CN110868941B - 包括可选择性致动的可旋转联接器的外科器械 - Google Patents

包括可选择性致动的可旋转联接器的外科器械 Download PDF

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CN110868941B
CN110868941B CN201880043628.6A CN201880043628A CN110868941B CN 110868941 B CN110868941 B CN 110868941B CN 201880043628 A CN201880043628 A CN 201880043628A CN 110868941 B CN110868941 B CN 110868941B
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articulation
end effector
surgical instrument
patent application
closure
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CN110868941A (zh
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F·E·谢尔顿四世
J·L·哈里斯
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Ethicon LLC
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Ethicon LLC
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Abstract

本发明公开了一种外科器械(20000)，其包括：端部执行器(11500)，该端部执行器包括第一钳口和第二钳口，其中该第一钳口能够相对于该第二钳口旋转；以及闭合系统(20110)，该闭合系统被构造成能够在闭合行程期间使该第一钳口闭合。该外科器械还包括：关节运动接头(11200)，该关节运动接头可旋转地将该端部执行器连接到轴；关节运动系统(20310，20320)，该关节运动系统被构造成能够使该端部执行器相对于该轴进行关节运动；以及击发系统，该击发系统与电动马达可操作地接合，其中击发构件能够在击发行程期间移动穿过该端部执行器。该外科器械还包括：第一可旋转构件，该第一可旋转构件被构造成能够选择性地使该击发系统的运动和该关节运动系统的运动同步；以及第二可旋转构件(20400)，该第二可旋转构件与该关节运动系统可操作地接合，其中该闭合系统被构造成能够阻止该第二可旋转构件的旋转。

Description

包括可选择性致动的可旋转联接器的外科器械
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中所描绘的可互换外科工具组件中的一者和柄部组件的部分的分解组装视图；
图3是图1中所描绘的可互换外科工具组件中的一者的透视图；
图4是图3的可互换外科工具组件的分解组装视图；
图5是图3和图4的可互换外科工具组件的远侧部分的另一分解组装视图；
图6是图3至图5的可互换外科工具组件的远侧部分的另一分解组装视图；
图7是图3至图6的可互换外科工具组件的近侧部分的分解组装视图；
图8是图3至图7的可互换外科工具组件的一部分的另一分解组装视图；
图9是图3至图8的可互换外科工具组件的一部分的另一分解组装视图；
图10是图3至图9的可互换外科工具组件的近侧部分的透视图；
图11是图3至图10的可互换外科工具组件的近侧部分的另一透视图；
图12是图3至图11的可互换外科工具组件的近侧部分的剖视透视图；
图13是图3至图12的可互换外科工具组件的近侧部分的另一剖视透视图；
图14是图3至图13的可互换外科工具组件的近侧部分的另一剖视透视图；
图15是图3至图14的可互换外科工具组件的远侧部分的剖视透视图；
图16是根据至少一个实施方案的外科器械的端部执行器的局部平面图；
图16A是图16的端部执行器的局部平面图，其示出了在第一方向上进行关节运动的端部执行器；
图16B是图16的端部执行器的局部平面图，其示出了在第二方向上进行关节运动的端部执行器；
图17是根据至少一个实施方案的外科器械的端部执行器的局部平面图；
图17A是图17的端部执行器的局部平面图，其示出了在第一方向上进行关节运动的端部执行器；
图17B是图17的端部执行器的局部平面图，其示出了在第二方向上进行关节运动的端部执行器；
图18是图16的端部执行器的局部平面图；
图19是图17的端部执行器的局部平面图；
图20是处于关节运动位置的图16的端部执行器的局部平面图；
图21是处于关节运动位置的图17的端部执行器的局部平面图；
图22是示出图16的端部执行器的关节运动范围的示意图；
图23是示出图17的端部执行器的关节运动范围的示意图；
图24是被示出为一些部件被移除的图17的端部执行器的局部透视图；
图25是被示出为一些部件被移除的图17的端部执行器的局部平面图；
图26是被示出为处于打开的非关节运动构型的图17的端部执行器的局部平面图；
图26A是被示出为处于打开的完全向右关节运动构型的图17的端部执行器的局部平面图；
图26B是被示出为处于打开的完全向左关节运动构型的图17的端部执行器的局部平面图；
图27是被示出为处于闭合的非关节运动构型的图17的端部执行器的局部平面图；
图27A是被示出为处于闭合的完全向右关节运动构型的图17的端部执行器的局部平面图；
图27B是被示出为处于闭合的完全向左关节运动构型的图17的端部执行器的局部平面图；
图28是被示出为处于非关节运动构型的图17的端部执行器的局部平面图；
图29是被示出为处于关节运动构型的图17的端部执行器的局部平面图；
图30是被示出为处于非关节运动构型的图17的端部执行器的局部平面图；
图30A是被示出为处于完全向右关节运动构型的图17的端部执行器的局部平面图；
图30B是被示出为处于完全向左关节运动构型的图17的端部执行器的局部平面图；
图31是被示出为处于非关节运动构型的图17的端部执行器的局部平面图；
图31A是被示出为处于完全向右关节运动构型的图17的端部执行器的局部平面图；
图31B是被示出为处于完全向左关节运动构型的图17的端部执行器的局部平面图；
图32是根据至少一个实施方案的端部执行器的局部透视图；
图33是图32的端部执行器的局部平面图；
图34是被示出为处于非关节运动构型的图32的端部执行器的剖视图；
图34A是被示出为处于关节运动构型的图32的端部执行器的剖视图；
图34B是被示出为处于关节运动构型的图32的端部执行器的剖视图；
图35是根据至少一个实施方案的端部执行器的局部透视图；
图36是被示出为一些部件被移除的图35的端部执行器的局部透视图；
图37是被示出为一些部件被移除的图35的端部执行器的局部平面图；
图38是被示出为一些部件被移除的图35的端部执行器的局部正视图；
图39是被示出为处于非关节运动构型的图35的端部执行器的剖视图；
图39A是被示出为处于关节运动构型的图35的端部执行器的剖视图；
图39B是被示出为处于关节运动构型的图35的端部执行器的剖视图；
图40是根据至少一个实施方案的包括关节运动系统的端部执行器的局部剖视图，该关节运动系统包括关节运动锁；
图41是图40的端部执行器的局部分解图；
图42是图40的端部执行器的横截面端视图；
图43是图40的端部执行器的局部剖视图，其示出了处于接合状态的关节运动锁；
图44是图40的端部执行器的剖视图，其示出了处于解锁状态的关节运动锁；
图45是图40的端部执行器的局部剖视图，其示出了处于锁定状态的关节运动锁；
图46是根据至少一个实施方案的包括可滑动锁定板的端部执行器的局部剖视图；
图47是根据至少一个实施方案的包括可滑动锁定板的另一端部执行器的局部剖视图；
图48是图47的端部执行器的局部剖视图，其示出了锁定板的自调整性；
图49是处于锁定状态的图47的端部执行器的局部剖视图；
图50是根据至少一个实施方案的包括另一可滑动锁定板的端部执行器的局部剖视图；
图51是被示出为处于锁定状态的图50的端部执行器的局部剖视图；
图52是被示出为处于另一锁定状态的图50的端部执行器的局部剖视图；
图53是根据至少一个实施方案的包括关节运动系统和关节运动锁的端部执行器的局部剖视图，被示出为一些部件被移除；
图53A是在第一方向上进行关节运动的图53的端部执行器的局部剖视图；
图53B是在第二方向上进行关节运动的图53的端部执行器的局部剖视图；
图54是处于解锁状态的图53的端部执行器的局部剖视图；
图55是处于部分锁定状态的图53的端部执行器的局部剖视图；
图56是处于锁定状态的图53的端部执行器的局部剖视图；
图57是示出图53的端部执行器的逐渐锁定的图表；
图58是根据至少一个实施方案的包括关节运动系统和关节运动锁的端部执行器的局部剖视图，被示出为一些部件被移除；
图59是被示出为处于部分锁定状态的图58的端部执行器的局部剖视图；
图60是处于锁定状态的图58的端部执行器的局部剖视图；
图61是根据至少一个实施方案的包括关节运动系统和关节运动锁的端部执行器的局部剖视图，被示出为一些部件被移除；
图62是图61的端部执行器的局部剖视图，其示出了朝向关节运动系统移动的关节运动锁；
图63是图61的端部执行器的局部剖视图，其示出了与关节运动系统接合的关节运动锁；
图64是图61的端部执行器的局部剖视图，其示出了处于锁定状态的关节运动锁；
图65是图61的端部执行器的另一局部剖视图，其示出了与关节运动系统接合的关节运动锁；
图66是根据至少一个实施方案的包括关节运动系统和关节运动锁的端部执行器的局部剖视图，被示出为一些部件被移除；
图67是图66的端部执行器的局部剖视图，其示出了与关节运动系统接合的关节运动锁；
图68是图66的端部执行器的局部剖视图，其示出了处于锁定状态的关节运动锁；
图69是根据至少一个实施方案的包括关节运动系统和关节运动锁的端部执行器的局部剖视图，被示出为一些部件被移除；
图70是图69的端部执行器的局部剖视图，其示出了朝向关节运动系统移动的关节运动锁；
图71是图69的端部执行器的局部剖视图，其示出了处于锁定状态的关节运动锁；
图72是根据至少一个实施方案的端部执行器关节运动驱动系统的局部透视图；
图73是图72的端部执行器关节运动驱动系统的平面图；
图74是图72的端部执行器关节运动驱动系统的正视图；
图75是根据至少一个实施方案的端部执行器关节运动驱动系统的局部透视图；
图76是图75的端部执行器关节运动驱动系统的平面图；
图77是图75的端部执行器关节运动驱动系统的正视图；
图78是图75的端部执行器关节运动驱动系统的详细视图；
图79是图75的端部执行器关节运动驱动系统的另一详细视图；
图80是根据至少一个实施方案的包括轴和端部执行器的外科器械的透视图；
图81是图80中的外科器械的透视图，其示出了相对于轴进行关节运动的端部执行器；
图82处于打开构型的图80的端部执行器的透视图；
图83是根据至少一个实施方案的击发构件的局部正视图；
图84是图83的击发构件的局部横截面平面图；
图85是根据至少一个实施方案的具有缩短鼻部的钉仓的远侧端部的局部剖视图；
图86是根据至少一个实施方案的具有缩短鼻部的钉仓的远侧端部的局部剖视图；
图87是图85的钉仓的各种内部部件的顶视图，其示出了跨越定位在楔形滑动件的一部分的顶部上的三个纵向排钉腔的三钉驱动器；
图88是图87的三钉驱动器的剖视图，其示出了相对于滑动件的三钉驱动器的中心线；
图89是图85的钉仓的局部平面图，其以横截面示出了钉仓平台的一个侧面，并且示出了在击发行程完成之后图88的滑动件在限定在仓的缩短鼻部中的凹陷部内的位置；
图90是沿图89中的线90-90截取的图85的钉仓的局部剖视图，其示出了在击发行程完成之后滑动件的位置；
图91是比较在骨盆腔外科手术期间包括图85和图86中的钉仓的端部执行器的可触及性的图；
图92是根据至少一个实施方案的包括图85的钉仓以及具有保护端头的缩短的相对砧座的端部执行器的局部透视图；
图93是图92的端部执行器的局部正视图；
图94是处于组装好构型的图92中所描绘的具有保护端头的砧座的一个实施方案的局部平面图；
图95是沿图94中的线95-95截取的并且被示出为处于部分未组装构型的图94中所描绘的砧座的局部剖视图，其示出了用于可移除地将保护端头附连到砧座的示例性附接装置；
图96是沿图95中的线96-96截取的并且被示出为处于部分未组装构型的图95中所描绘的砧座的局部剖视图，其示出了位于砧座上用于连接到保护端头上的对应几何形状的附接特征部的几何形状；
图97是处于部分未组装构型的图92中所描绘的砧座的附加实施方案的局部剖视图，其示出了定位在临时保持器内的保护端头；
图98是处于部分未组装构型的沿图97中的线98-98截取的图97中所描绘的砧座的剖视图，其出了砧座上端头附接特征部的几何形状；
图99是处于组装好构型的沿图97中的线99-99截取的图97中所描绘的砧座的剖视图，其中仍附接有临时保持器；
图100是在端部执行器插入其中之前的套管针密封系统的剖视图；
图101是图100的套管针密封系统的剖视图，其示出了插入套管针密封系统中的图100中所描绘的端部执行器；
图102是图100的套管针密封系统的剖视图，其示出了插入套管针密封系统中的图100中所描绘的端部执行器；
图103是图100的套管针密封系统的剖视图，其示出了插入套管针密封系统中的包括图85的缩短钉仓以及具有保护端头的缩短砧座的端部执行器；
图104是在包括图86的细长仓以及具有锋利端头的缩短砧座的端部执行器插入其中之前的图100的套管针密封系统的剖视图；
图105是图100的套管针密封系统的剖视图，其示出了插入套管针密封系统中的图104中所描绘的端部执行器；和
图106是图100的套管针密封系统的剖视图，其示出了插入套管针密封系统中的图104中所描绘的端部执行器。
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 INSTRUMENT COMPRISING AN OFFSET ARTICULATION JOINT”的美国专利申请序列号__________；代理人案卷号END8207USNP/170098；
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM RATIO”的美国专利申请序列号__________；代理人案卷号END8210USNP/170099；
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM RATIO”的美国专利申请序列号__________；代理人案卷号END8204USNP/170100；
-名称为“SURGICAL INSTRUMENT COMPRISING FIRING MEMBER SUPPORTS”的美国专利申请序列号__________；代理人案卷号END8218USNP/170101；
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEMLOCKABLE TO A FRAME”的美国专利申请序列号__________；代理人案卷号END8217USNP/070102；
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEMLOCKABLE BY A CLOSURE SYSTEM”的美国专利申请序列号__________；代理人案卷号END8211USNP/170103；
-名称为“SURGICAL INSTRUMENT COMPRISING A SHAFT INCLUDING A HOUSINGARRANGEMENT”的美国专利申请序列号__________；代理人案卷号END8215USNP/170107；
-名称为“SURGICAL STAPLING INSTRUMENTS COMPRISING SHORTENED STAPLECARTRIDGE NOSES”的美国专利申请序列号__________；代理人案卷号END8206USNP/170105；
-名称为“SURGICAL INSTRUMENT COMPRISING A SHAFT INCLUDING A CLOSURETUBE PROFILE”的美国专利申请序列号__________；代理人案卷号END8212USNP/170106；
-名称为“METHOD FOR ARTICULATING A SURGICAL INSTRUMENT”的美国专利申请序列号__________；代理人案卷号END8200USNP/170089M；
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTOR WITHAXIALLY SHORTENED ARTICULATION JOINT CONFIGURATIONS”的美国专利申请序列号__________；代理人案卷号END8214USNP/170090；
-名称为“SURGICAL INSTRUMENTS WITH OPEN AND CLOSABLE JAWS AND AXIALLYMOVABLE FIRING MEMBER THAT IS INITIALLY PARKED IN CLOSE PROXIMITY TO THE JAWSPRIOR TO FIRING”的美国专利申请序列号__________；代理人案卷号END8202USNP/170091；
-名称为“SURGICAL INSTRUMENTS WITH JAWS CONSTRAINED TO PIVOT ABOUT ANAXIS UPON CONTACT WITH A CLOSURE MEMBER THAT IS PARKED IN CLOSE PROXIMITY TOTHE PIVOT AXIS”的美国专利申请序列号__________；代理人案卷号END8213USNP/170092；
-名称为“SURGICAL END EFFECTORS WITH IMPROVED JAW APERTUREARRANGEMENTS”的美国专利申请序列号__________；代理人案卷号END8203USNP/170093；
-名称为“SURGICAL CUTTING AND FASTENING DEVICES WITH PIVOTABLE ANVILWITH A TISSUE LOCATING ARRANGEMENT IN CLOSE PROXIMITY TO AN ANVIL PIVOT”的美国专利申请序列号__________；代理人案卷号END8205USNP/170094；
-名称为“JAW RETAINER ARRANGEMENT FOR RETAINING A PIVOTABLE SURGICALINSTRUMENT JAW IN PIVOTABLE RETAINING ENGAGEMENT WITH A SECOND SURGICALINSTRUMENT JAW”的美国专利申请序列号__________；代理人案卷号END8216USNP/170095；
-名称为“SURGICAL INSTRUMENT WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号__________；代理人案卷号END8208USNP/170096；
-名称为“SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER”的美国专利申请序列号__________；代理人案卷号END8209USNP/170097；
-名称为“SURGICAL INSTRUMENT LOCKOUT ARRANGEMENT”的美国专利申请序列号__________；代理人案卷号END8233USNP/170084；
-名称为“STAPLE FORMING ANVIL”的美国设计专利申请序列号__________；代理人案卷号END8236USDP/170109D；
-名称为“SURGICAL INSTRUMENT SHAFT”的美国设计专利申请序列号__________；代理人案卷号END8239USDP/170108D；和
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号__________；代理人案卷号END8240USDP/170110D。
本申请的申请人拥有于2017年6月27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 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END8170USNP/170081；
-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 SURGICAL INSTRUMENTS”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2月9日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLYTRANSLATABLE END EFFECTOR”的美国专利申请序列号15/019,220；
-名称为“SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,228；
-名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTEDSECONDARY CONSTRAINT”的美国专利申请序列号15/019,196；
-名称为“SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLYARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY”的美国专利申请序列号15/019,206；
-名称为“SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,215；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATIONLINK ARRANGEMENTS”的美国专利申请序列号15/019,227；
-名称为“SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLEDRIVEN ARTICULATION SYSTEMS”的美国专利申请序列号15/019,235；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAMARRANGEMENTS”的美国专利申请序列号15/019,230；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开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开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开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开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开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开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开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开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开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2014年9月5日提交并且其各自全文以引用方式并入本文的以下专利申请：
-名称为“CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,103，现为美国专利申请公布2016/0066912；
-名称为“ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUECOMPRESSION”的美国专利申请序列号14/479,119，现为美国专利申请公布2016/0066914；
-名称为“MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION”的美国专利申请序列号14/478,908，现为美国专利申请公布2016/0066910；
-名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'SOUTPUT OR INTERPRETATION”的美国专利申请序列号14/478,895，现为美国专利申请公布2016/0066909；
-名称为“POLARITY OF HALL MAGNET TO DETECT MISLOADED CARTRIDGE”的美国专利申请序列号14/479,110，现为美国专利申请公布2016/0066915；
-名称为“SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION”的美国专利申请序列号14/479,098，现为美国专利申请公布2016/0066911；
-名称为“MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,115，现为美国专利申请公布2016/0066916；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2014年4月9日提交并且其各自全文以引用方式并入本文的以下专利申请：
-名称为“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2013年4月16日提交并且其各自全文以引用方式并入本文的以下专利申请：
-名称为“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”(以及“包括”的任何形式，诸如“包含”)、“具有”(以及“具有”的任何形式，诸如“含有”)、“包含”(以及“包含”的任何形式，诸如“包括”)、以及“含有”(以及“含有”的任何形式，诸如“带有”)为开放式系动词。因此，“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件，但不限于仅具有这些一个或多个元件。同样，“包括”、“具有”、“包含”或“含有”一个或多个特征部的系统、装置、或设备的元件具有那些一个或多个特征部，但不限于仅具有那些一个或多个特征部。
术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分，术语“远侧”是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而，外科器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以用于执行腹腔镜式和微创外科手术操作。然而，读者将容易理解，本文所公开的各种方法和装置可用于多种外科程序和应用中，包括例如与开放式外科程序结合。继续参阅本具体实施方式，读者将进一步理解，本文所公开的各种器械能够以任何方式插入体内，诸如通过自然腔道、通过成形于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可直接插入患者体内或者可通过具有工作通道的进入装置插入，外科器械的端部执行器和细长轴可通过所述工作通道推进。
外科缝合系统可包括轴和从轴延伸的端部执行器。端部执行器包括第一钳口和第二钳口。第一钳口包括钉仓。钉仓能够插入到第一钳口中并且能够从第一钳口移除；然而，设想到其中钉仓不能够从第一钳口移除或至少能够易于从第一钳口替换的其他实施方案。第二钳口包括被构造成能够使从钉仓射出的钉变形的砧座。第二钳口能够相对于第一钳口围绕闭合轴线枢转；然而，可设想到其中第一钳口能够相对于第二钳口枢转的其他实施方案。外科缝合系统还包括被构造成能够允许端部执行器相对于轴旋转或进行关节运动的关节运动接头。端部执行器能够围绕延伸穿过关节运动接头的关节运动轴线旋转。设想了不包括关节运动接头的其他实施方案。
钉仓包括仓体。仓体包括近侧端部、远侧端部和在近侧端部与远侧端部之间延伸的平台。在使用中，钉仓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。如在图1中可见，外科器械10的一个示例包括四个可互换外科工具组件1000、3000、5000和7000，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1000、3000、5000和7000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1000、3000、5000和7000中的一者或多者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 ROTATABLE STAPLE 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示出了可互换外科工具组件1000与柄部组件500的附接。应当理解，其它可互换工具组件3000、5000和7000中的任一者可以类似的方式联接到柄部组件500。图2中描绘的附接布置和方法也可以与可互换外科工具组件1000、3000、5000和7000中任一者与机器人系统的工具驱动部分或工具驱动壳体的附接结合使用。柄部组件500可包括柄部壳体502，柄部壳体502包括可由临床医生抓持和操纵的手枪式抓持部分504。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510、530，这些驱动系统被构造成能够生成各种控制动作并将各种控制动作施加到可操作地附接到柄部组件500的可互换外科工具组件1000、3000、5000和/或7000的对应部分。
如在图2中可见，柄部组件500还可以包括操作地支撑多个驱动系统的柄部框架506。例如，柄部框架506能够可操作地支撑通常表示为510的“第一”或闭合驱动系统，该“第一”或闭合驱动系统可用于将闭合和打开动作施加到可操作地附接或联接到柄部组件500的可互换外科工具组件1000、3000、5000和7000。在至少一种形式中，闭合驱动系统510可包括呈由柄部框架506枢转地支撑的闭合触发器512形式的致动器。此类布置使得闭合触发器512能够由临床医生操纵，使得当临床医生抓持柄部组件500的手枪式握把部504时，闭合触发器512可容易从启动或“未致动”位置枢转到“致动”位置并且更具体地枢转到完全压缩或完全致动位置。在各种形式中，闭合驱动系统510还包括闭合连杆组件514，闭合连杆组件514可枢转地联接到闭合触发器512或以其他方式可操作地与闭合触发器512连接。如下面将进一步详细讨论的，在例示的示例中，闭合连杆组件514包括横向附接销516，其有利于附接到外科工具组件上的对应驱动系统。在使用中，为了致动闭合驱动系统510，临床医生将闭合触发器512朝向手枪式抓持部分504按压。如名称为“SURGICAL INSTRUMENTCOMPRISING A SENSOR SYSTEM”的美国专利申请序列号14/226,142(现为美国专利申请公布2015/0272575，该申请专利据此全文以引用方式并入本文)中进一步详细描述的，闭合驱动系统510被构造成能够当临床医生完全压下闭合触发器512以实现完全闭合行程时，将闭合触发器512锁定到完全压下或完全致动的位置。当临床医生期望将闭合触发器512解锁以允许闭合触发器512被偏压到未致动位置时，临床医生致动使得闭合触发器能够返回到其未致动位置的闭合释放按钮组件518。闭合释放按钮组件518还可被构造成能够与各种传感器交互，这些传感器与柄部组件500中的微处理器560通信以跟踪闭合触发器512的位置。关于闭合释放按钮组件518的构造和操作的进一步的细节可见于美国专利申请公布2015/0272575中。
在至少一种形式中，柄部组件500和柄部框架506可以操作地支撑在本文中称为击发驱动系统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的可互换外科工具组件的对应部分。如在美国专利申请公布2015/0272575中详细描述的，击发驱动系统530可采用位于柄部组件500的手枪式握把部504中的电动马达505。在各种形式中，马达505可以是例如具有约25,000RPM的最大速度的直流有刷驱动马达。在其它布置方式中，马达505可包括无刷马达、无绳马达、同步马达、步进马达、或任何其它合适的电动马达。马达505可由功率源522供电，在一种形式中，该功率源可包括可移除电源组。电源组可将多个锂离子(“LI”)或其他合适的电池支撑在其中。可以使用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505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驱动可纵向移动的驱动构件。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将在远侧方向“DD”上被轴向地驱动。当马达505在相反的旋转方向上被驱动时，可纵向移动的驱动构件将在近侧方向“PD”上被轴向地驱动。柄部组件500可包括开关513，开关513可被构造成能够使通过功率源522施加到电动马达505的极性反转或以其他方式控制马达505。柄部组件500还可包括一个或多个传感器，该一个或多个传感器被构造成能够检测驱动构件的位置和/或驱动构件移动的方向。马达505的致动可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可由弹簧或其它偏压布置结构偏压到未致动位置，使得当临床医生释放击发触发器532时，击发触发器532可由弹簧或偏压布置枢转或以其它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可配备有用于防止击发触发器532的无意致动的击发触发器安全按钮。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，随后它们可由临床医生操纵。
在至少一种形式中，可纵向移动的驱动构件可具有形成在其上的齿条(未示出)，以用于与和马达交接的对应驱动齿轮布置结构啮合接合。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在马达505变得失效的情况下手动地回缩可纵向移动的驱动构件。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。参见图2。杠杆可被构造成能够被手动枢转成与驱动构件中的齿棘轮接合。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，以使驱动构件在近侧方向“PD”上做棘轮运动。名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUSWITH MANUALLY RETRACTABLE FIRING SYSTEM”的美国专利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可互换外科工具组件中的任一者一起采用的其它部件、布置和系统。
现在转向图3和图4，可互换外科工具组件1000包括外科端部执行器1500，该外科端部执行器1500包括第一钳口1600和第二钳口1800。在一个布置中，第一钳口1600包括细长通道1602，该细长通道被构造成能够在其中可操作地支撑外科钉/紧固件仓1700。第二钳口1800包括相对于细长通道1602被枢转地支撑的砧座1810。可互换外科工具组件1000包括关节运动系统1300，该关节运动系统1300包括关节运动接头1302和关节运动锁1400(图4至图6)，该关节运动锁1400可以被构造成能够将外科端部执行器1500相对于轴轴线SA1可释放地保持在期望关节运动的位置。
如在图4和图7至图9中进一步可见，可互换外科工具组件1000包括工具框架组件1200，该工具框架组件包括操作地支撑其上的喷嘴组件1240的工具底座1210。在一种形式中，喷嘴组件1240由喷嘴部分1242、1244以及致动器轮部分1246构成，该致动器轮部分被构造成能够例如通过按扣、凸耳和/或螺杆联接到组装好的喷嘴部分1242、1244。可互换外科工具组件1000包括近侧闭合组件1900，该近侧闭合组件可操作地联接到远侧闭合组件2000，该远侧闭合组件用于闭合和/或打开外科端部执行器1500的砧座1810，如将在下文进一步详细讨论的。此外，可互换外科工具组件1000包括脊组件1250，该脊组件1250操作地支撑近侧闭合组件1900并且联接到外科端部执行器1500。在各种情况下，为了便于组装，脊组件1250可由例如通过按扣特征部、粘合剂和/或焊接互连在一起的上脊段1251和下脊段1252制成。在各种情况下，脊组件1250包括可旋转地支撑在工具底座1210中的近侧端部1253。在一个布置中，例如，脊组件1250的近侧端部1253附接到脊轴承，该脊轴承被构造成能够支撑在工具底座1210内。这种布置有利于脊组件1250可旋转地附接到工具底座1210，使得脊组件1250可选择性地相对于工具底座1210围绕轴轴线SA1旋转。具体地，在至少一个布置中，例如，脊组件1250的近侧端部1253包括上凸耳支座1254(图4、图5、图7、图8和图10)和下凸耳支座，这些凸耳支座各自被构造成能够接收从喷嘴部分1242、1244中的每一者向内延伸的对应喷嘴凸耳1245。此类布置通过旋转喷嘴组件1240的致动器轮部分1246来促进脊组件1250围绕轴轴线SA1旋转。
如在图4和图5中可见，脊组件1250还包括中间脊轴段1256，该中间脊轴段具有比脊组件1250的近侧端部1253的直径小的直径。上脊段1251的中间脊轴段1256终止于上凸耳安装特征部1260中，并且下脊段1252的中间脊轴段终止于下凸耳安装特征部1270中。如在图6中可见，上凸耳安装特征部1260在其中形成有凸耳狭槽1262，该凸耳狭槽适于在其中以安装方式支撑上安装连接件1264。类似地，下凸耳安装特征部1270在其中形成有凸耳狭槽1272，该凸耳狭槽1272适于在其中安装地支撑下安装连接件1274。上安装连接件1264在其中包括与轴轴线SA1偏置的枢轴承窝1266。该枢轴承窝1266适于在其中可旋转地接收枢轴销1634，该枢轴销1634形成在附接到细长通道1602的近侧端部部分1610的通道顶盖或砧座保持器1630上。下安装连接件1274包括下枢轴销1276，该下枢轴销适于接收在形成于细长通道1602的近端部分1610中的枢轴孔1611内。参见图6。下枢轴销1276以及枢轴孔1611与轴轴线SA1偏置。下枢轴销1276与枢轴承窝1266竖直对准以限定关节运动轴线AA1，外科端部执行器1500可围绕该关节运动轴线相对于轴轴线SA1进行关节运动。尽管关节运动轴线AA1横向于轴轴线SA1，但该关节运动轴线AA1与轴轴线SA1侧向偏置，并且不与轴轴线SA1相交。
现参考图6和图15，砧座1810包括终止于砧座安装部分1820中的砧座主体1812。砧座安装部分1820可移动地或可枢转地支撑在细长通道1602上，以相对于其围绕横向于轴轴线SA1的固定砧座枢转轴线PA1(图15)选择性枢转行进。枢轴构件或砧座耳轴1822侧向延伸出砧座安装部分1820的每个侧面，以接收在形成于细长通道1602的近端部分1610的直立壁1612中的对应耳轴支架1614中。砧座耳轴1822通过通道顶盖或砧座保持器1630枢转地保持在其对应的耳轴支架1614中。通道顶盖或砧座保持器1630包括一对附接凸耳1636，该一对附接凸耳被构造成能够保持地接收在形成在细长通道1602的近侧端部部分1610的直立壁1612中的对应凸耳凹槽或凹口1616内。
外科端部执行器1500通过关节运动系统1300能够选择性地围绕关节运动轴线AA1进行关节运动。在一种形式中，关节运动系统1300包括枢转地联接到关节运动连接件1320的近侧关节运动驱动器1310。如在图6中可见，偏置附接凸耳1314形成在近侧关节运动驱动器1310的远侧端部1312上。枢轴孔1316形成在偏置附接凸耳1314中并且被构造成能够在其中枢转地接收形成在关节运动连接件1320的近侧端部1325上的近侧连接件销1326。关节运动连接件1320的远侧端部1322包括枢轴孔1324，该枢轴孔被构造成能够在其中枢转地接收形成在细长通道1602的近侧端部部分1610上的通道销1618。因此，近侧关节运动驱动器1310的轴向移动将向细长通道1602施加关节运动动作，以使外科端部执行器1500相对于脊组件1250围绕关节运动轴线AA1进行关节运动。
砧座1810相对于细长通道1602的移动通过近侧闭合组件1900和远侧闭合组件2000的轴向移动而实现。现参考图4和图7，近侧闭合组件1900包括近侧闭合管1910，该近侧闭合管具有近侧闭合管部分1920和远侧部分1930。远侧部分1930具有小于近侧闭合管部分1920的直径的直径。近侧闭合管部分1920的近侧端部1922可旋转地支撑在闭合梭动件1940中，该闭合梭动件可滑动地支撑在工具底座1210内使得闭合梭动件1940可相对于工具底座1210轴向地移动。在一种形式中，闭合梭动件1940包括一对朝近侧突出的钩1942，它们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。近侧闭合管部分1920的近侧端部1922可旋转地联接到闭合梭动件1940。例如，将U形连接器1944插入到近侧闭合管部分1920中的环形狭槽1924中，并使其保持在闭合梭动件1940中的竖直狭槽1946内。这种布置用于将近侧闭合组件1900附接到闭合梭动件1940，以便与闭合梭动件1940一起轴向行进，同时使得近侧闭合组件1900能够相对于闭合梭动件1940围绕轴轴线SA1旋转。闭合弹簧1948(图12至图14)在近侧闭合管部分1920上延伸，以在近侧方向PD上偏压闭合梭动件1940，这可以用于在可互换外科工具组件1000操作地联接到柄部组件500时使柄部组件500(图2)上的闭合触发器512枢转到未致动位置。
现参见图5和图6，近侧闭合管1910的远侧部分1930附接到远侧闭合组件2000。远侧闭合组件2000包括联接到远侧闭合管段2030的关节运动连接器2010。远侧闭合管段2030具有比近侧闭合管1910的远侧部分1930的直径大的直径。关节运动连接器2010具有朝近侧延伸的端部部分2012，该端部部分适于接收在形成在远侧部分1930的远侧端部上的连接凸缘1934上。关节运动连接器2010可通过例如适当的紧固件布置、粘合剂和/或焊接保持在连接凸缘1934上。关节运动连接器2010包括上柄脚2014和下柄脚2016，它们从关节运动连接器2010的远侧端部朝远侧突出以便可移动地联接到端部执行器闭合套管或远侧闭合管段2030。远侧闭合管段2030包括从其近侧端部朝近侧突出的上柄脚2032和下柄脚。上部双枢轴连接件2060包括近侧销2061和远侧销2062，该近侧销和该远侧销分别接合关节运动连接器2010和远侧闭合管段2030的上柄脚2014、2032中的对应孔2015、2034。类似地，下部双枢轴连接件2064包括近侧销2065和远侧销2066，该近侧销和该远侧销分别接合关节运动连接器2010和远侧闭合管段2030的下柄脚2016中的对应孔2019。如下文将进一步详细讨论的，近侧闭合组件1900和远侧闭合组件2000的远侧和近侧轴向平移将使得砧座1810相对于细长通道1602闭合和打开。
可互换外科工具组件1000还包括通常表示为2100的击发系统。该击发系统2100包括击发构件组件2110，该击发构件组件被支撑以便在脊组件1250内轴向行进。击发构件2110包括被构造成能够附接到远侧切割部分或刀杆2130的中间击发轴部分2120。击发构件组件2110在本文中也可称为“第二轴”和/或“第二轴组件”。如在图5中可见，中间击发轴部分2120可以包括在其远侧端部2122中的纵向狭槽2124，其可以被构造成能够接收刀杆2130的近侧端部2132。纵向狭槽2124和刀杆2130的近侧端部2132被设定尺寸并被构造成能够允许它们之间的相对移动并且可以包括滑动接头2134。该滑动接头2134可以允许击发构件组件2110的中间击发轴部分2120移动，以在不移动或至少基本上不移动刀杆2130的情况下使端部执行器1500进行关节运动。一旦端部执行器1500已合适地取向，则中间击发轴部分2120可以朝远侧推进，直到纵向狭槽2124的近侧侧壁与刀杆2130的一部分发生接触，以推进刀杆2130并击发定位在细长通道1602内的外科钉仓/紧固件仓1700。中间击发轴部分2120的近侧端部2127具有形成在其上的击发轴附接凸耳2128(图8)，该击发轴附接凸耳被构造成能够安置到附接支架中，该附接支架位于柄部组件500内的击发驱动系统530的可纵向移动的驱动构件的远侧端部上。这种布置有利于击发驱动系统530致动时中间击发轴部分2120的轴向移动。
除上述之外，可互换工具组件1000可包括离合器组件2200，该离合器组件可被构造成能够选择性且可释放地将近侧关节运动驱动器1310联接到击发系统2100。在一种形式中，离合器组件2200包括围绕击发系统2100的中间击发轴部分2120定位的锁定衬圈或锁定套筒2210，其中锁定套筒2210可以在接合位置和脱离位置之间旋转，在接合位置处，锁定套筒2210将近侧关节运动驱动器1310联接到击发构件组件2110，在脱离位置处，近侧关节运动驱动器1310未操作地联接到击发构件组件2110。当锁定套管2210处于其接合位置时，击发构件组件2110的远侧移动可使近侧关节运动驱动器1310朝远侧移动，并且对应地，击发构件组件2110的近侧移动可使近侧关节运动驱动器1310朝近侧移动。当锁定套管2210处于其脱离位置时，击发构件组件2110的移动不传递到近侧关节运动驱动器1310，并且因此，击发构件组件2110可独立于近侧关节运动驱动器1310移动。在各种情况下，当击发构件组件2110没有使近侧关节运动驱动器1310在近侧或远侧方向上运动时，近侧关节运动驱动器1310可被关节运动锁1400保持就位。
击发构件组件2110的中间击发轴部分2120形成有两个相对的平坦侧面2121、2123，其中驱动凹口2126形成于这两个侧面中。参见图8。如在图13中还可看出，锁定套管2210可包括柱形或至少大致柱形的主体，该主体包括纵向孔口2212，该纵向孔口被构造成能够接收穿过其中的中间击发轴部分2120。锁定套管2210包括沿直径相对的面向内的锁定突出部2214、2216，当锁定套管2210处于一个位置时，锁定突出部2214、2216被以接合方式接收在中间击发轴部分2120中的驱动凹口2126的对应部分内，并且当锁定套管2210处于另一位置时，锁定突出部2214、2216不被接收在驱动凹口2126内，从而允许在锁定套管2210和中间击发轴部分2120之间的相对轴向运动。
现参考图8以及图12至图14，锁定套管2210还包括锁定构件2218，该锁定构件被设定尺寸以便可移动地接收在近侧关节运动驱动器1310的近侧端部1318中的凹口1319内。这种布置允许锁定套管2210略微旋转到中间击发轴部分2120中以及与中间击发轴部分2120脱离接合，同时保持与近侧关节运动驱动器1310中的凹口1319的接合。例如，当锁定套筒2210处于其接合位置时，锁定突出部2214、2216被定位在中间击发轴部分2120中的驱动凹口2126内，使得远侧推力和/或近侧拉力可以从击发构件组件2110传递到锁定套筒2210。然后，此类轴向推动或拉动运动从锁定套筒2210传递到近侧关节运动驱动器1310，从而使外科端部执行器1500进行关节运动。实际上，当锁定套筒2210处于其接合(关节运动)位置时，击发构件组件2110、锁定套筒2210和近侧关节运动驱动器1310将一起移动。另一方面，当锁定套筒2210处于其脱离位置时，锁定突出部2214、2216未接收在中间击发轴部分2120的驱动凹口2126内，并且因此，远侧推力和/或近侧拉力可能不会从击发构件组件2110传递到锁定套筒2210(以及近侧关节运动驱动器1310)。
锁定套管2210在其接合位置和脱离位置之间的相对移动可由与近侧闭合组件1900的近侧闭合管1910交接的移位器组件2200控制。更具体地并参考图8和图9，离合器组件2200还包括离合器键2240，离合器键2240被构造成能够可滑动地接收在形成在锁定套筒2210的外周边中的键凹槽2217内。这种布置使得移位器键2240能够相对于锁定套管2210轴向地移动。参见图8至图11，离合器键2240包括致动器凸耳2242，该致动器凸耳延伸穿过近侧闭合管部分1920中的凸轮狭槽或凸轮开口1926。参见图9。还提供了与致动器凸耳2242相邻的凸轮表面2243，该凸轮表面被构造成能够与凸轮开口1926以凸轮方式相互作用，以便致使离合器键2240响应于近侧闭合管部分1920的轴向运动而旋转。
移位器组件2200还包括开关转筒2220，该开关转筒可旋转地接收在近侧闭合管部分1920的近端部分上。如在图10至图14中可见，致动器凸耳2242延伸穿过切换筒2220中的轴向狭槽段2222并且可移动地接收在切换筒2220中的弓形狭槽段2224内。切换筒扭转弹簧2226(图12至图14)安装在切换筒2220上并且接合喷嘴部分1244以施加扭转偏压或旋转(图10和图11中的箭头SR)，该扭转偏压或旋转用于旋转切换筒2220，直到致动器凸耳2242到达弓形狭槽段2224的端部。参见图11和图12。当处于此位置时，切换筒2220可向换档器键2240提供扭转偏压，该扭转偏压从而致使锁定套筒2210旋转到其与中间击发轴部分2120接合的位置。此位置也对应于近侧闭合组件1900的未致动构型。在一个布置中，例如，当近侧闭合组件1900处于未致动构型(砧座1810处于与外壳钉/紧固件仓1700间隔开的打开位置)时，致动器凸耳2242位于近侧闭合管部分1920中的凸轮开口1926的上部部分中。当处于该位置时，中间击发轴部分2120的致动将导致近侧关节运动驱动器1310的轴向移动。当使用者将外科端部执行器1500关节运动至期望的取向时，然后使用者可致动近侧闭合组件1900。近侧闭合组件1900的致动将导致近侧闭合管部分1920的远侧行进，以最终将闭合动作施加到砧座1810。近侧闭合管部分1920的这种远侧行进将导致凸轮开口1926与致动器凸耳2242上的凸轮表面2243以凸轮方式相互作用，从而致使离合器键2240沿致动方向AD旋转锁定套筒2210。锁定套筒2210的此类旋转将导致锁定突出部2214、2216与中间击发轴部分2120中的驱动凹口2126脱离。当处于这种构型时，击发驱动系统530可被致动以在不致动近侧关节运动驱动器1310的情况下致动中间击发轴部分2120。关于开关转筒2220和锁定套管2210的操作以及可与本文所述的各种可互换外科工具组件一起使用的另选关节运动和击发驱动布置的另外细节可见于名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING ANARTICULATION 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)以及2016年2月9日提交的名称为“SURGICAL INSTRUMENT ARTICULATIONMECHANISM WITH SLOTTED SECONDARY CONSTRAINT”的美国专利申请序列号15/019,196，这些专利申请的全部公开内容据此以引用方式并入本文。
再次参见图8至图13，切换筒2220可还包括限定于其中的至少部分周向开口2228、2230，这些开口可以接收从喷嘴部分1242、1244延伸的周向凸耳/安装件1245，并且允许切换筒2220和喷嘴组件1240之间的相对旋转(而不是相对平移)。喷嘴凸耳1245延伸穿过近侧闭合管部分1920中的对应开口1923，以安置在脊组件1250中的凸耳座1254中。参见图8和图9。这种布置使得使用者能够通过旋转喷嘴组件1240来使脊组件1250围绕轴轴线旋转。
还如图7以及图12至图14所示，可互换外科工具组件1000可包括滑环组件1230，该滑环组件可被构造成能够向和/或从外科端部执行器1500传导电力并且/或者向和/或从外科端部执行器1500传送信号，最终回到例如柄部组件500中的微处理器560(图2)或机器人系统控制器。有关滑环组件1230和相关联的连接器的另外细节可见于名称为“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)和2016年2月9日提交的名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTED SECONDARYCONSTRAINT”的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“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利申请序列号13/800,067(现为美国专利申请公布2014/0263552，该专利申请据此全文以引用方式并入本文)。还如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还可包括被配置成能够检测开关转筒2220的位置的至少一个传感器。
再次参考图2，工具底座1210包括形成在其上的至少一个锥形附接部分1212，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的柄部框架506的远端部分内。各种可互换外科工具组件采用闩锁系统1220，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的柄部框架506。在至少一种形式中，如在图7中可见，闩锁系统1220包括例如可移动地联接到工具底座1210的锁定构件或锁定轭1222。锁定轭1222为U形，其具有两个隔开并向下延伸的支腿1223。支腿1223各自具有形成在其上的枢轴凸耳，这些枢轴凸耳适于被接收在形成于工具底座1210中的对应孔中。这种布置有利于将锁定轭1222枢转附接到工具底座1210。锁定轭1222可包括两个向近侧突出的锁定凸耳1224，这两个锁定凸耳1224被构造用于与柄部组件500的柄部框架506的远侧端部中的对应锁定棘爪或凹槽509可释放地接合。参见图2。在各种形式中，锁定轭1222被弹簧或偏压构件1225沿近侧方向偏压。锁定轭1222的致动可通过可滑动地安装在闩锁致动器组件1221上的闩锁按钮1226来实现，该闩锁致动器组件1221安装到工具底盘1210。闩锁按钮1226可相对于锁定轭1222沿近侧方向偏压。锁定轭1222可通过沿远侧方向偏压闩锁按钮1226而移动到解锁位置，这也使锁定轭1222枢转成不再与柄部框架506的远侧端部保持接合。当锁定轭1222与柄部框架506的远侧端部“保持接合”时，锁定凸耳1224保持安置在柄部框架506的远侧端部中对应的锁定棘爪或凹槽509内。
锁定轭1222包括至少一个锁定钩1227，该至少一个锁定钩适于接触形成在闭合梭动件1940上的对应锁定凸耳部分1943。当闭合梭动件1940处于未致动位置时，锁定轭1222可在远侧方向上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，锁定钩1227不接触闭合梭动件1940上的锁定凸耳部分1943。然而，当闭合梭动件1940移动到致动位置时，防止锁定轭1222枢转到解锁位置。换句话讲，如果临床医生试图将锁定轭1222枢转到解锁位置，或者例如，锁定轭1222不经意地以原本可能致使其向远侧枢转的方式受到碰撞或发生接触，则锁定轭1222上的锁定钩1227将接触闭合梭动件1940上的锁定凸耳1943，并且防止锁定轭1222移动到解锁位置。
再次参见图6，刀杆2130可包括层压梁结构，该层压梁结构包括至少两个梁层。这些梁层可包括例如不锈钢带，这些不锈钢带通过例如焊接和/或销而在近侧端部和/或沿其长度的其它位置处互相连接。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2130足够柔性以适应端部执行器的关节运动。在名称为“SURGICAL INSTRUMENTS WITH CLOSURESTROKE REDUCTION ARRANGEMENTS”的美国专利申请序列号15/019,245中公开了各种层压刀杆布置，该专利申请全文以引用方式并入本文。同样如在图6中可见，使用击发轴支撑组件2300以在刀杆2130弯曲以适应外科端部执行器1500的关节运动时为该刀杆提供侧向支撑。关于击发轴支撑组件2300和另选的刀杆支撑布置的操作的进一步细节可见于：名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTION ARRANGEMENTS”的美国专利申请序列号15/019,245以及名称为“SURGICAL INSTRUMENT WITH ARTICULATING ANDAXIALLY TRANSLATABLE END EFFECTOR”的美国专利申请序列号15/019,220，这些美国专利申请各自据此全文以引用方式并入本文。
同样如在图6中可见，击发构件或刀构件2140附接到刀杆2130的远侧端部。在一个示例性形式中，击发构件2140包括支撑刀或组织切割部分2144的主体部分2142。主体部分2142突出穿过细长通道1602中的细长狭槽1604并且终止于在主体部分2142的每一侧上侧向延伸的脚部构件2146中。当通过外科钉/紧固件仓1700朝远侧驱动击发构件2140时，底脚构件2146跨置在细长通道1602中位于外科钉/紧固件仓1700下方的通路内。在一个布置中，主体部分2142包括可跨置在外科钉仓/紧固件仓1700内的中心通路之上的两个侧向突出的中心突片2145。参见图6。组织切割部分2144设置在朝远侧突出的顶部鼻部部分2143和底脚构件2146之间。如在图6中进一步可见，击发构件2140还可包括两个侧向延伸的顶部突片、销或砧座接合特征部2147。当朝远侧驱动击发构件2140时，主体部分2142的顶部部分延伸穿过居中设置的砧座狭槽1814，并且砧座接合特征部2147跨置在形成在砧座狭槽1814的每一侧上的对应砧座凸部1816上。在一个布置中，为了便于砧座1810和击发构件2140布置的组装，砧座主体1812的顶部在其中具有开口1817。当砧座1810被组装到细长通道1602上并且安设了击发构件2140时，开口1817被砧座盖1819覆盖，该砧座盖通过焊接和/或其它合适的紧固装置附连到砧座主体1812。
返回到图6，击发构件2140被构造成能够与滑动组件2150操作地交接，该滑动组件被操作地支撑在外科钉仓/紧固件仓1700的主体1702内。滑动组件2150在外科钉仓体/紧固件仓体1702内从邻近仓体1702的近侧端部1704的近侧端部起始位置可滑动地移位到邻近仓体1702的远侧端部1706的结束位置。仓体1702在其中可操作地支撑多个钉驱动器，这些钉驱动器在居中设置的狭槽1708的每侧上成排对准。居中设置的狭槽1708使得击发构件2140能够穿过其中，并切割夹持在砧座1810和外科钉/紧固件仓1700之间的组织。驱动器与对应的钉/紧固件凹坑1712相关联，这些钉/紧固件凹坑1712穿过仓体1702的上平台表面1710。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。滑动组件2150包括多个倾斜的或楔形凸轮2152，其中每个凸轮2152对应于位于狭槽1708的侧面上的特定行紧固件或驱动器。
为了将可互换外科工具组件1000附接到柄部组件500，参考图2，临床医生可将可互换外科工具组件1000的工具底座1210定位在柄部框架506的远侧端部上方或附近，使得形成于工具底座1210上的锥形附接部分1212与柄部框架506中的燕尾形狭槽507对准。然后临床医生可将外科工具组件1000沿垂直于轴轴线SA1的安装轴线IA运动，以使锥形附接部分1212安置成与柄部框架506的远侧端部中的对应燕尾形接收狭槽507“操作地接合”。这样做时，中间击发轴部分2120上的击发轴附接凸耳2128也将安置在柄部组件500内的可纵向移动的驱动构件中的附接支架中，并且闭合连接件514上的附接销516的部分将安置在闭合梭动件1940中的对应钩1942中。如本文所用，术语“可操作地接合”在两个部件的背景下意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动作、功能和/或程序。
在典型的外科手术期间，临床医生可通过套管针或患者体内的其它开口将外科端部执行器1500引入到手术部位中以触及目标组织。这样做时，临床医生沿轴轴线以非关节运动状态轴向地对准或至少基本上对准外科端部执行器1500，并且穿过套管针插入外科端部执行器1500。一旦外科端部执行器1500已经穿过套管针，临床医生就可能需要使端部执行器1500进行关节运动，以有利地将端部执行器1500定位在目标组织附近。除此之外，击发驱动系统530在有限的运动范围中进行操作，以移动关节运动驱动器1310并使端部执行器1500进行关节运动。这种关节运动发生在将砧座闭合到目标组织上之前。然后，一旦端部执行器已到达期望的关节运动位置，临床医生便可致动闭合驱动系统510以将砧座1810闭合到目标组织上。闭合驱动系统510的这种致动致动移位器组件2200，并且使关节运动驱动器1310与中间击发轴部分2120脱开连接。因此，一旦目标组织已被适当地捕获在外科端部执行器1500中，临床医生便可再一次致动击发驱动系统530，以将击发构件2140轴向推进穿过外科钉/紧固件仓1700，以将钉击发到目标组织中并切割目标组织。可采用其它闭合和击发驱动布置诸如手持式、手动式、自动化和/或机器人式布置，来控制外科工具组件1000的闭合系统部件、关节运动系统部件和/或击发系统部件的轴向移动。
外科器械10000的端部执行器10500在图16至图16B中示出。端部执行器10500包括仓钳口10600(图18)，该仓钳口包括钉仓10700以及另外地，砧座10800，该砧座被构造成能够使从钉仓10700射出的钉变形。在使用中，砧座10800可在打开的未夹紧位置和闭合的夹紧位置之间旋转；然而，在其它实施方案中，仓钳口10600可朝砧座10800旋转。外科器械10000还包括轴10100，其中端部执行器10500以能够围绕关节运动接头10200旋转的方式连接到轴10100。在使用中，端部执行器10500可围绕关节运动接头10200在由角度θR指示的完全关节运动的右位置(图16A)和由角度θL指示的完全关节运动的左位置(图16B)，和/或它们之间的任何合适的位置之间旋转。如下文更详细地讨论，角度θR和θL由外科器械10000的关节运动驱动系统的设计限制。在至少一种情况下，相对于端部执行器10500的非关节运动位置，角度θR和θL被限制为大约45度(图16)。
参考图18，外科器械10000的轴10100包括外部闭合管，该外部闭合管包括可朝远侧移动以接合砧座10800并使砧座10800朝钉仓10700移动的外部壳体10110。轴10100还包括远侧壳体部分10130，该远侧壳体部分通过定位在关节运动接头10200的相反两侧上的两个连接器板10120以能够旋转的方式连接到外部壳体10110。每个连接器板10120在枢轴10115处连接到外部壳体10110，并且类似地在枢轴10125处连接到远侧壳体部分10130。当端部执行器10500处于关节运动位置时，连接器板10120允许闭合管相对于关节运动接头10200滑动，并且因此，砧座10800可在端部执行器10500处于关节运动位置时打开和闭合。除此之外，远侧壳体10130包括限定于其中的开口，该开口被构造成能够接纳从砧座10800的近侧端部延伸的突片，该开口的侧壁被构造成能够接合突片并且将闭合管的近侧动作或打开动作传递到砧座10800。
外科器械系统11000的端部执行器11500在图17至图17B中示出。端部执行器11500包括仓钳口11600(图19)，该仓钳口包括钉仓11700以及另外地，砧座11800，该砧座被构造成能够使从钉仓11700射出的钉变形。在使用中，砧座11800能够在打开的未夹紧位置和闭合的夹紧位置之间旋转；然而，设想了其中仓钳口11600可相对于砧座11800旋转的实施方案。外科器械11000还包括轴11100，其中端部执行器11500以能够围绕关节运动接头11200旋转的方式连接到轴11100。在使用中，端部执行器11500可围绕关节运动接头11200在由角度αR指示的完全关节运动的右位置(图17A)和由角度αL指示的完全关节运动的左位置(图17B)，和/或它们之间的任何合适的位置之间旋转。尽管角度αR和αL最终受到手术器械11000的关节运动驱动系统的设计的限制，但是角度αR和αL可更大。在至少一种情况下，例如相对于端部执行器11500的非关节运动位置，角度αR和αL被限制为大约60度(图17)。
参考图19，外科器械11000的轴11100包括外部闭合管，该外部闭合管包括可朝远侧移动以接合砧座11800并使砧座11800朝钉仓11700移动的外部壳体11110。轴11100还包括远侧壳体11130，该远侧壳体通过定位在关节运动接头11200的相反两侧上的两个连接器板11120以能够旋转的方式连接到外部壳体11110。每个连接器板11120在枢轴11115处连接到外部壳体11110，并且类似地在枢轴11125处连接到远侧壳体11130。与上文类似，当端部执行器11500处于关节运动位置时，连接器板11120允许闭合管相对于关节运动接头11200滑动，其中因此，砧座11800可在端部执行器11500处于关节运动位置时打开和闭合。除此之外，远侧壳体11130包括限定于其中的开口，该开口被构造成能够接纳从砧座11800的近侧端部延伸的突片，该开口的侧壁被构造成能够接合突片并且将闭合管的近侧动作或打开动作传递到砧座11800。
再次参考图18，外科器械10000还包括关节运动驱动系统10300，该关节运动驱动系统包括延伸穿过限定在轴10100的闭合管10110内的内部孔口10105的关节运动驱动致动器10310。关节运动驱动致动器10310包括与端部执行器10500的仓钳口10600可操作地接合的远侧端部。更具体地讲，关节运动驱动致动器10310的远侧端部包括限定于其中的开口或狭槽10320，并且仓钳口10600包括延伸到狭槽10320中的销10620。当关节运动驱动致动器10310朝远侧推动时，端部执行器10500围绕由枢轴10210限定的固定轴线向右驱动(图16A)，枢轴10210将仓钳口10600以能够旋转的方式连接到轴10100的框架。对应地，当关节运动驱动致动器10310朝近侧牵拉时，端部执行器10500围绕枢轴10210向左旋转(图16B)。
再次参考图19，外科器械11000还包括关节运动驱动系统11300，该关节运动驱动系统包括延伸穿过限定在闭合管11110内的内部孔口11105的关节运动驱动致动器11310。该关节运动驱动系统11300还包括关节运动连接件11320，该关节运动连接件围绕销11315可旋转地联接到关节运动驱动致动器11310的远侧端部。类似地，关节运动连接件11320围绕驱动销11620可旋转地联接到仓钳口11600，该驱动销延伸穿过限定在关节运动连接件11320中的孔口。当关节运动驱动致动器11310朝远侧推动时，端部执行器11500围绕由枢轴11210限定的固定轴线向右驱动(图17A)，枢轴11210将仓钳口11600以能够旋转的方式连接到轴11100的框架。对应地，当关节运动驱动致动器11310朝近侧牵拉时，端部执行器11500围绕枢轴11210向左旋转(图17B)。
除此之外，关节运动系统11300的关节运动连接件11320允许端部执行器11500在给定的、或等于关节运动致动器10310和11310的行程长度的情况下，通过比端部执行器10500更大的关节运动角度进行关节运动。端部执行器10500和11500的并列比较在图20和图21中提供，图20和图21示出了处于它们的完全右关节运动构型的端部执行器10500和11500，并且还示出了端部执行器11500可比端部执行器10500进一步向右进行关节运动。可进行类似的比较以示出端部执行器10500和11500处于它们的完全左关节运动构型。此外，图22描绘了端部执行器10500的完全关节运动范围，而图23描绘了端部执行器11500的完全关节运动范围。
再次参考图22，外科器械10000的关节运动致动器10310相对于它的非关节运动位置推进远侧行程长度(DSL)，以使端部执行器10500向右进行完全关节运动。对应地，关节运动致动器10310相对于它的非关节运动位置回缩近侧行程长度(PSL)，以使端部执行器10500向左进行完全关节运动。关节运动致动器10310的远侧行程长度(DSL)和近侧行程长度(PSL)相等，或者至少基本上相等。现在参考图23，关节运动致动器11310相对于它的非关节运动位置推进远侧行程长度(DSL)，以使端部执行器11500向右进行完全关节运动。对应地，关节运动致动器11310相对于它的非关节运动位置回缩近侧行程长度(PSL)，以使端部执行器11500向左进行完全关节运动。关节运动致动器11310的远侧行程长度(DSL)和近侧行程长度(PSL)不相等，相反地，远侧行程长度(DSL)比近侧行程长度(PSL)短。在其它实施方案中，近侧行程长度(DSL)比远侧行程长度(PSL)短。在任何情况下，现在参考图31至图31B，近侧行程长度(PSL)和远侧行程长度(DSL)的组合等于整个行程长度(SL)。
除此之外，关节运动致动器10310被构造成能够通过销10620向端部执行器10500的第一钳口10600施加扭矩，以使端部执行器10500围绕关节运动接头10200旋转。再次参考图22，当端部执行器10500处于它的非关节运动位置时，限定在关节运动接头10200的枢转接头10210与销10620之间的侧向扭矩臂具有长度TAC1。该长度TAC1在正交方向上相对于延伸穿过关节运动枢轴接头10210的纵向轴线10190测量。类似地，当端部执行器10500向右进行完全关节运动时，限定在枢轴接头10210和销10620之间的侧向扭矩臂具有长度TAR1，并且类似地，当端部执行器10500向左进行完全关节运动时，限定在枢轴接头10210和销10620之间的侧向扭矩臂具有长度TAL1，这两个长度相对于纵向轴线10190被正交地测量。值得注意的是，长度TAR1和TAL1以及它们限定的扭矩臂相等，或者至少基本上相等。此外，长度TAR1和TAL1小于非关节运动的侧向扭矩臂长度TAC1。因此，当端部执行器10500处于它的非关节运动位置时，存在关节运动系统10300的最大扭矩臂或机械增益。
在至少一种情况下，例如臂长度TAC1为大约0.180"，臂长度TAR1为大约0.130"，并且臂长度TAL1为大约0.130"。
除此之外，外科器械11000的关节运动致动器11310被构造成能够通过销11620向端部执行器11500的第一钳口11600施加扭矩，以使端部执行器11500围绕关节运动接头11200旋转。参考图23、图28和图30，当端部执行器11500处于它的非关节运动位置时，限定在关节运动接头11200的枢转接头11210与销11620之间的侧向扭矩臂(LTA)由长ss度TAC2限定。该长度TAC2是在正交方向上相对于延伸穿过关节运动枢轴接头11210的纵向轴线11190测得的。值得注意的是，纵向轴线11190相对于轴11100的中心线偏置且平行，如下文结合图25更详细地讨论。与上文类似，当端部执行器11500向右进行完全关节运动时(图30A)，限定在枢轴接头11210和销11620之间的侧向扭矩臂由长度TAR2限定，并且类似地，当端部执行器11500向左进行完全关节运动时(图30B)，限定在枢轴接头11210和销11620之间的侧向扭矩臂由长度TAL2限定，这两个长度相对于纵向轴线11190被正交地测量。值得注意的是，长度TAR2大于非关节运动的侧向扭矩臂长度TAC1，并且长度TAL2小于非关节运动的侧向扭矩臂长度TAC1。此外，长度TAR2和TAL2以及它们限定的扭矩臂不相等。相反，右关节运动扭矩臂长度TAR2显著大于左关节运动扭矩臂长度TAL2。事实上，右关节运动扭矩臂长度TAR2和左关节运动扭矩臂长度TAL2在不同方向上延伸。与较小的牵拉扭矩臂相比，这种布置提供了更大的推动扭矩臂。因此，在各种情况下，由关节运动致动器11310施加以使端部执行器11500向左进行关节运动(图30B)的回缩拉力可大于或可能需要大于使端部执行器11500向右进行关节运动(图29和图30A)的远侧推力。有利地，当关节运动致动器11310在被牵拉时不受屈曲破坏时，关节运动致动器11310可容纳这种较大的拉力。
在至少一种情况下，例如臂长度TAC2为大约0.149"，臂长度TAR2为大约0.154"，并且臂长度TAL2为大约0.015"。
除此之外，外科器械11000被构造和布置成能够向端部执行器11500提供大扭矩，而与此同时响应于短关节运动行程而提供大关节运动范围或扫掠范围。就是说，可建立这些关系的若干设计比率并用于设计外科器械11000。例如，第一比率包括完全右关节运动扭矩臂长度(TA)除以关节运动致动器11310的完全关节运动行程长度(SL)。此第一比率的值是无量纲的。在至少一种情况下，例如完全右关节运动扭矩臂长度(TA)为0.154"，并且完全关节运动行程长度(SL)为0.275"，从而导致0.56的比率值。第一比率的较大比率值指示更有效的关节运动系统。在各种情况下，第一比率的值小于1.0，但可大于1.0。在至少一种情况下，例如完全右关节运动扭矩臂长度(TA)为2.79mm，并且完全关节运动行程长度(SL)为11.43mm，从而导致0.24的比率值。
上文针对第一比率提供的示例基于当端部执行器11500处于它的完全右关节运动位置时的扭矩臂长度(TA)。端部执行器11500的此特定位置是值得注意的，因为关节运动致动器11310处于压缩状态，并且当在那里传递的负载过大时可发生屈曲。也就是说，第一比率例如也可用于分析端部执行器11500的任何合适位置，诸如，端部执行器的非关节运动位置和端部执行器的完全左关节运动位置。在至少一种情况下，例如非关节运动的扭矩臂长度(TA)为6.17mm，从而导致11.43mm的行程长度(SL)的比率值为0.54。而且，在至少一种情况下，例如完全左关节运动扭矩臂长度(TA)为1.41mm，从而导致11.43mm的行程长度(SL)的比率值为0.12。
第二比率包括其中当端部执行器11500在它的完全右关节运动位置与它的完全左关节运动位置之间进行关节运动时驱动销11620扫过的弧长度(即，它的弧长扫掠范围(ALS))。更具体地，第二比率包括驱动销11620的弧长扫掠范围(ALS)除以关节运动致动器11310的完全关节运动行程长度(SL)。此第二比率的值是无量纲的。在至少一种情况下，例如驱动销11620的弧长扫掠范围(ALS)为0.387"，并且完全关节运动行程长度(SL)为0.275"，从而导致1.41的比率值。在至少一种情况下，例如弧长扫掠范围(ALS)为0.444"，并且完全关节运动行程长度(SL)为0.306"，从而导致1.45的比率值。在至少一种情况下，例如弧长扫掠范围(ALS)为12.94mm，并且完全关节运动行程长度(SL)为11.43mm，从而导致1.13的比率值。第二比率的较大比率值指示更有效的关节运动系统。在各种情况下，第二比率的值例如大于1.0，诸如在1.0和3.0之间。在至少一种情况下，第二比率值例如为大约2.0。在某些情况下，第二比率的值例如为约1.1，但是在0.9和1.3之间。
第三比率包括完全右关节运动扭矩臂长度(TA)和驱动销11620的弧长扫掠范围(ALS)的总和除以完全关节运动行程长度(SL)。此第三比率的值是无量纲的。在至少一种情况下，例如完全右关节运动扭矩臂长度(TA)为0.154"，驱动销11620的弧长扫掠范围(ALS)为0.387"，并且完全关节运动行程长度(SL)为0.275"，从而导致1.97的比率值。在至少一种情况下，例如完全右关节运动扭矩臂长度(TA)为2.79mm，驱动销11620的弧长扫掠范围(ALS)为12.94mm，并且完全关节运动行程长度(SL)为11.43mm，从而得到1.38的比率值。第三比率的较大比率值指示更有效的关节运动系统。在各种情况下，第三比率的值例如大于1.0，诸如在1.0和3.0之间。在至少一种情况下，第三比率值例如为大约2.0或大于2.0。
与上文类似，第三比率例如可用于在端部执行器11500处于任何合适位置(诸如它的非关节运动位置和完全左关节运动位置)时评估关节运动系统。
第四比率包括完全右关节运动扭矩臂长度(TA)和驱动销11620的弧长扫掠范围(ALS)的乘积除以完全关节运动行程长度(SL)。此第四比率的值不是无量纲的，相反，而是以距离测量的。在至少一种情况下，例如完全右关节运动扭矩臂长度(TA)为0.154"，驱动销11620的弧长扫掠范围(ALS)为0.387"，并且完全关节运动行程长度(SL)为0.275"，从而导致0.217的比率值。此值可通过将其再次除以行程长度(SL)而变得无量纲，从而导致0.79的值。在至少一种情况下，例如完全右关节运动扭矩臂长度(TA)为2.79mm，驱动销11620的弧长扫掠范围(ALS)为12.94mm，并且完全关节运动行程长度(SL)为11.43mm，从而得到3.15mm的比率值。在某些情况下，第四比率的值例如为约3.1mm，但是在0.9mm和5.4mm之间。与上文类似，此值可通过将其再次除以行程长度(SL)而变得无量纲，从而导致0.28的值。第四比率的较大第四值指示更有效的关节运动系统。
与上文类似，第四比率例如可用于在端部执行器11500处于任何合适位置(诸如它的非关节运动位置和完全左关节运动位置)时评估关节运动系统。
如上文所讨论，端部执行器11500围绕关节运动接头11200的固定枢轴11210可旋转地安装到轴11100。现在参考图24和图25，轴11100包括从轴11100的框架或脊延伸并固定地安装到轴11100的框架或脊的远侧安装突片11220。第一远侧安装突片11220安装到第一钳口11600，该钳口包括下框架部分，并且第二远侧安装突片11220安装到上部框架部分11230。在安装突片11220与第一钳口11600和上框架部分11230之间的互连限定了固定枢轴11210。如上文所讨论，固定轴线枢轴11210相对于轴11100的中心纵向轴线LA侧向偏置了偏置距离OD。在至少一种情况下，固定轴线枢轴11210例如侧向偏置了大约0.036"。此外，参考图28至图30B，销11620相对于固定枢轴11210纵向偏置，该固定枢轴产生纵向或轴向扭矩臂(ATA)。
如上文所讨论，轴11100的闭合管可朝远侧移动以接合端部执行器11500的砧座钳口11800并将砧座钳口11800朝定位在仓钳口11600中的钉仓11700移动。换句话讲，闭合管被构造成能够将砧座11800从打开位置(图26至图26B)移动到闭合位置(图27至图27B)，以抵靠钉仓11700夹持患者的组织。在此类情况下，包括壳体11110、连接器板11120和远侧壳体11130的闭合管在闭合行程期间相对于关节运动接头11200朝远侧滑动。现在参考图26，当端部执行器11500处于打开的非关节运动构型时，连接器板11120在略微横向于轴11100的中心纵向轴线LA的方向上延伸。更具体地，当端部执行器11500处于打开的非关节运动构型时，在接头11115和11125之间延伸的轴线CA相对于轴11100的中心纵向轴线LA略微横向。当端部执行器11500相对于向右(图26A)或向右(图26B)进行关节运动时，轴线CA相对于中心纵向轴线LA的取向可改变。
在各种情况下，除此之外，轴线CA的取向将相对于在端部执行器11500的近侧端部和远侧端部之间延伸的纵向轴线而改变。在至少一种情况下，轴线CA横向于这种纵向端部执行器轴线，不同的是在其中轴线CA将平行于纵向端部执行器轴线的一种构型中。
除此之外，限定在连接器板11120的关节运动枢轴11210和远侧枢轴11125之间的轴线AA的取向随着端部执行器11500的关节运动而改变。参考图26，当端部执行器11500处于打开的非关节运动构型时，轴线AA相对于轴线CA以角度β延伸。当将端部执行器11500关节运动成打开的向右构型时(图26A)，角度β减小。当将端部执行器11500关节运动成打开的向左构型时(图26B)，角度β增大。然而，当打开的端部执行器11500进行关节运动时，轴线AA根本不与轴线CA共线或平行。相反，当端部执行器11500以打开构型进行关节运动时，轴线AA横向于轴线CA。
参考图27，当端部执行器11500处于闭合的非关节运动构型时，轴线AA相对于轴线CA以角度γ延伸。当将端部执行器11500关节运动成闭合的向右构型时(图27A)，角度γ增大。当将端部执行器11500关节运动成闭合的向左构型时(图27B)，角度δ也增大。然而，在端部执行器11500以闭合构型和/或在打开构型和闭合构型之间的任何其它构型进行关节运动时，轴线AA根本不与轴线CA共线。相反，当端部执行器11500以闭合构型和/或在打开构型和闭合构型之间的任何其它构型进行关节运动时，轴线AA横向于轴线CA。
再次参考图20和图21，与端部执行器10500相比，外科器械11000的设计可缩短端部执行器11500。而且，在关节运动接头10200和由端部执行器10500施加到患者的组织的钉线的近侧端部之间的距离为距离L1，而在关节运动接头11200和由端部执行器11500施加的钉线的近侧端部之间的距离为距离L2，该距离L2比距离L1短。
现在转到图40至图45，外科器械11000还包括关节运动锁11400，该关节运动锁被构造成能够选择性地将关节运动驱动系统11300和端部执行器11500锁定就位。关节运动锁11400包括安装到轴11100的框架11180的远侧端部11402。更具体地，轴框架11180包括被紧密地接纳和/或压制在限定于远侧端部11402中的孔口内的销或突出部11182。关节运动锁11400还包括被构造成能够相对于远侧端部11402移动的近侧端部11404。在至少一个方面，关节运动锁11400包括悬臂梁，其中远侧端部11402包括固定端部并且近侧端部11404包括自由端部。近侧端部11404定位在限定于轴框架11180中的腔体11184中，并且被构造成能够朝向并且远离关节运动驱动致动器11310侧向移动，如下文更详细地描述。
除此之外，关节运动锁11400的近侧端部11404包括限定于其上的一个或多个齿11406，这些齿被构造成能够接合关节运动驱动致动器11310。如图40所示，齿11406以纵向阵列布置；然而，可使用任何其它合适的布置。关节运动驱动致动器11310包括限定于其上的纵向齿阵列11316，这些齿被构造成能够由关节运动锁定齿11406接合。参考图41，轴框架11180还包括限定于其中的纵向齿阵列11186，这些齿也被构造成能够由关节运动锁齿11406接合。当关节运动锁11400处于完全锁定状态时，如下文更详细地描述，关节运动锁定齿11406与驱动致动器齿11316和轴框架齿11186接合，使得关节运动锁11400将关节运动驱动致动器11310锁定到轴框架11180并且防止或至少抑制关节运动驱动致动器11310和轴框架11180之间的相对移动。
除此之外，关节运动锁11400可在三种状态中被构造：自锁定状态、解锁状态和完全锁定状态。参考图43，当关节运动锁11400处于自锁定状态时，关节运动锁11400的齿11406与驱动致动器齿11316和轴框架齿11186接合。在此类情况下，关节运动锁11400可抵抗穿过关节运动驱动致动器11310传递的一些力；然而，关节运动驱动致动器11310的近侧移动和/或远侧移动可克服关节运动锁11400的保持力并将关节运动锁11400位移到它的解锁构型中，如图44所示。在此类情况下，关节运动锁11400可侧向地远离驱动致动器11310挠曲或偏转。关节运动锁11400包括在远侧部分11402和近侧部分11404之间延伸的弹簧构件11403，该弹簧构件被构造成能够将关节运动锁弹性地返回到它的自锁定构型或至少朝它的自锁定构型偏压(图42)。因此，关节运动驱动系统11300可由于它的自身运动而自行锁定和解锁并且使端部执行器11500进行关节运动，除非关节运动锁11400被放置在它的完全锁定位置，如下文所讨论。
如上文进一步所讨论，外科器械11000的轴11100包括闭合管11110，该闭合管在闭合行程期间朝远侧推进以闭合端部执行器11500。在闭合行程之前，关节运动锁11400可在它的自锁定构型和解锁构型之间移动，以允许端部执行器11500由关节运动驱动系统11300进行关节运动。然而，在闭合行程期间，闭合管11110被构造成能够接合关节运动锁11400并将关节运动锁11400放置或保持在它的完全锁定构型中。更具体地，闭合管11110包括突出部或突片11118，该突出部或突片被构造成能够接合限定在关节运动锁11400的背面上的凸轮表面11408，并且防止关节运动锁定齿11406与驱动致动器齿11316和轴框架齿11186脱离啮合。当闭合管11110朝近侧回缩以打开端部执行器11500时，突片11118与关节运动锁11400脱离，并且关节运动锁11400可自由地在它的自锁定位置和解锁位置之间移动，如上文所讨论，以便端部执行器11500可再次进行关节运动。
上文描述的外科器械11000在图80至图82中进一步示出。外科器械11000包括轴11100，该轴被构造用于与其中限定有通道的套管针一起使用。外科器械轴11100在沿着外科器械轴11100的长度的不同点处包括不同的直径。除其它事项外，外科器械轴11100包括中心区域11160，该中心区域包括比外科器械轴11000的任何其它区域小的直径。外科器械轴11100的此几何形状提供优于先前设计的显著优点，并且解决了与套管针的使用相关联的长久问题。通常，当外科器械在外科手术期间与套管针结合使用时，外科手术受到该器械由于套管针通道产生的收缩而可采取的角度范围的限制。外科器械轴11100的构型是对现有轴构型的改进，因为现有轴构型增加了外科器械可相对于套管针的纵向轴线采取的角度范围。因此，由于外科器械轴11100的中心区域11160的直径较小，外科器械11000的使用者可相对于套管针的纵向轴线以多种角度操纵外科器械11000。
参考图80和图81，外科器械轴11100还包括近侧区域11150和远侧区域11170。外科器械轴11000的近侧区域11150邻近轴11100的喷嘴组件11140定位。远侧区域11170最靠近端部执行器11500定位。外科器械轴的近侧区域11150包括第一直径，并且中心区域11160包括第二直径。远侧区域11170还包括第三直径。近侧区域11150的第一直径与中心区域11160的第二直径不同。类似地，中心区域11160的第二直径与远侧区域11170的第三直径不同。近侧区域11150的第一直径与远侧区域11170的第三直径不同；然而，设想了其中第一直径和第三直径相同的实施方案。
除此之外，近侧区域11150限定中心纵向轴线。中心区域11160沿着中心纵向轴线延伸并且相对于中心纵向轴线居中。近侧区域11150和中心区域11160各自限定圆形轮廓，但它们可包括任何合适的构型。远侧区域11170不相对于中心纵向轴线居中。相反，远侧区域11170相对于中心纵向轴线侧向偏置。此外，远侧区域11170的横截面和/或周边的大部分定位在中心纵向轴线的第一侧上而不是第二侧上。在至少一种情况下，远侧区域11170包括延伸到中心纵向轴线的一个侧的放大部。此外，远侧区域11170不限定圆形轮廓。
再参考图80和图81，中心区域11160包括小于近侧区域11150的第一宽度的第二宽度。中心区域还包括小于远侧区域11170的第三宽度的第二宽度。近侧区域11150还包括与远侧区域11170的宽度不同的宽度。例如，近侧区域11150的宽度小于远侧区域11170的宽度，但仍大于中心区域11160的宽度。类似地，近侧区域11150的宽度大于远侧区域11170的宽度和中心区域11160的宽度。在其它情况下，近侧区域11150和远侧区域11170包括大约相同的宽度。
参考图80至图82，外科器械11000的外科器械轴11100被构造成能够例如配合穿过12mm套管针。在至少一个这种情况下，外科器械轴11100的中心区域11160包括大约9mm的最大直径。中心区域11160的这种直径提供了轴11100可相对于套管针的中心线采取的更宽范围的角度。而且，这种布置方式可减小在某些外科手术期间与将外科器械轴11100放置在患者的肋之间相关联的引起肋间神经损伤的可能性。外科器械轴11100的远侧区域11170被构造成能够配合穿过12mm套管针，并且包括一个或多个平坦侧11172，以便在需要高水平关节运动的手术期间提供增加的进入水平。设想了其中轴11100穿过例如8mm套管针和/或5mm套管针插入的其它实施方案。
近侧区域11150包括靠近外科器械轴11100的近侧端部的阶梯式向下或锥形区域，其中外科器械轴11100从近侧区域11150过渡到中心区域11160。中心区域11160还包括靠近外科器械轴11100的远侧端部的阶梯式向上或锥形区域，其中外科器械轴11100从中心区域11160过渡到远侧区域11170。
再参考图80和图81，近侧区域11150包括第一周长，中心区域11160包括第二周长，并且远侧区域11170包括第三周长。由于外科器械轴11100的此类部分的直径的不同，近侧区域11150的周长与中心区域11160的周长不同。类似地，中心区域11160的周长和远侧区域11170的周长是不同的。近侧区域11150的周长和远侧区域11170的周长是相同的，但在其它实施方案中可以是不同的。
再次参考图80和图81，外科器械轴11100包括单个成形材料件，但外科器械轴11100可包括在其它情况下被组合以形成单个内聚外科器械轴的多个材料件。可使用任何适当的方法组装材料件。外科器械轴11100被构造成能够以不限于上文描述的外科缝合器械的多种外科布置操作。外科器械轴11100可与具有可关节运动的端部执行器的其它外科器械一起使用。其它外科器械可包括：例如超声外科装置、夹具施放器和紧固件施放器。此外，外科器械轴11100被构造成能够与其中适当使用套管针通道的任何外科器械一起使用。
除此之外，轴11100的外部管11110包括近侧端部11150和包括直径或宽度的纵向部分11160，该直径或宽度比近侧端部11150的直径或宽度窄。也就是说，外科器械11000被构造和布置成向端部执行器11500提供大扭矩，与此同时纵向部分11160包括窄的直径。就是说，可建立此关系的至少一个设计比率并用于设计外科器械11000。例如，一个比率包括纵向部分11160(D)的直径除以完全右关节运动的扭矩臂长度(TA)。此比率的值是无量纲的。在至少一种情况下，例如纵向部分11160(D)的直径为0.316"，并且扭矩臂长度(TA)为0.154"，从而导致2.06的比率值。此比率的值越小指示关节运动系统效率越高。在各种情况下，此比率的值例如小于2.0，诸如在1.0和2.0之间。在至少一种情况下，比率值例如在2.0和3.0之间。在某些情况下，比率值例如小于3.38。
除此之外，轴11100的外部管11110包括纵向部分11160和放大的远侧端部11170(图80)。再次参考图40，关节运动锁11400的整体定位在纵向部分11160中而不是放大的远侧端部11170中。然而，设想了其中关节运动锁11400的至少一部分定位在放大的远侧端部11170中的实施方案。在至少一个这种情况下，关节运动锁11400安装到轴框架，使得关节运动锁11400的远侧端部11402位于外部管11110的放大的远侧端部11170中。在某些情况下，关节运动锁11400被重新布置成使得关节运动锁11400的活动端部定位在外部管11110的放大的远侧端部11170中。在各种情况下，关节运动锁11400的整体定位在放大的远侧端部11170中。
现在转到图46，外科器械14000包括：轴14100、端部执行器11500，并且此外包括关节运动驱动系统，该关节运动驱动系统包括被构造成能够使端部执行器11500进行关节运动的关节运动驱动致动器14310。轴14100包括关节运动锁定系统，该关节运动锁定系统被构造成能够选择性地将关节运动驱动致动器14310和端部执行器14500锁定就位。关节运动锁定系统包括关节运动锁14400，该关节运动锁包括安装到轴14100的框架14180的近侧端部和远侧端部。在至少一个方面，关节运动锁14400包括在两端固定地和/或仅支撑的梁。关节运动锁14400还包括定位在限定于轴框架14180中的腔体14184中的中间部分14404，该中间部分被构造成能够朝向并且远离关节运动驱动系统14300的关节运动驱动致动器14310侧向移动。与上文类似，关节运动锁14400包括被构造成能够允许关节运动锁14400朝向并且远离关节运动驱动致动器14310挠曲的一个或多个弹簧部分14403。
除此之外，关节运动锁14400的中间部分14404包括限定于其上的一个或多个齿14406，这些齿被构造成能够接合关节运动驱动致动器14310。齿14406以纵向阵列布置；然而，可使用任何其它合适的布置。关节运动驱动致动器14310包括限定于其上的纵向齿阵列14316，这些齿被构造成能够由关节运动锁定齿14406接合。关节运动锁定系统还包括可滑动地定位在轴腔体14184中的锁定板14420，该锁定板包括限定于其中的纵向齿阵列14226，这些齿14226也被构造成能够由关节运动锁定齿14406接合。当关节运动锁14400处于完全锁定状态时，如下文更详细地描述，关节运动锁定齿14406与驱动致动器齿14316和锁定板齿14226接合，使得关节运动锁14400将关节运动驱动致动器14310锁定就位并且防止或至少抑制关节运动驱动致动器14310和轴框架14180之间的相对移动。
锁定板14420包括定位在关节运动驱动致动器14310下方的肩部14424。锁定板齿14426被限定在肩部14424的侧向边缘上并且与限定在关节运动驱动致动器14310中的齿14316基本上对准。在至少一种情况下，关节运动驱动致动器齿14316沿着第一齿轴线对准，并且锁定板齿14406沿着与第一齿轴线平行或至少基本上平行的第二齿轴线被限定。在各种情况下，驱动致动器齿14316被限定在与包括锁定板齿14406的平面平行的平面中。此类布置允许关节运动锁14400同时接合锁定板14420和关节运动驱动致动器14310。尽管第一齿轴线和第二齿轴线与轴14100的纵向轴线平行，但设想了其中第一齿轴线和第二齿轴线相对于轴14100的纵向轴线偏斜或横向的实施方案。
再次参考图46，锁定板14420可在腔体14184内纵向滑动；然而，锁定板14420的纵向运动受到近侧端部壁和远侧端部壁14427的限制。因此，锁定板14420可在端部壁14427之间的轴腔体14184内浮动。在各种情况下，当关节运动锁14400接合齿14426和14316时，锁定板齿14426可不与驱动致动器齿14316完全对准。在此类情况下，锁定板14420可在一定程度上纵向移动，使得锁定板齿14426与驱动致动器齿14316对准。在各种情况下，锁定板14420可响应于由关节运动锁14400施加到其上的锁定力而移动。在至少一种情况下，例如可允许锁定板14420朝远侧移动一个齿节距距离并且相对于它的居中位置朝近侧移动一个齿节距距离，其中齿节距距离是在锁定板14420的相邻锁定齿14426的峰之间的距离。在其它情况下，例如可允许锁定板14420相对于它的居中位置朝远侧移动齿节距距离的1/4并且朝近侧移动齿节距距离的1/4。在各种情况下，可允许锁定板14420朝近侧移动多于一个齿节距距离并且朝远侧移动多于一个齿节距距离。
除上文之外，关节运动锁14400可在三种状态中被构造：自锁定状态、解锁状态和完全锁定状态。当关节运动锁14400处于自锁定状态时，关节运动锁14400的齿14406与驱动致动器齿14316和轴框架齿14186接合。在此类情况下，关节运动锁14400可抵抗穿过关节运动驱动致动器14310传递的一些力；然而，关节运动驱动致动器14310的近侧移动和/或远侧移动可克服关节运动锁14400的保持力并将关节运动锁14400位移到它的解锁构型中。在此类情况下，关节运动锁14400可远离驱动致动器14310侧向挠曲或偏转，以便端部执行器11500可进行关节运动。与上文类似，关节运动锁14400的弹簧构件14403可将关节运动锁14400弹性地返回到它的自锁定构型或至少朝它的自锁定构型偏压。因此，关节运动驱动系统可由于它的自身运动而自行锁定和解锁，除非它被放置在它的完全锁定位置，如下文所讨论。
与上文类似，外科器械14000的轴14100包括闭合管，该闭合管在闭合行程期间朝远侧推进以闭合端部执行器11500。在闭合行程之前，关节运动锁14400可在它的自锁定构型和解锁构型之间移动，以允许端部执行器11500由关节运动驱动系统进行关节运动。在闭合行程期间，闭合管被构造成能够接合关节运动锁14400并将关节运动锁14400放置、卡死或保持在它的完全锁定构型中。更具体地，闭合管包括凸轮14118，该凸轮被构造成能够接合限定在关节运动锁14400的背面上的凸轮表面14405，并且防止关节运动锁齿14406与驱动致动器齿14316和轴框架齿14186脱离。凸轮14118包括成角度表面14115，该成角度表面接合限定在凸轮表面14405上的对应的成角度表面，但也可使用任何合适的布置。当闭合管朝近侧回缩以允许端部执行器11500打开时，突片14118与关节运动锁14400脱离，并且关节运动锁14400可自由地在它的自锁定位置和解锁位置之间移动，如上文所讨论，以便端部执行器11500可再次进行关节运动。
再次参考图46，当关节运动锁14400由闭合管移动到它的完全锁定构型时，关节运动锁14400抵靠轴腔体14184的侧向侧壁14183推动锁定板14420。实际上，关节运动锁14400以足够的力接合锁定板14420，以将锁定板14420抵靠侧壁14183固定，使得锁定板14420不相对于轴框架14180纵向移动或至少基本上不移动。锁定板14420包括从它延伸出来的一个或多个突出部14422，该突出部被构造成能够在锁定板14420抵靠侧壁14183被推动时，嵌入、咬合和/或偏转轴腔体14184的侧壁14183，以防止或至少减小锁定板14420相对于轴框架14180纵向移动的可能性。
除此之外，轴框架14180包括限定于其中的一个或多个腔体或开口，这些一个或多个腔体或开口被构造成能够允许和/或有利于侧壁14183的偏转。例如，如图46所示，轴框架14180包括限定于其中的腔体14182，该腔体与突出部14422对准或至少基本上对准。当锁定板14420由闭合管侧向位移时，如上文所讨论，侧壁14183弹性地位移到腔体14182中，并且锁定板14420被锁定就位。在此类情况下，轴框架14180和锁定板14420之间的接合防止关节运动驱动致动器14310纵向移动并将端部执行器11500锁定就位。当闭合管从关节运动锁14400回缩和脱离时，侧壁14183可返回到它的未挠曲状态并且将锁定板14420侧向位移。此时，锁定板14420被解锁并且端部执行器11500可进行关节运动，如上文所概述。
外科器械15000在图47至图49中示出，并且在许多方面与外科器械14000类似，为了简洁起见，本文中的大多数将不再重复。除其它事项外，外科器械15000包括：轴、端部执行器11500和包括关节运动驱动致动器14310的关节运动驱动系统。外科器械15000还包括关节运动锁定系统，该关节运动锁定系统包括与上文类似的关节运动锁15400，该关节运动锁可在自锁定位置、解锁位置和完全锁定位置之间移动。关节运动锁定系统还包括在许多方面与锁定板14420类似的锁定板15420。例如，锁定板15420可侧向移动成与壁14183接合。而且，例如，锁定板15420可纵向移动以浮动到合适的锁定位置中，其中限定在锁定板15420上的齿15426与关节运动锁15400的齿14406啮合，如图48所描绘。也就是说，外科器械15000的轴还包括定位在锁定板15420中间的远侧弹簧15429和限定在轴框架中的远侧端部壁15427，此外还包括定位在锁定板15420的近侧弹簧15429和限定在轴框架中的近侧端部壁15427。弹簧15429被构造成能够将锁定板15420定位在端部壁15427之间的居中或平衡位置，如图47所示。这种居中位置在端部壁15427和锁定板15420之间产生近侧间隙(PG)和远侧间隙(DG)，该近侧间隙和远侧间隙彼此相等或至少基本上相等。也就是说，当锁定板15420将它自身与关节运动锁15400啮合接合时，如图49所示，弹簧15429可经受不同的偏转或负载，这可产生不相等的间隙PG和DG。
外科器械16000在图50至图52中示出，并且在许多方面与外科器械14000和15000类似，为了简洁起见，本文中的大多数将不再重复。除其它事项外，外科器械16000包括：轴、端部执行器11500和包括关节运动驱动器16310的关节运动驱动系统。主要参考图50，外科器械16000还包括关节运动锁定系统，该关节运动锁定系统包括与上文类似的关节运动锁16400，该关节运动锁可被构造成自锁定构型、解锁构型和完全锁定构型。关节运动锁定系统还包括在许多方面与锁定板14420类似的锁定板16420。例如，锁定板16420可侧向移动成与壁14183接合，如图51所示。而且，例如，锁定板16420可纵向移动以浮动到合适的锁定位置中，其中锁定板16420的齿16426与关节运动锁16400的齿16406啮合，如图52所描绘。此外，关节运动锁16400的齿16406、锁定板16420的齿16426和关节运动驱动器16310的锁定齿16316被构造和布置成提供多个位置或位置的排列，其中关节运动锁16400可将关节运动驱动器16310锁定到锁定板16420。例如，关节运动锁定系统已到达图51所示的一组位置中的完全锁定构型和图52所示的不同的一组位置中的完全锁定构型。上文讨论的关节运动锁定系统的适应性可通过关节运动锁定齿16406、关节运动驱动器齿16316和锁定板齿16426的齿节距来实现。例如，主要参考图50，关节运动锁定齿16406设定在第一节距16407处，关节运动驱动器齿16316设定在第二节距16317处，并且锁定板齿16426设定在第三节距16427处。第一节距与第二节距和第三节距不同—第二节距与第一节距和第三节距不同—并且第三节距与第一节距和第二节距不同，但设想其中第一节距、第二节距和第三节距中的两者是相同的实施方案。再次参考图50，锁定板齿16426的第三节距16427大于关节运动驱动器齿16316的第二节距16317，并且第二节距16317大于关节运动锁定齿16406的第一节距16407，但可使用任何合适的布置。
外科器械17000在图53至图56中示出，并且在许多方面与外科器械11000类似，为了简洁起见，本文中的大多数将不再重复。外科器械17000包括：轴、以能够围绕关节运动接头11200旋转的方式连接到轴的端部执行器11500、以及被构造成能够使端部执行器11500围绕关节运动接头11200进行关节运动的关节运动驱动系统。与上文类似，关节运动驱动系统包括：围绕销11620可旋转地安装到钳口11600的关节运动连接件17320和围绕销17315可旋转地安装到关节运动连接件17320的关节运动驱动器17310。外科器械17000还包括可移动地安装到外科器械17000的轴框架的关节运动锁17400，该关节运动锁可在解锁位置和锁定位置之间移动。关节运动锁17400包括固定地安装到轴框架的远侧端部17402和可滑动地安装到轴框架的近侧端部17404。更具体地，轴框架包括：延伸到限定在关节运动锁17400的远侧端部17402中的孔口中的销和延伸到限定在近侧端部17404中的细长孔口中的导向突出部17114。在某些情况下，轴框架可包括延伸到限定在关节运动锁17400的远侧端部17402中的孔口中的两个或更多个销，以将远侧端部17402固定到轴框架并且防止远侧端部17402相对于轴框架旋转。作为上文的结果，关节运动锁17400的至少近侧端部17404可相对于轴框架移动以接合关节运动驱动器17310并将关节运动系统和端部执行器11500锁定就位。
除此之外，关节运动驱动器17310包括限定于其上纵向齿条17316，并且关节运动锁17400包括限定于其上的纵向齿条17406。如图53和图54所示，当关节运动锁17400处于它的解锁位置时，关节运动锁17400的齿17406不与关节运动驱动器17310的齿17316接合。在此类情况下，关节运动驱动器17310可相对于关节运动锁17400自由地移动以使端部执行器11500进行关节运动。如图55所示，当关节运动锁17400处于部分锁定位置时，关节运动锁定齿17406与关节运动驱动器齿17316部分地接合。在此类情况下，关节运动驱动器17310的近侧端部和远侧端部移动被关节运动锁17400阻碍；然而，关节运动驱动器17310仍可相对于关节运动锁17400移动以使端部执行器11500进行关节运动。如图56所示，当关节运动锁17400处于完全锁定位置时，关节运动锁定齿17406与关节运动驱动器齿17316完全地接合。在此类情况下，关节运动驱动器17310的近侧移动和远侧移动以及端部执行器11500的关节运动被关节运动锁17400阻止。
除此之外，除了闭合构件或管17110之外，外科器械17000不包括被构造成能够将关节运动锁17400朝关节运动驱动器17310移动的偏压构件。闭合管17110被构造成能够接合关节运动锁17400并将关节运动锁17400从它的解锁位置(图54)移动到它的部分锁定位置(图55)和完全锁定位置(图56)。与上文类似，闭合管17110包括凸轮17118，该凸轮被构造成能够接合限定在关节运动锁17400上的凸轮表面，但也可使用其它布置。闭合管17110被构造成能够在闭合管17110朝远侧移动穿过使端部执行器11500至少部分地闭合的部分闭合行程(PCS)时，将关节运动锁17400在它的解锁位置与它的部分锁定位置之间移动。在此类情况下，外科器械17000的端部执行器11500可用于例如抓握患者的组织。闭合管17110被构造成能够在闭合管17110朝远侧移动穿过使端部执行器11500完全闭合的完全闭合行程(FCS)时，将关节运动锁17400移动到它的完全锁定位置。在此类情况下，外科器械17000的端部执行器11500可用于例如完全夹持患者的组织。
如上文所讨论，当闭合管17110朝远侧推进时，由关节运动锁17400施加到关节运动驱动器17310的锁定力增加。换句话讲，关节运动锁定力是闭合管17110行程的函数。除上文之外，现在转到图57，关节运动驱动器17310和关节运动锁17400之间的锁定力由线17101表示。如图57所示，关节运动锁齿17406在部分闭合行程期间初始与关节运动驱动器齿17316接合。在至少一种情况下，齿17406和17316的这种初始接合发生在闭合管17110的大约0.050"的闭合行程之后，但可使用任何合适的距离。值得注意的是，齿17406和17316的这种初始接合不一定与部分闭合行程的结束一致；相反，它可发生在部分闭合行程(PCS)期间的某个点。它还发生在完全闭合行程(FCS)期间的某个点。然而，这种初始接合不包括锁定力耦合。相反，齿17406和齿17316之间的锁定力耦合仅在完全闭合行程(FCS)期间的某个处建立。在至少一种情况下，完全闭合行程(FCS)具有例如大约0.260"的长度。
外科器械18000在图58至图60中示出，并且在许多方面与外科器械11000和17000类似，为了简洁起见，本文中的大多数将不再重复。外科器械18000包括：轴、以能够围绕关节运动接头旋转的方式连接到轴的端部执行器11500、以及被构造成能够使端部执行器11500进行关节运动的关节运动系统。该轴包括框架18180，该框架包括彼此平行或至少基本上平行的第一纵向齿条和第二纵向齿条18186，但齿条18186可横向地彼此延伸。外科器械18000还包括关节运动锁18400和包括凸轮18118的闭合构件。关节运动锁18400包括：被构造成能够接合第一纵向齿条18186的第一锁定臂18410以及被构造成能够接合第二纵向齿条18186的第二锁定臂18420。主要参考图59和图60，第一锁定臂18410包括限定于其上的第一凸轮表面18415，并且第二锁定臂18420包括限定于其上的第二凸轮表面18425，这些凸轮表面被构造成能够在闭合构件的闭合行程期间被凸轮18118接触并且被向外位移或挠曲成与纵向齿条18186完全锁定接合。此外，当锁定臂18410和18420向外位移成与轴框架18180接合时，锁定臂18410和18420中的一者或两者还接合关节运动系统以将端部执行器11500锁定就位。
一旦位移或挠曲到锁定臂18410和18420的完全锁定状态，这些锁定臂就在它们之间限定纵向狭槽18430，该纵向狭槽被构造成能够允许凸轮18118例如在闭合行程的剩余部分期间通过。此外，在此类情况下，凸轮18118将关节运动锁18400楔入成与框架18180接合，并且将锁定臂18410和18420牢固地保持在它们的完全锁定位置。
在至少一个替代的实施方案中，除此之外，关节运动锁18400的第一锁定臂18410可被构造成能够接合外科器械18000的轴框架18180，而关节运动锁18400的第二锁定臂18420可被构造成能够接合外科器械18000的关节运动系统。
外科器械19000在图61至图65中示出，并且在许多方面与外科器械11000类似，为了简洁起见，本文中的大多数将不再重复。外科器械19000包括：轴19100，该轴包括闭合构件19110；以能够围绕关节运动接头11200旋转的方式连接到轴19100的端部执行器11500；以及关节运动驱动系统19300，该关节运动驱动系统包括被构造成能够使端部执行器11500围绕关节运动接头11200进行关节运动的关节运动驱动器19310。主要参考图61，外科器械19000还包括关节运动锁19400，该关节运动锁被构造成能够选择性地接合关节运动驱动系统19300并且将端部执行器11500锁定就位。轴19100还包括框架19180，并且关节运动锁19400在解锁位置(图61)、部分锁定位置(图63)和锁定位置(图64)之间可移动地安装到框架19180。如下文更详细地描述，关节运动锁19400可朝关节运动驱动器19310侧向移动，以使关节运动锁19400与关节运动驱动器19310(图63)紧密接近，并且还横向成干涉关节运动驱动器19310(图64)。
除此之外，轴框架19180包括近侧导向柱19182和远侧导向柱19184。近侧导向柱19182延伸到限定于关节运动锁19400的近侧端部19402中的侧向细长狭槽中，并且类似地，远侧导向柱19184延伸到限定于关节运动锁19400的远侧端部19404中的侧向细长狭槽中。侧向细长狭槽允许关节运动锁19400朝向并且远离关节运动驱动器19310侧向移动，如上文所概述。侧向细长狭槽还限定关节运动锁19400的侧向路径，并且防止或至少基本上防止关节运动锁19400相对于轴框架19180的纵向移动。因此，关节运动锁19400的细长狭槽可在解锁位置(图61)—其中关节运动锁19400的锁定齿19406不与限定在关节运动驱动器19310上的纵向齿条19316接合、部分锁定位置(图63)—其中锁定齿19406与齿19316部分接合和完全锁定位置(图64)—其中锁定齿19406与齿19316完全接合之间导向关节运动锁19400。
除此之外，关节运动锁19400还包括限定于其中的纵向凸轮狭槽19408，并且闭合构件19110包括定位在凸轮狭槽19408中的凸轮销19188。当闭合构件19110处于未致动或打开位置(图61)时，凸轮销19188定位在凸轮狭槽19408的近侧部分19408a中。当闭合构件19110朝远侧移动到部分致动的或部分闭合的位置时，如图62所示，凸轮销19188移动到凸轮狭槽19408的中心部分19408b中。在此类情况下，凸轮销19188将关节运动锁19400朝关节运动驱动器19310位移。然而，在此类情况下，关节运动锁19400的齿19406可不与关节运动驱动器19310的齿19316接合，并且因此，关节运动驱动器19310仍可移动以使端部执行器11500相对于轴19100进行关节运动。因此，当闭合构件19110的闭合行程仅部分完成时，端部执行器11500可进行关节运动。
当闭合构件19110进一步朝远侧移动时，如图63所示，凸轮销19188移动到凸轮狭槽19408的远侧部分19408c中。在此类情况下，凸轮销19188将关节运动锁19400位移成与关节运动驱动器19310紧密接近，并且与关节运动驱动器19310的齿19316部分相互啮合。也就是说，齿19406和19316之间的这种部分相互啮合可仅抵抗穿过关节运动驱动器19310传递的一定量的力，并且可克服这种阻力以相对于关节运动锁19400移动关节运动驱动器19310并使端部执行器11500进行关节运动。
除此之外，在闭合构件19110的部分闭合行程期间(图61至图63)，关节运动锁19400不相对于轴框架19180横向提升或降低。相反，关节运动锁19400被向上提升，使得关节运动锁19400的齿19406完全接合关节运动驱动器19310的齿19316，并且在闭合构件19110的闭合行程的最终或最后部分期间将关节运动驱动器19310锁定就位，如图64所示。关节运动锁19400由从闭合构件19110延伸出来的不同凸轮销(即，在闭合构件19110的闭合行程结束时接合关节运动锁19400的凸轮销19189)向上移动。值得注意的是，凸轮销19189在闭合行程开始时或闭合构件19110的部分闭合行程期间不与关节运动锁19400接合。至多，凸轮销19189可在部分闭合行程期间滑动地触碰关节运动锁19400的底部。也就是说，主要参考图65，关节运动锁19400包括限定于其中的切口或凹槽19409，该切口或凹槽在部分闭合行程期间在凸轮销19189和关节运动锁19400之间提供空隙。也就是说，当凸轮销19189到达凹槽19409的端部时，凸轮销19189与关节运动锁19400接触，并且在此类情况下，使关节运动锁19400横向向上驱动，使得锁定齿19406与关节运动驱动器19310的齿19316干涉地接合，并且关节运动锁19400被放置在它的完全锁定位置，如图64所示。此时，关节运动驱动器19310被锁定就位并且不能纵向移动以使端部执行器11500进行关节运动。
再次参考图65，关节运动驱动器19310的齿19316相对于轴19100的纵向轴线成角度或倾斜。关节运动锁19400的锁定齿19406不成角度，或以与齿19316不同的取向成角度。因此，当关节运动锁19400处于它的降低位置(图63)并且与齿19316完全接合时，并且当关节运动锁19400处于它的升高位置(图64)时，关节运动锁19400的锁定齿19406可与关节运动驱动器19310的齿19316部分接合。
为了解锁外科器械19000的关节运动系统19300，必须回缩闭合构件19110以使凸轮销19189与关节运动锁19400脱离，以便关节运动锁19400可返回到它的降低位置。一旦凸轮销19189已与关节运动锁19400脱离，凸轮销19188的近侧回缩就可随着凸轮销19188朝近侧牵拉穿过凸轮狭槽19408而向下驱动关节运动锁19400。此外，当凸轮销19188朝近侧牵拉时，凸轮销19188可使关节运动锁19400位移远离关节运动驱动器19310。在各种实施方案中，轴19110可包括一个或多个偏压构件，诸如弹簧，例如一个或多个偏压构件被构造成能够向下偏压或推动关节运动锁19400，以将关节运动锁快速复位到解锁位置。
外科器械20000在图66至图68中示出，并且在许多方面与外科器械11000、17000、18000和19000类似，为了简洁起见，本文中的大多数将不再重复。外科器械20000包括：包括闭合管20110的轴、围绕关节运动接头11200可旋转地安装到轴的端部执行器11500、以及被构造成能够使端部执行器11500相对于轴进行关节运动的关节运动系统。与上文类似，关节运动系统包括：可旋转地固定到端部执行器11500的关节运动连接件20320，并且此外包括可旋转地固定到关节运动连接件20320的关节运动致动器20310。在使用中，关节运动致动器20310朝近侧和/或朝远侧移动，以驱动关节运动连接件20320并使端部执行器11500进行关节运动。外科器械20000还包括关节运动锁定系统，该关节运动锁定系统包括关节运动锁定齿轮20400，关节运动锁定齿轮围绕固定轴线可旋转地安装到轴的框架。关节运动锁定齿轮20400包括与限定在关节运动致动器20310上的纵向齿阵列20316啮合地接合的环形齿阵列20406。因此，通常参考图66，关节运动锁定齿轮20400将响应于关节运动致动器20310的近侧移动和/或远侧移动而旋转，直到关节运动锁定齿轮20400被闭合管20110锁定就位，如图68所示。
除此之外，关节运动锁定系统还包括从轴框架延伸到限定于关节运动锁定齿轮20400中的中心孔口中的锁定臂20405，并且当闭合管20110在闭合行程期间朝远侧移动以闭合端部执行器11500时，闭合管20110的凸轮或楔形件20118被构造成能够接合锁定臂20405并使锁定臂20405向外展开与关节运动锁定齿轮20400接合。一旦锁定臂20405与关节运动锁定齿轮20400接合，锁定臂20405就可防止关节运动锁定齿轮20400的旋转，并且还防止关节运动致动器20310的纵向移动。在此类情况下，锁定臂20405可防止或至少基本上防止端部执行器11500的关节运动，直到闭合管20110的楔形件20118在打开行程期间朝近侧回缩并且锁定臂20405弹性地返回到它们的未挠曲或解锁构型。
除此之外，外科器械20000的关节运动系统可被置于解锁构型(图66)、部分锁定构型(图67)和完全锁定构型(图68)。当闭合管20110朝远侧推进穿过部分闭合行程(PCS)时，关节运动系统可被置于它的部分锁定构型(图67)。在此类情况下，端部执行器11500至少部分地闭合，但仍可进行关节运动，即使锁定臂20405可部分地与关节运动锁定齿轮20400接合。更具体地，尽管由于锁定臂20405抵靠关节运动锁定齿轮20400的部分接合而产生曳力，关节运动锁定齿轮20400仍可旋转。在至少一种情况下，PCS例如大约为0.050"。当闭合管20110朝远侧推进穿过完全闭合行程(FCS)时，关节运动系统可被置于它的完全锁定构型(图68)。在此类情况下，端部执行器11500为完全闭合的，并且在关节运动系统返回到它的部分锁定构型和/或解锁构型之前不能进行关节运动。
外科器械21000在图69至图71中示出，并且在许多方面与外科器械11000、17000、18000、19000和20000类似，为了简洁起见，本文中的大多数将不再重复。外科器械21000包括：包括闭合构件21110的轴、围绕关节运动接头11200可旋转地安装到轴的端部执行器11500、以及包括被构造成能够使端部执行器11500相对于轴进行关节运动的关节运动致动器21130的关节运动系统。外科器械21000还包括关节运动锁定系统，该关节运动锁定系统包括关节运动锁定齿轮21400，关节运动锁定齿轮围绕固定轴线可旋转地安装到轴的框架。关节运动锁定齿轮21400包括与限定在关节运动致动器21310上的纵向齿阵列21316啮合地接合的环形齿阵列21406。因此，通常参考图69，关节运动锁定齿轮21400响应于关节运动致动器21310的近侧纵向移动和/或远侧纵向移动而旋转，直到关节运动锁定齿轮21400被闭合构件21110锁定就位(图71)，如下文更详细地描述。
除此之外，外科器械21000的关节运动锁定系统还包括可滑动地安装到轴框架的活动的锁定元件21405。更具体地，主要参考图69，锁定元件21405包括从它延伸的导向突出部21402，该导向突出部延伸到限定在轴框架中的侧向细长狭槽21403中，该侧向细长狭槽被构造成能够允许锁定元件21405朝向和/或远离关节运动驱动器21310侧向滑动。此外，主要参考图70，锁定元件21405在限定在关节运动锁定齿轮21400中的孔口内，在解锁位置(图69)和锁定位置(图71)之间侧向滑动。锁定元件21405包括锁定齿21407的环形阵列，并且关节运动锁定齿轮21400包括围绕它的内部孔口限定的锁定齿21408的环形阵列，并且当锁定元件21405处于它的解锁位置(图69)时，锁定元件21405的锁定齿21407不与关节运动锁定齿轮21400的锁定齿21408接合。当锁定元件21405处于它的锁定位置(图71)时，锁定元件21405的锁定齿21407与关节运动锁定齿轮21400的锁定齿21408接合，使得关节运动锁定齿轮21400不旋转，并且因此防止关节运动致动器21300纵向移动以使端部执行器11500进行关节运动。
图69至图71示出了闭合行程期间闭合构件21110的远侧行进。图69示出了处于未致动、打开位置的闭合构件21110。在这种位置中，闭合构件21110不与锁定元件21405接合。图70示出了处于部分闭合位置的闭合构件21110，其中闭合构件21110已使端部执行器11500至少部分地闭合。在此类位置中，闭合构件21110的凸轮表面21115接合了锁定元件21405。在至少一种情况下，闭合构件21110从它的打开位置(图69)朝远侧移动大约0.050"至它的部分闭合位置(图70)。图71示出了处于完全闭合位置的闭合构件21110，其中闭合构件21110已使端部执行器11500完全闭合。在此类位置中，凸轮表面21115已被锁定元件21405移动，并且锁定元件21405已被闭合构件21110的整个厚度位移。
根据上文所述，外科器械可包括关节运动锁定系统，该关节运动锁定系统被构造成能够防止外科器械的端部执行器被施加到端部执行器的负载或扭矩进行关节运动和/或无意地反向驱动。关节运动锁定系统的至少一部分可移动到与外科器械的关节运动驱动系统接合，以防止端部执行器的关节运动。在至少一种情况下，关节运动锁可与关节运动驱动系统成一整体，如下文更详细地描述。
参考图72至图74，外科器械22000包括：轴和关节运动驱动系统22300，该关节运动驱动系统被构造成能够使端部执行器(诸如例如外科器械22000的端部执行器11500)相对于轴进行关节运动。关节运动驱动系统22300包括关节运动驱动器22310和小齿轮22320。关节运动驱动器22310包括限定于其上的纵向齿条22316，这些齿与小齿轮22320的齿22326可操作地啮合。当关节运动驱动器22310朝远侧平移时，小齿轮22320沿第一方向旋转。对应地，当关节运动驱动器22310朝近侧平移时，小齿轮22320沿第二方向旋转。小齿轮22320包括固定地安装到其上的锥齿轮22330，使得锥齿轮22330随着小齿轮22320围绕公共旋转的轴线旋转。小齿轮22320和锥齿轮22330的组合组件可旋转地安装在外科器械22000的轴上。
除此之外，锥齿轮22330的齿22336与锥齿轮22340的齿22346啮合地接合，该锥齿轮围绕可旋转螺纹关节运动导螺杆22350可旋转地安装。更具体地，锥齿轮22340包括螺母部分，该螺母部分包括与关节运动导螺杆22350以螺纹方式接合的至少部分地螺纹的孔口。当锥齿轮22340沿第一方向由关节运动驱动器22310通过锥齿轮22330旋转时，锥齿轮22340使关节运动导螺杆22350沿第一方向旋转。对应地，当锥齿轮22340沿第二方向旋转时，锥齿轮22340使关节运动导螺杆22350在第二方向上旋转。此外，当关节运动导螺杆22350沿它的第一方向旋转时，端部执行器11500沿第一方向旋转，并且当螺纹关节运动驱动轴22350沿它的第二方向旋转时，对应地端部执行器11500沿它的第二方向旋转。
除此之外，可选择螺纹关节运动导螺杆22350上的螺纹的节距以防止在关节运动驱动系统22300内的反向驱动。换句话讲，限定在关节运动导螺杆22350上的螺纹的大节距将能够抵抗从端部执行器11500朝近侧穿过关节运动驱动系统22300传递的力和/或扭矩，并且因此可防止端部执行器11500无意地进行关节运动。因此，螺纹节距可用作与关节运动驱动系统22300成一整体的关节运动锁。在至少一种情况下，关节运动导螺杆包括例如ACME导螺杆。
参考图75至图79，外科器械23000包括：轴和关节运动驱动系统23300，该关节运动驱动系统被构造成能够使端部执行器(诸如例如外科器械23000的端部执行器11500)相对于轴进行关节运动。关节运动驱动系统23300包括关节运动驱动器23310和小齿轮23320。关节运动驱动器23310包括限定于其上的纵向齿条23316，这些齿与小齿轮23320的齿23326可操作地啮合。当关节运动驱动器23310朝远侧平移时，小齿轮23320沿第一方向旋转。对应地，当关节运动驱动器23310朝近侧平移时，小齿轮23320沿第二方向旋转。小齿轮23320包括固定地安装到其上的蜗齿轮23330，使得蜗齿轮23330随着小齿轮23320围绕公共旋转的轴线旋转。小齿轮23320和蜗齿轮23330的组合组件可旋转地安装在外科器械23000的轴上。
除此之外，蜗齿轮23330的齿23336与可旋转地安装到轴框架的蜗杆23340的齿23346啮合地接合。蜗杆23340包括固定地安装到其上的小齿轮23350，使得小齿轮23350随着蜗杆23340围绕公共旋转的轴线旋转。小齿轮23350与可平移的关节运动输出驱动器23360可操作地接合。更具体地，小齿轮23350包括与限定在输出驱动器23360上的齿条23366的啮合地接合的齿23356。当蜗杆23340沿第一方向由关节运动驱动器23310通过蜗齿轮23330旋转时，小齿轮23350朝远侧驱动输出驱动器23360。对应地，当蜗杆23340沿第二方向由蜗齿轮23330旋转时，蜗杆23340和小齿轮23350朝近侧驱动输出驱动器23360。此外，当输出驱动器23350由关节运动驱动系统23330朝远侧驱动时，端部执行器11500沿第一方向旋转，并且当输出驱动器23350由关节运动驱动系统23330朝近侧驱动时，端部执行器11500沿第二方向旋转。
除此之外，可选择蜗杆23340上的螺纹的节距以防止在关节运动驱动系统23300内的反向驱动。换句话讲，例如，限定在蜗杆23340上的螺纹的大节距将能够抵抗从端部执行器11500朝近侧穿过关节运动驱动系统23300传递的力和/或扭矩，并且可防止端部执行器11500无意地进行关节运动。因此，螺纹节距可用作与关节运动驱动系统23300成一整体的关节运动锁。
外科器械12000在图32至图34B中示出，在若干方面与外科器械11000类似，为了简洁起见，本文中的许多将不再重复。除了轴11100、端部执行器11500和关节运动接头11200之外，外科器械12000还包括例如包括延伸穿过关节运动接头11200的击发杆12910的钉击发系统12900。在使用中，击发杆12910可朝远侧平移以执行钉击发行程，并且在钉击发行程的至少一部分已完成之后朝近侧回缩。击发杆12910延伸穿过限定在轴11100的框架11180中的通道或狭槽11190，该通道或狭槽被构造成能够当击发杆12910相对于轴11100移动时紧密地接纳和/或引导击发杆12910。类似地，端部执行器11500包括限定在端部执行器11500的框架11580中的通道或狭槽11590，该通道或狭槽也被构造成能够在击发杆12910相对于端部执行器11500移动时紧密地接纳和/或引导击发杆12910。
除此之外，通道11190和11590不延伸到关节运动接头11200内，并且在无其它情况下，击发杆12910可不被支撑在关节运动接头11200内。当端部执行器11500处于非关节运动构型(图34)时，击发杆12910在钉击发行程期间不太可能在关节运动接头11120内屈曲，然而，当端部执行器11500处于关节运动构型(图34A和图34B)时，击发杆12910在钉击发行程期间很可能侧向屈曲。为了减小这种屈曲的可能性，外科器械12000还包括被构造成能够支撑击发杆12910的击发杆支撑件12400。击发杆支撑件12400包括：连接到轴框架11180的近侧部分12410、连接到端部执行器框架11580的远侧部分12430、以及在近侧部分12410和远侧部分12430之间延伸的中间部分12420。击发杆支撑件12400的部分12410、12420和12430是一体形成的；然而，设想了其中部分12410、12420和12430彼此组装和/或包括单独部件的其它实施方案。
除此之外，击发杆支撑件12400的远侧部分12430固定地安装到端部执行器框架11580，并且相对于端部执行器框架11580不移动或至少基本上不移动。击发杆支撑件12400的中间部分12420包括具有减小的横截面的一个或多个部分，除其它项外，这些部分允许击发杆支撑件12400在端部执行器11500进行关节运动时在关节运动接头11200内挠曲。击发杆支撑件12400的近侧部分12410可滑动地安装到轴框架11180，使得当端部执行器11500进行关节运动时，击发杆支撑件12400可相对于轴框架11180平移。也就是说，击发杆支撑件12400的近侧部分12410包括近侧头部12415，该近侧头部可在限定在轴框架11180内的腔室或腔体11185内滑动，这可限制击发杆支撑件12400的行进。然而，设想了不具有这种行进约束的实施方案。在任何情况下，击发杆支撑件12400的近侧部分12410、中间部分12420和远侧部分12430共同可操作地限定通道或狭槽12490，该通道或狭槽被构造成支撑击发杆12910(尤其是在关节运动接头11200内)并且减小击发杆12910在例如钉击发行程期间屈曲的可能性。
在各种情况下，击发杆12910由多个平行的或至少基本上平行的层构成。这些层附连到远侧切割构件并且可相对于彼此部分地平移或滑动，尤其是在关节运动接头11200内。每个此类层被构造成能够沿相同方向(即，朝近侧或朝远侧)传递负载，即使此类层可相对于彼此移动或滑动。除此之外，当端部执行器11500已进行关节运动时，此类层可相对于彼此侧向地展开，尤其是在关节运动接头11200内。击发杆支撑件12400的中间部分12420包括多个连接的控制元件，这些多个连接的控制元件可至少减小(即使不能防止)击发杆层的相对侧向展开。替代地，如上文所提及，控制元件中的一个或多个可彼此不连接。
除了击发杆支撑件12400之外或代替击发杆支撑件12400，外科器械12000还包括隔开和控制击发杆12910的层的一个或多个隔离件。参考图34至图34B，轴11110包括定位在击发杆12910的层内的隔离件12920。击发杆12910的两个层定位在隔离件12920的一侧上，同时两个层定位在隔离件12920的另一侧上，但也可使用任何合适的布置方式。当端部执行器11500进行关节运动时，隔离件12920防止击发杆12910的一半层向外展开。换句话讲，当端部执行器11500向右进行关节运动(图34A)时，隔离件12920防止两个最右击发杆层向左展开，并且类似地，当端部执行器11500向左进行关节运动(图34B)时，隔离件12920防止两个最左击发杆层向右展开。隔离件12920延伸穿过关节运动接头11200和击发杆支撑件12400并进入端部执行器11500中，并且可在端部执行器11500进行关节运动时弯曲。因此，在此类情况下，隔离件12920是柔性的。隔离件12920安装到轴11110的框架11180并且不相对于框架11180移动；然而，设想了其中隔离件12920未安装到框架11180并且可在击发杆层内浮动的实施方案。
外科器械13000在图35至图39B中示出，在若干方面与外科器械11000和12000类似，为了简洁起见，本文中的许多将不再重复。除了轴13100、端部执行器13500和关节运动接头11200之外，外科器械13000还包括例如包括延伸穿过关节运动接头11200的击发杆12910的钉击发系统12900。在使用中，击发杆12910可朝远侧平移以执行钉击发行程，并且在钉击发行程的至少一部分已完成之后朝近侧回缩。主要参考图39至图39B，击发杆12910延伸穿过限定在轴13100的框架13180中的通道或狭槽13190，该通道或狭槽被构造成能够当击发杆12910相对于轴11100移动时紧密地接纳和/或引导击发杆12910。类似地，端部执行器13500包括限定在端部执行器13500的框架13580中的通道或狭槽，该通道或狭槽也被构造成能够在击发杆12910相对于端部执行器13500移动时紧密地接纳和/或引导击发杆12910。
当端部执行器13500处于非关节运动构型(图39)时，除此之外，击发杆12910在钉击发行程期间不太可能在关节运动接头11120内屈曲，然而，当端部执行器13500处于关节运动构型(图39A和图39B)时，击发杆12910在钉击发行程期间很可能侧向屈曲。为了减小这种屈曲的可能性，外科器械13000还包括被构造成能够支撑击发杆12190的击发杆支撑件13400。击发杆支撑件13400包括第一侧板13410和第二侧板13420。侧板13410和13420定位在击发杆12910的相反的两侧上。每个侧板13410、13420包括：连接到轴框架13180的近侧部分、连接到端部执行器框架13580的远侧部分、以及在近侧部分和远侧部分之间延伸的中间部分。每个板13410、13420的部分是一体形成的；然而，设想了其中各部分彼此组装和/或包括单独部件的其它实施方案。
除此之外，第一侧板13410包括远侧部分13416，该远侧部分固定地安装到端部执行器框架13580，并且相对于端部执行器框架13580不移动或至少基本上不移动。类似地，第二侧板13420包括远侧部分13426，该远侧部分固定地安装到端部执行器框架13580并且相对于端部执行器框架13580不移动或至少基本上不移动。第一侧板13410包括近侧部分13412，该近侧部分可滑动地安装到轴框架13180，使得当端部执行器13500进行关节运动时，第一侧板13410可相对于轴框架13180平移。近侧部分13412包括头部，该头部可在限定在轴框架13180内的腔室或腔体13185内滑动，这可限制击发杆支撑件13400的行进。类似地，第二侧板13420包括近侧部分13422，该近侧部分可滑动地安装到轴框架13180，使得当端部执行器13500进行关节运动时，击发杆支撑件13400可相对于轴框架13180平移。近侧部分13422包括可在限定在轴框架13180内的腔室13185内滑动的头部，这也可限制击发杆支撑件13400的行进。
第一侧板13410包括定位在关节运动接头11200中的柔性部分13414，该柔性部分允许第一侧板13410的远侧部分13416相对于近侧部分13412挠曲并适应端部执行器13500的关节运动。柔性部分13414从第一侧板13410侧向延伸并且包括铰链，该铰链包括限定于其中的间隙13413，该间隙允许在第一侧板13410内旋转。除上文所述之外或代替上文所述，第一侧板13410包括限定于其中的纵向开口13415，该纵向开口允许第一侧板13410在端部执行器13500内挠曲并适应端部执行器13500的关节运动。第一侧板13410可包括在其中任何合适的位置处限定的任何合适数量和构型的开口和/或凹槽，该开口和/或凹槽被构造成能够允许第一侧板13410在端部执行器13500的关节运动期间挠曲。类似地，第二侧板13412包括定位在关节运动接头11200中的柔性部分13424，该柔性部分允许第二侧板13420的远侧部分13426相对于近侧部分13422挠曲并适应端部执行器13500的关节运动。柔性部分13424从第一侧板13420侧向延伸并且包括铰链，该铰链包括限定于其中的间隙，该间隙允许在第二侧板13420内旋转。除上文所述之外或代替上文所述，第二侧板13420包括限定于其中的纵向开口，该纵向开口允许第二侧板13420在端部执行器13500内挠曲并适应端部执行器13500的关节运动。第二侧板13420可包括在其中任何合适的位置处限定的任何合适数量和构型的开口和/或凹槽，该开口和/或凹槽被构造成能够允许第二侧板13420在端部执行器13500的关节运动期间挠曲。
除此之外，侧板13410和13420是柔性的，并且当端部执行器13500返回到它的非关节运动构型时，侧板13410和13420可弹性地返回到它们的未挠曲构型。在各种情况下，侧板13410和13420包括弹簧，该弹簧将端部执行器13500弹性地偏压成它的非关节运动构型。
击发构件24900在图83和图84中示出，并且可与本文所公开的任何外科缝合器械一起使用。击发构件24900包括击发杆24910，与上文所述的类似，该击发杆包括多个层。更具体地，击发杆24910包括两个外层24911和两个内层24912。击发构件24900还包括远侧切割构件24920，该远侧切割构件包括组织切割刃24926。远侧切割构件24920还包括：被构造成能够接合端部执行器的第一钳口的第一凸轮24922和被构造成能够接合端部执行器的第二钳口的第二凸轮24924。也就是说，设想了其中远侧切割构件24920被构造成能够仅接合端部执行器的一个钳口或替代地，不接合端部执行器的任一个钳口的实施方案。
击发杆24910的层24911和24912在焊缝24930处被焊接到远侧切割构件24920。如图84所示，第一焊缝24930存在于击发构件24900的第一侧上，并且第二焊缝24930存在于击发构件24900的第二侧上。第一焊缝24930穿透第一外层24911和相邻的内层24912。在各种情况下，第一焊缝24930完全穿透穿过相邻的内层24912和/或还穿透到另一个内层24912中。第二焊缝24930穿透第二外层24911和相邻的内层24912。在各种情况下，第二焊缝24930完全穿透穿过相邻的内层24912和/或还穿透到另一个内层24912中。
主要参考图83，击发构件24900的每个焊缝24930包括焊线，该焊线被构造成能够将击发杆24910牢固地保持到切割构件24920，并且与此同时在它们之间提供柔性连接。每个焊缝24930包括将切割构件24920连接到板24911和24912的远侧端部的对接焊缝24931，并且当纵向击发力穿过击发构件24900传递时，每个焊缝24930被置于张力和/或压缩状态。对接焊缝正交于或至少基本上正交于击发构件24900的纵向击发轴线(FA)。对接焊缝24931可包括任何合适的构型，例如诸如正方形、闭合的正方形、单斜面、双斜面、单J、双J、单V、双V、单U、双U、凸缘、侧翼和/或三通构型。
除此之外，每个焊缝24930还包括：远侧钩焊接部分24932和近侧钩焊接部分24933。每个钩焊接部分24932和24933包括纵向部分，该纵向部分与击发构件24900的纵向击发轴线(FA)对准或平行，并且在纵向击发力穿过击发构件24900传递时被置于剪切状态。此外，每个钩焊接部分24932和24933包括对接部分，该对接部分正交于或至少基本上正交于纵向击发轴线(FA)并且当纵向击发力穿过击发构件24900传递时被置于张力和/或压缩状态。值得注意的是，每组钩焊接部分24932和24933包括击发杆24910和切割构件24920之间的互锁连接，该互锁连接可在其间传递应力流而不会失效和/或产生不适。
每个焊缝24930通常为例如L形；然而，焊缝24930可包括任何合适的构型。
尽管外科器械10000、11000、12000、13000、14000、15000、16000、17000、18000、19000、20000、21000、22000和23000是外科缝合器，但它们的设计可容易地适应于具有可关节运动的端部执行器等的其它外科器械。此类其它外科器械可包括：例如夹具施放器、紧固件施放器和/或能够向组织递送电能和/或振动能量的外科器械。
图86示出了包括位于其远侧端部处的细长鼻部25150(通常表示为25102)的外科钉仓25100。细长鼻部25150具有基部25152，该基部由在钉线25056的端部和钉仓25100的远侧端头25142之间延伸一定距离的第一长度25154限定。远侧端头25142以与钉仓25100的基部25152成角度σ的形式形成。钉仓25100上的远侧端头25142被指向并被构造成能够在缝钉击发行程完成时充当击发系统的楔形滑动件(未示出)的停放区域。
为了缩短钉仓的总长度而不牺牲缝合的组织的长度，图85所描绘的外科钉仓25200包括仓体25210，该仓体包括位于其远侧端部处的缩短鼻部25250，通常表示为25202。缩短鼻部25250具有基部25252，该基部由在钉线25056的端部和钉仓25200的钝的远侧端头25242之间延伸一定距离的第二长度25254限定。缩短鼻部25250的第二长度25254通过使楔形滑动件25270(参见图89)的停放区域变钝而被最小化。尽管图85中的钉仓25200的钝的缩短鼻部25250仍然为楔形滑动件提供了停放区域，但是另外的存放空间可能被必须提供，如下文将讨论。钝的远侧端头25242以与钉仓25200的基部25252成角度γ的形式形成。
在比较图85和图86中所描绘的钉仓25200和25100时，读者应当认识到，第二长度25254比第一长度25154短。因此，除其它事项外，钉仓25200超出钉线25056的端部的长度被最小化，以允许改善手术部位内的空间进入。缩短鼻部25250还防止钝的远侧端头25242刺穿套管针系统上的密封件，如下文进一步所述。此外，人们将认识到，钉仓25200的钝的远侧端头25242相对于基部25252的角度γ大于钉仓25100的尖的远侧端头25142相对于基部25152的角度σ。例如，钝的远侧端头25242可相对于钉仓25200的基部25252成大约45度至50度的角度延伸，而尖的远侧端头25142可相对于钉仓25100的基部25152成大约30度的角度延伸。钝的远侧端头25242的更陡峭角度在钉仓25200的结构的整个远侧区域中提供增强的稳定性。
图89是钉仓25200的的平面图。钉仓25200的仓体25210包括细长狭槽25230，该细长狭槽从钉仓25200的近侧端部25204朝远侧缩短鼻部25250延伸。在仓体25210内形成多个钉腔体25220。钉腔体25220在钉仓25200的近侧端部25204和远侧端部25202之间延伸。钉腔体25220被布置成六个侧向间隔开的纵向排25221、25222、25223、25224、25225、25226，在细长狭槽25230的每一侧上具有三排。可移除地定位在钉腔体25220内的是钉25260。
图87示出了钉仓25200内用于支撑和驱动三个钉25260的三钉驱动器25240的一个实施方案。钉驱动器25240包括第一驱动器部分25342、第二驱动器部分25344和第三驱动器部分25346。中心基部构件25348将第一驱动器部分25342和第三驱动器部分25346连接到第二驱动器部分25344。第一驱动器部分25342至少部分地定位在第二驱动器部分25344的远侧。此外，第三驱动器部分25346至少部分地定位在第二驱动器部分25344的远侧。多个第一钉驱动器25240从细长狭槽25230的一侧上的三个纵向排25221、25222、25223可滑动地安装在对应的钉腔体25220内。换句话说，每个钉驱动器25240被构造成能够支撑三个钉25260：被存储在第一纵向排25221中的钉腔体25220内的钉25260；被存储在第二纵向排25222中的钉腔体25220内的钉25260；以及被存储在第三纵向排25223中的钉腔体25220内的钉25260。由于第一驱动器部分25342和第三驱动器部分25346相对于第二驱动器部分25344的远侧位置，钉25260以反向箭头构型被击发。如图89所示，第一纵向排25221和第三纵向排25223中的最后钉25260比第二纵向排25222中的最后钉25260更靠近钉仓25200的缩短鼻部25250。
在细长狭槽25230的另一侧，多个第二钉驱动器安装在三个纵向排25224、25225、25226中的对应钉腔体25220内。与钉驱动器25240类似，第二钉驱动器各自包括第一驱动器部分25342、第二驱动器部分25344和第三驱动器部分25346。中心基部构件25348将第一驱动器部分25342和第三驱动器部分25346连接到第二驱动器部分25344。第一驱动器部分25342至少部分地定位在第二驱动器部分25344的远侧。此外，第三驱动器部分25346至少部分地定位在第二驱动器部分25344的远侧。如上文的钉驱动器25240，每个第二钉驱动器被构造成能够支撑三个钉25260：被存储在第四纵向排25224中的钉腔体25220内的钉25260、被存储在第五纵向排25225中的钉腔体25220内的钉25260、以及被存储在第六纵向排25226中的钉腔体25220内的钉25260。由于第一驱动器部分25342和第三驱动器部分25346相对于第二驱动器部分25344的远侧位置，钉25260以反向箭头构型被击发。如图89所示，第四纵向排25224和第六纵向排25226中的最后钉25260比第五纵向排25225中的最后钉25260更靠近钉仓25200的缩短鼻部25250。
钉驱动器25240的第一驱动器部分25342具有第一前向支撑柱25352和从第一驱动器部分基部向上突出的第一后向支撑柱25354。第一前向支撑柱25352和第一后向支撑柱25354彼此间隔开并共同形成用于将钉25260支撑在竖直位置(即，钉面向砧座的叉尖)的第一钉支架。类似地，第二驱动器部分25344具有从第二驱动器部分基部向上突出的第二前向支撑柱25362和第二后向支撑柱25364。第二前向支撑柱25362和第二后向支撑柱25364彼此间隔开并共同形成用于将钉25260支撑在竖直位置(即，钉面向砧座的叉尖)的第二钉支架。第三驱动器部分25346具有：从第三驱动器部分基部向上突出的第三前向支撑柱25372和第三后向支撑柱25374。第三前向支撑柱25372和第三后向支撑柱25374彼此间隔开并共同形成用于将钉25260支撑在竖直位置(即，钉面向砧座的叉尖)的第三钉支架。
第一驱动器部分25342和第二驱动器部分25346的质量中心由虚线D-D表示。类似地，虚线P-P表示第二驱动器部分25344的质量中心。三钉驱动器25240的质量中心的组合在图87和图88中如虚线C-C表示。因此，钉驱动器25240不太可能向前滚动。值得注意的是，C-C比P-P更靠近D-D，这使得钉驱动器25240非常稳定。
如上文所讨论，图88中所描绘的钉驱动器25240的中心基部构件25348将第一驱动器部分25342和第三驱动器部分25346附接到第二驱动器部分25344。中心基部构件25348在第一驱动器部分25342和第三驱动器部分25346上分别在第一后向支撑柱25354和第三后向支撑柱25374的近侧端部之间侧向延伸，并且第二后向支撑柱25362的近侧端部在第二驱动器部分25344上。如在图90中可见，中心基部构件25348具有适于被楔形滑动件25270接合的带角度的向后边缘25349，如将在下文进一步详细地讨论。由于中心基部构件25348在所有三个驱动器部分25342、25344、25346之间的延伸，向后边缘25349的中点可分叉成更靠近第一部分25342的部分和更靠近第三部分25346的部分。这种布置可平衡在击发和形成储存在钉腔体25220内的钉25260期间产生的力矩。
主要参考图89，限定在钉仓25200的仓体25210中的每个钉腔体25220包括近侧壁25264和远侧壁25262。上文讨论的三钉驱动器25240的第一驱动器部分25342、第二驱动器部分25344、第三驱动器部分25346的布置所形成的反向箭头取向降低钉驱动器25240在钉击发行程期间的向前和/或侧向滚动。在各种情况下，第一前向支撑柱25352的远侧端部和第三前向支撑柱25372的远侧端部被推入它们相应的钉腔体25220的远侧壁25262中，这使驱动器25240稳定。因此，当滑动件25270(图89)在钉击发行程期间向上提升钉驱动器25240时，钉腔体25220的两个远侧壁25262抵靠前向支撑柱25352、25372提供相反的力，从而防止钉驱动器25240的任何不希望的移动或滚动。
如图87至图90所示，钉仓25200的细长狭槽25230被构造成能够接收击发组件25280的一部分。击发组件25280被构造成能够朝远侧推动滑动件25270以射出存储在钉腔体25220内的钉25260，并且抵靠定位在钉仓25200相对的砧座使钉25260变形。更具体地，联接构件25282朝远侧推动钉仓25200的楔形滑动件25270。楔形滑动件25270具有：四个导轨、两个内导轨25272和两个外部导轨25274，它们通过中心构件25276彼此连接。一个内轨25272和一个外部导轨25274定位在细长狭槽25230的一侧上，而另一个内轨25272和另一个外部导轨26274定位在细长狭槽25230的相反侧上。当将内导轨25272朝远侧驱动时，内导轨25272穿过限定在仓体25210内的内通道25212并接合支撑钉25260的驱动器25240的向后边缘25349，以使钉朝砧座击发。同样，外部导轨25274穿过限定在仓体25210内的外通道25214并接合支撑钉25260的驱动器25240的部分，以将钉朝砧座推动。楔形滑动件25270的远侧移动导致导轨25272、25274与钉驱动器25240的向后边缘25349接触，从而将驱动器25240向上推动以将钉25260从钉仓25200射出到被捕获在钉仓25200和相对的砧座之间的组织中。联接构件25282还包括切割边缘25284，该切割边缘在联接构件25282朝远侧推进以从仓体25210射出钉25260时切入组织。
再次参考图87，钉驱动器25240的第一驱动器部分25342、第二驱动器部分25344、第三驱动器部分25346在楔形滑动件25270的内导轨25272和外部导轨25274之间的定位提供了增加的侧向稳定性。两个导轨(一个内导轨25272和一个外部导轨25274)跨接钉驱动器25240，从而在整个击发行程期间提供增强的支撑和稳定性。除了为钉驱动器25240提供增强的稳定性之外，具有跨越楔形滑动件25270的两个导轨25272、25274的钉驱动器25240的另一个有益效果是执行击发行程所需的减小的力。所需的力减小，因为系统内的偏转和损耗较小。此外，由向后边缘25349提供的另外的驱动表面允许楔形滑动件25270的导轨25272、25274以与楔形滑动件25270的基部25278成较陡峭的角度延伸。楔形滑动件25270的较陡峭角度允许楔形滑动件25270的基部25278的长度总体减小，从而进一步有助于缩短钉仓25200的缩短鼻部25250的长度。再次参考图89，在钉击发行程完成时，击发组件25280的楔形滑动件25270停放在钉仓25200的缩短鼻部25250内。
图89示出了击发组件25280的楔形滑动件25270，该楔形滑动件在钉击发行程完成时停放在缩短鼻部25250中。缩短鼻部25250包括在缩短鼻部25250的远侧端部处的多个开口25292、25294以接纳四个导轨25272、25274。缩短鼻部25250还包括开口25296，该开口被构造成能够接纳楔形滑动件25270的中心滑动件构件25276。因此，楔形滑动件25270的导轨25272、25274和中心滑动件构件25276的部分暴露在钉仓25200的远侧端部25202处。开口25292、25294为通道25212、25214的连续体，在这些通道内，楔形滑动件25270的导轨25272、25274可滑动地行进。两个内部开口25292被构造成能够接纳楔形滑动件25270的两个内导轨25272，而两个外部开口25294被构造成能够接纳楔形滑动件25270的两个外部导轨25274。缩短鼻部25250的远侧部分25202的中心中的中心开口25296被构造成能够接纳楔形滑动件25270的中心构件25276。缩短鼻部25250的远侧端部25202处的开口25292、25294、25296允许完成钉击发行程并将楔形滑动件25270停放在缩短的远侧端部中。
再次参考图89，钉仓25200还包括围绕钉腔体25220的近侧端部和远侧端部延伸的突出部25262。第一纵向排25221中的突出部25262示出为单数的，而第二纵向排25222和第三纵向排25223中的突出部示出为连接的。突出部25262被构造成能够在钉25260从它们的钉腔25220向上击发时向钉25260提供另外的支撑。另外，形成在最远侧钉腔体25220上的突出部25264被倾斜以控制组织流入端部执行器中。对这些突出部的更详细讨论可见于2014年6月30日提交的名称为FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVINGDIFFERENT CONFIGURATIONS的美国专利申请公布2015/0297228，该专利申请公布的全部公开内容以引用方式并入本文。
图91示出了通过使用图85的缩短钉仓25200而不是图86的细长钉仓25100而获得的一些优点。两个钉仓均适用于各种外科手术，包括例如低前切除手术(LAR)。LAR例如是结肠直肠癌的常见治疗。此类手术需要精确分离并且对患者的骨盆腔体深处内的组织进行密封。如下文将更详细地讨论，除其它事项外，由于图85中的缩短鼻部25250，钉仓25200的缩短长度允许外科器械的端部执行器对骨盆腔体内的组织获得更多的进入。读者应当理解，本文所描述的钉仓可用于各种外科治疗中，并且不受本文所讨论的具体手术的限制。
除上述之外，短钉仓25200是第一外科器械25201上的第一端部执行器25202的一部分，该第一端部执行器还包括砧座25203。第一外科器械25201还包括第一轴25206，该第一轴以能够旋转的方式连接到第一端部执行器25202。第一端部执行器25202能够围绕定位在第一端部执行器25202和第一轴25206中间的关节运动接头25208进行关节运动。第一端部执行器25202能够相对于第一轴25206关节运动到角度α。类似地，细长钉仓25100是第二外科器械25101上的第二端部执行器25102的一部分，该第二端部执行器还包括砧座25103。此外，第二外科器械25101还包括第二轴25106，该第二轴以能够旋转的方式连接到第二端部执行器25102。第二端部执行器25102能够围绕定位在第二端部执行器25102和第二轴25106中间的关节运动接头25108进行关节运动。第二端部执行器25102能够相对于第二轴25106关节运动到角度β。
除上述之外，在使用中，临床医生在端部执行器25202处于其非关节运动状态时将端部执行器25202插入穿过插管或套管针，并插入患者体内。一旦穿过套管针，端部执行器25202便可如图91所示的那样进行关节运动。此时，轴25206可移动到将端部执行器25202定位在骨盆腔中。可使用类似的步骤来定位端部执行器25102。
在LAR手术期间，第一端部执行器25202能够到达距骨盆腔内的骨盆底的距离X1处。在LAR手术期间，第二端部执行器25102能够到达距骨盆腔内的骨盆底的距离X2处。距离X1比距离X2短，从而允许第一外科器械25201比第二外科手术器械25101更深地放入骨盆腔中，由此使外科医生除其它事项之外能够瞄准、触及并去除结肠中的更大量患病组织。此外，第一手术器械25201的关节运动能力允许更深地触及手术部位内的组织，同时对周围组织造成最小的创伤。第一端部执行器25202与第二端部执行器25102相比能够关节运动到更大程度，如β大于α。例如，第一端部执行器25202可关节运动到与第一轴25206成115度的角度，而第二端部执行器25102只可关节运动到与第二轴25106成135度的角度。
如图91所示，端部执行器25102的钉仓25100和砧座25103具有大致相同的长度，但是钉仓25100明显比砧座25103长。相比之下，端部执行器25202的钉仓25200和砧座25203具有基本上相同的长度(如果不是相同的长度)。在任何情况下，端部执行器25202的钉仓25200和砧座25203之间的长度差(如果有的话)比端部执行器25102小得多。
当端部执行器插入穿过套管针时，钉仓的远侧端部和砧座的远侧端部之间的极端差异可能导致对套管针的损坏。参考图92，端部执行器25810包括远侧端部25802、砧座25820和钉仓25830。钉仓25830具有与图85中位于钉仓25200上的缩短鼻部25250类似的钝的缩短鼻部25840。如图92和图93中可见，砧座25820在其上具有保护端头25822。保护端头25822以使得砧座25820的长度比钉仓25830短的方式被设定尺寸并且被定位在砧座25820上。因此，钉仓25830的缩短鼻部25840相对于砧座25820朝远侧延伸。保护端头25822可一体形成(模制、机加工等)在砧座25820的远侧端部25802上，或者保护端头25822可包括被构造成能够接收砧座的互补部分的单独件。保护端头的更广泛讨论可见于名称为“IMPROVEDBUTTRESS MATERIAL FOR USE WITH A SURGICAL STAPLER”的美国专利申请公布2008/0169328，该专利申请的全部公开内容据此以引用方式并入本文。
如图92和图93中可见，砧座25820的保护端头25822具有第一弯曲或成角度的外表面25824和第二弯曲或成角度的外表面25826，它们被构造成能够在砧座25820上形成粗短的远侧端部。第一成角度的外表面25824以第一角度Φ从砧座25820的顶表面25828向下延伸。第二成角度的外表面25826以第二角度θ从第一成角度的外表面25824朝向钉仓25830向下延伸。第二角度θ大于第一角度Φ。设想了其中角度θ为例如大约90度的各种实施方案。设想了仅具有第一成角度的外表面25824或第二成角度的外表面25826中的一者的保护端头25822的其它实施方案。第一成角度的外表面25824用于在端部执行器25810通过套管针插入期间使套管针密封组件的定心环偏转。当第二角度θ变得离90度越来越远时和/或当第一弯曲外表面25824和第二弯曲外表面25826不连续时，砧座25820可能刺穿套管针密封件或可使套管针密封系统的定心环位移，如将在下文更详细地讨论。
保护端头可以任何合适的方式附接到砧座。图94至图99示出了单独形成的保护端头25922、26022的示例性实施方案以及用于将它们附接到砧座的各种方法。如图94至图96所描绘，砧座25920的远侧部分包括附接特征部，该附接特征部包括被构造成能够与形成在保护端头25922中的互补的保持通道25926、25928保持配合的附接构件25927、25929。更具体地讲，中心保持通道25928形成在保护端头25922内，以接收砧座25920的中心附接构件25929。一对侧面保持通道25296形成在保护端头25922内，以接收砧座25920上的一对对应的侧面附接构件25927。图96是处于未组装构型的沿图95中的线96-96截取的图94的砧座25920的剖视图，其示出了保持通道25926、25928与其相应附接构件25927、25929的对准。细长狭槽25994从砧座25920的近侧端部25904朝向砧座25920的远侧端部25902纵向延伸。纵向狭槽25994被构造成能够接收本文所讨论的击发组件的一部分。
除上文之外或在替代方案中，保护端头25922可使用铆钉25924固定到砧座25920。如图96所示，通孔25925延伸穿过保护端头25922的中心保持通道25928。通孔25925还延伸穿过砧座25920的中心附接构件25929，使得当保护端头25922附接到砧座25920时，通孔25925对准以便于将铆钉25924插入其中。图95是处于未组装构型的沿图94中的线95-95截取的图94的砧座25920的剖视图，其示出了用于将保护端头25922可移除地附连到砧座25920的铆钉组件。除上文之外或在替代方案中，保护端头25922可通过粘合剂诸如例如氰基丙烯酸酯、光固化性丙烯酸、聚氨酯、聚硅氧烷、环氧树脂和/或紫外光固化性粘合剂(诸如HENKEL
Figure BDA0002341069110000831
)附连到砧座25920。在任何情况下，可在砧座25920和保护端头25922上提供附接构件和保持通道的组合。可使用又一些其它形式的附接件和附接布置来将保护端头25922附连到砧座25920。
图97至图99示出了端头附接布置的另一个实施方案。砧座26020的远侧部分包括附接构件26027，这些附接构件被构造成能够与限定在保护端头26022中的互补保持通道26026保持配合。此外，限定在保护端头26022内的中心保持通道26028被构造成能够接收砧座26020的中心附接构件26029。图98是处于未组装构型的沿图97中的线98-98截取的图97的砧座26020的剖视图，其示出了保持通道26026、26028与其相应附接构件26027、26029的对准。图99是处于组装好构型的沿图97中的线99-99截取的图97的砧座26020的剖视图。保护端头26022使用压缩配合固定到砧座26020。中心附接构件26029被压配合到中心保持通道26028中，从而由于中心保持通道26028的几何形状而保持就位。图98中的砧座26020的中心附接构件26029具有梯形形状，该梯形形状由中心保持通道26028模拟而成。细长狭槽26094从砧座26020的近侧端部26004朝向砧座26020的远侧端部26002纵向延伸。纵向狭槽26094被构造成能够接收本文所讨论的击发组件的一部分。
除上文之外或在替代方案中，保护端头26022可通过粘合剂诸如例如氰基丙烯酸酯、光固化性丙烯酸、聚氨酯、聚硅氧烷、环氧树脂和/或紫外光固化性粘合剂(诸如例如HENKEL
Figure BDA0002341069110000841
)附连到砧座26020。在各种实施方案中，可在砧座26020和保护端头26022上提供附接构件和保持通道的组合。可使用又一些其它形式的附接件和附接布置结构来将保护端头26022附连到砧座26020。图97至图99还示出了用于帮助使用者将保护端头26022附接到砧座26020的装置。图97示出了可移除地定位在临时保持器26030内的保护端头26022。为了将保护端头26022可释放地附连到砧座26020，使用者将临时保持器26030和砧座26020压在一起。临时保持器26030可在保护端头26022附连到砧座26020时向保护端头26022提供附加的灭菌屏障。此外，由于保护端头26022的尺寸可能较小，因此临时保持器26030向使用者提供在将保护端头26022附接到砧座26020时握持的更厚实的物体。设想了可以在保护端头的各种实施方案，包括本文所公开的其它实施方案上使用的临时保持器26030。
各种保护砧座端头在本文中已被描述和描绘为与线性端部执行器结合使用。然而，本领域的普通技术人员将容易地理解，在不脱离本公开的实质和范围的情况下，本文所述的保护砧座端头可与多种不同的端部执行器构型诸如弯曲端部执行器和其它类型的端部执行器结合使用。因此，上文所述的保护端头不应仅限于与线性端部执行器和/或钉结合使用。
图100至图106示出了当本文所述的各种端部执行器在被引入手术部位之前通过套管针密封系统插入时的示例性实际应用。图100至图106的套管针密封系统27040包括被构造成能够支撑浮动密封组件27050的外部壳体27042和被构造成能够接收外科器械的中心开口27044。该浮动密封组件27050包括第一密封门27052和第二密封门27054，它们一起工作以在外科手术期间禁止气体从患者体内的充气体腔逸出。浮动密封组件27050还包括定心环27058，该定心环被构造成能够引导外科器械穿过套管针密封系统27040的中心开口27044。浮动密封组件27050通过环形弹性构件27056附接到套管针密封系统27040的外部壳体27042。
图100描绘了包括砧座27010和钉仓27020的端部执行器27000。该钉仓27020包括与图85中被描绘为位于钉仓25200上的缩短鼻部25250类似的钝的缩短鼻部27022。砧座27010的远侧端部27202是尖头的并且不具有保护端头诸如图92中所示的保护端头。如在图100中可见，砧座27010的长度比钉仓27020短。换句话讲，钉仓27020的缩短鼻部27022纵向延伸超过砧座27010的远侧端部27002。在通过套管针密封系统27040插入端部执行器27000之前，第一密封门27052和第二密封门27054向内延伸以防止气体从手术部位逸出。图101描绘了部分插入套管针密封系统27040中的图100的端部执行器27000。钉仓27020的缩短鼻部27022是端部执行器27000的第一部件，用于与套管针密封系统27040的第一密封门27052和第二密封门27054接触，以使浮动密封组件27050向一侧倾斜。由于其钝的形状，缩短鼻部27022即使在第二密封门27054上施加力也不会损坏第二密封门27054。
图102描绘了当端部执行器27000已经被进一步引入套管针密封系统27040的中心开口27044中时的图100和图101的端部执行器27000。在缩短钉仓鼻部27022与套管针密封系统27040初始接触之后，砧座27010的尖头远侧端部27002接触套管针密封系统27040的第一密封门27052。在各种实例中，砧座27010的尖头远侧端部27002可使套管针密封系统27040的第一密封门27052破裂，这是因为缩短鼻部27022和第二密封门27054之间的接触已经使浮动密封组件27050的位置侧向移位。如图103所示，如果砧座27010的远侧端部27002包括与图92中所示的保护端头25822类似的保护端头27012，则使第一密封门27052破裂的风险将降低。通过在砧座27010上使用保护端头27012，破裂的风险降低，这是因为第一密封门27052将在保护端头27012周围平滑地伸展。此外，相同长度的仓和砧座减少了或防止了浮动密封组件的预移位。
图104描绘了包括砧座27110和钉仓27120的端部执行器27100。该钉仓27120包括与图86中被描绘为位于钉仓25100上的细长鼻部25150类似的尖头细长鼻部27122。砧座27110的远侧端部27102是尖头的并且不具有保护端头诸如图92中所示的保护端头。砧座27110的长度比钉仓27120短。换句话讲，钉仓27120的细长鼻部27122纵向延伸超过砧座27110的远侧端部27102。在通过套管针密封系统27040插入端部执行器27100之前，套管针密封系统27040的第一密封门27052和第二密封门27054向内延伸以防止气体从手术部位逸出。图105描绘了当端部执行器27100初始插入套管针密封系统27040中时的图104的端部执行器27100。钉仓27120的细长鼻部27122是端部执行器27100的第一部件，用于与套管针密封系统27040的第一密封门27052和第二密封门27054接触，以使浮动密封组件27050向一侧倾斜或预移位，如上文所讨论。
图106描绘了当端部执行器27100已经被进一步引入套管针密封系统27040的中心开口27044中时的图104和图105的端部执行器27100。在钉仓27120的细长鼻部27122的初始接触之后，砧座27110的尖头远侧端部27102接触套管针密封系统27040的第一密封门27052。在各种实例中，砧座27110的尖头远侧端部27102可使套管针密封系统27040的第一密封门27052破裂，这是因为细长鼻部27122和第二密封门27054之间的接触已经使浮动密封组件27050的位置发生位移。
如本文所讨论，第一钉仓可包括第一仓长度，并且第二钉仓可包括第二仓长度，该第二仓长度与该第一仓长度不同。在各种实例中，外科缝合器械的端部执行器可包括被构造成能够接收第一钉仓以及在替代方案中第二钉仓的仓钳口。换句话讲，仓钳口被构造成能够接收第一钉仓和第二钉仓，但不是同时进行。第一钉仓和第二钉仓各自包括近侧端部，该近侧端部在其被定位在仓钳口中时与近侧仓钳口基准对准。例如，在第一仓长度比第二仓长度长的情况下，第一钉仓的远侧端部将被定位成比第二钉仓的远侧端部更远离近侧仓钳口基准。读者应当理解，在其它实例中，第二仓长度可以比第一仓长度长。
除上述之外，端部执行器包括能够相对于仓钳口在打开位置或未夹紧位置和闭合位置或夹紧位置之间移动的砧座钳口。在另选的实施方案中，仓钳口能够相对于砧座钳口移动。在任一种情况下，砧座钳口都包括远侧砧座端部，该远侧砧座端部由第一钉仓和第二钉仓支撑，这取决于哪个钉仓位于仓钳口中。远侧砧座端部被支撑在第一仓钳口上的第一位置处和第二仓钳口上的第二位置处。在各种实例中，第一位置和第二位置距近侧仓钳口基准的距离可以不相同。然而，在一些实例中，第一位置和第二位置距近侧仓钳口基准的距离可以相同。此外，在各种实例中，第一位置位于距第一钉仓的远侧端部第一距离处，而第二位置位于距第二钉仓的远侧端部第二或不同的距离处。在使用中，患者的组织将被定位在砧座钳口和仓钳口之间，但是尽管如此，钉仓的支撑位置将仍然支撑砧座钳口或由砧座钳口施加的夹紧载荷。
在各种实例中，除上述之外，当端部执行器处于夹紧构型并且第一钉仓位于仓钳口中时，远侧砧座端部可朝远侧延伸超过第一钉仓的远侧端部，并且类似地，当端部执行器处于夹紧构型并且第二钉仓位于仓钳口中时，远侧砧座端部可朝远侧延伸超过第二钉仓的远侧端部。然而，在第一仓长度比第二仓长度长的情况下，在各种实例中，远侧砧座端头可朝远侧延伸超过第二钉仓的远侧端部，而不是朝远侧延伸超过第一钉仓的远侧端部。在此类实例中，当第二钉仓位于仓钳口中时，砧座钳口可以比第二钉仓长，但当第一钉仓位于仓钳口中时，砧座钳口可以比第一钉仓短。在一些实例中，砧座钳口与第一钉仓或第二钉仓的长度相同。
除上述之外，砧座钳口将在其移动到其夹紧位置时偏转。由于钉仓的不同仓长度，砧座钳口的偏转可以不同，这取决于哪个钉仓位于仓钳口中。因此，砧座钳口和第一仓钳口的钉驱动器之间的钉成形间隙可与砧座钳口和第二仓钳口的钉驱动器之间的钉成形间隙不同。在一些实例中，钉成形间隙中的差异可忽略不计，并且从第一钉仓和第二钉仓射出的钉将被成形为相同或至少合适的高度并且足够缝合捕获在砧座钳口和仓钳口之间的组织。在此类实例中，第一钉仓中钉的未成形高度可以与第二钉仓中钉的未成形高度相同。在其它实例中，第一钉仓中钉的未成形高度与第二钉仓中钉的未成形高度不同。在此类实例中，例如，较高的钉可以在第一钉仓中使用并且较短的钉可以在第二钉仓中使用，这取决于砧座钳口在抵靠第一钉仓和第二钉仓夹紧时的预期偏转和/或取向。在至少一个这种实例中，第一钉仓中的钉中的每一者具有在第一未成形高度范围中的未成形高度，并且第二钉仓中的钉中的每一者具有在第二未成形高度范围中的未成形高度。在一些实例中，第一未成形高度范围与第二未成形高度范围完全不同，而在其它实例中，第一未成形高度范围与第二未成形高度范围部分地重叠。
如上文所讨论，第一钉仓和第二钉仓选择性地定位在端部执行器的仓钳口中，并且除上述之外，仓钳口还包括底部支撑件或支撑表面，该底部支撑件或支撑表面被构造成能够在钉仓安置在仓钳口中时支撑钉仓。这种支撑件可包括竖直基准。在各种实例中，如上文所讨论的第一钉仓上的第一支撑位置和第二钉仓上的第二支撑位置距仓钳口的竖直基准的竖直距离相同。竖直距离是与竖直基准正交地测量的，但也可以任何合适的方式测量。在其它实例中，第一钉仓上的第一支撑位置具有与第二钉仓上的第二支撑位置不同的竖直高度。在此类实例中，砧座钳口在砧座钳口处于其夹紧位置时的取向和/或偏转可由于第一支撑位置和第二支撑位置具有不同的竖直高度而不同。除其它原因之外，在第一钉仓的远侧端部或鼻部与第二钉仓的远侧端部不同的情况下可能发生此类不同的竖直高度。
本文所述的许多外科器械系统由电动马达促动；但是本文所述的外科器械系统可以任何合适的方式促动。在各种实例中，例如，本文所述的外科器械系统可由手动操作的触发器促动。在某些实例中，本文公开的马达可包括机器人控制系统的一部分或多个部分。此外，本文公开的任何端部执行器和/或工具组件可与机器人外科器械系统一起使用。名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利申请公布2012/0298719)更详细地公开了机器人外科器械系统的若干示例。
已结合钉的部署和变形描述了本文所述的外科器械系统；然而，本文所述的实施方案不限于此。例如，设想了部署除钉之外的紧固件诸如夹具或大头钉的各种实施方案。此外，还设想了利用用于密封组织的任何合适装置的各种实施方案。例如，根据各种实施方案的端部执行器可包括被构造成能够加热和密封组织的电极。另外，例如，根据某些实施方案的端部执行器可施加振动能量来密封组织。
实施例
实施例1-一种外科器械，该外科器械包括端部执行器。该端部执行器包括仓钳口和砧座钳口，其中该仓钳口和该砧座钳口中的一者能够相对于另一者围绕闭合轴线旋转。该外科器械还包括轴，该轴包括限定纵向轴轴线的框架以及闭合致动器，其中该闭合致动器能够相对于该框架平移。该闭合致动器包括近侧部分、远侧部分和连接件。该连接件以能够围绕近侧连接件轴线旋转的方式连接到该近侧部分并以能够围绕远侧连接件轴线旋转的方式连接到该远侧部分。该近侧连接件轴线和该远侧连接件轴线在其间限定纵向连接件轴线。该外科器械还包括关节运动接头，其中该端部执行器以能够围绕由该关节运动接头限定的关节运动轴线旋转的方式连接到该轴。该端部执行器能够在关节运动平面内在非关节运动位置和关节运动位置之间进行关节运动，其中该关节运动轴线与该纵向轴轴线偏置。当该端部执行器处于该非关节运动位置或该关节运动位置时，该纵向连接件轴线与该纵向轴轴线不共线。
实施例2-根据实施例1所述的外科器械，其中，该近侧连接件轴线沿该纵向轴轴线定位。
实施例3-根据实施例1或2所述的外科器械，其中，该仓钳口包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例4-根据实施例3所述的外科器械，其中，该钉仓是可替换的。
实施例5-根据实施例3或4所述的外科器械，还包括击发致动器，该击发致动器与该闭合致动器分开且不同，其中该击发致动器能够致动以将这些钉从该钉仓射出。
实施例6-根据实施例3、4或5所述的外科器械，其中，当该端部执行器处于该非关节运动位置或该关节运动位置时，该纵向连接件轴线与该纵向轴轴线不平行。
实施例7-根据实施例3、4或5所述的外科器械，其中，该端部执行器还包括纵向端部执行器轴线。当该端部执行器处于该非关节运动位置时，该纵向端部执行器轴线与该纵向轴轴线共线。该端部执行器还包括远侧端部，该远侧端部沿该纵向端部执行器轴线定位，其中当该端部执行器处于该非关节运动位置和该关节运动位置中的任一者时，该远侧连接件轴线相对于在该远侧端部和该近侧连接件轴线之间延伸的轴线偏置。
实施例8-一种外科器械，该外科器械包括端部执行器。该端部执行器包括纵向端部执行器轴线、沿该端部执行器轴线定位的远侧端部、仓钳口和砧座钳口，其中该仓钳口和该砧座钳口中的一者能够相对于另一者围绕闭合轴线旋转。该外科器械还包括轴，该轴包括限定纵向轴轴线的框架和能够相对于该框架平移的闭合致动器。该闭合致动器包括近侧部分、远侧部分和连接件。该连接件以能够围绕近侧连接件轴线旋转的方式连接到该近侧部分并以能够围绕远侧连接件轴线旋转的方式连接到该远侧部分。该外科器械还包括关节运动接头，其中该端部执行器以能够围绕由该关节运动接头限定的关节运动轴线旋转的方式连接到该轴。该端部执行器能够在关节运动平面内在非关节运动位置和关节运动位置之间进行关节运动，其中该关节运动轴线与该纵向轴轴线偏置。当该端部执行器处于该非关节运动位置时，该纵向端部执行器轴线与该纵向轴轴线对准。当该端部执行器处于该非关节运动位置和该关节运动位置中的任一者时，该远侧连接件轴线相对于在该端部执行器的该远侧端部和该近侧连接件轴线之间延伸的轴线偏置。
实施例9-根据实施例8所述的外科器械，其中，该近侧连接件轴线和该远侧连接件轴线限定纵向连接件轴线。当该端部执行器处于该非关节运动位置和该关节运动位置中的任一者时，该纵向连接件轴线与该纵向轴轴线不共线。
实施例10-根据实施例9所述的外科器械，其中，当该端部执行器处于该非关节运动位置和该关节运动位置中的任一者时，该纵向连接件轴线与该纵向轴轴线不平行。
实施例11-根据实施例8、9或10所述的外科器械，其中，该近侧连接件轴线沿该纵向轴轴线定位。
实施例12-根据实施例8、9、10或11所述的外科器械，其中，该仓钳口包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例13-根据实施例12所述的外科器械，其中，该钉仓是可替换的。
实施例14-根据实施例12或13所述的外科器械，还包括击发致动器，该击发致动器与该闭合致动器分开且不同，其中该击发致动器能够致动以将这些钉从该钉仓射出。
实施例15-一种外科器械，该外科器械包括端部执行器。该端部执行器包括纵向端部执行器轴线、沿该端部执行器轴线定位的远侧端部、第一钳口和第二钳口，其中该第一钳口和该第二钳口中的一者能够相对于另一者在打开位置和闭合位置之间旋转。该外科器械还包括轴，该轴包括限定纵向轴轴线的框架和能够相对于该框架平移的闭合致动器。该闭合致动器包括近侧部分、远侧部分和连接件。该连接件以能够围绕近侧连接件轴线旋转的方式连接到该近侧部分并以能够围绕远侧连接件轴线旋转的方式连接到该远侧部分。该外科器械还包括关节运动接头，其中该端部执行器以能够围绕由该关节运动接头限定的关节运动轴线旋转的方式连接到该轴。该端部执行器能够在非关节运动位置和关节运动位置之间进行关节运动，其中该关节运动轴线相对于该纵向轴轴线侧向定位。当该端部执行器处于该非关节运动位置时，该纵向端部执行器轴线与该纵向轴轴线对准。当该第一钳口处于该打开位置、该闭合位置以及该打开位置和该闭合位置之间的任何位置时，该远侧连接件轴线相对于在该端部执行器的该远侧端部和该近侧连接件轴线之间延伸的轴线侧向定位。
实施例16-根据实施例15所述的外科器械，其中，该近侧连接件轴线和该远侧连接件轴线限定纵向连接件轴线。当该第一钳口处于该闭合位置时，不管该端部执行器处于该非关节运动位置还是该关节运动位置，该纵向连接件轴线都与该纵向轴轴线不对准。
实施例17-根据实施例15或16所述的外科器械，其中，当该第一钳口处于该闭合位置时，不管该端部执行器处于该非关节运动位置还是该关节运动位置，该纵向连接件轴线都与该纵向轴轴线不平行。
实施例18-根据实施例15、16或17所述的外科器械，其中，该近侧连接件轴线沿该纵向轴轴线定位。
实施例19-根据实施例15、16、17或18所述的外科器械，其中，该第一钳口包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例20-根据实施例19所述的外科器械，其中，该钉仓是可替换的。
实施例21-根据实施例19或20所述的外科器械，还包括击发致动器，该击发致动器与该闭合致动器分开且不同，其中，该击发致动器能够致动以将这些钉从该钉仓射出。
实施例22-一种外科器械，该外科器械包括轴，该轴包括近侧端部、远侧端部以及在该近侧端部和该远侧端部之间延伸的纵向轴线。该外科器械还包括端部执行器，该端部执行器包括端部执行器框架，该端部执行器框架围绕关节运动枢轴可旋转地联接到该轴，其中该关节运动枢轴限定固定关节运动轴线，并且其中该固定关节运动轴线被定位成相对于该纵向轴线侧向偏置。该外科器械还包括关节运动驱动器，该关节运动驱动器在附接位置处联接到该端部执行器框架，其中该关节运动驱动器能够移动到近侧位置以使该端部执行器旋转到第一完全关节运动位置，并且能够移动到远侧位置以使该端部执行器旋转到第二完全关节运动位置。该近侧位置和该远侧位置限定该关节运动驱动器的关节运动行程，其中该关节运动行程具有关节运动行程长度。侧向力矩臂被限定在该附接位置和该固定关节运动轴线之间，其中该侧向力矩臂与该纵向轴线正交。该外科器械被构造成能够使得该侧向力矩臂与该关节运动行程长度的比率最大。
实施例23-根据实施例22所述的外科器械，其中，该端部执行器能够定位在与该纵向轴线对准的非关节运动位置。当该端部执行器从该非关节运动位置移动到该第一完全关节运动位置时，该端部执行器扫过第一弧长。当该端部执行器从该非关节运动位置移动到该第二完全关节运动位置时，该端部执行器扫过第二弧长。
实施例24-根据实施例23所述的外科器械，其中，该第一弧长与该第二弧长相等。
实施例25-根据实施例23所述的外科器械，其中，该第一弧长和该第二弧长是不同的。
实施例26-根据实施例22、23、24或25所述的外科器械，其中，该比率在1.1和1.4之间。
实施例27-根据实施例22、23、24、25或26所述的外科器械，其中，当该端部执行器在该第一完全关节运动位置和该第二完全关节运动位置之间移动时，该附接位置扫过关节运动弧长。
实施例28-根据实施例27所述的外科器械，其中，该外科器械被构造成能够使得包括该关节运动弧长与该关节运动行程长度之比的关节运动比率最大。
实施例29-根据实施例28所述的外科器械，其中，该关节运动比率在1.2和1.7之间。
实施例30-根据实施例27、28或29所述的外科器械，其中，该外科器械被构造成能够使得包括该关节运动弧长和该侧向力矩臂的乘积与该关节运动行程长度之比的比率最大。
实施例31-根据实施例30所述的外科器械，其中，该比率在1和3之间。
实施例32-根据实施例22、23、24、25、26、27、28、29、30或31所述的外科器械，其中该端部执行器还包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例33-根据实施例32所述的外科器械，其中，该钉仓是可替换的。
实施例34-一种外科器械，该外科器械包括轴，该轴包括近侧端部、远侧端部以及在该近侧端部和该远侧端部之间延伸的纵向轴线。该外科器械还包括端部执行器，该端部执行器包括端部执行器框架，该端部执行器框架围绕关节运动枢轴可旋转地联接到该轴，其中该关节运动枢轴限定固定关节运动轴线，并且其中该固定关节运动轴线被定位成相对于该纵向轴线侧向偏置。该外科器械还包括关节运动驱动器，该关节运动驱动器在附接位置处联接到该端部执行器框架。该关节运动驱动器能够移动到近侧位置以使该端部执行器旋转到第一完全关节运动位置，并且能够移动到远侧位置以使该端部执行器旋转到第二完全关节运动位置。该近侧位置和该远侧位置限定该关节运动驱动器的关节运动行程。该关节运动行程具有关节运动行程长度，其中侧向力矩臂被限定在该附接位置和该固定关节运动轴线之间。该侧向力矩臂与该纵向轴线正交。该外科器械被构造成能够使得该侧向力矩臂与该关节运动行程长度的比率大于1。
实施例35-根据实施例34所述的外科器械，其中，该比率在1.1和1.4之间。
实施例36-根据实施例34或35所述的外科器械，其中，当该端部执行器在该第一完全关节运动位置和该第二完全关节运动位置之间移动时，该附接位置扫过关节运动弧长。
实施例37-根据实施例36所述的外科器械，其中，该外科器械被构造成能够使得包括该关节运动弧长与该关节运动行程长度之比的关节运动比率最大。
实施例38-根据实施例37所述的外科器械，其中，该关节运动比率在1.2和1.7之间。
实施例39-根据实施例36所述的外科器械，其中，该外科器械被构造成能够使得包括该关节运动弧长和该侧向力矩臂的乘积与该关节运动行程长度之比的比率最大。
实施例40-根据实施例39所述的外科器械，其中，该关节运动比率在1和3之间。
实施例41-根据实施例34、35、36、37、38、39或40所述的外科器械，其中，该端部执行器还包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例42-根据实施例41所述的外科器械，其中，该钉仓是可替换的。
实施例43-一种外科器械，该外科器械包括轴，该轴包括近侧端部、远侧端部以及在该近侧端部和该远侧端部之间延伸的纵向轴线。该外科器械还包括端部执行器，该端部执行器包括端部执行器框架，该端部执行器框架围绕关节运动枢轴可旋转地联接到该轴，其中该关节运动枢轴限定固定关节运动轴线，并且其中该固定关节运动轴线被定位成相对于该纵向轴线侧向偏置。该外科器械还包括关节运动驱动器，该关节运动驱动器在附接位置处联接到该端部执行器框架，其中该关节运动驱动器能够移动到近侧位置以使该端部执行器旋转到第一完全关节运动位置，并且能够移动到远侧位置以使该端部执行器旋转到第二完全关节运动位置。该近侧位置和该远侧位置限定该关节运动驱动器的关节运动行程，其中该关节运动行程具有关节运动行程长度。当该端部执行器在该第一完全关节运动位置和该第二完全关节运动位置之间移动时，该附接位置扫过关节运动弧长。侧向力矩臂被限定在该附接位置和该固定关节运动轴线之间，其中该侧向力矩臂与该纵向轴线正交。该外科器械被构造成能够使得该侧向力矩臂和该关节运动弧长的乘积与该关节运动行程长度的比率大于1。
实施例44-一种外科器械，该外科器械包括轴，该轴包括近侧端部、远侧端部以及在该近侧端部和该远侧端部之间延伸的纵向轴线。该外科器械还包括端部执行器，该端部执行器包括端部执行器框架，该端部执行器框架围绕关节运动枢轴可旋转地联接到该轴，其中该关节运动枢轴限定固定关节运动轴线，并且其中该固定关节运动轴线被定位成相对于该纵向轴线侧向偏置。该外科器械还包括关节运动驱动器，该关节运动驱动器在附接位置处联接到该端部执行器框架，其中该关节运动驱动器能够移动到近侧位置以使该端部执行器旋转到第一完全关节运动位置，并且能够移动到远侧位置以使该端部执行器旋转到第二完全关节运动位置。该近侧位置和该远侧位置限定该关节运动驱动器的关节运动行程，其中该关节运动行程具有关节运动行程长度。侧向力矩臂被限定在该附接位置和该固定关节运动轴线之间。该外科器械还包括用于在限制该关节运动行程的同时增加该侧向力矩臂的装置。
实施例45-一种外科器械，该外科器械包括轴，该轴包括近侧端部、远侧端部以及在该近侧端部和该远侧端部之间延伸的纵向轴线；以及外部壳体，该外部壳体包括相对于该纵向轴线限定的轴半径。该外科器械还包括端部执行器，该端部执行器包括端部执行器框架，该端部执行器框架围绕关节运动枢轴可旋转地联接到该轴，其中该关节运动枢轴限定固定关节运动轴线，并且其中该固定关节运动轴线被定位成相对于该纵向轴线侧向偏置。该外科器械还包括关节运动驱动器，该关节运动驱动器在附接位置处联接到该端部执行器框架，其中该关节运动驱动器能够朝近侧移动以使该端部执行器在第一方向上旋转，其中该关节运动驱动器能够朝远侧移动以使该端部执行器在第二方向上旋转，该第二方向与该第一方向相反。侧向力矩臂被限定在该附接位置和该固定关节运动轴线之间。该侧向力矩臂与该纵向轴线正交，其中该轴半径与该侧向力矩臂的比率小于1.4。
实施例46-根据实施例45所述的外科器械，其中，该比率小于1.3。
实施例47-根据实施例45所述的外科器械，其中，该比率小于1.2。
实施例48-根据实施例45所述的外科器械，其中，该比率小于1.1。
实施例49-根据实施例45、46、47或48所述的外科器械，其中，该端部执行器能够沿该第一方向旋转第一距离并且沿该第二方向旋转第二距离，并且其中该第一距离和该第二距离相等。
实施例50-根据实施例45、46、47或48所述的外科器械，其中，该端部执行器能够沿该第一方向旋转第一范围并且沿该第二方向旋转第二范围，并且其中该第一范围和该第二范围不相等。
实施例51-根据实施例45、46、47、48、49或50所述的外科器械，还包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例52-根据实施例51所述的外科器械，其中，该钉仓是可替换的。
实施例53-根据实施例45、46、47、48、49、50、51或52所述的外科器械，其中该外部壳体限定内部孔口，并且其中该轴半径由该内部孔口限定。
实施例54-根据实施例53所述的外科器械，其中，该轴包括延伸穿过该内部孔口的轴框架，并且其中该端部执行器框架可旋转地联接到该轴框架。
实施例55-根据实施例45、46、47、48、49、50、51、52、53或54所述的外科器械，其中，该轴包括第一纵向部分和第二纵向部分，其中该外部壳体的该轴半径包括该第一纵向部分中的第一轴半径和该第二纵向部分中的第二轴半径，并且其中该第一轴半径与该第二轴半径不同。
实施例56-一种轴组件，包括轴，该轴包括近侧端部、远侧端部以及在该近侧端部和该远侧端部之间延伸的纵向轴线；以及外部壳体，该外部壳体包括相对于该纵向轴线限定的轴半径。该轴组件还包括端部执行器，该端部执行器包括端部执行器框架，该端部执行器框架围绕关节运动枢轴可旋转地联接到该轴，其中该关节运动枢轴限定固定关节运动轴线，并且其中该固定关节运动轴线被定位成相对于该纵向轴线侧向偏置。该轴组件还包括关节运动驱动器，该关节运动驱动器在附接位置处联接到该端部执行器框架。该关节运动驱动器能够朝近侧移动以使该端部执行器在第一方向上旋转，其中该关节运动驱动器能够朝远侧移动以使该端部执行器在第二方向上旋转，该第二方向与该第一方向相反。侧向力矩臂被限定在该附接位置和该固定关节运动轴线之间。该侧向力矩臂与该纵向轴线正交，其中该轴组件被构造成能够使得该轴半径与该侧向力矩臂的比率最小。
实施例57-根据实施例56所述的轴组件，其中，该比率小于1.4。
实施例58-根据实施例56所述的轴组件，其中，该比率小于1.1。
实施例59-根据实施例56、57或58所述的轴组件，还包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例60-根据实施例59所述的轴组件，其中，该钉仓是可替换的。
实施例61-根据实施例56、57、58、59或60所述的轴组件，其中，该外部壳体限定内部孔口，并且其中该轴半径由该内部孔口限定。
实施例62-根据实施例56、57、58、59、60或61所述的轴组件，其中，该轴包括第一纵向部分和第二纵向部分。该外部壳体的该轴半径包括该第一纵向部分中的第一轴半径和该第二纵向部分中的第二轴半径。该第一轴半径与该第二轴半径不同。
实施例63-一种外科器械，该外科器械包括轴，该轴包括外部壳体，该外部壳体包括轴半径。该外科器械还包括端部执行器，该端部执行器包括端部执行器框架，该端部执行器框架围绕关节运动枢轴可旋转地联接到该轴，其中该关节运动枢轴限定关节运动轴线，并且其中该关节运动轴线被定位成相对于该轴的中心线侧向偏置。该外科器械还包括关节运动驱动器，该关节运动驱动器在附接位置处联接到该端部执行器框架。该关节运动驱动器能够朝近侧移动以使该端部执行器在第一方向上旋转到第一完全关节运动位置，其中该关节运动驱动器能够朝远侧移动以使该端部执行器在第二方向上旋转到第二完全关节运动位置。侧向力矩臂被限定在该附接位置和该关节运动轴线之间。该侧向力矩臂与该轴的该中心线正交，并且其中该轴半径与该侧向力矩臂的比率在1和1.4之间。
实施例64-一种外科器械，该外科器械包括轴和端部执行器。该端部执行器包括近侧端部、远侧端部、第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动，其中该第一钳口和该第二钳口中的一者包括钉仓，该钉仓包括可移除地储存在其中的钉。该外科器械还包括关节运动接头，其中该端部执行器以能够围绕该关节运动接头旋转的方式连接到该轴。该外科器械还包括关节运动杆，该关节运动杆可操作地连接到该端部执行器。该关节运动杆能够朝远侧移动以使该端部执行器在第一方向上旋转，其中该关节运动杆能够朝近侧移动以使该端部执行器在第二方向上旋转。该外科器械还包括闭合管，该闭合管被构造成能够在闭合行程期间接合该第一钳口并使该第一钳口朝向该闭合位置移动，其中该闭合管在该闭合行程期间能够在该关节运动接头上方滑动。该外科器械还包括钉击发组件。该钉击发组件包括在钉击发期间能够移动通过该端部执行器的切割构件、附接到该切割构件的击发杆，其中该击发杆包括多个柔性层，并且其中该击发杆延伸穿过该关节运动接头。该钉击发组件还包括定位在这些柔性层内的支撑件，其中该支撑件被定位在该关节运动接头近侧。该钉击发组件还包括多个控制元件，其中每个该控制元件包括限定在其中的孔口。该击发杆延伸穿过这些孔口。该控制元件被构造成能够将这些柔性层保持在一起。
实施例65-根据实施例64所述的外科器械，其中，该控制元件被定位在该关节运动接头内。
实施例66-根据实施例64或65所述的外科器械，其中，该第一钳口包括该钉仓。
实施例67-根据实施例64或65所述的外科器械，其中，该第二钳口包括该钉仓。
实施例68-根据实施例64、65、66或67所述的外科器械，其中，该切割构件焊接到该击发杆。
实施例69-根据实施例64、65、66、67或68所述的外科器械，其中，这些控制元件彼此连接。
实施例70-根据实施例64、65、66、67或68所述的外科器械，其中，这些控制元件不彼此连接。
实施例71-根据实施例64、65、66、67、68、69或70所述的外科器械，其中，这些控制元件不彼此连接。
实施例72-根据实施例64、65、66、67、68、69、70或71所述的外科器械，其中，该关节运动接头限定该端部执行器旋转所围绕的固定旋转轴线。
实施例73-一种外科器械，该外科器械包括限定纵向轴线的轴以及端部执行器。该端部执行器包括近侧端部、远侧端部、第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在未夹紧位置和夹紧位置之间移动。该外科器械还包括关节运动接头，其中该端部执行器以能够围绕该关节运动接头旋转的方式连接到该轴。该外科器械还包括关节运动连杆，该关节运动连杆可操作地连接到该端部执行器，其中该关节运动连杆能够朝远侧移动以使该端部执行器在第一方向上旋转，并且其中该关节运动连杆能够朝近侧移动以使该端部执行器在第二方向上旋转。该外科器械还包括夹紧构件，该夹紧构件被构造成能够在夹紧行程期间接合该第一钳口并使该第一钳口朝向该夹紧位置移动，其中该夹紧构件在该夹紧行程期间能够相对于该关节运动接头滑动。该外科器械还包括钉击发组件。该钉击发组件包括在钉击发行程期间能够移动穿过该端部执行器的切割构件以及击发构件。该击发构件包括附接到该切割构件的多个柔性层，其中这些柔性被构造成能够相对于彼此纵向滑动。该击发构件延伸穿过该关节运动接头。该外科器械还包括多个控制元件，其中每个该控制元件包括限定在其中的孔口。该击发杆延伸穿过这些孔口，其中这些控制元件被构造成能够将这些柔性层保持在一起。
实施例74-根据实施例73所述的外科器械，其中，这些控制元件被定位在该关节运动接头内。
实施例75-根据实施例73或74所述的外科器械，其中，该第一钳口包括钉仓。
实施例76-根据实施例73或74所述的外科器械，其中，该第二钳口包括钉仓。
实施例77-根据实施例73、74、75或76所述的外科器械，其中，该切割构件焊接到该击发杆。
实施例78-根据实施例73、74、75、76或77所述的外科器械，其中，这些控制元件彼此连接。
实施例79-根据实施例73、74、75、76或77所述的外科器械，其中，这些控制元件彼此连接。
实施例80-根据实施例73、74、75、76、77、78或79所述的外科器械，其中，该轴包括轴框架，并且其中该支撑件安装到该轴框架。
实施例81-一种外科器械，该外科器械包括限定纵向轴线的轴以及端部执行器。该端部执行器包括近侧端部、远侧端部、第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在未夹紧位置和夹紧位置之间移动。该外科器械还包括关节运动接头，其中该端部执行器以能够围绕该关节运动接头旋转的方式连接到该轴。该外科器械还包括关节运动连杆，该关节运动连杆可操作地连接到该端部执行器。该关节运动连杆能够朝远侧移动以使该端部执行器在第一方向上旋转，其中该关节运动连杆能够朝近侧移动以使该端部执行器在第二方向上旋转。该外科器械还包括夹紧构件，该夹紧构件被构造成能够在夹紧行程期间接合该第一钳口并使该第一钳口朝向该夹紧位置移动。该夹紧构件在该夹紧行程期间能够相对于该关节运动接头滑动。该外科器械还包括钉击发组件。该钉击发组件包括切割构件和击发构件。该击发构件在钉击发行程期间能够移动穿过该端部执行器。该击发构件包括附接到该切割构件的多个柔性层，其中这些柔性被构造成能够相对于彼此纵向滑动。该击发构件延伸穿过该关节运动接头。该钉击发组件还包括定位在这些柔性层中的两者之间的支撑件。该钉击发组件还包括用于限制这些柔性层之间的侧向位移的装置。
实施例82-根据实施例81所述的外科器械，其中，该第一钳口包括钉仓。
实施例83-根据实施例81所述的外科器械，其中，该第二钳口包括钉仓。
实施例84-一种外科器械，该外科器械包括轴和端部执行器。该端部执行器包括近侧端部、远侧端部、在该近侧端部和该远侧端部之间延伸的纵向轴线、第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在未夹紧位置和夹紧位置之间移动。该外科器械还包括关节运动接头，其中该端部执行器以能够围绕该关节运动接头旋转的方式连接到该轴。该外科器械还包括钉击发组件。该钉击发组件包括在钉击发行程期间能够移动穿过该端部执行器的切割构件以及击发构件，其中该切割构件包括被构造成能够接合该第一钳口的第一部分和被构造成能够接合该第二钳口的第二部分。该钉击发组件还包括击发构件，该击发构件包括沿焊接线焊接到该击发构件的多个柔性层。该焊接线包括纵向部分和正交于该纵向部分延伸的横向部分。
实施例85-根据实施例84所述的外科器械，其中，该第一钳口包括钉仓。
实施例86-根据实施例84所述的外科器械，其中，该第二钳口包括钉仓。
实施例87-根据实施例84、85或86所述的外科器械，其中，该第二钳口包括钉仓。
实施例88-根据实施例84、85、86或87所述的外科器械，其中，该击发构件包括第一侧面和第二侧面，并且其中该焊接线存在于该第一侧面和该第二侧面上。
实施例89-一种外科器械，该外科器械包括轴，该轴包括轴框架；以及端部执行器。该端部执行器包括近侧框架、远侧端部、第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在未夹紧位置和夹紧位置之间移动。该外科器械还包括关节运动接头，其中该端部执行器以能够围绕该关节运动接头旋转的方式连接到该轴。该外科器械还包括钉击发组件，该钉击发组件包括在钉击发行程期间能够移动穿过该端部执行器的切割构件。该钉击发组件还包括击发构件，其中该击发构件包括附接到该切割构件的多个柔性层，并且其中该击发构件延伸穿过该关节运动接头。该外科器械还包括邻近该击发构件定位的侧向弹簧支撑件。该侧向弹簧支撑件包括安装到该端部执行器的该近侧框架的远侧端部。该侧向弹簧支撑件还包括被构造成能够相对于该轴框架滑动的近侧端部。
实施例90-根据实施例89所述的外科器械，其中，该第一钳口包括钉仓。
实施例91-根据实施例89所述的外科器械，其中，该第二钳口包括钉仓。
实施例92-根据实施例89、90或91所述的外科器械，其中，该侧向弹簧支撑件包括沿该击发构件的第一侧面定位的第一侧向弹簧支撑件。该外科器械还包括沿该击发构件的第二侧面定位的第二侧向弹簧支撑件。
实施例93-一种外科器械，该外科器械包括轴和端部执行器。该端部执行器包括近侧端部、远侧端部、第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动，其中该第一钳口和该第二钳口中的一者包括钉仓，该钉仓包括可移除地储存在其中的钉。该外科器械还包括关节运动接头，其中该端部执行器以能够围绕该关节运动接头旋转的方式连接到该轴。该外科器械还包括关节运动杆，该关节运动杆可操作地连接到该端部执行器，其中该关节运动杆能够朝远侧移动以使该端部执行器在第一方向上旋转，并且其中该关节运动杆能够朝近侧移动以使该端部执行器在第二方向上旋转。该外科器械还包括击发杆，该击发杆包括多个柔性层，其中该击发杆在钉击发行程期间能够移动穿过该关节运动接头。该外科器械还包括定位在该击发杆的第一侧面上的第一柔性支撑件、定位在该击发杆的第二侧面上的第二柔性支撑件、以及多个控制元件，其中每个该控制元件包括限定在其中的孔口。该击发杆延伸穿过这些孔口，其中该第一柔性支撑件、该第二柔性支撑件以及这些控制元件被构造成能够将这些柔性层保持在一起。
实施例94-根据实施例93所述的外科器械，其中，该第一柔性支撑件和该第二柔性支撑件延伸穿过这些控制元件孔口中的至少一些。
实施例95-一种外科器械，该外科器械包括端部执行器，该端部执行器包括近侧端部和远侧端部。该外科器械还包括轴。该轴包括框架、能够相对于该框架移动的锁定板，其中该锁定板包括第一纵向齿条的锁定齿。该轴还包括关节运动接头，其中该端部执行器通过该关节运动接头以能够旋转的方式连接到该轴。该轴还包括关节运动致动器，该关节运动致动器可操作地连接到该端部执行器，其中该关节运动致动器能够朝远侧移动以使该端部执行器在第一方向上旋转并且能够朝近侧移动以使该端部执行器在第二方向上旋转。该关节运动致动器包括第二纵向齿条的锁定齿。该轴还包括关节运动锁，该关节运动锁包括第三纵向齿条的锁定齿。该关节运动锁能够定位在解锁位置和锁定位置，在该解锁位置，该关节运动致动器能够相对于该框架移动，在该锁定位置，该第三纵向齿条的锁定齿与该第一纵向齿条的锁定齿和该第二纵向齿条的锁定齿接合以防止该关节运动致动器的该近侧移动和该远侧移动。
实施例96-根据实施例95所述的外科器械，其中该第一纵向齿条的锁定齿被限定在第一平面中，并且该第二纵向齿条的锁定齿被限定在第二平面中。该第一平面和该第二平面是不同的。
实施例97-根据实施例95或96所述的外科器械，其中，该锁定板能够相对于该框架滑动。
实施例98-根据实施例95、96、或97所述的外科器械，其中，该框架包括凹陷部，并且该锁定板被定位在该凹陷部内。该凹陷部包括被构造成能够限制该凹陷部内该锁定板的该近侧移动的近侧端部壁。该凹陷部还包括被构造成能够限制该凹陷部内该锁定板的该远侧移动的远侧端部壁。
实施例99-根据实施例98所述的外科器械，还包括定位在该近侧端部壁和该锁定板之间的偏压构件。
实施例100-根据实施例98所述的外科器械，还包括定位在该远侧端部壁和该锁定板之间的偏压构件。
实施例101-根据实施例95、96、97、98、99或100所述的外科器械，其中，该端部执行器包括第一钳口和第二钳口，其中该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动。该外科器械还包括闭合构件，该闭合构件被构造成能够在闭合行程期间使该第一钳口朝向该闭合位置移动。该闭合构件被构造成能够在该闭合行程期间接合该关节运动锁并将该关节运动锁保持在该锁定位置。
实施例102-根据实施例101所述的外科器械，其中，该轴限定纵向轴线。该框架包括柔性部分，其中该闭合构件被构造成能够抵靠该柔性部分推动该锁定板并使该柔性部分相对于该纵向轴线侧向偏转。
实施例103-根据实施例102所述的外科器械，其中，该柔性部分包括侧向侧壁和限定在该侧向侧壁后面的腔体。该侧向侧壁被构造成能够挠曲到该腔体中。
实施例104-根据实施例95、96、97、98、99、100、101、102或103所述的外科器械，其中，该关节运动锁被偏压成与该锁定板和该关节运动致动器接合。
实施例105-根据实施例95、96、97、98、99、100、101、102、103或104所述的外科器械，其中，该端部执行器还包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例106-根据实施例105所述的外科器械，其中，该钉仓是可替换的。
实施例107-根据实施例105或106所述的外科器械，其中，该端部执行器包括第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动。该第一钳口包括该钉仓。
实施例108-根据实施例105或106所述的外科器械，其中，该端部执行器包括第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动。该第二钳口包括该钉仓。
实施例109-根据实施例95、96、97、98、99、100、101、102、103、104、105、106、107或108所述的外科器械，其中，该第一纵向齿条的锁定齿包括以第一节距间隔开的齿。该第二纵向齿条的锁定齿包括以第二节距间隔开的齿，其中该第二节距与该第一节距不同。该第三纵向齿条的锁定齿包括以第三节距间隔开的齿，其中该第三节距与该第一节距和该第二节距不同。
实施例110-一种外科器械，该外科器械包括端部执行器和轴。该端部执行器包括近侧端部和远侧端部。该轴包括框架，该框架包括第一纵向齿条的锁定齿。该轴还包括关节运动接头，其中该端部执行器通过该关节运动接头以能够旋转的方式连接到该轴。该轴还包括关节运动致动器，该关节运动致动器可操作地连接到该端部执行器。该关节运动致动器能够朝远侧移动以使该端部执行器在第一方向上旋转，并且该关节运动致动器能够朝近侧移动以使该端部执行器在第二方向上旋转。该关节运动致动器包括第二纵向齿条的锁定齿。该轴还包括关节运动锁，该关节运动锁包括第二纵向齿条的锁定齿。该关节运动锁能够定位在解锁位置和锁定位置，在该解锁位置，该关节运动致动器能够相对于该框架移动，在该锁定位置，该第三纵向齿条的锁定齿与该框架的该第一纵向齿条的锁定齿和该关节运动致动器的该第二纵向齿条的锁定齿接合以禁止该关节运动致动器的该近侧移动和该远侧移动。
实施例111-根据实施例110所述的外科器械，其中，该框架包括可滑动锁定板，并且其中该第一纵向齿条的锁定齿被限定在该锁定板上。
实施例112-根据实施例110或111所述的外科器械，其中，该端部执行器包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例113-一种外科器械，该外科器械包括端部执行器和轴。该轴包括框架和关节运动接头，其中，该端部执行器通过该关节运动接头以能够旋转的方式连接到该轴。该轴还包括关节运动致动器，该关节运动致动器可操作地连接到该端部执行器。该关节运动致动器能够沿第一方向移动以使该端部执行器在一个方向上旋转，并且该关节运动致动器能够沿第二方向移动以使该端部执行器在另一个方向上旋转。该轴还包括关节运动锁，该关节运动锁能够定位在第一位置和第二位置，在该第一位置，该关节运动锁能够相对于该框架移动，在该第二位置，该关节运动锁与该框架和该关节运动致动器接合以限制该关节运动致动器在该第一方向和该第二方向上的该移动。
实施例114-根据实施例113所述的外科器械，其中，该端部执行器包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例115-一种外科器械，该外科器械包括端部执行器头，该端部执行器头能够构造成未夹紧构型和夹紧构型。该外科器械还包括轴。该轴包括框架，该框架包括纵向轴线；以及关节运动接头，其中该端部执行器头通过该关节运动接头以能够旋转的方式连接到该轴。该轴还包括关节运动致动器，该关节运动致动器可操作地连接到该端部执行器头。该关节运动致动器能够沿第一方向移动以使该端部执行器头在一个方向上旋转，并且该关节运动致动器能够沿第二方向移动以使该端部执行器头在另一个方向上旋转。该关节运动致动器包括相对于该纵向轴线侧向延伸的至少一个锁定突出部。该轴还包括关节运动锁，该关节运动锁包括相对于该纵向轴线侧向延伸的至少两个突出部。该关节运动锁被构造成能够相对于该纵向轴线侧向挠曲以实现该端部执行器头的关节运动动作。该轴还包括闭合构件，该闭合构件被构造成能够在闭合行程期间使该端部执行器头从该未夹紧构型移动到该夹紧构型，其中该闭合构件防止该关节运动锁该闭合行程之后侧向挠曲，从而禁止该端部执行器头进行关节运动。
实施例116-一种外科器械，该外科器械包括端部执行器，该端部执行器包括近侧端部、远侧端部、第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动。该外科器械还包括轴，该轴包括框架，其中该框架包括第一纵向齿条的锁定齿。该轴还包括关节运动接头，其中该端部执行器通过该关节运动接头以能够旋转的方式连接到该轴。该轴还包括关节运动致动器，该关节运动致动器可操作地连接到该端部执行器，其中该关节运动致动器能够朝远侧移动以使该端部执行器在第一方向上旋转并且能够朝近侧移动以使该端部执行器在第二方向上旋转。该关节运动致动器包括第二纵向齿条的锁定齿。该轴还包括关节运动锁，该关节运动锁包括第三组锁定齿。该关节运动锁能够定位在脱离位置和接合位置，在该脱离位置，该第三组锁定齿不与该框架和该关节运动致动器接合，在该接合位置，该第三组锁定齿与该第一纵向齿条的锁定齿和该第二纵向齿条的锁定齿接合以防止该关节运动致动器的该近侧移动和该远侧移动。该轴还包括闭合构件，该闭合构件被构造成能够在闭合行程期间使该第一钳口朝向该闭合位置移动。该闭合构件被构造成能够在该闭合行程期间接合该关节运动锁并使该关节运动锁从该脱离位置移动到该接合位置。
实施例117-根据实施例116所述的外科器械，其中，该第一纵向齿条的锁定齿被限定在第一平面中。该第二纵向齿条的锁定齿被限定在第二平面中。该第一平面和该第二平面是不同的。
实施例118-根据实施例116或117所述的外科器械，其中，该端部执行器还包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例119-根据实施例118所述的外科器械，其中，该钉仓是可替换的。
实施例120-根据实施例118或119所述的外科器械，其中，该端部执行器包括第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动。该第一钳口包括该钉仓。
实施例121-根据实施例118或119所述的外科器械，其中，该端部执行器包括第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动。该第二钳口包括该钉仓。
实施例122-根据实施例116、117、118、119、120或121所述的外科器械，其中，该第一纵向齿条的锁定齿包括以第一节距间隔开的齿。该第二纵向齿条的锁定齿包括以第二节距间隔开的齿，其中该第二节距与该第一节距不同。该第三组锁定齿包括以第三节距间隔开的齿，其中该第三节距与该第一节距和该第二节距不同。
实施例123-根据实施例116、117、118、119、120、121或122所述的外科器械，其中，该轴限定纵向轴线。该关节运动锁包括锁定板，该锁定板能够相对于该纵向轴线在该脱离位置和该接合位置之间侧向滑动。该框架包括近侧导向柱和远侧导向柱。该锁定板包括近侧侧向狭槽和远侧侧向狭槽，其中该近侧导向柱延伸到该近侧侧向狭槽中并且该远侧导向柱延伸到该远侧侧向狭槽中。该近侧导向柱和该远侧导向柱配合以限定该锁定板的侧向路径。
实施例124-根据实施例123所述的外科器械，其中，该锁定板包括锁定狭槽，该锁定狭槽包括限定在其中的侧壁。该闭合构件包括延伸到该锁定狭槽中的锁定驱动器。该锁定驱动器被构造成能够在该闭合行程期间接合侧壁以使该锁定板从该脱离位置移位到该接合位置。
实施例125-根据实施例124所述的外科器械，其中，该闭合构件能够通过回缩行程移动以允许该第一钳口移动到该打开位置。该锁定驱动器被构造成能够在该回缩行程期间接合该锁定狭槽的这些侧壁中的一者以使该锁定板从该接合位置移位到该脱离位置。
实施例126-根据实施例124所述的外科器械，其中，该闭合构件能够通过打开行程移动以使该第一钳口移动到该打开位置。该锁定驱动器被构造成能够在该打开行程期间接合该锁定狭槽的这些侧壁中的一者以使该锁定板从该接合位置移位到该脱离位置。
实施例127-根据实施例116、117、118、119、120、121、122、123、124、125或126所述的外科器械，其中，该关节运动锁包括锁定臂，该锁定臂能够通过该闭合构件偏转到该接合位置。
实施例128-根据实施例116、117、118、119、120、121、122、123、124、125或126所述的外科器械，其中，该关节运动锁包括第一锁定臂和第二锁定臂。该闭合构件包括楔形件，该楔形件在该闭合行程期间能够定位在该第一锁定臂和该第二锁定臂之间以使该关节运动锁偏转到该接合位置。
实施例129-根据实施例128所述的外科器械，其中，该第三组锁定齿存在于该第一锁定臂和该第二锁定臂上。
实施例130-根据实施例128或129所述的外科器械，其中，该第一锁定臂被构造成能够接合该第一纵向齿条的锁定齿，并且该第二锁定臂被构造成能够接合该第二纵向齿条的锁定齿。
实施例131-一种外科器械，该外科器械包括端部执行器，该端部执行器包括第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动。该外科器械还包括轴。该轴包括框架和能够相对于该框架移动的锁定板，其中该锁定板包括第一组锁定齿。该轴还包括关节运动接头，其中该端部执行器通过该关节运动接头以能够旋转的方式连接到该轴。该轴还包括关节运动致动器，该关节运动致动器可操作地连接到该端部执行器，其中该关节运动致动器被构造成能够使该端部执行器在第一方向和第二方向上旋转。该关节运动致动器包括第二组锁定齿。该轴还包括关节运动锁，该关节运动锁包括第三组锁定齿。该关节运动锁能够定位在脱离位置和接合位置，在该脱离位置，该第三组锁定齿不与该锁定板、该框架和该关节运动致动器接合，在该接合位置，该第三组锁定齿与该第一组锁定齿和该第二组锁定齿接合以禁止该端部执行器的该关节运动。该轴还包括闭合构件，该闭合构件被构造成能够在闭合行程期间使该第一钳口朝向该闭合位置移动。该闭合构件被构造成能够在该闭合行程期间接合该关节运动锁并使该关节运动锁从该脱离位置移动到该接合位置。
实施例132-根据实施例131所述的外科器械，其中，该端部执行器还包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例133-一种外科器械，该外科器械包括端部执行器，该端部执行器包括第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动。该外科器械还包括轴。该轴包括框架，其中该框架包括第一组锁定齿。该轴还包括关节运动接头，其中该端部执行器通过该关节运动接头以能够旋转的方式连接到该轴。该轴还包括关节运动致动器，该关节运动致动器可操作地连接到该端部执行器，其中该关节运动致动器被构造成能够使该端部执行器在第一方向和第二方向上旋转。该轴还包括关节运动锁，该关节运动锁包括齿轮，该齿轮包括与该第一组齿啮合接合的第二组齿，其中该齿轮可旋转地安装到该框架。该轴还包括闭合构件，该闭合构件被构造成能够在闭合行程期间使该第一钳口朝向该闭合位置移动。该闭合构件被构造成能够在该闭合行程期间接合该齿轮以禁止该端部执行器进行关节运动。
实施例134-根据实施例133所述的外科器械，其中，该端部执行器还包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例135-一种外科器械，该外科器械包括端部执行器，该端部执行器包括第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动。该外科器械还包括轴。该轴包括框架和能够相对于该框架移动的锁定板，其中该锁定板包括第一组联接特征部。该轴还包括关节运动接头，其中该端部执行器通过该关节运动接头以能够旋转的方式连接到该轴。该轴还包括关节运动致动器，该关节运动致动器可操作地连接到该端部执行器，其中该关节运动致动器被构造成能够使该端部执行器在第一方向和第二方向上旋转。该关节运动致动器包括第二组联接特征部。该轴还包括关节运动锁，该关节运动锁包括第三组联接特征部，其中该关节运动锁能够定位在脱离位置和接合位置，在该脱离位置，该第三组联接特征部不与该锁定板和该关节运动致动器接合，在该接合位置，该第三组联接特征部与该第一组联接特征部和该第二组联接特征部接合以禁止该端部执行器的该关节运动。该轴还包括闭合构件，该闭合构件被构造成能够在闭合行程期间使该第一钳口朝向该闭合位置移动。该闭合构件被构造成能够在该闭合行程期间接合该关节运动锁并使该关节运动锁从该脱离位置移动到该接合位置。
实施例136-一种外科器械，该外科器械包括端部执行器，该端部执行器包括第一钳口和第二钳口。该第一钳口能够相对于该第二钳口在打开位置和闭合位置之间移动。该外科器械还包括轴。该轴包括框架、能够相对于该框架移动的接地构件以及关节运动接头，其中该端部执行器通过该关节运动接头以能够旋转的方式连接到该轴。该轴还包括关节运动致动器，该关节运动致动器可操作地连接到该端部执行器，其中该关节运动致动器被构造成能够使该端部执行器在第一方向和第二方向上旋转。该轴还包括关节运动锁，该关节运动锁能够定位在脱离位置和接合位置，在该脱离位置，该关节运动锁不与该接地构件和该关节运动致动器接合，在该接合位置，该关节运动锁与该接地构件和该关节运动致动器接合以禁止该端部执行器的该关节运动。该轴还包括闭合构件，该闭合构件被构造成能够在闭合行程期间使该第一钳口朝向该闭合位置移动。该闭合构件被构造成能够在该闭合行程期间接合该关节运动锁并使该关节运动锁从该脱离位置移动到该接合位置。
实施例137-一种能够通过套管针插入的外科器械。该外科器械包括柄部和从该柄部延伸的轴。该轴包括框架、连接到该柄部的近侧部分、包括端部执行器的远侧部分、以及关节运动接头，其中该端部执行器能够围绕该关节运动接头旋转。该轴还包括关节运动致动器，该关节运动致动器可操作地联接到该端部执行器，其中该关节运动致动器能够选择性地移动以使该端部执行器在第一方向和第二方向上旋转。该轴还包括能够相对于该框架滑动的外部壳体。该外部壳体包括邻近该关节运动接头的远侧非圆壳体部分以及在该近侧部分和该远侧非圆壳体部分之间延伸的纵向圆形壳体部分。该纵向圆形壳体部分包括第一直径。该远侧非圆壳体部分包括第二直径。该第一直径小于该第二直径。该远侧非圆壳体部分和该纵向圆形壳体部分被设定尺寸且被构造成能够通过该套管针插入到手术部位中。该轴还包括关节运动锁，该关节运动锁被构造成能够接合该关节运动致动器并防止该端部执行器的该旋转，其中该关节运动锁被定位在该远侧非圆壳体部分内。
实施例138-根据实施例137所述的外科器械，其中，该端部执行器包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例139-根据实施例138所述的外科器械，其中，该端部执行器还包括砧座，该砧座被构造成能够使这些钉变形。该砧座能够相对于该钉仓旋转。
实施例140-根据实施例138所述的外科器械，其中，该端部执行器还包括砧座，该砧座被构造成能够使这些钉变形，并且其中该钉仓能够相对于该砧座旋转。
实施例141-根据实施例137、138、139或140所述的外科器械，其中，该钉仓是可替换的。
实施例142-根据实施例137、138、139、140或141所述的外科器械，其中，该端部执行器是可替换的。
实施例143-根据实施例137、138、139、140、141或142所述的外科器械，其中，该纵向圆形壳体部分限定纵向轴线。该远侧非圆壳体部分相对于该纵向轴线偏心地偏置。
实施例144-根据实施例137、138、139、140、141、142或143所述的外科器械，其中，该轴的该近侧部分包括连接器，该连接器包括被构造成能够将该轴可释放地保持到该柄部的闩锁。
实施例145-根据实施例137、138、139、140、141、142、143或144所述的外科器械，其中，该关节运动锁完全位于该远侧非圆壳体部分中。
实施例146-根据实施例137、138、139、140、141、142、143或144所述的外科器械，其中，该关节运动锁包括安装到该框架的固定部分和能够在该远侧非圆壳体部分内移动的锁定部分。
实施例147-根据实施例146所述的外科器械，其中，该关节运动锁包括安装到该框架的固定部分和能够在该远侧非圆壳体部分内移动的锁定部分。
实施例148-一种能够通过套管针插入的外科器械。该外科器械包括柄部和从该柄部延伸的轴。该轴包括框架、能够附接到该柄部的近侧部分、包括端部执行器的远侧部分、以及关节运动接头，其中该端部执行器能够围绕该关节运动接头旋转。该轴还包括关节运动致动器，该关节运动致动器可操作地联接到该端部执行器，其中该关节运动致动器能够移动以使该端部执行器在第一方向和第二方向上旋转。该轴还包括能够相对于该框架滑动的外部壳体。该外部壳体包括邻近该关节运动接头的远侧壳体部分，其中该远侧壳体部分包括具有宽度的非圆周边。该外部壳体还包括在该近侧部分和该远侧壳体部分之间延伸的纵向壳体部分。该纵向壳体部分包括具有直径的基本上圆形的周边，其中该直径小于该宽度。该远侧壳体部分和该纵向壳体部分被设定尺寸且被构造成能够通过该套管针插入到手术部位中。该轴还包括关节运动锁，该关节运动锁被构造成能够接合该关节运动致动器并防止该端部执行器的该旋转，其中该关节运动锁被定位在该远侧壳体部分内。
实施例149-根据实施例148所述的外科器械，其中，该端部执行器包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例150-根据实施例148或149所述的外科器械，其中，该钉仓是可替换的。
实施例151-根据实施例148、149或150所述的外科器械，其中，该端部执行器是可替换的。
实施例152-根据实施例148、149、150或151所述的外科器械，其中，该关节运动锁完全位于该远侧壳体部分中。
实施例153-根据实施例148、149、150或151所述的外科器械，其中，该关节运动锁包括安装到该框架的固定部分和能够在该远侧壳体部分内移动的锁定部分。
实施例154-根据实施例153所述的外科器械，其中，该固定部分位于该纵向壳体部分中。
实施例155-一种外科器械，该外科器械包括柄部、从该柄部延伸的可拆卸轴。该可拆卸轴包括框架、能够附接到该柄部的近侧闩锁、包括端部执行器的远侧部分、以及关节运动接头，其中该端部执行器能够围绕该关节运动接头旋转。该可拆卸轴还包括关节运动致动器，该关节运动致动器被构造成能够使该端部执行器在第一方向和第二方向上进行关节运动。该可拆卸轴还包括能够相对于该框架平移的外部管。该外部管包括邻近该关节运动接头的远侧管部分，其中该远侧管部分包括具有宽度的非圆周边。该外部管还包括纵向管部分。该纵向管部分包括具有直径的基本上圆形的周边，其中该直径小于该宽度。该远侧管部分和该纵向管部分被设定尺寸且被构造成能够通过该套管针插入到手术部位中。该可拆卸轴还包括关节运动锁，该关节运动锁被构造成能够接合该关节运动致动器并防止该端部执行器的该旋转，其中该关节运动锁被定位在该远侧管部分内。
实施例156-一种外壳缝合器械系统，包括柄部、喷嘴和细长轴。该细长轴包括近侧端部；远侧端部；包括第一直径的近侧区域；包括第二直径的中心区域，其中该中心区域限定纵向轴线；以及包括第三直径的远侧区域。该第一直径与该第二直径不同，并且该远侧区域相对于该纵向轴线侧向偏置。该外科缝合器械系统还包括端部执行器，该端部执行器包括第一钳口。该第一钳口包括细长通道和钉仓，该钉仓包括多个钉，其中该钉仓可操作地支撑在该细长通道中。该端部执行器还包括第二钳口，其中该第二钳口能够相对于该第一钳口移动。该外科缝合器械系统还包括关节运动接头，该关节运动接头将该端部执行器以能够旋转的方式连接到该细长轴；击发构件，该击发构件被构造成能够在该端部执行器内移动；以及击发系统，该击发系统被构造成能够将击发动作施加到该击发构件。
实施例157-根据实施例156所述的外科缝合器械系统，其中，该第一直径大于该第二直径。
实施例158-根据实施例156或157所述的外科缝合器械系统，其中，该第一直径小于该第三直径。
实施例159-根据实施例156、157或158所述的外科缝合器械系统，其中，该第三直径小于该第一直径并且大于该第二直径。
实施例160-根据实施例156、157、158或159所述的外科缝合器械系统，其中，该第二钳口包括砧座，该砧座被构造成能够使这些钉变形。
实施例161-根据实施例156、157、158、159或160所述的外科缝合器械系统，其中，该细长轴的该远侧区域包括至少一个平坦侧。
实施例162-根据实施例156、157、158、159、160或161所述的外科缝合器械系统，其中，该远侧区域不是完全圆柱形的。
实施例163-一种外科缝合器械，包括细长轴。该细长轴包括近侧端部、远侧端部和在该近侧端部处的第一宽度，其中该细长轴的该第一宽度在该细长轴的中心转变为第二宽度，并且其中该细长轴的该第二宽度在该细长轴的该远侧端部处转变为第三宽度。该细长轴的该远侧端部不是圆柱形的，其中该远侧端部包括相对于该第二宽度侧向延伸的扩大部，并且其中该第一宽度、该第二宽度和该第三宽度是不同的。该外科缝合器械还包括端部执行器，该端部执行器被构造成能够附接到该细长轴的该远侧端部。该端部执行器包括第一钳口和第二钳口，并且其中该第一钳口能够相对于该第二钳口移动。该外科缝合器械还包括关节运动组件，该关节运动组件被构造成能够将关节运动动作施加到该端部执行器；击发构件；以及击发系统，该击发系统被构造成能够将击发动作施加到该击发构件。
实施例164-根据实施例163所述的外科缝合器械，其中，该第一宽度大于该第二宽度。
实施例165-根据实施例163或164所述的外科缝合器械，其中，该第二宽度小于该第三宽度。
实施例166-根据实施例163、164或165所述的外科缝合器械，其中，该第三宽度小于该第一宽度并且大于该第二宽度。
实施例167-根据实施例163、164、165或166所述的外科缝合器械，其中，该细长轴的该远侧端部被构造成能够配合通过12mm的套管通路。
实施例168-根据实施例163、164、165、166或167所述的外科缝合器械，其中，该细长轴的该中心包括小于10mm的宽度。
实施例169-一种外科紧固器械，包括细长轴。该细长轴包括近侧端部；远侧端部；包括第一周长的近侧区域；包括第二周长的中心区域，其中该中心区域限定中心纵向轴线；以及包括第三周长的远侧区域。该第一周长与该第二周长不同，并且该第三周长相对于该第二周长偏置。该外科紧固器械还包括端部执行器，该端部执行器被构造成能够附接到该细长轴的该远侧端部。该端部执行器包括紧固件仓钳口和砧座。该外科紧固器械还包括关节运动系统，该关节运动系统被构造成能够将关节运动动作施加到该端部执行器，其中该击发构件被构造成能够行进穿过该端部执行器；以及击发系统，该击发系统被构造成能够将击发和回缩动作施加到该击发构件。
实施例170-根据实施例169所述的外科紧固器械，其中，该第一周长大于该第二周长。
实施例171-根据实施例169或170所述的外科紧固器械，其中，该第二周长小于该第三周长。
实施例172-根据实施例169、170或171所述的外科紧固器械，其中，该第三周长小于该第一周长并且大于该第二周长。
实施例173-根据实施例169、170、171或172所述的外科紧固器械，其中，该近侧区域包括阶梯式下降构型。
实施例174-根据实施例169、170、171、172或173所述的外科紧固器械，其中，该细长轴的该远侧区域包括至少一个平坦侧。
实施例175-根据实施例169、170、171、172、173或174所述的外科紧固器械，其中，该中心区域在该远侧端部处包括阶梯式上升区域。
实施例176-一种外科器械，该外科器械包括壳体和从该壳体延伸的轴，该壳体包括外部管部分。该外部管部分包括近侧管部分，其中该近侧管部分限定纵向轴线；以及细长中间管部分，该细长中间管部分从该近侧管部分朝远侧延伸，其中该中间管部分沿该纵向轴线居中。该外部管部分还包括远侧管部分，该远侧管部分从该中间管部分朝远侧延伸，其中该远侧管部分相对于该纵向轴线侧向偏置，并且其中该远侧管部分包括延伸到该纵向轴线的一侧的扩大部。该外部管部分还包括限定在该中间管部分和该远侧管部分之间的渐缩颈缩部。
实施例177-根据实施例176所述的外科器械，还包括端部执行器和关节运动接头，该关节运动接头将该端部执行器以能够旋转的方式连接到该远侧管部分。
实施例178-根据实施例177所述的外科器械，其中，该端部执行器包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例179-一种外科器械，该外科器械包括壳体，该壳体包括电动马达。该外科器械还包括从该壳体延伸的轴，其中，该轴包括框架；以及端部执行器。该端部执行器包括第一钳口；第二钳口，其中该第一钳口能够相对于该第二钳口旋转；钉仓，该钉仓包括可移除地存储在其中的钉；以及砧座，该砧座被构造成能够使这些钉变形。该外科器械还包括闭合系统，该闭合系统被构造成能够在闭合行程期间使该第一钳口朝向该第二钳口移动；关节运动接头，该关节运动接头将该端部执行器以能够旋转的方式连接到该轴；关节运动系统，该关节运动系统被构造成能够使该端部执行器相对于该轴进行关节运动；以及击发系统，该击发系统与该电动马达可操作地接合。该击发系统被构造成能够在钉击发行程期间将这些钉从该钉仓射出。该外科器械还包括第一可旋转构件，该第一可旋转构件被构造成能够选择性地将来自该击发系统的运动传递到该关节运动系统；以及第二可旋转构件，该第二可旋转构件可旋转地安装到该框架，其中该第二可旋转构件与该关节运动系统可操作地接合。该闭合系统被构造成能够在该闭合行程期间接合该第二可旋转构件，以将该关节运动系统锁定就位并防止该端部执行器的该关节运动。
实施例180-根据实施例179所述的外科器械，其中，该闭合系统包括围绕该框架的闭合管。该闭合系统还包括楔形件，该楔形件被构造成能够在该闭合行程期间接合该第二可旋转构件并将该第二可旋转构件锁定就位。
实施例181-根据实施例179或180所述的外科器械，其中，该第一可旋转构件可旋转地安装在该框架内。
实施例182-根据实施例179、180或181所述的外科器械，其中，该第二可旋转构件包括齿轮，该齿轮与限定在该关节运动系统上的齿条相互啮合。
实施例183-根据实施例179、180、181或182所述的外科器械，其中，该第一钳口包括该钉仓，并且该第二钳口包括该砧座。
实施例184-根据实施例179、180、181或182所述的外科器械，其中，该第一钳口包括该砧座，并且该第二钳口包括该钉仓。
实施例185-根据实施例179、180、181、182、183或184所述的外科器械，其中，该壳体包括柄部。
实施例186-根据实施例179、180、181、182、183、184或185所述的外科器械，其中，该壳体能够附接到机器人外科系统。
实施例187-根据实施例179、180、181、182、183、184、185或186所述的外科器械，其中，该第一可旋转构件被构造成能够在该闭合行程期间可操作地将该关节运动系统与该击发系统分离。
实施例188-根据实施例179、180、181、182、183、184、185、186或187所述的外科器械，其中，该关节运动系统在该钉击发行程期间与该击发系统可操作地分离。
实施例189-根据实施例179、180、181、182、183、184、185、186、187或188所述的外科器械，其中，该闭合系统在该闭合行程之后能够回缩以打开该第一钳口并解锁该关节运动系统。
实施例190-根据实施例179、180、181、182、183、184、185、186、187、188或189所述的外科器械，其中，该第二可旋转构件能够围绕从该框架延伸的柱旋转。该柱包括第一制动臂和第二制动臂，其中该闭合系统被构造成能够在该闭合行程期间接合该第一制动臂和该第二制动臂，并防止该第二可旋转构件的旋转。
实施例191-根据实施例179、180、181、182、183、184、185、186、187、188、189或190所述的外科器械，其中，该第二可旋转构件包括环形齿阵列，并且其中该闭合系统被构造成能够在该闭合行程期间接合该环形齿阵列并防止该第二可旋转构件的该旋转。
实施例192-一种外科器械，该外科器械包括壳体，该壳体包括可旋转输入件；从该壳体延伸的轴，其中该轴包括框架；以及端部执行器。该端部执行器包括第一钳口和第二钳口，并且其中该第一钳口能够相对于该第二钳口旋转。该外科器械还包括闭合系统，该闭合系统被构造成能够在闭合行程期间闭合该第一钳口；关节运动接头，该关节运动接头将该端部执行器以能够旋转的方式连接到该轴；关节运动系统，该关节运动系统被构造成能够使该端部执行器相对于该轴进行关节运动；以及击发系统，该击发系统与该可旋转输入件可操作地接合。该击发系统被构造成能够在击发行程期间移动穿过该端部执行器。该外科器械还包括第一可旋转构件，该第一可旋转构件被构造成能够选择性地使该击发系统和该关节运动系统同步；以及第二可旋转构件，该第二可旋转构件可旋转地安装到该框架。该第二可旋转构件与该关节运动系统可操作地接合，其中该闭合系统被构造成能够在该闭合行程期间接合该第二可旋转构件，以将该关节运动系统锁定就位并防止该端部执行器的该关节运动。
实施例193-根据实施例192所述的外科器械，还包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例194-一种外科器械，该外科器械包括壳体，该壳体包括可旋转输入件；从该壳体延伸的轴，其中该轴包括框架；以及端部执行器。该端部执行器包括第一钳口和第二钳口，并且其中该第一钳口能够相对于该第二钳口旋转。该外科器械还包括闭合系统，该闭合系统被构造成能够在闭合行程期间闭合该第一钳口；关节运动接头，该关节运动接头将该端部执行器以能够旋转的方式连接到该轴；关节运动系统，该关节运动系统被构造成能够使该端部执行器相对于该轴进行关节运动；以及击发系统，该击发系统与该可旋转输入件可操作地接合。该击发系统被构造成能够在击发行程期间移动穿过该端部执行器。该外科器械还包括第一可旋转构件，该第一可旋转构件被构造成能够选择性地使该击发系统的该运动和该关节运动系统的该运动同步；以及第二可旋转构件，该第二可旋转构件与该关节运动系统可操作地接合。该闭合系统被构造成能够在该闭合行程期间停止该第二可旋转构件的该旋转，以将该关节运动系统锁定就位并防止该端部执行器的该关节运动。
实施例195-根据实施例194所述的外科器械，还包括钉仓，该钉仓包括可移除地储存在其中的钉。
实施例196-一种钉仓组件，包括近侧端部；远侧端部；仓体，该仓体在该远侧端部处包括钝的鼻部；多个钉腔，这些钉腔被限定在该仓体内，其中该多个钉腔从该近侧端部纵向延伸到该远侧端部；多个钉，这些钉可移除地存储在该多个钉腔内；驱动器，该驱动器被构造成能够支撑该多个钉中的至少一者；以及滑动件，该滑动件在击发行程期间能够朝向该远侧端部移动。该滑动件包括第一斜坡和第二斜坡，其中该第一斜坡与该第二斜坡侧向偏置。该第一斜坡和该第二斜坡被构造成能够提升该驱动器，其中该仓体的该钝的鼻部包括第一凹陷部，该第一凹陷部形成在该远侧端部内、被构造成能够在该击发行程完成之后接收该滑动件的该第一斜坡；以及第二凹陷部，该第二凹陷部形成在该远侧端部内、被构造成能够在该击发行程完成之后接收该滑动件的该第二斜坡。
实施例197-根据实施例196所述的钉仓组件，其中，当该击发行程完成时，该第一斜坡和该第二斜坡在该远侧端部处暴露。
实施例198-根据实施例196或197所述的钉仓组件，其中，该驱动器包括第一驱动器部分，该第一驱动器部分被构造成能够支撑第一钉；第二驱动器部分，该第二驱动器部分被构造成能够支撑第二钉；以及第三驱动器部分，该第三驱动器部分被构造成能够支撑第三钉。
实施例199-根据实施例198所述的钉仓组件，其中，该驱动器还包括中心基部构件，该中心基部构件连接该第一驱动器部分、该第二驱动器部分和该第三驱动器部分。
实施例200-根据实施例199所述的钉仓组件，其中，该第一驱动器部分包括具有近侧端部的第一前向支撑柱，并且该第二驱动器部分包括具有远侧端部的第二前向支撑柱。该中心基部构件在该第一前向支撑柱的该近侧端部和该第二前向支撑柱的该远侧端部之间纵向延伸。
实施例201-根据实施例196、197、198、199或200所述的钉仓组件，其中，该中心基部构件包括被构造成能够通过该滑动件接合的向后成角度倾斜的壁。
实施例202-根据实施例196、197、198、199、200或201所述的钉仓组件，其中，该滑动件被构造成能够将该驱动器朝向与该钉仓组件相对地定位的砧座驱动。
实施例203-一种钉仓组件，包括近侧端部；远侧端部；仓体，该仓体在该远侧端部处包括缩短鼻部；以及钉排，该钉排可移除地存储在该仓体中。该钉排从该近侧端部纵向延伸到该远侧端部。该钉排包括最远侧钉和最近侧钉。该钉仓组件还包括驱动器，其中每个该驱动器被构造成能够支撑这些钉中的至少一者；以及滑动件，该滑动件能够朝向该远侧端部移动。该滑动件包括斜坡，该斜坡被构造成能够在击发行程期间将这些驱动器和这些钉朝向与该钉仓组件相对地定位的砧座提升。该滑动件还包括基部，其中该缩短鼻部的长度从该最远侧钉延伸到该远侧端部，并且其中该缩短鼻部的该长度比该滑动件的该基部短。
实施例204-根据实施例203所述的钉仓组件，还包括该砧座，其中该砧座在该远侧端部上包括保护端头。
实施例205-根据实施例203或304所述的钉仓组件，还包括该砧座，其中该缩短鼻部的该远侧端部延伸超过该砧座的该远侧端部。
实施例206-根据实施例203、204或205所述的钉仓组件，其中，当该击发行程完成时，该滑动件的该斜坡在该远侧端部处暴露。
实施例207-一种用于外科缝合器械的端部执行器。该端部执行器包括钉仓组件。该钉仓组件包括近侧端部；远侧端部；仓体，该仓体在该远侧端部处包括缩短鼻部；钉，这些钉可移除地存储在该仓体中；驱动器，该驱动器被构造成能够支撑这些钉中的至少一者；以及滑动件，该滑动件能够朝向该远侧端部移动。该滑动件包括被构造成能够提升该驱动器和至少一个钉的斜坡。该滑动件还包括基部，其中该仓体的该缩短鼻部比该滑动件的该基部短。该端部执行器还包括砧座。该砧座包括钉成形表面，该钉成形表面包括多个钉成形凹坑。该砧座还包括朝向该钉仓组件向下延伸的钝的远侧鼻部。
实施例208-根据实施例207所述的端部执行器，其中，该钝的远侧鼻部可移除地附接到该砧座。
实施例209-根据实施例207或208所述的端部执行器，其中，该砧座还包括框架，该框架包括附接特征部，该附接特征部被构造成能够有利于该钝的远侧鼻部附接到该框架。
实施例210-根据实施例207、208或209所述的端部执行器，其中，该砧座包括远侧端部，并且其中该钉仓组件的该远侧端部延伸超过该砧座的该远侧端部。
实施例211-一种钉仓组件，包括仓体；近侧端部；远侧端部；狭槽，该狭槽被构造成能够接收切割构件；以及第一钉排，该第一钉排可移除地存储在该仓体中，其中该第一钉排沿该狭槽的第一侧在该近侧端部和该远侧端部之间延伸。该钉仓组件还包括第二钉排，该第二钉排可移除地存储在该仓体中，其中该第二钉排沿该狭槽的该第一侧上的该第一钉排在该近侧端部和该远侧端部之间延伸。该钉仓组件还包括第三钉排，该第三钉排可移除地存储在该仓体中，其中该第三钉排沿该狭槽的该第一侧上的该第二钉排在该近侧端部和该远侧端部之间延伸。该钉仓组件还包括驱动器，该驱动器被构造成能够支撑该第一钉排中的第一钉、该第二钉排中的第二钉和该第三钉排中的第三钉，其中该第二钉比该第一钉和该第三钉更靠近该近侧端部。
实施例212-根据实施例211所述的端部执行器，其中，该第一钉、该第二钉和该第三钉形成反向箭头构型。
实施例213-根据实施例211或212所述的钉仓组件，还包括滑动件，该滑动件被构造成能够将该驱动器朝向与该钉仓组件相对地定位的砧座提升。
实施例214-根据实施例211、212或213所述的钉仓组件，还包括砧座，其中，该砧座包括远侧端部。
实施例215-根据实施例214所述的钉仓组件，其中，该钉仓的该远侧端部相对于该砧座的该远侧端部朝远侧延伸。
实施例216-一种钉仓系统，包括端部执行器，该端部执行器能够构造成未夹紧构型和夹紧构型。该端部执行器包括砧座钳口和仓钳口。该仓钳口被构造成能够接收钉仓。该仓钳口包括仓支撑基准。该钉仓系统还包括第一钉仓。该第一钉仓包括第一平台，该第一平台被构造成能够支撑患者的组织；第一钉腔，该第一钉腔被限定在该第一平台中；第一钉，这些第一钉可移除地存储在该第一钉腔中；以及第一近侧端部。当该第一钉仓定位在该仓钳口中时，该第一近侧端部与该仓钳口的基准对准。该第一钉仓还包括第一远侧端部，其中第一仓长度被限定在该第一近侧端部和该第一远侧端部之间。该钉仓系统还包括第二钉仓。该第一钉仓包括第二平台，该第二平台被构造成能够支撑患者的组织；第二钉腔，该第二钉腔被限定在该第二平台中；第二钉，这些第二钉可移除地存储在该第二钉腔中；以及第二近侧端部。当该第二钉仓定位在该仓钳口中时，该第二近侧端部与该仓钳口的该基准对准。该第二钉仓还包括第二远侧端部，其中第二仓长度被限定在该第二近侧端部和该第二远侧端部之间，其中当该端部执行器处于该夹紧构型并且该第一钉仓位于该仓钳口中时，该砧座由该第一钉仓上的第一位置支撑。当该端部执行器处于该夹紧构型并且该第二钉仓位于该仓钳口中时，该砧座由该第二钉仓上的第二位置支撑。该第一位置是在该第一钉仓位于该仓钳口中时距该仓支撑基准的第一正交距离，并且该第二位置是在该第二钉仓位于该仓钳口中时距该仓支撑基准的第二正交距离。该第一正交距离与该第二正交距离不同。该砧座钳口响应于是该第一钉仓还是该第二钉仓位于该仓钳口中二不同地偏转。
实施例217-根据实施例216所述的钉仓系统，其中，该第二仓长度与该第一仓长度不同。
实施例218-根据实施例216或217所述的钉仓系统，其中，该第二仓长度比该第一仓长度短。
实施例219-根据实施例216、217或218所述的钉仓系统，其中，该第二正交距离比该第一正交距离短。
实施例220-根据实施例216、217或218所述的钉仓系统，其中，该第二正交距离比该第一正交距离高。
实施例221-根据实施例216、217、219或220所述的钉仓系统，其中，该第二仓长度比该第一仓长度长。
实施例222-根据实施例216、217、218或221所述的钉仓系统，其中，该第二正交距离比该第一正交距离短。
实施例223-根据实施例216、217、218或221所述的钉仓系统，其中，该第二正交距离比该第一正交距离高。
实施例224-根据实施例216、217、218、219、220、221、222或223所述的钉仓系统，其中，该第二位置与该第一位置距该第一远侧端部相比更靠近该第二远侧端部。
实施例225-根据实施例216、217、218、219、220、221、222或223所述的钉仓系统，其中，该第二位置被定位成与该第一位置距该第一远侧端部相比更远离该第二远侧端部。
实施例226-根据实施例216、217、218、219、220、221、222、223、224或225所述的钉仓系统，其中，该砧座钳口包括远侧砧座端头。该第一仓长度被设定成使得该远侧砧座端头延伸超过该第一远侧端部，其中该第二仓长度被设定成使得该远侧砧座端头不延伸超过该第一远侧端部。
实施例227-根据实施例216、217、218、219、220、221、222、223、224、225或226所述的钉仓系统，其中，当该端部执行器处于该夹紧构型并且该第一钉仓位于该仓钳口中时，该砧座钳口经历第一偏转。当该端部执行器处于该夹紧构型并且该第二钉仓位于该仓钳口中时，该砧座钳口经历第二偏转。该第二偏转比该第一偏转大。
实施例228-根据实施例216、217、218、219、220、221、222、223、224、225、226或227所述的钉仓系统，其中，每个第一钉包括在第一未成形高度范围内的未成形高度，其中每个第二钉包括在第二未成形高度范围内的未成形高度，并且其中该第二未成形高度范围包括比该第一未成形高度范围中的高度高的高度。
实施例229-根据实施例216、217、218、219、220、221、222、223、224、225、226或227所述的钉仓系统，其中，每个第一钉包括在第一未成形高度范围内的未成形高度，其中每个第二钉包括在第二未成形高度范围内的未成形高度，并且其中该第二未成形高度范围包括比该第一未成形高度范围中的高度短的高度。
实施例230-根据实施例216、217、218、219、220、221、222、223、224、225、226、227、228或229所述的钉仓系统，其中，每个第一钉包括在第一未成形高度范围内的未成形高度，其中每个第二钉包括在第二未成形高度范围内的未成形高度，并且其中该第二未成形高度范围与该第一未成形高度范围不同，但与第一未成形高度范围该部分地重叠。
实施例231-根据实施例216、217、218、219、220、221、222、223、224、225、226、227、228、229或230所述的钉仓系统，其中，该砧座钳口包括远侧砧座端头，其中该第一仓长度被设定成使得该远侧砧座端头延伸超过该第一远侧端部，并且其中该第二仓长度被设定成使得该远侧砧座端头比该第二远侧端部短。
实施例232-根据实施例216、217、218、219、220、221、222、223、224、225、226、227、228、229、230或231所述的钉仓系统，其中，该砧座钳口能够相对于该仓钳口旋转。
实施例233-根据实施例216、217、218、219、220、221、222、223、224、225、226、227、228、229、230或231所述的钉仓系统，其中，该仓钳口能够相对于该砧座钳口旋转。
实施例234-根据实施例216、217、218、219、220、221、222、223、224、225、226、227、228、229、230、231、232或233所述的钉仓系统，其中，该第一远侧端部包括第一仓鼻部，并且该第二远侧端部包括第二仓鼻部。该第二仓鼻部比该第一仓鼻部钝。
实施例235-根据实施例216、217、218、219、220、221、222、223、224、225、226、227、228、229、230、231、232、233或234所述的钉仓系统，其中，该第一远侧端部包括第一仓鼻部，并且该第二远侧端部包括第二仓鼻部。该第二仓鼻部比该第一仓鼻部短。
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、陈述或其他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 (16)

1.一种外科器械，包括：
壳体，所述壳体包括电动马达；
轴，所述轴从所述壳体延伸，其中所述轴包括框架；
端部执行器，所述端部执行器包括：
第一钳口；
第二钳口，其中所述第一钳口能够相对于所述第二钳口旋转；
钉仓，所述钉仓包括可移除地存储在其中的钉；和
砧座，所述砧座被构造成能够使所述钉变形；
闭合系统，所述闭合系统包括围绕所述框架的闭合管，所述闭合管被构造成能够在闭合行程期间使所述第一钳口朝向所述第二钳口运动，其中所述闭合管限定所述轴的外周边；
关节运动接头，所述关节运动接头将所述端部执行器可旋转地连接到所述轴；
关节运动系统，所述关节运动系统被构造成能够使所述端部执行器相对于所述轴进行关节运动；
击发系统，所述击发系统与所述电动马达可操作地接合，其中所述击发系统被构造成能够在钉击发行程期间将所述钉从所述钉仓射出；
第一可旋转驱动齿轮，所述第一可旋转驱动齿轮被构造成能够选择性地将运动从所述击发系统传递到所述关节运动系统；和
第二可旋转制动齿轮，所述第二可旋转制动齿轮可旋转地安装到所述框架，其中所述第二可旋转制动齿轮与所述关节运动系统可操作地接合，并且其中所述闭合管包括楔形件，所述楔形件被构造成能够在所述闭合行程期间接合所述第二可旋转制动齿轮，以将所述关节运动系统锁定就位并防止所述端部执行器的关节运动。
2.根据权利要求1所述的外科器械，其中，所述第一可旋转驱动齿轮可旋转地安装在所述框架内。
3.根据权利要求1所述的外科器械，其中，所述第二可旋转制动齿轮包括齿轮，所述齿轮与限定在所述关节运动系统上的齿条相互啮合。
4.根据权利要求1所述的外科器械，其中，所述第一钳口包括所述钉仓，并且所述第二钳口包括所述砧座。
5.根据权利要求1所述的外科器械，其中，所述第一钳口包括所述砧座，并且所述第二钳口包括所述钉仓。
6.根据权利要求1所述的外科器械，其中，所述壳体包括柄部。
7.根据权利要求1所述的外科器械，其中，所述壳体能够附接到机器人外科系统。
8.根据权利要求1所述的外科器械，其中，所述第一可旋转驱动齿轮被构造成能够在所述闭合行程期间可操作地使所述关节运动系统与所述击发系统分离。
9.根据权利要求1所述的外科器械，其中，所述关节运动系统在所述钉击发行程期间与所述击发系统可操作地分离。
10.根据权利要求1所述的外科器械，其中，所述闭合系统能够在所述闭合行程之后回缩以打开所述第一钳口并解锁所述关节运动系统。
11.根据权利要求1所述的外科器械，其中，所述第二可旋转制动齿轮能够围绕从所述框架延伸的柱旋转，其中所述柱包括第一制动臂和第二制动臂，并且其中所述闭合系统被构造成能够在所述闭合行程期间接合所述第一制动臂和所述第二制动臂以及防止所述第二可旋转制动齿轮的旋转。
12.根据权利要求1所述的外科器械，其中，所述第二可旋转制动齿轮包括环形齿阵列，并且其中所述闭合系统被构造成能够在所述闭合行程期间接合所述环形齿阵列以及防止所述第二可旋转制动齿轮的旋转。
13.一种外科器械，包括：
壳体，所述壳体包括可旋转输入件；
轴，所述轴从所述壳体延伸，其中所述轴包括框架；
端部执行器，所述端部执行器包括：
第一钳口；和
第二钳口，其中所述第一钳口能够相对于所述第二钳口旋转；
闭合系统，所述闭合系统包括围绕所述框架的闭合管，所述闭合管被构造成能够在闭合行程期间闭合所述第一钳口；
关节运动接头，所述关节运动接头将所述端部执行器可旋转地连接到所述轴；
关节运动系统，所述关节运动系统被构造成能够使所述端部执行器相对于所述轴进行关节运动；
击发系统，所述击发系统与所述可旋转输入件可操作地接合，其中所述击发系统被构造成能够在击发行程期间移动穿过所述端部执行器；
第一可旋转驱动齿轮，所述第一可旋转驱动齿轮被构造成能够选择性地使所述击发系统和所述关节运动系统同步；和
第二可旋转制动齿轮，所述第二可旋转制动齿轮可旋转地安装到所述框架，其中所述第二可旋转制动齿轮与所述关节运动系统可操作地接合，并且其中所述闭合管包括楔形件，所述楔形件被构造成能够在所述闭合行程期间接合所述第二可旋转制动齿轮，以将所述关节运动系统锁定就位并防止所述端部执行器的关节运动。
14.根据权利要求13所述的外科器械，还包括钉仓，所述钉仓包括可移除地储存在其中的钉。
15.一种外科器械，包括：
壳体，所述壳体包括可旋转输入件；
轴，所述轴从所述壳体延伸，其中所述轴包括框架；
端部执行器，所述端部执行器包括：
第一钳口；和
第二钳口，其中所述第一钳口能够相对于所述第二钳口旋转；
闭合系统，所述闭合系统包括围绕所述框架的闭合管，所述闭合管被构造成能够在闭合行程期间闭合所述第一钳口；
关节运动接头，所述关节运动接头将所述端部执行器可旋转地连接到所述轴；
关节运动系统，所述关节运动系统被构造成能够使所述端部执行器相对于所述轴进行关节运动；
击发系统，所述击发系统与所述可旋转输入件可操作地接合，其中所述击发系统被构造成能够在击发行程期间移动穿过所述端部执行器；
第一可旋转驱动齿轮，所述第一可旋转驱动齿轮被构造成能够选择性地使所述击发系统的运动与所述关节运动系统的运动同步；和
第二可旋转制动齿轮，所述第二可旋转制动齿轮能够与所述关节运动系统可操作地接合，其中所述闭合管被构造成能够在该闭合行程期间阻止所述第二可旋转制动齿轮的旋转，以将所述关节运动系统锁定就位并防止所述端部执行器的关节运动。
16.根据权利要求15所述的外科器械，还包括钉仓，所述钉仓包括可移除地储存在其中的钉。
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