CN114025678A - 具有被构造成能够解锁闭合闭锁件的基于仓的保持器的外科缝合组件 - Google Patents

具有被构造成能够解锁闭合闭锁件的基于仓的保持器的外科缝合组件 Download PDF

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CN114025678A
CN114025678A CN202080046788.3A CN202080046788A CN114025678A CN 114025678 A CN114025678 A CN 114025678A CN 202080046788 A CN202080046788 A CN 202080046788A CN 114025678 A CN114025678 A CN 114025678A
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jaw
cartridge
surgical stapling
lockout
staple
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C·P·布德罗
G·J·巴克斯
R·W·蒂姆
J·L·哈里斯
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Cilag GmbH International
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Cilag GmbH International
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Priority claimed from US16/453,289 external-priority patent/US11291444B2/en
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Publication of CN114025678A publication Critical patent/CN114025678A/zh
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Abstract

本发明公开了一种外科缝合组件，其包括保持器，该保持器被构造成能够可移除地安装到钉仓，该钉仓被构造成能够可操作地安置在缝合装置中。该保持器包括验证键，该验证键被构造成能够使该缝合装置的第一钳口闭锁件失效，该第一钳口闭锁件被构造成能够防止该缝合装置的钳口闭合。该缝合装置还包括第二闭锁件，该第二闭锁件被构造成能够在用尽的钉仓安置在这些钳口中的一个中时防止该缝合装置的击发构件推进通过钉击发行程。

Description

具有被构造成能够解锁闭合闭锁件的基于仓的保持器的外科 缝合组件
相关申请的交叉引用
本申请要求于2019年6月25日提交的名称为“STAPLE CARTRIDGES WITH FEATURESFOR DEFEATING LOCKOUTS IN SURGICAL STAPLING DEVICES”的美国临时专利申请序列号62/866,208、于2019年2月19日提交的名称为“METHODS FOR CONTROLLING A POWEREDSURGICAL STAPLER THAT HAS SEPARATE ROTARY CLOSURE AND FIRING SYSTEMS”的美国临时专利申请序列号62/807,310、于2019年2月19日提交的名称为“SURGICAL STAPLINGDEVICES WITH IMPROVED LOCKOUT SYSTEMS”的美国临时专利申请序列号62/807,319以及于2019年2月19日提交的名称为“SURGICAL STAPLING DEVICES WITH IMPROVED ROTARYDRIVEN CLOSURE SYSTEMS”的美国临时专利申请序列号62/807,309的权益，这些申请的公开内容全文以引用方式并入本文。
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可互换外科轴组件的透视图；
图3为图1的电动外科缝合系统的柄部组件的多个部分的分解组装视图；
图4为图2的可互换外科轴组件的分解组装视图；
图5为图4的可互换外科轴组件的一部分的另一个局部分解组装视图；
图6为外科缝合组件的外科缝合装置和钉仓的分解透视组装视图；
图7为图6的外科缝合装置的第一闭锁弹簧的透视图；
图8为图6的外科缝合装置的一部分的局部侧正视图，示出了第一闭锁弹簧与其击发构件保持接合，并且在将外科钉仓插入外科缝合装置的第一钳口中之前；
图9为图8的外科缝合装置的部分的顶视图；
图10为图8的外科缝合装置的多个部分的分解图，示出了包括附接到钉仓的保持器的仓组件的初始插入，其中保持器上的验证键接合外科缝合装置的第一闭锁弹簧；
图11为图10的保持器的验证键的透视图；
图12为图11的保持器的验证键的顶视图；
图13为图11的保持器的验证键的侧视图；
图14为图8的外科缝合装置的一部分的另一顶视图，示出了将图8的仓组件初始插入外科缝合装置的第一钳口中；
图15为图14的外科缝合装置的部分在将保持器从可操作地安置在外科缝合装置的第一钳口中的钉仓移除之后的另一顶视图；
图16为图6的外科缝合装置的一部分的侧正视图，其中用尽的钉仓安置在第一钳口中并且击发构件处于起始位置；
图17为图16的外科缝合装置和用尽的钉仓的另一侧正视图，示出了处于锁定位置的第二击发构件闭锁件，其中防止击发构件在钉击发行程期间朝远侧运动；
图18为图6的外科缝合装置的一部分的侧正视图，其中未击发的钉仓安置在第一钳口中并且击发构件处于起始位置；
图19为图18的外科缝合装置和未击发的钉仓的另一侧正视图，示出了处于解锁位置的第二击发构件闭锁件，其中钉仓中的滑动件与击发构件解锁接合；
图20为另一外科缝合组件的外科缝合装置和钉仓的分解透视组装视图；
图21为图20的外科缝合装置的一部分在将包括附接到钉仓的保持器的仓组件初始插入外科缝合装置中期间的局部侧正视图；
图22为图21的外科缝合装置在仓组件已经安置在外科缝合装置的第一钳口中之后并且在从钉仓移除保持器之前的另一局部侧视图；
图23为图22的外科缝合组件在保持器已从钉仓移除之后的另一局部侧视图；
图24为另一钉仓的近侧端部的透视图；
图25为示出图24的钉仓初始插入外科缝合装置中的局部侧正视图，其中其第一击发构件闭锁件处于接合位置或锁定位置；
图26为图25的外科缝合装置的另一局部侧视图，其中图24的钉仓可操作地安置在其中并且第一击发构件闭锁件处于脱离接合位置或解锁位置；
图27为另一外科缝合组件的外科缝合装置和钉仓的分解透视组装视图；
图28为图27的外科缝合装置的一部分的局部侧正视图，示出了处于钳口锁定位置的第一闭锁件的第一闭锁臂；
图29为图28的外科缝合装置的多个部分的顶视图，其中第一闭锁臂处于钳口锁定位置；
图30为图29的外科缝合装置的多个部分的另一顶视图，其中第一闭锁臂处于钳口闭合位置；
图31为图29的外科缝合装置的局部底部透视图，其中第一闭锁臂处于钳口锁定位置；
图32为包括附接到钉仓的另一保持器的仓组件的近侧端部的局部透视图；
图33为图32的保持器的近侧端部部分的底部透视图；
图34为图33的保持器的近侧端部的顶视图；
图35为图34的保持器的近侧端部的侧视图；
图36为图29的外科缝合装置的多个部分在图32的仓组件初始插入其中期间的另一顶视图；
图37为图36的外科缝合装置的多个部分在仓组件已安置在其中之后的另一顶视图；
图38为图37的外科缝合装置的多个部分在保持器已从安置在其中的钉仓移除之后的另一顶视图；
图38A为图37的外科缝合装置的多个部分的顶视图，其中另一仓组件安置在该部分中；
图39为另一钉仓的局部透视图，其中验证键折叠到钉仓的仓盘中；
图40为另一外科缝合装置的顶视图，示出了图39的钉仓初始插入该外科缝合装置中；
图41为图40的外科缝合装置和钉仓的侧正视图；
图42为图40的外科缝合装置的另一顶视图，其中图39的外科钉仓可操作地安置在该外科缝合装置中；
图43为另一钉仓的局部透视图，其中验证键折叠到钉仓的仓盘中；
图44为示出可操作地安置在另一外科缝合装置中的图43的钉仓的局部透视图；
图45为图44的外科缝合装置和钉仓的侧正视图，其中缝合装置的第一闭锁臂保持在钳口闭合位置；
图46为图44的外科缝合装置和钉仓在将钉仓初始插入外科缝合装置中期间的另一透视图；
图47为另一钉仓的局部透视图，其中验证键折叠到钉仓的仓盘中；
图48为另一外科缝合组件的外科缝合装置和钉仓的分解透视组装视图；
图49为图48的外科缝合装置的侧正视图，其中外科缝合装置的第一闭锁臂保持在钳口锁定位置；
图50为图49的外科缝合装置的顶视图，其中第一闭锁臂处于钳口锁定位置；
图51为图49的外科缝合装置的侧正视图，其中第一闭锁臂处于钳口闭合位置并且其砧座处于闭合位置；
图52为图49的外科缝合装置的另一顶视图，示出了包括附接到钉仓的保持器的仓组件初始插入外科缝合装置中；
图53为图52的仓组件的保持器的近侧端部的局部透视图；
图54为图53的保持器的近侧端部的顶视图；
图55为图54的保持器的近侧端部的侧视图；
图56为另一外科缝合装置的顶视图，其中第一闭锁臂支撑在外科缝合装置的相对侧中并且在图52的仓组件初始插入该外科缝合装置中期间；
图57为另一外科缝合组件的外科缝合装置和钉仓的分解透视组装视图；
图58为图57的外科缝合装置的第一闭锁弹簧的透视图；
图59为图57的外科缝合装置的局部侧正视图，其中其第一闭锁弹簧与外科缝合装置的击发构件锁定接合；
图60为图59的外科缝合装置的顶视图，其中第一闭锁弹簧处于接合位置或锁定位置；
图61为图60的外科缝合装置的多个部分的分解图，示出了包括附接到钉仓的保持器的仓组件的初始插入，其中保持器上的验证键接合外科缝合装置的第一闭锁弹簧；
图62为图60的外科缝合装置的顶视图，示出了图61的仓组件初始插入该外科缝合装置中；
图63为图62的外科缝合装置在保持器已从安置在外科缝合装置中的钉仓移除之后的另一顶视图；
图64为外科系统的分解图；
图64A-图64ZZ示出了可用于与不同外科缝合装置结合使用的各种钉仓的验证键布置结构的各种空间量的示例；
图65为另一外科缝合组件的外科缝合装置和钉仓的分解透视组装视图；
图66为图65的外科缝合装置的多个部分的局部透视图；
图67为图65的外科缝合装置的第一钳口的近侧端部部分的透视图；
图68为图65的外科缝合装置的顶视图，其中其第一闭锁臂处于钳口锁定位置；
图69为图68的外科缝合装置的侧正视图，其中第一闭锁臂处于钳口锁定位置；
图70为图69的外科缝合装置的另一侧正视图，其中第一闭锁臂处于钳口闭合位置并且其砧座处于闭合位置；
图71为外科缝合装置的一部分的端正视图，其中其第一闭锁臂处于钳口锁定位置；
图72为可与图65的外科缝合装置结合使用的钉仓的透视图；
图73为图65的外科缝合装置的第一闭锁臂的一部分的顶视图，示出了图72的钉仓初始插入该部分中；
图74为与钉仓的验证键的上斜坡特征部接合的第一闭锁臂的另一顶视图；
图75为图65的外科缝合装置的第一闭锁臂在图72的钉仓进一步插入其中期间的另一顶视图；
图76为图65的外科缝合装置的第一闭锁臂在钉仓已可操作地安置在外科缝合装置中之后处于钳口闭合位置的另一顶视图；
图77为图76的第一闭锁臂的一部分在图65的外科缝合装置的砧座的闭合期间的局部透视图；
图78为图77的外科缝合装置的局部顶视图，其中砧座的一部分以横截面示出；
图78A为附接到另一钉仓实施方案的另一保持器实施方案的透视图；
图78B为另一钉仓实施方案的透视图；并且
图78C为图78B的钉仓实施方案的顶视图。
在所述若干视图中，对应的参考符号指示对应的部件。本文所述的范例以一种形式示出了本发明的各种实施方案，且这种范例不应被解释为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“METHOD FOR PROVIDING AN AUTHENTICATION LOCKOUT IN A SURGICALSTAPLER WITH A REPLACEABLE CARTRIDGE”的美国专利申请，代理人案卷号END9170USNP1/190162-1M；
-名称为“SURGICAL STAPLING ASSEMBLY WITH CARTRIDGE BASED RETAINERCONFIGURED TO UNLOCK A FIRING LOCKOUT”的美国专利申请；代理人案卷号END9170USNP2/190162-2；
-名称为“UNIVERSAL CARTRIDGE BASED KEY FEATURE THAT UNLOCKS MULTIPLELOCKOUT ARRANGEMENTS IN DIFFERENT SURGICAL STAPLERS”的美国专利申请，代理人案卷号END9170USNP4/190162-4；
-名称为“STAPLE CARTRIDGE RETAINERS WITH FRANGIBLE RETENTION FEATURESAND METHODS OF USING SAME”的美国专利申请，代理人案卷号END9170USNP5/190162-5；
-名称为“STAPLE CARTRIDGE RETAINER WITH FRANGIBLE AUTHENTICATION KEY”的美国专利申请，代理人案卷号END9170USNP6/190162-6；
-名称为“STAPLE CARTRIDGE RETAINER WITH RETRACTABLE AUTHENTICATIONKEY”的美国专利申请，代理人案卷号END9170USNP7/190162-7；
-名称为“STAPLE CARTRIDGE RETAINER SYSTEM WITH AUTHENTICATION KEYS”的美国专利申请，代理人案卷号END9170USNP8/190162-8；
-名称为“INSERTABLE DEACTIVATOR ELEMENT FOR SURGICAL STAPLER LOCKOUTS”的美国专利申请，代理人案卷号END9170USNP9/190162-9；
-名称为“DUAL CAM CARTRIDGE BASED FEATURE FOR UNLOCKING A SURGICALSTAPLER LOCKOUT”的美国专利申请，代理人案卷号END9170USNP10/190162-10；
-名称为“STAPLE CARTRIDGES WITH CAM SURFACES CONFIGURED TO ENGAGEPRIMARY AND SECONDARY PORTIONS OF A LOCKOUT OF A SURGICAL STAPLING DEVICE”的美国专利申请，代理人案卷号END9170USNP11/190162-11；
-名称为“SURGICAL STAPLE CARTRIDGES WITH MOVABLE AUTHENTICATION KEYARRANGEMENTS”的美国专利申请，代理人案卷号END9170USNP12/190162-12；
-名称为“DEACTIVATOR ELEMENT FOR DEFEATING SURGICAL STAPLING DEVICELOCKOUTS”的美国专利申请，代理人案卷号END9170USNP13/190162-13；以及
-名称为“SURGICAL STAPLE CARTRIDGES WITH INTEGRAL AUTHENTICATION KEYS”的美国专利申请，代理人案卷号END9170USNP14/190162-14。
本申请的申请人拥有于2019年6月25日提交的各自全文以引用方式并入本文的以下美国设计专利申请：
-名称为“SURGICAL STAPLE CARTRIDGE RETAINER WITH FIRING SYSTEMAUTHENTICATION KEY”的美国设计专利申请序列号29/696,066；
-名称为“SURGICAL STAPLE CARTRIDGE RETAINER WITH CLOSURE SYSTEMAUTHENTICATION KEY”的美国设计专利申请序列号29/696,067；以及
-名称为“SURGICAL STAPLE CARTRIDGE”的美国设计专利申请序列号29/696,072。
本申请的申请人拥有于2019年2月21日提交的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“METHODS FOR CONTROLLING A POWERED SURGICAL STAPLER THAT HASSEPARATE ROTARY CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号16/281658；
-名称为“STAPLE CARTRIDGE COMPRISING A LOCKOUT KEY CONFIGURED TO LIFTA FIRING MEMBER”的美国专利申请序列号16/281,670；
-名称为“SURGICAL STAPLERS WITH ARRANGEMENTS FOR MAINTAINING A FIRINGMEMBER THEREOF IN A LOCKED CONFIGURATION UNLESS A COMPATIBLE CARTRIDGE HASBEEN INSTALLED THEREIN”的美国专利申请序列号16/281675；
-名称为“SURGICAL INSTRUMENT COMPRISING CO-OPERATING LOCKOUT FEATURES”的美国专利申请序列号16/281685；
-名称为“SURGICAL STAPLING ASSEMBLY COMPRISING A LOCKOUT AND ANEXTERIOR ACCESS ORIFICE TO PERMIT ARTIFICIAL UNLOCKING OF THE LOCKOUT”的美国专利申请序列号16/281693；
-名称为“SURGICAL STAPLING DEVICES WITH FEATURES FOR BLOCKINGADVANCEMENT OF A CAMMING ASSEMBLY OF AN INCOMPATIBLE CARTRIDGE INSTALLEDTHEREIN”的美国专利申请序列号16/281704；
-名称为“SURGICAL INSTRUMENT COMPRISING A DEACTIVATABLE LOCKOUT”的美国专利申请序列号16/281,707；
-名称为“SURGICAL INSTRUMENT COMPRISING A JAW CLOSURE LOCKOUT”的美国专利申请序列号16/281741；
-名称为“SURGICAL STAPLING DEVICES WITH CARTRIDGE COMPATIBLE CLOSUREAND FIRING LOCKOUT ARRANGEMENTS”的美国专利申请序列号16/281762；
-名称为“SURGICAL STAPLE CARTRIDGE WITH FIRING MEMBER DRIVEN CAMMINGASSEMBLY THAT HAS AN ONBOARD TISSUE CUTTING FEATURE”的美国专利申请序列号16/281660；
-名称为“SURGICAL STAPLING DEVICES WITH IMPROVED ROTARY DRIVEN CLOSURESYSTEMS”的美国专利申请序列号16/281666；
-名称为“SURGICAL STAPLING DEVICES WITH ASYMMETRIC CLOSURE FEATURES”的美国专利申请序列号16/281,660；
-名称为“ROTARY DRIVEN FIRING MEMBERS WITH DIFFERENT ANVIL AND FRAMEENGAGEMENT FEATURES”的美国专利申请序列号16/281,678；以及
-名称为“SURGICAL STAPLING DEVICE WITH SEPARATE ROTARY DRIVEN CLOSUREAND FIRING SYSTEMS AND FIRING MEMBER THAT ENGAGES BOTH JAWS WHILE FIRING”的美国专利申请序列号16/281,682。
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、通过形成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框架的进入装置插入，外科器械的端部执行器和细长轴可通过该工作框架推进。
外科缝合系统可包括轴和从轴延伸的端部执行器。所述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。仓体包括限定于仓体中的钉腔，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未击发位置和第二或击发位置之间运动，以从钉仓射出钉。驱动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未击发位置与其击发位置之间运动。滑动件能够在与近侧端部相邻的近侧位置和与远侧端部相邻的远侧位置之间运动。滑动件包括多个斜坡表面，该斜坡表面被构造成能够朝向砧座在驱动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纳击发构件。砧座还包括被构造成能够接纳击发构件的狭槽。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示出了包括可操作地联接到外壳1012的可互换轴组件1200的外科器械1010。图2示出了脱离外壳1012或柄部1014的可互换轴组件1200。如图3中可见，柄部1014可包括一对可互连柄部外壳段1016和1018，该对柄部外壳段可通过螺钉、按扣特征部、粘合剂等互连。在示出的结构中，柄部外壳段1016、1018配合形成手枪式握把部1019。图1和图3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1010。在例示的实施方案中，器械1010包括先前的外壳1012，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1014。外壳1012被构造能够可操作地附接到可互换轴组件1200，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1300，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。继续参阅本具体实施方式，将会理解，本文所公开的各种形式的可互换轴组件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。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”。在此类情况下，部件可不容纳在外壳内或由外壳直接支撑。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。例如，本文所公开的可互换轴组件可与名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利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。
图1所示的先前外壳1012结合可互换轴组件1200示出(图2、图4和图5)，该可互换轴组件包括端部执行器1300，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1350的外科切割和紧固装置。外壳1012可被构造能够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1012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，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可被临床医生抓握和操纵的紧固件。如将在下文进一步详细地讨论，柄部1014可操作地支撑其中的多个驱动系统，这些驱动系统被构造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3，柄部1014还可包括可操作地支撑多个驱动系统的框架1020。例如，框架1020可操作地支撑通常被标记为1030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1200。在至少一种形式中，闭合驱动系统1030可包括被框架1020枢转地支撑的闭合触发器1032形式的致动器。更具体地，如图3所示，闭合触发器1032经由销1033枢转地联接到柄部1014。此类布置结构使闭合触发器1032能够被临床医生操纵，使得当临床医生抓握柄部1014的手枪式握把部1019时，闭合触发器1032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1032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1030还包括枢转地联接到闭合触发器1032的闭合连杆组件1034。如图3中可见，闭合连杆组件1034可包括通过销1035枢转地联接到闭合触发器1032的第一闭合连接件1036和第二闭合连接件1038。第二闭合连接件1038在本文中也可被称为“附接构件”，并且包括横向附接销1037。
仍参见图3，可观察到，第一闭合连接件1036可在其上具有锁定壁或锁定端部1039，该锁定壁或锁定端部被构造成能够与枢转地联接到框架1020的闭合释放组件1060配合。在至少一种形式中，闭合释放组件1060可包括释放按钮组件1062，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1064。释放按钮组件1062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1032从其未致动位置朝向柄部1014的手枪式握把部1019压下时，第一闭合连接件1036向上枢转至某个点，其中锁定棘爪1064落入该点中以与第一闭合连接件1036上的锁定壁1039保持接合，从而阻止闭合触发器1032返回未致动位置。因此，闭合释放组件1060用来将闭合触发器1032锁定在完全致动位置。当临床医生期望将闭合触发器1032解锁以允许其被偏压到未致动位置时，临床医生只需枢转释放按钮组件1062，使得锁定棘爪1064运动成与第一闭合连接件1036上的锁定壁1039脱离接合。当锁定棘爪1064已运动成与第一闭合连接件1036脱离接合时，闭合触发器1032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1061可从释放按钮组件1062延伸。磁性元件1063(诸如永磁体)例如可安装到臂1061。当释放按钮组件1062被从其第一位置旋转到其第二位置时，磁性元件1063可朝电路板1100运动。电路板1100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1063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1100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1063的运动所引起的环绕霍尔效应传感器的磁场变化。霍耳效应传感器可与例如微控制器进行信号通信，该微控制器可确定释放按钮组件1062是处于其第一位置、还是处于其第二位置还是/或者处于该第一位置与该第二位置之间的任何位置，该第一位置与闭合触发器1032的未致动位置和端部执行器的打开构型相关联，该第二位置与闭合触发器1032的致动位置和端部执行器的闭合构型相关联。
在至少一种形式中，柄部1014和框架1020可操作地支撑在本文中被称为击发驱动系统1080的另一个驱动系统，该驱动系统被构造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1080在本文中也可被称为“第二驱动系统”。击发驱动系统1080可以采用定位在柄部1014的手枪式握把部1019中的电动马达1082。在各种形式中，马达1082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1082可由电源1090供电，在一种形式中，该电源可包括可移除电源组1092。如图3中可见，例如，电源组1092可包括近侧外壳部分1094，该近侧外壳部分被构造能够附接到远侧外壳部分1096。近侧外壳部分1094和远侧外壳部分1096被构造成能够在其中可操作地支撑多个电池1098。电池1098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1096被构造能够以可移除方式可操作地附接到同样可操作地联接到马达1082的柄部电路板1100。多个电池1098可以串联连接，可以用作外科器械1010的电源。此外，电源1090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1082可包括与齿轮减速器组件1084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1120上。在使用中，电源1090所提供的电压极性可沿顺时针方向操作电动马达1082，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1082。当电动马达1082在一个方向上旋转时，驱动构件1120将在远侧方向“DD”上被轴向地驱动。当马达82在相反的旋转方向上被驱动时，驱动构件1120将在近侧方向“PD”上被轴向地驱动。柄部1014可包括开关，该开关可被构造成能够使由电源1090施加到电动马达1082的极性反转。与本文所述的其他形式一样，柄部1014还可包括传感器，该传感器被配置成能够检测驱动构件1120的位置和/或驱动构件1120正在运动的方向。
马达1082的致动可通过被枢转地支撑在柄部1014上的击发触发器1130来控制。击发触发器1130可在未致动位置和致动位置之间枢转。击发触发器1130可由弹簧1132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1130时，击发触发器可由弹簧1132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1130可定位在闭合触发器1032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1134可由销1035枢转地安装到闭合触发器1032。安全按钮1134可定位在击发触发器1130和闭合触发器1032之间，并具有从其突出的枢转臂1136。参见图3。当闭合触发器1032处于未致动位置时，安全按钮1134被容纳在柄部1014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1130致动的安全位置与击发触发器1130可被击发的击发位置之间运动。临床医生压下闭合触发器1032时，安全按钮1134和击发触发器1130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1120具有形成于在其上的一齿条的齿1122，以用于与齿轮减速器组件1084的对应驱动齿轮1086啮合接合。至少一种形式还包括可手动致动的“应急”组件1140，该“应急”组件被构造成能够使得临床医生能够在马达1082变得失效情况下手动地回缩可纵向运动的驱动构件1120。应急组件1140可包括杠杆或应急柄部组件1142，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1120中的齿1122棘轮接合。因此，临床医生可通过使用应急柄部组件1142来手动地回缩驱动构件1120，以使驱动构件1120在近侧方向“PD”上做棘轮运动。名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLEFIRING 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2和图5，可互换轴组件1200包括外科端部执行器1300，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1350的细长框架1310。端部执行器1300还可包括相对于细长框架1310被枢转地支撑的砧座2000。可互换轴组件1200还可包括关节运动接头3020和关节运动锁2140，该关节运动锁可被构造成能够将端部执行器1300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1300、关节运动接头3020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13/803086(现为美国专利申请公布2014/0263541)。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(现为美国专利申请公布2014/0263541)的完整公开内容据此以引用方式并入本文。如图4中可见，可互换轴组件1200还可包括由喷嘴部分1202和1203组成的近侧外壳或喷嘴1201。
可互换轴组件1200还可包括闭合系统或闭合构件组件3000，该闭合构件组件可用于闭合和/或打开端部执行器1300的砧座2000。轴组件1200可包括脊1210，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1210延伸的闭合构件组件3000。如图5中可见，脊1210的远侧端部1212终止于上凸耳安装特征部1270和下凸耳安装特征部1280。上凸耳安装特征部1270在其中形成有凸耳狭槽1272，该凸耳狭槽适于在其中安装支撑上安装连接件1274。类似地，下凸耳安装特征部1280在其中形成有凸耳狭槽1282，该凸耳狭槽适于在其中安装支撑下安装连接件1284。上安装连接件1274中包括枢轴承窝1276，该枢轴承窝适于在其中可旋转地接纳枢轴销1292，该枢轴销形成在附接到细长框架1310的近侧端部部分1312的框架盖或砧座保持器1290上。下安装连接件1284包括下枢轴销1286，该下枢轴销适于被接纳在形成在细长框架1310的近侧端部部分1312中的枢轴孔1314内。参见图5。下枢轴销1286与枢轴承窝1276在竖直方向上对准以限定关节运动轴线AA，外科端部执行器1300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2。
在例示的示例中，外科端部执行器1300能够由关节运动系统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，关节运动系统2100包括近侧关节运动驱动器2102，该近侧关节运动驱动器枢转地联接到关节运动连接件2120。如图5中可以最具体地看出，在近侧关节运动驱动器2102的远侧端部2110上形成偏置附接凸耳2114。枢轴孔2116形成在偏置附接凸耳2114中，并且被构造成能够在其中枢转地接纳形成在关节运动连接件2120的近侧端部2122上的近侧连接件销2124。关节运动连接件2120的远侧端部2126包括枢轴孔2128，该枢轴孔被构造成能够在其中枢转地接纳形成在细长框架1310的近侧端部部分1312上的框架销1317。因此，近侧关节运动驱动器2102的轴向运动将由此向细长框架1310施加关节运动，从而使外科端部执行器1300围绕关节运动轴线AA相对于脊1210进行关节运动。有关于关节运动系统2100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“SURGICAL INSTRUMENT WITH AXIALLYMOVABLE CLOSURE MEMBER”的美国专利申请序列号15/635,631中，现为美国专利申请公布2019/0000464，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2102没有在近侧或远侧方向上运动时，近侧关节运动驱动器2102可被关节运动锁2140保持就位。关于关节运动锁2140的示例的附加细节可见于美国专利申请序列号15/635631(现为美国专利申请公布2019/0000464)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1210可包括近侧端部1211，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1210的近侧端部1211具有形成于其上的螺纹1214，以便通过螺纹附接到脊轴承1216，该脊轴承被构造成能够被支撑在底座1240内。参见图4。这种布置结构有利于脊1210至底座1240的可旋转附接，使得脊1210可相对于底座1240围绕轴轴线SA选择性地旋转。
主要参见图4，可互换轴组件1200包括闭合梭动件1250，该闭合梭动件被可滑动地支撑在底座1240内，使得闭合梭动件可相对于底座轴向运动。闭合梭动件1250包括被构造能够附接到附接销1037的一对朝近侧突起的钩1252(图3)，该附接销附接到第二闭合连接件1038，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3000包括具有近侧端部3012的近侧闭合构件段3010，该近侧端部联接到闭合梭动件1250以相对于闭合梭动件旋转。例如，将U形连接器1263插入近侧闭合构件段3010的近侧端部3012中的环形狭槽3014中，并使其保留在闭合梭动件1250中的竖直狭槽1253内。此类结构用于将近侧闭合构件段3010附接到闭合梭动件1250，以与闭合梭动件一起轴向地行进，同时使得近侧闭合构件段3010能够相对于闭合梭动件1250围绕轴轴线SA旋转。闭合弹簧1268轴颈连接在近侧闭合构件段3010上并且用于沿近侧方向“PD”偏压近侧闭合构件段3010，当轴组件可操作地联接到柄部1014时，该闭合弹簧可用来将闭合触发器1032枢转到未致动位置。
在至少一种形式中，可互换轴组件1200还可包括关节运动接头3020。然而，其他可互换轴组件可能无法进行关节运动。如图5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段3010的远侧端部。关节运动接头3020包括双枢轴闭合套管组件3022。根据各种形式，双枢轴闭合套管组件3022包括具有朝近侧突出的上柄脚3052和下柄脚3054的端部执行器闭合管3050。上部双枢轴连接件3056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3030上的朝近侧突出的上柄脚3052中的上部远侧销孔以及朝远侧突出的上柄脚3031中的上部近侧销孔3032。下部双枢轴连接件3058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3054中的下部远侧销孔以及朝远侧突出的下柄脚3034中的下部近侧销孔。参见图4和图5。如将在下文进一步详细讨论的，闭合构件组件3000朝远侧(方向“DD”)平移，以例如响应于闭合触发器1032的致动来闭合砧座2000。通过朝近侧平移闭合构件组件3000来打开砧座2000，这使得端部执行器闭合管3050与砧座2000相互作用并将砧座枢转至打开位置。
同样如上所述，可互换轴组件1200还包括击发构件1900，该击发构件被支撑以便在脊1210内轴向行进。击发构件1900包括被构造能够附接到远侧切割部分或刀杆1910的中间击发轴部分1222。中间击发轴部分1222可在其远侧端部中包括纵向狭槽1223，该纵向狭槽可被构造成能够接纳远侧刀杆1910的近侧端部上的插片1912。纵向狭槽1223和近侧端部插片1912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1914。滑动接头1914可以允许击发构件1900的中间击发轴部分1222运动，以在不运动或至少基本上不运动刀杆1910的情况下，使端部执行器1300进行关节运动。一旦端部执行器1300已被合适地取向，便可朝远侧推进中间击发轴部分1222，直到纵向狭槽1223的近侧侧壁与插片1912发生接触，以便推进刀杆1910并击发定位在框架1310内的钉仓1350。刀杆1910包括刀部分1920并且包括上部砧座接合插片1924和下部框架接合插片1926，该刀部分包括刀片或组织切割刃1922。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4中可见，轴组件1200还包括可旋转地接纳在近侧闭合构件段3010上的切换筒1500。切换筒1500包括中空轴段1502，该中空轴段具有形成于其上的轴凸台，以用于在其中接纳向外突出的致动销。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1420被构造成能够接合切换筒1500上的凸台和喷嘴1201的一部分，以将偏压力施加到切换筒1500。切换筒1500还可包括限定于其中的至少部分周边开口1506，这些开口被构造成能够接纳从喷嘴部分1202、1203延伸的周边安装座，并且允许切换筒1500和喷嘴1201之间的相对旋转而不是相对平移。安装座还延伸穿过待安置在脊1210中的凹陷部1219中的近侧闭合构件段3010中的开口3011。切换筒1500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1500的旋转可与闭合管或闭合构件的轴向推进关联。因此，实质上，闭合系统的致动可以各种方式使关节运动驱动系统与击发驱动系统可操作地接合和脱离接合，所述方式在名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803086(现为美国专利申请公布2014/0263541)以及名称为“SURGICALINSTRUMENT COMPRISING A SENSOR SYSTEM”的美国专利9913642中更详细地描述，这些专利各自的全部公开内容据此以引用方式并入本文。例如，当闭合构件段3010处于其对应于“钳口打开”位置的最近侧位置时，闭合构件段3010将已定位切换筒1500，以便将关节运动系统与击发驱动系统连接。当闭合管已运动到其对应于“钳口闭合”位置的远侧位置时，闭合管已将切换筒1500旋转到其中关节运动系统与击发驱动系统脱离连接的位置。
同样如图4所示，轴组件1200可包括滑环组件1600，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1300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1300和/或从该端部执行器接收信号。滑环组件1600可包括近侧连接器凸缘1604和远侧连接器凸缘，该近侧连接器凸缘安装到从底座1240延伸的底座凸缘1242，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1604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1604旋转。近侧连接器凸缘1604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1604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1604可包括电连接器1606，该电连接器可使导体与安装到轴底座1240的轴电路板1610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1606与轴电路板1610之间延伸。电连接器1606可朝近侧延伸穿过底座凸缘1242中限定的连接器开口1243。参见图4。关于滑环组件1600的更多细节可见于例如名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK”的美国专利申请序列号13/803086(现为美国专利申请公布2014/0263541)、2013年3月13日提交的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM”的美国专利申请序列号13/800067(现为美国专利申请公布2014/0263552)以及名称为“STAPLE CARTRIDGE TISSUETHICKNESS SENSOR SYSTEM”的美国专利9345481。美国专利申请序列号13/803,086(现为美国专利申请公布2014/0263541)、美国专利申请序列号13/800,067(现为美国专利申请公布2014/0263552)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1200可包括近侧部分和远侧部分，该近侧部分可固定地安装到柄部1014，该远侧部分能够围绕纵向轴线旋转。可旋转远侧轴部分可如上文所讨论围绕滑环组件1600相对于近侧部分旋转。滑环组件1600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1500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1500可彼此同步地旋转。另外，切换筒1500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1500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1200的端部执行器1300进行关节运动。当切换筒1500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1300进行关节运动。当切换筒1500在其第一位置和其第二位置之间运动时，切换筒1500相对于远侧连接器凸缘运动。在各种实例中，轴组件1200可包括被配置成能够检测切换筒1500的位置的至少一个传感器。
再次参见图4，底座1240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1244，这些锥形附接部分适于被接纳在对应的燕尾形狭槽1702内，该燕尾形狭槽形成在框架1020的远侧附接凸缘部分1700内。参见图3。每个燕尾形狭槽1702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1244接纳在其中。如可在图4中进一步所见，轴附接凸耳1226形成在中间击发轴部分1222的近侧端部上。如将在下文进一步详细地讨论，当可互换轴组件1200联接到柄部1014时，轴附接凸耳1226被接纳在纵向驱动构件1120的远侧端部1125中形成的击发轴附接支架1126中。参见图3。
各种轴组件实施方案采用闩锁系统1710用于将轴组件1200可移除地联接到外壳1012并且更具体地联接到框架1020。如图4中可见，例如，在至少一种形式中，闩锁系统1710包括可运动地联接到底座1240的锁定构件或锁定轭1712。在例示的实施方案中，例如，锁定轭1712为U形，具有两个隔开并向下延伸的支腿1714。支腿1714各自具有形成于其上的枢轴凸耳1715，这些枢轴凸耳适于被接纳在形成于底座1240中的对应孔1245中。这种布置结构有利于将锁定轭1712枢转附接到底座1240。锁定轭1712可包括两个朝近侧突起的锁定凸耳1716，这两个锁定凸耳被构造成能够与框架1020的远侧附接法兰部分1700中对应的锁定棘爪或凹槽1704可释放地接合。参见图3。在各种形式中，锁定轭1712被弹簧或偏压构件(未示出)沿近侧方向偏压。锁定轭1712的致动可通过闩锁按钮1722实现，该闩锁按钮可滑动地安装在安装到底座1240的闩锁致动器组件1720上。闩锁按钮1722可相对于锁定轭1712沿近侧方向偏压。如将在下文进一步详细地讨论，锁定轭1712可通过沿远侧方向偏压闩锁按钮而运动到解锁位置，这也使锁定轭1712枢转成不再与框架1020的远侧附接凸缘部分1700保持接合。当锁定轭1712与框架1020的远侧附接凸缘部分1700“保持接合”时，锁定凸耳1716保持坐置在远侧附接凸缘部分1700中对应的锁定棘爪或凹槽1704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1032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1300内，临床医生就可完全致动闭合触发器1032，以闭合砧座2000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1030已被完全致动。在目标组织已被夹紧在端部执行器1300中之后，可能有利的是防止轴组件1200不经意地从外壳1012脱离。闩锁系统1710的一种形式被构造成能够防止这种不经意的脱离。
如图4中可最清楚地看到的那样，锁定轭1712包括至少一个、并且优选两个锁钩1718，这些锁钩适于接触闭合梭动件1250上形成的对应锁定凸耳部分1256。当闭合梭动件1250处于未致动位置(即，第一驱动系统1030未致动并且砧座2000打开)时，锁定轭1712可沿远侧方向枢转，以将可互换轴组件1200从外壳1012解锁。处于该位置时，锁钩1718不接触闭合梭动件1250上的锁定凸耳部分1256。但是，当闭合梭动件1250运动到致动位置(即第一驱动系统1030被致动并且砧座2000处于闭合位置)时，锁定轭1712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1712枢转到解锁位置，或者例如，锁定轭1712不经意地以原本可能致使其朝远侧枢转的方式受到碰撞或发生接触，则锁定轭1712上的锁定钩1718将接触闭合梭动件1250上的锁定凸耳部分1256，并且防止锁定轭1712运动到解锁位置。
现在将描述可互换轴组件1200与柄部1014的附接。要开始联接过程，临床医生可将可互换轴组件1200的底座1240定位在框架1020的远侧附接凸缘部分1700上方或附近，使得底座1240上形成的锥形附接部分1244与框架1020中的燕尾形狭槽1702对准。然后临床医生可使轴组件1200沿垂直于轴轴线SA的安装轴线运动，以使附接部分1244安置成与对应的燕尾形接纳狭槽1702“可操作地接合”。这样做时，中间击发轴部分1222上的轴附接凸耳1226也将坐置在可纵向运动的驱动构件1120中的支架1126中，并且第二闭合连接件1038上的销1037的部分将坐置在闭合梭动件1250中的对应钩1252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1200的至少五个系统可以与柄部1014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1200的框架或脊与柄部1014的框架1020联接并/或对准。另一系统可包括闭合驱动系统1030，该闭合驱动系统可将柄部1014的闭合触发器1032与轴组件1200的闭合管3050和砧座2000可操作地连接。如上文所概述，轴组件1200的闭合梭动件1250可与第二闭合连接件1038上的销1037接合。另外的系统可包括击发驱动系统1080，该击发驱动系统可将柄部1014的击发触发器1130与轴组件1200的中间击发轴部分1222可操作地连接。如上文所概述，轴附接凸耳1226可与纵向驱动构件1120的支架1126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1200)已与柄部1014可操作地接合的信号到柄部1014中的控制器(诸如微控制器)，并且/或者在轴组件1200与柄部1014之间传导功率和/或通信信号。例如，轴组件1200可包括可操作地安装到轴电路板1610的电连接器1810。电连接器1810被构造能够与控制电路板1100上的对应电连接器1800配合接合。关于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(现为美国专利申请公布2014/0263541)和美国专利申请序列号14/226,142(现为美国专利9,913,642)，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1200可释放地锁定到柄部1014的闩锁系统组成。
在例示的示例中，砧座2000包括终止于砧座安装部分2010中的砧座主体2002。砧座安装部分2010被可运动地或枢转地支撑在细长框架1310上，以便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2012横向延伸出砧座安装部分2010的每个横向侧，以接纳在形成在细长框架1310的近侧端部部分1312的直立壁1315中的对应耳轴支架1316中。砧座耳轴2012由框架盖或砧座保持器1290枢转地保持在其对应的耳轴支架1316中。框架盖或砧座保持器1290包括一对附接凸耳，该对附接凸耳被构造成能够保持地接纳在形成在细长框架1310的近侧端部部分1312的直立壁1315中的对应凸耳凹槽或凹口内。参见图5。
仍然参见图5，在至少一种结构中，远侧闭合构件或端部执行器闭合管3050采用两个轴向偏置的近侧正钳口开口特征部3060和远侧正钳口开口特征部3062。正钳口打开特征部3060、3062被构造成能够与在砧座安装部分2010上形成的对应的释放区域和阶梯部分交接，如在名称为“SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER”的美国专利申请序列号15/635,631，现为美国专利申请公布2019/0000464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。
以下专利申请的公开内容全文以引用方式并入本文：提交于2003年5月20日的名称为“SURGICAL STAPLING INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT”的美国专利申请公布2004/0232200；名称为“SURGICAL STAPLING INSTRUMENT HAVING A FIRINGLOCKOUT FOR AN UNCLOSED ANVIL”的美国专利申请公布2004/0232199；提交于2003年5月20日的名称为“SURGICAL STAPLING INSTRUMENT INCORPORATING AN E-BEAM FIRINGMECHANISM”的美国专利申请公布2004/0232197；提交于2003年5月20日的名称为“SURGICALSTAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利申请公布2004/0232196；提交于2003年5月20日的名称为“SURGICAL STAPLINGINSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING”的美国专利申请公布2004/0232195；以及提交于2017年8月17日的名称为“ARTICULATINGSURGICAL STAPLING INSTRUMENT INCORPORATING A TWO-PIECE E-BEAM FIRINGMECHANISM”的美国专利申请公布2018/0085123。
参见图6，示出了外科缝合组件4000的示例。外科缝合组件4000可与上文描述的外科器械1010结合或与各种其他外科器械结合使用，这些其他外科器械在以引用方式并入本文的各种公开内容中描述。例如，外科缝合组件4000可以以上述并入的公开内容中公开的各种形式与电控制、电池供电、手动供电和/或机器人控制的外科器械结合使用。如图6中可见，外科缝合组件4000包括通常被标记为4002的外科缝合装置，该外科缝合装置包括被构造成能够在其中可操作地支撑钉仓4200的第一钳口或框架4010。第一钳口4010可以以本文以及以引用方式并入本文的各种公开内容中描述的各种方式附接到外科器械或机器人的轴组件的脊。在例示的示例中，第一钳口4010通过由销4032销连接或以其他方式附接到第一钳口4010的近侧端部4014的轴安装凸缘4030附接到轴组件的脊部分(图6中未示出)。具体地，销4032被构造成能够穿过第一钳口4010的直立侧壁4020中的对准孔4021以及穿过轴安装凸缘4030中的孔4031。轴安装凸缘4030被构造成能够与关节运动接头布置结构(未示出)交接，该关节运动接头布置结构被构造成能够以各种已知构型促进第一钳口4010相对于轴组件的关节运动。也可以采用将外科装置4002与外科器械的轴附接和可操作地交接的其他方法。例如，缝合装置4002可附接到轴组件，使得缝合装置(有时也称为“端部执行器”)不能相对于轴组件进行关节运动。
仍然参见图6，外科缝合装置4002还包括击发构件组件4040，该击发构件组件包括附接到刀构件或“击发构件”4050的刀杆4042。刀杆4042还与外科器械中的对应部件和击发系统交接，以接收击发运动，该击发运动可将刀杆4042和击发构件4050通过钉击发行程从起始位置朝远侧推进到结束位置，并且还将刀杆4042和击发构件4050朝近侧回缩到起始位置。在例示的布置结构中，击发构件4050包括支撑切割刃或刀刃4053的击发构件主体4052。击发构件4050还包括支脚4054，该支脚形成在击发构件主体4052的底部上并且从击发构件主体4052的每一侧横向延伸。击发构件4050还包括从击发构件主体4052横向延伸的一对顶部销或插片4056，该对顶部销或插片适于接合砧座上的凸部，如本文将进一步讨论的。另外，击发构件4050包括从击发构件主体4052的每一侧横向突出的一对中心销或插片4058。在以引用方式并入本文的公开内容中的一些公开内容中，击发构件4050也可称为“电子束”击发构件或切割构件。
除上述以外，外科缝合装置4002包括可相对于第一钳口或框架4010运动的第二钳口或砧座4100。砧座4100包括砧座主体部分4102和砧座安装部分4110。砧座主体4102包括钉成形下表面或组织接触表面4104，其具有形成于其中的一系列钉成形凹坑(未示出)，这些钉成形凹坑被布置成当它们被驱动成与对应钉成形接触时形成对应钉。砧座安装部分4110包括一对横向延伸的砧座销或耳轴销4112，其被构造成能够接纳在第一钳口4010的直立侧壁4020中的对应耳轴狭槽4022中。在例示的布置结构中，耳轴狭槽4022稍微呈“肾形”并且促进对应耳轴销4112在其中的枢转以及轴向行进。砧座4100的这样的枢转和轴向运动可称为砧座闭合序列期间砧座的“平移”。
如上文以及在以引用方式并入本文的公开内容中的若干公开内容中所讨论的，砧座4100可从打开位置运动到闭合位置，在该打开位置中用过的或用尽的外科钉仓可从第一钳口或框架4010移除，或者未击发的外科钉仓可以可操作地安置在其中。砧座4100可通过可轴向运动的闭合构件在打开位置与闭合位置之间运动，该可轴向运动的闭合构件可包括端部执行器闭合管(未示出)，该端部执行器闭合管是外科器械的轴组件的一部分，外科装置4002可操作地附接到该部分。例如，当闭合构件通过致动外科器械中的闭合控制系统从近侧位置朝远侧运动时，闭合构件可以可操作地接合砧座安装部分4110上的凸轮表面。闭合构件与砧座安装部分4110之间的这样的相互作用使砧座安装部分4110和砧座耳轴销4112枢转并沿耳轴狭槽4022向上平移，直到闭合构件使砧座4100运动到完全闭合位置。当处于完全闭合位置时，砧座4100中的钉成形凹坑与已经可操作地安置在第一钳口或框架4010中的对应兼容外科钉仓中的钉正确地对准。当可轴向运动的闭合构件之后在近侧方向上运动时，闭合构件与砧座安装部分4110上的直立插片4114交接，以将砧座4100返回到打开位置。
可与外科缝合装置4002兼容的一种形式的外科钉仓4200包括限定仓平台表面或组织接触表面4204的仓体4202。仓体4202还包括纵向狭槽4206，该纵向狭槽平分仓平台表面4204并且被构造成能够在钉击发行程期间使击发构件4050的轴向通道在仓体4202内在其起始位置与结束位置之间容纳在该纵向狭槽中。纵向狭槽4206沿着仓4200的中心轴线CA定位。外科钉仓4200还包括形成于仓体4202中的一系列钉凹坑4208。钉凹坑4208可以形成在位于纵向狭槽4206的每一侧上的偏置“线”中。每个钉凹坑4208可具有与其相关联的钉驱动器(未示出)，该钉驱动器在其上支撑外科钉或紧固件(未示出)。在至少一个示例中，仓体4202由其中模制或机加工有钉凹坑4208的聚合物材料模制而成。在一种布置结构中，钉凹坑4208还通过仓体4202的底部打开，以便于将驱动器和紧固件安装到其相应的钉凹坑4208中。一旦驱动器和紧固件被插入其相应的钉凹坑4208中，则仓盘4220附接到仓体4202。在一种形式中，仓盘4220由金属材料制成并且包括跨越仓体4202的底部的底部4222。仓盘4220还包括对应于仓体4202的每一侧的两个直立侧壁4224。仓盘4220可通过钩4226能够移除地附连到仓体4202，该钩形成在侧壁4224上并且被构造成能够以钩的形式接合仓体4202的对应部分。另外，仓体4202还可以具有从其突出的凸耳或附接形成物，该凸耳或附接形成物被构造成能够保持接合仓盘4220的对应部分。当安装时，仓盘4220可(除了别的以外)防止驱动器和紧固件在钉仓处理和安装到第一钳口或框架4010中期间从仓体4202的底部掉出。
根据特定仓设计，钉驱动器中的一些钉驱动器在其上可操作地支撑单个外科钉，而其他钉驱动器在其上支撑多于一个外科钉。每个外科钉包括钉冠部和两个直立的钉腿。钉冠部通常支撑在形成于对应钉驱动器中的支架布置结构上，使得当仓可操作地安置在框架4010中时，支腿朝向砧座在竖直方向上取向。在一些布置结构中，外科钉具有稍微V形形状，其中腿的端部略微向外张开。如果仓在使用期间无意中倒置或上下颠倒，由于支腿和钉凹坑的侧面之间的摩擦接合，此类布置结构可用于将钉保持在其对应钉凹坑中。其他外科钉是大致U形的(支腿的端部不向外张开)，并且如果在使用前将仓倒置，则可能更易于从钉凹坑中掉出。
外科钉仓4200还包括滑动件或凸轮作用构件4230，其被构造成能够在钉击发行程期间轴向推进通过仓体4202。在“新的”、“新近的”或“未击发的”外科钉仓中，滑动件4230处于其最近侧的“未击发”位置。滑动件4230包括多个楔形件或凸轮构件4232，其被构造成能够驱动地接合仓体中的钉驱动器的对应线。在钉击发行程期间，击发构件4050邻接并朝远侧推动滑动件4230以与钉驱动器凸轮接触，由此随着滑动件4230在仓体4202内从其未击发位置驱动到其最远侧的完全击发位置而向上朝向砧座4100顺序地驱动钉驱动器。当钉驱动器被向上驱动时，钉被驱动穿过夹在钉仓4200的平台表面4204与砧座4100之间的组织，并且与砧座4100的钉成形下表面4104成形接触。在击发构件4050被朝远侧驱动时，击发构件4050上的组织切割刀4053切割穿过缝合组织。在钉击发行程已完成之后，并且/或者在足够长度的钉击发行程已完成之后，击发构件4050朝近侧回缩。然而，滑动件4230不与击发构件4050一起朝近侧回缩。相反，滑动件4230留在其被击发构件4050推动到的最远侧位置处。
在钉仓已被击发或至少部分地击发之后，如果需要，将钉仓从框架移除，然后用另一个能够替换的钉仓替换。此时，缝合装置可重新用于继续缝合和切入患者组织。然而，在一些情况下，先前击发的钉仓可被意外地装载到框架中。如果击发构件将在此类先前击发的钉仓内朝远侧推进，则缝合器械将切割患者组织而不缝合患者组织。如果击发构件朝远侧推进通过钉击发行程而根本没有钉仓定位在仓钳口中，则缝合器械将类似地切割患者组织而不缝合患者组织。另外，各种外科钉仓可在其中具有钉/紧固件的不同阵列和/或取向。根据具体的外科手术或应用，钉或紧固件的尺寸以及紧固件的数量可因仓类型而异。为了确保钉被正确地压接或成形，外科钉仓必须与其中具有适当阵列的钉成形凹坑的对应兼容砧座以及适当的切割和击发部件结合使用。如果“不兼容”的仓被装载到具有与钉仓不匹配的砧座的外科缝合装置中，则钉可能在击发过程期间不能正确地成形，这可能导致灾难性结果。为此，外科缝合组件4000包括防止发生这种情况的一个或多个闭锁件，如下文更详细地讨论。
除上述以外，外科缝合装置4002包括第一闭锁件4300，该第一闭锁件被构造成能够防止击发构件4050从其最近侧起始位置朝远侧运动，除非经授权或兼容的钉仓可操作地安置在第一钳口或框架4010中。第一闭锁件4300在本文中也可称为“验证”闭锁件。在例示的布置结构中，第一闭锁件4300包括单个双横向第一闭锁弹簧4310，其支撑在框架4010的近侧端部4014中并且附接到轴安装凸缘4030。例如，在一种布置结构中，第一闭锁弹簧4310包括位于仓轴线CA的一侧上的第一闭锁臂4312以及位于仓轴线CA的相对侧上的第二闭锁臂4314。第一闭锁臂4312和第二闭锁臂4314附接到中心主体部分4316。参见图7。弹簧4310支撑在第一钳口或框架4010中，并且通过销4034附连到轴安装凸缘4030，该销延伸穿过轴安装凸缘4030中的孔4036并且穿过第一闭锁臂4312和第二闭锁臂4314中的孔4318。第一闭锁臂4312和第二闭锁臂4314各自还包括闭锁窗口或开口4320。闭锁窗口4320各自适于在击发构件4050处于其最近侧或起始位置时在其中接纳从击发构件4050的相邻第一横向侧或第二横向侧突出的对应中心销4058。参见图8和图9。
图8-图10示出了处于锁定位置的第一闭锁件4300，其中中心销4058被接纳在第一闭锁臂4312和第二闭锁臂4314中的闭锁窗口4320内。在一些布置结构中，与外科缝合装置4002兼容的那些钉仓，或换句话讲，具有适当数量、尺寸和布置结构的钉那些钉仓可具有直接形成在仓体上和/或仓盘上的一个或多个解锁或“验证”键，该一个或多个解锁或“验证”键被构造成能够在兼容钉仓可操作地安置在第一钳口或框架中时使第一闭锁件失效。下文以及以引用的方式并入本文中的各种公开内容中公开了具有从其突出的解锁键的各种钉仓。然而，在某些情况下，临床医生可能希望使用与外科缝合装置兼容但原本没有解锁键的钉仓。在此类情况下，临床医生将无法在外科缝合装置中以其他方式使用那些兼容的钉仓。外科缝合装置4002包括被设计成便于使用原本没有解锁键特征部的此类兼容钉仓的特征部。
现在转到图6和图10，缝合组合件4000还包括保持器4400，该保持器被构造成能够可移除地联接到钉仓4200，该钉仓以其他方式与外科缝合装置4002兼容。在例示的布置结构中，保持器4400包括顶部部分4402，该顶部部分与仓体4202的平台表面4204共同延伸并且被构造成能够接纳在该平台表面上。因此，在至少一个构型中，当保持器4400附接到仓体4202时，保持器4400覆盖仓体4202中的所有钉凹坑4208。因此，当保持器4400附接到钉仓4200时，如果钉仓4200在使用之前倒置或上下颠倒，则保持器4400可防止储存在钉凹坑4208内的外科钉掉出。保持器4400还保护平台表面以免在装运和储存期间被污染。
在一种布置结构中，保持器4400可由聚合物材料模制，并且包括多个保持器凸耳4410，该多个保持器凸耳被构造成能够闩锁地接合形成在仓体4202上的向外延伸的平台凸部部分4205。保持器4400还可包括成角度的鼻部部分4420和远侧闩锁插片4422，该远侧闩锁插片被构造成能够闩锁接合仓体4202的远侧鼻部4203。保持器4400可通过以下方式可移除地联接到外科钉仓4200：将远侧闩锁插片4422与远侧鼻部4203的端部接合并且对准保持器4400，使得顶部部分4402的下侧面对仓平台表面4204，并且保持器凸耳4410位于仓体4202的每一侧上的平台凸部部分4205上方。此后，保持器4400可被压向钉仓4200，从而使保持器凸耳4410横向向外挠曲并且卡扣成与对应平台凸部部分4205闩锁接合。本文公开的其他保持器闩锁布置结构也可用于将保持器4400可移除地附连到钉仓4200。保持器4400可通过以下方式从钉仓4200移除：对远侧闩锁插片4422施加撬动运动直到保持器凸耳4410与平台凸部部分4205脱离接合。在例示的示例中，术语“LIFT”被模制、压印、盖印或以其他方式设置在鼻部部分4420上以向用户提供移除指令。
现在参见图10-图13，保持器4400还包括验证键4430，该验证键被构造成能够在保持器4400附接到钉仓4200以形成仓组件4500并且仓组件4500已经可操作地安置在第一钳口或框架4010中时使第一闭锁件4300失效、停用或解除闩锁。如图11中可见，验证键4430从保持器4400的顶部部分4402的近侧端部4401朝近侧突出，并且包括被空间4460分开的右斜坡特征部4440和左斜坡特征部4450，该空间的尺寸被设定成在其间接纳击发构件主体4052。在例示的示例中，右斜坡特征部4440从保持器4400的顶部部分4402向下成角度，并且包括近侧右末端4442。近侧右末端4442限定第一右凸轮表面4444，该第一右凸轮表面在末端处向内成角度并且朝远侧延伸到第二右凸轮表面4446。第二右凸轮表面4446从第一右凸轮表面4444延伸到顶部部分4402。参见图12。类似地，左斜坡特征部4450从保持器4400的顶部部分4402向下成角度，并且包括近侧左末端4452。近侧左末端4452在末端处向内成角度并且朝远侧延伸到第二左凸轮表面4456。第二左凸轮表面4456从第一左凸轮表面4454延伸到顶部部分4402。保持器4400另外包括保持器龙骨4470，该保持器龙骨从顶部部分4402的底表面突出并且被取向成接纳在外科钉仓4200中的纵向狭槽4206内。保持器龙骨4470可用于将保持器4400正确地取向在钉仓4200上，使得右斜坡特征部4440和左斜坡特征部4450在击发构件4050的每一侧上延伸。另外，保持器龙骨4470可被构造成能够接合钉仓4200中的滑动件4230，并且在保持器4400附接到钉仓4200时将滑动件4230保持在未击发位置。保持器龙骨4470可相对于纵向狭槽4206设定尺寸，以与其建立摩擦配合，以将保持器4400保持在钉仓4200上。
现在参见图10、图14和图15，在保持器4400已经附接到钉仓4200以形成仓组件4500之后，仓组件4500可被纵向插入第一钳口或框架4010中，以便使验证键4430的右斜坡特征部4440的右末端4442与第一闭锁臂4312上的直立解锁插片4322接触，并且使左斜坡4450的左末端4452与第一闭锁弹簧4310的第二闭锁臂4314上的直立解锁插片4324接触。在组装好的仓布置结构4500在近侧方向上初始纵向插入框架4010中期间，第一右凸轮表面4444将第一闭锁弹簧4310的第一闭锁臂4312横向向外偏压(图14中的箭头RL)，并且第一左凸轮表面4454将第二闭锁臂4314横向向外偏压(箭头LL)。仓组件4500进一步近侧推进到第一钳口或框架4010中导致第一闭锁臂4312达到第一中间位置，其中第一闭锁臂4312与击发构件4050上的对应中心销4058脱离接合，并且还导致第二闭锁臂4314达到第二中间位置，其中第二闭锁臂4314与击发构件4050上的对应中心销4058脱离接合。组装好的仓布置结构4500在近侧方向上继续纵向插入第一钳口或框架4010中导致第二右凸轮表面4446将第一闭锁臂4312进一步横向向外偏压，并且第二左凸轮表面4456将第二闭锁臂4314进一步横向向外偏压，直到仓组件4500完全可操作地安置在第一钳口或框架4010中。参见图15。当仓组件4500已经可操作地安置在第一钳口或框架4010中时，第一闭锁臂4312上的远侧第一保持插片4326接合钉仓4200的对应侧以将第一闭锁臂4312保持在该解锁位置。同样，形成在第二闭锁臂4314上的远侧第二保持插片4328接合钉仓4200的另一对应侧以将第二闭锁臂4314保持在该解锁位置。当处于该位置时，第一闭锁件4300处于解锁位置，或者换句话讲，是“失效的”。在解锁过程期间，右斜坡4440和左斜坡4450可在由第一弹簧4310产生的锁定力较高的应用中由击发构件4050增强。然后，用户可通过以下方式从钉仓4200移除保持器4400：沿远侧闩锁插片4422向上撬动，并向上提升保持器4400，直到保持器凸耳4410与仓体4202上的平台凸部部分4205脱离接合。在第一闭锁件4300失效或解锁的情况下，击发构件4050可以从起始位置朝远侧推进并且处于“就绪状态”。在钉仓4200已被击发之后，击发构件4050回缩回到起始位置，并且第二钳口或砧座4100枢转回到打开位置。然后可以从第一钳口或框架4010移除用尽的钉仓。一旦已经将用尽的钉仓4200从第一钳口或框架4010移除，第一闭锁臂4312和第二闭锁臂4314便弹回与击发构件4050上的对应中心销4058接合，以再次将击发构件4050保持在起始位置。
设想到了其他第一闭锁弹簧布置结构。例如，第一闭锁弹簧可仅包括一个横向闭锁臂并且接合击发构件的仅一侧。在此类布置结构中，可能需要包括仅一个斜坡的验证键来解锁闭锁臂。
如上所讨论的，当仓组件4500可操作地安置在框架4010中时，第一闭锁件4300失效或解锁，以允许击发构件4050在钉击发行程期间从就绪状态朝远侧推进。当附接到钉仓4200时，保持器4400覆盖仓平台表面4204并且防止钉从钉凹坑4208掉出，以及防止任何碎屑或污染物进入纵向狭槽4206或钉凹坑4208，这可能损坏钉仓或防止其正确操作。设想到了保持器4400的其他变型，其中仓平台表面4204的仅一部分被保持器覆盖。其他构型可以不覆盖钉凹坑中的任一者和/或平台表面中的任一者。
同样上文所讨论的，在钉仓已被击发或至少部分地击发之后，如果需要，将钉仓从第一钳口或框架移除，然后用另一个兼容钉仓替换。此时，缝合装置可重新用于继续缝合和切入患者组织。然而，在一些情况下，先前击发的钉仓可被意外地装载到框架中。如果击发构件将在此类先前击发的钉仓(有时在本文中称为“用尽的”仓)内朝远侧推进，则缝合器械将切割患者组织而不缝合患者组织。即使保持器4400被无意中意外地附接到用尽的仓，并且所得仓组件随后安置到框架中以便使第一闭锁件失效，也可以想到这可能发生。如果击发构件朝远侧推进通过钉击发行程而根本没有钉仓定位在仓钳口中，则外科缝合装置将类似地切割患者组织而不缝合患者组织。为了防止这些情况发生，外科缝合装置4002还包括第二闭锁件4600，该第二闭锁件被构造成能够在用尽的钉仓安置在第一钳口或框架4010中时防止击发构件4050朝远侧推进通过钉击发行程。
现在参见图6和图16-图19，可包括实心或层压结构的刀杆4042包括弹簧插片4044，该弹簧插片被构造成能够与弹簧板4070可操作地交接，该弹簧板安装或着陆在第一钳口或框架4010的底部中。弹簧板4070设置有孔4072，该孔被构造成能够在击发构件4050处于其最近侧的“起始”位置时在其中接纳弹簧插片4044。当处于该位置时，弹簧插片4044延伸到孔4072中，并且可用于防止击发构件4050的任何无意的向远侧运动，直到操作者需要为止。在例示的示例中，第二闭锁件4600还包括形成在框架4010的底部中的阻挡特征部或凸部4602。如果用户尝试在仓已经可操作地安置到框架4010中之前朝远侧推进击发构件4050，则弹簧插片4044与弹簧板4070协作将导致击发构件4050向下冲，从而使击发构件4050上的中心销4058与框架中的阻挡特征部4602接触，并且由此防止击发构件4050朝远侧推进。
图16和图17示出了当用尽的钉仓4200S已安置到框架4010中时第二闭锁件4600的操作。如该上下文中所用，术语“用尽的”钉仓可以指先前已经完全击发或部分击发的钉仓。在任一种情况下，滑动件4230将从其最近侧的未击发位置朝远侧推进。图16描绘了处于最近侧的起始位置的击发构件4050，其中用尽的钉仓4200S安置在框架4010中。图17示出了防止击发构件4050朝远侧推进到用尽的仓4200S中的第二闭锁件4600。如图17中可见，弹簧插片4044与弹簧板4070协作导致击发构件4050向下冲，从而使击发构件4050上的中心销4058与框架中的阻挡特征部4602接触，由此防止击发构件4050朝远侧推进。
图18和图19示出了当未击发的钉仓4200已安置到第一钳口或框架4010中时第二闭锁件4600的操作。如图18和图19中可见，滑动件4230处于其最近侧的未击发位置。滑动件4230包括解锁凸部4234，该解锁凸部被构造成能够由形成在击发构件主体4052上的解锁特征部4055接合。图18示出处于最近侧的起始位置的击发构件4050，其中未击发的钉仓4200安置在第一钳口或框架4010中。当击发构件4050朝远侧推进时，击发构件4050上的解锁特征部4055接合滑动件4230上的解锁凸部4234，这导致击发构件4050被向上提升，使得击发构件4050上的中心销4058清除第一钳口或框架4010中的阻挡特征部4060。击发构件4050现在自由地继续其远侧推进到钉仓4200中以完成钉击发行程。当击发构件4050朝远侧推进时，支脚4054可接合第一钳口或框架4010的底部上的对应表面，并且顶部销4056可接合外科缝合装置4002的砧座4100上的凸轮表面，该凸轮表面协作以使砧座4100和钉仓4200相对于彼此定位。即便如此，设想了不具有支脚4054和顶部销4056中的一者或两者的实施方案。
从前述内容可以理解，第一闭锁件5300位于第二闭锁件4600的近侧。第一闭锁件5300定位在外科缝合装置4002内，使得第一闭锁件5300位于未击发的钉仓4200的滑动件4230的近侧，该钉仓已安置在第一钳口或框架4010中。第一闭锁件5300被构造成能够在接合位置和脱离接合位置之间横向运动，在该接合位置中第一闭锁件防止击发构件4050从起始位置朝远侧推进，在该脱离接合位置中击发构件4050可从其朝远侧推进(有时在本文中称为“就绪状态”)。例如，第一闭锁臂4312和第二闭锁臂4314被构造成能够在接合位置与脱离接合位置之间在第一水平平面FP中运动。参见图8。关于第二闭锁件4600，击发构件4050沿着第二平面SP在解锁位置与锁定位置之间在竖直方向上运动。参见图9。在例示的示例中，第二平面SP与第一平面FP正交。当击发构件4050处于就绪状态时，如果向其施加击发运动，则击发构件4050可朝远侧运动。然而，除非其中具有位于未击发位置的滑动件的兼容钉仓安置在框架中以解锁第二闭锁件，否则将防止击发构件朝远侧推进通过钉击发行程。
图20-图23示出了另一个外科缝合组件5000，其在许多方面类似于上文讨论的外科缝合组件4000。外科缝合组件5000包括外科缝合装置5002，该外科缝合装置可与上文描述的外科器械1010结合或与各种其他外科器械结合使用，这些其他外科器械在以引用方式并入本文的各种公开内容中描述。如图20中可见，外科缝合装置5002包括被构造成能够在其中可操作地支撑兼容钉仓4200的第一钳口或框架5010。第一钳口或框架5010可以以本文中描述和/或以引用方式并入本文的各种公开内容中描述的各种方式附接到外科器械或机器人的轴组件的脊。在例示的示例中，第一钳口或框架5010通过由销5032销连接或以其他方式附接到第一钳口5010的近侧端部5014的轴安装凸缘5030附接到轴组件的脊(图20中未示出)。具体地，销5032被构造成能够穿过第一钳口或框架5010的直立侧壁5020中的对准孔5021以及穿过轴安装凸缘5030中的孔5031。轴安装凸缘5030被构造成能够与关节运动接头布置结构(未示出)交接，该关节运动接头布置结构被构造成能够以各种已知构型促进第一钳口5010相对于轴组件的关节运动。外科缝合装置5002也可与不促进外科缝合装置5002的关节运动的轴组件结合使用。
仍然参见图20，外科缝合装置5002还包括击发构件组件5040，该击发构件组件包括附接到刀构件或击发构件5050的刀杆5042。刀杆5042还与外科器械或机器人中的对应部件和击发系统交接，以接收击发运动，该击发运动可将刀杆5042和击发构件5050通过钉击发行程从起始位置朝远侧推进到结束位置，并且还将刀杆5042和击发构件5050朝近侧回缩到起始位置。在例示的布置结构中，击发构件5050包括支撑切割刃或刀刃5053的击发构件主体5052。击发构件5050还包括支脚5054，该支脚形成在击发构件主体5052的底部上并且从该击发构件主体的每一侧横向延伸。击发构件5050还包括从击发构件主体5052横向延伸的一对顶部销或插片5056，该对顶部销或插片适于接合第二钳口或砧座上的凸部，如本文将进一步讨论的。另外，击发构件5050包括从击发构件主体5052的每一侧横向突出的一对中心销或插片5058。在以引用方式并入本文的公开内容中的一些公开内容中，击发构件5050也可称为“电子束”击发构件或切割构件。
除上述以外，外科缝合装置5002还包括可相对于第一钳口或框架5010运动的第二钳口或砧座5100。砧座5100包括砧座主体部分5102和砧座安装部分5110。砧座主体5102包括钉成形下表面或组织接触表面5104，其具有形成于其中的一系列钉成形凹坑(未示出)，这些钉成形凹坑被布置成当它们被驱动成与对应钉成形接触时形成对应钉。砧座安装部分5110包括一对横向延伸的砧座销或耳轴销5112，其被构造成能够接纳在设置于第一钳口或框架5010的直立侧壁5020中的对应耳轴孔5022中。与上述砧座4100不同，砧座5100枢转地销连接到框架5010，以围绕固定枢转轴线相对于该框架枢转行进。换句话讲，与砧座4100不同，砧座5100在砧座闭合过程期间实质上不会轴向运动或平移。在各种布置结构中，耳轴孔5022可相对于耳轴销5112设定尺寸以便于耳轴销安装在其中并且自由枢转行进，使得耳轴销可在其中具有一些略微的轴向运动，但是此类轴向运动中的任何轴向运动都远小于砧座4100的轴向平移。
如上文以及在以引用方式并入本文的公开内容中的若干公开内容中所讨论的，砧座5100可通过可轴向运动的闭合构件或端部执行器闭合管(未示出)从打开位置运动到闭合位置，在该打开位置中用过的或用尽的钉仓可从第一钳口或框架5010移除，或者未击发的钉仓可以可操作地安置在其中。例如，当闭合构件从近侧位置朝远侧运动时，闭合管可以可操作地接合砧座安装部分5110上的凸轮表面。闭合构件与砧座安装部分5110之间的这样的相互作用使砧座安装部分5110和砧座耳轴销5112枢转，直到闭合构件使砧座5100运动到完全闭合位置。当处于完全闭合位置时，砧座5100中的钉成形凹坑与已经可操作地安置在第一钳口或框架5010中的对应兼容外科钉仓中的钉正确地对准。当可轴向运动的闭合构件之后在近侧方向上运动时，闭合构件使砧座5100枢转回到打开位置。
除上述以外，外科缝合装置5002包括第一闭锁件5300，该第一闭锁件被构造成能够在经授权或兼容的钉仓并未可操作地安置在框架5010中时防止击发构件5050从其最近侧起始位置朝远侧运动。第一闭锁件5300在本文中也可称为“验证”闭锁件。在例示的布置结构中，第一闭锁件5300包括单个枢转第一弹簧组合件5310，其支撑在第一钳口或框架5010的近侧端部5014中并且附接到轴安装凸缘5030。在一种布置结构中，例如，第一弹簧组件5310包括附接到中心主体部分5316的第一闭锁臂5312和第二闭锁臂5314。第一弹簧组件5310通过销5034附接到轴安装凸缘5030，该销延伸穿过轴安装凸缘5030中的孔5036并且穿过第一闭锁臂5312和第二闭锁臂5314中的孔5318。第一闭锁臂5312和第二闭锁臂5314各自还包括闭锁闩锁特征部5320。每个闭锁闩锁特征部5320适于在击发构件5050处于其最近侧或起始位置时在其中可释放地捕获击发构件5050上的对应中心销5058。参见图21。另外，第一闭锁弹簧组件5310还包括一个或多个枢转弹簧5330，其用于使第一弹簧组件5310围绕销5034向下偏压或枢转，以使闩锁特征部5320与对应中心销5058闩锁或锁定接合。
外科缝合组件5000还可包括与上述保持器4400类似的保持器5400。保持器5400包括顶部部分5402，该顶部部分与钉仓4200的平台表面4204共同延伸并且被构造成能够接纳在该平台表面上，使得当保持器5400附接到仓体4202时，保持器5400覆盖仓体4202中的所有钉凹坑4208。因此，当保持器5400附接到钉仓4200时，如果外科钉仓4200在使用之前倒置或上下颠倒，则保持器5400可防止储存在钉凹坑4208内的外科钉掉出。设想到其他保持器构型，其中保持器顶部不覆盖所有钉凹坑或钉凹坑中的任一者。在例示的布置结构中，保持器5400可由聚合物材料模制，并且包括多个保持器凸耳5410，该多个保持器凸耳被构造成能够闩锁地接合钉仓体4202上的向外延伸的平台凸部部分4205。保持器5400还可包括成角度的鼻部部分5420和远侧闩锁插片5422，该远侧闩锁插片被构造成能够闩锁地接合仓体4202的远侧鼻部4203。保持器5400可通过以下方式可移除地联接到钉仓4200：将远侧闩锁插片5422与钉仓远侧鼻部4203的端部接合并且对准保持器5400，使得顶部部分5402的下侧面对仓平台表面4204，并且保持器凸耳5410位于钉仓体4202的每一侧上的平台凸部部分4205上方。此后，保持器5400可被压向钉仓4200，从而使保持器凸耳5410横向向外挠曲并且卡扣成与对应平台凸部部分4205闩锁接合。本文公开的其他保持器闩锁布置结构也可用于将保持器5400可移除地附连到钉仓4200。
保持器5400还包括验证键5430，该验证键适于接合形成在第一闭锁臂5312和第二闭锁臂5314中的键凹坑5322。如图20中可见，验证键5430从保持器5400的顶部部分5402的近侧端部5401朝近侧突出，并且包括被空间分开的右斜坡特征部5440和左斜坡特征部5450，该空间的尺寸被设定成在其间接纳击发构件主体5052。在例示的示例中，斜坡5440和5450从保持器5400的顶部部分5402向下成角度，并且被构造成能够进入第一闭锁臂5312和第二闭锁臂5314中的键凹坑5322。
在使用中，保持器5400可移除地附接到钉仓4200以形成仓组件5500。此后，仓组件最初插入第一钳口或框架5010中，以便将验证键5430的斜坡5440和5450插入第一闭锁臂5312和第二闭锁臂5314中的键凹坑5322中。参见图21。仓组件5500在近侧方向上进一步纵向推进到第一钳口或框架5010中导致斜坡5440和5450将第一弹簧5310向上枢转到脱离接合或解锁位置中，其中闩锁特征部5320已与对应中心销5058脱离接合。参见图22。当仓组件5500已经可操作地安置在第一钳口或框架5010中时，形成在第一闭锁臂5312和第二闭锁臂5314中的每一者上的面朝远侧的棘爪5326保持接合钉仓4200的近侧端部，如图22所示。此类布置结构用于将第一弹簧5310保持在脱离接合位置。当处于该位置时，第一闭锁件5300处于解锁位置，或者换句话讲，是“失效的”、解锁或解除闩锁的。然后，用户可通过以下方式从钉仓4200移除保持器5400：沿远侧闩锁插片5422向上撬动，并向上提升保持器5400，直到保持器凸耳5410与平台凸部部分4205脱离接合。在例示的示例中，术语“LIFT”被模制、压印、盖印或以其他方式设置在鼻部部分5420上以向用户提供移除指令。保持在框架5010中的外科钉仓5200准备击发。参见图23。
外科缝合装置5002还包括与上述第二闭锁件4600非常类似的第二闭锁件5600。现在参见图20和图21，可包括实心或层压结构的刀杆5042包括弹簧插片5044，该弹簧插片被构造成能够与弹簧板5070可操作地交接，该弹簧板安装在第一钳口5010的底部中。弹簧板5070用于使击发构件5050向下枢转，使得其上的中心销5038接触框架5010的底部中的框架阻挡或邻接特征部(未示出)，除未击发构件5050上的解锁特征部5055接合滑动件4230上的解锁凸部4234，从而导致击发构件5050被向上提升，使得击发构件5050上的中心销5058清除框架5010中的阻挡特征部，如上文所讨论的。
图24-图26示出了替代兼容外科钉仓4200’，其被构造成能够以上述方式致动第一闭锁件5300。然而，在这种布置结构中，验证键5030’形成在仓盘4220’上。如图24中可见，验证键5030’包括弯曲到仓盘4220’中以从其朝近侧突出右斜坡特征部5440’和向左斜坡特征部5450’。加强肋5441’可被压印到其中形成斜坡5440’和5450’的每个接头中，以向斜坡5440’、5450’中的每一者提供附加支撑和刚性。在例示的示例中，斜坡5440’具有成角度的近侧末端5442’，并且斜坡5450’包含成角度的近侧末端5452。末端5442’、5452’各自被构造成能够进入第一闭锁臂5312和第二闭锁臂5314中的键凹坑5322，以使第一闭锁件5300以上述方式枢转。第一闭锁件5300另外以上述方式操作。
参见图27，示出了外科缝合组件6000的示例。外科缝合组件6000包括外科缝合装置6002，该外科缝合装置可与上文描述的外科器械1010结合或与各种其他外科器械或机器人结合使用，这些其他外科器械或机器人在以引用方式并入本文的各种公开内容中描述。如图27中可见，外科缝合装置6002包括被构造成能够在其中可操作地支撑钉仓4200的第一钳口或框架6010。第一钳口或框架6010通过轴安装凸缘4030(图6)以本文所述的各种方式附接到轴组件的脊(未示出)。外科缝合装置6002还包括击发构件组件，该击发构件组件包括附接到刀构件或“击发构件”4050的刀杆，如上所述。
除上述以外，外科缝合装置6002包括可相对于第一钳口或框架6010运动的第二钳口或砧座6100。砧座6100类似于上述砧座4100，并且包括砧座主体6102和砧座安装部分6110。砧座主体6102包括钉成形下表面或组织接触表面6104，其具有形成于其中的一系列钉成形凹坑(未示出)，这些钉成形凹坑被布置成当它们被驱动成与对应钉成形接触时形成对应钉。砧座安装部分6110包括一对横向延伸的砧座销或耳轴组件6112。每个耳轴组件6112包括向外和向下突出的锁定凸耳部分6120，该锁定凸耳部分具有从其延伸的耳轴销6122。每个耳轴销6122被构造成能够接纳在第一钳口6010的直立侧壁6020中的对应耳轴狭槽6022中。在例示的布置结构中，耳轴狭槽6022稍微呈“肾形”并且促进对应耳轴销6122在其中的枢转以及轴向行进。
如上文以及在以引用方式并入本文的公开内容中的若干公开内容中所讨论的，砧座6100可通过可轴向运动的闭合构件或端部执行器闭合管(未示出)从打开位置运动到闭合位置，在该打开位置中用过的或用尽的外科钉仓可从框架6010移除，或者新近的、新的钉仓可以可操作地安置在其中。例如，当闭合构件从近侧位置朝远侧运动时，闭合构件可以可操作地接合砧座安装部分6110上的凸轮表面。闭合构件与砧座安装部分6110之间的这样的相互作用使砧座安装部分6110和砧座耳轴销6122枢转并沿耳轴狭槽6022向上平移，直到闭合构件使砧座6100运动到闭合位置。当处于完全闭合位置时，砧座6100中的钉成形凹坑与已经可操作地安置在框架6010中的对应兼容钉仓中的钉正确地对准。当可轴向运动的闭合构件之后在近侧方向上运动时，闭合构件与砧座安装部分6110上的直立插片6114交接，以将砧座6100返回到打开位置。
除上述以外，外科缝合装置6002包括第一闭锁件6300，该第一闭锁件被构造成能够防止第二钳口或砧座6100通过闭合构件从打开位置运动到闭合位置。第一闭锁件6300在本文中也可称为“验证”闭锁件。在例示的布置结构中，第一闭锁件6300包括第一闭锁臂6310，该第一闭锁臂通过附接到其的闭锁销6312枢转地支撑在框架6010中。在一个示例中，第一闭锁臂6310由不锈钢等制造，并且闭锁销6312被焊接或以其他方式附接到其上。闭锁销6312枢转地安置在框架6010中的枢轴孔6013中，以促进第一闭锁臂6310在锁定位置与解锁位置之间的枢转行进。参见图28。在例示的示例中，闭锁特征部6316形成在第一闭锁臂6310的近侧端部6314上，并且被构造成能够在第一闭锁臂6310处于接合位置时阻挡地接合对应耳轴组件6112上的锁定凸耳部分6120。当闭锁特征部6316阻挡地接合耳轴组件6112上的锁定凸耳部分6120时，闭锁特征部6316防止耳轴组件6112在第一钳口或框架6010中的对应耳轴狭槽6022内行进，这有效地防止第二钳口或砧座6100在闭合运动被施加到其的情况下从打开位置运动到闭合位置。第一闭锁臂6310的该位置在本文中可以称为“钳口锁定位置”。应当理解，闭锁特征部6316以及锁定凸耳部分6120可以足够坚固，以便抵抗施加到砧座6100的大量闭合运动，以防止砧座6100的闭合。
仍然参见图28，第一闭锁弹簧6330支撑在第一钳口或框架6010的对应侧壁6020中，以将第一闭锁臂6310在锁定方向LD上偏压到接合、锁定或“钳口锁定”位置，其中第一闭锁臂6310防止砧座6100从打开位置运动到闭合位置。行进限制板或安装板6070支撑在框架6010内并且附接到轴安装组件。当处于钳口锁定位置时，行进限制板6070还向第一闭锁臂6310提供横向支撑。参见图29。如图28和图29中可见，第一闭锁臂6310还包括形成在第一闭锁臂6310的远侧端部6320上的直立致动器凸轮臂6322。致动器凸轮臂6322包括致动器凸轮表面6324。第一闭锁臂6310还包括保持插片6326，该保持插片被构造成能够接纳在设置在框架侧壁6020中的对应开口或插片窗口6024内。
现在转到图27，缝合组件6000还包括保持器6400，该保持器被构造成能够可移除地联接到外科钉仓4200。在各种实施方案中，除了验证键6430之外，保持器6400基本上类似于上述保持器4400。在例示的布置结构中，保持器6400包括顶部部分6402，该顶部部分与平台表面4204共同延伸并且被构造成能够接纳在该平台表面上，使得当保持器6400附接到仓体4202时，保持器6400覆盖仓体4202中的所有钉凹坑4208。在替代型式中，保持器顶部可以仅覆盖钉凹坑中的一些钉凹坑或根本不覆盖钉凹坑。保持器6400可由聚合物材料模制，并且包括多个保持器凸耳6410，该多个保持器凸耳被构造成能够闩锁地接合形成在钉仓体4202上的向外延伸的平台凸部部分4205。保持器6400还可包括成角度的鼻部部分6420和远侧闩锁插片6422，该远侧闩锁插片被构造成能够闩锁接合钉仓体4202的远侧鼻部4203。保持器6400可通过以下方式可移除地联接到外科钉仓4200：将闩锁插片6422与远侧鼻部4203的端部接合并且对准保持器6400，使得保持器6400的顶部部分6402的下侧面对仓平台表面4204，并且保持器凸耳6410位于仓体4202的每一侧上的平台凸部部分4205上方。此后，保持器6400可被压向钉仓4200，从而使保持器凸耳6410横向向外挠曲并且卡扣成与对应平台凸部部分4205闩锁接合。本文公开的其他保持器闩锁布置结构也可用于将保持器6400可移除地附连到钉仓4200。保持器6400可通过以下方式从钉仓4200移除：对远侧闩锁插片6422施加撬动运动并且向上提升直到保持器凸耳6410与平台凸部部分4205脱离接合。在例示的示例中，术语“LIFT”被模制、压印到鼻部部分6420中以向用户提供移除指令。
现在参见图32-图35，保持器6400还包括验证键6430，该验证键被构造成能够在保持器6400附接到外科钉仓4200并且外科钉仓4200已经可操作地安置在第一钳口或框架6010中时使第一闭锁件6300失效、解锁或解除闩锁。如图32中可见，验证键6430从保持器6400的顶部部分6402的近侧端部6401朝近侧突出，并且包括当保持器6400附接到钉仓4200时定位在仓轴线CA的一侧上的成角度的斜坡特征部6440。在例示的示例中，斜坡6440从保持器6400的顶部部分6402向下成角度，并且包括近侧末端6442，该近侧末端限定在末端处向内成角度的第一或近侧凸轮表面6444。第二或远侧凸轮表面6446位于第一凸轮表面6444下方。这些双顺序凸轮表面6444、6446被构造成能够与致动器凸轮臂6322上的致动器凸轮表面6324交接，以将第一闭锁臂6310从锁定或钳口锁定位置运动到解锁或钳口闭合位置。当支撑保持器6400的钉仓可操作地安置在第一钳口或框架6010中时，此类布置结构为验证键6430解锁地致动致动器凸轮臂6322提供很少的空间。双凸轮表面布置结构便于将第一闭锁臂6310枢转致动将第一闭锁臂6310放置在脱离接合或钳口闭合位置中所需的足够枢转距离。例如，这种枢转行进量可以是斜坡6440的宽度的两倍以上。
图29示出了处于锁定或钳口锁定位置的第一闭锁件6300，其中第一闭锁臂6310被枢转到其中闭锁特征部6316与砧座6100上的耳轴组件6112上的锁定凸耳部分6120阻挡接合的位置。现在参见图36，在保持器6400已经附接到外科钉仓4200以形成仓组件6500之后，可将仓组件6500插入第一钳口或框架6010中，使得第一凸轮表面6444接合致动器凸轮臂6322上的致动器凸轮表面6324，并且开始将第一闭锁臂6310枢转离开锁定或钳口锁定位置到中间位置。组装好的仓布置结构6500在近侧方向上继续纵向插入框架6010中导致第一凸轮表面6444与致动器凸轮表面6324脱离接合，并且下部第二凸轮表面6446接合致动器凸轮表面6324以将第一闭锁臂6310从中间位置运动到钳口闭合位置。参见图37。当第一闭锁臂6310处于锁定或钳口锁定位置时，致动器凸轮臂6322位于击发构件6050的远侧。下部第二凸轮表面6446完成第一闭锁臂6310的枢转行进，使得致动器凸轮臂6322不干扰击发构件6050的操作，同时允许砧座6100运动到闭合位置。当第一闭锁臂6310处于解锁或钳口闭合位置时，保持插片6326被接纳在框架侧壁6020中的插片窗口6024内并且由钉仓4200保持在其中。当处于该位置时，第一闭锁件6300处于钳口闭合位置，或者换句话讲，是“失效的”、解锁或解除闩锁的。然后，用户可通过以下方式从外科钉仓4200移除保持器6400：沿远侧闩锁插片6422向上撬动，并向上提升保持器6400，直到保持器凸耳6410与平台凸部部分4205脱离接合。
如从前述内容可以理解的，与第一闭锁件6300交接所需的空间在砧座6100打开时是可用的，但在砧座6100闭合时是不可用的。只有当砧座6100在仓插入过程期间打开时，保持器6400才存在于仓4200上。此后，将保持器6400从钉仓4200移除。当保持器6400处于适当位置时，砧座6100不能闭合。当闭合时，砧座6100占据由保持器6400占据的空间。这种布置结构非常不同于在装置的闭合和击发期间保持驻留在缝合装置中的基于仓的验证键布置结构。在这种布置结构中采用双连续斜坡/凸轮作用表面，以使第一闭锁臂6310横向运动通过一定距离，该距离是验证键6430的宽度的大约至少两倍。这可能是该设计的重要方面。
近侧高斜坡或凸轮作用表面开始解锁运动并且接合在击发构件4050远侧的直立致动器凸轮臂6322。应当理解，无法运动或移除的固定锁定特征部将不能到达该区域而不影响使击发构件4050运动通过钉击发行程的能力。第二下斜坡/凸轮作用表面完成第一解锁臂6310的解锁运动，使得砧座6100完全畅通以闭合。第二斜坡/凸轮作用表面在第一斜坡/凸轮作用表面后面顺序地间隔开，使得在第一斜坡/凸轮作用表面已经将第一闭锁臂6310枢转到该中间位置之后，第二斜坡/凸轮作用表面只能接合该第一闭锁臂的远侧端部。
图38示出了可操作地安置在框架6010中的钉仓4200，其中第一闭锁件6300失效并且保持器6400从钉仓4200移除。砧座6100现在可在打开位置与闭合位置之间运动，并且外科钉仓4200以其他方式能够被击发。在至少一种形式中，外科缝合装置6002还可包括第二闭锁件4600，该第二闭锁件被构造成能够在用尽的钉仓以上文所讨论的各种方式安置在第一钳口或框架6010中时防止击发构件4050朝远侧推进通过钉击发行程。在钉仓4200已被击发之后，击发构件4050回缩回到起始位置，并且第二钳口或砧座6100枢转回到打开位置。然后可以从第一钳口或框架6010移除用尽的钉仓。一旦已经从第一钳口或框架6010移除了用尽的钉仓4200，第一闭锁弹簧就将第一闭锁臂6310偏压回到钳口锁定位置，其中防止第二钳口或砧座6100从打开位置运动到闭合位置。
图38A是仓组件6500’安置在其中的外科缝合装置6002的另一顶视图，该仓组件包括附接到钉仓4200的保持器6400’。保持器6400’类似于上述保持器6400，不同之处在于验证键6430’和斜坡6440’被结合到保持器6400’的侧壁6403’中。保持器6400’可另外以与上文讨论的保持器6400相同的方式操作。
图39是与上述钉仓4200相同的钉仓4200”的近侧端部的透视图，不同之处在于验证键4228”被折叠到仓盘4220”中，该仓盘附接到仓体4202”，如图所示。如图40-图42所示，钉仓4200”被构造成能够与外科缝合组件6000’结合使用，该外科缝合组件包括外科缝合装置6002’，该外科缝合装置包括第一闭锁件6300’。除了通过附接到其的闭锁销6312’枢转地支撑在框架6010’中的第一闭锁臂6310’的远侧端部6311’之外，外科缝合装置6002’与外科缝合装置6002基本上相同。第一闭锁臂6310’的近侧端部6314’与第一闭锁臂6310的近侧端部6314相同，并且被构造成能够以上文详细描述的方式阻挡地接合砧座6100’的对应耳轴组件6112’上的锁定凸耳部分。闭锁弹簧6330’用于以上述方式将第一闭锁臂6310’枢转到锁定位置。图40示出了将钉仓4200”插入框架6010’中。如图40中可见，第一闭锁臂6310’处于锁定或钳口锁定位置，其中近侧端部6314’(图41)与耳轴组件6112’上的锁定凸耳阻挡接合以防止砧座6100’的闭合。图41和图42示出了完全安置在框架6010’中的钉仓4200”。如图41和图42中可见，验证键4228”已经将第一闭锁臂6310’枢转到钳口闭合位置中，并且将第一闭锁臂6310’保持在该位置。当处于钳口闭合位置时，砧座6100自由枢转闭合，如图41所示。在这种布置结构中，验证键4228”包括钉仓的一部分并且不安装到可移除保持器。验证键4228”将第一闭锁臂6310’保持在钳口闭合位置，而钉仓在整个缝合程序中保持安置在框架6010’中。
在钉仓4200’已被击发之后，用户将外科缝合装置6002’的击发构件返回到起始位置，并且砧座6100’枢转到打开位置，从而允许用尽的钉仓从框架6010’移除。当从框架6010’移除用尽的钉仓4200’时，闭锁弹簧6330’使第一闭锁臂6310’枢转回到钳口锁定位置。在一些情况下，用尽的钉仓可被“再处理”以用于在另一缝合程序和/或另一缝合装置中重复使用。对于那些再处理实体重要的是将适当的外科钉以及适当数量的外科钉安装到所需的再处理钉仓中，以使该仓与特定缝合装置兼容以确保在使用期间的期望结果。不幸的是，一些再处理实体有时不能正确地再处理用尽的仓，但仍然将经再处理的用尽的仓作为由原始制造商制造的新仓提供。最终用户可能无意地获得有缺陷的仓并将其用于外科缝合装置中。为了防止此类情况发生，一旦已经从外科缝合装置6002’移除了用尽的仓，就可将验证键4228”不可恢复地压扁。例如，如图39中可见，验证键4228”形成有一对凸耳4229”，该对凸耳可滑动地接纳在设置在仓盘4220”中的狭槽4223”中。通过向验证键4228”的末端施加压扁力FF，键可以抵靠仓盘4220”的近侧端部4225”被压扁，从而使验证键4228”无法操作以供将来使用。
图43是与上述钉仓4200相同的钉仓4200”’的近侧端部的透视图，不同之处在于验证键4228”’被折叠到仓盘4220”’中，该仓盘附接到仓体4202”’，如图所示。在该实施方案中，验证键4228”’从仓盘4220”’的顶部翼片4225”’突出，该顶部翼片折叠在仓平台4204”’的一部分上方，该部分可用于增强验证键4228”’的强度。验证键4228”’还可包括折叠的加强壁部分4227”’并且具有成角度的致动或凸轮表面4229A”和闩锁表面4229B”’。如图44-图46所示，钉仓4200”’被构造成能够与外科缝合组件6000”结合使用，该外科缝合组件包括外科缝合装置6002”，该外科缝合装置包括第一闭锁件6300”。
在许多方面，外科缝合装置6002”与外科缝合装置6002基本上相同并且包括第一闭锁臂6310”，该第一闭锁臂通过附接到其的闭锁销6312”枢转地支撑在框架6010”中。第一闭锁臂6310”的近侧端部6314”可与第一闭锁臂6310的近侧端部6314相同，并且被构造成能够以上文详细描述的方式阻挡地接合砧座6100”的对应耳轴组件6112”上的锁定凸耳部分。闭锁弹簧6330”用于以上述方式将第一闭锁臂6310”枢转到锁定或钳口锁定位置。第一闭锁臂6310”的远侧端部包括直立致动器凸轮臂6322”，其被构造成能够由钉仓4200”’上的验证键4228”’接合。
图46示出了将钉仓4200”插入框架6010’中。第一闭锁臂6310”处于钳口锁定位置，在该钳口锁定位置，近侧端部6314”与耳轴组件6112’上的锁定凸耳阻挡接合以防止砧座6100”的闭合。在将钉仓4200”’初始插入框架6010”中期间，成角度的致动或凸轮表面4229A”’已接触直立致动器凸轮臂6322”以开始将第一闭锁臂6310”枢转离开钳口锁定位置。钉仓4200”’继续插入框架6010”中导致验证键4228”’将第一闭锁臂6310”枢转到解锁或钳口闭合位置，其中致动器凸轮臂6322”已与成角度的凸轮表面4229A”’脱离接合并且通过验证键4228”’上的闩锁表面4229B”’保持在该解锁或钳口闭合位置。参见图44和图45。当处于解锁或钳口闭合位置时，砧座6100”自由枢转闭合。在这种布置结构中，验证键4228”’包括钉仓的一部分并且不安装到可移除保持器。验证键4228”’将第一闭锁臂6310”保持在钳口闭合位置，而钉仓4200”’在整个缝合程序中保持安置在框架6010”中。
图47是在极大程度上与上述钉仓4200相同的钉仓4700的近侧端部的透视图，不同之处在于验证键4728被折叠到仓盘4720中，该仓盘附接到仓体4702，如图所示。在该实施方案中，验证键4728从仓盘4720的顶部翼片4725突出，该顶部翼片折叠在仓平台4704的一部分上方，该部分可用于增强验证键4728的强度。验证键4728包括成角度的致动或凸轮表面4729A和闩锁表面4729B。验证键4728被折叠以在由仓平台4704限定的平面下方延伸，并且可例如以上述方式与外科缝合装置6002”或具有略微较短的致动器凸轮臂的其他外科缝合装置一起使用。
图48-图51示出了另一个外科缝合组件7000，其在许多方面类似于上文讨论的外科缝合组件6000。外科缝合组件7000包括外科缝合装置7002，该外科缝合装置可与上文描述的外科器械1010结合或与各种其他外科器械或机器人结合使用，这些其他外科器械或机器人在以引用方式并入本文的各种公开内容中描述。如图48中可见，外科缝合装置7002包括被构造成能够在其中可操作地支撑钉仓4200的第一钳口或框架7010。第一钳口或框架7010以本文所述的各种方式附接到轴组件的棘。在例示的示例中，第一钳口或框架7010通过由销7032销连接或以其他方式附接到第一钳口7010的近侧端部7014的轴安装凸缘7030附接到轴组件的脊(图48中未示出)。具体地，销7032被构造成能够穿过第一钳口或框架7010的直立侧壁7020中的对准孔7021以及穿过轴安装凸缘7030中的孔7031。轴安装凸缘7030被构造成能够与关节运动接头布置结构(未示出)交接，该关节运动接头布置结构被构造成能够以各种已知构型促进第一钳口7010相对于轴组件的关节运动。外科缝合装置7002也可与不促进外科缝合装置7002的关节运动的轴组件结合使用。
仍然参见图48，外科缝合装置7002还包括击发构件组件4040，该击发构件组件包括附接到刀构件或击发构件4050的刀杆4042。上文详细讨论了击发构件4050和刀杆4042的操作。除上述以外，外科缝合装置7002还包括可相对于第一钳口或框架7010运动的第二钳口或砧座7100。砧座7100包括砧座主体部分7102和砧座安装部分7110。砧座主体7102包括钉成形下表面或组织接触表面7104，其具有形成于其中的一系列钉成形凹坑(未示出)，这些钉成形凹坑被布置成当它们被驱动成与对应钉成形接触时形成对应钉。砧座安装部分7110包括一对横向延伸的砧座销或耳轴销7112，其被构造成能够接纳在第一钳口或框架7010的直立侧壁7020中的对应耳轴孔7022中。与上述砧座6100不同，砧座7100枢转地销连接到框架7010，以围绕固定枢转轴线相对于该框架枢转行进。换句话讲，与砧座6100不同，砧座7100在砧座闭合过程期间实质上不会轴向运动或平移。
如上文以及在以引用方式并入本文的公开内容中的若干公开内容中所讨论的，砧座7100可通过可轴向运动的闭合构件或端部执行器闭合管7600从打开位置运动到闭合位置，在该打开位置中用过的或用尽的钉仓可从第一钳口或框架7010移除，或者未击发的钉仓可以可操作地安置在其中。例如，当闭合管7600从近侧位置朝远侧运动时，闭合管7600可以可操作地接合砧座安装部分7110上的凸轮表面7113。闭合管7600与砧座安装部分7110之间的这样的相互作用使砧座安装部分7110和耳轴销7112枢转，直到闭合构件使砧座7100运动到完全闭合位置。当处于完全闭合位置时，砧座7100中的钉成形凹坑与已经可操作地安置在第一钳口或框架7010中的对应兼容钉仓4200中的钉正确地对准。当可轴向运动的闭合管7600之后在近侧方向上运动时，闭合管7600上的插片7602与砧座安装部分7110上的插片7114交接，以使砧座7100枢转回到打开位置。
除上述以外，外科缝合装置7002包括第一闭锁件7300，该第一闭锁件被构造成能够防止第二钳口或砧座7100通过闭合构件7600从打开位置运动到闭合位置。第一闭锁件7300在本文中也可称为“验证”闭锁件。在例示的布置结构中，第一闭锁件7300包括第一闭锁臂7310，该第一闭锁臂通过附接到其的闭锁销7312枢转地支撑在第一钳口或框架7010中。在一个示例中，第一闭锁臂7310由不锈钢等制造，并且闭锁销7312可以被机加工到其近侧端部中。闭锁销7312枢转地安置在框架7010中的枢轴孔7013中，以促进第一闭锁臂7310在锁定方向LD上在钳口锁定位置与钳口闭合位置之间的枢转行进。参见图50。在例示的示例中，第一闭锁臂7310被构造成能够在第一闭锁臂7310处于钳口锁定位置时阻挡地接合从砧座安装部分7110向下突出的锁定凸耳部分7120。当第一闭锁臂7310处于该锁定或接合位置时，当锁定凸耳部分7120接触第一闭锁臂7310时，防止砧座7100的枢转行进。应当理解，第一闭锁臂7310以及锁定凸耳部分7120各自足够坚固，以便抵抗施加到砧座7100的大量闭合运动，以防止砧座7100的闭合。
现在参见图50，第一闭锁弹簧7330支撑在第一钳口或框架7010的对应侧壁7020中，以将第一闭锁臂7310在锁定方向LD上偏压到锁定或钳口锁定位置，其中第一闭锁臂7310防止砧座7100从打开位置运动到闭合位置。如图50中可见，第一闭锁臂7310还包括形成在第一闭锁臂7310的远侧端部7320上的直立致动器凸轮臂7322。致动器凸轮臂7322在其上包括致动器凸轮表面7324。第一闭锁臂7310还包括保持插片7326，该保持插片被构造成能够接纳在设置在框架侧壁7020中的对应开口或插片窗口7024内。
再次转到图48，缝合组件7000还包括保持器7400，该保持器被构造成能够可移除地联接到外科钉仓4200。在许多方面，保持器7400基本上类似于上述保持器4400。在例示的布置结构中，保持器7400包括顶部部分7402，该顶部部分与钉仓体4202的平台表面4204共同延伸并且被构造成能够接纳在该平台表面上。当保持器7400附接到仓体4202时，保持器7400覆盖仓体4202中的所有钉凹坑4208。在其他型式中，仅覆盖钉凹坑中的一些钉凹坑或者不覆盖钉凹坑。保持器7400可由聚合物材料模制，并且包括多个保持器凸耳7410，该多个保持器凸耳被构造成能够闩锁地接合向外延伸的平台凸部部分4205。保持器7400还可包括成角度的鼻部部分7420和远侧闩锁插片7422，该远侧闩锁插片被构造成能够闩锁接合仓体4202的远侧鼻部4203。
保持器7400可通过以下方式可移除地联接到外科钉仓4200：将远侧闩锁插片7422与远侧鼻部4203的端部接合并且对准保持器7400，使得顶部部分7402的下侧面对仓平台表面4204，并且保持器凸耳7410位于仓体4202的每一侧上的平台凸部部分4205上方。此后，保持器7400可被压向钉仓4200，从而使保持器凸耳7410横向向外挠曲并且卡扣成与对应平台凸部部分4205闩锁接合。本文公开的其他保持器闩锁布置结构也可用于将保持器7400可移除地附连到钉仓4200。保持器7400可通过以下方式从钉仓4200移除：对远侧闩锁插片7422施加撬动运动并且向上提升直到保持器凸耳7410与平台凸部部分4205脱离接合。在例示的示例中，术语“LIFT”被模制、压印到鼻部部分7420中以向用户提供移除指令。
现在参见图53-图56，保持器7400还包括验证键7430，该验证键被构造成能够在保持器7400附接到外科钉仓4200并且外科钉仓4200已经可操作地安置在第一钳口或框架7010中时使第一闭锁件7300失效。如图53中可见，验证键7430从保持器7400的顶部部分7402的近侧端部7401朝近侧突出，并且包括被空间7460分开的右斜坡特征部7440和左斜坡特征部7450，该空间的尺寸被设定成在其间接纳击发构件主体4052。在例示的示例中，右斜坡7440从保持器7400的顶部部分7402向下成角度，并且包括近侧右末端7442，该近侧末端包括在末端处向内成角度的第一右或近侧右凸轮表面7444。第二右或远侧右凸轮表面7446位于第一右凸轮表面7444下方。这些双顺序凸轮表面7444、7446被构造成能够与致动器凸轮臂7322上的致动器凸轮表面7324交接，以便以上述各种方式将第一闭锁臂7310从钳口锁定位置运动到“钳口闭合位置”。类似地，左斜坡7450从保持器7400的顶部部分7402向下成角度，并且包括近侧左末端7452，该近侧左末端包括在末端处向内成角度的第一左或近侧左凸轮表面7454。第二左或远侧左凸轮表面7456位于第一右凸轮表面7444下方。这些双顺序凸轮表面7454、7456被构造成能够与安装在框架轴线FA的左侧或相对侧上的第一闭锁臂7310的致动器凸轮臂7322上的致动器凸轮表面7324交接。保持器7400另外包括保持器龙骨7470，该保持器龙骨从顶部部分7402的底表面突出并且被取向成接纳在外科钉仓4200中的纵向狭槽4206内。保持器龙骨7470可用于将保持器7400正确地取向在外科钉仓4200上，使得右斜坡7440和左斜坡7450在击发构件4050的每一侧上延伸。保持器龙骨7470也可相对于纵向狭槽4206设定尺寸，以在保持器7400附接到钉仓4200时与其产生摩擦保持接合，并且还将滑动件4230与钉仓4200保持在未击发位置中。
在使用中，保持器7400以本文公开的各种方式附接到钉仓4200以形成仓组件7500。然后可将仓组件7500插入第一钳口或框架7010中，以便使验证键7430的右斜坡7440与致动器凸轮臂7322上的致动器凸轮表面7324接合。在仓组件7500的初始近侧插入期间，第一右凸轮表面7444将致动器凸轮臂7322横向向外偏压到中间位置。仓组件7500在近侧方向上进一步纵向推进到第一钳口或框架7010中导致第一凸轮表面7444与致动器凸轮表面7324脱离接合，并且第二右凸轮表面7446接合致动器凸轮表面7324以将第一闭锁臂7310从中间位置运动到完全脱离接合或钳口闭合位置。当第一闭锁臂7310处于解锁或钳口闭合位置时，保持插片7326被接纳在框架侧壁7020中的插片窗口7024内并且由钉仓4200保持在其中。当处于该位置时，第一闭锁件7300处于解锁或钳口闭合位置，或者换句话讲，是“失效的”、解锁或解除闩锁的。然后，用户可通过以下方式从外科钉仓4200移除保持器7400：沿远侧闩锁插片7422向上撬动，并向上提升保持器7400，直到保持器凸耳7410与平台凸部部分4205脱离接合。砧座7100现在可在打开位置与闭合位置之间运动，并且外科钉仓4200以其他方式能够被击发。在至少一种型式中，外科缝合装置7002可包括第二闭锁件4600，该第二闭锁件被构造成能够在用尽的钉仓以上文所讨论的各种方式安置在第一钳口或框架7010中时防止击发构件4050朝远侧推进通过钉击发行程。在钉仓4200已被击发之后，击发构件4050回缩回到起始位置，并且第二钳口或砧座7100枢转回到打开位置。然后可以从第一钳口或框架7010移除用尽的钉仓。一旦已经从第一钳口或框架7010移除了用尽的钉仓4200，第一闭锁弹簧就将第一闭锁臂7310偏压回到接合或钳口锁定位置，其中防止第二钳口或砧座从打开位置运动到闭合位置。
如图52中可见，外科缝合装置7002采用第一闭锁件7300，当钉仓可操作地安置在框架7010中时，该第一闭锁件定位在框架轴线FA的第一侧7005上的第一钳口或框架7010内，该框架轴线位于与仓轴线CA的共同平面上。图56示出了与外科缝合装置7002相同的第二外科缝合装置7002’，不同之处在于第一闭锁件7300’定位在中心框架轴线FA的第二或相对侧7007上的第一钳口或框架7010’内。在此类情况下，当仓组件7500’安置到外科缝合装置7002’的第一钳口或框架7010’中时，验证键7430的左斜坡7450用于将第一闭锁臂7310’从接合或锁定位置运动到脱离接合或解锁位置。45mm外科缝合装置可在仓轴线的右侧上具有第一闭锁件，而60mm外科缝合器可在仓轴线的左侧上具有第一闭锁件，并且反之亦然。或者，诸如血管缝合器或胸椎钉之类的特定专用缝合装置可在与多用途缝合器不同的一侧上具有闭锁件。
参见图57，示出了外科缝合组件8000的示例。外科缝合组件8000可与上文描述的外科器械1010结合或与各种其他外科器械或机器人结合使用，这些其他外科器械或机器人在以引用方式并入本文的各种公开内容中描述。外科缝合组件8000可以以上述并入的公开内容中公开的各种形式与电控制、电池供电、手动供电和/或机器人控制的外科器械结合使用。如图57中可见，外科缝合组件8000包括通常被标记为8002的外科缝合装置，该外科缝合装置包括被构造成能够在其中可操作地支撑钉仓4200的第一钳口或框架8010。第一钳口8010以本文所述的各种方式附接到外科器械或机器人的轴组件的脊。在例示的示例中，第一钳口8010通过由销进行销连接或以其他方式附接到第一钳口8010的近侧端部8014的轴安装凸缘8030附接到轴组件的脊部分(图57中未示出)。也可以采用将外科装置8002与外科器械的轴附接和可操作地交接的其他方法。例如，缝合装置8002可附接到轴组件，使得缝合装置(有时也称为“端部执行器”)不能相对于轴组件进行关节运动。
仍然参见图57，外科缝合组件8000还包括击发构件组件5040，该击发构件组件包括附接到刀构件5050或“击发构件”的刀杆5042。刀杆5042还与外科器械或机器人中的对应部件和击发系统交接，以接收击发运动，该击发运动可将刀杆5042和击发构件5050通过钉击发行程从起始位置朝远侧推进到结束位置，并且还将刀杆5042和击发构件5050朝近侧回缩以使击发构件5050返回到起始位置。在例示的布置结构中，击发构件5050包括支撑切割刃或刀刃5053的击发构件主体5052。击发构件5050还包括支脚5054，该支脚形成在击发构件主体5052的底部上并且从该击发构件主体的每一侧横向延伸。击发构件5050还包括从击发构件主体5052横向延伸的一对顶部销或插片5056，该对顶部销或插片适于接合砧座上的凸部，如本文将进一步讨论的。另外，击发构件5050包括从击发构件主体5052的每一侧横向突出的一对中心销或插片5058。在以引用方式并入本文的公开内容中的一些公开内容中，击发构件5050也可称为“电子束”击发构件或切割构件。
除上述以外，外科缝合装置8002还包括可相对于第一钳口或框架8010运动的第二钳口或砧座8100。砧座8100包括砧座主体部分8102和砧座安装部分8110。砧座主体8102包括钉成形下表面或组织接触表面8104，其具有形成于其中的一系列钉成形凹坑(未示出)，这些钉成形凹坑被布置成当它们被驱动成与对应钉成形接触时形成对应钉。砧座安装部分8110包括一对横向延伸的砧座销或耳轴销8112，其被构造成能够接纳在第一钳口或框架8010的直立侧壁8020中的对应耳轴孔8022中。与上述砧座4100不同，砧座8100枢转地销连接到框架8010，以围绕固定枢转轴线相对于该框架枢转行进。换句话讲，与砧座4100不同，砧座8100在砧座闭合过程期间实质上不会轴向运动或平移。
如上文以及在以引用方式并入本文的公开内容中的若干公开内容中所讨论的，砧座8100可通过可轴向运动的闭合构件或端部执行器闭合管(未示出)从打开位置运动到闭合位置，在该打开位置中用过的或用尽的钉仓可从第一钳口或框架8010移除，或者未击发的钉仓可以可操作地安置在其中。例如，当闭合构件从近侧位置朝远侧运动时，闭合管可以可操作地接合砧座安装部分8110上的凸轮表面。闭合构件与砧座安装部分8110之间的这样的相互作用使砧座安装部分8110和耳轴销8112枢转，直到闭合构件使砧座8100运动到完全闭合位置。当处于完全闭合位置时，砧座8100中的钉成形凹坑与已经可操作地安置在第一钳口或框架8010中的对应兼容外科钉仓中的钉正确地对准。当可轴向运动的闭合构件之后在近侧方向上运动时，闭合构件使砧座8100枢转回到打开位置。
除上述以外，外科缝合组件8000还包括第一闭锁件8300，该第一闭锁件被构造成能够在经授权或兼容的钉仓并未可操作地安置在第一钳口或框架8010中时防止击发构件5050从其最近侧起始位置朝远侧运动。第一闭锁件8300在本文中也可称为“验证”闭锁件。在例示的布置结构中，第一闭锁件8300包括单个双横向第一弹簧8310，其支撑在框架8010的近侧端部8014中并且附接到轴安装凸缘8030。例如，在一种布置结构中，第一弹簧8310包括位于仓轴线CA的一侧上的第一闭锁臂8312以及位于仓轴线CA的与第一闭锁臂8312相对的一侧上的第二闭锁臂8314。第一闭锁臂8312和第二闭锁臂8314附接到中心主体部分8316。参见图58。弹簧8310安装在第一钳口或框架8010中，并且通过销8034附连到轴安装凸缘8030，该销延伸穿过轴安装凸缘8030中的孔8036并且穿过第一闭锁臂8312和第二闭锁臂8314中的孔8318。第一闭锁臂8312和第二闭锁臂8314各自还在其中包括闭锁窗口或开口8320，该闭锁窗口或开口各自适于在击发构件5050处于其最近侧或起始位置时在其中接纳从击发构件5050的第一侧和第二侧突出的对应中心销5058。参见图59和图61。
图59-图61示出了处于锁定位置的第一闭锁件8300，其中中心销5058被接纳在第一闭锁臂8312和第二闭锁臂8314中的闭锁窗口8320内。在一些布置结构中，与外科缝合装置8002兼容的那些钉仓，或换句话讲，具有适当数量、尺寸和布置结构的钉那些钉仓可具有直接形成在仓体和/或仓盘上的一个或多个解锁键，该一个或多个解锁键被构造成能够在兼容仓可操作地安置在第一钳口或框架中时使第一闭锁件失效。在以引用的方式并入本文中的各种公开内容中公开了具有从其突出的解锁键的各种仓。然而，在其他情况下，临床医生可能希望使用原本与外科缝合组件兼容但原本没有解锁键的钉仓。在此类情况下，临床医生将无法在外科缝合装置中以其他方式使用那些兼容的钉仓。外科缝合组件8000包括被设计成便于使用原本没有解锁键特征部的此类兼容钉仓的特征部。
现在转到图51和图55，缝合组合件8000还包括保持器4400，该保持器被构造成能够可移除地联接到钉仓4200。上文讨论了关于保持器4400的特定细节，并且此处将不重复。如上所述，保持器4400还包括验证键4430，该验证键被构造成能够在保持器4400附接到钉仓4200并且钉仓4200已经可操作地安置在第一钳口或框架8010中时使第一闭锁件4300失效。如图11中可见，验证键4430从保持器4400的顶部部分4402的近侧端部4401朝近侧突出，并且包括被空间4460分开的右斜坡特征部4440和左斜坡特征部4450，该空间的尺寸被设定成在其间接纳击发构件主体4052。在例示的示例中，右斜坡4440从保持器4400的顶部部分4402向下成角度，并且包括近侧右末端4442。近侧右末端4442限定第一右凸轮表面4444，该第一右凸轮表面在末端处向内成角度并且朝远侧延伸到第二右凸轮表面4446。第二右凸轮表面4446从第一右凸轮表面4444延伸到顶部部分4402。参见图12。类似地，左斜坡4450从保持器4400的顶部部分4402向下成角度，并且包括近侧左末端4452。近侧左末端4452在末端处向内成角度并且朝远侧延伸到第二左凸轮表面4456。第二左凸轮表面从第一左凸轮表面4454延伸到顶部部分4402。
现在参见图61和图62，在使用中，保持器4400可移除地附接到钉仓4200以形成仓组件4500。然后将仓组件4500插入第一钳口或框架8010中，以便使验证键的右末端4442与第一闭锁臂8312上的直立解锁插片8322接触，并且左末端4452与第二闭锁臂8314上的直立解锁插片8324接触。在仓组件4500的初始近侧插入期间，第一右凸轮表面4444将第一闭锁臂8312横向向外偏压(图62中的箭头RL)，并且第一左凸轮表面4454将第二闭锁臂8314横向向外偏压(箭头LL)。仓组件4500在近侧方向上进一步纵向推进到第一钳口或框架8010中导致第一闭锁臂8312达到第一中间位置，其中第一闭锁臂8312与击发构件5050上的对应中心销5058脱离接合，并且还导致第二闭锁臂8314达到第二中间位置，其中第二闭锁臂8314与击发构件5050上的对应中心销5058脱离接合。仓组件4500在近侧方向上继续纵向插入第一钳口或框架8010中导致第二右凸轮表面4446将第一闭锁臂8312进一步横向向外偏压，并且第二左凸轮表面4456将第二闭锁臂8314进一步横向向外偏压，直到仓组件4500完全可操作地安置在第一钳口或框架8010中。参见图63。
当仓组件4500已经可操作地安置在第一钳口或框架5010中时，第一闭锁臂8312上的远侧第一保持插片8326接合钉仓4200的对应侧以将第一闭锁臂8312保持在该解锁位置。如图62中可见，间隙凹坑8021R设置在侧壁8020中以将第一保持插片8326容纳在该位置。同样，形成在第二闭锁臂8314上的远侧第二保持插片8328接合钉仓4200的另一对应侧以将第二闭锁臂8314保持在该解锁位置。间隙凹坑8021L设置在侧壁8020中以将第二保持插片8328容纳在该位置。当处于该位置时，第一闭锁件8300处于解锁位置，或者换句话讲，是“失效的”。然后，用户可以以上述方式从钉仓4200移除保持器4400。在第一闭锁件8300失效或解锁的情况下，击发构件5050可以从起始位置朝远侧推进并且处于“就绪状态”。
在钉仓4200已被击发之后，击发构件5050回缩回到起始位置，并且第二钳口或砧座8100枢转回到打开位置。然后可以从第一钳口或框架8010移除用尽的钉仓。一旦已经将用尽的钉仓4200从第一钳口或框架8010移除，第一闭锁臂8312和第二闭锁臂8314便弹回与击发构件5050上的对应中心销5058接合，以再次将击发构件5050保持在起始位置。另外，在至少一种型式中，外科缝合装置8002还包括第二闭锁件5600，该第二闭锁件被构造成能够在用尽的钉仓安置在第一钳口或框架8010中时防止击发构件5050朝远侧推进通过钉击发行程。上文提供了关于第二闭锁件的操作的细节，并且此处将不重复。
除上述以外，至少一种形式的保持器4400可附接到各种钉仓，这些钉仓适于与不同形式的外科缝合装置一起使用(兼容)。换句话讲，保持器4400可在可安置在不同缝合装置中的钉仓上使用，以使那些缝合装置的各种锁定机构失效。钉仓8200可类似地与具有不同形式的闭锁件的不同缝合装置一起使用。例如，图64示出了通常被标记为8600的外科缝合系统，该外科缝合系统包括第一缝合装置4002和至少第二缝合装置8002。保持器4400可联接到外科钉仓4200以形成仓组件4500，该仓组件与外科缝合装置4002、8002中的一者或两者兼容。当保持器4400附接到兼容钉仓4200以形成组装好的仓布置结构4500时，组装好的仓布置结构可用于装置4002、8002中的任一者。同样，钉仓4200也可用于缝合装置4002、8002中的任一者。外科缝合装置4002采用平移砧座4100；缝合装置8002采用枢转砧座8100。由于每个装置的砧座在打开位置和闭合位置之间运动所需的空间量不同，这些装置为验证键布置结构提供非常不同量的空间来操作。因此，在各种应用中，验证斜坡特征部可能需要是相当窄的，并且采用分级和在竖直方向上移位的凸轮作用表面，以便致动两种类型的缝合装置的闭锁构型。
结合另一个一般方面，本文公开的各种验证键和验证斜坡可以与本文公开的保持器主体构型组合并匹配，使得一个保持器/验证键/斜坡构型可以与可在本文公开的多个缝合装置中使用的钉仓一起使用。此类保持器验证键/斜坡构型可用于使那些各种缝合装置中的多个闭锁系统失效。换句话讲，可以采用一个保持器/验证键/验证斜坡构型来解锁本文所公开的缝合装置中的若干缝合装置上的钳口阻挡闭锁件和/或击发构件闭锁件。
如本文所讨论的，验证键布置结构可被设置在可拆卸的保持器上、仓盘上、仓体上、滑动件上或另一辅助附接部件上。这些验证键可以被制成使得它们可以使本文公开的那些外科缝合装置的采用平移钳口布置结构的各种第一闭锁系统以及那些外科缝合装置的采用可围绕固定枢转轴线枢转的钳口布置结构的第一闭锁系统失效。当可运动的钳口或砧座处于闭合位置(对于被设计成在整个缝合击发操作中驻留在装置中的那些键)以及处于打开位置时，此类“通用”验证键的设计可由此类装置中的可用空间量限制和决定。
当设计可用于使采用平移钳口的外科缝合装置中的闭锁件以及采用围绕固定轴线枢转的可运动钳口的外科缝合装置中的闭锁件失效的验证键构型时，每个外科缝合装置中可用的可用空间量将必须决定“通用”验证键的特定形状。因为钳口形状和行进路径在这些类型的外科缝合装置中是不同的，所以当钳口打开和闭合时，验证键的可用空间量不同。
图64A-图64C示出了可用于容纳钉仓4200A的验证键4228A的空间量的示例，其中验证键特征部4228A形成在仓盘4220A的底部部分上，并且当钉仓4200A安置在例如具有处于闭合位置的平移砧座4100的外科缝合装置4002中时。如在这些图中可见，“闭合”空间包络4800具有竖直支腿4800V和水平支腿4800H，其中当与一个外科缝合装置结合使用时：例如，a为大约0.16英寸，b为大约0.14英寸，c为大约0.047英寸，d为大约0.025英寸，e为大约0.04英寸，f为大约0.035英寸，并且g为大约0.05英寸。图64D-图64G示出了当外科缝合装置的钳口打开时用于钉仓4200A的“打开”空间包络4802，其中：例如，h为大约0.14英寸，i为大约0.26英寸，j为大约0.17英寸，k为大约0.04英寸，L为大约0.007英寸，并且M为大约0.03英寸。
图64H-图64J示出了可用于容纳另一钉仓4200B的验证键4228B的空间量的示例，其中验证键特征部4228B形成在仓盘4220B的底部部分上，并且当钉仓4200B安置在例如具有处于闭合位置的平移砧座4100的外科缝合装置4002中时。如在这些图中可见，“闭合”空间包络4804具有竖直支腿4804V和水平支腿4804H，其中当与一个外科缝合装置结合使用时：例如，n为大约0.16英寸，o为大约0.16英寸，p为大约0.14英寸，q为大约0.025英寸，r为大约0.04英寸，s为大约0.095英寸，t为大约0.05英寸。
图64K-图64M示出了可用于容纳钉仓4200C的验证键4228C的空间量的示例，其中验证键特征部4228C形成在仓盘4220C的底部部分上，并且当钉仓4200C安置在例如具有处于闭合位置的平移砧座4100的外科缝合装置4002中时。如在这些图中可见，“闭合”空间包络4806具有竖直支腿4806V和水平支腿4806H，其中当与一个外科缝合装置结合使用时：例如，u为大约0.16英寸，v为大约0.15英寸，w为大约0.037英寸，x为大约0.025英寸，y为大约0.04英寸，z为大约0.095英寸，并且aa为大约0.06英寸。图64N-图64Q示出了当外科缝合装置的钳口打开时用于钉仓4200C的“打开”空间包络4808，其中：例如，bb为大约0.26英寸，cc为大约0.23英寸，dd为大约0.12英寸，ee为大约0.12英寸，ff为大约0.08英寸，并且gg为大约0.04英寸。
图64R-图64T示出了可用于容纳钉仓4200D的验证键4228D的空间量的示例，其中验证键特征部4228D形成在仓盘4220D的底部部分上，并且当钉仓4200D安置在例如具有可围绕固定枢转轴线在打开位置和闭合位置之间运动的砧座8100的外科缝合装置8002中时。如在这些图中可见，“闭合”空间包络4810具有竖直支腿4810V和水平支腿4810H，其中当与一个外科缝合装置结合使用时：例如，hh为大约0.16英寸，ii为大约0.20英寸，jj为大约0.047英寸，kk为大约0.025英寸，ll为大约0.05英寸，mm为大约0.025英寸，并且nn为大约0.09英寸。图64U-图64X示出了当外科缝合装置的钳口打开时用于钉仓4200D的“打开”空间包络4812，其中：例如，oo为大约0.09英寸，pp为大约0.08英寸，qq为大约0.05英寸，rr为大约0.06英寸，ss为大约0.10英寸，并且tt为大约0.03英寸，并且uu为大约0.09英寸。
图64Y-图64ZZ示出了可用于容纳钉仓4200E的验证键4228E的空间量的示例，其中验证键特征部4228E形成在仓盘4220E的底部部分上，并且当钉仓4200E安置在例如具有可围绕固定枢转轴线在打开位置和闭合位置之间运动的砧座8100的外科缝合装置8002中时。如在这些图中可见，“闭合”空间包络4814具有竖直支腿4814V和水平支腿4814H，其中当与一个外科缝合装置结合使用时：例如，vv为大约0.16英寸，ww为大约0.20英寸，xx为大约0.047英寸，yy为大约0.025英寸，zz为大约0.05英寸，aaa为大约0.085英寸，并且bbb为大约0.09英寸。
图65-图71示出了另一个外科缝合组件9000，其在许多方面类似于上文讨论的外科缝合组件7000。外科缝合组件9000包括外科缝合装置9002，该外科缝合装置可与上文描述的外科器械1010结合或与各种其他外科器械和机器人结合使用，这些其他外科器械和机器人在以引用方式并入本文的各种公开内容中描述。如图65中可见，外科缝合装置9002包括被构造成能够在其中可操作地支撑钉仓9200的第一钳口或框架9010。第一钳口或框架9010以本文所述的各种方式附接到轴组件的棘。在例示的示例中，第一钳口或框架9010通过轴安装凸缘9030附接到轴组件的棘(在图65中未示出)。外科缝合装置9002也可与不促进外科缝合装置9002的关节运动的轴组件结合使用。
仍然参见图65，外科缝合装置9002还包括击发构件组件4040，该击发构件组件包括附接到刀构件4050或“击发构件”的刀杆(未示出)。上文详细讨论了击发构件4050和刀杆的操作，并且此处将不重复。外科缝合装置9002还包括可相对于第一钳口或框架9010运动的第二钳口或砧座9100。砧座9100包括砧座主体部分9102和砧座安装部分9110。砧座主体9102包括钉成形下表面或组织接触表面9104，其具有形成于其中的一系列钉成形凹坑(未示出)，这些钉成形凹坑被布置成当它们被驱动成与对应钉成形接触时形成对应钉。砧座安装部分9110包括一对横向延伸的砧座销或耳轴销9112，其被构造成能够接纳在第一钳口或框架9010的直立侧壁9020中的对应耳轴孔9022中。与上述砧座6100不同，砧座9100枢转地销连接到框架9010，以围绕固定枢转轴线相对于该框架枢转行进。换句话讲，与砧座6100不同，砧座9100在砧座闭合过程期间实质上不会轴向运动或平移。
如上文以及在以引用方式并入本文的公开内容中的若干公开内容中所讨论的，砧座9100可通过可轴向运动的闭合构件或端部执行器闭合管9600(图69)从打开位置运动到闭合位置，在该打开位置中用过的或用尽的钉仓可从第一钳口或框架9010移除，或者未击发的钉仓可以可操作地安置在其中。例如，当闭合管9600从近侧位置朝远侧运动时，闭合管9600可以可操作地接合砧座安装部分9110上的凸轮表面9113。闭合管9600与砧座安装部分9110之间的这样的相互作用使砧座安装部分9110和砧座耳轴销9112枢转，直到闭合构件使砧座9100运动到完全闭合位置。当处于完全闭合位置时，砧座9100中的钉成形凹坑与已经可操作地安置在第一钳口或框架9010中的对应兼容钉仓9200中的钉正确地对准。当可轴向运动的闭合管9600之后在近侧方向上运动时，闭合管9600上的特征部与砧座安装部分9110交接，以使砧座9100枢转回到打开位置。
除上述以外，外科缝合装置9002包括第一闭锁件9300，该第一闭锁件被构造成能够防止第二钳口或砧座9100通过闭合管9600从打开位置运动到闭合位置。第一闭锁件9300在本文中也可称为“验证”闭锁件。在例示的布置结构中，第一闭锁件9300包括第一闭锁臂9310，该第一闭锁臂通过附接到其的闭锁销9312枢转地支撑在第一钳口或框架9010中。参见图66。在一个示例中，第一闭锁臂9310由不锈钢等制造，并且闭锁销9312可以被机加工到其近侧端部中。闭锁销9312枢转地安置在框架9010中的枢轴孔9013中，以促进第一闭锁臂9310在钳口锁定位置与钳口闭合位置之间的枢转行进。参见图68。在例示的示例中，第一闭锁臂9310被构造成能够在第一闭锁臂9310处于锁定或钳口锁定位置时阻挡地接合从砧座安装部分9110向下突出的锁定凸耳部分9120。参见图69。当第一闭锁臂9310处于该锁定或接合位置时，当锁定凸耳部分9120接触第一闭锁臂9310时，防止砧座9100的枢转行进。应当理解，第一闭锁臂9310以及锁定凸耳部分9120各自足够坚固，以便抵抗施加到砧座9100的大量闭合运动，以防止砧座9100的闭合。
现在参见图66，第一闭锁弹簧9330支撑在第一钳口或框架9010的对应侧壁9020中以向第一闭锁臂9310施加横向偏压力，以将第一闭锁臂9310在锁定方向LD(图68)上偏压到锁定或钳口锁定位置，其中第一闭锁臂9310防止砧座9100从打开位置运动到闭合位置。如图66中可见，第一闭锁臂9310还包括形成在第一闭锁臂9310的远侧端部9320上的直立凸轮致动器插片9322。如图71中可见，凸轮致动器插片9322包括上致动器凸轮表面9324。另外，下致动器凸轮构件9326形成在第一闭锁臂9310的远侧端部9320上。
在至少一个示例中，缝合组件9000包括与上述钉仓4200相同的钉仓9200，不同之处在于验证键9430形成到仓盘9220中。参见图72。验证键9430被构造成能够在钉仓9200可操作地安置在框架9010中时使第一闭锁件9300失效、解锁或解除闩锁。如图72中可见，验证键9430从仓盘9220的近侧端部9221朝近侧突出，并且包括上斜坡特征部9440以及从上斜坡特征部9440在竖直方向上移位的下斜坡特征部9450。验证键9430以大致直角从仓盘9220的部分9223弯曲，该部分延伸跨过仓体9202的远侧端部的一部分。上斜坡特征部9440包括弯曲到验证键9430中的上斜坡插片9441，并且下斜坡特征部9450包括弯曲到验证键9430中的下斜坡插片9451。如图72中可见，上斜坡特征部9440和下斜坡特征部9450两者均位于由仓体9202限定的仓轴线CA的同一侧上。上斜坡特征部9440被形成为使得其也位于下斜坡特征部9450的近侧。如上所述，上斜坡特征部9440和下斜坡特征部9450从仓盘9220弯曲出来。换句话讲，上斜坡特征部9440和下斜坡特征部9450一体地形成在仓盘9220中。在例示的示例中，上斜坡特征部9440包括第一上凸轮表面9442和第二上凸轮表面9444。第一上凸轮表面9442位于第二上凸轮表面的近侧，并且也相对于第二上凸轮表面9444成角度。下斜坡特征部9450包括第一下凸轮表面9452和第二下凸轮表面9454。第一下凸轮表面9452位于第二下凸轮表面9454的近侧，并且也相对于第一下凸轮表面9452成角度。
图73-图77示出了验证键9430的上斜坡特征部9440和下斜坡特征部9450与凸轮致动器插片9322和下致动器凸轮构件9326上的上致动器凸轮表面9324之间的相互作用。图73示出了当钉仓9200最初纵向插入(方向PD)框架9010中时，验证键9430相对于凸轮致动器插片9322的位置。如图73中可见，上斜坡特征部9440的第一上凸轮表面9442正在与凸轮致动器插片9322上的上致动器凸轮表面9324凸轮接合，并且开始横向偏压凸轮致动器插片9322以及第一闭锁臂9310。如图73中进一步可见，闭锁凹坑9021设置在框架9010的相邻直立侧壁9020中，以在第一闭锁臂9310从锁定或钳口锁定位置运动到解锁或钳口闭合位置时容纳凸轮致动器插片9322。
图74示出了钉仓9200在近侧方向上继续纵向插入框架9010中。如图74中可见，钉仓9200已被插入其中第一上凸轮表面9442已前进经过上致动器凸轮表面9324的点，从而允许凸轮致动器插片9322的末端9325接合验证键9430的上斜坡特征部9440上的第二上凸轮表面9444。这样的顺序相互作用继续将凸轮致动器插片9322和第一闭锁臂9310横向运动到锁定或钳口锁定位置与解锁或钳口闭合位置之间的中间位置。
图75示出了钉仓9200在其继续在近侧方向PD上纵向插入框架9010中时的位置。如图75中可见，凸轮致动器插片9322的末端9325保持与上斜坡特征部9440上的第二上凸轮表面9444接合，并且下致动器凸轮构件9326现在已经接合下斜坡特征部9450上的第一下凸轮表面9452。这种顺序相互作用使凸轮致动器插片9322以及第一闭锁臂9310继续横向运动。
图76示出了在钉仓9200已经可操作地(完全)安置在框架9010中之后致动器插片9322的位置。如图76中可见，下致动器凸轮构件9326保持与下斜坡特征部9450上的第二下凸轮表面9454接合，并且已经使凸轮致动器插片9322横向运动以安置在框架9010的直立侧壁9020中的闭锁凹坑9021中。当第一闭锁臂9310处于图76所示的解锁或钳口闭合位置时，砧座9100可从打开位置枢转到闭合位置而不被第一闭锁臂9310阻挡。当第一闭锁臂9310处于锁定或钳口锁定位置时，下致动器凸轮构件9326位于击发构件主体4052的前面，使得钳口解锁程序不能通过朝远侧推进击发构件而开始。下致动器凸轮构件9326定位在击发构件4050的中心销4058上方，以在解锁程序期间在其间提供足够的间隙。图77和图78示出在砧座9100已枢转到闭合位置之后第一闭锁臂6310相对于砧座9100的一部分的位置。
外科缝合装置9002还可包括类似于第二闭锁件4600的第二闭锁件，用于在用尽的钉仓安置在第一钳口或框架9010中时防止击发构件4050推进通过击发行程。上文详细描述了第二闭锁件4600，并且此处将不重复。
图78A示出了可以以上述方式与外科缝合装置9002结合使用的替代仓组件9500。在例示的示例中，仓组件9500包括钉仓9200’，该钉仓具有附接到其上的保持器6400”。除了验证键6430”和斜坡6440”的形状和构型之外，保持器6400”类似于上述保持器6400。保持器6400”在许多方面可与上文讨论的保持器6400相同。
仍然参见图78A，仓组件9500包括与上述钉仓4200类似的钉仓9200’，不同之处在于第二验证斜坡9450’形成到附接到仓体9202’的仓盘9220’中。当保持器6400”如图所示附接到钉仓9200’时，斜坡6440”包括“第一”斜坡，该“第一”斜坡包括“第一”上凸轮表面6442”和第二上凸轮表面6444”。第一上凸轮表面6442”位于第二上凸轮表面6444”的近侧，并且也相对于第二上凸轮表面6444”成角度。位于仓盘9220’上的第二验证斜坡9450’包括第一下凸轮表面9452’和第二下凸轮表面9454’。第二斜坡9450’定位在保持器6400”上的第一斜坡6440”下方，并且定位在第一上凸轮表面6442”的远侧。当仓组件9500可操作地安置到外科缝合装置9002的框架9010中时，保持器6400”上的第一斜坡6440”和仓盘9220’上的第二斜坡9450”的组合以与仓9200上的上斜坡特征部9440和第二斜坡特征部9450相同的方式操作，以使第一闭锁件9300以上文详细描述的方式顺序地失效、解锁或解除闩锁。一旦第一闭锁臂9310已经运动到解锁或“钳口闭合位置”，第二斜坡9450’就将第一闭锁臂9310保持在该位置。然后，用户可以从钉仓9200’移除保持器6400”，并且砧座9100可从打开位置枢转到闭合位置。
图78B-图78C示出了类似于上文描述的钉仓9200的替代钉仓9200”，不同之处在于第一验证键9430”形成或模制到仓体9202”中。第一验证键9430”包括第一斜坡9440”，该第一斜坡具有形成于其上的第一上凸轮表面9442”和第二上凸轮表面9444”。第一上凸轮表面9442”位于第二上凸轮表面9444”的近侧，并且也相对于第二上凸轮表面9444”成角度。包括仓盘9220”的一部分的第二验证斜坡9450”包括第一下凸轮表面9452”和第二下凸轮表面9454”。第二验证斜坡9450”位于第一斜坡9440”下方，并且定位在第一上凸轮表面9442”的远侧。当仓组件9200”可操作地安置到外科缝合装置9002的框架9010中时，第一斜坡9440”和第二斜坡9450”的组合以与仓9200上的上斜坡特征部9440和下斜坡特征部9450相同的方式操作，以使第一闭锁件9300以上文详细描述的方式失效。
本文所述主题的各个方面在以下实施例中阐述：
实施例1-一种外科缝合组件，所述外科缝合组件被构造成能够接纳钉仓。所述钉仓包括具有纵向狭槽的仓体、平台表面、穿过所述平台表面开口的多个钉凹坑、可移除地储存在每个钉凹坑中的钉、以及被构造成能够在钉击发行程期间从所述仓体击发所述钉的滑动件。所述外科缝合组件包括缝合装置，所述缝合装置包括第一钳口、能够相对于所述第一钳口在打开位置与闭合位置之间运动的第二钳口、击发构件、第一闭锁件和第二闭锁件。所述击发构件在所述钉击发行程期间能够在所述纵向狭槽内的起始位置与结束位置之间运动。所述击发构件被构造成能够在所述钉击发行程期间致动所述滑动件以击发所述钉。所述第一闭锁件被构造成能够防止所述第二钳口从所述打开位置运动到所述闭合位置。所述第一闭锁件包括闭锁臂，所述闭锁臂被构造成能够将所述第二钳口可释放地保持在所述打开位置。所述第二闭锁件被构造成能够在用尽的钉仓安置在所述缝合装置中时防止所述击发构件推进通过所述钉击发行程。所述外科缝合组件还包括可移除地安装到所述仓体的保持器。所述保持器支撑在所述平台表面上以形成仓组件。所述保持器包括验证键，所述验证键被构造成能够在所述仓组件安置在所述缝合装置中时通过使所述闭锁臂从钳口锁定位置运动到钳口闭合位置而使所述第一闭锁件失效，其中在所述钳口锁定位置处所述闭锁臂防止所述第二钳口从所述打开位置运动到所述闭合位置，其中在所述钳口闭合位置处所述第二钳口能够从所述打开位置运动到所述闭合位置。
实施例2-根据实施例1所述的外科缝合组件，其中，当所述保持器附接到所述仓体时，所述保持器覆盖位于所述平台表面中的所述钉凹坑，并且其中当所述保持器从所述仓体移除时，所述钉凹坑被暴露。
实施例3-根据实施例1或2所述的外科缝合组件，其中，所述第一钳口限定钳口轴线，并且其中所述验证键定位在所述钳口轴线的仅一个横向侧上。
实施例4-根据实施例1、2或3所述的外科缝合组件，其中，所述第一闭锁件位于所述第二闭锁件的近侧。
实施例5-根据实施例1、2、3或4所述的外科缝合组件，其中，所述验证键从所述保持器的近侧端部朝近侧延伸。
实施例6-根据实施例1、2、3、4或5所述的外科缝合组件，其中，所述闭锁臂能够在所述钳口锁定位置与所述钳口闭合位置之间枢转地运动。
实施例7-根据实施例1、2、3、4、5或6所述的外科缝合组件，其中，所述验证键包括近侧凸轮表面和远侧凸轮表面。所述近侧凸轮表面被构造成能够在所述仓组件最初插入所述第一钳口中时接合所述闭锁臂。所述近侧凸轮表面使所述闭锁臂从所述钳口锁定位置运动到中间位置。所述远侧凸轮表面被构造成能够在所述闭锁臂处于所述中间位置时接合所述闭锁臂。所述远侧凸轮表面在所述仓组件安置在所述第一钳口中时使所述闭锁臂运动到所述钳口闭合位置。
实施例8-根据实施例7所述的外科缝合组件，其中，所述近侧凸轮表面位于所述远侧凸轮表面的近侧并且从所述远侧凸轮表面在竖直方向上偏离。
实施例9-根据实施例1、2、3、4、5、6、7或8所述的外科缝合组件，其中，所述第二闭锁件包括位于所述第一钳口和所述第二钳口中的一者上的邻接部分，所述邻接部分被构造成能够在用尽的所述钉仓安置在所述缝合装置中时被所述击发构件接触。
实施例10-根据实施例9所述的外科缝合组件，其中，所述击发构件能够在解锁位置和锁定位置之间运动，在所述解锁位置，所述击发构件在所述钉击发行程期间能够从所述起始位置朝远侧运动到所述结束位置，在所述锁定位置，所述邻接部分防止所述击发构件朝远侧运动。
实施例11-根据实施例10所述的外科缝合组件，其中，所述钉仓中的所述滑动件被构造成能够在所述滑动件处于所述钉仓内的未击发位置并且所述钉仓安置在所述外科缝合装置中时使所述击发构件从所述锁定位置运动到所述解锁位置。
实施例12-根据实施例10或11所述的外科缝合组件，其中，所述闭锁臂被构造成能够在所述钳口锁定位置与所述钳口闭合位置之间在第一平面中运动，并且其中所述击发构件能够在所述锁定位置与所述解锁位置之间在第二平面中运动，并且其中所述第一平面相对于所述第二平面正交。
实施例13-根据实施例11所述的外科缝合组件，其中，当所述滑动件处于所述未击发位置时，当所述钉仓安置在所述外科缝合组件中时，所述第一闭锁件位于所述钉仓的所述滑动件的近侧。
实施例14-根据实施例1、2、3、4、5、6、7、8、9、10、11、12或13所述的外科缝合组件，其中，所述第一钳口限定第一钳口轴线，并且其中所述闭锁臂被枢转地支撑在所述第一钳口轴线的一侧上。
实施例15-一种外科缝合系统，包括第一缝合装置、第二缝合装置、钉仓和保持器。所述第一缝合装置包括第一框架、能够相对于所述第一框架在第一打开位置与第一闭合位置之间运动的第一钳口、在第一钉击发行程期间能够在第一起始位置与第一结束位置之间运动的第一击发构件，以及被构造成能够防止所述第一钳口从所述第一打开位置运动到所述第一闭合位置的第一钳口闭锁件。所述第一钳口闭锁件包括第一钳口闭锁臂，所述第一钳口闭锁臂被构造成能够将所述第一钳口可释放地保持在所述第一打开位置。所述第二缝合装置包括第二框架、能够相对于所述第二框架在第二打开位置与第二闭合位置之间运动的第二钳口、在第二钉击发行程期间能够在第二起始位置与第二结束位置之间运动的第二击发构件，以及被构造成能够防止所述第二钳口从所述第二打开位置运动到所述第二闭合位置的第二钳口闭锁件。所述第二钳口闭锁件包括第二钳口闭锁臂，所述第二钳口闭锁臂被构造成能够将所述第二钳口可释放地保持在所述第二打开位置。所述钉仓被构造能够在所述第一缝合装置和所述第二缝合装置中的任一个中使用。所述钉仓包括具有纵向狭槽和平台表面的仓体、穿过所述平台表面开口的多个钉凹坑、可移除地储存在每个钉凹坑中的钉、以及能够在所述第一钉击发行程和所述第二钉击发行程期间运动穿过所述仓体以击发所述钉的滑动件。所述保持器可移除地安装到所述仓体。所述保持器在附接到所述仓体以形成仓组件时支撑在所述平台表面上。所述保持器包括验证键，所述验证键被构造成能够在所述仓组件安置在所述第一缝合装置中时通过使所述第一钳口闭锁臂离开第一钳口锁定位置运动到第一钳口闭合位置而使所述第一钳口闭锁件失效，其中在所述第一钳口闭合位置处所述第一钳口能够从所述第一打开位置运动到所述第一闭合位置。所述验证键被进一步构造成能够在所述仓组件安置在所述第二缝合装置中时通过使所述第二钳口闭锁臂离开第二钳口锁定位置运动到第二钳口闭合位置而使所述第二钳口闭锁件失效，其中在所述第二钳口闭合位置处所述第二钳口能够从所述第二打开位置运动到所述第二闭合位置。
实施例16-根据实施例15所述的外科缝合系统，其中，所述第一框架限定第一框架轴线，其中所述第一钳口闭锁臂被枢转地支撑在所述第一框架轴线的第一侧上，其中所述第二框架限定第二框架轴线，并且其中所述第二钳口闭锁臂被枢转地支撑在所述第二框架轴线的与所述第一框架轴线的所述第一侧相对的相对侧上。
实施例17-根据实施例15或16所述的外科缝合系统，其中，所述验证键包括第一闭锁斜坡和第二闭锁斜坡。所述第一闭锁斜坡从所述保持器的近侧端部突出，并且被构造成能够在所述仓组件安置在所述第一缝合装置中时使所述第一钳口闭锁臂从所述第一钳口锁定位置运动到所述第一钳口闭合位置。所述第二闭锁斜坡从所述保持器的所述近侧端部突出，并且被构造成能够在所述仓组件安置在所述第二缝合装置中时使所述第二钳口闭锁臂从所述第二钳口锁定位置运动到所述第二钳口闭合位置。
实施例18-根据实施例17所述的外科缝合系统，其中，所述第一闭锁斜坡包括第一近侧凸轮表面和第一远侧凸轮表面。所述第一近侧凸轮表面被构造成能够在所述钉仓组件最初插入所述第一缝合装置中时使所述第一钳口闭锁臂从所述第一钳口锁定位置运动到第一中间位置。所述第一远侧凸轮表面被构造成能够在所述第一钳口闭锁臂处于所述第一中间位置时接合所述第一钳口闭锁臂。当所述仓组件完全安置在所述第一缝合装置中时，所述第一远侧凸轮表面使所述第一钳口闭锁臂从所述第一中间位置运动到所述第一钳口闭合位置。所述第二闭锁斜坡包括第二近侧凸轮表面和第二远侧凸轮表面。所述第二近侧凸轮表面被构造成能够在所述钉仓组件最初插入所述第二缝合装置中时使所述第二钳口闭锁臂从所述第二钳口锁定位置运动到第二中间位置。所述第二远侧凸轮表面被构造成能够在所述第二钳口闭锁臂处于所述第二中间位置时接合所述第二钳口闭锁臂。当所述仓组件完全安置在所述第二缝合装置中时，所述第二远侧凸轮表面使所述第二钳口闭锁臂从所述第二中间位置运动到所述第二钳口闭合位置。
实施例19-根据实施例18所述的外科缝合系统，其中，所述第一近侧凸轮表面位于所述第一远侧凸轮表面的近侧并且从所述第一远侧凸轮表面在竖直方向上偏离，并且其中所述第二近侧凸轮表面位于所述第二远侧凸轮表面的近侧并且从所述第二远侧凸轮表面在竖直方向上偏离。
实施例20-一种用于与外科钉仓一起使用的保持器，所述外科钉仓被构造能够与第一外科缝合装置一起使用，所述第一外科缝合装置包括第一钳口和第一框架。所述第一钳口能够相对于所述第一框架在第一打开位置与第一闭合位置之间运动。所述钉仓包括具有纵向狭槽的仓体、平台表面、穿过所述平台表面开口的多个钉凹坑、可移除地储存在每个钉凹坑中的钉、以及被构造成能够在由所述第一外科缝合装置的第一击发构件驱动时从所述仓体击发所述钉的滑动件。所述第一外科缝合装置还包括第一闭锁臂，所述第一闭锁臂能够从第一钳口锁定位置运动到第一钳口闭合位置，其中在所述第一钳口锁定位置处所述第一闭锁臂防止所述第一钳口从所述第一打开位置运动到所述第一闭合位置，其中在所述第一钳口闭合位置处所述第一钳口能够从所述第一打开位置运动到所述第一闭合位置。所述保持器包括保持器主体和第一验证斜坡。所述保持器主体被构造能够可移除地附接到所述仓体。所述保持器主体的尺寸被设定成覆盖所述平台表面和所述钉凹坑以形成仓组件。所述第一验证斜坡被构造成能够在所述仓组件安置在所述第一外科缝合装置中并且所述保持器从所述仓体移除时使所述第一闭锁臂从所述第一钳口锁定位置运动到所述第一钳口闭合位置。
实施例21-根据实施例20所述的保持器，其中，所述第一验证斜坡包括第一近侧凸轮表面和第一远侧凸轮表面。所述第一近侧凸轮表面被构造成能够在所述仓组件最初插入所述第一外科缝合装置中时接合所述第一闭锁臂。所述第一近侧凸轮表面使所述第一闭锁臂从所述第一钳口锁定位置运动到第一中间位置。所述第一远侧凸轮表面被构造成能够在所述第一闭锁臂处于所述第一中间位置时接合所述第一闭锁臂。当所述仓组件安置在所述第一框架中时，所述第一远侧凸轮表面使所述第一闭锁臂从所述第一中间位置运动到所述第一钳口闭合位置。
实施例22-根据实施例20或21所述的保持器，其中，所述钉仓被构造能够与包括第二钳口、第二框架和第二闭锁臂的第二外科缝合装置一起使用，其中所述第二钳口能够相对于所述第二框架在第二开口位置与第二闭合位置之间运动，其中所述第二闭锁臂能够从第二钳口锁定位置运动到第二钳口闭合位置，其中在所述第二钳口闭合位置处所述第二钳口能够从所述第二打开位置运动到所述第二闭合位置，其中所述保持器还包括从所述保持器主体的近侧端部突出的第二验证斜坡，并且其中所述第二验证斜坡被构造成能够在所述仓组件安置在所述第二外科缝合装置中并且所述保持器从所述仓体移除时使所述第二闭锁臂从所述第二钳口锁定位置运动到所述第二钳口闭合位置。
实施例23-根据实施例22所述的保持器，其中，所述第一框架限定第一框架轴线，其中所述第一闭锁臂被枢转地支撑在所述第一框架轴线的第一侧上，其中所述第二框架限定第二框架轴线，其中所述第二闭锁臂被枢转地支撑在所述第二框架轴线的相对第二侧上，其中当所述仓组件支撑在所述第一框架中时，所述保持器限定与所述第一框架轴线在竖直方向上对准的保持器轴线，其中当所述仓组件支撑在所述第二框架中时，所述保持器轴线与所述第二框架轴线在竖直方向上对准，其中所述第一验证斜坡位于所述保持器轴线的第一侧上，并且其中所述第二验证斜坡位于所述保持器轴线的第二侧上。
实施例24-根据实施例22或23所述的保持器，其中，所述第一验证斜坡包括第一近侧凸轮表面和第一远侧凸轮表面。所述第一近侧凸轮表面被构造成能够在所述钉仓最初插入所述第一外科缝合装置中时接合所述第一闭锁臂。所述第一近侧凸轮表面使所述第一闭锁臂从所述第一钳口锁定位置运动到第一中间位置。所述第一远侧凸轮表面被构造成能够在所述第一闭锁臂处于所述第一中间位置时接合所述第一闭锁臂。当所述仓组件安置在所述第一框架中时，所述第一远侧凸轮表面使所述第一闭锁臂从所述第一中间位置运动到所述第一钳口闭合位置。所述第二验证斜坡包括第二近侧凸轮表面和第二远侧凸轮表面。所述第二近侧凸轮表面被构造成能够在所述钉仓最初插入所述第二外科缝合装置中时接合所述第二闭锁臂。所述第二近侧凸轮表面使所述第二闭锁臂从所述第二钳口锁定位置运动到第二中间位置。所述第二远侧凸轮表面被构造成能够在所述第钳口闭锁臂处于所述第二中间位置时接合所述第二闭锁臂。当所述仓组件安置在所述第二框架中时，所述第二远侧凸轮表面使所述第二闭锁臂从所述第二中间位置运动到所述第二钳口闭合位置。
实施例25-根据实施例24所述的保持器，其中，所述第一近侧凸轮表面位于所述第一远侧凸轮表面的近侧并且从所述第一远侧凸轮表面在竖直方向上偏离，并且其中所述第二近侧凸轮表面位于所述第二远侧凸轮表面的近侧并且从所述第二远侧凸轮表面在竖直方向上偏离。
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 (25)

1.一种外科缝合组件，所述外科缝合组件被构造成能够接纳钉仓，其中所述钉仓包括具有纵向狭槽的仓体、平台表面、穿过所述平台表面开口的多个钉凹坑、可移除地储存在每个钉凹坑中的钉、以及被构造成能够在钉击发行程期间从所述仓体击发所述钉的滑动件，并且其中所述外科缝合组件包括：
缝合装置，所述缝合装置包括：
第一钳口；
第二钳口，所述第二钳口能够相对于所述第一钳口在打开位置和闭合位置之间运动；
击发构件，所述击发构件在所述钉击发行程期间在所述纵向狭槽内能够在起始位置和结束位置之间运动，其中所述击发构件被构造成能够在所述钉击发行程期间致动所述滑动件以击发所述钉；
第一闭锁件，所述第一闭锁件被构造成能够防止所述第二钳口从所述打开位置运动到所述闭合位置，其中所述第一闭锁件包括闭锁臂，所述闭锁臂被构造成能够将所述第二钳口可释放地保持在所述打开位置；以及
第二闭锁件，所述第二闭锁件被构造成能够在用尽的钉仓安置在所述缝合装置中时防止所述击发构件推进通过所述钉击发行程；以及
保持器，所述保持器可移除地安装到所述仓体，其中所述保持器支撑在所述平台表面上以形成仓组件，并且其中所述保持器包括验证键，所述验证键被构造成能够在所述仓组件安置在所述缝合装置中时通过使所述闭锁臂从钳口锁定位置运动到钳口闭合位置而使所述第一闭锁件失效，其中在所述钳口锁定位置处所述闭锁臂防止所述第二钳口从所述打开位置运动到所述闭合位置，其中在所述钳口闭合位置处所述第二钳口能够从所述打开位置运动到所述闭合位置。
2.根据权利要求1所述的外科缝合组件，其中，当所述保持器附接到所述仓体时，所述保持器覆盖位于所述平台表面中的所述钉凹坑，并且其中当所述保持器从所述仓体移除时，所述钉凹坑被暴露。
3.根据权利要求1所述的外科缝合组件，其中，所述第一钳口限定钳口轴线，并且其中所述验证键定位在所述钳口轴线的仅一个横向侧上。
4.根据权利要求1所述的外科缝合组件，其中，所述第一闭锁件位于所述第二闭锁件的近侧。
5.根据权利要求1所述的外科缝合组件，其中，所述验证键从所述保持器的近侧端部朝近侧延伸。
6.根据权利要求1所述的外科缝合组件，其中，所述闭锁臂能够在所述钳口锁定位置与所述钳口闭合位置之间枢转地运动。
7.根据权利要求6所述的外科缝合组件，其中，所述验证键包括：
近侧凸轮表面，所述近侧凸轮表面被构造成能够在所述仓组件最初插入所述第一钳口中时接合所述闭锁臂，其中所述近侧凸轮表面使所述闭锁臂从所述钳口锁定位置运动到中间位置；以及
远侧凸轮表面，所述远侧凸轮表面被构造成能够在所述闭锁臂处于所述中间位置时接合所述闭锁臂，其中当所述仓组件安置在所述第一钳口中时，所述远侧凸轮表面使所述闭锁臂运动到所述钳口闭合位置。
8.根据权利要求7所述的外科缝合组件，其中，所述近侧凸轮表面位于所述远侧凸轮表面的近侧并且从所述远侧凸轮表面在竖直方向上偏离。
9.根据权利要求1所述的外科缝合组件，其中，所述第二闭锁件包括位于所述第一钳口和所述第二钳口中的一者上的邻接部分，所述邻接部分被构造成能够在用尽的所述钉仓安置在所述缝合装置中时被所述击发构件接触。
10.根据权利要求9所述的外科缝合组件，其中，所述击发构件能够在解锁位置和锁定位置之间运动，在所述解锁位置，所述击发构件在所述钉击发行程期间能够从所述起始位置朝远侧运动到所述结束位置，在所述锁定位置，所述邻接部分防止所述击发构件朝远侧运动。
11.根据权利要求10所述的外科缝合组件，其中，所述钉仓中的所述滑动件被构造成能够在所述滑动件处于所述钉仓内的未击发位置并且所述钉仓安置在所述外科缝合装置中时使所述击发构件从所述锁定位置运动到所述解锁位置。
12.根据权利要求11所述的外科缝合组件，其中，所述闭锁臂被构造成能够在所述钳口锁定位置与所述钳口闭合位置之间在第一平面中运动，并且其中所述击发构件能够在所述锁定位置与所述解锁位置之间在第二平面中运动，并且其中所述第一平面相对于所述第二平面正交。
13.根据权利要求11所述的外科缝合组件，其中，当所述滑动件处于所述未击发位置时，当所述钉仓安置在所述外科缝合组件中时，所述第一闭锁件位于所述钉仓的所述滑动件的近侧。
14.根据权利要求1所述的外科缝合组件，其中，所述第一钳口限定第一钳口轴线，并且其中所述闭锁臂被枢转地支撑在所述第一钳口轴线的一侧上。
15.一种外科缝合系统，所述外科缝合系统包括：
第一缝合装置，所述第一缝合装置包括：
第一框架；
第一钳口，所述第一钳口能够相对于所述第一框架在第一打开位置与第一闭合位置之间运动；
第一击发构件，所述第一击发构件在第一钉击发行程期间能够在第一起始位置与第一结束位置之间运动；以及
第一钳口闭锁件，所述第一钳口闭锁件被构造成能够防止所述第一钳口从所述第一打开位置运动到所述第一闭合位置，其中所述第一钳口闭锁件包括第一钳口闭锁臂，所述第一钳口闭锁臂被构造成能够将所述第一钳口可释放地保持在所述第一打开位置；以及
第二缝合装置，所述第二缝合装置包括：
第二框架；第二钳口，所述第二钳口能够相对于所述第二框架在第二打开位置与第二闭合位置之间运动；
第二击发构件，所述第二击发构件在第二钉击发行程期间能够在第二起始位置与第二结束位置之间运动；以及
第二钳口闭锁件，所述第二钳口闭锁件被构造成能够防止所述第二钳口从所述第二打开位置运动到所述第二闭合位置，其中所述第二钳口闭锁件包括第二钳口闭锁臂，所述第二钳口闭锁臂被构造成能够将所述第二钳口可释放地保持在所述第二打开位置；以及
钉仓，所述钉仓被构造能够在所述第一缝合装置和所述第二缝合装置中的任一个中使用，其中所述钉仓包括：
仓体，所述仓体包括纵向狭槽和平台表面；
多个钉凹坑，所述多个钉凹坑穿过所述平台表面开口；
钉，所述钉可移除地储存在每个所述钉凹坑中；以及
滑动件，所述滑动件能够在所述第一钉击发行程和所述第二钉击发行程期间运动穿过所述仓体以击发所述钉；以及
保持器，所述保持器可移除地安装到所述仓体，其中所述保持器在附接到所述仓体时支撑在所述平台表面上以形成仓组件，其中所述保持器包括验证键，所述验证键被构造成能够在所述仓组件安置在所述第一缝合装置中时通过使所述第一钳口闭锁臂离开第一钳口锁定位置运动到第一钳口闭合位置而使所述第一钳口闭锁件失效，其中在所述第一钳口闭合位置处所述第一钳口能够从所述第一打开位置运动到所述第一闭合位置，并且其中所述验证键被进一步构造成能够在所述仓组件安置在所述第二缝合装置中时通过使所述第二钳口闭锁臂离开第二钳口锁定位置运动到第二钳口闭合位置而使所述第二钳口闭锁件失效，其中在所述第二钳口闭合位置处所述第二钳口能够从所述第二打开位置运动到所述第二闭合位置。
16.根据权利要求15所述的外科缝合系统，其中，所述第一框架限定第一框架轴线，其中所述第一钳口闭锁臂被枢转地支撑在所述第一框架轴线的第一侧上，其中所述第二框架限定第二框架轴线，并且其中所述第二钳口闭锁臂被枢转地支撑在所述第二框架轴线的与所述第一框架轴线的所述第一侧相对的相对侧上。
17.根据权利要求16所述的外科缝合系统，其中，所述验证键包括：
第一闭锁斜坡，所述第一闭锁斜坡从所述保持器的近侧端部突出，其中所述第一闭锁斜坡被构造成能够在所述仓组件安置在所述第一缝合装置中时使所述第一钳口闭锁臂从所述第一钳口锁定位置运动到所述第一钳口闭合位置；以及
第二闭锁斜坡，所述第二闭锁斜坡从所述保持器的所述近侧端部突出，其中所述第二闭锁斜坡被构造成能够在所述仓组件安置在所述第二缝合装置中时使所述第二钳口闭锁臂从所述第二钳口锁定位置运动到所述第二钳口闭合位置。
18.根据权利要求17所述的外科缝合系统，其中，所述第一闭锁斜坡包括：
第一近侧凸轮表面，所述第一近侧凸轮表面被构造成能够在所述钉仓组件最初插入所述第一缝合装置中时使所述第一钳口闭锁臂从所述第一钳口锁定位置运动到第一中间位置；以及
第一远侧凸轮表面，所述第一远侧凸轮表面被构造成能够在所述第一钳口闭锁臂处于所述第一中间位置时接合所述第一钳口闭锁臂，其中当所述仓组件完全安置在所述第一缝合装置中时，所述第一远侧凸轮表面使所述第一钳口闭锁臂从所述第一中间位置运动到所述第一钳口闭合位置，并且其中所述第二闭锁斜坡包括：
第二近侧凸轮表面，所述第二近侧凸轮表面被构造成能够在所述钉仓组件最初插入所述第二缝合装置中时使所述第二钳口闭锁臂从所述第二钳口锁定位置运动到第二中间位置；以及
第二远侧凸轮表面，所述第二远侧凸轮表面被构造成能够在所述第二钳口闭锁臂处于所述第二中间位置时接合所述第二钳口闭锁臂，其中当所述仓组件完全安置在所述第二缝合装置中时，所述第二远侧凸轮表面使所述第二钳口闭锁臂从所述第二中间位置运动到所述第二钳口闭合位置。
19.根据权利要求18所述的外科缝合系统，其中，所述第一近侧凸轮表面位于所述第一远侧凸轮表面的近侧并且从所述第一远侧凸轮表面在竖直方向上偏离，并且其中所述第二近侧凸轮表面位于所述第二远侧凸轮表面的近侧并且从所述第二远侧凸轮表面在竖直方向上偏离。
20.一种用于与外科钉仓一起使用的保持器，所述外科钉仓被构造能够与第一外科缝合装置一起使用，所述第一外科缝合装置包括第一钳口和第一框架，其中所述第一钳口能够相对于所述第一框架在第一打开位置与第一闭合位置之间运动，其中所述钉仓包括具有纵向狭槽的仓体、平台表面、穿过所述平台表面开口的多个钉凹坑、可移除地储存在每个钉凹坑中的钉、以及被构造成能够在由所述第一外科缝合装置的第一击发构件驱动时从所述仓体击发所述钉的滑动件，其中所述第一外科缝合装置还包括第一闭锁臂，所述第一闭锁臂能够从第一钳口锁定位置运动到第一钳口闭合位置，其中在所述第一钳口锁定位置处所述第一闭锁臂防止所述第一钳口从所述第一打开位置运动到所述第一闭合位置，其中在所述第一钳口闭合位置处所述第一钳口能够从所述第一打开位置运动到所述第一闭合位置，并且其中所述保持器包括：
保持器主体，所述保持器主体被构造能够可移除地附接到所述仓体，其中所述保持器主体的尺寸被设定成覆盖所述平台表面和所述钉凹坑以形成仓组件；以及
第一验证斜坡，所述第一验证斜坡被构造成能够在所述仓组件安置在所述第一外科缝合装置中并且所述保持器从所述仓体移除时使所述第一闭锁臂从所述第一钳口锁定位置运动到所述第一钳口闭合位置。
21.根据权利要求20所述的保持器，其中，所述第一验证斜坡包括：
第一近侧凸轮表面，所述第一近侧凸轮表面被构造成能够在所述仓组件最初插入所述第一外科缝合装置中时接合所述第一闭锁臂，其中所述第一近侧凸轮表面使所述第一闭锁臂从所述第一钳口锁定位置运动到第一中间位置；以及
第一远侧凸轮表面，所述第一远侧凸轮表面被构造成能够在所述第一闭锁臂处于所述第一中间位置时接合所述第一闭锁臂，其中当所述仓组件安置在所述第一框架中时，所述第一远侧凸轮表面使所述第一闭锁臂从所述第一中间位置运动到所述第一钳口闭合位置。
22.根据权利要求20所述的保持器，其中，所述钉仓被构造能够与包括第二钳口、第二框架和第二闭锁臂的第二外科缝合装置一起使用，其中所述第二钳口能够相对于所述第二框架在第二开口位置与第二闭合位置之间运动，其中所述第二闭锁臂能够从第二钳口锁定位置运动到第二钳口闭合位置，其中在所述第二钳口闭合位置处所述第二钳口能够从所述第二打开位置运动到所述第二闭合位置，其中所述保持器还包括从所述保持器主体的近侧端部突出的第二验证斜坡，并且其中所述第二验证斜坡被构造成能够在所述仓组件安置在所述第二外科缝合装置中并且所述保持器从所述仓体移除时使所述第二闭锁臂从所述第二钳口锁定位置运动到所述第二钳口闭合位置。
23.根据权利要求22所述的保持器，其中，所述第一框架限定第一框架轴线，其中所述第一闭锁臂被枢转地支撑在所述第一框架轴线的第一侧上，其中所述第二框架限定第二框架轴线，其中所述第二闭锁臂被枢转地支撑在所述第二框架轴线的相对第二侧上，其中当所述仓组件支撑在所述第一框架中时，所述保持器限定与所述第一框架轴线在竖直方向上对准的保持器轴线，其中当所述仓组件支撑在所述第二框架中时，所述保持器轴线与所述第二框架轴线在竖直方向上对准，其中所述第一验证斜坡位于所述保持器轴线的第一侧上，并且其中所述第二验证斜坡位于所述保持器轴线的第二侧上。
24.根据权利要求22所述的保持器，其中，所述第一验证斜坡包括：
第一近侧凸轮表面，所述第一近侧凸轮表面被构造成能够在所述钉仓最初插入所述第一外科缝合装置中时接合所述第一闭锁臂，其中所述第一近侧凸轮表面使所述第一闭锁臂从所述第一钳口锁定位置运动到第一中间位置；以及
第一远侧凸轮表面，所述第一远侧凸轮表面被构造成能够在所述第一闭锁臂处于所述第一中间位置时接合所述第一闭锁臂，其中当所述仓组件安置在所述第一框架中时，所述第一远侧凸轮表面使所述第一闭锁臂从所述第一中间位置运动到所述第一钳口闭合位置，并且其中所述第二验证斜坡包括：
第二近侧凸轮表面，所述第二近侧凸轮表面被构造成能够在所述钉仓最初插入所述第二外科缝合装置中时接合所述第二闭锁臂，其中所述第二近侧凸轮表面使所述第二闭锁臂从所述第二钳口锁定位置运动到第二中间位置；以及
第二远侧凸轮表面，所述第二远侧凸轮表面被构造成能够在所述第二闭锁臂处于所述第二中间位置时接合所述第二闭锁臂，其中当所述仓组件安置在所述第二框架中时，所述第二远侧凸轮表面使所述第二闭锁臂从所述第二中间位置运动到所述第二钳口闭合位置。
25.根据权利要求24所述的保持器，其中，所述第一近侧凸轮表面位于所述第一远侧凸轮表面的近侧并且从所述第一远侧凸轮表面在竖直方向上偏离，并且其中所述第二近侧凸轮表面位于所述第二远侧凸轮表面的近侧并且从所述第二远侧凸轮表面在竖直方向上偏离。
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