JP2021049430A - 外科手術ステープラーのための射出アセンブリ - Google Patents
外科手術ステープラーのための射出アセンブリ Download PDFInfo
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Abstract
【課題】エンドエフェクターを提供すること。【解決手段】本発明は、エンドエフェクターであって、エンドエフェクターは、互いに対して移動可能である第１の顎および第２の顎と、第１の顎内に配置され、長手方向軸を規定する駆動ねじと、親ねじナットであって、親ねじナットは、駆動ねじが第１の方向に回転させられる場合、駆動ねじに沿って前進させられ、駆動ねじが第１の方向と反対の第２の方向に回転させられる場合、駆動ねじに沿って後退させられる、親ねじナットと、駆動梁であって、駆動梁は、親ねじナットが第１の前進位置に向かって前進させられる場合、親ねじナットによって引っ張られ、駆動梁は、親ねじナットが第１の前進位置まで前進させられると、親ねじナットから切り離され、その結果、親ねじナットは、第１の前進位置から第２の前進位置に、駆動梁に対して前進させられる、駆動梁とを含む、エンドエフェクターを提供する。【選択図】なし
Description
背景
技術分野
本開示は、内視鏡外科手術手順を実施するための外科手術の装置、デバイスおよび／またはシステム、ならびにその使用方法に関する。より詳しくは、本開示は、組織を締め付け、切断し、および／またはステープル留めするための、取り外し可能な使い捨てローディングユニットおよび／または単回使用ローディングユニットとの使用のために構成されている電気機械式のハンドヘルドの外科手術装置、デバイスおよび／またはシステムに関する。
技術分野
本開示は、内視鏡外科手術手順を実施するための外科手術の装置、デバイスおよび／またはシステム、ならびにその使用方法に関する。より詳しくは、本開示は、組織を締め付け、切断し、および／またはステープル留めするための、取り外し可能な使い捨てローディングユニットおよび／または単回使用ローディングユニットとの使用のために構成されている電気機械式のハンドヘルドの外科手術装置、デバイスおよび／またはシステムに関する。
関連技術の説明
多くの外科手術デバイス製造業者が、電気機械式外科手術デバイスを動作させるため、および／または操作するための自社の駆動システムを備えている製品種目を開発している。いくつかの電気機械式外科手術デバイスは、再使用可能なハンドルアセンブリ、ならびに交換可能なローディングユニットおよび／または単回使用ローディングユニットなどを含み、交換可能なローディングユニットおよび／または単回使用ローディングユニットなどは、使用前にハンドルアセンブリに選択的に接続され、次に、処分されるために、またはいくつかの例において、再使用のために滅菌されるために、使用後にハンドルアセンブリから接続解除される。
多くの外科手術デバイス製造業者が、電気機械式外科手術デバイスを動作させるため、および／または操作するための自社の駆動システムを備えている製品種目を開発している。いくつかの電気機械式外科手術デバイスは、再使用可能なハンドルアセンブリ、ならびに交換可能なローディングユニットおよび／または単回使用ローディングユニットなどを含み、交換可能なローディングユニットおよび／または単回使用ローディングユニットなどは、使用前にハンドルアセンブリに選択的に接続され、次に、処分されるために、またはいくつかの例において、再使用のために滅菌されるために、使用後にハンドルアセンブリから接続解除される。
これらの電気機械式外科手術デバイスの多くは、製造すること、購入すること、および／または動作させることが比較的高価である。製造すること、購入すること、および／または動作させることが比較的安価である電気機械式外科手術デバイスを開発することが、製造業者およびエンドユーザーによって望まれている。
従って、開発および製造、貯蔵および輸送が比較的経済的であり、そしてエンドユーザーの観点からは購入および使用が経済的かつ簡便である、電気機械式外科手術の装置、デバイスおよび／またはシステムが必要とされている。
概要
本開示の局面において、エンドエフェクターは、互いに対して移動可能である第１の顎部材および第２の顎部材と、駆動ねじと、親ねじナットと、駆動梁とを含む。駆動ねじは、第１の顎内に配置され、長手方向軸を規定する。親ねじナットは、ねじ切りされたボアを規定し、このねじ切りされたボアは、それを通して駆動ねじを受け取る。親ねじナットは、駆動ねじが第１の方向に回転させられる場合、駆動ねじに沿って前進させられ、駆動ねじが第１の方向と反対である第２の方向に回転する場合、駆動ねじに沿って後退させられる。駆動梁は、親ねじナットが後退位置にある場合、親ねじナットに解放可能に結合される。親ねじナットが第１の前進位置に向かって前進させられる場合、駆動梁は、親ねじナットによって引っ張られる。親ねじナットが第１の前進位置まで前進させられると、駆動梁は、親ねじナットから切り離され、その結果、親ねじナットは、第１の前進位置から第２の前進位置に、駆動梁に対して前進させられる。駆動梁は、通路を規定し得、この通路は、この通路を通して駆動ねじを受け取る。
本開示の局面において、エンドエフェクターは、互いに対して移動可能である第１の顎部材および第２の顎部材と、駆動ねじと、親ねじナットと、駆動梁とを含む。駆動ねじは、第１の顎内に配置され、長手方向軸を規定する。親ねじナットは、ねじ切りされたボアを規定し、このねじ切りされたボアは、それを通して駆動ねじを受け取る。親ねじナットは、駆動ねじが第１の方向に回転させられる場合、駆動ねじに沿って前進させられ、駆動ねじが第１の方向と反対である第２の方向に回転する場合、駆動ねじに沿って後退させられる。駆動梁は、親ねじナットが後退位置にある場合、親ねじナットに解放可能に結合される。親ねじナットが第１の前進位置に向かって前進させられる場合、駆動梁は、親ねじナットによって引っ張られる。親ねじナットが第１の前進位置まで前進させられると、駆動梁は、親ねじナットから切り離され、その結果、親ねじナットは、第１の前進位置から第２の前進位置に、駆動梁に対して前進させられる。駆動梁は、通路を規定し得、この通路は、この通路を通して駆動ねじを受け取る。
複数の局面において、エンドエフェクターは、そりを含み得、このそりは、チャネルを規定し、このチャネルは、駆動ねじを受け取り、そりを駆動ねじに沿って導くように構成されている。親ねじは、後退位置において、そりから間隔が空けられ、そりに対して近位に位置決めされている。親ねじナットは、第１の前進位置においてそりの近位表面を係合し得る。親ねじナットは、親ねじナットが第１の前進位置から第２の前進位置に向かって前進させられる場合、そりを遠位方向に押し得る。
いくつかの局面において、第１の顎は、カートリッジアセンブリを含み得、このカートリッジアセンブリは、その中に配置されているステープルを含む。親ねじナットが第１の前進位置から第２の前進位置に向かって前進させられる場合、そりは、ステープルをカートリッジアセンブリ内から第２の顎に向かって射出し得る。カートリッジアセンブリは、ステープルの各々と関連付けられているステープルプッシャーを含み得、そりは、ステープルプッシャーを連続して係合することにより、ステープルをカートリッジアセンブリ内から射出する。そりを押した後、親ねじナットが、第１の前進位置に後退させられる場合、そりは、第１の前進位置と第２の前進位置との間の位置において静止したままであり得る。親ねじナットが第１の前進位置から後退位置に向かって後退させられる場合、親ねじナットは、駆動梁を後退位置に向かって押し、駆動梁に結合する。
特定の局面において、エンドエフェクターは、ラッチを含み、このラッチは、近位端と遠位端とを有する細長い部分を有する。細長い部分の近位端は、駆動梁に旋回可能に結合されており、細長い部分の遠位端は、ブリッジを含む。ブリッジは、親ねじナットが後退位置にある場合、親ねじナットによって規定される切欠き内に受け取られることにより、駆動梁を親ねじナットに結合し得る。親ねじナットが第１の前進位置へ前進させられると、ブリッジは、切欠きの外に持ち上げられて、駆動梁を親ねじナットから切り離され得る。親ねじナットが第１の前進位置から後退位置に向かって後退させられる場合、ブリッジは、切欠きの中に下げられて、駆動梁を親ねじナットに結合し得る。
特定の局面において、エンドエフェクターは、カム部材を含み、このカム部材は、駆動ねじに隣接して位置決めされ、カムスロットを規定する。カムスロットは、駆動ねじの長手方向軸と平行である第１の部分と、駆動ねじの長手方向軸に対して駆動ねじの長手方向軸から離れるある角度で、第１の部分から遠位方向に延びている第２の部分とを有し得る。細長い部分の遠位端は、ピンを含み得、このピンは、カムスロットの中にスライド可能に受け取られている。ブリッジは、ピンがカムスロットの第１の部分の中にある場合、切欠きの中に受け取られ得、ブリッジは、ピンがカムスロットの第２の部分に沿って遠位方向にスライドする場合、切欠きの外に持ち上げられ得る。
本開示の別の局面において、外科手術器具は、ハンドルと、ハンドルから延びているシャフトと、シャフトの遠位端において支持されているエンドエフェクターとを含む。エンドエフェクターは、本明細書中に開示されるエンドエフェクターのうちの任意のものであり得る。
本開示のさらに別の局面において、ステープルをカートリッジアセンブリから射出する方法は、エンドエフェクターを提供することと、カートリッジアセンブリを第１の顎に結合すること、親ねじナットを第１の前進位置に向かって前進させることと、親ねじナットを第１の前進位置から前進させることとを含む。エンドエフェクターは、本明細書中に開示されるエンドエフェクターのうちの任意のものであり得る。親ねじナットを第１の前進位置に向かって前進させることは、駆動ねじを第１の方向に回転させることによって達成される。駆動梁は、親ねじナットが第１の前進位置に向かって前進させられる場合、親ねじナットによって引っ張られる。駆動梁は、親ねじナットが第１の前進位置に到達すると、親ねじナットから切り離される。親ねじナットが第１の位置から前進させられる場合、駆動梁は、静止したままであり、親ねじナットは、カートリッジアセンブリを通してそりを押すことにより、ステープルを連続して射出する。
複数の局面において、上記方法は、駆動ねじを第１の方向と反対の第２の方向に回転させることによって親ねじナットを第２の前進位置から第１の前進位置に向かって後退させることを含む。そりは、親ねじナットが後退させられる場合、静止したままである。上記方法は、親ねじナットを第１の前進位置から後退位置に向かって後退させることを含み得る。駆動梁は、親ねじナットが第１の前進位置から後退させられる場合、親ねじナットに結合する。
いくつかの局面において、駆動梁は、駆動梁と動作可能に関連付けられているラッチのブリッジを親ねじナットによって規定される切欠きの外に持ち上げることによって、親ねじナットから切り離される。
特定の局面において、駆動梁は、駆動梁と動作可能に関連付けられているラッチのブリッジを親ねじナットによって規定される切欠きの中に下げることによって、親ねじナットに結合する。
さらに、本明細書中に記載される局面のうちの任意のものは、一貫した程度まで、本明細書中に記載される他の局面のうちの任意のものまたは全てとともに使用され得る。
本発明は、例えば以下の項目を提供する。
（項目１）
エンドエフェクターであって、該エンドエフェクターは、
互いに対して移動可能である第１の顎および第２の顎と、
該第１の顎内に配置され、長手方向軸を規定する駆動ねじと、
親ねじナットであって、該親ねじナットは、ねじ切りされたボアを規定し、該ねじ切りされたボアは、該駆動ねじを受け取り、該親ねじナットは、該駆動ねじが第１の方向に回転させられる場合、該駆動ねじに沿って前進させられ、該駆動ねじが該第１の方向と反対の第２の方向に回転させられる場合、該駆動ねじに沿って後退させられる、親ねじナットと、
駆動梁であって、該駆動梁は、該親ねじナットが後退位置にある場合、該親ねじナットに解放可能に結合され、該駆動梁は、該親ねじナットが第１の前進位置に向かって前進させられる場合、該親ねじナットによって引っ張られ、該駆動梁は、該親ねじナットが該第１の前進位置まで前進させられると、該親ねじナットから切り離され、その結果、該親ねじナットは、該第１の前進位置から第２の前進位置に、該駆動梁に対して前進させられる、駆動梁と
を含む、エンドエフェクター。
（項目２）
上記駆動梁は、通路を規定し、該通路は、該通路を通して上記駆動ねじを受け取る、上記項目に記載のエンドエフェクター。
（項目３）
そりをさらに含み、該そりは、チャネルを規定し、該チャネルは、上記駆動ねじを受け取り、該そりを該駆動ねじに沿って導くように構成されている、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目４）
上記親ねじナットは、上記後退位置において、上記そりから間隔が空けられ、該そりに対して近位に位置決めされている、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目５）
上記親ねじナットは、上記第１の前進位置において上記そりの近位表面を係合し、該親ねじナットは、該親ねじナットが該第１の前進位置から上記第２の前進位置に向かって前進させられる場合、該そりを遠位方向に押す、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目６）
上記第１の顎は、カートリッジアセンブリを含み、該カートリッジアセンブリは、その中に配置されているステープルを含み、上記親ねじナットが上記第１の前進位置から上記第２の前進位置に向かって前進させられる場合、上記そりは、該ステープルを該カートリッジアセンブリ内から上記第２の顎に向かって射出する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目７）
上記カートリッジアセンブリは、上記ステープルの各々と関連付けられているステープルプッシャーを含み、上記そりは、該ステープルプッシャーを連続して係合することにより、該ステープルを該カートリッジアセンブリ内から射出する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目８）
上記親ねじナットが、上記そりを押した後、上記第１の前進位置に後退させられる場合、該そりは、該第１の前進位置と上記第２の前進位置との間の位置において静止したままである、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目９）
上記親ねじナットが上記第１の前進位置から上記後退位置に向かって後退させられる場合、該親ねじナットは、上記駆動梁を該後退位置に向かって押し、該駆動梁に結合する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１０）
ラッチをさらに含み、該ラッチは、細長い部分を含み、該細長い部分は、近位端と遠位端とを有し、該細長い部分の該近位端は、上記駆動梁に旋回可能に結合されており、該細長い部分の該遠位端は、ブリッジを含み、該ブリッジは、上記親ねじナットが上記後退位置にある場合、該親ねじナットによって規定される切欠き内に受け取られることにより、該駆動梁を該親ねじナットに結合する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１１）
上記親ねじナットが上記第１の前進位置へ前進させられると、上記ブリッジは、上記切欠きの外に持ち上げられて、上記駆動梁を該親ねじナットから切り離される、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１２）
上記親ねじナットが上記第１の前進位置から上記後退位置に向かって後退させられる場合、上記ブリッジは、上記切欠きの中に下げられて、上記駆動梁を該親ねじナットに結合する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１３）
カム部材をさらに含み、該カム部材は、上記駆動ねじに隣接して位置決めされ、カムスロットを規定し、該カムスロットは、該駆動ねじの上記長手方向軸と平行である第１の部分と、該駆動ねじの該長手方向軸に対して該駆動ねじの該長手方向軸から離れるある角度で、該第１の部分から遠位方向に延びている第２の部分とを有し、上記細長い部分の上記遠位端は、ピンを含み、該ピンは、該カムスロットの中にスライド可能に受け取られている、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１４）
上記ブリッジは、上記ピンが上記カムスロットの上記第１の部分の中にある場合、上記切欠きの中に受け取られており、上記ブリッジは、該ピンが該カムスロットの上記第２の部分に沿って遠位方向にスライドする場合、該切欠きの外に持ち上げられる、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１５）
外科手術器具であって、該外科手術器具は、
ハンドルと、
該ハンドルから遠位方向に延びているシャフトと、
該シャフトの遠位端において支持されているエンドエフェクターと
を含み、該エンドエフェクターは、
互いに対して移動可能である第１の顎および第２の顎と、
長手方向軸を規定し、該第１の顎内に配置されている駆動ねじと、
親ねじナットであって、該親ねじナットは、ねじ切りされたボアを規定し、該ねじ切りされたボアは、該駆動ねじを受け取り、該親ねじナットは、該駆動ねじが第１の方向に回転させられる場合、該駆動ねじに沿って前進させられ、該駆動ねじが該第１の方向と反対の第２の方向に回転させられる場合、該駆動ねじに沿って後退させられる、親ねじナットと、
駆動梁であって、該駆動梁は、該親ねじナットが後退位置にある場合、該親ねじナットに解放可能に結合され、該駆動梁は、該親ねじナットが第１の前進位置に向かって前進させられる場合、該親ねじナットによって引っ張られ、該駆動梁は、該親ねじナットが該第１の前進位置まで前進させられると、該親ねじナットから切り離され、その結果、該親ねじナットは、該第１の前進位置から第２の前進位置に、該駆動梁に対して前進させられる、駆動梁と
を含む、外科手術器具。
（項目１６）
エンドエフェクターであって、該エンドエフェクターは、
第１の顎と、
該第１の顎内に配置され、長手方向軸を規定する駆動ねじと、
親ねじナットであって、該親ねじナットは、ねじ切りされたボアを規定し、該ねじ切りされたボアは、該駆動ねじを受け取る、親ねじナットと、
後退位置において、該親ねじナットに解放可能に結合されている駆動梁と、
該第１の顎に解放可能に結合されているカートリッジアセンブリであって、該カートリッジアセンブリは、ステープルを含む、カートリッジアセンブリと
を含み、該駆動ねじを第１の方向に回転させることによって該親ねじナットが第１の前進位置に向かって前進させられる場合、該駆動梁は、該親ねじナットによって引っ張られ、該駆動梁は、該親ねじナットが該第１の前進位置に到達すると、該親ねじナットから切り離され、
該駆動梁は、該親ねじナットが該第１の前進位置から第２の前進位置に向かって前進させられる場合、静止したままであり、該親ねじナットは、該カートリッジアセンブリを通して該そりを押すことにより、該ステープルを連続して射出する、エンドエフェクター。
（項目１７）
上記駆動ねじを上記第１の方向と反対の第２の方向に回転させることによって上記親ねじナットが上記第２の前進位置から上記第１の前進位置に向かって後退させられる場合、上記そりは、静止したままである、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１８）
上記親ねじナットは、上記第１の前進位置から後退位置に向かって後退させられ、上記駆動梁は、該親ねじナットが該第１の前進位置から後退させられる場合、該親ねじナットに結合する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１９）
上記駆動梁は、該駆動梁と動作可能に関連付けられているラッチのブリッジを上記親ねじナットによって規定される切欠きの外に少なくとも持ち上げることによって切り離される、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目２０）
上記駆動梁は、該駆動梁と動作可能に関連付けられているラッチのブリッジを上記親ねじナットによって規定される切欠きの中に少なくとも下げることによって、該親ねじナットに結合される、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目２１）
外科手術エンドエフェクターであって、該外科手術エンドエフェクターは、
互いに対して移動可能である第１の顎および第２の顎と、
該第１の顎内に配置され、長手方向軸を規定するドライバー要素と、
該ドライバー要素に解放可能に結合されている駆動部材と
を含み、該駆動部材は、該ドライバー要素によって第１の前進位置に向かって引っ張られ、該第１の顎および該第２の顎の閉鎖位置に対応する所定の位置への到達時、該ドライバー要素から切り離され、該外科手術エンドエフェクターは、ステープルを該第１の顎から発射するためのそりを含み、該ドライバー要素は、該駆動部材が該ドライバー要素から切り離された後、該そりを移動させて、ステープルを発射させる、外科手術エンドエフェクター。
（項目２２）
上記駆動部材は、Ｉ梁の形状を有する、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２３）
上記ドライバー要素は、ねじ切りされた部材である、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２４）
内側がねじ切りされたナットをさらに含む、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２５）
上記駆動部材は、上記ナットに解放可能に結合され、該ナットは、上記ドライバー要素とねじ式に係合されている、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２６）
上記駆動部材は、ラッチによって上記ナットに解放可能に結合されている、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２７）
上記ラッチを係合解除するためのカムをさらに含む、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２８）
上記ナットは、上記ドライバー要素が第１の方向に回転させられる場合、該ドライバー要素に沿って前進させられ、該ドライバー要素が該第１の方向と反対の第２の方向に回転させられる場合、該ドライバー要素に沿って後退させられる、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目１６Ａ）
ステープルをカートリッジアセンブリから射出する方法であって、該方法は、
エンドエフェクターを提供することであって、該エンドエフェクターは、
第１の顎と、
該第１の顎内に配置され、長手方向軸を規定する駆動ねじと、
親ねじナットであって、該親ねじナットは、ねじ切りされたボアを規定し、該ねじ切りされたボアは、該駆動ねじを受け取る、親ねじナットと、
後退位置において、該親ねじナットに解放可能に結合されている駆動梁と
を含む、ことと、
カートリッジアセンブリを該第１の顎に結合することであって、該カートリッジアセンブリは、ステープルを含む、ことと、
該駆動ねじを第１の方向に回転させることによって該親ねじナットを第１の前進位置に向かって前進させることであって、該駆動梁は、該親ねじナットによって引っ張られ、該駆動梁は、該親ねじナットが該第１の前進位置に到達すると、該親ねじナットから切り離される、ことと、
該親ねじナットを該第１の前進位置から第２の前進位置に向かって前進させることであって、該駆動梁は、静止したままであり、該親ねじナットは、該カートリッジアセンブリを通して該そりを押すことにより、該ステープルを連続して射出する、ことと
を含む、方法。
（項目１７Ａ）
上記駆動ねじを上記第１の方向と反対の第２の方向に回転させることによって、上記親ねじナットを上記第２の前進位置から上記第１の前進位置に向かって後退させることをさらに含み、上記そりは、該親ねじナットが後退させられる場合、静止したままである、上記項目のうちのいずれか一項に記載の方法。
（項目１８Ａ）
上記親ねじナットを上記第１の前進位置から後退位置に向かって後退させることをさらに含み、上記駆動梁は、該親ねじナットが該第１の前進位置から後退させられる場合、該親ねじナットに結合する、上記項目のうちのいずれか一項に記載の方法。
（項目１９Ａ）
上記駆動梁を切り離すことは、該駆動梁と動作可能に関連付けられているラッチのブリッジを上記親ねじナットによって規定される切欠きの外に少なくとも持ち上げることを含む、上記項目のうちのいずれか一項に記載の方法。
（項目２０Ａ）
上記駆動梁を上記親ねじナットに結合することは、該駆動梁と動作可能に関連付けられているラッチのブリッジを該親ねじナットによって規定される切欠きの中に下げることを含む、上記項目のうちのいずれか一項に記載の方法。
（項目１）
エンドエフェクターであって、該エンドエフェクターは、
互いに対して移動可能である第１の顎および第２の顎と、
該第１の顎内に配置され、長手方向軸を規定する駆動ねじと、
親ねじナットであって、該親ねじナットは、ねじ切りされたボアを規定し、該ねじ切りされたボアは、該駆動ねじを受け取り、該親ねじナットは、該駆動ねじが第１の方向に回転させられる場合、該駆動ねじに沿って前進させられ、該駆動ねじが該第１の方向と反対の第２の方向に回転させられる場合、該駆動ねじに沿って後退させられる、親ねじナットと、
駆動梁であって、該駆動梁は、該親ねじナットが後退位置にある場合、該親ねじナットに解放可能に結合され、該駆動梁は、該親ねじナットが第１の前進位置に向かって前進させられる場合、該親ねじナットによって引っ張られ、該駆動梁は、該親ねじナットが該第１の前進位置まで前進させられると、該親ねじナットから切り離され、その結果、該親ねじナットは、該第１の前進位置から第２の前進位置に、該駆動梁に対して前進させられる、駆動梁と
を含む、エンドエフェクター。
（項目２）
上記駆動梁は、通路を規定し、該通路は、該通路を通して上記駆動ねじを受け取る、上記項目に記載のエンドエフェクター。
（項目３）
そりをさらに含み、該そりは、チャネルを規定し、該チャネルは、上記駆動ねじを受け取り、該そりを該駆動ねじに沿って導くように構成されている、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目４）
上記親ねじナットは、上記後退位置において、上記そりから間隔が空けられ、該そりに対して近位に位置決めされている、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目５）
上記親ねじナットは、上記第１の前進位置において上記そりの近位表面を係合し、該親ねじナットは、該親ねじナットが該第１の前進位置から上記第２の前進位置に向かって前進させられる場合、該そりを遠位方向に押す、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目６）
上記第１の顎は、カートリッジアセンブリを含み、該カートリッジアセンブリは、その中に配置されているステープルを含み、上記親ねじナットが上記第１の前進位置から上記第２の前進位置に向かって前進させられる場合、上記そりは、該ステープルを該カートリッジアセンブリ内から上記第２の顎に向かって射出する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目７）
上記カートリッジアセンブリは、上記ステープルの各々と関連付けられているステープルプッシャーを含み、上記そりは、該ステープルプッシャーを連続して係合することにより、該ステープルを該カートリッジアセンブリ内から射出する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目８）
上記親ねじナットが、上記そりを押した後、上記第１の前進位置に後退させられる場合、該そりは、該第１の前進位置と上記第２の前進位置との間の位置において静止したままである、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目９）
上記親ねじナットが上記第１の前進位置から上記後退位置に向かって後退させられる場合、該親ねじナットは、上記駆動梁を該後退位置に向かって押し、該駆動梁に結合する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１０）
ラッチをさらに含み、該ラッチは、細長い部分を含み、該細長い部分は、近位端と遠位端とを有し、該細長い部分の該近位端は、上記駆動梁に旋回可能に結合されており、該細長い部分の該遠位端は、ブリッジを含み、該ブリッジは、上記親ねじナットが上記後退位置にある場合、該親ねじナットによって規定される切欠き内に受け取られることにより、該駆動梁を該親ねじナットに結合する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１１）
上記親ねじナットが上記第１の前進位置へ前進させられると、上記ブリッジは、上記切欠きの外に持ち上げられて、上記駆動梁を該親ねじナットから切り離される、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１２）
上記親ねじナットが上記第１の前進位置から上記後退位置に向かって後退させられる場合、上記ブリッジは、上記切欠きの中に下げられて、上記駆動梁を該親ねじナットに結合する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１３）
カム部材をさらに含み、該カム部材は、上記駆動ねじに隣接して位置決めされ、カムスロットを規定し、該カムスロットは、該駆動ねじの上記長手方向軸と平行である第１の部分と、該駆動ねじの該長手方向軸に対して該駆動ねじの該長手方向軸から離れるある角度で、該第１の部分から遠位方向に延びている第２の部分とを有し、上記細長い部分の上記遠位端は、ピンを含み、該ピンは、該カムスロットの中にスライド可能に受け取られている、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１４）
上記ブリッジは、上記ピンが上記カムスロットの上記第１の部分の中にある場合、上記切欠きの中に受け取られており、上記ブリッジは、該ピンが該カムスロットの上記第２の部分に沿って遠位方向にスライドする場合、該切欠きの外に持ち上げられる、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１５）
外科手術器具であって、該外科手術器具は、
ハンドルと、
該ハンドルから遠位方向に延びているシャフトと、
該シャフトの遠位端において支持されているエンドエフェクターと
を含み、該エンドエフェクターは、
互いに対して移動可能である第１の顎および第２の顎と、
長手方向軸を規定し、該第１の顎内に配置されている駆動ねじと、
親ねじナットであって、該親ねじナットは、ねじ切りされたボアを規定し、該ねじ切りされたボアは、該駆動ねじを受け取り、該親ねじナットは、該駆動ねじが第１の方向に回転させられる場合、該駆動ねじに沿って前進させられ、該駆動ねじが該第１の方向と反対の第２の方向に回転させられる場合、該駆動ねじに沿って後退させられる、親ねじナットと、
駆動梁であって、該駆動梁は、該親ねじナットが後退位置にある場合、該親ねじナットに解放可能に結合され、該駆動梁は、該親ねじナットが第１の前進位置に向かって前進させられる場合、該親ねじナットによって引っ張られ、該駆動梁は、該親ねじナットが該第１の前進位置まで前進させられると、該親ねじナットから切り離され、その結果、該親ねじナットは、該第１の前進位置から第２の前進位置に、該駆動梁に対して前進させられる、駆動梁と
を含む、外科手術器具。
（項目１６）
エンドエフェクターであって、該エンドエフェクターは、
第１の顎と、
該第１の顎内に配置され、長手方向軸を規定する駆動ねじと、
親ねじナットであって、該親ねじナットは、ねじ切りされたボアを規定し、該ねじ切りされたボアは、該駆動ねじを受け取る、親ねじナットと、
後退位置において、該親ねじナットに解放可能に結合されている駆動梁と、
該第１の顎に解放可能に結合されているカートリッジアセンブリであって、該カートリッジアセンブリは、ステープルを含む、カートリッジアセンブリと
を含み、該駆動ねじを第１の方向に回転させることによって該親ねじナットが第１の前進位置に向かって前進させられる場合、該駆動梁は、該親ねじナットによって引っ張られ、該駆動梁は、該親ねじナットが該第１の前進位置に到達すると、該親ねじナットから切り離され、
該駆動梁は、該親ねじナットが該第１の前進位置から第２の前進位置に向かって前進させられる場合、静止したままであり、該親ねじナットは、該カートリッジアセンブリを通して該そりを押すことにより、該ステープルを連続して射出する、エンドエフェクター。
（項目１７）
上記駆動ねじを上記第１の方向と反対の第２の方向に回転させることによって上記親ねじナットが上記第２の前進位置から上記第１の前進位置に向かって後退させられる場合、上記そりは、静止したままである、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１８）
上記親ねじナットは、上記第１の前進位置から後退位置に向かって後退させられ、上記駆動梁は、該親ねじナットが該第１の前進位置から後退させられる場合、該親ねじナットに結合する、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目１９）
上記駆動梁は、該駆動梁と動作可能に関連付けられているラッチのブリッジを上記親ねじナットによって規定される切欠きの外に少なくとも持ち上げることによって切り離される、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目２０）
上記駆動梁は、該駆動梁と動作可能に関連付けられているラッチのブリッジを上記親ねじナットによって規定される切欠きの中に少なくとも下げることによって、該親ねじナットに結合される、上記項目のうちのいずれか一項に記載のエンドエフェクター。
（項目２１）
外科手術エンドエフェクターであって、該外科手術エンドエフェクターは、
互いに対して移動可能である第１の顎および第２の顎と、
該第１の顎内に配置され、長手方向軸を規定するドライバー要素と、
該ドライバー要素に解放可能に結合されている駆動部材と
を含み、該駆動部材は、該ドライバー要素によって第１の前進位置に向かって引っ張られ、該第１の顎および該第２の顎の閉鎖位置に対応する所定の位置への到達時、該ドライバー要素から切り離され、該外科手術エンドエフェクターは、ステープルを該第１の顎から発射するためのそりを含み、該ドライバー要素は、該駆動部材が該ドライバー要素から切り離された後、該そりを移動させて、ステープルを発射させる、外科手術エンドエフェクター。
（項目２２）
上記駆動部材は、Ｉ梁の形状を有する、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２３）
上記ドライバー要素は、ねじ切りされた部材である、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２４）
内側がねじ切りされたナットをさらに含む、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２５）
上記駆動部材は、上記ナットに解放可能に結合され、該ナットは、上記ドライバー要素とねじ式に係合されている、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２６）
上記駆動部材は、ラッチによって上記ナットに解放可能に結合されている、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２７）
上記ラッチを係合解除するためのカムをさらに含む、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目２８）
上記ナットは、上記ドライバー要素が第１の方向に回転させられる場合、該ドライバー要素に沿って前進させられ、該ドライバー要素が該第１の方向と反対の第２の方向に回転させられる場合、該ドライバー要素に沿って後退させられる、上記項目のうちのいずれか一項に記載の外科手術エンドエフェクター。
（項目１６Ａ）
ステープルをカートリッジアセンブリから射出する方法であって、該方法は、
エンドエフェクターを提供することであって、該エンドエフェクターは、
第１の顎と、
該第１の顎内に配置され、長手方向軸を規定する駆動ねじと、
親ねじナットであって、該親ねじナットは、ねじ切りされたボアを規定し、該ねじ切りされたボアは、該駆動ねじを受け取る、親ねじナットと、
後退位置において、該親ねじナットに解放可能に結合されている駆動梁と
を含む、ことと、
カートリッジアセンブリを該第１の顎に結合することであって、該カートリッジアセンブリは、ステープルを含む、ことと、
該駆動ねじを第１の方向に回転させることによって該親ねじナットを第１の前進位置に向かって前進させることであって、該駆動梁は、該親ねじナットによって引っ張られ、該駆動梁は、該親ねじナットが該第１の前進位置に到達すると、該親ねじナットから切り離される、ことと、
該親ねじナットを該第１の前進位置から第２の前進位置に向かって前進させることであって、該駆動梁は、静止したままであり、該親ねじナットは、該カートリッジアセンブリを通して該そりを押すことにより、該ステープルを連続して射出する、ことと
を含む、方法。
（項目１７Ａ）
上記駆動ねじを上記第１の方向と反対の第２の方向に回転させることによって、上記親ねじナットを上記第２の前進位置から上記第１の前進位置に向かって後退させることをさらに含み、上記そりは、該親ねじナットが後退させられる場合、静止したままである、上記項目のうちのいずれか一項に記載の方法。
（項目１８Ａ）
上記親ねじナットを上記第１の前進位置から後退位置に向かって後退させることをさらに含み、上記駆動梁は、該親ねじナットが該第１の前進位置から後退させられる場合、該親ねじナットに結合する、上記項目のうちのいずれか一項に記載の方法。
（項目１９Ａ）
上記駆動梁を切り離すことは、該駆動梁と動作可能に関連付けられているラッチのブリッジを上記親ねじナットによって規定される切欠きの外に少なくとも持ち上げることを含む、上記項目のうちのいずれか一項に記載の方法。
（項目２０Ａ）
上記駆動梁を上記親ねじナットに結合することは、該駆動梁と動作可能に関連付けられているラッチのブリッジを該親ねじナットによって規定される切欠きの中に下げることを含む、上記項目のうちのいずれか一項に記載の方法。
（摘要）
エンドエフェクターは、第１の顎および第２の顎と、駆動ねじと、親ねじナットと、駆動梁とを含む。駆動ねじは、第１の顎内に配置されている。親ねじナットは、ねじ切りされたボアを規定し、このねじ切りされたボアは、駆動ねじを受け取る。親ねじナットは、駆動ねじが第１の方向に回転させられる場合、駆動ねじに沿って前進させられ、駆動ねじが第２の方向に回転する場合、駆動ねじに沿って後退させられる。駆動梁は、親ねじナットが後退位置にある場合、親ねじナットに解放可能に結合されている。親ねじナットが前進させられる場合、駆動梁は、親ねじナットによって引っ張られる。駆動梁は、親ねじナットが前進させられる場合、親ねじナットから切り離され、その結果、親ねじナットは、駆動梁に対して前進させられる。
エンドエフェクターは、第１の顎および第２の顎と、駆動ねじと、親ねじナットと、駆動梁とを含む。駆動ねじは、第１の顎内に配置されている。親ねじナットは、ねじ切りされたボアを規定し、このねじ切りされたボアは、駆動ねじを受け取る。親ねじナットは、駆動ねじが第１の方向に回転させられる場合、駆動ねじに沿って前進させられ、駆動ねじが第２の方向に回転する場合、駆動ねじに沿って後退させられる。駆動梁は、親ねじナットが後退位置にある場合、親ねじナットに解放可能に結合されている。親ねじナットが前進させられる場合、駆動梁は、親ねじナットによって引っ張られる。駆動梁は、親ねじナットが前進させられる場合、親ねじナットから切り離され、その結果、親ねじナットは、駆動梁に対して前進させられる。
本開示の様々な局面が、図面を参照して以下に記載され、図面は、本明細書中に組み込まれ、本明細書の一部を構成する。
詳細な説明
次に、本開示の実施形態が、図面を参照して詳細に記載され、図面において、類似の参照数字は、数枚の図の各々における、同一の要素または対応する要素を表す。本明細書中で用いられる場合、用語「臨床医」は、医師、看護師、または任意の他の世話をする人を指し、援助要員を含み得る。本記載を通して、用語「近位」は、臨床医に最も近い、デバイスまたはその構成要素の部分を指し、用語「遠位」は、臨床医から最も遠い、デバイスまたはその構成要素の部分を指す。用語「左」および「右」は、それぞれ、外科手術のシステム、装置および／またはデバイスが回転していない構成に配向されているときに、電気機械式外科手術のシステム、装置および／またはデバイスの近位端から遠位端に向いているユーザーから見て、電気機械式外科手術のシステム、装置および／またはデバイス、あるいはその構成要素の、左（側）および右（側）にあるその部分を指す。
次に、本開示の実施形態が、図面を参照して詳細に記載され、図面において、類似の参照数字は、数枚の図の各々における、同一の要素または対応する要素を表す。本明細書中で用いられる場合、用語「臨床医」は、医師、看護師、または任意の他の世話をする人を指し、援助要員を含み得る。本記載を通して、用語「近位」は、臨床医に最も近い、デバイスまたはその構成要素の部分を指し、用語「遠位」は、臨床医から最も遠い、デバイスまたはその構成要素の部分を指す。用語「左」および「右」は、それぞれ、外科手術のシステム、装置および／またはデバイスが回転していない構成に配向されているときに、電気機械式外科手術のシステム、装置および／またはデバイスの近位端から遠位端に向いているユーザーから見て、電気機械式外科手術のシステム、装置および／またはデバイス、あるいはその構成要素の、左（側）および右（側）にあるその部分を指す。
最初に図１を参照すると、本開示の実施形態に従うエンドエフェクターが示され、全体的に１０と表されている。エンドエフェクター１０は、様々な外科手術ステープル留め器具（例えば、手動または動力式外科手術ステープル留め器具）に接続され得る。例示の目的のために、エンドエフェクター１０は、本明細書中で電気機械式ハンドヘルド動力式外科手術器具１００の形態での外科手術の装置またはデバイスに接続するように構成されているものとして記載されている。外科手術器具１００は、エンドエフェクター１０に接続するアダプターアセンブリ（例えば、細長い本体）２００を含む。エンドエフェクター１０およびアダプターアセンブリ２００は、電気機械式ハンドヘルド動力式外科手術器具１００による作動および操作のために構成されている。特に、外科手術器具１００、アダプターアセンブリ２００、およびエンドエフェクター１０は、外科手術器具１００がアダプターアセンブリ２００との選択的な接続のために構成され、次に、アダプターアセンブリ２００が複数の異なるエンドエフェクターのうちの任意の１つとの選択的な接続のために構成されるように互いに分離可能である。
手短に言うと、ハンドヘルド外科手術器具１００は、ハンドルハウジング１０２を含み、このハンドルハウジング１０２は、下方ハウジング部分１０４と、下方ハウジング部分１０４から延びているか、または下方ハウジング部分１０４において支持されている中間ハウジング部分１０６と、中間ハウジング部分１０６から延びているか、または中間ハウジング部分１０６において支持されている上方ハウジング部分１０８とを有する。中間ハウジング部分１０６および上方ハウジング部分１０８は、下方部分１０４と一体的に形成され、下方部分１０４から延びている遠位半体セクション１１０ａと、近位半体セクション１１０ｂとに分離され、この近位半体セクション１１０ｂは、複数のファスナーによって遠位半体セクション１１０ａに接続可能である。接合された場合、遠位半体セクション１１０ａおよび近位半体セクション１１０ｂは、ハンドルハウジング１０２を規定し、このハンドルハウジング１０２は、その中に空洞（示されない）を有し、この空洞の中に回路基板（示されない）および駆動機構（示されない）が置かれている。
ハンドルが、手動で動作させられ得ること、モーターによって動力を供給され得ること、および／または１つもしくは複数のコンピューター処理コントローラーを含み得ることが企図される。エンドエフェクターは、取り外し可能、かつ交換可能であり得、ステープルカートリッジを収容し得、このステープルカートリッジも取り外し可能、かつ交換可能であり得る。エンドエフェクターおよび／またはカートリッジは、コンピューター処理マイクロチップまたは機械的特徴を含み得、コンピューター処理マイクロチップまたは機械的特徴は、それらの構成要素の識別において使用される。メモリーユニットが含まれ得る（例えば、ＥＥＰＲＯＭ、同様のメモリーデバイス、および／またはＤａｌｌａｓ １ｗｉｒｅチップ）。アダプターは、別個に取り外し可能、かつ交換可能であり得るか、またはハンドルと一体的であり得、それ自体の識別特徴および／またはメモリー特徴を有し得る。
図１を引き続き参照すると、アダプターアセンブリ２００は、外科手術器具１００によって提供される回転力をエンドエフェクター１０に伝えるように構成されている。アダプターアセンブリ２００は、細長い実質的に剛な細長い本体部分２１０を含み、この細長い本体部分２１０は、近位端２１０ａと遠位端２１０ｂとを有する。トランスミッションハウジング２１２は、細長い本体部分２１０の近位端２１０ａに接続され、外科手術器具１００への選択的な接続のために構成されている。アダプターアセンブリ２００は、エンドエフェクター１０に結合するために、遠位端２１０ｂに配置されている関節運動アセンブリ２３０を含む。アダプターアセンブリ２００のトランスミッションハウジング２１２は、シャフト結合アセンブリ２１４を介して外科手術器具１００の上方ハウジング部分１０８の接続部分１０８ａに接続され、このシャフト結合アセンブリ２１４は、近位端２１０ａにおいて支持されている。
電気機械式ハンドヘルド動力式外科手術器具およびアダプターの例示的な例は、２０１２年４月１２日に米国特許公開第２０１２／００８９１３１号として公開された、２０１１年１２月２０日に出願された共有に係る同時係属中の米国特許出願第１３／３３１，０４７号、および２０１２年１０月４日に米国特許公開第２０１２／０２５３３２９号として公開された、２０１２年５月３１に出願された米国特許出願第１３／４８４，９７５号に開示され、各々の内容は、これにより、それらの全体が参考として援用される。
図１および図２を参照すると、エンドエフェクター１０は、第１の顎１２を含み、この第１の顎１２は、キャリアーまたはハウジング１８を含み、キャリアーまたはハウジング１８は、カートリッジアセンブリ１６（図２）に解放可能に結合するように構成されている。エンドエフェクター１０は、アンビルの形態での第２の顎１４を含む。カートリッジアセンブリ１６は、その中に配置されている１つ以上のファスナー３１０（図５）を収容し、器具１００の発射時にファスナー３１０を配備するように構成されている。第２の顎１４は、エンドエフェクター１０に取り付けられ、第２の顎１４は、第１の顎１２と第２の顎１４との間の組織を締め付けるために、第２の顎１４がカートリッジアセンブリ１６から離れるほうに間隔が空けられている開放位置と、第２の顎１４がカートリッジアセンブリ１６と密接に協働的に整列している閉鎖位置との間を第１の顎１２に対して移動可能である。第２の顎１４は、第１の顎１２に旋回可能に取り付けられ得る。
図３〜図５を参照すると、顎ハウジング１８は、駆動アセンブリを含み、この駆動アセンブリは、ステープル留め手順中に、アダプター２００（図１）の１つ以上の駆動シャフト（明示的に示されない）によって及ぼされる回転駆動力を駆動ねじナット３８に伝達するための軸方向の駆動ねじ２０を含む。駆動ねじ２０は、顎ハウジング１８の中で回転可能に支持され、ねじ切りされた部分２６と近位係合部分２７とを含む。駆動ねじ２０のねじ切りされた部分２６は、駆動梁２８を貫いて規定されるボア２９（図５）を通って延びており、駆動ねじ２０は、駆動梁２８のボア２９内で自由に回転する。駆動梁２８は、詳細に下に記載されるように、駆動ねじ２０によって規定される長手方向軸「Ａ−Ａ」に沿って長手方向に移動する。
駆動梁２８は、スライド可能、かつ回転不能に顎ハウジング１８内に配置されており、垂直支持支柱３４とアバットメント表面３６とを含み、このアバットメント表面３６は、駆動ねじナット３８を係合する。駆動梁２８は、カム部材４０も含み、このカム部材４０は、垂直支持支柱３４の上に配置されている。垂直支柱３４は、長手方向スロット４４（図２）を通って並進可能であり、この長手方向スロット４４は、第２の顎１４の外部カム作用表面４２（図２）によって規定される。使用において、カム部材４０は、第２の顎１４の外部カム作用表面４２を係合し、かつそれに沿って並進し、ファスナー３１０（図５）を射出する前に、第２の顎１４を第１の顎１２に対して進行的に閉じることにより、第１の顎１２と第２の顎１４との間に身体組織を捕捉する。
図３〜図５を引き続き参照すると、ラッチ４６が示されており、このラッチ４６は、第１の細長い部分、リンク、またはバー４８ａと、第２の細長い部分、リンク、またはバー４８ｂとを含み、これらは、それらの近位端において、第１のピン５０を介して駆動梁２８に旋回可能に結合されている。ピン５０は、駆動梁２８の近位端に隣接して、垂直支持支柱３４を通って延びている。
第１の細長い部分４８ａと第２の細長い部分４８ｂとは、それらの遠位端５２ａ、５２ｂにおいて、ブリッジ５４および第２のピン５８を介して互いに接続されている。第２のピン５８は、第１の細長い部分４８ａの遠位端５２ａおよびブリッジ５４から側方に延びている側面突出部５７ａと、第２の細長い部分４８ｂの遠位端５２ｂおよびブリッジ５４から側方に延びている側面突出部５７ｂとを含む。ブリッジ５４は、凹部５６と係合して、および凹部５６と係合せずに移動可能であり、この凹部５６は、駆動ねじナット３８の外側表面において形成され、駆動ねじナット３８の近位端に隣接して規定される。
第１のカム部材６０ａおよび第２のカム部材６０ｂは、顎ハウジング１８内に位置決めされ、例えば、ねじ、リベットなどで顎ハウジング１８の内部壁に結合される。第１のカム部材６０ａおよび第２のカム部材６０ｂの各々は、その中に、それぞれの第１のカムスロット６１ａおよび第２のカムスロット６１ｂを規定する。第１のカムスロット６１ａおよび第２のカムスロット６１ｂは、各々、それぞれの第１のカム部分６２ａ、６２ｂ、およびそれぞれの第２のカム部分６４ａ、６４ｂを含む。実施形態において、カム部材６０ａ、６０ｂのうちの一方のみが利用され、他方は省かれる。さらに、第１のカムスロット６１ａおよび第２のカムスロット６１ｂは、本明細書中で、第１のカム部材６０ａおよび第２のカム部材６０ｂの中に規定されるものとして記載されているが、第１のカム部材６０ａおよび第２のカム部材６０ｂが省かれ得、第１のカムスロット６１ａおよび第２のカムスロット６１ｂが、単純に、顎ハウジング１８の内部壁の中に規定され得ることは、本開示の範囲内である。
駆動ねじナット３８は、ねじ切りされたボア３９（図５）を含み、このねじ切りされたボア３９は、駆動ねじ２０のねじ切りされた部分２６にねじ式に結合され、その結果、駆動ねじ２０が回転させられると、駆動ねじナット３８が駆動ねじ２０によって規定される長手方向軸「Ａ−Ａ」に沿って並進する。駆動ねじナット３８は、より詳細に下に記載されるように、駆動ねじナット３８がブリッジ５４を介して駆動梁２８に結合されている場合に駆動梁２８を長手方向に並進させる。駆動ねじナット３８は、下に詳述されるように、カートリッジアセンブリ１６（図２）のそり２２を係合することにより、ファスナー３１０をカートリッジ１６から射出するように構成されている。
そり２２は、外方および側方に延びているフランジ２４を含み、フランジ２４の間にチャネル２５（図９）を規定する。そり２２は、チャネル２５がそり２２の並進を長手方向軸Ａ−Ａに沿って導くように、駆動ねじ２０を覆って位置決めされ、駆動ねじ２０をチャネル２５の中に受け取る。そり２２は、直立したカムウェッジ２３を有し、この直立したカムウェッジ２３は、カートリッジアセンブリ１６のプッシャー３１２にファスナー駆動力を及ぼすように構成されており、このプッシャー３１２は、ファスナー３１０をカートリッジアセンブリ１６から駆動する。カートリッジアセンブリ１６を通した駆動ねじナット３８の前進は、作動そり２２を並進させ、その結果、カムウェッジ２３の角度付けされたリーディングエッジが連続してプッシャー３１２と接触し、プッシャー３１２が垂直に並進することをもたらし、それにより、ファスナー３１０をカートリッジアセンブリ１６から押し付ける。
使用において、最初に、駆動アセンブリの駆動梁２８は、ホーム位置または後退位置にあり、ラッチ４６のブリッジ５４は、図３〜図６に示されるように、駆動ねじナット３８の凹部５６内に位置決めされている。この位置において、ユーザーは、未使用の新しい消耗していないカートリッジアセンブリ１６を第１の顎１２の顎ハウジング１８に結合し得る。
外科手術ステープラーが発射される場合、駆動ねじ２０は、例えば、時計回りの方向へ回転させられ、駆動ねじナット３８は、遠位方向に前進する。駆動ねじナット３８が前進するにつれ、駆動ねじナット３８は、駆動梁２８を遠位方向に引っ張り、カム部材４０が外側カム作用表面４２に対してカム作用して第１の顎１２と第２の顎１４とを接近させるように、垂直支持支柱３４をスロット４４を通して並進させることによって、第２の顎１４を閉じる。さらに、駆動梁２８が前進させられる場合、第２のピン５８の側面突出部５７ａ、５７ｂは、第１のカム部材６０ａおよび第２のカム部材６０ｂの第１のカムスロット６１ａおよび第２のカムスロット６１ｂを通ってスライドする。ラッチ４６のブリッジ５４は、第２のピン５８の側面突出部５７ａ、５７ｂが第１のカムスロット６１ａおよび第２のカムスロット６１ｂの第１のカム部分６２ａ、６２ｂに沿ってスライドする場合、駆動ねじナット３８の凹部５６内に位置決めされているままである。第２のピン５８の側面突出部５７ａ、５７ｂが第１のカムスロット６１ａおよび第２のカムスロット６１ｂの第２のカム部分６４ａ、６４ｂに沿ってスライドし始める場合、ラッチ４６の第１の細長い部分４８ａおよび第２の細長い部分４８ｂは、第１のピン５０を介して駆動梁２８の周りに旋回することにより、ブリッジ５４を駆動ねじナット３８の凹部５６内から徐々に持ち上げ始める。
図６〜図８を参照すると、駆動梁２８は、ブリッジ５４が、もはや凹部５６内に位置決めされなくなるように、第１の前進位置に向かって遠位方向に前進し続ける（例えば、第２のピン５８の側面突出部５７ａ、５７ｂが第２のカム部分６４ａ、６４ｂの遠位端にスライドした）。この時点において、親ねじナット３８は、駆動梁２８を伴わずに遠位方向に前進し続ける。親ねじナット３８が遠位方向に前進する場合、親ねじナット３８は、そり２２を係合することにより、第２の前進位置に向かってそり２２を遠位方向に前進させるか、または押す。そり２２が前進する場合、そり２２は、カムウェッジ２３を介してプッシャー３１２を係合することにより、ファスナー３１０をカートリッジアセンブリ１６から射出する。親ねじナット３８が駆動梁２８を引っ張り、同時にそり２２を押し得ることは、本開示の範囲内である。
カートリッジアセンブリ１６が消耗されるか、またはステープル留め手順が停止されると、駆動ねじ２０が反対方向（例えば、反時計回りの方向）に回転させられ、そのことは、駆動ねじナット３８を後退位置に向かって後退させる。駆動ねじナット３８が後退する場合、駆動ねじナット３８は、駆動梁２８のアバットメント表面３６に接触して、駆動梁２８を押すか、または後退させる。駆動梁２８が駆動ねじナット３８によって後退させられる場合、第２のピン５８の側面突出部５７ａ、５７ｂは、第１のカムスロット６１ａおよび第２のカムスロット６１ｂの第２のカム部分６４ａ、６４ｂに沿って近位方向にスライドし、ラッチ４６の第１の細長い部分４８ａおよび第２の細長い部分４８ｂが、第１のピン５０を介して駆動梁２８の周りを旋回することをもたらす。第２のカム部分６４ａ、６４ｂは、ブリッジ５４を駆動ねじナット３８の凹部５６の中に設置し戻す。さらに、ブリッジ５４および／または第２のピン５０の重量は、ブリッジ５４を駆動ねじナット３８の凹部５６の中に設置し戻すことを助け得る。駆動ねじナット３８が後退させられる場合、そり２２が遠位位置に留まることが認識される。
駆動ねじナット３８および駆動梁２８が後退位置にあると、未使用のカートリッジアセンブリ１６が、顎１２の顎ハウジング１８に結合され得、それから外科手術ステープラーは、再度発射され得る。
前述のものから、および様々な図面を参照して、当業者は、本開示の範囲から外れることなく、特定の改変がまた、本開示に対してなされ得ることを認識する。例えば、エンドエフェクター１０は、本明細書中に開示される実施形態のうちの任意のものにおいて、一体的なユニットとして構成され得る。エンドエフェクター１０は、本明細書中に開示される実施形態のうちの任意のものにおいて、コンソールおよび／または外科手術ロボットとの使用のために構成され得る。
実施形態において、弾力のある部材（示されない）が、ラッチ４６上に提供され得、この弾力のある部材は、ブリッジ５４を駆動ねじナット３８の凹部５６の中へ下方に押し付けるように構成される。
本開示のいくつかの実施形態が図面に示されてきたが、本開示は当該分野が許容するのと同じくらい範囲が広いこと、および本明細書が同様に読まれることが意図されるので、本開示はそれらの実施形態に限定されることが意図されない。上の実施形態のうちの任意の組み合わせも想定され、それは、添付の特許請求の範囲の範囲内である。従って、上の記載は、限定するものではなく、単に特定の実施形態の例証と解釈されるべきである。当業者は、本明細書に添付される特許請求の範囲の趣旨および範囲内の他の改変を想定する。
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2014
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2015
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2017
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2019
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2020
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- 2020-12-28 JP JP2020218939A patent/JP2021049430A/ja active Pending
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| Publication number | Publication date |
|---|---|
| JP2019122832A (ja) | 2019-07-25 |
| CA2883152A1 (en) | 2015-11-06 |
| AU2015200919A1 (en) | 2015-11-26 |
| AU2015200919B2 (en) | 2019-05-30 |
| JP2015211826A (ja) | 2015-11-26 |
| US9861366B2 (en) | 2018-01-09 |
| US20180092641A1 (en) | 2018-04-05 |
| US10751054B2 (en) | 2020-08-25 |
| EP2942019B1 (en) | 2019-02-06 |
| US20150320423A1 (en) | 2015-11-12 |
| JP6563664B2 (ja) | 2019-08-21 |
| EP2942019A1 (en) | 2015-11-11 |
| US20200345369A1 (en) | 2020-11-05 |
| US11426166B2 (en) | 2022-08-30 |
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