CN114025687A - 具有验证键的钉仓保持器系统 - Google Patents
具有验证键的钉仓保持器系统 Download PDFInfo
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- CN114025687A CN114025687A CN202080047405.4A CN202080047405A CN114025687A CN 114025687 A CN114025687 A CN 114025687A CN 202080047405 A CN202080047405 A CN 202080047405A CN 114025687 A CN114025687 A CN 114025687A
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- retainer
- staple cartridge
- cartridge
- surgical stapling
- assembly
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Abstract
本发明公开了一种用于与钉仓一起使用的保持器系统，该钉仓被构造成能够与外科缝合装置一起使用。保持器包括保持器主体，该保持器主体被构造成能够通过保持特征部附接到该钉仓。该系统包括使这些保持特征部在第一状态与第二状态之间运动的工具，在该第一状态下，这些保持特征部防止该保持器附接到该钉仓，在该第二状态下，该保持器可通过这些保持特征部联接到该钉仓。
Description
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；
图78C为图78B的钉仓实施方案的顶视图；
图79为另一保持器实施方案的透视图；
图80为图79的保持器实施方案的底部透视图；
图81为图79的保持器实施方案的另一底部透视图，其中从其移除了易损保持插片；
图82为另一保持器实施方案和钉仓的透视组装视图；
图83为图82的保持器和钉仓的分解横截面组装视图；
图84为联接在一起以形成安置在外科缝合装置的框架中的仓组件的图82的保持器和钉仓的横截面端视图；
图85为安置在图84的框架中的图84的仓组件的局部横截面透视图；
图86为钉仓的鼻部部分的局部透视图；
图87为另一钉仓的鼻部部分的局部透视图；
图88为另一钉仓的鼻部部分的局部透视图；
图89为另一钉仓的鼻部部分的局部透视图；
图90为另一钉仓的鼻部部分的局部透视图；
图91为另一钉仓的鼻部部分的局部透视图；
图92为另一钉仓的鼻部部分的局部透视图；
图93为外科缝合装置的一部分的侧视图，其示出了安置在外科缝合装置的框架中的兼容钉仓和兼容保持器；
图94为图93的外科缝合装置的另一侧视图，其中不兼容的钉仓和不兼容的保持器安置在该装置的框架中；
图95为具有可脱离验证键的另一保持器实施方案的透视图；
图96为图95的保持器的另一透视图，其中可脱离验证键与保持器的主体部分脱离并拴系到其；
图97为另一保持器实施方案的底视图；
图98为在使用之前图97的保持器的一部分的横截面视图；
图99为图97的保持器的该部分在保持器已被使用并从钉仓移除之后的另一横截面视图；
图100为保持器组件实施方案的近侧透视图；
图101为图100的保持器组件和钉仓的分解组装视图；
图102为图100的保持器组件的另一近侧透视图；
图103为图100的保持器组件的底部透视图；
图104为安装到钉仓以形成仓组件的图100的保持器组件的透视图；
图105为安装到钉仓以形成仓组件的另一保持器组件实施方案的透视图；
图106为图105的仓组件的分解透视组装视图；
图107为支撑图105的仓组件的外科缝合装置的一部分的局部透视图，其示出了从仓组件中移除保持器盖；
图108为安置在外科缝合装置的框架中的仓组件的侧视图，其中该仓组件包括可移除地联接到钉仓的另一保持器；
图109为另一保持器实施方案的近侧端部的底视图；
图110A为另一保持器实施方案的近侧端部的顶视图，其中该保持器的验证键处于第一位置；
图110B为图110A的保持器的另一顶视图，其中验证键处于第二位置，使保持器不可重复使用；
图111为另一保持器实施方案的近侧端部的底视图；
图112为另一保持器实施方案的近侧端部的底视图；
图113为沿图112的线113-113截取的图112的保持器的验证键的横截面视图；
图114为另一保持器实施方案组合的图解视图；
图115为图114的保持器实施方案的另一视图；
图116为被夹持在缝合装置的钳口之间的图114的保持器实施方案的图解视图；
图117为另一保持器实施方案的顶视图；
图118为图117的保持器的另一顶视图，其示出了横截面中的一些部分；
图119为示出了将图117的保持器初始安装到钉仓上的局部透视组装视图；
图120为示出了安装在图119的钉仓上的图117的保持器的另一局部透视图；
图121为图120的保持器和钉仓组件的近侧端部视图；
图122为安装在钉仓上的另一保持器实施方案的侧正视图，其中保持器的一部分以横截面示出，并且其验证键处于回缩位置；
图123为图122的保持器和钉仓的另一侧正视图，其中保持器的验证键从保持器上的键外壳向近侧突出；
图124为图123的保持器和钉仓的一部分的放大视图；
图125为图124的保持器和钉仓的部分的放大横截面视图，其中柱塞致动器处于下压位置以将保持器从钉仓脱离；
图126为图125的柱塞致动器的放大视图；
图127为另一保持器实施方案的近侧端部的透视图；
图128为示出了联接到未击发钉仓的图127的保持器的透视图；
图129为图128的保持器的一部分相对于图128的未击发钉仓的滑动件的分解组装视图；
图130为另一保持器实施方案的顶视图，其中该保持器的验证键处于延伸致动位置，为清楚起见省略了该保持器的一些特征部；
图131为图130的保持器的侧视图，其中该保持器的验证键处于回缩位置；
图132为保持器系统的分解组装视图；
图133为图132的保持器系统的保持器的局部横截面视图；
图134为支撑在钉仓上的图132的保持器系统的保持器工具的横截面组装视图；
图135为图132的保持器系统的另一分解组装视图，其示出了用于最初将保持器安装到钉仓上的保持器工具；
图136为另一分解组装视图，其示出了最初安装在图135的钉仓上的保持器，其中保持器工具从该保持器和该钉仓之间抽出；
图137为另一保持器系统的分解组装视图；
图138为示出在安装在钉仓上之前插入图137的系统的保持器中的图137的系统中工具的底部透视组装视图；
图139为插入图138的保持器中的图138的工具的横截面视图，其中该保持器安置在钉仓上；
图140为另一保持器实施方案的一部分的侧正视图；
图141为图140的保持器实施方案的一部分的底视图；
图142为另一保持器实施方案和外科缝合装置的分解组装视图；
图143为示出了附接到安置在图143的缝合装置的框架中的钉仓的图142的保持器的透视图；
图144为图143的保持器和缝合装置的侧正视图，其中该保持器的脱离构件的运动以虚线示出；
图145为示出了安装在图144的缝合装置中的图144的保持器的验证键位置的局部侧视图；
图146为图145的保持器和缝合装置的局部顶视图，其示出了钉仓/保持器组件初始插入该缝合装置中；
图147为安置在图146的缝合装置中的图146的钉仓/保持器组件的另一局部顶视图，并且其中保持器的验证键使该缝合装置的闭锁件失效；和
图148为用于向安装在外科缝合装置的框架中的用尽的钉仓的鼻部施加撬动运动的另一保持器实施方案的侧视图。
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“SURGICAL STAPLING ASSEMBLY WITH CARTRIDGE BASED RETAINERCONFIGURED TO UNLOCK A CLOSURE LOCKOUT”的美国专利申请，代理人案卷号END9170USNP3/190162-3；
-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“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；和
-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；和
-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；和
-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示出了从外壳1012或柄部1014脱离的可互换轴组件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被构造成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所描绘的先前外壳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可被构造成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能够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用于将闭合触发器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构造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也可在本文中被称为“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成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被构造成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，功率源1090可为可更换的和/或可再充电的。
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可操作地相互作用的可旋转轴(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沿一个方向旋转时，驱动构件1120将在远侧方向“DD”上被轴向地驱动。当马达82沿相反的旋转方向被驱动时，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可在未致动位置与致动位置之间枢转。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具有在其上形成的一齿条的齿1122，用于与齿轮减速器组件1084的相应驱动齿轮1086啮合。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“POWEREDSURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRINGSYSTEM”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收枢轴销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收在形成在细长框架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竖直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收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收形成在细长框架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到底座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包括被构造成能够附接到附接销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包括被构造成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收远侧刀杆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。此类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。在至少一种情况下，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，并且因此，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可包括被构造成能够检测切换筒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收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，从而以安置方式将附接部分1244接收在其中。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被接收在纵向驱动构件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于底座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。在该情况下，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中可以最具体地看出，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收狭槽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被构造成能够与控制电路板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，以接收在形成在细长框架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收在形成在细长框架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相互作用，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)相互作用，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相互作用的其他方法。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相互作用，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，其被构造成能够接收在第一钳口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相互作用，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，支腿朝向砧座竖直地取向。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完成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收从击发构件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被接收在第一闭锁臂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收在该平台表面上。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收击发构件主体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收在外科钉仓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完成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朝远侧推进完成钉击发行程。
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可操作地相互作用，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”位置时在其中接收弹簧插片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的任何无意的朝远侧运动，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竖直运动。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锁定件，否则将防止击发构件朝远侧推进完成钉击发行程。
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)相互作用，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相互作用，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，其被构造成能够接收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收在该平台表面上，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收击发构件主体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可操作地相互作用，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被构造成能够接收在第一钳口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相互作用，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收在设置在框架侧壁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收在该平台表面上，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相互作用，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被接收在框架侧壁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相互作用所需的空间在砧座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锁定臂的远侧端部。
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朝远侧推进完成钉击发行程。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收在设置在仓盘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)相互作用，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，其被构造成能够接收在第一钳口或框架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相互作用，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收在设置在框架侧壁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收在该平台表面上。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收击发构件主体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相互作用，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相互作用。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收在外科钉仓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被接收在框架侧壁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朝远侧推进完成钉击发行程。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相互作用的其他方法。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相互作用，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，其被构造成能够接收在第一钳口或框架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收从击发构件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被接收在第一闭锁臂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收击发构件主体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朝远侧推进完成钉击发行程。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，并且采用分级和竖直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，其被构造成能够接收在第一钳口或框架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相互作用，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由不锈钢等制成，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竖直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推进完成击发行程。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。
图79至图81描绘了保持器10400的一种形式，其被构造成能够可移除地联接到例如在图6中所描绘类型的钉仓4200。在各种实施方案中，保持器10400包括顶部部分10402，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收在该平台表面上，使得当保持器10400附接到仓体4202时，保持器10400覆盖仓体4202中的所有钉凹坑4208。保持器10400可由聚合物材料模制而成，并且包括从保持器10400的每个侧面向下突出的多个横向保持特征部。在例示的示例中，两个横向保持器凸耳组件10410与保持器10400的一般中心部分相关联。每个横向保持凸耳组件10410被模制到保持器10400的对应侧面部分中，使得保持臂10412在保持器10400的底表面10403下方向下延伸。在例示的示例中，每个保持臂10412从在顶表面10402上方延伸的对应侧凸台部分10414延伸。此类布置用于提供具有足够强度的保持器凸耳组件10410，同时提供保持臂10412中的每一者在将保持器10400附接到钉仓4200以及从其移除保持器10400期间稍微向外挠曲的能力。每个保持臂10412对应于保持器的底表面10403中的凹口10405，并且包括模制在其端部上的卡扣特征部10416。卡扣特征部10416被构造成能够锁定地接合形成于仓体4202上或钉仓4200的其他部分上的平台凸部部分4205的对应部分。
仍然参见图79至图81，保持器10400可包括横向保持器臂10480和10484形式的附加横向保持特征部，这些横向保持臂从保持器10400的每个侧面向下延伸并且远离横向保持器凸耳组件10410。每个横向保持器臂10480包括形成于其端部上的卡扣特征部10482。每个横向保持器臂10484包括插片，该插片包括被构造成能够接合钉仓4200的对应侧的成角度端部部分10486。保持器10400还包括成角度鼻部部分10420和远侧闩锁插片10422。远侧闩锁插片10422包括向内延伸的唇缘10424，该唇缘被构造成能够闩锁接合仓体4202的远侧鼻部4203。
如在图80和图81中可见，保持器10400另外包括近侧龙骨特征部10470、中心龙骨特征部10472和远侧龙骨特征部10474，这些特征部彼此轴向对准并从保持器主体的底表面10403突出。近侧龙骨特征部10470、中心龙骨特征部10472和远侧龙骨特征部10474被构造成能够插入钉仓4200中的纵向狭槽4206中。近侧龙骨特征部10470、中心龙骨特征部10472和远侧龙骨特征部10474用于确保保持器在钉仓4200上正确地对准，以促进保持器的附接和脱离，并确保保持器验证键10430被正确地定位成用于与该仓和保持器组件所安置在的缝合装置的解锁特征部接合。近侧龙骨特征部10470、中心龙骨特征部10472和远侧龙骨特征部10474可以相对于仓体42020中的纵向狭槽4206设定尺寸，以与其建立摩擦配合。另外，近侧龙骨特征部10472可以用于将钉仓中的滑动件保持在未击发位置。
同样，在至少一种布置中，一系列易损保持器插片被模制到保持器10400的底表面上，该底表面位于近侧龙骨10470与中心龙骨10472之间以及中心龙骨10472与远侧龙骨10474之间。更具体地且参考图80，在近侧龙骨10470与中心龙骨10472之间采用了四个易损保持插片，并且在中心龙骨10472与远侧龙骨10474之间采用了四个易损保持插片。然而，可以采用其他数量的易损保持插片。在例示的示例中，每系列易损保持插片包括两个右保持插片10490R和两个左保持插片10490L。每个右保持插片10490R和每个左保持插片10490L通过对应易损接头10492附接到保持器10400的底表面10403，该易损接头有助于保持插片10490R、10490L从保持器10400的选择性移除。每个右保持插片10490R被取向成插入钉仓4200的纵向狭槽4206中，并且具有向左成角度的偏压以摩擦地接合纵向狭槽4206的左侧壁。每个左保持插片10490L被取向成插入钉仓4200的纵向狭槽4206中，并且具有向右成角度的偏压以摩擦接合纵向狭槽4206的右侧壁。因此，右保持插片10490R和左保持插片10490L沿相反方向向下成角度。当右保持插片10490R和左保持插片10490L插入纵向狭槽4206中时，它们摩擦接合狭槽4206的相对侧壁，以进一步将保持器10400固定地附连到钉仓4200。
如本文所用，术语“易损接头”是指被构造成能够促进插片从保持器的主体脱离的接头。此类接头可包括与其附接到的插片/主体部分的剩余横截面相比减小的横截面区域。在其他布置中，易损接头可由具有与保持器主体材料特性不同特性的材料制成。此类特性可能会导致用户容易使接头被破坏。在所有此类情况下，一旦易损接头已被破坏并且插片从保持器主体脱离，就无法将插片重新附接到主体以供用户重复使用。此类易损接头/附接特征部布置可与采用可移除夹具或能够重新附接到保持器以促进其重复使用的其他特征部的其他保持器布置区分开。
保持器10400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10422上的向内延伸的唇缘10424与远侧鼻部4203的端部接合并且对准保持器10400，使得保持器顶部10402的下侧面对仓平台表面4204和近侧龙骨特征部10470、中心龙骨特征部10472、远侧龙骨特征部10474，并且易损保持插片10490R、10490L与钉仓4200中的纵向狭槽4206对准。此后，保持器10400可被压向钉仓4200，从而使保持器臂10412、10480、10484横向向外挠曲并且卡扣成与钉仓体4202的对应部分闩锁接合。当保持器10400向下压时，成角度的易损保持插片10490R、10490L摩擦地接合纵向狭槽4206的侧壁。保持插片10490R、10490L以及保持器臂10412、10480、10484将保持器10400附连到钉仓4200。
保持器10400可通过以下方式从钉仓4200移除：朝远侧闩锁插片10422施加撬动运动并且向上提升保持器10400，直到保持插片10490R、10490L和保持臂10412、10480、10484与仓4200脱离接合。在例示的示例中，术语“LIFT”被模制、压印到鼻部部分10420中以向用户提供移除指令。在各种情况下，保持器10400可以在使用与保持器材料兼容的常规清洁和消毒方法清洁和重新消毒之后在另一钉仓上重复使用。保持器的附接和移除以及重新消毒可能会随着时间的推移使保持器退化，直到保持器10400变得不可靠。此时，可以丢弃保持器10400以换取新的保持器。按照这样的过程，用户可以在每次使用之后移除易损保持插片10490R、10490L中的一者或多者，直到所有易损保持插片10490R、10490L都已被移除，此时应当丢弃保持器10400。参见图81。
在例示的示例中，保持器10400包括验证键10430，该验证键在构造和操作中类似于验证键6430。上文详细描述了验证键6430的构造和操作，并且这里将不重复。然而，在替代构型中，保持器10400可以由本文公开的各种验证键/验证斜坡布置中的任一种形成。
在某些情况下，一些保持器被设计成容易地安装到兼容钉仓上以及从其移除。许多保持器通常由仓制造商安装，其中制造商可以确保保持器与特定钉仓匹配，该特定钉仓与特定缝合装置兼容使用。一旦将保持器从钉仓移除并且已使用钉仓，就可以丢弃保持器以及用尽的钉仓。然而，在一些情况下，钉仓以及保持器可以被“再处理”以在另一缝合程序和/或另一缝合装置中重新使用。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。此外，当使用再处理保持器时，重要的是将该保持器附接到与特定缝合装置兼容或匹配的钉仓。例如，如果再处理保持器无意中附接到与特定缝合装置不兼容的钉仓，并且仓组件被安置到装置中以在其中使各种闭锁件失效，则用户可能随后在无意中击发安装了不适当的仓的装置。因此，本文公开的一些保持器被设计成使用一次或有限次数来减少其在不兼容或不适当的钉仓上重复使用的机会。
图82至图85描绘了保持器11400的一种形式，其被构造成能够可移除地联接到例如在图6中所描绘类型的钉仓4200。在各种实施方案中，保持器11400包括顶部部分11402，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收在该平台表面上，使得当保持器11400附接到仓体4202时，保持器11400覆盖仓体4202中的所有钉凹坑4208。保持器11400可由聚合物材料模制而成，并且包括从保持器11400的每个侧面向下突出的多个横向保持特征部。在例示的示例中，三个横向保持器凸耳组件11410与保持器11400的中心部分相关联。每个横向保持凸耳组件11410被模制到保持器11400的对应侧面部分中，使得保持臂11412在保持器11400的底表面11403下方向下延伸。在例示的示例中，每个保持臂11412从对应侧凸台部分11414延伸。此类布置用于提供具有足够强度的保持器凸耳组件11410，同时提供保持臂11412中的每一者在将保持器11400附接到钉仓4200以及从其移除保持器11400期间稍微向外挠曲的能力。每个保持臂11412对应于底表面11403中的凹口，并且具有模制在其端部上的卡扣特征部11416。卡扣特征部11416被构造成能够锁定地接合形成于仓体4202上的凸部4205的对应部分。仓体4202可以形成有成角度表面4011，以促进卡扣特征部在凸部4205下的闩锁，如图84所示。卡扣特征部11416还可被构造成能够接合仓体4202的其他部分。
仍然参见图82，保持器11400另外包括近侧龙骨特征部11470和远侧龙骨特征部11474，这些特征部彼此轴向对准并从保持器主体的底表面11403突出。近侧龙骨特征部11470和远侧龙骨特征部11474被构造成能够插入钉仓4200中的纵向狭槽4206中。近侧龙骨特征部11470和远侧龙骨特征部11474用于确保保持器11400在钉仓4200上正确地对准，以促进保持器11400的附接和脱离，并确保保持器验证键11430被正确地定位成用于与仓组件所安置在的缝合装置的解锁特征部接合。近侧龙骨特征部11470和远侧龙骨特征部11474可以相对于仓狭槽4206设定尺寸，以与其建立摩擦配合。近侧龙骨特征部11470还可被构造成能够在保持器11400联接到钉仓4200时将该钉仓中的滑动件保持在未击发位置。
同样，在至少一种布置中，一系列可释放保持构件被模制到近侧龙骨11470与远侧龙骨11474之间的底表面上。在例示的布置中，两对右可释放保持构件和左可释放保持构件定位在近侧龙骨11470与远侧龙骨11474之间。每对包括右可释放保持构件11480R和左可释放保持构件11480L。每个右可释放保持构件11480R模制有向左成角度的偏压(当从保持器的远侧端部观察时)，并且每个左可释放保持构件11480L模制有向右成角度的偏压。参见图83。每个右可释放保持构件11480R模制有右侧底部闩锁特征部11481R，该右侧底部闩锁特征部具有终止于相对钝的右尖端11483R的“右”成角度表面11482R。右中心凸耳11484R相对于每个右侧底部闩锁特征部11481R模制以在其间限定空间11485R，该空间的尺寸被设定成在其间接收仓盘4220的一部分。类似地，每个左可释放保持构件11480L模制有左侧底部闩锁特征部11481L，该左侧底部闩锁特征部具有终止于相对钝的左尖端11483L的“左”成角度表面11482L。左中心凸耳11484L相对于每个左侧底部闩锁特征部11481L模制以在其间限定空间11485L，该空间的尺寸被设定成在其间接收仓盘4220的一部分。
如图82中还可以看出，保持器11400还包括两对保持插片，该两对保持插片在所述对右可释放保持构件和左可释放保持构件之间取向。每对包括右保持插片11490R和左保持插片11490L。每个右保持插片11490R被取向成插入钉仓4200的纵向狭槽4206中，并且具有向左成角度的偏压，以使得右保持插片11490R能够摩擦地接合纵向狭槽4206的左侧壁。每个左保持插片11490L被取向成插入钉仓4200的纵向狭槽4206中，并且具有向右成角度的偏压，以使得左保持插片11490L能够摩擦地接合纵向狭槽4206的右侧壁。因此，如右可释放保持构件和左可释放保持构件，右保持插片11490R和左保持插片11490L沿相反方向向下成角度。当将右保持插片11490R和左保持插片11490L插入纵向狭槽4206中时，它们摩擦地接合仓狭槽4206的相对侧壁，以进一步将保持器11400固定地附连到钉仓4200。
现在参见图82至图84，保持器11400可通过以下方式可移除地联接到钉仓4200：将与远侧闩锁插片11422相关联的向内延伸的唇缘(未示出)与远侧鼻部4203的端部接合并且对准保持器11400，使得顶部11402的下侧面对仓平台表面4204，并且右可释放保持构件和左可释放保持构件11480R、11480L的尖端11483R、11483L插入钉仓4200中的纵向狭槽4206中。然后向保持器11400施加安装力“IF”以将该保持器向下压到钉仓4200上。当保持器11400向下推进到仓4200上时，右可释放保持构件11480R和左可释放保持构件11480L以及右保持插片11490R和左保持插片11490L可滑动地接合狭槽4206的相对壁4207L、4207R。如图83所示，
卡扣特征部11416中的每一者都包括成角度表面11417，该成角度表面被构造成能够接触仓4200上的凸部4205，并且枢转卡扣特征部11416横向向外以与凸部4205卡扣接合。继续向下推进保持器11400使得右可释放保持构件11480R和左可释放保持构件11480L的尖端11483R、11483L分别进入仓盘4220中的狭槽4221并且卡扣成与其接合，使得仓盘4220被接收在空间11485R、11485L中。当保持器11400附接到钉仓4200时，该组件包括“仓组件”11500。
图84和图85示出了将仓组件11500安装到缝合装置4002的第一钳口或框架4010中。如在图83和图85中可见，当仓组件11500插入框架4010中并在其中向下推动时(箭头IF)，卡扣特征部11416上的成角度表面11417可滑动地接触框架4010上的成角度表面11417，并且将卡扣特征部11416横向向外偏压(图84中的箭头L)，从而使卡扣特征部11416与钉仓4200上的凸部4205脱离接合。此外，右可释放保持构件11480R和左可释放保持构件11480L上的成角度表面11482R、11482L分别接触框架4010的底部中的通道狭槽4209的边缘，这使得右可释放保持构件11480R和左可释放保持构件11480L与仓盘4220脱离接合。然后，用户可以向保持器11400的远侧端部上的远侧闩锁插片11422施加撬动力，并且将保持器11400从现在安置在通道4010中的仓4200撬出。远侧闩锁插片11422从保持器11400的成角度鼻部部分11420朝远侧延伸。在各种布置中，右可释放保持构件11480R和左可释放保持构件11480L模制有相对强的成角度偏压，这使得保持器11400难以重新安装在另一钉仓上。在例示的示例中，保持器11400包括验证键11430，该验证键被构造成能够使外科缝合装置4002的闭锁件失效。保持器11400还可被构造成能够在与本文公开的任何外科钉仓兼容的其他钉仓上使用。在此类情况下，保持器11400将设置有验证键11430，该验证键与要和其一起使用的特定外科缝合装置的闭锁件兼容。
在各种情况下，期望用户确保在特定外科缝合装置中采用的钉仓是可靠的或与外科缝合装置兼容。例如，在许多情况下，由外科缝合装置的相同制造商制造的那些仓通常与那些缝合装置兼容。例如，为了向用户提供关于钉仓4200的制造商的身份的指示，例如，可以在钉仓4200的鼻部4203或其他部分上提供制造商的徽标4260或来源指示符标记。可以向外科缝合装置的每个组件以及钉仓和保持器的每个组件施加此类来源指示符标记。在图86所描绘的示例中，徽标4260被压印到鼻部4203上。在图87所描绘的示例中，徽标4260被凹入远侧鼻部4203的一部分中。图88和图89示出了设置在仓平台4204的远侧部分上的另一徽标或来源指示符标记4262。在图88所描绘的示例中，徽标4262被压印到平台4204上。在图89所描绘的示例中，徽标4262被凹入平台4204中。图90示出了在其上没有来源指示符标记的钉仓4200的鼻部4203。图91示出了钉仓4200的鼻部4203'，该鼻部设置有独特形状(其可与制造商或与特定类型的仓相关联)，并且还具有设置在仓平台4204上的徽标/来源指示符4264。图92示出了钉仓4200的另一鼻部构型4203”，该另一鼻部构型设置有独特形状，以向用户提供关于仓的来源的指示。
在各种情况下，还期望确保与钉仓结合使用的保持器是可靠的或与该仓和外科缝合装置兼容。在图91和图92的示例中，兼容保持器的鼻部部分的下侧可形成有与鼻部构型4203'、4203”配合或匹配的特征部，使得当保持器附接到那些仓时，向用户提供关于该保持器是否与这些钉仓匹配或换言之是否兼容的指示。图93描绘了另一示例，其中外科缝合装置11002的框架11010具有印刷或压印在其上的徽标或来源标记11260的底部部分11262。兼容钉仓11200具有印刷在仓11200的平台凸部11205的一侧上的徽标11260的中间部分11264。兼容保持器11400'具有印刷或形成在其上的徽标11260的顶部部分11266。因此，当如图93所示组装在一起时，框架11010上的标记11262、钉仓11200上的标记11264以及保持器11400'上的标记11266配合形成完整的徽标11260“ETHICON”或其他名称或徽标，以向用户提供了所有三个组件来自同一来源并且彼此兼容的确认。图94示出了钉仓11200'和保持器11400”的使用，它们可能彼此不兼容并且与缝合装置11202不兼容。如在图94中可见，保持器11400”和钉仓11200'在其上不具有标记以形成完整的徽标11260。上文所描述的各种标记可以被模制到(塑料)部件中、移印激光蚀刻、化学标记或被机械加工到部件/零件中。这些标记可以凹入或从其所位于的表面突出。例如，可以采用此类标记来增加距离或显示长度。
图95和图96示出了保持器12400，该保持器在许多方面与上文讨论的保持器4400相同。保持器12400包括可移除地联接到保持器主体12402的验证键组件12430。验证键组件12430包括键体部分12432和从键体部分12432向近侧突出的键斜坡12440。验证键组件12430可以包括本文公开的验证键/斜坡布置中的任一种。在至少一种布置中，验证键组件12430通过易损接头12435附接到保持器主体12402，使得用户能够在使用之后将验证键组件12430从保持器主体12402脱离。因此，一旦以本文公开的各种方式使用了保持器12400，保持器12400就从钉仓移除，并且用户然后将验证键组件12430从保持器主体脱离，从而使保持器12400成为“一次性”保持器。在至少一种布置中，系链12437将脱离的验证键组件12430附接到保持器主体12402，以防止脱离的验证键组件12430丢失。参见图87。本文公开的各种保持器主体构型中的任一种都可配备有验证键组件，该验证键组件通过易损或以其他方式可分离的接头可移除地联接到该保持器主体，从而使保持器成为“一次性”保持器。此类保持器布置可以或可以不以另外的方式采用易损保持构件/插片/臂，这些易损保持构件/插片/臂被构造成能够将保持器附接到钉仓并且此后在使用之后从钉仓移除。
图97示出了另一个一次性保持器13400，该一次性保持器在许多方面与上述保持器10400非常类似。在沿保持器主体13402的中心横截面的一个或多个位置中，一个或多个狭缝13405设置在保持器主体13402的底表面13403中。图98示出了在图97中指示的位置处的保持器13400的一部分的横截面视图(已经省略了保持特征部)，例如，示出了狭缝13405。狭缝13405仅部分地向上延伸到保持器主体13402中，使得在以本文公开的方式将保持器安装到钉仓上以形成仓组件期间，保持器主体13402保持足够刚性的横截面构型，以确保验证键13430被正确地取向，以便使该仓组件所安置在的缝合装置的闭锁件失效。然而，在以本文公开的各种方式移除保持器13400期间，狭缝13405可能充分削弱保持器主体13402，使得保持器主体13402呈现图99中所示的非平面构型或类似的不可用构型，其防止保持器13400在另一钉仓上重复使用。本文公开的各种保持器主体构型中的任一种都可以上述方式设置有至少一个狭缝以使保持器成为一次性保持器。此外，可以在保持器13400上采用本文公开的验证键布置中的任一种。
图100至图104示出了可以与外科钉仓4200或其他合适的钉仓布置结合使用的另一保持器组件14400。如在图101中可见，保持器组件14400包括保持器基座14500，该保持器基座被构造成能够可移除地安装在保持器盖14600内。保持器基座14500包括内部主体14502，该内部主体包括从保持器鼻部特征部14503突出的两个侧壁14504，该保持器鼻部特征部被构造成能够插入钉仓4200的鼻部4203上方。侧壁14504通过近侧桥接件14506连接，该近侧桥接件被构造成能够被安置在仓平台4204的近侧部分上。另外，验证键14530从近侧桥接件14506的端部向近侧延伸。验证键14530可包括本文公开的验证键布置中的任一种，这取决于其要与之一起采用的特定外科缝合装置。
保持器盖14600包括盖顶部14602和两个盖侧壁14604，这些部分具有形成于其中的一系列盖附接特征部或附接凸耳14606，以可释放地接合保持器基座14500的侧壁14504。远侧闩锁插片14608形成于保持器盖14600的远侧端部上，以辅助移除保持器盖14600。在使用中，保持器盖14600可以卡扣在保持器基座14500上方，使得附接凸耳14606锁定地接合侧壁14504的下侧，如图100所示。当保持器盖14600和保持器基座14500联接在一起时，该组件可被称为“保持器组件”14700。通过将保持器鼻部特征部14503插入钉仓4200的鼻部4203上方来将保持器组件14700安装到钉仓4200上。如图100中可见，龙骨14610形成于盖顶部14602的下侧上。龙骨14610被取向且尺寸被设定成在组装时被接收在钉仓4200中的纵向狭槽4206内。龙骨14610可以相对于纵向狭槽4206设定尺寸，以与其建立摩擦接合。另外，当保持器组件14700附接到钉仓4200时，龙骨14610可用于将滑动件保持在未击发位置。
当组装时，保持器盖14600完全覆盖钉仓4200并形成仓组件14702。参见图104。在一些情况下，钉仓4200的仓体4202以特定颜色模制来标记仓的类型或尺寸。在至少一种布置中，在保持器基座14500中提供了一个或多个窗口14505。窗口14505被构造成能够与保持器盖14600中的配合窗口14612重合以使得用户能够在保持器组件14700附接到钉仓4200或其他兼容钉仓时查看钉仓体4202。
一旦将保持器组件14700插入钉仓4200上以形成仓组件14702，就可以将仓组件14702插入外科缝合装置的通道中，以便通道的侧壁与盖侧壁14604中的附接凸耳14606之间的接触使盖附接特征部或附接凸耳14606与保持器基座14500脱离接合。另选地，可以在将仓组件14702安装在外科缝合装置的通道中之前通过朝远侧闩锁插片14608施加撬动运动来将保持器盖14600从保持器组件14700中移除。在任一情况下，在保持器盖14600已脱离之后，除去保持器盖14600的仓组件14702继续以本文所述的各种方式插入通道中，直到验证键特征部14530已使外科缝合装置的闭锁件失效、解锁或解除闩锁，并且仓组件14702安置在该通道中。如在图101中可见，保持器基座14500的侧壁14504不延伸到钉仓4200的底部，使得当仓组件14702安置在通道中时，钉仓侧面的部分暴露以接合闭锁件的闭锁臂的部分。然后，用户可以通过沿远侧方向拉动保持器基座14500而将保持器底座14500从钉仓4200拉出，留下钉仓4200可操作地安置在框架中，从而将闭锁件保持在解锁或钳口闭合位置，无论情况如何。
图105至图107示出了可以与外科钉仓4200或其他钉仓构型结合使用的另一保持器组件15400。如在图106中可见，保持器组件15400包括保持器基座15410，该保持器基座包括从保持器鼻部特征部15414突出的两个底部侧壁15412。保持器鼻部特征部15414被构造成能够插入钉仓4200的鼻部4203上方。底部侧壁15412通过近侧桥接件15416连接，该近侧桥接件被构造成能够被安置在钉仓平台4204的近侧部分上。另外，验证键15530从近侧桥接件15416的端部向近侧延伸。验证键15530可以包括本文公开的验证键布置中的任一种。保持器基座15410被构造成能够插入钉仓4200的鼻部4203上方。在至少一种布置中，可以在每个侧壁15412上形成一个或多个闩锁凸耳15413以接合仓体4202上的凸部4205。
保持器组件15400还包括保持器盖15600，该保持器盖通过一系列易损附接接头15604可移除地联接到保持器基座15410。在例示的布置中，保持器盖15600包括远侧闩锁插片15602和窗口15606。窗口15606被构造成能够使得用户当保持器组件15400附接到仓体4202时能够查看该仓体。当保持器组件15400附接到钉仓4200时，保持器组件15400覆盖了整个钉仓4200并且形成了仓组件15700。然后可以将仓组件15700插入外科缝合装置的框架中，使得近侧端部部分15608或保持器盖15600的其他部分与通道的侧壁或其他部分之间的接触引起易损附接接头15604破裂以允许保持器盖15600从保持器基座15410脱离。另选地，一旦仓组件15700已安置在外科缝合装置的通道中，用户就可以朝远侧闩锁插片15602施加撬动运动，以引起易损附接接头15604破裂以允许保持器盖15600从保持器基座15410移除。参见图107。在任一情况下，在保持器盖15600已脱离之后，仓/保持器基座组件继续以本文所述的各种方式插入通道中，直到例如验证键特征部15530已使外科缝合装置4002(或其他外科缝合装置)的闭锁件失效，并且仓组件15700安置在框架4010中。然后，用户可以通过沿远侧方向拉动保持器基座15410而将保持器底座15410从钉仓4200拉出，留下钉仓4200可操作地安置在框架4010中，从而将闭锁件保持在解锁或钳口闭合位置，无论情况如何。此类保持器组件15400可被称为“一次性”保持器。
图108示出了另一仓组件16500，该另一仓组件包括附接到钉仓4200的保持器16400。如在图108中可见，保持器16400包括保持器主体16402，该保持器主体被构造成能够延伸超过并覆盖仓平台4204。验证键16530形成于保持器主体16402的近侧端部上。验证键16530可包括本文公开的验证键布置中的任一种，这取决于要采用的特定外科缝合装置。如图108中进一步可见，脱离构件16406形成于保持器主体的远侧端部16404上。远侧端部16404包括钩在钉仓4200的鼻部4203上的鼻部附接部分16408。
在至少一种布置中，在制造商已经将钉装载到钉仓4200中之后，将保持器16400以图108所示的方式插入钉仓4200上方，并且鼻部附接部分16408上的下附接特征部16410暂时附接到仓鼻部4203以形成仓组件16500。例如，下附接特征部16410可以“热铆接”或塑料焊接到仓鼻部4203。在另一种布置中，附接特征部16410可以通过适当的粘合剂临时附接到仓鼻部或仓体4202，该适当的粘合剂将允许在需要时脱离保持器16400。在使用中，在仓组件16500已经安置在外科缝合装置4002的框架4010中并且验证键16530已使该外科缝合装置的闭锁件失效时，用户可以抓持脱离构件16406并且沿纵向远侧方向DD拉动保持器16400，这使得附接特征部16410与鼻部4203之间的接头切开或以其他方式被破坏以允许保持器16400从钉仓4200移除。
在其中可能期望防止本文公开的各种保持器中的任一种被再处理/重复使用的各种情况下，本文公开的各种验证键也可附接到具有接头布置的相应保持器主体部分，该接头布置允许验证键不可修复地被破坏或变形或从第一或正确的致动位置重新定位到让验证键无法使外科缝合装置中的闭锁件失效并且不完全从保持器的剩余部分脱离验证键的位置。例如，图109示出了保持器17400，该保持器包括保持器主体部分17402和验证键17430，该验证键通过可重新构造的铰链或接头布置17480附接到保持器主体部分17402的近侧端部17401。保持器主体17402可以与本文公开的各种保持器主体部分中的任一种相同并且能够通过本文公开的各种布置中的任一种可移除地附接到钉仓4200。验证键17430可包括本文公开的验证键布置中的任一种，这取决于要采用的特定外科缝合装置。
图110A至图110B示出了包括被切入验证键17430的底部的狭缝17482的可重新构造的接头或铰链布置17480。狭缝17482具有足够的深度以便削弱接头布置17480，从而使验证键17430能够在保持器17400已从钉仓4200移除而不完全从保持器主体17402脱离之后被重新构造为不可用的位置。
图111示出了另一可重新构造的接头布置，其包括由快速降解的聚合物材料制成的可重新构造的铰链或接头17480'，该快速降解的聚合物材料在一段时间之后将使验证键17430能够在初始使用之后被重新构造为不可用的构型。在此类布置中，保持器主体17402可以由第一聚合物材料制成。可重新构造的接头17480'可以由第二聚合物材料制成，诸如水解可降解材料，如聚乙醇酸，其以紧固件速率从第一聚合物材料降解。在其他布置中，第二材料可以包括羧基苯氧基聚酸酐，当包装开口和使用期间暴露于水分时，将会开始快速降解以充分削弱验证键接头以防止重复使用。可以基于所需的初始强度和降解速度“调整”材料特性。此外，如果再处理实体或其他用户试图重新使用验证键，则可以改变可降解聚合物材料的几何形状和量以增加验证键的降解效应(例如，增加的可降解聚合物的区域将允许断裂，但不完全破裂)。在另选的布置中，整个保持器可以由此类第二聚合物材料制成。此类材料组合物也可以与结合本文公开的其他易损接头布置描述的各种易损接头布置结合采用。
图112示出了验证键17430'，其中键17430'的部分17430A由浓度增加的可降解聚合物材料制成。图113示出了穿过验证键17430”的横截面，该验证键由可降解聚合物材料制成并且包括中空桁架元件17431”，该中空桁架元件有助于在降解期间削弱验证键17430”。
图114和图115以图解形式示出，另一保持器15400和验证键布置15430可以在初始使用之后被重新构造为不可用状况。如在图114中可见，保持器主体15402和验证键15430包括复合结构，该复合结构包括由更坚固的较厚件15405支撑在两侧的弱中心驻留部件15403。中心驻留部件15403构造有曲折路径，该曲折路径允许更坚固材料的薄腹板15407在制造期间连接，以向保持器15400提供结构完整性。那些腹板15407是低强度的并且与能够在初始使用期间将保持器15400保持在钉仓上的特征部连接，但是此后在移除保持器15400期间破裂。在这种情况下，例如，缝合装置钳口JA、JB的闭合可用于帮助移除保持器15400。参见图116。闭合钳口可以向保持器15400施加足够的负载/力，以使保持器破坏或变形。保持器15400还可包括嵌入式导线15409，其用于将验证键15430附接到保持器主体15402，以便在验证键15430从保持器主体15402断开时，它将通过导线15409保持附接到其上。参见图115。
在其他布置中，本文公开的保持器布置中的任一种都可以通过适当的粘合剂临时附连到未击发钉仓上。例如，粘合剂将把保持器附连到仓体上，但会断裂，从而允许保持器被用户从仓体上移除。
接下来转到图117至图121，示出了保持器18400。保持器18400被构造成能够可移除地联接到钉仓18200或与包括本文公开的各种类型的闭锁件的特定外科缝合装置兼容的其他钉仓，该闭锁件防止缝合装置操作，除非通过保持器或钉仓上的验证键使其失效、解锁或解除闩锁。在一种布置中，例如，保持器18400可以与钉仓18200一起使用，该钉仓与外科缝合装置6002兼容。钉仓18200包括仓体18204，该仓体包括被构造成能够容纳外科缝合装置的击发构件的纵向狭槽18206。钉仓18200还包括形成于仓体18202中的一系列钉凹坑18208。钉凹坑18208可以形成于位于纵向狭槽18206的每一侧上的偏置“线”中。每个钉凹坑18208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18202由其中模制或机加工有钉凹坑18208的聚合物材料模制而成。在一种布置结构中，钉凹坑18208还通过仓体18202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18208中。一旦驱动器和紧固件被插入其相应的钉凹坑18208中，则仓盘18220附接到仓体18202。在一种形式中，仓盘18220由金属材料制成并且包括跨越仓体18202的底部的底部18222。仓盘18220还包括对应于仓体18202的每一侧的两个直立侧壁18224。仓盘18220可通过钩18226能够移除地附连到仓体18202，该钩形成在侧壁18224上并且被构造成能够以钩的形式接合仓体18202的对应部分。
保持器18400包括顶部部分18403，该顶部部分与仓体18202的平台表面18204共同延伸并且被构造成能够接收在该平台表面上。因此，在至少一个构型中，当保持器18400附接到仓体18202时，保持器18400覆盖仓体4202中的所有钉凹坑18208。因此，当保持器18400附接到钉仓18200时，如果钉仓18200在使用之前倒置或上下颠倒，则保持器18400可防止储存在钉凹坑18208内的外科钉掉出。保持器主体18402可以包括本文公开的保持器主体布置中的任一种，使得保持器18400能够可移除地附接到钉仓18200。在一种布置结构中，保持器18400可由聚合物材料模制，并且包括多个保持器凸耳18410，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18205。参见图121。保持器18400另外包括保持器龙骨18470，该保持器龙骨从保持器主体部分18402的底表面突出并且被取向成接收在外科钉仓18200中的纵向狭槽18206内。保持器龙骨18470可相对于纵向狭槽18206设定尺寸，以便与其建立摩擦配合。保持器龙骨18470还可被构造成能够在保持器18400附接到仓18200时将该仓中的滑动件保持在未击发位置。
在例示的示例中，保持器18400包括可运动地支撑在保持器主体18402上的验证键18430，使得该验证键可在第一致动位置与回缩位置之间运动。验证键18430是L形的，其中一个支腿18440枢转地销连接到保持器主体18402和另一个支腿18442，该支腿包括斜坡特征部18446。验证键18430被支撑在键外壳18450内，该键外壳被模制或以其他方式附接到保持器主体18402的近侧端部18405。当验证键18430处于致动位置时，支腿18442从键外壳18450朝近侧突出，并且当验证键18430处于回缩位置时，验证键18430完全包含在键外壳18450内。在另一种布置中，当验证键18430处于回缩位置时，至少支腿18442不可操作地接收在键外壳18450内。如在图117和图118中可见，扭转弹簧或其他偏压构件18452安装在键外壳18450内，以将验证键18430偏压到回缩位置。
图119示出了原始制造商将保持器18400初始安装到钉仓18200上。在安装期间，验证键18430保持在致动位置，而保持器可移除地附接到钉仓18200。致动孔18448设置为穿过致动键18430的支腿18442，并且适于在其中接收从平台表面18204向上突出的保持器桩18209。当制造商将新的未使用的保持器18400安置在未击发仓18200上时，保持器桩18209被接收在支腿18442中的孔18448中以将验证键18430保持在致动位置。参见图120。当新的保持器18400附接到未击发钉仓18400时，所得的仓组件18500能够以本文公开的各种方式安置到外科缝合装置6002的框架6010中，使得验证键18430的支腿18442使外科缝合装置6002的闭锁件失效、解锁、解除闩锁。一旦仓组件18500已安置在外科缝合装置6002的框架6010中，并且已使该外科缝合装置的闭锁件失效、解锁、解除闩锁，用户然后就能够以本文公开的各种方式从钉仓18200移除保持器18400。此类动作使支腿18442与保持桩18209脱离接合。当支腿18442从保持桩18209移除时，扭转弹簧18452使验证键18430弹入键外壳18450中到回缩位置，在该位置中验证键18430可能不会被重新致动到致动位置。因此，保持器18400是一次性保持器，并且无法再次在另一钉仓上重复使用。
图122至图126示出了另一保持器19400，其被构造成能够可移除地联接到钉仓4200或与包括本文公开的各种类型的闭锁件的特定外科缝合装置兼容的其他钉仓。保持器19400包括顶部部分19403，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收在该平台表面上。因此，在至少一个构型中，当保持器19400附接到仓体4202时，保持器19400覆盖仓体4202中的所有钉凹坑。因此，当保持器19400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19400可防止储存在钉凹坑内的外科钉掉出。保持器主体19402可以包括本文公开的保持器主体布置中的任一种，使得保持器19400能够可移除地附接到钉仓4200。在一种布置中，保持器19400包括被构造成能够可移除地接合钉仓4200的保持插片或特征部19480。
在例示的示例中，保持器19400包括可运动地支撑在保持器主体19402上的验证键19430，使得该验证键可在第一致动位置与回缩位置之间运动。验证键19430被支撑用于在键外壳19450内进行轴向运动，该键外壳被模制或以其他方式附接到保持器主体19402的近侧端部19405。验证键19400可滑动地延伸穿过外壳壁19452并且具有形成在其上的凸部19431。回缩弹簧19454轴颈连接在外壳壁19452与凸部19431之间的验证键19430上，以将验证键19430朝远侧(方向DD)偏压到回缩位置中。当验证键19400处于致动位置时，其上可具有动作凸轮表面19442的近侧端部19440从键外壳19450突出。
如在图125和图126中可见，保持器19400还包括柱塞致动器19500，该柱塞致动器被构造成能够与验证键19430相互作用。在例示的布置中，柱塞致动器19500包括致动器杆19502，该致动器杆横向延伸穿过键外壳19450并且可在安装位置与移除位置之间轴向运动。柱塞垫19504附接到致动器杆19502的底端，该柱塞垫被构造成能够接合钉仓4200的平台表面4204。如图所示，柱塞按钮19506附接到致动器杆19502的顶端。致动器杆19502还包括与验证键19430的远侧端部19435相对应的竖直凹口19508。竖直凹口19508与延伸穿过致动器杆19502的通孔19510相交。
在使用中，保持器19400安装在钉仓4200上以形成仓组件19600，该仓组件可安置在本文公开的各种类型的外科缝合装置中。如在图123和图124中可见，验证键19430的远侧端部19435被接收在竖直凹口19508中，并且近侧端部19440从键外壳19450向近侧突出。当验证键19430处于该致动位置时，近侧端部部分19440被定位成与仓组件19600所安置在的外科缝合装置的闭锁件的闭锁臂相互作用。一旦仓组件19600已安置在外科缝合装置的框架中，并且验证键19430已使闭锁件失效、解锁或解除闩锁，用户就将柱塞致动器19500朝向钉仓4200压下。通过压下柱塞致动器19500，柱塞致动器使得保持器19400从钉仓4200脱离，并且验证键的远侧端部19435缩回竖直狭槽19508直到远侧端部19435进入致动器杆19502的通孔19510中，这允许验证键19430朝远侧运动到回缩位置。参见图125。当处于回缩位置时，验证键14430，并且更具体地，验证键19430的近侧端部19440无法使外科缝合装置的闭锁件失效。在至少一种布置中，将保持器19400从钉仓4200脱离所需的力量足够大而导致致动器杆的永久变形，这可防止保持器19400的重复使用。
图127至图129示出了另一保持器20400，其被构造成能够可移除地联接到钉仓4200或与包括本文公开的各种类型的闭锁件的特定外科缝合装置兼容的其他钉仓。保持器20400包括保持器主体20402，该保持器主体包括顶部部分20403，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被接收在该平台表面上。因此，在至少一个构型中，当保持器20400附接到仓体4202时，保持器20400覆盖仓体4202中的所有钉凹坑。因此，当保持器20400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20400可防止储存在钉凹坑内的外科钉掉出。保持器主体20402能够可移除地附接到钉仓4200。在一种布置中，保持器20400包括保持插片或特征部20480，其被构造成能够以本文所述的各种方式可移除地接合钉仓4200。
如上文所讨论，外科钉仓4200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穿过仓体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包括与仓体4202中的纵向狭槽4206重合的中心主体部分4231。滑动件4230还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4202。在钉击发行程期间，外科缝合装置的击发构件邻接滑动件4230的中心主体部分4231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顺序地驱动钉驱动器。
如在图127至图129中可见，保持器20400包括验证键组件20430，其包括可相对于彼此轴向运动的第一验证键部分20440和第二验证键部分20450。第一验证键部分20440和第二验证键部分20450被可滑动地支撑在形成于保持器主体20402中的纵向凹坑20405中。第一验证键部分20440包括在其近侧端部20442上的第一验证斜坡部分20444。类似地，第二验证键部分20450包括形成于其近侧端部20452上的第二验证斜坡部分20454。
当第一验证键部分20440和第二验证键部分20450轴向对准在致动位置中时，第一验证斜坡部分20444和第二认证斜坡部分20454配合形成验证键斜坡组件20700，该验证键斜坡组件被构造成能够以本文所述的各种方式使相关联的外科缝合装置的闭锁件失效。在至少一种布置中，第一验证键部分20440还包括第一滑动件接合特征部20446，其被构造成能够在保持器20400附接到钉仓4200并且滑动件4230处于未击发位置时接合滑动件4230的中心主体部分4231。类似地，第二验证键部分20450还包括第二滑动件接合特征部20456，其被构造成能够在保持器20400附接到钉仓4200并且滑动件4230处于未击发位置时接合滑动件4230的中心主体部分4231。在一种布置中，一个或多个偏压构件(未示出)被支撑在保持器主体20402中，以将第一验证键部分20440和第二验证键部分20450偏压出致动位置，除非第一滑动件接合特征部20446和第二滑动件接合特征部20456与保持器20400所附接的钉仓4200中的未击发滑动件4230的中心主体部分4231接合。换句话说，第一验证键部分20440和第二验证键部分20450未轴向对准，使得第一斜坡部分20444和第二斜坡部分20454也未对准，并且不会形成验证键斜坡组件20700。参见图127。其他布置不采用偏压构件。如在图127和图128中还可以看出，验证键部分20440包括行进限制器20448，其被接收在保持器20400的顶部部分20403中的腔20409内。类似地，验证键部分20450包括也接收在腔20409内的行进限制器20458。此类布置用于将验证键部分20440、20450的行进限制为有限量的轴向行进。
在使用中，保持器20400对准在未击发钉仓4200上方，使得第一滑动件接合特征部20446和第二滑动件接合特征部20456与钉仓4200中的纵向狭槽4206对准。此后，以本文所述的方式将保持器20400压到钉仓4200上以形成仓组件20800。当保持器20400附接到钉仓4200时，第一滑动件接合特征部20446和第二滑动件接合特征部20456接合未击发滑动件4230的中心主体部分4231，并且使第一验证键部分20440和第二验证键部分20450运动到致动位置中。当仓组件20800已安置在与保持器20400相关联的外科钉仓中时，验证键斜坡组件20700以本文公开的各种方式使外科缝合装置的闭锁件失效。一旦将保持器20400从钉仓4200移除，第一滑动件接合特征部20446和第二滑动件接合特征部20456就使滑动件4230的中心主体部分4231脱离接合，并且第一验证键部分20440和第二验证键部分20450运动到未对准位置。
图130和图131示出了另一保持器21400，其包括保持器主体21402，该保持器主体被构造成能够可移除地联接到钉仓4200或与包括本文公开的各种类型的闭锁件的特定外科缝合装置兼容的其他钉仓。保持器主体21402包括顶部部分21403，该顶部部分与钉仓4200的仓体4202的平台表面4204共同延伸并且被构造成能够被接收在该平台表面上。因此，在至少一个构型中，当保持器21400附接到仓体4202时，保持器21400覆盖仓体4202中的所有钉凹坑。因此，当保持器21400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21400可防止储存在钉凹坑内的外科钉掉出。保持器主体21402能够可移除地附接到钉仓4200以形成仓组件，该仓组件被构造成能够被安置在外科缝合装置的框架中。在一种布置中，保持器21400包括保持插片或特征部(未示出)，其被构造成能够以本文所述的各种方式可移除地接合钉仓4200。
如在图130至图131中可见，保持器21400包括被可运动地支撑在保持器主体21402中的验证键组件21430，使得该验证键组件可在致动位置与停用位置或回缩位置之间运动。在例示的布置中，验证键组件21430包括可滑动地支撑在保持器主体21402内的键体21432。近侧端部21440从保持器主体21402朝近侧突出。近侧端部21440可包括凸轮表面21442，该凸轮表面被构造成能够与仓组件所安置在的外科缝合装置的闭锁件的闭锁臂上的直立凸轮致动器臂或致动插片相互作用。如在图130中还可以看出，键体21432还包括一系列锁定齿21434，这些锁定齿被构造成能够与形成于保持器主体21402中的棘爪齿21405锁定地相互作用。如图所示，移除特征部21436形成于键体21432的远侧端部。
在被安装在钉仓4200上之前，验证键组件21430轴向运动到致动位置，其中近侧端部部分21440处于使仓组件所安置在的外科缝合装置的闭锁件失效、解锁或解除闩锁的位置。这可由将保持器组件21400安装到钉仓上的制造商完成。然后，以本文公开的各种方式将保持器组件21400压到钉仓上或以其他方式将其可移除地附接到钉仓。然后，最终用户可将仓组件安置到外科缝合装置的框架中，使得验证键组件21430的近侧端部21440以本文公开的各种方式使外科缝合装置的闭锁件失效、解锁、解除闩锁。此后，用户可然后通过拉动移除特征部21436并沿远侧方向轴向拉动保持器组件21400来从钉仓移除保持器组件21400。除了使保持器组件21400从钉仓4200脱离之外，此类动作还使验证键组件21430回缩到回缩位置，其中如果保持器21400重新附接到另一钉仓并被重新安置到缝合装置中，则验证键组件21430无法使闭锁件失效。
在至少一种布置中，移除特征部包括孔21438，可调整的尼龙扎带(有时称为“拉链(zip-tie)”)可穿过该孔插入，并且此后被拉开。另外或在替代布置中，拉链可通过螺纹连接在保持插片中的一者与仓体之间，以使得能够向其施加拉力。另外，在至少一个示例中，保持器组件21400的制造商最初将验证键组件21430设置在致动位置。一系列锁定齿21434和棘爪齿21405是“单向”齿，并且仅允许验证键组件21430沿远侧方向回缩到回缩位置。齿21434、21405不允许验证键组件21430从回缩位置朝近侧运动到致动位置。该一系列齿也可称为“单向闩锁”。一旦验证键组件21430处于回缩位置，它就无法用于使外科缝合装置的闭锁件失效。因此，保持器组件21400被构造成能够仅使用一次。
图132至图136示出了钉仓保持器系统，通常被标记为22000。在一种形式中，系统22000包括在设计上与本文公开的各种其他保持器类似的保持器22400。在一个示例中，保持器22400包括保持器主体22402，该保持器主体包括顶部部分22403，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被接收在该平台表面上，使得当保持器22400附接到仓体4202时，保持器22400覆盖仓体4202中的所有钉凹坑4208。保持器22400可由聚合物材料模制而成，并且包括从保持器22400的每个侧面向下突出的多个横向保持构件。在例示的示例中，两个横向保持器凸耳组件22410与保持器22400的一般中心部分相关联。每个横向保持凸耳组件22410被模制到保持器22400的对应侧面部分中，使得保持构件22412在保持器22400的底表面22405下方向下延伸。在例示的示例中，每个保持构件22412从对应侧凸台部分22414延伸。此类布置用于提供具有足够强度的保持器凸耳组件22410，同时提供保持臂22412中的每一者在将保持器22400附接到钉仓4200以及从其移除保持器22400期间稍微向外挠曲的能力。每个保持构件22412包括模制在其端部上的卡扣特征部22416。卡扣特征部22416各自包括成角度表面22417，并且该卡扣特征部被构造成能够锁定地接合形成于钉仓4200的仓体4202上的凸部4205的对应部分。
保持器22400可包括横向保持构件22480和22484形式的附加横向保持特征部，这些横向保持特征部从保持器22400的每个侧面向下延伸并且远离横向保持器凸耳组件22410。每个横向保持构件22480包括闩锁端部22482，该闩锁端部被构造成能够接合钉仓4200的对应部分。每个横向保持构件22484包括成角度端部部分22486，该端部部分被构造成能够接合钉仓4200的对应侧。保持器22400还包括成角度鼻部部分22420和远侧闩锁插片22422。
如在图135中可见，保持器22400另外包括近侧龙骨特征部22470和远侧龙骨特征部22474。同样，在至少一种布置中，一系列中心保持插片被模制到在近侧龙骨22740与远侧龙骨22474之间的保持器22400的底表面22405上。中心保持插片包括交替的右保持插片22490R和左保持插片22490L。每个右保持插片22490R包括一对卡扣特征部22492R，该对卡扣特征部被构造成能够延伸到仓盘4220中的狭槽4221中，该狭槽附接到钉仓4200并且卡扣成与其接合。参见图134。在安装之前，每个右保持插片22490R处于“第一状态”，其中向左成角度的偏压可防止右保持插片22490R插入纵向狭槽4206中。每个右保持插片22490R必须被拉直成“第二状态”以能够插入纵向狭槽4206中。每个左保持插片22490L包括一对卡扣特征部22492L，该对卡扣特征部被构造成能够延伸穿过仓盘4220中的狭槽4221并且卡扣成与其接合。在安装之前，每个左保持插片22490L取向为第一状态，其中向右成角度的偏压防止左保持插片22490L插入钉仓4200的纵向狭槽4206中。因此，当处于它们相应的第一状态时，右保持插片22490R和左保持插片22490L沿相反方向向下成角度。
在例示的示例中，利用显著强大的成角度偏压将右保持插片22490R和左保持插片22490L模制成第一状态，该第一状态防止右保持插片和左保持插片插入钉仓4200的纵向狭槽4206中，除非它们在组装过程期间被充分拉直成第二状态。在至少一种情况下，保持器系统22000包括保持器工具22800，该保持器工具被构造成能够用于在将保持器22400附接到钉仓4200期间拉直右保持插片22490R和左保持插片22490L(或将右保持插片22490R和左保持插片22490L从第一状态运动到第二状态)。在一种形式中，保持器工具22800包括细长主体22802，该细长主体包括顶部部分22810和两个向下悬挂的侧壁22820。侧壁22820彼此间隔开以在其间容纳钉仓平台4204。参见图134。顶部部分22810包括具有工具狭槽22814的凸起中心部分22812。凸起中心部分22812与保持器主体22402的底表面22405重合。工具狭槽22814包括较宽的顶部部分22816和较窄的底部部分22818，该较宽的顶部部分的尺寸被设定成在其中接收右保持插片22490R、左保持插片22490L的端部，该较窄的底部部分的宽度类似于或略微小于钉仓4200中的纵向狭槽4206的宽度。当保持器工具22800可移除地被支撑在钉仓平台4204上时，工具狭槽22814与钉仓4200中的纵向狭槽4206重合。在一种布置中，小凸部特征部22820形成于狭槽22814的顶部部分22816的一侧上，以在安装过程期间容纳右保持插片22490R和左保持插片22490L的初始位置。参见图134。
现在参考图132，如图所示通过最初将保持器工具22800放置到钉仓4200的平台4204上，来将保持器22400安装到钉仓4200上，使得工具狭槽22814与钉仓4200中的纵向狭槽4206对准。然后将保持器22400放置到保持器工具22800上，使得底表面22405取向在凸起中心部分22812上方，并且(在处于其相应的第一状态的情况下)右保持插片22490R和左保持插片22490L的端部被接收在工具狭槽22814的宽部分22816中。此后，将保持器22400向下压到工具22800上。当向下压保持器22400时，每个保持构件22412上的成角度表面22417接合对应的工具侧壁22820并且向外挠曲，使得卡扣特征部22416清除仓体4202上的凸部4205。右保持插片22490R和左保持插片22490L(假设它们处于其相应的第二状态)中的每一者向内挠曲以进入工具狭槽22814的底部部分22818，并且最终进入钉仓4200中的纵向狭槽4206。一旦保持器22400处于中间安装位置，就可通过抓持保持器工具22800的近侧端部并沿近侧纵向方向PD拉动工具来使保持器工具22800从保持器22400与钉仓4200之间纵向地滑出。参见图136。此后，可继续将保持器22400向下压到仓上的完全安置位置。当处于完全安置位置时，卡扣特征部22492R、22492L延伸到仓盘4220中的狭槽4221中并且卡扣成与其接合。每个保持构件22412与仓体4202上的凸部4205接合，并且横向保持器臂22480和22484中的每一者与钉仓4200的对应部分保持接合。
一旦保持器22400已附接到钉仓4200以形成仓组件22500，就可然后以本文公开的各种方式将仓组件22500插入外科缝合装置的框架中。保持器22400还包括验证键22430，该验证键被构造成能够使其中安置有仓组件22500的外科缝合装置中的闭锁件失效。当仓组件22500被安置到框架中时，保持臂22412的卡扣特征部22416上的成角度表面22417以及每个横向保持构件22482上的成角度表面22483接触框架的侧壁，这些侧壁用于使卡扣特征部22416、22482横向向外偏压成脱离与仓体4202上的凸部4205的接合。同样，当右保持插片22490R和左保持插片22490L上的卡扣特征部22492R、22492L接触外科缝合装置框架中的狭槽的对应侧壁时，使卡扣特征部22492R、22492L偏压成脱离与仓盘4220的接合。然后可通过朝远侧闩锁插片22422施加撬动运动并拉动保持器22400向上使其脱离钉仓4200来去除保持器22400。在至少一些布置中，左保持插片22490L和右保持插片22490R以及保持臂22412具有足够的刚性，使得当保持器22400尚未附接到仓时，在不使用保持器工具22800的情况下，将保持器22400安装在钉仓4200上可能会非常困难。在此类情况下，保持器实际上可包括一次性保持器。
图137至图139示出了另一钉仓保持器系统，其通常被标记为22000'，除了保持器工具22800'之外，该钉仓保持器系统类似于系统22000。在这种布置中，保持器工具22800'包括工具主体22802'，该工具主体具有向下延伸的拉直臂，该向下延伸的拉直臂对应于左保持插片22490L和右保持插片22490R中的每一者。在例示的布置中，保持器22400包括三个右保持插片22490R和两个左保持插片22490L。因此，保持器工具22800'包括三个右拉直臂22810R'和两个左拉直臂22810L'。拉直臂22810R'、22810L'中的每一者对应于保持器22400的顶部部分22403中的孔22407。参见图138。
为了将保持器22400安装到钉仓4200上，将拉直臂22810R'、22810L'插入保持器22400的顶部部分22403中的对应孔22407中，并与对应的左保持插片22490L和右保持插片22490R接合。拉直臂22810R'接合对应的右保持插片22490R并且将它们偏压到相对笔直的插入位置中，其中这些右保持插片能够插入钉仓4200中的狭槽4206中。同样，拉直臂22810L'接合对应的左保持插片22490L并且将它们偏压到相对笔直的插入位置中，其中这些左保持插片能够插入钉仓4200中的狭槽4206中。一旦已将保持器工具22800'插入保持器22400中，然后就可将保持器压到钉仓4200上。此后，可通过沿向上方向拉动工具22800’使其脱离保持器22400来从保持器移除该工具，从而允许左保持插片22490L和右保持插片22490R上的卡扣特征部接合仓盘4220中的狭槽4221的边缘。
图140和图141描绘了另一保持器23400的一部分，除了以下差异之外，该保持器可与本文公开的任何保持器相同或类似。具体地，保持器23400包括保持器主体23402，该保持器主体包括顶部部分23403。中心龙骨组件23470从顶部部分的下侧23405延伸并且被构造成能够被接收在钉仓的仓体中的纵向狭槽内。在例示的布置中，龙骨组件23470包括两个轴向对准的主龙骨部分23472、23474和两个可运动的保持翼片23476、23478，两个可运动的保持翼片被偏压出平面或与主龙骨部分23472、23474轴向对准。主龙骨部分23472、23474在保持器轴线RA上轴向对准。可运动保持翼片23476、23478被偏压成第一状态，在该状态下它们位于保持器轴线RA的相对侧上。参见图141。为了将保持器23400安装到钉仓4200上，在将龙骨组件23470偏压到钉仓4200的狭槽4206中的情况下，使龙骨组件23470与钉仓中的狭槽对准，并且将两个可运动的保持翼片23476、23478偏压到平面(第二状态)中。保持器23400还包括验证键组件23430，该验证键组件可包括本文公开的各种验证键布置中的任一种。
图142至图147描绘了另一个一次性保持器24400，其可与钉仓4200结合使用，该钉仓与外科缝合装置6002兼容使用。上文详细描述了外科缝合装置6002。在例示的示例中，保持器24400包括保持器主体24402，该保持器主体包括平坦的顶部部分24410。鼻部凹坑24414形成于顶部部分24410的远侧端部24412上。鼻部凹坑24414被构造成能够钩在钉仓4200的远侧鼻部4203上。顶部部分24410相对于钉仓4200设定尺寸，使得顶部部分24410与钉仓4200(或其他合适的钉仓)的平台表面4204共同延伸并且被构造成能够被接收在该平台表面上，使得当保持器24400附接到仓体4202时，保持器24400覆盖仓体4202中的所有钉凹坑4208。保持器24400可由聚合物材料模制而成，并且包括从保持器顶部部分24410的每个侧面向下突出的横向保持特征部24420。每个横向保持特征部24420被构造成能够保持接合钉仓体4202的凸部部分4205。参见图144。
在例示的布置中，保持器24400还包括保持器脱离构件24430，该保持器脱离构件通过活动铰链24432附接到顶部部分24410的近侧端部22416。验证键24440形成于保持器脱离构件24430上，并且被构造成能够使外科缝合装置6002的闭锁件6300或本文公开的其他外科缝合装置的其他闭锁件失效。保持器脱离构件24430还包括从保持器致动器24430的底表面突出的至少一个顶出器柱或单向插片特征部24434。在至少一种布置中，在保持器致动器24430的每个侧面附近形成顶出器柱或单向插片特征部24434。每个顶出器柱或单向插片特征部24434与保持器顶部部分24410中的孔24418对应。
可将保持器22400安装到钉仓4200上，其中保持器脱离构件24430处于第一未致动位置。通过将鼻部凹坑24414钩在钉仓4200的鼻部4203上，并且将顶部部分24410向下压到钉仓4200的平台表面4204上直到横向保持特征部24420保持接合仓体4202的凸部4205，来安装保持器24400。保持器24400和钉仓4200现在形成了仓组件24500。然后可将仓组件24500插入外科缝合装置6002的框架6010中，使得保持器的验证键24440接合外科缝合装置6002中的第一闭锁臂6310的致动器凸轮臂6322，以在保持器脱离构件24430处于第一未致动位置时使闭锁件6300失效。图145(以实线)示出了处于第一未致动位置的保持器脱离构件24430。如在图145中可见，验证键24440已接合致动器凸轮臂6322。图146还示出了在将仓组件24500初始插入框架6010中期间与致动器凸轮臂6322接合的验证键24440。图147示出了被可操作地安置到框架6010中的仓组件24500，其中验证键24440已将第一闭锁臂6310枢转到钳口闭合位置，从而使缝合装置6002的闭锁件6300失效。此后，用户可将保持器脱离构件24430压向保持器顶部部分24410到达第二致动位置，其中单向插片特征部24434穿过保持器顶部部分24410中的孔24418。当单向插片特征部24434穿过孔24418时，它们接合钉仓4200的平台表面4204并且使得横向保持特征部24420与平台凸部部分4205脱离接合。当保持器脱离构件24430枢转到第二位置或致动位置时，验证键24440从外科缝合装置6002的第一闭锁臂6310的致动器凸轮臂6322脱离，但钉仓4200将闭锁件6300保持在失效位置或解锁位置。现在可从安置在框架6010中的钉仓4200移除保持器24400。在例示的布置中，一旦单向插片特征部24434被压至穿过顶部部分24410中的对应孔24418，这些单向插片特征部就不能再穿回孔24418，从而将保持器脱离构件24430保持在第二位置或致动位置。因为当保持器脱离构件24430处于第二位置或致动位置(在图145中以虚线示出)时，验证键24440无法使外科缝合装置的闭锁件失效。并且因为通过单向插片特征部24434将保持器脱离构件24430保持在第二位置或致动位置，因此保持器24400无法再次在另一钉仓上使用。为了进一步使得保持器24400不可重复使用，用户可在初始使用保持器24400之后切断活动铰链24432。
图148示出了可与钉仓4200一起使用的另一保持器25400。保持器24500可类似于本文公开的各种保持器中的任一种，并且包括在其远侧端部上的仓移除特征部25600。换句话说，本文公开的各种保持器布置中的任一种可另外形成有仓移除特征部25600。在一个示例中，仓移除特征部25600包括撬杆部分25602，该撬杆部分一体形成于保持器25400的顶部部分25403的远侧端部上。撬杆部分25602朝远侧延伸超过保持器的成角度鼻部部分25420，以在其间形成鼻部凹坑25610。向下延伸的撬臂25604形成于撬杆部分25602的远侧端部上。
保持器25400以本文公开的各种方式附接到钉仓4200以形成仓组件。然后，将该仓组件安置在外科缝合装置的框架中，使得保持器25400的验证键25430以本文公开的各种方式中的任一种来使该外科缝合装置的闭锁件失效。然后，保持器25400从钉仓4200脱离，并且缝合装置用于击发钉仓4200中的钉。一旦钉仓被击发，用户就可使用仓移除特征部25600来从缝合装置的框架25010移除用尽的钉仓4200S。如在图148中可见，用尽的钉仓4200S的鼻部4203从框架25010朝远侧突出。用户操纵保持器25400以接合鼻部凹坑25610中的用尽的钉仓的鼻部4203，并且将撬臂25604插入用尽的钉仓4200S中的纵向狭槽的远侧部分中。此后，用户将移除力RF施加到保持器25400的近侧端部以向仓鼻部4203施加撬动力并使得用尽的钉仓4200S弹出框架25010。此类布置提供了用于从外科缝合装置移除用尽的仓的改善的机械效益，并且此类布置可被用于从本文公开的任意外科缝合装置移除用尽的仓。
本文所述主题的各个方面在以下实施例中阐述：
实施例1-一种用于与钉仓一起使用的保持器系统，所述钉仓被构造成能够与外科缝合装置一起使用，所述外科缝合装置包括用于防止所述外科缝合装置的操作的闭锁件。所述保持器系统包括保持器，所述保持器包括保持器主体和从所述保持器主体突出并被偏压成第一状态的至少一个保持插片。所述保持器主体被构造成能够被安装到钉仓以形成仓组件。所述仓组件被构造成能够被安置在所述外科缝合装置中。所述保持器主体包括验证键，所述验证键被构造成能够在所述仓组件安置在所述外科缝合装置中时使所述闭锁件失效。当所述至少一个保持插片处于所述第一状态时，所述至少一个保持插片无法将所述保持器主体联接到所述钉仓。所述保持器系统还包括保持器工具，所述保持器工具被构造成能够在所述保持器工具与所述至少一个保持插片可操作地接合时使每个所述至少一个保持插片从所述第一状态运动到第二状态。每个所述至少一个保持插片运动成与所述钉仓的一部分保持接合，以当所述至少一个保持插片处于所述第二状态并且所述保持器工具与所述至少一个保持插片脱离接合时将所述保持器主体可移除地附连到所述钉仓。
实施例2-根据实施例1所述的保持器系统，其中所述至少一个保持插片被构造成能够在所述至少一个保持插片处于所述第二状态时插入所述钉仓中的狭槽中，并且其中当所述至少一个保持插片被偏压成所述第一状态时，所述至少一个保持插片无法插入所述狭槽中，除非所述保持器工具与所述至少一个保持插片可操作地接合。
实施例3-根据实施例2所述的保持器系统，其中所述至少一个保持插片包括至少一对保持插片，并且其中每对保持插片包括第一保持插片和第二保持插片。所述第一保持插片从所述保持器主体的底表面突出并且包括第一卡扣特征部。所述第一保持插片在第一成角度方向上被偏压成所述第一状态，使得所述第一卡扣特征部无法插入所述狭槽中。所述第二保持插片从所述保持器主体的所述底表面突出并且包括第二卡扣特征部。所述第二保持插片在与所述第一成角度方向不同的第二成角方向上被偏压成所述第一状态，使得所述第二卡扣特征部无法插入所述狭槽中。所述保持器工具被构造成能够使所述第一保持插片和所述第二保持插片运动成所述第二状态以插入所述狭槽中，并且当所述保持器工具与所述第一保持插片和所述第二保持插片脱离接合时，所述第一卡扣特征部和所述第二卡扣特征部保持接合所述钉仓，以将所述保持器主体联接到所述钉仓。
实施例4-根据实施例3所述的保持器系统，其中所述仓组件被构造成能够被安置在所述外科缝合装置的框架中，并且其中所述第一卡扣特征部和所述第二卡扣特征部被构造成能够在所述仓组件安置在所述框架中时通过所述框架与所述钉仓脱离接合。
实施例5-根据实施例3或4所述的保持器系统，其中所述保持器主体包括对应于所述第一保持插片的第一开口和对应于所述第二保持插片的第二开口。所述保持器工具包括第一拉直臂和第二拉直臂，所述第一拉直臂能够插入穿过所述第一开口以使所述第一保持插片从所述第一状态运动到所述第二状态，所述第二拉直臂能够插入穿过所述第二开口以使所述第二保持插片从所述第一状态运动到所述第二状态。
实施例6-根据实施例1、2、3、4或5所述的保持器系统，其中所述保持器工具被构造成能够在所述保持器主体与所述钉仓之间可移除地被支撑在所述钉仓上。
实施例7-根据实施例1、2、3、4、5或6所述的保持器系统，其中所述保持器工具包括工具主体和开口，所述工具主体的尺寸被设定成可移除地接收在所述钉仓的平台上，所述开口延伸穿过所述工具主体。当所述工具主体定位在所述平台上时，所述开口与所述钉仓中的狭槽对准。所述开口被构造成能够：当所述至少一个保持插片插入穿过所述工具主体中的所述开口到所述钉仓中的所述狭槽中时，使所述至少一个保持插片从所述第一状态运动到所述第二状态，并且此后允许所述工具主体从所述平台可滑动地移除。
实施例8-根据实施例7所述的保持器系统，其中当所述工具主体支撑在所述平台上时，所述工具主体的尺寸被设定成突出超过所述钉仓的至少一个端部。
实施例9-根据实施例1、2、3、4、5、6、7或8所述的保持器系统，其中相对于所述钉仓的平台来设定所述保持器主体的尺寸，使得当所述保持器主体可移除地联接到所述钉仓时，所述保持器主体覆盖通过所述平台打开的钉凹坑。
实施例10-一种用于与钉仓一起使用的保持器，所述钉仓被构造成能够与外科缝合装置一起使用，所述外科缝合装置包括用于防止所述外科缝合装置的操作的闭锁件。所述保持器包括保持器主体，所述保持器主体被构造成能够可移除地安装到所述钉仓以形成仓组件。所述仓组件被构造成能够被安置在所述外科缝合装置中。所述保持器主体包括验证键，所述验证键被构造成能够在所述仓组件安置在所述外科缝合装置中时使所述闭锁件失效。所述保持器还包括从所述保持器主体突出的至少一个可变形保持构件。每个可变形保持构件被构造成能够将所述保持器主体可释放地联接到所述钉仓。每个可变形保持构件最初取向为第一状态，在所述第一状态下，所述可变形保持构件防止所述保持器主体联接到所述钉仓。每个可变形保持构件能够运动到第二状态，在所述第二状态下，所述可变形保持构件可释放地联接到所述钉仓，以将所述保持器主体可移除地附接到所述钉仓。
实施例11-根据实施例10所述的保持器，其中所述至少一个可变形保持构件包括第一可变形保持构件，所述第一可变形保持构件包括从所述保持器主体的下侧突出的第一龙骨部分和联接到所述第一龙骨部分的第一可变形翼片。所述第一可变形翼片取向为所述第一状态，在所述第一状态下，所述第一可变形翼片无法插入所述钉仓中的狭槽中。当所述第一龙骨部分与所述狭槽接合并且所述保持器主体被压向所述钉仓的顶表面时，所述第一可变形翼片能够运动成所述第二状态。所述至少一个可变形保持构件还包括从所述保持器主体的所述下侧突出的第二龙骨部分和联接到所述第二龙骨部分的第二可变形翼片。所述第二可变形翼片取向为所述第一状态，在所述第一状态下，所述第二可变形翼片无法插入所述钉仓中的所述狭槽中，并且当所述第二龙骨部分与所述狭槽接合并且所述保持器主体被压向所述钉仓的所述顶表面时，所述第二可变形翼片能够运动成所述第二状态。
实施例12-根据实施例11所述的保持器，其中所述保持器主体限定保持器轴线，其中当所述第一可变形保持构件处于所述第一状态时，所述第一可变形翼片定位在所述保持器轴线的第一侧上，并且其中当所述第二可变形保持构件处于所述第一状态时，所述第二可变形翼片定位在所述保持器轴线的第二侧上。
实施例13-根据实施例10、11或12所述的保持器，其中相对于所述钉仓的平台表面来设定所述保持器主体的尺寸，使得当所述保持器附接到所述钉仓时，所述保持器主体覆盖所述平台表面。
实施例14-一种用于与钉仓一起使用的保持器，所述钉仓被构造成能够与外科缝合装置一起使用，所述外科缝合装置包括用于防止所述外科缝合装置的操作的闭锁件。所述保持器包括保持器主体，所述保持器主体的尺寸被设定成接收在所述钉仓的平台表面上。所述保持器主体包括保持插片，所述保持插片被构造成能够将所述保持器主体可移除地联接到所述钉仓以形成仓组件。所述仓组件被构造成能够被安置在所述外科缝合装置中。所述保持器还包括可运动地联接到所述保持器主体的保持器脱离构件。所述保持器脱离构件包括验证键，并且能够在第一位置与第二保持器顶出位置之间运动，在所述第一位置中，所述验证键当所述仓组件安置在所述外科缝合装置中时使所述闭锁件失效，在所述第二保持器顶出位置中，所述保持器脱离构件使所述保持器与所述钉仓脱离联接。
实施例15-根据实施例14所述的保持器，其中所述保持器脱离构件能够通过铰链运动地附接到所述保持器主体。
实施例16-根据实施例14或15所述的保持器，其中所述保持器主体包括穿过所述保持器主体的顶出器孔，并且其中所述保持器脱离构件还包括从所述保持器脱离构件突出的顶出器柱，并且其中所述顶出器柱相对于所述顶出器孔取向，使得所述顶出器柱突出穿过所述顶出器孔，以当所述固定器脱离构件运动到所述第二保持器顶出位置时将脱离联接力施加到所述钉仓的所述平台表面。
实施例17-根据实施例16所述的保持器，其中所述顶出器柱包括单向闩锁插片，所述单向闩锁插片被构造成能够在所述保持器脱离构件运动到所述第二保持器顶出位置时保持接合所述保持器主体，以防止所述保持器脱离构件能够运动回到所述第一位置。
实施例18-一种用于与外科缝合装置一起使用的保持器，所述外科缝合装置包括用于防止所述外科缝合装置的操作的闭锁件。所述外科缝合装置还包括框架，所述框架被构造成能够可移除地支撑所述框架中的钉仓，使得当所述钉仓安置在所述框架中时，所述钉仓的鼻部从所述框架突出。所述保持器包括保持器主体、从所述保持器主体突出的验证键，以及撬杆部分。所述保持器主体被构造成能够可移除地附接到所述钉仓以形成仓组件。所述仓组件被构造成能够被安置在所述外科缝合装置的所述框架中。所述验证键被构造成能够在所述仓组件安置在所述框架中时使所述闭锁件失效。所述撬杆部分被构造成能够接合所述钉仓的从所述框架突出的所述鼻部以向所述鼻部施加撬动运动，从而将所述钉仓从所述框架移开。
实施例19-根据实施例18所述的保持器，其中所述撬杆部分包括位于所述保持器主体的远侧端部上的鼻部凹坑。所述鼻部凹坑被构造成能够在所述保持器主体已从所述钉仓移除之后接收从所述框架突出的所述鼻部的一部分。所述撬杆部分还包括形成在所述保持器主体的远侧端部上并且在所述保持器主体的下侧下方延伸的撬动构件。所述撬动构件被构造成能够：当从所述框架突出的所述鼻部的部分被支撑在所述鼻部凹坑中并且向所述保持器主体施加撬动运动以将所述钉仓与所述框架分离时，与所述钉仓撬动接合。
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；和
-提交于2010年4月22日的名称为“SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”的美国专利申请公布2010/0264194，现为美国专利8,308,040。
虽然本文已结合某些实施方案描述了各种装置，但也可实施对这些实施方案的许多修改和变型。在一个或多个实施方案中，具体特征、结构或特性可以任何合适的方式进行组合。因此，在无限制的情况下，结合一个实施方案示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其他实施方案的特征、结构或特性组合。另外，在公开了用于某些部件的材料的情况下，也可使用其他材料。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 (19)
1.一种用于与钉仓一起使用的保持器系统，所述钉仓被构造成能够与外科缝合装置一起使用，所述外科缝合装置包括用于防止所述外科缝合装置的操作的闭锁件，其中所述保持器系统包括：
保持器，所述保持器包括：
保持器主体，所述保持器主体被构造成能够被安装到所述钉仓以形成仓组件，其中所述仓组件被构造成能够被安置在所述外科缝合装置中，并且其中所述保持器主体包括被构造成能够在所述仓组件安置在所述外科缝合装置中时使所述闭锁件失效的验证键；和
至少一个保持插片，所述至少一个保持插片从所述保持器主体突出并被偏压成第一状态，其中当所述至少一个保持插片处于所述第一状态时，所述至少一个保持插片无法将所述保持器主体联接到所述钉仓，并且其中所述保持器系统还包括：
保持器工具，该保持器工具被构造成能够在所述保持器工具与所述至少一个保持插片可操作地接合时使每个所述至少一个保持插片从所述第一状态运动到第二状态，其中每个所述至少一个保持插片运动成与所述钉仓的一部分保持接合，以当所述至少一个保持插片处于所述第二状态并且所述保持器工具与所述至少一个保持插片脱离接合时将所述保持器主体可移除地附连到所述钉仓。
2.根据权利要求1所述的保持器系统，其中，所述至少一个保持插片被构造成能够在所述至少一个保持插片处于所述第二状态时插入所述钉仓中的狭槽中，并且其中当所述至少一个保持插片被偏压成所述第一状态时，所述至少一个保持插片无法插入所述狭槽中，除非所述保持器工具与所述至少一个保持插片可操作地接合。
3.根据权利要求2所述的保持器系统，其中，所述至少一个保持插片包括至少一对保持插片，并且其中每个所述保持插片对包括：
第一保持插片，所述第一保持插片从所述保持器主体的底表面突出并且包括第一卡扣特征部，其中所述第一保持插片在第一成角度方向上被偏压成所述第一状态，使得所述第一卡扣特征部无法插入所述狭槽中；和
第二保持插片，所述第二保持插片从所述保持器主体的所述底部表面突出并且包括第二卡扣特征部，其中所述第二保持插片在与所述第一成角度方向不同的第二成角方向上被偏压成所述第一状态，使得所述第二卡扣特征部无法插入所述狭槽中，并且其中所述保持器工具被构造成能够使所述第一保持插片和所述第二保持插片运动成所述第二状态以插入所述狭槽中，并且当所述保持器工具与所述第一保持插片和所述第二保持插片脱离接合时，所述第一卡扣特征部和所述第二卡扣特征部保持接合所述钉仓，以将所述保持器主体联接到所述钉仓。
4.根据权利要求3所述的保持器系统，其中，所述仓组件被构造成能够被安置在所述外科缝合装置的框架中，并且其中所述第一卡扣特征部和所述第二卡扣特征部被构造成能够在所述仓组件安置在所述框架中时通过所述框架与所述钉仓脱离接合。
5.根据权利要求3所述的保持器系统，其中，所述第一保持器主体包括：
第一开口，所述第一开口对应于所述第一保持插片；和
第二开口，所述第二开口对应于所述第二保持插片，其中所述保持器工具包括：
第一拉直臂，所述第一拉直臂能够插入穿过所述第一开口以使所述第一保持插片从所述第一状态运动到所述第二状态；和
第二拉直臂，所述第二拉直臂能够插入穿过所述第二开口以使所述第二保持插片从所述第一状态运动到所述第二状态。
6.根据权利要求1所述的保持器系统，其中，所述保持器工具被构造成能够在所述保持器主体与所述钉仓之间可移除地被支撑在所述钉仓上。
7.根据权利要求6所述的保持器系统，其中，所述保持器工具包括：
工具主体，所述工具主体的尺寸被设定成可移除地接收在所述钉仓的平台上；和
开口，所述开口延伸穿过所述工具主体，其中当所述工具主体定位在所述平台上时，所述开口与所述钉仓中的狭槽对准，并且其中所述开口被构造成能够：当所述至少一个保持插片插入穿过所述工具主体中的所述开口到所述钉仓中的所述狭槽中时，使所述至少一个保持插片从所述第一状态运动到所述第二状态，并且此后允许所述工具主体从所述平台可滑动地移除。
8.根据权利要求7所述的保持器系统，其中，当所述工具主体支撑在所述平台上时，所述工具主体的尺寸被设定成突出超过所述钉仓的至少一个端部。
9.根据权利要求1所述的保持器系统，其中，相对于所述钉仓的平台来设定所述保持器主体的尺寸，使得当所述保持器主体可移除地联接到所述钉仓时，所述保持器主体覆盖通过所述平台打开的钉凹坑。
10.一种用于与钉仓一起使用的保持器，所述钉仓被构造成能够与外科缝合装置一起使用，所述外科缝合装置包括用于防止所述外科缝合装置的操作的闭锁件，其中所述保持器包括：
保持器主体，所述保持器主体被构造成能够可移除地安装到所述钉仓以形成仓组件，其中所述仓组件被构造成能够被安置在所述外科缝合装置中，并且其中所述保持器主体包括被构造成能够在所述仓组件安置在所述外科缝合装置中时使所述闭锁件失效的验证键；和
至少一个可变形保持构件，所述至少一个可变形保持构件从所述保持器主体突出，其中每个所述可变形保持构件被构造成能够将所述保持器主体可释放地联接到所述钉仓，其中每个所述可变形保持构件最初取向为第一状态，在所述第一状态下，所述可变形保持构件防止所述保持器主体联接到所述钉仓，并且其中每个所述可变形保持构件能够运动到第二状态，在所述第二状态下，所述可变形保持构件可释放地联接到所述钉仓，以将所述保持器主体可移除地附接到所述钉仓。
11.根据权利要求10所述的保持器，其中，所述至少一个可变形保持构件包括：
第一可变形保持构件，所述第一可变形保持构件包括：
第一龙骨部分，所述第一龙骨部分从所述保持器主体的下侧突出；和
第一可变形翼片，所述第一可变形翼片联接到所述第一龙骨部分，所述第一可变形翼片取向为所述第一状态，在所述第一状态下，所述第一可变形翼片无法插入所述钉仓中的狭槽中，其中当所述第一龙骨部分与所述狭槽接合并且所述保持器主体被压向所述钉仓的顶表面时，所述第一可变形翼片能够运动成所述第二状态，并且其中所述至少一个可变形保持构件还包括：
第二龙骨部分，所述第二龙骨部分从所述保持器主体的所述下侧突出；和
第二可变形翼片，所述第二可变形翼片联接到所述第二龙骨部分，所述第二可变形翼片取向为所述第一状态，在所述第一状态下，所述第二可变形翼片无法插入所述钉仓中的所述狭槽中，并且当所述第二龙骨部分与所述狭槽接合并且所述保持器主体被压向所述钉仓的所述顶表面时，所述第二可变形翼片能够运动成所述第二状态。
12.根据权利要求11所述的保持器，其中，所述保持器主体限定保持器轴线，其中当所述第一可变形保持构件处于所述第一状态时，所述第一可变形翼片定位在所述保持器轴线的第一侧上，并且其中当所述第二可变形保持构件处于所述第一状态时，所述第二可变形翼片定位在所述保持器轴线的第二侧上。
13.根据权利要求10所述的保持器，其中，相对于所述钉仓的平台表面来设定所述保持器主体的尺寸，使得当所述保持器附接到所述钉仓时，所述保持器主体覆盖所述平台表面。
14.一种用于与钉仓一起使用的保持器，所述钉仓被构造成能够与外科缝合装置一起使用，所述外科缝合装置包括用于防止所述外科缝合装置的操作的闭锁件，其中所述保持器包括：
保持器主体，所述保持器主体的尺寸被设定成接收在所述钉仓的平台表面上，其中所述保持器主体包括保持插片，所述保持插片被构造成能够将所述保持器主体可移除地联接到所述钉仓以形成仓组件，并且其中所述仓组件被构造成能够被安置在所述外科缝合装置中；和
保持器脱离构件，所述保持器脱离构件能够运动地联接到所述保持器主体，其中所述保持器脱离构件包括验证键，并且能够在第一位置与第二保持器顶出位置之间运动，在所述第一位置中，所述验证键当所述仓组件安置在所述外科缝合装置中时使所述闭锁件失效，在所述第二保持器顶出位置中，所述保持器脱离构件使所述保持器与所述钉仓脱离联接。
15.根据权利要求14所述的保持器，其中，所述保持器脱离构件能够通过铰链运动地附接到所述保持器主体。
16.根据权利要求15所述的保持器，其中，所述保持器主体包括穿过所述保持器主体的顶出器孔，并且其中所述保持器脱离构件还包括从所述保持器脱离构件突出的顶出器柱，并且其中所述顶出器柱相对于所述顶出器孔取向，使得所述顶出器柱突出穿过所述顶出器孔，以当所述固定器脱离构件运动到所述第二保持器顶出位置时将脱离联接力施加到所述钉仓的所述平台表面。
17.根据权利要求16所述的保持器，其中，所述顶出器柱包括单向闩锁插片，所述单向闩锁插片被构造成能够在所述保持器脱离构件运动到所述第二保持器顶出位置时保持接合所述保持器主体，以防止所述保持器脱离构件能够运动回到所述第一位置。
18.一种用于与外科缝合装置一起使用的保持器，所述外科缝合装置包括用于防止所述外科缝合装置的操作的闭锁件，其中所述外科缝合装置还包括框架，所述框架被构造成能够可移除地支撑所述框架中的钉仓，使得当所述钉仓安置在所述框架中时，所述钉仓的鼻部从所述框架突出，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成能够可移除地附接到所述钉仓以形成仓组件，其中所述仓组件被构造成能够被安置在所述外科缝合装置的所述框架中；
验证键，所述验证键从所述保持器主体突出，其中所述验证键被构造成能够在所述仓组件安置在所述框架中时使所述闭锁件失效；和
撬杆部分，所述撬杆部分被构造成能够接合所述钉仓的从所述框架突出的所述鼻部以向所述鼻部施加撬动运动，从而将所述钉仓从所述框架移开。
19.根据权利要求18所述的保持器，其中，所述撬杆部分包括：
鼻部凹坑，所述鼻部凹坑位于所述保持器主体的远侧端部上，其中所述鼻部凹坑被构造成能够在所述保持器主体已从所述钉仓移除之后接收从所述框架突出的所述鼻部的一部分；和
撬动构件，所述撬动构件形成在所述保持器主体的远侧端部上并且在所述保持器主体的下侧下方延伸，其中所述撬动构件被构造成能够：当从所述框架突出的所述鼻部的部分被支撑在所述鼻部凹坑中并且向所述保持器主体施加撬动运动以将所述钉仓与所述框架分离时，与所述钉仓撬动接合。
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