JP6932717B2 - Surgical staple fastening system with grooved forming pockets - Google Patents

Description

The present invention relates to surgical instruments and, in various arrangements, surgical staple and cutting instruments designed to staple and cut tissue and staple cartridges for use with them.

The various features of the embodiments described herein, along with their advantages, may be understood as follows, together with the accompanying drawings, with the following description.
FIG. 3 is a perspective view of a surgical instrument, including a replaceable surgical tool assembly, according to at least one embodiment. Another perspective view of the surgical instrument handle assembly of FIG. 1, with a portion of the handle housing housed therein, omitted to expose components. It is an exploded view of a part of the handle assembly of the surgical instrument of FIG. 1 and FIG. 2 is a cross-sectional perspective view of the handle assembly of FIGS. 2 and 3. A partial cross-section of the handle assembly of FIGS. It is a side view. FIG. 5 is an end sectional view of the handle assembly of FIGS. 2 to 5 along lines 6 to 6 in FIG. Another end sectional view of the handle assembly of FIGS. 2-6, along lines 7-7 in FIG. 2 is another end sectional view of the handle assembly of FIGS. 2-7 showing a shift lever gear that meshes and engages with a drive gear in a rotary drive bearing. 2 is another end sectional view of the handle assembly of FIGS. 2-8 showing the position of the shift lever solenoid when the shift lever gear meshes and engages with the drive gear in a rotary drive bearing. Another perspective view of the handle assembly of FIGS. 2-9, with its particular portion shown in cross section and with its access panel portion shown in pseudo-form. It is a top view of the handle assembly of FIGS. 2-11 with the first aid system shown in the actuable position. It is a perspective view of the first aid handle of the first aid system shown in FIGS. 2-11. FIG. 5 is an exploded view of a portion of the first aid handle of FIG. 12 with a portion thereof shown in a cross section. FIG. 3 is a cross-sectional elevation view of the handle assembly of FIG. FIG. 3 is a perspective view of a surgical staple fastening accessory device comprising an accessory device portion, a shaft assembly, a joint joint, and an end effector assembly. FIG. 15 is a partial perspective view of a staple cartridge assembly, an end effector assembly, and a joint joint of the surgical staple attachment attachment device of FIG. FIG. 15 is a partially exploded view of the end effector assembly, joint joint, and shaft assembly of the surgical staple attachment attachment device of FIG. FIG. 15 is a partial perspective view of an accessory portion and a shaft assembly of the surgical staple fastening device of FIG. FIG. 15 is a partial perspective view of an end effector assembly, a joint joint, and a shaft assembly of an accessory device for surgical staple fastening, wherein the shaft assembly can be driven by a closed drive and a launch drive. It comprises a shift assembly configured to move between sexes, and the shift assembly is illustrated in a position to drive a launch drive. FIG. 15 is a partially disassembled perspective view of the end effector assembly, joint joint, and shaft assembly of the surgical staple attachment attachment device of FIG. 15, the shift assembly being illustrated at a position to drive the closure drive. There is. FIG. 15 is a perspective view of a closing frame of an end effector assembly of the surgical staple attachment attachment, wherein the closing frame is a corresponding slot that engages a tissue retention pin mechanism of the end effector assembly, and a staple cartridge assembly. Equipped with a corresponding drive tab to engage. FIG. 21 is a bottom view of the closed frame shown in FIG. FIG. 21 is a side view of the closed frame shown in FIG. FIG. 15 is a partially exploded view of the end effector assembly, joint joint, and shaft assembly of the surgical staple attachment attachment, the shift assembly being illustrated at the position where the closed drive is driven. .. FIG. 15 is a longitudinal sectional view of the end effector assembly, joint joint, and shaft assembly of the surgical staple attachment attachment device of FIG. 15, in which the shift assembly is in the first position to drive the closure drive and the end effector. The assembly is in an open arrangement. FIG. 15 is a longitudinal sectional view of the end effector assembly, joint joint, and shaft assembly of the surgical staple attachment device of FIG. 15, with the shift assembly in first position and the end effector assembly partially closed. In arrangement. FIG. 15 is a vertical cross-sectional view of the end effector assembly, joint joint, and shaft assembly of the surgical staple fastening attachment, with the shift assembly in first position and the end effector assembly fully secured. It is in the same arrangement. FIG. 15 is a vertical cross-sectional view of the end effector assembly, the joint joint, and the shaft assembly of the surgical staple attachment attachment device of FIG. 15, in which the shift assembly moves from the first position to the second position to drive the launch. And the end effector assembly is in a fully fixed arrangement. FIG. 15 is a longitudinal sectional view of the end effector assembly, joint joint, and shaft assembly of the surgical staple attachment device of FIG. 15, with the shift assembly in second position and the surgical staple attachment attachment fully. It is in the launch arrangement. FIG. 15 is a vertical cross-sectional view of the end effector assembly, the joint joint, and the shaft assembly of the surgical staple attachment attachment device of FIG. 15, in which the shift assembly moves from the second position to the third position to drive the launch. And the closed drive is driven simultaneously, and the surgical staple attachment is fully in the launch position. FIG. 3 is a perspective view of a shaft assembly comprising a staple cartridge according to at least one embodiment. FIG. 3 is a partial perspective view of the shaft assembly of FIG. 30A showing a staple cartridge removed from the shaft assembly. It is a partial exploded view of the shaft assembly of FIG. 30A. FIG. 3 is a partial cross-sectional view of the shaft assembly of FIG. 30A, shown in an open, non-fixed arrangement. FIG. 6 is a partial cross-sectional view of the shaft assembly of FIG. 30A, shown in a closed and fixed arrangement. FIG. 6 is a partial cross-sectional view of the shaft assembly of FIG. 30A, shown in launch arrangement. FIG. 6 is a partial cross-sectional view of the shaft assembly of FIG. 30A showing a power harvesting system according to at least one embodiment. FIG. 3 is a perspective view of a surgical staple fastening accessory or surgical staple fastening device comprising an accessory portion, a shaft assembly, a joint joint, and an end effector assembly. FIG. 31 is a partial cross-sectional view of the joint joint and end effector assembly of the instrument of FIG. 31, where the end effector assembly comprises an end effector frame, a closure frame, and a stapling cartridge assembly. FIG. 31 is a partial cross-sectional view of the instrument shaft assembly, joint joint, and end effector assembly of FIG. 31 showing a stapling cartridge assembly mounted within the end effector assembly. FIG. 31 is a cross-sectional perspective view of the accessory device portion and the shaft assembly of the appliance of FIG. 31, where the accessory device portion transmits the accessory device interface and the rotation control motion passively passively performed by the device interface to the main drive shaft of the shaft assembly. It is provided with a transmission device configured as described above. It is an exploded view of the end effector assembly and the shaft assembly of the instrument of FIG. 31. FIG. 3 is a partial perspective view of the end effector assembly of the instrument of FIG. 31. FIG. 31 is a partial perspective view of the end effector assembly and the shaft assembly of the fixture of FIG. 31, wherein a portion of the end effector assembly is completely or partially removed to drive the end effector assembly. The lock arrangement and tissue retention pin mechanism are exposed. It is a partial perspective view of a part of the closing frame and the end effector frame, and a part is removed to expose the drive system, the lock arrangement, and the tissue holding pin mechanism of the instrument of FIG. FIG. 3 is a partial cross-sectional elevation view of the end effector assembly of the appliance of FIG. 31, shown in an uncaptured, unfixed, unfired, unlocked arrangement. In the partial cross-sectional elevation of the end effector assembly of the appliance of FIG. 31, shown in the arrangement of FIG. 39, which is uncaptured, unfixed, unfired, and unlocked. be. Uncaptured, unfixed, unfired, unlocked, shown in the arrangement of FIG. 39, at lines 41-41 in FIG. 40 of the end effector assembly of the appliance of FIG. It is a partial cross-sectional elevation view along. FIG. 3 is a partial cross-sectional elevation view of the end effector assembly of the instrument of FIG. 31, shown in a captured, partially fixed, unfired arrangement. FIG. 3 is a partial cross-sectional elevation view of the end effector assembly of the instrument of FIG. 31, shown in the arrangement of FIG. 42, captured, partially fixed, and unfired. FIG. 3 is a partial cross-sectional elevation view of the end effector assembly of the appliance of FIG. 31, shown in a fully fixed, unfired arrangement. It is a partial cross-sectional elevation view of the end effector assembly of the appliance of FIG. 31, which is fully fixed and shown in the launch arrangement. It is a partial cross-sectional elevation view of the end effector assembly of the appliance of FIG. 31, which is partially retracted and shown in the launch arrangement. A partial cross-sectional elevation view of the end effector assembly of the appliance of FIG. 31 shown in a fully retracted and locked arrangement, with the used stapling cartridge assembly coming from the end effector assembly. It has been removed. A partial cross-sectional elevation view of the end effector assembly of the appliance of FIG. 31 shown in the fully retracted and locked arrangement of FIG. 46, with an unused stapling cartridge assembly. , End effector can be installed inside the assembly. A partial cross-sectional elevation view of the end effector assembly of the appliance of FIG. 31, which is fully fixed and shown in a partial launch arrangement, the stapling cartridge assembly comprising a launch status indicator system. And the launch status indicator system indicates that the fixture is fully fixed and in a partial launch arrangement. A partial cross-sectional elevation view of the end effector assembly of the fixture of FIG. 31 shown in a fully fixed and complete launch arrangement, the launch status indicator system, with the fixture fully fixed. Indicates that it is completely in the launch position. FIG. 3 is a perspective view of a surgical staple fastening accessory or surgical staple fastening device comprising an accessory portion, a shaft assembly, a joint joint, and an end effector assembly. FIG. 5 is a partial perspective view of a joint transmission transmission device of an accessory device portion of the device of FIG. 51. FIG. 51 is a perspective cross-sectional view of the instrument end effector assembly of FIG. 51, with some parts of the instrument removed to expose the inner part of the instrument. FIG. 5 is a partially exploded view of the instrument of FIG. FIG. 5 is a partial perspective view of the cartridge-supporting jaw of the instrument of FIG. 51, comprising a pivot pin defining an axis of rotation around which the cartridge-supporting jaw is rotatable. FIG. 5 is a partially exploded view of an accessory device portion, a shaft assembly, and a joint joint portion of the instrument of FIG. 51. FIG. 5 is a partial cross-sectional perspective view of the joint joint of the instrument of FIG. 51. FIG. 51 is a perspective view of the joint joint and end effector assembly of the instrument of FIG. 51, wherein the end effector assembly comprises a pair of movable jaws, staple cartridges, and a drive system. FIG. 5 is a cross-sectional elevation view of the instrument of FIG. 51, shown in a fixed, unlaunched arrangement. FIG. 5 is a cross-sectional elevation view of the end effector assembly of the appliance of FIG. 51, shown in a fixed, fully stapled arrangement. FIG. 5 is a cross-sectional elevation view of the end effector assembly of the appliance of FIG. 51, shown in retracted arrangement. FIG. 5 is a cross-sectional elevation view of the end effector assembly of the instrument of FIG. 51 along lines 62-62 in FIG. FIG. 5 is a cross-sectional elevation view of the end effector assembly of the instrument of FIG. 51, shown in a fixed, fully stapled, partially cut arrangement. FIG. 5 is a partial cross-sectional elevation view of the end effector assembly of the appliance of FIG. 51, unfixed or shown in an open arrangement. FIG. 5 is a partial top view of the end effector assembly, joint joint, and shaft assembly of the instrument of FIG. 51, shown in a fixed, non-joint arrangement. It is a partial top view of the end effector assembly, the joint joint, and the shaft assembly of the instrument of FIG. 51, unfixed and shown in the articulated joint arrangement. It is a partial top view of the end effector assembly, the joint joint, and the shaft assembly of the instrument of FIG. 51, which is fixed and shown in the articulated joint arrangement. FIG. 5 is a cross-sectional elevation view of a closing frame of the end effector assembly of the appliance of FIG. 51. FIG. 5 is a cross-sectional elevation view of the end effector frame of the instrument of FIG. 51. FIG. 5 is a perspective view of a portion of a surgical staple cartridge for use with a circular surgical staple retainer according to at least one embodiment. A pair of staples in an unformed and formed arrangement according to at least one embodiment is shown. FIG. 6 is a cross-sectional view of a portion of the anvil relative to the portion of the surgical staple cartridge of FIG. 70 prior to the operation of the staple forming process. Another cross-sectional view of the anvil of FIG. 72 and the staple cartridge of FIG. 70 after the staples have been formed. FIG. 5 is a perspective view of a portion of a surgical staple cartridge for use with a circular surgical staple retainer according to at least one embodiment. FIG. 6 is a cross-sectional view of a portion of the anvil relative to the portion of the surgical staple cartridge of FIG. 74 prior to the operation of the staple forming process. Another cross-sectional view of the anvil and staple cartridge of FIG. 75 after the staples have been formed. It is a top view of the staple cartridge according to at least one embodiment. It is a bottom view of the anvil according to at least one embodiment. FIG. 5 is a cross-sectional view of a portion of the anvil relative to a portion of the surgical staple cartridge. Three unformed surgical staples are shown. FIG. 5 is a perspective view of a portion of a surgical staple fastening device according to at least one embodiment. FIG. 8 is a top view of the surgical staple cartridge of the staple fastening device of FIG. 81. FIG. 8 is a perspective view of a part of the surgical staple fastening device of FIG. 81. FIG. 3 is a side elevation view of a staple drive assembly according to at least one embodiment. It is a bottom view of the anvil according to at least one embodiment. FIG. 8 is a side elevation cross-sectional view of a portion of the surgical staple fastening device using the anvil of FIG. 85. FIG. 8 is an enlarged view of the anvil staple forming pocket of FIG. 85 with corresponding preformed staples. Shown are staples according to at least one embodiment in unformed and formed arrangements. FIG. 5 is a side elevation cross-sectional view of a portion of a surgical staple fastening device according to at least one embodiment. Shown are staples according to at least one embodiment in unformed and formed arrangements. FIG. 5 is a side elevation cross-sectional view of a portion of a surgical staple fastening device according to at least one embodiment. FIG. 5 is a top view of a portion of a surgical staple fastening device according to at least one embodiment. FIG. 9 is a bottom view of an anvil according to at least one embodiment that may be used in connection with the surgical staple fastening device of FIG. It is a top view of the staple fossa by at least one embodiment and the corresponding staple. An unformed staple according to at least one embodiment is shown. FIG. 5 is a top view of a surgical staple fastening device according to at least one embodiment. It is a top view of the staple fossa by at least one embodiment and the corresponding staple. FIG. 6 is a bottom view of an anvil according to at least one embodiment that may be used in connection with the surgical staple fastening device of FIG. FIG. 8 is an enlarged view of the anvil staple forming pocket of FIG. 98 with corresponding preformed staples. FIG. 6 is a partial cross-sectional view of a surgical staple fastening device according to at least one embodiment. An unformed staple according to at least one embodiment is shown. It is a top view of the staple cartridge according to at least one embodiment. It is a top view of the staple fossa by at least one embodiment and the corresponding staple. It is a bottom view of the anvil of the surgical staple fastening device according to at least one embodiment. FIG. 3 is a top view of a pair of staple fossa with at least one embodiment and corresponding staples. FIG. 5 is a cross-sectional view of an anvil assembly of a surgical stapler according to at least one embodiment. It is sectional drawing of the anvil changing member of the anvil assembly of FIG. 106. It is a top view of the anvil changing member of the anvil assembly of FIG. 106. It is a top view of the anvil assembly of a surgical stapler according to at least one embodiment. It is a top view of the staple cartridge of the surgical stapler of FIG. 109. The forming pocket of the anvil changing member and the staple formed by the forming pocket are illustrated. The staple fossa and the unformed staple of the surgical stapler of FIG. 109 are illustrated. It is a perspective view of the staple driving part which supports three staples of the surgical stapler of FIG. 109. It is a top view of the staple drive part of FIG. 113. FIG. 5 is a cross-sectional view of an end effector comprising a staple cartridge, an anvil, and an anvil changing member according to at least one alternative embodiment. Three staples in unformed and formed shapes according to at least one embodiment are illustrated.

Over several drawings, the corresponding reference symbols indicate the corresponding parts. The examples described herein illustrate various embodiments of the invention in one form, and such examples should be construed as limiting the scope of the invention by any method. is not it.

The applicant of this application owns the following patent applications filed with this application on the same date, each of which is incorporated herein by reference in its entirety.
-US Patent Application No. ________, Title: "Method FOR OPERATING A SURGICAL STAPLING SYSTEM", Agent Reference No. END7821USNP / 150535,
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-US Patent Application No. ___________, Title: "CIRSULAR STAPLING SYSTEM COMPRISING PORTARY FIRING SYSTEM", Agent Reference Number END7845USNP / 150559, and-US Patent Application No. , Agent reference number END7845USNP 1/150559-1.

The applicant of this application also owns the following designated US patent applications filed on 31 December 2015, each of which is incorporated herein by reference in its entirety.
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The applicant of this application also owns the following designated US patent applications filed on 9 February 2016, each of which is incorporated herein by reference in its entirety.
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-US Pat. REDUCTION ARRANGEMENTS ".

The applicant of this application also owns the following designated US patent applications filed on February 12, 2016, each of which is incorporated herein by reference in its entirety.
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The applicant of this application owns the following patent applications filed on June 18, 2015, each of which is incorporated herein by reference in its entirety.
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The applicant of this application owns the following patent applications filed on March 6, 2015, each of which is incorporated herein by reference in its entirety.
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-US Pat. BATTERY HOUSING ".

The applicant of this application owns the following patent applications filed on February 27, 2015, each of which is incorporated herein by reference in its entirety.
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The applicant of this application owns the following patent applications filed on December 18, 2014, each of which is incorporated herein by reference in its entirety.
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The applicant of this application owns the following patent applications filed on March 1, 2013, each of which is incorporated herein by reference in its entirety.
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-US Patent Application No. 13 / 782,375, Title: "ROTARY POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEFREEDOM", now US Patent Application Publication No. 2014/0246473, and-US Patent Application No. 13 / 782,536 Issue, Title: "SURGICAL INSTRUMENT SOFT STOP", now US Patent Application Publication No. 2014/0246476.

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

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

The applicant of this application also owns the following patent applications filed on March 26, 2014, each of which is incorporated herein by reference in its entirety.
-US Patent Application No. 14 / 226,106, Title: "POWER MANAGEMENT CONTOROL SYSTEMS FOR SURGICAL INSTRUMENTS", now US Patent Publication No. 2015/0272582,
-US Patent Application No. 14 / 226,099, Title: "STERILIZATION VERIFICATION CIRCUIT", now US Patent Publication No. 2015/0272581,
-US Patent Application No. 14 / 226,094, Title: "VERIFICATION OF NUMBER OF BATTERY EXCHANGE COUNT", now US Patent Publication No. 2015/0272580,
-US Pat.
-US Patent Application No. 14 / 226,075, Title: "MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLES", now US Patent Publication No. 2015/0272579,
-US Patent Application No. 14 / 226,093, Title: "FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS", now US Patent Publication No. 2015/0272569,
-US Patent Application No. 14 / 226,116, Title: "SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION", now US Patent Publication No. 2015/0272571,
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-US Patent Application No. 14 / 226,097, Title: "SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS", now U.S. Patent Publication No. 2015/0272570,
-US Patent Application No. 14 / 226,126, Title: "INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS", now US Patent Publication No. 2015/0272572,
-US Patent Application No. 14 / 226,133, Title: "MODULAR SURGICAL INSTRUMENT SYSTEM", now US Patent Publication No. 2015/0272557,
-US Patent Application No. 14 / 226,081, Title: "SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT,", now US Patent Publication No. 2015/0277471,
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-US Patent Application No. 14 / 226,111, Title: "SURGICAL STAPLING INSTRUMENT SYSTEM", now US Patent Publication No. 2015/02272583, and-US Patent Application No. 14 / 226,125, Title: "SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT", currently US Patent Publication No. 2015/0280384.

The applicant of this application also owns the following patent applications filed on September 5, 2014, each of which is incorporated herein by reference in its entirety.
-US Patent Application No. 14 / 479,103, Title: "CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE", now US Patent Publication No. 2016/0066912,
-US Patent Application No. 14 / 479,119, Title: "ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION", now US Patent Application Publication No. 2016/0066914,
-US Patent Application No. 14 / 478,908, Title: "MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION", now US Patent Application Publication No. 2016/0066910,
-US Patent Application No. 14 / 478,895, Title: "MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION", now US Patent Application Publication No. 2016/0066909,
-US Pat.
-US Patent Application No. 14 / 479,098, Invention Title "SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION", Currently US Patent Application Publication No. 2016/0066911,
-US Patent Application No. 14 / 479,115, Title: "MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE", now US Patent Application Publication Nos. 2016/0066916, and-US Patent Application No. 14 / 479,108. , Title: "LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION", currently US Patent Application Publication No. 2016/0066913.

The applicant of the present application also owns the following patent applications filed on April 9, 2014, the entire contents of which are incorporated herein by reference:
-US Patent Application No. 14 / 248,590, Title: "MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS", now US Patent Publication No. 2014/030987,
-US Patent Application No. 14 / 248,581, Title: "SURGICAL INSTRUMENT COMPRISING A CLOSEING DRIVE AND A FIRING DRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT", currently U.S. Patent Publication No. 20
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-US Patent Application No. 14 / 248,588, Title: "POWERED LINEAR SURGICAL STAPLER", now US Patent Publication No. 2014/0309666,
-US Patent Application No. 14 / 248,591, Title: "TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT", now US Patent Publication No. 2014/0305911,
-US Patent Application No. 14 / 248,584, Title: "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURFTS
-US Patent Application No. 14 / 248,587, Title: "POWERED SURGICAL STAPLER", now US Patent Publication No. 2014/0309665,
-US Patent Application No. 14 / 248,586, Title: "DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT", now US Patent Publication No. 2014/03059090, and-US Patent Application No. 14 / 248,607. Gazette, Title: "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS", currently US Patent 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 Patent Provisional Application No. 61 / 812,365, Title: "SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFFORMED BY A SINGLE MOTOR",
-US Patent Provisional Application No. 61 / 812,376, Title: "LINEAR CUTTER WITH POWER",
-US Patent Provisional Application No. 61 / 812,382, Title: "LINEAR CUTTER WITH MOTOR AND PISTOL GRIP",
-US Patent Provisional Application No. 61 / 812,385, Title: "SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTION MOTORS AND MOTOR CONTROL", and-US Patent Provisional Application No. 61 / 812,372, Title: "SURGICAL" 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. I understand that it is possible. Modifications and modifications 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 instrument that "equipped", "has", "contains", or "contains" one or more elements has one or more of them. However, it is not limited to having only one or more of them. Similarly, an element of a system, device, or device that "includes", "has", "contains", or "contains" one or more features has one or more of these 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" means the part closest to the clinician and the term "distal" means the part far from the clinician. It will be further understood that for convenience and clarity, spatial terms such as "vertical", "horizontal", "top", and "bottom" may be used for drawings herein. 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. NS. By reading "Forms for Carrying Out the Invention" herein, the reader can read that the various instruments disclosed herein are incisions or incisions formed in the tissue, eg, through natural openings. You will further understand that it can be inserted into the body in any way, such as through a puncture 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 an operating channel capable of advancing the end effector and elongated shaft of the surgical instrument. 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 includes a staple cartridge. Other embodiments in which the staple cartridge is insertable into and removable from the first jaw, but the staple cartridge is not removable from the first jaw, or at least not easily replaceable. It is supposed. The second jaw comprises an anvil configured to deform the staple ejected from the staple cartridge. Other embodiments are also envisioned in which the second jaw is pivotable with respect to the first jaw around the closed axis, but the first jaw is pivotable with respect to the second jaw. ing. The surgical staple fastening system further comprises a joint joint configured to allow the end effector to rotate with respect to the shaft, i.e., to move the joint. The end effector is rotatable around the joint axis extending through the joint joint. Other embodiments that do not include joints are also envisioned.

The staple cartridge includes a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck that extends between the proximal and distal ends. During 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 squeeze and secure the tissue against the deck. The staples, which are detachably stored in the cartridge body, can then be placed in the tissue. The cartridge body includes a staple fossa defined within it, and the staples are detachably stored in the staple fossa. Staple pits 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. Staple fossa and other arrangements of staples are also possible.

The staples are supported by the staple drive unit in the cartridge body. The drive unit is movable between a first or unfired position and a second or fired position where the staples are ejected from the staple fossa. The drive unit is held in the cartridge body by a holder extending around the bottom of the cartridge body, and is an elastic member configured to hold the cartridge body and hold the holder against the cartridge body. including. Drives can be moved between their unlaunched positions and their launched positions by threads. The thread is movable between the proximal position adjacent to the proximal end and the distal position adjacent to the distal end. The thread comprises a plurality of inclined surfaces configured to slide under the drive and lift the drive, 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 includes a first cam that engages with the first jaw and a second cam that engages with the second jaw. When advancing the launching member distally, the first and second cams can control the distance between the staple cartridge deck and the anvil, i.e. the tissue gap. The launching member also comprises a knife configured to make an incision in the tissue trapped 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 staple is ejected forward of the knife.

FIG. 1 shows a motor-driven surgical system 10 that may be used to perform a variety of different surgical procedures. In the illustrated embodiment, the motor-driven surgical system 10 comprises a selectively reconfigurable housing or handle assembly 20 attached to one form of the replaceable surgical tool assembly 1000. For example, the system 10 shown in FIG. 1 includes a replaceable surgical tool assembly 1000 with surgical cutting and fastening instruments, sometimes referred to as end effectors. As will be discussed in more detail below, replaceable surgical tool assemblies may include end effectors adapted to support different dimensions and types of staple cartridges, and may also have different shaft lengths. It has staples, dimensions, types, etc. In such an arrangement, for example, any suitable fastener or fastener (s) may be used to fasten the tissue. For example, a fastening cartridge with multiple fasteners detachably stored therein can be removably inserted into the end effector of the surgical tool assembly and / or of the surgical tool assembly. It can be detachably attached to the end effector. Other surgical tool assemblies may be used interchangeably with the handle assembly 20. For example, the replaceable surgical tool assembly 1000 may be removed from the handle assembly 20 or replaced with a different surgical tool assembly configured to perform other surgical procedures. In other arrangements, the surgical tool assembly may not be replaceable with other surgical tool assemblies, and may be non-removably attached to the handle assembly 20 or non-removable handle assembly. It essentially comprises a dedicated shaft connected to the solid 20. Surgical tool assemblies are also sometimes referred to as elongated shaft assemblies. The surgical tool assembly may be reusable, or in other configurations, the surgical tool assembly may be designed to be disposed of after a single use.

As you read through the embodiments for practicing the present invention, the various forms of interchangeable shaft assemblies disclosed herein can be effectively used in connection with robotic surgical systems. That will also be understood. Therefore, the terms "housing" and "housing assembly" as well as at least one control motion that may be used to operate the elongated shaft assembly and their corresponding equivalents disclosed herein. Can include parts of a housing or similar robotic system that accommodates or otherwise operably supports at least one drive system configured to generate or apply. The term "frame" may also mean part of a hand-held surgical instrument. The term "frame" may represent 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, Title: "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS". , Now used with various robot systems, instruments, components, and methods disclosed in US Patent Publication No. 2012/0298719.

Here, referring to FIGS. 1 and 2, the housing assembly or handle assembly 20 may be formed from a pair of housing compartments 40, 70, which may be made of plastic, polymer material, metal, etc. And are joined together by appropriate fastener arrangements such as adhesives, screws, press fitting functions, snap fitting functions, latches and the like. As will be discussed in more detail below, the main housing portion 30 generates various control movements in response to a portion of the replaceable surgical tool assembly operably attached therein. It operably supports multiple drive systems within it that are configured to be operated or applied. The handle assembly 20 further comprises a grip 100 movably connected to the main housing 30 and is configured to be gripped and operated by a clinician at various positions relative to the main housing 30. There is. The grip 100 is made of a pair of grip compartments 110, 120, which may be made of plastic, polymer material, metal, etc., and for assembly and maintenance purposes, for example, adhesives, screws, press fit functions, snap fits. They are joined together by proper fastener placement such as function, latch, etc.

As can be seen in FIG. 2, the grip 100 defines a cavity 132 configured to operably support a drive motor and gearbox, which will be discussed in more detail below. , The grip housing 130 is provided. The upper 134 of the grip housing 130 is configured to extend over the opening 80 in the main housing portion 30 and is pivotally supported on the pivot shaft 180. The Axis Shaft 180 defines an Axis of Axis, designated as "PA". See FIG. For reference purposes, the handle assembly 20 may be parallel to the shaft axis "SA" of the elongated shaft assembly of the replaceable surgical tool operably attached to the handle assembly 20, "HA". Defines the handle axis shown as. The pivot axis PA crosses the handle axis HA. See FIG. Such an arrangement provides the grip to the main housing portion 30 around the Axis PA in the position most best suited for the type of replaceable surgical tool assembly connected to the handle assembly 20. Allows 100 to rotate pivotally. The grip housing 130 defines a grip shaft, commonly referred to as "GA". See FIG. If the replaceable surgical tool assembly connected to the handle assembly 20 comprises an end cutter, for example, the clinician may say that the grip axis GA is perpendicular to or nearly perpendicular to the handle axis HA (angle "H1"). ), It may be desired to position the grip portion 100 with respect to the main housing portion 30 (referred to herein as the "first grip position"). See FIG. However, when using the handle assembly 20 to control a replaceable surgical tool assembly with a circular stapler, for example, a clinician may say that the grip shaft GA is 45 degrees or about 45 degrees to the handle shaft HA. It may be desired to pivotally rotate the grip 100 relative to the main housing portion 30 to a position at that angle, or any other suitable acute angle (angle "H2"). This position is referred to herein as the "second grip position". FIG. 5 shows the grip portion 100 with an extremely thin line at the second grip position.

With reference to FIGS. 3-5, the handle assembly 20 also includes a grip locking system, usually shown as 150, for selectively locking the grip 100 in a desired orientation with respect to the main housing portion 30. In one arrangement, the grip locking system 150 comprises a bow-shaped continuous 152 with pointed teeth 154. The teeth 154 are spaced apart from each other and form a locking groove 156 between them. Each locking groove 156 corresponds to a particular angled locking portion for the grip portion 100. For example, in at least one arrangement, the teeth 154 and the locking groove or "locking position" 156 lock the grip 100 between the first grip position and the second grip position at intervals of 10-15 degrees. Arranged to enable that. The arrangement may use two stop positions (shaft arrangements) braided according to the type of instrument used. For example, the shaft placement of the end cutter may be about 90 degrees with respect to the shaft, and the circular stapler placement may be about 45 degrees with respect to the shaft while being swept forward towards the surgeon. It's okay. The gripping locking system 150 further includes a locking button 160 having a locking portion 162 configured to be fixedly engaged with the locking groove 156. For example, the locking button 160 is pivotally attached to the main handle portion 30 by the pivot pin 131 to allow the locking button 160 to pivotally rotate into its engagement with the corresponding locking groove 156. The locking spring 164 serves to urge the locking button 160 into an engaging or locking position with the corresponding locking groove 156. The locking portion 162 and the tooth structure help allow the tooth 154 to slide past the locking portion 162 when the clinician presses the locking button 160. Therefore, in order to adjust the angular position of the grip 100 with respect to the main housing portion 30, the clinician presses the locking button 160 and then pivotally rotates the grip 100 to the desired angular position. Once the grip 100 has moved to the desired position, the clinician releases the locking button 160. The locking spring 164 then urges the locking button 160 towards a series of teeth 154, whereby the locking portion 162 enters the corresponding locking groove 156 and holds the grip portion 100 within that position during use. do.

The handle assembly 20 operably supports the first rotary drive system 300, the second rotary drive system 320, and the third axial drive system 400. The rotary drive systems 300 and 320 are each operably powered by a motor 200 supported by the grip 100. As can be seen in FIG. 2, for example, the motor 200 has a gearbox assembly 202 with an output drive shaft 204 supported and projecting from the fossa 132 in the grip 100. In various forms, the motor 200 may be, for example, a DC brushed drive motor having a maximum rotation 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 200 may, in one form, be powered by a power source 210 that may include a removable power pack 212. The power supply 210 is, for example, a variety of power supplies disclosed in more detail in US Patent Publication No. 2015/0272575, title: "SURGIC Al INSTRUMENT COMPRISING A SENSOR SYSTEM", the entire disclosure of which is incorporated herein by reference. It may have any of the arrangements. In the illustrated arrangement, for example, the power pack 212 may include a proximal housing portion 214 configured for attachment to the distal housing portion 216. The near housing portion 214 and the distal housing portion 216 are configured to operably support a plurality of batteries 218 therein. Each battery 218 may include, for example, lithium ion (“LI”) or other suitable battery. The distal housing portion 216 is configured to be detachably and operably attached to the handle circuit board assembly 220, which is also operably connected to the motor 200. The handle circuit board assembly 220 may also be commonly referred to herein as a "control system or CPU 224". A plurality of batteries 218 that may be connected in series may be used as a power source for the handle assembly 20. The power supply 210 may be replaceable and / or rechargeable. In other embodiments, the surgical instrument 10 may be powered, for example, by alternating current (AC). The motor 200 may be controlled by a rocker switch 206 attached to the grip 100.

As outlined above, the motor 200 is operably coupled to the gearbox assembly 202, which includes the output drive shaft 204. A drive unit bevel gear 230 is attached to the output drive shaft 204. The motor 200, the gearbox assembly 202, the output drive shaft 204, and the drive unit bevel gear 230 may be collectively referred to in the present specification as the "motor assembly 231". The drive unit bevel gear 230 is joined to a driven bevel gear 234 attached to the system drive shaft 232, similar to the pivot bevel gear 238 pivotally supported on the pivot shaft 180. The driven bevel gear 234 is engaged at an engagement position (FIG. 5) in which the driven bevel gear 234 meshes with and engages with the drive unit bevel gear 230 on the system drive shaft 232, and the driven gear 234 meshes with and engages with the drive unit bevel gear 230. It is movable in the axial direction with and from the disengagement position (FIG. 14). The drive system spring 235 is pivotally supported between the driven bevel gear 234 and the proximal end flange 236 formed in the proximal portion of the system drive shaft 232. See FIGS. 4 and 14. The drive system spring 235 serves to urge the driven bevel gear 234 to engage and disengage with the drive bevel gear 230, as will be discussed in more detail below. The pivot bevel gear 238 facilitates the pivot movement of the drive bevel gear 230 with the output drive shaft 204 and the grip 100 with respect to the main handle portion 30.

In the illustrated embodiment, the system drive shaft 232 is generally joined to a rotary drive selector system, designated as 240. In at least one embodiment, for example, the rotary drive selector system 240 comprises a shift lever gear 250 that is selectively movable between the first rotary drive system 300 and the second rotary drive system 320. As can be seen in FIGS. 6-9, for example, the drive selector system 240 includes a non-movable shift lever mounting plate 242 mounted within the main handle portion 30. For example, the shift lever mounting plate 242 may be functionally held between the mounting protrusions (not shown) formed in the housing compartments 40, 70, or otherwise, by means of screws, adhesives, etc. It may be held inside. Still referring to FIGS. 6-9, the system drive shaft 232 has a drive gear 237 extending over a hole in the shift lever mounting plate 242 and non-rotatably mounted in the center or system therein. For example, the central drive gear 237 may be attached to the system drive shaft 232 by the keyway arrangement 233. See FIGS. 6-9. In other arrangements, the system drive shaft 232 may be rotatably supported on the shift lever mounting plate 242 by a corresponding bearing (not shown) mounted therein. In any case, the rotation of the system drive shaft 232 results in the rotation of the central drive gear 234.

As can be seen in FIG. 3, the first drive system 300 includes a first drive bearing 302 that is rotatably supported by a distal wall portion 32 formed in the main handle portion 30. The first drive bearing 302 may include a first body portion 304 having a spline bearing formed therein. The first driven gear 306 is formed on the first main body portion 304 or is immovably attached to the first main body portion 304. The first body portion 304 may be rotatably supported in a corresponding hole or passage provided in the distal wall portion 32, or in a corresponding bearing (not shown) attached to the distal wall portion 32. May be rotatably supported by. Similarly, the second drive system 320 includes a second drive bearing 322, which is also rotatably supported at the distal wall 32 of the main handle portion 30. The second drive bearing 322 may include a second body portion 324 having a spline bearing formed therein. The second driven gear 326 is formed on the second main body portion 324 or is non-rotatably attached to the second main body portion 324. The second body portion 324 may be rotatably supported in a corresponding hole or passage provided in the distal wall portion 32, or in a corresponding bearing (not shown) attached to the distal wall portion 32. May be rotatably supported by. The first and second drive bearings 302 and 322 are arranged apart from each other on each outer portion of the handle shaft HA. See, for example, FIG.

As shown above, in the illustrated embodiment, the rotary drive selector system 240 includes a shift lever gear 250. As can be seen in FIGS. 6-9, the shift lever gear 250 is rotatably mounted on an idler shaft 252 movably supported in the bow-shaped slot 244 of the shift lever mounting plate 242. The shift lever gear 250 is attached so as to rotate freely on the idler shaft 252, and is held by meshing with and engaging with the central drive gear 234. The idler shaft 252 is connected to the end of the shaft 262 of the shift lever solenoid 260. The shift lever solenoid 260 is pinned to or otherwise attached to the main handle housing 30 so that when the shift lever solenoid 260 is activated, the shift lever gear 250 is first. It moves so as to mesh and engage with one of the driven gear 306 or the second driven gear 326. For example, in one arrangement, when the solenoid shaft 262 is pulled in (FIGS. 6 and 7), the shift lever gear 250 meshes with and engages with the central drive gear 234 and the first driven gear 306, which causes the motor 200 to operate. The result is the rotation of the first drive bearing 302. As can be seen in FIGS. 6 and 7, the shift lever spring 266 may be used to urge the shift lever gear 250 to this first actuating position. Therefore, power should be consumed by the surgical instrument 10, and the shift lever spring 266 automatically urges the shift lever gear 250 to the first position. When the shift lever gear 250 is in this position, subsequent operation of the motor 200 results in the rotation of the first drive bearing 302 of the first rotary drive system 300. When the shift lever solenoid operates, the shift lever gear 250 moves on the second drive bearing 322 so as to mesh and engage with the second driven gear 326. The operation of the motor 200 then results in the operation or rotation of the second drive bearing 322 of the second rotation drive system 320.

As will be discussed in more detail below, the first and second rotary drive systems 300, 320 are used to connect to the various components of the replaceable surgical tool assembly. , May be powered. As shown above, in at least one arrangement, the shift lever spring 266 moves the shift lever gear 250 to the first position when power is consumed by the motor during operation of the replaceable surgical tool assembly. Bounce. Reversing the application of rotational drive motion to the first drive system 300 and removing the replaceable surgical tool assembly from the patient as components of the replaceable surgical tool assembly are manipulated. It may be necessary to make it possible. The handle assembly 20 of the illustrated embodiment is, for example, a manually actuable "first aid", commonly referred to as 330, for manually applying rotational drive motion to the first rotational drive system 300 in the above scenario. You are using a "treatment" system.

With reference to FIGS. 3, 10 and 11, the illustrated first aid system 330 includes a first aid drive transmission system 332 that includes a planetary gear assembly 334. In at least one form, the planetary gear assembly 334 includes a planetary gear housing 336 that houses a planetary gear arrangement (not shown) that includes a planetary bevel gear 338. The planetary gear assembly 334 includes a first aid drive shaft 340 that is operably connected to the planetary gear arrangement within the planetary gear housing 336. The rotation of the planetary bevel gear 338 ultimately rotates the planetary gear arrangement that rotates the first aid drive shaft 340. The first aid drive gear 342 is pivotally supported on the first aid drive shaft 340 so that the first aid drive gear 342 can move axially on the first aid drive shaft 340 and still rotate with it. .. The first aid drive gear 342 is movable between the spring stop flange 344 formed on the first aid drive shaft 340 and the shaft end stop device 346 formed on the distal end of the first aid drive shaft 340. Is. The first aid shaft spring 348 is pivotally supported on the first aid drive shaft 340 between the first aid drive gear 342 and the spring stop flange 344. The first aid shaft spring 348 urges the first aid drive gear 342 distally on the first aid drive shaft 340. When the first aid drive gear 342 is located at its most distal position on the first aid drive shaft 340, the first aid drive gear 342 is a non-rotatably attached first aid driven gear 350 to the system drive shaft 232. It is in mesh and engaged. See FIG.

With reference to FIGS. 12 and 13, first aid system 330 facilitates the manual application of first aid drive motion to first aid drive transmission system 332, first aid activator assembly or first aid handle assembly. Includes 360. As can be seen in these figures, the first aid handle assembly 360 includes a first aid bevel gear 362 with a first aid bevel gear 364 and a ratchet gear 366. The first aid handle assembly 360 further includes a first aid handle 370 that is movably connected to the first aid bevel gear assembly 362 by a pivot yoke 372 that is pivotally attached to the ratchet gear 366. The first aid handle 370 is pivotally connected to the Axis York 372 by a pin 374 for selective Axis movement between the retracted position "SP" and the operating position "AP". See FIG. The handle spring 376 is used to urge the first aid handle 370 to the actuation position AP. In at least one arrangement, the angle between the axis SP representing the stowed position and the axis AP representing the operating position may be, for example, about 30 degrees. See FIG. As can also be seen in FIG. 13, the first aid handle assembly 360 further includes a ratchet pawl 378 rotatably attached to the fossa or hole 377 in the Axis York 372. The ratchet pawl 378 is configured to engage and engage the ratchet gear 366 when rotating in the working direction (AD) and then disengages and engages the ratchet gear 366 when rotating in the opposite direction. Rotate to do. The ratchet spring 384 and the ball member 386 are movably supported by the socket 379 in the pivot yoke 372 and lock the movement stops 380, 382 in the ratchet pawl 378 when the first aid handle 370 is activated (stopped). Functions to engage as possible.

With reference to FIGS. 3 and 10, the first aid system 330 further includes a first aid access panel 390 that is capable of operating between open and closed positions. In the illustrated arrangement, the first aid access panel 390 is configured to be detachably connected to the housing compartment 70 of the main housing portion 30. Thus, at least in this embodiment, if the first aid access panel 390 is removed or separated from the main housing portion 30, it can be said to be in the "open" position and, as illustrated, first aid. When the access panel 390 is attached to the main housing portion 30, it can be said to be in the "closed position". Other embodiments are conceivable, in which the access panel is movably connected to the main housing portion so that it remains attached to the access panel when it is in the open position. For example, in such an embodiment, the access panel may be pivotally attached to the main housing portion or swingably attached to the main housing portion and between the open and closed positions. It may be possible to operate with. In the illustrated embodiment, the first aid access panel 390 is configured to quickly engage a portion of the corresponding housing compartment 70 and hold it removable in the "closed" position. Other forms of mechanical fastening, such as screws, pins, etc., can also be used.

Whether the first aid access panel 390 is removable from the main housing portion 30 or the first aid access panel 390 remains movably attached to the main housing portion 30, the first aid access panel 390 is driven. Includes a system locking member or yoke 392, and a first aid locking member or yoke 396, each of which projects from behind them or otherwise forms on it. The drive system locking yoke 392 has a portion of the system drive shaft 232 inside it when the first aid access panel 390 is mounted within the main housing portion 30 (ie, the first aid access panel is in the "closed" position). Includes a drive shaft notch 394 configured to accept. First Aid When the access panel 390 is located in the closed position or mounted in the closed position, the drive system locking yoke 392 sets the drive bevel gear 234 (against the urging of the drive system spring 235) to the drive unit umbrella. Helps to urge the gear 230 to mesh and engage. The first aid locking yoke 396 is a first aid drive shaft configured to receive a part of the first aid drive shaft 340 when the first aid access panel 390 is attached or positioned in a closed position. Includes notch 397. As can be seen in FIGS. 5 and 10, the first aid locking yoke 396 also disengages the first aid drive gear 342 (against the urging of the first aid shaft spring 348) from the meshing engagement with the first aid driven gear 350. Helps to urge you to release. Therefore, the first aid locking yoke 396 prevents the first aid drive gear 342 from interfering with the rotation of the system drive shaft 232 when the first aid access panel 390 is mounted in the closed position. The first aid locking yoke 396 includes a handle notch 398 for engaging the first aid handle 370 and holding the first aid handle 370 in the retracted position SP.

FIGS. 4, 5 and 10 illustrate the arrangement of drive system components and first aid system components when the first aid access panel 390 is mounted or in the closed position. As can be seen in these figures, the drive system locking member 392 urges the driven bevel gear 234 to mesh and engage with the drive bevel gear 230. Thus, when the first aid access panel 390 is installed or in the closed position, the operation of the motor 200 results in the rotation of the drive bevel gear 230 and ultimately the system drive shaft 232. The first aid locking yoke 396 also serves to urge the first aid drive gear 342 to disengage from meshing engagement with the first aid driven gear 350 on the system drive shaft 232. Thus, when the first aid access panel 390 is installed or in the closed position, the drive system can be actuated by the motor 200 and the first aid system 330 is blocked or blocked from any actuating movement to the system drive shaft 232. Be prevented. To activate the first aid system 330, the clinician first removes the first aid access panel 390 or otherwise moves the first aid access panel 390 to the open position. This action removes the drive system locking member 392 from its engagement with the driven bevel gear 234 so that the drive system spring 235 disengages the driven bevel gear 234 from its meshing engagement with the drive bevel gear 230. Allows you to be urged. Note that removing the first aid access panel 390 or moving the first aid access panel to an open position also results in disengagement between the first aid locking yoke 396 and the first aid drive gear 342, thereby providing first aid. The shaft spring 348 allows the first aid drive gear 342 to engage and engage with the first aid drive spring 350 on the system drive shaft 232. Therefore, the rotation of the first aid drive gear 342 can result in the rotation of the first aid driven bevel gear 350 and the system drive shaft 232. To remove the first aid access panel 390 or otherwise move the first aid access panel 390 to the open position, the handle spring 376 urges the first aid handle 370 to the actuation position shown in FIGS. 11 and 14. It also makes it possible. When in this position, the clinician can manually ratchet the first aid handle 370 in the ratchet direction RD, thereby allowing the ratchet bevel gear 364 (eg, in the clockwise direction of FIG. 14). It results in rotation and ultimately the application of pull-in rotary motion to the system drive shaft 232 via the first aid drive transmission system 332. The clinician has rotated the first aid handle 370 many times until the system drive shaft 232 has rotated sufficiently many times to pull in the components of the surgical end effector portion of the surgical tool assembly attached to the handle assembly 20. You may attach a ratchet. Once the first aid system 330 is fully manually activated, the clinician then replaces the first aid access panel 390 (ie, returns the first aid access panel 390 to the closed position), thereby locking the drive system. The member 392 may urge the driven gear 234 to mesh and engage the drive gear 230, and the first aid locking yoke 396 engages the first aid drive gear 342 from the first aid wheel 350. You may urge them to release the gear. As mentioned above, the power must be lost or cut off, and the shift lever spring 266 can urge the shift lever solenoid 260 to the first actuating position. Thus, the operation of the first aid system 330 can result in the application of a reversing or pulling motion to the first rotation drive system 300.

As mentioned above, the surgical staple fastening device can include, for example, a manually actuated first aid system configured to retract the staple launch drive. In many cases, it may be necessary to operate the first aid system more than once and / or crank to fully retract the staple launch drive. In such cases, users of staple fasteners may lose track of what first aid they have cranked, or may be confused as to how much more the launch drive needs to be retracted. There is. A system configured to detect the position of the launch member of the launch drive, determine the distance required for the launch member to be retracted, and display the distance to the user of the surgical instrument, stapling. Various embodiments are envisioned with respect to the provision of the fastener.

In at least one embodiment, the surgical staple fastening device comprises one or more sensors configured to detect the position of the launching member. In at least one case, for example, the sensor comprises a Hall effect sensor and the sensor can be positioned on the shaft and / or end effector of the staple fastener. The sensor signals and communicates with the controller of the surgical stapler and sequentially with the indicator on the surgical stapler. The controller comprises a microprocessor configured to compare the actual position of the launching member with respect to the reference position, or standard position-including the fully retracted position of the launching member-and the distance, i.e., the launching member. Calculate the remaining distance between the actual position and the standard position.

In addition to the above, the display is provided, for example, with an electronic display, and the controller is configured to display the remaining distance on the electronic display in any suitable manner. In at least one case, the controller displays a progress bar on the indicator. In such cases, an empty progress bar may indicate that the launching member has completed its firing stroke, and a full progress bar may represent, for example, that the launching member has been fully retracted. In at least one case, 0% may indicate that the launching member has completed its firing stroke, and 100% may represent, for example, that the launching member has been fully retracted. In certain cases, the controller is configured to display on the indicator how many times the first aid mechanism needs to be activated in order to pull the launcher into its fully retracted position. There is.

In addition to the above, the operation of the first aid mechanism can operably shut off the battery and power supply of the surgical stapling fastener from the electric motor of the launch drive. In at least one embodiment, the activation of the first aid mechanism flips the switch, which electrically disconnects the battery from the electric motor. Such a system prevents the electric motor from resisting the manual pulling of the launching member.

The illustrated handle assembly 20 also supports a third axial drive system, commonly referred to as 400. As can be seen in FIGS. 3 and 4, the third axial drive system 400 includes, in at least one form, a solenoid 402 having a third drive member or a rod 410 projecting from it. The distal end 412 of the third drive actuator member 410 is formed therein to receive the corresponding portion of the drive system component of the replaceable surgical tool assembly operably attached therein. It has a third drive cradle or socket 414. The solenoid 402 is wire-connected or otherwise communicates with the handle circuit board assembly 220 and the control system or CPU 224. In at least one arrangement, the solenoid 402 is "spring loaded" so that if the solenoid 402 is inactive, its spring components will return the third drive actuator 410 to the inactive start position. To urge.

As shown above, the reconfigurable handle assembly 20 may advantageously be used to operate a variety of different replaceable surgical tool assemblies. The handle assembly 20 includes, for that purpose, a tool attachment, commonly referred to as 500, for operably connecting a replaceable surgical tool assembly to its end. In the illustrated embodiment, the tool mounting portion 500 faces two inwardly, configured to engage the corresponding portion of the tool mounting module portion of the replaceable surgical tool assembly. Includes a dovetail receiving slot 502. Each dovetail receiving slot 502 may be tapered, or in other words, somewhat V-shaped. The dovetail receiving slot 502 is configured to releasably receive a corresponding tapered attachment or protrusion formed on a portion of the tool attachment nozzle portion of the replaceable surgical tool assembly. .. Each replaceable surgical tool assembly may also be attached to a latching system configured to disengageably engage the corresponding retaining pocket 504 formed in the tool attachment portion 500 of the handle assembly 20. ..

Various interchangeable surgical tool assemblies may have a "major" rotary drive system configured to operably connect or join to a primary rotary drive system 310, as well as a second rotary drive system. There may be a "secondary" rotary drive system configured to operably connect or join the drive system 320. The primary and secondary rotary drive systems may be configured to provide various rotational movements into parts of certain types of surgical end effectors that include a portion of a replaceable surgical tool assembly. In order to facilitate the operable connection of the main rotary drive system to the first rotary drive system and the operable connection of the secondary drive system to the second rotary drive system 320, the tool attachment portion 500 of the handle assembly 20 is also provided. Also, a portion of the primary and secondary rotary drive systems of the replaceable surgical tool assembly is distally urged during the coupling process, thereby leading to the first rotary drive system 300 on the handle assembly 20. Configured to facilitate alignment and operational connectivity of the primary rotary drive system, as well as alignment and operational connectivity of the secondary rotary drive system to the second rotary drive system 320 on the handle assembly 20. , Includes a pair of insertion lamps 506.

The replaceable surgical tool assembly is also a "third" axial drive system for applying axial motion (s) to the corresponding portion of the surgical end effector of the replaceable surgical tool assembly. May include. Inside a protrusion or other part of the third axial drive system to facilitate the operable connection of the third axial drive system to the third axial drive system 400 on the handle assembly 20. A third drive actuator member 410 is provided, along with a socket 414 configured to operably receive.

The surgical staple fastening tool assembly, or ancillary device 11100, is shown in FIGS. 15-30. The tool assembly 11100 is configured to capture, fix, staple, and cut tissue during a surgical procedure. Primarily with reference to FIG. 15, the tool assembly 11100 includes an accessory portion 11200, a shaft assembly 11300, a joint joint 11400, and an end effector assembly 11500. The tool assembly 11100 is configured to be attached to the instrument interface by the accessory device portion 11200. The instrument interface may include a surgical instrument handle as disclosed herein. Other embodiments assume that the tool assembly 11100 is not easily attachable to and detachable from the instrument interface and instead is part of a single instrument. I assume there is. The accessory portion 11200 is configured to receive rotation control motion from the instrument interface, the tool assembly 11100 is attached, and the rotation control motion is transmitted to the shaft assembly 11300. The shaft assembly 11300 transmits these rotation control motions to the end effector assembly 11500 via the joint joint 11400.

The accessory portion 11200, illustrated in more detail in FIG. 18, is configured to be attached to an instrument interface to provide rotational control motion generated by the instrument interface to the shaft assembly 11300. Ancillary device portion 11200 comprises a main mounting interface 11210 and a sub mounting interface 11220 supported by ancillary device portion housing 11201. Mounting interfaces 11210, 11220 are configured to mesh or connect with the corresponding mounting interfaces of the appliance interface. The corresponding mounting interface of the surgical instrument handle can include, for example, a gear transmission system configured to be rotated by one or more motors when actuated by the user and, when rotated, the primary mounting. The interface 11210 and the submount interface 11220 are rotated.

The user may choose to rotate both interfaces 11210, 11220 at the same time, or instead, rotate interfaces 11210, 11220 independently. The main mounting interface 11210 is configured to rotate the input drive shaft 11211 and the input drive gear 11213 mounted therein. The input drive shaft 11211 comprises a housing bearing 11212 configured to be adjacent to the housing 11201 and prevents the shaft 11211 from translating distally. The input drive gear 11213 is operably meshed with the moving gear 11313 of the shaft assembly 11300, which is attached to the main drive shaft 11311. As a result, the rotation of the interface 11210 is transmitted to the shaft 11311. A similar arrangement is used for the submount interface 11220. The sub-mounting interface 11220 is configured to rotate the input drive shaft 11221 and the input drive gear 11223 mounted therein. The input drive shaft 11221 comprises a housing bearing 11222 configured to be adjacent to the housing 11201 and prevents the shaft 11221 from translating distally. The input drive gear 11223 is operably meshed with the moving gear 11323 of the shaft assembly 11300, which is attached to the auxiliary drive shaft 11321. As a result, the rotation of the interface 11220 is transmitted to the shaft 11321. The main drive shaft 11311 is housed in the shaft assembly housing 11301. The drive shaft 11311 transmits the rotation control motion from the accessory interface 11210 to the end effector assembly 11500 via the joint 11400. The sub-drive shaft 11321 is also housed within the shaft assembly housing 11301. The sub-drive shaft 11321 transmits the rotation control motion from the accessory interface 11220 to the end effector assembly 11500 via the joint joint 11400.

The joint portion 11400 allows the end effector assembly 11500 to be passively jointed to the shaft assembly housing 11301. Primarily with reference to FIGS. 19 and 20, the joint joint 11400 is a proximal yoke 11410 attached to a shaft housing 11301, a distal yoke 11430 attached to an end effector assembly 11500, and a proximal yoke 11410 and distal. It includes a joint pin 11420 that pivotally connects the yoke 11430. The articulating pin 11420 is rotatably received within the proximal yoke opening 11411 and the distal yoke opening 11431 defined by the proximal yoke 11410 and the distal yoke 11430, respectively. The end effector assembly 11500 is a joint axis defined by a joint pin 11420 in the lateral direction with respect to the tool assembly 11100, and more specifically, the longitudinal tool axis LT defined by the shaft housing 11301. It is configured to be articulated around the AA. Proximal yoke 11410 includes a longitudinally extending opening 11419 therein that allows the coaxial main drive shaft 11311 and the sub-drive shaft 11321 to extend within it. The articulated pin 11420 also comprises a longitudinally extending opening 11421 within which the secondary drive shaft 11321 can extend through the articulated pin 11420.

The joint portion 11400 utilizes a passive joint joint system with a joint joint lock 11440 and a non-movement stop 11413. The user may manually pivotally rotate the end effector assembly 11500 around the joint pin 11420 to move the distal yoke 11430 to the joint lock 11440. The articulated lock 11440 moves relative to the proximal yoke 11410 and rotates around the articulated pin 11420, and the articulated lock 11440 grips or incrementally grips the anti-movement 11413 defined by the proximal yoke 11410. The distal yoke 11430 is configured to lock in place, thus locking the end effector assembly 11500 in place. As described otherwise, when rotating the end effector assembly 11500 around the joint pin 11420, the passive joint system is an incremental joint joint of the end effector assembly 11500 around the joint axis AA. To promote.

The joint joint portion 11400 is further configured to transmit and communicate the rotation of the main drive shaft 11311 to the end effector assembly 11500. To transmit the rotational movement of the main drive shaft 11311 through or across the joint 11400, the joint 11400 is an idler bevel gear 11416 that is rotatable around the main drive shaft 11311, the joint pin 11420. And further include a meshed gear transmission system comprising an input bevel gear 11415 attached to an output bevel gear 11417 attached to an input drive shaft 11518. When the main drive shaft 11311 rotates, the input bevel gear 11415 rotates and the idler bevel gear 11416 rotates. The rotation of the idler bevel gear 11416 rotates the output bevel gear 11417 and thus the input drive shaft 11518 to connect the output bevel gear 11417. This arrangement allows the output bevel gear 11417 to rotate around the articulated pin 11420 when the end effector assembly 11500 is articulated while maintaining drive engagement with the main input drive shaft 11518. ..

The main input drive gear 11519 is attached to the main input drive shaft 11518 and rotates when the main input drive shaft 11518 rotates. The main input drive gear 11519 is configured to operate as a single rotation input unit of the drive system 11510, which is discussed in more detail below.

The articulation joint 11400 is further configured to allow the auxiliary drive shaft 11321 to pass through it, whereby the drive screw 11325 of the auxiliary drive shaft 11321 is driven system 11510, which is discussed in more detail below. Shift assembly 11550 may be engaged. Each of the input bevel gear 11415, the output bevel gear 11417, and the main input drive shaft 11518 has an opening configured to allow the auxiliary drive shaft 11321 to extend through it. The sub-drive shaft 11321 can be flexible, for example, so that the end effector assembly 11500 bends as it articulates around the articulation axis AA. The thrust bearing 11326 is mounted on the auxiliary drive shaft 11321 to prevent the auxiliary drive shaft 11321 from being pulled through the main input drive shaft 11518 when the end effector assembly 11500 is articulated. Bearings 11326 are bordered or bordered by a main input drive gear 11519.

The articulation joint 11400 supports the end effector frame 11600 by attaching the proximal jaw 11610 of the end effector frame 11600 to the distal yoke 11430. The distal yoke 11430 comprises a sleeve portion 11433 having an outer surface and an inner surface, the outer surface being engaged by an end effector frame 11600, and the inner surface being configured to swingably support the shift assembly 11550. ing.

Primarily with reference to FIGS. 17 and 19, the end effector assembly 11500 is mounted within a drive system 11510, an end effector frame 11600, a closed frame 11700 movable relative to the end effector frame 11600, and an end effector frame 11600. It comprises a replaceable staple cartridge assembly 11800 configured as described above. The drive system 11510 includes a single rotation input section, a joint joint 11400, configured to receive rotation control motion from the shaft assembly 11300, and includes a closed drive device 11530 and a launch drive device 11540 of the drive system 11510. Drive selectively. The closure drive 11530 interacts with the closure frame 11700 and a portion of the staple cartridge assembly 11800 to capture the tissue within the end effector assembly 11500 with respect to the closure frame 11700 and the closure frame 11600. The staple cartridge assembly 11800 is configured to move to the capture stage position. This capture step involves automatically arranging a tissue retention pin mechanism 11870 with a tissue retention pin 11871. A closure drive can then be used to move the closure frame 11700 to a fixed stage position and secure the tissue with the staple cartridge assembly 11800. Once the tool assembly 11100 is in a completely fixed arrangement, the firing drive 11540 can be operated to eject multiple staples 11880 from the staple cartridge assembly 11800 and from the staple cartridge body 11810 of the staple cartridge assembly. Knife 11840 can be placed to cut tissue captured and fixed by staple cartridge assembly 11800. The shift assembly 11550 moves between the drivability of the closed drive 11530, the drivability of the launch drive 11540, and the simultaneous drivability of both the closed drive 11530 and the launch drive 11540. Providing capabilities to users.

The staple cartridge assembly 11800 is configured to be replaceable. The staple cartridge assembly 11800 can be mounted within the end effector frame 11600, which operably engages the staple assembly 11800 with the closure frame 11700 and drive system 11510 during mounting. Referring now to FIG. 16, the end effector frame 11600 includes a proximal jaw 11610, a distal jaw 11630, and a connecting portion 11620 that connects the proximal jaw 11610 and the distal jaw 11630. The proximal jaw 11610 is configured to operably support the drive system 11510 and the closure frame 11700, and to oscillately receive and movably support the staple cartridge body 11810. The distal jaw 11630 is configured to oscillately receive and fix and support the anvil portion 11830 of the staple cartridge assembly 11800. The anvil portion 11830 includes a staple forming surface 11831 configured to form the staple 11880 and a knife slot 11835 configured to at least partially receive the knife 11840 inside. The connection 11620 is configured to receive and support the anvil frame 11820 of the staple cartridge assembly 11800 having the locator pin arrangement 11821. The locating pin arrangement 11821 allows the staple cartridge assembly 11800 to be quickly and / or easily loaded into the end effector assembly 11500. The locating pin function unit 11821 corresponds to the recess of the locating pin at the connection unit 11620 of the end effector frame 11600. The staple cartridge assembly 11800 further comprises a guide pin 11823. The cartridge body 11810 is configured to move relative to the end effector frame 11600 using a knife and a cartridge guide pin 11823 for support and guidance purposes.

The cartridge body 11810 includes a cartridge deck 11811 having a plurality of staple cavities 11818 configured to detachably store the staples 11880, a knife slot 11815 in which the knife 11840 is movably positioned, and pins 11823 and 11871. It comprises a pair of pin slots 11812 configured to accept within it. The cartridge deck 11811 further comprises a closure stop device 11813 configured to be adjacent to the anvil portion 11830 when the cartridge body 11810 advances toward the staple forming surface 11831. The closure stop device 11813 defines the shortest reachable distance between the deck 11811 and the staple formation surface 11831 when the closure stop device is adjacent to the staple forming surface 11831. That said, it is assumed that the closure stop device 11813 may not come into contact with the staple forming surface 11831, for example, when thick tissue is stapled.

The closing frame 11700 engages with the cartridge drive tab 11701, the cartridge grip recess, or the cartridge body 11810, and allows the closing frame 11700 to push the cartridge body 11810 toward the distal jaw 11630. It also includes a functional unit 11703 configured to pull the cartridge body 11810 away from the distal jaw 11630. The cartridge drive tab 11701 engages the drive surface 11801 of the staple cartridge body 11810 so that the closure frame 11700 anvils the cartridge body 11810 when the closure frame 11730 is moved distally by the closure drive device 11530. It can be pushed or driven towards 11830. The cartridge gripping function unit 11703 is configured to act as a hook or arm and to pull the cartridge 11810 proximally when the closure frame 11700 is moved proximally by the closure drive device 11530.

Moving on to FIG. 17, the staple cartridge assembly 11800 further includes a plurality of drive units 11851 supported by the staple drive unit base 11850. The drive unit 11851 is configured to support the staples 11880 and push the staples 11880 out of their respective staple cavities 11818. The staple drive base 11850 and the knife 11840 are driven by the main drive 11860, which interacts with the launch bar 11560 of the drive system 11510. The knife 11840 is attached to the main drive 11860 by a knife support 11843. The launch drive 11540 interacts with the main drive 11860 so that when the launch drive 11540 is activated, the launch bar 11560 pushes the main drive 11860 distally and finally the staple cartridge assembly. The staple 11880 is ejected from the solid 11800 to place the knife 11840. The launch drive 11540 can operate to pull in the launch bar 11560, which pulls in the main drive 11860 using the knife reaction arm 11651 engaged with the launch bar 11560 and the main drive 11860. The main drive 11860 is a slot 11863 configured to receive the knife reaction arm 11651, and a launch bar guide configured to act as a positioning interface between the launch bar 11560 and the main drive 11860. It is equipped with pin 11865.

As mentioned above, the drive system 11510 of the end effector assembly 11500 engages with a single rotary input or main input drive gear 11519 to affect the combined function of the tool assembly 11100. Referring now to FIG. 24, the drive system 11510 comprises a closed drive 11530, a launch drive 11540, and a shift assembly 11550 to drive the closed drive 11530 and the launch drive 11540. And also provide the user with the ability to selectively move between the simultaneous driveability of both the closed drive 11530 and the launch drive 11540. As mentioned above, the interface 11220 can be selectively rotated to operate the shaft 11321. The shaft 11321 comprises a screw-in portion, or drive screw, 11325 that is screwably engaged with the shift assembly 11550. The shift assembly 11550 is longitudinally movable along the longitudinal tool axis LT using the drive screw 11325 of the auxiliary drive shaft 11321. When the sub-attachment interface 11220 rotates, the shift assembly 11550 moves relative to the distal yoke 11430. It is envisioned that instead of the shaft 11321, a motor and / or solenoid is positioned within the end effector assembly 11500 to move the shift assembly 11550 to and from the indicated position.

The closed drive device 11530 includes an input drive shaft having an input drive gear 11339 and an input spline portion 11538. The input drive gear 11339 meshes operably with the main input drive gear 11519. The closure drive 11530 further comprises an output shaft having an output spline portion 11537 and a screwed portion 11536. The output shaft of the closed drive 11530 is aligned with the input drive shaft of the closed drive 11530. When the main input drive gear 11319 rotates, the output shaft of the closed drive 11530 rotates in unison with the input drive shaft of the closed drive 11530 only when the splines 11538, 11537 are connected by the shift assembly 11550. The screwed portion 11536 of the output shaft of the closing drive device 11530 is screwably received by the screwing hole 11736 of the closing frame 11700. When the output shaft of the closure drive 11530 rotates, the closure frame 11700 moves relative to the end effector frame 11600, the staple cartridge body 11810 advances distally toward the anvil portion 11830, and within the end effector assembly 11500. Try to fix the tissue to.

The launch drive 11540 also comprises an input drive shaft having an input drive gear 11549 and an input spline portion 11548. The input drive gear 11549 also operably meshes with the main input drive gear 11519. The launch drive 11540 further comprises an output shaft having an output spline portion 11547 and an input spline portion 11546. The output shaft of the launch drive 11540 further comprises a tubular launch shaft 11545 that receives the input spline portion 11546 within the launch shaft hole 11545B. The tubular launch shaft 11545 rotatably engages the rib 11546S of the input spline portion 11546, whereby the tubular launch shaft 11545 is rotatably engaged with the input spline portion 11546 while maintaining a rotated driveable relationship with the input spline portion 11546. Moves in the longitudinal direction with respect to. The output shaft of the launch drive 11540 is aligned with the input drive shaft of the launch drive 11540. When the main input drive gear 11319 rotates, the output shaft of the launch drive 11540 rotates in unison with the input drive shaft of the launch drive 11540 only when the splines 11548, 11547 are connected by the shift assembly 11550.

The tubular launch shaft 11545 further comprises a launch shaft surface 11544 and further a screw output shaft 11543 that is screwably received by the launch bar 11560. If the closure frame 11700 advances distally by the closure drive 11530, the closure frame 11700 pushes the launch bar 11560 distally. As the launch bar advances distally through the closing frame 11700, the tubular launch shaft 11545 is screwed into engagement with the launch bar 11560 at least by screwing out the output shaft 11543 with respect to the input spline portion 11546 by the launch bar 11560. It is attracted to the distal side. The tubular launch shaft 11545 is axially received by a launch hole 11745 defined in the closure frame 11700 to allow rotation of the tubular launch shaft 11545 within the closure frame 11700. When the spline portions 11548 and 11547 are connected, the input spline portion 11546 rotates the tubular launch shaft 11545 of the launch drive device 11540, and similarly, the launch shaft surface 11544 of the tubular launch shaft 11545 launches the closing frame 11700. Press the spline portion 11744. By utilizing the flap 11744 as a movable contact mechanism, the tubular launch shaft 11545 drives the launch bar 11560 distally by the screwed output shaft 11543, thus placing the knife 11840 and stapling. Staples 11880 are ejected from the fossa 11818.

Connecting and disconnecting the set of splines 11537, 11538 and the set of 11547, 11548 allows the user to move the shift assembly 11550 between the driveability options described above. do. The shift assembly 11550 screwably accepts the drive screw 11325 of the auxiliary drive shaft 11321 so that when the drive screw 11325 rotates, the shift assembly 11550 sets the spline portions 11537, 11538 and 11547, 11548. A screw opening 11555 is provided that moves longitudinally with respect to the set of. The shift assembly 11550 further comprises a spline closure coupling or clutch ring 11553 corresponding to the closure drive 11530 and a spline launch coupling or clutch ring 11554 corresponding to the launch drive 11540. The spline connecting portions 11553, 11554 are cylindrical, tubular connecting portions pivotally supported within the shift assembly 11550 and are capable of rotating within the shift assembly 11550. Each of the spline connecting portions 11553, 11554 has an inner shell having a spline arrangement, whereby the connecting portions 11553, 11554 connect or bite a set of spline shaft portions 11537, 11538 and a set of 11547, 11548, respectively. Can be matched. When the shift assembly 11550 moves and the end effector assembly 11500 is placed in a fixed tissue arrangement, the closed connection portion 11553 engages the spline portions 11537, 11538. The closed connection portion 11553 transmits the rotation of the spline shaft portion 11538 to the spline shaft portion 11537, thus rotating the output shaft of the closed drive device 11530. The launch coupling 11554 engages the spline 11547, 11548 as the shift assembly 11550 moves to place the end effector assembly 11500 in a tissue cutting and stapled arrangement. The launch connection 11554 transmits the rotation of the input spline shaft 11548 to the output spline 11547, thus rotating the output shaft of the launch drive 11540. The shift assembly 11550 also has a columnar recess 11556 that allows the shift assembly 11550 to nest with respect to the thrust bearing 11326 of the secondary drive shaft 11321 when moved proximally to the second position. Be prepared.

The user of the tool assembly 11100 performs any function between the fixed state and the staple forming state via the instrument interface to which the controller built-in tool assembly 11100 and / or the tool assembly 11100 is attached. The tool assembly 11100 can be moved as desired. The controller may communicate with the motor to operate either the main accessory interface 11210, the sub-accessory interface 11220, or both the main accessory interface 11210 and the sub-attachment interface 11220 at the same time. With reference to FIGS. 25-30, the interaction and engagement between the drive system 11510 and the end effector assembly 11500 is possible for the tool assembly 11100, including capture, fixation, stapling, and tissue cutting. Features will be discussed here.

FIG. 25 shows the tool assembly 11100 in open or initial placement. In the shift assembly 11550, the closed connecting portion 11553 connects the spline shaft portions 11538 and 11537 of the closed driving device 11530 to drive the output shaft of the closed driving device 11530 when the main input drive gear 11319 rotates. It is in the first position to enable. The launch connector 11554 is in a position where it meshes only with the output shaft of the launch drive 11540. In this case, the launch coupling portion 11554 is not at a position configured to engage the spline shaft portions 11538, 11537. At this position, the launch coupling 11554 does not rotate within the shift assembly 11550 because the output shaft of the launch drive 11540 does not drive during rotation of the main input drive gear 11519.

The operation of the closure drive 11530 performs two functions, pinning (capturing) the tissue within the end effector assembly 11500, and fixing the tissue within the end effector assembly 11500. The main accessory interface 11210 is activated while the shift assembly 11550 is in the first position to capture the tissue within the tissue retention pin 11871. Since the main input drive gear 11519 is driven and the closed connection engages with both splines 11538 and 11537 of the closed drive 11530, the output shaft of the closed drive 11530 rotates to move away from the closed frame 11700. Advance to the rank. This initial distal movement of the closing frame 11700 automatically places the tissue retention pin mechanism 11870 with the lever 11770. The coupling portion 11873 having the coupler recess 11876 is configured to receive the lever tip portion 11774 extending from the pair of lever arms 11772 and connect the tissue holding pin mechanism 11870 and the lever 11770. A cartridge cap 11878 with a cap window 11877 and a cap base 11875 allows the lever 11770 to engage the staple cartridge assembly 11800 and interact with the pin mechanism 11870. The cap base 11875 defines the contact surface position for the pin, the coupler portion 11873, and thus the pin mechanism 11870. The lever 11770 interacts with the end effector frame 11600, the closure frame 11700, and the tissue retention pin mechanism 11870 to place the pin 11871. The lever 11770 includes a contact pin 11771 supported within a frame opening 11671 of the end effector frame 11600 and a frame slot 11741 of the closing frame 11700. Contact pin 11771 defines the lever rotation axis. The lever 11770 also comprises a lever arm 11772 having an actuating tine 11737 configured for engagement of the closing frame 11700 with the closing frame cam slot 11734. The lever further comprises a lever tip 11774 configured for engagement of the pin mechanism 11870 with the coupler portion 11873.

As best seen in FIGS. 21-23, the closure frame cam slot 11734 of the closure frame 11700 drives the actuating tine 11737 distally so that the lever 11770 rotates around the lever rotation axis and thus the lever. It comprises an early cam slot 11734A configured to pull up the tip 11774 to remove the pin 11871 from the corresponding pin slot 11812 and drive it towards the distal jaw 11630. The closing frame cam slot 11743 also comprises a final cam slot portion 11743B, allowing clearance in the closing frame 11700 for the actuating tine 11773 during the fixation phase discussed in more detail below. Activating tine 11773 prevents the tissue retention pin 11871 from being pulled in adjacent to the final cam slot portion 11743B during the fixation phase, or prevents opening during the fixation and / or firing / housing staple fastening phase. The frame slot 11741 also provides clearance, except for the contact pin 11771 during the fixation stage. The initial actuation phase of the closure drive 11530 is the initial capture phase in which the tissue retention pin 11871 is placed for engagement with the distal jaw 11630 and / or the anvil 11830 of the staple cartridge assembly 11800. Complete. This initial capture step may be sufficient to capture the tissue with the tool assembly 11100, as can be seen in FIG.

During the initial capture phase, the closure frame 11700 also advances a portion of the staple cartridge assembly 11800 and advances the firing bar 11560 towards the distal jaw 11630. The cartridge drive tab 11701 drives the cartridge body 11810, and the closing frame 11700 drives the tubular launch shaft 11545 and launch bar 11560. Other and / or additional contact points may be provided between the closing frame 11700, the launch drive 11540, and the staple cartridge assembly 11800 to assist in advancing certain parts of the end effector assembly 11500. .. As described above, the tubular launch shaft 11545 and the input spline portion 11546 of the launch drive 11540 can move longitudinally with respect to each other while maintaining a rotatable drive relationship. This facilitates the extension of the output shaft of the launch drive 11540, which may drive the tubular launch shaft 11545 if the input spline portion 11546 is driven after the closing frame 11700 has advanced.

FIG. 27 shows the tool assembly 11100 in a fully fixed arrangement after the final actuation stage of the closed drive 11530. The closure stop portion 11813 is bounded by an anvil portion 11830 and the tissue retention pin mechanism 11870 is fully disposed. To fully position the tissue retention pin mechanism 11870, the closing frame cam slot 11743 comprises the final cam slot end 11743C to advance the actuating tine 11737 to its final position. The arrangement of the tool assembly 11100 is considered to be in a completely fixed position. The user may decide to operate the closure drive in the opposite direction to retract the closure drive so that the tissue is not fixed and not captured, or the user can see the shift assembly in FIG. 28. It may be determined to move to the second position shown and launch the tool assembly 11100.

To move the shift assembly to the second position shown in FIG. 28, the user can actuate the sub-attachment interface 11220, which causes the drive screw 11325 to rotate and move the shift assembly 11550 to the second position. Move proximal to position. The shift assembly 11550 is configured to nest with respect to the thrust bearing 11326 as it moves to the second position. In the second position, the launch coupler 11554 of the shaft assembly 11550 connects the spline shaft portions 11548, 11547 of the launch drive 11540 to the output shaft of the launch drive 11540 during rotation of the main input drive gear 11519. Allows to be driven. Moving the shift assembly 11550 to the second position also disconnects the spline shaft portions 11538, 11537 of the closure drive device 11530. The closed coupler 11553 rotates in the shift assembly 11550 when the main input drive gear 11519 is driven, but the output shaft of the closed drive 11530 does not rotate because the closed coupler 11553 meshes only with the input spline portion 11548. ..

The user can now operate the launch drive 11540 by driving the main accessory interface 11210 to drive the main drive shaft 11311. The operation of the launch drive 11540 rotates the output spline portion 11546, thereby rotating the tubular launch shaft 11545. The tubular launch shaft 11545 rotates within the launch hole 11745 of the closing frame 11700. When the tubular launch shaft 11545 rotates, the launch shaft contact surface 11544 of the tubular launch shaft 11545 pushes out the projectile portion 11744 of the closing frame 11700, or is contacted by the projectile shape portion 11744 of the closing frame 11700. Rotation of the tubular launch shaft 11545 rotates the screwed output shaft 11543, thereby driving the launch bar 11560 distally. Distal movement of the firing bar 11560 causes the knife 11840 to be dislocated from the cartridge body 11810 and to drive the staple 11880 with the staple drive 11851 and drive base 11850 detached from the staple fossa 11818. The knife 11840 cuts the tissue fixed by the end effector assembly 11500, and the staple 11880 staples the tissue fixed by the end effector assembly.

At the stage shown in FIG. 29, the user can pull in the launch bar 11560 in opposite directions by activating the main accessory interface 11210, which pulls the drive bar 11560 and the knife 11840 proximally. The launch bar 11560 is configured to axially support the launch bar guide pin 11860 to maintain alignment of the launch bar 11560 and the main drive 11860 during movement of the launch bar 11560 and the main drive 11860. It also has an opening 11565. The launch bar 11560 also comprises a slot 11563 configured to receive the knife retracting arm 11651, which causes the launch bar 11560 to pull the knife 11840 proximally when the launch bar 11560 moves proximally. Can or can be pulled in. Another option for the user can involve moving the shift assembly 11550 to a third position, which is intermediate between the first and second positions, by activating the sub-attachment interface 11220. This third position, shown in FIG. 30, positions both couplers 11553, 11554 into a coupling engagement with their respective sets of spline portions 11538, 11537 and 11548, 11547. The user can then operate the main accessory interface 11210 in the reverse direction to operate the main drive gear 11519 and simultaneously drive both the output shaft of the closed drive 11530 and the output shaft of the launch drive 11540. can. The user desires this simultaneous driveability at any time to provide a rapid pull-in method when the user desires to pull the tool assembly 11100 out of the surgical unit while using the tool assembly 11100. May be done. The main input drive gear 11519 is inverted by programming a controller with a built-in appliance interface to automatically move the shift assembly 11550 to the third position and operate both the accessory interfaces 11210 and 11220 at the same time. Can be made to.

The tool assembly 11100'is shown in FIGS. 30A-30G. The tool assembly 11100'is similar to the tool assembly 11100 in many respects. Primarily with reference to FIG. 30A, the tool assembly 11100'is a joint joint connecting the accessory device portion 11200, the shaft 11300 extending from the accessory device portion 11200, the end effector 11500', and the end effector 11500' to the shaft 11300. The unit 11400'is provided. Primarily with reference to FIG. 30B, the end effector 11500'can be inserted into and into the end effector frame 11600' and the end effector frame 11600'and the anvil jaw 11630', and from the end effector frame 11600' and the anvil jaw 11630'. It is equipped with a removable staple cartridge 11800'. The staple cartridge 11800'provides a cartridge body 11810' that is slidable with respect to the anvil jaw 11630'between the open and non-fixed position (FIG. 30D) and the closed and fixed position (FIG. 30E). As described in more detail below, the tool assembly 11100' includes a closed drive 11530' configured to move the cartridge body 11810'to and from its non-fixed and fixed positions. Primarily with reference to FIG. 30F, the tool assembly 11100'is also configured to eject staples detachably stored in the staple cartridge 11800'after the cartridge body 11810' has moved to its fixed position. It comprises a launch drive 11540', which is described in more detail below.

As mentioned above, the articulation joint 11400 comprises a proximal yoke 11410 and a distal yoke 11430 rotatably connected by a pin 11420. The arthroplasty 11400'provides a similar arrangement that includes the proximal yoke 11410'and the distal yoke 11430'. Similarly, as described above, the joint joint portion 11400 includes bevel gears 11415, 11416, and 11417 that operably mesh with each other and transmit the rotation of the drive shaft 11311 to the drive system 11510. The articulated joint 11400'provides a similar arrangement of bevel gears configured to transmit the rotational motion of the shaft 11311 to the drive system 11510'. Further, the articulated joint 11400'is nested in the bevel gears 11415, 11416 and 11417 configured to articulate the end effector 11500'to the shaft 11300, and the second meshing bevel gears 11495'and 11496'. Equipped with a set of. The bevel gear 11495'is rotatably supported by the proximal yoke 11410' and operably engages the articulated input shaft 11391'(FIG. 30D) and the bevel gear 11496'. The bevel gear 11496'is fixedly attached to the distal yoke 11430'. A portion of the bevel gear 11496' extends into the notch 11439' of the distal yoke 11430'. Rotation of the input shaft 11391'in the first direction rotates the end effector 11500'in the first direction, and similarly, rotation of the input shaft 11391'in the second or opposite direction is in the second direction or Rotate the end effector 11500'in the opposite direction. The tool assembly 11100'may be actuated by an electric motor of the instrument interface to which the assembly 11100' is attached to rotate the input shaft 11391'. However, the tool assembly 11100'can be actuated by any suitable means.

Similar to the drive system 11510 of the end effector 11500, the drive system 11510'of the end effector 11500'operably engages the bevel gear 11417 and is operably the drive gear 11339 and launch drive of the closed drive 11530'. It includes an input gear 11519 that meshes with the drive gear 11549 of 11540'. Also, like the drive system 11510, the drive system 11510'has a first position (FIGS. 30D and 30E) and a first position (FIGS. 30D and 30E) to move the shaft assembly 11100' between a closed or fixed operation mode and a firing operation mode. It comprises a shift lever block or assembly, 11550'that can be moved between two positions (FIG. 30F). The drive gear 11339 is attached to the spline shaft 11538', and when the shift lever block 11550'is in its first position (FIGS. 30D and 30E), the spline shaft 11538'is the spline of the closed drive device 11530'. It is rotatably connected to the shaft 11537'. The spline shaft 11537'provides a screw-in distal end 11536 that engages the closure frame 11700'to be screwable, and the closure frame 11700' when the spline shaft 11537' is rotated in the first direction by the spline shaft 11538'. 'And the cartridge body 11810' are located distally as shown in FIG. 30E to close the end effector 11500'. Specifically, the rotation of the drive gear 11549 of the launch drive 11540'is a distal portion of the launch drive 11540' via the shift lever block 11550' when the shift lever block 11550'is in its first position. Not transmitted to. As a result, the closed drive 11530'operates the launch drive 11540' independently and further operates the launch drive 11540' until the shift lever block 11550' moves to its second position. I can't.

In addition to the above, the drive gear 11549 is attached to the spline shaft 11548', and when the shift lever block 11550'is in its second position (FIG. 30F), the shift lever block 11550'is the spline shaft. The 11548'is rotatably connected to the spline shaft 11547' of the launch drive 11540'. The spline shaft 11547'provides a distal end 11546 fixed to the rotatable drive shaft 11545 of the launch drive 11540', which causes both the spline shaft 11547' and the drive shaft 11545 to rotate. The drive shaft 11545 includes a screw-in distal end 11543 that screwably engages the launch block 11560', and the launch block 11560'is rotated in the first direction by the spline shaft 11548'. Displaced distally, the spline is fired from the spline cartridge 11800'to cut the tissue trapped between the spline cartridge body 11810' and the anvil jaw 11630'. Like the launch drive 11540 above, the launch drive 11540' includes a staple drive 11850', a knife block 11860', and a knife 11840', which fire during the launch stroke of the launch drive 11540'. Pushed distally by block 11560'. Specifically, the rotation of the drive gear 11339 of the closed drive 11530'is a distal portion of the closed drive 11530' via the shift lever block 11550' when the shift lever block 11550'is in its second position. Not transmitted to. As a result, the launch drive 11540'operates the closed drive 11530' independently.

In addition to the above, when comparing FIGS. 30D and 30E, it is noted that the launch drive 11540'extends or fits when the closure drive 11530'operates to close the end effector 11550'. , The reader must understand. As a result, the distal end 11546 of the spline shaft 11547'maintains rotatable engagement with the drive shaft 11545. Primarily with reference to FIG. 30C, the closure frame 11700'is adjacent to a shaft brim 11544 defined on the drive shaft 11545 when the closure frame 11700' is driven distally to close the end effector 11550'. The hook 11744'is configured to attract the drive shaft 11545. As will be described later, when the closed drive 11530'operates to reopen the end effector 11500', the drive shaft 11545 is pushed proximally to fold the launch drive 11540'.

After the launch stroke of the launch drive 11540', the spline shaft 11548' rotates in a second or opposite direction, pulling the launch block 11560', knife block 11860', and knife 11840' proximally. Specifically, the staple drive unit 11850'is not pulled into the firing block 11560'. However, in other embodiments, the staple drive unit 11850'can be retracted. Once the knife 11840'is fully pulled under the deck of the cartridge body 11810', the shift lever block 11550'can move back to its first position and move the launch drive 11540' from the drive shaft 11311. Disconnect as possible and similarly reconnect the closed drive 11530'operably within the drive shaft 11311. In such a position, the spline shaft 11538'can rotate in the second or opposite direction, pulling the cartridge body 11810'and the closing frame 11700'proximal and reopening the end effector 11500'. do.

The end effector 11500' includes a motor 11322' configured to move the shift lever block 11550'between its first and second positions, as described above. Motor 11322' includes a housing located within motor support 11329' mounted on the closing frame 11700'. The housing of the motor 11322'is completely mounted within the motor support 11329', which prevents the housing from moving relative to the motor support 11329'. Motor 11322 ′ further comprises a rotatable output shaft 11325 ′ that is screwably engaged with a screw opening 11555 defined by the shift lever block 11550 ′. When the motor 11322'operates in the first direction, the threaded output shaft 11325' moves the shift lever block 11550' to its first position. When the motor 11322'operates in the second direction, the threaded output shaft 11325' moves the shift lever block 11550' to its second position.

Primarily with reference to FIG. 30G, the battery and controller system 11324'is configured to communicate with motor 11322' to power motor 11322'. If the user and / or computer of the surgical instrument interface to which the instrument 11100'is attached wishes to move the shift block 11550', for example, a signal is wirelessly transmitted to the battery and controller system 11324. In other cases, the signal can be communicated to the system 11324'via the conductor. This signal is then communicated to motor 11322'to activate motor 11322'. In at least one alternative embodiment, a solenoid can be used to move the shift lever block 11550'.

The reader should understand that extending battery life can be important for such systems. Instrument 11100'is configured to take in kinetic energy during various stages of movement. The appliance 11100'provides an energy intake system capable of converting the motion of the drive system 11510' into electrical energy and storing that energy in the battery. The energy uptake system comprises a coil 11327'housed within the distal yoke 11430' and located close to the proximal portion of the closed drive 11530. Coil 11327'is electrically connected to the battery and controller system 11324' via conductor 11326'. A shaft extending proximally from the drive gear 11339 comprises a magnetic disk 11328' mounted on it. As the closed drive 11530'rotates, the magnetic disk 11328' rotates in close proximity to the coil 11327' to generate an electric current in the energy uptake system.

The energy intake system can operate as a generator when the shift lever block 11550'is in the neutral position (FIG. 30G). In this neutral position, the spline coupler 11554 meshes only with the spline shaft 11547', and similarly, the spline coupler 11553 meshes only with the spline shaft 11537'. Therefore, when the drive input unit 11519 rotates, the energy intake system is configured to generate energy to recharge the battery without performing any instrument function. Specifically, the energy intake system can also operate as a generator when the shift lever block 11550'is in its first and second positions. During fixation and / or firing, in such cases, the magnetic disk 11328'is rotated by the input 11339, regardless of which instrument function is activated. The energy taken in may be supplied to the battery and / or motor 11322'during the fixing and / or firing operation of the end effector 11500'.

A surgical staple attachment or tool assembly, 12100, is shown in FIGS. 31-50. The tool assembly, or instrument 12100, is configured to capture, fix, and staple tissue during a surgical procedure. Primarily with reference to FIGS. 31-33, the tool assembly 12100 includes an accessory portion 12200, a shaft assembly 12300, a joint joint 12400, and an end effector assembly 12500. The tool assembly 12100 is configured to be attached to the instrument interface by the accessory device portion 12200. The instrument interface may include a surgical instrument handle as disclosed herein. Other embodiments assume that the tool assembly 12100 is not easily attachable to and detachable from the instrument interface and instead is part of a single instrument. I assume there is. The accessory portion 12200 is configured to receive rotation control motion from the instrument interface, the tool assembly 12100 is attached, and the rotation control motion is transmitted to the shaft assembly 12300. The shaft assembly 12300 transmits these rotation control motions via the joint joint 12400 and the end effector assembly 12500.

Ancillary device portion 12200 comprises a conduction device system 12210. As shown in FIG. 34, the conduction device system 12210 housed within the accessory device portion housing 12201 comprises an accessory device interface 12220 with a coupler section 12223. The coupler portion 12223 is configured to operably couple to the appliance interface. The transmission device further includes a housing bearing 12221, an input shaft 12221 connected to the coupler portion 12223, and an input drive gear 12213 attached to the input shaft 12211. When the coupler unit 12223 is operated by the instrument interface, the input drive gear 12213 drives the main drive shaft gear 12313 to drive the main drive shaft 12311 attached to the main drive shaft gear 12313.

Primarily with reference to FIGS. 35-38, the end effector assembly 12500 is mounted within a drive system 12510, an end effector frame 12600, a closed frame 12700 movable relative to the end effector frame 12600, and an end effector frame 12600. It comprises a replaceable staple cartridge assembly 12800 configured as described above. The drive system 12510 includes a single rotation input section configured to receive rotation control motion from the shaft assembly 12300 and drives the main drive 12520 to secure the tissue within the tool assembly 12100. do. The main drive 12520 is configured to interact with the end effector assembly 12500 to move the closure frame 12700 and thus the staple cartridge assembly 12800 distally. The distal movement of the closure frame 12700 also results in the automatic placement of tissue retention pins 12860 of the staple cartridge assembly 12800 to capture tissue. The main drive 12520 is further configured to fire the tool assembly 12100 once it has reached a fully fixed arrangement. Launching the tool assembly 12100 involves arranging a plurality of staples from the staple cartridge assembly 12800 to staple the captured tissue and secure it with the tool assembly 12100.

The end effector frame 12600 houses various components of the end effector assembly 12500. The end effector frame 12600 houses the closing frame 12700 of the staple cartridge 12800. Within the end effector frame 12600, the closing frame 12700 and the staple cartridge assembly 12800 can reciprocally move. The end effector 12600 includes a proximal neck portion 12610, a first side frame 12620A, and a second side frame 12620B. Proximal neck 12610 is attached or connected to joint joint 12400. The articulated joint 12400 comprises a flexible neck 12401 configured to allow the user of the tool assembly 12100 to passively articulate the end effector assembly 12500 to the shaft housing 12301. .. An embodiment is envisioned in which the tool assembly 12100 does not have a joint and the proximal neck 12610 is attached directly to the shaft housing 12301 of the shaft assembly 12300.

The proximal neck 12610 and the first and second side frames 12620A, 12620B accommodate specific components of the end effector assembly 12500, including the drive system 12510. The first and second side frames 12620A, 12620B include proximal jaws 12621A, 12621B, intermediate jaws 12622A, 12622B, and distal jaws 12623A, 12623B, respectively. The distal jaws 12623A, 12623B are held together by an anvil 12640 having at least a staple forming surface 12641. Arrangements of bolts, screws, and / or rivets can be used, for example, to attach the side frames 12620A, 12620B to each other. The end effector frame 12600 is positioned between the intermediate jaws 12622A, 12622B and provides a gap for a portion or portion of the staple cartridge assembly 12800, which is lateral to the end effector frame 12600 as it moves. A spacer member 12630 that slides between the intermediate portions 12622A and 12622B of the frames 12620A and 12620B is further provided.

The closure frame 12700 is configured to push the staple cartridge assembly 12800 distally towards the anvil 12640 during operation of the main drive 12510. The closing frame 12700 includes a cartridge body drive surface 12708 for contacting and driving the staple cartridge body 12810 of the staple cartridge assembly 12800. The staple cartridge body 12810 includes a deck 12811, a plurality of staple pits 12813, and a closure stop 12815. The staple cartridge assembly 12800 also comprises a plurality of staples 12830 detachably housed within the staple fossa 12813. The plurality of staples 12830 are configured to be formed with respect to the staple forming surface 12641. The tool assembly 12100 is envisioned to reach a fully fixed arrangement when the closure stop 12815 lands adjacent to the staple forming surface 12461 and / or in a recess defined in the anvil 12640. When the staple cartridge assembly 12800 reaches its fully fixed position, the closure stop 12815 never reaches the anvil 12640 or the staple forming surface 12641, and instead the closure stop 12815 is adjacent to the staple forming surface 12461. Embodiments that are positioned to do so are also envisioned. Control of the distance between the deck 12811 and the staple forming surface 12641 in a fully fixed arrangement can be performed using the drive system 12510, which is described in more detail below.

With reference to FIGS. 36-38, the end effector assembly 12500 is shown in an unlocked arrangement prior to the operation of the drive system 12510. The end effector assembly 12500 is configured to capture, fix, and staple the tissue within the tool assembly 12100 by utilizing the rotational motion provided by the main drive shaft 12311. The closing frame 12700 is advanced or actuated to actuate the pin actuating mechanism 12560 in order to capture the tissue using the tool assembly 12100. The actuation of the pin actuating mechanism 12560 causes the tissue retention pin 12860 of the staple cartridge assembly 12800 to be placed. The pin actuating mechanism 12560 includes a pin lever 12651 and a contact pin 12565 fixed and extending from the end effector frame 12600. The contact pin 12565 defines the holding pin axis around the rotation of the pin lever 12651. The closure frame 12700 comprises a pair of contact pin slots 12706 defined on their opposite sides to provide clearance for the contact pins 12565, whereby the closure frame 12700 is relative to the contact pins 12565. Can be moved. The pin lever 12561 comprises a pair of lever arms 12562 comprising a pair of actuating protrusions or tines, 12563, received within a pair of cam slots 12702 defined by the closing frame 12700. The cam slot 12702 replaces the actuating protrusion 12563 distally and laterally as the closure frame 12700 moves longitudinally within the end effector frame 12600 to rotate the pin actuation mechanism 12560 around the retention pin axis. It is configured as follows. The pin lever 12651 further comprises a lever tip 12564 extending from the lever arm 12562. The lever tip portion 12564 extends to the coupler portion 12861 of the tissue holding pin 12860 to connect the pin actuating mechanism 12560 and the pin 12860. Tissue retention pin 12860 further comprises a pin shaft or rod, 12863, and a manual override knob 12865. When the pin actuating mechanism 12560 is actuated by the closing frame 12700, the lever tip 12564 advances the pin shaft 12863 towards the anvil 12640.

The manual override knob 1286 on pin 12860, for example, in the event of a drive system 12510 failure or power loss, allows the user of the tool assembly 12100 to manually retract the pin shaft 12863 to the staple cartridge assembly 12800. It is configured to allow it to be returned. The actuating protrusion 12563 provides the user with the ability to shear the protrusion 12563 from the lever arm 12562 and thus allows the pin lever 1256 to rotate freely around the tangent pin 12565. It may be composed of a more fragile material and / or form than 12562. As a result of this free rotation, the coupler section 12861 can move proximally to the staple cartridge body 12810, even with some resistance, thus allowing the pin shaft 12863 to be manually retracted. To. In addition to or instead of the above, the actuating protrusion 12563 is substantially thin, allowing the lever arm 12562 to be folded inward or curved when the manual override knob 12856 is pulled proximally. It may consist of a configuration or a feature, which inwardly prompts the actuating protrusion 12563 to disengage from the cam slot 12702 to provide the free rotation described above.

When unused or unfired, the cartridge can be mounted within the end effector assembly 12500 to activate the main drive 12520. As discussed in more detail below, the end effector assembly 12500 comprises one or more lockouts that are destroyed when an unused staple cartridge is inserted into the end effector assembly 12500. In any case, the main drive 12520 moves the closure frame 12700 and staple cartridge assembly 12800 towards the anvil 12640 to capture and fix the tissue with the end effector assembly 12500, as well as the tool assembly. It causes the 12100 to be fired and stapled to the tissue. The main drive 12520 comprises an input drive gear 12521 that is drivably meshed with the main input gear 12310. The input drive gear 12521 is attached to a main drive shaft 12523 comprising a drive screw portion 12525. The main drive 12520 also comprises a thrust bearing arrangement 12524 configured to support the shaft 12523. The drive screw portion 12525 is screwably received in the closing nut tube or the closing drive device, the screw opening 12531 of the 12530. The closing nut tube 12530 comprises a plurality of tabs 12533 that are movably supported within the mechanical holes 12563 of the inner frame structure 12650 and are received within the plurality of longitudinal extending slots 12653S within the frame holes 12653. , Prevents the closing nut tube 12530 from rotating with the drive screw portion 12525. Even though the illustrated embodiment includes four tabs 12533, only one tab 12533 and the corresponding slot 12653S may be sufficient. When the drive screw portion 12525 rotates in the first direction, the closing nut tube 12530 moves or slides in the longitudinal direction in the frame hole 12653, but does not rotate in the frame hole 12653. As a result of this distal movement, the trap 12537 of the closing nut tube 12530 pushes the closing frame 12700 so that the closing frame 12700 moves distally. When the drive screw portion 12525 rotates in the second position, the drive screw portion 12525 pulls the closing nut tube 12530 proximally.

When the closing nut tube 12530 reaches the most distal position associated with the complete fixation position of the staple cartridge 12800, the tab 12533 enters the distal annular recess 12653AD defined in the closing tube 12530. The annular recess 12653AD provides a clearance for the tab 12533. When tab 12533 is aligned with annular recess 12653AD, tab 12533 no longer prevents rotation of the closing nut tube 12530. As a result, the rotation of the drive screw portion 12525 when the closing nut tube 12530 reaches this most distal position results in the simultaneous rotation of both the closing nut tube 12530 and the drive screw portion 12525.

At this stage, further operation of the drive system 12510 in the same direction results in the launch of the tool assembly 12100. In various cases, the drive system 12510 may simultaneously generate a fixed-to-launch translation without interference. In various other cases, the tool assembly 12100 may be configured to interfere with the operation of the drive system 12510 when the closing nut tube 12530 reaches its most distal position. In each case, the tool assembly 12100 is configured to fire after the drive system 12510 has moved the cartridge assembly 12800 to a fully fixed position. The closing nut tube 12530 further comprises a launch screw portion, or launch drive device, 12535, which is screwably received by the launch nut portion 12555 of the drive portion bar 12550. Since the closing nut tube 12530 rotates freely here, the firing screw portion 12535 rotates here as the drive screw 12525 rotates to rotate the drive portion bar 12550 distally. The drive bar 12550 pushes the staple cartridge drive 12820 distally, thereby ejecting the staple 12830 from the staple cartridge assembly 12800. The staple drive unit 12820 supports the plurality of staples 12830 by a plurality of staple drive units 12823, each of which has a support cradle 12824. The staple drive unit 12820 moves distally toward the anvil 12640 within the staple cartridge body 12810 and ejects the staples 12830 from the staple fossa 12813 toward the staple retaining formation surface 12461. Any suitable number of columns may be used, even though only two columns of staples are shown. The drive bar 12550 is guided by the closing frame 12700 using guide pins 12553 and the corresponding guide pin slots 12703.

As described above, the main drive 12520 is activated to advance the closure frame 12700 to capture and immobilize the tissue within the end effector assembly 12500 and then advance the drive bar 12550 distally. By letting, the tissue is stapled. However, as mentioned above, the main drive 12520 cannot operate until the unused staple cartridge assembly is mounted within the end effector assembly 12500. A lockout drive 12540 is provided that provides this type of lock arrangement. More specifically, the lockout drive 12540 utilizes the same input as the main drive 12520 to prevent the hand main drive 12520 from being driven when the lockout drive 12540 is in a locked configuration. .. The main drive 12520 can be driven when the lockout drive 12540 is in the unlocked arrangement.

Referring to FIGS. 38-41, the lockout drive 12540 includes an outer drive gear 12541 that operably meshes with a main input gear or a common drive input unit, 12310, attached to the main drive shaft 12311. The lockout drive 12540 is configured to be engaged by a shaft 12542, a spring mounted interference gear 12545 that contacts the internal frame structure 12650 of the end effector frame 12600, and a key portion 12817 of the staple cartridge assembly 12800. A distal lock portion 12547 is further provided. The closing frame 12700 includes a window portion 12707 (FIG. 35) that allows relative movement between the closing frame 12700 and the distal locking portion 12547. The outer drive gear 12541 includes a serrated portion 12541S configured to swingably support and engage the inner spline or the inner drive gear 12543 attached to the shaft 12542. As a result, it is possible to allow the relative movement of the shaft 12542 and the outer drive gear 12541 in the front-rear direction while maintaining the drive relationship between the inner drive gear 12543 and the outer drive gear 12541. For example, the interference gear 12545 having a press-fitting relationship with the shaft 12542 is stopped in a normal position by a spring 12544 with respect to the inner frame structure 12650 of the end effector frame 12600. The spring 12544 may be composed of, for example, a compression spring. The shaft 12542 is always propelled distally at the closing frame 12700 by a spring 12544 that propels the interference gear 12545 towards the lockout slot 12704S of the lockout window 12704. The shaft 12542 is in the lock arrangement when the interference gear 12545 is in the lockout slot 12704S. This locking arrangement prevents the shaft 12542 from rotating and prevents the outer drive gear 12541 from being driven. This prevents the outer drive gear 12541 from being driven and prevents the drive system 12510 from operating. In the locked arrangement, the drive system 12510 may be, for example, in a joined state. The controller of the instrument handle and / or the on-board controller may detect the junction relationship, for example by measuring the energy spike, and then grasp the power delivered to the motor when the energy reaches its limit. ..

In order to place the lockout drive 12540 in an unlocked arrangement, the staple cartridge assembly must be mounted within the end effector assembly 12500. The key portion 12817 of the staple cartridge assembly 12800 is configured to contact the lamp surface 12548 of the distal lock portion 12547 and push the distal lock portion 12547 proximally. By pushing the distal lock 12547 proximally, the shaft 12542 is propelled proximally. By pushing the shaft 12542 proximally, the interference gear 12545 is moved from the lockout slot 12704S to a free rotation position in the lockout window 12704. If the interference gear 12545 can rotate freely, the shaft 12542 can also rotate. If the shaft 12542 is rotatable, the lockout drive 12540 is in an unlocked arrangement that allows the input gear 12310 to drive the main drive 12520 and the lockout drive 12540 at the same time. In the unlocked arrangement, the drive system 12510 is no longer in a joined state.

The distal lock 12547 is pinned to the shaft 12542 by the pin 12547P. The pin 12547P is received in the shaft opening 12549P of the shaft 12542 so that, for example, when the lockout drive 12540 is driven, the shaft 12542 and the pin 12547P both rotate due to the tight fit. This allows the pin 12547P to rotate within the distal lock 12547. Therefore, in addition to the spring-loaded interference gear 12545 prompting the shaft 12542 distally when shifting to the locking arrangement, the distal locking portion 12547 pushes the pinhead of pin 12547P distally and the distal locking portion. The 12547 also results in pulling the shaft 12542 distally (see FIG. 41). The distal locking portion 12547 is sandwiched or nested from the lever arm 12562. The drive bar 12550 includes a clearance slot 12547 for the distal lock 12557.

A separate lockout is provided to prevent the drive system 12500 from operating when the used staple cartridge assembly is installed within the end effector assembly 12510. The used cartridge lockout member or cartridge drive engaging arm, 12660, is positioned between the side frames 12620A, 12620B. The lockout member 12660 includes a spring member 12661 and a drive bar fastener mechanism or a hook 12663. The lockout member 12660 is shown in the unlocked arrangement of FIGS. 35-38. The staple cartridge assembly 12800 mounted within the end effector assembly 12500 is unused in FIGS. 35-37. Unused cartridges include a staple drive 12820 that has not been fired and is in its most recent position. In various embodiments, the staple drive unit, such as the staple drive device 12820, is not retracted after firing, so that when fired, the staple drive unit in the used cartridge remains in the most distal position. This causes the lockout member 12660 to be prompted by the spring member 12661 to catch the drive bar 12550 in the absence of the staple drive, but the cartridge is used due to the absence or presence of the staple cartridge assembly. Is it because of it? The drive system 12510 is activated when stopped by the cartridge drive stop mechanism 12663 at any rate. The lockout arrangement also puts the drive system 12510 in a joined state.

Primarily with reference to FIGS. 39-46, the operation of the drive assembly 12100 is described herein with respect to surgical staple procedures, or operations. The tool assembly 12100 is shown in the non-captured, non-fixed, non-launched, non-locked arrangement of FIGS. 39-41. The tool assembly 12100 is unlocked because the unused staple cartridge assembly 12800 is mounted within the end effector assembly 12500. The interference gear 12545 is pushed out of the lockout slot 12704S and freely rotates in the lockout window 12704 and the window or fossa of the inner frame structure 12650, 12655. The lockout member 12660 is pushed away from the drive bar 12550 by the staple drive 12820 of the unused staple cartridge assembly 12800, thereby providing a non-closing passage for the drive bar 12550 for movement. The actuating tine 12563 of the pin actuating mechanism 12560 is located in the first portion of cam slot 12702. The instrument user may now place tissue between the instrument cartridge deck 12811 and the anvil 12640 to prepare for tissue capture.

Here, referring to FIGS. 42-43, the drive system 12510 is activated and the tissue is captured by the tool assembly 12100. The closing frame 12700 automatically arranges the pin actuating mechanism 12560 and the pin 12860 by camming the actuating protrusion 12563 with the cam slot 12702. Pin 12860 contacts the anvil 12640, which defines the completed tissue capture process. The closing frame 12700 also advances the staple cartridge assembly 12800 distally towards the anvil. At this time, the tool assembly 12100 may continuously operate the main drive 12520 to completely fix the tissue. However, if the user wishes not to capture the tissue currently being captured (tissue not shown), the user operates the drive system 12510 in the opposite direction to invert the drive system 12510, thereby pinning. The actuating mechanism 12560 may be rotated around the pin holding axis to pull in the pin shaft 12863. For example, when the pin shaft 12863 reaches the perfect position, the instrument may be fitted into the sensor for detection. Detecting the complete placement of the pins results in a temporary pause in operation, allowing the user to decide whether to anchor the captured tissue at this stage and ultimately staple it. Can be. Once the user decides to fix the captured tissue and finally staple it, the user may further activate the main drive system 12510 to trigger the start of the fixing process.

In FIGS. 42 and 43, the shaft 12542 of the lockout drive 12540 springs back to its original position when it loses contact with its urging member, which is the key portion 12817 of the staple cartridge body 12810. In other words, the spring 12544 is in its neutral, uncompressed state. The interference gear 12545 is still in a free rotation position, one due to the lockout window 12655 of the inner frame structure 12650 and two due to the distal movement of the closing frame 12700. The inner drive gear 12543 moves in the longitudinal direction within the meshing relationship with the inner spline portion 12541S, which allows the lockout drive 12540 to rotate when the drive system 12510 is activated. To support. The closing nut tube 12530 tab 12533 is positioned in slot 12653S to translate the closing nut tube 12530 into the frame hole 12653 as the drive screw portion 12525 rotates.

Moving on to FIG. 44, the tool assembly 12100 in a perfectly fixed arrangement is shown. The tab 12533 of the closing nut tube 12530 reaches their distal position, where it allows the closing nut tube 12530 to rotate. When the tool assembly 12100 reaches a fully fixed position, the operation of the main drive 12510 is temporarily stopped, whereby the user of the tool assembly 12100 is captured and fixed here. It may be further configured so that it can be ascertained whether is the target organization to be stapled. If the user of the tool assembly 12100 wishes not to fix the tissue, the drive system 12510 may be inverted so that the tab 12533 of the closing nut tube 12530 is placed back into the slot 12653S of the hole 12653, thereby. The drive screw portion 12525 may pull back the closing nut tube 12530 and, as a result, pull back the closing frame 12700 proximally. If the user determines that the tissue captured and anchored here is the tissue of interest to be stapled, the user triggers further operation of the manual drive 12510 to fire the tool assembly 12100. You can.

FIG. 45 shows the tool assembly 12100 in full launch arrangement. The firing screw portion 12535 rotates to advance the drive portion bar 12550 to the anvil 12640 and push the staple drive portion 12820 distally within the staple cartridge body 12810. This distal advance of the staple drive 12820 results in the placement of the staple 12830 from the staple fossa 12813. The guide pin 12553 partially advances from its corresponding guide pin slot 12703 in the closing frame 12700. Upon full launch of the tool assembly 12100, the tool assembly 12100 automatically flips the drive system 12510 to pull in the staple cartridge assembly 12800 to defix and non-capture the tissue that has just been stapled. It's okay. This automatic pull-in may be due, for example, to any suitable sensor configured to ensure that the staple 12830 has been fully fired. In one case, full operation of the drive bar 12550 may be detected. In another case, the firing screw portion 12535 can be configured to rotate a specified number of revolutions to advance the staple drive to a specified distance, and when the specified number of revolutions has been rotated, the tool can be configured. The instrument interface to which the assembly 12100 and / or the tool assembly 12100 is attached may initialize automatic pull-in. This can be advantageous, for example, when different staple cartridge assemblies are used and the distance required for the drive bar 12550 to move is modified to accommodate different staple heights.

With reference to FIG. 46, the tool assembly 12100 is shown in a non-captured, non-fixed, fully fired arrangement. The lock member 12660 is pushed outward by the drive bar 12550. The lock member 12660 also pokes its drive bar fastener mechanism 12663 directly under the staple drive 12820. The fastener mechanism 12663 alone may prevent the staple drive unit 12820 of the staple cartridge assembly 12800 used here from moving proximally for any reason. The tab 12533 of the closing nut tube 12530 is in their most recent position. This nearest position places the tab 12533 in the proximal annular recess 12653AP in the launch hole 12653. The annular recess 12653AP allows the closing tube to rotate at the same time as the drive screw portion 12525 to pull in the drive portion bar 12550.

FIG. 47 shows a tool assembly 12100 with a staple cartridge assembly 12800 not mounted within the end effector assembly 12500. Prior to the non-mounting of the staple cartridge assembly 12800, the fastener mechanism 12663 of the locking member 12660 is urged inward by the spring member 12661 to fasten the drive bar 12550. At this position, the drive system 12510 is in a joined state because the drive bar 12550 cannot move forward. The locking member 12660 remains in this position when the used staple cartridge assembly 12800 is removed from the tool assembly 12100. Upon removal of the staple cartridge assembly 12800, the lockout drive 12540 activates its locking function. The spring 12544 induces an interference gear 12545 because the distal lock 12547 is not pushed proximally by the cartridge body key member, which causes the shaft 12542 to interfere in the lockout slot 12704S of the lockout window 12704. Position gear 12545 distally. Without the staple cartridge assembly mounted within the end effector assembly 12500, the lock member 12660 and the lockout drive 12540 provide two activators, or mechanisms, to prevent actuation of the drive system 12510. do.

With reference to FIG. 48 here, the unused cartridge assembly 12800 is shown as not mounted within the end effector assembly 12500. The base portion 12821 of the staple drive portion 12820 is configured to unlock the locking member 12660 by contacting the fastener 12663 and pushing and releasing the fastener 12663 from the drive portion bar 12550. As described above, the key portion 12817 is configured to engage the lamp surface 12548 of the distal lock portion 12547 to push the interference gear 12545 out of the lockout slot 12704S into a free rotation position.

The staple cartridge assembly 12800 further comprises a status indicator system that visually displays the status of the staples 12830 to the user of the tool assembly 12100. With reference to FIGS. 49 and 50, the staple cartridge assembly 12800 is in a completely fixed arrangement, with the staple drive 12823 of the staple drive 12820 partially extending onto the deck 12811 of the cartridge body 12810. Shown in a stapling arrangement. The cartridge window portion 12853 is provided in the staple cartridge body 12810 to indicate the movement of the staple drive portion 12823. The movement of the staple drive unit is displayed by the visual display units 12823A and 12823B on the staple drive unit 12823 itself. For example, the visual display units 12823A and 12823B may include, for example, a single color whose brightness or hue changes to indicate the progress of the staple drive unit 12823 within the cartridge body 12810. Higher brightness may indicate that the staple drive 12823 is approaching or has reached the perfect launch position. In other cases, the staple drive 12823 contains two colors, and the first color 12823A, such as blue, indicates, for example, that the progress of the staple drive 12823 is intermediate, and a second color, such as red. 12823B may indicate, for example, that the staple drive 12823 has reached the perfect launch position.

A surgical staple attachment, or tool assembly, 13100, is shown in FIGS. 51-69. The tool assembly, or instrument 13100, is configured to fix, staple, and cut tissue during a surgical procedure. Primarily with reference to FIGS. 51-55, the tool assembly 13100 includes an accessory portion 13200, a shaft assembly 13300, a joint joint 13400, and an end effector assembly 13500. The accessory device portion 13200 is configured to be attached to the interface of the surgical instrument. The device interface can include, for example, a handle as disclosed herein. Other embodiments assume that the tool assembly 13100 is not easily attachable to and detachable from the instrument interface and instead is part of a single instrument. I assume there is. The accessory portion 13200 is configured to receive rotation control motion from the instrument interface, to which the tool assembly 13100 is attached, and to transmit the rotation control motion to the shaft assembly 13300. As discussed in more detail below, the shaft assembly 13300 transmits these rotational control motions to the end effector assembly 13500 via the joint joint 13400.

The accessory device portion 13200 includes a housing 13201 and a joint transmission, and additionally a transmission 13205 including an end effector transmission. Referring to FIG. 56, the articulated transmission includes a jointed drive coupler 13210 (FIG. 52), an input shaft 13212, and a housing bearing 13211 configured to receive rotational movement from the instrument. The bearing 13211 rotatably supports the input shaft 13212. The input shaft 13212 includes a worm gear portion 13213 that meshes with the worm wheel 13214. The worm wheel 13214 works in translation or in conjunction with the pinion gear 13215 to actuate the articulated shaft or rod 13320 of the shaft assembly 13300. The gear 13215 rotates with the worm wheel 13214. The articulated shaft 13320 comprises a rack 13325 located on their proximal portion that meshes with the pinion gear 13215, whereby the articulated shaft, or link, 13320, when the pinion gear 13215 is rotated by the input shaft 13212. Moves longitudinally to actuate the end effector assembly 13500.

The end effector assembly 13500 is shown in FIG. 65 in a non-joint or neutral arrangement. As shown in FIG. 66, the articulated joint shaft 13320 can be pushed distally to actuate the end effector assembly 13500 in the first direction. Similarly, as shown in FIG. 67, the articulated joint shaft 13320 can be pulled proximally to actuate the end effector 13500 in the second or opposite direction. As shown in FIGS. 65-67, the articulated shaft 13320 is not directly attached to the end effector 13500, but rather the articulated shaft 13320 is attached to the end effector 13500 via the articulated link 13324. .. In the neutral or non-joint arrangement of the end effector 13500, as shown in FIG. 55, the joint link 13324 is a region proximal to the joint axes A-A to a region distal to the joint axes A-A. It extends to. Also, in the neutral arrangement of the end effector 13500, the articulated link 13324 is positioned on only one side of the longitudinal axis LA defined by the tool assembly 13100 and / or the shaft housing 13301. The joint link 13324 is an end effector assembly 13500 around the joint axes A to A when the joint shaft or drive, 13320, is translated proximally and / or distally by the joint transmission. It has a curved arrangement configured to assist in articulation.

The end effector assembly 13500 comprises a frame, or spline, 13501 that extends distally from the joint joint 13400. The articulation joint 13400 is attached to the proximal yoke 13401 fixedly attached to the shaft housing 13301, the distal yoke arm 13402 fixedly attached to the lower end effector spine 13501, and the upper end effector spine 13501. It comprises a distal yoke arm 13403 obtained in a fixed manner. The yoke arms 13402, 13403 are configured to rotate with respect to the yoke 13401 around the joint joint axes A through A. Although not shown, the pin or rod may be positioned along the articulated axes A to A such that the proximal yoke 13401 and the yoke arms 13402, 13403 rotate pivotally around. The articulated link 13324 is connected by a pin 13404 to the distal yoke arm 13403 at the top, which allows the articulated shaft 13320 to move longitudinally with respect to the shaft housing 13301. Can push or pull the upper yoke arm 13403 to actuate the end effector assembly 13500 around the articulation axes A-A.

The end effector transmission device of the transmission device 13205 includes a main drive coupler, 13220, configured to receive rotational motion from a drive input unit or instrument interface. The end effector transmission device further comprises a housing bearing 13221 that rotatably supports the input shaft 13222 and the input shaft 13222. The input shaft 13222 is arranged between the closed drive gear 13223 axially supported above it, the launch drive gear 13224 axially supported above it, and the closed drive gear 13223 and the launch drive gear 13224. The spline shaft portion 13225 is provided. The firing drive gear 13224 meshes with the corresponding output firing drive gear 13344 of the shaft assembly 13300, while the closure drive gear 13223 meshes with the corresponding output closing drive gear 13333 of the shaft assembly 13300.

The shift lever mechanism 13230 of the end effector transmission device is capable of moving between the driveability of the closed drive gear 13223 and the driveability of the launch drive gear 13224. The closing drive gear 13223 and the firing drive gear 13224 do not rotate unless they are engaged by the shift lever mechanism 13230. The closed drive gear 13223 comprises a set of teeth or protrusions, 13226, arranged on the side surface of a set of closed drive gears 13223 facing the launch drive gear 13224. The firing drive gear 13224 comprises a set of teeth or protrusions, 13227, located on the side surface of a set of firing drive gears 13224 facing the closed drive gear 13223. The shift lever body or disc 13235 is a second of the disc 13235 facing the teeth or protrusions 13236 and the firing drive gear 13224, located on the first side of the disc 13235 facing the closed drive gear 13223. It comprises a tooth or protrusion, 13237, arranged on the side. The shift disk 13235 meshes with the spline shaft portion 13225 and is slidable with respect to the spline shaft portion 13225. The shift disc 13235 is held by a shift lever arm 13233 actuated by a shift solenoid 13231 so that the first position where the disc 13235 is in mesh engagement with the closed drive gear 13223 and the disc 13235 are in mesh engagement with the firing drive gear 13224. The shift lever arm 13233 is moved to and from a second position. When the disk 13235 engages the closed drive gear 13223, the rotation of the drive coupler 13220 causes the closed drive gear 13223 to rotate, thereby rotating the closed shaft 13330. Similarly, when the disc 13235 engages with the launch drive gear 13224, the rotation of the drive coupler 13220 causes the launch drive gear 13224 to rotate, thereby rotating the launch shaft 13340. Operation of the shift solenoid 13231 may be accomplished via an on-board controller 13203 configured to receive signals from the appliance interface and deliver these signals to the shift solenoid 13231.

Moving to FIG. 57, the joint joint portion 13400 receives the rotation control motions from the shaft assembly 13300 and transmits or transmits these rotation control motions to the end effector assembly 13500 as described above. It is configured to do. Rotating the closing shaft 13330 of the shaft assembly 13300 to the closing shaft of the end effector assembly 13500, or the drive, 13530, while maintaining the ability to actuate the end effector assembly 13500 with respect to the shaft assembly 13300. The articulated joint 13400 comprises an arrangement of bevel gears for transmission and further for transmitting the rotational movement of the launch shaft 13340 to the launch shaft of the end effector assembly 13500, or to the drive 13540. The launch shaft 13340 meshes with and engages with the input bevel gear 13441 attached to the distal end of the launch shaft 13340, the idler bevel gear 13442 that meshes with and engages with the input bevel gear 13441, and the idler bevel gear 13442, and is an end effector. It comprises an output bevel gear 13443 attached to the launch shaft 13540 of the drive system of the assembly 13500. The idler bevel gear gear 13442 has a common rotation axis with respect to the joint joint axes A to A. In addition to the above, the closing shaft 13330 has an input bevel gear 13431 attached to the distal end of the closing shaft 13330, a rotating axis common to the articulated joint axes A to A, and with the input bevel gear 13431. It comprises an idler bevel gear 13432 that meshes and engages, and an output bevel gear 13433 that meshes and engages with the idler bevel gear 13432 and is attached to the closing shaft 13530 of the drive system of the end effector assembly 13500. The bevel gears 13441, 13442, 13443 are nested within the bevel gears 13431, 13432, 13433, whereby the (inner) launching bevel gears 13441, 13442, 13443 are placed on the (outer) closed bevel gears 13431, 13432, 13433. On the other hand, it can rotate and vice versa.

The output bevel gears 13433 and 13443 are rotatable around the joint connection axes A to A. Since the end effector assembly 13500 is articulated, the output bevel gears 13433 and 13443 are configured to reverse both the idler bevel gears 13432 and 13442. The reverse rotation of the idler bevel gears 13432 and 13442 causes the reverse rotation of the input bevel gears 13431 and 13441, which in turn causes the closing shaft 13330 and the firing shaft 13340 to rotate. In order to prevent the end effector assembly 13500 from being joined in the end effector while being jointed, the on-board controller 13203 of the accessory unit 13200 signals the shift solenoid 13231 when the user activates the joint drive coupler 13210. The shift disc 13235 may be positioned in a neutral position where the shift disc 13235 does not engage with either the drive gear 13223 or 13224 supported axially. As a result, the drive gears 13223 and 13224 can rotate freely with respect to the input shaft, thereby diffusing the rotation of the bevel gear assembly due to the joint joint.

The end effector assembly 13500 further comprises a first jaw portion 13510 and a second jaw portion 13520 that are movable relative to each other. Moving on to FIG. 58, the end effector assembly 13500 comprises a closure system configured to move jaws 13510, 13520 between open and closed positions. The closure system comprises a closure frame 13535 having a closure nut 13536 that screwably engages with the closure screw portion 1353 of the closure shaft 13530. The closing frame 13535 is movable with respect to the end effector frame 13501 during operation or rotation of the closing shaft 13530. The rotation of the closing shaft 13530 in the first rotation direction causes the distal movement of the frame 13501. The rotation of the closing shaft 13530 in the second rotation direction opposite to the first rotation direction causes the proximal movement of the frame 13501. The thrust bearing 13533, located at the distal end of the closure shaft 13530, is supported within the frame support 13503 of the end effector frame 13501. As discussed in more detail below, the end effector assembly 13500 also comprises a launch system 13550 actuated by the launch drive gear 13541 of the launch shaft 13540. The closing shaft 13530 and the firing shaft 13540 are configured to rotate independently of each other.

FIG. 64 is a partial view of the end effector assembly 13500 in an open or non-fixed arrangement. In order to secure the tissue by the tool assembly 13100, the actuation of the closure drive 13530 causes both jaws 13510 and 13520 to move from the open position to the closed position. The rotation of the closing drive device 13530 rotates the closing screw portion 13531. The rotation of the closing screw portion 13351 causes the closing nut 13536 to rotate, thereby translating the closing frame 13535 with respect to the end effector frame 13501. When the closing frame 13535 is fully retracted, the closing nut 13536 is configured to be received in a recess defined between the yoke arms 13402, 13403.

The end effector frame 13501 is at least partially positioned within the closure frame 13535 so that the two lateral sides of the end effector frame 13501 are received within the corresponding slots of the closure frame 13535. Such a configuration allows the end effector frame 13501 to extend through the closing frame 13535 and also allows the closing frame 13535 to move relative to the end effector frame 13501. The end effector assembly 13500 further comprises an anvil portion 13521 arranged on a jaw portion 13520 configured to form a staple 13575. The jaw 13520 is at least partially positioned within the end effector frame 13501. The jaw 13520 comprises a pair of closing frame slots 13537 defined by the closing frame 13535 and a pair of actuating pins 13527 movable within a pair of end effector frame slots 13507 defined by the end effector frame 13501. .. The jaw portion 13520 further comprises a proximal hook portion 13522 with a pair of slots 13522S located therein. The proximal hook portion 13522 is configured to be hooked or latched to the frame pin 13502 of the end effector frame 13501. The jaw 13520 is pivotable around the frame pin 13502. The open slot arrangement of the hook portion 13522 allows the jaw portion 13520 to be removed from the end effector assembly 13500 if the user wishes to replace the jaw portion 13520 for any reason.

The jaw 13520, which is contacted by the pin 13502 and rotatable by the pin 13502, rotates to the closed position by advancing the closing frame 13535 distally, and the pair of closing cam surfaces 13537C of the closing frame slot 13537 Cams pin 13527 of jaw 13520 towards jaw 13510. The jaw 13510, which is contacted by the pin 13515 and rotatable around the pin axis defined by the pin 13515, moves to the rotational position by advancing the closure frame 13535 distally to close the closure frame 13535. The cam surface 13532 cams the bottom surface 13512 of the jaw 13510 toward the jaw 13520. Similarly, moving the closure frame 13535 proximally causes the jaw 13520 to move to the open position, causing the pair of open cam surfaces 13537O (see FIG. 68) of the closure frame slot 13537 to move to the jaw 13520. Pin 13527 is camped upwards. The end effector frame slot 13507 is a clearance slot for the pin 13527 when the pin 13527 is camped upwards and downwards with respect to the frame 13501. The jaw 13510 moves to the open position by moving the closing frame 13535 proximally, the closing cam surface 13532 moves proximally, and the jaw 13510 descends and opens relative to the frame 13501. To enable. Jaw 13510 includes a pair of curved recesses 13517 that provide clearance for pins 13527.

In addition to the above, as can be seen in FIG. 69, the peripheral axis around which the jaw 13510 rotates and the peripheral axis around which the jaw 13520 rotates are not the same. The axes complement each other vertically and horizontally. The peripheral axis around which the jaw 13510 rotates is distal to the peripheral axis around which the jaw 13520 rotates. The vertical distance between the axes may define a predetermined tissue gap distance and / or fixed distance between the cartridge 13570 and the anvil 13521.

In addition to the above, when the tool assembly 13100 is in a non-fixed arrangement (FIG. 66), the closing nut 13536 is in its most recent position, which is a recess defined between the yoke arms 13402, 13403. In the non-fixed arrangement, the upper surface of the jaw 13520 is completely exposed, allowing the user of the tool assembly 13100 to remove the jaw 13520 from the instrument. This provides an easily replaceable anvil arrangement.

The end effector frame 13501 supports a launch system 13550 configured to staple and / or cut the tissue secured by the tool assembly 13100. The launch system 13550 is configured to be actuated by the launch drive gear 13541 of the launch shaft 13540, as discussed in more detail below. The jaw, or cartridge support channel, 13510 comprises a pair of pivot pins 13515 extending outward with respect to the jaw 13510 configured to be received within a pair of corresponding frame openings 13505. The jaw 13510, and thus the staple cartridge 13570, can be pivotally rotated with respect to the end effector frame 13501 around the pivot axis defined by the pin 13515.

The launch system 13550 includes a drive gear 13551 that meshes with the launch drive gear 13541. The drive gear 13551 is positioned on the proximal launch shaft 13552 rotatably supported by the frame support 13504 of the end effector frame 13501. The launch system 13550 comprises a proximal thrust bearing 13554 supported within the thrust bearing support 13514 of the jaw 13510 and a distal thrust bearing 13556 supported within the upper and lower bushing assemblies 13573. Further prepare. The bushing assembly 13573 is located within the distal cartridge fossa 1357. The launch system 13550 further comprises a U-joint 13535 that operably connects the launch shaft 13552 and the launch screw shaft 13555. The U junction 13353 allows the jaw 13510 to rotate around a pivot axis defined by pin 13515 while maintaining a driving relationship between the proximal launch shaft 13552 and the launch screw shaft 13555. do. In various cases, the U junction 13353 is located on the axis defined by the Axis pin 13515, but the U junction 13353 may be located at any suitable location.

The launch system 13550 further comprises a launch member or thread, 13560. The thread 13560 comprises a screw-in opening extending through which it screwably engages with the firing screw shaft 13555. Thread 13560 is restrained from rotation by the firing screw shaft 13555, and at least substantially restrained from rotating, and as a result, when the firing screw shaft 13355 rotates around its longitudinal axis, the firing screw shaft 13555 Shifts the thread 13560 in the longitudinal direction. When used, the thread 13560 is displaced distally when the launch screw shaft 13555 rotates in the launch direction, and the thread 13560 is displaced proximally when the launch screw shaft 13555 rotates in the second direction.

As described in more detail below, while the staple firing stroke ejects the staple 13575 from the staple cartridge 13570 and staples the tissue captured between the anvil section 13521 and the staple cartridge 13570. The thread 13560 is displaced distally between the unlaunched position (FIG. 59) and the launched position (FIG. 60). From FIGS. 59 and 60, the reader should understand that the tissue is not stapled while being stapled. More specifically, the thread 13560 comprises a knife, or cutting member, 13651, which remains unpositioned or in a downward position during the staple firing stroke. After the staple firing stroke is complete, here with reference to FIG. 61, the thread 13560 is pulled proximally. Thread 13560 is pulled proximally until the cutting member 13651 comes into contact with a pin, or cam, 13516 extending from the frame of the staple cartridge 13570. The cutting member 13651 is rotatably attached to the thread 13560, and when the cutting member 13651 comes into contact with the pin 13516, the cutting member 13651 rotates upward to the placement position. At this point, as shown in FIG. 63, the thread 13560 can once again advance distally to cut the stapled tissue during the cutting stroke.

The cutting member 13651 moves within the longitudinal slot 13571 defined in the staple cartridge 13570. Pin 13516 extends from thrust bearing support 13514 and is aligned with longitudinal slot 13571. As shown in FIG. 61, when the thread 13560 is in the unlaunched position (FIG. 59), the cutting member 13651 does not contact the pin 13516, but the thread 13560 is pulled proximal to its unlaunched position. , The cutting member 13651 comes into contact with the pin 13516 and rotates to its placement position. More specifically, the cam arm 13566 of the cutting member 13651 engages the pin 13516 and rotates upward from its non-cutting position to its cutting position.

As mentioned above, FIG. 59 shows a tool assembly 13100 with an unlaunched or initial arrangement at. In such an unlaunched arrangement of the tool assembly 13100, similarly, as described above, the thread 13560 is in its unlaunched position and the cutting member 13651 is in its uncut position. The tool assembly 13100 may be configured to detect if the thread 13560 is in its unlaunched position and / or if the cutting member 13651 is in its uncut position. In at least one case, the staple cartridge 13570 may include a first sensor configured to detect the presence of the thread 13560 when the thread 13560 is in the unlaunched position. Similarly, the staple cartridge 13570 can include a second sensor configured to detect the presence of the cutting member 13651 when the cutting member 13651 is in its cutting position. The first sensor and the second sensor can include, for example, a proximity sensor and can signal and communicate with the controller of the tool assembly 13100.

When the thread 13560 reaches its most distal position in its firing stroke, all staples 13575 can be placed from the staple cartridge 13570, as shown in FIG. In various cases, the sensor is located distal to the end effector assembly and is configured to detect if the thread 13560 has reached its most distal position. The sensor may include, for example, a proximity sensor that signals and communicates with the controller of the tool assembly 13100. Once all staples 13575 have been fired, the appliance controller can send a signal to the user that the firing stroke is complete. At this point, the user can operate the tool assembly 13100 to pull in the thread 13560 to prepare the tool assembly 13100 for the treatment cut. Alternatively, the tool assembly 13100 can be configured to automatically pull in the thread 13560 after the firing stroke is complete.

As mentioned above, FIG. 61 shows the tool assembly 13100 in an arrangement in which all staples are fired and the firing member is pulled into the nearest position or mode switch position. Similarly, as described above, this mode switch position allows the pin 13516 to engage the cam arm 13566 of the cutting member 13651 and rotate the cutting member 13651 to the cutting position. In various cases, the thread 13560 may prevent the mode switch position from being reached until the instrument controller receives a signal that the staple firing stroke has been completed. In at least one such case, once the thread 13560 reaches its unlaunched position, if the instrument controller does not receive a firing stroke completion confirmation signal from the firing stroke end sensor, the instrument controller will control the firing drive. The power supply to the motor can be cut off. When the instrument controller receives a signal that the staple firing stroke is complete, the instrument controller allows the thread 13560 to be pulled proximally beyond its unlaunched position to its mode switch position. Can be done.

Once the thread 13560 has moved to the mode switch position, the instrument controller can allow the thread 13560 to advance distally again. In various cases, the instrument is a tissue cutting switch that, when pressed, can reactivate the launch drive 13540 to drive the thread 13560 via the staple cartridge 13570 over a second or cutting stroke. Can be provided. The cutting member 13651 is now lifted to its cutting position and the cutting member 13651 can incise the stapled tissue.

In addition to the above, the tool assembly 13100 is configured to lower the cutting member 13651 to its non-cutting position after the thread 13560 completes its tissue cutting stroke. More specifically, with reference primarily to FIG. 63, the cam portion 13566 of the cutting member 13651 is configured to contact the distal pin, or cam, 13574 at the end of the tissue cutting stroke, such interactions. Rotates the cutting member 13651 downward to its non-cutting position. As a result, the thread 13560 can be pulled in without exposing the cutting member 13651 to the tissue. Similarly, as a result, the jaws 13510, 13520 can be unfixed from the tissue after the cutting stroke without exposing the cutting member 13651. The reader should understand that at the end of the firing stroke, the cutting member 13651 does not interact with the distal pin 13574 because the cutting member 13651 is already in its lower position during the firing stroke.

As outlined above, the tool assembly 13100 cuts the tissue fixed by the tool assembly 13100 until all staples 13575 are fired or until all staples 13575 are fully formed. It is configured to prevent it. Similarly, as outlined above, this function can be branched when the cutting member 13651 is pivotable between the non-cutting position and the cutting position.

FIG. 70 is a partial perspective view of a staple cartridge 4410 for use with a circular surgical staple fastener according to at least one embodiment. Various circular surgical staple fasteners are well known. For example, U.S. Patent Application No. 14 / 863,110, which is incorporated herein by reference in its entirety, entitled "SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS" (filed August 26, 2015). The arrangement of various circular surgical staple fasteners is disclosed. U.S. Patent Application No. 14 / 498,070, title: "CIRCULAR FASTENEER CARTRIDGES FOR APPLYING RADIALLY EXPANDING FASTENEER LINES" (filed September 26, 2014), the entire disclosure of which is incorporated herein by reference. The arrangement of various circular surgical staple fasteners is disclosed. As discussed in these references, circular surgical staple fasteners generally include a frame assembly that comprises ancillary device portions configured to operably connect the anvil to the circular surgical stapler.

Generally, the anvil includes an anvil head that supports a ring line or a line of staple forming pockets. The anvil stem or trocar portion is attached to the anvil head and is configured to be detachably connected to the anvil attachment portion of the circular staple fastener. Various circular surgical staple fasteners selectively move the anvil to the surgical staple cartridge so that the tissue of interest can be anchored between the anvil and the deck of the surgical staple cartridge, and the anvil Includes means for selectively moving away from the surgical staple cartridge. The surgical staple cartridge detachably stores a plurality of surgical staples arranged in one or more annular arrays corresponding to the staple forming pockets provided in the anvil. The staples are detachably housed in the corresponding staple cavities formed in the staple cartridge and supported on the corresponding portion of the selectively movable extruded assembly that is operably accepted within the circular stapler. Will be done. The circular stapler further comprises an annular knife or cutting member configured to make an incision in the tissue anchored between the anvil and the staple cartridge.

Referring again to FIG. 70, the staple cartridge 4410 includes a cartridge body 4411 defining the annular cartridge deck surface 4412. The cartridge body 4411 comprises an annular row 4420 of the spaced inner staple fossa 4422 and an annular row 4440 of the spaced outer staple fossa 4442. As can be seen in FIG. 70, the inner staple fossa 4422 is inconsistent with the outer staple fossa 4442. Supported within each medial staple fossa 4422 is the medial surgical staple 4430, and within each lateral staple fossa 4442 is the lateral surgical staple 4450. The outer staple 4450 in the outer annular row 4440 may have different characteristics than the inner staple 4430 in the inner annular row 4420. For example, as shown in the embodiment of FIG. 71, the outer staple 4450 has an unformed "gull-wing" arrangement. In particular, each outer staple 4450 includes a pair of legs 4454, 4464 extending from the staple crown 4452. Each leg 4454, 4464 includes a vertical portion 4456, 4466 extending from the crown 4452, respectively. The vertical portions 4456, 4466 may be parallel to each other in one embodiment. However, in the illustrated arrangement, the vertical portions 4456, 4466 are not parallel to each other. For example, in the arrangement shown, the angle _{A 1} between the crown 4452 and the vertical portion 4456,4466 is greater than 90 degrees. See FIG. 71. Further details regarding the staple arrangement are incorporated herein by reference in its entirety, US Patent Application No. 14 / 319,008, Title: "FASTENEER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS" (June 30, 2014). Japan), can be found in US Patent Application No. 2015/0297232. However, other vertical portions 4456, 4466 may be arranged at other angles with respect to the crown 4452. One advantage of having vertical portions 4456, 4466 oriented at an angle greater than 90 degrees with respect to the crown 4452 is that such an arrangement may aid in the temporary retention of the staple within its corresponding staple fossa. ,That's what it means.

At least one leg 4454, 4464 includes an inwardly extending end. In the hands-on form shown in FIG. 71, for example, each leg 4454, 4464 includes an inwardly extending leg. In the illustrated arrangement, the leg 4458 extends inward from the vertical leg 4456 and the leg 4468 extends inward from the vertical leg 4466. As can be seen in FIG. 71, the leg 4458 is shorter than the leg 4468. _{In other words, the distance HA} between the staple crown 4452 and the point where the leg 4458 is angled inward from the vertical leg 4456 is such that the staple crown 4452 and the leg 4468 are angled inward from the vertical leg 4466. The distance between the point and the attached point exceeds the _HC. Dependently, the distance H _B in at least one embodiment is shorter than the length H _{D. The angle A 2} at which the leg 4458 is angled with respect to the vertical leg 4556 _{may correspond to the angle A 3 at} which the leg 4468 is angled with respect to the vertical leg 4466, or the angles A ₂ and A ₃ are. May be different from each other. Further details regarding the staple arrangement are incorporated herein by reference in U.S. Patent Application No. 14 / 319,008, Title: "FASTENEER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS" (filed June 30, 2014). It can be found in US Patent Application Publication No. 2015/0297232.

In at least one embodiment, each medial surgical staple 4430 may have the arrangement shown in FIG. As can be seen in FIG. 71, the medial surgical staple 4430 has a crown 4432 and two legs 4434, 4436 extending from it. Vertical leg 4434,4436 may extend relatively perpendicularly from the crown 4432, or vertical leg 4434,4436 may extend at or angle _{A 4} to more than 90 degrees. Such an arrangement may assist in the temporary retention of the staple 4430 within their corresponding staple fossa 4422. However, the vertical legs 4434, 4436 may extend from the crown 4432 at different angles. In some embodiments, the angle A ₄ are equal to each other. In other embodiments, the angle A ₄ are different from each other. In the illustrated embodiment, the inner staple 4430 and the outer staple 4450 each have the same unformed height UFH. The medial and lateral staples 4430, 4450 are formed from conventional surgical staple wires. In at least one embodiment, the diameter of the staple wire used to form the outer staple 4450 exceeds the diameter of the staple wire used to form the inner staple 4430. In other embodiments, the inner and outer staples may have the same diameter and may be formed from wires of other diameters. In some arrangements, the inner and outer staples may be formed from the same type of staple wire. In such an arrangement, the wire diameters of the inner and outer staples can be the same. Still in another embodiment, however, the inner and outer staples may have the same unformed shape / arrangement and may still be formed from two different staple wires with different wire diameters. Similarly, in at least one arrangement, the crown width CW _O of each outer staple 4450 is greater than _{the crown width CW I} of each inner staple 4430. Further details regarding the staple arrangement are incorporated herein by reference in U.S. Patent Application No. 14 / 319,008, Title: "FASTENEER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS" (filed June 30, 2014). It can be found in US Patent Application Publication No. 2015/0297232.

Referring to FIG. 70, the staple cartridge 4410 includes an outer rim 4414 extending over the deck surface 4412. During surgery, the clinician can adjust the position of the anvil with respect to the cartridge of the circular stapler. In at least one such embodiment, the staple cartridge 4410 further comprises deck features 4416 and 4418 extending from the deck surface 4412. As can be seen in FIG. 70, a series of inner deck features 4416 are centered with the inner row 4420 of the staple fossa 4422 through the passage of a knife or cutting member during the firing process. Provided between and between the opening 4413. The deck feature 4416 may be shaped and disposed with respect to the inner staple fossa and opening 4413, as shown in FIGS. 70, 72 and 73. For example, the inner deck features 4416 each have a flat wall 4415 that extends in the same space as the wall of the knife opening 4413 and / or the conical or sloping body 4417 adjacent to the row of inner staple cavities 4422. You can. See FIGS. 72 and 73. In the embodiment shown in FIG. 70, the deck feature 4416 is oriented in the gap between the two adjacent inner staple cavities 4422 and is inconsistent with the pair of staple cavities 4422, as shown. The fossa extension arrangement or deck features in the system can generally help reduce pressure more than encountered in flat deck cartridges. The arrangement of the present disclosure can also help mitigate tissue movement and displacement. Outer diameter retention mechanisms may be larger and more numerous, as tissue misalignment is generally undesirable. The internal diameter mechanism may help increase tissue tension / strain as the blade passes next to the inner internal diameter, which may allow the system to perform better cutting. However, the deck features 4416 may have different shapes and arrangements and may be arranged at different positions on the deck surface 4412.

As can be seen in FIGS. 70, 72, and 73, any other outer staple fossa 4442 includes an outer deck feature 4418 associated with its respective end. The outer deck feature 4418 extends over the deck feature 4412 and guides the outer staple 4450 towards the anvil when the staples 4450 are ejected from the staple cartridge 4410. In such an embodiment, the outer staples 4450 may not extend over the outer deck feature 4418 until they are moved towards the anvil by the launching member. Primarily with reference to FIG. 70, in at least one embodiment, the outer deck feature 4418 does not extend around the entire corresponding outer staple fossa 4442. The first outer deck feature 4418 is positioned adjacent to the first end of the corresponding outer fossa 4442, and the second outer deck feature 4418 is adjacent to the second end of the outer fossa 4442. Be positioned. As can be seen in FIG. 70, the outer deck feature 4418 is associated with every other outer staple fossa 4442. Such an arrangement can help reduce overall pressure and minimize tissue tension and movement. However, in other embodiments, the first and second outer deck features 4418 may be associated with each of the outer staple fossa 4442. Still in other embodiments, the lateral deck features may extend around the entire circumference of the corresponding lateral fossa. As can be seen in FIG. 72, the inner deck feature 4416 is shorter than the outer deck feature 4418. In other words, each inner deck feature is a distance that is less than a distance that projects above the deck surface 4412 and each outer deck feature 4418 projects above the deck surface 4412. Each outer deck feature may project above the deck surface 4412 at the same distance that the outer rim 4414 projects above the deck surface 4412. Further, as can be seen in FIG. 72, each outer deck feature 4418 generally helps prevent tissue from sagging on the deck feature during insertion of the staple head across the patient's large intestine and rectum. The resulting, conical, or tapered outer contour.

The deck feature arrangement described above may provide one or more advantages. For example, an upright outer rim can help prevent tissue from sliding along the cartridge deck. This upright rim may also have a repeating pattern of highs and lows rather than one continuous lip-like structure. The inner upright mechanism can also help retain the tissue adjacent to the blade and can result in improved cutting. The inner deck features may be between all the fossa or in an alternative arrangement, and the deck features may include a continuous upright lip-like portion. It may be desirable to balance the deck special features to minimize the number of high force / compression zones while achieving the desired amount of tissue fixation. The fossa-coaxial feature can serve the additional purpose of minimizing tissue flow in the area where the staple leg protrudes. Such an arrangement also facilitates desirable staple formation as the staple legs are ejected and translated to accept anvil pockets that may consist of corresponding forming pockets. Such a localized pocket mechanism increases the low compression zone while facilitating leg support from the cartridge as the staple exits the cartridge. This arrangement thereby minimizes the distance the staple must "jump out" before it touches the anvil pocket. Tissue flow tends to increase radially outward from the center of the cartridge.

72 and 73 show the use of surgical staple cartridge 4410 associated with anvil 4480. The anvil 4480 includes an anvil head portion 4482 and a knife washer 4490 that operably support the staple forming insert or portion 4484. The knife washer 4490 is supported in a confrontational relationship with the knife 4492 supported by the stapler head. In the illustrated embodiment, the staple forming insert 4484 is made of, for example, steel, stainless steel, etc. and includes an inner row of inner staple forming pockets 4486 and an outer row of outer staple forming pockets 4488. Each inner stapling pocket 4486 corresponds to one of the inner stapling fossa 4422, and each outer stapling pocket 4488 corresponds to one of the outer stapling fossa 4442. In the illustrated arrangement, the inner staple forming pocket 4486 is closer to the cartridge deck surface 4412 than the outer staple forming pocket 4488 as the anvil 4480 moves to its firing position relative to the cartridge deck surface 4412. In other words, the first staple formation distance between the first gap g ₁ or the first staple forming portion 4485 and the cartridge deck surface 4412 is the second gap g ₂ or the second staple forming portion 4487 and the cartridge deck surface 4412. It is less than the second staple formation distance between.

As can be further seen in FIGS. 72 and 73, the inner staples 4430 are supported within their corresponding inner staple fossa 4422, respectively, in the corresponding inner drive portion 4502 of the extruded assembly 4500, and the outer staples 4450. Each of these is supported within their corresponding outer staple fossa 4442 at the corresponding drive portion 4504. The advance of the extruded assembly 4500 towards the anvil 4480 can be driven such that the inner and outer staples 4430, 4450 form contact with their respective corresponding staple forming pockets 4486, 4488, as shown in FIG. 73. The knife 4492 advances distally via the tissue fixed between the anvil 4480 and the deck surface 4412 and the non-metal button 4491 of the knife washer 4490. Such an arrangement involves the formation height FH _O is formed below the height FH _I inside staple 4430, help provide outside staple 4450. In other words, the outer row 4440 of the outer staple 4450 is formed into a larger "B" shape that results in greater capture and / or higher formation height that reduces tissue compression near the outer row of staple 4440. NS. Larger B shapes can also improve blood flow towards the medial row. In various cases, the outer row 4440 of the outer staple 4450 has greater resistance that is developed by utilizing a larger staple crown, longer staple leg width, and / or thicker staple leg thickness. ..

You can change the amount of staples used in each column. In one embodiment, for example, the outer staples 4450 are more than the inner staples 4430. In another embodiment, more inner staples 4430 than outer staples 4450 are used. In various cases, the wire diameter of the outer staple 4450 is larger than the wire diameter of the inner staple 4430. The inner and outer staples 4430, 4450 may have the same unformed height UFH. _{The crown width CW O} in the outer row 4440 of the outer staple 4450 is greater than _{the crown width CW I in} the inner row 4420 of the inner staple 4430. The gull-wing arrangement of the outer staples 4450 uses bends arranged at different distances from their respective crowns. Using a stepped anvil arrangement with a flat (non-stepped) cartridge deck surface 4412, along with similar drive or extrusion movements, results in staples with different formation heights.

FIG. 74 shows another staple cartridge embodiment 4610. As can be seen in FIG. 74, the staple cartridge 4610 includes a cartridge deck 4612 that includes an inner annular row 4620 of the isolated inner staple fossa 4622 and an outer annular row 4640 of the isolated outer staple fossa 4642. include. As can be seen in FIG. 74, the inner staple fossa 4622 is inconsistent with the outer staple fossa 4642. Supported within each medial staple fossa 4622 is the medial surgical staple 4630, and within each lateral staple fossa 4642 is the lateral surgical staple 4650. The outer rim 4614 extends on the deck surface 4612. In various embodiments, in addition to the above, the staples 4630, 4650 do not project on the deck surface 4612 until they are moved towards the anvil by the launching member. Such embodiments may frequently utilize staples that are smaller than the depth of each staple fossa of the staple in which the staples are stored. In other embodiments, the legs of the staples project onto the deck surface 4612 when the staples are in their unlaunched position. In at least one such embodiment, the staple cartridge 4610 further comprises deck features 4616 and 4618 extending from the deck surface 4612.

As can also be seen in FIG. 74, every other staple fossa 4622 includes an inner deck feature 4616 associated with each end thereof. The inner deck feature 4616 extends over the deck surface 4612 and guides the corresponding inner staple 4630 towards the anvil when the corresponding inner staple 4630 is ejected from the staple cartridge 4610. In such an embodiment, the inner staple 4630 may not extend over the inner deck feature 4616 until the firing member moves the staple towards the anvil. In the illustrated embodiment, the inner deck feature portion 4616 does not extend around the entire corresponding inner staple fossa 4622. The first inner deck feature 4616 is positioned adjacent to the first end of the corresponding inner fossa 4622, and the second inner deck feature 4616 is adjacent to the second end of the inner fossa 4622. It is positioned. However, in other embodiments, the inner deck features 4416 may be associated with each of the inner staple fossa 4622. Still in other embodiments, the inner deck features may extend around the entire circumference of the corresponding inner staple fossa. By using deck features with different heights in the coaxial pattern, which are associated with every other fossa, they can be balanced as desired, as many and as many as possible, as long as possible staples. It may provide a lower pressure tissue interstitial region while guiding the leg. In other words, such an arrangement can minimize the amount of tissue flow and reduce the overall amount of pressure applied to the tissue of interest.

Still referring to FIG. 74, each outer staple fossa 4642 includes an outer deck feature 4618 associated with each end thereof. The outer deck feature 4618 extends over the deck feature 4612 and guides the outer staple 4650 towards the anvil when the staples 4650 are ejected from the staple cartridge 4610. In such an embodiment, the inner staple 4650 may not extend over the inner deck feature 4618 until the firing member moves the staple towards the anvil. As can be seen in FIG. 74, in the illustrated embodiment, the outer deck mechanism 4618 does not extend around the entire corresponding outer staple fossa 4642. The first outer deck feature 4618 is positioned adjacent to the first end of the corresponding outer fossa 4642, and the second outer deck feature 4618 is positioned adjacent to the second end of the outer fossa 4642. .. As can be seen in FIG. 74, the outer deck mechanism 4618 is associated with each of the outer staple fossa 4642. However, in other embodiments, the first and second outer deck features 4618 may be associated with every other outer staple fossa 4642. Still in other embodiments, the lateral deck features may extend around the entire circumference of the corresponding lateral fossa. As can be seen in FIGS. 75 and 76, the inner deck feature 4616 and the outer deck feature 4618 extend over the deck surface 4612 at the same distance. In other words, they have the same height. As can also be seen in FIGS. 75 and 76, each inner deck feature 4416 and each outer deck feature 4618 are generally placed on the deck feature during insertion of the staple head over the patient's large intestine and rectum. It has a conical or tapered outer contour that can help prevent the tissue from sagging.

Figures 75 and 76 show the use of a surgical staple cartridge 4610 connected to the anvil 4680. The anvil 4680 includes an anvil head portion 4682 and a knife washer 4690 that operably support the staple forming insert or portion 4648. The knife washer 4690 is supported in a confrontational relationship with the knife 4692 supported by the staple head. In the illustrated embodiment, the staple forming insert 4864 is made of, for example, steel, stainless steel, etc. and includes an inner row of inner staple forming pockets 4686 and an outer row of outer staple forming pockets 4688. Each inner stapling pocket 4686 corresponds to one of the inner stapling fossa 4622, and each outer stapling pocket 4688 corresponds to one of the outer stapling fossa 4642. In the illustrated arrangement, the inner staple forming pocket 4686 is arranged from the deck surface 4612 at the same distance g _{1 as the} outer staple forming pocket 4688.

As can be further seen in FIGS. 75 and 76, the inner staple 4630 is supported within the corresponding inner staple fossa 4622 on the corresponding inner drive portion 4702 of the extruded assembly 4700. The outer staple 4650 is supported within the corresponding outer staple fossa 4642 at the corresponding outer drive portion 4704. The advance of the extruded assembly 4700 towards the anvil 4680 can be driven such that the inner and outer staples 4630, 4650 form contact with their respective corresponding staple forming pockets 4686, 4688, as shown in FIG. .. The knife 4692 advances distally via the tissue fixed between the anvil 4680 and the deck surface 4612 and the non-metal button 4691 of the knife washer 4690. In the embodiments shown in FIGS. 75 and 76, each inner staple 4630 is formed from a first staple wire having a _{first wire diameter D 1 and has a first unformed height L 1} . For example, the first wire diameter D ₁ is about 0.020 cm to 0.038 cm (0.0079 "to 0.015") (increments are generally 0.023 cm, 0.024 cm, and 0.00368 cm (0.0089). ", 0.0094", and 0.00145 ")), and the first unformed height L ₁ is about 0.503 cm to 0.635 cm (0.198" to 0.250 "). Each outer staple 4650 is formed from a second staple wire having a _{second wire diameter D 2 and has a second unformed height L 2. In the} embodiments shown in FIGS. 75 and 76, D ₁ <D ₂ and L ₁ <L _2. However, as can be seen in FIG. 76, the inner and outer staples 4630, 4650 are formed by the same formation height FH. Thicker wires on the outer side. Staples tend to provide higher tear strength and higher burst strength compared to the inner row of smaller diameter staples that tend to hold better hemostatically, in other words, the outer side of the less compressive staples. While the rows promote better healing and blood flow, the tighter inner rows of staples may provide better retention for hemostatics, with staples with longer legs having shorter legs. Produces longer leg staples that are more likely to be formed more tightly and sufficient to hold under heavy load conditions, even when formed at the same height as the staples with. The number of staples used in each row of staples can be varied. In one embodiment, for example, the inner row 4620 is outside the outer staples 4650. It has the same number of inner staples 4630 as row 4640. In various arrangements, the crown width of the staples 4650 is greater than the crown width of the inner staples 4630. In other embodiments, the staples 4630, 4650 are the same. In other arrangements, the staples 4630, 4650 may have the galwing type design described above. For example, at least one leg of the staple includes an inwardly curved end. Good, or both legs may include ends that curve inward towards each other. Such staples are used in both the inner and outer annular rows, or both the inner and outer annular rows. good.

FIG. 77 shows another circular staple cartridge embodiment 4810 that includes a cartridge deck 4812 that includes three annular rows 4820, 4840, 4860 of spaced staple cavities. The inside of the first row 4820 includes a plurality of first medial fossa, or first staple fossa 4822, each arranged at a first angle. Each inner staple fossa 4822 operably supports a corresponding inner staple or first staple 4830 within it. The medial fossa 4822 orients the first staple 4830 at the same uniform angle with respect to the tangential direction. In the illustrated embodiment, each inner staple 4830 is formed from a first staple wire having a first staple diameter D _1. In one example, the first staple wire diameter D ₁ is about 0.020 cm to 0.038 cm (0.0079 "to 0.015") (increments are generally 0.023 cm, 0.024 cm, and 0.00368 cm (0). .089 ", 0.0094", and 0.00145 "))). With reference to FIG. 80, each inner staple 4830 includes a first crown 4832 and two first leg 4834s. The crown has a first crown width C ₁ and each first leg 4834 has a first _{unformed leg length L 1. In} one embodiment, the first crown width C ₁ is from about 0.254 cm. It may be 0.762 cm (0.100 "to 0.300"), and the first _{unformed leg length L 1} is about 0.503 cm to 0.635 cm (0.198 "to 0.250"). may be at. the first leg 4834, each, the first staple crown 4832 may be disposed at an angle _{a 1.} angle _{a 1} may be about 90 degrees, or slightly 90 The degree may be exceeded, which allows the first leg portion 4834 to extend slightly outwards to help the first staple 4830 to be held in its corresponding first staple fossa 4822.

Moving on to FIGS. 78 and 79, the staple cartridge 4810 is connected to an anvil 4900 that includes two insides of a first pair 4903 or a first row 4902 of a first staple forming pocket 4904 that is staggered or angled. Intended to be used for. Each first pair 4903 of the first staple forming pocket 4904 corresponds to one first staple 4830. One first staple forming pocket 4904 corresponds to one first staple leg 4834, and the other 1st staple forming pocket 4904 vs. 4903 corresponds to the other first staple leg 4834. There is. Such an arrangement helps establish a forming staple arrangement, in which the first staple leg 4834 of the first staple 4830 is formed out of plane by the first crown 4832 of that particular first staple 4830, thereby forming one. The first leg 4834 is formed on one side of the first crown 4832, and the other first leg 4834 is formed on the other side of the first crown 4832. This "three-dimensional" forming staple arrangement is shown with respect to some first staple forming pockets 4904 in FIG.

As most particularly visible in FIG. 79, the cartridge deck 4812 has a "stepped" structure. The cartridge deck 4812 includes an inner or first cartridge deck portion 4814 that corresponds to the inner or inner of the first staple fossa 4822 or the first annular row 4820. As can be further seen in FIG. 79, when the anvil 4900 moves to a closed or fixed position, a portion of the anvil 4900 including the first forming pocket 4904 has a first clearance distance g _{1 from the deck portion 4814.} Are separated by.

With reference to FIGS. 77, 79 and 80 again, the middle row or the second row 4840 includes a second plurality of middle staple or second staple fossa 4842, each arranged at a second angle. Each intermediate staple fossa 4842 operably supports a corresponding intermediate staple or second staple 4850 within it. The intermediate fossa 4842 orients the intermediate staple or the second staple 4850 at the same uniform second angle with respect to the tangential direction. However, the second angle is different from the first angle. In other words, if the first and second staples are supported in their respective first and second fossa, the axis of the first crown of each first staple 4830 will ultimately, if extended. It may intersect the extending axis of the second crown of the adjacent second staple 4850. As can be seen in FIGS. 79 and 80, each second or intermediate staple 4850 comprises a second staple crown or base 4852 and two second legs 4854. The staple base 4852 may have some rectangular cross-sectional shape and is formed from a flat sheet material. The second staple leg 4854 may have, for example, a circular cross-sectional contour. The second staple or intermediate staple is, for example, incorporated herein by reference in its entirety, U.S. Patent Application No. 14 / 863,110, Title: "SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS" (2015). It may have various staple arrangements disclosed in (filed August 26). Having a circular staple leg extending from a staple base having a rectangular cross-sectional profile can provide a staple base portion and a staple leg without a preferred curved plane. The second staple 4850 includes a curved portion 4856 with the staple leg 4854 extending from the staple base portion 4852. The curved portion 4856 may have a substantially square cross-sectional contour. The square and rectangular contours of the bend 4856 and the staple base portion 4852 provide a tight connection and trunk to the circular staple legs 4854, respectively. The circular staple leg 4854 eliminates the preferred curved plane that a staple leg with a square, rectangular, or nodal or non-uniform shape can have with any shape, cross section. Each of the second staple legs 4854 has a second diameter D ₂ . In at least one embodiment, D ₂ > D ₁ . The second base or crown 4852 has a second crown width C ₂ . In one arrangement, C ₂ > C ₁ . The second leg portion 4854 may be arranged at _{an angle A 2 with} respect to the second base portion or the crown 4852, respectively. The angle A ₂ may be about 90 degrees, or just over 90 degrees, which causes the second leg 4854 to extend slightly outward and the second staple 4850 to its corresponding second staple fossa. Assists in holding within 4842.

Moving on to FIGS. 78 and 79, the anvil 4900 further comprises two intermediate rows or a second row 4912 of a second staple forming pocket 4914, a staggered or angled second pair 4913. Each second pair 4913 of the second staple forming pocket 4914 corresponds to one second staple 4850. One second staple forming pocket 4914 corresponds to one second staple leg 4854, and the other second staple forming pocket 4914 vs. 4913 corresponds to the other second staple leg 4854. Such an arrangement helps establish a forming staple arrangement, and the second leg 4854 is formed out of plane by the second base 4852 of the particular second staple 4850. This "three-dimensional" forming staple arrangement is shown with respect to some second staple forming pockets 4914 in FIG.

As most particularly visible in FIG. 79, the cartridge deck 4812 further comprises a second cartridge deck portion 4816 that corresponds to an intermediate ring or second ring 4840 of the intermediate stapling fossa or the second stapling fossa 4842. As can be further seen in FIG. 79, when the anvil 4900 moves to a closed or fixed position, a portion of the anvil 4900 including the second forming pocket 4914 has a second clearance distance g _{2 from the deck portion 4816.} Are separated by. In the illustrated example, g ₂ > g ₁ .

With reference to FIGS. 77, 79 and 80 again, the outer row or third row 4860 includes a third plurality of outer staple cavities or third staple cavities 4862 dimensioned relative to the second staple fossa 4842. The outer staple fossa or the third staple fossa 4862 extends the distance between two adjacent second fossa 4842s. Each outer staple fossa 4862 operably supports a corresponding outer staple or third staple 4870 within it. The outer fossa 4862 orients the outer staple or the third staple 4870 so that they are in direct contact with the circumferential direction. As can be seen in FIGS. 79 and 80, each third or outer staple 4870 comprises a third staple crown or base 4872 and two third leg 4874. The staple base 4872 may have some rectangular cross-sectional shape and is formed from a flat sheet material. The third staple leg 4874 may have, for example, a circular cross-sectional contour. The third staple or outer staple 4870 is, for example, incorporated herein by reference in its entirety, U.S. Patent Application No. 14 / 863,110, title: "SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS" (20). It may have various staple arrangements disclosed in (filed August 26, 2014). Having a circular staple leg extending from a staple base having a rectangular cross-sectional profile can provide a staple base portion and a staple leg without a preferred curved plane. The third staple 4870 includes a curved portion 4876 in which the staple leg portion 4874 extends from the staple base 4872. The curved portion 4876 may have a substantially square cross-sectional contour. The square and rectangular contours of the bend 4876 and the staple base portion 4872 each provide a tight connection and trunk to the circular staple leg 4874. The circular staple leg 4874 eliminates the preferred curved plane that a staple leg with a square, rectangular, or nodal or non-uniform shape may have with a staple leg with a cross section. In at least one embodiment, D ₃ > D ₂ . The third base or crown 4872 has a third crown width C ₃ and each third leg 4874 has a _{third unformed leg length L 3} . In one arrangement, C ₃ > C ₂ and L ₃ > L ₂ . The third leg 4874, to the third base or the crown 4872 may be arranged at an angle _{A 3.} Angle A ₃ may be about 90 degrees, or slightly better than 90 degrees, thereby, the third leg portion 4874 is slightly outwardly flared, third staple fossa its corresponding third staple 4870 Assists in holding in 4862.

Moving on to FIGS. 78 and 79, the anvil 4900 further comprises an outer row 4916 of the outer or third staple forming pocket 4918. Each third staple forming pocket 4918 corresponds to one third staple 4870. As most particularly visible in FIG. 79, the cartridge deck 4812 further comprises a third cartridge deck portion 4818 that corresponds to the outer row or third row 4860 of the outer staple fossa or the third staple fossa 4862. As can be further seen in FIG. 79, when the anvil 4900 moves to a closed or fixed position, a portion of the anvil 4900 including the third forming pocket 4918 is located at a third clearance distance g _{3 from the deck portion 4818.} Are separated by. In the illustrated example, g ₃ > g ₂ . As further seen in FIG. 79, in at least one embodiment, the tissue thickness compensating element 4920 is used in connection with each outer staple or third staple 4870. The tissue thickness compensating element may include a woven fabric material embedded in oxidized regenerated cellulose (ORC) to promote hemostasis. Tissue Thickness Compensation Element 4920, the entire disclosure of which is incorporated herein by reference, U.S. Patent Application No. 14 / 187,389, Title: "IMPLANTABLE LAYER ASSEMBLES" (filed February 24, 2014), U.S.A. It may comprise any of the various tissue thickness compensating element arrangements disclosed in Patent Application Publication No. 2015/0238187. As can be seen in FIG. 79, the tissue thickness compensating element 4920 has a thickness represented by "a". In one embodiment, the tissue thickness compensating element has a thickness of about 0.038 cm to 0.11 cm (0.015 "to 0.045"). However, other thicknesses may be used.

Therefore, in at least one embodiment, as shown in FIGS. 77-80, the staple cartridge 4810 may use different numbers of staples in each of the three staple rows. In one arrangement, the inner row of staples comprises conventional staples with the smallest wire diameter and the shortest unformed leg length. Each first staple has the shortest crown width and each first staple is oriented at a uniform angle with respect to the tangential direction. The intermediate staples have a different arrangement than the first staple arrangement. Each leg of the intermediate staple has a medium wire diameter and uniform leg length. Each intermediate staple has a crown width slightly greater than the crown width of the inner staple, and each intermediate staple is at a uniform angle with respect to the tangential direction, but at a different angle with respect to the inner row of inner staples. Is oriented at. Each outer staple has an arrangement similar to that of the intermediate staples. Each of the third legs of each outer staple has a maximum wire diameter compared to the wire diameter of the legs of the inner and intermediate staples. The crown width of each outer staple is significantly larger than the crown width of the inner and intermediate staples. Each outer staple is tangentially oriented in the circumferential direction of the cartridge. The outer row of staples uses a woven tissue thickness compensating element (spacer cloth) that is embedded within the ORC to promote hemostasis. The anvils on the steps and the stepped cartridge deck provide different forming staple heights with the staples having the shortest forming height in the inner row and the staples having the longest forming height in the outer row. The anvil pockets corresponding to the inner and middle rows of staples "tilt" to create three-dimensional staples in the inner and middle rows. The "bathtub type" anvil pocket corresponds to the outer row of staples. In at least one embodiment, the staples may be fired sequentially. For example, the staples in the inner and middle rows may be fired first, followed by the staples in the outer row. The annular knife cuts the anchored tissue during the firing process.

FIGS. 81-84 show a portion 5000 of a curved staple fastening device according to at least one embodiment configured to capture, incis, and staple tissue. The curved staple fastener 5000 comprises a frame assembly 5010, a staple cartridge 5020, and an anvil (not shown) configured to be supported in a confrontational manner with respect to the deck of the staple cartridge. As discussed in more detail below, upon receiving the first working force, the staple cartridge 5020 drives towards the anvil and captures tissue between them. The curved staple fastener 5000 further includes a knife assembly that includes a cutting member (not shown) configured to incise the tissue trapped between the staple cartridge 5020 and the anvil. The staple cartridge 5020 is a deck 5022 including a cutting slot 5024 configured to receive a cutting member, a plurality of staple pits 5030A and 5030B, and a plurality of staples 5040 removably housed in the staple pits 5030A, 5030B. FIG. 84) is provided. The curved staple fastener 5000 further comprises a drive assembly 5100 comprising a main drive 5102 configured for axial placement within the frame assembly 5010. Upon activation of the launch system, the main drive unit 5102 moves axially in the direction towards the anvil. In at least one arrangement, the axial movement of the main drive 5102 also advances the cutting member of the cutting slot 5024 to cut the anchored tissue between the cartridge 5020 and the anvil.

In the illustrated embodiment, the cartridge 5020 is longitudinally partitioned into three compartments, the "high" compartment 5030, the "intermediate" compartment 5050, and the "low" compartment 5070. The cutting slot 5024 branches each of the high division, the intermediate division, and the low division 5030, 5050, 5070, whereby two rows of staple cavities are placed on each side surface of the cutting slot 5024. As can be seen in FIG. 82, for example, the staple cartridge 5020 comprises two inner rows 5080A, 5080B of the inner staple fossa 5082 and two outer rows 5090A, 5090B of the outer staple fossa 5092. The staple cartridge 5020 further includes a plurality of deck features extending from the deck 5022. For example, referring to FIGS. 81 and 82, the outer rows 5090A, 5090B of the staple fossa 5092 have a set of deck features associated with it. In the illustrated embodiment, these staple cavities 5092 associated with the high compartment 5030 include a deck feature 5032 extending over the deck surface 5022 _{at a feature height H h.} These staple cavities 5092 associated with mediation compartment 5050 include a deck feature 5052 extending over the deck surface 5022 _{at a feature height of H m.} These staple cavities 5092 associated with the low compartment 5070 include a deck feature 5072 extending over the deck surface 5022 _{at feature height HL.} H _h > H _m > H _L. In at least one embodiment, for example, H _h is about 0.05 cm (0.020 ″), H _m is about 0.038 cm (0.015 ″), and _HL is about 0.025 cm (0.010”). ). The deck features 5032, 5052, and 5072 may be molded to the deck surface 5022. In the embodiment, the deck features 5032, 5052, 5072 are attached to the deck surface 5022. It is assumed that the deck features 5032, 5052, and 5072 are separate parts configured in the cartridge 5020 while accommodating or supporting the staples 5112 before ejecting the staples. And / or an extension of the staple socket 5092 for supporting, guiding, and / or controlling the staple while ejecting the staple 5112 from the cartridge 5020. Single deck features 5032, 5052, 5072. Supports two different staple legs of adjacent staples 5112 so that deck features 5032, 5052, 5072 support one or more sides, faces, and / or edges of each staple leg. In an embodiment, deck features 5032, 5052, 5072 on outer staple rows 5090A, 5090B are associated only with any other staple fossa 5092 in each outer row 5090A, 5090B. In the embodiment shown in FIG. 83, the staple cavities 5082 in the inner rows 5080A and 5080B (in FIG. 83, only row 5080B can be seen) are the deck features associated with them. For example, these staple cavities 5082 associated with high section 5030 include a deck feature section 5034 extending over deck surface 5022 _{at feature section height H h. Associated with mediation section 5050.} These staple cavities 5082 include _{a deck feature portion 5054 extending over the deck surface 5022 at feature height H m} . These staple cavities 5082 associated with the low section 5070 are feature height. _{Includes a deck feature 5074 of the HL} that extends over the deck surface 5022.

The staple cartridge 5020 includes a drive assembly 5100 configured to drive the staples supported within the staple fossa 5082, 5092 towards the anvil upon application of actuation force. In the arrangement shown in FIGS. 83 and 84, for example, the drive assembly 5100 moves towards the anvil when applying the actuating motion there and from the anvil when applying the pulling motion there. Includes a main drive 5102 configured to move away. The drive assembly 5100 includes a pair of high drive portions 5104 (one on each side of the cutting slot 5024), a pair of intermediate drive portions 5106 (one on each side of the cutting slot 5024), and a pair. It further comprises a low drive portion 5108 (one on each side of the cutting slot 5024). Each of the drive portions 5104, 5106, 5108 has a plurality of staple support drive portions 5110 associated thereto. The staple support drive unit 5110 is supported at each of the staple sockets 5082 and 5092, and the staple 5112 is supported on the staple fossa 5082 and 5092, respectively. See FIG. 84. Thus, when the staple fastening device is fired, the staples 5112 can be formed at different forming staple heights. For example, the formation height of the staples 5112 associated with the high division 5030 may have a formation height shorter than the formation height of these staples associated with the medium division 5050, and may also be associated with the medium division 5050. The formation height of the staple 5112 is shorter than the formation height of the staple 5112 associated with the low section 5070. It should be noted that by driving the staples, different distances can help adapt to the deflection of the anvil. However, in the absence of anvil deflection, such an arrangement provides staples with formation heights that vary from region to region. The operation of the drive assembly 5100 also results in the cutting member being driven over a fixed structure. The reader has read that different staples with different leg and / or crown arrangements and / or different wire diameters and / or different formation heights are used in different compartments 5030, 5050, 5070 for each aspect of the tissue cutting line. It will be appreciated that the desired forming staple height and arrangement may be obtained above.

FIGS. 85-88 show a portion of another curved stapler 5200, according to at least one embodiment, configured to capture, incise, and staple tissue. First referring to FIG. 86, the curved staple fastener 5200 has an anvil 5260 configured to be supported in a confrontational manner with respect to the frame assembly 5210, the staple cartridge 5220, and the deck 5222 of the staple cartridge 5220. Be prepared. The curved staple fastener 5200 further includes a knife assembly that includes a cutting member (not shown) configured to incise the tissue trapped between the staple cartridge 5220 and the anvil 5260. In the embodiment shown in FIG. 86, the deck 5222 comprises a "stepped" deck that includes a centrally located cutting slot 5228 configured to receive the cutting member. The deck 5222 further comprises a high deck portion 5224 that is centrally located across the location where the cutting slots 5228 extend and the low deck portion 5226. The inner row of inner staple fossa 5230A is provided on the high deck portion 5224 on each side surface of the cutting slot 5228. Each low deck portion 5226 has a corresponding row of outer staple fossa 5230B inside. As can be seen in FIG. 86, the various arrangements of deck feature 5231 disclosed herein are in each outer row of outer staple fossa 5230B, with each of the outer staple fossa 5230B, or any other. It may be associated with one of the outer staple fossa 5230B. In other arrangements, deck features may be further associated with each of the inner staple fossa 5230A or any other inner staple fossa 5230A in each row of medial staple fossa 5230A. Still in other arrangements, deck features may not be used in connection with any inner and outer staple pits 5230A, 5230B.

With reference to FIGS. 86 and 88, in at least one arrangement, each staple fossa 5230A detachably stores the inner staple 5240 within it, and each staple fossa 5230B detaches the outer staple 5250 within it. Store as possible. Each inner staple 5240 is supported on a corresponding drive 5214, and each outer staple 5250 is supported on a corresponding drive 5216. Drives 5214, 5216 form part of a movable drive assembly 5218 that is operably supported by staple fasteners 5200. It will be understood that by applying the actuating motion to the drive assembly 5218, each staple 5240, 5250 advances to provide contact formation with the anvil 5260.

The inner row of inner staples 5240 may have different characteristics than the outer row of outer staples 5250. For example, as shown in the embodiment of FIG. 88, the legs of the inner staple 5240 have a "gull-wing" arrangement. In particular, each outer staple 5240 includes a pair of legs 5244, 5246 extending from the staple crown 5242. Each leg 5244, 5246 includes a vertical portion 5245, 5247 extending from the crown 5242, respectively. The vertical portions 5245 and 5247 may be parallel to each other in one embodiment. However, in the illustrated arrangement, the vertical portions 5245 and 5247 are not parallel to each other. See FIG. 88. However, the vertical legs 5245, 5247 may be arranged at other angles with respect to the crown 5242. Further details regarding the staple arrangement are incorporated herein by reference in their entirety, U.S. Patent Application No. 14 / 319,008, Title: "FASTENEER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS" (June 30, 2014). Filing), US Patent Application Publication No. 2015/0297232. One advantage of having vertical portions 5245, 5247 oriented at an angle greater than 90 degrees with respect to the crown 5242 is that such an arrangement may aid in the temporary retention of the staple within its corresponding staple fossa. ,That's what it means. Still referring to FIG. 88, each leg 5244, 5246 further includes an inwardly extending leg. In the illustrated arrangement, the leg 5248 extends inward from the vertical leg 5244 and the leg 5249 extends inward from the vertical leg 5246. As can be seen in the figure, the leg 5248 is shorter than the leg 5244. Each inside staple 5240 has unformed height _{L 1.}

As can also be seen in FIG. 88, the legs of the outer staple 5250 also have a "gull-wing" arrangement. In particular, each outer staple 5250 includes a pair of legs 5254, 5256 extending from the staple crown 5252. Each leg 5254, 5256 includes a vertical portion 5255, 5257 extending from the crown 5252, respectively. The vertical portions 5255 and 5257 may be parallel to each other in one embodiment. However, in the illustrated arrangement, the vertical portions 5255, 5257 are not parallel to each other. See FIG. 88. Further details regarding the staple arrangement are incorporated herein by reference in their entirety, U.S. Patent Application No. 14 / 319,008, Title: "FASTENEER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS" (June 30, 2014). Filing), US Patent Application Publication No. 2015/0297232. However, the vertical legs 5245, 5247 may be arranged at other angles with respect to the crown 5242. One advantage of having vertical portions 5255, 5257 oriented at an angle greater than 90 degrees with respect to the crown 5252 is that such an arrangement may aid in the temporary retention of the staple within its corresponding staple fossa. ,That's what it means. Still referring to FIG. 88, each leg 5254, 5256 further includes an inwardly extending leg. In the illustrated arrangement, the leg 5258 extends inward from the vertical leg 5254 and the leg 5259 extends inward from the vertical leg 5256. As can be seen in the figure, the leg 5258 is shorter than the leg 5254. Each outer staple 5250 has an unformed height L ₂ . In the illustrated arrangement, L ₂ > L ₁ . In the illustrated embodiment, the inner staple and outer staple 5240,5250 have the same wire diameter _{D 1.} However, in other embodiments, the inner staples and the outer staples 5240, 5250 have different wire diameters. Still in other embodiments, the staple 5240 may provide a staple fossa 5230B and the staple 5250 may provide a staple fossa 5230A, whereby a longer unformed staple is in the medial line of the staple fossa and also. The shorter staple is on the outer line of the staple fossa.

As the stapling fastener 5200, an anvil 5260 may be used as shown in FIGS. 85 and 86. With reference to FIG. 85 first, the anvil 5260 may include two insertions 5264 supported by the anvil body 5260, which is a staple in which one insertion 5264 is located on one side of the cutting slot 5228. And the other insertion section 5264 corresponds to a staple located on the other side of the cutting slot 5228. As can be seen in FIG. 86, the insertion section 5264 provides the anvil 5260 with a stepped staple-forming inner surface 5261. Each insertion portion 5264 includes an inner portion 5265 and an outer portion 5267. When the anvil 5260 is positioned in the closed orientation for a fixed tissue, a gap _{G 1} is provided between the deck portion 5224 corresponding to the inner portion 5265 of the insertion portion 5264, also the gap _{G 2} is inserted It is formed between the outer portion 5267 of the portion 5264 and the corresponding deck portion 5226. In the illustrated arrangement, G ₂ > G ₁ . The inner portion 5265 comprises an inner row 5266A of a pair of inner staples 5268A of the staple forming fossa 5270. The outer portion 5267 of each insertion portion 5264 comprises an outer row 5266B of the outer pocket 5258B of the outer staple forming pocket 5270.

Moving on to FIG. 87, in at least one embodiment, each of the staple forming pockets 5270 and each of the 5268A and 5268B staple forming pockets 5270 has a triangular shape. The forming pockets 5270 in a single pair 5268A, 5268B are configured to be spaced apart from each other and to receive and form the corresponding leg of a particular staple. Such an arrangement helps to provide forming staples with three-dimensional structure. That is, each leg of the formed staple is not located in the same plane as the staple crown. See FIG. 87. In one arrangement, the formation height F ₂ of each outer staple 5250 exceeds _{the formation height F 1} of each inner staple 5240, as shown in FIG. 88. In an alternative arrangement, for example, the anvil inserts do not have to be in a stepped arrangement and are at the same distance from the corresponding portion of the cartridge deck to form similar staples of the various types disclosed herein. Inherently includes the pocket line. In such an arrangement, the cartridge deck may or may not include the various types of deck features disclosed herein. In at least one variant, the inner staple line may have a shorter unformed length than the staple in the outer line (farthest from the slot to which the cutting member is adapted) and vice versa. The staples on the inner and outer lines may be gull-winged arrangements disclosed herein, or they may be standard U-shaped designs. The staples in each line may have wire diameters that are different from or the same as the wire diameters of the staples in the adjacent lines.

FIGS. 89 and 90 show a stapler 5300 according to at least one embodiment configured to capture, incise, and staple tissue. First referring to FIG. 89, the staple fastener 5300 comprises an anvil 5360 configured to be supported in a confrontational manner with respect to the frame assembly 5310, the staple cartridge 5320, and the deck 5322 of the staple cartridge 5320. The staple cartridge 5320 and the anvil 5360 may be curved or linear. The staple fastener 5300 further includes a knife assembly that includes a cutting member 5312 configured to incise the tissue trapped between the staple cartridge 5320 and the anvil 5360. The staple cartridge body 5320 includes a deck 5322 including a centrally located cutting slot 5328 configured to receive the cutting member 5312. An inner row of spaced inner staple fossa 5330A is provided on each side of the cutting slot 5228. Spacing The outer rows of outer staple fossa 5330B are provided adjacent to each of the inner rows of inner staple fossa 5330A. As can be seen in FIG. 89, the various arrangements of deck feature 5331 disclosed herein may be associated with the inner and outer staple pits 5330A and 5330B, respectively. In other embodiments, one of every other inner staple fossa and / or outer staple fossa 5330A, 5330B in each row has a deck feature 5331 associated with them. Still in other arrangements, deck features may not be used in connection with any inner and outer staple cavities 5330A, 5330B.

In at least one arrangement, each inner staple fossa 5330A detachably stores the inner staple 5340 within it, and each outer staple fossa 5330B detachably stores the outer staple 5350 within it. Each inner staple 5340 is supported on a corresponding drive 5314 and each outer staple 5350 is supported on a corresponding drive 5316. Drives 5314, 5316 form part of a movable drive assembly 5318 that is operably supported by staple fasteners 5300. It will be understood that by applying the actuating motion to the drive assembly 5318, each staple 5340, 5350 advances to provide contact formation with the anvil 5260. In the illustrated arrangement, the inner staple 5340 is provided with a leg portion of the gull-wing design, and may have a unformed height L _1. The outer staples 5350 may have a leg portion of the gull-wing design, and may have a unformed height L _2. In the illustrated arrangement, L ₁ > L ₂ . However, other staple arrangements disclosed herein may also be used.

As the stapling fastener 5300, an anvil 5360 may be used as shown in FIG. 89. As can be seen in FIG. 89, the anvil 5360 may include two insertions 5364 supported by the anvil body 5362, whereby one insertion 5364 is placed on one side of the cutting slot 5328. The other insertion portion 5364 corresponds to a staple arranged on the other side of the cutting slot 5328. As can be seen in Figure 89, when the anvil 5360 is closed, the insertion portion 5364 is disposed at unformed distance _{G 1} from the cartridge deck 5322. Each insertion portion 5364 includes an inner row of inner staple forming pockets 5368A and an outer row of outer staple forming pockets 5368B. The stapling pockets 5368A, 5368B may be provided in any of the various stapling pocket arrangements disclosed herein. When the device 5300 is fired, the formation height F ₂ of each outer staple 5350 exceeds _{the formation height F 1} of each inner staple 5240, as shown in FIG. 90.

FIG. 91 shows a curved stapler 5400 according to at least one embodiment configured to capture, incise, and staple tissue. The staple fastener 5400 comprises an anvil 5470 configured to be supported in a confrontational manner with respect to the frame assembly 5410, the staple cartridge 5420, and the deck 5422 of the staple cartridge 5420. The staple cartridge 5420 and the anvil 5470 may be curved or linear. The staple fastener 5400 further includes a knife assembly that includes a cutting member 5412 configured to incise the tissue trapped between the staple cartridge 5420 and the anvil 5470. The staple cartridge body 5420 includes a deck 5422 including a centrally located cutting slot 5428 configured to receive the cutting member 5412. An inner row of spaced inner staple fossa 5430A is provided on each side of the cutting slot 5428. Intermediate rows of spaced intermediate staple fossa 5430B are provided on each side surface of the cutting slot 5428 adjacent to each inner row of spaced inner staple fossa 5430A. The outer rows of the isolated outer staple fossa 5430C are provided adjacent to each of the spaced intermediate rows of the intermediate staple fossa 5430B. In this embodiment, the deck feature portion is not shown. However, other embodiments relate to some or all inner staple follicles and / or some or all intermediate staple follicles and / or some or all. In connection with the outer staple fossa of, the deck features of various arrangements disclosed herein are used.

In at least one arrangement, each inner staple fossa 5430A detachably houses the inner staple 5440 within it. Each intermediate staple fossa 5430B detachably houses the intermediate staple 5450 within it. Each outer staple fossa 5430C detachably houses an interlateral staple 5460 within it. Each inner staple 5440 is supported on a corresponding drive 5414. Each intermediate staple 5450 is supported on a corresponding intermediate staple drive 5416. Each outer staple 5460 is supported on a corresponding outer drive 5418. Drives 5414, 5416, 5418 form part of a movable drive assembly 5419 that is operably supported by staple fasteners 5400. It will be understood that by applying the actuating motion to the drive assembly 5419, each staple 5440, 5450, 5460 advances to provide contact formation with the anvil 5470. In the illustrated arrangement, the inner staples, the intermediate staples, and the outer staples, 5440, 5450, 5460, may have the same configuration and may have the same unformed height.

As the stapling fastener 5400, an anvil 5470 may be used as shown in FIG. As can be seen in FIG. 91, the anvil 5470 may include two insertions 5474 supported by the anvil body 5472, whereby one insertion 5474 is placed on one side of the cutting slot 5428. The other insertion portion 5474 corresponds to a staple arranged on the other side of the cutting slot 5428. As can be seen in Figure 89, when the anvil 5470 is closed, the insertion portion 5474 is disposed at unformed distance _{G 1} from the cartridge deck 5422. Each insert 5474 comprises an inner row of inner staple forming fossa 5478A, an intermediate row of intermediate staple forming fossa 5478B, and an outer row of outer staple forming fossa 5478C. The stapling fossa 5478A, 5478B, and 5478C may comprise any of the various stapling pocket arrangements disclosed herein. When the drive 5400 is fired, each of the staples 5440, 5450, 5460 has the same formation height and arrangement. However, other staple arrangements and staple forming pocket arrangements disclosed herein are also used to create staples with different formation heights and arrangements.

FIG. 92 shows another stapler 5500 according to at least one embodiment configured to capture, incise, and staple tissue. The staple fastener 5500 includes an anvil 5570 (FIG. 93) configured to be supported in a confrontational manner with respect to the frame assembly 5510, the staple cartridge 5520, and the deck 5522 of the staple cartridge 5520. The staple fastener 5500 further includes a knife assembly that includes a cutting member 5512 configured to incise the tissue trapped between the staple cartridge 5520 and the anvil 5570. The staple cartridge 5520 comprises a deck 5522 including a centrally located cutting slot 5528 configured to receive the cutting member 5512. Spacing Inner rows of staple cavities 5530A are provided on each side of the cutting slot 5528. Intermediate rows of spaced intermediate staple pits 5530B are provided adjacent to each inner row of spaced inner staple pits 5530A on each side surface of the cutting slot 5528. The outer rows of the spaced outer staple fossa 5530C are provided adjacent to each of the intermediate rows of the intermediate staple fossa 5530B. In this embodiment, the deck feature portion is not shown. However, other embodiments relate to some or all inner staple follicles and / or some or all intermediate staple follicles and / or some or all. In connection with the outer staple fossa of, the deck features of various arrangements disclosed herein are used. Still in other arrangements, staple pits arranged in any other row may have deck features associated with it.

In at least one arrangement, each inner staple fossa 5530A detachably houses the inner staple 5540 within it. Each intermediate staple fossa 5530B detachably houses the intermediate staple 5550 within it. Each outer staple fossa 5530C detachably houses the outer staple 5560 within it. Each staple 5540, 5550, 5560 is supported on a corresponding drive that forms part of a movable drive assembly that is operably supported by the staple fastener 5500. It will be understood that the application of the actuating motion to the drive assembly causes each staple 5540, 5550, 5560 to move forward and provide contact formation with the anvil 5570. In the illustrated arrangement, as shown in FIG. 95, the inner staples, the intermediate staples, and the outer staples, 5440, 5450, 5460, may have the same configuration and may have the same unformed height. In one arrangement, for example, staples 5540, 5550, and 5560 are incorporated herein by reference in their entirety, US Patent Application No. 14 / 863,110, Title: "SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR". STAPLING ISTRUMENTS ”(filed August 26, 2015) The types and arrangements disclosed may be used.

In addition to the above, the staples of the staple cartridge disclosed herein can include one or more mechanisms configured to hold the staples in the staple fossa of the staple cartridge. Moving on to FIGS. 94 and 95, the staples 5540, 5550 and 5560 include the base 5542 and the staple legs 5544 and 5546 extending from the base 5542, respectively. The base 5542 comprises a protrusion 5543 extending from the corresponding stapling sockets 5530A, 5530B, and 5530C that engages with the corresponding stop or groove 5531 on the side wall. The interaction between the protrusion 5543 and the immobilization or groove 5531 on the side wall of the staple fossa prevents the staples 5540, 5550, 5560 from falling out of the bottom of the cartridge 5520. The interaction between the protrusion 5543 and the side wall of the staple fossa comprises a clasp, in which the staples 5540, 5550, 5560 are ejected from the fossa 5530A, 5530B, and 5530C, respectively. Does not prevent that. The overhang 5543 can be formed at the base 5542, for example, during the punching process. The punching process can form a protrusion 5543 by creating a recess on the opposite side of the base 5542. An alternative embodiment is envisioned that does not include a groove or stop 5531.

As the stapling fastener 5500, an anvil 5570 may be used as shown in FIG. 93. As can be seen in FIG. 93, the anvil 5570 has two inner rows of 5579 vs. 5578A of the inner stapling pockets, two intermediate rows of 5578B of the middle stapling pockets 5579 and 5579B of the outer stapling pockets 5579. Includes two outer rows 5577C vs. 5578C. The staple forming pockets 5579 in a single pair 5578A, 5578B and 5578C are spaced apart from each other and configured to accept and form the corresponding legs 5544, 5546 of the particular staples 5540, 5550, and 5560. There is. However, the stapling pocket 5579 may be provided in any of the various stapling pocket arrangements disclosed herein.

FIG. 96 shows another stapler 5600 according to at least one embodiment configured to capture, incise, and staple tissue. The staple fastener 5600 includes an anvil 5670 (FIG. 97) configured to be supported in a confrontational manner with respect to the frame assembly 5610, the staple cartridge 5620, and the deck 5622 of the staple cartridge 5620. The staple fastener 5600 further includes a knife assembly that includes a cutting member 5612 configured to incise the tissue trapped between the staple cartridge 5620 and the anvil 5670. The staple cartridge body 5620 comprises a deck 5622 including a centrally located cutting slot 5628 configured to receive the cutting member 5612. The inner row 5630A of the spaced stapling fossa 5632 is provided on each side surface of the cutting slot 5528. The outer row 5630B of the spaced stapling fossa 5632 is provided adjacent to each of the inner rows 5630A of the stapling fossa 5632. In this embodiment, the deck feature portion is not shown. However, other embodiments are various disclosed herein in connection with some or all inner staple follicles and / or in connection with some or all outer staple follicles. The deck feature part of the arrangement of is used.

In at least one arrangement, each staple fossa 5632 detachably stores the staple 5640 within it. Each staple 5640 is supported on a corresponding drive 5650 that forms part of a movable drive assembly that is operably supported by the staple fastener 5600. It will be understood that the application of the actuating motion to the drive assembly causes each staple 5640 to move forward and provide contact formation with the anvil 5670. In the illustrated arrangement, each staple 5640 comprises a crown 5642 and two spaced legs 5644, 5646. As discussed herein, the legs 5644, 5646 may be perpendicular to the crown 5642, or they may not be perpendicular to the crown 5642. As can be seen in FIG. 97, each staple drive 5650 comprises a central portion 5652 having a _first width W 1 and two end portions 5644 _{each having a narrower width W 2.} The end 5654 supports each end of the corresponding staple 5642. Each fossa 5632 is similar in shape to the central 5634 and the two end 5636s. The narrow end 5636 provides lateral support to the staple legs 5644, 5646 as the staple 5642 is ejected out of the fossa 5632.

As the stapling fastener 5600, an anvil 5670 may be used as shown in FIG. 98. As can be seen in this figure, the anvil 5670 includes two inner rows 5678A of staple forming pockets 5680, 5690 vs. 5679A and two outer rows 5678B of staple forming pockets 5680, 5690 vs. 5679B. The staple forming pockets 5680, 5690 in a single pair 5679A, 5679B are configured to be spaced apart from each other and to receive and form the corresponding legs 5544, 5546 of a particular staple 5640. As can be seen in FIG. 99, each staple pocket 5680 has an outer pocket portion 5682 formed so that it is first contacted by the ends of the corresponding legs 5644, and a forming process by which it is formed inside. Includes an inner pocket portion 5864 configured to capture the leg portion 5644 upon completion. Similarly, each staple pocket 5690 has an outer pocket 5692 formed so that it is first contacted by the end of the corresponding leg 5646, and the leg as it is formed inward to complete the forming process. Includes an inner pocket portion 5694 configured to capture the 5646. Outer pocket portion 5682 has a width _{S 1,} also inside the pocket portion 5684 has a width _{S 2.} In the illustrated embodiment, S ₁ > S ₂ . Such an arrangement helps to provide a wider initial contact area for the legs and also holds the legs by staple crowns in a planar arrangement during the forming process, as shown in FIG. In addition, the forming staples help to provide the staples 5640.

FIG. 100 shows a portion of another stapler 5700, according to at least one embodiment, configured to capture, incise, and staple tissue. The staple fastener 5700 comprises an elongated channel 5710, a staple cartridge 5720, and an anvil 5770 configured to be supported in a confrontational manner with respect to the deck 5722 of the staple cartridge 5720. The staple fastener 5700 further comprises a knife assembly 5780 comprising a cutting member 5782 configured to incise the tissue trapped between the staple cartridge 5720 and the anvil 5770. In the illustrated arrangement, the knife assembly 5780 is suspended from a rotary drive shaft 5770 operably supported within the anvil 5772. The rotation of the rotary drive shaft 5772 in the first rotation direction drives the knife assembly 5780 distally via the staple cartridge 5720. The rotation of the drive shaft 5772 in the second opposite direction causes the knife assembly 5780 to be pulled in in the proximal direction. The knife assembly 5780 serves to drive distally a wedge thread (not shown) that connects to a staple drive and eventually ejects staples from the staple cartridge 5720.

The staple cartridge body 5720 comprises a deck 5722 including a centrally located cutting slot 5728 configured to receive the cutting member 5782. An inner row of spaced inner staple fossa 5730A is provided on each side of the cutting slot 5728. An intermediate row of spaced intermediate staple fossa 5730B is provided on each side surface of the cutting slot 5728, adjacent to each medial row of spaced inner staple fossa 5730A. The outer rows of the spaced outer staple fossa 5730C are provided adjacent to each of the intermediate rows of the intermediate staple fossa 5730B. As can be seen in FIG. 100, the various arrangements of deck feature 5731 disclosed herein may be associated with each of the staple cavities 5730A, 5730B, 5730C. In other embodiments, one of any other inner staple fossa 5730A and / or one of any other intermediate staple fossa 5730B and / or one of any other outer staple fossa 5730C is with it. It has a related deck feature 5731. Still in other arrangements, deck features may not be used in connection with any staple cavities 5730A, 5730B, and 5730C.

As can be seen in FIG. 100, the anvil 5770 may include two insertions 5774 supported by the anvil body 5717, whereby one insertion 5774 is placed on one side of the cutting slot 5728. The other insertion portion 5774 corresponds to a staple arranged on the other side of the cutting slot 5728. As can be seen in FIG. 100, when the anvil 5770 is closed, the insertion portion 5774 is disposed at unformed distance _{G 1} from the cartridge deck 5722. Each insert 5774 comprises an inner row of inner staple forming fossa 5778A, an intermediate row of intermediate staple forming fossa 5778B, and an outer row of outer staple forming fossa 5778C. The stapling fossa 5778A, 5778B, and 5778C may comprise any of the various stapling pocket arrangements disclosed herein. When the drive 5700 is fired, each of the staples 5740 gets the same formation height and arrangement. However, other staple arrangements and staple forming pocket arrangements disclosed herein may also be used, thereby creating staples with different formation heights and arrangements.

Here, referring to FIG. 101, the staple 5740 includes a base 5742 and staple legs 5744, 5548 extending from the base 5542. In the illustrated arrangement, the legs 5744 may have a gull-winged arrangement. That is, the leg 5744 has a vertical extension 5745 and an inwardly angled end 5746. In other embodiments, US Patent Application No. 14 / 863,110, which is incorporated herein by reference in its entirety, is entitled "SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS" (August 26, 2015). The type and staple arrangement disclosed in the application) may be used.

FIG. 102 shows a surgical staple cartridge 5820, eg, relating to the staple fastening device 5700 described above, or one of the similar staple fastening device arrangements disclosed in the various references incorporated herein by reference. And may be used. The staple cartridge 5820 comprises a deck 5822 that includes a centrally located cutting slot 5828 configured to receive cutting members through it. The inner row 5830A of the spaced stapling fossa 5832 is provided on each side surface of the cutting slot 5828. An intermediate row 5830A of the spaced stapling fossa 5832 is provided adjacent to each inner row 5830A on each side surface of the cutting slot 5828. The outer rows 5832C of the spaced fossa 5832 are provided adjacent to each of the intermediate rows 5830B of the staple fossa 5832. In this embodiment, the deck feature portion is not shown. However, other embodiments relate to some or all inner staple follicles and / or some or all intermediate staple follicles and / or some or all. In connection with the outer staple fossa of, the deck features of various arrangements disclosed herein are used.

In at least one arrangement, each staple fossa 5832 detachably stores the staple 5840 within it. In one arrangement, for example, the staples 5840 are incorporated herein by reference in their entirety, U.S. Patent Application No. 14 / 863,110, title: "SURGICAL STAPLING CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS" (20). It may be the type and staple arrangement disclosed in (filed on August 26, 2014). In addition to the above, the staples of the staple cartridge disclosed herein can include one or more mechanisms configured to hold the staples in the staple fossa of the staple cartridge. Moving on to FIG. 103, the staple 5840 includes a base 5842 and staple legs 5844, 5846 extending from the base 5842. The base 5842 comprises a protrusion 5843 extending from it and engages with the corresponding anti-movement or groove 5833 at the side wall of the corresponding staple fossa 5832. The interaction between the protrusion 5843 and the immobilization or groove 5833 on the side wall of the staple fossa prevents the staple 5840 from falling out of the bottom of the cartridge 5820. The interaction between the protrusion 5843 and the side wall of the staple fossa comprises a tight fit, but such a tight fit does not prevent the staple 5840 from being ejected from the respective fossa 5832. The overhang 5843 can be formed at the base 5842, for example, during the punching process. The punching process can form a protrusion 5843 by creating a recess on the opposite side of the base 5842. An alternative embodiment without a groove or anti-movement 5833 is envisioned.

FIG. 104 shows an anvil 5970, including a rotary drive shaft 5792 for driving the knife in the manner described above. The anvil 5970 may include two insertions 5974 supported by the anvil body 5971, whereby one insertion 5974 is placed on one side of a cutting slot in the corresponding staple cartridge (not shown). The other insertion section 5974 corresponds to a staple arranged on the other side of the cutting slot. Each insert 5974 comprises an inner row 5978A of the staple forming fossa 5980 vs. 5979A, an intermediate row 5978B of the staple forming fossa 5980 vs. 5979B, and an outer row 5978C of the staple forming fossa 5980 vs. 5979C. The staple forming pockets 5980 in a single pair 5979A, 5979B, 5979C are spaced apart from each other and are configured to receive and form the corresponding legs 5944, 5946 of the corresponding staple 5940.

The various staple cartridges and staple configurations disclosed herein may be used in connection with various drug elution configurations. Each of the following references is incorporated herein by reference in its entirety. US Patent Application No. 14 / 840,613, Title: "DRUG ELUTING ADJUNCTS AND METHODS OF USING DRUG ELUTING" (filed August 31, 2015), US Patent Application No. 14 / 667,874, Title: " MALLEABLE BIOABSORBABLE POLYMER ADHESIVE FOR RELEASABLY ATTACHING a STAPLE BUTTRESS TO a SURGICAL STAPLER "(March 25, 2015 application), US patent application Ser. No. 13 / 531,619, JP title:" TISSUE STAPLER HAVING a THICKNESS COMPENSATOR COMPRISING INCORPORATING a HEMOSTATIC AGENT ”(filed on June 25, 2012), US Patent Application Publication No. 2012/0318842, US Patent Application No. 13 / 531,623, Title:“ TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORATING AN OXYGEN Published June 25, 2012), US Patent Application Publication No. 2012/0318843, US Patent Application No. 13 / 531,627, Title: "TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORATING AN ANTI-MICROBLAL AGENT" Filed on June 25), US Patent Application Publication No. 2012/0312860, US Patent Application No. 13 / 531,630, Title: "TISSUE STAPLER HAVING A THICKNESS COMPENSATOR INCORPORATING AN ANTI-INFRAMATORY AGENT 20" 25th application), US Patent Application Publication No. 2012/0318844, US Patent Application No. 13 / 763,161, Title: "RELEASABLE LAYER OF MATERIAL AND SURGICAL END EFFECTOR HAVING THE" "SAME" (filed on February 8, 2013), US Patent Application Publication No. 2013/0153641, US Patent Application No. 13 / 763,177, Title: "ACTUATOR FOR RELEASING A LAYER OF MATERIAL FROM A SURGICAL END EFFETOR" (February 8, 2013), US Patent Application Publication No. 2013/0146641, US Patent Application No. 13 / 763,192, Title: "MULTIPLE THICKNESS IMPLANTABLE LAYERS FOR SURGICAL STAPLING DEVICES" (February 8, 2013) ), US Patent Application Publication No. 2013/0146642, US Patent Application Publication No. 13 / 763,028, Title: "ADHESIVE FILM LAMINATE" (February 8, 2013), US Patent Application Publication No. 2013/0146643, US Patent Application No. 13 / 763,035, Title: "ACTUATOR FOR RELEASING A TISSUE THICKNESS COMPENSATOR FROM A FASTENEER CARTRIDGE" (February 8, 2013), US Patent Application Publication No. 2013/0214030, US Patent Application 13 / 763,042, Title: "RELEASABLE TISSUE TISSUE THICKNESS COMPENSATOR AND FASTENEER CARTRIDGE HAVING THE SAMME" (February 8, 2013), US Patent Application Publication No. 2013/0221063, US Patent Application No. 13/76240 Gazette, Title: "FASTENER CARTRIGGE COMPRISING A RELEASABLE TISSUE TISSUE THICKNESS COMPENSATOR" (February 8, 2013), US Patent Application Publication No. 2013/0221064, US Patent Application No. 13 / 763,054, Title: "FASTENER CARTRIDGE COMPRISING A CUTTING MEMBER FOR RELEASING A TISSUE THICKNESS COMPENSATOR ”(February 8, 2013), US Patent Application Publication No. 2014/00 No. 97227, U.S. Patent Application No. 13 / 763,065, Title: "FASTENEER CARTRIDGE COMPRISING A RELEASABLY ATTACEED TISSUE THICKNESS COMPENSATOR" (February 8, 2013), U.S. Patent Application Publication No. 2013/0221065, U.S.A. No. 13 / 763,078, Title: "ANVIL LAYER ATTACEED TO A PROXIMAL END OF AN END EFFECTOR" (February 8, 2013), US Patent Application Publication No. 2013/0256383, US Patent Application No. 13/763 , 094, Title: "LAYER COMPRISING DEPLOYABLE ATTACHMENT MEMBERS" (February 8, 2013), US Patent Application Publication No. 2013/0256377, US Patent Application No. 13 / 763,106, Title: "END EFFECTOR" COMPRISING A DISTAL TISSUE ABUTMENT MEMBER "(February 8, 2013), US Patent Application Publication No. 2013/0256378, US Patent Application No. 13 / 532,825, Title:" TISSUE THICKNESS COMPENSATOR HAVING IMP June 26, 2013), US Patent Application Publication No. 2013/0256376, US Patent Application No. 14 / 300,954, Title: "ADJUNCT MATERIALS AND METHODS OF USING SAME IN SURGICAL METHODS FOR TISSUE SEALING" (2014) US Patent Application Publication No. 2015/0351758, US Patent Application No. 14 / 926,027, Title: "SURGICAL STAPLER BUTTRESS ASSEMBLY WITH GEL ADHESIVE RETAINER" (October 29, 2015), US Patent Application No. 14 / 926,029, Title: "FLUID PENETRABLE BUTTRESS ASSEMBLY FOR A SURGICAL STAPLER" (2) (October 29, 015), US Patent Application No. 14 / 926,072, Title: "SURGICAL STAPLER BUTTRESS ASSEMBLY WITH FEATURES TO INTERACT WITH MOVABLE END EFFECTOR, October 29, 2015" Application No. 14 / 926,090, Title: "EXTENSIBLE BUTTRESS ASSEMBLY FOR SURGICAL STAPLER" (filed October 29, 2015), and US Patent Application No. 14 / 926,160, Title: "MULTI-LAYER SURGICAL" STAPLER BUTTRESS ASSEMBLY ”(filed on October 29, 2015).

The various anvil arrangements disclosed herein may use relatively flat forming inserts including staple forming pockets formed therein, or various anvil arrangements may be formed therein. It may have a "stepped" forming surface with corresponding staple forming pockets. The various staple cartridge arrangements herein may have a flat deck surface, or the deck surface may be stepped (including deck surfaces on different planes). In some embodiments, the deck features may be associated with all staple cavities in the staple cartridge. In other arrangements, deck features may be used in association with all staple cavities in the outer row of any other staple cavities. Still other embodiments assume that the deck features are associated with every other row of fossa in a particular row, with every other row of fossa being constructed. Still, in other embodiments, it is conceivable that the deck features will not be used.

In various embodiments disclosed herein, staples with a "U" shaped unformed arrangement may be used, or the staples may have different unformed shapes, eg, the base or crown is rectangular. Has a cross-sectional shape of. The various staples may be formed from wires having a circular cross-sectional shape, a square cross-sectional shape, a combination of circular and square cross-sectional shapes, and the like. Staples may provide one or more legs with a gull-wing or tapered arrangement. Staples may have different wire diameters and different maximum cross-sectional areas. The staple legs may be bilaterally symmetric, or they may be non-symmetrical (with or without curved ends). The legs of certain staples may be parallel to each other, or they may not be parallel to each other. Staples within a particular cartridge may have the same unformed height, or they may have different unformed heights. Staples within or in a particular cartridge may have the same crown width, or they may have different crown widths. Staples and their corresponding staple pockets may be configured so that the legs are coplanar with the staple crown or base when the staples are formed, or they are when the staples are formed. The legs may be configured so that they are not coplanar with the staple crown or base. All of the staple features described above can be changed from staple to staple between the area of the staple and the cartridge selection.

In a circular staple anvil arrangement, the staple forming pockets may be tangent to the circumference of the anvil. In other arrangements, or in addition to the tangentially arranged staple forming pockets, the other staple forming pockets may be provided at an angle to the tangential direction. Such changes in stapling pocket orientation may be provided within a particular row of stapling pockets or in different rows of stapling pockets. Different types of staple forming pocket shapes may be used. A conventional symmetrical staple forming pocket shape may be used. In addition or alternative, an asymmetrical staple-forming pocket shape may be used. Other staple forming pockets may have a bow tie shape with a wide landing zone for each staple leg that passes the corresponding leg through a narrower exit pocket. All the staple-forming pocket features described above can be varied from pocket to pocket between the area or line of the pocket and a particular anvil selection.

The various staple devices disclosed herein provide different sums of drive movements adjusted to achieve the desired forming staple height for the corresponding gap provided between the anvil and the cartridge. It may be configured to provide. For example, in some arrangement configurations, the staple drive may be driven to control the height of the formed staples just through the cartridge deck or moderately through the cartridge deck. By matching the total movement of the drive unit with a particular staple having the desired unformed length or height, a staple with the desired formed height can be obtained.

As described in various embodiments of the present disclosure, surgical staple fastening and cutting instruments include cartridge channels configured to accept anvils and staple cartridges. One or both of the anvil and staple cartridges are movable between the open and closed arrangements and relative to the other, capturing tissue between them. Staples are placed from the staple fossa in the staple cartridge to the captured tissue. Staples are formed on the forming pockets in the anvil. The staple cartridge can be replaced after the staples have been placed.

In order to properly form the staples, the staple cavities and forming pockets need to be closely aligned in a closed arrangement. The limitation on this one type of anvil is that it can only be used with one type of staple cartridge. Different staples with differently placed staple cavities cannot be used for the same anvil because the staple cavities cannot be properly aligned with the anvil forming pocket. The present disclosure includes various embodiments that modify the anvils that can be used with different staple cartridges. Another limitation arises if the anvil contains one or more components that are modified or configured to be used during the placement of the staples. The present disclosure presents various embodiments that modify the anvil to supplement components or features that are modified or used during the placement of staples, and / or present new features and / or components. include.

Referring to FIG. 106, the anvil assembly 15000 includes an anvil changing member 15004 attached to the anvil 15002. The anvil changing member 15004 includes a tissue contact surface 15006 and an anvil contact surface 15008. The tissue contact surface 15006 comprises a pocket 15010 that is different from the forming pocket 15012 of the anvil 15002. The forming pocket 15012 can be aligned with the staple fossa of the first staple cartridge when the anvil changing member 15004 is not attached to the anvil 15002. While the anvil changing member 15004 is different from the staple fossa of the first staple cartridge when attached to the anvil 15002, however, the forming pocket 15010 is misalignable with the staple fossa of the second staple cartridge.

As illustrated in FIG. 106, the anvil changing member 15004 comprises a non-stepped deck 15015, while the anvil 15002 comprises a stepped deck 15013. Alternatively, the anvil may include a non-stepped deck, which can be modified by an anvil changing member with a stepped deck. The stepped deck 15013 includes an outer row of forming pockets 15012'that step up from the inner row of forming pockets 15012. The non-step deck 15015 includes a forming pocket 15010 defined by a flat tissue contact surface 15006. In at least one case, the anvil changing member may include one or more rows of forming pockets 15010 that step up from the outer row of forming pockets 15010.

In at least one case, the anvil changing member 15004 can be used if one or more components or features of the anvil are changed or used during the previous use of the anvil. In this case, the anvil changing member can replace the used or modified tissue contact surface of the anvil with a new tissue contact surface with new components or features. For example, the molded pocket 15012 of the anvil 15002 may include circuit elements that can be cut during the placement of the staples. Instead of repairing the disconnected circuit element each time the anvil is used, an anvil modification member can be used to present a replacement tissue contact surface, including an anvil pocket with an undamaged circuit element. In another embodiment, the anvil may include an implantable layer positioned relative to the tissue contact surface of the anvil. Instead of attaching a new embedded layer to the anvil each time the anvil is used, an anvil changing member is used to present an exchange tissue contact surface with an embedded layer attached to the exchange tissue contact surface. be able to.

In at least one case, the anvil changing member 15004 can be used to introduce one or more new components and features into the anvil. As shown in FIG. 107, the anvil changing member 15004 includes an embedded layer 15014. Originally, although the anvil 15002 does not have to include the embedded layer, as shown in FIG. 106, the embedded layer is added to the anvil 15002 by attaching the anvil changing member 15004 to the anvil 15002. can do. For example, various attachment means such as biocompatible adhesives and / or straps can be used to attach the embedded layer 15014 to the anvil modification member 15004. The embedded layer 15014 is removed from the anvil changing member 15004 during the placement of the staples. In certain cases, the forming staples define an uptake region that may contain a portion of the tissue and implantable layer 15014. In such cases, the incorporated portion of the implantable layer 15014 can function as a tissue thickness compensating element. The embedded layer 15014 may contain a polymeric composition. The polymer composition may include one or more synthetic polymers and / or one or more non-synthetic polymers. The synthetic polymer may include a synthetic absorbent polymer and / or a synthetic non-absorbable polymer.

During the staple formation process, the anvil is exposed to considerable force. The gap between the anvil and the anvil changing member can result in reduced stability and / or increased risk of failure during the staple forming process. As shown in FIGS. 106 and 107, the anvil changing member 15004 includes a gap filter 15016 extending from the anvil contact surface 15008 of the anvil changing member 15004. The clearance filter 15016 is configured to provide additional support between the anvil 15002 and the anvil changing member 15004, and the clearance filter 15016 is particularly useful in situations where the anvil includes a stepped deck.

As shown in FIG. 106, the stepped deck 15013 of the anvil 15002 has one or more gaps between the anvil 15002 and the anvil changing member 15004. The clearance filter 15016 is strategically positioned with respect to the outer row of the forming pocket 15012'of the stepped deck 15013, with the anvil changing member 15004 and the anvil 15002 when the anvil changing member 15004 is attached to the anvil 15002. Minimize the gap between them. In at least one case, the anvil contact surface 15008 of the anvil modification member 15004 is configured to fill or substantially fill the corresponding anvil pocket of the anvil obtained attached to the anvil modification member 15004. including.

The anvil changing member 15004 includes one or more mounting mechanisms 15018. In at least one case, the attachment mechanism 15018 is configured to detachably attach the anvil changing member 15004 to the anvil 15002. As shown in FIGS. 106 and 107, the mounting mechanism 15018 of the anvil changing member 15004 is configured with side walls that are sufficiently spaced apart from each other to snugly grip the outer wall 15020 of the anvil 15002. The mounting mechanism 15018 is angled, curved, half-bent, and / or ground so that when the anvil changing member 15004 is attached to the anvil 15002, the anvil 15002 forms a continuous or flat surface. Includes the edge 15022. The resulting surface is intended to reduce or prevent damage to the tissue.

In at least one case, the anvil changing member can be designed to snap engage with the anvil. For example, the anvil may include one or more slits configured to functionally accept one or more upright tabs extending from the anvil contact surface of the anvil changing member. For example, other attachment means such as biocompatible adhesives and / or screws can be used to position the anvil changing member relative to the anvil.

Referring to FIGS. 106 and 107, the anvil changing member 15004 includes a cross-cuttable portion 15024 extending longitudinally between the two sides 15028 and 15030 of the anvil changing member 15004. As shown in FIG. 106, when the anvil changing member 15004 is attached to the anvil 15002, the cross-cuttable portion 15024 extends longitudinally between the two sides 15032 and 15034 of the stepped deck 15013 of the anvil 15002. Aligned along slot 15026. The cross-cuttable portion 15024 is cut by a cutting member that moves distally along the longitudinal slot 15026. When the anvil changing member 15004 is attached to the anvil 15002, the cross-cutting possible portion 15024 stabilizes the anvil changing member 15004. In at least one case, the sides 15028 and 15030 of the anvil changing member 15004 are completely cut and separated by the cutting member as the cutting member advances distally along the longitudinal slot 15026. In other cases, the sides 15028 and 15030 of the anvil changing member 15004 are only partially cut by the cutting member as the cutting member advances distally along the longitudinal slot 15026.

With reference to FIG. 108, the anvil changing member 15104 is shown. The anvil changing member 15104 is similar in many respects to the anvil changing member 15004. For example, the anvil changing member 15104 is detachably attached to the anvil 15002. Unlike the anvil changing member 15004, the anvil changing member 15104 lacks a cross-cutting possible portion. Instead, the anvil modification member 15104 includes an elongated slot 15124 extending between the two sides 15128 and 15130 of the anvil modification member 15104. In other cases, however, the anvil changing member 15104 may be equipped with a cross-cuttable portion instead of the elongated slot 15124.

The anvil changing member 15104 includes a proximal end 15136 and a distal end 15138. The elongated slot 15124 can be defined via the proximal end 15136 and / or the distal end 15138. The elongated slot 15124 defines the longitudinal axis 15140 between the two sides 15128 and 15130. As shown in FIG. 109, when the anvil changing member 15104 is attached to the anvil 15002, the elongated slot 15124 is aligned with the elongated slot 15026 of the anvil 15002. During alignment, the elongated slots 15124 and 15026 are configured to receive, for example, cutting members adapted to cut soft tissue.

The anvil changing member 15104 includes three rows of forming pockets 15110a, 15110b, and 15110c on the sides 15128 and 15130, respectively. As shown in FIG. 109, the plurality of first forming pockets 15110a can be parallel to each other, or at least substantially parallel to each other. Similarly, the plurality of second forming pockets 15110b can be parallel to each other, or at least substantially parallel to each other, and / or the plurality of third forming pockets 15110c can be parallel to each other, or at least substantially parallel to each other. Can be. In at least one case, "nearly parallel" can mean, for the purposes of this specification, that it is within a range of about 15 degrees parallel to any direction.

In certain cases, at least one first forming pocket 15110a, at least one second forming pocket 15110b, and at least one third forming pocket 15110c are defined at the tissue contact surface 15108 of the anvil changing member 15004. The first forming pocket 15110a, the second forming pocket 15110b, and the third forming pocket 15110c can be located on the side surface 15128 and / or the side surface 15130. As shown in FIG. 109, the first forming pocket 15110a defines a first axis 15142 extending across the proximal and distal ends of the first forming pocket 15110a. Similarly, the second forming pocket 15110b defines a second axis 15144 extending across the proximal and distal ends of the second forming pocket 15110b. The third forming pocket 15110c also defines a third axis 15146 extending across the proximal and distal ends of the third forming pocket 15110c. The second axis 15144 crosses the first axis 15142 so that the axes 15144 and 15142 generate an acute or obtuse angle between them. The second axis 15144 crosses the third axis 15146, whereby the axes 15144 and 15146 generate an acute angle or an obtuse angle between them.

As shown in FIG. 109, for example, the first axis 15142 is perpendicular to, or at least substantially perpendicular to, the first axis 15142 and / or the third axis 15146. , Parallel to the third axis 15146, or at least substantially parallel. In at least one case, "nearly vertical" can mean, for the purposes of this specification, that it is within a range of about 15 degrees perpendicular to either direction.

Referring to FIGS. 109-112, the first forming pocket 15110a, the second forming pocket 15110b, and the third forming pocket 15110c of the anvil changing member 15104 are the first staple fossa 15210a, the second staple fossa 15210b, and the second staple fossa 15210b of the staple cartridge 15200. It is configured to form or bend the staples, respectively, which can be placed from the third staple fossa 15210c. For example, the first forming pocket 15110a includes two forming pockets 15152 configured to receive and form the stapling leg 15254 of the stapling 15256 when the stapling 15256 is placed from the first stapling fossa 15210a. ..

In the closed configuration, the anvil 15002 is at least substantially aligned with the staple cartridge 15200 so that the tissue is captured between the tissue contact surface 15108 of the anvil changing member 15200 and the tissue contact surface 15208 of the staple cartridge 15104. .. The first forming pocket 15110a, the second forming pocket 15110b, and the third forming pocket 15110c of the anvil changing member 15104 are aligned with the first stapling fossa 15210a, the second stapling fossa 15210b, and the third stapling fossa 15210c, respectively. Or at least substantially aligned to capture and form the stapling legs 15254 of the placed stapling 15256.

The staple cartridge 15200 includes a first side 15228 and a second side 15230. The elongated slot 15224 extends between the first side 15228 and the second side 15230. The elongated slot 15224 can extend between and / or through the proximal end 15236 and the distal end 15238 of the staple cartridge 15200. The staple cartridge 15200 includes three rows of staple cavities 15210a, 15210b, and 15210c on the sides 15228 and 15230, respectively. In the closed arrangement, the elongated slot 15224 is aligned, or at least substantially aligned, between the elongated slot 15002 of the anvil 15026 and the elongated slot 15104 of the anvil changing member 15124. During alignment, the elongated slots 15224, 15124 and 15026 are configured to receive, for example, cutting members adapted to cut soft tissue.

As shown in FIG. 110, the plurality of first staple cavities 15210a are parallel to each other, or at least substantially parallel to each other. Similarly, the plurality of second staple cavities 15210b are parallel to each other, or at least substantially parallel to each other, and / or the plurality of third staple cavities 15210c are parallel to each other, or at least substantially parallel to each other.

In certain cases, at least one first staple fossa 15210a, at least one second staple fossa 15210b, and at least one third staple fossa 15210c are defined at the tissue contact surface 15208 of the staple cartridge 15200. The first staple fossa 15210a, the second staple fossa 15210b, and the third staple fossa 15210c can be located on the side surface 15228 and / or the side surface 15230. As shown in FIG. 110, the first staple fossa 15210a defines a first axis 15242 extending across the proximal and distal ends of the first staple fossa 15210a. Similarly, the second staple fossa 15210b defines a second axis 15244 extending across the proximal and distal ends of the second staple fossa 15210b. The third staple fossa 15210c also defines a third axis 15246 extending across the proximal and distal ends of the third staple fossa 15210c. The second axis 15244 crosses the first axis 15242 so that the axes 15244 and 15242 generate an acute or obtuse angle between them. The second axis 15244 crosses the third axis 15246, whereby the axes 15244 and 15246 generate an acute angle or an obtuse angle between them. As shown in FIG. 110, for example, the first axis 15242 is perpendicular to, or at least substantially perpendicular to, the first axis 15242 and / or the second axis 15246. , Parallel to the second axis 15246, or at least substantially parallel.

In various cases, in addition to the above, the anvil may include a row of staple forming pockets aligned along a first set of longitudinal axes. Anvil changing members that can be attached to the anvil may include a row of staple forming pockets that are aligned along a second set of longitudinal axes that are not aligned with the first set of longitudinal axes. As a result, the staple forming pocket on the anvil changing member is not longitudinally aligned with the staple forming pocket on the anvil. In some examples, the longitudinal rows of forming pockets on the anvil modification member, the rows are aligned with the longitudinal rows forming the pockets on the anvil, and the other longitudinal rows on the anvil modification member are on the anvil. Does not match the longitudinal row of forming pockets.

Referring to FIGS. 113 and 114, at least one first staple 15256a from at least one first staple fossa 15210a, at least one second staple 15256b from at least one second staple fossa 15210b, and at least one third. At least one third staple 15256c from the staple fossa 15210c can be simultaneously placed in the tissue captured between the anvil changing member 15104 and the staple cartridge 15200. The triple staple drive 15260 is configured to work with the cam thread of the staple cartridge 15200 to simultaneously place three staples 15256a, 15256b, and 15256c from their respective staple cavities 15210a, 15210b, and 15210c. obtain. The cam slot allows the staple drive unit 15260 to be lifted or slid upward within the staple sockets 15210a, 15210b, and 15210c, whereby the upward movement of the staple drive unit 15260 is allowed to move the staple drive unit 15260a, 15256b and 15256c can be ejected or placed.

As shown in FIGS. 113 and 114, each of the three staples 15256a, 15256b, and 15256c includes a base 15253 positioned relative to the cradle 15255 of the staple drive 15260. The staple drive 15260 is configured to work with the cam thread of the staple cartridge 15200 to simultaneously place three staples 15256a, 15256b, and 15256c from their respective staple cavities 15210a, 15210b, and 15210c. It is equipped with two lamps 15257.

The three staples 15256a, 15256b, and 15256c define common surfaces 15272, 15274, and 15276, respectively. The three staples 15256a, 15256b, and 15256c are oriented with respect to the ste-pull drive 15260 so that the second common surface 15274 crosses the first common surface 15272, thereby the common surface. 15274 and 15272 generate an acute or obtuse angle between them. The second common surface 15274 crosses the third common surface 15276, whereby the common surfaces 15274 and 15276 generate an acute angle or an obtuse angle between them. As shown in FIG. 114, the first common plane 15272 is perpendicular to, or at least substantially perpendicular to, the first common plane 15272 and the third common plane 15276. , Parallel to the third common plane 15276, or at least substantially parallel.

Referring to FIG. 115, the end effector 15300 includes a staple cartridge 15301 shown in a closed arrangement with an anvil assembly 15303 including an anvil modification member 15304 attached to the anvil 15002. The anvil changing member 15304 is similar in many respects to the anvil changing member 15004. For example, the anvil changing member 15304 includes a cross-cuttable portion 15024 and a forming pocket 15010 arranged on two sides 15028 and 15030 of the anvil changing member 15304. The embedded layer 15314 is arranged with respect to the forming pocket 15010 on the side surface 15028, and the embedded layer 15315 is arranged with respect to the forming pocket 15010 on the side surface 15030. Embedded layers 15314 and 15315 are spaced apart to define a gap 15317 between them. The gap 15317 extends in parallel with the longitudinal direction, or at least substantially parallel, with the cross-cuttable portion 15024. Embedded layers 15318 and 15319 are arranged with respect to the stepped deck 15321 of the staple cartridge 15301. The staples 15323 are supported by the cradle 15355 within the staple fossa 15325 of the staple cartridge 15301. As shown in FIG. 114, the staples 15323 are configured to be formed with respect to the forming pocket 15010 when the anvil changing member 15304 is attached to the anvil 15002. Alternatively, the staples 15323 are configured to form into the forming pockets 15012 and 15012'of the anvil 15002 when the anvil changing member 15304 is not attached to the anvil 15002.

FIG. 116 shows three non-formed staples 15323a, 15323b, and 15323c that are similar to each other and similarly located within the staple fossa 15325 of the staple cartridge 15301. Staples Staples 15323a, 15323b, and 15323c have the same, or at least substantially the same, unformed height H of about 0.038 cm (0.150 "). In various cases, the non-formed height H is. For example, it can be selected from the range of about 0.254 cm to about 0.508 cm (0.100 "to 0.200"). As shown in FIG. 116, the staples 15323a, 15323b, and 15323c are different. It has the heights H1, H2, and H3 formed. Staples 15323a, 15323b, and 15323c were formed in the inner row, middle row, and outer row of the staple cartridge 15301, respectively. Depends on the formation distance, defined between the corresponding cradle supporting the staple and the forming pocket in the corresponding staple fossa. Positioning the forming pocket closer to the corresponding cradle, or further from the corresponding cradle. The formation distance can be changed by speaking and positioning. The formation distance can be changed by using the anvil changing member. For example, as shown in FIG. 115, the second formation distance longer than the first formation distance D1. The formation distance D2 is defined between the formation pocket 15012'of the anvil 15002 and the same cradle 15355, while the first formation distance D1 is between the formation pocket 15010 and the formation cradle 15355 of the anvil changing member 15304. It is defined.

Referring to FIG. 116, the staple 15323b comprises a formed height H2 that is higher than the formed height H1 of the staple 15323a because the second forming distance D2 is larger than the first forming distance D1. In the alternative method, the staples 15323a were formed in the forming pocket 15010 of the anvil changing member 15304, while the staples 15323b were formed in the forming pocket 15012'of the anvil 15002. As shown in FIG. 116, the formed height H3 of the staple cartridge 15323c in the outer row of the staples of the staple cartridge 15301 is less than the formed height of the second staple leg of the staple 15323c. 1 The height at which the staple legs are formed. Staples such as staples 15323 may include staple legs formed to different staple heights, as shown in FIG. 116.

In various cases, the anvil changing member may include a stepped tissue contact surface, eg, at least one row of forming pockets is on or off the other rows of forming pockets. In certain cases, the anvil changing member may be positioned relative to a particular part of the anvil and modify that part. For example, the anvil changing member may be positioned relative to the proximal portion of the anvil to modify the proximal portion while keeping the distal and central portions unchanged. In another embodiment, the anvil changing member is positioned relative to the central portion of the anvil and may modify the central portion while keeping the distal and proximal portions unchanged. In yet another embodiment, the anvil changing member may be positioned relative to the distal portion of the anvil to modify the distal portion while keeping the proximal and central portions unchanged.

In various cases, the anvil changing member may be configured to modify a subset of the anvil forming pockets. For example, anvil changing members may be positioned relative to one or more rows of anvil forming pockets to keep one or more rows of forming pockets unchanged while keeping the remaining rows of anvil forming pockets unchanged. It can be fixed. In at least one case, the anvil modification member, such as the anvil modification member 15304, modifies or modifies the compression exerted on the tissue captured between the staple cartridge, eg, the staple cartridge 15301, and the anvil, eg, the anvil 15002. can do. The anvil changing member 15304 can increase the compression applied to the captured tissue by reducing the gap between the tissue compressions between the staple cartridge 15301 and the anvil 15002. By positioning the anvil changing member 15304 with respect to the anvil 15002, the size of the anvil changing member 15304, which increases the compression applied to the captured tissue, effectively reduces the dimensions between the tissue compression gaps. The tissue compression gap has a height of about 0.11 cm (0.045 "). In various cases, for example, the tissue compression gap is about 0.07 cm to 0.25 cm (0.03" to about 0. It may comprise a height selected from the range of 10 ″). Other values for the height of the tissue compression gap are considered in the present disclosure.

While many surgical instrument systems described herein are powered by electric motors, the surgical instrument systems described herein can be operated in any suitable manner. In various cases, the surgical instrument system described herein can be operated, for example, by a manually operated trigger. In certain cases, the motors disclosed herein may include parts or parts of a robotic control system. Also, any end effector and / or tool assembly disclosed herein can be used with a robotic surgical instrument system. U.S. Patent Application No. 13 / 118,241, Title: "SURGICAL STAPLING INSTRUMENTS WITH ROTABLE STAPLE DEPLOYMENT ARRANGEMENTS", now U.S. Patent Application Publication No. 2012/02987719, eg The example is disclosed in more detail.

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.

The entire disclosure below is incorporated herein by reference.
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Although various devices have been described herein with specific embodiments, modifications and modifications may 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 any case, the device can be readjusted for reuse after at least one use. The readjustment may include, but is not limited to, any combination of the disassembly step of the device, the subsequent cleaning or replacement step of a particular part of the device, and the subsequent reassembly step of the device. In particular, readjustment equipment and / or surgical teams can disassemble the device, clean and / or replace certain parts of the device, and then reassemble for subsequent use. Those skilled in the art will appreciate that readjustment of the equipment 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.

The devices disclosed herein can be processed prior to surgery. First, new or used utensils may be obtained and cleaned as needed. The instrument may 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 may 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 may also be sterilized using any other technique well known in the art, including but not limited to β-ray or gamma-ray, ethylene oxide, hydrogen peroxide plasma, and / or water vapor.

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

All patents, publications, or other disclosures that are incorporated herein by reference in whole or in part shall include existing definitions, descriptions, or other disclosures in which the incorporated material is described in this disclosure. It is incorporated herein by reference only to the extent that it does not conflict with the disclosure of the above. 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) An end effector for surgical staple fasteners
It ’s a staple cartridge,
The cartridge body including the deck and
A staple cartridge removably stored in the cartridge body, comprising a staple, each of which comprises a base and a leg extending from the base.
Anvil
Tissue compression surface and
Forming pockets defined on the tissue compression surface, each said forming pocket
A first end configured to receive the leg and
The second end and
A central longitudinal axis extending between the first end and the second end,
A concave rotating surface extending between the first end and the second end,
An end comprising a groove defined on the concave rotating surface, the groove being offset laterally from the central longitudinal axis, comprising a groove, comprising a forming pocket, comprising an anvil. Effector.
(2) The end effector according to the first embodiment, wherein the groove is parallel to the central longitudinal axis.
(3) The end effector according to the first embodiment, wherein the groove extends between the first end portion and the second end portion of the forming pocket.
(4) The end effector according to the first embodiment, wherein the rotating surface includes a bottom portion of the forming pocket and the groove is deeper than the bottom portion.
(5) The end effector according to the first embodiment, wherein the grooves of the forming pocket are aligned with each other.

(6) The end effector according to the first embodiment, wherein the forming pockets are arranged in an annular array, and the grooves of the forming pockets are positioned along the circumference.
(7) An end effector used together with a surgical fastening instrument.
It ’s a staple cartridge,
The cartridge body including the deck and
A staple cartridge comprising a fastener that is detachably stored in the cartridge body, wherein each fastener comprises a base and a leg extending from the base.
Anvil
Tissue compression surface and
Forming pockets defined on the tissue compression surface, each said forming pocket
A first end configured to receive the leg and
The second end and
A central axis extending between the first end and the second end,
A concave rotating surface extending between the first end and the second end,
An end effector comprising a channel defined on the concave rotating surface, comprising an anvil, comprising a channel, the channel being offset laterally from the central axis, and an anvil.
(8) The end effector according to embodiment 7, wherein the channel is parallel to the central axis.
(9) The end effector according to embodiment 7, wherein the channel extends between the first end and the second end of the forming pocket.
(10) The end effector according to embodiment 7, wherein the rotating surface comprises the bottom of the forming pocket and the channel is deeper than the bottom.

(11) The end effector according to embodiment 7, wherein the channels of the forming pocket are aligned with each other.
(12) The end effector according to embodiment 7, wherein the forming pockets are arranged in an annular array and the channels of the forming pockets are positioned along the circumference.
(13) Anvil of a surgical fastening instrument
Tissue compression surface and
Forming pockets defined on the tissue compression surface, each said forming pocket
A first end configured to receive the leg and
The second end and
A central axis extending between the first end and the second end,
A concave rotating surface extending between the first end and the second end,
Anvil comprising a forming pocket, comprising a channel defined on the concave rotating surface, wherein the channel is offset laterally from the central axis.
(14) The anvil according to embodiment 13, wherein the channel is parallel to the central axis.
(15) The anvil according to embodiment 13, wherein the channel extends between the first end and the second end of the forming pocket.

(16) The anvil according to embodiment 13, wherein the rotating surface comprises a bottom of the forming pocket and the channel is deeper than the bottom.
(17) The anvil according to embodiment 13, wherein the channels of the forming pocket are aligned with each other.
(18) The anvil according to embodiment 13, wherein the forming pockets are arranged in an annular array and the channels of the forming pockets are positioned along the circumference.

Claims (5)

An end effector for surgical staple fasteners
It ’s a staple cartridge,
The cartridge body including the deck and
A staple cartridge removably stored in the cartridge body, comprising a staple, each of which comprises a base , a protrusion extending from the base, and a leg extending from the base. ,
Anvil
And the formation plane,
A has been formed pocket defined in said formation plane, each said forming pockets,
The first end of the forming pocket configured to receive the leg and
The second end of the forming pocket and
The axis extending between the second end of the forming pockets and the first end of the forming pockets,
With, with a forming pocket, with, with anvil,
With
The staple cartridge
It ’s a staple fossa,
The first end of the staple fossa configured to receive the leg and
The second end of the staple fossa and
A side wall extending between the first end of the staple fossa and the second end of the staple fossa,
Staple fossa, provided with a groove defined in the side wall and engaged with the protrusion.
The end effector. The end effector according to claim 1, wherein the groove is orthogonal to the central longitudinal axis of the cartridge body. The end effector according to claim 1, wherein the groove extends between the first end and the second end of the staple fossa. The end effector according to claim 1, wherein the forming pocket and the staple fossa are aligned with each other. Wherein the forming pockets are arranged in an annular array, the end effector of claim 1.

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