JP2019513045A - Surgical stapling system with contourable shaft - Google Patents

Abstract

Disclosed is a surgical instrument configured to deploy an array of loop staples comprising a contourable frame.

Description

  The present invention relates to surgical instruments and, in various configurations, to surgical stapling and severing instruments and staple cartridges for use therewith, designed to staple and cut tissue.

Various features of the embodiments described herein, as well as their advantages, can be understood by the following description in conjunction with the accompanying drawings in which:
FIG. 10 is a perspective view of a surgical instrument with a replaceable surgical tool assembly, according to at least one embodiment. FIG. 7 is another perspective view of the handle assembly of the surgical instrument of FIG. 1 with portions of the handle housing omitted to expose the contained components. FIG. 4 is an exploded view of the handle assembly portion of the surgical instrument of FIGS. 1 and 2; FIG. 5 is a cross-sectional perspective view of the handle assembly of FIGS. 2 and 3; FIG. 5 is a partial cross-sectional side view of the handle assembly of FIGS. 2-4, showing the grip portion of the handle assembly as a solid line at one position relative to the main housing portion and a phantom line at another position relative to the main housing portion of the handle assembly Indicated. 6 is a cross-sectional view of the handle assembly of FIGS. 2-5, taken along line 6-6 in FIG. 5; FIG. 7 is another cross-sectional end view of the handle assembly of FIGS. 2-6, taken along line 7-7 in FIG. 5; FIG. 8 is another cross-sectional end view of the handle assembly of FIGS. 2-7, showing the shifter gear meshing with the drive gear on the rotational drive socket; FIG. 9 is another cross-sectional end view of the handle assembly of FIGS. 2-8, showing the position of the shifter solenoid when the shifter gear is meshing with the drive gear on the rotational drive socket; FIG. 10 is another perspective view of the handle assembly of FIGS. 2-9, with its particular portion shown in cross section and its access panel portion shown in phantom. FIG. 12 is a top view of the handle assembly of FIGS. 2-11, with the relief system shown in an operable position. FIG. 12 is a perspective view of the relief handle of the relief system shown in FIGS. FIG. 13 is an exploded view of the relief handle portion of FIG. 12 with the portion shown in cross section. FIG. 12 is a front elevational view of the handle assembly of FIG. FIG. 6 illustrates an exploded view of the replaceable tool assembly, according to at least one embodiment. FIG. 16 is a perspective view of the replaceable tool assembly of FIG. 15; FIG. 16 is a cross-sectional perspective view of the interchangeable tool assembly of FIG. 15; FIG. 16 is an exploded cross-sectional view of the interchangeable tool assembly of FIG. FIG. 16 is a perspective view of the articulation block of the interchangeable tool assembly of FIG. 15; FIG. 20 is a cross-sectional perspective view of an articulation joint in the interchangeable tool assembly of FIG. 15 comprising the articulation block of FIG. 19; FIG. 21 is another cross-sectional perspective view of the articulating joint of FIG. 20. FIG. 16 is a partially exploded view of the interchangeable tool assembly of FIG. 15; FIG. 16 is another partially exploded view of the interchangeable tool assembly of FIG. 15; FIG. 21 is a partially exploded view of the articulating joint of FIG. 20. FIG. 16 is a cross-sectional perspective view of the proximal end of the interchangeable tool assembly of FIG. 15; FIG. 16 is an end view of the interchangeable tool assembly of FIG. 15; FIG. 27 is a cross-sectional view of the end effector of the interchangeable tool assembly of FIG. 15 taken along line 27-27 of FIG. 26, illustrating the clamped end effector in the unfired state; FIG. 28 is a cross-sectional view of the end effector of the interchangeable tool assembly of FIG. 15 taken along line 28-28 of FIG. 26 illustrating the clamped end effector in the unfired state; FIG. 29 is a cross-sectional view of the end effector of the interchangeable tool assembly of FIG. 15 taken along line 29-29 of FIG. 26, illustrating the clamped end effector in the unfired state; FIG. 16 is a cross-sectional view of the end effector of the interchangeable tool assembly of FIG. 15 illustrated in a disassembled state. FIG. 16 illustrates the end effector of the interchangeable tool assembly of FIG. 15 articulated in a first direction. FIG. 16 illustrates the end effector of the interchangeable tool assembly of FIG. 15 articulated in a second direction. FIG. 16 is a perspective view of the cartridge body of the replaceable tool assembly of FIG. 15; FIG. 10 is a perspective view of a cartridge body in accordance with at least one alternative embodiment. FIG. 18 is an exploded view of an end effector of the interchangeable tool assembly, according to at least one alternative embodiment. FIG. 36 is an exploded view of the end effector of FIG. 35; FIG. 18 is an exploded view of an end effector of the interchangeable tool assembly, according to at least one alternative embodiment. FIG. 18 is an exploded view of an end effector of the interchangeable tool assembly, according to at least one alternative embodiment. FIG. 10 is a perspective view illustrating a staple cartridge and shaft of a surgical stapling instrument according to at least one embodiment. FIG. 40 is a partial cross-sectional view of a staple cartridge assembled to the stapling instrument of FIG. 39; FIG. 18 is a partial cross-sectional view of a surgical stapling instrument including a closure drive, an anvil, and a lockout configured to prevent the anvil from being assembled to the closure drive when the closure drive is not in a fully extended position. . FIG. 42 is a partial cross-sectional view of the surgical stapling instrument of FIG. 41 illustrating the anvil attached to the closure drive; FIG. 17 is a partial perspective view of a surgical stapling instrument comprising a staple cartridge and a closure drive configured to move the anvil relative to the staple cartridge; FIG. 44 is a partial cross-sectional view of the stapling instrument of FIG. 43 illustrating a lockout configured to prevent retraction of the closure drive without the anvil being attached to the closure drive; FIG. 45 is a partial cross-sectional view of the stapling instrument of FIG. 44 illustrating the anvil attached to the closure drive and the lockout being disengaged from the closure drive; A surgical instrument comprising: a staple cartridge in which staples are removably stored; an anvil; a closing drive configured to move the anvil relative to the staple cartridge; and a firing drive configured to eject the staples from the staple cartridge FIG. 2 is a partial cross-sectional view of a stapling instrument. FIG. 17 is a detail view of the lockout configured to prevent actuation of the firing drive prior to moving the anvil to the closed position. FIG. 48 is a detail view of the lockout of FIG. 47 being disengaged from the launch drive; A surgical instrument comprising: a staple cartridge in which staples are removably stored; an anvil; a closing drive configured to move the anvil relative to the staple cartridge; and a firing drive configured to eject the staples from the staple cartridge FIG. 1 is a partial perspective view of a stapling instrument. Details of the lockout of the surgical stapling instrument of FIG. 49 configured to prevent the firing drive from operating before the anvil applies sufficient pressure to the tissue captured between the anvil and the staple cartridge FIG. FIG. 51 is a detail view of the lockout of FIG. 50 being disengaged from the launch drive. A surgical instrument comprising: a staple cartridge in which staples are removably stored; an anvil; a closing drive configured to move the anvil relative to the staple cartridge; and a firing drive configured to eject the staples from the staple cartridge FIG. 1 is a partial perspective view of a stapling instrument. FIG. 53 is a detail view of the lockout of the surgical stapling instrument of FIG. 52 configured to prevent the anvil from disengaging from the closure drive while the cutting member of the firing drive is exposed on the staple cartridge. FIG. 54 is a detail view of the lockout of FIG. 53 being disengaged from the anvil after the firing drive is fully retracted after the firing stroke. A surgical instrument comprising: a staple cartridge in which staples are removably stored; an anvil; a closing drive configured to move the anvil relative to the staple cartridge; and a firing drive configured to eject the staples from the staple cartridge FIG. 2 is a partial cross-sectional view of a stapling instrument. FIG. 56 is a partial cross-sectional view of the surgical stapling instrument of FIG. 55 illustrating the closed drive in the clamped configuration and the firing drive in the unfired configuration; In the figure, the firing drive is holding the lockout in the unreleased configuration. FIG. 56 is a partial cross-sectional view of the surgical stapling instrument of FIG. 55 illustrating the firing drive in an at least partially fired configuration and the lockout of FIG. 56 in a released configuration; FIG. 56 is a partial cross-sectional view of the surgical stapling instrument of FIG. 55 illustrating the closure drive in an extended or open configuration and the lockout of FIG. 56 engaged with the closure drive to prevent the closure drive from being re-clamped; FIG. A staple cartridge from which staples are removably stored, an anvil, a closing drive configured to move the anvil relative to the staple cartridge, and a staple from the staple cartridge illustrated in an invalid or locked out configuration FIG. 1 is a cross-sectional view of a surgical stapling instrument with a firing drive configured to fire. FIG. 60 is an end cross-sectional view of the surgical stapling instrument of FIG. 59 taken along line 59A-59A of FIG. 59; FIG. 60 is a cross-sectional view of the surgical stapling instrument of FIG. 59 illustrated in a clamped configuration in which the firing drive is in effect; 60 is an end cross-sectional view of the surgical stapling instrument of FIG. 59 taken along line 60A-60A of FIG. 60; A surgical instrument comprising: a staple cartridge in which staples are removably stored; an anvil; a closing drive configured to move the anvil relative to the staple cartridge; and a firing drive configured to eject the staples from the staple cartridge FIG. 2 is a partial cross-sectional view of a stapling instrument. In the figure, the closed drive is illustrated in an unclamped configuration, and the launch drive is illustrated in an inoperable configuration. FIG. 62 is a partial cross-sectional view of the surgical stapling instrument of FIG. 61 with the closure drive illustrated in a clamped configuration and the firing drive illustrated in an operable configuration; FIG. 62 is a perspective view of the rotatable intermediate drive member of the firing drive of the surgical instrument of FIG. 61; FIG. 62 is a partial perspective view of the rotary firing shaft of the firing drive of the surgical instrument of FIG. 61; FIG. 65 is a front view of a spring system configured to bias the firing shaft of FIG. 64 out of engagement with the intermediate drive member of FIG. 63; FIG. 10 is an exploded view of an end effector of a surgical stapling instrument comprising a staple cartridge, according to at least one embodiment. FIG. 73 is a partial cross-sectional view of the end effector of FIG. 66 illustrating a lockout configured to prevent the end effector from operating when the staple cartridge is not fully assembled to the stapling instrument; FIG. 73 is a partial cross-sectional view of the end effector of FIG. 66 illustrating the lockout in an unlocked configuration; FIG. 10 is an exploded view of an end effector of a surgical stapling instrument comprising a staple cartridge, according to at least one embodiment. 70 is a partial cross-sectional view of the end effector of FIG. 69 illustrating a lock configured to releasably retain a staple cartridge in a stapling instrument. 70 is a partial cross-sectional view of the end effector of FIG. 69 illustrating the lock in an unlocked configuration. FIG. 7 illustrates a shaft of a surgical stapling instrument configured for use with a staple cartridge selected from a plurality of looped staple cartridges. FIG. 73 is a cross-sectional view of the distal end of the stapling instrument of FIG. 72; Partial cross-sectional view of a surgical stapling instrument comprising an unfired staple cartridge and a lockout system configured to prevent the staple cartridge from being fired again after having been previously fired by the firing drive of the surgical instrument It is. FIG. 75 is a partial cross-sectional view of the stapling instrument of FIG. 74 illustrated in a clamping configuration and the firing drive in a fired configuration; FIG. 74 is a partial cross-sectional view of the stapling instrument of FIG. 74 and the firing drive in a retracted configuration, illustrated in an unclamped configuration; FIG. 74 is an end view of the firing drive and frame of the stapling instrument of FIG. 74 illustrating the firing drive in an unfired configuration; 75 is an end view of the firing drive and frame of the stapling instrument of FIG. 74 illustrating the firing drive in a retracted configuration; FIG. FIG. 74 is an end view of an alternative staple cartridge design that can be used with the stapling instrument of FIG. 74; FIG. 74 is an end view of an alternative staple cartridge design that can be used with the stapling instrument of FIG. 74; FIG. 10 is a perspective view of a surgical stapling instrument comprising a flexible shaft, according to at least one embodiment. FIG. 10 is a schematic view of a surgical instrument kit comprising a plurality of end effectors according to at least one embodiment. FIG. 1 is a schematic view of a robotic surgical instrument system comprising a plurality of attachable end effectors according to at least one embodiment. FIG. 83 is a perspective view of the plurality of end effectors shown in FIG. 82. FIG. 10 is a perspective view of an anvil in accordance with at least one embodiment. Figure 84 is a cross-sectional view of the anvil of Figure 84; FIG. 84A is a partial cross-sectional view of an end effector comprising the anvil of FIG. 84, shown in a fired configuration; FIG. 10 is a perspective view of an anvil in accordance with at least one embodiment. FIG. 90 is a plan view of the anvil of FIG. 87. FIG. 10A is a cross-sectional view of an end effector according to at least one embodiment, illustrated in a clamped but unfired configuration. FIG. 90 is a cross-sectional view of the end effector of FIG. 89 illustrated in a fired configuration. FIG. 16 is a cross-sectional view of an end effector according to at least one alternative embodiment, illustrated in a clamped but unfired configuration. FIG. 91 is a cross-sectional view of the end effector of FIG. 91 illustrated in a fired configuration; FIG. 16 is a cross-sectional view of an end effector according to at least one alternative embodiment, illustrated in a clamped but unfired configuration. FIG. 91 is a cross-sectional view of the end effector of FIG. 91 illustrated in a fired configuration; FIG. 10 is a perspective view of a staple forming pocket according to at least one embodiment. FIG. 96 is a cross-sectional view of the staple forming pocket of FIG. 95; FIG. 17 is an exploded view of an end effector according to at least one embodiment configured to sequentially deploy a first annular row of staples and a second annular row of staples. FIG. 98 is a partial cross-sectional view of the end effector of FIG. 97 illustrating a firing driver deploying a first row of staples; FIG. 98 is a partial cross-sectional view of the end effector of FIG. 97 illustrating the firing driver of FIG. 98 deploying a second row of staples; Sequentially driving a first driver for firing the first row of staples, a second driver for firing the second row of staples, and then a third driver for driving the cutting member FIG. 10 is a partial perspective view of a launch drive that is configured to FIG. 100 is a partial perspective view of the firing drive of FIG. 100 illustrating the first driver in a fired position; FIG. 100 is a partial perspective view of the firing drive of FIG. 100 illustrating the second driver in a fired position; FIG. 100 is a partial perspective view of the firing drive of FIG. 100 illustrating the third driver in a fired position; FIG. 100 is an exploded view of the launch drive of FIG. 100; FIG. 140 is a partial perspective view of the launch drive of FIG. 100 in the configuration of FIG. 103; FIG. 10 is an exploded view of a launch drive, according to at least one alternative embodiment. FIG. 10 is a perspective view of a portion of a surgical staple cartridge for use with a circular surgical stapling instrument, according to at least one embodiment. Fig. 6 illustrates a pair of staples according to at least one embodiment in an unformed and formed configuration. FIG. 108 is a cross-sectional view of a portion of the anvil associated with the portion of the surgical staple cartridge of FIG. 107 prior to actuation of the staple forming process; FIG. 110 is another cross-sectional view of the anvil of FIG. 109 and the staple cartridge of FIG. 107 after the staples have been formed; FIG. 10 is a perspective view of a portion of a surgical staple cartridge for use with a circular surgical stapling instrument, according to at least one embodiment. FIG. 112 is a cross-sectional view of a portion of the anvil associated with the portion of the surgical staple cartridge of FIG. 111 prior to actuation of the staple formation process; FIG. 113 is another cross-sectional view of the anvil and staple cartridge of FIG. 112 after the staples have been formed. FIG. 5 is a top view of a staple cartridge, according to at least one embodiment. FIG. 10 is a bottom view of an anvil in accordance with at least one embodiment. FIG. 10 is a cross-sectional view of a portion of an anvil associated with a portion of a surgical staple cartridge. 3 shows three unformed surgical staples. FIG. 5 illustrates a partial cross-sectional view of a staple cartridge of an annular stapler, according to at least one embodiment. FIG. 6 illustrates a partial perspective view of a staple cartridge of an annular stapler according to at least one embodiment.

  Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set forth herein illustrate various embodiments of the invention in one form, and such exemplifications should be construed as limiting the scope of the invention in any manner. Absent.

The applicants of the present application own the following patent applications filed the same day as the present application, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. _________, title of the invention "METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM", Attorney Docket No. END 7821 USNP / 150 535,
-U.S. Patent Application No. _________, title of the invention "MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY", Attorney Docket No. END 7822 USNP / 150 536,
-U.S. Patent Application No. _________, title of the invention "SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD", Attorney Docket No. END 7822 USNP 1 / 150536-1,
-U.S. Patent Application No. _________, title of the invention "SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIP PORTION", Attorney Docket No. END 7823 USNP / 150537,
-U.S. Patent Application No. _________, Title of the invention "ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUALS BAILOUT SYSTEM", Attorney Docket No. END 7824 USNP / 150538,
-U.S. Patent Application No. _________, entitled "SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVIL CONCENTRIC DRIVE MEMBER", Attorney Docket No. END7825USNP / 150539;
-U.S. Patent Application No. _________, title of the invention "CLOSURE SYSTEM ARRANGEMENTS FOR SURGICAL CUTTING AND STAPLING DEVICES WITH SEPARATE AND DISTINCT FIRING SHAFTS", Attorney Docket No. END 7826 USNP / 150 540,
-U.S. Patent Application No. __________, entitled "INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL END EFFECTOR THAT IS SELECTIVELY ABOUT ABOUT SHAFT AXIS", Attorney Docket No. END 7827 USNP / 150541,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION", Attorney Docket Number END 7829 USNP / 150543,
-U.S. Patent Application No. _________, Title of the Invention "SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVE CUTTING OF TISSUE", Attorney Docket No. END 7830 USNP / 150544,
-U.S. Patent Application No. _________, title of the invention "SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSION LOCKOUT", Attorney Docket No. END 7832 USNP / 150 546,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT", Attorney Docket No. END 7833 USNP / 150547,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT", Attorney Docket No. END 7834 USNP / 150548,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT", Attorney Docket No. END 7835 USNP / 150549,
-U.S. Patent Application No. _________, title of the invention "SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGE LOCKOUT", Attorney Docket No. END 7836 USNP / 150 550,
-U.S. Patent Application No. _________, entitled "SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM", Attorney Docket No. END 7837 USNP / 150551,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS", Attorney Docket No. END 7838 USNP / 150552,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING INSTRUMENT", Attorney Docket No. END 7839 USNP / 150553,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OF STAPLES HAVING DIFFERENT HEIGHTS", Attorney Docket No. END 7840 USNP / 150 554,
-U.S. Patent Application No. _________, entitled "SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET", Attorney Docket No. END 7841 USNP / 150 555,
-U.S. Patent Application No. _________, entitled "ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS", Attorney Docket No. END7842USNP / 150556,
-U.S. Patent Application No. _________, title of the invention "STAPLE CARTRIDGES WITH ATRAUMATIC FEATURE", Attorney Docket No. END7843USNP / 150557,
-U.S. Patent Application No. _________, title of the invention "CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUE SUPPORT", Attorney Docket No. END 7844 USNP / 150 558,
-U.S. Patent Application No. _________, title of the invention "CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM", Attorney Docket No. END 7845 USNP / 150559, and-U.S. Patent Application No. _________, Name "CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL", Proxy Person serial number END7845USNP1 / 150559-1.

The applicant of the present application also holds the US patent applications designated below, filed on Dec. 31, 2015, each of which is incorporated herein by reference in its entirety.
-U.S. Patent Application No. 14 / 984,488, entitled "MECHANISMS FOR COMPENSATING FOR BATTERY PACKURE IN POWERED SURGICAL INSTRUMENTS",
-US patent application no. 14/984, 525, title of the invention "MECHANISMS FOR COMPENSATING FOR DRIVE TRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS", and-US patent application no. AND MOTOR CONTROL CIRCUITS.

The applicant of the present application also holds the US Patent Applications designated as follows, filed on February 9, 2016, each of which is incorporated herein by reference in its entirety.
-U.S. Patent Application No. 15 / 019,220, entitled "SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLY TRANSLATABLE END EFFECTOR",
-U.S. Patent Application No. 15 / 019,228, entitled "SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATION ARRANGEMENTS",
-U.S. Patent Application No. 15 / 019,196, entitled "SURGICAL INSTRUMENT ATICULATION MECHANISM WITH SLOTTED SECONDARY CONSTRAINT",
-U.S. Patent Application No. 15 / 019,206, entitled "SURGICAL INSTRUMENTS WITH AN END EFFECT EFFECTOR THAT IS HIGHLY ARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY",
-U.S. Patent Application No. 15 / 019,215, entitled "SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTIFICATION ARRANGEMENTS",
-U.S. Patent Application No. 15 / 019,227, entitled "ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATION LINK ARRANGEMENTS",
-U.S. Patent Application No. 15 / 019,235, entitled "SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLE DRIVEN ARTICULATION SYSTEMS",
-U.S. Patent Application No. 15 / 019,230, "ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAM ARRANGEMENTS",-U.S. Patent Application No. 15 / 019,245, "SURGICAL INSTRUMENTS WITH CLOSURE STROKE" REDUCTION ARRANGEMENTS ".

The applicant of the present application also holds the US Patent Applications designated as follows, filed on February 12, 2016, each of which is incorporated herein by reference in its entirety.
-U.S. Patent Application No. 15 / 043,254, entitled "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS";
-U.S. Patent Application No. 15 / 043,259, entitled "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS";
-U.S. Patent Application No. 15 / 043,275; title of the invention "MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS"; FAILURE IN POWERED SURGICAL INSTRUMENTS ".

The applicant of the present application owns the following patent applications filed on June 18, 2015, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 14 / 742,925, entitled "SURGICAL END EFFECTS WITH POSITIVE JAW OPENING ARRANGEMENTS",
-U.S. Patent Application No. 14 / 742,941, entitled "SURGICAL END EFFECTS WITH DUAL CAM ACTUATED JAW CLOSING FEATURES";
No. 14 / 742,914, entitled "MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS",
-U.S. Patent Application No. 14 / 742,900, entitled "ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAM STRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT",
-U.S. Patent Application No. 14 / 742,885, "DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS", and-U.S. Patent Application No. 14 / 742,876, names "PUSH / PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLE" SURGICAL INSTRUMENTS ".

The applicant of the present application owns the following patent applications filed on March 6, 2015, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 14 / 640,746, entitled "POWERED SURGICAL INSTRUMENT",
No. 14 / 640,795, entitled "MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWERED SURGICAL INSTRUMENTS",
-U.S. Patent Application No. 14 / 640,832, entitled "Adaptive TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATE FOR MULTIPLE TISSUE TYPES", Attorney Docket No. END7557USNP / 140482,
No. 14 / 640,935, entitled "OVERLAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION",
-US Patent Application No. 14 / 640,831, entitled "MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTOR FOR POWERED SURGICAL INSTRUMENTS",
-U.S. Patent Application No. 14 / 640,859, entitled "TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE STABILITY, CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES",
-U.S. Patent Application No. 14 / 640,817, entitled "INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS",
No. 14 / 640,844, entitled "CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULAR SHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE",
-US patent application Ser. No. 14 / 640,837, entitled "SMART SENSORS WITH LOCAL SIGNAL PROCESSING",
-U.S. Patent Application No. 14 / 640,765, entitled "SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGE INTO A SURGICAL STAPLER",
-U.S. Patent Application No. 14 / 640,799, title of the invention "SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A ROTATABLE SHAFT", and-U.S. Patent Application No. 14 / 640,780, title of the invention "SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING ".

The applicant of the present application owns the following patent applications filed on February 27, 2015, each of which is incorporated herein by reference in its entirety:
No. 14 / 633,576, entitled "SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION"
-U.S. Patent Application No. 14 / 633,546, entitled "SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCE PARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND",
-U.S. Patent Application No. 14 / 633,576, entitled "SURGICAL CHARGING SYSTEM THAT CHARGES AND / OR CONDITIONS ONE OR MORE BATTERIES",
-U.S. Patent Application No. 14 / 633,566, entitled "CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR CHARGING A BATTERY",
No. 14 / 633,555, entitled "SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TO BE SERVICED",
-U.S. Patent Application No. 14 / 633,542, entitled "REINFORCED BATTERY FOR A SURGICAL INSTRUMENT",
-US patent application Ser. No. 14 / 633,548, entitled "POWER ADAPTER FOR A SURGICAL INSTRUMENT",
No. 14 / 633,526, entitled "ADAPTABLE SURGICAL INSTRUMENT HANDLE",
-U.S. Patent Application No. 14 / 633,541, title of the invention "MODULAR STAPLING ASSEMBLY", and-U.S. Patent Application No. 14 / 633,562, title of the invention "SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFE PARAMETER ".

The applicants of the present application own the following patent applications filed on December 18, 2014, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 14 / 574,478, entitled "SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING",
No. 14 / 574,483, entitled "SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS",
-U.S. Patent Application No. 14 / 575,139, entitled "DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS",
-U.S. Patent Application No. 14 / 575,148, entitled "LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH ARTICULA TABLE SURGICAL END EFFECTORS";
No. 14 / 575,130, entitled "SURGICAL INSTRUMENT WITH ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE",
-U.S. Patent Application No. 14 / 575,143, entitled "SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS",
-U.S. Patent Application No. 14 / 575,117, entitled "SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS",
-U.S. Patent Application No. 14 / 575,154, entitled "SURGICAL INSTRUMENTS WITH ARTICULA TABLE END EFFECTS AND IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS",
-U.S. Patent Application No. 14/5744, 493, "SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM", and-U.S. Patent Application No. 14/574, 500, "SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION" SYSTEM ".

The applicant of the present application owns the following patent applications filed on March 1, 2013, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 13 / 782,295, entitled "Articulable Surgical Instruments With Conductive Pathways For Signal Communication", now U.S. Patent Application Publication No. 2014/0246471,
No. 13 / 782,323, entitled "Rotary Powered Articulation Joints For Surgical Instruments", now U.S. Patent Application Publication No. 2014/0246472,
No. 13 / 782,338, entitled "Thumbwheel Switch Arrangements For Surgical Instruments", now U.S. Patent Application Publication No. 2014/0249557,
No. 13 / 782,499, entitled "Electromechanical Surgical Device with Signal Relay Arrangement", now U.S. Patent Application Publication No. 2014/0246474,
-U.S. Patent Application No. 13 / 782,460, entitled "Multiple Processor Motor Control for Modular Surgical Instruments", now U.S. Patent Application Publication No. 2014/0246478,
No. 13 / 782,358, entitled "Joystick Switch Assemblies For Surgical Instruments", now U.S. Patent Application Publication No. 2014/0246477,
No. 13 / 782,481, entitled "Sensor Straightened End Effector During Removal Through Trocar", now U.S. Patent Application Publication No. 2014/0246479,
-U.S. Patent Application No. 13 / 782,518, entitled "Control Methods for Surgical Instruments with Removable Implement Portions", now U.S. Patent Application Publication No. 2014/0246475,
-U.S. patent application Ser. No. 13 / 782,375, entitled "Rotary Powered Surgical Instruments With Multiple Degrees of Freedom", now U.S. Patent Application Publication No. 2014/0246473, and
-U.S. Patent Application No. 13 / 782,536, entitled "Surgical Instrument Soft Stop", now U.S. Patent Application Publication No. 2014/0246476.

The applicant of the present application also owns the following patent applications filed on March 14, 2013, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 13 / 803,097, entitled "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE", now U.S. Patent Application Publication No. 2014 / 026,354;
No. 13 / 803,193, entitled "CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT", now U.S. Patent Application Publication No. 2014/0263537,
-U.S. Patent Application No. 13 / 803,053, entitled "INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT", now U.S. Patent Application Publication No. 2014/0263564,
-U.S. Patent Application No. 13 / 803,086, entitled "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTIFICATION LOCK", now U.S. Patent Application Publication No. 2014/0263541,
No. 13 / 803,210, entitled "SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS", currently U.S. Patent Application Publication No. 2014/0263538,
-U.S. Patent Application No. 13 / 803,148, entitled "MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT", now U.S. Patent Application Publication No. 2014/0263554,
-US patent application Ser. No. 13 / 803,066, entitled "DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS", now US Patent Application Publication No. 2014/0263565,
US patent application Ser. No. 13 / 803,117, entitled "ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS", now US Patent Application Publication No. 2014/0263553,
-U.S. patent application Ser. No. 13 / 803,130, entitled "DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS", currently U.S. Patent Application Publication No. 2014/0263543, and
US patent application Ser. No. 13 / 803,159, entitled "METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT", now US Patent Application Publication No. 2014/0277017.

The applicant of the present application also owns the following patent application filed on March 7, 2014, the entire content of which is incorporated herein by reference:
U.S. Patent Application No. 14 / 200,111, entitled "CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2014/0263539.

The applicant of the present application also owns the following patent applications filed on March 26, 2014, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 14 / 226,106, entitled "POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2015/0272582,
-U.S. Patent Application No. 14 / 226,099, entitled "STERILIZATION VERIFICATION CIRCUIT", now U.S. Patent Application Publication No. 2015/0272581;
-U.S. Patent Application No. 14 / 226,094, entitled "VERIFICATION OF NUMBER OF BATTERY EXCHANGES / PROCEDURE COUNT", now U.S. Patent Application Publication No. 2015/0272580,
No. 14 / 226,117, entitled "POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL", now U.S. Patent Application Publication No. 2015/0272574,
-U.S. Patent Application No. 14 / 226,075, entitled "MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES", now U.S. Patent Application Publication No. 2015/0272579,
No. 14 / 226,093, entitled "FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS", currently U.S. Patent Application Publication No. 2015/0272569,
-U.S. Patent Application No. 14 / 226,116, entitled "SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION", now U.S. Patent Application Publication No. 2015/0272571,
-U.S. Patent Application No. 14 / 226,071, entitled "SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR", now U.S. Patent Application Publication No. 2015/0272578,
-U.S. Patent Application No. 14 / 226,097, entitled "SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS", now U.S. Patent Application Publication No. 2015/0272570,
-U.S. Patent Application No. 14 / 226,126, entitled "INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2015/0272572,
-U.S. Patent Application No. 14 / 226,133, entitled "MODULAR SURGICAL INSTRUMENT SYSTEM", now U.S. Patent Application Publication No. 2015/0272557,
No. 14 / 226,081, entitled SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT, now U.S. Patent Application Publication No. 2015/0277471,
-U.S. Patent Application No. 14 / 226,076, entitled "POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION", now U.S. Patent Application Publication No. 2015/0280424,
-U.S. Patent Application No. 14 / 226,111, entitled "SURGICAL STAPLING INSTRUMENT SYSTEM", now U.S. Patent Application Publication No. 2015/0272583;
U.S. Patent Application No. 14 / 226,125, entitled "SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT", now U.S. Patent Application Publication No. 2015/0280384.

The applicant of the present application also owns the following patent applications filed on September 5, 2014, which are incorporated herein by reference in their respective entire contents:
-U.S. Patent Application No. 14 / 479,103, entitled "CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE", now U.S. Patent Application Publication No. 2016/0066912,
-U.S. Patent Application No. 14 / 479,119, entitled "ADJUNCT WITH INTEGRATED SENSOR TO QUANTIFY TISSUE COMPRESSION", now U.S. Patent Application Publication No. 2016/0066914,
-U.S. Patent Application No. 14 / 478,908, entitled "MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION", now U.S. Patent Application Publication No. 2016/0066910,
-U.S. Patent Application No. 14 / 478,895, entitled "MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION", now U.S. Patent Application Publication No. 2016/0066909,
No. 14 / 479,110, entitled "USE OF POLARITY OF HALL MAGNET DETECTION TO DETECT MISLOADED CARTRIDGE", now U.S. Patent Application Publication No. 2016/0066915,
No. 14 / 479,098, entitled "SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION", now U.S. Patent Application Publication No. 2016/0066911,
-U.S. Patent Application No. 14 / 479,115, "MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE", now U.S. Patent Application Publication No. 2016/0066916, and-U.S. Patent Application No. 14 / 479,108, Title of the invention "LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION", currently U.S. Patent Application Publication No. 2016/0066913.

The applicant of the present application also owns the following patent applications filed on April 9, 2014, which are incorporated herein by reference in their entirety:
-U.S. Patent Application No. 14 / 248,590, entitled "MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS", now U.S. Patent Application Publication No. 2014/0305987,
-U.S. Patent Application No. 14 / 248,581, entitled "SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRING DRIVE OPERATED FROM THE SAME ROTA TABLE OUTPUT", now U.S. Patent Application Publication No. 2014/0305989.
-U.S. Patent Application No. 14 / 248,595, entitled "SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING THE OPERATION OF THE SURGICAL INSTRUMENT", currently U.S. Patent Application Publication No. 2014/0305988,
-U.S. Patent Application No. 14 / 248,588, entitled "POWERED LINEAR SURGICAL STAPLER", now U.S. Patent Application Publication No. 2014/0309666,
-U.S. Patent Application No. 14 / 248,591, entitled "TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT", now U.S. Patent Application Publication No. 2014/0305991,
-U.S. Patent Application No. 14 / 248,584, entitled "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS", currently U.S. Patent Application Publication No. 2014/0305994,
No. 14 / 248,587, entitled POWERED SURGICAL STAPLER, now U.S. Patent Application Publication No. 2014/0309665,
-U.S. Patent Application No. 14 / 248,586, "DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT", now U.S. Patent Application Publication No. 2014/0305990, and
U.S. Patent Application No. 14 / 248,607, entitled "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS", now U.S. Patent Application Publication No. 2014/0305992.

The applicant of the present application also owns the following patent applications filed on April 16, 2013, which are incorporated herein by reference in their entirety:
US Provisional Patent Application No. 61 / 812,365, entitled "SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR",
-US Provisional Patent Application No. 61 / 812,376, entitled "LINEAR CUTTER WITH POWER",
-US Provisional Patent Application No. 61 / 812,382, entitled "LINEAR CUTTER WITH MOTOR AND PISTOL GRIP",
-US Provisional Patent Application No. 61/812, 385, "SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS AND MOTOR CONTROL", and
US Provisional Patent Application No. 61 / 812,372, entitled "SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR".

  Numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments described herein and illustrated in the accompanying drawings. Well-known operations, components and elements have not been described in detail in order not to obscure the embodiments described herein. It is understood by the reader that the embodiments described and illustrated herein are non-limiting examples, and thus the specific structural and functional details disclosed herein are exemplary and exemplary. It will be understood to get. Variations and modifications thereto can be made without departing from the scope of the claims.

  The terms "comprise" (any form of comprise, such as "comprises" and "comprises"), "have" (any term of have, such as "has" and "having"), "include (including "include" (any form of include such as "includes" and "including") and "contain" (any form of contain such as "contains" and "containing") It is a verb. As a result, a surgical system, device, or apparatus that "includes", "includes", "includes" or "contains" one or more elements may be one or more of them. Although having elements, it is not limited to having only one or more elements. Similarly, an element of a system, device, or apparatus that "includes", "has", "includes", or "contains" one or more features, one or more of those features However, the present invention is not limited to having only one or two or more features.

  The terms "proximal" and "distal" are used herein as a reference to the clinician operating the handle portion of the surgical instrument. The term "proximal" refers to the part closest to the clinician and the term "distal" refers to the part at a distance from the clinician. It will be further understood that, for convenience and clarity, spatial terms such as "vertical", "horizontal", "above", and "below" may be used herein for the drawings. I will. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.

  Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, it is readily understood by the reader that the various methods and devices disclosed herein can be used in many surgical procedures and applications, including, for example, those associated with open surgical procedures. Will. By reading the "Forms for Carrying Out the Invention" herein, the reader can use the various instruments disclosed herein to create an incision or puncture in the tissue, eg, through a natural opening. It will be further understood that it can be inserted into the body in any way, such as through a hole. The working or end effector portion of these instruments can be inserted directly into the patient's body or through the access device with working channels that can be advanced through the end effector of the surgical instrument and the elongated shaft. It can also be done.

  The surgical stapling system can include a shaft and an end effector extending from the shaft. The end effector comprises a first jaw and a second jaw. The first jaw comprises a staple cartridge. The staple cartridge is insertable into the first jaw and removable from the first jaw, but the staple cartridge is not replaceable from the first jaw or at least not easily replaceable with another Embodiments are also recalled. The second jaw comprises an anvil configured to deform the staples ejected from the staple cartridge. Other embodiments are also envisaged, in which the second jaw is pivotable relative to the first jaw about a closing axis, but the first jaw is pivotable relative to the second jaw . The surgical stapling system further comprises an articulating joint configured to allow the end effector to rotate or articulate relative to the shaft. The end effector is rotatable about an articulation axis extending through the articulation joint. Other embodiments that do not include articulating joints are also envisioned.

  The staple cartridge comprises a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck extending between the proximal and distal ends. In use, the staple cartridge is positioned on a first side of the tissue to be stapled and the anvil is positioned on a second side of the tissue. The anvil is moved toward the staple cartridge to compress and clamp the tissue against the deck. Subsequently, the staples removably stored in the cartridge body can be deployed into the tissue. The cartridge body includes a staple cavity defined therein, wherein the staples are removably stored within the staple cavity. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are located on the first side of the longitudinal slot, and three rows of staple cavities are located on the second side of the longitudinal slot. Other arrangements of staple cavities and staples may also be possible.

  The staples are supported by a staple driver in the cartridge body. The driver is movable between a first or unfired position and a second or firing position that ejects the staples from the staple cavity. The driver is retained within the cartridge body by a carrier extending around the bottom of the cartridge body, and includes an elastic member configured to grip the cartridge body and hold the carrier relative to the cartridge body. The drivers are movable by their threads between their unfired position and their fired position. The thread is movable between a proximal position adjacent to the proximal end and a distal position adjacent to the distal end. The sled slides under the driver and comprises a plurality of ramps configured to lift the driver, with the staples supported thereon and towards the anvil.

  In addition to the above, the sled is moved distally by the firing member. The firing member is configured to contact the sled and push the sled towards the distal end. A longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member further comprises a first cam engaged to the first jaw and a second cam engaged to the second jaw. When advancing the firing member distally, the first and second cams can control the distance between the deck of the staple cartridge and the anvil, ie, the tissue clearance. The firing member also comprises a knife configured to cut tissue captured intermediate the staple cartridge and the anvil. It is desirable for the knife to be positioned at least partially proximal to the bevel so that the staples are ejected forward of the knife.

  FIG. 1 illustrates a motorized surgical system 10 that may be used to perform a variety of different surgical procedures. In the illustrated embodiment, the motorized surgical system 10 comprises a selectively reconfigurable housing or handle assembly 20 attached to one form of the replaceable surgical tool assembly 1000. For example, the system 10 shown in FIG. 1 comprises a replaceable surgical tool assembly 1000 with surgical cutting and fastening instruments, which may be referred to as an endcutter. As will be discussed in more detail below, the replaceable surgical tool assembly is adapted to support various sizes and types of staple cartridges, and has various shaft lengths, sizes, types, etc. An end effector may be provided. For example, such an arrangement may utilize any one or more fasteners suitable for fastening tissue. For example, a fastener cartridge having a plurality of fasteners removably stored therein may be removably inserted and / or attached to an end effector of a surgical tool assembly. Other surgical tool assemblies may be utilized interchangeably with the handle assembly 20. For example, replaceable surgical tool assembly 1000 may be removed from handle assembly 20 and replaced with a different surgical tool assembly configured to perform other surgeries. In other configurations, the surgical tool assembly may not be interchangeable with other surgical tool assemblies, eg, essentially comprising a dedicated shaft that is nonremovably fixed or coupled to the handle assembly 20 It is also good. The surgical tool assembly can also be referred to as an elongated shaft assembly. The surgical tool assembly may be reusable, or in other configurations, the surgical tool assembly may be designed to be disposed of after a single use.

  As we read this "form to practice the invention", the various forms of interchangeable surgical tool assemblies disclosed herein may also be advantageously used in conjunction with a robotically controlled surgical system It will be understood that it can be Thus, the terms "housing" and "housing assembly" also generate at least one control motion that can be used to actuate the elongated shaft assemblies disclosed herein and their respective equivalents. A housing or similar portion of a robotic system that houses or otherwise operably supports at least one drive system configured to apply may be included. The term "frame" may refer to a portion of a hand-held surgical instrument. The term "frame" may also refer to a portion of a robotically controlled surgical instrument and / or a portion of a robotic system that may be used to operatively control a surgical instrument. For example, the surgical tool assemblies disclosed herein may be used in various robotic systems, instruments, components, and methods, eg, US Patent Application No. 13/118, which is incorporated herein by reference in its entirety. No. 241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS", which may be used with (but not limited to) those presently disclosed in US Patent Application Publication 2012/0298719.

  Referring now to FIGS. 1 and 2, the housing assembly or handle assembly 20 may be formed of plastic, polymeric material, metal or the like, and may have any suitable fastener configuration, such as, for example, an adhesive, a screw, a press fit. It comprises a main housing part 30 which may be formed from a pair of housing segments 40, 70 which may be connected to one another by mechanisms, snap fit mechanisms, latches etc. As will be discussed in more detail below, the main housing portion 30 operatively supports the plurality of drive systems therein. The drive system is configured to generate various control motions and apply to corresponding portions of the operably mounted replaceable surgical tool assembly. The handle assembly 20 further comprises a grip portion 100 movably coupled to the main housing portion 30 and configured to be grasped and manipulated by the clinician at various positions relative to the main housing portion 30. The grip portion 100 may be formed of plastic, polymeric material, metal or the like for assembly and maintenance purposes and suitable fastener configurations such as adhesives, screws, press fit mechanisms, snap fit mechanisms, latches etc. , And may be formed of a pair of grip segments 110, 120 coupled to one another.

  As can be seen from FIG. 2, the grip portion 100 defines a grip housing 130 defining a hollow cavity 132 configured to operably support a drive motor and gearbox as will be discussed in more detail below. Prepare. The upper portion 134 of the grip housing 130 is configured to extend through the opening 80 in the main housing portion 30 and is configured to be pivotably journaled on the pivot shaft 180. Pivot shaft 180 defines a pivot axis designated "PA". See FIG. For reference purposes, the handle assembly 20 defines a handle axis designated as "HA". The same handle axis may be parallel to the shaft axis "SA" of the elongated shaft assembly of the replaceable surgical tool operably attached to the handle assembly 20. The pivot axis PA is transverse to the handle axis HA. See FIG. Such a configuration allows the grip portion 100 to pivot relative to the main housing portion 30 about the pivot axis PA to a position most suitable for the type of interchangeable surgical tool assembly coupled to the handle assembly 20. It is. Grip housing 130 generally defines a grip axis designated as "GA". See FIG. If the replaceable surgical tool assembly coupled to the handle assembly 20 comprises, for example, an end cutter, the clinician may grip the grip portion 100 relative to the main housing portion 30 with the grip axis GA relative to the handle axis HA It may be desirable to position it to be vertical or nearly vertical (angle “H1”) (referred to herein as “first grip position”). See FIG. However, if the handle assembly 20 is used to control, for example, a replaceable surgical tool assembly comprising an annular stapler, the clinician may use the grip portion 100 relative to the main housing portion 30 with a grip axis GA It may be desired to pivot to a position that is at or about 45 degrees to the handle axis HA or at an appropriate acute angle (angle "H2"). This position is referred to herein as the "second grip position". FIG. 5 illustrates the grip portion 100 at an imaginary line in the second grip position.

  Referring now to FIGS. 3-5, the handle assembly 20 also includes a grip lock system (generally, a grip lock system for selectively locking the grip portion 100 in a desired orientation with respect to the main housing portion 30). (Designated as 150). In one configuration, the grip lock system 150 comprises an arcuate series 152 of pointed teeth 154. The teeth 154 are spaced apart from one another and form a locking groove 156 therebetween. Each locking groove 156 corresponds to a particular locking angular position for the grip portion 100. For example, in at least one configuration, the teeth 154 and the locking groove or "locking position" 156 may lock the grip portion 100 at intervals of 10-15 degrees between the first grip position and the second grip position. Are arranged to allow. This arrangement may utilize two stop positions which are adjusted according to the type of instrument utilized (shaft arrangement). For example, for an end-cutter shaft arrangement, it may be approximately 90 degrees to the shaft, and for an annular stapler arrangement, the angle may be approximately 45 degrees to the shaft while advancing towards the surgeon. The grip lock system 150 further comprises a lock button 160 having a lock portion configured to lock the lock groove 156. For example, the lock button 160 is pivotally mounted on the pivot pin 131 at the main handle portion 30 so that the lock button 160 can pivot into engagement with the corresponding lock groove 156 There is. The lock spring 164 functions to engage the lock button 160 with the corresponding lock groove 156 or bias it to the locked position. The locking portion and tooth configuration function to allow the teeth 154 to slide past the locking portion when the clinician presses the lock button 160. Thus, to adjust the angular position of the grip portion 100 relative to the main housing portion 30, the clinician presses the lock button 160 and then pivots the grip portion 100 to the desired angular position. Once the grip portion 100 is moved to the desired position, the clinician releases the lock button 160. The lock spring 164 will then bias the lock button 160 towards the series of teeth 154 so that the lock portion enters the corresponding lock groove 156 and hold the grip portion 100 in place during use .

  The handle assembly 20 operatively supports the first rotational drive system 300, the second rotational drive system 320, and the third axial drive system 400. The rotary drive systems 300, 320 are each driven by a motor 200 operatively supported on the grip portion 100. As can be seen in FIG. 2, for example, motor 200 is supported within cavity 132 in grip portion 100 and includes gearbox assembly 202. The gearbox assembly 202 has an output drive shaft 204 projecting therefrom. In various forms, motor 200 may be, for example, a brushed DC drive motor having a maximum number of revolutions of about 25,000 RPM. In other configurations, the motor may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor 200 may be powered by a power source 210, which may comprise a removable power pack 212 in one form. The power supply 210 is, for example, various power supplies disclosed in more detail in US Patent Application Publication No. 2015/0272575, entitled "SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM", the entire disclosure of which is incorporated herein by reference. One of the configurations may be provided. In the illustrated configuration, for example, power pack 212 may include a proximal housing portion 214 configured to be attached to distal housing portion 216. The proximal housing portion 214 and the distal housing portion 216 are configured to operably support the plurality of batteries 218 therein. The cells 218 may each include, for example, lithium ion ("LI") or other suitable cells. Distal housing portion 216 is configured to be removably and operably attached to handle circuit board assembly 220, which is also operably coupled to motor 200. The handle circuit board assembly 220 may also be generally referred to herein as a "control system or CPU 224." A number of batteries 218, which may be connected in series, may be used as a power source for the handle assembly 20. Additionally, power source 210 may be replaceable and / or rechargeable. In other embodiments, the surgical instrument 10 may be powered by, for example, alternating current (AC). The motor 200 may be controlled by a rocker switch 206 attached to the grip portion 100.

  As outlined above, motor 200 is operatively connected to a gearbox assembly 202 comprising an output drive shaft 204. A driver bevel gear 230 is attached to the output drive shaft 204. The motor 200, gearbox assembly 202, output drive shaft 204, and driver bevel gear 230 may also be collectively referred to herein as "motor assembly 231". The driver bevel gear 230 interfaces with a driven bevel gear 234 mounted on the system drive shaft 232 and a pivoting bevel gear 238 journaled to the pivot shaft 180. The driven bevel gear 234 is an engagement release position where the driven bevel gear 234 engages with the driver bevel gear 230 on the system drive shaft 232 and the driven bevel gear 234 disengages from the driver bevel gear 230. It is axially movable between (FIG. 14). Drive system spring 235 is journaled between driven bevel gear 234 and a proximal end flange 236 formed on the proximal portion of system drive shaft 232. See FIGS. 4 and 14. As will be discussed in further detail below, drive system spring 235 functions to bias driven bevel gear 234 into disengagement with driver bevel gear 230. The pivoting bevel gear 238 facilitates pivoting movement of the output drive shaft 204 and the driver bevel gear 230 about the grip portion 100 relative to the main handle portion 30.

  In the illustrated example, system drive shaft 232 interfaces with a rotary drive selector system (generally designated 240). In at least one form, for example, the rotary drive selector system 240 includes a shifter gear 250 that is selectively moveable between the first rotary drive system 300 and the second rotary drive system 320. As seen in FIGS. 6-9, for example, the drive selector system 240 includes a shifter mounting plate 242 non-movably mounted within the main handle portion 30. For example, the shifter mounting plate 242 may be formed on the housing segments 40, 70 or frictionally held there between mounting lugs (not shown) held in some way by screws, adhesives etc. Good. With further reference to FIGS. 6-9, the system drive shaft 232 extends through the hole to the shifter mounting plate 242 and has a center or system drive gear 237 rotatably attached thereto. For example, center drive gear 237 may be attached to system drive shaft 232 by keyway configuration 233. See Figures 6-9. In another configuration, system drive shaft 232 may be rotatably supported on shifter mounting plate 242 by a corresponding bearing (not shown) attached thereto. In any event, rotation of the system drive shaft 232 will result in rotation of the central drive gear 234.

  As can be seen in FIG. 3, the first drive system 300 comprises a first drive socket 302 rotatably supported in a distal wall 32 formed in the main handle portion 30. The first drive socket 302 may comprise a first body portion 304 having a splined socket formed therein. The first drive gear 306 is formed on the first body portion 304 or is immovably attached to the first body portion 304. The first body portion 304 may be rotatably supported in corresponding holes or passageways provided in the distal wall 32 or corresponding bearings mounted on the distal wall 32 (not shown) ) May be rotatably supported. Similarly, the second rotational drive system 320 comprises a second drive socket 322 rotatably supported also on the distal wall 32 of the main handle portion 30. The second drive socket 322 may comprise a second body portion 324 having a spline socket formed therein. The second drive gear 326 is formed on the second body portion 324 or is non-rotatably attached to the second body portion 324. The second body portion 324 may be rotatably supported in corresponding holes or passageways provided in the distal wall 32 or corresponding bearings mounted on the distal wall 32 (not shown) ) May be rotatably supported. The first and second drive sockets 302, 322 are spaced apart from one another on each outer side of the handle axis HA. See, for example, FIG.

  As mentioned above, in the illustrated example, the rotary drive selector system 240 comprises a shifter gear 250. As can be seen in FIGS. 6-9, shifter gear 250 is rotatably mounted on idler shaft 252 which is movably supported in arcuate slot 244 in shifter mounting plate 242. Shifter gear 250 is free to rotate on idler shaft 252 and is mounted to maintain mesh with central drive gear 234. The idler shaft 252 is coupled to the end of the shaft 262 of the shifter solenoid 260. The shifter solenoid 260 is pinned to the main handle housing 30 such that the shifter gear 250 moves to mesh with one of the first drive gear 306 or the second drive gear 326 when the shifter solenoid 260 is actuated. Or attached in some way. For example, in one configuration, as the solenoid shaft 262 retracts (FIGS. 6 and 7), the shifter gear 250 can be driven centrally, such that actuation of the motor 200 will result in rotation of the first drive socket 302. It meshes with the gear 234 and the first drive gear 306. As can be seen from FIGS. 6 and 7, shifter spring 266 may be utilized to bias shifter gear 250 to a first actuated position. Thus, if power to the surgical instrument 10 is lost, the shifter spring 266 will automatically bias the shifter gear 250 to the first position. If the shifter gear 250 is in that position, subsequent actuation of the motor 200 will result in rotation of the first drive socket 302 of the first rotational drive system 300. When the shifter solenoid is actuated, the shifter gear 250 is moved into engagement with the second drive gear 326 on the second drive socket 322. Thereafter, actuation of the motor 200 will result in actuation or rotation of the second drive socket 322 of the second rotational drive system 320.

  As will be discussed in more detail below, the first and second rotary drive systems 300, 320 are used to move various component parts of the interchangeable surgical tool assembly coupled thereto May be As mentioned above, in at least one configuration, the shifter spring 266 biases the shifter gear 250 to the first position if power to the motor is lost during operation of the replaceable surgical tool assembly. I will. Depending on the movement of the component part of the replaceable surgical tool assembly, the application of the rotational drive motion to the first drive system 300 needs to be reversed to allow the replaceable surgical tool assembly to be removed from the patient There may be. The handle assembly 20 of the illustrated example is, for example, a manually actuable “relief” system (generally for manually applying rotational drive motion to the first rotational drive system 300 in the scenario described above , Designated as 330).

  Referring now to FIGS. 3, 10 and 11, the relief system 330 illustrated comprises a relief drive train 332 comprising a planetary gear assembly 334. In at least one form, the planetary gear assembly 334 comprises a planetary gear housing 336 that houses a planetary gear arrangement (not shown) comprising the planetary bevel gear 338. The planetary gear assembly 334 includes a relief drive shaft 340 operatively coupled to a planetary gear arrangement within the planetary gear housing 336. The rotation of the planetary bevel gear 338 rotates the planetary gear arrangement that ultimately rotates the relief drive shaft 340. The relief drive gear 342 is journaled on the relief drive shaft 340 such that the relief drive gear 342 can axially move on the relief drive shaft 340 and rotate therewith. Relief drive gear 342 is movable between a spring stop flange 344 formed on relief drive shaft 340 and a shaft end stop 346 formed on the distal end of relief drive shaft 340. Relief shaft spring 348 is journaled on relief drive shaft 340 between relief drive gear 342 and spring stop flange 344. Relief shaft spring 348 biases relief drive gear 342 distally on relief drive shaft 340. When the relief drive gear 342 is at the most distal position on the relief drive shaft 340, it meshes with the relief drive gear 350 non-rotatably attached to the system drive shaft 232. See FIG.

  Referring now to FIGS. 12 and 13, the relief system 330 comprises a relief actuator assembly or relief handle assembly 360 that facilitates applying relief drive motion to the relief drive train 332 manually. As can be seen from those figures, the relief handle assembly 360 comprises a relief bevel gear assembly 362 comprising a relief bevel gear 364 and a ratchet gear 366. The relief handle assembly 360 further comprises a relief handle 370 movably coupled to the relief bevel gear assembly 362 by a pivoting yoke 372 pivotally attached to a ratchet gear 366. The relief handle 370 is pivotally connected to the pivot yoke 372 by a pin 374 for selective pivoting movement between the storage position “SP” and the actuation position “AP”. See FIG. The handle spring 376 is used to bias the relief handle 370 to the actuated position AP. In at least one configuration, the angle between the axis SP representing the storage position and the axis AP representing the working position may be, for example, approximately 30 degrees. See FIG. As seen in FIG. 13, the relief handle assembly 360 further comprises a ratchet pole 378 rotatably mounted in a cavity or hole 377 in the pivoting yoke 372. The ratchet pole 378 is configured to mesh with the ratchet gear 366 when rotated in the actuating direction "AD" and then to rotate so as to disengage when rotated in the opposite direction. . The ratchet spring 384 and the ball member 386 are movably supported in the cavity 379 in the pivoting yoke 372 and lock the detents 380, 382 in the ratchet pole 378 when the relief handle 370 is actuated (ratcheted). Function.

  Referring now to FIGS. 3 and 10, rescue system 330 further includes a rescue access panel 390 that is steerable between an open position and a closed position. In the illustrated configuration, the rescue access panel 390 is configured to be removably coupled to the housing segment 70 of the main housing portion 30. Thus, at least in that embodiment, when the rescue access panel 390 is removed or removed from the main housing portion 30, it is said to be in the "open" position, as the rescue access panel 390 is shown. When attached, it is said to be in the "closed" position. However, other embodiments are contemplated where the access panel is movably coupled to the main housing portion such that the access panel remains attached to the open position when the access panel is in the open position. For example, in such an embodiment, the access panel may be pivotably attached to the main housing portion or may be slidably attached to the main housing portion, in an open position and a closed position. It may be steerable between. In the illustrated example, the rescue access panel 390 is configured to snap-engage with the corresponding portion of the housing segment 70 to releasably hold it in the "closed" position. Other forms of mechanical fasteners may also be used, such as screws, pins and the like.

  Regardless of whether the rescue access panel 390 is removable from the main housing portion 30 or remains movably attached to the main housing portion 30, the rescue access panel 390 either protrudes from its back side or in any manner And a drive system lock member or yoke 392 and a relief lock member or yoke 396 formed thereon. Drive system lock yoke 392 is adapted to internally receive a portion of system drive shaft 232 when relief access panel 390 is attached to main housing portion 30 (ie, relief access panel is in the “closed” position) A drive shaft notch 394 is provided. Drive system lock yoke 392 biases driven bevel gear 234 into engagement with driver bevel gear 230 (against the bias of drive system spring 235) when relief access panel 390 is in the closed position or is mounted. To function. Additionally, the relief lock yoke 396 is configured to receive a portion of the relief drive shaft 340 therein when the relief access panel 390 is attached or positioned in the closed position. Equipped with As can be seen from FIGS. 5 and 10, the relief lock yoke 396 also biases the relief drive gear 342 into disengagement with the relief drive gear 350 (with respect to the bias of the relief shaft spring 348). It functions to do. Thus, the relief lock yoke 396 prevents the relief drive gear 342 from interfering with the rotation of the system drive shaft 232 when the relief access panel 390 is in the closed position or in the closed position. In addition, the relief lock yoke 396 includes a handle notch 398 for engaging the relief handle 370 and maintaining it in the storage position SP.

  FIGS. 4, 5 and 10 illustrate the configuration of drive system components and relief system components when the relief access panel 390 is in the closed position or in the closed position. As can be seen from those figures, drive system lock member 392 biases driven bevel gear 234 into engagement with driver bevel gear 230. Thus, when the rescue access panel 390 is mounted or in the closed position, actuation of the motor 200 will result in rotation of the driver bevel gear 230 and ultimately rotation of the system drive shaft 232. Also, when in position, relief lock yoke 396 functions to bias relief drive gear 342 on system drive shaft 232 to disengage meshing with relief drive gear 350. Thus, when the rescue access panel 390 is in the closed position or in the closed position, the drive system can be actuated by the motor 200 and the rescue system 330 can be applied to the system drive shaft 232 with any actuation motion It is disconnected or prevented. To activate the rescue system 330, the clinician first removes the rescue access panel 390 or moves the rescue access panel 390 to an open position in some way. This action releases the drive system lock member 392 from engagement with the driven bevel gear 234, thereby urging the drive system spring 235 to disengage the driven bevel gear 234 from the driver bevel gear 230. It is possible to In addition, removal of the relief access panel 390 or movement of the relief access panel to the open position also results in disengaging the relief lock yoke 396 with the relief drive gear 342, thereby causing the relief shaft spring 348 to The relief drive gear 342 can be biased onto the system drive shaft 232 to mesh with the relief drive gear 350. Thus, rotation of relief drive gear 342 will result in rotation of relief drive gear 350 and system drive shaft 232. Removal of the rescue access panel 390 or movement of the rescue access panel 390 to the open position also allows the handle spring 376 to bias the rescue handle 370 into the actuated position shown in FIGS. When in that position, the clinician can manually ratchet the relief handle 370 in a ratcheting direction RD (eg, clockwise in FIG. 14) that results in rotation of the ratchet bevel gear 364, which results in a final In turn, the application of a reverse rotational motion to the system drive shaft 232 through the relief drivetrain 332 is provided. The clinician is sufficiently rotated to retract the components of the surgical end effector portion of the surgical tool assembly attached to the handle assembly 20 at many points in time the system handle shaft 232 at many points in time. You may ratchet until Once the rescue system 330 is fully actuated manually, the clinician then displaces the rescue access panel 390 (ie, returns the rescue access panel 390 to the closed position) to cause the drive system lock member 392 to receive the driven bevel gear. 234 is urged to mesh with the driver bevel gear 230, and the relief lock yoke 396 is urged to release meshing with the relief drive gear 350. As discussed above, when power is lost or interrupted, shifter spring 266 will bias shifter solenoid 260 to the first actuated position. Also, actuation of the relief system 330 will result in the application of the reverse or reverse motion to the first rotational drive system 300.

  As discussed above, the surgical stapling instrument may, for example, comprise a manually actuated relief system configured to retract the staple firing drive. In many cases, the relief system may need to be operated more than once and / or cranked in order to fully retract the staple firing drive. In such a case, the user of the stapling instrument may forget how many times the bale out has been cranked and / or has some confusion as to how much the firing drive needs to be retracted further There is a risk of The stapling instrument comprises a system configured to detect the position of the firing member of the firing drive, to determine the distance at which the firing member needs to be retracted, and to display the distance of the surgical instrument to the user. Various embodiments are recalled.

  In at least one embodiment, the surgical stapling instrument comprises one or more sensors configured to detect the position of the firing member. In at least one case, the sensor comprises, for example, a Hall effect sensor, which may be arranged on the shaft of the stapling instrument and / or the end effector. The sensor is in signal communication with a controller of the surgical stapling instrument, which in turn is in signal communication with a display on the surgical stapling instrument. The controller compares the actual position of the launch member with the data or reference position (including the fully retracted position of the launch member) and calculates the distance between the actual position of the launch member and the reference position, ie And a microprocessor configured as follows.

  In addition to the above, the display includes, for example, an electronic display, and the controller is configured to display the remaining distance on the electronic display in any suitable manner. In at least one case, the controller displays a progress bar on the display. In such cases, for example, an empty progress bar may indicate that the firing member is at the end of its firing stroke, and a full progress bar may indicate that the firing member has been fully retracted. it can. In at least one case, for example, 0% may represent that the firing member is at the end of its firing stroke, and 100% may represent that the firing member has been fully retracted. In certain instances, the controller is configured to indicate on the display how much activation of the rescue mechanism is required to retract the firing member to its fully retracted position.

  In addition to the above, actuation of the rescue mechanism can operably disconnect the battery or power source of the surgical stapling instrument from the electric drive motor of the firing drive. In at least one embodiment, actuation of the rescue mechanism pushes a switch that electrically disconnects the battery from the electric motor. Such a system would prevent the electric motor from resisting manual retraction of the launch member.

  The illustrated handle assembly 20 also supports a third axial drive system (generally designated 400). As can be seen from FIGS. 3 and 4, the third axial drive system 400 comprises, in at least one form, a solenoid 402 having a third drive actuator member or rod 410 projecting therefrom. The distal end 412 of the third drive actuator member 410 is formed with a third drive cradle formed therein for receiving a corresponding portion of the drive system components of the operatively mounted replaceable surgical tool assembly. Or has a socket 414. The solenoid 402 is wired or otherwise in communication with the handle circuit board assembly 220 and the control system or CPU 224. In at least one configuration, the solenoid 402 is "spring-loaded" such that, when the solenoid 402 is inactive, its spring component biases the third drive actuator 410 back to the inactive start position. .

  As mentioned above, the reconfigurable handle assembly 20 may be advantageously utilized to operate a variety of different replaceable surgical tool assemblies. To that end, the handle assembly 20 includes a tool attachment portion (generally designated 500) for operatively coupling the replaceable surgical tool assembly thereto. In the illustrated example, the tool mounting portion 500 is configured with two inwardly facing dovetail receiving slots 502 configured to engage with corresponding portions of the tool mounting module portion of the replaceable surgical tool assembly. Prepare. Each dovetail receiving slot 502 may be tapered or, in other words, somewhat V-shaped. The dovetail receiving slot 502 is configured to releasably receive a corresponding tapered attachment or lug portion formed on a portion of the tool attachment nozzle portion of the replaceable surgical tool assembly. Each interchangeable surgical tool assembly may also include a latch system formed on the tool mounting portion 500 of the handle assembly 20 and configured to releasably engage with a corresponding retaining pocket 504.

  Various interchangeable surgical tool assemblies are operably coupled to the "main" rotational drive system configured to operably couple or align with the first rotational drive system 310 and to the second rotational drive system 320. It may have a "secondary" rotational drive system that is configured to couple or interface. The primary and secondary rotational drive systems may be configured to provide various rotational motions to portions of a particular type of surgical end effector that comprises portions of an interchangeable surgical tool assembly. Tool attachment portion of the handle assembly 20 to facilitate operable coupling of the primary rotational drive system to the first rotational drive system and operable connection of the secondary drive system to the second rotational drive system 320 500 also aligns the first rotational drive system 300 on the handle assembly 20 to the first rotational drive system 300 and the secondary rotational drive system on the handle assembly 20 to the second rotational drive system 320 and A pair of insertions configured to distally bias portions of the primary and secondary rotational drive systems of the replaceable surgical tool assembly during the coupling process to facilitate operable coupling A lamp 506 is provided.

  The interchangeable surgical tool assembly may also include a "tertiary" axial drive system for applying axial motion to the corresponding portion of the surgical end effector of the interchangeable surgical tool assembly. To facilitate operable coupling of the tertiary axial drive system to the third axial drive system 400 on the handle assembly 20, the third drive actuator member 410 is internally configured with the tertiary axial drive system. A socket 414 is provided that is configured to operably receive a lug or other portion.

  A replaceable tool assembly 2000 is illustrated in FIG. Although the replaceable tool assembly 2000 is similar to the replaceable tool assembly 1000 in many respects, it differs from the replaceable tool assembly 1000 in certain other respects. For example, replaceable assembly 2000 is an annular staple assembly. Referring mainly to FIGS. 15 and 16, the annular stapling assembly 2000 comprises a shaft portion 2100 and an end effector 2200. Shaft portion 2100 includes a proximal portion removably attachable to handle assembly 20, for example. The end effector 2200 comprises a first portion 2210 rotatably mounted on the shaft portion 2100 about an articulation joint 2300. The end effector 2200 further comprises a second portion 2220 removably attached to the first portion 2210. The second portion 2220 comprises a cartridge portion 2222 comprising an annular array of staple cavities 2224 defined therein and a staple stored in each staple cavity 2224. The second portion 2220 further comprises an anvil 2230, which is registered with the tissue compression surface 2232 and the staple cavity 2224 and deforms the staple as the staple is ejected from the staple cavity 2224 And an annular array of forming pockets or forming pockets 2234 (FIG. 27).

  In addition to the above, referring again to FIGS. 15 and 16, the second portion 2220 of the end effector 2200 is selectively attachable to and from the first portion 2210 of the end effector 2200. It is selectively removable. The second portion 2220 comprises an outer housing 2227 comprising a proximal connector 2229 configured to be received within an opening or chamber 2218 defined in the housing 2217 of the first portion 2210. The fit between the connector 2229 of the housing 2227 and the housing 2217 of the first portion 2210 is in close proximity. A press fit between the connector 2229 and the housing 2217 may prevent the second portion 2220 from accidentally moving longitudinally and / or rotationally relative to the first portion 2210. In various cases, the detent member may be utilized to releasably secure the second portion 2220 of the end effector 2200 to the first portion 2210.

  Referring to FIGS. 15 and 35-38, the second portion 2220 of the end effector 2200 is a second other portion, such as a second portion 2220 ′, a second portion 2220 ′ ′, a second And / or another second portion 2220 or the like. The second portions 2220 ', 2220 ", and 2220"' are similar to the second portion 2220 in many respects. For example, each second portion 2220, 2220 ′, 2220 ′ ′, and 2220 ′ ′ ′ includes a central opening 2226 defined therein. However, the second portions 2220 ′, 2220 ′ ′, and 2220 ′ ′ are different from the second portion 2220 in other respects. For example, the second portion 2220 'has a larger diameter than the second portion 2220. Further, the annular array of staple cavities 2224 defined in the second portion 2220 'has a larger circumferential diameter than the annular array of staple cavities 2224 defined in the second portion 2220. Similarly, the second portion 2220 ′ ′ has a larger diameter than the second portion 2220 ′, and the annular array of staple cavities 2224 defined in the second portion 2220 ′ ′ is a second portion 2220 ′. Have a circumferential diameter greater than the annular array of staple cavities 2224 defined therein. Also similarly, the second portion 2220 ′ ′ ′ has a larger diameter than the second portion 2220 ′ ′, and the annular array of staple cavities 2224 defined in the second portion 2220 ′ ′ ′ is second Have a larger circumferential diameter than the annular array of staple cavities 2224 defined in portions 2220 '' of the.

  In addition to the above, the anvil 2230 can be replaced with other anvils, such as, for example, anvil 2230 ', anvil 2230 ", anvil 2230"' and / or another anvil 2230 or the like. Anvils 2230 ', 2230 ", and 2230"' are similar to anvil 2230 in many respects. For example, each anvil 2230, 2230 ′, 2230 ′ ′, and 2230 ′ ′ ′ comprises a longitudinal shaft 2236 comprising a connecting flange 2238. Nevertheless, the anvils 2230 ', 2230 "and 2230"' are different from the anvil 2230 in other respects. For example, the anvil 2230 'has a diameter greater than the anvil 2230. Further, the annular array of forming pockets 2234 defined in the anvil 2230 'is defined in the anvil 2230 such that the forming pockets 2234 remain aligned with the staple cavities 2224 defined in the second portion 2220'. It has a larger circumferential diameter than the annular array of forming pockets 2234. Similarly, the anvil 2230 '' has a larger diameter than the anvil 2230 'and the annular array of forming pockets 2234 defined in the anvil 2230' 'has a forming pocket 2234 defined in the second portion 2220' '. It has a larger circumferential diameter than the annular array of formed pockets 2234 defined in the anvil 2230 'so as to remain aligned with the staple cavities 2224. Also similarly, the anvil 2230 ′ ′ ′ has a larger diameter than the anvil 2230 ′ ′ and the annular array of forming pockets 2234 defined in the second portion 2220 ′ ′ ′ has a second portion forming pocket 2234 It has a larger circumferential diameter than the annular array of formed pockets 2234 defined in the anvil 2230 '' so as to remain aligned with the staple cavities 2224 defined in 2220 '' '.

  Referring mainly to FIG. 17, shaft portion 2100 includes a proximal connector 2120 and an elongated shaft portion 2110 extending distally from proximal connector 2120. Proximal connector 2120 comprises a first input 2318 and a second input 2418. The first input 2318 is operably coupled to the end effector joint system and the second input 2418 is operably coupled to the end effector clamp and staple firing system. First input 2318 and second input 2418 may operate in any suitable order. For example, the first input 2318 can rotate in a first direction to articulate the end effector 2200 in a first direction, and correspondingly, the end effector 2200 in a second direction. A second direction can be rotated to effect articulation. Once end effector 2200 is suitably articulated, second input 2428 may then be rotated to close anvil 2230 to clamp tissue against cartridge portion 2222 of end effector 2200. As discussed in more detail below, the second input 2428 can then be operated to fire staples from the staple cavity 2224 and dissect tissue captured in the end effector 2200. In various alternative embodiments, the first input 2318 and the second input 2328 may operate in any suitable order and / or simultaneously.

  The first input 2318 is attached to the proximal end of an articulation shaft 2310 rotatably attached to the shaft portion 2010. Referring mainly to FIGS. 20 and 21, the rotatable joint shaft 2310 includes a distal end and a worm gear 2312 attached to the distal end. The worm gear 2312 screw-engages with the joint slide 2320. More specifically, the articulating slide 2320 includes a threaded aperture 2322 defined therein, and the worm gear 2312 threadably engages with the threaded aperture 2322. When the articulation shaft 2310 rotates in a first direction, the worm gear 2312 pushes the articulation slide 2320 distally (FIG. 32). When the articulation shaft 2310 is rotated in the second or opposite direction, the worm gear 2312 pulls the articulation slide 2320 proximally (FIG. 31). The articulation slide 2320 is slidably supported by an articulation block 2112 fixed to the distal end of the elongated shaft portion 2110. Movement of the joint slide 2320 is limited to proximal and distal movement by the joint block 2112 with the guide slot 2315 defined in the joint block 2112. The articulating slide 2320 is longitudinally received from the longitudinal key groove 2116 defined at the bottom of the guide slot 2315 which limits relative movement between the articulating slide 2320 and the articulating block 2112 to the longitudinal path. The key 2326 is further provided.

  Referring again to FIGS. 20, 21 and 24, joint slide 2320 is coupled to joint link 2330. Articulating slide 2320 includes a drive pin 2324 extending therefrom that is located within a proximal opening 2334 defined in articulating link 2330. The drive pin 2324 is rigidly received within the opening 2334 such that the sidewalls of the drive pin 2324 and the opening 2334 cooperate to define an axis of rotation between the articulating slide 2320 and the articulating link 2330. Articulated link 2330 is also coupled to housing 2217 of end effector 2200. More specifically, the articulation link 2330 further comprises a distal opening 2335 defined therein, and the housing 2217 comprises a pin 2215 located at the distal opening 2335. The pin 2215 is closely received in the opening 2335 such that the pin 2215 and the sidewall of the opening 2335 cooperate to define an axis of rotation between the articulation link 2330 and the housing 2217.

  In addition to the above, referring to FIGS. 18-21 and 24, end effector 2200 is rotatably coupled to joint block 2112 of shaft 2100 about joint joint 2300. The housing 2217 of the end effector 2200 includes openings 2213 defined on both sides thereof, and the joint block 2112 includes protrusions 2113 disposed on the openings 2213 and extending from both sides. The projections 2113 are tightly received in the openings 2213 such that the side walls of the projections 2113 and the openings 2213 cooperate to define an articulation axis to which the end effector 2200 can be articulated. When the articulation shaft 2310 is rotated to drive the articulation slide 2320 distally, the articulation slide 2320 drives the proximal end of the articulation link 2330 distally. In response to distal movement of the proximal end of articulation link 2330, articulation link 2330 rotates about drive pin 2324 which causes end effector 2200 to rotate about articulation joint 2300. When the joint input 2310 rotates to drive the joint slide 2320 proximally, the joint slide 2320 pulls the proximal end of the joint link 2330 proximally, as described above. In response to proximal movement of the proximal end of articulation link 2330, articulation link 2330 rotates about drive pin 2324 which causes end effector 2200 to rotate about articulation joint 2300. The articulation link 2330 provides at least one play between the articulation slide 2320 and the housing 2217. As a result, articulation link 2330 enables end effector 2200 to be articulated at a wide range of articulation angles.

  As discussed above, referring to FIGS. 17 and 25, the proximal connector 2120 of the interchangeable tool assembly 2000 comprises a second input 2418. The second input 2418 comprises a drive gear 2417 that meshes with a drive gear 2416 attached to the proximal end of the drive shaft 2410. As illustrated in FIG. 19, the drive shaft 2410 extends through an opening 2114 defined in the shaft portion 2110 and the articulation block 2112. Opening 2114 includes a bearing and rotatably supports drive shaft 2410. Alternatively, the opening 2114 may comprise a clearance opening. In any event, referring primarily to FIG. 22, drive shaft 2410 extends through articulating joint 2300 into a chamber 2218 defined in end effector housing 2217. The drive shaft 2410 is rotatably supported by bearings 2414 attached to the drive shaft 2410 captured in the recess 2214 defined in the housing 2217 of the end effector 2200. Drive shaft 2410 further includes an output gear 2412 mounted at its distal end such that rotation of drive shaft 2410 is transmitted to output gear 2412.

  Referring primarily to FIGS. 18, 22 and 23, output gear 2412 of drive shaft 2410 is operatively engaged with transmission 2420. As discussed in more detail below, the transmission 2420 is a first mode of operation in which the end effector 2200 causes the drive shaft 2410 to move the anvil 2230 relative to the cartridge body 222 and the drive shaft 2410 staples the staple cavity It is configured to fire between 2224 and switch between a second mode of operation in which tissue captured between the anvil 2230 and the cartridge body 222 is incised. The transmission 2420 comprises an orbit drive comprising a planetary plate 2421 and four planetary gears 2424 rotatably mounted on the planetary plate 2421. Planetary plate 2421 includes a clearance opening extending through its center, and drive shaft 2410 extends through the clearance opening. Planetary plate 2421 and planetary gear 2424 are disposed in a chamber 2219 defined in end effector housing 2217. Each planetary gear 2424 is rotatable about a gear pin 2423 extending from the planetary plate 2421. The gear pin 2423 is disposed along the circumferential diameter surrounding the clearance opening. The output gear 2412 meshes with the planetary gear 2424 and the drive shaft 2410 drives the planetary gear 2424 as described in more detail below.

  In addition to the above, drive shaft 2410 extends through, for example, articulation joint 2300. When end effector 2200 is articulated, drive shaft 2410 is flexible because output gear 2412 remains properly engaged with planetary gear 2424. In at least one case, drive shaft 2410 is made of, for example, plastic.

  As discussed above, transmission 2420 includes a first mode of operation and a second mode of operation. Referring mainly to FIGS. 23 and 28, the replaceable tool assembly 2000 has a first position and a second position to switch the transmission 2420 between its first mode of operation and its second mode of operation. It further comprises a shifter 2600 movable between the position of. As illustrated in FIGS. 28-30, when the shifter 2600 is in the first position, the shifter 2600 is not engaged with the planetary plate 2421 of the transmission 2420, and as a result, the planetary plate 2421 and the planetary Gear 2424 is rotated by drive shaft 2410. More specifically, as described in further detail below, the drive shafts 2410 rotate the planetary gears 2424 about their respective gear pins 2423 and the planetary gears 2424 include the planetary plates 2421, the planetary gears 2424. And the annular ring of teeth 2534 extending around the planetary gear 2424. Planetary plate 2421 is operatively coupled to output coupling 2430 such that rotation of planetary plate 2421 is transmitted to output coupling 2430. Referring mainly to FIG. 23, the output coupling 2430 comprises an array of openings 2433 extending around its outer periphery. In this case, the gear pin 2423 extending from the planetary plate 2421 extends into the opening 2433 defined in the output coupling 2430 and is tightly received by the opening 2433. As a result, there is little if any relative movement between planetary plate 2421 and output coupling 2430 occurs.

  Referring mainly to FIGS. 18 and 23, the output coupling 2430 includes a drive socket 2432. The drive socket 2432 comprises, for example, a substantially hexagonal opening. However, any suitable configuration may be utilized. The drive socket 2432 is configured to receive a closure shaft 2440 extending through the second portion 2220 of the end effector 2200. The closure shaft 2440 includes a proximal drive end 2442 having a substantially hexagonal shape that is closely received within the drive socket 2432 such that rotation of the drive shaft 2410 can be transmitted to the closure shaft 2440. The closure shaft 2440 is rotatably supported by bearings 2444 in the housing 2227 of the second portion 2220. The bearing 2444 includes, for example, a thrust bearing. However, the bearings 2444 may include any suitable bearing.

  Referring primarily to FIGS. 23 and 28-30, the closure shaft 2440 includes a threaded portion 2446 that threadedly engages a threaded opening 2456 defined in the trocar 2450. As discussed in more detail below, anvil 2230 is attachable to trocar 2450, which moves anvil 2230 toward and / or away from cartridge body 2222. So that it can translate. Referring again to FIG. 18, trocar 2450 is configured to cooperate with at least one longitudinal key extending from inner surface 2546 of drive sleeve 2540, at least one longitudinal key slot defined therein. It has 2459. The drive sleeve 2540 is part of the staple firing system discussed further below, and the reader slides one of the trocar 2450 and the drive sleeve 2540 relative to one another and the two cooperate to provide relative It should be understood that it interferes with typical rotational movements. The threaded engagement between the closure shaft 2440 and the trocar 2450 allows the closure shaft 2440 to displace or translate the trocar 2450 distally when the closure shaft 2440 is rotated in a first direction, Correspondingly, trocar 2450 can be displaced or translated proximally if closure shaft 2440 is rotated in the second or opposite direction.

  As discussed above, anvil 2230 is attachable to trocar 2450. Anvil 2230 includes a connecting flange 2238 configured to engage and grip trocar 2450. Coupling flange 2238 comprises a cantilever beam coupled to shaft portion 2236 of anvil 2230. Referring primarily to FIG. 23, trocar 2450 includes a retention notch or recess 2458 configured to releasably receive connecting flange 2238 when anvil 2230 is assembled to trocar 2450. Retaining notch 2458 and connecting flange 2238 are configured to resist accidental removal of anvil 2230 from trocar 2450. Coupling flange 2238 is separated by longitudinal slots 2237. Longitudinal slot 2237 is configured to receive longitudinal rib 2457 extending from trocar 2450 when anvil 2230 is assembled to trocar 2450. Ribs 2457 are tightly received in slots 2237 and as a result, anvil 2230 is prevented from rotating relative to trocar 2450.

  As discussed above, once the anvil 2230 is suitably positioned relative to the cartridge portion 2222, the tool assembly 2000 can be switched to its second mode of operation. The shifter 2600 comprises, for example, an electrically operated motor that is utilized to switch the transmission 2420 of the end effector 2200. In various other embodiments, the shifter 2600 may comprise any suitable electrically and / or manually actuated device. The shifter 2600 is in signal communication with the processor of the surgical stapling instrument and in electrical communication with the battery of the surgical stapling instrument. In various cases, the insulated electrical wire can be, for example, between the shifter 2600 and the handle of the surgical instrument so that the processor can communicate with the shifter 2600 and the battery can provide power to the shifter 2600 extend. In various other instances, shifter 2600 can comprise a wireless signal receiver, and a processor can be in wireless communication with shifter 2600. In particular cases, power may be wirelessly supplied to shifter 2600, such as, for example, via an inductive circuit. In various cases, the shifter 2600 may itself be equipped with a power supply.

  The shifter 2600 comprises a housing attached to a chamber 2218 defined at the proximal end of the end effector 2200. The shifter 2600 includes a clutch key or toggle 2602 and an output shaft 2604 movable between a first position and a second position relative to the shifter housing. The clutch key 2602 comprises a first locking tooth 2608 and a second locking tooth 2609, and when the clutch key 2602 is in its first position, the first locking tooth 2608 is a firing tube of the staple firing system At the same time, the second lock teeth 2609 are disengaged from the planetary plate 2421 of the transmission 2420. More specifically, the first locking tooth 2608 is disposed in the opening 2538, the opening 2538 is part of an annular array of openings 2538 defined around the firing tube 2530, and the second locking tooth 2609 is Not disposed in the openings 2429, the openings 2429 are part of an annular array of openings 2429 defined around the planetary plate 2421. As a result of the above, the shifter 2600 locks out the staple firing system by preventing the firing tube 2530 from rotating when the clutch key 2602 is in its first position. As discussed above, when the clutch key 2602 is in the first position, the staple firing system is locked out by the shifter 2600 while the drive shaft 2410 rotates the planetary plate 2421 to operate the anvil closure system It can be done.

  As primarily illustrated in FIG. 23, the firing tube 2530 comprises an inner annular rack of teeth 2534 defined in its inner sidewall 2532. Planetary gear 2424 operatively engages the rack of teeth 2534. As shown in FIG. 28, when the shifter 2600 is in the first position, the firing tube 2530 is held in place by the shifter 2600 and the planetary gear 2424 is against the rack consisting of the firing tube 2530 and the teeth 2534. Can be rotated by the drive shaft 2410. In such a case, the planetary gears 2424 are rotated about the longitudinal drive axis defined by the drive shaft 2410 and at the same time rotated about the axis defined by their respective gear pins 2423. Readers should understand that the planetary gear 2424 is directly driven by the drive shaft 2410, and the reaction force generated between the planetary gear 2424 and the firing tube 2530 drives the planetary gear 2424 to rotate the planetary plate 2421. It is. When the shifter 2600 is actuated to move the clutch key 2602 to its second position, the first lock tooth 2608 is disengaged from the firing tube 2530 and at the same time the second lock tooth 2609 is planetary. Engage with plate 2421. The planetary plate 2421 is held in place by the shifter 2600 when the clutch key 2602 is in the second position, and as a result, the closure drive is locked out and can not operate to move the anvil 2230. In such a case, when the drive shaft 2410 is rotated, the output gear 2412 is driven to rotate the planetary gear 2424 with respect to the planetary plate 2421 about their respective gear pins 2423. Planetary gear 2424 drives firing tube 2530 through the rack of teeth 2534 and rotates firing tube 2530 about its longitudinal axis.

  In addition to the above, referring again to FIG. 23, the firing tube 2530 is operably coupled to the drive sleeve 2540 of the staple firing system. More specifically, the inner sidewall 2532 of the firing tube 2530 is configured to closely receive the longitudinal rib 2545 defined on the drive sleeve 2540 such that the drive sleeve 2540 rotates with the firing tube 2530. A longitudinal slot 2535 defined therein is provided. Drive sleeve 2540 further includes a threaded distal end 2542 threaded with drive collar 2550. More specifically, drive collar 2550 includes a threaded opening 2552 that threadably engages threaded distal end 2542. The drive collar 2550 is disposed, for example, in the opening 2228 defined in the housing of the end effector 2200, and the longitudinal rib and groove configuration prevents rotation within the opening 2228. As a result of the above, rotation of the drive sleeve 2540 causes the drive collar 2550 to translate longitudinally. For example, drive collar 2550 may be advanced distally if drive sleeve 2540 is rotated in a first direction and retracted proximally if drive sleeve 2540 is rotated in a second or opposite direction.

  As discussed above, when the drive collar 2550 is pushed distally, the drive collar 2550 causes the staple driver block 2560 and the cutting member 2570, eg, a knife, to be distally during the firing stroke of the staple firing system. Push. More specifically, drive collar 2550 has staple driver block 2560 and cutting member 2570 disposed in staple cavity 2224 with staples defined in cartridge body portion 2222, with cutting member 2570 at the deck surface of cartridge body portion 2222. Proximal unfired position and staples are deformed relative to the anvil 2230 and tissue captured between the anvil 2230 and the cartridge body portion 2222 is cut away by the cutting member 2570 Push between the distal fired position. The drive collar 2550 includes a drive recess 2554 configured to abut the staple driver block 2560 and the cutting member 2570 as the drive collar 2550 is advanced distally. Staple driver block 2560 includes a plurality of staple cradles defined therein. In this case, each staple cradle is configured to support the base of the staples. The staple cradle is aligned with the staple cavities 2224 defined in the cartridge body portion 2222 and arranged in at least two concentric rows.

  The staple driver block 2560 and cutting member 2570 drive so that the staple driver block 2560 and cutting member 2570 are pulled proximally by the drive collar 2550 when the drive collar 2550 is moved proximally away from the anvil 2230 Attached to collar 2550. In at least one case, staple driver block 2560 and cutting member 2570 comprise one or more hooks extending into an opening 2557 defined in drive collar 2550. In various cases, the staple driver block 2560 and the cutting member 2570 can be retracted such that they completely retract under the deck surface of the cartridge body portion 2222.

  In addition to the above, the end effector 2200 is operable in a third mode of operation in which the clutch key 2602 of the shifter 2600 is operatively engaged simultaneously with the anvil closure system and the staple firing system. In this mode of operation, the first locking tooth 2608 engages the firing tube 2530 of the staple firing system and the second locking tooth 2609 engages the planetary plate 2421 of the transmission 2420. In such instances, the first locking tooth 2608 is disposed in the opening 2538 defined in the firing tube 2530 and the second locking tooth 2609 is disposed in the opening 2429 defined in the planetary plate 2421. As a result of the above, drive shaft 2410 simultaneously moves anvil 2230, staple driver block 2560 and cutting member 2570 relative to cartridge body 2222.

  Referring again to FIG. 15, the user of the replaceable tool assembly 2000 receives from the second portion 2220, 2220 ', 2220' ', 2220' '' and / or any other suitable second portion kit. The selected and selected second portion may be assembled to the first portion 2210 of the end effector 2200. Referring mainly to FIG. 18, each second portion comprises a housing connector 2229 that engages the housing 2217 of the first portion 2210 when the second portion is assembled to the first portion 2210. Additionally, each second portion comprises a closing shaft 2440 operatively engaged with the drive socket 2432 of the first portion 2210 when the second portion is assembled to the first portion 2210. Further, each second portion includes a drive sleeve 2540 operatively engaged with the firing tube 2530 of the first portion 2210 when the second portion is assembled to the first portion 2210.

  In addition to the above, referring to FIGS. 35 and 36, the tool assembly 2000 'is interchangeable with the tool assembly 2000. Tool assembly 2000 'is similar to tool assembly 2000 in many respects. However, tool assembly 2000 ′ is configured to apply an annular staple line having a larger diameter than the annular staple line applied by tool assembly 2000. The tool assembly 2000 'includes, among other things, a wider second portion 2220', a staple driver 2560 ', a knife assembly 2570', a cartridge body 2222 ', and an anvil 2230'. Referring to FIG. 37, tool assembly 2000 ′ ′ is interchangeable with tool assembly 2000. Tool assembly 2000 " is similar to tool assemblies 2000 and 2000 " in many respects. However, the tool assembly 2000 " is configured to apply an annular staple line having a diameter greater than that applied by the tool assembly 2000 '. The tool assembly 2000 "comprises, among other things, a wider second portion 2220", a staple driver 2560 ", a knife assembly 2570", a cartridge body 2222 ", and an anvil 2230". Referring to FIG. 38, tool assembly 2000 ′ ′ ′ is interchangeable with tool assembly 2000. The tool assembly 2000 '' 'is similar to the tool assemblies 2000, 2000' and 2000 '' in many respects. However, the tool assembly 2000 '' 'is configured to apply an annular staple line having a larger diameter than the annular staple line applied by the tool assembly 2000' '. The tool assembly 2000 ′ ′ ′ comprises, inter alia, a wider second portion 2220 ′ ′ ′, a staple driver 2560 ′ ′ ′, a knife assembly 2570 ′ ′ ′, a cartridge body 2222 ′ ′ ′, and an anvil 2230 ′ ′ ′ .

  In various embodiments, in addition to the above, the surgical instrument may have any suitable number of modes of operation. In at least one embodiment, the surgical stapling instrument simultaneously performs both a first mode of operation for firing the staples, a second mode of operation for deploying the cutting member, and deployment of the staple firing and cutting member. And a third operation mode. In the first mode of operation, the cutting member is not deployed. Furthermore, the processor of such a surgical instrument can be programmed such that the instrument can not enter into the second mode of operation without first completing the first mode of operation. As a result of the above, the user of the surgical instrument may decide whether to cut tissue after the staples have been fired.

  An alternative embodiment of a staple cartridge body for use with a surgical stapler is illustrated in FIG. Cartridge body 2222 ′ comprises an annular outer row of staple cavities 2224 and an annular inner row of staple cavities 2224 ′. Staple cavities 2224 are defined in the first step of the cartridge body deck, and staple cavities 2224 'are defined in the second step of the cartridge body deck. The second step extends over the first step. In other words, the first step has a first deck height and the second step has a second deck height that is higher than the first deck height. The deck wall separates the first and second steps. In various embodiments, the deck wall is sloped. In certain embodiments, the deck wall is orthogonal to the first step and / or the second step.

  The cartridge body 2222 'further comprises a cavity extension 2229' extending from the first step of the deck. The cavity extension 2229 'surrounds the end of the staple cavity 2224 and extends the staple cavity 2224 over the first step. The cavity extension 2229 'may at least partially control the staples on the first step when the staples are ejected from the staple cavities 2224. The cavity extension 2229 'is also configured to contact the captured tissue and compress the tissue against the cartridge body 2222'. The cavity extension 2229 'may also control the flow of tissue relative to the cartridge body 2222'. For example, the cavity extension 2229 'may limit the radial flow of tissue. The cavity extension 2229 'may have any suitable configuration and may extend at any suitable height from the first step. In at least one case, the top surface of the cavity extension 2229 'is, for example, aligned with the second step or has the same height as the second step. In other cases, the cavity extension 2229 'may extend above or below the second step.

  In addition to the above, the staple cavities 2224 each comprise a first staple having a first unformed height disposed therein. The staple cavities 2224 'each include a second staple disposed therein having a second unformed height different from the first unformed height. For example, the first unformed height is greater than the second unformed height. However, the second unformed height may be higher than the first unformed height. In an alternative embodiment, the first unformed staple height and the second unformed staple height are the same.

  The first staple is deformed to a first deformed height and the second staple is deformed to a second deformed height different from the first deformed height. For example, the first deformed height is higher than the second deformed height. Such a configuration may improve blood flow in the stapled tissue. Alternatively, the second deformed height may be higher than the first deformed height. Such a configuration may improve the pliability of the tissue along the inner excision line. In certain alternative embodiments, the first deformed height and the second deformed height are the same.

  As discussed above, the replaceable tool assembly may include, among other things, a shaft, an end effector, and a replaceable staple cartridge. The replaceable staple cartridge is moved to open and close the end effector to close and cut the tissue captured in the end effector, with a closure drive configured to capture tissue in the end effector And a configured launch drive. The closing and firing drives of the end effector are operatively coupled to the corresponding closing and firing drives of the shaft when the replaceable staple cartridge is assembled to the shaft. If the replaceable staple cartridge is not properly assembled to the shaft, the replaceable staple cartridge may not operate in its intended manner. As described in more detail below, the replaceable staple cartridge and / or the shaft may include lockouts that prevent the replaceable staple cartridge from operating unless the replaceable staple cartridge is properly attached to the shaft.

  Turning now to FIG. 39, the replaceable tool assembly 3000 comprises a shaft 3010 and a replaceable staple cartridge 3020. Similar to the above, the replaceable staple cartridge 3020 has a close drive input and a fire drive operatively coupled to the close drive output and the fire drive output, respectively, when the staple cartridge 3020 is completely fixed on the shaft 3010 It has an input. The operation of such a closure and launch system is not repeated herein for the sake of brevity.

  The replaceable tool assembly 3000 further comprises a lockout circuit 3090. The lockout circuit 3090 comprises a conductor 3096 and a contact 3092. The first contact 3092 is electrically connected to the first conductor 3096, and the second contact 3092 is electrically connected to the second conductor 3096. The first contact 3092 is not electrically connected to the second contact 3092 before the staple cartridge 3020 is completely fixed on the shaft 3010. Staple cartridge 3020 includes a contact bridge 3094 that engages and is electrically connected to contact 3092 when staple cartridge 3020 is fully secured on shaft 3010. The contacts 3092 and the contact bridge 3094 are configured and arranged such that the contact bridge 3094 is not electrically connected to the contacts 3092 when the staple cartridge 3020 is only partially fixed on the shaft 3010.

  The replaceable tool assembly 3000 can be used with a surgical instrument system, including, for example, a manually operable handle and / or a robotic system. In various embodiments, the surgical instrument system includes an electric motor configured to drive the staple firing system of the tool assembly 3000, as well as a controller configured to operate the electric motor. Prepare. The lockout circuit of tool assembly 3000 is in communication with the controller. If the controller detects that the contact bridge 3094 is not engaged with the contacts 3092 or that the lockout circuit is open, the controller prevents the electric motor from operating the staple firing system. In various cases, the controller is configured to not supply power to the electric motor when the lockout circuit is open. In certain other cases, the controller can operate the closing system when the lockout circuit is in the open state, but to supply power to the electric motor so that the firing system can not operate. It is configured. In at least one such case, the controller operates a transmission connected to the electric motor such that the output of the electric motor is directed only to the closing system. The controller enables the electric motor to operate the staple firing system when the controller detects that the contact bridge 3094 is engaged with the contact 3092 or that the lockout circuit is in a closed state. .

  When the surgical instrument system includes a handle, in addition to the above, the controller may activate a trigger lock that prevents the firing trigger of the handle from activating if the controller detects that the lockout circuit is in the open configuration. . When the staple cartridge 3020 is completely fixed on the shaft 3010 and the lockout circuit is closed, the controller can retract the trigger lock and activate the firing trigger. Such systems may be utilized with motorized and / or non-motorized launch drives. The non-motor type launch drive can be driven by, for example, a hand crank.

  As discussed above, the anvil 2230 may be assembled to the closed drive trocar shaft 2450 in the tool assembly 2000. The connecting flange 2238 of the anvil 2230 is configured to engage with the recess 2458 defined in the trocar shaft 2450 to couple the anvil 2230 thereto. When the anvil 2230 is assembled to the trocar shaft 2450, the trocar shaft 2450 and the anvil 2230 can be retracted or pulled by the closure drive toward the staple cartridge 2222 to compress tissue against the staple cartridge 2222. However, in some cases, the anvil 2230 may not be properly assembled to the trocar shaft 2450. Incorrect assembly of the anvil 2230 to the trocar shaft 2450 often results in the trocar shaft 2450 extending sufficiently onto the deck of the staple cartridge 2222 as the clinician attempts to assemble the anvil 2230 onto the trocar shaft 2450. It can happen if not. In such cases, the anvil 2230 is often attached sufficiently to the trocar shaft 2450 such that the trocar shaft 2450 can move the anvil 2230 towards the staple cartridge 2222, but the anvil 2230 can be used to staple tissue 2222 The anvil 2230 can be removed from the trocar shaft 2450 if it is beginning to compress against.

  Turning now to FIGS. 39 and 40, a replaceable tool assembly 3100 is shown that is similar in many aspects to the replaceable tool assembly 2000 discussed above. The tool assembly 2000 comprises a cartridge body 3120 comprising a deck 3121 configured to support tissue when the tissue is compressed by the anvil 2130 relative to the cartridge body 3120. The tool assembly 3100 further comprises a closure drive configured to move the anvil 2130 relative to the cartridge body 3120. The closing drive comprises a trocar shaft 3150 with a recess defined internally as described above. The recess comprises a distal shoulder 3158 configured to hold the anvil 2130 to the trocar shaft 3150. In addition, the tool assembly 3100 further comprises a firing drive that is configured to eject the staples from the cartridge body 3120. The firing drive comprises a rotatable shaft 3162 and a translating collar 3160 configured to eject the staples from the cartridge body 3120 and threadedly engaged with the rotatable shaft 3162. The rotatable shaft 3162 has a longitudinal opening 3164 defined therein, and the trocar shaft 3150 extends through the opening 3164.

  In addition to the above, the closing drive further comprises a clip 3190 attached to the trocar shaft 3150. Clip 3190 comprises a base 3192 mounted in a slot defined in trocar shaft 3150. The clip 3190 further comprises a flexible arm or appendage 3198 extending from the base 3192. Arm 3198 is movable between an expanded position (FIG. 39) and a deflected position (FIG. 40). As illustrated in FIG. 40, anvil 2130 can be locked to trocar shaft 3150 when arm 3198 is in its deflected position. As illustrated in FIG. 40, the arm 3198 is held in its deflected position by the translational collar 3160 of the firing drive when the trocar shaft 3150 is fully extended onto the deck 3121 of the cartridge body 3120. Translational collar 3160 includes an annular shoulder 3168 configured to resiliently bias arm 3198 inwardly when arm 3198 contacts shoulder 3168.

  If the trocar shaft 3150 is not in a fully extended position on the cartridge deck 3121, the arm 3198 is not biased inwardly by the shoulder 3168. In such a case, as illustrated in FIG. 39, arm 3198 is in its expanded position. When the arm 3198 is in its expanded position, the arm 3198 prevents the anvil 2130 from being attached to the trocar shaft 3150. More specifically, the arms 3198 prevent the connecting flange 2138 of the anvil 2130 from being secured behind a shoulder 3158 defined on the trocar shaft 3150. In such cases, the arm 3198 prevents the anvil 2130 from being partially attached to the trocar shaft 3150, and as a result, the clinician attempts to assemble the anvil 2130 onto the trocar shaft 3150, the trocar shaft It can not be partially assembled to the 3150 and can avoid the problems described above. The reader understands that the anvil 2130 is often assembled to the trocar shaft 3150 in situ or in the patient's body, and proper assembly of the anvil 2130 to the trocar shaft 3150 facilitates completion of the surgical technique used. It should. The discussed system provides a lockout that prevents the partially assembled anvil from being compressed against the tissue.

  Switching from here to FIGS. 41-43 and as discussed in more detail below, the interchangeable tool assembly 3200 is configured to prevent retraction of the closure drive without the anvil being attached to the closure drive With lockout being done. The tool assembly 3200 comprises a shaft 3210 and an end effector 3220. End effector 3220 includes an outer housing 3227, a cartridge body 3222 and a longitudinal opening 3226 defined therethrough. The tool assembly 3200 further comprises a closure drive comprising a trocar shaft 3250 and an anvil 3230 attachable to the trocar shaft 3250. Similar to the above, the closing drive is configured to move the anvil 3230 towards and away from the cartridge body 3222. The trocar shaft 3250 is movable between an extended position and a retracted position. Both FIGS. 42 and 43 illustrate the trocar shaft 3250 in its extended position.

  In addition to the above, the tool assembly 3200 prevents the trocar shaft 3250 from moving from its extended position (FIGS. 42 and 43) towards its retracted position when the anvil 3230 is not assembled to the trocar shaft 3250. It further comprises a retraction lock 3290 which is configured. The retraction lock 3290 comprises a lock arm 3292 rotatably mounted on the housing 3227 about a projection or pin 3294. Retraction lock 3290 is configured to bias lock arm 3292 toward trocar shaft 3250 and further comprises a spring 3296 engaged with lock arm 3292. The trocar shaft 3250 comprises a locking shoulder 3258, and as illustrated in FIG. 42, when the anvil 3230 is not assembled to the trocar shaft 3250, the locking arm 3292 catches the locking shoulder 3258 and the trocar shaft 3250 is close It is configured to prevent you from moving to a position. More specifically, the lock arm 3292 comprises a catch 3298 configured to slide under the lock shoulder 3258. As illustrated in FIG. 43, when the anvil 3230 is assembled to the trocarl shaft 3250, the anvil 3230 contacts the lock arm 3292 and displaces the lock arm 3292 away from the lock shoulder 3258. At such time, the trocar shaft 3250 may be unlocked and moved toward the cartridge body 3222 to its retracted position.

  Switching from here to FIGS. 44-46 and as discussed in more detail below, the replaceable tool assembly 3300 has the closure drive, the staple firing drive and the anvil of the closure drive set to the appropriate tissue gap And lockout configured to prevent the staple firing drive from operating until The tool assembly 3300 comprises a shaft 3310 and an end effector 3320. The end effector 3320 comprises an inner frame 3329, an outer housing 3327, and a cartridge body 3322. Similar to the above, the closing drive comprises a trocar shaft 3350 and an anvil 2230 attachable to the trocar shaft 3350. Also, as described above, the trocar shaft 3350 is between the extended position (FIG. 45) and the retracted position (FIG. 46) to move the anvil 2230 towards and away from the cartridge body 3322. It is movable with The firing drive comprises a rotatable shaft 3360 configured to displace the firing drive distally and eject the staples stored in the cartridge body 3322.

  In addition to the above, the end effector 3320 comprises a firing drive lock 3390 movably attached to the inner frame 3329. The firing drive lock 3390 comprises a lock pin 3394 and a lock spring 3398 disposed around the lock pin 3394. The lock pin 3394 comprises a head 3392 and a stop 3396. A lock spring 3398 is disposed between the stop 3396 and the sidewall of the cavity 3328 defined in the inner frame 3329. As illustrated in FIG. 45, when the trocar shaft 3350 is in the extended position, the lock spring 3398 biases the lock pin 3394 into the lock opening 3364 defined in the rotatable shaft 3360 of the staple firing drive. In such a case, the interaction between the lock pin 3394 and the sidewall of the lock opening 3364 rotates the shaft 3360 to prevent the staples from being ejected from the cartridge body 3322. When the trocar shaft 3350 is fully retracted, the trocar shaft 3350 engages the head 3392 of the lock pin 3394. The head 3392 is defined thereon and is engaged by the trocar shaft 3350 and configured to move the firing drive lock 3390 between the locking configuration (FIG. 45) and the non-locking configuration (FIG. 46) It has a cam surface. When the drive lock 3390 is in its unlocked configuration, the firing drive shaft 3360 can rotate.

  The firing drive lockout of the tool assembly 3300 requires the anvil 2230 to move into a predetermined position or range of positions before the staples can be fired. Further, the firing drive lockout of tool assembly 3300 requires that the tissue gap between the anvil 2230 and the cartridge body 3322 be less than a certain distance before staples can be fired. As a result, the position of the anvil 2230 and / or the closure system deactivates the staple firing lockout. Such an arrangement may, among other things, help prevent staple malformation and / or tissue underpressure.

  Turning now to FIGS. 47-49, the replaceable tool assembly 3400 is configured to clamp tissue, a closure drive, a staple firing drive, and before the closure drive applies sufficient clamping pressure to the tissue And a firing drive lockout 3490 configured to prevent the staple firing drive from operating. The closure drive comprises a trocar shaft 3450 and an anvil, such as an anvil 2230 attached to the trocar shaft 3450. Similar to the above, trocar shaft 3450 is moveable from an extended position (FIG. 48) to a retracted position (FIG. 49) to compress tissue against the cartridge body of tool assembly 3400. The firing drive comprises a rotatable shaft 3460 configured to displace the staple driver distally and eject the staples from the cartridge body.

  A launch drive lockout 3490 is disposed between the closed drive trocar shaft 3450 and the launch drive rotary shaft 3460. The firing drive lockout 3490 comprises a distal plate 3492, a proximal plate 3494, and a spring 3493 disposed between the distal plate 3492 and the proximal plate 3494. The firing drive lockout 3490 further comprises a lock pin 3498, the lock pin 3498 being in a lock configuration (FIG. 48) where the lock pin 3498 engages with the shaft 3460 and the lock pin 3498 is not disengaged from the shaft It is movable between the locking arrangement (FIG. 49). Locking pin 3498 is disposed in pin chamber 3496 defined between distal plate 3492 and proximal plate 3494. More specifically, the lock pin 3498 comprises a beveled head disposed between a cam 3495 defined on the distal plate 3492 and a cam 3495 defined on the proximal plate 3494. When the trocar shaft 3450 is retracted proximally, the trocar shaft 3450 pushes the distal plate 3492 proximally and the cam 3495 defined on the distal plate 3492 engages the head of the locking pin 3498. In such a case, as illustrated in FIG. 49, the cam 3495 defined on the distal plate 3492 cooperates with the cam 3495 defined on the proximal plate 3494 to provide the locking pin 3498, Displaced in its non-locking configuration.

  As discussed above, the cams 3495 of the firing drive lockout 3490 squeeze the head of the lock pin 3498 when the distal plate 3492 is moved by the trocar shaft 3450 towards the proximal plate 3494. More specifically, the cam 3495 drives the lock pin 3498 inwardly and disengages the rotatable shaft 3460. The locking pin 3498 is disposed in the locking opening 3468 defined in the shaft 3460 when the locking pin 3498 is in its locking configuration, and due to the interaction between the locking pin 3498 and the side wall of the locking opening 3468, the locking pin 3498 , Prevent the shaft 3460 from rotating. As a result, the staples can not be fired by the firing drive from the cartridge body. As discussed above, when the lock pin 3498 is moved to the unlocked configuration, the lock pin 3498 moves out of the lock opening and the shaft 3460 is driven by the firing drive to fire the staples from the cartridge body. It can be rotated. In various embodiments, the shaft 3460 can comprise a circumferential array of lock openings 3468 defined in the shaft 3460, each lock opening 3468 receiving a lock pin 3498 and locking out the firing drive. It is configured. Referring again to FIGS. 49-51, the firing drive lockout 3490 further comprises a biasing member, such as a spring 3499 configured to bias the lock pin 3498 into the lock opening 3468.

  In addition to the above, the spring 3493 of the firing drive lockout 3490 is configured to resist proximal movement of the trocar shaft 3450. The spring 3493 is a linear coil spring. However, any suitable spring may be used. Furthermore, more than one spring may be used. In any event, the spring 3493 or spring system has the rigidity to apply a spring force to the distal plate 3492 of the firing drive lockout 3490 when the trocar shaft 3450 is retracted. In other words, the force exerted by spring 3493 on distal plate 3492 increases in proportion to the distance by which trocar shaft 3450 is displaced proximally. The spring force generated by spring 3493 opposes the clamping force that anvil 2230 is applying to the tissue. As a result, the clamping force must overcome the specific or predetermined spring force generated by the spring 3493 in order to move the distal plate 3492 sufficiently to unlock the firing drive. In such cases, the force clamping the tissue must match a predetermined threshold before the firing drive lockout 3490 can be deactivated and the staple firing drive can be activated. .

  As discussed with respect to the various embodiments disclosed herein, the staple firing drive drives the staples against the anvil to deform the staples to a desired formed height. In various cases, the staple firing drive is also configured to push distally a cutting member, such as a knife, for cutting tissue captured between the cartridge body and the anvil. In such cases, the knife is exposed on the deck of the cartridge body. However, when the anvil is in its closed or clamped position, the anvil is placed in close relation to the cartridge body and most of the knife is covered by the anvil even though the knife is exposed on the cartridge body . If the anvil is moved to its open position and / or removed from the closing drive before the knife retracts under the deck of the cartridge body, the knife will be uncovered and exposed. 52-54 illustrate a tool assembly 3500 with a lockout 3590 configured to prevent the anvil from moving to its open position while the knife is exposed on the cartridge deck.

  Tool assembly 3500 comprises a closing drive and a firing drive. The closure drive comprises a trocar shaft 3550 and an anvil 3530 removably attachable to the trocar shaft 3550. As above, the trocar shaft 3550 is translatable proximally and distally by the rotatable closure shaft 2440 which is in threaded engagement with the trocar shaft 3550. The launch drive comprises a rotatable shaft 3562 and a translational collar 3560 threaded on the rotatable shaft 3562. As above, the collar 3560 can be translated proximally and distally as the shaft 3562 is rotated in the first and second directions, respectively. Also, as described above, the collar 3560 of the firing drive is configured to advance and retract the array of staple drivers and the knife assembly 2570 towards and away from the anvil 3530.

  In addition to the above, the lockout 3590 comprises a lock arm 3592 rotatably mounted on a shaft 3562 of the firing drive about a pivot 3594. The lockout 3590 further comprises a biasing member or spring 3599 engaged with the locking arm 3592 configured to bias the locking arm 3592 into contact with the anvil 3530. In use, the anvil 3530 is assembled to the trocar shaft 3550 and then the trocar shaft 3550 is retracted to place the anvil 3530 in its closed or clamped position relative to the cartridge body. As the anvil 3530 retracts, the lock arms 3592 of the lockout 3590 slide against the outer surface of the anvil 3530 until the lock arms 3592 are aligned with the lock recesses 3532 defined in the anvil 3530. As illustrated in FIG. 53, at this point, the spring 3599 biases the locking arm 3592 into the locking recess 3532. More specifically, the lock arm 3592 is disposed behind the lock shoulder that defines the lock recess 3532. The firing drive may then operate to fire the staples and cut the tissue. In such a case, the cutting edge of the knife assembly 2570 is exposed on the cartridge body, and the lockout 3590 causes the closure drive to lock out or open until the cutting edge of the knife assembly 2570 is no longer exposed. It is disturbed.

  Referring mainly to FIG. 52, lock arm 3592 further comprises a reset tab 3593 extending therefrom. The firing drive collar 3560 further includes a cam 3563 configured to engage the reset tab 3593 when the collar 3560 and the knife assembly 2570 are retracted proximally by the firing drive. The cam 3563 is configured to rotate the lock arm 3592 downwards to disengage the lock shoulder defined in the lock recess 3532 and unlock the closure drive. The cam 3563 is configured to unlock the closing drive when the cutting edge of the knife assembly 2570 is retracted below the cartridge deck. However, in other embodiments, the cam 3563 may unlock the closing drive if the cutting edge is at the same height or at least substantially the same height as the cartridge deck. In some embodiments, the closure drive may not be unlocked until the knife assembly 2570 is fully retracted. Once the closure drive is unlocked, the closure drive may operate to move the anvil 3530 back to the open or unclamped position.

  Once the staples of the replaceable tool assembly are fired, according to various embodiments, the tool assembly may not be reused. As discussed in more detail below, the tool assembly includes a lockout configured to prevent the tool assembly from being re-clamped on the tissue after being used to staple the tissue. obtain.

  In at least one embodiment, referring now to FIGS. 53-56, the replaceable tool assembly 3600 includes an anvil, eg, a closed drive, configured to position the anvil 2230 or the like relative to a staple cartridge. And, a firing drive configured to drive the staples from the staple cartridge. As above, the anvil 2230 is attachable to the translational trocar shaft 3650 of the closure drive. Also, as described above, the firing drive comprises a rotatable shaft 3660, a translational collar 2550 threadedly engaged with the rotatable shaft 3660, and a staple firing driver 2560 displaceable by the rotatable shaft 3660. In use, the closure drive is operable to place the anvil 2230 in a clamping position relative to the staple cartridge, and the firing driver then inserts the staples into the tissue captured between the anvil 2230 and the staple cartridge. Is operable to launch at Thereafter, the closure drive operates to open the anvil 2230 and release the tissue.

  In addition to the above, the tool assembly 3600 comprises a lockout 3690 configured to prevent the anvil 2230 from being re-clamped on tissue. The lockout 3690 comprises a lock arm 3692 rotatably mounted on a rotatable shaft 3660, the lock arm 3692 being in the unclamped position (FIG. 53) where the closing drive opened the anvil 2230 and in the closed clamping position (FIG. And is held by the launch drive in a non-locking configuration. Lock arm 3692 is unlocked between rotary shaft 3660 and translational collar 2550 as trocar shaft 3650 and anvil 2230 move relative to the firing drive to position anvil 2230 relative to the staple cartridge. Held in configuration. As illustrated in FIG. 55, arm 3692 is held in its unlocked configuration until the firing drive is activated. As the shaft 3460 rotates in a first direction, the collar 2550 is moved distally and the spring 3699 of the lockout 3690 may bias the lock arm 3692 against the trocar shaft 3650. The trocar shaft 3650 is rotated distally relative to the locking arm 3692 when firing the staples as the collar 2550 is displaced distally and then retracted proximally. The closure drive may then operate to reopen the anvil 2230, unclamp tissue, and / or remove the anvil 2230 from the trocar shaft 3650. When the anvil 2230 is reopened, the spring 3699 biases the locking arm 3692 into the locking recess 3652 defined in the trocar shaft 3650 and / or the anvil 2230. When the lock arm 3692 is disposed in the lock recess 3652, the lock arm 3692 prevents the trocar shaft 3650 from retracting proximally. If the closure drive operates in an attempt to retract trocar shaft 3650, lock arm 3692 will abut the lock shoulder defined in lock recess 3652 and prevent retraction of trocar shaft 3650 and anvil 2230. As a result, lockout 3690 prevents anvil 2230 from being re-clamped on tissue after tool assembly 3600 has received or at least partially received a firing cycle, and tool assembly 3600 can not be used again. Additionally, lockout 3690 may function as a used cartridge lockout.

  Turning now to FIGS. 59 and 60, the tool assembly 3700 comprises a staple cartridge 3720 and an anvil 3730. The tool assembly 3700 is configured to eject or fire the staples removably stored in the staple cartridge 3720, as well as a closing system configured to move the anvil 3730 towards the staple cartridge 3720 Further equipped with a launch system. Anvil 3730 includes a longitudinal shaft portion 3736 and a mounting arm 3738 extending from a shaft portion 3736 configured to resiliently grip a closing actuator or trocar 3734 of a closing system. The closure actuator 3734 is retractable proximally by the closure drive to move the trocar 3734 between the open unclamped position (FIG. 59) and the closed clamp position (FIG. 60). As illustrated in FIG. 59, when the closure system is in its open configuration, the staple firing system is disabled and firing staples stored in staple cartridge 3720 as described in more detail below. Can not operate.

  In addition to the above, the staple firing system comprises a rotary firing shaft 3750 comprising a threaded distal end and, additionally, a threaded opening configured to receive the threaded distal end of the firing shaft 3750 And a translational firing nut 2550. With particular reference to FIG. 59, when the anvil 3730 is in its open position, a gap exists between the threaded distal end of the firing shaft 3750 and the threaded opening defined in the firing nut 2550. As a result, the firing shaft 3750 can not displace the firing nut 2550 distally until the firing shaft 3750 threads onto the firing nut 2550.

  As illustrated in FIG. 60, the mounting arm 3738 of the anvil 3730 is configured to engage the firing shaft 3750 and deflect the firing shaft 3750 outwardly when the anvil 3730 is moved to its closed position. ing. Mainly with reference to FIGS. 59A and 60A, mounting arm 3738 engages inwardly extending projection 3758 defined on firing shaft 3750 and pushes projection 3758 and the periphery of firing shaft 3750 outward. Is configured as. In such a case, the threaded distal end of the firing shaft 3750 is pushed into operative engagement with the threaded opening of the firing nut 2550 at the threaded interface 3790, at which point Shaft 3750 may displace firing nut 2550 distally to eject the staples from staple cartridge 3720 when firing shaft 3750 is rotated by the firing drive. When the anvil 3730 is reopened, the firing shaft 3750 will return to its original configuration and be operatively disengaged from the firing nut 2550.

  As a result of the above, the tool assembly 3700 may not be attached to the closure system if the anvil 3730 was not attached to the closure system, if the anvil 3730 was improperly attached to the closure system, and / or if the anvil 3730 was not closed sufficiently. Have a lockout that prevents the staples from being fired.

  Turning now to FIGS. 61 and 62, the tool assembly 3800 includes a replaceable staple cartridge including releasably stored staples, an anvil configured to deform the staples, and an anvil to the staple cartridge. And a firing system configured to eject the staples from the staple cartridge. As discussed below, the tool assembly 3800 further comprises a lockout configured to prevent the firing system from operating unless the staple cartridge is fully secured on the tool assembly 3800.

  The staple cartridge comprises a cartridge frame 3820 configured to engage with the shaft frame 3810 of the tool assembly 3800. The staple cartridge further comprises a drive shaft 3830 that is inserted into the shaft frame 3810 when the staple cartridge is assembled to the tool assembly 3800. In particular, referring primarily to FIG. 64, drive shaft 3830 is configured to engage with transmission 3860 of the firing system and compress transmission 3860 when the staple cartridge is assembled to tool assembly 3800. A proximal end 3832 is provided, comprising a gear portion 3833. Referring mainly to FIG. 62, transmission 3860 comprises a first portion 3862, a second portion 3864, and a third portion 3868, which when pressed into operative engagement with one another, Rotational input motion can be transmitted to drive shaft 3830.

  Referring primarily to FIGS. 63 and 64, annular gear portion 3833 of drive shaft 3830 is configured to engage a corresponding gear portion 3863 defined on the distal side of first transmission portion 3862 The first transmission portion 3862 may be operatively engaged with the second transmission portion 3864 when the first transmission portion 3862 is pushed proximally by the drive shaft 3830. More specifically, the first transmission portion 3862 comprises a proximal gear portion 3865 which, when the first transmission portion 3862 is pushed proximally by the drive shaft 3830 Engaging with the distal gear portion 3866 of the transmission portion 3864 while simultaneously pushing the second transmission portion 3864 proximally. If the second transmission portion 3864 is pushed proximally by the first transmission portion 3862, the second transmission portion 3864 may be operatively engaged with the third transmission portion 3868, as described above. More specifically, the second transmission portion 3862 is a distal gear portion of the third transmission portion 3864 when the first transmission portion 3862 and the second transmission portion 3864 are pushed proximally by the drive shaft 3830 A proximal gear portion 3867 is engaged with the 3869. The third transmission portion 3868 is operably coupled to the input shaft and is supported for proximal displacement by the input shaft and / or shaft housing 3810.

  Referring mainly to FIG. 61, transmission 3860 further includes at least one spring member 3870 disposed between first transmission portion 3862 and second transmission portion 3864. In at least one case, the spring member 3870 can include, for example, one or more wave springs. The spring member 3870 is configured to bias the first transmission portion 3862 and the second transmission portion 3864 apart from one another. Additionally or alternatively, the transmission 3860 further comprises at least one spring member 3870 disposed between the second transmission portion 3864 and the third transmission portion 3868, the spring member 3870 Is configured to bias the second transmission portion 3864 and the third transmission portion 3868 away from one another, as described above. Referring mainly to FIG. 65, each spring member 3870 includes two disc springs 3872 that are configured to deflect when a compressive force is applied. However, spring member 3870 may include any suitable configuration.

  In addition to the above, referring again to FIG. 61, the input shaft of the tool assembly 3800 may rotate the third transmission portion 3868. However, a spring member 3870 disposed between the second transmission portion 3864 and the third transmission portion 3868 may move the proximal gear portion 3867 of the second transmission portion 3864 to the distal gear of the third transmission portion 3868. The rotation of the third transmission portion 3868 can not be transmitted to the second transmission portion 3864 unless it is compressed enough to couple with the portion 3869. Similarly, a spring member 3870 disposed between the first transmission portion 3862 and the second transmission portion 3864 extends the proximal gear portion 3865 of the first transmission portion 3862 distal to the second transmission portion 3864 The second transmission portion 3864 can not transmit rotational motion to the first transmission portion 3862 unless it is compressed enough to couple with the gear portion 3866. As discussed above, drive shaft 3830 may be configured with first transmission portion 3862 and second transmission portion 3864 when the staple cartridge is fully secured on shaft frame 3810 as illustrated in FIG. Engaging and engaging the second transmission portion 3864 with the third transmission portion 3868. In such cases, the rotation of the input shaft can be transmitted to the drive shaft 3830. However, if the staple cartridge was not completely fixed on the shaft frame 3810, one or more of the transmission portions 3862, 3864, and 3868 do not operatively engage one another and the input shaft The rotation can not be transmitted to the drive shaft 3830. Thus, the tool assembly 3800 ensures that the staples stored in the staple cartridge can not be ejected from the staple cartridge unless the staple cartridge is completely fixed on the shaft frame 3810.

  Turning now to FIGS. 66-68, the tool assembly 3900 comprises a shaft 3910 and a replaceable staple cartridge 3920. The replaceable staple cartridge 3920 is configured to move the anvil relative to the staple cartridge 3920, in addition to a rotation configured to eject the staples removably stored in the staple cartridge 3920. And a firing drive comprising an adjustable firing shaft 3930. As above, the tool assembly 3900 comprises a lockout configured to prevent the firing drive from ejecting staples from the staple cartridge 3920 unless the staple cartridge 3920 is fully or sufficiently fixed on the shaft 3910 . More specifically, lockout prevents the firing shaft 3930 from rotating within the staple cartridge 3920 unless the staple cartridge 3920 is fully or sufficiently fixed on the shaft 3910. In various cases, referring to FIG. 67, the firing shaft 3930 comprises an annular array of lock openings 3939 defined in its outer periphery, and the staple cartridge 3920 is detachable with the lock openings 3939 defined in the shaft 3930 And at least one lock 3929 configured to engage with the Lock 3929 comprises a cantilever beam extending proximally. However, any suitable configuration may be utilized. The lock 3929 further comprises a locking projection extending into the locking opening 3939 and preventing the firing shaft 3930 from rotating or at least substantially rotating relative to the body of the staple cartridge 3920. Lock 3929 is a lock defined on firing shaft 3930 until lock 3929 is lifted out of lock opening 3939 when staple cartridge 3920 is fully or fully assembled to shaft 3910 as illustrated in FIG. It is configured to be biased into engagement with the opening 3939. Referring to FIG. 68, the outer housing of shaft 3910 comprises a wedge 3919 configured to lift lock 3929 away from firing shaft 3930 and to disengage lock 3929 from lock opening 3939. The wedge 3919 is configured to not disengage the lock 3929 from the firing shaft 3930 unless the staple cartridge 3920 is fully or sufficiently fixed on the shaft 3910 as illustrated in FIG. FIG. 67 illustrates a scenario where the staple cartridge 3920 was not fully or fully fixed on the shaft 3910.

  Turning now to FIGS. 69-71, the tool assembly 4000 comprises a shaft 4010 and a replaceable staple cartridge 4020. The replaceable staple cartridge 4020 is configured to move the anvil relative to the staple cartridge 4020 and, in addition, is configured to eject staples removably stored in the staple cartridge 4020. And a firing drive comprising an adjustable firing shaft 3930. Staple cartridge 4020 includes a lock 4029 configured to releasably couple staple cartridge 4020 to shaft 4010. Lock 4029 includes a cantilever extending proximally and a lock shoulder 4028 extending therefrom. Lock 4029 assembles staple cartridge 4020 onto shaft 4010 as lock shoulder 4028 of lock 4029 is aligned with window 4019 defined in the outer housing of shaft 4010 and then in its unstrained state. It is configured to deflect inwardly within the shaft 4010 so as to resiliently return or at least go to the same state. In such a case, as illustrated in FIG. 70, when the staple cartridge 4020 is fully or fully fixed on the shaft 4010, the lock shoulder 4028 enters into the window 4019. To unlock the staple cartridge 4020, the clinician may, for example, insert the tool or his finger into the window and push the lock 4029 away from the window 4019. At such point, the staple cartridge 4020 can be removed from the shaft 4010 and a new staple cartridge can be attached to the shaft 4010 if the clinician so desires.

  Additionally or alternatively, the surgical stapling system may be configured such that when the staple cartridge is fully or fully fixed on the shaft of the stapling system, the closing drive of the stapling system holds the anvil over the tissue. An electrical lockout may be provided that is configured to prevent clamping and / or prevent the firing drive from performing its firing stroke. In various cases, the stapling system is configured to operate the firing drive in addition to a sensor configured to detect whether the staple cartridge is fully or fully fixed on the shaft And an electric motor. If the sensor detects that the staple cartridge was not fully or fully attached to the shaft, the motor may be electrically deactivated. In various cases, the stapling system comprises a sensor and a controller in communication with the electric motor, such as a microprocessor or the like. In at least one case, the controller first enables the electric motor to operate when the sensor detects a staple cartridge properly fixed on the shaft, and secondly, improperly on the shaft It is configured to prevent the electric motor from operating when the sensor detects a fixed staple cartridge.

  Turning now to FIG. 72, the tool assembly kit 4100 includes a shaft 4110 and a plurality of staple cartridges, such as 4120, 4120 ', 4120 ", and 4120"'. Each staple cartridge 4120, 4120 ', 4120 ", and 4120"' is configured to apply an annular array of staples having different diameters. For example, staple cartridge 4120 ′ ′ ′ is configured to apply staples in a pattern having a large diameter while staple cartridge 4120 is configured to apply staples in a pattern having a small diameter ing. In various cases, different staple cartridges may deploy staples having different unformed heights. In at least one case, a staple cartridge applying staples in a larger pattern deploys staples having a larger undeformed height, while a staple cartridge applying staples in a smaller pattern has a smaller undeformed high Deploy the staples that have the In some cases, the staple cartridge can deploy staples having two or more unformed heights. In any case, a staple cartridge selected from a plurality of staple cartridges may be assembled to the shaft 4110.

  Referring to FIGS. 72 and 73, tool assembly 4100 includes detection circuitry 4190 configured to detect whether the staple cartridge is fully or fully attached to shaft 4110. The detection circuit 4190 is not entirely housed within the shaft 4110. Rather, the staple cartridge must be properly assembled to the shaft 4110 in order to complete the detection circuit 4190. The detection circuit 4190 comprises a conductor 4193 extending through a path 4192 defined in the frame of the shaft 4110 and / or along the outer housing of the shaft 4110. Referring mainly to FIG. 73, each conductor 4193 is electrically connected to an electrical contact 4194 defined at the distal end of the housing. The staple cartridge 4120 comprises a corresponding electrical contact 4195 disposed or configured on the body 4122 of the staple cartridge 4120, for example, such that the contact 4195 engages the contact 4194 on the shaft 4110. The staple cartridge 4120 further includes a conductor 4196 extending through the cartridge body 4122 and / or along the cartridge body 4122. Each conductor 4196 is electrically connected to the contact 4195. In certain cases, the conductors 4196 are directly connected, and in such a case, the detection circuit 4190 is closed when the staple cartridge 4120 is properly assembled to the shaft 4110.

  In particular cases, further to the above, the detection circuitry 4190 of the tool assembly 4100 extends through the deck portion 4124 of the staple cartridge 4120. In at least one case, the deck portion 4124 is movably attached to the cartridge body 4122. More specifically, in at least one such case, the spring member 4198 is disposed between the cartridge body 4122 and the deck portion 4124 so that when the tissue is compressed against the deck portion 4124, the deck portion 4124 It is configured to allow it to move or float relative to the cartridge body 4122. In at least one case, the spring member 4198 includes, for example, one or more wave springs. The spring member 4198 also forms a conductive path between the cartridge body 4122 and the deck portion 4124. More specifically, spring members 4198 are respectively disposed between electrical contacts 4197 and 4199 defined on cartridge body 4122 and deck portion 4124. Conductor 4196 is electrically connected to an electrical contact 4197 defined on the distal end of cartridge body 4122, and electrical contacts 4199 are electrically connected through the conductor at deck portion 4125. doing. As discussed above, when the staple cartridge 4120 is properly assembled to the shaft 4110, the detection circuit 4190 is closed.

  Turning now to FIGS. 74-76, and as described in further detail below, the tool assembly 4200 is configured to prevent the replaceable annular staple cartridge from being fired more than once. Have a lockout. In use, replaceable annular staple cartridge 4220 is assembled to shaft 4210 of tool assembly 4200. The tool assembly 4200 is then placed at the surgical site and the anvil 2230 is assembled to the trocar 2450 of the closed drive. The closing drive is then used to move the anvil 2230 towards the staple cartridge 4220 to clamp the patient's tissue against the staple cartridge 4220 until the anvil 2230 reaches the closed or clamping position. This arrangement of anvil 2230 is illustrated in FIG. At such point, the firing drive may operate to deploy the staples removably stored in the staple cartridge 4220. The firing drive comprises, inter alia, a rotary drive shaft 4230 in threaded engagement with the drive collar 4240, and additionally a staple firing driver 2560. The drive collar 4240 and the launch driver 2560 comprise separate components. However, in alternative embodiments, the drive collar 4240 and the firing driver 2560 can be integrally formed. The firing drive pushes the drive collar 4240 and staple firing driver 2560 distally, between the unfired position (FIG. 74) and the firing position (FIG. 75), during the firing stroke to eject the staples from the staple cartridge 4220 In a first direction. Drive collar 4240 and staple driver 2560 are prevented from rotating within staple cartridge 4220, and as a result, drive shaft 4230 rotates relative to drive collar 4240 and staple driver 2560.

  In addition to the above, drive collar 4240 comprises one or more lockouts 4290 extending proximally therefrom. Each lockout 4290 includes a lockout pin 4292 slidably disposed within a pin aperture 4293 defined in the drive collar 4240. Each lockout 4290 further includes a biasing member, such as a spring 4294 configured to bias the pin 4292 proximally. As illustrated in FIG. 74, when the firing drive is in its unfired configuration, the lockouts 4290 do not engage the rotary drive shaft 4230 and / or the frame 4222 of the staple cartridge 4220. As shown in FIG. 75, when the drive collar 4240 and the staple driver 2560 are pushed distally by the drive shaft 4230, the lockout pin 4292 moves away from the drive shaft 4230. After the firing stroke is complete and the staples are fully deformed relative to the anvil 2230, the drive shaft 4230 is rotated in the opposite direction to pull the drive collar 4240 and staple driver 4260 proximally during the retraction stroke. . In such cases, lockout 4290 is moved towards drive shaft 4230. In particular, the retraction stroke is longer than the firing stroke, and as a result, as illustrated in FIG. 76, the drive collar 4240 is moved proximally to its original unfired position to a retracted position. In this retracted position of the drive collar 4240, the lockout 4290 will be engaged with the drive shaft 4230 and the frame 4222 of the staple cartridge 4220. More specifically, each lockout 4290 is within a lockout opening defined between the drive shaft 4230 and the cartridge frame 4222. Referring now to FIG. 78, each lockout opening is defined by an opening wall 4295 in the drive shaft 4230 and an opening wall 4296 in the frame 4222. When the lockout pin 4292 enters the lockout opening, the drive collar 4240 can not be rotated by the drive shaft 4230 and the firing system of the staple cartridge 4220 is locked out. As a result, that particular staple cartridge 4220 can not be used again and needs to be replaced with a new staple cartridge in order for the tool assembly 4200 to be used again.

  The reader, in addition to the above, may or may not be partially disposed in the lockout opening when the firing out drive is in its unfired configuration, as illustrated in FIG. 74, with the lockout pin 4292 It should be understood that However, in such a case, as long as the lockout pin 4292 is partially disposed in the lockout opening, the pin 4292 is within the pin opening 4293 defined in the drive collar 4240 when the firing drive shaft 4230 rotates. Can be moved distally. The reader may also prevent pin 4292 from being moved distally out of the lockout opening when firing drive shaft 4230 is again rotated in the first direction when drive collar 4240 is moved to its retracted position. It should be understood that the lockout pin 4292 is secured deep enough within the lockout opening defined in the drive shaft 4230.

  Referring again to FIG. 78, when drive collar 4240 is in its retracted position, sidewalls 4295 and 4296 of the lockout openings are aligned relative to one another. However, if drive shaft 4230 is rotated, side walls 4295 defined in drive shaft 4230 will rotate to de-align with side walls 4296 defined in cartridge frame 4222. In some cases, the sidewall 4295 may rotate momentarily as the firing drive 4230 rotates to re-align with the sidewall 4296. In any event, referring now to FIG. 77, sidewall 4295 is not aligned with sidewall 4296 when the launch system is in its unfired configuration. As a result, the lockout pin 4292 can not enter into the lockout opening when the firing system is in its unfired position and the staple cartridge 4220 can not be unintentionally locked out.

  In at least one alternative embodiment, referring now to FIG. 80, one or more lockout openings 4295 '' may be defined exclusively in the drive shaft 4230 '' of the tool assembly 4200 ''. . In such an embodiment, the drive collar 4240 will not rotate relative to the drive shaft 4230 "once the lockout pin 4292 is in the lockout opening 4295". In fact, both the drive collar 4240 and the drive shaft 4230 '' will come to be locked in unison, but they need not necessarily be locked to the frame of the tool assembly 4200 ''; The shaft 4230 '' will rotate relative to the drive collar 2440 and prevent it from displacing the drive collar 2440 distally.

  In at least one alternative embodiment, referring now to FIG. 79, each of the firing drive lockouts has a different configuration such that each lockout pin is uniquely indexed to its corresponding lockout opening . For example, tool assembly 4200 'may be configured with a first lockout pin configured to enter a first lockout opening defined by side walls 4295 and 4296, and a second defined by side walls 4295' and 4296 '. And a second lockout pin configured to enter the lockout opening. However, the first lockout pin of the tool assembly 4200 'is sized and configured such that it can not fit within the second lockout opening, and correspondingly, the second lockout pin is It is sized and configured such that it can not enter the lockout opening. Furthermore, neither the first lockout pin nor the second lockout pin may enter into the opening formed by the combination of the side walls 4295 and 4296 'or the combination of the side walls 4295' and the 4296 '. Absent.

  As discussed above, a stapling instrument configured to deploy an annular row of staples may comprise an articulation joint. The articulation joint is configured to allow the end effector of the stapling instrument to articulate relative to the shaft of the stapling instrument. Such stapling instruments may assist the surgeon in placing the end effector in the rectum and / or colon of the patient. In various embodiments, referring to FIG. 81, a stapling instrument configured to deploy an annular row of staples, such as a stapling instrument 9000, comprises a contourable or adjustable frame 9010. obtain. Frame 9010 may be configured to be permanently deformed during use. In at least one such embodiment, frame 9010 is comprised of, for example, malleable metals, such as silver, platinum, palladium, nickel, gold, and / or copper. In a particular embodiment, frame 9010 is made of, for example, malleable plastic. In at least one embodiment, the frame is comprised of, for example, a polymer comprising metal ions associated with the polymer chains, such as an ionic polymer-metal composite (IPMC). One or more voltage potentials may be applied to the IPMC material to defect the shaft in a desired manner. In certain cases, the shaft can be contoured along one radius of curvature, while in other cases the shaft can be contoured along more than one radius of curvature. For example, while the shaft is in the patient's body, one or more voltage potentials can be changed to contour the shaft. In certain embodiments, the contourable portion of the frame comprises a plurality of pivotable links. In at least one embodiment, the contourable portion of the frame is comprised of a visco-elastic material.

  In addition to the above, the stapling instrument may further comprise a lock configured to releasably hold the contourable portion of the frame of the stapling instrument in its contoured configuration. In at least one case, the frame of the stapling instrument comprises an articulated frame link and one or more longitudinal tensioning cables that can pull the frame link proximally and lock the frame links together. In particular cases, each frame link may comprise a longitudinal opening extending therethrough that is configured to receive a distally moveable rod. The rod is sufficiently flexible to pass through the longitudinal openings (these openings may not be perfectly aligned with one another when the contourable portion is contoured), but the staples It is rigid enough to hold the device in its contoured configuration.

  As discussed herein, a surgical instrument may be comprised of multiple modules assembled together. For example, in at least one embodiment, a surgical instrument comprises a first module comprising a handle and a second module comprising a shaft assembly. The shaft assembly comprises an end effector configured to staple and / or cut tissue of a patient. However, the shaft assembly may comprise any suitable end effector. In various cases, the end effector comprises a third module attachable to the shaft assembly. Referring now to FIGS. 82 and 83, the handle, eg, handle 20 etc., comprises a controller and a display 10000 in communication with the controller. The controller is configured to display data on the operation of the surgical instrument on the display 10000. The data displayed on the display 10000 relates to information to the surgeon regarding at least one operating parameter of the first module and / or at least one operating parameter of the second module. For example, the controller may display data on the progress of the staple firing stroke on the display 10000.

  In addition to the above, the shaft assembly comprises a second display. For example, shaft assembly 2000 includes a display 10100. However, any of the shaft assemblies disclosed herein may comprise a display, such as display 10100 or the like. The second module itself comprises a controller configured to display data on the operation of the surgical instrument on the display 10100. Similar to the above, the data displayed on the display 10100 relates to information on at least one operating parameter of the first module and / or at least one operating parameter of the second module. The controller of the second module is in signal communication with the controller of the first module. However, in other embodiments, the controller of the second module may operate independently of the controller of the first module. In certain alternative embodiments, the second module does not comprise a controller. In such an embodiment, the controller of the first module is in signal communication with the first display 10000 and the second display 10100 and the data displayed on the first display 10000 and the second display 10100 Control.

  As discussed above, tool assembly 2000 comprises an anvil and a staple cartridge. The handle 20 comprises an actuation system configured to move the anvil relative to the staple cartridge. The anvil controls the distance or gap between the anvil and the staple cartridge and, as a result, a range of positions relative to the staple cartridge to control the formed height of the staples as they are ejected from the staple cartridge. Can be placed. For example, the anvil is positioned closer to the staple cartridge to deform the staple to a lower formed height and further away from the staple cartridge to deform the staple to a higher formed height. Ru. In any event, the second display 10100 of the tool assembly 2000 is configured to indicate the position of the anvil relative to the staple cartridge and / or indicate the height at which the staple will or will be formed. It is done. In various embodiments, the shaft assembly may comprise an actuator configured to control a function of the end effector and a display adjacent to the actuator and displaying data regarding the function of the end effector.

  Referring to FIG. 1, tool assembly 1500 includes a shaft and an end effector extending from the shaft. The shaft comprises a shaft frame and a longitudinal shaft axis. The end effector comprises an end effector frame and a longitudinal end effector axis. The end effector further comprises a distal head and a revolute joint that allows the distal head to rotate relative to the end effector frame about the longitudinal end effector axis. The distal head comprises a first jaw and a second jaw. The first jaw comprises a staple cartridge containing staples removably stored therein or a channel configured to receive such a staple cartridge, and the second jaw is adapted to deform the staples. It comprises an anvil configured. The second jaw is movable relative to the first jaw between an open position and a closed position. However, other embodiments are recalled in which the first jaw is movable relative to the second jaw and / or both the first and second jaws are movable relative to one another. Ru.

  In certain embodiments, the tool assembly may comprise an articulating joint and, additionally, a revolute joint. In at least one such embodiment, the revolute joint is distal to the articulation joint. In such embodiments, rotation of the distal head does not affect the angle at which the end effector is articulated. However, other embodiments are envisioned where the articulation joint is distal to the revolute joint. Such an embodiment may provide a wide sweep of the distal head. In any case, the longitudinal end effector axis is movable relative to the longitudinal shaft axis. In at least one case, the longitudinal end effector axis is movable between a position collinear with the longitudinal shaft axis and a position transverse to the longitudinal shaft axis.

  In addition to the above, the distal head of tool assembly 1500 is rotatable between a starting position and a rotated position. In at least one case, the distal head is rotatable between the zero or top dead center position and the second position. In certain cases, the distal head is rotatable in a range of motions of at least 360 degrees. In other cases, the distal head is rotatable in a range of less than 360 degrees of rotation. In any event, tool assembly 1500 and / or handle 20 is configured to track the rotational position of the distal head. In various cases, the tool assembly 1500 and / or the handle 20 directly track the rotation of the distal head in addition to an electric motor operably connected to the distal head of the end effector and / or For example, an encoder configured to indirectly track the rotation of the distal head by evaluating the rotational position of the shaft of the electric motor. The controller of the handle 20 is in signal communication with, for example, an encoder and is configured to display the rotational position of the distal head on the display 10000.

  In at least one embodiment, the orientation and configuration of the data displayed on display 10000 is static while the distal head of the end effector is rotating. Of course, in such an embodiment, the data displayed on display 10000 will be updated by the controller of the surgical instrument. However, the data display is not reoriented and / or reconfigured as the distal head is rotated. Such an embodiment may provide the surgeon with the information necessary to properly utilize the surgical instrument in the static field. In at least one alternative embodiment, the data fields on display 10000 are dynamic. In this context, the term dynamic means more than updating data on display 10000. Rather, the term dynamic means that data is reoriented and / or reconstructed on display 10000 when the distal head is rotated. In at least one case, the orientation of the data tracks the orientation of the distal head. For example, if the distal head rotates 30 degrees, the data field on display 10000 rotates 30 degrees. In various cases, the distal head is rotatable 360 degrees and the data field is rotatable 360 degrees.

  In addition to the above, the data fields can be oriented in any orientation that matches the orientation of the distal head. Such an embodiment may provide the surgeon with an accurate and intuitive sense of the orientation of the distal head. In certain embodiments, the controller orients the data field to an orientation selected from an array of discrete locations that most closely matches the orientation of the distal head. For example, if the distal head is rotated 27 degrees and the selectable discrete data field positions are 15 degrees apart, the controller may reorient the data fields 30 degrees from the data orientation. Similarly, for example, if the distal head is rotated 17 degrees and the selectable discrete data field positions are 5 degrees apart, the controller may reorient the data fields 15 degrees from the data orientation. In at least one embodiment, the data orientation is aligned with the features of the surgical instrument itself. For example, the data orientation of the handle 20 is aligned with an axis extending through the grips of the handle 20. In such embodiments, the controller may ignore the orientation of the handle 20 relative to its environment. However, in at least one alternative embodiment, the data orientation is, for example, aligned with respect to the gravity axis.

  In addition to the above, the controller is configured to reorient the entire data field displayed on display 10000 relative to the orientation of the distal head. In another embodiment, the controller is configured to reorient only a portion of the displaced data field on display 10000 relative to the orientation of the distal head. In such embodiments, a portion of the data field is held static with respect to the data orientation, while another portion of the data field is rotated with respect to the data orientation. In a particular embodiment, a first portion of the data field is rotated at a first angular rotation and a second portion of the data field is rotated at a second angular rotation in the same direction. For example, the second portion may be rotated smaller than the first portion. In various embodiments, a first portion of the data field is rotated in a first direction and a second portion of the data field is rotated in a second or opposite direction.

  In addition to the above, the data fields are reoriented and / or reconfigured in real time, or at least substantially in real time, relative to rotation of the distal head. Such embodiments provide very responsive data display. In other embodiments, reorientation and / or reconstruction of data fields may delay rotation of the distal head. Such an embodiment may provide a less jittery data representation. In various embodiments, the first portion of the data field is reoriented and / or reconstructed at a first rate and the second portion of the data field is reoriented and / or redefined at a second or different rate. Configured For example, the second part may be rotated at a slower speed.

  As discussed above, the data fields on display 10000 are rotated as the distal head of the end effector is rotated. However, in other embodiments, the data field or a portion of the data field is translated as the distal head rotates. Also as discussed above, the controller of the surgical instrument is configured to reorient and / or reconstruct the data field on the handle display 10000. However, the controller of the surgical instrument may reorient and / or reconfigure the data field on the second display, such as a shaft display.

  Referring again to FIGS. 15 and 83, tool assembly 2000 includes an actuator 10200 configured to actuate the joint drive system of tool assembly 2000. The actuator 10200 is rotatable, for example, about a longitudinal axis parallel or at least substantially parallel to the longitudinal axis of the shaft 2100. The actuator 10200 is, for example, operatively connected to a rheostat, which is in signal communication with the controller of the handle 20. If the actuator 10200 rotates about its longitudinal axis in a first direction, the rheostat detects rotation of the actuator 10200 and the controller operates the electric motor to articulate the end effector 2200 in a first direction. Exercise. Similarly, if the actuator 10200 rotates about its longitudinal axis in a second or opposite direction, the rheostat detects the rotation of the actuator 10200 and the controller operates the electric motor to cause the end effector 2200 to Or Articulate in the opposite direction. In various cases, the end effector 2200 may be articulated, for example, approximately 30 degrees in a first direction from the longitudinal axis and / or approximately 30 degrees in a second or opposite direction from the longitudinal axis. obtain.

  The reader should further understand that, in addition to the above, the tool assembly 2000 does not have an on-board electric motor configured to operate the joint drive system. Rather, the electric motor of the joint drive system resides in a handle, such as handle 20 attached to tool assembly 2000. As a result, an actuator on the removable shaft assembly controls the movement of the handle. In another embodiment, the electric motor of the joint driver system may be present in the tool assembly 2000. In any event, display 10100 is configured to display articulation of end effector 2200 in at least some manners. The reader should understand that display 10100 is adjacent to actuator 10200 so that the surgeon can easily view the joint drive system's inputs and outputs simultaneously.

  In addition to the above, a surgical tool assembly comprising a contourable shaft may, for example, be advantageously shaped to fit within the rectum or colon of a patient. However, such a contourable shaft can not have a significant amount of tension and / or compression load. To compensate for that, in various embodiments, only the rotary drive system may extend through the contourable portion of the shaft. In such cases, the shaft only needs to resist the rotational reaction force generated by the rotary drive system. In such embodiments, rotational motion of the drive system may be converted into linear motion distal to the contourable shaft portion, as desired. Such longitudinal motion may generate tension and / or compression. However, such forces may be split or balanced distally within the end effector, i.e. with respect to the contourable shaft portion. Such embodiments may also utilize an articulating joint disposed distal to the contourable shaft portion. In such embodiments, the tool assembly may not utilize a push-pull drive system that traverses the contourable shaft portion.

  Referring to FIGS. 84 and 85, an anvil 6020 of the annular stapling instrument is illustrated. Anvil 6020 comprises a tissue compression surface 6022 and an annular array of staple forming pockets 6024 defined in tissue compression surface 6022. The anvil 6020 further comprises a frame 6028, a mounting mount 6026, and a stem extending from the mounting mount 6026. The stem is configured to be removably attached to the closure drive of the annular stapling instrument such that the anvil 6020 can be moved towards and away from the staple cartridge of the annular stapling instrument. Compression surface 6022, mounting mount 6026, and frame 6028 are made of, for example, stainless steel. However, any suitable one or more materials may be used.

  In addition to the above, anvil 6020 comprises a tissue support 6030. Tissue support 6030 is disposed within an annular opening defined in tissue support surface 6022. Tissue support 6030 is tightly fixed within anvil 6020 such that there is little, if any, relative motion between them. Tissue support 6030 comprises an annular tissue support surface 6032 adjacent an annular tissue compression surface 6022 of anvil 6020. Tissue support 6030 further comprises an inner annular wall 6036 defined therein and, in addition, a bottom wall 6038 disposed adjacent to anvil frame 6028 of anvil 6020.

  Referring now to FIG. 86, the annular stapler includes a first annular row of staples 6070, a second annular row of staples 6080, and staples 6070 and 6080 from staple cartridge 6040 during the firing stroke of the drive. And a firing drive that is configured to fire the staple cartridge 6040. As illustrated in FIG. 86, the staples 6070 and 6080 are deformed by the forming pocket 6024 as they are ejected from the staple cartridge 6040. In various cases, staples 6070 and staples 6080 are deformed to the same height, while in other cases staples 6070 and staples 6080 are deformed to different heights. For example, the staples 6070 can be deformed to a lower deformed height than the staples 6080. In another example, the staples 6080 are deformed to a lower height than the staples 6070.

  Additionally or alternatively, staples 6070 and staples 6080 can have different unformed heights. For example, staple 6070 can have an unformed height lower than staple 6080. In another example, staple 6080 has a lower unformed height than staple 6070. In certain cases, staples 6070 and staples 6080 have the same unformed height.

  In addition to the above, when the staples 6070 and 6080 are deformed relative to the anvil 6020 to staple the tissue T captured between the anvil 6020 and the staple cartridge 6040, the stapling instrument may incise the tissue T . A firing drive that ejects the staples from the staple cavity drives the cutting member 6050 towards the tissue T and anvil 6020. The distal edge of the cutting member 6050 cuts tissue T and then slides along the inner sidewall 6036 of the tissue support 6030 without cutting the inner sidewall 6036. The cutting edge of the cutting member 6050 is annular and aligned with the annular inner sidewall 6036 of the tissue support 6030. The cutting member 6050 is advanced within the anvil 6020 until the cutting member 6050 cuts the bottom wall 6038 as illustrated in FIG.

  The firing drive drives the staples 6070 and 6080 against the anvil 6020 and / or experiences various loads when cutting tissue. For example, the firing drive may experience increased loading when cutting tissue that has been pre-stapled, such as by staples 6090 (FIG. 86). However, the cutting of the bottom wall 6038 by the cutting member 6050 causes a sudden change or impact in the force transmitted through the firing drive. This sudden change in force may be perceived by a clinician using an electronic sensor system configured to detect load changes in the surgical stapler and / or the firing drive. The tissue support 6030 can be comprised of a material that can snap when the cutting member 6050 loads the bottom wall 6038. In at least one case, tissue support 6030 is made of, for example, plastic. In any event, a cut in the bottom wall 6038 can be detected, and when detected, the clinician and / or the electronic sensor system can determine that the cutting process is complete.

  The firing drive deforms the staples 6070, 6080 and simultaneously dissects the tissue with the cutting member 6050. However, it is contemplated that the staple formation and tissue cutting processes may be staggered. In at least one case, the tissue cutting process does not begin until the staple forming process is complete.

  While the surface 6032 may partially support the tissue T, the cutting member 6050 may mount the tissue T to the inner sidewall 6036 of the tissue support 6030 and the mounting mount 6026 as the cutting member 6050 is moved toward the bottom wall 6038 It should be understood from FIG. 86 that it can be pushed into the cavity defined between and. In other words, the cutting member 6050 can draw the tissue T along the wall 6036 before finally cutting the tissue T. In such cases, the incision made by cutting member 6050 may not be accurate. Improvements to the embodiment disclosed in FIG. 86 are discussed below.

  Turning now to FIGS. 87 and 88, the tissue support 6030 of the anvil 6020 has been replaced by a tissue support 6130. Tissue support 6130 comprises a first or outer annular wall 6131 and a second or inner annular wall 6133. The inner wall 6133 defines an opening 6136 which is configured to receive the mounting mount 6026 exactly. The outer wall 6131 and the inner wall 6133 are connected by a lateral wall 6132. The lateral wall 6132 extends radially around the center of the tissue support 6130 between the inner wall 6133 and the outer wall 6131. The lateral walls 6132 are equally spaced from one another. However, alternative embodiments are contemplated where the transverse walls 6132 are not equally spaced from one another. In any event, the lateral wall 6132 defines an annular array of cavities 6134 in the tissue support 6130. In various cases, each cavity 6134 may, for example, be square, but not the side facing the tissue. In other cases, the side of the cavity facing the tissue may be enclosed.

  Outer wall 6131 and inner wall 6133 of tissue support 6130 are configured to support tissue as it is cut by cutting member 6050. The lateral wall 6132 also supports the tissue as it is cut, as well as preventing or resisting the tissue sliding against the outer wall 6131 and the inner wall 6133. It should be understood that tissue may enter cavity 6134 when the tissue is cut. However, the relative movement between the tissue and the side wall can be significantly reduced. The composition and configuration of the lateral wall 6132 can be selected to provide more support for tissue or less support for tissue, depending on the amount of support desired. For example, thicker lateral wall 6132 may provide more tissue support than thinner lateral wall 6132. Similarly, more lateral walls 6132 may provide more tissue support than thinner lateral walls 6132.

  As the cutting member 6050 moves through its cutting stroke, the cutting member 6050 cuts tissue and cuts the lateral wall 6132. The cutting member 6050 is annular and cuts the lateral wall 6132 adjacent to the outer wall 6131. However, the cutting member may cut the wall 6132 at any suitable position. In any case, the lateral wall 6132 supports the tissue before, during and after the tissue is cut, preventing the tissue from being drawn along the outer wall 6131 and / or the inner wall 6133, or , At least reduce the possibility of the same. Similar to tissue support 6030, tissue support 6130 comprises a bottom wall 6138 that is cut at the end of the cutting stroke.

  89 and 90 disclose a surgical stapler comprising a staple cartridge 6240 and an anvil 6220. Staple cartridge 6240 is similar to staple cartridge 6040 in many respects. Anvil 6220 is similar to anvil 6020 and anvil 6120 in many respects. The anvil 6220 comprises a mounting stem 6226 and an annular tissue support 6230 disposed around the mounting stem 6226. Tissue support 6230 comprises a central opening configured to receive stem 6226 exactly. The tissue support 6230 further comprises an annular outer wall 6231 disposed adjacent to the tissue compression surface of the anvil 6220 and, additionally, a lateral wall 6232 radially extending from the outer wall 6231. Tissue support 6230 does not have an inner annual wall, and the inner end of lateral wall 6322 is not distorted. Tissue support 6230 further comprises a bottom wall 6238, which is dissected by cutting member 6050, as described above.

  In FIGS. 91 and 92, a surgical stapler comprising a staple cartridge 6240 and an anvil 6220 is illustrated. However, the reader should understand that tissue support 6230 of anvil 6220 has been replaced by tissue support 6330. Tissue support 6330 comprises an annular central opening configured to receive stem 6226 exactly. Tissue support 6330 further comprises a top wall 6332, a bottom wall 6338, and a side wall 6336 extending between top wall 6332 and bottom wall 6338. Top wall 6332 and bottom wall 6338 are parallel or at least substantially parallel. However, embodiments are envisioned where the walls 6332 and 6338 are not parallel. Side walls 6336 are parallel or at least substantially parallel. However, embodiments are envisioned where side walls 6336 are not parallel.

  The walls 6332, 6336 and 6338 define an annular cavity 6334 therebetween. The cavity 6334 is enclosed or at least substantially enclosed on all sides. Cavity 6334 extends uninterrupted around stem 6226. However, other embodiments are envisioned where the cavity 6334 is interrupted, for example by side wall and / or shape change.

  Similar to the above, tissue support 6330 is configured to support tissue as it is cut by cutting member 6050. Tissue support 6330 is rigidly received within anvil 6220 such that tissue support 6330 does not move or at least substantially does not move relative to anvil 6220. In addition, tissue support 6330 comprises a rigid box-shaped cross-section such that distortion of tissue support 6330 is minimized or minimized while cutting member 6050 is cutting tissue. As illustrated in FIG. 91, a gap exists between the bottom wall 6338 and the inner sidewall 6336. Such a gap may provide tissue support 6330 with some flexibility. However, other embodiments are envisioned where such gaps do not exist. Tissue support 6330 is made of, for example, plastic. However, in various embodiments, the tissue support 6330 can be comprised of, for example, a flexible and / or elastic material.

  The cutting member 6050 cuts the tissue support 6330 during its cutting stroke. As illustrated in FIG. 92, the cutting member 6050 cuts tissue and then cuts the top wall 6332 after entering the cavity 6334. Top wall 6332 includes an annular notch 6333 defined therein and aligned with the annular cutting edge of cutting member 6050. The notches 6333 reduce the cross-section of the top wall 6332 and facilitate dissection of the top wall 6332. The cutting member 6050 can also cut the bottom wall 6338 during its cutting stroke. The reader should understand that cutting the top 6332 and bottom 6338 walls of the tissue support 6330 can cause a pulse of force in the firing drive of the stapling instrument. Top wall 6332 and bottom wall 6338 allow the electronic sensor system of the clinician and / or surgical instrument to identify differences between the pulses at the end of the firing / cutting stroke, making the incision in top wall 6332 inappropriate It can be structurally configured to provide different pulses so that it can not be interrupted.

  Referring again to FIGS. 91 and 92, the top wall 6332 of the tissue support 6330 is aligned or at least substantially aligned with the tissue compression surface 6022 of the anvil 6220. Additionally or alternatively, the top wall 6332 can be recessed relative to the tissue compression surface 6022 and / or can extend over the tissue compression surface 6022. The top wall 6332 of the tissue support extends over the forming surface 6024 of the anvil 6220. Additionally or alternatively, the top wall 6332 can be recessed relative to the forming surface 6024 and / or can be aligned with the forming surface 6024.

  In FIGS. 93 and 94, a surgical stapler comprising a staple cartridge 6240 and an anvil 6220 is illustrated. However, the reader should understand that tissue support 6230 of anvil 6220 has been replaced by tissue support 6430. Tissue support 6430 comprises an annular central opening configured to receive stem 6226 exactly. Tissue support 6430 further includes a top wall 6432, a bottom wall 6438, and a side wall 6436 extending between top wall 6432 and bottom wall 6438. The walls 6432, 6436, and 6438 define an annular cavity 6434 therebetween. The cavity 6434 is enclosed or at least substantially enclosed on all sides. Cavity 6434 extends uninterrupted around stem 6226. However, other embodiments are envisioned where the cavity 6434 is interrupted, for example by a sidewall and / or shape change.

  Similar to the above, tissue support 6430 is configured to support tissue as it is cut by cutting member 6050. Tissue support 6430 is rigidly received within anvil 6220 such that tissue support 6430 does not move or at least substantially does not move relative to anvil 6220. In addition, tissue support 6430 comprises a rigid polygonal cross-section such that distortion of tissue support 6430 is minimized or minimized while cutting member 6050 is cutting tissue. As illustrated in FIG. 93, a gap exists between the bottom wall 6438 and the inner sidewall 6436. Such a gap may provide tissue support 6430 with some flexibility. However, other embodiments are envisioned where such gaps do not exist. The tissue support 6430 is made of, for example, plastic. However, in various embodiments, the tissue support 6430 can be comprised of, for example, a flexible and / or elastic material.

  As illustrated in FIGS. 93 and 94, the inner sidewall 6436 is shorter than the outer sidewall 3436. However, other embodiments are envisioned where the outer sidewall 6436 is shorter than the inner sidewall 6436. Furthermore, the top wall 6432 is not parallel to the bottom wall 6438. More specifically, the top wall 6432 comprises a sloped portion extending transverse to the bottom wall 6438 and / or other portions of the top wall 6432.

  The cutting member 6050 cuts the tissue support 6430 during its cutting stroke. As illustrated in FIG. 94, the cutting member 6050 cuts the top wall 6432 after cutting tissue and subsequently into the cavity 6434. Cutting member 6050 may also cut bottom wall 6438 during its cutting stroke.

As discussed above, the tissue support disclosed herein is configured to support tissue as the tissue is dissected by the cutting member. In many cases, the tissue to be cut by the cutting member, for example, is previously stapled, ie, stapled during a previous step in surgery. In various cases, such staples may also be cut with a cutting member, for example, even if they are made of metal, for example titanium and / or stainless steel. In other cases, such staples may not be incised by the cutting member. Rather, they may be pressed into the material making up the tissue support. Regardless of whether or not the staples are incised by the cutting member, in various cases, the tissue support disclosed herein demonstrates that the staples captured against the tissue support by the cutting member are at the tissue support. With sufficient strength and / or stiffness to prevent more local plastic deformation from occurring. In at least one such case, the local plastic deformation is limited to less than one characteristic length (CL) of the staple in any direction relative to the staple. In at least one case, the material of the tissue support is such that staples captured to the tissue support can only cause plastic deformation zones in the tissue support having a diameter of, for example, less than 2 ^* CL. It can be selected. In other cases, the material of the tissue support may be such that staples captured to the tissue support may cause only plastic deformation zones in the tissue support having a diameter of, for example, less than 1.5 ^* CL May be selected. The characteristic length of the staple may be, for example, the width or backspan of the staple crown and / or the formed height of the staple leg in its deformed configuration. Additionally, the tissue support disclosed herein can be constructed of a material that is sufficiently rigid to support the staples as they are cut by the cutting member. In at least one case, the hardness of the material comprising the tissue support is equal to or greater than the hardness of the material comprising the staples that are incised relative to the tissue support. In certain cases, the hardness of the material comprising the tissue support is less than the hardness of the material comprising the staple being dissected. However, the structural design of the tissue support is sufficient to prevent the tissue support from physically stretching beyond the acceptable zone of plastic deformation. In certain instances, the energy required to incise the tissue and the formed staples in the tissue is less than the energy required to incise the tissue support. In various cases, the material comprising the tissue support may be resistant to being swept by staples. In at least one case, a biocompatible lubricant may be disposed on and / or impregnated within the tissue support to prevent staples from becoming trapped on the tissue support .

  In various cases, the tissue compression surface of the anvil and the tissue contacting surface of the tissue support are flat or at least substantially flat. Such a configuration may distribute the force exerted by the anvil on the tissue over a large area. Other embodiments are envisioned where the tissue compression surface of the anvil and / or the tissue contacting surface of the tissue support is not flat. In certain cases, the tissue compression surface of the anvil and / or the tissue contacting surface of the tissue support comprises a tissue gripping member or spike that is configured to extend therefrom, engage with tissue, and grip. Such tissue gripping members may, for example, reduce relative movement or slippage between the tissue and the anvil. In at least one case, the density of the tissue gripping members on the tissue compression surface of the anvil and the tissue contacting surface of the tissue support is the same. In other cases, the density of the tissue gripping members on the tissue contacting surface of the tissue support is higher than the density of the tissue gripping members on the compression surface of the anvil. In such cases, when the tissue support is disposed radially inward with respect to the compression surface of the anvil, the tissue grasping member may prevent tissue from floating inward or sliding radially inward. .

  Anvil 6520 is disclosed in FIG. The anvil 6520 is, in addition, a tissue compression surface 6522 and a forming pocket defined in the tissue compression surface 6522 and configured to deform the staples into a desired configuration when the staples are ejected from the staple cartridge; Equipped with Each forming pocket comprises a pair of cups, wherein each cup pair is configured to deform the legs of the staples. For example, a pair of forming cups is configured to deform a first leg of the staple and a second forming configured to deform a second leg of the staple. And a cup 6530b. The first forming cup 6530a and the second forming cup 6530b are mirror images of one another with respect to an axis 6531 extending between the first forming cup 6530a and the second forming cup 6530b. However, other configurations may be utilized.

  The first forming cup 6530a comprises a first or outer end 6532 and a second or inner end 6534. The first forming cup 6530 a further comprises a bottom or bathtub surface 6536 extending between the outer end 6532 and the inner end 6534. The first end 6532 is configured to receive the leg of the staple and to initiate the leg formation process. The first end 6532 comprises a curved surface configured to distort the staple leg towards the second end 6534. The bottom surface 6536 comprises a curved or concave surface configured to at least partially fold the staple legs toward the staple cartridge. The second end 6534 comprises a curved surface configured to guide the staple leg out of the forming cup 6530a.

  The second forming cup 6530b comprises a structure similar to that of the first forming cup 6530a and is configured to deform the second leg of the staple. As a result of the above, the first forming cup 6530a guides the first leg of the staple towards the second leg, and the second forming cup 6530b transfers the second leg of the staple to the first leg. Guide towards. In various cases, the first forming cup 6530a and the second forming cup 6530b cooperate to, for example, deform the staple into a B-shaped configuration. However, the forming cup may be configured to deform the staples into any suitable configuration.

  Referring mainly to FIG. 96, each forming cup 6530 (6530a and 6530b) has a first lateral sidewall 6537 and a second lateral extending between the first end 6532 and the second end 6534. Directional side wall 6539 is provided. In various cases, the first lateral sidewall 6537 and the second lateral sidewall 6539 are mirror images of one another with respect to a longitudinal axis 6533 extending through the center of the forming cup 6530. In other cases, the first lateral sidewall 6537 and the second lateral sidewall 6539 are not mirror images of one another. In any case, the side walls 6537, 6539 are, for example, sloped or inclined to guide the staple legs towards the center of the forming cup, ie towards the axis 6533.

  Each forming cup 6530 comprises a groove or channel 6538 defined in its bottom surface 6536. The groove 6538 extends longitudinally between the first end 6532 and the second end 6534 of the forming cup 6530. The groove 6538 extends parallel to the central longitudinal axis 6535 of the forming cup 6530 and is laterally offset relative to the central longitudinal axis 6335. The groove 6538 is wider than the legs of the staple deformed by the forming cup 6530. However, other embodiments are envisioned where the grooves 6538 are narrower than the legs of the staples. In any event, the groove 6538 is configured to guide the staple legs along a predetermined path within the forming cup 6530.

  In various cases, the grooves of forming cup 6530 are configured to twist the legs of the staple while the legs are being deformed. In at least one case, the staple before being deformed is flat or at least substantially flat. In at least one such case, the legs and base of the staple lie in the same plane that is aligned with the longitudinal axis 6535 when the staple is ejected from the staple cartridge. The first end 6532 and the bottom surface 6536 are sloped to guide the leg towards the groove 6538 when the staple leg enters the forming cup 6530 and / or is otherwise configured It is done. As the staple legs enter groove 6538, groove 6538 will twist the staple legs out of the plane containing the base of the staple. As a result of the above, although the unformed staple configuration is flat, the formed staple configuration is not flat. However, other embodiments are envisioned where the staples have a non-flat configuration before and after deformation.

  The grooves 6538 of the forming cup 6530 for a given set of forming cups 6530 are disposed on the same side of the longitudinal axis 6535 and are configured to twist both legs of the staple on the same side of the staple base. However, other embodiments are envisioned where the first staple leg is twisted on one side of the staple base and the second staple leg is twisted on the other side of the staple base. In at least one such embodiment, the first groove 6538 is disposed on the first side of the longitudinal axis 6535 configured to twist the first staple leg to the first side of the staple base. A second groove 6538 is disposed on the second side of the longitudinal axis 6535 configured to twist the second staple leg to the second side of the staple base.

  The grooves 6538 of the forming cup 6530 for a given set of forming cups 6530 are colinear or at least substantially colinear. However, other embodiments are envisioned where the grooves 6538 are disposed on the same side of the longitudinal axis 6535 but not co-linear with one another. In at least one such case, grooves 6538 are parallel to one another, but in other such cases, grooves 6538 are not parallel to one another.

  Referring mainly to FIG. 96, the groove 6538 is deeper than the bottom surface 6536 of the forming cup 6530. However, other embodiments are envisaged, in which the grooves and the bottom of the forming cup have the same depth.

  In various cases, forming cups 6530 are configured in longitudinal rows when anvil 6520 is part of a longitudinal end effector configured to apply a longitudinal row of staples. In at least one such case, the groove 6538 of the forming cup is configured such that all staples deployed by the end effector are bent out of the plane in the same direction. In other cases, groove 6538 bends the staple legs in a first direction in a first longitudinal row of forming cups 6530 and second or different staple legs in a second longitudinal row of forming cups 6530 It is configured to bend in a direction. In particular cases, the groove 6538 is configured to bend the legs of the first staple in the staple row in a first direction and bend the second staple in the staple row in a second or opposite direction.

  In various cases, forming cups 6530 are configured in an annular array, where anvil 6520 is part of an annular end effector configured to apply an annular array of staples. In at least one such case, the grooves 6538 are disposed radially outward with respect to the central longitudinal axis 6535 of the forming cup 6530. In other cases, the grooves 6538 are disposed radially inward with respect to the central longitudinal axis 6535 of the forming cup 6530. In particular cases, the grooves 6538 are disposed radially outwardly in the first annular row of forming cups 6530 and radially inward in the second annular array of forming cups 6530.

  In addition to the above, the forming pocket of the anvil may have any suitable configuration. In at least one case, the forming pockets may comprise two forming cups that are mirror images of one another with respect to the central axis. Each forming cup has a triangular configuration with an outer end and an inner end. The inner ends of the pair of forming cups are adjacent to one another. The outer end of the forming cup is wider than the inner end and is configured to receive the legs of the staples. Each forming cup has a bottom or bathtub surface extending between the outer end and the inner end and, in addition, a longitudinal groove defined in the bottom and configured to guide the staple legs into the forming cup , And. In at least one case, the longitudinal grooves are concentrated at the bottom of the forming cup.

  Referring to FIGS. 97-99, an end effector 7000 of an annular stapling assembly is disclosed. The end effector 7000 comprises a staple cartridge comprising a deck 7030 and a cartridge body 7040. The deck 7030 comprises a tissue compression surface 7031 and a staple cavity 7032 defined in the tissue compression surface 7031. The staple cavities 7032 are configured in a first or inner annular row and a second or outer annular row. Each staple cavity 7032 in the inner row comprises a first staple 7070a removably stored, and each staple cavity 7032 in the outer row comprises a second staple 7070b removably stored.

  End effector 7000 further comprises a staple driver configured to push the staples out of the staple cartridge. For example, the staple cartridge is configured to eject a first annular array of staple drivers 7060a configured to eject a first array of staples 7070a and a second array of staples 7070b from cartridge body 7040. And a second annular row of staple drivers 7060b. Staple drivers 7060 a and 7060 b are disposed within staple cavities 7032 defined in deck 7030 and / or aligned with staple cavities 7032. Staple drivers 7060 a and 7060 b can slide within staple cavity 7032 to eject staples 7070 a and 7070 b, respectively, from staple cavity 7032.

  The end effector 7000 further includes an anvil 7020. The anvil 7020 comprises a tissue compression surface 7021 and a staple forming pocket 7022 defined in the compression surface 7021. The staple forming pockets 7022 are arranged in a first or inner annular row and a second or outer annular row. The staple forming pocket 7022 is aligned with the staple cavity 7032 such that when the staples 7070a, 7070b are ejected from the staple cavity 7032, the staples 7070a, 7070b contact the staple forming pocket 7022.

  End effector 7000 further includes a firing member 7056 configured to lift staple drivers 7060a and 7060b into staple cavity 7032 and eject staples 7070a and 7070, respectively, from staple cavity 7032. The firing member 7056 comprises a base 7054 and a lamp 7055. The base 7054 is slidably disposed within a recess 7052 defined in the firing drive 7050. The ramp 7055 is slidably disposed within a slot 7041 defined in the cartridge body 7040. As will be described in more detail below, the ramp 7055 slides within the slot 7041 to progressively eject the staples 7070a, 7070b from the staple cavity 7032, making progressive contact with the staple drivers 7060a, 7060b. It is configured to

  In addition to the above, the firing member 7056 is movable through the firing stroke to eject the staples 7070a, 7070b from the staple cavity 7032. During the firing stroke, the firing member 7056 moves along the curved or arcuate path defined by the slot 7041. Referring mainly to FIG. 97, the slot 7041 comprises a first end 7042 and a second end 7049 and a continuous path between them. The ramp 7055 of the firing member 7056 is positioned at the first end 7042 at the beginning of the firing stroke and at the second end 7049 at the end of the firing stroke. The first end 7042 of the slot 7041 is aligned with the inner row of staple cavities 7032 and the second end 7049 of the slot 7041 is aligned with the outer row of staple cavities 7032. The slot 7041 further comprises a first circumferential portion 7043 extending around a central longitudinal axis 7090 extending through the end effector 7000. The first circumferential portion 7043 of the slot 7041 is aligned with the staple driver 7060 a and extends below the staple driver 7060 a in the inner row of staple cavities 7032. The firing member ramp 7055 continuously engages the staple driver 7060a as the firing member 7056 moves through the first circumferential portion 7043 of the slot 7041 to fire the staples 7070a continuously.

  The first circumferential portion 7043 is defined by a constant or at least substantially constant radius of curvature about the longitudinal axis 7090. However, other embodiments are envisioned where the radius of curvature of the first circumferential portion 7043 is not constant. In at least one such case, the first circumferential portion 7043 includes a spiral. In other words, in such a case, the first circumferential portion 7043 moves away from the longitudinal axis 7090 as it extends around the longitudinal axis 7090.

  The second circumferential portion 7045 of the slot 7041 is aligned with the staple driver 7060 b and extends below the staple driver 7060 b in the outer row of staple cavities 7032. The ramp 7055 of the firing member continuously engages the staple driver 7060b as the firing member 7056 moves through the second circumferential portion 7045 of the slot 7041 to fire the staples 7070b continuously. The second circumferential portion 7045 is defined by a constant or at least substantially constant radius of curvature about the longitudinal axis 7090. However, other embodiments are envisioned where the radius of curvature of the second circumferential portion 7045 is not constant. In at least one such case, the second circumferential portion 7045 includes a helix. In other words, in such a case, the second circumferential portion 7045 moves away from the longitudinal axis 7090 as it extends around the longitudinal axis 7090.

  In addition to the above, the slot 7041 comprises a transition portion 7044 between the first circumferential portion 7043 and the second circumferential portion 7045. During the firing stroke, the ramp 7055 slides continuously through the first circumferential portion 7043, the transition portion 7044 and then the second circumferential portion 7045. The transition portion 7044 allows the firing member 7056 to shift between the first staple row of the first radius of curvature and the second staple row of the second radius of curvature. In certain embodiments, the transition portion 7044 between the first circumferential portion 7043 and the second circumferential portion 7045 may be unnecessary. In at least one such case, the first circumferential portion 7043 can comprise a first helical configuration and the second circumferential portion 7045 can, for example, be an end of the first helical configuration Can be provided with a second helical configuration aligned so as to be aligned with the start of the second helical configuration.

  The launch member 7056 is driven by the launch drive 7050 along its launch path. The launch drive 7050 is driven, for example, by a hand crank and / or an electric motor, about a longitudinal axis 7090. Launch drive 7050 includes a drive recess 7052 defined therein. The base 7054 of the firing member 7056 is disposed in the drive recess 7052. Drive recess 7052 is larger than base 7054 of firing member 7056 such that base 7054 can move or float within drive recess 7052. Drive recess 7052 is defined by sidewalls that limit movement of base 7054 within recess 7052. As the firing drive 7050 rotates about the longitudinal axis 7090, the sidewalls of the drive recess 7052 contact the base 7054 and push the drive member 7056 through the slot 7051. As discussed above, the slot 7051 has one or more changes in its radius of curvature, and as the firing member 7056 moves through such changes, the base 7054 of the firing member 7056 It can slide in the drive recess.

  As mentioned above, the staples in the first or inner row of staples are sequentially deployed, and then the staples in the second or outer row of staples are sequentially deployed. Such an embodiment may control, for example, the inner perimeter of the colon before stapling outward. In another embodiment, the staples in the outer row of staples are sequentially deployed, and then the staples in the inner row of staples are sequentially deployed. Such embodiments may, for example, establish a boundary in colon tissue prior to inward stapling.

  In various cases, further to the above, the first staple 7070a and the second staple 7070b have the same unformed height. In at least one such case, the first staple 7070a and the second staple 7070b are formed at the same formed height. In other such instances, the first staple 7070a is formed at a first formed height and the second staple 7070b is formed at a second formed height different from the first formed height. It can be formed. In at least one such case, the first formed height of the inner row of staples is less than the second formed height of the outer row of staples. Such an arrangement may, for example, provide a more gradual transition between stapled and unstaminated tissue. In other cases, the first formed height of the inner row of staples is higher than the second formed height of the outer row of staples. Such a configuration can, for example, make the innermost tissue of the stapled intestine more flexible.

  In certain cases, further to the above, the first staple 7070a has a first unformed height and the second staple 7070b has a second unformed height different from the first unformed height. Have In at least one such case, the first staple 7070a and the second staple 7070b are formed at the same formed height. In other such instances, the first staple 7070a is formed at a first formed height and the second staple 7070b is formed at a second formed height different from the first formed height. It is formed.

  End effector 7000 has two annular rows of staples. However, the end effector may have any suitable number of annular staple rows. For example, the end effector may have three annular rows of staples. In at least one such case, the staples in the first annular row can have a first unformed staple height and the staples in the second annular row have a second unformed staple height And the third staples in the third annular row can have a third green staple height. Furthermore, in at least one such case, the staples in the first annular row can have a first deformed staple height and the staples in the second annular row have a second deformed staple height The third staples in the third annular row can have a third deformed staple height.

  The launch drive 7150 is shown in FIGS. 100-105. The launch drive 7150 comprises a rotatable drive shaft 7152 rotatable about a longitudinal axis. The launch drive 7150 further comprises a three-stage continuous driver assembly comprising a first or inner driver 7154a, a second or middle driver 7154b, and a third or outer driver 7154c. Drive shaft 7152 includes drive pin 7151 extending therefrom. Drive pins 7151 extend through the drive slots in drivers 7154a, 7154b, and 7154c, respectively. For example, the first driver 7154a comprises a first drive slot 7153a defined therein, the second driver 7154b comprises a second drive slot 7153b defined therein, and the third driver 7154c comprises , And a third drive slot 7153c defined therein. Drive slots 7153a, 7153b, and 7153c do not have the same configuration. However, drive slots 7153a, 7153b, and 7153c have overlapping configurations that are aligned or at least substantially aligned with one another at drive pins 7151. For example, drive pin 7151 is in the unfired position in FIG. 100, and drive slots 7153a, 7153b, and 7153c are aligned with drive pin 7151.

  In addition to the above, FIG. 100 illustrates the drivers 7154a, 7154b, and 7154c in an unfired position. Referring now to FIG. 101, as drive shaft 7152 is rotated over a first portion of its firing stroke, drive pin 7151 is rotated through the circumferential path. Here, the drive pin 7151 engages the side wall of the drive slot 7153a and pushes or cams the first driver 7154a distally. In particular, drive pin 7151 does not drive drivers 7154 b and 7154 c distally during the first portion of the firing stroke. As can be seen in FIG. 100, drive slots 7153 b and 7153 c are aligned with the circumferential path of drive pin 7151 throughout the first portion of the firing stroke. The first driver 7154a is configured to fire a first annular row of staples when the first driver 7154a is moved distally.

  Referring now to FIG. 102, as the drive shaft 7152 rotates through the second portion of its firing stroke, the drive pin 7151 is rotated through the circumferential path. Here, the drive pin 7151 engages the side wall of the drive slot 7153b and pushes or cams the second driver 7154b distally. In particular, the drive pin 7151 does not drive the driver 7154c distally during the second part of the firing stroke. As above, drive slots 7153a and 7153c are aligned with the circumferential path of drive pin 7151 throughout the second portion of the firing stroke. The second driver 7154b is configured to fire a second annular row of staples when the second driver 7154b is moved distally.

  Referring now to FIG. 103, as the drive shaft 7152 rotates through the third portion of its firing stroke, the drive pin 7151 is rotated through the circumferential path. Here, the drive pin 7151 engages the side wall of the drive slot 7153c and pushes or cams the third driver 7154c distally. As above, drive slots 7153a and 7153b are aligned with the circumferential path of drive pin 7151 throughout the third portion of the firing stroke. The third driver 7154c is configured to deploy the cutting member when the third driver 7154c is moved distally. However, in certain embodiments, the third driver 7154c may, for example, deploy a third row of staples.

  As a result of the above, the first staple firing phase, the second staple firing phase and the tissue cutting phase do not overlap. They are performed at consecutive timings. Thus, the force required to deform the staples and cut the tissue is spread throughout the firing stroke. Furthermore, the firing drive 7150 can not cut tissue until the tissue is stapled. Various alternative embodiments are envisioned, with some overlap between the first staple firing phase, the second staple firing phase, and / or the tissue cutting phase. In at least one such embodiment, the configuration of drive slots 7153a, 7153b, and 7153c is a partial overlap in movement of first driver 7154a and second driver 7154b, and / or second driver 7154b. And a partial overlap in the movement of the third driver 7154c may be adapted to be present.

  Referring mainly to FIGS. 103 and 104, driver 7154a, drivers 7154b, and 7154c include cooperating mechanisms that prevent or at least prevent driver 7154a, driver 7154b, and driver 7154c from rotating relative to one another. For example, the first driver 7154a comprises a longitudinal key 7155a disposed in a longitudinal slot 7156b defined in the second driver 7154b. The key 7155a and the slot 7156b allow the first driver 7154a to slide longitudinally relative to the second driver 7154b but to prevent rotational movement between the first driver 7154a and the second driver 7154b. It is configured to allow. Similarly, the second driver 7154b comprises a longitudinal key 7155b arranged in a longitudinal slot 7156c defined in the third driver 7154c. The key 7155b and the slot 7156c cause the second driver 7154b to slide longitudinally relative to the third driver 7154c but to prevent rotational movement between the second driver 7154b and the third driver 7154c. It is configured to allow.

  In order to retract driver 7154a, driver 7154b and driver 7154c, drive shaft 7152 rotates in the opposite direction. In such a case, the drive shaft 7152 is a side wall of the drive slot 7153c, in order to return the third driver 7154c, the second driver 7154b and the first driver 7154a to their unfired position (FIG. 100) It continuously engages the side wall of slot 7153b and then the side wall of drive slot 7153a.

  In FIG. 106, the launch drive 7250 is illustrated. Launch drive 7250 operates in a manner similar to the operation of launch drive 7150. The launch drive 7250 includes a drive shaft 7252 rotatable about a longitudinal axis. Drive shaft 7252 comprises a cam surface or ramp 7256 that is rotated through multiple stages of the firing stroke. The launch drive 7250 further comprises a first driver 7254a, a second driver 7254b, and a third driver 7254c which are engaged by the cams 7256 of the drive shaft 7252 as the launch drive 7250 rotates. In the first phase of the firing stroke, the cam 7256 engages the cam surface 7255a defined on the first driver 7254a and drives the first driver 7254a distally. In the second phase of the firing stroke, the cam 7256 engages the cam surface 7255b defined on the second driver 7254b and drives the second driver 7254b distally, the third phase of the firing stroke In, the cam 7256 engages the cam surface 7255c defined on the third driver 7254c and drives the third driver 7254c distally.

  The first cam surface 7255a is shorter than the second cam surface 7255b, and as a result, the first driver 7254a has a shorter firing stroke than the second driver 7254b. Similarly, the second cam surface 7255b is shorter than the third cam surface 7255c, and as a result, the second driver 7254b has a shorter firing stroke than the third driver 7254c. Such an arrangement may be useful, for example, to form different rows of staples at different formed heights. In other embodiments, driver 7254a, driver 7254b, and driver 7254c may have any suitable firing stroke. In at least one embodiment, driver 7254a, driver 7254b, and driver 7254c, for example, have the same firing stroke. Such an arrangement may be useful, for example, to form different rows of staples at the same formed height.

  FIG. 107 is a perspective view of a portion of a staple cartridge 4410 for use with a circular surgical stapling instrument according to at least one embodiment. Various annular surgical stapling instruments are known. For example, US Patent Application No. 14 / 836,110, filed August 26, 2015, entitled "SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS", filed on August 26, 2015, which is incorporated by reference in its entirety, is incorporated by reference in its entirety. An annular surgical stapling instrument configuration is disclosed. No. 14 / 498,070, filed on Sep. 26, 2014, entitled "CIRCULAR FASTENER CARTRIDGES FOR APPLYING RADIALLY EXPANDING FASTNER LINES", the disclosure of which is incorporated herein by reference in its entirety. Various annular surgical stapler configurations are disclosed. As discussed in those references, an annular surgical stapler generally comprises a frame assembly that includes a mounting portion configured to operably couple an anvil to the annular surgical stapler.

  Generally, the anvil includes an anvil head that supports one or more annular lines of staple forming pockets. The anvil stem or trocar portion is attached to the anvil head and is configured to be releasably coupled to the anvil attachment portion of the annular stapling instrument. Various annular surgical stapling instruments are selected to direct the anvil toward and away from the surgical staple cartridge so that the target tissue may be clamped between the anvil and the deck of the surgical staple cartridge Means for moving the The surgical staple cartridge releasably stores therein a plurality of surgical staples configured in one or more annular arrays corresponding to the configuration of staple forming pockets provided in the anvil. The staples are removably stored in corresponding staple cavities formed in the staple cartridge and supported on corresponding portions of the selectively movable pusher assembly operably received within the annular stapler. . The annular stapler further comprises an annular knife or cutting member configured to cut tissue clamped between the anvil and the staple cartridge.

Referring again to FIG. 107, staple cartridge 4410 includes a cartridge body 4411 that defines an annular cartridge deck surface 4412. Cartridge body 4411 includes an inner annular row 4420 of spaced inner staple cavities 4422 and an outer annular row 4440 of spaced outer staple cavities 4442. As can be seen in FIG. 107, the inner staple cavities 4422 are staggered relative to the outer spaced staple cavities 4442. An inner surgical staple 4430 is supported within each inner staple cavity 4422 and an outer surgical staple 4450 is supported within each outer staple cavity 4442. Outer staples 4450 in outer annular row 4440 may have different features than inner staples 4430 in inner annular row 4420. For example, as illustrated in the embodiment of FIG. 108, the outer staple 4450 has an unformed "gull wing" configuration. In particular, each outer staple 4450 comprises a pair of legs 4454, 4464 extending from a staple crown 4452. Each leg 4454, 4464 comprises vertical portions 4456, 4466 extending respectively from the crown 4452. In one embodiment, the vertical portions 4456, 4466 may be parallel to one another. However, in the illustrated configuration, the vertical portions 4456, 4466 are not parallel to one another. For example, the angle _{A 1} between the crown 4452 and the vertical portion 4456,4466 in the illustrated arrangement, more than 90 degrees. See FIG. No. 14 / 319,008, filed on Jun. 30, 2014, entitled "FASTENER CARTRIDGE," filed on Jun. 30, 2014, which is incorporated herein by reference in its entirety, the disclosure of which is incorporated herein by reference in its entirety. COMPRISING NON-UNFORM FASTENERS ", U.S. Patent Application Publication No. 2015/0297232. However, other vertical portions 4456, 4466 may be configured at other angles with respect to the crown 4452. One advantage of having the vertical leg portions 4456, 4466 oriented at an angle greater than 90 degrees with respect to the crown 4452 is that such a configuration aids in the temporary retention of staples within its corresponding staple cavity It is possible.

The at least one leg 4454, 4464 comprises an inwardly extending end. In the embodiment shown in FIG. 108, for example, each leg 4454, 4464 comprises an inwardly extending leg. In the illustrated configuration, legs 4458 extend inwardly from vertical legs 4456 and legs 4468 extend inwardly from vertical legs 4466. As can be seen in FIG. 108, the legs 4458 are shorter than the legs 4468. In other words, the distance _HA between the staple crown 4452 and the point where the leg 4458 bends inwardly from the vertical leg 4456 is such that the staple crown 4452 and the leg 4468 bend inwardly from the vertical leg 4466 Greater than the distance H _C between the points. Thus, in at least one embodiment, the distance H _B is less than the length H _D. Angle _{A 2} of the legs 4458 are bent with respect to the vertical leg 4556 may be equal to the angle _{A 3} legs 4468 are bent with respect to the vertical leg 4466, or, angle _{A 2} and _{A 3} And may be different from each other. No. 14 / 319,008, filed Jun. 30, 2014, entitled "FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS", filed Jun. 30, 2014, which is incorporated herein by reference in its entirety. , U.S. Patent Application Publication No. 2015/0297232.

In at least one embodiment, each inner surgical staple 4430 may have the configuration illustrated in FIG. As can be seen in FIG. 108, the inner surgical staple 4430 has a crown 4432 and two vertical legs 4434, 4436 extending therefrom. Vertical leg 4434,4436 may extend from the crown 4432 relatively vertically, or they may extend at an angle _{A 4} which may exceed 90 degrees. Such an arrangement may assist in temporarily retaining staples 4430 within its corresponding staple cavity 4422. However, the vertical legs 4434, 4436 may extend from the crown 4432 at different angles. In some embodiments, the angles A ₄ are equal to one another. In other embodiments, the angle A ₄ are different from each other. In the illustrated embodiment, the inner staples 4430 and the outer staples 4450 each have the same unformed height UFH. The inner and outer staples 4430, 4450 are formed from conventional surgical staple wires. In at least one embodiment, the diameter of the staple wire used to form the outer staple 4450 is larger than the diameter of the staple wire used to form the inner staple 4430. In other embodiments, the inner and outer staples may have the same diameter or may be formed from wires having other diameters. In some configurations, the inner and outer staples may be formed from the same type of staple wire. Thus, in such a configuration, the wire diameters of the inner and outer staples will be the same. However, in yet another embodiment, the inner and outer staples may have the same unformed shape / configuration, and may further be formed from two different staple wires having different wire diameters. Also, in at least one configuration, the crown width CW _O of each outer staple 4450 is greater than the crown width CW _I of each inner staple 4430. No. 14 / 319,008, filed Jun. 30, 2014, entitled "FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS", filed Jun. 30, 2014, which is incorporated herein by reference in its entirety. , U.S. Patent Application Publication No. 2015/0297232.

  Returning to FIG. 107, staple cartridge 4410 comprises an outer rim 4414 extending over deck surface 4412. During surgery, the clinician can adjust the position of the anvil relative to the cartridge of the annular stapler. In at least one such embodiment, staple cartridge 4410 further comprises deck features 4416 and 4418 extending from deck surface 4412. As can be seen in FIG. 107, a series of inner decking mechanisms 4416 are provided between the inner row 4420 of staple cavities 4422 and the centering knife opening 4413 through which the knife or cutting member will pass during the firing process . As shown in FIGS. 107, 109 and 110, the decking mechanism 4416 may be formed and positioned relative to the inner staple cavity and the opening 4413. For example, each inner decking mechanism 4416 may have a flat wall 4415 coextensive with the wall of the knife opening 4413 and a conical or angled body portion 4417 adjacent the row of inner staple cavities 4422. See FIG. 109 and FIG. In the embodiment shown in FIG. 107, the decking mechanism 4416 is oriented in the gap between two adjacent inner staple cavities 4422 and, as shown, staggered between pairs of staple cavities 4422 There is. The cavity extension mechanism or decking mechanism in this system may function to reduce the pressure commonly generated on flat deck cartridges. The disclosed configurations may also help to reduce tissue migration and slip. Because tissue slippage is generally undesirable, the outer diameter retention mechanism may be larger or more numerous. The inner diameter mechanism may serve to increase tissue tension / shear as the blade passes close to the inner inner diameter, which may improve cutting by the system. However, the decking mechanism 4416 may have different shapes and configurations, and may be located at different locations on the deck surface 4412.

  As can also be seen in FIGS. 107, 109 and 110, all other outer staple cavities 4442 have outer deck features 4418 associated with their respective ends. The outer decking mechanism 4418 extends over the deck surface 4412 and guides the outer staples 4450 towards the anvil as the staples 4450 are ejected from the staple cartridge 4410. In such embodiments, the outer staples 4450 may not extend over the outer deck mechanism 4418 until the staples are moved by the firing member toward the anvil. Referring primarily to FIG. 107, in at least one embodiment, the outer decking mechanism 4418 does not extend around the entire circumference of the corresponding outer staple cavity 4442. A first outer deck mechanism 4418 is disposed adjacent to the first end of the corresponding outer cavity 4442 and a second outer deck mechanism 4418 is disposed adjacent to the second end of the outer cavity 4442 Be done. As can be seen in FIG. 107, the outer decking mechanism 4418 is associated with every other outer staple cavity 4442. Such an arrangement may function to lower the overall pressure and minimize tissue stretching and movement. However, in other embodiments, the first and second outer deck features 4418 may be associated with all the outer staple cavities 4442. In still other embodiments, the outer decking mechanism may extend around the entire perimeter of the corresponding outer cavity. As can be seen in FIG. 109, the inner deck mechanism 4416 is shorter than the outer deck mechanism 4418. In other words, each inner decking mechanism projects on the deck surface 4412 a shorter distance than the distance each outer decking mechanism 4418 projects on the deck surface 4412. Each outer decking mechanism may project onto the deck surface 4412 the same distance as the outer rim 4414 projects onto the deck surface 4412. In addition, as seen in FIG. 109, each outer decking mechanism 4418 can help prevent tissue snagging on the decking mechanism during insertion of a stapler head that passes the patient's colon and rectum. , Has a generally conical or tapered outer profile.

  The deck mechanism configuration may provide one or more advantages. For example, the upright outer rim can help prevent tissue from sliding across the cartridge deck. The upstanding rim may also be provided with a repeating pattern of high and low rather than being one continuous lip formation. The medial standing mechanism can also help hold the tissue adjacent to the blade and provide improved cutting. The inner decking mechanism can be between all the cavities or in an alternating configuration, and the decking mechanism may comprise one continuous upright lip. It may be desirable to balance the number of deck features in order to minimize the number of high force / compression zones while achieving the desired amount of tissue fixation. The cavity concentration mechanism may serve the additional purpose of minimizing tissue flow in the area where the staple legs protrude. Such an arrangement also facilitates the desired staple formation as the staple legs are fired and the transition to a receiving anvil pocket which may consist of a corresponding formed pocket. Such localized pocket features increase the low compression zone but facilitate the support of the leg from the cartridge when staples are present in the cartridge. This configuration then minimizes the distance that the staples should "jump" before contacting the anvil pocket. Tissue flow tends to increase radial outward movement from the cartridge center. Referring to FIG. 118, the improved upright outer row extensions have a tendency to stage tissue when inserted through the colon because they are tubes.

109 and 110 illustrate the use of a surgical staple cartridge 4410 in connection with anvil 4480. Anvil 4480 includes anvil head portion 4482 that operably supports staple forming insert or portion 4484 and knife washer 4490. The knife washer 4490 is supported in a facing relationship to the knife 4492 supported by the staple head. In the illustrated embodiment, staple forming inserts 4484 are formed, for example, of steel, stainless steel, etc., and include an inner row of inner staple forming pockets 4486 and an outer row of outer staple forming pockets 4488. Each inner staple forming pocket 4486 corresponds to one of the inner staple cavities 4422 and each outer staple forming pocket 4488 corresponds to one of the outer staple cavities 4442. In the illustrated configuration, the inner staple forming pocket 4486 is closer to the cartridge deck surface 4412 than the outer staple forming pocket 4488 when the anvil 4480 is moved relative to the cartridge deck surface 4412 to its firing position. In other words, the first gap g ₁ or first staple forming distance between the first staple forming portion 4485 and the cartridge deck surface 4412 is between the second staple forming portion 4487 and the cartridge deck surface 4412. second gap g ₂ or shorter than a second staple forming distance.

As further seen in FIGS. 109 and 110, each inner staple 4430 is supported within its corresponding inner staple cavity 4422 on the corresponding inner driver portion 4502 of pusher assembly 4500 and each outer staple 4450 is corresponding to the corresponding outer Supported within its corresponding outer staple cavity 4442 on driver portion 4504. Advancement of the pusher assembly 4500 into the anvil 4480 drives the inner and outer staples 4430 4450 into their forming contact with their respective staple forming pockets 4486 4488 as shown in FIG. I will. In addition, the knife 4492 is advanced distally through the tissue clamped between the anvil 4480 and the deck surface 4412 and through the fragile bottom 4491 of the knife washer 4490. Such a configuration functions to provide an outer staple 4450 having a formed height FH _O that is higher than the formed height FH _I of the inner staple 4430. In other words, the outer rows 4440 of the outer staples 4450 are shaped into a larger "B" shape and larger capture volumes and / or higher staples to relieve high tissue pressure near the outer rows 4440 of staples. Bring the forming height. Larger B shapes may also improve blood flow towards the inner row. In various cases, the outer rows 4440 of the outer staples 4450 include greater resistance to deployment by utilizing larger staple crowns, staple leg widths, and / or staple leg thickness.

The amount of staples used for each row of staples can vary. In one embodiment, for example, there are more outer staples 4450 than inner staples 4430 are present. Another embodiment utilizes more inner staples 4430 than outer staples 4450. In various cases, the wire diameter of the outer staple 4450 is greater than the wire diameter of the inner staple 4430. The inner and outer staples 4430, 4450 may have the same unformed height UFH. The crown width CW _O of the outer row 4440 of the outer staples 4450 is wider than the crown width CW _I of the inner row 4420 of the inner staples 4430. The gull-wing configuration of the outer staple 4450 utilizes bends located at different distances from its respective crown. The use of a graded anvil configuration with a flat (non-stepped) cartridge deck surface 4412 with uniform driver or pusher movement results in staples with different formed heights.

  Another staple cartridge embodiment 4610 is illustrated in FIG. As seen in FIG. 111, staple cartridge 4610 comprises a cartridge deck 4612 comprising an inner annular row 4620 of spaced inner staple cavities 4622 and an outer annular row 4640 of spaced outer staple cavities 4642. As can be seen in FIG. 111, the inner staple cavities 4622 are staggered relative to the spaced outer staple cavities 4642. An inner surgical staple 4630 is supported within each inner staple cavity 4622 and an outer surgical staple 4650 is supported within each outer staple cavity 4642. In addition, the outer rim 4614 extends over the deck surface 4612. In various embodiments, further to the above, the staples 4630, 4650 do not protrude above the deck surface 4612 until the staples are moved towards the anvil by the firing member. Such embodiments may often utilize small staples for the depth of their respective staple cavities in which the staples are stored. In another embodiment, the legs of the staples project above the deck surface 4612 when the staples are in their unfired position. In at least one such embodiment, staple cartridge 4610 further comprises decking features 4616 and 4618 extending from deck surface 4612.

  As also seen in FIG. 111, all other inner staple cavities 4622 have an inner decking feature 4616 associated with each end thereof. The inner decking mechanism 4616 extends over the deck surface 4612 and guides the corresponding inner staples 4630 towards the anvil as the corresponding inner staples 4630 are ejected from the staple cartridge 4610. In such embodiments, the inner staples 4630 may not extend over the inner decking mechanism 4616 until the staples are moved by the firing member toward the anvil. In the illustrated example, the inner decking mechanism 4616 does not extend around the entire corresponding inner staple cavity 4622. A first inner decking mechanism 4616 is disposed adjacent to a first end of the corresponding inner cavity 4622 and a second inner decking mechanism 4616 is disposed adjacent to a second end of the inner cavity 4622 Be done. However, in other embodiments, the inner decking mechanism 4416 may be associated with all the inner staple cavities 4622. In still other embodiments, the inner decking mechanism may extend around the entire perimeter of the corresponding inner staple cavity. Lower pressure may be provided to the tissue gap area by utilizing decking mechanisms with different heights in a concentrated pattern associated with all the other cavities, but they are as much as possible And balanced with the need to guide the long staple legs. In other words, such an arrangement may minimize tissue flow, which reduces the total amount of pressure applied to the target tissue.

  Still referring to FIG. 111, each outer staple cavity 4642 includes an outer deck mechanism 4618 associated with its respective end. An outer decking mechanism 4618 extends over the deck surface 4612 and guides the outer staples 4650 towards the anvil as the staples 4650 are ejected from the staple cartridge 4610. In such embodiments, the outer staples 4650 may not project onto the outer deck mechanism 4618 until the outer staples are moved by the firing member toward the anvil. As seen in FIG. 111, in the illustrated example, the outer decking mechanism 4618 does not extend around the entire corresponding outer staple cavity 4642. A first outer deck mechanism 4618 is disposed adjacent to a first end of the corresponding outer cavity 4642 and a second outer deck mechanism 4618 is disposed adjacent to a second end of the outer cavity 4642 Be done. As can be seen in FIG. 111, the outer decking mechanism 4618 is associated with all the outer staple cavities 4642. However, in other embodiments, the first and second outer deck features 4618 may be associated with every other outer staple cavity 4642. In still other embodiments, the outer decking mechanism may extend around the entire perimeter of the corresponding outer cavity. As can be seen in FIGS. 112 and 113, inner deck mechanism 4616 and outer deck mechanism 4618 extend the same distance on deck surface 4612. In other words, they have the same height. In addition, as can also be seen in FIGS. 112 and 113, each inner decking mechanism 4416 and each outer decking mechanism 4618 allow tissue to ride on the decking mechanism during insertion of a stapler head that passes the patient's colon and rectum. Have a generally conical or tapered outer profile that can help prevent

FIGS. 112 and 113 illustrate the use of the surgical staple cartridge 4610 in conjunction with the anvil 4680. Anvil 4680 includes anvil head portion 4682 which operably supports staple forming insert or portion 4684 and knife washer 4690. The knife washer 4690 is supported in a facing relationship with the knife 4692 supported by the staple head. In the illustrated embodiment, staple forming insert 4684 is formed, for example, of steel, stainless steel, etc., and includes an inner row of inner staple forming pockets 4686 and an outer row of outer staple forming pockets 4688. Each inner staple forming pocket 4686 corresponds to one of the inner staple cavities 4622 and each outer staple forming pocket 4688 corresponds to one of the outer staple cavities 4642. In the illustrated arrangement, the inner staple forming pockets 4686 are from the deck surface 4612, located at the same distance _{g 1} and outer staple forming pockets 4688.

As further seen in FIGS. 112 and 113, inner staples 4630 are supported within corresponding inner staple cavities 4622 on corresponding inner driver portions 4702 of pusher assembly 4700. Outer staples 4650 are supported in corresponding outer staple cavities 4642 on corresponding outer driver portions 4704. Advancement of the pusher assembly 4700 into the anvil 4680 drives the inner and outer staples 4630, 4650 into their forming contact with their respective staple forming pockets 4686, 4688, as shown in FIG. I will. In addition, the knife 4692 is advanced distally through the tissue clamped between the anvil 4680 and the deck surface 4612 and through the frangible bottom 4691 of the knife washer 4690. In the example illustrated in FIG. 112 and FIG 113, the inner staple 4630 may be formed from a first staple wire having a first wire diameter D _1, having a first unformed height L _1. For example, the first wire diameter D ₁ may be about 0.0079 ′ ′ to 0.015 ′ ′ (the increase width is typically 0.0089 ′ ′ (0. 023 cm), 0.0094 ′ ′ (0.024 cm), and 0.00145 ′ ′ (0.00368)), the first unformed height L ₁ is about 0.198 ′ ′ to about 0.250 '(About 0.503 cm-0.635 cm) may be sufficient. Each outer staple 4650 may be formed from a second staple wire having a second wire diameter D _2, with a second unformed height L _2. In the embodiment shown in FIGS. 112 and 113, D ₁ <D ₂ and L ₁ <L ₂ . However, as can be seen in FIG. 113, the inner and outer staples 4630, 4650 are formed with the same formed height FH. Outer thicker wire staples tend to have higher tear and burst strengths, as opposed to an inner row of smaller diameter staples which tends to provide better retention for hemostasis. In other words, a tighter inner staple row may provide better retention with respect to hemostasis, while a weaker row of compressed staples may promote better healing and blood flow. In addition, staples with longer legs have more B-bending that staples with longer legs may become stronger, even when formed at the same height as staples with shorter legs. It may be secured and formed well enough to hold at high load conditions. The amount of staples used for each row of staples can vary. In one embodiment, for example, the inner row 4620 has the same number of inner staples 4630 as the outer row 4640 of outer staples 4650 has. In various configurations, the crown width of the staples 4650 is wider than the crown width of the inner staples 4630. In other embodiments, the staples 4630, 4650 may have the same crown width. In other configurations, the staples 4630, 4650 may be of the gull wing design described above. For example, at least one leg of the staple may comprise an inwardly curved end, or both legs may comprise an inwardly curved end towards each other. Such staples may be utilized in the inner or outer annular rows or both the inner and outer annular rows.

FIG. 114 illustrates another annular staple cartridge embodiment 4810 comprising a cartridge deck 4812 comprising three annular rows 4820, 4840, 4860 of spaced apart staple cavities. The inner or first row 4820 houses a first plurality of inner or first staple cavities 4822 configured respectively at a first angle. Each inner staple cavity 4822 operatively supports a corresponding inner or first staple 4830 therein. The inner cavity 4822 directs the first staple 4830 at the same uniform angle with respect to the tangential direction. In the illustrated example, each inner staple 4830 is formed from a first staple wire having a _first staple diameter D1. In one example, the first staple wire diameter D ₁ may be about 0.0079 ′ ′ to 0.015 ′ ′ (the increase width is typically 0.0089 ′ ′ 0.023 cm), 0.0094 ′ ′ (0.024), and 0.00145 ′ ′ (0.00368)). Referring to FIG. 117, each inner staple 4830 comprises a first crown 4832 and two first legs 4834. The first crown, first have a crown width _{C 1,} the first leg 4834 has unformed leg _{L 1.} In one example, the first crown width C ₁ may be about 0.100 ′ ′ to 0.300 ′ ′ (about 0.254 cm to 0.762 cm), and the first unformed leg length L ₁ may be about 0. It may be 198 '' to 0.250 '' (about 0.503 cm to 0.635 cm). The first legs 4834 may each be configured at an angle A ₁ with respect to the first staple crown 4832. The angle A ₁ may be approximately 90 ° or the first leg 4834 may extend slightly outwardly to assist in holding the first staple 4830 in its corresponding first staple cavity 4822 As such, it may be slightly larger than 90 °.

  Switching to FIGS. 115 and 116, staple cartridge 4810 is intended to be used in combination with anvil 4900, wherein anvil 4900 is staggered or of first staple forming pockets 4904 or It comprises two inner or first rows 4902 consisting of a first angled pair 4903. Each first pair 4903 of the first staple forming pocket 4904 corresponds to one first staple 4830. One first staple forming pocket 4904 corresponds to one first staple leg 4834 and the other first first staple forming pocket 4904 of the pair 4903 corresponds to the other first staple leg 4834 Do. Such a configuration is such that one first leg 4834 is formed on one side of the first crown 4832 and the other first leg 4834 is formed on the other side of the first crown 4832 The first staple leg 4834 of the first staple 4830 functions to establish a formed staple configuration that is formed out of the plane with the first crown 4832 of that particular first staple 4830. This “three-dimensional” formed staple configuration is shown in FIG. 115 for some of the first staple forming pockets 4904.

As can be seen in particular from FIG. 116, the cartridge deck 4812 is of a “stepwise” configuration. The cartridge deck 4812 comprises an inner or first cartridge deck portion 4814 corresponding to an inner or first annular row 4820 of the inner or first staple cavity 4822. As further seen in FIG. 116, when the anvil 4900 is moved to the closed or clamped position, the portion of the anvil 4900 housing the first staple forming pocket 4904 is a first gap distance from the deck portion 4814. g ₁ leave.

Referring again to FIGS. 114, 116, and 117, the middle or second row 4840 receives a second plurality of middle or second staple cavities 4842 each configured at a second angle. Each intermediate staple cavity 4842 operatively supports a corresponding intermediate or second staple 4850 therein. The middle cavity 4842 directs the middle or second staple 4850 at the same uniform second angle with respect to the tangential direction. However, the second angle is different from the first angle. In other words, when the first and second staples are supported in their respective first and second cavities, the axis of the first crown of each first staple 4830 is adjacent when stretched. It will eventually intersect with the elongated axis of the second crown of the second staple 4850. As can be seen in FIGS. 116 and 117, each second or intermediate staple 4850 comprises a second staple crown or base 4852 and two second legs 4854. The staple base 4852 may have a somewhat rectangular cross-sectional shape and may be formed from a flat sheet of material. The second staple leg 4854 may have, for example, a circular cross-sectional profile. No. 14 / 836,110, filed Aug. 26, 2015, entitled "SURGICAL STAPLING CONFIGURATIONS FORCE, for example the second or intermediate staples, which is incorporated herein by reference in its entirety. The various staple configurations disclosed in CURVED AND CIRCULAR STAPLING INSTRUMENTS may be provided. By having a circular staple leg extending from a staple base having a rectangular cross-sectional profile, staple bases and staple legs can be provided that do not include a preferential bending plane. The second staple 4850 comprises a bend 4856 in which a staple leg 4854 extends from a staple base 4852. The bend 4856 may comprise a substantially square cross-sectional profile. The square and rectangular profiles of flexure 4856 and staple base 4852, respectively, provide a rigid connection and skeleton to circular staple legs 4854. The circular staple legs 4854 eliminate the preferential bending planes that staple legs having a square, rectangular, or cross-section with any shape or non-uniform shape with apexes may have. Each second staple legs 4854 has a second diameter _{D 2.} In at least one embodiment, D ₂ > D ₁ . Second base or crown 4852 has a second crown width _{C 2.} In one configuration, C ₂ > C ₁ . The second legs 4854 may each be configured at an angle A ₂ with respect to the second base or crown 4852. Angle A ₂ is approximately 90 ° but may, or to assist in holding the second staple 4850 to the second staple cavities 4842 its corresponding second leg 4854 is spread slightly outward As such, it may be slightly larger than 90 °.

  Turning to FIGS. 115 and 116, the anvil 4900 comprises two intermediate or second rows of staggered or angled second pairs 4913 of staple forming pockets 4914. It further comprises 4912. Each second pair 4913 of second staple forming pockets 4914 corresponds to one second staple 4850. One second staple forming pocket 4914 corresponds to one second staple leg 4854, and the other second staple forming pocket 4914 of the pair 4913 corresponds to the other second staple leg 4854. Such an arrangement functions to establish a formed staple arrangement in which the second leg 4854 is formed out of the side with the second base 4852 of that particular second staple 4850. This “three-dimensional” formed staple configuration is shown in FIG. 115 for some of the second staple forming pockets 4914.

As can be seen in particular from FIG. 116, the cartridge deck 4812 further comprises a second cartridge deck portion 4816 corresponding to the middle or second annular row 4840 of the middle or second staple cavities 4842. As further seen in FIG. 116, the anvil 4900 is moved to the closed position or the clamping position, the portion of the anvil 4900 includes a second staple forming pockets 4914 from deck section 4816, leaving the second gap distance _{g 2} . In the illustrated example, g ₂ > g ₁ .

Referring again to FIGS. 114, 116 and 117, the outer or third row 4860 is such that each outer or third staple cavity 4862 extends the distance between two adjacent second cavities 4842. , Third plurality of outer or third staple cavities 4862 having a size relative to the second staple cavity 4842. Each outer staple cavity 4862 operatively supports a corresponding outer or third staple 4870 therein. The outer cavity 4862 orients the outer or third staples 4870 circumferentially. As can be seen in FIGS. 116 and 117, each third or outer staple 4870 comprises a third staple crown or base 4872 and two third legs 4874. The staple base 4872 may have a somewhat rectangular cross-sectional shape and may be formed from a flat sheet of material. The third staple leg 4874 may have, for example, a circular cross-sectional profile. No. 14 / 836,110 filed Aug. 26, 2015, entitled "SURGICAL STAPLING CONFIGURATIONS, for example, which is incorporated herein by reference in its entirety. The various staple configurations disclosed in the FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS section may be provided. By having a circular staple leg extending from a staple base having a rectangular cross-sectional profile, staple bases and staple legs can be provided that do not include a preferential bending plane. The third staple 4870 comprises a bend 4876 in which the staple legs 4874 extend from the staple base 4872. Bend 4876 may comprise a substantially square cross-sectional profile. The square and rectangular profiles of flexure 4876 and staple base 4872, respectively, provide a rigid connection and skeleton for circular staple legs 4874. The circular staple legs 4874 eliminate the preferential bending plane that staple legs having a square, rectangular, or cross-section with any shape or non-uniform shape with apexes may have. In at least one embodiment, D ₃ > D ₂ . Third base or the crown 4872, a third crown width _{C 3,} each of the third leg 4874 has a third unformed leg _{L 3.} In one configuration, C ₃ > C ₂ and L ₃ > L ₂ . Each third leg 4874, to the third base or the crown 4872 may be configured at an angle _{A 3.} Angle A ₃ is approximately 90 ° but may, or to assist in holding the third staple 4870 to a third staple cavities 4862 its corresponding third leg 4874 is spread slightly outward As such, it may be slightly larger than 90 °.

Turning to FIGS. 115 and 116, the anvil 4900 further comprises an outer row 4916 of outer or third staple forming pockets 4918. Each third staple forming pocket 4918 corresponds to one third staple 4870. As can be seen in particular from FIG. 116, the cartridge deck 4812 further comprises a third cartridge deck portion 4818 corresponding to the outer or third row 4860 of the outer or third staple cavities 4862. As further seen in FIG. 116, the anvil 4900 is moved to the closed position or the clamping position, the portion of the anvil 4900 includes a third staple forming pockets 4918 from deck section 4818, leaving a third gap distance _{g 3} . In the illustrated example, g ₃ > g ₂ . As further seen in FIG. 116, in at least one embodiment, a tissue thickness compensation element 4920 is utilized in combination with each outer or third staple 4870. The tissue thickness compensation element may comprise a woven material embedded with oxidized regenerated cellulose (ORC) to promote hemostasis. No. 14 / 187,389, filed Feb. 24, 2014, entitled "IMPLANTABLE LAYER ASSEMBLIES", filed on February 24, 2014, the entire disclosure content of which is incorporated herein by reference. U.S. Patent Application Publication No. 2015/0238187, which may comprise any of a variety of tissue thickness compensating element configurations. As can be seen from FIG. 116, the tissue thickness compensating element 4920 has a thickness indicated by "a". In one embodiment, the tissue thickness compensation element has a thickness of about 0.015 ′ ′ to 0.045 ′ ′ (about 0.038 cm to 0.11 cm). However, other thicknesses may be used.

  Thus, in at least one embodiment shown in FIGS. 114-117, staple cartridge 4810 may utilize a different number of staples in each of the three rows of staples. In one configuration, the inner row of staples comprises a conventional staple having a minimum wire diameter and a shortest unformed leg length. Each first staple has a shortest crown width, and each first staple is oriented at a uniform angle with respect to the tangential direction. The intermediate staple has a different configuration than the first staple configuration. Each leg of the intermediate staple comprises medium wire diameter and unformed leg length. Each intermediate staple has a crown width slightly wider than the crown width of the inner staple, and each intermediate staple is oriented at a uniform angle to the tangential direction but at a different angle to the inner row of inner staples Be Each outer staple has a configuration similar to that of the intermediate staples. The third leg of each outer staple has a maximum wire diameter as compared to the wire diameter of the inner and middle staple legs, respectively. The crown width of each outer staple is substantially wider than the crown width of the inner and middle staples. Each outer staple is oriented tangential to the circumferential direction of the cartridge. The outer row of staples utilizes a woven tissue thickness compensation element (spacer fabric) embedded with ORC to promote hemostasis. The stepped anvil and the stepped cartridge deck provide different formed heights, wherein the staples having the lowest formed height are present in the inner row and the staples having the highest formed height are: Exists in the outer row. The anvil pockets corresponding to the inner and middle rows of staples are "tilted" to form three dimensional staples in the inner and middle rows. The "bathtub type" anvil pocket corresponds to the outer row of staples. In at least one embodiment, the staples may be fired continuously. For example, the staples in the inner and middle rows may be fired first, followed by the staples in the outer rows. The annular knife cuts tissue clamped during the firing process.

  As described in various embodiments of the present disclosure, the annular stapling instrument comprises an anvil and a staple cartridge. One or both of the anvil and the staple cartridge are movable relative to one another between an open configuration and a closed configuration to capture tissue therebetween. The staple cartridge receives the staples inside or at least partially inside of the annular row of staple cavities. The staples are deployed in an annular array within the tissue captured from their respective staple cavities and formed against the forming pockets of the corresponding annular array in the anvil. The firing drive is configured to eject the staples from the staple cartridge during the firing stroke of the firing drive.

  The anvil of the looped stapling instrument generally comprises a tissue compression surface and an annular array of staple forming pockets defined in the tissue compression surface. The anvil further comprises a mounting mount and a stem extending from the mounting mount. The stem is configured to be removably attached to the closure drive of the annular stapling instrument such that the anvil can be moved towards and away from the staple cartridge of the annular stapling instrument.

  The staple cartridge and anvil can be moved separately within the patient's body and are combined in the operative field. In various cases, the staple cartridge travels, for example, through a narrow tubular body of the patient, such as the colon. The staple cartridge may include multiple tissue contacting mechanisms, such as, for example, a stepped deck and pocket extensions. The present disclosure, among other things, provides various modifications to the plurality of tissue contacting mechanisms to avoid unintended injury to the patient as the staple cartridge moves toward the target tissue.

  Referring to FIG. 118, a partial cross sectional view shows staple cartridge 15500 of the annular surgical instrument that applies pressure to tissue (T) as staple cartridge 15500 moves within the patient's body. The structural features of the staple cartridge 15500 are modified to form a contoured outer frame 15502 specifically to protect tissue. Staple cartridge 15500 comprises a plurality of annular rows of staple cavities. In at least one example, as illustrated in FIG. 118, the outer row 15504 of staple cavities 15510 at least partially surround the inner row 15506 of staple cavities 15512. Staple cavities 15510 and 15512 are configured to receive staples 15530 and 15531, respectively.

  The terms inner and outer draw a relationship with respect to the central axis 15533. For example, the inner tissue contacting surface 15518 is closer to the central axis 15533 than the outer tissue contacting surface 15516.

  As illustrated in FIG. 119, the staple cartridge 15500 comprises a graduated cartridge deck 15508. The outer row 15504 is defined on the outer tissue contacting surface 15516 of the staged cartridge deck 15508, while the inner row 15506 is defined on the inner tissue contacting surface 15518 of the staged cartridge deck 15508. Outer tissue contacting surface 15516 is stepped down from inner tissue contacting surface 15518, thereby forming a gradient that reduces friction when staple cartridge 15500 is pressed against tissue.

  In certain cases, the outer tissue contacting surface 15516 is parallel or at least substantially parallel to the inner tissue contacting surface 15518. In other cases, the outer tissue contacting surface 15516 is angled such that the first surface defined by the outer tissue contacting surface 15516 is transverse to the second surface defined by the inner tissue contacting surface 15518 Ru. An angle is defined between the first surface and the second surface. The angle may be acute. In at least one case, the angle may be, for example, any angle selected from the range of more than about 0 ° and about 30 ° or less. In at least one case, the angle may be, for example, any angle selected from the range of greater than about 5 ° and less than or equal to about 25 °. In at least one case, the angle may be, for example, any angle selected from the range of more than about 10 ° and about 20 ° or less. The angled outer tissue contacting surface 15516 may reduce friction or tissue lift on tissue as the staple cartridge 15500 is moved relative to the tissue. In at least one case, the angled outer tissue contacting surface 15516 is also stepped down from the inner tissue contacting surface 15518.

  In at least one case, the inner portion of the outer tissue contacting surface 15516 is flat or at least substantially flat while the outer edge 15548 of the outer tissue contacting surface 15516 causes the staple cartridge 15500 to be moved relative to the tissue In this case, it is pitched, rounded, and / or sloped to reduce friction or tissue buildup on the tissue. Staple cavities 15510, for example, reside in a planar inner portion of the outer tissue contacting surface 15516. The outer edge 15550 of the inner tissue contacting surface 15518 is also heightened, beveled and / or R to reduce friction or tissue lift on tissue as the staple cartridge 15500 is moved relative to the tissue. It can be formed.

  In order to accommodate staples having the same or at least substantially the same unformed height in the staple cavities 15510 of the outer row 15504 and the staple cavities 15512 of the inner row 15504, the staple cavities 15510 of the outer row 15504 are pocket extensions 15514. Equipped with The pocket extensions 15514 are configured to control and guide the staples 15530 as they are ejected from their respective staple cavities 15510. In certain cases, the pocket extension 15514 can be configured to accommodate staples having a higher unformed height than, for example, the staples of the inner tissue contacting surface 15518.

  As illustrated in FIG. 119, the staple cavities 15510 in the outer row 15504 are laterally aligned or at least substantially aligned with the gap 15520 between two adjacent staple cavities 15512 in the inner row 15506. The staple cavity 15510 comprises a first end 15522 and a second end 15524. The second end 15524 is such that the staple legs 15530a disposed at the second end 15524 are radially aligned or at least substantially aligned with the staple legs 15531a disposed at the first end 15526 As illustrated in FIG. 118, it overlaps with one first end 15526 of two continuous staple cavities 15512. Similarly, a first end 15522 of staple cavity 15510 overlaps another one second end 15528 of two consecutive staple cavities 15512.

  The pocket extension 15514 comprises a first jacket 15532 projecting from the outer tissue contacting surface 15516 to conceal the tips 15536 of the staple legs 15530a extending beyond the outer tissue contacting surface 15516. The first jacket 15532 has an end 15538 projecting from the first end 15522 to form a first jacket 15532, an inner sidewall 15540, and an outer sidewall 15542 extending away from the end 15538; Equipped with In at least one case, the first jacket 15532 defines or at least substantially defines a "C" shaped wall extending over a portion of the perimeter 15535 of the staple cavity 15510 with the first end 15522.

  The inner sidewall 15540 projects from the outer tissue contacting surface 15516 at a higher height than the outer sidewall 15542 to reduce friction against tissue. In other words, the outer sidewall 15542 is lower in height than the inner sidewall 15540. This configuration creates a gradient for a smooth transition from the inner sidewall 15540 to the outer sidewall 15542 to the outer tissue contacting surface 15516. In at least one example, the inner sidewall 15540 and the inner tissue contacting surface 15518 comprise the same or at least substantially the same height with respect to the outer tissue contacting surface 15516. Alternatively, the inner sidewall 15540 and the inner tissue contacting surface 15518 have different heights relative to the outer tissue contacting surface 15516. In particular cases, the inner sidewall 15540 is lower in height relative to the inner tissue contacting surface 15518 relative to the outer tissue contacting surface 15516. This configuration creates a gradient for a smooth transition from the inner tissue contacting surface 15518 to the inner sidewall 15540 to the outer sidewall 15542 to the outer tissue contacting surface 15516.

  The inner tissue contacting surface 15518, the inner sidewall 15540, the outer sidewall 15542, and / or the outer tissue contacting surface 15516 define distinct portions of the contoured outer frame 15502. Nevertheless, as illustrated in FIG. 118, such portions are sufficiently close to one another that no tissue can be trapped therebetween as the staple cartridge 15500 is pressed against the tissue. Maintained. Additionally, one or more portions may be provided with an outer surface that is beveled, contoured, curved, radiused, and / or inclined to reduce friction against tissue. As illustrated in FIG. 118, the upper surface 15544 of the outer sidewall 15542 and the upper surface 15546 of the inner sidewall 15540 are beveled, contoured, curved and R-shaped to define a contoured outer frame 15502 And / or tilting.

  In at least one case, the upper surface 15544 and the upper surface 15546 are inclined surfaces transverse to a first surface defined by the outer tissue contacting surface 15516 and a second surface defined by the inner tissue contacting surface 15518. Define In at least one case, a first angle is defined between the inclined surface and the first surface. A second angle may also be defined between the inclined surface and the second surface. The first and second angles may be the same or at least substantially the same value. Alternatively, the first angle may differ in value from the second angle. In at least one case, the first angle and / or the second angle is an acute angle. In at least one case, the first angle is, for example, any angle selected from the range of more than about 0 ° and about 30 ° or less. In at least one case, the first angle is, for example, any angle selected from the range of more than about 5 ° and about 25 ° or less. In at least one case, the first angle is, for example, any angle selected from the range of more than about 10 ° and about 20 ° or less. In at least one case, the second angle is, for example, any angle selected from the range of more than about 0 ° and about 30 ° or less. In at least one case, the second angle is, for example, any angle selected from the range of more than about 5 ° and about 25 ° or less. In at least one case, the second angle is, for example, any angle selected from the range of more than about 10 ° and about 20 ° or less.

  In addition to the above, the pocket extension 15514 comprises a second jacket 15534 similar in many respects to the first jacket 15532. Similar to the first jacket 15532, the second jacket 15534 protrudes from the outer tissue contacting surface 15516 to hide the tips of the staple legs extending beyond the outer tissue contacting surface 15516. The second jacket 15534 includes an end 15538 projecting from the second end 15524, an inner sidewall 15540, and an outer sidewall 15542 extending from the end 15538 to form a second jacket 15534.

  While one pocket extension 15514 is illustrated in FIG. 119, it is understood that, for example, one or more outer pocket extensions 15514 may protrude from the outer tissue contacting surface 15516. In at least one case, the first jacket 15532 and the second jacket 15534 connect via sidewalls and, for example, define a pocket extension that completely encloses the staple cavity.

  Although many of the surgical instrument systems described herein are operated by electric motors, the surgical instrument systems described herein can operate in any suitable manner. In various cases, the surgical instrument system described herein can operate, for example, with a manually operated trigger. In certain cases, the motors disclosed herein may comprise one or more portions of a robotic control system. Additionally, any of the end effector and / or tool assemblies disclosed herein may be utilized with a robotic surgical instrument system. FIG. 82A schematically illustrates a robotic surgical instrument system 20 '. On the other hand, U.S. Patent Application No. 13 / 118,241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS", and U.S. Patent Application Publication No. 2012/0298719, for example, includes a plurality of robotic surgical instrument systems. Examples of are disclosed in more detail.

  Although the surgical instrument system described herein is described in connection with deployment and deformation of staples, the embodiments described herein are not limited thereto. Various embodiments are also envisioned that deploy fasteners other than staples, such as clamps or tacks. Furthermore, various embodiments are also contemplated that utilize any suitable means for sealing tissue. For example, an end effector according to various embodiments may include an electrode configured to heat and seal tissue. Also for example, end effectors according to certain embodiments can apply vibrational energy to seal tissue.

The following disclosure is incorporated herein by reference in its entirety.
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  Although various devices have been described herein with particular embodiments, modifications and variations may be implemented to those embodiments. Also, although materials are disclosed for specific components, other materials may be used. Further, in accordance with various embodiments, a single component may be replaced by multiple components, and multiple components may be replaced by a single component, to perform a given function. . The above description and the following claims are intended to cover all such modifications and variations.

  The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. However, in each case, the device may be reconditioned for reuse after at least one use. Reconditioning includes any combination of steps including, but not limited to, disassembly of the device, followed by cleaning of the device or replacement of particular parts, and subsequent reassembly of the device. be able to. In particular, the reconditioning facility and / or the surgery team can disassemble the device and reassemble the device for subsequent use after the cleaning step of the device and / or the replacement step of particular parts. Those skilled in the art will appreciate that reconditioning of the device can utilize various techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques, and the resulting reconditioned device, are all within the scope of the present invention.

  The devices disclosed herein may be processed prior to surgery. Initially, new or used equipment may be obtained and cleaned as needed. The device can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic bag or TYVEK bag. The container and instrument can then be placed in a radiation field that can penetrate the container, such as gamma radiation, x-rays, and / or high energy electrons. Radiation can kill bacteria on the instrument and in the container. The sterilized device can then be stored in the sterile container. The sealed container can keep the device sterile until it is opened at the medical facility. The device may also be sterilized using any other technique known in the art, including but not limited to beta radiation, gamma radiation, ethylene oxide, hydrogen peroxide plasma, and / or water vapor.

  Although the invention has been described as having a representative design, the invention may be further modified within the spirit and scope of the present disclosure. Accordingly, the present application is intended to cover any variations, uses, or adaptations of the present invention that use its general principles.

  All patents, publications, or other disclosures incorporated herein, in whole or in part, in their existing definitions, descriptions, or other disclosures, are incorporated herein by reference. It shall be incorporated herein only to the extent not inconsistent with the contents. As such, and to the extent necessary, the disclosure content as explicitly set forth herein supersedes any conflicting description incorporated herein by reference. Any documents, or portions thereof that conflict with the existing definitions, descriptions, or other disclosed documents described herein, which are incorporated herein by reference, will be incorporated from the incorporated documents and existing documents. It shall be incorporated only to the extent that no contradiction arises with the disclosed contents.

[Aspect of embodiment]
(1) With the handle,
A shaft extending from the handle, the shaft comprising a contourable frame, the frame being contourable to fit at least a portion of a patient's colon
An end effector,
With the cartridge body,
An annular array of staple cavities defined in the cartridge body;
Staples removably stored within the annular array of staple cavities;
And an anvil comprising an annular array of formed pockets aligned with the annular array of staple cavities; and an end effector comprising: an end effector.
The surgical instrument of claim 1, wherein the frame is comprised of a visco-elastic material.
The surgical instrument of claim 1, wherein the frame is comprised of a contourable array of pivotable links.
The surgical instrument according to claim 1, wherein the frame is contourable along a radius of curvature.
The surgical instrument according to claim 1, wherein the frame is contourable along more than one radius of curvature.

The surgical instrument according to claim 1, wherein the frame is configured to undergo plastic deformation during use.
(7) With the handle,
A shaft extending from the handle, the shaft comprising an adjustable frame, the frame being adjustable to fit at least a portion of the patient's colon;
An end effector,
With the cartridge body,
An annular array of staple cavities defined in the cartridge body;
Staples removably stored within the annular array of staple cavities;
And an anvil comprising an annular array of formed pockets aligned with the annular array of staple cavities; and an end effector comprising: an end effector.
The surgical instrument of claim 7, wherein the frame is comprised of a visco-elastic material.
The surgical instrument according to claim 7, wherein the frame is comprised of a contourable array of pivotable links.
The surgical instrument according to claim 7, wherein the frame is contourable along a radius of curvature.

The surgical instrument according to claim 7, wherein the frame is contourable along more than one radius of curvature.
The surgical instrument according to claim 7, wherein the frame is configured to undergo plastic deformation during use.
(13) A shaft comprising a contourable frame that is contourable to conform to at least a portion of the patient's colon;
An end effector,
With the cartridge body,
An annular array of staple cavities defined in the cartridge body;
Staples removably stored within the annular array of staple cavities;
And an anvil comprising a looped array of formed pockets aligned with the looped array of staple cavities; and an end effector.
The surgical instrument of claim 13, wherein the frame is comprised of a visco-elastic material.
The surgical instrument according to claim 13, wherein the frame is comprised of a contourable array of pivotable links.

The surgical instrument according to claim 13, wherein the frame is contourable along a radius of curvature.
The surgical instrument according to claim 13, wherein the frame is contourable along more than one radius of curvature.
The surgical instrument according to claim 13, wherein the frame is configured to undergo plastic deformation during use.

Claims (18)

With the handle,
A shaft extending from the handle, the shaft comprising a contourable frame, the frame being contourable to fit at least a portion of a patient's colon
An end effector,
With the cartridge body,
An annular array of staple cavities defined in the cartridge body;
Staples removably stored within the annular array of staple cavities;
And an anvil comprising an annular array of formed pockets aligned with the annular array of staple cavities; and an end effector comprising: an end effector.   The surgical instrument of claim 1, wherein the frame is comprised of a visco-elastic material.   The surgical instrument of claim 1, wherein the frame is comprised of a contourable array of pivotable links.   The surgical instrument of claim 1, wherein the frame is contourable along a radius of curvature.   The surgical instrument according to any one of the preceding claims, wherein the frame is contourable along more than one radius of curvature.   The surgical instrument according to any one of the preceding claims, wherein the frame is configured to undergo plastic deformation during use. With the handle,
A shaft extending from the handle, the shaft comprising an adjustable frame, the frame being adjustable to fit at least a portion of the patient's colon;
An end effector,
With the cartridge body,
An annular array of staple cavities defined in the cartridge body;
Staples removably stored within the annular array of staple cavities;
And an anvil comprising an annular array of formed pockets aligned with the annular array of staple cavities; and an end effector comprising: an end effector.   The surgical instrument according to claim 7, wherein the frame is comprised of a visco-elastic material.   The surgical instrument according to claim 7, wherein the frame is comprised of a contourable array of pivotable links.   The surgical instrument according to claim 7, wherein the frame is contourable along a radius of curvature.   The surgical instrument according to claim 7, wherein the frame is contourable along more than one radius of curvature.   The surgical instrument according to claim 7, wherein the frame is configured to undergo plastic deformation during use. A shaft comprising a contourable frame which is contourable to fit at least a portion of the patient's colon;
An end effector,
With the cartridge body,
An annular array of staple cavities defined in the cartridge body;
Staples removably stored within the annular array of staple cavities;
And an anvil comprising a looped array of formed pockets aligned with the looped array of staple cavities; and an end effector.   The surgical instrument of claim 13, wherein the frame is comprised of a visco-elastic material.   The surgical instrument according to claim 13, wherein the frame is comprised of a contourable array of pivotable links.   The surgical instrument according to claim 13, wherein the frame is contourable along a radius of curvature.   The surgical instrument according to claim 13, wherein the frame is contourable along more than one radius of curvature.   The surgical instrument according to claim 13, wherein the frame is configured to undergo plastic deformation during use.

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