JP2020501802A - Surgical stapling instrument and replaceable tool assembly - Google Patents

Abstract

An exchangeable surgical tool assembly is disclosed. The interchangeable surgical tool assembly includes an end effector, wherein the end effector includes a first jaw, a second jaw rotatably coupled to the first jaw, a first jaw and a second jaw. And a thread configured to translate with respect to The interchangeable surgical tool assembly also includes a firing member, the firing member configured to engage a first jaw, and a first flange configured to engage a second jaw. A second flange formed. The interchangeable surgical tool assembly can further include a pusher plate and a firing bar selectively coupled to the pusher plate, wherein the firing bar has a first distal firing stroke, a first proximal firing. It is configured to travel over a plurality of consecutive firing strokes, including a stroke, a second distal firing stroke, and a second proximal firing stroke. Additionally or alternatively, the replaceable surgical tool assembly may include a rotatable end effector and a flexible spine.

Description

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

The various features of the embodiments described herein, together with their advantages, can be understood by the following description in conjunction with the accompanying drawings, in which:
FIG. 14 is a perspective view of a replaceable surgical tool assembly operably connected to a handle assembly. FIG. 2 is an exploded elevation view of the handle assembly of FIG. 1 and a plurality of interchangeable surgical tool assemblies therefor. FIG. 2 is an exploded perspective view of the handle assembly and a portion of the interchangeable surgical tool assembly of FIG. 1. FIG. 2 is a perspective view of a distal portion of the replaceable surgical tool assembly shown in FIG. 1 with a portion thereof omitted for clarity. FIG. 2 is a perspective cross-sectional view of the distal portion of the interchangeable surgical tool assembly shown in FIG. 1 along a longitudinal axis, a portion of which is omitted for clarity. FIG. 2 is an exploded view of a distal portion of the interchangeable surgical tool assembly of FIG. FIG. 2 is a perspective view of the anvil of the interchangeable surgical tool assembly shown in FIG. FIG. 2 is a perspective view of an elongated channel of the replaceable surgical tool assembly shown in FIG. FIG. 2 is a perspective view of a pivot joint of the interchangeable surgical tool assembly of FIG. FIG. 9 is a plan view of the pivot joint of FIG. 8. FIG. 9 is a cross-sectional view of the distal portion of the replaceable surgical tool assembly of FIG. 1 showing the firing member in the pivot joint of FIG. 8 in an initial position. FIG. 9 is a cross-sectional view of the distal portion of the interchangeable surgical tool assembly of FIG. 1 showing the firing member at the pivot joint of FIG. 8 in a position retracted proximally from an initial position. FIG. 9 is a cross-sectional view of the distal portion of the interchangeable surgical tool assembly of FIG. 1 showing the firing member at the pivot joint of FIG. 8 in a position advanced distally from an initial position. FIG. 4 is a perspective view of the distal portion of the interchangeable surgical tool assembly showing the distal nose portion in an initial configuration. FIG. 14 is an elevational view of the distal portion of the interchangeable surgical tool assembly of FIG. 13 showing the distal nose portion in an initial configuration. FIG. 14 is a perspective view of the distal portion of the interchangeable surgical tool assembly of FIG. 13 showing the distal nose portion in a pivoted configuration. FIG. 14 is an elevational view of the distal portion of the interchangeable surgical tool assembly of FIG. 13 showing the distal nose portion in a pivoted configuration. FIG. 14 is a cross-sectional view of the end effector of FIG. 13 showing the distal nose portion in a pivoted configuration. It is a perspective view of the upper part of a firing member. FIG. 19 is a perspective view of an upper flange of the firing member of FIG. 18. FIG. 19 is an elevational view of the upper portion of the firing member of FIG. 18 showing the firing member in a first configuration. FIG. 19 is an elevational view of the upper portion of the firing member of FIG. 18 showing the firing member in a stressed configuration. FIG. 19 is an elevational view of the upper portion of the firing member of FIG. 18 showing the firing member in a conforming configuration. FIG. 19 is an elevational view of the upper portion of the firing member of FIG. 18 showing the firing member in a loaded configuration. FIG. 3 is an elevational view of the upper portion of the firing member, showing the firing member in a first configuration. FIG. 23 is an elevational view of the upper portion of the firing member of FIG. 22 showing the firing member in a conforming configuration. FIG. 9 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly showing the firing member distally displaced from a home position to a first intermediate position and a first load on the upper flange of the firing member. . 24 is a partial cross-sectional view of a portion of the interchangeable surgical tool assembly of FIG. 24 showing the firing member displaced distally from a first intermediate position to a second intermediate position and having a reduced load on the upper flange. It is. 24 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 24 showing the firing member displaced distally from a second intermediate position to a third intermediate position and having an increased load on the upper flange; It is. FIG. 4 is a partial perspective cross-sectional view of a distal portion of the replaceable surgical tool assembly, with a portion omitted for clarity. FIG. 28 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 27, with no staple cartridge present in the replaceable surgical tool assembly. FIG. 28 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 27 with a staple cartridge disposed within the replaceable surgical tool assembly. FIG. 4 is a partial cross-sectional view of a portion of the interchangeable surgical tool assembly having a lockout, wherein the lockout configuration is in the locked configuration. FIG. 31 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 30 with the staple cartridge disposed therein, wherein the lockout configuration is in the unlocked configuration and the staple cartridge is in a pre-fired state. FIG. 32 is a perspective view of the proximal portion of the staple cartridge of FIG. 31 showing the staple cartridge before firing. FIG. 31 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 30 with the staple cartridge of FIG. 31 disposed therein, with the replaceable surgical tool assembly advanced to an intermediate position during an initial portion of the firing stroke; And the staple cartridge is in a fired state. FIG. 32 is a perspective view of the proximal portion of the staple cartridge of FIG. 31 showing the staple cartridge after firing. FIG. 31 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 30 with the firing stroke completed and the staple cartridge of FIG. 31 disposed therein; It is an exploded perspective view of an anvil. FIG. 37 is a perspective cross-sectional view of a portion of the replaceable surgical tool assembly, taken along a centerline of the replaceable surgical tool assembly, showing a portion of the anvil, a portion of the elongated channel, and a lockout spring of FIG. 36. FIG. 38 is a partial cross-sectional perspective view of a portion of the replaceable surgical tool assembly of FIG. 37 along a centerline of the replaceable surgical tool assembly. FIG. 38 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 37, taken along a centerline of the replaceable surgical tool assembly, showing the anvil in an open position. FIG. 38 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 37, taken along a plane shown in FIG. 36, showing the anvil in an open position. FIG. 38 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 37, taken along a centerline of the replaceable surgical tool assembly, showing the staple cartridge introduced into the elongated channel and the anvil in an open position. FIG. 38 is a partial cross-sectional view of a portion of the interchangeable surgical tool assembly of FIG. 37, taken along the plane shown in FIG. 36, showing the staple cartridge introduced into the elongated channel and the anvil in an open position. FIG. 38 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 37, taken along a centerline of the replaceable surgical tool assembly, moved to a closed position by a staple cartridge and firing member introduced into the elongated channel. Is shown. FIG. 38 is a partial cross-sectional view of the proximal portion of the replaceable surgical tool assembly of FIG. 37, taken along the plane shown in FIG. 36, showing the staple cartridge introduced into the elongated channel and the anvil moved to the closed position by the firing member. ing. FIG. 4 is a partial cross-sectional perspective view of a portion of the replaceable surgical tool assembly, showing an unfired staple cartridge introduced therein and a firing member in a proximal position. FIG. 46 is another partial cross-sectional perspective view of a portion of the replaceable surgical tool assembly of FIG. 45, showing an unfired staple cartridge introduced therein and a firing member in a proximal position. FIG. 46 is an exploded perspective view of the lockout configuration within the replaceable surgical tool assembly of FIG. 45. FIG. 46 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 45, showing an unfired staple cartridge introduced therein and a firing member in a proximal home position; FIG. 46 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 45, showing the firing member displaced distally from a proximal home position during an initial portion of a firing stroke. FIG. 46 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 45, showing the firing member returning to a proximal home position upon completion of the firing stroke. FIG. 46 is a partial cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 45, showing the firing member returned to a proximal home position. FIG. 46 is a partial cross-sectional view of a portion of the interchangeable surgical tool assembly of FIG. 45, showing the firing member displaced distally from a proximal home position during a subsequent attempted firing stroke. FIG. 48 is a perspective view of the lockout configuration of FIG. 47. FIG. 9 is a detailed partial cross-sectional view of the pivot joint of FIG. 8 showing the firing member at the pivot joint in an advanced position and further illustrating the spring assembly. FIG. 4 is an exploded perspective view of the distal portion of the replaceable surgical tool assembly. FIG. 9 is a cross-sectional view of a distal portion of an interchangeable surgical tool assembly. FIG. 57 is a plan view of a portion of the replaceable surgical tool assembly of FIG. 56. FIG. 57 is a cross-sectional view of the replaceable surgical tool assembly of FIG. 56, taken along the plane shown in FIG. 56. FIG. 57 is an exploded view of the pusher plate and firing rod of the replaceable surgical tool assembly of FIG. 56. FIG. 60 is a cross-sectional view of the pusher plate and firing rod of FIG. 59, taken along the plane shown in FIG. 59. FIG. 60 is an elevation view of the pusher plate of FIG. 59. FIG. 57 is a cross-sectional view of the distal portion of the replaceable surgical tool assembly of FIG. 56 at the start of a first firing stroke. FIG. 63 is a cross-sectional view of the replaceable surgical tool assembly of FIG. 56 taken along the plane shown in FIG. 62 at the beginning of a first firing stroke. FIG. 57 is a cross-sectional view of the distal portion of the replaceable surgical tool assembly of FIG. 56 upon completion of a first firing stroke. FIG. 57 is a cross-sectional view of the distal portion of the replaceable surgical tool assembly of FIG. 56 upon completion of a second firing stroke. FIG. 57 is a plan view of a portion of the replaceable surgical tool assembly of FIG. 56 upon completion of a second firing stroke. FIG. 57 is a cross-sectional view of the distal portion of the replaceable surgical tool assembly of FIG. 56 upon completion of a third firing stroke. FIG. 57 is a plan view of a portion of the replaceable surgical tool assembly of FIG. 56 upon completion of a third firing stroke. FIG. 67 is a cross-sectional view of the replaceable surgical tool assembly of FIG. 56 along the plane shown in FIG. 67 upon completion of a third firing stroke. FIG. 57 is a cross-sectional view of the distal portion of the replaceable surgical tool assembly of FIG. 56 upon completion of a fourth firing stroke. FIG. 6 is a perspective view of a distal portion of the replaceable surgical tool assembly. FIG. 73 is an exploded perspective view of the distal portion of the replaceable surgical tool assembly of FIG. 71. FIG. 72 is a cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 71. FIG. 72 is a cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 71. FIG. 9 is a perspective view of a portion of another embodiment of a surgical instrument. FIG. 76 is an exploded perspective view of a portion of the surgical instrument of FIG. 75. FIG. 77 is another exploded view of the surgical instrument of FIGS. 75 and 76 with the channel portion removed from the shaft assembly. FIG. 78 is another exploded view of a portion of the channel and shaft assembly of the surgical instrument of FIGS. 75-77. FIG. 79 is a partial cross-sectional view of a portion of the surgical instrument of FIGS. 75-78, wherein the channel supports the surgical staple cartridge therein, is mounted to the shaft assembly, the anvil is in the closed position, and the firing member is the surgical staple cartridge. Has been advanced distally to fire staples therein. FIG. 9 is a partial perspective view of a portion of another embodiment of a surgical instrument. FIG. 79 is a cross-sectional view of a portion of the surgical instrument of FIGS. FIG. 83 is another cross-sectional view of a portion of the surgical instrument shown in FIG. 81. FIG. 79 is a partial side view of the surgical instrument of FIGS. 75-79 with the end effector articulated in a first articulation plane with respect to the shaft assembly. FIG. 84 is a partial perspective view of the surgical instrument of FIG. 83 with the end effector articulated in a second articulation plane with respect to the shaft assembly. FIG. 85 is another perspective view of the surgical instrument of FIGS. 83 and 84 showing the end effector articulated in first and second articulation planes. FIG. 9 is a perspective view of a portion of another embodiment of a surgical instrument. FIG. 89 is an exploded perspective view of a portion of the surgical instrument of FIG. 86. FIG. 87 is a perspective view of a coupler arrangement for removably connecting an end effector portion to a portion of a shaft assembly of the surgical instrument of FIGS. 86 and 87. FIG. 89 is a plan view of the end effector attached to the shaft assembly of FIGS. 86-88, shown in cross-section for clarity of a portion of the end effector and shaft assembly. FIG. 4 is a cross-sectional view of a portion of a replaceable surgical tool assembly showing the anvil in an open position. FIG. 90 is a cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 90, showing the staple cartridge introduced into the elongated channel and the anvil in the open position. FIG. 90 is a cross-sectional view of a portion of the replaceable surgical tool assembly of FIG. 90, showing the staple cartridge introduced into the elongate channel and the anvil moved to a closed position.

  Corresponding reference characters indicate corresponding parts throughout the drawings. The exemplifications set forth herein illustrate, in one form, various embodiments of the invention, and such exemplifications are not to be construed as limiting the scope of the invention in any manner. Absent.

The applicant of the present application owns the following U.S. patent applications filed on December 21, 2016, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 15 / 386,230, entitled "ARTICULABLE SURGICAL STAPLING INSTRUMENTS",
-U.S. Patent Application No. 15 / 386,221 entitled "LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS";
-U.S. Patent Application No. 15 / 386,209, entitled "SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF",
-U.S. Patent Application No. 15 / 386,198, Title of Invention "LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS AND REPLACEABLE TOOL ASSEMBLIES", and-U.S. Patent Application No. 15 / 386,240, Title of Invention "SUDARDEFFALED AGREED ECE FIRING MEMBERS THEREFOR ”.

The applicant of the present application owns the following U.S. patent applications filed on December 21, 2016, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 15 / 385,939, entitled "STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES THEREIN",
-U.S. Patent Application No. 15 / 385,941, entitled "SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FOR SHIFTING BETWEEN CLOSURE WORKS STORE RESOURCE STORE RESOURCE STORE RESOURCE STORE PRODUCT SERIES RESOURCES
-U.S. Patent Application No. 15 / 385,943, entitled "SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS",
-U.S. Patent Application No. 15 / 385,950, entitled "SURGICAL TOOL ASSEMBLIES WITH CLOSE STROKE REDUCTION FEATURES",
-U.S. Patent Application No. 15 / 385,945, entitled "STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES THEREIN",
-U.S. Patent Application No. 15 / 385,946, entitled "SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS",
-U.S. Patent Application No. 15 / 385,951, entitled "SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASING A JAW OPENING DISTANCE,"
-U.S. Patent Application No. 15 / 385,953, entitled "METHODS OF STAPLING TISSUE",
-U.S. Patent Application No. 15 / 385,954, entitled "FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGENENT FEATURES FOR SURGICAL END EFFECTORS",
-U.S. Patent Application No. 15 / 385,955, entitled "SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOP ARRANGEMENTS",
-U.S. Patent Application No. 15 / 385,948, entitled "SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS",
-U.S. Patent Application No. 15 / 385,956, entitled "SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES",
-U.S. Patent Application No. 15 / 385,958, entitled "SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTING FIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLET REPORT, U.S. Pat. The name "STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES THEREIN".

The applicant of the present application owns the following U.S. patent applications filed on December 21, 2016, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 15 / 385,896, entitled "METHOD FOR RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT",
-U.S. Patent Application No. 15 / 385,898, entitled "STAPLE FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENT TYPES OF STAPLES",
-U.S. Patent Application No. 15 / 385,899, entitled "SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL",
-U.S. Patent Application No. 15 / 385,901, entitled "STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISING WINDOWS DEFINED THEREIN",
-U.S. Patent Application No. 15 / 385,902, entitled "SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER",
-US Patent Application No. 15 / 385,904, entitled "STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND / OR SPENT CARTRIDGE LOCKOUT",
-U.S. Patent Application No. 15 / 385,905, entitled "FIRING ASSEMBLY COMPRISING A LOCKOUT",
-U.S. Patent Application No. 15 / 385,907, entitled "SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUT AND A FIRING ASSEMBLY LOCKOUT",
-U.S. Patent Application No. 15 / 385,908, Title of Invention "FIRING ASSEMBLY COMPRISING A FUSE"; .

The applicant of the present application owns the following U.S. patent applications filed on December 21, 2016, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 15 / 385,920, entitled "STAPLE FORMING POCKET ARRANGEMENTS",
-U.S. Patent Application No. 15 / 385,913, entitled "ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS",
-U.S. Patent Application No. 15 / 385,914, entitled "METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPES OF STAPLE CARTRIDGES WITH THE THE SAME SURGICAL STAPLING INSTRUMENT,"
-U.S. Patent Application No. 15 / 385,893, entitled "BILATERALLY ASYMMETRIC STAPLE FORMING POCKET PAIRS",
-U.S. Patent Application No. 15 / 385,929, entitled "CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICAL INSTRUMENTS WITH SEPARATE AND DISTINCT CLOSURE AND FIRINGS,"
-U.S. Patent Application No. 15 / 385,911, entitled "SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSEING AND FIRING SYSTEM",
-U.S. Patent Application No. 15 / 385,927, entitled "SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES",
-U.S. Patent Application No. 15 / 385,917, entitled "STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPING BREADTHS",
-U.S. Patent Application No. 15 / 385,900, entitled "STAPLE FORMING POCKET ARRANGEMENTS COMPRISING PRIMARY SIDEWALLS AND POCKET SIDEWALLS",
U.S. Patent Application No. 15 / 385,931, entitled "NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FOR SURGICAL STAPLERS",
-U.S. Patent Application No. 15 / 385,915, entitled "FIRING MEMBER PIN ANGLE",
-U.S. Patent Application No. 15 / 385,897, entitled "STAPLE FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMING SURFACE GROOVES",
-U.S. Patent Application No. 15 / 385,922, entitled "SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES,"
-U.S. Patent Application No. 15 / 385,924, entitled "SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS",
-U.S. Patent Application No. 15 / 385,912, entitled "SURGICAL INSTRUMENTS WITH JAWS THAT ARE PIVOTABLE ABOUT A FIXED AXIS AND INCLUDED SEPARATE AND DISTINCE CROSURENED CLOSURE ANS REGISTERS
-U.S. Patent Application No. 15 / 385,910, entitled "ANVIL HAVING A KNIFE SLOT WIDTH",
-U.S. Patent Application No. 15 / 385,903, title of invention "CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS", and-U.S. Patent Application No. 15 / 385,906, title of invention "FIRING MEMBER PIN CONFIGURATIONS".

The applicant of the present application owns the following U.S. patent applications filed on December 21, 2016, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 15 / 386,188, entitled "STEPTED STAPLE CARTRIDGE WITH ASYMMETRIC STAPLES",
-U.S. Patent Application No. 15 / 386,192, entitled "STEPTED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAP SETTING FEATURES",
-U.S. Patent Application No. 15,386,206, entitled "STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES",
U.S. Pat.
-U.S. Patent Application No. 15 / 386,222, Title of the Invention "SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITH POSITIVE OPENING FEATURES", and-U.S. Patent Application No. 15 / 386,236, Title of the Invention "CONNECTION CONNECTIONS UNITS FOR SURGICAL STAPLING INSTRUMENTS ".

The applicant of the present application owns the following U.S. patent applications filed on December 21, 2016, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 15 / 385,887, entitled "METHOD FOR ATTACHING A SHAFT ASSEMBLY TO A SURGICAL INSTRUMENT AND, ALTERNATIVELY, TO A SURGICAL ROBOT",
-U.S. Patent Application No. 15 / 385,889, entitled "SHAFT ASSEMBLY COMPRISING A MANUALLY-OPERABLE RETRACTION SYSTEM FOR US WITH A MOTORIZED SURGITAL INSTRUMENTS,"
-U.S. Patent Application No. 15 / 385,890, entitled "SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE AND RETRACTABLE SYSTEMS",
-U.S. Patent Application No. 15 / 385,891, entitled "SHAFT ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO ADAPT THE OUTPUT OF A ROTARY FIRING MEMBER TO TWO DIFFERENTS,"
-U.S. Patent Application No. 15 / 385,892, entitled "SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO AN ARTICULATION STATE TOTO ARTICULATE AN END EFFECTOR FURTHER FO
U.S. Patent Application No. 15 / 385,894, Title of the Invention "SHAFT ASSEMBLY COMPRISING A LOCKOUT";

The applicant of the present application owns the following U.S. patent applications filed on December 21, 2016, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 15 / 385,916, entitled "SURGICAL STAPLING SYSTEMS,"
-U.S. Patent Application No. 15 / 385,918, entitled "SURGICAL STAPLING SYSTEMS",
-U.S. Patent Application No. 15 / 385,919, entitled "SURGICAL STAPLING SYSTEMS",
-U.S. Patent Application No. 15 / 385,921, entitled "SURGICAL STAPLE CARTRIDGE WITH MOVABLE CAMMING MEMBER CONFIGURATION TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES,"
-U.S. Patent Application No. 15 / 385,923, entitled "SURGICAL STAPLING SYSTEMS,"
-U.S. Patent Application No. 15 / 385,925, entitled "JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OF A FIRING MEMBER IN A SURGERIAL END ENGINE SERIAL ENGINE REFERENCE SIGNAL ENGINE INTERNATIONAL SERIES
-U.S. Patent Application No. 15 / 385,926, entitled "AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYING CLOSURE MOTIONS TO JAWS OF OF SURGICAL INSTRUMENTS",
-U.S. patent application Ser. No. 15 / 385,928, entitled "PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN A MOVABLE JAW AND ACTUAL SHAFT OF ASURGAIN INSTRUMENT,"
-U.S. Patent Application No. 15 / 385,930, entitled "SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERATING OPENING FEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS";
-U.S. Patent Application No. 15 / 385,932, entitled "ARTICULABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFT ARRANGEMENT",
-U.S. Patent Application No. 15 / 385,933, entitled "ARTICULABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLE LINKAGE DISTAL OF AN ARTICULATION LOCK",
-U.S. Patent Application No. 15 / 385,934, entitled "ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR IN AN ARTICULATED POSITION IN RESPONSE TO ACTUS ACTION WORKS AREA FUSION AREA FUSION AREA
U.S. Patent Application No. 15 / 385,935, title of invention "LATEALLY ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR OF A SURGITAL INSTRUMENT IN AUTHORUS, US Pat. "ARTICULABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKE AMPLIFICATION FEATURES".

The applicant of the present application owns the following U.S. patent applications filed on June 24, 2016, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 15 / 191,775, entitled "STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES",
-U.S. Patent Application No. 15 / 191,807, entitled "STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPED STAPLES",
-U.S. Patent Application No. 15 / 191,834, entitled "STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME",
U.S. Patent Application No. 15 / 191,788, Title of Invention "STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES";

The applicant of the present application owns the following U.S. patent applications filed on June 24, 2016, each of which is incorporated herein by reference in its entirety:
-U.S. Design Patent Application No. 29 / 569,218, entitled "SURGICAL FASTENER",
-U.S. Design Patent Application No. 29 / 569,227, entitled "SURGICAL FASTENER",
-U.S. Design Patent Application No. 29 / 569,259, title of the invention "SURGICAL FASTENER CARTRIDGE", and-U.S. Design Patent Application No. 29 / 569,264, title of the invention "SURGICAL FASTENER CARTRIDGE".

The applicant of the present application owns the following patent applications filed on April 1, 2016, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 15 / 089,325, entitled "METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM",
-U.S. Patent Application No. 15 / 089,321, entitled "MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY",
-U.S. Patent Application No. 15 / 089,326, entitled "SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD",
-U.S. Patent Application No. 15 / 089,263, entitled "SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURE GRIP PORTION,"
-U.S. Patent Application No. 15 / 089,262, entitled "ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUABLE BAILOUT SYSTEM",
-U.S. Patent Application No. 15 / 089,277, entitled "SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVIL CONCENTRIC DRIVE MEMBER",
-U.S. Patent Application No. 15 / 089,296, entitled "INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL END EFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT ASH FASH
-U.S. Patent Application No. 15 / 089,258, entitled "SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION",
-U.S. Patent Application No. 15 / 089,278, entitled "SURGICAL STAPLING SYSTEM CONFIGURATION TO PROVIDE SELECTIVE CUTTING OF TISSUE",
-U.S. Patent Application No. 15 / 089,284, entitled "SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT",
-U.S. Patent Application No. 15 / 089,295, entitled "SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSION LOCKOUT",
-U.S. Patent Application No. 15 / 089,300, entitled "SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT",
-U.S. Patent Application No. 15 / 089,196, entitled "SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT",
-U.S. Patent Application No. 15 / 089,203, entitled "SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT",
-U.S. Patent Application No. 15 / 089,210, entitled "SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGE LOCKOUT",
-U.S. Patent Application No. 15 / 089,324, entitled "SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM",
-U.S. Patent Application No. 15 / 089,335, entitled "SURGICAL STAPLING INSTRUMENT COMPULSING MULTIPLE LOCKOUTS",
-U.S. Patent Application No. 15 / 089,339, entitled "SURGICAL STAPLING INSTRUMENT",
-U.S. Patent Application No. 15 / 089,253, entitled "SURGICAL STAPLING SYSTEM CONFIGURATION TO APPLY ANNULAR ROWS OF STAPLES HAVING DIFFERENT HEIGHTS",
-U.S. Patent Application No. 15 / 089,304, entitled "SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET",
-U.S. Patent Application No. 15 / 089,331, entitled "ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS",
-U.S. Patent Application No. 15 / 089,336, entitled "STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES,"
-U.S. Patent Application No. 15 / 089,312, entitled "CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUE SUPPORT",
-U.S. Patent Application No. 15 / 089,309, title of invention "CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM", and-U.S. Patent Application No. 15 / 089,349, title of invention "CIRCULAR STAPLING SYSTEM CONFIGURATION COLOR CONFIGURATION CONFIGURATION CONFIGURATION.

The applicant of the present application also owns the following identified U.S. patent applications filed December 31, 2015, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 14 / 984,488, entitled "MECHANISMS FOR COMPENSATION FOR BATTERY PACK FAILURE IN POWERED SURGICAL INSTRUMENTS",
-U.S. patent application Ser. No. 14 / 984,525, title of invention "MECHANISMS FOR COMPENSATION FOR DRIVETTRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS", and-U.S. patent application Ser. AND MOTOR CONTROL CIRCUITS ".

Applicant also owns the following identified U.S. patent applications, filed 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 ARTICULATION MECHANISM WITH SLOTTED SECONDARY CONSTRAIN",
-U.S. Patent Application No. 15 / 019,206, entitled "SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLY ARTICULATEABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY";
-U.S. Patent Application No. 15 / 019,215, entitled "SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATION ARRANGEMENTS",
-U.S. Patent Application No. 15 / 019,227, entitled "ARTICULABLE 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; Title of Invention "ARTICULABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAM ARRANGEMENTS"; REDUCTION ARRANGEMENTS ”.

The applicant of the present application also owns the following identified U.S. patent applications, filed 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, title of invention "MECHANISMS FOR COMPENSATE FOR DIVIVTRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS",
-U.S. Patent Application No. 15 / 043,275; Title of Invention "MECHANISMS FOR COMPENSATE FOR DIVIVTRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS"; and-U.S. Patent Application No. 15 / 043,289; 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 Ser. No. 14 / 742,925, entitled "SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING ARRANGEMENTS",
-U.S. Patent Application No. 14 / 742,941, entitled "SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSING FEATURES",
-U.S. Patent Application No. 14 / 742,914, entitled "MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS",
-U.S. patent application Ser. No. 14 / 742,900, entitled "ARTICULABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAM STRUCTURES WITH CENTER FIRING SUPPORT PORTER PORTER PORTER ART OVER PORT INTERNATIONAL
-U.S. Patent Application No. 14 / 742,885; title of invention "DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS"; and-U.S. Patent Application No. 14 / 742,876; FOR ARTICULABLE SURGICAL INSTRUMENTS ".

The applicant of the present application owns the following patent applications filed on March 6, 2015, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 14 / 640,746, entitled "POWERED SURGICAL INSTRUMENT", current U.S. Patent Application Publication No. 2016/0256184,
-U.S. Patent Application No. 14 / 640,795; title of invention "MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWERED SURGICAL INSTRUMENTS"; current U.S. Patent Application Publication No. 2016/02561185;
-U.S. patent application Ser. No. 14 / 640,832, entitled "ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATES FOR MULTIPLE TISSUE TYPES", U.S. Patent Application Publication No. 2016/0256154.
-U.S. patent application Ser. No. 14 / 640,935, title of the invention "OVERLAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION," U.S. Patent Application Publication No. 2016/0256071.
-U.S. Patent Application No. 14 / 640,831, entitled "MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTOR FOR POWERED SURGICAL INSTRUMENTS", U.S. Patent Application Publication No. 2016/0256153;
-U.S. Patent Application No. 14 / 640,859, Title of Invention "TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE STABILITY, CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES, U.S. Pat.
-U.S. Patent Application No. 14 / 640,817, entitled "INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS", current U.S. Patent Application Publication No. 2016/0256186,
-U.S. Patent Application No. 14 / 640,844, entitled "CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULAR SHAFT WITH SELECT SELECT CONTROL PROFILESING FROM HANDLE, U.S. Pat.
-U.S. Patent Application No. 14 / 640,837, entitled "SMART SENSORS WITH LOCAL SIGNAL PROCESSING," current U.S. Patent Application Publication No. 2016/0256163,
-U.S. Patent Application No. 14 / 640,765; title of invention "SYSTEM FOR DETECTION THE THE MIS-INSERTION OF A STAPLE CARTRIDGE INTO A SURGICAL STAPLLER"; U.S. Patent Application Publication No. 2016/0256160;
-U.S. Patent Application No. 14 / 640,799, entitled "SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A ROTATABLE SHAFT", current U.S. Patent Application Publication No. 2016/0256162, and-U.S. Patent Application No. 14/640, No. 780, entitled "SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING", U.S. Patent Application Publication No. 2016/0256161.

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:
-U.S. Patent Application No. 14 / 633,576, entitled "SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION", current U.S. Patent Application Publication No. 2016/0249919,
-U.S. Patent Application No. 14 / 633,546, entitled "SURGICAL APPARATUS CONFIGURATION TO ASSESS WHETHER A PERFORMANCE PARAMETER OF THE SURGICAL APPARATUS IS WIPE AN EPA NATION ACCESSORIES OF THE SUPPORT OF THE SURGICAL APPARATUS WIPO INTERNATIONAL
-U.S. Patent Application No. 14 / 633,560, entitled "SURGICAL CHARGING SYSTEM THAT CHARGES AND / OR CONDITIONS ONE OR MORE BATTERIES", current U.S. Patent Application Publication No. 2016/0249910;
-U.S. patent application Ser. No. 14 / 633,566, entitled "CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR CHARGING A BATTERY", current U.S. Patent Application Publication No. 2016/0249918;
-U.S. Patent Application No. 14 / 633,555, entitled "SYSTEM FOR MONITORING WHEETHER A SURGICAL INSTRUMENT NEEDS TO BE SERVICED", current U.S. Patent Application Publication No. 2016/0249916;
-U.S. Patent Application No. 14 / 633,542, entitled "REINFORCED BATTERY FOR A SURGICAL INSTRUMENT," current U.S. Patent Application Publication No. 2016/0249908,
-U.S. Patent Application No. 14 / 633,548, entitled "POWER ADAPTER FOR A SURGICAL INSTRUMENT", current U.S. Patent Application Publication No. 2016/0249909,
-U.S. Patent Application No. 14 / 633,526, title of the invention "ADAPTABLE SURGICAL INSTRUMENT HANDLE", current U.S. Patent Application Publication No. 2016/0249945,
-U.S. Patent Application No. 14 / 633,541; title of invention "MODULAR STAPLING ASSEMBLY"; current U.S. Patent Application Publication No. 2016/0249927; and-U.S. Patent Application No. 14 / 633,562; title of invention. SURGICAL APPARATUS CONFIGURATION TO TRACK AN END-OF-LIFE PARAMETER ", current U.S. Patent Application Publication No. 2016/0249917.

The applicant of the present application owns the following patent applications filed on December 18, 2014, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 14 / 574,478, entitled "SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATEABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STOCKER's US Patent Application No.
-U.S. Patent Application No. 14 / 574,483, title of invention "SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS," current U.S. Patent Application Publication No. 2016/0174969,
-U.S. Patent Application No. 14 / 575,139, entitled "DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS", current U.S. Patent Application Publication No. 2016/0174978,
-U.S. Patent Application No. 14 / 575,148, entitled "LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH ARTICULATABLE SURGICAL END EFFECTORS", U.S. Patent Application Publication No. 2016/01749;
-U.S. Patent Application No. 14 / 575,130, entitled "SURGICAL INSTRUMENT WITH WITH AN ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON-MOVABLE AXIS RELAIVE TOTO AUGUST REGISTER TO AREA REPORT TO STA 16 ,
U.S. Patent Application No. 14 / 575,143, entitled "SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS," current U.S. Patent Application Publication No. 2016/0174983,
-U.S. Patent Application No. 14 / 575,117, entitled "SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS," U.S. Pat.
-U.S. patent application Ser. No. 14 / 575,154, entitled "SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS," U.S. Pat.
-U.S. Patent Application No. 14 / 574,493, entitled "SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM", current U.S. Patent Application Publication No. 2016/0174970, and-U.S. Patent Application No. 14 / 574,500. The title of the invention is "SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION SYSTEM", U.S. Patent Application Publication No. 2016/0174971.

The applicant of the present application owns the following patent applications filed on March 1, 2013, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 13 / 782,295, entitled "Articulatable Surgical Instruments With Conductive Pathways For Signal Communication", currently U.S. Patent Application Publication No. 2014/0246461,
-U.S. Patent Application No. 13 / 782,323, titled "Rotary Powered Articulation Joints For Surgical Instruments", currently U.S. Patent Application Publication No. 2014/0246472;
-U.S. Patent Application No. 13 / 782,338, entitled "Thumbwheel Switch Arrangements For Surgical Instruments", currently U.S. Patent Application Publication No. 2014/02494957;
-U.S. Patent Application No. 13 / 782,499, entitled "Electromechanical Surgical Device with Signal Relay Arrangement", current U.S. Patent No. 9,358,003,
-U.S. Patent Application No. 13 / 782,460, entitled "Multiple Processor Motor Control for Modular Surgical Instruments", currently U.S. Patent Application Publication No. 2014/0246478,
-U.S. Patent Application No. 13 / 782,358, entitled "Joystick Switch Assemblies For Surgical Instruments", current U.S. Patent No. 9,326,767;
-U.S. patent application Ser. No. 13 / 782,481, entitled "Sensor Straightened End Effector During Removal Through Trocar", current U.S. Pat. No. 9,468,438;
-U.S. Patent Application No. 13 / 782,518, entitled "Control Methods for Surgical Instruments with Removable Implementions Portions", currently U.S. Patent Application Publication No. 2014/0246475;
-U.S. Patent Application No. 13 / 782,375, entitled "Rotary Powered Surgical Instruments With Multiple Multiple Degrees of Freedom", current U.S. Patent No. 9,398,911, and-U.S. Patent Application No. 13 / 782,536. No., title of invention "Surgical Instrument Soft Stop", current U.S. Pat. No. 9,307,986.

Applicants also own the following patent applications filed on March 14, 2013, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 13 / 803,097, entitled "ARTICULABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE", currently U.S. Patent Application Publication No. 2014/0263542,
-U.S. patent application Ser. No. 13 / 803,193, entitled "CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT", current U.S. Pat. No. 9,332,987;
U.S. patent application Ser. No. 13 / 803,053, title of invention "INTERCHANGEABLE SHAFT ASSEMBLYES FOR US WITH A SURGICAL INSTRUMENT", currently U.S. Patent Application Publication No. 2014/0263564;
U.S. Patent Application No. 13 / 803,086, entitled "ARTICULABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK", currently U.S. Patent Application Publication No. 2014/0263541,
-U.S. Patent Application 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", currently U.S. Patent Application Publication No. 2014/0263554;
U.S. Patent Application No. 13 / 803,066, entitled "DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS", currently U.S. Patent Application Publication No. 2014/0263565;
-U.S. Patent Application No. 13 / 803,117, entitled "ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS", current U.S. Patent No. 9,351,726,
-U.S. Patent Application No. 13 / 803,130, entitled "DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS", current U.S. Patent No. 9,351,727, and-U.S. Patent Application No. 13 / 803,159. The title of the invention is "METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT", currently U.S. Patent Application Publication No. 2014/0277017.

The applicant of the present application also owns the following patent application, filed March 7, 2014, the entire contents of which are 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, each of which is incorporated herein by reference in its entirety:
-U.S. Patent Application No. 14 / 226,106, entitled "POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS", currently U.S. Patent Application Publication No. 2015/0275258,
-U.S. Patent Application No. 14 / 226,099, entitled "STERILIZATION VERIFICATION CIRCUIT", currently 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", currently U.S. Patent Application Publication No. 2015/0272580,
-U.S. Patent Application No. 14 / 226,117, entitled "POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL", currently 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", currently U.S. Patent Application Publication No. 2015/0272579,
-U.S. Patent Application 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", currently 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", currently U.S. Patent Application Publication No. 2015/0272578;
-U.S. Patent Application No. 14 / 226,097, entitled "SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS," currently U.S. Patent Application Publication No. 2015/0272570,
-U.S. Patent Application No. 14 / 226,126, entitled "INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS", currently U.S. Patent Application Publication No. 2015/0272572,
-U.S. Patent Application No. 14 / 226,133, titled "MODULAR SURGICAL INSTRUMENT SYSTEM", currently U.S. Patent Application Publication No. 2015/0272557;
-U.S. patent application Ser. No. 14 / 226,081, entitled "SYSTEMS AND METHODS FOR CONTROL A SEGMENTED CIRCUIT", currently 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", currently U.S. Patent Application Publication No. 2015/0280424;
-U.S. Patent Application No. 14 / 226,111, title of the invention "SURGICAL STAPLING INSTRUMENT SYSTEM", currently U.S. Patent Application Publication No. 2015/0272583, and-U.S. Patent Application No. 14 / 226,125, "SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT", currently 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, each of which is incorporated herein by reference in its entirety:
-U.S. patent application Ser. No. 14 / 479,103, entitled "CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE", currently U.S. Patent Application Publication No. 2016/0066912,
-U.S. Patent Application No. 14 / 479,119, entitled "ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION", currently U.S. Patent Application Publication No. 2016/0066914;
-U.S. Patent Application No. 14 / 478,908, entitled "MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION," currently 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;
-U.S. Patent Application No. 14 / 479,110, entitled "POLARITY OF HALL MAGNET TO DETECT MISLOADED CARTRIDGE", current U.S. Patent Application Publication No. 2016/0066915,
-U.S. Patent Application No. 14 / 479,098, entitled "SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION," currently U.S. Patent Application Publication No. 2016/0066911,
-U.S. Patent Application No. 14 / 479,115, titled "MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE", currently U.S. Patent Application Publication No. 2016/0066916, and-U.S. Patent Application No. 14 / 479,108, The name of the invention, "LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION", currently US Patent Application Publication No. 2016/0066913.

The applicant of the present application also owns the following patent applications filed on April 9, 2014, each of which is incorporated herein by reference in its entirety:
U.S. Patent Application No. 14 / 248,590, entitled "MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS", currently 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 ROTATABLE OUTPUT," currently US Patent Application No. 305, U.S. Pat.
-U.S. Patent Application No. 14 / 248,595, entitled "SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROL LING THE OPERATION OF THE THE SURGITAL INSTRUMENT", now U.S. Pat.
-U.S. Patent Application No. 14 / 248,588, entitled "POWERED LINEAR SURGICAL STAPLER", currently U.S. Patent Application Publication No. 2014/0309666,
-U.S. Patent Application No. 14 / 248,591, entitled "TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT", current U.S. Patent Application Publication No. 2014/0305991,
-U.S. patent application Ser. No. 14 / 248,584, entitled "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY ROTARY DRIVE SHAFTS WITH SERVICES RIGHT SERVICES RIGHT SERVICES RIGHT SERVICES RIGHT RIGHT SERVICES RIGHT SERVICES RIGHT SERVICES RIGHT SERVICES RIGHT SERVICES CURRENT SERVICES CURRENT SERVICES CURRENT SERVICES CURRENT SERVICES CURRENT SERVICES CURRENT SERVICES CURRENT SERVICES CURRENT SERVICES CURRENT SERVICES CURRENT SERVICES CURRENT SERVICES U.S. Pat.
-U.S. Patent Application No. 14 / 248,587, entitled "POWERED SURGICAL STAPLLER", currently U.S. Patent Application Publication No. 2014/0309665,
-U.S. Patent Application No. 14 / 248,586, title of invention "DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT", currently U.S. Patent Application Publication No. 2014/0305990, and-U.S. Patent Application No. 14 / 248,607. The title of the invention is "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS", currently US Patent Application Publication No. 2014/0305992.

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

  As set forth in the specification and illustrated in the accompanying drawings, numerous specific details are set forth in order to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments. Well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described herein. The reader is advised that the embodiments described and illustrated herein are non-limiting examples, and thus certain structural and functional details disclosed herein may be representative and illustrative. Will understand. Modifications and changes may be made thereto without departing from the scope of the claims.

  The terms "comprise" (any form of comprises, such as "comprises" and "comprising"), "have" (any form of have, such as "has" and "having"), "include ( include) "(any word form of include, such as" includes "and" including "), and" contain "(any word form of container, such as" contains "and" containing ") are open-ended concatenations. Verb. As a result, a surgical system, device, or apparatus that “comprises,” “has,” “includes,” or “contains” one or more elements has one or more of those elements. But not limited to having only one or more of them. Similarly, an element of a system, device, or apparatus “comprising,” “having,” “including,” or “containing” one or more features is one or more of those features. , But is not limited to having only one or more of these features.

  The terms "proximal" and "distal" are used herein with reference to a clinician operating the handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician, and the term "distal" refers to the portion remote from the clinician. It will be further understood that for convenience and clarity, spatial terms such as "vertical", "horizontal", "top", and "bottom" may be used herein with respect to the drawings. 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 surgery. However, the reader will readily appreciate that the various methods and devices disclosed herein may be used in many surgical procedures and applications, including those associated with open surgery. By reading through the Detailed Description of the Invention herein, the reader will appreciate that various instruments disclosed herein can be used, for example, through incisions or punctures made in tissue through natural orifices. It will be further appreciated that it can be inserted into the body in any manner, 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 an access device having a working passageway through which the end effector and elongate shaft of the surgical instrument can be advanced. You can also.

  A surgical stapling system can include a shaft and an end effector extending from the shaft. The end effector includes a first jaw and a second jaw. The first jaw includes a staple cartridge. Other implementations in which the staple cartridge is insertable into and removable from the first jaw, but the staple cartridge is not removable from the first jaw or at least not easily replaceable Forms are also envisioned. The second jaw includes an anvil configured to deform staples ejected from the staple cartridge. The second jaw is pivotable about the closed axis with respect to the first jaw, although other embodiments are envisioned wherein the first jaw is pivotable with respect to the second jaw. Is done. The surgical stapling system further includes an articulation configured to allow the end effector to rotate, ie, articulate, with respect to the shaft. The end effector is rotatable about an articulation axis extending through the articulation. Other embodiments that do not include an articulation are also contemplated.

  The staple cartridge includes 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 tissue against the deck. Subsequently, the staple removably stored in the cartridge body can be deployed in the tissue. The cartridge body includes a staple cavity defined therein, and the staple is removably stored within the staple cavity. The staple cavities are arranged in four longitudinal rows. Two rows of staple cavities are located on a first side of the longitudinal slot, and two rows of staple cavities are located on a second side of the longitudinal slot. Other arrangements of staple cavities and staples may also be possible.

  The staples are movable between their unfired position and their fired position by the sled assembly. The sled assembly is movable between a proximal position adjacent the proximal end and a distal position adjacent the distal end. The sled assembly includes a plurality of ramp surfaces that are configured to slide below the staples and lift the staples toward the anvil. Other configurations may include a staple driver that supports the staples in the staple cavity, in which configuration the sled assembly not only can slide below the driver and lift the driver, but also The supported staples can be lifted toward the anvil.

  In addition to the above, the sled assembly is moved distally by the firing member. The firing member is configured to contact the sled assembly and to push the sled assembly toward the distal end. A longitudinal slot defined in the cartridge body is configured to receive a firing member. The anvil also includes a slot configured to receive the firing member. The firing member further includes a first cam that engages the first jaw, and a second cam that engages the second jaw. As the firing member is advanced in the distal direction, the first and second cams can control the distance between the staple cartridge deck and the anvil, ie, the tissue gap. The firing member also includes a knife configured to cut tissue captured between the staple cartridge and the anvil. It is desirable that the knife be positioned at least partially proximal to the ramp surface so that the staples are ejected forward of the knife.

  In certain instances, the end effectors described herein may define a width of 8 mm or less and a height of 8 mm or less. For example, the end effectors described herein may be 5 mm wide by 8 mm high. In another example, the end effector may be, for example, 5 mm wide by 5 mm high. The miniature end effector described herein may include various features that contribute to its smaller footprint. For example, such an end effector is described in U.S. patent application Ser. No. 14 / 836,324, filed Aug. 26, 2051, entitled "SURGICAL STAPLES FOR MINIMIZING," which is incorporated herein by reference in its entirety. And staples such as those described in "STAPLE ROLL". Since the driver is eliminated when the staples are driven directly by the sled assembly, the height of the staple cartridge is reduced, and thus the height of the end effector configured to receive the staple cartridge may also be reduced. Additionally or alternatively, such an end effector can include a multifunctional firing member. For example, the firing member drives a sled to fire staples from the staple cartridge, cut tissue clamped between the jaws, cam the jaws into a clamped configuration, and cam the jaws into an open configuration. obtain. Such a clamp firing open firing member can perform a combination of surgical functions using a single actuation system, thereby reducing the number of independent actuation systems within the end effector, and therefore The size of the end effector can also be reduced. For example, a translational closure tube that moves around at least a portion of the end effector to provide a closure movement may be eliminated in certain instances.

  The miniature end effectors described herein can be advantageous for a wide variety of surgical procedures, including surgical procedures where a small surgical footprint is evaluated. For example, in certain thoracic procedures, the end effector may be utilized to cut and seal blood vessels, such as, for example, pulmonary vessels having small diameters and high flow rates. Small end effectors may require a smaller insertion opening and may provide the surgeon with improved visibility around the surgical site.

  FIGS. 1 and 2 illustrate one form of a surgical instrument 10 that includes a replaceable surgical tool assembly 1000 operably coupled to a motorized handle assembly 500. Referring to FIG. 1A, handle assembly 500 may be compatible with a number of different replaceable surgical tool assemblies, in addition to replaceable surgical tool assembly 1000. For example, handle assembly 500 may be compatible with interchangeable surgical tool assemblies 1000 ', 1000 ", 1000"', and 1000 "" shown in FIG. 1A. The replaceable surgical tool assembly 1000 may also be effectively used with a tool drive assembly of a robotic or automatic surgical system. For example, the interchangeable surgical tool assembly disclosed herein includes, but is not limited to, U.S. Patent No. 9,072,535, entitled "SURGICAL," which is incorporated herein by reference in its entirety. STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS "can be used with a variety of robotic systems, instruments, components and methods. The handle assembly 500, as well as the tool drive assembly of the robotic system, may also be referred to herein as a "control system" or "control unit."

  1 and 2 illustrate the attachment of a replaceable surgical tool assembly 1000 to a handle assembly 500. FIG. The handle assembly 500 may include a handle housing 502 that includes a pistol grip portion 504 that can be grasped and manipulated by a clinician. Handle assembly 500 may further include a frame 506 operatively supporting at least one drive system.

  In at least one form, the handle assembly 500 and the frame 506 operate the drive system 530 configured to apply a closing and firing movement to a corresponding portion of the replaceable surgical tool assembly attached thereto. May be supported. No. 14 / 226,142, entitled "SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM", the current US Patent Application Publication No. As noted, drive system 530 may employ an electric motor 505 located within pistol grip portion 504 of handle assembly 500. In various embodiments, the motor 505 may be, for example, a brushed DC drive motor having a maximum speed of about 25,000 RPM. In other configurations, motor 505 may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. Motor 505 may be powered by power supply 522, which in one form may include a removable power pack. The power pack may support a plurality of lithium ion ("LI") or other suitable batteries therein. Multiple batteries may be connected in series and may be used as power source 522 for handle assembly 500. In addition, power supply 522 may be replaceable and / or rechargeable.

  Referring primarily to FIG. 2, the electric motor 505 is configured to axially drive a longitudinally movable drive member 540 in a distal direction and a proximal direction depending on the polarity of the motor 505. . For example, when the motor 505 is driven in a rotational direction, the longitudinally movable drive member 540 will be axially driven in the distal direction "DD". When the motor 505 is driven in the opposite rotational direction, the longitudinally movable drive member 540 will be axially driven in the proximal direction "PD". Handle assembly 500 may include a switch 513 that may be configured to reverse the polarity applied to electric motor 505 by power supply 522 or otherwise control motor 505. Handle assembly 500 may also include a sensor (not shown) configured to detect the position of drive member 540 and / or the direction in which drive member 540 is being moved. When the replaceable surgical tool assembly 1000 is mounted on the handle assembly 500, the drive member 540 of the handle drive system 530 is coupled to the drive member 1602 of the tool drive system 1600 within the replaceable surgical tool assembly 1000 and the drive member 1602 is connected to firing member 1760 in end effector 1100 via flexible firing bar 1770 (see FIGS. 3-5).

  During the firing stroke, drive member 540 transmits firing motion to firing bar 1770 via firing member 1602 to fire firing member 1760. For example, actuation of drive member 540 is configured to displace firing bar 1770 and firing member 1760 in a distal direction to cut tissue and effect firing of staples from the staple cartridge. Thereafter, drive member 540 may be retracted proximally, causing firing bar 1770 and firing member 1760 to retract proximally. Fire bar 1770 may be comprised of a stacked beam structure that includes at least two layers. The firing bar 1770 may be configured to flex within the joint 1200. Such beam layers may include, for example, stainless steel bands interconnected by welding or pinning to one another at their proximal ends and / or elsewhere along their length. . In an alternative embodiment, the distal ends of the bands are not connected to each other to allow the laminate or band to spread relative to each other when the end effector is articulated. Such a configuration allows firing bar 1770 to be sufficiently flexible to accommodate articulation of end effector 1100. Various stacked knife bar configurations are disclosed in U.S. Patent Application No. 15 / 019,245, entitled "SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTION ARRANGEMENTS," which is incorporated herein by reference in its entirety. The reader will readily appreciate that, in certain instances, the various firing members described herein can be coupled to the firing bar 1770.

  In various examples, handle assembly 500 may be configured to sense the type of replaceable surgical tool assembly 1000 mounted or attached thereto. For example, the handle assembly 500 can include a Hall effect sensor that detects a detectable element, such as a magnetic element, on an exchangeable surgical tool assembly, such as, for example, the exchangeable surgical tool assembly 1000. It can be configured to detect. Different replaceable surgical tool assemblies may have different detectable elements and / or arrangements. A variety of sensors for sensing different replaceable surgical tool assemblies are disclosed in U.S. patent application Ser. No. 13 / 803,053, entitled "INTERCHANGEABLE SHAFT ASSEMBLEES FOR USE WITH," which is hereby incorporated by reference in its entirety. A SURGICAL INSTRUMENT ", which is described in the current US Patent Application Publication No. 2014/0263564.

  Based on the type of replaceable surgical tool assembly 1000 detected, the handle assembly 500 may perform a particular surgical function and / or lock out a particular surgical function. For example, the handle assembly 500 can include one or more separate drive systems (eg, a closed drive system and a firing drive system), but upon detecting the replaceable surgical tool assembly 1000, the handle assembly 500 Can release or deactivate a particular drive system (e.g., deactivate a closed drive system and use a firing drive system to close and fire the end effector). For example, a handle assembly including a plurality of drive systems is disclosed in co-pending U.S. patent application Ser. No. 15 / 385,941, entitled "SURGICAL TOOL ASSEMBLEES WITH CLUTCHING ARRANGEMENTS FOR SHIFTING," which is incorporated herein by reference in its entirety. BETWEEN CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES AND ARTICULATION AND FIRING SYSTEMS ".

  In at least one form, the longitudinally movable drive member 540 includes a rack of teeth (not shown) thereon for mating engagement with a corresponding drive gear arrangement (not shown) that interfaces with the motor 505. May be formed. Various details regarding these features can be found in U.S. Patent Application No. 14 / 226,142, entitled "SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM," which is hereby incorporated by reference in its entirety, the entire disclosure of which is incorporated herein by reference. It can be found in Patent Application Publication No. 2015/0272575. The at least one configuration also includes a manually actuated mechanism configured to allow the clinician to manually retract the longitudinally movable drive member 540 if the motor 505 becomes inoperable. Includes an "escape" assembly. The escape assembly may include a lever or escape handle assembly that is stored below the open door 550 in the handle assembly 500. The lever is configured to be manually pivoted into ratchet engagement with the teeth of the drive member 540. Accordingly, the clinician can manually drive the drive member 540 by ratcheting the drive member 540 in the proximal direction "PD" using the escape handle assembly. U.S. patent application Ser. No. 12 / 249,117, entitled "POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM," U.S. Pat. No. 045 discloses an escape configuration and other components, configurations, and systems that can be used with the replaceable surgical tool assembly 1000.

  Still referring to FIG. 2, the operation of the motor 505 for the drive system 530 may be controlled by one or more actuators. In at least one form, drive system 530 may include an actuator in the form of a closure trigger 512 pivotally supported by frame 506. Such an arrangement allows the clinician to operate the closure trigger 512 so that when the clinician grips the pistol grip portion 504 of the handle assembly 500, the closure trigger 512 is moved to a start or "inactive" position. To the "actuated" position, and more specifically to the fully compressed or fully activated position. Closure trigger 512 may be used to apply a closing movement and, optionally, an opening movement to replaceable surgical tool assembly 1000 operatively attached or coupled to handle assembly 500.

  Further details are found in U.S. Patent Application No. 14 / 226,142, entitled "SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM," current U.S. Patent Application Publication No. 2015/0272575, which is incorporated herein by reference in its entirety. When the clinician presses the closure trigger 512 completely to achieve a “full” closure stroke, the drive system 530 (or another drive system within the handle assembly 500) causes the closure trigger 512 to It may be configured to lock in a fully depressed or fully activated position. When the clinician desires to unlock the closure trigger 512 and cause the closure trigger to be biased to the inactive position, the clinician simply activates the closure release button assembly 518, thereby causing the closure trigger 512 Can be returned to the inoperative position. The closure release button assembly 518 may also be configured to interact with various sensors in communication with the microcontroller 520 (see FIG. 2) in the handle assembly 500 to track the position of the closure trigger 512. . For further details regarding the construction and operation of the closure release button assembly 518, see U.S. Patent Application No. 14 / 226,142, entitled "SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM," the entire contents of which are incorporated herein by reference. ", Can be found in the current U.S. Patent Application Publication No. 2015/0272575.

  In at least one form, drive system 530 may also include an actuator in the form of firing trigger 532 that is pivotally supported by frame 506. The firing trigger 532 may be pivoted between a non-activated position and an activated position. The firing trigger 532 may be biased to a non-actuated position by a spring (not shown) or other biasing configuration so that when the clinician releases the firing trigger 532, the firing trigger may be spring or biased. Depending on the configuration, it may be pivoted to an inoperative position or otherwise returned. In at least one form, the firing trigger 532 may be positioned “outboard” of the closure trigger 512. Discussed in U.S. Patent Application No. 14 / 226,142, entitled "SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM", current U.S. Patent Application Publication No. 2015/0272575, which is incorporated herein by reference in its entirety. As such, handle assembly 500 may be equipped with a firing trigger safety button (not shown) to prevent accidental activation of firing trigger 532. When the closure trigger 512 is in the non-actuated position, the safety button is housed within the handle assembly 500, the clinician cannot easily access the safety button, and the safety button prevents actuation of the firing trigger 532. Nor can the safety button be moved between the position and the firing position at which the firing trigger 532 can be fired. When the clinician presses the closure trigger 512, the safety button 1122 and the firing trigger 532 pivot downward, which can then be operated by the clinician.

  As described further herein, the closure trigger 512 can be configured to operate the motor 505 to drive the drive system 530 over a first range and / or a first range of motion, and the firing trigger 532. May be configured to operate the motor 505 to drive the drive system 530 over a second range and / or a second range of motion. In another example, handle assembly 500 can include a single actuator for closing and firing the end effector.

  Referring primarily to FIG. 2, the replaceable surgical tool assembly 1000 includes a tool drive system 1600 that is supported for axial movement within a spine assembly 1500. In the illustrated embodiment, the tool drive system 1600 includes a proximal drive shaft segment 1602. Proximal drive shaft segment 1602 may be coupled to an intermediate drive member such as drive member 3540 (see FIGS. 30, 31, 33, and 35), which includes a firing member such as firing bar 3770 and firing member 1760. (See FIGS. 30, 31, 33, and 35). As can be seen in FIG. 2, the proximal mounting lug 1606 projects proximally from the proximal end of the proximal drive shaft segment 1602 and is within a longitudinally movable drive member 540 supported within the handle assembly 500. It is configured to be operably received within the launch shaft mounting cradle 542. When assembled, handle drive member 540 is configured to transmit motion to proximal drive shaft segment 1602 and ultimately to firing member 1760 via an intermediate drive member and firing bar.

  Still referring to FIGS. 1 and 2, the replaceable surgical tool assembly 1000 includes a shaft mounting portion 1300 operably attached to an elongate shaft assembly 1400. A surgical end effector 1100 comprising an elongated channel 1102 configured to operably support a staple cartridge 1110 is operably attached to an elongated shaft assembly 1400. End effector 1100 may further include an anvil 1130 pivotally supported with respect to elongate channel 1102. Elongated channel 1102 / staple cartridge assembly 1110 and anvil 1130 may also be referred to as "jaws." The replaceable surgical tool assembly 1000 may further include an articulation 1200 (see FIG. 1) and an articulation lock, wherein the articulation lock is about an articulation axis BB that is transverse to the shaft axis SA and the end effector 1100. May be configured to releasably hold a desired articulated position. For details regarding the structure and operation of the articulation lock, see U.S. patent application Ser. No. 13 / 803,086, entitled "ARTICULATEABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK," which is incorporated herein by reference in its entirety. It can be found in US Patent Application Publication No. 2014/0263541. Additional details regarding joint locks are also available in U.S. Patent Application No. 15 / 019,196, filed February 9, 2016, entitled "SURGICAL INSTRUMENT ARTICULATION," filed February 9, 2016, the disclosure of which is incorporated herein by reference in its entirety. MECHANISM WITH SLOTTED SECONDARY CONSTRAIN ".

  Referring primarily now to FIGS. 3-5, the firing member 1760 is configured to operably interface with a sled assembly 1120 operably supported within the cartridge body 1111 of the surgical staple cartridge 1110. The sled assembly 1120 is slidable within the surgical staple cartridge body 1111 from a proximal start position adjacent the proximal end 1112 of the cartridge body 1111 to an end position adjacent the distal end 1113 of the cartridge body 1111. It can be displaced.

  The staple pockets or cavities 1116 are aligned in rows on each side of the centrally located slot 1114. The cavity 1116 opens through the upper deck surface 1115 of the cartridge body 1111. The centrally located slot 1114 allows the firing member 1760 to pass therethrough and cut tissue clamped between the anvil 1130 and the staple cartridge 1110. A direct drive surgical staple or fastener 1126 (see FIG. 5) is positioned within each staple cavity 1116. Referring primarily to FIG. 5, staples 1126 are staples in a flat configuration that can be cut and / or punched from a sheet of material, for example. The sheet of material may be made of metal and may include, for example, stainless steel and / or titanium. In at least one example, the contours are traced, etched, and / or cut into a sheet of material, which is processed and / or laser cut to form the direct drive staple 1126 into a ready-made shape.

  The staple 1126 includes a pair of staple legs and a staple base portion or crown from which the staple legs extend. Each staple leg includes a staple tip or piercing portion configured to pierce tissue and contact a corresponding shaped pocket 1128 (see FIG. 6) of the anvil of the surgical stapling instrument. The staple legs are configured to change shape to achieve a molded configuration and secure tissue. The staple base portion defines a first plane and the staple legs define a second plane laterally offset from the first plane but at least substantially parallel to the first plane. I do. In another example, the first plane and the second plane may not be parallel.

  Staple 1126 includes a drive surface on a base portion or crown. The drive surface is configured to receive a driving force from sled assembly 1120. As the sled assembly 1120 translates distally through the staple cartridge 1110, the sled assembly 1120 contacts the drive surface to lift the staple 1126 from the staple cartridge 1110 and form the staple 1126 into its firing configuration. For example, for direct drive staples, such as staple 1126, U.S. Patent Application No. 14 / 836,324, filed August 26, 2015, entitled "SURGICAL STAPLES," which is incorporated herein by reference in its entirety. FOR MINIMIZING STAPLE ROLL ".

  The sled assembly 1120 includes a plurality of beveled or wedge-shaped cams 1122, each cam 1122 corresponding to a particular line of staples 1126 located on the side of a centrally located slot 1114. When firing member 1760 is fired or driven distally, firing member 1760 also drives sled assembly 1120 in a distal direction. As firing member 1760 moves distally through staple cartridge 1110, tissue cutting mechanism 1766 cuts tissue clamped between anvil assembly 1130 and staple cartridge 1110, and sled assembly 1120 causes staple cartridge 1110 to move. The staples 1126 are driven upwardly within and make molding contact with the anvil assembly 1130.

  The firing member 1760 defines an I-beam structure that includes a lower flange 1764, an upper flange 1762, and a support portion 1763 extending between the flanges 1762 and 1764. The upper flange 1762 is comprised of a horizontal pin extending from the support portion 1763. The lower flange 1764 is composed of enlarged or widened legs at the base of the support portion 1763. The tissue cutting mechanism 1766 is supported by a support portion 1763 between the flanges 1762 and 1764. Support portion 1763 is configured to move through aligned slots in elongate channel 1102, staple cartridge 1110, and anvil 1130. For example, the support portion 1763 may include a central longitudinal channel slot in the elongate channel 1102 such that the lower flange 1764 is movably positioned within the passage 1106 defined by the elongate channel 1102 (see FIGS. 10 and 11). Extending through 1104. For example, passageway 1106 may be defined below cartridge support base 1101 of elongate channel 1102.

  The support portion 1763 extends through the anvil slot 1132 in the anvil 1130 such that the upper flange 1762 is movably positioned within the passage 1136 defined by the anvil 1130 (see FIGS. 10 and 11). I have. For example, passage 1136 may be defined through anvil 1130. The I-beam flanges 1762 and 1764 provide a cam surface that interacts with the elongated channel 1102 and the anvil 1130, respectively, to open, clamp, or close the jaws, as described further herein. I have. Further, firing member 1760 is configured to maintain a constant distance between elongate channel 1102 and anvil 1130 along the length of end effector 1100 to ensure proper tissue clearance.

  Referring now primarily to FIG. 6, anvil 1130 includes downwardly extending sidewalls 1133, commonly referred to as "tissue stops." The tissue stop 1133 is configured to prevent target tissue from reaching too proximal between the anvil 1130 and the staple cartridge 1110 (see FIGS. 3-5). For example, tissue stop 1133 extends toward staple cartridge 1110 (see FIG. 3). When the anvil 1130 is closed toward the staple cartridge 1110, the tissue stop 1133 on either side of the anvil 1130 extends down beyond the cartridge deck surface 1115 to form a wall or barrier. Or, the barrier prevents tissue from being positioned too proximal between the anvil 1130 and the staple cartridge 1110. Additionally or alternatively, the elongate channel 1102 may include an upwardly extending tissue stop to block proximal tissue.

  Anvil 1130 also includes an inner rail 1135 that extends down toward staple cartridge 1110. The inner rail 1135 extends parallel to the tissue stop 1133 and is positioned laterally inward of the tissue stop 1133. Inner rail 1135 is configured to guide anvil 1130 relative to elongate channel 1102 as anvil 1130 pivots relative to elongate channel 1102. For example, as the anvil 1130 pivots toward the closed position, the inner rail 1135 may nest within the sidewall 1103 of the elongate channel 1102 and the tissue stop 1133 may be located outside the sidewall 1103 of the elongate channel 1102. . In various examples, the inner rail 1135 can slide or move adjacent the inner surface of the side wall 1103 of the elongate channel 1102 as the anvil 1130 approaches the staple cartridge 1110, and the anvil 1130 can And ensure that it remains properly aligned with the staple cartridge 1110 introduced therein.

  A slot 1132 in the anvil 1130 extends from the proximal end to the distal end of the anvil 1130. Referring primarily to FIG. 6, the slot 1132 and passage 1136 extend to a T-shaped opening 1129 at the distal end of the anvil 1130, which can provide an assembly path for the firing member 1760. For example, firing member 1760 may be inserted into anvil 1130 from the distal end of T-shaped opening 1129 and proximally retracted into position before staple cartridge 1110 is inserted into elongate channel 1102. obtain.

  Referring now primarily to FIG. 7, elongated channel 1102 includes sidewalls 1103 and pinholes 1108 defined in a proximal portion of each sidewall 1103. The elongate channel 1102 also includes a plate 1105 that is mounted on the underside of the cartridge support base 1101 of the elongate channel 1102. Plate 1105 may be laser welded to elongate channel 1102, for example, and may increase the structural integrity of elongate channel 1102. For example, plate 1105 can be configured to prevent and / or limit bending, twisting, and / or deformation of elongate channel 1102 during a stapling operation. Plate 1105 may be positioned over a portion of longitudinal channel slot 1104 and define a passage 1106 throughout elongated channel 1102. For example, the passage 1106 of the lower flange 1764 may be defined by the plate 1105 and the cartridge support base 1101. The opening 1107 in the plate 1105 is positioned along its length so that the firing member 1760 is visible as it traverses the longitudinal channel slot 1104 during the firing stroke. For example, an operator may view the progress of firing member 1760 through opening 1107 throughout the firing stroke.

  Referring primarily now to FIGS. 8-12, a pivot joint 1150 of the end effector 1100 is shown. The pivot joint 1150 includes a pivot pin 1152 (see FIG. 8) through which the anvil 1130 pivots with respect to the elongated channel 1102. Although only a single pivot pin 1152 is shown in FIG. 8, it will be readily apparent to the reader that a symmetric pivot pin 1152 is located on the opposite side of the end effector 1100. A symmetric pivot pin 1152 is shown in FIG. Pivot pins 1152 extend through apertures 1131 on each side of anvil 1130 and into pinholes 1108 on each respective side of elongate channel 1102. For example, pivot pin 1152 can be pushed into aperture 1131. At the beginning of the firing stroke, firing member 1760 is configured to move distally from an initial or home position (FIG. 10). As firing member 1760 moves distally, anvil 1130 is pivoted toward the clamp configuration by the I-beam configuration of firing member 1760. More specifically, lower flange 1764 of firing member 1760 moves through passage 1106 defined by elongated channel 1102, and upper flange 1762 is defined along ramp surface 1134 of anvil 1130 and then by anvil 1130. Move through the passage 1136.

  Referring primarily to FIGS. 10 and 11, the ramp surface 1134 defines an open closed cavity 1148 in the anvil 1130 where a portion of the firing member 1760 extends during a portion of the firing stroke. For example, the upper flange 1762 projects from the anvil 1130 via an open closed cavity 1148 during a portion of the firing stroke. The ramp surface 1134 slopes down along the proximal open surface 1142, extends along the middle portion 1138, and slopes up along the distal closure ramp 1140. When firing member 1760 is in the initial or home position (see FIG. 10), upper flange 1762 is spaced from middle portion 1138. In other words, the upper flange 1762 is not cammed with the open closed cavity 1148. In place, firing member 1760 may dwell or hover with respect to open and closed cavity 1148 such that neither an opening nor a closing force is applied to anvil 1130 by firing member 1760.

  From the home position (see FIG. 10), the firing member 1760 can be retracted proximally. The retracted position of firing member 1760 is shown in FIG. As firing member 1760 continues to move in the proximal direction, upper flange 1762 of firing member 1760 engaged with proximal opening surface 1142 is configured to exert an opening force on proximal opening surface 1142. As the upper flange 1762 moves relative to the proximal open surface 1142, the proximal open surface 1142 pivots, thereby causing the anvil 1130 to pivot and open. Proximal open surface 1142 is positioned proximal to pivot joint 1150. As a result, when the upper flange 1762 exerts a downward force on the proximal opening surface 1142, the anvil 1130 is pushed upward by leverage on the proximal opening surface 1142.

  The ramp surface 1134 also includes a fillet 1144 between the middle portion 1138 and the proximal open surface 1142. In certain examples, the proximal end of open closed cavity 1148 may include an open ramp that may extend to a protruding tail. The upper flange 1762 of the firing member 1760 can be configured to cam engage an open ramp and / or a protruding tail to generate an open movement of the end effector 1100. In certain examples, the upper flange 1762 can also include a proximally extending boss that can be configured to generate an additional opening movement, as further described herein.

  From the retracted position (see FIG. 11), the firing member 1760 may be advanced distally to return to a home position (see FIG. 10). To close the end effector, the firing member 1760 can be further advanced from the home position to the advanced position shown in FIG. Regarding the portion of the firing motion intermediate the retracted and advanced positions, the upper flange 1762 is spaced from the ramp surface 1134. For example, the upper flange 1762 hoveres or dwells over the intermediate portion 1138 as the firing member 1760 transitions between a closing motion (see FIG. 12) and an opening motion (see FIG. 11). The dwell portion of the firing motion may be configured, for example, to prevent jamming of the opening and / or closing motion.

  The firing member 1760 moves into contact with the ramp surface 1134 and its distal closure ramp 1140 in the advanced position shown in FIG. As firing member 1760 is advanced further distally, upper flange 1762 moves along distal closure ramp 1140 to clamp anvil 1130 against elongated channel 1102. Distal closure ramp 1140 is positioned distal to pivot joint 1150. As a result, when the upper flange 1762 exerts a downward force on the distal closure ramp 1140, the anvil 1130 is pushed downward.

  As firing member 1760 continues to travel distally, upper flange 1762 moves through passageway 1136 to ensure a constant distance between anvil 1130 and elongated channel 1102 along the length of end effector 1100. . For example, passage 1136 includes a lower ledge 1137 and an upper cap 1139 that define a lower and upper limit for passage 1136. The upper flange 1762 is constrained within these lower and upper limits during the firing stroke. The upper flange 1762 may be dimensioned to fit snugly within the limits of the passage 1136. In other examples, as further described herein, the upper flange 1762 can be configured to float and / or adjust vertically within the clearance provided by the passage 1136 or a portion thereof.

  The firing member 1760 is a multifunctional firing member. For example, the firing member 1760 can fire the driven staples 1126 directly from the staple cartridge 1110, cut tissue clamped between the jaws 1102 and 1130, and enter the jaw 1102 and clamped configuration at the beginning of the firing stroke. Sled assembly 1120 is configured to cam drive 1130 and to cam jaws 1102 and 1130 into an open configuration upon completion of the firing stroke. In other words, firing member 1760 is configured to achieve a combination of surgical functions using a single actuation system. As a result, the independent actuation system required to fit within the footprint of the end effector 1100 can be minimized by the multifunctional firing member 1760.

  In another example, the replaceable surgical tool assembly may include a closure tube for opening and closing the jaws of the end effector. The closure tube may be configured to translate with respect to the end effector. For example, as the closure tube translates over the end effector, the closure tube may be configured to bias the jaws of the end effector into a closed state. In certain examples, a spring may be configured to bias the jaws of the end effector toward an open configuration, and the closing tube may overcome the biasing force of the spring to close the jaws.

  A replaceable surgical tool assembly 7000 including an end effector 7100 and a distal closure tube 7430 is shown in FIGS. End effector 7100 includes an anvil 7130 and an elongated channel 7102 similar to anvil 1130 and an elongated channel 1102, respectively. The closure assembly 7406 is utilized to close and / or open the anvil 7130 and the elongate channel 7102 of the end effector 7100. The closure assembly 7406 includes a middle closure member 7410 and a distal closure member 7430. The intermediate closure member 7410 and the distal closure member 7430 are connected to each other by an upper double pivot link 7220.

  In the configuration shown, the distal closure member 7430 comprises a hollow tubular member slidably supported relative to the end effector 7100. Accordingly, the distal closure member 7430 may also be referred to herein as a distal closure tube. Actuation of the closure trigger 512 (see FIGS. 1 and 2) on the handle assembly 500 of the surgical instrument can result in axial movement of the closure assembly 7406, including the distal closure tube 7430. A closure spring (not shown) is also journaled on closure assembly 7406 and serves to bias closure assembly 7406 in a proximal direction “PD”, thereby replacing exchangeable surgical tool assembly 7000 with handle assembly. When operably coupled to 500, it may serve to pivot closure trigger 512 to a non-activated position. In use, closure assembly 7406 is configured to translate distally (direction DD) to close anvil 7130, for example, in response to actuation of closure trigger 512.

  Figures 13 and 14 show the anvil 7130 and the elongate channel 7102 ("jaws") in the closed position. As the distal closure member 7430 is advanced in the distal direction DD, the distal end 7431 of the distal closure member 7430 is moved over the closure cam surface formed on the anvil mounting wall and near the elongate channel 7102. It can be configured to move over a closure cam surface formed on the distal end. When the clinician desires to move anvil 7130 and elongate channel 7102 to the open position, distal closure member 7430 is moved in a proximal direction PD. Regarding the actuation of the closure trigger and closure assembly, including the distal closure tube, co-pending US patent application Ser. POSITIVE JAW OPENING FEATURES ".

  Referring primarily now to FIG. 17, firing member 7760 is positioned within end effector 7100. The firing member 7760 is configured to translate through the end effector 7100 during the firing stroke, move the sled assembly 7120 through the end effector 7100, and cut tissue clamped between the jaws of the end effector 7100. ing. Anvil 7130 includes a passageway 7136 configured to receive a portion of firing member 7760 during the firing stroke. For example, an upper flange on firing member 7760 can be movably positioned within passage 7136.

  Anvil 7130 also includes a channel 7138 (see FIGS. 13 and 15) through which rod 7140 extends. Referring primarily to FIG. 17, rod 7140 includes a proximal end 7142 and a distal end 7144. Distal end 7144 is operably positioned to engage a distal nose 7150 of anvil 7130, as further described herein. Proximal end 7142 is operably positioned to abut distal end 7431 of distal closure tube 7430. Once the distal closure tube 7430 has been moved distally to complete the closure of the anvil 7130, the distal end 7431 of the distal closure tube 7430 moves into abutting contact with the proximal end 7142 of the rod 7140. Can be done. As a result, upon completion of the closing motion, rod 7140 extends or is pushed distally, which causes distal nose 7150 to pivot. Referring primarily to FIGS. 15-17, after the anvil 7130 has been moved to the closed configuration by the distal closure tube 7430, the rod 7140 is pushed distally by the closure tube 7430 to pivot the distal nose 7150. .

  Referring again to FIGS. 13 and 15, the channel 7138 extends from the proximal portion of the anvil 7130 to the distal nose 7150. Distal nose 7150 is pivotally connected to the body of anvil 7130 at pivot joint 7152. Resilient support 7154 is configured to hold distal nose 7150 in a linear or non-pivoting position (see FIGS. 13 and 14). The elastic support 7154 may be, for example, an elastic member or a spring such as a leaf spring or a hairpin spring. As rod 7140 extends distally, its distal end 7144 engages distal nose 7150 and overcomes elastic support 7154. For example, rod 7140 has been extended in FIGS. 15-17 to pivot distal nose 7150 to a pivoted position. In the pivoted position, distal nose 7150 is configured to clamp tissue against a distal nose portion of a staple cartridge. Such a clamping mechanism is configured to capture or retain a distal portion of the tissue and restrict tissue flow during the firing stroke. For example, additional clamping pressure may be applied at the distal end portion by end effector 7100.

  As discussed above, in certain instances, the upper flange 1762 of the firing member may hover out of contact with the ramp surface 1134 for a portion of the firing motion (see FIG. 10). For example, ramp surface 1134 may include an intermediate surface 1138 extending between distal closure ramp 1140 and proximal closure surface 1142. Intermediate surface 1124 may separate distal closure ramp 1140 from proximal closure surface 1142 such that surfaces 1140 and 1142 are separate and distinct.

  For example, the closure trigger 512 (see FIGS. 1 and 2) may pivot within the range of motion to displace the firing member 1760, such that the pivoting movement causes a corresponding pivoting movement of the anvil 1130. Is not configured. In other words, within the range of motion of the closure trigger 512, activation of the closure trigger 512 does not correspond to the closing and opening movements of the anvil 1130. In certain instances, providing feedback to anvil 1130, i.e., hovering upper flange 1762 on an intermediate surface 1138 between engagement with distal closure ramp 1140 and engagement with proximal closure surface 1142. It is desirable to achieve pivoting throughout the firing motion, including while performing. For example, the spring assembly may be configured to exert a bias on the anvil 1130 during the dwell portion of the firing stroke.

  Referring now to FIG. 54, the spring assembly 1160 is located proximally with respect to the upper flange 1762 of the firing member 1760. Spring assembly 1160 includes a tubular member 1162 and a compression spring 1164 positioned partially within tubular member 1162. Tubular member 1162 is located in a proximal notch or recess 1149 in anvil 1130. For example, anvil 1130 includes a proximal notch 1149 extending proximally from open and closed cavity 1148. Spring assembly 1160 is retained within recess 1149 and is positioned to operably engage firing member 1760.

  Spring assembly 1160 is configured to provide an opening movement of anvil 1130 when upper flange 1762 is hovering over intermediate surface 1138. The upper flange 1762 may be configured to move and contact the compression spring 1164 when the anvil 1130 is in a closed configuration and the firing member 1760 is in place. As firing member 1760 continues to be retracted proximally, firing member 1760 may be configured to compress compression spring 1164 into tubular member 1162. The compression of the compression spring 1164 is configured to apply a force to the anvil 1130 that can correspond to the opening force on the anvil 1130. For example, the spring assembly 1160 can be configured to apply proximal and downward forces to the distally facing surface of the notch 1149 to achieve an upward pivot toward the open configuration of the anvil 1130.

  In various examples, compression spring 1164 can be compressed by firing member 1760 until upper flange 1762 moves and engages proximal closure surface 1142. Compression spring 1164 may define a spring force sufficient to initiate opening of anvil 1130 before upper flange 1762 moves and abuts proximal closure surface 1142. In various examples, the spring force can be adjusted to provide sufficient feedback during the dwell portion of the firing stroke. In certain instances, compression spring 1164 may be compressed to the height of tubular member 1162. When the compression spring 1164 is fully compressed within the tubular member 1162, the opening movement may be proportional to the proximal displacement of the firing member 1760 and the corresponding actuation movement of the closing trigger 512.

  In various examples, when the anvil 1130 is fully open to the elongate channel 1102, the tissue divergence between the shaping surface of the anvil 1130 and the deck 1115 of the staple cartridge 1110 disposed within the elongate channel 1102. May be defined between Tissue divergence may be quantified as the vertical height between the anvil forming surface at the distal end and the deck 1115 of the end effector 1100 when the anvil 1130 is fully open. In certain instances, it may be desirable to increase tissue opening without increasing the angle between anvil 1130 and elongate channel 1102. In such an example, the proximal end of anvil 1130 may be configured to move away from elongate channel 1102 to increase tissue flaring at the distal end.

  For example, referring now to FIG. 55, the elongate channel 11102 includes a vertical slot 11108 to allow vertical movement of the anvil 1130 relative to the elongate channel 11102. The elongate channel 11102 is similar in many respects to the elongate channel 1102, however, the elongate channel 11102 includes a vertical slot 11108 instead of a pinhole 1108 (see FIG. 5). The elongate channel 11102 can be utilized with an end effector 11100, which also includes an anvil 1130 and is configured to receive a staple cartridge 1110. Anvil 1130 is pivotally connected to elongate channel 11102 by a pivot pin 11152, which is operably engaged by spring 11154. The spring 11154 is configured to bias the pivot pin 11152 downward within the vertical slot 11108. The spring 11154 shown in FIG. 55 is a leaf spring, however, it will be readily apparent to the reader that alternative spring geometries and configurations may be utilized. When pivot pin 11152 is positioned at the bottom of vertical slot 11108, end effector 11100 defines a first tissue opening. When the pivot pin 11152 can move toward the top of the vertical slot 11108, the end effector 11100 defines a larger second tissue opening.

  In various examples, the pivot pin 11152 overcomes the spring 11154 when the firing member is retracted proximally and out of engagement with the distal closure ramp 1140 on the anvil 1130 and faces upward in the vertical slot 11108. May be able to "jump" or jump up. For example, pivot pin 11152 is configured to shift upward in vertical slot 11108 as the firing member moves and dwells or hover above intermediate surface 1138 on anvil 1130. Still referring to FIG. 55, the firing member 11760 is configured to lift the pivot pin 11152 upward. For example, firing member 11760 is similar in many respects to firing member 1760, however, firing member 11760 includes a wedge-shaped projection 11770 having a ramp surface 11772, which ramp surface has a vertical slot 11108. For engaging the pivot pin 11152 therein and lifting the pivot pin upward. Although only a single wedge-shaped protrusion 11170 is shown in FIG. 55, it will be readily understood by the reader that a pair of symmetric wedges 11170 are located on opposite sides of the firing member 11760.

  When the firing member 11760 is retracted proximally to exert an opening motion on the anvil 1130, the anvil 1130 is configured to move vertically away from the elongate channel 11102 to increase tissue opening. Further, wedge-shaped protrusion 11770 is configured to move out of engagement with pivot pin 11152 when firing member 11760 is advanced distally during a subsequent closing movement, thereby causing the spring 11154 may return pivot pin 11152 to its initial position at the bottom of vertical slot 11108. In various examples, the pivot pin 11152 is configured to return to the bottom of the vertical slot 11108 before the top flange of the firing member 11760 engages and affects the closure of the distal closure ramp 1140 of the anvil 1130. Be composed.

  In certain examples, the end effector may be configured to clamp and staple tissue within a range of thickness. The end effector can clamp tissue having a first thickness during a first surgical function and clamp tissue having a different thickness during a second surgical function. be able to. In certain surgical functions, the thickness of the tissue clamped between the end effector jaws may be constant or substantially constant. In another example, the end effector may be configured to clamp and staple tissue having a varying or varying thickness. For example, the thickness of the tissue clamped between the end effector jaws can vary longitudinally along the length of the end effector.

  As described herein, the firing member may include a flange for setting a tissue gap between the end effector jaws. For example, the upper flange may be configured to move along a channel in the anvil, and the lower flange may be configured to move along a channel in the elongated channel during the firing stroke. The flange of the firing member includes a cam surface configured to engage an inner surface of a respective channel to limit a tissue gap between the jaws. For example, the flange may define a maximum and / or minimum spacing between the jaws, which limits the spacing between the tissue contacting deck on the staple cartridge introduced into the end effector and the tissue facing anvil of the end effector. Is equivalent to In certain instances, the maximum and minimum spacing defined by the firing member flanges may be fixed. In another example, one or both of the flanges may be configured to float or shift to accommodate variations in tissue thickness. The flange may shift, for example, during the launch stroke or during a portion thereof.

  Referring now to FIGS. 18-21, the upper portion of firing member 8760 is shown. The firing member 8760 is similar in many respects to the firing member 1760 (see FIGS. 4 and 5). For example, firing member 8760 defines an I-beam configuration that includes a lower flange (not shown), an upper flange 8762, and a support portion 8763 that extends between the lower and upper flanges 8764. The upper flange 8762 is comprised of a horizontal pin extending from the support portion 8763. For example, the lower flange may be the same as the lower flange 1764 (see FIGS. 4 and 5). The tissue cutting mechanism 8766 is supported by support portions 8763 between the flanges.

  The support portion 8763 is configured to move through the elongated channel, the staple cartridge, and the aligned slots in the anvil. For example, firing member 8760 may be compatible with end effector 1100 such that support portion 8763 moves through aligned slots in elongate channel 1102, staple cartridge 1110, and anvil 1130 (see FIGS. 1-5). reference). As with firing member 1760, when firing member 8760 is fired or driven distally, firing member 8760 is configured to also drive the sled assembly in a distal direction as well. Also, as firing member 8760 moves distally through the staple cartridge, tissue cutting mechanism 8766 causes the end effector to move as the sled assembly drives the staples upwardly in staple cartridge 1110 and into molded contact with anvil 1130. 1100 is configured to cut tissue to be clamped.

  The firing member 8760 includes a slot 8761 extending along an upper portion of the support portion 8763. Slot 8761 is a wedge-shaped slot, and the height of slot 8761 varies longitudinally along the length of firing member 8760. More specifically, the height of the slot 8761 at the proximal end 8765 is greater than the height at the distal end 8767. In other examples, the height of slot 8761 may be constant, but slot 8761 may be obliquely oriented, graded, and / or non-horizontal along the length of firing member 8760. . Slot 8761 includes an upper edge 8768 that defines a maximum tissue gap. As described herein, the upper flange or pin 8762 is configured to move within the slot 8761 to adjust the tissue gap. Further, when a load is applied to the upper pin 8762, the upper pin 8762 is configured to slide along the upper edge 8768 as the upper pin 8762 moves within the slot 8761.

  Referring primarily to FIG. 18A, the upper pin 8762 includes a central groove 8770 that guides the upper pin 8762 within the slot 8761. For example, the upper edge 8768 is configured to extend into the groove 8770 when the upper pin 8762 is positioned in the slot 8761. In other embodiments, the top pin 8762 can include a guide block that can be secured on the pins 8762 on one or both sides of the support portion 8763. The central groove 8770 and / or the guide block may be configured to prevent twisting or torque generation of the upper pin 8762 during the firing stroke and as the upper pin 8762 moves within the slot 8761. The guide block may be welded onto the pin 8762, for example. In other examples, one or more guide blocks may be secured to support portion 8763.

A first or initial configuration of the firing member 8760 is shown in FIG. The upper pin 8762 is held in place by friction in the first configuration. For example, the top pin 8762 can be compressed and press fit within the slot 8761. In a first configuration, the top pin 8762 is positioned adjacent the distal end 8767 of the slot 8761. First height H _1, when the firing member 8760 in a first configuration is defined between the upper pin 8762 and a lower flange. More specifically, the first height H ₁ is defined between the upper and lower surfaces of the upper pin 8762 of the lower flange. First height H ₁ corresponds to the minimum tissue gap defined by firing member 8760.

  Still referring to FIG. 19, the upper edge 8768 of the slot 8761 extends along the inner contour. In other words, the upper edge 8768 defines the compression radius R. The inner contour of the upper edge 8768 applies a compressive force to the upper pin 8762 that attempts to hold the upper pin 8762 in the most distal position within the slot 8761 relative to the distal end 8767.

  Referring now to FIG. 20, a force F may be applied to the upper pin 8762 during the firing stroke. For example, when tissue is clamped between the jaws of an end effector, the tissue may be compressed by the jaws. As a result, the compressed tissue is configured to exert an opening force on the jaws, and such a force is applied to the upper pin 8762 and the lower flange of the firing member 8760. The force F increases when the clamped tissue is accompanied by increased compression, for example, when thicker tissue is clamped between the jaws. The force F in FIG. 20 is sufficient to deflect the inner contour of the upper edge 8768 such that the upper boundary of the firing member 8760 is deflected and the compressive force on the upper pin 8762 in the slot 8761 is reduced. Be relaxed. The force F is equal to or exceeds the threshold force required to deflect the upper edge 8768 and release the upper pin 8762. In FIG. 20, force F applied to upper pin 8762 has caused firing member 8760 to move to a stressed configuration.

Since the upper pin 8762 is released by the force F, the upper pin 8762 is free to slide in the slot 8761 in the proximal direction (PD) (see FIG. 20). For example, the upper pin 8762 has moved to the proximal upper position in FIG. The proximal upper position of FIG. 21, the second height H ₂ defined between the upper pin 8762 and a lower flange. More specifically, the second height H ₂ is defined between the upper and lower surfaces of the upper pin 8762 of the lower flange. Second height H _2, the maximum tissue gap, or firing member 8760 corresponds to the tissue gap when in the adaptation configuration. In such an example, firing member 8760 is configured to allow for a greater tissue gap between the second portion of the firing stroke. As described herein, in certain instances, further limiting the maximum tissue gap during the initial portion of the firing stroke when the load can be highest to prevent jamming of the firing member 8760. May be desirable.

  The upper pin 8762 is configured to shift to the proximal upper position shown in FIG. 21 when a force equal to or greater than the threshold force is applied to the upper pin 8762. As the force F is applied upwardly to the upper pin 8762, the force F urges the upper pin 8762 along the upper edge 8768 of the slot 8761 to maintain alignment between the groove 8770 and the upper edge 8768. As a result, firing member 8760 is configured to adjust or adapt to accommodate variations in tissue thickness.

  In another example, firing member 8760 can be configured to define a decreasing tissue gap between distal portions of the firing stroke. In such cases, compression at the distal end of the end effector may be increased. For example, the top surface 8768 of the slot 8761 may be different from that shown in FIGS. 19-23, such that the height of the slot 8761 is at a maximum at the distal end 8767 of the slot 8761, at the proximal end of the firing member 8760. It may be angled downward toward it.

  Referring now to FIG. 21A, the upper pin 8762 is shown in a loaded configuration. To load the upper pin 8762 into the slot 8761, the upper pin 8762 may be aligned with the largest or highest portion of the slot 8761 at the proximal end 8765. From the proximal end 8765, the upper pin 8762 can be slid toward the distal end 8767 such that the upper edge 8768 projects into the central groove 8770 of the upper pin 8762 and into the slot 8761. The upper pin 8762 is restrained. For example, as firing member 8760 is advanced distally, upper pin 8762 is configured to slide toward distal end 8767 and to the configuration shown in FIG. As described herein, a first load on the upper pin 8762 can bias the upper pin 8762 in a distal direction and into compression at the distal end 8767, A greater second load on the 8762 can deform the firing member 8760 to release compression of the upper pin 8762 and allow the upper pin to slide proximally.

  Although firing member 8760 is described as having a single floating flange, ie, upper flange 8762, in other examples, the lower flange may also float and / or float when a force above a second threshold force is applied. Or it may be configured to shift. For example, the upper flange 8762 may be configured to shift when a first force is applied by the compressed tissue, and the lower flange may be configured to apply a greater second force by the compressed tissue. It may be configured to shift when it is moved. In other examples, only the lower flange may be configured to shift and / or float.

  22 and 23, the upper portion of firing member 9760 is shown. Firing member 9760 is similar in many respects to firing member 1760 (see FIGS. 4 and 5). For example, firing member 9760 defines an I-beam structure that includes a lower flange, an upper flange 9762, and a support portion 9763 that extends between the lower and upper flanges 9764. The upper flange 9762 is comprised of a horizontal pin extending from the support portion 9763. For example, the lower flange may be the same as the lower flange 1764 (see FIGS. 4 and 5). Tissue cutting mechanism 9766 is supported by support portions 9763 between the flanges.

  The support portion 9763 is configured to move through the elongated channel, the staple cartridge, and the aligned slots in the anvil. For example, firing member 9760 may be compatible with end effector 1100 such that support portion 9763 moves through aligned slots in elongate channel 1102, staple cartridge 1110, and anvil 1130 (see FIGS. 1-5). reference). As with firing member 1760, when firing member 9760 is fired or driven distally, firing member 9760 is configured to also drive the sled assembly in a distal direction as well. Also, as the firing member 9760 moves distally through the staple cartridge, the tissue cutting mechanism 9766 causes the sled assembly to drive the staples upwardly within the cartridge, causing the staples to form by the end effector as they make molded contact with the anvil. It is configured to cut tissue to be clamped.

  The firing member 9760 includes a slot 9761 extending along an upper portion of the support portion 9763. Slot 9761 is a wedge-shaped slot, and the height of slot 9761 varies longitudinally along the length of firing member 9760. More specifically, the height of the slot 9761 at the proximal end 9765 is greater than the height at the distal end 9767. Additionally or alternatively, slot 9761 may be obliquely oriented, graded, and / or non-horizontal such that distal end 9767 is higher than proximal end 9765. . Slot 9761 includes an upper edge 9768 that defines a maximum tissue gap. As described herein, the upper flange or pin 9762 is configured to move within the slot 9761 to adjust the tissue gap, such that the upper pin 9762 moves as the upper pin 9762 moves within the slot 9761. Then slide along the upper edge 9768. Firing member 9760 also includes a spring 9769 configured to exert a biasing force on upper pin 9762.

  The upper pin 9762 includes a central groove 9770 that guides the upper pin 9762 within the slot 9761. For example, the upper edge 9768 is configured to extend into the groove 9770 when the upper pin 9762 is positioned in the slot 9761. In the illustrated embodiment, the upper pin 9762 includes guide blocks 9780 fixed on opposite sides of the support portion 9763. The guide block 9780 is configured to prevent twisting or torque generation of the upper pin 9762 during the firing stroke and as the upper pin 9762 moves within the slot 9761. In other examples, one or more guide blocks may be secured to the upper pin 9762, and in still other examples, the firing member 9760 may not include a guide block.

A first or initial configuration of the firing member 9760 is shown in FIG. The upper pin 9762 is held in place by a spring 9769. For example, spring 9769 is configured to bias upper pin 9762 toward distal end 9767 of slot 9761. First height H _1, when the firing member 9760 in a first configuration is defined between the upper pin 9762 and a lower flange. More specifically, the first height H ₁ is defined between the upper and lower surfaces of the upper pin 9762 of the lower flange. First height H ₁ corresponds to the smallest tissue gap.

  Still referring to FIG. 22, when the tissue is clamped between the jaws of the end effector, the tissue may be compressed by the jaws. As a result, the compressed tissue can exert an opening force on the jaws, and such force is applied to the upper pin 9762 and the lower flange of the firing member 9760. The force F increases when the clamped tissue is accompanied by increased compression, for example, when thicker tissue is clamped between the jaws. When the force F is greater than or equal to the threshold force, the force F may be configured to overcome the biasing force of the spring 9769, as shown in FIG. For example, the force F is sufficient to cause the spring 9969 to deform into a compressed configuration and allow the upper pin 9762 to move along the slot 9761 toward its proximal end 9765.

The upper pin 9762 has moved to the proximal upper position in FIG. The proximal upper position of FIG. 23, the second height H ₂ defined between the upper pin 9762 and a lower flange. More specifically, the second height H ₂ is defined between the upper and lower surfaces of the upper pin 9762 of the lower flange. Second height H _2, the maximum tissue gap, or firing member 9760 corresponds to the tissue gap when in the adaptation configuration. As force F (FIG. 22) is exerted upwardly on the upper pin 9762, the force F urges the upper pin 9762 along the upper edge 9768 of the slot 9761 to align the groove 9770 with the upper edge 9768. maintain. As a result, firing member 9760 is configured to adjust or adapt to accommodate variations in tissue thickness.

  Although the firing member 9760 is described as having a single floating flange, ie, the upper flange 9762, in other examples, the lower flange may also float and / or float when a force above a second threshold force is applied. Or it may be configured to shift. For example, the upper flange 9762 may be configured to shift when a first force is applied by the compressed tissue, and the lower flange may be configured to apply a greater second force by the compressed tissue. It may be configured to shift when it is moved. In other examples, only the lower flange may be configured to shift and / or float.

  As described herein, the firing member may include at least one floating flange, which shifts or is applied when a threshold force is applied to accommodate variations in tissue thickness. It can be configured to move. In certain instances, the floating flange may be positioned within the slot and may be biased and / or held in the initial configuration until a threshold force is applied. In another example, a portion of the firing member can include a deformable or flexible material, which can be configured to flex or otherwise deform when a threshold force is applied. In certain examples, the flexible core of the firing member can support at least one flange configured to shift or move when a threshold force is applied.

  Referring now to FIGS. 24-26, a portion of the replaceable surgical tool assembly 10000 including the end effector 10100 is shown. The end effector 10100 includes an elongated channel 1102 and an anvil 1130, and a staple cartridge 1110 is located within the elongated channel 1102. End effector 10100 also includes a firing member 10760, which is similar in many respects to firing member 1760 (see FIGS. 4 and 5). For example, the firing member 10760 defines an I-beam structure that includes a lower flange 10765, an upper flange 10762, and a support portion 10763 extending between the lower and upper flanges 10762. The upper flange 10762 comprises a horizontal pin extending from the support portion 10763. The lower flange 10765 comprises an enlarged or widened leg at the base of the support portion 10763. The tissue cutting mechanism 10766 is supported by a support portion 10763 between the flanges 10762 and 10765.

  Support portion 10763 is configured to move through aligned slots in elongate channel 1102, staple cartridge 1110, and anvil 1130. As with firing member 1760, when firing member 10760 is fired or driven in a distal direction, firing member 10760 is configured to also drive sled assembly 1120 in a distal direction as well. Also, as firing member 10760 moves distally through the staple cartridge, tissue cutting mechanism 10766 causes sled assembly 1120 to drive staples 1126 (see FIG. 5) upward in staple cartridge 1110, causing anvil 1130 to move. It is configured to cut tissue that is clamped by the end effector 10100 upon forming contact.

  Still referring to FIGS. 24-26, the firing member 10760 includes a body 10772 and a flexible portion or core 10770 embedded in the body 10772. For example, body 10772 includes a cutout or cavity 10774, and flexible portion 10770 is positioned within cutout 10774. Flexible portion 10770 includes an upper flange 10762. As described further herein, the upper flange 10762 is configured to shift or move as the flexible portion 10770 deforms.

  The elasticity of the main body 10772 may be lower than the elastic modulus of the flexible core 10770. In a particular example, the flexible core 10770 can be formed from a shape memory material, such as Nitinol, which can provide a constant spring constant over its full range of vertical flexion. Further, the body 10772 of the firing member 10760 can be formed from a non-flexible or substantially less flexible material, such as, for example, stainless steel or titanium.

  Flexible portion 10770 includes a first end 10776 and a second end 10778. First end 10776 is held or secured within cutout 10774 within body 10772. For example, cutout 10774 can securely enclose first end 10776 to prevent movement of first end 10776 within body 10772. The second end 10778 supports the upper flange 10762. For example, the upper flange 10762 may be integrally formed with the second end 10778 and / or may be securely connected thereto. The second end 10778 is provided with a clearance 10780 within the cutout 10774, in which the second end 10778 is controlled and deflected. For example, the second end 10778 and the upper flange 10762 supported thereon shift in response to a force applied to the upper flange 10762 with respect to the first end 10776 and with respect to the lower flange 10765. It is configured to Movement of upper flange 10762 is constrained by the geometry of cutout 10774 and passageway 1136 defined in anvil 1130.

  As described with respect to firing member 1760 (see FIGS. 4 and 5), firing member 10760 is configured to engage open and closed cavity 1148 of anvil 1130 to move anvil 1130 to the clamped position. For example, the upper flange 10762 of the firing member 10760 is configured to move into the passage 1136 along the distal closure ramp 1140 of the anvil 1130 (see FIGS. 8-12). The passage 1136 includes a lower ledge 1137 and an upper cap 1139 that define a lower and upper limit for the passage 1136.

  In FIG. 24, the firing member 10760 has been displaced distally from a home position to a first intermediate position. Between the home position and the first intermediate position, the upper flange 10762 is moved along the distal closure ramp 1140 to pivot the anvil 1130 toward the staple cartridge 1110 and clamp tissue therebetween. I do. Still referring to FIG. 24, a first load is applied to the upper flange 10762 of the firing member 10760. The first load may correspond to a first thickness, density, and / or toughness of tissue clamped by end effector 10100.

  When a first load is applied to upper flange 10762, flexible portion 10770 is configured to assume the configuration shown in FIG. Specifically, the second end 10778 of the flexible portion 10770 is spaced between the lower ledge 1137 of the passage 1136 and the upper cap 1139. A portion of the clearance 10780 is above the second end 10778, and another portion of the clearance 10780 is below the second end 10778. In such an example, the upper flange 10762 defines an intermediate tissue gap that is between the minimum and maximum tissue gaps allowed by the replaceable surgical tool assembly 10000 at the first intermediate position.

  In FIG. 25, the firing member 10760 has been advanced distally from a first intermediate position (see FIG. 24) to a second intermediate position, and a second load is applied to the upper flange 10762 of the firing member 10760. Have been added. The second load is less than the first load and reduces the second thickness, density, and / or toughness of the tissue clamped by the end effector 10100, each below the first thickness, density, and / or toughness. It can respond. For example, the second load may be less than the first load because the tissue is thinner.

  When a second load is applied to the upper flange 10762, the flexible portion 10770 is configured to take the configuration shown in FIG. Specifically, the second end 10778 of the flexible portion 10770 is positioned relative to the lower ledge 1137 of the passage 1136, and the clearance 10780 is above the second end 10778. In such an example, upper flange 10762 defines a minimum tissue gap. In order to take the configuration of FIG. 25, the flexible portion 10770 has contracted to pull the second end 10778 toward the fixed first end 10776. Shrinkage of the flexible portion 10770 may be limited by its material, the location of the lower ledge 1137, and / or by a limiting pin 10768, which is described further herein.

  In FIG. 26, the firing member 10760 has been advanced distally from the second intermediate position (see FIG. 25) to a third intermediate position, and a third load is applied to the upper flange 10762 of the firing member 10760. Have been added. The third load is greater than the first load and the second load, and exceeds the first thickness, density, and / or toughness, respectively, and has a second thickness, density, and / or Or may correspond to a third thickness, density, and / or toughness of the tissue clamped by the end effector 10100, each of which also exceeds toughness. For example, the third load may be greater than the first and second loads because the tissue is thicker, denser, and / or tougher.

  When a third load is applied to the upper flange 10762, the flexible portion 10770 is configured to assume the configuration shown in FIG. Specifically, the second end 10778 of the flexible portion 10770 is positioned relative to the upper cap 1139 of the passage 1136 and the clearance 10780 is below the second end 10778. In such an example, upper flange 10762 defines a maximum tissue gap. To take the configuration of FIG. 26, the flexible portion 10770 has been extended or extended to separate the second end 10778 from the fixed first end 10776. The extension of the flexible portion 10770 may be limited by its material, the location of the top cap 1139, and / or the restriction pin 10768, which is described further herein.

  The firing member 10670 also includes a first side protruding lug or restriction pin 10768 configured to move within passageway 1136 of anvil 1130. Restriction pin 10768 is configured to limit the tissue gap during a portion of the firing stroke. Limiting pin 10768 is fixed relative to support portion 10763 and is configured to move within passageway 1136 during at least a portion of the firing stroke. As the restriction pin 10768 advances along the anvil ledge 1137 (see FIG. 24), the restriction pin 10768 is configured to limit the maximum tissue gap. As the restriction pin 10768 advances along the upper cap 1139, the restriction pin 10768 is configured to limit the minimum tissue gap. For example, the upper flange 10762 is movable with respect to the support portion 10763, but the displacement of the upper flange 10762 is limited by the fixed position of the limiting pin 10768 in the passage 1136.

  In various examples, the restriction pin 10768 can protrude laterally by a first distance, which can be less than the laterally protruding distance of the upper flange 10762. In other words, the limiting pin 10768 may be narrower than the upper flange 10762. In addition, the slots 1132 in the anvil 1130 that provide access to the passage 1136 can be wider in a portion of the anvil 1130. In such an example, the shorter restriction pin 10768 may extend below the anvil ledge 1137 without limiting the maximum tissue gap over a portion of the firing stroke.

  In the illustrated embodiment, the restriction pin 10768 is positioned within the passageway 1136 during the initial proximal portion of the firing stroke (see FIG. 24) and the anvil ledge 1037 during the distal portion of the subsequent firing stroke. It protrudes downward (see FIG. 26). More specifically, between the proximal portion of the firing stroke and the distal portion of the firing stroke, slot 1132 extends so that the locking pin is not restrained in passage 1136, while wider upper flange 1762 is It may remain confined within passage 1136. In various examples, slot 1132 may extend more than limit pin 10768 at or near one-third of the distance from the proximal starting point. In another example, the slot 1132 may extend more than the restriction pin 10768 about one-third of the distance from the proximal starting point.

  In various examples, it may be desirable to limit the maximum tissue gap during the initial portion of the firing stroke. For example, at the beginning of a firing stroke through thick, dense and / or tough tissue, the load on firing member 10760 can be large, and upper flange 10762 can be biased a maximum distance away from lower flange 10760. In such an example, the firing member 10760 may not jam or otherwise become inoperable during the initial portion of the firing stroke when the maximum load is applied to the firing member 10760. The maximum tissue gap may be controlled by the distance between the fixed limiting pin 10767 and the lower flange 10765. Thereafter, as the tissue is cut by the cutting edge 10766, as the load on the firing member 10760 decreases, the restriction pin 10768 disengages the passage 1136 and its anvil ledge 1137 and is controlled by the floating upper flange 10762. Additional or increased maximum tissue gap that may be allowed may be tolerated.

  The firing member 10760 also includes a second laterally projecting lug 10768 operably configured to engage the elongate channel 1102. For example, a laterally projecting lug 10769 is configured to travel along an inner surface within elongate channel 1102 (eg, along cartridge support base 1101) to further control the tissue gap. Additionally or alternatively, the laterally projecting lugs 10769 are configured to engage with a lockout configuration, such as a lockout configuration 6180 (see FIGS. 45-53), further described herein. Can be done.

  During the firing stroke, staples can be fired into the tissue and the tissue can be cut by the cutting element. Upon completion of the firing stroke, rows of staples may be placed on either side of the cutting line, and the staple rows may be provided with tissue seals on either side of the cutting line. In order to minimize bleeding, staples can be fired before the tissue is cut by the cutting element. In such an example, the staple can provide a tissue seal before the tissue between the seals is cut by the cutting element.

  In certain instances, it is advantageous to prevent a surgical instrument from performing a firing stroke. For example, if the staple cartridge is absent from the end effector, it is advantageous to prevent the firing stroke because such firing stroke may result in tissue being cut by the cutting element but not sealed by the staples Can be Similarly, if an empty or used staple cartridge is introduced into the end effector, the tissue will also be cut by the cutting element but not sealed by the staple as a result of such firing stroke. Thus, it may be advantageous to hinder the firing stroke.

  Surgical instruments may be provided with various mechanisms to prevent the firing stroke in certain instances. Such a mechanism is commonly referred to as "lockout" and may be located, for example, within a handle, shaft, replaceable surgical tool assembly, end effector, and / or staple cartridge. 27-29, an end effector 2100 having a lockout configuration 2180 is shown. End effector 2100 includes an elongated channel 2102, which is similar in many respects to elongated channel 1102 (see FIGS. 3-5). For example, elongate channel 2102 includes a pair of sidewalls 2103 extending from a cartridge support surface or base 2101. Elongated channel 2102 is configured to operably support a staple cartridge, such as staple cartridge 1110 (see FIGS. 3-5) therein. End effector 2100 also includes an anvil 1130 and firing member 1760.

  Lockout configuration 2180 includes a lock 2182 having a first leg or prong 2181, a second leg or prong 2183, and a third leg or prong 2185. First leg 2181 and second leg 2183 form a V-shaped body of lock 2182. Third leg 2185 extends proximally from the V-shaped body. A lockout pivot 2184 is located at the central hub portion intermediate the legs 2181, 2183 and 2185. Lock 2182 is configured to pivot about lockout pivot 2814 between a locked position (see FIGS. 27 and 28) and an unlocked position (see FIG. 29). Lockout pivot 2184 may be pivotally mounted to sidewall 2103 of elongate channel 2102. Lockout configuration 2180 also includes a lockout spring 2186 configured to act on lock 2182. Although only one lock 2182 and one lockout spring 2186 are shown in FIGS. 27-29, it will be readily apparent to the reader that lockout configuration 2180 may include symmetrical lock 2182 and lockout spring 2186. Will be understood. For example, a pair of each lock 2182 and lockout spring 2186 may be located on one side of firing member 1760. In another example, lockout configuration 2180 can include a single lock 2182 and a single lockout spring 2186.

  First leg 2181 constitutes an anvil engaging leg, which acts as a support ledge for anvil 1130 when lock 2182 is in the first orientation. The second leg 2183 constitutes a cartridge engaging leg which can be biased by a staple cartridge to pivot the lock 2182 to the unlocked position. Third leg 2185 comprises a spring engaging leg or nub, whereas lockout spring 2186 urges lock 2182 toward the locked position. More specifically, lockout configuration 2180 includes a lockout spring 2186 that applies a downward force on third leg 2185. The force on third leg 2185 is configured to bias first leg 2181 upwardly toward anvil 1130 in a proximal direction. A proximal portion of lockout spring 2186 is fixedly secured to elongate channel 2102, and a distal portion of lockout spring 2186 is configured to deflect relative to the fixed proximal portion. Lockout spring 2186 is a leaf spring; however, the reader will readily appreciate that alternative springs may be used to bias lock 2182 toward the locked position.

  Referring primarily to FIG. 28, lock 2182 is initially biased to a locked position by lockout spring 2186. When in the locked position, first leg 2181 abuts anvil 1130. Specifically, end 2181a of first leg 2181 is positioned relative to inner rail 1135 of anvil 1130. As a result of the engagement between the first leg 2181 and the inner rail 2135, the anvil 1130 is held in an open orientation with respect to the elongated channel 2102. Even if a closing motion is applied to the anvil 1130 (eg, by advancing the firing member 1760 distally), closure of the anvil 1130 is prevented by engagement of the first leg 2181 with the inner rail 1135. You.

  Lock 2182 is configured to remain in the locked position until an unfired staple cartridge is introduced into elongate channel 2102. When the staple cartridge 1110 is positioned within the elongate channel 2102, as shown in FIG. 29, a portion of the staple cartridge 1110 abuts the second leg 2183. More specifically, sled assembly 1120 is in a proximal position when staple cartridge 1110 is unfired, and the proximal end of unfired sled assembly 1120 is attached to second leg 2183 of lock 2182. Position. The sled assembly 1120 applies a force F (see FIG. 29) to the second leg 2183, which forces the second leg 2183 downward and locks out of the elongated channel 2102 in the cartridge support base 2101. Displace into notch 2109. Since the second leg 2183 is nested within the lockout notch 2109, the introduced staple cartridge 1110 may be flush with the cartridge support base 2101 of the elongated channel 2102. The force F exerted by the sled assembly 1120 on the second leg 2183 is sufficient to overcome the spring bias of the lockout spring 2186.

  In other examples, another portion of staple cartridge 1110, such as cartridge body 1111, may abut lock 2182. In such an example, lockout configuration 1280 may be a cartridge-less or cartridge-free lockout that prevents clamping of end effector 2100 until a staple cartridge is introduced therein. However, while the staple cartridge is being introduced into the end effector 2100, the lockout configuration can be overcome if the staple cartridge has already been fired. Such a cartridge-free lockout may be combined with, for example, an empty or used cartridge lockout. An empty cartridge lockout detects the proper position of the sled assembly 1120 within the staple cartridge 1110, for example, a sensor (e.g., an electronic device) that allows only the firing stroke when the sled assembly 1120 is in the proper pre-fire position. Contact sensor).

  Still referring to FIG. 29, as the second leg 2183 rotates into the lockout notch 2109, the lock 2182 pivots to the unlocked position. As a result, the first leg 2181 moves and disengages from the inner rail 1135. When a closing motion is applied to the anvil 1130 (eg, by advancing the firing member 1760 distally), the anvil 1130 is free to pivot downwardly toward the staple cartridge 1110. In other words, closure of the anvil 1130 is allowed when an unfired staple cartridge is positioned within the elongated channel 2102. For example, the firing member 1760 can be advanced distally, and the upper flange 1762 can move along the distal closure ramp 1140 of the open closure cavity 1148 to cam the anvil 1130 toward the closed position.

  Sled assembly 1120 holds lock 2182 in the unlocked position while sled assembly 1120 is positioned in the proximal position shown in FIG. As sled assembly 1120 is advanced distally during the firing stroke, lock 2182 is released, however, rotation of lock 2182 again to the locked position causes anvil 1130 to move relative to staple cartridge 1110. While clamped, it is prevented by the inner rail 1135. Thereafter, when the anvil 1130 is returned to the open position (eg, by retracting the firing member 1760 proximally), the lockout spring 2186 is configured to bias the lock 2182 again toward the locked position. (See FIGS. 27 and 28), whereby the staple cartridge 1110 is removed from the elongate channel 2102 and replaced with a new staple cartridge having a proximally-located sled assembly positioned to overcome the lockout configuration 1280. Until the subsequent closing and firing strokes are prevented.

  Lockout configuration 1280 prevents pivoting of anvil 1130 relative to elongated channel 2102 unless an unfired staple cartridge 1110 has been introduced into end effector 1000. In various examples, anvil 1130 may be fixed or immobile, and elongate channel 2102 may be configured to pivot with respect to fixed anvil 1130. In such an example, lockout configuration 1280 may be configured to prevent pivoting of elongate channel 2102 relative to anvil 1130 unless an unfired staple cartridge 1110 has been introduced into end effector 2100. The reader will easily understand.

  In certain examples, the lockout may be located within the end effector. For example, lock 2182 of lockout configuration 2180 is located within elongated channel 2102 of end effector 2100. In another example, the lockout may be located within a shaft portion of a surgical instrument. For example, a replaceable surgical tool assembly can include a shaft portion and an end effector portion, and the lockout can be located within the shaft portion.

  FIG. 30 illustrates an exchangeable surgical tool assembly 3000 that is similar in many respects to the exchangeable surgical tool assembly 1000. The replaceable surgical tool assembly includes an end effector 3100 and a shaft portion 3400. Lockout configuration 3480 is located within shaft portion 3400. Replaceable surgical tool assembly 3000 also includes a firing member 3760 connected to firing bar 3770.

  The firing member 3760 is similar in many respects to the firing member 1760 (see FIGS. 4 and 5). For example, the firing member 3760 defines an I-beam structure that includes a lower flange 3764, an upper flange 3762, and a support portion 3763 extending between the flanges 3762 and 3764. The upper flange 3762 is comprised of a horizontal pin extending from the support portion 3763. The lower flange 3764 is comprised of enlarged or widened legs at the base of the support portion 3763. The tissue cutting mechanism 3766 is supported by a support portion 3763 between the flanges 3762 and 3764. The support portion 3763 travels through elongated slots 3102, staple cartridges, and aligned slots in the anvil 3130.

  Unlike anvil 1130, anvil 3130 does not include an open-closed cavity 1148 engageable by a firing member to open and close the jaws of end effector 3100. Rather, the closure tube 3430 is configured to translate around a portion of the end effector 3100 to open and close the anvil 3130. Distal translation of the closure tube 3430 is configured to cam the jaws toward the clamped configuration, and proximal displacement of the closure tube 3430 is configured to cam the jaws toward the open configuration. The operation of the closure tube to open and close the end effector jaws is further described herein.

  Shaft portion 3400 includes a longitudinally movable drive member 3540 that is similar in many respects to drive member 1602. During the firing stroke, drive member 3540 transmits firing motion to firing bar 3770 to fire firing member 3760. For example, actuation of drive member 3540 is configured to displace firing bar 3770 and firing member 3760 in a distal direction to cut tissue and effect firing of staples from the staple cartridge. Thereafter, drive member 3540 may be retracted proximally, causing firing bar 3770 and firing member 3760 to retract proximally.

  In certain examples, drive member 3540 may be directly connected to firing bar 3770. In other cases, a biasing spring 3560 is located between the drive member 3540 and the firing bar 3770, as shown in FIG. For example, biasing spring 3560 extends proximally from firing bar 3770 toward drive member 3540. In various examples, one end of bias spring 3560 may be connected to firing bar 3770, while the opposite end of bias spring 3560 may be connected to drive member 3540. Drive member 3540 includes a spring aperture 3544 at its distal end. Spring aperture 3544 is configured to receive and restrain a portion of biasing spring 3560. Although the biasing spring 3560 is a coil spring, it is noted that alternative spring shapes may be configured to apply a proximal biasing force to the drive member 3540 and a corresponding distal biasing force to the firing bar 3770. Will be easily understood.

  Lockout configuration 3480 in shaft portion 3400 includes a lockout lever 3482 having a detent 3484 (see FIGS. 33 and 35) and a distal nose 3486. Detent 3484 of lockout lever 3482 is positioned for operable engagement with drive member 3540 and distal nose 3486 of lockout lever 3482 is positioned for operable engagement with firing bar 3770. . Specifically, firing bar 3770 includes a proximal reset claw 3772 having a proximal nose 3774. Proximal reset pawl 3772 extends from the proximal end of firing bar 3770 toward lockout configuration 3480. As further described herein, the ramp surface of the distal nose 3486 and the ramp surface of the proximal nose 3774 on the lockout lever 3482 are slidably engaged.

  Lockout mechanism 3480 also includes a reset spring 3450 operably engaged with lockout lever 3482. Reset spring 3450 is positioned to apply a force F (see FIG. 30) to lockout lever 3482 to bias lockout lever 3482 toward the locked position shown in FIG. As described further herein, lockout lever 3482 is configured to rotate about pivot 3488 to move from a locked position to an unlocked position (see FIG. 31). . When in the locked position, the detent 3484 (see FIGS. 33 and 35) of the lockout lever 3482 is engaged with the drive member 3540. More specifically, detent 3484 is positioned within lockout recess 3542 of drive member 3540 such that longitudinal displacement of drive member 3540 is prevented by detent 3484.

  Still referring to FIG. 30, a staple cartridge is not present in end effector 3100. When the staple cartridge is not positioned in end effector 3100, force F from reset spring 3450 pivots lockout lever 3482 to the locked position, so detent 3484 (see FIGS. 33 and 35) locks out. Positioned within recess 3542. As a result, distal displacement of drive member 3540 is prevented. The firing motion may be applied to the drive member 3540 from an actuator in the handle of the surgical instrument (eg, the handle assembly 500 of FIGS. 1 and 2), but the detent 3484 holds and / or restrains the drive member 3540. To prevent distal displacement, the drive member 3540 is not displaced and does not transmit firing motion to the firing bar 3770 and firing member 3760.

  Referring now to FIG. 31, staple cartridge 3110 is positioned within end effector 3100. Staple cartridge 3110 is similar in many respects to staple cartridge 1110. However, staple cartridge 3110 also includes a proximal gate 3120 operably configured to abut firing member 3760. Referring primarily to FIG. 32, a staple cartridge 3110 includes a cartridge body 3111 and a longitudinal slot 3114 defined within the cartridge body 3111. A longitudinal slot 3114 extends from the proximal end 3112 of the staple cartridge 3110. At the proximal end 3112 of the staple cartridge 3110, the proximal gate 3120 extends across the longitudinal slot 3114. As a result, the proximal gate 3120 forms a fragile or fragile barrier to the firing member 3760.

  Still referring to FIG. 32, the proximal gate 3120 is connected to the cartridge body 3111 by a hinge 3122 on a first side of the longitudinal slot 3114. Proximal gate 3120 abuts cartridge body 3111 opposite longitudinal slot 3114. Specifically, the cartridge body 3111 includes a cutout 3124 sized to fit and receive a portion of the gate 3120. In various examples, gate 3120 can be press-fit or friction-fit into cut-out 3124. Additionally or alternatively, cutout 3124 may define a stop 3126. Stop 3126 constitutes a distal abutment surface or shelf for gate 3120. In various examples, the cartridge body 3111 may be molded from a plastic material, and the cutout 3124 and / or the stop 3126 may be a molding mechanism of the cartridge body 3111.

  Referring again to FIG. 31, when the staple cartridge 3110 is positioned within the end effector 3100, the proximal gate 3120 is positioned relative to the distal end portion of the firing member 3760. As a result, proximal gate 3120 is configured to shift firing member 3760 and firing bar 3770 in a proximal direction. As shown in FIG. 31, the biasing spring 3560 is configured to contract or otherwise deform to allow the firing member 3760 to be displaced proximally toward the drive member 3540. . Although the proximal gate 3120 is fragile, the proximal gate 3120 is configured to withstand the biasing force generated by the compressed biasing spring 3560.

  Still referring to FIG. 31, proximal displacement of firing member 3760 drives proximal nose 3774 on reset pawl 3772 in a proximal direction relative to lockout lever 3482. Proximal nose 3774 is configured to overcome reset spring 3450, so that lockout lever 3482 may pivot toward the unlocked position shown in FIG. When in the unlocked position, reset spring 3450 is compressed flush against the inside surface of shaft portion 3400 and detent 3484 on lockout lever 3482 (see FIGS. 33 and 35) causes lockout recess 3542. Is released from the engagement. As a result, distal displacement of drive member 3540 is tolerated by lockout configuration 3480. Further, the firing force of drive member 3540 transmitted to firing bar 3770 and firing member 3760 is configured to break proximal gate 3120 on staple cartridge 3110.

  Referring now to FIG. 33, drive member 3540 pushes firing bar 3770 distally, causing firing member 3760 to break or otherwise release proximal gate 3120. The threshold force required to break or otherwise release the proximal gate 3120 may be less than the force generated by the surgical instrument to perform the firing stroke. In other words, the firing stroke can be designed to destroy or otherwise overcome the proximal gate 3120. As shown in FIG. 34, when firing member 3760 pushes proximal gate 3120 with the force of the firing stroke, proximal gate 3120 may be configured to pivot at hinge 3122. In various examples, stop 3126 of cutout 3124 can be deformed or broken to release proximal gate 3120. For example, as shown in FIG. 34, the corner of the stop 3126 is broken to accommodate the distal pivot gate 3120.

  Referring again to FIG. 33, as drive member 3540 moves distally during the firing stroke, firing bar 3770 and its reset claw 3772 also move distally. Distal displacement of reset pawl 3772 moves reset pawl 3772 out of engagement with lockout lever 3482. As a result, the force of the reset spring 3450 on the lockout lever 3482 is configured to urge the disengagement lockout lever 3482 back to the locked position. The lockout lever 3482 has returned to the locked position in FIG. 33, but since the lockout recess 3542 in the drive member 3540 is longitudinally offset from the detent 3484 on the lockout lever 3482, the Completion is allowed.

  Upon completion of the firing stroke, firing member 3760 may be retracted proximally. As firing member 3760, firing bar 3770, and drive member 3540 move proximally, ramp surface 3546 on drive member 3540 engages lockout lever 3482. For example, ramp surface 3546 may slide along distal nose 3486 of lockout lever 3482 to temporarily compress reset spring 3450 and pivot lockout lever 3482 relative to reset spring 3450. it can. As shown in FIG. 35, when the drive member 3540 continues to retract in the proximal direction and the ramp surface 3546 moves past the detent 3484 on the lockout lever 3482, the detent 3484 causes the lock within the drive member 3540 to lock. It may be spring-loaded to engage the out recess 3542. The reset spring 3450 exerts a spring force on the lockout lever 3482 to reset the lockout mechanism 3480. Lockout configuration 3480 has been reset in FIG. 35 because detent 3484 re-engages lockout recess 3542 and is biased to such a position by reset spring 3450. In other words, subsequent firing strokes are prevented by lockout configuration 3480.

  The firing member 3760 has been retracted to its home position in FIG. 35, but the firing member 3760 is slightly distal to the position shown in FIG. As the proximal gate 3120 was overcome during the firing stroke, the gate 3120 no longer biases the firing member 3760 and thus the firing bar 3770 in a proximal direction. As a result, the lockout configuration 3480 in the shaft portion 3400 cannot be overcome by the used staple cartridge 3110 shown in FIG.

  Although lockout mechanism 3480 has been described in connection with end effector 3100, such as end effector 1100, which utilizes a multifunctional firing member to open and close the end effector jaws, fire staples, and cut tissue. The reader will readily appreciate that lockout configuration 3480 may also be utilized with other end effectors.

  In certain examples, the replaceable surgical tool assembly may include a spring configured to bias the jaws of the end effector toward a closed position. Such a spring may be located, for example, distal to the pivot joint of the end effector. In certain instances, the spring can interact with a lockout configuration that prevents the firing stroke when the staple cartridge is not introduced into the end effector, ie, lockout without or without a cartridge.

  Referring to FIG. 36, an anvil 4130 is shown. Anvil 4130 is similar in many respects to anvil 1130 (see FIGS. 3-6), however, anvil 4130 also includes a spring slot 4146 and a release notch 4136. A spring slot 4146 is defined in the outer proximal surface 4147 of the anvil 4130. For example, anvil 4130 includes a ramp surface 4134 defining an open and closed cavity 4148 similar to lamp surface 1134 and open and closed cavity 1148 (see FIGS. 8-12), respectively. For example, open closure cavity 4148 includes a distal closure ramp 4140 and a proximal opening surface 4142. Spring slot 4146 is located at the proximal end of anvil 4130 proximal to open closed cavity 4148. Anvil 4130 also includes inner rails 4135 positioned laterally inward of sidewall tissue stop 4133.

  Inner rail 4135 is similar to inner rail 1135 (see FIGS. 4 and 6) and includes a release notch 4136 therein. Release notch 4136 is engaged by a lockout mechanism, as described further herein. The lockout configuration of FIGS. 36-44 includes a pair of lockout springs 4450 and a pair of lock bars 4180. Lockout spring 4450 and lock bar 4180 are symmetric with respect to the longitudinal axis of anvil 4130. In other examples, a lockout configuration may include a single lockout spring 4450 and a single lockbar 4180.

  Referring primarily to FIGS. 33-40, the replaceable surgical tool assembly 4000 includes an end having an anvil 4130, an elongated channel 4102, and a lockout spring 4450 extending between the anvil 4130 and the elongated channel 4102. An effector 4100 is included. Anvil 4130 is configured to pivot at a pivot pin 4152 relative to an elongated channel 4102 at pivot joint 4150. The elongate channel 4102 is similar in many respects to the elongate channel 1102 (see FIGS. 3-5 and 7), however, the elongate channel 4102 also includes, for example, an aperture 4107 for the spring 4450 (FIG. 24). , 26, and 28) and a recess 4109 for the lock bar 4180. Anvil 4130 is similar in many respects to anvil 1130 (see FIGS. 3-6), however, anvil 4130 also includes, for example, a spring slot 4146 for receiving a portion of lockout spring 4450. In.

  Lockout spring 4450 extends through spring slot 4146 between elongate channel 4102 and anvil 4130. Each spring 4450 includes a first end 4452 retained within an aperture 4107 of the elongate channel 4102 and a second end 4454 that engages the anvil 4130. First end 4452 of spring 4450 may be embedded or otherwise secured in elongate channel 4102. For example, a first end 4452 of the spring 4450 can be retained within a respective aperture 4107 of the elongate channel 4102. A second end 4454 of the spring 4450 may be positioned relative to a corresponding abutment surface 4149 on the outer proximal surface 4147 of the anvil 4130. For example, the abutment surface 4149 is aligned with the spring slot 4146 directly adjacent to the open closed cavity 4148.

  A firing member 4760 (see FIGS. 38-40) is located within end effector 4100. The firing member 4760 is similar in many respects to the firing member 1760 (see FIGS. 4 and 5). For example, firing member 4760 defines an I-beam structure that includes a lower flange 4764, an upper flange 4762, and a support portion 4763 that extends between flanges 4762 and 4764. The upper flange 4762 is comprised of a horizontal pin extending from the support portion 4763. The lower flange 4764 is comprised of enlarged or widened legs at the base of the support portion 4763. The tissue cutting mechanism 4766 is supported by a support portion 4763 between the flanges 4762 and 4764. The support portion 4763 moves through the elongated channel 4102, a staple cartridge such as staple cartridge 1110 (see FIGS. 3-5), and aligned slots in the anvil 4130.

  Firing member 4760 also includes a proximal boss 4768 extending proximally from a top portion of firing member 4760. Proximal boss 4768 is operably configured to engage with anvil 4130 to facilitate the opening movement of anvil 4130. More specifically, proximal boss 4768 is positioned to engage central intersection surface 4145 of anvil 4130. The central intersection plane 4145 is located intermediate the spring slot 4146 and proximal to the open closure cavity 4148 and the pivot joint 4150 of the end effector 4100. When the firing member 4760 is retracted proximally past the pivot joint 4150, the proximal boss 4768 is configured to slidably engage the central intersection plane 4145, whereby the central intersection plane 4145 Are biased downward to pivot the anvil 4130 toward the open position.

  End effector 4100 includes a lock bar 4180 slidably positioned within recess 4109 of elongate channel 4102. Each lock bar 4180 includes a proximal end 4182 and a distal end 4184. Proximal end 4182 is operatively positioned within release notch 4136. Distal end 4184 is positioned to engage a staple cartridge when the staple cartridge is inserted into elongate channel 4102. The engagement surface at the proximal end 4182 and the notch 4136 of the locking bar 4180 is configured to bias the locking bar 4180 distally. For example, notch 4136 defines a ramp surface that pushes proximal end 4182 of lock bar 4180 in a distal direction. Additionally or alternatively, the lockout configuration may include a biasing spring 4186 (see FIG. 40) for biasing the lock bar 4180 toward a distal position. The biasing spring 4186 is positioned in abutting contact with the proximal end 4182 of the lock bar 4180. In various examples, a recess in the elongate channel 4102 can be configured to receive and support a biasing spring 4186.

  Referring primarily to FIGS. 39 and 40, the end effector 4100 is shown in an unclamped or open configuration. Further, a staple cartridge has not been introduced into the elongate channel 4102. The anvil 4130 is not clamped to the staple cartridge, but the lockout spring 4450 is configured to exert a closing force on the anvil 4130. For example, lockout spring 4450 is configured to bias anvil 4130 downward and forward. Referring primarily to FIG. 40, the second end 4454 of the spring 4450 is positioned against the abutment surface 4149 on the outer proximal surface 4147, and the spring 4450 exerts a force f (see FIG. 40), and the force f urges the anvil 4130 toward the closed position.

  Force f from lockout spring 4450 is also configured to bias anvil pin 4152 against lockout notch 4105 in elongate channel 4102. More specifically, elongate channel 4102 includes a pair of curved slots 4108 defined in a proximal portion of each sidewall. The curved slots 4108 are commonly referred to as "kidney slots" or "banana slots" due to their geometry. Lockout notch 4105 extends from the lower proximal portion of curved slot 4108. When anvil pin 4152 is positioned within lockout notch 4105, rotation of anvil 4130 from an open position (see FIGS. 39-42) to a closed position (see FIGS. 43 and 44) is prevented. For example, if the proximal end 4182 of the lock bar 4180 is located within the release notch 4136, the ramp surface at the proximal end 4182 will cause the ramp in the release notch 4136 to move so that movement of the anvil 4130 is suppressed. It can be arranged flush with the plane.

  Referring now to FIGS. 41 and 42, a staple cartridge 1110 has been introduced into the elongated channel 4102. When the staple cartridge 1110 is inserted into the end effector 4100, the proximal end 1112 of the staple cartridge 1110 is positioned relative to the distal end 4184 of the lock bar 4180, and the lock bar 4180 is moved proximally within the recess 4109. Move in the direction. For example, the distal end 4184 of the lock bar 4180 can include a cartridge facing surface against which the proximal end 1112 of the staple cartridge abuts. Proximal displacement of locking bar 4180 also moves locking bar proximal end 4182 within release notch 4136. Proximal end 4182 includes a ramp surface that engages the ramp surface of release notch 4136 to lift anvil 4130 upwardly away from elongated channel 4102. As the anvil 4130 moves upward, the anvil pin 4152 also moves upward from the lockout notch 4105 and into the curved slot 4108. The spring 4450 continues to bias the anvil 4130 downward, thus biasing the anvil pin 4152 into the lockout notch 4105, but the proximal displacement of the lock bar 4180 by the installed staple cartridge 1110 causes the lockout to occur. Sufficient to overcome the bias of spring 4450. As shown in FIG. 42, when the anvil pin 4152 is positioned within the curved slot 4108, the anvil 4130 operates to pivot about the pivot joint 4150 at the anvil pin 4152 toward the closed position. It is configured to be possible.

  43 and 44, firing member 4760 has been advanced distally to close anvil 4130. For example, the upper flange 4762 of the anvil 4130 can be moved farther on the anvil 1130, such as on the anvil 4130, as the distal closure ramp 1140 (see FIGS. 8-12) when the firing member 4760 moves distally. It is configured to cam against the position closing ramp. The cam force generated by the firing member 4760 is sufficient to pivot the anvil 4130 toward the closed position and the anvil pin 4152 causes the anvil 4130 to be curved as the anvil 4130 pivots relative to the elongate channel 4102. Is configured to move along the slot 4108 of the. Thereafter, firing member 4760 can continue to move distally along a firing path within end effector 4100 to complete the firing stroke.

  Upon completion of the firing stroke, firing member 4760 is retracted toward proximal end 1112 of used staple cartridge 1110. Although firing member 4760 has been retracted proximally, sled assembly 1120 is configured to remain at distal end 1113 of used staple cartridge 1110. In such an example, the proximal end 1112 of the used staple cartridge 1110 may continue to bias the lock bar 4180 in a proximal direction such that the anvil pin 4152 remains in the curved slot 4108.

  In another example, sled assembly 1120 operates with lock bar 4180 such that lock bar 4180 is biased proximally only when sled assembly 1120 is in a proximal pre-fire position within staple cartridge 1110. Can be engaged as much as possible. In such an example, at the beginning of the firing stroke, lock bar 4180 is allowed to shift distally and can re-engage with the lockout configuration, so that a new staple cartridge is inserted into end effector 4100. Until introduced, subsequent firing strokes will be prevented.

  As described herein, in certain instances, the elongated channel of the end effector has a curved slot (eg, a “kidney-shaped” or “banana” slot) to facilitate opening and closing of the anvil. Can be included. In another example, the elongate channel may include a pinhole to facilitate opening and closing of the anvil. In such a case, the anvil is configured to pivot about a single pivot axis at the pivot joint. The lockout configuration, including the lock bar 4180, can be modified for closure by a single pivot axis of the anvil.

  For example, referring now to FIGS. 90-92, a replaceable surgical tool assembly 5000 includes an end effector 5100 having an anvil 5130 and an elongated channel 5102. The anvil 5130 is configured to pivot at a pivot pin 5152 about a pivot joint 5150 relative to the elongate channel 5102. The elongate channel 5102 is similar in many respects to the elongate channel 4102 (see FIGS. 37-44), however, the elongate channel 5102 is for receiving a pivot pin 5152 instead of a curved slot. Including a pinhole 5108. Anvil 5130 is similar in many respects to anvil 4130 (see FIGS. 36-44), however, anvil 5130 does not include a notch in inner rail 5135 for engaging a lock bar.

  Although the firing member is not shown in FIGS. 90-92, the reader will readily appreciate that the firing member within end effector 5100 can be, for example, the same as firing member 4760 (see FIG. 38). Like. The firing member of the end effector 5100 may be configured to engage a ramp surface defining an open and closed cavity similar to the ramp surface 1134 and the open and closed cavity 1148 (see FIGS. 8-12), respectively. For example, the open closing cavity includes a distal closing ramp and a proximal opening surface. In certain examples, a lockout spring may extend through spring slot 5146 between elongate channel 5102 and anvil 5130. Such a lockout spring may be, for example, the same as the lockout spring 4450. In other examples, end effector 5100 may not include a lockout spring extending between anvil 5130 and elongate channel 5102.

  End effector 5100 includes a lock bar 5180 slidably positioned within recess 5109 of elongate channel 5102. Each lock bar 5180 includes a proximal end 5182 and a distal end 5184. Proximal end 5182 is positioned in abutment with compression spring 5190, which is also located in recess 5109. Distal end 5184 is positioned to engage the staple cartridge when the staple cartridge is inserted into elongate channel 5102. Although only a single lock bar 5180 is shown in FIGS. 90-92, it will be readily apparent to the reader that symmetrical lock bars 5180 may be located on each outer side of the end effector 5100. In other examples, the lockout configuration of the end effector 5100 may be asymmetric with respect to the firing member, for example, including only a single lock bar 5180.

  Referring primarily to FIG. 90, the end effector 5100 is shown in an unclamped or open configuration. Further, a staple cartridge has not been introduced into the elongate channel 5102. Although the anvil 5130 is not clamped to the staple cartridge, in certain instances, the lockout spring may be configured to exert a closing force on the anvil 5130. For example, the lockout spring may be configured to bias the anvil 5130 downward and forward. The anvil 5130 may be biased toward the clamping configuration, but the pivot pin 5152 may be configured to prevent the anvil 5130 from pivoting.

  The pivot pin 5152 has a semi-circular perimeter or cross-section that includes a circular, rounded or otherwise curved portion 5154, and a flat or straight portion 5156. When the anvil 5130 is in the unclamped configuration, the pivot pin 5152 is oriented such that the flat portion 5156 is flush with the upper surface 5186 of the lock bar 5180. When the flat portion 5156 is flush with the upper surface 5186, rotation of the pivot pin 5152, and thus rotation of the anvil 5130 from the open position to the closed position (see FIG. 92), is suppressed or completely eliminated. Is prevented. For example, when the firing member is advanced distally from a home position within the open closure cavity toward the distal closure ramp, the attempted distal displacement of the firing member locks with the flat surface 5156 of the pivot pin 5152. It may be insufficient to overcome rotational resistance between bar 5180 and upper surface 5186. As a result, the anvil 5130 may be prevented from moving toward the closed configuration until the staple cartridge is positioned within the elongate channel 5102 and the lockout configuration is overcome.

  Referring now to FIG. 91, a staple cartridge 1110 has been introduced into an elongated channel 5102. When the staple cartridge 1110 is inserted into the end effector 5100, the proximal end 1112 of the staple cartridge 1110 is positioned relative to the distal end 5184 of the lock bar 5180, and the lock bar 5180 is positioned proximally within the recess 5109. Move in the direction. For example, the distal end 5184 of the lock bar 5180 can include a cartridge facing surface against which the proximal end 1112 of the staple cartridge abuts.

  Proximal displacement of lock bar 5180 also moves notch 5188 in lockout bar 5180 in a proximal direction. Notch 5188 is defined below upper surface 5186 intermediate the proximal end 5182 and the distal end 5184. Notch 5188 is configured to longitudinally align with pivot pin 5152 when compression spring 5190 is compressed to allow proximal movement of lock bar 5180 within recess 5109. As shown in FIG. 91, when the notch 5188 is aligned with the pivot pin 5152, the flat portion 5156 of the pivot pin 5152 may be spaced from the lock bar 5180. As a result, the anvil 5130 is operably permitted to pivot about the anvil pin 5152 at the pivot joint 5150 toward the closed position.

  Referring now to FIG. 92, a closing motion has been applied to the anvil 5130. For example, the firing member may be advanced distally to close the anvil 5130. Distal advancement of the firing member is configured to cam its upper flange against a distal closure ramp on anvil 5130. The cam force generated by the firing member is sufficient to cause the pin 5152 to pivot within the pinhole 5108. Thereafter, the firing member can continue to move distally along a firing path within end effector 5100 to complete the firing stroke.

  Upon completion of the firing stroke, the firing member may be retracted toward the proximal end 1112 of the used staple cartridge 1110. Although the firing member has been retracted proximally, the sled assembly 1120 is configured to remain at the distal end 1113 of the used staple cartridge 1110. In such an example, the proximal end 1112 of the used staple cartridge 1110 may continue to bias the lock bar 5180 proximally so that the anvil pin 5152 is still aligned with the notch 5188.

  In another example, sled assembly 1120 operates with lock bar 5180 such that lock bar 5180 is biased proximally only when sled assembly 1120 is in a proximal pre-fire position within staple cartridge 1110. Can be engaged. In such an example, at the beginning of the firing stroke, lock bar 5180 is allowed to shift distally and can re-engage with the lockout configuration so that a new staple cartridge is inserted into end effector 5100. Until introduced, subsequent firing strokes will be prevented.

  Referring now to FIGS. 45-53, a surgical end effector 6100 is shown. The surgical end effector 6100 includes an elongated channel 6102 and an anvil 1130. Elongated channel 6102 is similar in many respects to elongated channel 1102 (see FIGS. 3-5 and 7), however, elongated channel 6102 also operably receives a portion of lockout spring 6182. Sized and arranged as described above. In other examples, the surgical end effector 6100 can include an elongate channel 1102 instead of the elongate channel 6102, as described further herein.

  A firing member 6760 is positioned within end effector 6100. Firing member 6760 is similar in many respects to firing member 1760 (see FIGS. 4 and 5). For example, the firing member 6760 defines an I-beam structure that includes a lower flange 6764, an upper flange 6762, and a support portion 6763 that extends between the flanges 6762 and 6764. The upper flange 6762 is comprised of a horizontal pin extending from the support portion 6763. The lower flange 6764 is comprised of enlarged or widened legs at the base of the support portion 6763. The tissue cutting mechanism 6766 is supported by a support portion 6763 between the flanges 6762 and 6764. The support portion 6763 travels through aligned slots in the elongate channel 6102, the staple cartridge 6110, and the anvil 1130.

  Like the firing member 1760, the firing member 6760 is configured to exert a closing cam force on the end effector 6100 to clamp the anvil 1130 against the elongate channel 6102 during a portion of the firing stroke, and Upon completion of the stroke, an open cam force is applied to the end effector 6100 to pivot the anvil 1130 away from the elongate channel 6102. For example, firing member 6730 is positioned to operatively engage open and closed cavity 1148 in anvil 1130 to facilitate pivoting of anvil 1130.

  Surgical end effector 6100 includes a lockout configuration 6180 that prevents the firing stroke of anvil 1130 and / or elongates unless an unfired staple cartridge is positioned in the first jaw. Rotational movement of the anvil toward channel 6102 may be prevented. In other words, lockout configuration 6180 is an absent and empty cartridge lockout and may also be considered a clamp lockout. Because firing member 6760 is a multifunctional firing member, the firing member is configured to perform a combination of surgical functions using a single actuation system. As a result, when lockout configuration 6180 prevents actuation of firing member 6760, lockout configuration 6180 performs the surgical function performed by firing member 6760, including clamping of end effector 6100 and advancement of cutting edge 6766. Effectively prevent combinations.

  In other examples, lockout configuration 6180 can be configured to engage firing member 6760 after firing member 6760 closes the end effector jaw. For example, lockout configuration 6180 may be positioned further distally such that firing member 6760 engages lockout configuration 6180 after engagement of open closure cavity 1148 with distal closure ramp 1140. In such an example, firing member 6760 can be configured to clamp anvil 1130 against elongate channel 6102 before lockout configuration 6180 is optionally engaged.

  Lockout configuration 6180 includes lockout spring 6182 as well as lockout lug 6770 on firing member 6760. Lockout spring 6182 is located within recess 6109 of elongate channel 6102. Lockout spring 6182 defines a U-shaped member having a fixed end and a pair of deflectable ends. Although lockout spring 6182 is a leaf spring, the reader will readily appreciate that various alternative springs may be configured to operably engage lockout lug 6770. For example, lockout spring 6182 may be comprised of two separate leaf springs on either side of firing member 6760.

  The fixed end of lockout spring 6182 is a proximal end 6184 that is fixed to elongate channel 6102. For example, proximal end 6184 may be welded to elongated channel 6102 at spot weld 6196 (see FIG. 47). The deflectable or free end of lockout spring 6182 defines its distal end 6186. A spring arm 6188 extends between the proximal end 6184 of the lockout spring 6182 and each free distal end 6186.

  Referring primarily to FIG. 47, a pair of laterally extending tabs or hooks 6190 extend inward from the distal end 6186 toward the centerline of the lockout spring 6182. The hook 6190 is laterally inside the spring arm 6188. As further described herein, the hook is operably configured to catch or engage lockout lug 6770. With further reference to FIG. 47, lockout spring 6182 is shown in a default configuration in an unstressed or undeflected state. In a non-stressed configuration, the spring arms 6188 define a bend or contour such that the distal end 6186 is offset upward from the proximal end 6184. The lockout spring 6182 is configured to deflect or otherwise deform during operation of the end effector 6100, but the lockout spring 6182 attempts to regain the unstressed configuration of FIG. Is configured.

  Lockout lug 6770 defines a laterally projecting lug on support portion 6763 of firing member 6760. A lock or notch 6772 is defined in each laterally projecting lug 6770. Lock 6772 receives hook 6190 on lockout spring 6182 as lockout spring 6182 is in the unstressed configuration of FIG. 47 and firing member 6760 is advanced distally to engage hook 6190. Is a rectangular cutout that is dimensioned and aligned. For example, each lock 6772 includes a distal opposing opening configured to receive hook 6190 when hook 6190 is aligned with the distal opposing opening and firing member 6760 is advanced distally. In. When hook 6190 is retained within lock 6772, distal advancement of firing member 6760 is prevented. As a result, advancement of the clamp and knife edge 6766 of the anvil 1130 is prevented by the lockout configuration 6180.

  In use, lockout spring 6182 may initially be in the unstressed configuration of FIG. In a non-stressed configuration, the hook 6190 on the distal end 6186 of the lockout spring 6182 is biased upward to align with the lock 6772 in the firing member 6760. As a result, when firing member 6760 is advanced in the distal direction, hook 6190 slides into lock 6772 on advancing firing member 6760 so that firing member 6760 moves distally beyond hook 6190. Side displacement is prevented.

  Referring now to FIG. 48, when the staple cartridge 6110 is introduced into the end effector 6100, a portion of the staple cartridge 6110 is configured to engage a lockout spring 6182. Staple cartridge 6110 is similar in many respects to staple cartridge 1110 (see FIGS. 3-5). Staple cartridge 6110 includes a sled assembly 6120, which is similar in many respects to sled assembly 1120 (see FIGS. 4 and 5), however, sled assembly 6120 is proximal to staple cartridge 6110. The end 6112 has a cutout or recess 6122. A cutout 6122 is defined in the channel-facing surface of the sled assembly 6120 and its hook 6190 when the sled assembly 6120 is in a proximal home position (see FIG. 48) within the staple cartridge 6110. The lockout spring 6182 is configured to receive a distal end 6186 thereof. Sled assembly 6120 engages distal end 6186 of lockout spring 6182 to deflect hook 6190 into cutout 6122 and out of alignment with lock 6772.

  In another example, a staple cartridge 1110 (see FIGS. 3-5) can be introduced into an elongate channel 6102, whose thread assembly 1120 has hooks 6190 downward into lockout recesses 6109 of the elongate channel 6102. It may be configured to deflect. In such an example, lockout recess 6109 is dimensioned to accommodate the height of lockout spring 6182 such that staple cartridge 1110 can be positioned flush with the cartridge support surface of elongate channel 6102. obtain. In still other examples, elongate channel 6102 may not include lockout recess 6109, similar to elongate channel 1102 (see FIGS. 3-5). In such an example, the cutout 6122 of the sled assembly 6120 is adapted to accommodate the height of the lockout spring 6182 such that the staple cartridge 6110 can be positioned flush with the cartridge support surface of the elongate channel 6102. Can be dimensioned.

  During the firing stroke, sled assembly 6120 is advanced distally through cartridge body 6111 by firing member 6760. When firing member 6760 is retracted proximally after the firing stroke, sled assembly 6120 is left on the distal portion of staple cartridge 6110. For example, referring now to FIG. 49, the firing member 6760 has been advanced distally from a proximal home position during an initial portion of the firing stroke. As the firing member 6760 moves distally away from the lockout spring 6182, the lockout spring 6182 deflects the hook 6190 upward relative to the fixed proximal end 6184 of the lockout spring 6182. 47 is configured to recover the unstressed orientation.

  Referring now to FIG. 50, upon completion of the firing stroke, firing member 6760 is retracted proximally toward a proximal home position. As firing member 6760 moves proximally beyond distal end 6186 of lockout spring 6182, hook 6190 on lockout spring 6182 runs along ramp surface 6774 on laterally projecting lug 6770. Or, it is configured to slide. The hook 6190 is configured so that the ramp surface 6774 cams or lifts the hook 6190 and the distal end 6186 of the lockout spring 6182 along the upper surface of the lug 6770, which projects laterally above the lock 6772. At 50, it is engaged with the ramp face 6774. When the hook 6190 bypasses the lock 6772, the lockout configuration 6180 is effectively reset.

  Referring now to FIG. 51, the firing member 6760 has returned to its proximal home position and the lockout spring 6182 has returned to its unstressed configuration. As a result, the hook 6190 on the lockout spring 6182 is aligned with the lock 6772 on the firing member 6760. For example, the locks 6772 are configured to move along respective locking paths within the end effector 6100 as the firing member 6760 is advanced in the distal direction, and each hook 6190 is configured to move the locking path of the corresponding lock 6772. Is within. Although the staple cartridge 6110 remains in the elongate channel 6102 of FIG. 51, the sled 6120 (see FIGS. 33 and 34) is still in the staple cartridge 6110 because the staple cartridge 6110 has already been fired or used. At the distal end. The distally displaced sled 6120 is not arranged to engage the distal end 6186 of the lockout spring 6182 to overcome the lockout mechanism 6180 as shown in FIG.

  As shown in FIG. 52, firing member 6170 is prevented from displacing distally beyond reset lockout configuration 6180. Specifically, firing member 6760 has been displaced distally from a proximal home position during a subsequent attempted firing stroke. However, as firing members 6760 move distally, locks 6772 move along their corresponding locking paths to engage hooks 6190. Hook 6190 slides into lock 6772 to prevent further distal movement of firing member 6760.

  Lockout configuration 6180 includes symmetrical lock 6772 and symmetrical hook 6190. For example, the lock 6772 and the hook 6190 are symmetric about the longitudinal axis of the end effector 6100 so that the firing force generated by the firing member is controlled by the lockout configuration 6180 in a balanced and symmetric manner. Be suppressed. In other examples, lockout configuration 6180 may be asymmetric, and may include, for example, a single lock 6772 and a single hook 6190.

  In various examples, as described herein, a replaceable surgical tool assembly for a surgical instrument can be fired upon activation of a firing trigger on its handle assembly. In certain instances, multiple actuations of the firing trigger may be configured to fire the replaceable surgical tool assembly. For example, each actuation of the firing trigger may implement a portion of the firing stroke. In another example, a single actuation of the firing stroke may be configured to provide a series of consecutive firing strokes. In certain instances, each successive firing stroke may contribute to distal advancement and / or proximal retraction of the firing member, cutting edge, and / or sled assembly. For example, the firing rod in the replaceable surgical tool assembly may be extended and retracted multiple times in a series of consecutive firing strokes to complete firing of the end effector.

  In certain instances, it may be desirable to advance the firing member distally to a middle portion of the end effector. The firing member can fire the sled assembly and / or the cutting element to an intermediate portion of the end effector. Further, in various examples, the pusher plate may be advanced distally to complete firing of the sled assembly and / or cutting element. As described herein, the firing member may include an upper flange configured to move through the anvil of the replaceable surgical tool assembly. If the distal advancement of the firing member terminates at a middle portion of the end effector, the distal portion of the anvil may not have a passage. For example, the distal portion of the anvil may be solid such that the upper flange of the firing member cannot move therethrough. When the distal portion of the anvil is solid, the stiffness of the anvil may be higher than an anvil having a passage extending to its distal end. Increasing the stiffness of the anvil may be configured to limit deformation and / or warpage of the anvil.

  A replaceable surgical tool assembly 12000 configured to perform a series of consecutive firing strokes is shown in FIGS. The replaceable surgical tool assembly 12000 may be mounted on the handle assembly 500 (see FIGS. 1 and 2). In a particular example, each firing stroke in a series of consecutive firing strokes may be achieved by a single actuation of firing trigger 532 (see FIGS. 1 and 2). In other examples, one actuation of firing trigger 532 may implement one or more of the firing strokes. For example, a single actuation of the firing trigger 532 may achieve a series of all firing strokes for firing staples and cutting the target tissue clamped between the end effector jaws.

  The replaceable surgical tool assembly 12000 includes an end effector 12100, a shaft portion 12400, a firing member 12760, and a firing bar 12770. End effector 12100 includes an elongate channel 12102 configured to operably support staple cartridge 11210 therein. Elongated channel 12102 is operatively attached to shaft portion 12400. End effector 12100 also includes an anvil 12130 pivotally supported with respect to elongate channel 12102.

  The firing member 12760 is configured to operably interface with a sled assembly 12120 operably supported within the cartridge body 12111 of the surgical staple cartridge 12110. The sled assembly 12120 is slidable within the surgical staple cartridge body 12111 from a proximal start position adjacent the proximal end 12112 of the cartridge body 12111 to an end position adjacent the distal end 12113 of the cartridge body 12111. It can be displaced. The sled assembly 12120 includes a plurality of beveled or wedge-shaped cams 12122, each cam 12122 corresponding to a particular line of staples 1126. The thread assembly 12120 also includes a cutting edge 12124. The cutting edge 12124 is configured to move with the sled assembly 12120 through the end effector 12100. For example, the cutting edge 12124 is integrally formed on the thread assembly 12120.

  A direct drive surgical staple 1126 (see also FIG. 5) is positioned within the staple cavity in the body 12111. When the sled assembly 12120 is driven in a distal direction, the tissue cutting edge 12124 is configured to cut tissue clamped between the anvil assembly 12130 and the staple cartridge 12110, and the sled assembly 12120 is configured to cut the staple cartridge. The staples 1126 are driven upward within 12110 to make molding contact with the anvil assembly 12130. As described further herein, the sled assembly 12120 can be driven distally by the firing member 12760 and / or by the pusher plate 12780. For example, the firing member 12760 is configured to push the sled assembly 12120 distally to an intermediate position within the end effector 12100, and the pusher plate 12780 bypasses the firing member 12760 and moves distally within the end effector 12100. The threaded assembly 12120 is configured to be further advanced distally into the position.

  During the firing stroke, a drive member within shaft portion 12400, such as, for example, drive member 1602 (see FIG. 2), is configured to transmit firing motion to firing bar 12770. For example, displacement of drive member 1602 is configured to displace firing bar 12770. As described herein, firing bar 12770 may be operably configured to fire firing member 12760. For example, firing bar 12770 can push firing member 12760 distally during at least a portion of the firing sequence.

  The firing member 12760 is similar in many respects to the firing member 1760 (see FIGS. 4 and 5). For example, the firing member 12760 defines an I-beam structure that includes a lower flange 12764, an upper flange 12762, and a support portion 12763 that extends between the lower flange 12764 and the upper flange 12762. The upper flange 12762 is comprised of a horizontal pin extending from the support portion 12763. The lower flange 12764 is comprised of enlarged or widened legs at the base of the support portion 12763. The firing member 12760 is configured to engage with an open and closed cavity such as an open and closed cavity 1148 on the anvil 12130 (see FIGS. 8-12) to effectuate opening and closing of the anvil 12130 with respect to the staple cartridge 12110. obtain. In addition, upper flange 12762 may be configured to move through passage 12136 in anvil 12130 and lower flange 12764 may be configured to move through passage 12106 in elongate channel 12102. Good. Unlike firing member 1760, firing member 12760 does not include a cutting edge. Rather, firing member 12760 is configured to selectively engage sled assembly 12120 including cutting edge 12124.

  The replaceable surgical tool assembly 12000 also includes a pusher assembly 12778 having a pusher plate 12780 and a spring 12782. Referring primarily to FIGS. 56-58, when the replaceable surgical tool assembly 12000 is in the unfired configuration, the spring 12782 is configured to bias the pusher plate 12780 laterally toward the firing bar 12770. . For example, the spring 12782 is positioned intermediate the pusher plate 12780 and the side wall of the shaft assembly 12400. Pusher plate 12780 is biased against firing bar 12770 positioned against stop plate 12784 in shaft portion 12400. The spring 12782 is a straight wave spring, however, it is readily apparent to the reader that alternative spring designs may be configured to bias the pusher plate 12780 laterally toward the firing bar 12770. Will be understood. As further described herein, pusher plate 12780 is retained within shaft portion 12400 of replaceable surgical tool assembly 12000 until firing bar 12770 is retracted to a more proximal position, thereby. The pusher plate 12780 can spring laterally into engagement with the firing bar 12770.

  Referring now to FIGS. 59-61, the pusher plate 12780 comprises a straight body 12786 having a plurality of leaf springs 12788 along the body 12786. The leaf spring 12788 is shown in FIGS. 60 and 61 in an unstressed or undeformed configuration, which shows the leaf spring 12788 urged laterally outwardly from the linear body 12786. ing. The cartridge body 12786 extends between a proximal end 12788 and a distal end 12790. A T-shaped slot 12792 is defined at the proximal end 12788. T-shaped slot 12792 is configured to operably receive a distal key or nub 12771 on firing bar 12770. The distal key 12771 may include, for example, a disk-shaped key (see FIG. 63) projecting from the firing bar 12770. When the key 12771 is positioned in the T-shaped slot 12792, the proximal and distal translation of the firing bar 12770 is transmitted to the pusher plate 12780. The reader will readily appreciate that alternative complementary slot and key geometries may be used to transfer firing motion between the firing bar 12770 and the pusher plate 12780.

  Referring primarily to FIGS. 62 and 63, at the beginning of the first firing stroke, the distal end of firing bar 12770 is positioned for abutting and driving contact with firing member 12760. Further, firing bar 12770 is configured to restrain pusher plate 12780 and its leaf spring 12788. In such an example, the firing bar 12770 can be advanced distally to push the firing member 12760 distally. As the firing member 12760 moves distally, the firing member 12760 pushes the sled assembly 12120 distally. In FIG. 62, the ramp surface 12122 of the sled assembly 12120 engages the nearest staple 1126 in the row shown and begins to lift the staple 1126 toward the anvil 12130.

  The firing bar 12770 is moving distally in FIG. 62, while the pusher plate 12780 is configured to remain in a proximal position within the shaft portion 12400 of the interchangeable surgical tool assembly 12000. Referring primarily to FIG. 63, as further described herein, the firing member 12760 includes a notch 12766 that, at a later stage in the firing stroke sequence, causes the pusher plate 12780 to move the firing member 12760. Sized to allow for bypassing.

  The replaceable surgical tool assembly 12000 is shown in FIG. 64 having completed a first firing stroke. Comparing FIG. 58 with FIG. 64, the reader will readily appreciate that firing member 12760 has been moved distally by a distance V from point A to point B by firing bar 12770. Point B is about one third of the distance between the proximal end 12112 and the distal end 12113 of the staple cartridge 12110. In other examples, point B may be less than or greater than one third of the distance between proximal end 12112 and distal end 12113. For example, point B may be about one-quarter or one-sixth of the distance between proximal end 12112 and distal end 12113. In another example, point B may be more than halfway between the proximal end 12112 and the distal end 12113.

  Upon reaching point B, the sled assembly 12120 has moved the two staples 1126 in the row shown to the forming position, and has moved the third staple in the row shown to the forming position. Thereafter, firing bar 12770 is configured to be retracted proximally during the second firing stroke. When firing bar 12770 is retracted in the proximal direction, firing member 12770 simply moves into abutting drive contact with firing member 12760 and is not connected to the firing member, so that firing member 12770 can move within end effector 12100. It is configured to stay at the intermediate position (point B).

  Referring primarily to FIGS. 65 and 66, the replaceable surgical tool assembly 12000 is shown having completed a second firing stroke. Comparing FIG. 64 with FIG. 66, the reader will readily understand that firing bar 12770 has been moved proximally by a distance W from point B to point C. Point C is proximal to point A. In other words, the distance W is larger than the distance V (see FIG. 64). Further, point C is proximal to pusher assembly 12778. More specifically, when firing bar 12770 is retracted to point C, firing bar 12770 is retracted proximally, thereby causing T-shaped slot 12792 in proximal end 12788 of pusher plate 12780 to fire. Aligned with distal key 12771 on bar 12770. When the distal key 12771 is aligned with the T-shaped slot 12792, the T-shaped slot 12792 is configured to receive the distal key 12771 therein. For example, referring primarily to FIG. 66, the spring 12782 is configured to laterally bias the pusher plate 12780 into engagement with the firing bar 12770. Additionally, leaf spring 12788 is allowed to restore the unstressed configuration when firing bar 12770 is retracted in its proximal direction (see FIGS. 60 and 61).

  The replaceable surgical tool assembly 12000 is shown in FIGS. 67-69 after completing a third firing stroke. Comparing FIG. 66 with FIG. 67, it will be readily apparent to the reader that firing bar 12770 has been moved distally from point C to point D by a distance X. Point D is also distal to point B (see FIG. 64). Distance X, which is the distal displacement of firing bar 12770, is configured to move firing member 12760 by distance Y and move sled assembly 12120 to distal end 12113 of staple cartridge 12110. Pusher plate 12780 is advanced distally by firing bar 12770 during a third firing stroke.

  During the third firing stroke, pusher plate 12780 pushes firing member 12760 distally until firing member 12760 reaches the end of passage 12136. When the upper flange 12762 of the firing member 12760 abuts the distal end of the passageway 12136 (or is prevented from otherwise moving the firing member 12760 further in the distal direction), the pusher plate 12780 causes the firing member 12780 to fire. It is configured to bypass the member 12760. For example, leaf spring 12788 is configured to deflect toward body 12786, which allows pusher plate 12780 to fit within notch 12766 of firing member 12760. When pusher plate 12780 is positioned within notch 12766, pusher plate 12780 is configured to move distally beyond firing member 12760. In certain examples, pusher plate 12780 may not displace the firing member distally during the third firing stroke. For example, point B may be aligned with the distal end of passage 12136.

  At the completion of the third firing stroke, the sled assembly 12120 has been positioned at the distal end 12113 of the staple cartridge 12110 and all of the staples 1126 in the row shown have been moved to the molding position with the anvil 12130. Further, sled assembly 12120 is configured to lower or move downwardly toward cartridge support surface 12101 of elongate channel 12102 upon completion of the third firing stroke. The lowered sled assembly 12120 shown in FIG. 67 is configured to shift the cutting edge 12124 downward. For example, the cutting edge 12124 may be located below the staple cartridge 12110 deck. In such an example, when the firing member 12760 is retracted and the anvil 12130 is pivoted to the open configuration, the cutting edge 12124 may be concealed within the cartridge body 12111 or shielded by the cartridge body. This may prevent accidental cutting and / or injury by the cutting edge 12124. In certain examples, the body 12111 of the staple cartridge 12110 includes a distal cavity configured to have the sled assembly 12120 housed or shifted upon completion of the third firing stroke.

  Still referring to FIGS. 67-69, the leaf spring 12788 is in a non-stressed configuration, so that the leaf spring extends laterally outward of the body 12786. When in the unstressed configuration, a proximally outwardly-facing end 12789 of one of the leaf springs 12788 extends forward of the support portion 12763 of the firing member 12760 (see FIG. 69). In other words, the end 12789 of the leaf spring 12788 extends beyond the notch 12766 and overlaps laterally with the support portion 12763 of the firing member 12760. As a result, end 12789 acts as a spring-loaded barb that captures firing member 12760 when pusher plate 12780 is later retracted proximally.

  During the fourth firing stroke, pusher plate 12780 is retracted proximally. Comparing FIG. 67 with FIG. 70, the reader will readily understand that firing bar 12770 has been moved proximally by distance Z from point D to point E. The firing bar 12770 is engaged with the pusher plate 12780 via the lock 12771 and the T-shaped slot 12792, so that the pusher plate 12780 is also withdrawn proximally with the firing bar 12770. Further, retraction of pusher plate 12780 also causes firing member 12760 to retract as one end 12789 of leaf spring 12788 is captured or otherwise engaged with firing member 12760. The firing member 12760 of FIG. 70 has been retracted such that the upper flange 12762 is withdrawn from the passage 12136 in the anvil 12130. In a particular example, the upper flange 12762 can be configured to engage an open closed cavity to open the anvil 12130 toward the open configuration when withdrawn to point E. Further, the sled assembly 12120, including its cutting edge 12124, is still shielded within the descending cavity at the distal end 12113 of the staple cartridge 12110.

  In certain examples, the replaceable surgical tool assembly may include a flexible spine, which may allow at least a portion of the shaft to bend away from a linear configuration. The flexible spine is configured to move the end effector of the replaceable surgical tool assembly vertically and / or horizontally with respect to the longitudinal axis of the shaft. Additionally or alternatively, in certain instances, the end effector and / or distal portion of the interchangeable surgical tool assembly may be configured to rotate with respect to the longitudinal axis of the shaft. The flexibility and rotatable nature of the replaceable surgical tool assembly is configured to increase the range of motion so that the end effector can be manipulated to assume various positions relative to the target tissue. In addition, the flexibility and rotatable nature may be configured to increase the visibility of the operator at the surgical site.

  An exchangeable surgical tool assembly 14000 is shown in FIGS. The replaceable surgical tool assembly 14000 includes an end effector 1100 that includes an elongated channel 1102, an anvil 1130, and a firing member 1760. Staple cartridge 1110 (see FIGS. 72 and 74) is removably positioned within elongate channel 1102. The replaceable surgical tool assembly 14000 also includes a shaft portion 14400 that includes a flexible spine 14402. US Patent Application No. 14 / 138,554, filed December 23, 2013, entitled "SURGICAL INSTRUMENTS," filed December 23, 2013, further includes a flexible spine for surgical instruments. WITH ARTICULABLE SHAFT ARRANGEMENTS ", which is described in the current US Patent Application Publication No. 2015/0173789.

  The flexible spine 14402 includes a vertebral body 14404 and a distal tube segment 14440 mounted to the vertebral body 14404 (see FIG. 74). The vertebral body 14404 includes a central portion 14408 and a pair of laterally symmetric vertebrae 14406 extending from the central portion 14408. Vertebrates 14406 are positioned along each outer side 14410, 14412 of vertebral body 14404. Vertebrates 14406 along the length of the vertebral body 14404 are nested. For example, each vertebra 14406 includes a protrusion and an adjacent vertebra 14406 includes a corresponding recess into which the protrusion projects. The associated protrusions and recesses are configured to limit torque generation or torsion of the vertebral body 14404.

  Adjacent vertebrae 14406 within vertebral body 14404 are separated by gaps 14405 when vertebral body 14404 is in a linear orientation. For example, gap 14405 can extend between the associated protrusion and recess. The gap 14405 between adjacent vertebrae 14406 is configured to allow articulation of the vertebral body 14404 in the articulation plane.

  Referring primarily to FIGS. 72 and 73, in order to articulate the flexible spine 14402 and the distal canal segment 14440 attached thereto, the respective outer portions 14410, 14412 of the vertebral body 14404 are rotated by the vertebral body 14404. Are simultaneously compressed and unfolded by selective movement of the articulation band 14420 longitudinally through a passageway along each respective outer portion 14410, 14412. The distal end of the articulation band 14420 is anchored to an articulation head 14430 that is attached to or otherwise secured to the distal tube segment 14440. For example, the articulation band 14420 terminates in a distal loop 14422 located around the mounting tab 14432 on the articulation head 14430. Accordingly, the reciprocating motion of the articulation band 14420 is configured to cause the articulation head 14430 and the distal tube segment 14440 to articulate with respect to the flexible spine 14402. The articulation band 14420 can be comprised of, for example, a metal band that can be at least partially encapsulated or encased in plastic. In various examples, the articulation band may be actuated (ie, proximally or distally) by a lever or other actuator on a handle assembly, such as a surgical instrument handle assembly 500 (see FIGS. 1 and 2). Can be displaced).

  As the vertebral body 14404 flexes and the distal tube segment 14440 articulates, the end effector 1100 is also configured to articulate. More specifically, end effector 1100 includes a proximal mounting portion 14450. Referring primarily to FIG. 74, the proximal mounting portion 14450 is mounted on the elongate channel 1102. For example, the proximal mounting portion 14450 may be secured to the elongate channel 1102 and / or may be formed integrally with the elongate channel 1102. Proximal mounting portion 14450 is positioned adjacent distal tube segment 14440 and articulation head 14430 therein. As further described herein, a thrust bearing 14460 is positioned intermediate the proximal mounting portion 14450 and the distal tube segment 14440, such that the proximal mounting portion 14450 moves relative to the distal tube segment 14440. It can rotate. When distal tube segment 14440 articulates, proximal mounting portion 14450 and end effector 1100 extending therefrom are also configured to articulate.

  In various examples, end effector 1100 may also be configured to rotate about a longitudinal axis of shaft portion 14000. For example, end effector 1100 can be rotated with respect to flexible spine 14402. Exchangeable surgical tool assembly 14000 includes a rotating shaft 14470 extending proximally from proximal mounting portion 14450. Rotation shaft 14470 may extend proximally through distal tube section 14440 and flexible spine 14402 and may be secured at a rotation connection in the handle assembly. The rotating shaft 14470 and the proximal mounting portion 14450 may be connected such that rotation of the rotating shaft 14470 causes rotation of the proximal mounting portion 14450, and thus also rotation of the end effector 1100. For example, the rotating shaft 14470 can be fixed to the proximal mounting portion 14450 and / or formed integrally with the proximal mounting portion. In other examples, a rotation transmission mechanism, such as a gear tooth, for example, may be configured to transmit rotation of the rotating shaft 14470 to the proximal mounting portion 14450.

  Rotating shaft 14470 extends through flexible spine 14402. For example, rotating shaft 14470 can be concentric with flexible spine 14402 and its vertebral body 14404. Rotating shaft 14470 extends through and rotates within flexible spine 14402, but rotation of rotating shaft 14470 is not transmitted to flexible spine 14402. For example, a thrust bearing 14460 intermediate the proximal mounting portion 14450 and the articulating head 1430 is configured to allow rotation of the proximal mounting portion 14450 relative to the articulating head 1430. In other examples, flexible spine 14402 may be configured to rotate with rotating shaft 14470, and thrust support 14460 may be positioned between flexible spine 14402 and a non-rotatable portion of shaft 14400. May be positioned.

  Referring primarily to FIG. 73, the rotating shaft 14470 may be serrated or notched. The saw teeth and / or notches are configured to allow bending of the rotating shaft 14470 within the flexible spine 14402. Although the rotating shaft 14470 is capable of flexing, the saw teeth may be configured to limit torsional or torque generation of the rotating shaft 14470 so that the rotational motion generated at its proximal end is reduced. It can be efficiently transmitted to the distal end of the rotating shaft 14470 and thus to the proximal mounting portion 14450.

  Referring primarily to FIGS. 73 and 74, shaft portion 14400 includes a longitudinally movable firing bar 14770 that is similar in many respects to firing bar 1770 (see FIGS. 3-5). During the firing stroke, a drive member within the handle assembly (eg, drive member 540 (see FIGS. 1 and 2) within handle assembly 500) fires via a drive member (eg, drive member 1602 (see FIG. 2)). The firing motion is transmitted to the bar 1770 to fire the firing member 1760. For example, actuation of drive member 540 can be configured to displace firing bar 14770 and firing member 1760 in a distal direction to cut tissue and effect firing of staples from staple cartridge 1110. Thereafter, drive member 540 may be retracted proximally, causing firing bar 14770 and firing member 1760 to retract proximally. Fire bar 14770 is configured to flex within flexible spine 14402.

  The firing bar 14770 is concentric with the rotating shaft 14470. Further, as rotating shaft 14470 rotates within flexible spine 14402, firing bar 14770 is configured to rotate as well. For example, firing bar 14770 extends distally to firing member 1760 having upper flange 1462 constrained by anvil 1130 and lower flange 1464 constrained by elongate channel 1102. As end effector 1100 rotates with rotating shaft 14470, firing member 1760 located within end effector 1100 is also configured to rotate, as described herein.

  As described herein, the rotational joint between the proximal mounting portion 14450 and the distal tube segment 14440 is distal to the articulating vertebral body 14404. Accordingly, rotation of the end effector 1100 occurs distal to the articulation region of the shaft portion 14400. In other examples, the replaceable surgical tool assembly 14000 may include alternative and / or additional articulations and / or regions. For example, various additional articulations are described further herein. In such an example, the revolute joint between the proximal mounting portion 14450 and the distal tube segment 14440 may be located distally with respect to the most distal articulation joint.

  In various examples, translation of firing member 1760 and / or firing bar 14770 may be prevented until an unfired staple cartridge is positioned within end effector 1100. For example, various lockout configurations disclosed herein may be incorporated into end effector 1100 and / or replaceable surgical tool assembly 14000. Although translation of firing member 1760 and / or firing bar 14770 may be prevented in such a case, rotation of firing member and firing bar 14770 with rotating shaft 14470 and end effector 1100 may be accomplished by such a lockout configuration. It can be acceptable.

  75-81, a portion of another surgical instrument embodiment 15010 of the present invention is shown. In the illustrated configuration, the surgical instrument 15010 includes a shaft assembly 15100 that may be operably coupled to a housing (not shown) in the form of a handle assembly or part of a robotic system. For example, shaft assembly 15100 may be operatively coupled to or otherwise configured for use with the handle assemblies and other drive configurations disclosed above, and / or by reference to Various handle and launch joint assemblies disclosed in U.S. Patent Application Publication No. 2014/0246471, entitled "ARTICULABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS FOR SIGNAL COMMUNICATION," the disclosure of which is incorporated herein by reference in its entirety. It may be coupled to the system or otherwise configured to be used with them.

  As seen in FIG. 75, the shaft assembly 15100 is operable with a proximal rotary drive shaft 15120 that operably interfaces with a source of rotary motion (eg, a handle assembly or a motor or motor configuration supported within a robotic system). And a spine member 15110 that supports the spine member. In the configuration shown, the proximal rotary drive shaft 15120 is flexible to accommodate articulation of a portion of the shaft assembly 15100. For example, a rotary drive shaft may comprise a somewhat flexible cable. The spine member 15110 defines a shaft axis SA, for example, a handle assembly or robot in various known ways to facilitate selective rotation of the spine member 15110 about the shaft axis SA relative to the handle assembly or robotic system. It may be connected to a system. In the illustrated embodiment, the shaft assembly 15100 includes a proximal or "first" articulation 15130 defining a first articulation axis AA1 transverse to the shaft axis SA, the shaft axis SA and the first articulation. A distal or "second" articulation 15150 defining a second articulation axis AA2 that also traverses the axis AA1.

  Referring now to FIG. 76, a proximal or first articulation joint 15130 is coupled to a distal end 15112 of a spine member 15110 by a first articulation pin 15134 for a first channel mounting assembly. 15132. First articulation pin 15134 defines a first articulation axis AA1 on which first channel mounting assembly 15132 can pivot. The illustrated shaft assembly 15100 comprises a first articulation system 15136 comprising a first axially movable articulation actuator 15138, wherein the first axially movable articulation actuator comprises a first axially movable articulation actuator 15138. Operably interfaces with one source of axial articulation. Such a first axial joint motion is represented by arrows AD1 and AD2 in FIG. As seen in FIG. 76, the distal end 15139 of the first axially movable articulation member 15138 is pivotally pinned to the first channel mounting assembly 15132 by a mounting pin 15135. As a result of the axial movement of the first articulation actuator 15138 in the first and second articulation directions AD1, AD2, the first channel mounting assembly 15132 causes the spine member 15110 to rotate about the first articulation axis AA1. Pivot with respect to

  Still referring to FIG. 76, the distal or second articulation joint 15150 includes a second channel mounting member 15152 pivotally connected to the first channel mounting assembly 15132 by a second articulation pin 15154. . The second articulation pin 15154 defines a second articulation axis AA2 where the second channel mounting member 15152 can pivot with respect to the first channel mounting assembly 15132. See FIG. 75. The illustrated shaft assembly 15100 further comprises a second articulation system 15160 comprising a second endless articulation member 15162, the second endless articulation member comprising a pulley shaft 15165 attached to the spine member 15110 It is pivoted on a proximal idle pulley 15164 rotatably supported thereon. The second endless articulating member 15162 is also immovably attached to the second channel mounting member 15152, or is attached to an articulating pulley 15156 formed thereon, such that the second endless articulating member 15162 Of the endless articulation member 15162 will cause the second channel mounting member 15152 to pivot with respect to the first channel mounting assembly 15132 about the second articulation axis AA2. Second articulation system 15160 further comprises a second axially movable articulation actuator 15166 operatively interfaced with a second source of axial articulation in the handle assembly or robotic system. Such a second axial articulation is represented by arrows AD3 and AD4 in FIG. As seen in FIG. 76, the distal end 15167 of the second axially movable articulation member 15166 is clamped to a portion of the second endless articulation member 15162 by a clamping member 15168. Clamping member 15168 includes a cable guide hole 15169 therethrough for slidably supporting another portion of second endless articulation member 15162 during application of the second articulation.

  In the illustrated embodiment, anvil member 15200 is movably coupled to shaft assembly 15100. Anvil 15200 may be similar to anvil 1130 described above. For example, anvil 15200 is pivotally coupled to a second channel mounting member for selective pivoting movement with respect to the second channel mounting member 15162. As seen in FIG. 76, anvil 15200 includes an anvil body 15202 that includes a staple forming portion 15204 and an anvil mounting portion 15210. The anvil attachment portion 15210 includes downwardly extending sidewalls 15212, commonly referred to as a tissue stop, the purpose of which is described herein above.

  In the illustrated embodiment, the second channel mounting member 15152 includes two distally protruding anvil mounting portions 15190, each adapted to receive a corresponding anvil mounting pin 15193 therein. It has a pinhole 15192. Anvil mounting pins 15193 are received in pin holes 15192 and in corresponding apertures 15213 in sidewalls 15212 of anvil 15200. As described above, the pins may be pushed into apertures 15213. Such a configuration forms a pivot joint 15191 that facilitates pivotal movement of the anvil 15200 relative to the second channel mounting member 15152 while remaining attached thereto. In such a configuration, anvil 15200 is not intended to be removed from shaft assembly 15100, or more specifically, from second channel mounting member 15152 during normal use. Thus, when used in this context to describe the attachment of the anvil 15200 to the shaft assembly 15100, the term "non-removably attached" is used during operation of the surgical instrument, as described in further detail below. Not only that, but also when other surgical staple cartridges are operatively introduced, it means that the anvil 15200 is still attached to the shaft assembly 15100.

  As can be seen from FIGS. 76 and 77, the surgical instrument 15010 further includes a channel 15300 configured to operatively support a surgical staple cartridge 15400 therein. In the illustrated embodiment, the channel 15300 includes a proximal attachment 15302 configured to be removably attached to the second channel attachment member 15152. For example, the second channel mounting member 15152 includes a mounting body or mounting hub portion 15194 formed with two channel mounting slots 15196 that are mounted on the proximal mounting portion 15302 of the channel 15300. It is configured to receive the formed corresponding channel rail 15304. As can be seen in FIG. 77, the channel 15300 is inserted into the corresponding channel mounting slot 15196 of the second channel mounting member 15152 by introducing the channel rail 15304 in an introduction direction ID transverse to the shaft axis SA. Removably attached to assembly 15100. In the illustrated example, channel 15300 is removably locked to shaft assembly 15100 by locking member 15350.

  Still referring to FIGS. 76 and 77, in the illustrated embodiment, the locking member 15350 includes a distal tube segment 15352 that is axially movably supported on the mounting hub portion 15194 of the second channel mounting member 15152. ing. Distal tube segment 15352 is pivotally mounted to a flexible proximal tube segment (not shown) of shaft assembly 15100 to facilitate articulation about the first and second articulation axes. You may be. Distal tube segment 15352 has a most distal "locked" position where distal-to-distal segment 15352 prevents channel 15300 from being removed from shaft assembly 15100 in removal direction RD, and removes channel 15300 from shaft assembly 15100. To enable, the distal tube segment 15352 is configured to move axially between a proximal “unlocked” position located proximal to the channel mounting slot 15196. Thus, the distal tube segment 15352 may be coupled to the proximal tube segment to facilitate axial movement relative to the proximal tube segment, or the entire assembly (distal tube segment 15352 and proximal tube segment) may be axially moved. Can be moved to As can be seen in FIGS. 76-79, a clearance slot 15309 is provided in the upright side wall 15308 of the elongate channel 15300 to accommodate an anvil mounting pin 15193 that attaches the anvil 15200 to the second channel mounting member 15152. When the anvil 15200 is closed and the elongate channel 15300 is attached to the second channel mounting member 15152, the anvil side wall 15212 is adapted to accommodate the corresponding anvil mounting portion 15190 to accommodate the corresponding side wall 15308 of the elongate channel 15300. Away from

  In one configuration, the surgical staple cartridge 15400 is configured to be snapped or otherwise removably retained within the channel 15200 to facilitate easy replacement after use. A main body 15402 is included. The cartridge body 15402 includes a centrally disposed elongated slot 15404 configured to accommodate axial movement of the firing member 15500 therethrough. Cartridge body 15402 further includes a plurality of staple pockets 15406 therein. In the illustrated example, the staple pockets 15406 are arranged in two lines on each side of the elongated slot 15404. One line of staple pockets 15406 are staggered relative to the lines of adjacent staple pockets. In the illustrated example, each staple pocket 15406 contains a “direct-drive” surgical staple 1126 therein. In the configuration shown in FIG. 79, surgical staples 1126 are movably supported within staple pockets 15406 and are configured such that a separate, movable staple driver is not used. FIG. 80 shows that conventional surgical staples 1126 'are each supported on a staple driver 15412 supported in a staple pocket 15406' in the cartridge body 15402 '. The staple driver 15412 is driven upwardly within the surgical staple cartridge as the firing member 15500 'is driven distally through the surgical staple cartridge 15400'. For more information on the operation of firing member 15500 'and staple driver 15412, see U.S. Patent Application No. 14 / 308,240, entitled "SURGICAL CUTTING AND STAPLING INSTRUMENTS AND OPERATING," the disclosure of which is incorporated herein by reference in its entirety. SYSTEMS THEREFOR ", which can be found in the current US Patent Application Publication No. 2014/0299648.

  Referring now to FIGS. 78 and 81, in the illustrated example, the proximal rotary drive shaft 15120 extends through the second channel mounting member 15152 and is rotatably supported therein by the bearing assembly 15122. The distal end 15124 of the proximal rotary drive shaft 15120 has an attached firing member drive gear 15126 configured to operatively engage a distal rotary drive shaft assembly 15310 mounted within the elongate channel 15300. I have. Distal rotary drive shaft assembly 15310 includes a proximal shaft end 15312 with a firing member driven gear 15314 mounted. Proximal shaft end 15312 is rotatably supported within a proximal shaft bearing 15316 mounted on a proximal mounting portion 15302 of channel 15300. See FIG. 77 and FIG. 81. Distal rotary drive shaft assembly 15310 further includes a distal shaft end 15320 rotatably supported within a distal shaft bearing 15322 supported within distal end 15306 of channel 15300. See FIG. 78. The central portion 15330 of the distal rotary drive shaft assembly 15310 is threaded for threaded drive engagement with the threaded nut portion 15502 of the firing member 15500.

  In one example, the firing member 15500 includes an upright body 15504 that extends upwardly from the screw drive nut portion 15502 and has a tissue cutting surface 15506 formed or attached thereto. In at least one embodiment, the firing member body 15504 has a sled assembly 15540 formed thereon or attached thereto. In other configurations, the sled assembly may not be attached to the firing member 15500, but may be remoted through the surgical staple cartridge as the firing member 15500 is driven distally through the surgical staple cartridge 15400. It is configured to be driven in the shift direction. The sled assembly 15540 is a series of wedge-shaped cams configured to cam drive the staples upwardly into camming engagement with the staple forming lower surface 15220 on the anvil 15200 with the staples 1126 or the driver 15412. 15542. See FIG. 79. As seen in FIG. 77, for example, the staple forming lower surface 15220 includes a series of staple forming pockets 15222 corresponding to each staple in the surgical staple cartridge 15400. When the staple legs contact the forming pocket, the staples are formed or closed. For example, see staple 1126 'shown in FIG. In the illustrated embodiment, the firing member driven gear 15314 is in mating engagement with the firing member drive gear 15126 on the proximal drive shaft 15120 when the channel 15300 is attached to the second channel mounting member 15152 of the shaft assembly 15100. It is configured to be. Accordingly, rotation of the proximal drive shaft 15120 will result in rotation of the distal drive shaft assembly 15310. Rotation of the proximal drive shaft 15120 in the first rotational direction causes the firing member 15500 to be driven distally within the channel 15300 and also causes the proximal drive shaft 15120 to move in the second rotational direction. Rotation will cause firing member 15500 to be driven proximally within channel 15300.

  The firing member 15500 defines a structure similar to an I-beam and includes a lower flange portion 15560 formed from two laterally extending flanges 15562 extending from a screw drive nut portion 15502. In addition, the firing member includes an upper flange portion 15564 formed from two laterally extending flanges 15566. The firing member body 15504 extends through an elongated channel slot 15301 in the elongated channel 15300, an elongated slot 15404 in the surgical staple cartridge 15400, and an anvil slot 15230 in the anvil 15200. For example, firing member body 15504 extends through bore channel slot 15301 in elongate channel 15300 such that lower flange 15562 is movably positioned within passageway 15303 defined by elongate channel 15300. . In the embodiment shown in FIG. 77, the bottom of channel 15300 is open. A plate 15305 is attached to provide additional rigidity to this. Plate 15305 has a series of windows 15307 therein to allow the surgeon to see the position of firing member 15500 during firing and retraction.

  In the illustrated embodiment, anvil member 15200 is moved between an open position and a closed position by firing member 15500. As described above, the firing member body 15504 extends through the elongated slot 15404 of the cartridge body. The upper end 15505 of the firing member body 15504 is configured to extend into the anvil slot 15230 of the staple forming portion 15204 of the anvil body 15202. See FIG. 77. The upper end 15505 extends through the anvil slot 15230 such that the upper flange 15566 is movably positioned within the passageway 15232 (see FIG. 79) defined by the anvil 15200. For example, passageway 15232 may be defined through anvil 15200. I-beam flanges 15562 and 15566 provide cam surfaces that interact with elongated channel 15300 and anvil 15200, respectively, to open, clamp, or close the jaws, as described further herein. I have. Further, firing member 15500 is configured to maintain a constant distance between elongated channel 15300 and anvil 15200 along the length of end effector 1100.

  At the start of the firing stroke, firing member 15500 is configured to move distally from an initial position. As firing member 15500 moves distally, anvil 15200 is pivoted toward the clamp configuration by the I-beam configuration of firing member 15500. More specifically, lower flange 15562 of firing member 15500 moves through passage 15303 defined by elongate channel 15300 and upper flange 15566 is defined along ramp surface 15234 of anvil 15200 and then by anvil 15200. Move through the passage 15232.

  Referring primarily to FIGS. 79 and 81, the ramp surface 15234 defines an open closed cavity 15236 in an anvil 15200 in which a portion of the firing member 15500 extends during a portion of the firing stroke. For example, the upper flange 15566 projects from the anvil 15200 via an open closed cavity 15236. The ramp surface 15234 slopes down along the proximal open surface 15238, extends along the middle portion 15239, and slopes up along the distal closure ramp 15234. When firing member 15500 is in the initial or home position, upper flange 15566 is spaced from middle portion 15239. In other words, the upper flange 15566 is not cammed with the open closed cavity 15236. In place, firing member 15500 may dwell against open and closed cavity 15234 such that neither an opening nor a closing force is applied to anvil 15200 by firing member 15500.

  From the home position, the firing member 15500 can be retracted proximally. As firing member 15500 continues to move in the proximal direction, upper flange 15566 of firing member 15500 engaged with proximal opening surface 15238 is configured to exert an opening force on proximal opening surface 15238. As the upper flange 15566 moves relative to the proximal open surface 15238, the proximal open surface 15238 pivots, which causes the anvil 15200 to pivot open. When the upper flange 15566 exerts a downward force on the proximal open surface 15238, the anvil 15200 is pushed upward by leverage on the proximal open surface 15238.

  From the retracted position, the firing member 15500 may be advanced distally to return to the home position. To close the end effector, the firing member 15500 can be further advanced from a home position to an advanced position. With respect to the portion of the firing motion between the home position and the advanced position, upper flange 15566 is spaced from ramp surface 15234. For example, the upper flange 15566 hovers or dwells over the intermediate portion 15239 as the firing member 15500 transitions between a closing motion and an opening motion. The dwell portion of the firing motion may be configured, for example, to prevent jamming of the opening and / or closing motion.

  As firing member 15500 moves distally, flange 15566 contacts ramp surface 15234 and applies a downward force on the anvil to pivotally close anvil 15200. As firing member 15500 continues to move distally, upper flange 15566 moves through passageway 15232 to ensure a constant distance between anvil 15200 and elongated channel 15300 along the length of the end effector. For example, passage 15232 includes a lower ledge and an upper cap defining a lower and upper limit for passage 15232. The upper flange 15566 is constrained within these lower and upper limits during the firing stroke. The upper flange 15566 can be dimensioned to fit snugly within the limits of the passage 15232. In other examples, as further described herein, the upper flange 15566 can be configured to float and / or adjust vertically within the passageway 15232.

  The firing member 15500 is a multifunctional firing member. For example, firing member 15500 fires staples 1126 from surgical staple cartridge 15400, cuts tissue clamped between jaws 15200 and 15300, and cams jaws 15200 into a clamped configuration at the beginning of the firing stroke. , Configured to drive the sled assembly 15540 to cam the jaws 15200 into the open configuration upon completion of the firing stroke. The firing member 15500 may achieve a combination of surgical functions using a single actuation system. As a result, the independent actuation system required to fit within the footprint of the end effector can be minimized by the multifunctional firing member 15500. Additionally, the elongate channel and surgical staple cartridge 15400 can be replaced as a unit without removing or replacing the anvil 15200. In an alternative configuration, the surgical staple cartridge 15400 may be replaced without replacing the elongate channel 15300 regardless of whether the elongate channel 15300 remains attached to or removed from the shaft assembly 15100. In addition, as can be seen in FIGS. 83-85, the elongated channel 15300 and the surgical staple cartridge 15400 and anvil 15200 can be selectively pivoted within a plurality of articulation planes AP1, AP2 that are perpendicular to one another.

  86-89 illustrate a portion of another surgical instrument embodiment 16010 of the present invention. In the configuration shown, the surgical instrument 16010 includes a shaft assembly 16100 that may be operably coupled to a housing (not shown) in the form of a handle assembly or a part of a robotic system. For example, shaft assembly 16100 may be operatively coupled to, or otherwise configured for use with, the various drive configurations disclosed herein and / or by reference thereto. It is linked to various handle assemblies, firing and joint drive systems disclosed in U.S. Patent Application Publication No. 2015/0173789, entitled "SURGICAL INSTRUMENTS WITH ARTICULATABLE SHAFT ARRANGEMENTS", the disclosure of which is incorporated herein in its entirety. Or may be otherwise configured to be used with them.

  As shown in FIGS. 86-89, the illustrated shaft assembly includes a flexible shaft portion 16110. Flexible shaft portion 16110 may be of the type and configuration disclosed in more detail in U.S. Patent Application Publication No. 2015/0173789. Accordingly, for the sake of brevity, specific details of the flexible shaft portion 16110 will not be described herein other than as necessary to understand the structure and operation of the surgical instrument 16010. In various configurations, the flexible shaft portion 16110 may comprise a segment of the shaft assembly 16100, for example, a housing (handle, robotic system, etc.) as described in the aforementioned U.S. patent application, or herein. May be attached to a mounting stem portion (not shown) that is connected to the interchangeable shaft configuration disclosed in. The flexible shaft portion 16110 may be made, for example, from a rigid thermoplastic polyurethane commercially available from Dow Chemical Company as ISOPLAST grade 2510, and may include a centrally disposed, vertically extending articulating spine 16112. May be included. The articulation spine 16112 includes a centrally located component or knife slot 16114 to facilitate passage of various control components. See FIG. 87. In the configuration shown, the knife slot 16114 movably supports a central firing beam or bar 16200 therein. The flexible shaft portion 16110 further comprises a plurality of right ribs 16116 and a plurality of left ribs 16118, which are integrally formed with the articulating spine 16112 and can project laterally from the articulating spine. . The right and left ribs 16116, 16118 have an arcuate shape that provides the flexible shaft portion 16110 with a substantially circular cross-sectional shape. Such a shape may facilitate flexible shaft portion 16110 to easily pass through a circular passage, for example, a suitably sized trocar.

  In various configurations, each of the right ribs 16116 serves to define a right articulation passageway, through which the right articulation band 16120 is movably received. Right articulation band 16120 may extend through the right articulation passage and be coupled to connector assembly 16150. For example, the distal end 16122 of the right articulation band 16120 may have a right hook portion 16124 that is adapted to be coupled to a right mounting portion 16152 of the connector assembly 16150. . See FIG. 89. Similarly, each of the left ribs 16118 serves to define a left articulation path, the left articulation path being for movably receiving the left articulation band 16130 therethrough. Left articulation band 16130 may extend through the left articulation passageway and be coupled to connector assembly 16150. For example, the distal end 16132 of the left articulation band 16130 may have a left hook portion 16134 that is adapted to be coupled to a left mounting portion 16154 of the connector assembly 16150. . In the illustrated example, the right and left articulation bands 16120, 16130 may include an articulation system within a handle or housing, such as, for example, those disclosed in U.S. Patent Application Publication No. 2015/0173789, or disclosed herein. Operably interfaces with the articulating system of the interchangeable shaft configuration that is implemented.

  Referring now to FIG. 87, in the illustrated example, connector assembly 16150 has a proximal outer tubular member 16160 mounted thereon. As seen in FIG. 89, the proximal outer tubular member 16160 has the same outer diameter as the outer diameter of the flexible shaft portion 16110 to facilitate its insertion into a trocar cannula or other passageway. May be. Open proximal end 16162 is dimensioned to be immovably received on distal mounting hub 16119 on distal end 16111 of flexible shaft portion 16110. Proximal outer tube member 16160 has an open distal end 16163 and an inner flange 16164 formed therein. As seen in FIG. 89, the right and left articulation bands 16120, 16130 are free to move axially within the proximal outer tubular member 16160. Connector assembly 16150 is configured to facilitate quick attachment and removal of surgical end effector 16300 to shaft assembly 16100.

  In the illustrated example, end effector 16300 includes an elongated channel 16310 configured to operatively support surgical staple cartridge 1110 therein. The elongate channel 16310 is substantially similar to the elongate channel 1102 described in detail above, except that the elongate channel 16310 includes a proximal end portion 16312 having a distal tube connector 16314 immovably attached thereto. The same may be applied. Distal tube connector 16314 projects proximally from proximal end 16312 of channel 16310 and is proximally sized to be received within open distal end 16163 of proximal outer tubular member 16160. Includes mounting hub portion 16316. See FIG. 89. In addition, distal tube connector 16314 includes a pair of diametrically opposed, inwardly extending bayonet pins 16318 and 16320. Bayonet pins 16318 are configured to be received in corresponding slots 16156 in distal end 16155 of connector assembly 16150, and bayonet pins 16320 are configured in corresponding slots 16158 in distal end 16155 of connector assembly 16150. Configured to be accepted. See FIG. 88. In addition, a biasing member 16170 is received within the open distal end 16163 of the proximal outer tubular member 16160 in butt engagement with the inner flange 16164. In the illustrated configuration, for example, the biasing member 16170 includes a wave spring. See FIG. 87 and FIG. To attach the surgical end effector 16300 to the shaft assembly 16100, the proximal mounting hub portion 16316 of the distal connector tube is inserted into the open distal end 16163 of the proximal outer tube member 16160, such that Bayonet pin 16318 is aligned with slot 16156 of connector assembly 16150, and bayonet pin 16320 is aligned with slot 16158. The end effector 16300 is then moved in the proximal direction PD and rotated about the shaft axis until the bayonet pin 16318 is seated in the retaining groove 16157 of the connector assembly 16150 and the bayonet pin 16320 is seated in the retaining groove 16159. You. See FIG. 88. The biasing member 16170 applies a biasing motion to the distal tube connector 16314 to retain the bayonet pins 16318, 16320 seated in the respective retaining grooves 16157, 16159. To remove end effector 16300 from shaft assembly 16100, the user applies a proximal force to surgical end effector 16300 to compress biasing member 16170 and then rotate surgical end effector 16300 in the opposite direction. The bayonet pins 16318, 16320 are unseated from their respective retaining grooves 16157, 16159, and then the surgical end effector 16300 is pulled distally away from the connector assembly 16150.

  In at least one embodiment, the surgical end effector 16300 includes an anvil 1130 as detailed above. Elongated channels 16310 include upstanding side walls 16330, each having a pinhole 16332 therein. See FIG. 87. Anvil 1130 is pivotally attached to elongate channel 16310 by pivot pins 1152 that extend through apertures 1131 on each side of anvil 1130 and into pinholes 16332 in the manner described in detail above. .

  As seen in FIG. 87, elongate channel 16310 is configured to operably support staple cartridge 1110 therein. Surgical instrument 16010 also includes a firing member 16210 similar to firing member 1760 described above, except that firing member 16210 is configured for quick axial attachment and detachment to firing beam 16200. Firing beam 16200 may be comprised of a plurality of stacked plates and may be configured to flex sufficiently to accommodate the articulation of the end effector relative to the shaft assembly. In the illustrated example, firing member 16210 projects proximally configured to be removably inserted into a corresponding retaining cavity 16204 formed on distal end 16202 of firing beam 16200. Includes coupler 16212. In one configuration, coupler 16212 comprises a member that is somewhat barbed, and retaining cavity 16204 couples the firing member during normal operation (eg, firing and retraction) of surgical instrument 16010. Retained in engagement, but correspondingly shaped to facilitate removal of firing member 16210 from firing beam 16200 when surgical end effector 16300 is removed from shaft assembly 16100. Actuation of firing member 16210 may otherwise facilitate opening and closing anvil 1130 in various manners as disclosed herein. Such a configuration facilitates easy attachment and detachment of the surgical end effector from the shaft assembly. Thus, such a configuration can serve to provide a user with a new (unused) firing member and tissue cutting surface and a new anvil and staple cartridge when the entire end effector is replaced. However, if desired, the user may simply replace the cartridge without replacing the entire end effector. Firing member 16210 is otherwise operated in a manner similar to firing member 1760 described above, and interacts with sled 1120 in a manner described herein to eject staples from staple cartridge 1110. To work.

  Example 1-A replaceable surgical tool assembly comprising an end effector, wherein the end effector comprises a thread and a cutting edge. The replaceable tool assembly also includes a firing bar operably configured to fire a sled and a cutting edge, the firing bar includes a distal engagement portion, and the firing bar includes a first proximal position. To a first distal position, to a second proximal position, and to a second distal position. The replaceable tool assembly is a pusher assembly, a plate having a proximal engagement portion, the proximal engagement portion being selectively coupled to the distal engagement portion, and a firing bar. Is configured to laterally bias the proximal engagement portion into engagement with the distal engagement portion when is moved from the first distal position to the second proximal position. And a pusher assembly, comprising:

  Example 2-Further comprising a firing member, wherein the firing bar is configured to push the firing member in a distal direction as the firing bar moves from a first proximal position to a first distal position. 2. The replaceable surgical tool assembly according to claim 1.

  Example 3-A firing member includes a first flange configured to engage a first jaw of an end effector, and a second flange configured to engage a second jaw of the end effector. 3. The replaceable surgical tool assembly according to example 2, comprising: a support portion extending between the first flange and the second flange. A notch is defined in the support portion and the plate is adapted to slide distally through the notch as the firing bar is moved from the second proximal position to the second distal position. It is configured.

  Example 4-The replaceable of Example 3 wherein the plate comprises a spring-loaded fastener configured to engage the support portion when the plate is retracted proximally by the firing bar. Surgical tool assembly.

  Example 5 The replaceable surgical tool assembly of Examples 1, 2, 3, or 4, wherein the first proximal position is distal to the second proximal position.

  Example 6-The replaceable surgical tool assembly of Examples 1, 2, 3, 4, or 5, wherein the first distal location is proximal to the second distal location.

  Example 7-The replaceable surgical tool assembly of Examples 1, 2, 3, 4, 5, or 6, wherein the cutting edge is formed integrally with the thread.

  Example 8-The replaceable surgical tool according to Examples 1, 2, 3, 4, 5, 6, or 7, wherein the proximal engaging portion comprises a T-shaped slot and the distal engaging portion comprises a key. assembly.

  Example 9-A replaceable surgical tool assembly comprising an end effector, a first jaw, a second jaw rotatably coupled to the first jaw, and a first jaw. A replaceable surgical tool assembly comprising: a jaw and a thread configured to translate relative to the second jaw. The replaceable surgical tool assembly also includes a firing member, the firing member configured to engage a first jaw and a second jaw. And a second flange. The interchangeable surgical tool assembly further includes a pusher plate and a firing bar selectively coupled to the pusher plate, wherein the firing bar is configured to move over a plurality of successive firing strokes. The plurality of successive firing strokes includes a first distal firing stroke, wherein the firing bar is configured to push the firing member distally, and the firing bar is retracted proximally to engage the pusher plate. A first proximal firing stroke configured as described above. The plurality of successive firing strokes includes a second distal firing stroke wherein the firing bar is configured to advance the pusher plate distally beyond the firing member, and the firing bar approaches the pusher plate and the firing member. A second proximal firing stroke configured to retract in the proximal direction.

  Example 10-The replaceable surgical tool assembly according to Example 9, wherein the firing member is configured to push the sled distally during the first distal firing stroke.

  Example 11-The replaceable surgical tool assembly of Examples 9 or 10, wherein the pusher plate is configured to push the sled distally during the second distal firing stroke.

  Example 12-The pusher plate comprises a leaf spring with an end, the end being connected to the firing member when the pusher plate is retracted proximally during the second proximal firing stroke. 12. The replaceable surgical tool assembly according to example 9, 10, or 11, configured to engage.

  Example 13-The replaceable surgical tool assembly according to Examples 9, 10, 11, or 12, wherein the sled comprises a cutting edge.

  Example 14-Further comprising a staple cartridge removably positioned within a first jaw, wherein the first jaw is configured to receive a cutting edge upon completion of a second distal firing stroke. 14. The replaceable surgical tool assembly according to example 13, comprising a positioning cavity.

  Example 15-The replaceable surgical instrument of Example 9, further comprising a spring configured to laterally bias the pusher plate into engagement with the firing bar during the first proximal firing stroke. Tool assembly.

  Example 16-An exchangeable surgical tool assembly comprising an end effector, wherein the end effector has a first jaw having a proximal end and a second jaw rotatably connected to the first jaw. A replaceable surgical tool assembly comprising: a jaw; The replaceable surgical tool assembly also includes a distal mounting portion fixedly attached to the proximal end and a proximal mounting portion rotatably mounted to the distal mounting portion. The replaceable surgical tool assembly also includes a rotating bearing intermediate the proximal mounting portion and the distal mounting portion, and a rotating shaft extending from the distal mounting portion through the proximal mounting portion, wherein the rotating shaft includes The rotation is configured to rotate the distal mounting portion. The replaceable surgical tool assembly further comprises a flexible spine extending from the proximal mounting portion, the flexible spine comprising a plurality of laterally symmetric vertebrae.

  Example 17-further comprising a firing member configured to translate with a rotating shaft, the firing member configured to cam engage an open and closed cavity in a first jaw; 17. The replaceable surgical tool assembly according to example 16, comprising a second jaw and a second flange configured for cam engagement.

  Example 18-The replaceable surgical tool assembly according to Examples 16 or 17, wherein the rotating shaft comprises a plurality of perforations to allow bending of the rotating shaft within the flexible spine.

  Example 19-The replaceable surgical tool assembly according to Examples 16, 17, or 18, wherein the flexible spine comprises a plurality of intermediately positioned gaps adjacent to the laterally symmetric vertebrae. .

  Example 20-A flexible spine is an articulating head mounted on a proximal mounting portion, the articulating head comprising a pair of mounting tabs, and a pair extending distally to each mounting tab. 20. A replaceable surgical tool assembly according to any of embodiments 16, 17, 18, or 19, comprising:

  Example 21-A surgical instrument comprising a shaft assembly defining a shaft axis, the shaft assembly comprising a proximal articulation defining a first articulation axis transverse to the shaft axis, a shaft axis and a first axis. A distal articulation defining a second articulation axis transverse to the articulation axis. The surgical instrument also includes a drive shaft configured to transmit rotational drive motion from a rotational drive motion source, and a movable anvil. The surgical instrument further comprises a channel configured to operatively support the surgical staple cartridge therein, the channel configured to be removably attached to the shaft assembly. The surgical instrument further comprises a firing member movably supported within the channel and configured to operably interface with the drive shaft when the channel is operatively connected to the shaft assembly, the firing member comprising: Is operably movable between a first proximal position in which the firing member applies an opening motion to the anvil and a closed position in which the firing member applies a closing motion to the anvil.

  Example 22-The surgical instrument of example 21, wherein the channel is configured to be attached to the shaft assembly in a direction of introduction transverse to the shaft axis.

  Example 23-The shaft assembly further comprises a spine member, wherein the proximal articulation is pivotally coupled to the spine member to selectively articulate relative to the spine member about a first articulation axis. A first channel mounting assembly coupled to the first channel mounting assembly for selectively pivoting relative to the first channel mounting assembly about a second articulation axis. 23. The surgical instrument according to example 21 or 22, comprising a second channel mounting member pivotally connected to the channel mounting assembly.

  Example 24-A first articulation system operably interfacing with a first channel mounting assembly to selectively apply a first articulation to a first channel mounting assembly; The surgical instrument of any of embodiments 21, 22 or 23, further comprising: a second articulation system operably interfaced with the second channel mounting member to selectively apply a second articulation. .

  Example 25-A first articulation system comprises a first axially movable articulation actuator operably coupled to a first channel mounting assembly, and the second articulation system comprises a second channel mounting A second endless articulation member operatively interfaced with the member, the second endless articulation member configured to apply a second articulation to the second channel mounting member when the second endless articulation member is rotated. 25. The surgical instrument of embodiment 24, comprising: a second endless articulation member, and means for rotating the second articulation member.

  Example 26-The surgical instrument of example 25, wherein the means for rotating comprises a second axially movable articulation actuator operably interfaced with the second endless articulation member.

  Example 27-Examples 21, 22, 23, 24, 25, or 26 wherein a portion of a channel is configured to be slidably received in a corresponding slot in a second channel mounting member. A surgical instrument according to claim 1.

  Example 28-Examples 21 and 22 wherein a portion of the channel is configured to be slidably inserted into a corresponding slot in the second channel mounting member in an introduction direction transverse to the shaft axis. , 23, 24, 25, 26, or 27.

  Example 29-The surgical instrument of Examples 21, 22, 23, 24, 25, 26, 27, or 28, further comprising means for releasably retaining a portion of the channel in a corresponding slot.

  Example 30-Means for releasably retaining a locked position in which a portion of a channel is retained in a corresponding slot, and a portion of the channel is moved from a corresponding slot in a removal direction opposite to the introduction direction. 30. The surgical instrument of embodiment 29, comprising a locking member selectively axially movable between an unlocked position that is removable.

  Example 31-The surgical instrument of example 30, wherein the locking member is axially movable in a locking direction transverse to the introduction and removal directions.

  Example 32-A surgical instrument, a shaft assembly, a spine member defining a shaft axis, and a spine member selectively articulating relative to the spine member in a first articulation plane. A first channel mounting assembly movably coupled and selectively articulated relative to the first channel mounting assembly in a second articulation plane perpendicular to the first articulation plane. And a second channel mounting member movably connected to the first channel mounting assembly. The surgical instrument also includes a flexible rotary drive shaft and an anvil pivotally connected to the second channel mounting member. The surgical instrument also includes a channel configured to operatively support the surgical staple cartridge therein, such that the channel is removably detachable from the second channel mounting member separately from the anvil. Is configured. A firing instrument movably supported within the channel and configured to operably interface with the flexible rotary drive shaft when the channel is operatively connected to the second channel mounting member. The firing member is further operably movable between a first proximal position in which the firing member applies an opening motion to the anvil and a closed position in which the firing member applies a closing motion to the anvil.

  Example 33-A firing member is moved from a tissue cutting portion and a surgical staple cartridge supported in a channel when the firing member is driven between a first proximal position and an end position in the channel. Means for ejecting surgical staples.

  Example 34-The surgical instrument of examples 32 or 33, wherein the channel is configured to be attached to the second channel mounting member in a direction of introduction transverse to the shaft axis.

  Example 35-A shaft assembly is movably supported on a spine member, a locked position in which the channel is locked to a second channel mounting member, and an unlocked position in which the channel is removable from the second channel mounting member. 35. The surgical instrument of any one of embodiments 32, 33, or 34, further comprising a locking member that is selectively axially movable on and between the spine member.

  Example 36-A surgical instrument comprising a shaft assembly, the shaft assembly comprising a spine assembly and an axially movable firing bar. The surgical instrument also includes a surgical end effector having a channel configured to operatively support the surgical staple cartridge therein, the channel being removably coupled to the spine assembly by a connector assembly. Is configured. The surgical instrument further comprises a firing member supported for axial movement within a surgical staple cartridge supported within the channel. The firing member includes a proximally projecting coupler sized to be removably inserted into a corresponding retaining cavity formed at a distal end of the axially movable firing bar. Prepare. A corresponding retaining cavity is dimensioned with respect to the proximally protruding coupler so as to snap-fit into the proximally protruding coupler when the channel is removably coupled to the spine assembly. Is done.

  Example 37-A connector assembly includes a channel retainer operably coupled to a spine assembly and a distal channel coupler, wherein the distal channel coupler is a pair of inwardly extending, diametrically opposed. 37. The surgical device of embodiment 36, further comprising a mounting pin configured to be axially inserted into a corresponding coupling slot in the channel retainer transverse to the shaft axis. Appliances.

  Example 38-The surgical instrument of examples 36 or 37, wherein the spine assembly comprises a flexible articulation segment movably connected to the channel retainer.

  Example 39-an embodiment wherein the channel retainer is movably coupled to the flexible articulation segment by at least one axially movable articulation bar movably supported by the flexible articulation segment. The surgical instrument according to Example 38.

  Example 40-The surgical instrument of Examples 36, 37, 38, or 39, wherein the axially moving firing bar comprises a plurality of laminated plates.

  Embodiment 41-A surgical end effector, wherein a first jaw, a second jaw rotatably coupled to the first jaw, and a firing member configured to translate during a firing stroke. And the firing member comprises a notch. The surgical end effector further comprises a lockout spring with a hook, the notch being aligned to receive the hook during the firing stroke unless the unfired staple cartridge is positioned in the first jaw. The unfired staple cartridge sled assembly is positioned to deflect the hook out of alignment with the notch.

  Example 42-The surgical end effector of example 41, wherein the lockout spring comprises a leaf spring. The leaf spring includes a proximal portion secured to the first jaw and a distal portion with a hook.

  Example 43-Example 41 wherein the firing member comprises a cutting edge, an intermediate portion supporting the cutting edge, and a lug projecting laterally from the intermediate portion, wherein a notch is defined in the lug. Or a surgical end effector according to 42.

  Example 44-A firing member further includes a first flange configured to cam engage a first jaw, and a second flange configured to cam engage a second jaw. 44. The surgical end effector according to example 41, 42 or 43, comprising:

  Embodiment 45-A lockout spring is configured to prevent the firing member from translating distally beyond the hook unless an unfired staple cartridge is positioned in the first jaw. The surgical end effector according to any one of claims 41, 42, 43, or 44.

  Example 46-A first jaw includes a cartridge support surface, a recess is defined in the cartridge support surface, and the hook is at least partially positioned when an unfired staple cartridge is positioned in the first jaw. 45. The surgical end effector according to any of embodiments 41, 42, 43, 44, or 45, wherein the surgical end effector is biased into the recess.

  Embodiment 47-The lock of any of embodiments 41, 42, 43, 44, 45, or 46, wherein the lockout spring comprises a spring arm supporting the hook, the spring arm being laterally offset from the firing member. Surgical end effector.

  Embodiment 48-The lockout spring includes a second hook, and the firing member receives the second hook during the firing stroke unless an unfired staple cartridge is positioned in the first jaw. The surgical end effector according to any one of embodiments 41, 42, 43, 44, 45, 46, or 47, comprising a second notch aligned with the end effector.

  Embodiment 49-A surgical end effector, wherein a first jaw, a second jaw rotatably coupled to the first jaw, and a firing member configured to translate during a firing stroke. A surgical end effector comprising: The firing member includes a laterally projecting lug and a lock defined within the laterally projecting lug. The surgical end effector further includes a lockout spring with a laterally projecting tab, wherein the lock is configured to move laterally during the firing stroke unless an unfired staple cartridge is positioned in the first jaw. Is positioned to receive the tab projecting therefrom.

  Example 50-The surgical end effector of Example 49, further comprising an unfired staple cartridge with a sled assembly configured to translate distally during the firing stroke.

  Example 51-A lock is configured to translate along a lock path during a firing stroke, and a sled assembly in an unfired staple cartridge deflects a laterally projecting tab away from the lock path. The surgical end effector according to example 50, wherein the surgical end effector is configured as follows.

  Example 52-A first jaw has a cartridge support surface, a recess is defined in the cartridge support surface, and a laterally projecting tab has an unfired staple cartridge positioned within the first jaw. 52. The surgical end effector according to any one of embodiments 49, 50, or 51, which is sometimes deflected into the recess.

  Example 53-The surgical end effector of any one of Examples 49, 50, 51, or 52, wherein the lockout spring comprises a leaf spring. The leaf spring includes a first portion secured to the first jaw, a second portion supporting the laterally projecting tab, and a spring extending intermediate the first portion and the second portion. Arm, wherein the spring arm is laterally offset from the firing member.

  Example 54-The surgical end effector of any one of Examples 49, 50, 51, 52, or 53, wherein the firing member further comprises a support with a cutting edge. The firing member is a first flange extending from the support, the first flange configured to cam engage the first jaw, and a second flange extending from the support. And a second flange configured to cam engage the second jaw.

  Embodiment 55-The firing member further comprises a second laterally projecting lug and a second lock defined within the second laterally projecting lug, wherein the lockout spring comprises a second And the second lock includes a second laterally projecting tab during the firing stroke, unless an unfired staple cartridge is positioned in the first jaw. 55. The surgical end effector according to example 49, 50, 51, 52, 53 or 54, wherein the surgical end effector is positioned to receive.

  Example 56-A surgical end effector comprising a first jaw, a second jaw rotatably coupled to the first jaw, and a lockout configuration. The lockout configuration includes a lock configured to translate along a lock path during a firing stroke, and a lockout spring with an inwardly projecting tab, wherein the lock is such that an unfired staple cartridge is inserted. Unless positioned within one jaw, it is positioned to receive an inwardly projecting tab during the firing stroke.

  Example 57-Further comprising an unfired staple cartridge, wherein the unfired staple cartridge comprises a sled assembly configured to translate in a distal direction during the firing stroke, and wherein the lock is moved during the firing stroke. Embodiment 56. The embodiment of embodiment 56, wherein the sled assembly in the unfired staple cartridge is configured to translate along the locking path and is configured to deflect the inwardly projecting tab away from the locking path. Surgical end effector.

  Example 58-A first jaw has a cartridge support surface, a recess is defined in the cartridge support surface, and an inwardly projecting tab is provided when an unfired staple cartridge is positioned in the first jaw. 58. The surgical end effector according to example 56 or 57, wherein the surgical end effector is biased into the recess.

  Example 59-The surgical end effector of any of Examples 56, 57, or 58, wherein the lockout spring comprises a leaf spring. The leaf spring includes a first portion fixed to the first jaw and a second portion supporting a laterally projecting tab. The leaf spring further comprises a spring arm extending midway between the first and second portions, the spring arm being laterally offset from the firing member.

  Example 60-The surgical end effector of any of Examples 56, 57, 58, or 59, further comprising a firing member, the firing member comprising a support having a cutting edge and a lock. The firing member is a first flange extending from the support, the first flange configured to cam engage the first jaw, and a second flange extending from the support. And a second flange configured to cam engage the second jaw.

  Example 61-A surgical end effector comprising a first jaw, a second jaw having a closed surface and an open surface, and a pivot joint, wherein the second jaw comprises a pivot joint. Wherein the closed surface is positioned distally with respect to the pivot joint and the open surface is positioned proximally with respect to the pivot joint. There is a surgical end effector. The surgical end effector further comprises a firing member configured to move distally during a firing stroke. The firing member includes a first flange positioned to engage the first jaw, and a second flange positioned to engage the second jaw, wherein the second flange is , Configured to engage the closure surface to pivot the second jaw toward the closed position, and wherein the second flange is open to pivot the second jaw toward the open position. It is configured to engage a surface.

  Example 62-A firing member is movable distally from a home position to pivot a second jaw toward a closed position and a firing member moves the second jaw toward an open position. 62. The surgical end effector according to example 61, wherein the surgical end effector is movable proximally from a home position for pivoting.

  Example 63-Example 61 wherein the second jaw has an intermediate surface between the closed surface and the open surface and the second flange is spaced from the intermediate surface when the firing member is in place. Or a surgical end effector according to 62.

  Example 64-The surgical end effector of any of Examples 61, 62, or 63, wherein the firing member further comprises a knife intermediate the first flange and the second flange.

  Example 65-The surgical end effector of any of Examples 61, 62, 63, or 64, wherein the first jaw is configured to receive a staple cartridge.

  Example 66-The surgical end effector of any of Examples 61, 62, 63, 64, or 65, wherein the second jaw comprises a staple forming anvil.

  Example 67-Examples 61, 62, wherein the first jaw comprises a first passage for a first flange and the second jaw comprises a second passage for a second flange. 63. The surgical end effector according to 63, 64, 65 or 66.

  Example 68-Examples 61, 62, 63, 64 further comprising a spring configured to bias the second jaw toward an open position when the firing member is proximal to the home position. , 65, 66, or 67.

  Example 69-A surgical end effector comprising a first jaw, a second jaw having a closed surface and an open surface, and a pivot joint, wherein the second jaw comprises a pivot joint. A surgical end effector configured to pivot with respect to the first jaw. The surgical end effector further comprises a firing member configured to move distally from a home position during a firing stroke. The firing member includes a first flange positioned to engage the first jaw, and a second flange positioned to engage the second jaw, wherein the second flange is Configured to engage the closure surface when the firing member is moved distally from the home position, and wherein the second flange is open when the firing member is moved proximally from the home position. It is configured to engage a surface.

  Example 70-A second flange is configured to engage a closing surface to pivot a second jaw toward a closed position, and the second flange is configured to position the second jaw in an open position. 70. The surgical end effector of embodiment 69 configured to engage an open surface for pivoting toward.

  Example 71-Example 69 wherein the second jaw has an intermediate surface between the closed surface and the open surface and the second flange is spaced from the intermediate surface when the firing member is in place. Or a surgical end effector according to 70.

  Example 72-The surgical end effector of any one of Examples 69, 70, or 71, wherein the firing member further comprises a knife intermediate the first flange and the second flange.

  Example 73-The surgical end effector of any one of Examples 69, 70, 71, or 72, wherein the first jaw is configured to receive a staple cartridge.

  Example 74-The surgical end effector according to any one of Examples 69, 70, 71, 72, or 73, wherein the second jaw comprises an anvil.

  Example 75-Examples 69, 70, wherein the first jaw comprises a first passage for a first flange and the second jaw comprises a second passage for a second flange. 74. The surgical end effector according to 71, 72, 73 or 74.

  Embodiment 76-Embodiments 69, 70, 71, 72, 73, further comprising a spring configured to bias the second jaw away from the first jaw when the firing member is in position. 74. The surgical end effector according to 74 or 75.

  Embodiment 77-A surgical end effector comprising a first jaw, a second jaw comprising first and second cam means, a pivot joint, and a second jaw. Is a surgical end effector configured to pivot with respect to a first jaw at a pivot joint. The surgical end effector further comprises a firing member configured to move distally from a home position during a firing stroke. The firing member includes a first flange positioned to engage the first jaw, and a second flange positioned to engage the second jaw, wherein the second flange is , The firing member is configured to engage the first cam means when moved distally from the home position, and the second flange allows the firing member to be moved proximally from the home position. Sometimes it is configured to engage with the second cam means.

  Embodiment 78-The first cam means is configured to cam drive the second jaw toward a closed position, and the second cam means is configured to cam drive the second jaw toward an open position. The surgical end effector according to example 77, wherein the surgical end effector is configured to:

  Embodiment 79-The first cam means comprises a distal closure ramp extending upwardly from the intermediate plane into the passage in the second jaw, the second cam means extending upwardly from the intermediate plane. 79. The surgical end effector according to example 77 or 78, wherein the surgical end effector comprises an existing proximal closure surface.

  Example 80-The surgical end effector according to example 77, 78 or 79, wherein the home position includes a range of positions.

  Example 81-A surgical end effector wherein a first jaw, a second jaw rotatably connected to the first jaw, and an unfired staple cartridge are positioned within the first jaw. A lockout configuration configured to prevent rotational movement of the second jaw toward the first jaw unless otherwise, wherein the lockout configuration is configured to switch between a locked orientation and an unlocked orientation. A surgical end effector comprising a pivotable lock configured to pivot. The pivotable lock includes a first leg configured to engage the second jaw when the pivotable lock is in the locked orientation, and an unfired staple cartridge within the first jaw. And a second leg configured to engage an unfired staple cartridge when positioned at the second position.

  Example 82-Further comprising a spring with a distal end, the distal end engaged with a pivotable lock, the spring biasing the pivotable lock toward the lock orientation. The surgical end effector according to embodiment 81, wherein the surgical end effector is configured as follows.

  Example 83-The surgical end effector of Example 82, wherein the spring comprises a leaf spring.

  Example 84-The surgical end of Examples 81, 82, or 83, wherein the pivotable lock includes a third leg and the distal end is positioned relative to the third leg. Effector.

  Example 85-A lockout notch is defined in a first jaw and a second leg is at least partially positioned within the lockout notch when the pivotable lock is in the unlocked orientation. The surgical end effector according to any one of Examples 81, 82, 83, or 84.

  Example 86-A first jaw comprises an elongated channel, a second jaw comprises an anvil with an inner rail extending into the elongated channel, and a distal portion of the first leg pivots. 85. The surgical end effector of any of embodiments 81, 82, 83, 84, or 85, wherein the possible lock abuts the inner rail when in a locked orientation.

  Example 87-The surgical end effector of any one of Examples 81, 82, 83, 84, 85, or 86, wherein the lockout configuration comprises a second pivotable lock.

  Embodiment 88-An embodiment further comprising an unfired staple cartridge with a sled assembly, wherein the sled assembly is configured to engage the second leg when the sled assembly is in the pre-fired position. 91. The surgical end effector according to 81, 82, 83, 84, 85, 86 or 87.

  Example 89-A replaceable surgical tool assembly comprising an end effector configured to receive a staple cartridge and a shaft. The shaft includes a firing assembly, the firing assembly including a distal portion, a proximal portion with a notch, and a spring intermediate the proximal and distal portions. The shaft further comprises a lockout lever movable between an unlocked orientation and a locked orientation, the lockout lever extending into the notch when the lockout lever is in the locked orientation, and Displacement of the distal portion is configured to move the lockout lever to the unlocked orientation.

Example 90 further comprising a staple cartridge, the staple cartridge having a proximal end,
90. The replaceable surgical tool assembly of embodiment 89 comprising a longitudinal slot extending distally from the proximal end and a frangible gate extending across the longitudinal slot at the proximal end. . The frangible gate is configured to shift the distal portion of the firing assembly proximally when the staple cartridge is introduced into the end effector.

  Embodiment 91-The replaceable embodiment 89 or 90, wherein the spring is configured to compress between a proximal portion and a distal portion when the staple cartridge is introduced into the end effector. Surgical tool assembly.

  Example 92-Example 89 wherein the distal portion comprises a proximally extending wedge configured to move the lockout lever to the unlocked orientation when the distal portion is shifted proximally. 90. A replaceable surgical tool assembly according to any of claims 90, 91 or 91.

  Example 93-A staple cartridge comprises a cartridge body with a cutout, wherein the frangible gate has a first end pivotally connected to the cartridge body and a second end frictionally fitted to the cutout. 90. A replaceable surgical tool assembly according to any of embodiments 90, 91 or 92, comprising:

  Example 94-The replaceable surgical tool assembly according to any one of Examples 90, 91, 92, or 93, wherein the firing assembly is configured to break the fragile gate during the firing stroke.

  Embodiment 95-The replaceable surgical device of any of embodiments 89, 90, 91, 92, 93, or 94, wherein the shaft further comprises a reset spring configured to bias the lockout lever toward the lock orientation. Tool assembly.

  Example 96-The distal portion of the firing assembly is advanced from a pre-firing proximal position to a distal position during the firing stroke, retracted from the distal position to a post-firing proximal position after the firing stroke, and fired. The replaceable surgical tool assembly of any of embodiments 89, 90, 91, 92, 93, 94, or 95, wherein the posterior proximal position is distal to the pre-firing proximal position.

  Example 97-A surgical end effector, comprising a first jaw and a second jaw rotatably coupled to the first jaw, the second jaw having a locked configuration and an unlocked configuration. A surgical end effector comprising a pin movable between. The surgical end effector further includes a lockout configuration configured to prevent the second jaw from rotating toward the first jaw unless the staple cartridge is positioned within the first jaw. The lockout configuration comprises a lock bar configured to translate from a distal position to a proximal position within the first jaw when the staple cartridge is positioned within the first jaw. Is configured to move the pin to the unlocked configuration when the lock bar moves to the proximal position.

  Example 98-further comprising a spring extending between the first and second jaws, wherein the spring is configured to bias the second jaw toward the first jaw. The surgical end effector according to example 97.

  Example 99-A first jaw has a curved slot, and a pin is configured to move along the curved slot as the second jaw rotates toward the first jaw. 98. The surgical end effector of embodiment 98, wherein the one jaw further comprises a lockout notch extending from the curved slot, and wherein the spring biases the pin into the lockout notch.

  Example 100-The surgical end effector according to examples 97, 98, or 99, wherein the pin comprises a semi-circular perimeter.

  Example 101-A surgical end effector, wherein a first jaw, a second jaw, and a firing member configured to translate with respect to the first and second jaws during a firing stroke. A surgical end effector comprising: The firing member includes a support portion having a slot and a first flange extending from the support portion, the first flange configured to engage the first jaw during a firing stroke. ing. The firing member further comprises a second flange positioned within the slot, the second flange configured to engage a second jaw during a firing stroke, and the second flange has a threshold. It is configured to move away from the first flange within the slot when a force is applied to the second flange.

  Example 102-The surgical end effector of Example 101, wherein the slot comprises a wedge-shaped slot.

  Example 103-The surgical end effector of Examples 101 or 102, wherein the slot has a proximal end and a distal end, and the second flange is frictionally fitted to the distal end of the slot.

  Example 104-The surgical end effector of example 103, wherein the threshold force is configured to overcome friction securing the second flange to the distal end.

  Example 105-Slot includes a shaped upper edge and second flange slides along the shaped upper edge when a threshold force is applied to second flange 104. The surgical end effector according to any of embodiments 101, 102, 103, or 104, configured as follows.

  Example 106-The surgical end effector according to any one of Examples 101, 102, 103, 104, or 105, wherein the second flange comprises a groove aligned with the slot.

  Example 107-The surgical end effector according to any one of Examples 101, 102, 103, 104, 105, or 106, wherein the firing member further comprises a guide secured to the second flange.

  Example 108-The surgical end effector of any of Examples 101, 102, 103, 104, 105, 106, or 107, wherein the second jaw is rotatably connected to the first jaw.

  Example 109-A surgical end effector, wherein a first jaw, a second jaw, and a firing member configured to translate relative to the first and second jaws during a firing stroke. A surgical end effector comprising: The firing member includes a fixed flange configured to engage the first jaw during the firing stroke, a floating flange configured to engage the second jaw during the firing stroke, and a floating flange. And a spring configured to bias the spring toward the first position.

  Example 110. The surgical procedure of Example 109, wherein the slot is defined in the firing member and the floating flange is configured to slide along the slot when a threshold force is applied to the floating flange. End effector.

Example 111-The slot has a proximal end and a distal end, the distal end being closer to the fixed flange as compared to the proximal end;
Embodiment 110. The surgical end effector of embodiment 110, comprising: a top edge extending from a proximal end to a distal end.

  Example 112-The surgical end effector of Example 111, wherein the first location is adjacent a distal end.

  Example 113-The surgical end effector of Examples 111 or 112, wherein the spring comprises a coil spring extending between the floating flange and the proximal end of the slot.

  Example 114-The surgical end effector of any of Examples 110, 111, 112, or 113, wherein the floating flange comprises a groove aligned with the slot.

  Example 115-The surgical end effector of any of Examples 109, 110, 111, 112, 113, or 114, wherein the firing member further comprises a guide.

  Example 116-A surgical end effector, wherein a first jaw, a second jaw, and a firing member configured to translate relative to the first jaw and the second jaw during a firing stroke. A surgical end effector comprising: The firing member includes a fixed flange configured to engage the first jaw during a firing stroke, and a flexible portion with a floating flange, wherein the floating flange includes a second jaw during the firing stroke. It is configured to engage with.

  Example 117-The surgical end effector of Example 116, wherein the flexible portion is comprised of Nitinol.

  Example 118-The surgical end effector of Examples 116 or 117, wherein the cutout is defined in the firing member and the flexible portion is embedded in the cutout.

  Example 119-The surgical end effector of Example 118, wherein the cutout comprises a lower portion and the flexible portion comprises a leg positioned within the lower portion.

  Example 120-The surgical procedure of Examples 116, 117, 118, or 119, wherein the floating flange is configured to move away from the fixed flange when a threshold force is applied to the floating flange. End effector.

  Although many of the surgical instrument systems described herein operate with electric motors, the surgical instrument systems described herein can operate in any suitable manner. In various cases, the surgical instrument systems described herein can operate, for example, with a manually operated trigger. In certain examples, the motors disclosed herein may include portions of a robot control system. Further, any of the end effector and / or tool assemblies disclosed herein can be utilized with a robotic surgical instrument system. For example, U.S. patent application Ser. No. 13 / 118,241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTABLE STAPLE DEPLOYMENT ARRANGEMENTS" (now U.S. Pat. No. 9,072,535), describes some robotic surgical instrument systems. Examples are disclosed in more detail.

  Although the surgical instrument systems described herein have been described in connection with staple deployment and deformation, the embodiments described herein are not so limited. Various embodiments are envisioned for deploying fasteners other than staples, such as clamps or tacks. Furthermore, various embodiments are envisioned 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, an end effector according to certain embodiments can apply vibrational energy to seal tissue.

The entire disclosure below is incorporated herein by reference.
U.S. Pat. No. 5,403,312, issued Apr. 4, 1995, entitled "Electrosurgical Hemostatic Device",
U.S. Patent No. 7,000,818, issued February 21, 2006, entitled "SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTING CLOSING AND FIRING SYSTEMS,"
U.S. Patent No. 7,422,139, issued September 9, 2008, titled "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK";
U.S. Pat. No. 7,464,849 issued on Dec. 16, 2008, entitled "Electro-Mechanical Surgical Installation with Close System and Anvil Aliment Components",
U.S. Pat. No. 7,670,334, issued Mar. 2, 2010, entitled "SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR",
U.S. Pat. No. 7,753,245 issued Jul. 13, 2010, entitled "SURGICAL STAPLING INSTRUMENTS",
U.S. Patent No. 8,393,514 issued March 12, 2013, titled "SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE",
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  Although various instruments have been described herein with particular embodiments, modifications and changes may be made to those embodiments. Certain features, structures, or characteristics may be combined in one or more embodiments in any suitable manner. Thus, a particular feature, structure, or characteristic illustrated or described in connection with one embodiment, without limitation, may be combined, in whole or in part, with one or more other embodiments of the feature, structure, or feature. May be combined. Also, while materials are disclosed with respect to particular components, other materials may be used. Further, according to various embodiments, a single component may be replaced with multiple components to perform a given function (s), and multiple components may be replaced with a single component. It may be replaced. 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 either case, the device may be reconditioned for reuse after at least one use. Reconditioning can include, but is not limited to, any combination of the steps of disassembly of the device, subsequent cleaning or replacement of certain parts of the device, and subsequent reassembly of the device. Specifically, the reconditioning facility and / or surgical team can disassemble the device, clean and / or replace certain parts of the device, and then reassemble the device for future use. Can be. Those skilled in the art will appreciate that reconditioning of a device may utilize various techniques for disassembly, cleaning / replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present invention.

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

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

  All patents, publications, or other disclosures that are incorporated by reference in their entirety or in part herein are subject to the existing definitions, descriptions, or other disclosures in which the materials incorporated are described in this disclosure. It shall be incorporated herein only to the extent not inconsistent with the content. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting description incorporated herein by reference. Any references, or portions thereof, which are incorporated herein by reference, but which conflict with existing definitions, descriptions, or other disclosures set forth herein, or portions thereof, It shall be incorporated only to the extent that there is no inconsistency with the disclosure.

(Embodiment)
(1) An exchangeable surgical tool assembly,
An end effector having a thread and a cutting edge;
A firing bar operably configured to fire the sled and the cutting edge, the firing bar including a distal engagement portion, wherein the firing bar includes a second distal end and a second distal end. A firing bar movable to a proximal position and to a second distal position;
A pusher assembly,
A plate comprising a proximal engagement portion, wherein the proximal engagement portion is selectively coupled to the distal engagement portion;
When the firing bar is being moved from the first distal position to the second proximal position, the proximal engagement portion is laterally biased to engage the distal engagement portion. A replaceable surgical tool assembly comprising: a pusher assembly comprising: a spring configured to mate.
(2) further comprising a firing member, wherein the firing bar pushes the firing member in a distal direction when the firing bar moves from the first proximal position to the first distal position. The replaceable surgical tool assembly according to embodiment 1, wherein the surgical tool assembly is configured.
(3) The firing member includes:
A first flange configured to engage a first jaw of the end effector;
A second flange configured to engage a second jaw of the end effector;
A support portion extending between the first flange and the second flange, wherein a notch is defined in the support portion, and wherein the plate is configured such that the firing bar extends from the second proximal position; Embodiment 3. The replaceable embodiment according to embodiment 2, comprising a support portion configured to slide distally through the notch when being moved to the second distal position. Surgical tool assembly.
The plate of claim 3, wherein the plate comprises a spring-loaded fastener configured to engage the support portion when the plate is retracted proximally by the firing bar. Replaceable surgical tool assembly.
The replaceable surgical tool assembly according to claim 1, wherein the first proximal position is distal to the second proximal position.

6. The replaceable surgical tool assembly according to claim 1, wherein the first distal position is proximal to the second distal position.
7. The replaceable surgical tool assembly according to claim 1, wherein the cutting edge is formed integrally with the thread.
The replaceable surgical tool assembly according to claim 1, wherein the proximal engagement portion comprises a T-shaped slot and the distal engagement portion comprises a key.
(9) An exchangeable surgical tool assembly,
An end effector,
The first Joe,
A second jaw rotatably connected to the first jaw;
An end effector comprising: a thread configured to translate with respect to the first jaw and the second jaw;
A firing member,
A first flange configured to engage the first jaw;
A firing member, comprising: a second flange configured to engage the second jaw;
A pusher plate,
A firing bar selectively coupled to the pusher plate, wherein the firing bar is configured to move over a plurality of consecutive firing strokes, the plurality of consecutive firing strokes comprising:
A first distal firing stroke, wherein the firing bar is configured to push the firing member in a distal direction;
A first proximal firing stroke, wherein the firing bar is retracted proximally to engage the pusher plate;
A second distal firing stroke wherein the firing bar is configured to advance the pusher plate distally beyond the firing member;
A firing bar, wherein the firing bar comprises a second proximal firing stroke configured to retract the pusher plate and the firing member in a proximal direction.
The replaceable surgical tool assembly according to claim 9, wherein the firing member is configured to push the sled distally during the first distal firing stroke.

11. The replaceable surgical tool assembly according to claim 10, wherein the pusher plate is configured to push the sled distally during the second distal firing stroke.
(12) the pusher plate includes a leaf spring having an end, wherein the end is configured to retract when the pusher plate is retracted proximally during the second proximal firing stroke; 12. The replaceable surgical tool assembly according to embodiment 11, wherein the replaceable surgical tool assembly is configured to engage a firing member.
13. The replaceable surgical tool assembly according to claim 9, wherein the thread comprises a cutting edge.
(14) further comprising a staple cartridge removably positioned within the first jaw, the first jaw configured to receive the cutting edge upon completion of the second distal firing stroke. 14. The replaceable surgical tool assembly according to embodiment 13, comprising a shaped distal cavity.
15. The replaceable of claim 9, further comprising a spring configured to bias the pusher plate laterally into engagement with the firing bar during the first proximal firing stroke. Surgical tool assembly.

(16) An exchangeable surgical tool assembly,
An end effector,
A first jaw having a proximal end;
An end effector, comprising: a second jaw rotatably connected to the first jaw;
A distal mounting portion fixedly attached to the proximal end;
A proximal mounting portion rotatably attached to the distal mounting portion;
A rotary bearing intermediate the proximal mounting portion and the distal mounting portion;
A rotating shaft extending from the distal mounting portion through the proximal mounting portion, wherein rotation of the rotating shaft is configured to rotate the distal mounting portion;
A flexible spine extending from the proximal mounting portion, the flexible spine comprising a plurality of laterally symmetric vertebrae.
(17) further comprising a firing member configured to translate with the rotating shaft, wherein the firing member comprises:
A first flange configured for cam engagement with an open and closed cavity in the first jaw;
17. The replaceable surgical tool assembly according to embodiment 16, comprising a second flange configured for cam engagement with the second jaw.
The replaceable surgical tool assembly according to claim 16, wherein the rotating shaft comprises a plurality of perforations to allow bending of the rotating shaft within the flexible spine.
19. The replaceable surgical tool assembly according to claim 16, wherein the flexible spine comprises a plurality of intervening gaps adjacent the laterally symmetric vertebrae.
(20) The flexible spine includes:
An articulating head mounted on the proximal mounting portion, the articulating head comprising a pair of mounting tabs;
17. A replaceable surgical tool assembly according to embodiment 16, comprising: a pair of flexible mounting bands extending distally to each of the mounting tabs.

Claims (20)

An interchangeable surgical tool assembly, comprising:
An end effector having a thread and a cutting edge;
A firing bar operably configured to fire the sled and the cutting edge, the firing bar including a distal engagement portion, wherein the firing bar includes a second distal end and a second distal end. A firing bar movable to a proximal position and to a second distal position;
A pusher assembly,
A plate comprising a proximal engagement portion, wherein the proximal engagement portion is selectively coupled to the distal engagement portion;
When the firing bar is being moved from the first distal position to the second proximal position, the proximal engagement portion is laterally biased to engage the distal engagement portion. A replaceable surgical tool assembly comprising: a pusher assembly comprising: a spring configured to mate.   A firing member, wherein the firing bar is configured to push the firing member in a distal direction as the firing bar moves from the first proximal position to the first distal position. The replaceable surgical tool assembly according to claim 1, wherein The firing member,
A first flange configured to engage a first jaw of the end effector;
A second flange configured to engage a second jaw of the end effector;
A support portion extending between the first flange and the second flange, wherein a notch is defined in the support portion, and wherein the plate is configured such that the firing bar extends from the second proximal position; The support portion configured to slide distally through the notch when being moved to the second distal position. Surgical tool assembly.   The replaceable of claim 3, wherein the plate comprises a spring-loaded fastener configured to engage the support portion when the plate is retracted proximally by the firing bar. Surgical tool assembly.   The replaceable surgical tool assembly according to claim 1, wherein the first proximal position is distal to the second proximal position.   The replaceable surgical tool assembly according to claim 1, wherein the first distal position is proximal to the second distal position.   The replaceable surgical tool assembly according to claim 1, wherein the cutting edge is integrally formed with the thread.   The replaceable surgical tool assembly according to claim 1, wherein the proximal engaging portion comprises a T-shaped slot and the distal engaging portion comprises a key. An interchangeable surgical tool assembly, comprising:
An end effector,
The first Joe,
A second jaw rotatably connected to the first jaw;
An end effector comprising: a thread configured to translate with respect to the first jaw and the second jaw;
A firing member,
A first flange configured to engage the first jaw;
A firing member, comprising: a second flange configured to engage the second jaw;
A pusher plate,
A firing bar selectively coupled to the pusher plate, wherein the firing bar is configured to move over a plurality of consecutive firing strokes, the plurality of consecutive firing strokes comprising:
A first distal firing stroke, wherein the firing bar is configured to push the firing member in a distal direction;
A first proximal firing stroke, wherein the firing bar is retracted proximally to engage the pusher plate;
A second distal firing stroke wherein the firing bar is configured to advance the pusher plate distally beyond the firing member;
A firing bar, wherein the firing bar comprises a second proximal firing stroke configured to retract the pusher plate and the firing member in a proximal direction.   The replaceable surgical tool assembly according to claim 9, wherein the firing member is configured to push the sled distally during the first distal firing stroke.   The replaceable surgical tool assembly according to claim 10, wherein the pusher plate is configured to push the sled distally during the second distal firing stroke.   The pusher plate includes a leaf spring having an end, wherein the end is configured to be coupled to the firing member when the pusher plate is retracted proximally during the second proximal firing stroke. The replaceable surgical tool assembly according to claim 11, wherein the replaceable surgical tool assembly is configured to engage.   The replaceable surgical tool assembly according to claim 9, wherein the sled comprises a cutting edge.   A staple cartridge removably positioned within the first jaw, wherein the first jaw is configured to receive the cutting edge upon completion of the second distal firing stroke. The replaceable surgical tool assembly according to claim 13, comprising a positioning cavity.   The replaceable surgical tool according to claim 9, further comprising a spring configured to laterally bias the pusher plate into engagement with the firing bar during the first proximal firing stroke. assembly. An interchangeable surgical tool assembly, comprising:
An end effector,
A first jaw having a proximal end;
An end effector, comprising: a second jaw rotatably connected to the first jaw;
A distal mounting portion fixedly attached to the proximal end;
A proximal mounting portion rotatably attached to the distal mounting portion;
A rotary bearing intermediate the proximal mounting portion and the distal mounting portion;
A rotating shaft extending from the distal mounting portion through the proximal mounting portion, wherein rotation of the rotating shaft is configured to rotate the distal mounting portion;
A flexible spine extending from the proximal mounting portion, the flexible spine comprising a plurality of laterally symmetric vertebrae. A firing member configured to translate with the rotating shaft, wherein the firing member comprises:
A first flange configured for cam engagement with an open and closed cavity in the first jaw;
17. The replaceable surgical tool assembly according to claim 16, comprising a second flange configured for cam engagement with the second jaw.   17. The replaceable surgical tool assembly according to claim 16, wherein the rotating shaft comprises a plurality of perforations to allow bending of the rotating shaft within the flexible spine.   17. The replaceable surgical tool assembly according to claim 16, wherein the flexible spine comprises a plurality of gaps intermediately positioned adjacent the laterally symmetric vertebrae. The flexible spine is
An articulating head mounted on the proximal mounting portion, the articulating head comprising a pair of mounting tabs;
17. The replaceable surgical tool assembly of claim 16, comprising: a pair of flexible mounting bands extending distally to each of the mounting tabs.

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