JP2021534873A - 線形駆動運動を回転駆動運動に変換するためのクラッチ構成を有する電動外科用器具 - Google Patents

線形駆動運動を回転駆動運動に変換するためのクラッチ構成を有する電動外科用器具 Download PDF

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JP2021534873A
JP2021534873A JP2021509925A JP2021509925A JP2021534873A JP 2021534873 A JP2021534873 A JP 2021534873A JP 2021509925 A JP2021509925 A JP 2021509925A JP 2021509925 A JP2021509925 A JP 2021509925A JP 2021534873 A JP2021534873 A JP 2021534873A
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ハリス・ジェイソン・エル
シェルトン・ザ・フォース・フレデリック・イー
バクスター・ザ・サード・チェスター・オー
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Abstract

外科用エンドエフェクタと、外科用エンドエフェクタと動作可能にインターフェース接続するシャフトアセンブリと、を含む、外科用器具。シャフトアセンブリは、外科用エンドエフェクタと動作可能にインターフェース接続する第1のシャフトアクチュエータ及び第2のシャフトアクチュエータを含む。第1の駆動システムは、第1のシャフトアクチュエータに軸方向作動運動を選択的に加えるように構成されている。シャフトアセンブリ内に支持されたクラッチアセンブリは、クラッチアセンブリが第1の駆動システムの軸方向作動運動を第2のシャフトアクチュエータに加える回転作動運動に変換する、係合位置と、第1の駆動システムの軸方向作動運動が第2のシャフトアクチュエータに加えられない、係合解除位置との間で移動可能である。

Description

本発明は、外科用器具に関し、また、様々な状況において組織をステープル留めし、切断するために設計された、外科用ステープル留め及び切断器具、並びにそれらと共に使用するためのステープルカートリッジに関する。
本明細書に記載する実施形態の様々な特徴は、それらの利点と共に、以下の添付図面と併せて以下の説明によって理解することができる。
電動外科用ステープル留めシステムの斜視図である。 図1の電動外科用ステープル留めシステムのシャフトアセンブリの分解組立図である。 外科用エンドエフェクタのアンビルが開放位置にある、図1の電動外科用ステープル留めシステムのシャフトアセンブリ及び外科用エンドエフェクタの一部分の断面図である。 非関節運動位置にある図3のシャフトアセンブリ及び外科用エンドエフェクタの一部分の上面図である。 関節運動位置にある図3のシャフトアセンブリ及び外科用エンドエフェクタの一部分の別の上面図である。 図1の電動外科用ステープル留めシステムのハンドル又はハウジングの分解組立図である。 明確にするためにシャフトアセンブリの一部を省略した、図6のハンドルの断面図である。 図7のハンドル及びシャフトアセンブリの拡大断面図である。 図7のハンドル及びシャフトアセンブリの別の拡大断面図である。 外科用エンドエフェクタの顎部が開放位置に配向されることをもたらす位置にある、図7のハンドル及びシャフトアセンブリの別の側面断面図である。 エンドエフェクタの顎部の閉鎖をもたらす位置にある、図7のハンドル及びシャフトアセンブリの別の側面断面図である。 漸進的閉鎖駆動システムを採用する外科用器具の実施形態と、異なる閉鎖駆動システム構成を採用する2つの以前の外科用器具との間の閉鎖力のグラフ比較である。 Aは、発射部材又はそのナイフが、アンビルを通ってアンビルの最近位開始位置から最遠位終了位置(インチ単位のクロスヘッド距離)まで移動する際の、そのアンビル上のカム面を採用する以前の外科用器具の実施形態によって経験される、発射力(force to fire、FTF)及び閉鎖力(force to close、FTC)のグラフ描写である。Bは、漸進的閉鎖駆動システムを採用する外科用器具の実施形態によって経験される、発射力(FTF)及び閉鎖力(FTC)、アンビル高さ及びばね高さのグラフ描写である。 シャフトアセンブリの一部分の部分斜視図である。 別の電動外科用器具の一部分の側面図である。 明確にするためにその一部分が省略された、図15の電動外科用器具の一部分の部分斜視図である。 明確にするためにその一部分が省略された、図15の電動外科用器具の一部分の別の部分斜視図である。 明確にするためにその一部分が省略された、図15の電動外科用器具の一部分の別の部分斜視図である。 明確にするためにその一部が省略された、図15の電動外科用器具のモータスイッチシステムの斜視図である。 図15の電動外科用器具のノズルアセンブリの近位ノズルセグメント又はフィンセグメントの斜視図である。 明確にするために遠位ノズル部分が省略された、図15の電動外科用器具の一部分の部分斜視図である。 明確にするためにそのノズルアセンブリの一部分が省略された、図15の電動外科用器具のシャーシ部分及び近位ノズルセグメントの一部分の側面図である。 図15の電動外科用器具のエンドエフェクタの関節運動位置に関連する、そのスイッチトラベラの位置に対する図19のスイッチシステムのスイッチの位置のグラフ描写である。 図15の電動外科用器具のエンドエフェクタの関節運動位置に関連する、スイッチトラベラの別の位置に対する図19のスイッチシステムのスイッチの位置の別のグラフ描写である。 図15の電動外科用器具のエンドエフェクタの関節運動位置に関連する、スイッチトラベラの別の位置に対する図19のスイッチシステムのスイッチの位置の別のグラフ描写である。 図15の電動外科用器具のエンドエフェクタの関節運動位置に関連する、スイッチトラベラの別の位置に対する図19のスイッチシステムのスイッチの位置の別のグラフ描写である。 図19のスイッチシステムに採用され得る3つの異なるスイッチトラベラ実施形態の一部分の形状を描写する。 図27に描写される各幾何学的スイッチトラベラ形状に対するモータ速度と、それに連結された外科用エンドエフェクタの関節運動角度とのグラフ比較である。 図16の電動外科用器具の関節運動モータを制御するために採用され得る制御回路の一形態を例解する。 別の電動外科用ステープル留めシステムの斜視図である。 図29の電動外科用ステープル留めシステムのシャフトアセンブリの分解組立図である。 明確にするためにその一部が省略された、図29の電動外科用ステープル留めシステムのシャフトアセンブリの一部分の斜視図である。 その閉鎖部材が後退位置にあるときの、図31のシャフトアセンブリの一部分の上面断面図である。 その閉鎖部材が前進した閉鎖位置にあるときの、図32Aに示されるシャフトアセンブリの一部分の別の上面断面図である。 関節運動ロック構成の部分断面斜視図である。
複数の図面を通して、対応する参照符号は対応する部分を示す。本明細書に記載される例示は、本発明の様々な実施形態を1つの形態で例解するものであり、かかる例示は、いかなる方法によっても本発明の範囲を限定するものとして解釈されるべきではない。
本願の出願人は、本願と同日に出願された以下の米国特許出願を所有しており、これらは各々、それらの全体が参照により本明細書に組み込まれる。
−米国特許出願第______号、発明の名称「METHOD FOR FABRICATING SURGICAL STAPLER ANVILS」、代理人整理番号END8577USNP/180088M、
−米国特許出願第______号、発明の名称「REINFORCED DEFORMABLE ANVIL TIP FOR SURGICAL STAPLER ANVIL」、代理人整理番号END8578USNP/180393、
−米国特許出願第______号、発明の名称「SURGICAL STAPLER ANVILS WITH STAPLE DIRECTING PROTRUSIONS AND TISSUE STABILITY FEATURES」、米代理人整理番号END8579USNP/180089、
−米国特許出願第______号、発明の名称「FABRICATING TECHNIQUES FOR SURGICAL STAPLER ANVILS」、代理人整理番号END8580USNP/180090、
−米国特許出願第______号、発明の名称「SURGICAL STAPLING DEVICES WITH IMPROVED CLOSURE MEMBERS」、代理人整理番号END8581USNP/180091、
−米国特許出願第______号、発明の名称「SURGICAL STAPLER ANVILS WITH TISSUE STOP FEATURES CONFIGURED TO AVOID TISSUE PINCH」、代理人整理番号END8582USNP/180092、
−米国特許出願第______号、発明の名称「METHOD FOR OPERATING A POWERED ARTICULATABLE SURGICAL INSTRUMENT」、代理人整理番号END8583USNP/180093M、
−米国特許出願第______号、発明の名称「SURGICAL INSTRUMENTS WITH PROGRESSIVE JAW CLOSURE ARRANGEMENTS」、代理人整理番号END8584USNP/180094、
−米国特許出願第______号、発明の名称「POWERED ARTICULATABLE SURGICAL INSTRUMENTS WITH CLUTCHING AND LOCKING ARRANGEMENTS FOR LINKING AN ARTICULATION DRIVE SYSTEM TO A FIRING DRIVE SYSTEM」、代理人整理番号END8586USNP/180096、
−米国特許出願第______号、発明の名称「ARTICULATABLE MOTOR POWERED SURGICAL INSTRUMENTS WITH DEDICATED ARTICULATION MOTOR ARRANGEMENTS」、代理人整理番号END8587USNP/180097、
−米国特許出願第______号、発明の名称「SWITCHING ARRANGEMENTS FOR MOTOR POWERED ARTICULATABLE SURGICAL INSTRUMENTS」、代理人整理番号END8588USNP/180098、及び
−米国意匠特許出願第______号、発明の名称「SURGICAL INSTRUMENT ANVIL」、代理人整理番号END8581USDP/180099D。
本願の出願人は、それぞれの全ての内容が参照により本明細書に組み込まれる、以下の米国特許出願及び米国特許を所有している。
−米国特許出願第15/386,185号、発明の名称「SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIES THEREOF」、米国特許出願公開第2018/0168642号、
−米国特許出願第15/386,230号、発明の名称「ARTICULATABLE SURGICAL STAPLING INSTRUMENTS」、米国特許出願公開第2018/0168649号、
−米国特許出願第15/386,221号、発明の名称「LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS」、米国特許出願公開第2018/01686号、
−米国特許出願第15/386,209号、発明の名称「SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF」、米国特許出願公開第2018/0168645号、
−米国特許出願第15/386,198号、発明の名称「LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS AND REPLACEABLE TOOL ASSEMBLIES」、米国特許出願公開第2018/0168644号、
−米国特許出願第15/386,240号、発明の名称「SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR」、米国特許出願公開第2018/0168651号、
−米国特許出願第15/385,939号、発明の名称「STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES THEREIN」、米国特許出願公開第2018/0168629号、
−米国特許出願第15/385,941号、発明の名称「SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FOR SHIFTING BETWEEN CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES AND ARTICULATION AND FIRING SYSTEMS」、米国特許出願公開第2018/0168630号、
−米国特許出願第15/385,943号、発明の名称「SURGICAL STAPLING INSTRUMENTS AND STAPLE−FORMING ANVILS」、米国特許出願公開第2018/0168631号、
−米国特許出願第15/385,950号、発明の名称「SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTION FEATURES」、米国特許出願公開第2018/0168635号、
−米国特許出願第15/385,945号、発明の名称「STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES THEREIN」、米国特許出願公開第2018/0168632号、
−米国特許出願第15/385,946号、発明の名称「SURGICAL STAPLING INSTRUMENTS AND STAPLE−FORMING ANVILS」、米国特許出願公開第2018/0168633号、
−米国特許出願第15/385,951号、発明の名称「SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASING A JAW OPENING DISTANCE」、米国特許出願公開第2018/0168636号、
−米国特許出願第15/385,953号、発明の名称「METHODS OF STAPLING TISSUE」、米国特許出願公開第2018/0168637号、
−米国特許出願第15/385,954号、発明の名称「FIRING MEMBERS WITH NON−PARALLEL JAW ENGAGEMENT FEATURES FOR SURGICAL END EFFECTORS」、米国特許出願公開第2018/0168638号、
−米国特許出願第15/385,955号、発明の名称「SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOP ARRANGEMENTS」、米国特許出願公開第2018/0168639号、
−米国特許出願第15/385,948号、発明の名称「SURGICAL STAPLING INSTRUMENTS AND STAPLE−FORMING ANVILS」、米国特許出願公開第2018/0168584号、
−米国特許出願第15/385,956号、発明の名称「SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES」、米国特許出願公開第2018/0168640号、
−米国特許出願第15/385,958号、発明の名称「SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTING FIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT」、米国特許出願公開第2018/0168641号、
−米国特許出願第15/385,947号、発明の名称「STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES THEREIN」、米国特許出願公開第2018/0168634号、
−米国特許出願第15/385,896号、発明の名称「METHOD FOR RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT」、米国特許出願公開第2018/0168597号、
−米国特許出願第15/385,898号、発明の名称「STAPLE−FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENT TYPES OF STAPLES」、米国特許出願公開第2018/0168599号、
−米国特許出願第15/385,899号、発明の名称「SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL」、米国特許出願公開第2018/0168600号、
−米国特許出願第15/385,901号、発明の名称「STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISING WINDOWS DEFINED THEREIN」、米国特許出願公開第2018/0168602号、
−米国特許出願第15/385,902号、発明の名称「SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER」、米国特許出願公開第2018/0168603号、
−米国特許出願第15/385,904号、発明の名称「STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/OR SPENT CARTRIDGE LOCKOUT」、米国特許出願公開第2018/0168605号、
−米国特許出願第15/385,905号、発明の名称「FIRING ASSEMBLY COMPRISING A LOCKOUT」、米国特許出願公開第2018/0168606号、
−米国特許出願第15/385,907号、発明の名称「SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUT AND A FIRING ASSEMBLY LOCKOUT」、米国特許出願公開第2018/0168608号、
−米国特許出願第15/385,908号、発明の名称「FIRING ASSEMBLY COMPRISING A FUSE」、米国特許出願公開第2018/0168609号、
−米国特許出願第15/385,909号、発明の名称「FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED−STATE FUSE」、米国特許出願公開第2018/0168610号、
−米国特許出願第15/385,920号、発明の名称「STAPLE−FORMING POCKET ARRANGEMENTS」、米国特許出願公開第2018/0168620号、
−米国特許出願第15/385,913号、発明の名称「ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS」、米国特許出願公開第2018/0168614号、
−米国特許出願第15/385,914号、発明の名称「METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPES OF STAPLE CARTRIDGES WITH THE SAME SURGICAL STAPLING INSTRUMENT」、米国特許出願公開第2018/0168615号、
−米国特許出願第15/385,893号、発明の名称「BILATERALLY ASYMMETRIC STAPLE−FORMING POCKET PAIRS」、米国特許出願公開第2018/0168594号、
−米国特許出願第15/385,929号、発明の名称「CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICAL INSTRUMENTS WITH SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS」、米国特許出願公開第2018/0168626号、
−米国特許出願第15/385,911号、発明の名称「SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING AND FIRING SYSTEMS」、米国特許出願公開第2018/0168612号、
−米国特許出願第15/385,927号、発明の名称「SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES」、米国特許出願公開第2018/0168625号、
−米国特許出願第15/385,917号、発明の名称「STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPING BREADTHS」、米国特許出願公開第2018/0168617号、
−米国特許出願第15/385,900号、発明の名称「STAPLE−FORMING POCKET ARRANGEMENTS COMPRISING PRIMARY SIDEWALLS AND POCKET SIDEWALLS」、米国特許出願公開第2018/0168601号、
−米国特許出願第15/385,931号、発明の名称「NO−CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FOR SURGICAL STAPLERS」、米国特許出願公開第2018/0168627号、
−米国特許出願第15/385,915号、発明の名称「FIRING MEMBER PIN ANGLE」、米国特許出願公開第2018/0168616号、
−米国特許出願第15/385,897号、発明の名称「STAPLE−FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMING SURFACE GROOVES」、米国特許出願公開第2018/0168598号、
−米国特許出願第15/385,922号、発明の名称「SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES」、米国特許出願公開第2018/0168622号、
−米国特許出願第15/385,924号、発明の名称「SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS」、米国特許出願公開第2018/0168624号、
−米国特許出願第15/385,910号、発明の名称「ANVIL HAVING A KNIFE SLOT WIDTH」、米国特許出願公開第2018/0168611号、
−米国特許出願第15/385,903号、発明の名称「CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS」、米国特許出願公開第2018/0168604号、
−米国特許出願第15/385,906号、発明の名称「FIRING MEMBER PIN CONFIGURATIONS」、米国特許出願公開第2018/0168607号、
−米国特許出願第15/386,188号、発明の名称「STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES」、米国特許出願公開第2018/0168585号、
−米国特許出願第15/386,192号、発明の名称「STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAP SETTING FEATURES」、米国特許出願公開第2018/0168643号、
−米国特許出願第15/386,206号、発明の名称「STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES」、米国特許出願公開第2018/0168586号、
−米国特許出願第15/386,226号、発明の名称「DURABILITY FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIES OF SURGICAL STAPLING INSTRUMENTS」、米国特許出願公開第2018/0168648号、
−米国特許出願第15/386,222号、発明の名称「SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITH POSITIVE OPENING FEATURES」、米国特許出願公開第2018/0168647号、
−米国特許出願第15/386,236号、発明の名称「CONNECTION PORTIONS FOR DEPOSABLE LOADING UNITS FOR SURGICAL STAPLING INSTRUMENTS」、米国特許出願公開第2018/0168650号、
−米国特許出願第15/385,887号、発明の名称「METHOD FOR ATTACHING A SHAFT ASSEMBLY TO A SURGICAL INSTRUMENT AND,ALTERNATIVELY,TO A SURGICAL ROBOT」、米国特許出願公開第2018/0168589号、
−米国特許出願第15/385,889号、発明の名称「SHAFT ASSEMBLY COMPRISING A MANUALLY−OPERABLE RETRACTION SYSTEM FOR USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM」、米国特許出願公開第2018/0168590号、
−米国特許出願第15/385,890号、発明の名称「SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE AND RETRACTABLE SYSTEMS」、米国特許出願公開第2018/0168591号、
−米国特許出願第15/385,891号、発明の名称「SHAFT ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO ADAPT THE OUTPUT OF A ROTARY FIRING MEMBER TO TWO DIFFERENT SYSTEMS」、米国特許出願公開第2018/0168592号、
−米国特許出願第15/385,892号、発明の名称「SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO AN ARTICULATION STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM」、米国特許出願公開第2018/0168593号、
−米国特許出願第15/385,894号、発明の名称「SHAFT ASSEMBLY COMPRISING A LOCKOUT」、米国特許出願公開第2018/0168595号、
−米国特許出願第15/385,895号、発明の名称「SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATION LOCKOUTS」、米国特許出願公開第2018/0168596号、
−米国特許出願第15/385,916号、発明の名称「SURGICAL STAPLING SYSTEMS」、米国特許出願公開第2018/0168575号、
−米国特許出願第15/385,918号、発明の名称「SURGICAL STAPLING SYSTEMS」、米国特許出願公開第2018/0168618号、
−米国特許出願第15/385,919号、発明の名称「SURGICAL STAPLING SYSTEMS」、米国特許出願公開第2018/0168619号、
−米国特許出願第15/385,921号、発明の名称「SURGICAL STAPLE CARTRIDGE WITH MOVABLE CAMMING MEMBER CONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES」、米国特許出願公開第2018/0168621号、
−米国特許出願第15/385,923号、発明の名称「SURGICAL STAPLING SYSTEMS」、米国特許出願公開第2018/0168623号、
−米国特許出願第15/385,925号、発明の名称「JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OF A FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN UNFIRED CARTRIDGE IS INSTALLED IN THE END EFFECTOR」、米国特許出願公開第2018/0168576号、
−米国特許出願第15/385,926号、発明の名称「AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYING CLOSURE MOTIONS TO JAWS OF SURGICAL INSTRUMENTS」、米国特許出願公開第2018/0168577号、
−米国特許出願第15/385,928号、発明の名称「PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN A MOVABLE JAW AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT」、米国特許出願公開第2018/0168578号、
−米国特許出願第15/385,930号、発明の名称「SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERATING OPENING FEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS」、米国特許出願公開第2018/0168579号、
−米国特許出願第15/385,932号、発明の名称「ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFT ARRANGEMENT」、米国特許出願公開第2018/0168628号、
−米国特許出願第15/385,933号、発明の名称「ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLE LINKAGE DISTAL OF AN ARTICULATION LOCK」、米国特許出願公開第2018/0168580号、
−米国特許出願第15/385,934号、発明の名称「ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR IN AN ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE SYSTEM」、米国特許出願公開第2018/0168581号、
−米国特許出願第15/385,935号、発明の名称「LATERALLY ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR OF A SURGICAL INSTRUMENT IN AN ARTICULATED CONFIGURATION」、米国特許出願公開第2018/0168582号、
−米国特許出願第15/385,936号、発明の名称「ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKE AMPLIFICATION FEATURES」、米国特許出願公開第2018/0168583号、
−米国特許出願第14/318,996号、発明の名称「FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENT CONFIGURATIONS」、米国特許出願公開第2015/0297228号、
−米国特許出願第14/319,006号、発明の名称「FASTENER CARTRIDGE COMPRISING FASTENER CAVITIES INCLUDING FASTENER CONTROL FEATURES」、現在は、米国特許第10,010,324号、
−米国特許出願第14/318,991号、発明の名称「SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS」、現在は、米国特許第9,833,241号、
−米国特許出願第14/319,004号、発明の名称「SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITORING ARRANGEMENTS」、現在は、米国特許第9,844,369号、
−米国特許出願第14/319,008号、発明の名称「FASTENER CARTRIDGE COMPRISING NON−UNIFORM FASTENERS」、米国特許出願公開第2015/0297232号、
−米国特許出願第14/318,997号、発明の名称「FASTENER CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGING MEMBERS」、米国特許出願公開第2015/0297229号、
−米国特許出願第14/319,002号、発明の名称「FASTENER CARTRIDGE COMPRISING TISSUE CONTROL FEATURES」、現在は、米国特許第9,877,721号、
−米国特許出願第14/319,013号、発明の名称「FASTENER CARTRIDGE ASSEMBLIES AND STAPLE RETAINER COVER ARRANGEMENTS」、米国特許出願公開第2015/0297233号、及び
−米国特許出願第14/319,016号、発明の名称「FASTENER CARTRIDGE INCLUDING A LAYER ATTACHED THERETO」、米国特許出願公開第2015/0297235号。
本願の出願人は、2016年6月24日に出願された以下の米国特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第15/191,775号、発明の名称「STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES」、
−米国特許出願第15/191,807号、発明の名称「STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPED STAPLES」、
−米国特許出願第15/191,834号、発明の名称「STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME」、
−米国特許出願第15/191,788号、発明の名称「STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES」、及び
−米国特許出願第15/191,818号、発明の名称「STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL STAPLE ROWS」。
本願の出願人は、2016年6月24日に出願された以下の米国特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国意匠特許出願第29/569,218号、発明の名称「SURGICAL FASTENER」、
−米国意匠特許出願第29/569,227号、発明の名称「SURGICAL FASTENER」、
−米国意匠特許出願第29/569,259号、発明の名称「SURGICAL FASTENER CARTRIDGE」、及び
−米国意匠特許出願第29/569,264号、発明の名称「SURGICAL FASTENER CARTRIDGE」。
本願の出願人は、2016年4月1日に出願された以下の特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第15/089,325号、発明の名称「METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM」、
−米国特許出願第15/089,321号、発明の名称「MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY」、
−米国特許出願第15/089,326号、発明の名称「SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE−ORIENTABLE DISPLAY FIELD」、
−米国特許出願第15/089,263号、発明の名称「SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIP PORTION」、
−米国特許出願第15/089,262号、発明の名称「ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLE BAILOUT SYSTEM」、
−米国特許出願第15/089,277号、発明の名称「SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVIL CONCENTRIC DRIVE MEMBER」、
−米国特許出願第15/089,296号、発明の名称「INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL END EFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS」、
−米国特許出願第15/089,258号、発明の名称「SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION」、
−米国特許出願第15/089,278号、発明の名称「SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVE CUTTING OF TISSUE」、
−米国特許出願第15/089,284号、発明の名称「SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT」、
−米国特許出願第15/089,295号、発明の名称「SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSION LOCKOUT」、
−米国特許出願第15/089,300号、発明の名称「SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT」、
−米国特許出願第15/089,196号、発明の名称「SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT」、
−米国特許出願第15/089,203号、発明の名称「SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT」、
−米国特許出願第15/089,210号、発明の名称「SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGE LOCKOUT」、
−米国特許出願第15/089,324号、発明の名称「SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM」、
−米国特許出願第15/089,335号、発明の名称「SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS」、
−米国特許出願第15/089,339号、発明の名称「SURGICAL STAPLING INSTRUMENT」、
−米国特許出願第15/089,253号、発明の名称「SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OF STAPLES HAVING DIFFERENT HEIGHTS」、
−米国特許出願第15/089,304号、発明の名称「SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET」、
−米国特許出願第15/089,331号、発明の名称「ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS」、
−米国特許出願第15/089,336号、発明の名称「STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES」、
−米国特許出願第15/089,312号、発明の名称「CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUE SUPPORT」、
−米国特許出願第15/089,309号、発明の名称「CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM」、及び
−米国特許出願第15/089,349号、発明の名称「CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL」。
本願の出願人はまた、2015年12月31日に出願された以下に特定する米国特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第14/984,488号、発明の名称「MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE IN POWERED SURGICAL INSTRUMENTS」、
−米国特許出願第14/984,525号、発明の名称「MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS」、及び
−米国特許出願第14/984,552号、発明の名称「SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROL CIRCUITS」。
本願の出願人はまた、2016年2月9日に出願された以下に特定する米国特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第15/019,220号、発明の名称「SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLY TRANSLATABLE END EFFECTOR」、
−米国特許出願第15/019,228号、発明の名称「SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATION ARRANGEMENTS」、
−米国特許出願第15/019,196号、発明の名称「SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTED SECONDARY CONSTRAINT」、
−米国特許出願第15/019,206号、発明の名称「SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLY ARTICULATABLE RELATIVE TO AN ELONGATED SHAFT ASSEMBLY」、
−米国特許出願第15/019,215号、発明の名称「SURGICAL INSTRUMENTS WITH NON−SYMMETRICAL ARTICULATION ARRANGEMENTS」、
−米国特許出願第15/019,227号、発明の名称「ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATION LINK ARRANGEMENTS」、
−米国特許出願第15/019,235号、発明の名称「SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLE DRIVEN ARTICULATION SYSTEMS」、
−米国特許出願第15/019,230号、発明の名称「ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF−AXIS FIRING BEAM ARRANGEMENTS」、及び
−米国特許出願第15/019,245号、発明の名称「SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTION ARRANGEMENTS」。
本願の出願人はまた、2016年2月12日に出願された以下に特定する米国特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第15/043,254号、発明の名称「MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS」、
−米国特許出願第15/043,259号、発明の名称「MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS」、
−米国特許出願第15/043,275号、発明の名称「MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS」、及び
−米国特許出願第15/043,289号、発明の名称「MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS」。
本願の出願人は、2015年6月18日に出願された以下の特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第14/742,925号、発明の名称「SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING ARRANGEMENTS」、
−米国特許出願第14/742,941号、発明の名称「SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSING FEATURES」、
−米国特許出願第14/742,914号、発明の名称「MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS」、
−米国特許出願第14/742,900号、発明の名称「ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAM STRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT」、
−米国特許出願第14/742,885号、発明の名称「DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS」、及び
−米国特許出願第14/742,876号、発明の名称「PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLE SURGICAL INSTRUMENTS」。
本願の出願人は、2015年3月6日に出願された以下の特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第14/640,746号、発明の名称「POWERED SURGICAL INSTRUMENT」、現在は米国特許出願公開第2016/0256184号、
−米国特許出願第14/640,795号、発明の名称「MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWERED SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2016/02561185号、
−米国特許出願第14/640,832号、発明の名称「ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATES FOR MULTIPLE TISSUE TYPES」、現在は米国特許出願公開第2016/0256154号、
−米国特許出願第14/640,935号、発明の名称「OVERLAID MULTI SENSOR RADIO FREQUENCY(RF)ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION」、現在は米国特許出願公開第2016/0256071号、
−米国特許出願第14/640,831号、発明の名称「MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTOR FOR POWERED SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2016/0256153号、
−米国特許出願第14/640,859号、発明の名称「TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE STABILITY,CREEP,AND VISCOELASTIC ELEMENTS OF MEASURES」、現在は米国特許出願公開第2016/0256187号、
−米国特許出願第14/640,817号、発明の名称「INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2016/0256186号、
−米国特許出願第14/640,844号、発明の名称「CONTROL TECHNIQUES AND SUB−PROCESSOR CONTAINED WITHIN MODULAR SHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE」、現在は米国特許出願公開第2016/0256155号、
−米国特許出願第14/640,837号、発明の名称「SMART SENSORS WITH LOCAL SIGNAL PROCESSING」、現在は米国特許出願公開第2016/0256163号、
−米国特許出願第14/640,765号、発明の名称「SYSTEM FOR DETECTING THE MIS−INSERTION OF A STAPLE CARTRIDGE INTO A SURGICAL STAPLER」、現在は米国特許出願公開第2016/0256160号、
−米国特許出願第14/640,799号、発明の名称「SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A ROTATABLE SHAFT」、現在は米国特許出願公開第2016/0256162号、及び
−米国特許出願第14/640,780号、発明の名称「SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING」、現在は米国特許出願公開第2016/0256161号。
本願の出願人は、2015年2月27日に出願された以下の特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第14/633,576号、発明の名称「SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION」、現在は米国特許出願公開第2016/0249919号、
−米国特許出願第14/633,546号、発明の名称「SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCE PARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND」、現在は米国特許出願公開第2016/0249915号、
−米国特許出願第14/633,560号、発明の名称「SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONE OR MORE BATTERIES」、現在は米国特許出願公開第2016/0249910号、
−米国特許出願第14/633,566号、発明の名称「CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR CHARGING A BATTERY」、現在は米国特許出願公開第2016/0249918号、
−米国特許出願第14/633,555号、発明の名称「SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TO BE SERVICED」、現在は米国特許出願公開第2016/0249916号、
−米国特許出願第14/633,542号、発明の名称「REINFORCED BATTERY FOR A SURGICAL INSTRUMENT」、現在は米国特許出願公開第2016/0249908号、
−米国特許出願第14/633,548号、発明の名称「POWER ADAPTER FOR A SURGICAL INSTRUMENT」、現在は米国特許出願公開第2016/0249909号、
−米国特許出願第14/633,526号、発明の名称「ADAPTABLE SURGICAL INSTRUMENT HANDLE」、現在は米国特許出願公開第2016/0249945号、
−米国特許出願第14/633,541号、発明の名称「MODULAR STAPLING ASSEMBLY」、現在は米国特許出願公開第2016/0249927号、
−米国特許出願第14/633,562号、発明の名称「SURGICAL APPARATUS CONFIGURED TO TRACK AN END−OF−LIFE PARAMETER」、現在は米国特許出願公開第2016/0249917号。
本願の出願人は、2014年12月18日に出願された以下の特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第14/574,478号、発明の名称「SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER」、現在は米国特許出願公開第2016/0174977号、
−米国特許出願第14/574,483号、発明の名称「SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS」、現在は米国特許出願公開第2016/0174969号、
−米国特許出願第14/575,139号、発明の名称「DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2016/0174978号、
−米国特許出願第14/575,148号、発明の名称「LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH ARTICULATABLE SURGICAL END EFFECTORS」、現在は米国特許出願公開第2016/0174976号、
−米国特許出願第14/575,130号、発明の名称「SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON−MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE」、現在は米国特許出願公開第2016/0174972号、
−米国特許出願第14/575,143号、発明の名称「SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS」、現在は米国特許出願公開第2016/0174983号、
−米国特許出願第14/575,117号、発明の名称「SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS」、現在は米国特許出願公開第2016/0174975号、
−米国特許出願第14/575,154号、発明の名称SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS」、現在は米国特許出願公開第2016/0174973号、
−米国特許出願第14/574,493号、発明の名称「SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM」、現在は米国特許出願公開第2016/0174970号、及び
−米国特許出願第14/574,500号、発明の名称「SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION SYSTEM」、現在は米国特許出願公開第2016/0174971号。
本願の出願人は、2013年3月1日に出願された以下の特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第13/782,295号、発明の名称「ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS FOR SIGNAL COMMUNICATION」、現在は米国特許出願公開第2014/0246471号、
−米国特許出願第13/782,323号、発明の名称「ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2014/0246472号、
−米国特許出願第13/782,338号、発明の名称「THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2014/0249557号、
−米国特許出願第13/782,499号、発明の名称「ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAY ARRANGEMENT」、現在は米国特許第9,358,003号、
−米国特許出願第13/782,460号、発明の名称「MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2014/0246478号、
−米国特許出願第13/782,358号、発明の名称「JOYSTICK SWITCH ASSEMBLIES FOR SURGICAL INSTRUMENTS」、現在は米国特許第9,326,767号、
−米国特許出願第13/782,481号、発明の名称「SENSOR STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGH TROCAR」、現在は米国特許第9,468,438号、
−米国特許出願第13/782,518号、発明の名称「CONTROL METHODS FOR SURGICAL INSTRUMENTS WITH REMOVABLE IMPLEMENT PORTIONS」、現在は米国特許出願公開第2014/0246475号、
−米国特許出願第13/782,375号、発明の名称「ROTARY POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OF FREEDOM」、現在は米国特許第9,398,911号、及び
−米国特許出願第13/782,536号、発明の名称「SURGICAL INSTRUMENT SOFT STOP」、現在は米国特許第9,307,986号。
本願の出願人はまた、2013年3月14日に出願された以下の特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第13/803,097号、発明の名称「ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE」、現在は米国特許出願公開第2014/0263542号、
−米国特許出願第13/803,193号、発明の名称「CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT」、現在は米国特許第9,332,987号、
−米国特許出願第13/803,053号、発明の名称「INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT」、現在は米国特許出願公開第2014/0263564号、
−米国特許出願第13/803,086号、発明の名称「ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK」、現在は米国特許出願公開第2014/0263541号、
−米国特許出願第13/803,210号、発明の名称「SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2014/0263538号、
−米国特許出願第13/803,148号、発明の名称「MULTI−FUNCTION MOTOR FOR A SURGICAL INSTRUMENT」、現在は米国特許出願公開第2014/0263554号、
−米国特許出願第13/803,066号、発明の名称「DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2014/0263565号、
−米国特許出願第13/803,117号、発明の名称「ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS」、現在は米国特許第9,351,726号、
−米国特許出願第13/803,130号、発明の名称「DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS」、現在は米国特許第9,351,727号、及び
−米国特許出願第13/803,159号、発明の名称「METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT」、現在は米国特許出願公開第2014/0277017号。
本願の出願人はまた、2014年3月7日に出願された以下の特許出願を所有しており、その全体内容が参照により本明細書に組み込まれる。
−米国特許出願第14/200,111号、発明の名称「CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2014/0263539号。
本願の出願人はまた、2014年3月26日に出願された以下の特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第14/226,106号、発明の名称「POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2015/0272582号、
−米国特許出願第14/226,099号、発明の名称「STERILIZATION VERIFICATION CIRCUIT」、現在は米国特許出願公開第2015/0272581号、
−米国特許出願第14/226,094号、発明の名称「VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT」、現在は米国特許出願公開第2015/0272580号、
−米国特許出願第14/226,117号、発明の名称「POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL」、現在は米国特許出願公開第2015/0272574号、
−米国特許出願第14/226,075号、発明の名称「MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES」、現在は米国特許出願公開第2015/0272579号、
−米国特許出願第14/226,093号、発明の名称「FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2015/0272569号、
−米国特許出願第14/226,116号、発明の名称「SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION」、現在は米国特許出願公開第2015/0272571号、
−米国特許出願第14/226,071号、発明の名称「SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR」、現在は米国特許出願公開第2015/0272578号、
−米国特許出願第14/226,097号、発明の名称「SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS」、現在は米国特許出願公開第2015/0272570号、
−米国特許出願第14/226,126号、発明の名称「INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS」、現在は米国特許出願公開第2015/0272572号、
−米国特許出願第14/226,133号、発明の名称「MODULAR SURGICAL INSTRUMENT SYSTEM」、現在は米国特許出願公開第2015/0272557号、
−米国特許出願第14/226,081号、発明の名称「SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT」、現在は米国特許出願公開第2015/0277471号、
−米国特許出願第14/226,076号、発明の名称「POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION」、現在は米国特許出願公開第2015/0280424号、
−米国特許出願第14/226,111号、発明の名称「SURGICAL STAPLING INSTRUMENT SYSTEM」、現在は米国特許出願公開第2015/0272583号、及び
−米国特許出願第14/226,125号、発明の名称「SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT」、現在は、米国特許出願公開第2015/0280384号。
本願の出願人はまた、2014年9月5日に出願された以下の特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第14/479,103号、発明の名称「CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE」、現在は米国特許出願公開第2016/0066912号、
−米国特許出願第14/479,119号、発明の名称「ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION」、現在は米国特許出願公開第2016/0066914号、
−米国特許出願第14/478,908号、発明の名称「MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION」、現在は米国特許出願公開第2016/0066910号、
−米国特許出願第14/478,895号、発明の名称「MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR’S OUTPUT OR INTERPRETATION」、現在は米国特許出願公開第2016/0066909号、
−米国特許出願第14/479,110号、発明の名称「POLARITY OF HALL MAGNET TO DETECT MISLOADED CARTRIDGE」、現在は米国特許出願公開第2016/0066915号、
−米国特許出願第14/479,098号、発明の名称「SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION」、現在は米国特許出願公開第2016/0066911号、
−米国特許出願第14/479,115号、発明の名称「MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE」、現在は米国特許出願公開第2016/0066916号、及び
−米国特許出願第14/479,108号、発明の名称「LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION」、現在は米国特許出願公開第2016/0066913号。
本願の出願人はまた、2014年4月9日に出願された以下の特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許出願第14/248,590号、発明の名称「MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS」、現在は米国特許出願公開第2014/0305987号、
−米国特許出願第14/248,581号、発明の名称「SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRING DRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT」、現在は米国特許出願公開第2014/0305989号、
−米国特許出願第14/248,595号、発明の名称「SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING THE OPERATION OF THE SURGICAL INSTRUMENT」、現在は米国特許出願公開第2014/0305988号、
−米国特許出願第14/248,588号、発明の名称「POWERED LINEAR SURGICAL STAPLER」、現在は米国特許出願公開第2014/0309666号、
−米国特許出願第14/248,591号、発明の名称「TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT」、現在は米国特許出願公開第2014/0305991号、
−米国特許出願第14/248,584号、発明の名称「MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS」、現在は米国特許出願公開第2014/0305994号、
−米国特許出願第14/248,587号、発明の名称「POWERED SURGICAL STAPLER」、現在は米国特許出願公開第2014/0309665号、
−米国特許出願第14/248,586号、発明の名称「DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT」、現在は米国特許出願公開第2014/0305990号、及び
−米国特許出願第14/248,607号、発明の名称「MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS」、現在は米国特許出願公開第2014/0305992号。
本願の出願人はまた、2013年4月16日に出願された以下の特許出願を所有しており、これらはそれぞれの内容全体が参照により本明細書に組み込まれる。
−米国特許仮出願第61/812,365号、発明の名称「SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR」、
−米国特許仮出願第61/812,376号、発明の名称「LINEAR CUTTER WITH POWER」、
−米国特許仮出願第61/812,382号、発明の名称「LINEAR CUTTER WITH MOTOR AND PISTOL GRIP」、
−米国特許仮出願第61/812,385号、発明の名称「SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS AND MOTOR CONTROL」、及び
−米国特許仮出願第61/812,372号、発明の名称「SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR」。
明細書に説明され、添付の図面に例解されるように、実施形態の全体的な構造、機能、製造、及び使用の完全な理解を提供するために、多数の具体的な詳細が説明される。周知の動作、構成要素、及び要素は、本明細書に記載される実施形態を不明瞭にしないようにするため、詳細に記載されていない。読者は、本明細書に説明及び例解された実施形態は、非限定的な例であり、したがって本明細書に開示された特定の構造的及び機能的詳細は、代表的及び例解的であり得ることを、理解するであろう。特許請求の範囲の範囲から逸脱することなく、それに対する変形及び変更を行うことができる。
「含む(comprise)」(「comprises」及び「comprising」など、compriseの任意の語形)、「有する(have)」(「has」及び「having」など、haveの任意の語形)、「含む(include)」(「includes」及び「including」など、includeの任意の語形)、及び「含有する(contain)」(「contains」及び「containing」など、containの任意の語形)という用語は、オープンエンドの連結動詞である。結果として、1つ以上の要素を「含む(comprise)」、「有する」、「含む(include)」、若しくは「含有する」外科用システム、デバイス、又は装置は、それらの1つ以上の要素を有するが、それらの1つ以上のみを有することに限定されない。同様に、1つ以上の特徴を「含む(comprise)」、「有する」、「含む(include)」、若しくは「含有する」、システム、デバイス、又は装置の要素は、それら1つ以上の特徴を有するが、それら1つ以上の特徴のみを有することに限定されない。
「近位」及び「遠位」という用語は、本明細書では、外科用器具のハンドル部分を操作する臨床医を基準として使用される。「近位」という用語は、臨床医に最も近い部分を指し、「遠位」という用語は、臨床医から離れた位置にある部分を指す。便宜上及び明確性のために、「垂直」、「水平」、「上」、及び「下」などの空間的用語が、本明細書において図面に対して使用され得ることが更に理解されよう。しかしながら、外科用器具は、多くの配向及び位置で使用されるものであり、これらの用語は限定的及び/又は絶対的であることを意図したものではない。
腹腔鏡下及び低侵襲性の外科処置を行うための、様々な例示的なデバイス及び方法が提供される。しかしながら、本明細書に開示される様々な方法及びデバイスが、例えば切開外科処置と関連するものを含む、多くの外科処置及び用途で使用され得ることが、読者には容易に理解されよう。本明細書の「発明を実施するための形態」を読み進めることで、読者は、本明細書に開示される様々な器具が、例えば、天然の開口部を通じて、組織に形成された切開又は穿刺穴を通じてなど、任意の方法で体内に挿入され得ることを更に理解するであろう。これらの器具の作用部分即ちエンドエフェクタ部分は、患者の体内に直接に挿入することもでき、又は、外科用器具のエンドエフェクタ及び細長いシャフトを進めることが可能な作用通路を有するアクセスデバイスを通じて挿入することもできる。
外科用ステープル留めシステムは、シャフトと、シャフトから延在するエンドエフェクタと、を含むことができる。エンドエフェクタは、第1の顎部及び第2の顎部を含む。第1の顎部は、ステープルカートリッジを含む。ステープルカートリッジは、第1の顎部へと挿入可能であり、かつ第1の顎部から取り外し可能であるが、ステープルカートリッジが第1の顎部から取り外し可能でない、又は第1の顎部から少なくとも容易に交換可能ではない、他の実施形態が想到される。第2の顎部は、ステープルカートリッジから排出されたステープルを変形させるように構成されたアンビルを含む。第2の顎部は、閉鎖軸の周囲にて、第1の顎部に対して枢動可能であるが、第1の顎部が第2の顎部に対して枢動可能である、他の実施形態が想定される。外科用ステープル留めシステムは、エンドエフェクタをシャフトに対して回転させる、すなわち関節運動させることができるように構成された関節運動接合部を更に含む。エンドエフェクタは、関節運動接合部を通って延在する関節運動軸を中心にして回転可能である。関節運動接合部を含まない他の実施形態も想到される。
ステープルカートリッジは、カートリッジ本体を含む。カートリッジ本体は、近位端と、遠位端と、近位端と遠位端との間に延在するデッキ部と、を含む。使用中、ステープルカートリッジは、ステープル留めされる組織の第1の側に位置付けられ、アンビルは、組織の第2の側に位置付けられる。アンビルは、ステープルカートリッジに向かって移動させられて、デッキ部に対して組織を圧縮及びクランプする。続いて、カートリッジ本体内に取り外し可能に格納されたステープルを、組織内に配備することができる。カートリッジ本体は、内部に画定されたステープルキャビティを含み、ステープルは、ステープルキャビティ内に取り外し可能に格納される。ステープルキャビティは、6つの長手方向列に配置されている。3列のステープルキャビティが長手方向スロットの第1の側に位置付けられ、3列のステープルキャビティが長手方向スロットの第2の側に位置付けられている。ステープルキャビティ及びステープルの他の配置も可能であり得る。
ステープルは、カートリッジ本体内のステープル駆動部によって支持されている。駆動部は、第1の、すなわち未発射位置と、ステープルキャビティからステープルを排出する、第2の、すなわち発射済み位置と、の間で移動可能である。駆動部は、カートリッジ本体の底部周辺に延在する保持具によってカートリッジ本体内に保持され、また、カートリッジ本体を把持し、保持具をカートリッジ本体に対して保持するように構成された、弾性部材を含む。駆動部は、スレッドによってそれらの未発射位置とそれらの発射済み位置との間で移動可能である。スレッドは、近位端に隣接した近位位置と、遠位端に隣接した遠位位置と、の間で移動可能である。スレッドは、駆動部の下を摺動し、駆動部を持ち上げるように構成された複数の傾斜面を含み、ステープルがその上に支持され、アンビルに向かう。
上記に加えて、スレッドは発射部材によって遠位に移動される。発射部材は、スレッドに接触し、スレッドを遠位端部に向かって押し出すように構成されている。カートリッジ本体内に画定された長手方向スロットは、発射部材を受け入れるように構成されている。アンビルは、発射部材を受け入れるように構成されたスロットも含む。発射部材は、第1の顎部に係合する第1のカムと、第2の顎部に係合する第2のカムと、を更に含む。発射部材を遠位に前進させる際、第1のカム及び第2のカムは、ステープルカートリッジのデッキ部とアンビルとの間の距離、すなわち組織隙間を制御することができる。発射部材はまた、ステープルカートリッジとアンビルとの中間に捕捉された組織を切除するように構成されたナイフも含む。ステープルがナイフよりも前方に排出されるように、ナイフが傾斜面に対して少なくとも部分的に近位側に位置付けられることが望ましい。
図1は、再使用されてもされなくてもよい、モータ駆動の外科用切断及び締結器具10を描写する。例解される実施形態では、器具10は、臨床医が把持し、操作し、作動させるように構成されたハンドル110を備えるハウジング100を含む。例解される実施例では、専用シャフトアセンブリ1000は、ハンドル110に動作可能に連結されている。しかしながら、代替的な実施形態では、ハンドルアセンブリは、1つ又は2つ以上の外科的タスク又は処置を実行するように構成された外科用エンドエフェクタが動作可能にそれぞれ連結された、様々な異なる交換式シャフトアセンブリと共に採用されるように構成されている。例えば、本明細書で開示する交換式シャフトアセンブリは、参照によって全ての内容が本明細書に組み込まれる、2011年5月27日出願の米国特許出願第13/118,241号、発明の名称「SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS」、現在は米国特許第9,072,535号に開示された、様々なロボットシステム、器具、構成要素、及び方法と共に採用され得る。
本発明を実施するための形態を読み進めるに従って、様々な態様のシャフトアセンブリ1000がまた、ロボット制御式の外科用システムと関連させて効果的に採用され得ることが理解されよう。したがって、「ハウジング」という用語はまた、本明細書に開示する交換式シャフトアセンブリ及びそれらそれぞれの等価物を作動させるのに使用することができる、少なくとも1つの制御運動を生成し加えるように構成された、少なくとも1つの駆動システムを収容するか又は別の方法で動作可能に支持するか又は別の方法でそれと関連付けられる、ロボットシステムのハウジング又は類似の部分を包含し得る。「フレーム」という用語は、手持ち式外科用器具の一部分を指し得る。「フレーム」という用語はまた、ロボット制御式の外科用器具の一部分、及び/又は外科用器具を動作可能に制御するのに使用され得るロボットシステムの一部分を表し得る。加えて、様々な構成要素は、ハウジング内に「収容」されるか若しくは含まれ得るか、又は様々な構成要素は、ハウジングに「関連付け」られ得る。このような例では、構成要素は、ハウジングに含まれていなくてもよく、又はハウジングによって直接支持されていなくてもよい。
例解される実施形態は、内視鏡器具であり、概して、本明細書において説明される器具10の実施形態は、内視鏡型の外科用切断及び締結器具である。しかしながら、他の実施形態により、この器具は、例えば、非内視鏡外科用切断及び締結器具であってもよいことに留意すべきである。様々な外科用器具が、米国特許第7,845,537号、発明の名称「SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES」、米国特許第8,608,045号、発明の名称「POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM」、及び米国特許第9,050,083号、発明の名称「MOTORIZED SURGICAL INSTRUMENT」に開示されており、これらの開示全体が参照により本明細書に組み込まれる。
図2を参照すると、例解される実施例では、シャフトアセンブリ1000は、組織を切断及びステープル留めするように構成されたエンドエフェクタ1500を含む。エンドエフェクタ1500は、第1の顎部1510と、第1の顎部1510上で移動可能に支持される第2の顎部1600とを備える。第1の顎部は、外科用ステープルカートリッジ1540を内部に動作可能に支持するように構成されている細長いチャネル1520を備える。第2の顎部1600は、細長いアンビル本体1612及びアンビル装着部分1620を含むアンビル1610を備える。しかしながら、第1の顎部がアンビルを備え、第2の顎部が外科用ステープルカートリッジ又は外科用ステープルカートリッジを支持するように構成されたチャネルを備える、代替的な構成が想到される。例解される実施例では、細長いアンビル本体1612は、上部にステープル形成下面1614を含み、その下面は、外科用ステープルカートリッジ1540に関して対面する関係に適合されている。アンビル1610は、アンビル装着部分1620上に形成された一対のアンビルトラニオン1622によって細長いチャネル1520上に枢動可能に支持されるか、又は移動可能に支持される。各トラニオン1622は、細長いチャネル1520の近位端部分に形成された対応するトラニオンクレードル1524内に枢動可能に受容される。トラニオン1622は、アンビルリテーナ1530によって、それらのそれぞれのクレードル1524内に枢動可能に保持される。
更に図2を参照すると、シャフトアセンブリ1000は、スパインシャフト1210を含むスパインアセンブリ1200を含み、このスパインシャフトは、1つ目に、発射部材アセンブリ1900を内部に摺動可能に支持し、2つ目に、スパインアセンブリ1200の周囲に延在する閉鎖部材アセンブリ2000を摺動可能に支持するように構成されている。スパインアセンブリ1200は、スパインシャフト1210によって支持される上部スパインステー1220及び下部スパインステー1230を更に含む。図2に見られるように、スパインシャフト1210の遠位端1212は、上部ラグ装着機構1240及び下部ラグ装着機構1250で終端する。上部ラグ装着機構1240の内部には、上部スパインステー1220の遠位端1222を内部に装着支持するように適合されたラグスロット1242が形成されている。同様に、下部ラグ装着機構1250の内部には、下部スパインステー1230の遠位端1232を内部に装着支持するように適合されたラグスロット1252が形成されている。上部スパインステー1220の遠位端1222の内部には、チャネルキャップ又はアンビルリテーナ1530上に形成された枢動ピン1532を内部に回転可能に受容するように適合された枢動ソケット1224が含まれている。下部スパインステー1230の遠位端1232は、細長いチャネル1520の近位端部分1522内に形成された枢動穴(図示せず)内に受容されるように適合された下部枢動ピン1234を含む。下部枢動ピン1234は、枢動ソケット1224と垂直に整列して、関節運動軸AAを画定し、外科用エンドエフェクタ1500は、シャフト1000に対してその軸を中心として関節運動することができる。図3を参照。
例解される構成では、閉鎖部材アセンブリ2000は、近位閉鎖管セグメント又は閉鎖部材セグメント2010を備える。近位閉鎖管セグメント2010は、関節運動接合部2105を画定する二重枢動閉鎖スリーブアセンブリ2020に動作可能に連結されており、エンドエフェクタ1500は、シャフトアセンブリ1000の残りの部分に対してその関節運動接合部を中心として関節運動することができる。しかしながら、他のシャフトアセンブリは、関節運動可能でなくてもよい。図2に見られるように、一形態では、二重枢動閉鎖スリーブアセンブリ2020は、近位閉鎖管セグメント2010の遠位端2012に取り付けられた中間閉鎖管セグメント2030を備える。加えて、二重枢動閉鎖スリーブアセンブリ2020は、上部及び下部の遠位突出タング2042、2044を有するエンドエフェクタ閉鎖管又は遠位閉鎖管2040を含む。上部二重枢動リンク2060は、中間閉鎖管セグメント2030上にある上部近位突出タング2042の上部遠位ピンホール、及び上部遠位突出タング2032の上部近位ピンホールにそれぞれ係合する、上向きに突出する遠位及び近位枢動ピンを含む。下部二重枢動リンク2070は、下部近位突出タング2044の下部遠位ピンホール、及び下部遠位突出タング2034の下部近位ピンホールにそれぞれ係合する、上向きに突出する遠位及び近位枢動ピンを含む。図2及び図3を参照されたい。
以下で更に詳細に説明するように、アンビル1610は、閉鎖部材アセンブリ2000を遠位側(方向「DD」)に並進させることによって、開放位置から閉鎖位置まで移動される。アンビル1610は、閉鎖部材アセンブリ2000を近位側に並進させることによって開放され、これによってエンドエフェクタ閉鎖スリーブ2020がアンビル1610と相互作用し、そのアンビルを開放位置に枢動させる。図4及び図5を参照すると、少なくとも一構成では、遠位閉鎖部材又はエンドエフェクタ閉鎖管2040は、2つの軸方向にオフセットされた近位側及び遠位側の正の顎部開放機構2050及び2052を採用する。図4及び図5では、近位側の正の顎部開放機構2050は、シャフト軸SA(shaft axis、SA)の(ツールアセンブリのユーザから見て)右側に配置されている。正の顎部開放機構2050、2052は、その開示全体が参照によって本明細書に、並びに本明細書に組み込まれる他の参考文献に組み込まれている、米国特許出願第15/635,631号、2017年6月28日出願、発明の名称「SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER」に更に詳細に説明されるように、対応する解放領域(図示せず)と、アンビル装着部分1620上に形成された段差部分(図示せず)と相互作用するように構成されている。他の顎部開放構成を採用してもよい。
例解される実施例、並びに本明細書に組み込まれる参考文献に開示された他のアンビル構成では、アンビル装着部分1620は、上部に形成されたカム表面又は複数のカム表面1624を有する。エンドエフェクタ閉鎖管2040が遠位側に移動されると、エンドエフェクタ閉鎖管2040の遠位端上に形成されたカム表面は、アンビル装着部分1620上のカム表面1624と相互作用して、アンビル1610を閉鎖位置にカム動作させる。
これも上述したように、シャフトアセンブリ1000は、スパインシャフト1210内で軸方向移動するように支持される発射部材アセンブリ1900を更に含む。発射部材アセンブリ1900は、遠位側切断部分又はナイフバー1930に取り付けられるように構成された中間発射シャフト部分1910を含む。中間発射シャフト部分1910の遠位端には、遠位側ナイフバー1930の近位端にあるタブ1932を受容するように構成され得る長手方向スロット1912が含まれ得る。長手方向スロット1932及び近位端タブ1932は、それらの間の相対運動を可能にするような大きさ及び構成とすることができ、スリップ接合部1940を備えることができる。スリップ接合部1940は、例えば、ナイフバー1930が中間発射シャフト部分1910に対して軸方向に移動して、エンドエフェクタ1500の関節運動に適応することを可能にし得る。ナイフバー1930は、ブレード又は組織切断縁部1952を含むナイフ部分1950を含み、上部アンビル係合タブ1954及び下部チャネル係合タブ1956を含む。様々な発射部材の構成及び動作は、参照により本明細書に組み込まれる様々な他の参考文献に開示されている。
例解される実施例において、外科用エンドエフェクタ1500は、関節運動駆動システム2100により、関節運動軸AA(articulation axis、AA)を中心として選択的に関節運動可能である。一形態では、関節運動駆動システム2100は、遠位関節運動リンク2130に枢動可能に連結された中間関節運動ドライバ2120に動作可能に連結された近位関節運動ドライバ2110を含む。図4及び図5に最も具体的に確認できるように、オフセット取り付けラグ2122が、中間関節運動ドライバ2120の遠位端に形成される。枢動穴2123は、オフセット取り付けラグ2122内に形成されており、遠位関節運動リンク2130の近位端2132に形成された近位リンクピン2134を内部に枢動可能に受容するように構成されている。関節運動リンク2120の遠位端2136は、細長いチャネル1520の近位端部分1522に形成されたチャネルピン1526を内部に枢動可能に受容するように構成された枢動穴2138を含む。したがって、中間関節運動ドライバ2120の軸移動により、関節運動が細長いチャネル1520に加えられ、これによって、外科用エンドエフェクタ1500がスパインアセンブリ1200に対して関節運動軸AAを中心として関節移動する。
次に、図6及び7に目を向けると、ハンドル110は、臨床医に把持及び操作され得るピストルグリップ部分119を形成するように協働するハンドルハウジングセグメント116、118を備える。以下に更に詳しく記述されるように、ハンドル110は、内部に複数の駆動システムを動作可能に支持しており、これらの駆動システムは、シャフトアセンブリ1200に対して、様々な制御運動を生成し加えるように構成されている。ここで図2を参照すると、ハンドル110は、複数の駆動システムを動作可能に支持するフレームアセンブリ又はシャーシ200を更に含んでもよい。例えば、フレームアセンブリ200は、一般的に300として指定される「第1の」又は閉鎖駆動システムを動作可能に支持することができ、これを採用して、シャフトアセンブリ1000のエンドエフェクタ1500に開閉運動を加えることができる。例解される実施例では、フレームアセンブリ200は、右フレーム部分210と、スナップ機構、ラグ、ねじなどによってフレームアセンブリに取り付けられたフレームキャップ212とを含み、内部にシャトルキャビティ214を画定する。図6及び図7を参照されたい。
少なくとも1つの形態では、閉鎖駆動システム300は、フレームアセンブリ200によって枢動可能に支持される閉鎖トリガ332の形態のアクチュエータを含んでもよい。より具体的には、図6及び図7に例解されるように、閉鎖トリガ332は、ピン333によってフレームアセンブリ200に枢動可能に連結されている。かかる配置によって、閉鎖トリガ332を臨床医が操作することが可能になり、それによって、臨床医がハンドル100のピストルグリップ部分119を把持すると、閉鎖トリガ332を、開始位置又は「非作動」位置から「作動」位置へと、より詳細には完全圧縮位置又は完全作動位置へと容易に枢動させることができる。閉鎖トリガ332は、ばね又は他の付勢装置によって、非作動位置へと付勢されてもよい。様々な形態では、閉鎖駆動システム300は、閉鎖トリガ1032に枢動可能に連結された閉鎖リンケージアセンブリ340を更に含む。図6に見られるように、閉鎖リンケージアセンブリ340は、ピン335によって閉鎖トリガ332に各々枢動可能に連結されている第1の閉鎖リンク342及び第2の閉鎖リンク344を含み得る。
図6を引き続き参照すると、第1の閉鎖リンク342はその上に、右フレーム部分210に枢動可能に連結されている閉鎖解放アセンブリ350と協働するように構成されている、ロック壁又は端部345を有し得ることが観察され得る。少なくとも1つの形態では、閉鎖解放アセンブリ350は、遠位側に突出するロック爪354がその上に形成された解放ボタンアセンブリ352を備えてもよい。解放ボタンアセンブリ352は、解放ばね(図示せず)によって反時計方向に枢動させられてもよい。臨床医が閉鎖トリガ332をその非作動位置からハンドル100のピストルグリップ部分119に向かって押下すると、ロック爪354が第1の閉鎖リンク344上のロック壁345との保持係合に至る地点に向かって第1の閉鎖リンク342が上向きに枢動し、それによって閉鎖トリガ332が非作動位置に復帰することが防止される。したがって、閉鎖解放アセンブリ350は、閉鎖トリガ332を完全作動位置にロックするように働く。臨床医が、閉鎖トリガ332をロック解除して、それを非作動位置へ付勢することができるようにしたい場合、臨床医は単純に、閉鎖解放ボタンアセンブリ352を枢動させ、それによってロック爪354を移動させて、第1の閉鎖リンク344上のロック壁345との係合から外す。ロック爪354が移動させられて第1の閉鎖リンク344との係合から外れると、閉鎖トリガ332は枢動して非作動位置に戻ってもよい。他の閉鎖トリガロック及び解放構成が用いられてもよい。
例解される実施例では、アーム355は、閉鎖解放ボタン352から延在する。例えば、永久磁石などの磁気要素356をアーム355に装着してもよい。閉鎖解放ボタン352をその第1の位置から第2の位置へと回転させると、磁気素子356は、回路基板400に向かって移動することができる。回路基板400は、磁気要素356の移動を検出するように構成された、少なくとも1つのセンサを含むことができる。少なくとも1つの実施形態では、例えば「ホール効果」センサ(図示せず)は、回路基板400の下面に装着され得る。ホール効果センサは、磁気素子356の移動によって生じる、ホール効果センサを取り囲む磁場の変化を検出するように構成することができる。ホール効果センサは、例えば、マイクロコントローラとの信号通信が可能であり、それによって、閉鎖解放ボタン352が、閉鎖トリガ332の非作動位置とエンドエフェクタの開放構成とに関連付けられた第1の位置にあるか、閉鎖トリガ332の作動位置とエンドエフェクタの閉鎖構成とに関連付けられた第2の位置にあるか、かつ/又は第1の位置と第2の位置との間の任意の位置にあるかを判断することができる。
少なくとも1つの形態では、ハンドル100及びフレームアセンブリ200は、シャフトアセンブリ1000の発射部材アセンブリ1900に対して発射運動を加えるように構成されている、本明細書では発射駆動システム500と称される別の駆動システムを動作可能に支持する。発射駆動システム500はまた、本明細書において「第2の駆動システム」と称され得る。発射駆動システム500は、ハンドル100のピストルグリップ部分119内に位置する電気モータ502を用いてもよい。様々な形態において、モータ502は、例えば、約25,000RPMの最大回転数を有するブラシ付きDC駆動モータであってもよい。他の構成では、モータとしては、ブラシレスモータ、コードレスモータ、同期モータ、ステッパモータ、又は他の任意の好適な電気モータが挙げられ得る。モータ502は、電源510によって給電されてもよく、一形態においては、取り外し可能なパワーパック512を備えてもよい。図8に見られるように、例えば、パワーパック512は、内部に複数の電池514を支持してもよい。電池514はそれぞれ、例えば、リチウムイオン(Lithium Ion、「LI」)又は他の好適な電池を含んでもよい。パワーパック512は、モータ502にやはり動作可能に連結されている回路基板アセンブリ400に取り外し可能かつ動作可能に取り付けられるように構成されている。直列に接続されてもよい多数の電池514が、外科用器具10の電源として使用されてもよい。加えて、電源510は、交換可能及び/又は再充電可能であってもよい。
他の様々な形態に関連して上に概説したように、電動モータ502は、回転式シャフト506を含むことができ、この回転式シャフトは、長手方向に移動可能な駆動部材530の駆動歯の組又はラックとの噛合係合をなして装着される歯車減速機アセンブリ520と動作可能にインターフェース接続する。取り付けラグ1916が、中間発射シャフト部分1910の近位端1914上に形成される。取り付けラグ1916は、長手方向に移動可能な駆動部材530の遠位端部に形成された取り付けクレードル536内に受容されるように構成されている。使用の際、電源510によって提供される電圧極性によって電気モータ502を時計方向に動作させることができるが、電池によって電気モータに印加される電圧極性は、電気モータ502を反時計方向に動作させるために反転させることができる。電気モータ502が1つの方向に回転されると、駆動部材530は、遠位方向「DD」に軸方向駆動されることになる。モータ502が反対の回転方向に駆動されると、駆動部材530は、近位方向(proximal direction、「PD」)に軸方向駆動されることになる。ハンドル100は、電源510によって電気モータ502に印加される極性を反転させるように構成することができるスイッチを含むことができる。本明細書に記載される他の形態と同様に、ハンドル100はまた、駆動部材530の位置、及び/又は駆動部材530が移動させられている方向を検出するように構成されたセンサを含むことができる。
モータ502の作動は、ハンドル100上で枢動可能に支持される発射トリガ540によって制御され得る。発射トリガ540は、非作動位置と作動位置との間を枢動してもよい。発射トリガ540は、ばね542又は他の付勢装置によって非作動位置へと付勢されてもよく、それにより、臨床医が発射トリガ540を解放すると、それがばね又は付勢装置によって非作動位置へと枢動されるか又は別の方法で復帰させられてもよい。少なくとも1つの形態では、発射トリガ540は、上述したように、閉鎖トリガ332の「外側」に配置することができる。少なくとも1つの形態において、発射トリガ安全ボタン550が閉鎖トリガ332に枢動可能に装着されてもよい。安全ボタン550は、発射トリガ540と閉鎖トリガ332との間に位置付けられ、そこから突出する枢動アームを有してもよい。閉鎖トリガ332が非作動位置にあるとき、安全ボタン550は、ハンドル100に収容され、臨床医が容易にアクセスすることができず、発射トリガ540の作動を防止する安全位置と、発射トリガ540が発射されてもよい発射位置との間で移動させることもできない。臨床医が閉鎖トリガ332を押下すると、安全ボタン550及び発射トリガ540が下に枢動して、次いで、臨床医がそれらを操作することが可能になる。
上に示したように、少なくとも1つの形態において、長手方向に移動可能な駆動部材530は、その上に、歯車減速機アセンブリ520の対応する駆動歯車と噛合係合するための歯のラックを有している。少なくとも1つの形態はまた、モータ502が無効化された場合に、臨床医が長手方向に移動可能な駆動部材530を手動で後退させることができるように構成された、手動作動式の「緊急離脱」アセンブリ560を含む。図7を参照されたい。緊急離脱アセンブリ560は、手動で枢動させて、駆動部材530にやはり設けられた歯532とラチェット係合するように構成された、レバー又は緊急離脱ハンドルアセンブリ562を含んでもよい。したがって、臨床医は、緊急離脱ハンドルアセンブリ562を使用して駆動部材530を近位方向PDにラチェットで駆動させることによって、駆動部材530を手動により後退させることができる。2008年10月10日出願の米国特許出願第12/249,117号、現在は米国特許第8,608,045号、発明の名称「POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM」は、緊急離脱装置、並びに本明細書に開示される様々な器具とも共に用いられてもよい他の構成要素、装置、及びシステムを開示している。米国特許第8,608,045号は、その全体が参照により本明細書に組み込まれる。
以下、ハンドルに対するシャフトアセンブリ1000の取り付けの1つの方法について、図6〜9を参照して記載する。例解される実施例では、シャフトアセンブリ1000は、近位ノズルアセンブリ2210及び遠位ノズルアセンブリ2250を含むノズルアセンブリ2200を含む。近位ノズルアセンブリ2210は、右側近位ノズルセグメント2220及び左側近位ノズルセグメント2230を含む。近位ノズルセグメント2220、2230は、スナップラグ、ねじ、接着剤などによって一緒に取り付けられてもよい。遠位ノズルアセンブリ2250は、右側遠位ノズルセグメント2260及び左側遠位ノズルセグメント2270を含む。右側遠位ノズルセグメント2260及び左側遠位ノズルセグメント2270は、スナップ機構、ラグ、ねじ、接着剤などによって一緒に連結される。近位ノズルアセンブリ2210及び遠位ノズルアセンブリ2250は、接着剤、摩擦などによって一緒に取り付けられてもよい。ノズルアセンブリ2200は、シャフト軸SAを中心にしてハウジングに対して選択的に回転するように、ハウジング100上に軸支される。例解される実施例では、遠位ノズルアセンブリ2250は、フレームアセンブリ200のフレーム部分210上に形成されたフレーム装着フランジ220とインターフェース接続する、内側に延在する近位装着フランジ2252を備えている。近位ノズルアセンブリ2210は、シャフト軸SAを中心としたノズルアセンブリ2200の回転を促進するために、フィン2212と共に形成される。
例解される構成では、エンドエフェクタ1500を取り付けて含んでいるシャフトアセンブリ1000は、ハンドル100に対してノズルアセンブリ2200を回転させることによってシャフト軸SAを中心に回転可能である。図8に見られるように、例えば、遠位ノズルアセンブリ2250は、近位閉鎖管セグメント2010の近位端部分2014のノズル係合開口部2016を通って内側に延在するシャフト係合フランジ2254を含む。このような構成により、臨床医がノズルアセンブリ2200を回転させるとき、シャフトアセンブリ1000をシャフト軸SAを中心に回転させることが可能になる。ノズル係合開口部2016は、シャフト係合フランジ2254に対する近位閉鎖管セグメント2010の軸方向移動を可能にするような大きさである。更に図8を参照すると、遠位ノズルアセンブリ2250は、近位閉鎖管セグメント2010を内部に移動可能に支持するように構成された支持スリーブ部分2256を更に含んでもよい。加えて、図9に見られるように、上部スパインステー1220の近位端1226及び下部スパインステー1230の近位端1236はそれぞれ、フレームアセンブリ200内で回転可能に支持されるスパインベアリング1260内に支持される。
ここで図6、8及び9を参照すると、近位閉鎖管セグメント2010の近位端部分2014は、閉鎖リンケージ機構アセンブリ340の第2の閉鎖リンク344に連結された閉鎖シャトル360内で移動可能に支持されている(図6)。閉鎖シャトル360は、フレームアセンブリ200内のシャトルキャビティ214内に摺動可能に支持されている。近位閉鎖管セグメント2010の近位端部分2014は、閉鎖シャトル360内のU字形状のクレードル開口部362を通って延在し、内部に回転可能に支持されている。このような構成により、シャフトアセンブリ1000がハンドル100に対して回転されるとき、近位閉鎖管セグメント2010の近位端部分2014が、閉鎖シャトル360に対して回転することを可能にする。加えて、臨床医が閉鎖トリガ332を押下すると、閉鎖シャトルは、シャトルキャビティ214内で遠位方向DDに移動され、また、閉鎖部材アセンブリ2000を遠位方向にさせて、エンドエフェクタ1500に閉鎖運動を加える。
図8及び9に見られるように、第1のばね370は、閉鎖シャトル360のクレードル壁362と右フレーム部分210(第1のばね空間221)上に形成された遠位端壁219との間の近位閉鎖管セグメント2010の近位部分2014上に軸支されている。第1のばね空間の軸方向長さは、Xと指定される。第1のばね370は、閉鎖シャトル360を、アンビルの完全開放位置に対応する開始位置へと近位側(矢印PD)に付勢する。図10を参照されたい。例解される実施例では、近位フランジ2018は、近位閉鎖管セグメント2010の近位端部分2014上に形成される。近位フランジ2018は、図示のように閉鎖シャトル360内に形成された閉鎖又は第2のキャビティ364内を摺動可能に移動するように構成されている。第2のキャビティ又は第2のばね空間363の軸方向長さは、Xとして指定される。少なくとも1つの構成では、例えば、X>Xである。第2の閉鎖ばね又は付勢部材380は、第2のばね空間363内に位置し、近位閉鎖管セグメント2010上の近位フランジ2018を閉鎖シャトル360のクレードル壁362に対して遠位方向DDに付勢する。
アンビル1610と外科用ステープルカートリッジ1540との間の標的組織の初期クランプの間、閉鎖駆動システム300は、アンビル1610に十分な量の軸方向閉鎖力を加えて、アンビル1610を閉鎖位置に枢動させ、ステープル形成プロセス全体にわたってその位置に保持しなければならない。少なくとも1つの適用において「閉鎖処置」という用語は、ステープル形成プロセスが完全に完了し、アンビルがエンドエフェクタから標的組織を解放するために再開放される準備が整うまで、アンビルを標的組織上の完全開放位置から閉鎖位置まで移動させ、アンビルを閉鎖位置に保持するプロセスを指す。アンビルを閉鎖し、閉鎖位置に保持するために必要とされる閉鎖力の量は、「組織クリープ」によるステープル留めプロセス中に変動し得る。例えば、アンビルが標的組織を圧縮すると、クランプされた標的組織内の流体は、組織内で「クリープ」又は移動することができ、隣接するクランプされていない組織に流れ得る。更に組織のクリープは、ナイフ部分1950がクランプされた標的組織を通って駆動される際に経験され得る。したがって、組織クリープはまた、標的組織を切断し、ステープルカートリッジ内のステープルを発射するために必要とされる発射力の量に影響を及ぼし得る。ナイフ部分1950がそのストロークの終わりに近づくにつれて、クリープする流体が、隣接するクランプされていない組織への移動を完了するため、必要とされる発射力の量は低減され得る。
図10は、非作動配向にある閉鎖駆動システム300を例解する。図10に見られるように、第1のばね370は、閉鎖シャトル360をフレームアセンブリ200のシャトルキャビティ214内でPD方向に近位側に、その最近位又は開始位置まで付勢している。閉鎖シャトル360が閉鎖リンケージアセンブリ340によって閉鎖トリガ332に取り付けられた結果として、閉鎖トリガ332は、非作動の開始位置へと枢動される。閉鎖駆動システム300が非作動位置にあるとき、アンビル1610は完全開放位置にある。少なくとも1つの実施例では、第1のばね370は、第2のばね380よりも「弱い」。換言すれば、第2のばね380は、第1のばね370よりも剛性である。すなわち、第1のばね370のばね定数Kは、第2のばね380のばね定数Kよりも小さい。それゆえ、K>Kである。代替的な構成では、K<Kである。いくつかの構成では、例えば、Kは、Kよりも最大10倍まで大きくてもよい。他の構成では、K/K>1である。臨床医は、閉鎖トリガ332をハウジング100のピストルグリップ119に向かって押下することによって閉鎖プロセスを開始する。この動作により、遠位方向DDに閉鎖シャトル360を移動し始め、これは、第1のばね370を圧縮し始める。閉鎖シャトル360が遠位側に移動し始めると、閉鎖シャトル360はまた、近位閉鎖管セグメント2010を遠位側に移動させ始める。近位閉鎖管セグメント2010が遠位側に移動すると、閉鎖部材アセンブリ2000(近位閉鎖管セグメント2010がその一部である)全体が遠位側に移動して、アンビル1610に閉鎖運動を加える。臨床医が閉鎖トリガ332をピストルグリップ119に向かって枢動させ続けると、閉鎖シャトル360は遠位側に移動し続け、第1のばね370を圧縮する。アンビル1610が閉鎖し始めると、アンビル1610が標的組織を圧縮し始めるにつれて、必要とされる閉鎖力の量は増加し始め得る。標的組織が圧縮し始めるにつれて、内部に含まれる流体は、標的組織内でクリープを始め得、これは、アンビルを完全に閉鎖するために必要とされる閉鎖力の量に直接影響を及ぼし得る。閉鎖に対する抵抗が増加するにつれて、閉鎖部材アセンブリ2000は、第2のばね380によって近位閉鎖管セグメント2010に加えられる閉鎖力に対して近位方向PDに移動することができる。図11は、アンビル1610の完全閉鎖位置に対応する完全閉鎖位置にある閉鎖駆動システム300を描写する。したがって、閉鎖部材アセンブリ2000を介してアンビル1610に加えられる閉鎖力の最終量は、閉鎖処置中にアンビルが経験する閉鎖抵抗に応答して、第2のばね380が圧縮する能力に起因して変動し得る。したがって、アンビルは、標的組織によって作り出される抵抗の量の変化を経験するとき、「漸進的に閉鎖する」ことができる。これはまた、本明細書では、「漸進的閉鎖力」を生成することと称されてもよい。
顎部1510、1600が標的組織上に閉鎖され、その位置でロックされると、臨床医はその後、発射トリガ540を押下することによって発射プロセスを開始してもよく、これによってナイフバー1910がクランプされた標的組織を通ってナイフ部分1950を駆動させる。ナイフ部分1950がエンドエフェクタ1500を通って遠位側に駆動されると、ナイフブレード152は、標的組織を切断する。加えて、少なくとも1つの構成において、ナイフ部分1950は、外科用ステープルカートリッジ1540内で摺動可能に支持される楔形スレッド1970と称される場合がある、カムアセンブリを係合し、遠位側に駆動する。楔形スレッド1970がステープルカートリッジ1540を通って遠位側に駆動されると、楔形スレッド1970上に形成されたカムは、ステープルカートリッジ1540内で移動可能に支持されたステープルドライバ(図示せず)と係合してカム動作する。各ステープルドライバは、その上に1つ又は2つ以上の外科用ステープルを支持し得る。ステープルドライバは、一般に、ステープルカートリッジ内に形成された細長いスロットの各側に位置する軸線に支持される。楔形スレッド1570がステープルドライバに接触すると、それらは上方に(閉鎖したアンビル1610に向かって)駆動され、それによって、その上に支持されたステープル(複数可)を標的組織を通して駆動し、アンビル本体1612のステープル形成下面1614との接触を形成する。楔形スレッド1570は、組織切断ナイフブレードの遠位に位置するため、標的組織が切断される前に、ステープルが標的組織を通して配備される。
更に、ナイフ部分1950が標的組織を通って駆動されると、ナイフ部分に形成されたタブ又はフランジが、アンビル1610並びに細長いチャネル1510と係合し、ステープル留めプロセス中に閉鎖し所望の間隔配置で離間させたアンビル1610及びチャネル1510を保持する。ナイフ部分のそのような遠位前進は、閉鎖システムから必要とされる閉鎖力の量を低減し得るが、発射システムによって有意な量の「発射力」を生成して、ナイフ部分1950を標的組織を通して押さなければならないし、楔形スレッドがステープルドライバを作動させる際にシステムの抵抗力及び摩擦を克服しなければならない。したがって、発射システムは、十分な発射力を生成することができなければならず、発射システム構成要素は、そのような力に効果的に適応するために十分に堅牢でなければならず、また一方で、エンドエフェクタの関節運動に適応するのに十分な可撓性でなければならない。閉鎖及び発射システムのこれらの設計要件はまた、標的組織の種類及び組成によって悪化し得る。更に、これらのシステムの構成要素は、トロカールの小さなカニューレを通して挿入されるのに十分に小さくなければならない。
図12は、上述の漸進的性閉鎖駆動システム300を採用する外科用器具10と、異なる閉鎖駆動構成を採用する2つの以前の外科用器具A及びBとの間のグラフ比較である。以前の外科用器具Aは、閉鎖アクチュエータ又は閉鎖トリガに直接連結された閉鎖駆動システムを採用する。以前の外科用器具Aは、閉鎖システムを非作動位置に付勢するためのばねを採用しているが、以前の外科用器具Aは、上述の外科用器具10のような第2の付勢部材を採用していない。加えて、外科用器具Aのアンビルは、上述のアンビル1610のようなカム面又は表面を欠いている。その代わりに、外科用器具Aのアンビルは、閉鎖部材又は管と接触するように配置された硬質縁部を有する。閉鎖部材が硬質縁部と接触すると、アンビルは枢動して閉鎖される。
更に図12を参照すると、外科用器具Bが、閉鎖システムを非作動位置に付勢するための第1の付勢部材を有するという点で、外科用器具Bは、一部の態様では、以前の外科用器具Aと同様である。しかしながら、外科用器具Bは、上述の器具10のような第2の付勢部材を採用していない。しかしながら、外科用器具Bのアンビルは、閉鎖部材によって接触されてアンビルを閉鎖位置に枢動させるように構成されたカム面を採用する。図12は、3つの外科用器具、すなわち、外科用器具10、外科用器具A及び外科用器具Bのそれぞれに対する処置中に必要とされる閉鎖力の量に対して閉鎖処置を完了する時間の量を示すプロットである。図12に見ることができるように、外科用器具10の閉鎖処置全体を通して必要とされる閉鎖力の量は、外科用器具A及びBによって必要とされる閉鎖力よりも小さい。外科用器具Bによって必要とされる閉鎖力は、外科用器具Aによって必要とされる閉鎖力よりも小さいが、外科用器具10によって必要とされる閉鎖力は、閉鎖プロセス全体を通してA及びBの両方によって必要とされる閉鎖力よりもかなり小さい。
図13A及び13Bは、発射部材又はナイフがアンビル内の最近位の開始位置から最遠位の終了位置(クロスヘッド距離)までアンビルを通って移動する際の発射力(FTF)、外科用器具10及び外科用器具B(アンビル上のカム面を伴う)によって経験される閉鎖力(FTC)を比較する。図13Aは、外科用器具Bの発射処置中のFTF、FTC、及びアンビル高さを例解する。図13Bは、外科用器具10のFTF、FTC、アンビル高さ、及びばね高さを例解する。図13A及び13Bを参照して分かるように、外科用器具Bの初期アンビル高さは0.0510インチであり、外科用器具10の初期アンビル高さは0.511インチであった。ポンド単位のピーク閉鎖力FTCは、外科用器具Bについては51.5ポンドであり、外科用器具10については98.7ポンドであった。ポンド単位のピークFTFは、外科用器具Bについては48.9ポンドであり、外科用器具10については36.4ポンドであった。したがって、外科用器具10は、外科用器具10によって必要とされる閉鎖力の量の25.6%の減少を経験した。必要とされる発射力の量のこの低減は、発射システム構成要素が、より軽量かつ又はより小さい構成要素配置から作製されることを可能にし得る。
上記のように、外科用器具10は、シャフト軸SAを横断する関節運動軸AAを中心にしてシャフトアセンブリ1000に対して外科用エンドエフェクタ1500を選択的に関節運動させるように構成された関節運動駆動システム2100を含む。図14を参照されたい。関節運動駆動システム2100は、細長いチャネル1520の近位端に取り付けられた遠位関節運動リンク2130に枢動可能に連結された中間関節運動ドライバ2120に連結された近位関節運動ドライバ2110を備える関節運動駆動アセンブリ2102を含む。図2を参照されたい。一実施例では、遠位関節運動リンク2130は、シャフト軸SAの一方の側で中間関節運動ドライバ2120に取り付けられる。遠位関節運動リンク2130は、シャフト軸SAの反対側の細長いチャネル1520に取り付けられており、その結果、遠位関節運動リンク2130は、シャフト軸SAを横切って横方向に延在する。例解される実施例では、近位関節運動ドライバ2110と中間関節運動ドライバ2120との間の接合部はまた、関節運動ロックアセンブリ2121として機能してもよく、この関節運動ロックアセンブリは、近位関節運動ドライバ2110に加えられた関節運動が中断された後に関節運動位置に外科用エンドエフェクタ1500を保持する役割を果たす。例解される実施例では、近位関節運動ドライバ2110の遠位端2112はねじ式である。近位関節運動ドライバ2110のねじ式遠位端2112は、中間関節運動ドライバ2120の近位端2124のねじ式ソケット2126とねじ式係合している。近位関節運動ドライバ2110が第1の回転方向に回転すると、中間関節運動ドライバ2120が第1の又は遠位方向DDに軸方向に移動することになる。中間関節運動ドライバ2120が遠位方向DDに移動すると、外科用エンドエフェクタ1500が第1の関節運動方向ADに関節運動軸AAを中心として枢動することになる。近位関節運動ドライバが第2の回転方向に回転すると、中間関節運動ドライバ2120が第2の又は近位方向PDに移動することになる。中間関節運動ドライバ2120が近位方向PDに軸方向移動すると、外科用エンドエフェクタ1500が第2の関節運動方向ADに関節運動軸AAを中心として枢動することになる。
例解される実施例では、ハウジング100又はハンドル110は、長手方向軸LA(longitudinal axis、LA)を画定する。図15及び図16を参照されたい。上記のように、シャフトアセンブリ1000はまた、シャフト軸SAを画定する。シャフト軸SA及び長手方向軸LAは同軸であってもよい。関節運動駆動システム2100の長手方向は、ユーザがノズルアセンブリ2250をハウジング100に対して回転させるとき、長手方向軸LAを中心とした軌道で回転移動するために、遠位ノズルアセンブリ2250内に装着された関節運動モータ2140を含む。遠位ノズルアセンブリ2250はまた、シャフトアセンブリ1000をハウジング100に回転可能に連結するように構成された「シャフト回転子アセンブリ」とも称され得る。1つの構成では、関節運動モータ2140は、モータ出力歯車2142を含む歯車構成を含む。モータ出力歯車2142は、長手方向軸LAに平行であり、かつ長手方向軸LAからオフセットされたモータ軸MAを中心に回転する。図16を参照されたい。例解される実施例では、モータ出力歯車2142は、モータスイッチシステム2150の制御スイッチ歯車2152と噛合係合している。制御スイッチ歯車2152は、近位関節運動ドライバ2110の近位端2116上に形成される近位関節運動駆動歯車2118と噛合係合している。したがって、モータ出力歯車2142が一方向に回転すると、近位関節運動ドライバ2110が第1の方向に回転することにより、中間関節運動ドライバ2120を遠位方向に回転させ、外科用エンドエフェクタ1500を第1の関節運動方向ADに関節運動させることになる。同様に、関節運動モータが反対の回転方向に回転すると、近位関節運動ドライバ2110を第2の回転方向に回転させ、それによって中間関節運動ドライバ2120を近位方向PDに移動させることになる。中間関節運動ドライバ2120の近位方向PDへの移動により、外科用エンドエフェクタ1500を第2の関節運動方向ADに関節運動させることになる。様々な実施形態において、関節運動モータ2140及び歯車構成は、例えば、直径12mm未満及び長さ1.5インチ未満であってもよい。関節運動モータ2140は、1.5ワット未満の電力出力を有するブラシ付き設計であってもよい。少なくともいくつかの実施形態において、モータ2140の電力出力は、約.75〜1.0ワットである。歯車構成は、モータハウジングによって支持されてもよく、又はモータハウジングとは別個であってもよい。少なくとも1つの実施例では、歯車構成は100:1減速を有するが、より高い減速比を有する歯車構成が採用されてもよい。代替的な構成では、他のモータ構成を採用してもよい。
関節運動ロック2121関して、近位関節運動ドライバ2110の遠位端2112上のねじ山は、例えば、細かい(例えば、64ねじ/インチ)又は粗い(64未満のねじ/インチ)のいずれかの#2のねじ山を備えてもよく、これは、関節運動モータ2140が通電解除された後に外科用エンドエフェクタ1500の移動を防止するロックとしても機能しながら、関節運動モータ2140が外科用エンドエフェクタ1500の関節運動を引き起こすのに十分な機械的利点を提供する。図2にも見られるように、近位関節運動ドライバ2110は、近位関節運動ドライバ2110の隣接する部分よりも大きい直径を有する支持肩部部分2119を備えてもよい。より大きい肩部2119は、ロック位置にあるときに、追加的な支持のために、スパインシャフト1210と摺動可能にインターフェース接続する。
更に図16〜19を参照すると、モータスイッチシステム2150は、制御スイッチギヤ2152に取り付けられているスイッチ駆動ねじ2160の上にねじ式であるスイッチトラベラ2170を含む。モータ出力歯車2142の回転により、制御スイッチ歯車2152を回転させ、これは最終的にスイッチ駆動ねじ2160を回転させる。スイッチドライバねじ2160の回転により、遠位ノズルアセンブリ2250に装着されたスイッチハウジング2162に対するスイッチトラベラ2170の軸方向移動をもたらす。スイッチハウジング2162は、以下で更に説明するように、ハウジング100内に支持されるか、又は別の方法でハウジングと関連付けられた制御回路基板400と通信する複数のリミットスイッチを動作可能に支持する。図16を参照されたい。例解される実施例では、3つのリミットスイッチ、すなわち、中央リミットスイッチ2172、近位リミットスイッチ2174、及び遠位リミットスイッチ2176が採用される。スイッチ2172、2174、2176は、近位ノズルアセンブリ2210内に装着されている一連の回路トレース又は導体2222、2224、2226、2228に配線される。図20を参照されたい。回路トレース2222、2224、2226、及び2228は、ワイヤ又はフレキシブル回路導体(図示せず)によって関節運動モータ2140及びスイッチ2172、2174、2176に配線されるか又は電気的に連結される。図21及び22を参照すると、接点ブロック410は、フレームアセンブリ200に固定的に装着され、回路トレース2222、2224、2226及び2228にそれぞれ対応する接点412、424、416及び418を含む。接点412、414、416、418は、制御回路基板400に配線される。近位ノズルアセンブリ2210がシャフト軸SAを中心にハウジング100に対して回転すると、電力/制御信号が、回路トレース2222、2224、2226、2228及び接点412、414、416、418を備えるスリップ接合部アセンブリ411を介して制御回路基板400と関節運動モータ2140及びスイッチ2172、2174、2176との間に提供され得、シャフト軸SAを中心としたハウジング100に対する関節運動モータ2140及び制御スイッチアセンブリの回転を促進する。関節運動制御スイッチ2180は、ハウジング100の各側に装着され、関節運動モータ2140の回転を制御するために使用される。図15を参照されたい。スイッチ2180は、一方向(矢印2182)に押下されると、関節運動モータ2140がモータ出力歯車2142を1つの回転方向に回転させ、スイッチ2180が反対方向(矢印2184)に押下されると、関節運動モータがモータ出力歯車2142を反対の回転方向に回転させる、「ロッカータイプ」のスイッチを備えてもよい。
ここで図19及び図23〜26を参照すると、スイッチトラベラ2170の経路に対するスイッチ2172、2174、2176の位置は、外科用エンドエフェクタ1500の関節運動の範囲を画定する役割を果たす。スイッチ2172は、外科用エンドエフェクタ1500の非関節運動位置に対応する中央スイッチ又はホームスイッチを備える。その位置にあるとき、中央エンドエフェクタ軸EA(effector axis、EA)は、シャフト軸SAと概ね位置合わせされる。この位置にあるとき、例えば、エンドエフェクタ1500は、トロカールカニューレを通して挿入されてもよく、又はトロカールカニューレから取り外されてもよい。スイッチ2174は、−60°左関節運動境界線に対応し、スイッチ2176は、+60°右関節運動境界に対応する。−60°左関節運動境界はまた、本明細書では、シャフト軸SAの「第1の側」又は左側に位置する外科用エンドエフェクタ1500の「第1の最大関節運動位置」と称され得る。左の−60°角度(図26のLA)はまた、「第1の最大関節角度」とも称され得、外科用エンドエフェクタ1500が第1の最大関節運動位置にあるとき、エンドエフェクタ軸EAとシャフト軸SAとの間の角度を含む。同様に、+60°右関節運動境界はまた、本明細書では、シャフト軸SAの「第2の側」又は右側に位置する外科用エンドエフェクタ1500の「第2の最大関節運動位置」と称され得る。右の+60°角度(図23の(right angle、RA))はまた、「第2の最大関節運動角度」とも称され得、外科用エンドエフェクタ1500が第2の最大関節運動位置にあるとき、エンドエフェクタ軸EAとシャフト軸SAとの間の角度を含む。したがって、例解される実施例では、スイッチ2174及び2176の位置は、各関節運動方向(左及び右)の最大関節運動位置を確立する。代替的な構成では、2つのスイッチ(2174、2176)のみが採用されてもよい。スイッチ2172、2174、2176は、機械的スイッチ、ホール効果スイッチなどを含んでもよい。
少なくとも1つの実施例では、中央ホームスイッチ2172を使用して、ホーム又は非関節運動位置を横断する前に関節運動モータ2140を減速させてもよく、エンドエフェクタ1500がシャフトアセンブリ1000と位置合わせされたときをより容易に判定することができ、これにより、例えば、トロカールを介して取り外しが容易になる。
実施例では、スイッチ2172、2174、2176に係合するように構成された領域内のスイッチトラベラの幾何学的形状は、ホームから「X」度でスイッチと係合し、X度から−X度までスイッチと接触したままであるような幅を有するように選択される。少なくとも1つの実施例では、X=約10度であるが、Xは他の値であってもよい。図23〜26は、スイッチトラベラ2170とスイッチ2172、2174、2176との間の関係、及び外科用エンドエフェクタ1500の関節運動位置を例解する。例えば、図25において、スイッチトラベラ2170がその位置にあるとき、外科用エンドエフェクタ1500は、シャフト軸SAの第1の側の第1の関節運動位置にあってもよく、外科用エンドエフェクタ軸EAは、シャフト軸SAに対して第1の関節角度LAに位置付けられる。同様に、スイッチトラベラ2170が、例えば、図24に例解される位置にあるとき、外科用エンドエフェクタ1500は、シャフト軸SAの第2の側に位置する第2の関節運動位置にあってもよく、外科用エンドエフェクタ軸EAは、シャフト軸SAに対して第2の関節運動角度LAに位置付けられる。少なくとも1つの構成では、LA=LA=例えば約10°である。
図27は、スイッチ2172、2174、2176と相互作用するように構成されたスイッチトラベラ2170の自由端から見たときの、スイッチトラベラ2170の代替的な幾何学的形状を提供する。図28は、関節運動角度に対する(各幾何学的形状2170A、2170B、2170Cについての)モータ速度のグラフ比較である。スイッチトラベラ2170Aもまた、図23〜26に描写される。2170Cは、スイッチ2172、2174、2176のより正確な作動のために、上部に形成されたアクチュエータポイント21701Cを有する。図28に見られるように、モータ速度MS2Cは、アクチュエータポイント2171Cが、−60°、0°、+60°の関節運動角度に対応するスイッチ2172、2174、2176のうちの1つと作動接触しているときにのみ低下する。2170Aは、−10°〜+10°の関節運動角度範囲の第1のモータ速度MS1Aをもたらす断面厚さCTを有する。−10°〜−60°及び+10°〜+60°の関節運動角度に関して、関節運動モータ2140は、MS1Aよりも大きい第2のモータ速度MS2Aで動作する。2170Bは、断面厚さCTよりも大きい断面厚さCTを有し、−20°〜+20°の関節運動角度範囲の第1のモータ速度MS1Bをもたらす。−20°〜−50°及び+20°〜+50°の関節運動角度に関して、関節運動モータ2140は、MS1Bよりも大きい第2のモータ速度MS2Bで動作してもよい。−50〜−60及び+50〜+60の関節運動角度に関して、関節運動モータ2140は、第3のモータ速度MS3Bで動作してもよい。例解される実施例では、MS3B=MS1Bである。
様々な構成において、制御回路基板400は、関節運動限界を画定するスイッチ420、422、424、426、並びにエンドエフェクタの中心又はホーム位置を制御するラッチ可能な又はリレースイッチ428を含んでもよい。図28Aを参照されたい。そのような構成では、関節運動モータ2140がエンドエフェクタを直線又はホーム位置にわたって駆動すると、ラッチ可能な又はリレースイッチ428は外され得、これにより、関節運動モータ2140を停止させる。関節運動制御スイッチ2180を解放することで、中央スイッチ又はホームスイッチ2172を停止させ得るバイパスリレーを起動させ得、制御スイッチ2180を再び押圧することで、関節運動がホーム位置を通って継続することを可能にし得る。図28Aを参照されたい。
図29〜図33は、以下で考察される相違点以外は外科用器具10と同様の外科用器具3010を示す。外科用器具3010は、シャフトアセンブリ1000と同様のシャフトアセンブリ4000を備える。細長いシャフトアセンブリ4000は、ハンドル3110を備えるハウジング3100に動作可能に連結される。ハウジング3100は、以下で考察される相違点以外は、上に記載されるハウジング100と同様であり得る。細長いシャフトアセンブリ4000の例の一部を図30に示す。シャフトアセンブリ1000の要素と同じ又は同一の要素は、同様の要素番号で識別されている。外科用器具3010は、スパインアセンブリ5200に移動可能に連結された(上に記載されるような)エンドエフェクタ1500を備える。スパインアセンブリ5200は、(1)発射部材アセンブリ1900を内部で摺動可能に支持し、(2)スパインシャフト5200の周囲に延在する閉鎖部材アセンブリ6000を摺動可能に支持するように構成されている。閉鎖部材アセンブリ6000は、以下で考察される相違点以外は、上に記載されるような閉鎖部材アセンブリ2000と同様である。閉鎖部材アセンブリ6000は、近位閉鎖管セグメント2010と同様の近位閉鎖管又は閉鎖部材セグメント6010を備える。近位閉鎖管セグメント6010は、上で考察される手法で、又は参照により本明細書に組み込まれている様々な参照文献に記載されている手法で、ハウジング3100内で動作可能に支持される閉鎖シャトルとインターフェース接続する。外科用器具はまた、発射運動をシャフトアセンブリ4000内の発射部材アセンブリ1900に加えるように構成された発射駆動システム500を備える。上に記載されるように、発射駆動システム500は、長手方向に移動可能な駆動部材530を駆動するモータを含む。モータの作動は、ハンドル3110上で枢動可能に支持される発射トリガ540によって制御され得る。
これも上でも考察されるように、シャフトアセンブリ4000は、スパインシャフト1210内で軸方向移動するように支持される発射部材アセンブリ1900を更に含む。発射部材アセンブリ1900は、遠位側切断部分又はナイフバー1930に取り付けられるように構成された中間発射シャフト部分1910を含む。中間発射シャフト部分1910は、その遠位端に、遠位側ナイフバー1930の近位端にあるタブ1932を受容するように構成され得る長手方向スロット1912を含んでもよい。長手方向スロット1932及び近位端タブ1932は、それらの間の相対運動を可能にするような大きさ及び構成とすることができ、スリップ継手1940を備えることができる。スリップ継手1940は、例えば、ナイフバー1930が中間発射シャフト部分1910に対して軸方向に移動して、エンドエフェクタ1500の関節運動に適応することを可能にし得る。ナイフバー1910は、ナイフ部分1950を含む。
示した例において、外科用エンドエフェクタ1500は、関節運動駆動システム6100により、関節運動軸AAを中心として選択的に関節運動可能である。少なくとも1つの例では、関節運動駆動システム6100は、中間発射シャフト部分1910の直線ストロークを、細長いシャフトアセンブリ4000に対して外科用エンドエフェクタ1500を関節運動させるために採用され得る回転関節運動に変換するように構成されている。一形態では、関節運動駆動システム6100は、以下で更に詳細に考察されるように、遠位関節運動リンク6130に枢動可能に連結された中間関節運動ドライバ6120に動作可能に連結された近位関節運動ドライバ6110を含む。
ここで図31、図32A、及び図32Bを参照すると、少なくとも1つの形態では、関節運動駆動システムは、上に記載したようにハウジング3100に回転可能に連結されるノズルアセンブリ6250内で動作可能に支持される関節運動クラッチアセンブリ6300を備える。示した例において、関節運動クラッチアセンブリ6300は、ノズルアセンブリ6250に固定的に取り付けられている、クラッチ装着部材6302を備える。クラッチ装着部材6302内に移動可能に支持されるのは、クラッチシフタアセンブリ6310である。一形態では、クラッチシフタアセンブリ6310は、シャフト軸SAを横断する方向に移動可能な第1及び第2の横方向に対向するロックアセンブリ6320、6330を含む。この横方向のロック移動は、図32A及び図32B中の矢印Lによって表される。示した例において、第1のロックアセンブリ6320は、第1のクラッチロック6324を支持する第1の移動可能なロック支持体6322を含む。第1のクラッチロック6324は、中間発射シャフト部分1910内の第1のロック溝1911に係止係合するように構成されている。第1の付勢部材又はばね6328は、第1のロックアセンブリ6320を中間発射シャフト部分1910に向かって付勢して、図32Aに示すように第1のクラッチロック6324を中間発射シャフト部分1910内の第1のロック溝1911に係止係合させる役割を果たす。
同様に、第2のロックアセンブリ6330は、第2のクラッチロック6334を支持する第2の移動可能なロック支持体6332を含む。第2のクラッチロック6334は、中間発射シャフト部分1910内の第2のロック溝1913に係止係合するように構成されている。第2の付勢部材又はばね6338は、第2のロックアセンブリ6330を中間発射シャフト部分1910に向かって付勢して、図32Aに示すように第2のクラッチロック6334を中間発射シャフト部分1910内の第2のロック溝1913に係止係合させる役割を果たす。
示した例において、関節運動クラッチアセンブリ6300は、第1及び第2のクラッチロック6324、6334と共に軸方向に移動し、一方で、第1及び第2のクラッチロックが、「係止」又は「係合」位置と「係止解除」又は「係合解除」位置との間でシャフト軸に対して横方向に移動することを可能にするように取り付けられている、クラッチドライバラック6340を更に備える。図31を参照されたい。クラッチドライバラック6340は、クラッチ歯車アセンブリ6350と噛合係合し、そのクラッチ歯車アセンブリは、クラッチドライバラック6340と噛合係合するラック歯車6352を含み、第1及び第2の噛合クラッチ傘歯車6354、6356に第1の伝達シャフト6353によって取り付けられている。更に図31を参照すると、第2のクラッチ傘歯車6356は、第2の伝達シャフト6358に取り付けられ、その第2の伝達シャフトは、それに取り付けられた伝達駆動歯車6360を有する。伝達駆動歯車6360は、近位関節運動ドライバ6110の近位端上に形成された近位関節運動駆動歯車6118と噛合係合する遊び歯車6362と噛合係合している。したがって、クラッチドライバラック6340の軸方向移動は、最終的に、上に記載される歯車構成を通じた近位関節運動ドライバ6110の回転をもたらす。第1の方向の近位関節運動ドライバ6110のそのような回転により、中間関節運動ドライバ2120を近位方向に移動させ、外科用エンドエフェクタ1500を第1の関節運動方向に関節運動させる。同様に、クラッチドライバラック6340が近位方向PDに軸方向移動すると、近位関節運動ドライバ6110を第2の回転方向に回転させ、それによって中間関節運動ドライバを遠位方向DDに移動させることになる。遠位方向DDの中間関節運動ドライバ2120の移動により、外科用エンドエフェクタ1500を第2の関節運動方向に関節運動させることになる。
図32Aは、発射シャフトアセンブリ1900の中間発射シャフト部分1910と係合位置又はロック位置にある関節運動クラッチアセンブリ6300を示す。その位置にあるとき、中間発射シャフト部分1910の軸方向移動(上に記載される発射トリガ540を作動させることによって引き起こされる)は、関節運動クラッチドライバラック6340の軸方向移動をもたらし、最終的には、本明細書に記載されるような外科用エンドエフェクタの関節運動をもたらす。第1の付勢部材6328及び第2の付勢部材6338は、この通常係合位置でクラッチアセンブリ6300を付勢する。図32Aは、ジョー1610、1610が開放位置にある結果となる最近位の非作動位置にある近位閉鎖管セグメント6010を示す。したがって、ジョーが開放位置にあるとき、発射駆動システムの作動は、外科用エンドエフェクタ1500の関節運動をもたらすことになる。
臨床医が所望の関節運動位置に外科用エンドエフェクタを関節運動させた後、臨床医は次に、閉鎖トリガ332を押下することによって閉鎖システムを作動させることによって閉鎖システムを作動させることによってジョー閉鎖プロセスを開始し得る。図32A及び図32Bに見られるように、クラッチアセンブリは、近位閉鎖管セグメント6010内のクラッチ開口部6011を通って突出する。上で考察されるように、閉鎖トリガ332を押下すると、近位閉鎖管セグメント6010を遠位方向DDに軸方向に移動させることになる。近位閉鎖管セグメント6010が遠位方向に移動すると、第1の移動可能なロック支持体6322における第1のカム面6323と、第2の移動可能なロック支持体6332における第2のカム面6333と接触して、第1及び第2のロック支持体6322、6332をシャフト軸から離れる反対方向に横方向に移動させる。第1及び第2の移動可能なロック支持体6322、6332のこのような移動により、第1及び第2のクラッチロック6324、6334を、図32Bに示すように、中間発射シャフト部分1910内の第1のロック溝1911及び第2のロック溝1913を係合解除させる。したがって、関節運動クラッチアセンブリ6300は、関節運動システムを発射駆動システムから係合解除し、臨床医は、外科用エンドエフェクタが関節運動したままである間、発射駆動システムを作動させることができる。
示した例において、関節運動駆動システムはまた、関節運動駆動システムが停止された後、外科用エンドエフェクタを関節運動位置に保持するための関節運動ロック構成6400を含む。より具体的には、図33を参照すると、近位関節運動ドライバ6110の遠位端部分6112は、その上に形成されたねじ付き部分6114を含む。1つの構成では、ねじ付き部分6114は、中間関節運動ドライバ6120内のねじ付き通路セグメント6122内に落とされ得る、アクメねじを含む。中間関節運動ドライバ6120は、スパインシャフト5200内の遠位ドライバ空洞5202内に摺動可能に支持される。上に示されるように、中間関節運動ドライバ6120は、遠位関節運動リンク6130に枢動可能にピン留めされる。遠位関節リンク6130は、シャフト軸SAを横切って横方向に延在し、細長いチャネル1520の近位端に枢動可能にピン留めされる。図33に見られるように、肩部6119は、近位関節運動ドライバ6110上に形成され、スパインシャフト5200内の肩部空洞5204内に回転可能に受容される。近位関節運動ドライバ6110の回転により、中間関節運動ドライバ6120の線形又は軸方向運動を引き起こし、これによって遠位関節運動リンク6130に細長いチャネル1520を関節運動させる。肩部6119は、動作中に近位関節運動ドライバ6110を支持する役割と、エンドエフェクタを意図せずに関節運動解除させるように試みる外力に遭遇すると、近位関節運動ドライバ6110の運動に抵抗する役割とを果たす。アクメねじ構成6116は、近位関節運動ドライバ6110へ回転関節運動を加えることが中断されたときに関節運動ロックとして機能するように、中間関節運動ドライバ6120内のねじ付き通路セグメント6122との摩擦を確立する。少なくとも1つの構成では、アクメねじ構成6116は、17°未満のねじ角度を有してもよく、「自己ロック式」であってもよい。また、他の関節運動ロック構成を採用してもよい。
実施例1−外科用エンドエフェクタと、外科用エンドエフェクタと動作可能にインターフェース接続する細長いシャフトアセンブリと、を備える、外科用器具。細長いシャフトアセンブリは、外科用エンドエフェクタの対応する部分と動作可能にインターフェース接続する第1のシャフトアクチュエータと、外科用エンドエフェクタの別の対応する部分と動作可能にインターフェース接続する第2のシャフトアクチュエータと、を備える。外科用器具は、第1のシャフトアクチュエータに軸方向作動運動を選択的に加えるように構成された第1の駆動システムと、クラッチアセンブリであって、クラッチアセンブリが第1の駆動システムの軸方向作動運動を第2のシャフトアクチュエータに加えられる回転作動運動に変換する、係合位置と、第1の駆動システムの軸方向作動運動が第2のシャフトアクチュエータに加えられない、係合解除位置との間で移動可能である、クラッチアセンブリと、を更に備える。
実施例2−クラッチアセンブリが係合解除位置にあるとき、第2のシャフトアクチュエータを定位置にロックするための手段を更に備える、実施例1に記載の外科用器具。
実施例3−クラッチアセンブリが、係合位置と係合解除位置との間で軸方向に移動可能である、実施例1又は2に記載の外科用器具。
実施例4−細長いシャフトアセンブリが、他の軸方向作動運動を外科用エンドエフェクタに加えるように構成された第3のシャフトアクチュエータを更に備える、実施例1、2、又は3に記載の外科用器具。
実施例5−第3のシャフトアクチュエータが、非作動位置と、他の軸方向作動運動が外科用エンドエフェクタに加えられる作動位置との間で軸方向に移動可能であり、外科用器具が、非作動位置と作動位置との間で第3のシャフトアクチュエータを選択的に移動させるために、第3のシャフトアクチュエータとインターフェース接続する第2の駆動システムを更に備える、実施例4に記載の外科用器具。
実施例6−第3のシャフトアクチュエータが、非作動位置から作動位置に移動されると、第3のシャフトアクチュエータが、クラッチアセンブリを係合位置から係合解除位置まで移動させる、実施例5に記載の外科用器具。
実施例7−回転作動運動を第2のシャフトアクチュエータに加えると、外科用エンドエフェクタが、第2のシャフトアクチュエータによって細長いシャフトアセンブリに対して関節運動するように構成されている、実施例1、2、3、4、5、又は6に記載の外科用器具。
実施例8−第2のシャフトアクチュエータが、クラッチアセンブリとインターフェース接続して、クラッチアセンブリから回転作動運動を受容する近位関節運動ドライバと、中間関節運動ドライバであって、外科用エンドエフェクタとインターフェース接続し、かつ近位関節運動ドライバに螺合可能に連結されており、そのため、近位関節運動ドライバの回転により、中間関節運動ドライバに関節運動を外科用エンドエフェクタに加えさせる、中間関節運動ドライバと、を備える、実施例7に記載の外科用器具。
実施例9−細長いシャフトアセンブリがシャフト軸を画定し、外科用器具が、シャフト軸の一方の側で外科用エンドエフェクタに連結され、シャフト軸の別の側で中間関節運動ドライバに取り付けられた遠位関節リンクを更に備える、実施例8に記載の外科用器具。
実施例10−第1のジョーと、閉鎖運動が加えられると開放位置と閉鎖位置との間で選択的に移動するために第1のジョーに対して移動可能に支持された第2のジョーと、を含む、外科用エンドエフェクタを備える、外科用器具。外科用エンドエフェクタが細長いシャフトアセンブリに対して選択的に関節運動可能であるように、外科用器具は、外科用エンドエフェクタに動作可能に連結された細長いシャフトアセンブリを更に備える。細長いシャフトアセンブリは、第1のジョー及び第2のジョーを開放位置と閉鎖位置との間で移動させるように構成された軸方向に移動可能な閉鎖部材アセンブリを備える。発射シャフトアセンブリは、外科用エンドエフェクタと動作可能にインターフェース接続する。関節運動ドライバアセンブリは、エンドエフェクタと動作可能にインターフェース接続して、関節運動を外科用エンドエフェクタに加える。外科用器具はまた、軸方向に移動可能な閉鎖部材アセンブリを作動させるように構成された閉鎖駆動システムと、発射シャフトアセンブリに軸方向作動運動を選択的に加えるように構成された発射駆動システムと、を備える。クラッチアセンブリは、クラッチアセンブリが発射駆動システムの軸方向作動運動を関節運動ドライバアセンブリに加えられる回転作動運動に変換して、関節運動ドライバアセンブリに関節運動を外科用エンドエフェクタに加えさせる、係合位置と、第1の駆動システムの軸方向作動運動が関節運動ドライバアセンブリに加えられない、係合解除位置との間で移動可能である。
実施例11−クラッチアセンブリが係合解除位置にあるとき、関節運動ドライバアセンブリを定位置にロックするための手段を更に備える、実施例10に記載の外科用器具。
実施例12−クラッチアセンブリが、軸方向に移動可能な閉鎖部材アセンブリが開放位置に対応する非作動位置にあるときに係合位置に付勢され、クラッチアセンブリが、軸方向に移動可能な閉鎖部材アセンブリが非作動位置から閉鎖位置に対応する作動位置まで移動する際、軸方向に移動可能な閉鎖部材アセンブリによって係合位置から係合解除位置まで移動される、実施例10又は11に記載の外科用器具。
実施例13−関節運動ドライバアセンブリは、クラッチアセンブリとインターフェース接続して、クラッチアセンブリから回転作動運動を受容する近位関節運動ドライバと、中間関節運動ドライバであって、外科用エンドエフェクタとインターフェース接続して、近位関節運動ドライバに螺合可能に連結されており、そのため、近位関節運動ドライバの回転により、中間関節運動ドライバに関節運動を外科用エンドエフェクタに加えさせる、中間関節運動ドライバと、を備える、実施例10、11、又は12に記載の外科用器具。
実施例14−細長いシャフトアセンブリが、シャフト軸を画定し、外科用器具が、シャフト軸の一方の側で外科用エンドエフェクタに連結され、シャフト軸の別の側で中間関節運動ドライバに取り付けられた遠位関節リンクを更に備える、実施例13に記載の外科用器具。
実施例15−第1のジョーが、複数の外科用ステープルを内部に動作可能に格納する外科用ステープルカートリッジを備え、第2のジョーが、アンビルを備える、実施例10、11、12、13、又は14に記載の外科用器具。外科用エンドエフェクタは、発射シャフトアセンブリから受容した第1の発射運動に応答して、外科用ステープルカートリッジ内の開始位置から終了位置まで軸方向に移動して、外科用ステープルカートリッジ内部に格納された外科用ステープルを駆動して、アンビルとの接触を形成するように構成された発射部材を更に備える。
実施例16−外科用エンドエフェクタと、外科用エンドエフェクタと動作可能にインターフェース接続する細長いシャフトアセンブリと、を備える、外科用器具。細長いシャフトアセンブリは、外科用エンドエフェクタの対応する部分と動作可能にインターフェース接続する第1のシャフトアクチュエータと、外科用エンドエフェクタの別の対応する部分と動作可能にインターフェース接続する第2のシャフトアクチュエータと、を備える。外科用器具は、第1のシャフトアクチュエータに軸方向作動運動を選択的に軸方向に加えるための手段と、軸方向作動運動を回転作動運動に変換し、係合位置にあるときに回転作動運動を第2のシャフトアクチュエータに加えるための手段と、を更に備える。変換するための手段が係合解除位置にあるとき、回転作動運動は、第2のシャフトアクチュエータに加えられない。
実施例17−係合位置と係合解除位置との間で変換するための手段を移動させるための手段を更に備える、実施例16に記載の外科用器具。
実施例18−移動させるための手段が、非作動位置と作動位置との間で選択的に移動可能である、実施例17に記載の外科用器具。移動させるための手段が非作動位置と作動位置との間で移動されるときに、移動させるための手段は、外科用エンドエフェクタに追加の制御運動を加えるように構成されている。
実施例19−第2のシャフトアクチュエータが、変換するための手段とインターフェース接続して、回転作動運動を変換するための手段から受容する近位関節運動ドライバと、中間関節運動ドライバであって、外科用エンドエフェクタとインターフェース接続し、かつ近位関節運動ドライバに螺合可能に連結されており、そのため、近位関節運動ドライバの回転により、中間関節運動ドライバに関節運動を外科用エンドエフェクタに加えさせる、中間関節運動ドライバと、を備える、実施例16、17、又は18に記載の外科用器具。
実施例20−外科用エンドエフェクタが、複数の外科用ステープルを内部に動作可能に格納する外科用ステープルカートリッジを備える、第1のジョーを備える、実施例16、17、18、又は19に記載の外科用器具。外科用エンドエフェクタが、アンビルを備える第2のジョーを更に備える。発射部材は、第1のシャフトアクチュエータに軸方向作動運動が加えられるのに応答して、外科用ステープルカートリッジ内の開始位置から終了位置まで軸方向に移動して、外科用ステープルカートリッジ内部に格納された外科用ステープルを駆動して、アンビルとの接触を形成するように構成されている。本明細書で説明する外科用器具システムの多くは、電動モータによって駆動されている。本明細書に記載された外科用器具システムは、任意の好適な様態で動作することができる。様々な事例において、本明細書で説明した外科用器具システムは、例えば、手動操作トリガにより動作することができる。特定の例では、本明細書に開示されるモータは、ロボット制御式システムの1つ又は複数の部分を備えることができる。更に、本明細書に開示されるエンドエフェクタ及び/又は工具アセンブリのいずれもロボット手術器具システムと共に利用することができる。例えば、米国特許出願第13/118,241号、発明の名称「SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS」、現在は米国特許第9,072,535号は、ロボット外科用器具システムのいくつかの例をより詳細に開示している。
本明細書に記載される外科用器具システムは、ステープルの展開及び変形に関連して説明されてきた。しかしながら、本明細書に記載された実施形態は、これに限定されない。例えば、クランプ又はタックなど、ステープル以外の締結要素を展開する様々な実施形態が想定される。更に、組織を封止するための任意の好適な手段を利用する、様々な実施形態も想到される。例えば、様々な実施形態によるエンドエフェクタは、組織を加熱して封止するように構成された電極を備え得る。また例えば、特定の実施形態によるエンドエフェクタは、組織を封止するために振動エネルギーを加えることができる。
以下の開示の内容全体が参照により本明細書に組み込まれる。
−米国特許第5,403,312号、発明の名称「ELECTROSURGICAL HEMOSTATIC DEVICE」、1995年4月4日に発行、
−米国特許第7,000,818号、発明の名称「SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS」、2006年2月21日に発行、
−米国特許第7,422,139号、発明の名称「MOTOR−DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK」、2008年9月9日に発行、
−米国特許第7,464,849号、発明の名称「ELECTRO−MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS」、2008年12月16日に発行、
−米国特許第7,670,334号、発明の名称「SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR」、2010年3月2日に発行、
−米国特許第7,753,245号、発明の名称「SURGICAL STAPLING INSTRUMENTS」、2010年7月13日に発行、
−米国特許第8,393,514号、発明の名称「SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE」、2013年3月12日に発行、
−米国特許出願第11/343,803号、発明の名称「SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES」、現在は、米国特許第7,845,537号、
−米国特許出願第12/031,573号、発明の名称「SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES」、2008年2月14日に出願、
−米国特許出願第12/031,873号、発明の名称「END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT」、2008年2月15日に出願、現在は米国特許第7,980,443号、
−米国特許出願第12/235,782号、発明の名称「MOTOR−DRIVEN SURGICAL CUTTING INSTRUMENT」、現在は米国特許第8,210,411号、
−米国特許出願第12/235,972号、発明の名称「MOTORIZED SURGICAL INSTRUMENT」、現在は米国特許第9,050,083号。
−米国特許出願第12/249,117号、発明の名称「POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM」、現在は米国特許第8,608,045号、
−米国特許出願第12/647,100号、発明の名称「MOTOR−DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY」、2009年12月24日に出願、現在は、米国特許第8,220,688号、
−米国特許出願第12/893,461号、発明の名称「STAPLE CARTRIDGE」、2012年9月29日に出願、現在は米国特許第8,733,613号、
−米国特許出願第13/036,647号、発明の名称「SURGICAL STAPLING INSTRUMENT」、2011年2月28日に出願、現在は米国特許第8,561,870号、
−米国特許出願第13/118,241号、発明の名称「SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS」、現在は米国特許第9,072,535号、
−2012年6月15日付けで出願された米国特許出願第13/524,049号、発明の名称「ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE」、現在は、米国特許第9,101,358号、
−2013年3月13日付けで出願された米国特許出願第13/800,025号、発明の名称「STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM」、現在は、米国特許第9,345,481号、
−2013年3月13日に出願された米国特許出願第13/800,067号、発明の名称「STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM」、現在は米国特許出願公開第2014/0263552号、
−米国特許出願公開第2007/0175955号、発明の名称「SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM」、2006年1月31日に出願、及び
−米国特許出願公開第2010/0264194号、発明の名称「SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR」、2010年4月22日に出願、現在は米国特許第8,308,040号。
特定の実施形態と共に本明細書で様々なデバイスについて説明したが、それらの実施形態に対して修正及び変更が実施されてもよい。特定の特徴、構造又は特性を、1つ又は2つ以上の実施形態で、任意の好適な様態で組み合わせてもよい。したがって、一実施形態に関して例解又は説明される特定の特徴、構造、又は特性は、無制限に、1つ以上の他の実施形態の特徴、構造、又は特性と全て、あるいは、部分的に組み合わされてよい。また、材料が特定の構成要素に関して開示されているが、他の材料が使用されてもよい。更に、様々な実施形態に従って、所与の機能(複数可)を実行するために、単一の構成要素を複数の構成要素に置き換えてもよく、また複数の構成要素を単一の構成要素に置き換えてもよい。以上の説明及び以下の特許請求の範囲は、そのような修正及び変形形態を全て包含することが意図される。
本明細書に開示されるデバイスは、1回の使用後に廃棄されるように設計することができ、又は複数回使用されるように設計することができる。しかしながら、いずれの場合も、デバイスは少なくとも1回の使用後に再利用のために再調整され得る。再調整には、デバイスの分解工程、それに続くデバイスの特定の部品の洗浄工程又は交換工程、及びその後のデバイスの再組み立て工程の任意の組み合わせを含むことができるが、これらに限定されない。具体的には、再調整の施設及び/又は外科チームは、デバイスを分解することができ、デバイスの特定の部品を洗浄及び/又は交換した後、デバイスをその後の使用のために再組み立てすることができる。当業者であれば、デバイスの再調整が、分解、洗浄/交換、及び再組み立てのための様々な技術を利用できることを理解するであろう。このような技術の使用、及び結果として得られる再調整されたデバイスは、全て本出願の範囲内にある。
本明細書に開示のデバイスは、手術前に処理され得る。最初に、新品又は使用済みの器具が入手され、必要に応じて洗浄されてもよい。次いで器具を滅菌することができる。1つの滅菌技術では、器具は、プラスチックバッグ又はTYVEKバッグなど、閉鎖され密封された容器に入れられる。次いで、容器及び器具を、γ線、X線、及び/又は高エネルギー電子などの、容器を透過し得る放射線野に置くことができる。放射線は、器具上及び容器内の細菌を死滅させることができる。この後、滅菌済みの器具を滅菌容器内で保管することができる。密封容器は、医療施設で開けられるまで、器具を滅菌状態に保つことができる。デバイスはまた、β線、γ線、エチレンオキシド、過酸化水素プラズマ、及び/又は水蒸気が挙げられるが、これらに限定されない、当該技術分野で既知の任意の他の技術を用いて滅菌され得る。
代表的な設計を有するものとして本発明について記載してきたが、本発明は、本開示の趣旨及び範囲内で更に修正されてもよい。したがって、本出願は、その一般的原理を使用する本発明のあらゆる変形、使用、又は適合を包含するものとする。
〔実施の態様〕
(1) 外科用器具であって、
外科用エンドエフェクタと、
前記外科用エンドエフェクタと動作可能にインターフェース接続する細長いシャフトアセンブリであって、
前記外科用エンドエフェクタの対応する部分と動作可能にインターフェース接続する第1のシャフトアクチュエータと、
前記外科用エンドエフェクタの別の対応する部分と動作可能にインターフェース接続する第2のシャフトアクチュエータと、を備える、細長いシャフトアセンブリと、を備え、前記外科用器具が、
前記第1のシャフトアクチュエータに軸方向作動運動を選択的に加えるように構成された第1の駆動システムと、
クラッチアセンブリであって、前記クラッチアセンブリが前記第1の駆動システムの前記軸方向作動運動を前記第2のシャフトアクチュエータに加えられる回転作動運動に変換する、係合位置と、前記第1の駆動システムの前記軸方向作動運動が前記第2のシャフトアクチュエータに加えられない、係合解除位置との間で移動可能である、クラッチアセンブリと、を更に備える、外科用器具。
(2) 前記クラッチアセンブリが前記係合解除位置にあるとき、前記第2のシャフトアクチュエータを定位置にロックするための手段を更に備える、実施態様1に記載の外科用器具。
(3) 前記クラッチアセンブリが、前記係合位置と前記係合解除位置との間で軸方向に移動可能である、実施態様1に記載の外科用器具。
(4) 前記細長いシャフトアセンブリが、他の軸方向作動運動を前記外科用エンドエフェクタに加えるように構成された第3のシャフトアクチュエータを更に備える、実施態様3に記載の外科用器具。
(5) 前記第3のシャフトアクチュエータが、非作動位置と、前記他の軸方向作動運動が前記外科用エンドエフェクタに加えられる作動位置との間で軸方向に移動可能であり、前記外科用器具が、前記非作動位置と前記作動位置との間で前記第3のシャフトアクチュエータを選択的に移動させるために、前記第3のシャフトアクチュエータとインターフェース接続する第2の駆動システムを更に備える、実施態様4に記載の外科用器具。
(6) 前記第3のシャフトアクチュエータが、前記非作動位置から前記作動位置に移動されると、前記第3のシャフトアクチュエータが、前記クラッチアセンブリを前記係合位置から前記係合解除位置まで移動させる、実施態様5に記載の外科用器具。
(7) 前記回転作動運動を前記第2のシャフトアクチュエータに加えると、前記外科用エンドエフェクタが、前記第2のシャフトアクチュエータによって前記細長いシャフトアセンブリに対して関節運動するように構成されている、実施態様1に記載の外科用器具。
(8) 前記第2のシャフトアクチュエータが、
前記クラッチアセンブリとインターフェース接続して、前記クラッチアセンブリから前記回転作動運動を受容する近位関節運動ドライバと、
中間関節運動ドライバであって、前記外科用エンドエフェクタとインターフェース接続し、かつ前記近位関節運動ドライバに螺合可能に連結されており、そのため、前記近位関節運動ドライバの回転により、前記中間関節運動ドライバに関節運動を前記外科用エンドエフェクタに加えさせる、中間関節運動ドライバと、を備える、実施態様7に記載の外科用器具。
(9) 前記細長いシャフトアセンブリがシャフト軸を画定し、前記外科用器具が、前記シャフト軸の一方の側で前記外科用エンドエフェクタに連結され、前記シャフト軸の別の側で前記中間関節運動ドライバに取り付けられた遠位関節運動リンクを更に備える、実施態様8に記載の外科用器具。
(10) 外科用器具であって、
外科用エンドエフェクタと、
第1のジョーと、
閉鎖運動が加えられると開放位置と閉鎖位置との間で選択的に移動するために前記第1のジョーに対して移動可能に支持された第2のジョーと、を備え、前記外科用器具が、
前記外科用エンドエフェクタに動作可能に連結された細長いシャフトアセンブリであって、前記外科用エンドエフェクタが、前記細長いシャフトアセンブリに対して選択的に関節運動可能であり、前記細長いシャフトアセンブリが、
前記第1のジョー及び前記第2のジョーを前記開放位置と前記閉鎖位置との間で移動させるように構成された軸方向に移動可能な閉鎖部材アセンブリと、
前記外科用エンドエフェクタと動作可能にインターフェース接続する発射シャフトアセンブリと、
前記外科用エンドエフェクタと動作可能にインターフェース接続して、関節運動を前記外科用エンドエフェクタに加える関節運動ドライバアセンブリと、を備える、細長いシャフトアセンブリを更に備え、前記外科用器具が、
前記軸方向に移動可能な閉鎖部材アセンブリを作動させるように構成された閉鎖駆動システムと、
前記発射シャフトアセンブリに軸方向作動運動を選択的に加えるように構成された発射駆動システムと、
クラッチアセンブリであって、前記クラッチアセンブリが前記発射駆動システムの前記軸方向作動運動を前記関節運動ドライバアセンブリに加えられる回転作動運動に変換して、前記関節運動ドライバアセンブリに前記関節運動を前記外科用エンドエフェクタに加えさせる、係合位置と、前記第1の駆動システムの前記軸方向作動運動が前記関節運動ドライバアセンブリに加えられない、係合解除位置との間で移動可能である、クラッチアセンブリと、を更に備える、外科用器具。
(11) 前記クラッチアセンブリが前記係合解除位置にあるとき、前記関節運動ドライバアセンブリを定位置にロックするための手段を更に備える、実施態様10に記載の外科用器具。
(12) 前記クラッチアセンブリが、前記軸方向に移動可能な閉鎖部材アセンブリが前記開放位置に対応する非作動位置にあるときに前記係合位置に付勢され、前記クラッチアセンブリが、前記軸方向に移動可能な閉鎖部材アセンブリが前記非作動位置から前記閉鎖位置に対応する作動位置まで移動する際、前記軸方向に移動可能な閉鎖部材アセンブリによって前記係合位置から前記係合解除位置まで移動される、実施態様10に記載の外科用器具。
(13) 前記関節運動ドライバアセンブリが、
前記クラッチアセンブリとインターフェース接続して、前記クラッチアセンブリから前記回転作動運動を受容する近位関節運動ドライバと、
中間関節運動ドライバであって、前記外科用エンドエフェクタとインターフェース接続して、前記近位関節運動ドライバに螺合可能に連結されており、そのため、前記近位関節運動ドライバの回転により、前記中間関節運動ドライバに前記関節運動を前記外科用エンドエフェクタに加えさせる、中間関節運動ドライバと、を備える、実施態様10に記載の外科用器具。
(14) 前記細長いシャフトアセンブリが、シャフト軸を画定し、前記外科用器具が、前記シャフト軸の一方の側で前記外科用エンドエフェクタに連結され、前記シャフト軸の別の側で前記中間関節運動ドライバに取り付けられた遠位関節運動リンクを更に備える、実施態様13に記載の外科用器具。
(15) 前記第1のジョーが、複数の外科用ステープルを内部に動作可能に格納する外科用ステープルカートリッジを備え、前記第2のジョーが、アンビルを備え、前記外科用エンドエフェクタが、前記発射シャフトアセンブリから受容した第1の発射運動に応答して、前記外科用ステープルカートリッジ内の開始位置から終了位置まで軸方向に移動して、前記外科用ステープルカートリッジ内部に格納された前記外科用ステープルを駆動して、前記アンビルとの接触を形成するように構成された発射部材を更に備える、実施態様10に記載の外科用器具。
(16) 外科用器具であって、
外科用エンドエフェクタと、
前記外科用エンドエフェクタと動作可能にインターフェース接続する細長いシャフトアセンブリであって、
前記外科用エンドエフェクタの対応する部分と動作可能にインターフェース接続する第1のシャフトアクチュエータと、
前記外科用エンドエフェクタの別の対応する部分と動作可能にインターフェース接続する第2のシャフトアクチュエータと、を備える、細長いシャフトアセンブリと、を備え、前記外科用器具が、
前記第1のシャフトアクチュエータに軸方向作動運動を選択的に軸方向に加えるための手段と、
前記軸方向作動運動を回転作動運動に変換し、係合位置にあるときに前記回転作動運動を前記第2のシャフトアクチュエータに加えるための手段であって、変換するための前記手段が係合解除位置にあるとき、前記回転作動運動が、前記第2のシャフトアクチュエータに加えられない、変換するための手段と、を更に備える、外科用器具。
(17) 前記係合位置と前記係合解除位置との間で前記変換するための手段を移動させるための手段を更に備える、実施態様16に記載の外科用器具。
(18) 前記移動させるための手段が、非作動位置と作動位置との間で選択的に移動可能であり、前記移動させるための手段が前記非作動位置と前記作動位置との間で移動されるときに、前記移動させるための手段が、前記外科用エンドエフェクタに追加の制御運動を加えるように構成されている、実施態様17に記載の外科用器具。
(19) 前記第2のシャフトアクチュエータが、
前記変換するための手段とインターフェース接続して、前記回転作動運動を前記変換するための手段から受容する近位関節運動ドライバと、
中間関節運動ドライバであって、前記外科用エンドエフェクタとインターフェース接続し、かつ前記近位関節運動ドライバに螺合可能に連結されており、そのため、前記近位関節運動ドライバの回転により、前記中間関節運動ドライバに関節運動を前記外科用エンドエフェクタに加えさせる、中間関節運動ドライバと、を備える、実施態様16に記載の外科用器具。
(20) 前記外科用エンドエフェクタが、
複数の外科用ステープルを内部に動作可能に格納する外科用ステープルカートリッジを備える、第1のジョーと、
アンビルを備える第2のジョーと、
前記第1のシャフトアクチュエータに前記軸方向作動運動が加えられるのに応答して、前記外科用ステープルカートリッジ内の開始位置から終了位置まで軸方向に移動して、前記外科用ステープルカートリッジ内部に格納された前記外科用ステープルを駆動して、前記アンビルとの接触を形成するように構成された発射部材と、を備える、実施態様16に記載の外科用器具。

Claims (20)

  1. 外科用器具であって、
    外科用エンドエフェクタと、
    前記外科用エンドエフェクタと動作可能にインターフェース接続する細長いシャフトアセンブリであって、
    前記外科用エンドエフェクタの対応する部分と動作可能にインターフェース接続する第1のシャフトアクチュエータと、
    前記外科用エンドエフェクタの別の対応する部分と動作可能にインターフェース接続する第2のシャフトアクチュエータと、を備える、細長いシャフトアセンブリと、を備え、前記外科用器具が、
    前記第1のシャフトアクチュエータに軸方向作動運動を選択的に加えるように構成された第1の駆動システムと、
    クラッチアセンブリであって、前記クラッチアセンブリが前記第1の駆動システムの前記軸方向作動運動を前記第2のシャフトアクチュエータに加えられる回転作動運動に変換する、係合位置と、前記第1の駆動システムの前記軸方向作動運動が前記第2のシャフトアクチュエータに加えられない、係合解除位置との間で移動可能である、クラッチアセンブリと、を更に備える、外科用器具。
  2. 前記クラッチアセンブリが前記係合解除位置にあるとき、前記第2のシャフトアクチュエータを定位置にロックするための手段を更に備える、請求項1に記載の外科用器具。
  3. 前記クラッチアセンブリが、前記係合位置と前記係合解除位置との間で軸方向に移動可能である、請求項1に記載の外科用器具。
  4. 前記細長いシャフトアセンブリが、他の軸方向作動運動を前記外科用エンドエフェクタに加えるように構成された第3のシャフトアクチュエータを更に備える、請求項3に記載の外科用器具。
  5. 前記第3のシャフトアクチュエータが、非作動位置と、前記他の軸方向作動運動が前記外科用エンドエフェクタに加えられる作動位置との間で軸方向に移動可能であり、前記外科用器具が、前記非作動位置と前記作動位置との間で前記第3のシャフトアクチュエータを選択的に移動させるために、前記第3のシャフトアクチュエータとインターフェース接続する第2の駆動システムを更に備える、請求項4に記載の外科用器具。
  6. 前記第3のシャフトアクチュエータが、前記非作動位置から前記作動位置に移動されると、前記第3のシャフトアクチュエータが、前記クラッチアセンブリを前記係合位置から前記係合解除位置まで移動させる、請求項5に記載の外科用器具。
  7. 前記回転作動運動を前記第2のシャフトアクチュエータに加えると、前記外科用エンドエフェクタが、前記第2のシャフトアクチュエータによって前記細長いシャフトアセンブリに対して関節運動するように構成されている、請求項1に記載の外科用器具。
  8. 前記第2のシャフトアクチュエータが、
    前記クラッチアセンブリとインターフェース接続して、前記クラッチアセンブリから前記回転作動運動を受容する近位関節運動ドライバと、
    中間関節運動ドライバであって、前記外科用エンドエフェクタとインターフェース接続し、かつ前記近位関節運動ドライバに螺合可能に連結されており、そのため、前記近位関節運動ドライバの回転により、前記中間関節運動ドライバに関節運動を前記外科用エンドエフェクタに加えさせる、中間関節運動ドライバと、を備える、請求項7に記載の外科用器具。
  9. 前記細長いシャフトアセンブリがシャフト軸を画定し、前記外科用器具が、前記シャフト軸の一方の側で前記外科用エンドエフェクタに連結され、前記シャフト軸の別の側で前記中間関節運動ドライバに取り付けられた遠位関節運動リンクを更に備える、請求項8に記載の外科用器具。
  10. 外科用器具であって、
    外科用エンドエフェクタと、
    第1のジョーと、
    閉鎖運動が加えられると開放位置と閉鎖位置との間で選択的に移動するために前記第1のジョーに対して移動可能に支持された第2のジョーと、を備え、前記外科用器具が、
    前記外科用エンドエフェクタに動作可能に連結された細長いシャフトアセンブリであって、前記外科用エンドエフェクタが、前記細長いシャフトアセンブリに対して選択的に関節運動可能であり、前記細長いシャフトアセンブリが、
    前記第1のジョー及び前記第2のジョーを前記開放位置と前記閉鎖位置との間で移動させるように構成された軸方向に移動可能な閉鎖部材アセンブリと、
    前記外科用エンドエフェクタと動作可能にインターフェース接続する発射シャフトアセンブリと、
    前記外科用エンドエフェクタと動作可能にインターフェース接続して、関節運動を前記外科用エンドエフェクタに加える関節運動ドライバアセンブリと、を備える、細長いシャフトアセンブリを更に備え、前記外科用器具が、
    前記軸方向に移動可能な閉鎖部材アセンブリを作動させるように構成された閉鎖駆動システムと、
    前記発射シャフトアセンブリに軸方向作動運動を選択的に加えるように構成された発射駆動システムと、
    クラッチアセンブリであって、前記クラッチアセンブリが前記発射駆動システムの前記軸方向作動運動を前記関節運動ドライバアセンブリに加えられる回転作動運動に変換して、前記関節運動ドライバアセンブリに前記関節運動を前記外科用エンドエフェクタに加えさせる、係合位置と、前記第1の駆動システムの前記軸方向作動運動が前記関節運動ドライバアセンブリに加えられない、係合解除位置との間で移動可能である、クラッチアセンブリと、を更に備える、外科用器具。
  11. 前記クラッチアセンブリが前記係合解除位置にあるとき、前記関節運動ドライバアセンブリを定位置にロックするための手段を更に備える、請求項10に記載の外科用器具。
  12. 前記クラッチアセンブリが、前記軸方向に移動可能な閉鎖部材アセンブリが前記開放位置に対応する非作動位置にあるときに前記係合位置に付勢され、前記クラッチアセンブリが、前記軸方向に移動可能な閉鎖部材アセンブリが前記非作動位置から前記閉鎖位置に対応する作動位置まで移動する際、前記軸方向に移動可能な閉鎖部材アセンブリによって前記係合位置から前記係合解除位置まで移動される、請求項10に記載の外科用器具。
  13. 前記関節運動ドライバアセンブリが、
    前記クラッチアセンブリとインターフェース接続して、前記クラッチアセンブリから前記回転作動運動を受容する近位関節運動ドライバと、
    中間関節運動ドライバであって、前記外科用エンドエフェクタとインターフェース接続して、前記近位関節運動ドライバに螺合可能に連結されており、そのため、前記近位関節運動ドライバの回転により、前記中間関節運動ドライバに前記関節運動を前記外科用エンドエフェクタに加えさせる、中間関節運動ドライバと、を備える、請求項10に記載の外科用器具。
  14. 前記細長いシャフトアセンブリが、シャフト軸を画定し、前記外科用器具が、前記シャフト軸の一方の側で前記外科用エンドエフェクタに連結され、前記シャフト軸の別の側で前記中間関節運動ドライバに取り付けられた遠位関節運動リンクを更に備える、請求項13に記載の外科用器具。
  15. 前記第1のジョーが、複数の外科用ステープルを内部に動作可能に格納する外科用ステープルカートリッジを備え、前記第2のジョーが、アンビルを備え、前記外科用エンドエフェクタが、前記発射シャフトアセンブリから受容した第1の発射運動に応答して、前記外科用ステープルカートリッジ内の開始位置から終了位置まで軸方向に移動して、前記外科用ステープルカートリッジ内部に格納された前記外科用ステープルを駆動して、前記アンビルとの接触を形成するように構成された発射部材を更に備える、請求項10に記載の外科用器具。
  16. 外科用器具であって、
    外科用エンドエフェクタと、
    前記外科用エンドエフェクタと動作可能にインターフェース接続する細長いシャフトアセンブリであって、
    前記外科用エンドエフェクタの対応する部分と動作可能にインターフェース接続する第1のシャフトアクチュエータと、
    前記外科用エンドエフェクタの別の対応する部分と動作可能にインターフェース接続する第2のシャフトアクチュエータと、を備える、細長いシャフトアセンブリと、を備え、前記外科用器具が、
    前記第1のシャフトアクチュエータに軸方向作動運動を選択的に軸方向に加えるための手段と、
    前記軸方向作動運動を回転作動運動に変換し、係合位置にあるときに前記回転作動運動を前記第2のシャフトアクチュエータに加えるための手段であって、変換するための前記手段が係合解除位置にあるとき、前記回転作動運動が、前記第2のシャフトアクチュエータに加えられない、変換するための手段と、を更に備える、外科用器具。
  17. 前記係合位置と前記係合解除位置との間で前記変換するための手段を移動させるための手段を更に備える、請求項16に記載の外科用器具。
  18. 前記移動させるための手段が、非作動位置と作動位置との間で選択的に移動可能であり、前記移動させるための手段が前記非作動位置と前記作動位置との間で移動されるときに、前記移動させるための手段が、前記外科用エンドエフェクタに追加の制御運動を加えるように構成されている、請求項17に記載の外科用器具。
  19. 前記第2のシャフトアクチュエータが、
    前記変換するための手段とインターフェース接続して、前記回転作動運動を前記変換するための手段から受容する近位関節運動ドライバと、
    中間関節運動ドライバであって、前記外科用エンドエフェクタとインターフェース接続し、かつ前記近位関節運動ドライバに螺合可能に連結されており、そのため、前記近位関節運動ドライバの回転により、前記中間関節運動ドライバに関節運動を前記外科用エンドエフェクタに加えさせる、中間関節運動ドライバと、を備える、請求項16に記載の外科用器具。
  20. 前記外科用エンドエフェクタが、
    複数の外科用ステープルを内部に動作可能に格納する外科用ステープルカートリッジを備える、第1のジョーと、
    アンビルを備える第2のジョーと、
    前記第1のシャフトアクチュエータに前記軸方向作動運動が加えられるのに応答して、前記外科用ステープルカートリッジ内の開始位置から終了位置まで軸方向に移動して、前記外科用ステープルカートリッジ内部に格納された前記外科用ステープルを駆動して、前記アンビルとの接触を形成するように構成された発射部材と、を備える、請求項16に記載の外科用器具。
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