CN112839597A - 带有用于将关节运动驱动系统关联到击发驱动系统的离合器和锁定布置结构的电动可关节运动外科器械 - Google Patents
带有用于将关节运动驱动系统关联到击发驱动系统的离合器和锁定布置结构的电动可关节运动外科器械 Download PDFInfo
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Abstract
本发明公开了一种外科器械，该外科器械包括外科端部执行器以及第一驱动构件和第二驱动构件，该第一驱动构件和第二驱动构件被构造成能够向外科端部执行器施加致动动作。驱动离合器组件与第一驱动构件和第二驱动构件可操作地交接，并且被构造成能够在接合位置和第二脱离接合位置之间运动，在接合位置，第二驱动构件关联到第一驱动构件，在第二脱离接合位置，第一驱动构件能够独立地运动。锁组件被构造成能够在锁定位置和解锁位置之间运动，在锁定位置，防止第二驱动构件运动，在解锁位置，第二驱动构件能够运动。
Description
背景技术
本发明涉及外科器械，并且在各种布置结构中，涉及被设计成缝合和切割组织的外科缝合和切割器械以及与它们一起使用的钉仓。
附图说明
本文所述的实施方案的各种特征连同其优点可结合如下附图根据以下描述来加以理解：
图1为电动外科缝合系统的透视图；
图2为图1的电动外科缝合系统的轴组件的分解组装视图；
图3为图1的电动外科缝合系统的轴组件和外科端部执行器的一部分的剖视图，其中外科端部执行器的砧座处于打开位置；
图4为处于非关节运动位置的图3的轴组件和外科端部执行器的一部分的顶视图；
图5为处于关节运动位置的图3的轴组件和外科端部执行器的一部分的另一个顶视图；
图6为图1的电动外科缝合系统的柄部或外壳的分解组装视图；
图7为图6的柄部的剖视图，其中为清楚起见省略了轴组件的多个部分；
图8为图7的柄部和轴组件的放大剖视图；
图9为图7的柄部和轴组件的另一个放大剖视图；
图10为处于导致外科端部执行器的钳口被取向在打开位置中的位置的图7的柄部和轴组件的另一个侧剖视图；
图11为处于导致端部执行器钳口闭合的位置的图7的柄部和轴组件的另一个侧剖视图；
图12为采用渐进式闭合驱动系统的外科器械实施方案与采用不同闭合驱动系统布置结构的两个先前外科器械之间的闭合力的图形比较；
图13A为在砧座上采用凸轮作用表面的先前外科器械实施方案随着其击发构件或刀穿过砧座从砧座中的最近侧起始位置行进到最远侧结束位置(夹头距离，以英寸为单位)所经历的击发力(FTF)和闭合力(FTC)的图形描绘；
图13B为采用渐进式闭合驱动系统的外科器械实施方案所经历的击发力(FTF)和闭合力(FTC)、砧座高度和弹簧高度的图形描绘；
图14为轴组件的一部分的局部透视图；
图15为另一个电动外科器械的一部分的侧正视图；
图16为图15的电动外科器械的一部分的局部透视图，其中为清楚起见省略了其多个部分；
图17为图15的电动外科器械的一部分的另一个局部透视图，其中为清楚起见省略了其多个部分；
图18为图15的电动外科器械的一部分的另一个局部透视图，其中为清楚起见省略了其多个部分；
图19为图15的电动外科器械的马达开关系统的透视图，其中为清楚起见省略了其多个部分；
图20为图15的电动外科器械的喷嘴组件的近侧喷嘴端或翅片段的透视图；
图21为图15的电动外科器械的多个部分的局部透视图，其中为清楚起见省略了远侧喷嘴部分；
图22为图15的电动外科器械的底座部分和近侧喷嘴段的一部分的侧正视图，其中为清楚起见省略了其喷嘴组件的多个部分；
图23为关于图15的电动外科器械的端部执行器的关节运动位置，图19的开关系统的开关的位置相对于其开关滑动件的位置的图形描绘；
图24为关于图15的电动外科器械的端部执行器的关节运动位置，图19的开关系统的开关的位置相对于开关滑动件的另一个位置的另一个图形描绘；
图25为关于图15的电动外科器械的端部执行器的关节运动位置，图19的开关系统的开关的位置相对于开关滑动件的另一个位置的另一个图形描绘；
图26为关于图15的电动外科器械的端部执行器的关节运动位置，图19的开关系统的开关的位置相对于开关滑动件的另一个位置的另一个图形描绘；
图27示出了可用于图19的开关系统中的三个不同开关滑动件实施方案的多个部分的形状；
图28为图27所示的每个几何开关滑动件形状的马达速度与联接到其的外科端部执行器的关节运动角度的图形比较；
图28A示出了可用于控制图16的电动外科器械的关节运动马达的控制电路的一种形式；
图29为另一个电动外科缝合系统的透视图；
图30为图29的电动外科缝合系统的轴组件的分解组装视图；
图31为图29的电动外科缝合系统的轴组件的一部分的透视图，其中为清楚起见省略了其多个部分；
图32A为图31的轴组件的一部分的在其闭合构件处于回缩位置时的俯视剖视图；
图32B为图32A所示的轴组件的该部分的在其闭合构件处于推进闭合位置时的另一个俯视剖视图；
图33为关节运动锁布置结构的局部剖面透视图；
图34为采用可移除轴组件的先前电动外科缝合系统的透视图；
图35为图34所示的先前可移除轴组件的透视图；
图36为图34的电动外科缝合系统的外壳或柄部部分的分解组装视图；
图37为图35的轴组件的局部分解组装视图；
图38为图35的轴组件的一部分的另一个局部分解组装视图；
图39为可与图36的柄部部分一起使用的另一个轴组件的一部分的透视图；
图40为图39的轴组件的近侧部分的侧视图，其中为清楚起见省略了其多个部分并且其多个部分以横截面示出；
图41为图40的轴组件沿图40中的线41-41截取的端部剖视图；
图42为图39的轴组件的一部分的分解组装视图；
图43为图39的轴组件的一部分的另一个分解组装视图；
图44为图39的轴组件的一部分的剖视图，其示出了轴组件的关节运动驱动器和离合器连接件之间的附接；
图45为图39的轴组件的一部分的分解透视图；
图46为图45的轴组件的一部分的透视图；
图47为图39的轴组件的脊轴插入件的一部分的透视图；
图48为图39的轴组件的一部分的另一个局部剖面透视图；
图49为处于接合位置的图39的轴组件的驱动离合器组件的剖视图；
图50为图39的轴组件的端视图，其中驱动离合器组件处于接合位置；
图51为图39的轴组件的一部分的后透视图，其示出了该轴组件的驱动离合器组件的位置，所述位置对应于附接到该轴组件的外科端部执行器的右关节运动位置；
图52为图39的轴组件的一部分的透视图，其示出了该轴组件的驱动离合器组件的位置，所述位置对应于附接到该轴组件的外科端部执行器的左关节运动位置；
图53为处于脱离接合位置的图39的轴组件的驱动离合器组件的另一个剖视图；
图54为图39的轴组件的端视图，其中驱动离合器组件处于脱离接合位置；
图55为可互换轴组件实施方案的一部分的局部剖面透视图；
图56为图55的可互换轴组件的一部分的局部透视图；
图57为图55和图56的可互换轴组件的一部分的局部分解组装视图；
图58为描述在图55和图56的可互换轴组件的操作期间的各种操作步骤和参数的图表；
图59为描述在图55和图56的可互换轴组件的操作期间的附加操作步骤和参数的另一个图表；
图60为移位筒组件的局部透视图，该移位筒组件处于其中其关节运动系统与图55和图56的轴组件的击发驱动系统接合的位置；
图61为处于图60所示位置的移位筒组件的另一个局部透视图，其中近侧闭合管段处于部分推进位置；
图62为图60和图61的移位筒组件的另一个局部透视图，该移位筒组件处于其中关节运动系统与击发驱动系统接合的位置；
图63为处于图62所示位置的移位筒组件的另一个局部透视图，其中近侧闭合管段处于完全回缩位置；
图64为处于图62所示位置的移位筒组件的另一个局部透视图，其中近侧闭合管段处于完全回缩位置；
图65为通过回位弹簧朝近侧偏压的移位筒组件的另一个局部透视图；
图66为移位筒组件的另一个局部透视图，其中关节运动系统与击发驱动系统和处于完全回缩位置的近侧闭合管段接合；
图67为电动外科器械的轴组件和柄部组件的局部侧正视图，示出了其喷嘴组件的致动以使其关节运动系统与其击发系统脱离接合；
图68为图67的轴组件的一部分的局部透视图，其中关节运动系统与击发驱动系统接合；
图69为图68的轴组件的一部分的另一个局部透视图，其中关节运动系统已脱离接合击发驱动系统；
图70为另一个轴组件实施方案的一部分的侧正视图，其中其近侧闭合管段处于完全回缩位置并且其关节运动系统与其击发系统接合；
图71为沿着图70中的线71-71截取的图70的轴组件的一部分的剖视图；
图72为图70和图71的轴组件的近侧闭合管段的一部分的局部侧视图；
图73为图70和图71的轴组件的近侧闭合管段的一部分的另一个侧视图，其中筒移位器销示出在闭合管段中的闭合狭槽中；
图74为图70至图72的轴组件的近侧闭合管段的一部分的另一个侧视图，其中筒移位器销示出在闭合管段中的闭合狭槽中的中途；
图75为另一个轴组件实施方案的一部分的侧正视图，其中其近侧闭合管段已朝远侧推进到其中其上的插片与其移位筒组件接触的点；
图76为图75的轴组件的近侧闭合管段的一部分的局部侧视图；
图77为穿过图75的轴组件的一部分的剖面端视图；
图78为图75的轴组件的另一个侧正视图，其中其移位器键处于“骑行模式”位置；
图79为另一个电动外科器械的一部分的透视图；
图80为图79的电动外科器械的柔性电路组件的一部分的局部顶视图；
图81为沿着图80中的线81-81截取的图80的柔性电路组件的一部分的剖视图；
图82为沿着图80中的线82-82截取的图80的柔性电路组件的一部分的另一个剖视图；
图83为图80的柔性电路组件的一部分和图79的电动外科器械的脊轴的一部分的局部分解组装视图；
图84为轴组件实施方案的一部分的局部透视图，其中为清楚起见省略了喷嘴组件的一部分，并且其近侧闭合管段处于完全回缩位置；
图85为图84的轴组件实施方案的一部分的另一个局部透视图，其近侧闭合管段处于完全推进位置；
图86为图84和图85的轴组件的一部分的分解组装视图；
图87为图84至图86的轴组件的一部分的横截面端视图，其中其锁定套管与其中间击发构件接合；
图88为图84和图85的轴组件的一部分的横截面侧正视图，其中其近侧关节运动驱动器处于未致动位置；
图89为图84和图85的轴组件的一部分的另一个横截面侧正视图，其中其近侧关节运动驱动器处于完全致动位置；
图90为图84至图86的轴组件的一部分的另一个横截面端视图，其中其锁定套管与其中间击发构件脱离接合；并且
图91为图84和图85的轴组件的局部透视图，其中为清楚起见省略了其多个部分。
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“METHOD FOR FAbricating SURGICAL STAPLER ANVILS”(代理人案卷号END8577USNP/180088m)的美国专利申请序列号________；
-名称为“REINFORCED DEFORMABLE ANVIL TIP FOR SURGICAL STAPLER ANVIL”(代理人案卷号END8578USNP/180393)的美国专利申请序列号________；
-名称为“SURGICAL STAPLER ANVILS WITH STAPLE DIRECTING PROTRUSIONS ANDTISSUE STABILITY FEATURES”(代理人案卷号END8579USNP/180089)的美国专利申请序列号________；
-名称为“FABRICATING TECHNIQUES FOR SURGICAL STAPLER ANVILS”(代理人案卷号END8580USNP/180090)的美国专利申请序列号________；
-名称为“SURGICAL STAPLING DEVICES WITH IMPROVED CLOSURE MEMBERS”(代理人案卷号END8581USNP/180091)的美国专利申请序列号________；
-名称为“SURGICAL STAPLER ANVILS WITH TISSUE STOP FEATURES CONFIGUREDTO AVOID TISSUE PINCH”(代理人案卷号END8582USNP/180092)的美国专利申请序列号________；
-名称为“METHOD FOR OPERATING A POWERED ARTICULATABLE SURGICALINSTRUMENT”(代理人案卷号END8583USNP/180093M)的美国专利申请序列号________；
-名称为“SURGICAL INSTRUMENTS WITH PROGRESSIVE JAW CLOSUREARRANGEMENTS”(代理人案卷号END8584USNP/180094)的美国专利申请序列号________；
-名称为“POWERED SURGICAL INSTRUMENTS WITH CLUTCHING ARRANGEMENTS TOCONVERT LINEAR DRIVE MOTIONS TO ROTARY DRIVE MOTIONS”(代理人案卷号END8585USNP/180095)的美国专利申请序列号________；
-名称为“ARTICULATABLE MOTOR POWERED SURGICAL INSTRUMENTS WITHDEDICATED ARTICULATION MOTOR ARRANGEMENTS”(代理人案卷号END8587USNP/180097)的美国专利申请序列号________；
-名称为“SWITCHING ARRANGEMENTS FOR MOTOR POWERED ARTICULATABLESURGICAL INSTRUMENTS”(代理人案卷号END8588USNP/180098)的美国专利申请序列号________；以及
-名称为“SURGICAL INSTRUMENT ANVIL”(代理人案卷号END8581USDP/180099D)的美国专利申请序列号________。
本申请的申请人拥有各自全文以引用方式并入本文的以下美国专利申请和美国专利：
-名称为“SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIESTHEREOF”的美国专利申请序列号15/386,185，美国专利申请公布2018/-0168642；
-名称为“ARTICULATABLE SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,230，美国专利申请公布2018/-0168649；
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS”的美国专利申请序列号15/386,221，美国专利申请公布2018/-01686；
-名称为“SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF”的美国专利申请序列号15/386,209，美国专利申请公布2018-0168645；
-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，美国专利申请公布2018-0168644；
-名称为“SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR”的美国专利申请序列号15/386,240，美国专利申请公布2018-0168651；
-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，美国专利申请公布2018-0168629；
-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，美国专利申请公布2018-0168630；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,943，美国专利申请公布2018-0168631；
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTIONFEATURES”的美国专利申请序列号15/385,950，美国专利申请公布2018-0168635；
-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；美国专利申请公布2018-0168632；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,946，美国专利申请公布2018-0168633；
-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，美国专利申请公布2018-0168636；
-名称为“METHODS OF STAPLING TISSUE”的美国专利申请序列号15/385,953，美国专利申请公布2018/-0168637；
-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，美国专利申请公布2018-0168638；
-名称为“SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOPARRANGEMENTS”的美国专利申请序列号15/385,955，美国专利申请公布2018-0168639；
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,948，美国专利申请公布2018-0168584；
-名称为“SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号15/385,956，美国专利申请公布2018-0168640；
-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，美国专利申请公布2018-0168641；
-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，美国专利申请公布2018-0168634；
-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，美国专利申请公布2018-0168597；
-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，美国专利申请公布2018-0168599；
-名称为“SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL”的美国专利申请序列号15/385,899，美国专利申请公布2018-0168600；
-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，美国专利申请公布2018-0168602；
-名称为“SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER”的美国专利申请序列号15/385,902，美国专利申请公布2018-0168603；
-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，美国专利申请公布2018-0168605；
-名称为“FIRING ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,905，美国专利申请公布2018-0168606；
-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，美国专利申请公布2018-0168608；
-名称为“FIRING ASSEMBLY COMPRISING A FUSE”的美国专利申请序列号15/385,908，美国专利申请公布2018-0168609；
-名称为“FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE”的美国专利申请序列号15/385,909，美国专利申请公布2018-0168610；
-名称为“STAPLE-FORMING POCKET ARRANGEMENTS”的美国专利申请序列号15/385,920，美国专利申请公布2018-0168620；
-名称为“ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS”的美国专利申请序列号15/385,913，美国专利申请公布2018-0168614；
-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，美国专利申请公布2018-0168615；
-名称为“BILATERALLY ASYMMETRIC STAPLE-FORMING POCKET PAIRS”的美国专利申请序列号15/385,893，美国专利申请公布2018-0168594；
-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，美国专利申请公布2018-0168626；
-名称为“SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING ANDFIRING SYSTEMS”的美国专利申请序列号15/385,911，现为美国专利申请公布2018-0168612；
-名称为“SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES”的美国专利申请序列号15/385,927，美国专利申请公布2018/-0168625；
-名称为“STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPINGBREADTHS”的美国专利申请序列号15/385,917，现为美国专利申请公布2018-0168617；
-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，美国专利申请公布2018-0168601；
-名称为“NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FORSURGICAL STAPLERS”的美国专利申请序列号15/385,931，美国专利申请公布2018-0168627；
-名称为“FIRING MEMBER PIN ANGLE”的美国专利申请序列号15/385,915，美国专利申请公布2018-0168616；
-名称为“STAPLE-FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMINGSURFACE GROOVES”的美国专利申请序列号15/385,897，美国专利申请公布2018-0168598；
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES”的美国专利申请序列号15/385,922，美国专利申请公布2018-0168622；
-名称为“SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS”的美国专利申请序列号15/385,924，美国专利申请公布2018-0168624；
-名称为“ANVIL HAVING A KNIFE SLOT WIDTH”的美国专利申请序列号15/385,910，美国专利申请公布2018-0168611；
-名称为“CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号15/385,903，美国专利申请公布2018/-0168604；
-名称为“FIRING MEMBER PIN CONFIGURATIONS”的美国专利申请序列号15/385,906，美国专利申请公布2018-0168607；
-名称为“STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES”的美国专利申请序列号15/386,188，美国专利申请公布2018-0168585；
-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，美国专利申请公布2018-0168643；
-名称为“STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES”的美国专利申请序列号15/386,206，美国专利申请公布2018-0168586；
-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，美国专利申请公布2018-0168648；
-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，美国专利申请公布2018-0168647；
-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，美国专利申请公布2018-0168650；
-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，美国专利申请公布2018-0168589；
-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，美国专利申请公布2018-0168590；
-名称为“SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE ANDRETRACTABLE SYSTEMS”的美国专利申请序列号15/385,890，美国专利申请公布2018-0168591；
-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，美国专利申请公布2018-0168592；
-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，美国专利申请公布2018-0168593；
-名称为“SHAFT ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,894，美国专利申请公布2018-0168595；
-名称为“SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATIONLOCKOUTS”的美国专利申请序列号15/385,895，美国专利申请公布2018-0168596；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,916，美国专利申请公布2018-0168575；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,918，美国专利申请公布2018-0168618；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,919，美国专利申请公布2018-0168619；
-名称为“SURGICAL STAPLE CARTRIDGE WITH MOVABLE CAMMING MEMBERCONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES”的美国专利申请序列号15/385,921，美国专利申请公布2018-0168621；
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,923，美国专利申请公布2018-0168623；
-名称为“JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OFA FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN UNFIRED CARTRIDGE ISINSTALLED IN THE END EFFECTOR”的美国专利申请序列号15/385,925，美国专利申请公布2018-0168576；
-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，美国专利申请公布2018-0168577；
-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，美国专利申请公布2018-0168578；
-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，美国专利申请公布2018-0168579；
-名称为“ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFTARRANGEMENT”的美国专利申请序列号15/385,932，美国专利申请公布2018-0168628；
-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，美国专利申请公布2018-0168580；
-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，美国专利申请公布2018-0168581；
-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，美国专利申请公布2018-0168582；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKEAMPLIFICATION FEATURES”的美国专利申请序列号15/385,936，美国专利申请公布2018-0168583；
-名称为“FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENTCONFIGURATIONS”的美国专利申请序列号14/318,996，美国专利申请公布2015-0297228；
-名称为“FASTENER CARTRIDGE COMPRISING FASTENER CAVITIES INCLUDINGFASTENER CONTROL FEATURES”的美国专利申请序列号14/319,006，现为美国专利10,010,324；
-名称为“SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZINGARRANGEMENTS”的美国专利申请序列号14/318,991，现为美国专利9,833,241；
-名称为“SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITORINGARRANGEMENTS”的美国专利申请序列号14/319,004，现为美国专利9,844,369；
-名称为“FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS”的美国专利申请序列号14/319,008，美国专利申请公布2015-0297232；
-名称为“FASTENER CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGINGMEMBERS”的美国专利申请序列号14/318,997，现为美国专利申请公布2015-0297229；
-名称为“FASTENER CARTRIDGE COMPRISING TISSUE CONTROL FEATURES”的美国专利申请序列号14/319,002，现为美国专利9,877,721；
-名称为“FASTENER CARTRIDGE ASSEMBLIES AND STAPLE RETAINER COVERARRANGEMENTS”的美国专利申请序列号14/319,013，美国专利申请公布2015-0297233；以及
-名称为“FASTENER CARTRIDGE INCLUDING A LAYER ATTACHED THERETO”的美国专利申请序列号14/319,016，美国专利申请公布2015-0297235。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES”的美国专利申请序列号15/191,775；
-名称为“STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPEDSTAPLES”的美国专利申请序列号15/191,807；
-名称为“STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME”的美国专利申请序列号15/191,834；
-名称为“STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES”的美国专利申请序列号15/191,788；以及
-名称为“STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL STAPLE ROWS”的美国专利申请序列号15/191,818。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,218；
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,227；
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,259；以及
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,264。
本申请的申请人拥有于2016年4月1日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM”的美国专利申请序列号15/089,325；
-名称为“MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY”的美国专利申请序列号15/089,321；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD”的美国专利申请序列号15/089,326；
-名称为“SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIPPORTION”的美国专利申请序列号15/089,263；
-名称为“ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLEBAILOUT SYSTEM”的美国专利申请序列号15/089,262；
-名称为“SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVILCONCENTRIC DRIVE MEMBER”的美国专利申请序列号15/089,277；
-名称为“INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL ENDEFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS”的美国专利申请序列号15/089,296；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION”的美国专利申请序列号15/089,258；
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVECUTTING OF TISSUE”的美国专利申请序列号15/089,278；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT”的美国专利申请序列号15/089,284；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSIONLOCKOUT”的美国专利申请序列号15/089,295；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT”的美国专利申请序列号15/089,300；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT”的美国专利申请序列号15/089,196；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT”的美国专利申请序列号15/089,203；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGELOCKOUT”的美国专利申请序列号15/089,210；
-名称为“SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM”的美国专利申请序列号15/089,324；
-名称为“SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS”的美国专利申请序列号15/089,335；
-名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/089,339；
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OFSTAPLES HAVING DIFFERENT HEIGHTS”的美国专利申请序列号15/089,253；
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET”的美国专利申请序列号15/089,304；
-名称为“ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS”的美国专利申请序列号15/089,331；
-名称为“STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES”的美国专利申请序列号15/089,336；
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUESUPPORT”的美国专利申请序列号15/089,312；
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM”的美国专利申请序列号15/089,309；以及
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL”的美国专利申请序列号15/089,349。
本申请的申请人还拥有于2015年12月31日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE INPOWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/984,488；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/984,525；以及
-名称为“SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROLCIRCUITS”的美国专利申请序列号14/984,552。
本申请的申请人还拥有于2016年2月9日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLYTRANSLATABLE END EFFECTOR”的美国专利申请序列号15/019,220；
-名称为“SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,228；
-名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTEDSECONDARY CONSTRAINT”的美国专利申请序列号15/019,196；
-名称为“SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLYARTICULATABLE RELATIVE TO AN ELONGATED SHAFT ASSEMBLY”的美国专利申请序列号15/019,206；
-名称为“SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,215；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATIONLINK ARRANGEMENTS”的美国专利申请序列号15/019,227；
-名称为“SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLEDRIVEN ARTICULATION SYSTEMS”的美国专利申请序列号15/019,235；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAMARRANGEMENTS”的美国专利申请序列号15/019,230；以及
-名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTIONARRANGEMENTS”的美国专利申请序列号15/019,245。
本申请的申请人还拥有于2016年2月12日提交且各自全文以引用方式并入本文的如下标识的美国专利申请：
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,254；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,259；
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,275；以及
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,289。
本申请的申请人拥有于2015年6月18日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL END EFFECTORS WITH POSITIVE JAW OPENINGARRANGEMENTS”的美国专利申请序列号14/742,925；
-名称为“SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSINGFEATURES”的美国专利申请序列号14/742,941；
-名称为“MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,914；
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAMSTRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT”的美国专利申请序列号14/742,900；
-名称为“DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,885；以及
-名称为“PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,876。
本申请的申请人拥有于2015年3月6日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“POWERED SURGICAL INSTRUMENT”的美国专利申请序列号14/640,746，现为美国专利申请公布2016/0256184；
-名称为“MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/640,795，现为美国专利申请公布2016/02561185；
-名称为“ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURERATES FOR MULTIPLE TISSUE TYPES”的美国专利申请序列号14/640,832，现为美国专利申请公布2016/0256154；
-名称为“OVERLAID MULTI SENSOR RADIO FREQUENCY(RF)ELECTRODE SYSTEM TOMEASURE TISSUE COMPRESSION”的美国专利申请序列号14/640,935，现为美国专利申请公布2016/0256071；
-名称为“MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTORFOR POWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/640,831，现为美国专利申请公布2016/0256153；
-名称为“TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINESTABILITY,CREEP,AND VISCOELASTIC ELEMENTS OF MEASURES”的美国专利申请序列号14/640,859，现为美国专利申请公布2016/0256187；
-名称为“INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/640,817，现为美国专利申请公布2016/0256186；
-名称为“CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULARSHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE”的美国专利申请序列号14/640,844，现为美国专利申请公布2016/0256155；
-名称为“SMART SENSORS WITH LOCAL SIGNAL PROCESSING”的美国专利申请序列号14/640,837，现为美国专利申请公布2016/0256163；
-名称为“SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGEINTO A SURGICAL STAPLER”的美国专利申请序列号14/640,765，现为美国专利申请公布2016/0256160；
-名称为“SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON AROTATABLE SHAFT”的美国专利申请序列号14/640,799，现为美国专利申请公布2016/0256162；以及
-名称为“SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING”的美国专利申请序列号14/640,780，现为美国专利申请公布2016/0256161。
本申请的申请人拥有于2015年2月27日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION”的美国专利申请序列号14/633,576，现为美国专利申请公布2016/0249919；
-名称为“SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCEPARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND”的美国专利申请序列号14/633,546，现为美国专利申请公布2016/0249915；
-名称为“SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONEOR MORE BATTERIES”的美国专利申请序列号14/633,560，现为美国专利申请公布2016/0249910；
-名称为“CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FORCHARGING A BATTERY”的美国专利申请序列号14/633,566，现为美国专利申请公布2016/0249918；
-名称为“SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TOBE SERVICED”的美国专利申请序列号14/633,555，现为美国专利申请公布2016/0249916；
-名称为“REINFORCED BATTERY FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,542，现为美国专利申请公布2016/0249908；
-名称为“POWER ADAPTER FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,548，现为美国专利申请公布2016/0249909；
-名称为“ADAPTABLE SURGICAL INSTRUMENT HANDLE”的美国专利申请序列号14/633,526，现为美国专利申请公布2016/0249945；
-名称为“MODULAR STAPLING ASSEMBLY”的美国专利申请序列号14/633,541，现为美国专利申请公布2016/0249927；以及
-名称为“SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFEPARAMETER”的美国专利申请序列号14/633,562，现为美国专利申请公布2016/0249917。
本申请的申请人拥有于2014年12月18日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE ENDEFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER”的美国专利申请序列号14/574,478，现为美国专利申请公布2016/0174977；
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS”的美国专利申请序列号14/574,483，现为美国专利申请公布2016/0174969；
-名称为“DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS”的美国专利申请序列号14/575,139，现为美国专利申请公布2016/0174978；
-名称为“LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITHARTICULATABLE SURGICAL END EFFECTORS”的美国专利申请序列号14/575,148，现为美国专利申请公布2016/0174976；
-名称为“SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLEABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE的美国专利申请序列号14/575,130，现为美国专利申请公布2016/0174972；
-名称为“SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS”的美国专利申请序列号14/575,143，现为美国专利申请公布2016/0174983；
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDMOVABLE FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,117，现为美国专利申请公布2016/0174975；
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDIMPROVED FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,154，现为美国专利申请公布2016/0174973；
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLEARTICULATION SYSTEM”的美国专利申请序列号14/574,493；现为美国专利申请公布2016/0174970；以及
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLEARTICULATION SYSTEM”的美国专利申请序列号14/574,500，现为美国专利申请公布2016/0174971。
本申请的申请人拥有2013年3月1日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“Articulatable Surgical Instruments With Conductive PathwaysFor Signal Communication”的美国专利申请序列号13/782,295，现为美国专利申请公布2014/0246471；
-名称为“Rotary Powered Articulation Joints For Surgical Instruments”的美国专利申请序列号13/782,323，现为美国专利申请公布2014/0246472；
-名称为“Thumbwheel Switch Arrangements For Surgical Instruments”的美国专利申请序列号13/782,338，现为美国专利申请公布2014/0249557；
-名称为“Electromechanical Surgical Device with Signal RelayArrangement”的美国专利申请序列号13/782,499，现为美国专利申请公布9,358,003；
-名称为“Multiple Processor Motor Control for Modular SurgicalInstruments”的美国专利申请序列号13/782,460，现为美国专利申请公布2014/0246478；
-名称为“Joystick Switch Assemblies For Surgical Instruments”的美国专利申请序列号13/782,358，现为美国专利申请公布9,326,767；
-名称为“Sensor Straightened End Effector During Removal ThroughTrocar”的美国专利申请序列号13/782,481，现为美国专利申请公布9,468,438；
-名称为“Control Methods for Surgical Instruments with RemovableImplement Portions”的美国专利申请序列号13/782,518，现为美国专利申请公布2014/0246475；
-名称为“Rotary Powered Surgical Instruments With Multiple Degrees ofFreedom”的美国专利申请序列号13/782,375，现为美国专利申请公布9,398,911；以及
-名称为“Surgical Instrument Soft Stop”的美国专利申请序列号13/782,536，现为美国专利申请公布9,307,986。
本申请的申请人还拥有2013年3月14日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE”的美国专利申请序列号13/803,097，现为美国专利申请公布2014/0263542；
-名称为“CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICALINSTRUMENT”的美国专利申请序列号13/803,193，现为美国专利申请公布9,332,987；
-名称为“INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICALINSTRUMENT”的美国专利申请序列号13/803,053，现为美国专利申请公布2014/0263564；
-名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATIONLOCK”的美国专利申请序列号13/803,086，现为美国专利申请公布2014/0263541；
-名称为“SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FORSURGICAL INSTRUMENTS”的美国专利申请序列号13/803,210，现为美国专利申请公布2014/0263538；
-名称为“MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT”的美国专利申请序列号13/803,148，现为美国专利申请公布2014/0263554；
-名称为“DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/803,066，现为美国专利申请公布2014/0263565；
-名称为“ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICALINSTRUMENTS”的美国专利申请序列号13/803,117，现为美国专利申请公布9,351,726；
-名称为“DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/803,130，现为美国专利申请公布9,351,727；以及-名称为“METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT”的美国专利申请序列号13/803,159，现为美国专利申请公布2014/0277017。
本申请的申请人还拥有于2014年3月7日提交且全文以引用方式并入本文的以下专利申请：
-名称为“CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/200,111，现为美国专利申请公布2014/0263539。
本申请的申请人还拥有于2014年3月26日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,106，现为美国专利申请公布2015/0272582；
-名称为“STERILIZATION VERIFICATION CIRCUIT”的美国专利申请序列号14/226,099，现为美国专利申请公布2015/0272581；
-名称为“VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT”的美国专利申请序列号14/226,094，现为美国专利申请公布2015/0272580；
-名称为“POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUITAND WAKE UP CONTROL”的美国专利申请序列号14/226,117，现为美国专利申请公布2015/0272574；
-名称为“MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFTASSEMBLIES”的美国专利申请序列号14/226,075，现为美国专利申请公布2015/0272579；
-名称为“FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICALINSTRUMENTS”的美国专利申请序列号14/226,093，现为美国专利申请公布2015/0272569；
-名称为“SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION”的美国专利申请序列号14/226,116，现为美国专利申请公布2015/0272571；
-名称为“SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETYPROCESSOR”的美国专利申请序列号14/226,071，现为美国专利申请公布2015/0272578；
-名称为“SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS”的美国专利申请序列号14/226,097，现为美国专利申请公布2015/0272570；
-名称为“INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,126，现为美国专利申请公布2015/0272572；
-名称为“MODULAR SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号14/226,133，现为美国专利申请公布2015/0272557；
-名称为“SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT”的美国专利申请序列号14/226,081，现为美国专利申请公布2015/0277471；
-名称为“POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLEVOLTAGE PROTECTION”的美国专利申请序列号14/226,076，现为美国专利申请公布2015/0280424；
-名称为“SURGICAL STAPLING INSTRUMENT SYSTEM”的美国专利申请序列号14/226,111，现为美国专利申请公布2015/0272583；以及
-名称为“SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT”的美国专利申请序列号14/226,125，现为美国专利申请公布2015/0280384。
本申请的申请人还拥有2014年9月5日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,103，现为美国专利申请公布2016/0066912；
-名称为“ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUECOMPRESSION”的美国专利申请序列号14/479,119，现为美国专利申请公布2016/0066914；
-名称为“MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION”的美国专利申请序列号14/478,908，现为美国专利申请公布2016/0066910；
-名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'SOUTPUT OR INTERPRETATION”的美国专利申请序列号14/478,895，现为美国专利申请公布2016/0066909；
-名称为“POLARITY OF HALL MAGNET TO DETECT MISLOADED CARTRIDGE”的美国专利申请序列号14/479,110，现为美国专利申请公布2016/0066915；
-名称为“SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION”的美国专利申请序列号14/479,098，现为美国专利申请公布2016/0066911；
-名称为“MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,115，现为美国专利申请公布2016/0066916；以及
-名称为“LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION”的美国专利申请序列号14/479,108，现为美国专利申请公布2016/0066913。
本申请的申请人还拥有2014年4月9日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVESHAFTS”的美国专利申请序列号14/248,590，现为美国专利申请公布2014/0305987；
-名称为“SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRINGDRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT”的美国专利申请序列号14/248,581，现为美国专利申请公布2014/0305989；
-名称为“SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLINGTHE OPERATION OF THE SURGICAL INSTRUMENT”的美国专利申请序列号14/248,595，现为美国专利申请公布2014/0305988；
-名称为“POWERED LINEAR SURGICAL STAPLER”的美国专利申请序列号14/248,588，现为美国专利申请公布2014/0309666；
-名称为“TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/248,591，现为美国专利申请公布2014/0305991；
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENTFEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS”的美国专利申请序列号14/248,584，现为美国专利申请公布2014/0305994；
-名称为“POWERED SURGICAL STAPLER”的美国专利申请序列号14/248,587，现为美国专利申请公布2014/0309665；
-名称为“DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICALINSTRUMENT”的美国专利申请序列号14/248,586，现为美国专利申请公布2014/0305990；以及
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUSINDICATION ARRANGEMENTS”的美国专利申请序列号14/248,607，现为美国专利申请公布2014/0305992。
本申请的申请人还拥有于2013年4月16日提交且各自全文以引用方式并入本文的以下专利申请：
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,365；
-名称为“LINEAR CUTTER WITH POWER”的美国临时专利申请序列号61/812,376；
-名称为“LINEAR CUTTER WITH MOTOR AND PISTOL GRIP”的美国临时专利申请序列号61/812,382；
-名称为“SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS ANDMOTOR CONTROL”的美国临时专利申请序列号61/812,385；以及
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,372。
本文列出了许多具体细节，以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件，以免使说明书中描述的实施方案模糊不清。读者将会理解，本文所述和所示的实施方案为非限制性示例，从而可认识到，本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求的范围的情况下，可对这些实施方案进行变型和改变。
术语“包括(comprise)”(以及“包括(comprise)”的任何形式，诸如“包括(comprises)”和“包括(comprising)”)、“具有(have)”(以及“具有(have)”的任何形式，诸如“具有(has)”和“具有(having)”)、“包含(include)”(以及“包含(include)”的任何形式，诸如“包含(includes)”和“包含(including)”)、以及“含有(contain)”(以及“含有(contain)”的任何形式，诸如“含有(contains)”和“含有(containing)”)为开放式系动词。因此，“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件，但不限于仅具有这些一个或多个元件。同样，“包括”、“具有”、“包含”或“含有”一个或多个特征部的系统、装置、或设备的元件具有那些一个或多个特征部，但不限于仅具有那些一个或多个特征部。
术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分，术语“远侧”是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而，外科器械在许多取向和方位中使用，并且这些术语并非是限制性的和/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。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手术和应用中，包括例如与开放式外科手术结合。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。第二钳口能够围绕闭合轴线相对于第一钳口枢转；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抵靠平台夹持。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。钉腔被布置成六个纵向排。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结构也是可能的。
钉由仓体中的钉驱动器支撑。驱动器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。驱动器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。驱动器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器下方滑动以及提升驱动器，并且钉在驱动器上受到支撑。
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。随着击发构件朝远侧推进，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获的组织的刀。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示出了可再利用或不可再利用的马达驱动外科切割和紧固器械10。在例示的实施方案中，器械10包括外壳100，该外壳包括被构造成能够被临床医生抓持、操纵和致动的柄部110。在例示的示例中，专用轴组件1000可操作地联接到柄部110。然而，在另选的实施方案中，柄部组件被构造成能够与各种不同的可互换轴组件一起使用，每个可互换轴组件具有可操作地联接到其的外科端部执行器，该外科端部执行器被构造成能够执行一个或多个外科任务或手术。例如，本文所公开的可互换轴组件可与2011年5月27日提交的名称为“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9,072,535)中公开的各种机器人系统、器械、部件和方法一起使用，该专利全文以引用方式并入本文。
继续参阅本具体实施方式，将会理解，轴组件1000的各个方面也可有效地与机器人控制的外科系统结合使用。因此，术语“外壳”也可涵盖机器人系统的容纳或以其他方式可操作地支撑至少一个驱动系统或以其他方式与至少一个驱动系统相关联的外壳或类似部分，该至少一个驱动系统被构造成能够生成和施加可用于致动本文所公开的可互换轴组件及其相应的等同物的至少一个控制动作。术语“框架”可指手持式外科器械的一部分。术语“框架”还可表示机器人控制的外科器械的一部分和/或机器人系统的可用于可操作地控制外科器械的一部分。此外，各种部件可“容纳”或包含在外壳中，或者各种部件可与外壳“相关联”。在此类实例中，部件可不容纳在外壳内或由外壳直接支撑。
例示的实施方案为内窥镜式器械，并且一般来讲，本文所述的器械10的实施方案为内窥镜式外科切割和紧固器械。然而，应当指出的是，根据各种实施方案，器械可为例如非内窥镜式外科切割和紧固器械。各种外科器械公开于以下专利中：名称为“SURGICALINSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利7,845,537；名称为“POWEREDSURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRINGSYSTEM”的美国专利8,608,045；以及名称为“MOTORIZED SURGICAL INSTRUMENT”的美国专利9,050,083，这些专利的全部公开内容据此以引用方式并入本文。
转到图2，在例示的示例中，轴组件1000包括端部执行器1500，该端部执行器被构造成能够切割和缝合组织。端部执行器1500包括第一钳口1510和可运动地支撑在第一钳口1510上的第二钳口1600。第一钳口包括细长通道1520，该细长通道被构造成能够在其中可操作地支撑外科钉仓1540。第二钳口1600包括砧座1610，该砧座包括细长砧座主体1612和砧座安装部分1620。然而，设想了另选的布置结构，其中第一钳口包括砧座，并且第二钳口包括外科钉仓或被构造成能够支撑外科钉仓的通道。在例示的示例中，细长砧座主体1612在其上包括钉成形下表面1614，该钉成形下表面适于与外科钉仓1540成面对关系。砧座1610通过形成于砧座安装部分1620上的一对砧座耳轴1622被枢转地支撑在或可运动地支撑在细长通道1520上。每个耳轴1622被枢转地接收在形成于细长通道1520的近侧端部部分中的对应耳轴支架1524中。耳轴1622通过砧座保持器1530被枢转地保持在其相应的支架1524内。
仍然参见图2，轴组件1000包括脊组件1200，该脊组件包括脊轴1210，该脊轴被构造成能够：(一)在其中可滑动地支撑击发构件组件1900，以及(二)可滑动地支撑围绕脊组件1200延伸的闭合构件组件2000。脊组件1200还包括由脊轴1210支撑的上脊支柱1220和下脊支柱1230。如图2中可见，脊轴1210的远侧端部1212终止于上凸耳安装特征部1240和下凸耳安装特征部1250。上凸耳安装特征部1240在其中形成有凸耳狭槽1242，该凸耳狭槽适于在其中安装地支撑上脊支柱1220的远侧端部1222。类似地，下凸耳安装特征部1250在其中形成有凸耳狭槽1252，该凸耳狭槽适于在其中安装地支撑下脊支柱1230的远侧端部1232。上脊支柱1220的远侧端部1222在其中包括枢轴承窝1224，该枢轴承窝适于在其中可旋转地接收枢轴销1532，该枢轴销形成在通道盖或砧座保持器1530上。下脊支柱1230的远侧端部1232包括下枢轴销1234，该下枢轴销适于被接收在形成于细长通道1520的近侧端部部分1522中的枢轴孔(未示出)内。下枢轴销1234与枢轴承窝1224竖直对准以限定关节运动轴线AA，外科端部执行器1500可围绕该关节运动轴线AA相对于轴1000进行关节运动。参见图3。
在例示的布置结构中，闭合构件组件2000包括近侧闭合管段或闭合构件段2010。近侧闭合管段2010可操作地联接到限定关节运动接头2105的双枢轴闭合套管组件2020，端部执行器1500可围绕该关节运动接头相对于轴组件1000的剩余部分进行关节运动。然而，其他轴组件可能无法进行关节运动。如图2中可见，在一种形式中，双枢轴闭合套管组件2020包括中间闭合管段2030，该中间闭合管段附接到近侧闭合管段2010的远侧端部2012。此外，双枢轴闭合套管组件2020包括具有朝远侧突出的上柄脚2042和下柄脚2044的端部执行器闭合管或远侧闭合管2040。上部双枢轴连接件2060包括向上突出的远侧枢轴销和近侧枢轴销，这些枢轴销分别接合中间闭合管段2030上的朝近侧突出的上柄脚2042中的上部远侧销孔以及朝远侧突出的上柄脚2032中的上部近侧销孔。下部双枢轴连接件2070包括向上突出的远侧枢轴销和近侧枢轴销，这些枢轴销分别接合朝近侧突出的下柄脚2044中的下部远侧销孔以及朝远侧突出的下柄脚2034中的下部近侧销孔。参见图2和图3。
如将在下文中进一步详细地讨论，通过使闭合构件组件2000在远侧方向(方向“DD”)上平移，使砧座1610从打开位置运动到闭合位置。通过朝近侧平移闭合构件组件2000来打开砧座1610，这使得端部执行器闭合套管2020与砧座1610交接并将砧座枢转至打开位置。参见图4和图5，在至少一种布置结构中，远侧闭合构件或端部执行器闭合管2040采用两个轴向偏置的近侧正钳口开口特征部2050和远侧正钳口开口特征部2052。在图4和图5中，近侧正钳口开口特征部2050位于轴轴线SA的右侧(如工具组件的使用者所观察的角度)。正钳口开口特征部2050、2052被构造成能够与形成于砧座安装部分1620上的对应的释放区域(未示出)和阶梯部分(未示出)交接，如在2017年6月28日提交的名称为“SURGICALINSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER”的美国专利申请序列号15/635,631以及并入本文中的其他参考文献中进一步详细描述的，该专利申请的全部公开内容以引用方式并入本文。也可采用其他钳口开口布置结构。
在例示的示例以及并入本文的参考文献中公开的其他砧座构型中，砧座安装部分1620具有形成于其上的一个或多个凸轮表面1624。随着端部执行器闭合管2040朝远侧运动，形成于端部执行器闭合管2040的远侧端部上的凸轮表面与砧座安装部分1620上的凸轮表面1624交接，以使砧座1610凸轮运动到闭合位置。
同样如上所述，轴组件1000还包括击发构件组件1900，该击发构件组件被支撑以便在脊轴1210内轴向行进。击发构件组件1900包括中间击发轴部分1910，该中间击发轴部分被构造用于附接到远侧切割部分或刀杆1930。中间击发轴部分1910可在其远侧端部中包括纵向狭槽1912，该纵向狭槽可被构造成能够接收远侧刀杆1930的近侧端部上的插片1932。纵向狭槽1912和近侧端部插片1932可被设定尺寸并被构造成能够允许该纵向狭槽和该近侧端部插片之间的相对运动并且可包括滑动接头1940。滑动接头1940可例如允许刀杆1930相对于中间击发轴部分1910轴向运动，以适应端部执行器1500的关节运动。刀杆1930包括刀部分1950并且包括上部砧座接合插片1954和下部通道接合插片1956，该刀部分包括刀片或组织切割刃1952。各种击发构件构型和操作公开于以引用方式并入本文的各种其他参考文献中。
在例示的示例中，外科端部执行器1500能够由关节运动驱动系统2100围绕关节运动轴线AA选择性地进行关节运动。在一种形式中，关节运动驱动系统2100包括近侧关节运动驱动器2110，该近侧关节运动驱动器可操作地联接到中间关节运动驱动器2120，该中间关节运动驱动器枢转地联接到远侧关节运动连接件2130。如图4和图5中可以最具体地看出，在中间关节运动驱动器2120的远侧端部上形成偏置附接凸耳2122。枢轴孔2123形成于偏置附接凸耳2122中，并且被构造成能够将形成于远侧关节运动连接件2130的近侧端部2132上的近侧连接件销2134枢转地接收在其中。关节运动连接件2120的远侧端部2136包括枢轴孔2138，该枢轴孔被构造成能够在其中枢转地接收通道销1526，该通道销形成在细长通道1520的近侧端部部分1522上。因此，中间关节运动驱动器2120的轴向运动将由此向细长通道1520施加关节运动动作，从而使外科端部执行器1500围绕关节运动轴线AA相对于脊组件1200进行关节运动。
现在转到图6和图7，柄部110包括柄部外壳段116、118，这些柄部外壳段配合以形成可由临床医生抓握和操纵的手枪式握把部119。如将在下面更详细地讨论的，柄部110在其中可操作地支撑多个驱动系统，该多个驱动系统被构造成能够产生各种控制动作并将这些控制动作施加到轴组件1200。现在参见图2，柄部110还可包括可操作地支撑多个驱动系统的框架组件或底座200。例如，框架组件200可以可操作地支撑“第一”或闭合驱动系统(通常表示为300)，该“第一”或闭合驱动系统可用于将闭合动作和打开动作施加到轴组件1000的端部执行器1500。在例示的示例中，框架组件200包括右框架部分210和框架盖212，该框架盖通过按扣特征部、凸耳、螺钉等附接到该框架组件以在其中限定梭动件腔214。参见图6和图7。
在至少一种形式中，闭合驱动系统300可包括闭合触发器332形式的致动器，该闭合触发器由框架组件200可枢转地支撑。更具体地，如图6和图7所示，闭合触发器332通过销333枢转地联接到框架组件200。此类布置结构使闭合触发器332能够被临床医生操纵，使得当临床医生抓握柄部100的手枪式握把部119时，闭合触发器332可被其轻易地从起始或“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。闭合触发器332可由弹簧或其他偏压布置结构偏压到未致动位置中。在各种形式中，闭合驱动系统300还包括可枢转地联接到闭合触发器1032的闭合连杆组件340。如图6中可见，闭合连杆组件340可包括各自通过销335可枢转地联接到闭合触发器332的第一闭合连接件342和第二闭合连接件344。
仍参见图6，可观察到，第一闭合连接件342可在其上具有锁定壁或锁定端部345，该锁定壁或锁定端部被构造成能够与枢转地联接到右框架部分210的闭合释放组件350配合。在至少一种形式中，闭合释放组件350可包括释放按钮组件352，该释放按钮组件具有形成于其上的朝远侧突出的锁定棘爪354。释放按钮组件352可被释放弹簧(未示出)沿逆时针方向枢转。临床医生将闭合触发器332从其未致动位置朝向柄部100的手枪式握把部119压下时，第一闭合连接件342向上枢转至某个点，其中锁定棘爪354落入该点中以与第一闭合连接件344上的锁定壁345保持接合，从而阻止闭合触发器332返回未致动位置。因此，闭合释放组件350用来将闭合触发器332锁定在完全致动位置。当临床医生期望将闭合触发器332解锁以允许其被偏压到未致动位置时，临床医生只需枢转闭合释放按钮组件352，使得锁定棘爪354运动成与第一闭合连接件344上的锁定壁345脱离接合。当锁定棘爪354已运动成与第一闭合连接件344脱离接合时，闭合触发器332可枢转回到未致动位置。也可采用其他闭合触发器锁定布置结构和释放布置结构。
在例示的示例中，臂355从闭合释放按钮352延伸。磁性元件356(诸如永磁体)例如可安装到臂355。当闭合释放按钮352从其第一位置旋转到其第二位置时，磁性元件356可朝向电路板400运动。电路板400可包括至少一个传感器，该至少一个传感器被构造成能够检测磁性元件356的运动。在至少一个实施方案中，例如，“霍尔效应”传感器(未示出)可安装到电路板400的底部表面。霍尔效应传感器可被配置成能够检测由磁性元件356的运动所引起的环绕霍尔效应传感器周围的磁场的变化。霍尔效应传感器可与例如微控制器进行信号通信，该微控制器可确定闭合释放按钮352是否处于其与闭合触发器332的未致动位置和端部执行器的打开构型相关联的第一位置、其与闭合触发器332的致动位置和端部执行器的闭合构型相关联的第二位置和/或第一位置与第二位置之间的任何位置。
在至少一种形式中，柄部100和框架组件200可操作地支撑本文中被称为击发驱动系统500的另一个驱动系统，该驱动系统被配置成能够向轴组件1000的击发构件组件1900施加击发动作。击发驱动系统500在本文中也可被称为“第二驱动系统”。击发驱动系统500可以采用定位在柄部100的手枪式握把部119中的电动马达502。在各种形式中，马达502例如可为具有约25,000RPM的最大转速的DC有刷驱动马达。在其他布置结构中，马达可包括无刷马达、无绳马达、同步马达、步进马达、或任何其他合适的电动马达。马达502可由电源510供电，在一种形式中，该电源可包括可移除电源组512。如图8中可见，例如，电源组512可在其中支撑多个电池514。电池514可各自包括例如锂离子(“LI”)或其他合适的电池。电源组512被构造用于以可移除方式可操作地附接到同样可操作地联接到马达502的电路板组件400。多个电池514可以串联连接，可以用作外科器械10的电源。此外，电源510可为可更换的和/或可充电的。
如上文相对于其他各种形式所概述，电动马达502可包括与齿轮减速器组件520可操作地交接的可旋转轴506，该齿轮减速器组件与一组或一齿条的驱动齿啮合接合地安装在可纵向运动的驱动构件530上。附接凸耳1916形成于中间击发轴部分1910的近侧端部1914上。附接凸耳1916被构造成能够被接收在附接支架536内，该附接支架形成在可纵向运动的驱动构件530的远侧端部中。在使用中，电源510所提供的电压极性可沿顺时针方向操作电动马达502，其中由电池施加给电动马达的电压极性可被反转，以便沿逆时针方向操作电动马达502。当电动马达502在一个方向上旋转时，驱动构件530将在远侧方向“DD”上被轴向地驱动。当马达502在相反的旋转方向上被驱动时，驱动构件530将在近侧方向“PD”上被轴向地驱动。柄部100可包括开关，该开关可被构造成能够使由电源510施加到电动马达502的极性反转。与本文所述的其他形式一样，柄部100还可包括传感器，该传感器被配置成能够检测驱动构件530的位置和/或驱动构件530正在运动的方向。
马达502的致动可通过被可枢转地支撑在柄部100上的击发触发器540来控制。击发触发器540可在未致动位置和致动位置之间枢转。击发触发器540可由弹簧542或其他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540时，击发触发器可由弹簧或偏压布置结构枢转或以其他方式返回到未致动位置。在至少一种形式中，击发触发器540可定位在闭合触发器332的“外侧”，如上文所讨论。在至少一种形式中，击发触发器安全按钮550可以枢转地安装到闭合触发器332。安全按钮550可定位在击发触发器540和闭合触发器332之间，并具有从其突出的枢转臂。当闭合触发器332处于未致动位置时，安全按钮550被容纳在柄部100中，此时临床医生可能无法轻易触及该按钮，也无法将该按钮在防止对击发触发器540致动的安全位置与击发触发器540可被击发的击发位置之间运动。临床医生压下闭合触发器332时，安全按钮550和击发触发器540向下枢转，随后可被临床医生操纵。
如上所述，在至少一种形式中，可纵向运动的驱动构件530具有形成于其上的一齿条的齿，以用于与齿轮减速器组件520的对应驱动齿轮啮合接合。至少一种形式还包括可手动致动的“应急”组件560，该“应急”组件被构造成能够使得临床医生能够在马达502变得失效情况下手动地回缩可纵向运动的驱动构件530。参见图7。应急组件560可包括杠杆或应急柄部组件562，该杠杆或应急柄部组件被构造成能够被手动地枢转成与同样设置在驱动构件530中的齿532棘轮接合。因此，临床医生可通过使用应急柄部组件562来手动地回缩驱动构件530，以使驱动构件530在近侧方向PD上做棘轮运动。2008年10月提交的名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLEFIRING SYSTEM”的美国专利申请序列号12/249,117(现为美国专利8,608,045)公开了也可与本文所公开的各种器械一起使用的应急布置结构和其他部件、布置结构和系统。美国专利8,608,045据此全文以引用方式并入本文。
现在将参照图6至图9描述一种将轴组件1000附接到柄部的方法。在例示的示例中，轴组件1000包括喷嘴组件2200，该喷嘴组件包括近侧喷嘴组件2210和远侧喷嘴组件2250。近侧喷嘴组件2210包括右近侧喷嘴段2220和左近侧喷嘴段2230。近侧喷嘴段2220、2230可通过按扣凸耳、螺钉、粘合剂等附接在一起。远侧喷嘴组件2250包括右远侧喷嘴段2260和左远侧喷嘴段2270。右远侧喷嘴段2260和左远侧喷嘴段2270通过按扣特征部、凸耳、螺钉、粘合剂等联接在一起。近侧喷嘴组件2210和远侧喷嘴组件2250可通过粘合剂、摩擦等附接在一起。喷嘴组件2200轴颈连接在外壳100上，以用于围绕轴轴线SA相对于外壳选择性旋转。在例示的示例中，远侧喷嘴组件2250设置有向内延伸的近侧安装凸缘2252，该近侧安装凸缘与形成于框架组件200的框架部分210上的框架安装凸缘220交接。近侧喷嘴组件2210形成有翅片2212以有利于喷嘴组件2200围绕轴轴线SA旋转。
在例示的布置结构中，包括附接到其上的端部执行器1500的轴组件1000能够通过使喷嘴组件2200相对于柄部100旋转而围绕轴轴线SA旋转。如图8中可见，例如，远侧喷嘴组件2250包括轴接合凸缘2254，该轴接合凸缘向内延伸穿过近侧闭合管段2010的近侧端部部分2014中的喷嘴接合开口2016。当临床医生旋转喷嘴组件2200时，这种布置结构允许轴组件1000围绕轴轴线SA旋转。喷嘴接合开口2016的尺寸设定成允许近侧闭合管段2010相对于轴接合凸缘2254轴向运动。仍然参见图8，远侧喷嘴组件2250还可包括支撑套管部分2256，该支撑套管部分被构造成能够在其中可运动地支撑近侧闭合管段2010。此外，如图9中可见，上脊支柱1220的近侧端部1226和下脊支柱1230的近侧端部1236各自支撑在脊轴承1260中，该脊轴承可旋转地支撑在框架组件200中。
现在参见图6、图8和图9，近侧闭合管段2010的近侧端部部分2014被可运动地支撑在闭合梭动件360中，该闭合梭动件关联到闭合连杆组件340的第二闭合连接件344(图6)。闭合梭动件360可滑动地支撑在框架组件200中的梭动件腔214中。近侧闭合管段2010的近侧端部部分2014延伸穿过闭合梭动件360中的U形支架开口362以在其中被可旋转地支撑。当轴组件1000相对于柄部100旋转时，此类布置结构允许近侧闭合管段2010的近侧端部部分2014相对于闭合梭动件360旋转。此外，当临床医生压下闭合触发器332时，闭合梭动件在梭动件腔214内沿远侧方向DD运动，并且还使得闭合构件组件2000沿远侧方向将闭合动作施加到端部执行器1500。
如图8和图9中可见，第一弹簧370轴颈连接在近侧闭合管段2010的近侧部分2014上在闭合梭动件360的支架壁362与形成于右框架部分210上的远侧端部壁219之间(第一弹簧空间221)。第一弹簧空间的轴向长度被指定为X1。第一弹簧370将闭合梭动件360朝近侧(箭头PD)偏压到对应于砧座的完全打开位置的起始位置中。参见图10。在例示的示例中，近侧凸缘2018形成于近侧闭合管段2010的近侧端部部分2014上。近侧凸缘2018被构造成能够在形成于闭合梭动件360中的闭合或第二腔364内可滑动地行进，如图所示。第二腔或第二弹簧空间363的轴向长度被指定为X2。在至少一种布置结构中，例如，X1>X2。第二闭合弹簧或偏压构件380位于第二弹簧空间363内，以抵靠闭合梭动件360的支架壁362沿远侧方向DD偏压近侧闭合管段2010上的近侧凸缘2018。
在目标组织初始夹持在砧座1610和外科钉仓1540之间期间，闭合驱动系统300必须向砧座1610施加足够量的轴向闭合力，以将砧座1610枢转到闭合位置并且在整个钉成形过程中将砧座1610保持在该位置。在至少一个应用中，术语“闭合规程”是指在目标组织上使砧座从完全打开位置运动到闭合位置并且将砧座保持在闭合位置直到钉成形过程已完全完成并且砧座准备好重新打开以从端部执行器释放目标组织的过程。使砧座闭合并将砧座保持在闭合位置所需的闭合力的量可在缝合过程中因“组织蠕变”而变化。例如，随着砧座压缩目标组织，被夹持的目标组织内的流体可在组织内“蠕变”或迁移，并且甚至流动到相邻的未夹持组织。随着刀部分1950被驱动穿过被夹持的目标组织，可经历另外的组织蠕变。因此，组织蠕变还可影响切割目标组织和击发钉仓内的钉所需的击发力的大小。当刀部分1950快要结束其行程时，所需的击发力的量可以减小，因为蠕变的流体已经迁移到了相邻的未夹持组织中。
图10示出了处于未致动取向的闭合驱动系统300。如图10中可见，第一弹簧370已使闭合梭动件360在框架组件200中的梭动件腔214内沿PD方向朝近侧偏移到其最近侧或起始位置。由于闭合梭动件360通过闭合连杆组件340附接到闭合触发器332，闭合触发器332枢转到未致动起始位置中。当闭合驱动系统300处于该未致动位置时，砧座1610处于完全打开位置。在至少一个示例中，第一弹簧370“弱”于第二弹簧380。换句话讲，第二弹簧380比第一弹簧370硬。即，第一弹簧370的弹簧常数K1小于第二弹簧380的弹簧常数K2。因此，K2>K1。在另选的布置结构中，K2<K1。在一些布置结构中，例如，K2可为K1的至多十倍。在其他布置结构中，K2/K1>1。临床医生通过朝外壳100的手枪式握把119压下闭合触发器332来引发闭合过程。该动作开始使闭合梭动件360沿远侧方向DD运动，这开始压缩第一弹簧370。随着闭合梭动件360开始朝远侧运动，闭合梭动件360还开始使近侧闭合管段2010朝远侧运动。随着近侧闭合管段2010朝远侧运动，整个闭合构件组件2000(近侧闭合管段2010为其一部分)朝远侧运动以将闭合动作施加到砧座1610。随着临床医生继续朝向手枪式握把119枢转闭合触发器332，闭合梭动件360继续朝远侧运动并压缩第一弹簧370。随着砧座1610开始闭合，所需的闭合力的量可随着砧座1610开始压缩目标组织而开始增加。随着目标组织开始压缩，目标组织中容纳的流体可开始在目标组织内蠕变，这可直接影响完全闭合砧座所需的闭合力的量。随着闭合阻力增加，闭合构件组件2000可抵抗由第二弹簧380施加到近侧闭合管段2010的闭合力而沿近侧方向PD运动。图11示出了处于完全闭合位置的闭合驱动系统300，该完全闭合位置对应于砧座1610的完全闭合位置。因此，通过闭合构件组件2000施加到砧座1610的闭合力的最终量可因第二弹簧380响应于砧座在闭合规程期间所经历的闭合阻力而压缩的能力而变化。因此，砧座可随着其经历由目标组织产生的阻力的量的变化而“渐进式闭合”。这在本文中也可被称为产生“渐进式闭合力”。
一旦钳口1510、1600闭合到目标组织上并锁定在该位置，临床医生就可通过压下击发触发器540来开始击发过程，这使得刀杆1910驱动刀部分1950穿过被夹持的目标组织。随着刀部分1950朝远侧驱动穿过端部执行器1500时，刀的刀片152切穿目标组织。此外，在至少一种布置结构中，刀部分1950接合凸轮作用组件并且朝远侧驱动该凸轮作用组件，有时被称为楔形滑动件1970，该楔形滑动件可滑动地支撑在外科钉仓1540中。随着楔形滑动件1970朝远侧驱动穿过钉仓1540，形成于楔形滑动件1970上的凸轮以凸轮方式接合可运动地支撑在钉仓1540内的钉驱动器(未示出)。每个钉驱动器在其上可支撑一个或多个外科钉。钉驱动器通常被支撑在位于形成于钉仓中的细长狭槽的每一侧上的轴向线中。随着楔形滑动件1570接触钉驱动器，它们被向上驱动(朝向闭合砧座)1610，从而驱动支撑在其上的钉穿过目标组织并与砧座主体1612的钉成形下表面1614成形接触。楔形滑动件1570定位在组织切割刀刀片的远侧，因此在切割目标组织之前将钉部署成穿过目标组织。
此外，随着刀部分1950被驱动穿过目标组织，形成于刀部分中的插片或凸缘接合砧座1610以及细长通道1510，并且在缝合过程中保持砧座1610和通道1510闭合并以期望的间隔布置结构间隔开。虽然刀部分的此类远侧推进可减少闭合系统所需的闭合力的量，但击发系统必须产生显著量的“击发力”，以随着楔形滑动件致动钉驱动器而推动刀部分1950穿过目标组织并克服系统的阻力和摩擦。因此，击发系统必须能够产生足够的击发力，并且击发系统部件必须足够稳固以有效地适应此类力，同时还足够柔性以适应端部执行器的关节运动。闭合和击发系统的这些设计要求也可因目标组织的类型和组成而加剧。此外，这些系统的部件必须足够小以便通过套管针的小插管插入。
图12为采用上述渐进式闭合驱动系统300的外科器械10与采用不同闭合驱动布置结构的两个先前外科器械A和B之间的图形比较。先前的外科器械A采用直接关联到闭合致动器或闭合触发器的闭合驱动系统。虽然先前的外科器械A确实采用弹簧来将闭合系统偏压到未致动位置，但先前的外科器械A不采用类似于上述外科器械10的第二偏压构件。此外，外科器械A的砧座缺少类似于上述砧座1610的一个或多个凸轮作用表面。相反，外科器械A的砧座具有被布置用于由闭合构件或管接触的硬边缘。随着闭合构件接触该硬边缘，砧座被枢转闭合。
仍然参见图12，先前的外科器械B在一些方面类似于先前的外科器械A，因为外科器械B具有第一偏压构件，该第一偏压构件用于将闭合系统偏压到未致动位置。然而，外科器械B不采用类似于上述器械10的第二偏压构件。然而，外科器械B的砧座确实采用凸轮作用表面，该凸轮作用表面被构造成能够由闭合构件接触以将砧座枢转到闭合位置。图12为示出针对三个外科器械：外科器械10、外科器械A和外科器械B中的每一者的完成闭合规程的时间量与在该规程期间所需的闭合力的量的关系的曲线图。如图12中可见，在外科器械10的整个闭合规程中所需的闭合力的量小于外科器械A和B所需的闭合力的量。虽然外科器械B所需的闭合力小于外科器械A所需的闭合力，但外科器械10所需的闭合力在整个闭合过程中显著小于A和B两者所需的闭合力。
图13A和图13B比较了外科器械10和外科器械B(在砧座上具有凸轮作用表面)随着击发构件或刀穿过砧座从砧座中的最近侧起始位置行进到最远侧结束位置(夹头距离)所经历的击发力(FTF)、闭合力(FTC)。图13A示出了外科器械B的击发规程期间的FTF、FTC和砧座高度。图13B示出了外科器械10的FTF、FTC、砧座高度和弹簧高度。如通过参考图13A和图13B可见，外科器械B的初始砧座高度为0.0510英寸，并且外科器械10的初始砧座高度为0.511英寸。外科器械B的峰值闭合力FTC(以磅计)为51.5磅，并且外科器械10的峰值闭合力FTC(以磅计)为98.7磅。外科器械B的峰值FTC(以磅计)为48.9磅，并且外科器械10的峰值FTC(以磅计)为36.4磅。因此，外科器械10经历了外科器械10所需的闭合力的量的25.6％的减小。所需的击发力的量的这种减小可允许击发系统部件由较轻和/或较小的部件布置结构制成。
如上所述，外科器械10包括关节运动驱动系统2100，该关节运动驱动系统被构造成能够使外科端部执行器1500围绕横向于轴轴线SA的关节运动轴线AA相对于轴组件1000进行选择性地关节运动。参见图14。关节运动驱动系统2100包括关节运动驱动组件2102，该关节运动驱动组件包括联接到中间关节运动驱动器2120的近侧关节运动驱动器2110，该中间关节运动驱动器枢转地联接到远侧关节运动连接件2130，该远侧关节运动连接件附接到细长通道1520的近侧端部。参见图2。在一个示例中，远侧关节运动连接件2130在轴轴线SA的一侧上附接到中间关节运动驱动器2120。远侧关节运动连接件2130在轴轴线SA的相对侧上附接到细长通道1520，使得远侧关节运动连接件2130跨轴轴线SA横向地延伸。在例示的示例中，近侧关节运动驱动器2110与中间关节运动驱动器2120之间的接头还可用作关节运动锁组件2121，该关节运动锁组件用于在停止施加到近侧关节运动驱动器2110的关节运动动作之后将外科端部执行器1500保持在关节运动位置。在例示的示例中，近侧关节运动驱动器2110的远侧端部2112是带螺纹的。近侧关节运动驱动器2110的螺纹远侧端部2112与中间关节运动驱动器2120的近侧端部2124中的螺纹承窝2126螺纹接合。近侧关节运动驱动器2110沿第一旋转方向的旋转将使得中间关节运动驱动器2120沿第一或远侧方向DD轴向运动。中间关节运动驱动器2120沿远侧方向DD的运动将使得外科端部执行器1500沿第一关节运动方向AD1围绕关节运动轴线AA枢转。近侧关节运动驱动器沿第二旋转方向的旋转将使得中间关节运动驱动器2120沿第二或近侧方向PD运动。中间关节运动驱动器2120沿近侧方向PD的轴向运动将使得外科端部执行器1500沿第二关节运动方向AD2围绕关节运动轴线AA枢转。
在例示的示例中，外壳100或柄部110限定纵向轴线LA。参见图15和图16。如上所述，轴组件1000还限定轴轴线SA。轴轴线SA和纵向轴线LA可以同轴。纵向关节运动驱动系统2100包括关节运动马达2140，该关节运动马达安装在远侧喷嘴组件2250内以用于当使用者相对于外壳100旋转喷嘴组件2250时与远侧喷嘴组件一起围绕纵向轴线LA沿轨道旋转行进。远侧喷嘴组件2250在本文中也可被称为“轴旋转器组件”，其被构造成能够将轴组件1000可旋转地联接到外壳100。在一种布置结构中，关节运动马达2140包括齿轮构型，该齿轮构型包括马达输出齿轮2142。马达输出齿轮2142围绕马达轴线MA旋转，该马达轴线平行于纵向轴线LA且从纵向轴线LA偏置。参见图16。在例示的示例中，马达输出齿轮2142与马达开关系统2150的控制开关齿轮2152啮合接合。控制开关齿轮2152与形成于近侧关节运动驱动器2110的近侧端部2116上的近侧关节运动驱动齿轮2118啮合接合。因此，马达输出齿轮2142沿一个方向的旋转将导致近侧关节运动驱动器2110沿第一方向旋转，这将使得中间关节运动驱动器2120沿远侧方向进行关节运动并且使得外科端部执行器1500沿第一关节运动方向AD1进行关节运动。同样，关节运动马达沿相反旋转方向的旋转将使得近侧关节运动驱动器2110沿第二旋转方向旋转，从而使得中间关节运动驱动器2120沿近侧方向PD运动。中间关节运动驱动器2120沿近侧方向PD的运动将使得外科端部执行器1500沿第二关节运动方向AD2进行关节运动。在各种实施方案中，关节运动马达2140和齿轮构型的直径可例如具有小于12mm且长度小于1.5英寸。关节运动马达2140可为具有小于1.5瓦特功率输出的有刷设计。在至少一些实施方案中，马达2140的功率输出为约0.75瓦-1.0瓦。齿轮构型可由马达外壳支撑，或者其可与马达外壳分开。在至少一个示例中，齿轮构型具有100:1的缩小，但可采用具有更大缩小比率的齿轮构型。在另选的布置结构中，可采用其他马达构型。
相对于关节运动锁2121，近侧关节运动驱动器2110的远侧端部2112上的螺纹可例如包括细牙(例如，64牙/英寸)或粗牙(少于64牙/英寸)的#2螺纹，提供了足以使关节运动马达2140引起外科端部执行器1500的关节运动的机械优势同时还用作锁以防止外科端部执行器1500在关节运动马达2140已断电之后的运动。如图2中另外可见，近侧关节运动驱动器2110可设置有支撑肩部部分2119，该支撑肩部部分具有比近侧关节运动驱动器2110的相邻部分更大的直径。较大的肩部2119与脊轴1210可滑动地交接，以在处于锁定位置时提供额外的支撑。
仍然参见图16至图19，马达开关系统2150包括开关滑动件2170，该开关滑动件螺纹连接到开关驱动螺杆2160，该开关驱动螺杆附接至控制开关齿轮2152。马达输出齿轮2142的旋转将使得控制开关齿轮2152旋转，这最终使得开关驱动螺杆2160旋转。开关驱动螺杆2160的旋转导致开关滑动件2170相对于安装在远侧喷嘴组件2250中的开关外壳2162轴向运动。开关外壳2162可操作地支撑多个限位开关，该多个限位开关与支撑在外壳100中或以其他方式与外壳相关联的控制电路板400进行通信，如将在下文进一步讨论。参见图16。在例示的示例中，采用三个限位开关：中心限位开关2172、近侧限位开关2174和远侧限位开关2176。开关2172、2174、2176被有线连接到安装在近侧喷嘴组件2210内的一系列电路迹线或导体2222、2224、2226、2228。参见图20。电路迹线2222、2224、2226和2228通过电线或柔性电路导体(未示出)有线连接到或电联接到关节运动马达2140和开关2172、2174、2176。转到图21和图22，接触块410固定地安装到框架组件200并且包括分别对应于电路迹线2222、2224、2226和2228的触点412、424、416和418。触点412、414、416、418有线连接到控制电路板400。随着近侧喷嘴组件2210围绕轴轴线SA相对于外壳100旋转，可通过滑动接头组件411在控制电路板400与关节运动马达2140和开关2172、2174、2176之间提供功率/控制信号，该滑动接头组件包括电路迹线2222、2224、2226、2228和触点412、414、416、418，以有利于关节运动马达2140和控制开关组件围绕轴轴线SA相对于外壳100的旋转。关节运动控制开关2180安装在外壳100的每一侧上并且用于控制关节运动马达2140的旋转。参见图15。开关2180可包括“摇臂型”开关，当沿一个方向(箭头2182)压下时，关节运动马达2140使马达输出齿轮2142沿一个旋转方向旋转，并且当沿相反方向(箭头2184)压下开关2180时，关节运动马达使马达输出齿轮2142沿相反旋转方向旋转。
现在转到图19和图23至图26，开关2172、2174、2176相对于开关滑动件2170的路径的位置用于限定外科端部执行器1500的关节运动范围。开关2172包括对应于外科端部执行器1500的非关节运动位置的中心开关或主开关。当处于该位置时，中心端部执行器轴线EA与轴轴线SA大致对准。例如，当处于该位置时，端部执行器1500可通过套管针插管插入或从套管针插管移除。开关2174对应于-60°左关节运动边界，并且开关2176对应于+60°右关节运动边界。-60°左关节运动边界在本文中也可被称为位于轴轴线SA的“第一侧”或左侧上的外科端部执行器1500的“第一最大关节运动位置”。左-60°角(图26中的LA)也可被称为“第一最大关节运动角度”，并且包括当外科端部执行器1500处于该第一最大关节运动位置时在端部执行器轴线EA和轴轴线SA之间的角度。类似地，+60°右关节运动边界在本文中也可被称为位于轴轴线SA的“第二侧”或右侧上的外科端部执行器1500的“第二最大关节运动位置”。右+60°角(图23中的RA)也可被称为“第二最大关节运动角度”，并且包括当外科端部执行器1500处于该第二最大关节运动位置时在端部执行器轴线EA和轴轴线SA之间的角度。因此，在例示的示例中，开关2174和2176的位置为每个关节运动方向(左和右)建立最大关节运动位置。在另选的布置结构中，可仅采用两个开关(2174、2176)。开关2172、2174、2176可包括机械开关、霍尔效应开关等。
在至少一个示例中，中心主开关2172还可用于在跨过原始位置或非关节运动位置之前减慢关节运动马达2140，以允许使用者更容易地确定端部执行器1500何时与轴组件1000对齐，这将有利于例如可通过套管针移除。
在一个示例中，开关滑动件在被构造成能够接合开关2172、2174、2176的区域中的几何形状被选择为具有一定宽度，使得其以与原始位置成“X”度的角度接合开关并且能够与开关从＝X度至-X度保持接触。在至少一个示例中，X＝大约10度，但X也可以是其他值。图23至图26示出了开关滑动件2170和开关2172、2174、2176与外科端部执行器1500的关节运动位置之间的关系。例如，在图25中，当开关滑动件2170处于该位置时，外科端部执行器1500可处于轴轴线SA的第一侧上的第一关节运动位置，其中外科端部执行器轴线EA相对于轴轴线SA以第一关节运动角度LA1定位。同样，当开关滑动件2170处于例如图24所示的位置时，外科端部执行器1500可处于位于轴轴线SA的第二侧上的第二关节运动位置，其中外科端部执行器轴线EA相对于轴轴线SA以第二关节运动角度LA2定位。在至少一种布置结构中，例如，LA1＝LA2＝大约10°。
图27提供了当从开关滑动件2170的自由端观察时开关滑动件2170的另选几何形状，该开关滑动件被构造成能够与开关2172、2174、2176交接。图28为马达速度(对于每个几何形状2170A、2170B、2170C)与关节运动角度的图形比较。图23至图26中也示出了开关滑动件2170A。2170C具有形成于其上的致动器点21701C，以用于更精确地致动开关2172、2174、2176。如图28中可见，马达速度MS2C仅在致动器点2171C与开关2172、2174、2176中的一者致动接触时下降，这些开关对应于-60°、0°、+60°的关节运动角度。2170A具有横截面厚度CTA，这产生关节运动角度范围在-10°至+10°之间的第一马达速度MS1A。对于在-10°至-60°与+10°至+60°之间的关节运动角度，关节运动马达2140可以大于MS1A的第二马达速度MS2A操作。2170B具有大于横截面厚度CTA的横截面厚度CTB，并且产生关节运动角度范围在-20°至+20°之间的第一马达速度MS1B。对于在-20°至-50°与+20°至+50°之间的关节运动角度，关节运动马达2140可以大于MS1B的第二马达速度MS2B操作。对于在-50至-60与+50至+60之间的关节运动角度，关节运动马达2140可以第三马达速度MS3B操作。在例示的示例中，MS3B＝MS1B。
在各种布置结构中，控制电路板400可包括限定关节运动极限的开关420、422、424、426，以及控制端部执行器的中心或原始位置的可闩锁开关或继电器开关428。参见图28A。在此类布置结构中，随着关节运动马达2140驱动端部执行器跨过直的或原始位置，可闩锁开关或继电器开关428可被触动，这将使关节运动马达2140停用。释放关节运动控制开关2180可启动旁路继电器，该旁路继电器可使中心或主开关2172停用并且再次按压控制开关2180可允许关节运动继续通过原始位置。参见图28A。
图29至图33示出了外科器械3010，除了下文讨论的差异之外，该外科器械类似于外科器械10。外科器械3010包括类似于轴组件1000的轴组件4000。细长轴组件4000可操作地联接到包括柄部3110的外壳3100。除了下文讨论的差异之外，外壳3100可类似于上述外壳100。细长轴组件4000的示例的多个部分在图30中示出。与轴组件1000的元件相同或同等的那些元件已用类似的元件编号来标识。外科器械3010包括可运动地联接到脊组件5200的端部执行器1500(如上所述)。脊组件5200被构造成能够：第一，在其中可滑动地支撑击发构件组件1900；以及第二，可滑动地支撑围绕脊轴5200延伸的闭合构件组件6000。除了下文讨论的差异之外，闭合构件组件6000类似于上述闭合构件组件2000。闭合构件组件6000包括类似于近侧闭合管段2010的近侧闭合管段或近侧闭合构件段6010。近侧闭合管段6010与闭合梭动件交接，该闭合梭动件以上文所述或已以引用方式并入本文的各种参考文献中所述的方式可操作地支撑在外壳3100中。外科器械还包括击发驱动系统500，该击发驱动系统被构造成能够将击发动作施加到轴组件4000中的击发构件组件1900。如上所述，击发驱动系统500包括马达驱动的可纵向运动的驱动构件530。马达的致动可通过被枢转地支撑在柄部3110上的击发触发器540来控制。
同样如上文所讨论，轴组件4000还包括击发构件组件1900，该击发构件组件被支撑以用于在脊轴1210内轴向行进。击发构件组件1900包括中间击发轴部分1910，该中间击发轴部分被构造用于附接到远侧切割部分或刀杆1930。中间击发轴部分1910可在其远侧端部中包括纵向狭槽1912，该纵向狭槽可被构造成能够接收远侧刀杆1930的近侧端部上的插片1932。纵向狭槽1912和近侧端部插片1932可被设定尺寸并被构造成能够允许该纵向狭槽和该近侧端部插片之间的相对运动并且可包括滑动接头1940。滑动接头1940可例如允许刀杆1930相对于中间击发轴部分1910轴向运动，以适应端部执行器1500的关节运动。刀杆1910包括刀部分1950。
在例示的示例中，外科端部执行器1500能够由关节运动驱动系统6100围绕关节运动轴线AA选择性地进行关节运动。在至少一个示例中，关节运动驱动系统6100被构造成能够将中间击发轴部分1910的线性行程转换成可用于使外科端部执行器1500相对于细长轴组件4000进行关节运动的旋转关节运动动作。在一种形式中，关节运动驱动系统6100包括近侧关节运动驱动器6110，该近侧关节运动驱动器可操作地联接到中间关节运动驱动器6120，该中间关节运动驱动器枢转地联接到远侧关节运动连接件6130，如将在下文进一步讨论的。
现在转到图31、图32A和图32B，在至少一种形式中，关节运动驱动系统包括关节运动离合器组件6300，该关节运动离合器组件可操作地支撑在喷嘴组件6250中，该喷嘴组件可旋转地联接到外壳3100，如上所述。在例示的示例中，关节运动离合器组件6300包括固定地附接到喷嘴组件6250的离合器安装构件6302。离合器移位器组件6310可运动地支撑在离合器安装构件6302内。在一种形式中，离合器移位器组件6310包括侧向相对的第一锁组件6320和第二锁组件6330，该第一锁组件和该第二锁组件能够沿横向于轴轴线SA的方向运动。这种横向锁定运动在图32A和图32B中由箭头L表示。在例示的示例中，第一锁组件6320包括支撑第一离合器锁6324的第一可运动的锁支撑件6322。第一离合器锁6324被构造成能够锁定地接合中间击发轴部分1910中的第一锁凹槽1911。第一偏压构件或弹簧6328用于将第一锁组件6320朝向中间击发轴部分1910偏压，以使得第一离合器锁6324锁定地接合中间击发轴部分1910中的第一锁凹槽1911，如图32A所示。
类似地，第二锁组件6330包括支撑第二离合器锁6334的第二可运动的锁支撑件6332。第二离合器锁6334被构造成能够锁定地接合中间击发轴部分1910中的第二锁定凹槽1913。第二偏压构件或弹簧6338用于将第二锁组件6330朝向中间击发轴部分1910偏压，以使得第二离合器锁6334锁定地接合中间击发轴部分1910中的第二锁凹槽1913，如图32A所示。
在例示的示例中，关节运动离合器组件6300还包括附接到其上的离合器驱动器齿条6340，以便与第一离合器锁6324和第二离合器锁6334一起轴向运动，同时允许第一离合器锁和第二离合器锁相对于轴轴线在“锁定”位置或“接合”位置与“解锁”位置或“脱离”位置之间横向运动。参见图31。离合器驱动器齿条6340与离合器齿轮组件6350啮合接合，该离合器齿轮组件包括齿条齿轮6352，该齿条齿轮与离合器驱动器齿条6340啮合接合并且通过第一传送轴6353附接到啮合的第一离合器锥齿轮6354和第二离合器锥齿轮6356。仍然参见图31，第二离合器锥齿轮6356附接到其上附接有传送驱动齿轮6360的第二传送轴6358。传送传动齿轮6360与惰轮6362啮合接合，该惰轮与形成于近侧关节运动驱动器6110的近侧端部上的近侧关节运动驱动齿轮6118啮合接合。因此，离合器驱动器齿条6340的轴向运动将最终导致近侧关节运动驱动器6110通过上述齿轮布置结构的旋转。近侧关节运动驱动器6110沿第一方向的此类旋转将使得中间关节运动驱动器2120沿近侧方向运动并且使得外科端部执行器1500沿第一关节运动方向进行关节运动。同样，离合器驱动器齿条6340沿近侧方向PD的轴向运动将使得近侧关节运动驱动器6110沿第二旋转方向旋转，从而使得中间关节运动驱动器沿远侧方向DD运动。中间关节运动驱动器2120沿远侧方向DD的运动使得外科端部执行器1500沿第二关节运动方向进行关节运动。
图32A示出了与击发轴组件1900的中间击发轴部分1910处于接合或锁定位置的关节运动离合器组件6300。当处于该位置时，中间击发轴部分1910的轴向运动(如上所述通过致动击发触发器540而引起)将导致关节运动离合器驱动器齿条6340的轴向运动并且最终导致外科端部执行器的关节运动，如本文所述。第一偏压构件6328和第二偏压构件6338将离合器组件6300偏压在该正常接合的位置。图32A示出了处于其最近侧未致动位置的近侧闭合管段6010，这导致钳口1610、1610处于打开位置。因此，在钳口处于打开位置的情况下，击发驱动系统的致动将导致外科端部执行器1500的关节运动。
在临床医生已使外科端部执行器在期望的关节运动位置进行关节运动之后，临床医生随后可通过压下闭合触发器332致动闭合系统来致动闭合系统，从而开始钳口闭合过程。如图32A和图32B中可见，离合器组件穿过近侧闭合管段6010中的离合器开口6011突出。如上文所讨论，压下闭合触发器332使得近侧闭合管段6010沿远侧方向DD轴向运动。随着近侧闭合管段6010朝远侧运动，其接触第一可运动锁支撑件6322上的第一凸轮表面6323和第二可运动锁支撑件6332上的第二凸轮表面6333，以使第一锁支撑件6322和第二锁支撑件6332沿远离轴轴线的相反方向横向地运动。第一可运动锁支撑件6322和第二可运动锁支撑件6332的这种运动使得第一离合器锁6324和第二离合器锁6334与中间击发轴部分1910中的第一锁凹槽1911和第二锁凹槽1913脱离接合，如图32B所示。因此，关节运动离合器组件6300已使关节运动系统与击发驱动系统脱离接合，并且临床医生现在可在外科端部执行器保持关节运动的同时致动击发驱动系统。
在例示的示例中，关节运动驱动系统还包括关节运动锁布置结构6400，该关节运动锁布置结构用于在关节运动驱动系统已被停用之后将外科端部执行器保持在关节运动位置。更具体地并且参考图33，近侧关节运动驱动器6110的远侧端部部分6112包括形成于其上的螺纹部分6114。在一种布置结构中，螺纹部分6114包括ACME螺纹，该ACME螺纹可落入中间关节运动驱动器6120中的螺纹通道段6122中。中间关节运动驱动器6120可滑动地支撑在脊轴5200中的远侧驱动器腔体5202中。如上所述，中间关节运动驱动器6120枢转地销接到远侧关节运动连接件6130。远侧关节运动连接件6130跨轴轴线SA横向延伸并且枢转地销接到细长通道1520的近侧端部。如图33中可见，肩部6119形成于近侧关节运动驱动器6110上并且被可旋转地接收在脊轴5200中的肩部腔体5204内。近侧关节运动驱动器6110的旋转引起中间关节运动驱动器6120的线性或轴向动作，这引起远侧关节运动连接件6130使细长通道1520进行关节运动。肩部6119用于在操作期间支撑近侧关节运动驱动器6110，并且在遇到试图无意地使端部执行器脱离关节运动的外力时抵抗近侧关节运动驱动器6110的动作。ACME螺纹布置结构6116与中间关节运动驱动器6120中的螺纹通道段6122产生摩擦，以便在中断向近侧关节运动驱动器6110施加旋转关节运动动作时用作关节运动锁。在至少一种布置结构中，ACME螺纹布置结构6116可具有小于17°的螺纹角并且为“自锁定的”。也可采用其他关节运动锁布置结构。
图34至图38示出了可再利用或不可再利用的先前马达驱动的外科切割和紧固器械11010。该器械11010包括外壳11012，该外壳包括被构造成能够被临床医生抓持、操纵和致动的柄部11014。外壳11012被构造用于可操作地附接到可互换轴组件11200，该可互换轴组件具有与其可操作地联接的外科端部执行器11300，该外科端部执行器被构造成能够执行一种或多种外科任务或外科手术。
图34所示的外壳11012结合可互换轴组件11200(图35、图37和图38)示出，该可互换轴组件包括端部执行器11300，该端部执行器包括被构造成能够在其中可操作地支撑外科钉仓4000的外科切割和紧固装置。外壳11012可被构造用于与可互换轴组件结合使用，该可互换轴组件包括端部执行器，该端部执行器适于支撑不同尺寸和类型的钉仓，并且可互换轴组件具有不同的轴长度、尺寸和类型等。此外，外壳11012还可有效地用于多种其他可互换轴组件，其包括被构造成能够将其他动作和形式的能量(诸如例如射频(RF)能量、超声能量和/或动作)施加到适合与各种外科应用和手术结合使用的端部执行器布置结构的那些组件。此外，该端部执行器、轴组件、柄部、外科器械和/或外科器械系统可利用任意合适的紧固件来紧固组织。例如，包括可移除地被存储在其中的多个紧固件的紧固件仓能够可移除地插入轴组件的端部执行器中和/或附接到轴组件的端部执行器。
轴组件11200的各种方面也可以有效地与机器人控制的外科系统结合使用。因此，术语“外壳”也可涵盖机器人系统的容纳或以其他方式可操作地支撑至少一个驱动系统的外壳或类似部分，所述至少一个驱动系统被构造成能够生成并施加可用于致动本文所公开的可互换轴组件及其相应的等同物的至少一种控制动作。术语“框架”可指手持式外科器械的一部分。术语“框架”还可表示机器人控制的外科器械的一部分和/或机器人系统的可用于可操作地控制外科器械的一部分。此外，各种部件可“容纳”或包含在外壳中，或者各种部件可与外壳“相关联”。在此类实例中，部件可不容纳在外壳内或由外壳直接支撑。
例示的实施方案为内窥镜式器械，并且一般来讲，本文所述的外科器械11010的实施方案为内窥镜式外科切割和紧固器械。然而，应当指出的是，根据各种实施方案，器械可为例如非内窥镜式外科切割和紧固器械。各种外科器械公开于以下专利中：名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利7,845,537；名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLEFIRING SYSTEM”的美国专利8,608,045；以及名称为“MOTORIZED SURGICAL INSTRUMENT”的美国专利9,050,083，这些专利的全部公开内容据此以引用方式并入本文。
图34示出了外科器械11010，其中先前的可互换轴组件11200可操作地联接到其上。图35示出了脱离外壳11012或柄部11014的可互换轴组件11200。如图36中可见，柄部11014可包括一对可互连的柄部外壳段11016和11018，这对柄部外壳段可借助螺钉、按扣特征部、粘合剂等互连。在例示的布置结构中，柄部外壳段11016和11018配合形成可被临床医生抓握和操纵的手枪式握把部11019。如将在下文进一步详细地讨论，柄部11014可操作地支撑其中的多个驱动系统，这些驱动系统被配置成能够生成各种控制动作并将这些控制动作施加到可操作地附接到其上的可互换轴组件的对应部分。
现在参见图36，柄部11014还可包括可操作地支撑多个驱动系统的框架11020。例如，框架11020可操作地支撑通常被标记为11030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动作和打开动作施加到可操作地附接或联接到其的可互换轴组件11200。在至少一种形式中，闭合驱动系统11030可包括被框架11020枢转地支撑的闭合触发器11032形式的致动器。更具体地，如图36所示，闭合触发器11032通过销11033枢转地联接到外壳11014。此类布置结构使闭合触发器11032能够被临床医生操纵，使得当临床医生抓握柄部11014的手枪式握把部11019时，闭合触发器11032可被其轻易地从起始或“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。闭合触发器11032可由弹簧或其他偏压布置结构(未示出)偏压到未致动位置。在各种形式中，闭合驱动系统11030还包括枢转地联接到闭合触发器11032的闭合连杆组件11034。如图36中可见，闭合连杆组件11034可包括通过销11035枢转地联接到闭合触发器11032的第一闭合连接件11036和第二闭合连接件11038。第二闭合连接件11038在本文中也可被称为“附接构件”，并且包括横向附接销11037。
仍参见图36，可观察到，第一闭合连接件11036可在其上具有锁定壁或锁定端部11039，该锁定壁或锁定端部被构造成能够与枢转地联接到框架11020的闭合释放组件11060配合。在至少一种形式中，闭合释放组件11060可包括释放按钮组件11062，该释放按钮组件具有形成于其上的朝远侧突出的锁定棘爪11064。释放按钮组件11062可被释放弹簧(未示出)沿逆时针方向枢转。临床医生将闭合触发器11032从其未致动位置朝向柄部11014的手枪式握把部11019压下时，第一闭合连接件11036向上枢转至某个点，其中锁定棘爪11064落入该点中以与第一闭合连接件11036上的锁定壁11039保持接合，从而阻止闭合触发器11032返回未致动位置。因此，闭合释放组件11060用来将闭合触发器11032锁定在完全致动位置。当临床医生期望将闭合触发器11032解锁以允许其被偏压到未致动位置时，临床医生只需枢转闭合释放按钮组件11062，使得锁定棘爪11064运动成与第一闭合连接件11036上的锁定壁11039脱离接合。当锁定棘爪11064已运动成与第一闭合连接件11036脱离接合时，闭合触发器11032可枢转回到未致动位置。也可采用其他闭合触发器锁定布置结构和释放布置结构。
臂11061可从闭合释放按钮11062延伸。磁性元件11063(诸如永磁体)例如可安装到臂11061。当闭合释放按钮11062从其第一位置旋转到其第二位置时，磁性元件11063可朝向电路板11100运动。电路板11100可包括至少一个传感器，该至少一个传感器被配置成能够检测磁性元件11063的运动。在至少一个实施方案中，例如，“霍尔效应”传感器(未示出)可安装到电路板11100的底部表面。霍尔效应传感器可被配置成能够检测由磁性元件11063的运动所引起的环绕霍尔效应传感器的磁场变化。霍尔效应传感器可与例如微控制器进行信号通信，该微控制器可确定闭合释放按钮11062是否处于其与闭合触发器11032的未致动位置和端部执行器的打开构型相关联的第一位置、其与闭合触发器11032的致动位置和端部执行器的闭合构型相关联的第二位置、和/或第一位置与第二位置之间的任何位置。
在至少一种形式中，柄部11014和框架11020可操作地支撑在本文中被称为击发驱动系统11080的另一个驱动系统，该驱动系统被配置成能够向附接到其的可互换轴组件的对应部分施加击发动作。击发驱动系统11080在本文中也可被称为“第二驱动系统”。击发驱动系统11080可以采用定位在柄部1014的手枪式握把部1019中的电动马达11082。在各种形式中，马达11082例如可为具有约25,000RPM的最大转速的DC有刷驱动马达。在其他布置结构中，马达可包括无刷马达、无绳马达、同步马达、步进马达、或任何其他合适的电动马达。马达11082可由电源11090供电，在一种形式中，该电源可包括可移除电源组11092。如图36中可见，例如，电源组11092可包括近侧外壳部分11094，该近侧外壳部分被构造用于附接到远侧外壳部分11096。近侧外壳部分11094和远侧外壳部分11096被构造成能够在其中可操作地支撑多个电池11098。电池11098可各自包括例如锂离子(“LI”)或其他合适的电池。远侧外壳部分11096被构造用于以可移除方式可操作地附接到同样可操作地联接到马达11082的电路板组件11100。多个电池11098可以串联连接，可以用作外科器械11010的电源。此外，电源11090可为可更换的和/或可充电的。
如上文相对于其他各种形式所概述，电动马达11082可包括与齿轮减速器组件11084可操作地交接的可旋转轴(未示出)，该齿轮减速器组件与一组或一齿条的驱动齿1122啮合接合地安装在可纵向运动的驱动构件11120上。在使用中，电源11090所提供的电压极性可沿顺时针方向操作电动马达11082，其中由电池施加给电动马达的电压极性可被反转，以便沿逆时针方向操作电动马达11082。当电动马达11082在一个方向上旋转时，驱动构件11120将在远侧方向“DD”上被轴向地驱动。当马达11082在相反的旋转方向上被驱动时，驱动构件11120将在近侧方向“PD”上被轴向地驱动。柄部11014可包括开关，该开关可被构造成能够使由电源11090施加到电动马达11082的极性反转。与本文所述的其他形式一样，柄部11014还可包括传感器，该传感器被配置成能够检测驱动构件11120的位置和/或驱动构件11120正在运动的方向。
马达11082的致动可通过被枢转地支撑在柄部11014上的击发触发器11130来控制。击发触发器11130可在未致动位置和致动位置之间枢转。击发触发器11130可由弹簧11132或其他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11130时，击发触发器可由弹簧11132或偏压布置结构枢转或以其他方式返回到未致动位置。在至少一种形式中，击发触发器11130可定位在闭合触发器11032的“外侧”，如上文所讨论。在至少一种形式中，击发触发器安全按钮11134可由销11035枢转地安装到闭合触发器11032。安全按钮11134可定位在击发触发器11130和闭合触发器11032之间，并具有从其突出的枢转臂1136。当闭合触发器11032处于未致动位置时，安全按钮11134被容纳在柄部11014中，此时临床医生可能无法轻易触及该按钮，也无法使该按钮在防止对击发触发器11130致动的安全位置与击发触发器11130可被击发的击发位置之间运动。临床医生压下闭合触发器11032时，安全按钮1134和击发触发器11130向下枢转，随后可被临床医生操纵。
如上所述，在至少一种形式中，可纵向运动的驱动构件11120具有形成于在其上的一齿条的齿11122，以用于与齿轮减速器组件11084的对应驱动齿轮11086啮合接合。至少一种形式还包括可手动致动的“应急”组件11140，该“应急”组件被构造成能够使得临床医生能够在马达11082变得失效情况下手动地回缩可纵向运动的驱动构件11120。应急组件11140可包括杠杆或应急柄部组件11142，该杠杆或应急柄部组件被构造成能够被手动地枢转成与同样设置在驱动构件11120中的齿11124棘轮接合。因此，临床医生可通过使用应急柄部组件11142来手动地回缩驱动构件11120，以使驱动构件11120在近侧方向“PD”上做棘轮运动。名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利8608045公开了也可与本文所公开的各种器械一起使用的应急布置结构和其他部件、布置结构和系统。美国专利8,608,045据此全文以引用方式并入本文。
现在转到图35和图38，可互换轴组件11200包括外科端部执行器11300，该外科端部执行器包括被构造成能够在其中可操作地支撑钉仓4000的细长通道11310。端部执行器1300还可包括砧座2000，该砧座相对于细长通道11310被枢转地支撑。可互换轴组件11200还可包括关节运动接头13020和关节运动锁12140，该关节运动锁可被构造成能够将端部执行器11300相对于轴轴线SA可释放地保持在期望的位置。有关端部执行器11300、关节运动接头13020和关节运动锁的至少一种形式的各种特征部的示例可见于2013年3月14日提交的名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803,086。2013年3月14日提交的名称为“ARTICULATABLE SURGICALINSTRUMENT COMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803,086的完整公开内容据此以引用方式并入本文。如图38中可见，可互换轴组件11200还可包括由喷嘴部分11202和11203组成的近侧外壳或喷嘴11201。
可互换轴组件11200还可包括闭合系统或闭合构件组件13000，该闭合构件组件可用于闭合和/或打开端部执行器11300的砧座12000。轴组件11200可包括脊11210，该脊被构造成能够：第一，在其中可滑动地支撑击发构件；第二，可滑动地支撑围绕脊11210延伸的闭合构件组件13000。如图38中可见，脊11210的远侧端部11211终止于上凸耳安装特征部11270和下凸耳安装特征部11280。上凸耳安装特征部11270在其中形成有凸耳狭槽11272，该凸耳狭槽适于在其中安装支撑上安装连接件11274。类似地，下凸耳安装特征部11280在其中形成有凸耳狭槽11282，该凸耳狭槽适于在其中安装支撑下安装连接件11284。上安装连接件11274中包括枢轴承窝11276，该枢轴承窝适于在其中可旋转地接收枢轴销11292，该枢轴销形成在附接到细长通道11310的近侧端部部分11312的通道盖或砧座保持器11290上。下安装连接件11284包括下枢轴销11286，该下枢轴销适于被接收在形成于细长通道11310的近侧端部部分11312中的枢轴孔11314内。参见图38。下枢轴销11286与枢轴承窝11276竖直对准以限定关节运动轴线AA，外科端部执行器11300可围绕该关节运动轴线AA相对于轴轴线SA进行关节运动。参见图35。
在例示的示例中，外科端部执行器11300能够由关节运动系统12100围绕关节运动轴线AA选择性地进行关节运动。在一种形式中，关节运动系统12100包括近侧关节运动驱动器12102，该近侧关节运动驱动器枢转地联接到关节运动连接件12120。如图38中可以最具体地看出，在近侧关节运动驱动器12102的远侧端部上形成偏置附接凸耳12114。枢轴孔12116形成在偏置附接凸耳12114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12120的近侧端部12122上的近侧连接件销12124。关节运动连接件12120的远侧端部12126包括枢轴孔12128，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11310的近侧端部部分11312上的通道销11316。因此，近侧关节运动驱动器12102的轴向运动将由此向细长通道11310施加关节运动动作，从而使外科端部执行器11300相对于脊组件11210围绕关节运动轴线AA进行关节运动。关于关节运动系统12100的构造和操作的更多细节可见于以引用方式并入本文的各种参考文献中，包括2017年6月28日提交的名称为“SURGICALINSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER”的美国专利申请序列号15/635,631中，其全部公开内容据此以引用方式并入本文。在各种情况下，当近侧关节运动驱动器12102没有在近侧或远侧方向上运动时，近侧关节运动驱动器12102可被关节运动锁12140保持就位。关于关节运动锁12140的示例的附加细节可见于美国专利申请序列号15/635631以及以引用方式并入本文的其他参考文献中。
在各种情况下，脊11210可包括近侧端部11211，该近侧端部可旋转地支撑在底座1240中。在一种布置结构中，例如，脊11210的近侧端部11211具有形成于其上的螺纹11214，以便通过螺纹附接到脊轴承11216，该脊轴承被构造成能够被支撑在底座11240内。参见图4。这种布置结构有利于脊11210至底座11240的可旋转附接，使得脊11210可相对于底座11240围绕轴轴线SA选择性地旋转。
主要参见图37，可互换轴组件11200包括闭合梭动件11250，该闭合梭动件被可滑动地支撑在底座11240内，使得闭合梭动件可相对于底座轴向运动。闭合梭动件11250包括被构造用于附接到附接销11037的一对朝近侧突起的钩11252(图36)，该附接销附接到第二闭合连接件11038，如将在下文进一步详细地讨论。在至少一个示例中，闭合构件组件13000包括具有近侧端部13012的近侧闭合构件段或近侧闭合管段13010，该近侧端部联接到闭合梭动件11250以相对于闭合梭动件旋转。例如，将U形连接器11263插入近侧闭合构件段13010的近侧端部13012中的环形狭槽13014中，并使其保留在闭合梭动件11250中的竖直狭槽11253内。这种布置结构用于将近侧闭合管段13010附接到闭合梭动件11250，以与闭合梭动件一起轴向行进，同时使得近侧闭合管段13010能够相对于闭合梭动件11250围绕轴轴线SA旋转。闭合弹簧11268轴颈连接在近侧闭合管段13010上并且用于沿近侧方向“PD”偏压近侧闭合管段13010，当轴组件可操作地联接到柄部11014时，该闭合弹簧可用来将闭合触发器11032枢转到未致动位置。
可互换轴组件11200还包括关节运动接头13020。如图38中可见，例如，远侧闭合构件或远侧闭合管段3030联接到近侧闭合构件或近侧闭合管段13010的远侧端部。关节运动接头13020包括双枢轴闭合套管组件13022。根据各种形式，双枢轴闭合套管组件13022包括具有朝远侧突出的上柄脚13052和下柄脚13054的端部执行器闭合管13050。上部双枢轴连接件13056包括向上突出的远侧枢轴销和近侧枢轴销，这些枢轴销分别接合远侧闭合管段13030上的朝近侧突出的上柄脚13052中的上部远侧销孔以及朝远侧突出的上柄脚13032中的上部近侧销孔。下部双枢轴连接件13058包括向上突出的远侧枢轴销和近侧枢轴销，这些枢轴销分别接合朝近侧突出的下柄脚13054中的下部远侧销孔以及朝远侧突出的下柄脚13034中的下部近侧销孔。如将在下文进一步详细讨论的，闭合构件或闭合管组件13000朝远侧(方向“DD”)平移，以例如响应于闭合触发器11032的致动而使砧座12000闭合。通过使闭合管组件13000朝近侧平移来打开砧座12000，这使得端部执行器闭合套管与砧座12000相互作用并使其枢转至打开位置。
同样如上所述，可互换轴组件11200还包括击发驱动组件11900，该击发驱动组件被支撑以用于在轴脊11210内轴向行进。击发驱动组件11900包括中间击发轴部分11222，该中间击发轴部分被构造用于附接到远侧切割部分或刀杆11910。中间击发轴部分11222可在其远侧端部中包括纵向狭槽11223，该纵向狭槽可被构造成能够接收远侧刀杆11910的近侧端部上的插片11912。纵向狭槽11223和近侧端部插片11912可被设定尺寸并被构造成能够允许该纵向狭槽和该近侧端部插片之间的相对运动并且可包括滑动接头11914。滑动接头11914可允许击发驱动装置的中间击发轴部分11222运动，以在不使刀杆11910运动或至少基本上不运动的情况下，使端部执行器11300进行关节运动。一旦端部执行器11300已被合适地取向，便可朝远侧推进中间击发轴部分11222，直到纵向狭槽11223的近侧侧壁与插片11912发生接触，以便推进刀杆11910并击发定位在通道11310内的钉仓14000。刀杆11910包括刀部分11920并且包括上部砧座接合插片11924和下部通道接合插片11926，该刀部分包括刀片或组织切割刃11922。各种击发构件构型和操作公开于以引用方式并入本文的各种其他参考文献中。
如图37中可见，轴组件1200还包括被可旋转地接收在近侧闭合管段13010上的切换筒11500。切换筒11500包括中空轴段11502，该中空轴段具有形成于其上的轴凸台，以用于在其中接收向外突出的致动销。在各种情况下，该致动销延伸穿过狭槽进入设置在锁定套管中的纵向狭槽，以在锁定套管与关节运动驱动器接合时有利于该锁定套管轴向运动。旋转扭簧11420被构造成能够接合切换筒11500上的凸台和喷嘴外壳11203的一部分，以将偏压力施加到切换筒11500。切换筒11500还可包括限定于其中的至少部分周边开口，所述开口可被构造成能够接收从喷嘴半部11202、11203延伸的周边安装座，并且允许切换筒11500和近侧喷嘴11201之间的相对旋转而不是相对平移。安装座还延伸穿过待坐置在脊轴11210中的凹陷部中的近侧闭合管段13010中的开口13011。切换筒11500围绕轴轴线SA的旋转最终将引起致动销和锁定套管在其接合位置和脱离接合位置之间的旋转。在一种布置结构中，切换筒11500的旋转可与闭合管或闭合构件的轴向推进关联。因此，闭合系统的致动本质上可按下列文献中进一步详细描述的各种方式，将关节运动驱动系统与击发驱动系统可操作地接合，以及使这两个系统脱离接合：美国专利申请序列号13/803,086，和名称为“SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM”的美国专利9,913,642，这些文献各自的完整公开内容据此以引用方式并入本文。例如，当闭合管处于其对应于“钳口打开”位置的最近侧位置时，闭合管13010将已定位切换筒11500，以便将关节运动系统与击发驱动系统关联。当闭合管已运动到其对应于“钳口闭合”位置的最远侧位置时，闭合管已使切换筒1500旋转到其中关节运动系统与击发驱动系统去关联的位置。
同样如图37所示，轴组件11200可包括滑环组件11600，该滑环组件例如可被构造成能够将电力传导至端部执行器11300和/或从该端部执行器传导电力，并且/或者将信号传送至端部执行器11300和/或从该端部执行器接收信号。滑环组件11600可包括近侧连接器凸缘11604和远侧连接器凸缘，该近侧连接器凸缘安装到从底座11240延伸的底座凸缘11242，该远侧连接器凸缘定位在限定在轴外壳中的狭槽内。近侧连接器凸缘11604可包括第一面，并且远侧连接器凸缘可包括第二面，该第二面与第一面相邻定位并能够相对于第一面运动。远侧连接器凸缘可围绕轴轴线SA相对于近侧连接器凸缘11604旋转。近侧连接器凸缘11604可包括限定在其第一面中的多个同心或至少基本上同心的导体。连接器可安装在连接器凸缘的近侧侧面上，并且可具有多个触点，其中每个触点对应于导体中的一个并且与其电接触。这种布置结构在保持近侧连接器凸缘11604与远侧连接器凸缘之间电接触的同时，允许这两个凸缘之间进行相对旋转。例如，近侧连接器凸缘11604可包括电连接器11606，该电连接器可使导体与安装到轴底座11240的轴电路板11610进行信号通信。在至少一种实例中，包括多个导体的线束可在电连接器11606与轴电路板1610之间延伸。电连接器11606可朝近侧延伸穿过底座安装凸缘11242中限定的连接器开口11243。参见图38。关于滑环组件11600的更多细节可见于例如美国专利申请序列号13/803,086、名称为“STAPLECARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利申请序列号13/800,067，以及2013年3月13日提交的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利9,345,481。美国专利申请序列号13/803,086、美国专利申请序列号13/800,067和美国专利9,345,481，据此各自全文以引用方式并入本文。
如上文所讨论，轴组件11200包括可固定地安装到柄部11014的近侧部分，以及能够围绕纵向轴线旋转的远侧部分。可旋转远侧轴部分可如上文所讨论围绕滑环组件11600相对于近侧部分旋转。滑环组件11600的远侧连接器凸缘可定位在可旋转远侧轴部分内。而且，除上述以外，切换筒11500也可定位在可旋转远侧轴部分内。当可旋转远侧轴部分旋转时，远侧连接器凸缘和切换筒11500可彼此同步地旋转。另外，切换筒11500可相对于远侧连接器凸缘在第一位置与第二位置之间旋转。当切换筒11500处于其第一位置时，关节运动驱动系统可与击发驱动系统可操作地脱离接合，因此，击发驱动系统的操作可不使轴组件11200的端部执行器11300进行关节运动。当切换筒11500处于其第二位置时，关节运动驱动系统可以与击发驱动系统可操作地接合，因此，击发驱动系统的操作可以使轴组件1200的端部执行器11300进行关节运动。当切换筒11500在其第一位置和其第二位置之间运动时，切换筒11500相对于远侧连接器凸缘运动。在各种实例中，轴组件11200可包括被配置成能够检测切换筒11500的位置的至少一个传感器。
再次参见图37，底座11240包括形成于其上的至少一个、并且优选地两个锥形附接部分11244，这些锥形附接部分适于被接收在对应的燕尾形狭槽11702内，该燕尾形狭槽形成在框架11020的远侧附接凸缘部分11700内。参见图36。每个燕尾形狭槽11702可以是锥形，或换句话讲，可以略成V形，从而以坐置方式将附接部分11244接收在其中。如图37和图38中可进一步看到的那样，轴附接凸耳11226在中间击发轴11222的近侧端部上形成。当可互换轴组件11200联接到柄部11014时，轴附接凸耳1226被接收在形成于纵向驱动构件11120的远侧端部11125中的击发轴附接支架11126中。参见图36。
各种轴组件实施方案采用闩锁系统11710用于将轴组件11200可移除地联接到外壳11012并且更具体地联接到框架11020。如图37中可见，例如，在至少一种形式中，闩锁系统11710包括可运动地联接到底座11240的锁定构件或锁定轭11712。在例示的实施方案中，例如，锁定轭11712为U形，具有两个隔开并向下延伸的支腿11714。支腿11714各自具有形成于其上的枢轴凸耳11715，这些枢轴凸耳适于被接收在形成于底座11240中的对应孔11245中。这种布置结构有利于将锁定轭11712枢转附接到底座11240。锁定轭11712可包括两个朝近侧突起的锁定耳状物11716，这两个锁定耳状物被构造用于与框架11020的远侧附接凸缘11700中对应的锁定棘爪或凹槽11704可释放地接合。参见图36。在各种形式中，锁定轭11712被弹簧或偏压构件(未示出)沿近侧方向偏压。锁定轭11712的致动可通过闩锁按钮11722实现，该闩锁按钮可滑动地安装在安装到底座11240的闩锁致动器组件11720上。闩锁按钮11722可相对于锁定轭11712沿近侧方向偏压。锁定轭11712可通过沿远侧方向偏压闩锁按钮而运动到解锁位置，这也使得锁定轭11712枢转成不再与框架11020的远侧附接凸缘11700保持接合。当锁定轭11712与框架11020的远侧附接凸缘11700“保持接合”时，锁定凸耳11716以保持方式安置在远侧附接凸缘11700的相应锁定棘爪或凹槽11704内。
当采用包括适于切割和紧固组织的本文所述类型的端部执行器以及其他类型的端部执行器的可互换轴组件时，可能有利的是防止可互换轴组件在端部执行器致动期间不经意地从外壳脱离。例如，在使用中，临床医生可致动闭合触发器11032以抓持目标组织并将其操纵到期望的位置中。一旦目标组织以期望的取向定位在端部执行器11300内，临床医生就可完全致动闭合触发器11032，以闭合砧座12000并将目标组织夹紧在合适位置以用于切割和缝合。在这种实例中，第一驱动系统11030已被完全致动。在目标组织已被夹紧在端部执行器11300中之后，可能有利的是防止轴组件11200不经意地从外壳11012脱离。闩锁系统11710的一种形式被构造成能够防止这种不经意的脱离。
如图37中可最清楚地看到的那样，锁定轭11712包括至少一个、并且优选两个锁钩11718，这些锁钩适于接触闭合梭动件11250上形成的对应锁定凸耳部分11。当闭合梭动件11250处于未致动位置(即，第一驱动系统11030未致动并且砧座12000打开)时，锁定轭11712可沿远侧方向枢转，以将可互换轴组件11200从外壳11012解锁。处于该位置时，锁钩11718不接触闭合梭动件11250上的锁定凸耳部分11256。但是，当闭合梭动件11250运动到致动位置(即第一驱动系统11030被致动并且砧座11306处于闭合位置)时，锁定轭11712受到阻碍，不能枢转到解锁位置。换句话讲，如果临床医生试图将锁定轭11712枢转到解锁位置，或者例如，锁定轭11712不经意地以原本可能引起其朝远侧枢转的方式受到碰撞或发生接触，则锁定轭11712上的锁钩11718将接触闭合梭动件11250上的锁耳11256，并防止锁定轭11712运动到解锁位置。
现在将描述可互换轴组件11200与柄部11014的附接。要开始联接过程，临床医生可将可互换轴组件11200的底座11240定位在框架11020的远侧附接凸缘11700上方或附近，使得底座11240上形成的渐缩附接部分11244与框架11020中的燕尾形狭槽11702对准。然后临床医生可使轴组件11200沿垂直于轴轴线SA的安装轴线运动，以使附接部分11244坐置成与对应的燕尾形接收狭槽11702“可操作地接合”。在这样做时，中间击发轴11222上的轴附接凸耳11226也将安置在可纵向运动的驱动构件11120中的支架11126中且第二闭合连接件1038上的销11037的部分将安置在闭合轭11250中的相应钩11252中。如本文所用，术语“可操作地接合”在两个部件的背景下是指这两个部件彼此充分地接合，使得一旦向其施加致动动作，这些部件便可执行其预期行动、功能和/或程序。
可互换轴组件11200的至少五个系统可以与柄部11014的至少五个对应系统可操作地联接。第一系统可包括框架系统，该框架系统将轴组件11200的框架或脊与柄部11014的框架11020联接并/或对准。另外的系统可包括闭合驱动系统11030，该闭合驱动系统可将柄部11014的闭合触发器11032与轴组件11200的闭合管组件13000和砧座12000可操作地连接。如上文所概述，轴组件11200的闭合管附接轭1250可与第二闭合连接件11038上的销11037接合。另外的系统可包括击发驱动系统11080，该击发驱动系统可将柄部1014的击发触发器11130与轴组件11200的中间击发轴11222可操作地连接。如上文所概述，轴附接凸耳11226可与纵向驱动构件11120的支架11126可操作地连接。另一个系统可包括电气系统，该电气系统能够：发送轴组件(诸如轴组件11200)已与柄部11014可操作地接合的信号到柄部11014中的控制器(诸如微控制器)，并且/或者在轴组件11200与柄部11014之间传导功率和/或通信信号。例如，轴组件11200可包括可操作地安装到轴电路板11610的电连接器11810。电连接器11810被构造成用于与柄部控制板11100上的对应电连接器11800配合接合。有关电路系统和控制系统的更多细节可见于美国专利申请序列号13/803,086和美国专利申请序列号14/226,142，这两者各自的完整公开内容此前以引用方式并入本文。第五系统可由用于将轴组件11200可释放地锁定到柄部11014的闩锁系统组成。
当使用本文所述类型和构造的端部执行器11300时，临床医生操纵第一钳口和第二钳口(砧座12000和细长通道11310，该细长通道具有可操作地安装在其中的外科钉仓)，以将待切割和缝合的组织(“目标组织”)捕获在其间。如图38中可见，例如，外科钉仓14000包括仓体14010，该仓体被构造成能够被可移除地支撑在细长通道11310内。仓体14010包括细长仓狭槽14016，该细长仓狭槽从近侧端部14012穿过仓体14010延伸到远侧端部部分14014以使刀构件或击发构件11920能够穿过其中。仓体14010还在细长狭槽14016的每一侧上限定仓平台表面14020。多个钉腔14022在细长狭槽14016的每一侧上设置在仓体14010中。每个腔14022打开穿过平台表面14020以在其中可移除地支撑一个或多个外科钉。在至少一个仓布置结构中，在细长狭槽14016的每一侧上设置三排钉腔14022。这些排被成形为使得中心排中的钉相对于两个相邻外排中的钉交错。这些钉被支撑在钉驱动器上，这些钉驱动器可运动地支撑在每个钉腔内。在至少一些布置结构中，例如，钉驱动器被布置成当被与刀构件11920相关联的凸轮构件或凸轮作用部分接触时向上接触或“击发”。在一些布置结构中，楔形滑动件或凸轮作用滑动件可运动地支撑在仓体中，并且适于在刀构件11920穿过仓从仓体14010的近侧端部部分14012轴向部署到远侧端部部分14014时，轴向移位穿过仓体。楔形滑动件包括与每排钉腔相关联的凸轮作用构件或楔形件，以便连续地部署支撑在其中的钉驱动器。当凸轮接触钉驱动器时，驱动器在钉腔内被向上驱动，从而驱动支撑在其上的一个或多个钉离开钉腔并穿过夹紧的组织，与砧座的钉成形表面成形接触。楔形滑动件或凸轮作用构件位于刀或击发构件11920的刀或组织切割刃的远侧，使得组织在被组织切割刃切断之前被缝合。
再次参见图38，在例示的示例中，砧座12000包括终止于砧座安装部分12010中的砧座主体12002。砧座安装部分12010被可运动地或可枢转地支撑在细长通道11310上，以用于围绕横向于轴轴线SA的固定砧座枢转轴线PA相对于该细长通道选择性地枢转行进。在例示的布置结构中，枢轴构件或砧座耳轴12012侧向延伸出砧座安装部分12010的每个侧向侧，以被接收在形成于细长通道11310的近侧端部部分11312的直立壁11315中的对应耳轴支架11316中。砧座耳轴12012由通道盖或砧座保持器11290枢转地保持在其对应的耳轴支架11316中。通道盖或砧座保持器11290包括一对附接凸耳，该对附接凸耳被构造成能够以保持方式被接收在形成于细长通道11310的近侧端部部分11312的直立壁11315中的对应凸耳凹槽或凹口内。
在至少一种布置结构中，远侧闭合构件或端部执行器闭合管13050采用两个轴向偏置的近侧正钳口开口特征部13060和远侧正钳口开口特征部13062。正钳口打开特征部13060、13062被构造成能够与形成于砧座安装部分12010上的对应释放区域和阶梯部分交接，如在2017年6月28日提交的名称为“SURGICAL INSTRUMENT WITH AXIALLY MOVABLECLOSURE MEMBER”的美国专利申请序列号15/635,631中进一步详细描述的，其全部公开内容以引用方式并入本文。可采用其他钳口开口布置结构。
除了下面讨论的差异之外，图39示出了与先前轴组件11200类似的轴组件15200的一部分。为了简洁起见，将不再重复关于两个轴组件中的类似部件的构造和操作的细节。如下所讨论，轴组件可与类似于先前外壳11012的外壳结合使用。在例示的布置结构中，轴组件15200包括远侧脊轴段15210，该远侧脊轴段被构造成能够在关节运动接头处枢转地联接到外科端部执行器，以使得外科端部执行器能够通过关节运动系统15100围绕关节运动轴线相对于远侧脊轴段15210的远侧端部进行关节运动。在一种形式中，关节运动系统15100包括近侧关节运动驱动器15102，该近侧关节运动驱动器以上述方式枢转地联接到关节运动连接件。近侧关节运动驱动器15102的轴向运动将向外科端部执行器施加关节运动动作，以使外科端部执行器围绕关节运动轴线相对于脊组件15210进行关节运动。
轴组件15200还包括闭合系统或闭合构件组件17000，其可用于以上述方式闭合和/或打开外科端部执行器的钳口。闭合构件组件17000包括附接到远侧闭合构件的近侧闭合构件段或近侧闭合管段17010。远侧闭合构件形成具有端部执行器闭合管的双枢轴闭合套管组件，以有利于外科端部执行器的关节运动，如上文相对于轴组件11200所讨论。
轴组件15200还包括击发驱动组件11900，该击发驱动组件被支撑以用于在脊轴15210内轴向行进。击发驱动组件11900包括中间击发轴部分11902，该中间击发轴部分被构造用于附接到远侧切割部分或刀杆，如上文所讨论。
转到图40，为了清楚起见，已省略轴组件15200的底座部分以及闭合梭动件布置结构。近侧闭合管段17010以本文所公开的各种方式中的任一种支撑在闭合梭动件中，以用于与闭合梭动件一起轴向行进。如上文所讨论，闭合梭动件能够通过致动闭合触发器或(其他形式的闭合致动器)在底座内轴向运动。近侧闭合管段17010的近侧端部部分17012联接到闭合梭动件，以相对于闭合梭动件旋转。闭合梭动件的轴向运动导致闭合构件组件17000的轴向运动，以向外科端部执行器的钳口施加闭合动作和打开动作。如上所述，轴附接凸耳11904形成于中间击发轴11902的近侧端部上。当轴组件15200联接到外科器械的外壳时，轴附接凸耳11902以上述方式被接收在形成于马达驱动的纵向驱动构件的远侧端部中的击发轴附接支架中。
轴组件15200采用驱动离合器组件16000以用于将关节运动系统15100选择性地联接到击发驱动组件11900，使得当端部执行器的钳口打开时，关节运动系统15100能够由击发驱动组件11900致动。当端部执行器的钳口闭合时，关节运动系统15100被锁定在适当位置而不与击发驱动组件接合，使得击发驱动组件11900可在不致动关节运动系统15100的情况下被致动。在例示的布置结构中，近侧关节运动驱动器15102的近侧端部15104联接到轴颈连接在中间击发轴11902上的离合器连接件16010。换句话讲，中间击发轴11902延伸穿过中心轴孔16011，该中心轴孔延伸穿过离合器连接件16010。离合器连接件16010被支撑在近侧脊轴插入件16030内，该近侧脊轴插入件被支撑在远侧脊轴段15210的近侧。
在例示的布置结构中，脊轴插入件16030包括轴向连接件狭槽16034，该轴向连接件狭槽用于将离合器连接件16010轴向支撑在其中。中间击发轴11902延伸穿过脊轴插入件16030中的中心轴孔16032，并且穿过离合器连接件16010中的中心孔16011，如图43所示。轴向连接件狭槽16034包括下部轴向狭槽16036(图43和图47)，其被构造成能够可滑动地容纳离合器连接件16010上的下部支撑插片16014。此类布置结构允许离合器连接件16010在轴向连接件狭槽16034内轴向运动，但被防止在其中旋转。
如图43和图44中可见，钩15106形成在近侧关节运动驱动器15102的近侧端部15104上并且被构造成能够被接收在离合器连接件16010中的钩腔16013中。离合器连接件16010被构造成能够通过锁定杆或锁定构件16020与中间击发轴11902接合或联接，该锁定杆或锁定构件可滑动地安装在离合器连接件16010中的狭槽16012中，以用于在其中选择性地径向行进。锁定构件10620能够在狭槽16012内在接合位置(图49)与中间击发轴11902中的径向锁定凹口11906之间径向运动，在接合位置所述锁定构件16020被接收在径向锁定凹口内。
驱动离合器组件16000还包括可径向伸展的离合器板组件16050。如图45和图46中可见，在至少一种布置结构中，离合器板组件16050部分地围绕近侧闭合管段17010延伸。离合器板组件16050可类似于蛤壳，该蛤壳包括联接在一起或通过活动铰链16056互连的第一夹具段16052和第二夹具段16054，该活动铰链允许夹具段16052、16054径向向内和向外的相对运动。离合器板组件16035通过一对C形夹16066松散地保持在近侧闭合管段17010上，这对C形夹有利于离合器板组件16030的少量径向扩展，同时将离合器板组件保持在近侧闭合管段17010上。
在例示的布置结构中，锁定构件16020延伸穿过近侧闭合管段17010(图43、图49、图53)中的轴向狭槽17014和形成于第二夹具段16054(图43和图45)中的轴向狭槽16058。轴向狭槽16058限定两个向内延伸的横档16060，这两个向内延伸的横档可通过形成于锁定构件16020上的两个侧向延伸的翅片16022接合。横档16060可滑动地接收在翅片16022和离合器连接件16010之间。此类布置结构使得离合器连接件16010和锁定构件16020能够相对于第二夹具段16054轴向运动(图45中的箭头AT)。此类布置结构还将锁定构件16020联接到第二夹具段16054，使得锁定构件16020将与第二夹具段16054一起径向行进。横档16060凹入第二夹具段16054中以限定锁定腔16062。锁定盖16070被接收在锁定腔16062中。锁定盖16050包括轴向狭槽16052，锁定构件16020延伸穿过该轴向狭槽。参见图45和图46。
现在转到图39至图42，轴组件15200包括喷嘴组件15201，该喷嘴组件类似于喷嘴11201并且包括喷嘴部分15202和15203。此外，近侧喷嘴区段15204附接到喷嘴组件15201，以有利于喷嘴组件15201以本文所述的各种方式围绕轴轴线SA相对于底座旋转。如图40中可见，喷嘴组件15201包括一系列径向锁定凹槽15206，该一系列径向锁定凹槽被构造成能够与形成于锁定构件16020的顶端中的一系列锁定翅片16024锁定地接合。
接下来转到图47和图48，在例示的示例中，近侧脊轴插入件16030还形成有关节运动锁组件16040。在一种形式中，关节运动锁组件16040包括夹持布置结构，其中锁定夹持部分16042通过活动铰链16044可运动地附接到近侧脊轴插入件16030。锁定夹持部分16042包括夹持插片16046，该夹持插片被布置成与形成于近侧脊轴插入件16030中的夹持表面16038成面对的布置结构。如图48中可见，近侧关节运动驱动器15102可滑动地接收在夹持插片16046和夹持表面16038之间。此外，夹持致动器插片17016被压接到近侧闭合管段17010中，使得夹持致动器插片17016与夹持插片16046接合。
如上所述，在例示的示例中，驱动离合器组件16000被构造成能够将关节运动系统15100联接到击发驱动组件11900，使得当端部执行器的钳口打开时，关节运动系统15100能够由击发驱动组件11900致动。当端部执行器的钳口闭合时，关节运动系统15100被锁定在适当位置而不与击发驱动组件接合，使得击发驱动组件11900可在不致动关节运动系统15100的情况下被致动。为了完成驱动离合器组件16000的此类自动致动，可轴向运动的致动器构件16080附接到近侧闭合管段17010的近侧端部部分17012。在至少一种布置结构中，例如，中间击发轴部分11902包括致动器环16082，该致动器环固定地附接到近侧闭合管段17010的近侧端部部分17012。在一个示例中，致动器环16082通过压接件16084压接到近侧闭合管段17010上。然而，可采用将致动器构件16080附接到近侧闭合管段17010的其他方法。
现在将参考图49至图54描述驱动离合器组件16000的操作。图49和图50示出了处于接合取向的驱动离合器16000。当处于该位置时，近侧闭合管段17010处于其与钳口打开位置对应的最近侧位置。当处于该位置时，闭合系统尚未被致动。例如，在其中轴组件15200已附接到手持式外壳的应用中，闭合触发器尚未被压下。如图49中可见，致动器16080位于可径向扩展的离合器板组件16050的近侧。如图49中可进一步看到的那样，离合器板组件16050通过夹具环16066被夹持到处于其第一夹紧位置的近侧闭合管段17010上。当处于该位置时，锁定构件16020与中间击发轴11902中的径向锁定凹口11906锁定接合。因此，锁定构件16020和离合器连接件16010被锁定到中间击发轴11902。因为近侧关节运动驱动器15102钩到离合器连接件16010，所以它也关联到中间击发轴11902。因此，临床医生现在能够通过致动击发驱动组件11900以使中间击发轴部分11902轴向运动来使附接到轴组件15200的外科端部执行器进行关节运动。因为近侧击发驱动器15102联接到中间击发轴部分11902，所以中间击发轴部分11902的轴向运动还使得近侧关节运动驱动器15102轴向运动并且使外科端部执行器进行关节运动。如果临床医生使得中间击发轴部分11902沿远侧方向DD驱动，则外科端部执行器将围绕关节运动轴线沿向右方向进行关节运动。参见图51。如果临床医生驱动中间击发轴部分11902沿近侧方向PD运动，则外科端部执行器将围绕关节运动轴线沿向左方向进行关节运动。参见图52。在任一种情况下，关节运动在端部执行器的钳口处于打开位置的情况下发生。
一旦临床医生已使处于期望位置的外科端部执行器进行关节运动，击发驱动系统11900就被停用。临床医生然后可激活闭合系统以将关节运动的端部执行器的钳口闭合到目标组织上。如上所述，当轴组件15200附接到手持式外壳时，临床医生可通过压下闭合触发器来致动闭合系统。闭合系统的致动使得近侧闭合管段17010沿远侧方向轴向运动。近侧闭合管段17010朝远侧的运动还使得形成于致动器构件16080的远侧端部上的凸轮表面16086在可径向伸展的离合器板组件16050下方滑动，从而将其径向向外驱动(图54中的箭头RD)。第二夹具段16054的径向运动使得锁定构件16020与中间击发轴11902中的径向锁定凹口11906以及形成于其上的锁定翅片16024脱离接合，以锁定地接合喷嘴组件15201中的径向锁定凹槽15206。参见图53和图54。当处于该位置时，关节运动系统即近侧关节运动驱动器15102不再关联到击发驱动系统。临床医生可致动闭合驱动系统，直到外科端部执行器的钳口处于闭合位置。近侧闭合管段17010的远侧运动还使夹持致动器插片17016与关节运动锁组件16040的夹持插片16046接合，从而将近侧关节运动驱动器15102夹持在适当位置并防止其任何轴向运动。因此，当钳口处于闭合位置时，关节运动驱动系统与击发驱动系统脱离接合，并且关节运动驱动系统被锁定在适当位置。临床医生然后可操作击发驱动系统以朝远侧驱动中间击发轴部分11902和附接到该中间击发轴部分的击发杆，以完成外科端部执行器的击发。当临床医生将近侧闭合管段17010朝近侧回缩回到起始位置或未致动位置时，压紧环16066将使得离合器板组件16050返回到夹持接合位置，从而再次将关节运动系统关联到击发驱动系统并且解锁关节运动锁组件16040，以允许近侧关节运动驱动器15102再次轴向运动。
除了下面讨论的差异之外，图55至图57示出了与可互换轴组件11200类似的另一个可互换轴组件18200的多个部分。在可互换轴组件11200中，关节运动系统关联到击发驱动系统，直到闭合系统被致动。闭合系统的致动使得关节运动系统与击发驱动系统去关联，使得击发驱动系统随后可在不致动关节运动系统的情况下被致动。在可互换轴组件18200中，关节运动系统能够独立于闭合系统致动。因此，在可互换轴组件18200中，外科端部执行器能够进行关节运动，同时其钳口完全打开、部分打开或完全闭合。此类关节运动能力对于先前的可互换轴组件11200是不可用的。
首先转到图56和图57，轴组件18200采用轴颈连接在近侧闭合管段20010的近侧端部部分上的移位筒组件18500。近侧闭合管段20010的轴向移位以上文相对于近侧闭合管段13010所述的方式被控制。近侧闭合管段20010可轴向运动而不使移位筒组件18500运动。如图57中可见，轴组件18200可包括离合器组件18400，该离合器组件可被构造成能够将近侧关节运动驱动器19102选择性地和可释放地联接到中间击发构件18222。在一种形式中，离合器组件18400包括围绕中间击发构件18222定位的锁定衬圈或锁定套管18402，其中锁定套管18402可在接合位置与脱离接合位置之间旋转，在接合位置，锁定套管18402将近侧关节运动驱动器19102联接到中间击发构件18222，在脱离接合位置，近侧关节运动驱动器19102没有可操作地联接到中间击发构件18222。当锁定套管18402处于其接合位置时，中间击发构件18222的远侧运动可使关节运动驱动器19102朝远侧运动，并且相应地，中间击发构件18222的近侧运动可使近侧关节运动驱动器19102朝近侧运动。当锁定套管18402处于其脱离接合位置时，中间击发构件18222的运动不传递到近侧关节运动驱动器19102，因此，中间击发构件18222可独立于近侧关节运动驱动器19102运动。在各种情况下，关节运动驱动器19102可通过2013年3月14日提交的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803,086中公开的类型的关节运动锁保持在适当位置，该专利申请的全部公开内容以引用方式并入本文。
主要参见图57，锁定套管18402可包括圆柱形或至少基本上圆柱形的主体，该主体包括限定于其中、被构造成能够接收中间击发构件18222的纵向孔18403。锁定套管18402可包括沿直径相对的、面朝内的锁定突起18404和面朝外的锁定构件18406。锁定突起18404可被构造成能够与中间击发构件18222选择性地接合。更具体地，当锁定套管18402处于其接合位置时，锁定突起18404被定位在限定于中间击发构件18222中的驱动凹口18228内，使得远侧推力和/或近侧推力可从中间击发构件18222传输至锁定套管18402。当锁定套管18402处于其接合位置时，第二锁定构件18406被接纳在限定于近侧关节运动驱动器19102中的驱动凹口19104内，使得施加到锁定套管18402的远侧推力和/或近侧拉力可传递到近侧关节运动驱动器19102。实际上，当锁定套管18402处于其接合位置时，中间击发构件18222、锁定套管18402和近侧关节运动驱动器19102将一起运动。另一方面，当锁定套管18402处于其脱离接合位置时，锁定突起18404可能并不定位在中间击发构件18222的驱动凹口18228内，因此，远侧推力和/或近侧拉力可能不会从中间击发构件18222传输至锁定套管18402。对应地，远侧推力和/或近侧拉力可不传递至近侧关节运动驱动器19102。在此类情况下，中间击发构件18222可相对于锁定套管18402和近侧关节运动驱动器19102朝近侧和/或朝远侧滑动。中间击发构件18222可以本文所述的各种方式轴向推进。近侧关节运动驱动器19102沿远侧方向的轴向推进将使外科端部执行器向左进行关节运动，并且近侧关节运动驱动器沿近侧方向的轴向回缩将使外科端部执行器以本文所述的各种方式向右进行关节运动。
如图57中可见，移位筒组件18500包括被接收在近侧闭合管段20010的近侧部分上的管状或圆柱形主体18502。移位筒组件18500还包括近侧凸缘18504，该近侧凸缘被布置成与从底座18240延伸的底座凸缘18242成面对布置结构。底座18240还以本文所述的各种方式可操作地支撑喷嘴组件18201。在例示的示例中，凸轮狭槽18506设置在移位筒主体18502中并且被构造成能够在其中接收移位器键18420上的移位器销18422，该移位器键被构造成能够被接收在锁定套管18402中的狭槽18410内。如图57中可见，移位器键18420延伸穿过脊轴21010中的离合器狭槽21012。脊轴21010可另外类似于上述脊轴1210。移位器销18422延伸穿过脊轴21010中的销狭槽12014并穿过近侧闭合管段20010中的移位器窗口20011。如将在下文进一步所述，移位筒18500的轴向运动将导致锁定套管18402的旋转行进，以便如上所述使锁定套管18402与中间击发构件18222和近侧关节运动驱动器19102驱动接合。
在例示的示例中，切换筒18502的轴向运动可由至少一个螺线管组件18600控制。如图57中可见，所例示的示例采用两个螺线管组件18600。在至少一个示例中，每个螺线管组件18600包括由底座凸缘18242可运动地支撑的可轴向运动的螺线管致动器18602。螺线管组件18600以本文所述的各种方式以及以引用方式并入本文的各种参考文献联接到轴组件18200所附接的外壳上的电路控制板。当螺线管18600被致动时，致动器18602接触切换筒组件18500的近侧凸缘18504以使切换筒组件沿远侧方向DD运动。位于喷嘴组件(未示出)中的回位弹簧18700用于沿近侧方向PD偏压切换筒。参见图65。
现在将参考图58和图59描述操作轴组件18200的一种方法，以图表形式示出了用于操作轴组件18200的各种步骤或动作。如图58中可见，例如，在步骤1中，外壳中的控制系统处于“活动”状态，以使得联接到轴组件18200的外科端部执行器能够进行关节运动。如上文所讨论，轴组件18200可操作地联接到其上的外壳包括控制电路或系统，并且可包括位于外壳上或远离外壳定位的显示屏，以向使用者显示某些操作参数和指示标识。当关节运动系统处于在步骤1处指示的活动状态时，闭合系统处于其未致动或完全回缩状态，这对应于外科端部执行器的钳口处于其完全打开位置。螺线管是未致动的，其中其致动器处于其回缩位置。参见图60。如图60中可见，移位器销18422位于凸轮狭槽18506的最远侧部分18508中。当处于该位置时，如果需要，随着移位器销18422已使锁定套管18402沿逆时针CCW方向(使用者的角度)旋转，使用者可致动关节运动系统以使端部执行器进行关节运动，从而使得锁定套管18402上的第二锁定构件18406旋转成与近侧关节运动驱动器19102中的驱动凹口19104接合。当处于该位置时，锁定套管18402与中间击发构件18222接合。
仍然参见图58，在步骤2处，使用者已通过以本文所述的各种方式致动闭合系统而使近侧闭合管段20010部分地向前运动。参见图61。在这一阶段，使用者可能已经部分或完全闭合了钳口，但是如果需要，系统仍然有利于外科端部执行器的关节运动。在步骤3处，使用者已经闭合了端部执行器钳口。在这一阶段，如果需要，器械可被击发。在一种布置结构中，例如，器械的显示屏可显示指令，该指令指示“准备好击发”，击发驱动系统可被初始致动。例如，在包括击发触发器的布置结构中，显示屏可指示使用者“拉动”或以其他方式致动击发触发器。击发驱动系统的这种初始致动可使螺线管18600通电，以使得螺线管致动器18602使移位筒组件18500沿远侧方向DD运动。控制系统算法可提供预先确定的延迟周期(例如，15秒等)，并且在致动击发驱动系统之后显示消息“等待十五秒”等。
随着移位筒组件18500沿远侧方向运动，移位器销18422进入移位筒组件18500中的凸轮狭槽18506的凸轮作用部分18510。随着移位器销18422进入凸轮作用狭槽18506的凸轮作用部分18510，移位筒组件使得移位器销18422和移位器键18420使锁定套管18402沿顺时针CW方向(使用者的角度)旋转。随着锁定套管18402在顺时针位置旋转，第二锁定构件18406旋转脱离与近侧关节运动驱动器19102中的驱动凹口19104的接合，以使关节运动系统与击发驱动系统脱离接合。参见图62。在步骤4处，使用者可随后致动击发驱动系统以推进中间击发构件18222并且以本文所述的各种方式驱动击发构件(“刀”)穿过外科端部执行器。
在步骤5处，击发构件或刀已完全返回到其起始位置，并且使用者已致动闭合系统以打开端部执行器钳口。参见图63。接下来转到图59，在步骤6处，外科器械控制系统的算法然后可以在系统检测到钳口已经打开之后使得螺线管18600回缩。这可以用检测闭合管和/或钳口在外科端部执行器上的位置的传感器来实现。当螺线管18600断电时，致动器18602回缩。参见图65。在步骤7中，回位弹簧18700沿近侧方向PD将移位筒组件18500偏压到“骑行模式”。当处于骑行模式时，移位器销18422未使凸轮狭槽18506的凸轮部分18510完全凸起，使得锁定套管18402上的面向内的锁定突起18404未旋转成与中间击发构件18222中的驱动凹口18228接合。在这一阶段，控制系统可启动关节运动捕获算法，该算法使得移位筒组件18500能够旋转回到图66所示的起始位置。当处于该位置时，关节运动系统再次可操作地联接到击发驱动系统，并且外科端部执行器的钳口处于打开位置。然后，使用者可以上述方式致动关节运动系统，以使外科端部执行器在其钳口打开时进行关节运动。在至少一种布置结构中，移位筒组件18500可具有比用于先前的轴组件(诸如先前的可互换轴组件11200)中的移位筒组件更厚的壁和/或由更硬的材料制成。当螺线管被去致动时，回位弹簧还可将移位筒组件18500偏压回到关节运动模式。可采用当前关节运动接合开关，并且该当前关节运动接合开关可包括磁体/线性霍尔效应传感器，可通过简单的接触开关、感应线圈或用于检测移位筒凸缘18504相对于传感器运动的接近度的其他选项来替换传感器。
图67示出了附接到外壳21012的另一个可互换轴组件21200的多个部分，该外壳包括被构造成能够由临床医生抓握、操纵和致动的柄部21014，如上所述。可互换轴组件21200具有可操作地附接到其上的外科端部执行器并且包括底座21240，该底座被构造成能够可操作地附接到外壳21012。参见图68和图69。外科端部执行器可类似于上述外科端部执行器11300。底座21240可操作地支撑喷嘴组件21201，除了下文讨论的差异之外，该喷嘴组件类似于上述喷嘴组件。在至少一种布置结构中，喷嘴组件21201包括近侧部分或翅片组件21203和远侧位置2107。在图68和图69中，仅示出了翅片组件21203。为了清楚起见，省略了远侧喷嘴部分。然而，应当理解，远侧喷嘴部分2107可被构造成能够与脊组件(未示出)可操作地交接，以使喷嘴组件21201能够用于使轴组件以本文所述的各种方式围绕轴轴线SA旋转。
转到图68和图69，喷嘴组件21330的翅片组件21203通过两个连接臂21205可操作地关联到移位筒组件21500，这两个连接臂销接或以其他方式附接到移位筒组件21500的近侧凸缘21504。移位筒组件21500在其他方面类似于上述移位筒组件18500。具体地，移位筒组件21500包括主体部分21502，该主体部分中具有凸轮狭槽21506，该凸轮狭槽被构造成能够以上述方式将移位器键18420上的移位器销18422接收在其中。使用者可通过拉回喷嘴组件21201的翅片组件21203来致动移位筒组件21500。参见图67。
图68示出了当关节运动系统处于启用状态时移位筒组件21500的位置。闭合系统可处于其未致动或完全回缩状态，这对应于外科端部执行器的钳口处于其完全打开位置。闭合系统也可被致动以部分地闭合或者闭合钳口，如上所述。如图68中可见，移位器销18422位于凸轮狭槽21506的最近侧部分21512中。当处于该位置时，如果需要，随着移位器销18422已使锁定套管18402沿逆时针CCW方向(使用者的角度)旋转，使用者可致动关节运动系统以使端部执行器进行关节运动，从而使得锁定套管18402上的第二锁定构件18406旋转成与近侧关节运动驱动器19102中的驱动凹口19104接合。当处于该位置时，锁定套管18402与中间击发构件18222接合，如上所述。参见图57。此外，喷嘴组件21201的翅片组件21203处于其最远侧位置。然后可通过启用击发驱动系统以朝远侧推进中间击发构件18222来启用关节运动系统。
如上所述，一旦使用者已使端部执行器关节运动到期望位置并且钳口已完全闭合，关节运动系统就可通过沿近侧方向PD拉动翅片组件21203而与击发系统脱离接合。参见图67。如图69中可见，沿近侧方向拉动翅片组件21203使得朝近侧拉动移位筒组件21500。随着移位筒组件21500朝近侧运动，移位器销18242进入凸轮狭槽21506的凸轮作用部分21510，并且使得移位器销18422和移位器键18420使锁定套管18402沿顺时针CW方向(使用者的角度)旋转。随着锁定套管沿顺时针方向旋转，第二锁定构件18406旋转脱离与近侧关节运动驱动器19102中的驱动凹口19104的接合，以使关节运动系统与击发驱动系统脱离接合。移位筒组件21500以及翅片组件21203处于其最近侧位置。
如图69中可见，当移位筒组件21500处于其最近侧位置时，移位筒组件21500的凸缘21504与底座凸缘21242相邻。在例示的示例中，一个或多个磁体21600安装在底座凸缘21242中，以将移位筒组件21500保持在该最近侧位置，该最近侧位置对应于关节运动系统已与击发驱动系统脱离接合的位置。另外，在至少一种布置结构中，一个或多个传感器21602安装在底座凸缘21242中，该一个或多个传感器被构造成能够在处于近侧位置时检测移位筒凸缘21504的存在。传感器21602与板载电路控制板21604电通信，该板载电路控制板与和外壳相关联的控制板通信。在另选的布置结构中，例如，可使用简单的接触开关或感应线圈来感测金属移位筒组件21500的存在。如上文所讨论，轴组件21200可操作地联接到其上的外壳可包括位于外壳上或远离外壳定位的显示屏，以向使用者显示某些操作参数和指示标识。当传感器检测到移位筒组件凸缘21504的存在时，显示器可显示例如“关节运动系统不活动”。另选的布置结构可采用喷嘴组件中的一个或多个偏压弹簧或磁体来将移位筒组件21500切换到移位位置和未移位位置。此类布置结构有利于外科端部执行器的关节运动，同时其钳口完全打开、部分打开或完全闭合。该布置结构还可适于与不可移除地附接到外壳的专用轴组件一起使用。
图70至图74示出了另一个轴组件22200的各种部件，该另一个轴组件可附接到上述类型的外壳，或者其可包括专用于外壳布置结构并且不被设计成可互换的轴组件。在任一种情况下，轴组件22200具有可操作地附接到其上的外科端部执行器并且包括被构造成能够可操作地附接到外壳的底座22240。外科端部执行器可类似于上述外科端部执行器11300并且附接到其上以用于围绕横向于轴轴线SA的关节运动轴线进行选择性关节运动。底座22240可操作地支撑与上述喷嘴组件11201类似的喷嘴组件22201。如图70中可见，喷嘴组件22201包括近侧部分22205和翅片组件22203。近侧喷嘴部分22205被构造成能够与脊轴23010(图71)可操作地交接，以使得喷嘴组件22201能够用于使轴组件以本文所述的各种方式围绕轴轴线SA旋转。除下文讨论的差异外，脊轴23010类似于上文所述和图57所示的脊轴21010。中间击发轴18222可滑动地支撑在脊轴23010中。上文讨论了击发轴18222的操作，并且为了简洁起见将不再重复。
轴组件22200采用在一定程度上类似于移位筒组件18500的移位筒组件22500，不同的是移位筒组件22500可通过致动闭合系统而移位。在一种布置结构中，移位筒组件22500包括主体部分22502，该主体部分中具有凸轮狭槽22506，该凸轮狭槽被构造成能够以上述方式将移位器键18420上的移位器销18422接收在其中。移位筒组件22500包括一对沿直径相对的筒移位器销22520，该一对沿直径相对的筒移位器销通过例如螺纹、焊接件、压配合、粘合剂等附接到其上。筒移位器销22520被构造成能够延伸穿过近侧闭合管段22010中的对应闭合狭槽22020。图72至图74示出了近侧闭合管段22010的一种形式。近侧闭合管段22010以本文所公开的各种方式附接到闭合系统，以选择性地轴向推进近侧闭合管段22010，从而将闭合动作施加到外科端部执行器的一个或多个钳口。
如图72至图74中可见，近侧闭合管段22010还包括移位器窗口22011，该移位器窗口被构造成能够允许移位器销18422以上述方式延伸穿过其中。另外，近侧闭合管段22010包括沿直径相对的凸耳窗口22013、22015，这些凸耳窗口被构造成能够允许喷嘴组件22201上的凸耳(未示出)延伸穿过其中以接合脊轴23010上的平坦部(未示出)。凸耳用于将喷嘴组件22201联接到脊轴23010，使得喷嘴组件22201围绕轴轴线SA的旋转使得脊轴23010以及与其联接的外科端部执行器也围绕轴轴线SA旋转。图70示出了当近侧闭合管段22010处于对应于未致动位置的最近侧位置时近侧闭合管段22010相对于移位筒组件22500的位置。当处于该位置时，闭合系统尚未被致动，并且外科端部执行器的钳口处于打开位置。回位弹簧18700用于将移位筒组件22500朝近侧偏压到该位置中。当处于该位置时，移位器销18422处于凸轮狭槽22506的最远侧部分22508中。当处于该位置时，如果需要，随着移位器销18422已使锁定套管18402沿逆时针CCW方向(使用者的角度)旋转，使用者可致动关节运动系统以使端部执行器进行关节运动，从而使得锁定套管18402上的第二锁定构件18406旋转成与近侧关节运动驱动器19102中的驱动凹口19104接合。参见图57。当处于该位置时，锁定套管18402与中间击发构件18222接合。然后，使用者可启动击发驱动系统以朝远侧推进中间击发构件18222，以致动关节运动系统。
当使用者启动闭合系统以使近侧闭合管段22010沿远侧方向DD运动以将闭合动作施加到端部执行器时，近侧闭合管段使筒移位器销22520沿远侧方向DD运动，这也使得移位筒组件22500朝远侧运动。随着移位筒22500朝远侧运动，移位器销18422进入凸轮作用狭槽22506的凸轮作用部分22510，移位筒组件22500使得移位器销18422和移位器键18420使锁定套管18402沿顺时针CW方向(使用者的角度)旋转。当近侧闭合管段22010已朝远侧推进到完全闭合位置时，移位筒组件22500已使锁定套管18402旋转到如下位置，在该位置第二锁定构件18406已旋转成与近侧关节运动驱动器19102中的驱动凹口19104脱离接合以使关节运动系统与击发驱动系统脱离接合。然后，使用者可致动击发驱动系统以击发该击发构件。一旦击发过程完成并且击发构件已回缩到其在外科端部执行器内或邻近外科端部执行器的起始位置，使用者便可启动闭合系统以沿近侧方向PD回缩近侧闭合管段22010。在至少一种布置结构中，闭合狭槽22020的尺寸被设定成足以允许近侧闭合管段22010在使用者打开和闭合端部执行器钳口时以“骑行”模式来回致动，以避免关节运动系统与击发系统重新接合。参见图74。
如图70中可见，在至少一种布置结构中，一个或多个传感器22602安装在底座凸缘22242中，该一个或多个传感器被构造成能够在处于近侧位置时检测移位筒凸缘22504的存在。传感器21602与板载电路控制板22604电通信，该板载电路控制板与和外壳相关联的控制板通信。该布置结构还可适于与不可移除地附接到外壳的专用轴组件一起使用。
图75至图78示出了另一个轴组件24200的各种部件，该另一个轴组件可附接到上述类型的外壳，或者其可包括专用于外壳布置结构并且不被设计成可互换的轴组件。在任一种情况下，轴组件24200具有可操作地附接到其上的外科端部执行器并且包括被构造成能够可操作地附接到外壳的底座24240。外科端部执行器可类似于上述外科端部执行器11300并且附接到其上以用于围绕横向于轴轴线SA的关节运动轴线进行选择性关节运动。底座24240可操作地支撑与上述喷嘴组件11201类似的喷嘴组件24201。如图75中可见，喷嘴组件24201包括远侧部分24205和翅片组件24203。远侧喷嘴部分23205被构造成能够与脊轴25010(图77)可操作地交接，以使得喷嘴组件24201能够用于使轴组件以本文所述的各种方式围绕轴轴线SA旋转。除下文讨论的差异外，脊轴25010类似于上文所述和图57所示的脊轴21010。中间击发轴18222可滑动地支撑在脊轴25010中。上文讨论了击发轴18222的操作，并且为了简洁起见将不再重复。
轴组件24200采用在一定程度上类似于移位筒组件18500的移位筒组件24500，不同的是移位筒组件24500可通过致动闭合系统而移位。在一种布置结构中，移位筒组件24500包括主体部分24502，该主体部分中具有凸轮狭槽24506，该凸轮狭槽被构造成能够以上述方式将移位器键18420上的移位器销18422接收在其中。轴组件24200包括近侧闭合管段24010。近侧闭合管段24010以本文所公开的各种方式附接到闭合系统，以选择性地轴向推进近侧闭合管段24010，从而将闭合动作施加到外科端部执行器的一个或多个钳口。
图76示出了包括移位器窗口24011的示例性近侧闭合管段24010的一部分，该移位器窗口被构造成能够允许移位器销18422以上述方式延伸穿过其中。另外，近侧闭合管段24010包括沿直径相对的凸耳窗口24013、24015，这些凸耳窗口被构造成能够允许喷嘴组件24201上的凸耳(未示出)延伸穿过其中以接合脊轴25010上的平坦部(未示出)。凸耳用于将喷嘴组件24201联接到脊轴25010，使得喷嘴组件24201围绕轴轴线SA的旋转使得脊轴25010以及与其联接的外科端部执行器也围绕轴轴线SA旋转。近侧闭合管段24010还包括至少一个且优选地两个沿直径相对的侧向延伸的移位器插片24017。在例示的实施方案中，移位器插片24017被切割成近侧闭合管壁并且侧向向外弯曲，使得它们横向于轴轴线SA。然而，在另选的布置结构中，移位器插片可通过焊接、粘合剂、摩擦配合/压力配合等附接到近侧闭合管段。移位器插片24017被构造成能够在近侧闭合管段24010以上述方式沿远侧方向DD朝远侧推进时接合移位筒凸缘24504。
如图75中可见，近侧闭合管段24010已朝远侧推进到其中移位器插片24017已接触移位器筒凸缘24504的位置。移位筒组件24500已被回位弹簧18700偏压到该位置中。当处于该位置时，移位器销18422处于凸轮狭槽24506的最远侧部分24508中。当处于该位置时，如果需要，随着移位器销18422已使锁定套管18402沿逆时针CCW方向(使用者的角度)旋转，使用者可致动关节运动系统以使端部执行器进行关节运动，从而使得锁定套管18402上的第二锁定构件18406旋转成与近侧关节运动驱动器19102中的驱动凹口19104接合。参见图57。当处于该位置时，锁定套管18402与中间击发构件18222接合。
当使用者启动闭合系统以使近侧闭合管段24010沿远侧方向DD运动以将闭合动作施加到端部执行器时，近侧闭合管段24010上的移位器插片24017接触移位筒凸缘24504并使移位筒组件24500朝远侧运动。随着移位筒组件24500朝远侧运动，移位器销18422进入凸轮作用狭槽24506的凸轮作用部分24510，这使得移位器销18422和移位器键18420使锁定套管18402沿顺时针CW方向(使用者的角度)旋转。当近侧闭合管段24010已朝远侧推进到完全闭合位置时，移位筒组件24500已使锁定套管18402旋转到如下位置，在该位置第二锁定构件18406已旋转成与近侧关节运动驱动器19102中的驱动凹口19104脱离接合以使关节运动系统与击发驱动系统脱离接合。然后，使用者可致动击发驱动系统以击发该击发构件。一旦击发过程完成并且击发构件已回缩到其在外科端部执行器内或邻近外科端部执行器的起始位置，使用者便可启动闭合系统以沿近侧方向PD回缩近侧闭合管段24010。在至少一种布置结构中，当移位筒组件24500仍处于其中移位器销18422仍处于凸轮狭槽24506的凸轮作用部分2410内的位置时，在移位筒凸缘24504与移位器插片24017之间提供轴向间隙24019，使得关节运动系统尚未重新接合击发系统。当使用者打开和闭合端部执行器钳口时，此类布置结构使得近侧闭合管段24010能够以“骑行”模式来回致动，以避免关节运动系统与击发系统重新接合。参见图78。
如图75中可见，在至少一种布置结构中，一个或多个传感器24602安装在底座凸缘24242中，该一个或多个传感器被构造成能够在处于近侧位置时检测移位筒凸缘24504的存在。传感器24602与板载电路控制板24604电通信，该板载电路控制板与和外壳相关联的控制板通信。该布置结构还可适于与不可移除地附接到外壳的专用轴组件一起使用。
图79示出了附接到上述类型的外壳11012的另一个可互换轴组件26200。可互换轴组件26200包括机载关节运动马达2140，该机载关节运动马达安装在喷嘴组件26201内以用于当使用者相对于外壳11012旋转喷嘴组件26201时与喷嘴组件一起围绕轴轴线SA沿轨道旋转行进。关节运动马达2410和齿轮布置结构的构造在上文中有所讨论，并且为了简洁起见将不再重复。轴组件26200可以其他方式类似于上述轴组件1000，并且包括如上所述的关节运动接头和关节运动系统，以有利于可操作地联接到其上的外科端部执行器1500的选择性关节运动。
图79至图83示出了柔性电路组件27000，该柔性电路组件可用于轴组件26200中以最终在端部执行器1500与外壳11012中的或换句话讲与轴组件26200可操作地附接的外壳相关联的处理器之间传输电信号。如图79所示，轴组件26200可包括滑环组件27600，例如，该滑环组件可被构造成能够将电力传导至端部执行器1500和/或从该端部执行器传导电力，并且/或者将信号传送至端部执行器1500和/或从该端部执行器接收信号。滑环组件27600可包括近侧连接器凸缘27604，该近侧连接器凸缘安装到从底座26240延伸的底座凸缘26242。滑环组件27600还包括远侧连接器凸缘(未示出)，该远侧连接器凸缘定位在限定于喷嘴组件26201中的狭槽内或以其他方式安装在其中。近侧连接器凸缘27604可包括第一面，并且远侧连接器凸缘可包括第二面，该第二面与第一面相邻定位并能够相对于第一面运动。远侧连接器凸缘可如上所述与喷嘴组件26201一起围绕轴轴线SA相对于近侧连接器凸缘27604旋转。近侧连接器凸缘27604可包括限定在其第一面中的多个同心或至少基本上同心的导体。在例示的示例中，在近侧连接器凸缘27604的第一面上设置四个导体27620、27630、27640和27650。连接器27700安装在远侧连接器凸缘的近侧面上，并且可具有多个触点，其中每个触点对应于导体27620、27630、27640、27650中的一者并与之电接触。这种布置结构在保持近侧连接器凸缘与远侧连接器凸缘27604之间的电接触的同时，允许这两个凸缘之间的相对旋转。例如，近侧连接器凸缘27604包括电连接器27606，该电连接器可使导体27620、27630、27640、27650与安装到轴底座26240的轴电路板(未示出)进行信号通信。关于滑环组件的更多细节可见于例如美国专利申请序列号13/803,086、名称为“STAPLECARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利申请序列号13/800,067，以及2013年3月13日提交的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利9,345,481。美国专利申请序列号13/803,086、美国专利申请序列号13/800,067和美国专利9,345,481，据此各自全文以引用方式并入本文。
在例示的示例中，轴组件26200采用柔性线束组件27000，该柔性线束组件包括柔性基底中的多个导体，该多个导体在电连接器27606与安装在轴组件和/或外科端部执行器1500自身的远侧的对应传感器之间延伸。图80示出了可采用的柔性线束组件27000的一种形式。柔性线束组件27000包括如图80所示成形的柔性基底部分27010和27050。近侧柔性基底部分27010包括连接在关节运动马达2140和连接器27700之间的马达导体27012和27014。在例示的示例中，远侧柔性基底部分27050支撑四个导体/电路路径27060、27070、27080、27090。例如，第一电路路径27060包括第一近侧导体部分27062，该第一近侧导体部分可联接到基底部分27050上的第一信号处理器芯片27100。第一近侧导体部分27062也可连接到关节运动马达2140。第一电路路径27060还可包括第一远侧导体部分27064，该第一远侧导体部分连接到第一信号处理器芯片27100以及连接到与外科端部执行器和/或关节运动接头布置结构相关联的对应的第一传感器或部件(未示出)。第二电路路径27070可连接到关节运动马达2140并且连接到与外科端部执行器和/或关节运动接头布置结构相关联的第二传感器或部件(未示出)。第三电路路径27080可连接到电连接器27700并且连接到与外科端部执行器和/或关节运动接头布置结构相关联的第三传感器或部件(未示出)。第四电路路径27090包括第四近侧导体部分27092，该第四近侧导体部分27092可联接到基底部分27050上的第二信号处理器芯片27200以及联接到电连接器27700。第四电路路径27090还可包括第四远侧导体部分27094，该第四远侧导体部分连接到第二信号处理器芯片27200以及与外科端部执行器和/或关节运动接头布置结构相关联的对应第四传感器(未示出)。
在例示的布置结构中，远侧基底部分27050包括分叉部分27052，该分叉部分包括支撑其上的导体27064、27074的右基底部分27054和支撑其中的导体27084、27094的左基底部分27056。右基底部分27054和左基底部分27056可由中心空间27058分开。参见图80至图82，在例示的示例中，远侧基底部分27050可具有横截面厚度ha，并且导体27064、27070、27080、27094可各自具有导体宽度Wa，如图81所示。远侧基底27050的位于分叉部分27052近侧的部分具有类似的横截面厚度ha，并且该基底部分上的导体27064、27070、27080、27094也可具有导体宽度Wa。类似地，远侧基底2750的邻近第一处理器芯片27100和第二处理器芯片27200的部分具有相似的横截面厚度ha，并且该基底部分上的导体27062、27070、27080、27092也可具有导体宽度Wa。如图82中可见，分叉部分27052的右基底部分27054和左基底部分27056可各自具有横截面厚度hb，并且导体27064、27070、27080、27094可各自具有横跨那些基底部分的长度的导体宽度Wb。在例示的示例中，ha>hb并且Wa<Wb。此类布置结构为分叉部分27052提供更大的灵活性，并且使得该部分27052能够例如在关节运动接头的位置中折叠。
转到图83，包括信号处理器芯片27100、27200的柔性线束组件27800的连接器部分27800可包括其上支撑有芯片27100、27200的刚性安装块27802。安装块27802可由刚性电绝缘材料诸如刚性硅树脂或塑料制成，并且具有大于上述厚度ha的厚度BT。安装块27802可保持在设置于脊轴1210中的安装腔1211内。此外，位于连接器部分27800远侧的远侧基底部分2750的部分27900可具有形成于其中的偏置，以向柔性线束组件27000提供应变消除。例示的示例还包括竖直阶梯部分27910，其使得线束能够围绕轴组件中的机械部件(例如，关节运动杆、连杆连接件等)延伸。
在至少一个示例中，基底部分27010、27050可包括柔性有机硅材料或柔性塑性材料。可将各种导体27012、27014、27062、27064、27070、27080、27092、27094模制到基底材料中，使得导体完全封装于其中，如图81和图82所示。这种布置结构用于使导体与体液、碎屑等绝缘，否则可能会使电路短路。然而，在其他布置结构中，电路可被电镀到基底材料上。柔性线束组件27000可与本文所公开的其他轴组件结合使用。
图84至图91示出了另一个轴组件28200的各种部件，该另一个轴组件可附接到上述类型的外壳，或者其可包括专用于外壳布置结构并且不被设计成可互换的轴组件。在任一种情况下，轴组件28200具有可操作地附接到其上的外科端部执行器并且包括被构造成能够可操作地附接到外壳的底座28240。外科端部执行器可类似于上述外科端部执行器11300并且附接到其上以用于围绕横向于轴轴线SA的关节运动轴线进行选择性关节运动。底座24240可操作地支撑与上述喷嘴组件11201类似的喷嘴组件28201。如图83至图85中可见，喷嘴组件28201包括远侧喷嘴部分28205和翅片组件28203。远侧喷嘴部分28205被构造成能够与脊轴29010(图86)可操作地交接，以使得喷嘴组件28201能够用于使轴组件28200的远侧部分28207以本文所述的各种方式围绕轴轴线SA旋转。
接下来转到图86，轴组件28200采用轴颈连接在近侧闭合管段30010的近侧端部部分上的移位筒组件28500。近侧闭合管段30010的轴向移位可以上文相对于近侧闭合管段13010所述的方式被控制。如图86中可见，近侧闭合管段30010的近侧端部30012被构造成能够被接收在闭合梭动件11250内。近侧端部30012通过U形连接器11263可旋转地附连到闭合梭动件11250，该U形连接器接收在近侧闭合管段300010中的凹槽300014中并且安置在闭合梭动件11250中的凹槽11253中，如上所述。闭合梭动件11250被构造成能够在轴组件28200附接到闭合梭动件时与外壳中的闭合系统关联。闭合系统在底座28240内轴向推进和回缩闭合梭动件的操作如上所述，并且为了简洁起见将不再重复。
如图86中可见，轴组件28200可包括离合器组件28400，该离合器组件可被构造成能够将近侧关节运动驱动器29102选择性地和可释放地联接到中间击发构件28222。在一种形式中，离合器组件28400包括围绕中间击发构件28222定位的锁定衬圈或套管28402。锁定套管28402可包括圆柱形或至少基本上圆柱形的主体，该主体包括限定在其中的被构造成能够接收中间击发构件28222的纵向开孔28403。锁定套管28402可包括沿直径相对的、面朝内的锁定突起28404和面朝外的锁定插片28406。锁定突起28404可被构造成能够与中间击发构件28222选择性地接合。更具体地，当锁定套管28402处于其接合位置时，锁定突起28404被定位在限定于中间击发构件28222中的轴向驱动凹口28228内，使得远侧推力和/或近侧推力可从中间击发构件28222传输至锁定套管28402。
锁定套管28402附接到或接纳在近侧关节运动驱动器29102中的近侧安装部分29104内。当锁定套管28402与中间击发构件28222处于其接合位置时，施加到锁定套管28402的远侧推力和/或近侧拉力可以传递至近侧关节运动驱动器29102。实际上，当锁定套管28402处于其接合位置时，中间击发构件28222、锁定套管28402和近侧关节运动驱动器29102将一起运动。另一方面，当锁定套管28402处于其脱离接合位置时，远侧推力和/或近侧拉力可能不会从中间击发构件28222传递到锁定套管28402。对应地，远侧推力和/或近侧拉力可不传递至近侧关节运动驱动器29102。在此类情况下，中间击发构件28222可相对于锁定套管28402和近侧关节运动驱动器29102朝近侧和/或朝远侧滑动。中间击发构件28222可以本文所述的各种方式轴向推进。在至少一种布置结构中，例如，近侧关节运动驱动器29102沿远侧方向的轴向推进将使外科端部执行器向左进行关节运动，并且近侧关节运动驱动器沿近侧方向的轴向回缩将使外科端部执行器以本文所述的各种方式向右进行关节运动。
如图86中可见，移位筒组件28500包括被接收在近侧闭合管段30010的近侧部分上的管状或圆柱形主体28502。移位筒组件28500还包括近侧移位筒凸缘28504和从其突起的凸轮销28506。锁定套管28402上的锁定插片28406被接收在移位筒主体28502中的狭槽28508中。此类布置结构使得锁定套管28402能够与移位筒组件28500一起旋转。移位筒组件28500的主体28502可旋转地接收在凸轮螺母28900内，该凸轮螺母不可旋转地安装在喷嘴组件28201内。在例示的示例中，凸轮狭槽28902设置在固定式凸轮螺母28900中并且被构造成能够在其中接收移位筒组件28500上的凸轮销28506。当近侧闭合管段30010被轴向推进时，离合器组件28400被致动。在至少一个示例中，C形夹28910附接到近侧闭合管段30010，使得C形夹28910在移位筒凸缘28504的近侧。因此，当近侧闭合管段30010被朝远侧推进时，C形夹28910接触移位筒凸缘28504并朝远侧推动移位筒组件28500。
图84和图87示出了例如当闭合系统处于未致动位置时移位筒组件28500的位置。近侧闭合管段30010以本文所述的各种方式处于其最近侧位置，该最近侧位置对应于外科端部执行器中的“钳口打开”位置。如图87中可见，面向内的锁定突起28404与中间击发构件28222接合，使得远侧推力和/或近侧拉力可从中间击发构件28222传递到锁定套管28402。移位筒组件28500由移位筒弹簧28509偏压到其最近侧位置中，该移位筒弹簧被接收在移位筒主体28502周围并且在移位筒凸缘28504与凸轮螺母28900之间延伸。如图84中可见，凸轮销28506位于凸轮螺母28900中的凸轮狭槽28902的最近侧部分中。图88示出了锁定套管28402和近侧关节运动驱动器29102的最近侧位置。图89示出了例如对应于外科端部执行器的完全关节运动位置的锁定套管28402和近侧关节运动驱动器29102的最远侧位置。
图85和图90示出了例如当闭合系统处于完全致动位置时移位筒组件28500的位置。近侧闭合管段30010以本文所述的各种方式处于其最远侧位置，该最远侧位置对应于外科端部执行器中的“钳口闭合”位置。随着近侧闭合管段30010朝远侧运动，C形夹18910接触移位筒凸缘28504并且抵抗移位筒弹簧28509的偏压朝远侧推动移位筒组件28500。随着移位筒组件28500朝远侧运动，凸轮销28506在凸轮螺母28900中的凸轮狭槽28902内运动，这使得移位筒组件28500旋转。随着移位筒组件28500旋转，锁定套管28402也旋转，使得其中面向内的锁定突起28404脱离接合中间击发构件28222。参见图90。当处于该位置时，远侧推力和/或近侧拉力不从中间击发构件28222传递到锁定套管28402。当锁定套管28402处于其脱离接合位置时，中间击发构件28222的运动不传递到近侧关节运动驱动器29102，因此，中间击发构件28222可独立于近侧关节运动驱动器29102运动。在各种情况下，近侧关节运动驱动器29102可通过2013年3月14日提交的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803,086中公开的类型的关节运动锁以及本文所公开的其他锁布置结构保持在适当位置，该专利申请的全部公开内容以引用方式并入本文。
返回图86，在例示的示例中，脊轴29010的近侧端部部分29012可通过脊轴承组件29020可旋转地支撑在底座28240内。轴组件28200也可包括滑环组件29600，该滑环组件可被构造成能够例如将电力传导至端部执行器和/或从端部执行器传导电力，和/或将信号传达至端部执行器和/或从端部执行器传达信号。滑环组件29600可包括近侧连接器凸缘29604，该近侧连接器凸缘安装到从底座26240延伸的底座凸缘28242。滑环组件29600还包括远侧连接器凸缘29620，该远侧连接器凸缘定位在限定于喷嘴组件28201中的狭槽内或以其他方式安装在其中。近侧连接器凸缘29604可包括第一面29605，并且远侧连接器凸缘29620可包括第二面29622，其中第二面与第一面29605相邻定位并能够相对于该第一面运动。参见图88和图89。远侧连接器凸缘29620可如上所述与喷嘴组件28201一起围绕轴轴线SA相对于近侧连接器凸缘29604旋转。近侧连接器凸缘29604可包括限定在其第一面29505中的多个同心或至少基本上同心的导体29606。连接器29700安装在远侧连接器凸缘29620的第二面29622上，并且可具有多个触点，其中每个触点对应于导体29606中的一个并与之电接触。这种布置结构在保持近侧连接器凸缘29620与远侧连接器凸缘29604之间的电接触的同时，允许这两个凸缘之间的相对旋转。例如，近侧连接器凸缘29604与电连接器29608通信，该电连接器可使导体29606与安装到轴底座28240的轴电路板(未示出)进行信号通信。关于滑环组件的更多细节可见于例如美国专利申请序列号13/803,086、名称为“STAPLECARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利申请序列号13/800,067，以及2013年3月13日提交的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利9,345,481。本文所公开的各种柔性电路布置结构可用于传输来自电连接器29608和与外科端部执行器和/或关节运动接头相关联的传感器/部件的信号。此外，传感器29630可安装到近侧连接器凸缘29604并且被构造成能够检测形成在移位筒凸缘28504上的对应传感器凸耳28505的位置。传感器29630可包括例如霍尔效应传感器，并且传感器凸耳28505可支撑磁体28507。传感器29630被配置成能够检测磁体28507的位置并且例如通过滑环组件29600将该信息传达到控制电路。
实施例
实施例1-一种外科器械，包括外科端部执行器和可操作地联接到所述外科端部执行器的细长轴。所述细长轴包括被构造成能够向所述外科端部执行器施加第一致动动作的第一可轴向运动的驱动构件和被构造成能够向所述外科端部执行器施加第二致动动作的第二可轴向运动的驱动构件。所述外科器械还包括第一驱动系统，所述第一驱动系统被构造成能够将第一轴向控制动作施加到所述第一可轴向运动的驱动构件。驱动离合器组件与所述第一可轴向运动的驱动构件和所述第二可轴向运动的驱动构件可操作地交接，并且被构造成能够在接合位置和第二脱离接合位置之间运动，在所述接合位置，所述驱动离合器组件将所述第二可轴向运动的驱动构件关联到所述第一可轴向运动的驱动构件，在所述第二脱离接合位置，所述第一可轴向运动的驱动构件能够相对于所述第二可轴向运动的驱动构件独立地运动。锁组件被构造成能够在锁定位置和解锁位置之间运动，在所述锁定位置，所述锁组件防止所述第二可轴向运动的驱动构件的轴向运动，在所述解锁位置，所述第二可轴向运动的驱动构件响应于所述第一驱动系统的致动而自由地轴向运动。致动器组件被构造成能够使所述驱动离合器组件在所述接合位置和所述脱离接合位置之间运动并且与所述锁组件交接，以在所述致动器组件使所述驱动离合器组件运动到所述脱离接合位置时使所述锁组件运动到所述锁定位置。
实施例2-根据实施例1所述的外科器械，其中，所述致动器组件包括第三可轴向运动的驱动构件，所述第三可轴向运动的驱动构件被构造成能够向所述外科端部执行器施加第三致动动作。
实施例3-根据实施例2所述的外科器械，其中，所述外科端部执行器包括第一钳口和第二钳口，所述第一钳口和所述第二钳口相对于彼此被可运动地支撑并且能够在闭合位置和打开位置之间选择性地运动。所述第三可轴向运动的驱动构件被构造成能够向所述第一钳口和所述第二钳口中的至少一者施加闭合动作和打开动作，以使所述第一钳口和所述第二钳口在所述闭合位置和所述打开位置之间运动。
实施例4-根据实施例1、2或3所述的外科器械，其中，所述外科端部执行器可操作地联接到所述细长轴以用于相对于所述细长轴进行选择性关节运动，并且其中所述第二可轴向运动的驱动构件被构造成能够向所述外科端部执行器施加关节运动动作。
实施例5-根据实施例1、2或3所述的外科器械，其中，所述细长轴限定轴轴线，并且其中所述外科端部执行器可操作地联接到所述细长轴以用于围绕横向于所述轴轴线的关节运动轴线进行选择性关节运动，并且其中所述第二可轴向运动的驱动构件被构造成能够向所述外科端部执行器施加关节运动动作。
实施例6-根据实施例1、2、3、4或5所述的外科器械，还包括用于将所述驱动离合器组件选择性地锁定在所述脱离接合位置的装置。
实施例7-根据实施例1、2、3、4、5或6所述的外科器械，其中，所述第一驱动系统包括马达，所述马达被构造成能够向可轴向运动的击发驱动轴施加旋转驱动动作，所述可轴向运动的击发驱动轴与所述第一可轴向运动的驱动构件可操作地交接以向其施加轴向驱动动作。
实施例8-根据实施例1、2、3、4、5、6或7所述的外科器械，其中，所述致动器组件还包括可手动致动的触发器，所述可手动致动的触发器与所述第三可轴向运动的驱动构件可操作地交接，使得所述可手动致动的触发器的运动致使所述第三可轴向运动的驱动构件使所述驱动离合器组件从所述接合位置运动到所述脱离接合位置并且使所述锁组件运动到所述锁定位置。
实施例9-根据实施例1、2、3、4、5、6、7或8所述的外科器械，其中，所述细长轴组件可操作地联接到外壳，所述外壳可操作地支撑所述第一驱动系统的至少一部分。
实施例10-根据实施例9所述的外科器械，其中，所述外壳包括柄部。
实施例11-根据实施例1、2、3、4、5、6、7、8、9或10所述的外科器械，其中，所述第一钳口包括外科钉仓，并且其中所述第二钳口包括砧座。
实施例12—根据实施例1、2、3、4、5、6、7、8、9、10或11所述的外科器械，其中，所述第一钳口被构造成能够可移除地支撑可替换的外科钉仓。
实施例13-根据实施例11所述的外科器械，其中，所述第一可轴向运动的驱动构件与击发构件交接，所述击发构件由所述外科端部执行器支撑并且被构造成能够将储存在所述外科钉仓中的外科钉驱动成与所述砧座成形接触，并且随着所述击发构件被轴向驱动穿过所述外科端部执行器而切割被夹持在所述外科钉仓和所述砧座之间的组织。
实施例14-一种外科器械，包括外科端部执行器，所述外科端部执行器包括第一钳口和第二钳口，所述第一钳口和所述第二钳口相对于彼此被可运动地支撑并且能够在闭合位置和打开位置之间选择性地运动。细长轴可操作地联接到所述外科端部执行器，使得所述外科端部执行器能够相对于所述细长轴选择性地进行关节运动。所述细长轴包括第一可轴向运动的驱动构件和可轴向运动的关节运动驱动构件，所述第一可轴向运动的驱动构件被构造成能够向所述外科端部执行器施加第一致动动作，所述可轴向运动的关节运动驱动构件被构造成能够可操作地联接到所述外科端部执行器并且被构造成能够向所述外科端部执行器施加关节运动动作。所述外科器械还包括第一驱动系统和驱动离合器组件，所述第一驱动系统被构造成能够向所述第一可轴向运动的驱动构件施加第一轴向控制动作，所述驱动离合器组件与所述第一可轴向运动的驱动构件和所述可轴向运动的关节运动驱动构件可操作地交接并且被构造成能够在接合位置和第二脱离接合位置之间运动，在所述接合位置，所述驱动离合器组件将所述第一可轴向运动的驱动构件关联到所述可轴向运动的关节运动驱动构件，在所述第二脱离接合位置，所述第一可轴向运动的驱动构件能够相对于所述可轴向运动的关节运动驱动构件独立地运动。锁组件被构造成能够在锁定位置和解锁位置之间运动，在所述锁定位置，所述锁组件防止所述可轴向运动的关节运动驱动构件的轴向运动，在所述解锁位置，所述可轴向运动的关节运动驱动构件响应于所述第一驱动系统的致动而自由地轴向运动。可轴向运动的闭合构件组件被构造成能够向所述第一钳口和所述第二钳口中的至少一者施加闭合动作和打开动作，以使所述第一钳口和所述第二钳口在所述闭合位置和所述打开位置之间运动。所述可轴向运动的闭合构件组件与所述驱动离合器组件可操作地交接以使所述驱动离合器组件在所述接合位置和所述脱离接合位置之间运动，并且与所述锁组件交接以在所述可轴向运动的闭合构件组件使所述驱动离合器组件运动到所述脱离接合位置时，使所述锁组件运动到所述锁定位置。
实施例15-根据实施例14所述的外科器械，其中，所述细长轴组件可操作地联接到外壳，所述外壳可操作地支撑所述第一驱动系统的至少一部分。
实施例16-根据实施例15所述的外科器械，其中，所述外壳包括柄部。
实施例17-根据实施例14、15或16所述的外科器械，其中，所述第一钳口包括外科钉仓，并且其中所述第二钳口包括砧座。
实施例18-根据实施例16所述的外科器械，其中，所述第一驱动系统包括马达，所述马达与所述柄部相关联并且被构造成能够向可轴向运动的击发驱动轴施加旋转驱动动作，所述可轴向运动的击发驱动轴与所述第一可轴向运动的驱动构件可操作地交接以向其施加轴向驱动动作。
实施例19-根据实施例18所述的外科器械，其中，所述致动器组件还包括可手动致动的触发器，所述可手动致动的触发器由所述柄部支撑并且与所述可轴向运动的闭合构件组件可操作地交接，使得所述可手动致动的触发器的运动致使所述可轴向运动的闭合构件组件使所述驱动离合器组件从所述接合位置运动到所述脱离接合位置，并且使所述锁组件运动到所述锁定位置。
实施例20-一种外科器械，包括外科端部执行器，所述外科端部执行器包括第一钳口和第二钳口，所述第一钳口和所述第二钳口相对于彼此被可运动地支撑并且能够在闭合位置和打开位置之间选择性地运动。细长轴组件可操作地联接到所述外科端部执行器，使得所述外科端部执行器能够相对于所述细长轴组件选择性地进行关节运动。所述细长轴包括被构造成能够向所述外科端部执行器施加第一致动动作的可轴向运动的驱动构件和用于使所述外科端部执行器相对于所述细长轴组件进行关节运动的装置。所述外科器械还包括用于向可轴向运动的驱动构件施加轴向控制动作的装置以及用于将所述可轴向运动的驱动构件与用于在接合位置进行关节运动的所述装置接合的装置，其中用于施加轴向控制动作的所述装置的致动致动用于进行关节运动的所述装置。用于接合的所述装置还被构造成能够使用于进行关节运动的所述装置从所述可轴向运动的驱动构件脱离接合到脱离接合位置，使得用于施加轴向控制动作的所述装置的致动不致动用于进行关节运动的所述装置。所述外科器械还包括用于将用于进行关节运动的所述装置锁定在锁定位置的装置以及用于向所述第一钳口和所述第二钳口中的至少一者施加闭合动作和打开动作以使所述第一钳口和所述第二钳口在所述闭合位置和所述打开位置之间运动的装置。用于施加的所述装置与用于接合的所述装置可操作地交接，使得当用于施加闭合动作和打开动作的所述装置被致动以施加所述闭合动作时，用于施加的所述装置使用于接合的所述装置运动到所述脱离接合位置，并且用于施加闭合动作和打开动作的所述装置使用于锁定的所述装置运动到锁定位置中。
本文所述的许多外科器械系统由电动马达促动；但是本文所述的外科器械系统可以任何合适的方式促动。在各种实例中，例如，本文所述的外科器械系统可由手动操作的触发器促动。在某些实例中，本文公开的马达可包括机器人控制系统的一部分或多个部分。此外，本文公开的任何端部执行器和/或工具组件可与机器人外科器械系统一起使用。例如，名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利9,072,535)更详细地公开了机器人外科器械系统的若干示例。
已结合钉的部署和变形描述了本文所述的外科器械系统；然而，本文所述的实施方案不限于此。例如，设想了部署除钉之外的紧固件诸如夹具或大头钉的各种实施方案。此外，还设想了利用用于密封组织的任何合适装置的各种实施方案。例如，根据各种实施方案的端部执行器可包括被配置成能够加热和密封组织的电极。另外，例如，根据某些实施方案的端部执行器可施加振动能量来密封组织。
下述专利的全部公开内容据此以引用方式并入本文：
-公布于1995年4月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312；
-公布于2006年2月21日的名称为“SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利7,000,818；
-公布于2008年9月9日的名称为“MOTOR-DRIVEN SURGICAL CUTTING ANDFASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK”的美国专利7,422,139；
-公布于2008年12月16日的名称为“ELECTRO-MECHANICAL SURGICAL INSTRUMENTWITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”的美国专利7,464,849；
-公布于2010年3月2日的名称为“SURGICAL INSTRUMENT HAVING ANARTICULATING END EFFECTOR”的美国专利7,670,334；
-公布于2010年7月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245；
-公布于2013年3月12日的名称为“SELECTIVELY ORIENTABLE IMPLANTABLEFASTENER CARTRIDGE”的美国专利8,393,514；
-名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利申请序列号11/343,803；现为美国专利7,845,537；
-提交于2008年2月14日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT HAVING RF ELECTRODES”的美国专利申请序列号12/031,573；
-提交于2008年2月15日的名称为“END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT”的美国专利申请序列号12/031,873(现为美国专利7,980,443)；
-名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”的美国专利申请序列号12/235,782，现为美国专利8,210,411；
-名称为“MOTORIZED SURGICAL INSTRUMENT”的美国专利申请序列号12/235972，现为美国专利9050083。
-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；以及
-提交于2010年4月22日的名称为“SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”的美国专利申请公布2010/0264194，现为美国专利8,308,040。
虽然本文已结合某些实施方案描述了各种装置，但也可实施对这些实施方案的许多修改和变型。在一个或多个实施方案中，具体特征、结构或特性可以任何合适的方式进行组合。因此，在无限制的情况下，结合一个实施方案示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其他实施方案的特征、结构或特性组合。另外，在公开了用于某些部件的材料的情况下，也可使用其他材料。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之后废弃，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。修整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，修整设施和/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。在一种消毒技术中，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。
Claims (20)
1.一种外科器械，包括：
外科端部执行器；
细长轴，所述细长轴可操作地联接到所述外科端部执行器，所述细长轴包括：
第一可轴向运动的驱动构件，所述第一可轴向运动的驱动构件被构造成能够向所述外科端部执行器施加第一致动动作；
第二可轴向运动的驱动构件，所述第二可轴向运动的驱动构件被构造成能够向所述外科端部执行器施加第二致动动作，并且其中所述外科器械还包括：
第一驱动系统，所述第一驱动系统被构造成能够向所述第一可轴向运动的驱动构件施加第一轴向控制动作；
驱动离合器组件，所述驱动离合器组件与所述第一可轴向运动的驱动构件和所述第二可轴向运动的驱动构件可操作地交接，并且被构造成能够在接合位置和第二脱离接合位置之间运动，在所述接合位置，所述驱动离合器组件将所述第二可轴向运动的驱动构件关联到所述第一可轴向运动的驱动构件，在所述第二脱离接合位置，所述第一可轴向运动的驱动构件能够相对于所述第二可轴向运动的驱动构件独立地运动；
锁组件，所述锁组件被构造成能够在锁定位置和解锁位置之间运动，在所述锁定位置，所述锁组件防止所述第二可轴向运动的驱动构件的轴向运动，在所述解锁位置，所述第二可轴向运动的驱动构件响应于所述第一驱动系统的致动而自由地轴向运动；和
致动器组件，所述致动器组件被构造成能够使所述驱动离合器组件在所述接合位置和所述脱离接合位置之间运动并且与所述锁组件交接，以在所述致动器组件使所述驱动离合器组件运动到所述脱离接合位置时使所述锁组件运动到所述锁定位置。
2.根据权利要求1所述的外科器械，其中，所述致动器组件包括第三可轴向运动的驱动构件，所述第三可轴向运动的驱动构件被构造成能够向所述外科端部执行器施加第三致动动作。
3.根据权利要求2所述的外科器械，其中，所述外科端部执行器包括第一钳口和第二钳口，所述第一钳口和所述第二钳口相对于彼此被可运动地支撑并且能够在闭合位置和打开位置之间选择性地运动，并且其中所述第三可轴向运动的驱动构件被构造成能够向所述第一钳口和所述第二钳口中的至少一者施加闭合动作和打开动作以使所述第一钳口和所述第二钳口在所述闭合位置和所述打开位置之间运动。
4.根据权利要求1所述的外科器械，其中，所述外科端部执行器可操作地联接到所述细长轴以用于相对于所述细长轴进行选择性关节运动，并且其中所述第二可轴向运动的驱动构件被构造成能够向所述外科端部执行器施加关节运动动作。
5.根据权利要求3所述的外科器械，其中，所述细长轴限定轴轴线，并且其中所述外科端部执行器可操作地联接到所述细长轴以用于围绕横向于所述轴轴线的关节运动轴线进行选择性关节运动，并且其中所述第二可轴向运动的驱动构件被构造成能够向所述外科端部执行器施加关节运动动作。
6.根据权利要求1所述的外科器械，还包括用于将所述驱动离合器组件选择性地锁定在所述脱离接合位置的装置。
7.根据权利要求1所述的外科器械，其中，所述第一驱动系统包括马达，所述马达被构造成能够向可轴向运动的击发驱动轴施加旋转驱动动作，所述可轴向运动的击发驱动轴与所述第一可轴向运动的驱动构件可操作地交接以向其施加轴向驱动动作。
8.根据权利要求1所述的外科器械，其中，所述致动器组件还包括可手动致动的触发器，所述可手动致动的触发器与所述第三可轴向运动的驱动构件可操作地交接，使得所述可手动致动的触发器的运动致使所述第三可轴向运动的驱动构件使所述驱动离合器组件从所述接合位置运动到所述脱离接合位置并且使所述锁组件运动到所述锁定位置。
9.根据权利要求1所述的外科器械，其中，所述细长轴组件可操作地联接到外壳，所述外壳可操作地支撑所述第一驱动系统的至少一部分。
10.根据权利要求9所述的外科器械，其中，所述外壳包括柄部。
11.根据权利要求3所述的外科器械，其中，所述第一钳口包括外科钉仓，并且其中所述第二钳口包括砧座。
12.根据权利要求11所述的外科器械，其中，所述第一钳口被构造成能够可移除地支撑可替换的外科钉仓。
13.根据权利要求11所述的外科器械，其中，所述第一可轴向运动的驱动构件与击发构件交接，所述击发构件由所述外科端部执行器支撑并且被构造成能够将储存在所述外科钉仓中的外科钉驱动成与所述砧座成形接触，并且随着所述击发构件被轴向驱动穿过所述外科端部执行器而切割被夹持在所述外科钉仓和所述砧座之间的组织。
14.一种外科器械，包括：
外科端部执行器，所述外科端部执行器包括相对于彼此被可运动地支撑并且能够在闭合位置和打开位置之间选择性地运动的第一钳口和第二钳口；
细长轴，所述细长轴可操作地联接到所述外科端部执行器，使得所述外科端部执行器能够相对于所述细长轴选择性地进行关节运动，所述细长轴包括：
第一可轴向运动的驱动构件，所述第一可轴向运动的驱动构件被构造成能够向所述外科端部执行器施加第一致动动作；
可轴向运动的关节运动驱动构件，所述可轴向运动的关节运动驱动构件可操作地联接到所述外科端部执行器并且被构造成能够向其施加关节运动动作，并且其中所述外科器械还包括：
第一驱动系统，所述第一驱动系统被构造成能够向所述第一可轴向运动的关节运动驱动构件施加第一轴向控制动作；
驱动离合器组件，所述驱动离合器组件与所述第一可轴向运动的驱动构件和所述可轴向运动的关节运动驱动构件可操作地交接并且被构造成能够在接合位置和第二脱离接合位置之间运动，在所述接合位置，所述驱动离合器组件将所述第一可轴向运动的驱动构件关联到所述可轴向运动的关节运动驱动构件，在所述第二脱离接合位置，所述第一可轴向运动的驱动构件能够相对于所述可轴向运动的关节运动驱动构件独立地运动；
锁组件，所述锁组件被构造成能够在锁定位置和解锁位置之间运动，在所述锁定位置，所述锁组件防止所述可轴向运动的关节运动驱动构件的轴向运动，在所述解锁位置，所述可轴向运动的关节运动驱动构件响应于所述第一驱动系统的致动而自由地轴向运动；和
可轴向运动的闭合构件组件，所述可轴向运动的闭合构件组件被构造成能够向所述第一钳口和所述第二钳口中的至少一者施加闭合动作和打开动作，以使所述第一钳口和所述第二钳口在所述闭合位置和所述打开位置之间运动，所述可轴向运动的闭合构件组件与所述驱动离合器组件可操作地交接以使所述驱动离合器组件在所述接合位置和所述脱离接合位置之间运动，并且与所述锁组件交接以在所述可轴向运动的闭合构件组件使所述驱动离合器组件运动到所述脱离接合位置时，使所述锁组件运动到所述锁定位置。
15.根据权利要求14所述的外科器械，其中，所述细长轴组件可操作地联接到外壳，所述外壳可操作地支撑所述第一驱动系统的至少一部分。
16.根据权利要求15所述的外科器械，其中，所述外壳包括柄部。
17.根据权利要求14所述的外科器械，其中，所述第一钳口包括外科钉仓，并且其中所述第二钳口包括砧座。
18.根据权利要求16所述的外科器械，其中，所述第一驱动系统包括马达，所述马达与所述柄部相关联并且被构造成能够向可轴向运动的击发驱动轴施加旋转驱动动作，所述可轴向运动的击发驱动轴与所述第一可轴向运动的驱动构件可操作地交接以向其施加轴向驱动动作。
19.根据权利要求18所述的外科器械，其中，所述致动器组件还包括可手动致动的触发器，所述可手动致动的触发器由所述柄部支撑并且与所述可轴向运动的闭合构件组件可操作地交接，使得所述可手动致动的触发器的运动致使所述可轴向运动的闭合构件组件使所述驱动离合器组件从所述接合位置运动到所述脱离接合位置，并且使所述锁组件运动到所述锁定位置。
20.一种外科器械，包括：
外科端部执行器，所述外科端部执行器包括相对于彼此被可运动地支撑并且能够在闭合位置和打开位置之间选择性地运动的第一钳口和第二钳口；
细长轴组件，所述细长轴组件可操作地联接到所述外科端部执行器，使得所述外科端部执行器能够相对于所述细长轴组件选择性地进行关节运动，所述细长轴包括：
可轴向运动的驱动构件，所述可轴向运动的驱动构件被构造成能够向所述外科端部执行器施加第一致动动作；
用于使所述外科端部执行器相对于所述细长轴组件进行关节运动的装置，并且其中所述外科器械还包括：
用于向所述可轴向运动的驱动构件施加轴向控制动作的装置；
用于使所述可轴向运动的驱动构件与用于进行关节运动的所述装置在接合位置接合的装置，在所述接合位置，用于施加轴向控制动作的所述装置的致动致动用于进行关节运动的所述装置，用于接合的所述装置进一步被构造成能够使用于进行关节运动的所述装置从所述可轴向运动的驱动构件脱离接合到脱离接合位置中，使得用于施加轴向控制动作的所述装置的致动不致动用于进行关节运动的所述装置；
用于将用于进行关节运动的所述装置锁定在锁定位置的装置；以及
用于向所述第一钳口和所述第二钳口中的至少一者施加闭合动作和打开动作以使所述第一钳口和所述第二钳口在所述闭合位置和所述打开位置之间运动的装置，用于施加的所述装置与用于接合的所述装置可操作地交接，使得：当用于施加闭合动作和打开动作的所述装置被致动以施加所述闭合动作时，用于施加的所述装置使用于接合的所述装置运动到所述脱离接合位置，并且用于施加闭合动作和打开动作的所述装置使用于锁定的所述装置运动到所述锁定位置中。
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US16/105,104 | 2018-08-20 | ||
| US16/105,104 US10842492B2 (en) | 2018-08-20 | 2018-08-20 | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
| PCT/IB2019/056908 WO2020039315A2 (en) | 2018-08-20 | 2019-08-14 | Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system |
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| CN112839597A true CN112839597A (zh) | 2021-05-25 |
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| CN201980067299.3A Pending CN112839597A (zh) | 2018-08-20 | 2019-08-14 | 带有用于将关节运动驱动系统关联到击发驱动系统的离合器和锁定布置结构的电动可关节运动外科器械 |
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| US (1) | US10842492B2 (zh) |
| EP (1) | EP3613356B1 (zh) |
| JP (1) | JP7379466B2 (zh) |
| CN (1) | CN112839597A (zh) |
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| WO (1) | WO2020039315A2 (zh) |
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| EP3613356A2 (en) | 2020-02-26 |
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