CN117337156A - 包括纵向支撑梁的外科钉仓 - Google Patents

包括纵向支撑梁的外科钉仓 Download PDF

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CN117337156A
CN117337156A CN202280037605.0A CN202280037605A CN117337156A CN 117337156 A CN117337156 A CN 117337156A CN 202280037605 A CN202280037605 A CN 202280037605A CN 117337156 A CN117337156 A CN 117337156A
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assembly
firing
drive
firing member
cartridge
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G·J·巴克斯
F·E·谢尔顿四世
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Cilag GmbH International
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Cilag GmbH International
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    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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Abstract

本发明公开了一种外科缝合组件。该外科缝合组件可包括第一钳口、第二钳口、关节运动接头、闭合驱动器和击发驱动器，该闭合驱动器包括延伸穿过该关节运动接头的第一柔性旋转驱动器，该击发驱动器包括延伸穿过该关节运动接头并且能够独立于该第一柔性旋转驱动器旋转的第二柔性旋转驱动器。该外科缝合组件还可包括3D打印的部件。该外科缝合组件可被构造成能够成形不同的钉形状，诸如非平面钉和平面钉，可包括偏心驱动的击发组件，和/或可包括可浮动部件。该外科缝合组件可包括钉仓，该钉仓包括纵向支撑梁。

Description

包括纵向支撑梁的外科钉仓
背景技术
本发明涉及外科器械，并且在各种布置结构中，涉及被设计成能够缝合和切割组织的外科缝合和切割器械、端部执行器以及与它们一起使用的钉仓。
附图说明
本文所述的实施方案的各种特征连同其优点可结合如下附图根据以下描述来加以理解：
图1是根据本公开的至少一个方面的包括柄部、轴组件和端部执行器的外科缝合器械的透视图。
图2是根据本公开的至少一个方面的图1的外科缝合器械的端部执行器和轴组件的一部分的透视图，其中端部执行器被示为处于直的、或非关节运动构型。
图3是根据本公开的至少一个方面的图1的外科缝合器械的端部执行器和轴组件的一部分的透视图，其中端部执行器被示为处于关节运动构型。
图4是根据本公开的至少一个方面的图1的外科缝合器械的端部执行器和轴组件的一部分的分解透视图。
图5是根据本公开的至少一个方面的图1的外科缝合器械的端部执行器和轴组件的一部分的剖面正视图，其中端部执行器被示为处于非击发、夹紧构型。
图6是根据本公开的至少一个方面的图1的外科缝合器械的端部执行器和轴组件的一部分的平面图。
图7是根据本公开的至少一个方面的沿图6中的剖面线6-6截取的图1的端部执行器和轴组件的一部分的剖面正视图，其中端部执行器被示为处于打开构型。
图8是根据本公开的至少一个方面的沿图6中的剖面线7-7截取的图1的端部执行器和轴组件的一部分的剖面正视图，其中端部执行器被示为处于夹紧构型。
图9是根据本公开的至少一个方面的图1的包括轴组件和端部执行器的外科缝合组件的透视图，其中端部执行器通过关节运动接头附接到轴组件。
图10是根据本公开的至少一个方面的图9的外科缝合组件的分解透视图。
图11是根据本公开的至少一个方面的图9的外科缝合组件的剖面正视图，其中端部执行器被示为处于非击发、夹紧构型。
图12是根据本公开的至少一个方面的图1的包括轴组件和端部执行器的外科缝合组件的透视图，其中端部执行器通过关节运动接头附接到轴组件。
图13是根据本公开的至少一个方面的图12的外科缝合组件的分解透视图。
图14是根据本公开的至少一个方面的图12的外科缝合组件的剖面正视图，其中端部执行器被示为处于非击发、夹紧构型。
图15是根据本公开的至少一个方面的图1的包括轴组件和端部执行器的外科缝合组件的透视图，其中端部执行器通过关节运动接头附接到轴组件。
图16是根据本公开的至少一个方面的图15的外科缝合组件的分解透视图。
图17是根据本公开的至少一个方面的图15的外科缝合组件的剖面正视图，其中端部执行器被示为处于非击发、夹紧构型。
图18是根据本公开的至少一个方面的包括图1的端部执行器和柔性击发驱动系统的外科端部执行器组件的透视图。
图19是根据本公开的至少一个方面的图18的外科缝合组件的分解透视图。
图20是根据本公开的至少一个方面的图18的外科端部执行器组件的剖面正视图，其中外科端部执行器组件被示为处于非击发、夹紧构型。
图21是根据本公开的至少一个方面的机器人控制器的透视图。
图22是根据本公开的至少一个方面的用于机器人外科系统的机器人臂车的透视图，其示出了可操作地支撑外科工具的机器人臂车上的操纵器。
图23是根据本公开的至少一个方面的图22的外科臂车的操纵器和外科抓持工具的侧视图。
图24是根据本公开的至少一个方面的包括砧座、通道和钉仓的端部执行器组件的透视图。
图25是根据本公开的至少一个方面的图24的端部执行器组件的剖面透视图。
图26是根据本公开的至少一个方面的图24的端部执行器组件的局部剖面透视图，其中端部执行器组件包括被构造成能够从钉仓部署钉的击发驱动装置和被构造成能够相对于通道打开和闭合砧座的闭合驱动装置。
图27是根据本公开的至少一个方面的图24的端部执行器组件的剖面正视图。
图28是根据本公开的至少一个方面的图24的端部执行器组件的局部剖面透视图，其中端部执行器组件包括击发组件，该击发组件包括上击发构件和下击发构件，并且其中上击发构件被示为与下击发构件脱离。
图29是根据本公开的至少一个方面的图24的端部执行器组件的钉仓和支撑梁的分解透视图。
图30是根据本公开的至少一个方面的图24的端部执行器组件的钉仓和支撑梁的剖面透视图。
图31是根据本公开的至少一个方面的图24的端部执行器组件的剖面正视图。
图32是根据本公开的至少一个方面的图24的端部执行器组件的近侧端部的剖面透视图，其中为了清楚起见未示出各种部件。
图33是根据本公开的至少一个方面的图24的端部执行器组件的远侧端部的剖面透视图。
图34是根据本公开的至少一个方面的用于与缝合组件一起使用的支撑梁的透视图。
图35是根据本公开的至少一个方面的图34的支撑梁和销接到支撑梁的滑动件的剖面正视图。
图36是根据本公开的至少一个方面的包括支撑梁、击发构件组件和滑动件的缝合组件的部分的分解透视图。
图37是根据本公开的至少一个方面的图33的缝合组件的部分的分解透视图，其中支撑梁的远侧端部以隐藏线示出以便示出支撑梁的纵向通道的轮廓。
图38是根据本公开的至少一个方面的用于与缝合组件一起使用的支撑梁的正视图。
图39是根据本公开的至少一个方面的用于与缝合组件一起使用的支撑梁的正视图。
图40是根据本公开的至少一个方面的包括钉仓、滑动件、仓支撑件和工字梁的缝合组件的剖面正视图。
图41是根据本公开的至少一个方面的图40的仓支撑件的正视图。
图42是根据本公开的至少一个方面的用于与外科缝合组件一起使用的仓支撑件的正视图。
图43是根据本公开的至少一个方面的包括滑动件和仓支撑件的缝合组件的部分的剖面正视图。
图44是根据本公开的至少一个方面的被构造成能够配合在缝合组件的钉仓或仓支撑件的引导狭槽内的滑动件的正视图。
图45是根据本公开的至少一个方面的被构造成能够在其中接纳滑动件的仓支撑件的一部分的剖面透视图。
图46是根据本公开的至少一个方面的包括砧座、击发构件、仓钳口和销接到击发构件的滑动件的缝合组件的部分的示意图。
图47是根据本公开的至少一个方面的包括仓通道和砧座的缝合组件的剖面视图。
图48是根据本公开的至少一个方面的包括主体部分和驱动螺母的击发构件组件的透视图。
图49是根据本公开的至少一个方面的图48的击发构件组件的分解透视图。
图50是根据本公开的至少一个方面的包括图48的击发构件组件的主体部分和驱动螺母的击发构件组件的透视图。
图51是根据本公开的至少一个方面的图50的击发构件组件的分解透视图。
图52是根据本公开的至少一个方面的图50的击发构件组件的透视图，其中驱动螺母被焊接到主体部分。
图53是根据本公开的至少一个方面的包括通道钳口、驱动螺杆和击发构件组件的缝合组件的局部剖面分解透视图。
图54是根据本公开的至少一个方面的图53的击发构件组件的正视图。
图55是根据本公开的至少一个方面的图53的击发构件组件的分解正视图。
图56是根据本公开的至少一个方面的图53的击发构件组件的局部剖面正视图。
图57是根据本公开的至少一个方面的包括主体部分和驱动螺母的击发构件组件的透视图。
图58是根据本公开的至少一个方面的图57的击发构件组件的正视图。
图59是根据本公开的至少一个方面的图57的击发构件组件的主体部分的透视图。
图60是根据本公开的至少一个方面的图57的击发构件组件的剖面正视图。
图61是根据本公开的至少一个方面的通过主体部分的远侧孔截取的图57的击发构件组件的另一个剖面正视图。
图62是根据本公开的至少一个方面的包括主体部分和驱动螺母组件的击发构件组件的透视图，该驱动螺母组件包括内部驱动螺母和外部驱动部分。
图63是根据本公开的至少一个方面的图62的击发构件组件的透视图，其中驱动螺母的外部驱动部分的一部分出于例示性目的被切掉以暴露内部驱动螺母。
图64是根据本公开的至少一个方面的图62的击发构件组件的主体部分和内部驱动螺母的透视图。
图65是根据本公开的至少一个方面的图62的击发构件组件的主体部分和内部驱动螺母的正视图。
图66是根据本公开的至少一个方面的图62的击发构件组件的透视图。
图67是根据本公开的至少一个方面的包括主体部分和驱动螺母的击发构件组件的正视图，其中主体部分包括近侧尾部延伸部。
图68是根据本公开的至少一个方面的与击发驱动螺杆经螺纹联接的击发构件组件的透视图，其中击发构件组件包括主体部分和驱动螺母。
图69是根据本公开的至少一个方面的图68的击发构件组件的局部剖面正视图，其中驱动螺母是通过竖直平面截取的。
图70是根据本公开的至少一个方面的图68的击发构件组件的驱动螺母的透视图。
图71是根据本公开的至少一个方面的图68的击发构件组件的透视剖面视图。
图72是根据本公开的至少一个方面的图68的击发构件组件的正视图。
图73是根据本公开的至少一个方面的包括主体部分和驱动螺母的击发构件组件的正视图。
图74是根据本公开的至少一个方面的包括仓通道、钉仓、砧座和击发组件的端部执行器组件的剖面透视图。
图75是根据本公开的至少一个方面的从端部执行器组件的近侧端部观看的图74的端部执行器组件的剖面正视图。
图76是根据本公开的至少一个方面的图74的端部执行器组件的局部剖面透视图，其中击发构件组件包括击发驱动螺杆和击发构件组件。
图77是根据本公开的至少一个方面的图74的通道和击发组件的局部剖面透视图，其中出于例示性目的，某些隐藏特征部用虚线示出。
图78是根据本公开的至少一个方面的图74的端部执行器组件的局部剖面正视图。
图79是根据本公开的至少一个方面的包括通道、钉仓、砧座和击发组件的外科缝合组件的剖面正视图，该击发组件包括驱动螺杆、击发构件组件和滑动件。
图80是根据本公开的至少一个方面的图79的击发构件组件的正视图。
图81是根据本公开的至少一个方面的用于与外科缝合组件一起使用的钳口组件的剖面正视图，其中钳口组件包括通道和击发驱动螺杆。
图82是根据本公开的至少一个方面的包括钉仓、仓通道和击发驱动组件的外科缝合组件的透视图，其中钉仓在图82中被隐藏。
图83是根据本公开的至少一个方面的图82的外科缝合组件的局部剖面透视图。
图84是根据本公开的至少一个方面的图82的仓通道和击发构件组件的一部分的正视图，其中远侧支撑头和一对衬套在图84中被隐藏。
图85是根据本公开的至少一个方面的包括仓通道和由仓通道的支撑凸缘支撑的击发构件组件的外科缝合组件的透视图。
图86是根据本公开的至少一个方面的包括击发驱动螺杆和通道支撑件的外科缝合组件的一部分的正视图，其中击发驱动螺杆的近侧端部枢转地安装在仓支撑件处。
图87是根据本公开的至少一个方面的图86的外科缝合组件的部分的正视图，其中击发驱动螺杆被示为处于加载构型。
图88是根据本公开的至少一个方面的包括主体部分和可浮动地安装在主体部分内的驱动螺母的击发构件组件的正视图。
图89是根据本公开的至少一个方面的预组装的图88的击发构件组件的正视图。
图90是根据本公开的至少一个方面的组装中的图88的击发构件组件的正视图。
图91是根据本公开的至少一个方面的部分组装的图88的击发构件组件的正视图。
图92是根据本公开的至少一个方面的包括柔性芯构件和外螺旋构件的柔性击发驱动螺杆的正视图。
图93是根据本公开的至少一个方面的图92的柔性击发驱动螺杆的剖面示意图。
图94是根据本公开的至少一个方面的包括柔性击发驱动螺杆的击发组件的示意性表示。
图95是根据本公开的至少一个方面的用于与外科缝合组件一起使用的击发驱动螺杆的一部分的正视图。
图96是根据本公开的至少一个方面的用于与外科缝合组件一起使用的击发驱动螺杆的一部分的正视图，其中击发驱动螺杆包括螺纹的包覆模制区段。
图97是根据本公开的至少一个方面的图96的击发驱动螺杆的一部分的正视图，其中为了清楚起见移除了螺纹的包覆模制区段。
图98是根据本公开的至少一个方面的用于与外科缝合组件的驱动系统一起使用的轴联接件的透视图。
图99是根据本公开的至少一个方面的用于与外科缝合组件的驱动系统一起使用的轴联接件的透视图。
图100是根据本公开的至少一个方面的用于与外科缝合组件的驱动系统一起使用的轴联接件的透视图。
图101是根据本公开的至少一个方面的包括闭合驱动螺杆和闭合楔形件的闭合驱动组件的透视图，该闭合驱动组件被构造成能够打开和闭合端部执行器组件的钳口。
图102是根据本公开的至少一个方面的图101的闭合驱动组件和砧座的正视图。
图103是根据本公开的至少一个方面的图101的闭合驱动组件的剖面正视图。
图104是根据本公开的至少一个方面的包括驱动螺杆和限制套环的闭合驱动器的剖面正视图，其中限制套环未被安装到驱动螺杆上。
图105是根据本公开的至少一个方面的图104的闭合驱动装置的剖面正视图，其中限制套环被安装到驱动螺杆上。
图106是根据本公开的至少一个方面的通过锁定构件安装到通道凸缘的驱动组件的剖面正视图，其中图106示出了处于预组装构型的驱动组件。
图107是根据本公开的至少一个方面的图106的驱动组件和通道凸缘的剖面正视图，其中图107示出了处于组装构型的驱动组件。
图108是根据本公开的至少一个方面的外科缝合组件的透视图，该外科缝合组件包括通道钳口、闭合驱动装置、击发驱动装置和被定位在通道钳口内的支撑部件，并且出于例示性目的，外科缝合组件的部分被隐藏。
图109是根据本公开的至少一个方面的图108的外科缝合组件的透视图，其中为了清楚起见，各种部件被隐藏。
图110是根据本公开的至少一个方面的图108的外科缝合组件的透视图，其中为了清楚起见，各种部件被隐藏。
图111是根据本公开的至少一个方面的包括闭合驱动装置和支撑元件的闭合驱动组件的透视图。
图112是根据本公开的至少一个方面的图111的闭合驱动组件的驱动螺杆轴的透视图。
图113是根据本公开的至少一个方面的图111的闭合驱动组件的保持夹具的透视图。
图114是根据本公开的至少一个方面的包括驱动螺杆轴和闭合驱动螺母的闭合驱动装置的透视图。
图115是根据本公开的至少一个方面的图114的驱动螺杆轴的透视图。
图116是根据本公开的至少一个方面的图114的闭合驱动装置的剖面正视图，其中驱动螺杆轴的远侧端部被示为处于预成形构型。
图117是根据本公开的至少一个方面的图114的闭合驱动装置的剖面正视图，其中驱动螺杆轴的远侧端部被示为处于已成形构型。
图118是根据本公开的至少一个方面的包括旋转击发轴、经螺纹联接到旋转击发轴的击发构件、以及纾困件的击发驱动组件的透视图，该纾困件被构造成能够使旋转击发轴和击发构件之间的螺纹接合脱离。
图119是根据本公开的至少一个方面的图118的击发构件的透视图。
图120是根据本公开的至少一个方面的图118的击发驱动组件的剖面正视图，其中纾困件被示为处于未致动构型。
图121是根据本公开的至少一个方面的通过纾困件的壳体部件截取的图118的击发驱动组件的剖面正视图，其中纾困件被示为处于未致动构型。
图122是根据本公开的至少一个方面的图118的击发驱动组件的剖面正视图，其中纾困件被示为处于致动构型。
图123是根据本公开的至少一个方面的通过纾困件的壳体部件截取的图118的击发驱动组件的剖面正视图，其中纾困件被示为处于致动构型。
图124是根据本公开的至少一个方面的外科缝合组件的透视图。
图125是根据本公开的至少一个方面的图124的外科缝合组件的砧座的砧座表面的平面图。
图126是根据本公开的至少一个方面的图124的外科缝合组件的已成形钉线的平面图。
图127是根据本公开的至少一个方面的平面成形的钉的端正视图和侧正视图。
图128是根据本公开的至少一个方面的非平面成形的钉的端正视图和侧正视图。
图129是根据本公开的至少一个方面的包括多个钉成形凹坑排的砧座的剖面正视图。
图130是根据本公开的至少一个方面的用于与钉仓一起使用的滑动件的正视图。
图131是根据本公开的至少一个方面的用于与外科缝合组件一起使用的第一钉和第二钉的正视图。
图132是根据本公开的至少一个方面的平面成形的钉的端正视图和侧正视图。
图133是根据本公开的至少一个方面的非平面成形的钉的端正视图和侧正视图。
图134是根据本公开的至少一个方面的外科缝合组件的剖面正视图。
图135是根据本公开的至少一个方面的图134的外科缝合组件的局部剖面正视图。
图136是根据本公开的至少一个方面的图134的外科缝合组件的钉仓和钉驱动器的剖面正视图。
图137是根据本公开的至少一个方面的包括可替换钉仓和可替换砧座板的外科缝合组件的透视图。
图138是根据本公开的至少一个方面的被示为处于未夹紧构型的图137的外科缝合组件的透视图，其中砧座板未附接到外科缝合组件的砧座钳口。
图139是根据本公开的至少一个方面的图137的外科缝合组件的透视图，其中砧座板部分地附接到砧座钳口。
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各种实施方案，且这种范例不应被解释为以任何方式限制本发明的范围。
具体实施方式
本申请的申请人拥有与本申请于同一日期提交且各自全文以引用方式并入本文的以下美国专利申请：
-名称为“METHOD OF USING A POWERED STAPLING DEVICE”的美国专利申请，代理人案卷END9298USNP1/200859-1M号；
-名称为“SURGICAL STAPLING ASSEMBLY COMPRISING NONPLANAR STAPLES ANDPLANAR STAPLE”的美国专利申请，
代理人案卷END9298USNP2/200859-2号；
-名称为“STAPLING ASSEMBLY COMPRISING ECCENTRICALLY DRIVEN FIRINGMEMBER”的美国专利申请，代理人案卷END9298USNP4/200859-4号；
-名称为“ROTARY-DRIVEN SURGICAL STAPLING ASSEMBLY COMPRISING AFLOATABLE COMPONENT”的美国专利申请，代理人案卷END9298USNP5/200859-5号；
-名称为“DRIVERS FOR FASTENER CARTRIDGE ASSEMBLIES HAVING ROTARY DRIVESCREWS”的美国专利申请，代理人案卷END9298USNP6/200859-6号；
-名称为“MATING FEATURES BETWEEN DRIVERS AND UNDERSIDE OF A CARTRIDGEDECK”的美国专利申请，代理人案卷END9298USNP7/200859-7号；
-名称为“LEVERAGING SURFACES FOR CARTRIDGEINSTALLATION”的美国专利申请，代理人案卷END9298USNP8/200859-8号；
-名称为“FASTENER CARTRIDGE WITH NON-REPEATINGFASTENER ROWS”的美国专利申请，代理人案卷END9298USNP9/200859-9号；
-名称为“HAVING FLEXIBLE PORTIONS FOR ADAPTING TO ALOAD DURING ASURGICAL FIRING STROKE”的美国专利申请，代理人案卷END9298USNP10/200859-10号；
-名称为“STAPLING ASSEMBLY COMPONENTS HAVING METALSUBSTRATES ANDPLASTIC BODIES”的美国专利申请，代理人案卷END9298USNP11/200859-11号；
-名称为“MULTI-AXISPIVOT JOINTS FOR SURGICALINSTRUMENTS AND METHODS OFMANUFACTURING SAME”的美国专利申请，代理人案卷END9298USNP12/200859-12号；
-名称为“ARRANGEMENTS FOR MULTI-PLANAR ALIGNMENTAND SUPPORT OFOPERATIONAL DRIVE SHAFTS INARTICULATABLE SURGICAL INSTRUMENTS”的美国专利申请，代理人案卷END9298USNP13/200859-13号；以及
-名称为“SURGICAL INSTRUMENT ARTICULATION JOINTARRANGEMENTS COMPRISINGMULTIPLE MOVING LINKAGEFEATURES”的美国专利申请，代理人案卷END9298USNP14/200859-14号。
本申请的申请人拥有于2017年12月19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和美国专利：
-名称为“METHOD FOR DETERMINING THE POSITION OF AROTATABLE JAW OF ASURGICAL INSTRUMENTATTACHMENT ASSEMBLY”的美国专利10,835,330号；
-名称为“SURGICAL INSTRUMENTS WITH DUAL ARTICULATIONDRIVERS”的美国专利10,716,565号；
-名称为“SURGICAL TOOLS CONFIGURED FORINTERCHANGEABLE USE WITHDIFFERENT CONTROLLERINTERFACES”的美国专利申请序列15/847,325号，现为美国专利申请公布2019/0183491号；
-名称为“SURGICAL INSTRUMENT COMPRISING CLOSURE AND FIRING LOCKINGMECHANISM”的美国专利10,729,509号；
-名称为“ROBOTIC ATTACHMENT COMPRISING EXTERIOR DRIVE ACTUATOR”的美国专利申请序列15/847,315号，现为美国专利申请公布2019/0183594号；以及
-名称为“SURGICAL INSTRUMENT ASSEMBLY”的美国设计专利D910,847号。
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和美国专利：
-名称为“SURGICAL INSTRUMENT COMPRISING AN OFFSET ARTICULATION JOINT”的美国专利申请序列15/635,693号，现为美国专利申请公布2019/0000466号；
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM RATIO”的美国专利申请序列15/635,729号，现为美国专利申请公布2019/0000467号；
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM RATIO”的美国专利申请序列号15/635,785，现为美国专利申请公布号2019/0000469；
-名称为“SURGICAL INSTRUMENT COMPRISING FIRING MEMBER SUPPORTS”的美国专利申请序列15/635,808号，现为美国专利申请公布2019/0000471号；
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEMLOCKABLE TO A FRAME”的美国专利申请序列15/635,837号，现为美国专利申请公布2019/0000472号；
-名称为“SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEMLOCKABLE BY A CLOSURE SYSTEM”的美国专利10,779,824号；
-名称为“SURGICAL INSTRUMENT COMPRISING A SHAFT INCLUDING A HOUSINGARRANGEMENT”的美国专利申请序列15/636,029号，现为美国专利申请公布2019/0000477号；
-名称为“SURGICAL INSTRUMENT COMPRISING SELECTIVELYACTUATABLEROTATABLE COUPLERS”的美国专利申请序列15/635,958号，现为美国专利申请公布2019/0000474号；
-名称为“SURGICAL STAPLING INSTRUMENTS COMPRISINGSHORTENED STAPLECARTRIDGE NOSES”的美国专利申请序列15/635,981号，现为美国专利申请公布2019/0000475号；
-名称为“SURGICAL INSTRUMENT COMPRISING A SHAFTINCLUDING A CLOSURETUBE PROFILE”的美国专利申请序列15/636,009号，现为美国专利申请公布2019/0000476号；
-名称为“METHOD FOR ARTICULATING A SURGICALINSTRUMENT”的美国专利10,765,427号；
-名称为“SURGICAL INSTRUMENTS WITH ARTICULATABLEEND EFFECTOR WITHAXIALLY SHORTENED ARTICULATIONJOINT CONFIGURATIONS”的美国专利申请序列15/635,530号，现为美国专利申请公布2019/0000457号；
-名称为“SURGICAL INSTRUMENTS WITH OPEN AND CLOSABLEJAWS AND AXIALLYMOVABLE FIRING MEMBER THAT ISINITIALLY PARKED IN CLOSE PROXIMITY TO THEJAWSPRIOR TO FIRING”的美国专利10,588,633号；
-名称为“SURGICAL INSTRUMENTS WITH JAWS CONSTRAINEDTO PIVOT ABOUT ANAXIS UPON CONTACT WITH A CLOSUREMEMBER THAT IS PARKED IN CLOSE PROXIMITY TOTHEPIVOT AXIS”的美国专利申请序列15/635,559号，现为美国专利申请公布2019/0000459号；
-名称为“SURGICAL END EFFECTORS WITH IMPROVED JAWAPERTUREARRANGEMENTS”的美国专利10,786,253号；
-名称为“SURGICAL CUTTING AND FASTENING DEVICES WITHPIVOTABLE ANVILWITH A TISSUE LOCATINGARRANGEMENT IN CLOSE PROXIMITY TO AN ANVIL PIVOTAXIS”的美国专利申请序列15/635,594号，现为美国专利申请公布号2019/0000461号；
-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15/635,612号，现为美国专利申请公布2019/0000462号；
-名称为“SURGICAL INSTRUMENT WITH POSITIVE JAW OPENING FEATURES”的美国专利10,758,232号；
-名称为“SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER”的美国专利10,639,037号；
-名称为“SURGICAL INSTRUMENT LOCKOUT ARRANGEMENT”的美国专利10,695,057号；
-名称为“ANVIL”的美国设计专利D851,762号；
-名称为“SURGICAL INSTRUMENT SHAFT”的美国设计专利D854,151号；以及
-名称为“SURGICAL FASTENER CARTRIDGE”的美国设计专利D869,655号。
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和美国专利：
-名称为“SURGICAL ANVIL MANUFACTURING METHODS”的美国专利申请序列15/634,024号，现为美国专利申请公布2018/0368839号；
-名称为“SURGICAL ANVIL ARRANGEMENTS”的美国专利10,772,629号；
-名称为“SURGICAL ANVIL ARRANGEMENTS”的美国专利申请序列15/634,046号，现为美国专利申请公布2018/0368841号；
-名称为“SURGICAL ANVIL ARRANGEMENTS”的美国专利10,856,869号；
-名称为“SURGICAL FIRING MEMBER ARRANGEMENTS”的美国专利申请序列15/634,068号，现为美国专利申请公布2018/0368843号；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列15/634,076号，现为美国专利申请公布2018/0368844号；
-名称为“STAPLE FORMING POCKET ARRANGEMENTS”的美国专利申请序列15/634,090号，现为美国专利申请公布2018/0368845号；
-名称为“SURGICAL END EFFECTORS AND ANVILS”的美国专利申请序列15/634,099号，现为美国专利申请公布2018/0368846号；以及
-名称为“ARTICULATION SYSTEMS FOR SURGICAL INSTRUMENTS”的美国专利10,631,859号。
本申请的申请人拥有于2020年6月2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”的美国设计专利申请序列29/736,648号；
-名称为“STAPLE CARTRIDGE”的美国设计专利申请序列29/736,649；号
-名称为“STAPLE CARTRIDGE”的美国设计专利申请序列29/736,651号；
-名称为“STAPLE CARTRIDGE”的美国设计专利申请序列29/736,652号；
-名称为“STAPLE CARTRIDGE”的美国设计专利申请序列29/736,653号；
-名称为“STAPLE CARTRIDGE”的美国设计专利申请序列29/736,654号；以及
-名称为“STAPLE CARTRIDGE”的美国设计专利申请序列29/736,655号。
本申请的申请人拥有于2016年11月14日提交且各自全文以引用方式并入本文的以下美国设计专利申请和美国专利：
-名称为“STAPLE FORMING POCKET CONFIGURATIONS FOR CIRCULAR STAPLERANVIL”的美国专利申请序列15/350,621号，现为美国专利申请公布2018/0132849号；
-名称为“CIRCULAR SURGICAL STAPLER WITH ANGULARLY ASYMMETRIC DECKFEATURES”的美国专利申请序列15/350,624号，现为美国专利申请公布2018/0132854号；
-名称为“STAPLING HEAD FEATURE FOR SURGICAL STAPLER”的美国设计专利D833,608号；以及
-名称为“SURGICAL STAPLER”的美国设计专利D830,550号。
本文列出了许多具体细节，以提供对说明书中所述和附图中所示的实施方案的整体结构、功能、制造和用途的透彻理解。没有详细描述熟知的操作、部件和元件，以免使说明书中描述的实施方案模糊不清。读者将会理解，本文所述和所示的实施方案为非限制性示例，从而可认识到，本文所公开的特定结构和功能细节可为代表性和例示性的。在不脱离权利要求的范围的情况下，可对这些实施方案进行变型和改变。
术语“包括(comprise)”(以及“包括(comprise)”的任何形式，诸如“包括(comprises)”和“包括(comprising)”)、“具有(have)”(以及“具有(have)”的任何形式，诸如“具有(has)”和“具有(having)”)、“包含(include)”(以及“包含(include)”的任何形式，诸如“包含(includes)”和“包含(including)”)、以及“含有(contain)”(以及“含有(contain)”的任何形式，诸如“含有(contains)”和“含有(containing)”)为开放式系动词。因此，“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件，但不限于仅具有这些一个或多个元件。同样，“包括”、“具有”、“包含”或“含有”一个或多个特征部的系统、装置、或设备的元件具有那些一个或多个特征部，但不限于仅具有那些一个或多个特征部。
术语“近侧”和“远侧”在本文中是相对于操纵外科装置的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分，术语“远侧”是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用诸如“竖直”、“水平”、“上”和“下”等空间术语。然而，外科装置在许多取向和位置中使用，并且这些术语并非旨在为限制性的和/或绝对的。在以下说明中，诸如“第一”、“第二”、“顶部”、“底部”、“上”、“下”等的术语是方便的言语，并且不应当理解为限制性术语。
对单数的项目的引用应被理解为包括复数的项目，反之亦然，除非另有明确说明或从文本中清楚可见。语法连接词旨在表达连接的从句、句子、字词等的任何和所有转折和连接组合，除非另有说明或从上下文清楚可见。因此，术语“或”通常应被理解为是指“和/或”等。
除非本文另外指明，否则本文列举的数值范围并不是旨在进行限制，而是单独地指属于该范围内的任何或所有值，并且在此范围内的每个单独的值就像在本文中个别地引用那样并入本公开。当伴随数值时，字词“约”、“大约”等应被解释为指示如本领域普通技术人员将理解的偏差，以令人满意地用于预期目的。类似地，当参考物理特性使用时，近似字词诸如“大约”或“基本上”应被解释为设想了本领域普通技术人员将理解的偏差范围，以令人满意地用于对应的用途、功能、目的等。
本文所提供的任何和全部示例或示例性语言(“例如”、“诸如”等)仅仅旨在更好地举例说明实施方案，而并不用来限制实施方案的范围。说明书中的任何语言都不应理解为表示任何不受权利要求书保护的要素是实施实施方案所必需的。
提供各种示例性装置和方法以用于执行腹腔镜式和微创外科手术。然而，读者将容易理解，本文所公开的各种方法和装置可用于多种外科手术和应用中，包括例如与开放式外科手术结合。继续参阅本具体实施方式，读者将进一步理解，本文所公开的各种外科装置能够以任何方式插入体内，诸如通过自然腔道、通过成形于组织中的切口或穿刺孔等。外科装置的工作部分或端部执行器部分可直接插入患者体内或者可通过具有工作通道的进入装置插入，外科装置的端部执行器和细长轴可通过所述工作通道推进。
外科缝合系统可包括轴和从轴延伸的端部执行器。所述端部执行器包括第一钳口和第二钳口。第一钳口包括钉仓。钉仓能够插入第一钳口中并且能够从第一钳口移除；然而，设想到其中钉仓不能够从第一钳口移除或至少能够易于从第一钳口替换的其他实施方案。第二钳口包括被构造成能够使从钉仓射出的钉变形的砧座。第二钳口能够围绕闭合轴线相对于第一钳口枢转；然而，可设想到其中第一钳口能够相对于第二钳口枢转的其他实施方案。外科缝合系统还包括被构造成能够允许端部执行器相对于轴旋转或进行关节运动的关节运动接头。端部执行器能够围绕延伸穿过关节运动接头的关节运动轴线旋转。设想了不包括关节运动接头的其他实施方案。
所述钉仓包括仓体。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，并且砧座被定位在待缝合的组织的第二侧上。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。设想了钉腔和钉的其他布置。
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移动以从钉腔射出钉。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。滑动件能够在与仓体的近侧端部相邻的近侧位置和与仓体的远侧端部相邻的远侧位置之间移动。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。希望刀被定位成至少部分接近斜坡表面，使得在刀横切组织之前，钉被射出到组织中。
图1至图8示出了被构造成能够夹持、缝合和切割患者组织的外科缝合器械10。外科缝合器械10包括柄部20、附接到柄部20的轴组件100和端部执行器200。为了切割和缝合患者的组织，端部执行器200包括仓钳口201和砧座钳口203。砧座钳口203可相对于仓钳口203枢转以将组织夹持在砧座钳口203和仓钳口203之间。一旦组织被夹持在钳口201、203之间，外科缝合器械10可被致动以推进击发构件穿过钳口201、203以便通过端部执行器200缝合和切割组织，如下文更详细讨论的。
如下文更详细讨论的，端部执行器200可通过轴组件100的关节运动区域110进行关节运动。此类关节运动为外科缝合器械10的用户提供更准确地在目标组织附近定位和/或操纵端部执行器200的能力。
柄部20包括被构造成能够容纳各种机械和电气部件的壳体21和从壳体21延伸的柄部部分22。柄部部分22被构造成能够在使用外科缝合器械10时配合在用户的手掌中和/或由用户抓持和/或保持。柄部20还包括被构造成能够由用户致动以操作外科缝合器械10的一个或多个功能的各种致动器和/或触发器。柄部20包括闭合触发器24、击发触发器25和至少一个关节运动致动器26。当由用户致动时，闭合触发器24被构造成能够通过使砧座钳口203朝向仓钳口201运动而用端部执行器200夹持组织。当由用户致动时，击发触发器25被构造成能够通过推进击发构件以射出钉并用刀切割组织来用端部执行器200切割并缝合组织。当由用户致动时，关节运动致动器26被构造成能够通过关节运动区域110使端部执行器200相对于轴组件100进行关节运动。外科缝合器械10的触发器和致动器可触发柄部20内的一个或多个马达以致动外科缝合器械10的各种功能和/或手动地驱动各种驱动轴和部件以致动外科缝合器械10的各种功能。
柄部20还包括被构造成能够在其中支撑轴组件100的喷嘴组件30。喷嘴组件30包括致动轮31，该致动轮被构造成能够由用户旋转以使轴组件100和端部执行器200围绕纵向轴线LA相对于柄部20旋转。此类机构允许外科缝合器械10的用户仅旋转轴组件100和/或端部执行器200而不必旋转整个柄部20。
柄部20还包括电池23，该电池被构造成能够向外科缝合器械10的各种电子部件、传感器和/或马达提供电力。设想了其中外科缝合器械10直接连接到电源的实施方案。还设想了其中外科缝合器械10完全是手动的或例如非动力的实施方案。还设想了其中端部执行器的关节运动、钳口的夹紧和松开、击发端部执行器钉以缝合和切割组织、以及轴和/或端部执行器旋转都是动力系统的实施方案。
在至少一个实例中，轴组件100和端部执行器200可以是模块化的并且可从柄部20移除。在至少一个实例中，端部执行器200可以是模块化的，因为端部执行器200可从轴组件100移除并且用不同的端部执行器来替换。在至少一个实例中，轴组件100和/或端部执行器200可用于外科机器人环境中。此类实施方案将从外科机器人接口提供动力输入以致动端部执行器200的每个功能。此类外科机器人和外科工具的示例在2020年5月7日公布的名称为“ROBOTIC SURGICAL SYSTEM”的美国专利申请公布2020/0138534号中进一步描述，该专利申请公布全文以引用方式并入本文。
在至少一个实例中，轴组件100和端部执行器200被构造成能够与外科机器人一起使用。在此类实例中，轴组件100和端部执行器200被构造成能够联接到包括多个输出驱动装置的外科机器人。外科机器人的多个输出驱动装置被构造成能够与轴组件100和端部执行器200的驱动系统配合。在此类实例中，外科机器人可致动端部执行器200的各种不同功能，例如，使端部执行器围绕多个不同的关节运动接头进行关节运动，使轴组件100和/或端部执行器200围绕其纵向轴线旋转，夹紧端部执行器200以将组织夹紧在端部执行器200的钳口之间，和/或击发端部执行器200以切割和/或缝合组织。
轴组件100被构造成能够容纳外科缝合器械10的各种驱动系统部件和/或电子部件，使得端部执行器200和轴组件100可插入穿过套管针以进行腹腔镜外科手术。各种驱动系统部件被构造成能够由柄部20的各种触发器和致动器致动。此类部件可包括用于关节运动的驱动轴、用于夹紧和松开端部执行器200的驱动轴和/或用于击发端部执行器200的驱动轴。在其中轴组件100连接到柄部20或外科机器人接口中的驱动系统的实例中，此类驱动轴可由该驱动系统旋转。在各种方面中，缝合端部执行器可包括两个可独立旋转的驱动构件-例如，一个驱动构件用于抓持组织，并且一个驱动构件用于击发钉。缝合端部执行器还可包括关节运动接头，并且旋转运动可通过关节运动接头传递。在各种方面中，缝合端部执行器可包括可结合到关节运动系统、抓持系统或击发系统中的一个或多个3D印刷组件。
在其中轴组件100连接到柄部20或外科机器人接口中的驱动系统的实例中，此类驱动轴可由该驱动系统致动。此类驱动轴可包括线性致动、旋转致动或它们的组合。例如，旋转致动和线性致动的组合可采用一系列齿条齿轮和/或驱动螺杆。
在至少一个实例中，例如，轴组件100还被构造成能够容纳用于例如被定位在轴组件100和/或端部执行器200内的各种传感器和/或马达的电引线。
轴组件100包括从喷嘴组件30延伸到关节运动区域110的外轴101，该外轴包括双关节运动接头，这将在下面更详细地讨论。关节运动区域110允许端部执行器200围绕两个单独轴线AA1、AA2在两个不同平面中相对于外轴101进行关节运动。
现在主要参照图4，现在将描述端部执行器200的关节运动。关节运动区域110包括两个不同的关节运动接头和两个关节运动致动器150、160。这允许端部执行器200围绕彼此独立的两个不同轴线AA1、AA2在两个不同平面中进行关节运动。关节运动区域110包括近侧接头轴部件120、中间接头轴部件130和远侧接头轴部件140。近侧接头轴部件120附接到轴组件100的远侧端部，中间接头轴部件130枢转地连接到近侧接头轴部件120和远侧接头轴部件140，并且远侧接头轴部件140通过保持环146固定地附接到端部执行器200。下面更详细地讨论，这种布置提供了端部执行器200围绕彼此独立的轴线AA1和轴线AA2相对于轴组件100的关节运动。
近侧接头轴部件120包括固定地配合在外轴101内的近侧环形部分121。近侧接头轴部件120还包括中空通道122以允许各种驱动系统部件从中穿过，并且还包括关节运动突片123，该关节运动突片包括被构造成能够接纳关节运动销125的销孔124。关节运动销125将近侧接头轴部件120枢转地连接到中间接头轴部件130的近侧关节运动突片131。为了使端部执行器200围绕轴线AA1进行关节运动，关节运动致动器150沿远侧方向或近侧方向被线性地致动。例如，此类致动器可包括由任何合适材料(诸如金属和/或塑料)制成的杆或棒。关节运动致动器150枢转地安装到关节运动交连杆151。关节运动交连杆151相对于关节运动销125偏轴地枢转安装到中间接头轴部件130，使得当关节运动致动器150被致动时，扭矩由关节运动交连杆151相对于关节运动销125偏轴地施加到中间接头轴部件130以致使中间接头轴部件130并且因此使端部执行器200相对于近侧接头轴部件120围绕轴线AA1枢转。
中间接头轴部件130通过限定轴线AA1的关节运动销125来枢转地连接到近侧接头轴部件120。具体地，中间接头轴部件130包括近侧关节运动突片131，该近侧关节运动突片通过关节运动销125枢转地连接到近侧接头轴部件120。中间接头轴部件130还包括中空通道132和远侧关节运动突片133，该中空通道被构造成能够允许各种驱动系统部件从中穿过。远侧关节运动突片133包括销孔134和远侧突出键135，该销孔被构造成能够接纳限定轴线AA2的另一个关节运动销136。
为了使端部执行器200围绕轴线AA2进行关节运动，关节运动线缆160被致动以通过键135将关节运动扭矩施加到远侧接头轴部件140的近侧突片141。关节运动线缆160固定到键135，使得当线缆160旋转时，键135相对于中间接头轴部件130枢转。键135被配合在远侧接头轴部件140的键孔144中。明显地，键135不固定到中间接头轴部件130，并且键135可相对于中间接头轴部件130旋转。关节运动线缆160还接触围绕销孔142的近侧突片141。这提供了从关节运动线缆160到远侧接头轴部件140的附加扭矩。关节运动销136被接纳在销孔142内以枢转地联接中间接头轴部件130和远侧接头轴部件140。
在至少一个实例中，关节运动线缆160仅能够在近侧方向上被拉动。在此类实例中，将仅朝近侧拉动关节运动线缆160的一侧以使端部执行器200沿期望方向进行关节运动。在至少一个实例中，对抗地推动和拉动关节运动线缆160。换句话讲，线缆160可包括刚性构造，使得关节运动线缆160的一侧被朝远侧推动，而关节运动线缆160的另一侧被朝近侧拉动。此类布置可允许关节运动力在缆线160的被推动的一半与线缆160的被拉动的一半之间分配。在至少一个实例中，推拉布置允许更大的关节运动力被传递到对应关节运动接头。此类力在具有两个关节运动接头的布置中可能是必要的。例如，如果使近侧关节运动接头进行完全关节运动，则由于用于远侧关节运动接头的关节运动致动器必须行进的拉伸和/或延长的距离，可能需要旨在使远侧关节运动接头进行关节运动的关节运动致动器的更大力。
远侧接头轴部件140还包括切口143以允许各种驱动部件从中穿过。保持环146将仓钳口201的通道210固定到远侧接头轴部件140，由此将端部执行器组件200固定到关节运动区域110的远侧端部。
如上文所讨论，砧座钳口201可相对于仓钳口203移动以通过端部执行器200夹紧和松开组织。现在将描述端部执行器200的该功能的操作。仓钳口201包括通道210和钉仓220，该钉仓被构造成能够接纳在通道210的腔214内。通道210还包括被构造成能够接纳保持环146的环形凹槽211和被构造成能够接纳钳口联接销233的一对枢转孔213。钳口联接销233允许砧座钳口203相对于仓钳口201枢转。
砧座钳口203包括砧座主体230和一对枢转孔231。砧座钳口203的近侧部分中的枢转孔231被构造成能够接纳钳口联接销233，由此将砧座钳口203枢转地联接到仓钳口201。为了相对于仓钳口201打开和闭合砧座钳口203，提供了闭合驱动装置250。
闭合驱动装置250由柔性驱动区段175致动，该柔性驱动区段包括端对端布置或形成的通用可移动接头。在各种实例中，柔性驱动区段175可包括串联3D打印万向接头，其被一起打印作为单个连续系统。下面更详细地讨论，柔性驱动区段175由穿过轴组件100的输入轴驱动。柔性驱动区段175通过双关节运动接头传递旋转致动运动。闭合驱动装置250包括闭合螺杆251和经螺纹联接到闭合螺杆251的闭合楔形件255。闭合楔形件255被构造成能够明确地用凸轮带动砧座钳口203打开和闭合。闭合螺杆251由固定在通道210内的第一支撑主体258和第二支撑主体259支撑。
为了在夹紧位置(图8)和松开位置(图7)之间移动砧座钳口203，闭合驱动轴被致动以致动柔性驱动区段175。柔性驱动区段175被构造成能够使闭合螺杆251旋转，这使闭合楔形件255移位。例如，闭合楔形件255经螺纹联接到闭合件螺杆251，并且闭合楔形件255与钉仓220的旋转行进被限制。闭合螺杆251取决于闭合螺杆251旋转的方向朝近侧或朝远侧驱动闭合楔形件255。
为了从松开位置(图7)夹紧端部执行器200，闭合楔形件255朝近侧移动。当闭合楔形件255朝近侧移动时，闭合楔形件255的近侧凸轮表面256接触限定在砧座主体230的近侧端部235中的对应凸轮表面234。当凸轮表面256接触凸轮表面234时，力被施加到砧座主体230的近侧端部235，从而致使砧座主体230围绕销233旋转到夹紧位置中(图8)。
为了从夹紧位置打开或松开端部执行器200(图8)，通过沿与致使闭合楔形件255朝近侧移动的方向相反的方向旋转闭合件螺杆251而使闭合楔形件255朝远侧移动。当闭合楔形件255朝远侧运动时，从闭合楔形件255的远侧端部延伸的一对凸块257在砧座主体230的向下延伸突片237附近接触凸轮表面234。当凸块257在突片237附近接触凸轮表面234时，力被施加到砧座主体230以使砧座主体230围绕销233旋转到打开位置中(图7)。
在至少一个实例中，凸轮表面234的轮廓对应于凸轮表面256的轮廓。例如，凸轮表面234和凸轮表面256可匹配以使得最大凸轮力被施加到砧座主体230以引起砧座主体230的期望旋转。如图8中可见，例如，由砧座主体230的近侧端部235限定的凸轮表面234包括类似于凸轮表面256的上斜坡区段的斜坡区段。
如上文所讨论，外科缝合器械10可被致动以推进击发构件穿过钳口201、203以便通过端部执行器200缝合和切割组织。现在将描述从钉仓220部署钉226并且用刀283切割组织的功能。钉仓220包括仓体221、多个钉驱动器225和可移除地存储在仓体221内的多个钉226。仓体221包括平台表面222、限定在仓体221中的布置成纵向排的多个钉腔223、以及使仓体221分叉的纵向狭槽224。刀283被构造成能够被驱动穿过纵向狭槽224以切割在砧座主体230和平台表面221之间夹紧的组织。
平台表面221包括侧向轮廓的组织支撑表面。在各种方面中，平台表面221的轮廓可沿仓体221的中心部分形成峰。此类峰可覆盖纵向延伸的击发螺杆261，该击发螺杆延伸穿过仓体221的中心部分，这将在本文中进一步描述。在各种实例中，沿峰的增加的高度可与沿刀283的击发路径的较小组织间隙相关联。在本公开的某些方面中，驱动器高度、所成形的钉高度、钉凹坑延伸高度和/或钉过度驱动距离也可沿平台表面221侧向变化。也设想了并且在本文中进一步描述了可侧向变化的钉成形(例如，2D钉和3D钉的组合)。
钉驱动器225被构造成能够当滑动件280被朝远侧推动穿过钉仓220时由滑动件280提升以射出在钉腔223中由钉驱动器225支撑的钉226。滑动件280包括斜面281以接触钉驱动器225。滑动件280还包括刀283。滑动件280被构造成能够由击发构件270推动。
为了部署钉226并用刀283切割组织，端部执行器200包括击发驱动装置260。击发驱动装置260由柔性驱动轴176致动。下面更详细地讨论，柔性驱动轴176由穿过轴组件100的输入轴驱动。柔性驱动轴176通过双关节运动接头传递旋转致动运动。击发驱动装置260包括被构造成能够由柔性驱动轴176旋转的击发螺杆261。击发螺杆261包括支撑在支撑构件259和通道210中的轴承内的轴颈。在各种实例中，击发螺杆261可相对于通道210浮动，如本文进一步所述。击发螺杆261包括支撑在支撑构件259和通道210内的近侧端部262、支撑在通道210内的远侧端部263、以及沿着击发螺杆261的长度的一部分延伸的螺纹265。
击发构件270经螺纹联接到击发螺杆261，使得当击发螺杆261旋转时，击发构件270沿着击发螺杆261朝远侧推进或朝近侧回缩。具体地，击发构件270包括主体部分271，该主体部分包括限定在其中的中空通道272。击发螺杆261被构造成能够被接纳在中空通道272内并且被构造成能够与击发构件270的螺纹部件273经螺纹联接。因此，当击发螺杆261旋转时，螺纹部件273向主体部分271施加线性力以使击发构件270朝远侧推进或使击发构件270朝近侧回缩。当击发构件270朝远侧推进时，击发构件270推动滑动件280。滑动件280的远侧移动穿过接合多个钉驱动器225而引起钉223的射出，如本文进一步所述。驱动器225是被构造成能够同时击发多个钉223的三重驱动器。驱动器225可包括侧向不对称，如本文进一步所述，以在各种实例中使滑动件轨道的宽度最大并且沿钉仓220的中心向下容纳击发螺杆261。
在端部执行器200的击发期间的某一点，用户可使击发构件270回缩以允许钳口201、203松开。在至少一个实例中，需要击发构件270的完全回缩以打开钳口201、203，其中上凸轮作用构件和下凸轮作用构件设置在主体部分271上，一旦击发构件270完全回缩，其仅可从钳口201、203脱离。
在各种实例中，击发构件270可为如本文进一步描述的塑料部分和金属部分的混合构造。在各种实例中，螺纹部件273可以是例如金属部件，其通过嵌件模制或包覆模制结合到击发构件主体271中。
在某些实例中，击发构件270还可被称为工字梁。击发构件270可包括在其中包括网格图案空间的复杂3D打印几何形状。在各种实例中，3D打印可允许击发构件或其一部分充当弹簧并允许一部分更容易挠曲，这可改善例如在击发行程期间的力分布和/或公差。
图9至图11示出了外科缝合组件300，其包括轴组件310和附接到轴组件310的图1至图8的端部执行器200。轴组件310可在许多方面类似于本文所讨论的各种其他轴组件；然而，轴组件310包括单个关节运动接头和被构造成能够使端部执行器200围绕单个关节运动接头进行关节运动的关节运动杆。外科缝合组件300被构造成能够切割和缝合组织。外科缝合组件300可附接到外科器械柄部和/或外科机器人接口。外科器械柄部和/或外科机器人接口可被构造成能够致动外科缝合组件300的各种功能。轴组件310包括关节运动接头320。如下文更详细讨论的，端部执行器200被构造成能够围绕轴线AA相对于轴组件310的外轴311进行关节运动。
轴组件310包括外轴311、第一轴接头部件330和通过关节运动销354枢转地联接到第一轴接头部件330的第二轴接头部件350。第一轴接头部件330包括被构造成能够配合在外轴311的内径内的近侧管部分331。例如，此类配合可包括压配合。然而，可使用任何合适的附接装置。第一轴接头部件330还包括远侧部分332。远侧部分332包括关节运动突片333，该关节运动突片包括限定在其中的销孔334，以及中空通道335，外科缝合组件300的各种驱动部件可穿过该中空通道。此类驱动部件可包括例如关节运动致动器、闭合致动器和/或击发致动器。
第一轴接头部件330通过关节运动销354枢转地连接到第二轴接头部件350。关节运动销354还被接纳在第二轴接头部件350的朝近侧延伸的关节运动突片351的销孔353内。销孔353与销孔334轴向对准。关节运动销354允许第二轴接头部件350围绕关节运动轴线AA相对于第一轴接头部件330进行关节运动。第二轴接头部件350还包括从近侧延伸的关节运动突片351延伸的销突起部352。下面更详细地讨论，销突起部352被构造成能够枢转地联接到关节运动驱动系统。第二轴接头部件350还包括远侧部分355，该远侧部分包括被构造成能够接纳保持环358的环形凹槽356。远侧部分355还包括外科缝合组件300的各种驱动部件可穿过的中空通道357。保持环358被构造成能够通过配合在仓通道210的环形凹槽211和第二轴接头部件350的环形凹槽356内而将第一钳口201保持到第二轴接头部件350。
为了使端部执行器200围绕关节运动轴线AA进行关节运动，提供了关节运动杆360。关节运动杆360可通过任何合适的装置致动，诸如通过机器人或机动输入和/或手动柄部触发器。例如，可在近侧方向和远侧方向上致动关节运动杆360。设想了其中除了线性致动之外或代替线性致动，关节运动系统包括旋转驱动的致动的实施方案。关节运动杆360延伸穿过外轴311。关节运动杆360包括枢转地联接到关节运动连杆362的远侧端部361。关节运动连杆362枢转地联接到销突起部352，该销突起部从近侧延伸的关节运动突片351相对于关节运动轴线AA偏心地延伸。关节运动连杆362的此类偏心联接允许关节运动杆360向第二接头轴部件350施加力，以使第二接头轴部件350并且因此使端部执行器200相对于第一接头轴部件330旋转。关节运动杆360可朝远侧推进以使端部执行器200围绕关节运动轴线AA沿第一方向旋转，并且可朝近侧回缩以使端部执行器200围绕关节运动轴线AA沿与第一方向相反的第二方向旋转。
轴组件310还包括被定位在关节运动接头320内的关节运动部件支撑结构340。此类支撑结构可向各种驱动部件提供支撑，该驱动部件被构造成能够在端部执行器200进行关节运动时穿过关节运动接头320到达端部执行器200。支撑结构340还可用于在使用期间将驱动部件与组织残余物隔离。
图12至图14示出了外科缝合组件400，其包括轴组件410和附接到轴组件410的图1至图8的端部执行器200。轴组件410可在许多方面类似于本文所讨论的各种其他轴组件；然而，轴组件410包括单个关节运动接头和被构造成能够使端部执行器200围绕单个关节运动接头进行关节运动的关节运动线缆。外科缝合组件400被构造成能够切割和缝合组织。外科缝合组件400可附接到外科器械柄部和/或外科机器人接口。外科器械柄部和/或外科机器人接口可被构造成能够致动外科缝合组件400的各种功能。轴组件410包括关节运动接头420。如下文更详细讨论的，端部执行器200被构造成能够围绕轴线AA相对于轴组件310的外轴411进行关节运动。
轴组件410包括外轴411、第一轴接头部件430和通过关节运动销454枢转地联接到第一轴接头部件430的第二轴接头部件450。第一轴接头部件430包括被构造成能够配合在外轴411的内径内的近侧管部分431。例如，此类配合可包括压配合。然而，可使用任何合适的附接装置。第一轴接头部件430还包括远侧部分432，该远侧部分包括关节运动突片433，该关节运动突片包括限定在其中的销孔434。远侧部分432还包括外科缝合组件400的各种驱动部件可穿过的中空通道435。此类驱动部件可包括例如关节运动致动器、闭合致动器和/或击发致动器。
第一轴接头部件430通过关节运动销454枢转地连接到第二轴接头部件450。关节运动销454还被接纳在第二轴接头部件450的朝近侧延伸的关节运动突片451的销孔453内。关节运动销454允许第二轴接头部件450围绕关节运动轴线AA相对于第一轴接头部件430进行关节运动。第二轴接头部件450还包括驱动环结构452。驱动环结构452从朝近侧延伸的关节运动突片451延伸并且还限定销孔453的一部分。下面更详细地讨论，驱动环结构452被构造成能够由关节运动驱动系统接合。第二轴接头部件450还包括远侧部分455，该远侧部分包括被构造成能够接纳保持环458的环形凹槽456。穿过远侧部分455的中空通道457被构造成能够接纳穿过其中的外科缝合组件400的各种驱动部件。保持环458被构造成能够通过配合在仓通道210的环形凹槽211和第二轴接头部件450的环形凹槽456内而将第一钳口201保持到第二轴接头部件450。
为了使端部执行器200围绕关节运动轴线AA进行关节运动，提供了关节运动线缆460。关节运动线缆460可由任何合适的装置致动，诸如例如由机器人输入和/或手持式外科器械的柄部上的手动触发器致动。关节运动线缆460可包括对抗致动轮廓。换句话讲，当朝近侧拉动关节运动线缆460的第一侧时，允许关节运动线缆460的第二侧像滑轮系统那样朝远侧推进。相似地，当朝近侧拉动第二侧时，允许第一侧朝远侧推进。关节运动线缆460延伸穿过外轴411。关节运动线缆460围绕驱动环结构452定位并且摩擦地保持在其上以允许第二轴接头部件450在关节运动线缆460被致动时旋转。当关节运动线缆460被致动时，关节运动线缆460被构造成能够将旋转扭矩施加到第二接头轴部件450的驱动环结构452并且因此施加到端部执行器200。此类扭矩被构造成能够致使第二接头轴部件450相对于第一接头轴部件430旋转或枢转，由此使端部执行器200相对于外轴411进行关节运动。关节运动线缆460的第一侧可被拉动以使端部执行器200围绕关节运动轴线AA沿第一方向旋转，并且关节运动线缆460的第二侧可被拉动以使端部执行器200围绕关节运动轴线AA沿与第一方向相反的第二方向旋转。
轴组件410还包括被定位在关节运动接头420内的关节运动部件支撑结构440。此类支撑结构440可向各种驱动部件提供支撑，该驱动部件被构造成能够在端部执行器200进行关节运动时穿过关节运动接头420到达端部执行器200。支撑结构440还可用于在使用期间将驱动部件与组织残余物隔离。
外科缝合组件400还包括闭合驱动轴区段475和击发驱动轴区段476，其各自被构造成能够通过关节运动接头420将旋转运动传递到端部执行器200。驱动轴区段475、476被构造成能够在端部执行器200进行关节运动时被动地纵向扩张和收缩。例如，关节运动可引起驱动轴区段475、476的扩张和收缩以考虑由于端部执行器200相对于轴组件410的关节运动而引起的驱动轴长度的相应纵向拉伸或收缩。在驱动轴区段475、476的扩张和收缩期间，驱动轴区段475、476维持与端部执行器200中的延伸穿过外轴411的对应输入轴和输出轴的旋转驱动接合。在至少一个实例中，输出轴包括闭合螺杆251和击发螺杆261，该闭合螺杆被构造成能够通过钳口201、203来实现抓持、闭合或组织操纵，该击发螺杆被构造成能够实现钳口201、203的夹紧和击发构件270的击发。
图15至图17示出了外科缝合组件500，其包括轴组件510和附接到轴组件510的图1至图8的端部执行器200。轴组件510可在许多方面类似于本文所讨论的各种其他轴组件；然而，轴组件510包括单个关节运动接头和被构造成能够被动地扩张和收缩的驱动轴区段。外科缝合组件500被构造成能够切割和缝合组织。外科缝合组件500可附接到外科器械柄部和/或外科机器人接口。外科器械柄部和/或外科机器人接口可被构造成能够致动外科缝合组件500的各种功能。轴组件510包括关节运动接头520。如下文更详细讨论的，端部执行器200被构造成能够围绕轴线AA进行关节运动。
轴组件510包括第一轴接头部件530和通过关节运动销543枢转地联接到第一轴接头部件530的第二轴接头部件540。第一轴接头部件530被构造成能够附接到外科器械组件和/或外科机器人接口的轴。第一轴接头部件530包括近侧部分531和关节运动突片533，该关节运动突片包括限定在其中的销孔534。在至少一个实例中，第一轴接头部件530包括中空通道，外科缝合组件400的各种驱动部件可穿过该中空通道。此类驱动部件可包括例如关节运动致动器、闭合致动器和/或击发致动器。
第一轴接头部件530通过关节运动销543枢转地连接到第二轴接头部件540。关节运动销543还被接纳在第二轴接头部件540的朝近侧延伸的关节运动突片541的销孔542内。关节运动销543允许第二轴接头部件540围绕关节运动轴线AA相对于第一轴接头部件530进行关节运动。第二轴接头部件540还包括远侧部分545，该远侧部分包括被构造成能够接纳保持环548的环形凹槽547以及外科缝合组件500的各种驱动部件可穿过的中空通道546。保持环548被构造成能够通过配合在仓通道210的环形凹槽211和第二轴接头部件540的环形凹槽547内而将第一钳口201保持到第二轴接头部件540。
任何合适的关节运动驱动系统均可用于使端部执行器200绕轴线AA进行关节运动。在至少一个实例中，端部执行器200被动地进行关节运动。在此类实例中，端部执行器200可被压靠组织，例如，以向端部执行器200施加力并致使端部执行器200围绕关节运动轴线进行关节运动。在至少一个实例中，端部执行器200还包括弹簧，该弹簧被构造成能够向第二轴接头区段540施加中性偏置力，例如，以致使端部执行器200朝向非关节运动构型偏置。
外科缝合组件500还包括闭合驱动轴区段575和击发驱动轴区段576，其各自被构造成能够通过关节运动接头520将旋转运动传递到端部执行器200。驱动轴区段575、576被构造成能够在端部执行器200进行关节运动时被动地纵向扩张和收缩。关节运动致使驱动轴区段575、576扩张和收缩以解决由于端部执行器200的关节运动而引起的驱动轴长度的纵向拉伸或收缩。在驱动轴区段575、576的扩张和收缩期间，驱动轴区段575、576维持与端部执行器200中的对应输入轴和输出轴的旋转驱动接合。在至少一个实例中，输出轴包括闭合螺杆251和击发螺杆261，其将在本文中进一步描述。
图18至图20示出了包括轴部分610和端部执行器600的外科缝合端部执行器组件600。端部执行器组件600在许多方面类似于本文所公开的各种其他端部执行器组件；然而，端部执行器组件600包括由柔性击发轴驱动的多部件击发构件。端部执行器组件600被构造成能够切割和缝合组织。端部执行器组件600可通过轴部分610的近侧突片611附接到外科器械柄部和/或外科机器人接口。外科器械柄部和/或外科机器人接口可被构造成能够致动端部执行器组件600的各种功能。端部执行器组件600包括仓通道钳口620和砧座钳口660，该砧座钳口枢转地安装到仓通道钳口620以将组织夹紧在仓通道钳口620和砧座钳口660之间。
仓通道钳口620包括：通道630，其包括近侧端部631；钉仓640，其被构造成能够在其中存储多个钉并且被构造成能够被接纳在通道630内；和支撑支架650，其配合在钉仓640内。钉仓640和支撑支架650被构造成能够在将钉仓640安装到通道630中之前组装在一起。下文更详细地讨论，支撑支架650被构造成能够当击发构件组件被推进穿过端部执行器组件600时进一步支撑击发构件组件。
砧座钳口660被构造成能够成形从钉仓640射出的钉。砧座钳口660包括近侧端部661，该近侧端部包括限定在其中的被构造成能够接纳联接销663的一对销孔662。砧座钳口660可围绕联接销663在松开位置和完全夹紧位置之间枢转。联接销663也被接纳在通道630的近侧端部631中限定的一对销孔633内。联接销663用于将砧座钳口660枢转地安装到通道630。在至少一个实例中，通道630通过围绕通道630的环形凹槽632和轴部分610的环形凹槽615配合的保持环或带安装到轴部分610。保持环或带被构造成能够将通道630保持到轴部分610。
端部执行器组件600包括闭合驱动装置670，该闭合驱动装置被构造成能够通过使砧座钳口660相对于通道630枢转而在砧座钳口660与仓通道钳口620之间夹持组织。端部执行器组件600还包括击发驱动装置680，该击发驱动装置被构造成能够通过部署来自钉仓640的多个钉来夹紧、缝合和切割组织。闭合驱动装置670包括被定位在通道630内的闭合螺杆671和经螺纹联接到闭合螺杆671的闭合楔形件675。当闭合螺杆671旋转时，闭合楔形件675朝远侧推进或朝近侧回缩以分别打开或闭合砧座钳口660。闭合驱动装置670可由任何合适的装置致动。例如，旋转驱动轴可从致动接口延伸穿过轴部分610，例如以旋转闭合螺杆671。合适的旋转驱动轴的其他示例在本文中进一步描述。
击发驱动装置680包括柔性驱动轴681，该驱动轴被构造成能够线性地移动穿过端部执行器组件600。例如，柔性驱动轴681可由机器人输入和/或柄部组件的手动致动的驱动轴致动。柔性驱动轴681被构造成能够延伸穿过轴部分610的远侧端部613的中空通道614并且是柔性的，使得端部执行器组件600可相对于端部执行器600从其延伸的轴进行关节运动。柔性驱动轴681延伸穿过限定在闭合楔形件675中的间距狭槽676并且固定地附接到下击发构件682。下击发构件682被构造成能够与不同的钉仓一起重复使用。
钉仓640包括一次性上击发构件683，该一次性上击发构件被构造成能够以钩的方式接合或闩锁到下击发构件682上，使得下击发构件582可推动或驱动上击发构件683穿过钉仓640和支撑支架650。换句话讲，击发致动涉及两部分式击发构件-结合到仓640中的一次性上击发构件683和结合到击发驱动装置680中的可重复使用的下击发构件682，当钉仓640位于细长通道630中时，这些击发构件可联接在一起。两部分式击发构件在本文中进一步描述。
上击发构件683包括被构造成能够接合并定位砧座钳口660的上凸缘、被构造成能够切割组织的刀刃、以及被构造成能够以钩的方式接合下击发构件682的闩锁部分。钉仓640还包括被构造成能够接合被定位在钉仓640内的钉驱动器以从钉仓640射出钉的滑动件684。因为刀和切割刃被结合到钉仓640的一次性上击发构件683中，所以新的和/或全新的切割刃可与装载到端部执行器组件600中的每个钉仓一起供应。
下击发构件682和上击发构件683被构造成能够移动穿过支撑支架650，使得与击发序列相关联的竖直负载被构造成能够通过支撑支架650、钉仓640、通道630和砧座钳口660分布。支撑支架650可由例如待插入钉仓640内的金属材料构成。支撑支架650包括被构造成能够配合在钉仓640的纵向狭槽中限定的对应键狭槽内的键轨道655。支撑支架650还包括被构造成能够接纳上击发构件683的刀的纵向狭槽653、被构造成能够接纳上击发构件683的一部分的圆柱形通道657、下击发构件682的一部分和柔性驱动轴681。支撑支架650还包括竖直键延伸部656，该竖直键延伸部被构造成能够被接纳在仓平台中的对应键孔内。当支撑支架650安装在钉仓640内时，此类延伸部可通过仓平台可见。在至少一个实例中，支撑支架650被构造成能够从钉仓640的面向通道630的底部插入到钉仓640中。
支撑支架650还包括都被构造成能够与通道630接合的近侧突片651和远侧突片653。突片651、653被构造成能够分配由击发驱动装置680和对应部件通过组件600传递的力中的至少一些力。远侧突片651可用于通过与通道630共享和/或重新分配由击发驱动装置680施加到支撑支架650的负载来阻止上击发构件683和下击发构件682被推动穿过支撑支架650的远侧端部。
当替换钉仓640以使得可重复使用端部执行器组件600时，将钉仓640从通道钳口630移除。从通道钳口630移除钉仓640会移除上击发构件683、滑动件684、支撑支架650和钉仓640。新刀可被设置有替换钉仓。
本文所公开的各种实施方案可与机器人系统700结合使用。例如，在图21至图23中示出了示例性机器人系统。图21示出了主控制器701，其可与外科机器人结合使用，例如图22中示出的从属机器人臂车800。主控制器701和从属机器人臂车800以及它们各自的部件和控制系统在本文中统称为机器人系统700。此类系统和装置的示例在名称为“MECHANICALACTUATOR INTERFACE SYSTEM FOR ROBOTIC SURGICAL TOOLS”的美国专利7,524,320号，以及名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利9,072,535号中公开，这些专利申请各自全文以引用方式并入本文。众所周知，主控制器701通常包括控制器(在图21中一般表示为703)，在外科医生经由立体显示器702观察手术的同时，该控制器由外科医生抓持并在空中操纵。控制器701通常包括手动输入装置，这些手动输入装置优选地以多个自由度运动并通常还具有用于致动工具(例如，用于闭合抓持钳口、施加电势到电极等)的可致动柄部、触发器或致动器。
如图22中可见，在一种形式中，机器人臂车800可被构造成能够致动一个或多个外科工具，通常称为900。采用主控制器和机器人臂车布置结构的各种机器人外科系统和方法在名称为“MULTI-COMPONENT TELEPRESENCE SYSTEM AND METHOD”的美国专利号6,132,368号中公开，该专利申请的全部公开内容据此以引用方式并入本文。
在各种形式中，机器人臂车800包括基座702，在例示的实施方案中，该基座可支撑外科工具900。在各种形式中，外科工具900可由一系列手动关节运动的连杆(通常称为装置接头804)和机器人操纵器806支撑。在各种实施方案中，连杆和接头布置结构可有利于外科工具围绕空间点的旋转，如在名称为“REMOTE CENTER POSITIONING DEVICE WITHFLEXIBLE DRIVE”的美国专利5,817,084号中更完整地描述，该专利申请的全部公开内容据此以引用方式并入本文。平行四边形布置结构将旋转约束为围绕轴线812a(有时称为俯仰轴)枢转。支撑平行四边形连杆的连接件以枢转方式安装到装置接头804(图22)，使得外科工具还围绕轴线812b(有时称为偏航轴)旋转。俯仰轴812a和偏航轴812b在远程中心814处相交，该远程中心沿外科工具900的细长轴对准。当由操纵器806支撑时，外科工具900可具有另外的从动自由度，包括外科工具900沿纵向轴线“LT-LT”的滑动运动。当外科工具900相对于操纵器806(箭头812c)沿工具轴线LT-LT运动时，远程中心814相对于操纵器806的基座816保持固定。因此，整个操纵器通常移动以使远程中心814重新定位。操纵器806的连杆808可由一系列马达820驱动。这些马达响应于来自控制系统的处理器的命令而主动地使连杆808移动。还可采用马达820来操纵外科工具900。还设想了另选的接头结构和装置布置结构。其他接头和装置布置结构的示例例如在名称为“AUTOMATED ENDOSCOPE SYSTEM FOROPTIMAL POSITIONING”的美国专利5,878,193号中公开，该专利申请的全部公开内容据此以引用方式并入本文。
虽然结合外科工具与主控制器701之间的通信在本文中初步描述了机器人部件与机器人外科系统的处理器之间的数据通信，但应当理解，类似的通信可发生在操纵器、装置接头、内窥镜或其他图像捕获装置等的电路与机器人外科系统的处理器之间，该机器人外科系统的处理器用于部件兼容性确认、部件类型识别、部件校正(诸如偏移等)通信、部件与机器人外科系统的联接确认等。根据至少一个方面，本文所公开的各种外科器械可结合其他机器人控制的或自动外科系统使用，并且不一定限于与图21至图23所示和上述参考文献中所述的特定机器人系统部件一起使用。
在各种腹腔镜外科手术期间，通常的做法是通过已安装在患者的腹壁中的套管针插入外科器械的外科端部执行器部分，以触及位于患者腹部内的外科部位。在其最简单的形式中，套管针是在一端具有尖锐的三角形点的笔形器械，其通常在被称为插管或套管的中空管内部使用，以形成进入身体的开口，外科端部执行器可通过该开口引入。这种布置形成进入体腔的入口，外科端部执行器可通过该入口插入。套管针的插管的内径不可避免地限制可通过套管针插入的外科器械的端部执行器和驱动支承轴的尺寸。
无论所执行的外科手术的具体类型如何，一旦外科端部执行器通过套管针插管插入患者体内，通常需要相对于被定位在套管针插管内的轴组件运动外科端部执行器，以便相对于待处理的组织或器官适当地定位外科端部执行器。外科端部执行器相对于保持在套管针插管内的轴部分的这种运动或定位通常被称为外科端部执行器的“关节运动”。已开发多种关节运动接头来将外科端部执行器附接到相关联的轴，以便于外科端部执行器的这种关节运动。可以预期，在许多外科手术中，希望采用具有尽可能大的关节运动范围的外科端部执行器。
由于套管针插套的尺寸所施加的尺寸约束，关节运动接头部件的尺寸必须设定成以便自由地通过套管针插套插入。这些尺寸约束还限制了各种驱动构件和部件的尺寸和组成，该驱动构件和部件与被支撑在外壳中的马达和/或其他控制系统可操作地交接，该外壳可为手持式的或包括较大自动化系统的一部分。在许多情况下，这些驱动构件必须可操作地穿过关节运动接头以可操作地耦接到外科端部执行器或与外科端部执行器可操作地交接。例如，一个此类驱动构件通常用于向外科端部执行器施加关节运动控制运动。在使用期间，关节运动驱动构件可以未被致动以将外科端部执行器定位在非关节运动位置以便于将外科端部执行器通过套管针插入，然后被致动以在外科端部执行器进入患者体内时使外科端部执行器关节运动到期望位置。
因此，上述尺寸约束对开发关节运动系统构成了许多挑战，所述关节运动系统可实现期望关节运动范围，还适合操作外科端部执行器的各个特征部所需的多种不同驱动系统。此外，一旦外科端部执行器已被定位在期望的关节运动位置，在端部执行器的致动和外科手术的完成期间，关节运动系统和关节运动接头必须能够将外科端部执行器保持在该锁定位置。此类关节运动接头布置还必须能够承受在使用期间端部执行器所经历的外力。
各种外科器械采用各种不同的驱动轴布置，该驱动轴布置用于从被支撑在外科器械的柄部中或自动化或机器人控制系统的其他部分中的对应驱动运动源传递驱动运动。这些驱动轴布置必须能够适应端部执行器的显著的关节运动取向，同时有效地将此类驱动运动传递跨过外科器械的关节运动接头。此外，由于器械轴必须被插入穿过的套管针的尺寸所规定的上述尺寸限制，这些驱动轴部件必须在轴内占据尽可能小的空间。为了适应此类要求，许多驱动轴布置包括串联联接在一起的若干可移动元件。部件的小尺寸(例如，4mm直径)和数量导致困难且冗长的组装规程，其增加了装置的成本和复杂性。
如本文进一步所述，动力缝合装置可包括两个可独立旋转的驱动构件：被构造成能够实现端部执行器的钳口的闭合的第一旋转驱动构件和被构造成能够实现安装在端部执行器中的钉仓的击发的第二旋转驱动构件。第一旋转驱动构件和第二旋转驱动构件是柔性的并且被构造成能够延伸穿过至少一个关节运动接头。在此类实例中，第一旋转驱动构件和第二旋转驱动构件可在处于非挠曲构型时和处于挠曲构型时通过关节运动接头传递旋转致动运动。示例性旋转驱动构件在本文中进一步描述。
动力缝合组件还包括第一钳口、第二钳口、闭合驱动装置和击发驱动装置，该闭合驱动装置包括延伸穿过关节运动接头的第一旋转驱动构件，该击发驱动装置包括延伸穿过关节运动接头的第二旋转驱动构件。第二旋转驱动构件可独立于第一旋转驱动构件旋转。例如，闭合驱动装置可由闭合触发器激活，于是闭合驱动装置的致动引起第一旋转驱动构件的旋转，该第一旋转驱动构件通过关节运动接头将旋转运动传递到闭合螺杆。闭合驱动装置还包括经螺纹联接到闭合螺杆的闭合楔形件，其中闭合楔形件被构造成能够接合第一钳口以在第一旋转驱动构件旋转时将第一钳口从打开位置移动到闭合位置。
击发驱动装置可由例如与闭合触发器分开的击发触发器激活。第二旋转驱动构件的旋转与第一旋转驱动构件的旋转分开，并且闭合运动与击发运动分开且不同。击发驱动装置的启动实现了第二旋转驱动构件的旋转，该第二旋转驱动构件通过关节运动接头将旋转运动传递到击发螺杆。击发驱动装置还包括经螺纹联接到击发螺杆的击发构件，其中击发构件被构造成能够以凸轮方式接合第一钳口和第二钳口并且在第二旋转驱动构件的旋转时移动切割构件和/或钉击发滑动件。
在各种实例中，动力缝合装置中的至少一个部件可以是3D打印部件。3D打印部件可被结合到关节运动系统、闭合/抓持系统和/或击发系统中，如本文进一步所述。在某些实例中，可利用3D打印技术来改善部件能力。例如，3D打印可允许打印的部件表现出超材料性质，使得3D打印的部件表现出更大的结构强度和刚度，同时允许精确地形成小细节特征部并且优化部件的其他性质，例如选择性的柔性和/或润滑。动力缝合装置的示例性3D打印部件在本文中进一步描述并且包括柔性可旋转驱动构件，例如串联3D打印万向接头、击发构件或工字梁、和/或钉仓和/或它们的子部件。在一种实例中，钉仓可以是复合塑料-金属3D打印部件。各种部件的3D打印及对其的考虑在本文中进一步描述。
还设想了通过此类外科缝合组件进行缝合的方法。方法可包括获得外科缝合组件以及由闭合触发器致动闭合驱动装置，其中闭合楔形件被构造成能够接合第一钳口以在第一旋转驱动构件旋转时将第一钳口从打开位置移动到闭合位置。方法还可包括由击发触发器激活击发驱动装置，其中击发构件被构造成能够以凸轮方式接合第一钳口和第二钳口并且在第二旋转驱动构件的旋转时在击发运动期间推进切割构件和钉击发滑动件。本文进一步描述了3D打印部件在此类组件中的各种应用。
图24至图33示出了用于缝合组织的端部执行器组件1000。端部执行器组件1000类似于端部执行器组件600；然而，端部执行器组件1000和所附的描述包括除端部执行器组件600之外的更多细节。端部执行器组件1000包括轴部分1010和端部执行器，该端部执行器包括第一钳口1011和可相对于第一钳口1011移动的第二钳口1013。端部执行器组件1000被构造成能够切割和缝合在钳口1011、1013之间捕获的组织。端部执行器组件1000可通过轴部分1010附接到外科器械柄部和/或外科机器人接口。外科器械柄部和/或外科机器人接口可被构造成能够致动端部执行器组件1000的各种功能。第一钳口1011包括仓通道1020，并且第二钳口1013包括砧座1080，该砧座通过销1084枢转地安装到仓通道1020以将组织夹紧在钳口1011、1013之间。
端部执行器组件1000还包括被构造成能够被安装在仓通道1020内的可替换钉仓1050和被定位在钉仓1050内的支撑梁1100。下文更详细地讨论，支撑梁1100被构造成能够向钉仓1050内的端部执行器组件1100提供附加内部支撑。钉仓1050包括仓体1055，该仓体包括近侧端部1051、远侧端部1053和仓平台1056。仓体1055还包括：多个钉腔1057，该多个钉腔被布置成限定在平台1056中的纵向排；和纵向狭槽1059，该纵向狭槽限定在平台1056中并且被构造成能够接纳下文更详细讨论的击发构件组件的一部分。
可替换钉仓1050被构造成能够将多个钉可移除地存储在钉腔1057内。钉被构造成能够从钉仓并抵靠砧座1080的砧座表面1083射出以成形钉并且缝合被捕获在平台1056与砧座表面1083之间的组织。为了射出钉，通过击发构件组件将滑动件1070从钉仓1050的近侧端部1051朝向钉仓1050的远侧端部1053推动。当滑动件1070在钉仓1050内纵向平移时，滑动件1070被构造成能够接触并提升支撑钉仓1050内的钉的多个钉驱动器并且抵靠砧座表面1083成形钉。
为了相对于仓通道1020和钉仓1050打开和闭合砧座1080，提供了闭合驱动装置1210。参照图25至图27，闭合驱动装置1210包括旋转闭合驱动装置1211，其被构造成能够由例如外科器械柄部和/或机器人接口的旋转输出轴致动。旋转闭合驱动装置1211被支撑在通道1020的近侧端部1021内并且包括螺纹1212。闭合驱动装置1210还包括闭合楔形件1220，该闭合楔形件包括与旋转闭合驱动装置1211的螺纹1212经螺纹联接的螺纹1223。因此，当旋转闭合驱动装置1211旋转时，闭合楔形件1220被构造成能够在砧座1080的近侧端部1081中限定的砧座腔1085内纵向平移。在各种实例中，旋转闭合驱动装置1211可被称为闭合螺杆。
闭合楔形件1220包括打开凸轮表面1222和闭合件凸轮凸块1223。为了闭合砧座1080，闭合楔形件1220由旋转闭合驱动装置1221朝近侧移动，使得限定在其上的打开凸轮表面1222接合砧座1080的近侧端部1081，由此使砧座1080围绕销1084朝向闭合位置枢转。为了打开砧座1080，闭合楔形件1220由旋转闭合驱动装置1221朝远侧移动，使得闭合凸轮凸块1223接合砧座1080的近侧端部1081，由此使砧座1080围绕销1084朝向打开位置枢转。闭合楔形件1220还包括U形狭槽1221，该U形狭槽被构造成能够允许线性致动的击发驱动装置从中穿过，这将在下文更详细地讨论。
为了击发端部执行器组件1000，提供了击发驱动装置1250。击发驱动装置1250包括柔性击发轴1251，该柔性击发轴被构造成能够由外科器械柄部和/或机器人接口的线性输出轴致动。柔性击发轴1251朝向包括下击发构件1260和上击发构件1270的击发组件穿过闭合楔形件1220的U形狭槽1221。击发轴1251包括固定在驱动狭槽1263内的远侧端部1252，该驱动狭槽限定在下击发构件1260的引导部分1265中。在至少一个实例中，击发轴1251被可旋转地支撑(例如，轴颈连接)在驱动狭槽1263内，使得击发轴1251可推拉下击发构件1260，同时能够在驱动狭槽1263内旋转。此类构型可允许柔性击发轴1251相对于下击发构件1260旋转，同时保持可线性致动的接合。砧座1080还包括被构造成能够附接到砧座1080的上砧座盖1090。例如，砧座盖1090可被焊接到砧座1080，并且可用于加强砧座1080。通道1020也可包括通道盖1030。
下击发构件1260包括从下击发构件1260侧向延伸的下凸轮作用凸缘1261、从下击发构件1260侧向延伸的上凸轮作用凸缘1262、以及被构造成能够被接纳在支撑梁1100内的引导部分1265，如下文更详细地讨论。下凸轮作用凸缘1261被构造成能够在击发行程期间接合通道1020以在钉仓1050和砧座1080之间保持限定的夹紧组织间隙。上凸轮作用凸缘1262被构造成能够在击发行程期间接合支撑梁1100。下文更详细地讨论，在击发组件内设置多个凸轮作用凸缘可有助于在端部执行器组件1000内分配夹紧力。当讨论凸轮作用凸缘时，应当理解，如图中可见，凸缘从击发构件的主体部分的两侧侧向向外延伸。
还提供了上击发构件1270。上击发构件1270被构造成能够由下击发构件1260推进通过击发行程。引导部分1265被构造成能够推动上击发构件1270的引导部分1274。上击发构件1270包括从上击发构件1270侧向延伸的上凸轮作用凸缘1272、从上击发构件1270侧向延伸的下凸轮作用凸缘1273、以及被构造成能够被接纳在支撑梁1100内的引导部分1274，如下文更详细地讨论。上凸轮作用凸缘1272被构造成能够在击发行程期间接合砧座1080。具体地，上凸轮作用凸缘1272被构造成能够向狭槽1086内的砧座1080施加夹紧力。在击发行程的开始时，上凸轮作用凸缘1272被构造成能够接合狭槽1086的近侧斜面部分1087以开始在端部执行器组件1000内施加夹紧力。
上击发构件1270的下凸轮作用凸缘1273被构造成能够在击发行程期间接合支撑梁1100。此类下凸轮作用凸缘1273可在击发构件组件内提供附加凸轮作用凸缘以帮助在端部执行器组件1000内分配夹紧力。上击发构件1270还包括切割刃或刀1271，其被构造成能够切割在钉仓1050和砧座1280之间夹紧的组织。上击发构件1270还包括限定在上击发构件1270的前部上的驱动表面1276。驱动表面1276被构造成能够推动滑动件1070的驱动凸缘1071。当滑动件1070由上击发构件1270推进穿过端部执行器组件1000时，滑动件1070的滑动件轨道1072被构造成能够接合钉驱动器、提升钉驱动器并且射出钉以缝合组织。
在至少一个实例中，上击发构件1270是一次性的，并且下击发构件1260是可重复使用的。在此类实例中，上击发构件1270被替换并且附带钉仓1050被定位在准备安装或准备击发位置。换句话讲，每当要安装新钉仓时，用户接纳新上击发构件。此类构型可提供各自具有全新钉仓的新刀。
下击发构件1260包括接纳钩狭槽1264，并且上击发构件1270包括被构造成能够被接纳在接纳钩狭槽1264内的钩部分1275。包括滑动件1070和上击发构件1270的钉仓1050可以与被定位在其打开位置的砧座1080的角度类似的角度安装。当用户将钉仓1050安装到通道1020中时，此类角度允许用户将上击发构件1270闩锁或钩连到下击发构件1260中。在至少一个实例中，下击发构件1260被构造成能够通过用引导部分1265推动引导部分1274并且用钩部分1264拉动钩部分1275来在端部执行器组件1000内推拉上击发构件1270。在某些实例中，钉仓1050和通道1020中间的对准和/或杠杆作用特征部被构造成能够相互作用以确保钉仓1050的正确对准和插入。
因为每次安装钉仓时可提供全新且一次性的刀，所以钉仓1050还包括从平台1056向上延伸的护刀突片1060。当处理钉仓1050时，护刀突片1060可保护用户不被刀刃1271切割。当组织被端部执行器组件1000夹紧时并且在切割运动之前，护刀突片1060还可防止组织被无意地切割。如果组织在击发之前朝向护刀突片1060泄漏，则护刀突片1060将在击发之前保护未缝合的组织。
如上文所讨论，各种类型的击发力和夹紧力存在于端部执行器组件1000内。支撑梁1100被构造成能够有助于将端部执行器组件内的夹紧力分配到各个部件以通过增加端部执行器组件内的力的分布来减小任何单个部件发生故障的可能性。在没有支撑梁的端部执行器中，夹紧力可主要被施加到通道和砧座。端部执行器组件1000允许夹紧力在端部执行器组件1000内的更大分布。
主要参见图28至图33，内部支撑梁1100被定位在钉仓1050的内部纵向通道1060内。内部支撑梁1100可由比仓体1055更坚固的材料构成。在至少一个实例中，支撑梁1100由金属材料构成并且仓体1055由聚合物构成。在此类实例中，支撑梁1100可通过由比仓体1055的材料更坚固的材料制成支撑梁1100来帮助将夹紧力分布在端部执行器组件1100内。
支撑梁1100包括上表面1110，该上表面包括从其突出并且被构造成能够被接纳在钉仓1050的平台1056中限定的对应狭槽1058内的多个突起部1111。突起部1111可在钉仓1050内提供附加的侧向和纵向支撑。换句话讲，突起部1111可防止支撑梁1100相对于仓体1055侧向或纵向滑动。当组装支撑梁1100和仓体1055时，突起部1111还可帮助将支撑梁1100与仓体1055对准。在至少一个实例中，在包装之前将支撑梁1100安装在钉仓1050中。在此类实例中，可替换钉仓1050已经包括支撑梁1100。因此，当替换钉仓1050时，提供了新支撑梁。
支撑梁1100可从与平台1056相对的钉仓1050的底部竖直地滑入仓体1055的内部纵向通道1060中。仓体1055还包括限定在内部纵向通道1060的通道壁1061上的侧向轨道或凸耳1062。轨道1062被构造成能够配合在支撑梁1100的侧面中限定的对应狭槽1109内。轨道1062被构造成能够将支撑梁1100保持在仓体1055内并且防止支撑梁1100从仓体1055的底部掉落。内部纵向通道1060还包括限定在平台1056的厚度下方的上表面1063。支撑梁1100的上表面1110被构造成能够邻接上表面1063。
在至少一个实例中，仓体1055被包覆模制到支撑梁1100上。此类构型可提供各种内部特征部，否则在部件需要被单独制造并且在其制造之后进行组装的情况下难以提供这些特征部。在至少一个实例中，仓体1055被包覆模制和/或嵌件模制到支撑梁1100和上击发构件1270上。在此类实例中，钉、钉驱动器和滑动件可在包覆模制过程完成之后组装到钉仓1050和支撑梁1100中。在至少一个实例中，支撑梁1100被嵌件模制到钉仓1050中。
支撑梁1100还包括纵向腔1120，该纵向腔包括下凸轮狭槽1121、上凸轮狭槽1123和圆柱形狭槽1122。下凸轮狭槽1121被构造成能够接纳下击发构件1260的上凸轮作用凸缘1262。上凸轮狭槽1123被构造成能够接纳上击发构件1270的下凸轮作用凸缘1273。圆柱形狭槽1122被构造成能够在上击发构件1270和下击发构件1260被推进穿过端部执行器组件1000时接纳引导部分1274、引导部分1265和柔性击发轴1251。纵向腔1120还被构造成能够当滑动件1070被上击发构件1270推动时接纳滑动件1070的驱动凸缘1071。在至少一个实例中，柔性击发轴1251被构造成能够紧密地接纳在圆柱形狭槽1122内，使得每一者的剖面轮廓基本上匹配。在此类实例中，圆柱形狭槽1122可用于在柔性击发轴1251被推进穿过圆柱形狭槽1122时帮助防止柔性击发轴1251的屈曲。当柔性击发轴1251经受压缩力时，圆柱形狭槽1122可支撑被定位在其中的柔性击发轴1251的长度并且有助于防止柔性击发轴1251的屈曲。
如上文所讨论，支撑梁1100被构造成能够帮助分配由凸缘1272、1273、1262和1261施加到端部执行器组件1100的夹紧力。引导部分1274、1265还可通过凸缘1272、1273、1262和1261施加竖直夹紧力并且还可帮助使夹紧力通过支撑梁1100分布。当上击发构件1270和下击发构件1260被推进穿过端部执行器组件1000时，凸缘1272、1273、1262和1261可向砧座1080、通道1020和支撑梁1100施加竖直夹紧力。这些力可主要分布在砧座1080、通道1020和支撑梁1100之间；该部件比可主要由金属构成的钉仓1050更坚固。使夹紧负载通过这些部件分布可减小施加到仓体1055本身的竖直挤压力。此类布置还可减小凸缘1272、1273、1262和1261中的任一者从其相应击发构件主体剪切的可能性，因为它们可沿着端部执行器组件1000的竖直长度共享竖直夹紧力。支撑梁1100还可提供通道1020和砧座1080之间的附加支撑，而不是只依靠通道1020和砧座1080来处理仅由通道凸缘和砧座凸缘施加的所有夹紧力。
在至少一个实例中，上击发构件1270和下击发构件1260被称为双工字梁。此类构型可允许被定位在下击发构件1260的上凸缘1262与上击发构件1270的下凸缘1273之间的中心纵向腔，诸如限定在支撑梁1100中的圆柱形狭槽1122。
引导部分1265、1274还可通过提供与支撑梁1100接合的圆形部分来帮助加强击发构件1260、1270。圆形部分还可向击发构件1260、1270提供强度源，因为它们可处理显著的竖直力。对于发生故障，在某些实例中，它们可能需要剪切型故障而不是弯曲型故障，从而使得圆形部分比侧向凸缘更坚固。具有带有侧向凸缘和圆形部分两者的击发构件可增加击发组件的总体强度，因为其适于在端部执行器组件1000内经受的竖直夹紧力。所有竖直夹紧力可用于维持钉仓1050和砧座1080之间的预定义组织间隙。
在端部执行器组件1000内也经受纵向负载。例如，击发构件组件可经受由组织在刀1271上施加的纵向负载。击发构件组件还可经受由施加到通道1020和砧座1080的夹紧力生成的纵向负载。当击发构件组件在其最近侧位置邻接部件时，也可经受纵向负载。当击发构件组件和/或滑动件邻接端部执行器组件1000的远侧端部时，也可经受纵向负载。在此类实例中，滑动件和/或击发构件组件部件可被朝远侧推动到钉仓的鼻部、砧座和/或支撑梁中。端部执行器组件1000还包括有助于将这些纵向负载分布在端部执行器组件1000内的特征部。
支撑梁1100包括从支撑梁1100向下延伸的近侧钩1102(图29)和远侧钩1104(图30)。近侧钩1102被构造成能够被接纳在通道1020的近侧端部1021中限定的对应通道孔1023内。当钉仓1050和支撑梁1100被安装到通道1020中时，近侧钩1102可被闩锁到孔1023中。可安装钩1102，伴随例如可听到的咔嗒声以向用户通知成功安装。钩1102还可从通道1020下面可见，使得用户可看到钩1102是否已经与通道1020适当地接合。远侧钩1104被构造成能够被接纳在通道1020的远侧端部1022中限定的对应通道孔1024内。在近侧钩1104被成功地安装到通道1022的近侧端部1021中之后，远侧钩1102可通过倾斜表面1104'卡合到孔1024中。钩1102、1104可用于分配在端部执行器组件1000内经受的纵向负载。远侧钩1104可致使击发构件1260、1270在击发行程的结束时主要向通道1020施加力而不是向钉仓1050的远侧端部或鼻部1053施加力。此类构型可保护钉仓1050的鼻部1053的完整性，该鼻部通常由比通道1020更脆的材料制成。通道1020可用于代替仓鼻部1053支持由击发构件1260、1270朝远侧施加的力。支撑梁1100的远侧端部1103还包括被构造成能够配合在钉仓1053的鼻部1053内的配合轮廓。
如上文所讨论，上击发构件1270可为一次性的并且与钉仓1050一起移除，使得新上击发构件可安装在新钉仓内。在此类实例中，上击发构件70可在击发行程完成后移动到其最近侧位置。当上击发构件1270被拉动到其最近侧位置时，砧座1080可由闭合驱动装置1210枢转打开。当砧座1080被枢转打开时，接合表面1087可使上击发构件相对于下击发构件1260朝近侧倾斜并且使钩1275解闩锁。此时，钉仓1050和上击发构件1270可被撬开和/或脱出通道1020，使得新钉仓、支撑梁和上击发构件可被安装在通道1020中，并且端部执行器组件1000可被再次使用。
图34和图35示出了包括支撑梁1210、击发构件(诸如滑动件)1220、以及将击发构件1220联接到支撑梁1210的联接构件1201的缝合组件1200的一部分。缝合组件1200可用于任何合适的钉仓(诸如本文所公开的钉仓)内。支撑梁1210包括被构造成能够接纳击发梁和/或击发构件组件(诸如上文所讨论的上击发构件和下击发构件)的至少一部分的中心驱动腔1211、被构造成能够接纳击发构件组件的至少一部分的上狭槽1214、以及被构造成能够接纳联接构件1201的一对水平狭槽1213。上狭槽1214可与限定在钉仓的平台中的纵向狭槽对准。联接构件1201可由例如销构成。
击发构件1220被构造成能够当击发构件被推进穿过钉仓和支撑梁1210时从钉仓射出钉。支撑梁1210还包括部分地包围中心驱动腔1211的至少部分地弯曲的壁或凸缘1212。击发构件1220包括被构造成能够将钉和/或钉驱动器推出钉仓的驱动斜坡1222。
在至少一个实例中，击发构件组件被构造成能够仅在击发构件1220上推动以使击发构件1220推进穿过钉仓和支撑梁1210。此类构型可允许大部分击发力被直接施加到击发构件1220。在至少一个实例中，击发构件组件被构造成能够在联接构件1201和击发构件1220两者上推动以使击发构件1220推进穿过钉仓和支撑梁1210。此类构型可允许所施加的击发力的共享并且可将所施加的击发力分布在整个联接构件1201和击发构件1220上。
在至少一个实例中，击发构件组件被构造成能够仅在联接构件1201上推动以使击发构件1220推进穿过钉仓和支撑梁1210。在某些实例中，此类构型可允许在由金属制成的部件上而不是在由聚合物制成的部件上施加更集中的发射力。例如，击发构件1220可由聚合物构成，而联接构件1201可由金属构成。在至少一个实例中，击发构件1220和联接构件1201包括相同的材料。
例如，将击发力施加到联接构件(诸如联接构件1201)可相对于击发构件1220的纵向行进路径侧向地展开击发力的施加。这种侧向分布可帮助将击发力分布在整个支撑梁1210上。击发构件1220被构造成能够围绕支撑梁1210的底部。此类构型可允许在仓通道内使用不同尺寸的滑动件。
图36和图37示出了被构造成能够与本文公开的任何合适的钉仓一起使用的缝合组件1300。缝合组件1300包括：击发组件1310，其被构造成能够由击发轴致动；支撑梁1340，其被构造成能够与钉仓一起定位；和滑动件或击发构件1350，其被构造成能够从钉仓射出钉。击发组件1310包括下击发构件1320和被构造成能够由下击发构件1320致动的上击发构件1330。下击发构件1320包括被构造成能够驱动上击发构件1330的驱动部分1323、被构造成能够在其中接纳击发轴的轴连接腔1321，和底部1322。上击发构件1330包括被构造成能够例如接合砧座的上凸缘1331和被构造成能够接合支撑梁1340的一部分的下凸缘1332。
支撑梁1340包括被构造成能够在其中接纳击发构件组件1310的纵向通道1343和被构造成能够支撑击发构件1350的张开凸耳1341。下凸缘1332被构造成能够将凸轮作用力施加到纵向通道1343内的支撑梁1340。共同地，上凸缘1331和下凸缘1332被构造成能够维持钉仓和砧座之间的预定组织间隙。
滑动件1350包括被构造成能够由支撑梁1340的张开凸耳1341支撑的引导臂1351和被构造成能够从钉仓射出钉的驱动斜坡1352。滑动件1350可滑动到支撑梁1340的一个端部上以用于组装。滑动件1350从张开凸耳1341悬挂。此类构型可允许使用针对不同仓的不同尺寸的滑动件和相同支撑梁1340。击发构件组件1310被构造成能够在击发行程期间推动滑动件1350。扩张凸耳1341还可用于将由击发构件组件1310施加的竖直凸轮作用力传递到钉仓。在至少一个实例中，由击发构件组件1310施加的竖直凸轮作用力与钉仓隔离。在此类实例中，例如除了砧座和/或通道之外，支撑梁1340被构造成能够还经受大部分(如果不是全部的话)竖直夹紧力。此类构型可将竖直夹紧力集中在更坚固的部件上，诸如由金属制成的那些部件。
还设想了另选支撑梁几何形状。例如，图38示出了被构造成能够被定位在钉仓(诸如本文所公开的那些钉仓)内的支撑梁1410。支撑梁1410被构造成能够有助于将竖直夹紧力分布在整个端部执行器组件中。支撑梁1410包括基本上圆形的、椭圆形的或径向的外周边1411以及因此剖面轮廓。支撑梁1410还包括上通道1413和下通道1415。通道1413、1415被构造成能够接纳击发构件组件的一个或多个部件(诸如本文所公开的那些部件)。例如，通道1413包括圆柱形腔部分1414并且可接纳上击发构件的引导部分。例如，通道1415包括圆柱形腔部分1416并且可接纳下击发构件的引导部分。支撑梁的基本上径向的剖面轮廓可用于加强支撑梁1410。在此类构型中，支撑梁1410不太可能由于由竖直夹紧力施加的弯曲负载而发生故障。圆形凸轮作用凸缘也可与支撑梁1410一起使用。圆形凸轮作用凸缘可在端部执行器组件内提供加强凸缘系统，如本文进一步所述。
图39示出了被构造成能够被定位在钉仓(诸如本文所公开的那些钉仓)内的支撑梁1420。支撑梁1420被构造成能够有助于将竖直夹紧力分布在整个端部执行器组件中。支撑梁1420包括基本上圆形的或径向的外周边1421以及因此剖面轮廓。支撑梁1410还包括从基本上圆形的或径向的外周边1421延伸的下凸缘1424。在至少一个实例中，下凸缘1424被构造成能够例如接合钉仓的底部，并且可包括多凸缘系统中的凸缘中的一者。在此类实例中，击发构件组件的击发构件可包括凸缘接纳腔而不是侧向延伸的凸缘。
支撑梁1420还包括上通道1422。通道1422被构造成能够接纳击发构件组件的一个或多个部件(诸如本文所公开的那些部件)。例如，通道1422包括圆柱形腔部分1423并且可接纳上击发构件的引导部分。
图40和图41示出了被构造成能够切割和缝合患者的组织的缝合组件1500。缝合组件1500包括：钉仓1510，其被构造成能够在其中可移除地存储多个钉；滑动件1520，其包括被构造成能够射出存储在钉仓1510内的钉的驱动斜坡1521；和工字梁1570，其被构造成能够推动滑动件1520穿过钉仓1510。缝合组件1500还包括被定位在由内壁1512和凸耳1513限定的钉仓1510的纵向通道1511内的仓支撑件1530。仓支撑件1530包括被构造成能够接纳工字梁1570的下凸轮作用凸缘1572的上凸轮通道1533和被构造成能够接纳滑动件1520的凸轮作用凸缘1523的下凸轮通道1531。
凸轮作用凸缘1523包括向上延伸到凸轮通道1531中的支撑部分1524和凸缘1525。凸缘1525从支撑部分1524延伸以形成T形形状；然而，也设想了其他几何形状。当滑动件1520被推进通过钉仓1510和仓支撑件1530时，凸缘1525移动穿过凸轮通道1531。仓支撑件1530被构造成能够支撑由工字梁1570和滑动件1520施加在缝合组件1500内的竖直夹紧力。
缝合组件1500还包括被定位在钉仓1510的平台表面1514上的平台板1560。平台板1560可帮助将夹紧力分布在缝合组件1500内。平台板1560例如可由金属材料构成。平台板1560包括被构造成能够与限定在钉仓1510中的钉腔对准的多个孔1561。平台板1560还包括与纵向通道1511对准的纵向狭槽1562。仓支撑件1530还包括被构造成能够接纳击发构件组件的至少一部分的中心圆柱形支撑腔1535。例如，中心圆柱形支撑腔1535被构造成能够接纳例如线性致动器、击发构件部件的引导部分和/或滑动件的引导部分。
主要参见图41，仓支撑件1530包括被构造成能够接纳钉仓1510的凸耳1513的纵向狭槽1536。例如，可调整宽度1541和高度1542以适应不同尺寸的钉仓、钉和/或钉驱动器。仓支撑件1530的宽度1541和高度1542也可针对钉仓1510与砧座之间的不同组织间隙距离进行调整。在至少一个实例中，宽度1541和高度1542可被调整以针对不同场景调谐夹紧负载分布。例如，具有较低夹紧力的缝合器械可由具有比仓支撑件1530更薄的宽度的仓支撑件更好地服务。
图42示出了被构造成能够被定位在钉仓(诸如本文所公开的那些钉仓)内的仓支撑件1600。仓支撑件1600包括限定中心纵向引导腔1605的圆柱形中心部分1606、上凸轮通道1603和下凸轮通道1601(其各自被构造成能够接纳凸轮作用凸缘)。中心纵向引导腔1605可被构造成能够接纳击发组件的一个或多个部件(诸如滑动件、上击发构件或下击发构件)的引导部分。中心纵向引导腔1605还可被构造成能够在其中接纳击发轴。凸轮通道1601、1603包括径向横截面。此类布置可减小接纳在其中的相应凸缘由于弯曲负载而发生故障的可能性。
图43示出了包括仓支撑件1710和滑动件1720的缝合组件1700。仓支撑件1710包括纵向狭槽1711，该纵向狭槽被构造成能够在击发行程期间接纳穿过其中的滑动件1720的至少一部分。滑动件1720包括底部部分1721和第一臂1722，该底部部分被构造成能够例如经螺纹联接到击发驱动螺杆，该第一臂围绕仓支撑件1710的第一侧从底部部分1721向上延伸。滑动件1720还包括围绕料仓支撑件1710的第二侧从底部1721向上延伸的第二臂1723。臂1722、1723各自分别包括引导齿1724、1725，该引导齿分别被接纳在仓支撑件1710的对应狭槽1712、1713内。用于将滑动件1720固定在仓支撑件1710中的接合特征部相对于竖直中心线平面是不对称的。更具体地，臂1722、1723包括不同的几何形状，例如不同的高度，并且引导齿1724、1724也包括不同的几何形状，例如不同的长度和/或形状。狭槽1712、1713包括与它们被构造成能够接纳的齿类似的轮廓。此类构型可提供用于确保滑动件1720以正确方向安装的手段。此类构型还可允许通过不同尺寸的臂1722、1723对施加到滑动件1720的负载进行精细调节。
图44示出了被构造成能够与本文所讨论的任何合适的钉仓和/或仓支撑件一起使用的滑动件1730。与滑动件1720不同，滑动件1730包括具有相同高度和轮廓的臂1732。臂1732从底部部分1731延伸并且包括相对于滑动件1731向外延伸的齿1733。由于向外延伸的齿1733，此类滑动件可被构造成能够由仓支撑件和/或钉仓在仓支撑件和/或钉仓中限定的内部引导狭槽内引导。
图45示出了仓支撑件1740，该仓支撑件包括被构造成能够例如在其中接纳滑动件1730(图45)的中心腔1741。例如，中心腔1741包括侧向相对的狭槽1742，该狭槽包括被构造成能够接纳齿1733的竖直安装部分1743。击发构件组件可被构造成能够在击发行程期间推动滑动件1730穿过仓支撑件1740。
图46示出了包括仓钳口1810、砧座1820、击发构件1840、和被构造成能够由击发构件1840推动穿过仓钳口1810的滑动件1830的缝合组件1800。滑动件1830通过销1812销接到击发构件1840。例如，当击发构件1840由击发轴推进时，通过销1812推动滑动件1830。击发构件1840包括被构造成能够被接纳在仓钳口1810的狭槽1811内的底部凸缘1842和被构造成能够被接纳在砧座1820中限定的狭槽1821内的上凸缘1841。
图47示出了包括仓通道1910和砧座1920的外科缝合组件1900。外科缝合组件1900还包括支撑梁1940和钉仓1970。外科缝合组件1900还包括击发构件1950，该击发构件包括被构造成能够接合砧座1920的上凸缘1952和被构造成能够接合支撑梁1940的下凸缘1951。外科缝合组件还包括通过销1960销接到钉仓1970和支撑梁1940的滑动件1930。
在各种实例中，被构造成能够由被定位在端部执行器内的击发驱动螺杆驱动的击发构件组件可在击发行程期间黏连。黏连可存在于击发构件组件与击发驱动螺杆之间的经螺纹联接接合处。在某些实例中，此类黏连可归因于驱动力从驱动螺杆传递到击发构件组件的位置。在各种实例中，驱动力传递的位置紧邻击发驱动螺杆的螺纹和击发构件组件的接纳螺纹出现。因为击发驱动螺杆通常被定位在仓通道钳口内，所以传递力的位置被定位成与击发构件组件的质心和/或驱动中心相距一定距离。这种力的施加可导致施加到击发构件组件的扭矩负载，该扭矩负载可导致击发驱动螺杆与击发构件组件之间的螺纹接合发生黏连。
本文公开了可将传递力的位置移动得更靠近击发构件组件的质心和/或驱动中心以减小黏连的发生的各种击发构件组件。更具体地讲，这些构型可减小击发构件组件与击发驱动螺杆之间的螺纹黏连的可能性。此类构型还可提供从击发驱动螺杆到击发构件组件、到滑动件和/或切割构件的更有效的力传递。通过击发构件组件向滑动件和/或切割构件施加更直接力可减小击发驱动螺杆所必需的过度驱动力。在击发构件组件的中心附近施加的此类直接力还可减小使用击发构件组件的上凸轮作用凸缘和下凸轮作用凸缘来维持预定义组织间隙所需的驱动力。这可归因于将施加到击发构件组件的力集中在凸轮作用凸缘的竖直中心处或中心附近。
图48和图49示出了被构造成能够在外科缝合组件(诸如本文所公开的那些)内使用的击发构件组件2000。击发构件组件2000被构造成能够由击发驱动螺杆致动以切割和缝合组织。具体地，击发构件组件2000被构造成能够推动滑动件以从钉仓部署钉。在至少一个实例中，滑动件包括切割构件，该切割构件被构造成能够当击发构件组件2000被致动穿过端部执行器时切割组织。在另一个实例中，切割构件是击发构件组件的一部分。击发构件组件2000被进一步构造成能够通过提供接合端部执行器的上钳口和下钳口的凸轮作用凸缘来保持预定义组织间隙。
击发构件组件2000包括主体部分或远侧头部2010和驱动螺母2030，该驱动螺母被构造成能够配合在主体部分2010的驱动腔或容座2023内。主体部分2010包括上部部分2011，该上部部分包括钳口接合凸缘2012。上部部分2011还包括可用于从未夹紧位置夹紧钳口的远侧鼻部2013。例如，主体部分2010包括驱动表面2014，该驱动表面被构造成能够推动滑动件和/或切割构件。主体部分2010还包括下部部分2015，该下部部分包括限定驱动腔2023的近侧部分2016和远侧部分2019。近侧部分2016包括从其侧向延伸的近侧下凸缘2018和驱动螺杆管道2017。远侧部分2019包括远侧下凸缘2021和驱动螺杆管道2020。驱动螺杆管道2017、2020彼此对准并且被构造成能够接纳穿过其中的击发驱动螺杆；然而，驱动螺杆管道2017、2020不与驱动螺杆经螺纹联接。相反，驱动螺杆管道2017、2020可包括支撑通道，该支撑通道例如被构造成能够支撑与击发构件组件2000经螺纹联接的击发驱动螺杆(例如，图4和图5中的击发螺杆261)。
驱动螺母2030被构造成能够与击发驱动螺杆经螺纹联接并且被构造成能够向主体部分2010施加致动力。驱动螺母2030被构造成能够配合在驱动腔2023内。驱动螺母2030包括：下螺纹部分2035，其包括被构造成能够接合端部执行器的钳口的凸轮作用凸缘2031；螺纹通道2037，其被构造成能够与击发驱动螺杆经螺纹联接；和近侧突起部2036，其被构造成能够配合在驱动腔2023内。驱动螺母2030还包括从螺纹部分2035向上延伸的上驱动部分2040。驱动部分2040包括近侧驱动表面2041和远侧驱动表面2043。近侧驱动表面2041被构造成能够当击发构件组件2000朝近侧移动时在驱动腔2023的近侧驱动表面2025上推动，并且远侧驱动表面2043被构造成能够当击发构件组件2000朝远侧移动时在驱动腔2023的远侧驱动表面2024上推动。
如图49中可见，驱动螺母2030被构造成能够相对于纵向螺杆轴线SA偏心地向主体部分2010施加驱动力DF。纵向螺杆轴线SA由通过被构造成能够致动击发构件组件2000的驱动螺杆的纵向中心线限定。纵向螺杆轴线SA也可与通过管道2017、2020限定的纵向中心线同义。
在至少一个实例中，驱动螺母2030包括与主体部分2010基本上类似的剖面轮廓。驱动部分2040被构造成能够远离击发驱动螺杆和螺纹2037和/或相对于该击发驱动螺杆和螺纹离轴地将轴向驱动力施加到主体部分2010。
图50和图51示出了包括击发构件组件2000的主体部分2010和驱动螺母2130的击发构件组件2100。除了驱动螺母2100之外，击发构件组件2100类似于击发构件组件2000。驱动螺母2100被构造成能够配合在主体部分2010的驱动腔2023内。与驱动螺母2030不同，驱动螺母2130不包括近侧突起部。驱动螺母2130包括：下螺纹部分2135，其包括被构造成能够接合端部执行器的钳口的凸轮作用凸缘2131；和螺纹通道2137，其被构造成能够与击发驱动螺杆经螺纹联接。驱动螺母2130还包括从螺纹部分2135向上延伸的上驱动部分2140。驱动部分2140包括近侧驱动表面2141和远侧驱动表面2143。近侧驱动表面2141被构造成能够当击发构件组件朝近侧移动时在驱动腔2023的近侧驱动表面2025上推动，并且远侧驱动表面2043被构造成能够当击发构件组件朝远侧移动时在驱动腔2023的远侧驱动表面2024上推动。驱动部分2140还包括上表面2145。上表面2145不邻接驱动腔2023内的主体部分2010。设想了其中上表面2145邻接驱动腔2023内的主体部分2010的实施方案。在至少一个实例中，凸缘2131被构造成能够防止驱动螺母2130在致动期间与击发驱动螺杆一起旋转。
图52示出了包括击发构件组件2000的主体部分2010和驱动螺母2130的击发构件组件2200。除了焊接部2251、2253、2255之外，击发构件组件2100类似于击发构件组件2100。与击发构件组件2100不同，焊接部2251、2253、2255在驱动腔2023内提供强制附接机构以将驱动螺母2130附接到主体部分2010。换句话讲，驱动螺母2130被焊接到主体部分2010。焊接可在驱动螺母2130被定位在驱动腔2023内并螺纹连接到击发驱动螺杆之后进行。驱动螺母2130的螺纹部分2135被焊接到主体部分2010的近侧部分2016和主体部分2010的远侧部分2019。驱动部分2140的上表面2045也焊接到主体部分2010。这些焊接部可向击发构件组件2200提供强度。
图53至图56示出了包括通道钳口2310、包括螺纹2321的击发驱动螺杆或旋转驱动构件2320、以及击发构件组件2330的缝合组件2300。击发构件组件2330类似于上文所讨论的击发构件组件；然而，击发构件组件2330包括不同的驱动螺母和用于将驱动螺母附接到主体部分的附接装置。如图53中可见，击发构件组件2330经螺纹联接到击发驱动螺杆2320的螺纹2321。击发驱动螺杆2320被构造成能够支撑在通道钳口2310内。击发构件组件2330被构造成能够相对于通道钳口2310朝近侧和朝远侧致动通过击发行程。
击发构件组件2330包括主体部分2331和驱动螺母2360，该驱动螺母被构造成能够配合在主体部分2331的驱动腔或容座2343内。主体部分2331包括上部部分2332，该上部部分包括砧座接合凸缘2333。上部部分2332还包括可用于从未夹紧位置夹紧砧座钳口的远侧鼻部2334。例如，主体部分2331包括驱动表面2335，该驱动表面被构造成能够推动滑动件和/或切割构件。主体部分2331还包括下部部分2336，该下部部分包括限定驱动腔2343的近侧部分2337和远侧部分2339。近侧部分2337包括从其侧向延伸的近侧下凸缘2338和驱动螺杆管道。远侧部分2339包括远侧下凸缘2341和驱动螺杆管道2340。凸缘2338、2341被构造成能够接合通道钳口2310以肯定地保持砧座钳口和通道钳口2310之间的一致组织间隙。近侧部分2337的驱动螺杆管道和驱动螺杆管道2340彼此对准并且被构造成能够以不通过螺纹的方式接纳穿过其中的击发驱动螺杆2320。
驱动螺母2360包括被构造成能够通过螺纹2366与击发驱动螺杆2320经螺纹联接的螺纹部分2365和驱动部分2070。驱动螺母2360还包括下凸轮作用凸缘2361，该下凸轮作用凸缘也被构造成能够在击发行程期间以凸轮方式接合通道钳口2310。驱动部分2370包括从螺纹部分2365向上延伸的侧向相对突片2371。驱动突片2371被构造成能够支承或跨过从主体部分2331向下延伸并进入驱动腔2343中的对应驱动突片2350。驱动部分2370还包括内部交叉构件或支架2372，其将突片2371彼此连接并且将驱动部分2370固定或附接到驱动突片2350并且因此固定或附接到主体部分2331。交叉构件2372被构造成能够被接纳在驱动突片2350中限定的驱动狭槽2351内。当驱动螺母2360被致动时，力可从交叉构件2372到狭槽2351内的驱动突片2350施加到主体部分2331。此类构型可相对于驱动螺杆2320偏心地且更靠近击发构件组件2330的中心地向主体部分2331提供驱动力。换句话讲，驱动螺母2360可相对于驱动螺杆2320的纵向轴线偏心地向主体部分2331施加驱动力。例如，这可在图53中看到。驱动螺母2360可相对于纵向螺杆轴线SA偏心地向主体部分2310施加驱动力DF。
驱动突片2350还包括在驱动螺母2360中限定的内部通道2367内从其向下延伸的一对驱动齿2353。驱动齿2353被构造成能够直接与驱动螺杆2320的螺纹2321配合。齿2353可增强作为整体的击发驱动螺杆2320和击发构件组件2330的螺纹接合。
在至少一个实例中，驱动螺母2360被嵌件模制在驱动螺杆2320上方。这允许驱动螺母的复杂形状并且允许驱动螺母2360与主体部分2331之间的精细调节的接合特征部。此类接合特征部例如包括交叉构件2372。一旦被模制在驱动螺杆2320上方并穿过狭槽2351，驱动螺母2360被永久地固定到主体部分2331，尽管破坏驱动螺母2360以从主体部分2331移除驱动螺母2360。
在至少一个实例中，驱动螺母2360卡合到驱动突片2350。例如，驱动螺母2360可在对应于内部通道2367的材料中包括一定程度的柔性和制造的裂口或断裂，从而允许驱动螺母2360围绕驱动突片2350展开并且卡合到其上。在至少一个实例中，驱动螺母2360在驱动突片2350与交叉构件2372的一侧之间分离，使得驱动突片2359可被撬开以将交叉构件2372定位到狭槽2351中。
在至少一个实例中，交叉构件2372被构造成能够在如果驱动螺杆2320与驱动螺母2360之间的击发力超过预定阈值时剪切掉驱动螺母2360。此类构型可提供安全特征部以便当击发构件组件经受高于正常的负载时不会过度驱动击发构件组件通过击发行程。
图57至图61示出了击发构件组件2400。击发构件组件2400类似于上文所讨论的击发构件组件；然而，击发构件组件2400包括不同的驱动螺母和用于将驱动螺母附接到主体部分的附接装置。击发构件组件2400还包括用于与模制工具一起使用的配准特征部。击发构件组件2400被构造成能够经螺纹联接到击发驱动螺杆，并且被构造成能够通过击发驱动螺杆朝近侧和朝远侧致动通过击发行程。
击发构件组件2400包括主体部分或远侧头部2410和驱动螺母2450，该驱动螺母被构造成能够配合在主体部分2410的驱动腔或容座2430内。主体部分2410包括上部部分2411，该上部部分包括钳口接合凸缘2412。上部部分2411还包括可用于从未夹紧位置夹紧砧座钳口的远侧鼻部2413。例如，主体部分2410还包括驱动表面2414，该驱动表面被构造成能够推动滑动件和/或切割构件。主体部分2410还包括下部部分2415，该下部部分包括限定驱动腔2430的近侧部分2416和远侧部分2420。近侧部分2416包括从其侧向延伸的近侧下凸缘2417和驱动螺杆管道2418。远侧部分2420包括远侧下凸缘2421和驱动螺杆管道2422。凸缘2417、2421被构造成能够接合端部执行器的钳口以肯定地保持钳口与端部执行器的另一钳口之间的一致组织间隙。驱动螺杆管道2418、2422彼此对准并且被构造成能够以不通过螺纹的方式接纳穿过其中的击发驱动螺杆。如下文更详细讨论的，近侧部分2416和远侧部分2420各自包括被构造成用于在包覆模制和/或嵌件模制过程中使用的配准孔2423。
驱动螺母2450包括被构造成能够通过螺纹2453与击发驱动螺杆经螺纹联接的螺纹部分或从动部分2451并且包括驱动部分2460。驱动螺母2450还包括下凸轮作用凸缘2452，该下凸轮作用凸缘也被构造成能够在击发行程期间以凸轮方式接合端部执行器钳口。驱动螺母2450包括基本上梯形的形状。下文更详细地讨论，击发构件组件2400包括限定在近侧部分2416与螺纹部分2451的近侧驱动表面2454之间的近侧间距空隙或纵向空间2431，以及限定在远侧部分2420与螺纹部分2451的远侧驱动表面2455之间的远侧间距空隙或纵向空间2455。
驱动部分2460包括从螺纹部分2451向上延伸的侧向相对突片2461。应当理解，除了螺纹2453之外，主体部分2410和驱动螺母2450相对于由主体部分2410限定的竖直平面是对称的。驱动突片2461被构造成能够支承或跨过从主体部分2410向下延伸并进入驱动腔2430的上部部分2433中的对应驱动突片2440。驱动部分2060还包括在多个突片2461之间延伸的多个内部交叉构件或肋2463。肋2463将驱动部分2460固定或附接到驱动突片2440并因此固定或附接到主体部分2410。肋2463被构造成能够被接纳在驱动突片2440中限定的多个对应孔2441内。当驱动螺母2450被致动时，力可从肋2463到狭槽2441内的驱动突片2440施加到主体部分2410。此类构型可相对于被定位在螺纹通道2453内的驱动螺杆偏心地且更靠近击发构件组件2400的中心地向主体部分2331提供驱动力。如图57和图60中可见，驱动螺母2450可相对于纵向螺杆轴线SA偏心地向主体部分2410施加驱动力DF。
驱动螺母2450的突片2461被进一步构造成能够将力施加到驱动腔2430的上部部分2433内的主体部分2410，施加到近侧驱动表面2443和远侧驱动表面2445。这些附加驱动表面还可使对主体部分2410的驱动力施加更靠近击发构件组件2400的中心集中。
如上文所讨论，击发构件组件2400包括被定位在驱动螺母2450的螺纹部分2451与主体部分2410的近侧部分2416和远侧部分2420之间的间距空隙2431、2432。间距空隙被构造成能够进一步将击发构件组件2400内的驱动力施加从驱动螺母2450集中到主体部分2410。间距空隙2431、2432防止螺纹部分2451接触主体部分2410的近侧部分2416和远侧部分2420，由此防止紧邻被构造成能够驱动击发构件组件2400的驱动螺杆的驱动力施加。
间距空隙2431、2432还可被构造成能够控制驱动螺母2450的总体偏转。在各种实例中，击发驱动螺杆可相对于其所位于的端部执行器偏转。这尤其可归因于在击发行程期间施加到端部执行器的钳口的夹紧力。值得注意的是，当驱动螺杆偏转时，由于驱动螺母2450与击发驱动螺杆之间的螺纹接合，驱动螺母2450将被推动以便连同驱动螺杆一起相对于主体部分2410偏转或旋转。梯形形状和间距空隙2431、2432提供一定程度的灵活性或宽容性以供驱动螺母2450与击发驱动螺杆一起偏转和旋转。允许击发构件组件2400内的这种宽容性可有助于防止驱动螺母2450与击发螺杆之间的螺纹接合的黏连。例如，刚性击发组件和驱动螺母的组合可提供很少的灵活性甚至没有灵活性，从而进一步增加例如螺纹黏连的可能性。在某些情况下，击发构件组件的其他部件(诸如上文所讨论的凸轮作用凸缘和/或驱动交叉构件)可由于端部执行器组件内的弯曲和/或剪切力而弹性变形。在至少一个实例中，除了驱动螺母2450之外或代替驱动螺母，驱动腔2430包括梯形形状。
在至少一个实例中，驱动螺母2450被嵌件模制在驱动螺杆上方。这允许驱动螺母的复杂形状并且允许驱动螺母2450与主体部分2410之间的精细调节的接合特征部。此类接合特征部例如包括肋2463。在至少一个实例中，驱动螺母2450被包覆模制到主体部分2410上。
如上文所讨论，近侧部分2416和远侧部分2420各自包括被构造成用于在包覆模制和/或嵌件模制过程中使用的配准孔2419、2423。配准孔2419、2423被构造成能够将主体部分2410保持在模制工具内并且在管道2418、2020的赤道或中心处对准。这种定位可帮助将用于驱动螺母2450的模具与管道2418、2020对准以用于制造，使得驱动螺母2450并且具体地螺纹部分2451与管道2418、2020对准。这种对准确保了在组装时击发驱动螺杆在管道2018、2020和螺纹部分2451内对准。在至少一个实例中，击发驱动螺杆和主体部分2410均在模制驱动螺母2450之前被呈现。在此类实例中，驱动螺母2450可围绕预先放置的主体部分2410和击发驱动螺杆模制。在至少一个实例中，在模制驱动螺母2450之前仅呈现主体部分2410。
图62至图66示出了击发构件组件2500。击发构件组件2500类似于上文所讨论的击发构件组件；然而，击发构件组件2500包括驱动螺母组件，该驱动螺母组件包括外部驱动部分2550和被定位在外部驱动部分2550内的内部驱动螺母2560。击发构件组件2500被构造成能够经螺纹联接到击发驱动螺杆，并且被构造成能够通过端部执行器组件内的击发驱动螺杆朝近侧和朝远侧致动通过击发行程。
击发构件组件2500包括主体部分2510和驱动螺母组件，该驱动螺母组件被构造成能够配合在主体部分25510的驱动腔或容座2530内。主体部分2510包括上部部分2511，该上部部分包括砧座接合凸缘2512。上部部分2511还包括可用于从未夹紧位置夹紧砧座钳口的远侧鼻部2513。例如，主体部分2510还包括驱动表面2514，该驱动表面被构造成能够推动滑动件和/或切割构件。主体部分2510还包括下部部分2515，该下部部分包括限定驱动腔2530的近侧部分2516和远侧部分2520。近侧部分2516包括从其侧向延伸的近侧下凸缘2517和驱动螺杆管道2518。远侧部分2520包括远侧下凸缘2521和驱动螺杆管道2522。凸缘2517、2521被构造成能够接合端部执行器的钳口以肯定地保持钳口与端部执行器的另一钳口之间的一致组织间隙。驱动螺杆管道2518、2522彼此对准并且被构造成能够以不通过螺纹的方式接纳穿过其中的击发驱动螺杆。
如上文所讨论，驱动螺母组件包括外部驱动部分2550和被定位在外部驱动部分2550内的内部驱动螺母2560。在至少一个实例中，内部驱动螺母2560包括例如由金属材料构成的原料驱动螺母。在至少一个实例中，外部驱动部分2550例如由聚合物构成并且在击发构件组件2500内包覆模制和/或嵌件模制。在此类实例中，驱动螺母组件包括混合多材料驱动螺母组件并且在某些实例中可具有超材料特性。在至少一个实例中，外部驱动部分2560被插入模制到内部驱动螺母2550，并且然后驱动螺母组件被定位在驱动腔2530内以用于组装到击发驱动螺杆和主体部分2510。无论如何，驱动螺母组件包括多件式布置。
外部驱动部分2550包括下部部分2551，该下部部分包括凸缘2552。下部部分2551被构造成能够围绕内部驱动螺母2560并且将其固定驱动螺母组件内。外部驱动部分2550还包括被定位在驱动腔2530的上部部分内的驱动突片部分2553。驱动腔2530还包括被定位在驱动突片2553和主体部分2510之间的间距狭槽2531。此类间距狭槽2531可允许驱动螺母组件与击发驱动螺杆一起相对于主体部分2510浮动。在此类实例中，主体部分2510可由端部执行器组件的各种元件(例如，砧座钳口和通道钳口)约束。
如上文所讨论，外部驱动部分2550被构造成能够将内部驱动螺母2560固定在其中并且与螺杆轴线SA共线。螺杆轴线SA被限定为管道2518、2522和内驱动螺母2560的主要圆柱形部分2561的中心。螺纹2562被限定在内部驱动螺母2560的主要圆柱形部分2561中。螺纹2562被构造成能够与击发驱动螺杆的螺纹进行螺纹接合或联接。内部驱动螺母2560还包括多排2563的抓持特征部2564，该抓持特征部被构造成能够在驱动螺杆旋转期间防止内部驱动螺母2560相对于外部驱动部分2550旋转。外部驱动部分2550可在模制过程期间包封内部驱动螺母2560。内部驱动螺母2560还包括张开近侧端部2565。张开近侧端部2565可帮助击发构件组件2500与击发驱动螺杆的组装。例如，击发驱动螺杆可通过管道2518插入并且由扩张近侧端部2565引导到内部驱动螺母2560的螺纹2562中。
在至少一个实例中，抓持特征部2564可有助于驱动螺母组件的制造过程。例如，抓持特征部2564可配合到被构造成能够在外部驱动部分2550的模制期间保持驱动螺母2560的模具的对应狭槽中。
图67示出了击发构件组件2600。击发组件2600类似于上文所讨论的击发构件组件；然而，击发构件组件2600包括被构造成能够通过击发行程进一步支撑击发构件组件2600的近侧尾部延伸部。击发构件组件2600被构造成能够经螺纹联接到击发驱动螺杆，并且被构造成能够通过端部执行器组件内的击发驱动螺杆朝近侧和朝远侧致动通过击发行程。
击发构件组件2600包括主体部分2610和驱动螺母2630。主体部分2610包括上部部分2611和下部部分2615。上部部分2611包括砧座-凸轮作用凸缘2612。上部部分2611还包括被构造成能够将端部执行器的钳口从打开位置闭合到闭合位置的远侧鼻部2613。例如，主体部分2610还包括驱动表面2614，该驱动表面被构造成能够推动滑动件和/或切割构件。下部部分2615包括近侧部分2616，该近侧部分包括近侧下凸缘2617和近侧尾部延伸部2618。下部部分2615还包括远侧部分2620，该远侧部分包括远侧下凸缘2621。凸缘2617、2621、2612可被构造成能够在击发构件组件2600的整个击发行程中保持钉仓与砧座之间的预定义组织间隙。
近侧尾部延伸部2618是近侧部分2616的螺杆管道(诸如上文所讨论的那些螺杆管道)的延伸部。此类近侧尾部延伸部还可通过击发行程支撑击发构件组件2500。此类近侧尾部延伸部还可抵抗主体部分2610的偏转或旋转，该偏转或旋转可致使驱动螺母2630与击发驱动螺杆之间的螺纹接合进行黏连。
图68至图72示出了与击发驱动螺杆2701经螺纹联接的击发构件组件2700。击发组件2700类似于上文所讨论的击发构件组件；然而，击发构件组件2700包括主体部分2710和可卡合到主体部分2710的驱动螺母2750。击发构件组件2700被构造成能够通过端部执行器组件内的击发驱动螺杆2701朝近侧和朝远侧致动通过击发行程。
主体部分2710包括限定驱动腔2730的上部部分2711和下部部分2715。驱动螺母2750被构造成能够被定位在驱动腔2730内。上部部分2711包括钳口-凸轮作用凸缘2712。上部部分2711还包括被构造成能够将端部执行器的钳口从打开位置闭合到闭合位置的远侧鼻部2713。例如，主体部分2710还包括驱动表面2714，该驱动表面被构造成能够推动滑动件。下部部分2715包括近侧部分2716，该近侧部分包括近侧下凸缘2717。下部部分2715还包括远侧部分27720，该远侧部分包括远侧下凸缘2721和限定在其中的被构造成能够以不通过螺纹的方式接纳击发驱动螺杆2701的驱动螺杆管道2722。凸缘2617、2721、2712可被构造成能够在击发构件组件2700的整个击发行程中保持钉仓与砧座之间的预定义组织间隙。
在至少一个实例中，驱动螺杆管道2722和/或驱动螺杆管道的近侧部分的轮廓或周边可以是例如椭圆形和/或长方形或非圆形。此类构型可减小偏转的驱动螺杆在螺杆管道内摩擦或干涉的可能性，此类摩擦或干涉在此类驱动螺杆偏转的情况下可导致堆叠损失。堆叠损失可指将在驱动螺杆实质上偏转的场景中导致各种干涉的驱动螺杆与系统内的其他部件的各种有问题的接合。例如，如果驱动螺杆基本上偏转，则例如，如上文所讨论，偏转的驱动螺杆可摩擦驱动螺杆管道，偏转的驱动螺杆可致使驱动螺母的螺纹黏连，和/或偏转的驱动螺杆可在其与击发输出轴的连接部附近黏连。例如，提供最小化此类堆叠损失的特征部可防止部件的过早故障和/或减小驱动击发构件组件所需的击发力。
在至少一个实例中，驱动螺杆管道2722和/或驱动螺杆管道的近侧部分包括圆角或倒角边缘。此类构型可进一步减小管道与击发驱动螺杆接触并黏连的可能性。
在至少一个实例中，主体部分的螺杆管道可向驱动螺杆提供侧向和/或竖直支撑，使得如果驱动螺杆被加载到足以引起驱动螺杆的弯曲，则驱动螺杆管道可防止驱动螺杆至少在螺纹驱动螺母附近弯曲。此类构型可帮助防止驱动螺杆和螺纹驱动螺母的螺纹之间的黏连。
在至少一个实例中，钉仓的滑动件可包括从滑动件的远侧端部延伸的朝远侧延伸的托架支撑特征部。托架支撑特征部还可支撑击发驱动螺杆并且帮助防止击发驱动螺杆至少在托架支撑特征部附近的弯曲。在至少一个实例中，滑动件防止驱动螺杆仅在一个方向上的弯曲。在至少一个实例中，除了远侧托架支撑特征部之外或代替远侧托架支撑特征部，滑动件还包括近侧托架支撑特征部。
驱动螺母2750包括钳口接合凸缘2751、被构造成能够通过螺纹2756与击发驱动螺杆2701经螺纹联接的螺纹部分2755、以及从螺纹部分2755向上延伸的侧向相对的驱动突片2760。驱动螺母2750包括基本上梯形的形状，诸如本文所讨论的包括梯形形状的那些驱动螺母。
驱动突片2760被构造成能够支承或跨过从主体部分2710向下延伸的对应驱动突片2740。驱动突片2760在它们之间限定狭槽2761并且各自包括从其向内突出的卡合凸块2762。每个卡合凸块2762包括倾斜上表面2763和闩锁表面2764。如图71中可见，驱动突片2760被构造成能够卡合到主体部分2710的驱动突片2740。具体地，驱动突片2740包括限定在其中的水平延伸的狭槽2741，并且卡合凸块2762被构造成能够在驱动螺母2750与主体部分2710的安装期间使驱动突片2760加宽到足以使得闩锁表面2764离开驱动突出部分2740并且可向内偏置到狭槽2741中。在至少一个实例中，卡合凸块2762不被构造成能够将任何纵向驱动力从击发驱动螺杆2701传递到主体部分2710。相反，驱动突片2760被构造成能够配合在驱动腔2730内，使得驱动突片2760相对于击发驱动螺杆直接推拉主体部分2710，类似于本文所讨论的各种击发构件组件。此类构型可减轻对驱动螺母2750的内部交叉构件的依赖以将击发力从击发驱动螺杆2701传递到主体部分2710。这可以是有利的，因为驱动螺母2750可通过比正常负载更高的负载通过驱动凸块2762保持附接到主体部分2710。类似于本文所讨论的各种驱动突片，驱动螺母2750的驱动突片2760被进一步构造成能够向更靠近主体部分2710的中心向主体部分2710施加力。如图69中可见，驱动螺母2750被构造成能够相对于纵向螺杆轴线SA离轴地将驱动力DF施加到主体部分2710。
在至少一个实例中，驱动螺母2750在被卡合到主体部分2710上之前被注射模制。在至少一个实例中，驱动螺母2750被插入模制到主体部分2710和击发驱动螺杆2701上。在此类实例中，例如，如果驱动螺母2750随时间推移而磨损，则驱动螺母2750可被折断并替换。
图73示出了击发构件组件2800，该击发构件组件包括主体部分2810和驱动螺母2850，该驱动螺母被构造成能够经螺纹联接到击发驱动螺杆。击发构件组件2800类似于上文所讨论的各种击发构件组件；然而，击发构件组件2800还包括驱动腔2830，该驱动腔被构造成能够允许主体部分2810在击发驱动行程期间挠曲，如下文更详细地讨论的。
主体部分2810包括上部部分2811，该上部部分包括凸缘2812和远侧鼻部2813，该凸缘从该上部部分侧向延伸，该远侧鼻部被构造成能够在闭合行程期间从打开位置闭合钳口。例如，主体部分2810还包括驱动表面2814，该驱动表面被构造成能够推动滑动件和/或切割构件通过钉击发行程。设想了其他实施方案，其中在主体部分2810的前部上的各种其他表面被构造成能够驱动各种部件，诸如例如滑动件和/或切割构件。主体部分2810还包括下部部分2815，该下部部分包括具有近侧下凸缘2817的近侧部分2816和具有远侧下凸缘2821的远侧部分2820。共同地，凸缘2812、2817、2821被构造成能够在击发行程期间肯定地使相对的钳口间隔开，并且在相对的钳口之间保持一致的组织间隙。
驱动螺母2850被定位在驱动腔2830内，并且被构造成能够经螺纹联接到击发驱动螺杆。驱动螺母2850被构造成能够在击发驱动螺杆被致动时向主体部分2810施加轴向驱动力，以使击发构件组件2810在端部执行器内朝近侧和朝远侧移动。驱动腔2830包括下部部分2833，驱动螺母2850主要被定位在其中并且被构造成能够在其内浮动，并且包括上部三角形部分2831。上部三角形部分2831被构造成能够允许主体部分2810在击发行程期间挠曲。例如，在夹紧负载下，三角形部分2831被构造成能够允许近侧部分2816远离远侧部分2820纵向挠曲。此类挠曲可在击发构件组件2800内提供容差，以便例如防止黏连。除了主体部分2810的挠曲之外，驱动螺母2850被构造成能够在驱动腔2850内浮动。共同地，此类布置可减少螺纹连接之间的黏连接合和/或凸缘与钳口之间的黏连接合。
本文所公开的各种驱动螺母包括与主体部分的下部部分的近侧和远侧下凸缘对准的侧向延伸的凸缘。此类凸缘可防止驱动螺母随着击发驱动螺杆一起旋转。此类凸缘可包括圆形底部，以便减少与对应的钳口的黏连接合。例如，近侧和远侧下凸缘可被构造成能够处理大部分夹紧负载，而驱动螺母凸缘被设置用于支撑驱动螺母，但不必处理高夹紧负载。使凸缘圆化可减少与对应的钳口的整体接触，从而减少凸缘与对应的钳口黏连的可能性。在此类实例中，驱动螺母的凸缘或侧向翅片被构造成能够在对应的钳口(诸如通道钳口)内是松散的。凸缘与对应的钳口之间的这种松散接合可提供防旋转特征，而不需要凸缘处理高夹紧负载。在至少一个实例中，侧向翅片整体上更薄并且包括顶部边缘，该顶部边缘被定位在主体部分的对应的近侧和远侧下凸缘的顶部边缘下方。
在至少一个实例中，主体部分由金属材料机加工而成，并且驱动螺母由聚合物和/或塑料材料注射模制、嵌入模制或包覆模制而成。此类构型可降低制造成本和机加工复杂性，因为各种模制工艺可允许更复杂的几何形状和形状。各种模制工艺还可允许部件组装和制造的各种次序。如上所讨论，嵌入模制允许多材料击发构件组件包括各种材料以及不同的材料之间的复杂整合的几何形状。此外，例如，嵌入模制允许在模制驱动螺母之前将击发驱动螺杆定位在击发构件组件内。
图74至图78示出了被构造成能够切割和缝合患者的组织的端部执行器组件3000。端部执行器组件3000包括第一钳口3010和能够相对于第一钳口3010移动的第二钳口3020。设想了其中第一钳口3010能够相对于第二钳口3020移动的实施方案。第一钳口3010包括仓通道3100和被构造成能够可移除地被定位在仓通道3100内的可替换钉仓3300。第二钳口3020包括砧座3200，该砧座被构造成能够在钉击发行程期间使可移除地储存在钉仓3300中的钉变形。第二钳口3020能够相对于第一钳口3010移动或枢转，以将组织夹紧在砧座3200与钉仓3300之间。一旦组织被夹紧在砧座3200与钉仓3300之间，就利用端部执行器组件3000的击发组件3400击发端部执行器组件3000以射出钉并且切割组织。
下面更详细地讨论，击发组件3400包括支撑在仓通道3100内的击发驱动螺杆3401。击发组件3400还包括经螺纹联接到击发驱动螺杆3401的击发构件组件3409，该击发构件组件被构造成能够在击发行程期间推动滑动件以从钉仓3300部署钉，在击发行程期间推动切割构件以切割组织，并且在击发行程期间在钉仓3300与砧座3200之间保持一致的组织间隙。
仓通道3100包括纵向通道腔3111，钉仓3300可移除地被定位在该纵向通道腔内。仓通道3100还包括侧壁3113，该侧壁被构造成能够支撑钉仓3300。在至少一个实例中，钉仓包括被构造成能够搁置在侧壁3113的顶部上的凸缘。仓通道3100还包括基部部分3120。基部部分3120包括内部底表面3121和凸轮作用凸耳3123。纵向狭槽3125限定在凸轮作用凸耳3123之间并且被构造成能够接纳穿过其中的击发组件3400的至少一部分。
砧座3200包括主体部分3210和砧座帽3220，该砧座帽被构造成能够在纵向通道3212内附接到主体部分3210。主体部分3210包括砧座表面3211。砧座表面3211包括与限定在钉仓主体3310的平台3311中的钉腔3312对准的多个钉成形凹坑。主体部分3210还包括侧向向内延伸到纵向通道3212中并且在其间限定纵向狭槽3225的凸轮作用凸耳3213。下面更详细地讨论，凸轮作用凸耳3123、3213被构造成能够由击发构件组件3409的对应的凸缘协作地接合，以肯定地使钳口3010、3020相对于彼此间隔开。在至少一个实例中，在击发行程期间，通过击发构件组件3409的凸缘与凸轮作用凸耳3213、3123的接合，在仓平台3311与砧座表面3211之间限定预定义的组织间隙。
钉仓3300还包括被构造成能够延伸每个钉腔3312的有效高度的平台突起部或凹坑扩展部3314。平台突起部3314可被构造成能够帮助抓持夹紧在钳口3010、3020之间的组织。钉仓3300还包括纵向狭槽3315，该纵向狭槽被构造成能够接纳穿过其中的击发构件组件3409的至少一部分。如上所讨论，滑动件和/或切割构件被构造成能够被推进穿过钳口3010、3020以切割组织并且在钉击发行程期间利用击发组件4400击发钉。
击发组件3400包括击发驱动螺杆3401和经螺纹联接到击发驱动螺杆3401的击发构件组件3409。击发构件组件3409包括主体部分3410、被构造成能够经螺纹联接到击发驱动螺杆3401的驱动螺母3450，以及后支撑支架3430。主体部分3410包括上部部分3411，该上部部分包括砧座接合凸缘3412和远侧鼻状部分3413。砧座接合凸缘3412被构造成能够在纵向通道3212内移动，并且更具体地，被构造成能够向凸轮作用凸耳3213的上表面3214施加夹紧压力。在至少一个实例中，砧座帽3220被构造成能够为砧座-凸轮作用凸缘3412提供上部边界。尽管如此，砧座凸轮作用凸缘3412被构造成能够在击发行程期间在纵向通道3212内移动以向其施加凸轮作用力，以确保仓平台3311与砧座表面3211之间的一致的组织间隙距离。
主体部分3410还包括下部部分3415，该下部部分包括近侧部分3416，该近侧部分包括通道-凸轮作用凸缘3417和被构造成能够以以不通过螺纹的方式接纳穿过其中的击发驱动螺杆3401的螺杆管道3418。下部部分3415还包括远侧部分3420，该远侧部分包括通道-凸轮作用凸缘3421和被构造成能够以以不通过螺纹的方式接纳击发驱动螺杆3401的螺杆管道3422。驱动螺母3450被构造成能够适配在近侧部分3416与远侧部分3420之间。驱动螺母3450包括螺纹部分3451，该螺纹部分被构造成能够经螺纹联接到击发驱动螺杆3401并且包括通道-凸轮作用凸缘3452。在至少一个实例中，通道-凸轮作用凸缘3452包括厚度，该厚度小于通道-凸轮作用凸缘3417、3421的厚度。驱动螺母3450还包括朝向主体部分3410向上延伸的驱动突片3460。驱动螺母3450被构造成能够朝近侧和朝远侧向主体部分3410施加轴向驱动力，以使击发构件组件3409移动穿过钳口3010、3020。通道-凸轮作用凸缘3417、3452、3421被构造成能够向凸轮作用凸耳3123施加凸轮作用力。共同地，凸轮作用凸缘3412和凸缘3417、3452、3421被构造成能够在仓平台3311与砧座表面3211之间保持一致的组织间隙距离。
击发构件组件可受到会导致偏心力矩负载的负载。例如，在某些实例中，诸如当厚的和/或韧的组织被夹紧在钳口之间时，与上凸轮作用凸缘3412接合的砧座凸耳可将偏心力矩负载施加到击发构件3400。有利的是提供一种用于抵消此类偏心力矩负载的装置。击发构件组件3409包括从主体部分3410的上部部分3411成一角度朝近侧延伸的后支撑支架3430。后支撑支架3430包括撑条构件3431和从撑条构件3431延伸的弓形支架部分3433。弓形支架部分3433包括侧向延伸的凸缘3435，该凸缘被构造成能够支撑后支撑支架3430并且抵消主体部分3410的力矩负载。凸缘3435被构造成能够骑靠在内部底表面3121上。值得注意的是，凸缘3435骑跨在凸轮作用凸耳3123上方，使得后支撑支架3430的凸缘3432和通道-凸轮作用凸缘3421接触通道3100的基部部分3120的相对侧。
在至少一个实例中，如果主体部分3410被加载并且引起相反方向上的旋转，则凸缘3435可提供柔性以提升离开内部底表面3121并且抵抗砧座-凸轮作用凸缘3412脱离与纵向通道3214的基本上平行对准的扭转。后支撑支架3430可被构造成能够提供一定程度的柔性，以便在加载期间允许主体部分3410的一些挠曲，同时防止将在驱动螺母3450与击发驱动螺杆3401之间螺纹接合的情形下导致黏连的挠曲量值。在某些实例中，后支撑支架3430可充当用于平衡负载的弹簧特征部。
设想了其中凸缘3435被定位在凸耳3123下方的实施方案。还设想了其中提供两组凸缘的实施方案。一组凸缘可被定位在凸耳3123上方，并且一组凸缘可被定位在凸耳3123下方。
在各种实例中，后支撑支架3430充当击发构件组件3409的弹簧构件以平衡击发构件组件3409所经历的各种负载。此外，在弓形支架部分3433与击发驱动螺杆3401之间提供间隙。此类构型可防止例如工字梁滚动，并且在整个钉击发行程中平衡工字梁或击发构件组件。设想了其中弓形支架部分3433也带有螺纹并且经螺纹联接到击发驱动螺杆3401的实施方案。
在各种实例中，可优化各种击发构件部件的几何形状。参考图78，例如，主体部分3410的中央部分的长度被称为主体长度BL，并且下凸缘3417、3421的长度共同地被称为销长度PL。一般来讲，销长度PL大约是主体长度BL的长度的两倍。这也适用于上凸缘3412。然而，在某些实例中，上凸缘3412例如可包括比主体长度BL的两倍更短的销长度，至少因为后支撑支架3430可帮助防止上凸缘3412在负载下旋转和/或偏转。在各种实例中，销长度越长，对应的凸缘将越可能黏连在其狭槽内。在此类实例中，凸缘被定位在其中的间隙槽应当更小，以便减少凸缘与间隙狭槽之间的黏连。
图79和图80示出了类似于上面讨论的那些的外科缝合组件3700。然而，除了本文所讨论的各种其他特征部之外，外科缝合组件3700还结合了三角形驱动腔切口。外科缝合组件3700包括通道钳口3710、被构造成能够接纳在通道钳口3710内的钉仓3730，以及支撑在通道钳口3710内的击发驱动螺杆3711。外科缝合组件3700还包括被构造成能够使从钉仓3730射出的钉变形的砧座钳口3720。外科缝合组件还包括击发构件组件3740，该发构件组件被构造成能够由击发驱动螺杆3711致动穿过钳口3710、3720。击发构件组件3740包括主体部分3741、后支撑支架3745和经螺纹联接到击发驱动螺杆3711的驱动螺母3743。主体部分3741包括三角形驱动腔切口3745，该三角形驱动腔切口被构造成能够在击发构件组件3740内提供附加弹簧特征部，该附加弹簧特征部被构造成能够平衡击发构件组件3740所经历的各种负载。外科缝合组件3700还包括被构造成能够在击发行程期间切割组织的刀3750和被构造成能够从钉仓3730部署钉的滑动件3760。刀3750和滑动件3760可各自经历负载并将负载传递到击发构件组件3740。
刀3750是滑动件3760的部件并且在枢轴处安装到滑动件3760。在远侧击发运动期间，刀3750可采取图79所示的直立构型，其中刀3750突出到仓体外并且其切割刃被构造成能够切割组织。在近侧击发运动期间，刀3750可采取屏蔽构型，其中刀3750的切割边缘的至少一部分被紧固件仓遮罩。刀3750可响应于击发方向和/或钉仓中的各种机械闭锁和/或偏压机构而在直立构型与遮罩构型之间枢转。
图81示出了被构造成能够在其中支撑击发驱动螺杆3801的钳口组件3800。在高负载下，击发驱动螺杆可能趋于挠曲。钳口组件3800被构造成能够防止击发驱动螺杆3801的屈曲。钳口组件包括通道钳口3810，该通道钳口包括底部3811和从底部3811延伸的通道壁3813。底部3811包括被构造成能够接纳击发驱动螺杆3801的驱动腔3815和一个或多个凸缘，诸如本文所讨论的凸轮作用凸缘。底部3811还包括从凸轮作用架3817延伸的下支撑件3816和侧向支撑件3818。下支撑件3816和侧向支撑件3818被构造成能够限制击发驱动螺杆3801在高负载下屈曲。在至少一个实例中，支撑件3816、3818仅被定位在例如击发行程的中间和通道钳口附近。由于在高负载下，击发驱动螺杆3801可能趋于在其有效长度的中心附近屈曲的事实，此类布置可能是足够的。在至少一个实例中，支撑件3816、3818可以是沿击发驱动螺杆3801和通道钳口3810的大部分长度延伸的纵向肋。支撑件3818可包括金属臂并且充当击发驱动螺杆3801的硬障碍物。
在至少一个实例中，支撑件3818包括塑料臂。在此类实例中，当击发构件组件在击发行程期间经过支撑件3818时，支撑件3818可被击发构件组件撬开而不妨碍击发构件组件。此类构型可以是有利的，至少因为一旦击发构件组件在击发行程期间到达支撑件3818的位置，击发构件组件就可以自身支撑击发驱动螺杆3801并且防止其屈曲。
在各种实例中，平衡工字梁或击发构件组件可以是有利的，以便例如优化击发构件组件在砧座凸轮作用凸缘与通道凸轮作用凸缘之间的加载。各种力被施加到击发构件组件。这些力由击发驱动螺杆和/或驱动螺母、砧座凸轮作用凸缘、通道凸轮作用凸缘、组织和/或被构造成能够部署钉的滑动件施加。平衡这些力可以是有利的，使得由驱动螺杆提供的驱动力在最佳位置处驱动击发构件组件。小于最佳的驱动力施加可能导致击发构件组件相对于击发螺杆和/或相对于由击发螺杆限定的纵向轴线的不必要的滚动、旋转和/或摇动。例如，扭转负载可能导致此类滚动、旋转和/或摇动。在某一位置处施加驱动力以最佳地抵消施加到击发构件组件的可预测的扭转负载可帮助防止击发构件组件的滚动、旋转和/或摇动。
在各种实例中，通道/砧座凸轮作用凸缘或销包括宽度和长度，该宽度和长度被构造成能够相对于其对应的狭槽进行调节，通道/砧座凸轮作用凸缘或销通过该狭槽被接纳。在至少一个实例中，凸缘沿纵向轴线的长度越大，则在其对应的凸轮作用狭槽内所需的间隙就越小。换句话讲，对应的凸轮作用狭槽可包括更紧密地接纳凸缘的几何形状。另一方面，凸缘沿纵向轴线的长度越小，在其对应的凸轮作用狭槽内所需的间隙就越大。换句话讲，对应的凸轮作用狭槽可包括更松散地接纳凸缘的几何形状。在至少一个实例中，凸缘中的一个或多个凸缘的理想长度可包括击发构件组件的主体部分的宽度的大约两倍。值得注意的是，主体部分的厚度与主体部分的被构造成能够行进穿过纵向钉仓狭槽的部分同义。
在各种实例中，本文所公开的驱动螺母被构造成能够相对于击发构件组件的主体部分上下浮动，相对于击发构件组件的主体部分上下和左右浮动，和/或相对于击发构件组件的主体部分左右浮动。驱动螺母的浮动可减小驱动螺杆与各种其他部件黏连的可能性。如上所讨论，在某些实例中，驱动螺母可刚性地焊接到主体部分。
在各种实例中，本文所公开的外科缝合组件的各种部件可按特定次序组装，以便防止意外拆卸。例如，各种部件在组装期间可在击发构件组件被引入之后被引入，否则在没有例如由击发构件组件的凸缘提供的组装保持力的情况下，各种部件将趋于掉出或被意外拆卸。例如，除了击发构件组件之外或不同于击发构件组件的部件和子组件也可提供组装保持力。例如，如本文所讨论，驱动螺杆可被预加载，并且可在组装期间提供内部组装保持力。驱动螺杆可在各种其他部件之前安装到外科缝合组件中。在某些实例中，上面讨论的组装保持力实际上可能促动一个或多个部件的意外拆卸。在此类实例中，此类部件将在某些部件之后被安装，以便确保当此类部件被安装时，整个组件在该时间点可保持组装状态，以便减少意外拆卸的可能性。
在至少一个实例中，击发构件组件的塑料和/或金属注射模制(MIM)的驱动螺母可首先组装到击发构件组件的主体部分。一旦驱动螺母被定位，则驱动螺杆可通过主体部分的对应的管道被螺纹拧入驱动螺母中。以此类方式组装允许驱动螺杆联接驱动螺母和击发构件组件的主体部，从而防止驱动螺母和主体部分的意外拆卸。
除上述以外，驱动螺杆端部然后可利用其对应的附接装置联接到其对应的支撑件。例如，所使用的任何轴承和/或弹簧可以在此时被组装。这将防止击发构件组件脱离驱动螺杆的近侧端部或远侧端部。另外，例如，如果击发构件组件被过度驱动，则推力轴承将已经存在，并且击发构件组件将例如通过推力轴承和/或通道支撑凸缘可预测地偏转通道，而不是例如仅异常地加载推力轴承和/或驱动螺杆的远侧头部部分。如果击发构件组件被推进到推力轴承和/或驱动螺杆的远侧头部部分中，则击发构件组件可将意料不到的负载施加到推力轴承和/或驱动螺杆的远侧头部部分上，并且可能导致例如推力轴承和/或远侧头部部分的过早失效。这可归因于不组装到例如其对应的通道支撑凸缘，驱动螺杆的端部被设计成能够与通道支撑凸缘相互作用且协作地加载。例如，在没有通道凸缘和通道的情况下，例如，如果在将驱动螺杆安装到通道支撑凸缘中之前驱动螺杆的远侧头部部分过早地被加载，则驱动螺杆的远侧头部部分可能被剪断。
在至少一个实例中，在驱动螺杆上的外科缝合组件的实际操作期间，击发构件组件被推进超过其最远侧位置，使得击发构件组件的凸缘可插入例如砧座、通道和/或钉仓中的其对应的狭槽内。一旦凸缘与其对应的狭槽对准，驱动螺杆就可旋转以朝近侧移动击发构件组件，从而将凸缘移动到其对应的狭槽中。例如，在此类实例中，驱动螺杆可安置在其支撑凸缘内。例如，在至少一个实例中，使用此类顺序组装方法可防止凸缘在组装期间从其对应的狭槽中松脱。
例如，在至少一个实例中，被定位在端部执行器组件的近侧端部内的各种支撑件被构造成能够支撑击发驱动螺杆的近侧端部并且被构造成能够支撑与仓通道互锁的闭合驱动螺杆。在此类实例中，在各种支撑件被定位在仓通道中之后，砧座可被引入到端部执行器组件并且利用枢转销销接到仓通道。枢轴销自身可防止竖直脱离负载使端部执行器组件的各种部件脱离接合。在此类实例中，侧向通道壁连同侧向组织止挡件、被构造成能够在夹紧组织时横跨侧向通道壁的砧座的侧壁可防止侧向脱离负载使端部执行器组件的各种部件脱离接合。在各种实例中，端部执行器组件被构造成能够使得每个部件和子组件以一种唯一的顺序方式可组装和可拆卸。这将确保系统可以仅一种方式组装，该方式提供支撑并且防止在组装期间的意外拆卸。
在各种实例中，本文所讨论的外科缝合组件的一个或多个部件可3D打印而成。更具体地，此类部件可使用基于石墨的选择性激光烧结工艺来制造，该工艺可以是允许部件的复杂几何形状同时消除对昂贵工具的需要的增材制造工艺。具体地，击发构件组件的推力轴承和/或驱动螺母可使用该方法来制造。在各种实例中，驱动螺母可例如由石墨和钢3D打印而成。在至少一个实例中，部件的大约1％至大约5％包括石墨并且部件的其余部分包括钢材料。在此类实例中，例如驱动螺母的暴露的石墨可在例如螺纹连接内提供一定程度的润滑。
在各种实例中，击发构件组件被构造成能够由被定位在端部执行器内的击发驱动螺杆驱动。击发构件组件和/或击发驱动螺杆可在击发行程期间经历各种负载。例如，当击发构件组件被推进通过击发行程时，击发构件组件可经历由组织向其施加的负载。击发构件组件可受到由击发驱动螺杆自身向其施加的各种负载。击发构件组件还可经历由击发构件组件的凸轮作用凸缘与仓通道钳口和/或砧座钳口的接合生成的负载。击发驱动螺杆还可在螺杆被定位在其内的端部执行器组件的使用的各个阶段期间受到各种负载。例如，当钳口闭合以夹紧组织时和/或当组织在钉击发行程期间被击发构件组件的凸缘进一步夹紧时，击发驱动螺杆可由于施加在端部执行器组件内的凸轮作用和/或夹紧力而受到弯曲负载。本文所讨论的是被构造成能够管理击发构件组件和击发驱动螺杆所经历的各种负载的各种布置。例如，此类布置可减少击发驱动螺杆与各种部件的黏连。此类布置也可以与闭合驱动系统一起采用。例如，在各种实例中，端部执行器组件可包括独立的闭合驱动螺杆，该闭合驱动螺杆被构造成能够将钳口相对于另一钳口打开和闭合。在此类实例中，闭合驱动螺杆还可受到可能导致例如弯曲和/或与各种驱动部件黏连的各种负载
图82至图84示出了外科缝合组件5000，该外科缝合组件包括仓通道5010、位于仓通道5010内的钉仓5050，以及支撑在通道5010内的旋转驱动组件5030。仓通道5010包括远侧部分5011、底部5020，以及从底部5020竖直延伸的侧壁5012。底部5020包括远侧端部5021、限定在底部的远侧端部5021中的环形托架狭槽5022，以及从底部5020向上延伸的一对弓形凸缘5023。弓形凸缘5023被构造成能够可浮动地支撑旋转驱动组件5030。远侧端部5021的各种特征部包括例如驱动螺杆5031的远侧安装件。
旋转驱动组件5030包括螺纹螺杆部分5031和由仓通道5010的远侧部分5011支撑的远侧端部5033。旋转驱动组件5030的远侧端部5033包括例如被构造成能够接触弓形凸缘5023的两个推力轴承或衬套5034。远侧端部5033还包括远侧支撑头部5035，该远侧支撑头部被构造成能够抵靠弓形凸缘5023支撑推力轴承5034。例如，远侧支撑头部5035可使用轨道成形工艺形成在击发驱动螺杆的远侧端部上。该成形工艺可例如在一个或多个衬套和/或轴承被定位在击发驱动螺杆的远侧端部上之后进行。
弓形凸缘5023在它们之间在仓通道5010的远侧部分5011中限定浮动腔5025。旋转驱动组件5030的部分5032被构造成能够被支撑在浮动腔5025内，使得例如在仓通道5010偏转时允许旋转驱动组件5030的远侧端部5033在浮动腔5025内浮动。在其中仓通道5011的远侧部分5011向下偏转的此类实例中，旋转驱动组件5030的远侧端部5033可通过在浮动腔5025内浮动而保持相对卸载。如图84中可见，浮动腔5025包括竖直狭槽部分5026，该竖直狭槽部分被构造成能够允许驱动组件5030和/或旋转驱动组件5030的部分5032的预定义的浮动距离或竖直浮动极限。例如，部分5032可通过凸缘5023限制其在浮动腔5025内竖直地浮动的能力。
设想了其中不存在由仓通道5010的底部5020限定的竖直限制特征部的实施方案。在至少一个实例中，环形托架狭槽5022被构造成能够支撑衬套5034和/或远侧支撑头部5035。在至少一个实例中，环形托架狭槽5022限定下竖直限制特征部或止动件，该下竖直限制特征部或止动件被构造成能够防止旋转驱动组件5030的远侧端部5033浮动到例如由衬套5034和/或5035与环形托架狭槽5022之间的接触限定的特定阈值以下。在至少一个实例中，竖直狭槽部分5026和凸缘5023限定上竖直限制特征部或止动件，该上竖直限制特征部或止动件被构造成能够防止旋转驱动组件5030的远侧端部5033浮动到由远侧端部5033与凸缘5023之间的接触限定的特定阈值以上。
如图83中可见，钉仓5050包括在其中限定鼻部腔5053的远侧鼻部5051。鼻部腔5053可以为旋转驱动组件的远侧端部5033提供在其中浮动的空间。
在至少一个实例中，旋转驱动组件5030的近侧端部固定在适当位置。在至少一个实例中，旋转驱动组件5030的近侧端部还被构造成能够相对于仓通道5010浮动。
在至少一个实例中，例如，弹簧设置在仓通道内的击发驱动螺杆的近侧安装位置和/或远侧安装位置处。弹簧被构造成能够将击发驱动螺杆偏压成中立构型。在至少一个实例中，弹簧被构造成能够抵消施加到击发驱动螺杆的弯曲负载。在至少一个实例中，一个或多个磁体设置在安装位置内，并且相反极性的螺杆磁体在安装位置处设置在击发驱动螺杆上。此类构型可将击发驱动螺杆朝向中立构型偏压，并且抵消施加到击发驱动螺杆的弯曲负载。例如，此类弹簧可包括可竖直变形的衬套。在至少一个实例中，在安装位置内采用螺旋弹簧。
在各种实例中，本文所述的柔性浮动安装件被构造成能够允许旋转驱动组件相对于仓通道的有限的竖直浮动范围。例如，本文所述的远侧安装件可允许0.0002英寸至0.0003英寸的竖直浮动范围。在其他实例中，可允许0.001英寸的竖直浮动范围，并且在某些实例中，柔性浮动安装件可允许高达0.0015英寸的竖直浮动范围。竖直浮动范围的尺寸可被构造成能够避免侧向负载施加到旋转驱动组件，这非常适合于拉伸负载，但可能导致在侧向负载下弯曲。相反，旋转驱动组件可在有限的竖直浮动范围内浮动，以确保旋转驱动组件不被侧向加载。即使当厚的和/或韧的组织被夹紧在钳口之间并且砧座在夹紧构型中被弓曲时，竖直浮动范围也可允许旋转驱动组件的移位并且避免旋转驱动组件上的侧向负载。
在至少一个实例中，击发构件组件的凸缘被构造成能够限定击发驱动螺杆通过击发构件组件与击发驱动螺杆之间的螺纹连接的有限的竖直浮动范围。例如，砧座接合凸缘可接触砧座狭槽的上部部分和/或通道接合凸缘可接触通道狭槽的上部部分，以提供用于击发驱动螺杆的上止挡件。除上述以外，砧座接合凸缘可接触砧座狭槽的下部部分和/或通道接合凸缘可接触通道狭槽的下部部分，以提供用于击发驱动螺杆的下止挡件。在至少一个实例中，被构造成能够接纳驱动螺母的驱动螺母切口、驱动腔和/或容座被构造成能够进一步限定击发驱动螺杆的竖直浮动范围。
图85示出了外科缝合组件5000，该外科缝合组件包括外科缝合组件5100的仓通道5010。外科缝合组件5100包括旋转驱动组件5130，该旋转驱动组件包括螺纹部分5131和远侧端部5133。远侧端部5133包括被构造成能够抵靠凸缘5023支撑远侧端部5133的一个或多个轴承5134。远侧端部5133还包括远侧支撑头部5135，该远侧支撑头部包括型锻螺杆端部5136。型锻螺杆端部5136可以在外部型锻和/或在内部型锻。型锻螺杆端部5136被构造成能够为一个或多个轴承5134提供远侧轴承表面。类似于旋转驱动组件5030，旋转驱动组件5130被构造成能够在仓通道5010内浮动。
任何合适的衬套和/或轴承可与本文所公开的各种旋转驱动组件和/或击发驱动螺杆中的任一者一起采用。在至少一个实例中，压缩衬套可以用在仓通道内的击发驱动螺杆的近侧端部或远侧端部处。例如，一旦安装在仓通道中，此类压缩衬套可向击发驱动螺杆提供压缩预加载。此类压缩预加载可防止击发驱动螺杆与在仓通道中支撑击发驱动螺杆的任何支撑元件脱离接合。例如，压缩衬套可用在击发驱动螺杆的一个或多个端部处，以防止击发驱动螺杆的近侧端部和/或远侧端部与对应的支撑件(诸如例如，从仓通道延伸的弓形凸缘)脱离接合。
压缩预加载可由例如压缩衬套上的弹簧、纵向螺杆和/或铆钉引起。在此类实例中，压缩衬套将趋于在压缩预加载下径向伸展。此类径向伸展可填充环形托架支撑件和/或浮动腔，诸如本文所讨论的那些。压缩衬套填充此类狭槽和/或腔的此类趋势例如可帮助防止击发驱动螺杆纵向地、侧向地和/或竖直地从支撑元件(诸如本文所讨论的弓形凸缘)移位。
在至少一个实例中，被构造成能够支撑本文所公开的旋转驱动组件的衬套和/或轴承包括从其径向向外延伸的凸缘。凸缘被构造成能够被定位在通道支撑凸缘的与击发驱动螺杆的远侧支撑头部相对的一侧上。然后，径向凸缘可通过弹簧远离通道支撑凸缘并且因此远离远侧支撑头部偏压。在此类实例中，例如，弹簧将推靠通道支撑凸缘和衬套的径向凸缘。在此类实例中，径向凸缘和弹簧可被构造成能够将远侧支撑头部拉入通道支撑凸缘中。在至少一个实例中，施加到远侧支撑头部的该拉力可被构造成能够使远侧支撑头部就位，使得在不首先朝远侧拉动击发驱动螺杆并克服由弹簧施加的力的情况下，击发驱动螺杆不能被直接提升离开通道支撑凸缘。然后，克服该力将使远侧支撑头部与通道支撑凸缘脱离接合，然后仅允许击发驱动螺杆被提升离开通道支撑凸缘。
除上述以外，例如，弹簧可被远侧紧固螺杆压缩，该远侧紧固螺杆被构造成能够相对于包括径向凸缘的衬套朝向通道支撑凸缘朝近侧拉动远侧支撑头。设想了其他实施方案，其中轴承被定位在通道支撑凸缘的远侧，并且然后螺母螺纹连接到驱动螺杆上。然后，可转动螺母以将轴承压靠在通道支撑凸缘上。
图86和图87示出了外科缝合组件5200，该外科缝合组件包括支撑通道5210和击发驱动螺杆5220，该击发驱动螺杆被构造成能够致动击发构件组件，诸如本文所公开的击发构件组件。击发驱动螺杆5220限定螺杆轴线SA。如上所讨论，用在外科端部执行器组件内的击发驱动螺杆可受到弯曲负载。如图87中可见，箭头5230指示施加到击发驱动螺杆5220的远侧端部5223的弯曲负载。击发驱动螺杆5220包括安装在通道支撑件5211的球形接头承窝或安装件5211内的近侧球形接头25221。此类构型允许击发驱动螺杆5220在经历弯曲负载时相对于通道支撑件5211枢转。在至少一个实例中，球形接头5221和承窝5211允许击发驱动螺杆5220枢转而不使击发驱动螺杆5220显著弯曲。例如，弯曲可能导致螺纹部分5225和击发构件组件的黏连。球窝接头可被精细地调节以允许预定义量的枢转，不允许击发驱动螺杆5220枢转到所允许的预定义量之外并且可能导致端部执行器组件内的其他问题。在至少一个实例中，击发驱动螺杆5220的近侧安装位置包括径向和/或球形形状，以允许击发驱动螺杆5220相对于螺杆轴线SA略微旋转。此类构型还可防止击发驱动螺杆5220在近侧安装位置内的黏连和/或熔刮。
在至少一个实例中，驱动螺杆的近侧端部和/或远侧端部例如通过从通道和/或砧座延伸的多于一个支撑凸缘支撑在通道和/或砧座内。例如，多于一个支撑凸缘可包括彼此串联的多个凸缘。驱动螺杆的一个或多个对应的推力轴承可被构造成能够抵靠该多于一个支撑凸缘支撑。例如，如果驱动螺杆想要朝近侧和朝远侧移动，此类构型可帮助支撑驱动螺杆。例如，在至少一个实例中，针对从通道和/或砧座延伸的每个支撑凸缘，在驱动螺杆上设置独立的推力轴承。在至少一个实例中，每个推力轴承被构造成能够接合仅其对应的支撑凸缘。在其他实例中，一个推力轴承设置在两个凸缘之间，其中该一个推力轴承被构造成能够在近侧方向和远侧方向上接合这两个凸缘。在此类实例中，一个或多个附加的推力轴承可设置在这两个支撑凸缘的近侧和/或这两个支撑凸缘的远侧。此类布置可提供多个推力表面，而不是驱动螺杆的单个推力表面。
在至少一个实例中，例如，支撑凸缘的推力表面包括例如内圆环形凹孔。在此类实例中，驱动螺杆的推力轴承可被构造成能够被接纳在该内圆环形凹孔内。在至少一个实例中，可变形推力轴承被压缩到凹孔中。在至少一个实例中，可变形推力轴承包括大于凹孔的外径的直径。此类构型可以为驱动螺杆提供附加的支撑。在至少一个实例中，可变形推力轴承包括软的低密度聚乙烯垫圈。在至少一个实例中，使用轨道成形工艺来压缩推力轴承。在至少一个实例中，推力轴承可包括例如螺纹垫圈。
在各种实例中，弹簧和/或磁体可整合在端部执行器组件的各种部件中，以允许端部执行器组件的各种部件在负载下相对于彼此浮动和/或移动。例如，弹簧和/或磁体可整合在近侧和/或远侧安装位置中，其中击发驱动螺杆由例如仓通道支撑。另一示例包括将弹簧和/或磁体整合在击发构件组件中以允许其驱动螺母例如相对于主体部分浮动。
图88至图91示出了击发构件组件5300，该击发构件组件被构造成能够推动滑动件和/或切割构件通过端部执行器组件内的钉击发行程。击发构件组件5300包括主体部分5010和螺纹驱动螺母5350，该螺纹驱动螺母被构造成能够经螺纹联接到击发驱动螺杆。驱动螺母5350被构造成能够向主体部分5010施加轴向驱动力，以推动和拉动主体部分5010通过端部执行器组件。主体部分5010包括被构造成能够接合端部执行器组件的第一钳口的上部部分5311以及被构造成能够接合端部执行器组件的第二钳口的下部部分5315。下部部分5315包括近侧部分5316和远侧部分5320，该近侧部分和该远侧部分各自被构造成能够以以不通过螺纹的方式接纳穿过其中的击发驱动螺杆。驱动螺母腔5330被限定在近侧部分5316与远侧部分5320之间，该驱动螺母腔被构造成能够在其中接纳驱动螺母5350。击发构件组件5300还包括磁性元件5360，该磁性元件被构造成能够将驱动螺母5350联接到主体部分5310。
磁性元件5360可包括例如圆柱形杆或销和/或矩形杆或销。尽管如此，磁性元件5360中的一个磁性元件附接到限定在近侧部分5316中的近侧通道5363内的弹簧5361并且由该弹簧弹性加载。磁性元件5360中的另一个磁性元件附接到限定在远侧部分5320中的远侧通道5365内的弹簧5361并且由该弹簧弹性加载。为了将驱动螺母5350安装到主体部分5310，磁性元件5360通过外部存在的磁体5370(图90)回缩到其相应的通道5363、5365中，该外部存在的磁体被构造成能够克服由弹簧5361施加到磁性元件的弹簧力。然后，才可以将驱动螺母5350插入驱动螺母腔5330中。一旦驱动螺母5350就位，外部存在的磁体5370就可移动远离磁性元件5360以允许弹簧5361将磁性元件5360朝向驱动螺母5350向内偏压。
具体地，磁性元件5360被构造成能够驻留在限定在驱动螺母5350中的对应的近侧通道5351和限定在驱动螺母5350中的对应的远侧通道5355内。通道5351、5355包括宽度和/或直径，其大于磁性元件5360的宽度和/或直径。这种尺寸差异允许驱动螺母5350相对于主体部分5310浮动。驱动螺母5350相对于主体部分5310的浮动量可至少部分地由磁性元件5360和通道5351、5355的尺寸差异5371限定和限制。在至少一个实例中，宽度和/或高度中的一者基本上与磁性元件5360的宽度和/或高度相同。此类构型将允许驱动螺母在仅一个平面中浮动。例如，如果磁性元件5360和驱动螺母通道5351、5355的竖直高度基本上相同并且驱动螺母通道5351、5355的宽度大于磁性元件5360的宽度，则允许驱动螺母5350相对于主体部分5310仅水平地或侧向地浮动。另一方面，在宽度基本上相同并且竖直高度不同的情况下，允许驱动螺母5350相对于主体部分5310仅竖直地浮动。任何浮动可最终由近侧部分5316和远侧部分5320的驱动螺杆管道的尺寸限制，如上文更详细地讨论的。
在至少一个实例中，通道或凹坑5363、5365可以被机加工到金属主体部分中。在至少一个实例中，当制造驱动螺母5350时，通道或凹坑5351、5355可以是注射模具的一部分。在至少一个实例中，磁性元件5360包括例如钢销。在至少一个实例中，上面讨论的布置可减少对限定在要与击发驱动螺杆联接的驱动螺母中的内螺纹通道与主体部分的对应的驱动螺杆管道精确对准的需要。在此类实例中，如果内螺纹通道相对于主体部分的对应的驱动螺杆管道略微偏心地模制，则上面讨论的磁性元件布置可允许驱动螺母5350浮动成与主体部分5310对准。例如，驱动螺母5350的浮动还可帮助防止驱动螺母5350和击发驱动螺杆的黏连。在至少一个实例中，第三运动程度可由近侧部分5316和远侧部分5320控制和限定，这可限定沿纵向轴线相对于主体部分5310允许的浮动量(如果有的话)。
例如，在各种实例中，击发驱动螺杆可被构造成能够提供顺应驱动螺杆，该顺应驱动螺杆可适应击发驱动螺杆所经历的各种负载并且减小驱动螺杆黏连的可能性。例如，此类顺应驱动螺杆可以在不同的负载条件下自动适应和/或顺应。此类顺应性可能导致驱动螺杆自身的形状改变，如下文更详细地讨论的。
图92和图93示出了被构造成能够在负载下自动适应的击发驱动螺杆5400。击发驱动螺杆5400包括线缆或主芯构件5410，该线缆或主芯构件包括近侧端部5401和远侧端部5403。例如，远侧端部5403可包括从其直接延伸的凸缘部分和/或压力配合推力轴承。击发驱动螺杆5400还包括弹簧或螺旋构件5420，该弹簧或螺旋构件限定单独的螺纹区段5421，该单独的螺纹区段被构造成能够例如为螺纹击发构件组件提供螺纹界面。主芯构件5410包括柔性材料，使得主芯构件5410可以在负载下挠曲并且适应其形状。与主芯构件5410一样，螺旋构件5420也包括柔性材料，使得螺旋构件5420可以与主芯构件5410一样在负载下挠曲。芯构件5410和螺旋构件5420的这种柔性允许单独的螺纹区段5421相对于彼此移位。每个单独的螺纹区段5421可相对于彼此移位。然而，螺纹区段5421可被构造成能够半独立地移位。此类构型可允许每个构件5421的略微移位；然而，螺纹区段5421中的所有螺纹区段是单个螺旋构件5420的一部分，因此一个螺纹区段5421的移位可能导致一个或多个相邻螺旋构件的一些移位，等等。这也可被称为当击发驱动螺杆5420在负载下时螺纹区段5421的展开。击发驱动螺杆5420可降低驱动螺杆在负载下黏连的可能性。在各种实例中，主芯构件5410和螺旋构件可包括不同的材料。尽管图93的示意性剖视图示出了螺旋构件5420的内径与主芯构件5410的外径之间的空间或间隙，但在其他实例中，螺旋构件5420的内径与主芯构件5410的外径接触和/或邻接。
图94是包括柔性击发驱动螺杆5550的击发组件5500的示意图。击发驱动螺杆5550可包括与例如本文所公开的击发驱动螺杆5400的许多相似性。击发组件5500包括安装到通道框架5510上的击发驱动螺杆5550。击发驱动螺杆5550的近侧驱动构件或实心衬套5551包括凸缘5552，该凸缘被构造成能够由通道框架5510的近侧端部5511支撑。击发驱动螺杆5550的远侧部分5556被构造成能够由从通道框架5512延伸的远侧支撑凸缘5513支撑。击发驱动螺杆5550还包括柔性芯构件5556，以及围绕柔性芯构件5556并且限定螺纹区段或区域5555的螺旋构件5554。螺旋构件5554附接到近侧驱动构件5551，并且套管/插座5557可固定地附接到击发驱动螺杆5550的远侧部分5556。例如，近侧驱动构件5551可被型锻到击发驱动螺杆5556的柔性芯构件5556上。远侧部分5556包括螺纹区段5558、衬套5559和螺纹连接到螺纹区段5558的远侧螺母5560。一对衬套5559被定位在承窝中的远侧螺母5560的近侧，并且可夹置在远侧螺母560与远侧支撑凸缘551之间(参见例如图82中的轴承5034)。
在至少一个实例中，螺旋构件5554的内径被构造成能够围绕并且接触柔性芯构件5553的外径。例如，螺旋构件5554可包括一种类型的螺旋弹簧。例如，柔性芯构件5553可包括柔性线缆。在至少一个实例中，螺旋构件5554被制造成具有小于柔性芯构件5553的外径的内径。在此类实例中，螺旋构件5554可反向旋转以增大其内径，用于组装到柔性芯构件5553上。一旦螺旋构件5554被定位在柔性芯构件5553上，螺旋构件5554可以被释放。一旦螺旋构件5554被释放，它就将偏压回到其中立、无负载构型并且将自身紧紧地同步或夹紧到柔性芯构件5553。在至少一个实例中，螺旋构件5554在沿柔性芯构件5553的长度的不同位置处被焊接到柔性芯构件5553。
在至少一个实例中，螺母5560被构造成能够被拧紧和/或松开以提供螺旋构件5554的期望构型。拧紧和/或松开螺母5560还可允许调节柔性芯构件5553的张力。调节柔性芯构件5553的张力可与柔性芯构件5553在负载下沿其长度所允许的偏转量直接相关。例如，更紧的线缆可允许比更松的线缆更少的挠曲。例如，这可以在制造期间被调节到期望的张力。设想了其中例如针对不同尺寸的仓和/或需要不同的击发力的外科缝合系统进行不同的调节的实施方案。
在各种实例中，提供了一种击发驱动螺杆，该击发驱动螺杆被构造成能够使其在各种负载下的塑料变形最小化。此类击发驱动螺杆可包括横截面几何形状沿其纵向长度的变化。此类变化可能导致击发驱动螺杆的一部分比击发驱动螺杆的相邻部分更柔性。例如，击发驱动螺杆的更柔性的部分可受到比不太柔性的部分更大的弯曲负载。击发驱动螺杆的变化可位于近侧部分、中间部分、远侧部分或它们的任何组合处。例如，变化的位置可取决于应用和受到最高负载的击发驱动螺杆的区域。
图95示出了击发驱动螺杆5600，该击发驱动螺杆被构造成能够与外科缝合组件诸如本文所讨论的外科缝合组件一起使用。击发驱动螺杆5600包括被构造成能够附接到旋转驱动轴的近侧从动端部5601。击发驱动螺杆5600还包括近侧凸缘5602，该近侧凸缘被构造成能够例如被支撑在端部执行器组件的框架部件内。击发驱动螺杆5600包括螺杆轴5610，该螺杆轴包括主螺纹部分5613和近侧颈缩部分5611。近侧颈缩部分5611包括比主螺纹部分5613更小的横截面直径。此类横截面直径的变化可允许颈缩部分5611的略微弯曲，以减小主螺纹部分5613上的过度弯曲效应。在击发构件组件被构造成能够相对于主螺纹部分5613朝近侧和朝远侧被螺纹驱动的情况下，减小主螺纹部分上的弯曲效应可减小驱动螺杆黏连在击发驱动螺杆5600的与击发构件组件接合的区段中的可能性。在至少一个实例中，击发构件组件还被构造成能够螺纹行进穿过颈缩部分5611；然而，在至少一个实例中，在由颈缩部分5611组成的行程的长度上可能不需要高驱动力。
图96和图97示出了包括近侧从动端部5701和安装凸缘5702的击发驱动螺杆5700。击发驱动螺杆5700还包括螺纹5721的近侧区段5720，该近侧区段例如包覆模制和/或嵌入模制到击发驱动螺杆5700的主轴5710的近侧部分5711上。击发驱动螺杆5700包括主螺纹部分5712，该主螺纹部分包括大于近侧部分5711的直径的横截面直径。如上所讨论，横截面直径的变化可允许主轴5710的挠曲并且将该挠曲具体地局部化到近侧部分5711，以便减小驱动螺杆与击发构件组件的驱动螺母黏连的可能性。例如，螺纹5721可由聚合物材料组成，而主轴5710由金属材料组成。螺纹5721可帮助沿经螺纹联接到击发驱动螺杆5700的击发构件组件的行进行程保持一致的螺纹图案。
在至少一个实例中，沿击发驱动螺杆的长度的各个部分包括例如包覆模制的塑料螺纹区段。在至少一个实例中，各种包覆模制的部分可适应击发组件的驱动螺母与击发驱动螺杆螺纹轮廓之间的制造公差差异，并且在某些实例中可提供例如更光滑的螺纹接合表面。在至少一个实例中，击发驱动螺杆的中心区段(在击发行程的中途)区段包括变化的横截面轮廓。
图98至图100示出了各种类型的联轴器5810、5820、5830，其可与击发驱动螺杆(诸如本文所公开的那些击发驱动螺杆)一起使用。联轴器5810、5820、5830可被定位在沿击发驱动螺杆的长度的任何位置处，以提供旨在使击发驱动螺杆的弯曲局部化的位置。联轴器5810、5820、5830被构造成能够将旋转轴运动从一个轴转换到另一个轴。联轴器5810可在与其一起采用的击发驱动螺杆中引入很少反冲甚至不引入反冲。例如，由于施加到端部执行器内的击发驱动螺杆的弯曲力、轴的平行未对准和/或轴的轴向移动，联轴器5810、5820、5830可允许轴的一定程度的角度未对准。
联轴器5810可以是例如梁式联轴器。联轴器5810包括被构造成能够附接到击发驱动螺杆的一部分的远侧端部的近侧毂5811、被构造成能够附接到击发驱动螺杆的另一部分的近侧端部的远侧毂5813，以及被构造成能够在轴未对准的场景期间挠曲的螺旋切口5815。
联轴器5820可以是例如波纹管联轴器。联轴器5820包括被构造成能够附接到击发驱动螺杆的一部分的远侧端部的近侧毂5821、被构造成能够附接到击发驱动螺杆的另一部分的近侧端部的远侧毂5823，以及被构造成能够在轴未对准的场景期间挠曲的柔性波纹部分5825。
联轴器5830可以是例如曲面爪型联轴器。联轴器5830包括被构造成能够附接到击发驱动螺杆的一部分的远侧端部的近侧毂5831、被构造成能够附接到击发驱动螺杆的另一部分的近侧端部的远侧毂5833，以及包括齿5835的星形齿轮。星形齿轮可包括较软材料，其被构造成能够在毂5831、5833之间挠曲，同时保持星形齿轮、近侧毂5831和远侧毂5833之间的驱动接合。
在端部执行器组件中，此类联轴器5810、5820和5830可允许击发驱动螺杆在联轴器自身处弯曲，并且减少螺纹轴自身内的弯曲。如本文所讨论，螺纹轴的弯曲可能导致彼此经螺纹联接的击发驱动螺杆和击发构件组件的黏连。
图101至图103示出了闭合驱动组件6000，该闭合驱动组件包括闭合驱动器6010和经螺纹联接到闭合驱动器6010的闭合螺母或楔形件6020。闭合螺母6010被构造成能够将闭合驱动组件6000的钳口6040相对于具有凸轮凸块6023和凸轮表面6021的相对钳口分别打开和闭合。闭合驱动组件6000包括支撑元件6030，该支撑元件被构造成能够在其上支撑闭合驱动器6010。支撑元件6030可固定到例如通道保持器。支撑元件6030包括轴座凸缘6031、6032，该轴座凸缘被构造成能够在其中支撑闭合驱动器6010的闭合驱动螺杆6013。闭合驱动器6010还包括被构造成能够由旋转闭合驱动轴驱动的近侧从动部分6010、被构造成能够邻接凸缘6032的推力轴承6012，以及被构造成能够邻接凸缘6031的远侧推力轴承部分6016。
闭合驱动螺杆6013包括螺纹区段6014和远侧非螺纹区段6015。闭合螺母6020还包括内螺纹区段6025，该内螺纹区段被构造成能够与螺纹区段6014螺纹接合，使得闭合螺母可沿螺纹区段朝近侧和朝远侧推进，以打开和闭合钳口6003。在至少一个实例中，闭合螺母6020被构造成能够被3D打印到预先制造的闭合驱动器6010上。例如，闭合螺母6020可包括金属材料和/或聚合物材料。闭合螺母6020被构造成能够围绕远侧非螺纹区段6015打印。此类布置可允许封闭螺母6020的内螺纹区段6025打印成具有有效直径，该有效直径略微小于封闭螺母直接围绕螺纹区段6015打印的情形。打印在闭合驱动螺杆6013上的闭合螺母6020可被有效地限制在轴承6012与轴承部分6016之间，从而防止在制造之后的意外拆卸。在至少一个实例中，轴承6012和轴承部分6016在打印闭合螺母6020之前打印在驱动螺杆6013上。
在至少一个实例中，闭合驱动器6010的一个或多个部分也3D打印而成。在此类实例中，闭合驱动器6010可以被3D打印成比期望尺寸略微更大的尺寸。例如，闭合驱动器6010可以比期望尺寸大0.5％。在此类实例中，需要精确尺寸的闭合驱动器6010的各种细节可以在闭合驱动器6010打印之后进行机加工。在某些实例中，此类制造过程可减少机加工浪费并且减少制造一个或多个部件所需的时间量。例如，包括具有非螺纹区段和螺纹区段的轴的闭合驱动器需要至少移除宽度为非螺纹区段处的螺纹深度的材料环，其中非螺纹区段包括小于或等于螺纹区段的小径的直径。此类闭合驱动器的3D打印可允许非螺纹区段被打印成更接近于螺纹的小径，尽管由于上面讨论的原因而略微更大。
图104和图105示出了闭合驱动器6100，该闭合驱动器包括驱动螺杆6110和被构造成能够固定到驱动螺杆6110的限制套环6120。限制套环6120可类似于闭合驱动器6010的远侧推力轴承部分6016。例如，限制套环6120可被构造成能够抵靠支撑凸缘支撑闭合驱动器6110。例如，限制套环6120可以被称为垫圈、螺母和/或凸缘。驱动螺杆6110包括具有螺纹6112的主螺纹部分6111。主螺纹部分6111可被构造成能够在其上例如朝近侧和朝远侧驱动闭合螺母，以打开和闭合端部执行器的钳口。
驱动螺杆6110还包括远侧端部6113，该远侧端部包括环形狭槽6114和螺纹6115。环形狭槽6114被构造成能够在其中支撑限制套环6120。螺纹6115被构造成能够允许安装限制套环6120，并且防止限制套环6120从驱动螺杆6110移除。限制套环6120包括限定在其中的近侧斜坡表面6122。近侧斜坡表面6122被构造成能够允许限制套环6120旋拧到驱动螺杆6110的螺纹6115上，使得限制套环6120可离开螺纹6115并且将内部支撑表面6121适配到环形狭槽6114。一旦安装到驱动螺杆6110上，螺纹6115就驻留在限定在限制套环6120中的远侧竖直壁6123的远侧。远侧壁6123被构造成能够防止限制套环6120从驱动螺杆6110的远侧端部6113被拉出。
在至少一个实例中，驱动螺杆6110由金属材料机加工和/或3D打印而成。在至少一个实例中，限制套环6120由聚合物模制和/或3D打印而成。在至少一个实例中，限制套环6120由允许一定程度的柔性的材料构造，以便允许限制套环6120围绕螺纹6115挠曲并且离开螺纹。可能需要很大程度的力来将限制套环6120安装到驱动螺杆6110上。在至少一个实例中，至少由于远侧壁6123，可能需要更大程度的力来从驱动螺杆6110移除限制套环6120。
在至少一个实例中，此类限制套环可与击发驱动螺杆一起使用，该击发驱动螺杆被构造成能够螺纹驱动击发构件组件。在各种实例中，在驱动螺杆的近侧端部、驱动螺杆的远侧端部或驱动螺杆的两个端部处，使用此类限制套环。
在至少一个实例中，利用锁紧垫圈将限制套环安装到驱动螺杆上。在此类实例中，限制套环被构造成能够被安装在其上的螺纹和/或多个螺纹可被构造成能够例如当驱动螺杆在负载下时进一步拧紧锁紧垫圈和限制套环的锁定接合。例如，限制套环的每个端部可包括具有相反螺纹方向的螺纹。例如，限制套环的近侧端部可包括左旋螺纹，并且限制套环的远侧端部可包括右旋螺纹，反之亦然。一旦安装好，限制套环就可被引入到相反的螺纹图案，使得当限制套环被促动离开驱动螺杆的远侧端部时，相反的螺纹图案可用于进一步拧紧锁紧垫圈和限制套环的锁定接合。
在至少一个实例中，击发驱动螺杆和/或闭合驱动螺杆可3D打印而成。在此类实例中，可利用驱动螺杆直接打印各种特征部。例如，支撑凸缘、轴承、限制套环等可直接打印到驱动螺杆上。在至少一个实例中，这些各种特征部中的一个或多个特征部可包括与驱动螺杆自身不同的材料。在此类实例中，包括与驱动螺杆不同的材料的特征部可直接打印到金属上，例如，驱动螺杆上。在至少一个实例中，各种特征部包括与驱动螺杆相同的材料。在此类实例中，可使用例如被称为定向能量沉积的工艺将各种金属(例如，特征部)打印到金属驱动螺杆上。在至少一个实例中，各种特征部可包括不同的材料，该不同的材料在例如打印到驱动螺杆上之后可焊接到驱动螺杆。
在各种实例中，与例如包括金属材料的支撑结构和凸缘两者相比，在驱动螺杆上使用不同材料的特征部(诸如例如凸缘)可在凸缘与支撑结构之间提供较低的摩擦系数。例如，在驱动螺杆的主要部分被机加工之后制造这些特征部还可减少整个闭合驱动器的制造时间和成本。
图106和图107示出了安装到通道凸缘6210的驱动组件6200。驱动组件6200包括驱动螺杆轴6220，该驱动螺杆轴包括螺纹部分，该螺纹部分被构造成能够经螺纹联接到外科缝合组件的击发构件。驱动螺杆轴6220还包括远侧端部6223，该远侧端部包括凸缘端部6224和环形狭槽6225。为了将驱动螺杆轴6220固定到通道凸缘6210，提供了锁定组件6230。锁定组件6230包括远侧螺母6240和锁定构件6250。锁定构件6250被构造成能够锁定到环形狭槽6225中，以提供驱动螺杆轴6220的远侧端部6223抵靠其固定的邻接表面。在锁定构件6250抵靠通道凸缘6210被定位在驱动螺杆轴6220上之后，远侧端部螺母6240可螺纹连接到远侧端部6223上。当远侧螺母6240被拧紧或朝向通道凸缘6210朝近侧移动时，锁定构件6250可包括柔性材料，以便被远侧螺母6240的斜坡表面6241推入环形狭槽6225中。在至少一个实例中，锁定构件6250被构造成能够当通过远侧螺母6240向其施加压力时形状成蘑菇形和/或气球形。在至少一个实例中，远侧螺母6240包括金属材料。在至少一个实例中，锁定构件6250包括用于驱动螺杆轴6200的可变形限制件。例如，当在方向6260上向驱动螺杆轴施加负载时，由于锁定构件6250的膨胀，驱动螺杆轴6220被防止相对于通道凸缘6210朝近侧伸展。凸缘端部6224可将负载传递到锁定构件6250，该锁定构件将负载传递到通道凸缘6210。
在至少一个实例中，驱动螺杆轴(诸如本文所讨论的那些)可使用减材制造工艺(诸如例如Swiss螺杆制造工艺)来制造。例如，此类制造工艺可减少驱动螺杆的材料浪费和制造时间。此类制造工艺还可允许此类相对小的驱动螺杆的高精度机加工，其中沿此类驱动螺杆轴的长度的直径可变化并且包括相对小的尺寸差异。
在各种实例中，锁定构件(诸如锁定构件6250)例如包括橡胶材料和/或低密度聚乙烯和/或聚丙烯。锁定构件的材料可基于其在负载下剪切的能力来选择，使得在预定阈值负载下，锁定构件可剪切以防止系统内的其他部件失效。此类锁定构件也可自动使驱动螺杆轴对中，因为锁定构件通过在其周围均匀地受限制来安装。
在各种实例中，端部执行器组件(诸如本文所公开的那些)可包括被构造成能够支撑端部执行器组件的一个或多个驱动器的可堆叠支撑件。例如，一个或多个可堆叠支撑件被构造成能够支撑不同心的闭合驱动器和击发驱动器。该一个或多个可堆叠支撑件被构造成能够抵靠公共框架元件(诸如例如，通道钳口)支撑一个或多个驱动器。
图108至图110示出了外科缝合组件6300。外科缝合组件6300包括接头部件6310和通道钳口6320。通道钳口6320通过固定带或环附接到接头部件6310，该固定带或环被构造成能够被接纳在接头部件6310的环形狭槽6315内。通道钳口6320包括底部6321和在通道钳口6320的每一侧上的竖直狭槽6322，这些竖直狭槽被构造成能够接纳在接头部件6310的每一侧上的突片6314。接头部件6310在其中限定关节运动销狭槽6311。通道钳口6310可围绕由关节运动销狭槽6311限定的轴线关节运动。接头部件6310被构造成能够接纳穿过其中的一个或多个驱动轴，以驱动外科缝合组件6300的闭合驱动器6340和击发驱动器6350。
闭合驱动器6340包括驱动螺杆6341和螺纹连接到驱动螺杆6341的闭合楔形件6342。闭合楔形件6342被构造成能够利用驱动螺杆6341朝近侧和朝远侧致动，以将钳口相对于通道钳口6320(诸如例如，砧座钳口)打开和闭合。击发驱动装置6350包括驱动螺杆6351和击发构件组件6353，该驱动螺杆包括近侧端部6352，该击发构件组件被构造成能够经螺纹联接到驱动螺杆6351。击发驱动装置6350被构造成能够当击发构件组件6350沿驱动螺杆6351被致动时在钉击发行程期间从钉仓射出钉并且切割患者的组织。
闭合驱动器6340和击发驱动器6350由下支撑元件或安装件6380和上支撑元件或安装件6370支撑在通道钳口6320内。支撑元件6370、6380可以是可堆叠的并且支撑闭合驱动器6340和击发驱动器6350的一个或多个元件。下支撑元件6380包括下部部分6381和上部部分6383。下部部分6381包括键6382，该键被构造成能够被接纳在限定在通道钳口6320中的对应的狭槽内。此类键和狭槽构型可防止下支撑元件6380相对于通道钳口6320移动。上部部分6383包括轴支撑件6384，该轴支撑件包括下弓形支撑部分6385和上弓形支撑部分6386。下弓形支撑部分6385被构造成能够接纳击发驱动器6350的输入轴6355，该输入轴被构造成能够联接并且驱动驱动螺杆6351的近侧端部6352。上弓形支撑部分6386被构造成能够接纳并且支撑闭合驱动器6340的驱动螺杆6341。
上支撑元件6370可以类似轨道的方式被接纳在下支撑元件6380的顶部上。例如，限定在上支撑元件6370中的对应的腔可被构造成能够接纳下支撑元件6370的上部部分6383，使得在安装时上支撑元件6370适配并且围绕上部部分6383。上支撑元件6370还包括键6371，该键被构造成能够被接纳在限定在通道钳口6320中的对应的狭槽内。上支撑元件6370还包括顶表面6373和远侧支撑突片6372，该远侧支撑突片被构造成能够在其中接纳并且支撑驱动螺杆6341的一部分。顶表面6373被构造成能够在其上支撑闭合楔形件6342的底表面6343。在至少一个实例中，闭合楔形件轨道被限定在顶表面6373上，并且闭合楔形件6342可以在近侧和远侧行进期间与闭合楔形件轨道配合并且沿闭合楔形件轨道骑跨。上支撑元件6370还包括被构造成能够接纳上部部分6383的窗口6374。上支撑元件6370和下支撑元件6380两者可由通道钳口6320的底部6321支撑。
在至少一个实例中，上支撑元件6370和/或下支撑元件6380可被支撑在限定在通道钳口6320中的对应的轨道内，使得上支撑元件6370和下支撑元件6380允许一定程度的纵向行进，同时仍由通道钳口6320支撑。这可在端部执行器组件的夹紧、松开和/或关节运动期间有帮助，其中由于端部执行器组件的夹紧、松开和/或关节运动以及相关联的力，各种驱动轴部件需要伸长或缩短。
在至少一个实例中，上支撑元件6370和/或下支撑元件6380由单一材料制造成单个部件。例如，此类构型可使用金属机加工工艺来实现。在至少一个实例中，上支撑元件6370和/或下支撑元件6380单独地制造。在此类实例中，例如，上支撑元件6370和下支撑元件6380中的一者包括机加工部件，并且上支撑元件6370和下支撑元件6380中的另一者包括片材冲压部件。在至少一个实例中，上支撑元件6370和下支撑元件6380两者是冲压的。
本文公开了各种类型的闭合楔形件和/或螺母。闭合楔形件可包括被构造成能够闭合钳口的凸轮作用表面和被构造成能够打开钳口的一个或多个凸轮作用表面。在各种实例中，对应的凸轮表面的角度可包括相对于表面以凸轮作用方式接合的钳口的接合表面更尖锐的角度。凸轮作用表面可被调节成使得对应的闭合驱动螺杆所需的驱动力最小，同时保持大于足够的闭合驱动凸轮力。
图111至图113示出了闭合驱动组件6400，该闭合驱动组件被构造成能够打开和闭合端部执行器组件的钳口。闭合驱动组件6400包括钳口支撑元件6410和由钳口支撑元件6410的支撑凸缘6411、6413支撑的闭合驱动器6420。闭合驱动器6420包括驱动螺杆轴6430，该驱动螺杆轴包括被构造成能够由旋转驱动轴旋转的近侧端部6431、被构造成能够防止驱动螺杆轴6430相对于凸缘6413朝远侧移动的近侧轴承部分6432，以及被构造成能够经螺纹联接到闭合楔形件6450的螺纹部分6433。驱动螺杆轴6430还包括远侧端部6434，该远侧端部支撑在凸缘6411的凸缘支撑狭槽6412内并且通过夹具6440固定到凸缘6411。夹具6440被构造成能够被接纳在限定在驱动螺杆轴6430的远侧端部6435中的夹具狭槽6435内。夹具6440被构造成能够防止驱动螺杆轴6430相对于凸缘6411朝近侧移动。夹具6440可包括例如e夹具。然而，可使用任何合适的夹具、保持夹具和/或保持环。在至少一个实例中，闭合楔形件6450可从远侧端部6434螺纹连接到驱动螺杆轴6430上。
图114至图117示出了闭合驱动器6500，该闭合驱动器包括驱动螺杆轴6510和闭合驱动螺母或楔形件6540，该闭合驱动螺母或楔形件被构造成能够打开和闭合端部执行器组件的钳口。驱动螺杆轴6510包括近侧端部6511和远侧端部6515。近侧端部6511包括被构造成能够由旋转驱动轴旋转的从动部分6512、近侧轴承部分6513，以及被构造成能够经螺纹联接到闭合楔形件6540的螺纹部分6514。远侧端部6515包括附接区段6516，该附接区段的直径小于紧邻附接区段6516的驱动螺杆轴6510的直径。附接区段6516被构造成能够在其上接纳锁定构件或径向垫圈6520。
现在转到图116至图117，现在将描述锁定构件6520的安装。例如，远侧端部6515可被型锻以使附接区段6516径向伸展。这种径向伸展可以在锁定构件6520与附接区段6516之间提供摩擦保持接合。设置中心狭槽6517。狭槽6517可用于在其中插入型锻工具，以使附接区段6516伸展，从而将锁定构件6520锁定在适当位置。在至少一个实例中，锁定构件6520是可变形的，并且附接区段6516的型锻例如被构造成能够使锁定构件6520变形成安装构型。
在至少一个实例中，除了或代替上面讨论的型锻工艺，锁定构件6520销接到附接区段6516。在至少一个实例中，锁定构件6520还包括环形沟槽，并且附接区段6516还包括限定在其外侧上的对应的环形狭槽，该对应的环形狭槽被构造成能够接纳锁定构件6520的环形沟槽。在至少一个实例中，在驱动螺杆中机加工出孔，并且定位销被构造成能够插入该孔中以将闭合楔形件保持在驱动螺杆上。
在至少一个实例中，高密度聚乙烯垫圈被定位在锁定构件6520的近侧。例如，高密度聚乙烯垫圈还可包括可变形支撑凸缘，使得当锁定构件6520组装到驱动螺杆轴6510时垫圈变形。
在至少一个实例中，本文所用的可变形垫圈包括带沟槽和/或滚花的面。此类带沟槽和/或滚花的面可用于补偿驱动系统内的各种部件的公差累积。例如，此类带沟槽和/或滚花的面在组装之后的第一致动阶段之后可能略微磨损，以便补偿公差累积。
图118至图123示出了击发驱动组件7000，该击发驱动组件包括旋转驱动轴7010、经螺纹联接到旋转驱动轴7010的击发构件7020、以及纾困组件7030，该纾困组件被构造成能够将击发构件7020经螺纹联接到旋转驱动轴7010并且允许旋转驱动轴7010与击发构件7020之间的螺纹接合脱开和/或脱离接合。旋转驱动轴7010包括远侧端部7011和螺纹或带沟槽的区段7013。击发构件7020包括上凸缘、近侧边缘7022和远侧边缘7023。击发构件7020还包括下部部分7024，该下部部分包括驱动轴管道7026，该驱动轴管道被构造成能够接纳穿过其中的旋转驱动轴7010。下部部分7024还包括下凸缘7025。
纾困组件7030包括纾困致动器或线缆7031以及限定壳体腔7033的壳体7032。纾困组件7030还包括偏压板7040和致动器板7050。致动器板7050包括主板部分7051和从主板部分向内延伸以由旋转驱动轴7013的螺纹区段7013接纳和驱动的尖端或销7052。销7052被构造成能够被接纳在限定在下部部分7024中的销狭槽7028内，以驱动地接合螺纹或带沟槽的区段7013。致动器板7050抵靠下部部分7024被弹性加载，其中弹簧7060被定位在限定在下部部分7024中的弹簧狭槽7027内。弹簧7060被构造成能够将致动器板7050偏压成脱离与旋转驱动轴7010的螺纹接合。
为了保持致动器板7050与旋转驱动轴7010螺纹接合，偏压板7040定位或楔入在壳体腔7033内的壳体7032与主板部分7051之间。这种楔入接合克服了由弹簧7060施加到致动器板7050上的弹簧力并且保持销7052与旋转驱动轴7010的螺纹区段7013接合。在各种实例中，击发驱动组件7000可能由于多种情况而被困在或卡在端部执行器组件内。纾困组件7030允许击发构件7020与旋转驱动轴7010脱离接合并且独立于旋转驱动轴7010朝近侧被拉动以克服被困住或卡住的场景。
为了使击发驱动组件7000脱开，将销7052从最内侧位置(图120、图121)移动到最外侧位置(图122、图123)，从而使销7052以及因此击发构件7020与旋转驱动轴7010脱离接合。为了实现该运动，偏压板7040被致动器7031朝近侧拉动以将偏压板7040移动脱离致动器板7050的路径，从而允许弹簧7060推动主板部分7051以及因此销7052脱离与旋转驱动轴7010的螺纹区段7013的螺纹接合。此时，可继续朝近侧拉动致动器7031，以通过偏压板7040向击发构件7020施加拉力。壳体腔7033包括近侧限制壁，该近侧限制壁被构造成能够将拉力从偏压板7040传递到击发构件7050。例如，一旦击发构件7020被拉入其最近侧位置，则端部执行器组件就可打开并且从外科部位移除。
在至少一个实例中，击发驱动组件7000和采用击发驱动组件7000的端部执行器组件由于纾困组件7030的性质而不可再次使用。例如，纾困组件7030可能不能重置回与旋转驱动轴7010螺纹接合。在至少一个实例中，纾困组件7030可能能够被重置和再利用。在至少一个实例中，另一销7052和对应的结构设置在击发构件7020的另一侧上。在此类实例中，可设置相同或独立的线缆来致动另一销。
在至少一个实例中，可使用齿轮滑轮系统来控制致动器或线缆。在至少一个实例中，线缆可以是马达驱动的。在至少一个实例中，线缆可以是手动致动的。在至少一个实例中，线缆可以是手动致动的和马达驱动的。例如，在电力失效期间，可以在电机驱动系统暂时停机的情况下使用手动致动方法。在至少一个实例中，当击发构件被致动时允许线缆伸长，以便不会过早地致动纾困组件。线缆可被动地移动或主动地移动以适应击发构件的移动。
在各种实例中，提供了外科缝合装置，该外科缝合装置被构造成能够在单个钉仓内不同地成形钉，诸如传统线材钉。更具体地，钉仓可储存具有例如相同的未成形高度、尺寸和形状的钉。在此类实例中，设置不同的特征部以便将相同的未成形钉成形为不同的最终成形构型。在至少一个实例中，变化的钉成形沿钉仓的侧向宽度逐渐变化。更具体地，内排钉可成形为平面或2D成形的构型，而中间排钉和/或外排钉可成形为非平面或3D成形的构型。此类布置可沿钉仓的侧向宽度提供变化的缝合组织压缩。
除上述以外，此类外科缝合布置还可包括限定在钉仓的平台上的组织抓持特征部或钉腔延伸部。此类组织抓持特征部可在形状和/或尺寸上变化，例如，侧向地跨钉仓变化。钉仓的平台可包括曲面表面，其中此类曲面平台的顶点限定在钉仓的纵向狭槽处。钉仓的平台还可包括一个或多个平坦表面，该一个或多个平坦表面提供限定钉排中的所有钉排的单个平坦表面，或者提供台阶式平台布置，其中平台的各种台阶式部分包括限定在其中的一个或多个对应的钉排。
组织抓持特征部也可沿钉仓的侧向宽度互连。例如，在钉仓的纵向狭槽的每一侧上，钉仓可包括三排钉腔，并且因此三排钉可移除地储存在其中。组织抓持特征部或平台突起部可围绕每排的每个腔定位；然而，组织抓持特征部可在一排或多排钉腔之间互连，同时例如仍在形状和/或尺寸上变化。此类组织抓持特征部可沿钉仓的侧向宽度提供变化的组织压缩。当将某些排的钉成形为非平面的3D构型并且将某些排的钉成形为平面的2D构型时，不同尺寸的组织抓持特征部可以是有利的。此类特征部可针对要穿过由特征部抓持的组织而成形的钉的对应的钉构型进行具体调节。例如，被构造成能够在砧座与包括被构造成能够成形为非平面构型的钉的一排钉腔之间抓持要缝合的组织的抓持特征部可包括第一轮廓，并且被构造成能够在砧座与包括被构造成能够成形为平面构型的钉的一排钉腔之间抓持要缝合的组织的抓持特征部可包括第二轮廓，其中第一轮廓不同于第二轮廓。在某些实例中，与成排的3D钉对准的抓持特征部可包括位于弯曲的、成形的腿会干涉的区域中的切口。例如，与2D钉对准的排可包括围绕钉腔的完全抓持特征部，并且与3D钉对准的排可包括围绕其具有切口的抓持特征部，以在其3D成形期间容纳钉腿。
在各种实例中，成形为平面构型的钉和成形为非平面构型的钉可能导致不同的成形压缩高度。这可归因于需要每个钉的腿行进到限定在砧座中的其对应的钉成形凹坑的距离。例如，成形为非平面构型的钉腿可能必须沿对角线行进到对应的钉成形凹坑。在不改变缝合组件的任何其他特征部的情况下，该距离可比需要成形为平面构型的钉腿行进到对应的钉成形凹坑的距离更远。
在各种实例中，可通过改变外科缝合组件的一个或多个特征部来调节每个腿必须行进以成形为其对应的构型(非平面或平面)的距离。在至少一个实例中，限定在砧座中的钉成形凹坑的深度与要由其成形的钉的成形构型相对应地进行调节。在至少一个实例中，钉的未成形长度被构造成能够与要由其成形的钉的成形构型相对应地进行调节。在至少一个实例中，对应的驱动器高度与要由其成形的钉的成形构型相对应地进行调节。在至少一个实例中，这些调节中的一种或多种调节组合在一起以适应2D成形的钉和3D成形的钉。
图124至图128示出了外科缝合组件8000。外科缝合组件8000包括仓钳口8001，该仓钳口包括仓通道8010和钉仓8020。外科缝合组件8000还包括具有砧座8050的砧座钳口8003。钉仓8020包括多个钉腔8030和限定在仓平台8021中的纵向狭槽8022。钉仓8020还包括限定在平台8021上的多个组织抓持特征部或腔延伸部8040。钉腔8030以纵向排偏移相对于彼此对准。在该实例中，钉仓8020包括位于纵向狭槽的每一侧上的三排钉腔；然而，可采用任何合适排数的钉腔。钉腔8030被构造成能够可移除地储存钉，这些钉被构造成能够朝向限定在砧座8050的砧座表面8051中的钉成形凹坑射出。
参考图125和图126，砧座8050包括限定在砧座表面8051中的砧座狭槽8052。砧座8050还包括一对内钉成形凹坑排8061、一对中间钉成形凹坑排8063和一对外钉成形凹坑排8065。排8061、8063、8065与对应排的钉腔8030对准。内钉排8081包括被构造成能够由钉成形凹坑排8061成形的钉8070，中间钉排8082包括被构造成能够由钉成形凹坑排8063成形的钉8070，并且外钉排8083包括被构造成能够由钉成形凹坑排8065成形的钉8075。钉成形凹坑排8065中的凹坑的钉尖端进入位置与外钉排8065中的钉的尖端对准或基本上对准；然而，这些凹坑的钉尖端退出位置可相对于被定位在外钉排8065中的钉侧向偏移。钉8070、8075包括传统线材钉。钉8070、8075包括相同的未成形高度。钉8070成形为平面构型，而钉8075成形为非平面构型。
排8061的每对成形凹坑包括近侧成形凹坑8061A和远侧成形凹坑8061B。排8063的每对成形凹坑包括近侧成形凹坑8063A和远侧成形凹坑8063B。排8065的每对成形凹坑包括近侧成形凹坑8065A和远侧成形凹坑8065B。成形凹坑8061A、8061B包括沿排8061彼此对准的中心线轴线或纵向凹坑轴线。相似地，成形凹坑8063A、8063B包括沿排8063彼此对准的中心线轴线或纵向凹坑轴线。成形凹坑8065A、8065B包括中心线轴线或横向凹坑轴线，其相对于凹坑8061A、8061B的中心线轴线和凹坑8063A、8063B的中心线轴线是横向的。凹坑8065A、8065B的中心线轴线可基本上彼此平行。除上述以外，钉8070中的一个钉的近侧腿被构造成能够进入近侧成形凹坑8065A，并且钉的远侧腿被构造成能够进入远侧成形凹坑8065B。成形凹坑8065A、8065B被构造成能够引导钉8075的腿侧向远离钉的冠或侧向远离彼此(参见图126)。2D成形的钉和3D成形的钉沿缝合组件8000的宽度相对于由其限定的纵向轴线在侧向的这种变化可在缝合的组织上提供变化的组织压缩。例如，与组织的切割线附近的内2D成形的钉相比，外3D钉可提供较小的组织压缩。
如图125中可见，在每对成形凹坑8061A、8061B之间纵向限定间隙，在每对成形凹坑8063A、8063B之间纵向限定间隙，并且在每对成形凹坑8065A、8065B之间限定间隙。限定在成形凹坑8061A、8061B之间的间隙可与限定在成形凹坑8063A、8063B之间的间隙基本上相同和/或相似。限定在成形凹坑8065A、8065B之间的间隙大于限定在成形凹坑8061A、8061B之间的间隙和限定在成形凹坑8063A、8063B之间的间隙。限定在成形凹坑8065A、8065B之间的间隙可被限定为成形凹坑8065A、8065B中间的空间。
如图127和图128中可见，钉8070成形为平面构型，并且钉8075成形为非平面构型。钉8070包括冠8071和从冠8071延伸的腿8072。腿8072还包括被构造成能够刺穿组织并且进入对应的成形凹坑的钉尖端部分8073。钉8070限定成形的压缩高度“X1”，其是由钉8070捕获的组织压缩的有效高度。钉8075包括冠8076和从冠8076延伸的腿8077。腿8077还包括被构造成能够刺穿组织并且进入对应的成形凹坑的钉尖端部分8078。钉8075限定成形的压缩高度“X2”，其是由钉8075捕获的组织压缩的有效高度。由于钉8075的非平面成形构型，成形的压缩高度X2高于成形的压缩高度X1。在至少一个实例中，这是期望的，并且当钉线远离切割线侧向移动时，可提供逐渐减小的压缩。例如，当钉线相对于切割线侧向向外移动时，靠近切割线的成形较紧的压缩高度可提供足够的组织密封压力，并且远离切割线的成形较松的压缩高度逐渐减小组织上的压力。
在至少一个实例中，腿8077远离冠8076相对于彼此以不同的角度成形。例如，近侧腿可远离冠以第一角度成形，并且远侧腿可沿相反方向远离冠以第二角度成形。第一角度与第二角度不同。这将允许对应的钉成形凹坑的较窄的占有面积。此外，当将这些凹坑形状冲压到砧座中时，不同的角度和/或较窄的占有面积可确保相邻排的成形凹坑之间的壁被充分地保持，这可防止在冲压过程期间一排中的特征部渗出或冲入相邻排中的特征部中。
3D钉可在纵向排内和/或跨纵向排混合，这可最大限度地使用砧座表面并且进一步嵌套凹坑并允许较窄的占有面积。在某些实例中，3D钉凹坑的混合可改善沿砧座的组织压力分散。在至少一个实例中，3D钉凹坑可沿最外排的凹坑定位，以进一步减轻和/或逐渐减小沿离切割线最远的钉线的边缘的组织压力。
在各种实例中，抓持特征部8040和曲面平台8021可提供侧向变化的组织间隙。更具体地，每排对应的钉腔与钉成形凹坑之间用于要捕获的组织的间隙在每排之间是不同的。与内排和中间排相比，最外排包括最高的抓持特征部。这可以在3D钉被构造成能够在其中成形的排中提供附加的组织压缩。由于外钉腔的附加的腔延伸部长度，这可在钉成形期间提供更大的稳定性。较高的抓持特征部可在抓持特征部与对应的成形凹坑之间保持类似的压缩轮廓；然而，由于平台的侧向曲率，平台表面8021的限定外排钉腔的部分比平台表面8021的限定内排钉腔和中间排钉腔的部分离砧座更远。共同地，在某些实例中，较高的抓持特征部和较低的平台表面可以为3D成形的钉提供更稳定的平台。
在各种实例中，除了或代替线材钉，可使用扁平形式或冲压的钉。在各种实例中，钉仓的每一侧上的三排钉中的两排被构造成能够成形为非平面构型，而钉仓的该侧上的三排钉中的另一排被构造成能够成形为平面构型。在至少一个实例中，同一纵向排的钉包括平面成形的钉以及非平面成形的钉。在至少一个实例中，同一排内的钉的未成形高度是变化的。在至少一个实例中，不同排内的钉的未成形高度是变化的。在至少一个实例中，平面钉和非平面钉沿横向于钉仓的纵向狭槽的轴线变化以分散钉压力。在至少一个实例中，非平面成形的钉的钉腿侧向地成形在冠的一侧上，而不是相对于冠彼此远离的相反方向上。在此类实例中，每排之间的排间隙可以是基本上类似的，至少因为腿尽管在射出时远离冠成形，但是可朝向冠向后成形以收紧钉线。此类构型可帮助在每排钉成形凹坑之间保持一致的侧向排间隙。
如上所讨论，可进行一种或多种调节以改变钉的最终成形高度和/或压缩高度，因为其形式可例如侧向地、逐排地变化。图129示出了被构造成能够使从钉仓射出的钉变形的砧座8100。砧座8100包括砧座本体8110，该砧座本体包括砧座表面8111和限定在砧座本体8110中的击发构件狭槽8112。砧座表面8111包括多个钉成形凹坑排，其包括内排8121、中间排8123和外排8125。内排8121和中间排8123被构造成能够将钉成形为平面构型，并且外排8125被构造成能够将钉成形为非平面构型。如图129中可见，内排8121和中间排8123限定凹坑深度8131，并且外排限定比凹坑深度8131浅的凹坑深度8135。由于非平面钉的对角成形路径，这种较浅的凹坑深度可适应压缩损失或最终成形高度。在至少一个实例中，调节凹坑深度，使得最终压缩高度在非平面钉与平面钉之间是相同的。在另一个实例中，调节凹坑深度，使得非平面钉与平面钉之间的最终压缩高度不同。
图130示出了包括内斜坡8220和外斜坡8230的滑动件8200。内斜坡被构造成能够将钉提升高度8221，并且外斜坡8230被构造成能够将钉提升高度8231。斜坡8220被构造成能够提升要成形为平面构型的钉，并且斜坡8230被构造成能够提升要成形为非平面构型的钉。由于非平面钉的对角成形路径，高度8231可适应压缩损失或最终成形高度。
图131示出了要与外科缝合组件一起使用的钉8300。钉8300包括具有第一未成形高度8311的第一钉8310和具有第二未成形高度8321的第二钉8320。第一未成形高度8311小于第二未成形高度8321。由于非平面钉的对角成形路径，不同的未成形高度可适应压缩损失或最终成形高度。第二钉8320可被构造成能够成形为非平面构型，而第一钉8310可被构造成能够成形为平面构型。
图132和图133示出了钉8410、8420。成形为平面构型的钉8410限定最终压缩高度8411，并且成形为非平面构型的钉8420限定最终压缩高度8421。最终压缩高度8421小于压缩高度8411；然而，钉8420限定在每个成形的腿的顶点与冠之间限定的距离8422。距离8422可基本上等于最终压缩高度8411。距离8422可以是钉8420的有效压缩高度。
在各种实例中，提供了外科缝合组件，该外科缝合组件被构造成能够从钉仓过度驱动钉。钉过度驱动的量可逐排地变化。在各种实例中，钉驱动器可包括来自对应的钉仓支撑壁的变化量的支撑件。更具体地，由于仓体和击发组件和/或其中的驱动螺杆的几何形状，内部钉驱动器与外部钉驱动器相比可更少被钉仓支撑壁支撑。在各种实例中，组织间隙可逐排地变化，同时保持排之间的相似或相同驱动距离。
图134至图136示出了外科缝合组件8500。外科缝合组件8500包括下钳口8501和上钳口8502。下钳口8501包括仓通道8510和被构造成能够被接纳在仓通道8510内的钉仓8520。上钳口8502包括具有砧座主体8531的砧座8530。砧座主体8531包括砧座表面8532和限定在砧座表面8532中的多个钉成形凹坑。砧座表面8532包括内成形凹坑8533、中间成形凹坑8534和外成形凹坑8535。钉仓包括多个钉腔8522，其包括与内成形凹坑8533对准的内钉腔8522A、与中间成形凹坑8534对准的中间钉腔8522B、以及与外成形凹坑8534对准的外腔8522C。钉腔8522被构造成能够在其中储存对应的驱动器和钉，钉要被射出到与其对准的成形凹坑。
钉仓8520包括弯曲的仓平台8529，该弯曲的仓平台包括限定在其中的多个钉腔8522和从仓平台8529延伸的多个组织抓持特征部或腔延伸部8523、8524、8525。钉仓8520还包括具有斜坡8551、8552的滑动件8550。钉仓8520包括多个驱动器8540，当被斜坡8551、8552提升时，该多个驱动器顺序地对准以从钉腔射出成排的钉。每个驱动器8540包括：内排支撑件或内支撑柱8541，其被构造成能够支撑和驱动要储存在内钉腔8522A中和从其中射出的钉；中间排支撑件或中间支撑柱8542，其被构造成能够支撑和驱动要储存在中间钉腔8522B中和从其中射出的钉；以及外排支撑件或外支撑柱8543，其被构造成能够支撑和驱动要储存在外钉腔8522C中和从其中射出的钉。
如图135中可见，钉仓8520包括：内支撑壁8526A，其被构造成能够当驱动器8540被滑动件8550提升时支撑内排支撑件8541；中间支撑壁或柱8526B，其被构造成能够当驱动器8540被滑动件8550提升时支撑中间排支撑件8542；以及外支撑壁8526c，其被构造成能够当驱动器8540被滑动件8550提升时支撑外排支撑件8543。如图135中可见，每个支撑件8541、8542、8543与其对应的支撑壁8526A、8526B、8526C之间的支撑接触水平逐排地变化。在未击发位置中，外支撑件8541具有最多的支撑接触，中间支撑件8542具有比外支撑件8541少的支撑接触，并且内支撑件8541具有最少量的支撑接触。如图135中还可见，支撑件8541、8542、8543被过度驱动到相同的极限，从而导致由支撑件8541、8542、8543支撑的每个钉的相同的驱动成形距离；然而，相对于其对应的抓持特征部8523、8524、8525的过度驱动的量逐排地变化。外排被过度驱动通过其抓持特征部最多，并且内排被过度驱动通过其抓持特征部最少。
如本文所讨论，可在外科缝合组件内替换钉仓。在各种实例中，设置也可被替换的砧座板。在此类实例中，砧座板可与对应的钉仓一起出现，使得新的钉仓和砧座板被包装在一起并且在外科缝合组件内被一起更换。在此类实例中，砧座板和对应的钉仓的各种特征部可针对彼此进行具体调节。例如，不同的砧座板可包括具有不同图案的钉成形凹坑、具有不同成形深度的钉成形凹坑和/或例如逐排变化的钉成形凹坑类型等。
通用配件轮廓可用于多种砧座板，使得缝合组件可接纳若干不同的砧座板。替换砧座板还可提供新的钉成形凹坑。砧座板和钉仓可基于钉腿长度、储存在钉仓中的钉的类型和/或钉的期望成形高度来配对。在此类实例中，被构造成能够接纳砧座板的砧座钳口可被制造成具有或不具有直接限定在其上的钉成形凹坑。这可降低制造成本，因为砧座钳口可在不同场景中再利用，而不是引入具有不同类型的成形凹坑的完全不同的外科缝合器械。
图137至图139示出了外科缝合组件8600，该外科缝合组件包括第一钳口8601和能够相对于第一钳口8601移动的第二钳口8603，以在二者之间夹紧组织。外科缝合组件8600被构造成能够切割和缝合在钳口8601、8603捕获之间的组织。第一钳口8601包括可替换钉仓8620，该可替换钉仓被构造成能够在其中的多个钉腔8622中可移除地储存多个钉，该多个钉腔限定在钉仓8620的平台表面8621中。第一钳口8601还包括被构造成能够在其中接纳可替换钉仓8620的仓通道8610。如上所讨论，各种不同类型的钉仓可安装在仓通道8610内。可替换钉仓之间的各种差异可包括例如不同的未成形钉腿高度和/或取向、不同的仓长度和/或不同的钉直径。
第二钳口8603包括可替换砧座板8640，该可替换砧座包括砧座表面8641和限定在砧座表面8641中的多个成形凹坑8642。第二钳口8603还包括上砧座钳口部分8630，该上砧座钳口部分被构造成能够在其中接纳可替换砧座板8640。在至少一个实例中，可替换砧座板8640滑入砧座钳口部分8630的远侧端部中。在至少一个实例中，可替换砧座板8640被构造成能够卡合到砧座钳口部分8630中。在至少一个实例中，砧座钳口部分8630包括由金属材料制成的可变形臂，例如，从砧座钳口部分8630的周边悬垂。可变形臂可被构造成能够在定位砧座板8640之后在将钳口8601、8603夹紧在一起时变形。在达到完全夹紧位置时，可变形臂变形，并且在其变形构型中，被构造成能够将砧座板8640抓持并保持到砧座钳口部分8630。在至少一个实例中，可夹紧构件被构造成能够由钳口8601、8603夹紧以将砧座板8640固定到砧座钳口部分8630。在此类实例中，可夹紧构件可负责使可变形臂变形。在砧座板8640固定到砧座钳口部分8630之后，可夹紧构件可在使用外科缝合组件8600之前被移除并被丢弃。在至少一个实例中，可变形构件是砧座板8630的一部分并且被构造成能够固定到砧座钳口部分8630。
在至少一个实例中，砧座帽被构造成能够被定位在砧座钳口部分8630的远侧端部上。砧座帽被构造成能够将砧座板8640固定到砧座钳口部分8630。在至少一个实例中，砧座板8640滑入砧座钳口部分8630中，并且在没有砧座帽的情况下，仅可通过从砧座钳口部分8630的远侧端部朝远侧拉动砧座板8640来移除。此类砧座帽可将砧座板8640固定在砧座钳口部分8630的远侧端部处。在至少一个实例中，砧座钳口部分8630的远侧端部包括螺纹，并且砧座帽包括对应的螺纹，该对应的螺纹被构造成能够螺纹连接到砧座钳口部分8630的远侧端部上的螺纹上，以将砧座帽固定到砧座钳口部分8630上。在至少一个实例中，砧座帽包括聚合物材料。在至少一个实例中，砧座帽卡合到砧座钳口部分8630的远侧端部上，并且从砧座钳口部分8630的远侧端部脱出以替换砧座板8640。在各种实例中，用户可安装和拆卸砧座帽。在其他实例中，需要特定工具来安装砧座帽和/或从砧座钳口部分8630拆卸砧座帽。在至少一个实例中，特定工具设置有可替换砧座板8640和/或可替换钉仓8620。如上所讨论，可替换砧座板和可替换钉仓可作为要安装在外科缝合组件内的单个可替换单元一起出现。在各种实例中，用户可混合并匹配砧座板和可替换钉仓以调节例如特定用途所需的钉线的类型、组织压缩和/或夹紧压力。这可基于例如目标组织和/或手术类型。例如，某些砧座板8640中的一排或多排成形凹坑8642可包括具有横向凹坑轴线并且被构造成能够成形3D或非平面钉的成形凹坑，如本文进一步所述，而其他排成形凹坑8642包括具有对准的凹坑轴线并且被构造成能够成形2D或平面钉的成形凹坑。附加地或另选地，砧座板可包括台阶状和/或波状外形表面，以针对某些应用优化组织间隙。
本文所述主题的各个方面在以下实施例中阐述。
实施例集1
实施例1-一种外科缝合组件，该外科缝合组件包括砧座和钉仓。砧座包括砧座表面、限定在砧座表面中的第一排成形凹坑以及限定在砧座表面中的第二排成形凹坑。钉仓包括平台表面、限定钉仓的第一仓侧和第二仓侧的纵向狭槽以及限定在第一仓侧的平台表面中的第一排钉腔，其中，第一排钉腔被定位成与纵向狭槽相距第一侧向距离。钉仓还包括：从平台表面延伸的第一排组织抓持特征部，其中，第一排组织抓持特征部与第一排钉腔和第一排成形凹坑对准，并且其中，第一排组织抓持特征部包括第一轮廓；限定在第一仓侧的平台表面中的第二排钉腔，其中，第二排钉腔被定位成与纵向狭槽相距第二侧向距离，其中，第二侧向距离大于第一侧向距离；以及从平台表面延伸的第二排组织抓持特征部，其中，第二排组织抓持特征部与第二排钉腔和第二排成形凹坑对准，其中，第二排组织抓持特征部包括第二轮廓，并且其中，第二轮廓和第一轮廓是不同的几何形状。钉仓还包括可移除地储存在第一排钉腔和第二排钉腔内的多个钉，其中，可移除地储存在第一排钉腔内的钉被构造成能够通过第一排成形凹坑成形为平面钉构型，并且其中，可移除地储存在第二排钉腔内的钉被构造成能够通过第二排成形凹坑成形为非平面钉构型。
实施例2-根据实施例1所述的外科缝合组件，其中，第一排成形凹坑中的每个成形凹坑限定纵向凹坑轴线，并且其中，纵向凹坑轴线对准。
实施例3-根据实施例2所述的外科缝合组件，其中，第二排成形凹坑中的每个成形凹坑限定横向凹坑轴线，并且其中，横向凹坑轴线横向于纵向凹坑轴线。
实施例4-根据实施例1、2和3中任一项所述的外科缝合组件，其中，砧座还包括限定在砧座表面中的第三排成形凹坑，其中，钉仓还包括限定在第一仓侧的平台表面中的第三排钉腔，其中，第三排钉腔被定位成与纵向狭槽相距第三侧向距离，并且其中，第三侧向距离小于第一侧向距离和第二侧向距离。
实施例5-根据实施例1、2、3和4中任一项所述的外科缝合组件，其中，砧座和钉仓中的至少一者能够移动以将外科缝合组件重新定位在夹紧构型中，其中，第一组织间隙距离在夹紧构型中限定在第一排钉腔与第一排成形凹坑之间，其中，第二组织间隙距离在夹紧构型中限定在第二排钉腔与第二排成形凹坑之间，并且其中，第一组织间隙距离和第二组织间隙距离是不同的距离。
实施例6-根据实施例1、2、3、4和5中任一项所述的外科缝合组件，其中，该多个钉包括线材钉。
实施例7-根据实施例6所述的外科缝合组件，其中，该多个钉包括一致的未成形高度。
实施例8-根据实施例1、2、3、4、5、6和7中任一项所述的外科缝合组件，其中，砧座和钉仓中的至少一者能够移动以将外科缝合组件重新定位在夹紧构型中，其中，钉仓还包括被定位在第一排钉腔中的多个第一钉驱动器和被定位在第二排钉腔中的多个第二钉驱动器，其中，第一成形距离在夹紧构型中限定在第一排成形凹坑与第一钉驱动器之间，其中，第二成形距离在夹紧构型中限定在第二排成形凹坑与第二钉驱动器之间，并且其中，第一成形距离和第二成形距离是不同的成形距离。
实施例9-根据实施例1、2、3、4、5、6、7和8中任一项所述的外科缝合组件，其中，平台表面包括侧向弯曲的轮廓。
实施例10-一种外科缝合组件，该外科缝合组件包括砧座和钉仓。砧座包括砧座表面、限定在砧座表面中的第一排成形凹坑以及限定在砧座表面中的第二排成形凹坑。钉仓包括平台表面，该平台表面包括第一排平台突起部和第二排平台突起部。钉仓还包括：限定第一仓侧和第二仓侧的纵向狭槽；限定在第一仓侧的平台表面中、被定位成与纵向狭槽相距第一侧向距离的第一排钉腔，其中，第一排平台突起部与第一排钉腔对准；以及限定在平台表面中、被定位成与纵向狭槽相距第二距离的第二排钉腔，其中，第二距离大于第一距离，其中，第二排平台突起部与第二排钉腔对准。钉仓还包括可移除地储存在第一排钉腔和第二排钉腔内的多个钉，其中，第一排成形凹坑被构造成能够将可移除地储存在第一排钉腔内的钉成形为平面钉构型，并且其中，第二排成形凹坑被构造成能够将可移除地储存在第二排钉腔内的钉成形为非平面钉构型。
实施例11-根据实施例10所述的外科缝合组件，其中，第一轮廓包括第一高度，其中，第二轮廓包括第二高度，并且其中，第一高度和第二高度是不同的高度。
实施例12-根据实施例10和11中任一项所述的外科缝合组件，其中，该多个钉中的每个钉包括冠、从冠延伸的近侧腿以及从冠延伸的远侧腿，其中，在平面钉构型中，近侧腿和远侧腿限定与冠共面的腿平面。
实施例13-根据实施例12所述的外科缝合组件，其中，在非平面钉构型中，近侧腿限定近侧腿平面，并且远侧腿限定远侧腿平面，并且其中，近侧腿平面横向于远侧腿平面。
实施例14-根据实施例10、11、12和13中任一项所述的外科缝合组件，其中，该多个钉中的每个钉包括相同的未成形高度。
实施例15-根据实施例10、11、12、13和14中任一项所述的外科缝合组件，其中，平台表面包括侧向弯曲的轮廓。
实施例16-根据实施例10、11、12、13、14和15中任一项所述的外科缝合组件，其中，该多个钉包括线材钉。
实施例17-根据实施例10、11、12、13、14、15和16中任一项所述的外科缝合组件，其中，第一排成形凹坑中的每个成形凹坑限定纵向凹坑轴线，其中，纵向凹坑轴线对准，其中，第二排成形凹坑中的每个成形凹坑限定横向凹坑轴线，并且其中，横向凹坑轴线横向于纵向凹坑轴线。
实施例18-一种外科缝合组件，该外科缝合组件包括轴和附接到轴的端部执行器。端部执行器包括砧座和钉仓。砧座包括砧座表面、限定在砧座表面中的第一排成形凹坑以及限定在砧座表面中的第二排成形凹坑。钉仓包括：平台表面；限定第一仓侧和第二仓侧的纵向狭槽；以及限定在第一仓侧的平台表面中、被定位成与纵向狭槽相距第一侧向距离的第一排钉腔，其中，平台表面包括与第一排钉腔对准的多个第一组织抓持特征部。钉仓还包括：限定在第二仓侧的平台表面中、被定位成与纵向狭槽相距第二距离的第二排钉腔，其中，第二距离大于第一距离，其中，第二排钉腔中的每个钉腔包括与第二排钉腔对准的多个第二组织抓持特征部，其中，第一组织抓持特征部和第二组织抓持特征部限定不同的几何形状；可移除地储存在第一排钉腔内的多个第一钉，其中，第一排成形凹坑被构造成能够将第一钉成形为具有成形高度的平面钉构型；以及可移除地储存在第二排钉腔内的多个第二钉，其中，第二排成形凹坑被构造成能够将第二钉成形为具有成形高度的非平面钉构型。
实施例19-根据实施例18所述的外科缝合组件，其中，第一排成形凹坑中的每个成形凹坑包括第一凹坑深度，并且第二排成形凹坑中的每个成形凹坑包括第二凹坑深度，并且其中，第二凹坑深度小于第一凹坑深度。
实施例20-根据实施例19所述的外科缝合组件，其中，第一成形距离由第一排成形凹坑中的成形凹坑限定，并且第二成形距离由第二排成形凹坑中的成形凹坑限定，并且其中，第一成形距离和第二成形距离是不同的成形距离。
实施例21-根据实施例18、19和20中任一项所述的外科缝合组件，其中，钉仓还包括：被构造成能够支撑第一钉的多个第一钉驱动器主体，其中，第一成形距离限定在第一钉驱动器主体与第一排成形凹坑中的成形凹坑之间；以及被构造成能够支撑第二钉的多个第二钉驱动器主体，其中，第二成形距离限定在第二钉驱动器主体与第二排成形凹坑中的成形凹坑之间。
实施例22-根据实施例21所述的外科缝合组件，其中，第一成形距离和第二成形距离是不同的成形距离。
实施例23-根据实施例18、19、20、21和22中任一项所述的外科缝合组件，其中，钉仓还包括滑动件，该滑动件包括被构造成能够射出第一钉的第一轨道以及被构造成能够射出第二钉的第二轨道，其中，第一轨道包括第一轨道驱动高度，并且第二轨道包括第二轨道驱动高度，并且其中，第一轨道驱动高度限定第一钉的第一成形距离，并且第二轨道驱动高度限定第二钉的第二成形距离。
实施例24-根据实施例23所述的外科缝合组件，其中，第一成形距离和第二成形距离是不同的成形距离。
实施例集2
实施例1-一种外科缝合组件，该外科缝合组件包括钉仓组件和击发构件组件。钉仓组件包括：滑动件；包括多个钉腔和纵向狭槽的仓体；被定位在仓体内的纵向支撑梁；以及可移除地储存在钉腔内的多个钉。击发构件组件被构造成能够移动穿过钉仓组件，其中，击发构件组件被构造成能够推动滑动件通过击发行程以从仓体射出钉，并且其中，击发构件组件包括第一击发构件，该第一击发构件包括被定位在仓体外的第一凸轮作用凸缘以及被构造成能够向纵向支撑梁施加凸轮作用力的第二凸轮作用凸缘。击发构件组件还包括第二击发构件，该第二击发构件包括被定位在仓体外侧的第三凸轮作用凸缘以及被构造成能够向纵向支撑梁施加凸轮作用力的第四凸轮作用凸缘。
实施例2-根据实施例1所述的外科缝合组件，其中，仓体包括第一材料，其中，纵向支撑梁包括第二材料，并且其中，第一材料和第二材料是不同的材料。
实施例3-根据实施例1和实施例2中任一项所述的外科缝合组件，其中，纵向支撑梁包括圆柱形腔，该圆柱形腔被构造成能够在击发行程期间接纳穿过其中的击发驱动轴。
实施例4-根据实施例3所述的外科缝合组件，其中，第一击发构件包括第一圆柱形引导件，其中，第二击发构件包括第二圆柱形引导件，并且其中，第一圆柱形引导件和第二圆柱形引导件被构造成能够在圆柱形腔内纵向平移。
实施例5-根据实施例1、2、3和4中任一项所述的外科缝合组件，其中，纵向支撑梁被定位在第一凸轮作用凸缘与第三凸轮作用凸缘之间。
实施例6-根据实施例1、2、3、4和5中任一项所述的外科缝合组件，其中，第一击发构件是钉仓组件的一部分，其中，钉仓组件是可替换的，并且其中，第一击发构件包括能够在将钉仓组件安装在仓通道中时联接到第二击发构件的钩。
实施例7-根据实施例1、2、3、4、5和6中任一项所述的外科缝合组件，其中，仓体还包括侧向相对壁和从侧向相对壁延伸的侧向支撑凸耳，并且其中，侧向支撑凸耳被构造成能够被接纳在限定在纵向支撑梁中的对应的侧向支撑狭槽内。
实施例8-根据实施例1、2、3、4、5、6和7中任一项所述的外科缝合组件，其中，第二击发构件被构造成能够推动第一击发构件。
实施例9-根据实施例1、2、3、4、5、6、7和8中任一项所述的外科缝合组件，其中，纵向支撑梁包括被构造成能够与仓通道接合的近侧钩和远侧钩，并且其中，近侧钩和远侧钩被构造成能够相对于仓通道纵向地约束纵向支撑梁。
实施例10-根据实施例1、2、3、4、5、6、7、8和9中任一项所述的外科缝合组件，其中，纵向支撑梁包括限定在其中并且被构造成能够接纳第二凸轮作用凸缘的第一凸轮作用通道，以及限定在其中并且被构造成能够接纳第四凸轮作用凸缘的第二凸轮作用通道。
实施例11-根据实施例1、2、3、4、5、6、7、8、9和10中任一项所述的外科缝合组件，其中，第一击发构件包括突出到仓体外的刀。
实施例12-一种被构造成能够被安装到外科缝合组件中的可替换钉仓，其中，可替换钉仓包括仓体，该仓体包括：内纵向支撑通道；可移除地储存在仓体内的多个钉；以及被定位在内纵向支撑通道内的内纵向支撑件。内纵向支撑件包括：限定第一上限和第一下限的第一凸轮作用通道；限定第二上限和第二下限的第二凸轮作用通道；以及被构造成能够接纳击发构件组件的对应的引导部分的引导腔。
实施例13-根据实施例12所述的可替换钉仓，其中，内纵向支撑件被构造成能够将施加到其上的凸轮作用力传递到仓体。
实施例14-根据实施例12和13中任一项所述的可替换钉仓，其中，引导腔被构造成能够在击发行程期间接纳穿过其中的柔性击发驱动轴。
实施例15-根据实施例12、13和14中任一项所述的可替换钉仓，其中，仓体还包括仓平台和仓底部，并且其中，内纵向支撑件被定位在仓平台与仓底部之间。
实施例16-根据实施例12、13、14和15中任一项所述的可替换钉仓，还包括击发构件，该击发构件包括刀和钩，该钩能够在将可替换钉仓安装到外科缝合组件中时联接到击发构件组件的可重复使用的部分。
实施例17-一种可替换钉仓，该可替换钉仓被构造成能够被安装到外科缝合组件的仓通道中。可替换钉仓包括：滑动件；包括刀和凸轮作用部分的切割构件；以及仓体，该仓体包括仓平台、限定在仓平台中的多个钉腔以及纵向支撑通道。可替换钉仓还包括：可移除地储存在钉腔内的多个钉；以及被定位在纵向支撑通道内的金属支撑主体。金属支撑主体包括：第一纵向凸轮通道，该第一纵向凸轮通道被构造成能够在击发行程期间接纳切割构件的凸轮作用部分；第二纵向凸轮通道，该第二纵向凸轮通道基本上平行于第一纵向凸轮通道；以及圆柱形引导腔，该圆柱形引导腔位于第一纵向凸轮通道与第二纵向凸轮通道之间。
实施例18-根据实施例17所述的可替换钉仓，其中，圆柱形引导腔被构造成能够在击发行程期间接纳穿过其中的柔性击发驱动轴。
实施例19-根据实施例17和18中任一项所述的可替换钉仓，其中，仓体还包括从仓体的相对壁侧向向内延伸的纵向延伸的支撑凸耳，并且其中，支撑凸耳被构造成能够被接纳在限定在金属支撑主体中的对应的纵向支撑狭槽内。
实施例20-根据实施例17、18和19中任一项所述的可替换钉仓，其中，切割构件还包括钩，该钩被构造成能够在将可替换钉仓安装到外科缝合组件中时可释放地接合外科缝合组件中的器械击发构件。
实施例集3
实施例1-一种外科缝合组件，该外科缝合组件包括：第一钳口；能够相对于第一钳口移动的第二钳口；击发螺杆；以及被构造成能够由击发螺杆致动通过击发行程的击发组件。击发组件包括主体部分和螺母。主体部分包括：被构造成能够在击发行程期间接合第一钳口的第一凸轮、被构造成能够在击发行程期间接合第二钳口的第二凸轮、被构造成能够以以不通过螺纹的方式接纳击发螺杆的通道；以及从动表面。螺母被构造成能够在击发行程期间将驱动力从击发螺杆传递到主体部分。螺母包括：从动部分，该从动部分包括经螺纹联接到击发螺杆的通道，其中，在从动部分与主体部分之间限定间隙；以及从该从动部分延伸的驱动部分，其中，驱动部分被构造成能够在击发行程期间将驱动力从击发螺杆偏心地传递到从动表面。
实施例2-根据实施例1所述的外科缝合组件，其中，驱动力相对于由击发螺杆限定的纵向轴线偏心地施加。
实施例3-根据实施例1和2中任一项所述的外科缝合组件，其中，间隙包括位于螺母的近侧端部与主体部分之间的第一纵向空间，并且其中，第二纵向空间位于螺母的远侧端部与主体部分之间。
实施例4-根据实施例1、2和3中任一项所述的外科缝合组件，其中，第一钳口和第二钳口中的一者被构造成能够接纳包括多个紧固件的紧固件仓。
实施例5-根据实施例1、2、3和4中任一项所述的外科缝合组件，其中，螺母包括聚合物材料，并且主体部分包括金属材料。
实施例6-根据实施例1、2、3、4和5中任一项所述的外科缝合组件，其中，螺母嵌入模制在击发组件内。
实施例7-根据实施例1、2、3、4、5和6中任一项所述的外科缝合组件，其中，螺母包括防旋转凸缘，该防旋转凸缘被构造成能够防止螺母随着击发螺杆一起旋转，并且其中，防旋转凸缘与述第一钳口和第二钳口中的一者接合。
实施例8-根据实施例1、2、3、4、5、6和7中任一项所述的外科缝合组件，其中，从动部分包括金属螺母，其中，驱动部分包括聚合物，并且其中，金属螺母嵌入模制在驱动部分内。
实施例9-根据实施例8所述的外科缝合组件，其中，金属螺母包括固定特征部，该固定特征部被构造成能够将金属螺母相对于驱动部分固定。
实施例10-根据实施例1、2、3、4、5、6、7、8和9中任一项所述的外科缝合组件，其中，螺母包括在螺母的第一侧与螺母的第二侧之间延伸的内交叉支架。
实施例11-根据实施例10所述的外科缝合组件，其中，击发组件的主体部分包括水平延伸的狭槽，该水平延伸的狭槽被构造成能够接纳内交叉支架。
实施例12-一种外科缝合组件，该外科缝合组件包括：第一钳口；能够相对于第一钳口移动的第二钳口；限定纵向轴线的驱动螺杆；以及被构造成能够由驱动螺杆致动通过击发行程的击发组件。击发组件包括主体部分和螺母。主体部分包括：第一凸轮，该第一凸轮被构造成能够在击发行程期间接合第一钳口；第二凸轮，该第二凸轮被构造成能够在击发行程期间接合第二钳口；驱动螺杆通道，该驱动螺杆通道的尺寸设定成接纳驱动螺杆；接合部分；以及容座，其中，接合部分延伸到容座中。螺母安装在容座中，其中，螺母包括：从动部分；以及从该从动部分延伸的驱动部分，其中，驱动部分包括安装到接合部分的支架，其中，螺母被构造成能够当螺母被驱动螺杆朝远侧和朝近侧移动时在支架处并且从驱动螺杆偏心地将驱动力传递到主体部分。
实施例13-根据实施例12所述的外科缝合组件，其中，击发组件还包括限定在从动部分与主体部分之间的间隙，并且其中，接合部分被定位在间隙上方。
实施例14-根据实施例12和13中任一项所述的外科缝合组件，其中，螺母包括梯形形状。
实施例15-根据实施例12、13和14中任一项所述的外科缝合组件，其中，螺母包括聚合物材料，并且主体部分包括金属材料。
实施例16-根据实施例12、13、14和15中任一项所述的外科缝合组件，其中，螺母嵌入模制在击发组件内。
实施例17-根据实施例12、13、14、15和16中任一项所述的外科缝合组件，其中，螺母包括防旋转凸缘，该防旋转凸缘被构造成能够防止螺母随着驱动螺杆一起旋转。
实施例18-根据实施例12、13、14、15、16和17中任一项所述的外科缝合组件，其中，支架包括多个横杆。
实施例19-一种外科端部执行器组件，该外科端部执行器组件包括：砧座；包括滑动件和多个钉的钉仓；旋转驱动螺杆；以及被构造成能够由旋转驱动螺杆致动通过击发行程以沿纵向轴线推进滑动件通过钉仓的击发构件组件。击发构件组件包括远侧头部和螺母。远侧头部包括：滑动件驱动表面，该滑动件驱动表面被构造成能够在钉仓内朝远侧推动滑动件；驱动构件通道，其中，旋转驱动螺杆被定位在驱动构件通道内；第一驱动表面；以及腔，该腔沿横向于纵向轴线定向的腔轴线限定在远侧头部中，其中，腔包括第二驱动表面。螺母包括：驱动地联接到旋转驱动螺杆的从动部分；以及从该从动部分延伸的驱动部分。驱动部分包括：邻接该第一驱动表面的第一驱动表面；以及延伸到腔中的侧向交叉构件，其中，侧向交叉构件包括邻接该第二驱动表面的第二驱动表面。
实施例20-根据实施例19所述的外科端部执行器组件，其中，螺母被构造成能够相对于旋转驱动螺杆偏心地朝远侧头部施加轴向驱动力。
实施例21-根据实施例19和20中任一项所述的外科端部执行器组件，其中，击发构件组件还包括限定在从动部分与远侧头部之间的间隙，并且其中，第一从动表面和第二从动表面被定位在间隙上方。
实施例22-根据实施例19、20和21中任一项所述的外科端部执行器组件，其中，螺母大致限定梯形形状。
实施例23-根据实施例19、20、21和22中任一项所述的外科端部执行器组件，其中，螺母嵌入模制在击发构件组件内。
实施例24-一种外科缝合组件，该外科缝合组件包括：第一钳口；能够相对于第一钳口移动的第二钳口；被构造成能够围绕驱动轴线旋转的旋转驱动构件；以及联接到旋转驱动构件的击发组件。击发组件包括第一凸轮和第二凸轮，第一凸轮被构造成能够在击发行程期间接合第一钳口，第二凸轮被构造成能够在击发行程期间接合第二钳口。击发组件还包括：驱动地联接到旋转驱动构件的从动部分；以及从该从动部分偏心地延伸的驱动部分，其中，驱动部分被构造成能够在击发行程期间将驱动力从旋转驱动构件传递到相对于驱动轴线离轴的主体部分。
实施例集4
实施例1-一种外科缝合组件，该外科缝合组件包括：砧座；被构造成能够在其中接纳钉仓的仓通道；以及击发组件。击发组件包括击发构件、击发驱动螺杆和安装件，其中，击发构件经螺纹联接到击发驱动螺杆，并且其中，击发驱动螺杆的旋转被配置成能够使击发构件在外科缝合组件内纵向移动，安装件被构造成能够将击发驱动螺杆支撑在仓通道内，其中，安装件被构造成能够允许击发驱动螺杆相对于仓通道在有限的竖直浮动范围内浮动。
实施例2-根据实施例1所述的外科缝合组件，其中，安装件包括上止挡件和下止挡件，该上止挡件和该下止挡件限定击发驱动螺杆在上止挡件与下止挡件之间的有限的竖直浮动范围。
实施例3-根据实施例1和2中任一项所述的外科缝合组件，其中，击发构件包括被构造成能够接合砧座的上凸缘和被构造成能够接合仓通道的下凸缘，其中，上凸缘和下凸缘限定击发驱动螺杆的有限的竖直浮动范围。
实施例4-根据实施例1、2和3中任一项所述的外科缝合组件，其中，击发构件包括驱动螺母切口，并且其中，驱动螺母切口限定有限的竖直浮动范围。
实施例5-根据实施例1、2、3和4中任一项所述的外科缝合组件，其中，仓通道包括近侧端部部分和远侧端部部分，其中，击发驱动螺杆在近侧端部部分和远侧端部部分处安装在仓通道内，并且其中，安装件被定位在远侧端部部分处。
实施例6-根据实施例5所述的外科缝合组件，其中，安装件包括第一安装件，其中，仓通道还包括被定位在近侧端部部分处的第二安装件，并且其中，第二安装件包括球形接头安装件。
实施例7-根据实施例1、2、3、4、5和6中任一项所述的外科缝合组件，还包括偏压构件，该偏压构件被构造成能够将击发驱动螺杆朝向安装件内的中立位置偏压。
实施例8-根据实施例1、2、3、4、5、6和7中任一项所述的外科缝合组件，其中，安装件包括凹陷的凸缘和夹具。
实施例9-根据实施例1、2、3、4、5、6、7和8中任一项所述的外科缝合组件，其中，击发驱动螺杆包括近侧端部和远侧端部，并且其中，远侧端部被型锻。
实施例10-根据实施例1、2、3、4、5、6、7、8或9中任一项所述的外科缝合组件，还包括钉仓，该钉仓包括多个钉。
实施例11-根据实施例1、2、3、4、5、6、7、8、9和10中任一项所述的外科缝合组件，其中，有限的竖直浮动范围包括介于大约0.0002英寸与大约0.0003英寸之间的范围。
实施例12-根据实施例1、2、3、4、5、6、7、8、9、10和11中任一项所述的外科缝合组件，其中，有限的竖直浮动范围包括大约0.0001英寸的范围。
实施例13-一种外科端部执行器组件，该外科端部执行器组件包括：第一钳口；能够相对于第一钳口移动的第二钳口；砧座；被构造成能够在其中接纳钉仓的仓通道，其中，仓通道包括驱动构件支撑件和击发组件。击发组件包括击发构件，该击发构件包括被构造成能够接合砧座的上凸缘和被构造成能够接合仓通道的下凸缘。击发组件还包括旋转驱动螺杆，其中，击发构件经螺纹联接到旋转驱动螺杆，使得旋转驱动螺杆的旋转被配置成能够使击发构件在外科端部执行器组件内移动通过击发行程，并且其中，驱动构件支撑件被构造成能够支撑旋转驱动螺杆并且当击发构件被推进通过击发行程时允许旋转驱动螺杆相对于驱动构件支撑件竖直地浮动。
实施例14-根据实施例13所述的外科端部执行器组件，其中，驱动构件支撑件包括上止挡件和下止挡件，该上止挡件和该下止挡件限定旋转驱动螺杆在上止挡件与下止挡件之间的有限的竖直浮动范围。
实施例15-根据实施例13和14中任一项所述的外科端部执行器组件，其中，上凸缘和下凸缘限定有限的竖直浮动范围。
实施例16-根据实施例13、14和15中任一项所述的外科端部执行器组件，其中，仓通道包括近侧端部部分和远侧端部部分，其中，旋转驱动螺杆由仓通道支撑在近侧端部部分和远侧端部部分处，并且其中，驱动构件支撑件被定位在远侧端部部分处。
实施例17-根据实施例16所述的外科端部执行器组件，其中，驱动构件支撑件包括第一驱动构件支撑件，其中，外科端部执行器组件还包括被定位在近侧端部部分处的第二驱动构件支撑件，其中，旋转驱动螺杆包括近侧安装端部，并且其中，近侧安装端部包括安装在第二驱动构件支撑件内的球形接头部分。
实施例18-根据实施例13、14、15、16和17中任一项所述的外科端部执行器组件，还包括偏压构件，该偏压构件被构造成能够将旋转驱动螺杆朝向驱动构件支撑件内的中立位置偏压。
实施例19-根据实施例13、14、15、16、17和18中任一项所述的外科端部执行器组件，其中，驱动构件支撑件包括凹陷的凸缘和夹具。
实施例20-根据实施例13、14、15、16、17、18和19中任一项所述的外科端部执行器组件，还包括钉仓，该钉仓包括多个钉。
实施例21-一种外科缝合组件，该外科缝合组件包括轴和端部执行器。端部执行器包括第一钳口、能够相对于第一钳口移动的第二钳口、砧座、仓通道和击发组件。击发组件包括击发驱动螺杆和击发构件，该击发构件包括经螺纹联接到击发驱动螺杆的驱动螺母，其中，击发驱动螺杆的旋转致动被构造成能够使击发构件在端部执行器内纵向移动通过击发行程，并且其中，驱动螺母被构造成能够在击发行程期间相对于击发构件浮动。
实施例22-根据实施例21的外科缝合组件，其中，驱动螺母被构造成能够相对于击发构件相对于击发行程侧向地和竖直地浮动。
本文所述的许多外科器械系统由电动马达促动；但是本文所述的外科器械系统可以任何合适的方式促动。在各种实例中，例如，本文所述的外科器械系统可由手动操作的触发器促动。在某些实例中，本文公开的马达可包括机器人控制系统的一部分或多个部分。此外，本文公开的任何端部执行器和/或工具组件可与机器人外科器械系统一起使用。例如，名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS”的美国专利申请序列13/118,241号(现为美国专利9,072,535号)更详细地公开了机器人外科器械系统的若干示例。
已结合钉的部署和变形描述了本文所述的外科器械系统；然而，本文所述的实施方案不限于此。例如，设想了部署除钉之外的紧固件诸如夹具或大头钉的各种实施方案。此外，还设想了利用用于密封组织的任何合适装置的各种实施方案。例如，根据各种实施方案的端部执行器可包括被配置成能够加热和密封组织的电极。另外，例如，根据某些实施方案的端部执行器可施加振动能量来密封组织。
下述专利的全部公开内容据此以引用方式并入本文：
-公布于1995年4月4日的名称为“ELECTROSURGICAL HEMOSTATIC DEVICE”的美国专利5,403,312号；
-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号；
-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号；
-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号；
-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号；
-公布于2010年7月13日的名称为“SURGICAL STAPLING INSTRUMENTS”的美国专利7,753,245号；
-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号；
-名称为“SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”的美国专利申请序列11/343,803号，现为美国专利7,845,537号；
-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12/031,573号；
-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12/031,873号，现为美国专利7,980,443号；
-名称为“MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”的美国专利申请序列12/235,782号，现为美国专利8,210,411号；
-名称为“POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLYRETRACTABLE FIRING SYSTEM”的美国专利申请序列12/249,117号，现为美国专利8,608,045号；
-提交于2009年12月24日的名称为“MOTOR-DRIVEN SURGICAL CUTTINGINSTRUMENT WITH ELECTRIC ACTUATORDIRECTIONAL CONTROL ASSEMBLY”的美国专利申请序列12/647,100号，现为美国专利8,220,688号；
-提交于2012年9月29日的名称为“STAPLE CARTRIDGE”的美国专利申请序列12/893,461号，现为美国专利8,733,613号；
-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13/036,647号，现为美国专利8,561,870号；
-名称为“SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS”的美国专利申请序列13/118,241号，现为美国专利9,072,535号；
-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13/524,049号，现为美国专利9,101,358号；
-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13/800,025号，现为美国专利9,345,481号；
-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13/800,067号，现为美国专利申请公布2014/0263552号；
-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号；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号，现为美国专利8,308,040号。
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能够在单次使用之后废弃，或者其可被设计成能够多次使用。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理解，对装置进行修整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，将该器械放置在密闭且密封的容器(诸如，塑料或TYVEK袋)中。然后可将容器和器械置于可穿透容器的辐射场，诸如γ辐射、X射线和/或高能电子。辐射可杀死器械上和容器中的细菌。经消毒的器械随后可被储存在无菌容器中。密封容器可将器械保持为无菌的，直至在医疗设施中将该容器打开。还可使用本领域已知的任何其他技术对装置进行消毒，所述技术包括但不限于β辐射、γ辐射、环氧乙烷、等离子过氧化物和/或蒸汽。
尽管本发明已被描述为具有示例性设计，但可在本公开的实质和范围内进一步修改本发明。因此，本申请旨在涵盖使用本发明的一般原理的本发明的任何变型、用途或改型。
以引用方式全文或部分地并入本文的任何专利、公布或其他公开材料均仅在所并入的材料不与本发明所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。因此，并且在必要的程度下，本文明确列出的公开内容代替以引用方式并入本文的任何冲突材料。据称以引用方式并入本文但与本文列出的现有定义、陈述或其他公开材料相冲突的任何材料或其部分，将仅在所并入的材料与现有的公开材料之间不产生冲突的程度下并入。

Claims (20)

1.一种外科缝合组件，包括：
钉仓组件，所述钉仓组件包括：
滑动件；
仓体，所述仓体包括：
多个钉腔；以及
纵向狭槽；
纵向支撑梁，所述纵向支撑梁被定位在所述仓体内；以及
多个钉，所述多个钉可移除地储存在所述钉腔内；以及
击发构件组件，所述击发构件组件被构造成能够移动穿过所述钉仓组件，其中，所述击发构件组件被构造成能够推动所述滑动件通过击发行程以从所述仓体射出所述钉，并且其中，所述击发构件组件包括：
第一击发构件，所述第一击发构件包括：
第一凸轮作用凸缘，所述第一凸轮作用凸缘被定位在所述仓体外部；以及
第二凸轮作用凸缘，所述第二凸轮作用凸缘被构造成能够向所述纵向支撑梁施加凸轮作用力；以及
第二击发构件，所述第二击发构件包括：
第三凸轮作用凸缘，所述第三凸轮作用凸缘被定位在所述仓体外部；以及
第四凸轮作用凸缘，所述第四凸轮作用凸缘被构造成能够向所述纵向支撑梁施加凸轮作用力。
2.根据权利要求1所述的外科缝合组件，其中，所述仓体包括第一材料，其中，所述纵向支撑梁包括第二材料，并且其中，所述第一材料和所述第二材料是不同的材料。
3.根据权利要求1所述的外科缝合组件，其中，所述纵向支撑梁包括圆柱形腔，所述圆柱形腔被构造成能够在所述击发行程期间接纳穿过所述圆柱形腔的击发驱动轴。
4.根据权利要求3所述的外科缝合组件，其中，所述第一击发构件包括第一圆柱形引导件，其中，所述第二击发构件包括第二圆柱形引导件，并且其中，所述第一圆柱形引导件和所述第二圆柱形引导件被构造成能够在所述圆柱形腔内纵向平移。
5.根据权利要求1所述的外科缝合组件，其中，所述纵向支撑梁被定位在所述第一凸轮作用凸缘和所述第三凸轮作用凸缘之间。
6.根据权利要求1所述的外科缝合组件，其中，所述第一击发构件是所述钉仓组件的一部分，其中，所述钉仓组件是可替换的，并且其中，所述第一击发构件包括能够在将所述钉仓组件安装在仓通道中时联接到所述第二击发构件的钩。
7.根据权利要求1所述的外科缝合组件，其中，所述仓体还包括侧向相对壁和从所述侧向相对壁延伸的侧向支撑凸耳，并且其中，所述侧向支撑凸耳被构造成能够被接纳在限定在所述纵向支撑梁中的对应的侧向支撑狭槽内。
8.根据权利要求1所述的外科缝合组件，其中，所述第二击发构件被构造成能够推动所述第一击发构件。
9.根据权利要求1所述的外科缝合组件，其中，所述纵向支撑梁包括被构造成能够与仓通道接合的近侧钩和远侧钩，并且其中，所述近侧钩和所述远侧钩被构造成能够相对于所述仓通道纵向地约束所述纵向支撑梁。
10.根据权利要求1所述的外科缝合组件，其中，所述纵向支撑梁包括：
第一凸轮作用通道，所述第一凸轮作用通道限定在所述纵向支撑梁中并且被构造成能够接纳所述第二凸轮作用凸缘；以及
第二凸轮作用通道，所述第二凸轮作用通道限定在所述纵向支撑梁中并且被构造成能够接纳所述第四凸轮作用凸缘。
11.根据权利要求10所述的外科缝合组件，其中，所述第一击发构件包括突出到所述仓体外的刀。
12.一种可替换钉仓，所述可替换钉仓被构造成能够被安装到外科缝合组件中，其中，所述可替换钉仓包括：
仓体，所述仓体包括内纵向支撑通道；
多个钉，所述多个钉可移除地储存在所述仓体内；以及
内纵向支撑件，所述内纵向支撑件被定位在所述内纵向支撑件通道内，其中，所述内纵向支撑件包括：
第一凸轮作用通道，所述第一凸轮作用通道限定第一上限和
第一下限；
第二凸轮作用通道，所述第二凸轮作用通道限定第二上限和
第二下限；以及
引导腔，所述引导腔被构造成能够接纳击发构件组件的对应引导部分。
13.根据权利要求12所述的可替换钉仓，其中，所述内纵向支撑件被构造成能够将施加到其上的凸轮作用力传递到所述仓体。
14.根据权利要求12所述的可替换钉仓，其中，所述引导腔被构造成能够在击发行程期间接纳穿过所述引导腔的柔性击发驱动轴。
15.根据权利要求12所述的可替换钉仓，其中，所述仓体还包括仓平台和仓底部，并且其中，所述内纵向支撑件被定位在所述仓平台与所述仓底部之间。
16.根据权利要求12所述的可替换钉仓，还包括击发构件，所述击发构件包括：
刀；以及
钩，当所述可替换钉仓安装到所述外科缝合组件中时，所述钩能够联接到击发构件组件的可重复使用部分。
17.一种可替换钉仓，所述可替换钉仓被构造成能够被安装到外科缝合组件的仓通道中，其中，所述可替换钉仓包括：
滑动件；
切割构件，所述切割构件包括刀和凸轮作用部分；
仓体，所述仓体包括：
仓平台；
多个钉腔，所述多个钉腔限定在所述仓平台中；以及
纵向支撑通道；
多个钉，所述多个钉可移除地储存在所述钉腔内；以及
金属支撑体，所述金属支撑体被定位在所述纵向支撑通道内，其中，所述金属支撑体包括：
第一纵向凸轮通道，所述第一纵向凸轮通道被构造成能够在击发行程期间接纳所述切割构件的所述凸轮作用部分；
第二纵向凸轮通道，所述第二纵向凸轮通道基本上平行于所述第一纵向凸轮通道；以及
圆柱形引导腔，所述圆柱形引导腔介于所述第一纵向凸轮通道和所述第二纵向凸轮通道之间。
18.根据权利要求17所述的可替换钉仓，其中，所述圆柱形引导腔被构造成能够在所述击发行程期间接纳穿过所述圆柱形引导腔的柔性击发驱动轴。
19.根据权利要求17所述的可替换钉仓，其中，所述仓体还包括从所述仓体的相对壁侧向向内延伸的纵向延伸的支撑凸耳，并且其中，所述支撑凸耳被构造成能够被接纳在限定在所述金属支撑主体中的对应的纵向支撑狭槽内。
20.根据权利要求17所述的可替换钉仓，其中，所述切割构件还包括钩，所述钩被构造成能够在将所述可替换钉仓安装到所述外科缝合组件中时可释放地接合所述外科缝合组件中的器械击发构件。
CN202280037605.0A 2021-03-24 2022-03-21 包括纵向支撑梁的外科钉仓 Pending CN117337156A (zh)

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