CN115135254A - 包括弯曲的平台表面的钉仓 - Google Patents
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Abstract
本发明公开了一种用于与外科器械一起使用的钉仓。该钉仓包括细长狭槽、平台表面和一排钉腔。每个钉腔包括近侧端部和远侧端部。远侧端部比近侧端部更靠近细长狭槽。击发构件被构造成能够将钉驱动器从未击发位置驱动到击发位置。钉腔的远侧端部与钉驱动器的第一端部对准,并且钉腔的近侧端部与钉驱动器的第二端部对准。当钉驱动器处于击发位置时,钉驱动器的第一端部在平台表面上方延伸第一距离,并且钉驱动器的第二端部在平台表面上方延伸第二距离。第一距离不同于第二距离。
Description
背景技术
本发明涉及外科器械,并且在各种实施方案中,涉及被设计成用于切割和缝合组织的外科切割和缝合器械及其钉仓。
附图说明
通过结合附图来参考本发明实施方案的以下说明,本发明的特征和优点以及其获取方法将会变得更加明显,并可更好地理解发明本身,其中:
图1是根据至少一个实施方案的外科缝合器械的远侧端部的透视图;
图2是被示出为处于闭合或夹持构型的图1的缝合器械的远侧端部的透视图;
图3是被示出为处于关节运动构型的图1的缝合器械的远侧端部的透视图;
图4是从图1的缝合器械移除的钉仓的透视图;
图5是示出为一些部件被移除的图1的缝合器械的远侧端部的透视图;
图6是示出为附加部件被移除的图1的缝合器械的远侧端部的透视图;
图7是包括图1的缝合器械的快速钳口闭合系统、高负载钳口夹持系统和钉击发系统的驱动系统的透视图;
图8是图7的钉击发系统的透视图;
图9是图1的缝合器械的远侧端部的分解图;
图10是图7的快速钳口闭合系统和高负载钳口夹持系统的分解图;
图11示出了图1的缝合器械的砧座钳口处于打开位置;
图12示出了由图7的快速钳口闭合系统闭合的图11的砧座钳口;
图13示出了将高夹持负载施加到砧座钳口的图7的高负载钳口夹持系统;
图14示出了与砧座钳口脱离接合的图7的高负载钳口夹持系统;
图15示出了与砧座钳口脱离接合的快速钳口闭合系统;
图16是源自图14的详细视图;
图17是源自图15的详细视图;
图18是根据至少一个实施方案的包括驱动器保持特征部的钉仓的透视图;
图19是图18的钉仓的局部剖视图;
图20是图18的钉仓的侧壁的局部正视图;
图21是图18的钉仓的局部剖视图,其还包括处于未击发和/或保持位置的钉驱动器;
图22是当钉驱动器处于未击发和/或保持位置时图18至图21的钉仓以及钉驱动器和驱动器保持特征部之间的界面的局部剖视图;
图23是根据至少一个实施方案的包括处于限定于其中的窗口和钉驱动器的钉仓的局部剖视图;
图24是图23的钉驱动器的透视图;
图25是根据至少一个实施方案的包括驱动器保持特征部的钉仓的透视图;
图26是图25的钉仓的剖视图,其中钉仓包括钉驱动器;
图27是图26的钉驱动器中的一者的透视图;
图28是根据至少一个实施方案的包括保持凸缘的钉驱动器的透视图;
图29是用于形成钉仓的顶部模具和底部模具的剖视图,该钉仓被构造成能够在其中可运动地接纳图28的钉驱动器;
图30是图29的底部模具的透视图;
图31A是根据至少一个实施方案的钉仓的局部剖视图,该钉仓包括当击发构件在钉击发行程期间向远侧平移时接触钉驱动器的击发构件;
图31B是处于完全击发位置的图31A的钉驱动器的局部剖视图;
图32A是在击发构件向远侧平移超过钉驱动器之后的图31A的击发构件和钉驱动器的局部剖视图;
图32B是当击发构件在钉击发行程之后向近侧平移时接触钉驱动器的图31A的击发构件的局部剖视图;
图33是根据至少一个实施方案的包括钉驱动器和驱动器保持构件的钉仓的局部平面图;
图34是图33的钉驱动器的透视图,其中孔口限定在钉驱动器中,并且其中孔被构造成能够在钉驱动器处于升高或保持位置时接纳驱动器保持构件;
图35是当钉驱动器处于升高位置时驱动器保持构件和图34的钉驱动器的孔口之间的相互作用的局部剖视图;
图36A是根据至少一个实施方案的包括弯曲平台表面和从该平台表面延伸的突起部的钉仓的局部正视图;
图36B是从图36A的弯曲平台表面延伸的突起部的局部平面图;
图37A是根据至少一个实施方案的包括弯曲平台表面的钉仓的局部正视图;
图37B是从图37A的弯曲平台表面延伸的突起部的局部平面图;
图38A是根据至少一个实施方案的包括弯曲平台表面的钉仓的局部正视图;
图38B是从图38B的弯曲平台表面延伸的突起部的局部平面图;
图39A是根据至少一个实施方案的包括弯曲平台表面的钉仓的局部正视图;
图39B是从图39A的弯曲平台表面延伸的突起部的局部平面图;
图40是根据至少一个实施方案的安置在端部执行器中的钉仓的局部剖视图,其中钉仓包括弯曲平台表面和从该弯曲平台表面延伸的突起部;
图41是处于未击发位置和完全击发位置的图40的钉仓的钉驱动器的局部剖视图,其中当钉驱动器处于完全击发位置时,钉驱动器的一部分延伸到突起部和弯曲平台表面上方;
图42是根据至少一个实施方案的包括三个纵向排钉腔的钉仓的局部平面图,其中最近侧钉腔位于中间排中;
图43是根据至少一个实施方案的包括三个纵向排钉腔的钉仓的局部平面图,其中最近侧钉腔不位于中间排中;
图44是根据至少一个实施方案的包括从弯曲平台表面延伸的突起部的钉仓的局部透视图;
图45是图44的钉仓的局部剖视图,其中突起部从弯曲平台表面延伸第一距离;
图46是处于闭合构型的端部执行器的局部剖视图,其中端部执行器包括安置在仓钳口中的图45的钉仓;
图47是根据至少一个实施方案的包括自由突起的弯曲平台表面的钉仓的局部剖视图;
图48是处于闭合构型的端部执行器的局部剖视图,其中端部执行器包括安置在仓钳口中的图47的钉仓;
图49是根据至少一个实施方案的包括从弯曲平台表面延伸各种距离的突起部的钉仓的局部剖视图;
图50是处于闭合构型的端部执行器的局部剖视图,其中端部执行器包括安置在仓钳口中的图49的钉仓;
图51是根据至少一个实施方案的处于闭合构型的端部执行器的局部剖视图,其中端部执行器包括钉仓,该钉仓包括从弯曲平台表面延伸不同距离的突起部;
图52是根据至少一个实施方案的处于闭合构型的端部执行器的局部剖视图,其中端部执行器包括钉仓,该钉仓包括从弯曲平台表面延伸均匀距离的突起部;
图53是根据至少一个实施方案的包括从弯曲平台表面延伸的可变突起部的钉仓的局部剖视图;
图54是来自限定在图53的钉仓的弯曲平台表面上的第一纵向排钉腔的钉腔的局部剖视图,其中第一纵向排在细长狭槽旁边延伸;
图55是来自限定在图53和图54的钉仓的弯曲平台表面上的第二纵向排钉腔的钉腔的局部剖视图,其中第二纵向排在第一纵向排旁边延伸;
图56是来自限定在图53至图55的钉仓的弯曲平台表面上的第三纵向排钉腔的钉腔的局部剖视图,其中第三纵向排在第二纵向排旁边延伸;
图57是根据至少一个实施方案的钉仓和砧座的局部透视图;
图58是示出处于未安置构型的钉仓的图57的钉仓和砧座的局部剖视图;
图59是示出处于安置构型的钉仓的图57的钉仓和砧座的局部剖视图;
图60是示出处于夹持构型的砧座的图57的钉仓和砧座的局部剖视图;
图61是根据至少一个实施方案的钉仓和砧座的局部透视图;
图62是示出处于未安置构型的钉仓的图61的钉仓和砧座的局部剖视图;
图63是示出处于夹持构型的砧座的图61的钉仓和砧座的局部剖视图;
图64是示出处于过度夹持构型的砧座的图61的钉仓和砧座的局部剖视图;
图65是根据至少一个实施方案的钉仓和砧座的局部透视图;
图66是示出处于未安置构型的钉仓的图65的钉仓和砧座的局部剖视图;
图67是示出处于局部安置构型的钉仓的图65的钉仓和砧座的局部剖视图;
图68是示出处于完全安置构型的钉仓的图65的钉仓和砧座的局部剖视图;
图69是根据至少一个实施方案的砧座的平面图;
图70是图69的砧座的细部图;
图71是根据至少一个实施方案的钉仓的局部平面图;
图72是图71的钉仓的透视图;
图73是根据至少一个实施方案的缝合器械的端部执行器的局部正视图;
图74是被示为处于夹持构型的图73的端部执行器的局部正视图;
图75是根据至少一个实施方案的缝合器械的端部执行器的局部正视图;
图76是被示为处于夹持构型的图75的端部执行器的局部正视图;
图77是根据至少一个实施方案的缝合器械的端部执行器的局部正视图;
图78是被示为处于局部夹持构型的图77的端部执行器的局部正视图;
图79是被示为处于过度夹持构型的图77的端部执行器的局部正视图;
图80是图77的缝合器械的端部执行器缝合器械的分解图;
图81是根据至少一个实施方案的外科器械的端部执行器的局部正视图;
图82是图81的端部执行器的另一个局部正视图;
图83是根据至少一个实施方案的示出处于局部闭合构型的端部执行器的外科器械的端部执行器的局部剖视图;
图84是被示出处于闭合构型的图83的端部执行器的局部剖视图;
图85是被示出处于局部打开构型的图83的端部执行器的局部剖视图;
图86是被示出处于完全打开构型的图83的端部执行器的局部剖视图;
图87是根据至少一个实施方案的外科器械的端部执行器的局部剖视图;
图88是包括击发构件的击发组件的正视图;
图89是图88的端部执行器的击发构件的正视图;
图90是图88的击发构件的另一个正视图;
图91是根据至少一个实施方案的外科器械的击发组件的透视图;
图92是图91的击发组件的另一个透视图;
图93是示出处于部署构型的击发组件的组织切割刀的图91的击发组件的剖面正视图;
图94是处于未部署构型的图91的击发组件的剖面正视图;
图95是包括图91的击发组件的钉仓的局部正视图;
图96是图95的钉仓的局部透视图;
图97是根据至少一个实施方案的外科器械的击发组件的局部分解图;
图98是图97的击发组件以及钉仓的局部正视图,示出了处于未击发位置的击发组件;
图99是图97的击发组件和图98的钉仓的局部正视图,示出了处于局部击发位置的击发组件;
图100是图97的击发组件和图98的钉仓的局部正视图,示出了处于击发位置的击发组件;
图101是图97的击发组件和图98的钉仓的局部正视图,示出了在钉击发行程结束时的击发组件;
图102是图97的击发组件和图98的钉仓的局部正视图,示出了在钉击发行程之后的击发组件回缩;
图103是图97的击发组件和图98的钉仓的局部正视图,示出了处于回缩位置的击发组件;
图104示出了根据至少一个实施方案的钉击发系统和钉仓;
图105示出了在钉击发行程期间向远侧推进图104的钉击发系统的击发构件;
图106示出了将钉击发系统的组织切割刀从未部署位置旋转到部署位置的图105的击发构件;
图107示出了处于完全部署位置的图106的组织切割刀;
图108示出了在钉击发行程期间向远侧推进图104的钉击发系统;
图109示出了在钉击发行程之后回缩的图105的击发构件;
图110示出了当击发构件回缩时图106的组织切割刀通过图105的击发构件朝向其未部署位置旋转;
图111示出了图106的组织切割刀的刀刃回缩到钉仓的平台下方;
图112示出了与图106的组织切割刀脱离接合的图105的击发构件;
图113是图104的钉击发系统和钉仓的分解图;
图114是根据至少一个实施方案的外科器械的端部执行器的局部剖视图;
图115是被示出处于闭合构型的图114的端部执行器的局部剖视图;
图116是被示出处于局部击发构型的图114的端部执行器的局部剖视图;
图117是被示出处于击发构型的图114的端部执行器的局部剖视图;
图118是图114的端部执行器的局部剖视图,示出了处于回缩模式的外科器械的击发系统;
图119是图114的端部执行器的局部剖视图,示出了击发系统的一部分与回缩的钉击发系统的一部分脱离接合;
图120是图114的端部执行器的局部剖视图,示出了在重新打开之后的端部执行器;
图121是根据至少一个实施方案的示出为一些部件被移除的端部执行器的局部分解图;
图122是根据至少一个实施方案的包括处于未用尽状态的钉仓的外科器械的端部执行器的局部剖视图;
图123是图122的端部执行器的局部剖视图,示出了在预击发行程构型中的外科器械的钉击发系统,其中钉击发系统的击发杆与钉击发系统的滑动件/刀构件接合;
图124是处于局部击发构型的图122的端部执行器的局部剖视图,其中钉击发系统仅前进超过缝合器械的用尽的仓闭锁件;
图125是图122的端部执行器的局部剖视图,示出了回缩的钉击发系统;
图126是图122的端部执行器的局部剖视图,示出了在钉击发系统的回缩期间钉击发系统的击发杆通过用尽的仓闭锁件与滑动件脱离接合;
图127是图122的端部执行器的局部剖视图,示出了钉击发系统的击发杆处于完全回缩位置,其中钉仓处于用尽状态;
图128是图122的端部执行器的局部剖视图,示出了钉击发系统的击发杆因为用尽的钉仓尚未用未用尽的钉仓替换而被用尽的仓闭锁件阻挡;
图129是包括钉击发驱动器的钉仓的局部透视图;
图130是图129的钉仓的局部平面图;
图131是处于未击发状态的图129的钉击发驱动器的局部透视图;
图132是处于局部击发状态的图129的钉击发驱动器的局部透视图;
图133是处于回缩状态的图129的钉击发驱动器的局部透视图;
图134是根据至少一个实施方案的示出处于打开位置的端部执行器的钳口的外科器械的端部执行器的局部透视图;
图135是图134的端部执行器的局部正视图,示出了由于不存在安置在端部执行器中的未击发的钉仓处于锁定状态的钳口闭合闭锁件和处于锁定状态的钉击发闭锁件;
图136是闭锁组件的透视图,其包括图135的钳口闭合闭锁件和钉击发闭锁件;
图137是图134的端部执行器的局部正视图,示出了由于存在安置在端部执行器中的未击发的钉仓处于解锁状态的钳口闭合闭锁件和处于解锁状态的钉击发闭锁件;
图138是图134的端部执行器的局部正视图,示出了处于部分击发状态的图137的钉仓;
图139是根据至少一个实施方案的包括仓体和滑动件的钉仓的局部分解图;
图140是图139的钉仓的局部剖视图,示出了处于近侧未击发位置的滑动件;
图141是图139的钉仓的局部剖视图,示出了在钉击发行程期间向远侧推进并激活钉仓中的用尽的仓闭锁件的滑动件;
图142是图139的钉仓的局部剖视图,示出了在钉击发行程期间向远侧推进的滑动件和处于激活状态的用尽的仓闭锁件;
图143是图139的钉仓的局部剖视图,示出了在钉击发行程之后回缩的滑动件以及处于激活状态的用于防止滑动件返回到其近侧未击发位置的用尽的仓闭锁件;
图144是根据示出为处于打开构型的至少一个实施方案的包括砧座钳口和钉仓钳口的外科器械的端部执行器的局部正视图;
图144A是图144的端部执行器的局部剖视图;
图145示出了处于闭合构型的图144的端部执行器;
图145A是示出为图145的闭合构型的图144的端部执行器的细部图;
图146是示出为图145的闭合构型的图144的端部执行器的局部剖视图;
图147是示出为砧座钳口相对于钉仓钳口处于打开位置的图144的端部执行器的正视图;
图148是示出为砧座钳口相对于钉仓钳口处于平行位置的图144的端部执行器的正视图;
图149是示出为砧座钳口相对于钉仓钳口处于过度夹持位置的图144的端部执行器的正视图;
图149A是处于图149的构型的图144的端部执行器的细部图;
图149B是示出为重新打开构型的图144的端部执行器的细部图;
图150是示出由图144的外科器械的端部执行器夹持系统和钉击发系统所经历的位移和负载的图表;
图151是根据至少一个实施方案的端部执行器的正视图;
图152是图151的端部执行器被夹持在患者组织T上的正视图;
图153是示出由图151的外科器械的端部执行器夹持系统和钉击发系统所经历的位移和负载的图表;图154是根据至少一个实施方案的外科器械的关节运动接头的透视图;
图155是示出为处于关节运动构型的图154的外科器械的关节运动接头的透视图;
图156是图154的外科器械的关节运动接头的局部透视图,该关节运动接头被示出为处于关节式构型,其中为了说明的目的,关节运动接头的一部分隐藏;
图157是根据至少一个实施方案的外科器械的关节运动接头的透视图;
图158是根据至少一个实施方案的外科器械的关节运动接头的局部透视图;
图159是根据至少一个实施方案的外科器械的关节运动接头的透视图;
图160是示出了外科器械的击发构件的图159的外科器械的关节运动接头的侧视图;
图161是图159的外科器械的关节运动接头的一部分的透视图,示出了远侧关节运动锁定件;
图162是根据至少一个实施方案的外科器械的关节运动接头的平面图;
图163是根据至少一个实施方案的外科器械的关节运动接头的透视图;
图164是图163的外科器械的关节运动接头的透视图,为了清楚起见,示出关节运动接头的部分被隐藏;
图165是图164的外科器械的关节运动接头的透视图,示出了处于关节运动构型的关节运动接头;
图166是图163的外科器械的关节运动接头的透视图,为了清楚起见,关节运动接头的部分被隐藏;以及
图167是图163的外科器械的关节运动接头的平面图。
在若干视图中,对应的参考符号指示对应的零件。本文所述的范例以一种形式示出了本发明的某些实施方案,并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的以下美国专利申请:
-名称为“METHOD FOR OPERATING A SURGICAL INSTRUMENT”的代理人案卷号END9199USNP1/190434-1M;
-名称为“STAPLE CARTRIDGE COMPRISING A SEATING CAM”的代理人案卷号END9203USNP1/190438-1;
-名称为“SURGICAL INSTRUMENT COMPRISING A RAPID CLOSURE MECHANISM”的代理人案卷号END9204USNP1/190443-1;
-名称为“SURGICAL INSTRUMENT COMPRISING A CLOSURE SYSTEM INCLUDING ACLOSURE MEMBER AND AN OPENING MEMBER DRIVEN BY A DRIVE SCREW”的代理人案卷号END9204USNP2/190443-2;
-名称为“SURGICAL INSTRUMENT COMPRISING A NESTED FIRING MEMBER”的代理人案卷号END9204USNP3/190443-3;
-名称为“STAPLE CARTRIDGE COMPRISING A DEPLOYABLE KNIFE”的代理人案卷号END9204USNP4/190443-4;
-名称为“STAPLE CARTRIDGE COMPRISING A DETACHABLE TISSUE CUTTINGKNIFE”的代理人案卷号END9204USNP5/190443-5;
-名称为“STAPLING SYSTEM COMPRISING A CLAMP LOCKOUT AND A FIRINGLOCKOUT”的代理人案卷号END9205USNP1/190448-1;
-名称为“STAPLE CARTRIDGE COMPRISING A LATCH LOCKOUT”的代理人案卷号END9205USNP2/190448-2;
-名称为“SURGICAL INSTRUMENT COMPRISING A POWERED ARTICULATION SYSTEM”的代理人案卷号END9200USNP1/190435-1;
-名称为“MOTOR DRIVEN SURGICAL INSTRUMENT”的代理人案卷号END9201USNP1/190436-1;
-名称为“STAPLING INSTRUMENT COMPRISING INDEPENDENT JAW CLOSING ANDSTAPLE FIRING SYSTEMS”的代理人案卷号END9202USNP1/190437-1;
-名称为“STAPLE CARTRIDGE COMPRISING DRIVER RETENTION MEMBERS”的代理人案卷号END9203USNP2/190438-2;
-名称为“STAPLE CARTRIDGE COMPRISING DRIVER RETENTION MEMBERS”的代理人案卷号END9203USNP3/190438-3;以及
-名称为“STAPLE CARTRIDGE COMPRISING PROJECTIONS EXTENDING FROM ACURVED DECK SURFACE”的代理人案卷号END9203USNP4/190438-4;
本申请的申请人拥有于2019年3月25日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“FIRING DRIVE ARRANGEMENTS FOR SURGICAL SYSTEMS”的美国专利申请序列号16/363,070;
-名称为“FIRING DRIVE ARRANGEMENTS FOR SURGICAL SYSTEMS”的美国专利申请序列号16/363,051;
-名称为“ARTICULATION DRIVE ARRANGEMENTS FOR SURGICAL SYSTEMS”的美国专利申请序列号16/363,045;以及
-名称为“FIRING DRIVE ARRANGEMENTS FOR SURGICAL SYSTEMS”的美国专利申请序列号16/363,062。
本申请的申请人拥有于2019年6月30日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“METHOD FOR AUTHENTICATING THE COMPATIBILITY OF A STAPLECARTRIDGE WITH A SURGICAL INSTRUMENT”的美国专利申请序列号16/458,104;
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN RFID SYSTEM”的美国专利申请序列号16/458,108;
-名称为“SURGICAL INSTRUMENT COMPRISING AN RFID SYSTEM FOR TRACKING AMOVABLE COMPONENT”的美国专利申请序列号16/458,111;
-名称为“SURGICAL INSTRUMENT COMPRISING AN ALIGNED RFID SENSOR”的美国专利申请序列号16/458,114;
-名称为“SURGICAL STAPLING SYSTEM HAVING AN INFORMATION DECRYPTIONPROTOCOL”的美国专利申请序列号16/458,105;
-名称为“SURGICAL STAPLING SYSTEM HAVING AN INFORMATION ENCRYPTIONPROTOCOL”的美国专利申请序列号16/458,110;
-名称为“SURGICAL STAPLING SYSTEM HAVING A LOCKOUT MECHANISM FOR ANINCOMPATIBLE CARTRIDGE”的美国专利申请序列号16/458,120;
-名称为“SURGICAL STAPLING SYSTEM HAVING A FRANGIBLE RFID TAG”的美国专利申请序列号16/458,125;以及
-名称为“PACKAGING FOR A REPLACEABLE COMPONENT OF A SURGICAL STAPLINGSYSTEM”的美国专利申请序列号16/458,103。
本申请的申请人拥有于2019年6月30日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“METHOD OF USING MULTIPLE RFID CHIPS WITH A SURGICAL ASSEMBLY”的美国专利申请序列号16/458,107;
-名称为“MECHANISMS FOR PROPER ANVIL ATTACHMENT SURGICAL STAPLING HEADASSEMBLY”的美国专利申请序列号16/458,109;
-名称为“MECHANISMS FOR MOTOR CONTROL ADJUSTMENTS OF A MOTORIZEDSURGICAL INSTRUMENT”的美国专利申请序列号16/458,119;
-名称为“SURGICAL INSTRUMENT WITH BATTERY COMPATIBILITY VERIFICATIONFUNCTIONALITY”的美国专利申请序列号16/458,115;
-名称为“SURGICAL SYSTEM WITH RFID TAGS FOR UPDATING MOTOR ASSEMBLYPARAMETERS”的美国专利申请序列号16/458,117;
-名称为“SURGICAL SYSTEMS WITH MULTIPLE RFID TAGS”的美国专利申请序列号16/458,121;
-名称为“RFID IDENTIFICATION SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号16/458,122;
-名称为“RFID IDENTIFICATION SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号16/458,106;
-名称为“SURGICAL RFID ASSEMBLIES FOR DISPLAY AND COMMUNICATION”的美国专利申请序列号16/458,112;
-名称为“SURGICAL RFID ASSEMBLIES FOR COMPATIBILITY DETECTION”的美国专利申请序列号16/458,116;以及
-名称为“SURGICAL RFID ASSEMBLIES FOR INSTRUMENT OPERATIONAL SETTINGCONTROL”的美国专利申请序列号16/458,118。
本专利申请的申请人拥有于2018年12月4日提交的以下美国专利申请,这些临时专利申请中的每个的公开内容全文以引用方式并入本文:
-名称为“METHOD OF HUB COMMUNICATION,PROCESSING,STORAGE AND DISPLAY”的美国专利申请序列号16/209,385;
-名称为“METHOD OF HUB COMMUNICATION”的美国专利申请序列号16/209,395;
-名称为“METHOD OF CLOUD BASED DATA ANALYTICS FOR USE WITH THE HUB”的美国专利申请序列号16/209,403;
-名称为“METHOD OF ROBOTIC HUB COMMUNICATION,DETECTION,AND CONTROL”的美国专利申请序列号16/209,407;
-名称为“METHOD OF HUB COMMUNICATION,PROCESSING,DISPLAY,AND CLOUDANALYTICS”的美国专利申请序列号16/209,416;
-名称为“METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE ANDSIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS”的美国专利申请序列号16/209,423;
-名称为“METHOD OF USING REINFORCED FLEXIBLE CIRCUITS WITH MULTIPLESENSORS TO OPTIMIZE PERFORMANCE OF RADIO FREQUENCY DEVICES”的美国专利申请序列号16/209,427;
-名称为“METHOD OF SENSING PARTICULATE FROM SMOKE EVACUATED FROM APATIENT,ADJUSTING THE PUMP SPEED BASED ON THE SENSED INFORMATION,ANDCOMMUNICATING THE FUNCTIONAL PARAMETERS OF THE SYSTEM TO THE HUB”的美国专利申请序列号16/209,433;
-名称为“METHOD FOR SMOKE EVACUATION FOR SURGICAL HUB”的美国专利申请序列号16/209,447;
-名称为“METHOD FOR CONTROLLING SMART ENERGY DEVICES”的美国专利申请序列号16/209,453;
-名称为“METHOD FOR SMART ENERGY DEVICE INFRASTRUCTURE”的美国专利申请序列号16/209,458;
-名称为“METHOD FOR ADAPTIVE CONTROL SCHEMES FOR SURGICAL NETWORKCONTROL AND INTERACTION”的美国专利申请序列号16/209,465;
-名称为“METHOD FOR SITUATIONAL AWARENESS FOR SURGICAL NETWORK ORSURGICAL NETWORK CONNECTED DEVICE CAPABLE OF ADJUSTING FUNCTION BASED ON ASENSED SITUATION OR USAGE”的美国专利申请序列号16/209,478;
-名称为“METHOD FOR FACILITY DATA COLLECTION AND INTERPRETATION”的美国专利申请序列号16/209,490;以及
-名称为“METHOD FOR CIRCULAR STAPLER CONTROL ALGORITHM ADJUSTMENTBASED ON SITUATIONAL AWARENESS”的美国专利申请序列号16/209,491。
本申请的申请人拥有于2019年6月26日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“METHOD FOR PROVIDING AN AUTHENTICATION LOCKOUT IN A SURGICALSTAPLER WITH A REPLACEABLE CARTRIDGE”的美国专利申请序列号16/453,273;
-名称为“SURGICAL STAPLING ASSEMBLY WITH CARTRIDGE BASED RETAINERCONFIGURED TO UNLOCK A FIRING LOCKOUT”的美国专利申请序列号16/453,283;
-名称为“SURGICAL STAPLING ASSEMBLY WITH CARTRIDGE BASED RETAINERCONFIGURED TO UNLOCK A CLOSURE LOCKOUT”的美国专利申请序列号16/453,289;
-名称为“UNIVERSAL CARTRIDGE BASED KEY FEATURE THAT UNLOCKS MULTIPLELOCKOUT ARRANGEMENTS IN DIFFERENT SURGICAL STAPLERS”的美国专利申请序列号16/453,302;
-名称为“STAPLE CARTRIDGE RETAINERS WITH FRANGIBLE RETENTION FEATURESAND METHODS OF USING SAME”的美国专利申请序列号16/453,310;
-名称为“STAPLE CARTRIDGE RETAINER WITH FRANGIBLE AUTHENTICATION KEY”的美国专利申请序列号16/453,330;
-名称为“STAPLE CARTRIDGE RETAINER WITH RETRACTABLE AUTHENTICATIONKEY”的美国专利申请序列号16/453,335;
-名称为“STAPLE CARTRIDGE RETAINER SYSTEM WITH AUTHENTICATION KEYS”的美国专利申请序列号16/453,343;
-名称为“INSERTABLE DEACTIVATOR ELEMENT FOR SURGICAL STAPLER LOCKOUTS”的美国专利申请序列号16/453,355;
-名称为“DUAL CAM CARTRIDGE BASED FEATURE FOR UNLOCKING A SURGICALSTAPLER LOCKOUT”的美国专利申请序列号16/453,369;
-名称为“STAPLE CARTRIDGES WITH CAM SURFACES CONFIGURED TO ENGAGEPRIMARY AND SECONDARY PORTIONS OF A LOCKOUT OF A SURGICAL STAPLING DEVICE”的美国专利申请序列号16/453,391;
-名称为“SURGICAL STAPLE CARTRIDGES WITH MOVABLE AUTHENTICATION KEYARRANGEMENTS”的美国专利申请序列号16/453,413;
-名称为“DEACTIVATOR ELEMENT FOR DEFEATING SURGICAL STAPLING DEVICELOCKOUTS”的美国专利申请序列号16/453,423;以及
-名称为“SURGICAL STAPLE CARTRIDGES WITH INTEGRAL AUTHENTICATION KEYS”的美国专利申请序列号16/453,429。
本申请的申请人拥有于2019年6月25日提交的各自全文以引用方式并入本文的以下美国设计专利申请:
-名称为“SURGICAL STAPLE CARTRIDGE RETAINER WITH FIRING SYSTEMAUTHENTICATION KEY”的美国设计专利申请序列号29/696,066;
-名称为“SURGICAL STAPLE CARTRIDGE RETAINER WITH CLOSURE SYSTEMAUTHENTICATION KEY”的美国设计专利申请序列号29/696,067;以及
-名称为“SURGICAL STAPLE CARTRIDGE”的美国设计专利申请序列号29/696,072。
本申请的申请人拥有于2019年2月21日提交的各自全文以引用方式并入本文的以下美国专利申请:
-名称为“METHODS FOR CONTROLLING A POWERED SURGICAL STAPLER THAT HASSEPARATE ROTARY CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号16/281658;
-名称为“STAPLE CARTRIDGE COMPRISING A LOCKOUT KEY CONFIGURED TO LIFTA FIRING MEMBER”的美国专利申请序列号16/281,670;
-名称为“surgical staplers with arrangements for maintaining a firingmember thereof in a locked configuration unless a compatible cartridge hasbeen installed therein”的美国专利申请序列号16/281,675;
-名称为“SURGICAL INSTRUMENT COMPRISING CO-OPERATING LOCKOUT FEATURES”的美国专利申请序列号16/281,685;
-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16/281,693;
-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16/281,704;
-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16/281,762;
-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16/281,660;
-名称为“SURGICAL STAPLING DEVICES WITH IMPROVED ROTARY DRIVEN CLOSURESYSTEMS”的美国专利申请序列号16/281,666;
-名称为“SURGICAL STAPLING DEVICES WITH ASYMMETRIC CLOSURE FEATURES”的美国专利申请序列号16/281672;
-名称为“ROTARY DRIVEN FIRING MEMBERS WITH DIFFERENT ANVIL AND FRAMEENGAGEMENT FEATURES”的美国专利申请序列号16/281,678;以及
-名称为“SURGICAL STAPLING DEVICE WITH SEPARATE ROTARY DRIVEN CLOSUREAND FIRING SYSTEMS AND FIRING MEMBER THAT ENGAGES BOTH JAWS WHILE FIRING”的美国专利申请序列号16/281,682。
本专利申请的申请人拥有于2018年3月28日提交的以下美国临时专利申请,这些临时专利申请中的每个临时专利申请全文以引用方式并入本文:
-名称为“INTERACTIVE SURGICAL SYSTEMS WITH encrypted COMMUNICATIONCAPABILITIES”的美国临时专利申请序列号62/649,302;
-名称为“DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS ANDCREATE ANONYMIZED RECORD”的美国临时专利申请序列号62/649,294;
-名称为“SURGICAL HUB SITUATIONAL AWARENESS”的美国临时专利申请序列号62/649,300;
-名称为“SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES INOPERATING THEATER”的美国临时专利申请序列号62/649,309;
-名称为“COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS”的美国临时专利申请序列号62/649,310;
-名称为“USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINEPROPERTIES OF BACK SCATTERED LIGHT”的美国临时专利申请序列号62/649,291;
-名称为“ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES”的美国临时专利申请序列号62/649,296;
-名称为“CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION ANDRECOMMENDATIONS TO A USER”的美国临时专利申请序列号62/649,333;
-名称为“CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATIONTRENDS AND REACTIVE MEASURES”的美国临时专利申请序列号62/649,327;
-名称为“DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICSNETWORK”的美国临时专利申请序列号62/649,315;
-名称为“CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES”的美国临时专利申请序列号62/649,313;
-名称为“DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS”的美国临时专利申请序列号62/649,320;
-名称为“AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICALPLATFORMS”的美国临时专利申请序列号62/649,307;以及
-名称为“SENSING ARRANGEMENTS FOR Robot-Assisted Surgical PlatformS”的美国临时专利申请序列号62/649,323。
本申请的申请人拥有于2018年3月30日提交的以下美国临时专利申请,该临时专利申请全文以引用方式并入本文:
-名称为“SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES”的美国临时专利申请序列号62/650,887。
本申请的申请人拥有于2018年12月4日提交的以下美国专利申请,该专利申请以引用方式全文并入本文:
-名称为“METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE ANDSIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS”的美国专利申请序列号16/209,423。
本申请的申请人拥有于2018年8月20日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“METHOD FOR FAbricating SURGICAL STAPLER ANVILS”的美国专利申请序列号16/105,101;
-名称为“REINFORCED DEFORMABLE ANVIL TIP FOR SURGICAL STAPLER ANVIL”的美国专利申请序列号16/105,183;
-名称为“SURGICAL STAPLER ANVILS WITH STAPLE DIRECTING PROTRUSIONS ANDTISSUE STABILITY FEATURES”的美国专利申请序列号16/105,150;
-名称为“FABRICATING TECHNIQUES FOR SURGICAL STAPLER ANVILS”的美国专利申请序列号16/105,098;
-名称为“SURGICAL STAPLER ANVILS WITH TISSUE STOP FEATURES CONFIGUREDTO AVOID TISSUE PINCH”的美国专利申请序列号16/105,140;
-名称为“METHOD FOR OPERATING A POWERED ARTICULATABLE SURGICALINSTRUMENT”的美国专利申请序列号16/105,081;
-名称为“SURGICAL INSTRUMENTS WITH PROGRESSIVE JAW CLOSUREARRANGEMENTS”的美国专利申请序列号16/105,094;
-名称为“POWERED SURGICAL INSTRUMENTS WITH CLUTCHING ARRANGEMENTS TOCONVERT LINEAR DRIVE MOTIONS TO ROTARY DRIVE MOTIONS”的美国专利申请序列号16/105,097;
-名称为“POWERED ARTICULATABLE SURGICAL INSTRUMENTS WITH CLUTCHING ANDLOCKING ARRANGEMENTS FOR LINKING AN ARTICULATION DRIVE SYSTEM TO A FIRINGDRIVE SYSTEM”的美国专利申请序列号16/105,104;
-名称为“ARTICULATABLE MOTOR POWERED SURGICAL INSTRUMENTS WITHDEDICATED ARTICULATION MOTOR ARRANGEMENTS”的美国专利申请序列号16/105,119;
-名称为“SWITCHING ARRANGEMENTS FOR MOTOR POWERED ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号16/105,160;以及
-名称为“SURGICAL STAPLER ANVILS”的美国设计专利申请序列号29/660,252。
本申请的申请人拥有于2017年8月3日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“SURGICAL SYSTEM SHAFT INTERCONNECTION”的美国专利申请序列号15/668,324;
-名称为“SURGICAL SYSTEM BAILOUT”的美国专利申请序列号15/668,301;以及
-名称为“SURGICAL SYSTEM COMPRISING AN ARTICULATION BAILOUT”的美国专利申请序列号15/668,319。
本申请的申请人拥有于2017年6月28日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“SURGICAL INSTRUMENT COMPRISING AN OFFSET ARTICULATION JOINT”的美国专利申请序列号15/635,693;
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM RATIO”的美国专利申请序列号15/635,729;
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM RATIO”的美国专利申请序列号15/635,785;
-名称为“SURGICAL INSTRUMENT COMPRISING FIRING MEMBER SUPPORTS”的美国专利申请序列号15/635,808;
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEMLOCKABLE TO A FRAME”的美国专利申请序列号15/635,837;
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEMLOCKABLE BY A CLOSURE SYSTEM”的美国专利申请序列号15/635,941;
-名称为“SURGICAL INSTRUMENT COMPRISING A SHAFT INCLUDING A HOUSINGARRANGEMENT”的美国专利申请序列号15/636,029;
-名称为“SURGICAL INSTRUMENT COMPRISING SELECTIVELY ACTUATABLEROTATABLE COUPLERS”的美国专利申请序列号15/635,958;
-名称为“SURGICAL STAPLING INSTRUMENTS COMPRISING SHORTENED STAPLECARTRIDGE NOSES”的美国专利申请序列号15/635,981;
-名称为“SURGICAL INSTRUMENT COMPRISING A SHAFT INCLUDING A CLOSURETUBE PROFILE”的美国专利申请序列号15/636,009;
-名称为“METHOD FOR ARTICULATING A SURGICAL INSTRUMENT”的美国专利申请序列号15/635,663;
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTOR WITHAXIALLY SHORTENED ARTICULATIONJOINT CONFIGURATIONS”的美国专利申请序列号15/635,530;
-名称为“SURGICAL INSTRUMENTS WITH OPEN AND CLOSABLE JAWS AND AXIALLYMOVABLE FIRING MEMBER THAT IS INITIALLY PARKED IN CLOSE PROXIMITY TO THE JAWSPRIOR TO FIRING”的美国专利申请序列号15/635,549;
-名称为“SURGICAL INSTRUMENTS WITH JAWS CONSTRAINED TO PIVOT ABOUT ANAXIS UPON CONTACT WITH A CLOSURE MEMBER THAT IS PARKED IN CLOSE PROXIMITY TOTHE PIVOT AXIS”的美国专利申请序列号15/635,559;
-名称为“SURGICAL END EFFECTORS WITH IMPROVED JAW APERTUREARRANGEMENTS”的美国专利申请序列号15/635,578;
-名称为“SURGICAL CUTTING AND FASTENING DEVICES WITH PIVOTABLE ANVILWITH A TISSUE LOCATING ARRANGEMENT IN CLOSE PROXIMITY TO AN ANVIL PIVOT AXIS”的美国专利申请序列号15/635,594;
-名称为“JAW RETAINER ARRANGEMENT FOR RETAINING A PIVOTABLE SURGICALINSTRUMENT JAW IN PIVOTABLE RETAINING ENGAGEMENT WITH A SECOND SURGICALINSTRUMENT JAW”的美国专利申请序列号15/635,612;
-名称为“SURGICAL INSTRUMENT WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号15/635,621;
-名称为“SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER”的美国专利申请序列号15/635,631;
-名称为“SURGICAL INSTRUMENT LOCKOUT ARRANGEMENT”的美国专利申请序列号15/635,521;
-名称为“SURGICAL INSTRUMENT SHAFT”的美国设计专利申请序列号29/609,083;
-名称为“SURGICAL FORMING ANVI”的美国设计专利申请序列号29/609,087;
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/609,093;
-名称为“SURGICAL INSTRUMENT”的美国设计专利申请序列号29/609,121;
-名称为“SURGICAL INSTRUMENT”的美国设计专利申请序列号29/609,125;
-名称为“SURGICAL INSTRUMENT”的美国设计专利申请序列号29/609,128;以及
-名称为“DISPLAY SCREEN PORTION OF A SURGICAL INSTRUMENT HAVING AGRAPHICAL USER INTERFACE”的美国设计专利申请序列号29/609,129。
本申请的申请人拥有于2017年6月27日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“SURGICAL ANVIL MANUFACTURING METHODS”的美国专利申请序列号15/634,024;
-名称为“SURGICAL ANVIL ARRANGEMENTS”的美国专利申请序列号15/634,035;
-名称为“SURGICAL ANVIL ARRANGEMENTS”的美国专利申请序列号15/634,046;
-名称为“SURGICAL ANVIL ARRANGEMENTS”的美国专利申请序列号15/634,054;
-名称为“SURGICAL FIRING MEMBER ARRANGEMENTS”的美国专利申请序列号15/634,068;
-名称为“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列号15/634,076;
-名称为“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列号15/634,090;
-名称为“SURGICAL END EFFECTORS AND ANVILS”的美国专利申请序列号15/634,099;以及
-名称为“ARTICULATION SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号15/634,117。
本申请的申请人拥有于2016年12月21日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIESTHEREOF”的美国专利申请序列号15/386,185;
-名称为“ARTICULATABLE SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,230;
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS”的美国专利申请序列号15/386,221;
-名称为“SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF”的美国专利申请序列号15/386,209;
-名称为“LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS ANDREPLACEABLE TOOL ASSEMBLIES”的美国专利申请序列号15/386,198;
-名称为“SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR”的美国专利申请序列号15/386,240;
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,939;
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FORSHIFTING BETWEEN CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES ANDARTICULATION AND FIRING SYSTEMS”的美国专利申请序列号15/385,941;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,943;
-名称为“SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTIONFEATURES”的美国专利申请序列号15/385,950;
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,945;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,946;
-名称为“SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASINGA JAW OPENING DISTANCE”的美国专利申请序列号15/385,951;
-名称为“METHODS OF STAPLING TISSUE”的美国专利申请序列号15/385,953;
-名称为“FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FORSURGICAL END EFFECTORS”的美国专利申请序列号15/385,954;
-名称为“SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOPARRANGEMENTS”的美国专利申请序列号15/385,955;
-名称为“SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS”的美国专利申请序列号15/385,948;
-名称为“SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES”的美国专利申请序列号15/385,956;
-名称为“SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTINGFIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE ISPRESENT”的美国专利申请序列号15/385,958;
-名称为“STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLECAVITIES THEREIN”的美国专利申请序列号15/385,947;
-名称为“METHOD FOR RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT”的美国专利申请序列号15/385,896;
-名称为“STAPLE FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENTTYPES OF STAPLES”的美国专利申请序列号15/385,898;
-名称为“SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL”的美国专利申请序列号15/385,899;
-名称为“STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISINGWINDOWS DEFINED THEREIN”的美国专利申请序列号15/385,901;
-名称为“SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER”的美国专利申请序列号15/385,902;
-名称为“STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/ORSPENT CARTRIDGE LOCKOUT”的美国专利申请序列号15/385,904;
-名称为“FIRING ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,905,;
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUTAND A FIRING ASSEMBLY LOCKOUT”的美国专利申请序列号15/385,907;
-名称为“FIRING ASSEMBLY COMPRISING A FUSE”的美国专利申请序列号15/385,908;
-名称为“FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE”的美国专利申请序列号15/385,909;
-名称为“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列号15/385,920;
-名称为“ANVIL ARRANGEMENTS FOR SURGICAL STAPLE/FASTENERS”的美国专利申请序列号15/385,913;
-名称为“METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPES OFSTAPLE CARTRIDGES WITH THE SAME SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/385,914;
-名称为“BILATERALLY ASYMMETRIC STAPLE FORMING POCKET PAIRS”的美国专利申请序列号15/385,893;
-名称为“CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICALINSTRUMENTS WITH SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号15/385,929;
-名称为“SURGICAL STAPLE/FASTENERS WITH INDEPENDENTLY ACTUATABLECLOSING AND FIRING SYSTEMS”的美国专利申请序列号15/385,911;
-名称为“SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES”的美国专利申请序列号15/385,927;
-名称为“STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPINGBREADTHS”的美国专利申请序列号15/385,917;
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING PRIMARYSIDEWALLS AND POCKET SIDEWALLS”的美国专利申请序列号15/385,900;
-名称为“NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FORSURGICAL STAPLE/FASTENERS”的美国专利申请序列号15/385,931;
-名称为“FIRING MEMBER PIN ANGLE”的美国专利申请序列号15/385,915;
-名称为“STAPLE FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMINGSURFACE GROOVES”的美国专利申请序列号15/385,897;
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES”的美国专利申请序列号15/385,922;
-名称为“SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS”的美国专利申请序列号15/385,924;
-名称为“SURGICAL INSTRUMENTS WITH JAWS THAT ARE PIVOTABLE ABOUT AFIXED AXIS AND INCLUDE SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS”的美国专利申请序列号15/385,912;
-名称为“ANVIL HAVING A KNIFE SLOT WIDTH”的美国专利申请序列号15/385,910;
-名称为“FIRING MEMBER PIN CONFIGURATIONS”的美国专利申请序列号15/385,906;
-名称为“STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES”的美国专利申请序列号15/386,188;
-名称为“STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAPSETTING FEATURES”的美国专利申请序列号15/386,192;
-名称为“STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES”的美国专利申请序列号15/386,206;
-名称为“DURABILITY FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIESOF SURGICAL STAPLING INSTRUMENTS”的美国专利申请序列号15/386,226;
-名称为“SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITHPOSITIVE OPENING FEATURES”的美国专利申请序列号15/386,222;
-名称为“CONNECTION PORTIONS FOR DEPOSABLE LOADING UNITS FOR SURGICALSTAPLING INSTRUMENTS”的美国专利申请序列号15/386,236;
-名称为“METHOD FOR ATTACHING A SHAFT ASSEMBLY TO A SURGICALINSTRUMENT AND,ALTERNATIVELY,TO A SURGICAL ROBOT”的美国专利申请序列号15/385,887;
-名称为“SHAFT ASSEMBLY COMPRISING A MANUALLY-OPERABLE RETRACTIONSYSTEM FOR USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号15/385,889;
-名称为“SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE ANDRETRACTABLE SYSTEMS”的美国专利申请序列号15/385,890;
-名称为“SHAFT ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO ADAPT THEOUTPUT OF A ROTARY FIRING MEMBER TO TWO DIFFERENT SYSTEMS”的美国专利申请序列号15/385,891;
-名称为“SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO ANARTICULATION STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM”的美国专利申请序列号15/385,892;
-名称为“SHAFT ASSEMBLY COMPRISING A LOCKOUT”的美国专利申请序列号15/385,894;
-名称为“SHAFT ASSEMBLY COMPRISING FIRST AND SECONDARTICULATIONLOCKOUTS”的美国专利申请序列号15/385,895;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,916;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,918;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,919;
-名称为“SURGICAL STAPLE/FASTENER CARTRIDGE WITH MOVABLE CAMMINGMEMBER CONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES”的美国专利申请序列号15/385,921;
-名称为“SURGICAL STAPLING SYSTEMS”的美国专利申请序列号15/385,923;
-名称为“JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OFA FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN FIRED CARTRIDGE ISINSTALLED IN THE END EFFECTOR”的美国专利申请序列号15/385,925;
-名称为“AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYINGCLOSURE MOTIONS TO JAWS OF SURGICAL INSTRUMENTS”的美国专利申请序列号15/385,926;
-名称为“PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN AMOVABLE JAW AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT”的美国专利申请序列号15/385,928;
-名称为“SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERATING OPENINGFEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS”的美国专利申请序列号15/385,930;
-名称为“ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFTARRANGEMENT”的美国专利申请序列号15/385,932;
-名称为“ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLELINKAGE DISTAL OF AN ARTICULATION LOCK”的美国专利申请序列号15/385,933;
-名称为“ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR INAN ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE SYSTEM”的美国专利申请序列号15/385,934;
-名称为“LATERALLY ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FORLOCKING AN END EFFECTOR OF A SURGICAL INSTRUMENT IN AN ARTICULATEDCONFIGURATION”的美国专利申请序列号15/385,935;以及
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKEAMPLIFICATION FEATURES”的美国专利申请序列号15/385,936。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES”的美国专利申请序列号15/191,775;
-名称为“STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPEDSTAPLES”的美国专利申请序列号15/191,807;
-名称为“STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME”的美国专利申请序列号15/191,834;
-名称为“STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES”的美国专利申请序列号15/191,788;以及
-名称为“STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL STAPLE ROWS”的美国专利申请序列号15/191,818。
本申请的申请人拥有于2016年6月24日提交且各自全文以引用方式并入本文的以下美国专利申请:
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,218;
-名称为“SURGICAL FASTENER”的美国设计专利申请序列号29/569,227;
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,259;以及
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利申请序列号29/569,264。
本申请的申请人拥有于2016年4月1日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM”的美国专利申请序列号15/089,325;
-名称为“MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY”的美国专利申请序列号15/089,321;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD”的美国专利申请序列号15/089,326;
-名称为“SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIPPORTION”的美国专利申请序列号15/089,263;
-名称为“ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLEBAILOUT SYSTEM”的美国专利申请序列号15/089,262;
-名称为“SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVILCONCENTRIC DRIVE MEMBER”的美国专利申请序列号15/089,277;
-名称为“INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL ENDEFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS”的美国专利申请序列号15/089,296;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION”的美国专利申请序列号15/089,258;
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVECUTTING OF TISSUE”的美国专利申请序列号15/089,278;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT”的美国专利申请序列号15/089,284;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSIONLOCKOUT”的美国专利申请序列号15/089,295;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT”的美国专利申请序列号15/089,300;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT”的美国专利申请序列号15/089,196;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT”的美国专利申请序列号15/089,203;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGELOCKOUT”的美国专利申请序列号15/089,210;
-名称为“SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM”的美国专利申请序列号15/089,324;
-名称为“SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS”的美国专利申请序列号15/089,335;
-名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号15/089,339;
-名称为“SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OFSTAPLES HAVING DIFFERENT HEIGHTS”的美国专利申请序列号15/089,253;
-名称为“SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET”的美国专利申请序列号15/089,304;
-名称为“ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLE/FASTENERS”的美国专利申请序列号15/089,331;
-名称为“STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES”的美国专利申请序列号15/089,336;
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUESUPPORT”的美国专利申请序列号15/089,312;
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM”的美国专利申请序列号15/089,309;以及
-名称为“CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL”的美国专利申请序列号15/089,349。
本申请的申请人还拥有于2015年12月31日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE INPOWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/984,488;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/984,525;以及
-名称为“SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROLCIRCUITS”的美国专利申请序列号14/984,552。
本申请的申请人还拥有于2016年2月9日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLYTRANSLATABLE END EFFECTOR”的美国专利申请序列号15/019,220;
-名称为“SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,228;
-名称为“SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTEDSECONDARY CONSTRAINT”的美国专利申请序列号15/019,196;
-名称为“SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLYARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY”的美国专利申请序列号15/019,206;
-名称为“SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATIONARRANGEMENTS”的美国专利申请序列号15/019,215;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATIONLINK ARRANGEMENTS”的美国专利申请序列号15/019,227;
-名称为“SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLEDRIVEN ARTICULATION SYSTEMS”的美国专利申请序列号15/019,235;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAMARRANGEMENTS”的美国专利申请序列号15/019,230;以及
-名称为“SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTIONARRANGEMENTS”的美国专利申请序列号15/019,245。
本申请的申请人还拥有于2016年2月12日提交且各自全文以引用方式并入本文的如下标识的美国专利申请:
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,254;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,259;
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,275;以及
-名称为“MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号15/043,289。
本申请的申请人拥有于2015年6月18日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL END EFFECTORS WITH POSITIVE JAW OPENINGARRANGEMENTS”的美国专利申请序列号14/742,925,现为美国专利10,182,818;
-名称为“SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSINGFEATURES”的美国专利申请序列号14/742,941,现为美国专利10,052,102;
-名称为“MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,914,现为美国专利10,405,863;
-名称为“ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAMSTRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT”的美国专利申请序列号14/742,900,现为美国专利10,335,149;
-名称为“DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLESURGICALINSTRUMENTS”的美国专利申请序列号14/742,885,现为美国专利10,368,861;以及
-名称为“PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLESURGICAL INSTRUMENTS”的美国专利申请序列号14/742,876,现为美国专利10,178,992。
本申请的申请人拥有于2015年3月6日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“POWERED SURGICAL INSTRUMENT”的美国专利申请序列号14/640,746,现为美国专利9,808,246;
-名称为“MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWEREDSURGICAL INSTRUMENTS”的美国专利申请序列号14/640,795,现为美国专利10,441,279;
-名称为“ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURERATES FOR MULTIPLE TISSUE TYPES”的美国专利申请序列号14/640,832,现为美国专利申请公布2016/0256154;
-名称为“OVERLAID MULTI SENSOR RADIO FREQUENCY(RF)ELECTRODE SYSTEM TOMEASURE TISSUE COMPRESSION”的美国专利申请序列号14/640,935,现为美国专利申请公布2016/0256071;
-名称为“MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTORFOR POWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/640,831,现为美国专利9,985,148;
-名称为“TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINESTABILITY,CREEP,AND VISCOELASTIC ELEMENTS OF MEASURES”的美国专利申请序列号14/640,859,现为美国专利10,052,044;
-名称为“INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS”的美国专利申请序列号14/640,817,现为美国专利申请公布9,924,961;
-名称为“CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULARSHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE”的美国专利申请序列号14/640,844,现为美国专利10,045,776;
-名称为“SMART SENSORS WITH LOCAL SIGNAL PROCESSING”的美国专利申请序列号14/640,837,现为美国专利9,993,248;
-名称为“SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGEINTO A SURGICAL STAPLE/FASTENER”的美国专利申请序列号14/640,765,现为美国专利申请公布2016/0256160;
-名称为“SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON AROTATABLE SHAFT”的美国专利申请序列号14/640,799,现为美国专利9,901,342;以及
-名称为“SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING”的美国专利申请序列号14/640,780,现为美国专利10,245,033。
本申请的申请人拥有于2015年2月27日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION”的美国专利申请序列号14/633,576,现为美国专利10,045,779;
-名称为“SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCEPARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND”的美国专利申请序列号14/633,546,现为美国专利10,180,463;
-名称为“SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONEOR MORE BATTERIES”的美国专利申请序列号14/633,560,现为美国专利申请公布2016/0249910;
-名称为“CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FORCHARGING A BATTERY”的美国专利申请序列号14/633,566,现为美国专利10,182,816;
-名称为“SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TOBE SERVICED”的美国专利申请序列号14/633,555,现为美国专利10,321,907;
-名称为“REINFORCED BATTERY FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,542,现为美国专利9,931,118;
-名称为“POWER ADAPTER FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/633,548,现为美国专利10,245,028;
-名称为“ADAPTABLE SURGICAL INSTRUMENT HANDLE”的美国专利申请序列号14/633,526,现为美国专利9,993,258;
-名称为“MODULAR STAPLING ASSEMBLY”的美国专利申请序列号14/633,541,现为美国专利10,226,250;以及
-名称为“SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFEPARAMETER”的美国专利申请序列号14/633,562,现为美国专利10,159,483。
本申请的申请人拥有于2014年12月18日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE ENDEFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER”的美国专利申请序列号14/574,478,现为美国专利9,844,374;
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS”的美国专利申请序列号14/574,483,现为美国专利10,188,385;
-名称为“DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS”的美国专利申请序列号14/575,139,现为美国专利9,844,375;
-名称为“LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITHARTICULATABLE SURGICAL END EFFECTORS”的美国专利申请序列号14/575,148,现为美国专利10,085,748;
-名称为“SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLEABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE”的美国专利申请序列号14/575,130,现为美国专利10,245,027;
-名称为“SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS”的美国专利申请序列号14/575,143,现为美国专利10,004,501;
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDMOVABLE FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,117,现为美国专利9,943,309;
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS ANDIMPROVED FIRING BEAM SUPPORT ARRANGEMENTS”的美国专利申请序列号14/575,154,现为美国专利9,968,355;
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLEARTICULATION SYSTEM”的美国专利申请序列号14/574,493,现为美国专利9,897,000;以及
-名称为“SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLEARTICULATION SYSTEM”的美国专利申请序列号14/574,500,现为美国专利10,117,649。
本申请的申请人拥有2013年3月1日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“Articulatable Surgical Instruments With Conductive PathwaysFor Signal Communication”的美国专利申请序列号13/782,295,现为美国专利9,700,309;
-名称为“Rotary Powered Articulation Joints For Surgical Instruments”的美国专利申请序列号13/782,323,现为美国专利9,782,169;
-名称为“Thumbwheel Switch Arrangements For Surgical Instruments”的美国专利申请序列号13/782,338,现为美国专利申请公布2014/0249557;
-名称为“Electromechanical Surgical Device with Signal RelayArrangement”的美国专利申请序列号13/782,499,现为美国专利9,358,003;
-名称为“Multiple Processor Motor Control for Modular SurgicalInstruments”的美国专利申请序列号13/782,460,现为美国专利9,554,794;
-名称为“Joystick Switch Assemblies For Surgical Instruments”的美国专利申请序列号13/782,358,现为美国专利9,326,767;
-名称为“Sensor Straightened End Effector During Removal ThroughTrocar”的美国专利申请序列号13/782,481,现为美国专利9,468,438;
-名称为“Control Methods for Surgical Instruments with RemovableImplement Portions”的美国专利申请序列号13/782,518,现为美国专利申请公布2014/0246475;
-名称为“Rotary Powered Surgical Instruments With Multiple Degrees ofFreedom”的美国专利申请序列号13/782,375,现为美国专利9,398,911;以及
-名称为“SURGICAL INSTRUMENT SOFT STOP”的美国专利申请序列号13/782,536,现为美国专利9,307,986。
本申请的申请人还拥有于2013年3月14日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE”的美国专利申请序列号13/803,097,现为美国专利9,687,230;
-名称为“CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICALINSTRUMENT”的美国专利申请序列号13/803,193,现为美国专利申请公布9,332,987;
-名称为“INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICALINSTRUMENT”的美国专利申请序列号13/803,053,现为美国专利9,883,860;
-名称为“ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATIONLOCK”的美国专利申请序列号13/803,086,现为美国专利申请公布2014/0263541;
-名称为“SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FORSURGICAL INSTRUMENTS”的美国专利申请序列号13/803,210,现为美国专利9,808,244;
-名称为“MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT”的美国专利申请序列号13/803,148,现为美国专利10,470,762;
-名称为“DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/803,066,现为美国专利9,629,623;
-名称为“ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICALINSTRUMENTS”的美国专利申请序列号13/803,117,现为美国专利申请公布9,351,726;
-名称为“DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICALINSTRUMENTS”的美国专利申请序列号13/803,130,现为美国专利申请公布9,351,727;以及
-名称为“METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT”的美国专利申请序列号13/803,159,现为美国专利9,888,919。
本申请的申请人还拥有于2014年3月7日提交且全文以引用方式并入本文的以下专利申请:
-名称为“CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/200,111,现为美国专利9,629,629。
本申请的申请人还拥有于2014年3月26日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,106,现为美国专利申请公布2015/0272582;
-名称为“STERILIZATION VERIFICATION CIRCUIT”的美国专利申请序列号14/226,099,现为美国专利9,826,977;
-名称为“VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT”的美国专利申请序列号14/226,094,现为美国专利申请公布2015/0272580;
-名称为“POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUITAND WAKE UP CONTROL”的美国专利申请序列号14/226,117,现为美国专利10,013,049;
-名称为“MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFTASSEMBLIES”的美国专利申请序列号14/226,075,现为美国专利9,743,929;
-名称为“FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICALINSTRUMENTS”的美国专利申请序列号14/226,093,现为美国专利10,028,761;
-名称为“SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION”的美国专利申请序列号14/226,116,现为美国专利申请公布2015/0272571;
-名称为“SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETYPROCESSOR”的美国专利申请序列号14/226,071,现为美国专利9,690,362;
-名称为“SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS”的美国专利申请序列号14/226,097,现为美国专利9,820,738;
-名称为“INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS”的美国专利申请序列号14/226,126,现为美国专利申请公布10,004,497;
-名称为“MODULAR SURGICAL INSTRUMENT SYSTEM”的美国专利申请序列号14/226,133,现为美国专利申请公布2015/0272557;
-名称为“SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT”的美国专利申请序列号14/226,081,现为美国专利9,804,618;
-名称为“POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLEVOLTAGE PROTECTION”的美国专利申请序列号14/226,076,现为美国专利9,733,663;
-名称为“SURGICAL STAPLING INSTRUMENT SYSTEM”的美国专利申请序列号14/226,111,现为美国专利9,750,499;以及
-名称为“SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT”的美国专利申请序列号14/226,125,现为美国专利10,201,364。
本申请的申请人还拥有于2014年9月5日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,103,现为美国专利10,111,679;
-名称为“ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUECOMPRESSION”的美国专利申请序列号14/479,119,现为美国专利9,724,094;
-名称为“MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION”的美国专利申请序列号14/478,908,现为美国专利9,737,301;
-名称为“MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'SOUTPUT OR INTERPRETATION”的美国专利申请序列号14/478,895,现为美国专利9,757,128;
-名称为“POLARITY OF HALL MAGNET TO DETECT MISLOADED CARTRIDGE”的美国专利申请序列号14/479,110,现为美国专利10,016,199;
-名称为“SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION”的美国专利申请序列号14/479,098,现为美国专利10,135,242;
-名称为“MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE”的美国专利申请序列号14/479,115,现为美国专利9,788,836;以及
-名称为“LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION”的美国专利申请序列号14/479,108,现为美国专利申请公布2016/0066913。
本申请的申请人还拥有于2014年4月9日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVESHAFTS”的美国专利申请序列号14/248,590,现为美国专利9,826,976;
-名称为“SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRINGDRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT”的美国专利申请序列号14/248,581,现为美国专利9,649,110;
-名称为“SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLINGTHE OPERATION OF THE SURGICAL INSTRUMENT”的美国专利申请序列号14/248,595,现为美国专利9,844,368;
-名称为“POWERED LINEAR SURGICAL STAPLE/FASTENER”的美国专利申请序列号14/248,588,现为美国专利10,405,857;
-名称为“TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT”的美国专利申请序列号14/248,591,现为美国专利10,149,680;
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENTFEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS”的美国专利申请序列号14/248,584,现为美国专利9,801,626;
-名称为“POWERED SURGICAL STAPLE/FASTENER”的美国专利申请序列号14/248,587,现为美国专利9,867,612;
-名称为“DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICALINSTRUMENT”的美国专利申请序列号14/248,586,现为美国专利10,136,887;以及
-名称为“MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUSINDICATION ARRANGEMENTS”的美国专利申请序列号14/248,607,现为美国专利9,814,460。
本申请的申请人还拥有于2013年4月16日提交且各自全文以引用方式并入本文的以下专利申请:
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,365;
-名称为“LINEAR CUTTER WITH POWER”的美国临时专利申请序列号61/812,376;
-名称为“LINEAR CUTTER WITH MOTOR AND PISTOL GRIP”的美国临时专利申请序列号61/812,382;
-名称为“SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS ANDMOTOR CONTROL”的美国临时专利申请序列号61/812,385;以及
-名称为“SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY ASINGLE MOTOR”的美国临时专利申请序列号61/812,372。
现在将描述某些示例性实施方案,以提供对本文所公开的装置和方法的结构、功能、制造和用途的原理的全面理解。这些实施方案的一个或多个示例在附图中示出。本领域的普通技术人员将会理解,在本文中具体描述并示出于附图中的装置和方法为非限制性的示例性实施方案,并且本发明的各种实施方案的范围仅由权利要求书限定。结合一个示例性实施方案示出或描述的特征部可与其他实施方案的特征部进行组合。此类修改和变型旨在包括在本发明的范围之内。
本说明书通篇提及的“各种实施方案”、“一些实施方案”、“一个实施方案”或“实施方案”等意味着结合实施方案描述的具体特征、结构或特性包括在至少一个实施方案中。因此,本说明书通篇出现的短语“在各种实施方案中”、“在一些实施方案中”、“在一个实施方案中”或“在实施方案中”等并不一定都指相同的实施方案。此外,在一个或多个实施方案中,具体特征结构、结构或特性可以任何合适的方式组合。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。此类修改和变型旨在包括在本发明的范围之内。
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,并且术语“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,本领域的普通技术人员将容易理解,本文所公开的各种方法和装置可用于许多外科手术和应用中,包括例如与开放式外科手术相结合。继续参阅本具体实施方式,本领域中的普通技术人员将进一步理解,本文所公开的各种器械可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被直接插入患者体内或可通过具有工作通道的进入装置插入,外科器械的端部执行器及细长轴可通过所述工作通道而推进。
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。钉仓能够插入到第一钳口中并且能够从第一钳口移除;然而,设想到其中钉仓不能够从第一钳口移除或至少能够易于从第一钳口替换的其他实施方案。第二钳口包括被构造成能够使从钉仓射出的钉变形的砧座。第二钳口能够围绕闭合轴线相对于第一钳口枢转;然而,可设想到其中第一钳口能够相对于第二钳口枢转的其他实施方案。外科缝合系统还包括被构造成能够允许端部执行器相对于轴旋转或进行关节运动的关节运动接头。端部执行器能够围绕延伸穿过关节运动接头的关节运动轴线旋转。设想了不包括关节运动接头的其他实施方案。
钉仓包括仓体。仓体包括近侧端部、远侧端部和在近侧端部与远侧端部之间延伸的平台。在使用中,钉仓被定位在待缝合的组织的第一侧上,并且砧座被定位在组织的第二侧上。砧座朝向钉仓运动以将组织压缩并抵靠平台夹持。然后,可移除地储存在仓体中的钉可被部署到组织中。仓体包括限定于仓体中的钉腔,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。
外科缝合器械1000示于图1至图17中。缝合器械1000包括轴1100、端部执行器1200和将端部执行器1200可旋转地连接到轴1100的关节运动接头1300。关节运动接头1300包括围绕第一关节运动枢轴1320可旋转地连接到轴1100的远侧端部1110的可关节运动部分1310。可关节运动部分1310还围绕第二关节运动枢轴1330可旋转地连接到端部执行器的近侧端部1210。因此,可关节运动部分1310能够围绕第一关节运动轴线AA1相对于轴1100的框架1120旋转,并且端部执行器1200能够围绕第二关节运动轴线AA2相对于可关节运动部分1310旋转。缝合器械1000还包括关节运动驱动系统1500,该关节运动驱动系统被构造成能够使端部执行器1200围绕关节运动接头1300进行关节运动。
除上述之外,关节运动驱动系统1500包括附接到第一可关节运动部分1310的第一关节运动驱动线缆1520和附接到端部执行器1200的近侧端部1210的第二关节运动驱动线缆1530。第一关节运动驱动线缆1520可操作地联接到一个或多个电动马达,使得当向近侧拉动第一关节运动驱动线缆1520中的一者时,可关节运动部分1310在第一方向上围绕第一关节运动枢轴1320进行关节运动,并且当向近侧拉动另一关节运动驱动线缆1520时,可关节运动部分1310在第二或相反方向上围绕第一关节运动枢轴1320进行关节运动。类似地,第二关节运动驱动线缆1530可操作地联接到一个或多个电动马达,使得当向近侧拉动第二关节运动驱动线缆1530中的一者时,端部执行器1200在第一方向上围绕第二关节运动枢轴1330进行关节运动,并且当向近侧拉动另一关节运动驱动线缆1520时,端部执行器1200在第二或相反方向上围绕第二关节运动枢轴1330进行关节运动。
端部执行器1200包括第一钳口1220和第二钳口1230,第二钳口能够围绕由枢轴1240限定的旋转轴线或闭合轴线CA相对于第一钳口1220旋转。第一钳口1220包括被构造成能够接纳钉仓1400或任何其他合适的钉仓的通道。钉仓1400包括具有限定于其中的钉腔1423(图4)的仓体1422(图4)、可移除地储存在钉腔1423中的钉和被构造成能够在钉击发行程期间支撑钉并将钉推出仓体1422的钉驱动器。第二钳口1230包括砧座,该砧座包括被构造成能够在钉击发行程期间钉从钉仓1400射出时使钉变形的钉成形凹坑。钉仓1400包括组织支撑表面1421,并且第二钳口1230包括组织压缩表面1231,该组织压缩表面被构造成能够在第二钳口1230运动到其闭合或夹持位置时将患者组织压缩在钳口1220和1230之间。如下文更详细地描述的,缝合器械1000包括闭合驱动系统1600,该闭合驱动系统被构造成能够使第二钳口1230在打开、未夹持位置和闭合、夹持位置之间运动。
主要参考图7至图9,闭合驱动系统1600包括可旋转驱动轴1610,该可旋转驱动轴由通过柔性驱动轴1910可操作地联接到驱动轴1610的电动马达驱动。柔性驱动轴1910延伸穿过轴1100和关节运动接头1300,使得柔性驱动轴1910的远侧端部在相对于关节运动接头1300远侧的位置处联接到闭合驱动轴1610,但是闭合驱动轴1610可在任何合适的位置联接到柔性驱动轴1910。柔性驱动轴1910的远侧端部包括六角形凹陷部,该六角形凹陷部被构造成能够接纳从闭合驱动轴1610向近侧延伸的六角形凸耳,使得柔性驱动轴1910和闭合驱动轴1610一起旋转;然而,可使用轴1610和1910之间的任何合适的联接。
除上述之外,闭合驱动系统1600包括快速闭合系统和强力闭合系统。快速闭合系统和强力闭合系统两者均被构造成能够闭合第二钳口1230,但是以不同的方式。主要参考图7,闭合驱动系统1600包括快速闭合构件1630和强力闭合构件1620。强力闭合构件1620包括限定于其中的螺纹孔口,该螺纹孔口与闭合驱动轴1610的螺纹以螺纹方式接合。当驱动轴1610在第一方向上转动时,驱动轴1610向近侧驱动强力闭合构件1620。快速闭合构件1630不与驱动轴1610以螺纹方式接合,并且当驱动轴1610在第一方向上转动时,快速闭合构件1630经由定位在强力闭合构件1620和快速闭合构件1630中间的弹簧1640被强力闭合构件1620向近侧推动。在闭合过程开始时,快速闭合构件1630与第二钳口1230直接接触,但是强力闭合构件1620不与第二钳口直接接触。快速闭合构件1630包括近侧端部1632和从其向远侧延伸的驱动臂1634。驱动臂1634中的每一者包括驱动销1639,该驱动销向内延伸到限定于第二钳口1230中的驱动凹陷部1239中,使得当快速闭合构件1630被强力闭合构件1620向近侧推动时,快速闭合构件1630使第二钳口1230旋转到闭合位置。由于这种布置,第二钳口1230的初始闭合运动由快速闭合构件1630引起。
值得注意的是,除上述之外,当向近侧驱动作为闭合构件1620的强力时,弹簧1640在强力闭合构件1620和快速闭合构件1630之间压缩。高闭合构件1620和快速闭合构件1630之间的相对运动的量是弹簧1640的弹簧常数以及另外由第二钳口1230施加到组织上的夹持负载或阻力的函数。因此,在闭合行程的该阶段处的第二钳口1230的闭合位置可根据定位在第二钳口1230和钉仓1400中间的组织的例如厚度和/或密度而变化。如果较厚的组织定位在第二钳口1230和钉仓1400之间,例如,则第二钳口1230的组织压缩表面1231可能不平行于钉仓1400的组织支撑表面1421。如果较薄的组织定位在第二钳口1230和钉仓1400之间,则第二钳口1230的组织压缩表面1231可平行于钉仓1400的组织支撑表面1421或过去相对于该组织支撑表面平行。由于闭合系统1600的快速闭合系统被设计成在组织被高负载闭合系统完全夹持之前并且在钉被钉击发系统1700击发之前给出第二钳口1230在患者组织上的位置的粗略近似值,因此这种可变性在该阶段并不重要。
如果临床医生希望重新打开第二钳口1230,除上述之外,临床医生控制电动马达以在相反方向上操作电动马达以在相反方向上旋转闭合驱动轴1610。在此类实例中,闭合驱动轴1610向远侧驱动强力闭合构件1620,该强力闭合构件松弛或降低弹簧1640内的力,以允许第二钳口1230至少稍微打开。此外,在此类实例中,强力闭合构件1620可向远侧推动快速闭合构件1630以将第二钳口1230推入打开或未夹持位置。更具体地,快速闭合构件1630的驱动臂1634中的每一者包括向内延伸的突片1635,当强力闭合构件1620向远侧回缩时,该向内延伸的突片与强力闭合构件1620接触,使得在打开行程期间强力闭合构件1620直接或确定地向远侧推动快速闭合构件1630。临床医生可根据需要打开和闭合第二钳口1230,以便正确地将缝合器械1000的钳口定位在患者组织上。与下面更详细地讨论的强力闭合系统相比,快速闭合系统使第二钳口1230快速运动而不必向患者组织施加大的压缩或夹持负载。
如上所述,闭合驱动轴1610旋转以向近侧驱动强力闭合构件1620,以向近侧推动快速闭合构件1630并且快速闭合第二钳口1230。此时,强力闭合构件1620不与第二钳口1230直接接触。然而,闭合驱动轴1610的持续旋转使强力闭合构件1620与第二钳口1230接触。更具体地,强力闭合构件1620包括限定于其上的凸轮1625,这些凸轮与限定在第二钳口1230的底部上的凸轮表面1235接触,并且将第二钳口1230驱动到其闭合位置。由于凸轮1625和第二钳口1230之间的直接接触,因此第二钳口1230确定地定位成处于其闭合位置。在这种实例中,因此,限定在第二钳口1230中的钉成形凹坑与钉仓1400中的钉正确对准。另外,因此,将高夹持力施加到夹持在第二钳口1230和钉仓1400之间的组织。此时,钉击发系统1700可操作以从钉仓1400击发钉。然而,如果临床医生反而期望重新打开第二钳口1230,则闭合驱动轴1610可在相反方向上操作以向远侧驱动强力闭合构件1620以使凸轮1625与第二钳口1230脱离接合,并且为了完全打开第二钳口1230,如上所述驱动快速闭合构件1240。公布于2017年3月7日的名称为“STAPLING SYSTEMS”的美国专利9,585,658的全部公开内容以引用方式并入本文。
缝合器械1000的钉击发系统1700包括击发驱动轴1710。击发驱动轴1710的近侧端部包括向近侧延伸的六角形凸耳,该六角形凸耳与延伸穿过闭合驱动轴1610的柔性可旋转击发驱动轴可操作地接合;然而,可使用轴1610和1710之间的任何合适的联接。柔性驱动轴可操作地联接到电动马达,该电动马达独立于闭合马达操作,使得击发驱动轴1710独立于闭合驱动轴1610操作。钉击发系统1700还包括击发构件1720,该击发构件包括与击发驱动轴1710的螺纹部分以螺纹方式接合的螺母1730。当击发驱动轴1710在第一方向上旋转时,向远侧驱动击发构件1720以执行钉击发行程。击发构件1720还包括斜坡1740,这些斜坡被构造成能够接合钉仓1400中的驱动器并且在钉击发行程期间从钉仓1400射出钉。击发构件1720还包括组织切割刀1750,该组织切割刀在钉击发行程期间切割缝合组织。当击发驱动轴1710在第二或相反方向上旋转时,向近侧驱动击发构件1720。
如上所述,主要参考图4和图9,第一钳口1220包括被构造成能够接纳钉仓1400的通道1222。第一钳口1220通过两个销1214销连接在端部执行器1200的近侧端部1210上,使得第一钳口1220和近侧端部1210之间不存在相对运动或至少基本上相对运动。第一钳口1220包括被构造成能够接纳钉仓1400的近侧端部1424的近侧端部1224和被构造成能够接纳钉仓1400的远侧端部1426的远侧端部1226。在该实施方案中,钉仓1400的远侧端部1426悬挂在第一钳口1220的远侧端部1226上方,这提供了用于相对于通道1222正确定位钉仓1400的远侧端部1426的基准。钉仓1400包括限定在仓体1422中的纵向狭槽1428,该纵向狭槽被构造成能够在其中接纳击发构件1420的一部分。第一钳口1220还包括限定于其中的纵向狭槽1229,当钉仓1400安置在通道1222中时,该纵向狭槽与纵向狭槽1428对准。纵向狭槽1228是限定在通道1222的底部部分中的内部狭槽,该内部狭槽被构造成能够在钉击发行程期间接纳击发构件1720的底部凸轮1729。第一钳口1220还包括通过焊接附接到通道1222的盖1223,例如,该盖包封了通道1222的内部纵向狭槽1228。
如上所述,第二钳口1230围绕枢轴1240可旋转地安装到第一钳口1220。主要参考图9,第二钳口1230包括向外延伸的销1237,这些销紧密地接纳在限定在第一钳口1220中的狭槽1227中。销1237通过压配合到销1237上的保持构件1225在狭槽1227中捕获,使得销1237可在狭槽1227内枢转,但在狭槽1227内不平移。第二钳口1230还包括砧座主体1232、近侧端部1234和远侧端部1236。类似于第一钳口1220,第二钳口1230包括限定于其中的内部狭槽1238,该内部狭槽被构造成能够在钉击发行程期间接纳击发构件1720的顶部凸轮1728。第二钳口1230还包括通过焊接附接到砧座主体1232的盖1233,例如,该盖包封了砧座主体1232的内部纵向狭槽1238。在钉击发行程期间,击发构件1720的顶部凸轮1728接合第二钳口1230,并且底部凸轮1729接合第一钳口1220。因此,凸轮1728和1729共同操作以将第二钳口1230相对于第一钳口1220保持在适当位置。
主要参考图8,缝合器械1000还包括被构造成能够评估击发构件1720的位置的传感器系统1800。传感器系统1800包括延伸穿过轴1100的线缆1810,该线缆包裹至少两个导体或导线1820。导线1820形成具有传感器1830的电路,诸如RFID天线,例如,其与缝合器械的控制器进行信号通信。击发构件1720包括可检测构件,诸如RFID标签,例如当击发构件1720处于其近侧未击发位置时,其可由传感器系统1800检测到。当击发构件1720在钉击发行程期间向远侧推进时,RFID标签不再由传感器系统1800检测到,并且控制器可确定钉击发行程正在进行中,或者至少钉仓1400已经至少部分地被击发。端部执行器1200还包括支撑传感器1830的传感器支撑件1840。
外科器械32000示于图73和图74中。与上述类似,外科器械32000包括端部执行器32200和闭合系统32600。外科器械32000还包括端部执行器关节运动系统和钉击发系统,但是为了简洁起见,本文未描述这些系统。端部执行器32200包括被构造成能够接纳钉仓的第一钳口以及另外包括具有围绕枢轴32240可旋转地联接到第一钳口的砧座的第二钳口32230。第二钳口32230可由闭合系统32600从打开或未夹持位置(图73)运动到闭合或夹持位置(图74)。闭合系统32600包括可旋转驱动轴32610,该可旋转驱动轴包括通过轴承可旋转地支撑在第一钳口内的远侧端部。闭合系统32600还包括与可旋转驱动轴32610的螺纹部分以螺纹方式接合的闭合构件或螺母32620。当驱动轴32610在第一方向上旋转时,向近侧驱动闭合构件32620以闭合端部执行器32200,并且当驱动轴32610在第二或相反方向上旋转时,向远侧驱动闭合构件32620以打开端部执行器32200。闭合系统32600还包括闭合连接件32630,该闭合连接件围绕枢轴32622枢转地安装到闭合构件32620,并且围绕枢轴32632枢转地安装到第二钳口32230。当向近侧驱动闭合构件32620时,闭合连接件32630向上驱动第二钳口32230的近侧端部32234,以使第二钳口32230旋转到其闭合位置,如图74所示。值得注意的是,闭合连接件32630被驱动成直立位置,其中枢轴32632与枢轴32622成一直线,并且因此,闭合连接件32630被锁定在同一相位,从而为捕获在第二钳口32230和第一钳口之间的组织提供大量夹持力。在该位置,第二钳口32230的组织压缩表面32231平行于钉仓的组织支撑表面;然而,当第二钳口32230被闭合驱动系统32600驱动时,该系统可被布置成通过朝向钉仓取向压缩表面32231来过度夹持组织。在任何情况下,对于闭合驱动轴32610的给定速度,与闭合行程结束时相比,连接件32630在闭合行程开始时快速旋转。这是由于闭合连接件32630的初始取向相对平坦或基本上与闭合构件32620的运动成一直线,并且闭合连接件32630的最终取向与闭合构件32620的运动正交或至少基本上垂直。因此,对于闭合驱动轴32610的给定速度,与闭合行程的结束相比,第二钳口32230朝向第一钳口的初始运动是快速的。当向远侧驱动闭合构件32620时,闭合构件32620经由连接件32640向下拉动近侧端部32234以打开第二钳口32230。
外科器械33000示于图75和图76中。外科器械33000包括端部执行器33200和闭合系统33600。外科器械33000还包括端部执行器关节运动系统和钉击发系统,但是为了简洁起见,本文未描述这些系统。端部执行器33200包括被构造成能够接纳钉仓的第一钳口以及另外包括具有围绕枢轴33240可旋转地联接到第一钳口的砧座的第二钳口33230。第二钳口33230可由闭合系统33600从打开或未夹持位置(图75)运动到闭合或夹持位置(图76)。闭合系统33600包括可旋转驱动轴33610,该可旋转驱动轴包括通过轴承由第一钳口可旋转地支撑的远侧端部。闭合系统33600还包括与可旋转驱动轴33610的螺纹部分以螺纹方式接合的闭合构件或螺母33620。当驱动轴33610在第一方向上旋转时,向近侧驱动闭合构件33620以闭合端部执行器33200,并且当驱动轴33610在第二或相反方向上旋转时,向远侧驱动闭合构件33620以允许端部执行器32200打开。第二钳口33230的近侧端部33234包括在闭合行程期间由闭合构件33620顺序地接合的远侧凸轮表面33233和近侧凸轮表面33235。值得注意的是,远侧凸轮表面33233包括线性或至少基本上线性的成角度表面。当闭合构件33620接触远侧凸轮表面33233时,闭合构件33620使第二钳口33230以第一速率向下旋转。类似地,近侧凸轮表面33235包括线性或至少基本上线性的成角度表面。当闭合构件33620接触近侧凸轮表面33235时,闭合构件33620以比第一速率快的第二速率使第二钳口33230向下旋转。因此,第二钳口33230的初始夹持运动是快速的,而第二钳口33230的最终夹持运动较慢。此外,近侧凸轮表面33235的较浅凸轮角度允许第二钳口33230在第二钳口33230的最终夹持运动期间向组织施加大夹持力。当向远侧驱动闭合构件33620时,闭合构件33620与近侧凸轮表面33235和远侧凸轮表面33233脱离接合,使得第二钳口33230可打开。在至少一个实施方案中,当击发构件回缩时,第二钳口33230由例如弹簧和/或钉击发系统打开。
图77至图80中示出了外科器械34000。外科器械34000包括端部执行器34200和闭合系统34600。外科器械34000还包括端部执行器关节运动系统和钉击发系统,但是为了简洁起见,本文未描述这些系统。端部执行器34200包括被构造成能够接纳钉仓的第一钳口34220以及另外包括具有围绕枢轴34240可旋转地联接到第一钳口34220的砧座的第二钳口34230。第二钳口34230可由闭合系统34600从打开或未夹持位置(图77)运动到闭合或夹持位置(图78)到过度夹持位置(图79)。闭合系统34600包括可旋转驱动轴42610(图80),该可旋转驱动轴包括由第一钳口中的轴承可旋转地支撑的远侧端部。闭合系统34600还包括与可旋转驱动轴34610的螺纹部分以螺纹方式接合的闭合构件或螺母34620和围绕销34622可旋转地安装到闭合构件34620的可枢转凸轮34630。当驱动轴34610在第一方向上旋转时,向近侧驱动闭合构件34620,使得限定在凸轮34630上的凸轮表面34633和限定在闭合构件34620上的凸轮表面34625顺序地接合第二钳口34230以闭合端部执行器34200。第二钳口34230包括分别由凸轮表面34633和凸轮表面34625接合的限定于其上的第一凸轮表面34233和第二凸轮表面34235。在闭合行程开始时,参考图78,凸轮34630接合第二钳口34230上的第一凸轮表面34233,以将第二钳口34230快速枢转到闭合或夹持位置。然而,此时,限定在闭合构件34620上的凸轮表面34625尚未与限定在第二钳口34230上的第二凸轮表面34235接触。然而,闭合驱动轴34610在相同方向上的进一步旋转向近侧驱动闭合构件34620,以将凸轮表面34625放置成与第二钳口34230上的凸轮表面34235接触。同时,凸轮34630被向下顶起,从而不与第二钳口34230接触。更具体地,主要参考图80,凸轮34630包括从其横向延伸的销34632,该销在限定在第一钳口34220中的狭槽34222中行进,并且由于狭槽34222的轮廓,因此当闭合构件34620与第二钳口34230接触时,凸轮34630被向下拉出,从而不与第二钳口34230接触。此时,闭合驱动轴34610在相同方向上的进一步旋转使闭合构件34620驱动第二钳口34230进入其过度夹持的取向,如图79所示。在这种情况下,闭合构件34620楔入第一钳口34220和第二钳口34230之间,并且第二钳口34230的位置由闭合构件34620确定地设定。
当闭合驱动轴34610在第二或相反方向上旋转时,向远侧驱动闭合构件34620以使闭合构件34620与第二钳口34230脱离接合。此外,在此类实例中,由于销34632和狭槽34222的侧壁之间的相互作用,可枢转凸轮34630向上枢转到适当位置,以便重置凸轮34630。闭合系统34600还包括打开连接件34640,这些打开连接件围绕枢轴销34624枢转地安装到闭合构件34620,并且围绕枢轴34632枢转地安装到第二钳口34230。当向远侧驱动闭合构件34620时,打开连接件34640向下驱动第二钳口34230的近侧端部34234,以使第二钳口34230旋转到其打开位置(图77)。值得注意的是,打开连接件34640各自包括限定于其中的狭槽34644,该狭槽允许枢轴销34624在连接件34640内滑动,并且在闭合行程期间允许打开连接件34640和闭合构件34620之间的相对运动,如上所讨论的。
外科器械35000示于图81和图82中。外科器械35000包括端部执行器35200、闭合系统35600、钉击发系统34700和端部执行器关节运动系统。类似于端部执行器34200,端部执行器35200包括第一钳口34220和第二钳口34230。第一钳口34220被构造成能够接纳钉仓34400或任何其他合适的钉仓。第二钳口34230可通过闭合系统35600相对于第一钳口34220围绕枢轴34240在打开位置和闭合位置之间枢转。闭合系统35600包括可旋转驱动轴35610和与驱动轴35610的螺纹部分以螺纹方式接合的闭合构件或螺母35620。当驱动轴35610在第一方向上旋转时,向近侧驱动闭合构件35620以与第二钳口34230接触以闭合第二钳口34230。闭合系统35600还包括打开连接件35460,该打开连接件围绕延伸到限定在打开连接件35460中的狭槽35642中的销35622可旋转地安装到闭合构件35620。打开连接件35460还围绕销25232可枢转地安装到第二钳口35230,使得当驱动轴35610在相反方向上旋转并且向远侧驱动闭合构件35620时,闭合构件35630通过拉动打开连接件35460将第二钳口35230拉到打开位置。值得注意的是,闭合构件35630在与其施加闭合力的不同位置处向第二钳口34230施加打开力。一旦第二钳口35230已经闭合,或至少适当地闭合,钉击发系统34700的可旋转驱动轴34710就根据本文其他地方描述的方式被驱动以执行钉击发行程。
图83至图86中示出了外科器械36000。外科器械36000包括端部执行器36200、闭合系统36600、钉击发系统36700和端部执行器关节运动系统。端部执行器36200包括第一钳口36220和第二钳口36230。第一钳口36220被构造成能够在第二钳口36230可通过闭合系统36600相对于第一钳口36220围绕枢轴36240在打开位置和闭合位置之间枢转时接纳钉仓。闭合系统36600包括可旋转驱动轴36610和与驱动轴36610的螺纹部分以螺纹方式接合的闭合构件或螺母36620。当驱动轴36610在第一方向上旋转时,向近侧驱动闭合构件36620以与限定在第二钳口36230上的凸轮表面36235接触以闭合第二钳口36230,如图83和图84所示。外科器械36000还包括打开构件36630,该打开构件被构造成能够将第二钳口36230偏置成打开位置。打开构件36630通过定位在打开构件36630和端部执行器36200的框架中间的打开弹簧36640被推靠在第二钳口36320上。因此,当闭合构件36620闭合第二钳口36230时,闭合构件36620的近侧运动对抗并克服了由打开构件36630施加到第二钳口36320的打开力。然而,当向远侧驱动闭合构件36620时,通过打开构件36630施加到第二钳口36320的打开力可推动第二钳口36230打开。然而,在一些实例中,由打开构件36630施加的打开力可能不足以打开或至少充分打开第二钳口36230,如图85所示。当打开弹簧36640的弹簧常数低时,可能出现此类实例。在任何情况下,参考图86,闭合构件36320的继续远侧运动使闭合构件36320与打开构件36630接触,并且驱动打开构件36630以确定地打开第二钳口36230。因此,当打开弹簧36640的强度不足以推动第二钳口36230打开时,闭合构件36620的回缩可使第二钳口36230脱离。
再次参考图83至图86,钉击发系统36700包括可旋转驱动轴。钉击发系统36700包括I形梁部分36720、螺纹部分36730和滑动件部分36740。螺纹部分36730以螺纹方式联接到击发驱动轴,并且I形梁部分36720固定地安装到螺纹部分36730。因此,当通过击发驱动轴向近侧和远侧驱动螺纹部分36730时,I形梁部分36720与该螺纹部分36730一起运动。此外,I形梁部分36720和螺纹部分36730共同操作以在钉击发行程期间相对于彼此将第一钳口36220和第二钳口36230保持在适当位置。更具体地,螺纹部分36730包括接合第一钳口36220的第一凸轮36739,并且I形梁部分36720包括在钉击发行程期间接合第二钳口36230的第二凸轮36729。第一钳口36220包括限定于其中的被构造成能够接纳第一凸轮36739的内部狭槽36229,并且类似地,第二钳口36230包括限定于其中的被构造成能够接纳第二凸轮36729的内部狭槽36239。钉击发系统36700还包括滑动件36740,该滑动件被螺纹部分36730向远侧推动。滑动件36740被构造成能够接合包含在钉仓内的钉驱动器,并且在钉击发行程期间将钉驱动出钉仓。I形梁部分36720包括刀刃36750,该刀刃被构造成能够切割被缝合的组织。值得注意的是,刀刃36750在滑动件36740后面的近侧定位,使得刀刃36750不会切割未缝合的组织。在任何情况下,滑动件36740不会附接到螺纹部分36730,并且因此,当在钉击发行程之后向近侧驱动螺纹部分36370时,滑动件36740不会与I形梁部分36720和螺纹部分36370一起向近侧返回。相反,在钉击发行程结束的任何地方都会留下滑动件36740。
缝合器械37000的钉击发系统37700示于图87至图90中。类似于钉击发系统36700,钉击发系统37700包括I形梁部分37720、螺纹部分37730和滑动件部分37740。螺纹部分37730经由螺纹孔口37732以螺纹方式联接到击发驱动轴,并且I形梁部分37720固定地安装到螺纹部分37730。主要参考图89,I形梁部分37720和螺纹部分37730分别包括将I形梁部分33720固定到螺纹部分37730的互锁突片37724和37734。在至少一个实例中,互锁突片37724和37734被压配合到互锁关系中。因此,当通过击发驱动轴向近侧和远侧驱动螺纹部分37730时,I形梁部分37720与该螺纹部分37730一起运动。
与上述类似,I形梁部分37720和螺纹部分37730共同操作以在钉击发行程期间相对于彼此将第一钳口36220和第二钳口36230保持在适当位置。更具体地,螺纹部分37730包括接合第一钳口36220的第一凸轮37739,并且I形梁部分37720包括在钉击发行程期间接合第二钳口36230的第二凸轮37729。第一钳口36220包括限定于其中的被构造成能够接纳第一凸轮37739的内部狭槽36229,并且类似地,第二钳口36230包括限定于其中的被构造成能够接纳第二凸轮37729的内部狭槽36239。当包括I形梁部分37720和螺纹部分37730的组件处于其近侧未击发位置(图87)时,第一凸轮37739至少部分地定位在第一内部狭槽36229中,并且第二凸轮37729定位在限定在第二钳口36230中的放大腔室36237中,该放大腔室通向第二内部狭槽36239。放大腔室36237允许第二钳口36230打开和闭合,而不受I形梁部分37720的干扰。此外,I形梁部分37720包括限定于其中的凹口或凹陷部37722,该凹口或凹陷部被构造成能够在I形梁部分37720处于其最近侧位置时接纳将第二钳口36230连接到第一钳口36220的枢轴销36242。凹口37722允许I形梁部分37720处于非常近侧的位置,如上所述,这可为可枢转第二钳口36230提供间隙,并且还允许端部执行器37200较短,从而允许端部执行器37200插入较小空间中。事实上,当I形梁部分37720处于其近侧未击发位置时,凹口37722的侧壁可与枢轴销36242接触。
除上述之外,主要参考图88,钉击发系统37700还包括滑动件37740,该滑动件安装到螺纹部分37730,使得滑动件37740分别在钉击发行程和回缩行程期间与螺纹部分37730向远侧和近侧行进。在使用中,主要参考图87,当钉仓37400安置在第一钳口36220中时,可替换的钉仓诸如钉仓37400例如定位在滑动件37740上方。钉仓37400包括仓体37420(图87)、可移除地储存在仓体37420中的钉37410(图88)和定位在仓体37420内的钉驱动器37430,这些钉驱动器在钉击发行程期间支撑钉37410并朝向第二钳口36230的砧座部分驱动这些钉。滑动件37740包括限定于其上的斜坡37742,这些斜坡接合钉驱动器37430以朝向第二钳口36230提升钉37410。值得注意的是,钉仓37400还包括滑动件部分37440,该滑动件部分储存在仓体37420内并且在钉击发行程期间由I形梁部分37720向远侧推动。滑动件部分37440包括斜坡37442,该斜坡在钉击发行程开始时与滑动件37740上的斜坡37742对准,并且与斜坡37742共同操作以在钉击发行程期间完全驱动钉驱动器37430并完全地形成或击发钉37410。如将在下文结合不同实施方案更详细地描述的,滑动件部分37440包括组织切割刀37452,该组织切割刀在未部署位置和部署位置之间旋转,在未部署位置中,组织切割刀37452的刀刃定位在仓体37420的平台或顶表面下方,如图87所示,在部署位置中,刀刃延伸到平台上方。当击发组件在钉击发行程开始时接触或拾起滑动件部分37440时,组织切割刀通过击发组件围绕枢轴37452旋转。值得注意的是,在回缩行程期间,钉仓37400中的滑动件部分37440不与滑板37740一起回缩。相反,滑动件部分37440留在钉击发行程的结束处。公布于2018年10月23日的名称为“SURGICAL STAPLER WITH PLURALITY OF CUTTINGELEMENTS”的美国专利10,105,142和公布于2017年10月17日的名称为“DEVICES ANDMETHODS FOR FACILITATING EJECTION OF SURGICAL FASTENERS FROM CARTRIDGES”的美国专利9,788,835的全部公开内容以引用方式并入本文。
如上文结合图83和图84所述,并且现在结合图144、图144A、图145和图145A,向近侧驱动闭合驱动装置36600的闭合构件36620以与限定在第二钳口36230上的凸轮表面36235接触以闭合第二钳口36230。还如上所述,并且参考图146,在钉击发行程期间向远侧驱动包括I形梁部分37720和螺纹部分37730的击发组件,使得凸轮37739在限定在第一钳口36220中的纵向狭槽36229内行进,并且凸轮37729在纵向狭槽36239内行进。在各种实例中,第二钳口36230由闭合系统36600闭合,并且然后致动钉击发系统37700。在此类实例中,顺序地执行端部执行器闭合操作和钉击发操作。在其他实例中,同时操作端部执行器闭合系统和钉击发系统两者。在至少一个这种实例中,端部执行器闭合系统用于闭合第二钳口36230,并且然后使用钉击发系统来从钉仓37400击发钉。然而,在钉击发行程期间,端部执行器闭合系统也被致动以在钉击发行程期间减小和/或维持第二钳口36230和钉仓37400之间的距离或组织间隙。在至少一个实例中,端部执行器钳口闭合系统37600用于将第二钳口36320运动到过度夹持位置,即,在钉击发行程期间第二钳口36320朝向钉仓36400倾斜或过去相对于该钉仓平行的取向。图147至图149示出了第二钳口36230从打开位置(图147)、平行夹持位置(图148)和过度夹持位置(图149)的进展。在图148中,在端部执行器37200的近侧端部和远侧端部之间,第二钳口36230的底部或组织压缩表面和钉仓36400的顶表面或平台之间的组织间隙相同或至少基本上相同。在这种实例中,组织间隙距离为大约6mm,例如,可使用任何合适的组织间隙距离。在图149中,可以看出,第二钳口36230的远侧端部36234比图148的平行位置更靠近远侧端部37424,这指示过度夹持位置。在这种实例中,例如,第二钳口36230被过度夹持大约3度,但可使用任何合适量的过度夹持。将第二钳口36230放置在过度夹持位置可允许第二钳口36230抵抗由钉变形产生的打开力和/或补偿在钉击发行程期间第二钳口36230的内部偏转。
在图150的曲线图37900中图形描绘了上述提供的讨论。曲线图37900包括描绘闭合驱动装置36600和钉击发驱动装置37700的运动的底部部分37980以及描绘闭合驱动装置36600和钉击发驱动装置37700经受的力负载的顶部部分37990。关于图37900的顶部部分37990,闭合驱动装置36600内的力负载由迹线36690描绘,并且击发驱动装置37700内的力负载由迹线37790描绘。事实上,迹线36690分成描绘闭合驱动装置36600在钉击发行程期间未致动的场景的第一部分36690’和描述闭合驱动装置36600在钉击发行程期间致动的场景的第二部分36690”。闭合驱动装置36600的这两个不同操作场景在钉击发驱动装置37700的迹线37790内反映在两种不同操作场景中。更具体地,迹线37790分成对应于闭合驱动装置的第一部分36690’的第一部分37790’和对应于第二部分37790的第二部分37790”。第一部分37790’描绘了当闭合驱动装置36600在钉击发行程期间未致动时钉击发负载较高,并且第二部分37790”描绘了当闭合驱动装置36600在钉击发行程期间致动时钉击发负载较低。为此,在钉击发行程期间操作闭合驱动装置36600也反映在曲线图37900的底部部分37980中。第二钳口36230的运动由运动迹线36680描绘,该运动迹线类似于上述,分成对应于上文所讨论的力迹线36690’和37790’的第一部分36680’以及对应于上文也所述的力迹线36690”和37790”的第二部分36680”。当闭合驱动装置36600在钉击发行程期间未操作时,第二钳口36230维持在平行或至少基本上平行的取向,如运动迹线36680’所描绘。当闭合驱动装置36600在钉击发行程期间操作时,第二钳口36230运动到过度夹持取向,如运动迹线36680”所描绘。值得注意的是,这两种操作可能性没有反映在钉击发驱动装置37700的运动迹线37780中。换句话说,钉击发驱动装置37700的运动可独立于闭合驱动装置36600的操作。
在各种实例中,除上述之外,钉击发驱动装置37700可用于闭合第二钳口36230。在至少一个这种实例中,钉击发驱动装置37700可用于向远侧推进击发组件,使得凸轮37729和37739共同操作以在闭合驱动装置36600被操作以闭合第二钳口36230的同时将第二钳口36230拉向其闭合位置。在至少一个其他实例中,钉击发驱动装置37700可用于向远侧推进击发组件以闭合第二钳口36230,而无需闭合驱动装置36600的辅助。鉴于闭合驱动装置36600和钉击发驱动装置37700可顺序地和/或同时操作,闭合驱动装置36600和钉击发驱动装置37700各自由单独的电动马达操作。在至少一个实例中,缝合器械37000附接到机器人外科器械,该机器人外科器械包括用于驱动闭合驱动装置36600的第一电动马达和用于驱动钉击发驱动装置37700的第二电动马达。在至少一个其他实例中,缝合器械37000包括手持式缝合器械,该手持式缝合器械包括手柄,该手柄包括与闭合驱动装置36600可操作地接合的第一电动马达和与钉击发驱动装置37700可操作地接合的第二电动马达。
外科器械系统49000的端部执行器49200示于图151和图152中。端部执行器49200包括第一钳口49220和可枢转地连接到第一钳口49220的第二钳口49230。外科器械49000还包括关节运动接头,端部执行器49200可围绕该关节运动接头旋转。各种关节运动接头在本文其他地方描述。端部执行器49200的各种构型或闭合状态描绘在图153的顶部。第二钳口49230可通过闭合驱动装置49600在打开位置、部分闭合位置、平行位置和过度夹持位置之间运动,在打开位置,钳口49220和49230之间例如存在大约30度的角度或钳口孔口,在过度夹持位置,钳口49220和49230之间例如存在大约-1度至-3度的角度。第二钳口49220的完全打开位置建立了操作条件49610,第二钳口49220的闭合建立了操作条件49620,第二钳口49230的平行位置建立了操作条件49630,并且第二钳口49220的过度夹持位置建立了操作条件49640。闭合驱动装置49600包括由外科器械49000的控制系统控制的电动马达。闭合驱动装置49600包括闭合构件,该闭合构件与上述类似,由闭合马达向近侧回缩以闭合第二钳口49230。其中闭合构件回缩的距离由迹线49680描绘,并且闭合构件的运动对应于图153的顶部描绘的端部执行器49200的闭合状态。值得注意的是,一旦第二钳口49230在操作条件49630期间已经到达其平行位置,闭合系统49600就进入等待时间段或停留。类似地,闭合系统49600在操作条件49650中进入等待时间段或停留。然后在操作条件49660期间打开第二钳口49230。
外科器械49000还包括钉击发系统49700和关节运动驱动系统49800。钉击发系统49700和关节运动驱动系统49800由相同的电动马达操作,该电动马达在驱动关节运动驱动系统49800的第一操作状态和驱动钉击发系统49700的第二操作状态之间移位。在各种实例中,电动马达包括传动装置,该传动装置电子移位和/或机械地移位以将电动马达放置在其第一操作状态和其第二操作状态。在操作条件49610和49620期间,电动马达处于其第一操作状态,并且因此,端部执行器49200在其打开和/或其闭合时可进行关节运动。然而,一旦端部执行器49200在操作条件49630中闭合,则电动马达被移位到其第二操作状态。在此类实例中,端部执行器49200被锁定到其关节运动位置中,并且然后电动马达断电。通过在向电动马达供电之前将端部执行器49200锁定到适当位置,可防止端部执行器49200的突然抖动运动。换句话说,例如,如果端部执行器49200受到来自组织T的对其关节运动的阻力,并且在端部执行器49200锁定在适当位置之前电动马达断电,则端部执行器49200可能意外地进行关节运动或脱离关节运动。关节运动系统49800的全动力条件由图153中的条件49810描绘,并且关节运动系统49800的斜降条件由条件49820描绘。
一旦电动马达移位到其第二状态,就可使钉击发驱动装置49700致动以执行钉击发行程。钉击发驱动装置49700包括击发构件,该击发构件在钉击发行程期间向远侧推进,并且然后在钉击发行程之后向近侧回缩。击发构件的运动由图153中的运动迹线49780描绘。此外,图153描绘了在钉击发系统49700解锁之前电动马达在操作条件49710期间通电,并且然后通电以在操作条件49730期间执行钉击发行程。由力迹线49790描绘由击发构件经历的力负载,该力迹线示出了击发构件在钉击发行程期间经历高负载,并且然后在操作条件49730期间在击发构件回缩时经历更低的负载。在击发构件已回缩之后,锁定钉击发系统49700,并且然后在操作条件49740期间电动马达断电。与上述类似,在使电动马达断电之前锁定击发驱动装置减少了钉击发系统49700内突然抖动的可能性。此时,电动马达被切换回其第一操作状态,电动马达被重新供电,并且关节运动驱动系统49800在操作状态49830期间解锁。值得注意的是,其中端部执行器49200可进行关节运动的操作状态49830和其中可打开端部执行器49200的操作状态49660重叠。
除上述之外,外科器械49000包括一个或多个位置传感器,以确定闭合系统49600的闭合构件的位置和/或第二钳口49230的位置。外科器械49000还包括一个或多个位置传感器,以确定钉击发系统49700的击发构件的位置。外科器械49000包括被构造成能够评估由闭合驱动系统49600的电动马达所消耗的电流以评价由闭合驱动系统49600的闭合构件经历的力负载的电路。外科器械49000还包括被构造成能够评估由用于驱动钉击发系统49700的第二电动马达所消耗的电流以评估由钉击发系统49700的击发构件所经历的击发负载的电路。所有这些传感器和电路与外科器械49000的控制系统通信。利用该信息,控制系统可确定何时已到达某些操作状态。例如,当控制系统确定第二钳口49230已经到达其平行位置时,作为操作状态49630的一部分,控制系统可停止闭合马达。此时,控制系统可监测闭合驱动系统49600内的力负载,直到力负载下降到阈值以下,并且在该点处确定操作状态49630结束并向外科器械49000的用户发送信号表明已经到达用于执行钉击发行程的最佳条件。
如上所讨论的,用于驱动关节运动驱动系统49800和击发驱动系统49700的电动马达可在第一操作状态和第二操作状态之间切换。在至少一个实施方案中,闭合驱动装置49600可用于在其第一操作状态和第二操作状态之间使该电动马达移位。公布于2015年10月8日的名称为“SURGICAL INSTRUMENT WITH SHIFTABLE TRANSMISSION”的国际专利公布WO2015/153642和公布于2016年5月31日的名称为“ARTICULATION CONTROL SYSTEM FORARTICULATABLE SURGICAL INSTRUMENTS”的美国专利9,351,726的全部公开内容以引用方式并入本文。
钉击发系统38700示于图91至图96中。钉击发系统38700包括可旋转驱动轴和与驱动轴以螺纹方式接合的击发构件。钉击发系统38700还包括驱动部分38730和滑动件部分38740。滑动件部分38740包括限定在其近侧侧上的至少一个推动表面38741,当击发构件在钉击发行程期间向远侧推进时,该至少一个推动表面与击发构件接触。当击发构件向远侧运动成与滑动件部分38740接触时,滑动件部分38740还通过锁定臂38734附接到击发构件。至少最初,滑动件部分38740相对于驱动部分38370运动。此时,如下文更详细地描述的,滑动件部分38740和驱动部分38370一起向远侧推进,使得限定在滑动件部分38740上的斜坡38742在钉击发行程期间从钉仓击发钉。钉击发系统38700还包括围绕枢轴销38752可旋转地安装到驱动部分38730的组织切割刀38750。
在钉击发行程开始时,组织切割刀38750可在未部署位置(图94)和部署位置(图93)之间旋转。滑动件部分38740至少在开始时可相对于驱动部分38730向远侧运动,直到限定在滑动件部分38740中的凸轮表面38746接触组织切割刀38750,如图93所示,并将组织切割刀38750向上旋转到其部署位置。凸轮表面38746是弯曲的或弓形的,以促进组织切割刀38750围绕枢轴销38752的旋转,尽管可使用任何合适的构型。当组织切割刀38750接触限定在滑动件部分38740上的肩部38748时,组织切割刀38750停止旋转,并且反而滑动件部分38740的远侧运动通过组织切割刀38750传递到驱动部分38730。此时,驱动部分38730和滑动件部分38740一起向远侧平移,以在组织切割刀38750处于其部署位置的情况下执行钉击发行程。事实上,滑动件部分38740在钉击发行程期间将组织切割刀38750保持在其部署位置。值得注意的是,当组织切割刀38750处于其部署位置时(图93),组织切割刀38750的刀刃38751延伸到滑动件部分38740上方,并且当组织切割刀38750处于其未部署位置(图94)时不延伸到滑动件部分38740上方。
在钉击发行程结束时或在钉击发行程已经停止之后,除上述之外,可旋转驱动轴在相反方向上旋转,并且在相反方向上驱动钉击发系统38700的击发构件。当击发构件回缩时,由于锁定臂38734将滑动件部分38740附接到击发构件,因此击发构件向近侧拉动滑动件部分38740。也就是说,击发构件和滑动件部分38740的初始回缩运动不会向近侧平移驱动部分38730。相反,滑动件部分38740的初始回缩运动使组织切割刀38750向下旋转到其未部署位置,如图94所示。此后,参考图95和图96,滑动件部分38740的近侧运动由于滑动件部分38740与击发构件的脱离而停止。更具体地,滑动件部分38740的近侧延伸的止挡臂38744接合仓体38420并且防止滑动件部分38740与击发构件回缩。此时,滑动件部分38740的锁定臂38734与击发构件脱离接合,使滑动件部分38740和驱动部分38730处于其击发位置。这种布置防止用尽的钉仓38400再次使用。因此,用尽的钉仓38400必须用未用尽的钉仓替换,以便再次使用外科器械。也就是说,可使用其他用尽的仓闭锁件系统,这些仓闭锁件系统可允许在钉击发行程之后返回滑动件部分38740,只要不能重新击发用尽的钉仓即可。
钉击发系统39700示于图97至图103中。钉击发系统39700包括击发杆39720,该击发杆可通过例如钉仓39400向远侧平移,诸如,以执行钉击发行程。击发杆39720包括接合第一钳口的第一凸轮39278和在钉击发行程期间接合第二钳口以将第一钳口和第二钳口保持在一起的第二凸轮39279。钉击发系统39700还包括滑动件39740,该滑动件在钉击发行程期间由击发杆39720向远侧推动。滑动件39740包括近侧推动表面39741,该近侧推动表面与击发杆39720上的远侧推动表面39271接触。滑动件39740还包括中心体39743和从中心体39743延伸的斜坡39742。
除上述以外,钉击发系统39700还包括组织切割刀39750和刀回缩器39730。组织切割刀39750包括定位在限定在滑动件39740中的凹陷部39744内的基座39754和包括刀刃39751的刀体39753。刀回缩器39730包括锁定臂39732,该锁定臂接合限定在击发杆39720中的肩部39722和连接锁定臂39732的远侧端部的横杆39733。参考图98,滑动件39740、组织切割刀39750和刀片回缩器39730储存在钉仓39400的仓体39420中,使得当钉仓39400插入到第一钳口中时,刀回缩器39730的锁定臂39732附接到击发杆39720,并且组织切割刀39750的刀体39753邻接限定在击发杆39720上的远侧推动表面39723(图97)。此时,刀刃39731延伸到仓体39420的顶表面或平台上方,但是由从仓体39420向上延伸的导轨39425覆盖,使得当钉击发系统39700处于其未击发状态时,刀刃39731不暴露。
当向远侧推进钉击发系统39700以执行钉击发行程时,参考图99,击发杆39720接触并向远侧推动滑动件39740和组织切割刀39750。值得注意的是,参考图100,滑动件39740在钉击发行程开始时穿过从第一钳口延伸的突起部39222。突起部39222包括允许滑动件39740从其上方穿过的面向近侧的斜坡。在整个钉击发行程中,刀回缩器39730在组织切割刀39750的前面延伸。在钉击发行程已经完成或以其他方式停止之后,参考图101,击发杆39720回缩到其未击发位置。在此类实例中,刀回缩器39730接触组织切割刀39750以向近侧拉动组织切割刀39750和滑动件39740。值得注意的是,当向近侧拉动组织切割刀39750时,组织切割刀39750的基座39754最初在滑动件凹陷部39744内滑动,即,直到刀基座39754接触滑动件凹陷部39744的近侧端部。此时,组织切割刀39750和滑动件39740一起向近侧运动,直到滑动件39740到达从第一钳口延伸的突起部39222,如图102所示。突起部39222停止滑动件39740的近侧运动,并且因此,击发杆39720的继续近侧回缩使组织切割刀39750向近侧旋转,直到组织切割刀39750完全回缩到仓体39420的平台下方。此时,用尽的钉仓39400可安全地从第一钳口移除并且被另一钉仓替换。
包括钉仓40400和钉击发系统40700的缝合器械40000示于图104至图113中。主要参考图104,钉击发系统40700包括击发杆40720、在钉击发行程期间可通过击发杆40720向远侧运动的滑动件40740和围绕枢轴40752可旋转地安装到滑动件40740的组织切割刀40750。也就是说,滑动件40740和组织切割刀40750定位在钉仓40400中,并且当钉仓40400被安置在缝合器械40000中时呈现在击发杆40720的前面。当向远侧推进击发杆40720以执行钉击发行程时,如图105所示,击发杆40720接触组织切割刀40750。当进一步向远侧运动击发杆40720时,参考图106和图107,击发杆40720使组织切割刀40750从未部署位置(图104和图105)旋转到部署位置,其中组织切割刀40750的刀刃40751暴露在钉仓40400的仓体40420的顶部或平台上方。组织切割刀40750包括弓形凸轮表面40754,该弓形凸轮表面限定在其近侧侧上,该弓形凸轮表面与限定在击发杆40720中的弓形凸轮凹陷部40724接触,该弓形凸轮凹陷部使组织切割刀40750旋转到其部署位置中。当组织切割刀40750处于其部署位置时,如图107所示,从组织切割刀40750延伸的锁定突片40753被接纳在限定在击发杆40720中的锁定凹陷部或卡扣40723中,该锁定凹陷部或卡扣使组织切割刀40750在其部署位置的旋转停止。此外,当组织切割刀40750处于其部署位置时,从组织切割刀40750延伸的止挡突片40755被安置在滑动件40740的顶表面40745上。在任何情况下,此时,参考图108,击发杆40720可通过钉击发行程推动组织切割刀40740和滑动件40750。参考图113,滑动件40740的中心部分40743和组织切割刀40750的底部部分在钉仓40400的仓体40420中限定的纵向狭槽40423内行进。
在钉击发行程之后或在钉击发行程已经停止之后,参考图109至图112,击发杆40720可回缩到其未击发位置。在此类实例中,击发杆40720向近侧拉动组织切割刀40750的锁定突片40753,这导致组织切割刀40750朝其未部署位置旋转。钉仓40400的仓体40420包括延伸到纵向狭槽40423中的成角度脊40425,这些成角度脊被构造成能够在向近侧回缩击发杆40720时将组织切割刀40750引导回其回缩位置。组织切割刀40750包括从其横向侧面延伸的销40752,当组织切割刀40750向后旋转到纵向狭槽40423中时这些销接合脊40425。此外,在各种实施方案中,销40752和脊40425之间的接合可防止组织切割刀40750完全回缩。在此类实例中,参考图112,击发杆40720变得与组织切割刀40750脱离接合,并且因此,击发杆40720不会回缩组织切割刀40750和滑动件40740。相反,组织切割刀40750和滑动件40740保持处于其击发位置,但是组织切割刀40750处于其未部署位置,这允许用尽的钉仓40400安全地从缝合器械40000移除。
包括端部执行器41200和钉击发系统41700的缝合器械41000示于图114至图120中。主要参考图114,端部执行器41200包括第一钳口41220以及另外可旋转地安装到第一钳口41220的第二钳口41230。第二钳口41230可通过缝合器械41000的闭合系统在打开、未夹持位置(图114)和闭合、夹持位置(图115)之间旋转。第一钳口41220包括限定于其中的纵向狭槽,该纵向狭槽被构造成能够接纳钉击发系统41700的一部分。类似地,第二钳口41230包括限定于其中的纵向狭槽41239,该纵向狭槽被构造成能够接纳钉击发系统41700的一部分。第一钳口41220被构造成能够在其中接纳钉仓41400,该钉仓包括仓体41420、可移除地储存在限定在仓体41420中的钉腔中的钉和可运动地定位在仓体41420中的钉驱动器,这些钉驱动器被构造成能够在钉击发行程期间从仓体41420中射出钉。
钉击发系统41700包括可旋转驱动轴41710和与驱动轴41710的螺纹部分以螺纹方式接合的击发螺母41720。与上述类似,当驱动轴41710在第一方向上旋转时,向远侧推进击发螺母41720,并且当驱动轴41710在第二或相反方向上旋转时,向近侧回缩该击发螺母。钉击发系统41700还包括夹持构件41730、在钉击发行程期间可向远侧运动以将钉驱动器和钉推向限定在第二钳口41230中的钉成形凹坑的滑动件41740,以及可旋转地安装到滑动件41740的组织切割刀41750。主要参考图114,夹持构件41730保持在第二钳口或砧座41230中。更具体地,从夹持构件41730延伸的横向凸轮41739包含在限定在第二钳口41230中的纵向狭槽41239中,使得夹持构件41730与第二钳口41230一起运动。因此,当第二钳口41230处于打开位置时,如图114所示,夹持构件41730处于升高位置,并且当第二钳口41230处于闭合位置时,如图115所示,夹持构件41730处于降低位置。当夹持构件41730处于其升高位置时,夹持构件41730不与击发螺母41720接合。然而,当夹持构件41730处于其降低位置时,夹持构件41730与击发螺母41720接合。当夹持构件41730处于其降低位置时,击发螺母41720和夹持构件41730可向远侧推进以执行钉击发行程。公布于2016年9月1日的名称为“SURGICAL APPARATUS”的美国专利申请公布2016/0249928和公布于2018年6月21日的名称为“CONNECTION PORTIONS FOR DISPOSABLE LOADING UNITS FOR SURGICAL STAPLINGINSTRUMENTS”的美国专利公布2018/0168650的全部公开内容以引用方式并入本文。
除上述之外,夹持构件41730包括限定于其中的凹陷部41732,该凹陷部被构造成能够在夹持构件41730降低到击发螺母41720上时接纳击发螺母41720的顶部部分41722,如图115所示。此外,夹持构件41730还包括钩41734,当夹持构件41730降低到击发螺母41720上时,该钩被接纳在限定在组织切割刀41750中的凹陷部41754中。当向远侧推进击发螺母41720时,参考图116和图117,击发螺母41720向远侧推动夹持构件41730,该夹持构件邻接滑动件41740以通过钉击发行程推动滑动件41740。夹持构件41730还邻接组织切割刀41750以在钉击发行程期间支撑组织切割刀41750,并且当组织切割刀41750切割组织时防止组织切割刀41750向后或向近侧旋转。当驱动轴41710在相反方向上旋转时,参考图118,向近侧驱动击发螺母41720,该击发螺母向近侧推动夹持构件41730。在此类实例中,夹持构件41730的钩41734接触组织切割刀41750的向后旋转组织切割刀41750的近侧端部,使得夹持构件41730可与组织切割刀41750脱离接合。此时,参考图119,击发螺母41720和夹持构件41730返回到其近侧未击发位置,而滑动件41740和组织切割刀41750保持在其击发位置的后面。值得注意的是,当组织切割刀41750留下时,组织切割刀41750的刀刃41751在仓体41420的平台或顶部上方延伸;然而,在其他实施方案中,当组织切割刀41750向后旋转时,刀刃41751完全凹入仓体41420的平台下方。在任何情况下,参考图120,一旦击发螺母41720和夹持构件41730已经返回到其近侧未击发位置,第二钳口41230就可重新打开。
如上所讨论的,滑动件41740和组织切割刀41750在钉击发行程之后或在钉击发行程停止之后留在其击发位置中。在一些实例中,组织切割刀41750可能不与夹持构件41730脱离接合。图121示出了可帮助将滑动件41740和组织切割刀41750保持在其击发位置的实施方案。图121示出了钉仓42400和被构造成能够接纳钉仓42400的钳口42220。钳口42220包括底部支撑件42225和两个横向直立壁42223。钉仓42400包括定位在横向壁42223之间的仓体42420以及另外可在仓体42420内平移的滑动件42440。仓体42420包括限定于其中的钉腔,其中钉可移除地储存在钉腔中。仓体42420还包括限定于其中的被构造成能够接纳滑动件42440的中心部分42446的纵向狭槽42426。仓体42420还包括突起部42429,这些突起部从纵向狭槽42426的侧壁向内延伸,这可抑制或防止滑动件42440向近侧运动。更具体地,每个突起部42429包括允许滑动件42440在钉击发行程期间穿过的面向近侧的斜坡和使滑动件42440向近侧运动停止的面向远侧的肩部。突起部42429在纵向狭槽42426内纵向布置,使得突起部42429可停止滑动件42440向近侧运动,而不管钉击发行程停止。
除上述以外,再次参考图121,仓体42420还包括限定于其中的纵向狭槽42427,这些纵向狭槽被构造成能够接纳滑动件42440的横向钉部署斜坡42447。与上述类似,仓体42420还包括突起部42426,这些突起部从纵向狭槽42427的侧壁向内延伸,这可抑制或防止滑动件42440向近侧运动。更具体地,每个突起部42428包括允许滑动件42440在钉击发行程期间穿过的面向近侧的斜坡和使滑动件42440向近侧运动停止的面向远侧的肩部。滑动件42240包括从导轨42447延伸的钩42248,当滑动件42240向近侧运动时,这些钩可邻接突起部42428的面向远侧的肩部。突起部42428在纵向狭槽42427内纵向布置,使得突起部42428可使滑动件42440向近侧运动停止,而不管钉击发行程停止。除了或代替上文所述,钳口42220包括从底部支撑件42225向上延伸的突起部42224,这些突起部被构造成能够与滑动件42440的底部部分42445相互作用。每个突起部42224包括允许滑动件42440在钉击发行程期间穿过的面向近侧的斜坡和使滑动件42440向近侧运动停止的面向远侧的肩部。
外科缝合器械43000示于图122至图128中。外科器械43000包括具有第一钳口43220和第二钳口43230的端部执行器43200、定位在第一钳口43220中的可替换的钉仓43400以及钉击发驱动装置43700。钉仓43400包括仓体43420和定位在仓体43420内的滑动件43440,该滑动件在钉击发行程期间从近侧位置(图122)滑动到远侧位置。滑动件43440包括被构造成能够接合仓体43420内的钉驱动器以从钉仓43400射出钉的斜坡。滑动件43440还包括固定地附接到其上的组织切割刀43450。当滑动件43440处于其近侧未击发位置时,参考图122,组织切割刀43450的刀刃定位在从仓体43420的平台或顶部向上延伸的横向刀防护件43425之间。当在钉击发行程期间向远侧推进滑动件43440时,组织切割刀43450的刀刃暴露于捕获在钳口43220和43230之间的患者组织。如下文更详细地描述的,滑动件43440可通过钉击发系统43700的击发杆43720向远侧运动。公布于2013年9月24日的名称为“STAPLE CARTRIDGE”的美国专利8,540,133的全部公开内容以引用方式并入本文。
当第二钳口43230处于打开位置时,未用尽的钉仓43400可插入第一钳口43220中。当未用尽的钉仓43400被完全安置在第一钳口43220中时,未用尽的钉仓43400的滑动件43440压缩安装到第一钳口43220的底部的用尽的仓闭锁件43290。用尽的仓闭锁件43290包括折叠弹簧,例如,其中一侧安装到第一钳口43220并且另一侧向上延伸,与滑动件43220接触。一旦用尽的仓闭锁件43290已经被滑动件43220按下或解除,就可向远侧推进击发杆43720以将击发杆43720与滑动件43440联接,如图123和图124所示。更具体地,击发杆43720包括可旋转地安装到其上的闩锁43730,当向远侧推进击发杆43720并且用尽的仓闭锁件43290已经被向下推出滑动件43440时,该闩锁变为闩锁到滑动件43440。闩锁43730包括远侧闩锁端部43731,该远侧闩锁端部接合限定在滑动件43440中的闩锁凹陷部43441,并且一旦联接,就向远侧推动击发杆43720以推动滑动件43440穿过钉击发行程。值得注意的是,击发杆43720包括被构造成能够接合第一钳口43220的第一凸轮43728和被构造成能够在钉击发行程期间接合第二钳口43230以将钳口43220和43230相对于彼此保持在适当位置的第二凸轮43729。另外,值得注意的是,用尽的仓闭锁件43290被构造成能够在滑动件43440已经被向远侧推出用尽的仓闭锁件43290之后弹性地返回到其锁定状态,但在这种实例中其不会阻碍当前的钉击发行程,因为用尽的仓闭锁件43290已经被未用尽的钉仓43400绕过。
在钉击发行程已经完成之后或在钉击发行程已经停止之后,击发杆43720回缩到其近侧未击发位置。当击发杆43720回缩时,参考图125,闩锁43730用击发杆43720向近侧拉动滑动件43440。当击发杆43720接近其近侧未击发位置时,闩锁43730与滑动件43740脱离接合。更具体地,参考图126,闩锁43730接触用尽的仓闭锁件43290,该用尽的仓闭锁件将闩锁43730的远侧闩锁端部43731提升离开限定在滑动件43440中的闩锁凹陷部43441。此时,滑动件43440不与击发杆43720一起回缩。事实上,在这种情况下,滑动件43440未完全回缩。相反,参考图127,滑动件43440保持在部分前进或击发位置,其中滑动件43440未坐置在用尽的仓闭锁件43290上(但是处于其中组织切割刀43750的刀刃被刀防护件43425保护的位置中)。因此,用尽的仓闭锁件43290保持处于其锁定位置,直到用尽的钉仓43400从第一钳口43220移除并且用未用尽的钉仓43400替换,或另一个合适的未用尽的钉仓替换。在替换用尽的钉仓43400之前再次向远侧推进一次击发杆43720的情况下,参考图128,闩锁43730将接触钉仓闭锁件43290,并且击发杆43720的远侧前进将停止。因此,如果未用尽的钉仓43400未安置在第一钳口43220中,则用尽的仓闭锁件43290防止钉击发系统43700的钉击发行程。
除了或代替上文所述,任何合适的用尽的仓闭锁件可与本文公开的实施方案中的任一者一起使用。例如,可使用电子用尽的仓闭锁件。在至少一个这种实施方案中,缝合器械包括被构造成能够驱动钉击发系统43700的电动马达、包括被构造成能够控制电动马达的微处理器的控制器和与被构造成能够检测第一钳口43220中的未用尽的钉仓的存在的控制器进行通信的传感器。例如,传感器可被构造成能够检测处于其近侧未击发位置的滑动件43440的存在。值得注意的是,缝合器械43000的用尽的仓闭锁件43290也用作缺失的仓闭锁件。如果完全从第一钳口43220缺失钉仓,则用尽的仓闭锁件43290以相同或类似的方式防止钉击发系统43700的钉击发行程。
缝合器械44000的部分示于图129至图133中。缝合器械44000包括钉仓44400和钉击发驱动装置44700。钉仓44400包括具有钉腔44424和限定于其中的纵向狭槽44426的仓体44420、可移除地储存在钉腔44424中的钉,以及储存在仓体44420的近侧端部中的组织切割刀44450。组织切割刀44450包括可滑动地定位在纵向狭槽44426中的部分和延伸到仓体44420上方的刀刃44451。当组织切割刀44450处于近侧未击发位置时,参考图129和图130,刀刃44451定位在从仓体44420向上延伸的刀防护件44425之间,使得刀刃44451未暴露。当将钉仓44400负载到缝合器械44000中时,组织切割刀44450定位在钉击发驱动装置44700的击发构件44720的前面。此时,在击发构件44720和组织切割刀44450之间存在间隙,并且击发构件44720未连接到组织切割刀44450。然而,当向远侧推进击发构件44720时,击发构件44720连接到组织切割刀44450。更具体地,组织切割刀44450包括向近侧延伸的闩锁臂44452,当击发构件44720接触组织切割刀44450并且最初向远侧推进组织切割刀44450时,这些向近侧延伸的闩锁臂通过纵向狭槽44426的侧壁向内偏置到限定在击发构件44720的相对侧上的锁定凹陷部44722中。此时,参考图131,组织切割刀44450附接到击发构件44720,并且通过钉击发行程一起向远侧推进组织切割刀44450和击发构件44720,如图132所示。向远侧推进组织切割刀44450使刀刃44451从刀防护件44425之间移出,并且将组织切割刀44450暴露于组织。此外,击发构件44720包括整体滑动件44740,该整体滑动件被构造成能够接合钉仓44400中的钉驱动器并且在钉击发行程期间从钉腔44424射出钉。
在钉击发行程已经完成之后或在钉击发行程已经停止之后,击发构件44720回缩到其近侧未击发位置。在此类实例中,击发构件44720向近侧拉动组织切割刀44450。当组织切割刀44450返回到其近侧未击发位置时,刀刃44451定位在刀防护件44425之间。此外,参考图133,当组织切割刀44450返回到其近侧位置时,组织切割刀44450从击发构件44720释放。更具体地,参考图130,当组织切割刀44450到达其近侧位置时,闩锁臂44452由于由限定在仓体44420中的凹陷部44422提供的间隙弹性地向外弹起。一旦组织切割刀44450从击发构件44720脱离,就向近侧运动击发构件44720到其未击发位置。在各种实例中,当组织切割刀44450邻接仓体44420中的近侧肩部或壁时,使组织切割刀44450向近侧运动停止。在此类实例中,如果闩锁臂44452仍然与限定在击发构件44720中的锁定凹陷部44722部分接合,则击发构件44720可从闩锁臂44452拉离。
图134至图138中示出了外科器械45000。主要参考图134,外科器械45000包括端部执行器45200,该端部执行器包括第一钳口45220和第二钳口或砧座45230,该第二钳口或砧座可相对于第一钳口45220在打开、未夹持位置和闭合、夹持位置之间围绕枢轴销45240旋转。外科器械45000还包括被构造成能够闭合第二钳口45230的钳口闭合系统45600。更具体地,钳口闭合系统45600包括可向近侧运动以朝向其闭合位置向下顶起的第二钳口45230的闭合构件45620。外科器械45000还包括钉击发系统45700,该钉击发系统包括可旋转驱动轴45710和与驱动轴45710以螺纹方式接合的击发构件45720,该驱动轴可在钉击发行程期间向远侧运动。第一钳口45220被构造成能够在其中接纳可替换的钉仓45400,该可替换的钉仓包括仓体45420、可移除地储存在仓体45420中的钉和被构造成能够在钉击发行程期间支撑钉并将钉驱动出仓体45420的钉驱动器。钉仓45400还包括滑动件45440,该滑动件可通过击发构件45720从近侧未击发位置运动到远侧击发位置,以在钉击发行程期间将钉驱动器在仓体45420内向上推向仓体45420的顶部或平台。
除上述之外,外科器械45000还包括闭锁组件45900,该闭锁组件被构造成能够在钉仓45400从第一钳口45220中缺失或者定位在第一钳口45220中的钉仓45400先前已经击发的情况下防止第二钳口45230完全闭合并则防止击发构件45720向远侧推进通过钉击发行程。主要参考图135和图136,闭锁组件45900包括框架45910、砧座闭合闭锁件45920和钉击发闭锁件45930。框架45910固定地安装到第一钳口45220并且定位在枢轴销45240下方,但是也可定位在任何合适的位置。砧座闭合闭锁件45920围绕枢轴45922可旋转地安装到框架45910,并且可围绕枢轴45922在锁定位置(图135)和解锁位置(图137和图138)之间旋转。砧座闭合闭锁件45920包括近侧端部45924和远侧端部45926。当砧座闭合闭锁件45920处于其锁定位置(图135)时,砧座闭合闭锁件45920的近侧端部45924包括可释放地与限定在闭合构件45620上的闩锁肩部45624接合的闩锁。在此类实例中,砧座闭合闭锁件45920防止闭合构件45620向近侧运动以闭合第二钳口45230。然而,当钉仓45400插入到第一钳口45220中时,仓体45420的近侧端部接触砧座闭合闭锁件45920的远侧端部45926,并且使砧座闭合闭锁件45920旋转到其解锁位置,如图137所示。在此类实例中,砧座闭合闭锁件45920的近侧端部45924与闭合构件45620脱离接合,并且可向近侧运动闭合构件45620以闭合第二钳口45230。事实上,只要钉仓45400安置在第一钳口45220中,砧座闭合闭锁件45920就保持解锁,并且因此,只要钉仓45400安置在第一钳口45220中,第二钳口45230就可由临床医生打开和闭合任意多次。然而,一旦移除钉仓45400,砧座闭合闭锁件45920就自动重新锁定。更具体地,锁定组件45900包括偏置弹簧45940,该偏置弹簧定位在砧座闭合闭锁件45920和钉击发锁定件45930中间,当砧座闭合闭锁件45920旋转到其解锁位置时,该偏置弹簧被压缩,并且当移除钉仓45400时,偏置弹簧45940将砧座闭合闭锁件45920弹性地返回到其锁定位置。
缝合击发闭锁件45930围绕枢轴45932可旋转地安装到框架45910,并且可围绕枢轴45932在锁定位置(图135)和解锁位置(图137)之间旋转。钉击发闭锁件45930包括近侧端部45934和远侧端部45936。当钉击发闭锁件45930处于其锁定位置(图135)时,钉击发闭锁件45930的远侧端部45936包括可释放地与击发构件45720接合的闩锁。在此类实例中,钉击发闭锁件45930防止击发构件45720向远侧运动以执行钉击发行程。然而,当未用尽的钉仓45400插入到第一钳口45220中时,钉仓45400的滑动件45440接触钉击发闭锁件45930的远侧端部45936,并且使钉击发闭锁件45930旋转到其解锁位置,如图137所示。在此类实例中,钉击发闭锁件45930的远侧端部45936与击发构件45720脱离接合,并且可向远侧运动击发构件45720以执行钉击发行程。然而,一旦向远侧推进滑动件45440,钉击发闭锁件45930就自动重新锁定。更具体地,当钉击发闭锁件45930旋转到其解锁位置时,定位在砧座闭合闭锁件45920和钉击发闭锁件45930中间的偏置弹簧45940被压缩,并且当向远侧推进滑动件45440时,偏置弹簧45940将钉击发闭锁件45930弹性地返回到其锁定位置。因此,当滑动件45440通过击发构件45720向远侧推进通过其钉击发行程时,钉击发闭锁件45930旋转回到其锁定位置。在这一点上,这是不重要的,因为已经向远侧推进击发构件45720,并且钉击发闭锁件45930不再能够停止钉击发行程。值得注意的是,尽管在钉击发行程之后,滑动件45440未通过击发构件45720向近侧返回,并且当击发构件45720返回到其近侧未击发位置时,钉击发闭锁件45930通过偏置弹簧45940偏置在击发构件45720的前面,使得击发构件45720的后续击发行程是不可能的,直到用尽的钉仓45400被未用尽的钉仓45400替换。2019年6月30日提交的名称为“SURGICAL INSTRUMENT SYSTEM COMPRISING AN RFID SYSTEM”的美国专利申请序列号16/458,108的全部公开内容以引用方式并入本文。
钉仓46400示于图139至图143中。钉仓46400包括仓体46420、可移除地储存在仓体46420中的钉、被构造成能够支撑钉并将钉驱动出仓体46420的钉驱动器和被构造成能够在钉击发行程期间朝向仓体46420的顶部或平台推动钉驱动器的滑动件46440。滑动件46440包括被构造成能够接合钉驱动器的斜坡或导轨46442,这些斜坡或导轨可滑动地定位在限定在仓体46420中的纵向狭槽46422中。滑动件46440还包括中心部分46446,该中心部分可滑动地定位在限定在仓体46420中的中心纵向狭槽46426中。滑动件46440在钉击发行程期间可从近侧未击发位置运动到远侧击发位置,其中滑动件46440被钉击发系统向远侧推动。在钉击发行程之后或在钉击发行程已经停止之后,将钉击发系统反向操作以重置钉击发系统。在此类实例中,钉击发系统将滑动件46440向近侧拉向其近侧未击发位置;然而,滑动件46440在其到达其近侧未击发位置之前停止,如下文更详细地描述的。此时,钉击发系统从滑动件46440脱离,使得滑动件46440保持在部分击发位置的后面。
主要参考图139,除上述之外,钉仓46400还包括围绕销46425可旋转地安装到仓体46420的用尽的仓锁定件46490。主要参考图140,当用尽的仓锁定件46490处于其解锁位置(图140)时,用尽的仓锁定件46490包括延伸到限定在滑动件46440中的孔口46447中的可倾倒部分46497。当向远侧推进滑动件46440时,如图141所示,限定在滑动件46440中的孔口46447的端壁接触用尽的仓锁定件46490的可倾倒部分46497并且使用尽的仓锁定件46490旋转到锁定位置(图142)。在用尽的仓锁定件46490的锁定位置,参考图142,用尽的仓锁定件46490的锁定部分46495定位在限定在仓体46420中的锁定孔口46427中。当滑动件46440在钉击发行程之后回缩时,除上述之外,滑动件46440的近侧运动被锁定部分46495阻挡,这防止了滑动件46440返回到其近侧未击发位置。相反,滑动件46440保持在回缩但用尽的位置。在与外科器械中的钉击发闭锁件共操作时,防止钉击发系统将滑动件46440推出其回缩用尽的位置。名称为“SURGICAL STAPLING INSTRUMENT HAVING SEPARATE AND DISTINCTCLOSING AND FIRING SYSTEMS”的美国专利7,000,818、名称为“SURGICAL STAPLINGINSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT”的美国专利6,988,649、名称为“SURGICAL STAPLING INSTRUMENT INCORPORATING AN E-BEAM FIRING MECHANISM”的美国专利6,978,921、名称为“SURGICAL STAPLING INSTRUMENT WITH MULTISTROKE FIRINGINCORPORATING AN ANTI-BACKUP MECHANISM”的美国专利6,959,852,以及名称为“SURGICAL STAPLING INSTRUMENT INCORPORATING A FIRING MECHANISM HAVING ALINKED TRANSMISSION”的美国专利6,905,057的全部公开内容以引用方式并入本文。在此类实施方案中,钉击发系统的击发杆必须在钉击发行程开始时接合滑动件46440,以便越过限定在第一钳口46220中的钉击发闭锁件,并且如果在钉击发行程开始时击发杆没有接合滑动件46440,则击发杆邻接钉击发闭锁件,并且击发杆被阻止执行钉击发行程。由于这种布置,用尽的仓不会被意外重新使用。为了重新使用缝合器械,必须移除用尽的钉仓46400并用未用尽的钉仓46400或任何其他合适的未用尽的钉仓替换。
参考图57,缝合器械的端部执行器包括钉仓30220和砧座30230。砧座30230可相对于钉仓30220在打开、未夹持位置和闭合、夹持位置之间运动。钉仓30220包括仓体30222,该仓体包括近侧端部30224、远侧端部和在近侧端部30224和远侧端部之间延伸的平台。仓体30222还包括从近侧端部30224朝向远侧端部延伸的纵向狭槽30228以及另外的在纵向狭槽30228的相对侧上以纵向排布置的钉腔30223。钉或任何其他合适的紧固件可移除地储存在每个钉腔30223中。
除上述之外,缝合器械包括被构造成能够接纳钉仓30220的仓钳口。仓钳口和/或钉仓30220包括被构造成能够将钉仓30220可释放地保持在仓钳口中的特征部。在各种实例中,例如,钉仓30220包括在钉仓体30222的近侧端部30224和远侧端部处的卡扣配合特征部,例如,这些卡扣配合特征部将钉仓30220可释放地保持在仓钳口中。在各种实例中,参考图58,当钉仓30220插入到仓钳口中时,钉仓30220的近侧端部可能没有完全坐置或卡扣到仓钳口中。在此类实例中,仓体30222的近侧端部30224可高于远侧端部,从而在近侧端部30224和远侧端部之间产生倾斜的平台。如果临床医生注意到的话,他们可通过向下推动仓体30222的近侧端部30224以完全安置近侧端部30234来校正该状况。如果临床医生没有注意到,则缝合器械具有自校正特征部,该自校正特征部将钉仓30220完全安置在仓钳口中,如下文更详细地讨论的。
仓体30222包括从仓体30222的近侧端部30224向上延伸的突起部30225。第一突起部30225从纵向狭槽30228的第一侧向上延伸并且第二突起部30225从纵向狭槽30228的第二侧向上延伸。每个突起部30225包括从其延伸的对准柱30227,该对准柱被构造成能够在砧座30230运动到其夹持位置时接纳在限定在砧座30230中的对准狭槽30237内。如图58所示,如果当砧座30230运动到夹持位置时,钉仓30220没有被正确地安置在仓钳口中,则砧座30230将接触对准柱30227并向下推动钉仓30220,直到钉仓30220被安置在仓钳口中。另一方面,如果钉仓30220被正确地安置在仓钳口中,则对准狭槽30237可接纳对准柱30227而不会向下推动钉仓30220。有利地,这种布置确保当砧座30230处于其夹持位置时,钉仓30220的组织支撑表面30221和砧座30230的组织支撑表面30231正确对准。此外,当砧座30230处于其夹持位置时,这种布置确保储存在钉仓30220内的钉与限定在砧座30230中的钉成形凹坑正确对准。
除上述之外,参考图59和图60,钉仓30220可还包括从突起部30225中的每一者延伸的一个或多个挤压肋30229。挤压肋30229的尺寸和构造使得砧座30230接触钉仓30220,无论钉仓30220是否被正确或不正确地安置在仓钳口中。当砧座30230运动到其夹持位置时,砧座30230接触挤压肋30229并且永久地使它们变形。在这种实例中,因此,在钉仓30220和砧座30230之间产生紧密界面。这种布置可考虑钉仓30220和砧座30230的各种制造公差等。此外,挤压肋30229和对准柱30227可协同工作,使钉仓30220与砧座30230对准。例如,对准柱可在砧座30230和钉仓30220之间提供大致对准,而挤压肋30229可在砧座30230和钉仓30220之间提供精细对准。
除上述之外,缝合器械的钉仓30220和/或钉击发驱动装置包括可在钉击发行程期间从仓体30222的近侧端部30224朝向远侧端部30226平移以从仓体30222射出钉的组织切割刀。在钉击发行程期间,组织切割刀的刀刃延伸到仓体30222的顶表面30221上方,以切割夹持在钉仓30220和砧座30230之间的组织。在各种实例中,如果组织切割刀是钉仓30220的一部分当钉仓30220没有定位在钉仓钳口中时以及/或者当钉仓30220定位在钉仓钳口中并且砧座处于打开或未夹持位置时,刀刃将暴露在顶表面30221上方。考虑到这一点,突起部30225的尺寸和构造被设置成在组织切割构件处于其近侧未击发位置时延伸到到刀刃上方并覆盖刀刃。此外,突起部30225的尺寸和构造被设置成当组织切割构件处于其近侧未击发位置时相对于刀刃纵向延伸。当在钉击发行程期间向远侧运动组织切割构件时,刀刃从突起部30225之间向远侧移出并变得暴露。
在图61至图64中描绘了在许多方面类似于钉仓30220和砧座30230的钉仓31220和砧座31230。钉仓31220包括仓体31222,该仓体包括近侧端部31224,与上述类似,该近侧端部在砧座31230运动到其夹持位置时将被砧座31230推入其完全安置位置。仓体31222包括从仓体31222的近侧端部31224向上延伸的突起部31225。与上述类似,突起部31225位于纵向狭槽30228侧翼,并且各自包括从其延伸的对准柱31227。当砧座31230运动到夹持位置时,对准柱31227被构造成能够接纳在限定在砧座31230中的对准狭槽31237内。对准柱31227还包括从其延伸的挤压肋31229,当砧座31230被过度夹持(图64)超过平行位置(图63)时,这些挤压肋被砧座31230挤压,以使钉仓31220在尚未安置的情况下安置。
在图65至图68中描绘了在许多方面类似于钉仓30220、31220和砧座30230、31230的钉仓32220和砧座32230。钉仓32220包括仓体32222,该仓体包括近侧端部32224,与上述类似,该近侧端部在砧座32230运动到其夹持位置时将被砧座32230推入其完全安置位置。仓体32222包括从仓体32222的近侧端部32224向上延伸的凸轮32227。与上述类似,凸轮32227位于纵向狭槽30228侧翼,并且各自包括弓形轮廓。凸轮32227被构造成能够在砧座32230运动到夹持位置时与从砧座32230延伸的对应凸轮32237接合,以在钉仓32220尚未安置的情况下安置钉仓32220。
参见图71和图72,钉仓48400包括仓体,该仓体包括限定于其中的钉腔48425。参考图69和图70,砧座48230可旋转地安装到围绕枢轴销48240支撑钉仓48400的钳口。砧座48230包括限定于其中的钉成形凹坑48235,当砧座48230闭合时这些钉形成凹坑与钉腔48245对准。更具体地,每个钉成形凹坑48235与对应钉腔48245对准,使得从钉腔48245射出的钉被其对应成形凹坑48235变形。在至少一个实例中,每个成形凹坑48235包括两个成形杯,每个成形杯被构造成能够使钉的支腿变形。
钉仓10000示于图18中。钉仓10000还包括平台表面10010和基座10015。侧壁10020在平台表面10010和基座10015之间延伸。钉仓10000还包括从近侧端部10002朝向远侧端部10004延伸的细长狭槽10006。纵向轴线由细长狭槽10006沿钉仓10000限定。钉仓10000包括限定于其中的钉腔。钉腔被布置成三个纵向排。第一排钉腔10100在细长狭槽10006旁边延伸。第二排钉腔10200在细长狭槽10006的同一侧上在第一排钉腔10100旁边延伸。第三排钉腔10300在第二排钉腔10200旁边延伸。
钉驱动器10500可运动地定位在钉腔10100、10200、10300内。更具体地,钉驱动器10500被构造成能够在钉击发行程期间从未击发位置运动到击发位置。每个钉驱动器10500包括第一钉支撑部分10510、第二钉支撑部分10520和第三钉支撑部分10530。第一钉支撑部分10510支撑来自第一纵向排钉腔10100中的钉,第二钉支撑部分10520支撑来自第二纵向排钉腔10200中的钉,并且第三钉支撑部分10530支撑来自第三纵向排的钉腔10300中的钉。基座10550将三个钉支撑部分10510、10520、10530彼此连接。
在各种实例中,钉仓包括部件,诸如例如定位在钉仓的基座下面和/或底部的托盘,以防止元件诸如例如钉驱动器和/或钉在储存和/或处理期间与钉仓解除关联。在此类附加部件是不期望的实例中,钉仓可包括一个或多个驱动器保持特征部,如本文更详细地讨论的。除了维持钉仓内的钉驱动器之外,驱动器保持特征部还可用于在钉击发行程之前将钉驱动器维持在其未击发位置。在钉击发行程之前将钉驱动器保持在其未击发位置可促进均匀和/或成功的钉击发行程。在此类实例中,本文所讨论的驱动器保持特征部防止钉驱动器在钉腔内任何方向上不需要运动。
现在参考图18至图22,钉仓10000包括多个锁定臂10022,该多个锁定臂被构造成能够用作驱动器保持特征部。该多个锁定臂10022被限定在钉仓10000的外侧壁10020内。锁定臂10022沿钉仓10000的长度彼此纵向间隔开。每个锁定臂10022包括弹性接合部分,该弹性接合部分被构造成能够与钉驱动器介接以将钉驱动器维持在其未击发位置。在图19所示的实施方案中,每个锁定臂10022包括从第三纵向排延伸到钉腔10300中的突起部;然而,锁定臂10022可延伸到任何合适的钉腔中。钉驱动器10500在图21和图22中示出为处于其未击发位置。钉驱动器10500包括限定在第三钉支撑部分10530中的凹痕和/或凹口10535。当钉驱动器10500处于其未击发位置时,凹口10535与钉仓10000的锁定臂10022介接和/或接纳突起部。钉驱动器10500和锁定臂10022之间的界面向钉仓10000提供驱动器保持能力。本文更详细地描述了另外的驱动器保持特征部。
在许多方面类似于钉仓10000的钉仓10000’示于图23中。钉仓10000’包括限定在侧壁10020中的窗口10025,其中窗口10025彼此纵向间隔开。窗口10025沿钉仓10000定位在彼此相同的高度处。在许多方面类似于钉驱动器10500钉驱动器10500’被构造成能够可运动地接纳在钉仓10000’内。图24所示的钉驱动器10500’包括从第三钉支撑部分10530’的侧壁朝向钉仓10000’的侧壁10020弹性地延伸的驱动器保持构件和/或突起部10535’。换句话说,钉驱动器10500’的从第三纵向排延伸到钉腔10300中的部分10530’包括从第三钉支撑部分10530’朝向钉仓10000’的侧壁10020延伸的驱动器保持构件和/或突起部10535’。
驱动器保持构件10535’弹性连接到钉驱动器10500’的基座10550’。当钉驱动器10500’处于其未击发位置时,如图23所示,驱动器保持构件10535’延伸穿过限定在钉仓10000’中的窗口10025。驱动器保持构件10535穿过窗口10025的突起部防止钉驱动器10500’在钉腔10100、10200、10300内任何方向上自由运动。换句话说,必须将外力施加到钉驱动器10500’和/或钉仓10000’,以便将突起部10535’偏置出窗口10025。驱动器保持构件10535’包括被构造成能够在钉击发行程期间促进驱动器保持构件10535’与窗口10025的脱离接合的截面渐变的和/或斜坡的上表面。当作为向上力诸如由推进的击发构件施加的力施加到钉驱动器10500’时,驱动器保持构件10535’偏置离开钉仓10000’的侧壁10020。然后,驱动器保持构件10535’与窗口10025脱离接合,并且钉驱动器10500’自由从未击发位置朝向击发位置平移。
在各种实例中,窗口10025沿钉仓10000’的侧壁10020定位在不同的高度处。这种窗口布置促进了将钉驱动器保持在钉仓10000’中的不同的高度处的能力。
图25和图26中描绘了在许多方面类似于钉仓10000的钉仓11000。钉仓11000包括平台表面11010和基座11015。钉仓11000还包括从近侧端部11002朝向远侧端部11004延伸的细长狭槽11006。纵向轴线由细长狭槽11006沿钉仓11000限定。钉仓11000包括限定于其中的钉腔。钉腔被布置成三个纵向排。第一排钉腔11100在细长狭槽11006旁边延伸。第二排钉腔11200在细长狭槽11006的同一侧上在第一排钉腔11100旁边延伸。第三排钉腔11300在第二排钉腔11200旁边延伸。
钉驱动器11500可运动地定位在钉腔11100、11200、11300中。每个钉驱动器11500被构造成能够在钉击发行程期间从未击发位置运动到击发位置。如图27所示,钉驱动器11500包括第一钉支撑部分11510、第二钉支撑部分11520和第三钉支撑部分11530。第一钉支撑部分11510支撑来自第一纵向排钉腔11100中的钉,第二钉支撑部分11520支撑来自第二纵向排钉腔11200中的钉,并且第三钉支撑部分11530支撑来自第三纵向排的钉腔11300中的钉。基座11550将三个钉支撑部分11510、11520、11530彼此连接。
钉仓11000包括用作第三纵向排11300内的钉腔的侧壁的外壁11020。外壁11020包括弹性接合部分,该弹性接合部分包括限定于其上的突起部11025。钉仓11000还包括用作第一纵向排11100内的钉腔的侧壁的内壁11030。内壁11030包括弹性接合部分,该弹性接合部分包括限定于其上的突起部11035。钉仓11000的突起部11025、11035被构造成能够在钉驱动器11500在钉腔内运动时接合每个钉驱动器11500。如图26和图27所示,棘爪和/或凹口11515被限定在第一钉支撑部分11510和第三钉支撑部分11530中。在各种实施方案中,棘爪和/或凹口11515可被限定在钉驱动器11500的任何合适部分(诸如例如第二钉支撑部分11520)上。
钉驱动器11500被示出为插入基座11015中,位于图26所示钉仓11000的细长狭槽11006的右侧。钉驱动器11500的插入路径被钉仓11000的弹性接合部分11025、11035阻挡。换句话说,弹性接合部分11025、11035防止钉驱动器11500插入到钉仓11000中而不施加外力。当向钉驱动器11500施加向上力时,第一钉支撑部分11510接触钉仓11000的内壁11030。第一钉支撑部分11510和内壁11030之间的接触使内壁11030的至少一部分偏置远离钉驱动器11500并朝向细长狭槽11006。类似地,当钉驱动器11500被负载到钉仓11000中时,第三钉支撑部分11530接触钉仓11000的外壁11020。第三钉支撑部分11530和外壁11020之间的接触使外壁11020的至少一部分偏置远离钉驱动器11500并且偏置远离细长狭槽11006。当内壁11030和外壁11020偏置远离钉腔时,将钉驱动器11500的插入路径清除,并且钉驱动器11500能够负载到钉仓11000中并保持在未击发位置。
钉驱动器11500被示出为保持在未击发位置,位于图26所示钉仓11000的细长狭槽11006的左侧。值得注意的是,内壁11030和外壁11020的弹性接合部分处于未偏置和/或自然构型。当限定在弹性接合部分上的突起部11025、11035被限定在钉驱动器11500的第一钉支撑部分11510和第三钉支撑部分11530中的棘爪和/或凹口11515接纳时,钉驱动器11500保持在未击发位置。换句话说,钉仓11000的突起部11025、11035和钉驱动器11500的凹口和/或棘爪11515之间的界面防止钉驱动器11500在任一方向上运动出未击发位置。
如本文更详细地讨论的,驱动器保持特征部可一体地形成在钉仓内。可通过注模成型工艺制造钉仓诸如钉仓11900。如图29所示,顶部模具11800和底部模具11700以允许注模包括驱动器保持特征部的钉仓11900的方式定位。类似于钉仓11000,钉仓11900包括沿细长狭槽的每一侧延伸的三个纵向排钉腔。
如图29和图30所示,底部模具11700包括从基座延伸的中心突起部11750,其中中心突起部11750被构造成能够限定钉仓11900中的细长狭槽。底部模具11700还包括沿中心突起部11750的每一侧从基座延伸的三个突起部。第一突起部11710在中心突起部11750旁边从基座延伸第一距离并且被构造成能够限定第一纵向排内的钉腔。第二突起部11720在第一突起部11710旁边从基座延伸第二距离并且被构造成能够限定第二纵向排内的钉腔。第三突起部11730在第二突起部11720旁边从基座延伸第三距离并且被构造成能够限定第三纵向排内的钉腔。第三距离短于第一距离和第二距离。
顶部模具11800包括从基座延伸的中心突起部11850,其中中心突起部11850被构造成能够与底部模具11700的中心突起部11750对准,以便在钉仓19000中限定细长狭槽。顶部模具11800还包括沿中心突起部11850的每一侧从基座延伸的三个突起部。第一突起部11810在中心突起部11850旁边从基座延伸第一距离。第一突起部11810与底部模具11700的第一突起部11710对准和/或配合以限定第一纵向排钉腔。第二突起部11820在第一突起部11810旁边从基座延伸第二距离。第二突起部11820与底部模具11700的第二突起部11720对准和/或配合以限定第二纵向排钉腔。第三突起部11830在第二突起部11820旁边从基座延伸第三距离。第三突起部11830与底部模具11700的第三突起部11730对准和/或配合,以限定第三排钉腔和驱动器保持特征部。第三距离大于第一距离和第二距离。换句话说,因为第一突起部11710和第二突起部11720高于底部模具11700的第三突起部11730,因此底部模具11700的第一突起部11710和第二突起部11720限定了第一纵向排钉腔和第二纵向排钉腔的大部分。相反,因为第三突起部11830高于顶部模具11800的第一突起部11820和第二突起部11830,因此顶部模具11800的第三突起部11830限定了第三纵向排钉腔的大部分。
第三突起部11730从底部模具11700的基座延伸较短的距离,以便在钉仓11900内形成驱动器保持特征部。虽然第一突起部11710、11810和第二突起部11720、11820的端部包括矩形轮廓,但是第三突起部11730、11830的端部包括截面渐变的和/或斜坡的轮廓。底部模具11700的第三突起部11730的截面渐变的和/或斜坡的轮廓与顶部模具11800的第三突起部11830的截面渐变的和/或斜坡的轮廓互补。截面渐变的轮廓允许限定弹性接合部分,该弹性接合部分包括在钉仓11900的外壁上的锁定突起部11925,其中锁定突起部11925延伸到钉腔中。在所描绘的实施方案中,锁定突起部11925从第三纵向排延伸到钉腔中。锁定突起部11925以与钉驱动器介接的方式定位以将钉驱动器维持在其未击发位置。锁定突起部11925被构造成能够防止钉驱动器在钉腔内的不需要的运动,诸如钉驱动器从其未击发位置朝向击发位置的运动和/或与钉仓19000解除关联。
图28示出了与钉仓11900一起使用的钉驱动器11600。钉驱动器11600包括被构造成能够定位在来自第一纵向排的钉腔中的第一钉支撑部分11610和被构造成能够定位在来自第二纵向排的钉腔中的第二钉支撑部分11620和被构造成能够定位在来自第三纵向排的钉腔中的第三钉支撑部分11630。第三钉支撑部分11630包括凸缘11634。在各种实例中,移除第三钉支撑部分11630的底部区段11636以便形成凸缘11634。凸缘11634包括平坦表面,当钉驱动器11600处于未击发位置时,该平坦表面直接邻接形成在钉仓11900的每个锁定突起部11925上的平坦表面。这种介接防止钉驱动器11600通过钉仓11900的基部与钉仓11900解除关联。每个锁定突起部11925还包括斜坡表面,以促进在钉击发行程期间由与击发构件接触时钉驱动器11600从其未击发位置朝向其击发位置的平移。在所描绘的实施方案中,将钉驱动器11600从其未击发位置朝向其击发位置运动所需的力小于将钉驱动器11600从其未击发位置朝向钉仓11900的基座运动所需的力。
图31A至图32B示出了钉仓12000在钉击发行程期间的各种元件。钉仓12000包括具有平台表面12010的仓体12005。钉腔12020被限定在仓体12005内。钉可移除地定位在钉腔12020内。钉驱动器12200定位在钉腔12020内以支撑钉,这些钉驱动器被构造成能够在钉击发行程期间朝向与钉仓12000相对定位的砧座驱动钉。钉驱动器12200中的每一者被构造成能够支撑限定于其上的钉支撑表面12230上的钉。每个钉驱动器12200包括近侧端部12202和远侧端部12204。每个钉驱动器12200的近侧端部12202包括截面渐变的接合表面或斜坡12210。图31A至图32B描绘了当击发构件12100在钉击发行程期间从近侧位置运动到远侧位置时击发构件12100和钉仓12000的钉驱动器12200之间的关系。当击发构件12100处于近侧位置时,击发构件12100在钉驱动器12200近侧,并且当击发构件12100处于远侧位置时,击发构件12100在钉驱动器12200远侧。
钉驱动器12200被构造成能够在钉击发行程期间在钉腔12020内向上平移。如本文更详细地讨论的,在钉击发行程期间,在由击发构件12100接触之前,钉驱动器12200处于未击发位置或构型。图31A示出了从其近侧位置朝向其远侧端部位置推进的击发构件12100。由于击发构件12100的远侧运动,击发构件12100的远侧端部12104接触钉驱动器12200的截面渐变的接合表面12210。截面渐变的接合表面12210和击发构件12100的远侧端部12104之间的接触使钉驱动器12200在第一方向1上开始向上驱动。击发构件12100包括被构造成能够在击发构件12100向远侧推进穿过钉仓12000时促进钉驱动器12200向上平移的斜坡表面12210。
当钉驱动器12200被击发构件12100向上驱动时,钉驱动器12200最终到达完全击发位置。在图31B中,钉驱动器12200示出为处于完全击发位置。在完全击发位置,钉驱动器12200的至少一部分延伸到钉仓12000的平台表面12010上方,或者相对于该平台表面被过度驱动。如图31B所示,当钉驱动器12200处于完全击发位置时,击发构件12100能够向近侧和远侧平移,而与钉驱动器12200几乎没有接触。因此,当钉驱动器12200维持在其完全击发位置时,钉驱动器12200不防止击发构件12100沿击发路径和/或回缩路径平移。
一旦钉驱动器12200到达其完全击发位置,击发构件12100就继续向远侧平移,直到击发构件12100经过钉驱动器12200。当击发构件12100向远侧平移超过钉驱动器12200时,钉驱动器12200在一些实例中可在第二方向2上从其完全击发位置向下落到在其未击发位置和其完全击发位置之间的某处的位置,即,升高位置。在图32A中,钉驱动器12200示出为处于升高位置。当钉驱动器12200处于升高和/或保持位置时,钉驱动器12200定位成高于处于其未击发位置的钉驱动器12200,但低于处于其完全击发位置的钉驱动器12200。在各种实例中,例如,当钉驱动器12200处于升高位置时,钉驱动器12200不延伸到钉仓12000的平台表面12010上方。
在许多实施方案中,在钉击发行程已经完成或以其他方式停止之后,击发构件12100从其远侧位置向近侧回缩。然而,如果一个或多个钉驱动器12200已经朝向未击发位置向下跌落,则击发构件12100被阻挡回缩超过跌落的钉驱动器12200。如本文更详细地讨论的,当钉驱动器12200处于其升高位置和/或其完全击发位置时,不防止击发构件12100向近侧回缩。
如图32B所示,击发构件12100的近侧端部12102包括成角度接合表面或斜坡12120。当击发构件12100向近侧回缩时,击发构件12100的成角度接合表面12120接触钉驱动器12200的远侧端部12204。在击发构件12100的成角度接合表面12120和钉驱动器12200的远侧端部12204之间进行的接触使钉驱动器12200在第一方向1上再次向上驱动。钉驱动器12200被驱动到完全击发位置或允许击发构件12100向近侧回缩超过钉驱动器12200的任何合适的位置。在所描绘的实施方案中,钉驱动器12200的一部分运动到钉仓12000的平台表面12010上方,以允许击发构件12100回缩。一旦击发构件12100回缩到钉驱动器12200,钉驱动器12200就可朝向未击发位置回退。本文更详细地讨论了将钉驱动器保持在完全击发位置和/或升高位置的各种方式。
钉仓13000描绘于图33中。钉仓13000包括从近侧端部13002朝向远侧端部13004延伸的细长狭槽13006。细长狭槽13006限定钉仓13000的纵向轴线。钉腔被限定在钉仓13000中,并且钉腔被布置成纵向排。第一纵向排钉腔13100在细长狭槽13006旁边延伸。第二纵向排钉腔13200在细长狭槽13006的同一侧上在第一纵向排钉腔13100旁边延伸。第三纵向排钉腔13300在第二纵向排钉腔13200旁边延伸。第一纵向排内的钉腔13100与第三纵向排内的钉腔13300横向对准。第二纵向排内的钉腔13200分别从第一纵向排和第三纵向排内的钉腔13100、13300横向偏移。
如本文更详细地讨论的,钉仓13000包括从平台表面13010向上和/或朝向砧座延伸的突起部13400。突起部13400围绕钉腔13100、13200、13300的至少一部分并且用于例如防止组织相对于平台表面13010运动和/或当钉在钉击发行程期间被射出时支撑钉。
钉驱动器13500可运动地定位在钉腔内,并且被构造成能够在钉击发行程期间支撑钉并朝向与钉仓13000相对定位的砧座驱动钉。如图34所示,每个钉驱动器13500包括第一钉支撑部分13510、第二钉支撑部分13520和第三钉支撑部分13530。第一钉支撑部分13510定位在钉腔13100内以支撑并驱动第一纵向排内的钉,第二钉支撑部分13520定位在钉腔13200内以支撑并驱动第二纵向排内的钉,并且第三钉支撑部分13530定位在钉腔13300内以支撑并驱动第三纵向排内的钉。三个钉支撑部分13510、13520、13530通过钉驱动器13500的基座13550连接在一起。虽然所描绘的钉驱动器13500包括三个钉支撑部分,但是钉驱动器可包括任何合适数量的钉支撑部分,诸如例如一个钉支撑部分或两个钉支撑部分。
钉驱动器13500被构造成能够在钉击发行程期间在钉腔内平移。如本文更详细地讨论的,在钉击发行程期间,在由击发构件接触之前,钉驱动器13500处于未击发位置。当钉驱动器13500被击发构件向上驱动时,钉驱动器13500最终到达完全击发位置。一旦钉驱动器13500到达其完全击发位置,击发构件就继续向远侧平移,直到击发构件不再与钉驱动器13500接触。当击发构件向远侧平移超过钉驱动器13500时,钉驱动器13500可落到在未击发位置和完全击发位置之间的升高位置。
为了在击发构件不再与钉驱动器接触之后至少在它们的升高位置中维持钉驱动器,钉仓13000包括延伸到钉腔中和/或其之上的驱动器保持构件13050,以接合钉驱动器13500并将钉驱动器13500保持在其升高位置和/或完全击发位置。每个驱动器保持构件13050从仓体13008延伸到第二纵向排钉腔内的单独钉腔13200中。在图35所描绘的实施方案中,驱动器保持构件13050定位在包围钉腔13200的一部分的突起部13400之间。孔口13525被限定在钉驱动器13500的被构造成能够接纳驱动器保持构件13050的一部分中。当所描绘的驱动器保持构件13050从第二纵向排延伸到钉腔13200中时,孔口13525被限定在第二钉支撑部分13520中。
孔口13525可位于钉驱动器13500的任何合适部分上。在各种实例中,钉驱动器13500可具有限定于其中的多于一个孔口13525。孔口13525可以任何合适的方式形成在钉驱动器13500内。在各种实例中,孔口13525由注模销产生。
在各种实例中,第二钉支撑部分13520包括除了第一钉支撑部分和第三钉支撑部分13510、13530之外的附加材料,以考虑限定于其中的孔口13525。例如,参考图34,第一钉支撑部分13510包括第一端部13512和第二端部13514。第一端部13512被构造成能够支撑钉的第一支腿,并且第二端部13514被构造成能够支撑钉的第二支腿。第一端部13512和第二端部13514通过中间部分13516彼此连接。中间部分13516定位在第一端部13512和第二端部13514下方第一距离处。当钉由第一钉支撑部分13510支撑时,中间部分13516不接触钉。第二钉支撑部分13520包括第一端部13522和第二端部13524。第一端部13522被构造成能够支撑钉的第一支腿,并且第二端部13524被构造成能够支撑钉的第二支腿。第一端部13522和第二端部13524通过中间部分13526彼此连接。中间部分13526定位在第一端部13522和第二端部13524下方第二距离处。第二距离小于第一距离。换句话讲,第二钉支撑部分13520的中间部分13526较大,以适应限定于其中的孔口13525。
驱动器保持构件13050包括柔性突片13252和从凸片13252延伸的突起部13255。当击发构件将钉驱动器13500从未击发位置朝向完全击发位置驱动时,钉驱动器13500使驱动器保持构件13050的突片13252弹性地弯曲出钉驱动器13500的驱动路径。换句话说,通过击发构件施加到钉驱动器13500的向上力足够强,以将驱动器保持构件13050偏置出钉驱动器13500的驱动路径,从而允许钉驱动器13500到达完全击发位置。突起部13255被构造成能够在钉驱动器13500处于和/或接近其完全击发位置时被钉驱动器13500的孔口13525接纳。在所描绘的实施方案中,当钉驱动器13500处于完全击发位置时,孔口13525定位在驱动器保持构件13050的突起部13255上方。当击发构件向远侧平移超过钉驱动器13500时,钉驱动器13500可开始朝向未击发位置回退。在此类实例中,驱动器保持构件13050的突片13252弹回到钉驱动器13500的驱动路径中,使得驱动器保持构件13050的突起部13255被钉驱动器13500的孔口13525卡住和/或以其他方式与其接合。当突起部13255被孔口13525接纳时,驱动器保持构件13050将钉驱动器13500保持在其升高位置。如关于图31A至图32B更详细地描述的,当钉驱动器13500被锁定在该位置时,钉驱动器13500不防止击发构件近侧回缩超过钉驱动器13500。突起部13255和孔口13525可被构造成能够和/或布置成将钉驱动器13500保持在其完全击发位置,或者另选地,突起部13255和孔口13525可被构造成能够和/或布置成将钉驱动器13500保持在未击发位置和其完全击发位置之间的升高位置。
现在转到图36A和图36B,描绘了包括平台表面14010和从近侧端部14002朝向远侧端部14004延伸的细长狭槽14006的钉仓14000。钉仓14000的平台表面14010是圆形和/或弯曲的。换句话说,平台表面14010相对于由细长狭槽14006限定的纵向轴线横向变化。所示的平台表面14010的最高点与细长狭槽14006相邻。钉仓14000还包括被布置成三个纵向排的钉腔。第一纵向排钉腔14100在细长狭槽14006旁边延伸。第二纵向排钉腔14200在第一纵向排钉腔14100旁边延伸,并且第三纵向排钉腔14300在第二纵向排钉腔14200旁边延伸。钉仓14000还包括延伸到平台表面14010上方的突起部。钉仓14000上描绘的突起部呈凹坑扩展部的形式。凹坑扩展部支撑钉仓的平台上方的钉的支腿。设想了其中突起部不是凹坑扩展部的实施方案。第一突起部14150围绕第一纵向排内的每个钉腔14100的一部分,第二突起部14250围绕第二纵向排内的每个钉腔14200的一部分,并且第三突起部14350围绕第三纵向排内的每个钉腔14300的一部分。这些突起部彼此连接。例如,第一突起部14150连接到第二突起部14250并且/或者第二突起部14250连接到第三突起部14350。在其他实例中,突起部彼此分离且不同,并且除了通过平台表面14010之外不彼此连接。
突起部14150、14250、14350包括正方形或基本上正方形几何形状。换句话说,突起部14150、14250、14350以模拟正方形的几何形状的方式围绕钉腔的部分。除此之外,突起部14150、14250、14350的曲线和/或边缘并不尖锐。在所描绘的实施方案中,第一突起部14150从第一纵向排内整体围绕钉腔14100。第二突起部14250从第二纵向排内围绕钉腔14200的大约四分之三。第三突起部14350由从第三纵向排内围绕钉腔14300的近侧端部14302和的远侧端部14304的两个突起部构成,其中两个突起部未连接。总体而言,第三突起部14350包围大约一半的钉腔14300。在各种实例中,第一突起部14150比第二突起部14250和第三突起部14350围绕钉腔的量更大。如所描绘的实施方案中所示,突起部14150、14250、14350包围特定钉腔的程度基于钉腔相对于细长狭槽14006的横向位置而变化。虽然特定纵向排钉腔内的所描绘的突起部均相同,但是可以设想,相同纵向排内的突起部可基于特定钉腔相对于钉仓14000的近侧端部14002和/或远侧端部14004的位置而变化。
图36A和图36B所示的突起部14150、14250、14350从平台表面14010延伸到不同的高度。更具体地,每个突起部14150、14250、14350的高度基于突起部14150、14250、14350和/或钉腔14100、14200、14300相对于细长狭槽14006的位置而变化。在各种实例中,每个突起部14150、14250、14350包括不同的高度;然而,设想任何合适的高度以实现特定的组织效应。在所描绘的实施方案中,第一突起部14150的高度大于第二突起部14250的高度,并且第二突起部14250的高度小于第三突起部14350的高度。
图37A和图37B中描绘了包括平台表面14510和从近侧端部14502朝向远侧端部14504延伸的细长狭槽14506的钉仓14500。钉仓14500的平台表面14510的高度是圆形和/或弯曲的。换句话说,平台表面14510相对于由细长狭槽14506限定的纵向轴线横向变化。所示的平台表面14510的最高点与细长狭槽14506相邻。钉仓14500还包括被布置成三个纵向排的钉腔。第一纵向排钉腔14600在细长狭槽14506旁边延伸。第二纵向排钉腔14700在第一纵向排钉腔14600旁边延伸,并且第三纵向排钉腔14800在第二纵向排钉腔14700旁边延伸。钉仓14500还包括延伸到平台表面14510上方的突起部。钉仓14500上描绘的突起部呈凹坑扩展部的形式。凹坑扩展部支撑钉仓的平台上方的钉的支腿。设想了其中突起部不是凹坑扩展部的实施方案。第一突起部14650围绕第一纵向排内的每个钉腔14600的第一部分,第二突起部14750围绕第二纵向排内的每个钉腔14700的第二部分,并且第三突起部14850围绕第三纵向排内的每个钉腔14800的第三部分。在各种实例中,这些突起部彼此连接。然而,在图37A和图37B中所描绘的实施方案中,这些突起部彼此分离且不同。
突起部14650、14750、14850各自包括细长或类金刚石几何形状。突起部14650、14750、14850以紧密地符合钉腔的边界的方式围绕钉腔的部分,这些边界也是细长和类金刚石形状。另外,突起部14650、14750、14850的曲线和/或边缘形成锐角和/或钝角。在所描绘的实施方案中,第一突起部14650从第一纵向排内围绕钉腔14600的大约四分之三。第二突起部14750由从第二纵向排内围绕钉腔14700的近侧端部14702和的远侧端部14704的两个突起部构成,其中两个突起部未连接。总体而言,第二突起部14750包围大约一半的钉腔14700。类似地,第三突起部14850由从第三纵向排内围绕钉腔14800的近侧端部14802和的远侧端部14804的两个突起部构成,其中两个突起部未连接。总体而言,第三突起部14850包围大约一半的钉腔14800。在各种实例中,第一突起部14650比第二突起部14750和第三突起部14850更大程度地围绕钉腔。在各种实例中,第二突起部14750和第三突起部14850以相同和/或类似的程度围绕钉腔。如所描绘的实施方案中所示,突起部14650、14750、14850包围特定钉腔的程度可基于钉腔相对于细长狭槽14506的横向位置而变化。虽然特定纵向排钉腔内的所描绘的突起部均相同,但是可以设想,相同纵向排内的突起部可基于特定钉腔相对于钉仓14500的近侧端部14502和/或远侧端部14504的位置而变化。
图37A和图37B所示的突起部14650、14750、14850从平台表面14510延伸到相同或类似的高度。更具体地,不管突起部14650、14750、14850和/或钉腔14600、14700、14800相对于细长狭槽14506的位置如何,每个突起部14650、14750、14850的高度基本上是相同的;然而,设想任何合适的高度以实现特定的组织效应。
现在转到图38A和图38B,描绘了包括平台表面15010和从近侧端部15002朝向远侧端部15004延伸的细长狭槽15006的钉仓15000。钉仓15000的平台表面15010是圆形和/或弯曲的。换句话说,平台表面15010的高度相对于由细长狭槽15006限定的纵向轴线横向变化。所示的平台表面15010的最高点与细长狭槽15006相邻。钉仓15000还包括被布置成三个纵向排的钉腔。第一纵向排钉腔15100在细长狭槽15006旁边延伸。第二纵向排钉腔15200在第一纵向排钉腔15100旁边延伸,并且第三纵向排钉腔15300在第二纵向排钉腔15200旁边延伸。钉仓15000还包括延伸到平台表面15010上方的突起部。钉仓15000上描绘的突起部呈凹坑扩展部的形式。凹坑扩展部支撑钉仓的平台上方的钉的支腿。设想了其中突起部不是凹坑扩展部的实施方案。第一突起部15150围绕第一纵向排内的每个钉腔15100的第一部分,第二突起部15250围绕第二纵向排内的每个钉腔15200的第二部分,并且第三突起部15350围绕第三纵向排内的每个钉腔15300的第三部分。在所描绘的实施方案中,这些突起部彼此连接。更具体地,第一突起部15150连接到第二突起部15250,并且第二突起部15250连接到第三突起部15350。
突起部15150、15250、15350包括细长或类金刚石几何形状。换句话说,突起部15150、15250、15350以紧密符合钉腔的边界的方式围绕钉腔的部分。在所描绘的实施方案中,第一突起部15150从第一纵向排内整体围绕钉腔15100。第二突起部15250从第二纵向排内整体围绕钉腔15200。第三突起部15350从第三纵向排内整体围绕钉腔15300。如所描绘的实施方案中所示,不管钉腔相对于细长狭槽15006的横向位置如何,突起部15150、15250、15350包围特定钉腔的程度是相同的。
图38A和图38B所示的突起部15150、15250、15350从平台表面15010延伸到不同的高度。不仅可基于钉腔15100、15200、15300相对于细长狭槽15006的位置而变化,而且突起部15150、15250、15350的高度可在每个单独钉腔上变化。换句话说,特定突起部的高度在整个突起部中是不均匀的。在所描绘的实施方案中,突起部的高度随着突起部与横向狭槽15006间隔越来越远而增加,以说明平台表面15010的弯曲性质。更具体地,靠近细长狭槽15006的突起部的部分比远离细长狭槽15006的突起部的部分短。
图39A和图39B中描绘了包括平台表面15510和从近侧端部15502朝向远侧端部15504延伸的细长狭槽15506的钉仓15500。钉仓15500的平台表面15510是圆形和/或弯曲的。换句话说,平台表面15510的高度相对于由细长狭槽15506限定的纵向轴线横向变化。所示的平台表面15510的最高点与细长狭槽15506相邻。钉仓15500还包括被布置成三个纵向排的钉腔。第一纵向排钉腔15600在细长狭槽15506旁边延伸。第二纵向排钉腔15700在第一纵向排钉腔15600旁边延伸,并且第三纵向排钉腔15800在第二纵向排钉腔15700旁边延伸。钉仓15500还包括延伸到平台表面15510上方的突起部15900。钉仓15000上描绘的突起部15900呈凹坑扩展部的形式。凹坑扩展部支撑钉仓的平台上方的钉的支腿。设想了其中突起部不是凹坑扩展部的实施方案。突起部15900跨越三个纵向排钉腔。例如,突起部15900包围来自第一纵向排的钉腔15600的近侧端部15602、来自第二纵向排的钉腔15700的远侧端部15704以及来自第三纵向排的钉腔15800的近侧端部15802。另一突起部15900包围来自第一纵向排的钉腔15600的远侧端部15604、来自第二纵向排的钉腔15700的近侧端部15702以及来自第三纵向排的钉腔15800的远侧端部15804。
突起部15900包括类金刚石几何形状。突起部15900以紧密符合钉腔的边界的方式围绕钉腔的部分。每个突起部15900的高度随着突起部15900远离细长狭槽15506横向延伸而变化。如图39A和图39B所示,包括突起部15900的钉仓15500的总高度在每个突起部15900上是相同的。为了在突起部15900上通过弯曲的平台表面15506实现水平表面,突起部15900的高度必须随着突起部15900远离细长狭槽15606延伸而变化。例如,在所描绘的实施方案中,突起部15900的与细长狭槽15506间隔最远的部分比突起部15900的与细长狭槽15506间隔最近的部分从平台表面15510延伸更大的距离。
图40示出了与外科缝合器械一起使用的端部执行器16000。端部执行器16000包括砧座16010和钉仓钳口16020。砧座16010和钉仓钳口16020中的至少一者可相对于彼此在打开构型和闭合构型之间运动。图40中所示的端部执行器16000处于闭合构型。砧座16010包括平面组织支撑表面16014,其中组织支撑表面16014包括限定于其中的多个钉成形凹坑16012。
钉仓16100被构造成能够可替换地坐置在钉仓钳口16020中。钉仓16100包括从近侧端部朝向远侧端部延伸的细长狭槽16106。钉仓16100的纵向轴线沿细长狭槽16106限定。钉仓16100还包括圆形和/或弯曲的平台表面16108。在各种实例中,钉仓16100包括倾斜的平台表面。在平台表面16108和砧座16010的组织支撑表面16014之间限定组织间隙。组织间隙相对于细长狭槽16106横向变化。在所描绘的实施方案中,组织间隙在与细长狭槽16106相邻的点处是最小的。组织间隙在远离细长狭槽16106横向间隔开的点处变大。
钉仓16100包括限定于其中的钉腔。第一纵向排钉腔16100在细长狭槽16106旁边延伸。第二纵向排钉腔16200在细长狭槽16106的同一侧上在第一纵向排钉腔16100旁边延伸。第三纵向排钉腔16300在第二纵向排钉腔16200旁边延伸。当纵向排钉腔横向间隔开时,组织间隙在纵向排之间变化。第一纵向排内的钉腔16110和砧座16010的组织支撑表面16014之间的组织间隙最小,而第三纵向排内的钉腔16130和砧座16010的组织支撑表面16014之间的组织间隙最大。
钉仓16100包括从弯曲的平台表面16108向上和/或朝向砧座16010延伸的突起部16400。突起部16400围绕钉腔16110、16120、16130的至少一部分并且用于例如防止支撑在平台表面16108和砧座16010的组织支撑表面16014之间的组织从期望位置移出以及/或者在钉击发行程期间向钉驱动器和/或钉提供稳定性。突起部16400围绕特定钉腔的程度可基于钉仓16100中的钉腔的位置而变化。突起部16400可基于特定钉腔相对于细长狭槽16106的位置而变化。例如,围绕第一纵向排内的钉腔16110的突起部16400可全部相同。然而,围绕第一纵向排内的钉腔16110的突起部16400可与围绕第二纵向排和第三纵向排内的钉腔16120、16130的突起部16400不同。突起部16400还可基于特定钉腔相对于钉仓16100的近侧端部和/或远侧端部的位置而变化。例如,突起部16400可在高度、长度和/或几何形状上变化。在本文中更详细地讨论了其中突起部16400可变化的方式。
在所描绘的实施方案中,第一突起部16400a围绕第一纵向排钉腔内的钉腔16110的第一部分。第一突起部16400a在平台表面16108上方延伸第一距离。第二突起部16400b围绕第二纵向排钉腔内的钉腔16120的第二部分。第二突起部16400b在平台表面16108上方延伸第二距离。第三突起部16400c围绕第三纵向排钉腔内的钉腔16130的第三部分。第三突起部16400c在平台表面16108上方延伸第三距离。在各种实例中,第一距离不同于第二距离和第三距离。在图40和图41中所描绘的实施方案中,第三距离大于第一距离,并且第一距离大于第二距离;然而,突起部16400可从平台表面16108延伸到任何距离以实现期望的组织抓握效果。
现在转到图41,钉仓16100还包括钉驱动器16500。钉驱动器16500包括第一钉支撑部分16510、第二钉支撑部分16520和第三钉支撑部分16530。第一钉支撑部分16510在钉腔16110内从第一纵向排钉腔延伸。第二钉支撑部分16520在钉腔16120内从第二纵向排钉腔延伸。第三钉支撑部分16530在钉腔16130内从第三纵向排钉腔延伸。钉支撑部分16510、16520、16530通过基座16550连接在一起。钉支撑部分16510、16520、16530全部远离钉驱动器16500的基座16550延伸一定距离。每个钉支撑部分16510、16520、16530的顶表面与钉仓16100中的钉驱动器16500的其他钉支撑部分16510、16520、16530的顶表面对准。
钉支撑部分16510、16520、16530被构造成能够在钉击发行程期间在相应钉腔16110、16120、16130内平移。如本文更详细地讨论的,在钉击发行程期间,钉驱动器16500在未击发位置和完全击发位置之间运动。钉驱动器16500被示出为处于未击发位置,位于图41中的钉仓16100的基座16107附近。在所描绘的实施方案中,当钉驱动器16500处于其未击发位置时,钉驱动器16500的基座16550与钉仓16100的基座16107对准和/或齐平。
钉驱动器16500还被示出为处于完全击发位置,位于图41中的钉仓16100的平台表面16108附近。在完全击发位置,钉驱动器16500的一部分是“过度驱动的”并且延伸到钉仓16100的平台表面16108上方。如本文更详细地讨论的,钉仓16100包括从平台表面16108朝向砧座16010延伸的突起部16400。围绕每个钉腔的至少一部分的突起部16400用于例如进一步压缩组织,同时还提供对过度驱动的钉驱动器16500的支撑。如上所讨论的,所有突起部16400从平台表面16108延伸到不同的高度。突起部16400用于在形成期间引导钉的支腿和/或在钉击发行程期间向钉驱动器16500提供附加的稳定性。第一突起部16400a通过第一突起部16400a的高度减小了第一钉腔16110和砧座16010的组织支撑表面16014之间的组织间隙。同样,第二突起部16400b通过第二突起部16400b的高度减小了第二钉腔16120和砧座16010的组织支撑表面16014之间的组织间隙。第三突起部16400c通过第三突起部16400c的高度减小了第三钉腔16130和砧座16010的组织支撑表面16014之间的组织间隙。
在完全击发位置中,钉驱动器16500的第一钉支撑表面16510在突起部16400a上方延伸第一距离OD1,第二钉支撑表面16520在突起部16400b上方延伸第二距离OD2,并且第三钉支撑表面在突起部16400c上方延伸第三距离OD3。由于平台表面16108的弯曲性质和突起部16400的变化高度,第一距离OD1不同于第二距离OD2和第三距离OD3。在所描绘的实施方案中,第三距离OD3大于第二距离OD2,并且第二距离OD2大于第一距离OD1。
钉可移除地定位在每个钉腔内。在至少一个实例中,钉变形到相同或至少基本上相同的高度。由于钉驱动器16500的过度驱动距离OD1、OD2、OD3考虑了沿平台表面16108的组织间隙的变化,因此实现了均匀的钉成形。如图41所示,当钉驱动器16500处于完全击发位置时,钉驱动器19150的第一钉支撑部分16510和砧座16010的对应钉成形凹坑16012之间的距离与第二钉支撑部分16520和对应钉成形凹坑16012之间的距离相同。同样,当钉驱动器16500处于完全击发位置时,第一钉支撑表面16510和第二钉支撑表面16520和对应钉成形凹坑16012之间的距离与第三钉支撑表面16530和对应钉成形凹坑16012之间的距离相同。因此,定位在所有三个纵向排钉腔内的钉被构造成能够形成和/或弯曲到相同的高度。
如上所述,外科端部执行器包括砧座和钉仓钳口。在一些实施方案中,钉仓钳口可相对于砧座运动,而在其他实施方案中,砧座可相对于钉仓钳口运动。当砧座处于其打开位置时,钉仓钳口定位在待缝合的组织的一侧上,并且砧座钳口定位在相对侧上。在此类实例中,端部执行器相对于组织运动,直到组织被适当地定位在钉仓钳口和砧座之间。为了避免目标组织定位在最近侧钉腔的近侧,砧座可包括向下延伸的突起部,通常被称为“组织止挡件”,其用于阻止目标组织在砧座和钉仓之间的过近侧定位。组织止挡件向下延伸超过钉仓的平台表面,以防止组织在砧座和钉仓之间定位在过近侧。换句话说,组织止挡件确保定位在端部执行器的钳口之间的组织不被切割构件准确地切割而无需缝合。组织止挡件的尺寸和构造被设置成使得组织不会意外地挤压在组织止挡件与钉仓钳口的横向侧面之间。在名称为“SURGICAL STAPLER ANVILS WITH TISSUE STOP FEATURES CONFIGURED TO AVOIDTISSUE PINCH”的美国专利申请序列号16/105,140中更详细地讨论了组织止挡件,该专利申请的全部内容以引用方式并入本文。在各种实例中,钉仓包括组织止挡件,该组织止挡件与砧座的组织止挡件协作地工作。
图42示出了钉仓17000,该钉仓包括从近侧端部17002朝向远侧端部17004延伸的细长狭槽17006。纵向轴线由细长狭槽17006限定。钉仓17000包括限定在细长狭槽17006的每一侧上的三个纵向排钉腔。第一纵向排钉腔17100在细长狭槽17006旁边延伸。第二纵向排钉腔17200在第一纵向排钉腔17100旁边延伸。第三纵向排钉腔17300在第二纵向排钉腔17200旁边延伸。第一纵向排内的钉腔17100与第三纵向排内的钉腔17300对准,而第二纵向排内的钉腔17200从第一纵向排和第三纵向排内的钉腔17100、17300偏移。第一纵向排和第三纵向排内的最近侧钉腔17100、17300分别在第二纵向排内的最近侧钉腔17200的近侧。钉仓17000还包括在第一纵向排和第三纵向排的最近侧钉腔17100、17300之间延伸的一对组织止挡件或壁17600。虚线横向延伸穿过钉仓17000,以表示相对砧座的组织止挡件的位置。如图42所示,来自第一纵向排和第三纵向排的最近侧钉腔17100、17300的近侧半部在虚线近侧,并且由于组织止挡件17600,防止组织相对于这些钉腔在近侧运动。由于最近侧的钉腔位于第一纵向排中,因此当切割构件切穿位于端部执行器的钳口之间的组织时,由钉线形成紧密的密封。
图43示出了钉仓17000,该钉仓包括从近侧端部17002朝向远侧端部17004延伸的细长狭槽17006。纵向轴线由细长狭槽17006限定。钉仓17000包括限定在细长狭槽17006的每一侧上的三个纵向排钉腔。第一纵向排钉腔17100在细长狭槽17006旁边延伸。第二纵向排钉腔17200在第一纵向排钉腔17100旁边延伸。第三纵向排钉腔17300在第二纵向排钉腔17200旁边延伸。第一纵向排内的钉腔17100与第三纵向排内的钉腔17300对准,而第二纵向排内的钉腔17200从第一纵向排和第三纵向排内的钉腔17100、17300偏移。第一纵向排和第三纵向排内的最近侧钉腔17100、17300分别在第二纵向排内的最近侧钉腔17200的远侧。虚线横向延伸穿过钉仓17000’,以表示相对砧座的组织止挡件的位置。值得注意的是,与钉仓17000’相互作用的组织止挡件在与钉仓17000相互作用的组织止挡件的远侧定位。组织止挡件位置的这种差异至少部分地是由于第一纵向排内的最近侧钉腔17100相对于来自其他纵向排的最近侧钉腔的位置。
钉仓19000描绘于图44中。钉仓19000被构造成能够安置在外科端部执行器的仓钳口的通道中。端部执行器包括砧座钳口19050,当端部执行器处于闭合构型时,该砧座钳口与仓钳口相对。砧座钳口19050和仓钳口中的至少一者可相对于彼此在打开构型和闭合构型之间运动。砧座19050包括限定于其中的多个钉成形凹坑,该多个钉成形凹坑被构造成能够使从钉仓19000射出的钉变形。
钉仓19000包括仓体19008,该仓体包括从仓体19008的近侧端部19002朝向远侧端部19004延伸的细长狭槽19006。仓体19008还包括平台表面19010。钉腔19100、19200、19300被限定在仓体19008内。钉腔19100、19200、19300被布置成三排,其中这三排沿细长狭槽19006的相同侧延伸。第一排钉腔19100与细长狭槽19006相邻和/或在其旁边延伸。第三排钉腔19300定位成远离细长狭槽19006,并且第二排钉腔19200在第一排钉腔19100和第三排钉腔19300之间延伸。
沿钉仓19000的细长狭槽19006限定纵向轴线。如图44所示,这三排内的钉腔19100、19200、19300均不平行于纵向轴线取向。换句话讲,由钉腔19100、19200、19300限定的轴线不平行于由细长狭槽19006限定的纵向轴线。第一排内的每个钉腔19100限定基本上平行于由第三排内的每个钉腔19300限定的轴线的轴线。第二排内的每个钉腔19200基本上垂直于第一排和第三排内的钉腔19100、19300取向。
钉仓19000的平台表面19010是圆形和/或弯曲的。换句话说,平台表面19010的高度相对于由细长狭槽19006限定的纵向轴线横向变化。所示的平台表面19010的最高点与向下延伸到仓体19008的中心部分的细长狭槽19006相邻。图44中的钉仓19000的一部分被示出为没有钉腔,以更清楚地说明平台表面19010的圆形性质和/或曲率。
现在转到图45和图46,更详细地示出了钉仓19000。钉仓19000包括延伸到平台表面19010上方的突起部19400。除此之外,突起部19400被构造成能够抓握夹持在端部执行器的钳口之间的组织并且/或者防止组织相对于钉仓19000滑动。钉仓19000上描绘的突起部19400呈凹坑扩展部的形式。当钉朝向砧座19050驱动出钉仓19000时,所描绘的凹坑扩展部向钉和/或钉驱动器提供支撑。第一突起部19400a围绕钉腔19100的第一端部19102,并且第二突起部19400b围绕钉腔19100的第二端部19104。虽然突起部19400被示出为仅围绕每个钉腔的一部分,但是可设想,突起部19400可围绕任何期望量的钉腔诸如例如整个钉腔。
图45、图46和图52中所示的突起部19400在高度上是均匀的。换句话讲,所有突起部19400从钉仓19000的平台表面19010延伸相同的距离。图46和图52示出了处于闭合构型的端部执行器。在闭合构型中,在钉仓19000的平台表面19010和砧座19050的组织压缩表面19056之间限定组织间隙。由于平台表面19010的弯曲性质,组织间隙相对于细长狭槽19006在仓平台19010上横向变化。
砧座19050还包括限定在组织压缩表面19056中的多个钉成形凹坑19060。每个钉成形凹坑19060对应于钉仓19000的单独钉腔19100、19200、19300。如图46所示,每个钉成形凹坑19060包括第一凹坑19062和第二凹坑19064。第一凹坑19062与钉驱动器的第一端部19152对准,并且第二凹坑19064与钉驱动器的第二端部19154对准。钉的第一支腿被构造成能够在钉形成时接触第一凹坑19062,而钉的第二支腿被构造成能够接触第二凹坑19064,该第二凹坑被构造成能够在形成钉时接触钉的第二支腿。
如图46所示,在钉仓19000的平台表面19010和砧座19050的组织支撑表面19056之间限定第一组织间隙g组织1。在与细长狭槽19006相邻的点处测量第一组织间隙g组织1。在钉仓19000的平台表面19010和砧座19050的组织支撑表面19056之间限定第二组织间隙g组织2。在远离细长狭槽19006横向间隔开的点处测量第二组织间隙g组织2。第二组织间隙g组织2大于第一组织间隙g组织1。与细长狭槽19006相邻的较小组织间隙的存在使在细长狭槽19006旁边的组织被压缩到比远离细长狭槽19006横向间隔开的组织更大的程度。当夹持在端部执行器的钳口之间的组织的厚度基本上均匀时,尤其如此。这种较大的压缩导致体液分散远离细长狭槽19006,除此之外,这还促进了均匀的切割线和/或固定的钉线。
来自第一排钉腔19100的钉驱动器19150在图46和图52中示出为处于完全击发的位置。在完全击发位置,钉驱动器19150的一部分是“过度驱动的”并且延伸到钉仓19000的平台表面19010上方。如本文更详细地讨论的,钉仓19000包括从平台表面19010朝向围绕钉腔的至少一部分的砧座19050延伸的突起部19400。突起部19400用于例如进一步压缩组织,同时还提供对过度驱动的钉驱动器19150和/或由钉驱动器19150驱动的钉的支撑。如上所讨论的,所有突起部19400从平台表面19010延伸到相同的最高高度h1。如图52所示,第一突起部19400a在形成钉的第一钉支腿的点处将组织间隙g1减小超过第一突起部19400a的高度h1。同样,第二突起部19400b在形成钉的第二钉支腿的点处将组织间隙g2减小超过第二突起部19400b的高度h1。
在钉驱动器19150的完全击发位置中,钉驱动器19150的第一端部19152在突起部19400a上方延伸第一距离OD1,而钉驱动器19150的第二端部19154在突起部19400b上方延伸第二距离OD2。由于平台表面19010的弯曲性质、突起部19400的均匀高度h1、以及钉腔19100相对于纵向轴线的取向,第一距离OD1不同于第二距离OD2。在所描绘的实施方案中,第二距离OD2大于第一距离OD1。
钉腔19100内的钉的支腿被构造成能够形成为彼此相同的高度或至少基本上相同的高度。由于钉驱动器19150的过度驱动距离OD1、OD2考虑了沿钉腔19100的组织间隙的变化,因此实现了均匀的钉支腿成形。如图46所示,钉驱动器19150的第一端部19152和成形凹坑19060的第一凹坑19062之间的距离与钉驱动器19150的第二端部19154和成形凹坑19060的第二凹坑19064之间的距离相同。因此,钉的支腿形成和/或弯曲到相同的程度。
与延伸到钉仓19000的平台表面19010上方的突起部19400不同,图47和图48中所示的钉仓19000’包括平滑的平台表面19010。换句话说,没有东西突起和/或延伸到平台表面19010上方。钉驱动器19150、19250、19350可运动地定位在钉腔19100、19200、19300内。每个钉驱动器(诸如钉驱动器19150)包括支架19156,该支架被构造成能够支撑钉的基座。支架19156包括第一端部19152和第二端部19154。第一端部19152被构造成能够在钉的基座与钉的第一支腿相遇的位置附近支撑钉。第二端部19154被构造成能够在钉的基座与钉的第二支腿相遇的位置附近支撑钉。
图48示出了包括安置在钉仓钳口中的钉仓19000’的端部执行器。端部执行器处于闭合构型。在闭合构型中,在钉仓19000’的平台表面19010和砧座19050的组织压缩表面19056之间限定组织间隙。由于平台表面19010的弯曲性质,组织间隙相对于细长狭槽19006在仓平台19010上横向变化。在所描绘的实施方案中,组织间隙在与细长狭槽19006相邻的点处是最小的。组织间隙在远离细长狭槽19006横向间隔开的点处变大。
更具体地,在钉仓19000’的平台表面19010和砧座19050的组织支撑表面19056之间限定第一组织间隙g组织1。在与细长狭槽19006相邻的点处测量第一组织间隙g组织1。在钉仓19000’的平台表面19010和砧座19050的组织支撑表面19056之间限定第二组织间隙g组织2。在远离细长狭槽19006横向间隔开的点处测量第二组织间隙g组织2。第二组织间隙g组织2大于第一组织间隙g组织1。与细长狭槽19006相邻的较小组织间隙的存在导致在细长狭槽19006旁边的组织被压缩到比远离细长狭槽19006横向间隔开的组织更大的程度。当夹持在端部执行器的钳口之间的组织的厚度基本上均匀时,尤其如此。这种较大的压缩导致体液分散远离细长狭槽19006,除此之外,这还促进了均匀的切割线和/或固定的钉线。
来自第一排钉腔19100的钉驱动器19150在图48中示出为处于完全击发的位置。在完全击发位置,钉驱动器19150的一部分是“过度驱动的”并且延伸到钉仓19000’的平台表面19010上方。钉驱动器19150的第一端部19152在平台表面19006上方延伸第一距离OD1,而钉驱动器19150的第二端部19154在平台表面上方延伸第二距离OD2。由于平台表面19010的弯曲性质以及钉腔19100相对于纵向轴线的取向,第一距离OD1不同于第二距离OD2。在所描绘的实施方案中,第二距离OD2大于第一距离OD1。值得注意的是,包括平滑和/或无突起部平台表面19010的钉仓19000’的过度驱动距离大于包括从平台表面延伸的突起部的钉仓19000的过度驱动距离。
钉腔19100内的钉的支腿被构造成能够形成为彼此相同的高度或至少基本上相同的高度。由于钉驱动器19150的过度驱动距离OD1、OD2考虑了沿钉腔19100的组织间隙的变化,因此实现了均匀的钉支腿成形。如图48所示,钉驱动器19150的第一端部19152和钉成形凹坑19060的第一凹坑19062之间的距离与钉驱动器19150的第二端部19154和钉成形凹坑19060的第二凹坑19064之间的距离相同。因此,钉的支腿形成和/或弯曲到相同的程度。
图49和图50描绘了在许多方面类似于钉仓19000的钉仓19000”。例如,两个钉仓19000、19000”两者均包括弯曲和/或圆形的平台表面19010轮廓,其中突起部19400延伸到平台表面上方。此外,钉仓19000”上的突起部19400也呈凹坑扩展部的形式。第一突起部19400a围绕钉腔19100的第一端部19102,并且第二突起部19400b围绕钉腔19100的第二端部19104。虽然突起部19400被示出为仅围绕每个钉腔的一部分,但是可设想,突起部19400可围绕任何合适量的钉腔诸如例如整个钉腔。
图49和图50所示的突起部19400从平台表面19010延伸到不同的高度。更具体地,每个突起部19400的高度基于突起部19400相对于细长狭槽19006的位置而变化。在各种实例中,突起部19400的高度随着突起部19400定位成远离细长狭槽19006而减小。如图49所示,围绕钉腔19100的第一端部19102的第一突起部19400a从平台表面19010延伸到第一高度h1。围绕同一钉腔19100的第二端部19104的第二突起部19400a从平台表面19010延伸到第二高度h2。第一高度h1不同于第二高度h2。在所描绘的实施方案中,第二高度h2短于第一高度h1。除此之外,在更靠近刀狭槽19006处具有较大高度的突起部可促进流体远离切割线流动。
图50示出了包括安置在钉仓钳口中的钉仓19000”的端部执行器。端部执行器处于闭合构型。在闭合构型中,在钉仓19000”的平台表面19010和砧座19050的组织支撑表面19056之间限定组织间隙。由于平台表面19010的弯曲性质,组织间隙相对于细长狭槽19006在仓平台19010上横向变化。如图50所示,在钉仓19000”的平台表面19010和砧座19050的组织压缩表面19056之间限定第一组织间隙g组织1。在与细长狭槽19006相邻的点处测量第一组织间隙g组织1。在钉仓19000”的平台表面19010和砧座19050的组织压缩表面19056之间限定第二组织间隙g组织2。在远离细长狭槽19006横向间隔开的点处测量第二组织间隙g组织2。第二组织间隙g组织2大于第一组织间隙g组织1。与细长狭槽19006相邻的较小组织间隙的存在使在细长狭槽19006旁边的组织被压缩到比远离细长狭槽19006横向间隔开的组织更大的程度。当夹持在端部执行器的钳口之间的组织的厚度基本上均匀时,尤其如此。这种较大的压缩导致体液分散远离细长狭槽19006,除此之外,这还促进了均匀的切割线和/或固定的钉线。
来自第一排钉腔19100的钉驱动器19150在图50中示出为处于完全击发的位置。在完全击发位置,钉驱动器19150的一部分是“过度驱动的”并且延伸到钉仓19000”的平台表面19010上方。如上文更详细地讨论的,钉仓19000”包括从平台表面19010朝向围绕钉腔的至少一部分的砧座19050延伸的突起部19400。突起部19400用于例如进一步压缩组织,同时还提供对过度驱动的钉驱动器19150和/或由钉驱动器19150驱动的钉的支撑。突起部19400从钉仓19000”的平台表面19010延伸到不同的最终高度。
在钉驱动器19150的完全驱动位置中,钉驱动器19150的第一端部19152在突起部19400a上方延伸第一距离OD1,而钉驱动器19150的第二端部19154在突起部19400b上方延伸第二距离OD2。值得注意的是,钉仓19000”的过度驱动距离小于包括平滑平台表面19010的钉仓19000’的过度驱动距离。由于平台表面19010的弯曲性质以及钉腔19100相对于纵向轴线的取向,第一距离OD1不同于第二距离OD2。在所描绘的实施方案中,第二距离OD2大于第一距离OD1。
钉腔19100内的钉的支腿被构造成能够形成为彼此相同的高度或至少基本上相同的高度。由于钉驱动器19150的过度驱动距离OD1、OD2考虑了沿钉腔19100的组织间隙的变化,因此实现了均匀的钉支腿成形。如图50所示,钉驱动器19150的第一端部19152和成形凹坑19060的第一凹坑19062之间的距离与钉驱动器19150的第二端部19154和成形凹坑19060的第二凹坑19064之间的距离相同。因此,钉的支腿均匀地形成。
图51示出了包括钉仓的端部执行器的一部分,该钉仓具有不同高度的突起部19400。第一突起部19400a从钉腔19100的第一侧19102延伸到第一高度h1。第二突起部19400b从钉腔19100的第二侧19104延伸到第二高度h2。第二高度h2不同于第一高度h1。在所描绘的实施方案中,第二高度h2高于第一高度h1;然而,设想了任何合适的布置。虽然第二突起部19400b高于第一突起部19400a时,但当端部执行器处于闭合构型时,第一突起部19400a的顶表面19402a和第二突起部19400b的顶表面19402b距砧座19050的组织支撑表面19056的距离相同。换句话说,组织间隙包括跨钉腔19100的均匀间隙距离“g”。
如上文更详细地讨论的,突起部19400可向钉和/或钉驱动器提供支撑,因为钉驱动器和钉朝向砧座驱动。第二突起部19400b的较大高度h2最小化了钉驱动器19150的第二端部19154的过度驱动。使钉驱动器19150暴露在平台表面19010上方的部分最小化使得钉驱动器19150在钉击发行程期间不容易移位和/或不对准。突起部19400用于例如增强钉驱动器的稳定性,在执行钉击发行程时维持钉驱动器对准,以及/或者防止钉驱动器移位。
图53至图56示出了跨单独钉腔的组织抓握特征部和/或突起部的可变性。如本文更详细地描述的,钉腔被限定在仓体内。仓体包括具有弯曲和/或圆形轮廓的平台表面。组织抓握特征部和/或突起部的各种参数可沿钉仓的平台表面变化,以实现期望的组织效应。此类参数包括例如突起部从平台表面延伸的角度、突起部延伸的高度、突起部围绕的钉腔的长度和/或突起部围绕钉腔端部弯曲的半径。图53示出了包括多个组织抓握特征部的钉仓18000的一部分。钉仓18000包括从近侧端部18002朝向远侧端部18004延伸的细长狭槽18006。类似于钉仓19000,钉仓18000包括圆形和/或弯曲的平台表面18010。换句话说,平台表面18010的高度相对于细长狭槽18006横向变化。所示的平台表面18010的最高点与细长狭槽18006相邻。
钉腔18100、18200、18300被限定在仓体18008内。钉腔18100、18200、18300被布置成三排,其中这三排沿细长狭槽18006的相同侧延伸。第一排钉腔18100与细长狭槽18006相邻和/或在其旁边延伸。第三排钉腔18300定位成远离细长狭槽18006,并且第二排钉腔18200在第一排钉腔18100和第三排钉腔18300之间延伸。
纵向轴线由细长狭槽18006限定。如图53所示,钉腔18100、18200、18300均不平行于纵向轴线取向。换句话讲,由钉腔18100、18200、18300限定的轴线不平行于由细长狭槽18006限定的纵向轴线。第一排内的每个钉腔18100限定第一腔轴线。第二排内的每个钉腔18200限定第二腔轴线。第三排内的每个钉腔18300限定第三腔轴线。如图53所示,第一腔轴线以与第二腔轴线不同的方向取向。第一腔轴线基本上平行于第三腔轴线。
钉仓18000包括从平台表面18010延伸的各种突起部18400。突起部18400围绕每个钉腔的一部分到不同程度。与上述类似,突起部18400可基于仓体18008上的位置和/或取向而在大小和/或几何形状上变化。在各种实例中,并且如图53所示,特定排内围绕钉腔的所有突起部18400都是相同的。在其他实例中,围绕特定排内的钉腔的突起部18400彼此不同。例如,突起部18400的大小和/或几何形状可基于单独钉腔相对于其他钉腔的纵向位置而变化。每个突起部的高度可跨钉仓不同,并且甚至在围绕单独钉腔的突起部之间也是不同的。
除上述之外,钉腔18100包括近侧端部18102和远侧端部18104,其中远侧端部18104比近侧端部18102更靠近细长狭槽18006。第一突起部18110与远侧端部18104对准,并且远离平台表面18010延伸到第一高度h1。第二突起部18120与近侧端部18102对准,并且远离平台表面18010延伸到第二高度h2。在所描绘的实施方案中,第一高度h1短于第二高度h2。在各种实例中,定位成更靠近细长狭槽18006的突起部具有比定位成横向更远离细长狭槽18006的突起部更短的高度。例如,第三排内的钉腔18300的突起部18310延伸高度h3,该高度小于第一排的钉腔18100的突起部18110、18120的高度h1、h2。
突起部远离平台表面延伸的角度也可不同。例如,钉腔18100的第一突起部18110以第一角度a1远离平台表面18010延伸,而第二突起部18120以第二角度a2远离平台表面18010延伸。在所描绘的实施方案中,第一角度a1与平台表面18010垂直,并且第一角度a1不与平台表面18010垂直。第二突起部18120相对于平台表面18010以更倾斜的角度延伸,而第一突起部18110相对于平台表面18010以更陡和/或更峭的角度延伸。在各种实例中,定位成更靠近细长狭槽18006的突起部以比定位成横向更远离细长狭槽18006的突起部以更尖锐的角度远离钉仓的平台表面延伸。例如,第三排内的钉腔18300的突起部18310以角度a3从平台表面延伸,该角度小于第一排的钉腔18100的突起部18110、18120的角度a1、a2。其他布置是可能的。
每个突起部覆盖的钉腔的总长度也可以是变化的参数。在各种实例中,突起部可围绕钉腔的整个长度。在其他实例中,突起部可仅围绕钉腔的长度的一部分。例如,钉腔18100的第一突起部18110围绕钉腔18100的一小部分,诸如例如10%。第一突起部18110覆盖钉腔18100的第一长度l1。然而,第二突起部18120围绕钉腔18100的较大部分,诸如例如30%。第二突起部18120覆盖钉腔18100的第二长度l2。因此,第二长度l2大于第一长度l1。在各种实例中,定位成更靠近细长狭槽18006的突起部比定位成横向更远离细长狭槽18006的突起部围绕钉腔的较小部分。例如,第三排内的钉腔18300的突起部18310围绕第三长度l3,该第三长度恰好是钉腔18300的整个长度。第三长度l3大于被第一排的钉腔18100的突起部18110、18120覆盖的长度l1、l2中的任一者。其他布置是可能的。
围绕钉腔的端部的突起部弯曲的半径可在钉仓上变化。在各种实例中,突起部可围绕钉腔的端部形成尖锐曲线。在其他实例中,突起部可围绕钉腔的端部形成钝曲线。例如,钉腔18100的第一突起部18110围绕钉腔18100的远侧端部18104形成具有第一半径r1的曲线。钉腔18100的第二突起部18120围绕钉腔18100的近侧端部18102形成具有第二半径r2的曲线。第一半径r1小于第二半径r2,从而导致由围绕钉腔18100的远侧端部18104的第一突起部18110形成的曲线比由围绕钉腔18100的近侧端部18102的第二突起部18120形成的曲线更尖锐。在各种实例中,定位成横向更靠近细长狭槽18006的突起部以比定位成横向更远离该细长狭槽的突起部更尖锐的曲线围绕钉腔的端部。例如,第三排内的钉腔18300的突起部18310围绕钉腔18300的边缘形成具有第三半径r3的曲线。第三半径r3小于由第一排的钉腔18100的突起部18110、18120形成的半径r1、r2。因此,第三半径r3比半径r1、r2更钝和/或更不尖锐。其他布置是可能的。
其他参数,诸如突起部19400的顶表面的几何形状,可以不同以实现期望的组织效应。在各种实例中,突起部19400包括圆形外边缘以防止和/或最小化对支撑在端部执行器的钳口之间的组织的创伤。在其他实例中,突起部19400包括尖锐外边缘,以促进突起部19400和支撑在端部执行器的钳口之间的组织之间的抓握。
图54示出了围绕限定在钉仓18000中的第一纵向排钉腔的钉腔18100的部分的突起部。如上文更详细地讨论的,第一纵向排在细长狭槽18006旁边和/或邻近该细长狭槽延伸。第一突起部18400a延伸跨过钉腔18100的近侧端部18102的第一长度l1b,而第二突起部18400b延伸跨过钉腔18100的远侧端部18104的第二长度l1a。第一长度l1b长于第二长度l1a。因此,第一突起部18400a围绕钉腔18100的比第二突起部18400b更大的部分。突起部18400a、18400b以第一角度a1从平台表面18010延伸。在所描绘的实施方案中,突起部18400a、18400b以相同角度从平台表面18010延伸;然而,可设想,突起部18400a、18400b可以任何合适的角度从平台表面18010延伸以控制组织的流动。第一突起部18400a包括具有第一曲率半径r1b的组织支撑边缘,并且第二突起部18400b包括具有第二曲率半径r1a的组织支撑边缘。在各种实例中,第一曲率半径r1b不同于第二曲率半径r1a,但是在其他实施方案中它们可相同。在所描绘的实施方案中,第一曲率半径r1b大于第二曲率半径r1a。换句话说,由第二突起部18400b形成了更尖锐的边缘。当第二突起部18400b定位成最靠近细长狭槽18006并且因此更靠近切割线时,例如,更尖锐的边缘可对定位在端部执行器的钳口之间的组织提供更强的抓握,并防止组织移出期望的位置。如图53所示,由于钉腔18100的取向,钉腔18100的近侧端部18102比钉腔18100的远侧端部18104更远离钉仓18000的细长狭槽18006。例如,突起部18400b的围绕钉腔18100的近侧端部18102的一部分在平台表面18010上方延伸第一高度h1b。突起部18400a的围绕钉腔18100的远侧端部18104的一部分在平台表面18010上方延伸第二高度1a。第一高度h1b不同于第二高度h1a,但是在其他实施方案中可相同。在所描绘的实施方案中,突起部18400b的围绕钉腔18100的近侧端部18102的部分比突起部18400a的围绕钉腔18100的远侧端部18104的部分在平台表面18010上方延伸得更远。由于平台表面18010是弯曲的,因此高度差允许突起部18400的顶表面在钉腔18100上基本上水平。
图55示出了围绕限定在钉仓18000中的第二纵向排钉腔的钉腔18200的部分的突起部。如上文更详细地讨论的,第二纵向排在钉腔18100的第一纵向排旁边和/或邻近于该第一纵向排延伸。第二纵向排与细长狭槽18006的横向间隔比第一纵向排更远。第一突起部18400a延伸跨过钉腔18200的近侧端部18202的长度l2,并且第二突起部18400b延伸跨过钉腔18200的远侧端部18204的长度l2。在所描绘的实施方案中,第一长度l2和第二长度l2相同;然而,设想任何合适的长度以实现期望的结果。因此,第一突起部18400a围绕钉腔18200的与第二突起部18400b相同的尺寸。突起部18400a、18400b以第二角度a2从平台表面18010延伸。在所描绘的实施方案中,突起部18400a、18400b以相同角度从平台表面18010延伸;然而,可设想,突起部18400a、18400b可以任何合适的角度从平台表面18010延伸以控制组织的流动。第二钉腔18200的突起部从平台表面18010延伸的第二角度a2大于第一钉腔18100的突起部从平台表面18010延伸的第一角度a1。换句话说,当钉腔远离细长狭槽18006横向定位时,突起部从平台表面18010延伸的角度变大和/或不那么峭。第一突起部18400a和第二突起部18400b包括组织支撑边缘,该组织支撑边缘包括第二曲率半径r2。在所描绘的实施方案中,曲率半径r2对于两个突起部18400a、18400b是相同的,但在其他实施方案中它们可不同。在各种实例中,第二钉腔18200的突起部的曲率半径r2大于第一钉腔18100的突起部的曲率半径r1a、r1b。换句话说,通过来自第一钉腔18100的突起部形成更尖锐的边缘。当第一钉腔18100定位成最靠近细长狭槽18006并且因此更靠近切割线时,例如,更尖锐的边缘可对定位在端部执行器的钳口之间的组织提供更强的抓握,并防止组织移出期望的位置。如图53所示,钉腔18200的取向与钉腔18100的取向相反。更具体地,钉腔18200的远侧端部18204比钉腔18200的近侧端部18202更远离钉仓18000的细长狭槽18006。例如,突起部18400a的围绕钉腔18200的近侧端部18202的一部分在平台表面18010上方延伸第一高度h2a。突起部18400b的围绕钉腔18200的远侧端部18204的一部分在平台表面18010上方延伸第二高度2b。第一高度h2a不同于第二高度h2b,但是在其他实施方案中可相同。在所描绘的实施方案中,突起部18400b的围绕钉腔18200的远侧端部18204的部分比突起部18400a的围绕钉腔18200的近侧端部18202的部分在平台表面18010上方延伸得更远。由于平台表面18010是弯曲的,因此高度差允许突起部18400的顶表面在钉腔18200上基本上水平。
图56示出了围绕限定在钉仓18000中的第三纵向排钉腔的钉腔18300的突起部18400。如上文更详细地讨论的,第三纵向排与细长狭槽18006横向间隔开最远。突起部18400延伸跨过钉腔18300的第三长度l3。第三长度l3大于围绕第一纵向排18100和第二纵向排18200的钉腔的部分的突起部18400的长度l1、l2中的任一者。在所描绘的实施方案中,第三长度l3是整个圆周,并且因此是钉腔18300的整个长度。突起部18400以第三角度a3从平台表面18010延伸。第三钉腔18300的突起部从平台表面18010延伸的第三角度a3分别大于第一钉腔18100的突起部从平台表面18010延伸的第一角度a1和第二角度a2。换句话说,当钉腔远离细长狭槽18006横向定位时,突起部从平台表面18010延伸的角度变大和/或不那么峭。突起部18400包括组织支撑边缘,该组织支撑边缘包括第三曲率半径r3。在各种实例中,第三钉腔18300的突起部的曲率半径r3大于第一钉腔18100和第二钉腔18200的突起部的曲率半径r1a、r1b、r2。因此,通过来自第一钉腔18100的突起部形成更尖锐的边缘。当第一钉腔18100定位成最靠近细长狭槽18006并且因此更靠近切割线时,更尖锐的边缘可对定位在端部执行器的钳口之间的组织提供更强的抓握。例如,这种更强的抓握可防止组织移出期望的位置。如图53所示,由于钉腔18300的取向,钉腔18300的近侧端部18302比钉腔18300的远侧端部18304更远离钉仓18000的细长狭槽18006。突起部18400跨钉腔18300的高度是不均匀的。突起部18400的围绕钉腔18300的近侧端部18302的一部分在平台表面18010上方延伸第一高度h3b。突起部18400的围绕钉腔18300的远侧端部18304的一部分在平台表面18010上方延伸第二高度3a。第一高度h3b不同于第二高度h3a,但是在其他实施方案中它们可相同。在所描绘的实施方案中,突起部18400的围绕钉腔18300的近侧端部18302的部分比突起部18400的围绕钉腔18300的远侧端部18304的部分在平台表面18010上方延伸得更远。由于平台表面18010是弯曲的,因此高度差允许突起部18400的顶表面在钉腔18300上基本上水平。
公布于2015年10月25日的名称为“FASTENER CARTRIDGE INCLUDING EXTENSIONSHAVING DIFFERENT CONFIGURATIONS”的美国专利申请公布2015/0297222、公布于2012年3月29日的名称为“STAPLE CARTRIDGE”的美国专利申请公布2012/0074198,以及公布于2013年10月3日的名称为“SURGICAL STAPLING CARTRIDGE WITH LAYER RETENTION FEATURES”的美国专利申请公布2013/0256379的全部公开内容以引用方式并入本文。
值得注意的是,上述布置也可适于与其中钉仓钳口相对于砧座旋转的实施方案一起使用。
包括动力关节运动系统50100的外科器械50000示于图154至图156中。外科器械50000还包括外壳、从该外壳延伸的轴50200和从轴50200延伸的端部执行器。在至少一个实施方案中,端部执行器包括钉仓。轴50200限定纵向轴轴线SA,并且包括纵向轴部分50210、从纵向轴部分50210延伸的第一可关节运动轴部分50220和从第一可关节运动轴部分50220延伸的第二可关节运动轴部分50240。端部执行器从第二可关节运动轴部分50240延伸。第一可关节运动轴部分50220通过第一关节运动接头50230可旋转地连接到纵向轴部分50210,该第一关节运动接头限定与纵向轴轴线SA正交的第一关节运动轴线AA1。在至少一个实施方案中,例如,第一可关节运动轴部分50220通过一个或多个销可旋转地连接到纵向轴部分50210。第二可关节运动轴部分50240通过第二关节运动接头50250可旋转地连接到第一可关节运动轴部分50220,该第二关节运动接头限定与第一关节运动轴线AA1和轴轴线SA正交的第二关节运动轴线AA2。在至少一个实施方案中,例如,第二可关节运动轴部分50240通过一个或多个销可旋转地连接到第一可关节运动轴部分50220。
除上述之外,第一可关节运动轴部分50220包括限定于其上的第一准双曲面驱动齿轮50222。第一驱动齿轮50222围绕第一关节运动轴线AA1为中心,并且包括第一组径向齿50224。第一组径向齿50224的至少一部分在第一关节运动轴线AA1远侧定位。然而,设想了其他实施方案,其中整个第一组径向齿50224定位在第一关节运动轴线AA1远侧。在任何情况下,外科器械50000还包括第一旋转驱动轴50300,该第一旋转驱动轴在其远侧端部包括第一锥齿轮50310。第一锥齿轮50310与第一驱动齿轮50222的第一组径向齿50224接合,使得当第一旋转驱动轴50300旋转时,第一驱动齿轮50222和第一可关节运动轴部分50220围绕第一关节运动轴线AA1旋转。第一旋转驱动轴50300平行于纵向轴轴线SA并且与第一关节运动轴线AA1正交。
除上述之外,第二可关节运动轴部分50240包括限定于其上的第二准双曲面驱动齿轮50242。第二驱动齿轮50242围绕第二关节运动轴线AA2为中心,并且包括第二组径向齿50244(参见图154)。第二组径向齿50244的至少一部分在第二关节运动轴线AA2远侧定位。然而,设想了其他实施方案,其中整个第二组径向齿50244在第二关节运动轴线AA2远侧定位。在任何情况下,外科器械50000还包括第二旋转驱动轴50400,该第二旋转驱动轴在其远侧端部包括第二锥齿轮50410。第二锥齿轮50410与第二驱动齿轮50242的第二组径向齿50244接合,使得当第二旋转驱动轴50400旋转时,第二驱动齿轮50242和第二可关节运动轴部分50240围绕第二关节运动轴线AA2旋转。当第一可关节运动轴部分50220尚未围绕第一关节运动轴线AA1旋转时,第二旋转驱动轴50400平行于纵向轴轴线SA并且与第一关节运动轴线AA1和第二关节运动轴线AA2正交。
除上述之外,第一旋转驱动轴50300和第二旋转驱动轴50400彼此独立地操作。第一旋转驱动轴50300由第一电动马达驱动,并且第二旋转驱动轴50400由第二电动马达驱动。第一电动马达和第二电动马达定位在外科器械50000的外壳中,但也可定位在任何合适的位置。因为第一旋转驱动轴50300和第二旋转驱动轴50400彼此独立地操作,因此端部执行器可同时或独立地相对于轴50200围绕多个轴线(即,第一关节运动轴线AA1和第二关节运动轴线AA2)进行关节运动。此外,第一旋转驱动轴50300和第二旋转驱动轴50400与第一驱动齿轮50222和第二驱动齿轮50242之间的布置不允许动力关节运动系统50100被反向驱动。换句话讲,当第一旋转驱动轴50300和第二旋转驱动轴50400旋转指定量时,第一关节运动接头50230和第二关节运动接头50250将保持锁定在适当位置,而不管施加到第一可关节运动轴部分50220或第二可关节运动轴部分50240的外力如何。
图157示出了在许多方面类似于图154至图156中描绘的动力关节运动系统50100的另一个动力关节运动系统50100’。动力关节运动系统50100’在第一旋转驱动轴50300的远侧端部包括第一蜗轮50310’。在至少一个实施方案中,动力关节运动系统50100’还包括用于例如联接第一蜗轮50310’和第一旋转驱动轴50300的万向接头。在任何情况下,第一蜗轮50310’与第一准双曲面驱动齿轮50222上的第一组径向齿50224接合。因此,第一旋转驱动轴50300的旋转将导致第一可关节运动轴部分50220围绕第一关节运动轴线AA1的旋转。动力关节运动系统50100’还包括可由第二旋转驱动轴50400旋转的第二蜗轮50410’。第二蜗轮50410’横向于纵向轴轴线SA成角度。在至少一种实例中,该角度例如大约为45度。在至少一个实施方案中,万向接头用于例如联接第二蜗齿轮50410’和第二旋转驱动轴50400。在任何情况下,第二准双曲面驱动齿轮50242的第二组径向齿50244与第二蜗轮50410’接合,并且因此,第二旋转驱动轴50400的旋转将导致第二可关节运动轴部分50240围绕第二关节运动轴线AA2旋转。
除上述之外,与图154至图156所描绘的第一锥齿轮50310相比,第一蜗轮50310’接合更多的第一准双曲面驱动齿轮50222的第一组径向齿50224。此外,与图154至图156所描绘的第二锥齿轮50410相比,第二蜗轮50410’接合更多的第二准双曲面驱动齿轮50242的第二组径向齿50244。第一蜗轮50310’和第二蜗轮50410’与其相应准双曲面驱动齿轮50222、50242的附加螺纹接合有助于防止当外力施加到端部执行器时准双曲面驱动齿轮50222、50242被反向驱动。
图158示出了在许多方面类似于图154至图157中描绘的动力关节运动系统50100和50100’的另一个动力关节运动系统50100”。动力关节运动系统50100”包括可由第二旋转驱动轴50400旋转的第二蜗轮50410”。第二蜗轮50410”垂直于纵向轴轴线SA。在至少一个实施方案中,万向接头用于例如联接第二蜗齿轮50410”和第二旋转驱动轴50400。在任何情况下,第二准双曲面驱动齿轮50242的第二组径向齿50244与第二蜗轮50410”接合,并且因此,第二旋转驱动轴50400的旋转将导致第二可关节运动轴部分50240围绕第二关节运动轴线AA2旋转。
除上述之外,与图154至图156所描绘的第二锥齿轮50410和图157所描绘的第二涡轮50410’相比,第二蜗轮50410”接合更多的第二准双曲面驱动齿轮50242的第二组径向齿50244。第二蜗轮50410”与准双曲面驱动齿轮50242的附加螺纹接合有助于防止当外力施加到端部执行器时准双曲面驱动齿轮50242被反向驱动。
包括动力关节运动系统51100的外科器械51000示于图159至图161中。外科器械51000还包括外壳、从该外壳延伸的轴51200和从轴51200延伸的端部执行器51300。在至少一个实施方案中,端部执行器51300包括钉仓。轴51200限定纵向轴轴线SA并且在其远侧端部包括远侧轴部分51210。外科器械还包括被构造成能够将端部执行器51300可旋转地连接到轴51200使得端部执行器51300可相对于轴51200围绕两个轴线旋转的第一关节运动接头51400和第二关节运动接头51500。更具体地,可关节运动轴部分51600可旋转地连接到远侧轴部分51210以限定第一关节运动接头51400,并且端部执行器51300可旋转地连接到可关节运动轴部分51600以限定第二关节运动接头51500。可关节运动轴部分51600可相对于轴51200围绕与轴轴线SA正交的第一关节运动轴线AA1旋转。端部执行器51300可相对于可关节运动轴部分51600围绕与第一关节运动轴线AA1和轴轴线SA正交的第二关节运动轴线AA2旋转。例如,在至少一个实施方案中,可关节运动轴部分51600通过销可旋转地连接到远侧轴部分51210,并且可关节运动轴部分51600通过销可旋转地连接到端部执行器51300。
除上述之外,外科器械51000还包括第一线缆致动器51700和第二线缆致动器51800。第一对关节运动线缆51710在第一线缆致动器51700的任一侧从第一线缆致动器51700延伸。第一对关节运动线缆51710延伸超过第一关节运动轴线AA1,并且与可关节运动轴部分51600可操作地接合。第一对关节运动线缆51710被构造成能够在向近侧和向远侧平移第一线缆致动器51700时一起平移。
除上述之外,第二线缆致动器51800包括驱动部分51820和在轴51200的相对侧上的固定部分。外科器械51000还包括第二关节运动线缆51810,该第二关节运动线缆包括附接到线缆致动器51800的驱动部分51820的第一端部51812和附接到第二线缆致动器51800的固定部分的第二端部以形成连续环。更具体地,第二关节运动线缆51810限定从第二线缆致动器51800的驱动部分51820延伸,穿过第一关节运动接头51400、超过第二关节运动轴线AA2、围绕可关节运动轴部分51600的远侧端部、穿过第一关节运动接头51400返回并且进入第二线缆致动器51800的固定部分的环。当第二线缆致动器51800的驱动部分51820平移使得驱动部分51820的运动被抵抗但不被阻止时,第二线缆致动器51800的固定部分充当弹簧或柱塞。为了使端部执行器51300进行关节运动,第二关节运动线缆51810被推动或拉动穿过上文所论述的连续环。设想了其他实施方案,其中第二线缆致动器51800包括在轴51200的任一侧上的推动致动器和拉动致动器。在这样的实施方案中,在相反方向上致动推动和拉动致动器以穿过连续环推动或拉动第二关节运动线缆51810。
第一线缆致动器51700和第二线缆致动器51800被构造成能够响应于外壳内的致动而相对于轴51200独立地平移。在至少一个实施方案中,外壳包括被构造成能够输出旋转运动的马达,并且第一线缆致动器51700和第二线缆致动器51800可操作地响应于这些旋转运动。然而,设想了其他实施方案,其中外壳中的两个马达产生用于平移第一线缆致动器51700和第二线缆致动器51800的单独旋转运动。
在使用中,除上述之外,当第一对关节运动缆线51710由第一线缆致动器51700致动时,可关节运动轴部分51600和从其延伸的端部执行器51300围绕第一关节运动轴线AA1旋转。更具体地,第一线缆致动器51700在近侧方向上的致动将使可关节运动轴部分51600和端部执行器51300围绕第一关节运动轴线AA1在顺时针CW方向上旋转,并且第一线缆致动器51700在远侧方向上的致动将使可关节运动轴部分51600和端部执行器51300围绕第一关节运动轴线AA1在逆时针CCW方向上旋转。当第二关节运动线缆51810由第二线缆致动器51800的驱动部分51820致动时,端部执行器51300围绕第二关节运动轴线AA2旋转。更具体地,端部执行器51300包括与第二关节运动线缆51810可操作地接合的凸台部分51310。当第二关节运动线缆51810被致动时,凸台部分51310围绕第二关节运动轴线AA2旋转,这导致端部执行器51300围绕第二关节运动轴线AA2旋转。
除上述之外,端部执行器51300的凸台部分51310还包括限定在其近侧端部上的一组径向齿51312。外科器械51000还包括远侧关节运动锁定构件51314,该远侧关节运动锁定构件被构造成能够接合一组径向齿51312,以当远侧关节运动锁定件51314与该组径向齿51312接合时,防止端部执行器51300围绕第二关节运动轴线AA2进行关节运动。远侧关节运动锁定构件51314可经由电动马达51316平移,但也可包括任何合适的促动器。远侧关节运动锁定构件和电动马达相对于第一关节运动轴线AA1在远侧定位。在使用中,当远侧关节运动锁定构件51314与径向齿51312接合时,端部执行器51300不能围绕第二关节运动轴线AA2旋转,并且当远侧关节运动锁定构件51314未与一组径向齿51312接合时,端部执行器51300可围绕第二关节运动轴线AA2旋转。
除上述之外,可关节运动轴部分51600包括在可关节运动轴部分51600的近侧端部上的第二组径向齿。第二组径向齿的至少一部分在第一关节运动轴线AA1近侧定位。外科器械51000还包括近侧关节运动锁定构件,该近侧关节运动锁定构件被构造成能够选择性地接合可关节运动轴部分51600上的第二组径向齿,以防止可关节运动轴部分51600和端部执行器51300围绕第一关节运动轴线AA1旋转。近侧关节运动锁定构件可经由电动马达平移。近侧关节运动锁定构件和电动马达相对于第一关节运动轴线AA1在近侧定位。
除上述之外,外科器械51000还包括柔性击发致动器51900,该柔性击发致动器从外壳延伸,穿过轴51200,穿过第一关节运动接头51400和第二关节运动接头51500并进入端部执行器51300。柔性击发致动器51900被构造成能够响应于来自外科器械51000的外壳的致动而执行端部执行器功能。如图159和图160所示,第一对关节运动线缆51710和第二关节运动线缆51810定位在外科器械51000的外周上,沿外科器械的轴轴线SA留出空间,以便柔性击发致动器51900延伸穿过。这种布置允许柔性击发致动器51900与例如可围绕两个不同轴线(即,第一关节运动轴线AA1和第二关节运动轴线AA2)旋转的端部执行器一起采用。
包括动力关节运动系统52100的外科器械52000示于图162中。外科器械52000还包括外壳、限定轴轴线SA并从该外壳延伸的轴52200、从轴52200延伸的可关节运动轴部分52300和从可关节运动轴部分52300延伸的端部执行器52400。第一关节运动接头52500位于轴52200和可关节运动轴部分52300之间,并且第二关节运动接头52600位于可关节运动轴部分52300和端部执行器52400之间。第一关节运动接头52500限定与轴轴线SA正交的第一关节运动轴线AA1。第二关节运动接头52600限定与第一关节运动轴线AA1和轴线SA正交的第二关节运动轴线AA2。
外科器械52000还包括从轴52200延伸并与可关节运动轴部分52300可操作地接合的第一对关节运动线缆52210。可关节运动轴部分52300包括限定在其近侧端部的旋转盘52310,并且第一对关节运动线缆52210中的一者连接到旋转盘52310的一侧,并且第一对关节运动线缆52210中的另一者连接到旋转盘52310的另一侧。第一对关节运动线缆52210被构造成能够在被致动时使可关节运动轴部分52300围绕第一关节运动轴线AA1旋转。换句话讲,向远侧驱动第一对关节运动线缆52210中的一者和/或向近侧驱动第一对关节运动缆线52210中的另一者以使旋转盘52310旋转,并且因此使可关节运动轴部分52300围绕第一关节运动轴线AA1旋转。例如,第一对关节运动线缆52210可操作地响应于定位在外壳内的电动马达。
除上述之外,可关节运动轴部分52300包括限定在旋转盘52310的近侧端部上的一组径向齿52320。该组径向齿52320的至少一部分在第一关节运动轴线AA1近侧定位。外科器械52000还包括近侧关节运动锁定构件52330,该近侧关节运动锁定构件被构造成能够在可关节运动轴部分52300上选择性地接合一组径向齿52320,以当近侧关节运动锁定构件52330与一组径向齿52320接合时,防止可关节运动轴部分52300围绕第一关节运动轴线AA1的旋转。近侧关节运动锁定构件52330可经由电动马达52340或任何合适的促动器平移。近侧关节运动锁定构件52330和电动马达52340相对于第一关节运动轴线AA1在近侧定位。当第一对关节运动线缆52210被致动以使可关节运动轴部分52300围绕第一关节运动轴线AA1旋转时,近侧关节运动锁定构件52330与一组径向齿52320自动脱离接合,以允许可关节运动轴部分52300围绕第一关节运动轴线AA1进行关节运动。
外科器械52000还包括从轴52200延伸并与端部执行器52400可操作地接合的第二对关节运动线缆52410。更具体地,第二对关节运动线缆52410中的一者在第二关节运动轴线AA2的一侧附接到端部执行器52400,并且第二对关节运动缆线52410中的另一者在第二关节运动轴线AA2的另一侧附接到端部执行器52400。第二对关节运动线缆52410被构造成能够在被致动时使端部执行器52400围绕第二关节运动轴线AA2旋转。换句话讲,向远侧驱动第二对关节运动线缆52410中的一者和/或向近侧驱动第二对关节运动缆线52410中的另一者以使端部执行器52400相对于可关节运动轴部分52300围绕第二关节运动轴线AA2旋转。第二对关节运动线缆52410可操作地响应于定位在外壳内的电动马达。
除上述之外,端部执行器52400包括限定在端部执行器52400的近侧端部上的一组径向齿52420。该组径向齿52420的至少一部分在第二关节运动轴线AA2近侧定位。外科器械52000还包括远侧关节运动锁定构件52430,该远侧关节运动锁定构件被构造成能够在端部执行器52400上接合该组径向齿52420,以当远侧端部关节运动锁定构件52430与一组径向齿52420接合时,防止端部执行器52400围绕第二关节运动轴线AA2旋转。远侧关节运动锁定构件52430可经由电动马达52440或任何合适的促动器平移。当第二对关节运动线缆52410被致动以使端部执行器52400围绕第二关节运动轴线AA2旋转时,远侧关节运动锁定构件52430自动与该组径向齿52420脱离接合以允许进行关节运动。
包括动力关节运动系统53100的外科器械53000示于图163至图167中。外科器械53000包括外壳、限定轴轴线SA并从该外壳延伸的轴53200、从轴52200延伸的可关节运动轴部分53300和从可关节运动轴部分53300延伸的端部执行器53400。第一关节运动接头53500位于轴53200和可关节运动轴部分53300之间,并且第二关节运动接头53600位于可关节运动轴部分53300和端部执行器53400之间。第一关节运动接头53500限定与轴轴线SA正交的第一关节运动轴线AA1。第二关节运动接头53600限定与第一关节运动轴线AA1和轴线SA正交的第二关节运动轴线AA2。
动力关节运动系统53100包括第一组关节运动线缆,该第一组关节运动线缆包括右关节运动线缆53210和左关节运动线缆53212。右关节运动线缆53210与第一外关节运动齿轮53310a可操作地接合,该第一外关节运动齿轮可旋转地安装到轴53200的远侧端部并且可围绕第一关节运动轴线AA1旋转。左关节运动线缆53212与第二外关节运动齿轮53310b可操作地接合,该第二外关节运动齿轮安装到轴53200的远侧端部并且可围绕第一关节运动轴线AA1旋转。当右关节运动线缆53210和左关节运动线缆53212被致动时,第一外关节运动齿轮53310a和第二外关节运动齿轮53310b旋转。
除上述之外,第一外关节运动齿轮53310a包括第一齿轮狭槽53312,并且第二外关节运动齿轮53310a包括第二齿轮狭槽53314。第一销53900延伸穿过第一滑块构件53700的近侧端部中的第一开口,穿过限定在轴53200中的第一狭槽53240a并且穿过第一外关节运动齿轮53310a的第一齿轮狭槽53312。第二销53910延伸穿过第二滑块构件53800的近侧端部中的第二开口53810,穿过限定在轴53200中的第二狭槽53240b并且穿过第二外关节运动齿轮53310b的第二齿轮狭槽53314。第一滑块构件53700和第二滑动构件53800的远侧端部在限定在端部执行器53400的顶表面上的凹槽53410内可滑动地固定到端部执行器53400的任一侧。更具体地,第一滑块构件53700通过第一销53420附接到凹槽53410,并且第二滑块构件53800通过第二销53430附接到凹槽53410。第一滑块构件53700固定到第二关节运动轴线AA2的一侧上的端部执行器53400,并且第二滑块构件53800固定到第二关节运动轴线AA2的另一侧上的端部执行器53400。其他实施方案设想在滑块构件53700、53800和端部执行器53400之间具有不同的销和凹槽布置,以适应端部执行器53400围绕第二关节运动轴线AA2的预先确定的关节运动范围。
在使用中,当右和左关节运动线缆53210、53212在相反方向上致动时,第一外关节运动齿轮53310a将在第一方向上旋转,并且第二外关节运动齿轮53310b将在与第一方向相反的第二方向上旋转。此外,当第一外关节运动齿轮53310a和第二外关节运动齿轮53310b在相反方向上旋转时,第一滑块构件53700和第二滑块构件53800在相反方向上平移,并且端部执行器53400围绕第二关节运动轴线AA2旋转,如下文更详细地讨论的。
除上述之外,当与右关节运动线缆53210接合的第一外齿轮53310a在逆时针方向CCW上旋转时,第一外齿轮53310a的第一齿轮狭槽53312向第一销53900施加凸轮作用力,从而迫使第一销53900在第一齿轮狭槽53312内径向向外运动。如上所讨论的,第一销53900穿过轴53200中的第一狭槽53240a定位,并且因此限制为在第一狭槽53240a内的近侧和远侧平移。因此,当第一外齿轮53310a在逆时针方向CCW上旋转时,第一销53900在轴53200的第一狭槽53240a内向近侧平移,并且第一滑块构件53700向近侧平移,如图165所示。当与左关节运动线缆53212接合的第二外齿轮53310b在顺时针方向CW上旋转时,第二外齿轮53310b的第二齿轮狭槽53314向第二销53910施加凸轮作用力,从而迫使第二销53910在第二外齿轮53310b的第二齿轮狭槽53312内径向向外运动。如上所讨论的,第二销53910穿过轴53200中的第二狭槽53240b定位,并且因此限制为在第二狭槽53240b内的近侧和远侧平移。因此,当第二外齿轮53310b在顺时针方向CW上旋转时,第二销53910在第二狭槽53240b内向远侧平移,并且第二滑块构件53800向远侧平移,如图165所示。类似地,当与右关节运动线缆53210接合的第一外齿轮53310a在顺时针方向CW上旋转并且与左关节运动线缆53212接合的第二外齿轮53310b在逆时针方向CCW上旋转时,第一滑块构件53700向远侧平移并且第二滑块构件53800向近侧平移。
如上所讨论的,第一滑块构件53700和第二滑块构件53800的远侧端部附接到第二关节运动轴线AA2的任一侧上的端部执行器53400。因此,当第一滑块构件53700和第二滑块构件53800分别通过右关节运动线缆53210和左关节运动线缆53212在相反方向上平移时,端部执行器53400围绕第二关节运动轴线AA2旋转。设想了其他实施方案,其中动力关节运动系统53100的仅一半被用于使端部执行器围绕第二关节运动轴线AA2旋转。在一种这种布置中,例如,仅右关节运动线缆53210、第一外关节运动齿轮53310a、第一销53900和第一滑块53700用于使端部执行器53400围绕第二关节运动轴线AA2旋转。
除上述之外,第一内关节运动齿轮53320a和第二内关节运动齿轮53320b(参见图166)安装到可关节运动轴部分53300的近侧端部,并且可旋转地安装到轴53200的远侧端部,使得第一内关节运动齿轮53320a和第二内关节运动齿轮53320b可围绕第一关节运动轴线AA1旋转。第二右关节运动线缆53214和第二左关节运动线缆53216分别与第一内关节运动齿轮53320a和第二内关节运动齿轮53320b可操作地接合。在使用中,当第二组关节运动线缆53214、53216被致动时,第一内关节运动齿轮53320a和第二内关节运动齿轮53320b围绕第一关节运动轴线AA1旋转。因此,当第二组关节运动线缆被致动时,可关节运动轴部分53300和从其延伸的端部执行器53400围绕第一关节运动轴线AA1旋转。
除上述之外,外科器械53000包括定位在外科器械53000的轴53200内的第一关节运动锁定构件53950和第二关节运动锁定构件53960。第一关节运动锁定构件53950和第二关节运动锁定构件53960被构造成能够可操作地接合关节运动齿轮53310a、53310b、53320a、53320b上的径向齿组,以防止可关节运动轴部分53300围绕第一关节运动轴线AA1旋转,并且防止端部执行器53400围绕第二关节运动轴线AA2旋转。外科器械53000还包括被构造成能够致动第一关节运动锁定构件53950的第一锁定致动器53955和被构造成能够致动第二关节运动锁定构件53960的第二锁定致动器53965。在至少一个实施方案中,第一锁定致动器53955和第二锁定致动器53965包括螺线管、电动马达或任何合适的促动器和/或它们的组合。设想了其他实施方案,其中第一锁定致动器53955和第二锁定致动器53965由于外科器械53000的外壳中产生的旋转运动而可致动。在至少一个实施方案中,第一关节运动锁定构件53950和第二关节运动锁定构件53960被构造成能够在第一关节运动线缆和第二组关节运动线缆被致动时与关节运动齿轮53310a、53310b、53320a、53320b自动脱离接合。
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。本文所公开的任何系统都可与手持式外科器械一起使用。此外,本文所公开的任何系统都可与机器人外科器械系统一起使用。例如,名称为“SURGICAL STAPLING INSTRUMENTS WITHROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241(现为美国专利9,072,535)更详细地公开了机器人外科器械系统的若干示例并且全文以引用方式并入本文。
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。
在线性端部执行器和/或线性紧固件仓的上下文中描述了本文所述的各种实施方案。此类实施方案和其教导内容可应用于非线性端部执行器和/或非线性紧固件仓,诸如例如圆形和/或波状端部执行器。例如,2011年2月28日提交的名称为“SURGICAL STAPLINGINSTRUMENT”的美国专利申请序列号13/036,647(现为美国专利申请公布2011/0226837,现为美国专利8,561,870)中公开了包括非线性端部执行器的各种端部执行器,该专利据此全文以引用方式并入。另外,2012年9月29日提交的名称为“STAPLE CARTRIDGE”的美国专利申请序列号12/893,461(现为美国专利申请公布2012/0074198)据此全文以引用方式并入。2008年2月15日提交的名称为“END EFFECTORS FOR A SURGICAL CUTTING AND STAPLINGINSTRUMENT”的美国专利申请序列号12/031,873(现为美国专利7,980,443)据此全文以引用方式并入。2013年3月12日公布的名称为“SELECTIVELY ORIENTABLE IMPLANTABLEFASTENER CARTRIDGE”的美国专利8,393,514同样据此全文以引入方式并入。
下述专利的全部公开内容据此以引用方式并入本文:
-公布于1995年4月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312;
-公布于2006年2月21日的名称为“SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”的美国专利7,000,818;
-公布于2008年9月9日的名称为“MOTOR-DRIVEN SURGICAL CUTTING ANDFASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK”的美国专利7,422,139;
-公布于2008年12月16日的名称为“ELECTRO-MECHANICAL SURGICAL INSTRUMENTWITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”的美国专利7,464,849;
-公布于2010年3月2日的名称为“SURGICAL INSTRUMENT HAVING ANARTICULATING END EFFECTOR”的美国专利7,670,334;
-公布于2010年7月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245;
-公布于2013年3月12日的名称为“SELECTIVELY ORIENTABLE IMPLANTABLEFASTENER CARTRIDGE”的美国专利8,393,514;
-名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利申请序列号11/343,803,现为美国专利7,845,537;
-提交于2008年2月14日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT HAVING RF ELECTRODES”的美国专利申请序列号12/031,573;
-提交于2008年2月15日的名称为“END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT”的美国专利申请序列号12/031,873(现为美国专利7,980,443);
-名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”的美国专利申请序列号12/235,782,现为美国专利8,210,411;
-名称为“MOTORIZED SURGICAL INSTRUMENT”的美国专利申请序列号12/235972,现为美国专利9050083。
-名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列号12/249,117,现为美国专利8,608,045;
-提交于2009年12月24日的名称为“MOTOR-DRIVEN SURGICAL CUTTINGINSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY”的美国专利申请序列号12/647,100,现为美国专利8,220,688;
-提交于2012年9月29日的名称为“STAPLE CARTRIDGE”的美国专利申请序列号12/893,461,现为美国专利8,733,613;
-提交于2011年2月28日的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列号13/036,647,现为美国专利8,561,870;
-名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS”的美国专利申请序列号13/118,241,现为美国专利9,072,535;
-提交于2012年6月15日的名称为“ARTICULATABLE SURGICAL INSTRUMENTCOMPRISING A FIRING DRIVE”的美国专利申请序列号13/524,049,现为美国专利9,101,358;
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,025,现为美国专利9,345,481;
-提交于2013年3月13日的名称为“STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”的美国专利申请序列号13/800,067,现为美国专利申请公布2014/0263552;
-提交于2006年1月31日的名称为“SURGICAL CUTTING AND FASTENINGINSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM”的美国专利申请公布2007/0175955;以及
-提交于2010年4月22日的名称为“SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”的美国专利申请公布2010/0264194,现为美国专利8,308,040。
虽然本文已结合某些实施方案描述了各种装置,但也可实施对这些实施方案的许多修改和变型。在一个或多个实施方案中,具体特征、结构或特性可以任何合适的方式进行组合。因此,在无限制的情况下,结合一个实施方案示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其他实施方案的特征、结构或特性组合。另外,在公开了用于某些部件的材料的情况下,也可使用其他材料。此外,根据多种实施方案,单个部件可被替换为多个部件,并且多个部件也可被替换为单个部件,以执行给定的一种或多种功能。上述具体实施方式和下述权利要求旨在涵盖所有此类修改和变型。
本文所公开的装置可被设计成在单次使用之后废弃,或者其可被设计成多次使用。然而无论是哪种情况,该装置都可在至少使用一次后经过修整再行使用。修整可包括以下步骤的任意组合,这些步骤包括但不限于拆卸装置、之后进行装置具体部件的清洁或更换、以及随后重新组装装置。具体地,修整设施和/或外科团队可拆卸装置,并且在清洁和/或更换装置的特定部件之后,可重新组装装置以供后续使用。本领域的技术人员将会理解,修整装置可利用各种技术来进行拆卸、清洁/替换和重新组装。此类技术的使用以及所得的修复装置均在本申请的范围内。
本文所公开的装置可在手术之前进行处理。首先,可获得新的或用过的器械,并且根据需要进行清洁。然后,可对器械进行消毒。在一种消毒技术中,将所述器械放置在密闭且密封的容器(诸如,塑料或TYVEK袋)中。然后可将容器和器械置于可穿透容器的辐射场,诸如γ辐射、X射线和/或高能电子。辐射可杀死器械上和容器中的细菌。经消毒的器械随后可被储存在无菌容器中。密封容器可将器械保持为无菌的,直至在医疗设施中将该容器打开。还可使用本领域已知的任何其他技术对装置进行消毒,所述技术包括但不限于β辐射、γ辐射、环氧乙烷、等离子过氧化物和/或蒸汽。
尽管本发明已被描述为具有示例性设计,但可在本公开的实质和范围内进一步修改本发明。因此,本申请旨在涵盖使用本发明的一般原理的本发明的任何变型、用途或改型。
Claims (20)
1.一种用于与外科器械一起使用的钉仓,其中所述钉仓包括:
近侧端部;
远侧端部;
仓体,所述仓体包括:
中心部分;以及
平台表面,其中所述平台表面的高度相对于所述中心部分横向变化;
细长狭槽,所述细长狭槽从所述近侧端部朝向远侧端部延伸,其中所述细长狭槽限定纵向轴线;
平台表面,其中所述平台表面相对于所述细长狭槽横向变化;
一排钉腔,所述一排钉腔在所述细长狭槽旁边延伸,其中每个所述钉腔包括近侧端部和远侧端部,并且其中所述远侧端部比所述近侧端部更靠近所述细长狭槽;
钉驱动器,所述钉驱动器可运动地定位在所述一排钉腔内,其中每个所述钉驱动器包括第一端部和第二端部,其中每个所述钉驱动器的所述第一端部与所述钉腔的所述远侧端部对准,并且其中所述钉驱动器的每个所述第二端部与所述钉腔的所述近侧端部对准;以及
击发构件,所述击发构件被构造成能够在钉击发行程期间将所述钉驱动器从未击发位置驱动到完全击发位置,其中当所述钉驱动器处于所述完全击发位置时,所述钉驱动器的所述第一端部在所述平台表面上方延伸第一距离,其中当所述钉驱动器处于所述完全击发位置时,所述钉驱动器的所述第二端部在所述平台表面上方延伸第二距离,并且其中所述第一距离和所述第二距离是不同的。
2.根据权利要求1所述的钉仓,其中,所述第一距离小于所述第二距离。
3.根据权利要求1所述的钉仓,其中,所述平台表面为弯曲的。
4.根据权利要求1所述的钉仓,还包括:
第一突起部,所述第一突起部从所述平台表面延伸,其中所述第一突起部围绕所述钉腔的所述远侧端部的一部分;以及
第二突起部,所述第二突起部从所述平台表面延伸,其中所述第二突起部围绕所述钉腔的所述近侧端部的一部分。
5.根据权利要求4所述的钉仓,其中,所述第一突起部在所述平台表面上方延伸到第一高度,其中所述第二突起部在所述平台表面上方延伸到第二高度,并且其中所述第一高度和所述第二高度是不同的。
6.根据权利要求4所述的钉仓,其中,所述第一突起部包括平面组织支撑表面。
7.根据权利要求4所述的钉仓,其中,所述第一突起部包括弯曲的组织支撑表面。
8.根据权利要求4所述的钉仓,其中,所述第一突起部以第一角度远离所述平台表面延伸,其中所述第二突起部以第二角度远离所述平台表面延伸,并且其中所述第一角度不同于所述第二角度。
9.根据权利要求1所述的钉仓,其中,所述一排钉腔包括第一排钉腔,其中所述钉仓还包括第二排钉腔,所述第二排钉腔在所述第一排钉腔旁边延伸,其中所述第二排内的每个所述钉腔包括近侧端部和远侧端部,并且其中所述第二排内的所述钉腔的所述近侧端部比所述远侧端部更靠近所述细长狭槽。
10.一种外科端部执行器,包括:
砧座;
钉仓钳口,其中所述砧座和所述钉仓钳口中的至少一者能够相对于另一者在打开构型和闭合构型之间运动;以及
钉仓,所述钉仓包括:
近侧端部;
远侧端部;
细长狭槽,所述细长狭槽从所述近侧端部朝向所述远侧端部延伸,其中所述细长狭槽限定纵向轴线;
平台表面,其中所述平台表面是横向弯曲的;
第一排钉腔,所述第一排钉腔在所述细长狭槽旁边延伸,其中所述第一排内的所述钉腔相对于所述纵向轴线以第一角度取向;以及
第二排钉腔,所述第二排钉腔在所述第一排钉腔旁边延伸,其中所述第二排内的所述钉腔相对于所述纵向轴线以第二角度取向,并且其中所述第一角度和所述第二角度是不同的。
11.根据权利要求10所述的外科端部执行器,其中,每个所述钉腔包括近侧端部和远侧端部,其中当所述砧座和所述钉仓钳口处于所述闭合构型时,在所述钉腔的所述远侧端部处的所述平台表面与所述砧座之间限定第一组织间隙,其中当所述砧座和所述钉仓钳口处于所述闭合构型时在所述钉腔的所述远侧端部处的所述平台表面与所述砧座之间限定第二组织间隙,并且其中所述第一组织间隙不同于所述第二组织间隙。
12.根据权利要求10所述的外科端部执行器,其中,每个所述钉腔包括近侧端部和远侧端部,并且其中所述钉仓还包括:
从所述平台表面延伸的第一突起部,其中所述第一突起部围绕所述钉腔的所述远侧端部,并且其中所述第一突起部包括第一组织支撑表面;以及
从所述平台表面延伸的第二突起部,其中所述第二突起部围绕所述钉腔的所述近侧端部,并且其中所述第二突起部包括第二组织支撑表面。
13.根据权利要求12所述的外科端部执行器,其中,当所述砧座和所述钉仓钳口处于所述闭合构型时,在所述第一组织支撑表面与所述砧座之间限定第一组织间隙,其中当所述砧座和所述钉仓钳口处于所述闭合构型时,在所述第二组织支撑表面与所述砧座之间限定第二组织间隙,并且其中所述第一组织间隙不同于所述第二组织间隙。
14.根据权利要求10所述的外科端部执行器,其中,所述钉仓还包括可运动地定位在所述钉腔内的多个钉驱动器,其中所述多个钉驱动器在钉击发行程期间从未击发位置被驱动到完全击发位置,其中每个所述钉驱动器包括第一端部和第二端部,其中当所述钉驱动器处于所述完全击发位置时,所述钉驱动器的所述第一端部在所述平台表面上方延伸第一距离,其中当所述钉驱动器处于所述完全击发位置时,所述钉驱动器的所述第二端部在所述平台表面上方延伸第二距离,并且其中所述第一距离和所述第二距离是不同的。
15.根据权利要求10所述的外科端部执行器,其中,所述平台表面相对于所述细长狭槽是横向弯曲的。
16.根据权利要求10所述的外科端部执行器,其中,所述平台表面是截面渐变的。
17.根据权利要求10所述的外科端部执行器,其中,所述第一排内的所述钉腔不是基本上平行于所述纵向轴线成角度的。
18.根据权利要求10所述的外科端部执行器,其中,所述细长狭槽被构造成能够接收切割构件。
19.一种用于与外科器械一起使用的钉仓,其中所述钉仓包括:
细长狭槽,所述细长狭槽从近侧端部朝向远侧端部延伸;
平台表面;
一排钉腔,所述一排钉腔在所述细长狭槽旁边延伸,其中每个所述钉腔相对于所述细长狭槽以第一角度取向,并且其中每个所述钉腔包括近侧端部和远侧端部;以及
钉驱动器,所述钉驱动器可运动地定位在所述一排钉腔内,其中每个所述钉驱动器包括第一端部和第二端部,其中每个所述钉驱动器的所述第一端部与所述钉腔的所述远侧端部对准,其中每个所述钉驱动器的所述第二端部与所述钉腔的所述近侧端部对准,其中所述钉驱动器被构造成能够在钉击发行程期间从未击发位置驱动到击发位置,其中当所述钉驱动器处于所述击发位置时,所述钉驱动器的所述第一端部在所述平台表面上方延伸第一距离,其中当所述钉驱动器处于所述击发位置时,所述钉驱动器的所述第二端部在所述平台表面上方延伸第二距离,并且其中所述第一距离和所述第二距离是不同的。
20.根据权利要求19所述的钉仓,其中,所述钉腔不相对于所述纵向轴线平行取向。
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US16/720,806 US11464512B2 (en) | 2019-12-19 | 2019-12-19 | Staple cartridge comprising a curved deck surface |
PCT/IB2020/061642 WO2021124017A1 (en) | 2019-12-19 | 2020-12-08 | Staple cartridge comprising a curved deck surface |
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