JP6336492B2 - Method for controlling a surgical instrument with a removable tool part - Google Patents

Description

  The present invention relates to surgical instruments, and to surgical cutting and stapling instruments and staple cartridges thereof designed to cut and staple tissue in various configurations.

  Surgical staplers are often used to deploy staples into soft tissue to reduce or eliminate bleeding from the soft tissue, particularly when the tissue is being transected, for example. For example, a surgical stapler, such as an end cutter, can include an end effector that can be moved or articulated relative to the elongated shaft assembly. The end effector is often configured to secure soft tissue between the first jaw member and the second jaw member, and the first jaw member is configured to removably store the staples. The second jaw member often includes an anvil. Such surgical staples can include a closure system for pivoting the anvil relative to the staple cartridge.

  As outlined above, the surgical stapler can be configured to pivot the anvil of the end effector relative to the staple cartridge to capture soft tissue therebetween. In various cases, the anvil can be configured to apply a clamping force against the soft tissue to securely hold the soft tissue between the anvil and the staple cartridge. However, if the surgeon is not satisfied with the position of the end effector, the surgeon typically activates the surgical stapler release mechanism to pivot the anvil to the open position and then reposition the end effector. There must be. Thereafter, the staple is typically deployed from the staple cartridge by a driver that traverses a channel in the staple cartridge, deforms the staple relative to the anvil, and secures the soft tissue layers together. In many cases, as is known in the art, staples are deployed in the form of a plurality of staple lines, i.e., in a row, to more accurately secure multiple layers of tissue together. The end effector may also include a cutting member that is advanced between two rows of staples, such as a knife, to cut the soft tissue after the multiple layers of soft tissue are stapled together.

  Such surgical staplers and effectors may be sized and configured to be inserted into a body cavity through a trocar or other access opening. The end effector is typically coupled to an elongate shaft that is sized to penetrate the trocar or opening. The elongate shaft assembly is often operably coupled to a handle that supports a control system and / or trigger that controls the operation of the end effector. In order to facilitate proper positioning and orientation of the end effector within the body, many surgical instruments are configured to facilitate articulation of the end effector relative to a portion of the elongate shaft.

  The above discussion is merely intended to illustrate various aspects of the related art in the field of the invention at that time and should not be construed as denying the scope of the claims.

The features and advantages of the present invention as well as the manner in which they are realized will become more apparent and the invention itself will be more fully understood by reference to the following description of embodiments of the invention in conjunction with the accompanying drawings. .
1 is a perspective view of one form of surgical stapling instrument of the present invention. FIG. FIG. 3 is another perspective view of the surgical instrument of FIG. 1 with a portion of the handle housing removed. It is an exploded view showing one end effector configuration of the present invention. FIG. 3 is a partial cross-sectional view showing a portion of the end effector and elongate shaft assembly of the surgical instrument of FIGS. 1 and 2 with the anvil assembly in an open position. FIG. 5 is another partial cross-sectional view of the end effector and elongate shaft assembly of FIG. 4 with the anvil assembly in a closed position prior to firing. FIG. 6 is another partial cross-sectional view of the end effector and elongate shaft assembly of FIGS. 4 and 5 after the tissue cutting member has been advanced to the most distal position within the end effector. It is a perspective view which shows the coupler assembly structure of this invention. FIG. 8 is an exploded view showing the coupler assembly of FIG. 7. FIG. 6 is a perspective view showing the proximal end of the end effector and the distal end of the elongated shaft assembly and the coupler assembly attached thereto. FIG. 10 is an elevational view showing the proximal end of the end effector of FIG. 9. FIG. 10 is an elevational view showing the distal end of the coupler assembly of FIG. 9. FIG. 6 is a perspective assembly view showing the end effector and a portion of the elongate shaft assembly prior to coupling the end effector. FIG. 10 is another perspective view showing a portion of the end effector and elongate shaft assembly configuration after the end effector is first engaged with the coupler assembly portion of the elongate shaft assembly. FIG. 14 is another perspective view showing the components shown in FIG. 13 after the end effector is coupled to the coupler assembly portion of the elongated shaft assembly. It is a perspective view which shows the joint motion control structure of this invention. It is a perspective view which shows a part of articulation axis segment structure. It is a disassembled perspective view which shows the joint joint structure of this invention. It is a perspective view which shows the joint joint structure of FIG. It is a top view which shows the joint joint structure of FIG.17 and FIG.18. It is sectional drawing of the component shown by FIG. FIG. 21 is another cross-sectional view showing the joint joint of FIGS. 19 and 20. FIG. 22 is another cross-sectional view showing the joint joint of FIG. 21 in an articulated configuration. It is a perspective view which shows the launch system structure of this invention. It is a perspective view which shows the end effector rotation system structure of this invention. FIG. 6 is a perspective view of a portion of the articulation joint and coupler assembly of the present invention. It is a perspective view which shows the shaft rotation system structure of this invention. FIG. 3 is an exploded perspective view showing the surgical instrument of FIGS. 1 and 2. It is a disassembled perspective view which shows the drive mount structure which can be separated of this invention. FIG. 29 is an end elevation view showing a portion of the separable drive mount configuration of FIG. 28 attached to a motor mounting assembly configuration. FIG. 28B is a perspective view of a portion of the separable drive mount configuration and motor mounting assembly configuration of FIG. 28A. FIG. 6 is a cross-sectional view illustrating a portion of a handle assembly configuration. FIG. 5 is an exploded view showing a separable drive mount and motor mounting assembly within the handle housing portion. It is a disassembled assembly figure which shows a motor mounting assembly structure. FIG. 6 is another exploded cross-sectional assembly view showing a separable drive mount and motor mounting assembly within the handle housing portion. FIG. 6 is a side elevational view showing a portion of the handle assembly with various components omitted for clarity. It is a bottom perspective view showing a switch configuration of the present invention. FIG. 35 is an exploded view showing the switch configuration of FIG. 34. FIG. 36 is a cross-sectional view of a portion of the switch configuration of FIGS. 34 and 35 mounted to the handle assembly with the joystick control portion in an inoperative position. FIG. 37 is another cross-sectional view of the switch configuration of FIG. 36 with the joystick control portion in the activated position. It is side surface sectional drawing which shows the switch structure of FIG. It is side surface sectional drawing which shows the switch structure of FIG. FIG. 40 is a side elevational view showing the switch configuration of FIGS. FIG. 41 is a front elevation view showing the switch configuration of FIGS. FIG. 42 is another exploded view illustrating the switch configuration of FIGS. 34 to 41. FIG. 6 is a rear elevation view showing the thumbwheel paddle control assembly configuration in the activated position. FIG. 10 is another rear elevational view showing the thumbwheel paddle control assembly configuration in another operational position. FIG. 6 is another partial cross-sectional view showing an end effector and elongate shaft assembly configuration. FIG. 5 is an enlarged cross-sectional view illustrating a portion of a coupler assembly configuration with an articulated joint configuration and an end effector coupled thereto. FIG. 6 is a perspective view of a portion of the handle assembly configuration with a portion of the handle housing removed. FIG. 6 is an enlarged perspective view of a portion of a handle assembly showing a conductor coupling configuration. FIG. 6 is an exploded perspective view showing a portion of another coupler assembly configuration and an articulation joint configuration. It is a perspective view which shows another joint joint structure of this invention. FIG. 51 is an exploded view showing the joint joint configuration of FIG. 50. FIG. 52 is a cross-sectional view showing the joint joint configuration of FIGS. 50 and 51. FIG. 53 is another cross-sectional perspective view showing the joint joint configuration of FIGS. 50 to 52. It is a perspective view which shows another joint joint structure of this invention. FIG. 55 is an exploded view showing the joint joint configuration of FIG. 54. FIG. 56 is a partial cross-sectional view showing the joint joint configuration of FIGS. 54 and 55. FIG. 57 is another partial cross-sectional view showing the joint joint configuration of FIGS. 54 to 56. FIG. 58 is another partial perspective sectional view showing the joint joint configuration of FIGS. 54 to 57; FIG. 59 is another partial perspective cross-sectional view of the articulated joint configuration of FIGS. 54-58 with the joint in an articulated orientation. FIG. 60 is another partial perspective cross-sectional view illustrating the articulated joint configuration of FIGS. 54-59 with the joint in another articulated orientation. It is a perspective view which shows another joint joint structure of this invention. FIG. 61 is another perspective view of the articulated joint configuration of FIG. 60 in an articulated orientation. FIG. 63 is an exploded view showing the joint joint of FIGS. 61 and 62; FIG. 64 is a cross-sectional view showing the joint joint configuration of FIGS. FIG. 67 is another cross-sectional perspective view showing the joint joint configuration of FIGS. 61 to 64. FIG. 66 is another cross-sectional perspective view of the articulated joint configuration of FIGS. 61-65 with the articulated joint in an articulated orientation. It is a perspective view which shows another motor mounting assembly structure of this invention. FIG. 68 is a front elevation view showing the motor mounting assembly configuration of FIG. 67; FIG. 69 is an exploded view showing the motor mounting assembly configuration of FIGS. 67 and 68; FIG. 6 is a perspective view of one form of an electrosurgical end effector used with a surgical instrument. FIG. 71 is a perspective view of an embodiment of the end effector of FIG. 70 with the jaws closed and the distal end of the axially movable member in a partially advanced position. FIG. 71 is a perspective view showing a form of the axially movable member of the end effector of FIG. 70. FIG. 71 is a cross-sectional view showing a form of the end effector of FIG. 70. 1 illustrates one form of an ultrasonic end effector for use with a surgical instrument. 1 illustrates one form of an ultrasonic end effector for use with a surgical instrument. FIG. 75 is an additional view of one form of the axially movable member of the end effector of FIG. 74. FIG. 75 is an additional view of one form of the axially movable member of the end effector of FIG. 74. FIG. 6 illustrates one form of a linear staple end effector that may be used with a surgical instrument. FIG. 6 illustrates one form of a circular staple end effector that may be used with a surgical instrument. Figure 2 shows some examples of power cords used with surgical instruments. Figure 2 shows some examples of shafts that can be used with a surgical instrument. 1 is a block diagram of a handle assembly of a surgical instrument showing various control elements. FIG. 1 illustrates one form of various end effector tool portions comprising circuitry as described herein. FIG. 6 is a block diagram illustrating one form of a control configuration implemented by a control circuit that controls a surgical instrument. It is a flowchart which shows an example of the form of the process flow which implement | achieves the control algorithm of FIG. It is a block diagram which shows another form of the control structure implement | achieved by the control circuit which controls a surgical instrument. FIG. 87 is a flowchart showing an example of a process flow for realizing the control algorithm of FIG. 86. FIG. 6 shows one form of surgical instrument with a relay station in the handle. FIG. 3 illustrates one form of an end effector with a sensor module configured to transmit a signal disposed therein. It is a block diagram which shows one form of a sensor module. It is a block diagram which shows one form of a relay station. FIG. 2 is a block diagram illustrating one form of a relay station configured to convert a received low power signal. It is a flowchart which shows one form of the method of relaying the signal which shows the state in an end effector. 2 illustrates a distal portion of an instrument with a mechanical stop as shown in FIG. 1 in accordance with certain aspects described herein. FIG. 6 illustrates a system that can be adapted for use with an electromechanical stop comprising a power source, a control system, and a drive motor, in accordance with certain aspects described herein. 6 is a graph showing the change in current over time associated with an instrument comprising an electromechanical stop without a soft stop, according to certain aspects described herein. An instrument equipped with a mechanical stop including a soft stop, wherein the drive member is actuated to a position prior to contact with the soft stop at a second position at the end of the stroke, according to certain aspects described herein. The distal part of is shown. 97 illustrates the instrument shown in FIG. 97 having actuated a drive member through a first position at a stroke end to a second position at a stroke end, according to certain aspects described herein. 6 is a graph illustrating the change in current over time associated with an instrument comprising an electromechanical stop including a soft stop, according to certain aspects described herein. FIG. 6 is a perspective view of an alternative motor mounting assembly that uses a gear driven drive mount assembly. FIG. 100 is another perspective view of the motor mounting assembly of FIG. 100 with the distal shaft housing omitted for clarity. FIG. 102 is another perspective view showing the motor mounting assembly of FIGS. 100 and 101. FIG. 103 is a cross-sectional view of the motor mounting assembly of FIGS. FIG. 110 is a top view of the motor mounting assembly of FIGS. 100-103. 1 illustrates one form of a surgical instrument with a sensor-straightened end effector in an articulated state. 106 shows the surgical instrument of FIG. 105 in a straight state. FIG. 6 illustrates one form of a sensor correction end effector inserted into a surgical overtube. FIG. FIG. 6 illustrates one form of a sensor correction end effector inserted into a surgical overtube in an articulated state. FIG. 6 illustrates one form of a sensor correction end effector in an articulated state. FIG. FIG. 110 illustrates one form of the sensor correction end effector of FIG. 109 in a straight state. FIG. 6 illustrates one form of magnetic ring for use with a sensor correction end effector. FIG. 1 shows one form of a sensor correction end effector comprising a magnetic sensor. 1 shows one form of a magnetic lead sensor. 1 illustrates one form of a modular motor control platform. 1 illustrates one form of a modular motor control platform comprising multiple motor controller pairs. 1 illustrates one form of a modular motor control platform comprising a master controller and a slave controller. FIG. 4 illustrates one form of a control process that can be achieved with a multi-motor controlled surgical instrument.

Applicant also owns the following patent applications filed on the same day as the present application, the entire contents of each of which are incorporated herein by reference.
US patent application, name “Rotary Powered Surgical Instruments With Multiple Degrees of Freedom”, Attorney Docket Number END7195USNP / 120287,
US patent application, name “Rotary Powered Articulation Joints for Surgical Instruments”, Attorney Docket No. END7188USNP / 120280,
US patent application, “Articulatable Surgical Instruments With Conductive Pathways for Signal Communication”, Attorney Docket No. END7187USNP / 120279,
US patent application, “Thumwheel Switch Arrangements For Surgical Instruments”, Attorney Docket No. END7189USNP / 120281,
US patent application, name "Joystick Switch Assemblies For Surgical Instruments", Attorney Docket No. END 7192 USNP / 120284,
US patent application, name “Electromechanical Software Stops For Surgical Instruments”, Attorney Docket No. END7196USNP / 120288,
US patent application, name “Electromechanical Medical Device With Signal Relay Arrangement”, Attorney Docket No. END7190USNP / 120282,
United States patent application, name “Sensor Straitened End Effector Removing Through Through Trocar”, Attorney Docket Number END 7193 USNP / 120285, and
US patent application, name “Multiple Processor Motor Control For Modular Surgical Device”, Attorney Docket No. END7091USNP / 120283.

  Certain exemplary embodiments are described below to provide a general understanding of the principles of structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. The devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments, and the scope of the various embodiments of the present invention is limited only by the claims. It will be understood by those skilled in the art that it is defined. Features illustrated or described in the context of certain exemplary embodiments may be combined with features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.

  The terms “comprise” (and any word form of complies, such as complies and comprising), “have” (and any word form of have, such as has and having), “include” (and includes) Any word form of include, such as and including, and “contain” (and any word form of container, such as contains and containing) are open connective verbs. As a result, a surgical system, device, or apparatus that “comprises”, “haves”, “includes”, or “contains” one or more elements has one or more of those elements Is not limited to having only one or more of those elements. Similarly, an element of a system, device, or apparatus that “comprises”, “haves”, “includes”, or “contains” one or more structures has one or more of those structures. However, it is not limited to having only one or more of these structures.

  The terms “proximal” and “distal” are used herein with reference to the clinician operating the handle portion of the surgical instrument. The term “proximal” refers to the portion closest to the clinician, and the term “distal” refers to the portion located away from the clinician. For convenience and clarity, it is further understood that spatial terms such as “vertical”, “horizontal”, “top”, “bottom” may be used herein with respect to the drawings. It will be. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.

  Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, one of ordinary skill in the art will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications, including, for example, in connection with open surgical procedures. Will be done. As one reads through the “Detailed Description of the Invention” herein, those skilled in the art will be able to use the various instruments disclosed herein through natural openings to make incisions or punctures made in tissue. It will be further understood that it can be inserted into the body in any manner, such as through a hole. The working or end effector portion of the instrument can be inserted directly into the patient's body, or inserted through an access device having a working channel that can be advanced through the end effector and elongated shaft of the surgical instrument. can do.

  Turning to the drawings, wherein like numerals refer to like components throughout the drawings, FIGS. 1-3 can apply rotational actuation motion to the operatively coupled device portion 100. A surgical instrument 10 is shown. As will be described in more detail below, the instrument 10 may be effectively used with a variety of different devices that may be interchangeably coupled to the instrument 10. The configuration of FIGS. 1 and 2 is shown coupled to an end effector 102 that is configured to cut and staple tissue, for example. However, other tool configurations may be operated by the instrument 10.

End Effector The end effector 102 shown in FIGS. 1-6 includes an elongate channel member 110 that may be configured to operably and detachably support the staple cartridge 130. The staple cartridge 130 may include a top surface or cartridge deck 132 that includes a plurality of staple pockets 134 arranged in a staggered fashion on either side of the elongated slot 136. Please refer to FIG. The plurality of surgical staples 140 are supported on corresponding staple drivers 138 that are operatively supported within the staple pocket 134. As can also be seen in FIG. 3, in one form, the end effector 102 includes an end base 150 that is coupled to the proximal end of the staple cartridge 130 and configured to fit within the proximal end of the elongate channel 110. For example, the end base 150 may be formed with a distally extending latch tab 152 configured to be received in a corresponding latch slot 142 of the cartridge deck 132. In addition, the end base 150 may include a laterally extending mounting protrusion 154 for attaching the end base 150 to the elongate channel 110. For example, the mounting protrusion 154 may be configured to be received in the corresponding mounting hole 112 of the elongate channel 110.

  In one form, end base 150 includes a centrally disposed slot 156 configured to support tissue cutting member 160 and sled 170. Tissue cutting member 160 may include a body portion 162 with or otherwise attached to tissue cutting portion 164 thereon. The body portion 162 may be pivotally supported on an end effector drive screw 180 that is rotatably mounted within the elongated channel 110. The sled 170 may be supported to move axially relative to the end effector drive screw 180 and may be configured to interface with the body portion 162 of the tissue cutting member 160. As the tissue cutting member 160 is driven distally, the sled 170 is driven distally by the tissue cutting member 160. As sled 170 is driven distally, wedge 172 formed thereon serves to advance driver 138 upwardly within staple cartridge 130.

  The end effector 102 may further include an anvil assembly 190 that is supported for selective movement relative to the staple cartridge 130. In at least one form, anvil assembly 190 may include a first anvil portion 192 coupled to a rear anvil portion 194 and a top anvil portion 196. The rear anvil portion 194 is received in a corresponding trunnion hole or cavity 114 in the elongate channel 110 to facilitate movable or pivotal movement of the anvil assembly 190 relative to the elongate channel 110 and the staple cartridge 130 supported therein. May have a pair of laterally projecting trunnions 198.

  Tissue cutting member 160 may include a pair of laterally projecting actuator tabs 166 configured to be slidably received within slot 199 of anvil assembly 190. In addition, the tissue cutting member 160 may further include a leg 168 sized to engage the bottom portion of the elongate channel 110, thereby driving the tissue cutting member 160 distally. As the tab 166 and legs 168 move the anvil assembly 190 to the closed position. Tabs 166 and legs 168 may serve to space the anvil assembly 190 relative to the staple cartridge 130 at a desired interval as the tissue is cut and stapled. The first anvil portion 192 may have a staple forming lower surface 193 to shape the staple when the surgical staple 140 is driven into contact therewith. FIG. 4 shows the position of the anvil assembly 190 and the cutting member 160 when the anvil assembly 190 is in the open position. FIG. 5 shows the position of the anvil assembly 190 and cutting member 160 after the anvil assembly 190 is closed, but before the tissue cutting member 160 is advanced or “fired” distally. . FIG. 6 shows the position of the tissue cutting member 160 after it has been advanced within the staple cartridge 130 to its distal most position.

  End effector drive screw 180 may be rotatably supported within elongated channel 110. In one form, for example, the end effector drive screw 180 may have a proximal end 182 that is coupled to a drive shaft attachment member 184 that is configured to interface with the coupler assembly 200. The drive shaft attachment member 184 may be configured to attach to the proximal end 182 of the end effector drive screw 180. For example, the drive shaft mounting member 184 is a hexagon extending from the mounting member 184 adapted to be non-rotatably received in a corresponding hexagonal socket comprising a portion of the firing system generally designated 500. You may have the protrusion part 186 of. Rotation of the end effector drive screw 180 in the first direction results in the tissue cutting member 160 moving in the distal direction. In various configurations, the staple cartridge 130 may be mated with a pair of bumpers 174 that serve to cushion the sled 170 as it reaches its distal most position within the elongated channel 110. Each bumper 174 may have a spring 176 to provide a desired amount of buffering to the bumper.

End Effector Coupler Assembly Various forms of the instrument 100 may be operably coupled to the surgical instrument 10 using the coupler assembly 200. One form of coupler assembly 200 is shown in FIGS. The coupler assembly 200 may include a coupler housing segment 202 configured to operably support a drive gear assembly collectively designated as 220. In at least one form, the drive gear assembly 220 includes an input gear 222, a transmission gear 228, and an output gear 232. Please refer to FIG. The input gear 222 is mounted on or formed on the input shaft 224 that is rotatably supported by the first and second partition members 204, 206. The input shaft 224 has a proximal end 226 that is configured to mate with the distal firing shaft segment 510 with a portion of a unique novel firing system 500 described in more detail below. For example, the proximal end 226 may be configured with a hexagonal cross-sectional shape for non-rotatable insertion into a hexagonal socket 512 formed at the distal end of the distal firing axis segment 510. The transmission gear 228 may be mounted on or formed on the transmission shaft 230 that is rotatably supported by the baffle members 204, 206. The output gear 232 may be mounted on or formed on the output drive shaft 234 that is rotatably supported by the baffle members 204, 206. For assembly purposes, the distal end 236 of the output drive shaft 234 may be configured to be non-rotatably attached to an output socket 238 that projects distally through the distal end cap 210. In one configuration, the distal end cap 210 may be attached to the coupler housing 202 by a fastener 208 or any other suitable fastener configuration. The output socket 238 may be pinned to the distal end 236 of the output drive shaft 234. The output socket 238 may be configured to mesh with the drive shaft mounting member 184 in a non-rotatable manner. For example, the output socket 238 may be configured in a hexagonal shape so that the output socket 238 can mesh with the hexagonal protrusion 186 of the drive shaft mounting member 184. In addition, attachment protrusions may be formed or attached to the end cap 210 to facilitate operably attaching the device 100 to the coupler assembly 200.

  One configuration of the coupler assembly 200 may further include a locking assembly designated generally as 240. In at least one form, the locking assembly 240 includes a spring-biased locking member or pin 242 that is movably supported within a locking slot 214 formed in the coupler housing segment 202. The locking pin 242 may be configured to move axially within the locking slot 214 such that its locking end 244 protrudes through the hole 211 in the end cap 210. Please refer to FIG. The locking spring 246 is pivoted on the locking pin 242 to bias the locking pin 242 in the locking slot 214 in the distal direction “DD”. The actuator arm 248 may be formed on or attached to the locking pin 242 to allow the user to apply an unlocking motion in the proximal direction “PD” relative to the locking pin 242. Good.

  As can be seen in FIGS. 3, 9, and 10, the elongated channel 110 of the end effector 102 has a proximal end wall 116 with a coupling opening 118 formed therein for receiving the mounting projection 212. May be. In one configuration, for example, the mounting protrusion 212 may include a neck portion 213 having a mushroom-shaped mounting head 215 formed thereon. The coupling opening 118 may have a first circular portion 120 that is sized to allow the mounting head 215 to be inserted therein. The coupling opening 118 may further include a narrow slot 122 formed therein that is sized to allow the neck 213 to be received therein. The proximal end wall 116 may further include a locking hole 124 for receiving the distal end 244 of the locking pin 242 therein.

  One way of attaching the end effector 102 to the coupling assembly 200 of the surgical instrument 10 can be understood by referring to FIGS. For example, to attach the end effector 102 to the coupling assembly 200, the user may align the hexagonal protrusion 186 on the drive shaft attachment member 184 with the hexagonal output socket 238. Similarly, the mushroom head 215 may be aligned with the circular opening portion 120 of the coupling opening 118 as shown in FIGS. 9 and 12. The user may then insert the protrusion 186 into the socket 238 and the mounting head 215 axially into the coupling opening 118 as shown in FIG. The user then rotates the end effector 102 (represented by the arrow “R” in FIG. 14) to place the neck 213 into the slot 122 and the distal end 244 of the locking pin 242 into the locking hole 124. It may be snapped to allow further relative rotation between the end effector 102 and the coupling assembly 200 to be prevented. Such a configuration serves to operably couple the end effector 102 to the surgical instrument 10.

  To separate end effector 102 from coupling assembly 200, the user may apply an unlocking motion to actuator arm 246 to bias the locking pin in the proximal direction “PD”. Such movement of the locking pin 242 causes the distal end 244 of the locking pin 242 to exit the locking hole 124 in the end wall 116 of the elongated channel 110. The user then rotates the end effector 102 in the opposite direction relative to the coupling assembly to eject the neck portion 213 of the mounting button 212 from the slot 122 and the mounting head 215 from the coupling opening 118 in the end effector 102. It can be pulled axially, thereby separating the end effector 102 from the coupling assembly 200. As can be appreciated from the above, coupling assembly 200 is a unique novelty for operably coupling surgical tool 100 operable by applying rotational drive motion (s) to surgical instrument 10. Provide a simple configuration. In particular, the coupling assembly 200 allows a variety of different surgical tools 100 or end effectors 102 to be operably coupled to the elongate shaft assembly 30 of the surgical instrument 10.

Articulation System As can be seen in FIGS. 1 and 2, the elongate shaft assembly 30 may define an axial centerline AA. In at least one form, the elongate shaft assembly 30 includes an articulation system 300 that selectively articulates the end effector 102 about an articulation axis BB that is substantially transverse to the axial centerline AA. May be included. One form of articulation system 300 is shown in FIGS. As can be seen in the figures, the articulation system 300 may include a motorized joint joint 310. In at least one configuration, the articulation joint 310 is a distal fitting portion or distal portion that is rotatably supported on a hub portion 203 that extends proximally of the coupler housing segment 202 by a distal housing bearing 314. The distal clevis 312 is included. See FIG. The distal clevis 312 may be pivotally attached to the proximal joint portion or proximal clevis 330 by an articulation pin 332 that defines an articulation axis BB. See FIG. The distal clevis 312 may include a distally projecting mounting hub 316 sized to be received within the proximal end of the coupler housing segment 202. The mounting hub 316 may have an annular groove 318 configured therein to receive the mounting pin 320 therein. Please refer to FIG. A mounting pin 320 attaches the coupler housing segment 202 to the distal clevis 312 such that the coupler housing segment 202 may rotate relative to the distal clevis 312 about the axial centerline AA. Play a role. As can be seen in FIG. 20, the distal firing axis segment 510 extends through the hub portion 203 of the coupler housing segment 202 and is segmented by a distal firing bearing 322 mounted within the hub portion 203. On the other hand, it is supported rotatably.

  To facilitate applying a rotational drive or firing motion to the end effector 102 and to maintain the end effector 102 articulating relative to the elongated shaft assembly 30 about the articulation axis BB. However, to facilitate rotation of the end effector 102 relative to the elongate shaft 30 about the axial centerline AA, the articulation joint 310 is designated generally as 350 and the distal clevis 312 And a unique new “nested” gear assembly located in the gear section 351 between the proximal clevis 330 and the proximal clevis 330. Please refer to FIG. In at least one form, for example, the nested gear assembly 350 includes an inner drive shaft gear train or “nesting” that is “nested” with an outer end effector gear train or “second gear train” 380. A "first gear train" 360 may be included. As used herein, the term “nested” means that no portion of the first gear train 360 extends radially outward beyond any portion of the second gear train 380. May be. Such a unique novel gear configuration is compact and facilitates transmitting rotational control motion to the end effector and also allows the distal clevis portion to pivot relative to the proximal clevis portion. . As will be described in more detail below, the inner drive shaft gear train 360 facilitates applying rotational drive or firing motion from the proximal firing shaft segment 520 to the distal firing shaft segment 510 through the articulation joint 310. To. Similarly, the outer end effector gear train 380 facilitates applying rotational control motion from the end effector rotation system 550 to the coupler assembly 200, as described in more detail below.

  In at least one form, for example, the inner drive shaft gear train 360 may include a distal drive shaft bevel gear 362 that may be attached to the proximal end of the distal firing shaft segment 510 by a screw 364. . See FIG. The inner drive shaft gear train 360 may also include a proximal drive shaft bevel gear 366 that is attached to the proximal firing shaft segment 520 by screws 368. See FIG. In addition, the inner drive shaft gear train 360 may further include a drive shaft transmission gear 370 mounted on a transmission gear bearing 374 mounted on the transverse gear shaft 372. See FIG. Such an inner drive shaft gear train 360 may facilitate transmitting rotational drive motion from the proximal firing shaft segment 520 through the articulation joint 310 to the distal firing shaft segment 510.

  As described above, the nested gear assembly 350 also provides an outer end effector gear train 380 that facilitates applying rotational control motion from the end effector rotation system 550 to the coupler assembly 200 through the articulation joint 310. including. In at least one form, the outer end effector gear train 380 is non-rotatable (eg, keyed), for example, on a hub portion 203 that extends proximally of the coupler housing segment 202, and an output bevel gear. 382 may be included. The outer end effector gear train 380 may further include an input bevel gear 384 that is non-rotatably attached (eg, keyed thereon) to the proximal rotation axis segment 552 of the end effector rotation system 550. In addition, the outer end effector gear train 380 may further include a rotary shaft transmission gear 388 mounted on an outer transmission gear bearing 386 supported on a transversely extending articulation pin 332. See FIG. The articulation pin 332 extends through a hollow transverse gear shaft 372 and causes the distal clevis 312 to move relative to the proximal clevis 330 for articulation about the transverse articulation axis BB. It plays the role of pinning. The articulation shaft 332 may be held in place by a spring clip 334. The unique novel articulation joint 310 and the nested gear assembly 350 facilitate the transfer of various control movements from the handle assembly 20 through the elongated shaft assembly 30 to the end effector 102, while the end effector 102. Rotate about the long axis center line AA and allow articulation about the articulation axis BB.

  Articulation of the end effector 102 relative to the elongated shaft assembly 30 about the articulation axis BB may be accomplished by the articulation control system 400. In various forms, the articulation control system 400 may include an articulation control motor 402 that is operatively supported within the handle assembly 20. See FIG. The articulation control motor 402 is coupled to an articulation drive assembly 410 that is operatively supported on a detachable drive mount 700 that is removably supported within the handle assembly 20, as described in more detail below. Also good. In at least one form, the articulation drive assembly 410 may include a proximal articulation drive shaft segment 412 that is rotatably supported within the shaft housing assembly 710 of the separable drive mount 700. Please refer to FIG. 27 and FIG. For example, the proximal articulation drive shaft segment 412 may be rotatably supported within the distal shaft housing portion 712 by an articulation bearing 414. In addition, the proximal articulation drive shaft segment 412 may be rotatably supported within the proximal shaft housing portion 714 by a bearing 415. See FIG. The articulation control system 400 may further comprise a proximal articulation axis segment 420 that is driven to rotate about an axis centerline AA by an articulation control motor 402. As can also be seen in FIG. 15, the articulation drive assembly 410 may also include a pair of articulation drive pulleys 416, 417 that serve to drive the articulation drive belt 418. Accordingly, actuation of the articulation control motor 402 may result in rotation of the proximal articulation axis segment 420 about the axis centerline AA. See FIG.

  As can be seen in FIGS. 15 and 16, the proximal articulation axis segment 420 has a threaded portion 422 adapted to threadably engage the articulation drive link 424. By rotating the distal articulation drive shaft segment 420 in a first direction, the articulation drive link 424 may be driven axially in the distal direction “DD”, the distal articulation drive shaft segment By rotating 420 in the opposite second direction, the articulation drive link 424 may move axially in the proximal direction “PD”. Articulation drive link 424 may be pinned to articulation bar 426 by pin 428. Articulation bar 426 may then be pinned to distal clevis 312 by pin 429. See FIG. Thus, when the clinician wishes to articulate the end effector 102 or device 100 relative to the elongated shaft assembly 30 about the articulation axis BB, the clinician activates the articulation control motor 402. , The articulation control motor 402 rotates the proximal articulation axis segment 420, thereby actuating the articulation bar 426 in the desired direction, causing the distal clevis 312 (and the end effector 102 attached thereto) to move. Pivot in the desired direction. Please refer to FIG. 21 and FIG.

Firing System As described above, the end effector 102 may be operated by a rotational control motion applied to the end effector drive screw 180 by the firing system 500 including the distal firing axis segment 510 and the proximal firing axis segment 520. Good. See FIG. Proximal firing axis segment 520 includes a portion of elongate shaft assembly 30 and may be rotatably supported within hollow proximal rotation axis segment 552 by distal bearing sleeve 522. See FIG. Referring again to FIG. 23, in at least one form, firing system 500 includes a firing motor 530 that is operatively supported within handle assembly 20. The proximal end of the proximal firing axis segment 520 may be rotatably supported within the separable drive mount 700 and is configured to be coupled to the firing motor 530 in a manner that will be described in more detail below. May be. As can be seen in FIG. 30, the proximal end of the proximal firing axis segment 520 may be rotatably supported within a thrust bearing 524 mounted to the distal partition plate 722 of the drive mount partition assembly 720. Actuation of firing motor 530 ultimately results in rotation of end effector drive screw 180 and rotational control motion is applied to end effector 102.

End Effector Rotation System In various configurations, the surgical instrument 10 can also be an end effector rotation system or for selectively rotating the end effector 102 relative to the elongated shaft assembly 30 about the axis centerline AA. A “distal roll system” 550 may be included. End effector rotation system 550 may include a proximal rotation axis segment 552 that also includes a portion of elongate axis assembly 30. As can be seen in FIG. 20, the proximal rotational axis segment 552 may be rotatably supported within the proximal clevis 330 by a distal bearing 554 and a proximal bearing 556. In addition, the proximal rotation axis segment 552 may be rotatably supported within the proximal articulation axis segment 420 by the distal bearing sleeve 558 and the proximal bearing 559. See FIGS. 20 and 30. The proximal end of the proximal rotational axis segment 552 may also be rotatably supported within the drive mount septum assembly 720 by a proximal bearing 555, as can be seen in FIG.

  In at least one form, end effector rotation system 550 may include an end effector rotation or “distal roll” motor 560 that is operatively supported within handle assembly 20. See FIG. The end effector rotation motor 560 may be coupled to a rotary drive assembly 570 that is operably supported on a separable drive mount 700. In at least one form, the rotational drive assembly 570 includes a proximal rotational drive shaft segment 572 that is rotatably supported within the shaft housing assembly 710 of the separable drive mount 700. See FIG. For example, the proximal rotational drive shaft segment 572 may be rotatably supported within the distal shaft housing portion 712 by a bearing 576. In addition, the proximal rotational drive shaft segment 572 is rotatably supported within the proximal housing portion 714 by a bearing 577. See FIG. As can be seen in FIGS. 24 and 28, the rotary drive assembly 570 may also include a pair of rotary drive pulleys 574, 575 that serve to drive the rotary drive belt 578. Accordingly, operation of the end effector rotation motor 560 results in rotation of the proximal rotation axis segment 552 about the axis centerline AA. The rotation of the proximal rotational axis segment 552 results in the rotation of the end effector 102 of the coupler assembly 200 and ultimately coupled thereto.

Axial Rotation System Various forms of surgical instrument 10 may also include an axial rotation system designated generally as 600. The axial rotation system may also be referred to herein as a “proximal roll system”. In at least one form, the shaft rotation system 600 includes a proximal outer shaft segment 602 that also comprises a portion of the elongate shaft assembly 30. Proximal outer shaft segment 602 has a distal end 604 that is non-rotatably coupled to proximal clevis 330. As can be seen in FIGS. 19 and 26, the distal end 604 has a clearance notch 606 therein that allows actuation of the articulation bar 426 thereto. The shaft rotation system 600 may include a shaft rotation or “proximal roll” motor 610 that is operatively supported within the handle assembly 20. The shaft rotation motor 610 may be coupled to a shaft drive assembly 620 that is operatively supported on a separable drive mount 700. In at least one form, the shaft drive assembly 620 includes a proximal drive shaft segment 622 that is rotatably supported within a distal shaft housing portion 712 of the drive mount 700 that is separable by a bearing 624. See FIG. In addition, the proximal drive shaft segment 622 is rotatably supported within the proximal drive shaft housing portion 714 by a bearing 626. As can be seen in FIGS. 26 and 28, the shaft drive assembly 620 may also include a pair of rotational drive pulleys 630, 632 that serve to drive the shaft drive belt 634. The drive pulley 632 has a proximal drive shaft such that rotation of the drive pulley 632 results in rotation of the proximal drive shaft segment 602 and the end effector 102 attached thereto about the axis centerline AA. It is non-rotatably attached to the segment 602. As further seen in FIGS. 28 and 30, the proximal drive shaft segment 602 is rotatably supported within the distal shaft housing portion 712 by a pair of sleeve bearings 607 and 608.

  The unique novel articulation system configuration of the present invention provides multiple degrees of freedom to the end effector and makes it easy to apply rotational control motion thereto. For example, in connection with some surgical procedures, it may be necessary to position the end effector to a position that is flush with the target tissue. Various configurations of the present invention provide at least three degrees of freedom for the end effector while meeting the size limitations often encountered when performing surgical procedures, for example, laparoscopically.

  Various forms of the surgical instrument of the present invention facilitate improving the user's dexterity, accuracy, and efficiency in positioning the end effector relative to the target tissue. For example, conventional shaft joints commonly used in power transmission frequently use universal joints (one or more), which are hinged vertebral and flexurally compliant couplings. Use. All of these methods may tend to be subject to performance limitations, including limitations on bend radii and excessive length characteristics. Various forms of the unique novel elongate shaft assembly and drive system disclosed herein minimize the distance between the articulation axis and the end effector, for example when compared to other conventional articulation configurations. To the limit. The elongated shaft assembly and articulation arrangement disclosed herein facilitates transmitting at least one rotational control motion to the end effector while also providing multiple degrees of freedom for the end effector. Can be precisely positioned relative to the target tissue.

  After use of the end effector 102 or tool 100, it may be separated from the coupler assembly 200 of the surgical instrument 10 and discarded, or may be separately reprocessed and sterilized using an appropriate sterilization method. Surgical instrument 10 may be used multiple times in conjunction with a new end effector / tool. Depending on the particular application, it may be desirable to re-sterilize surgical instrument 10. For example, the instrument 10 may be re-sterilized before being used to complete another surgical procedure.

  Surgical instruments must be sterile before use. One common method of sterilizing medical devices involves exposing the device to wet steam at a desired temperature for a desired period of time. While such sterilization procedures are effective, they are generally unsuitable for sterilizing surgical instruments using electrical components due to the high temperatures generated when using steam sterilization methods. Such devices are generally sterilized by exposure to a gas such as ethylene oxide.

  Various forms of surgical instrument 10 may be sterilized using conventional sterilization methods. In at least one form, for example, the elongate shaft assembly 30 may be fabricated from components and materials that may be effectively sterilized utilizing methods that use relatively high sterilization temperatures. However, it may be desirable to use a sterilization method that has a lower operating temperature when sterilizing the handle assembly, for example, to avoid the possibility of damaging electrical components. Accordingly, it may be desirable to sterilize the handle assembly 20 that houses various electrical components separately from the elongate shaft assembly 30. To facilitate the use of such a separate sterilization procedure, the elongate shaft assembly 30 is separable from the handle assembly 20 in at least one form.

Separable Drive Mount Assembly More specifically, and referring to FIG. 28, the detachable drive mount assembly 700 is operably supported within a portion of the handle assembly 20. In one form, for example, the separable drive mount assembly 700 is mounted within distal handle housing segments 21 and 22 that may be interconnected using snap structures, screws, or other fastener configurations. May be. The distal handle housing segments 21 and 22 when coupled together may be referred to herein as “distal handle housing portions” or “housings” 25. The separable drive mount assembly 700 may include, for example, a shaft housing assembly 710 comprising a distal shaft housing 712 and a proximal shaft housing 714. The separable drive mount assembly 700 may further comprise a drive mount septum assembly 720 that includes a distal septum plate 722 and a proximal coupler septum plate 724. As described above, in at least one form, the separable drive mount assembly 700 operates the articulation drive assembly 410, the proximal end of the proximal firing shaft segment 520, the rotational drive assembly 570, and the shaft drive assembly 620. It may be supported as possible. Rapidly couple firing axis segment 520, articulation drive assembly 410, rotational drive assembly 570, and axial drive assembly 620 to firing motor 530, articulation control motor 402, end effector rotational motor 560, and axial rotational motor 610, respectively. In order to facilitate this, a unique novel coupler configuration may be used.

Motor Mounting Assembly In at least one form, for example, the detachable drive mount assembly 700 may be configured to be removably coupled to a motor mounting assembly designated generally as 750. The motor mounting assembly 750 may be supported within the handle housing segments 23 and 24 that can be coupled together by snap structures, screws, etc. and serve to form the pistol grip portion 26 of the handle assembly 20. Please refer to FIG. Handle housing segments 23 and 24, when joined together, may be referred to herein as “proximal handle housing portions” or “housings” 28. With reference to FIGS. 29-32, the motor mounting assembly 750 may include a motor mount 752 that is removably supported within the handle housing segments 23 and 24. In at least one form, for example, the motor mount 752 may have a bottom plate 754 and a motor partition assembly 756 extending vertically. A fastener tab 758 may be formed on the bottom plate 754 that is configured to engage and receive the bottom plate portion 730 of the separable drive mount 700 to retain it. In addition, the right locator pin 772 and the left locator pin 774 are attached to the motor bulkhead assembly 756 and pass therethrough into corresponding right and left socket tubes 716, 718 formed in the proximal shaft housing portion 714. Projects distally. See FIG. 32.

  In at least one configuration, the detachable drive mount assembly 700 may be removably coupled to the motor mounting assembly 750 by a releasable latch configuration 760. As can be seen in FIG. 31, for example, a releasable latch arrangement 760 may be located on each side of the motor mounting assembly 750. Each releasable latch configuration 760 may include a latch arm 762 that is pivotally attached to the motor septum assembly 756 by a corresponding pin 764. Each latch arm 762 may protrude outwardly through a corresponding fastener projection 766 formed on the distal surface of the motor septum assembly 756. Fastener protrusion 766 may be configured to be slidably received within a corresponding receiver member 726 that protrudes proximally from proximal coupler partition plate 724. See FIGS. 30 and 32. When the drive mount assembly 700 is brought into mating engagement with the motor mounting assembly 750, the fastener projection 766 slides into the corresponding receiver member 726 so that the latch arm 762 can be moved to the corresponding receiver member 726. The latch portion 728 is retained and engaged. Each latch arm 762 has a corresponding latch spring 768 associated therewith to bias the latch arm 762 into a retaining engagement with the corresponding latch portion 728 to mount the separable drive mount assembly 700 to a motor. Bind to assembly 750 and hold. In addition, in at least one form, each latch arrangement 760 further includes a release button 770 that is movably coupled to the motor septum 756 and oriented to selectively contact it. Each release button 770 may include a release spring 771 that biases button 770 out of contact with its corresponding latch arm 762. When the clinician wishes to detach the separable drive mount assembly 700 from the motor mounting assembly 750, the clinician simply pushes the respective button 770 inward to bias the latch arm 762 and the latch portion on the receiver member 726. The retaining engagement with 728 is disengaged, and then the separable drive mount assembly 700 is pulled to disengage the mating engagement with the motor mounting assembly 750. Other releasable latch configurations may be used to releasably couple the detachable drive mount assembly 700 that may be removably coupled to the motor mounting assembly 750.

  At least one form of surgical instrument 10 also uses a coupler assembly for coupling a control motor to each drive assembly that is operably supported and mounted on separable drive mount 700. Also good. More specifically, and referring to FIGS. 28-32, the coupler assembly 780 is used to removably couple the articulation drive assembly 410 to the articulation control motor 402. The coupler assembly 780 may include a proximal coupler portion 782 that is operably coupled to the drive shaft 404 of the articulation control motor 402. In addition, the coupler assembly 780 may further include a distal coupler portion 784 attached to the proximal articulation drive shaft 412. See FIGS. 28 and 32. Each distal coupler portion 784 is a plurality of (three shown) couplers that are designed to be non-rotatably received in corresponding shell-like sections 788 formed in the proximal coupler portion 782. A protrusion 786 may be provided. See FIG. Similarly, another distal coupler portion 784 may be attached to the proximal rotational drive shaft 572 of the rotational drive assembly 570 and the corresponding proximal coupler portion 782 is attached to the rotational motor drive shaft 562. It is done. In addition, another distal coupler portion 784 may be attached to the proximal firing axis segment 520 and the corresponding proximal coupler portion 782 is attached to the firing motor drive shaft 532. Yet another distal coupler portion 784 may be attached to the proximal drive shaft segment 622 of the shaft drive assembly 620, and the corresponding proximal coupler portion 782 is attached to the drive shaft 612 of the shaft rotation motor 610. It is attached. Such a coupler assembly 780 facilitates coupling the control motor to their respective drive assemblies regardless of the position of the drive shaft and motor shaft.

  Various forms of the unique novel handle assembly configuration described above provide for the motor assembly 402, 530, 560, and 610, and the handle assembly 20 containing various electrical components with a control system designated generally as 800. The elongated shaft assembly 30 can be easily separated from the rest. As such, the elongate shaft assembly 30 and the separable drive mount portion 700 may be sterilized separately from the remainder of the handle assembly containing the motor and control system, which may be damaged using high temperature sterilization methods. Good. Such a unique novel separable drive mount configuration may also be used in connection with configurations where the drive system (motor and control components) comprises a portion of a robotic system that may or may not be handheld. .

Gear Driven Drive Mount Configuration FIGS. 100-103 show an alternative drive mount 5700 that uses a group of gear drives that transmit drive motion from the motor to their respective axes. As can be seen in FIG. 100, the drive mount 5700 may include a distal shaft housing assembly 5710 that includes a distal shaft housing 5712 that operatively supports a plurality of gear train configurations. The distal shaft housing 5712 has a pair of mounting sockets 5725 that protrude from the distal shaft housing 5712 and receive corresponding mounting projections 5713, as seen in FIG. Configured to be removably mounted. Similar to the configuration described above, the axis of the firing or transection motor 530 is directly coupled to the proximal firing axis segment 5520 by the coupler assembly 5780, as can be seen in FIG. The proximal rotation axis segment 5552 of the end effector rotation system 550 is rotated by a gear train, indicated generally as 5565. In at least one form, for example, the gear train 5565 includes a driven gear 5566 that is attached to the proximal rotary shaft segment 5552 and supported in meshing engagement with the drive gear 5567. As best seen in FIG. 103, the drive gear 5567 is mounted on a spur gear shaft 5568 that is rotatably supported within the distal shaft housing 5712. Spur gear shaft 5568 is coupled to the shaft of end effector rotation or distal roll motor 560 by coupler assembly 5780.

  Proximal articulation axis segment 5420 is rotated by a gear train generally indicated as 5430. In at least one form, for example, the gear train 5430 includes a driven gear 5432 that is attached to the proximal articulation shaft segment 5420 and supported in meshing engagement with the drive gear 5434. As best seen in FIG. 102, the drive gear 5434 is mounted on a spur gear shaft 5436 that is rotatably supported within the distal shaft housing 5712. Spur gear shaft 5436 is coupled to the shaft of articulation control motor 402 by coupler assembly 5780.

  Proximal outer shaft segment 5602 is rotated by a gear train generally indicated at 5640. In at least one form, for example, the gear train 5640 is attached to the proximal outer shaft segment 5602 and in meshing engagement with a composite bevel gear 5644 that is rotatably supported within the distal shaft housing 5712. A supported gear 5642 is included. The compound bevel gear 5644 is in meshing engagement with a drive bevel gear assembly 5646 that is mounted on a spur gear shaft 5648 that is also rotatably supported in the distal shaft housing 5712. Spur gear shaft 5648 is coupled to the shaft of shaft rotation or proximal roll motor 610 by coupler assembly 5780. See FIG. Alternative drive mount 5700 motors and gear trains may be used to power and control the surgical instrument in the manner described herein.

Power and Control System In various forms, the surgical instrument 10 may use a control system designated generally as 800 to control the various motors used by the instrument. Motors 402, 530, 560, and 610, and their associated control components, may also be referred to herein as “drive systems”, designated generally as 398. In one form, the drive system 398 serves to “electrically generate” multiple control movements. The term “electrically generated” refers to using an electrical signal to operate a motor or other electrically powered device, a control that is generated manually or otherwise mechanically without using current. It may be distinguished from exercise. In one form, the drive system 398 may be operably supported within the handle assembly, which may be held with one or both hands of the clinician. In other forms, however, the drive system 398 may include and / or be operated by and / or supported by a portion of the robotic system.

  In one form, the motors 402, 530, 560, and 610 and their associated control components may receive power from a battery 802 housed within the pistol grip portion 26 of the handle assembly 20. In other configurations, the battery may be supported, for example, by a robot system. In other embodiments, however, the handle assembly 20 may have a power cord (not shown) projecting therefrom for supplying power from another source power. In yet other configurations, the motor and electrical components may receive power and control signals from the robot system. The control system 800 may comprise various control system components that may include, for example, a distal circuit board 810 supported on a separable drive mount 700. The distal circuit board 810 may include electrical connectors 812 and / or electrical components that can be sterilized utilizing conventional steam sterilization techniques as well as by other pasteurization methods. The control system 800 may further include a proximal circuit board 820 that is supported by the portion of the handle assembly 20 formed by the handle housing segments 23 and 24. Proximal circuit board 820 is configured to be electrically coupled to distal circuit board 810 when separable drive mount 700 is coupled to motor mounting assembly 750.

  Various forms of surgical instrument 10 may employ a unique novel control switch configuration 830 that may be operably housed or supported by pistol grip portion 26 of handle assembly 20. For example, in at least one form, the control switch configuration 830 enables a unique novelty that allows a user to maximize the functional control of various aspects of the surgical instrument 10 through a single interface. A joystick controller 840 may be included. More specifically, and with reference to FIGS. 33-39, one form of joystick controller 840 is operably attached to a joystick switch assembly 850 that is movably housed within a switch housing assembly 844. A rod 842 may be included. The switch housing assembly 844 may be mounted within the pistol grip portion 26 of the handle assembly 20. In at least one form, for example, the switch housing assembly 844 may include a housing body 846 and a rear housing plate 848. As best seen in FIGS. 35-39, the joystick printed circuit board 852 may be operatively supported on the joystick switch assembly 850 by a rear mounting plate 854. The rear mounting plate 854 may be configured to move within the switch housing 844 as a unit with the joystick switch assembly 850 and the joystick printed circuit board 852. The joystick spring 856 may be supported between the rear housing plate 848 and the rear mounting plate 854 to bias the joystick switch assembly 850 and the joystick control rod 842 in the forward or distal direction. See FIGS. 36 and 38.

  A joystick controller 840 provides control power to the various motors 402, 530, 560, and 610 of the surgical instrument 10 through the various connector cables 864 and the proximal circuit board 820 and battery of the control system 800. 802 may be electrically coupled. For example, by swinging or otherwise activating the joystick control rod 842, the user controls the articulation control motor 402 and / or the distal roll motor 560 and / or the proximal roll motor 610. May be.

  Joystick control switch assembly 850 may be referred to herein as a “first switch” that controls one or more of the motors of the drive system. The joystick controller 840 may further include a first sensor 860 that may be mounted on the joystick printed circuit board 852 to move together, eg, may include a magnet. In addition, a second or fixed sensor 862 may be mounted within the rear housing plate 848. The second sensor 862 may include, for example, a “Hall Effect” sensor or similar sensing device. In at least one configuration, for example, sensor 862 may be configured to communicate with firing motor 530. The first and second sensors 860, 862 may be referred to herein as “second switches”, designated generally as 858. With the configuration described above, when the user depresses the joystick control rod 842, the joystick switch assembly 850 can enter and exit in the axial direction. By taking advantage of the movement in and out of the entire joystick switch assembly 850, in at least one form, the design consists essentially of the switches in the switch. In the inoperative position, the joystick spring 856 biases the joystick switch assembly 850 in the forward (distal) direction. When the clinician pushes the joystick 842 inward (proximal), the first sensor 860 moves and approaches the second sensor 862. Moving the first sensor 860 closer to the second sensor 862 may actuate a so-called second switch 858, which may result in activation of a transverse incision or firing motor 530.

  When performing a procedure using the end effector 102, the clinician may wish to open and close the anvil assembly 190 to manipulate the target tissue to the desired position without transecting or cutting the tissue. In one form, when the clinician first depresses the joystick control rod 842, the second switch 858 activates the firing motor 530, thereby causing the tissue cutting member 160 to begin moving distally. In various configurations, the tissue cutting member 160 may be closed by the tissue cutting member 160 first moving distally (i.e., without cutting tissue or firing surgical staples). Pivoted toward the staple cartridge 130). When the clinician releases the joystick control rod 842, the joystick spring 856 biases the joystick assembly 850 distally, thereby causing the first sensor 860 to move away from the second sensor 862. Movement of sensor 860 away from second sensor 862 may reduce the rotational speed of firing motor 530 until firing motor 530 eventually stops or stops operating. In at least one form, this second switch configuration 858 may be configured such that the rotational speed of the firing motor 530 is directly proportional to the speed at which the user depresses the joystick control rod 842.

  Once the clinician positions and captures the desired tissue within the end effector 102, the end effector 102 may be actuated or “fired” by fully depressing the joystick control rod 842. In various forms, the joystick switch assembly 850 may also include a third compression switch 866 that is integrally formed therein and also communicates with the control system 800. Full depression of the joystick control rod 842 may result in activation of the third switch 866. In at least one form, when the third switch 866 is activated, the firing motor 530 remains activated even if the clinician releases the joystick control rod 842. After the firing stroke is complete (ie, tissue cutting member 160 has been driven to its most distal position within end effector 102), the user fully depresses joystick control rod 842 again to release third switch 866. Thereby, control of firing motor 530 may be returned to second switch 858. Thus, if the clinician releases the joystick control rod 842 fully after releasing it a second time, the joystick spring 856 will bias the joystick switch assembly 850 to the starting position. Control system 800 causes firing motor 530 to rotate in the opposite direction until tissue cutting member 160 returns to its starting position, thereby moving anvil assembly 190 once more to the open position, thereby causing end effector 102 to transect. The released tissue can be released.

  In various configurations, the switch configuration 830 may also use its own new thumbwheel control assembly 870. As can be seen in FIG. 42, the thumbwheel control assembly 870 includes a hub portion that projects distally of the switch housing assembly 844 such that the thumbwheel control assembly 870 is pivotable about the switch axis SA-SA. 845 may be rotatably mounted on 845. Such a position conveniently provides the thumbwheel actuator member 872 of the thumbwheel control assembly 870 to a position where the clinician can pivot with the thumb and / or index finger while grasping the pistol grip portion 26 of the handle assembly 20. Is located. The thumbwheel actuator member 872 may be attached to a thumbwheel collar 874 received on the hub portion 845 and may be rotatably held in place by a mounting flange 27 formed by the handle segments 23 and 24. The left sensor (magnet) 876 and the right sensor (magnet) 878 are attached to the thumb wheel collar 874 as shown in FIG. Sensors 876 and 878 may have opposite polarities. Fixed sensor 880 may be mounted to switch housing assembly 844 such that it is centrally disposed between left sensor 876 and right sensor 878. Fixed sensor 880 may include, for example, a “Hall Effect” sensor, and may be coupled to proximal circuit board 820 of control system 800 to control one of the control motors. For example, the thumbwheel control assembly 870 may be used to control the proximal roll or shaft rotation motor 610, for example. In other configurations, the thumbwheel control assembly 870 may be used to control the distal roll motor 560 to rotate the end effector about the axis centerline relative to the elongated shaft assembly. A pair of decentering springs 882 may be used to bias the thumb wheel collar 874 to a central or neutral position. When the thumbwheel collar 874 is in the neutral position as shown in FIG. 41, the shaft rotation or proximal roll motor 610 (or possibly the distal roll motor 560) is deactivated.

  When the user pivots the thumbwheel actuator 872 clockwise to the position shown in FIG. 43, the control system 800 causes the shaft rotation motor 610 to clock the elongated shaft assembly 30 about the shaft centerline AA. It may be rotated in the direction. Similarly, when the user pivots the thumbwheel actuator 872 counterclockwise to the position shown in FIG. 44, the control system 800 causes the shaft rotation motor 610 to move the elongated shaft about the axis centerline AA. The assembly 30 may be rotated counterclockwise. In other words, when the user pivots the thumbwheel actuator 872 clockwise or counterclockwise, the fixed sensor 880 is based on the proximity of the left and right sensors 876, 878 in relation to the fixed sensor 880. Control the direction of rotation of the elongate shaft assembly 30. The response of the fixed sensor 880 can be configured such that the relative speed at which the motor 610 rotates the elongate shaft assembly 30 increases as the user increases the rotation of the thumbwheel actuator 872. As can be seen in FIGS. 41-44, the stop protrusion 847 cooperates with the notch 875 of the thumbwheel collar to prevent contact between the movable sensors 876, 878 and the fixed sensor 880. It may be formed on the housing assembly 844. One skilled in the art will appreciate that the thumbwheel control assembly 870 may be used to control any of the other motors of the surgical instrument 10. Similarly, joystick controller 840 may be configured to control any one or more of the surgical instrument 10 motors. The unique novel thumbwheel control assembly configuration disclosed herein allows a user to perform functional control through rotation of an ergonomic thumbwheel actuator interface. In an alternative form, the movable sensors 876, 878 may include Hall effect sensors that are each in communication with the motor. Fixed sensor 880 may include a magnet.

  In various forms, each of the motors of surgical instrument 10 may include a corresponding encoder that communicates with a microprocessor chip on proximal circuit board 820. For example, the articulation control motor 402 may be operably coupled with an encoder 404 that communicates with the proximal circuit board 820. An encoder 534 that is in communication with the proximal circuit board 820 may be operably coupled to the firing or transection motor 530. An encoder 564 in communication with the proximal circuit board 820 may be operably coupled to the end effector rotation or distal roll motor 560. An encoder 614 that communicates with the proximal circuit board 820 may be operably coupled to the axial rotation or proximal roll motor 610. The encoder may serve to provide feedback on the number and direction of rotation for each of the motors to the corresponding microprocessor chip. In some forms, in addition to the encoder, the rotary drive assembly 570 may employ a sensor configuration that tracks the rotation of various axis segments. For example, as can be seen in FIGS. 15, 28, and 29, the articulation drive pulley 417 may include a second articulation sensor 421 that may include, for example, a Hall effect sensor mounted on the distal circuit board 810. A first articulation sensor 419 adapted to be detected by may be mounted. The first and second articulation sensors 419, 421 serve to provide additional means of feedback for tracking the rotatable position of the proximal articulation axis 420. Similarly, the distal rotary pulley 575 of the rotary drive assembly 570 has a first far end adapted to be detected by a second distal roll sensor 582 mounted on the distal circuit board 810. A position side roll sensor 580 may be attached. Please refer to FIG. 24, FIG. 28 and FIG. The first and second distal roll sensors 580, 582 serve to provide an additional means of feedback for tracking the rotatable position of the proximal rotational axis segment 552. In addition, the pulley 632 of the proximal roll drive assembly 620 has a first proximal side adapted to be detected by a second proximal roll sensor 636 mounted on the distal circuit board 810. A roll sensor 634 may be included. See FIGS. 26, 28, and 29. The first and second proximal roll sensors 634, 636 serve to provide an additional means of feedback for tracking the rotatable position of the proximal outer shaft segment 602.

Conductive Path from End Effector to Handle Assembly As discussed herein, various configurations of surgical instrument 10 can be used in various ways that require or use rotational motion or other motion for operation / operation of the end effector / tool. May be used effectively with different end effectors or surgical tools. For example, one form of end effector 102 requires rotational control movement to open and close anvil assembly 190, drive surgical staples, and transversely incise tissue. One form of the end effector 102 may also include a distal sensor configuration that senses the degree or amount of closure that the anvil assembly 190 reaches relative to the surgical staple cartridge 130. For example, the anvil assembly 190 may include a first anvil sensor 890 attached to its distal end. Please refer to FIG. Anvil sensor 890 may include, for example, a Hall effect sensor configured to detect a second staple cartridge sensor (magnet) 892 mounted within the distal end of surgical staple cartridge 130. In at least one form, the first anvil sensor 890 may communicate with at least one end effector conductor 894 attached to the anvil assembly 190 as shown. In one form, for example, the end effector conductor 894 comprises a flat metal strip with a flexible hook 896 formed at the proximal end. As normally used herein, the term “conductor” or “conductive” refers to a member or component capable of conducting electricity. The conductors may include, for example, one or more wires, flexible conductive strips or metal traces, multi-channel conductive ribbon cables, and the like. As used herein, the terms “electrically contacting” and “electrically communicating with” are configured such that components pass current or signals between each other. Means.

  45 and 46, it can be seen that the flexible hook 896 may be oriented to contact the distal end 244 of the locking pin 242. The locking pin 242 may be constructed, for example, from a conductive material and may be coated with an insulating coating (eg, a polymer, etc.) to electrically insulate the locking pin 242 from the coupler housing segment 202. Preferably, it has an exposed tip configured to make electrical contact with hook 896. In addition, the locking spring 246 may also be made from a conductive material (eg, metal). The locking spring 246 may be attached to the locking pin 242 such that the locking pin 242 and the locking spring 246 form a conductive coupler path for conducting current through the coupler assembly 200. Good (for example, soldered). The locking spring 246 may also be coated with an insulating coating to electrically insulate from the coupler housing segment 202. Lock pin 242 and lock spring 246 may be collectively referred to herein as “lock pin assembly” 249. The locking spring 246 may terminate at a proximal end 247 configured to be in electrical sliding contact with the proximal conductor assembly 250 that is attached to the distal clevis 312 of the articulation joint 310.

  As can be seen in FIG. 8, one form of proximal conductor assembly 250 may include a conductor wire / wires / trace 252 and an annular conductor, for example in the form of a conductive washer 254. As can be seen in FIG. 46, the conductor 252 protrudes out through the distal clevis 312 to communicate with the articulation conductor 258 supported by the flexible joint cover 900 extending over the articulation joint 310. Communicating with the proximal conductor portion 256. In at least one form, the joint cover 900 includes a hollow body 902 having an open proximal end 904 and an open distal end 906 and a joint receiving passage 908 extending therebetween. The hollow body 902 may include a plurality of ribs 910 and may be made from a polymer or similar non-conductive material that is omnidirectionally extensible to accommodate movement of the articulation joint component. However, the joint cover 900 can also be fabricated from other suitable materials and configurations, such as flexible microcut tubing. The joint joint conductor 258 may include, for example, a conductive ribbon cable, wire, multiple wires, traces, and the like. As further seen in FIG. 46, the proximal end of the articulation joint conductor 258 is electrically coupled to the shaft conductor 260 on the proximal outer shaft segment 602.

  47 and 48, in at least one form, the proximal end of the axial conductor 260 may be oriented in sliding contact with an annular conductor ring 262 mounted within the handle assembly 20. With such a configuration, when the elongated shaft assembly 30 is rotated with respect to the handle assembly 20 about the shaft center line AA, a current can flow between the shaft conductor 260 and the conductor ring 262. Good. As further seen in FIGS. 47 and 48, the conductor 264 is coupled to the conductor ring 262 and extends proximally through the handle housing 20. The conductor 264 may include a wire or other suitable conductor and may have a proximal end 266 configured to flexibly contact the tip of the left locator pin 774. In particular, for example, the proximal end 266 may extend through the wall of the left locator socket 718 so that when the left locator pin 774 is inserted therein, the proximal end portion 266 of the conductor 264 is Contact left locator pin 744. In at least one form, left locator pin 774 is fabricated from a conductive material (metal) so that current can flow between the components when proximal end 266 of conductor 264 contacts. . In addition, the mounting conductor 776 serves to electrically couple the left locator pin 774 to the proximal circuit board assembly 820 to facilitate the transfer of current therebetween.

  With the configuration described above, current is passed between the end effector or surgical tool attached to the elongate shaft assembly 30 of the surgical instrument 10 and the control system components within the handle assembly 20 of the surgical instrument 10. Becomes easier. This conductive path maintains the ability to rotate the end effector relative to the elongate shaft assembly, articulate the end effector relative to the elongate shaft assembly, and rotate the end effector and elongate shaft assembly as a unit. Is done. The joint cover 900 may provide an electrical communication path between the elongated shaft and the end effector. The coupling cover 900 may include electrical flex strips, wires, traces, etc. that guide more than one signal for telecommunications. Accordingly, multiple different sensors or electrical components may be used in the end effector to provide various forms of feedback to the user. For example, the sensor determines the number of user cycles, tracks the progress of the cutting instrument in the firing end effector, provides feedback to the control system, automatically controls various motors in the handle assembly, etc. May be used for

  FIG. 49 shows an alternative articulation joint 310 ′ configured to allow current or signals to pass. In this configuration, the distal electrical coupling conductor 270 is provided through the distal clevis 312 'and contacts a distal metal washer 272 embedded therein as shown. Proximal clevis 330 ′ has a proximal clevis 312 ′ in rotational contact with distal metal washer 272 when distal clevis 312 ′ is coupled to proximal clevis 330 ″ in the manner described above. A metal washer 274 may be attached. Proximal metal washer 274 may be curved or angled to maintain sliding contact between washers 272, 274. For example, a proximal electrical coupling conductor 276 in the form of a conductor strip, wire, or trace is attached to the washer 274 and is configured to make electrical contact with the axial conductor 260 on the proximal outer shaft segment 602. . Accordingly, such a configuration results in locking pin 242, locking spring 242 (ie, locking pin assembly 249), conductor ring 252, distal electrical coupling conductor 270, washers 272, 274, and proximal electrical coupling conductor 276. It is easier to pass the current / signal from the end effector 102 to the shaft conductor 260 through.

Alternative Joint Joint Configurations Another form of joint joint 1000 is shown in FIGS. Such an articulation joint 1000 can facilitate the articulation and rotation of the coupled end effector or surgical tool relative to the axial centerline AA of the elongated shaft to which the articulation joint 1000 is attached. The articulation joint may also facilitate rotational movement for end effector / tool actuation or manipulation while facilitating such movement of the end effector or surgical tool. The articulation joint 1000 may be coupled to an elongate shaft assembly that is similar in structure to the elongate shaft assembly 30 described above, or may be coupled to other suitable shaft assemblies. The elongate shaft assembly may be coupled to a handle assembly that houses a plurality of motors. One motor may be used to apply control motion to the flexible cable member 1010 that extends through the elongate shaft assembly and is operably coupled to the articulation joint 1000. For example, the flexible cable 1010 may be attached to a sheave or pulley assembly that is operably attached to or in communication with a corresponding motor shaft such that the operation of the motor activates the cable 1010. The handle assembly may also include a firing motor that is operatively attached to the proximal firing shaft 1030 that extends through the elongated shaft assembly and interfaces with the articulation joint 1000, as described in more detail below. The handle assembly may also transmit an end effector or articulation joint 1000 that may be used to rotate the end effector or surgical tool about an elongate axis about an axis centerline AA. A motor may be included that operatively interfaces with the distal roll shaft 1040. The handle assembly may also include a proximal roll motor that is used to rotate the elongate shaft assembly about the shaft centerline AA in the manner described above.

  In at least one form, the articulation joint 1000 may include a proximal clevis assembly 1020 attached to or formed on the end of the elongate shaft assembly. In the configuration shown in FIGS. 50-53, the proximal clevis assembly 1020 is formed on the distal end of the elongate shaft assembly 30 '. As can be seen in those figures, the proximal clevis assembly 1020 has a distal end wall 1022 and a pair of spaced clevis arms 1024, 1026. The proximal clevis 1020 is configured to be pivotally coupled to the distal clevis 1050 by a pivot shaft 1051 that serves to define an articulation axis BB. The articulation axis BB may substantially traverse the axis centerline AA.

  Distal clevis 1050 has a socket 1052 formed thereon and a pair of distal clevis arms 1054, 1056. The pivot shaft 1051 extends through the center of the clevis arms 1024, 1054, 1056, and 1026, as shown in FIG. A cable pulley 1058 to which the flexible cable 1010 is attached may be formed on the clevis arm 1054. Accordingly, rotation of the cable 1010 by its corresponding motor results in rotation of the distal clevis 1050 relative to the proximal clevis 1020 about the articulation axis BB.

  In various forms, the articulation joint 1000 may further include a rotatable mounting hub 1060 that is rotatably received in the socket 1052. The mounting hub 1060 may be fitted with a ring gear 1062 that is adapted to mesh with the distal roll pinion gear 1064. The distal roll pinion gear 1064 is attached to a pinion shaft 1066 that is rotatably supported by the end wall 1053 of the distal clevis 1050. A distal roll output gear 1068 is attached to the pinion shaft 1066. Distal roll output gear 1068 is in meshing engagement with distal roll transmission gear 1070 that is pivotally supported on pivot shaft 1051 and in meshing engagement with distal roll input gear 1072. Supported in state. The distal roll input gear 1072 is attached to the distal roll shaft 1040. Distal roll output gear 1068, distal roll transmission gear 1070, and distal roll input gear 1072 are referred to herein as a “distal roll gear train”, designated generally as 1069. The distal roll transmission gear 1070 has a pivot shaft 1051 such that rotation of the distal roll shaft 1040 ultimately results in rotation of the distal roll pinion gear 1064 without rotating the pivot shaft 1051. Above, "roll freely". The rotation of the distal roll pinion gear 1064 within the ring gear 1062 results in rotation of the mounting hub 1060 about the axial centerline AA. In various configurations, the end effector or surgical tool may be coupled directly to the mounting hub 1060 such that rotation of the mounting hub 1060 results in rotation of the end effector / tool. For example, the mounting hub 1060 may be formed with a hub socket 1061 sized to retain and receive a portion of the end effector / tool therein. In alternative configurations, the mounting hub 1060 may comprise an integral part of the end effector, or the end effector may be attached to the mounting hub 1060 by other fastener configurations. For example, the mounting hub 1060 may be attached to a coupling assembly of the type and structure described above, and then the end effector / tool may be separably attached to the coupling assembly.

  The articulation joint 1000 may also facilitate transmitting rotational control motion through the joint 1000 to an end effector / tool attached thereto. As can be seen in FIGS. 52 and 53, the distal end of the proximal firing shaft 1030 is rotatably supported by the distal end wall 1022 of the proximal clevis assembly 1020 and the input firing gear 1080 is attached. . The input firing gear 1080 is meshingly engaged with a firing transmission gear 1082 that is supported on the pivot shaft 1051. The firing transmission gear 1082 is in meshing engagement with a firing output gear 1084 that is mounted on a firing output shaft 1090 that is mounted on the end wall 1053 of the distal clevis 1050. The firing output shaft 1090 may be configured to drive engagement with a corresponding drive member or shaft on the end effector / tool. For example, the distal end 1092 of the firing output shaft 1090 may be received in a corresponding hexagonal socket formed in the mounting flange 1094 that may be configured to attach to the end effector / tool drive shaft. Thus, it may be formed in a hexagonal shape. The firing input gear 1080, the firing transmission gear 1082, and the firing output gear 1084 are referred to herein as a “fire shaft gear train”, designated generally as 1081. The firing transmission gear 1082 “freely rotates” on the pivot shaft 1051 such that rotation of the proximal firing shaft 1030 ultimately results in rotation of the firing output shaft 1090 without rotating the pivot shaft 1051. ” The distal roll gear train 1069 and the firing shaft gear train 1081 are essentially “nested” with respect to each other to facilitate articulation of the end effector / tool relative to the elongated shaft assembly while ending the rotational control motion. This facilitates transmission to the effector, and facilitates rotation of the end effector about the axis center line AA.

  54-60 illustrate another alternative articulation joint configuration 1100. FIG. In at least one form, articulation joint 1100 may include a proximal clevis 1110, a central clevis 1130, and a distal clevis 1150. The articulation joint 1100 includes two different articulation axes BB and CC, the end effector or surgical tool attached to which is substantially transverse to each other, and an elongated shaft assembly 30 'to which the joint is attached. It may be configured so that the joint movement can be easily performed around the axis center line AA of '. For example, the articulation joint 1100 may pivot the central clevis 1130 relative to the first clevis 1110 about the first articulation axis BB, and the distal clevis 1150 may be pivoted about the central clevis 1130. In contrast, the second articulation axis C-C may be selectively pivoted. The articulation joint 1100 may also facilitate such articulation of the end effector or surgical tool while also providing rotational control movement for operation or manipulation of the end effector / tool.

  The articulation joint 1100 may be coupled to an elongate shaft assembly that is similar in structure to the elongate shaft assembly 30 described above, or may be coupled to other suitable shaft assemblies. In one configuration, the proximal clevis 1110 is integrally formed with the outer tube of the elongate shaft assembly 30 ''. As can be seen in FIGS. 54-60, the proximal clevis 1110 has an upper proximal clevis arm 1112 and a lower proximal clevis arm 1114. The central clevis 1130 also has an upper central clevis arm 1132 and a lower central clevis arm 1134. The upper proximal clevis arm is pivotally coupled to the upper central clevis arm 1132 by a proximal pivot pin 1116. A proximal pivot pin 1116 also pivotally couples the lower proximal clevis arm 1114 to the lower central clevis arm 1134. Proximal pivot pin 1116 serves to define a first articulation axis BB.

  Also, in at least one configuration, the central clevis 1130 has a right central clevis arm 1136 and a left central clevis arm 1138. The distal clevis 1150 has a right distal clevis arm 1152 and a left distal clevis arm 1154. The right central clevis arm 1136 is pivotally coupled to the right distal clevis arm 1152 by a distal pivot pin 1156. The left central clevis arm 1138 is pivotally coupled to the left distal clevis arm 1154 by a distal pivot pin 1156. Distal pivot pin 1156 defines a second articulation axis CC. In one configuration, the distal pivot pin 1156 includes right and left distal clevis arms 1152, such that the distal pivot pin 1156 rotates with the distal clevis 1150 relative to the central clevis 1130. 1154 non-pivotally attached.

  The elongate shaft assembly 30 '' may be coupled to a handle assembly that houses a plurality of motors. One motor may be used to apply control motion to the first flexible cable member 1170 that extends through the elongate shaft assembly 30 ″ and is operably coupled to the articulation joint 1100. . For example, a first flexible cable 1170 is a first sheave or pulley that is operably attached to or in communication with a corresponding motor shaft such that operation of the motor causes the first cable 1170 to operate. It may be attached to the assembly.

  In one configuration, the first flexible cable 1170 is used to selectively pivot the central clevis 1130 relative to the proximal clevis 1110 about the first articulation axis BB. May be. In such a configuration, for example, the first cable 1170 extends around a first pulley or sheave 1180 attached to the central clevis 1130. For example, the first pulley 1180 is attached to the upper central clevis arm 1132 and is pivotally supported on the proximal pivot pin 1116. Actuating the first cable 1170 causes the central clevis 1130 to pivot relative to the proximal clevis 1110 about the first articulation axis BB.

  The articulation joint 1100 is also received on a sheave or pulley assembly that is operably attached to or in communication with a corresponding motor shaft in the handle assembly to activate the second cable 1190 by operation of the motor. A second flexible cable 1190 may be used. The second cable 1190 may be used to selectively pivot the distal clevis 1150 relative to the central clevis 1130 about the second articulation axis CC. In such a configuration, for example, the second cable 1190 extends around a second pulley or sheave 1158 that is non-rotatably attached to the distal pivot pin 1156. By actuating the second cable 1190, the distal pivot pin 1156 and the distal clevis 1150 attached thereto rotate relative to the central clevis 1130 about the second articulation axis CC. To do.

  The articulation joint 1100 may also facilitate transmitting rotational control motion through the joint 1100 to an end effector / tool attached thereto. Proximal rotary firing shaft 1200 extends through elongate shaft assembly 30 " and may be operably coupled to a firing motor in the handle assembly for applying rotational firing motion. In one configuration, the proximal firing axis 1200 may be hollow so that the second cable 1190 may extend therethrough. The proximal firing axis 1200 may be operatively interfaced with a proximal firing gear train 1210 that is operatively supported within the articulation joint 1100. For example, in one configuration, the first firing gear train 1210 may include a proximal input firing gear 1212 that is attached to the proximal firing shaft 1200. The proximal input firing gear 1212 is oriented in meshing engagement with a proximal firing transmission gear 1214 that is pivotally supported on the proximal pivot shaft 1116 for free rotation. The proximal firing transmission gear 1212 is oriented in meshing engagement with a proximal firing output gear 1216 that is coupled to a central firing shaft 1218 that rotatably passes through the central web 1131 of the central clevis 1130.

  The articulation joint 1100 may further include a distal firing gear train 1220 that cooperates with the proximal firing gear train 1210 to transmit rotational firing or control motion through the articulation joint 1100. The distal firing gear train 1220 may include a distal firing input gear 1222 that is attached to the central firing shaft 1216. The distal firing input gear 1222 is in meshing engagement with a distal firing transmission gear 1224 that is rotatably mounted on the distal pivot pin 1156 so that it may rotate freely. Distal firing transmission gear 1224 is in meshing engagement with a distal firing output gear 1226 that is rotatably supported within distal clevis 1150. The distal firing output gear 1226 may be configured to drive engagement with a corresponding drive member or shaft on the end effector / tool.

  Another form of the joint joint 1300 is shown in FIGS. Such an articulation joint 1300 can facilitate the articulation and rotation of the coupled end effector or surgical tool relative to the axial centerline AA of the elongated shaft to which the articulation joint 1300 is attached. The articulation joint may also facilitate rotational movement for end effector / tool actuation or manipulation while facilitating such movement of the end effector or surgical tool. The articulation joint 1300 may be coupled to an elongated shaft assembly that is similar in structure to the elongated shaft assembly 30 described above, or may be coupled to other suitable shaft assemblies. The elongate shaft assembly may be coupled to a handle assembly that houses a plurality of motors. One motor may be used to apply control motion to the flexible cable 1310 that extends through the elongated shaft assembly and is operably coupled to the articulation joint 1300. For example, the flexible cable 1310 may be attached to a sheave or pulley assembly that is operably attached to or in communication with a corresponding motor shaft such that the operation of the motor activates the cable 1310. The handle assembly may also include a firing motor operatively attached to the proximal firing shaft 1330 that extends through the elongated shaft assembly and interfaces with the articulation joint 1300, as described in more detail below. The handle assembly is also flexible to transmit rotational control motion to an articulation joint 1300 that may be used to rotate an end effector or surgical tool about an elongate axis about an axial centerline AA. A motor may be included that operatively interfaces with the distal roll shaft 1340. The handle assembly may also include a proximal roll motor that is used to rotate the elongate shaft assembly about the shaft centerline AA in the manner described above.

  In at least one form, the articulation joint 1300 may include a proximal clevis assembly 1320 attached to or formed on the end of the elongate shaft assembly. In the configuration shown in FIGS. 61-66, the proximal clevis assembly 1320 is formed on the distal end of the outer tube that forms part of the elongate shaft assembly 30 ''. As can be seen in the figures, the proximal clevis assembly 1320 has a distal end wall 1322 and a pair of spaced clevis arms 1324, 1326. The proximal clevis 1320 is configured to be pivotally coupled to the distal clevis 1350 by an upper pivot shaft 1351 and a lower pivot shaft 1353 that serve to define an articulation axis BB. The The articulation axis BB substantially traverses the axis centerline AA.

  Distal clevis 1350 has a socket 1352 formed thereon and a pair of distal clevis arms 1354, 1356. Upper pivot shaft 1351 extends through the centers of clevis arms 1324 and 1354. Lower pivot shaft 1353 extends through clevis arms 1356 and 1026 as shown in FIG. The clevis arm 1356 further includes a cable pulley 1358 formed thereon or attached thereto. Flexible cable 1310 is attached to cable pulley 1358 such that actuation of cable 1310 results in articulation of distal clevis 1350 relative to proximal clevis 1320 about articulation axis BB.

  In various forms, the articulation joint 1300 may further include a rotatable mounting hub 1360 that is rotatably received in the socket 1052. The mounting hub 1060 may be fitted with a driven gear 1362 that is adapted to mesh with a distal roll pinion gear 1364. The distal roll pinion gear 1364 is attached to a pinion shaft 1366 that is rotatably supported by the end wall 1355 of the distal clevis 1350. In at least one configuration, the distal roll pinion gear 1364 is provided by a flexible distal roll shaft 1340 that extends through a proximal support shaft 1342 that extends through an elongated shaft assembly 30 ''. Be operated. In various configurations, the end effector or surgical tool may be coupled directly to the mounting hub 1360 such that rotation of the mounting hub 1360 results in rotation of the end effector / tool. For example, the mounting hub 1360 may be formed with a hub socket 1361 sized to retain and receive a portion of the end effector / tool therein. In alternative configurations, the mounting hub 1360 may comprise an integral part of the end effector, or the end effector may be attached to the mounting hub 1360 by other fastener configurations. For example, the mounting hub 1360 may be attached to a coupling assembly of the type and structure described above, and then the end effector / tool may be separably attached to the coupling assembly.

  The articulation joint 1300 may also facilitate transmitting rotational control motion through the joint 1300 to an end effector / tool attached thereto. 63 and 64, the distal end of the proximal firing shaft 1330 is rotatably supported by the distal end wall 1322 of the proximal clevis assembly 1320 and a firing input gear 1380 is attached. . The input firing gear 1380 is meshed with a firing transmission gear 1382 that is pivotally supported on the lower pivot shaft 1353. Firing transmission gear 1382 is in meshing engagement with a firing output gear 1384 mounted on firing output shaft 1390 that extends through end wall 1355 of distal clevis 1350 and end wall 1370 of mounting hub 1360. . The firing output shaft 1390 may be configured to drive engagement with a corresponding drive member or shaft on the end effector / tool. For example, the distal end 1392 of the firing output shaft 1390 may be received in a corresponding hexagonal socket formed in the mounting flange 1394 that may be configured to attach to the end effector / tool drive shaft. Thus, it may be formed in a hexagonal shape. The firing input gear 1380, the firing transmission gear 1382, and the firing output gear 1384 are referred to herein as a firing axis gear train designated generally as 1381. The firing transmission gear 1382 is on the lower pivot shaft 1353 such that rotation of the proximal firing shaft 1330 ultimately results in rotation of the firing output shaft 1390 without rotating the lower pivot shaft 1353. "Roll freely." Distal roll gear train 1369 and firing shaft gear train 1381 facilitate end effector / tool articulation relative to the elongated shaft assembly while facilitating transfer of rotational control motion to the end effector and shaft It is easy to rotate the end effector about the center line AA.

Alternative Motor Mounting Assembly FIGS. 67-69 show an alternative motor mounting assembly designated generally as 1750. The motor mounting assembly 1750 may be supported within the handle housing segments 23 and 24 that may be coupled together by snap structures, screws, etc. and serve to form the pistol grip portion 26 of the handle assembly 20. In at least one form, the motor mounting assembly 1750 may comprise a motor housing 1752 that is removably supported within the handle housing segments 23 and 24. In at least one form, for example, motor partition 1756 is attached to motor housing 1752. The motor housing 1752 serves to support the motors 402, 530, 560, and 610. Each motor is fitted with its own circuit control board 1780 that controls the operation of the respective motor in various ways as described herein.

  In some forms, the tool portion 100 may include an electrosurgical end effector that utilizes electrical energy to treat tissue. Examples of electrosurgical end effectors and related instruments are described in US patent application Ser. No. 13 / 536,393 entitled “Surgical End Effector Jaw and Electrode Configurations”, Attorney Docket No. END7137USNP / 120141, and “Electrode Connections for Rt. US patent application Ser. No. 13 / 536,417 entitled “Drive Surgical Tools”, Attorney Docket No. END7149 USNP / 120153, both of which are incorporated herein by reference in their entirety. 70-73 show an example of an end effector 3156 that constructs an alternative tool portion 100. The end effector 3156 may be adapted to fuse and capture the captured tissue by capturing and transecting the tissue and simultaneously applying controlled energy (eg, radio frequency (RF) energy). Good. The first jaw 3160A and the second jaw 3160B may be closed, thereby capturing or engaging tissue about the longitudinal axis 3194 defined by the axially movable member 3182. The first jaw 3160A and the second jaw 3160B may also apply compression to the tissue.

  FIG. 70 shows a perspective view of one form of an electrosurgical end effector 3156 used with the surgical instrument 10. FIG. 70 shows end effector 3156 with jaws 3160A, 3160B open. FIG. 71 shows a perspective view of one form of end effector 3156 with jaws 3160A, 3160B closed. As described above, the end effector 3156 may include an upper first jaw 3160A and a lower second jaw 3160B, which may be straight or curved. First jaw 3160A and second jaw 3160B may each comprise an elongated slot or channel 3162A and 3162B (FIG. 70) disposed outwardly along each intermediate portion. Further, the first jaw 3160A and the second jaw 3160B may each have a tissue gripping element, such as a tooth 3198, disposed on the inner portion of the first jaw 3160A and the second jaw 3160B. The first jaw 3160A may comprise an upper first jaw body 3200A with an upper first outer facing surface 3202A and an upper first energy delivery surface 3204A. The second jaw 3160B may comprise a lower second jaw body 3200B with a lower second outer facing surface 3202B and a lower second energy delivery surface 3204B. Both the first energy delivery surface 3204A and the second energy delivery surface 3204B may extend in a “U” shape around the distal end of the end effector 3156. It will be appreciated that the end effector 3156 may be rotatable and articulatable in a manner similar to that described herein with respect to the end effector 102.

  FIG. 72 shows one form of the axially movable member 3182 of the end effector 3156. The axially movable member 3182 is driven by a threaded drive shaft 3151 (FIG. 70). The proximal end of the threaded drive shaft 3151 may be non-rotatably coupled to the output socket 238 and thereby configured to receive the rotational motion provided by the motor 530. The axially movable member 3182 includes a threaded nut 3153 that receives the threaded drive shaft 3151 such that rotation of the threaded drive shaft 3151 translates the axially movable member 3182 distally and proximally along the axis 3194. (FIG. 72). The axially movable member 3182 may include one or more pieces, but in either case may be movable or translatable relative to the elongated shaft 158 and / or the jaws 3160A, 3160B. Also, in at least some forms, the axially movable member 3182 may be made of 17-4 precipitation hardened stainless steel. The distal end of the axially movable member 3182 may include a flanged “I” shaped steel configured to slide within the channels 3162A and 3162B of the jaws 3160A and 3160B. The axially movable member 3182 may slide within the channels 3162A, 3162B to open and close the first jaw 3160A and the second jaw 3160B. The distal end of the axially movable member 3182 may also include an upper flange or “c” shaped portion 3182A and a lower flange or “c” shaped portion 3182B. Flanges 3182A and 3182B define inner cam surfaces 3206A and 3206B that engage the outer facing surfaces of first jaw 3160A and second jaw 3160B, respectively. The opening and closing of the jaws 3160A and 3160B is highly accomplished using a cam mechanism that may include a movable "I-steel" axially movable member 3182 and surfaces 3208A, 3208B facing the outside of the jaws 3160A, 3160B. High compressive force can be applied to the tissue.

  More specifically, referring now collectively to FIGS. 70-72, the inner cam surfaces 3206A and 3206B at the distal end of the axially movable member 3182 have first and second jaws 3160A and 3160B, respectively. The first outer facing surface 3208A and the second outer facing surface 3208B may be adapted to slidably engage. The channel 3162A in the first jaw 3160A and the channel 3162B in the second jaw 3160B are adapted for movement of the axially movable member 3182, which may comprise a tissue cutting element 3210 with a sharp distal blade, for example. It may be sized and configured as such. FIG. 71 shows the distal end of axially movable member 3182 advanced, for example, at least partially through channels 3162A and 3162B (FIG. 70). Advancement of the axially movable member 3182 may close the end effector 3156 from the open configuration shown in FIG. In the closed position illustrated by FIG. 71, the upper first jaw 3160A and the lower second jaw 3160B are connected to the first energy delivery surface 3204A and the second of the first jaw 3160A and the second jaw 3160B, respectively. A gap or dimension D is defined with respect to the energy delivery surface 3204B. In various forms, for example, the dimension D is about 0.01 mm to about 1.0 mm (about 0.0005 inches to about 0.040 inches), for example, in some forms, about 0.03 mm to about 0.25 mm. (About 0.001 inch to about 0.010 inch). Also, the edges of the first energy delivery surface 3204A and the second energy delivery surface 3204B may be rounded to prevent tissue from being torn.

  FIG. 73 is a cross-sectional view of one form of end effector 3156. The engaging or tissue contacting surface 3204B of the lower jaw 3160B passes energy to the tissue, at least in part, through a conductive resistive matrix such as a variable resistive positive temperature coefficient (PTC) body. Adapted to deliver. At least one of the upper and lower jaws 3160A, 3160B may have at least one electrode 3212 configured to deliver energy from the generator 3164 to the captured tissue. The engagement surface of the upper jaw 3160A, i.e., the tissue contacting surface 3204A, may have a similar conductive resistive matrix (e.g., PCT material), or in some forms the surface may be, e.g., a conductive electrode. Alternatively, it may be an insulating layer. Alternatively, the engaging surface of the jaw may be any of the energy delivery components disclosed in US Pat. No. 6,773,409, filed Oct. 22, 2001, entitled “ELECTROSURGICAL JAW STRUCTURE FOR CONTROLLED ENERGY DELIVERY”. The entire disclosure of which is incorporated herein by reference.

  First energy delivery surface 3204A and second energy delivery surface 3204B may each be in electrical communication with generator 3164. Generator 3164 is connected to end effector 3156 via a suitable transmission medium such as conductors 3172, 3174. In some forms, the generator 3164 is coupled to a controller, such as the controller 3168, for example. In various configurations, the controller 3168 may be integrally formed with the generator 3164 or a separate, electrically coupled to the generator 3164 (shown in phantom lines to illustrate this option). It may be provided as a circuit module or device. Generator 3164 may be implemented as an external part of the instrument and / or may be implemented integrated with surgical instrument 10.

  The first energy delivery surface 3204A and the second energy delivery surface 3204B contact the tissue and deliver electrosurgical energy adapted to seal or fuse the tissue to the captured tissue. It may be configured. Controller 3168 regulates the electrical energy delivered by generator 3164, which in turn delivers electrosurgical energy to first energy delivery surface 3204A and second energy delivery surface 3204B. Controller 3168 may adjust the power generated by generator 3164 during startup.

  As mentioned above, the electrosurgical energy delivered by generator 3164 and regulated or otherwise controlled by controller 3168 is radio frequency (RF) energy, or other suitable form of electrical energy. May be included. Further, the opposing first and second energy delivery surfaces 3204A and 3204B may have a variable resistive positive temperature coefficient (PTC) body in electrical communication with the generator 3164 and the controller 3168. Good. Further details regarding electrosurgical end effectors, jaw closure mechanisms, and electrosurgical energy delivery surfaces are described in the following US patents and patent publications: US Pat. No. 7,087,054; No. 08,619; No. 7,070,597; No. 7,041,102; No. 7,011,657; No. 6,929,644; No. 6,926,716; No. 6,913 579; 6,905,497; 6,802,843; 6,770,072; 6,656,177; 6,533,784; and 6,500,176 And U.S. Patent Application Publication Nos. 2010/0036370 and 2009/0076506, all of which are hereby incorporated by reference in their entirety and made a part hereof.

  A suitable generator 3164 is available as model number GEN11 from Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. Also, in some forms, generator 3164 is implemented as an electrosurgical unit (ESU) that can use radio frequency (RF) energy to provide sufficient power to perform bipolar electrosurgery. May be. In some forms, the ESU may be a bipolar ERBE ICC 350 sold by ERBE USA, Inc. of Marietta, Georgia. In some forms, such as for bipolar electrosurgical applications, a surgical instrument having an active electrode and a counter electrode can be utilized, where the active electrode and the counter electrode are adjacent to and in contact with the tissue to be treated. And / or in electrical communication, thereby allowing current to flow through the tissue from the active electrode through the positive temperature coefficient (PTC) body to the counter electrode. it can. Thus, in various configurations, the surgical instrument 10 utilizing the end effector 3156 creates a supply path and a return path, and the captured tissue being treated completes or closes the circuit. In some forms, the generator 3164 may be a monopolar RF ESU and the surgical instrument 10 may utilize a monopolar end effector in which one or more active electrodes are integrated. For such a system, the generator 3164 may utilize a return pad and / or other suitable return path that is in intimate contact with the patient at a location remote from the surgical site. The return pad may be connected to the generator 3164 via a cable.

  During operation of the electrosurgical instrument 150, a user generally grasps tissue and supplies energy to the captured tissue to form a fusion or seal, and then an axially movable member through the captured tissue. The tissue cutting element 3210 is driven at the distal end of 3182. According to various aspects, the translational movement of the axially movable member 3182 is tuned or otherwise controlled to help drive the axially movable member 3182 at a suitable rate of movement. May be. By controlling the speed of movement, the likelihood that the captured tissue will be properly functionally sealed before being transected by the cutting element 3210 is increased.

  In some forms, the device portion 100 may include an ultrasonic end effector that utilizes harmonics or ultrasonic energy to treat the tissue. FIG. 74 illustrates one form of an ultrasonic end effector 3026 for use with the surgical instrument 10. The end effector assembly 3026 includes a clamp arm assembly 3064 and a blade 3066 that form the jaws of the clamping mechanism. The blade 3066 may be an ultrasonically actuated blade that is acoustically coupled to an ultrasonic transducer 3016 positioned within the end effector 3026. Examples of small transducers and end effectors with transducers are listed in co-pending US Patent Application No. 13 / 538,601, named Ultrasonic Surgical Instruments with Positioned Transducers, and US Patent Publication No. 2009/0036912. Is provided in the issue. The transducer 3016 may be acoustically coupled (eg, mechanically coupled directly or indirectly) to the blade 3066 via the waveguide 3078.

  Tubular actuation member 3058 may move clamp arm assembly 3064 in direction 3062A to an open position in which clamp arm assembly 3064 and blade 3066 are disposed in spaced relation to each other, and in direction 3062B. The clamp arm assembly 3064 and the blade 3066 may move together to a clamped or closed position that grips tissue therebetween. The distal end of reciprocating tubular actuation member 3058 is mechanically engaged to end effector assembly 3026. In the illustrated form, the distal end of the reciprocating tubular actuation member 3058 is mechanically engaged to a clamp arm assembly 3064 that is pivotable about a pivot point 3070 to open and close the clamp arm assembly 3064. Combined. For example, in the illustrated form, when the reciprocating tubular actuating member 3058 is retracted proximally, the clamp arm assembly 3064 is movable from an open position to a closed position in a direction 3062B about a pivot point 3070. It is. When the reciprocating tubular actuating member 3058 is translated distally, the clamp arm assembly 3064 is movable from a closed position to an open position in a direction 3062A about a pivot point 3070 (FIG. 75).

  Tubular actuation member 3058 may be translated proximally and distally by rotation of threaded drive shaft 3001. The proximal end of the threaded drive shaft 3001 may be non-rotatably coupled to the output socket 238 and thereby configured to receive the rotational motion provided by the motor 530. Tubular actuation member 3058 may include a threaded nut 3059 that receives threaded drive shaft 3001 such that rotation of threaded drive shaft 3001 translates tubular actuation member 3058 distally and proximally. FIGS. 76-77 show additional views of one form of axially movable member 3058 and tubular nut 3059. In some forms, the tubular actuation member 3058 defines a cavity 3003. As shown in FIG. 74, a portion of the waveguide 3078 and / or blade 3066 may extend through the cavity 3003.

  In one example form, the distal end of the ultrasonic transmission waveguide 3078 may be coupled to the proximal end of the blade 3066 by an internally threaded connection, preferably at or near the antinode. It is contemplated that the blade 3066 may be attached to the ultrasonic transmission waveguide 3078 by any suitable means such as a welded joint. The blade 3066 may be separable from the ultrasonic transmission waveguide 3078, although the single element end effector (eg, blade 3066) and the ultrasonic transmission waveguide 3078 may be formed as a single piece. Good things are also conceived.

  The ultrasonic transducer 3016, known as the “Languban stack”, generally vibrates in response to the electrical signal provided by the generator 3005 (FIG. 74). For example, the transducer 3016 is a machine that provides electrical signals from the generator 3005 to a standing acoustic wave of longitudinal oscillating motion at ultrasonic frequencies primarily in the ultrasonic transducer 3016 and the blade 3066 portion of the end effector assembly 3026. Multiple piezoelectric elements or other elements that convert to energy may be provided. The ultrasonic transducer 3016 has a length equal to half the length of the system wavelength integral (nλ / 2; where “n” is any positive integer; eg, n = 1, 2, 3,...). However, this is not necessarily the case. A suitable vibration frequency range for the transducer 3016 and blade 3066 may be about 20 Hz to 32 kHz, and a well-suited vibration frequency range may be about 30 to 10 kHz. A suitable operating vibration frequency may be, for example, about 55.5 kHz.

  The generator 3005 may be any suitable type of generator located inside or outside the surgical instrument 10. A suitable generator is available as model number GEN11 from Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. When the transducer 3016 is energized, an oscillating motion standing wave is generated through the waveguide 3078 and the blade 3066. The end effector 3026 is designed to operate at resonance such that an acoustic standing wave pattern with a predetermined amplitude is generated. The amplitude of the oscillating motion at any point along the transducer 3016, the waveguide 3078, and the blade 3066 depends on the position along those components where the oscillating motion is measured. The minimum or zero crossing in an oscillating motion standing wave is commonly referred to as the wave node (ie where the motion is minimal) and the local absolute maximum or peak of the standing wave is generally Called the antinode (for example, where local motion is maximal). The distance between the antinode and the nearest wave node is a quarter wavelength (λ / 4).

  In one example form, blade 3066 may have a length approximately equal to an integral multiple of one-half system wavelength (nλ / 2). The distal end of blade 3066 may be disposed near the antinode to provide maximum longitudinal deflection of the distal end. When the transducer assembly is energized, the distal end of the blade 3066 is, for example, in the range of about 10 to 500 microns peak to peak, and preferably about 30 to 64 at a predetermined vibration frequency of, for example, 55 kHz. It may be configured to move in the micron range.

  In one example form, blade 3066 may be coupled to ultrasonic transmission waveguide 3078. The blade 3066 and ultrasonic transmission waveguide 3078 as shown are formed from a material suitable for transmission of ultrasonic energy as a single unitary structure. Examples of such materials include Ti6Al4V (a titanium alloy containing aluminum and vanadium), aluminum, stainless steel, or other suitable materials. Alternatively, the blade 3066 may be separable (and differently configured) from the ultrasonic transmission waveguide 3078, eg coupled by studs, welds, adhesives, quick connections, or other suitable known methods May be. The length of the ultrasonic transmission waveguide 3078 may be approximately equal to an integer of half wavelength (nλ / 2), for example. The ultrasonic transmission waveguide 3078 is preferably made from a material suitable for efficiently transmitting ultrasonic energy, such as, for example, the titanium alloy described above (ie, Ti6Al4V) or any suitable aluminum alloy or other alloy. It may be fabricated from a solid core shaft that is constructed.

  In some forms, the surgical instrument 10 may also be utilized with other stapler type end effectors. For example, FIG. 78 shows one form of a linear staple end effector 3500 that may be used with the surgical instrument 10. End effector 3500 includes an anvil portion 3502 and a translatable staple channel 3514. The translatable staple channel 3514 is translatable in the distal and proximal directions as indicated by arrow 3516. The threaded drive shaft 3056 may be coupled to the output socket 238, for example, to receive the rotational motion provided by the motor 530 as described above. Threaded drive shaft 3506 is coupled to threaded nut 3508 that is fixedly coupled to staple channel 3514 such that rotation of threaded drive shaft 3506 translates staple channel 3514 in the direction indicated by arrow 3516. Also good. Nut 3508 may also be coupled to driver 3510, which may then contact staple cartridge 3512. As driver 3510 translates distally, staples may be pushed from staple cartridge 3512 to anvil 3502 so that the staples pass through any tissue positioned between staple channel 3514 and anvil 3502. Promoted.

  In some forms, the surgical instrument may also be utilized with a circular staple end effector. FIG. 79 shows one form of a circular staple end effector 3520 that may be used with the surgical instrument 10. End effector 3520 includes an anvil 3522 and a staple portion 3524. Threaded drive shaft 3530 extends from anvil 3522 through staple portion 3524. The threaded drive shaft 3530 may be coupled to the output socket 238, for example, to receive the rotational motion provided by the motor 530 as described above. Threaded nut 3532 may be coupled to staple portion 3524 such that rotation of threaded drive shaft 3530 causes staple portion 3524 to translate alternately distally and proximally as indicated by arrow 3534. . The threaded shaft also causes the cartridge within any tissue positioned between the anvil 3522 and the staple portion 3524 such that distal movement of the staple portion 3524 causes the driver 3528 to be pushed distally into the staple cartridge 3526. A driver 3528 may be coupled to drive staples from 3526. In some embodiments, end effector 3520 may also include a knife or cutting tool 3535 that cuts tissue prior to stapling.

  It will be appreciated that other instrument portions may be interchangeable with respect to the surgical instrument 10 in addition to different end effectors. For example, some forms of surgical instrument 10 utilize different power cords. FIG. A shows some example power cords 3540, 3542, 3544 for use with surgical instruments. Each of the power cords 3540, 3542, 3544 includes a socket 3546 for coupling to the surgical instrument 10. The power cords 3540, 3542, 3544 may be utilized to connect the surgical instrument 10 to various power sources. For example, power cords 3540 and 3542 are sockets 3550 that are received by a generator, such as the generator of model number GEN11 from Ethicon Endo-Surgery, Inc. of Cincinnati, Ohio. , 3552. Such a generator may provide power to the instrument 10 and / or provide a signal to drive an electrosurgical and / or ultrasonic end effector. The power cord 3544 includes a plug 3548 that may be plugged into a wall socket to provide power to the instrument 10 (eg, instead of the battery 802).

  In some forms, the surgical instrument may also include a replaceable tool portion that includes different axes. FIG. 81 illustrates some example axes 3554, 3556, 3558 that can be used with the surgical instrument 10. Axes 3554, 3556, 3558 are each separable drive mount portions 700 ′, 700 ″, similar to separable drive mount portion 700, which may be received by instrument 10 as described hereinabove. 700 '' '. Each of the shafts 3554, 3556, 3558 also includes a coupler assembly 3557 that receives an end effector, similar to the coupler assembly 200 described hereinabove. In some embodiments, the different shafts are configured to accept different types of end effectors at the coupler assembly 3557. Each of the axes 3554, 3556, 3558 may have different characteristics including, for example, different lengths, presence or absence of articulation, passive or active articulation, different degrees of articulation, different diameters, different curvatures, etc. Good. For example, axis 3554 defines a curve 3559 that deviates from the axis of gravity of the axis. The shaft 3558 defines an articulation joint 3560 that may be articulated in a manner similar to that described hereinabove with respect to the articulation joint 310.

  It will be appreciated that different types of instrument portions 100 (eg, power cords, shafts, end effectors, etc.) require various motors and other components of the surgical instrument 10 to operate differently. Let's go. For example, powered end effectors such as electrosurgical end effector 3156 and ultrasonic end effector 3026 require energy signals to power the electrodes and / or ultrasonic blades. Different end effectors may also require different movements of the various motors 402, 560, 530, 610 for actuation, including, for example, actuating different motors, providing different amounts of torque, etc. . In various forms, the tool portion 100 may provide control parameters to the surgical instrument 10.

  FIG. 82 is a block diagram of the handle assembly 20 of the surgical instrument 10 showing various control elements. The control elements shown in FIG. 82 receive control parameters from various instrument parts and based on the received control parameters and from the clinician (eg, via a joystick controller 840 or other suitable actuation device). The surgical instrument 10 is configured to be controlled based on one or more input control signals received. The control element may comprise a control circuit 3702 for controlling the surgical instrument 10. In various forms, the control circuit 3702 may execute a control algorithm for operating the surgical instrument 10 including any installed instrument portion. In some forms, the control circuit 3702 is mounted on the proximal circuit board 820 described hereinabove. The control circuit 3702 includes a memory and / or data storage device 3708 associated with the microprocessor 3706. In some forms, the control circuit 3702 may also include a generator circuit 3704 for providing a power signal to the ultrasound and / or electrosurgical device. Generator circuit 3704 may operate as a stand-alone component or in conjunction with an external generator.

  FIG. 82 also shows a motor 3714 that may correspond to the motors 402, 560, 530, 610 described above. The battery 3713 may correspond to the battery 802 described above in this specification. Input to the control circuit 3702 may be provided by a joystick controller 840 or other suitable actuation device. The various surgical instrument portions 100 described herein may be coupled to the handle 20 with respective sockets 3710, 3712. Socket 3712 may receive a shaft such as shaft 3554, 3556, 3558. For example, the socket 3712 may receive the shaft in a manner similar to the manner in which the handle 20 receives the separable drive mount 700 as described hereinabove. Socket 3710 may be configured to receive a cord socket, such as socket 3546 described hereinabove.

  The control circuit 3702 may receive control parameters from various installed tool parts along with various other control elements such as sockets 3710, 3712. The control parameter may include, for example, data explaining the property of the tool part, data explaining an algorithm for operating the instrument 10 on which the tool part is installed, and the like. Sockets 3710, 3712 may be mechanically and communicably coupled to various device parts. For example, the various tool parts may include a circuit 3720 for storing control parameters. Such a circuit 3720 is shown in FIG. 80 in conjunction with power cords 3540, 3542, 3544 and in conjunction with shafts 3554, 3556, 3558 in FIG. FIG. 83 also illustrates one form of various end effector tool portions 3730, 3732, 3734, 3736, 3738 comprising a circuit 3720 as described herein. The circuit 3720 may comprise one or more data storage components that store control parameters for provision to the control circuit 3702. Such data storage components may include any suitable type of memory device (eg, electrically erasable programmable read only memory (EEPROM), digital register, any other type of memory, etc.). The memory device may also include a coil or other hardware component configured to modify a predetermined control parameter in response to, for example, a radio frequency identification (RFID) interrogation signal. In some forms, the circuit 3720 makes a direct wired connection to the control circuit 3702, eg, via respective sockets 3710, 3712. Accordingly, the control circuit 3702 may communicate directly with the various circuits 3720 to receive control parameters.

  In some forms, circuit 3720 includes a passive or active RFID device. The handle 20 may include one or more antennas 3716, 3718 that may be positioned at or near respective sockets 3710, 3712. Using the antennas 3716 and 3718, the control circuit 3702 may query the circuit 3720 on the installed tool portion to retrieve control parameters. In some forms, the control circuit 3702 is programmed to interrogate various instrument parts during start-up and / or when it is indicated that the instrument part has been installed and / or removed. In response, the control circuit 3702 may receive a reflected signal from the RFID device. The reflected signal may indicate an associated control parameter. In some forms, the circuit 3720 may include active RFID devices that transmit data describing their associated tool portions, eg, during installation.

  As shown in FIG. 81, some axial configurations may include an antenna 3719 at the distal portion. The antenna 3719 communicates with the control circuit 3702 via conductors (not shown) extending through the respective axes so that the control circuit 3702 is on end effectors such as end effectors 3730, 3732, 3734, 3736, 3738. The RFID device circuit 3720 may be queried. In some forms, the antenna 3718 positioned in the handle may receive and transmit sufficient power to interrogate the RFID device circuit 3720 on the end effector without requiring a separate antenna 379 in the axis. Good. In some configurations, the circuit 3720 may be configured to make a wired connection to the control circuit 3702. For example, the antennas 3716, 3718, and 3719 may be omitted.

  FIG. 84 is a block diagram illustrating one form of a control configuration 3800 implemented by a control circuit 3702 that controls the surgical instrument 10. According to configuration 3800, control circuit 3702 is programmed using control algorithm 3802. The control algorithm 3802 receives control parameters from the installed equipment portion in the form of input variables 3801. Input variable 3801 may describe the nature of the installed tool part. The control algorithm 3802 also receives one or more input control signals 3818 (eg, from a joystick controller 840, a robotic system, or other suitable actuation device operated by a clinician). Based on the input variable 3801, the control algorithm 3802 may control one or more input control signals 3818, an output motor control signal 3814 for controlling the motor 3714, and an ultrasonic and / or electrosurgical end effector. Surgical instrument 10 may be operated by switching to any output energy control signal 3816. It will be appreciated that not all forms of surgical instrument 10 need to receive input variables from all of the listed instrument parts. For example, some forms of surgical instruments include a single shaft and / or a fixed end effector. Also, some forms of surgical instruments (or configurations thereof) may omit the power cord.

  The control algorithm 3802 may implement a plurality of functional modules 3804, 3806, 3810, 3812 related to different aspects of the surgical instrument 10. The firing module 3804 may convert one or more input control signals 3818 into one or more output motor control signals 3814 to control the respective motors 3714 to fire the instrument 10. Articulation module 3806 may convert one or more input control signals 3818 into one or more output motor control signals 3814 to articulate the axis of instrument 10. The power module 3812 may send power to various components of the surgical instrument 10 as required by the installed power cord. In the form of an instrument 10 that utilizes energy at the end effector (eg, an ultrasound and / or electrosurgical instrument), the energy module 3810 outputs one or more input control signals 3818 to output energy provided to the end effector. The signal 3816 may be converted. The energy signal 3816 may be generated by the generator 3704 and / or an external generator (not shown in FIG. 84) and provided to the transducer 3016 and / or the energy delivery surfaces 3204A, 3204B of the end effector. Good.

  Various modules 3804, 3806, 3810, 3812 of the control algorithm 3802 may utilize control parameters in the form of input variables 3801 to convert one or more input control signals 3818 to output signals 3814, 3816. For example, input variables 3801 received from different tool parts may affect the control algorithm 3802 in different ways. Input variables 3801 received from power cords such as 3540, 3542, and 3544 include, for example, the type of cord, whether the cord is connected to an external target such as a generator or a power socket, and the external to which the cord is connected The identification information of the target can be listed. One type of power cord, such as cord 3544, may be configured to receive power from an external power socket such as a wall outlet. When the control circuit 3702 determines that this type of cord is installed (eg, in the socket 3710), the power supply module 3812 receives power from the installed cord tool to the motor 3714 and / or energy element. The control circuit 3702 may be programmed to provide power. The power provided through the installed cord tool may be used in addition to or instead of the power provided by battery 3713.

  Another type of code, such as 3540 and 3542, may be configured to communicate with an external generator. The power module 3812 and / or the energy module 3810 may configure the control circuit 3702 to power the energy element based on an energy signal received via the installed power cord. In addition, the energy module 3810 may configure the control circuit 3702 to provide input to the generator via an installed power cord. Such input may include, for example, an input control signal 3818 indicating that the clinician is requesting energy. In some forms, the input variable 3801 received from the power cord may also indicate the type of generator that is configured to be coupled to the power cord (and / or the power cord is coupled). Examples of generators may include stand-alone electrosurgical generators, stand-alone ultrasound generators, electrosurgical / ultrasound generator combinations, and the like. In some forms, the input variable 3801 received from the code may also indicate the type of generator that the code is configured to combine. In some forms, the type of generator shown may affect the operation of the control algorithm 3802. For example, different generator types may have different control interfaces, different forms of commands may be expected from the surgical instrument 10, and / or provide different forms of output.

  When an axis, such as one of axes 3554, 3556, 3558, is a removable tool part, the input variable 3801 received from the axis may indicate various properties of the axis. Such properties may include, for example, the length of the shaft, the position and degree of curvature of the shaft (if present), the parameters describing the joint joint of the shaft (if present), and the like. The length of the shaft and the position and extent of the shaft curvature may be utilized by the firing module 3804 and / or the articulation module 3806 of the control algorithm 3802, for example, to determine torque requirements and / or tolerances. The parameters describing the articulation of the shaft may indicate the various motor movements required to articulate the shaft in different directions or allow the articulation module 3806 to derive it. In some embodiments, the input variable 3801 may also indicate an acceptable degree of articulation that the articulation module 3806 may translate into a maximum allowable motor movement. In some forms, the input variable 3801 received from the shaft may also indicate whether the installed shaft supports shaft rotation and / or end effector rotation. Such a variable 3801 may also be utilized by the control algorithm 3802 to derive which motor 3714 is actuated for rotation of the shaft and / or end effector, the rotational torque and number of revolutions indicated for each motor 3714, etc. Good.

  The input variable 3801 received from the end effector tool portion may take different forms based on the type of end effector used. For example, end cutters, and other stapler end effectors, such as the end effector 102 described hereinabove, may have end effector length (eg, 45 mm or 60 mm staple lines), anvils and elongated channels that are either straight or curved. Or a variable value indicating a motor 3714 or the like to which a drive shaft such as drive shaft 180 is coupled may be provided. Such an input variable 3801 may be utilized by the firing module 3804 to convert an input control signal 3818 requesting firing of the instrument 10 to an output motor control signal 3814. For example, the length of the end effector, the curvature, etc. may determine the motor 3714 to be activated, the amount of force or torque that needs to be provided, the number of revolutions of the motor required to fire, and the like. Similarly, input variables 3818 received from linear or circular stapler end effectors such as 3500 and 3520 are responsive to different levels of motor 3714 activated for firing, and input control signals 3818 associated with firing, by firing algorithm 3804. And may be used to determine the amount of force or torque required to be provided, the number of motor revolutions required for firing, and the like.

  When the end effector is an energy end effector, such as an electrosurgical end effector 3156 or an ultrasonic end effector 3026, the received input variable 3801 is associated with information related to the end effector closing motion, as well as, for example, a firing stroke. Information describing energy elements, including the timing of energy provision, may be described. Information describing the closing motion may be used, for example, by the firing module 3804 to determine which motor 3714 to operate for firing and / or retraction, the torque and number of rotations shown for each motor 3714, etc. May be. Information describing the energy component may be utilized by the energy module 3810 to generate an output energy signal 3816, for example. For example, the energy module 3810 may determine what type of output energy signal 3816 (eg, voltage, current, etc.) is required, whether the signal can be generated by the internal generator 3704, and any lockout implemented by the signal. It may be determined whether or not exists. An example of a lockout may prevent a firing motion from being performed unless energy is provided and / or may prevent energy from being provided unless a firing motion is performed. In some embodiments, the energy module 3810 may also derive the timing of the output energy signal 3816 in relation to the firing stroke of the instrument. For example, referring to the electrosurgical end effector 3156, the energy module 3810 may derive how long the energy delivery surfaces 3204A, 3204B should be activated before the tissue cutting element 3210 is advanced.

  FIG. 85 is a flowchart illustrating an example form of process flow 3600 for implementing control algorithm 3802 using control circuit 3702. At 3602, the control circuit 3702 may receive an indication that a tool portion (eg, power cord, shaft, end effector, etc.) is present. The instructions may be automatically generated when installing the tool portion. For example, in a form where the device portion includes an active RFID, an indication that the device portion is present may be provided by the active RFID. Also, in some embodiments, the sockets 3710, 3712 used to connect the device portion to the instrument 10 may include a switch that indicates that the device portion is present. At 3604, control circuit 3702 may query the tool portion for input variable 3801. When the tool portion includes a passive RFID device, the query may include illuminating the RFID device with a radio frequency signal. If the tool portion is in wired communication with control circuit 3702, the query may include sending a request to a memory device associated with the tool portion.

  At 3606, control circuit 3702 may receive input variable 3801 from the tool portion. Input variable 3801 may be received in any suitable manner. For example, when the tool portion includes a passive RFID device, the input variable 3801 may be derived by demodulating the feedback signal from the RFID device. When there is a wired connection between the tool portion and the circuit 3702, the input variable 3801 may be received directly from a memory device or the like of the tool portion. At 3608, the control circuit 3702 may apply the input variable 3801 to the control algorithm 3802, for example, as described herein above. This may have the effect of configuring the pre-existing algorithm 3802 to operate the instrument 10 regardless of which equipment part is installed.

  FIG. 86 is a block diagram illustrating another form of control configuration 3900 implemented by a control circuit 3702 that controls the surgical instrument 10. In configuration 3900, the control parameters received from the various tool parts include an algorithm for controlling each tool part. The control circuit 3702 implements a shell control algorithm 3902 including an operating system 3904. The operating system 3904 is programmed to query the installed tool portion and receive control parameters in the form of a tool algorithm 3906. Each of the tool algorithms 3906 may describe how to convert the input control signal 3908 into an output motor control signal 3910 and an output energy signal 3912. Upon receiving the tool algorithm 3906, the operating system 3904 may execute the algorithm 3906 to operate the instrument 10.

  In some embodiments, the operating system 3904 may also be compatible with various algorithms 3906. For example, the tool algorithm 3906 received from the energy end effector may take different configurations based on whether the instrument is communicating with an external generator or utilizing an internal generator 3704. Accordingly, the operating system 3904 configures the tool algorithm 3906 for the energy end effector based on whether the tool algorithm 3906 is received from a corresponding power cord configured to couple with an external generator. Also good. Also, in some forms, the tolerance and / or number of rotations required to fire the end effector may depend on the configuration of the shaft. Accordingly, the operating system 3904 may be configured to modify the tool algorithm 3906 received from the end effector based on the corresponding tool algorithm 3906 received from the axis.

  FIG. 87 is a flowchart showing an example of a process flow 3400 for realizing a control algorithm 3902 that uses the control circuit 3702. At 3402, the control circuit 3702 may execute the operating system 3904. Operating system 3904 may program control circuit 3702 to perform various other actions described herein with respect to control configuration 3900. At 3404, the control circuit 3702 may query one or more instrument portions installed in the surgical instrument 10, for example, as described herein. At 3406, the control circuit 3702 may receive a tool algorithm 3906, as described herein. At 3408, the control circuit 3702 may apply the received algorithm 3906 to operate the surgical instrument. Application of received algorithm 3906 may include, for example, matching algorithm 3906 as described herein above.

  88 and 89 show one form of a surgical instrument 4010 that includes a sensing module 4004 located within the end effector 4002. In some forms, the surgical instrument 4010 may be similar to the surgical instrument 10 and the end effector 4002 may be similar to the end effector 102 described above. Sensing module 4004 may be configured to measure one or more conditions at end effector 4002. For example, in one configuration, sensing module 4004 may include a tissue thickness sensing module that senses the thickness of tissue clamped to end effector 4002 between staple cartridge 130 and anvil assembly 190. Sensing module 4004 may be configured to generate a wireless signal indicative of one or more measured conditions of end effector 4002. According to one configuration shown in FIG. 89, sensing module 4004 is located at the distal end of end effector 4002 so that sensing module 4004 does not interfere with the staples of staple cartridge 130 when staples are fired. May be. In various forms, the sensing module 4004 may comprise a sensor, a wireless module, and a power source. See FIG. 90. The sensor may be disposed at the distal end of the end effector 4002 (as shown in FIG. 89) at the electric joint 310 or any other suitable portion of the tool portion 100.

  In various configurations, the sensors may include any suitable sensor that detects one or more conditions in the end effector 4002. For example, without limitation, the sensor at the distal end of the end effector 4002 can be a Hall effect sensor or a reed switch sensor, an optical sensor, a magnetic induction sensor, a force sensor, a pressure sensor, a piezoresistive film sensor, an ultrasonic sensor, Includes tissue thickness sensors such as eddy current sensors, accelerometers, pulse oximetry sensors, temperature sensors, sensors configured to detect electrical properties (such as capacitance or resistance) of tissue pathways, or any combination thereof But you can. As another example, without limitation, a sensor located at the electric joint 310 may be a potentiometer, a capacitive sensor (slide potentiometer), a piezoresistive film sensor, a pressure sensor, a pressure sensor, or any other suitable sensor. May include type. In some configurations, the sensing module 4004 may include a plurality of sensors at a plurality of locations within the end effector 4002. Sensing module 4004 may further include one or more visual markers that provide a visual indication of current conditions at end effector 4002 to the user, such as through a video feed.

  Sensing module 4004 may include a wireless module configured to generate and transmit a wireless signal indicative of the measured condition of end effector 4002. See FIG. 90. The wireless module may include an antenna configured to transmit a wireless signal at a first frequency. The transmission power of the sensing module 4004 may be limited by the size of the antenna and the power source that can be positioned in the sensing module 4004. The size of the end effector 4002 may reduce the space available to locate the antenna or power supply that is powerful enough to transmit signals from the sensing module 4004 to a remote location, such as a video monitor 4014, for example. Due to the forced size of the antenna and the low power delivered to the sensing module 4004 by the power source, the sensing module 4004 may generate a low output signal 4006 that can be transmitted over short distances. For example, in some forms, the sensing module 4004 may transmit a signal from the end effector 4002 to a relay station 4008 located in the vicinity of the end effector 4002. For example, the relay station 4008 is located on the handle 4020 of the instrument 4010, in an axis 4030 (eg, a proximal portion of the axis 4030) and / or in an implantable device positioned within or on the patient's body surface. May be.

  The relay station 4008 may be configured to receive the low power signal 4006 from the sensing module 4004. The low power signal 4006 is limited by the size of the antenna and power source that may be located in the end effector 4002 as part of the sensing module 4004. The relay station 4008 may be configured to receive the low power signal 4006 and retransmit the received signal as the high power signal 4012. The high power signal 4012 may be sent to a remote network or device, such as a video monitor 4014, configured to display a graphical representation of the condition measured at the end effector 4002. Although the sensing module 4004 and relay station 4008 have been generally described in connection with the surgical instrument 4010, those skilled in the art will appreciate that the configuration of the sensing module 4004 and relay station 4008 can be any suitable configuration, such as, for example, a robotic surgical system. It will be appreciated that it may be used with any surgical system. For example, the relay station 4008 may be positioned within the axis and / or instrument portion of a robotic surgical instrument. A suitable robotic surgical system is described in US patent application Ser. No. 13 / 538,700 entitled “Surgical Instruments with Articulating Shafts,” which is incorporated herein by reference in its entirety.

  In some forms, the video monitor 4014 is a stand-alone unit that displays conditions measured by the end effector 4002, a standard observation monitor used in endoscopic, laparoscopic, or open surgery, or Any other suitable monitor may be included. The displayed graphical representation may be displayed on a video feed or other information displayed on the video monitor. In some forms, the high power signal 4012 may interrupt the display of the video monitor 4014 and may cause only a graphical representation of the condition measured by the end effector 4002 to be displayed on the video monitor. Receiver module 4015 may be interfaced with video monitor 4014 to allow video monitor 4014 to receive high power signal 4012 from relay station 4008. In some configurations, the receiver module 4015 may be integrally formed with the video monitor 4014. The high power signal 4012 may be transmitted wirelessly, through a wired connection, or both. High power signal 4012 may be received by a wide area network (WAN), a local area network (LAN), or any other suitable network or device.

  In some forms, the video monitor 4014 may display an image based on data included in the received high power signal 4012. For example, the clinician may view real-time data regarding the thickness of the clamped tissue throughout the procedure involving the surgical instrument 4010. Video monitor 4014 may include a monitor such as a cathode ray tube (CRT) monitor, a plasma monitor, a liquid crystal display (LCD) monitor, or any other suitable visual display monitor. The video monitor 4014 may display a graphical representation of the conditions at the end effector 4002 based on the data included in the received high power signal 4012. The video monitor 4014 displays the condition at the end effector 4002 in any suitable manner, for example, overlaying a graphical representation of the condition at the end effector over a video feed or other data displayed on the video monitor 4014. May be. In some forms, video monitor 4014 may be configured to display only data received from high power signal 4012. Similarly, the high power signal 4012 may be received by a computer system (not shown). The computer system may include a radio frequency module (eg, receiver module 4015) to communicate with relay station 4008. The computer system may store data from the high power signal 4012 in a memory unit (eg, ROM or hard disk drive) and may process the data using a processor.

  In some forms, the relay station 4008 amplifies the power of the low power signal 4006 to the high power signal 4012, but otherwise does not change the low power signal 4006. The relay station 4008 may be configured to retransmit the high power signal 4012 to the remote network or device. In some configurations, relay station 4008 may modify or process received low power signal 4006 before retransmitting high power signal 4012. The relay station 4008 may be configured to convert the received signal from a first frequency transmitted by the sensing module 4004 to a second frequency that can be received by a remote network or device such as the video monitor 4014. For example, in one configuration, the sensing module 4004 may transmit the low power signal 4006 using a first frequency that includes a human tissue permeable frequency. Human tissue permeable frequencies may include frequencies that are configured to penetrate human tissue with minimal signal attenuation. For example, the frequency may be selected outside the water absorption zone to limit signal attenuation by human tissue (which may contain a high percentage of water). For example, the sensing module 4004 may include a medical implant communication service (MICS) frequency band (402-405 MHz), a suitable industrial, scientific, medical (ISM) radio band (such as a center frequency of 433 MHz or a center frequency of 915 MHz), short range Field communication band (13.56 MHz), Bluetooth communication band (2.4 GHz), ultrasonic frequency, or any other suitable human tissue permeable frequency or frequency band may be used. The relay station 4008 may receive the low power signal 4006 of the first frequency. The relay station 4008 may convert the low power signal 4006 from a first frequency to a second frequency suitable for transmission through air over a long range. The relay station 4008 may transmit the high power signal 4012 using any suitable frequency, such as, for example, a Wi-Fi frequency (2.4 GHz or 5 GHz).

  In some forms, the relay station 4008 may convert the received low power signal 4006 from the first communication protocol to the second communication protocol before transmitting the high power signal 4012. For example, the sensing module 4004 may use a first communication protocol, such as a near field communication (NFC) protocol, a Bluetooth communication protocol, a corporate private communication protocol, or any other suitable communication protocol, to 4006 may be transmitted. The relay station 4008 may receive the low power signal 4006 using the first communication protocol. The relay station 4008 may include a protocol conversion module that converts the received signal from a first communication protocol to a second communication protocol such as, for example, TCP / IP, UDP, or any other suitable communication protocol.

  FIG. 90 is a block diagram illustrating a sensing module 4104 that represents an example configuration of the sensing module 4004 described herein above. The sensing module 4104 may include a sensor 4116, a controller 4118, a wireless module 4124, and a power source 4126. The controller 4118 may include a processor unit 4120 and a memory unit 4122. Sensor 4116 may be disposed at the distal end of end effector 4002 (as shown in FIG. 89) at articulation joint 310 or any other suitable portion of device portion 100. In various forms, the sensor 4116 may include any suitable sensor that detects one or more conditions in the end effector.

  In some configurations, sensor 4116 may include a tissue thickness sensor, such as a Hall effect sensor. The tissue thickness sensor may detect the thickness of the tissue clamped to the end effector 4002 based on the magnetic field generated by the magnet 4042, for example, at the distal end of the anvil assembly 190. See FIG. 89. When the clinician closes the anvil assembly 190, the magnet 4042 rotates downward and approaches the sensing module 4004, thereby detecting by the sensing module 4004 as the anvil assembly 190 rotates to the closed (or clamped) position. The applied magnetic field fluctuates. The strength of the magnetic field from the magnet 4042 sensed by the sensing module 4004 indicates the distance between the channel 130 and the anvil assembly 190, which is the channel when the end effector 4002 is in the closed (or clamped) position. The thickness of the tissue being clamped between 130 and anvil assembly 190 is shown.

  Sensing module 4104 may be configured to generate a wireless signal indicative of the measured condition of the end effector. The wireless signal may be generated by the wireless module 4124. In some forms, the transmit power of the wireless module 4124 is limited by the size of the antenna included in the wireless module 4124 and the size of the power supply 4126 within the sensing module 4104. The size of the end effector 4002 may reduce the space available for positioning the antenna or power source 4126 that is powerful enough to transmit signals from the sensor 4116 to a remote location, such as a video monitor 4014. Due to the limitations on the low power delivered by the antenna and power supply 4126, the wireless module 4124 may only generate a low power signal 4006 that can be transmitted over a short distance, such as a distance to the proximal end of the axis 4030. For example, in one form, the wireless module 4124 may transmit a low power signal 4006 from the end effector 4002 to the handle 4020 of the surgical instrument 4010. In some configurations, a power supply 4126 capable of delivering higher power levels may generate a low output signal 4006 to extend the operation of the surgical instrument 4010.

  The memory unit 4122 of the controller 4118 may include one or more solid state read only memory (ROM) and / or random access memory (RAM) units. In various configurations, the processor 4120 and memory unit (s) 4122 may be integrated into a single integrated circuit (IC) or multiple ICs. The ROM memory unit (s) may include flash memory. The ROM memory unit (s) may store code instructions that are executed by the processor 4120 of the controller 4118. In addition, the ROM memory unit (s) 4122 may store data indicating the cartridge type of the cartridge 130. That is, for example, the ROM memory unit (one or more) 4122 may store data indicating the model type of the staple cartridge 130. In some configurations, the controller in the handle 4020 of the surgical instrument 4010 may utilize the condition information and model type of the staple cartridge 130 to detect proper operation of the surgical instrument 4010. For example, sensing module 4004 may be configured to measure tissue thickness. The tissue thickness information and cartridge model type determine whether the tissue clamped on the end effector 4002 is too thick or too thin based on the tissue thickness range specified for a particular staple cartridge 130. May be used. The wireless module 4124 may be a low power bi-directional wireless module that wirelessly communicates with the relay station 4008 in the handle 4020 of the surgical instrument 4010 using a wireless data communication protocol. The wireless module 4124 may include any antenna suitable for transmitting the low power signal 4006. For example, the wireless module 4124 may include a dipole antenna, a half-wave dipole antenna, a monopole antenna, a near field communication antenna, or any other suitable antenna for the low power signal 4006. The size of the antenna, and thus the available transmit power and frequency, may be limited by the size of the end effector 4002.

  According to various aspects, the wireless module 4124 may communicate with the relay station 4008 using a human tissue permeable frequency. For example, communication between the wireless module 4124 and the relay station 4008 is performed in the Medical Implant Communication Services (MICS) frequency band (402-405 MHz), in the appropriate industry, in the Scientific, Medical (ISM) radio band (433 MHz center frequency). Or using a near field communication band (13.56 MHz), a Bluetooth communication band (2.4 GHz), an ultrasonic frequency, or any other suitable frequency or frequency band of human tissue permeability. Also good. The power source 4126 may include a battery cell suitable for powering the components of the sensing module 4004, such as a lithium ion battery or some other suitable battery cell.

  In some forms, the components of the sensing module 4104 may be in the end effector 4002, on the shaft 4030, or any other suitable location of the surgical instrument 4010. For example, the sensor 4116 may be located at the distal end of the end effector 4002. Controller 4118, wireless module 4124, and power source 4126 may be located on axis 4030. One or more wires may connect sensor 4116 to controller 4118, wireless module 4124, and power supply 4126. In some forms, the arrangement of the sensing module 4104 may be limited by the functions of the end effector 4002 and the axis 4030. For example, in the illustrated form, the end effector 4002 is articulatable and rotatable by the electric joint joint 310. Placing the wire over the power articulation joint 310 may cause twisting or bending of the wire and may interfere with the operation of the power articulation joint 310. In order to prevent operational problems with the articulation joint 310 or sensing module 4004, the placement of the sensing module 4004 components may be limited to positions distal to the power articulation joint 310.

  In some configurations, the sensing module 4104 may comprise an analog to digital converter (ADC) 4123. The sensor 4116 may generate an analog signal that represents a condition in the end effector 4002. In order to transmit a signal representing a condition in the end effector 4002 wirelessly, it may be necessary to convert an analog signal into a digital signal. The analog signal generated by sensor 4116 may be converted to a digital signal by ADC 4123 prior to generation and transmission of low power signal 4006. The ADC 4123 may be included in the controller 4118, or may include a separate controller, such as a microprocessor, programmable gate array, or any other suitable ADC circuit.

  FIG. 91 is a block diagram illustrating a relay station 4208, which represents an exemplary configuration of the relay station 4208 described above in this specification. The relay station 4208 may be located close to the axis, such as near the battery 4226, and away from the sensing module 4004 within the end effector 4002, for example, by the axis 4030. For example, the relay station 4208 may be located within the handle 4020 of the surgical instrument 4010. Therefore, the relay station 4208 may receive a radio signal from the sensing module 4004. The relay station 4208 may include a releasable module that may be selectively interfaced with the handle 4020 of the surgical instrument 4002.

  As shown in FIG. 91, the relay station 4208 may include a wireless module 4228 and an amplification module 4230. In some configurations, the wireless module 4228 is configured to receive the low power signal 4006. A low power signal 4006 may be transmitted from the sensing module 4004 and indicates a condition at the end effector 4002. The radio module 4228 of the relay station 4208 receives the low power signal 4006 and provides the low power signal 4006 to the amplification module 4230. The amplification module 4230 may amplify the low power signal 4006 into a high power signal 4012 suitable for transmission over a longer range than the low power signal 4006. After amplifying the received low power signal 4006 to a high power signal 4012, the amplification module 4230 may also provide the high power signal 4012 to the wireless module 4228 for transmission to a remote network or device, such as a video monitor 4014, for example. Good. The amplification module 4230 may include any suitable amplifier circuit, such as a transistor, an operational amplifier (op amp), a fully differential amplifier, or any other suitable signal amplifier.

  FIG. 92 is a block diagram illustrating a relay station 4308 that represents the configuration of another example of the relay station 4308 described above in this specification. In the illustrated form, the relay station 4308 includes a wireless module 4328, an amplification module 4330, and a processing module 4336. The amplification module 4330 may amplify the received low output signal 4006 before processing by the processing module 4336, after processing the low output signal 4006 received by the processing module 4336, or both before and after processing by the processing module 4336. Good. The wireless module 4328 may include a receiver module 4332 and a transmitter module 4334. In some forms, receiver module 4332 and transmitter module 4334 may be combined in the form of a signal transceiver module (not shown). Receiver module 4332 may be configured to receive a low power signal 4006 from sensing module 4004. Receiver module 4332 may provide received low power signal 4006 to processing module 4336.

  In the illustrated configuration, the processing module 4336 includes a frequency conversion module 4338 and a protocol conversion module 4340. The frequency conversion module 4338 may be configured to convert the received low power signal 4006 from a first frequency to a second frequency. For example, the sensing module 4004 may transmit the low power signal 4006 using a first frequency suitable for transmission through human tissue, such as a MICS or ISM frequency. Receiver module 4332 may receive a low power signal 4006 at a first frequency. The frequency conversion module 4338 may convert the low power signal 4006 from a first frequency to a second frequency suitable for transmission through air over a long range. The frequency conversion module 4338 may convert the received low-power signal 4006 to any frequency suitable for transmission of a high-power signal, such as a Wi-Fi frequency (2.4 GHz or 5 GHz frequency).

  The protocol conversion module 4340 may be configured to convert the received signal from a first communication protocol to a second communication protocol. For example, the sensing module 4004 may use a first communication protocol, such as a near field communication (NFC) protocol, a Bluetooth communication protocol, a corporate private communication protocol, or any other suitable communication protocol, to 4006 may be transmitted. The relay station 4308 may receive the low power signal 4006 using the first communication protocol. The relay station 4308 converts the received low power signal 4006 from the first communication protocol to a second communication protocol such as, for example, a TCP / IP protocol, a Bluetooth protocol, or any other suitable communication protocol. Module 4340 may be included. Processing module 4336 including frequency conversion module 4338 and protocol conversion module 4340 may include one or more microprocessors, programmable gate arrays, integrated circuits, or any other suitable controller, or any combination thereof.

  In some forms, the frequency conversion module 4338 and / or the protocol conversion module 4340 may be programmable. A network, video monitor, or other receiving device may be configured to receive signals on a specific frequency and a specific protocol. For example, a local area network (LAN) may receive radio signals using the 802.11 wireless standard and using the TCP / IP communication protocol, which requires transmission at a frequency of 2.4 GHz or 5 GHz. May be configured. The user may select an 802.11 wireless communication standard from a plurality of communication standards stored by the relay station 4308. The memory module may be included in the relay station 4308 to store a plurality of communication standards. The user may select a communication standard for the high output signal 4012 from a plurality of communication standards stored by the memory module. For example, the user may select the 802.11 communication standard as the communication standard for transmitting the high output signal 4012. When the communication standard is selected by the user, the frequency conversion module 4338 or the protocol conversion module 4340 converts the frequency or communication protocol of the received low output signal 4006 to select the received low output signal 4006 as the selected communication standard. May be programmed by the memory module to convert to In some configurations, the relay station 4308 may automatically detect the appropriate frequency and communication protocol for receiving the low power signal 4006 or transmitting the high power signal 4012. For example, the relay station 4308 may detect a hospital wireless communication network. The relay station 4308 automatically programs the frequency conversion module 4338 and the protocol conversion module 4340 to convert the received low power signal 4006 into a frequency and protocol suitable for communication of the high power signal 4012 to the hospital wireless communication network. May be.

  In the illustrated form, the processing module 4336 may provide the processed signal to the amplification module 4330 to amplify the processed signal to a high power signal 4012 prior to transmission. The amplification module 4330 may amplify the processed signal to a level suitable for transmission by the transmission module 4334. The amplification module 4330 may include any suitable amplifier circuit, such as a transistor, an operational amplifier (op amp), a fully differential amplifier, or any other suitable electronic amplifier. The amplification module 4330 may include a battery (not shown) or may be connected to a power source 4326 within the handle 4020 of the surgical instrument 4010. Amplification module 4330 may be programmable to provide one or more amplification levels in response to selection of a particular communication type.

  The amplification module 4330 may provide a high power signal to the transmission module 4334 for transmission. Although the wireless module 4328, the processing module 4336, and the amplification module 4330 are shown as separate modules, those skilled in the art can combine any or all of the illustrated modules into a single integrated circuit. It will also be appreciated that multiple integrated circuits may be provided.

  FIG. 93 illustrates one embodiment of a method for relaying a signal indicating a condition of the end effector 4400. Method 4400 may include causing a sensing module (eg, sensing module 4004 described herein) to generate a signal indicative of a condition of an end effector, such as end effector 4002 (4402). The signal may represent any measurable condition at the end effector 4002, such as the thickness of tissue clamped to the end effector 4002. The sensing module may generate a signal using, for example, a sensor such as sensor 4116 of sensing module 4104 shown in FIG. The method 4400 may further include transmitting (4404) the generated signal as a low power signal by the wireless module. For example, the wireless module 4124 shown in FIG. 90 may transmit a low power signal 4006. In practice, the transmit power of the wireless module may be limited by the size of the antenna and power source that may be disposed within the end effector 4002. Given the limited space, the transmit power of the wireless module may be limited to the low power signal 4006. The low power signal 4006 may be transmitted using a wireless module at a power level that allows the low power signal 4006 to be received by the relay station 4008 in the handle 4020 of the surgical instrument 4010.

  The method of relaying a signal indicative of a condition at the end effector 4400 may further include receiving (4406) a low power signal by a relay station, such as the relay station 4008, for example. After receiving the low power signal, the relay station may convert the low power signal to a high power signal, such as a high power signal 4012 (4408). The conversion of the low output signal to the high output signal may include amplification of the low output signal by an amplification module such as the amplification module 4230 shown in FIG. The conversion of the low output signal to the high output signal may also include converting the communication standard of the low output signal to a communication standard suitable for transmission of the high output signal. For example, the method 4400 may use a processing module to convert the received low power signal from a first frequency to a second frequency (4408).

  After step 4408 of converting the low power signal to the high power signal, the method 4400 further includes transmitting (4410) the high power signal by the relay station to a remote location, such as an operating room viewing screen or hospital network, for example. May be included. The high power signal may be received 4412 by a viewing screen that may display a graphical representation of the condition at the end effector to the user. In some configurations, the method may include selecting the frequency and / or communication protocol of the high power signal by the user prior to converting the low power signal. The frequency and communication protocol may be selected from a plurality of frequencies stored in the memory module of the relay station.

Electromechanical Soft Stop In various forms, the surgical instrument may use a mechanical stop adapted to stop or decelerate the motor drive element at or near the end of the drive stroke. According to various embodiments, the mechanical stop is constructed to decelerate the motor drive element at or near the end of the stroke, and / or a hard stop constructed to terminate the movement of the motor drive element abruptly Soft stop may be included. As will be described in more detail below, in certain embodiments, such an instrument measures and provides current provided to an electromechanical stop including a mechanical stop and a motor used to drive the motor drive element. And / or a control system configured to monitor. In one form, the control system is configured to terminate power to the motor or otherwise disengage the drive motion of the motor drive element upon determining that a current that satisfies a predetermined parameter has occurred. .

  For the sake of brevity and ease of understanding, the mechanical and electromechanical stops described herein are generally described in terms of surgical instruments and drive members that include associated cutting and fastening devices. I want you to understand. However, those skilled in the art will not be limited to this disclosure, and the various mechanical stops and associated electromechanical structures disclosed herein may be used in various other devices known in the art. You will understand that you may find the law. For example, additional usage will become more apparent below, but the various mechanical stops disclosed herein may include, for example, any device with an electrically controlled motor and / or control or drive system, As well as non-endoscopic surgical instruments such as laparoscopic instruments. Referring again to FIGS. 1-6, which shows an electromechanical surgical instrument 10 with a mechanical stop configuration according to one aspect. Handle assembly 20 is operably coupled to elongate shaft assembly 30 and its distal portion is operably attached to end effector 102. End effector 102 includes a proximal end 103 and a distal end 104. As described above, the elongate channel member 110 may be configured to operably and detachably support the staple cartridge 130 and the anvil assembly 190 may be in an open position (see FIG. 4) and an open position (FIG. 6). ), And can be selectively moved relative to the staple cartridge 130 to capture tissue therebetween.

  In a particular form, the instrument 10 comprises a drive member, which may be any part or component of the instrument 10 that is movable by the action of a motor. In various forms, the drive member is rotatably mounted within the elongate channel 110 with the elongate shaft assembly 30 and one or more portions or components thereof, such as the end effector 102 or the thread 170 or the tissue cutting member 160. And a body portion 162 that may be pivotally supported on the end effector drive screw 180 by screwing. As described above, the thread 170 may be indicated with respect to an axial stroke relative to the end effector drive screw 180 and may be configured to interface with the body portion 162 of the tissue cutting member 160. The end effector drive screw 180 may be rotatably supported within the elongated channel 110 as described above. The end effector drive screw 180 rotates in the first direction, causing the tissue cutting member 160 to move distally through the drive stroke. As the tissue cutting member 160 is driven distally through the drive stroke, the sled 170 is driven distally by the tissue cutting member 160. In various forms, the staple cartridge 130 may be equipped with a mechanical stop that includes a soft stop. According to one aspect, the soft stop includes one or more bumpers 174 that cushion the sled 170 as it reaches the end of its stroke near the distal most location within the elongate channel 110. Each bumper 174 may be associated with a resistance member 175, such as a spring, that provides the desired amount of cushioning to the bumper.

  As described in more detail above, the sled 170 and the tissue cutting member 160 are along an axial centerline AA that extends between the proximal end 103 of the end effector 102 and the distal end 104 of the end effector 102. It is movable through the drive stroke and is fastened simultaneously with cutting the tissue. The illustrated end effector 102 is configured to operate as an end cutter for tissue clamping, cutting, and stapling; in other aspects, a grasper, cutter, stapler, clip applier, access device, Different types of end effectors may be used, such as end effectors for other types of surgical devices such as drug / gene therapy devices, ultrasound, RF, or laser devices.

  Referring to FIG. 94, which shows the distal end 104 of the end effector 102 shown in FIGS. 1-6, the drive member 158 comprising the sled 170 and the cutting member 160 has a proximal home position and a distal position in the stroke position. Through a drive stroke defined along an axial centerline AA. In one aspect, the end of the stroke position is defined between the first and second positions S1, S2 (see FIGS. 97 and 78). In various forms, at least one of the home position and the end of the stroke may be physically inhibited, e.g., blocked or restricted from moving further longitudinally beyond the respective stop position, Includes mechanical stops such as soft stops. In one form, both the home position and the end of the stroke are provided with mechanical stops. As shown, the drive member 158 is disposed distally before or adjacent to the end of the stroke.

  As described above, the surgical instrument 10 may employ a control system that controls one or more motors and associated drive components as described above. FIG. 95 illustrates one of a system comprising a control system 1400, a drive motor 1402, and a power supply 1404 for use with a surgical instrument that employs an electromechanical stop that may include mechanical soft or hard stops according to various aspects. It is a figure which shows a form. Surgical system includes a power source 1404 operably coupled to drive motor 1402 via control system 1400. The power source 1404 may be configured to supply power to a drive motor 1402 that drives a drive member such as the drive member 158. In particular aspects, the power source 1404 may include any conventional power source, such as a battery, an AC outlet, or a generator. The control system 1400 may comprise various modules or circuits and may operate to control various system components, such as the drive member 158, the power source 1404, or the user interface. The control system 1400 may be configured to control, monitor, or measure various operations, signals, inputs, outputs, or parameters of the instrument 10, for example.

  In various forms, the control system 1400 may be similar to the control system 800 described above. For example, in various aspects, the control system 1400 may be configured to “electrically generate” a plurality of control movements. The term “electrically generated” means that an electrical signal is used to activate or otherwise control a motor 1402, such as motors 402, 530, 560, and 610, or other electrically powered devices. It may also be distinguished from control movements that are generated manually or mechanically without using current. For example, the control system 1400 may be responsive to a user command, such as an electrical signal provided to the control system via actuation of an actuator, such as a drive or firing trigger associated with the handle assembly 20, and a power driven motor Control motions, such as rotational control motions, including delivering to the device may be generated electrically. In certain aspects, the control system 1400 includes rotational control, including termination of delivery of power to the drive motor 1402, which may be responsive to a user or biasing mechanism returning the actuator or firing trigger to the open position. Motion may be generated electrically. In at least one aspect, the control system 1400 may electrically generate a rotational control motion that includes termination or reduction of power delivery to the drive motor 1402 due to the measured electrical parameter reaching a predetermined value. Good. For example, when the measured current reaches a predetermined threshold, the control system 1400 may end the power supply to the drive motor 1402.

  Referring generally to FIGS. 1, 94 and 95, in various configurations, the surgical instrument 10 transmits an actuation signal from a user, eg, a clinician, to the control system 1400 to provide an elongate shaft assembly 30, an end. The handle assembly 20 is equipped with a user interface configured to electrically generate a control motion for the effector 102 or drive member 148. For example, in certain aspects, the user interface is operable to provide an input signal to the control system 1400 to control the supply of power to a drive motor 1402, such as the firing motor 530 (see FIG. 23). Or a trigger assembly comprising a trigger. The assembly may include a closing trigger that closes and / or locks the anvil assembly 190 and a firing trigger that activates the end effector 102, eg, drives the drive member 148 through a drive stroke. In operation, the closure trigger may be actuated first, thereby bringing the anvil assembly 190 to the closed position, eg, capturing tissue between the staple cartridge 130 and the anvil assembly 190. Once the clinician is satisfied with the positioning of the end effector 102, the clinician may pull the closure trigger back to its fully closed locked position. Next, the firing trigger may be actuated from the open position to the closed position to actuate the drive member 158 through the drive stroke. In various aspects, the firing trigger may return to the open position when the clinician removes pressure, or mechanically into the open position by operably connecting to actuation of the drive member 158 or a separate mechanism. May be resettable. In one aspect, the firing trigger may be a multi-position trigger so that once the drive member 158 reaches a position at or near the end of the stroke, the firing trigger is moved from the second open position to the second closed position. Acting into position, actuating member 158 may be actuated proximally toward the home position. In some such aspects, the first and second open positions and the closed position may be substantially the same. Depending on the desired configuration, in certain aspects, the release button or latch may be configured to release the closure trigger from the locked position. As will be described in more detail below, the firing trigger may be operably disengaged after the firing trigger is actuated from the open position to the closed position, for example, activation of the firing trigger causes the control system 1400 to An initial actuation input signal may be provided that may be sent to instruct the control system 1400 to initiate actuation of the drive member 158. In certain configurations, since there is no user override mechanism, actuation of drive member 158 is terminated at or near the end of the stroke by an action initiated by the control system, even when the firing trigger is in the closed position, For example, power delivery to the drive motor is disengaged or interrupted.

  In one form, the trigger assembly comprises a joystick controller that may be similar to the joystick controller 840 described above. For example, as shown in FIGS. 33-39, the joystick controller advantageously allows the user to maximally functionally control various aspects of the surgical instrument 10 through a single interface. It may be possible. In one aspect, the joystick control rod 842 operates on a joystick switch assembly 850 that is movably housed within the switch housing assembly 844 such that the switch housing assembly 844 is mounted within the pistol grip 26 of the handle assembly 20. It may be attached as possible. The switch housing assembly 844 may include a biasing member 856 that biases the joystick switch assembly 850 and joystick control rod 842 in a desired position, for example when not externally positioned by the user. Joystick controller 840 may be electrically coupled to control system 1400 to provide control instructions to control system 1400. For example, manipulation of the joystick control rod 842, such as depression or directional movement, allows the user to control various control movements associated with the surgical instrument 10, which may include actuation of the drive member 158. May be.

  As discussed above, various forms of surgical instrument 10 may comprise one or more electrically operated or electrically powered motors, such as motors 402, 530, 560, and 610. One or more motors may be located, for example, within a portion of the handle assembly 20 or elongate shaft assembly 30 of the instrument 10 and are operable to drive the drive member 158 between the home position and the end of the stroke. It may be. In one form, the motor may include a brushless motor, a cordless motor, a synchronous motor, a step motor, or any other suitable electric motor. In certain configurations, the motor may be, for example, a linear actuator that operates in a rotational or linear mode of operation, including a transmission coupling between the drive motor 1402 and the drive member 158 to provide rotational motion of the drive motor 1402. May be converted into linear motion, or rotational motion may be combined between multiple components. In various forms, a transmission coupling that includes one or more gears, or a coupling element such as a belt or pulley, transmits rotational movement from the drive motor 1400 to one or more segments of the elongate shaft assembly 30 to end. Operable to activate the effector 102. For example, the end effector driving screw 180 rotates in the first direction, so that the drive member 158 moves in the first direction, for example, in the distal direction, along the axial center line AA. In various aspects, the end effector drive screw 180 rotates in a second direction opposite to the first such that the drive member 148 moves in a second direction along the axial centerline AA, eg, in a proximal direction. Move to. In one aspect, the drive motor 1400 is reversible to drive the drive member 158 distally toward the end of the stroke and drive the drive member 158 proximally toward the home position. For example, the drive motor 1402 may be reversible, for example, by reversing the polarity of the voltage supply, thereby creating a reverse rotation or movement of the motor and thus a reverse movement of the drive member 158. The As such, the drive member 158 is both proximal and distal by conventional methods or by methods such as those disclosed in US patent application Ser. No. 12 / 235,782, incorporated herein by reference in its entirety. It may be moved between positions along the drive stroke in the direction of. In particular, the instrument 10 described herein refers to a hand-held instrument that generally includes a handle, but in various forms, an instrument that includes a mechanical stop that may operate as part of an electromechanical stop. 10 may be adapted for use with a robot or similar device used by a robotic system.

  In certain aspects, the surgical instrument 10 comprises a reversible motor and includes a proximal mechanical stop and a distal mechanical stop. In various aspects, as described above, actuating the firing trigger provides a cue to actuate the drive member 158 through the drive stroke. When the drive member 158 reaches the end of the drive stroke, for example, when the cutting member 160 reaches the distal end of the cut stroke, the stroke end or direction switch is switched to, for example, the closed position, and the voltage applied to the motor 1402 May be reversed so that the direction of rotation of the motor 1402 is reversed. Such a switch may be associated with the control system 1400 and may be in addition to, or in lieu of, completion of power delivery to the drive motor 1402. In particular, however, in other aspects, a manual return switch may be provided to reverse motor 1402 and return drive member 158 to its original or home position.

  A mechanical stop is disposed at or near the end of the stroke and is constructed to increase resistance to movement of the drive member 158 through the end of the stroke. The mechanical stop includes a soft stop with a pair of bumpers 174 that are each operably coupled to the resistance member 175. The bumper 174 is configured to contact the drive member 158 at or near the end of the stroke. For example, the bumper 174 shown in FIG. 94 is constructed to contact the contact surface 173 of at least one wedge 172. In various aspects, the bumper 174 may be sized to complement the dimensions of the contact surface 173. For example, in at least one aspect, bumper 174 may be dimensioned to exhibit an angled surface that is substantially equivalent to contact surface 173. In this way, the stability of the contact between the bumper 174 and the wedge 172 may be increased and the force applied to the contact surface 173 may be distributed along the larger structural area of the wedge 174. Similarly, in one aspect, the bumper 174 includes a flexible surface, such as an elastic or cushioning surface, to accept the contact surface 173 and reduce component failure. In one form, each resistance member 175 includes a spring 176 positioned between the bumper 174 and the hard stop 178 to provide resistance and deceleration of the drive member 158 at or near the stroke end 158.

  Various aspects of the surgical instrument 10 may be equipped with a plurality of bumpers 174 and resistance members 175, and the bumpers 174 and resistance members 175 may be constructed to contact other portions of the drive member 158. It will be recognized. For example, the instrument 10 may include additional stops that may be added to, or in lieu of, the hard stop 178 and / or soft stop configurations described above. Thus, in one form, referring to FIG. 94, the drive screw 180 has a bumper 290 associated with the resistance member 291 positioned along the drive stroke and opposite the contact surface 292 of the drive member 158. A stop may be provided, which may include a soft stop provided. In one form, the resistance member 291 includes an elastomeric material that may be compressible between the bumper 292 and the hard stop 294 that absorbs the longitudinal force of the drive member 158. In certain aspects, the plurality of soft stops may be configured to contact the drive member 158 at different predetermined positions. For example, in one form, the drive member 158 contacts the bumper 290 in front of the bumper 174 to provide a more distinguishable current spike, for example, generating a current spike that includes two separate current spike components. However, its magnitude and / or temporal separation may be used to increase the certainty of occurrence of current spikes.

  In various forms, the resistance member 175 comprises a compressible portion that may or may not be associated with the hard stop 178. For example, in one aspect, the resistance member 175 may be housed between the hard stop 178 and the bumper 174 and includes a compressible portion such as a spring 176, an elastomeric material such as a polymer, foam, or gel. But you can. In operation, bumper 174 may be accelerated toward the compressible portion upon contact with drive member 158, thereby compressing the compressible portion to a given degree. In various aspects, the resistance member 175 may include a deceleration portion such as a brake. In one aspect, the deceleration member comprises a compressible cell, such as a hydraulic compressed air cell, through which it contacts a drive member 158 to compress a piston positioned within the cell to drive the drive member An increase in pressure configured to decelerate or brake 158 may be applied. In certain aspects, the soft stop may be constructed to add a smooth or gradual resistance and / or deceleration with respect to time and / or distance. For example, one or more coil springs having the same or different compressibility characteristics may be constructed or arranged to precisely control deceleration or braking of the deceleration member, for example, in a gradual or stepwise manner. Good. In one form, the soft stop may be constructed to add a progressive resistance to distal movement of the drive member 158.

  In various forms, the soft stop includes a biasing member configured to bias the contact member away from the hard stop. It will be appreciated that in some aspects the biasing member may be the same as the resistance member 175 or may share similar components. Thus, in some forms, the biasing member is compressed between the bumper 174 and the hard stop 178 by the longitudinal actuation force of the drive member 158 and then returns to the pre-compression state when the force is removed. May be constructed as follows. In certain aspects, the biasing member may be actuable, movable, and / or compressible to oppose the actuating movement of the drive member 158. In particular, compressing or otherwise countering the bias associated with the resistance member 175 provides an energy transfer that may be at least temporarily accumulated or retained by a soft stop at the potential energy position. May be. In one aspect, the resistance member 175 may be maintained in a potential energy position by a latch, hook, or obstacle, which may prevent, for example, one or more resistance members 175 from returning to their pre-compression state. . Beneficially, the stored energy may be released, for example, by the user and / or control system 1400 so that at least a portion of the stored energy is applied and the drive member 158 is returned to the home position.

  In various aspects, the resistance member 175 may have additional configurations. For example, in one aspect, one or more magnets, such as permanent magnets, may be positioned to repel the opposite permanent magnet associated with the drive member 158. For example, the one or more magnets may be rotatable or movable so as to adjust the size of the repulsive magnetic field that opposes longitudinal movement. Various other aspects may use a coil magnet that is electrically coupled to the control system for start-up before or after successful deceleration of the drive member 158. For example, the additional resistance member 175 may include a reciprocating structure including, for example, a configuration that implements a pulley and / or gear.

  In various aspects, a mechanical stop that includes a soft stop may or may not be associated with a hard stop 178. For example, in some forms the soft stop includes a hard stop 178, while in other forms the soft stop does not include a hard stop or the hard stop 178 may operate as an auxiliary stop. In some forms, the soft stop may include a spring loaded hard stop 178 that provides progressive and / or progressive resistance to the drive stroke or deceleration of the drive member 158. For example, a soft stop gradually increases the speed of the drive member 158 by providing resistance to proximal or distal forces applied to the drive member 158 by the drive motor 1402 or present in the inertia of the system. It may be configured to decrease. In at least one form, the magnitude of the resistance provided by the soft stop that counteracts or slows the actuation or drive motion may be selectively adjustable. For example, the instrument 10 may be equipped with one or more soft stops that may be selectively slid or rotated to multiple positions along the drive stroke. Thus, the user may customize the position of the soft stop for a specific application. In one form, an electrochemical device with a soft stop may include an adjustable dial that adjusts the resistance provided by the soft stop along the end of the stroke. In some such forms, adjustment of the dial simultaneously adjusts the longitudinal distance encompassed by the soft stop, and thus the end of the stroke, as well as the threshold associated with the determination of the current spike, as described in more detail below. May be. In one form, a warning signal may be provided to the user when the manual setting is set beyond a predetermined mechanical tolerance.

  Referring again to FIG. 95, in various forms, the control system 1400 may provide feedback information that may be derived, at least in part, from information measured by the control system 1400 or derived from other system components. Configured to and / or respond to it. For example, in one aspect, control system 1400 may be configured to initiate power delivery to system components in response to an input signal, such as a command provided by a user. In certain aspects, the control system 1400 may cause the user to generate or provide information, such as a warning or instrument status, via a user interface, such as a visual or audible display. The signal or input generated by the control system 1400 may be responsive to, for example, other signals or inputs provided by the user, instrument component, or may be a function of one or more measurements associated with the instrument 10. May be. In certain aspects, the control system 1400 may be configured to monitor or receive various measurements and then interpret, calculate, and / or decode information and respond in a predetermined manner.

  In one aspect, the control system 1400 may include or be selectively associated with a semiconductor, computer chip, or memory. As described above, inputs to and from the control system 1400, such as those supplied by the user or generated by the control system 1400 in response to commands, signals, or measurement parameters, may be analog or digital. There may be. Thus, in some forms, the control system 1400 may be configured to send and receive analog or digital inputs or signals to and from instrument components. In various aspects, the control system 1400 may organize the input signal to control and monitor the instrument components using software that may employ one or more algorithms. Such organized input signals may be a function of criteria measured and / or calculated by control system 1400 or, in some examples, operate with another instrument component, user, or control system 1400. Control system 1400 may be provided by a separate system that communicates in a possible manner. For example, the control system 1400 may activate or deactivate the drive motor 1402, terminate and start power to the drive motor 1402 or additional system components, or command or add to these or other operations. You may respond by providing the input. In various aspects, the control system 1400 may comprise circuitry, eg, transistors or switches, configured to monitor electrical parameters associated with the operation of the instrument 10. For example, the control system circuitry may activate or deactivate the drive motor 1402 when an electrical parameter associated with the operation of the instrument 10 reaches a threshold, such as a current spike, determined by the circuitry, or the drive motor. The power delivery path for 1402 may be configured to open or close.

  In certain configurations, surgical instruments 10 and systems that use mechanical stops may operate in an open loop. For example, in one form, the instrument may operate without assistance from a position feedback device configured to provide the control system 1400 with information regarding how the instrument 10 is responding to input. Well, thereby, the control system 1400 may modify the output. In various aspects, as described above, the control system 1400 may monitor power delivery to the drive motor 1402 to determine the end of the stroke position of the drive member 158. That is, for example, the control system 1400 may be verified using a mechanical stop, at least in part, by various voltage monitoring techniques that may determine current, i.e., current spikes. For example, the control system 1400 may monitor the voltage to determine the current for power delivery to the drive motor 1402, ie, to the drive member 148, as described above. Resistance to the drive stroke increases the torque in drive motor 1402, resulting in a detectable current spike in the power delivered to drive motor 1402. Thus, when the drive member 158 contacts the mechanical stop, a high current spike may be measured by the control system 1400, at which point the control system 1400 responds by terminating power delivery to the drive motor 1402. May be. Accordingly, the mechanical stop may initiate a disengagement of the drive motor 1400 by decelerating the drive member 158 and providing a physical force that generates a current spike that may be confirmed by the control system 1400. .

  As described above, in certain aspects, the control system 1400 is configured to control various operations of the device 10. For example, in certain aspects, the control system 1400 includes a control circuit 1406 operably coupled to the drive circuit 1408. The drive circuit 1408 may be configured to deliver power from the power source 1404 to the drive motor 1402 to drive the drive member 158. The control circuit 1406 may be configured to control the delivery of power to the drive circuit 1408. Accordingly, the control circuit 1406 may be configured to control the drive motor 1402 via control over power delivery to the drive circuit 1408. The control circuit 1406 may be further configured to monitor, eg, sample or measure, the power delivered to the drive motor 1402. For example, the control circuit 1406 may sample input / output voltages and / or currents at one or more points in the drive circuit 1408 through which the drive motor 1402 receives power to operate the drive member 158. . In various aspects, the control circuit 1406 may include or be coupled to a drive circuit 1408 through which, for example, across a resistor coupled to a current path associated with the drive circuit 1408. The output voltage may be monitored. Those skilled in the art will appreciate that the above description is just one way to measure and / or monitor the current supplied to drive motor 1402, and that current can be generated by alternative methods known in the art. It will be appreciated that such methods may be measured and / or monitored as well and thus are within the scope of this disclosure. In some forms, the control system 1400 terminates energy delivery to the drive motor 1402 through the drive circuit 1408 when the control circuit 1406 detects a spike of current supplied to the drive motor 1402. In various aspects, the control system 1400 can also disengage an operable coupling, eg, transmission, between the drive motor 1402 and the drive member 158 in response to the measured current spike at least instantaneously. Good.

  In certain configurations, when the electromechanical stop includes a hard stop that is designed to abruptly terminate the drive stroke, the instrument 10 may, for example, detect a current spike followed by a drive motor 1402 provided. May be vulnerable to mechanical failure due to time delays between relaxation from power. Also, due to the inertia of the system, for example, the drive member 158 may also continue to be actuated or driven after reaching the end of the stroke despite ending power delivery to the drive motor 1402. In some examples, a delay in mitigating the actuation force of drive member 158 may drive drive member 158, drive motor 1402, drive screw 180, or other transmission coupling into a mechanical failure.

  FIG. 96 is a graph showing the current over time of the instrument 10 using an electromechanical stop that includes a hard stop 178 without a soft stop. The current between time A corresponding to the position of the drive member 148 near the end of the stroke and time B corresponding to the position of the drive member 158 when contacting the hard stop 178 at the end of the stroke is relatively low or Steady. However, at time B, the current spikes, representing contact between the drive member 158 and the hard stop positioned at the end of the stroke. The drive motor 1402 continues to drive the drive member 158 due to a time lag between the detection of the current spike slightly after time B and the end of power delivery to the drive motor 1402, but when power delivery to the drive member 258 ends. By the time C, it will end unsuccessfully in contact with the hard stop 178. Although not shown, the inertia of the system may also continue to actuate the drive member 158 against a hard stop 178 for a period of time after time C.

As described above, a surgical instrument operating as shown in FIG. 76 while providing the convenience of open loop operation, for example, is the time between detection of a current spike and subsequent relaxation from actuation motion. Delay can be vulnerable to mechanical failure. According to various aspects, referring to FIGS. 97 and 98, the instrument 10 disclosed herein contacts the drive member 148 and decelerates it before reaching the end of the stroke to identify identifiable current spikes. There may be an electromechanical stop with a soft stop structure that induces an increase in the amount of time that the control system 1400 must detect and react to the current spike. Surgical instrument 10 includes various structures similar to those shown in FIGS. 1 and 70, and therefore similar structures are identified using similar numerical identifiers, again for the sake of brevity. It shall not be described. Instrument 10, along the axial center line A-A, proximal home position, or the first soft stop position S ₁ and the distal end of the step extending between the second soft stop position S ₂ Including an electromechanical stop, including a soft stop, opposite the movement of the drive member 158 at or near the end of the drive stroke or segment thereof. The electromechanical stop further includes a hard stop 178 disposed at position H. Soft stop, for example, comprise at least partially the first soft stop position S ₁ and the second soft stop inside position S _2, bumpers 174 and resistor member 175 that is the end or disposed near its stroke. Bumper 174 and resistor member 175, in the end of travel that is defined between the first soft stop position S ₁ and the second soft stop position S _2, functions to provide resistance to the driving member 158 To do. In various embodiments, bumpers 174 and resistor member 175 may also function to decelerate the drive member 158 from the first soft stop position S ₁ to the second soft stop position S _2. In certain forms, the soft stop may be positioned in any preferred position where it is desirable to provide resistance to the drive member 158 or begin to decelerate it.

Figure 97 shows the drive member 158 in the process of extending through the drive stroke at a position near the first soft stop position S _1. Figure 98 is to be positioned in the second soft stop position S ₂ of the end of travel, stroke of the first end soft stop position S ₁ a after extending fully through the drive stroke beyond The drive member 158 is shown. Therefore, soft-stop contacts the driven member 158 in the first soft stop position S _1, then, by compressing the interaction between the hard stop at the position H, the distal side to the second soft stop position S ₂ To be compressed. Accordingly, the second soft stop position S ₂ may include enable hard stop position H ^* to the deepest distal end of the end of the drive member and stroke. In various embodiments, the drive member 158, prior to reaching the hard stop position H ^* in the second soft stop position S _2, may be completely or considerably decelerated. Thus, in such an aspect, if a hard stop exists, it may include a redundant or safety function.

The resistance to the actuating motion provided by the mechanical stop may be accompanied by a deceleration or braking force and may be gradual, progressive or stepped, for example with respect to distance and / or time. That is, in some embodiments, soft stop presents a first soft stop position S ₁ and the path resistance is increased between the second soft stop position S _2. In particular, the end of the stroke, throughout the end of the stroke, for example, to a second soft stop position S _2, does not necessarily suggest that functional operation of the drive member continues. For example, in one form, the end of the stroke is positioned at or slightly near the distal most staple. In another form, the first soft stop position S ₁ example, the position of the soft-stop and first contact, a distal side of the distal-most staple. That is, the drive member 158 does not contact or experience significant resistance to longitudinal movement through the drive stroke until the point when the most distal staples are ejected, where an increase in resistance and / or deceleration may occur. There are things that do not. In this way, the movement of the drive member is not limited early by the action of the control system 1400.

FIG. 75 is a graph illustrating current over time of the instrument 10 using an electromechanical stop including a soft stop according to various aspects. The current between the time A ^* corresponding to the position of the drive member 158 near the end of the stroke and the time B ^* ₀ corresponding to the position of the drive member 158 when in contact with the soft stop, for example at the bumper 174, is compared Low or steady. However, following time B ^* 0, the current begins to gradually spike, representing an increase in resistance to the longitudinal movement of the drive member. In various aspects, the gradual increase in resistance advantageously advantageously increases the time at which a current spike between times B ^* ₀ and B ^* ₂ occurs, giving the control system 1400 a time to react. The response time is effectively slowed so that the adverse effects of the time delay described above with respect to FIG. 96 are minimized. In certain aspects, the control system 1400 may monitor the voltage supplied to the drive motor 1402 and measure the current, as described above. The control system 1400 may be configured to respond in a predetermined manner to changes in current. For example, when a threshold current is reached at time B ^* ₁ , for example, the control system 1400 may end the power supply to the drive motor 1402. In one configuration, the threshold current may include a time component. For example, the threshold current may include a current difference over a specific period. In certain configurations, the current spike may include one of a plurality of predetermined current thresholds, each defined by a ratio of current actuation over a period of time. As can be seen in FIG. 99, the incremental increase in resistance also advantageously reduces the impact load on the end effector 102 and stops distal movement when contacted with a hard stop at time B ^* _2. After that, the period from B ^* ₂ to C ^* in which the drive motor 1402 continues to operate the drive member 158 against the hard stop 178 may be reduced.

  In certain aspects, the control system 1400 may determine that a predetermined current threshold has been achieved, as measured by a current increase or slope over time, and then provided to the drive motor 1402. The power input signal may be terminated. For example, in one configuration, the control system 1400 may monitor the current, thereby terminating power delivery to the drive motor 1402 when the magnitude of the current increases by a predetermined amount over a given period of time. In various aspects, these or other values, such as thresholds, may be adjusted by accessing the protocol on the board via a management link, such as manually by a user or through a computer. In at least one configuration, the drive circuit 1408 or the control circuit 1406 comprises a variable resistor so that the user can vary the current supplied to the drive motor 1402 by varying the degree of actuation relative to the trigger. Good. For example, the rotation of the firing motor 530 may be proportional to the pressure or movement that the user applies to the actuator or trigger. In one form, the control circuit 1406 may communicate with the drive circuit 1408 such that the threshold is increased or desensitized.

  In certain configurations, multiple sensors or electrical components may be used in the end effector 102 to provide various forms of feedback to the user. In one aspect, the sensor may provide feedback to the control system 1400 to automatically control various motors associated with the instrument. For example, in one aspect, the surgical instrument is operable by one or more control systems, such as control systems 800 and 1400, to cause the control motion to be electrically generated, motors 402, 530, 560, and / or Or a plurality of motors such as 610 are provided. The control system may be configured to operably control the motor and receive position feedback from a plurality of sensors configured to monitor position information. In certain aspects, the control system may use position information to electrically generate a modified or modulated control motion via control of power delivery to one or more motors, or, for example, Various position information may be provided to the user. In various aspects, the control system may be operable in a hybrid open / close loop system. For example, the control system 1400 operates a drive motor 1402 such as an open loop firing motor 530 as described herein, while also operating various other motors such as a closed loop shaft rotation motor 610, for example. It may be configured as follows. In one aspect, the control system 1400 allows the user to select which motors the control system 1400 may operate in closed loop or open loop, for example, to customize various operations of the instrument 10 as desired. You may be comprised so that it may select automatically.

  It will be appreciated that one or more inputs may be provided by the user, which may or may not follow the evaluation by the control system 1400. For example, the control system 1400 may transfer and / or provide one or more inputs provided to the control system 1400 to the instrument 10 by one or more users or other control systems in communication with the control system 1400. An override mode may be included. For example, when the drive member 158 is in the home position, the control system 1400 couples the delivery of power to the drive member 1402 or otherwise engages the drive motor 1402 to cause the drive member 158 to operate. Instructions that are generated electrically may be locked out, prevented, or ignored. In at least one aspect, one or more events, such as closure of anvil 190, or component latching, user-initiated override, measured, for example, in, near, or along the path of a drive member, is measured. Lockout occurs or lockout is the default state or condition of the system until the occurrence of appropriate mechanical or electrical feedback, such as a parameter change.

  In various aspects, one or more mechanical stops including a soft stop assembly according to the present disclosure may be provided in the form of a kit. The kit may have a particular use for one or more selected devices, or may be general purpose or amendable for general use for multiple devices. For example, the soft stop assembly kit may include an alternative deceleration member, such as a resistance member, and / or a contact member, such as a bumper. In one form, the kit is used as a housing sized to support a resistance member to increase the resistance provided by the soft stop at one or more positions along the drive stroke, or Includes an alternative or repair bushing that may be insertable therein. In various forms, shims that adjust play between the stop and the body of the device may be provided. In some aspects, the contact member is permanently or replaceable, modifiable, or improved constructed to be disposed between the drive member and the bumper, resistance member, and / or hard stop. Any possible temporary contact guard may be included. The contact guard may be formed from an elastic or other material that is at least partially compressible when the accelerated mass of the drive member contacts or impacts a soft or hard stop. One aspect of the guard may be a polymer that may slide, slide, snap, or molded onto a portion such as a contact surface of the drive member 158. In another aspect, the guard may be fitted or adaptable on the surface of the bumper 174. In yet another aspect, the bumper 174 prevents or partially limits the degree of physical damage or mechanical failure to the drive member 158, drive motor 1402, drive screw 180, or related components. A contact configured to contact the accelerated mass of the drive member 158 and at least partially absorb the force may be provided.

  In some forms, the end effector 102 may be in an articulated or rotational position, preventing the end effector 102 from passing through a trocar or other access point into the patient's body, as shown in FIGS. It may be difficult to remove a surgical instrument such as the surgical instrument 10 shown in FIG. The clinician may be unaware of the current articulation state of the end effector 102, eg, articulated along the articulation axis BB, and without first turning the end effector 102 straight. The appliance 10 may be removed. In various forms, a surgical instrument may be configured such that its end effector is straightened based on input from a sensor (eg, the instrument may have a sensor correction end effector). In this way, the clinician may ensure that the end effector 102 is straight to the articulation axis BB before it is removed from the patient, such as through a trocar. Good. In various forms, the sensor may be configured to trigger an electric straightening event when the end effector is removed from the patient.

  FIG. 105 shows one form of a surgical instrument 5810 that includes a sensor correction end effector 5802. Sensors 5826a, 5826b may detect overall proximal movement of surgical instrument 5810. The overall proximal movement may indicate that surgical instrument 5810 has been removed from the patient, such as through a trocar or overtube. A minimum threshold proximal motion may be set to prevent the end effector 5802 from being straightened by adjusting the surgical instrument 5810 slightly proximally during treatment. In various configurations, when the overall proximal movement of the surgical instrument 5810 exceeds a minimum threshold, the sensors 5826a, 5826b send a signal to a motor, such as the articulation control motor 402, for example, by the motor to cause the end effector 5802. May be straightened.

  In some forms, sensors 5826a, 5826b are located on shaft 5831, end effector 5802, handle 5820, or any other suitable location to detect overall proximal movement of surgical instrument 5810. May be. In various forms, the sensors 5826a, 5826b may include any suitable sensor that detects movement of the surgical instrument 5810. For example, the sensors 5826a, 5826b may include sensors configured to measure acceleration, such as accelerometers. When the accelerometer detects a proximal acceleration above a predetermined threshold, the accelerometer may send a signal to the articulation control motor 402 to initiate the straightening process. As another example, sensors 5826a, 5826b may include proximity sensors, such as magnetic sensors, Hall effect sensors, reed switch sensors, or any other suitable proximity sensor. In various forms, the proximity sensor may be configured to measure the proximity of sensors 5826a, 5826b to a fixed point, such as trocar 5858 or overtube 5960. As the surgical instrument 5810 is withdrawn proximally, the proximity between the sensors 5826a, 5826b and the anchoring point decreases and the sensor 5826a, 5826b signals the articulation control motor 502 to provide an end effector 5802. The electric correction process may be activated. In various forms, multiple sensors may be included to provide a redundant check of the correction process.

  In one form, the first sensor 5826a and the second sensor 5826b may be disposed on the surgical instrument 5810. The first sensor 5826a may be located at the proximal portion of the shaft 5831 and the second sensor 5826b may be located at the distal portion of the shaft 5831. One skilled in the art will recognize that the first and second sensors 5826a, 5826b may be any suitable portion of the surgical instrument 5810, such as the handle 5820, the detachable surgical module, the shaft 5831, or the sensor correction end effector 5802, for example. May be located. In some forms, the first sensor 5826a may include an accelerometer configured to detect an overall proximal movement of the surgical instrument 5810. In some forms, the second sensor 5826b may include a proximity sensor configured to detect a distance between the second sensor 5826b and a fixed point, such as a trocar 5858, for example. In the illustrated form, the trocar 5858 includes a plurality of magnets 5822. The plurality of magnets 5822 may generate a constant magnetic field. The second sensor 5826b may be configured to detect an increase in the strength of the magnetic field indicative of movement of the second sensor 5826b, and thus the sensor correction end effector 5802, toward the trocar 5858.

  In one form, the first sensor 5826a and the second sensor 5826b may be configured to trigger an electric correction process of the sensor correction end effector 5802. In operation, the first sensor 5826a may detect the overall proximal movement of the surgical instrument 5810 by detecting proximal acceleration above a predetermined threshold. The first sensor 5826a may send a first signal to the articulation control motor 402 to activate the electric correction process. In some forms, the second sensor 5826b also detects the overall proximal movement of the end effector by detecting a change in magnetic field strength between the sensor 5826b and a fixed point such as the trocar 5858. The second sensor 5826b may send a second signal to the articulation control motor 402 to initiate an electric correction process that may be performed.

  As shown in FIG. 105, the sensor correction end effector 5802 is articulated at the articulation axis BB (shown in FIG. 1). A sensor correction end effector 5802 may be coupled to the shaft 5831. The operator may move surgical instrument 5810 in the proximal direction and move shaft 5831 and sensor correction end effector 5802 in the proximal direction. Proximal movement may be detected by the first sensor 5826a. The first sensor 5826a may include an accelerometer. The first sensor 5826a may send a signal to an articulation control motor, such as the articulation control motor 402, to initiate an electric correction process. Proximal movement may also be detected by the second sensor 5826b. The second sensor 5826b may include a magnetic proximity sensor such as, for example, a Hall effect sensor or a reed switch sensor. The second sensor 5826b may send a signal to the articulation control motor 402 to initiate an electric correction process. The second sensor 5826b may send a signal to the articulation control motor 402 independently of the first sensor 5826a.

  As the clinician removes surgical instrument 5810 from trocar 5858, the motorized correction process straightens sensor correction end effector 5802. After the motorized correction process is complete, the sensor correction end effector 5802 is in a linear configuration, as shown in FIG. The straightened sensor correction end effector 5802 may be pulled through the trocar 5858 without damaging the patient or trocar 5858 and without the clinician having to manually straighten the sensor correction end effector 5802. Good. In some forms, the surgical instrument 5810 may provide a feedback signal to the user to indicate the activation or progress of the motorized correction process. For example, in some configurations, a light emitting diode (LED) may be located on the handle 5820. The LED may be illuminated during the motorized correction process to provide the user with a visual indication that the motorized correction process is occurring.

  In some forms, the first and second sensors 5826a, 5826b may function as a redundant check of the correction process. For example, in some forms, both the first and second sensors 5826a, 5826b may provide a signal to the articulation control motor 402 to initiate the correction process. The articulation control motor 402 may straighten the sensor correction end effector 5802 by a signal from either the first sensor 5826a or the second sensor 5826b. In some forms, the motorized correction process may not be performed until a signal is received from both the first sensor 5826a and the second sensor 5826b. In some forms, either the first sensor 5826a or the second sensor 5826b may independently activate the electric correction process, but the first and second sensors 5826a, If no signal is received from both 5826b, the process may be aborted. For example, the electric correction process may be triggered by a signal from the first sensor 5826a. If no signal is received from the second sensor 5826b within a predetermined time period, the powered correction process may be aborted by the surgical instrument 5810.

  In some forms, the surgical instrument 5810 may include a stop sensor. The stop sensor may detect contact between the sensor correction end effector 5802 and the tissue compartment during the correction process. If the stop sensor detects contact between the sensor correction end effector 5802 and the tissue compartment, the stop sensor may send a signal to the articulation control motor 402 to deactivate the correction process and prevent damage to the patient. . In some forms, when the stop sensor determines that the sensor correction end effector 5802 is no longer in contact with the tissue portion, the stop sensor may signal the articulation control motor 402 to continue the correction process. . In some forms, the stop sensor may notify the operator that the sensor correction end effector 5802 is in contact with the tissue compartment and the correction process has been deactivated, for example, through a feedback device to the operator. A signal may also be sent. The stop sensor may include, for example, a pressure sensor disposed on the sensor correction end effector 5802.

  107 and 108 show one form of sensor correction end effector 5902. In some forms, sensor correction end effector 5902 may be inserted into the patient through overtube 5960. Overtube 5960 may comprise a magnetic ring 5922 located at the distal end of overtube 5960. The first sensor 5926a and the second sensor 5926b may be configured to detect movement of the sensor correction end effector 5902 when the shaft 5931 is withdrawn from the overtube 5960. In some forms, the first sensor 5926a may include an accelerometer and the second sensor 5926b may include a magnetic proximity sensor. The second sensor 5926b may detect a change in magnetic field strength when the second sensor 5926b is moved proximally toward the magnetic ring 5922. As the second sensor 5926b approaches the magnetic ring 5922, the second sensor 5926b may generate a signal that initiates the electric correction process of the end effector 5902. The second sensor 5926b may include any suitable sensor that senses a change in the magnetic field, such as, for example, a reed switch sensor or a Hall effect sensor. As described above, the first sensor 5926a and the second sensor 5926b may provide a redundant check of the electric correction process. One skilled in the art will recognize that in some forms, only the first sensor 5926a or the second sensor 5926b may be included. In some forms, additional sensors that detect overall proximal movement of the surgical instrument 5910 may be included.

  109 and 110 illustrate one form of a sensor correction end effector 6002 that transitions from an articulated state to a straightened state during removal from the trocar 6058. In FIG. 109, the sensor correction end effector 6002 is in an articulated position with respect to the axis 6031. The clinician may begin to withdraw the sensor correction end effector 6002 through the trocar 6058 in the proximal direction as indicated by arrow “A”. Proximal movement may be detected by the first sensor 6026a, the second sensor 6026b, or both the first and second sensors 6026a, 6026b. The first sensor 6026a may include an accelerometer configured to detect the overall proximal movement of the axis 6031. Second sensor 6026b may include a magnetic sensor configured to detect a change in magnetic field between second sensor 6026b and a fixed point, such as trocar 6058, for example. The trocar 6058 may include a magnet 6022 that generates a magnetic field. As shaft 6031 is withdrawn through trocar 6058, the strength of the magnetic field detected by magnetic sensor 6026b will change in proportion to the distance between magnetic sensor 6026b and magnet 6022. The first sensor 6026a or the second sensor 6026b may generate a signal to the articulation control motor 402 to initiate an electric correction process that straightens the sensor correction end effector 6002 relative to the axis 6831.

  After the motorized correction process is completed, the sensor correction end effector 6002 is in a linear state as shown in FIG. In the linear state, the sensor correction end effector 6002 may be withdrawn through the trocar 6058 without damaging the patient, the trocar 6058, and without the clinician needing to manually straighten the end effector 6002. In some forms, the clinician may be able to ignore the motorized correction process and keep the sensor correction end effector 6002 articulated during removal from the trocar 6058.

  FIG. 111 shows one form of a magnetic ring 6121 that may be attached to a trocar 5858, 6058, or overtube 5960. The magnetic ring 6121 may include a plurality of magnets 6122 that may generate a magnetic field. The magnetic field may be detected by a magnetic sensor disposed on the surgical instrument, such as second sensor 6026b. The magnetic sensor 6026b may be configured to maintain a sensor-correcting end effector such as the end effector 6002 in a straightened state when the magnetic sensor detects a magnetic field generated by the magnetic ring 6121. For example, in one form, the magnetic sensor 6026b may be configured to generate a lockout signal that prevents articulation of the end effector when the magnetic sensor 6026b detects a magnetic field that exceeds a predetermined threshold. The predetermined threshold may be determined based on the strength of the magnetic field generated by the magnetic ring 6121 at a specific distance corresponding to the articulation axis BB located outside the trocar 5858 or the overtube 5960. In some forms, the magnetic sensor 6026b may trigger an electric correction process when the detected magnetic field strength exceeds a predetermined threshold, until the detected magnetic field strength falls below the predetermined threshold, A lockout signal that prevents joint movement of the sensor correction end effector 6002 may be generated.

  112 and 113 show one form of a magnetic sensor 6226 that includes a reed switch sensor. The reed switch may include an electrical switch 6250 that is operated by an applied magnetic field. The pair of contacts may be disposed on a ferrous metal lead in a hermetically sealed glass envelope. The contacts may be normally open and closed when the magnetic field is present, or normally closed and open when a magnetic field is applied.

  Referring now to FIGS. 105 and 106, a method for controlling a sensor correction end effector is disclosed. A method for controlling a sensor correction end effector is described herein with reference to FIGS. 105 and 106, but those skilled in the art will now include, for example, the configurations shown in FIGS. 107-113. It will be appreciated that the method may be used with any of the disclosed sensor correction end effector configurations. In one form, the method may include detecting an overall proximal movement of the surgical instrument 5810 with the first sensor 5826a. Surgical instrument 5810 may include a sensor correction end effector 5802. The clinician may articulate the sensor correction end effector 5802 during treatment. Once treatment is complete, the clinician may move the surgical instrument 5810 proximally and begin to withdraw the surgical instrument 5810 from the patient. Proximal movement of surgical instrument 5810 may be detected by first sensor 5826a. In some forms, the first sensor 5826a may include an accelerometer configured to detect an overall proximal movement of the surgical instrument 5810. The method may further include causing the first sensor 5826a to generate a signal indicating that an overall proximal movement has been detected. The signal may be transmitted by the first sensor 5826a to a controller for the articulation control motor 402, such as, for example, a control circuit such as the control circuit 3702 shown in FIG. Additional motor controllers are provided and described with respect to FIGS. 84, 114-116, and the like. The method receives a signal from the first sensor 5826a by the articulation control motor 402, and activates an electric correction process by the articulation control motor 402 and reacts to the received signal with a sensor correction end effector. It may further include straightening the angle of 5802 articulation. The motorized correction process may return the sensor correction end effector 5802 to a zero articulation state.

  In some forms, the method may further include detecting an overall proximal movement of the surgical instrument 5810 with the second sensor 5826b. In some forms, the second sensor 5826b may include a magnetic proximity sensor, such as a Hall effect sensor or a reed switch sensor. The second sensor 5826b may be configured to detect the distance between the second sensor 5826b and a fixed point such as the trocar 5858 or the overtube 5960. The method of controlling the sensor correction end effector 5802 may include causing the second sensor 5826b to generate a signal indicating that an overall proximal movement has been detected. The second signal may be transmitted to the articulation control motor 402. The method receives a second signal by the articulation control motor 402 and activates an electric correction process by the articulation control motor 402 to straighten the articulation angle of the sensor correction end effector 5802. It may further include. In some forms, the second sensor 5826b may generate a second signal independent of the first sensor 5826a.

  In some forms, the first and second sensors 5826a, 5826b may function as a redundant check of the correction process. For example, in some forms, both the first and second sensors 5826a, 5826b may provide a signal to the articulation control motor 402 to initiate the correction process. The articulation control motor 402 may straighten the sensor correction end effector 5802 by a signal from either the first sensor 5826a or the second sensor 5826b. In some forms, the motorized correction process may not be performed until a signal is received from both the first and second sensors 5826a, 5826b. In some forms, either the first sensor 5826a or the second sensor 5826b may independently activate the electric correction process, but the first and second sensors 5826a, If no signal is received from both 5826b, the process may be aborted. For example, the electric correction process may be triggered by a signal from the first sensor 5826a. If no signal is received from the second sensor 5826b within a predetermined time period, the powered correction process may be aborted by the surgical instrument 5810.

  In one form, various surgical instruments may utilize a modular motor control platform. For example, a modular control platform may be implemented by the control circuit 3702. FIG. 114 illustrates one form of a modular motor control platform 6300 that includes a master controller 6306, one or more motor controller pairs 6309a-6309c. Platform 6300 may control one or more motors 6318a, 6318b, 6318c. The motors 6318a, 6318b, 6318c may be any motor utilized in a surgical instrument. For example, in some forms, one or more of motors 6318a, 6318b, 6318c correspond to one or more of articulation motor 402, firing motor 530, end effector rotation motor 560, and / or shaft rotation motor 610. Also good.

  In various forms, each controller 6306, 6309a-6309c may be implemented utilizing one or more processors (eg, a processor implemented on control circuit 3702). The modular motor control platform 6300 may be suitable for controlling motor controlled surgical instruments, such as the surgical instrument 10 shown in FIGS. 1 and 2, for example. In various configurations, the master controller 6306 may be mounted on the distal circuit board 810 or the proximal circuit board 820. The first motor controller 6314a is operably coupled to the first motor 6318a to provide one or more control signals to the first motor 6318a. The second motor controller 6314b may be operably coupled to the second motor 6318b, and the third motor controller 6314c may be operably coupled to the third motor 6318c. Motor controllers 6314a-6314c are in electrical communication with master controller 6306. Master controller 6306 provides control signals to motor controllers 6314a-6314c based on a main control process that controls one or more functions of end effector 6302. The main control process may be a predefined process, a user-defined process, or a device creation process.

  In one form, the main control process may define one or more surgical procedures that can be performed by the surgical instrument 10 including one or more functions of the shaft 30 and the end effector 102. For example, in one form, the main control process may define the cutting and sealing actions of the surgical instrument 10. The cutting and sealing operations may include multiple functions of the surgical instrument 10, such as, for example, a clamping function, a stapling function, a cutting function, and a clamping relief function. The user may instruct the start of the cutting and sealing operation in any suitable manner, for example, pressing a button or switch on the handle 20. One skilled in the art will appreciate that any suitable input method may be used to activate one or more functions of surgical instrument 10.

  In one form, when the clinician indicates the start of a cutting and sealing operation, such as by pressing a button on the handle 20, the master controller 6306 generates a series of control signals to cause one or more motor controllers 6314a. ˜6314c may be provided with a control signal. For example, the cutting and sealing operation may be started at time t0. The master controller 6306 may generate a first control signal indicating that the clamping function should be performed. The first control signal may be sent to a first motor controller 6314a coupled to the first motor 6318a configured to control the clamping motion of the end effector 6302. The first motor controller 6314a then provides one or more signals to the first motor 6318a to activate the first motor 6318a to compress the tissue located between the anvil assembly 190 and the cartridge 130. The anvil assembly 190 of the end effector 102 may be pivoted to tighten. The master controller 6306 may poll the first motor controller 6314a for a status signal until the first motor controller 6314a indicates that the crimping operation has been completed. At time t1, the first motor controller 6314a may provide a signal to the master controller 6306 indicating that the clamping function has been completed.

At time t _2, a second control signal indicating that it should perform the stapling and cutting operation may be transmitted from the master controller 6306. The second control signal may be sent to a second motor controller 6314b coupled to the second motor 6318b. The second motor 6318b may be configured to control the proximal and distal movement of the cutting portion 164 and / or sled 170 disposed within the end effector 102. The stapling and cutting operation control signal causes the second motor controller 6314b to activate the second motor 6318b to advance the cutting portion 164 and / or sled 170 distally, as described in more detail above. The staple cartridge 130 may be fired and the tissue clamped by the anvil assembly 190 may be cut into the cutting portion 164. At time t ₃ , the cutting portion 164 has reached the most distal point and the second motor controller 6314b may provide a signal to the master controller 6306 indicating that the stapling and cutting operation is complete. The second motor controller 6314b may automatically generate a control signal for the second motor 6318b that reverses the direction of the cutting portion 164 until the cutting portion 164 is fully retracted.

After receiving the signal from the second motor controller 6314b at time t _3, the master controller 6306, a third control signal indicating that the release function is to be performed, providing the first motor controller 6314a Also good. The first motor controller 6314a may generate a control signal for the first motor 6318a, reverse the previous pressing operation by the first motor 6318a, and loosen the pressing of the anvil assembly 190. The release function may be performed simultaneously with the first motor controller 6314a and the first motor 6318a reversing the second motor 6318b and retracting the cutting portion 164 to its starting position. By using the master controller 6306 and the individual motor controllers 6314a, 6314b, the surgical instrument 10 can perform multiple operations simultaneously without undue stress on any of the individual controllers 6306, 6314a, 6314b. It becomes possible.

  Motor controllers 6314a-6314c may include one or more independent processes for monitoring and controlling the surgical procedure, such as, for example, motor movement. In some forms, the motor controllers 6314a-6314c may be configured to operate one or more control feedback loop mechanisms. For example, in some forms, the motor controllers 6314a-6314c may be configured as a closed loop controller, such as a single input single output (SISO) or multiple input multiple output (MIMO) controller. In some forms, the motor controllers 6314a-6314c may operate as proportional integral deviation (PID) controllers. The PID controller may operate the control loop using three tuning terms, a proportional gain term, an integral gain term, and a derivative gain term. The PID controller may include a control process configured to measure a specified variable and compare the measured value of the specified variable to an expected value or set value of the specified variable. The PID controller may adjust the control variable based on the difference between the measured value and the expected value of the designated variable. In some forms, the motor controllers 6314a-6314c may include PID speed controllers. For example, the first motor controller 6314a may measure a specified variable such as the position of the motor 6314a. The first motor controller 6314a may adjust control variables such as the speed of the motor 6314a based on the difference between the measured position of the motor 6314a and the setting or expected position of the motor 6314a.

  In some forms, motor controllers 6314a-6314c may be configured as failure detection controllers. The fault detection controller may operate a fault detection process. In some forms, the fault detection controller performs a direct pattern recognition fault process that includes monitoring one or more sensors configured to directly indicate a fault, sometimes referred to as signal processing based fault detection. It may be operated. In some forms, the sensor value provided by the sensor is compared to an expected value of the sensor derived from a model of the surgical process controlled by the fault detection controller, sometimes referred to as model-based fault detection. One skilled in the art will recognize that a combination of signal processing and model-based fault detection may be used by the motor controller.

  In some forms, the motor controllers 6314a-6314c may be configured as current / force limiting controllers. The current / force limit controller may be configured to limit a measured value, such as a current delivered to the motor or a force exerted by the motor, to a predetermined value. For example, in one form, the first motor controller 6314a may be configured to limit the force exerted during the clamping operation to a predetermined value. The force sensor may monitor the force provided by the first motor 6318a configured to control the clamping action of the surgical instrument. When the force value measured by the force sensor matches a predetermined value, the first motor controller 6314a may stop the operation of the first motor 6318a. In some forms, the motor controllers 6314a-6314c may be configured to monitor the current delivered to the motors 6318a-6318c. The current drawn by the motors 6318a-6318c may indicate one or more functions of the motors 6318a-6318c, such as the speed of the motor or the force exerted by the motor during surgery. If the current drawn by the motors 6318a-6318c exceeds a predetermined threshold, the motor controllers 6314a-6314c may stop the motor operation to prevent damage to the patient and the surgical instrument.

  In some forms, the motor controllers 6314a-6314c may provide independent verification of the main control process performed by the master controller 6306. For example, the motor controllers 6314a-6314c may verify that the action requested by the master controller 6306 is a valid action prior to execution of the requested action. In some forms, the motor controllers 6314a-6314c may use the status information to verify that the requested action is valid. For example, in one form, the first motor controller 6314a may receive an instruction from the master controller 6306 to perform a cutting and stapling operation. The first motor controller 6314a may check the current state of the surgical instrument, for example, checking whether the anvil assembly 190 is in the clamped position. If the status information matches a valid state for performing the cutting and stapling operation, the first motor controller 6314a may perform the cutting and stapling operation. However, if the status information does not match the valid status for cutting and stapling, the first motor controller 6314a may indicate a failure of the master controller 6306 or the main control process. One skilled in the art will recognize that the motor controllers 6314a-6314c may include one or more control processes and one or more types of control processes.

  FIG. 115 shows one form of a modular motor control platform 6400 that includes a master controller 6406 and four motor controller pairs 6409a-6409d. The modular motor control platform 6400 may also be implemented by the control circuit 3702 described herein above, for example using one or more processors. Modular motor control platform 6400 may be configured to control various motors. For example, the distal roll motor 6418a may operate in a manner similar to that described herein with respect to the end effector rotation motor 560. Articulation motor 6418b may operate in a manner similar to that described herein with respect to articulation motor 402. Proximal roll motor 6418c may operate in a manner similar to that described herein with respect to axial rotation motor 610. Transaction motor 6418d may operate in a manner similar to that described herein with respect to firing motor 530.

  Master controller 6406 may be electrically coupled to one or more motor controllers 6414a-6414d. Master controller 6406 may be coupled to one or more motor controllers 6414a-6414d through a wired or wireless connection. In some forms, motors 6418a-6418d may include associated motor encoders 6416a-6416d configured to provide a signal indicative of the position of the motor shaft. In some forms, motor encoders 6416a-6416d may be omitted. In one form, the master controller 6406 may be configured to communicate with any number of motor controllers 6414a-6414d, such as, for example, 1-10 motor controllers. In some forms, the master controller 6406 may be configured to communicate with one or more additional peripheral devices controllers (not shown), where the peripheral devices may be configured with, for example, ultrasound functionality, electrosurgical The function, or any other suitable function of the surgical instrument, may be configured to control one or more non-powered surgical functions.

  In one form, master controller 6406 may communicate synchronously with motor controllers 6414a-6414d. Communication from master controller 6406 may include, for example, providing instructions to execute specific subroutines or functions of motor controllers 6414a-6414d, querying motor controllers 6414a-6414d for status updates, and from motor controllers 6414a-6414d. Receiving feedback information may be included. The synchronous communication may be direct communication between the master controller 6406 and the motor controllers 6414a to 6414d when the communication is time-synchronized. For example, in the form shown in FIG. 114, master controller 6406 may communicate with each of motor controllers 6414a-6414d during a predefined time window. In another form, a token is passed between the motor controllers 6414a-6414d to allow the motor controller 6414a-6414d that currently holds the token for a predetermined period of time to communicate with the master controller 6406. Also good.

  In one form, master controller 6406 may perform a main control process. The main control process may monitor user input, perform an operation of surgical instrument 10, provide feedback to the user, or perform any other function of surgical instrument 10. For example, in one form, the master controller 6406 may perform a main control process that includes cutting and sealing operations. In some forms, the main control process may provide a control signal to each of the motor controllers 6414a-6414d. Execution of individual functions of motors 6418a-6418d may be controlled by motor controllers 6414a-6414d. In some forms, the main control process activates one or more of the motors 6418-6418d based on the installation or removal of modular surgical components, such as the modular shaft 30 or the tool portion 100, or The operation may be stopped. Master controller 6406 may provide control signals to motor controllers 6414a-6414d and may receive status signals from motor controllers 6414a-6414d. The status signal may include, for example, a function completion signal, a failure signal, an idle signal, or a feedback signal.

  In some forms, the function signal may indicate an operation or completion status of a function that can be performed by the motor controller pair 6409a-6409d. For example, the function signal may indicate that a crimping operation is occurring or has been completed. The function signal may also indicate the success of the operation, for example, indicating the amount of force applied by the clamped tissue during the pressing operation. The motor controllers 6414a-6414d may cause a failure signal to be generated when the motor controllers 6414a-6414d detect errors in the associated motors 6418a-6418d or at the completion of the surgical procedure. The failure signal may cause the master controller 6406 to generate a failure signal for the operator, such as a visual indicator or an audible indicator. The fault signal may also be sent by the master controller 6406 to the motor controllers 6414a-6414d to stop any currently executing function.

  The idle signal is provided to the master controller 6406 by the motor controllers 6414a-6414d to indicate that the associated motors 6418a-6418d are idle and may be utilized to perform the associated function of the surgical instrument 10. May be. In one form, the idle signal may indicate that the function was performed by motors 6418a-6418d. For example, in one form, the first motor controller 6414a may receive a control signal from the master controller 6406 to perform a crimping operation. The first motor controller 6414a may convert the control signal from the master controller 6406 into one or more control signals for the motor 6418a. Once motor 6418a performs the indicated function, motor controller 6414a may send an idle signal to master controller 6406 to indicate that motor 6418a has completed the requested function.

  In various forms, the feedback signal may be provided to master controller 6406 by motor controllers 6414a-6414d. The master controller 6406 may have one or more associated feedback devices (not shown) that provide feedback to the operator. Feedback signals received from the motor controllers 6414a-6414d may be converted by the master controller 6406 into control signals for the feedback device. In some forms, the motor controllers 6414a-6414d may provide feedback signals directly to the feedback device.

  In some forms, synchronous communication between the master controller 6406 and the motor controllers 6414a-6414d may be interrupted by an override signal. The override signal may cause the master controller 6406 to stop synchronous communication and communicate with the motor controller 6414a to generate the override signal. In various forms, the override signal may be generated by the motor controller 6414a as a result of a motor failure, an input signal from a user, or based on a predetermined threshold of one or more feedback signals. The override signal may be delayed by the master controller 6406 to each of the motor controllers 6414a-6414d to cease all operations of the motors 6418a-6418d until the condition that resulted in the generation of the override signal is resolved. . In one form, the master controller 6406 may generate a signal for the feedback device to notify the operator of the override signal.

  FIG. 116 illustrates one form of a dual controller modular motor control platform 6500. As described herein, platform 6500 may also be implemented by a control circuit 3702. The dual controller modular motor control platform 6500 includes a master controller 6506, a slave slave controller 6507, and four motor controller pairs 6509a-6509d. Modular motor control platform 6400 may be configured to control motors 6518a, 6518b, 6518c, 6518c. For example, the distal roll motor 6518a may operate in a manner similar to that described herein with respect to the end effector rotation motor 560. Articulation motor 6518b may operate in a manner similar to that described herein with respect to articulation motor 402. Proximal roll motor 6518c may operate in a manner similar to that described herein with respect to axial rotation motor 610. Transaction motor 6518d may operate in a manner similar to that described herein with respect to firing motor 530.

  Modular motor control platform 6400 is configured to control articulation motor 402, firing motor 530, end effector rotation or “distal roll” motor 560, and axial rotation or “proximal roll” motor 610. Also good. Master controller 6506 and slave controller 6507 may each be associated with a subset of available motor controllers. For example, in the illustrated form, master controller 6506 is associated with first and second motor controllers 6526a-6526b, and slave controller 6507 is associated with third and fourth motor controllers 6526c-6526d. Master controller 6506 and slave controller 6507 may be in electrical communication. In some forms, the slave controller 6507 may be located on the distal circuit board 810 or the proximal circuit board 820. Slave controller 6507 may reduce the load on master controller 6506 by reducing the number of motor controllers 6526a-6526d that master controller 6506 must communicate and control. Master controller 6506 and slave controller 6507 may receive one or more controller inputs 6508.

  In one form, the master controller 6506 may provide control signals directly to the first motor controller 6526a and the second motor controller 6526. Master controller 6506 may also provide control signals to slave controller 6507. The slave controller may provide control signals to the third motor controller 6526c and the fourth motor controller 6526d. By reducing the number of motor controllers 6526a-6526d that the master controller 6506 must query and control, the dual controller modular motor control platform 6500 may increase response time or the master controller 6506. The additional processing load may be dedicated to other tasks. In one form, the master controller 6506 may perform a main control process, and the slave controller 6507 may generate one or more signals for the motor controllers 6526a-6526d based on input from the master controller 6506. A process may be performed. In one form, the slave controller 6507 may receive controller input from one or more user controls, such as a clamp button or a fire switch, for example. In one form, the master controller 6506 may communicate with one or more slave controllers 6507 and may not provide any control signals directly to the motor controllers 6526a-6526d.

  In one form, an additional slave controller 6507 may be added to the system to control an additional motor controller or surgical module. In one form, slave controller 6507 may be utilized only when a predefined threshold for the motor controller is required. For example, in the configuration shown in FIG. 115, four motor controllers 6526a-6526d are connected to a dual controller modular motor control platform 6500. Each of the master controller 6506 and the slave controller 6507 is associated with two motor controllers 6526a-6526d. For example, the slave controller may reduce the processing load on the master controller 6506 by deactivating one or more motors, such as by replacing the shaft 30 with a different shaft that is only required for the articulation motor. Since 6507 additional processing power is not required, deactivation of the slave controller 6507 may result. In some forms, the deactivation of one or more motor controllers 6526a-6526d may cause the remaining motor controllers to be assigned to the idle slave controller 6507. For example, the slave controller 6507 may idle by stopping the operation of the third and fourth motors 6518c and 6518d. The second motor controller 6526b may be separated from the master controller 6506 and connected to the slave controller 6507 in order to reduce the processing load on the master controller 6506. One or more load balancing processes may be performed as part of the main control process to ensure an optimal distribution of control between the master controller 6506 and one or more slave controllers 6507.

  Referring again to FIGS. 114-116, a method for controlling a modular surgical instrument 10 comprising a plurality of motor controllers may be disclosed. Although a method for controlling the modular surgical instrument 10 will be discussed with respect to FIGS. 114-116, those skilled in the art will recognize any method of the surgical instrument or the various controls described herein. It will be appreciated that it may be used in relation to the platform. The method may include causing the master controller 6506 to generate a main control process that includes one or more control signals. The method may further include transmitting the generated control signal from the master controller 6506 to one or more motor controllers 6526a-6526d. Motor controllers 6526a-6526d may receive the transmitted control signal. In some forms, the subset of control signals received by the first motor controller 6526a is transmitted by the master controller 6506 during a particular period of time that the master controller 6506 and the first motor controller 6526a are in synchronous communication. A control signal may be included. The method may further include controlling one or more associated motors 6518a-6518d by motor controllers 6526a-6526d based on control signals received from master controller 6506.

  In some forms, the method may include sending one or more control signals by the master controller 6506 to the slave controller 6507. Slave controller 6507 may be in electrical communication with one or more motor controllers 6526c-6526d. The slave controller 6507 may perform a slave control process that includes generating one or more motor control signals based on the input received from the master controller 6506. The slave control process may further include sending a motor control signal by the slave controller 6507 to one or more electrically coupled motor controllers 6526c-6526d. The method may further include controlling one or more associated motors in response to the received motor control signal by motor controllers 6526c-6526d. In various forms, the generated subset of motor control signals may be transmitted synchronously to each of the motor controllers 6526c-6526d for a predetermined period of time.

  FIG. 117 illustrates one form of a main control process 6600 that may be performed by a master controller, such as, for example, the master controller shown in FIGS. 114-116 or any other suitable master controller. In one form, surgical instrument 10 includes, for example, articulation motor 402, firing motor 530, end effector rotation or “distal roll” motor 560, and axial rotation or “proximal roll” motor 610, and joystick 842. For example, four motors may be provided. Surgical instrument 10 may be configured to perform a distal rotation function, a gripping function, a clamping function, and a firing function. Surgical instrument 10 may include one or more buttons for controlling various operations of surgical instrument 10, such as a home button, an unload button, a grip button, a clamp button, or a fire button, for example. Surgical instrument 10 may include light emitting diodes (LEDs) to provide visual feedback to the user regarding the operation of surgical instrument 10.

  In some forms, when the surgical instrument 10 is activated, the master controller 6406 places the device in a default mode. In the illustrated main control process 6600, the default mode is the articulation state 6602. Articulation state 6602 may include activating three of the four available motors. The activated motor may include rotation of the shaft 30 (eg, shaft rotation motor 610), rotation of the end effector 102 (eg, end effector rotation motor 560), and / or articulation of the end effector 102 (eg, articulation motor 410). May be controlled. In the default articulation mode, joystick 842 may be active. In articulation state 6602, joystick 842 may be used to control articulation or rotation of shaft 30 and end effector 102. The distal rotation function may be active (or available), but the gripping, clamping, and firing functions are not available. The home button may also be activated in the default state. The LED may be green to indicate that the surgical instrument 10 is in a state where the surgical instrument 10 may be safely moved.

  When the user presses the home button 6604, the surgical instrument 10 is returned to the home state 6606, for example, the end effector 102 is straightened with respect to the shaft 30, and the shaft 30 and the end effector 102 are returned to the starting state where they are returned to the zero rotation state. May be. Home state 6606 may be useful for moving from one operation to another, or may allow a user to quickly reorient surgical instrument 10 during operation. Once home state 6606 is reached, main control process 6600 may return to default articulation state 6602 (6605).

  In one form, the end effector 102 shown in FIGS. 1 and 2 may be releasably connected to the shaft 30 to allow different tools to be attached to the shaft 30. The shaft 30 may be releasably connected to the handle 20 to allow various shafts to be attached to the surgical instrument 10. In one form, the master controller 6406 may sense the discharge 6608 of the end effector 102 or shaft 30 from the surgical instrument 10 and a new shaft or instrument portion is attached to the surgical instrument 10 and the surgical instrument 10 Surgical instrument 10 may be disabled until is returned to home state 6606. After the main control process 6600 detects the new end effector 102 and returns to the home state 6606, the main control process 6600 may enter the default state 6602.

  In one form, the surgical instrument 10 may have an end effector 102 attached thereto. The end effector 102 may be configured to perform a gripping function. The grasping function may include grasping a region of tissue between the anvil assembly 190 and the cartridge 130 of the end effector 102. The surgical instrument 10 may include a grip button that activates a grip function. When the user presses the grip button (6614), the surgical instrument 10 may enter a grip mode 6616 to lock out movement of the end effector 102, such as rotation or articulation relative to the shaft 30. Gripping mode 6616 may activate a fourth motor (eg, firing motor 530) to grasp the tissue compartment by a portion of the end effector 102, such as moving the anvil assembly 190 from an open position to a closed position. . When the surgical instrument 10 enters the gripping state, the clamping button may be activated.

  In some forms, the clinician may press the clamp button (6620) to cause the surgical instrument 10 to enter the clamp mode 6622. In the clamping mode 6622, the surgical instrument 10 may lock out the fourth motor to prevent the release of subsequent tissue sections during operation. The clamping mode 6622 may activate a firing button on the handle 20. Once the surgical instrument 10 enters the clamping mode 6622, the master controller 6406 changes the LED to blue to fire that the tissue is clamped to the anvil assembly 190 and fire the surgical instrument 10. The clinician may be instructed that stapling and cutting operations can be performed.

  The clinician may press the fire button (6626) to place surgical instrument 10 in fire mode 6628. In firing mode 6628, surgical instrument 10 may deactivate a motor configured to control movement of surgical instrument 10, such as motors 1-3, for example. Firing mode 6628 may activate a fourth motor that may be configurable to control stapling and cutting operations as described above. The firing button is depressed and the master controller 6406 generates a control signal for the motor controller associated with the fourth motor to actuate the stapling and cutting operation, causing the cutting portion 164 and / or sled 170 to move to the end effector. It may be advanced within staple cartridge 130 located within 102. During the firing sequence, the LED may be set to red by the master controller 6406 to inform the clinician that the surgical instrument 10 is firing. The “fired tag” may be set to true by the master controller 6406 to indicate that the surgical instrument has been fired and cannot be fired again. When the cutting portion 164 reaches the distal end of the end effector 102, the master controller 6406, or a motor controller associated with the fourth motor, may retract the cutting portion 164 to the master controller 6406. Once the cutting portion 164 has completed the reversal stroke and returned to its starting position, the main control process 6600 may return to the clamped state 6622 (6630).

  The clinician may deactivate the clamping state 622 by depressing the clamping button (6624). The main control process 6600 generates one or more control signals and returns to the gripping state 6616 when the clamping state 6622 is deactivated. The clinician may then release (6618) the gripping state 6616 and transition to the articulation state 6602 or any other suitable default state. One skilled in the art will recognize that the main control process 6600 may be modified to accommodate any surgical procedure or function that can be performed by the surgical instrument 10 or any attached surgical module. Will do. In some forms, the main control process 6600 may be automatically configured based on the attached shaft, end effector, or power supply module.

  According to one general form, there is provided a surgical instrument comprising a handle assembly configured to electrically generate at least two discrete rotational control movements simultaneously and independently. The surgical instrument is an elongated shaft operatively interfaced with the handle assembly for independently and simultaneously transmitting and receiving at least two discrete rotational control movements relative to an end effector operably coupled to the elongated shaft assembly. An assembly may further be included.

  According to another general form, there is provided a surgical instrument comprising a handle assembly configured to generate at least three discrete rotational control movements simultaneously and independently. The surgical instrument operably interfaces with the handle assembly for independently and simultaneously transmitting and receiving at least three discrete rotational control motions to an end effector operably coupled to the elongate shaft assembly. An assembly may further be included.

  According to another general form, there is provided a surgical instrument comprising a drive system configured to electrically generate a plurality of discrete rotational control movements. The surgical instrument may further include an elongate shaft assembly operably coupled to a drive system that receives the first rotational control motion that rotates the elongate shaft assembly about the axial centerline. The elongate shaft assembly transmits and receives a second rotational control motion from the drive system to a surgical end effector operably coupled to the elongate shaft assembly, with respect to the elongate shaft assembly about the axis centerline. And the surgical end effector may be configured to rotate. The elongate shaft assembly transmits and receives a third rotational control motion from the drive system to an articulation joint in communication with the elongate shaft assembly and the surgical end effector to produce an articulation axis that is substantially transverse to the axis centerline. It may be further configured to articulate the surgical end effector about the center.

  According to yet another general form, an articulation joint for a surgical instrument comprising an elongate shaft assembly and a drive system configured to generate and apply a plurality of rotational control motions to the elongate shaft assembly. Is provided. In at least one form, the articulation joint is configured to interface with a surgical end effector and a proximal coupling portion coupled to the elongate shaft assembly, movably coupled to the proximal coupling portion. A distal joint portion. The first gear train may be operatively interfaced with a proximal firing shaft portion of the elongated shaft assembly. The distal firing axis is operatively interfaced with the surgical end effector to transmit rotational firing motion from the proximal firing axis to the surgical end effector and to the distal fitting relative to the proximal fitting portion Partial articulation may be facilitated. The second gear train is operatively interfaced with the proximal rotational shaft portion of the elongate shaft assembly to transmit distal rotational control motion to the surgical end effector to transfer the surgical end effector to the elongate shaft assembly. It may be rotated relative to and facilitate articulation of the distal joint portion relative to the proximal joint portion.

  According to another general form, an articulation joint for a surgical instrument having an elongate shaft assembly and a drive system configured to generate and apply a plurality of rotational control motions to the elongate shaft assembly. Provided. In at least one form, the articulation joint is proximal with a proximal clevis coupled to the elongate shaft assembly and an articulation axis substantially transverse to an axial centerline defined by the elongate shaft assembly. And a distal clevis that is pivotally pinned to the proximal clevis for selective pivoting relative to the clevis. The first gear train is defined between the proximal and distal clevises such that no portion of the first gear train extends radially outward beyond any portion of the articulation joint. May be supported in the gear section. The first gear train may be operatively interfaced with a proximal firing shaft portion of the elongated shaft assembly. The distal firing axis is operatively interfaced with the surgical end effector to transmit rotational firing motion from the proximal firing axis to the surgical end effector and to pivot the distal clevis relative to the proximal clevis. Dynamic movement may be facilitated. The second gear train may be supported within the gear section such that no portion of the first gear train extends radially outward beyond any portion of the articulation joint. The second gear train is operatively interfaced with the proximal rotational shaft portion of the elongate shaft assembly to transmit distal rotational control motion to the surgical end effector to transfer the surgical end effector to the elongate shaft assembly. It may be rotated relative to and facilitate the articulation of the distal clevis relative to the proximal clevis.

  According to another general form, a surgical instrument is provided that includes a drive system configured to generate a plurality of rotational control movements. The elongate shaft assembly may include an outer shaft segment operably interfaced with the drive system and operatively interfaced with the drive system to receive distal rotational control motion therefrom. The articulation axis may be operatively interfaced with the drive system to receive rotational articulation therefrom. The elongate shaft assembly may further include a proximal firing shaft segment that is operatively interfaced with the drive system and receives rotational firing motion therefrom. The surgical instrument is selectively pivoted about a proximal clevis coupled to the elongate shaft assembly and an articulation axis that traverses an axial centerline defined by the elongate shaft assembly into the substantial fluid. It may further include an articulation joint that may include a distal clevis pivotally pinned to the proximal clevis for movement. The coupling assembly may be configured to rotationally interface with the distal clevis and to be attached to the surgical end effector. The distal firing axis segment may be operatively supported on the coupling assembly and configured to interface with the drive shaft portion of the surgical end effector. The first gear train is operatively interfaced with the proximal firing axis segment and the distal firing axis segment to transmit rotational firing motion from the proximal firing axis segment to the distal firing axis segment. It may be possible to selectively pivot the distal clevis relative to the proximal clevis. The second gear train is operably interfaced with the proximal rotational axis to transmit distal rotational control motion to the coupling assembly and selectively transmits the distal clevis relative to the proximal clevis. It may be possible to pivot. The articulation drive link is interfaced with the articulation axis and the distal clevis and is forced to move axially relative to the articulation joint in response to applying rotational articulation to the articulation axis. Also good.

  According to yet another general form, an articulation joint supported in an elongated shaft assembly of a surgical instrument operably coupled to a surgical end effector having at least one end effector conductor therein. A cover is provided. In at least one form, the cover includes a non-conductive hollow body having an open distal end and an open proximal end, and a joint receiving passage extending therebetween for receiving an articulation joint therein. Prepare. The hollow body is configured to substantially encapsulate the portions within the hollow body while allowing multiple portions of the articulation joint to be selectively articulated relative to each other. At least one conductive path extends from the distal end of the hollow body to the proximal end of the hollow body. Each of the at least one conductive path includes a distal end portion configured to electrically contact a corresponding end effector when the end effector is coupled to the elongated shaft assembly, and a corresponding shaft of the elongated shaft assembly. A proximal end portion configured to be in electrical contact with the conductor.

  According to another general form, a surgical instrument is provided that includes an elongate shaft assembly having at least one electrical shaft conductor and an articulation joint therein. In at least one form, the articulation joint includes a proximal joint portion coupled to the elongate shaft assembly. The distal joint portion is movably coupled thereto for selective articulation relative to the proximal joint portion. The coupler assembly is rotatably coupled thereto for selective rotation relative to the distal joint portion. The coupler assembly may be detachably coupled to the surgical end effector and configured to form a conductive coupler path from the end effector conductor in the end effector to the articulation joint. The surgical instrument may further include an articulation conductor that contacts the conductive coupler path and traverses the articulation joint to contact a corresponding axial conductor to form a conductive path therebetween.

  According to another general form, a surgical instrument is provided that includes a control system that includes at least one electrical control component. The surgical instrument further includes an elongate shaft assembly having an electrical shaft conductor in operative communication with at least one of the electrical control components. The surgical instrument further includes an articulation joint including a proximal clevis coupled to the elongate shaft assembly. The distal clevis is pivotally coupled thereto for selective pivoting relative to the proximal clevis. The surgical instrument may further include a coupler assembly coupled to the distal clevis and a surgical end effector releasably coupled to the coupler assembly. The surgical end effector includes an end effector conductor configured to be in electrical contact with a conductive coupler path formed in the coupler assembly when the surgical end effector is coupled to the coupler assembly. May be included. The articulated joint conductor may traverse the articulated joint and be in electrical contact with a conductive path through the coupler assembly and the shaft conductor.

  According to yet another general form, a surgical instrument is provided that includes a handle assembly that is configured to be operably coupled to an elongate shaft assembly and operatively attached to a surgical end effector. The motor is supported by the handle assembly and applies rotational motion to one of the elongated shaft or the surgical end effector coupled thereto. The thumbwheel control assembly is operably supported on the handle assembly and communicates with the motor so that when the actuator portion of the thumbwheel control assembly is pivoted in the first direction, the motor When one of the end effectors is rotationally moved in a first direction and the actuator portion is pivoted in the second direction, the motor rotates in the second direction to one of the elongated shaft assembly and the end effector. Add exercise.

  According to another general form, a surgical instrument is provided that includes a handle assembly, wherein an elongate shaft assembly is rotatably coupled and configured to be operably attached to a surgical end effector. The motor is supported by the handle assembly and is configured to apply rotational motion to the elongate shaft assembly for selective rotation about the shaft centerline. The surgical instrument further includes a thumbwheel control assembly that includes a thumbwheel actuator member that is pivotally supported relative to the handle assembly. The first magnet is supported on the thumbwheel actuator member and the second magnet is supported on the thumbwheel actuator member. When the thumbwheel actuator member is in the inoperative position, the fixed sensor is centrally disposed between the first and second magnets. The fixed sensor is configured such that when the thumbwheel actuator pivots in a first direction, the motor applies rotational movement in the first direction relative to the elongated shaft assembly, and when the thumbwheel actuator pivots in the second direction, the motor Communicates with the motor to apply rotational motion in a second direction relative to the elongated shaft assembly.

  According to another general configuration, the surgical device is rotatably coupled so that the end effector may be selectively rotated relative to the elongated shaft assembly about the axial centerline. A surgical instrument is provided that includes a handle assembly configured to be operably attached to a surgical end effector. The motor is supported by the handle assembly and selectively rotates about the axis centerline so as to apply a rotational motion to the end effector or to the coupler portion of the elongated shaft assembly to which the end effector is coupled. Composed. The surgical instrument further includes a thumbwheel control assembly that includes a thumbwheel actuator member that is pivotally directed relative to the handle assembly. The first and second magnets are supported on the thumbwheel actuator member. A fixed sensor is centrally disposed between the first and second magnets when the thumbwheel actuator member is in the inoperative position. The fixed sensor causes the motor to rotate in the first direction to the end effector or coupler portion when the thumb wheel actuator is pivoted in the first direction, causing the thumb wheel actuator to pivot in the second direction. And the motor communicates with the motor to apply a rotational motion in a second direction to the end effector or coupler portion.

  According to yet another general form, a surgical instrument is provided that includes a housing that supports a plurality of motors. The surgical instrument includes a first switch assembly that is movably supported by a housing and is pivotally moved by a joystick relative to the first switch assembly relative to at least one of the motors in communication therewith. It further includes a joystick control assembly in which the joystick is movably mounted so that at least one corresponding control signal is sent. The joystick assembly includes a first sensor and a second sensor, and at least one for another one of the motors in communication therewith by moving the second sensor relative to the first sensor. It further includes a second switch assembly that is movable with the first switch assembly such that two other control signals are sent.

  According to another general form, a surgical instrument is provided that includes a handle assembly on which an elongate shaft assembly is rotatably supported. The proximal roll motor is supported by the handle assembly and is configured to apply a proximal rotational motion relative to the elongated shaft assembly to rotate the elongated shaft assembly relative to the handle assembly about the axis centerline. The The surgical end effector is operably coupled to the elongate shaft assembly and is configured to perform a surgical procedure upon application of at least one firing motion. The firing motor is supported by the handle assembly and is configured to apply a firing motion transferred to the surgical end effector to a portion of the elongate shaft assembly. The surgical instrument includes a first switch assembly that is movably supported by a handle assembly, and pivoting movement of the joystick relative to the first switch assembly causes at least one corresponding control signal to be transmitted to the proximal roll motor. It further includes a joystick control assembly on which the joystick is movably mounted for delivery. The joystick control assembly includes a first sensor and a second sensor such that at least one other control signal is sent to the firing motor as the second sensor moves relative to the first sensor. And a second switch assembly movable with the first switch assembly.

  In accordance with another general form, a surgical instrument is provided that includes a handle assembly with an elongate shaft assembly rotatably supported thereto. The surgical instrument further includes an articulation joint comprising a proximal joint portion coupled to the elongate shaft assembly and a distal joint portion movably coupled to the proximal joint portion. The articulation motor is supported by the handle assembly and is configured to apply articulation to the articulation joint to move the distal coupling portion relative to the proximal coupling portion. The surgical end effector is operably coupled to the elongate shaft assembly and is configured to perform a surgical procedure upon application of at least one firing motion. The firing motor is supported by the handle assembly and is configured to apply a firing motion transferred to the surgical end effector to a portion of the elongate shaft assembly. The surgical instrument includes a first switch assembly that is movably supported by a handle assembly, and pivoting movement of the joystick relative to the first switch assembly sends at least one corresponding control signal to the articulation motor. As such, it further includes a joystick control assembly in which the joystick is movably mounted. The joystick control assembly includes a first sensor and a second sensor such that at least one other control signal is sent to the firing motor as the second sensor moves relative to the first sensor. And a second switch assembly movable with the first switch assembly.

  According to another general form, a surgical instrument is provided that operates on tissue. The instrument comprises at least one processor and operatively associated memory, at least one motor in communication with the processor, and at least one actuation device. The processor is programmed to receive a first variable describing the removable tool from the removable tool portion. The processor is also programmed to add the first variable to the instrument control algorithm. Further, the processor receives the input control signal from the drive device and is programmed to control at least one motor that operates the surgical instrument in conjunction with the removable instrument according to an instrument control algorithm that takes the input control signal into account. Is done.

  According to an additional general form, the processor may be programmed to receive from the removable tool a tool control algorithm that describes the operation of the surgical instrument associated with the removable tool. The processor also receives an input control signal from the actuation device and is programmed to control at least one motor that operates the surgical instrument in conjunction with the removable tool according to the tool control algorithm taking the input control signal into account. May be.

  According to another general form, a surgical instrument configured to relay a low power signal from an end effector to a remote device may be disclosed. The surgical instrument may include a handle, a shaft extending distally from the handle, and an end effector attached to the distal end of the shaft. The sensor may be disposed in the end effector. The sensor may generate a signal indicative of a condition at the end effector. The transmitter may be located in the end effector. The transmitter may transmit a signal from the sensor at the first power level. The signal may be received by a relay station in the handle of the surgical instrument. The relay station is configured to amplify the signal and retransmit at a second power level that is higher than the first power level.

  According to additional general aspects, a relay station may be disclosed that relays a signal from a surgical instrument end effector to a remote device. The relay station includes a receiver configured to receive a signal from a sensor disposed on the end effector. The signal is transmitted at a first power level. The relay station further comprises an amplifier configured to amplify the signal to a second power level. The transmitter is configured to transmit the signal at the second power level. The second power level is higher than the first power level.

  According to a general form, a method for relaying a signal received from a sensing module in an end effector may be disclosed. The method includes causing a sensor to generate a first signal indicative of a condition at the surgical end effector. The sensor is located in the end effector. The method further includes transmitting a first signal at a first power level using a transmitter and receiving the transmitted signal at a relay station using a receiver. The first signal is amplified to a high power signal including the second power level by the relay station using an amplifier. The second power level is higher than the first power level. The high power signal is transmitted at the second power level using the relay station. The high power signal is received by a remote device such as a video monitor. The video monitor displays a graphical representation of the condition at the surgical end effector.

  Some parts of the above are presented in terms of methods of operation and symbolic representations for data bits in computer memory. These descriptions and representations are the means by which those skilled in the art will most effectively convey the substance of their work to others skilled in the art. The method is also considered herein and generally a consistent series of actions (commands) that lead to the desired result. The action requires physical manipulation of physical quantities. Usually, though not necessarily, these quantities take the form of electrical, magnetic, or optical signals capable of being stored, transferred, combined, compared, or otherwise manipulated. In some cases, it is convenient to refer to these signals as bits, values, elements, characters, terms, numbers, etc. mainly for general application reasons. Further, in some cases, it is convenient to refer to a specific configuration of actions that require physical manipulation of physical quantities as modules or code devices without compromising universality.

  Certain aspects of the present invention include process steps and instructions described herein in the form of a method. The process steps and instructions of the present invention can be embodied in software, firmware, or hardware, and when embodied in software, can be downloaded to different platforms used by various operating systems. Note that it can be resident and run from there.

  The present invention also relates to an apparatus for performing the operations herein. This apparatus may be specially constructed for the required purposes, or it may comprise a general purpose computer selectively activated or reconfigured by a computer program stored in the computer. Such a computer program includes a floppy disk, an optical disk, a CD-ROM, a magneto-optical disk, a read only memory (ROM), a random access memory (RAM), an EPROM, an EEPROM, a magnetic or optical card, and an application specific integrated circuit (ASIC). Or any type of medium suitable for storing electronic instructions, each stored on a computer readable storage medium, such as, but not limited to, any type of disk coupled to a computer system bus May be. Further, the computers and computer systems referred to herein may include a single processor or an architecture that uses multiple processor designs to accommodate increased computing power.

  The methods and displays presented herein are not inherently related to any particular computer or other apparatus. Various general purpose systems may also be used with the program according to the teachings herein, or it may prove convenient to build a more specialized device to perform the required method actions. . The required structure for a variety of these systems will appear from the description above. In addition, the present invention is not described with respect to any particular programming language. Various programming languages may be used to implement the teachings of the invention as described herein, and any reference above to a particular language refers to the usability and best mode of the invention. Will be understood to be used to disclose.

  In various forms, a surgical instrument configured to relay a low power signal from an end effector to a remote device is disclosed. The surgical instrument may include a handle, a shaft extending distally from the handle, and an end effector attached to the distal end of the shaft. The sensor may be disposed in the end effector. The sensor may generate a signal indicative of a condition at the end effector. The transmitter may be located in the end effector. The transmitter may transmit a signal from the sensor at the first power level. The signal may be received by a relay station in the handle of the surgical instrument. The relay station is configured to amplify the signal and retransmit at a second power level that is higher than the first power level.

  In various forms, a relay station is disclosed that relays signals from a surgical instrument end effector to a remote device. The relay station includes a receiver configured to receive a signal from a sensor disposed on the end effector. The signal is transmitted at a first power level. The relay station further comprises an amplifier configured to amplify the signal to a second power level. The transmitter is configured to transmit the signal at the second power level. The second power level is higher than the first power level.

  In various aspects, a method for relaying a signal received from a sensing module in an end effector is disclosed. The method includes causing a sensor to generate a first signal indicative of a condition at the surgical end effector. The sensor is located in the end effector. The method further includes transmitting a first signal at a first power level using a transmitter and receiving the transmitted signal at a relay station using a receiver. The first signal is amplified to a high power signal including the second power level by the relay station using an amplifier. The second power level is higher than the first power level. The high power signal is transmitted at the second power level using the relay station. The high power signal is received by a remote device such as a video monitor. The video monitor displays a graphical representation of the condition at the surgical end effector.

  In various forms, a sensor correction end effector is disclosed. The sensor correction end effector may include an end effector coupled to the shaft at an articulation point. The end effector may be articulatable at an angle with respect to the axis. The sensor may be disposed on a sensor correction end effector, such as on an axis or on an end effector. The sensor is configured to detect an overall proximal movement of the surgical instrument. Upon detecting an overall proximal movement, the sensor generates a signal that controls the motor to straighten the end effector relative to the axis.

  In various forms, a surgical instrument comprising a sensor correction end effector is disclosed. The surgical instrument may comprise a handle. The shaft may extend distally from the handle. A motor may be disposed in the handle to control the articulation of the surgical instrument. An articulating end effector is disposed at the distal end of the shaft. The sensor may be disposed in the handle, shaft, or end effector. The sensor may be configured to detect an overall proximal movement of the surgical instrument. When the sensor detects an overall proximal movement, the sensor may initiate a motorized correction process to straighten the articulated end effector by the motor. In some forms, multiple sensors may provide a redundant check for the correction process.

  In various forms, a method of operating a surgical instrument comprising a sensor correction end effector is disclosed. The method may include detecting proximal movement of the surgical instrument with the first sensor. The first sensor may be located in any suitable section of the surgical instrument, such as a handle, shaft, or end effector. The first sensor may be an accelerometer, a magnetic sensor, or any other suitable sensor type. The sensor may generate a signal indicating that an overall proximal movement is being detected. The method may further include receiving a signal generated by the motor from the first sensor. The motor may straighten the articulation angle of the motor controlled articulation end effector in response to the received signal. The second sensor may generate a second signal that provides a redundancy check.

  In various forms, the present disclosure is directed to a motor driven surgical instrument comprising a modular motor control platform. The master controller may perform a main control process that controls one or more operations of the surgical instrument. The first motor controller and the second motor controller may be operably coupled to the master controller. The first motor controller may have an associated first motor and the second motor controller may have an associated second motor. The main control process may generate control signals for the first and second motor controllers. The first and second motor controllers may operate the first and second motors in response to the control signal. In some forms, the modular motor control system comprises a slave controller configured to control one or more of the motor controllers based on one or more control signals received from the master controller by the slave controller. Also good.

  In various forms, the modular motor control system may comprise one or more motor controllers each having an associated motor. One or more motor controllers may be in communication with the master controller. The master controller may be configured to provide control signals to the motor controller as part of the main control process. The motor controller may control the associated motor in response to the received control signal. In some forms, the one or more motor controllers and associated motors may be located in a handle adapted to receive a modular shaft, a modular end effector, and a modular power source. The handle may provide an interface between the motor and the modular shaft and end effector.

  In various forms, the surgical instrument may include a modular motor control system. The surgical instrument may comprise a master controller. The surgical instrument may be configured to receive modular surgical components such as a modular shaft and tool portion. The surgical instrument may have one or more motors and associated motor controllers mounted therein. The motor controller may be operably coupled to the motor. The motor may be configured to control one or more movements of the attached shaft or tool portion. The master controller and the motor controller may be in electrical communication. The master controller may be configured to provide one or more control signals to the motor controller as part of the main control process. The motor controller may control the motor in response to the received control signal.

  In various forms, a method for controlling a motor-driven surgical instrument is disclosed. The method may include generating one or more control signals by a master controller. The first control signal may be transmitted to a first motor controller configured to control the first motor. The first motor controller may operate the first motor in response to the first control signal received from the master controller. The second control signal may be transmitted to a second motor controller configured to control the second motor. The second motor controller may operate the second motor in response to the second control signal received from the master controller. In some forms, the second control signal may be generated by a slave controller.

  According to one general form, there is provided a surgical instrument comprising a drive motor and a drive member movable by the drive motor through a drive stroke between a home position and an end of the stroke position. . The end of the stroke position extends between the first position and the second position. The mechanical stop may be disposed at or near the end of the stroke position and is constructed to increase resistance to movement of the drive member through the drive stroke from the first position to the second position. Also good. The mechanical stop may comprise a bumper and a resistance member. The bumper may be movable from the first position to the second position, and may be configured to contact the drive member at the first position. The resistance member may be operably coupled to the bumper and configured to increase resistance to movement of the drive member from the first position to the second position. The resistance member may be configured to decelerate the drive member before actuating the drive member to the second position. In one form, the resistance member is constructed to be compressible to progressively increase resistance to movement of the drive member between the first position and the second position. The resistance member may include a spring in one form. The bumper may comprise a contact surface that is sized to complement the dimensions of the drive member surface that contacts in the first position.

  In one form, the control system is configured to detect a current spike that is associated with an increase in resistance to movement of the drive member. The control system may monitor the voltage associated with the delivery of power to the drive motor to detect current spikes. The current spike may include a predetermined threshold current. The predetermined threshold current may include at least one predetermined threshold current difference over at least one defined period. When the control system detects a current spike, the delivery of power to the drive motor may be interrupted. In one form, the mechanical stop may further include a hard stop that may prevent the drive member from moving beyond the second position.

  According to one general form, a mechanical stop for use in a surgical instrument is provided that generates a detectable current spike associated with an electromechanical stop. For example, the mechanical stop may be disposed at or near the end of a stroke associated with the drive stroke of the drive member. The end of the stroke may extend between the first position and the second position. The mechanical stop may comprise one or more bumpers and one or more resistance members. The bumper may be movable from the first position to the second position, and may be configured to contact the drive member at the first position. The resistance member may be operably coupled to the bumper and configured to increase resistance to movement of the drive member from the first position to the second position to generate a current spike. The resistance member may be configured to decelerate the drive member before actuating the drive member to the second position. One or more of the resistance members may be constructed to be compressible to progressively increase resistance to movement of the drive member between the first position and the second position. The one or more resistance members may also be constructed to be compressible and may include at least one spring. The bumper may comprise a contact surface that is sized to complement the dimensions of the drive member surface that contacts in the first position. The current spike associated with the increase in resistance may be detectable by a control system associated with the electromechanical surgical instrument. The control system may be configured to monitor a voltage associated with delivery of power to the drive motor and interrupt delivery of power to the drive motor when the current spike includes at least one predetermined threshold current. The at least one threshold current may include a current difference over at least one defined period. In one form, the mechanical stop further includes a hard stop that prevents the drive member from moving beyond the second position.

  The devices disclosed herein can be designed to be discarded after a single use, or can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembling the device, followed by cleaning or replacing certain parts, and subsequent reassembly. In particular, the device can be disassembled and any number of the particular parts or parts of the device can be selectively replaced or removed in any combination. When cleaning and / or replacing certain parts, the device can be reassembled for later use either at a reconditioning facility or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of the device can utilize various techniques of disassembly, cleaning / replacement, and reassembly. Such techniques, and the use of the resulting reconditioned device, are all within the scope of the present invention.

  Preferably, the invention described herein will be processed before surgery. Initially, a new or used instrument is obtained and cleaned as necessary. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument are then placed in a radiation field that can penetrate the container, such as gamma rays, x-rays, and high energy electrons. Radiation kills bacteria on the instrument or in the container. The sterilized instrument can then be stored in a sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility.

  Any patents, publications, or other disclosure materials described as incorporated herein by reference may, in whole or in part, include existing definitions, claims, Or to the extent that they are not inconsistent with other disclosed materials. As such, and to the extent necessary, the disclosure explicitly described herein takes precedence over any conflicting material incorporated herein by reference. Any material or portion thereof described as incorporated herein by reference, but inconsistent with the existing definitions, claims, or other disclosed materials described herein, It shall be incorporated only to the extent that there is no conflict with the disclosed material.

  While this invention has been described as having an exemplary design, the present invention may be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles. Furthermore, this application is intended to cover such deviations as they become known or customary in the field to which this invention pertains.

Embodiment
(1) a surgical instrument acting on tissue,
At least one processor and operatively associated memory;
At least one motor in communication with the processor;
At least one actuating device;
The processor is
Receiving from the removable tool portion a first variable describing the removable tool;
Applying the first variable to an instrument control algorithm;
Receiving an input control signal from the actuating device;
Surgical instrument programmed to control the at least one motor to operate the surgical instrument in conjunction with the removable instrument according to the instrument control algorithm taking into account the input control signal .
The surgical instrument of claim 1, wherein the removable instrument includes an end effector.
(3) The first variable is selected from the group consisting of a variable describing the length of the end effector, a variable describing the curvature of the end effector, and a variable describing an energy element of the end effector. The surgical instrument of embodiment 2, wherein at least one value is described.
(4) applying the first variable to the instrument control algorithm activates to fire the end effector, a motor selected from the at least one motor, and an amount by which the motor is to be activated The surgical instrument of embodiment 2, comprising deriving.
(5) the end effector includes an energy element, and applying the first variable to the instrument control algorithm includes deriving when to provide energy to the energy element with respect to a firing stroke of the end effector. The surgical instrument of claim 2.

6. The surgical instrument of embodiment 1, wherein the removable tool includes a removable shaft.
(7) The first variable is a variable indicating the length of the shaft, a variable describing the curvature of the shaft, a variable describing a joint joint of the shaft, a variable describing the rotation of the shaft, and the shaft Embodiment 7. The surgical instrument of embodiment 6, wherein the surgical instrument describes at least one value selected from the group consisting of variables describing the rotation of the end effector supported by.
The surgical instrument of embodiment 1, wherein the removable tool includes a power cord.
(9) The first variable is a variable describing a power source configured to be attached with the power cord, a variable describing an energy element generator configured to be mounted with the power cord, and the power cord Embodiment 9. The surgical instrument of embodiment 8, wherein the surgical instrument describes at least one value selected from the group consisting of: instructions for a power supply to which the power cord is attached;
(10) The removable tool includes a radio frequency identification (RFID) device, and the processor is further programmed to query the RFID device and receive the first variable describing the removable tool. The surgical instrument of embodiment 1, wherein receiving includes a reflected signal from the RFID device.

The surgical instrument of claim 1, wherein the removable instrument includes a data storage component that stores the first variable.
(12) An implementation wherein a wired connection exists between the processor and the removable device, and wherein the at least one processor is further programmed to request the first variable via the wired connection. The surgical instrument according to aspect 11.
(13) The processor
Receiving from a second removable tool a second variable describing the second removable tool;
Further programmed to apply the second variable to the instrument control algorithm, controlling the at least one motor to operate the surgical instrument is also associated with the second removable instrument The surgical instrument of embodiment 1, wherein
(14) a surgical instrument acting on tissue,
At least one processor and operatively associated memory;
At least one motor in communication with the processor;
At least one actuating device;
The processor is
Receiving from a removable tool a tool control algorithm that describes the operation of the surgical instrument in conjunction with the removable tool;
Receiving an input control signal from the actuating device;
Surgical instrument programmed to control the at least one motor to operate the surgical instrument in conjunction with the removable instrument according to the instrument control algorithm taking into account the input control signal .
(15) The processor is
Receiving from a second removable tool a second tool control algorithm describing the operation of the surgical instrument in conjunction with the second removable tool;
Control the at least one motor to operate the surgical instrument in conjunction with the removable tool and the second removable tool according to the tool control algorithm and the second tool control algorithm. Embodiment 15. The surgical instrument of embodiment 14, further programmed as described above.

16. The surgical instrument of embodiment 15, wherein the removable tool is an end effector and the second removable tool is a power cord.
The surgical instrument of claim 15, wherein the processor is further programmed to reconcile the tool control algorithm and the second tool control algorithm.
(18) The reflected signal from the RFID device wherein the removable tool includes a radio frequency identification (RFID) device and the processor is further programmed to query the RFID device and receive the tool control algorithm Embodiment 15. The surgical instrument of embodiment 14, comprising receiving.
The surgical instrument of claim 14, wherein the removable instrument includes a data storage component that stores the first variable.
(20) An implementation wherein a wired connection exists between the processor and the removable device, and wherein the at least one processor is further programmed to request the first variable via the wired connection. The surgical instrument according to aspect 14.

Claims (18)

A surgical instrument acting on tissue,
At least one processor;
At least one motor in communication with the processor;
At least one actuating device;
The processor is
Receiving a first variable describing the removable tool from a removable tool;
Applying the first variable to an instrument control algorithm;
Receiving an input control signal from the actuating device;
Programmed to control the at least one motor to operate the surgical instrument in conjunction with the removable tool in accordance with the instrument control algorithm taking into account the input control signal ;
The processor is
A second variable describing the second removable tool can be received from a second removable tool;
Further programmed to apply the second variable to the instrument control algorithm when the second variable is received and manipulates the surgical instrument when the second variable is received Controlling the at least one motor in conjunction with the second removable tool,
A surgical instrument , wherein the instrument control algorithm based on the first variable is modified when the second variable is received .   The surgical instrument according to claim 1, wherein the removable tool includes an end effector.   The first variable is selected from the group consisting of: a variable describing the length of the end effector; a variable describing the curvature of the end effector; and a variable describing the energy element of the end effector. The surgical instrument of claim 2, wherein the surgical instrument describes a value. Applying the first variable to the instrument control algorithm derives a motor selected from the at least one motor and an amount that the motor is to be activated that causes the end effector to be activated for firing motion. The surgical instrument according to claim 2, comprising:   The end effector includes an energy element, and applying the first variable to the instrument control algorithm includes deriving when to provide energy to the energy element with respect to a firing stroke of the end effector. The surgical instrument according to 2.   The surgical instrument of claim 1, wherein the removable tool includes a removable shaft.   The first variable is supported by a variable indicating the length of the shaft, a variable describing the curvature of the shaft, a variable describing a joint joint of the shaft, a variable describing the rotation of the shaft, and the shaft. The surgical instrument according to claim 6, wherein the surgical instrument describes at least one value selected from the group consisting of variables describing rotation of the end effector.   The surgical instrument according to claim 1, wherein the removable instrument includes a power cord.   The first variable is a variable describing a power source configured to be attached to the power cord, a variable describing an energy element generator configured to be attached to the power cord, and the power cord is attached The surgical instrument according to claim 8, wherein the surgical instrument describes at least one value selected from the group consisting of an instruction for a power source and an instruction for an energy element generator to which the power cord is attached.   The removable tool includes a radio frequency identification (RFID) device, and the processor is further programmed to query the RFID device and receive the first variable describing the removable tool; The surgical instrument of claim 1, comprising receiving a reflected signal from an RFID device.   The surgical instrument according to claim 1, wherein the removable instrument includes a data storage component that stores the first variable.   12. The wired connection between the processor and the removable device exists, and the at least one processor is further programmed to request the first variable via the wired connection. The surgical instrument as described. A surgical instrument acting on tissue,
At least one processor;
At least one motor in communication with the processor;
At least one actuating device;
The processor is
Receiving from a removable tool a tool control algorithm that describes the operation of the surgical instrument in conjunction with the removable tool;
Receiving an input control signal from the actuating device;
Programmed to control the at least one motor to operate the surgical instrument in conjunction with the removable tool according to the tool control algorithm taking into account the input control signal ;
The processor is
Receiving from a second removable tool a second tool control algorithm describing the operation of the surgical instrument in conjunction with the second removable tool;
Control the at least one motor to operate the surgical instrument in conjunction with the removable tool and the second removable tool according to the tool control algorithm and the second tool control algorithm. As further programmed
A surgical instrument , wherein the processor is further programmed to reconcile the tool control algorithm and the second tool control algorithm, and the tool control algorithm is modified based on the second tool control algorithm . The surgical instrument of claim 13 , wherein the removable tool is an end effector and the second removable tool is a removable shaft . The surgical instrument of claim 13 , wherein the removable tool is an end effector and the second removable tool is a power cord. The removable tool includes a radio frequency identification (RFID) device, and the processor is further programmed to query the RFID device and receiving the tool control algorithm receives a reflected signal from the RFID device The surgical instrument of claim 13 , comprising: The surgical instrument of claim 13 , wherein the removable tool includes a data storage component that stores the tool control algorithm . Wired connection exists between the removable tool and said processor, said at least one processor is further programmed to request the implement control algorithm via the wired connection, according to claim 13 Surgical instruments.

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