面成角度的第三平面，其中第一砧座构件和第二砧座构件在第三配合区域处由所述至少一个焊接部焊接。
实施例39—根据实施例38所述的砧座，其中第三配合区域具有长度，并且其中所述至少一个焊接部包括至少约等于该长度的焊接熔深。
实施例40—根据实施例39所述的砧座，其中焊接熔深大于该长度。
实施例41—根据实施例38、39或40所述的砧座，其中第一配合区域包括被构造成能够将第一砧座构件和第二砧座构件对准以用于焊接的对准表面。
实施例42—根据实施例38、39、40或41所述的砧座，其中第二砧座构件包括Y形横截面。
实施例43—根据实施例38、39、40、41或42所述的砧座，其中所述至少一个焊接部包括激光焊接部。
实施例44—一种外科缝合砧座，该外科缝合砧座包括砧座主体，该砧座主体包括纵向狭槽和面向组织的表面，该纵向狭槽被构造成能够在其中接收击发构件，并且该面向组织的表面包括限定于其中的多个钉成形凹坑。砧座还包括砧座帽和将砧座帽和砧座主体焊接在一起的多个焊接部，这些焊接部包括具有第一焊接深度的浅焊区和具有不同于第一焊接深度的第二焊接深度的深焊区，其中浅焊区和深焊区被构造成能够增加所述多个焊接部的净焊接深度。
实施例45—根据实施例44所述的外科缝合砧座，其中砧座帽和砧座主体包括被构造成能够帮助将砧座主体和砧座帽对准以用于焊接的对应对准特征结构。
实施例46—根据实施例45所述的外科缝合砧座，其中对应对准特征结构包括第一对准特征结构和第二对准特征结构，第一对准特征结构位于定位在距面向组织的表面第一距离处的纵向狭槽的第一侧上，第二对准特征结构位于定位在距面向组织的表面第二距离处的纵向狭槽的第二侧上，并且其中第一距离和第二距离不同。
实施例47—根据实施例44、45或46所述的外科缝合砧座，其中深焊区包括第一纵向长度，其中浅焊区包括第二纵向长度，并且其中第一纵向长度和第二纵向长度不同。
实施例48—根据实施例44，45，46或47所述的外科缝合砧座，其中深焊区包括第一纵向长度，其中浅焊区包括第二纵向长度，并且其中第一纵向长度和第二纵向长度沿外科缝合砧座的长度彼此重叠。
实施例49—根据实施例44、45、46、47或48所述的外科缝合砧座，其中深焊区包括焊接机进入区域。
实施例50—根据实施例49所述的外科缝合砧座，其中焊接机进入区域包括填料焊接部。
实施例51—根据实施例44、45、46、47、48、49或50所述的外科缝合砧座，其中浅焊区具有第一刚度，其中深焊区具有第二刚度，并且其中第一刚度和第二刚度不同。
实施例52—根据实施例44、45、46、47、48、49、50或51所述的外科缝合砧座，其中砧座主体和砧座帽使用金属注射模制过程来制造。
实施例53—一种外科缝合砧座，该外科缝合砧座包括第一砧座构件，第一砧座构件包括纵向狭槽、面向组织的表面和上砧座表面，该纵向狭槽被构造成能够在其中接收击发构件，该面向组织的表面包括限定于其中的多个钉成形凹坑，其中该上砧座表面包括限定第一砧座构件的边缘的孔。砧座还包括第二砧座构件，以及将第一砧座构件和第二砧座构件焊接在一起的焊接构型。焊接构型包括第一焊接部和第二焊接部，第一焊接部包括具有第一焊根的第一焊接深度，其中第一焊接深度被定义为边缘和第一焊根之间的距离，第二焊接部包括具有第二焊根的第二焊接深度，其中第二焊接深度被定义为边缘和第二焊根之间的距离，其中第二焊接深度和第一焊接深度不同，并且其中第一焊接部和第二焊接部被构造成能够增加焊接构型的净焊接深度。
实施例54—根据实施例53所述的外科缝合砧座，其中第一砧座构件和第二砧座构件包括被构造成能够帮助将第一砧座构件和第二砧座构件对准以用于焊接的对应对准特征结构。
实施例55—根据实施例54所述的外科缝合砧座，其中对应对准特征结构包括第一对准特征结构和第二对准特征结构，第一对准特征结构位于定位在距面向组织的表面第一距离处的纵向狭槽的第一侧上，第二对准特征结构位于定位在距面向组织的表面第二距离处的纵向狭槽的第二侧上，并且其中第一距离和第二距离不同。
实施例56—根据实施例53、54或55所述的外科缝合砧座，其中第一焊接部包括第一纵向长度，其中第二焊接部包括第二纵向长度，并且其中第一纵向长度和第二纵向长度不同。
实施例57—根据实施例53、54、55或56所述的外科缝合砧座，其中第一焊接部包括第一纵向长度，其中第二焊接部包括第二纵向长度，并且其中第一纵向长度和第二纵向长度沿外科缝合砧座的长度彼此重叠。
实施例58—根据实施例53、54、55、56或57所述的外科缝合砧座，还包括定位在第一焊接部上的填料焊接部。
实施例59—根据实施例53、54、55、56、57或58所述的外科缝合砧座，还具有沿第一焊接部的第一刚度和沿第二焊接部的第二刚度，其中第一刚度和第二刚度不同。
实施例60—根据实施例53、54、55、56、57、58或59所述的外科缝合砧座，其中第一砧座构件和第二砧座构件使用金属注射模制过程来制造。
实施例61—一种外科缝合砧座，该外科缝合砧座包括砧座主体，该砧座主体包括具有多个钉成形凹坑的面向组织的表面和互锁孔。砧座还包括砧座帽，其中砧座主体和砧座帽焊接在一起，并且其中砧座帽包括被构造成能够接收在互锁孔内的互锁特征结构。
实施例62—根据实施例61所述的外科缝合砧座，其中砧座主体还包括被构造成能够在其中接收外科器械的击发构件的纵向狭槽，其中该纵向狭槽限定纵向轴线，并且其中砧座主体和砧座帽只能沿纵向轴线组装。
实施例63—根据实施例61或62所述的外科缝合砧座，其中砧座主体和砧座帽使用金属注射模制过程来制造。
实施例64—一种外科缝合组件，该外科缝合组件包括限定轴轴线的轴、包括钉仓通道的第一钳口、包括可移除地储存在其中的多个钉的钉仓，以及被构造成能够使钉变形的砧座。砧座包括面向组织的表面、限定在面向组织的表面中的多个钉成形凹坑和纵向狭槽。砧座还包括击发构件，该击发构件包括主体部分，该主体部分包括第一侧面和第二侧面、切割构件、被构造成能够在击发构件移动通过钉击发行程时可滑动地接合第一钳口的通道接合部分，以及被构造成能够在击发构件移动通过钉击发行程时可滑动地接合砧座的砧座接合部分，其中砧座接合部分包括从主体部分延伸的侧向部分，其中侧向部分限定相对于轴轴线成角度的砧座接合部分轴线，其中侧向部分包括纵向长度和竖直厚度，并且其中纵向长度和竖直厚度的比率在约2.5:1和约20:1之间。
实施例65—根据实施例64所述的外科缝合组件，其中该比率在约5:1和约10:1之间。
实施例66—根据实施例64所述的外科缝合组件，其中该比率为约5:1。
实施例67—根据实施例64、65或66所述的外科缝合组件，其中每个侧向部分和主体部分在它们之间包括圆角。
实施例68—根据实施例64、65、66或67所述的外科缝合组件，其中侧向部分包括圆形外端。
实施例69—根据实施例64、65、66、67或68所述的外科缝合组件，其中砧座接合部分包括平面上表面。
实施例70—根据实施例64、65、66、67、68或69所述的外科缝合组件，其中每个侧向部分包括圆形前边缘。
实施例71—根据实施例64，65，66，67，68，69或70所述的外科缝合组件，其中砧座接合部分轴线相对于轴轴线成约一度角。
实施例72—一种外科缝合组件，该外科缝合组件包括限定轴轴线的轴、包括钉仓通道的第一钳口、包括可移除地储存在其中的多个钉的钉仓，以及包括砧座的第二钳口，其中砧座被构造成能够使钉变形。砧座包括面向组织的表面、限定在面向组织的表面中的多个钉成形凹坑和纵向狭槽。缝合组件还包括击发构件，该击发构件包括具有两个侧面的竖直延伸主体部分、被构造成能够在击发构件移动通过钉击发行程时可滑动地接合第一钳口的第一钳口接合构件，以及从主体部分的每个侧面侧向延伸的第二钳口接合构件，其中第二钳口接合构件相对于轴轴线以一定角度取向，其中第二钳口接合构件被构造成能够在击发构件移动通过钉击发行程时可滑动地接合第二钳口。第二钳口接合构件包括竖直厚度和侧向宽度，该侧向宽度被定义为主体部分和第二钳口接合构件的外边缘之间的距离，并且其中该竖直厚度和侧向宽度的比率在约1:2和约1:1之间。
实施例73—根据实施例72所述的外科缝合组件，其中该比率为约1:1。
实施例74—根据实施例72或73所述的外科缝合组件，其中第二钳口接合构件和主体部分在它们之间包括圆角。
实施例75—根据实施例72、73或74所述的外科缝合组件，其中第二钳口接合构件包括圆形外端。
实施例76—根据实施例72、73、74或75所述的外科缝合组件，其中第二钳口接合构件包括平面上表面。
实施例77—根据实施例72、73、74、75或76所述的外科缝合组件，其中第二钳口接合构件包括圆形前边缘。
实施例78—根据实施例72、73、74、75、76或77所述的外科缝合组件，其中第二钳口接合构件相对于轴轴线以约一度角取向。
实施例79—一种外科缝合组件，该外科缝合组件包括限定轴轴线的轴、包括钉仓通道的第一钳口、包括可移除地储存在其中的多个钉的钉仓，以及包括砧座的第二钳口，其中砧座被构造成能够使钉变形。砧座包括面向组织的表面、限定在面向组织的表面中的多个钉成形凹坑和纵向狭槽。缝合组件还包括击发构件，该击发构件包括主体部分，该主体部分包括第一侧面和第二侧面、切割构件、被构造成能够在击发构件移动通过钉击发行程时可滑动地接合第一钳口的第一钳口联接构件，以及被构造成能够在击发构件移动通过钉击发行程时可滑动地接合砧座的第二钳口联接构件，其中第二钳口联接构件包括从第一侧面和第二侧面延伸并限定平面上表面的侧向部分，其中第二钳口联接构件相对于轴轴线成角度，其中侧向部分和侧面在它们之间包括圆角，并且其中侧向部分包括圆形外端。
实施例80—根据实施例79所述的外科缝合组件，其中每个侧向部分包括圆形前边缘。
实施例81—根据实施例79或80所述的外科缝合组件，其中纵向狭槽包括限定纵向狭槽的开口的圆形狭槽边缘，并且其中圆角被构造成能够可滑动地接合圆形狭槽边缘。
实施例82—根据实施例79、80或81所述的外科缝合组件，其中纵向狭槽包括圆形侧向狭槽部分，并且其中圆形外端被构造成能够可滑动地接合对应的圆形狭槽部分。
实施例83—根据实施例79、80、81或82所述的外科缝合组件，其中第二钳口联接构件相对于轴轴线成约一度角。
实施例84—一种外科器械组件，该外科器械组件包括具有第一刚度的砧座凸轮部分、具有被构造成能够由击发构件从钉仓中射出的多个钉的钉仓以及砧座。砧座包括面向组织的表面，该面向组织的表面包括被构造成能够使钉变形的多个钉成形凹坑和被构造成能够在击发行程期间由击发构件的砧座凸轮部分接合的砧座凸部，其中该砧座凸部具有第二刚度，并且其中第二刚度基本上等于第一刚度，使得砧座凸部的偏转将基本上等于砧座凸轮部分的偏转。
实施例85—根据实施例84所述的外科器械组件，还包括用于平衡第一刚度和第二刚度的装置。
实施例86—根据实施例85所述的外科器械组件，其中所述装置包括对砧座凸轮部分的第一几何形状和砧座凸部的第二几何形状中的至少一个进行调整以提供基本上类似的刚度。
实施例87—根据实施例85或86所述的外科器械组件，其中所述装置还包括对砧座凸轮部分的第一高度和砧座凸部的第二高度中的至少一个进行调整以提供基本上类似的刚度。
实施例88—根据实施例85、86或87所述的外科器械组件，其中所述装置包括使砧座凸轮部分和砧座凸部的屈服强度基本上相等。
实施例89—根据实施例85、86、87或88所述的外科器械组件，其中所述装置包括使砧座凸轮部分和砧座凸部的硬度基本上相等。
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8,733,613；
-提交于2011年2月28日的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号13/036,647，现为美国专利8,561,870；
-名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241，现为美国专利9,072,535；
-提交于2012年6月15日的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING A FIRING DRIVE”的美国专利申请序列号13/524,049；现为美国专利9,101,358；
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,025，现为美国专利9,345,481；
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,067，现为美国专利申请公布2014/0263552；
-提交于2006年1月31日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM”的美国专利申请公布2007/0175955；和
-提交于2010年4月22日的名称为“SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”的美国专利申请公布2010/0264194，现为美国专利8,308,040。
虽然本文已结合某些实施方案描述了各种装置，但也可实施对这些实施方案的许多修改和变型。在一个或多个实施方案中，具体特征、结构或特性可以任何合适的方式进行组合。因此，在无限制的情况下，结合一个实施方案示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其他实施方案的特征、结构或特性组合。另外，在公开了用于某些部件的材料的情况下，也可使用其它材料。此外，根据多种实施方案，单个部件可被替换为多个部件，并且多个部件也可被替换为单个部件，以执行给定的一种或多种功能。上述具体实施方式和下述权利要求旨在涵盖所有此类修改和变型。
本文所公开的装置可被设计成在单次使用后废弃，或者其可被设计成多次使用。然而无论是哪种情况，该装置都可在至少使用一次后经过修整再行使用。修复可包括以下步骤的任意组合，这些步骤包括但不限于拆卸装置、之后进行装置具体部件的清洁或更换、以及随后重新组装装置。具体地，修复设施和/或外科团队可拆卸装置，并且在清洁和/或更换装置的特定部件之后，可重新组装装置以供后续使用。本领域的技术人员将会理解，修整装置可利用各种技术来进行拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修复装置均在本申请的范围内。
本文所公开的装置可在手术之前进行处理。首先，可获得新的或用过的器械，并且根据需要进行清洁。然后，可对器械进行消毒。在一种灭菌技术中，将所述器械放置在密闭且密封的容器(诸如，塑料或TYVEK袋)中。然后可将容器和器械置于可穿透容器的辐射场，诸如γ辐射、X射线和/或高能电子。辐射可杀死器械上和容器中的细菌。经消毒的器械随后可被储存在无菌容器中。密封容器可将器械保持为无菌的，直至在医疗设施中将该容器打开。还可使用本领域已知的任何其他技术对装置进行消毒，所述技术包括但不限于β辐射、γ辐射、环氧乙烷、等离子过氧化物和/或蒸汽。
尽管本发明已被描述为具有示例性设计，但可在本公开的实质和范围内进一步修改本发明。因此，本申请旨在涵盖使用本发明的一般原理的本发明的任何变型、用途或改型。
以引用方式全文或部分地并入本文的任何专利、公布或其他公开材料均仅在所并入的材料不与本发明所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。因此，并且在必要的程度下，本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其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 (8)
1.一种外科缝合砧座，包括：
砧座主体，所述砧座主体包括：
限定狭槽轴线的纵向狭槽，其中，所述纵向狭槽包括面向彼此的狭槽表面；
面向组织的表面，所述面向组织的表面包括：
由所述纵向狭槽限定的第一侧和第二侧；
多个钉成形凹坑，所述多个钉成形凹坑布置成多个纵向排，其中，所述钉成形凹坑的多个纵向排包括最靠近所述纵向狭槽的钉成形凹坑的最内侧排，其中，所述钉成形凹坑的最内侧排限定排轴线距所述狭槽轴线第一距离，并且限定第一外边界轴线距所述狭槽轴线第二距离，所述第二距离大于所述第一距离；和
第一凸部，所述第一凸部被构造成能够随着击发构件运动经过击发行程而通过击发构件接合；以及
第二凸部，所述第二凸部与所述第一凸部间隔开；
砧座帽，所述砧座帽焊接到所述砧座主体，其中，所述砧座帽被构造成能够接触所述第二凸部，其中，所述砧座帽包括：
焊接部分，所述焊接部分被焊接到所述砧座主体的第一表面；和
非焊接部分，所述非焊接部分邻接所述砧座主体的第二表面，其中，所述非焊接部分包括最外侧非焊接区域，所述最外侧非焊接区域限定定位在距所述狭槽轴线第三距离的第二外边界轴线，其中，所述第三距离小于所述第二距离。
2.根据权利要求1所述的外科缝合砧座，其中，所述第三距离大于所述第一距离。
3.根据权利要求1所述的外科缝合砧座，其中，所述第三距离小于所述第一距离。
4.根据权利要求1所述的外科缝合砧座，其中，所述砧座帽还包括被构造成能够将所述砧座帽和所述砧座主体对准以用于焊接的对准表面。
5.根据权利要求4所述的外科缝合砧座，其中，所述面向组织的表面限定第一平面，并且其中，所述对准表面限定至少基本上平行于所述第一平面的第二平面。
6.根据权利要求1所述的外科缝合砧座，其中，所述焊接部分相对于所述非焊接部分呈喇叭形张开。
7.根据权利要求6所述的外科缝合砧座，其中，所述焊接部分包括对应于所述砧座主体的斜面的焊接斜面。
8.根据权利要求1所述的外科缝合砧座，其中，所述砧座帽包括Y形横截面。
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| US15/634,046 | 2017-06-27 | ||
| US15/634,046 US10993716B2 (en) | 2017-06-27 | 2017-06-27 | Surgical anvil arrangements |
| PCT/IB2018/054402 WO2019003036A1 (en) | 2017-06-27 | 2018-06-14 | SURGICAL ENCLOSURE ARRANGEMENTS |
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| CN110868940A CN110868940A (zh) | 2020-03-06 |
| CN110868940B true CN110868940B (zh) | 2023-01-20 |
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| EP (1) | EP3420960A1 (zh) |
| JP (1) | JP7200144B2 (zh) |
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2017
- 2017-06-27 US US15/634,046 patent/US10993716B2/en active Active
- 2017-12-21 EP EP17209647.1A patent/EP3420960A1/en not_active Withdrawn
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2018
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- 2018-06-14 CN CN201880043087.7A patent/CN110868940B/zh active Active
- 2018-06-14 MX MX2019015666A patent/MX2019015666A/es unknown
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2021
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2023
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Also Published As
| Publication number | Publication date |
|---|---|
| US10993716B2 (en) | 2021-05-04 |
| US20240058000A1 (en) | 2024-02-22 |
| US11766258B2 (en) | 2023-09-26 |
| JP2020525131A (ja) | 2020-08-27 |
| US20180368841A1 (en) | 2018-12-27 |
| EP3420960A1 (en) | 2019-01-02 |
| JP7200144B2 (ja) | 2023-01-06 |
| WO2019003036A1 (en) | 2019-01-03 |
| CN110868940A (zh) | 2020-03-06 |
| MX2019015666A (es) | 2020-08-03 |
| US20210236124A1 (en) | 2021-08-05 |
| BR112019027055A2 (pt) | 2020-06-30 |
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