JP6957500B2 - Circular staple fastening system including load control - Google Patents

Description

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

The various features of the embodiments described herein, along with their advantages, can be understood by the following description in conjunction with the following accompanying drawings.
FIG. 3 is a perspective view of a surgical instrument with an interchangeable surgical tool assembly according to at least one embodiment. FIG. 3 is another perspective view of the handle assembly of the surgical instrument of FIG. 1 in which a portion of the handle housing is omitted to expose the components housed therein. 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. It is a partial cross-sectional side view of the handle assembly of FIGS. The grip in is shown by a virtual line. 5 is an end sectional view of the handle assembly of FIGS. 2 to 5 along line 6-6 in FIG. FIG. 5 is another end sectional view of the handle assembly of FIGS. 2 to 6 along line 7-7 in FIG. 2 is another end sectional view of the handle assembly of FIGS. 2-7 showing the shifter gear meshing and engaging with the drive gear on the rotary drive socket. 2 is another end sectional view of the handle assembly of FIGS. 2-8 showing the position of the shifter solenoid when the shifter gear meshes and engages with the drive gear on the rotary drive socket. Another perspective view of the handle assembly of FIGS. 2-9, wherein a particular portion of the handle assembly is shown in cross section and the access panel portion of the handle assembly is shown by virtual lines. FIG. 2 is a plan view of the handle assembly of FIGS. 2-11, showing the bailout system in the operable position. 2 is a perspective view of the escape handle of the ejection system shown in FIGS. 2 to 11. FIG. 2 is an exploded view of a part of the escape handle of FIG. 12, in which a part of the escape handle is shown in cross section. FIG. 11 is a cross-sectional elevation view of the handle assembly of FIG. FIG. 5 is an exploded view of an interchangeable tool assembly according to at least one embodiment. FIG. 15 is a perspective view of the interchangeable tool assembly of FIG. FIG. 15 is a cross-sectional perspective view of the interchangeable tool assembly of FIG. FIG. 15 is a cross-sectional exploded view of the replaceable tool assembly of FIG. FIG. 15 is a perspective view of a range of motion block of the interchangeable tool assembly of FIG. FIG. 5 is a cross-sectional perspective view of a range of motion joint of the interchangeable tool assembly of FIG. 15 including the range of motion block of FIG. It is another cross-sectional perspective view of the range of motion joint of FIG. FIG. 15 is a partially exploded view of the replaceable tool assembly of FIG. FIG. 15 is another partially exploded view of the replaceable tool assembly of FIG. It is a partial exploded view of the range of motion joint of FIG. FIG. 15 is a cross-sectional perspective view of the proximal end of the interchangeable tool assembly of FIG. FIG. 15 is an end view of the interchangeable tool assembly of FIG. FIG. 6 is a cross-sectional view of the end effector of the interchangeable tool assembly of FIG. 15 along lines 27-27 in FIG. 26, illustrating a clamped but unfired end effector. FIG. 5 is a cross-sectional view of the end effector of the interchangeable tool assembly of FIG. 15 along lines 28-28 in FIG. 26, illustrating a clamped but unfired end effector. FIG. 6 is a cross-sectional view of the end effector of the interchangeable tool assembly of FIG. 15 along lines 29-29 in FIG. 26, illustrating a clamped but unfired end effector. It is sectional drawing of the end effector of the interchangeable tool assembly of FIG. 15 shown in the disassembled state. The end effector of the interchangeable tool assembly of FIG. 15 that has been range of motion in the first direction. The end effector of the interchangeable tool assembly of FIG. 15 that has been range of motion in the second direction. FIG. 15 is a perspective view of the cartridge body of the replaceable tool assembly of FIG. It is a perspective view of the cartridge body by at least one alternative embodiment. It is an exploded view of the end effector of the interchangeable tool assembly by at least one alternative embodiment. It is an exploded view of the end effector of FIG. 35. It is an exploded view of the end effector of the interchangeable tool assembly by at least one alternative embodiment. It is an exploded view of the end effector of the interchangeable tool assembly by at least one alternative embodiment. FIG. 3 is a perspective view illustrating a staple cartridge and a shaft of a surgical staple fastener according to at least one embodiment. FIG. 3 is a partial cross-sectional view of a staple cartridge assembled to the staple fastener of FIG. 39. A portion of the surgical staple fastener that includes the closure drive, the anvil, and a lockout configured to prevent the anvil from being assembled to the closure drive if the closure drive is not in the fully extended position. It is a cross-sectional view. FIG. 4 is a partial cross-sectional view of the surgical staple fastening device of FIG. 41, illustrating where the anvil is attached to the closure drive. FIG. 6 is a partial perspective view of a surgical staple fastening instrument including a staple cartridge and a closure drive configured to move the anvil with respect to the staple cartridge. FIG. 43 is a partial cross-sectional view of the staple fastener of FIG. 43, illustrating a lockout configured to prevent the closure drive from retracting while the anvil is not attached to the closure drive. FIG. 4 is a partial cross-sectional view of the staple fastener of FIG. 44, illustrating an anvil attached to the closure drive and a lockout disengaged from the closure drive. A staple cartridge containing staples that are detachably stored inside, an anvil, a closure drive that is configured to move the anvil with respect to the staple cartridge, and a launch that is configured to eject the staples from the staple cartridge. FIG. 6 is a partial cross-sectional view of a surgical staple fastening device including a drive unit. It is a detailed view of the lockout configured to prevent the launch drive from operating before the anvil moves to the closed position. It is a detailed view of the lockout of FIG. 47 which was disengaged from the firing drive part. A staple cartridge containing staples that are detachably stored inside, an anvil, a closure drive that is configured to move the anvil with respect to the staple cartridge, and a launch that is configured to eject the staples from the staple cartridge. FIG. 6 is a partial perspective view of a surgical staple fastening device including a drive unit. Lockout of the surgical staple fastener of FIG. 49, configured to prevent the firing drive from operating before the anvil exerts sufficient pressure on the tissue trapped between the anvil and the staple cartridge. It is a detailed view. It is a detailed view of the lockout of FIG. 50 which was disengaged from the firing drive part. A staple cartridge containing staples that are detachably stored inside, an anvil, a closure drive that is configured to move the anvil with respect to the staple cartridge, and a launch that is configured to eject the staples from the staple cartridge. FIG. 6 is a partial perspective view of a surgical staple fastening device including a drive unit. Detailed view of the lockout of the surgical staple clamp of FIG. 52, configured to prevent the anvil from being removed from the closure drive while the firing drive cutting member is exposed above the staple cartridge. Is. FIG. 5 is a detailed view of the lockout of FIG. 53 disengaged from the anvil after the launch drive has fully retracted after the launch stroke. A staple cartridge containing staples that are detachably stored inside, an anvil, a closure drive that is configured to move the anvil with respect to the staple cartridge, and a launch that is configured to eject the staples from the staple cartridge. FIG. 6 is a partial cross-sectional view of a surgical staple fastening device including a drive unit. Partial cross section of the surgical staple fastening device of FIG. 55, showing that the closure drive is in a clamped configuration and the firing drive is in an unlaunched configuration, with the firing drive holding the lockout in an unreleased configuration. It is a figure. FIG. 5 is a partial cross-sectional view of the surgical staple clamp of FIG. 55, illustrating a launch drive at least partially in the launch configuration and the lockout of FIG. 56 in the release configuration. FIG. 55 illustrates that the closure drive is in an extended or open configuration and the lockout of FIG. 56 is engaged with the closure drive to prevent the closure drive from being clamped again. It is a partial cross-sectional view of the surgical staple fastening instrument of. A staple cartridge containing staples that are detachably stored inside, an anvil, a closure drive that is configured to move the anvil with respect to the staple cartridge, and a staple that is configured to eject from the staple cartridge. FIG. 3 is a partial cross-sectional view of a surgical staple fastening device, including a firing drive, indicated as disabled or locked out, configuration. FIG. 5 is a cross-sectional end view of the surgical staple fastening device of FIG. 59, along lines 59A-59A of FIG. 59. FIG. 5 is a cross-sectional view of the surgical staple fastening device of FIG. 59 illustrating a clamp configuration in which a firing drive is enabled. FIG. 5 is a cross-sectional end view of the surgical staple fastening device of FIG. 59, along line 60A-60A in FIG. 60. A staple cartridge containing staples that are detachably stored inside, an anvil, a closure drive that is configured to move the anvil with respect to the staple cartridge, and a launch that is configured to eject the staples from the staple cartridge. It is a partial cross-sectional view of a surgical staple fastening instrument including a drive part, the closure drive part is shown in a non-clamping configuration, and the firing drive part is shown in an inoperable configuration. FIG. 6 is a partial cross-sectional view of the surgical staple fastening device of FIG. 61, wherein the closure drive is shown in a clamp configuration and the launch drive is shown in an operable configuration. It is a perspective view of the rotatable intermediate drive member of the firing drive part of the surgical instrument of FIG. 61. FIG. 61 is a partial perspective view of a rotatable launch shaft of the launch drive portion of the surgical instrument of FIG. FIG. 5 is a front view of a spring system configured to urge the launch shaft of FIG. 64 to disengage from engagement with the intermediate drive member of FIG. 63. FIG. 3 is an exploded view of an end effector of a surgical staple fastening device including a staple cartridge according to at least one embodiment. FIG. 6 is a partial cross-sectional view of the end effector of FIG. 66, illustrating a lockout configured to prevent the end effector from operating when the staple cartridge is not fully assembled to the staple fastener. FIG. 6 is a partial cross-sectional view of the end effector of FIG. 66 showing a lockout in an unlocked configuration. FIG. 3 is an exploded view of an end effector of a surgical staple fastening device including a staple cartridge according to at least one embodiment. FIG. 6 is a partial cross-sectional view of the end effector of FIG. 69, illustrating a lock configured to hold the staple cartridge detachably against a staple fastener. FIG. 6 is a partial cross-sectional view of the end effector of FIG. 69 showing a lock in an unlocked configuration. A shaft of a surgical staple fastener configured for use with a staple cartridge selected from multiple circular staple cartridges. FIG. 7 is a cross-sectional view of the distal end of the staple fastening device of FIG. 72. Of surgical staples, including unfired staple cartridges and a lockout system configured to prevent the staple cartridges from being re-launched after being previously fired by the surgical instrument's firing drive. It is a partial sectional view. FIG. 7 is a partial cross-sectional view of the staple fastener of FIG. 74, shown in a clamp configuration and with a launch drive in the launch configuration. FIG. 7 is a partial cross-sectional view of the staple fastener of FIG. 74, shown in a non-clamped configuration and with a firing drive in a retracted configuration. It is an end view of the firing drive part and the frame of the staple fastening device of FIG. 74 which illustrates the place where the firing drive part is in an unlaunched configuration. It is an end view of the firing drive part and the frame of the staple fastening device of FIG. 74 which shows the place where the firing drive part is in a retracted structure. FIG. 5 is an end view of an alternative staple cartridge design that can be used with the staple fasteners of FIG. 74. FIG. 5 is an end view of an alternative staple cartridge design that can be used with the staple fasteners of FIG. 74. FIG. 3 is a perspective view of a surgical staple fastening instrument comprising a flexible shaft according to at least one embodiment. It is a schematic diagram of a surgical instrument kit including a plurality of end effectors according to at least one embodiment. FIG. 6 is a schematic representation of a robotic surgical instrument system comprising a plurality of attachable end effectors according to at least one embodiment. It is a perspective view of some end effectors shown in FIG. 82. FIG. 3 is a perspective view of an anvil according to at least one embodiment. FIG. 8 is a cross-sectional view of the anvil of FIG. 84. It is a partial cross-sectional view of the end effector including the anvil of FIG. 84 shown in the launch configuration. FIG. 3 is a perspective view of an anvil according to at least one embodiment. It is a top view of the anvil of FIG. 87. FIG. 6 is a cross-sectional view of an end effector according to at least one embodiment, shown in a clamped, unfired configuration. It is sectional drawing of the end effector of FIG. 89 shown in the launch configuration. FIG. 6 is a cross-sectional view of an end effector according to at least one alternative embodiment, shown in a clamped, unfired configuration. FIG. 9 is a cross-sectional view of the end effector of FIG. 91 shown in the launch configuration. FIG. 6 is a cross-sectional view of an end effector according to at least one alternative embodiment, shown in a clamped, unfired configuration. FIG. 9 is a cross-sectional view of the end effector of FIG. 91 shown in the launch configuration. FIG. 3 is a perspective view of a staple forming pocket according to at least one embodiment. It is sectional drawing of the staple formation pocket of FIG. FIG. 5 is an exploded view of an end effector according to at least one embodiment configured to continuously deploy a first annular staple row and a second annular staple row. FIG. 9 is a partial cross-sectional view of the end effector of FIG. 97, illustrating where the firing driver deploys the staples in the first staple row. FIG. 9 is a partial cross-sectional view of the end effector of FIG. 97, illustrating where the launch driver of FIG. 98 deploys staples in a second staple row. The first driver for firing the first staple row, the second driver for firing the second staple row, and then the third driver for driving the cutting member are continuously driven. It is a partial perspective view of the launch drive part configured as described above. It is a partial perspective view of the launch drive part of FIG. 100 which illustrates the first driver in the launch position. It is a partial perspective view of the launch drive part of FIG. 100 which illustrates the second driver at the launch position. It is a partial perspective view of the launch drive part of FIG. 100 which illustrates the third driver at the launch position. It is an exploded assembly view of the launch drive part of FIG. 100. It is a partial perspective view of the firing drive part of FIG. 100 in the configuration of FIG. 103. It is an exploded view of the launch drive part by at least one alternative embodiment. 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 according to at least one embodiment of unformed and formed configurations. FIG. 6 is a cross-sectional view of a portion of an anvil associated with a portion of the surgical staple cartridge of FIG. 107 before the staple forming process is activated. Another cross-sectional view of the anvil of FIG. 109 and the staple cartridge of FIG. 107 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 fastening instrument, according to at least one embodiment. FIG. 6 is a cross-sectional view of a portion of an anvil associated with a portion of the surgical staple cartridge of FIG. 111 before the staple forming process is activated. Another cross-sectional view of the anvil and staple cartridge of FIG. 112 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. 3 is a cross-sectional view of a portion of an anvil associated with a portion of a surgical staple cartridge. Three staples for plastic surgery. FIG. 3 is a partial cross-sectional view of a staple cartridge of a circular stapler according to at least one embodiment. It is a partial perspective view of the staple cartridge of a circular stapler according to at least one embodiment.

Throughout the drawings, the corresponding reference numerals indicate the corresponding parts. The illustrations described herein illustrate various embodiments of the invention in one form, and such illustrations should be construed as limiting the scope of the invention in any way. No.

The applicant of the present application owns the following patent applications filed on the same date as the present application, the entire contents of which are incorporated herein by reference:
-US Patent Application No. ________, Title of Invention METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM ", Agent Reference Number END7821USNP / 150535,
-US Patent Application No. ________, title of invention "MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY", agent reference number END7822USNP / 150536,
-US Patent Application No. ________, title of invention "SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD", agent reference number END7822USNP1 / 150536
-US Patent Application No. ________, title of invention "SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIP PORTION", agent reference number END7823USNP / 150537,
-US Patent Application No. ________, title of invention "ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLE BAILOUT SYSTEM", agent reference number END7824USNP / 150538,
-US Patent Application No. ________, Title of Invention SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVIL CONCENTRIC DRIVE MEMBER ", Agent Reference Number END7825USNP / 150539,
-US Patent Application No. ________, title of invention "CLOSE SYSTEM ARRANGEMENTS FOR SURGICAL CUTTING AND STAPLING DEVICES WITH SEPARATE AND DISTINCT FIRING SHAFTS", proxy number
-US Patent Application No. ________, Title of Invention INTERCHANGE SURGICAL TOOL ASSEMBLY WITH A SURGICAL END EFFECTOR THAT IS SELECTIVELY ROTATABLE
-US Pat.
-US Patent Application No. ________, title of invention "SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVE CUTTING OF TISSUE", agent reference number END7830USNP / 150544,
-US Patent Application No. ________, title of invention "SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT", agent reference number END7831USNP / 150545,
-US Patent Application No. ________, title of invention "SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSION LOCKOUT", agent reference number END7832USNP / 150546,
-US Patent Application No. ________, title of invention "SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT", agent reference number END7833USNP / 150547,
-US Patent Application No. ________, Invention Name "SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSE LOCKOUT", Agent Reference Number END7834USNP / 150548,
-US Patent Application No. ________, title of invention "SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT", agent reference number END7835USNP / 150549,
-US Patent Application No. ________, title of invention "SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGE LOCKOUT", agent reference number END7836USNP / 150550,
-US Patent Application No. ________, title of invention "SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM", agent reference number END7837USNP / 150551,
-US Patent Application No. ________, title of invention "SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS", agent reference number END7838USNP / 150552,
-US Patent Application No. ________, title of invention "SURGICAL STAPLING INSTRUMENT", agent reference number END7839USNP / 150553,
-US Patent Application No. ________, title of invention "SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OF STAPLES HAVING DIFFERENT HEIGHTS", agent reference number END7840USNP / 150
-US Patent Application No. ________, title of invention "SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET", agent reference number END7841USNP / 150555,
-US Patent Application No. ________, title of invention "ANVIL MODEFICATION MEMBERS FOR SURGICAL STAPLERS", agent reference number END7842USNP / 150556,
-US Patent Application No. ________, title of invention "STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES", agent reference number END7843USNP / 150557,
-U.S. Patent Application No. ________, title of invention "CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUE SUPPORT", agent reference number END7844USNP / 150558, and-U.S. Patent Application No. ______ , Agent reference number END7845USNP / 150559.

The applicant of this application also owns the following US patent applications filed on December 31, 2015, the entire contents of which are incorporated herein by reference:
-US Patent Application No. 14 / 984,488, Invention Title "MECHANIMSS FOR COMPENSATING FOR BATTERY PACK FAIRURE IN POWERED SURGICAL INSTRUMENTS",
-US Patent Application No. 14 / 984,525, title of invention "MECHANIMSS FOR COMPENSATING FOR DRIVETRAIN FAIRURE IN POWERED SURGICAL INSTRUMENTS", and-US Patent Application No. 14 / 984,552, title of invention "SURGMENTRAIN" AND MOTOR CONTROL CIRCUITS ".

The applicant of this application also owns the following US patent applications filed on February 9, 2016, the entire contents of which are incorporated herein by reference:
-US Patent Application No. 15 / 019,220, Title of Invention "SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLY TRANSLATABLE END EFFECTOR",
-US Patent Application No. 15 / 019,228, Title of Invention "SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATION ARRANGEMENTS",
-US Patent Application No. 15 / 019,196, Title of Invention "SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTED SECONDARY CONSTRAINT",
-US Patent Application No. 15 / 019,206, Title of Invention SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLY ARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY ",
-US Patent Application No. 15 / 019,215, Title of Invention "SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATION ARRANGEMENTS",
-US Patent Application No. 15 / 019,227, Title of Invention "ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATION LINK ARRANGEMENTS",
-US Patent Application No. 15 / 019,235, title of invention "SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLE DRIVEEN ARTICULATION SYSTEMS",
-US Patent Application No. 15 / 019,230, title of invention "ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAM ARRANGEMENTS", and-US Patent Application No. 15 / 019,245, title of invention "SURGICAL INSTRUMENTS" REDUCTION ARRANGEMENTS ".

The applicant of this application also owns the following US patent applications filed on February 12, 2016, the entire contents of which are incorporated herein by reference:
-US Patent Application No. 15 / 043,254, Title of Invention "MEMHANIMSS FOR COMPENSATING FOR DRIVETRAIN FAIRURE IN POWERED SURGICAL INSTRUMENTS",
-US Patent Application No. 15 / 043,259, title of invention "MEMHANIMSS FOR COMPENSATING FOR DRIVETRAIN FAIRURE IN POWERED SURGICAL INSTRUMENTS",
-US Patent Application No. 15 / 043,275, title of invention "MECHANIMS FOR COMPENSATING FOR DRIVETRAIN FAIRURE IN POWERED SURGICAL INSTRUMENTS", and-US Patent Application No. 15 / 043,289, title of invention "MECHANISMS FOR FAIRURE IN POWERED SURGICAL INSTRUMENTS ".

The applicant of the present application owns the following patent applications filed on June 18, 2015, the entire contents of which are incorporated herein by reference:
U.S. Patent Application No. 14 / 742,925, Invention Title "SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING ARRANGEMENTS",
U.S. Patent Application No. 14 / 742,941, Title of Invention "SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSEING FEATURES",
U.S. Patent Application No. 14 / 742,914, Invention Title "MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS",
-US Patent Application No. 14 / 742,900, title of invention "ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAM STRUCTURES WITH CENTER FIRING SUPPORT MEMBERFORT
-US Patent Application No. 14 / 742,885, title of invention "DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS", and US Patent Application No. 14 / 742,876, name "PUSTION INSTRUMENTS ".

The applicant of the present application owns the following patent applications filed on March 6, 2015, the entire contents of which are incorporated herein by reference:
-US Patent Application No. 14 / 640,746, Invention Title "POWERED SURGICAL INSTRUMENT",
-US Patent Application No. 14 / 640,795, Title of Invention "MULTIPLE LEVEL THRESHOLDS TO MODEIFY OPERATION OF POWERED SURGICAL INSTRUMENTS",
-US Patent Application No. 14 / 640,832, Title of Invention "ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATES FOR MULTIPLE TISSUE TYPES", Agent Reference Number END7557USNP / 1402
-US Patent Application No. 14 / 640,935, Title of Invention "OVERLAID MULTI SENSOR RADIO FREENCY (RF) ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION",
-US Patent Application No. 14 / 640,831, Title of Invention "MONITORING SPEED CONTROLL AND PRECISION INCREMENTING OF MOTOR FOR FOR POWERED SURGICAL INSTRUMENTS",
-US Patent Application No. 14 / 640,859, title of invention "TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE STABILITY, CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES",.
-US Patent Application No. 14 / 640,817, Title of Invention "INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS",
-US Patent Application No. 14 / 640,844, title of invention "CONTROLL TECHNIQUES AND SUB-PROCESSOR CONTROL WITHIN MODELAR SHAFT WITH SELECT CONTROLL PROCESSING FROM HANDLE",
-US Patent Application No. 14 / 640,837, Invention Title "SMART SENSORS WITH LOCAL SIGNAL PROCESSING",
-US Patent Application No. 14 / 640,765, Title of Invention "SYSTEM FOR DETECTING THE MIS-INSTRETION OF A STAPLE CARTRIDGE INTO A SURGICAL STAPLER",
-US Patent Application No. 14 / 640,799, title of invention "SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A ROTATABLE SHAFT", and-US Patent Application No. 14 / 640,780, title of invention "SURGICAL INSTRUME" BATTERY HOUSING ".

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

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

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

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

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

The applicant of the present application also owns the following patent applications filed on March 26, 2014, the entire contents of which are incorporated herein by reference:
U.S. Patent Application No. 14 / 226,106, Invention Title "POWER MANAGEMENT CONTOROL SYSTEMS FOR SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2015/0272582,
U.S. Patent Application No. 14 / 226,099, Invention Title "STERILIZATION VERIFICATION CIRCUIT", Now U.S. Patent Application Publication No. 2015/02272581,
U.S. Patent Application No. 14 / 226,094, Invention Title "VERIFICATION OF NUMBER OF BATTERY EXCHANGE COUNT", now U.S. Patent Application Publication No. 2015/0272580,
U.S. Pat.
U.S. Patent Application No. 14 / 226,075, Invention Title "MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLES", now U.S. Patent Application Publication No. 2015/0272579
U.S. Patent Application No. 14 / 226,093, Invention Title "FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2015/0272569,
U.S. Patent Application No. 14 / 226,116, Invention Title "SURGICAL INSTRUMENT UTILIZING SENSOR ADAPATION", now U.S. Patent Application Publication No. 2015/0272571.
U.S. Pat.
U.S. Patent Application No. 14 / 226,097, Invention Title "SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS", now U.S. Patent Application Publication No. 2015/0272570,
U.S. Patent Application No. 14 / 226,126, Invention Title "INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS", now U.S. Patent Application Publication No. 2015/0272572,
U.S. Patent Application No. 14 / 226,133, Invention Title "MODULAR SURGICAL INSTRUMENT SYSTEM", Currently U.S. Patent Application Publication No. 2015/0272557,
U.S. Patent Application No. 14 / 226,081, Invention title "SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT", now U.S. Patent Application Publication No. 2015/0277471,
U.S. Pat.
U.S. Patent Application No. 14 / 226,111, Invention Title "SURGICAL STAPLING INSTRUMENT SYSTEM", Currently U.S. Patent Application Publication No. 2015/0272583,
U.S. Patent Application No. 14 / 226,125, Invention Title "SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT", now U.S. Patent Application Publication No. 2015/0280384.

The applicant of the present application also owns the following patent applications filed on September 5, 2014, the entire contents of which are incorporated herein by reference:
-US Patent Application No. 14 / 479,103, Title of Invention CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE ", Currently US Patent Application Publication No. 2016/0066912,
-US Patent Application No. 14 / 479,119, Invention Title "ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION", Currently US Patent Application Publication No. 2016/0066914,
-US Patent Application No. 14 / 478,908, Invention Title "MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION", Currently US Patent Application Publication No. 2016/0066910,
-US Patent Application No. 14 / 478,895, Title of Invention "MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION", now US Patent Application Publication No. 2016/0066909,
-US Patent Application No. 14 / 479,110, Invention Title "USE OF POLARITY OF HALL MAGNET DETECTION TO DETECT MISLOADED CARTRIDGE", now US Patent Application Publication No. 2016/0066915,
-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 of Invention MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE ", now US Patent Application Publication Nos. 2016/0066916, and-US Patent Application No. 14 / 479,108, Invention Name "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, Invention Title "MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS", now US Patent Application Publication No. 2014/030987,
-US Patent Application No. 14 / 248,581, Title of Invention "SURGICAL INSTRUMENT COMPRISING A CLOSEING DRIVE AND A FIRING DRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT", Currently US Patent Application No. 3059
-US Patent Application No. 14 / 248,595, title of invention "SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING THE OPERATION OF THE SURGICAL INSTRUMENT", currently published in U.S. Patent No. 14 / 248,595
-US Patent Application No. 14 / 248,588, Invention Title "POWERED LINEAR SURGICAL STAPLER", Currently US Patent Application Publication No. 2014/0309666,
-US Patent Application No. 14 / 248,591, Invention Title "TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT", Currently US Patent Application Publication No. 2014/0305911,
-US Patent Application No. 14 / 248,584, Title of Invention "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURFTS
-US Patent Application No. 14 / 248,587, Invention Title "POWERED SURGICAL STAPLER", Currently US Patent Application Publication No. 2014/0309665,
-US Patent Application No. 14 / 248,586, Invention Title "DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT", now US Patent Application Publication No. 2014/03059090, and-US Patent Application No. 14 / 248,607. , The title of the invention "MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS", currently US Patent Application Publication No. 2014/0305992.

The applicant of the present application also owns the following patent applications filed on April 16, 2013, the entire contents of which are incorporated herein by reference:
-US Provisional Patent Application No. 61 / 812,365, Title of Invention "SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFFORMED BY A SINGLE MOTOR",
-US Provisional Patent Application No. 61 / 812,376, Invention Name "LINEAR CUTTER WITH POWER",
-US Provisional Patent Application No. 61 / 812,382, Invention Name "LINEAR CUTTER WITH MOTOR AND PISTOL GRIP",
-US provisional patent application No. 61 / 812,385, title of invention "SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTION MOTORS AND MOTOR CONTROL", and-US provisional patent application No. 61 / 812,372, title of invention "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. It will be understood to get. Modifications and changes to them can be made without departing from the claims.

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

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

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

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

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

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

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

FIG. 1 shows a motorized surgical system 10 that can be used to perform a variety of different surgical procedures. In the illustrated embodiment, the electrosurgical system 10 includes a selectively reconfigurable housing or handle assembly 20 attached to an embodiment of the interchangeable surgical tool assembly 1000. For example, the system 10 shown in FIG. 1 includes an interchangeable surgical tool assembly 1000 that includes a surgical cutting and fastening instrument, sometimes referred to as an end cutter. As described in more detail below, the replaceable surgical tool assembly may include end effectors adapted to support different sizes and types of staple cartridges, and different shaft lengths, sizes, and. It may have a type or the like. Such a device can fasten the tissue using, for example, any suitable fastener (s). For example, a fastener cartridge containing a plurality of fasteners detachably stored therein can be detachably inserted and / or attached to an end effector of a surgical tool assembly. 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 and replaced with a different surgical tool assembly configured to perform other surgical procedures. In other configurations, the surgical tool assembly may not be replaceable with other surgical tool assemblies, including, for example, a dedicated shaft that is essentially non-detachably secured or connected to the handle assembly 20. good. Surgical tool assemblies are sometimes referred to as elongated shaft assemblies. The surgical tool assembly may be reusable, or in other structures, the surgical tool assembly may be designed to be discarded after a single use.

As you read through the embodiments for practicing the present invention, the various forms of interchangeable surgical tool assemblies disclosed herein can be effectively used in connection with robotic surgical systems. Will also be understood. Thus, the terms "housing" and "housing assembly" also generate at least one control motion that can be used to actuate the elongated shaft assemblies and their respective equivalents disclosed herein. It may include a housing or similar portion of a robotic system that accommodates or otherwise operably supports at least one drive system configured to apply. The term "frame" may refer to a portion of a handheld surgical instrument. The term "frame" may also refer to a portion of a robot-controlled surgical instrument and / or a portion of a robotic system that may be used to operably control the surgical instrument. For example, the surgical tool assemblies disclosed herein are incorporated herein by reference in their entirety, U.S. Patent Application No. 13 / 118,241, title of the invention "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS". , Currently disclosed in U.S. Patent Application Publication No. 2012/02987719, but may be used with a variety of robotic systems, instruments, components, and methods without limitation.

With reference to FIGS. 1 and 2, the housing assembly or handle assembly 20 includes a main housing portion 30 that can be formed from a pair of housing portions 40, 70, the pair of housing portions 40, 70 being plastic, polymer. It may be manufactured from a material, metal, etc., and may be joined together by an appropriate fastener configuration such as an adhesive, a screw, a press-fit mechanism, a snap fitting mechanism, a latch, or the like. As will be described in more detail below, the main housing portion 30 operably supports a plurality of internal drive systems. The drive system is configured to generate various control actions and apply these control actions to the corresponding parts of the replaceable surgical tool assembly operably attached to the drive system. The handle assembly 20 further includes a grip 100 movably connected to the main housing 30 and is configured for the physician to grip and operate the grip 100 at various positions relative to the main housing 30. .. The grip 100 may be manufactured from a pair of grips 110, 120 that may be made of plastic, polymer material, metal, etc., and for assembly and maintenance purposes, for example, adhesives, screws, press-fitting mechanisms, snap fitting mechanisms. , Latch, etc. are joined together by an appropriate fastener configuration.

As can be seen from FIG. 2, the grip 100 includes a grip housing 130 that defines a hollow cavity 132 configured to operably support a drive motor and gearbox, which will be described in further detail below. The upper portion 134 of the grip housing 130 extends through the opening 80 in the main housing portion 30 and is configured to pivotally support the pivot shaft 180. The pivot shaft 180 defines a pivot 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 interchangeable surgical tool operably attached to the handle assembly 20 with a handle shaft labeled "HA". Define. The pivot axis PA crosses the handle axis HA. See FIG. With such a configuration, the grip 100 is pivoted about the pivot PA with respect to the main housing 30 to a position most suitable for the type of interchangeable surgical tool assembly connected to the handle assembly 20. It becomes possible. The grip housing 130 defines a grip shaft, generally labeled "GA". See FIG. If the replaceable surgical tool assembly coupled to the handle assembly 20 includes, for example, an end cutter, the physician will grip the grip axis GA so that it is perpendicular or nearly perpendicular to the handle axis HA (angle "H1"). It may be desired to position the portion 100 with respect to the main housing portion 30 (referred to as the "first grip position"). See FIG. However, for example, when using the handle assembly 20 to control an interchangeable surgical tool assembly that includes a circular stapler, the physician will tell that the grip axis GA is at an angle of 45 or about 45 degrees with respect to the handle axis HA. , Or other suitable acute angles (angle "H2") may be desired to pivot the grip 100 with respect to the main housing 30. This position is referred to herein as the "second grip position". In FIG. 5, the grip portion 100 at the second grip position is shown by a virtual line.

With reference to FIGS. 3-5, the handle assembly 20 also has a grip locking system (usually referred to as 150) for selectively locking the grip 100 with respect to the main housing 30 in a desired orientation. including. In one configuration, the grip locking system 150 includes a series of arcuate (152) pointed teeth 154. The tooth portions 154 are arranged apart from each other and form a lock groove 156 between them. Each lock groove 156 corresponds to a place where the grip portion 100 is locked at a specific angle. For example, in at least one configuration, the tooth portion 154 and the lock groove or "lock position" 156 are such that the grip portion 100 is locked between the first grip position and the second grip position at intervals of 10 to 15 degrees. Arranged to get. This arrangement can use two stop positions adjusted according to the type of instrument used (shaft configuration). For example, in an end-cutter shaft configuration, the stop position may be around 90 degrees with respect to the shaft, and in a circular stapler configuration, the angle is approximately arcuate towards the surgeon. It may be 45 degrees. The grip lock system 150 further includes a lock button 160 having a lock configured to lock and engage the lock groove 156. For example, the lock button 160 is pivotally mounted on a pivot pin 131 within the main handle 30 so that the lock button 160 can pivot and engage the corresponding lock groove 156. The lock spring 164 serves to urge the lock button 160 to the engagement position or lock position with the corresponding lock groove 156. The lock and tooth structures serve to allow the tooth 154 to slide over the lock when the physician presses the lock button 160. Therefore, in order to adjust the angular position of the grip portion 100 with respect to the main housing portion 30, the doctor pushes the lock button 160 and then pivots the grip portion 100 to a desired angular position. After the grip 100 has moved to the desired position, the doctor releases the lock button 160. The lock spring 164 then urges the lock button 160 toward the series of teeth 154, which allows the lock to enter the corresponding lock groove 156 and hold the grip 100 in that position during use. do.

The handle assembly 20 operably supports a first rotary drive system 300, a second rotary drive system 320, and a third shaft drive system 400. The rotary drive systems 300 and 320 are each fed by a motor 200 operably supported in the grip 100. As can be seen from FIG. 2, for example, the motor 200 has a gearbox assembly 202 that is supported inside a cavity 132 in the grip 100 and from which the output drive shaft 204 projects. In various forms, the motor 200 may be, for example, a brushed DC drive motor having a maximum rotation speed of about 25,000 RPM. In other configurations, the motor may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor 200 may include a removable power pack 212 in one form and may be powered by a power source 210. The power supply 210 is, for example, various disclosed in more detail by U.S. Patent Application Publication No. 2015/02725575, the title of the invention "SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM", the entire disclosure of which is incorporated herein by reference. Any of the power supply configurations may be included. In the illustrated configuration, for example, the power pack 212 may include a proximal housing portion 214 configured to be attached to the distal housing portion 216. The proximal housing portion 214 and the distal housing portion 216 are configured to operably support a plurality of batteries 218 inside. 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 coupled 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 large number of batteries 218, which may be connected in series, may be used as a power source for the handle assembly 20. In addition, the power supply 210 may be replaceable and / or rechargeable. In one embodiment, the surgical instrument 10 may be powered by, for example, alternating current (AC). The motor 200 can 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. Attached to the output drive shaft 204 is a drive bevel gear 230. The motor 200, gearbox assembly 202, output drive shaft 204 and drive bevel gear 230 as a whole may also be referred to herein as "motor assembly 231". The drive bevel gear 230 is interlocked with a driven gear 234 attached to the system drive shaft 232 and a pivot gear 238 pivotally supported by the pivot shaft 180. The driven gear 234 engages on the system drive shaft 232 with the engaging position (FIG. 5) in which the driven gear 234 meshes with and engages with the drive bevel gear 230, and the driven gear 234 meshes with the drive bevel gear 230. It is axially movable to and from the disengaged disengaged position (FIG. 14). The drive system spring 235 is pivotally supported between the driven 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 gear 234 to disengage the meshing engagement with the drive bevel gear 230, as will be described in more detail below. The pivot gear 238 facilitates the pivotal movement of the output drive shaft 204 and the drive bevel gear 230 with respect to the main handle portion 30 together with the grip portion 100.

In the illustrated example, the system drive shaft 232 works with a rotary drive selector system, usually designated 240. In at least one embodiment, for example, the rotary drive selector system 240 includes a shifter gear 250 that is selectively movable between the first rotary drive system 300 and the second rotary drive system 320. As can be seen from FIGS. 6-9, for example, the drive selector system 240 includes a shifter mounting plate 242 immovably mounted within the main handle portion 30. For example, the shifter mounting plate 242 can be held by friction between the mounting lugs (not shown) formed in the housing portions 40, 70, or by another method such as screws, adhesives, etc. between the mounting lugs. Can be held at. Further referring to FIGS. 6-9, the system drive shaft 232 extends through a hole in the shifter mounting plate 242, to which the central (or system) drive gear 237 is non-rotatably mounted. For example, the central drive gear 237 may be attached to the system drive shaft 232 by the keyway configuration 233. See FIGS. 6-9. In other configurations, the system drive shaft 232 may be rotatably supported within the shifter mounting plate 242 by a corresponding bearing (not shown) attached to the system drive shaft 232. 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 from FIG. 3, the first drive system 300 includes a first drive socket 302 rotatably supported within a distal wall 32 formed within the main handle portion 30. The first drive socket 302 may include a first body portion 304 in which a spline socket is formed. The first drive 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 32, or a corresponding bearing mounted within the distal wall 32 (not shown). ) May be rotatably supported. Similarly, the second rotational drive system 320 includes a second drive socket 322 that is also rotatably supported within the distal wall 32 of the main handle 30. The second drive socket 322 may include a second body portion 324 with a spline socket formed therein. The second drive gear 326 is formed on or non-rotatably attached to the second body portion 324. The second body portion 324 may be rotatably supported in a corresponding hole or passage provided in the distal wall 32, or a corresponding bearing mounted within the distal wall 32 (not shown). ) May be rotatably supported. The first and second drive sockets 302 and 322 are arranged on both sides of the handle shaft HA in the lateral direction so as to be separated from each other. See, for example, FIG.

As mentioned above, in the illustrated example, the rotary drive selector system 240 includes a shifter gear 250. As can be seen from FIGS. 6-9, the shifter gear 250 is rotatably mounted on an idler shaft 252 movably supported in the bow slot 244 within the shifter mounting plate 242. The shifter gear 250 is mounted so as to rotate freely on the idler shaft 252 and maintain mesh engagement with the central drive gear 234. The idler shaft 252 is connected to the end of the shaft 262 of the shifter solenoid 260. The shifter solenoid 260 is pinned to the main handle housing 30 so that when the shifter solenoid 260 is activated, the shifter gear 250 moves and engages with one of the first drive gear 306 or the second drive gear 326. It can be stopped or installed in another way. For example, in one configuration, when the solenoid shaft 262 retracts (FIGS. 6 and 7), the shifter gear 250 meshes and engages with the central drive gear 234 and the first drive gear 306, which results in the motor 200 operating. The first drive socket 302 rotates. As can be seen from FIGS. 6 and 7, the shifter spring 266 can be used to urge the shifter gear 250 to this first operating position. Therefore, if the power supply to the surgical instrument 10 is lost, the shifter spring 266 will automatically urge the shifter gear 250 to the first position. If the motor 200 is continuously operated while the shifter gear 250 is in this position, the first drive socket 302 of the first rotary drive system 300 will rotate as a result. When the shifter solenoid is activated, the shifter gear 250 moves and meshes with and engages with the second drive gear 326 on the second drive socket 322. After that, when the motor 200 is operated, as a result, the second drive socket 322 of the second rotary drive system 320 is operated or rotated.

As will be described in more detail below, the first and second rotary drive systems 300, 320 are various configurations of interchangeable surgical tool assemblies coupled to the first and second rotary drive systems 300, 320. Can be used to power element parts. As mentioned above, in at least one configuration, the shifter spring 266 urges the shifter gear 250 to the first position if power is lost to the motor during operation of the replaceable surgical tool assembly. Depending on which component part of the replaceable surgical tool assembly was being manipulated, the application of rotational drive motion to the first drive system 300 could be reversed to remove the replaceable surgical tool assembly from the patient. You may need to be able to. The handle assembly 20 of the embodiment of the figure is a manually operable "escape", usually designated 330, for manually applying rotational drive motion to the first rotational drive system 300, for example in the scenario described above. I am using the system.

Here, with reference to FIGS. 3, 10 and 11, the escape system 330 of the figure includes an escape power 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 configuration (not shown) that includes a planetary bevel gear 338. The planetary gear assembly 334 includes an escape drive shaft 340 operably linked to a planetary gear configuration within the planetary gear housing 336. When the planetary bevel gear 338 rotates, the planetary gear configuration rotates, and finally the escape drive shaft 340 rotates. The escape drive gear 342 is pivotally supported by the escape drive shaft 340 so that the escape drive gear 342 can move axially on the escape drive shaft 340 and rotate together with the escape drive shaft 340. The escape drive gear 342 is movable between a spring stop flange 344 formed on the escape drive shaft 340 and a shaft end stop 346 formed at the distal end of the escape drive shaft 340. The escape shaft spring 348 is pivotally supported between the escape drive gear 342 on the escape drive shaft 340 and the spring stop flange 344. The escape shaft spring 348 urges the escape drive gear 342 distally on the escape drive shaft 340. When the escape drive gear 342 is in the most distal position on the escape drive shaft 340, the escape drive gear 342 meshes with and engages with the escape drive gear 350 non-rotatably attached to the system drive shaft 232. See FIG.

With reference to FIGS. 12 and 13, the escape system 330 includes an escape actuator assembly or an escape handle assembly 360 that facilitates the manual application of escape drive motion to the escape power transmission system 332. As can be seen from these figures, the escape handle assembly 360 includes an escape bevel gear assembly 362 that includes an escape bevel gear 364 and a ratchet gear 366. The escape handle assembly 360 further includes an escape handle 370 movably connected to the escape bevel gear assembly 362 by a pivot yoke 372 pivotally mounted on the ratchet gear 366. The escape handle 370 is pivotally connected to the pivot yoke 372 by a pin 374 and selectively pivotally moves between the retracted position "SP" and the actuating position "AP". See FIG. A handle spring 376 is used to urge the escape handle 370 to the actuating position AP. In at least one configuration, the angle between the axis SP representing the stowed position and the axis AP representing the operating position can be, for example, about 30 degrees. See FIG. As can also be seen in FIG. 13, the escape handle assembly 360 further includes a ratchet pole 378 rotatably mounted in a cavity or hole 377 in the pivot yoke 372. The ratchet pole 378 is configured to mesh and engage with the ratchet gear 366 when rotated in the working direction "AD" and then to disengage and disengage when rotated in the opposite direction. ing. The ratchet spring 384 and ball member 386 are movably supported in the cavity 379 in the pivot yoke 372 to detent the ratchet pole 378 when the escape handle 370 is actuated (ratcheted). It plays a role of locking and engaging with 380 and 382.

With reference to FIGS. 3 and 10, the escape system 330 further includes an escape access panel 390 that can be operated between open and closed positions. In the illustrated configuration, the escape access panel 390 is configured to be detachably connected to the housing portion 70 of the main housing portion 30. Therefore, at least in this embodiment, when the escape access panel 390 is removed from or removed from the main housing portion 30, it is said to be in the "open" position and the escape access panel 390 is said to be in the main housing portion 30. When attached to, it is said to be in the "closed" position. However, other embodiments are contemplated in which the access panel is movably connected to the main housing portion so that the access panel remains attached to the main housing portion when the access panel is in the open position. For example, in such an embodiment, the access panel is pivotally attached to the main housing or slidably attached to the main housing and can be operated between the open and closed positions. May be. In the illustrated example, the escape access panel 390 is configured to snap into the corresponding portion of the housing portion 70 to hold the escape access panel 390 in a "closed" position detachably. It is also possible to use other forms of mechanical fasteners such as screws, pins and the like.

Whether the escape access panel 390 is removable from the main housing portion 30 or remains movably attached to the main housing portion 30, the escape access panel 390 is with a drive system locking member or yoke 392. It includes an escape lock member or a yoke 396, each of which projects from the back side of the escape access panel 390 or is otherwise formed on the escape access panel 390. The drive system lock yoke 392 is such that when the escape access panel 390 is installed in the main housing portion 30, it receives a portion of the system drive shaft 232 (ie, the escape access panel is in the "closed" position) therein. Includes a drive shaft notch 394 configured in. When the escape access panel 390 is positioned or installed in the closed position, the drive system lock yoke 392 urges the driven gear 234 (against the urging of the drive system spring 235) to urge the drive bevel gear 230. It plays a role of engaging and engaging with. In addition, the law-evading rock yoke 396 is a notch for the law-evading drive shaft configured to receive a portion of the law-evading drive shaft 340 into it when the law-evading access panel 390 is installed or positioned in a closed position. 397 is included. As can be seen from FIGS. 5 and 10, the escape lock yoke 396 also urges the escape drive gear 342 (against the urging of the escape shaft spring 348) to disengage the engagement with the escape drive gear 350. Play a role. Thus, the law-evading lock yoke 396 prevents the law-evading drive gear 342 from interfering with the rotation of the system drive shaft 232 when the law-evading access panel 390 is installed or in the closed position. Further, the escape lock yoke 396 includes a handle notch 398 for engaging the escape handle 370 and holding it in the retracted position SP.

4, 5 and 10 illustrate the structure of drive system components and escape system components when the escape access panel 390 is installed or in a closed position. As can be seen from these figures, the drive system lock member 392 urges the driven gear 234 to mesh and engage with the drive bevel gear 230. Therefore, if the motor 200 is operated when the escape access panel 390 is installed or in the closed position, the drive bevel gear 230 will rotate as a result, and finally the system drive shaft 232 will rotate. Further, when in this position, the escape lock yoke 396 serves to urge the escape drive gear 342 to disengage the meshing engagement with the escape drive gear 350 on the system drive shaft 232. Thus, when the escape access panel 390 is installed or in the closed position, the drive system is actuated by the motor 200 and the escape system 330 is separated from the system drive shaft 232 or the system drive shaft 232. Cannot add working motion to the system. To activate the escape system 330, the physician first removes the escape access panel 390 or otherwise moves the escape access panel 390 to an open position. This action disengages the drive system lock member 392 from engagement with the driven gear 234, whereby the drive system spring 235 urges the driven gear 234 to disengage the engagement with the drive bevel gear 230. Enables. In addition, by removing the escape access panel 390 or moving the escape access panel to the open position, the escape lock yoke 396 also disengages with the escape drive gear 342, thereby causing the escape shaft spring 348 to disengage. The escape drive gear 342 can be urged to engage and engage with the escape drive gear 350 on the system drive shaft 232. Therefore, the rotation of the escape drive gear 342 results in the rotation of the escape drive gear 350 and the system drive shaft 232. It is also possible for the handle spring 376 to urge the escape handle 370 to the actuating position shown in FIGS. 11 and 14 by removing the escape access panel 390 or otherwise moving the escape access panel 390 to the open position. It will be possible. When in this position, the doctor can manually ratchet the escape handle 370 in the ratchet direction RD, resulting in rotation of the ratchet bevel gear 364 (eg, in the clockwise direction of FIG. 14). As a result, a backward rotation motion is finally applied to the system drive shaft 232 via the escape power transmission system 332. The physician repeatedly rotates the escape handle 370 until the system drive shaft 232 has rotated sufficiently enough to retract the components of the surgical end effector portion of the surgical tool assembly attached to the handle assembly 20. Ratchet can operate. Once the escape system 330 has been fully manually activated, the physician then returns the escape access panel 390 to its original position (ie, the escape access panel 390 to its closed position), thereby the drive system lock member 392. Can urge the driven gear 234 to engage and engage with the drive bevel gear 230, and the escape lock yoke 396 can urge the escape drive gear 342 to disengage the engagement with the escape drive gear 350. As mentioned above, if the power supply is lost or interrupted, the shifter spring 266 will urge the shifter solenoid 260 to the first operating position. Therefore, by operating the escape system 330, as a result, the first rotary drive system 300 is provided with a retrograde operation or a backward operation.

As mentioned above, surgical staple fasteners can include, for example, a manually actuated escape system configured to retract the staple launch drive. In many cases, it may be necessary to operate and / or crank the escape system more than once in order to fully retract the staple launch drive. In such cases, the user of the staple fastener may not know how many times the escape section has been cranked and / or may be confused as to how far the launch drive needs to be retracted. A system in which a stapler is configured to detect the position of the launch member of the launch drive, determine the distance at which the launch member needs to be retracted, and display that distance to the user of the surgical instrument. Various embodiments are recalled, including.

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, the sensor may include, for example, a Hall effect sensor and may be positioned within the shaft and / or end effector of the staple fastener. The sensor signals the controller of the surgical stapler, which in turn signals the display of the surgical stapler. The controller includes a microprocessor that compares the actual position of the launcher with the reference (or reference) position (including the fully retracted position of the launcher) with the actual position and reference position of the launcher. It is configured to calculate the distance between (ie, the remaining distance).

In addition to the above, the display includes, for example, 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 display. In such cases, for example, an empty progress bar can indicate that the launcher is at the end of its launch stroke, and when the progress bar is buried, the launcher has completely retracted. Can be represented. In at least one case, for example, 0% can indicate that the launching member is at the end of its firing stroke, and 100% can represent that the launching member has completely retracted. In some cases, the controller is configured to indicate on the display how many times the escape mechanism needs to be actuated in order to retract the launching member to its fully retracted position.

In addition to the above, the operation of the escape mechanism can operably shut off the battery or power source of the surgical staple fastener from the electric motor of the firing drive. In at least one embodiment, the actuation of the escape mechanism turns on a switch that electrically disconnects the battery from the electric motor. Such a system would prevent the electric motor from resisting the manual retreat of the launcher.

The handle assembly 20 in the figure also supports a third shaft drive system, usually labeled 400. As can be seen from FIGS. 3 and 4, the third shaft drive system 400 includes a solenoid 402 in at least one form, from which the third drive actuator member or rod 410 projects. A third drive cradle or socket 414 is formed therein at the distal end 412 of the third drive actuator member 410 and is operably attached to the third drive cradle or socket 414 as an interchangeable surgical tool assembly. Accepts the corresponding parts of the drive system components of. The solenoid 402 is wired to or otherwise communicates with the handle circuit board assembly 220 and the control system or CPU 224. In at least one configuration, the solenoid 402 is "spring-loaded" so that when the solenoid 402 is not activated, its spring component returns to the inactive starting position of the third drive actuator 410. To be urged to.

As mentioned above, the reconfigurable handle assembly 20 can be advantageously used to activate a variety of different interchangeable surgical tool assemblies. For that purpose, the handle assembly 20 includes a tool mount, usually designated 500, for operably connecting the replaceable surgical tool assembly to the handle assembly 20. In the illustrated example, the tool mounting portion 500 includes two inwardly facing dovetail receiving slots 502 configured to engage the corresponding portion of the tool mounting module portion of the replaceable surgical tool assembly. Each dovetail receiving slot 502 may be tapered or, in other words, somewhat V-shaped. The dovetail receiving slot 502 is configured to removably receive a corresponding tapered fitting or protrusion formed on a portion of the tool mounting nozzle portion of the replaceable surgical tool assembly. Each interchangeable surgical tool assembly may also include a latching system configured to releasably engage the corresponding holding pocket 504 formed in the tool mounting portion 500 of the handle assembly 20.

Various interchangeable surgical tool assemblies work with a "primary" rotary drive system configured to be operably coupled or interlocked with a first rotary drive system 310, as well as a second rotary drive system 320. It is possible to have a "secondary" rotary drive system that is configured to be coupled or interlocked as possible. Primary and secondary rotational drive systems may be configured to provide various rotational movements to some of the particular types of surgical end effectors that form part of an interchangeable surgical tool assembly. Tool mounting of handle assembly 20 to facilitate operational connection between the primary drive system and the first rotational drive system and operational connection between the secondary drive system and the second rotational drive system 320. The portion 500 further includes a pair of insertion inclined surfaces 506. The pair of insertion ramps 506 distally urges a portion of the primary and secondary rotational drive systems of the interchangeable surgical tool assembly during the coupling process to provide the primary rotational drive system and the handle assembly 20. Easy alignment and operable connection with the first rotational drive system 300, as well as alignment and operational connectivity of the secondary rotational drive system with the second rotational drive system 320 on the handle assembly 20. It is configured to do.

The interchangeable surgical tool assembly can include a "tertiary" axial drive system for applying axial motion (s) to the corresponding portion of the surgical end effector of the interchangeable surgical tool assembly. To facilitate the operable connection between the tertiary axis drive system and the third axis drive system 400 on the handle assembly 20, the third drive actuator member 410 is a protrusion or other portion of the tertiary axis drive system. 414 is provided that is configured to operably receive the.

The replaceable tool assembly 2000 is shown in FIG. The interchangeable tool assembly 2000 is similar to the interchangeable tool assembly 1000 in many respects, but differs from the interchangeable tool assembly 1000 in several other respects. For example, the replaceable assembly 2000 is a circular stapled assembly. Primarily with reference to FIGS. 15 and 16, the circular stapled assembly 2000 includes a shaft portion 2100 and an end effector 2200. The shaft portion 2100 includes, for example, a proximal portion that is removable and attachable to the handle assembly 20. The end effector 2200 includes a first portion 2210 rotatably attached to the shaft portion 2100 around the range of motion joint 2300. The end effector 2200 further includes a second portion 2220 detachably attached to the first portion 2210. The second portion 2220 includes a cartridge portion 2222 including an annular array of staple cavities 2224 defined internally, and staples housed in each staple cavity 2224. The second portion 2220 further comprises an anvil 2230 comprising a tissue compression surface 2232 and an annular array of forming pockets or forming pockets 2234 (FIG. 27) aligned with staple cavities 2224, wherein the forming pockets are stapled. It is configured to deform the staple when ejected from the staple cavity 2224.

In addition to the above, with reference to FIGS. 15 and 16 again, the second portion 2220 of the end effector 2200 can be selectively attached to the first portion 2210 of the end effector 2200, and the first portion 2210. It can be selectively removed from. The second portion 2220 includes an outer housing 2227 that includes a proximal connector 2229, and the proximal connector 2229 is received within an opening (or chamber) 2218 defined within the housing 2217 of the first portion 2210. It is configured as follows. The fit between the connector 2229 of the housing 2227 and the housing 2217 of the first portion 2210 is a slip fit. The compression fit between the connector 2229 and the housing 2217 can prevent the second portion 2220 from accidentally displaced in the longitudinal and / or rotational direction with respect to the first portion 2210. In various examples, detent members may be used to removably secure the second portion 2220 of the end effector 2200 to the first portion 2210.

With reference to FIGS. 15 and 35-38, the second portion 2220 of the end effector 2200 may be a second portion of another, eg, a second portion 2220', a second portion 2220'', a second portion. It is interchangeable with a portion 2220'' and / or another second portion 2220 and the like. The second portion 2220 ″, 2220 ″, and 2220 ″ ″ are in many respects similar to the second portion 2220. For example, each of the second portions 2220, 2220 ′, 2220 ″, and 2220 ″ ″ includes an internally defined central opening 2226. However, the second portion 2220 ″, 2220 ″, and 2220 ″ ″ are otherwise different from the second portion 2220. For example, the second portion 2220'has a larger diameter than the second portion 2220. Further, the annular array of staple cavities 2224 defined in the second portion 2220'has a larger circumference than the annular array of staple cavities 2224 defined in the second portion 2220. Similarly, the second portion 2220'' has a larger diameter than the second portion 2220', and the annular array of staple cavities 2224 defined within the second portion 2220'' is second. It has a larger peripheral diameter than the annular array of staple cavities 2224 defined within the portion 2220'. Further, similarly, the second portion 2220'''' has a larger diameter than the second portion 2220'' and is an annular of the staple cavities 2224 defined within the second portion 2220'''. The array has a larger circumference than the annular array of staple cavities 2224 defined within the second portion 2220''.

In addition to the above, the anvil 2230 is interchangeable with other anvils such as anvil 2230', anvil 2230 ", anvil 2230", and / or another anvil 2230. Anvil 2230 ″, 2230 ″, and 2230 ″ are similar to Anvil 2230 in many respects. For example, each anvil 2230, 2230 ″, 2230 ″, and 2230 ″ Include a longitudinal shaft 2236 that includes a connecting flange 2238. However, Anvil 2230 ″, 2230 ″, and 2230 ″ ″ are otherwise different from Anvil 2230. For example, the anvil 2230'has a larger diameter than the anvil 2230. In addition, the annular array of forming pockets 2234 defined within the anvil 2230'is anvil so that the forming pocket 2234 remains aligned with the staple cavity 2224 defined within the second portion 2220'. It has a larger circumference than the annular array of forming pockets 2234 defined within 2230. In addition, the anvil 2230'' has a larger diameter than the anvil 2230'so that the forming pocket 2234 remains aligned with the staple cavity 2224 defined within the second portion 2220''. The annular array of forming pockets 2234 defined in the anvil 2230'' has a larger circumference than the annular array of forming pockets 2234 defined in the anvil 2230'. Further, similarly, the anvil 2230'''is from the anvil 2230'' so that the forming pocket 2234 remains aligned with the staple cavity 2224 defined within the second portion 2220''. Also has a larger diameter, the annular array of forming pockets 2234 defined in the second portion 2220'''' has a larger circumference than the annular array of forming pockets 2234 defined in the anvil 2230''. have.

Primarily with reference to FIG. 17, the shaft portion 2100 includes a proximal connector 2120 and an elongated shaft portion 2110 extending distally from the proximal connector 2120. The proximal connector 2120 includes a first input section 2318 and a second input section 2418. The first input unit 2318 is operably connected to the end effector's range of motion system and the second input unit 2418 is operably connected to the end effector's clamp and staple firing system. The first input unit 2318 and the second input unit 2418 can be operated in any suitable order. For example, the first input unit 2318 can be rotated in the first direction to jointly move the end effector 2200 in the first direction, and the end effector 2200 can be rotated in the second direction correspondingly. The joint movement can be performed in the second direction. Once the end effector 2200 has been properly articulated, the second input portion 2428 can then be rotated to close the anvil 2230 and clamp the tissue to the cartridge portion 2222 of the end effector 2200. As will be described in more detail below, the second input section 2428 can then be manipulated to eject staples from the staple cavity 2224 to incise the tissue captured within the end effector 2200. In various alternative embodiments, the first input unit 2318 and the second input unit 2328 can be operated in any suitable order and / or simultaneously.

The first input unit 2318 is attached to the proximal end of the joint motion shaft 2310 rotatably attached to the shaft unit 2010. Primarily with reference to FIGS. 20 and 21, the rotatable range of motion shaft 2310 includes a distal end and a worm gear 2312 mounted at the distal end. The worm gear 2312 is engaged with the joint sliding portion 2320 by screwing. More specifically, the joint sliding portion 2320 includes an internally defined threaded opening 2322, and the worm gear 2312 is screwed into the threaded opening 2322. When the joint motion shaft 2310 rotates in the first direction, the worm gear 2312 pushes the joint sliding portion 2320 distally (FIG. 32). When the joint motion shaft 2310 rotates in the second direction or the opposite direction, the worm gear 2312 pushes the joint sliding portion 2320 proximally (FIG. 31). The joint sliding portion 2320 is slidably supported by a joint movement block 2112 fixedly mounted in the distal end of the elongated shaft portion 2110. The movement of the joint sliding portion 2320 is restricted to proximal and distal movement by the joint movement block 2112 by the guide slot 2315 defined within the joint movement block 2112. The joint sliding portion 2320 further includes a longitudinal key portion 2326 extending from the joint sliding portion 2320 that is snugly received within the longitudinal key groove 2116 defined in the bottom surface of the guide slot 2315, and the key. The portion 2326 limits the relative motion between the joint sliding portion 2320 and the joint motion block 2112 in the longitudinal path.

With reference to FIGS. 20, 21, and 24 again, the joint sliding portion 2320 is connected to the range of motion link 2330. The joint sliding portion 2320 includes a drive pin 2324 extending from the joint sliding portion 2320, and the drive pin 2324 is positioned within the proximal opening 2334 defined within the range of motion link 2330. The drive pin 2324 is snugly received within the opening 2334, whereby the drive pin 2324 and the side wall of the opening 2334 work together to provide a rotation axis between the joint sliding portion 2320 and the range of motion link 2330. Define. The range of motion link 2330 is also connected to the end effector 2200 housing 2217. More specifically, the range of motion link 2330 further includes a distal opening 2335 defined within the range of motion link 2330, and the housing 2217 includes a pin 2215 located within the distal opening 2335. The pin 2215 is snugly received within the opening 2335, whereby the pin 2215 and the side wall of the opening 2335 work together to define a rotation axis between the joint motion link 2330 and the housing 2217.

In addition to the above, with reference to FIGS. 18-21 and 24, the end effector 2200 is rotatably connected to the joint motion block 2112 of the shaft 2100 around the joint motion joint 2300. The housing 2217 of the end effector 2200 includes an opening 2213 defined on the opposite surface of the housing 2217, and the joint movement block 2112 includes a protrusion 2113 extending from the opposite surface of the joint movement block 2112. The 2113 is positioned within the opening 2213. The protrusion 2113 is snugly received within the opening 2213, which allows the protrusion 2113 and the side wall of the opening 2213 to work together to allow the end effector 2200 to jointly move around it. Is defined. When the joint motion shaft 2310 rotates to drive the joint sliding portion 2320 distally, the joint sliding portion 2320 drives the proximal end of the joint motion link 2330 distally. In response to the distal movement of the proximal end of the articulation link 2330, the articulation link 2330 rotates about the drive pin 2324, which causes the end effector 2200 to rotate about the articulation joint 2300. When the joint movement input portion 2310 rotates to drive the joint sliding portion 2320 proximally, the joint sliding portion 2320 pulls the proximal end of the joint movement link 2330 proximally in the same manner as described above. In response to the proximal movement of the proximal end of the joint motion link 2330, the joint motion link 2330 rotates about the drive pin 2324, which causes the end effector 2200 to rotate around the joint motion joint 2300. The range of motion link 2330 provides at least one degree of freedom between the joint sliding portion 2320 and the housing 2217. As a result, the joint motion link 2330 can jointly move the end effector 2200 over a wide range of motion angles.

As mentioned above, with reference to FIGS. 17 and 25, the proximal connector 2120 of the interchangeable tool assembly 2000 includes a second input section 2418. The second input unit 2418 includes a drive gear 2417 that meshes and engages with the drive gear 2416 mounted at the proximal end of the drive shaft 2410. The drive shaft 2410 extends through the shaft portion 2110 and the opening 2114 defined within the joint motion block 2112 illustrated in FIG. The opening 2114 includes a bearing and rotatably supports the drive shaft 2410. Alternatively, the opening 2114 may include a gap opening. In both cases, with reference primarily to FIG. 22, the drive shaft 2410 extends through the range of motion joint 2300 into the chamber 2218 defined within the end effector housing 2217. The drive shaft 2410 is rotatably supported by a bearing 2414 mounted on the drive shaft 2410, which is captured in a recess 2214 defined in the housing 2217 of the end effector 2200. The drive shaft 2410 further includes an output gear 2412 mounted at the distal end of the drive shaft 2410, whereby the rotation of the drive shaft 2410 is transmitted to the output gear 2412.

Primarily with reference to FIGS. 18, 22, and 23, the output gear 2412 of the drive shaft 2410 operably engages the transmission device 2420. As will be described in more detail below, the transmission device 2420 has a first mode of operation in which the drive shaft 2410 moves the anvil 2230 with respect to the cartridge body 2222 and the drive shaft 2410 from the staple cavity 2224. It is configured to fire staples and transition between a second mode of operation that incises the tissue captured between the anvil 2230 and the cartridge body 2222. The transmission device 2420 includes an orbit drive unit including a planetary plate 2421 and four planetary gears 2424 rotatably mounted on the planetary plate 2421. The planetary plate 2421 includes a gap opening extending through the center of the planetary plate 2421 and a drive shaft 2410 extending through the gap opening. The planet plate 2421 and the planet gear 2424 are located in the chamber 2219 defined in the end effector housing 2217. Each planetary gear 2424 is rotatable about a gear pin 2423 extending from the planetary plate 2421. The gear pin 2423 is positioned along the perimeter surrounding the gap opening. The output gear 2412 meshes with and engages with the planetary gear 2424, and the drive shaft 2410 drives the planetary gear 2424, as will be described in more detail below.

In addition to the above, the drive shaft 2410 extends through the range of motion joint 2300. The drive shaft 2410 is flexible so that the output gear 2412 maintains proper engagement with the planetary gear 2424 as the end effector 2200 articulates. In at least one case, the drive shaft 2410 is made of, for example, plastic.

As described above, the transmission device 2420 includes a first operation mode and a second operation mode. Primarily with reference to FIGS. 23 and 28, the interchangeable tool assembly 2000 has a first position and a second position to switch the transmission 2420 between its first mode of operation and its second mode of operation. Further includes a shifter 2600 that can be moved to and from the position of. When the shifter 2600 is in its first position, as illustrated in FIGS. 28-30, the shifter 2600 does not engage the planetary plate 2421 of the transmission device 2420, resulting in the planetary plate 2421 and the planetary gear 2424. It is rotated by the drive shaft 2410. More specifically, as described in more detail below, the drive shaft 2410 rotates the planetary gears 2424 around their corresponding gear pins 2423, and the planetary gears 2424 are the planetary gears 2424 and the planetary gears 2424. The planetary plate 2421 is rotated by the reaction force between the annular ring of the tooth portion 2534 extending around it. The planet plate 2421 is operably connected to the output connecting unit 2430 so that the rotation of the planet plate 2421 is transmitted to the output connecting unit 2430. Primarily with reference to FIG. 23, the output connecting portion 2430 includes an array of openings 2433 extending around the outer perimeter of the output connecting portion 2430, and the gear pin 2423 extending from the planetary plate 2421 includes the output connecting portion 2430. It extends into the opening 2433 defined in (1) and is snugly received by the opening 2433, whereby there is little, if any, relative movement between the planetary plate 2421 and the output connection 2430.

Primarily with reference to FIGS. 18 and 23, the output coupling portion 2430 includes a drive socket 2432. The drive socket 2432 includes, for example, a substantially hexagonal opening. However, any suitable configuration can be used. The drive socket 2432 is configured to receive a closure shaft 2440 extending through a second portion 2220 of the end effector 2200. The closure shaft 2440 includes a proximal drive end 2442 having a substantially hexagonal shape, the proximal drive end 2442 being within the drive socket 2432 such that rotation of the drive shaft 2410 can be transmitted to the closure shaft 2440. It is perfectly accepted. The closure shaft 2440 is rotatably supported by bearings 2444 in the housing 2227 of the second portion 2220. The bearing 2444 includes, for example, a thrust bearing, but the bearing 2444 may include any suitable bearing.

Primarily with reference to FIGS. 23 and 28-30, the closure shaft 2440 includes a threaded portion 2446 that is screwed into a threaded opening 2456 defined within the trocar 2450. As described in more detail below, the anvil 2230 can be attached to the trocar 2450, which translates the anvil 2230 towards and / or away from the cartridge body 2222. be able to. Referring again to FIG. 18, the trocar 2450 includes at least one longitudinal key slot 2459 defined within the trocar 2450, which key slot 2459 extends from the inner surface 2546 of the drive sleeve 2540. It is configured to work with the longitudinal key. The drive sleeve 2540 is part of a staple firing system described further below, and the reader has read that the trocar 2450 and drive sleeve 2540 are, firstly, slid relative to each other, secondly. It should be understood that they work together to prevent relative rotation between them. Due to the threaded engagement between the closure shaft 2440 and the trocar 2450, the closure shaft 2440 can rotate or translate the trocar 2450 distally as the closure shaft 2440 rotates in the first direction. Thus, when the closure shaft 2440 rotates in the second direction or in the opposite direction, the trocar 2450 can be moved proximally or translated.

As mentioned above, the anvil 2230 can be attached to the trocar 2450. The anvil 2230 includes a connecting flange 2238 configured to engage and grip the trocar 2450. The connecting flange 2238 includes a cantilever connected to the shaft portion 2236 of the anvil 2230. Primarily with reference to FIG. 23, the trocar 2450 includes a holding notch (or / or recess) 2458 configured to detachably receive the connecting flange 2238 when the anvil 2230 is assembled to the trocar 2450. The holding notch 2458 and the connecting flange 2238 are configured to resist the unintended separation of the anvil 2230 from the trocar 2450. The connecting flange 2238 is separated by a longitudinal slot 2237. Slot 2237 is configured to receive longitudinal ribs 2457 extending from the trocar 2450 when the anvil 2230 is assembled to the trocar 2450. The ribs 2457 are snugly received within slot 2237, resulting in. , Anvil 2230 is prevented from rotating relative to Trocar 2450.

Once the anvil 2230 is properly positioned relative to the cartridge section 2222, the tool assembly 2000 can be transitioned to its second mode of operation, as described above. The shifter 2600 includes, for example, an electrically actuated motor used to move the transmission device 2420 of the end effector 2200. In various other embodiments, the shifter 2600 can include any suitable device that is electrically and / or manually actuated. The shifter 2600 signals and communicates with the processor of the surgical stapler and powers the battery of the surgical stapler. In various examples, an insulated wire extends, for example, between the shifter 2600 and the handle of the surgical instrument so that the processor can communicate with the shifter 2600 and the battery can power the shifter 2600. May be good. In various other examples, the shifter 2600 can include a radio signal receiver and the processor can wirelessly communicate with the shifter 2600. In some cases, power may be wirelessly supplied to the shifter 2600, for example, by an inductive circuit or the like. In various examples, the shifter 2600 can include its own power supply.

The shifter 2600 includes a housing mounted within a chamber 2218 defined within the proximal end of the end effector 2200. The shifter 2600 includes a clutch key (or toggle) 2602 and an output shaft 2604 movable between a first position and a second position with respect to the shifter housing. The clutch key 2602 includes one lock tooth 2608 and a second lock tooth 2609, and when the clutch key 2602 is in its first position, the first lock tooth 2608 is attached to the launch tube 2530 of the staple launch system. Engage, and at the same time, the second lock tooth 2609 disengages the transmission device 2420 from the planet plate 2421. More specifically, the first lock tooth 2608 is located within the opening 2538, which is part of an annular array of openings 2538 defined around the launch tube 2530, with the second lock tooth 2609 being It is not located within opening 2429, which is part of an annular array of openings 2429 defined around the planetary plate 2421. As a result of the above, when the clutch key 2602 is in its first position, the shifter 2600 prevents the launch tube 2530 from rotating, thereby locking out the staple launch system. When the clutch key 2602 is in its first position, the staple launch system is locked out by the shifter 2600, but the drive shaft 2410 rotates the planet plate 2421 to operate the anvil closure system, as described above. be able to.

Primarily as shown in FIG. 23, the launch tube 2530 includes an inner annular rack of teeth 2534 defined within its inner side wall 2532. The planetary gear 2424 operably meshes with the rack of the tooth 2534. When the shifter 2600 is in its first position as illustrated in FIG. 28, the launch tube 2530 is held in place by the shifter 2600 and the planetary gear 242 is held by the drive shaft 2410 on the launch tube 2530 and the teeth 2534. It can rotate with respect to the rack. In such cases, the planetary gear 2424 rotates about a longitudinal drive shaft defined by the drive shaft 2410 and at the same time around an axis defined by their respective gear pins 2423. The reader understands that the planetary gear 2424 is driven directly by the drive shaft 2410 and that the reaction force generated between the planetary gear 2424 and the launch tube 2530 causes the planetary gear 2424 to drive and rotate the planetary plate 2421. Should be. When the shifter 2600 is activated to move the clutch key 2602 to its second position, the first locking tooth 2608 disengages from the launch tube 2530, and at the same time the second locking tooth 2609 disengages the planet plate 2421. Engage in. When the clutch key 2602 is in its second position, the planetary plate 2421 is held in place by the shifter 2600, and as a result the closure drive is locked out, so it is not possible to operate the anvil 2230 to move. Can not. When the drive shaft 2410 is rotated in such a case, the output gear 2412 drives the planetary gear 2424 and rotates the planetary gear 2424 with respect to the planetary plate 2421 about their corresponding gear pins 2423. The planetary gear 2424 drives the launch tube 2530 via a rack of teeth 2534 to rotate the launch tube 2530 about its longitudinal axis.

In addition to the above, with reference to FIG. 23, the launch tube 2530 is operably coupled to the drive sleeve 2540 of the staple launch system. More specifically, the inner side wall 2532 of the launch tube 2530 includes a longitudinal slot 2535 defined within the sidewall, which longitudinal slot 2535 snugly fits the longitudinal rib 2545 defined on the drive sleeve 2540. It is configured to accept, which causes the drive sleeve 2540 to rotate with the launch tube 2530. The drive sleeve 2540 further includes a threaded distal end 2542 that is screwed into the drive collar 2550. More specifically, the drive collar 2550 includes a threaded opening 2552 that is screwed into the threaded distal end 2542. The drive collar 2550 is positioned within the opening 2228 defined within the housing of the end effector 2200, for example, the arrangement of longitudinal ribs and grooves prevents rotation within the opening 2228. As a result of the above, the rotation of the drive sleeve 2540 translates the drive collar 2550 in the longitudinal direction. For example, the drive collar 2550 advances distally when the drive sleeve 2540 is rotated in the first direction, and retracts proximally when the drive sleeve 2540 is rotated in the second or opposite direction.

When the drive collar 2550 is pushed distally, as described above, the drive collar 2550 pushes the staple driver block 2560 and a cutting member 2570 such as a knife distally during the firing stroke of the staple firing system. More specifically, the drive collar 2550 is near, where the staples are located in the staple cavity 2224 defined in the cartridge body portion 2222 and the cutting member 2570 is fitted under the deck surface of the cartridge body portion 2222. Staples between the unlaunched position and the distal launch position where the staples are deformed relative to the anvil 2230 and the tissue captured between the anvil 2230 and the cartridge body portion 2222 is transected by the cutting member 2570. Push the driver block 2560 and the cutting member 2570. The drive collar 2550 includes a drive recess 2554 configured to abut the staple driver block 2560 and the cutting member 2570 as the drive collar 2550 advances distally. The staple driver block 2560 includes a plurality of staple cradle defined internally, and each staple cradle is configured to support the base of the staple. The staple cradle is aligned with the staple cavities 2224 defined within the cartridge body portion 2222 and arranged in at least two concentric rows.

Since the staple driver block 2560 and the cutting member 2570 are attached to the drive collar 2550, when the drive collar 2550 moves proximally away from the anvil 2230, the staple driver block 2560 and the cutting member 2570 are moved proximally by the drive collar 2550. Be pulled. In at least one case, the staple driver block 2560 and the cutting member 2570 include one or more hooks extending into an opening 2557 defined within the drive collar 2550. In various examples, the staple driver block 2560 and the cutting member 2570 can be retracted so as to be completely retracted below the deck surface of the cartridge body portion 2222.

In addition to the above, the end effector 2200 can operate in a third mode of operation in which the clutch key 2602 of the shifter 2600 is operably engaged with the anvil closure system and the staple firing system. In this mode of operation, the first lock tooth 2608 engages the launch tube 2530 of the staple launch system and the second lock tooth 2609 engages the planetary plate 2421 of the transmission device 2420. In such a case, the first lock tooth 2608 is positioned within the opening 2538 defined in the launch tube 2530 and the second lock tooth 2609 is the opening 2429 defined within the planetary plate 2421. Positioned inside. As a result of the above, the drive shaft 2410 simultaneously moves the anvil 2230, the staple driver block 2560, and the cutting member 2570 with respect to the cartridge body 2222.

With reference to FIG. 15 again, the user of the interchangeable tool assembly 2000 selects from the kit of the second part 2220, 2220', 2220'', 2220''' and / or any other suitable second part. The selected second portion can be assembled to the first portion 2210 of the end effector 2200. Primarily with reference to FIG. 18, each second portion includes a housing connector 2229 that engages the housing 2217 of the first portion 2210 when the second portion is assembled to the first portion 2210. In addition, each second portion includes a closure shaft 2440 that operably engages with the drive socket 2432 of the first portion 2210 when the second portion is assembled to the first portion 2210. Further, each second portion includes a drive sleeve 2540 that operably engages with the launch tube 2530 of the first portion 2210 when the second portion is assembled to the first portion 2210.

In addition to the above, with reference to FIGS. 35 and 36, the tool assembly 2000'is interchangeable with the tool assembly 2000. The tool assembly 2000'is similar to the tool assembly 2000 in many respects. However, the tool assembly 2000'is configured to provide a circular staple line with a diameter larger than the circular staple line provided by the tool assembly 2000. Tool assembly 2000' includes, among other things, a wider second portion 2220', staple driver 2560', knife assembly 2570', cartridge body 2222', and anvil 2230'. With reference to FIG. 37, the tool assembly 2000 ″ is interchangeable with the tool assembly 2000. Tool assemblies 2000 ″ are similar to tool assemblies 2000 and 2000 ″ in many respects. However, the tool assembly 2000 ″ is configured to provide a circular staple line with a diameter larger than the circular staple line provided by the tool assembly 2000 ″. Tool assembly 2000 ″ includes, among other things, a wider second portion 2220 ″, staple driver 2560 ″, knife assembly 2570 ″, cartridge body 2222 ″, and anvil 2230 ″. With reference to FIG. 38, the tool assembly 2000 ″ is interchangeable with the tool assembly 2000. The tool assembly 2000 ″ is similar to the tool assemblies 2000, 2000 ″, and 2000 ″ in many respects. However, the tool assembly 2000 ″ is configured to provide a circular staple line with a diameter larger than the circular staple line provided by the tool assembly 2000 ″. Tool assembly 2000'''', among other things, the wider second part 2220'''', staple driver 2560'''', knife assembly 2570'''', cartridge body 2222'''', and anvil 2230''''. include.

In various embodiments, in addition to the above, the surgical instrument can have any suitable number of modes of operation. In at least one embodiment, the surgical staple fastening instrument has a first mode of operation for firing staples, a second mode of operation for deploying cutting members, and a third mode for simultaneously firing staples and deploying cutting members. Including operating modes. In the first mode of operation, the cutting member is not deployed. Moreover, the processor of such a surgical instrument can be programmed so that the instrument cannot be put into a second mode of operation without first completing the first mode of operation. As a result of the above, the user of the surgical instrument can decide whether to cut the tissue after firing the staples.

An alternative embodiment of the staple cartridge body for use with a surgical stapler is shown in FIG. The cartridge body 2222'includes an annular outer row of staple cavities 2224 and an annular inner row of staple cavities 2224'. The staple cavity 2224 is defined in the first stage of the deck of the cartridge body, and the staple cavity 2224'is defined in the second stage of the deck of the cartridge body. The second stage extends beyond the first stage. In other words, the first tier has a first deck height and the second tier has a second deck height that is higher than the first deck height. The deck wall separates the first and second tiers. In various embodiments, the deck wall is sloping. In certain embodiments, the deck wall is orthogonal to the first and / or second tier.

The cartridge body 2222' further includes a cavity expansion 2229' extending from the first stage of the deck. The cavity expansion portion 2229'surrounds both ends of the staple cavity 2224 and extends the staple cavity 2224 above the first stage. Cavity expansion 2229'can at least partially control the staples above the first stage as the staples are ejected from the staple cavity 2224. The cavity expansion 2229'is also configured to contact and compress the captured tissue with respect to the cartridge body 2222'. Cavity expansion 2229'can also control tissue flow with respect to the cartridge body 2222'. For example, the cavity expansion 2229'can limit the radial flow of tissue. The cavity expansion portion 2229'can have any suitable structure and can extend from the first stage by any suitable height. In at least one case, the top surface of the cavity expansion 2229'is, for example, aligned with the second step or has the same height as the second step. In other cases, the cavity expansion 2229'may extend above or below the second stage.

In addition to the above, each staple cavity 2224 includes an internally placed first staple having a first unformed height. Each staple cavity 2224'includes an internally disposed second staple having a second unformed height that is different from the first unformed height. For example, the first unformed height is higher than the second unformed height, but the second unformed height may be higher than the first unformed height. In the alternative embodiment, the height of the first unformed staple and the height of the second unformed staple are the same.

The first staple is deformed to the first deformation height, and the second staple is deformed to a second deformation height different from the first deformation height. For example, the first deformation height is higher than the second deformation height. Such a configuration may improve blood flow to stapled tissue. Alternatively, the second deformation height may be higher than the first deformation height. Such a configuration may increase the flexibility of the tissue along the medial transverse cutting line. In certain alternative embodiments, the first deformation height and the second deformation height are the same.

As mentioned above, replaceable tool assemblies include, among other things, shafts, end effectors, and replaceable staple cartridges. The replaceable staple cartridge has a closure drive that is configured to move and open the end effector to trap the tissue in the end effector, and staples and cuts the tissue trapped in the end effector. Includes a configured launch drive. When the replaceable staple cartridge is assembled to the shaft, the closure and launch drives of the end effector are operably coupled to the corresponding closure and launch drives of the shaft. If the replaceable staple cartridge is not properly assembled to the shaft, the replaceable staple cartridge will not operate as intended. As will be described in more detail below, the replaceable staple cartridge and / or shaft is a lock that prevents the replaceable staple cartridge from being activated if the replaceable staple cartridge is not properly attached to the shaft. Can include outs.

With reference to FIG. 39 here, the replaceable tool assembly 3000 includes a shaft 3010 and a replaceable staple cartridge 3020. Similar to the above, the replaceable staple cartridge 3020 is operably connected to the closure drive output and the firing drive output, respectively, when the staple cartridge 3020 is fully seated on the shaft 3010. And the launch drive input. The operation of such closures and launch systems will not be repeated here for brevity.

The replaceable tool assembly 3000 further includes a lockout circuit 3090. The lockout circuit 3090 includes a conductor 3096 and a contact 3092. The first contact 3092 is electrically coupled to the first conductor 3096 and the second contact 3092 is electrically coupled to the second conductor 3096. The first contact 3092 is not electrically coupled to the second contact 3092 until the staple cartridge 3020 is fully seated on the shaft 3010. The staple cartridge 3020 includes a contact bridge 3094, which engages with and electrically couples to the contact 3092 when the staple cartridge 3020 is fully seated on the shaft 3010. The contacts 3092 and the contact bridge 3094 are configured and arranged so that the contact bridge 3094 does not electrically couple the contacts 3092 when the staple cartridge 3020 is only partially seated on the shaft 3010.

The replaceable tool assembly 3000 can be used with, for example, a surgical instrument system including a manually operable handle and / or robot system. In various embodiments, the surgical instrument system includes an electric motor configured to drive the staple firing system of the tool assembly 3000, as well as a controller configured to operate the electric motor. The lockout circuit of the tool assembly 3000 communicates with the controller. When the controller detects that the contact bridge 3094 is not engaged with the contact 3092 or the lockout circuit is open, the controller prevents the electric motor from operating the staple firing system. In various examples, the controller is configured not to power the electric motor when the lockout circuit is open. In certain other cases, the controller powers the electric motor so that when the lockout circuit is open, the electric motor can activate the closure system, but not the launch system. It is configured to do. In at least one such example, the controller activates a transmission connected to the electric motor so that the output of the electric motor is directed only to the closure system. When the controller detects that the contact bridge 3094 is engaged with the contact 3092 or that the lockout circuit is closed, the controller allows the electric motor to operate the staple firing system.

If the surgical instrument system includes a handle, in addition to the above, when the controller detects that the lockout circuit is open, the controller activates a trigger lock that prevents the handle's firing trigger from being activated. be able to. Once the staple cartridge 3020 is fully seated on the shaft 3010 and the lockout circuit is closed, the controller can retract the trigger lock to allow the firing trigger to operate. Such systems can be used with motorized and / or non-motorized launch drives. The non-motorized launch drive may be driven, for example, by a manual crank.

As mentioned above, the anvil 2230 may be assembled to the trocar shaft 2450 of the closure drive of the tool assembly 2000. The connecting flange 2238 of the anvil 2230 is configured to engage a recess 2458 defined within the trocar shaft 2450 to connect the anvil 2230 to it. Once the anvil 2230 is assembled to the trocar shaft 2450, the closure drive can retract or pull the trocar shaft 2450 and the anvil 2230 towards the staple cartridge 2222 to compress the tissue against the staple cartridge 2222. However, in some cases, the anvil 2230 may not be properly assembled to the trocar shaft 2450. Misassembly of the anvil 2230 with respect to the trocar shaft 2450 can often occur when the physician attempts to assemble the anvil 2230 to the trocar shaft 2450 if the trocar shaft 2450 does not extend sufficiently above the deck of the staple cartridge 2222. In most cases, the anvil 2230 is fully attached to the trocar shaft 2450, which allows the trocar shaft 2450 to move the anvil 2230 towards the staple cartridge 2222, which allows the anvil 2230 to move the tissue. The anvil 2230 may disengage from the trocar shaft 2450 when it begins to compress against the staple cartridge 2222.

Here, with reference to FIGS. 39 and 40, an interchangeable tool assembly 3100, which is in many respects similar to the interchangeable tool assembly 2000 described above, is shown. Tool assembly 2000 includes a cartridge body 3120 that includes a deck 3121 configured to support the tissue as it is compressed against the cartridge body 3120 by the anvil 2130. The tool assembly 3100 further includes a closure drive configured to move the anvil 2130 with respect to the cartridge body 3120. The closure drive includes a trocar shaft 3150 having a recess formed therein as above. The recess includes a distal shoulder 3158 configured to hold the anvil 2130 against the trocar shaft 3150. In addition, the tool assembly 3100 further includes a firing drive configured to eject staples from the cartridge body 3120. The firing drive includes a rotatable shaft 3162 and a translatable collar 3160 screwed onto the rotatable shaft 3162, the rotatable shaft 3162 ejecting staples from the cartridge body 3120. It is configured as follows. The rotatable shaft 3162 includes an internally defined longitudinal opening 3164 and a trocar shaft 3150 extending through the opening 3164.

In addition to the above, the closure drive further includes a clip 3190 mounted on the trocar shaft 3150. Clip 3190 includes a base 3192 mounted in a slot defined within the trocar shaft 3150. Clip 3190 further includes a flexible arm extending from base 3192, or appendage 3198. The arm 3198 is movable between the extension position (FIG. 39) and the deflection position (FIG. 40). When the arms 3198 are in their deflection positions, the anvil 2130 can be locked to the trocar shaft 3150, as illustrated in FIG. As illustrated in FIG. 40, the arms 3198 are held in their deflection positions by the translatable collar 3160 of the firing drive when the trocar shaft 3150 extends sufficiently above the deck 3121 of the cartridge body 3120. NS. The translatable collar 3160 includes an annular shoulder 3168, which elastically urges the arm 3198 inward when the arm 3198 comes into contact with the shoulder 3168. It is configured.

If the trocar shaft 3150 is not fully extended above the cartridge deck 3121, the arm 3198 will not be urged inward by the shoulder 3168. In such cases, the arms 3198 are in their extended positions, as illustrated in FIG. When the arms 3198 are in their extended positions, the arms 3198 prevent the anvil 2130 from being attached to the trocar shaft 3150. More specifically, the arm 3198 prevents the connecting flange 2138 of the anvil 2130 from sitting behind the shoulder-shaped portion 3158 defined within the trocar shaft 3150. In such cases, the arm 3198 prevents the anvil 2130 from being partially attached to the trocar shaft 3150, so that a physician attempting to assemble the anvil 2130 to the trocar shaft 3150 will attach the anvil 2130 to the trocar shaft. It cannot be partially assembled to the 3150, and the above-mentioned problems can be avoided. Readers should understand that the anvil 2130 is often assembled to the trocar shaft 3150 on the fly or in the patient's body, and proper assembly of the anvil 2130 to the trocar shaft 3150 accelerates the completion of the surgical procedure being used. Is. The system described above provides a lockout that prevents the partially assembled anvil from being compressed against the tissue.

With reference to FIGS. 41-43, the replaceable tool assembly 3200 is configured to prevent the closure drive from retracting unless the anvil is attached to the closure drive, as detailed below. including. The tool assembly 3200 includes a shaft 3210 and an end effector 3220. The end effector 3220 includes an outer housing 3227, a cartridge body 3222, and a longitudinal opening 3226 defined through the cartridge body 3222. The tool assembly 3200 further includes a closure drive that includes a trocar shaft 3250 and an anvil 3230 that can be attached to the trocar shaft 3250. Similar to the above, the closure drive is configured to move the anvil 3230 towards or away from the cartridge body 3222. The trocar shaft 3250 is movable between an extended position and a retracted position. Both FIGS. 42 and 43 show the trocar shaft 3250 in the extended position.

In addition to the above, the tool assembly 3200 prevents the trocar shaft 3250 from moving from its extended position (FIGS. 42 and 43) towards its retracted position when the anvil 3230 is not assembled to the trocar shaft 3250. It further includes a retreat lock 3290 configured as described above. The retractable lock 3290 includes a lock arm 3292 rotatably mounted around a protrusion (or pin) 3294 on the housing 3227. The retractable lock 3290 further includes a spring 3296 engaged to the lock arm 3292, which spring 3296 is configured to urge the lock arm 3292 towards the trocar shaft 3250. The trocar shaft 3250 includes a locking shoulder portion 3258, and if the anvil 3230 is not assembled to the trocar shaft 3250 as shown in FIG. 42, the lock arm 3292 is hooked on the locking shoulder portion 3258 and the trocar It is configured to prevent the shaft 3250 from moving proximally. More specifically, the lock arm 3292 includes a claw 3298 configured to slide under the locking shoulder 3258. When the anvil 3230 is assembled to the trocar shaft 3250, the anvil 3230 comes into contact with the lock arm 3292 and shifts the lock arm 3292 away from the locking shoulder 3258, as shown in FIG. At that point, the trocar shaft 3250 is unlocked and can move towards its retracted position towards the cartridge body 3222.

With reference to FIGS. 44-46, the interchangeable tool assembly 3300 has a closure drive, a staple launch drive, and an anvil of the closure drive appropriate for tissue gaps, as detailed below. Includes a lockout configured to prevent the staple launch drive from operating until placed in. The tool assembly 3300 includes a shaft 3310 and an end effector 3320. The end effector 3320 includes an inner frame 3329, an outer housing 3327, and a cartridge body 3322. Similar to the above, the closure drive includes a trocar shaft 3350 and an anvil 2230 that can be attached to the trocar shaft 3350. Further, similarly to the above, the trocar shaft 3350 moves between the extension position (FIG. 45) and the retracted position (FIG. 46) so as to move the anvil 2230 toward the cartridge body 3322 or away from the cartridge body 3322. It is movable. The launch drive includes a rotatable shaft 3360 configured to distract the launch drive distally to eject staples stored within the cartridge body 3322.

In addition to the above, the end effector 3320 includes a launch drive lock 3390 movably mounted on the inner frame 3329. The firing drive lock 3390 includes a lock pin 3394 and a lock spring 3398 located around the lock pin 3394. The lock pin 3394 includes a head 3392 and a stop 3396. The lock spring 3398 is located between the stop 3396 and the side wall 3328 of the cavity defined in the inner frame 3329. When the trocar shaft 3350 is in the extended position, as shown in FIG. 45, the lock spring 3398 urges the lock pin 3394 to define a lock opening 3364 within the rotatable shaft 3360 of the staple firing drive. Put in. In such cases, the interaction between the lock pin 3394 and the side wall 3364 of the lock opening prevents the shaft 3360 from rotating and firing staples from the cartridge body 3322. When the trocar shaft 3350 is fully retracted, the trocar shaft 3350 engages the head 3392 of the lock pin 3394. The head 3392 is configured on the head 3392 to be engaged by a trocar shaft 3350 to move the launch drive lock 3390 between the locking configuration (FIG. 45) and the unlocking configuration (FIG. 46). Includes the cam surface defined in. When the drive lock 3390 is in its unlocked configuration, the shaft 3360 of the launch drive can rotate.

To lock out the firing drive of the tool assembly 3300 before the staples can be fired, it is necessary to move the anvil 2230 to or within a predetermined position. In addition, the tissue gap between the anvil 2230 and the cartridge body 3322 must be less than a certain distance to lock out the firing drive of the tool assembly 3300 before the staples can be fired. be. As a result, the position of the anvil 2230 and / or closure system unlocks the staple firing lockout. Such a configuration can, among other things, help prevent staple dysplasia and / or inadequate compression of tissue.

With reference to FIGS. 47-49, the interchangeable tool assembly 3400 has a closure drive configured to clamp the tissue, a staple launch drive, and a closure drive sufficient clamping pressure on the tissue. Includes a launch drive lockout 3490, which is configured to prevent the staple launch drive from operating prior to addition. The closure drive includes a trocar shaft 3450 and an anvil attached to the trocar shaft 3450, such as an anvil 2230. Further, similarly to the above, the trocar shaft 3450 is movable between the extension position (FIG. 48) and the retracted position (FIG. 49) in order to compress the tissue against the cartridge body of the tool assembly 3400. The firing drive includes a rotatable shaft 3460 configured to offset the staple driver distally to eject staples from the cartridge body.

The launch drive lockout 3490 is located between the trocar shaft 3450 of the closure drive and the rotatable shaft 3460 of the launch drive. The launch drive lockout 3490 includes a distal plate 3492, a proximal plate 3494, and a spring 3493 located between the distal plate 3492 and the proximal plate 3494. The launch drive lockout 3490 further includes a lock pin 3498, which is a lock configuration in which the lock pin 3498 engages the shaft 3460 (FIG. 48) and the lock pin 3498 disengages the shaft 3460. It is movable to and from the unlock configuration (FIG. 49). The lock pin 3498 is located within the pin chamber 3496 defined between the distal plate 3492 and the proximal plate 3494. More specifically, the lock pin 3498 includes a chamfered head located between the cam 3495 defined on the distal plate 3492 and the cam 3495 defined on the proximal plate 3494. When the trocar shaft 3450 retracts proximally, the trocar shaft 3450 pushes the distal plate 3492 proximally and the cam 3495 defined on the distal plate 3492 engages the head of the lock pin 3498. In such cases, as illustrated in FIG. 49, the cam 3495 defined on the distal plate 3492 cooperates with the cam 3495 defined on the proximal plate 3494 to provide the lock pin 3498. Shift to unlock configuration.

As mentioned above, the cam 3495 of the launch drive lockout 3490 squeezes the head of the lock pin 3498 as the distal plate 3492 moves towards the proximal plate 3494 by the trocar shaft 3450. More specifically, the cam 3495 drives the lock pin 3498 inwardly to disengage it from its engagement with the rotatable shaft 3460. When the lock pin 3498 is in its locking configuration, the lock pin 3498 is positioned within the lock opening 3468 defined within the shaft 3460 and by the interaction between the lock pin 3498 and the side wall 3468 of the lock opening. The lock pin 3498 prevents the shaft 3460 from rotating. As a result, the staples cannot be fired from the cartridge body by the firing drive. When the lock pin 3498 moves to the unlock configuration, the lock pin 3498 comes out of the lock opening and the shaft 3460 is rotated by the firing drive to fire the staples from the cartridge body, as described above. In various embodiments, the shaft 3460 may include a circumferential array of lock openings 3468 defined within the shaft 3460, each lock opening 3468 receiving a lock pin 3498 to lock the launch drive. It is configured to be out. With reference to FIGS. 49-51 again, the launch drive lockout 3490 further includes an urging member such as a spring 3499 configured to urge the lock pin 3498 into the lock opening 3468.

In addition to the above, the spring 3493 of the launch drive lockout 3490 is configured to resist the proximal movement of the trocar shaft 3450. The spring 3493 is a linear coil spring, but any suitable spring can be used. In addition, more than one spring can be used. In any case, the spring 3493, or spring system, has the rigidity to apply a spring force to the distal plate 3492 of the launch drive lockout 3490 as the trocar shaft 3450 retracts. In other words, the force exerted by the spring 3493 on the distal plate 3492 increases in proportion to the distance the trocar shaft 3450 is displaced proximally. The spring force generated by the spring 3493 opposes the clamping force exerted by the anvil 2230 on the tissue. As a result, the clamping force must overcome the constant or predetermined spring force generated by the spring 3493 in order to sufficiently shift the distal plate 3492 to unlock the firing drive. In such a case, the tissue clamping force must meet a predetermined threshold before the launch drive lockout 3490 can be released and the staple launch drive can be activated.

As discussed in connection with the various embodiments disclosed herein, the staple launch drive drives the staple against the anvil, deforming the staple to the desired formation height. In various examples, the staple launch drive is also configured to push a cutting member, such as a knife, distally to cut the tissue trapped between the cartridge body and the anvil. In such cases, the knife is exposed above the deck of the cartridge body. However, when the anvil is in the closed (or clamped) position, the anvil is positioned in close proximity to the cartridge body, so most of the knife is covered by the anvil, even if the knife is exposed above the cartridge body. .. If the anvil is moved to its open position and / or removed from the closure drive before the knife retracts below the deck of the cartridge body, the knife is uncovered and exposed. 52-54 show a tool assembly 3500 including a lockout 3590 configured to prevent the anvil from moving to its open position while the knife is exposed above the cartridge deck. There is.

The tool assembly 3500 includes a closure drive and a launch drive. The closure drive includes a trocar shaft 3550 and a removable anvil 3530 attached to the trocar shaft 3550. Similar to the above, the trocar shaft 3550 can be translated proximally and distally by a rotatable closure shaft 2440 screwed onto the trocar shaft 3550. The launch drive includes a rotatable shaft 3562 and a translatable collar 3560 screwed onto the rotatable shaft 3562. Similar to the above, the collar 3560 can be translated proximally and distally as the shaft 3562 rotates in the first and second directions, respectively. Further, similarly to the above, the collar 3560 of the launch drive is configured to advance and retract the staple driver array and knife assembly 2570 towards or away from the anvil 3530.

In addition to the above, the lockout 3590 includes a lockarm 3592 rotatably mounted around a pivot 3594 shaft 3562 of the launch drive. The lockout 3590 further includes an urging member (or spring) 3599 engaged to the lock arm 3592, which urging member 3599 is configured to urge the lock arm 3592 to come into contact with the anvil 3530. .. In use, after assembling the anvil 3530 to the trocar shaft 3550, the trocar shaft 3550 is retracted to position the anvil 3530 in its closed (or clamp) position with respect to the cartridge body. When the anvil 3530 is retracted, the lock arm 3592 of the lockout 3590 slides in contact with the outer surface of the anvil 3530 until the lock arm 3592 is aligned with the lock recess 3532 defined in the anvil 3530. At that time, as shown in FIG. 53, the spring 3599 urges the lock arm 3592 to be inserted into the lock recess 3532. More specifically, the lock arm 3592 is positioned behind the locking shoulder that defines the lock recess 3532. The firing drive can then be actuated to fire the staples and cut the tissue. In such cases, the cutting edge of the knife assembly 2570 is exposed above the cartridge body and the closure drive is locked out or opened by the lockout 3590 until the cutting edge of the knife assembly 2570 is no longer exposed. It is designed not to be exposed.

Primarily with reference to FIG. 52, the lock arm 3592 further includes a reset tab 3593 extending from it. The launch drive collar 3560 further includes a cam 3563 configured to engage the reset tab 3593 as the launch drive retracts the collar 3560 and knife assembly 2570 proximally. The cam 3563 is configured to rotate the lock arm 3592 downward to disengage the lock shoulder shape defined in the lock recess 3532 and unlock the closure drive portion. The cam 3563 is configured to unlock the closure drive when the cutting edge of the knife assembly 2570 retracts below the cartridge deck. However, in one embodiment, the cam 3563 can unlock the closure drive when the cutting edge is flush with, or at least substantially flush with, the cartridge deck. In some embodiments, the closure drive does not have to be unlocked until the knife assembly 2570 has completely retracted. Once the closure drive is unlocked, the closure drive can be activated to relocate the anvil 3530 to the open (or non-clamped) position.

According to various embodiments, once the staples of the replaceable tool assembly are fired, the tool assembly cannot be reused. As detailed below, the tool assembly may include a lockout configured to prevent the tool assembly from re-clamping onto the tissue after it has been used to staple the tissue. ..

In at least one embodiment, with reference to FIGS. 53-56, the replaceable tool assembly 3600 includes a closure drive configured to position an anvil, such as an anvil 2230, with respect to a staple cartridge, and a staple cartridge. Includes a launch drive configured to be driven from. Similar to the above, the anvil 2230 can be attached to the translational trocar shaft 3650 of the closure drive. Further similar to the above, the launch drive is a staple launch driver displaceable by a rotatable shaft 3660, a translatable collar 2550 screwed onto the rotatable shaft 3660, and a rotatable shaft 3660. Includes 2560 and. In use, the closure drive can operate to position the anvil 2230 in a clamped position with respect to the staple cartridge, and then the launch driver is placed in the tissue trapped between the anvil 2230 and the staple cartridge. It can act like firing staples. The closure drive is then activated to open the anvil 2230 and release the tissue.

In addition to the above, the tool assembly 3600 includes a lockout 3690 configured to prevent the anvil 2230 from being re-clamped onto the tissue. The lockout 3690 includes a lock arm 3692 rotatably mounted on a rotatable shaft 3660, wherein the lock arm 3692 is in a non-clamp position (FIG. 53) in which the closure drive opens the anvil 2230 and a clamp position in which it is closed (FIG. 53). When it is moved to and from FIG. 54), it is held in the unlocked configuration by the firing drive unit. When the trocar shaft 3650 and the anvil 2230 move relative to the firing drive to position the anvil 2230 with respect to the staple cartridge, the lock arm 3692 locks between the rotatable shaft 3660 and the translatable collar 2550. Retained in the release configuration. As illustrated in FIG. 55, the arm 3692 is held in its unlocked configuration until the launch drive is activated. As the shaft 3460 rotates in the first direction, the collar 2550 is displaced distally and the spring 3699 of the lockout 3690 can urge the lockarm 3692 against the trocar shaft 3650. The trocar shaft 3650 rotates with respect to the lock arm 3692 as the collar 2550 displaces distally to fire the staples and then retracts proximally. The closure drive can then be actuated to reopen the anvil 2230 to unclamp the tissue and / or remove the anvil 2230 from the trocar shaft 3650. When the anvil 2230 is reopened, the spring 3699 urges the lock arm 3692 into the trocar shaft 3650 and / or into the locking recess 3652 defined within the anvil 2230. When the lock arm 3692 is positioned within the lock recess 3652, the lock arm 3692 prevents the trocar shaft 3650 from retracting proximally. When the closure drive is actuated in an attempt to retract the trocar shaft 3650, the lock arm 3692 abuts the locking shoulder defined in the lock recess 3652 to prevent the trocar shaft 3650 and the anvil 2230 from retracting. do. As a result, the lockout 3690 prevents the anvil 2230 from re-clamping onto the tissue after the tool assembly 3600 has completed the firing cycle, or at least partially, so that the tool assembly 3600 is used again. Can't. In addition, the lockout 3690 can function as a lockout for used cartridges.

With reference to FIGS. 59 and 60, the tool assembly 3700 includes a staple cartridge 3720 and an anvil 3730. The tool assembly 3700 is configured to eject (or fire) staples detachably stored in the staple cartridge 3720, as well as a closure system configured to move the anvil 3730 towards the staple cartridge 3720. It also includes a launch system. The anvil 3730 includes a longitudinal shaft portion 3736 and a mounting arm 3738 extending from the shaft portion 3736 so that the mounting arm 3738 elastically grips the closure actuator (or trocar) 3734 of the closure system. It is configured. The closure actuator 3734 can be retracted proximally by a closure drive that moves the trocar 3734 between the open non-clamp position (FIG. 59) and the closed clamp position (FIG. 60). As will be described in more detail below, when the closure system is in its open configuration as illustrated in FIG. 59, the staple firing system is disabled and actuated to fire the staples stored in the staple cartridge 3720. Can't.

In addition to the above, the staple launch system has a threaded opening configured to receive the threaded distal end of the launch shaft 3750, as well as a rotatable launch shaft 3750 that includes a threaded distal end. Includes a translatable firing nut 2550 that includes a portion. Notably, referring to FIG. 59, when the anvil 3730 is in its open position, between the threaded distal end of the launch shaft 3750 and the threaded opening defined within the launch nut 2550. There is a gap in. As a result, the launch shaft 3750 cannot displace the launch nut 2550 distally until the launch shaft 3750 is screwed onto the launch nut 2550.

As illustrated in FIG. 60, the mounting arm 3738 of the anvil 3730 is configured to engage the launch shaft 3750 and flex the launch shaft 3750 outward when the anvil 3730 moves to its closed position. NS. Primarily with reference to FIGS. 59A and 60A, the mounting arm 3738 engages with an inwardly extending protrusion 3758 defined on the launch shaft 3750 and outside the protrusion 3758 of the launch shaft 3750 and its surroundings. It is configured to push in the direction. In such cases, the threaded distal end of the launch shaft 3750 is pushed and operably engaged at the threaded interface 3790 to the threaded opening of the launch nut 2550, at which point. When the launch shaft 3750 is rotated by the launch drive unit, the launch shaft 3750 can displace the launch nut 2550 distally and eject the staples from the staple cartridge 3720. When the anvil 3730 is reopened, the launch shaft 3750 returns to its original configuration and is operably disengaged from the launch nut 2550.

As a result of the above, the tool assembly 3700 will perform if the anvil 3730 is not attached to the closure system, if the anvil 3730 is improperly attached to the closure system, and / or if the anvil 3730 is not fully closed. Includes a lockout to prevent the staples from being fired.

With reference to FIGS. 61 and 62, the tool assembly 3800 includes a replaceable staple cartridge in which the staples are detachably stored, an anvil configured to deform the staples, and an anvil staple cartridge. It includes a closure drive system configured to move relative to and a launch system configured to eject staples from staple cartridges. As described below, the tool assembly 3800 further includes a lockout configured to prevent the launch system from operating unless the staple cartridge is fully seated on the tool assembly 3800.

The staple cartridge includes a cartridge frame 3820 configured to engage the shaft frame 3810 of the tool assembly 3800. The staple cartridge further includes a drive shaft 3830 that is inserted into the shaft frame 3810 when the staple cartridge is assembled to the tool assembly 3800. More specifically, with reference primarily to FIG. 64, the drive shaft 3830 includes a proximal end 3832 that includes an annular gear portion 3833 that the annular gear portion 3833 is when the staple cartridge is assembled to the tool assembly 3800. It is configured to engage and compress the transmission 3860 of the launch system. Primarily with reference to FIG. 62, the transmission device 3860 includes a first portion 3862, a second portion 3864, and a third portion 3868, which engage operably with each other when pressed. The rotational input motion can be transmitted to the drive shaft 3830.

Primarily with reference to FIGS. 63 and 64, the annular gear portion 3833 of the drive shaft 3830 is configured to engage the corresponding gear portion 3863 defined on the distal side of the first transmission portion 3862. When the first transmission portion 3862 is pushed proximally by the drive shaft 3830, the first transmission portion 3862 can operably engage the second transmission portion 3864. More specifically, the first transmission portion 3862 includes the proximal gear portion 3865, which is the proximal gear portion 3865 when the first transmission portion 3862 is pushed proximally by the drive shaft 3830. At the same time as engaging with the distal gear portion 3866 of the second transmission portion 3864, the second transmission portion 3864 is pushed proximally. When the second transmission portion 3864 is pushed proximally by the first transmission portion 3862, the second transmission portion 3864 operably engages with the third transmission portion 3868, as described above. be able to. More specifically, the second transmission portion 3862 includes a proximal gear portion 3867, wherein the proximal gear portion 3867 has a first transmission portion 3862 and a second transmission portion 3864 by a drive shaft 3830. When pushed proximally, it engages with the distal gear portion 3869 of the third transmission portion 3864. The third transmission portion 3868 is operably connected to the input shaft and is supported by the input shaft and / or shaft housing 3810 so as not to be displaced proximally.

Primarily with reference to FIG. 61, the transmission device 3860 further includes at least one spring member 3870 located between the first transmission device portion 3862 and the second transmission device portion 3864. In at least one case, the spring member 3870 may include, for example, one or more corrugated springs. The spring member 3870 is configured to urge the first transmission device portion 3862 and the second transmission device portion 3864 to separate them from each other. In addition to or instead of the above, the transmission 3860 further comprises at least one spring member 3870 located between the second transmission portion 3864 and the third transmission portion 3868, which spring member 3870. Is configured to urge the second transmission device portion 3864 and the third transmission device portion 3868 to be separated from each other in the same manner as described above. Primarily with reference to FIG. 65, each spring member 3870 includes two disc springs 3872 configured to bend when a compressive force is applied therein. However, the spring member 3870 may include any suitable configuration.

In addition to the above, with reference to FIG. 61 again, the input shaft of the tool assembly 3800 can rotate the third transmission portion 3868. However, the spring member 3870 located between the second transmission part 3864 and the third transmission part 3868 makes the proximal gear part 3867 of the second transmission part 3864 the third transmission part 3868. The rotation of the third transmission portion 3868 cannot be transmitted to the second transmission portion 3864 unless it is sufficiently compressed to connect with the distal gear portion 3869. Similarly, the spring member 3870 located between the first transmission portion 3862 and the second transmission portion 3864 is a proximal gear portion 3865 and a second transmission portion 3864 of the first transmission portion 3862. The second transmission portion 3864 cannot be transmitted to the first transmission portion 3862 unless it is sufficiently compressed to connect the distal gear portion 3866 of the. As described above, when the staple cartridge is fully seated on the shaft frame 3810, the drive shaft 3830 engages the first transmission portion 3862 and the second transmission portion 3864, as illustrated in FIG. Together, the second transmission portion 3864 and the third transmission portion 3868 are engaged. In such cases, the rotation of the input shaft may be transmitted to the drive shaft 3830. However, if the staple cartridge is not fully seated on the shaft frame 3810, one or more of the transmission parts 3862, 3864, and 3868 will not operably engage with each other and the rotation of the input shaft will rotate the drive shaft 3830. Cannot be transmitted to. Therefore, the tool assembly 3800 ensures that the staples stored in the staple cartridge cannot be ejected from the staple cartridge unless the staple cartridge is fully seated on the shaft frame 3810.

With reference to FIGS. 66-68, the tool assembly 3900 includes a shaft 3910 and a replaceable staple cartridge 3920. The replaceable staple cartridge 3920 is configured to eject staples that are detachably stored in the staple cartridge 3920, in addition to a closure drive that is configured to move the anvil with respect to the staple cartridge 3920. It includes a launch drive that includes a rotatable launch shaft 3930. Similar to the above, the tool assembly 3900 is a lock configured to prevent the firing drive from ejecting the staples from the staple cartridge 3920 unless the staple cartridge 3920 is fully or fully seated on the shaft 3910. Including out. More specifically, the lockout prevents the firing shaft 3930 from rotating within the staple cartridge 3920 unless the staple cartridge 3920 is fully or fully seated on the shaft 3910. In various examples, with reference to FIG. 67, the launch shaft 3930 includes an annular array of lock openings 3939 defined on the outer circumference of the launch shaft 3930, and the staple cartridge 3920 has a lock opening 3939 defined on the shaft 3930. Includes at least one locking portion 3929 configured to engage detachably. The locking portion 3929 includes a cantilever extending proximally, but any suitable configuration can be used. The lock portion 3929 further comprises a lock protrusion, which extends to the lock opening 3939 to allow the firing shaft 3930 to rotate, or at least substantially substantially, with respect to the body of the staple cartridge 3920. To prevent. The locking portion 3929, as illustrated in FIG. 68, is the firing shaft 3930 until the locking portion 3929 is lifted and disengaged from the lock opening 3939 when the staple cartridge 3920 is fully or fully assembled to the shaft 3910. It is configured to be urged and engaged with a lock opening 3939 defined therein. Referring to FIG. 68, the outer housing of the shaft 3910 includes a wedge-shaped portion 3919 configured to lift the lock portion 3929 away from the firing shaft 3930 and disengage the lock portion 3929 from the lock opening 3939. I'm out. The wedge-shaped portion 3919 is configured so that the locking portion 3929 is not disengaged from the firing shaft 3930 until the table cartridge 3920 has been fully or sufficiently seated on the shaft 3910 as illustrated in FIG. Has been done. FIG. 67 illustrates a scenario in which the staple cartridge 3920 is not fully or fully seated on the shaft 3910.

With reference to FIGS. 69-71, tool assembly 4000 includes a shaft 4010 and a replaceable staple cartridge 4020. The replaceable staple cartridge 4020 is configured to eject staples that are detachably stored in the staple cartridge 4020, in addition to a closure drive that is configured to move the anvil with respect to the staple cartridge 4020. It includes a launch drive that includes a rotatable launch shaft 3930. The staple cartridge 4020 includes a locking portion 4029 configured to removably connect the staple cartridge 4020 to the shaft 4010. The locking portion 4029 includes a cantilever extending proximally and a locking shoulder portion 4028 extending from the cantilever. The locking portion 4029 flexes inward within the shaft 4010 when the staple cartridge 4020 is assembled to the shaft 4010, and then the locking shoulder 4028 of the locking portion 4029 is defined in the outer housing of the shaft 4010. When aligned with the window 4019, it is configured to elastically return to its non-flexible state, or at least towards its non-flexible state. In such a case, as illustrated in FIG. 70, the locking shoulder 4028 enters the window 4019 when the staple cartridge 4020 is fully or fully seated on the shaft 4010. To unlock the staple cartridge 4020, the physician may, for example, insert a tool or his or her finger into the window and press the lock 4029 away from the window 4019. At that point, the staple cartridge 4020 can be removed from the shaft 4010 and a new staple cartridge can be attached to the shaft 4010 if the physician so desires.

In addition to or instead of the above, the surgical staple system provides the closure drive of the staple system when the staple cartridge is not fully or sufficiently seated on the shaft of the staple system. It may include an electrical lockout configured to prevent the anvil from being clamped onto the tissue and / or to prevent the firing drive from making its firing stroke. In various examples, the staple system is configured to operate the launch drive, in addition to a sensor configured to detect whether the staple cartridge has fully or sufficiently seated on the shaft. Can include staples. If the sensor detects that the staple cartridge is not fully or fully mounted on the shaft, the motor may be electrically shut down. In various examples, stapled systems include controllers that communicate with sensors and electric motors, such as microprocessors. In at least one case, the controller will, firstly, activate the electric motor if the sensor detects a staple cartridge properly seated on the shaft, and secondly, not on the shaft. It is configured to not activate the electric motor when the sensor detects a properly seated staple cartridge.

With reference to FIG. 72, the tool assembly kit 4100 includes a shaft 4110 and a plurality of staple cartridges such as 4120, 4120 ′, 4120 ″, 4120 ″ and the like. Each staple cartridge 4120, 4120 ″, 4120 ″, and 4120 ″ ″ are configured to provide a circular row of staples with different diameters. For example, the staple cartridge 4120 ″ is configured to apply staples in a pattern with a large diameter, and the staple cartridge 4120 is configured to apply staples in a pattern with a small diameter. In various examples, different staple cartridges can be deployed with staples having different unformed heights. In at least one case, staple cartridges that apply staples in a larger pattern deploy staples with a larger undeformed height, while staple cartridges that apply staples in a smaller pattern have a smaller undeformed height. Deploy staples with. In some cases, the staple cartridge can be deployed with staples having two or more unformed heights. In any case, a staple cartridge selected from a plurality of staple cartridges can be assembled to the shaft 4110.

With reference to FIGS. 72 and 73, the tool assembly 4100 includes a detection circuit 4190 configured to detect whether the staple cartridge is fully or fully mounted on the shaft 4110. The detection circuit 4190 is not completely housed inside the shaft 4110, but rather the staple cartridge needs to be properly assembled to the shaft 4110 in order to complete the detection circuit 4190. The detection circuit 4190 includes a conductor 4193 extending through a passage 4192 defined within the frame of the shaft 4110 and / or along the outer housing of the shaft 4110. Primarily with reference to FIG. 73, each conductor 4193 is electrically coupled to an electrical contact 4194 defined at the distal end of the housing. The staple cartridge 4120 includes, for example, the corresponding electrical contacts 4195, which are positioned and arranged on the body 4122 of the staple cartridge 4120 such that the contacts 4195 engage the contacts 4194 on the shaft 4110. NS. The staple cartridge 4120 further includes a conductor 4196 extending through and / or along the cartridge body 4122. Each conductor 4196 is electrically coupled to the contact 4195. In some cases, the conductors 4196 are directly coupled to each other, in which case the detection circuit 4190 is closed when the staple cartridge 4120 is properly assembled to the shaft 4110.

In some cases, in addition to the above, the detection circuit 4190 of the tool assembly 4100 extends through the deck portion 4124 of the staple cartridge 4120. In at least one case, the deck portion 4124 is movably attached to the cartridge body 4122. More specifically, in at least one such case, the spring member 4198 is located between the cartridge body 4122 and the deck portion 4124. The spring member 4198 is configured to allow the deck portion 4124 to move or float with respect to the cartridge body 4122 when the tissue is compressed with respect to the deck portion 4124. In at least one case, the spring member 4198 may include, for example, one or more corrugated springs. Further, the spring member 4198 forms a conductive path between the cartridge main body 4122 and the deck portion 4124. More specifically, the spring member 4198 is located between the electrical contacts 4197 and 4199 defined in the cartridge body 4122 and the deck portion 4124, respectively. The conductor 4196 is electrically coupled to an electrical contact 4197 defined at the distal end of the cartridge body 4122, and the electrical contacts 4199 are electrically coupled to each other via a conductor in the deck portion 4125. As described above, the detection circuit 4190 is closed when the staple cartridge 4120 is properly assembled to the shaft 4110.

With reference to FIGS. 74-76, the tool assembly 4200 is configured to prevent the replaceable circular staple cartridge from being fired more than once, as described in more detail below. Includes. In use, a replaceable circular staple cartridge 4220 is assembled to the shaft 4210 of the tool assembly 4200. Next, the tool assembly 4200 is positioned at the surgical site and the anvil 2230 is assembled to the trocar 2450 of the closure drive. The closure drive is then used to move the anvil 2230 towards the staple cartridge 4220 and clamp the patient's tissue against the staple cartridge 4220 until the anvil 2230 is in the closed (or clamped) position. The location of the anvil 2230 is illustrated in FIG. At that point, the firing drive can be activated to deploy the staples detachably stored in the staple cartridge 4220. The launch drive includes, among other things, a staple launch driver 2560, as well as a rotatable drive shaft 4230 screwed into the drive collar 4240. The drive collar 4240 and the launch driver 2560 constitute separate components, but in alternative embodiments, the drive collar 4240 and the launch driver 2560 may be integrally formed. The firing drive unit pushes the drive collar 4240 and the staple firing driver 2560 distally between the unlaunched position (FIG. 74) and the firing position (FIG. 75) during the firing stroke to eject the staples from the staple cartridge 4220. It can rotate in one direction. Since the drive collar 4240 and the staple driver 2560 are prevented from rotating in the staple cartridge 4220, as a result, the drive shaft 4230 rotates with respect to the drive collar 4240 and the staple driver 2560.

In addition to the above, the drive collar 4240 includes one or more lockouts 4290 extending proximally from it. Each lockout 4290 includes a lockout pin 4292 slidably positioned within a pin opening 4293 defined within the drive collar 4240. Each lockout 4290 further includes an urging member such as a spring 4294 configured to urge the pin 4292 proximally. When the firing drive is in its unfired configuration as shown in FIG. 74, the lockout 4290 does not engage the rotatable drive shaft 4230 and / or the frame 4222 of the staple cartridge 4220. When the drive collar 4240 and staple driver 2560 are pushed distally by the drive shaft 4230, the lockout pin 4292 moves away from the drive shaft 4230, as illustrated in FIG. Once the firing stroke is complete and the staples are sufficiently deformed relative to the anvil 2230, the drive shaft 4230 is rotated in the opposite direction during the retreat stroke, pulling the drive collar 4240 and staple driver 4260 proximally. In such a case, the lockout 4290 moves towards the drive shaft 4230. Notably, the retreat stroke is longer than the firing stroke, so that the drive collar 4240 moves proximally to its retreating position relative to its original unlaunched position, as illustrated in FIG. At this retracted position of the drive collar 4240, the lockout 4290 engages the drive shaft 4230 and the frame 4222 of the staple cartridge 4220. More specifically, each lockout 4290 is contained in a lockout opening defined between the drive shaft 4230 and the cartridge frame 4222. With reference to FIG. 78, each lockout opening is defined by an opening wall 4295 of the drive shaft 4230 and an opening wall 4296 of the frame 4222. When the lockout pin 4292 enters the lockout opening, the drive collar 4240 cannot be rotated by the drive shaft 4230 and the firing system of the staple cartridge 4220 is locked out. As a result, this particular staple cartridge 4220 cannot be reused and the tool assembly 4200 must be replaced with a new staple cartridge in order to be reused.

In addition to the above, the reader may or may not position the lockout pin 4292 partially within the lockout opening when the launch drive is in its unfired configuration as illustrated in FIG. You should understand that it is okay. However, as long as the lockout pin 4292 is partially positioned within the lockout opening, in such cases the pin 4292 is defined within the drive collar 4240 as the firing drive shaft 4230 rotates. The inside of the pin opening 4293 can be displaced distally. Also, the reader may read that when the drive collar 4240 moves to its retracted position, the lockout pin 4292 is seated sufficiently deep within the lockout opening defined within the drive shaft 4230 so that the launch drive shaft 4230. It should be understood that even if the pin 4292 is rotated again in its first direction, the pin 4292 is prevented from being displaced distally and out of the lockout opening.

Referring again to FIG. 78, the side walls 4295 and 4296 of the lockout opening are aligned with each other when the drive collar 4240 is in its retracted position. However, when the drive shaft 4230 rotates, the side wall 4295 defined on the drive shaft 4230 rotates and is out of alignment with the side wall 4296 defined on the cartridge frame 4222. In some cases, the side wall 4295 may rotate as the launch drive 4230 rotates and realign with the side wall 4296 for a brief moment. In any case, referring here to FIG. 77, the side wall 4295 does not align with the side wall 4296 when the launch system is in its unlaunched configuration. As a result, when the launch system is in its unfired configuration, the lockout pin 4292 cannot enter the lockout opening and the staple cartridge 4220 cannot be unintentionally locked out.

Referring now to FIG. 80, in at least one alternative embodiment, one or more lockout openings 4295 ″ may be defined only within the drive shaft 4230 ″ of the tool assembly 4200''. .. In such an embodiment, the drive collar 4240 cannot rotate with respect to the drive shaft 4230 ″ once the lockout pin 4292 enters the lockout opening 4295 ″. In effect, the drive collar 4240 and the drive shaft 4230'' are integrally and synchronously locked, but not necessarily against the frame of the tool assembly 4200'', thereby causing the drive shaft 4230'. 'Rolls relative to the drive collar 2440, preventing the drive collar 2440 from being displaced distally.

In at least one alternative embodiment, referring here to FIG. 79, each of the launch drive lockouts has a different configuration such that each lockout pin is uniquely indexed to its corresponding lockout opening. There is. For example, the tool assembly 4200'has a first lockout pin configured to enter a first lockout opening defined by side walls 4295 and 4296 and a second lockout pin defined by side walls 4295'and 4296'. It has a second lockout pin configured to enter the lockout opening. However, the first lockout pin of the tool assembly 4200'is dimensioned and configured so that it cannot enter the second lockout opening, and correspondingly the second lockout pin is the first. It is sized and configured so that it cannot enter the lockout opening of the. Further, both the first lockout pin and the second lockout pin enter the opening formed by the combination of side walls 4295 and 4296'or the opening formed by the combination of side walls 4295'and 4296'. Can't.

As mentioned above, staple fasteners configured to deploy a circular row of staples may include a range of motion joint. The range of motion joint is configured to allow the end effector of the staple fastener to jointly move with respect to the shaft of the staple fastener. Such staples can help the surgeon place the end effector in the patient's rectum and / or colon. In various embodiments, with reference to FIG. 81, staple fasteners configured to deploy a circular row of staples (eg, staple fastener 9000) are contourable or adjustable frames. 9010 can be included. The frame 9010 may be configured to be permanently deformed during use. In at least one such embodiment, the frame 9010 consists of malleable metals such as, for example, silver, platinum, palladium, nickel, gold, and / or copper. In certain embodiments, the frame 9010 is made of, for example, malleable plastic. In at least one embodiment, the frame consists of a polymer containing metal ions attached to a polymer chain, such as, for example, ionic polymer-metal composites (IPMCs). A potential difference, or potential, can be applied to the IPMC material to defect the shaft in the desired manner. In some cases, the shaft can be contoured along one radius of curvature, in other cases the shaft can be contoured along more than one radius of curvature. For example, it is possible to contour the shaft by changing the potential difference or potential while the shaft is in the patient's body. In certain embodiments, the contourable portion of the frame comprises a plurality of pivotable links. In at least one embodiment, the contourable portion of the frame is made of a viscoelastic material.

In addition to the above, the staple fastener may further include a locking portion configured to detachably hold the contourable portion of the frame of the staple fastener in its contouring configuration. In at least one case, the frame of the staple fastener comprises a commutable frame link and one or more longitudinal tension cables, the longitudinal tension cable proximal to the frame link. Both pull and frame link can be locked. In some cases, each frame link can include a longitudinal opening that extends through the frame link and is configured to receive a rod that can move distally. The rod is flexible enough to pass through longitudinal openings that may not be perfectly aligned when the contourable portions are contoured, but retains the staple fastener in its contouring configuration. Has sufficient rigidity to do so.

As described herein, surgical instruments may consist of multiple modules that are assembled together. For example, in at least one embodiment, the surgical instrument includes a first module that includes a handle and a second module that includes a shaft assembly. The shaft assembly includes end effectors configured to staple and / or incise the patient's tissue, but the shaft assembly can include any suitable end effect. In various examples, the end effector includes a third module that can be attached to the shaft assembly. Here, referring to FIGS. 82 and 83, a handle such as the handle 20 includes a controller and a display unit 10000 that communicates with the controller. The controller is configured to display data on the operation of the surgical instrument on the display unit 10000. The data displayed on the display 10000 conveys to the surgeon information about at least one motion parameter of the first module and / or at least one motion parameter of the second module. For example, the controller can display data on the progress of the staple firing stroke on the display unit 10000.

In addition to the above, the shaft assembly includes a second display. For example, the shaft assembly 2000 includes a display unit 10100, but any shaft assembly disclosed herein can include a display unit such as the display unit 10100, for example. The second module includes a unique controller configured to display data on the operation of the surgical instrument on the display unit 10100. Similar to the above, the data displayed on the display unit 10100 conveys information about at least one operating parameter of the first module and / or at least one operating parameter of the second module. The controller of the second module communicates with the controller of the first module in a signal, but in one embodiment, the controller of the second module may operate independently of the controller of the first module. In certain alternative embodiments, the second module does not include a controller. In such an embodiment, the controller of the first module signals and communicates with the first display unit 10000 and the second display unit 10100, and is displayed on the first display unit 10000 and the second display unit 10100. Control the data.

As mentioned above, the tool assembly 2000 includes an anvil and staple cartridges. The handle 20 includes an actuation system configured to move the anvil with respect to the staple cartridge. The anvil controls the distance or gap between the anvil and the staple cartridge, and as a result, is constant with respect to the staple cartridge to control the height of staple formation as the staple is ejected from the staple cartridge. It can be positioned within the range. For example, the anvil is positioned closer to the staple cartridge to deform the staples to a shorter formation height and farther away to deform the staples to a higher formation height. In any case, the second display unit 10100 of the tool assembly 2000 is configured to display the position of the anvil with respect to the staple cartridge and / or the height at which the staples are formed or formed. .. In various embodiments, the shaft assembly can include an actuator configured to control the function of the end effector and a display adjacent to the actuator that displays data about the function of the end effector.

Referring to FIG. 1, the tool assembly 1500 includes a shaft and an end effector extending from the shaft. The shaft includes a shaft frame and a longitudinal shaft shaft. The end effector includes an end effector frame and a longitudinal end effector shaft. The end effector further includes a distal head portion and a rotary joint that allows the distal head portion to rotate about the longitudinal end effector axis with respect to the end effector. The distal head portion includes a first jaw portion and a second jaw portion. The first jaw comprises a staple cartridge containing staples retractably housed therein, or a channel configured to receive such staple cartridges, the second jaw so as to deform the staples. Includes configured anvils. The second jaw can be moved between the open and closed positions with respect to the first jaw. However, other embodiments are recalled in which the first jaw is movable relative to the second jaw and / or both the first and second jaws are movable relative to each other. Will be done.

In certain embodiments, the tool assembly can include range of motion joints in addition to rotary joints. In at least one such embodiment, the rotary joint is distal to the range of motion joint. In such an embodiment, the rotation of the distal head does not affect the angle of motion of the end effector. However, other embodiments are recalled in which the range of motion joint is distal to the rotary joint. In such an embodiment, the distal head portion can be moved extensively in an arc. In both cases, the longitudinal end effector shaft is movable with respect to the longitudinal shaft shaft. In at least one case, the longitudinal end effector shaft is movable between a position that is in line with the longitudinal shaft axis and a position that traverses the longitudinal shaft axis.

In addition to the above, the distal head portion of the tool assembly 1500 is rotatable between the initial position and the rotational position. In at least one case, the distal head portion is rotatable between a zero or top dead center position and a second position. In some cases, the distal head section is rotatable over a range of motion of at least 360 degrees. In other cases, the distal head portion is rotatable over a rotation range of less than 360 degrees. In both cases, the tool assembly 1500 and / or the handle 20 is configured to track the rotational position of the distal end. In various examples, the tool assembly 1500 and / or handle 20 directly tracks the rotation of the distal head and / or eg, in addition to an electric motor operably connected to the distal head of the end effector. Includes an encoder configured to indirectly track the rotation of the distal head portion by assessing the rotational position of the shaft of the electric motor. The controller of the handle 20 is configured to communicate with an encoder and display, for example, the rotational position of the distal head portion on the display unit 10000.

In at least one embodiment, the orientation and placement of the data displayed on the display unit 10000 is static, but the distal head portion of the end effector rotates. Of course, the data displayed on the display 10000 in such an embodiment is updated by the surgical instrument controller, but the data display is reoriented and / or as the distal head rotates. It will not be relocated. Such embodiments can provide the surgeon with the information necessary to properly use the surgical instrument in the static field. In at least one alternative embodiment, the data field of display 10000 is dynamic. In this context, the term dynamic has more than just that the data is updated on the display 10000. More precisely, the term dynamic means that the data is reoriented and / or rearranged on the display 10000 as the distal head rotates. In at least one case, the orientation of the data tracks the orientation of the distal head. For example, if the distal head is rotated 30 degrees, the data field on the display 10000 will be rotated 30 degrees. In various examples, the distal head portion is rotatable 360 degrees and the data field is rotatable 360 degrees.

In addition to the above, the data fields can be arranged in any orientation that matches the orientation of the distal head. Such an embodiment can provide the surgeon with an accurate and intuitive sensation of distal head orientation. In certain embodiments, the controller orients the data field in an orientation that most closely matches the orientation of the distal head, selected from an array of individual locations. For example, if the distal head is rotated 27 degrees and the selectable individual data field positions are spaced 15 degrees apart, the controller can reorient the data fields to 30 degrees from the orientation of the data. Similarly, for example, if the distal head is rotated 17 degrees and the selectable individual data field positions are spaced 5 degrees apart, the controller can reorient the data fields to 15 degrees from the orientation of the data. .. In at least one embodiment, the orientation of the data is aligned with the characteristics of the surgical instrument itself. For example, the orientation of the data on the handle 20 is aligned with the axis extending through the grip of the handle 20. In such an embodiment, the controller can ignore the orientation of the handle 20 with respect to its environment. However, in at least one alternative embodiment, the orientation of the data is aligned, for example, with respect to the axis of gravity.

In addition to the above, the controller is configured to reorient the entire data field displayed on the display 10000 with respect to the orientation of the distal head. In one embodiment, the controller is configured to reorient only part of the data field displayed on the display 10000 with respect to the orientation of the distal head. In such an embodiment, one part of the data field is held stationary with respect to the orientation of the data, while another part of the data field is rotated with respect to the orientation of the data. In certain embodiments, the first portion of the data field is rotated by a first rotation angle and the second portion of the data field is rotated by a second rotation angle in the same direction. For example, the second portion may be rotated less than the first portion. In various embodiments, the first portion of the data field is rotated in the first direction and the second portion of the data field is rotated in the second direction or in the opposite direction.

In addition to the above, the data fields are reoriented and / or rearranged in real time, or at least substantially in real time, with the rotation of the distal head. Such an embodiment provides a very responsive data display. In one embodiment, the reorientation and / or repositioning of the data field may lag behind the rotation of the distal head. Such an embodiment can provide a data display with less jitter. In various embodiments, the first part of the data field is reoriented and / or rearranged at the first rate, and the second part of the data field is reoriented at a second or different rate. Attached and / or rearranged. For example, the second part may be rotated at a slower speed.

As mentioned above, the data field on the display 10000 rotates as the distal head of the end effector rotates. However, in another embodiment, the data field, or part of the data field, may translate as the distal head portion rotates. Also as described above, the controller of the surgical instrument is configured to reorient and / or rearrange the data fields on the handle display 10000. However, the controller of the surgical instrument can reorient and / or rearrange the data fields on the second display, such as the shaft display.

With reference to FIGS. 15 and 83 again, the tool assembly 2000 includes an actuator 10200 configured to actuate the joint motion drive system of the tool assembly 2000. Actuator 10200 is rotatable about, for example, a longitudinal axis that is parallel to, or at least substantially parallel to, the longitudinal axis of shaft 2100. The actuator 10200 is operably connected to, for example, an adjusting resistor that signals and communicates with the controller of the handle 20. When the actuator 10200 rotates about its longitudinal axis in the first direction, the control resistor detects the rotation of the actuator 10200, the controller activates an electric motor, and the end effector 2200 is jointly moved in the first direction. Let me. Similarly, when the actuator 10200 rotates about its longitudinal axis in a second direction or in the opposite direction, the regulator detects the rotation of the actuator 10200 and the controller activates an electric motor to drive the end effector 2200. Move the joint in the second direction or in the opposite direction. In various examples, the end effector 2200 joints, for example, about 30 degrees from the longitudinal axis in the first direction and / or about 30 degrees from the longitudinal axis in the second or opposite direction. can do.

As the reader will understand, in addition to the above, the tool assembly 2000 does not have a built-in electric motor configured to actuate the range of motion drive system. Rather, the electric motor of the range of motion drive system is in a handle, such as the handle 20, to which the tool assembly 2000 is attached, for example. As a result, the actuator on the removable shaft assembly controls the movement of the handle. In one embodiment, the electric motor of the range of motion drive system may be in the tool assembly 2000. In either case, the display unit 10100 is configured to display the joint motion of the end effector 2200 in at least some way. As the reader will understand, the display 10100 is adjacent to the actuator 10200 so that the surgeon can easily see the inputs and outputs of the joint motion drive system at the same time.

In addition to the above, a surgical tool assembly that includes a contourable shaft can be formed in favor of, for example, a shape that fits into the patient's rectum or colon. However, such contourable shafts cannot withstand significant tensile and / or compressive loads. To compensate for this, in various embodiments, only the rotatable drive system may extend through the contourable portion of the shaft. In such cases, the shaft needs to resist only the rotational reaction force generated by the rotatable drive system. In such an embodiment, the rotational motion of the drive system can be translated into a linear motion distal to the contourable shaft portion, if desired. Such longitudinal movements can generate tension and / or compressive forces, but such forces are relieved or eliminated within the end effector, i.e., distal to the contourable shaft. Can be offset. Such embodiments can also utilize range of motion joints located distal to the contourable shaft portion. In such an embodiment, the tool assembly cannot utilize a push-pull drive system across a contourable shaft portion.

Anvil 6020 of circular staple fasteners is illustrated in FIGS. 84 and 85. The anvil 6020 includes a tissue compression surface 6022 and an annular array of staple forming pockets 6024 defined within the tissue compression surface 6022. The anvil 6020 further includes a frame 6028, a mounting mount 6026, and a stem extending from the mounting mount 6026. The stem is configured to be removablely attached to the closure drive of the circular staple fastener so that the anvil 6020 can move towards and away from the staple cartridge of the circular staple fastener. There is. The compression surface 6022, the mounting mount 6026, and the frame 6028 are made of, for example, stainless steel, but any suitable material (s) can be used.

In addition to the above, the anvil 6020 includes an tissue support 6030. The tissue support 6030 is positioned within the annular opening defined within the tissue support surface 6022. The tissue support 6030 is snugly secured within the anvil 6020, which results in minimal, if any, relative movement between the tissue support 6030 and the anvil 6020. The tissue support 6030 includes an annular structure support surface 6032 adjacent to the annular structure compression surface 6022 of the anvil 6020. In addition to the internally defined annular inner wall 6036, the tissue support 6030 further includes a bottom wall 6038 located adjacent to the anvil frame 6028 of the anvil 6020.

Referring here to FIG. 86, the circular staple fastener is a staple cartridge 6040 including a first annular staple row 6070 and a second annular staple row 6080, and staples 6070 and 6080 stapled during the firing stroke of the firing drive. Includes a firing drive configured to eject from cartridge 6040. As illustrated in FIG. 86, the staples 6070 and 6080 are deformed by the forming pocket 6024 as they are ejected from the staple cartridge 6040. In various examples, the staples 6070 and staples 6080 are deformed to the same height, but in other cases the staples 6070 and staples 6080 are deformed to different heights. For example, the staple 6070 may be deformed to a deformation height shorter than the staple 6080. In another embodiment, the staple 6080 is deformed to a height shorter than the staple 6070.

In addition to or instead of the above, staples 6070 and staples 6080 can have different unformed heights. For example, staple 6070 may have a shorter unformed height than staple 6080. In another embodiment, the staple 6080 has a shorter unformed height than the staple 6070. In some cases, the staples 6070 and staples 6080 have the same unformed height.

In addition to the above, when the staples 6070 and 6080 are deformed relative to the anvil 6020 to staple the tissue T trapped between the anvil 6020 and the staple cartridge 6040, the staple fastener device incises the tissue T. Can be done. The firing drive, which ejects the staples from those staple cavities, drives the cutting member 6050 towards the tissue T and the anvil 6020. After cutting the tissue T, the distal edge of the cutting member 6050 slides along the inner side wall 6036 of the tissue support 6030 without cutting the inner side wall 6036. The cutting edge of the cutting member 6050 is annular and aligns with the annular inner wall 6036 of the tissue support 6030. As illustrated in FIG. 86, the cutting member 6050 advances into the anvil 6020 until the cutting member 6050 cuts off the bottom wall 6038.

When driving the staples 6070 and 6080 against the anvil 6020 and / or cutting the tissue, the launch drive is subject to various loads. For example, the launch drive may receive an increased load when it dissects pre-stapled tissue, for example, with staples 6090 (FIG. 86). However, when the bottom wall 6038 is cut off by the cutting member 6050, a sudden change or impact of the force transmitted through the launch drive unit occurs. This force-induced abrupt change can be sensed by a physician using a surgical stapler and / or an electronic sensor system configured to detect load fluctuations in the launch drive. The tissue support portion 6030 can be made of a material capable of making a noise when the cutting member 6050 applies a load to the bottom wall 6038. In at least one case, the tissue support 6030 is made of, for example, plastic. In any case, the transection of the bottom wall 6038 can be detected, and once detected, the physician and / or the electronic sensor system can determine that the cutting process is complete.

The firing drive unit simultaneously deforms the staples 6070 and 6080 and incises the tissue with the cutting member 6050, but it is conceivable that the formation of the staples and the cutting of the tissue are staggered. In at least one case, the tissue cutting step is not initiated until the staple forming step is complete.

The surface 6032 can partially support the tissue T, but when the cutting member 6050 moves towards the bottom wall 6038, the cutting member 6050 is between the inner wall 6036 of the tissue support 6030 and the mounting mount 6026. It should be understood from FIG. 86 that the tissue T can be pushed into the defined cavity. In other words, the cutting member 6050 can drag the tissue T along the wall 6036 before finally cutting the tissue T. In such cases, the incision made by the cutting member 6050 may not be accurate. Discussed below are improvements to the embodiments disclosed in FIG.

Here, referring to FIGS. 87 and 88, the tissue support 6030 of the anvil 6020 has been replaced by the tissue support 6130. Tissue support 6130 includes a first (or outer) annular wall 6131 and a second (or inner) annular wall 6133. The inner wall 6133 defines an opening 6136 configured to snugly receive the mounting mount 6026. The outer wall 6131 and the inner wall 6133 are connected by a side wall 6132. The lateral wall 6132 extends radially between the inner wall 6133 and the outer wall 6131 with the center of the tissue support portion 6130 as the center. The lateral walls 6132 are evenly spaced apart from each other. However, alternative embodiments are recalled in which the lateral walls 6132 are not evenly spaced apart from each other. In either case, the lateral wall 6132 defines an annular array of cavities 6134 within the tissue support 6130. In various examples, any side of each cavity 6134, except for example, the side facing the tissue, may be enclosed. In other cases, the side of the cavity facing the tissue may be enclosed.

The outer wall 6131 and inner wall 6133 of the tissue support portion 6130 are configured to support the tissue when the tissue is transected by the cutting member 6050. In addition to supporting the tissue as well, the lateral wall 6132 prevents or prevents the tissue from slipping against the outer wall 6131 and the inner wall 6133 when the tissue is transected. It should be understood that when the tissue is transected, the tissue can enter the cavity 6134, but the relative movement between the tissue and the sidewalls can be significantly reduced. The configuration and arrangement of the lateral wall 6132 can be selected to provide greater support to the tissue or less support to the tissue, depending on the amount of support desired. For example, a thicker lateral wall 6132 can provide greater tissue support than a thinner lateral wall 6132. Similarly, more lateral walls 6132 can provide greater tissue support than thinner lateral walls 6132.

While the cutting member 6050 is moving during its cutting stroke, the cutting member 6050 cuts the tissue and cuts the side wall 6132. The cutting member 6050 is annular and cuts off the lateral wall 6132 adjacent to the outer wall 6131. However, the cutting member can cut the wall 6132 at any suitable position. In any case, the lateral wall 6132 supports the tissue before, during and after cutting the tissue, preventing or possibly dragging the tissue along the outer wall 6131 and / or the inner wall 6133. At least reduce. Like the tissue support 6030, the tissue support 6130 includes a bottom wall 6138 that is cut off at the end of the cutting stroke.

Surgical staplers, including staple cartridges 6240 and anvil 6220, are disclosed in FIGS. 89 and 90. The staple cartridge 6240 is similar to the staple cartridge 6040 in many respects. Anvil 6220 is similar to Anvil 6020 and Anvil 6120 in many respects. The anvil 6220 includes a mounting stem 6226 and an annular tissue support 6230 located around the mounting stem 6226. Tissue support 6230 includes a central opening configured to snugly receive stem 6226. The tissue support 6230 further includes a lateral wall 6232 extending radially from the outer wall 6231, in addition to the annular outer wall 6231 positioned adjacent to the tissue compression surface of the anvil 6220. The tissue support 6230 does not include an annular inner wall and the medial end of the lateral wall 6232 can be freely deflected. Tissue support 6230 further includes a bottom wall 6238 that is incised by the cutting member 6050, as above.

Surgical staplers, including staple cartridges 6240 and anvil 6220, are illustrated in FIGS. 91 and 92. However, the reader should understand that the Organizational Support 6230 of the Anvil 6220 has been replaced by the Organizational Support 6330. Tissue support 6330 includes an annular central opening configured to snugly receive stem 6226. The tissue support 6330 further includes an upper wall 6332, a bottom wall 6338, and a side wall 6336 extending between the upper wall 6332 and the bottom wall 6338. An embodiment is recalled in which the upper wall 6332 and the bottom wall 6338 are parallel or at least substantially parallel, but the wall 6332 and the wall 6338 are not parallel. The embodiment in which the side wall 6336 is parallel or at least substantially parallel, but the side wall 6336 is not parallel is recalled.

The walls 6332, 6336, and 6338 define an annular cavity 6334 between them. The cavity 6334 is enclosed on all sides, or at least substantially enclosed. The cavity 6334 extends uninterruptedly around the stem 6226, but other embodiments are recalled, for example, where the cavity 6334 is interrupted by a side wall and / or the shape of the cavity 6334 changes.

Similar to the above, the tissue support portion 6330 is configured to support the tissue when it is transected by the cutting member 6050. The tissue support 6330 is snugly received within the anvil 6220 so that it does not move relative to the anvil 6220, or at least substantially. In addition, the tissue support 6330 has a rigid box cross section so that the deflection of the tissue support 6330 while the cutting member 6050 is translating the tissue is minimized or minimal. including. As shown in FIG. 91, there is a gap between the bottom wall 6338 and the inner side wall 6336. Such a gap can provide some flexibility to the tissue support 6330. However, other embodiments in which such a gap does not exist are recalled. The tissue support 6330 is made of, for example, plastic, but in various embodiments, the tissue support 6330 may be made of, for example, a flexible material and / or an elastomeric material.

The cutting member 6050 cuts the tissue support portion 6330 during its cutting stroke. As illustrated in FIG. 92, the cutting member 6050 cuts the upper wall 6332 after cutting the tissue and then enters the cavity 6334. The upper wall 6332 includes an annular notch 6333 defined in the upper wall, and the annular notch 6333 is aligned with the annular cutting edge of the cutting member 6050. The notch 6333 reduces the cross section of the upper wall 6332 and facilitates the incision of the upper wall 6332. The cutting member 6050 can also cut the bottom wall 6338 during its cutting stroke. As the reader will understand, the transection of the upper wall 6332 and bottom wall 6338 of the tissue support 6330 can cause a force impact within the firing drive of the staple fastener. Upper wall 6332 so that the surgeon and / or electronic sensor system of the surgical instrument can recognize the difference in impact and do not mistakenly interpret the incision in the upper wall 6332 as the end of the firing / cutting stroke. And the bottom wall 6338 may be structurally configured to give different impacts.

With reference to FIGS. 91 and 92 again, the upper wall 6332 of the tissue support 6330 is aligned with, or at least substantially aligned with, the tissue compression surface 6022 of the anvil 6220. In addition to or instead of the above, the upper wall 6332 may be behind the tissue compression surface 6022 and / or may extend above the tissue compression surface 6022. The upper wall 6332 of the tissue support portion extends above the forming surface 6024 of the anvil 6220. In addition to or instead of the above, the upper wall 6332 may be behind the forming surface 6024 and / or may be aligned with the forming surface 6024.

Surgical staplers, including staple cartridges 6240 and anvil 6220, are shown in FIGS. 93 and 94. However, the reader should understand that the Organizational Support 6230 of the Anvil 6220 has been replaced by the Organizational Support 6430. Tissue support 6430 includes an annular central opening configured to snugly receive stem 6226. The tissue support 6430 further includes an upper wall 6432, a bottom wall 6438, and a side wall 6436 extending between the upper wall 6432 and the bottom wall 6438. The walls 6432, 6436, and 6438 define an annular cavity 6434 between them. Cavity 6434 is surrounded on all sides, or at least substantially surrounded. The cavity 6434 extends uninterruptedly around the stem 6226, but other embodiments are recalled, for example, where the cavity 6434 is interrupted by a side wall and / or the shape of the cavity 6434 changes.

Similar to the above, the tissue support portion 6430 is configured to support the tissue when it is transected by the cutting member 6050. The tissue support 6430 is snugly received within the anvil 6220 so that it does not move relative to the anvil 6220, or at least substantially. In addition, the tissue support 6430 has a rigid polygonal cross section so that the deflection of the tissue support 6430 is minimized or minimal while the cutting member 6050 is translating the tissue. including. As shown in FIG. 93, there is a gap between the bottom wall 6438 and the inner side wall 6436. Such a gap can provide some flexibility to the tissue support 6430. However, other embodiments in which such a gap does not exist are recalled. The tissue support 6430 is made of, for example, plastic, but in various embodiments, the tissue support 6430 may be made of, for example, a flexible material and / or an elastomeric material.

As illustrated in FIGS. 93 and 94, the inner side wall 6436 is shorter than the outer side wall 3436. However, other embodiments are recalled in which the outer side wall 6436 is shorter than the inner side wall 6436. Moreover, the upper wall 6432 is not parallel to the bottom wall 6438. More specifically, the upper wall 6432 includes an inclined portion extending in the transverse direction with respect to the bottom wall 6438 and / or other part of the wall 6432.

The cutting member 6050 cuts the tissue support portion 6430 during its cutting stroke. As illustrated in FIG. 94, the cutting member 6050 cuts the upper wall 6432 after cutting the tissue and then enters the cavity 6434. The cutting member 6050 can also cut the bottom wall 6438 during its cutting stroke.

As mentioned above, the tissue supports disclosed herein are configured to support the tissue when it is incised by a cutting member. Often, the tissue incised by the cutting member is pre-stapled, i.e., for example, during the early stages of the surgical procedure. In various examples, even though such staples are made of metals such as titanium and / or stainless steel, such staples can also be cut by cutting members. In other cases, such staples may not be incised by the cutting member, but rather may be pushed into the material that constitutes the tissue support. Regardless of whether the staples are incised by the cutting member, the tissue supports disclosed herein are, in various examples, the staples captured by the cutting member in the tissue support that are localized within the tissue support. It has sufficient strength and / or rigidity so as not to cause deformation beyond plastic plastic deformation. In at least one such example, the local plastic deformation is limited to less than a predetermined characteristic length (CL) of the staple in any direction with respect to the staple. In at least one case, the tissue support material is selected such that the staples trapped in the tissue support can only form, for example, a plastic deformation region with a diameter of less than ^{2 * CL within the tissue support.} May be done. In other cases, the tissue support material may only allow staples trapped in the tissue support to form, for example, a plastic deformation region within the tissue support with a diameter of less than ^{1.5 * CL.} May be selected. The representative length of the staple can be, for example, the width of the staple crown, the backspan, and / or the formation height of the staple leg in the modified configuration of the staple. Further, the tissue support disclosed herein may be made of a material having sufficient hardness to support the staple when the staple is incised by a cutting member. In at least one case, the hardness of the material constituting the tissue support portion is equal to or higher than the hardness of the material constituting the staple that is incised in contact with the tissue support portion. In some cases, the hardness of the material constituting the tissue support is less than the hardness of the material constituting the incised staple, but the structural design of the tissue support provides a plastic deformation region that the tissue support can tolerate. Sufficient to prevent it from extending plastically beyond. In some cases, the energy required to incise the tissue and the formed staples within the tissue is less than the energy required to incise the tissue support. In various examples, the materials that make up the tissue support may be resistant to being scooped out by staples. In at least one case, a biocompatible lubricant may be placed on the tissue support and / or impregnated with the tissue support to prevent the staples from getting caught in the tissue support.

In various examples, the tissue compression surface of the anvil and the tissue contact surface of the tissue support are flat, or at least substantially flat. Such a configuration can distribute the force exerted by the anvil over a wide area of the organization. Other embodiments are recalled in which the tissue compression surface of the anvil and / or the tissue contact surface of the tissue support is not flat. In some cases, the tissue compression surfaces of the anvil and / or the tissue contact surfaces of the tissue support are configured to engage and grip the tissue, extending from these surfaces, or spikes. Including part. Such tissue gripping members can, for example, reduce relative motion (or slip) between tissue and anvil. In at least one case, the density of the tissue gripping member on the tissue compression surface of the anvil is the same as the density of the tissue gripping member on the tissue contact surface of the tissue support. In other cases, the density of the tissue gripping member on the tissue contact surface of the tissue support is higher than the density of the tissue gripping member on the compression surface of the anvil. When the tissue support is positioned radially inward with respect to the compression surface of the anvil, the tissue gripping member can prevent the tissue from flowing or sliding radially inward in such cases.

Anvil 6520 is shown in FIG. In addition to the tissue compression surface 6522, the anvil 6520 includes a formation pocket defined within the tissue compression surface 6522. The forming pockets are configured to deform the staples into the desired configuration as the staples are ejected from those staple cartridges. Each forming pocket contains a pair of cups, each of which is configured to deform the legs of the staples. For example, the pair of forming cups consists of a first forming cup 6530a configured to deform the first leg of the staple and a second forming configured to deform the second leg of the staple. It may include a cup 6530b and the like. The first forming cup 6530a and the second forming cup 6530b are mirror images of each other with respect to the axis 6531 extending between the first forming cup 6530a and the second forming cup 6530b, but have other configurations. It can be used.

The first forming cup 6530a includes a first (or outer) end 6532 and a second (or inner) end 6534. The first forming cup 6530a further includes a bottom surface (or bathtub surface) 6536 extending between the outer end 6532 and the inner end 6534. The first end 6532 is configured to receive the staple legs and initiate the leg formation process. The first end 6532 includes a curved surface configured to deflect the staple legs towards the second end 6534. The bottom surface 6536 includes a curved surface (or concave surface) configured to or at least partially reorient the staple legs towards the staple cartridge. The second end 6534 includes a curved surface configured to guide the staple legs out of the forming cup 6530a.

The second forming cup 6530b includes a structure similar to that of the first forming cup 6530a and is configured to deform the second leg of the staple. As a result of the above, the first forming cup 6530a guides the first leg of the staple toward the second leg, and the second forming cup 6530b directs the second leg of the staple to the first leg. Guide towards the legs. In various examples, the first forming cup 6530a and the second forming cup 6530b work together to, for example, transform the staples into a B-shaped configuration. However, the forming cup may be configured to deform the staples into any suitable configuration.

Primarily with reference to FIG. 96, each forming cup 6530 (6530a and 6530b) has one lateral side wall 6537 and a second side wall extending between the first end 6532 and the second end 6534. Includes lateral side wall 6539. In various examples, the first lateral side wall 6537 and the second lateral side wall 6539 are mirror images of each other with respect to the longitudinal axis 6533 extending through the center of the forming cup 6530. In other cases, the first lateral side wall 6537 and the second lateral side wall 6539 are not mirror images of each other. In either case, the sidewalls 6537, 6539 are tilted or tilted, for example, to guide the staple legs towards the center of the forming cup, i.e. towards the axis 6533.

Each forming cup 6530 includes a groove or channel 6538 defined on its bottom surface 6536. The groove 6538 extends longitudinally between the first end 6532 and the second end 6534 of the forming cup 6530. The groove 6538 extends parallel to the central longitudinal axis 6535 of the forming cup 6530 or laterally offset with respect to the central longitudinal axis 6535. The groove 6538 is wider than the staple leg deformed by the forming cup 6530, but other embodiments are recalled in which the groove 6538 is narrower than the staple leg. In both cases, the groove 6538 is configured to guide the staple legs along a predetermined path within the forming cup 6530.

In various examples, the grooves in the forming cup 6530 are configured to twist the legs while deforming the legs of the staples. In at least one case, the staples are planar, or at least substantially planar, before being deformed. In at least one such example, when the staple is ejected from the staple cartridge, the legs and base of the staple are coplanar with the longitudinal axis 6535. The first end 6532 and bottom 6536 are inclined and / or otherwise configured to guide the legs towards the groove 6538 as the staple legs enter the forming cup 6530. After the staple legs have entered the groove 6538, the grooves 6538 twist the staple legs together with the base of the staples so that the staple legs deviate from the plane. As a result of the above, the structure of the unformed staples is planar, but the structure of the formed staples is non-planar. However, other embodiments are recalled in which the staples have a non-planar configuration before and after the staples are deformed.

Grooves 6538 of the forming cup 6530 are located on the same side of the longitudinal axis 6535 with respect to a given set of forming cups 6530 and are configured to twist both staple legs to the same side of the staple base. Has been done. However, other embodiments are recalled in which the first staple leg is twisted to one side of the staple base and the second staple leg is twisted to the other side of the staple base. In at least one such embodiment, the first groove 6538 is located on the first side of the longitudinal axis 6535 and is configured to twist the first staple leg towards the first side of the staple base. The second groove 6538 is arranged on the second side of the longitudinal axis 6535 and is configured to twist the second staple leg to the second side of the staple base.

The grooves 6538 of the forming cup 6530 are collinear, or at least substantially collinear, with respect to a given set of forming cups 6530. However, other embodiments are recalled in which each groove 6538 is located on the same side of the longitudinal axis 6535 but is not collinear with each other. In at least one such example, the grooves 6538 are parallel to each other, whereas in the other such example, the grooves 6538 are not parallel to each other.

Primarily with reference to FIG. 96, the groove 6538 is deeper than the bottom surface 6536 of the forming cup 6530. However, other embodiments are recalled in which the groove of the forming cup and the bottom surface have the same depth.

In various examples, if the anvil 6520 is part of a longitudinal end effector configured to apply a longitudinal row of staples, the forming cup 6530 is placed in the longitudinal row. In at least one such example, the groove 6538 of the forming cup is arranged so that all staples deployed by the end effector are bent out of the plane in the same direction. In other cases, the groove 6538 bends the staple legs in the first direction, the first longitudinal row of the forming cup 6530 and the staple legs in the second (or different) direction, the forming cup 6530. Is arranged in a second longitudinal row of. In some cases, the groove 6538 bends the leg of the first staple in the staple row in the first direction and the leg of the second staple in the staple row in the second direction or in the opposite direction. Placed in.

In various examples, where the anvil 6520 is part of an annular end effector configured to apply an annular row of staples, the forming cup 6530 is arranged in an annular row. In at least one such example, the groove 6538 is located radially outward with respect to the central longitudinal axis 6535 of the forming cup 6530. In other cases, the groove 6538 is located radially inward with respect to the central longitudinal axis 6535 of the forming cup 6530. In some cases, the groove 6538 is located radially outward in the first annular row of the forming cup 6530 and radially inward in the second annular row of the forming cup 6530.

In addition to the above, the anvil forming pocket can include any suitable configuration. In at least one case, the forming pocket may include two forming cups that are mirror images of each other with respect to the central axis. Each forming cup comprises a triangular configuration with an outer end and an inner end. The inner ends of the pair of forming cups are adjacent to each other. The outer end of the forming cup is wider than the inner end and is configured to receive the staple legs. Each forming cup is defined within a bottom surface that is configured to guide staple legs within the forming cup, as well as a bottom surface (or bathtub surface) that extends between the outer and inner ends. Also includes longitudinal grooves. In at least one case, the longitudinal groove is in the center of the bottom surface of the forming cup.

End effectors 7000 of circular stapled assemblies are disclosed in FIGS. 97-99. The end effector 7000 includes a staple cartridge including a deck 7030 and a cartridge body 7040. The deck 7030 includes a tissue compression surface 7031 and a staple cavity 7032 defined within the tissue compression surface 7031. The staple cavities 7032 are arranged in a first (or inner) annular row and a second (or outer) annular row. Each staple cavity 7032 in the inner row contains a first staple 7070a detachably stored therein, and each staple cavity 7032 in the outer row contains a second staple 7070b detachably stored therein. include.

The end effector 7000 further includes a staple driver configured to push the staples out of the staple cartridge. For example, the staple cartridge has a first annular staple driver row 7060a configured to eject a first staple row 7070a from a cartridge body 7040 and a second staple row 7070b configured to eject a second staple row 7070b. Includes an annular staple driver row 7060b, and the like. The staple drivers 7060a and 7060b are positioned within the staple cavity 7032 defined within the deck 7030 and / or are aligned with the staple cavity 7032. The staple drivers 7060a and 7060b are slidable in the staple cavity 7032 in order to eject the staples 7070a and 7070b from the staple cavity 7032, respectively.

End effector 7000 further includes anvil 7020. The anvil 7020 includes a tissue compression surface 7021 and a staple forming pocket 7022 defined within the compression surface 7021. The staple forming pockets 7022 are arranged in a first (or inner) annular row and a second (or outer) annular row. The staple forming pocket 7022 is aligned with the staple cavity 7032 so that the staples 7070a, 7070b come into contact with the staple forming pocket 7022 when the staples 7070a, 7070b are ejected from the staple cavity 7032.

The end effector 7000 further includes a launching member 7056 configured to lift the staple drivers 7060a and 7060b in the staple cavity 7032 and eject the staples 7070a and 7070b from the staple cavity 7032, respectively. The launching member 7056 includes a base 7054 and an inclined surface 7055. The base 7054 is slidably positioned in the recess 7052 defined in the launch drive 7050. The inclined surface 7055 is slidably positioned in the slot 7041 defined in the cartridge body 7040. As will be described in more detail later, the inclined surface 7055 is configured to slide in the slot 7041 and gradually come into contact with the staple drivers 7060a and 7060b to eject the staples 7070a and 7070b from the staple cavity 7032.

In addition to the above, the launching member 7056 is movable throughout the firing stroke to eject the staples 7070a, 7070b from the staple cavity 7032. During the firing stroke, the firing member 7056 moves along a curved (or arched) path defined by slot 7041. Primarily with reference to FIG. 97, slot 7041 includes a first end 7042, a second end 7049, and a continuous path between them. The inclined surface 7055 of the launch member 7056 is positioned within the first end 7042 at the beginning of the launch stroke and within the second end 7049 at the end of the launch stroke. The first end 7042 of slot 7041 is aligned with the inner row of staple cavities 7032, and the second end 7049 of slot 7041 is aligned with the outer row of staple cavities 7032. Slot 7041 further includes a first circumferential 7043 extending around a central longitudinal axis 7090 extending through the end effector 7000. The first circumferential portion 7043 of slot 7041 aligns with and extends below the staple driver 7060a in the inner row of staple cavities 7032. When the launching member 7056 moves through the first circumferential portion 7043 of the slot 7041, the inclined surface 7055 of the launching member continuously engages with the staple driver 7060a to continuously launch the staple 7070a.

The first circumferential portion 7043 is defined around the longitudinal axis 7090 by a constant, or at least substantially constant radius of curvature. However, other embodiments in which the radius of curvature of the first circumferential portion 7043 is not constant are recalled. In at least one such example, the first circumferential 7043 comprises a helical structure. In other words, in such a case, the first circumferential portion 7043 moves away from the longitudinal axis 7090 as it extends around the longitudinal axis 7090.

The second circumferential portion 7045 of slot 7041 aligns with and extends below the staple driver 7060b in the outer row of staple cavities 7032. As the launching member 7056 moves through the second circumferential portion 7045 of slot 7041, the inclined surface 7055 of the launching member continuously engages with the staple driver 7060b to continuously launch the staple 7070b. The second circumference 7045 is defined around the longitudinal axis 7090 by a constant, or at least substantially constant radius of curvature. However, other embodiments are recalled in which the radius of curvature of the second circumferential 7045 is not constant. In at least one such example, the second circumferential 7045 comprises a helical structure. In other words, in such a case, the second circumferential 7045 moves away from the longitudinal axis 7090 as it extends around the longitudinal axis 7090.

In addition to the above, slot 7041 includes a transition portion 7044 intermediate between the first circumferential portion 7043 and the second circumferential portion 7045. During the firing stroke, the inclined surface 7055 slides continuously through the first circumferential portion 7043, the transition portion 7044, and then the second circumferential portion 7045. The transition 7044 allows the launching member 7056 to reposition between a first staple row with a first radius of curvature and a second staple row with a second radius of curvature. In certain embodiments, the transition 7044 between the first circumference 7043 and the second circumference 7045 may be unnecessary. In at least one such example, the first circumferential portion 7043 may include a first helical configuration, the second circumferential portion 7045, for example, the end point of the first helical configuration having a second helical configuration. A second helical configuration can be included that aligns with the origin of.

The launch member 7056 is driven along the launch path by the launch drive unit 7050. The launch drive unit 7050 is driven around the longitudinal axis 7090 by, for example, a manual crank and / or an electric motor. The launch drive unit 7050 includes a drive recess 7052 defined therein. The base 7054 of the launching member 7056 is positioned within the drive recess 7052. The drive recess 7052 is larger than the base 7054 of the launching member 7056 so that the base 7054 can move or float within the drive recess 7052. The drive recess 7052 is defined by a side wall that limits the movement of the base 7054 within the recess 7052. When the launch drive unit 7050 rotates about the longitudinal axis 7090, the side wall of the drive recess 7052 comes into contact with the base 7054 and pushes the drive member 7056 to pass through the slot 7051. As described above, slot 7051 has one or more points of change in its radius of curvature, and when the launching member 7056 moves through such points of change, the base 7054 of the launching member 7056 is driven into a recess. It can slide inside.

As described above, the staples in the first (or inner) staple row are continuously deployed, and then the staples in the second (or outer) staple row are continuously deployed. Such embodiments can control the medial circumference of the colon, for example, prior to staping outwards. In one embodiment, the staples in the outer staple row are continuously deployed and then the staples in the inner staple row are continuously deployed. Such embodiments can establish boundaries within the colonic tissue, for example, prior to inward stapling.

In various examples, in addition to the above, the first staple 7070a and the second staple 7070b have the same unformed height. In at least one such example, the first staple 7070a and the second staple 7070b are formed at the same formation height. In another such example, the first staple 7070a may be formed at a first forming height and the second staple 7070b may be formed at a second forming height that is different from the first forming height. In at least one such example, the first formation height of the inner staple row is shorter than the second formation height of the outer staple row. With such a configuration, for example, the transition between stapled and non-stapled tissue can be more gradual. In other cases, the first formation height of the inner staple row is higher than the second formation height of the outer staple row. Such a configuration can, for example, make the innermost tissue of the stapled intestine more flexible, for example.

In some cases, in addition to the above, the first staple 7070a has a first unformed height and the second staple 7070b has a second unformed height that is different from the first unformed height. .. In at least one such example, the first staple 7070a and the second staple 7070b are formed at the same formation height. In another such example, the first staple 7070a is formed at a first forming height and the second staple 7070b is formed at a second forming height that is different from the first forming height.

The end effector 7000 has two annular staple rows, but the end effector may have any suitable number of annular staple rows. For example, the end effector may have three annular staple rows. In at least one such example, the staples in the first annular row may have a first unformed staple height and the staples in the second annular row may have a second unformed staple height. The third staple in the third annular row may have a third unformed staple height. Further, in at least one such example, the staples in the first annular row may have a first modified staple height and the staples in the second annular row may have a second modified staple height. The third staple in the third annular row may have a third modified staple height.

The launch drive unit 7150 is shown in FIGS. 100-105. The launch drive unit 7150 includes a rotatable drive shaft 7152 that is rotatable about a longitudinal axis. The launch drive 7150 further includes a three-stage sequential driver assembly that includes a first (or inner) driver 7154a, a second (or intermediate) driver 7154b, and a third (or outer) driver 7154c. The drive shaft 7152 includes a drive pin 7151 extending from the drive shaft 7152. The drive pin 7151 extends through the drive slots of the drivers 7154a, 7154b, and 7154c, respectively. For example, the first driver 7154a includes a first drive slot 7153a defined therein, the second driver 7154b includes a second drive slot 7153b defined therein, and a third driver. The 7154c includes a third drive slot 7153c defined therein. Drive slots 7153a, 7153b, and 7153c do not have the same configuration. However, the drive slots 7153a, 7153b, and 7153c have an overlapping configuration that is aligned, or at least substantially aligned, at the drive pin 7151. For example, in FIG. 100, the drive pin 7151 is in the unfired position and the drive slots 7153a, 7153b, and 7153c are aligned with the drive pin 7151.

In addition to the above, FIG. 100 illustrates drivers 7154a, 7154b, and 7154c in unlaunched positions. Here, referring to FIG. 101, when the drive shaft 7152 rotates during the first portion of its firing stroke, the drive pin 7151 rotates through a circumferential path and the drive pin 7151 engages with the side wall of the drive slot 7153a. Together, the first driver 7154a is pushed or camped distally. Notably, during the first portion of the firing stroke, drive pin 7151 does not drive drivers 7154b and 7154c distally. As can be seen from FIG. 100, the drive slots 7153b and 7153c are aligned with the circumferential path of the drive pin 7151 throughout the first portion of the firing stroke. The first driver 7154a is configured to fire a first array of annular staples when the first driver 7154a is displaced distally.

Referring here to FIG. 102, when the drive shaft 7152 rotates during the second portion of its firing stroke, the drive pin 7151 rotates along a circumferential path and the drive pin 7151 engages with the side wall of the drive slot 7153b. In conjunction, the second driver 7154b is pushed or camped distally. Notably, during the second portion of the firing stroke, the drive pin 7151 does not drive the driver 7154c distally. Similar to the above, the drive slots 7153a and 7153c are aligned with the circumferential path of the drive pin 7151 throughout the second portion of the firing stroke. The second driver 7154b is configured to fire a second array of annular staples when the second driver 7154b is displaced distally.

Referring here to FIG. 103, when the drive shaft 7152 rotates during the third portion of its firing stroke, the drive pin 7151 rotates through a circumferential path and the drive pin 7151 engages with the side wall of the drive slot 7153c. Together, the third driver 7154c is pushed or camped distally. Similar to the above, the drive slots 7153a and 7153b are aligned with the circumferential path of the drive pin 7151 throughout the third portion of the firing stroke. The third driver 7154c is configured to deploy a cutting member when the third driver 7154c is displaced distally. However, in certain embodiments, the third driver 7154c can deploy, for example, a third staple row.

As a result of the above, there is no overlap between the first staple firing step, the second staple firing step, and the tissue cutting step. Each step is performed at consecutive timings. Therefore, the forces required to deform the staples and cut the tissue are distributed over the firing stroke. Moreover, the launch drive 7150 cannot cut the tissue until it is stapled. Various alternative embodiments are recalled in which there is some overlap between the first staple firing step, the second staple firing step, and / or the tissue cutting step. In at least one such embodiment, the configuration of drive slots 7153a, 7153b, and 7153c is a partial overlap of the movements of the first driver 7154a and the second driver 7154b and / or the second driver 7154b and the third. Can be adapted so that there is a partial overlap of the movements of the driver 7154c.

Primarily with reference to FIGS. 103 and 104, drivers 7154a, 7154b, and 7154c include collaborative features that prevent, or at least prevent, drivers 7154a, 7154b, and 7154c from rotating relative to each other. There is. For example, the first driver 7154a includes a longitudinal key portion 7155a located in a longitudinal slot 7156b defined within a second driver 7154b. The key portion 7155a and slot 7156b allow the first driver 7154a to slide longitudinally with respect to the second driver 7154b, but between the first driver 7154a and the second driver 7154b. It is configured to block rotational movement. Similarly, the second driver 7154b includes a longitudinal key portion 7155b located in the longitudinal slot 7156c defined within the third driver 7154c. The key portion 7155b and slot 7156c allow the second driver 7154b to slide longitudinally with respect to the third driver 7154c, but between the second driver 7154b and the third driver 7154c. It is configured to block rotational movement.

In order to retract the drivers 7154a, 7154b, and 7154c, the drive shaft 7152 is rotated in opposite directions. In such a case, the drive shaft 7152 continuously engages with the side wall of the drive slot 7153c, the side wall of the drive slot 7153b, and then the side wall of the drive slot 7153a to form a third driver 7154c, a second. The driver 7154b and the first driver 7154a are returned to their unlaunched positions (FIG. 100).

The launch drive unit 7250 is shown in FIG. 106. The launch drive unit 7250 operates in the same manner as the launch drive unit 7150. The launch drive unit 7250 includes a drive shaft 7252 that is rotatable about a longitudinal axis. The drive shaft 7252 includes a cam surface (or inclined surface) 7256 that rotates throughout several stages of the firing stroke. The launch drive unit 7250 further includes a first driver 7254a, a second driver 7254b, and a third driver 7254c to which the cam 7256 of the drive shaft 7252 engages when the launch drive unit 7250 rotates. In the first stage of the firing stroke, the cam 7256 engages with the cam surface 7255a defined on the first driver 7254a and drives the first driver 7254a distally. In the second stage of the firing stroke, the cam 7256 engages with the cam surface 7255b defined on the second driver 7254b and drives the second driver 7254b distally. In the third stage of the firing stroke, the cam 7256 engages with the cam surface 7255c defined on the third driver 7254c, driving the third driver 7254c distally.

The first cam surface 7255a is shorter than the second cam surface 7255b, so that the first driver 7254a has a shorter firing stroke than the second driver 7254b. Similarly, the second cam surface 7255b is shorter than the third cam surface 7255c, so that the second driver 7254b has a shorter firing stroke than the third driver 7254c. Such a configuration can be useful, for example, to form different rows of staples at different formation heights. In one embodiment, the drivers 7254a, 7254b, and 7254c can have any suitable firing stroke. In at least one embodiment, the drivers 7254a, 7254b, and 7254c have, for example, the same firing stroke. Such a configuration can be useful, for example, to form different rows of staples at the same formation height.

FIG. 107 is a partial perspective view of a staple cartridge 4410 for use with a circular surgical staple fastening instrument, according to at least one embodiment. Various circular surgical staple fastening instruments are known. For example, US Pat. Discloses the configuration of stapler fasteners for circular surgery. U.S. Pat. The configuration of the circular surgical stapler is disclosed. As discussed in these references, circular surgical staplers generally include a frame assembly that includes attachments configured to operably connect the anvil to the circular surgical stapler.

Broadly, the anvil includes an anvil head that supports the annular wire (s) of the staple forming pocket. The anvil stem or trocar portion is configured to be attached to the anvil head and detachably connected to the anvil attachment portion of the circular staple fastener. Various circular surgical staple fasteners point the anvil toward and away from the surgical staple cartridge so that the target tissue can be clamped between the anvil and the deck of the surgical staple cartridge. Includes means for selective movement. Surgical staple cartridges contain multiple surgical staples detachably inside, and surgical staples are arranged in one or more annular arrays that correspond to the placement of staple forming pockets in the anvil. NS. The staples are detachably housed in the corresponding staple cavities formed within the staple cartridge and are supported by the corresponding portion of the selectively movable pusher assembly operably received within the circular stapler. The circular stapler further includes an annular knife or cutting member configured to make an incision in the tissue clamped between the anvil and the staple cartridge.

Referring again to FIG. 107, the staple cartridge 4410 includes a cartridge body 4411 defining an annular cartridge deck surface 4412. The cartridge body 4411 includes an inner annular row 4420 of the spaced inner staple cavities 4422 and an outer annular row 4440 of the spaced outer staple cavities 4442. As can be seen from FIG. 107, the inner staple cavities 4422 are offset with respect to the spaced outer staple cavities 4442. Inside each medial staple cavity 4422, medial surgical staples 4430 are supported, and within each lateral staple cavity 4442, lateral surgical staples 4450 are supported. The outer staples 4450 in the outer annular row 4440 may have different characteristics than the inner staples 4430 in the inner annular row 4420. For example, as shown in the embodiment of FIG. 108, the outer staple 4450 has an unformed "gull wing" configuration. Specifically, 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, in one embodiment, be parallel to each other. However, in the illustrated configuration, the vertical portions 4456, 4466 are not parallel to each other. For example, in the illustrated arrangement, the angle _{A 1} between the crown 4452 and the vertical portion 4456,4466 is greater than 90 degrees. See FIG. 108. Further details regarding the composition of the staples are incorporated herein by reference in its entirety, US Patent Application No. 14 / 319,008 filed June 30, 2014, title of the invention "FASTENEER CARTRIDGE COMPRISING NON-". It can be found in "UNIFORM FASTENERS", US Patent Application Publication No. 2015/0297232. However, the vertical portions 4456, 4466 may be arranged at different angles with respect to the crown portion 4452. One advantage of having vertical leg portions 4456, 4466 arranged at an angle greater than 90 degrees with respect to the crown 4452 is that such a configuration temporarily holds the staples within its corresponding staple cavities. It can be useful for.

At least one leg 4454, 4464 has an inwardly extending end. In the embodiment shown in FIG. 108, for example, each leg portion 4454, 4464 includes an inwardly extending leg portion. In the illustrated configuration, the leg portion 4458 extends inward from the vertical leg portion 4456 and the leg portion 4468 extends inward from the vertical leg portion 4466. As can be seen from FIG. 108, the leg portion 4458 is shorter than the leg portion 4468. _{In other words, the distance HA} between the staple crown 4452 and the point where the leg 4458 bends inward from the vertical leg 4456 is such that the staple crown 4452 and the leg 4468 are inward from the vertical leg 4466. longer than the distance H _C between the point to bend. Therefore, in at least one embodiment, the distance H _B is shorter than the length H _{D. The angle A 2 at which the} leg portion 4458 bends with respect to the vertical leg portion 4556 may be equal to the _{angle A 3 at} which the leg portion 4468 bends with respect to the vertical leg portion 4466 _{, or A 2} and A ₃ may be different from each other. .. Further details regarding the composition of the staples are incorporated herein by reference in US Patent Application No. 14 / 319,008, filed June 30, 2014, the title of the invention, "FASTENEER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS. , US Patent Application Publication No. 2015/0297232.

In at least one embodiment, each medial surgical staple 4430 may have the configuration illustrated in FIG. 108. As can be seen from FIG. 108, the medial surgical staple 4430 has a crown 4432 and two vertical legs 4434, 4436 extending from the crown 4432. Vertical leg 4434,4436 may extend relatively perpendicularly from the crown portion 4432, or may extend at an angle _{A 4} which may be greater than 90 degrees. Such a configuration may help temporarily hold the staples 4430 within their corresponding staple cavities 4422. However, the vertical legs 4434, 4436 may extend from the crown 4432 at various 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 staples 4430 and the outer staples 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 is larger than the diameter of the staple wire used to form the inner staple 4430. In one embodiment, the inner and outer staples may have the same diameter or may be formed from wires of other diameters. In some configurations, the inner and outer staples may be formed from the same type of staple wire. Therefore, in such a configuration, the wire diameters of the inner and outer staples are the same. However, in yet another embodiment, the inner and outer staples may have the same unformed shape / configuration, but may be formed from two different staple wires with different wire diameters. Further, in at least one configuration, 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 configuration are incorporated herein by reference in US Patent Application No. 14 / 319,008, filed June 30, 2014, title of the invention "FASTENEER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS". , US Patent Application Publication No. 2015/0297232.

Referring to FIG. 107, the staple cartridge 4410 has an outer edge 4414 extending above the deck surface 4412. During surgery, the physician 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 includes deck features 4416 and 4418 extending from the deck surface 4412. As can be seen from FIG. 107, a series of inner deck features 4416 with an inner row 4420 of the staple cavity 4422 and a centrally located knife opening 4413 through which the knife or cutting member will pass during the firing process. It is provided between. The deck feature 4416 can be molded as shown in FIGS. 107, 109 and 110 and can be positioned relative to the inner staple cavity and opening 4413. For example, each inner deck feature 4416 has a flat wall 4415 having the same extent as the wall of the knife opening 4413 and a conical or slanted body portion 4417 adjacent to a row of inner staple cavities 4422. Can have. See FIGS. 109 and 110. In the embodiment shown in FIG. 107, the deck feature 4416 is directed to the gap between adjacent inner staple cavities 4422 and is offset between the pair of staple cavities 4422 as shown. The cavity expansion configuration or deck features of this system can serve to reduce the pressure normally applied to flat deck cartridges. The configurations disclosed herein can also help reduce tissue movement and slippage. Since it is generally not desirable for the tissue to slip, the outer diameter retaining features may be larger or larger in number. The inner diameter feature can serve to increase tissue tension / shear forces as the blade passes adjacent to the inside of the inner diameter, which can result in better cutting by the system. However, the deck feature 4416 may have different shapes and configurations and may be installed at different positions on the deck surface 4412.

Also, as can be seen from FIGS. 107, 109 and 110, every other outer staple cavity 4442 includes an outer deck feature 4418 associated with each end of the cavity 4442. The outer deck feature 4418 extends above the deck surface 4412 and guides the outer staples 4450 toward the anvil when the staples 4450 are ejected from the staple cartridge 4410. In such an embodiment, the outer staple 4450 may not project above the outer deck feature 4418 until it is moved towards the anvil by the launching member. Primarily with reference to FIG. 107, in at least one embodiment, the outer deck feature 4418 does not extend around the entire corresponding outer staple cavity 4442. The first outer deck feature 4418 is positioned adjacent to the first end of the corresponding outer cavity 4442, and the second outer deck feature 4418 is adjacent to the second end of the outer cavity 4442. Is positioned. As can be seen in FIG. 107, the outer deck feature 4418 is associated with every other cavity of the outer staple cavities 4442. Such a configuration can serve to reduce total pressure and minimize tissue extension and movement. However, in other embodiments, the first and second outer deck features 4418 may be associated with each of the outer staple cavities 4442. In yet another embodiment, the outer deck features may extend around the entire perimeter of the corresponding outer cavity. As can be seen from FIG. 109, the inner deck feature portion 4416 is shorter than the outer deck feature portion 4418. In other words, each inner deck feature portion projects above the deck surface 4412 by a distance shorter than the distance by which each outer deck feature portion 4418 projects above the deck surface 4412. Each outer deck feature may project above the deck surface 4412 by the same distance that the outer edge 4414 projects above the deck surface 4412. In addition, as further seen in FIG. 109, each outer deck feature 4418 has a substantially conical or tapered outer shape that inserts the stapler head into the patient's colon and rectum. In the meantime, it can help prevent the tissue from getting caught in the deck features.

The above deck feature configuration can provide one or more advantages. For example, an upright outer edge can help prevent tissue from slipping across the cartridge deck. This upright edge may include a repeating pattern of peaks and valleys rather than one continuous lip forming portion. An upright feature on the inside can also help hold the tissue adjacent to the blade and result in improved cutting. The inner deck features may be located between the cavities, or in an alternative configuration, the deck features (s) may include one continuous upright lip. It may be desirable to balance the number of deck features in order to minimize the number of high energy (force) / compression zones while achieving the desired amount of tissue immobilization. Features concentric with the cavity can serve the additional purpose of minimizing tissue flow in the area where the staple legs project. Such a configuration also facilitates the desired formation of staples when the staple legs are ejected and transitioned to a receiving anvil pocket which may consist of corresponding forming pockets. Such local pocket features increase the low compression zone while facilitating the cartridge to support the legs as the staples exit the cartridge. Therefore, this configuration minimizes the distance the staple must "jump" before it comes into contact with the anvil pocket. Tissue flow tends to increase radially outward from the center of the cartridge. Referring to FIG. 118, the improved lateral upright column extension puts tissue on top because the colon is a tube when the extension is inserted upward through the colon (stage). Tend.

FIGS. 109 and 110 illustrate the use of surgical staple cartridge 4410 in connection with anvil 4480. The anvil 4480 includes an anvil head portion 4482 that operably supports the staple forming insert or portion 4484, and a knife washer 4490. The knife washer 4490 is supported in a face-to-face relationship with the knife 4492 supported within the stapler head. In the illustrated embodiment, the staple forming insert 4484 is made of, for example, steel, stainless steel, etc. and accommodates an inner row of inner staple forming pockets 4486 and an outer row of outer staple forming pockets 4488. Each inner staple forming pocket 4486 corresponds to one of the inner staple cavities 4422 and each outer staple forming pocket 4488 corresponds to one of the outer staple cavities 4442. In the illustrated configuration, when the anvil 4480 moves relative to the cartridge deck surface 4412 to its firing position, the inner staple forming pocket 4486 is closer to the cartridge deck surface 4412 than the outer staple forming pocket 4488. In other words, the first gap _{g 1} or a first staple forming distance between the first staple forming portion 4485 and the cartridge deck surface 4412 between the second staple forming portion 4487 and the cartridge deck surface 4412 Second gap g ₂ or smaller than the second staple formation distance.

As further seen from FIGS. 109 and 110, the inner staples 4430 are respectively supported within their corresponding inner staple cavities 4422 on the corresponding inner driver section 4502 of the pusher assembly 4500, and each of the outer staples 4450 is Supported within their corresponding outer staple cavities 4442 on the corresponding outer driver section 4504. As the pusher assembly 4500 is advanced towards the anvil 4480, the inner and outer staples 4430, 4450 are driven into forming contact with their respective corresponding staple forming pockets 4486, 4488, as shown in FIG. Further, the knife 4492 penetrates the tissue clamped between the anvil 4480 and the deck surface 4412 and advances distally through the brittle bottom surface 4491 of the knife washer 4490. Such a configuration, the outer staple 4450, to impart greater formation height FH _O than formed heights FH _I inside staple 4430. In other words, the outer row 4440 of the outer staple 4450 is formed in a larger "B" shape, with a larger trapping volume and / or higher staple formation to alleviate high tissue compression near the outer staple row 4440. Brings height. Larger B shapes can also improve blood flow towards the inner row. In various examples, the outer row 4440 of the outer staple 4450 comprises greater resistance to deployment by utilizing the larger staple crown, the width of the staple legs, and / or the thickness of the staple legs.

The amount of staples used in each staple row can vary. In one embodiment, for example, there are more outer staples 4450 than inner staples 4430. Another embodiment uses more inner staples 4430 than outer staples 4450. In various examples, 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} of the inner row 4420 of the inner staple 4430. The gull-wing structure of the outer staples 4450 uses bends located at different distances from their respective crowns. Staples with different heights are obtained by using a stepped anvil structure with a flat (non-stepped) cartridge deck surface 4412 and uniform movement of the driver or pusher.

FIG. 111 illustrates another staple cartridge embodiment 4610. As can be seen from FIG. 111, the staple cartridge 4610 includes a cartridge deck 4612 that includes an inner annular row 4620 of the spaced inner staple cavities 4622 and an outer annular row 4640 of the spaced outer staple cavities 4642. As can be seen from FIG. 111, the inner staple cavities 4622 are offset with respect to the spaced outer staple cavities 4642. Internal surgical staples 4630 are supported within each medial staple cavity 4622, and lateral surgical staples 4650 are supported within each lateral staple cavity 4642. In addition, the outer edge 4614 extends above the deck surface 4612. In various embodiments, in addition to the above, the staples 4630, 4650 do not project above the deck surface 4612 until the staples are moved towards the anvil by the launching member. Such embodiments often utilize staples that are small relative to the depth of their corresponding staple cavities in which the staples are housed. In one embodiment, the legs of the staples project above the deck surface 4612 when the staples are in their unlaunched position. In at least one such embodiment, the staple cartridge 4610 further includes deck features 4616 and 4618 extending from the deck surface 4612.

Also, as can be seen from FIG. 111, every other inner staple cavity 4622 includes an inner deck feature 4616 associated with each end of the cavity 4622. The inner deck feature portion 4616 extends above the deck surface 4612 and guides the corresponding inner staple 4630 toward 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 above the inner deck feature 4616 until it is moved towards the anvil by the launching member. In the illustrated example, the inner deck feature 4616 does not extend around the entire corresponding inner staple cavity 4622. The first inner deck feature 4616 is positioned adjacent to the first end of the corresponding inner cavity 4622, and the second inner deck feature 4616 is adjacent to the second end of the inner cavity 4622. Is positioned. However, in one embodiment, the inner deck feature 4416 may be associated with each of the inner staple cavities 4622. In yet another embodiment, the inner deck features may extend around the entire perimeter of the corresponding inner staple cavity. Pressure while balancing the desire to guide as many staple legs as possible by using deck features associated with every other cavity with different heights in a concentric pattern. More low tissue staple areas can be provided. In other words, such a configuration can minimize the amount of tissue flow by reducing the total amount of pressure exerted on the target tissue.

Further referring to FIG. 111, each outer staple cavity 4642 includes an outer deck feature 4618 associated with each end of the cavity 4642. The outer deck feature portion 4618 extends above the deck surface 4612 and guides the outer staples 4650 toward the anvil when the staples 4650 are ejected from the staple cartridge 4610. In such an embodiment, the outer staple 4650 may not extend above the outer deck feature 4618 until it is moved towards the anvil by the launching member. As can be seen from FIG. 111, in the illustrated example, the outer deck feature 4618 does not extend around the entire corresponding outer staple cavity 4642. The first outer deck feature 4618 is positioned adjacent to the first end of the corresponding outer cavity 4642, and the second outer deck feature 4618 is adjacent to the second end of the outer cavity 4642. Is positioned. As can be seen from FIG. 111, the outer deck feature 4618 is associated with each of the outer staple cavities 4642. However, in other embodiments, the first and second outer deck features 4618 may be associated with every other outer staple cavity 4642. In yet another embodiment, the outer deck features may extend around the entire perimeter of the corresponding outer cavity. As can be seen from FIGS. 112 and 113, the inner deck feature portion 4616 and the outer deck feature portion 4618 extend above the deck surface 4612 by the same distance. In other words, these features have the same height. In addition, as can be further seen from FIGS. 112 and 113, each inner deck feature 4416 and each outer deck feature 4618 has a substantially conical or tapered outer shape, which outer shape provides the stapler head. It can help prevent tissue from getting caught in the deck features during insertion into the patient's colon and rectum.

112 and 113 illustrate the use of the surgical staple cartridge 4610 in connection with the anvil 4680. The anvil 4680 includes an anvil head portion 4682 that operably supports the staple forming insert or portion 4648, and a knife washer 4690. The knife washer 4690 is supported in a face-to-face relationship with the knife 4692 supported within the stapler head. In the illustrated embodiment, the staple forming insert 4864 is manufactured from, for example, steel, stainless steel, etc. and accommodates an inner row of inner staple forming pockets 4686 and an outer row of outer staple forming pockets 4688. Each inner staple forming pocket 4686 corresponds to one of the inner staple cavities 4622 and each outer staple forming pocket 4688 corresponds to one of the outer staple cavities 4642. In the illustrated configuration, the inner staple forming pocket 4686 is located away from the deck surface 4612 by the same distance g ₁ that the outer staple forming pocket 4688 is located away from the deck surface 4612.

As further seen in FIGS. 112 and 113, the inner staple 4630 is supported within the corresponding inner staple cavity 4622 on the corresponding inner driver portion 4702 of the pusher assembly 4700. The outer staples 4650 are supported within the corresponding outer staple cavities 4642 on the corresponding outer driver section 4704. As the pusher assembly 4700 is advanced towards the anvil 4680, the inner and outer staples 4630, 4650 are driven into forming contact with their respective corresponding staple forming pockets 4686, 4688, as shown in FIG. Further, the knife 4692 penetrates the tissue clamped between the anvil 4680 and the deck surface 4612 and advances distally through the brittle bottom surface 469 of the knife washer 4690. In the embodiments illustrated in FIGS. 112 and 113, 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 approximately 0.0201 cm to 0.038 cm (about 0.0079 "to 0.015") (increments are typically 0.0226 cm, 0.0239 cm, and 0.00368 cm (0). It may be (0.99”, 0.0094 ”, 0.00145”)), and the first _{unformed height L 1} is about 0.501 cm to 0.635 cm (about 0.0079 ”to 0). It may be .015 ") (increments are usually 0.0089", 0.0094 ", and 0.00145"), and the first unformed height L ₁ is approximately 0.5029 cm to 0. It may be .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. 112 and 113, D ₁ <D ₂ and L ₁ <L ₂ . However, as can be seen from FIG. 113, the inner and outer staples 4630, 4650 are formed with the same formation height FH'. Thicker wire staples on the outside tend to provide higher tear and burst strength compared to smaller diameter staples in the inner row that tend to maintain good hemostatic properties. In other words, the tighter inner row of staples can maintain good hemostasis, while the outer row of staples with less compression can promote good healing and blood flow. In addition, long-legged staples can ensure a greater degree of B-shaped flexion, even if formed at the same height as short-legged staples, to a greater degree. The B-shaped bend may increase the strength of the long-legged staples and increase the likelihood that the long-legged staples will be formed adequately enough to hold under high load conditions. The amount of staples used in each staple row can vary. In one embodiment, for example, the inner row 4620 has as many inner staples 4630 as the outer row 4640 of the outer staples 4650 has. In various configurations, the crown width of the staples 4650 is greater than the crown width of the inner staples 4630. In one embodiment, the staples 4630, 4650 may have the same crown width. In other configurations, the staples 4630, 4650 may have the gull wing design described above. For example, at least one leg of the staple may include an inwardly curved end, or both legs may include an inwardly curved end. Such staples can be used for the inner ring, or the outer ring, or both the inner and outer rings.

FIG. 114 illustrates another embodiment of a circular staple cartridge 4810, which includes a cartridge deck 4812 that includes three annular rows 4820, 4840, 4860 of spaced staple cavities. The inner or first row 4820 contains a first plurality of inner or first staple cavities 4822, each arranged at a first angle. Each inner staple cavity 4822 operably supports a corresponding inner or first staple 4830 therein. The inner cavity 4822 orients the first staple 4830 at the same uniform angle with respect to the tangential direction. In the embodiment of the figure, each inner staple 4830 is formed from a first staple wire having a _{first staple diameter D1.} In one embodiment, the first staple wire diameter D ₁ is approximately 0.0201 cm to 0.038 cm (increments are typically 0.0226 cm, 0.0239 cm, and 0.00368 cm) (0.0079 "to 0.015". "(Increments are usually 0.0089", 0.0094 ", and 0.00145"). With reference to FIG. 117, each inner staple 4830 has a first crown 4832 and two. and a first leg 4834. the first crown have a first crown width C _1, the first leg 4834 includes first unformed leg length L ₁ In one embodiment, the first crown width C ₁ may be approximately 0.254 cm to 0.762 cm (0.100 "to 0.300") and the first unformed leg length. L ₁ may be approximately 0.503 cm to 0.635 cm (0.100 "to 0.300" and the first unformed cab length L ₁ may be approximately 0.198 "to 0.250"). The first legs 4834 may be arranged at _{an angle A 1} with respect to the first staple crown 4832, respectively _{. The angle A 1} may be about 90 °, or the angle A ₁ may be. , Slightly greater than 90 ° so that the first leg 4834 is slightly extended outward to assist in holding the first staple 4830 within its corresponding first staple cavity 4822. You may.

With reference to FIGS. 115 and 116, the staple cartridge 4810 is intended to be used with the anvil 4900. The anvil 4900 includes two inner or first rows 4902 of a first pair 4903 offset or angled first staple forming pocket 4904. Each first pair 4903 of the first staple forming pockets 4904 corresponds to one first staple 4830. One first staple forming pocket 4904 corresponds to one first staple leg 4834 and the other first staple forming pocket 4904 of the pair 4903 to the other first staple leg 4834. handle. In such a configuration, one 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. As such, the first staple leg 4834 of the first staple 4830 establishes a formed staple configuration that is formed out of plane with the first crown 4832 of this particular first staple 4830. Useful for. This "three-dimensional" formed staple configuration is shown in FIG. 115 with respect to some of the first staple forming pockets 4904.

As best seen from FIG. 116, 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 first annular row 4820 of the inner or first staple cavity 4822. As further seen in FIG. 116, the anvil 4900 is moved to the closed or clamping position, the anvil 4900, a portion containing a first staple forming pockets 4904 is separated from the deck portion 4814 by a first gap distance _{g 1} ..

With reference to FIGS. 114, 116 and 117 again, the middle or second row 4840 contains a second plurality of middle or second staple cavities 4842 arranged at a second angle, respectively. Each intermediate staple cavity 4842 operably supports a corresponding intermediate or second staple 4850 therein. The intermediate cavity 4842 orients the intermediate or 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, the axis of the first crown of each first staple 4830 when the first and second staples are supported within their corresponding first and second cavities. Will eventually intersect the extended axis of the second crown of the adjacent second staple 4850. As can be seen from FIGS. 116 and 117, each second or intermediate staple 4850 includes a second staple crown or base 4852 and two second legs 4854. The staple base 4852 has a slightly rectangular cross-sectional shape and can be formed from a flat sheet of material. The second staple leg 4854 may have, for example, a circular cross-sectional contour shape. The second or intermediate staples are, for example, incorporated herein by reference in their entirety, U.S. Patent Application No. 14 / 863,110, filed August 26, 2015, the title of the invention, "SURGICAL STAPLING CONFIGURATIONS." It may include various staple configurations disclosed in "FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS". By having a circular staple leg portion extending from the staple base portion having a rectangular cross-sectional contour shape, it is possible to provide a staple base portion and a staple leg portion that do not include a priority bending plane. The second staple 4850 includes a bend 4856 where the staple legs 4854 extend from the staple base 4852. The bend 4856 may include a substantially square cross-sectional contour shape. The square and rectangular contours of the bend 4856 and staple base 4852, respectively, provide a solid connection and skeleton to the circular staple legs 4854. The circular staple leg 4854 eliminates the preferred bending plane that a staple leg having a cross section of any shape with squares, rectangles, or vertices, or a non-uniform shape can have. 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 configuration, C ₂ > C ₁ . The second leg 4854 may be arranged at _{an angle A 2} with respect to the second base or crown 4852, respectively. The angle A ₂ may be about 90 °, or the angle A ₂ may be a second to assist in holding the second staple 4850 within its corresponding second staple cavity 4842. It may be slightly larger than 90 ° so that the legs 4854 are slightly extended outwards.

With reference to FIGS. 115 and 116, the anvil 4900 further comprises two intermediate or second rows 4912 of a second pair 4913 offset or angled in the second staple forming pocket 4914. 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 of the pair 4913 to the other second staple leg 4854. handle. Such a configuration helps establish a formed staple configuration in which the second leg 4854 is formed out of plane with the second base 4852 of the particular second staple 4850. This "three-dimensional" formed staple configuration is shown in FIG. 115 with respect to some of the second staple forming pockets 4914.

As most specifically as can be seen in FIG. 116, the cartridge deck 4812 further includes a second cartridge deck portion 4816 that corresponds to an intermediate or second annular row 4840 of the intermediate or second staple cavity 4842. As further seen in FIG. 116, the anvil 4900 is moved to the closed or clamping position, the anvil 4900, the portion containing the second staple forming pockets 4914 is separated from the deck portion 4816 by a second gap distance _{g 2} .. In the embodiment of the figure, g ₂ > g ₁ .

With reference to FIG. 114, FIG. 116 and FIG. 117 again, the outer or third row 4860 contains a third plurality of outer or third staple cavities 4862, the outer or third staple cavities 4862. Each outer or third staple cavity 4862 is dimensioned relative to the second staple cavity 4842 so as to extend the distance between two adjacent second cavities 4842. Each outer staple cavity 4862 operably supports a corresponding outer or third staple 4870 therein. The outer cavity 4862 directs the outer or third staple 4870 to a circumferential tangent. As can be seen from FIGS. 116 and 117, each third or outer staple 4870 includes a third staple crown or base 4872 and two third legs 4874. The staple base 4872 has a slightly rectangular cross-sectional shape and can be formed from a flat sheet of material. The third staple leg 4874 may have, for example, a circular cross-sectional contour shape. The third or outer staple 4870 is, for example, incorporated herein by reference in its entirety, U.S. Patent Application No. 14 / 863,110, filed August 26, 2015, the title of the invention, "SURGICAL STAPLING." It may include various staple configurations disclosed in "CONFIGURATIONS FOR CURVED AND CIRCULAR STAPLING INSTRUMENTS". By having a circular staple leg portion extending from the staple base portion having a rectangular cross-sectional contour shape, it is possible to provide a staple base portion and a staple leg portion that do not include a priority bending plane. The third staple 4870 includes a bend 4876 where the staple legs 4874 extend from the staple base 4872. The bent portion 4876 may include a substantially square cross-sectional contour shape. The square and rectangular contours of the bend 4876 and staple base 4872, respectively, provide a solid connection and skeleton to the circular staple legs 4874. The circular staple leg 4874 eliminates the preferred bending plane that a staple leg having a cross section of any shape with squares, rectangles, or vertices, or a non-uniform shape can have. In at least one embodiment, D ₃ > D ₂ . Third base or crown 4872 has a third crown width _{C 3,} each of the third leg 4874 includes a third unformed leg length _{L 3.} In one configuration, C ₃ > C ₂ and L ₃ > L ₂ . The third leg 4874, respectively, may be arranged at an angle _{A 3} relative to the third base or the crown 4872. Angle A ₃ may be about 90 °, or the angle A ₃ is to assist in retaining the third staple 4870 in the third staple cavity 4862 of its corresponding third It may be slightly larger than 90 ° so that the legs 4874 are slightly extended outwards.

With reference to FIGS. 115 and 116, the anvil 4900 further includes 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 specifically as can be seen in FIG. 116, the cartridge deck 4812 further includes a third cartridge deck portion 4818 corresponding to the outer or third row 4860 of the outer or third staple cavity 4862. As further seen in FIG. 116, the anvil 4900 is moved to the closed or clamping position, the anvil 4900, the portion containing the third staple forming pockets 4918 is separated from the deck portion 4818 by a third gap distance _{g 3} .. In the embodiment of the figure, g ₃ > g ₂ . As further seen in FIG. 116, in at least one embodiment, a tissue thickness compensator 4920 is used with each outer or third staple 4870. Tissue thickness compensators may include woven fabric materials incorporating oxidized regenerated cellulose (ORC) to promote hemostasis. The Tissue Thickness Compensator 4920 is incorporated herein by reference in its entirety, US Patent Application No. 14 / 187,389 filed February 24, 2014, the title of the invention "IMPLANTABLE LAYER ASSEMBLES", US Patent. It may include any of the various tissue thickness compensator configurations disclosed in Publication No. 2015/0238187. As can be seen from FIG. 116, the tissue thickness compensator 4920 has a thickness indicated by “a”. In one embodiment, the tissue thickness compensator has a thickness of approximately 0.038 cm to 0.114 cm (0.015 "to 0.045"). However, other thicknesses may be used.

Furthermore, in at least one embodiment shown in FIGS. 114-117, the staple cartridge 4810 may use different numbers of staples in each of the three rows of staples. In one configuration, the inner staple row includes 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 staple has a different configuration from the first staple configuration. Each leg of the intermediate staple contains a medium wire diameter and unformed leg length. Each intermediate staple has a crown width that is slightly greater than the crown width of the inner staple. Each intermediate staple is oriented at a uniform angle with respect to the tangential direction, but at a different angle with respect to the inner row of inner staples. Each outer staple has a configuration similar to that of the intermediate staple. Each of the third legs of each outer staple contains the largest 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 greater than the crown width of the inner and intermediate staples. Each outer staple is oriented tangentially to the circumference of the cartridge. The outer staple rows use a woven tissue thickness compensator (spacer cloth) with ORC incorporated to promote hemostasis. Stepped anvils and stepped cartridge decks provide different forming staple heights, the staple with the shortest forming height is in the inner row and the staple with the longest forming height is in the outer row. .. The anvil pockets corresponding to the inner and middle rows of staples are "tilted" to create three-dimensional staples within the inner and middle rows. "Bathtub" anvil pockets accommodate outer staple rows. In at least one embodiment, the staples are fired continuously. For example, the staples in the inner and middle rows may be fired first and the staples in the outer row may be fired afterwards. The annular knife cuts the clamped tissue during the firing process.

As described in various embodiments of the present disclosure, the circular staple fasteners include anvils and staple cartridges. One or both of the anvil and staple cartridges are movable relative to the other between the open and closed configurations to capture tissue between them. The staple cartridge houses the staples inside, or at least in part, inside a circular row of staple cavities. Staples are deployed in a circular row from their corresponding staple cavities into the captured tissue and are formed against the corresponding circular row of forming pockets in the anvil. The firing drive unit is configured to eject staples from the staple cartridge during the firing stroke of the firing drive unit.

Anvils of circular staple fasteners generally include a tissue compression surface and an annular array of staple forming pockets defined within the tissue compression surface. The anvil further includes a mounting mount and a stem extending from the mounting mount. The stem is configured to be removablely attached to the closure drive of the circular staple fastener so that the anvil can move towards and away from the staple cartridge of the circular staple fastener. ..

Staple cartridges and anvils can be moved separately within the patient's body and combined in the surgical field. In various examples, for example, the staple cartridge travels through the patient's thin tubular body, such as the colon. The staple cartridge may include several tissue contact features, such as a stepped deck and a pocket extender. To avoid unintentional damage to the patient as the staple cartridge moves towards the target tissue, the present disclosure presents, among other things, various changes to some tissue contact features.

Referring to FIG. 118, a partial cross-sectional view shows the staple cartridge 15500 of a circular surgical instrument being pressed against tissue (T) as it moves through the patient's body. Numerous structural features of the staple cartridge 15500 have been modified to create a specifically contoured outer frame 15502 to protect the tissue. The staple cartridge 15500 includes a plurality of annular staple row cavities. In at least one embodiment, as illustrated in FIG. 118, the outer row 15504 of the staple cavity 15510 surrounds the inner row 15506 of the staple cavity 15512 at least partially. The staple cavities 15510 and 15512 are configured to house the staples 15530 and 15531, respectively.

The terms inner and outer describe a relationship relative to the central axis 15533. For example, the inner tissue contact surface 15518 is closer to the central axis 15533 than the outer tissue contact surface 15516.

As illustrated in FIG. 119, the staple cartridge 15500 includes a stepped cartridge deck 15508. The outer row 15504 is defined within the outer tissue contact surface 15516 of the stepped cartridge deck 15508, while the inner row 15506 is defined within the inner tissue contact surface 15518 of the stepped cartridge deck 15508. The outer tissue contact surface 15516 descends stepwise from the inner tissue contact surface 15518, forming a slope that reduces friction when the staple cartridge 15500 is pressed against the tissue.

In some cases, the outer tissue contact surface 15516 is parallel to, or at least substantially parallel to, the inner tissue contact surface 15518. In other cases, the outer tissue contact surface 15516 is beveled so that the first plane defined by the outer tissue contact surface 15516 crosses the second plane defined by the inner tissue contact surface 15518. .. A predetermined angle is defined between the first plane and the second plane. The angle can be an acute angle. In at least one case, the angle can be, for example, any angle selected from the range greater than about 0 ° and less than or equal to about 30 °. In at least one case, the angle can be, for example, any angle selected from the range greater than about 5 ° and less than or equal to about 25 °. In at least one case, the angle can be, for example, any angle selected from the range greater than about 10 ° and less than or equal to about 20 °. The slanted outer tissue contact surface 15516 can reduce friction with the tissue or catching of the tissue as the staple cartridge 15500 moves relative to the tissue. In at least one case, the slanted outer tissue contact surface 15516 also descends stepwise from the inner tissue contact surface 15518.

In at least one case, the inner portion of the outer tissue contact surface 15516 is planar, or at least substantially planar, while the outer edge 15548 of the outer tissue contact surface 15516 has the staple cartridge 15500 in the tissue. In contrast, it is sloped, arcuate, and / or chamfered to reduce friction with the tissue or catching of the tissue. The staple cavity 15510 exists, for example, in the planar inner portion of the outer tissue contact surface 15516. The outer edge 15550 of the inner tissue contact surface 15518 is also sloped and chamfered to reduce friction with the tissue or catching of the tissue as the staple cartridge 15500 moves relative to the tissue. And / or can be arcuate.

In order to accommodate staples having the same, or at least substantially the same, unformed height in the staple cavities 15510 in the outer row 15504 and the staple cavities 15512 in the inner row 15504, the staple cavities 15510 in the outer row 15504 are pocket-expanded. Includes part 15514. The pocket extension 15514 is configured to control and guide the staples 15530 as they are ejected from their corresponding staple cavities 15510. In some cases, the pocket extension 15514 may be configured to accommodate staples having an unformed height greater than, for example, the staples of the inner tissue contact surface 15518.

As illustrated in FIG. 119, the staple cavities 15510 in the outer row 15504 are laterally aligned, or at least substantially aligned with, the gap 15520 between two adjacent staple cavities 15512 in the inner row 15506. The staple cavity 15510 has a first end 15522 and a second end 15524. The second end 15524 overlaps the first end 15526 of one of two consecutive staple cavities 15512, which causes the staple located at the second end 15524 as shown in FIG. 118. The leg 15530a is radially aligned, or at least substantially aligned with, the staple leg 15531a located at the first end 15526. Similarly, the first end 15522 of the staple cavity 15510 overlaps the second end 15528 of one of two consecutive staple cavities 15512.

The pocket extension 15514 includes a first jacket 15532 protruding from the outer tissue contact surface 15516 to hide the tip 15536 of the staple leg 15530a extending beyond the outer tissue contact surface 15516. The first jacket 15532 includes an end 15538 projecting from the first end 15522 and an inner side wall 15540 and an outer side wall 15542 extending away from the end 15538 to form the first jacket 15532. include. In at least one case, the first jacket 15532 defines, or at least substantially, a "C" -shaped wall extending over a portion of the outer circumference 15535 of the staple cavity 15510, including the first end 15522. do.

To reduce friction with the tissue, the inner side wall 15540 projects from the outer tissue contact surface 15516 to a height higher than the outer side wall 15542. In other words, the height of the outer side wall 15542 is lower than the height of the inner side wall 15540. With this configuration, a slope is formed that smoothly transitions from the inner side wall 15540 through the outer side wall 15542 to the outer tissue contact surface 15516. In at least one embodiment, the inner side wall 15540 and the inner tissue contact surface 15518 include the same, or at least substantially the same height, relative to the outer tissue contact surface 15516. Alternatively, the inner side wall 15540 and the inner tissue contact surface 15518 include different heights relative to the outer tissue contact surface 15516. In some cases, the height of the inner side wall 15540 is lower than that of the inner tissue contact surface 15518 with respect to the outer tissue contact surface 15516. This configuration forms a slope that smoothly transitions from the inner tissue contact surface 15518 through the inner side wall 15540, through the outer side wall 15542, and to the outer tissue contact surface 15516.

The inner tissue contact surface 15518, the inner side wall 15540, the outer side wall 15542, and / or the outer tissue contact surface 15516 define a separate portion of the contoured outer frame 15502. Nevertheless, as illustrated in FIG. 118, such portions are so close to each other that no tissue can be captured between the portions when the staple cartridge 15500 is pressed against the tissue. It has become like. Further, one or more of these portions may include a slanted, contoured, curved, arcuate and / or chamfered outer surface to reduce friction with the tissue. As illustrated in FIG. 118, the top surface 15544 of the outer side wall 15542 and the top surface 15546 of the inner side wall 15540 are beveled, contoured, curved, circular to define the contoured outer frame 15502. Arced and / or chamfered.

In at least one case, the top surface 15544 and the top surface 15546 define an inclined plane across a first plane defined by the outer tissue contact surface 15516 and a second plane defined by the inner tissue contact surface 15518. In at least one case, a first angle is defined between the tilted plane and the first plane. The second angle can also be defined between the tilted plane and the second plane. The value of the first angle and the value of the second angle can be the same, or at least substantially the same. Alternatively, the value of the first angle may be different from the value of the second angle. In at least one case, the first angle and / or the second angle is an acute angle. In at least one case, the first angle is, for example, any angle selected from the range greater than about 0 ° and less than or equal to about 30 °. In at least one case, the first angle is, for example, any angle selected from the range greater than about 5 ° and less than or equal to about 25 °. In at least one case, the first angle is, for example, any angle selected from the range greater than about 10 ° and less than or equal to about 20 °. In at least one case, the second angle is, for example, any angle selected from the range greater than about 0 ° and less than or equal to about 30 °. In at least one case, the second angle is, for example, any angle selected from the range greater than about 5 ° and less than or equal to about 25 °. In at least one case, the second angle is, for example, any angle selected from the range greater than about 10 ° and less than or equal to about 20 °.

In addition to the above, the pocket extension 15514 includes a second jacket 15534, which is similar to the first jacket 15532 in many respects. Similar to the first jacket 15532, the second jacket 15534 projects from the outer tissue contact surface 15516 to hide the tip of the staple leg extending beyond the outer tissue contact surface 15516. The second jacket 15534 includes an end 15538 protruding from the second end 15524 and an inner side wall 15540 and an outer side wall 15542 extending from the end 15538 to form the second jacket 15534.

Although one pocket extension 15514 is illustrated in FIG. 119, it is understood that, for example, one or more other pocket extensions 15514 may project from the outer tissue contact surface 15516. In at least one case, the first jacket 15532 and the second jacket 15534 are connected by side walls, for example defining a pocket extension that completely surrounds the staple cavity.

While many of the surgical instrument systems described herein are powered by electric motors, the surgical instrument systems described herein can operate in any suitable manner. In various cases, the surgical instrument system described herein can be operated, for example, by a manually operated trigger. In some cases, the motors disclosed herein may include parts of a robotic control system. In addition, any of the end effectors and / or tool assemblies disclosed herein can be used with robotic surgical instrument systems. FIG. 82A schematically shows a robotic surgical instrument system 20'. However, U.S. Patent Application Nos. 13 / 118,241, the title of the invention "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENT", currently U.S. Patent Application Publication No. 2012/02987719, are some of the robotic surgical instrument systems, for example. 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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US Pat. No. 7,422,139 issued September 9, 2008, title of invention "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK",
U.S. Pat. No. 7,464,849, issued December 16, 2008, title of invention "ELECTRO-MEMHANICAL SURGICAL INSTRUMENT WITH CLOSE CROSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS",
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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 either case, the device can be readjusted for reuse after at least one use. The readjustment may include any combination of steps including, but not limited to, a disassembly step of the device, a subsequent cleaning or replacement step of a particular part of the device, and a subsequent reassembly step of the device. can. Specifically, after the readjustment equipment and / or surgical team disassembles the device, certain parts of the device can be cleaned and / or replaced, and the device can be reassembled for subsequent use. Those skilled in the art will appreciate that readjustment of the device can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques and the resulting readjustment device are all within the scope of the present invention.

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

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

All patents, publications, or other disclosures that are incorporated herein by reference in whole or in part are existing definitions, statements, or other disclosures in which the incorporated material is described in this disclosure. Incorporated herein only to the extent that it is consistent with the content. 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 use with a surgical stapler.
The cartridge body including the longitudinal axis and
A plurality of staple cavities defined in the cartridge body.
A first staple cavity annular row extending around the longitudinal axis,
A plurality of staple cavities, including a second staple cavity annular row extending around the longitudinal axis.
Staples that are detachably stored in the staple cavity and
Anvils configured to deform the staples,
With cutting members
After ejecting the staple from the staple cavity, it is rotatable about the longitudinal axis to deploy the cutting member to incise the captured tissue between the cartridge body and the anvil. End effectors, including sloping surfaces.
(2) In the first embodiment, the staple driver is further included, and the inclined surface is configured to continuously engage with the staple driver in order to continuously eject the staple from the staple cavity. The described end effector.
(3) The inclined surface continuously ejects the staples stored in the first staple cavity row before continuously ejecting the staples stored in the second staple cavity row. The end effector according to the second embodiment.
(4) The cartridge body includes a spiral slot configured to guide the inclined surface, the spiral slot being around the longitudinal axis while constantly approaching the longitudinal axis. The end effector according to embodiment 1, which is postponed.
(5) The cartridge body includes a spiral slot configured to guide the inclined surface, which extends around the longitudinal axis while constantly moving away from the longitudinal axis. The end effector according to the first embodiment, which is present.

(6) The cartridge body includes a curved slot configured to receive the inclined surface, and the curved slot extends around the longitudinal axis while approaching the longitudinal axis. The end effector according to the first embodiment.
(7) The cartridge body includes a curved slot configured to receive the inclined surface, the curved slot extending around the longitudinal axis, constantly away from the longitudinal axis. The end effector according to the first embodiment.
(8) The staples are
A plurality of first staples, each said first staple being positioned within the first staple cavity annular row, each said first staple being defined by a first unformed height. Yes, with multiple first staples,
A plurality of second staples, each said second staple being positioned within the second staple cavity annular row, each said second staple being a second stapling different from the first unformed height. The end effector according to embodiment 1, comprising a plurality of second staples, defined by the unformed height of the.
(9) The anvil is configured to deform the first staple to the first formation height and the second staple to the second formation height. The end effector according to the eighth embodiment, wherein the formation height of the robot is different from that of the second formation height.
(10) An end effector for a surgical stapler
The cartridge body, including the deck and longitudinal axis,
A plurality of staple cavities defined in the cartridge body,
Staples that are detachably stored in the staple cavity and
With cutting members
An end that includes, after the staples are continuously ejected from the staple cavities, a launching member that is rotatable about the longitudinal axis in order to continuously deploy the cutting member above the deck. Effector.

(11) The tenth embodiment, further comprising a staple driver, wherein the launching member is configured to continuously engage the staple driver in order to continuously eject the staple from the staple cavity. The described end effector.
(12) The plurality of staple cavities are
A first staple cavity annular row extending around the longitudinal axis,
A second staple cavity annular row extending around the longitudinal axis is included, and the launching member comprises the staples housed in the second staple cavity row before continuously ejecting the staples. The end effector according to embodiment 10, wherein the staples stored in the first staple cavity row are continuously ejected.
(13) The cartridge body includes a spiral slot configured to guide the launching member, the spiral slot being around the longitudinal axis while constantly approaching the longitudinal axis. The end effector according to embodiment 10, which is protracted.
(14) The cartridge body includes a spiral slot configured to guide the launching member, the spiral slot extending around the longitudinal axis, constantly moving away from the longitudinal axis. The end effector according to embodiment 10, which is present.
(15) The cartridge body includes a curved slot configured to receive the launching member, the curved slot extending around the longitudinal axis while approaching the longitudinal axis. The end effector according to the tenth embodiment.

(16) The cartridge body includes a curved slot configured to receive the launching member, the curved slot extending around the longitudinal axis, constantly away from the longitudinal axis. The end effector according to the tenth embodiment.
(17) The staples are
A plurality of first staples, each said first staple being positioned within the first staple cavity annular row, each said first staple being defined by a first unformed height. Yes, with multiple first staples,
A plurality of second staples, each said second staple being positioned within the second staple cavity annular row, each said second staple being a second stapling different from the first unformed height. 12. The end effector according to embodiment 12, comprising a plurality of second staples, defined by the unformed height of the.
(18) Further including an anvil configured to deform the staple, the anvil deforms the first staple to a first formation height and forms the second staple a second. The end effector according to embodiment 17, which is configured to be deformed to a height and the first formation height is different from the second formation height.
(19) An end effector for use with a surgical stapler configured to apply an annular row of staples.
Cartridge body and
A plurality of staple cavities defined in the cartridge body.
The first staple cavity ring road and
A plurality of staple cavities, including a second staple cavity annular row,
The first staple group detachably stored in the first staple cavity annular row and the first staple group.
A second staple group detachably stored in the second staple cavity annular row, and a second staple group.
A plurality of staple drivers, each of which is configured to eject the staple from the staple cavity, and a plurality of staple drivers.
With cutting members
A drive slot defined along an arched path, said arched path.
A first portion extending below the first staple cavity ring road and
A second portion following the first portion, which extends below the second staple cavity annular row, and
A drive slot comprising a third portion following the second portion, which extends below the cutting member.
An inclined surface that is slidable in the drive slot, the inclined surface is configured to engage with the staple driver to eject the staple from the staple cavity and to deploy the cutting member. End effectors, including sloping surfaces.

Claims (9)

An end effector for use with surgical staplers
The cartridge body including the longitudinal axis and
A plurality of staple cavities defined in the deck included in the cartridge body.
A first staple cavity annular row extending around the longitudinal axis,
A plurality of staple cavities, including a second staple cavity annular row extending around the longitudinal axis.
Staples that are detachably stored in the staple cavity and
Anvils configured to deform the staples,
With cutting members
After ejecting the staple from the staple cavity, it is rotatable about the longitudinal axis to deploy the cutting member to incise the captured tissue between the cartridge body and the anvil. the inclined surface, only including,
Further including a staple driver, the inclined surface is configured to continuously engage the staple driver in order to continuously eject the staple from the staple cavity.
The inclined surface continuously ejects the staples stored in the first staple cavity annular row before continuously ejecting the staples stored in the second staple cavity annular row. , End effector. An end effector for use with surgical staplers
The cartridge body including the longitudinal axis and
A plurality of staple cavities defined in the deck included in the cartridge body.
A first staple cavity annular row extending around the longitudinal axis,
A plurality of staple cavities, including a second staple cavity annular row extending around the longitudinal axis.
Staples that are detachably stored in the staple cavity and
Anvils configured to deform the staples,
A plurality of staple drivers, each of which is configured to eject the staple from the staple cavity, and a plurality of staple drivers.
With cutting members
A first portion extending below the first staple cavity annular row, a second portion extending below the second staple cavity annular row, following the first portion, and the cutting. A drive slot, including a third portion following the second portion, which extends below the member.
An inclined surface that is slidable in the drive slot, the inclined surface is configured to engage with the staple driver to eject the staple from the staple cavity and to deploy the cutting member. End effectors, including sloping surfaces. An end effector for use with surgical staplers
The cartridge body including the longitudinal axis and
A plurality of staple cavities defined in the deck included in the cartridge body.
A first staple cavity annular row extending around the longitudinal axis,
A plurality of staple cavities, including a second staple cavity annular row extending around the longitudinal axis.
Staples that are detachably stored in the staple cavity and
Anvils configured to deform the staples,
With cutting members
After ejecting the staple from the staple cavity, it is rotatable about the longitudinal axis to deploy the cutting member to incise the captured tissue between the cartridge body and the anvil. Including sloping surfaces,
The cartridge body includes a spiral slot configured to guide the inclined surface, which extends around the longitudinal axis while constantly approaching the longitudinal axis. and are, end-effector. An end effector for use with surgical staplers
The cartridge body including the longitudinal axis and
A plurality of staple cavities defined in the deck included in the cartridge body.
A first staple cavity annular row extending around the longitudinal axis,
A plurality of staple cavities, including a second staple cavity annular row extending around the longitudinal axis.
Staples that are detachably stored in the staple cavity and
Anvils configured to deform the staples,
With cutting members
After ejecting the staple from the staple cavity, it is rotatable about the longitudinal axis to deploy the cutting member to incise the captured tissue between the cartridge body and the anvil. Including sloping surfaces,
The cartridge body includes a spiral slot configured to guide the inclined surface, the spiral slot extending around the longitudinal axis, constantly away from the longitudinal axis. It is, end-effector. An end effector for use with surgical staplers
The cartridge body including the longitudinal axis and
A plurality of staple cavities defined in the deck included in the cartridge body.
A first staple cavity annular row extending around the longitudinal axis,
A plurality of staple cavities, including a second staple cavity annular row extending around the longitudinal axis.
Staples that are detachably stored in the staple cavity and
Anvils configured to deform the staples,
With cutting members
After ejecting the staple from the staple cavity, it is rotatable about the longitudinal axis to deploy the cutting member to incise the captured tissue between the cartridge body and the anvil. Including sloping surfaces,
The cartridge body includes a curved slot configured to receive the inclined surface, the curved slot extending around the longitudinal axis while approaching the longitudinal axis . end-effector. An end effector for use with surgical staplers
The cartridge body including the longitudinal axis and
A plurality of staple cavities defined in the deck included in the cartridge body.
A first staple cavity annular row extending around the longitudinal axis,
A plurality of staple cavities, including a second staple cavity annular row extending around the longitudinal axis.
Staples that are detachably stored in the staple cavity and
Anvils configured to deform the staples,
With cutting members
After ejecting the staple from the staple cavity, it is rotatable about the longitudinal axis to deploy the cutting member to incise the captured tissue between the cartridge body and the anvil. Including sloping surfaces,
The cartridge body includes a curved slot configured to receive the inclined surface, the curved slot extending around the longitudinal axis, constantly away from the longitudinal axis . end-effector. The staples
A plurality of first staples, each said first staple being positioned within the first staple cavity annular row, each said first staple being defined by a first unformed height. Yes, with multiple first staples,
A plurality of second staples, each said second staple being positioned within the second staple cavity annular row, each said second staple being a second stapling different from the first unformed height. The end effector according to claim 1, comprising a plurality of second staples, defined by the unformed height of the. The anvil is configured to deform the first staple to the first formation height and the second staple to the second formation height, and the first formation height. The end effector according to claim 7 , wherein the staple is different from the second formation height. An end effector for use with surgical staplers configured to apply a ring of staples.
Cartridge body and
A plurality of staple cavities defined in the deck included in the cartridge body.
The first staple cavity ring road and
A plurality of staple cavities, including a second staple cavity annular row,
The first staple group detachably stored in the first staple cavity annular row and the first staple group.
A second staple group detachably stored in the second staple cavity annular row, and a second staple group.
A plurality of staple drivers, each of which is configured to eject the staple from the staple cavity, and a plurality of staple drivers.
With cutting members
A drive slot defined along an arched path, said arched path.
A first portion extending below the first staple cavity ring road and
A second portion following the first portion, which extends below the second staple cavity annular row, and
A drive slot comprising a third portion following the second portion, which extends below the cutting member.
An inclined surface that is slidable in the drive slot, the inclined surface is configured to engage with the staple driver to eject the staple from the staple cavity and to deploy the cutting member. End effectors, including sloping surfaces.

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