JP6896766B2 - Surgical instrument with closed stroke reduction configuration - Google Patents

Description

The present invention relates to surgical instruments and, in various embodiments, to surgical staple fastening and cutting instruments, and staple cartridges used with them.

Staple fasteners can include a pair of collaborative elongated jaw members, each jaw member being inserted into the patient and adapted to be positioned with respect to the tissue to be stapled and / or incised. it can. In various embodiments, one of the jaw members can support a staple cartridge containing at least two rows of laterally spaced staples, and the other jaw member is a staple in the staple cartridge. Anvils with stapled pockets aligned with the rows can be supported. In general, staple fasteners further include a push bar and knife blade that are slidable with respect to the jaw member, which are the cam surface on the push bar and / or the cam surface on the wedge thread that is pushed by the push bar. Staples can be continuously ejected from the staple cartridge via. In at least one embodiment, the staples are pushed against the anvil and held by a cartridge to form a laterally spaced row of deformed staples within the tissue gripped between the jaw members, with the staples. The cam surface can be configured to actuate a plurality of associated staple drivers. In at least one embodiment, the knife blade can follow the cam surface and cut tissue along the lines between the staple rows.

The above discussion is intended only to explain various aspects of the art in the field of the invention at the time and should not be regarded as denying the claims.

The various features of the embodiments described herein, along with their advantages, can be understood by the following description in conjunction with the following accompanying drawings.
FIG. 5 is a perspective view of an embodiment of a surgical instrument and an elongated shaft assembly. It is an exploded view of the handle or housing part of the surgical instrument of FIG. It is an exploded view of a part of an elongated shaft assembly. FIG. 3 is another exploded view of another portion of the elongated shaft assembly of FIG. It is an exploded view of a part of the embodiment of a surgical end effector and the embodiment of a closing sleeve. FIG. 5 is a partial cross-sectional view of a portion of the surgical end effector and closure sleeve configuration of FIG. FIG. 5 is a perspective view of the surgical end effector and closure sleeve configuration of FIGS. 5 and 6 with the anvil in an open position or configuration. Another perspective view of the surgical end effector and closure sleeve configuration with FIGS. 5-7, in which the anvil is in a closed position or configuration. FIG. 5 is a perspective view of an embodiment of a surgical end effector and elongated shaft assembly, some of which have been omitted for clarity. FIG. 5 is a top view of a portion of an embodiment of the surgical end effector and elongated shaft assembly of FIG. 9 in which the surgical end effector is in a range of motion position or configuration. 9 is a partially exploded view of a portion of the surgical end effector and elongated shaft assembly of FIGS. 9 and 10. 9 is a top view of a portion of the surgical end effector and elongated shaft assembly of FIGS. 9-11. FIG. 5 is a perspective view of a portion of an embodiment of the surgical end effector and elongated shaft assembly of FIGS. 9-12, wherein the surgical end effector is in a range of motion position or configuration. Embodiments of the surgical end effector and elongated shaft assembly of FIGS. 9-13, wherein the surgical end effector is in a range of motion configuration and some of its components are shown in cross section for clarity. It is a top view of a part. FIG. 5 is a perspective view of a portion of an embodiment of another elongated shaft assembly. FIG. 15 is another perspective view of an embodiment of the elongated shaft assembly of FIG. 15 with the closure sleeve and closure sleeve components omitted for clarity. It is a top view of a part of the embodiment of the elongated shaft assembly of FIGS. 15 and 16. FIG. 5 is a cross-sectional side view of an embodiment of an elongated shaft assembly of FIGS. 15-17, in which a surgical staple cartridge is mounted on a surgical end effector portion. Another cross-sectional side view of the elongated shaft assembly of FIGS. 15-18, in which a surgical staple cartridge is mounted on the surgical end effector portion. FIG. 5 is a top view of a portion of the surgical end effector and elongated shaft assembly of FIGS. 15-19, wherein the surgical end effector is in a range of motion position or configuration. FIG. 5 is a side view of a portion of an embodiment of another surgical end effector and closure sleeve. FIG. 5 is a perspective view of an embodiment of another surgical end effector and elongated shaft assembly, some of which have been omitted for clarity. FIG. 21 is an exploded view of a portion of an embodiment of the surgical end effector and elongated shaft assembly of FIG. 21 is a top view of a portion of an embodiment of the surgical end effector and elongated shaft assembly of FIGS. 21 and 22. Another top view of a portion of an embodiment of the surgical end effector and elongated shaft assembly of FIGS. 21-23, with a portion omitted for clarity. Another top view of a portion of an embodiment of the surgical end effector and elongated shaft assembly of FIGS. 21-24, wherein the surgical end effector is in a range of motion position or configuration. It is an exploded perspective view of a part of an embodiment of another elongated shaft assembly. FIG. 3 is an exploded view of a portion of an embodiment of another surgical end effector and elongated shaft assembly. FIG. 2 is a partial perspective view of a portion of an embodiment of an elongated shaft assembly of FIG. 27, of which a portion has been omitted for clarity. FIG. 2 is another partial perspective view of a portion of an embodiment of the elongated shaft assembly of FIGS. 27 and 28, some of which have been omitted for clarity. FIG. 2 is another partial perspective view of a portion of an embodiment of the elongated shaft assembly of FIGS. 27-29, some of which have been omitted for clarity. Another top view of a portion of an embodiment of the surgical end effector and elongated shaft assembly of FIGS. 27-30, with some parts omitted for clarity. Another top view of a portion of an embodiment of the surgical end effector and elongated shaft assembly of FIGS. 27-31, wherein a portion thereof is omitted for clarity and the surgical end effector is in a range of motion position or configuration. FIG. 2 is a side view of a portion of an embodiment of the surgical end effector and elongated shaft assembly of FIGS. 27-32, some of which have been omitted for clarity. FIG. 2 is a perspective view of a portion of an embodiment of the surgical end effector and elongated shaft assembly of FIGS. 27-33, some of which have been omitted for clarity. FIG. 2 is another partial perspective view of a portion of an embodiment of the surgical end effector and elongated shaft assembly of FIGS. 27-34, some of which have been omitted for clarity. It is an exploded view of a part of the embodiment of the distal firing beam assembly and the embodiment of the lateral load support member. FIG. 36 is a perspective view of the distal firing beam assembly and the lateral load bearing member of FIG. FIG. 36 and 37 are enlarged cross-sectional views of a portion of the distal firing beam assembly and lateral load bearing members of FIGS. 36 and 37. It is another cross-sectional view of the distal firing beam assembly and the lateral load bearing member of FIGS. 36-38. FIG. 5 is a side view of a portion of an embodiment of a distal firing beam assembly attached to a firing member embodiment. It is a top view of a part of the embodiment of the distal firing beam assembly and the embodiment of the firing member of FIG. 40. FIG. 6 is a cross-sectional view of a portion of an embodiment of the distal firing beam assembly of FIGS. 40 and 41, wherein a lateral load bearing member is pivotally supported on it and the embodiment of the distal firing beam assembly is in a bent position or configuration. .. FIG. 42 is a perspective view of an embodiment of a distal firing beam assembly and an embodiment of a lateral load bearing member of FIG. 42. It is a perspective view of a part of an embodiment of another surgical end effector and an embodiment of an elongated shaft assembly in which a part thereof is omitted for clarity and the surgical end effector is in a range of motion position or configuration. FIG. 4 is a top view of an embodiment of a surgical end effector and an embodiment of an elongated shaft assembly of FIG. 44. Another top view of the surgical end effector embodiment and the elongated shaft assembly embodiment of FIG. 45, wherein a portion of the pivot link is shown in cross section. It is a partial perspective view of a part of another surgical end effector embodiment and an embodiment of an elongated shaft assembly, some of which have been omitted for clarity. Another top view of a portion of the surgical end effector embodiment and the elongated shaft assembly embodiment of FIG. 47, some of which have been omitted for clarity. FIG. 48 is another top view of the surgical end effector embodiment and the elongated shaft assembly embodiment of FIG. 48. In the top perspective view of a portion of the surgical end effector embodiment and the elongated shaft assembly embodiment of FIGS. 47-49, wherein a portion thereof is omitted for clarity and the surgical end effector is in a range of motion position or configuration. is there. FIG. 50 is another top perspective view of a portion of the surgical end effector embodiment and the elongated shaft assembly embodiment of FIG. FIG. 5 is an enlarged perspective view of a part of an embodiment of a surgical end effector and an embodiment of an elongated shaft assembly of FIG. 51. Part of an embodiment of another surgical end effector and an embodiment of an elongated shaft assembly, some of which are omitted for clarity and indicate a non-joint motion position or configuration and a surgical end effector in a joint motion position or configuration. It is a top view of. FIG. 5 is a top view of a portion of an embodiment of an elongated shaft assembly of FIG. 53 in which the range of motion system is in a neutral or non-joint range of motion position or configuration and a portion of the elongated shaft assembly is omitted for clarity. Another top view of a portion of an embodiment of the elongated shaft assembly of FIG. 54, wherein the range of motion system is in a first range of motion position or configuration. Another top view of a portion of an embodiment of the elongated shaft assembly of FIGS. 54 and 55, wherein the range of motion system is in a second range of motion position or configuration. It is a partial perspective view of another part of the embodiment of the elongated shaft assembly of FIGS. 53-56 and a part of the embodiment of the surgical end effector in a non-joint range of motion position or configuration, some of which are for clarity. It has been omitted. It is another partial perspective view of the surgical end effector embodiment and the elongated shaft assembly embodiment of FIG. 57, some of which have been omitted for clarity. It is a top view of a part of an embodiment of another elongated shaft assembly, the part of which is omitted for clarity. FIG. 5 is a top view of a portion of an embodiment of another range of motion system in a neutral or non-range of motion position. It is a top view of the embodiment of the driver joint disk of the joint movement system of FIG. 60. It is a top view of the embodiment of the driven joint disk of the joint movement system of FIG. 60. FIG. 6 is another top view of the embodiment of the range of motion system of FIG. 60, which is in position or configuration after the joint motion control motion is initially applied. It is another top view of the embodiment of the joint movement system of FIG. 63 in the first joint movement position or configuration. It is another top view of the embodiment of the range of motion system of FIGS. 63 and 64 in the second range of motion position or configuration. FIG. 3 is a perspective view of another surgical end effector and closure sleeve embodiment in which the jaw is in a closed position or configuration. Another perspective view of the surgical end effector and closure sleeve embodiment of FIG. 66, wherein the jaw is in an open position or configuration. FIG. 6 is a side view of an embodiment of the surgical end effector and closure sleeve of FIGS. 66 and 67, wherein the closure sleeve is shown in cross section and the jaw is in an open position or configuration. FIG. 6 is a side view of an embodiment of the surgical end effector and closure sleeve of FIGS. 66-68, shown in cross-section and with its jaw in an open position or configuration. It is an exploded view of the embodiment of the surgical end effector and the closing sleeve of FIGS. 66-69. It is an exploded view of the embodiment of another surgical end effector and closing sleeve. FIG. 3 is a perspective view of another surgical end effector and closure sleeve embodiment in which the jaw is in an open position or configuration. Another perspective view of the surgical end effector and closure sleeve embodiment of FIG. 72, wherein the jaw is in a closed position or configuration. It is an exploded perspective assembly drawing of the embodiment of the surgical end effector and the closing sleeve of FIGS. 72 and 73. FIG. 5 is a side view of an embodiment of the surgical end effector and closure sleeve of FIGS. 72-74, wherein the jaw is in a closed position or configuration. It is a rear perspective view of the embodiment of the surgical end effector of FIGS. 72-75, wherein the embodiment of the closure sleeve is shown by imagination for clarity. FIG. 2 is a side cross-sectional view of an embodiment of the surgical end effector and closure sleeve of FIGS. 72-76, wherein the jaw is in a closed position or configuration. FIG. 2 is another side cross-sectional view comprising one of the cam plates of the surgical end effector and closure sleeve embodiments of FIGS. 72-77, wherein the jaw is in a closed position or configuration. Another lateral cross-sectional view including one of the cam plates of the surgical end effector and closure sleeve embodiments of FIGS. 72-78, wherein the jaw is in an open position or configuration. FIG. 3 is a partial perspective view of another surgical end effector and closure sleeve embodiment in which the jaw is in an open position or configuration. FIG. 8 is a partial perspective view of an embodiment of the surgical end effector and closure sleeve of FIG. 80, wherein the jaw is in a closed position or configuration. It is an exploded perspective assembly drawing of the embodiment of the surgical end effector and the closing sleeve of FIGS. 80 and 81. FIG. 8 is a side view of an embodiment of the surgical end effector and closure sleeve of FIGS. 80-82, wherein the jaw is in a closed position or configuration. FIG. 8 is a side view of an embodiment of the surgical end effector and closure sleeve of FIGS. 80-83, wherein a portion of the closure sleeve is shown in cross section and the jaw is in an open position or configuration. FIG. 3 is an exploded perspective assembly of another surgical end effector and closure sleeve embodiment. FIG. 8 is a side view of an embodiment of the surgical end effector and closure sleeve of FIG. 85, wherein the jaw is in a closed position or configuration. FIG. 5 is a side view of an embodiment of the surgical end effector and closure sleeve of FIGS. 85 and 86, wherein the jaw is in an open position or configuration and a portion of the closure sleeve is shown in cross section. FIG. 5 is a perspective view of a portion of an embodiment of another elongated shaft assembly. FIG. 8 is another perspective view of an embodiment of the elongated shaft assembly of FIG. 88, with some of its components omitted for clarity. Another perspective view of the elongated shaft assembly of FIGS. 88 and 89, wherein the surgical end effector is in the range of motion position or configuration. It is an exploded view of the slender shaft assembly of FIGS. 88 to 90. Top view of the elongated shaft assembly of FIGS. 88-91, with some components omitted for clarity and the surgical end effector range of motion in one direction. It is another top view of the elongated shaft assembly of FIGS. 88-92, in which some of its components have been omitted for clarity and the surgical end effector has been range of motion in different directions. It is a perspective view of the embodiment of a surgical staple cartridge. It is a perspective view of the embodiment of another surgical staple cartridge. FIG. 3 is a perspective view of a portion of another elongated shaft assembly coupled to a surgical end effector. Another perspective view of the elongated shaft assembly and surgical end effector of FIG. 96, in non-joint motion orientation and partially omitted for clarity. It is a top view of a part of the embodiment of the surgical end effector and the elongated shaft assembly of FIGS. 96 and 97 in which the surgical end effector is in the range of motion orientation. It is another top view of a part of an embodiment of a surgical end effector and an embodiment of an elongated shaft assembly of FIGS. 96-98, some of which have been omitted for clarity. Another top view of a portion of the surgical end effector embodiment and the elongated shaft assembly embodiment of FIG. 99 in range of motion orientation. Another top view of a portion of the surgical end effector embodiment and the elongated shaft assembly embodiment of FIG. 100 in non-joint motion orientation. It is another top view of a part of the embodiment of the surgical end effector and the embodiment of the elongated shaft assembly of FIG. 101 in which the surgical end effector is jointly moved in the first range of motion. It is another top view of a part of the embodiment of the surgical end effector and the embodiment of the elongated shaft assembly of FIG. 102 in which the surgical end effector is jointly moved in the second range of motion. Another top view of a portion of another surgical end effector embodiment and another elongated shaft assembly embodiment in non-joint motion orientation. Another top view of the surgical end effector embodiment and the elongated shaft assembly embodiment of FIG. 104, wherein the surgical end effector is in range of motion orientation. It is a top view of a part of an embodiment of another surgical end effector in a non-joint motion orientation and an embodiment of an elongated shaft assembly, some of which have been omitted for clarity. Another top view of the surgical end effector and elongated shaft assembly of FIG. 106 in the first range of motion orientation. Another top view of the surgical end effector and elongated shaft assembly of FIG. 107 in a second range of motion orientation. It is a top view of a part of an embodiment of another surgical end effector in a non-joint motion orientation and an embodiment of an elongated shaft assembly, some of which have been omitted for clarity. Another top view of the surgical end effector and elongated shaft assembly of FIG. 109 in the first range of motion orientation. Another top view of the surgical end effector and elongated shaft assembly of FIG. 110 in a second range of motion orientation. It is a top view of a part of an embodiment of another surgical end effector in a non-joint motion orientation and an embodiment of an elongated shaft assembly, some of which have been omitted for clarity. Another top view of the surgical end effector and elongated shaft assembly of FIG. 112 in the first range of motion orientation. Another top view of the surgical end effector and elongated shaft assembly of FIG. 113 in the second range of motion orientation. It is a top view of a part of an embodiment of another surgical end effector in a non-joint motion orientation and an embodiment of an elongated shaft assembly, some of which have been omitted for clarity. Another top view of the surgical end effector and elongated shaft assembly of FIG. 115 in the first range of motion orientation. Another top view of the surgical end effector and elongated shaft assembly of FIG. 116 in the second range of motion orientation. It is a top view of a part of an embodiment of another surgical end effector in a non-joint motion orientation and an embodiment of an elongated shaft assembly, some of which have been omitted for clarity. Another top view of the surgical end effector and elongated shaft assembly of FIG. 118 in the first range of motion orientation. It is a partial perspective view of a part of an embodiment of another surgical end effector in a non-joint motion orientation and an embodiment of an elongated shaft assembly, the part of which is omitted for clarity. Top view of the surgical end effector and elongated shaft assembly of FIG. 120 in non-joint motion orientation. Another top view of the surgical end effector and elongated shaft assembly of FIG. 121 in the first range of motion orientation. It is a partial perspective view of a part of an embodiment of another surgical end effector in a non-joint motion orientation and an embodiment of an elongated shaft assembly, the part of which is omitted for clarity. FIG. 2 is another perspective view of an embodiment of the surgical end effector and an embodiment of an elongated shaft assembly in non-joint motion orientation. It is an exploded assembly perspective view of the embodiment of the surgical end effector and the embodiment of the elongated shaft assembly of FIGS. 123 and 124. It is a top view of the embodiment of the surgical end effector and the elongated shaft assembly of FIGS. 123-125 in the non-joint motion orientation. Another top view of the surgical end effector and elongated shaft assembly of FIGS. 123-126 in the first range of motion orientation. Another top view of the surgical end effector and elongated shaft assembly of FIGS. 123-128 in the second range of motion orientation. It is a partial perspective view of a part of an embodiment of another surgical end effector in a non-joint motion orientation and an embodiment of an elongated shaft assembly, the part of which is omitted for clarity. Top view of the surgical end effector and elongated shaft assembly of FIG. 129 in non-joint motion orientation. Another top view of the surgical end effector and elongated shaft assembly of FIGS. 129 and 130 in the first range of motion orientation. FIG. 3 is a partial perspective view of a portion of an embodiment of a spine and firing beam coupler of an elongated shaft assembly. FIG. 3 is a partial cross-sectional view of a spine of an elongated shaft assembly and a portion of another firing beam coupler and lock configuration. It is a top view of the embodiment of the spine and the firing beam coupler of FIG. 132, in which the firing beam embodiment is introduced. It is a top view of the proximal end portion of the embodiment of the firing beam. FIG. 3 is a top view of the proximal end of another firing beam embodiment. It is a top view of another surgical end effector embodiment and an elongated shaft assembly embodiment that are in non-joint motion orientation and omit various components for clarity. Another top view of the surgical end effector and elongated shaft assembly of FIG. 136 in the first range of motion orientation. FIG. 3 is a partial perspective view of an embodiment of another surgical end effector and elongated shaft assembly in a non-joint motion orientation and with its components omitted for clarity. FIG. 138 is an exploded perspective assembly view of the surgical end effector and elongated shaft assembly of FIG. 138. FIG. 139 is another exploded perspective view of a portion of the surgical end effector and elongated shaft assembly of FIG. 139. Another perspective view of the surgical end effector and elongated shaft assembly of FIGS. 138-140 in the first range of motion orientation. Another perspective view of the surgical end effector and elongated shaft assembly of FIGS. 138-141 in the second range of motion orientation. It is a top view of a part of another elongated shaft assembly. FIG. 143 is a partially exploded view of a portion of the elongated shaft assembly and surgical end effector of FIG. 143. FIG. 3 is a perspective view of another surgical end effector embodiment and an elongated shaft assembly embodiment in non-joint motion orientation. FIG. 145 is a top view of the cable member and pulley configuration of the surgical end effector and elongated shaft assembly of FIG. 145. FIG. 145 is an exploded view of a portion of the surgical end effector and elongated shaft assembly of FIG. 145. It is a side view of a part of another elongated shaft assembly. FIG. 6 is an exploded view of the elongated shaft assembly of FIG. 148. Top view of a portion of another elongated shaft assembly, with its components omitted for clarity. FIG. 5 is a partial cross-sectional view of a cable member of an elongated shaft assembly and a part of a tension applying screw configuration for introducing tension into the cable member. FIG. 3 is a cross-sectional perspective view of an embodiment of a closing sleeve. FIG. 5 is a cross-sectional view of another closed sleeve embodiment. FIG. 5 is a cross-sectional view of a portion of another closure sleeve embodiment. FIG. 5 is a cross-sectional view of a portion of another closure sleeve embodiment. FIG. 5 is a cross-sectional view of a portion of another closure sleeve embodiment. FIG. 3 is a cross-sectional perspective view of a portion of another elongated shaft assembly. Another cross-sectional view of a portion of the elongated shaft assembly of FIG. 157.

Throughout the drawings, the corresponding reference numerals indicate the corresponding parts. The illustrations described herein illustrate various embodiments of the invention in one form, and such illustrations should be construed as limiting the scope of the invention in any way. Absent.

The applicant of the present application owns the following patent applications filed on the same date as the present application, the entire contents of which are incorporated herein by reference:
U.S. Patent Application No. ___________, Invention Title "SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATION ARRANGEMENTS", Agent Reference No. END7851USNP / 150530,
U.S. Patent Application No. ___________, Invention Title "ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAM ARRANGEMENTS", Agent Reference Number END7854USNP / 150533,
U.S. Patent Application No. ___________, title of invention "ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATION LINK ARRANGEMENTS", agent reference number END7852USNP / 150531
US Pat.
U.S. Patent Application No. ___________, Invention Name "SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTED SECONDARY CONSTRAINT", Agent Reference Number END7849USNP / 150528,
U.S. Patent Application No. ___________, Invention Title "SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATION ARRANGEMENTS", Agent Reference Number END7848USNP / 150527,
U.S. Patent Application No. __________ No., entitled "SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLY TRANSLATABLE END EFFECTOR" of the invention, Attorney Docket No. END7847USNP / 150526, and U.S. Patent Application No. __________ No., entitled "SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLE DRIVEN the invention ARTICULATION SYSTEMS ", agent reference number END7853USNP / 150532.

The applicant of the present application owns the following patent applications filed on June 18, 2015, the entire contents of which are incorporated herein by reference:
U.S. Patent Application No. 14 / 742,925, Invention Title "SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING ARRANGEMENTS",
U.S. Patent Application No. 14 / 742,941, Title of Invention "SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSEING FEATURES",
U.S. Patent Application No. 14 / 742,933, title of invention "SURGICAL STAPLING INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTING FIRING SYSTEM ACTION
U.S. Patent Application No. 14 / 742,914, Invention Title "MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS",
U.S. Pat. "ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLE SURGICAL INSTRUMENTS".

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

The applicant of the present application owns the following patent applications filed on February 27, 2015, the entire contents of which are incorporated herein by reference:
-US Patent Application No. 14 / 633,576, Title of Invention "SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSTECTION STATION",
-US Patent Application No. 14 / 633,546, title of invention "SURGICAL APPARATUS CONFIGURED TO ASSESS WHERETER A PERFORMANCE PARAMETER OF THE SURGICAL APPARATUS IS WITHIN ANCE"
-US Patent Application No. 14 / 633,576, title of invention "SURGICAL CHARGING SYSTEM THAT CHARGES AND / OR CONDITIONS ONE OR MORE BATTERIES",
-US Patent Application No. 14 / 633,566, Title of Invention "CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR CHARGING A BATTERY",
-US Patent Application No. 14 / 633,555, Title of Invention "SYSTEM FOR MONITORING WHERTHER A SURGICAL INSTRUMENT NEEDS TO BE SERVICED",
-US Patent Application No. 14 / 633,542, Title of Invention "REINFORCED BATTERY FOR A SURGICAL INSTRUMENT",
-US Patent Application No. 14 / 633,548, Title of Invention "POWER ADAPTER FOR A SURGICAL INSTRUMENT",
-US Patent Application No. 14 / 633,526, Invention Title "ADAPTABLE SURGICAL INSTRUMENT HANDLE",
-US Patent Application No. 14 / 633,541, Invention Name "MODULAR STAPLING ASSEMBLY", and-US Patent Application No. 14 / 633,562, Invention Name "SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFE PARAMETER"".

The applicant of the present application owns the following patent applications filed on December 18, 2014, the entire contents of which are incorporated herein by reference:
-US Patent Application No. 14 / 574,478, title of invention "SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF"
-US Patent Application No. 14 / 574,483, Invention Title "SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS",
-US Patent Application No. 14 / 575,139, Title of Invention "DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS",
-US Patent Application No. 14 / 575,148, Title of Invention "LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLES WITH ARTICULATABLE SURGICAL END EFFECTORS",
-US Patent Application No. 14 / 575,130, title of invention "SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO ASTAPLE"
-US Patent Application No. 14 / 575,143, Invention Title "SURGICAL INSTRUMENTS WITH IMPROVEED CLOSE ARRANGEMENTS",
-US Patent Application No. 14 / 575,117, title of invention "SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS",
-US Patent Application No. 14 / 575,154, Title of Invention "SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND IMPROVEED FIRING BEAM SUPPORT ARRANGEMENTS",
-US Patent Application No. 14 / 574,493, title of invention "SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM", and-US Patent Application No. 14 / 574,500, title of invention "SURGICAL SYSTEM ".

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

The applicant of the present application also owns the following patent applications filed on March 14, 2013, the entire contents of which are incorporated herein by reference:
-US Patent Application No. 13 / 803,097, Invention Title "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE", Currently US Patent Application Publication No. 2014/0263542,
-US Patent Application No. 13 / 803,193, Invention Title "CONTROLL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT", now US Patent Application Publication No. 2014/0263537,
-US Patent Application No. 13 / 803,053, Invention Title "INTERCHANGE SHAFT ASSEMBLES FOR USE WITH A SURGICAL INSTRUMENT", now US Patent Application Publication No. 2014/0263564,
-US Patent Application No. 13 / 803,086, Invention title "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK", now US Patent Application Publication No. 2014/0263541,
-US Patent Application No. 13 / 803,210, Invention Title "SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS", now US Patent Application Publication No. 2014/0263538,
-US Patent Application No. 13 / 803,148, Invention Title "MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT", Currently US Patent Application Publication No. 2014/0263554,
-US Patent Application No. 13 / 803,066, Invention Title "DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODELAR SURGICAL INSTRUMENTS", Currently US Patent Application Publication No. 2014/0263565,
-US Patent Application No. 13 / 803,117, Invention Title "ARTICULATION CONTORL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS", now US Patent Application Publication No. 2014/0263553,
-US Patent Application No. 13 / 803,130, Invention Title "DRIVE TRAIN CONTOROL ARRANGEMENTS FOR MODELAR SURGICAL INSTRUMENTS", now US Patent Application Publication No. 2014/0263543, and
-US Patent Application No. 13 / 803,159, Invention Title "METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT", now US Patent Application Publication No. 2014/0277017.

The applicant of the present application also owns the following patent application filed on March 7, 2014, the entire contents of which are incorporated herein by reference:
-US Patent Application No. 14 / 200,111, Invention Title "CONTROLL SYSTEMS FOR SURGICAL INSTRUMENTS", now US Patent Application Publication No. 2014/0263539.

The applicant of the present application also owns the following patent applications filed on March 26, 2014, the entire contents of which are incorporated herein by reference:
U.S. Patent Application No. 14 / 226,106, Invention Title "POWER MANAGEMENT CONTORL SYSTEMS FOR SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2015/0272582,
U.S. Patent Application No. 14 / 226,099, Invention Title "STERILIZATION VERIFICATION CIRCUIT", Now U.S. Patent Application Publication No. 2015/02272581,
U.S. Patent Application No. 14 / 226,094, Invention Title "VERIFICATION OF NUMBER OF BATTERY EXCHANGE COUNT", now U.S. Patent Application Publication No. 2015/0272580,
U.S. Pat.
U.S. Patent Application No. 14 / 226,075, Invention Title "MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLES", now U.S. Patent Application Publication No. 2015/0272579,
U.S. Patent Application No. 14 / 226,093, Invention Title "FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2015/0272569,
U.S. Patent Application No. 14 / 226,116, Invention Title "SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION", Currently U.S. Patent Application Publication No. 2015/0272571,
U.S. Pat.
U.S. Patent Application No. 14 / 226,097, Invention Title "SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS", now U.S. Patent Application Publication No. 2015/0272570,
U.S. Patent Application No. 14 / 226,126, Invention Title "INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2015/0272572,
U.S. Patent Application No. 14 / 226,133, Invention Title "MODULAR SURGICAL INSTRUMENT SYSTEM", Currently U.S. Patent Application Publication No. 2015/0272557,
U.S. Patent Application No. 14 / 226,081, Invention title "SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT,", now U.S. Patent Application Publication No. 2015/02777471
U.S. Pat.
U.S. Patent Application No. 14 / 226,111, Invention Title "SURGICAL STAPLING INSTRUMENT SYSTEM", Currently U.S. Patent Application Publication No. 2015/0272583,
U.S. Patent Application No. 14 / 226,125, Invention Title "SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT", now U.S. Patent Application Publication No. 2015/0280384.

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

The applicant of the present application also owns the following patent applications filed on April 9, 2014, the entire contents of which are incorporated herein by reference:
-US Patent Application No. 14 / 248,590, Invention Title "MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS", now US Patent Application Publication No. 2014/030987,
-US Patent Application No. 14 / 248,581, Title of Invention "SURGICAL INSTRUMENT COMPRISING A CLOSEING DRIVE AND A FIRING DRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT", Currently US Patent Application No. 30
-US Patent Application No. 14 / 248,595, title of invention "SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING THE OPERATION OF THE SURGICAL INSTRUMENT", currently published in U.S. Patent No. 14 / 248,595
-US Patent Application No. 14 / 248,588, Invention Title "POWERED LINEAR SURGICAL STAPLER", Currently US Patent Application Publication No. 2014/0309666,
-US Patent Application No. 14 / 248,591, Invention Title "TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT", Currently US Patent Application Publication No. 2014/0305911,
-US Patent Application No. 14 / 248,584, Title of Invention "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURFTS
-US Patent Application No. 14 / 248,587, Invention Title "POWERED SURGICAL STAPLER", Currently US Patent Application Publication No. 2014/0309665,
-US Patent Application No. 14 / 248,586, Invention Title "DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT", now US Patent Application Publication No. 2014/035990, and
-US Patent Application No. 14 / 248,607, title of invention "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS", now US Patent Application Publication No. 2014/0305992.

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

Many specific details are provided to provide a complete understanding of the overall structure, function, manufacture, and use of embodiments described herein and shown in the accompanying drawings. Well-known behaviors, components, and elements are not described in detail to avoid obscuring the embodiments described herein. It is understood by the reader that the embodiments described and illustrated herein are non-limiting examples, and therefore the particular structural and functional details disclosed herein are exemplary and exemplary. It will be understood to get. Modifications and changes to them can be made without departing from the claims.

The terms "comprise" (any form of comprise, such as "comprises" and "comprising"), "have" (any form of have, such as "has" and "having"), "include ( ”(Any word form of include, such as“ includes ”and“ inclusion ”), and“ contain ”(any word form of content, such as“ context ”and“ contouring ”) are open concatenations. It is a verb. As a result, a surgical system, device, or device that "includes", "has", "contains", or "contains" one or more elements is one or more of them. It has elements, but is not limited to having only one or more of them. Similarly, one or more elements of a system, device, or device that "equips", "has", "contains", or "contains" one or more features. However, it is not limited to having only one or more of these characteristics.

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 part closest to the clinician, and the term "distal" refers to the part located away from the clinician. For convenience and clarity, it is further understood that spatial terms such as "vertical", "horizontal", "top", and "bottom" can be used with respect to the drawings herein. Let's go. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limited and / or absolute.

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

Surgical staple fastening systems can include a shaft and an end effector extending from the shaft. The end effector includes a first jaw portion and a second jaw portion. The first jaw comprises a staple cartridge. The staple cartridge is removable from the first jaw and is removable from the first jaw, but the staple cartridge is not removable from the first jaw, or at least not easily replaceable. Other embodiments are also recalled. The second jaw comprises an anvil configured to deform the staples ejected from the staple cartridge. The second jaw is pivotable with respect to the first jaw about the closure axis, but the first jaw is pivotable with respect to the second jaw. Embodiments are also recalled. Surgical staple fastening systems further include articulated joints configured to allow the end effector to rotate, i.e., range of motion with respect to the shaft. The end effector is rotatable about a range of motion that extends through the joint. Other embodiments that do not include joints are also recalled.

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

The staples are supported by a staple driver inside the cartridge body. The driver can move between the first, i.e., unlaunched position and the second, i.e., the launched position, which ejects the staples from the staple cavity. The driver includes an elastic member that is held within the cartridge body by a retainer that extends around the bottom of the cartridge body and is configured to grip the cartridge body and hold the holder against the cartridge body. .. Drivers can be moved between their unfired positions and their fired positions by threads. The thread can move between the proximal position adjacent to the proximal end and the distal position adjacent to the distal end. The thread slides under the driver and has multiple ramps configured to lift the driver, on which the staples are supported and towards the anvil.

In addition to the above, the thread is moved distally by the launching member. The launching member is configured to contact the thread and push the thread towards the distal end. Longitudinal slots defined within the cartridge body are configured to receive launching members. The anvil also includes a slot configured to receive the launching member. The launching member further comprises a first cam that engages the first jaw and a second cam that engages the second jaw. When advancing the launching member distally, the first cam and the second cam can control the distance between the deck of the staple cartridge and the anvil, i.e. the tissue gap. The launching member also comprises a knife configured to incise the captured tissue between the staple cartridge and the anvil. It is desirable that the knife be positioned at least partially proximal to the slope so that the staples are ejected forward of the knife.

FIGS. 1 to 4 show a motor driven surgical cutting and fastening instrument 10 that may or may not be reused. In the illustrated embodiment, the instrument 10 includes a housing 12 with a handle 14 configured to be gripped, operated, and actuated by a clinician. The housing 12 is operably attached to an elongated shaft assembly 200 to which a surgical end effector 300 configured to perform one or more surgical tasks or procedures is operably coupled. It is configured. The elongated shaft assembly 200 is described, for example, in U.S. Patent Application No. 14 / 226,075, the title of the invention "MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLES," which is incorporated herein by reference in its entirety. It may be interchangeable with other shaft assemblies in various ways as disclosed in US Patent Application Publication No. 2015/0272579. In other configurations, the elongated shaft assembly may not be replaceable with other shaft assemblies and may essentially include a dedicated non-detachable portion of the instrument.

As you read through the embodiments for practicing the present invention, the various forms of interchangeable shaft assemblies disclosed herein may also be effectively used in connection with robotic surgical systems. Will be understood. Therefore, the term "housing" is also configured to generate and apply at least one control motion that can be used to actuate the elongated shaft assemblies disclosed herein and their respective equivalents. It may include a housing or similar portion of the robotic system that accommodates or otherwise operably supports at least one drive system. The term "frame" may refer to a portion of a handheld surgical instrument. The term "frame" may also refer to a portion of a robot-controlled surgical instrument and / or a portion of a robotic system that may be used to operably control the surgical instrument. For example, the shaft assemblies disclosed herein are incorporated herein by reference in their entirety, U.S. Patent Application No. 13 / 118,241, the title of the invention "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS", now May be used in conjunction with various robot systems, instruments, components, and methods disclosed in US Pat. No. 9,072,535.

The housing 12 shown in FIG. 1 is shown with an elongated shaft assembly 200 including an end effector 300 with a surgical cutting and fastening device configured to operably support the surgical staple cartridge 304 inside. There is. The housing 12 includes end effectors adapted to support staple cartridges of various sizes and types, and is to be used in conjunction with shaft assemblies having various shaft lengths, sizes, types, and the like. It may be configured. In addition, the housing 12 also adapts other kinetic and morphological energies, such as radio frequency (RF) energy, ultrasonic energies and / or kinetic, for use in connection with various surgical applications and procedures. It may be effectively used with a variety of other shaft assemblies, including assemblies configured to apply to the finished end effector configuration. In addition, end effectors, shaft assemblies, handles, surgical instruments, and / or surgical instrument systems can utilize any suitable fastener to fasten the tissue. For example, a fastener cartridge with a plurality of fasteners retractably housed therein can be detachably inserted and / or mounted on an end effector of a shaft assembly.

FIG. 1 shows a housing 12 or handle 14 of a surgical instrument 10 to which a replaceable elongated shaft assembly 200 is operably coupled. As can be seen in FIG. 1, the handle 14 may include a pair of interconnectable housing segments 16 and 18 that may be interconnected with screws, snap mechanisms, adhesives and the like. In the illustrated configuration, the handle housing segments 16 and 18 work together to form a pistol grip portion 19 that can be gripped and manipulated by the clinician. As described in more detail below, the handle 14 operably supports a plurality of drive systems internally, which are operably attached to the corresponding portion of the replaceable shaft assembly. On the other hand, it is configured to generate and apply various control motions.

With reference to FIG. 2, the handle 14 may further include a frame 20 that operably supports a plurality of drive systems. For example, the frame 20 can operably support a "first" or closed drive system, represented by 30 as a whole, the closed drive system operably mounted or coupled therein. It may be used to apply closing and opening motions to the shaft assembly 200. In at least one form, the closure drive system 30 may include an actuator in the form of a closure trigger 32 pivotally supported by the frame 20. More specifically, as shown in FIG. 2, the closure trigger 32 is pivotally coupled to the housing 14 by a pin 33. Such an arrangement allows the clinician to operate the closure trigger 32 so that when the clinician grips the pistol grip portion 19 of the handle 14, the closure trigger 32 is moved from the starting position or the "inactive" position. It can be easily pivoted to the "actuated" position, and more specifically to the fully compressed or fully actuated position. The closure trigger 32 may be urged to a non-actuated position by a spring or other urging device (not shown). In various forms, the closure drive system 30 further comprises a closure linkage assembly 34 pivotally coupled to the closure trigger 32. As can be seen in FIG. 2, the closed link cage assembly 34 may include a first closed link 36 and a second closed link 38 that are pivotally coupled to the closed trigger 32 by a pin 35. The second closing link 38, sometimes referred to herein as a "mounting member," includes a sideways mounting pin 37.

Continuing with reference to FIG. 2, the first closure link 36 has a locking wall or end 39 on it configured to work with the unlocking assembly 60 pivotally coupled to the frame 20. You can observe what you may do. In at least one form, the release release assembly 60 may include an release button assembly 62 on which a locking claw 64 projecting distally is formed. The release button assembly 62 may be pivoted counterclockwise by a release spring (not shown). When the clinician pushes the closure trigger 32 from its non-actuated position towards the pistol grip portion 19 of the handle 14, the lock claw 64 heads towards the point where the lock claw 64 reaches the retention engagement with the lock wall 39 on the first closure link 36. The first closing link 36 is pivoted upwards, thereby preventing the closing trigger 32 from returning to the non-actuated position. Therefore, the closure release assembly 60 acts to lock the closure trigger 32 in the fully actuated position. If the clinician wants to unlock the closure trigger 32 so that it can be urged to the inactive position, the clinician simply pivots the unlock button assembly 62, thereby locking the claw. The 64 is moved to disengage from engagement with the lock wall 39 on the first closing link 36. When the lock claw 64 is moved to disengage from engagement with the first closing link 36, the closing trigger 32 may pivot and return to the non-actuated position. Other closure trigger lock and release configurations may be used.

When the closure trigger 32 is moved from the non-actuated position to the actuated position, the closure release button 62 is pivoted between the first and second positions. The rotation of the release button 62 can be referred to as an upward rotation, but at least a portion of the release button 62 is rotated towards the circuit board 100. With reference to FIG. 2, the closure release button 62 may include an arm 61 extending from the arm 61 and a magnetic element 63 attached to the arm 61, such as a permanent magnet. When the closure release button 62 is rotated from its first position to its second position, the magnetic element 63 can move toward the circuit board 100. The circuit board 100 can include at least one sensor configured to detect the movement of the magnetic element 63. In at least one embodiment, the "Hall effect" sensor can be mounted on the bottom surface of the circuit board 100. The Hall effect sensor can be configured to detect changes in the magnetic field surrounding the Hall effect sensor caused by the movement of the magnetic element 63. The Hall effect sensor is capable of signal communication with, for example, a microcontroller, whereby the close release button 62 is placed in the first position associated with the non-actuated position of the close trigger 32 and the open configuration of the end effector. Is it in a second position associated with the actuation position of the closure trigger 32 and the closure configuration of the end effector, and / or in any position between the first and second positions? Can be judged.

Also in the illustrated configuration, the handle 14 and frame 20 are configured to apply firing motion to the corresponding portion of the attached interchangeable shaft assembly, another which is referred to herein as the firing drive system 80. Support the drive system operably. The launch drive system 80 is also sometimes referred to herein as a "second drive system." The launch drive system 80 may use an electric motor 82 located within the pistol grip portion 19 of the handle 14. In various forms, the motor 82 may be, for example, a brushed DC drive motor having a maximum rotation speed of about 25,000 RPM. In other configurations, the motor may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor 82 may include a removable power pack 92 in one form, or may be powered by a power source 90. For example, as can be seen in FIG. 2, the power pack 92 may include a proximal housing portion 94 configured to attach to the distal housing portion 96. The proximal housing portion 94 and the distal housing portion 96 are configured to operably support a plurality of batteries 98 therein. Each of the batteries 98 may include, for example, lithium ion (“LI”) or other suitable battery. The distal housing portion 96 is configured to be detachably and operably attached to the control circuit board assembly 100, which is also operably coupled to the motor 82. A large number of batteries 98, which may be connected in series, may be used as a power source for the surgical instrument 10. In addition, the power supply 90 may be replaceable and / or rechargeable.

As outlined above in relation to various other forms, the electric motor 82 is a gear reducer mounted in meshing engagement with a set or rack of drive teeth 122 on a longitudinally movable drive member 120. Includes a rotary shaft (not shown) that operably interfaces with assembly 84. In use, the voltage polarity provided by the power supply 90 can cause the electric motor 82 to operate clockwise, but the voltage polarity applied to the electric motor by the battery causes the electric motor 82 to operate counterclockwise. Can be inverted to. When the electric motor 82 is rotated in a certain direction, the drive member 120 is axially driven in the distal direction DD. When the motor 82 is driven in the opposite rotational direction, the drive member 120 is axially driven in the proximal direction PD. The handle 14 may include a switch that can be configured to reverse the polarity applied to the electric motor 82 by the power source 90. Similar to other embodiments described herein, the handle 14 also includes a sensor configured to detect the position of the drive member 120 and / or the direction in which the drive member 120 is being moved. Can be done.

The operation of the motor 82 is controlled by a firing trigger 130 pivotally supported on the handle 14. The firing trigger 130 may be pivoted between the non-actuated position and the actuated position. The firing trigger 130 may be urged to a non-actuated position by a spring 132 or other urging device, whereby when the clinician releases the firing trigger 130, it is deactivated by the spring 132 or other urging device. It may be pivoted to a position or otherwise returned. In at least one form, the firing trigger 130 can be positioned "outside" the closing trigger 32, as described above. In at least one embodiment, the firing trigger safety button 134 may be pivotally attached to the closing trigger 32 by a pin 35. The safety button 134 may have a pivot arm 136 that is positioned between the firing trigger 130 and the closing trigger 32 and projects from it. See FIG. When the closure trigger 32 is in the non-actuated position, the safety button 134 is housed in the handle 14 and is not easily accessible to the clinician, with a safety position to prevent the firing trigger 130 from operating and the firing trigger 130. It cannot be moved to or from a firing position where it may be fired. When the clinician presses the closure trigger 32, the safety button 134 and the firing trigger 130 are pivoted down, which in turn allows the clinician to operate them.

As mentioned above, the handle 14 includes a closing trigger 32 and a firing trigger 130. The firing trigger 130 can be pivotally attached to the closing trigger 32. When the closing trigger 32 is moved from its non-operating position to the operating position, the firing trigger 130 can descend downward as described above. After the safety button 134 has been moved to its launch position, the launch trigger 130 can be pressed to activate the motor of the surgical instrument launch system. In various cases, the handle 14 may include a tracking system configured to determine the position of the closing trigger 32 and / or the position of the firing trigger 130.

As described above, in at least one embodiment, the longitudinal movable drive member 120 engages with the corresponding drive gear 86 of the gear reducer assembly 84 by engaging a rack of drive teeth 122 formed on the rack. Have. At least one form is also a manually actuated "emergency" configured to allow the clinician to manually retract the longitudinally movable drive member 120 if the motor 82 becomes unavailable. Includes "disengagement" assembly 140. The emergency disengagement assembly 140 may include a lever or emergency disengagement handle assembly 142 that is manually pivoted to ratchet engage the teeth 124 also provided on the drive member 120. Therefore, the clinician can manually retract the drive member 120 by ratcheting the drive member 120 into the proximal direction PD using the emergency withdrawal handle assembly 142. U.S. Patent Application Publication No. 2010/0008970, now U.S. Pat. No. 8,608,045, is an emergency withdrawal device and other components that can also be used with the various instruments disclosed herein. , Devices, and systems are disclosed. U.S. Patent Application No. 12 / 249,117, title of invention "POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM", see U.S. Pat. No. 8,608,045 in its entirety. Be incorporated.

Next, referring to FIGS. 1 and 3, the elongated shaft assembly 200 includes a surgical end effector 300 with an elongated channel 302 configured to operably support the staple cartridge 304 inside. The end effector 300 may further include an anvil 310 that is pivotally supported with respect to the elongated channel 302. As discussed in more detail below, the surgical end effector 300 can be ranged around the articulation joint 270 with respect to the elongated shaft assembly. As can be seen in FIGS. 3 and 4, the shaft assembly 200 can further include a proximal housing or nozzle 201 composed of nozzle portions 202 and 203. The shaft assembly 200 further includes a closing sleeve 260 that can be used to close and / or open the anvil 310 of the end effector 300. As can be seen in FIG. 4, the shaft assembly 200 includes a spine 210 that can be configured to fixably support the shaft frame portion 212 of the joint lock 350. U.S. Patent Application No. 13 / 803,086, the title of the invention "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK", which is incorporated herein by reference in its entirety for details regarding the configuration and operation of the joint lock 350. It is described in the current US Patent Application Publication No. 2014/0263541. The spine 210 is configured to slidably support the launching member 220 therein, first and to slidably support the closure sleeve 260 extending around the spine 210. The spine 210 also slidably supports the proximal joint driver 230. The proximal joint driver 230 has a distal end 231 configured to operably engage the joint lock 350. In one configuration, the joint lock 350 interfaces with a joint frame 352 adapted to operably engage a drive pin (not shown) on an end effector frame (not shown).

In the configuration shown, the spine 210 comprises a proximal end 211 rotatably supported within the chassis 240. In one configuration, for example, a thread 214 is formed at the proximal end 211 of the spine 210 so that it can be screwed into a spine bearing 216 configured to be supported within the chassis 240. See FIG. With such a configuration, it becomes easy to rotatably attach the spine 210 to the chassis 240, so that the spine 210 can be selectively rotated about the shaft axis SA-SA with respect to the chassis 240. The shaft assembly 200 also includes a closed shuttle 250 that is slidably supported within the chassis 240 so that it can be moved axially with respect to the chassis 240. As can be seen in FIG. 3, the closure shuttle 250 includes a pair of proximally projecting hooks 252, which, as described in more detail below, are attached to a mounting pin 37 attached to a second closure link 38. It is configured to be attached. See FIG. The proximal end 261 of the closure sleeve 260 is coupled to the closure shuttle 250 so that it rotates relative to each other. For example, the U-connector 263 is inserted into an annular slot 262 at the proximal end 261 of the closure sleeve 260 and retained in the vertical slot 253 of the closure shuttle 250. See FIG. Such a configuration serves to attach the closure sleeve 260 to it so as to move axially with the closure shuttle 250, while the closure sleeve 260 rotates about the shaft axis SA-SA with respect to the closure shuttle 250. to enable. The closing spring 268 is pivotally supported on the closing sleeve 260 and serves to urge the closing sleeve 260 to the proximal direction PD, whereby the closing trigger when the shaft assembly 200 is operably coupled to the handle 14. Can play a role of pivoting to a non-working position.

As also mentioned above, the elongated shaft assembly 200 further includes a launching member 220 that is supported to move axially within the shaft spine 210. The launch member 220 includes an intermediate launch shaft portion 222 configured to attach to a distal cut portion or launch beam 280. The launching member 220 may also be referred to herein as a "second shaft" and / or a "second shaft assembly". As can be seen in FIG. 4, the intermediate launch shaft portion 222 may include a longitudinal slot 223 at its distal end, which is a tab at the proximal end 282 of the distal launch beam 280. It can be configured to accept 284. The longitudinal slot 223 and the proximal end 282 can be sized and configured to allow relative movement between them and can include a slip joint 286. The slip joint 286 moves the intermediate launch shaft portion 222 of the launch drive 220 to articulate the surgical end effector 300 without moving the launch bar 280, or at least substantially. It can be possible. When the surgical end effector 300 is suitably oriented, the proximal side wall of the longitudinal slot 223 contacts the tab 284 to advance the firing beam 280 and launch a staple cartridge that can be supported within the end effector 300. Until then, the intermediate launch shaft portion 222 can be advanced distally. As further seen in FIG. 4, the shaft spine 210 has an elongated opening or window 213 to facilitate assembly and insertion of the intermediate launch shaft portion 222 into the shaft frame 210. When the intermediate launch shaft portion 222 is inserted into the shaft frame 210, the top frame segment 215 can be engaged with the shaft frame 212 to encapsulate the intermediate launch shaft portion 222 and the launch beam 280. Further statements regarding the operation of the launching member 220 can be found in US Patent Application No. 13 / 803,086, and current US Patent Application Publication No. 2014/0263541.

In addition to the above, the illustrated shaft assembly 200 includes a clutch assembly 400 that can be configured to selectively and releasably couple the joint driver 230 to the launch member 220. In one form, the clutch assembly 400 includes a lock collar, i.e. a sleeve 402, that is positioned around the launch member 220, the lock sleeve 402 with an engaging position where the lock sleeve 402 couples the joint driver 360 to the launch member 220. , The joint driver 360 may be rotated between disengagement positions that are not operably coupled to the launch member 200. When the lock sleeve 402 is in its engaging position, the distal movement of the launching member 220 allows the joint driver 360 to be moved distally, and correspondingly by the proximal movement of the launching member 220. , The proximal joint driver 230 can be moved to the proximal side. When the lock sleeve 402 is in its engaged / disengaged position, the movement of the launching member 220 is not transmitted to the proximal joint driver 230, and as a result, the launching member 220 moves independently of the proximal joint driver 230. Can be done. Under various circumstances, the proximal joint driver 230 can be held in place by the joint lock 350 when the proximal joint driver 230 has not been moved proximally or distally by the launching member 220.

As further seen in FIG. 4, the lock sleeve 402 comprises a cylindrical, or at least substantially cylindrical body, in which a longitudinal aperture 403 configured to receive the launching member 220 is defined. be able to. The lock sleeve 402 may include an inwardly facing lock protrusion 404 and an outwardly facing locking member 406 that face each other in the radial direction. The lock protrusion 404 may be configured to selectively engage the launching member 220. More specifically, when the lock sleeve 402 is in its engaging position, the lock overhang 404 is located within a drive notch 224 defined in the launching member 220 so that the distal push force and / or proximal The tensile force can be transmitted from the launching member 220 to the lock sleeve 402. When the lock sleeve 402 is in its engaging position, the second locking member 406 is received within the drive notch 232 defined in the proximal joint driver 230, thus exerting a distal push force and exerted on the lock sleeve 402. / Or the proximal tensile force can be transmitted to the proximal joint driver 230. In essence, the launch member 220, the lock sleeve 402, and the proximal joint driver 230 will move with each other when the lock sleeve 402 is in its engaging position. On the other hand, when the lock sleeve 402 is in its disengaged position, the lock overhang 404 cannot be located within the drive notch 224 of the launching member 220, resulting in a distal push and / or proximal tensile force. Cannot be transmitted from the launching member 220 to the lock sleeve 402. Correspondingly, the distal pushing force and / or the proximal tensile force may not be transmitted to the proximal joint driver 230. Under such circumstances, the launching member 220 may slide proximally and / or distally to the lock sleeve 402 and the proximal joint driver 230.

As can also be seen in FIG. 4, the elongated shaft assembly 200 further includes a switch drum 500 that is rotatably received on the closure sleeve 260. The switch drum 500 includes a hollow shaft segment 502 in which a shaft boss 504 for receiving the outward protrusion actuating pin 410 is formed therein. In various situations, the actuating pin 410 extends through slot 267 into the longitudinal slot 408 provided in the lock sleeve 402 when the lock sleeve 402 is engaged with the proximal joint driver 230. To facilitate the axial movement of the lock sleeve 402. The rotary torsion spring 420 is configured to engage a shaft boss 504 on the switch drum 500 and a portion of the nozzle housing 203 to apply urging force to the switch drum 500. The switch drum 500 may further comprise an opening 506 defined therein, at least partially, in the circumferential direction, the opening extending from nozzle portions 202, 203, with reference to FIGS. 5 and 6. It can be configured to accept existing circumferential mounts and allow relative rotation between the switch drum 500 and the proximal nozzle 201 but not translation. The mount also extends through the opening 266 of the closure sleeve 260 and is seated in the recess of the shaft spine 210. However, when the nozzle 201 is rotated to the point where the mount reaches the end of each slot 506 in the switch drum 500, the switch drum 500 rotates about the shaft axis SA-SA. When the switch drum 500 rotates, the actuating pin 410 and the lock sleeve 402 will eventually rotate between their engaging and disengaging positions. Thus, in essence, Nozzle 201 is a joint drive system and launch in a variety of manners described in more detail in U.S. Patent Application No. 13 / 803,086 and current U.S. Patent Application Publication No. 2014/0263541. It may be used to operably engage and disengage with the drive system.

As also shown in FIGS. 3 and 4, the elongated shaft assembly 200 is configured to, for example, conduct power with and / or communicate signals with the surgical end effector 300. The slip ring assembly 600 to obtain may be provided. The slip ring assembly 600 may include a proximal connector flange 604 mounted on a chassis flange 242 extending from the chassis 240 and a distal connector flange 601 located within a slot defined in shaft housings 202, 203. it can. The proximal connector flange 604 can comprise a first surface, the distal connector flange 601 is positioned adjacent to the first surface and is movable relative to the first surface. Can be provided. The distal connector flange 601 can rotate about the shaft axis SA-SA with respect to the proximal connector flange 604. The proximal connector flange 604 can include a plurality of concentric, or at least substantially concentric, conductors 602 defined on its first surface. The connector 607 can be mounted on the proximal side of the distal connector flange 601 and may have a plurality of contacts (not shown), where each contact corresponds to one of the conductors 602 and is electrically connected to it. Contact. Such a configuration allows the proximal connector flange 604 and the distal connector flange 601 to rotate relative to each other while maintaining electrical contact between them. The proximal connector flange 604 can include, for example, an electrical connector 606 in which the conductor 602 can be arranged in signal communication with the shaft circuit board 610 mounted on the shaft chassis 240. In at least one example, a wiring harness with a plurality of conductors can extend between the electrical connector 606 and the shaft circuit board 610. The electrical connector 606 may extend proximally through the connector opening 243 defined in the chassis mounting flange 242. See FIG. 7. The entire contents of US Patent Application No. 13 / 800,067 filed on March 13, 2013, the title of the invention "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", and the current US Patent Application Publication No. 2014/0263552 Incorporated herein by reference. See U.S. Patent Application No. 13 / 800,025 filed on March 13, 2013, the title of the invention "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM", and the current U.S. Patent Application Publication No. 2014/0263551 in its entirety. Is incorporated herein by. Further details regarding the slip ring assembly 600 can be found in US Patent Application No. 13 / 803,086, and current US Patent Application Publication No. 2014/0263541.

As described above, the elongated shaft assembly 200 can include a proximal portion that is fixably mounted to the handle 14 and a distal portion that is rotatable about the longitudinal shaft axis SA-SA. The rotatable distal shaft portion can be rotated relative to the proximal portion about the slip ring assembly 600, as described above. The distal connector flange 601 of the slip ring assembly 600 can be positioned within a rotatable distal shaft portion. In addition to the above, the switch drum 500 can also be positioned within the rotatable distal shaft portion. Rotating the rotatable distal shaft portion allows the distal connector flange 601 and the switch drum 500 to rotate synchronously with each other. In addition, the switch drum 500 can be rotated between the first and second positions with respect to the distal connector flange 601. When the switch drum 500 is in the first position, the joint drive system (ie, the proximal joint driver 230) can be operably disengaged from the launch drive system, thus the operation of the launch drive system is the shaft assembly. The end effector 300 of 200 cannot be jointly moved. When the switch drum 500 is in its second position, the joint drive system (ie, the proximal joint driver 230) can be operably engaged with the launch drive system, thus the operation of the launch drive system is the shaft assembly. 200 end effectors 300 can be articulated. When the switch drum 500 is moved between its first and second positions, the switch drum 500 is moved relative to the distal connector flange 601. In various cases, the shaft assembly 200 may include at least one sensor configured to detect the position of the switch drum 500.

With reference to FIG. 4 again, the closure sleeve assembly 260 includes a double pivot closure sleeve assembly 271. According to various forms, the double pivot closure sleeve assembly 271 includes an end effector closure sleeve 272 that includes tongues 273 and 274 that project to the upper and lower distal sides. The upper double pivot link 277 projects upward, engaging the upper distal pinhole of the upper proximal protruding tongue 273 and the upper proximal pinhole of the upper distal protruding tongue 264, respectively, on the closure sleeve 260. Includes distal and proximal pivot pins. The lower dual pivot link 278 engages the lower distal pinhole of the lower proximal protruding tongue 274 and the lower proximal pinhole of the lower distal protruding tongue 265, respectively, with an upwardly projecting distal and proximal. Includes pivot pins. See also FIG.

FIGS. 5-8 generate a control motion for axially moving a closing member configured to add closing and opening motion to a portion of a surgical instrument of the type described above, or a surgical end effector. It shows an embodiment of a surgical end effector 300 configured to be operably attached to an elongated shaft assembly of another surgical instrument configuration, including a closure system configured as described above. In the illustrated example, as discussed in more detail below, the surgical end effector is configured to be articulated with respect to the proximal portion of the elongated shaft assembly around the joint 339, indicated by 339 as a whole. There is. Other configurations, however, may not allow range of motion. As can be seen in FIG. 6, the joint joint 339 defines a range of motion BB through which the surgical end effector 300 can be selectively jointed. In the illustrated example, the range of motion BB substantially crosses the shaft axis SA-SA of the elongated shaft assembly.

The illustrated surgical end effector 300 comprises a first jaw 308 and a second jaw 309, the second jaw 309 being in an open position with respect to the first jaw 308 (FIG. 7). It can be selectively moved to and from various closed positions (FIG. 8). In the illustrated embodiment, the first jaw 308 comprises an elongated channel 302 configured to operably support the surgical staple cartridge 304 in, and the second jaw 309 comprises an anvil 310. There is. However, other surgical jaw configurations can also be used without departing from the spirit and scope of the present invention. As can be seen in FIG. 5, used to provide additional support to the surgical staple cartridge 304 and by a staple driver (not shown) supported in a staple pocket 306 formed in the surgical staple cartridge 304. A support pan 305 may be attached to the surgical staple cartridge 304 to prevent it from being previously detached from the surgical staple cartridge. As can be seen in FIG. 5, the elongated channel 302 has a proximal end portion 320 that includes two upright outer walls 322. The anvil 310 includes an anvil body 312 formed on which a staple-molded lower surface 313 is formed. The proximal end 314 of the anvil body is branched by launching member slots 315 defining a pair of anvil mounting arms 316. Each anvil mounting arm 316 includes an inclined top surface 321 and also includes a laterally projecting anvil trunnion 317 and a cam slot 318 defining a cam surface or "slotted cam surface" 319. See FIG. One of the cam slots 318 may be referred to herein as a "first cam slot", the cam surface of which is referred to as a "first cam surface". Similarly, the other cam slot 318 may be referred to as a "second cam slot", the cam surface of which is referred to herein as the "second cam surface". Trunnion holes 324 for receiving the corresponding one of the anvil trunnions 317 are provided on each outer wall 322 of the elongated channel 302. Such a configuration is defined by the trunnion hole 324 and the anvil 310 can be moved to the elongated channel 302 for selective pivotable movement around the anvil axis AA across the shaft axis SA-SA. Helps to stick to. See FIG.

In the illustrated configuration, the anvil 310 is pivotally moved to an open position by a pair of open cams 354 with respect to the elongated channel 302 and the surgical staple cartridge 304 supported therein, with the pair of open cams 354. Whether it is detachably supported within the anvil actuator member, detachably attached to the anvil actuator member, permanently attached to the anvil actuator member, or integrally formed within the anvil actuator member. Good. In the illustrated embodiment, the anvil actuator member comprises an end effector closing sleeve 272. See FIG. Each open cam 354 includes an outer body portion 356, the outer body portion 356 having a cam tab 358 projecting inward from it. The outer body portion 356 is configured to be snap-fitted and detachably engaged in a corresponding cam hole 355 formed within the end effector closing sleeve 272 in at least one configuration. For example, the outer body portion 356 may include a chamfer stop portion 357 configured to snap into the corresponding portion of the end effector closure sleeve wall defining the cam hole 355. Another portion of the outer body portion 356 may form a dogleg form 359 configured to be received inside the portion of the end effector closure sleeve 272 adjacent to the cam hole 355. Other snap tab configurations may also be used to detachably attach the outer body portion 356 to the end effector closure sleeve 272. In other configurations, for example, the outer body portion may not be configured to snap engage with the end effector closure sleeve 272. In such a configuration, the outer body portion can be held in place by an annular crimp ring that covers the outer body portion of the open cam and extends around the outer circumference of the end effector closure sleeve and can be crimped in place. The crimp ring acts to capture the outer body portion with respect to the outer surface of the end effector closure sleeve. The crimpling is designed to provide the end effector closure sleeve with a relatively smooth or continuous outer surface that can advantageously avoid damage to adjacent tissue and / or accumulation of tissue / fluid etc. between these components. It can actually be crimped into the annular recess formed in the end effector closure sleeve.

When the open cam 350 is introduced into the end effector closure sleeve 272, each cam tab 358 extends through the elongated slot 326 of the corresponding outer wall 322 of the elongated channel 302 and is received in the corresponding cam slot 318 of the anvil 310. To. See FIG. In such a configuration, the open cams 350 are diametrically opposite to each other in the end effector closure sleeve. In use, the closure sleeve 260 is translated distally (direction DD) to close the anvil 310, for example, in response to the activation of the closure trigger 32. The anvil 310 is closed when the closure sleeve 260 is translated in the distal DD so that the distal end 275 of the end effector closure sleeve 272 is in contact with the closure lip 311 on the anvil body 312. Specifically, the distal end 275 of the end effector closure sleeve 272 is the upper surface of the anvil mounting arm 316 as the closure sleeve 260 is moved distally to begin pivoting the anvil 310 to the closure position. Get on 321. For example, in one configuration, closure of the anvil 310 occurs only by contact between the end effector closure sleeve 272 and the anvil 310, not by the interaction of the open cam with the anvil. In other configurations, however, the open cam may also be configured to add a closing motion to the anvil as the closing sleeve 260 is moved distally. The anvil 310 is opened by translating the closure sleeve 260 proximally in the proximal direction PD, which translation causes the cam tab 358 within the cam slot 318 on the cam surface 319, as shown in FIGS. 6 and 7. It is moved in the proximal direction "PD" to pivot the anvil 310 to the open position.

Embodiment 300 of the surgical end effector uses two open cams to ensure reliable opening of the end effector jaw even under load. It is conceivable that only one open cam may be used or three or more open cams may be used without the other configuration deviating from the gist and scope of the present invention. In the illustrated example, the open cam is detachably attached to an end effector closure sleeve that facilitates easy assembly or attachment of surgical end effector components to an elongated shaft assembly and their disassembly. Such configurations also allow the use of smaller or shorter articulated joint configurations that further facilitate better operation of the surgical end effector within the confined space within the patient's body. To facilitate easy removal of the open cam that snaps into place, an additional hole is provided in the end effector closure sleeve through which a ply member is inserted to close the end effector. It may be possible to remove the open cam from the sleeve. In yet other configurations, the open cam may be integrally formed within the anvil actuator member or end effector closure sleeve. For example, each open cam may have tabs, but those tabs are cut into or otherwise formed in the wall of the anvil actuator member or end effector closure sleeve, and then the second jaw. It is bent, crimped, or permanently deformed inward to engage the corresponding cam surface above the portion. For example, the tab can be bent inward at an angle of 90 degrees (90 °) with respect to the outer wall of the end effector closure sleeve. Such a configuration avoids the need for a separate open cam component. In other variants, one or more pins may be used, but those pins are attached to the second jaw and configured to rest on the corresponding cam surface on the first jaw. Is. The pin can be pressed, knurled, and then pressed and / or welded to the first jaw, for example. The open cam configuration described above is described in the context of surgical end effectors, including anvils that are configured to support surgical staple cartridges and are configured to move relative to surgical staple cartridges. However, it will be clear to the reader that the open cam configuration can also be used with other end effector configurations with jaws that are movable relative to each other.

9 and 10 show an elongated shaft assembly marked 200', incorporating many of the features of the elongated shaft assembly 200 described above. In the illustrated example, the elongated shaft assembly 200'includes a double joint link configuration marked 800 with a joint lock 810 similar to the joint lock 350 described above. The components of the joint lock 810 that are different from the components of the joint lock 350 and that may be necessary to understand the operation of the joint lock 350 will be described in more detail below. Various details regarding the joint lock 350 are incorporated herein by reference in its entirety, US Patent Application No. 13 / 803,086, title of invention "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK", current. It can be found in US Patent Application Publication No. 2014/0263541. The joint lock 810 can be configured and manipulated to selectively lock the surgical end effector 300 to various range of motion positions. Such a configuration allows the surgical end effector 300 to rotate, or jointly move, with respect to the shaft closure sleeve 260 when the joint lock 810 is in the unlocked state.

As described above, when the proximal joint driver 230 is operably engaged with the launching member 220 via the clutch system 400, the launching member 220 makes the proximal joint driver 230 proximal and / or It can be moved to the distal side. For example, the proximal joint driver 230 can be moved proximally by moving the launching member 220 to the proximal side, and similarly, the proximal joint by moving the launching member 220 to the distal side. The driver 230 can be moved distally. The movement of the proximal joint driver 230, whether proximal or distal, allows the joint lock 810 to be unlocked, as described in more detail below. For example, as can be seen in FIG. 9, the elongated shaft assembly 200'includes a shaft frame 812 that is somewhat as wide as the first distal joint driver 820. The first distal joint driver 820 responds to the corresponding joint motion control motion applied thereto so that the elongated shaft assembly 200 selectively moves longitudinally in the distal DD and the proximal PD. 'Supported within. The shaft frame 812 includes a distal end portion 814 having a downward projecting pivot pin (not shown) above it, which downward projecting pivot pin is a pivot formed in the proximal end portion 320 of the elongated channel 302. It is adapted to be pivotally accepted within the moving hole 328. See, for example, the same configuration shown in FIG. Such a configuration facilitates the pivotal movement of the elongated channel 302 of the surgical end effector 300 with respect to the shaft frame 812 centered on the range of motion BB defined by the pivot hole 328. As shown above, the range of motion BB crosses the shaft axis SA-SA defined by the elongated shaft assembly 200'.

Referring again to FIG. 9, the first distal joint driver 820 includes a first or distal lock cavity 822 and a second or proximal lock cavity 824, with the first lock cavity 822. The second lock cavity 824 can be separated by an intermediate frame member 825. The joint lock 810 can further include at least one first lock element 826 disposed in at least partially in the first lock cavity 822, the first lock element 826 being the first far. The position joint driver 820 may be configured to prevent or prevent proximal movement. For example, in the embodiment shown in FIG. 9, there are three first lock elements 826 arranged in the first lock cavity 822, and these first lock elements 826 all operate in the same parallel manner. And can act collaboratively as a single locking element. Other embodiments are also conceivable in which four or more or two or less first locking elements 826 can be utilized. Similarly, the joint lock 810 can further include at least one second lock element 828, which is at least partially located in the second lock cavity 824, the second lock element 824 being the second. The distal joint driver 820 of 1 may be configured to suppress or prevent the movement to the distal side. Regarding the specific embodiment shown in FIG. 9, there are three second lock elements 828 arranged in the second lock cavity 824, and these second lock elements 828 all operate in the same parallel manner. And can act collaboratively as a single locking element. Other embodiments are also conceivable in which four or more or two or less second locking elements 828 can be utilized.

In addition to the above, primarily with reference to FIG. 9, each first locking element 826 is slidably supported on the frame rail 830 and includes a locking tongue 827. Each of the first locking elements 826 has a locking aperture (not shown) therein for receiving the frame rail 830 through it. The lock tongue 827 may be disposed within the first lock cavity 822, and the lock aperture may be slidably engaged with the frame rail 830 attached to the shaft frame 812. The first locking element 826 is not oriented perpendicular to the frame rail 830, rather the first locking element 826 is configured and aligned at an angle not perpendicular to the frame rail 830. Therefore, the edge or side wall of the lock aperture is adapted to be engaged with the frame rail 830. Further, the interaction between the side wall of the lock aperture and the frame rail 830 can generate a resistance or frictional force between them, which resistance or frictional force is the first locking element 826 and the frame rail 830. It can suppress relative movement with and, as a result, resist the proximal push force P applied to the first distal joint driver 820. In other words, the first locking element 826 can prevent, or at least suppress, the surgical end effector 300 from rotating in the direction indicated by the arrow 821. When torque is applied to the end effector 300 in the direction of arrow 821, the proximal push force P will be transmitted to the distal joint driver 820. The proximal push force P will only act to enhance the lock engagement between the first locking element 826 and the frame rail 830. More specifically, the proximal push force P can be transmitted to the tongue 827 of the first locking element 826, which rotates the first locking element 826 to rotate the first locking element 826 and the frame rail. The angle defined between the 830 and the 830 can be reduced and, as a result, the bite between the side wall of the lock aperture and the frame rail 830 can be increased. Ultimately, the first locking element 826 can then lock the movement of the first distal joint driver 820 in one direction.

To release the first locking element 826 and rotate the surgical end effector 300 in the direction indicated by arrow 821, the proximal joint driver 230 may rotate the first locking element 826 vertically, or at least substantially substantially. It can be pulled proximally to realign to a vertical position, or at least substantially realign. In such a position, the bite or resistance between the side wall of the lock aperture and the frame rail 830 can be sufficiently reduced or eliminated so that the first distal joint driver 820 can be moved proximally. To reposition the first locking element 826, the proximal joint driver 230 can be pulled proximally so that the distal arm 233 of the proximal joint driver 230 comes into contact with the first locking element 826. , The first locking element 826 is pulled to the straightening position and rotated. In various situations, the proximal joint driver 230 has a proximal arm 235 extending from it that contacts or abuts the proximal drive wall 832 of the first distal joint driver 820, bringing the distal joint driver 820 to the proximal side. It can continue to be pulled proximally until it is pulled to articulate the surgical end effector 300. In essence, proximal tensile force can be applied from the proximal joint driver 230 to the distal joint driver 820 through the interaction of the proximal arm 235 and the proximal drive wall 832, such tensile force being the first. Transmitted to the end effector 300 through the distal joint driver 820, the end effector 300 can be articulated in the direction indicated by the arrow 821, as further described below. After the surgical end effector 300 has been suitably articulated in the direction of arrow 821, the joint lock 810 can relock the first distal joint driver 820 and the surgical end effector 300 in place. One distal joint driver 820 can be released in a variety of situations.

Simultaneously with the above, with reference to FIG. 9 again, the second locking element 828 can still remain in the angled position while the first locking element 826 is locked and unlocked as described above. It should be understood by the reader that the second locking element 828 is aligned and aligned in an angled position with respect to the shaft rail 830, whereas the second locking element 828 is of the first distal joint driver 820. It is not configured to interfere with, or at least substantially, interfere with motion to the proximal side. When the first distal joint driver 820 and joint lock 810 are slid proximally as described above, the second locking element 828 is angled alignment with respect to the frame rail 830 in various situations. Can be slid distally along the frame rail 830 with little or at least substantially no change. The second locking element 828 allows the first distal joint driver 820 and joint lock 810 to move proximally, while the second locking element 828 is discussed in more detail below. , The first distal joint driver 820 may be configured to selectively prevent, or at least suppress, the movement to the distal side.

Each second locking element 828 may include a locking aperture (not shown) and a locking tongue 829. The lock tongue 829 may be disposed within the second lock cavity 824, and the lock aperture may be slidably engaged with the frame rail 830 attached to the shaft frame 812. The frame rail 830 extends through the aperture of the second locking element 828. The second locking element 828 is not oriented perpendicular to the frame rail 830, rather the second locking element 828 is configured and aligned at an angle not perpendicular to the frame rail 830. Therefore, the edge or side wall of the lock aperture is adapted to be engaged with the frame rail 830. Further, the interaction between the side wall of the lock aperture and the frame rail 830 can generate a resistance or frictional force between them, which resistance or frictional force is the second locking element 828 and the frame rail 830. It can suppress relative movement with and, as a result, resist the distal force D applied to the first distal joint driver 820. In other words, the second locking element 828 can prevent, or at least suppress, the surgical end effector 300 from rotating in the direction indicated by arrow 823. When torque is applied to the end effector 300 in the direction of arrow 823, the distal tensile force D will be transmitted to the first distal joint driver 820. The distal tensile force D will only act to enhance the lock engagement between the second locking element 828 and the frame rail 830. More specifically, the distal tensile force D can be transmitted to the tongue 829 of the second locking element 828, which rotates the second locking element 828 with the second locking element 828. The angle defined with the frame rail 830 can be reduced and, as a result, the bite between the side wall of the lock aperture and the frame rail 830 can be increased. Ultimately, the second locking element 828 can then lock the movement of the first distal joint driver 820 in one direction.

To release the second locking element 828 and joint the surgical end effector 300 in the direction indicated by arrow 823, the proximal joint driver 230 moves the second locking element 828 vertically, or at least substantially. It can be pushed distally to straighten to a position perpendicular to, or at least substantially straighten. In such a position, the bite or resistance between the side wall of the lock aperture and the frame rail 830 can be sufficiently reduced or eliminated so that the first distal joint driver 820 can be moved distally. To reposition the second locking element 828, the proximal joint driver 230 can be pushed distally so that the proximal arm 235 of the proximal joint driver 230 comes into contact with the second locking element 828. , The second lock element 828 is pushed into the straightening position and rotated. In various situations, the proximal joint driver 230 has a distal arm 233 extending from it that contacts or abuts the distal drive wall 833 of the first distal joint driver 820 and distances the first distal joint driver 820. It can continue to be pushed distally until it is pushed laterally to articulate the surgical end effector 300. In essence, a distal push force can be applied from the proximal joint driver 230 to the first distal joint driver 820 through the interaction of the distal arm 233 and the distal drive wall 833, such push. Force is transmitted through the first distal joint driver 820 to allow the end effector 300 to joint in the direction indicated by arrow 823. After the surgical end effector 300 has been suitably articulated in the direction of arrow 823, the joint lock 810 can relock the first distal joint driver 820 and the surgical end effector 300 in place. One distal joint driver 820 can be released in a variety of situations.

Simultaneously with the above, the first locking element 826 can still remain in the angled position while the second locking element 828 is locked and unlocked as described above. It should be understood by the reader that the first locking element 826 is aligned and aligned in an angled position with respect to the shaft rail 830, whereas the first locking element 826 is of the first distal joint driver 820. It is not configured to interfere with, or at least substantially, interfere with distal motion. When the first distal joint driver 820 and joint lock 810 are slid distally as described above, the first locking element 826 is angled alignment with respect to the frame rail 830 in various situations. Can be slid distally along the frame rail 830 with little or at least substantially no change. The first locking element 826 allows the first distal joint driver 820 and the joint lock 810 to move distally, whereas the first locking element 826 is the first, as described above. The distal joint driver 820 is configured to selectively prevent, or at least suppress, the proximal movement.

In view of the above, the joint lock 810 may be configured to resist the proximal and distal movement of the first distal joint driver 820 in the locked state. In terms of resistance, the joint lock 810 may be configured to prevent, or at least substantially prevent, the proximal and distal movement of the first distal joint driver 820. Overall, as described above, the motion towards the proximal side of the first distal joint driver 820 is resisted by the first locking element 826 when the first locking element 826 is in the locking direction, and the first The distal motion of the distal joint driver 820 of 1 is resisted by the second locking element 828 when the second locking element 828 is in the locking direction. In other words, the first locking element 826 comprises a first unidirectional lock and the second locking element 828 comprises a second unidirectional lock that locks in the opposite direction.

Although discussed in connection with the exemplary embodiments shown in FIGS. 9 and 10, due to the initial proximal movement of the proximal joint driver 230, the proximity of the first distal joint driver 820 and the joint lock 810. While the movement to the position side can be unlocked, the further movement of the proximal joint driver 230 to the proximal side drives the first distal joint driver 820 and the joint lock 810 to the proximal side. be able to. Similarly, the initial distal movement of the proximal joint driver 230 can unlock the distal movement of the first distal joint driver 820 and joint lock 810, while proximal. Further distal movement of the joint driver 230 can drive the first distal joint driver 820 and joint lock 810 to the distal side. Such an overall concept will be discussed in the context of some further exemplary embodiments disclosed below. To the extent that such arguments are the same as or largely overlap with those presented above, we do not reproduce such arguments for the sake of brevity.

Still referring to FIGS. 9 and 10, the double joint link configuration 800 is configured to establish a "push / pull" configuration when joint kinetic force is applied through the first distal joint driver 820. .. As can be seen in these figures, the first distal joint driver 820 has a first drive rack 842 formed therein. The first joint rod 844 projects distally from the first distal joint driver 820 and is attached to a first movable coupler 850 that is attached to the first distal joint driver 820 by a first ball joint 852. Has been done. The first coupler 850 is also pivotally pinned to the proximal end portion 320 of the elongated channel 302 by a first pin 854, as can be seen in FIG. The double joint link configuration 800 further comprises a second distal joint driver 860 with a second drive rack 862 formed therein. The second distal joint driver 860 is movably supported within the elongated shaft assembly 200'for longitudinal movement in the distal DD and proximal PD. The second joint rod 864 projects distally from the second distal joint driver 860 and is attached to a second movable coupler 870 that is attached to the second distal joint driver 860 by a second ball joint 872. Has been done. The second coupler 870 is also pivotally pinned to the proximal end portion 320 of the elongated channel 302 by a second pin 874, as can be seen in FIG. As can be seen in FIG. 9, the first coupler 850 is attached to the elongated channel 302 on one outer side of the shaft axis SA, and the second coupler 870 is attached to the elongated channel 302 on the opposite outer side of the shaft axis. Has been done. Therefore, by pulling one of the couplers 850 and 870 and simultaneously pushing the other coupler 850 and 870, the surgical end effector 300 joints the elongated shaft assembly 200'with respect to the range of motion BB. You will be exercising. In the illustrated configuration, the couplers 850, 870, and the elongated channel 302, which promote relative motion between the first distal joint driver 820 and the second distal joint driver 860, respectively, are made of relatively rigid components. However, coupler configurations with other relatively "soft" configurations may be used. For example, a cable or the like extends through one or both of the distal joint drivers 820, 860, couplers 850, 870 and ball joints 852, 872 so that they are coupled to an elongated channel to transmit joint motion motion to them. It may be promoted.

Similarly, as can be seen in FIGS. 9 and 10, the proximal pinion gear 880 and the distal pinion gear 882 are centrally located between the first drive rack 842 and the second drive rack 862 and mesh with them. It is in agreement. In an alternative embodiment, only one pinion gear or three or more pinion gears may be used. Therefore, at least one pinion gear is used. The proximal pinion gear 880 and the distal pinion gear 882 are rotatably supported within the shaft frame 812 to rotate freely with respect to them, so that the first distal joint driver 820 is in the distal DD. When moved, the pinion gears 870, 872 act to drive the second distal joint driver 860 in the proximal direction PD. Similarly, when the first distal joint driver 820 is pulled in the proximal PD, the pinion gears 880, 882 drive the second distal driver 860 into the distal DD. Therefore, in order to jointly move the end effector 300 in the direction of arrow 821 about the joint movement axis BB, the joint driver 230 is operably engaged with the launching member 220 via the clutch system 400, thereby. , The launching member 220 moves or pulls the proximal joint driver 230 in the proximal direction PD. As the proximal joint driver 230 moves in the proximal direction, the first distal joint driver 820 also moves in the proximal direction. When the first distal joint driver 820 moves in the proximal direction, the pinion gears 880, 882 act to drive the second distal joint driver 860 in the distal DD. Such movement of the first and second distal joint drivers 820, 860 causes the surgical end effector 300, more specifically the elongated channel 302 of the surgical end effector 300, to move the joint motion axis B-. It will pivot in the direction of joint movement of arrow 821 with B as the center. Conversely, in order to joint the end effector 300 in the direction of arrow 823, the launching member 220 is actuated to push the first distal joint driver 820 in the distal direction DD. When the first distal joint driver 820 moves in the distal direction, the pinion gears 880, 882 act to drive the second distal joint driver 860 in the proximal direction PD. Such movement of the first and second distal joint drivers 820, 860 causes the surgical end effector 300, more specifically the elongated channel 302 of the surgical end effector 300, to move the joint motion axis B-. It will be pivoted in the direction of joint movement of arrow 823 with B as the center.

The dual integrated link joint configuration 800 and its variants can provide a wider range of joint motion to the surgical end effector when compared to the configurations of other range of motion surgical end effectors. Specifically, the monolithic link joint configurations disclosed herein promote a range of motion beyond the 45 ° to 50 ° range commonly achieved by other articulated end effector configurations. obtain. Using at least one pinion gear to interface between distal joint drivers is also in use so that the end effector can be "pushed" and "pulled" in place. It can reduce the amount of "slop" or unwanted or unintended movement of the end effector. The dual integrated link joint configurations disclosed herein also include a range of motion system with improved strength characteristics as compared to other range of motion system configurations.

As briefly described above, the intermediate launch shaft portion 222 is configured to operably interface with a distal cut or launch beam 280. The distal emission beam 280 may have a laminated structure. With such a configuration, the distal firing beam 280 can be sufficiently flexed when the surgical end effector 300 is jointly moved about the range of motion BB. The distal firing beam 280 is supported to move axially within the shaft assembly 200'and is slidably supported by two upright lateral support walls 330 formed on the proximal end of the elongated channel 302. Will be done. Referring to FIG. 11, the distal firing beam 280 is attached to a firing member 900 that includes a vertically extending launching member body 902, the firing member body 902 having a tissue cut surface or blade 904 on it. There is. In addition, wedge threads 910 may be mounted within the surgical staple cartridge 304 for drive contact with the launching member 900. When the launching member 900 is driven distally through the cartridge body 304, the wedge surface 912 of the wedge thread 910 comes into contact with the staple driver, bringing the driver and the surgical staples supported on it into the surgical staple cartridge 304. Operate upward with.

An end effector that uses a firing beam or launching member and is capable of range of motion over a range, such as 45 degrees (45 °), can have many challenges to overcome. To facilitate the movable joint movement of such end effectors, the launching member or firing beam must be sufficiently flexible to adapt to such range of motion. However, the firing beam or launching member must also avoid buckling during compressive firing loads. Various "support" or "blow-out" plate configurations have been developed to provide additional support for the firing beam or launching member. Some such configurations are described in US Pat. No. 6,964,363, titles of the invention "SURGICAL STAPLING INSTRUMENT HAVING ARTICULATION JOINT SUPPORT PLATES FOR SUPPORTING A FIRING BAR" STAPLING INSTRUMENT INCORPORATING AN ELECTROACTIVE POLYMER ACTION FIRING BAR TRACK THROUGH AN ARTICULATION JOINT, the entire disclosure of which is incorporated herein by reference. Blow-out plates that provide substantial buckling resistance are also generally difficult to bend, which applies the forces that the articulated joint system must handle. U.S. Patent Application No. 14 / 575,117, title of the invention "SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAMSULP, Is disclosed in.

Referring to FIGS. 11-15, the elongated shaft assembly 200'is a plurality for laterally supporting the distal firing beam 280 when the surgical end effector 300 is jointly moved around the range of motion BB. The support link assembly 920 is further provided. As can be seen in FIG. 11, the plurality of support link assemblies 920 include a surgical end effector 300 and a central support member 922 that is movably coupled to the elongated shaft assembly 200'. For example, the central support member 922 is pivotally pinned to the proximal end 320 of the elongated channel 302 so that it is pivotable with respect to the proximal end 320 about the pivot axis PA. .. As can be seen in FIG. 11, the central support member 922 includes a distal overhang tab 923 to receive the upright support pin 332 formed on the proximal end portion 320 of the elongated channel 302. Has a distal pivotal hole 924 inside. As further seen in FIG. 11, the central support member 922 further includes a proximal overhang tab 926, the proximal overhang tab 926 having an elongated proximal slot 928 therein. The proximal slot 928 is configured to slidably receive a central support pin 816 formed on the frame portion 812. With such a configuration, the central support member 922 can, for example, pivot and move axially with respect to the elongated shaft assembly 200'. As can be seen in FIGS. 11-13, the central support member 922 further includes a centrally disposed slot 930 through which the distal firing beam 280 is movably received.

Still referring to FIGS. 11-15, the plurality of support link assemblies 920 further comprise a proximal support link 940 and a distal support link 950. The proximal support link 940 includes an elongated proximal body 942 having a round proximal nose portion 943 and a round distal nose portion 944. Proximal support links 940 further include a pair of downward projecting opposed proximal support walls 945, 946, defining a proximal slot 947 between them. Similarly, the distal support link 950 includes an elongated distal body 952 with a round proximal nose portion 953 and a round distal nose portion 954. The distal support link 950 further includes a pair of downward projecting opposed distal support walls 955, 956, defining a distal slot 957 between them. As can be seen in FIG. 14, the soft distal firing beam 280 extends between the proximal support walls 945, 946 of the proximal support link 940 and the distal support walls 955, 956 of the distal support link 950. It is configured. The proximal support wall 945 includes an inwardly oriented proximal arched surface 948, and the proximal support wall 946 includes an inwardly directed proximal arched surface 949 facing the inwardly oriented proximal arched surface 948. Proximal arched support surfaces 948, 949 are the lateral portion of the proximal portion of the soft distal launch beam 280 as the soft distal launch beam 280 flexes during end effector range of motion and traverses the joint. Works to support laterally. The rounded surface may adapt to the outer diameter of the distal firing beam 280 depending on the direction of joint motion. Similarly, the distal support wall 955 includes an inwardly directed distal arched surface 958, and the distal support wall 956 includes an inwardly directed distal arched surface 959 that faces the distal arched surface 958. The distal arched support surfaces 958, 959 flex over the distal portion of the distal launch beam 280 as the distal launch beam 280 bends during the range of motion of the surgical end effector 300 and traverses the joint. It works to support laterally. The distal arched surfaces 958, 959 may adapt to the outer diameter of the distal firing beam 280 depending on the direction of joint movement. As can be seen in FIGS. 12 and 13, the distal end 217 of the shaft spine 210 includes a distal arcuate spine pocket 218 with a round proximal nose portion 943 of the proximal support link 940 extending inward. The round distal nose portion 944 of the proximal support link 940 is pivotally received within the arched proximal pocket 932 of the central support member 922. In addition, the round proximal nose portion 953 of the distal support link is received within the arcuate distal support member pocket 934 at the distal end of the central support member 922. The round distal nose portion 954 of the distal support link 950 moves into a V-shaped channel cavity 334 formed within an upright lateral support wall 330 formed on the proximal end 320 of the elongated channel 302. Acceptable as possible.

Multiple support linkage assemblies can provide a high degree of lateral support due to the flexible firing beam laminate as the beam bends over a higher range of motion angles. Such a configuration will also prevent the firing beam from buckling over relatively high range of motion angles under high firing loads. The elongated support link, along with the central support member, serves to provide improved lateral support to the firing beam throughout the range of motion compared to many conventional support configurations. In an alternative configuration, the support link may be configured to actually interlock with the central support member at various joint motion angles. The U-shaped support link facilitates easy introduction and supports the soft support beam not only at each lateral part of the launch beam but also at the top, countering upwards while the launch beam is articulated during launch. To prevent that.

In embodiments where the launch member comprises a tissue cut surface, a method that prevents the launch member from accidentally advancing if the unused staple cartridge is not properly supported within the elongated channel 302 of the surgical end effector 300. It may be desirable to construct an elongated shaft assembly. For example, if there are no staple cartridges and the launcher is advanced distally through the end effector, the tissue is cut but not stapled. Similarly, if a used staple cartridge (ie, a staple cartridge in which at least some of the staples have already been fired) is present in the end effector and the firing member is advanced, the tissue will be cut. , Staples may not be complete, if at all. It will become clear that the occurrence of such a phenomenon can lead to undesired catastrophic consequences during surgical procedures. U.S. Pat. , And No. 7,380,695, the title of the invention "SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION OF FIRING", respectively, and their US patents. Is incorporated herein by reference in its entirety.

Such a lockout configuration can be effectively used with various surgical staple fasteners. Such configurations, however, may not be particularly suitable for use in connection with the various surgical staple fastening instruments disclosed herein, using relatively small and short articulated joint configurations. For example, FIGS. 15-19 show a surgical end effector 300 operably attached to an elongated shaft assembly 200'by a joint 270'. The elongated shaft assembly 200'defines the shaft axis SA-SA, and the joint 270' is a surgical end effector for the elongated shaft assembly 200' centered on the range of motion BB that traverses the shaft axis SA-SA. Promotes 300 selective range of motion. In the illustrated embodiment, the dual integral link joint configuration 800 (as described above) can be used to selectively add range of motion motion to the surgical end effector 300. The elongated shaft assembly 200' includes a distal firing beam 280 of the type described above, which, when a firing motion is applied to it, is a surgical end effector from start to end. Within 300, it can be selectively moved in the axial direction. The distal firing beam 280 extends through the joint 270'and is centered on the range of motion BB to adapt to the joint movement of the surgical end effector 300 in the various schemes described herein. It is configured to bend. In the illustrated embodiment, the joint 270'includes a central support member 922 movably attached to the distal end 814 of the shaft frame 812 and the proximal end 320 of the elongated channel 302. As described above, the central support member 922 has a distal projecting tab 923, which receives the upright support pin 332 formed on the proximal end portion 320 of the elongated channel 302. It has a distal pivot hole 924 in it. The central support member 922 further includes a proximal overhang tab 926 with an elongated proximal slot 928. The proximal slot 928 is configured to slidably receive a central support pin 816 formed on the frame portion 812. The central support 922 further includes a centrally disposed slot 930 through which the distal firing beam 280 is axially received. The central support member 922 facilitates the axial passage of the distal launch beam 280 during launch, while at the same time during the joint motion of the surgical end effector 300 centered on the range of motion axis BB, the distal launch beam. Supports the 280 laterally.

In the illustrated embodiment, the distal firing beam 280 is erroneously advanced from the start position to the end position unless the unlaunched surgical staple cartridge 304 is operably seated in the cartridge support member or the elongated channel 302. A firing beam lock assembly 980 is used to prevent this. As can be seen in FIGS. 15-19, the firing beam lock assembly 980 in one embodiment includes a lock cam or detent 281 formed on the distal firing beam 280 so as to project upward from the top surface of the distal firing beam 280. .. The urging member 984 is supported on the central support member 922 and attached to the central support member 922. As can be seen in FIG. 16, for example, the urging member 984 is substantially planar and includes a window 985 configured to accommodate the lock cam 281 during the joint movement of the surgical end effector 300. There is. Therefore, when the surgical end effector 300 is articulated about the range of motion axis BB, the urging member 984 does not apply any urging force or load to the distal firing beam 280. This feature can avoid an increase in the magnitude of the range of motion that must be generated to move the surgical end effector 300 around the range of motion BB. The urging member 984 may be tack welded to the central support member 922, or may be attached to the central support member by other fastening methods such as screws, pins, or adhesives. The window 985 may also define a lock band or portion 986 that acts to contact the lock cam 281 when the distal firing beam 280 is in the starting position. The lock cam 281 is accompanied by a distally inclined surface 283 and a proximally inclined surface 285 so as to reduce the magnitude of the firing and retreating forces required to move the distal firing beam 280 axially. Can be formed. See FIG.

As described above, the distal firing beam 280 is operably mounted on the firing member body 902 on the firing member 900 including the tissue cutting surface 904. In an alternative configuration, the tissue cut surface may be attached to a portion of the distal firing beam 280, or may be formed separately on or directly supported by that portion. .. In the illustrated configuration, a laterally extending foot 905 is formed at the bottom of the launching member body 902. The launching member body 902 further comprises a wedge thread engaging member 906, which wedge thread engaging member 906 is configured to engage the wedge thread in the surgical staple cartridge 304, as discussed in more detail below. Has been done.

FIG. 18 shows an "unused" or "unfired" surgical staple cartridge 304 properly introduced into the elongated channel 302. As can be seen in this figure, the wedge thread 910 is located in the "unfired" (recent position) position within the surgical staple cartridge 304. The wedge thread 910 is configured to engage the wedge thread engaging member 906 on the launching member 900, thereby urging the launching member 900 in the upward direction represented by arrow 988. The surface 914 is included, so that the bottom surface portion of the launching member 900 and the foot 905 are free to pass through the lock wall 307 formed by the lock opening 303 at the bottom of the elongated channel 302. When in that position, the distal firing beam 280 and firing member 900 are located within the elongated channel 302, or more precisely within the surgical staple cartridge 304 mounted therein, from the starting position shown in FIG. All of the surgical staples operably supported within the surgical staple cartridge 304 may be moved distally to the end position within the surgical staple cartridge 304 where the wedge threads 910 have finished ejecting. In such a configuration, after the launch member 900 has been fully launched (ie, fully advanced from the start position to the end position within the surgical staple cartridge 304), the launch member 900 has started as shown in FIG. It is retracted to the position again. The wedge thread 910 is advanced distally to the end position in the staple cartridge 304 by the launch member 900, and the launch member 900 is not attached to the wedge thread 910, so that the launch member 900 returns to the start position. When retracted, the wedge thread 910 is still in the end position within the surgical staple cartridge 304 and does not return the launching member 900 to the start position again. Therefore, the surgical staple cartridge 304 is said to be in a "after", "used", or "launched" state. As can be seen in FIG. 19, when the wedge thread is not in the unlaunched state, the bottom of the body portion 902 and the foot 905 of the launch member 900 are brought to the lock cam 281 on the distal launch beam 280 by the lock band 986 of the urging member 984. The urging motion applied extends into the lock opening 303 at the bottom of the elongated channel 302. When in that position, if the clinician deliberately attempts to refire the used surgical staple cartridge, the body portion 902 and / or the foot 905 will come into contact with the wall 307 of the elongated channel 302 and also initiate. It will be prevented from moving from the position to the end position. Thus, the firing beam lock assembly 980 is a distal firing beam 280 as well as a firing member if an unlaunched or unused surgical staple cartridge is not properly / operably introduced into the elongated channel of the surgical end effector. Prevents the 900 from advancing from the start position to the end position. It will also be apparent that the firing beam lock assembly 980 prevents the distal firing beam 280 from advancing when no staple cartridge has been introduced into the elongated channel 302. Centered on the range of motion axis BB, without the addition of additional loads to the distal launch beam, which may result in increased range of motion to joint the surgical end effector. In addition to adapting to the range of motion of the surgical end effector 300, the firing beam lock assembly 980 is distal across the lockout wall, regardless of whether the end effector jaw is open or closed. When advanced, no additional load is applied to the launch member and / or the distal launch beam.

FIG. 20A shows another embodiment 300'of a range of motion surgical end effector using a firing beam lock assembly 980'with an urging member 984' mounted within an end effector closure sleeve 272. As can be seen in this figure, for example, the urging member 984'applies an urging force to the tilted or tapered portion 283' of the distal firing beam 280'. The launch beam lock assembly 980'otherwise operates in the same manner as described above for the launch beam lock assembly 980'. More specifically, the urging member 984'applies an urging force to the distal firing beam 280' that pushes the distal firing beam 280'and the firing member attached to it downward within the elongated channel. An unused surgical staple cartridge, with the wedge thread or other staple ejector member in the unlaunched position, to move the launch member / launch beam out of engagement with the lock wall. If not properly introduced into the staple channel or cartridge support member to operably engage with, the launch member / launch beam is prevented from being axially advanced from the start position to the end position. Will be.

21-25 show a portion of another elongated shaft assembly 1200 similar to the elongated shaft assembly 200 described above, except for various differences described in more detail below. The components of the elongated shaft assembly 1200 described in detail above are referred to by similar element codes for brevity, eg, when used with each part of the surgical instrument 10 described above, the shaft. No further details will be given beyond what may be necessary to understand the operation of the assembly 1200. As can be seen in FIG. 21, the elongated shaft assembly 1200 includes a joint lock 1810, which is substantially equivalent to the joint lock 810 and operates in essentially the same manner. As can be seen in FIG. 22, the elongated shaft assembly 1200 includes a shaft frame 1812, which is configured to movably support the proximal portion 1821 of the first distal joint driver 1820. It has a proximal cavity 1815. Within the elongated shaft assembly 1200, the first distal joint driver 1820 selectively moves longitudinally in the distal DD and proximal PD in response to the joint motion control motion applied thereto. It is supported so that it can be moved. The shaft frame 1812 further includes a distal end portion 1814 formed on which a pivot pin 1818 is formed. The pivot pin 1818 is adapted to be pivotally received within the pivot hole (not shown) of the proximal end portion 1320 of the elongated channel 1302 of the surgical end effector 1300. With such a configuration, the pivotal movement (ie, joint movement) of the elongated channel 1302 of the surgical end effector 1300 with respect to the shaft frame 1812 about the joint movement axis BB defined by the pivot hole and pin 1818. Be promoted. The shaft frame 1812 further includes a centrally disposed cavity 1817 and a distal notch 1819, the distal notch 1819 being disposed between the distal end 1814 and the centrally disposed cavity 1817.

The shaft assembly 1200 further includes a second distal joint driver 1860, which comprises an endless member 1862 rotatably pivoted on the proximal pulley 1840 and the distal pulley 1340. .. Still referring to FIG. 22, the proximal pulley 1840 is rotatably pivotally supported on the pulley spindle 1842, and the pulley spindle 1842 is mounted in the centrally arranged cavity 1817 in the shaft frame 1812. The distal pulley 1340 is non-rotatably supported or formed on the proximal end 1320 of the elongated channel 1302 of the surgical end effector 1300. In one form, the endless member 1862 comprises a cable made of, for example, stainless steel, tungsten, aluminum, titanium, or the like. The cable may have a braided or multi-stranded structure with varying numbers of strands to obtain the desired level of tensile strength and flexibility. In various configurations, for example, the cable 2382 ranges from 0.08 cm to 0.2 cm (0.03 inch to 0.08 inch), more preferably 0.1 cm to 0.2 cm. Can have a diameter in the range of 0.05 inches to 0.08 inches. Preferred cables can be made from, for example, semi-rigid to fully rigid 300 ferritic steels. In various configurations, the cable can also be coated with, for example, Teflon®, copper, etc. to improve lubricity and / or reduce elongation. For example, by crimping, a first lug 1863 is attached to one end of the cable and a second lug 1864 is attached to the other end of the cable. The cable is stretched under tension while the ends and / or lugs 1863, 1864 are welded, glued and mechanically fastened to each other to form the endless member 1862. Spindle 1842 may include a cam mount that engages the pulley 1840 so as to move the proximal pulley 1840 to the proximal side. Other forms of tensioning configurations, such as belt tensioners, turnbuckle configurations, may also be used to tension the endless member 1862.

Still referring to FIG. 22, the endless member 1862 is coupled to the distal end 1821 of the first distal joint driver 1820 by a coupler assembly 1830. The coupler assembly 1830 comprises an upper coupler portion 1832 formed on the distal end 1822 of the first distal joint driver 1820 and a lower coupler portion 1834. The lower coupler portion 1834 is formed with two cradle 1835 configured to receive lugs 1862, 1864 inside. A pair of mounting pins 1836 are configured to be pressed into holes 1837 of the upper coupler portion 1832 to secure the two coupler portions 1832 and 1834 to each other. Other fastening configurations, screws, rivets, adhesives and the like may be used. When the endless member 1862 is pivotally supported on pulleys 1840 and 1340, the coupler assembly 1830 shafts within the distal notch 1819 of the shaft frame 1812 in response to axial movement of the first distal joint driver 1820. Move freely in any direction. The range of motion generated by the axial movement of the first distal joint driver 1820 is transmitted to the second distal joint driver 1860 or the endless member 1862. A mounting ball or lug 1866 is mounted on the endless member 1862 and is received in a groove or pocket 1342 formed in the distal pulley 1340. Therefore, the movement of the endless member 1862 is transmitted to the surgical end effector 1300, more specifically to the elongated channel 1302 of the surgical end effector 1300, and causes the end effector to jointly move around the joint movement axis BB. Therefore, when the first distal joint driver 1820 is moved in the distal direction DD, the endless member 1862 is a surgical end effector 1300 centered on the range of motion BB in the range of motion represented by arrow 823. To exercise joints. See FIG. 21. Similarly, when the first distal joint driver 1820 is moved in the proximal direction PD, the endless member 1862 is a surgical end effector centered on the joint movement axis BB in the joint movement direction represented by arrow 821. The 1300 is jointly exercised. See FIGS. 21 and 25. As shown in FIG. 21, the joint movement direction 823 is opposite to the joint movement direction 821.

26-31 show a portion of another elongated shaft assembly 2200 similar to the elongated shaft assembly 200 described above, except for various differences described in more detail below. The components of the elongated shaft assembly 2200 described in detail above are referred to by similar element codes for brevity, eg, when used with each part of the surgical instrument 10 described above. No further details will be given beyond what may be necessary to understand the operation of the shaft assembly 2200. As can be seen in FIG. 26, the elongated shaft assembly 2200 includes a proximal housing or nozzle 201 consisting of nozzle portions 202 and 203. The elongated shaft assembly 2200 further includes an anvil actuator member in the form of a closure sleeve 2260 that can be used to close and / or open the anvil 2310 of the surgical end effector 2300 operably attached to it. As can be seen in FIG. 26, the elongated shaft assembly 2200 includes a proximal spine 2210 configured to operably interface with the joint lock 2350. The proximal spine 2210 slidably supports the launching member 2220 therein, and the closure sleeve 2260 extending around the proximal spine 2210 slidably. It is composed. The proximal spine 2210 also slidably supports the proximal joint driver 2230. The proximal joint driver 2230 has a distal end 2231 configured to operably engage the joint lock 2350.

In the illustrated configuration, the proximal spine 2210 includes a proximal end 2211 that is rotatably supported within the chassis 240. In one configuration, for example, the proximal end 2211 of the proximal spine 2210 is formed with a thread 2214 so that it can be screwed into a spine bearing configured to be supported within the chassis 240. Such a configuration facilitates the rotatable attachment of the proximal spine 2210 to the chassis 240 so that the proximal spine 2210 can be selectively rotated with respect to the chassis 240 about the shaft axis SA-SA. The proximal end of the closure sleeve 2260 is attached to a closure shuttle supported within the chassis, as described in detail above. When the elongated shaft assembly 2200 is operably coupled to the handle or housing of the surgical instrument 10, the closure trigger operates to advance the closure sleeve 2260 distally.

As also mentioned above, the elongated shaft assembly 2200 further includes a launching member 2220 that is supported to move axially within the proximal spine 2210. The launch member 2220 includes an intermediate launch shaft portion 2222 configured to be attached to a distal cut or launch beam assembly 2280. See FIG. 27. The intermediate launch shaft portion 2222 may include a longitudinal slot 2223 at its distal end, which may be configured to receive a tab on the proximal end of the distal launch beam assembly 2280. .. The longitudinal slots 2223 and proximal ends of the distal firing beam assembly 2280 can be sized and configured to allow relative movement between them and may also include slip joints. The slip joint moves the intermediate launch shaft portion 2222 of the launch drive 2220 to articulate the end effector 300 without moving the distal launch beam assembly 2280, or at least substantially. It can be possible. When the surgical end effector 2300 is suitably oriented, the proximal side wall of the longitudinal slot 2223 is tabbed to advance the distal firing beam assembly 2280 and launch a staple cartridge that can be supported within the end effector 300. The intermediate launch shaft portion 2222 can be advanced distally until contact. Proximal spine 2210 is also bound to distal spine 2212.

Similar to the elongated shaft assembly 200, the elongated shaft assembly 2200 shown includes a clutch assembly 2400 that may be configured to selectively and releasably couple the proximal joint driver 2230 to the launching member 2220. In one form, the clutch assembly 2400 comprises a lock collar or sleeve 2402 disposed around the launch member 2220, the lock sleeve 2402 in which the lock sleeve 2402 engages the proximal joint driver 2230 with the launch member 2220. And the proximal joint driver 2230 may be rotated between the disengagement position where it is not operably coupled to the launch member 2220. When the lock sleeve 2402 is in its engaging position, the launch member 2220 can be moved distally to move the proximal joint driver 2230 distally, and the launch member 2220 corresponds accordingly. By moving to the proximal side, the proximal joint driver 2230 can be moved to the proximal side. When the lock sleeve 2402 is in its disengaged position, the movement of the launching member 2220 is not transmitted to the proximal joint driver 2230, so that the launching member 2220 moves independently of the proximal joint driver 2230. be able to. Under various circumstances, the proximal joint driver 2230 may be held in place by the joint lock 2350 when the proximal joint driver 2230 has not been moved proximally or distally by the launching member 2220.

As described above, the lock sleeve 2402 may comprise a cylindrical or at least substantially cylindrical body in which a longitudinal aperture 2403 configured to receive the launching member 2220 is defined. The lock sleeve 2402 may include an inwardly facing lock protrusion 2404 and an outwardly facing locking member 2406 that face each other in the radial direction. The lock protrusion 2404 may be configured to selectively engage the launching member 2220. More specifically, when the lock sleeve 2402 is in its engaging position, the lock overhang 2404 is located within a drive notch 2224 defined in the launch member 2220 and thus distal push force and / or proximal. The tensile force can be transmitted from the launching member 2220 to the lock sleeve 2402. When the lock sleeve 2402 is in its engaging position, the second locking member 2406 is received within the drive notch 2232 defined in the joint driver 2230 and thus the distal push force and / or applied to the lock sleeve 2402. Proximal tensile force can be transmitted to the proximal joint driver 2230. In essence, the launch member 2220, the lock sleeve 2402, and the proximal joint driver 2230 will move with each other when the lock sleeve 2402 is in its engaging position. On the other hand, when the lock sleeve 2402 is in its disengaged position, the lock overhang 2404 cannot be located within the drive notch 2224 of the launching member 2220, resulting in a distal pushing force and / or a proximal tensile force. Cannot be transmitted from the launching member 2220 to the lock sleeve 2402. Accordingly, the distal pushing force and / or the proximal tensile force need not be transmitted to the proximal joint driver 2230. Under such circumstances, the launching member 2220 may slide proximally and / or distally to the lock sleeve 2402 and the proximal joint driver 2230.

Similarly, as described above, the elongated shaft assembly 2200 further includes a switch drum 2500 that is rotatably received on the closure sleeve 2260. The switch drum 2500 comprises a hollow shaft segment 2502 on which a shaft boss 2504 for receiving the outward projecting actuating pin 2410 is formed therein. In various situations, the actuating pin 2410 extends through the slot into the longitudinal slot provided in the lock sleeve 2402 and its axial direction when the lock sleeve 2402 is engaged with the joint driver 2230. Make exercise easier. The rotary torsion spring 2420 is configured to engage a boss 2504 on the switch drum 2500 and a portion of the nozzle housing 203 to apply urging force to the switch drum 2500. The switch drum 2500 may further comprise a circumferential opening 2506 defined therein, at least in part, the opening having a circumferential mount extending from nozzle halves 202, 203. It may be configured to accept and allow relative rotation between the switch drum 2500 and the proximal nozzle 201 but not translation. As described above, when the switch drum 2500 rotates, the actuating pin 2410 and the lock sleeve 2402 will eventually rotate between their engaging and disengaging positions. Thus, in essence, the nozzle 201 is articulated in the various schemes described above, as well as in the various schemes of US Patent Application No. 13 / 803,086 and current US Patent Application Publication No. 2014/0263541. It can be used to operably engage and disengage the system and the launch drive system.

With reference to FIG. 27, the closure sleeve assembly 2260 includes a double pivot closure sleeve assembly 2271. According to various forms, the double pivot closure sleeve assembly 2271 includes an end effector closure sleeve 2272 with upper and lower distal protruding tongues. The upper double pivot link 2277 engages the upper distal pinhole of the upper proximal protruding tongue and the upper proximal pinhole of the upper distal protruding tongue on the closure sleeve 2260, respectively, with an upwardly projecting distal And including proximal pivot pins. The lower double pivot link 2278 includes an upwardly projecting distal pivot pin and a proximal pivot pin, each of which is a lower distal pin of the lower proximal protruding tongue. Engage with the hole and the lower proximal pinhole of the lower distal protruding tongue.

The elongated shaft assembly 2200 also includes a surgical end effector 2300 similar to the surgical end effector 300 described above. As can be seen in FIG. 27, the surgical end effector 2300 includes an elongated channel 2302, which elongated channel 2302 is configured to operably support the surgical staple cartridge 2304 inside. The elongated channel 2302 has a proximal end portion 2320 that includes two upright outer walls 2322. The surgical end effector 2300 further comprises an anvil 2310, which anvil has an anvil body 2312 formed on which a stapled lower surface 2313 is formed. The proximal end 2314 of the anvil body 2312 is branched by a firing member slot 2315 to form two anvil mounting arms 2316. Each anvil mounting arm 2316 includes a laterally projecting anvil trunnion 2317. A trunnion slot 2324 for receiving the corresponding one of the anvil trunnions 2317 is provided on each outer wall 2322 of the elongated channel 2302. Such a configuration acts to movably anchor the anvil 2310 to the elongated channel 2302 so that it selectively pivotally moves between the open position and the closed or clamped position. The anvil 2310 is moved to the closed position by advancing the closure sleeve 2260, more specifically the end effector closure sleeve 2272, distally onto the tapered mounting arm 2316, whereby the anvil 2310 is closed. It will be moved distally while pivoting to position. A horseshoe-shaped opening 2273 configured to engage an upright tab 2318 on the anvil 2310 of the end effector 2300 is provided on the end effector closing sleeve 2272. To open the anvil 2310, the closure sleeve 2260, or more specifically the end effector closure sleeve 2272, is moved proximally. In doing so, the central tab portion defined by the horseshoe-shaped opening 2273 works with the tab 2318 on the anvil 2310 to pivot the anvil 2310 back to the open position.

With reference to FIGS. 26, 28 and 29, as described above, the elongated shaft assembly 2200 includes a joint lock 2350 that is substantially equivalent to the joint locks 350 and 810 described above. The components of the joint lock 2350, which are different from the components of the joint lock 350 and are necessary for understanding the operation of the joint lock 350, will be described in more detail below. As described above, the joint lock 2350 may be configured and manipulated to selectively lock the end effector 2300 in place. Such a configuration allows the surgical end effector 2300 to rotate, or jointly move, with respect to the shaft closure tube 2260 when the joint lock 2350 is in its unlocked state. In addition to the above, when the proximal joint driver 2230 is operably engaged with the launching member 2220 via the clutch system 2400, the launching member 2220 makes the proximal joint driver 2230 proximal and / or distal. Can be moved to. The movement of the proximal joint driver 2230, whether proximal or distal, allows the joint lock 2350 to be unlocked, as described above. This embodiment includes a proximal lock adapter member 2360 that is movably supported between the proximal spine 2210 and the distal spine 2212. To receive in the proximal lock adapter 2360 a first locking element 2364 and a second locking element 2366 pivotally supported on a frame rail 2368 extending between the proximal frame 2210 and the distal frame 2212. Includes a lock cavity 2362 of. The joint lock 2350 operates in the various manners described above and is not described further herein for brevity.

As can be seen in FIGS. 26, 28 and 29, a first distal joint driver 2370 is attached to the proximal lock adapter 2360. The first distal joint driver 2370 is operably attached to a second distal joint driver 2380 that operably interfaces with the elongated channel 2302 of the end effector 2300. The second distal joint driver 2380 comprises a cable 2382 rotatably pivoted on the proximal pulley 2383 and the distal pulley 2392. The distal pulley 2392 is non-rotatably supported or integrally formed on the end effector mounting assembly 2390 and includes a detent or pocket 2396. In the illustrated example, the end effector mounting assembly 2390 is moved to the proximal end 2320 of the elongated channel 2302 by a spring pin 2393 extending through a hole in the end effector mounting assembly 2390 and a hole 2394 in the proximal end 2320 of the elongated channel 2302. It is installed impossible. The proximal pulley 2383 is rotatably supported on the distal spine 2212. The distal end of the distal spine 2212 has a pivot pin 2213 formed on it, which is rotatably received within the pivot hole 2395 formed in the end effector mounting assembly 2390. It is configured as follows. Such a configuration facilitates the pivotal movement (ie, range of motion) of the elongated channel 2302 with respect to the distal spine 2212, centered on the range of motion BB defined by the pivot hole 2395 and pin 2213.

In one form, the cable 2382 can be made of, for example, stainless steel, tungsten, aluminum, titanium and the like. The cable may have a braided or multi-stranded structure with varying numbers of strands to obtain the desired level of tensile strength and flexibility. In various configurations, for example, the cable 2382 ranges from 0.08 cm to 0.2 cm (0.03 inch to 0.08 inch), more preferably 0.1 cm to 0.2 cm. Can have a diameter in the range of 0.05 inches to 0.08 inches. Preferred cables can be made from, for example, semi-rigid to fully rigid 300 ferritic steels. In various configurations, the cable can also be coated with, for example, Teflon®, copper, etc. to improve lubricity and / or reduce elongation. In the illustrated example, the cable 2382 has a lug 2384 attached to one end thereof, for example by a crimp, and a lug 2385 attached to the other end. The first distal joint driver 2370 includes a pair of separated cleats 2372, 2374, the cleats 2372, 2374 being sufficiently separated from each other to accommodate lugs 2384, 2385 between them. For example, proximal cleat 2372 includes a proximal slot 2373 for receiving a portion of cable 2382 adjacent to lug 2384, and distal cleat 2374 includes a corresponding portion of cable 2382 adjacent to lug 2385. Includes a distal slot 2375 for reception. Slots 2373 and 2375 are dimensioned relative to lugs 2384, 2385, respectively, to prevent lugs 2384, 2385 from passing through them, respectively. The proximal slot 2375 is angled relative to the distal slot 2375 so that it firmly grips the corresponding portion of the cable 2382 therein. See FIG. A mounting ball or lug 2398 is mounted on the endless member 2382 and is received in a detent or pocket 2396 formed in the distal pulley 2392. See FIG. 31. Thus, when the first distal joint driver 2370 is axially retracted in the proximal direction PD in the manner described above, the endless member 2382 will end effector in the direction represented by arrow 2376 in FIG. The 2300 will be jointly exercised. Conversely, when the first distal joint driver 2370 is axially advanced in the distal DD, the surgical end effector 2300 is articulated in the direction indicated by arrow 2399 in FIG. In addition, the proximal and distal cleats 2372, 2374 are sufficiently spaced between them to accommodate the lugs 2384, 2385. To apply sufficient tension to the cable 2382, a tensioning wedge 2378 is used as shown in FIGS. 29-32 so that when the cable is activated, a range of motion motion is applied to the end effector 2300. .. In the alternative configuration shown in FIG. 35, the proximal cleat 2374'is initially not attached to the first joint driver 2370. Proximal cleats 2374'are placed on the first distal joint driver 2370 to capture the lugs 2384 and 2385 between the distal cleats 2372 and the proximal cleats 2374'. Proximal cleats 2374'are moved towards distal cleats 2372 until sufficient tension is applied to cable 2382, then proximal cleats 2374' are attached to the first distal joint driver 2370. .. For example, the proximal cleat 2374'can be attached to the first distal joint driver 2370 by laser welding or other suitable form of attachment or fastener configuration.

With reference to FIGS. 36-39, the surgical instrument comprises, for example, a centrally-launched beam support member 2286, which extends over the entire joint to support the flexible-launched beam assembly 2280. It is configured in. In one form, the centrally-launched beam support member 2286 comprises a flexible plate member or band with a downwardly projecting distal mounting tab 2287 that is attached to a surgical end effector and an upwardly extending proximal end that is attached to an elongated shaft assembly. Includes portion 2288 and. In at least one configuration, the distal mounting tab 2287 is attached to the end effector mounting assembly 2390 by a spring pin 2393 and the proximal end portion 2288 is pinned to the distal spine 2212 by a pin (not shown). The central launch beam support member 2286 is located along the centerline or shaft axis of the device and acts to support the launch beam during range of motion. It is located on the outer side of the firing beam, thereby deviating from the shaft axis and increasing the tension and compressive forces received during the range of motion, a "blow-out" plate or lateral support plate. It is different from the configuration using. In the illustrated example, the longitudinally movable flexible firing beam assembly 2280 comprises a stacked beam structure comprising at least two beam layers, the at least one beam layer having one adjacent outer side of the central firing beam support member. It is configured to pass, and at least one other beam member is configured to pass through another adjacent outer portion of the centrally launched beam support member. In the illustrated example, the two laminates 2282 and 2284 are configured to pass near each side of the flexible tension transfer member. See, for example, FIGS. 35 and 36. In various embodiments, the laminates 2282 and 2284 may comprise, for example, stainless steel bands that are interconnected by welding or pinning to each other at their proximal ends, but their corresponding distal ends. The portions are not connected to each other so that the laminates or bands separate from each other when the end effectors are articulated. Each pair of laminates or bands 2282, 2284 is represented as the side firing band assembly 2285 of the firing beam assembly 2280. Thus, as shown in FIG. 36, one lateral launch band assembly 2285 is axially moved relative to the central joint bar 2286 by a series of lateral load bearing members 2290 on each outer side of the central joint bar 2286. Supported by the department. Each lateral load bearing member 2290 is made of, for example, stainless steel, aluminum, titanium, liquid crystal polymer material, plastic material, nylon, acrylonitrile butadiene styrene (ABS), polyethylene, etc., and is formed with arched ends 2292 on both sides. Can be done. Each lateral load bearing member 2290 also has an axial passage 2294 extending through it to receive the assembly of the lateral launch band assembly 2285 and the central joint bar 2286. As most specifically seen in FIG. 38, each axial passage is defined by two opposing bow-shaped surfaces 2295 that facilitate the movement of the lateral load bearing member 290 over the longitudinally movable flexible launch beam assembly 2280. Has been done. The lateral load bearing members 2290 are continuously arranged on the lateral launch band assembly 2285 and the central joint bar 2286 so that the opposing arched ends 2292 correspond to the adjacent lateral load bearing members 2290. It is designed to come into contact with the bow-shaped end 2292. See, for example, FIGS. 36 and 37.

Referencing FIG. 37 again, it can be seen that the proximal end portion 2288 of the central joint bar 2286 extends downward for attachment to the distal spine 2212. The distal end 2287 of the firing beam assembly 2280 is attached, for example, to the firing member 2900 of the type and structure described above. As can be seen in this figure, the launching member 2900 includes a vertically extending launching member body 2902, which launching member body 902 has a tissue cut surface or blade 2904 on it. In addition, wedge threads 2910 may be mounted within the surgical staple cartridge 2304 for drive contact with the launching member 2900. When the firing member 2900 is driven distally through the cartridge body 2304, the wedge surface 2912 of the wedge thread 2910 contacts the staple driver, pointing the driver and the surgical staples supported on it upward in the cartridge 2304. To operate. The firing beam assembly 2280 is operated in the various manners described above. When the firing beam assembly 2280 is advanced distally around the articulation joint, the lateral load support member 2290 can help resist the buckling load on the firing beam assembly 2280. The lateral load support member 2290 can also reduce the magnitude of the force required to joint the end effector and adapt to a larger range of motion compared to other joint configurations. The fixed central firing beam support member 2286 serves to support the tensile load generated during joint motion and firing.

As described above, the launch beam assembly comprises a stacked beam structure that includes at least two beam layers. When the firing beam assembly is advanced distally (during firing), the firing beam assembly is essentially branched by a central firing beam support member, so that each part of the firing beam assembly (ie, stacking) is centrally fired. It will pass on both sides of the beam support member.

40-43 show the portion of another firing beam assembly 2280'attached to the firing member 2900. As can be seen in this figure, the launch beam assembly 2280 has two outer beams or layers 228', each of which has a thickness indicated by "a", and four centers, each of which has a thickness of "b". It has a laminated structure including layer 2284'. In at least one configuration, for example, "a" is about 0.01 centimeters to 0.02 centimeters (0.005 inches to 0.008 inches), more preferably 0.020 centimeters (0.008 inches). The "b" may be about 0.02 centimeters to 0.030 centimeters (about 0.008 inches to 0.012 inches), more preferably 0.025 centimeters (0.010 inches). You can. However, other thicknesses may be used. In the illustrated example, "a" is thinner than "b". In another example, "a" is thicker than "b". In an alternative configuration, for example, the laminate may consist of three different thicknesses "a", "b", "c", where "a" = 0.02 centimeters (0.006 inches). ), "B" = 0.025 cm (0.008 inch), "c" = 0.025 cm (0.010 inch) (the thickest laminate or band is in the center of the assembly). In various configurations, an even number of laminates or bands may be present, where the "c" is the single thickest laminate in the center.

This laminate composition is appropriate due to the magnitude of the strain applied to the beam assembly based on the thickness and distance from the bending centerline. Thicker laminates or bands closer to the centerline can receive the same level of strain as thinner laminates or bands away from the centerline, but this is because thinner laminates or bands overlap them with each other. This is because it must be bent more in view of the fact that it has been done. The radius of curvature becomes steeper inside the curve away from the centerline. Given the same radius of curvature, thicker laminates or bands tend to be subject to greater internal stresses than thinner laminates. Therefore, a thinner side laminate or band with the smallest radius of curvature may have the same plastic deformation potential as a thicker laminate or band near the centerline. In other words, when the end effector moves in a certain direction, the laminate or band located away from the direction of the joint movement has the maximum bending radius and is the laminate or band closest to the direction of the joint movement. The band has the densest bending radius. However, the opposite is true when the end effector is range of motion in the opposite direction. Laminates inside the stack stack undergo the same deviation, but their bend radii are always within the outer bend radii. Therefore, it may be desirable to place a thinner laminate outside the stack to maintain flexibility. However, the thicker material inside to maximize stiffness and buckling resistance adds an additional advantage. Instead, if the end effector needs to be jointed in only one direction, the laminate or band located away from that direction will receive the maximum bending radius and will be in the direction of joint movement. The laminated body or band located will have the densest bending radius. However, since the end effectors do not joint in the opposite direction, the reverse is no longer true and therefore the stacking stack does not have to be symmetrical. Therefore, in such a configuration, it is desirable that the thinnest laminate or band be the one that receives the steepest bend radius (the laminate or band on the side in the direction of joint motion).

Still in other configurations, the laminate or band may be made of different metals with different strengths and moduluss. For example, the outer laminate or band can have the same thickness as the inner laminate or band, the inner laminate or band is made of 300 series stainless steel, and the outer laminate or band is titanium or nitinol. Made from.

As can also be seen in FIGS. 42 and 43, the distal firing beam assembly 2280'can be effectively used with the series of lateral load bearing members 2290 described above. The distal firing beam assembly 2280'can also be used with the central joint bar 2286 in the manner described above, so that some of the layers or lateral beams (or bands or laminates) are on the sides of the central joint bar. It will be clear that it advances axially along it. In some embodiments, the advancing layers on each side of the central joint bar 2286 may have the same thickness, composition, shape and composition. In other configurations, one side of the central joint bar to achieve the desired range of movement and flexibility while maintaining the desired amount of stiffness to avoid buckling during firing. The layer traveling along the portion has a thickness and / or composition and / or shape different from the thickness and / or composition and / or shape of the layer traveling along the other side of the central joint bar. You may.

Figures 44-46 show a portion of another elongated shaft assembly 3200 including the surgical end effector 300 of the type and structure described above. Other forms of surgical end effectors may also be used. The elongated shaft assembly 3200 also includes a longitudinally movable flexible launch beam assembly 3280 that is attached to the launch member 900. In an alternative configuration, the distal end of the firing beam assembly 3280 may be configured to perform various movements within the surgical end effector without the need for a firing member attached to it. The flexible launch beam assembly 3280 may comprise the various types of laminated beam configurations described herein. In one configuration, at least two compression bands are used to laterally support the flexible launch beam assembly 8280 as it traverses the joint. The illustrated embodiment uses a total of four compression bands to laterally support the flexible firing beam as it traverses the joint. For example, the elongated shaft assembly 3200 further comprises a spine 3210 that includes a distal end 3217, the distal end 3217 having two distal cavities or notches 3219 formed therein and two proximal cavities or It has a notch 3219'and. One distal cavity 3219 houses the first proximal end 3904 of the first compression band 3900 located on one outer portion 3281 of the flexible firing beam assembly 3280 and the other distal. The cavity 3219 accommodates a second proximal end 3905 of a second compression band 3901 located on another outer portion 3283 of the flexible firing beam assembly 3280. The first compression band 3900 includes a first distal end 3902, the first distal end 3902 corresponding formed on the proximal end 320 of the elongated channel 302 of the surgical end effector 300. It is mounted in the upright lateral support wall 330. Similarly, the second compression band 3901 includes a second distal end 3907, which second distal end 3907 is also on the proximal end 320 of the elongated channel 302 of the surgical end effector 300. It is mounted within the corresponding upright lateral support wall 330 formed. The first and second distal compression bands 3900, 3901 may be made of spring steel or the like so that the proximal ends 3904, 3905 are movably received within the distal notch 3219 as shown. It may be bent in a U-shape so as to form an urging portion configured in. With such a configuration, the first and second distal compression bands 3900, 3901 hold the proximal ends 3904, 3905 within their corresponding distal notches 3219, while the surgical end effector 300. It becomes possible to flex in response to joint movement.

As can be seen in FIGS. 44-46, the elongated shaft assembly 3200 further includes a third compression band 3910 and a fourth compression band 3911. Similar to the first and second compression bands 3900, 3901, the third and fourth compression bands 3910, 3911 may be made of spring steel. As can be seen in FIGS. 44-46, the third compression band 3910 may be disposed between the first compression band 3900 and the outer portion 3281 of the flexible firing beam assembly 3280 and the fourth compression band. The 3911 may be disposed between the second compression band 3901 of the flexible firing band assembly 3280 and the other outer portion 3283. The third proximal end 3914 of the third compression band 3910 and the fourth proximal end 3915 of the fourth compression band 3911 are each movable within the corresponding proximal cavity 3219'in the spine 3210. It may be bent in a U-shaped manner to form a receiving urging portion. The third distal end 3912 of the third compression band 3910 and the fourth distal end 3917 of the fourth compression band 3911 are mounted within the corresponding lateral support wall 330 of the surgical end effector 300. ing.

The elongated shaft assembly 3200 further comprises a movable support link assembly 3920 for further laterally supporting the flexible launch beam assembly 3280 as the end effector 300 is articulated about the articulation axis. As can be seen in FIGS. 44-46, the movable support link assembly 3920 includes a surgical end effector 300 as well as a central support member 3922 movably coupled to the elongated shaft assembly 3200. In one embodiment, the central support member 3922 is pivotally pinned to the proximal end 320 of the elongated channel 302. The central support member 3922 further includes a proximal overhang tab 3926, the proximal overhang tab 3926 having an elongated proximal slot 3928 therein. The proximal slot 3928 is configured to slidably receive the central support pin 3211 formed on the spine 3210. Such a configuration allows dynamic movement to maintain proper lateral support on the firing beam assembly 3280, while central support member 3922 to accommodate a wider range of joint movements. Allows relative pivotal and axial movement between and the spine 3210 of the elongated shaft assembly 3200. As can be seen in FIGS. 44-46, the central support member 3922 further includes a centrally disposed slot 3930 through which the firing beam assembly 3280 is axially received.

As further seen in FIGS. 44-46, the movable support link assembly 3920 further comprises an elongated movable pivot link 3940. The pivot link 3940 includes a central body portion 3942 having a proximal protruding proximal nose portion 3943 and a distal protruding distal nose portion 3944. The pivot link 3940 further includes a first downward projecting lateral support wall 3945 and a second downward projecting lateral support wall 3946, defining a beam slot 3847 between them. As can be seen in FIG. 46, the firing beam assembly 3280 has a first lateral support wall 3945 and a second lateral support wall 3946 during the activation of the firing beam assembly 3280 and the joint movement of the surgical end effector 300. It is configured to extend in between. Further, in the illustrated configuration, for example, the first compression band 3900 extends between the first lateral support wall 3945 and the third compression band 3910, and the second compression band 3901 is a second lateral support. It extends between the wall 3946 and the fourth compression band 3911. The first lateral support wall 3945 includes an inward first bow-shaped surface 3948 and the second lateral support wall 3946 includes an inward second bow-shaped surface 3949. The first and second arcuate surfaces 3948, 3949 serve to provide lateral support to the launch beam assembly 3280 as the launch beam assembly 3280 flexes during the joint movement of the end effector 300. These rounded surfaces may be compatible with the outer diameters of the firing beam assembly 3280 and compression bands 3900, 3901, 3910, 3911, depending on the direction and extent of joint motion. As can also be seen in FIGS. 44 and 45, the distal end 3217 of the spine 3210 includes a pair of left and right opposing shaft notches 3218, within which the surgical end effector is centered on the range of motion. Depending on the direction of joint movement, the round proximal protruding proximal nose portion 3943 of the pivot link 3940 extends. Similarly, left and right opposed support notches 3932 are provided in the central support 3922 to accommodate the distal protruding distal nose portion 3944 of the pivot link 3940, depending on the direction in which the end effector is articulated. There is. Such a notch configuration provides lateral support to the pivot link 3940 and at the same time serves to properly align the pivot link 3940 in a direction suitable for adapting to the direction of joint movement.

FIGS. 47-51 show another elongated shaft assembly 4200 similar to the elongated shaft assembly 2200 described above in some embodiments, except for various differences described in more detail below. The components of the elongated shaft assembly 2200 described in detail above will have similar element codes for brevity, eg, when used with each part of the surgical instrument 10 described above. No further details will be given beyond what may be necessary to understand the operation of the shaft assembly 4200. As can be seen in FIG. 47, in at least one example, the elongated shaft assembly 4200 includes a joint lock 2350. As described in detail above, the joint lock assembly 2350 includes a proximal lock adapter 2360 coupled (eg, pinned) to a first distal joint driver 4370. As can be seen in FIGS. 47 and 50, the first distal joint driver 4370 has a first proximal gear rack segment 4371 and a first distal gear rack segment 4373 formed on its distal end 4372. And include. The elongated shaft assembly 4200 also includes a second distal joint driver 4380, which is formed on a second proximal gear rack segment 4381 and its distal end 4382. Includes a second distal gear rack segment 4383.

The first distal joint driver 4370 and the second distal joint driver 4380 are configured to move axially in the proximal PD and the distal DD with respect to the distal spine assembly 4212. As can be seen in FIG. 50, the first proximal gear rack segment 4371 and the second proximal gear rack segment 4381 engage with the proximal power distribution gear 4390 rotatably supported by the distal spine assembly 4212. There is no engagement. Similarly, the first distal gear rack segment 4373 and the second distal gear rack segment 4383 are in mesh engagement with the distal power distribution gear assembly 4392. Specifically, in at least one configuration, the distal power distribution gear assembly 4392 meshes with and engages with the first distal gear rack segment 4373 and the second distal gear rack segment 4383. including. The distal power distribution gear assembly 4392 further includes a drive gear 4394 configured in mesh engagement with the idler gear 4395. The idler gear 4395 is then supported in meshing engagement with a driven gear 4306 formed on the proximal end portion 4320 of the elongated channel 4302 of the surgical end effector 4300. The surgical end effector 4300 is otherwise similar to the surgical end effector 2300 and may include an anvil 4310 that can be opened and closed in the various manners described above. With reference to FIGS. 48, 49 and 51, the distal spine assembly 4212 may include an upper spine portion 4212A and a lower spine portion 4212B. The distal power distribution gear assembly 4392, idler gear 4395 and driven gear portion 4306 of the elongated channel 4302 are respectively pivotally attached to or supported on the bottom portion 4212B of the distal spine assembly 4212.

The elongated shaft assembly 4200 shown in FIG. 47 includes a firing beam assembly 3280 attached to a firing member (not shown). The firing beam assembly 3280 may comprise a laminated beam configuration of the type described herein. The operation of the launching member has been described in detail above and will not be repeated for brevity. As can also be seen in FIG. 47, U.S. Patent Application No. 14 / 575,117, the title of the invention "SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAMS SUPPORT", the entire disclosure of which is incorporated herein by reference. The disclosed type of emission beam support member 4400 is used to support the emission beam assembly 3280 during the articulation of the surgical end effector 4300. FIG. 52 shows the use of the distal firing beam assembly 2280 in the elongated shaft assembly 4200. As can be seen in this figure, a plurality of lateral load bearing members 2290 are used in the manner described above to support the distal firing beam assembly 2280 when the surgical end effector 4300 is in range of motion. ..

FIGS. 53-58 show another elongated shaft assembly 5200 similar to the elongated shaft assembly 2200 described above in some embodiments, except for various differences described in more detail below. The components of the elongated shaft assembly 5200 described in detail above in connection with the elongated shaft assembly 2200 are identified by similar element codes for brevity, eg, each portion of the surgical instrument 10 described above. When used with, no further details will be given beyond what may be necessary to understand the operation of the elongated shaft assembly 5200.

Similar to the elongated shaft assembly 2200, the elongated shaft assembly 5200 shown includes a clutch assembly 2400, which is a push-and-pull joint motion of a surgical end effector 300 operably coupled to the elongated shaft assembly 5200. It is configured to operably engage with the range of motion system 5600, which is configured to add motion. In this embodiment, the clutch assembly 2400 includes a lock collar or lock sleeve 2402 disposed around the launch member 2220, the lock sleeve 2402 operably coupling the lock sleeve 2402 to the range of motion system 5600 to the launch member 2220. It can be rotated between the engaging position and the disengaging position where the range of motion system 5600 is not operably coupled to the launching member 2220. In particular, with reference to FIGS. 54-56, in the illustrated example, the joint motion system 5600 includes a joint disc or rotating member 5602 that is supported to rotate within the nozzle 201. The joint disc 5602 is rotatably driven by the drive coupling assembly 5610. In the illustrated example, the drive coupling assembly 5610 includes a drive pin 5621 attached to the joint disc 5602. The joint drive link 5614 is operably attached to the drive pin 5612 by a connector 5616 that facilitates some movement of the joint drive link 5614 with respect to the drive pin 5612. See FIGS. 54-56. The joint drive link 5614 includes a drive coupler 5618, which is configured to drively engage the outward locking member 2406 on the lock sleeve 2402. See FIG. 53.

As described above, the lock sleeve 2402 may comprise a cylindrical or at least substantially cylindrical body in which a longitudinal aperture 2403 configured to receive the launching member 2220 is defined. See FIG. 53. The lock sleeve 2402 may include an inwardly facing lock protrusion 2404 and an outwardly facing locking member 2406 that face each other in the radial direction. The lock protrusion 2404 may be configured to selectively engage the launching member 2220. More specifically, when the lock sleeve 2402 is in its engaging position, the lock overhang 2404 is located within a drive notch 2224 defined in the launch member 2220 and thus distal push force and / or proximal. The tensile force can be transmitted from the launching member 2220 to the lock sleeve 2402. When the lock sleeve 2402 is in its engaging position, the outward locking member 2406 is received within the drive notch 5619 of the drive coupler 5618 as shown in FIG. / Or proximal tensile force can be transmitted to the joint drive link 5614. In essence, the launch member 2220, the lock sleeve 2402, and the joint drive link 5614 will move with each other when the lock sleeve 2402 is in its engaging position. On the other hand, when the lock sleeve 2402 is in its disengaged position, the lock overhang 2404 cannot be located within the drive notch 2224 of the launching member 2220, resulting in a distal pushing force and / or a proximal tensile force. Cannot be transmitted from the launching member 2220 to the lock sleeve 2402. Similarly, the driving force DF cannot be applied to the joint disc 5602. Under such circumstances, the launching member 2220 may slide proximally and / or distally to the lock sleeve 2402 and the proximal joint driver 2230.

Similarly, as described above, the elongated shaft assembly 5200 further comprises a switch drum 2500 that is rotatably received on the closure sleeve 2260. See FIG. 53. The switch drum 2500 comprises a hollow shaft segment 2502 on which a shaft boss 2504 for receiving the outward projecting actuating pin 2410 is formed therein. In various situations, the actuating pin 2410 extends into the longitudinal slot 2401 provided in the lock sleeve 2402 and is the axis of the lock sleeve 2402 when the lock sleeve 2402 is engaged with the joint drive link 5614. Promote directional movement. The rotary torsion spring 2420 is configured to engage a boss 2504 on the switch drum 2500 and a portion of the nozzle housing 201 to apply urging force to the switch drum 2500. Similarly, as described above, the switch drum 2500 may further include an opening defined therein, at least partially along the circumferential direction, the opening extending from the nozzle half. It may be configured to accept a circumferential mount and allow relative rotation between the switch drum 2500 and the nozzle housing 201 but not translation. As described above, when the switch drum 2500 rotates, the actuating pin 2410 and the lock sleeve 2402 will eventually rotate between their engaging and disengaging positions. Thus, in essence, the nozzle housing 201 uses the various methods described above, as well as the various methods in US Patent Application 13 / 803,086 and current US Patent Application Publication No. 2014/0263541, for joint motion. It can be used to operably engage and disengage the system 5600 and the launch drive system.

Referring again to FIGS. 53-56, the illustrated example range of motion system 5600 further comprises a "first" or right joint linkage 5620 and a "second" or left joint linkage 5640. The first joint linkage 5620 includes a first joint link 5622, which first joint link 5622 provides a first joint pin 5624 that is movably received within the first joint slot 5604 of the joint disc 5602. Including. The first joint link 5622 is movably pinned to a first joint connector 5626 configured to engage the joint lock 2350. As described above, the joint lock 2350 may be configured and manipulated to selectively lock the surgical end effector 300 in place. Such a configuration allows the surgical end effector 300 to rotate, or jointly move, with respect to the shaft closure tube 2260 when the joint lock 2350 is in its unlocked state. In addition to the above, when the joint drive link 5614 is operably engaged with the launch member 2220 via the clutch system 2400, the launch member 2220 rotates the joint disc 6502 to proximal the first joint linkage 5620. Can be moved laterally and / or distally. The movement of the first joint connector 5626 of the first joint linkage 5620, whether proximal or distal, allows the joint lock 2350 to be unlocked, as described above. The proximal lock adapter 2360 is a lock for receiving a first locking element 2364 and a second locking element 2366 pivotally supported on a frame rail extending between the proximal frame 2210 and the distal frame. Includes cavity 2362. The operation of the joint lock 2350 has been described above and is not described further herein for brevity. As can be seen in FIG. 53, a first distal joint driver 5370 is attached to the proximal lock adapter 2360. The first distal joint driver 5370 is operably attached to the proximal end 320 of the elongated channel 302 of the surgical end effector 300.

Similarly, as shown above, the range of motion system 5600 in the illustrated example further comprises a "second" or left joint linkage 5640. As can be seen in FIGS. 54-56, the second joint linkage 5640 includes a second joint link 5642, which movably accepts the second joint link 5642 into the second joint slot 5606 of the joint disc 5602. Includes a second joint pin 5644 to be made. The second joint link 5642 is pinned to a second joint bar 5646 attached to the proximal end 320 of the elongated channel 302 of the surgical end effector 300. Referring to FIG. 54, the range of motion system 5600 has a first joint urging member 5628 received in the first joint slot 5604 and a second joint urging member received in the second joint slot 5606. It further includes a member 5648. FIG. 54 shows a joint movement system 5600 in a neutral or non-joint movement configuration. As can be seen in this figure, the first joint pin 5624 is in contact with the first joint urging member 5628, and the second joint pin 5644 is in contact with the second joint urging member 5648. However, when in its neutral position, the first and second joint urging members 5628, 5648 do not have to be in the compressed state. FIG. 55 shows that the driving force DF is applied to the joint disk 5602 in the proximal direction PD by the joint driving link 5614 by the method described above. Applying the driving force DF in the proximal direction "PD" results in the joint disk 5602 being rotated in the direction of rotation represented by the arrow 5601. When the joint disc 5602 rotates in the direction of rotation 5601, the end of the second joint slot contacts the second joint pin 5644 to the second joint linkage 5640 and finally the second joint bar 5646. Apply pushing force to. Conversely, the first joint urging member 5628 pushes the first joint pin 5624 in the first joint slot 5604 in the direction of arrow 5601, whereby the tensile force is first in the proximal direction PD. Added to the joint linkage 5620. This proximal tensile force is transmitted to the first distal joint driver 5370 through the joint lock 2350. Such "pushing and pulling motion" applied to the surgical end effector will cause the surgical end effector 300 to jointly move around the range of motion in the direction represented by the arrow 5300. See FIG. 53. When the joint disc 5602 is in the position shown in FIG. 55, the second joint urging member 5648 may be in a compressed state, and the first joint urging member may not be compressed. Therefore, when the force of the driving force DF on the joint driving link 5614 is interrupted, the second joint urging member 5648 may again urge the joint disc 5602 to, for example, the neutral position shown in FIG.

Conversely, as shown in FIG. 56, when the driving force DF is applied to the joint driving link 5614 in the distal direction DD, the joint disc 5602 rotates in the direction of rotation represented by arrow 5603. As the joint disc 5602 rotates in the direction of rotation 5603, the end of the first joint slot 5604 contacts the first joint pin 5624 and through the joint lock 2350 to the first joint linkage 5620 and finally to the first. A pushing force is applied to the distal joint driver 5370 of 1. In addition, the second joint urging member 5648 pushes the second joint pin 5644 in the second joint slot 5606 in the direction of arrow 5603, whereby the tensile force is second in the proximal direction PD. Added to joint linkage 5640. This proximal tensile force is transmitted to the second joint bar 5646. Such a "pushing and pulling motion" applied to the surgical end effector 300 will cause the surgical end effector 300 to jointly move around the range of motion in the direction represented by arrow 5302. See FIG. 53. When the joint disc 5602 is in the position shown in FIG. 56, the first joint urging member 5628 may be in a compressed state and the second joint urging member 5648 may not be compressed. Therefore, when the force of the driving force DF on the joint driving link 5614 is interrupted, the first joint urging member 5628 may again urge the joint disc 5602 to, for example, the neutral position shown in FIG.

FIG. 57 shows the attachment of the distal end portion 814 of the shaft frame 812 to the surgical end effector 300 operably coupled to the elongated shaft assembly 5200. As described above, the distal end portion 814 has a downward protruding pivot pin (not shown) on it, which downward protruding pivot pin is formed on the proximal end portion 320 of the elongated channel 302. It is adapted to be pivotally accepted within the pivotal hall (not shown). With such a configuration, the pivotal movement of the elongated channel 302 with respect to the shaft frame 812 about the joint motion axis BB defined by the pivot hole is promoted. As can be seen in FIG. 57, the first distal joint driver 5370 is attached to the first coupler 850 by the first ball joint 852. The first coupler 850 is also pivotally pinned to the proximal end portion 320 of the elongated channel 302 by a first pin 854, as can be seen in FIG. Similarly, a second joint bar 5646 is attached to the second coupler 870 by a second ball joint 872. The second coupler 870 is also pivotally pinned to the proximal end portion 320 of the elongated channel 302 by a second pin 874, as can be seen in FIG.

With reference to FIGS. 53 and 58, the elongated shaft assembly 5200 may also include a launch beam assembly 2280 attached to the launch member 900 of the type described above. The firing beam assembly 2280 is attached to the firing member 2220 and can be axially advanced and retracted in the various manners described above. The elongated shaft assembly 5200 further comprises a plurality of support link assemblies 920 for laterally supporting the distal firing beam 2280 as the surgical end effector 300 is articulated around the range of motion BB. May be good. As can be seen in FIG. 58, the plurality of support link assemblies 920 include a central support member 922 that is pivotally pinned to the proximal end 320 of the elongated channel 302 in the manner described above. The central support member 922 further includes a centrally disposed slot 930 through which the distal firing beam 2280 is axially received. A plurality of support link assemblies 920 further include a proximal support link 940 and a distal support link 950. The proximal support link 940 includes a body portion 942 having a round proximal end 943 and a round distal end 944. The proximal support link 940 further includes a pair of downward projecting lateral support walls 945, defining a proximal slot between them. Similarly, the distal support link 950 includes a body portion 952 having a round proximal end 953 and a round distal end 954. The distal support link 950 further includes a pair of downwardly projecting lateral support walls 955, defining a distal slot between them. As can be seen in FIG. 58, the distal firing beam 2280 is configured to extend between the lateral support wall 945 of the proximal support link 940 and the lateral support wall 955 of the distal support link 950. Each support wall 945 and 955 includes an inwardly bowed surface, as described above. These support surfaces serve to provide lateral support to the distal launch beam assembly 2280 as the distal launch beam 2280 flexes during the joint movement of the end effector 300. In addition, the closure sleeve assembly 2260 may include a dual pivot closure sleeve assembly of the type described above configured to operably interact with the anvil of the surgical end effector 300. The operation of the closure sleeve assembly 2260 results in the surgical effector anvil opening and closing in the various manners described above.

FIG. 59 shows a portion of another elongated shaft assembly 5700 that may be substantially equivalent to the elongated shaft assembly 5200, except for the differences described below. Specifically, the joint disc 5702 of the joint motion system 5701 is rotated by a worm gear motor 5710 operably supported by the nozzle housing 201. In one embodiment, for example, the driven gear 5703 is integrally formed with or immovably attached to the joint disc 5702, resulting in meshing engagement of the motor 5710 with the worm gear drive 5712. Eggplant. In the illustrated example, the first joint rod or member 5720 can be attached directly to a portion of the surgical end effector by any of the various methods described herein. A first joint pin 5722 is attached to a first joint rod 5720 and is received in a bow-shaped first joint slot 5704 formed in a joint disc 5702. A first joint urging member 5705 is received in the first joint slot 5704 to urge contact with the first joint pin 5722. Similarly, the second joint rod or member 5730 may be attached directly or indirectly to a portion of the surgical end effector in any of the various methods described herein. A second joint pin 5732 is attached to the second joint rod 5730 and is received in a bow-shaped second joint slot 5706 formed in the joint disc 5702. A second joint urging member 5707 is received in the second joint slot 5706 to urge contact with the second joint pin 5732.

FIG. 59 shows a joint movement system 5701 in a neutral or non-joint movement configuration. As can be seen in this figure, the first joint pin 5722 is in contact with the first joint urging member 5705, and the second joint pin 5732 is in contact with the second joint urging member 5707. However, when in its neutral position, the first and second joint urging members 5705 and 5707 do not have to be in the compressed state. By activating the motor 5710 to rotate the joint disc 5702 in the direction of rotation represented by the arrow 5601, a tensile motion is applied to the first joint rod 5720 and the first joint rod 5720 is directed to the proximal PD. At the same time as being moved, a pushing motion is applied to the second joint rod 5730 to move the second joint rod 5730 in the distal "DD" direction. Conversely, by activating the motor 5710 to rotate the joint disc 5702 in the direction of rotation represented by the arrow 5603, a pushing motion is applied to the first joint rod 5720 and the first joint rod 5720 is distal. At the same time that it is moved in the directional DD, a tensile motion is applied to the second joint rod 5730 and the second joint rod 5730 is moved in the proximal direction PD. Such "pushing and pulling motions" applied to the surgical end effector will cause the surgical end effector to jointly move around the range of motion in the various manners described above.

Figures 60-65 show another range of motion system 5800 that can be used with the various elongated shaft assemblies and effector configurations described herein. In this embodiment, however, the range of motion system 5800 comprises a double joint disc assembly 5810 with a driver joint disc 5820 and a driven joint disc 5830. Even if both joint discs 5820 and 5830 are rotatably supported, for example, in the nozzle housing of an elongated shaft assembly so that both joint disc discs 5820 and 5830 can rotate independently about a common axis. Good. In various embodiments, drive motion can be applied to the driver joint disc 5820 by the joint drive link 5614 and the launch member configuration 2220 as described above. In another embodiment, rotational drive motion may be applied to the driver joint disk 5820 by the worm gear motor 5710 in the manner described above.

FIG. 61 shows one form of the driver disk 5820. As can be seen in this figure, the driver disc 5820 includes a first pair of first bow joint slots 5822L, 5822R, each of which has a first bow length FL. In addition, the driver joint disc 5820 further includes a driver slot 5824 centrally located between the first joint slots 5822, as can be seen in FIG. Depending on the method used to drive the driver joint disc 5820, the joint drive link 5614 or worm gear motor 5710 interfaces with the driver joint disc 5820 in the various manners described above to rotate motion into the driver joint disc 5820. Can be added. FIG. 62 shows one form of the driven joint disc 5830. As can be seen in this figure, the driven joint discs 5830 have a second pair of second bow joint slots 5832L, 5832R, each of which has a second bow length "SL" shorter than the first bow length FL. Includes. In addition, the driven joint disc 5830 further includes a driver post 5834 configured to be movably received within the driver slot 5824.

With reference to FIGS. 60 and 63-65, the range of motion system 5800 is attached directly or jointly to a portion of the surgical end effector in any of the various methods described herein. It further comprises a possible first joint rod 5840. A first joint pin 5842 is attached to a first joint rod 5840 and is received in the corresponding first and second arched joint slots 5822L, 5832L. Similarly, a second joint rod or member 5850 may be attached directly to a portion of the same surgical end effector in any of the various methods described herein. A second joint pin 5852 is attached to the second joint rod 5850 and is received in the corresponding first and second arched joint slots 5822R, 5832R. FIG. 60 shows a range of motion system 5800 in a null position where the surgical end effector can be moved freely. FIG. 63 shows the placement of the joint motion system 5800 when a rotational motion is first applied to the driver joint disc 5820 in the direction indicated by the arrow 5860. As can be seen in this figure, during the initial rotation of the driver joint disc 5820, the joint slots 5822L, 5832L are inconsistent with each other, and the joint slots 5822R, 5832R are also inconsistent with each other, but the motion is still on the joint rods 5840, 5850. Not communicated. FIG. 64 shows the placement of the range of motion system 5800 when a rotational motion is subsequently applied to the driver joint disk 5820 in the direction of arrow 5860, which rotational motion is, for example, a surgical end effector with respect to the shaft axis. It is sufficient to result in a 75 degree range of motion. As can be seen in this figure, a pushing motion is applied to the first joint rod 5840, the first joint rod 5840 is axially moved in the distal DD, and a tensile motion is applied to the second joint rod 5850. The second joint rod 5850 is axially moved in the proximal direction PD. The movement of the first and second joint rods 5840, 5850 in opposite directions results in the joint movements of the surgical end effector operably interfacing with them. FIG. 65 shows the arrangement of the joint motion system 5800 when a rotational motion is applied to the driver joint disk 5820 in the opposite direction represented by the arrow 5862, which rotational motion is, for example, the opposite joint motion. It is sufficient to result in a 75 degree range of motion of the surgical end effector with respect to the shaft axis in the direction. As can be seen in this figure, a pushing motion is applied to the second joint rod 5850, a second joint rod 5850 is axially moved in the distal DD, and a tensile motion is applied to the first joint rod 5840. The first joint rod 5840 is axially moved in the proximal direction PD. The opposite movement of the first and second joint rods 5840, 5850 results in joint movement of the surgical end effectors operably attached to them. In one configuration, the first joint rod 5840 may only apply tensile force to the surgical end effector when the joint driver disc 5820 is rotated a sufficient distance to reach a range of motion of 75 degrees. Good.

FIGS. 66-70 show the surgical end effector 6300 with first and second jaws that can move simultaneously between the open and closed positions with respect to the shaft axis SA-SA. The first and second jaws may comprise a variety of surgical jaw configurations without departing from the spirit and scope of the present invention. Gaining access to target tissue using the jaw of a surgical end effector can sometimes be difficult. The operability of surgical end effectors, especially those designed to cut and staple tissue, is the distance between the point where the jaws are supported against each other and the most recent staple position. Can be improved if minimized. For example, a surgical end effector that uses only one movable jaw (ie, one of the jaws is fixed to the shaft axis) has one movable jaw that moves relatively widely to accommodate the target tissue. It may be necessary to have a range. Such a wider range of movement can complicate the process of favorably placing target tissue using end effectors. The surgical end effector 6300 uses first and second jaws that move around a common pivot axis and with respect to each other and with respect to the shaft axis. Such a configuration can, for example, reduce the distance between the pivot axis and the most recent staple position compared to the same distance in a particular surgical end effector that uses only one movable jaw. It will be possible.

In the illustrated example, the first jaw 6310 includes an elongated channel 6312 configured to support a surgical staple cartridge 6320 inside. As can be seen in FIG. 70, the surgical staple cartridge 6320 is configured to operably support a plurality of staple drivers 6322 therein, on which the staple driver 6322 can operate the surgical staple 6324. To support. The staple driver 6322 is movably supported in a corresponding driver slot 6321 formed within the surgical staple cartridge 6320. Staple drivers 6322 are held in their respective driver slots 6321 by cartridge pans 6330, which are clipped to or otherwise attached to surgical staple cartridges 6320. Staple drivers 6322 are arranged in rows on each side of the elongated slot 6326 of the surgical staple cartridge 6320 to accommodate the axial passages of the firing member 6340 through it. A wedge thread 6350 is movably supported within the surgical staple cartridge 6320 and the launching member 6340 is within the distal portion of the surgical staple cartridge 6320 from a starting position adjacent to the proximal end of the surgical staple cartridge 6320. It is configured to be drivenly engaged by the launching member 6340 when driven to the end position. As described above, when the wedge threads 6350 are driven distally through the surgical staple cartridge 6320, the wedge threads 6350 drive into contact with the staple drivers 6322 and direct them towards the cartridge deck surface 6323. Drive. The firing member 6340 has a tissue cutting surface 6346, which serves to cut the tissue clamped between the jaws when the firing member 6340 is driven distally. Various types of distal firing beams (not shown) described herein are operably attached to a firing member 6340 as well as an intermediate firing shaft portion 2222 or other firing system configuration. The operation of the intermediate firing shaft portion 2222 to drive and retract the distal firing beam has been described in detail above and is not repeated for brevity. Other firing beam and firing system configurations (motor driven and manually driven) may also be used to power the launching member without departing from the spirit and scope of the present invention.

The illustrated surgical end effector 6300 is also configured to selectively articulate around the range of motion BB that substantially traverses the shaft axis SA-SA. As can be seen in FIGS. 66-70, the surgical end effector 6300 includes an end effector mounting assembly 6390, which is rotatably received, for example, in the mounting hole 6392 of the end effector mounting assembly 6390. It is adapted to be pivotally mounted on a distal shaft frame (not shown) that includes a pivot pin configured as described above. The surgical end effector 6300 can be ranged by the type of joint lock described above as well as the first and second joint rod configurations. As can be seen in FIG. 70, the end effector mounting assembly 6390 further includes a pair of bilateral laterally extending trunnion pins 6394. The trunnion pin 6394 extends laterally from the outer 6391 on either side of the end effector mounting assembly 6390, which also defines a pocket area 6395 configured to receive the launch member 6340 inside. There is. The trunnion pin 6394 serves to define the pivot axis PA-PA through which the first and second jaws 6310, 6360 can pivot around it. The first jaw 6310 or the proximal end 6314 of the elongated channel 6312 is a pair of opposing U-shaped or open types adapted to receive the corresponding one of the trunnion pins 6394 inside. Includes slot 6316. Such a configuration acts to movably or pivotally support the first jaw 6310 with respect to the end effector mounting assembly 6390.

The illustrated surgical end effector 6300 further comprises a second jaw 6360 that may include anvil 6362. The illustrated anvil 6362 includes an anvil body 6364 that includes an elongated slot 6366 and two stapled surfaces 6368 formed on each side. The anvil 6362 further has a proximal end portion 6370, which is also a pair of U-shapes adapted to receive the corresponding one of the trunnion pins 6394 inside. Alternatively, it has an open slot 6372. Such a configuration acts to movably or pivotally support the second jaw 6360 with respect to the end effector mounting assembly 6390 so that the first and second jaws are mutually pivoted. Not only can it move with respect to it, but it can also move with respect to the shaft axis SA-SA. The first and second jaws 6310 and 6360 may be movably actuated by the various types of closure systems disclosed herein. For example, a first closure drive system of the type described herein may be used to operate the closure sleeve in the manner described herein. The closure sleeve can also be attached to the end effector closure sleeve 6272, which can be pivotally attached to the closure sleeve by a double pivot closure sleeve assembly in the manner described above. As described above, for example, the axial movement of the closure sleeve can be controlled through the activation of the closure trigger 32. As can be seen in FIGS. 67-69, the end effector closure sleeve 6272 extends over the end effector mounting assembly 6390 and is proximal to the proximal end 6370 of the second jaw 6360 and the first jaw 6310. It is configured to engage the end 6314. At least one cam surface 6336 may be formed on the proximal end 6314 of the first jaw 6310, whereby when the distal end 6274 of the end effector closure sleeve 6272 comes into contact with the cam surface 6336. The first jaw 6310 is cam driven towards the second jaw and shaft axis SA-SA. Similarly, one or more cam surfaces 6376 may be formed on the proximal end portion 6370 of the second jaw 6360, thereby contacted by the distal end 6274 of the end effector closure sleeve 6272. When so, the second jaw 6360 is moved towards the first jaw 6310 and the shaft axis SA-SA. The cam surfaces 6336, 6376 may be configured and arranged relative to each other such that the first and second jaws close relative to each other at various "closing speeds" or closing times. One such configuration is shown in FIG. As seen in Figure 68, when the first and second jaws are in their respective fully open position, the corresponding point P on the first and the point P ₁ on the jaw 6310 second jaw 6360 _The distance along the bow path between 2 is represented by _DT. P ₁ and point P ₂ of the first and second is said to be "compatible" with each other. For example, the first point P ₁ and the second point P ₂ may each be on a common line or axis extending between them and perpendicular to the shaft axis SA-SA. Distance along the arcuate path between the another point P _A and shaft axis SA-SA of the first jaw 6310 is represented by D _1, another corresponding point P on the second jaw _The distance along another bow path between B and the shaft axis SA-SA is represented by _{D 2.} Points P _A and the point P _B is also said to correspond to each other. For example, the point P _A and the point P _B may be on a common line or axis which is perpendicular to the extending therebetween and the shaft axis SA-SA. _{In the illustrated configuration, the distance D2 at which the second} jaw 6360 or anvil 6362 travels from the fully open position to the closed position where the stapled surface of the anvil 6362 is located along the shaft axis SA-SA is the second. _{The jaw 6310 or surgical staple cartridge 6320 of 1} is longer than the distance D1 from which the cartridge deck surface moves from the fully open position to the closed position where the cartridge deck surface is located along the shaft axis SA-SA. For example, in at least one configuration, the second jaw or anvil _{opens or moves over two-thirds of the distance DT} (or another distance along another movement path between the jaws). The first jaw or staple cartridge _{opens or moves over one-third of the distance DT} (or other distance along yet another path of travel between the jaws) and is therefore essentially essentially. Even if the closing motion is initially applied to both jaws at the same or equivalent time, one jaw will be fully closed faster or faster than the other jaw will obtain its fully closed position. Get a closed position. For example, the cam surfaces on the first and second jaws can be arranged / configured to obtain different jaw movement ratios / speeds without departing from the gist and scope of this embodiment of the invention. When the end effector closing sleeve 6272 is in the starting or inactive position, the opening spring 6380 (FIG. 70) is in the first jaw to urge the first and second jaws 6310, 6360 to the open position. It may be located between the proximal end 6314 of the portion 6310 and the proximal end 6370 of the second jaw 6360. See FIGS. 67-69.

To move the first and second jaws 6310, 6360 to the closed position (FIG. 66), the clinician activates the closure system to activate the cam surface on the proximal end 6314 of the first jaw 6310. The 6336 and the cam surface 6376 on the proximal end 6370 of the second jaw 6360 are simultaneously in contact with each other (and the shaft axis SA) to the positions shown in FIG. 66 of the first and second jaws 6310, 6360. Move the end effector closure sleeve 6272 in the distal DD to urge it towards (-SA). The first and second jaws 6310 and 6360 are held in this closed position while the end effector closing sleeve 6272 is held in this position. The launch system can then be actuated to axially advance the launch member 6340 distally through the surgical end effector 6300. As can be seen in FIG. 70, the launch member 6340 is slidable within the slotted passage 6318 of the elongated channel 6312 and the foot portion 6342 configured to slidably engage the slotted passage 6374 of the anvil 6362. It may have an upper tab portion 6344 adapted to be accepted by the. See FIG. 69. Thus, such launch member configurations are provided during launch of the launch member (ie, during staple launch and cutting of tissue clamped between the first jaw 6310 and the second jaw 6360). , The first and second jaws 6310, 6360 serve to reliably hold in the desired distance arrangement. The first jaw cover 6315 is provided to prevent tissue and / or body fluids from entering the first and second jaws, which may interfere with or interfere with the operation of the launching member 6340, as well as for assembly purposes. It is detachably attached to the elongated channel 6312 and the second jaw cover 6363 is detachably attached to the anvil 6362.

FIG. 71 shows another surgical end effector 6300'similar to the surgical end effector 6300. As can be seen in this figure, the surgical end effector 6300'has two jaws that can move simultaneously between the open and closed positions with respect to the shaft axis SA-SA. In the illustrated example, the first jaw 6310'contains an elongated channel 6312' configured to support a surgical staple cartridge 6320'into. The surgical staple cartridge 6320'is configured to operably support a plurality of staple drivers 6322 therein, on which the staple driver 6322 operably supports the surgical staples 6324. The staple driver 6322 is movably supported in a corresponding driver pocket 6321'formed within the surgical staple cartridge 6320'. Staple drivers 6322 are held in their respective driver slots 6321'by cartridge pans 6330', which cartridge pans 6330' are clipped to or otherwise attached to surgical staple cartridges 6320'. Staple drivers 6322 are arranged in rows on each side of the elongated slot 6326'of the surgical staple cartridge 6320 to accommodate the axial passages of the launching member 6340'through it. The wedge thread 6350'is movably supported within the surgical staple cartridge 6320', and the launching member 6340' is from the starting position adjacent to the proximal end of the surgical staple cartridge 6320' to the surgical staple cartridge 6320'. It is configured to be driven and engaged by a launching member 6340'when driven to an end position within the distal portion. As described above, when the wedge thread 6350'is driven distally through the surgical staple cartridge 6320', the wedge thread 6350'drives into contact with the staple driver 6322 to bring them into cartridge deck surface 6323. Drive towards'. The launching member 6340'contains a tissue cutting surface 6346', which acts to cut the tissue clamped between the jaws when the launching member 6340 is driven distally. Is. Various types of distal firing beams (not shown) described herein are operably attached to a firing member 6340'as well as an intermediate firing shaft portion 2222 or other firing system configuration. The operation of the intermediate firing shaft portion 2222 to drive and retract the distal firing beam has been described in detail above and is not repeated for brevity. Other firing beam and firing system configurations (motor driven and manually driven) may also be used to power the launching member without departing from the spirit and scope of the present invention.

The illustrated surgical end effector 6300'is also configured to selectively articulate around the range of motion BB that substantially traverses the shaft axis SA-SA. The end effector 6300' includes an end effector mounting assembly 6390', which is configured to be rotatably received, for example, in the mounting hole 6392' of the end effector mounting assembly 6390'. It is adapted to be pivotally mounted on a distal shaft frame that includes a moving pin. The surgical end effector 6300'can be ranged by the type of joint lock described above as well as the first and second joint rod configurations. As can be seen in FIG. 71, the end effector mounting assembly 6390' further includes a pair of bilateral laterally extending trunnion pins 6394'. The trunnion pin 6394'extends laterally from the outer 6391' on both sides of the end effector mounting assembly 6390', and the outer 6391'is also a pocket area configured to receive the launching member 6340'into. It defines 6395'. The trunnion pin 6394'acts to define the pivot axis PA-PA on which the first and second jaws 6310', 6360' can be pivoted around it. The first jaw 6310'or the proximal end 6314' of the elongated channel 6312'is a pair of opposing U-shapes adapted to receive the corresponding one of the trunnion pins 6394'. Includes or open slot 6316'. Such a configuration acts to movably or pivotally support the first jaw 6310'with respect to the end effector mounting assembly 6390'.

The illustrated surgical end effector 6300'adds a second jaw 6360' which may include anvil 6362'. The illustrated anvil 6362'includes an anvil body 6364' that includes an elongated slot 6366'and two staple-molded surfaces formed on each side. The anvil 6362'has an additional proximal end portion 6370', and the proximal end portion 6370'is also adapted to accept the corresponding one of the trunnion pins 6394'into a pair. It has a U-shaped or open slot 6372'. Such a configuration acts to movably or pivotally support the second jaw portion 6360'with respect to the end effector mounting assembly 6390'. The first and second jaws 6310'and 6360' are movably actuated by the various types of closure systems disclosed herein. For example, a first closure drive system 30 may be used to operate the closure sleeve 260 in the manner described herein. The closure sleeve 260 may also be attached to the end effector closure sleeve 6272, which may be pivotally attached to the closure sleeve 260 by the double pivot closure sleeve assembly 271 in the manner described above. As described above, for example, the axial movement of the closure sleeve 260 can be controlled through the activation of the closure trigger 32. The end effector closure sleeve 6272 extends over the end effector mounting assembly 6390'with the proximal end 6370' of the second jaw 6360' and the proximal end 6314' of the first jaw 6310'. It is configured to engage. At least one cam surface 6336'may be formed on the proximal end 6314' of the first jaw 6310', whereby the distal end 6274 of the end effector closure sleeve 6272 and the cam surface 6336' Upon contact, the first jaw 6310'is cam driven towards the second jaw 6360' and the shaft axis SA-SA. Similarly, one or more cam surfaces 6376'may be formed on the proximal end portion 6370' of the second jaw 6360', thereby the distal end of the end effector closure sleeve 6272. When contacted by 6274, the second jaw 6360'is moved towards the first jaw 6310' and the shaft axis SA-SA. When the end effector closing sleeve 6272 is in the starting or inactive position, a spring (not shown) is provided to urge the first and second jaws 6310', 6360' to the open position. It may be located between the proximal end 6314'of the jaw 6310'and the proximal end 6370' of the second jaw 6360'.

To move the first and second jaws 6310', 6360' to the closed position, the clinician activates the closure system to activate the cam surface on the proximal end 6314' of the first jaw 6310'. Simultaneously contact the 6336'and the cam surface 6376' on the proximal end 6370' of the second jaw 6360' to bring the first and second jaws 6310', 6360' to each other (and the shaft axis SA- Move the end effector closure sleeve 6272 toward the distal DD to urge it towards (SA). The first and second jaws 6310'and 6360' are held in this closed position while the end effector closing sleeve 62772 is held in this position. The launch system can then be actuated to axially advance the launch member 6340'to the distal side through the surgical end effector 6300'. The launch member 6340'slablely accommodates the upper tab portion 6344' configured to slidably engage the slotted passage 6374' of the anvil 6362'and the slotted passage of the elongated channel 6312'. It may have a foot portion 6342'fitted to be. Thus, such a launch member configuration is during launch of the launch member (ie, during staple launch and cutting of tissue clamped between the first jaw 6310'and the second jaw 6360'. ), The first and second jaws 6310', 6360' work to ensure that they are held in the desired distance arrangement. First jaw cover 6315 to prevent tissue and / or body fluids from entering the first and second jaws, which may interfere with or interfere with the movement of the launching member 6340'as well as for assembly purposes. 'Is detachably attached to the elongated channel 6312' and the second jaw cover 6363' is detachably attached to the anvil 6362'.

In the surgical end effector embodiments described herein, where both use jaws that move relative to each other and with respect to the shaft axis, one of the jaws is fixed, eg, with respect to the shaft axis, and does not move. It can offer a variety of advantages over other surgical end effector configurations. In such a configuration, one movable jaw has a relatively wide range of movement relative to the fixed jaw so that the target tissue can be manipulated, placed and then clamped in between. Is often desirable. In embodiments where both jaws are mobile, each jaw does not require extensive motion to adapt to the manipulation, placement and clamping of the target tissue between them. For example, such reduction of anvil movement can result in improved organizational placement. Such a configuration may also make it possible to minimize the distance between the pivot axis and the first staple position. In addition, the launching member may always remain engaged with the movable jaws (anvil and elongated channels) during the opening and closing movements.

Figures 72-79 show another surgical end effector 6400 configured to be operably attached to the type of elongated shaft assembly described herein that defines the shaft axis SA-SA. The surgical end effector 6400 comprises two jaws that can be simultaneously moved between an open position and a closed position with respect to the shaft axis SA-SA. The first and second jaws may comprise a wide variety of surgical-related jaw configurations. In the illustrated example, the first jaw 6410 includes an elongated channel 6412 configured to support a surgical staple cartridge 6420 inside. Similar to the various surgical staple cartridges described above, the surgical staple cartridge 6420 is configured to operably support multiple staple drivers (not shown) therein. Operately support surgical staples (not shown) above. The staple driver is movably supported in a corresponding driver pocket formed within the surgical staple cartridge 6420. Staple drivers are arranged in rows on each side of an elongated slot (not shown) of the surgical staple cartridge 6420 to accommodate the axial passage of the launch member 6440 through it. A wedge thread (not shown) is movably supported within the surgical staple cartridge 6420, and the launching member 6440 is far from the starting position adjacent to the proximal end of the surgical staple cartridge 6420 to the surgical staple cartridge 6420. It is configured to be driven and engaged by a launching member 6440 when driven to an end position within the staple. As described above, when the wedge threads are driven distally through the surgical staple cartridge 6420, the wedge threads drive into contact with the staple drivers and direct them towards the cartridge deck surface (not shown). Drive. The firing member 6440 comprises a tissue cutting surface 6446, which serves to cut the tissue clamped between the jaws when the firing member 6440 is driven distally. .. Various types of distal firing beams (not shown) described herein are operably attached to a firing member 6440 and an intermediate firing shaft portion 2222 or other firing system configuration. The operation of the intermediate firing shaft portion 2222 to drive and retract the distal firing beam has been described in detail above and is not repeated for brevity. Other firing beam and firing system configurations (motor driven and manually driven) may also be used to power the launching member without departing from the spirit and scope of the present invention.

The illustrated surgical end effector 6400 is also configured to selectively articulate around the range of motion BB that substantially traverses the shaft axis SA-SA. As can be seen in FIGS. 72-79, the surgical end effector 6400 includes an end effector mounting assembly 6490, which end effector mounting assembly 6490 is rotatably received, for example, in the mounting hole 6492 of the end effector mounting assembly 6490. It is adapted to be pivotally mounted on a distal shaft frame that includes a pivot pin configured as described above. The surgical end effector 6400 can be ranged by the type of joint lock described above as well as the first and second joint rod configurations. As can be seen in FIG. 74, a pair of cam plates 6500 are immovably attached to, for example, the end effector mounting assembly 6490 by spring pins 6502. As further seen in FIG. 74, each cam plate 6500 has a cam slot 6504 with a closed wedge portion 6505 and an open wedge portion 6507. The closed wedge portion 6505 is formed from two opposing closed cam surfaces 6506, and the open wedge portion 6507 is formed from two opposing open cam surfaces 6508. The elongated channel 6412 includes two proximal extension actuator arms 6416, each of which has an open trunnion pinion 6418 and a closed trunnion pin 6419 projecting laterally from them. .. Open and closed trunnion pins 6418 and 6419 are received using the cam slot 6504 of the corresponding cam plate 6500. Such a configuration acts to movably or pivotally support the first jaw 6410 with respect to the end effector mounting assembly 6490.

The illustrated surgical end effector 6400 further comprises a second jaw 6460 that may include anvil 6462. The illustrated anvil 6462 includes an anvil body 6464 including an elongated slot 6466 and two staple molded surfaces 6468 formed on each side. The anvil 6462 further comprises a proximal end portion 6470, the proximal end portion 6470 comprising two proximal extension actuator arms 6472 protruding from it. Each actuator arm 6472 has an open trunnion pinion 6474 and a closed trunnion pin 6476 projecting laterally from them, which are also received in the cam slot 6504 of the corresponding cam plate 6500. Such a configuration acts to movably or pivotally support the second jaw 6460 with respect to the end effector mounting assembly 6490.

The first and second jaws 6410 and 6460 are movably actuated by the various types of closure systems disclosed herein. For example, a first closure drive system 30 may be used to operate the closure sleeve in the manner described herein. The closure sleeve 260 can also be attached to the end effector closure sleeve 657, which can be pivotally attached to the closure sleeve by a double pivot closure sleeve assembly in the manner described above. As described above, for example, the axial movement of the closure sleeve can be controlled through the activation of the closure trigger. As can be seen in FIGS. 77 and 78, the end effector closure sleeve 6527 extends over the end effector mounting assembly 6490 and the actuator arm 6416 of the first jaw 6410 and the actuator arm 6472 of the second jaw 6460. When the closure sleeve 6572 is advanced distally, the distal end 6574 of the closure sleeve 6527 is with the proximal end 6411 of the first jaw 6410 and the proximal end 6461 of the second jaw 6460. Contact and move the first and second jaws 6410, 6460 in the distal DD. When the first and second jaws 6410, 6460 move distally, the closed trunnions 6419, 6476 enter the closed wedge portion 6505 of the cam slot 6504, and the closed cam surface 6506 is the first and second. The jaws 6410, 6460 of the jaws 6410, 6460 are cam driven toward each other toward the closed position (FIGS. 73, 75, 77 and 78).

In order to facilitate the opening of the first and second jaws 6410, 6460 using the closing sleeve 6572, the closing sleeve 6572 is provided with two inwardly extending open tabs 6576, these inwardly extending. The exit tab is configured to engage the closure trunnions 6419, 6476 as the closure sleeve 6527 retracts into the proximal PD by the closure system. As can be seen in FIGS. 72 and 76, for example, when the closure sleeve 6571 moves in the proximal direction PD, the open tab 6576 contacts the closure trunnions 6419, 6476 and similarly drives the closure trunnions 6419, 6476 in the proximal direction. To do. As the closed trunnions 6419 and 6476 move proximally, the open trunnions 6418 and 6474 enter the open wedge portion 6507 of the cam plate slot 6504. The open cam surface 6508 interacts with the open trunnions 6418, 6474, causing the actuator arms 6416 and 6472 to rock open on the rocker surfaces 6417 and 6475, respectively, as shown in FIGS. 76 and 79. Similar to the above configuration in which both the first and second jaws move relative to the shaft axis SA-SA, the closed wedge portion 6505 and the open wedge portion 6507 have the first and second jaws on them. When a closing motion is applied, it can be configured to close relative to each other at different closing speeds or times.

Figures 80-84 show another surgical end effector 7400 with two jaws in which one jaw is movable with respect to the other between the open and closed positions. In the illustrated example, the first jaw 7410 comprises an anvil 7412. The illustrated anvil 7412 has an anvil body 7414, which has a proximal end portion 7416 that is immovably attached to the end effector mounting assembly 7430. For example, the proximal end portion 7416 comprises two upright outer walls 7418, each having a mounting hole 7419 inside. See FIG. 82. The end effector mounting assembly 7430 is non-movably attached to the upright outer wall by a spring pin 7421 that is received between the upright outer walls 7418 and extends through the upright outer wall to the hole 7419. The end effector mounting assembly 7430 is pivotally mounted, for example, on a distal shaft frame that includes a pivot pin configured to be rotatably received within the mounting hole 7432 of the end effector mounting assembly 7430. It is adapted. The surgical end effector 7400, without departing from the spirit and scope of the invention, by the type of joint lock and first and second joint rod configurations described above, or by the various joints described herein. The joint can be exercised by either the motion system and the articulated rod and / or rod / cable configuration. Similarly, as can be seen in FIGS. 80 and 82, the anvil body 7414 also includes an elongated slot 7422 with two staple molded surfaces 7424 formed on each side.

The surgical end effector 7400 further includes a second jaw 7440 with an elongated channel 7442, which elongated channel is configured to support a surgical staple cartridge 7450. Similar to the particular surgical staple cartridge described above, the surgical staple cartridge 7450 is configured to operably support multiple staple drivers (not shown) therein. Operately support surgical staples (not shown) above. The staple driver is movably supported in a corresponding driver pocket 7452 formed within the surgical staple cartridge 7450. Staple drivers are arranged in rows on each side of the elongated slot 7454 of the surgical staple cartridge 7450 to accommodate the axial passages of the firing member 7460 through it. A cartridge pan 7451 is attached to the staple cartridge 7450 to prevent the staple driver from coming out of its respective driver pocket 7452 when the surgical end effector 7400 is operated in various directions. A wedge thread 7462 is movably supported within the surgical staple cartridge 7450 and the launching member 7460 is within the distal portion of the surgical staple cartridge 7450 from a starting position adjacent to the proximal end of the surgical staple cartridge 7450. It is configured to be driven and engaged by the launching member 7460 when driven to the end position. As described above, when the wedge threads 7462 are driven distally through the surgical staple cartridge 7450, the wedge threads 7462 drive into contact with the staple drivers and bring them to the cartridge deck surface (not shown). Drive towards. The firing member 7460 comprises a tissue cutting surface 7464, which serves to cut the tissue clamped between the jaws 7410, 7440 when the firing member 7460 is driven distally. Is. Various other types of distal launch beams 280 described herein are operably attached to the launch member 7460 as well as the intermediate launch shaft portion 2222 or other launch system configurations. The operation of the intermediate firing shaft portion 2222 to drive and retract the distal firing beam 280 has been described in detail above and is not repeated for brevity. Other firing beam and firing system configurations (motor driven and manually driven) may also be used to power the launching member without departing from the spirit and scope of the present invention. The first jaw cover 7415 is provided to prevent tissue and / or body fluids from entering the first and second jaws, which may interfere with or interfere with the operation of the launching member 6340, as well as for assembly purposes. It is detachably attached to the anvil 7412 and the second jaw cover 7441 is detachably attached to the second jaw 7440.

As can be seen in FIG. 82, the elongated channel 7442 includes a proximal end portion 7444 with two outer portions 7445. Each outer portion 7445 has a corresponding U-shaped or open slot 7446 in which the corresponding pivot pin projects laterally from the proximal end portion 7416 of the anvil body 7414. It is adapted to accept 7426. Such a configuration acts to movably or pivotally support the second jaw 7440 or elongated channel 7442 with respect to the first jaw 7410 or anvil 7412. As most specifically seen in FIGS. 80, 82 and 84, the closed lamp segment 7447 is formed on the proximal end 7444 of the elongated channel 7442. In addition, each outer portion 7445 of the proximal end portion 7444 has a lateral recessed area 7448 formed therein. Each lateral recessed area 7448 is located proximal to the corresponding closed lamp segment 7447. An open ramp or cam 7449 is formed adjacent to the proximal end of each lateral recessed area 7448. Each open ramp or cam 7449 terminates at the top surface 7580. See FIGS. 82 and 84.

The second jaw 7440 or elongated channel 7442 may be movably actuated relative to the first jaw 7410 or anvil 7412 by various types of closure systems disclosed herein. For example, as described in detail above, the type of closure drive system described herein can be used to activate the type of closure sleeve described herein. The closure sleeve can also be attached to the end effector closure sleeve 7572, which can be pivotally attached to the closure sleeve in a dual pivot configuration, in the manner described above. As described above, for example, the axial movement of the closure sleeve can be controlled through the activation of the closure trigger. In other configurations, the closure sleeve may be axially moved, such as by a robotic control system. As can be seen in FIGS. 80, 81, 83 and 84, the end effector closure sleeve 757 extends over the end effector mounting assembly 7430 and the proximal end portion 7444 of the elongated channel 7442 of the second jaw 7440. The end effector closure sleeve 7527 includes two diametrically opposed open members 7574 configured to operably engage the second jaw 7440 or the proximal end portion 7444 of the elongated channel 7442. In the illustrated embodiment, the opening member 7574 comprises an inward extending opening tab 7576 formed in each portion of the end effector closing sleeve 7572.

The second jaw 7440 is moved to the closed position (FIGS. 81 and 83) by advancing the end effector closing sleeve 757 in the distal direction DD. When the end effector closure sleeve 757 moves distally, its distal end 7575 contacts the closure lamp segment 7447 formed on the proximal end 7444 of the elongated channel 7442 and anvil 7412 the elongated channel 7442. It works to drive the cam towards. When the end effector closure sleeve 7552 is moved to its most distal position, the distal end 7575 contacts the contact surface 7443 on the elongated channel 7442 to maintain the closure load or force on the elongated channel 7442. To do. See FIGS. 81 and 83. When the end effector closing sleeve 7572 is in the fully closed position, the end of the opening tab 7576 is received within the corresponding lateral recessed area 7448. To move the second jaw 7440 or elongated channel 7442 to the open position, the closure system is actuated to move the closure sleeve 757 in the proximal direction PD. When the end effector closure sleeve 7572 moves proximally, the open tab 7542 rides on the corresponding open ramp or cam 7449 on the proximal end portion 7444 of the elongated channel 7442 to separate the elongated channel 7442 from the anvil 7412. Cam driven or pivoted. Each tab rides onto cam 7449 over the top surface 7580 and acts to ensure that the elongated channel 7442 is held in its fully open position. See FIG. 84.

FIGS. 85-87 show another surgical end effector 8400 with two jaws 8410, 8440 that can move simultaneously between the open and closed positions with respect to the shaft axis SA-SA. In the illustrated example, the first jaw 8410 comprises an anvil 8412. The illustrated anvil 8412 has an anvil body 8414, which has a proximal end portion 8416 that movably interface with the end effector adapter 8600. As can be seen in FIG. 85, the end effector adapter 8600 includes two distal protruding distal walls 8602, each with a lateral pivot pin 8604 protruding laterally from them. Each lateral pivot pin 8604 is received in a corresponding open U-shaped slot 8418 formed in the outer wall 8417 of the proximal end portion 8416 of the anvil 8412. See FIG. 85. Such a configuration allows the elongated channel 8412 to move or pivot with respect to the end effector adapter 8600. As further seen in FIG. 85, the end effector adapter 8600 is immovably attached to the end effector mounting assembly 8430. For example, the end effector adapter 8600 further includes two upright outer walls 8606, each having a mounting hole 8608 inside. The end effector mounting assembly 8430 is irremovably attached to the upright outer wall 8606 by a spring pin 8421 that is received between the upright outer wall 8606 and extends to the hole 8508 through its upright outer wall 8606. The effector mounting assembly 8430 is pivotally mounted, for example, on a distal shaft frame that includes a pivot pin configured to be rotatably received within the mounting hole 8432 of the end effector mounting assembly 8430. It is adapted. The surgical end effector 8400, without departing from the spirit and scope of the invention, by the type of joint lock and first and second joint rod configurations described above, or by the various joints described herein. The joint can be exercised by any of the motion systems and joint rods and / or rod / cable configurations. Similarly, as can be seen in FIG. 85, the anvil body 8414 also includes an elongated slot 8422 with two staple molded surfaces 8424 formed on each side.

The surgical end effector 8400 further includes a second jaw 8440 with an elongated channel 8442, which elongated channel 8442 is configured to support a surgical staple cartridge 8450. Similar to the various surgical staple cartridges described above, the surgical staple cartridge 8450 is configured to operably support multiple staple drivers (not shown) therein. Operately support surgical staples (not shown) above. The staple driver is movably supported in a corresponding driver pocket 8452 formed within the surgical staple cartridge 8450. Staple drivers are arranged in rows on each side of the elongated slot 8454 of the surgical staple cartridge 8450 to accommodate the axial passages of the launching member 8460 through it. A cartridge pan 8451 is attached to the staple cartridge 8450 to prevent the staple driver from coming out of each driver pocket 8452 when the surgical end effector 8400 is operated in different directions. A wedge thread 8462 is movably supported within the surgical staple cartridge 8450 and the launching member 8460 ends within the distal portion of the surgical staple cartridge 8450 from a starting position adjacent to the proximal end of the surgical staple cartridge 8450. It is configured to be drivenly engaged by a launching member 8460 when driven to a position. As described above, when the wedge threads 8462 are driven distally through the surgical staple cartridge 8450, the wedge threads 8462 drive into contact with the staple drivers and bring them to the cartridge deck surface (not shown). Drive towards. The launching member 8460 comprises a tissue cutting surface 8464, which serves to cut the tissue clamped between the jaws 8410, 8440 when the launching member 8460 is driven distally. It is a thing. Various other types of distal launch beams 280 described herein are operably attached to the launch member 8460 as well as the intermediate launch shaft portion 2222 or other launch system configurations. The operation of the intermediate firing shaft portion 2222 to drive and retract the distal firing beam 280 has been described in detail above and is not repeated for brevity. Other firing beam and firing system configurations (motor driven and manually driven) may also be used to power the launching member without departing from the spirit and scope of the present invention. The first jaw cover 8415 is provided to prevent tissue and / or body fluids from entering the first and second jaws, which may interfere with or interfere with the operation of the launching member 8460, as well as for assembly purposes. It is detachably attached to the anvil 8412 and the second jaw cover 8441 is detachably attached to the second jaw 8440.

As can be seen in FIG. 85, the elongated channel 8442 includes a proximal end portion 8444 with two outer portions 8445. Each outer portion 8445 has a corresponding U-shaped or open slot 8446 therein, the slot 8446 receiving a corresponding lateral pivot pin 8604 projecting laterally from the end effector adapter 8600. It is adapted to be. Such a configuration acts to movably or pivotally support the second jaw 8440 or elongated channel 8442 with respect to the first jaw 8410 or anvil 8412. Similarly, as can be seen in FIG. 85, a closed lamp segment 8447 is formed on the proximal end 8444 of the elongated channel 8442. In addition, each outer portion 8445 of the proximal end portion 8444 forms a second lateral recessed area 8448 therein. Each second lateral recess area 8448 is located proximal to the corresponding second closed lamp segment 8447. A second open ramp or cam 8449 is formed adjacent to the proximal end of each second lateral recessed area 8448. Each second open ramp or cam 8449 terminates at a second top surface 8450. Similarly, a first recessed area 8420 is formed at the bottom of each side wall 8417 of the proximal end portion 8416 of the anvil 8412. A first open ramp or cam 8426 is formed adjacent to the proximal end of each first lateral recessed area 8420. Each first open ramp or cam 8426 terminates at a first top surface 8428.

The second jaw 8440 or elongated channel 8442 and the first jaw 8410 or anvil 8412 can be simultaneously moved between open and closed positions by the various types of closure systems disclosed herein. For example, a closure drive system 30 may be used to operate the closure sleeve 260 in the manner described herein. The closure sleeve 260 may also be attached to an end effector closure sleeve 8572 which may be pivotally attached to the closure sleeve 260 by a dual pivot configuration in the manner described above. As described above, for example, the axial movement of the closure sleeve 260 can be controlled through the activation of the closure trigger 32. In other configurations, the closure sleeve may be axially moved, such as by a robotic control system. As can be seen in FIGS. 86 and 87, the end effector closure sleeve 8527 includes an end effector mounting assembly 8430, an end effector adapter 8600, and a proximal end portion 8444 and a first jaw portion of an elongated channel 8442 of a second jaw portion 8440. It extends over the proximal end portion 8416 of the 8410 or anvil 8412. The end effector closure sleeve 8527 includes two diametrically opposed first open members 8574 configured to operably engage the proximal end portion 8416 of the first jaw 8410. In the illustrated embodiment, the first opening member 8574 includes a first inward extending opening tab 8576 formed in each portion of the end effector closing sleeve 8572. Similarly, the end effector closure sleeve 857 further includes two diametrically opposed second opening members 8580 configured to operably engage the proximal end portion 8444 of the second jaw 8440. Including. In the illustrated embodiment, the second opening member 8580 comprises a second inward extending opening tab 8582 formed in each portion of the end effector closing sleeve 8572.

The first jaw 8410 and the second jaw 8440 are simultaneously moved to the closed position (FIG. 86) by advancing the end effector closure sleeve 857 in the distal direction DD. When the end effector closure sleeve 857 moves distally, its distal end 8575 is the bottom of the first jaw 8410 or the proximal end portion 8416 of the anvil 8412, as well as the proximal end 8444 of the elongated channel 8442. It contacts the closed lamp segment 8447 formed above and acts to cam drive the first and second jaws 8410, 8440 towards each other. When the end effector closure sleeve 8527 is moved to its most distal position, the distal end 8575 of the end effector closure sleeve 8527 is the first jaw 8410 or the first contact surface 8419 on the anvil 8412, as well as Contact with the second contact surface 8443 on the second jaw 8440 or elongated channel 8442 to maintain a closing load or force on both jaws 8410 and 8440. See FIG. 86. When the end effector closure sleeve 8572 is in its fully enclosed position, the end of the first open tab 8576 is received within the corresponding first lateral recess area 8420 and the end of the second open tab 8582. Is received within the corresponding second lateral recess area 8448. To move the first and second jaws 8410, 8440 away from each other to the open position, the closure system is actuated to move the closure sleeve 8572 in the proximal direction PD. When the end effector closure sleeve 8527 moves proximally, the first open tab 8576 rides on the corresponding first open ramp or cam 8426 at the bottom of the proximal end portion 8416 of the first jaw 8410. The first jaw 8410 or anvil 8412 is cam driven or pivoted away from the second jaw 8440 or the elongated channel 8442, and the second open tab 8582 is the proximal end portion 8444 of the elongated channel 8442. Riding on the corresponding second ramp 8449 above, the elongated channel 8442 is cam driven or pivoted away from the first jaw or anvil 8412. Each of the first tabs 8576 rides on the corresponding cam or lamp 8426 onto the corresponding first locking surface 8428, and each of the second tabs 8582 onto the corresponding second locking surface 8450. Riding on the corresponding second cam or ramp 8449, whereby the first and second jaws 8410, 8400 are held in the open position. The axial position of the first tab 8576 with respect to the second tab 8582 may be arranged so that the first and second jaws are separated from each other and moved simultaneously, or the first and second jaws. The reader will understand that the portions may be axially staggered so that one of the jaws moves before the other jaw moves.

Figures 88-93 show each part of another surgical instrument 9010, including a surgical end effector 9300 that operably interfaces with the elongated shaft assembly 9200. The surgical end effector 9300 is similar to the surgical end effector 300 described in detail above and is in the form of an elongated channel 9302 configured to operably support the surgical staple cartridge 304 inside. Includes 1 jaw. The illustrated surgical end effector 9300 further includes a second jaw in the form of an anvil 310 supported to move relative to it on the elongated channel 9302. The anvil 310 may be movably actuated by the closure system described above and shown in FIGS. 88 and 91. For example, a first closure drive system may be used to operate the closure sleeve 260 in the manner described herein. The closure sleeve 260 is attached to the end effector closure sleeve 272 which is pivotally attached to the closure sleeve 260 by the double pivot closure sleeve assembly 271 in the manner described above. As described above, for example, the axial movement of the closure sleeve 260 can be controlled through the activation of the closure trigger. Similarly, as described above, the closure sleeve 272 includes an opening cam that acts to actuate the anvil 310 so that it can be moved to the open position. In use, the closure sleeve 260 is translated distally (direction DD) to close the anvil 310, for example, in response to the activation of the closure trigger. The anvil 310 is closed by translating the closure sleeve 260 into the distal DD and the end effector closure sleeve 272 pivotally coupled to it distally. When the end effector closure sleeve 272 is driven distally, the cam tab 358 of the open cam 354 moves distally within the cam slot 318 of the anvil 310 and operably interfaces with or cam surface 319. It rides on the cam surface 319 and drives the main body portion 312 of the anvil 310 away from the surgical staple cartridge 304 to the open position. The anvil 310 is closed by translating the closure sleeve 260 distally into the distal DD until the distal end 275 of the end effector closure sleeve 272 rides onto and contacts the anvil mounting arm 316. The cam tab 358 will move in the proximal direction PD within the cam slot 318 on the cam surface 319 to pivot the anvil 310 to the open position.

As can be seen in FIG. 91, for example, the elongated shaft assembly 9200 includes a bifurcated shaft frame or spine assembly 9812 on which the closure sleeve assembly 260 is received. The spine assembly 9812 includes a proximal spine portion 9814 and a distal spine portion 9816. Proximal spine portion 9816 is rotatable within a handle or housing (not shown) in various ways as described herein to facilitate rotation of the surgical end effector 9300 around shaft axis SA. Can be axially supported. Although not shown, the surgical instrument 9010 also has a firing beam configuration and various firing drives disclosed herein to drive the firing member through the surgical staple cartridge in the various manners described above. It may have any of the system configurations. As can be seen in FIG. 91, the distal spine portion 9816 includes a distal end portion 9818 having an upward protruding pivot pin 9819 on it, which upward protruding pivot pin 9819 is a proximal end portion of the elongated channel 9302. It is adapted to be pivotally accepted within the pivot hole 9328 formed in 9320. Such a configuration facilitates the pivotal movement of the elongated channel 9302 of the surgical end effector 9300 with respect to the spine assembly 9812 centered on the range of motion BB defined by the pivot hole 9328. As shown above, the range of motion BB crosses the shaft axis SA-SA defined by the elongated shaft assembly 9200.

Still referring to FIG. 91, the elongated shaft assembly 9200 further comprises the range of motion system shown by 9900 as a whole, which includes a first joint bar 9910 and a second joint bar 9920. .. The first joint bar 9910 operably interfaces with the first joint motor 9912, which is operably supported within a surgical instrument handle or housing or part of a robotic control system. As can be seen in FIGS. 92 and 93, the first joint bar 9910 is attached to a first joint nut 9914 that is screwed on the first threaded drive shaft 9916 of the first joint motor 9912. There is. The rotation of the first threaded drive shaft 9916 in the first direction of rotation results in a distal advance of the first joint bar 9910 in the distal direction DD, in the second or opposite direction of rotation. The rotation of the first threaded drive shaft 9916 results in a proximal advance of the first joint drive bar 9910 in the proximal direction PD.

The illustrated joint movement system 9900 further includes a second joint bar 9920 that operably interfaces with a second joint motor 9922 operably supported within a surgical instrument handle or housing or part of a robotic control system. As can be seen in FIGS. 92 and 93, the second joint bar 9920 is attached to a second joint nut 9924 that is screwed on the second threaded drive shaft 9926 of the second joint motor 9922. There is. The rotation of the second threaded drive shaft 9926 in the first direction of rotation results in a proximal advance of the second joint bar 9920 in the proximal direction PD, in the second or opposite direction of rotation. The rotation of the second threaded drive shaft 9926 results in a distal advance of the second joint drive bar 9920 in the distal DD.

The range of motion system 9900 further includes a cross-linkage assembly 9940 that is operably attached to the first and second joint bars 9910, 9920. As can be seen in FIG. 91, the cross-linkage assembly 9940 includes a central support member 9950 that is pivotally pinned to the proximal end 9320 of the elongated channel 9302 at the first pin 9952. The central support member 9950 further includes a proximal connector tab 9954, which is a second to pivotally attach the proximal connector tab 9954 to the distal end portion 9818 of the distal spine portion 9816. Includes slot 9956 for receiving pins 9958 in. This pin and slot configuration facilitates pivotal and axial movement of the central support member 9950 with respect to the spine assembly 9812. The central support member 9950 further includes a slot 9960 for receiving a firing beam through it. The central support member 9950 acts to provide lateral support to the launch beam as it flexes to adapt to the joint motion of the surgical end effector 9300.

As most specifically shown in FIGS. 92 and 93, the central support member 9950 has a proximal linkage tab portion 9970 that facilitates attachment of the first and second joint bars 9910, 9920. Specifically, the distal end 9911 of the first joint bar 9910 is pivotally attached to the first joint link 9972, which is pivotally pinned to the proximal linkage tab portion 9970. Similarly, the distal end 9921 of the second joint bar 9920 is pivotally attached to the second joint link 9974, which is pivotally pinned to the proximal linkage tab portion 9970 of the central support member 9950. .. FIG. 92 shows the joint motion of the surgical end effector 9300 in the direction represented by arrow 9980. As can be seen in this figure, the first threaded drive shaft 9916 of the first joint motor is rotated in the first rotational direction to drive the first joint bar 9910 in the distal direction. In addition, the second threaded drive shaft 9926 of the second joint motor 9922 is rotated in the second rotational direction to pull the second joint bar 9920 in the proximal direction. The first and second joint motors 9912, 9922 are operated by a computer control system, and as can be seen in FIG. 92, the distance that the first joint bar 9910 moves in the distal direction is the second joint bar. It is not equal to the distance the 9920 travels in the proximal direction.

FIG. 93 shows the joint motion of the surgical end effector 9300 in the direction indicated by arrow 9982. As can be seen in this figure, the second threaded drive shaft 9926 of the second joint motor 9922 is rotated in the first rotational direction to drive the second joint bar 9920 in the distal direction. In addition, the first threaded drive shaft 9916 of the first joint motor 9912 is rotated in the second rotational direction to pull the first joint bar 9910 proximally. The first and second joint motors 9912, 9922 are operated by a computer control system, and as can be seen in FIG. It is not equal to the distance the 9910 travels in the proximal direction. In an alternative configuration, only one joint motor may be used to joint the end effector. In such a configuration, for example, the second link may be proximally coupled to the first link by a rack and pinion configuration similar to the rack and pinion configuration detailed herein.

FIGS. 94 and 95 show surgical staple cartridges 9304 and 9304', each having a light member 9305, for the light member 9305 to illuminate the distal end of the surgical end effector on which it is supported. belongs to. Each of the staple cartridges 9304, 9304'is the bottom or cartridge side of a cartridge configured to make electrical contact with a corresponding conductor in an elongated channel that communicates with an electrical energy source located within the instrument handle or housing. The unit may have an instrumented conductor (not shown). Thus, when the cartridges 9304, 9304'are properly seated in the elongated channel of the surgical end effector, the light 9305 therein may receive power from a power source in the handle or housing through the corresponding conductor. ..

FIGS. 96-105 show another surgical instrument 10010, including a surgical end effector 10300 that operably interfaces with an elongated shaft assembly 10200 using many of the various shaft assembly features disclosed herein. Each part is shown. The surgical end effector 10300 may essentially include any of the various end effectors described herein, or other form of surgery configured to perform other surgical procedures / procedures. End effector for use may be included. In the illustrated configuration, for example, the surgical end effector 10300 is adapted to cut and staple tissue and has an elongated channel 10302 configured to operably support the surgical staple cartridge 10304 inside. Includes a morphological first jaw. See FIGS. 96 and 97. The illustrated surgical end effector 10300 further includes a second jaw in the form of anvil 10310 supported to move relative to it on the elongated channel 10302. See FIG. 96. Anvil 10310 may be movably actuated by one of the closed drive systems described herein. For example, a first closure drive system may be used to operate the closure sleeve 260 in the manner described herein. The closure sleeve 260 is attached to an end effector closure sleeve 272 that is pivotally attached to the closure sleeve 260 by a double pivot closure sleeve assembly 271 in any of the methods described herein. As described above, for example, the axial movement of the closure sleeve 260 can be controlled through the activation of the closure trigger. When the end effector closing sleeve 272 is advanced in the distal direction DD, the anvil 10310 is cam driven and closed. In at least one configuration, a spring (not shown) may be used to pivot the anvil 10310 to the open position when the end effector closing sleeve 272 is retracted back to the starting position.

As can be seen in FIGS. 96-105, the surgical end effector 10300 can be articulated with respect to the elongated shaft assembly 10200 around the articulation joint 10270. In the illustrated example, the elongated shaft assembly 10200 includes a range of motion system marked 10800 with a joint lock 10810 similar to the joint locks 350 and 810 described above. See FIG. 97. For example, the components of the joint lock 10810 that are different from the components of the joint lock 810 and / or the joint lock 350 and that may be necessary to understand the operation of the joint lock 10810 will be described in more detail below. I will decide. As mentioned above, further details regarding the Joint Lock 350 are incorporated herein by reference in its entirety, U.S. Patent Application No. 13 / 803,086, title of the invention "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING. "AN ARTICULATION LOCK", which can be found in the current US Patent Application Publication No. 2014/0263541. The joint lock 10810 can be configured and manipulated to selectively lock the surgical end effector 10300 to various range of motion positions. Such a configuration allows the surgical end effector 10300 to rotate, or jointly move, with respect to the shaft closure sleeve 260 when the joint lock 10810 is in its unlocked state.

Particularly with reference to FIGS. 96 and 97, the elongated shaft assembly 10200 includes a spine 210, which first slidably supports the launching member 220 therein and secondly the spine. It is configured to slidably support the closure sleeve 260 extending around the 210. The spine 210 also slidably supports the proximal joint driver 230. The proximal joint driver 230 has a distal end 231 configured to operably engage the joint lock 10810. The joint lock 10810 further comprises a shaft frame 10812 that is attached to the spine 210 in various ways disclosed herein. As shown in FIG. 97, the shaft frame 10812 is configured to movably support the proximal portion 10821 of the distal joint driver 10820 therein. The distal joint driver 10820 can be moved within the elongated shaft assembly 10200 to selectively move longitudinally in the distal DD and proximal PD in response to the joint motion control motion applied to it. It is supported.

One feature that many clinicians may be interested in during the surgical procedure is the net length of the range of motion end effector from its pivot point. This dimension affects the amount of access that the end effector can achieve within the restricted space within the patient's body. Surgical instrument 10010 may be configured to address this issue. In the illustrated configuration, for example, the shaft frame 10812 includes a distal end portion 10814 with a pivot pin 10818 formed on it. The pivot pin 10818 is pivotally received within slot 10395 formed in the end effector mounting assembly 10390 attached to the proximal end 10303 of the elongated channel 10302 by a spring pin 10393 or other suitable member. It is adapted. The pivot pin 10818 defines the range of motion BB across the shaft axis SA-SA. With such a configuration, the pivotal movement (ie, joint movement) of the end effector 10300 about the joint movement axis BB with respect to the shaft frame 10812, and the reference point on the shaft frame 10812, for example, the joint movement axis B- Axial or translational movement of elongated channel 10302 with respect to B is promoted. As can be seen in FIGS. 99 and 100, the range of motion system 10800 further includes a joint drive gear 10840 that is rotatably supported on a shaft 10842 formed on or attached to the shaft frame 10812. As further seen in FIGS. 99 and 100, the end effector mounting assembly 10390 has a range of motion gear profile 10396 configured on it that is configured to mesh and engage with the joint drive gear 10840. As can be seen most specifically in FIGS. 97 and 101-103, the drive pin 10844 projects from the joint drive gear 10840. The drive pin 10844 is received in slot 10822 of the distal joint driver 10820. Therefore, as the distal joint driver 10820 moves in the proximal direction PD (in various ways described herein), the joint drive gear 10840 is rotated in the counterclockwise direction (arrow CCW in FIG. 103). This results in joint movement of the surgical end effector 10300 in the direction indicated by arrow 10848. Similarly, the movement of the distal joint driver 10820 in the distal DD causes the joint drive gear 10840 to rotate in the clockwise direction (arrow CW in FIG. 102), thereby the surgical end effector. The 10300 will make joint movements in the direction indicated by the arrow 10849.

Still referring to FIGS. 99-105, in at least one configuration, the range of motion gear profile 10396 is elliptical in shape. The elliptical configuration of the range of motion gear profile 10396, coupled with slot 10395, allows the end effector to translate (or move axially) when the end effector 10300 is in rotation or range of motion. There is. The eccentricity of the elliptical joint gear profile 10396 makes it possible to reduce the "center-to-center" distance between the joint drive gear 10840 and the gear profile 10396, which is then translated into translation of the end effector 10300. .. FIGS. 101 and 103 show the surgical end effector 10300 in the non-joint range of motion. In other words, the end effector axis EA defined by the elongated channel 10302 is aligned with the shaft axis SA-SA. When used in this situation, the term "aligned with" can mean "aligned coaxially" with the shaft axis SA-SA or simply parallel to the shaft axis SA-SA. When in this non-joint range of motion, the elongated channel 10302 occupies a certain amount of space (ie, which can be referred to as a "footprint"). In other words, the distal end 10309 of the elongated channel 10302 is also referred to as the first distance D1 from the range of motion BB defined by pin 10818 (also referred to herein as the "non-joint range of motion"). Can be called). See FIG. 104. When the surgical end effector 10300 is range of motion, the elongated channel 10302 is proximal to the shaft frame 10812, more specifically to the range of motion axis BB (arrows TL in FIGS. 102 and 103). The distance D2 (also referred to herein as the "range of motion") between the distal end 10309 of the elongated channel 10302 and the range of motion BB is shorter than the distance D1. .. See FIG. 105. This reduction in the overall length of the surgical end effector 10300 allows for better access when the end effector 10300 is in range of motion and also has the same net length when linear. Will be maintained. In other words, when the end effector is range of motion, the distance between the first staple in the end effector and the range of motion axis increases, thereby the end effector while in the range of motion configuration. The footprint will be reduced.

The surgical end effector 10300 of the embodiments shown in FIGS. 96-105 comprises a surgical cutting and stapling device using a firing beam 220 of various types and configurations described herein. However, the surgical end effector 10300 of the present embodiment may include other forms of surgical end effector that do not cut and / or staple the tissue. In the illustrated configuration, the central support member 10950 is pivotally and slidably supported with respect to the shaft frame 10812. As can be seen in FIG. 98, the central support member 10950 includes a slot 10952, which slot receives a pin 10954 that projects from the spine 210 or is attached to or attached to the spine or is formed within the spine. It is adapted to be. Such a configuration allows the central support member 10950 to pivot and translate with respect to pin 10954 when the surgical end effector 10300 is range of motion. The central support member 10950 further includes a slot 10960 through which the firing beam 220 is received. The central support member 10950 acts to provide lateral support to the launch beam as the launch beam 220 bends to adapt to the joint motion of the surgical end effector 10300.

FIGS. 106-108 show another surgical instrument 11010, including a surgical end effector 11300 that operably interfaces with an elongated shaft assembly 11200 that may utilize many of the various shaft assembly features disclosed herein. Each part is shown. The surgical end effector 11300 may essentially include any of the various end effectors described herein, or other form of surgery configured to perform other surgical procedures / procedures. End effector for use may be included. In the illustrated configuration, for example, the surgical end effector 11300 includes an elongated channel 11302 that can be adapted to support, for example, a surgical staple cartridge inside. The elongated shaft assembly 11200 may include a spine 11210 that is pivotally coupled to the elongated channel 11302 by a joint 11270. In the illustrated configuration, the elongated channel 11302 of the surgical end effector 11300 is movably received by an elongated joint slot 11395 formed in the elongated channel 11302 or in an end effector mounting assembly (not shown) by a joint pin 11818. It is bound to spine 11210. This pin and slot configuration facilitates the pivotal and translational movement of the elongated channel 11302 with respect to the spine 11210 of the elongated shaft assembly 11200. The joint pin 11818 defines the range of motion BB, which extends through the center of the pin 11818 and projects from the paper in FIGS. 106-108 so as to cross the shaft axis SA-SA. Is. The spine 11210 may be otherwise similar to the spine 210 described above and may support the launch member and closure sleeve configurations described herein, such launch member and closure sleeve. The configuration is not shown in detail in FIGS. 106-108 for clarity.

In the illustrated example, the elongated shaft assembly 11200 includes a range of motion system designated 11800, which includes a joint lock similar to the joint locks 350, 810 and / or 10810 described above. It is gainable and can be operated by any of the various methods described herein. The joint movement system 11800 includes a distal joint driver 11820, which may include a portion of a joint lock (not shown) or a distal joint to joint the surgical end effector 11300. The driver 11820 may simply interface with a joint motion control system configured to selectively move distally and proximally. The range of motion system 11800 further includes a central joint link 11900 that is rotatably pivotally supported on the joint pin 11818 so as to rotate about the range of motion axis BB. In the illustrated configuration, the central joint link 11900 has a triangular shape defining the three end portions 11902, 11904 and 11906. The range of motion system 11800 in the illustrated embodiment further includes a driver link 11910 that is pivotally coupled to the end of the distal joint driver 11820 and the end 11902 of the central joint link 11900. As described in more detail below, the movement of the distal joint driver 11820 in the proximal and distal directions will rotate or pivot the central joint link 11900 around the range of motion BB.

The range of motion system 11800 further includes an end effector driver link 11920 with a first end 11922 that is pivotally coupled to the elongated channel 11302. The second end 11924 of the end effector driver link 11920 is pivotally coupled to the end 11904 of the central joint link 11900. The point where the driver link 11910 is attached to the central joint link 11900 and the point where the second end 11924 of the end effector driver link 11920 is attached to the central joint link 11900 can be located along the common axis OAS. The axis is deviated from the joint motion axis BB. See FIG. 106. The second end 11924 of the end effector driver link 11920 has a gear profile 11926 configured to mesh and engage with a central joint motion gear 11930 rotatably pivotally supported on the joint pin 11818. doing. When the distal joint driver 11820 is moved in the distal DD, the central joint link 11900 maintains meshing engagement with the central joint motion gear 11930 while maintaining the meshing engagement with the second end 11924 of the end effector driver link 11920. In the clockwise direction CW. Moving the joint driver link 11920 in the clockwise direction also moves the surgical end effector 11300 clockwise with respect to the elongated shaft assembly 11200 about the range of motion BB. See FIG. 107. Similarly, the movement of the distal joint driver 11820 in the proximal direction will move the central joint link 11900 in the counterclockwise direction of CCW. Such movement of the central joint link 11900 also moves the second end 11924 in the counterclockwise direction CCW while maintaining meshing engagement with the central joint movement gear 11930. The movement of the joint driver link 11920 in the counterclockwise direction pivots the surgical end effector 11300 counterclockwise with respect to the elongated shaft assembly 11200 around the range of motion BB. See FIG. 108.

FIG. 106 shows the surgical end effector 11300 in a non-joint range of motion relative to the elongated shaft assembly 11200. When in its non-joint range of motion, the end effector axis EA of elongated channel 11302 is essentially aligned with the shaft axis SA-SA. In other words, the end effector axis EA defined by the elongated channel 10302 is aligned with the shaft axis SA-SA. When used in this situation, the term "aligned with" can mean "aligned coaxially" with the shaft axis SA-SA or simply parallel to the shaft axis SA-SA. FIG. 107 shows the position of the surgical end effector 11300 after being moved clockwise to the full range of motion position with respect to the elongated shaft assembly 11200, where the end effector axis EA and the shaft axis SA- The angle 11950 with the SA is about 90 degrees (90 °). FIG. 108 shows the position of the surgical end effector 11300 after being moved counterclockwise to the full range of motion position with respect to the elongated shaft assembly 11200, where the end effector axis EA and shaft axis SA. The angle between −SA and 11950 is about 90 degrees (90 °). Similarly, as can be seen in FIGS. 107 and 108, the elongated channel 11302 translates in the direction towards the shaft axis SA-SA (represented by the arrow TD in FIGS. 107 and 108) and articulates with the distal end of the elongated channel 11302. The distal end 11201 of the elongated shaft assembly 11200 is notched on both sides of the shaft axis SA so that the distance between it and the motion axis BB can be effectively reduced. Such a configuration is a conventional articulated joint configuration in which end effector joint movement to a position 90 degrees (90 °) relative to the shaft axis (through a 180 degree path across the shaft axis) cannot occur. On the other hand, it can represent a significant improvement. This embodiment also effectively reduces the footprint of the end effector during range of motion by translating the end effector towards the shaft axis during range of motion.

Referring to FIG. 106, when the end effector 11300 is in the non-joint range of motion, the driver link 11910 is coupled to the first end of the central joint link 11900 at a location on one side of the shaft axis. It can be observed that the second end 11924 of the end effector driver link 11920 is attached to the end 11904 of the central joint link 11900 at a location opposite the shaft axis. The central range of motion gear configuration works to minimize backlash and also to transmit such force to the joint pin 11818, thereby comparing it to other joint joint configurations of comparable size. Thus, the overall strength of the joint can be enhanced. The ability to articulate the surgical end effector at a relatively high angle to the shaft to which the surgical end effector is attached is often excised in a confined space, such as in the thoracic cavity or pelvic bowl. Is desirable when performing various surgical procedures that can make access to the target soft tissue difficult. The conventional end effector has a drawback that it cannot move the joint at an angle exceeding 45 degrees (45 °) with respect to the shaft axis. The embodiments described above can overcome these drawbacks.

FIGS. 109-111 show another surgical instrument 12010, including a surgical end effector 12300 that operably interfaces with an elongated shaft assembly 12200 that may utilize many of the various shaft assembly features disclosed herein. Each part is shown. The surgical end effector 12300 may essentially include any of the various end effectors described herein, or other form of surgery configured to perform other surgical procedures / procedures. End effector for use may be included. In the illustrated configuration, for example, the surgical end effector 12300 includes an elongated channel 12302 that can be adapted to support, for example, a surgical staple cartridge inside. The elongated shaft assembly 12200 may include a spine 12210 that is pivotally coupled to the elongated channel 12302 by a joint 12270. In the illustrated configuration, the elongated channel 12302 of the surgical end effector 12300 is configured to extend into the distal end portion 12213 of the spine 12210 and is operably coupled to the spine by the range of motion system 12800. ing.

In the illustrated example, the range of motion system 12800 includes a spine 12210 and a distal joint driver 12820 that is pivotally coupled to an elongated channel 12302. As can be seen in FIG. 109, the distal joint driver 12820 is configured to movably extend on the first side of the shaft axis SA-SA. In addition, the range of motion system 12800 further includes a second joint link 12900 attached to the spine 12210 on the second side of the shaft axis SA-SA. When the distal joint driver 12820 is moved in the distal DD, the elongated channel 12302 is moved in the clockwise direction CW. During such range of motion, the proximal end 12303 of the elongated channel 12302 translates in the direction represented by the arrow TD to reduce the end effector footprint. See FIG. 110. Similarly, when the distal joint driver 12820 is moved to the proximal PD, the elongated channel 12302 is pivoted counterclockwise in the CCW direction. During such range of motion, the proximal end of elongated channel 12302 translates in the direction represented by the arrow TD to reduce the end effector footprint during range of motion.

FIG. 109 shows the surgical end effector 12300 in a non-joint range of motion relative to the elongated shaft assembly 12200. When in its non-joint range of motion, the end effector axis EA of elongated channel 12302 is essentially aligned with the shaft axis SA-SA. In other words, the end effector axis EA defined by the elongated channel 10302 is aligned with the shaft axis SA-SA. When used in this situation, the term "aligned with" can mean "aligned coaxially" with the shaft axis SA or simply parallel to the shaft axis SA-SA. FIG. 110 shows the position of the surgical end effector 12300 after being moved clockwise to the full range of motion position with respect to the elongated shaft assembly 12200. FIG. 111 shows the position of the surgical end effector 12300 after being moved counterclockwise to the full range of motion position with respect to the elongated shaft assembly 12200.

The ability to articulate the surgical end effector at a relatively high angle to the shaft to which the surgical end effector is attached is often excised in a confined space, such as in the thoracic cavity or pelvic bowl. Is desirable when performing various surgical procedures that can make access to the target soft tissue difficult. However, with conventional end effectors, a larger range of motion usually results in a larger moment around the joint motion system that can more easily flex or break the mechanism. The embodiments shown in FIGS. 112-114 include features that can address these shortcomings of conventional range of motion end effectors. Figures 112-114 show another surgical instrument 13010, including a surgical end effector 13300 that operably interfaces with an elongated shaft assembly 13200 that may utilize many of the various shaft assembly features disclosed herein. Each part is shown. The elongated shaft assembly 13200 defines the shaft axis SA-SA. In addition, the surgical end effector 13300 may essentially include any of the various end effectors described herein, or any other configured to perform other surgical procedures / procedures. May include a form of surgical end effector. In the illustrated configuration, for example, the surgical end effector 13300 includes an elongated channel 13302 that can be adapted to support, for example, a surgical staple cartridge inside. The slender channel 13302 defines the end effector axis EA. The elongated shaft assembly 13200 may include a spine 13210 that is pivotally coupled to the elongated channel 13302 by a joint 13270. In the illustrated configuration, the elongated channel 13302 of the surgical end effector 13300 is coupled to the spine 13210 by a joint pin 13818 that defines the range of motion BB across the shaft axis SA-SA. In FIGS. 112-114, the range of motion BB may coincide with, for example, the central axis of the joint pin 13818, and is essentially protruding from the paper in each of these figures. The spine 13210 may otherwise be similar to the spine 210 described above and may support the launch member and closure sleeve configurations described herein, such launch member and closure sleeve. The configuration is not shown in detail in FIGS. 112-114 for clarity.

In the illustrated example, the elongated shaft assembly 13200 includes a range of motion system labeled 13800, which includes a joint lock similar to the joint locks 350, 810 and / or 10810 described above. It is gainable and can be operated by any of the various methods described herein. The joint motion system 13800 includes a distal joint driver 13820, which distal joint driver may include a portion of a joint lock (not shown) or a surgical end effector 13300 centered on the joint motion axis BB. May simply interface with a joint movement control system configured to selectively move the distal joint driver 13820 in the distal and proximal directions for joint movement. The joint motion system 13800 further includes a central joint link 13900 rotatably pivoted onto the joint pin 13818 to rotate about the joint motion axis BB with respect to the distal end of the elongated shaft assembly 13200. I'm out. In the illustrated configuration, the central joint link 13900 has a triangular shape and defines three end portions 13902, 13904, 13906. The range of motion system 13800 in the illustrated embodiment further includes an intermediate driver link 13910 that is pivotally coupled to the end of the distal joint driver 13820 and the end 13902 of the central joint link 13900. As described in more detail below, the movement of the distal joint driver 13820 in the proximal and distal directions will rotate the central joint link 13900 around the range of motion BB.

The range of motion system 13800 further includes an end effector driver link 13920 having a first or distal driver link end 13922 having a slot 13923 in it. An end effector mounting member or pin 13960 is mounted on the end effector 13300 and is received in slot 13923. Such a configuration facilitates pivotal and translatable or axial movement (represented by arrow AT) of pin 13960 within slot 13923. The second or proximal driver link end 13924 of the end effector driver link 13920 is pivotally coupled to the end 13904 of the central joint link 13900. The point where the intermediate driver link 13910 is attached to the central joint link 13900 and the point where the second end 13924 of the end effector driver link 13920 is attached to the central joint link 13900 can be located along the common axis OAS. This axis deviates from the joint motion axis BB. See FIG. 112. The second end 13924 of the end effector driver link 13920 has a gear profile 13926 over which it is configured to mesh and engage with a gear profile 13930 formed on or attached to the spine 13210. ing. When the distal joint driver 13820 is moved to the proximal PD, the central joint link 13900 is in a counterclockwise CCW about the joint motion axis BB with respect to the distal end of the elongated shaft assembly 13200. Rotate the end effector 13300. During such movement, the second end 11924 of the end effector driver link 13920 still engages with the gear profile 13930. Depending on the amount of proximal movement of the distal joint driver 13820, the surgical end effector 13300 may be pivoted to the range of motion shown in FIG. 113, where the end effector axis EA is the shaft axis SA-SA ( (Represented by angle 13950 in FIG. 113). Similarly, the movement of the distal joint driver 11820 to the distal DD rotates the end effector 13300 in the clockwise direction CW about the range of motion BB with respect to the distal end of the elongated shaft assembly 13200. Will let you. During such movement, the second end 11924 of the end effector driver link 13920 still engages with the gear profile 13930. Depending on the amount of distal movement of the distal joint driver 13820, the surgical end effector 13300 may be pivoted to the range of motion shown in FIG. 114, where the end effector axis EA is the shaft axis SA-SA ( (Represented by angle 13952 in FIG. 114).

As can be seen in FIG. 112, the end effector axis EA is axially aligned with the shaft axis SA-SA when in the non-joint range of motion. In addition, as further seen in FIGS. 112-114, the distal joint driver 13820 and the intermediate driver 13910 are each supported to selectively move longitudinally along one lateral portion of the shaft axis SA. , The end effector mounting pin 13960 is located on the second outer portion of the end effector axis EA corresponding to the second outer portion of the shaft axis SA. An alternative embodiment may use other means for applying range of motion control motion to the central joint link 13900. For example, instead of the distal joint drivers 13820 and 13910, the cable configuration may be attached directly to the central joint link. In such a configuration, the central joint link will be pivoted when the corresponding range of motion system located within the handle or housing of the device tensions or pulls on the cable. In yet another alternative embodiment, the distal joint driver 13820 is directly coupled to the central joint link 13900. In such a configuration, for example, the central joint link 13900 may include a slot instead of a pin at this connection to allow rotation about the range of motion axis BB. In yet another embodiment, slot 13923 of the end effector drive link 13920 may be replaced with a pin connection. To achieve joint motion of the surgical end effector 13300 centered on the range of motion axis BB, the gear profile 13926 on the end effector driver link 13920 was formed on or attached to the spine 13210. The cam is shaped to maintain meshing engagement with the gear profile 13390.

The embodiments of FIGS. 112-114 are more robust as compared to conventional configurations, to a position at 90 degrees (90 °) with respect to the shaft axis (through a 180 degree path across the shaft axis). It provides a wider range of joint motion compared to joint configurations that cannot adapt to the joint motion of the end effector. This embodiment can also effectively reduce the footprint of the end effector during range of motion by translating the end effector towards the shaft axis during range of motion. This wider range of motion can also be achieved by the stroke length of the joint drive, which is generally shorter than the stroke length normally required to joint a conventional articulated joint configuration. Triangular central joint links can also provide some advantages. The triangular (three-point) central joint link connects the distal joint driver (through the intermediate drive link), the joint pin, and the end effector driver link to each other. This triangular central link can improve resistance to forces that can cause the end effector to undesirably dejoint. Such a triangular link configuration can also increase resistance to bending forces that may occur on the joint driver rod. In addition, such configurations can also reduce the occurrence of backlash by connecting the central joint link directly to the spine portion of the elongated shaft assembly. In the configuration described above, the planetary gear rotates around a fixed gear located on the distal end of the elongated shaft. A slotted driver arm extends from the planetary gear, creating a moment that causes the end effector to move at a higher angle to reduce the stroke length of the joint driver. This slot provides the end effector with a second center of rotation. The triangular central joint link also reduces buckling loads or the system's range of motion and backlash. Larger planetary gears result in greater mechanical benefit, but less joint motion and vice versa for smaller planetary gears.

The ability to articulate the surgical end effector at a relatively high angle to the shaft to which the surgical end effector is attached is often excised in a confined space, such as in the thoracic cavity or pelvic bowl. Is desirable when performing various surgical procedures that can make access to the target soft tissue difficult. Commercially available endoscopic cutters (endocutters) are generally unable to articulate beyond an angle of 45 degrees (45 °) with respect to the elongated shaft. Figures 115-117 are capable of 90 ° (90 °) range of motion on either side of the elongated shaft, and outweigh the mechanical benefits achievable with many commercially available endoscopic cutter configurations. Each part of another surgical instrument 14010 that can provide great mechanical benefit is shown. As can be seen in these figures, the surgical instrument 14010 has a surgical end effector 14300 that operably interfaces with the elongated shaft assembly 14200, which may utilize many of the features of the various shaft assemblies disclosed herein. Includes. The elongated shaft assembly 14200 defines the shaft axis SA-S. In addition, the surgical end effector 14300 may essentially include any of the various end effectors described herein, or any other configured to perform other surgical procedures / procedures. May include a form of surgical end effector. In the illustrated configuration, for example, the surgical end effector 14300 includes an elongated channel 14302 that can be adapted to support a surgical staple cartridge inside. Elongated channel 14302 defines the end effector axis EA. The elongated shaft assembly 14200 may include a spine 14210 that is pivotally coupled to the elongated channel 14302 by a joint 14270. In the illustrated configuration, the elongated channel 14302 of the surgical end effector 14300 is coupled to the spine 14210 by a joint pin 14818 that defines the range of motion BB across the shaft axis SA-SA. In FIGS. 115-117, the range of motion BB may coincide with, for example, the central axis of the joint pin 14818, and in each of these figures is essentially protruding from the paper. The spine 14210 may otherwise be similar to the spine 210 described above and may support the launch member and closure sleeve configurations described herein, such launch member and closure sleeve. The configuration is not shown in detail in FIGS. 115-117 for clarity.

In the illustrated example, the elongated shaft assembly 14200 includes a range of motion system labeled 14800, which includes a joint lock similar to the joint locks 350, 810 and / or 10810 described above. It is gainable and can be operated by any of the various methods described herein. The joint movement system 14800 includes a distal joint driver 14820, which may include a portion of a joint lock (not shown) or a surgical end effector 14300 centered on the joint movement axis BB. May simply interface with a joint movement control system configured to selectively move the distal joint driver 14820 in the distal and proximal directions for joint movement. The range of motion system 14800 further includes a central link 14900 that is pivotally attached to the spine 14210 by a link pin 14902. In the illustrated configuration, the link pin 14901 defines a link axis LA that deviates from the range of motion BB and allows the central link 14900 to pivot around it. In FIGS. 115-117, the link axis LA may coincide with, for example, the central axis of the link pin 14901, and in each of these figures is essentially protruding from the paper and the range of motion BB. It deviates from and is parallel to the range of motion BB. As further seen in these figures, in the illustrated configuration, the central joint link 14900 is pivotally coupled to the spine 14210 in an asymmetrical configuration. More specifically, the first distance between the first end 14902 of the central joint link 14900 and the link axis LA is the first distance between the second end 14904 of the central joint link 14900 and the link axis LA. Shorter than the second distance.

The range of motion system 14800 in the illustrated embodiment further includes an intermediate driver link 14910 that is pivotally coupled to the end of the distal joint driver 14820 and the first end 14902 of the central joint link 14900. The range of motion system 14800 also includes an end effector driver link 14920 having a first or distal driver link end 14922 that is pivotally or movably coupled to an elongated channel 14302. The second or proximal driver link end 14924 of the end effector driver link 14920 is pivotally coupled to the second end 14904 of the central joint link 14900. In the illustrated configuration, the intermediate link 14910 is the shortest of the three links 14910, 14900 and 14920, and in at least one configuration it has a slightly arched shape. The end effector driver link 14920 is the longest of the three links 14910, 14900 and 14920, and also has a slightly arched shape in at least one configuration. When the distal joint driver 14820 is moved in the distal DD, the central joint link 14900 is in the clockwise direction CW about the range of motion BB with respect to the distal end of the elongated shaft assembly 14200. The end effector driver link 14920 pulls the end effector 14300. See FIG. 116. Depending on the amount of proximal movement of the distal joint driver 14820, the surgical end effector 14300 may be pivoted to the range of motion shown in FIG. 116, where the end effector axis EA is the shaft axis SA-SA ( (Represented by angle 14950 in FIG. 116). Similarly, the movement of the distal joint driver 14820 to the proximal PD is in the counterclockwise direction CCW about the joint motion axis BB with respect to the distal end of the elongated shaft assembly 14200, the end effector driver. The end effector 14300 will be pushed into the link 14920. See FIG. 117. Depending on the amount of distal movement of the distal joint driver 14820, the surgical end effector 14300 may be pivoted to the range of motion shown in FIG. 117, where the end effector axis EA is the shaft axis SA-SA ( (Represented by angle 14952 in FIG. 117).

As can be seen in FIG. 115, the end effector axis EA is axially aligned with the shaft axis SA-SA when in the non-joint range of motion. When used in this situation, the term "aligned with" can mean "aligned coaxially" with the shaft axis SA-SA or simply parallel to the shaft axis SA-SA. The embodiments of FIGS. 115-117 are more robust than the conventional configuration, to a position at 90 degrees (90 °) with respect to the shaft axis (through a 180 degree path across the shaft axis). It provides a wider range of joint motion compared to joint configurations that cannot result in end effector joint motion. This embodiment can also effectively reduce the footprint of the end effector 14300 during range of motion by translating the end effector 14300 towards the shaft axis SA-SA during range of motion. This wider range of motion can also be achieved at the same time as providing a higher amount of resistance to bending forces. A second attachment point (link pin 14901) of the elongated shaft assembly 14200 to the spine 14210 can reduce the amount of backlash that occurs in the articulation joint 14270. The articulated joint configuration of FIGS. 115-117 can also provide a high amount of mechanical benefit to the amount of force required to joint the end effector 14300. Moreover, when the asymmetric central link 14900 is rotated 180 degrees (180 °), a high amount of mechanical benefit can be obtained during the disjoint movement. The end effector driver link 14920 translates anteriorly and posteriorly to make the end effector 14300 jointly move around the range of motion BB. The proximal end 14912 of the smallest link (intermediate link 14910) is such that the distal end 14914 of the smaller link (intermediate link 14910) rotates about its proximal end (attachment to the distal joint driver). When translated back and forth with the distal joint driver 14820. When the distal end 14914 of the small link 14910 is pivoted, a lever effect occurs on the central (grounded) link 14900, which reduces the backlash that occurs in the range of motion system, while joint motion. There is a mechanical benefit of force. The central (grounded) link 14900 pivots around its pinning position (pin 14901) to push / pull the longest link (end effector driver 14920). The longest link 14920 then pivots to articulate the end effector 14300.

As shown above, the ability to articulate the surgical end effector at a relatively high angle to the shaft to which the surgical end effector is attached is often, such as in the thoracic cavity or pelvic bowl. It is desirable when performing various surgical procedures that require excision within a confined space and can make access to the target soft tissue difficult. Commercially available endoscopic cutters (endocutters) are generally unable to articulate beyond an angle of 45 degrees (45 °) with respect to the elongated shaft. Figures 118 and 119 are generally achieved with many commercially available endoscopic cutter configurations that allow 90 ° (90 °) range of motion on one side of the elongated shaft. Each part of another surgical instrument 15010 that is capable of providing greater mechanical benefit than is possible is shown. As can be seen in these figures, the surgical instrument 15010 has a surgical end effector 15300 that operably interfaces with the elongated shaft assembly 15200, which may utilize many of the features of the various shaft assemblies disclosed herein. Includes. The elongated shaft assembly 15200 defines the shaft axis SA-SA. In addition, the surgical end effector 15300 may essentially include any of the various end effectors described herein, or any other configured to perform other surgical procedures / procedures. May include a form of surgical end effector. In the illustrated configuration, for example, the surgical end effector 15300 includes an elongated channel 15302 that can be adapted to support a surgical staple cartridge inside. In other end effector embodiments not specifically configured to cut and staple tissue, element 15302 may include the jaw or other portion of the end effector. The slender channel 15302 defines the end effector axis EA. The elongated shaft assembly 15200 may include a spine 15210 that is pivotally coupled to the elongated channel 15302 by a joint 15270. In the illustrated configuration, the elongated channel 15302 of the surgical end effector 15300 is coupled to the spine 15210 by a joint pin 15818 that defines the range of motion BB across the shaft axis SA-SA. In FIGS. 118 and 119, the range of motion BB may coincide with, for example, the central axis of the joint pin 15818, and in each of these figures is essentially protruding from the paper. As can be seen from these figures, in the illustrated embodiment, the range of motion BB is deviated from one outer side of the shaft axis SA-SA. In other words, the range of motion BB does not intersect the shaft axis SA-SA or the end effector axis EA. The spine 15210 may be otherwise similar to the spine 210 described above and may support the launch member and closure sleeve configurations described herein, such launch member and closure sleeve. The configuration is not shown in detail in FIGS. 118-119 for clarity.

In the illustrated example, the elongated shaft assembly 15200 includes a range of motion system labeled 15800, which includes a joint lock similar to the joint locks 350, 810 and / or 10810 described above. It is gainable and can be operated by any of the various methods described herein. The joint movement system 15800 includes a distal joint driver 15820, which may include a portion of a joint lock (not shown) or a surgical end effector 15300 centered on the joint movement axis BB. May simply interface with a joint movement control system configured to selectively move the distal joint driver 15820 in the distal and proximal directions for joint movement. The range of motion system 15800 further includes an end effector link 15900 that is pivotally attached to the distal end of the distal joint driver 15820 and the elongated channel 15302 of the surgical end effector 15300. Therefore, when the distal joint driver 15820 is moved to the proximal PD, the surgical end effector 15300 is pivoted in the counterclockwise CCW direction around the range of motion BB.

As can be seen in FIG. 118, the end effector axis EA is axially aligned with the shaft axis SA when in the non-joint range of motion. When used in this situation, the term "aligned with" can mean "aligned coaxially" with the shaft axis SA-SA or simply parallel to the shaft axis SA-SA. Advancement of the distal joint driver 15820 to the proximal PD will pivot the surgical end effector 15300 around the range of motion BB in the counterclockwise direction. The proximal end 15305 of the elongated channel 15302 and the distal end 15211 of the spine 15210 are angled to allow the surgical end effector 15300 to pivot to the full range of motion position. For example, the end effector axis EA is perpendicular to the shaft axis SA (angle 15952 is 90 degrees (90 °)). See FIG. 119. In one configuration, the proximal end 15305 of the surgical end effector 15300 is oriented at an end effector angle 15307 with respect to the end effector axis EA, and the distal end 15211 of the elongated shaft assembly 15200 is on the shaft axis SA-SA. On the other hand, it is oriented at a shaft angle of 15213. In one configuration, the end effector angle 15307 is equal to the shaft angle 15213. For example, the end effector angle 15307 and the shaft angle 15213 may both be about 45 degrees (45 °).

The embodiments of FIGS. 118 and 119 are also flexible dejoining movements that can be attached to a portion of a surgical instrument configured to selectively apply only tensile motion to the proximal PD to the dejoining movement member. Includes member 15910. As can be seen in FIG. 119, the dejoint movement member 15910 is oriented to flex around the joint pin 15818 during the joint movement of the surgical end effector 15300. In an alternative configuration, the de-joint range of motion is elastic and is located proximal to the joint 15270 to the spine 15210 or other portion of the surgical instrument 15010, as well as the elongated channel of the surgical end effector 15300. It is attached to the proximal end 15305 or other part of 15302. The flexible dejoining range of motion is made of, for example, spring tempered stainless steel, plastic material, nylon, etc., and dejoints the surgical end effector 15300 from the joint range of motion to the non-joint range of motion again. It can be formed into a flat band or cable to help. When the clinician wishes to return the surgical end effector 15300 to a non-joint motor orientation, the distal joint driver 15820 is moved to the distal DD, thereby moving the surgical end effector clockwise in the CW direction. The disjoint movement member 15910 is pulled in the proximal direction PD. The dejoint movement member 15910 also serves to help pull the surgical end effector clockwise in the CW direction back into the non-joint movement position.

The embodiments of FIGS. 118 and 119 may have some advantages over other commercially available range of motion surgical instruments. Such a configuration can reduce the backlash that occurs during range of motion, for example due to the minimum number of links. Such a configuration also results in an increase in range of motion compared to conventional designs. As described above, the surgical end effector may comprise the various types of surgical stapled configurations described herein. Such a configuration uses an axially movable launcher or launch bar or beam that experiences a certain amount of flexion when the end effector is articulated. The embodiments of FIGS. 118 and 119 can result in improved radius of curvature for the launching member due to asymmetric joint motion. In other words, the distal joint driver 15820 and the end effector link 15910 are located on one side of the shaft axis SA-SA, thereby achieving more gradual flexion of the launch member during range of motion. To do so, additional clearance is provided. The construction of such a deviated range of motion axis, which results in joint motion in a single range of motion across the shaft axis, is described herein as "asymmetric" which can promote relatively high range of motion angles. Sometimes referred to as the range of motion composition or system. Further, in this embodiment, the joint motion axis BB is laterally deviated from the shaft axis. In such an embodiment, the distance from the intersection of the shaft axis to the end effector axis to the distal end of the end effector is shorter when the device is in range of motion than when the device is in range of motion. Become.

Figures 120-122 show another range of motion surgery, including a surgical end effector 16300 that operably interfaces with an elongated shaft assembly 16200 that may utilize many of the various shaft assembly features disclosed herein. Each part of the instrument 16010 is shown. The elongated shaft assembly 16200 defines the shaft axis SA-SA. In addition, the surgical end effector 16300 may essentially include any of the various end effectors described herein, or any other configured to perform other surgical procedures / procedures. May include a form of surgical end effector. In the illustrated configuration, for example, the surgical end effector 16300 includes an elongated channel 16302 that can be adapted to support, for example, a surgical staple cartridge inside. In other end effector embodiments not specifically configured to cut and staple tissue, element 16302 may include the jaw or other portion of the end effector. The slender channel 16302 defines the end effector axis EA. The elongated shaft assembly 16200 may include a spine 16210 that is pivotally coupled to the elongated channel 16302 by a joint 16270. In the illustrated configuration, the elongated channel 16302 of the surgical end effector 16300 includes a proximal overhang mounting arm 16309 that is coupled to the spine 16210 by a spring pin 16818 that defines the range of motion axis BB. The range of motion BB crosses the shaft axis SA-SA. In FIGS. 121 and 122, the range of motion BB may coincide with, for example, the central axis of the spring pin 16818, and in each of these figures is essentially protruding from the paper. As can be seen from these figures, in the illustrated embodiment, the range of motion BB is deviated from one outer side of the shaft axis SA-SA. In other words, the range of motion BB does not intersect the shaft axis SA-SA or the end effector axis EA. The spine 16210 may otherwise be similar to the spine 210 described above and may support the launch member and closure sleeve configurations described herein, such launch member and closure sleeve. The configuration is not shown in detail in FIGS. 120-122 for clarity. The spring pin 16818 is configured to apply an urging force to the mounting arm 16309 to urge the mounting arm 16309 and the surgical end effector 16300 in the clockwise CW direction. Therefore, the spring pin 16818 acts to urge the surgical end effector 16300 to the non-joint range of motion shown in FIG. 121 where the end effector axis EA and the shaft axis SA-SA are axially aligned. When used in this situation, the term "aligned with" can mean "aligned coaxially" with the shaft axis SA-SA or simply parallel to the shaft axis SA-SA.

In the illustrated example, the elongated shaft assembly 16200 also includes a range of motion system referred to as 16800, which is a joint lock similar to the joint locks 350, 810 and / or 10810 described above. It can be included and can be operated by any of the various methods described herein. The joint motion system 16800 includes a distal joint driver 16820, which distal joint driver may include a portion of a joint lock (not shown) or a surgical end effector 16300 centered on the joint motion axis BB. May simply interface with a joint movement control system configured to selectively move the distal joint driver 16820 in the distal and proximal directions for joint movement. The distal joint driver 16820 is pivotally pinned to the proximal end 16305 of the elongated channel 16302. As can be seen in FIG. 121, the distal joint driver 16820 is pinned to the elongated channel 16302 at a position on one side of the shaft axis SA-SA and the end effector axis EA. The range of motion BB is located opposite the shaft axis with respect to the point where the distal joint driver is attached to the elongated channel 16302. As can be seen in FIG. 121, in the illustrated configuration, the point where the distal joint driver 16820 is attached to the elongated channel 16302 is distal to the range of motion axis BB. When the distal joint driver 15820 is moved proximally, the surgical end effector 16300 is pivoted in the counterclockwise CCW direction around the range of motion BB.

As can be seen in FIG. 121, the end effector axis EA is axially aligned with the shaft axis SA when in the non-joint range of motion. When used in this situation, the term "aligned with" can mean "aligned coaxially" with the shaft axis SA-SA or simply parallel to the shaft axis SA-SA. Advancement of the distal joint driver 16820 to the proximal PD will pivot the surgical end effector 16300 around the range of motion BB in the counterclockwise direction. When the clinician wishes to return the surgical end effector 16300 to non-joint motor orientation, the distal joint driver 16820 is moved to the distal DD, thereby causing the surgical end effector 16300 to move clockwise in the CW direction. It will start to be moved. The spring pin 16818 also serves to help pull the surgical end effector 16300 back into the non-joint range of motion in the clockwise CW direction.

Figures 123-128 show another surgical instrument 17010, including a surgical end effector 17300 that operably interfaces with an elongated shaft assembly 17200 using many of the various shaft assembly features disclosed herein. Each part is shown. The surgical end effector 17300 may essentially include any of the various end effectors described herein, or other form of surgery configured to perform other surgical procedures / procedures. End effector for use may be included. In the illustrated configuration, for example, the surgical end effector 17300 is adapted to cut and staple tissue and has an elongated channel 17302 configured to operably support the surgical staple cartridge 17304 in. Includes a morphological first jaw. See FIGS. 123 and 124. The illustrated surgical end effector 17300 further includes a second jaw in the form of an anvil 17310 supported to move relative to it on the elongated channel 17302. See FIG. 123. The anvil 17310 may be movably actuated by one of the closure systems described herein. For example, a first closure drive system may be used to operate the closure sleeve 260 in the manner described herein. The closure sleeve 260 is attached to an end effector closure sleeve 272 that is pivotally attached to the closure sleeve 260 by a double pivot closure sleeve assembly 271 in any of the methods described herein. As described above, for example, the axial movement of the closure sleeve 260 can be controlled through the activation of the closure trigger. When the end effector closing sleeve 272 is advanced in the distal DD, the anvil 17310 is cam driven and closed. In at least one configuration, a spring (not shown) may be used to pivot the anvil 17310 to the open position when the end effector closing sleeve 272 is retracted back to the starting position.

As can be seen in FIGS. 123-128, the surgical end effector 17300 can be articulated with respect to the elongated shaft assembly 17200 around the articulation joint 17270. In the illustrated example, the elongated shaft assembly 17200 includes a range of motion system marked 17800 with joint locks 17810 similar to the joint locks 350, 810 and 10810 described above. See FIGS. 124 and 125. For example, the components of the joint lock 17810 that are different from the components of the joint lock 810 and / or the joint lock 350 and / or the joint lock 10810 and that may be necessary to understand the operation of the joint lock 17810 are described below. It will be described in more detail. As mentioned above, further details regarding the Joint Lock 350 are incorporated herein by reference in its entirety, U.S. Patent Application No. 13 / 803,086, title of the invention "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING. "AN ARTICULATION LOCK", which can be found in the current US Patent Application Publication No. 2014/0263541. The joint lock 17810 may be configured and manipulated to selectively lock the surgical end effector 17300 to various range of motion positions. Such a configuration allows the surgical end effector 17300 to rotate, or jointly move, with respect to the shaft closure sleeve 260 when the joint lock 17810 is in its unlocked state.

In particular, with reference to FIG. 125, the elongated shaft assembly 17200 includes a spine 210, which first slidably supports a launching member (not shown) therein and secondly. , The closure sleeve 260 (FIG. 123) extending around the spine 210 is configured to slidably support. The spine 210 also slidably supports the proximal joint driver 230. The proximal joint driver 230 has a distal end 231 configured to operably engage the joint lock 17810. The joint lock 17810 further comprises a shaft frame 17812 that is attached to the spine 210 in various ways disclosed herein. The shaft frame 17812 is configured to movably support the proximal portion 17821 of the distal joint driver 17820 therein. In response to the joint motion control motion applied to the distal joint driver 17820, the distal joint driver 17820 laterally deviates from the shaft axis SA-SA and is along the joint actuation axis AAA parallel to the shaft axis SA-SA. It is movably supported within the elongated shaft assembly 17200 to selectively move longitudinally to the distal DD and the proximal PD.

Still referring to FIGS. 124 and 125, in the illustrated configuration, the shaft frame 17812 includes a distal end portion 17814 with a pivot pin 17818 formed on top. The pivot pin 17818 is adapted to be pivotally received within the pivot hole 17397 formed in the pivot base portion 17395 of the end effector mounting assembly 17390. The end effector mounting assembly 17390 is attached to the proximal end 17303 of the elongated channel 10302 by a spring pin 17393 or other suitable member. The pivot pin 17818 defines the range of motion BB across the shaft axis SA-SA. Such a configuration facilitates the pivotal movement (ie, range of motion) of the end effector 17300 about the joint motion axis BB with respect to the shaft frame 17812.

As can be seen in FIG. 125, a link pin 17825 is formed on the distal end 17823 of the distal joint link 17820 and is configured to be received within hole 17904 of the proximal end 17902 of the cross link 17900. ing. The crosslink 17900 extends across the shaft axis SA-SA and includes a distal end portion 17906. A distal link hole 17908 is provided through the distal end portion 17906 of the cross link 17900 so as to pivotally receive a base pin 17398 extending from the bottom of the pivot base portion 17395 of the end effector mounting assembly 17390. It is configured. The base pin 17395 defines a link axis LA that is parallel to the range of motion axis BB. FIGS. 124 and 127 show the surgical end effector 17300 in the non-joint range of motion. In other words, the end effector axis EA defined by the elongated channel 17302 is aligned with the shaft axis SA-SA. When used in this situation, the term "aligned with" can mean "aligned coaxially" with the shaft axis SA-SA or simply parallel to the shaft axis SA-SA. As the distal joint driver 17820 moves in the proximal direction PD (in the manner described herein), the crosslink 17900 watches around the joint motion axis BB as shown in FIG. 126. The surgical end effector 17300 will be pulled in the surrounding CW direction. As the distal joint driver 17820 moves in the distal DD, the crosslink 17900 moves the surgical end effector 17300 in the counterclockwise CCW direction around the range of motion BB as shown in FIG. 128. Will let you. As can be seen in this figure, the crosslink 17900 has a curved shape, which causes the crosslink 17900 to be placed around the joint pin 17818 when the surgical end effector 17300 is jointed in that direction. It makes it possible to bend. When the surgical end effector 17300 is in full range of motion on both sides of the shaft axis SA-SA, the joint range of motion 17700 between the end effector axis EA and the shaft axis SA-SA is about 65 degrees (65 °). .. Therefore, the range of motion of any of the shaft axes in the above is from 1 degree (1 °) to 65 degrees (65 °).

The surgical end effector 17300 of the embodiments shown in FIGS. 123-128 comprises a surgical cutting and stapling device using a firing beam 220 of various types and configurations described herein. However, the surgical end effector 17300 of this embodiment may include other forms of surgical end effector that do not cut and / or staple the tissue. In the illustrated configuration, the central support member 17950 is pivotally and slidably supported with respect to the spine 210. As can be seen in FIG. 125, the central support member 17950 includes a slot 17952, which slot is adapted to receive a pin 17954 protruding from the spine 210. Such a configuration allows the central support member 17950 to pivot and translate with respect to pin 17954 when the surgical end effector 17300 is range of motion. The pivot pin 17958 projects from the underside of the central support member 17950 so that it is pivotally received within the corresponding pivot hole 17399 provided in the base portion 17395 of the end effector mounting assembly 17390. .. The central support member 17950 further includes a slot 17960 for receiving the firing beam 220 through it. The central support member 17950 acts to provide lateral support to the launch beam as the launch beam 220 bends to adapt to the joint motion of the surgical end effector 17300.

Figures 129-131 show another surgical instrument 18010, including a surgical end effector 18300 that operably interfaces with an elongated shaft assembly 18200 using many of the various shaft assembly features disclosed herein. Each part is shown. The surgical end effector 18300 is adapted to cut and staple tissue and has a first jaw in the form of an elongated channel 18302 configured to operably support a surgical staple cartridge inside. Includes. The illustrated surgical end effector 18300 further includes a second jaw in the form of an anvil 18310 supported to move relative to it on the elongated channel 18302. The anvil 18310 may be movably actuated by one of the closure systems described herein.

The elongated shaft assembly 18200 includes a shaft spine 18210 that defines a shaft axis SA-SA that coincides with the center of the elongated shaft assembly 18200. In other words, the shaft axis SA-SA extends axially below the geometric center of the elongated shaft assembly 18200. The spine 18210 may be otherwise similar to the spine 210 described above and may support the launch member and closure sleeve configurations described herein, such launch member and closure sleeve. The configuration is not shown in detail in FIGS. 129-131 for clarity. As can be seen in FIG. 131, the surgical end effector 18300 can be articulated with respect to the elongated shaft assembly 18200 around the articulation joint 18270. The joint 18270 serves to connect the elongated channel 18302 to the distal end 18215 of the spine 18210. The surgical end effector 18300, more specifically the elongated channel 18302 of the surgical end effector 18300, defines an end effector axis EA that represents the axis of the elongated channel 18302. When the surgical end effector 18300 is in a non-joint motion orientation, the end effector axis EA is axially aligned with the shaft axis SA-SA as shown in FIG. When used in this situation, the term "aligned with" can mean "aligned coaxially" with the shaft axis SA-SA or simply parallel to the shaft axis SA-SA. In the illustrated configuration, the elongated channel 18302 of the surgical end effector 18300 includes a proximal projecting mounting arm 18309 that is coupled to the spine 18210 by a spring pin 18818 that defines the range of motion BB. The range of motion BB crosses the shaft axis SA-SA. In FIGS. 130 and 131, the range of motion BB may coincide with, for example, the central axis of the spring pin 18818, and in each of these figures is essentially protruding from the paper. As can be seen from these figures, in the illustrated configuration, the range of motion axis BB is deviated from one outer portion 18213 of the shaft axis SA-SA. In other words, the range of motion BB does not intersect the shaft axis SA or the end effector axis EA. The spring pin 18818 is configured to apply a urging force to the mounting arm 18309 to urge the mounting arm 18309 and the surgical end effector 18300 in the clockwise CW direction. Therefore, the spring pin 18818 acts to urge the surgical end effector 18300 to the non-joint range of motion shown in FIG. 130 in which the end effector axis EA and the shaft axis SA-SA are axially aligned.

The illustrated embodiment further comprises a range of motion system described as 18800, which uses a joint lock 18810 similar to the joint locks 350, 810 and 10810 described above. The joint lock 18810 may be configured and manipulated to selectively lock the surgical end effector 18300 to various range of motion positions. Such a configuration allows the surgical end effector 18300 to rotate or range of motion with respect to the elongated shaft assembly 18200 when the joint lock 18810 is in its unlocked state. The joint lock 18810 includes a distal joint driver 18820, which is movable within the elongated shaft assembly 18200 for selective longitudinal movement in the distal DD and proximal PD. Is supported by. The distal joint driver 18820 is movable along the joint actuation axis AAA, which is laterally deviated from and parallel to the shaft axis SA-SA in response to the joint motion control motion applied thereto. .. In an alternative embodiment, the distal joint driver 18820 does not include a portion of the joint lock, but instead the distal joint driver 18820 is selectively axially advanced in the distal DD and proximally. It operably interfaces with the source of joint motion motion (in the handle or in the robotic system) that acts to retract the distal joint driver 18820 to the PD. The distal joint driver 18820 is pivotally pinned to the proximal end 18305 of the elongated channel 18302. As can be seen in FIG. 130, the distal joint driver 18820 is pinned to the elongated channel 18302 at a position on one lateral portion 1821 of one of the shaft axis SA-SA and the end effector axis EA. The range of motion BB is located at the lateral portion 18213 opposite the shaft axis SA-SA with respect to the point where the distal joint driver 18820 is attached to the elongated channel 18302. As can be seen in FIG. 130, in the illustrated configuration, the point where the distal joint driver 18820 is attached to the elongated channel 18302 is distal to the range of motion axis BB. As can be seen in FIG. 130, the end effector axis EA aligns axially with the shaft axis SA-SA when in the non-joint range of motion. As the distal joint driver 18820 advances in the proximal direction PD, the surgical end effector 18300 will pivot in the counterclockwise direction CCW around the range of motion BB. In other words, the surgical end effector 18300 is capable of range of motion to a position on one side of the shaft axis SA that coincides with the first side 18211 of the spine 18210. When the clinician wishes to return the surgical end effector 18300 to non-joint motor orientation, the distal joint driver 18820 is moved to the distal DD, thereby causing the surgical end effector 18300 to move clockwise to the CW. It will start to be moved. The spring pin 16818 also serves to help pull the surgical end effector 18300 back into the non-joint range of motion in the clockwise direction CW.

The surgical end effector 18300 of the embodiments shown in FIGS. 129-131 comprises a surgical cutting and stapling device using a firing beam 18220 of various types and configurations described herein. In one configuration, for example, the firing beam 18220 may have a laminated structure as described herein. In an exemplary embodiment, the firing beam 18220 is slidably supported within a path 18230 formed in the spine 18210, selectively advancing the firing beam 18220 in the distal DD and firing in the proximal PD. It interfaces with the various types of launch systems described herein that are configured to retract the beam 18220. The distal end of the firing beam 18220 is coupled to or operably interfaced with various types of firing members (not shown) or tissue cutting members disclosed herein. In at least one form, for example, the launch member 18220 comprises a tissue cut surface and also provides a staple support member (and staples supported on it) as the launch member 18220 is driven distally through a staple cartridge. It is configured to interact with a staple support member that is operably supported within the staple cartridge to drive towards the anvil.

The articulated joint 18270 of the illustrated embodiment facilitates joint movement of the surgical end effector 18300 in only one direction (CCW). In other words, the surgical end effector 18300 can be pivoted to a range of motion that coincides with the first lateral portion 18211 of the spine 18210. In one example, the surgical end effector 18300 may jointly move to the full range of motion position shown in FIG. 131, where the angle 18950 between the end effector axis EA and the shaft axis is about 75 degrees (75 °). To adapt to such a range of motion, the distal end 18215 of the spine 18210 has a notch 18217 adjacent to the first side of the spine 18210.

As shown above, the firing beam 18220 is slidably supported within the path 18220 provided in the spine 18210. In the illustrated configuration, the path 18230 has a "first" or proximal portion 18232 that is axially aligned with the shaft axis SA-SA and a "second" or that is not axially aligned with the shaft axis SA-SA. Includes the distal portion 18234 and. In the illustrated embodiment, the distal portion 18234 of the path 18230 is open at the distal end of the spine at a position that is not axially aligned with the shaft axis SA-SA. As can be seen in FIGS. 130 and 131, for example, the distal portion 18234 of path 18230 is laterally displaced with respect to the second outer portion 18213 of the shaft axis SA-SA (at 18236 in FIGS. 130 and 131). (Shown) is open. Further, at least in the illustrated embodiment, the distal portion 18234 of the path 18230 is curved so that the launch beam 18220 begins to bend in the range of motion before exiting the spine 18210. Such a configuration is unidirectionally articulated and the firing beam exits the spine 18210 while aligned with the shaft axis SA-SA compared to the bending radius of the firing beam in other articulated end effector configurations. Gives the firing beam 18220 a larger bending radius. Further, the path 18230 in the illustrated configuration has a first or proximal portion 18232 that is axially aligned with the shaft axis SA-SA and a second that curves in a first direction away from the shaft axis SA-SA. It includes an arched portion 18233 and a third arched section 18235 that curves toward the shaft axis SA-SA. As further seen in FIGS. 130 and 131, the position 18236 where the launch beam 18220 exits the spine 18210 is at the second side 18213 of the shaft axis SA, opposite the first side 18211 where the end effector 18300 joints. positioned. Therefore, the distal portion 18234 of the path 18230 acts to position or urge the firing beam 18220 to an "off-axis position" (a position that is not axially aligned with the shaft axis SA) with respect to the shaft axis SA-SA. .. Such a configuration gives the launch beam a gradual arc as the launch beam 18220 exits the spine 18210. This feature can work to reduce the likelihood that the firing beam 18220 will buckle when the joint 18270 expands to accommodate the surgical end effector 18300. In other configurations, the proximal portion of the path may be laterally displaced from the shaft axis. In yet other configurations, the proximal portion of the pathway may be axially aligned with the shaft axis, and the distal portion of the pathway is the end effector's range of motion as the firing beam exits the distal portion of the pathway. It may be angled to one side of the shaft axis so that the firing beam is axially offset to the opposite side of the possible shaft axis. In such a configuration, the distal portion of the pathway may be relatively straight or non-curved. In yet other configurations, the distal and proximal parts of the pathway may be along a common axis laterally offset from the shaft axis on the side opposite to the range of motion of the end effector. Good. All of these configurations result in an off-axis shift of the firing beam as it exits the spine, resulting in a larger bend radius without adding space distal to the range of motion axis. ..

The firing beams used in the various surgical instruments disclosed herein are configured to flex sufficiently to adapt to the various range of motion positions of the end effector. In some configurations, the firing beam may actually include a firing rod 18600 coupled to the flexible firing beam 18700 at the coupling or coupling 18702. See FIG. 132. The launch rod 18600 is slidably supported within the spine 18210 of the elongated shaft assembly and is translated, for example, in response to a drive motion initiated within the handle of the surgical instrument or by a robotic system. obtain. In various cases, the firing rod 18600 may resist deformation, twisting, and / or bending as it transmits the firing motion. For example, the launch rod 18600 may be constructed of rigid and / or inflexible materials and / or structures.

At the connection 18702, the firing rod 18600 is engaged with the downwardly projecting key 18701 of the flexible firing beam 18700 (see, eg, FIG. 132A). For example, the key 18701 may extend into an elongated aperture 18606 formed at the distal end 18604 of the firing rod 18600. This firing rod-key engagement is configured to transmit the translation of the firing rod 18600 to the flexible firing beam 18700. In various cases, the coupling 18702 may be in close proximity to the joint 18270, whereby the flexible firing beam 18700 extends from the coupler 18702 through the range of motion joint 18270.

In the configuration shown in FIGS. 133, 135, the flexible launch beam 18700 includes a plurality of outer portions or layers 18702a, 18702b, 18702c, 18702d, 18702e, 18702f. In various cases, the portions 18702a, 18702b, 18702c, 18702d, 18702e, 18702f can be held together and can be movable and / or shiftable with respect to each other. For example, the outer portions 18702a, 18702b, 18702c, 18702d, 18702e, 18702f can be anchored together at the distal end of the flexible firing beam 18700. The portions 18702a, 18702b, 18702c, 18702d, 18702e, 18702f may be fixed together at their distal ends, eg, by welding, integral molding, fastening, and / or other methods. At least a portion of the remaining length of the outer portions 18702a, 18702b, 18702c, 18702d, 18702e, 18702f so as to move and / or shift with respect to the adjacent outer portions 18702a, 18702b, 18702c, 18702d, 18702e, 18702f. Can be configured in. For example, when the flexible firing beam 18700 bends at the joint 18270, the outer portions 18702a, 18702b, 18702c, 18702d, 18702e, 18702f flex at the joint 18270 and the proximal end of the flexible firing beam 18700. Can shift to configurations that are staggered and / or displaced from each other. FIG. 134 shows the proximal end 18704 of one form of the firing beam 18700', with the outer portions 18702a, 18702b, 18702c, 18702d, 18702e coplanar with each other when the firing beam 18700 is linear. .. FIG. 135 shows another flexible beam configuration, where layered portions 18702a, 18702b, 18702c, 18702d, 18702e and 18702f are offset from each other at the proximal end 18704.

With reference to FIGS. 132 and 133 again, the proximal end 18704 of the flexible launch beam 18700 extends into the cavity 18608 formed in the distal end 18604 of the launch rod 18600 and is a flexible launch. Each portion of the beam 18700, 18702a, 18702b, 18702c, 18702d, 18702e, 18702f, may extend along the launch path through the articulation joint 18270. When the end effector 18300 is articulated with respect to the elongated shaft assembly 18200, the flexible launch beam 18700 and its respective portions 18702a, 18702b, 18702c, 18702d, 18702e, 18702f can flex within the articulation joint 18270. In such cases, the outer portion adjacent to the outer portions 18702a, 18702b, 18702c, 18702d, 18702e, 18702f may extend along a variable path when the end effector 18300. A bumper member 18610 is supported in the cavity to accommodate the shift of each portion 18702a, 18702b, 18702c, 18702d, 18702e, 18702f during range of motion. For example, the bumper member 18610 is expected to be evenly loaded (ie, moved forward) by the bumper member 18610 during launch with each portion 18702a, 18702b, 18702c, 18702d, 18702e, 18702f. In addition, when the firing beam portions 18702a, 18702b, 18702c, 18702d, 18702e, 18702f extend relative to each other, they may rotate within the cavity 18608. The bumper member 18610 may or may not be made of a flexible material. Further details and specifications relating to the firing beam / firing rod configuration described above and other configurations that may be used with the various embodiments disclosed herein are incorporated herein by reference in their entirety. U.S. Pat.

FIG. 132A shows a coupling configuration 18702'using a one-way latch configuration to limit the distal movement of the launch rod 18600'. As can be seen in this figure, the launch rod 18600'contains a lock aperture 18620, which is either perpendicular to the slanted distal surface 18622 and the direction in which the launch rod 18600'moves. It has a vertical surface 18624, which traverses that direction. The locking member 18630 is movably supported within the locking cavity 18640 of the shaft spine 18210. A lock spring 18642 is supported within the lock cavity 18640 to urge the lock member 18630 into sliding contact with the launch rod 18600'. In the illustrated embodiment, the locking member 18630 has an inclined distal surface 18632 and a vertical posterior surface 18634, which lock aperture when the launch rod 18600'is moved to a predetermined most distal position. It is sized to extend into 18620. When the launch rod 18600'is moved distally to the position shown in FIG. 132A, the spring 18642 of the locking member 18630 urges the locking member into the lock aperture 18620, thereby furthering the launch rod 18600'. Any distal movement is further prevented. However, when the launch rod 18600'is retracted in the proximal direction PD, the launch rod 18600' contacts the inclined distal surface 18632 and attaches the locking member 18630 into the locking cavity 18640 of the shaft spine 18210. It is possible for the launch rod 18600'to move beyond the lock member 18630 in the proximal direction PD.

Figures 136 and 137 show another surgical instrument 19010, including a surgical end effector 19300 that operably interfaces with an elongated shaft assembly 19200 using many of the various shaft assembly features disclosed herein. Each part is shown. For example, the elongated shaft assembly 19200 is similar to the elongated shaft assembly 200'described in detail above, except for the differences described below. In the illustrated example, the elongated shaft assembly 19200 includes a double joint link configuration marked 19800 with joint locks 19810 similar to the joint locks 350, 810 and 10810 described above. The joint lock 19810 can be configured and manipulated to selectively lock the surgical end effector 19300 to various range of motion positions. Such a configuration allows the surgical end effector 19300 to rotate or range of motion with respect to the elongated shaft assembly 19200 when the joint lock 19810 is in its unlocked state. The first distal joint driver 19820 has an elongated shaft assembly 19200 to selectively move longitudinally in the distal DD and proximal PD in response to the corresponding joint motion control motion applied thereto. Supported within the spine 19210. The downward projecting pivot pin 19818 is adapted to be pivotally received within a pivot hole (not shown) formed in the proximal end portion of the elongated channel 19302 of the surgical end effector 19800. Such a configuration facilitates the pivotal movement of the elongated channel 19302 of the surgical end effector 19300 with respect to the spine 19210 centered on the range of motion BB defined by the pivot hole. As shown above, the range of motion BB crosses the shaft axis SA-SA defined by the elongated shaft assembly 19200.

Still referring to FIGS. 136 and 137, the double joint link configuration 19800 establishes a "push / pull" configuration when joint kinetic force is applied to the double joint link configuration 19800 through the first distal joint driver 19820. It is configured to do. As can be seen in these figures, the first distal joint driver 19820 has a first drive rack 19842 formed therein. The first joint rod 19844 projects distally from the first distal joint driver 19820 and has a first axial slot 19845 therein. In addition, a first end effector link 19850 is movably coupled to the surgical end effector 19300. In one configuration, for example, the distal end 19852 of the first end effector link 19850 is pivotally pinned to the elongated channel 19302 of the end effector 19300. The proximal end 19854 of the first end effector link 19850 is slidably received within the first axial slot 19845 of the first joint rod 19844 of the first distal joint driver 19820. Includes pin 19856. The double joint link configuration 19800 further comprises a second distal joint driver 19860 formed within a second drive rack 19862. The second distal joint driver 19860 is movably supported within the elongated shaft assembly 19200 for longitudinal movement in the distal DD and proximal PD. A second joint rod 19864 projects distally from the second distal joint driver 19860 and has a second axial slot 19856 therein. In addition, a second end effector link 19870 is movably coupled to the surgical end effector 19300. In one configuration, for example, the distal end 19872 of the second end effector link 19870 is pivotally pinned to the elongated channel 19302 of the end effector 19300. The proximal end 19874 of the second end effector link 19870 is a second slidably received in the second axial slot 1986 of the second joint rod 19864 of the second distal joint driver 19860. Includes pin 1976. As can be seen in FIG. 136, the first end effector link 19850 is a first joint motion axis FA parallel to the first axial side of the shaft axis SA-SA and located on the first axial side thereof. It is attached to the elongated channel 19302 so as to move longitudinally along. The second end effector link 19870 is attached to the elongated channel 19302 so as to move longitudinally along the second range of motion SDA parallel and distant from the second lateral portion of the shaft axis SA-SA. Be done. See FIG. 136. Therefore, by pulling one of the end effector links 19850 and 19870 at the same time, the surgical end effector 19300 is jointly moved with respect to the elongated shaft assembly 19200 about the range of motion BB. In the illustrated configuration, the first axial slot 19845 and the second slot 19856 are parallel to each other and parallel to the shaft axis SA-SA. As further seen in FIGS. 136 and 137, the first end effector link 19850 and the second end effector link 19870 each have a curved or arched shape that curves around the range of motion BB. There is. Such a curvilinear shape can also lead to an expanded range of motion. In addition, each of the first and second axial slots 19845, 1986 may have a predetermined length that promotes the desired joint momentum, respectively.

Similarly, as can be seen in FIGS. 136 and 137, the proximal pinion gear 19880 and the distal pinion gear 19882 are centrally located between the first drive rack 19842 and the second drive rack 19862 and mesh with them. It is in agreement. In an alternative embodiment, only one pinion gear or three or more pinion gears may be used. Therefore, at least one pinion gear is used. The proximal pinion gear 19880 and the distal pinion gear 19882 are rotatably supported within the spine 19810 to rotate freely relative to them, so that the first distal joint driver 19820 moves in the distal DD. When so, the pinion gears 19880, 19882 act to drive the second distal joint driver 19860 in the proximal direction PD. Similarly, when the first distal joint driver 19820 is pulled in the proximal PD, the pinion gears 19880, 19882 drive the second distal driver 19860 into the distal DD. When the first distal joint driver 19820 moves proximally, the pinion gears 19880, 19882 act to drive the second distal joint driver 19860 into the distal DD. Such movement of the first and second distal joint drivers 19820, 19860 causes the surgical end effector 19300, more specifically the elongated channel 19302 of the surgical end effector 19300, to move the joint motion axis B-. It will be pivoted in the direction of joint movement of arrow 19821 with B as the center. Conversely, in order to joint the end effector 19300 in the direction of arrow 19823, the first distal joint driver 19820 is moved distally so that the pinion gears 19880, 19882 are the second distal joint driver 19860. Will be driven in the proximal direction PD. Such movement of the first and second distal joint drivers 19820, 19860 causes the surgical end effector 19300, more specifically the elongated channel 19302 of the surgical end effector 19300, to move the joint motion axis B-. It will be pivoted in the direction of joint movement of arrow 19823 with B as the center.

The dual integrated link joint configuration 19800 and its variants can provide a wider range of joint motion to the surgical end effector when compared to the configurations of other range of motion surgical end effectors. Specifically, the solid link joint motion configurations disclosed herein can promote the range of motion in the range of 1 degree (1 °) to 65 degrees (65 °). Using at least one pinion gear to interface between distal joint drivers is also in use so that the end effector can be "pushed" and "pulled" in place. It can reduce the amount of "slop" or unwanted or unintended movement of the end effector. The dual integrated link joint configurations disclosed herein also include a range of motion system with improved strength characteristics as compared to other range of motion system configurations. The proximal end of the dual link translates anteriorly and posteriorly along their respective slots as the end effector is range of motion. These slots can provide the system with a higher degree of resistance to the bending force applied to the double link and reduced backlash by suppressing the motion of the double link.

Figures 138-142 show another surgical instrument 2010, including a surgical end effector 20300 that operably interfaces with an elongated shaft assembly 20200 using many of the various shaft assembly features disclosed herein. Each part is shown. For example, the elongated shaft assembly 20200 is similar to the elongated shaft assembly 200'described in detail above, except for the differences described below. The downward projecting pivot pin 20818 is adapted to be pivotally received within the pivot hole 20305 formed in the proximal end portion of the elongated channel 20302 of the surgical end effector 20300. See FIG. 139. Such a configuration facilitates the pivotal movement of the elongated channel 20302 of the surgical end effector 20300 with respect to the spine 20210 centered on the range of motion BB defined by the pivot hall 20305. The range of motion BB crosses the shaft axis SA-SA defined by the elongated shaft assembly 20200. In the illustrated example, the elongated shaft assembly 20200 includes a double joint driver configuration marked 20800 with joint locks 20810 (FIG. 139) similar to the joint locks 350, 810 and 10810 described above. .. The joint lock 20810 can be configured and manipulated to selectively lock the surgical end effector 20300 to various range of motion positions. Such a configuration allows the surgical end effector 20300 to rotate or range of motion with respect to the elongated shaft assembly 20200 when the joint lock 20810 is in its unlocked state. The first distal joint driver 20820 selectively longitudinally along the first joint motion axis FA in the distal DD and proximal PD in response to the corresponding joint motion control motion applied thereto. Supported within the spine 20210 of the elongated shaft assembly 20200 to move to. The first range of motion FA is parallel to the first outer portion of the shaft axis SA-SA and is located on the outer side thereof. The first distal joint driver 20820 includes a first proximal drive rack 20842 and a first distal drive rack 20844 formed therein. The double joint link configuration 20800 further comprises a second distal joint driver 20860 with a second proximal drive rack 20862 and a second distal drive rack 20864 formed therein. The second distal joint driver 20860 is movably supported within the elongated shaft assembly 20200 to move longitudinally along the second range of motion SDA to the distal DD and proximal PD. There is. The second range of motion SDA is parallel to and located on the outer side of the second outer portion of the shaft axis SA-SA. See FIG. 138. The first and second distal joint drivers 20820, 20860 operably interface with the central joint movement member 20850. As can be seen in FIG. 140, the central joint exercise member 20850 is pivotally attached to the shaft spine 20210 by a pin 20851 that acts to define a gear axis GA on which the central joint exercise member 20850 can pivot around it. Has been done. The gear axis GA is parallel to the range of motion axis BB. See FIG. 139. The central joint motion member 20850 includes a body portion 20852 formed on which a gear portion 20854 is formed. The gear portion 20854 meshes and engages with the first distal drive rack 20844 and the second distal drive rack 20864.

The surgical end effector 20300 of the embodiments shown in FIGS. 138-142 comprises a surgical cutting and staple fastening device. The elongated channel 20302 is configured to operably support a surgical staple cartridge (not shown) and anvil assembly 20310. The surgical end effector 20300 also uses firing beams (not shown) of various types and configurations described herein. In the illustrated configuration, the central support member 20950 is pivotally and slidably supported with respect to the shaft spine frame 20810. As can be seen in FIG. 140, the central support member 20950 passes through the elongated shaft assembly 20200 to laterally support the launching member as it traverses across the articulation 20270 to the elongated channel 20302. Includes a central body portion 20952 defining a central slot 20954 configured to slidably receive the launch member. The proximal tongue 20955 projects proximally from the body portion 20952 so that it is movably coupled to the central joint movement member 20850. In the configuration shown, mounting pins 20960 extend through the proximal hole 20965 of the proximal tongue 20955. The mounting pin 20960 is received in the mounting slot 20856 provided in the main body portion 20852 of the central joint movement member 20850. The proximal tongue 20955 further includes an elongated slot 20957 configured to receive a pivot pin 20211 formed in the shaft spine 20210. See FIG. 139. The central support member 20950 further includes a distal tongue 20958 movably coupled to the proximal portion of the elongated channel 20302. As further seen in FIG. 139, the coupler assembly 20970 pivotally couples the central support member 20950 to the elongated channel 20302. More specifically, the coupler assembly 20970 includes a body plate 20972 having an end effector mounting pin 20974 protruding from it, the end effector mounting pin being the first pivot hole 20307 and the center of the elongated channel 20302. It is configured to extend through the distal pivot hole 20959 of the distal tongue 20958 of the support member 20950. Such a configuration serves to facilitate the pivotal movement of the central support member 20950 with respect to the elongated channel 20302 centered on the end effector pivot axis EPA as defined by the end effector mounting pin 20974. As can be seen in FIG. 139, the end effector pivot axis EPA is parallel to the range of motion axis BB. In the illustrated configuration, the plurality of support link assemblies 920 further include a proximal support link 940 and a distal support link 950. See FIG. 139. Specific details regarding the operation of the proximal and distal support links and the central support member have been described above and will not be repeated for brevity.

The double joint driver configuration 20800 is configured to establish a "push / pull" configuration when joint kinetic force is applied to it through the first distal joint driver 20820. Similarly, as can be seen in FIGS. 138, 139, 141 and 142, the proximal pinion gear 20880 and the distal pinion gear 20882 are centrally located between the first proximal drive rack 20842 and the second proximal drive rack 20862. And are engaged in engagement with them. In an alternative embodiment, only one pinion gear or three or more pinion gears may be used. Therefore, at least one pinion gear is used. The proximal pinion gear 20880 and the distal pinion gear 20882 are rotatably supported within the spine 20810 to rotate freely with respect to them, so that the first distal joint driver 20820 moves in the distal DD. When so, the pinion gears 20880, 20882 act to drive the second distal joint driver 20860 in the proximal direction PD. Similarly, when the first distal joint driver 20820 is pulled in the proximal PD, the pinion gears 20880, 20882 drive the second distal driver 20860 into the distal DD. When the first distal joint driver 20820 moves proximally, the pinion gears 20880, 20882 act to drive the second distal joint driver 20860 in the distal DD. As the first and second distal joint drivers 20820, 20860 move in this way, the central joint range of motion member 20850 moves the surgical end effector 20300 through the central support member 20950, more specifically the surgical end effector 20300. The elongated channel 20302 of the above is to be jointly moved in the direction of the joint movement of the arrow 20821 with the joint movement axis BB as the center. See FIG. 141. Conversely, to move the end effector 20300 in the direction of arrow 20823, the first distal joint driver 20820 is moved to the distal DD, whereby the pinion gears 20880, 20882 are the second distal joint driver. The 20860 will be driven in the proximal direction PD. Such movement of the first and second distal joint drivers 20820, 20860 causes the surgical end effector 20300, more specifically the elongated channel 20302 of the surgical end effector 20300, to move the joint motion axis B-. It will pivot in the direction of joint movement of arrow 20823 with B as the center. See FIG. 142.

The dual integral joint driver configuration 20800 and its variants can provide a wider range of joint motion to the surgical end effector when compared to the configurations of other range of motion surgical end effectors. Specifically, the dual integrated driver joint motion configuration disclosed herein can promote the range of motion in the range of 65 ° (65 °). Using at least one pinion gear to interface between distal joint drivers is also in use so that the end effector can be "pushed" and "pulled" in place. It can reduce the amount of "slop" or unwanted or unintended movement of the end effector. The dual integrated driver range of motion configurations disclosed herein also comprises a range of motion system with improved strength characteristics as compared to other range of motion system configurations.

FIGS. 143 and 144 show a portion of an elongated shaft assembly 21200 that is substantially similar to the elongated shaft assembly 1200 described above, except for various differences described in more detail below. As can be seen in FIG. 143, the elongated shaft assembly 21200 includes a joint lock 21810, which is substantially equivalent to the joint locks 810 and 1810 and operates in essentially the same manner. As can be seen in FIG. 22, the elongated shaft assembly 21200 includes a shaft frame 21812 that includes a portion of the shaft frame 21210. Within the elongated shaft assembly 21200, the first distal joint driver 21820 selectively moves longitudinally in the distal DD and proximal PD in response to the joint motion control motion applied thereto. It is supported so that it can be moved. The shaft frame 21812 further includes a distal end portion 21814 with a pivot pin 21818 formed on it. The pivot pin 21818 is pivoted within a pivot hole (not shown) provided on a distal pulley 21340 formed non-rotatably on the proximal end 21320 of the elongated channel 21302 of the surgical end effector 21300. Adapted to be accepted as possible. See FIG. 144. With such a configuration, the pivotal movement (ie, range of motion) of the elongated channel 21302 of the surgical end effector 21300 with respect to the shaft frame 21812 around the range of motion axis BB defined by the pivot hole and pin 21818. Be promoted. The shaft frame 21812 further includes a centrally disposed cavity 21817 and a distal notch 21819, the distal notch being located between the distal end 21814 and the centrally disposed cavity 21817.

The shaft assembly 21200 further includes a second distal joint driver 21860, the second distal joint driver rotatably pivotally supported on the proximal pulley assembly 21840 and the distal pulley 21340. Be prepared. In one form, the cable member 21862 comprises a cable made of, for example, stainless steel, tungsten, aluminum, titanium and the like. The cable may have a braided or multi-stranded structure with varying numbers of strands to obtain the desired level of tensile strength and flexibility. In various configurations, for example, the cable member 21862 is in the range of 0.08 cm to 0.2 cm (0.03 inch to 0.08 inch), more preferably 0.1 cm to 0.2 cm. It can have a diameter of meters (range 0.05 inches to 0.08 inches). Preferred cables can be made from, for example, semi-rigid to fully rigid 300 ferritic steels. In various configurations, the cable 21862 may also be coated with, for example, Teflon®, copper, etc. to improve lubricity and / or reduce elongation. For example, by crimping, a first lug 21863 is attached to one end of the cable 21862 and a second lug 21864 is attached to the other end of the cable 21862. See FIG. 144.

Still referring to FIG. 144, the cable member 21862 is coupled to the distal end 21821 of the first distal joint driver 21820 by a coupler assembly 21830. The coupler assembly 21830 includes a coupler body 21832 in which a proximal lug cavity 21834 is formed and a distal lug cavity 21836 is formed therein. The first lug 21863 is configured to be retentively received within the first lug cavity 21834, and the second lug 21836 is configured to be retentively received within the second lug cavity 21836. ing. Other fastening configurations, screws, rivets, clamps, adhesives and the like may also be used. When the cable member 21862 is pivotally supported on the pulleys 21840 and 21340, the coupler assembly 21830 shafts within the distal notch 21819 of the shaft frame 21812 in response to axial movement of the first distal joint driver 21820. Move freely in any direction. The range of motion generated by the axial movement of the first distal joint driver 21820 is transmitted to the second distal joint driver 21860 or the cable member 21862. A mounting ball or lug 21866 is attached to the cable member 21862 and is received in a groove or pocket (not shown) formed in the distal pulley 21340. Therefore, the movement of the endless member 21862 is transmitted to the surgical end effector 21300, more specifically to the elongated channel 21302 of the surgical end effector 21300, and causes the end effector to jointly move around the joint movement axis BB. Therefore, when the first distal joint driver 21820 is moved in the distal direction DD, the cable member 21862 causes the surgical end effector 21300 to move the surgical end effector 21300 in one joint movement direction about the joint movement axis BB. Also, when the first distal joint driver 21820 is moved in the proximal direction PD, the cable member 21862 moves the surgical end effector 21300 in the opposite joint movement direction around the joint movement axis BB. Let me.

In the illustrated configuration, the proximal pulley assembly 21840 is configured to selectively introduce tension into the cable member 21862. For example, as can be seen in FIG. 144, the proximal pulley assembly 21840 includes a proximal pulley 21842 rotatably mounted on a pulley mount or bearing 21844. The axis of the pulley mount 21844 is concentric with the central pulley axis CPA, so that the proximal pulley 21842 is freely rotatable on the pulley mount 21844. The pulley mount 21844 is fixed to the shaft frame 21812 by an eccentric mounting shaft 21846 attached to the pulley mount 21844. In other words, the central axis MSA of the mounting shaft 21846 deviates from the central pulley axis CPA (and the central axis of the pulley mount). See FIG. 143. The mounting shaft 21846 is sized so that it is received by friction in the mounting holes 21813 provided in the shaft frame 21812. A hex socket 21848 configured to accept a standard hex wrench is provided on the pulley mount 21844. See FIG. 143. Therefore, the tension of the cable member 21862 can be increased by inserting a hex wrench into the hex socket 21848 and turning the mounting shaft 21846 in the appropriate direction. Such an operation would rotate the mounting shaft 21846 and the pulley cloak 21844. Since the central axis CPA of the pulley mount 21844 is deviated from the central axis MSA of the mounting shaft 21846, the central axis CPA is the central axis of the distal pulley 21340 (may be coaxial with the range of motion axis BB). It is moved further away from, which can increase the tension of the cable member 21862.

FIGS. 145-147 show a portion of an elongated shaft assembly 22200 that is substantially similar to the elongated shaft assembly 1200 described above, except for various differences described in more detail below. The components of the elongated shaft assembly 1200 described in detail above are referenced by similar element codes and, for the sake of brevity, are detailed beyond what may be necessary to understand the operation of the shaft assembly 22200. Will not be explained further. As can be seen in FIG. 147, the elongated shaft assembly 22200 includes a joint lock 22810, which is substantially equivalent to the joint locks 810 and 1810 and operates in essentially the same manner. As can be seen in FIG. 147, the elongated shaft assembly 22200 includes a shaft frame 22812 that includes a portion of the shaft spine 22210. The first distal joint driver (omitted for brevity in FIGS. 145-147) is selected for distal DD and proximal PD in response to joint motion control motion applied to it. It is movably supported within the elongated shaft assembly 22200 so as to move in the longitudinal direction. The shaft frame 22812 further includes a distal end portion 22814 on which a pivot pin 22818 is formed. The pivot pin 22818 is pivotally received within a pivot hole 22342 provided on a distal pulley 22340 formed non-rotatably in the proximal end portion 22320 of the elongated channel 22302 of the surgical end effector 22300. It is adapted as. See FIG. 147. Such a configuration facilitates the pivotal movement (ie, joint movement) of the elongated channel 22302 with respect to the shaft frame 22812 about the joint movement axis BB defined by the pivot hole 22342 and the pin 22818. The shaft frame 22812 further includes a centrally disposed cavity 22817 and a distal notch 22819, the distal notch being located between the distal end 22814 and the centrally disposed cavity 22817.

The shaft assembly 22200 further includes a second distal joint driver 22860, which is a cable member 1862 rotatably pivoted on the proximal pulley assembly 22840 and the distal pulley 22340. Be prepared. In one form, the cable member 1862 comprises a cable made of, for example, stainless steel, tungsten, aluminum, titanium and the like. The cable may have a braided or multi-stranded structure with varying numbers of strands to obtain the desired level of tensile strength and flexibility. In various configurations, for example, the cable member 1862 is in the range of 0.08 cm to 0.2 cm (0.03 inch to 0.08 inch), more preferably 0.1 cm to 0.2 cm. It can have a diameter in the range of meters (0.05 inches to 0.08 inches). Preferred cables can be made from, for example, semi-rigid to fully rigid 300 ferritic steels. In various configurations, the cable can also be coated with, for example, Teflon®, copper, etc. to improve lubricity and / or reduce elongation. For example, by crimping, a first lug 1863 is attached to one end of the cable and a second lug 1864 is attached to the other end of the cable member 1862.

With reference to FIGS. 145 and 147, the cable member 1862 is coupled to the distal end 1821 of the first distal joint driver by a coupler assembly 1830. The joint driver may include a distal joint driver portion of the joint lock 22810 and is not shown in FIGS. 145 and 147 for brevity. The coupler assembly 1830 comprises an upper coupler portion (not shown) formed on the distal end of a first distal joint driver (not shown) and a lower coupler portion 1834. The lower coupler portion 1834 is formed with two cradle 1835 configured to receive lugs 1862, 1864 inside. A pair of mounting pins 1836 are configured to be pressed into holes (not shown) in the upper coupler portion (not shown) to secure the two coupler portions to each other. Other fastening configurations, screws, rivets, adhesives and the like may be used. When the cable member 1862 is pivotally supported on the proximal pulley assembly 22840 and the distal pulley assembly 22340, the coupler assembly 1830 responds to the axial movement of the first distal joint driver and distances the shaft frame 22812. It moves freely in the axial direction within the position notch 22819. The joint motion motion generated by the axial movement of the first distal joint driver is transmitted to the second distal joint driver 22860 or the cable member 1862. A mounting ball or lug 1866 is attached to the cable member 1862 and is received in a groove or pocket 1342 formed in the distal pulley 22340. Therefore, the movement of the cable member 1862 is transmitted to the surgical end effector 22300, more specifically to the elongated channel 22302 of the surgical end effector 22300, and causes the end effector to jointly move around the joint movement axis BB. Therefore, when the first distal joint driver is moved in the distal DD, the cable member 1862 joints the surgical end effector 22300 in one joint movement direction around the joint movement axis BB. Further, when the first distal joint driver is moved to the proximal direction PD, the cable member 1862 causes the surgical end effector 22300 to jointly move in the opposite joint movement direction around the joint movement axis BB.

In the illustrated configuration, the proximal pulley assembly 22840 is configured to selectively introduce tension into the cable member 1862. For example, as can be seen in FIG. 147, the proximal pulley assembly 22840 includes a proximal pulley 22842 rotatably mounted on a pulley mount or bearing 22844. The pulley mount 22844 is attached to a mounting block 22846 that is movably received within the axial mounting cavity 22821 formed in the shaft frame 22812. A tensioning screw 22823 is arranged in the shaft frame 22812 to adjust the position of the mounting block 22846 in the axial mounting cavity 22821. See FIGS. 145 and 147. When the tensioning screw 22823 is turned inward, the end 22825 of the tensioning screw 22823 urges the mounting block 22846 in the proximal direction to introduce tension into the cable member 1862. Such an operation would move the central axis CPA of the proximal pulley 22842 away from the central axis of the distal pulley 22340 by a tension distance DT. Therefore, as the tension distance DT increases, so does the tension of the cable member 1862.

148 and 149 show an alternative proximal pulley assembly 22840'that can be used to tension the cable member 1862. For example, as can be seen in FIG. 148, the proximal pulley assembly 22840'includes a proximal pulley 22842 that is rotatably mounted on a pulley mount or bearing 22844. The pulley mount 22844 is attached to a mounting block 22846 that is movably received within the axial mounting cavity 22821 formed in the shaft frame 22812. In this configuration, the tension cam 22850 is attached to the eccentric mounting spindle 22854. The eccentric mounting spindle 22854 defines a central axis MSA'deviated from the central axis of the tension cam 22850. As can be seen in FIG. 149, the mounting spindle 22854 has a knurled outer surface and is adapted to be received within the knurled bore 22855 of the shaft frame 22812'. A hex socket 22856 configured to accept a standard hex wrench is provided on the mounting spindle 22854. See FIG. 149. Therefore, the tension of the cable member 1862 can be increased by inserting a hex wrench into the hex socket 22856 and turning the mounting spindle 22854 in the appropriate direction. The rotation of the mounting spindle 22854 causes the tension cam 22852 to rotate, driving the mounting block 22846 to the proximal PD in the axial slot 22821 to introduce tension into the cable member 1862. Such an operation would move the central axis CPA of the proximal pulley 22842 away from the central axis of the distal pulley 22340 by a tension distance DT. Therefore, as the tension distance DT increases, so does the tension of the cable member 1862.

FIG. 150 shows another second distal joint driver 23860 with a cable member 1862 rotatably pivotally supported on the proximal pulley 23842 and the distal pulley 22340. For example, by crimping, a first lug 1863 is attached to one end of the cable 1862 and a second lug 1864 is attached to the other end of the cable 1862. The cable member 1862 is coupled to the distal end 1821 of the first distal joint driver 1820 by the coupler assembly 1830 in the manner described herein. In this embodiment, the cable tensioning assembly 23900 is used to introduce a desired amount of tension into the cable member 1862. As can be seen in FIG. 150, the cable tensioning assembly 23900 is oriented such that the mounting bracket 23902, which is mounted on one outer portion of the shaft frame, is in contact with the cable member 1862 near the second outer portion of the shaft frame. Includes a tension roller assembly 23910 and the like. The tension roller assembly 23910 includes an outer bracket 23912 that is movably coupled to the mounting bracket 23902. In the illustrated configuration, the outer bracket 23912 is configured to screw engage with the mounting bracket 23902. The tension roller 23914 is attached to the outer bracket 23912 in contact with the cable member 1862. To increase the tension of the cable member 1862, the outer bracket 23912 is moved laterally towards the mounting bracket. Such movement involves moving the tension roller 23914 laterally inward toward the mounting member, bringing it into contact with the cable member 1862, and attaching the cable member 1862 to the lateral LD that traverses the rotational direction RD1 and the rotational direction RD2. It will increase the tension of the cable member 1862.

FIG. 151 shows another second distal joint driver 23860'with a proximal pulley (not shown) and a cable member 1862 rotatably pivotally supported on the distal pulley (not shown). .. For example, by crimping, a first lug 1863 is attached to one end of the cable 1862 and a second lug 1864 is attached to the other end of the cable 1862. The cable member 1862 is coupled to the distal end 1821 of the first distal joint driver 1820 by a tensioning assembly 1830'in the manner described herein. In this embodiment, the distal end 1821'of the first distal joint driver 1820' includes proximal cleats 1823' and distal cleats 1825'. The distal cleat 1825'is movably secured to the proximal cleat 1823' by a tensioning screw member 23900'. In the illustrated configuration, the tensioning screw member 23900'is screwed into the threaded hole 23940 of the proximal cleat 1823' in the first screwing direction with a first or proximal threaded portion 23922 and a first. Includes a second or distal threaded portion 23924 that is screwed into the threaded hole 23942 of the distal cleat 1825'in a second screwing direction opposite to the screwing direction of the. At the central position between the first threaded portion 23922 and the second threaded portion 23924, the actuating nut 23926 is fixed to the threaded member 23900'. The tensioning screw 23900'can be rotated by rotating the working nut 23926 using a wrench or other suitable tool. The rotation of the tensioning screw 23900'in the first direction directs the proximal cleat 1823'and the distal cleat to each other in the first direction along the tensioning axis TA parallel to the cable member axis CA. Will attract you. When the proximal cleats 1823'and the distal cleats 1825' move toward each other, the first and second lugs 1863, 1864 also move toward each other, introducing tension into the cable member 1862. The rotation of the tension applying screw 23920 in the second opposite direction drives the first cleat and the second cleat apart from each other along the tension applying axis TA. As the first and second cleats 1823', 1825' move away from each other, the first and second lugs 1863, 1864 move away from each other, thereby tensioning the cable member 1862. Can be reduced.

FIG. 152 shows a closure sleeve 260 that can be used to close and / or open the anvil of the end effector 300 as detailed above, or in other words, this closure sleeve for surgery. It can be used to close the movable jaw of an end effector. As shown in cross section in the figure, the closure sleeve 260 includes a proximal end 261 having an annular slot 262 inside. Such a configuration acts to attach the closure sleeve 260 to the closure shuttle so as to move axially with the closure shuttle, while allowing the closure sleeve 260 to rotate relative to the closure shuttle about the shaft axis. .. Similarly, as described above, the closure shuttle is axially actuated by a corresponding closure system or closure drive system configured to generate a closure actuation motion. The closure sleeve 260 further includes an opening 266, and the mount on the rotating nozzle can extend through the opening and be seated in the recess of the shaft spine. Such a configuration facilitates rotation of the shaft spine and closure sleeve 260 around the shaft axis as the nozzle is rotated relative to the handle. Similarly, as described above, the elongated shaft assembly 200 further includes a switch drum 500 that is rotatably received on the closure sleeve 260. See FIGS. 3 and 4. The switch drum 500 includes a hollow shaft segment 502 in which a shaft boss 504 for receiving the outward protrusion actuating pin 410 is formed therein. In various situations, the actuating pin 410 extends through slot 267 into the longitudinal slot 408 provided in the lock sleeve 402 when the lock sleeve 402 is engaged with the proximal joint driver 230. To facilitate the axial movement of the lock sleeve 402. Further details regarding their structure and their operation are given above. As further described above, the closure sleeve 260 also includes a double pivot closure sleeve assembly to facilitate attachment of the closure sleeve 260 to the end effector closure sleeve 272. Upper and lower tongues 264 and 265 are formed at the distal end of the closure sleeve 260 to facilitate such attachment in the various schemes described above.

Similarly, as described above, to close the anvil of the end effector (or to apply a closing motion to the jaw or other part of the end effector), the closing sleeve 260 is of the closing system or closing drive system. When activated, it is axially advanced in the distal DD. The axial distance that the closure sleeve 260 must move on the shaft spine to move the anvil (or jaw) to the closure position is called the "closing stroke". The maximum axial distance that the closure sleeve must move to completely close the jaw or other part of the end effector may be referred to herein as the "complete closure stroke distance." This distance may include, for example, the omnidirectional distance that the closure sleeve 260 moves from the start or non-actuated position to the end position corresponding to the fully closed end effector position. In one embodiment, the complete closure stroke distance of the closure sleeve 260 is, for example, about 0.584 centimeters (0.230 inches).

FIG. 153 shows a multipart closure member assembly 24260 configured to be movably supported on a spine assembly (not shown) of various types of elongated shaft assemblies disclosed herein. As described below, the "distal closure member" or "distal closure sleeve" 24400 has the corresponding "proximal closure member" or "proximal closure sleeve" 24261 subjected to closure actuation motion from the closure system. It is configured to move on the spine assembly by an "axial closure distance" that is shorter than the "complete closure stroke distance" that moves in response. As can be seen in FIG. 153, the proximal closure sleeve 24261 may be identical to the portion of the closure sleeve 260 located proximal to the point where the diameter of the closure sleeve 260 is reduced. Therefore, the shape of the proximal closing sleeve 24261, which is identical to the shape of the closing sleeve 260, is identified by a similar element code in FIG. 153. The proximal closure sleeve 24261 differs from the closure sleeve 260 as follows: First, the proximal closure sleeve 24261 terminates at the "necked portion" as a whole, marked with 24300, and includes an internal stop wall or contact portion 24302. In the illustrated embodiment, the distal end 24402 of the distal closure sleeve 24400 is identical to the distal end of the closure sleeve 260 and is attached to the end effector closure sleeve in various ways disclosed herein. Includes upper and lower tongues 264 and 265 to facilitate. The proximal end 24404 of the distal closure sleeve 24400 slidably extends through the opening 24304 at the necked portion or distal end 24300 of the proximal closure sleeve 24261. The proximal end 24404 of the distal closure sleeve portion 24400 prevents the distal closure sleeve 24400 from separating from the proximal closure sleeve 24261 while facilitating relative sliding between their components. Therefore, it is flared outward. Still referring to FIG. 153, such a configuration allows the proximal closure sleeve 24261 to move in the distal DD by an axial distance before the distal closure sleeve 24400 is axially advanced. Facilitate. This distance is referred to as the "proximal movement zone" or "dead zone" described by 24307. In one configuration, for example, the proximal closure sleeve 24261 is configured to travel over a complete closure stroke distance of 0.584 centimeters (0.230 inches). In such a configuration, for example, the "proximal axial length" DZ of the proximal movement zone 24307 (see FIG. 153) is, for example, 0.127 cm to 0.381 cm (0.050 inch). It may be in the range of ~ 0.150 inch). Therefore, the proximal axial length DZ is shorter than the complete closure stroke distance in which the proximal closure sleeve 24261 moves from the start position to the end position corresponding to the fully closed state of the end effector. In other words, this configuration acts to reduce the amount of axial movement of the distal closure sleeve during operation of the closure system. Such a configuration also allows the distal closure sleeve 24400 to have a diameter smaller than the diameter of the proximal closure sleeve 24261.

FIG. 154 shows another multipart closure assembly 25260 that can be used with elongated shaft assemblies of various structures described herein, including spine assemblies or configurations in which the closure assembly 25260 can be movably supported. There is. In this embodiment, when the proximal closure sleeve 25261 is axially advanced by the closure system over a complete closure stroke or sequence, the axial movement of the distal closure sleeve 25400 is shorter than the axial movement of the proximal closure sleeve 25261. .. The proximal closure sleeve 25261 may be identical to a portion of the closure sleeve 260 located proximal to the point where the diameter of the closure sleeve 260 is reduced. Therefore, the shape of the proximal closing sleeve 25261, which is identical to the shape of the closing sleeve 260, is identified by a similar element code. The proximal closure sleeve 25261 interfaces with the closure system or closure drive system in the manner described above, so that when the closure system is activated, the proximal closure sleeve 25261 is axially moved by the closure sleeve 260 during activation. It will move in the axial direction by the same axial distance as the distance. The proximal closure sleeve 25261 differs from the closure sleeve 260 as follows: First, the proximal closure sleeve 25261 terminates at the necked portion marked 25300 as a whole. The distal end 24402 of the distal closure sleeve portion 24400 is identical to the distal end of the closure sleeve 260 to facilitate attachment to the end effector closure sleeve in the various manners disclosed herein. Includes upper and lower tongues. The proximal end 25404 of the distal closure sleeve 25400 extends slidably through the opening 25304 at the necked portion 25300 of the proximal closure sleeve 25261. The proximal end 25404 of the distal closure sleeve 25400 includes an opening 25406 through which the central tab member 25306 extends. The central tab member 25306 serves to prevent the distal closure sleeve 25400 from separating from the proximal closure sleeve 25261. In addition, the proximal end 25404 includes a diametrically opposed slot 25308 configured to receive the corresponding upper and lower tabs 25310 therein. Such a configuration facilitates the proximal closure sleeve 25261 to move in the distal DD by an axial distance before the distal closure sleeve 24400 is axially advanced. The space between the tab 25310 and the bottom of the slot 25308 is referred to as the "proximal movement zone" or "dead zone" described by 25307. The proximal closure sleeve 25261 is configured to travel over a complete closure stroke distance of 0.584 cm (0.230 inch). In such a configuration, for example, the "proximal axial length" DZ of the proximal movement zone 25307 (see FIG. 154) is, for example, 0.127 cm to 0.381 cm (0.050 inch). It may be in the range of ~ 0.150 inch). Therefore, the proximal axial length DZ is shorter than the complete closure stroke distance in which the proximal closure sleeve 25261 moves from the start position to the end position corresponding to the fully closed state of the end effector. In other words, this configuration acts to reduce the amount of axial movement of the distal closure sleeve during operation of the closure system. Such a configuration also allows the distal closure sleeve 25400 to have a diameter smaller than the diameter of the proximal closure sleeve 25261.

FIG. 155 shows another two-part closure assembly 26260 that can be used with elongated shaft assemblies of various structures described herein, including spine assemblies or configurations in which the closure assembly 26260 can be movably supported. .. In this embodiment, when the proximal closure sleeve 26261 is axially advanced by the closure system over a complete closure stroke or sequence, the axial movement of the distal closure sleeve 26400 is shorter than the axial movement of the proximal closure sleeve 26261. .. The proximal closure sleeve 26261 may be identical to the portion of the closure sleeve 260 located proximal to the point where the diameter of the closure sleeve is reduced. Therefore, the shape of the proximal closing sleeve portion 26261, which is identical to the shape of the closing sleeve 260, is identified by a similar element code. The proximal closure sleeve 26261 interfaces with the closure system in the manner described above, and thus when the closure system or closure drive system is activated, the proximal closure sleeve portion 26261 is the distance traveled by the closure sleeve 260 during activation. Can move in the axial direction by the same distance as. The proximal closure sleeve 26261 differs from the closure sleeve 260 as follows: First, the proximal closure sleeve 26261 has a flanged distal end 26300. Specifically, the annular flange 26302 extends inward from the distal end 26300, defining the opening 26304. The distal end of the distal closure sleeve 26400 is identical to the distal end of the closure sleeve 260 and is topped to facilitate attachment to the end effector closure sleeve in the various manners disclosed herein. And includes the lower tongue. The proximal end 26404 of the distal closure sleeve 26400 extends slidably through the opening 26304 at the distal end 26300 of the proximal closure sleeve 26261. The proximal end 26404 of the distal closure sleeve 26400 includes an annular flange 26406 extending outward through the opening 26304, which in cooperation with the annular flange 26302 extending inward, the distal closure sleeve. It prevents the 26400 from separating from the proximal closure sleeve 26261. In addition, the proximal closure sleeve 26261 includes a stop portion proximal to the distal end 26300. In the illustrated configuration, the stop portion comprises a pleated portion 26306 extending inward. In such a configuration, the proximal closure sleeve 26261 is in the distal DD, before the fold portion 26306 contacts the annular flange 26406 to axially drive the distal closure sleeve 26400 in the distal DD. Promotes movement by axial distance. The space between the pleated portion 26306 and the outwardly extending flange 26406 is referred to as the "proximal movement zone" or "dead zone" described by 26307. The proximal closure sleeve 26261 is configured to travel, for example, over a complete closure stroke distance of 0.584 centimeters (0.230 inches). In such a configuration, for example, the "proximal axial length" DZ of the proximal movement zone 26307 (see FIG. 154) is, for example, 0.127 cm to 0.381 cm (0.050 inch). It may be in the range of ~ 0.150 inch). Therefore, the proximal axial length DZ is shorter than the complete closure stroke distance in which the proximal closure sleeve 26261 moves axially from the start position to the end position corresponding to the fully closed state of the end effector. In other words, this configuration acts to reduce the amount of axial movement of the distal closure sleeve during operation of the closure system. Such a configuration also allows the distal closure sleeve 26400 to have a diameter smaller than the diameter of the proximal closure sleeve 26261.

FIG. 156 shows another two-part closure assembly 27260 that can be used with elongated shaft assemblies of various structures described herein, including spine assemblies or configurations in which the closure assembly 27260 can be movably supported. .. In this embodiment, when the proximal closure sleeve 27261 is axially advanced by the closure system over a complete closure stroke or sequence, the axial movement of the distal closure sleeve 27400 is shorter than the axial movement of the proximal closure sleeve 27261. .. The proximal closure sleeve portion 27261 may be identical to the portion of the closure sleeve 260 located proximal to the point where the diameter of the closure sleeve is reduced. Therefore, the shape of the proximal closing sleeve portion 27261, which is identical to the shape of the closing sleeve 260, is identified by a similar element code. The proximal closure sleeve portion 27261 interfaces with the closure system or closure drive system in the manner described above, so that when the closure system or closure drive system is activated, the proximal closure sleeve 27261 activates the closure sleeve 260. It can move in the axial direction by the same distance as it sometimes moves. The proximal closure sleeve 27261 differs from the closure sleeve 260 as follows: First, the proximal closure sleeve 27261 has a flanged distal end 27300. Specifically, the annular flange 27302 extends inward from the distal end 27300, defining the opening 27304. The distal end of the distal closure sleeve 27400 is identical to the distal end of the closure sleeve 260 and is topped to facilitate attachment to the end effector closure sleeve in the various manners disclosed herein. And includes the lower tongue. The proximal end 27404 of the distal closure sleeve 27400 extends slidably through the opening 27304 at the distal end 27300 of the proximal closure sleeve 27261. The proximal end 27404 of the distal closure sleeve 27400 includes an annular flange 27406 extending outward through the opening 27304, which in cooperation with the annular flange 27302 extending inward, the distal closure sleeve. It prevents the 27400 from separating from the proximal closure sleeve 27261. In addition, a stop ring 27305 is attached to the proximal closure sleeve 27261 within the distal end 27300. The stop ring 27305 may be welded to, for example, the proximal closure sleeve 27261. The stop ring 27305 includes an inwardly extending proximal stop flange 27306. In such a configuration, the proximal closure sleeve 27261 is in the distal DD before the stop flange 27306 contacts the annular flange 27406 to axially drive the distal closure sleeve portion 27400 into the distal DD. Promotes movement by axial distance. The space 27307 between the proximal stop flange 27306 and the outwardly extending flange 27406 is referred to as the "proximal movement zone" or "dead zone". For example, in one configuration with a fully closed stroke distance of 0.584 centimeters (0.230 inches), the "proximal axial length" DZ of the proximal movement zone 27307 is, for example, 0.127 centimeters to 0. It may be in the range of .381 centimeters (0.050 inches to 0.150 inches). Therefore, the proximal axial length DZ is shorter than the complete closure stroke distance in which the proximal closure sleeve 27261 moves axially from the start position to the end position corresponding to the fully closed state of the end effector. In other words, this configuration acts to reduce the amount of axial movement of the distal closure sleeve during operation of the closure system. Such a configuration also allows the distal closure sleeve 27400 to have a diameter smaller than the diameter of the proximal closure sleeve 27261.

Figures 157-158 show another multipart closure sleeve embodiment 28260, where the distal closure sleeve portion 28400 is a proximal closure sleeve when the closure system is actuated over a complete closure stroke or sequence. The portion 28261 travels a distance shorter than the distance traveled. The proximal closure sleeve portion 28261 may be essentially identical to the portion of the closure sleeve 260 located proximal to the point where the diameter of the closure sleeve is reduced. Therefore, the shape of the proximal closing sleeve portion 28261, which is identical to the shape of the closing sleeve 260, is identified by a similar element code. The proximal closure sleeve 28261 interfaces with the closure system in the manner described above, so when the closure system is activated, the proximal closure sleeve portion 28261 is only as far as the closure sleeve 260 travels during activation. Can move in the axial direction. The proximal closure sleeve portion 28261 is different from the closure sleeve 260 as described below. First, the proximal closure sleeve portion 28261 is configured to interface with the closure stroke reduction assembly as a whole, marked 29000.

As can be seen in FIGS. 157-158, in the illustrated configuration, the closure stroke reduction assembly 29000 comprises a proximal attachment ring 29002, which receives the distal end 28300 of the proximal closure sleeve 28261. It has a proximal hub portion 29004 attached to it. For example, the distal end 28300 of the proximal closure sleeve 28261 may be attached to the proximal hub portion 29004 by welding, adhesive, or the like. Therefore, the proximal mounting ring 29002 will move axially with the proximal closure sleeve 28261. As further seen in FIGS. 157 and 158, an inwardly extending proximal flange 29006 extends from the proximal end of the proximal hub portion 29004. Holes 29008 are provided through the proximal flange 29006 to slidably receive the shaft spine assembly 2210 and 2212 through it. A distal conical member 29010 is attached to the distal end of the proximal mounting ring 29002. The distal conical member 29010 can be attached to the proximal mounting ring 29002, for example by welding, adhesive, etc., and the distal closure sleeve when the proximal mounting ring 29002 is advanced distally. It slides freely on the portion 28400.

The proximal mounting ring 29002 is slidably supported on the distal mounting ring 29020 mounted on the distal closure sleeve portion 28400. The distal mounting ring 90020 includes a distal portion 29022 with a proximal mounting hub 29024 protruding from it. The proximal mounting hub 29024 has a diameter smaller than the diameter of the distal portion 29022 of the distal mounting ring 90020. The proximal mounting hub 29024 can be attached to the proximal end 28404 of the distal closure sleeve portion 28400 by welding, adhesive, etc. The proximal hub portion 29004 of the proximal mounting ring 29002 is slidably received on the proximal mounting hub 90024 to move axially. The compression spring 29032 is received in the spring cavity 29030 formed between the distal portion 29022 of the distal mounting ring 90020 and the proximal hub portion 29004 of the proximal mounting ring 29002. When the closure system is in a non-joint motion configuration, the proximal flange 29006 of the proximal hub portion 29004 is only the "proximal movement zone" or "proximal dead zone" 29009 from the proximal end 28404 of the distal closure sleeve 28400. Be separated. The proximal axial length of the proximal movement zone 2909 is indicated by DZ. The spring cavity 29030, also sometimes referred to as the "distal movement zone" or "distal dead zone," has a distal axial length DS, which distal axial length DS is the dead zone axial. In addition to the length DZ, it may include the amount of clearance required to accommodate the compression spring 29032 when in the fully compressed state. For example, in one configuration with a fully closed stroke distance of 0.584 centimeters (0.230 inches), the "proximal axial length" DZ of the proximal movement zone 2909 is, for example, 0.127 centimeters to 0. It can be in the range of 381 centimeters (0.050 inches to 0.150 inches) and the distal axial length DS is 0.254 centimeters to 0.508 centimeters (0.100 inches to 0.200 inches). ) May be the length required to accommodate the fully compressed compression spring 29032. In other words, in the illustrated configuration, the DS is always larger than the DZ. Therefore, the proximal axial length DZ is shorter than the complete closure stroke distance in which the proximal closure sleeve 27261 moves axially from the start position to the end position corresponding to the fully closed state of the end effector. In such a configuration, the proximal flange 29006 of the proximal mounting ring 29002 contacts the proximal end 28404 of the distal closure sleeve portion 28400 to axially drive the distal closure sleeve portion 28400 in the distal DD. Previously, the proximal closure sleeve portion 28261 facilitates movement to the distal DD by an axial distance. The closed stroke reduction assembly 29000 is provided as a plurality of parts to facilitate ease of assembly. This configuration serves to reduce the amount of axial movement of the distal closure sleeve portion 28400 during operation of the closure system. Such a configuration uses a distal closure sleeve portion 28400 having an outer diameter smaller than the outer diameter of the proximal closure sleeve portion 28261. In an alternative embodiment, the closed stroke reduction assembly can be placed anywhere in the shaft assembly (eg, in the nozzle section, along the length of the shaft, in the joint or at the end effector pivot point). .. Specifically, a slot may be present at the end effector pivot point / fitting to provide a dead stroke during closure.

While the surgical instrument system described herein is operated by an electric motor, the surgical instrument system described herein can operate in any suitable manner. In various cases, the surgical instrument system described herein can be operated, for example, by a manually operated trigger. The motor may include a portion of the robot control system.

The surgical instrument system described herein has been described in connection with the deployment and deformation of staples, but the embodiments described herein are not limited thereto. Various embodiments are also conceivable in which fasteners other than staples, such as clamps or tacks, are deployed. In addition, various embodiments have been conceived that utilize any suitable means for sealing the tissue. For example, end effectors according to various embodiments may include electrodes configured to heat and seal the tissue. Also, for example, end effectors according to certain embodiments can apply vibrational energy to seal the tissue.

While the surgical instrument system described herein is operated by one or more electric motors, the surgical instrument system described herein can operate in any suitable manner. In various cases, the surgical instrument system described herein can be operated, for example, by a manually operated trigger.

Example 1-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector pivots to the elongated shaft assembly so that it selectively articulates the elongated shaft assembly around the range of motion that crosses the shaft axis and is laterally deviated from the shaft axis. Can be combined. Surgical end effectors define the end effector axis, one of the non-joint range of motion where the end effector axis is axially aligned with the shaft axis and one of the shaft axes where the end effector axis is perpendicular to the shaft axis. It is configured to be selectively jointed with the maximum lateral range of motion. The range of motion system operably interfaces with the surgical end effector to selectively move the surgical end effector between the non-joint and range of motion positions.

Example 2-The surgical end effect according to Example 1, wherein the range of motion system comprises a joint driving member operably coupled to the surgical end effector to selectively apply a pushing and pulling motion to the surgical end effector. Instrument.

Example 3-The surgical instrument according to Example 1 or 2, wherein the range of motion system comprises a dejoint range of motion member configured to selectively apply only tensile motion to the surgical end effector.

Example 4-The surgical instrument according to Example 1, 2 or 3, wherein the range of motion system comprises an end effector driver link coupled to a surgical end effector. The distal joint driver is coupled to the end effector driver link and is configured to selectively add push and pull motions to the end effector driver link. The de-joint range of motion is attached to the surgical end effector and is configured to apply only tensile motion to the surgical end effector.

Example 5-The surgical instrument according to Example 1, 2 or 3, wherein the range of motion system comprises an end effector driver link coupled to a surgical end effector. The distal joint driver is coupled to the end effector driver link and is configured to selectively add push and pull motions to the end effector driver link. The dejoint movement member is configured to add dejoint movement motion to the surgical end effector.

Example 6-The surgical end effector is pivotally coupled to the elongated shaft assembly by a spring pin so that the spring pin defines the range of motion and applies dejoint motion urging motion to the surgical end effector. The surgical instrument according to Example 1, 2, 3, 4 or 5, which is configured.

Example 7-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. Surgical instruments further include a surgical end effector that defines the end effector axis. Joint joints are surgical for elongated shaft assemblies between a non-joint range of motion where the end effector axis is axially aligned with the shaft axis and a complete range of motion where the end effector axis is perpendicular to the shaft axis. It is configured to facilitate joint movement of the end effector. Surgical instruments further include means for applying range of motion motion to the surgical end effector. Means for addition are arranged only along one outer side of the shaft axis.

Example 8-The proximal end of the surgical end effector is angled with respect to the end effector axis and the distal end of the elongated shaft assembly is angled with respect to the shaft axis, in Example 7. Described surgical instruments.

Example 9-The proximal end of the surgical end effector is oriented at the end effector angle with respect to the end effector axis, and the distal end of the elongated shaft assembly is oriented at the shaft angle with respect to the shaft axis. The surgical instrument according to Example 8.

Example 10-The surgical instrument according to Example 8, wherein the end effector angle and the shaft angle are equal to each other.

Example 11-The surgical instrument according to Example 7, 8, 9 or 10, further comprising means for applying dejoint motion motion to the surgical end effector.

Example 12-A surgical instrument that defines a shaft axis and comprises an elongated shaft assembly that includes a distal end. Surgical instruments are elongated shafts that are laterally displaced from the shaft axis and selectively pivotally move relative to the elongated shaft assembly around the range of motion axis that extends laterally to the shaft axis. It further comprises a surgical end effector with a proximal end that is pivotally coupled to the distal end of the assembly. Surgical instruments further include a range of motion system with an end effector driver link that is operably coupled to the surgical end effector. The joint driver is supported to move longitudinally in the distal and proximal directions when a range of motion motion is applied. The joint driver is coupled to the end effector driver link to selectively joint the surgical end effector with respect to the elongated shaft assembly around the range of motion axis. A flexible dejoining motion member is coupled to the elongated shaft assembly and the surgical end effector to add dejoint motion motion to the surgical end effector.

Example 13-The surgical instrument according to Example 12, wherein the joint driver is configured to apply a first range of motion motion to the surgical end effector in only one joint motion direction across the shaft axis. ..

Example 14-The surgical end effector defines the end effector axis, and the end effector has a non-joint range of motion in which the end effector axis is axially aligned with the shaft axis and the end effector axis relative to the shaft axis. The surgical instrument according to Example 12 or 13, which is vertical and can be moved to and from the maximum range of motion on one lateral side of the shaft axis.

Example 15-The surgery according to Example 12, 13 or 14, wherein the joint driver and end effector driver link is located on one lateral side of the shaft axis when the surgical end effector is in non-joint motion orientation. Equipment.

Example 16-The surgical end effector comprises a launching member configured to move axially within the surgical end effector, the elongated shaft assembly further comprises an axially movable firing beam and an axially movable firing beam. The surgical instrument according to Example 12, 13, 14 or 15, which is operably interfaced with a launching member and is selectively movable distally in response to the launching motion being applied. .. The firing beam is also selectively movable in the proximal direction in response to the backward motion applied.

Example 17-The proximal end of the surgical end effector is pivotally pinned to the distal end of the elongated shaft assembly by a joint pin, and the flexible dejoining range of motion is articulated by the surgical end effector. The surgical instrument according to Example 12, 13, 14, 15 or 16, which is configured to flex around a joint pin when the joint is being exercised about a range of motion.

Example 18-The proximal end of the surgical end effector is angled with respect to the end effector axis and the distal end of the elongated shaft assembly is angled with respect to the shaft axis, Example 12. 13, 14, 15, 16 or 17 for a surgical instrument.

Example 19-The proximal end of the surgical end effector is oriented at the end effector angle with respect to the end effector axis, and the distal end of the elongated shaft assembly is oriented at the shaft angle with respect to the shaft axis. The surgical instrument according to Example 18.

Example 20-The surgical instrument according to Example 19, wherein the end effector angle and the shaft angle are equal to each other.

Example 21-A surgical instrument that defines a shaft axis and comprises an elongated shaft assembly that includes a distal end. Surgical instruments further include a proximal end that is pivotally coupled to the distal end of the elongated shaft assembly, which allows the surgical end effector to be in a non-joint range of motion and complete with respect to the shaft axis. It can be selectively moved to and from the joint movement position. The firing beam is movably supported within the path of the elongated shaft assembly for selective longitudinal movement. This path is configured to place a portion of the firing beam exiting the distal end of the elongated shaft member at an off-axis position with respect to the shaft axis.

Example 22-The path is a first path portion aligned on the shaft axis and a second arched path portion that communicates with the first path portion and curves in a first direction away from the shaft axis. 21. The surgical instrument according to Example 21. The path further comprises a third bow-shaped path portion that communicates with the second bow-shaped path portion and curves in a second direction toward the shaft axis.

Example 23-The surgical instrument according to Example 22 or 21, wherein the surgical end effector is configured to perform joint motion in only one range of motion across the shaft axis.

Example 24-The proximal end of the surgical end effector is selected between a non-joint range of motion position and a full range of motion position centered on a range of motion axis that extends laterally with respect to the shaft axis but does not intersect the shaft axis. 21. 22 or 23. The surgical instrument according to Example 21, 22 or 23, which is pivotally coupled to the elongated shaft assembly at a mounting position on the distal end of the elongated shaft assembly so as to move pivotally. ..

Example 25-Embodiment further comprising a joint driver supported to move longitudinally with respect to the elongated shaft assembly and coupled to the surgical end effector to add range of motion motion to the surgical end effector. 21, 22, 23 or 24. The surgical instrument.

Example 26-The surgical instrument of Example 25, wherein the joint driver is configured to apply a pushing and pulling motion to the surgical end effector.

Example 27-The path communicates with a first path portion that is axially aligned on the shaft axis and a second path portion that communicates with the first path portion and extends distally from the first path portion. 21.23, Examples 21 and 23, comprising a second path portion, which is a path portion, whereby at least a portion of the second path portion is not axially aligned with the shaft axis. 24, 25 or 26. The surgical instrument.

Example 28-The surgical instrument according to Example 21, 22, 23, 24, 25, 26 or 27, wherein the firing beam comprises a plurality of beam layers stacked on top of each other.

Example 29-Surgical end effectors include launching members operably interfaced with a firing beam and configured to move axially within the surgical end effector, Examples 21, 22, 23, 24, 25, 26, 27 or 28. The surgical instrument.

Example 30-A surgical instrument that defines a shaft axis and comprises an elongated shaft assembly that includes a distal end. Surgical instruments further include surgical end effectors, including the proximal end. The joint joins the proximal end of the surgical end effector to the distal end of the elongated shaft assembly. The firing beam is movably supported within the elongated shaft assembly so that it travels longitudinally within the elongated shaft assembly along the shaft axis. Surgical instruments are further provided with means for urging a portion of the firing beam into an arched configuration that deviates from the axial alignment with the shaft axis prior to the joint.

Example 31-The surgical end of the articulated joint so that it selectively articulates the elongated shaft assembly around the range of motion axis that traverses the shaft axis and is laterally deviated from the shaft axis. 30. The surgical instrument of Example 30, wherein the proximal end of the effector is pivotally coupled to the distal end of the elongated shaft assembly.

Example 32-The surgical end effector defines the end effector axis, and the surgical end effector has a non-joint range of motion in which the end effector axis is axially aligned with the shaft axis and one outer portion of the shaft axis. 30 or 31. The surgical instrument according to Example 30 or 31, which is selectively range of motion with and from a complete range of motion position located in.

Example 33-The surgical instrument according to Example 30, 31 or 32, wherein the firing beam comprises a plurality of beam layers stacked on top of each other.

Example 34-The surgical end effector comprises a firing member operably interfaced with the firing beam and configured to move axially within the surgical end effector, eg 30, 31, 32 or. 33. The surgical instrument.

Example 35-A surgical instrument that defines a shaft axis and comprises an elongated shaft assembly that includes a distal end. Surgical instruments further include surgical end effectors, including the proximal end. The joint joins the proximal end of the surgical end effector to the distal end of the elongated shaft assembly. The firing beam is movably supported within the elongated shaft assembly so that it travels longitudinally within the elongated shaft assembly along the shaft axis. Surgical instruments are further provided with means for urging a portion of the firing beam to deviate from the axial alignment with the shaft axis prior to the joint.

Example 36-The joint is a surgical end effector such that it selectively articulates the elongated shaft assembly around the range of motion that is laterally offset from the shaft axis and across the shaft axis. 35. The surgical instrument of Example 35, wherein the proximal end of the is pivotally coupled to the distal end of the elongated shaft assembly.

Example 37-The surgical end effector defines the end effector axis, and the surgical end effector has a non-joint range of motion in which the end effector axis is axially aligned with the shaft axis and one outer portion of the shaft axis. 35 or 36. The surgical instrument according to Example 35 or 36, which is capable of selectively range of motion with and from a complete range of motion position located in.

Example 38-The surgical instrument according to Example 35, 36 or 37, wherein the firing beam comprises a plurality of beam layers stacked on top of each other.

Example 39-The surgical end effector comprises a launching member operably interfaced with the firing beam and configured to move axially within the surgical end effector, eg 35, 36, 37 or. 38. The surgical instrument.

Example 40-The surgical instrument according to Example 35, 36, 37, 38 or 39, wherein the means comprises an arched path in the spine portion of the elongated shaft assembly. The arcuate path is configured to slidably receive the firing beam therein and is open at the distal end of the spine portion at a position axially deviated from the shaft axis.

Example 41-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector is pivotally coupled to an elongated shaft assembly for selective pivotal movement about a range of motion axis that extends laterally to the shaft axis. Surgical instruments further include a range of motion system that includes a single joint driver that is supported to move longitudinally along a path that is laterally displaced from the shaft axis. The crosslink is coupled to the joint driver and extends across the shaft axis so that it is coupled to the surgical end effector.

Example 42-The surgical instrument according to Example 41, wherein the range of motion intersects the shaft axis.

Example 43-The surgical end effector defines the end effector axis, and the surgical end effector has a non-joint range of motion in which the end effector axis is axially aligned with the shaft axis and the end effector axis defines the shaft axis. The surgical instrument according to Example 41, wherein the surgical instrument is selectively capable of range of motion with and from a complete range of motion position located on one lateral side of the shaft axis that traverses.

Example 44-The surgical instrument of Example 43, wherein when the surgical end effector is in full range of motion, the end effector axis is located at a range of motion angle with respect to the shaft axis. The range of motion is at least 65 degrees.

Example 45-The surgical staple fastening device according to Example 43 or 44, wherein the surgical end effector is selectively articulated to another complete range of motion position located on another lateral side of the shaft axis.

Example 46-The cross-link is pivotally coupled to the proximal end of the surgical end effector, centered on the link axis parallel to the range of motion axis, Examples 41, 42, 43, 44 or 45. The surgical instrument.

Example 47-The surgical instrument according to Example 41, 42, 43, 44, 45, or 46, wherein a single distal joint driver is configured to apply a pushing and pulling motion to the crosslink.

Example 48-The surgical end effector comprises a firing member configured to move axially within the surgical end effector, the elongated shaft assembly further comprises an axially movable firing beam, and the axially movable firing beam. It is operably interfaced with the launching member and is selectively movable in the distal direction in response to the launch motion applied and in the proximal direction in response to the backward motion applied. A surgical instrument according to any of Examples 41, 42, 43, 44, 45, 46 or 47.

Example 49-Surgery according to Example 48, further comprising a central support member configured to laterally support the launch member when the surgical end effector is jointly moved about a range of motion axis. Equipment. The central support member is pivotally coupled to the surgical end effector and is pivotally and slidably supported with respect to the elongated shaft assembly.

Example 50-A surgical instrument that defines a shaft axis and comprises an elongated shaft assembly that includes a distal end. The surgical instrument pivots to the elongated shaft assembly at a mounting position on the distal end of the elongated shaft assembly so that it selectively moves pivotally around the range of motion axis extending laterally to the shaft axis. It further comprises a surgical end effector that includes a proximal end that is optionally coupled. The joint drive assembly moves longitudinally with respect to the elongated shaft assembly along the joint actuation axis that is parallel to the shaft axis and separated from the first lateral portion of the shaft axis. Be supported. The joint drive assembly is coupled to the surgical end effector in a single mounting position located on the other lateral side of the shaft axis.

Example 51-The joint drive assembly comprises a distal joint driver supported by an elongated shaft assembly to move longitudinally along the joint working axis in response to an application of joint motion control motion. The surgical instrument according to Example 50. The crosslink is coupled to the distal joint driver and extends across the shaft axis so that it is coupled to the surgical end effector in a single mounting position.

Example 52-In Example 50 or 51, the proximal end of the surgical end effector is pivotally coupled to the distal end of the elongated shaft assembly by a pivot member defining the range of motion axis. Described surgical instruments.

Example 53-The surgical instrument according to Example 51 or 52, wherein the crosslink has a curvilinear shape.

Example 54-A surgical instrument that defines a shaft axis and comprises an elongated shaft assembly that includes a distal end. Surgical instruments are applied relative to the shaft axis over a first range of motion angle on the first lateral portion of the shaft axis and over a second range of motion angle on the second lateral portion of the shaft axis. Proximal end pivotally coupled to the elongated shaft assembly at a mounting position on the distal end of the elongated shaft assembly for selective pivotal movement about the laterally extending range of motion. Further equipped with a surgical end effector. The joint drive assembly is parallel to one of the first and second lateral parts of the shaft axis and laterally biased to one of the first and second lateral parts of the shaft axis. It is supported to move longitudinally with respect to the elongated shaft assembly along the locating articulation axis. The joint drive assembly is surgical in a single mounting position located on the other side of the first and second lateral parts of the shaft axis to selectively apply pulling and pushing motion to the surgical end effector. It is attached to the end effector.

Example 55-The surgical staple fastening device according to Example 54, wherein the first range of motion angles is 1 degree to 65 degrees and the second range of motion angles is 1 degree to 65 degrees.

Example 56-Imagine 54 or 55, wherein the joint drive assembly comprises a distal joint driver supported by an elongated shaft assembly to move longitudinally in response to a joint motion control motion being applied. Surgical screwdriver fasteners. The crosslink is coupled to the distal joint driver and extends across the shaft axis so that it is coupled to the surgical end effector at the mounting position.

Example 57-When the distal joint driver is moved distally, the surgical end effector is pivoted in the first range of motion, and when the distal joint driver is moved proximally, it is surgical. The surgical staple fastening device according to Example 56, wherein the end effector is pivoted in the second range of motion.

Example 58-The surgical end effector comprises a launching member configured to move axially within the surgical end effector, the elongated shaft assembly further comprises an axially movable firing beam and an axially movable firing beam. Is operably interfaced with the launcher and can selectively move distally in response to the launch motion applied and proximally in response to the backward motion applied. The surgical staple fastening device according to Example 57.

Example 59-The 58th embodiment, further comprising a central support member configured to laterally support the launch member when the surgical end effector is jointly moving about a range of motion axis. Surgical staple fastening device. The central support member is pivotally coupled to the surgical end effector and is pivotally and slidably supported against the elongated shaft assembly.

Example 60-A surgical instrument that defines a shaft axis and comprises an elongated shaft assembly that includes a distal end. Surgical instruments include a proximal end that is pivotally coupled to an elongated shaft assembly for selective pivotal movement around a range of motion axis that extends laterally to the shaft axis. Further equipped with an end effector. The joint link configuration is configured to rotate with respect to the shaft axis so that the rotation of the joint link configuration induces joint movement of the surgical end effector around the range of motion axis for the elongated shaft assembly. There is. Surgical instruments further include means for selectively rotating the joint link configuration about the shaft axis.

Example 61-The surgical instrument of Example 60, wherein the joint link configuration comprises a central joint link that is movably coupled to the distal end of an elongated shaft assembly. The end effector driver link is movably coupled to the central joint link so that it moves pivotally with respect to the central joint link. The end effector driver link is operably coupled to the surgical end effector so as to selectively move pivotally and axially with respect to the surgical end effector. Means for selective rotation include joint drivers that are supported to selectively move longitudinally with respect to the elongated shaft assembly in the distal and proximal directions. The joint driver is operably coupled to the central joint link.

Example 62-The end effector driver link has a proximal driver link end pivotally coupled to the central joint link and a shaft configured to slidably receive an end effector mounting member therein. The surgical instrument of Example 61, comprising a distal driver link end with a directional slot.

Example 63-The surgical instrument of Example 62, wherein the proximal driver link end is in a pivotal engagement with the distal end of the elongated shaft assembly.

Example 64-The surgical instrument according to Example 62, wherein the joint driver is movably coupled to the central joint link by an intermediate driver link.

Example 65-The central joint link is pivotally coupled to the distal end of the elongated shaft assembly so that it moves pivotally with respect to the elongated shaft assembly about the range of motion axis. 62, 63 or 64. The surgical instrument.

Example 66-The central joint link is a triangular shape that is pivotally coupled to the distal end of the elongated shaft assembly so that it moves pivotally with respect to the elongated shaft assembly about the range of motion axis. The surgical instrument according to Example 62, 63, 64 or 65, comprising a link.

Example 67-The surgical end effector defines an end effector axis that is configured to align axially with the shaft axis when the surgical end effector is in a non-joint motion position, and the joint driver defines the shaft axis. Supported to selectively move longitudinally along one outer portion, the end effector mounting member is on the second outer portion of the end effector shaft axis corresponding to the second outer portion of the shaft axis. The surgical instrument according to Example 62, 63, 64, 65 or 66, which is arranged.

Example 68-The distal end of an elongated shaft assembly comprises a bow-shaped central gear section, and the end effector driver link comprises a planetary gear portion that engages with the bow-shaped central gear section. 62, 63, 64, 65, 66 or 67. The surgical instrument.

Example 69-The surgical instrument of Example 68, wherein the planetary gear portion comprises a plurality of planetary gear teeth formed at the proximal end of the end effector driver link.

Example 70-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector is pivotally coupled to an elongated shaft assembly for selective pivotal movement about a range of motion axis that extends laterally to the shaft axis. Surgical instruments further include a range of motion system with a joint driver supported to selectively move longitudinally with respect to the elongated shaft assembly in the distal and proximal directions. The range of motion system further comprises means for operably connecting the joint driver to the surgical end effector. Means for operably coupling are configured to apply joint motion motion to the surgical end effector in response to longitudinal movement of the joint driver. Means for operably coupled are further configured to move pivotally and axially with respect to the surgical end effector.

Example 71-The joint driver is coupled to a means for operably coupling at one lateral portion of the shaft axis, and the means for operably coupling is a surgical end effector at the other lateral portion of the shaft axis. The surgical instrument according to Example 70, which is coupled to.

Example 72-The surgical end effector comprises a launching member configured to move axially within the surgical end effector, the elongated shaft assembly further comprises an axially movable firing beam and an axially movable firing beam. Is operably interfaced with the launching member and can selectively move distally in response to the launching motion applied and proximally in response to the receding motion applied. The surgical instrument according to Example 70 or 71.

Example 73-Means for operably coupled comprises a triangular link, the triangular link comprising a first link corner portion operably coupled to the joint driver, Example 71 or 72. The surgical instrument. The triangular link further comprises a second link corner portion that operably interfaces with the surgical end effector and a third link corner portion that is pivotally coupled to the distal end of the elongated shaft assembly. Be prepared.

Example 74-The third link corner portion is pivotally coupled to the distal end of the elongated shaft assembly so that it moves pivotally with respect to the elongated shaft assembly about the range of motion axis. , The surgical instrument according to Example 73.

Example 75-The second corner portion of the triangular link is to the end effector driver link that is coupled to the surgical end effector so that it moves pivotally and axially with respect to the surgical end effector. The surgical instrument according to Example 73 or 74, which is operably coupled.

Example 76-The end effector driver link is configured to slidably receive an end effector mounting member into an intermediate proximal drive link end that is pivotally coupled to a triangular link. 23. The surgical instrument of Example 73, 74 or 75, comprising an end effector driver link end with an axial slot.

Example 77-A surgical instrument comprising an elongated shaft assembly comprising a distal end and a shaft axis. The surgical end effector is pivotally coupled to the distal end of the elongated shaft assembly for selective pivotal movement about the range of motion across the shaft axis. A stationary central gear section is located on the distal end of the elongated shaft assembly. The surgical instrument makes a meshing engagement between the distal end, which is coupled to the end effector so that it moves pivotally and axially with respect to the end effector, and the stationary central gear section. It further comprises an end effector driver link including a proximal end with a supported planetary gear section. A selectively movable joint driver assembly operably interfaces with the end effector driver link to add joint motion motion to the end effector driver link.

Example 78-The joint driver assembly deviates from the shaft axis and is selectively longitudinal with respect to the elongated shaft assembly in the distal and proximal directions along an axis that is parallel to the shaft axis. The surgical instrument according to Example 77, comprising a joint driver member that is supported to move. The linkage assembly is coupled to the distal joint driver member at the first attachment position on one side of the shaft axis. In addition, the linkage assembly is further coupled to the end effector driver link.

Example 79-The surgical end effector comprises a launching member configured to move axially within the surgical end effector, the elongated shaft assembly further comprises an axially movable firing beam, and the axially movable firing beam. It is operably interfaced with the launching member and is selectively movable in the distal direction in response to the launch motion applied and in the proximal direction in response to the backward motion applied. A surgical instrument according to Example 77 or 78.

Example 80-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector is pivotally coupled to an elongated shaft assembly for selective pivotal movement about a range of motion axis that extends laterally to the shaft axis. Surgical instruments further include a range of motion system with a first joint driver supported to selectively move longitudinally with respect to the elongated shaft assembly in the distal and proximal directions. The range of motion system further comprises a first end effector link that is movably coupled to the surgical end effector. The first end effector link is coupled to the first joint driver so as to move axially and pivotally with respect to the first joint driver. A second joint driver is supported to move selectively longitudinally with respect to the elongated shaft assembly in the distal and proximal directions. A second end effector link is movably coupled to the surgical end effector. The second end effector link is coupled to the second joint driver so that it moves axially and pivotally with respect to the second joint driver.

Example 81-The first end effector link is a first joint by a first coupler member that is received in the first axial slot of the first joint driver to selectively move axially. The second end effector link is coupled to the driver and is coupled to the second joint driver by a second coupler member that is received in the second axial slot of the second joint driver, eg. 80. The surgical instrument.

Example 82-The surgical instrument of Example 81, wherein the first axial slot is parallel to the shaft axis and the second axial slot is parallel to the shaft axis.

Example 83-The first coupler member comprises a first pin sized to rotate and move axially within the first axial slot, and the second coupler member is a second coupler member. The surgical instrument according to Example 81 or 82, comprising a second pin sized to rotate and move axially within the axial slot.

Example 84-The first joint driver is supported to selectively move longitudinally along the first range of motion axis extending along one lateral side of the shaft axis, and the second joint driver 80, 81, 82 or 83 of Example 80, 81, 82 or 83, which is supported to selectively move longitudinally along a second range of motion axis extending along another lateral portion of the shaft axis. Instrument.

Example 85-The surgical end effector is a joint over a first range of motion angles at the first lateral portion of the shaft axis and over a second range of motion angles at the second lateral portion of the shaft axis. The surgical instrument according to Example 80, 81, 82, 83 or 84, which is configured to pivot around a range of motion.

Example 86-The surgical instrument according to Example 85, wherein the first range of motion angles is 1 degree to 65 degrees and the second range of motion angles is 1 degree to 65 degrees.

Example 87-The surgical end effector comprises a firing member configured to move axially within the surgical end effector, the elongated shaft assembly further comprises an axially movable firing beam, and the axially movable firing beam. It is operably interfaced with the launching member and is selectively movable in the distal direction in response to the launch motion applied and in the proximal direction in response to the backward motion applied. A surgical instrument according to Example 80, 81, 82, 83, 84, 85 or 86.

Example 88-1 The surgical use of Examples 80, 81, 82, 83, 84, 85, 86 or 87, wherein the first end effector link is curvilinear and the second end effector link is curvilinear. Instrument.

Example 89-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector is pivotally coupled to an elongated shaft assembly for selective pivotal movement about a range of motion axis that extends laterally to the shaft axis. Surgical instruments further include a range of motion system with a first joint driver supported to selectively move longitudinally with respect to the elongated shaft assembly in the distal and proximal directions. The first end effector link is pivotally coupled to the surgical end effector. The first end effector link is coupled to the first joint driver at the first attachment point. A second joint driver is supported to move selectively longitudinally with respect to the elongated shaft assembly in the distal and proximal directions. The second end effector link is pivotally coupled to the surgical end effector. The second end effector link is coupled to the second joint driver at the second attachment point. The range of motion system further comprises a first means for suppressing the movement of a first attachment point to a first path having a first predetermined shape and a first length. The range of motion system further comprises a second means for suppressing the movement of the second attachment point to the second path having the second predetermined shape and the second length.

Example 90-A first means for restraint comprises a first axial slot at the first distal end of a first joint driver, and a second means for restraint is a second. 89. The surgical instrument of Example 89, comprising a second axial slot at the second distal end of the joint driver of the joint driver.

Example 91-The surgical instrument according to Example 90, wherein the first axial slot and the second axial slot are parallel to each other.

Example 92-The surgical instrument according to Example 89, 90 or 91, wherein the first length and the second length are equal to each other.

Example 93-The first end effector link is pivotable around the first attachment point and the second end effector link is pivotable around the second attachment point, Example 89, 90, 91 or 92. The surgical instrument.

Example 94-The surgical end effector is a joint over a first range of motion angle at the first lateral portion of the shaft axis and over a second range of motion angle at the second lateral portion of the shaft axis. The surgical instrument according to Example 89, 90, 91, 92 or 93, which is configured to pivot around a range of motion.

Example 95-The surgical instrument according to Example 94, wherein the first range of motion angles is 1 degree to 65 degrees and the second range of motion angles is 1 degree to 65 degrees.

Example 96-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector is pivotally coupled to an elongated shaft assembly for selective pivotal movement about a range of motion axis that extends laterally to the shaft axis. Surgical instruments further include a range of motion system with a first joint driver supported to selectively move longitudinally with respect to the elongated shaft assembly in the distal and proximal directions. The first curved end effector link is pivotally coupled to the surgical end effector and movably coupled to the first joint driver. The first pin projects from the first curved end effector link and is movably received within the first axial slot of the first joint driver. A second joint driver is supported to move selectively longitudinally with respect to the elongated shaft assembly in the distal and proximal directions. A second curved end effector link is pivotally coupled to the surgical end effector and movably coupled to the second joint driver. The second pin projects from the second curved end effector link and is movably received within the second axial slot of the second joint driver.

Example 97-The surgical instrument according to Example 96, wherein the first pin is rotatable in the first axial slot and the second pin is rotatable in the second axial slot.

Example 98-The surgical instrument according to Example 97, wherein the first axial slot and the second axial slot are parallel to each other.

Example 99-The surgical end effector comprises a firing member configured to move axially within the surgical end effector, the elongated shaft assembly further comprises an axially movable firing beam, and the axially movable firing beam. It is operably interfaced with the launching member and is selectively movable in the distal direction in response to the launch motion applied and in the proximal direction in response to the backward motion applied. A surgical instrument according to Example 96, 97 or 98.

Example 100-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector is pivotally coupled to an elongated shaft assembly for selective pivotal movement about a range of motion axis that extends laterally to the shaft axis. Surgical instruments further include a range of motion system with a joint driver supported to selectively move longitudinally with respect to the elongated shaft assembly in the distal and proximal directions. The central joint link is pivotally coupled to the elongated shaft assembly so that it moves pivotally with respect to the elongated shaft assembly. The intermediate link is movably coupled to the joint driver and central joint link. The end effector driver is movably coupled to the central joint link and the surgical end effector.

Example 101-The central joint link is pivotally coupled to the elongated shaft assembly so as to move pivotally with respect to the elongated shaft assembly about the link axis deviating from the range of motion axis. , The surgical instrument according to Example 100.

Example 102-The surgical instrument of Example 101, wherein the first axial slot is parallel to the shaft axis and the second axial slot is parallel to the shaft axis.

Example 103-The central joint link comprises a first central link end movably coupled to an intermediate link and a second central link end movably attached to an end effector driver. The first central link end is at the first distance from the link axis, the second central link end is at the second distance from the link axis, the first distance is different from the second distance, implementation. The surgical instrument according to Example 101 or 102.

Example 104-The surgical instrument according to Example 103, wherein the first distance is shorter than the second distance.

Example 105-The central joint link has a first length, the intermediate link has a second length, the end effector driver has a third length, and the second length is the first. And the surgical instrument according to Example 100, 101, 102, 103 or 104, which is shorter than the third length.

Example 106-The surgical instrument according to Example 105, wherein the first length is shorter than the third length.

Example 107-The surgical instrument according to Example 100, 101, 102, 103, 104, 105 or 106, wherein the intermediate link is curved in the first direction.

Example 108-The surgical staple fastening device of Example 107, wherein the end effector driver curves in a second direction opposite to the first direction.

Example 109-The surgical end effector is pushed in the first joint movement direction when a tensile motion is applied to the joint driver, and the surgical end effector is pushed into the second joint movement when a pushing motion is applied to the joint driver. The surgical instrument according to Example 100, 101, 102, 103, 104, 105, 106, 107 or 108, which is pulled in a direction.

Example 110-The surgical end effector is capable of selectively articulating between the non-joint range of motion and the first range of motion over a first range of motion angles, and the surgical end effector is a surgical end effector. Examples 100, 101, 102, 103, 104, 105, 106, 107, 108 or The surgical instrument according to 109.

Example 111-The surgical instrument according to Example 110, wherein the first range of motion angles is 1 degree to 90 degrees and the second range of motion angles is 1 degree to 90 degrees.

Example 112-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector is pivotally coupled to an elongated shaft assembly for selective pivotal movement about a range of motion axis that extends laterally to the shaft axis. Surgical instruments further include a range of motion system with a joint driver supported to selectively move longitudinally with respect to the elongated shaft assembly in the distal and proximal directions. The central joint link is pivotally coupled to the elongated shaft assembly so that it selectively moves pivotally about the link axis deviating from the range of motion axis. A curved intermediate link is movably coupled to the joint driver and central joint link. A curved end effector driver is movably coupled to the central joint link and surgical end effector.

Example 113-The central joint link comprises a first central link end movably coupled to an intermediate link and a second central link end movably attached to an end effector driver. The first central link end is at the first distance from the link axis, the second central link end is at the second distance from the link axis, the first distance is different from the second distance, implementation. The surgical instrument according to Example 112.

Example 114-The surgical instrument according to Example 113, wherein the first distance is shorter than the second distance.

Example 115-The central joint link has a first length, the intermediate link has a second length, the end effector driver has a third length, and the second length is the first. And the surgical instrument according to Example 112, 113 or 114, which is shorter than the third length.

Example 116-The surgical instrument according to Example 115, wherein the first length is shorter than the third length.

Example 117-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector is pivotally coupled to an elongated shaft assembly for selective pivotal movement about a range of motion axis that extends laterally to the shaft axis. The surgical end effector also comprises a launching member configured to move axially within the surgical end effector. Surgical instruments further include a range of motion system with a distal joint driver supported to selectively move longitudinally with respect to the elongated shaft assembly in the distal and proximal directions. The central joint link is movably pinned to the distal end of the elongated shaft assembly. The intermediate link is movably coupled to the distal and central joint links. The end effector driver is movably coupled to the central link and surgical end effector.

Example 118-The surgical end effector defines the end effector axis, and the surgical end effector has a first range of motion where the end effector axis is aligned with the shaft axis and the end effector axis is on the shaft axis. The first maximum range of motion position on the first outer side of the shaft axis extending perpendicular to it and the second on the second outer side of the shaft axis where the end effector axis is perpendicular to the shaft axis. The surgical instrument according to Example 117, wherein the range of motion can be selectively performed between the maximum range of motion and the range of motion.

Example 119-The central joint link comprises a first central link end movably coupled to an intermediate link and a second central link end movably attached to an end effector driver. The first central link end is at the first distance from the link axis, the second central link end is at the second distance from the link axis, the first distance is different from the second distance, implementation. The surgical instrument according to Example 117 or 118.

Example 120-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. Surgical instruments further include a surgical end effector with a distal end and a proximal end. The proximal end is pivotally coupled to the elongated shaft assembly for selective pivotal movement around a range of motion that extends laterally to the shaft axis. In the surgical end effector, the distal end of the surgical end effector is non-joint movement from the non-joint movement position where the distal end of the surgical end effector is located at the non-joint movement distance from the range of motion axis. It is possible to selectively pivot around the range of motion to the range of motion located at the corresponding range of motion from the range of motion, which is shorter than the distance.

Example 121-The elongated shaft assembly comprises a pivot member defining the range of motion axis, and the proximal end of the surgical end effector is configured to slidably receive the pivot member therein. The surgical instrument according to Example 120, comprising a slot.

Example 122-The surgical instrument according to Example 120 or 121, further comprising means for applying range of motion motion to the surgical end effector.

Example 123-The surgical instrument of Example 122, wherein the means for selectively adding is a rotary gear that engages with a surgical end effector.

Example 124-The surgical instrument of Example 123, wherein the proximal end of the surgical end effector comprises an elliptical gear profile that engages with a rotary gear.

Example 125-Surgical instrument according to Example 123 or 124, wherein the means for selectively adding is a distal joint driver that is operably interfaced with a rotary gear and is selectively axially movable.

Example 126-Examples further comprising a drive slot in a distal joint driver that is selectively axially movable and a drive pin that is attached to a rotary gear and is slidably received in the drive slot. 125. The surgical instrument.

Example 127-The surgical end effector defines an end effector axis, which end effector axis is arranged such that the end effector axis is aligned with the shaft axis when the surgical end effector is in the non-articular motion position. When the surgical end effector is articulated to the maximum joint movement position of the joint movement positions, the end effector axis is perpendicular to the shaft axis, Examples 120, 121, 122, 123, 124, 125 or 126 for surgical instruments.

Example 128-Surgery according to Example 122, 123, 124, 125, 126 or 127, wherein the means for selectively adding is a central joint link that is supported to rotate about the range of motion axis. Equipment. The selectively axially movable joint driver interfaces with the central joint link at a first position on the first side of the shaft axis. Means for selective addition are a first end that is coupled to the surgical end effector and a second end that is coupled to the central joint link at a second position on the second side of the shaft axis. It further comprises a joint drive link including and.

Example 129-Means for selective addition comprises a central joint gear supported to move about the range of motion axis and a gear profile at the second end of the joint drive link. 128. The surgical instrument. The gear profile engages with the central joint gear.

Example 130-A surgical instrument that defines a shaft axis and comprises an elongated shaft assembly that includes a distal shaft portion. Surgical instruments define the end effector axis and further include a surgical end effector that includes a distal end and a proximal end. The proximal end is a non-joint range of motion where the end effector axis is aligned with the shaft axis and the distal end of the surgical end effector is located at a non-joint range of motion from the distal end of the elongated shaft assembly. And the end effector axis crosses the shaft axis, and the distal end of the surgical end effector is located at the corresponding range of motion from the distal shaft portion, which is shorter than the non-joint movement distance. It is movably coupled to the distal shaft portion for selective movement with and from.

Example 131-The proximal end of the surgical end effector is movably coupled to the distal shaft portion of the elongated shaft assembly by a joint driver and joint link that are selectively axially movable, Example 130. Surgical instruments described in.

Example 132-The surgical instrument according to Example 130 or 131, wherein when the surgical end effector is jointed to one of the range of motion positions, the end effector axis is perpendicular to the shaft axis.

Example 133-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. Surgical instruments further include a surgical end effector that includes a distal end and a proximal end. The proximal end is selectively pivotally pivoted around the range of motion axis extending laterally to the shaft axis and can be moved to the elongated shaft assembly so that it translates relative to the range of motion axis. Is combined with. The range of motion system operably interfaces with the surgical end effector to selectively add range of motion motion to the surgical end effector.

Example 134-The surgical instrument of Example 133, wherein the range of motion system comprises a rotary gear that meshes and engages with a surgical end effector and means for rotating the rotary gear.

Example 135-The surgical instrument of Example 134, further comprising an elliptical gear section on the proximal end of the surgical end effector that engages with the rotary gear.

Example 136-Means for rotating a rotary gear are a distal joint driver that is selectively axially movable, including a drive slot, and is attached to the rotary gear and slidably received within the drive slot. The surgical instrument according to Example 134 or 135, comprising a drive pin.

Example 137-The surgical instrument according to Example 136, wherein the drive slot traverses the shaft axis.

Example 138-The surgical instrument according to Example 133, 134, 135, 136 or 137, wherein the surgical end effector is configured to cut and staple tissue.

Example 139-The surgical instrument according to Example 133, 134, 135, 136, 137 or 138, wherein the range of motion system comprises a central joint link that is supported to rotate about a range of motion axis. The selectively axially movable joint driver interfaces with the central joint link at a first position on the first side of the shaft axis. The range of motion system is a joint that includes a first end that is connected to a surgical end effector and a second end that is connected to a central joint link at a second position on the second side of the shaft axis. Further equipped with a drive link.

Example 140-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector is pivotally coupled to the elongated shaft assembly so that it selectively articulates with respect to the elongated shaft assembly about the range of motion that traverses the shaft axis. Surgical instruments further include a range of motion system that includes a joint cable that is coupled to a surgical end effector at the attachment point and is pivotally supported on a proximal pulley that is supported on an elongated shaft assembly. The proximal pulley defines the proximal pulley axis located at a tension distance from the attachment point. The joint driver is coupled to the joint cable so as to selectively rotate the joint cable around the proximal pulley in the first and second joint motion directions. An adjustable tensioning assembly interfaces with the proximal pulley to selectively adjust the tensioning distance.

Example 141-The surgical instrument according to Example 140, further comprising a distal pulley that is attached to a surgical end effector and defines an attachment point.

Example 142-The surgical instrument according to Example 141, wherein the distal pulley defines the range of motion.

Example 143-Adjustable tensioning assembly is a surgical instrument of Example 140, 141 or 142 comprising a pulley mount that supports a proximal pulley above. The mounting shaft is coupled to a pulley mount and is supported by a portion of the elongated shaft assembly to selectively rotate relative to the elongated shaft assembly. The mounting shaft is mounted eccentrically on the pulley mount, whereby the rotation of the mounting shaft moves the proximal pulley axially to adjust the tension distance between the proximal pulley axis and the mounting point.

Example 144-The surgical staple fastening device of Example 143, wherein the mounting shaft defines a mounting shaft axis that deviates from the proximal pulley axis.

Example 145-Adjustable tensioning assembly is a surgical instrument of Example 140, 141 or 142 comprising a pulley mount that supports a proximal pulley above. The mounting member is coupled to the pulley mount and is slidably supported on the elongated shaft assembly so as to selectively move axially with respect to the elongated shaft assembly. The adjustable tensioning assembly further comprises means for selectively axially moving the mounting member on the elongated shaft assembly.

Example 146-Means for selectively axially moving include tensioning screws, which are mounted in an elongated shaft assembly and axially move a mounting member within an axial slot of the elongated shaft assembly. The surgical instrument according to Example 145, which is configured to allow.

Example 147-Means for selective axial movement comprises a rotating cam assembly, which is mounted on an elongated shaft assembly and axially moves a mounting member within an axial slot of the elongated shaft assembly. The surgical instrument according to Example 145, which is configured to allow.

Example 148-The surgical instrument of Example 147, wherein the rotary cam assembly comprises a tension cam configured to make cam contact with a mounting member. The mounting spindle is coupled to a tension cam and is supported in a portion of the elongated shaft assembly so that it rotates selectively with respect to the elongated shaft assembly. The mounting spindle is mounted on the tension cam so that when the mounting spindle rotates in the first direction, the tension cam will axially urge the mounting member within the axial slot.

Example 149-The surgical instrument of Example 148, wherein the mounting spindle has a knurled outer surface and is configured to be received within a knurled hole in a portion of an elongated shaft assembly.

Example 150-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector is pivotally coupled to the elongated shaft assembly so that it selectively articulates with respect to the elongated shaft assembly about the range of motion that traverses the shaft axis. Surgical instruments further include a range of motion system including a distal pulley attached to a surgical end effector and a joint cable pivotally supported on a proximal pulley supported on an elongated shaft assembly. The joint driver is coupled to the joint cable so as to selectively rotate the joint cable around the proximal pulley in the first and second rotation directions. The adjustable tensioning assembly is supported on the elongated shaft assembly and is selective with a portion of the joint cable in a direction across the first and second rotational directions to increase the amount of tension in the joint cable. It is configured to come into contact with.

The surgery according to Example 150, wherein the 151-joint cable comprises a first cable end and a second cable end, the first and second cable ends operably interfacing with a joint driver. Equipment.

Example 152-The surgical instrument of Example 151, wherein the joint driver comprises a distal end portion that includes a pair of cleats. Cleats define a mounting space between them. The first cable end comprises a first lug attached to the cable that is received within the mounting space, the second cable end is attached to the second cable end, and a pair of cleats. It comprises a second lug that is received within the mounting space between.

Example 153. The surgical instrument according to Example 150, 151 or 152, wherein the joint cable is non-rotatably coupled to a distal pulley.

Example 154-A surgical instrument comprising an elongated shaft assembly that defines a shaft axis. The surgical end effector is pivotally coupled to the elongated shaft assembly so that it selectively articulates with respect to the elongated shaft assembly about the range of motion that traverses the shaft axis. Surgical instruments further include a range of motion system including a distal pulley attached to a surgical end effector and a joint cable pivotally supported on a proximal pulley supported on an elongated shaft assembly. The articulated cable comprises a first cable end and a second cable end. The joint movement system further comprises a joint driver for selectively rotating the joint cable around the proximal pulley in the first and second joint movement directions. The joint driver includes a first cleat attached to the end of the first cable and a second cleat attached to the end of the second cable and separated from the first cleat. The range of motion system also includes means of being coupled to the first and second cleats to move the ends of the first and second cables towards each other in order to increase the amount of tension in the joint cable.

Example 155-Means that are coupled to the first and second cleats so as to move the first and second cable ends towards each other include rotating members that are coupled to the first and second cleats. As a result, the rotation of the rotating member in the first rotation direction moves the first and second cleats toward each other, and the rotation of the rotating member in the second rotation direction causes the first and second cleats. The surgical instrument according to Example 154, which is designed to be moved away from each other.

Example 156-The surgical instrument of Example 155, wherein the rotating member comprises a tension screw that makes a screw engagement with the first and second cleats.

Example 157-The first cable end comprises a first lathe attached to the cable that is received between the first cleat and the second cleat, and the second cable end is. The surgical instrument according to Example 154, comprising a second lug attached to a cable and received between the first cleat and the second cleat.

Example 158-The surgical instrument according to Example 154, 155, 156 or 157, wherein the joint cable is non-rotatably coupled to a distal pulley.

Example 159-The surgical instrument according to Example 154, 155, 156, 157 or 158, wherein the surgical end effector is configured to cut and staple tissue.

Example 160-A surgical instrument comprising a surgical end effector including a first jaw and a second jaw, one of the first jaw and the second jaw being a surgical end. A surgical instrument that, when a closing motion is applied to an effector, can be selectively moved with respect to the first jaw and the other of the second jaw. Surgical instruments further include an elongated shaft assembly that includes a closing member assembly that is supported to move axially with respect to the surgical end effector. The closure member assembly comprises a proximal closure member configured to be axially advanced by a complete closure stroke distance when a closure actuation motion is applied. The distal closure member movably interfaces with the proximal closure member, so that the distal closure member moves by the axial closure distance in response to the proximal closure member moving axially over the complete closure stroke distance. Thus, the distal closure member applies a closure motion to the surgical end effector, where the axial closure distance is shorter than the complete closure stroke distance.

Example 161-The proximal closure member comprises a distal end, and the distal closure member comprises a proximal end that is slidably secured to the distal end of the proximal closure member, and thus near. When the position closure member moves over the complete closure stroke distance, the distal closure member may begin to move axially over the axial closure distance until the proximal closure member moves axially over a portion of the complete closure stroke distance. No, the surgical instrument according to Example 160.

Example 162 The elongated shaft assembly comprises a spine assembly that is coupled to a surgical end effector, the proximal closure member over a portion of the spine assembly such that it moves axially over the spine assembly over a complete closure stroke distance. With a proximal closure sleeve supported by, the distal closure member has a distal closure sleeve slidably pivoted over another portion of the spine assembly and is movable to the proximal closure sleeve. The surgical instrument according to Example 161 that is combined.

Example 163-The proximal closure sleeve has an opening at its distal end, the proximal end of the distal closure sleeve extends through the opening, and the proximal end of the distal closure sleeve is close. The surgical instrument according to Example 162, which is configured to prevent separation from the distal end of the position closure sleeve.

Example 164 The distal end of the proximal closure sleeve is flared inward around the opening and the proximal end of the distal closure sleeve spans a portion of the complete closure stroke distance to the distal closure sleeve. It is flared outward to facilitate axial movement of the proximal closure sleeve and at the same time prevent the proximal end of the distal closure sleeve from separating from the distal end of the proximal closure sleeve. The surgical instrument according to Example 163.

Example 165-Proximal closure sleeve comprises an inwardly extending flange having an opening at its distal end, the proximal end of the distal closure sleeve extending through the opening and distal closure sleeve. 16. Surgical Example 162, comprising an outwardly extending flange that cooperates with an inwardly extending flange to prevent the proximal end of the proximal closure sleeve from separating from the distal end of the proximal closure sleeve. Instrument.

Example 166-The surgical instrument of Example 162, wherein the proximal closure sleeve comprises a contact portion proximal to the distal end of the proximal closure sleeve. The contact portion is configured to axially contact the proximal end of the distal closure sleeve after the proximal closure sleeve has been axially advanced over a predetermined portion of the complete closure stroke distance.

Example 167-The surgical instrument of Example 166, wherein the contact portion comprises a pleated portion of a proximal closure sleeve.

Example 168-The contact portion comprises at least one inwardly extending tab member such that the tab member is formed on the proximal closure sleeve and contacts the corresponding portion of the proximal end of the distal closure sleeve. 166. The surgical instrument according to Example 166, which is oriented in.

Example 169-The surgical instrument of Example 166, wherein the contact portion comprises an inwardly extending flange formed on a stop member attached to the inner wall of the proximal closure sleeve.

Example 170-A surgical instrument comprising a surgical end effector including a first jaw and a second jaw, one of the first jaw and the second jaw being a surgical end. A surgical instrument that, when a closing motion is applied to an effector, can be selectively moved with respect to the first jaw and the other of the second jaw. Surgical instruments further include an elongated shaft assembly that includes a closing member assembly that is supported to move axially with respect to the surgical end effector. The closure member assembly comprises a proximal closure member configured to be axially advanced by a complete closure stroke distance when a closure actuation motion is applied. The distal closure member is supported to move axially by an axial closure distance shorter than the complete closure stroke distance to add closure motion to the surgical end effector. The closure stroke reduction assembly interfaces with the proximal closure member and the distal closure member, so that when the proximal closure member moves over the complete closure stroke distance, the proximal closure member moves axially over a portion of the complete closure stroke distance. Until then, the distal closure member does not begin to move axially over the closure distance.

Example 171-The elongated shaft assembly comprises a spine assembly that is coupled to a surgical end effector, the proximal closure member over a portion of the spine assembly such that it moves axially over the spine assembly over a complete closure stroke distance. The distal closure member comprises a proximal closure sleeve that is slidably supported over another portion of the spine assembly to move axially over the closure distance. The surgical instrument according to Example 170.

Example 172-The closure stroke reduction assembly is a shaft with a proximal closure sleeve that is coupled to the proximal closure sleeve to move axially with the proximal closure sleeve over a complete closure stroke distance and a distal closure sleeve over the closure distance. The surgical instrument according to Example 170 or 171 comprising a distal mounting member that is coupled to a distal closure sleeve so as to move in a direction.

Example 173-Proximal mounting member comprises a contact portion configured to contact at least one of the proximal mounting member and the proximal closing sleeve after the proximal closing sleeve has moved over a portion of the complete closing stroke distance. , The surgical instrument according to Example 172.

Example 174-The distal mounting member defines the distal ledge, the proximal mounting member defines the proximal ledge away from the distal ledge, forming a distal movement zone in between, and the contact portions are near. 173. Example 173, wherein a proximal movement zone is defined between the contact portion and at least one of the proximal mount and the proximal closure sleeve, separated from at least one of the position mount member and the proximal closure sleeve. Surgical instruments.

Example 175. The surgical instrument of Example 174, wherein the proximal movement zone has a proximal axial width and the distal movement zone has a distal axial width that is different from the proximal axial width.

Example 176-The surgical instrument according to Example 172, 173, 174 or 175, further comprising an urging member disposed between the proximal mounting member and the distal mounting member.

Example 177-The surgical instrument according to Example 174 or 175, further comprising an urging member supported within the distal movement zone.

Example 178-A surgical instrument comprising a surgical end effector including a first jaw and a second jaw, one of the first jaw and the second jaw being a surgical end. A surgical instrument that, when a closing motion is applied to an effector, can be selectively moved with respect to the first jaw and the other of the second jaw. Surgical instruments further include an elongated shaft assembly that includes a closing member assembly that is supported to move axially with respect to the surgical end effector. The closure member assembly comprises a proximal closure member configured to be axially advanced by a complete closure stroke distance when a closure actuation motion is applied. The proximal closure member is configured to exert maximum closure force upon reaching the end of the maximum closure stroke distance. The distal closure member is supported to move axially by an axial closure distance shorter than the complete closure stroke distance to add closure motion to the surgical end effector. The closure stroke reduction assembly interfaces with the proximal closure member and the distal closure member, so that when the proximal closure member moves over the complete closure stroke distance, the proximal closure member has another closure force less than the maximum closure force. To the distal closure member.

Example 179-The surgical use of Example 178, wherein the closure stroke reduction assembly comprises a proximal attachment member that is coupled to the proximal closure member so as to move axially with the proximal closure member over a complete closure stroke distance. Instrument. The distal mounting member is coupled to the distal closure member so as to move axially with the distal closure member over an axial closure distance. The urging member is placed between one portion of the proximal mounting member and another portion of the distal mounting member.

The entire disclosure below is incorporated herein by reference:
U.S. Pat. No. 5,403,312, issued April 4, 1995, title of invention "ELECTROSURGICAL HEMOSTATIC DEVICE",
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Although various embodiments of the device have been described herein in connection with certain disclosed embodiments, many modifications and modifications can be made to those embodiments. Also, although the material is disclosed for a particular component, other materials may be used. Further, according to various embodiments, a single component may be replaced by a plurality of components, or a plurality of components may be replaced by a single component in order to perform a given function. .. The above description and the following claims are intended to include all such amendments and changes.

The devices disclosed herein can be designed to be discarded after a single use, or can be designed to be used multiple times. However, in either case, the device can be readjusted for reuse after at least one use. The readjustment can include any combination of a disassembly step of the device, followed by a cleaning or replacement step of a particular part, and a subsequent reassembly step. In particular, the device can be disassembled and any number of specific parts or parts of the device can be selectively replaced or removed in any combination. After cleaning and / or replacing certain parts, the device can be reassembled for later use by the surgical team at a readjustment facility or shortly before a surgical procedure. Those skilled in the art will appreciate that readjustment of the device can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques and the resulting readjustment device are all within the scope of the present invention.

As a mere example, the embodiments described herein may be processed prior to surgery. First, new or used utensils may be obtained and cleaned as needed. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic bag or TYVEK bag. The vessel and instrument can then be placed in a radiation field that can penetrate the vessel, such as gamma rays, X-rays, or high energy electrons. Radiation can kill bacteria on instruments and in containers. After this, the sterilized instrument can be stored in a sterilized container. The sealed container can keep the instrument sterile until it is opened in a medical facility. The device can also be sterilized using any other technique known in the art, including but not limited to beta or gamma rays, ethylene oxide, hydrogen peroxide plasma, or water vapor.

Although the present invention has been described as having a representative design, the present invention may be further modified within the spirit and scope of the present disclosure. Accordingly, this application shall include any modification, use, or adaptation of the invention that uses its general principles.

Any patent, publication or other disclosure referred to herein in whole or in part by reference has any existing definition, description, or other disclosure that is incorporated herein by reference. It is incorporated herein only to the extent that it is consistent with the disclosure of. As such, and to the extent necessary, the disclosures expressly set forth herein shall supersede any contradictory statements incorporated herein by reference. Any document that is incorporated herein by reference, but is inconsistent with existing definitions, descriptions, or other disclosed documents described herein, or parts thereof, is incorporated and existing. It shall be incorporated only to the extent that there is no contradiction with the disclosed content.

[Implementation mode]
(1) Surgical instrument
A surgical end effector including a first jaw and a second jaw, wherein one of the first jaw and the second jaw is subjected to a closing motion to the surgical end effector. And a surgical end effector that can be selectively moved with respect to the first jaw and the other of the second jaw.
An elongated shaft assembly
A closing member assembly that is supported to move axially with respect to the surgical end effector.
A proximal closure member configured to advance axially by a complete closure stroke distance when a closure motion is applied.
A distal closure member that movably interfaces with the proximal closure member, whereby the distal closure member responds to axial movement of the proximal closure member over the complete closure stroke distance. The distal closure member is adapted to apply the closure motion to the surgical end effector so that the axial closure distance is shorter than the complete closure stroke distance. A surgical instrument comprising an elongated shaft assembly comprising a distal closing member, comprising a closing member assembly.
(2) The proximal closing member comprises a distal end, and the distal closing member comprises a proximal end slidably secured to the distal end of the proximal closing member. Therefore, when the proximal closure member moves over the complete closure stroke distance, the distal closure member stays at the axial closure distance until the proximal closure member moves axially over a portion of the complete closure stroke distance. The surgical instrument according to embodiment 1, which does not begin to move axially across.
(3) The elongated shaft assembly comprises a spine assembly coupled to the surgical end effector, the proximal closing member axially moving over the spine assembly over the fully closing stroke distance. The distal closure member comprises a proximal closure sleeve supported on one portion of the assembly, the distal closure member comprising a distal closure sleeve slidably pivotally supported over another portion of the spine assembly, and said. The surgical instrument according to embodiment 2, which is movably coupled to a proximal closure sleeve.
(4) The proximal closure sleeve has an opening at its distal end, the proximal end of the distal closure sleeve extends through the opening, and the proximal end of the distal closure sleeve. The surgical instrument according to embodiment 3, wherein the portion is configured to prevent separation from the distal end of the proximal closure sleeve.
(5) The distal end of the proximal closure sleeve is flared inward around the opening and the proximal end of the distal closure sleeve is said complete with respect to the distal closure sleeve. Promotes axial movement of the proximal closure sleeve over a portion of the closure stroke distance while preventing the proximal end of the distal closure sleeve from separating from the distal end of the proximal closure sleeve. The surgical instrument according to embodiment 4, which is flared outward for this purpose.

(6) The proximal closing sleeve comprises an inwardly extending flange that defines an opening at its distal end, the proximal end of the distal closing sleeve extending through the opening and said far away. Provided with an outwardly extending flange that cooperates with the inwardly extending flange to prevent the proximal end of the position closing sleeve from separating from the distal end of the proximal closing sleeve. The surgical instrument according to embodiment 3.
(7) The proximal closure sleeve comprises a contact portion proximal to the distal end of the proximal closure sleeve, the contact portion being the complete closure stroke distance of the proximal closure sleeve. The surgical instrument according to embodiment 3, which is configured to make axial contact with the proximal end of the distal closure sleeve after being axially advanced over a predetermined portion of the.
(8) The surgical instrument according to embodiment 7, wherein the contact portion comprises a pleated portion of the proximal closure sleeve.
(9) The contact portion comprises at least one inwardly extending tab member, which is formed on the proximal closure sleeve and with a corresponding portion of the proximal end of the distal closure sleeve. 7. The surgical instrument according to embodiment 7, which is oriented to contact.
(10) The surgical instrument according to embodiment 7, wherein the contact portion comprises an inwardly extending flange formed on a stop member attached to the inner wall of the proximal closure sleeve.

(11) Surgical instrument
A surgical end effector including a first jaw and a second jaw, wherein one of the first jaw and the second jaw is subjected to a closing motion to the surgical end effector. And a surgical end effector that can be selectively moved with respect to the first jaw and the other of the second jaw.
An elongated shaft assembly
A closing member assembly that is supported to move axially with respect to the surgical end effector.
A proximal closure member configured to advance axially by a complete closure stroke distance when a closure motion is applied.
A distal closure member supported to move axially by an axial closure distance shorter than the complete closure stroke distance to add the closure motion to the surgical end effector.
A closure stroke reduction assembly that interfaces with the proximal closure member and the distal closure member, whereby when the proximal closure member moves over the complete closure stroke distance, the proximal closure member is said to be fully closed. A closure member assembly, comprising a closure stroke reduction assembly, wherein the distal closure member does not begin to move axially over the closure distance until it has moved axially over a portion of the stroke distance. With an elongated shaft assembly, and with a surgical instrument.
(12) The elongated shaft assembly comprises a spine assembly coupled to the surgical end effector, the proximal closing member axially moving over the spine assembly over the fully closing stroke distance. It comprises a proximal closure sleeve that is supported over one portion of the assembly, and the distal closure member is slidably supported over another portion of the spine assembly to move axially over the closure distance. 11. The surgical instrument according to embodiment 11, comprising a distal closure sleeve.
(13) The closed stroke reduction assembly is
With the proximal mounting member coupled to the proximal closure sleeve so as to move axially with the proximal closure sleeve over the complete closure stroke distance.
12. The surgical instrument according to embodiment 12, comprising a distal mounting member coupled to the distal closure sleeve so as to move axially with the distal closure sleeve over the closure distance.
(14) The proximal attachment member is configured to come into contact with at least one of the proximal attachment member and the proximal closure sleeve after the proximal closure sleeve has moved over the portion of the complete closure stroke distance. 13. The surgical instrument according to embodiment 13, comprising a contact portion.
(15) The distal mounting member defines a distal ledge, the proximal mounting member defines a proximal ledge away from the distal ledge, and between the distal ledge and the proximal ledge. A distal movement zone is formed, the contact portion being separated from at least one of the proximal mounting member and the proximal closing sleeve of the contact portion and the proximal mounting member and the proximal closing sleeve. The surgical instrument according to embodiment 14, wherein a proximal movement zone is defined between the two and at least one of them.

(16) The surgical use according to embodiment 15, wherein the proximal movement zone has a proximal axial width, and the distal movement zone has a distal axial width different from the proximal axial width. Instrument.
(17) The surgical instrument according to embodiment 13, further comprising an urging member between the proximal mounting member and the distal mounting member.
(18) The surgical instrument according to embodiment 16, further comprising an urging member supported within the distal movement zone.
(19) Surgical instrument
A surgical end effector including a first jaw and a second jaw, wherein one of the first jaw and the second jaw is subjected to a closing motion to the surgical end effector. And a surgical end effector that can be selectively moved with respect to the first jaw and the other of the second jaw.
An elongated shaft assembly
A closing member assembly that is supported to move axially with respect to the surgical end effector.
A proximal closure member configured to advance axially by a complete closure stroke distance when a closure motion is applied, and is configured to apply a maximum closure force when the end of the maximum closure stroke distance is reached. With the proximal closure member,
A distal closure member supported to move axially by an axial closure distance shorter than the complete closure stroke distance to add the closure motion to the surgical end effector.
A closure stroke reduction assembly that interfaces with the proximal closure member and the distal closure member, whereby when the proximal closure member moves over the complete closure stroke distance, the proximal closure member is said to be maximal. A surgical instrument comprising an elongated shaft assembly comprising a closure stroke reducing assembly, comprising a closure member assembly, comprising applying another closure force less than the closure force to the distal closure member. ..
(20) The closed stroke reduction assembly is
A proximal mounting member coupled to the proximal closure member so as to move axially with the proximal closure member over the complete closure stroke distance.
A distal mounting member coupled to the distal closure member so as to move axially with the distal closure member over the axial closure distance.
19. The surgical instrument according to embodiment 19, comprising an urging member between one portion of the proximal mounting member and another portion of the distal mounting member.

Claims (15)

It ’s a surgical instrument,
A surgical end effector including a first jaw and a second jaw, wherein one of the first jaw and the second jaw is subjected to a closing motion to the surgical end effector. And a surgical end effector that can be selectively moved with respect to the first jaw and the other of the second jaw.
An elongated shaft assembly
A closing member assembly that is supported to move axially with respect to the surgical end effector.
A proximal closure member configured to advance axially by a complete closure stroke distance when a closure motion is applied.
A distal closure member that movably interfaces with the proximal closure member, whereby the distal closure member responds to axial movement of the proximal closure member over the complete closure stroke distance. The distal closure member is adapted to apply the closure motion to the surgical end effector so that the axial closure distance is shorter than the complete closure stroke distance. With a distal closure member, with a closure member assembly, with an elongated shaft assembly ,
The proximal closure member comprises a distal end, the distal closure member comprises a proximal end that is slidable with respect to the distal end of the proximal closure member, and thus said proximal. When the closing member moves over the complete closure stroke distance, the distal closure member moves axially over the axial closure distance until the proximal closure member moves axially over a portion of the complete closure stroke distance. Without starting to
The elongated shaft assembly comprises a spine assembly that is coupled to the surgical end effector, and the proximal closure member is a portion of the spine assembly such that it moves axially over the spine assembly over the complete closure stroke distance. The distal closure member comprises a proximal closure sleeve supported above, the distal closure member comprising a distal closure sleeve slidably pivotally supported over another portion of the spine assembly, and said proximal closure. A surgical instrument that is movably attached to the sleeve. The proximal closure sleeve has an opening at its distal end, the proximal end of the distal closure sleeve extends through the opening, and the proximal end of the distal closure sleeve is said. The surgical instrument according to claim 1 , which is configured to prevent separation of the proximal closure sleeve from the distal end. The distal end of the proximal closure sleeve is flared inward around the opening, and the proximal end of the distal closure sleeve is the complete closure stroke distance to the distal closure sleeve. To facilitate axial movement of the proximal closure sleeve over a portion of the, and at the same time prevent the proximal end of the distal closure sleeve from separating from the distal end of the proximal closure sleeve. The surgical instrument according to claim 2 , which is flared outward. The proximal closure sleeve comprises an inwardly extending flange that defines an opening at its distal end, the proximal end of the distal closure sleeve extending through the opening and said distal closure sleeve. said to prevent the proximal end portion to separate from the distal end of the proximal closure sleeve, flanges cooperate extending in the inward, and a flange extending outwardly claim 1 Surgical instruments described in. The proximal closure sleeve comprises a contact portion proximal to the distal end of the proximal closure sleeve, wherein the proximal closure sleeve is the default portion of the complete closure stroke distance. The surgical instrument according to claim 1 , which is configured to make axial contact with the proximal end of the distal closure sleeve after being axially advanced over. The surgical instrument of claim 5 , wherein the contact portion comprises a pleated portion of the proximal closure sleeve. The contact portion comprises at least one inwardly extending tab member such that the tab member is formed on the proximal closure sleeve and contacts the corresponding portion of the proximal end of the distal closure sleeve. The surgical instrument according to claim 5 , which is oriented in. The surgical instrument of claim 5 , wherein the contact portion comprises an inwardly extending flange formed on a stop member attached to the inner wall of the proximal closure sleeve. It ’s a surgical instrument,
A surgical end effector including a first jaw and a second jaw, wherein one of the first jaw and the second jaw is subjected to a closing motion to the surgical end effector. And a surgical end effector that can be selectively moved with respect to the first jaw and the other of the second jaw.
An elongated shaft assembly
A closing member assembly that is supported to move axially with respect to the surgical end effector.
A proximal closure member configured to advance axially by a complete closure stroke distance when a closure motion is applied.
A distal closure member supported to move axially by an axial closure distance shorter than the complete closure stroke distance to add the closure motion to the surgical end effector.
A closure stroke reduction assembly that interfaces with the proximal closure member and the distal closure member, whereby when the proximal closure member moves over the complete closure stroke distance, the proximal closure member is said to be fully closed. over a portion of the stroke distance to move in the axial direction, the distal closure member and a are, closed stroke reduction assembly so never begin to move in the axial direction over the axial closure distance, the closing member With an assembly, with an elongated shaft assembly, with ,
The elongated shaft assembly comprises a spine assembly that is coupled to the surgical end effector, and the proximal closure member is a portion of the spine assembly such that it moves axially over the spine assembly over the complete closure stroke distance. A proximal closure sleeve supported on the distal closure member is slidably supported over another portion of the spine assembly to move axially over the axial closure distance. A surgical instrument with a distal closure sleeve. The closed stroke reduction assembly
With the proximal mounting member coupled to the proximal closure sleeve so as to move axially with the proximal closure sleeve over the complete closure stroke distance.
9. The surgical instrument of claim 9 , comprising a distal mounting member coupled to the distal closure sleeve so as to move axially with the distal closure sleeve over the axial closure distance. The distal attachment member is a contact portion configured to come into contact with at least one of the proximal attachment member and the proximal closure sleeve after the proximal closure sleeve has moved over the portion of the complete closure stroke distance. 10. The surgical instrument according to claim 10. The distal mounting member defines a distal ledge, and the proximal mounting member defines a proximal ledge away from the distal ledge and moves distally between the distal ledge and the proximal ledge. A zone is formed, and the contact portion is separated from at least one of the proximal mounting member and the proximal closing sleeve, and the contact portion and at least one of the proximal mounting member and the proximal closing sleeve. The surgical instrument according to claim 11 , which defines a proximal movement zone between and. 12. The surgical instrument according to claim 12 , wherein the proximal movement zone has a proximal axial width, and the distal movement zone has a distal axial width that is different from the proximal axial width. The surgical instrument according to claim 10 , further comprising an urging member between the proximal mounting member and the distal mounting member. 13. The surgical instrument of claim 13 , further comprising an urging member supported within the distal movement zone.

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