MX2008001321A

MX2008001321A - A surgical device

Info

Publication number: MX2008001321A
Application number: MXMX/A/2008/001321A
Authority: MX
Inventors: P Whitman Michael; T Datcuk Peter
Original assignee: Power Medical Interventions Llc
Priority date: 2005-07-27
Filing date: 2008-01-28
Publication date: 2008-09-26

Abstract

A surgical device includes a first jaw and a second jaw moveable relative to the first, jaw between a first position, in which the first and second jaws are aligned within a plane, and a second position, in which the second jaw is in non-parallel correspondence to the plane. The surgical device may include a surgical member, e.g., a cutting and/or stapling element, disposed within the first jaw, and a second driver configured to cause relative movement of the surgical member in a direction parallel to the plane. The first and second jaws may include a camming arrangement that is configured to move the second jaw between the first and second positions. The camming arrangement may include a channel disposed along at least a portion of one or both of the first and second jaws, a ball bearing disposed within the channel.

Description

SURGICAL EQUIPMENT FIELD OF THE INVENTION The present invention relates to a surgical apparatus. Specifically, the present invention relates to a stapling, cutting and clamping apparatus that has a rotating jaw.

CROSS REFERENCE RELATED TO OTHER APPLICATIONS The present application relates to the U.S. Patent Application. No. 09 / 510,923, filed on February 22, 200, now issued as U.S. patent. No. 6,517,565 on February 11, 2003, US Patent Application 0 09 / 836,781, filed on April 17, 2001, US Patent Application No. 09 / 877,789 filed on June 22, 2001 and the provisional application of the patent No. 60 / 337,544 filed on December 4, 2001, Patent Application No. 10 / 309,532 entered on December 4, 2002, Patent Application No. 10 / 094,051 entered on March 8, 2002 each of the which is incorporated herein by reference in its entirety.

INFORMATION BACKGROUND The literature is replete with descriptions of surgical devices. . some of the surgical apparatuses are described in U.S. Patent No. 4,705,038 to Sjostrom et al .; Patent No. 4,995,877 to Ams et al .; U.S. No. 5,249,583 to Mallaba; U.S. Patent No. 5,395,033 to Byrne et al .; U.S. Patent No. 5,467,911 to Tsuruta et al .; U.S. Patent Nos. 5,383,880, 5, 518,163, 5, 518,164 and 5,779,130 to Hooven et al .; and U.S. Patent No. 5,653,374 to Young et al .; U.S. Patent No. 5,779,130 to Alesi et al .; and U.S. Patent No. 5,954,259 to Viola et al.

One type of surgical apparatus apparatus is a straight stapling apparatus, which is a guillotine-type apparatus that is used to cut and staple a section of tissue. Fig. 1 a illustrates an example of said apparatus as set forth in U.S. Patent No. 3, 494,533. The apparatus illustrated in fig. 1 a includes opposing jaws that move in parallel correspondence with one another. A first jaw has a staple configuration while the second jaw provides an anvil to receive and close the staples. A staple pusher is located within the first jaw and extends from a proximal end of the first jaw to a distal end of the first jaw. A drive shaft coupled to the first jaw and the staple pusher is located in the plane of movement of the first jaw and the staple pusher. When activated, the drive shaft moves the staple pusher to simultaneously push all the staples against the staple guides on the anvil of the second jaw. Other examples of surgical devices are described in U.S. Pat. No. 4, 442,964, U.S. No. 4,671,445 and U.S No. 5,413,267. Said surgical staplers include opposed jaws which move in parallel correspondence with each other, wherein the first jaw has a configuration of staples while the second jaw causes the anvil to receive the staples and close them. A staple pusher is located within the first jaw and extends from the proximal end of the first jaw to the distal end of the first jaw. A drive shaft, coupled to the first jaw and the staple pusher, is located in the plane of movement of the first jaw and the staple pusher and when activated, the shaft drives the staple pusher to simultaneously push all the staples against the staple guides on the anvil of the second jaw.

Another type of surgical apparatus is a stapling, stapling and linear clamping apparatus, such as that described in U.S. Patent No. 6,264,087. Said apparatus can be used in a surgical procedure to resect a cancerous or abnormal tissue from a gastrointestinal tract. A conventional surgical cutting apparatus, stapled in the form of a linear clamp, is illustrated in a perspective of FIG. 1 B. the apparatus includes a gun-shaped portion having an elongated shaft and a distal portion. The distal portion includes a pair of scissor-type fasteners, which hold the open ends of the closed colon. Together with these two scissor-like fastening elements, the anvil portion moves or rotates relative to the general structure. The activation of this device in the form of a scissor, that is, the rotation of the anvil portion is controlled by the trigger handle configured in the handle. In addition to the scissor apparatus, the distal portion includes a stapling mechanism. The fixed holding member of the scissor mechanism includes a staple cartridge that receives the region and a mechanism for moving the staples through the fastened portion of the tissue against the anvil portion in this manner, sealing the open end previously. The scissor elements can be formed in one piece with the shaft or can be disconnected as such to exchange several stapling or scissors elements.

Generally, these surgical devices are used in the following way: by identifying the cancerous or anomalous tissue in the gastrointestinal tract (and by determining that the cinchonaceous tissue is located in a position in the colon) the patient's abdomen is initially opened to expose the intestines. The surgeon cuts the colon tube on both sides of the cancerous tissue and staples the two open ends of the intestine (one distal end that goes to the anus, and the near end that is closest to the small intestine). This temporary closure is done to minimize the risk of contamination of the abdomen exposed by the contents of the intestines. In particular, this temporary closure of the two open ends of the intestine is achieved when the colon is placed between the jaws of the surgical apparatus. By activating the first movement mechanism, the surgeon causes the jaws to join. A second mechanism is activated to move a series of staples and a knife or scalpel through the stapled end of the colon, thereby closing and cutting the ends transversely. This procedure is typically repeated a second time at the other end of the cancerous or abnormal tissue. One problem with the aforementioned surgical devices is that the devices can be difficult to maneuver. Because these devices are employed within a patient's body, the apparatus must be configured to be maneuverable within a patient's body. Conventional surgical devices. As illustrated in Figures 1 a and 1 b, it is difficult to maneuver especially within the patient's body.

Another problem with the aforementioned surgical apparatuses is that the apparatuses can not be placed satisfactorily inside the patient's body. For example, when the conventional apparatus is used to close, cut and staple a section of tissue immediately adjacent to an anal stump, it may be desirable to place the apparatus and grasp, cut and staple a section of tissue as close as possible to the anus - however, conventional appliances may not be able to be placed so close to the anus because the jaws of the surgical apparatus when in the open position require a large space and this prevents a satisfactory placement within the patient's body and anus. .

The present invention according to an example of the inclusion thereof, relates to a surgical apparatus. The surgical apparatus includes a first jaw. The surgical apparatus also includes a second jaw that moves in relation to the first jaw between a first position, wherein the first and second jaws are aligned within a plane, and a second position wherein the second jaw is in correspondence not parallel with the plane. In this way, the second jaw moves, for example, in a hinge or swivel in relation to the first jaw between a closed position and an open position. For example, during an operation, the second jaw can move within the plane when the second jaw moves from a first distance relative to the first jaw and can be partially moved out of the plane for example it can rotate, while the second jaw moves at a second distance relative to the first jaw. The surgical apparatus may include a first motor configured to cause a relative movement of the first jaw and the second jaw, the first motor configured to engage with the rotary motor shaft about a rotation axis configured either in parallel or non-parallel ie , perpendicular, in correspondence with a plane. The surgical apparatus may include a surgical member ie a Cutting and / or stapling member, disposed within the first jaw, a second motor configured to cause a relative movement of a surgical member in a direction parallel to the plane. The second motor can be configured to be coupled to a second rotating motor shaft on the axis of rotation configured either in parallel or non-parallel ie, perpendicular correspondence with the plane. An electromechanical motor can be used to rotate the first rotating shaft, such that the first rotating shaft is rotated in a first direction to extend the jaws and rotated in a second direction opposite the first direction to close the jaws. In an inclusion, the first motor includes at least one straight gear and a helical gear to rotate in relation to one another and an external ring screw fixedly connected to the end of the helical gear and in engagement with a hole with internal rings of the second jaw, the rotation of the gears causes the relative movement of the first and second jaw.

In addition, the electromechanical motor can be used to rotate a second rotating shaft, such that the second rotating shaft is rotated in a first direction to extend the surgical member and rotated in a second direction opposite the first direction to retract the surgical member. . In one inclusion, the second driver.

In an inclusion, the hole with internal rings of the second jaw is disposed within an arm, the arm is configured to move longitudinally within and in relation to a sleeve connected to the first jaw, the sleeve and the arm have a configuration of cams that is configured to move the second jaw between the first and second positions. The cam configuration may include a channel disposed along at least one arm and sleeve, a bearing arranged within the channel. The present invention according to an example of inclusion, relates to a surgical apparatus that includes a first jaw and a second jaw. The second jaw engages and moves relative to the first jaw between a closed position and an intermediate open position. Between the closed position and the intermediate open position, the clamping surfaces of the first and second jaws define a first and second planes that remain in parallel correspondence in relation to one another. In addition, the second jaw moves in relation to the first jaw between the intermediate position of open and a total position of open. Between the intermediate open position and the fully open position, the first and second planes defined by the clamping surfaces of the first and second jaws move out of parallel correspondence in relation to one another. In fact, between the intermediate open position and the fully open position, the second jaw can be rotated in relation to the first jaw on an axis in a perpendicular plane. In the closed position, the first jaw and the second jaw can be configured in a third plane, and a first driver configured to cause a relative movement of the first jaw and the second jaw can be configured to engage with the first rotational axis that it can rotate on the axis of rotation in a parallel and non-parallel correspondence with the third plane. The surgical apparatus may include a surgical member for example cutting and / or stapling or a push plate to which the cutting and / or stapling element is mounted, the surgical member is disposed within the first jaw wherein the second The impeller is configured to cause a relative movement of the surgical member in a direction parallel to the third plane. The second motor is coupled to a second drive shaft rotating on the axis of rotation in a parallel and non-parallel correspondence with the third plane. An electromechanical motor can be used to rotate the first and second rotary axes.

BRIEF DESCRIPTION OF THE ILLUSTRATIONS Fig. 1 a is a side view of a conventional surgical apparatus; Fig. 1 b is a perspective of a conventional stapler, cutter and clamp apparatus; Fig. 2 is a perspective view of an electromechanical surgical system according to an example of inclusion of the present invention; Fig. 3 is a perspective view of a cutting and stapling attachment according to an example of including the present invention in the open position; Fig. 4 is a side view of the cutting and stapling attachment illustrated in FIG. 3 in closed position; Fig. 5 is a side view of the cutting and stapling attachment illustrated in FIG. 3 and 4 that has a surgical element in a retracted position; Fig. 6 is a side view of the cutting and stapling attachment illustrated in Figures 3 and 5 having surgical elements in the extended position; Fig. 7 is a top view of a cutting and stapling attachment illustrated in Figures 3 and 4; Fig. 8 a is an enlargement of a cartridge configuration for staples according to an inclusion example of the present invention; Fig. 8 b is an enlargement of a push plate component according to another embodiment of the present invention; Fig. 8 c is an enlargement of an anvil component according to an inclusion example of the present invention; Fig. 8 d is an enlargement of a side plate component, according to another example of inclusion of the present invention; Fig. 8 e is a partially enlarged view of a cutting and stapling attachment according to another example of inclusion of the present invention; Fig. 9 is an assembled perspective of the cutting and stapling attachment illustrated in FIGS. 8 a to 8 e in the open position; Fig. 10 is a side elevational view, partly in section of the flexible axis of the electromechanical surgical apparatus illustrated in FIG. 2; Fig. 11 to a cross-half view of the flexible shaft taken along lines 11-11 shown in FIG. 10; Fig. 12 is a rear view of the first coupling of the flexible shaft illustrated in FIG. 10; Fig. 13 is a front view of the second flexible shaft coupling illustrated in FIG. 10; Fig. 14 is a schematic of the configuration of the motor of the surgical electromechanical system illustrated in FIG. 2; Fig. 15 is a schematic of an electromechanical surgical system illustrated in FIG. 2; Fig. 16e is a schematic of a flexible shaft encoder illustrated in FIG. 10; Fig. 17 is a schematic of a memory apparatus of a surgical fastening, cutting and stapling apparatus according to an example of the present invention; Fig. 18 is a schematic of a remote control unit of the surgical electromechanical system illustrated in FIG. 2; and Fig. 19 is a schematic of a remote control unit of the electromechanical surgical system illustrated in FIG. 2. Figures 20 a-c are various views of the cutting and stapling attachment according to an inclusion of the present invention.

DETAILED DESCRIPTION An example of an inclusion of the surgical apparatus 11 according to the present invention is illustrated in Figures 3 to 7. With reference to Figures 3 and 4, an example of inclusion of the surgical apparatus 11 for example the holding apparatus is illustrated, cut and stapled. In this inclusion example, the surgical apparatus 11 includes a second jaw 50 movable relative to the first jaw 80. A first end 50 a of the second jaw 50 is mechanically coupled to the first end 80 a of the first jaw 80.

Figure 3 is a perspective illustrating the surgical apparatus 11 in the open position, wherein the second jaw 50 and the first jaw 80 are in contact with each other at their first end 50 a and 80 a. in the open position, the first jaw 80 is maintained in the longitudinal plane defined by x and y axis illustrated in figure 3, while the second jaw 50 moves, that is to say it is rotated at least partially out of the longitudinal plane defined by the x and y axis. Specifically, the surgical apparatus 11 is configured such that in addition to the second jaw 50 that moves vertically relative to the first jaw 80, the distal end 50 b of the second jaw 50 moves in and out of alignment with the end distal 80 b of the first jaw 80 b.

Mounted on the side of the first jaw 80 a is a notch for gears 255. The gear notch 255 includes a first drive socket 180 coupled to a first driver 150 which for illustrative purposes is illustrated schematically. The first driver 150 engages a first end 50a of the second jaw 50 to open and close the first jaw 80 and the second jaw 50. In addition the gear notch 255 also includes a second drive socket 310.

Fig. 4 illustrates the surgical apparatus 11 in the closed position. In the closed position, the second jaw 50 in the first jaw 80 are in contact with each other at their first ends 50 a and 80 a and also at the second end 50 a and 50 b. in this way, between the open and closed positions illustrated in Figures 3 and 4, respectively, the distal end 50 b of the second jaw 50 moves in alignment with the distal end 80 b of the first jaw 80 b. in the closed position, a tissue section can be clamped between the second jaw 50 and the first jaw 80. Figures 5 and 6 also illustrate the surgical apparatus 11 in the closed position. Figures 5 and 6 illustrate the second drive socket 310 of the meshing notch 255 coupled to a second driver 261 that is illustrated as a schematic. The second pusher 261 is coupled to a surgical member 262. The surgical member 262 may include a cut-and-staple configuration 262 although other types of surgical members may be provided. The second impeller 261 is coupled to a cutting and stapling configuration 262 to move the cutting and stapling configuration 262 from a first retracted position as illustrated in Figure 5, to a second extended position as illustrated in Figure 6. While the two drive sockets, i.e. the first drive socket 180 and the second drive socket 310, and two corresponding axes, i.e. the first drive shaft 630 and the second drive shaft 632 (see below) are illustrated, it is possible to provide an adequate number of drive sockets and drive shafts. For example, a single drive shaft can be provided to move the surgical apparatus.

Fig. 7 is a top view of the surgical apparatus 11 illustrated in Figures 3 to 6. Figure 7 illustrates the surgical apparatus 11 permanently attached or removed to an electromechanical drive component 610. Figure 7 illustrates the surgical apparatus 11 including the first impeller 150 which is coupled via the first drive socket 180 to a first motor 680 of the system 610 by a first drive shaft 630. The first driver 150 when coupled by the system 610, operates to open and close the first relative jaw 80 second jaw 50. In addition, Figure 7 illustrates the surgical apparatus 11 including a second driver 261 which is coupled via the second drive socket 310 to a second motor 676 of the system 610 by a second drive shaft 632. The second driver 261 when coupled to the system 610, the cut-and-staple configuration 262 operates. As illustrated in FIG. 7, the first drive socket 180 and the second socket Push 310 are disposed in the surgical apparatus 11 so that the first drive shaft 630 and the second drive shaft 632 can be coupled to the surgical apparatus 11 at the angle, perpendicular to the plane xy illustrated in FIG. 3. That is, the first drive shaft 630 and the second drive shaft 632 can be coupled to the surgical apparatus 11 in the direction of the Z axis illustrated in FIG. 7. FIGS. 8 a to 8 e are several enlarged views of the surgical apparatus 11 in accordance with a example of inclusion of the present invention, and Figure 9 is a perspective of the armed surgical apparatus. Figure 8 a is an enlarged view of a staple cartridge configuration 507. The staple cartridge configuration 570 includes a staple pusher 514. The staple pusher 514 is connected to a lower surface 5022 of a push plate 502 (FIG. explained below). The staple pusher 514 includes parallel rows 5141 and 5142 of downwardly disposed teeth 5143, each of which corresponds to and is aligned with a staple guide 5053 of the anvil 505 (explained below). A knife 519 having a cutting edge 5191 facing downward and disposed between parallel rows of the downwardly disposed teeth 5143 of the staple pusher 514. The staple holder 513 is located under the staple pusher 514. The fastener staples 513 includes a cartridge having vertically disposed grooves 5132 each corresponding to and aligned with the downward teeth 5143 of the staple pusher 514 and with the staple guides 5053 of the anvil 505. A staple 528 including tips 5281 , is provided in each slot 5132. The staple holder 513 also includes a longitudinally disposed slot 5131, which extends through the staple holder 513 and through which the knife 519 can be passed. The staple holder 513 includes a hole 5133 adjacent one end 5134.

The hole 5133 of the staple holder 513 that is adjacent one end 5134 of the staple holder 513 is configured to receive one end 5181 of a bolt 518. In the inclusion example, the bolt 518 is maintained in a substantially vertical position to be perpendicular to staple holder 513. Bolt 518 includes a centrally disposed hole 5183 at opposite end 5184 configured to receive a spring 524. Also located at end 5184 of bolt 518 is a lever 5181 that is connected perpendicularly to the pin 518. The spring 524 biases the end 5181 of the bolt 518 into an anvil hole 5057 (explained below). A cartridge cover 515 is welded to a staple holder end 5134 513. The bolts 5151 and 5152 and 5153 of the cartridge cover 515 are attached to the openings 5135, 5136, 5137 respectively of the staple holder 513. The cartridge cover 5 15 also includes an internally arranged orifice 5154 that is configured to receive a bolt 518. The hole 5154 of the cartridge cover 515 includes a slot 5153 in communication, the slot 5153 configured to guide the lever 5182 of the bolt 518. example of inclusion the internally disposed hole 5154 of the cartridge cover 515 does not extend through the upper surface 5155 of the cartridge cover 515; instead, it holds the spring 524 within the inner hole 5154. The biasing force of the spring 524 pushes the end 5158 of the bolt 518 into the hole 51 33 of the staple holder 513 and tends to ensure that the staple holder 513 is positioned in position. such that the grooves 5132 align with the downwardly disposed teeth 5143 of the staple pusher 514 and with the staple guides 5053 of the anvil 505. The cartridge cover 515 is also held in place by a cartridge sleeve 526. which covers the staple holder 513. Within the slot 5261 of the sleeve of the staple cartridge 526, a memory unit 5011 is mounted. Figure 8 b is an enlargement of a push plate component 50 31. The plate thrust 5031 includes screws 503 and 504. Both screws 503 and 504 are fixed or engaged by welding to a surface 5021 of the thrust plate 502.

Figure 8 c is an enlarged view of an anvil component 504. According to this inclusion example, the anvil component 504 includes an anvil 505 which is welded to a rotating anvil arm 509. The anvil rotary arm 509 includes an internal vertical orifice with ring 5051 extending longitudinally therethrough. The rotary arm of the anvil 509 also includes a cam configuration ie a channel 5052 on its outer surface. The channel 5052 extends longitudinally along a lower portion of the outer surface of the rotating arm of the anvil 509 and is then bent as illustrated in FIG. 8 ac along the upper portion of the outer surface of the anvil rotating arm. 509. In addition the anvil 505 includes a plurality of staples for guides or guides 5053 in a parallel configuration along a region 5054 of the anvil 505 that is in opposite relationship with the first jaw 80. A knife pad 520 is disposed between a plurality of staple guides 5053.

Figure 8 d is an enlarged view of a component of the side plate 560. The side plate or plate 560 has an upper plate 5601 and a side plate 5602. The upper plate 5601 has a first groove 5603 and a second groove 5604, each of which has a lateral open end. Also, the side plate 5601 has a third slot 5605 that has an open end at the rear. Mounted by welding to a side plate component 560 is a sleeve for rotating arm 570 that has an internal hole 5701 extending therein. A portion of the orifice 5701 is open to form a vertically disposed slot 5702. An inner surface of the orifice 5701 has an opening into which is mounted a portion of the cam configuration ie a cam follower 571 such as a balero Fig. 8 e is a partial enlarged view of the surgical apparatus 11, according to an example of inclusion of the present invention. According to this example of inclusion, the second jaw 50 includes an anvil component 504. The anvil component 504 is shown in Figure 8 e already assembled, in relation to the enlarged view illustrated in Figure 8 c.

The first jaw 80 includes a second side component configuration 506. An outer surface 5062 of the second plate component 506 has a notch configuration for gear assembly 255. The gear notch 255 is mounted to an outer surface 5062 of the second component of side plate 506 via fasteners ie screws 533. A quick coupler 511 is mounted to the gear notch 255 and deflected via a set of springs. The gear notch 255 includes a first drive socket 180 and a second drive socket 310. In this inclusion example, the first drive socket 180 includes a first pinion 508 a (hidden) at one end of which extends through of the opening 2551 of the notch 255 and the other side of which includes a gear of straight teeth. The second drive socket 310 includes a second pinion 508 b (concealed) at one end of which extends through the second opening 2552 of the gear notch 255 and the other end including a coupling end. A memory module 501 designed in the gear slot 255 and includes a connector that extends through or is accessible through an opening in the gear slot 255. The memory module 501 is held in position within the notch of the notch. engage 255 by one shoe inwards and one shoes out. The memory module 501 is deflected in its position by a spring 539. The first and second pinions 508 a and 508 b engage the straight gear 529 a and a coupling element 529 b respectively. The first straight gear 529 a includes an internal hole 5293 (shown in dotted line) which engages without rotation at one end 5231 of the first helical gear 523 a. the coupling element 529 b includes an internal hole 5294 which engages without rotation to an end 5234 of the second helical gear 523 b and which engages without rotation to the coupling end of the second pinion 508 b. as illustrated in figure 8 a, the holes 5293 and 5294, the ends 5231, 5234 and the coupling end of the second pinion 508 b which can be square. It should be understood that the holes 5293, 5294 and the ends 5231 and 5234 and the coupling end of the second pinion can have any shape or configuration that provides a non-rotating coupling therebetween.

In this inclusion example, the first helical gear 523 has an end 5231 that engages without rotation to the inner hole 5293 of the first straight gear 529 a and the second end 5232 which includes a circumferential ring 5233. the second helical gear 523 b it has an end 5234 that engages without rotation with the inner hole 5294 of the coupling element 529 b and a second end 5235 including rings arranged in circumference 5236. The second end 5232 of the first gear 523 a extends through a hole 5607 in the side plate 5602 of the side plate component 560 and the end 5231 of the helical gear 523 a is coupled with the first straight gear 529 a. the second end 5235 of the second helical gear 523 b extends through a hole 5606 in the side plate 5602 of the side plate component 560 and the end 5234 of the helical gear 523 b engages with the coupling element 529 b.

Also disposed in the surgical apparatus 11 is a helical gear configuration 522. The helical gear 522 has teeth disposed in circumference 5221 which engage the rings 5233 of the second end 5232 of the gear 523 a. the helical gear 522 includes an internal hole through which a screw 521 is disposed. The screw 521 has a head 5211 below which a circumferential groove 5222 is formed. The screw 521 engages without rotation to the internal orifice of the gear helical 522. Helical gear 522 and screw 521 can be formed integrally or separately. The head 5211 and the slot 5222 are configured to fit and be retained within the slot 5605 of the side plate component 560. The screw 521 has externally arranged rings 5214 which engage the hole with internal rings 5051 of the rotating arm 509.

A helical gear 516 and a helical gear 517 are disposed within the surgical apparatus 11. The helical gear configuration 516 and helical gear 517 are placed on opposite sides of the helical gear 523 b. specifically, the helical gear 516 includes gear teeth arranged in circumference 5161, which engage a first side of the helical gear 523 b and the helical gear 517 includes teeth arranged in a circumferential shape 5171 which engage the second helical side 523 b. The helical gear 516 includes a head 5162 under which a circumferential groove 5163 is formed. The head 5162 and the slot 5163 are configured to fit and hold within the slot 5606 of the side plate 560, for the configuration to engage helical 516 rotate around its vertical central axis. The helical gear 517 includes a head 5172 under which a circumferential groove 5173 is formed. The head 5172 and the slot 5173 are configured to fit and be retained within the slot 5607 of the side plate component 560 so that the helical gear 517 turn on its vertical central axis. The external ring screw 504 of the thrust plate configuration 5031 (shown in FIG. 8 e as an assembly, actual to the enlarged view illustrated in FIG. 8 b, is disposed through an orifice with internal rings 5164 of the gear. helical 516. The outer ring bolts 503 is disposed through the bore with internal rings 5174 of the helical gear 517. Because the helical gears 516 and 517 are located in and engage on opposite sides of 523 b helix, the holes internal rings 5164 and 5175 of the helical gears 516 and 517 as well as the outer ring screws 504 and 503 can have an opposite ringed in relation to each other In the example of the illustrated embodiment, the internal ring hole 5164 of the helical gear 516 can have a right-side banding that engages with the right external banding hole of screw 505 and the hole with internal ringing 5174 of the gear helical 517 may have a left hand ringed which engages the left external ring of the screw 503. As stated above, both screws 503 and 504 are attached coupled to the upper surface 5021 of the push plate 502.

The staple cartridge configuration 507 is shown assembled in FIG. 8e in relation to the enlarged view illustrated in FIG. 8 a, is arranged such that the staple pusher 514 is located below the lower surface 5022 on the staple plate. push 502. The staple holder 513 is disposed below the staple pusher 514.

To assemble the surgical apparatus 11, the proximal end 5071 of the staple cartridge 507 engages the surfaces 5073 on the sides of the slot 5702 of the rotatable arm 570. The gears are configured between the push plate component 5031 and the top plate 5601 of the side plate component 560 and is held in position in part by its engagement with the slots and openings of the side plate components 560 ie by coupling with the heads ie the head 5162, 5172 and 5211 within the slots 5603, 5604, 5605 of the side plate component 560. The rings 5214 of the screw 521 are coupled with the inner ring hole 5051 of the swivel arm 509. The swivel arm 509 resides within the central hole 5701 of the sleeve rotary arm 570. The cam follower 571 is held within and extends internally within the hole 5071 of the arm of the rotating arm such that the portion of the follower 571 is located within the channel 5052 of the rotating arm 509. The second side plate component 506 is connected by screws 599 to the side plate component 560 such that the gears, the pusher plate component 5031, the cartridge configuration for staples 507 and rotating arm 509 (within rotating sleeve 570) are disposed therebetween. The gear notch 255 is connected to the second side plate component 506 by screws 533.

Figure 9 is a perspective of the fully assembled surgical apparatus 11 in the open position. It should be understood that while the examples of inclusions of the present invention illustrated in Figures 3 and 9 include guillotine-like configurations for the cutting and stapling elements, in another inclusion, the cutting and stapling member moves between the proximal end and the end. distal of the surgical apparatus 11. For example, an alternative example of inclusion of the surgical apparatus 11 may include gears coupled to a stapling and cutting element that moves from a proximal end to a distal end of the surgical apparatus 11, the gears move the movement axes that are coupled in a non-parallel manner, that is to say perpendicular with a correspondence to the plane of movement of the first jaw 80 and of the second jaw 50.

Furthermore, it should be understood that although the example of the inclusions of the present invention illustrated in Figures 3 to 9 include a configuration in which the driving sockets 180, 310 are configured to be coupled with the movement axes 630 and 632, respectively, which are rotatable and rotate on a perpendicular axis, corresponding to the xy plane (see for example figure 3) in another inclusion the surgical apparatus 11 can provide a configuration wherein the impulse sockets 180, 310 are configured to be coupled with the drive axes ie 630, 632 respectively which are rotatable about the axis of rotation and in parallel correspondence with the plane xy. Furthermore, it should be understood that the configuration of cams for rotating the second jaw 50 in relation to the first jaw 80 may have several different configurations. For example, the channel 5052 of the rotating arm 509 may have a different shape than that described above. On the other hand, the present invention can include any configuration of cams to move the second jaw 50 in non-parallel correspondence in relation to the plane defined by the first and second jaws when they are in the closed position.

Still further, it should be understood that the examples of the inclusions of the present invention illustrated in Figures 3 to 9 include a configuration wherein the clamping or clamping surfaces of the first and second jaws define planes that follow in parallel correspondence in relation to one of another during the operation, in another embodiment, the surgical apparatus 11 can provide a configuration wherein the clamping surfaces of the first and second jaw define planes that do not follow in parallel correspondence in relation to one another during the operation. For example in the example inclusion, the surgical apparatus 1 can provide a configuration wherein the first and second jaw are opened and closed at least partially as scissors, the first and second jaws are connected at their proximal ends by a hinge. For example, the surgical apparatus may provide a configuration wherein the second jaw engages and moves relative to the first jaw between a closed position and an intermediate position wherein, between the closed position and the intermediate open position, the surfaces of the first and second jaws define a second plane that follows in parallel correspondence in relation to each other. In addition, the second jaw can be moved relative to the first jaw between the intermediate position open to a fully open position where between the open intermediate position and the fully open position, the first and second planes defined by the clamping surfaces of the first and second jaws move out of the parallel correspondence in relation to one another, ie the first and second jaw move scissor-like between an intermediate position and the fully open position. Said configuration is illustrated for example in figures 20 a-c which are several views of a cutting and stapling configuration according to another embodiment example of the present invention. Specifically, Fig. 20 a is a perspective of an apparatus having said configuration. Fig. 20 b is a cross-section of the apparatus taken from the levator pin.

Still further, it should be understood that although these examples of inclusions of the present invention illustrated in Figures 3 to 9 include a configuration wherein the first and second jaws move at least in rotation during a portion of the operation such as when the second jaw moves out of the plane defined by a first and second jaws when the first and second jaws are completely in closed position, in an example of inclusion, the surgical apparatus 11 can provide a configuration wherein the first and second jaws are not they move at least in relative rotation with each other outside the plane defined by a first and second jaws when the first and second jaws are in completely closed position. For example, in one example of inclusion, the surgical apparatus 11 can provide a configuration wherein the first and second jaws are opened and closed at least partially in the form of scissors, the first and second jaws are connected at their respective proximal ends by a hinge so that the second jaw is held in a plane defined by the first and follow jaws when the second jaw is in closed position. For example, the surgical apparatus can provide a configuration wherein the second jaw engages and can be moved between a closed position and an open intermediate position, the first and second jaws are held within a plane defined by a first and second Jaws when the first and second jaws are in a complete closed position. In addition, the second jaw can be moved further in relation to the first jaw between the intermediate open position to a fully open position where between the intermediate position and the fully open position, the first and second jaws move in the form of scissors while remaining within a plane defined by the first and second jaws when the first and second jaws are in closed position.

According to an example of an inclusion of the present invention, the surgical apparatus 11 can be configured as an abutment or can be an integral part thereof with an electromechanical surgical system, such as the electromechanical drive component 610. In another example, the surgical apparatus it can be an add-on or integral with a mechanical drive system.

Figure 2 is a perspective of an example of inclusion of an electromechanical drive component 610 according to the present invention. Examples of said electromechanical drive system are described in US Patent No. 09 / 723,715, US Patent No. 09 / 836,781 and Patent No. 09 / 887,789 each of which is hereby expressly incorporated herein in its entirety. as a reference to it. The electromechanical drive component 610 may include for example a remote power console 612, which includes a notch 614 having a front panel 615. Mounted on the front panel 615 is a display 616 with indicators 618 a and 618 b. a flexible shaft 620 can extend from the groove 614 and can be disconnected and connected via the first coupling 622. The distal end 624 of the flexible shaft 620 can include a second coupler 626 adapted to be connected and disconnected to the surgical apparatus 11 described above, distal end 624 of flexible shaft 620. Second coupler 626 can also be adapted and disconnected to different surgical devices or instruments. In another inclusion example, distal end 624 of flexible shaft 620 may be permanently connected or integral with the surgical apparatus.

Referring to Figure 10, it can be seen in the side view of the flexible shaft 620. According to an example of another inclusion, the flexible shaft 620 includes a tubular cover 628 which may include a cover or sealing configuration configured to provide a seal against fluids between the interior of channel 640 thereof and the environment. The cover 628 can be formed of a material compatible with the fabrics and elastomeric material. The cover 628 can also be formed of an autoclavable material. Arranged within the interior of the channel 640 of the flexible cover 620 and extending along the entire length thereof can be found a first rotary motor of axis 630 and a second rotary motor shaft 636, a first steering cable 634, a second steering cable 635, a third steering cable 636 and a fourth steering cable 637 and a data transfer cable 638. Figure 11 is a cross-sectional view of the flexible shaft 620 taken along the lines 11-11 illustrated in Figure 10 and illustrating several cables 630, 632, 634, 635, 636, 637 638. Each distal end of the steering cables 634, 635, 636, 637, is fixed to distal end 624 of flexible shaft 620. Each of the various cables 630, 632, 634, 636, 637, 638 may be contained within their respective cover. The first rotating shaft 630 and the second rotary shaft 632 can be configured, for example, as a highly flexible drive shaft, for example twisted or with helical cables. It should be understood that such highly flexible cables may have limited torque characteristics and capacities of the transmission, it should be understood that the surgical apparatus 11 or other devices connected to the flexible shaft 620 may require a higher input of torque than the torque transmitted by the drive shafts 630, 632. The drive shafts 630, 632, can thus be configured to transmit a low torque but at high speed, the high speed / low torque becomes at a low speed / high torque by the gear configurations provided for example at the distal end and / or near end of the flexible shaft 620, in the surgical instrument or abutment and / or remote power console 612. It should be appreciated that said gear configuration can be provided at any suitable location along the power train between the motors disposed in the notch or in clusion 614 and the connected surgical instrument or other connected instrument, a straight gear configuration, a satellite gear configuration, a harmonic gear configuration, a cycloidal gear configuration, a gear configuration of epicycles etc.

Referring now to fig. 12 the first coupling 622 can be seen in the rear view. This first coupling 622 includes a first connector 644, a second connector 648 and a third connector 652 and a fourth connector 656, each secured in a hinge to a first coupling 622. Each one of connectors 644, 648, 652, 656 includes its respective recess or recess 646, 650, 654,658. As illustrated in Figure 12, each recess 646, 650, 654, 658, may have a hexagonal shape. It should be appreciated however that the recesses 646, 650, 654, 658 can have any shape and configuration adapted to be coupled without rotation and connected to rigid connectors 644, 648 652, 656 respectively to drive the shafts of the motor configurations contained within the notch. 612. It should be noted that complementary projections can be provided on the respective axes of the motor configuration to move the drive elements of the flexible shaft 620. It should also be appreciated that the recesses may have drive shaft and complementary projections provided for the Connectors 644, 648, 652,656. Any other coupling configuration configured to free and engage motionless connectors 644, 648,656 and drive shafts of the motor configuration can be provided.

One of the concentres 644,648, 652, 656 is secured without rotation to the first drive shaft 630 and another of the connectors 644, 648, 652,656 is secured without rotation to the second drive shaft 632. The remaining two connectors 644, 648, 652,656 are they engage with the transmission elements configured to apply tension forces on the steering cables 634, 636, 636, 637 to move the distal end 624 of the flexible shaft 620. The data transfer cable 638 is electrically and logically connected to the connector data 660. Data corrector 660 includes for example electrical contacts 662, corresponding to an equal number of individual cables contained within data cable 638. First coupling 622 includes a key structure 642 configured to adequately orient the first coupler 622 to a coupler and complementary configuration disposed at inclusion 612. Said key structure 642 may have one or both of the first coupler 622 and the coupler and the additional coupling configuration disposed in notch 612. The first coupler may include a quick-connect connector, which can be coupled with the first coupler 622 to the notch 612 by a simple pressure movement. Seals are provided along with any of the different connectors 644, 648, 652, 656, 660 to provide an anti-liquid seal between the interior of the first coupler 622 and the environment. Referring now to fig. 13 a second coupler 626 of the flexible shaft 620 is seen from the front view. In the example of inclusion, the second coupler 626 includes a first connector 666 and a second connector 668 each secured to the second coupler 626 and each secured without rotation to a distal end of each of the first and second axes 630, 632. A quick connect frame 664 is provided in the second coupler 626 which may be for example a quick-mount, bayonet-type rotating connector, etc. A key structure 674 is provided in the second coupler 626 and is configured to be properly aligned with the surgical apparatus 11 of the second coupler 626. The key or key structure or other configuration is accommodated to suitably align with the surgical apparatus 11 to the flexible shaft 620 that can be provided in either one or both, the second coupler 626 and the surgical apparatus 11. In addition, the quick connection can be provided in the surgical apparatus 11 as illustrated in Figure 8 e as a quick connect coupler 511 A data connector 670 having electrical contacts 672 is also provided in the second coupler 626. Like the data connector 660 of the first coupler 622, the data connector 670 of the second coupler 626 includes contacts 672 electrically and logically connected to their respective data transfer cable 638 cables and contacts 662 of the data connector 660. Seals can be provided together with the connectors 666, 668, 670 to provide an anti-fluid seal between the interior of the second coupler 626 and the environment. Arranged within the notch 614 of the remote control console 612 are electromechanical drive elements configured to drive the drive shafts 6730, 632 and the yaw cables 634, 635, 636, 637 to operate an electromechanical drive component 610 and the surgical apparatus 11 connected to the second coupler 626. In the example of inclusion illustrated schematically in Figure 14, the five electric motors 676,680, 684, 690, 696 each operated via the power source, can be disposed between the remote control console 612. It should be appreciated, however, that any suitable number of motors can be provided and that the motors operate via batteries, current, DC current, and an electronically controlled source of DC current, etc. It should be noted that the motors can be connected to the DC current which in turn is connected to the current that provides the current for the motors to work.

Figure 14 illustrates a possible configuration of the motors. An output shaft 678 of the first motor 676 engages with the first connector 644, of the first coupler 622 when the first coupler 622 and consequently the flexible shaft 620 engage with the notch 614 to move the first drive shaft 630 and the first connector 666 of the second coupler 626. Similarly, an output shaft 682 of the second motor 680 engages with the second connector 648 of the first coupler 622 when the first coupler 622 and consequently the flexible shaft 620 engage with the notch 614 for moving to the second drive shaft 632 and to the second connector 668 of the second coupler 626. An output shaft 686 of a third motor 684 is coupled to a third connector 652 of the first coupler 622 when the first coupler 622 and consequently the flexible shaft 620 engages the notch 614 to drive the first and second steering cables 634,635 via a first pulley configuration 688. An output shaft 692 of the fourth motor 690 is coupled to a fourth connector 6 56 of the first coupler 622 when the first coupler 622 and consequently the flexible shaft 620 engages with the notch 614 to move the third and fourth yaw cables 636,637 via a second pulley configuration. The third and fourth motor 684,690 can be secured on the cart 1100, which selectively moves via an output shaft 698 and a fifth motor 696 between a first position and a second position to selectively couple and release the third and fourth motor 684, 690 with the respective configuration of pulleys 688, 694 to allow the flexible shaft 620 to stretch and move or loosen if necessary. It should be appreciated that other mechanical, electromechanical and / or electrical mechanisms can be employed PATRA selectively to couple or release the turning mechanism. The motors can be configured as described, for example, in US Patent Application No. 09 / 510,923, entitled A Wagon Configuration for Controlling a Turning Mechanism within a Flexible Shaft "which was entered on February 22, 2000, now issued. as US Patent No. 6,517,565 on February 11, 2003, which is expressly incorporated herein by reference in its entirety It should be appreciated that any of the engines 676,680, 684, 690, 696 may be for example a high speed / low torque motor or a low speed / high torque motor etc. As indicated above, the first rotating shaft 630 and the second rotating shaft 632 can be configured to transmit a high speed and a low Torque Thus, the first motor 676 and the second motor 680 can be configured as high speed / low torque motors.Alternatively, the first motor 676 and the second motor 680 can be configured as low speed / high torque motors with a configuration of gears that increase the speed / and reduce the torque set between the first motor 676 and the second motor 680 and respectively one of the rotating drive shafts 630 and the second axis Rotary drive 632. Said torque reduction / speed increase configurations may include for example a flat gear configuration, a planetary gear configuration, a harmonic gear configuration, a cycloidal gear configuration, an epicyclic gear etc. It should be appreciated that any gear configuration can be arranged within the remote control console 612 at the proximal end of the flexible shaft 620 such that, for example, in the first coupling 622. It should be appreciated, that such gear configuration should having a proximal and distal end of the first rotating shaft 630 and / or the second rotating shaft 632 to prevent it from being rolled or broken.

Referring now to Figure 15, an electromechanical drive component 610 is seen in the scheme. A controller 1122 is provided in the notch 614 of the remote control console 612 and is configured to control all functions and operations of the electromechanical component 610. and the linear clamps, of the cutting and stapling apparatus 11 or other surgical apparatus or attachment attached to the flexible shaft 620. A memory unit 1130 is provided and may include memory devices such as a ROM component 1132, a RAM component 1134, etc. The ROM component 1132 is in electrical and logical communication with the controller 1122 via the line 1138. The RAM component 1134 can include any type of random access memory such as a magnetic memory device, a memory optical device, a device Magnetic optical memory, an electronic memory device etc. Similarly, the ROM component 1132 can include any type of read-only memory, such as a removable memory device, such as a PCMCIA PC memory card. It should be appreciated that the ROM component 1132 and the RAM component 1134 can be configured as a single unit or can be separate units and that the ROM component 1132 and / or the RAM component 1134 can be provided in the form of a PC or PCMCIA card.

The controller 1122 connects to the front panel 615 of the notch 614 and in particular to the display apparatus 616 via line 1154 and indicators 618 a, 618 b via the respective lines 1156, 1158. Lines 116, 118, 1124, 1126, 1128 electrically and logically connected to the controller 1122, to the first, second, third and fifth engines 675, 680, 684, 690, 696 respectively. A wired remote control unit (RCU) 1150 is electrically and logically connected to the controller 1122 via line 1152. A wireless controller RCU 1148 is also provided and communicated via a wireless link 1160 with a receiving / sending unit 1146 connected via line 1144 to transceiver 1140. Transceiver 1140 is electrically and logically connected to controller 1122 via line 1142. Wireless connection 1160 may be for example an optical link, such as infrared rays, a radio link or any other form of wireless communication.

A switch 1186 may include, for example, a configuration of DIP switches that can be connected to the controller 1122 via line 1188. The switch apparatus 1186 can be configured, for example, to select a plurality of languages used to display messages and display it on the screen 616. The messages and notes relate for example to the operation or status of the electromechanical component 610 and / or to the surgical apparatus 1 connected thereto. According to another inclusion example of the present invention, a first encoder 1106 is provided within the second coupler 626 and is configured to an output signal in response to and in accordance with the rotation of the first axis 630. A second encoder 1108 is provided within of the second coupler 626 and is configured to an output signal response in accordance with the rotation of the second drive shaft 632. The output signal by each of the encoders 1106, 1108 can represent the rotational position of the respective axis of rotation 630, 632 as well as the direction of rotation thereof. Said encoders 1106 and 1108 may, for example, include Hall effect apparatuses, optical apparatuses, etc. Although the encoders 1106 1108 are described as being arranged within the second coupling 626, it should be appreciated that the encoders 1106, 1108 can be placed anywhere between the motor system and the surgical apparatus 11. It should be appreciated that by providing encoders 1106, 1108 within the second coupling 626 or at the distal end of the flexible shaft 620, it can provide an accurate determination of the rotation of the shaft. If the encoders 1106, 1108 are disposed at the proximal end of the flexible shaft 620, the winding of the first and second rotary axes 630, 632 may result in an error in the measurements.

Figure 16 is a schematic of an encoder 1106, 1108 that includes a Hall effect apparatus. Mounted on the fine axis of movement 630, 632 is a magnet 1240 which has a north pole 1242 and a south pole 1244. The encoder 1106, 1108 includes a first sensor 1246 and a second sensor 1248, which are arranged approximately 90 ° separation in relation to the longitudinal and rotational axis of the driving axes 630, 632. The output of the sensors 1246, 1248 is persistent and changes its state when the functions change the polarity of the magnetic field in the detection range of the sensor. Thus, based on the output signal of the encoders 1106, 1108, it is possible to determine the angular position of the drive shaft 630, 632 can be determined with a quarter revolution and the direction of rotation of the drive shaft 630, 632. The output of each encoder 1106, 1108 is transmitted via a line respectively 1110, 1112 of the data transfer cable 638 to the controller 1122. The controller 1122, by tracking the angular position and direction of rotation of the drive axes 630, 632 based on the output signal of the encoders 1106, 1108 can determine the position and / or condition of the components of the surgical apparatus connected to the electromechanical component 610. That is, by counting the revolutions of the drive shaft 630, 632, I controller 1122, can determine the position and / or condition of the components of the surgical apparatus connected to the electromechanical component 610. For example, the distance of movement between the first jaw 80 and the second jaw 50 and the push plate 502 are functions of and with certainty, the rotation of each of the drive shafts 630, 632. By discerning the absolute position of the second jaw 50 and the push plate 502 at the time point, the relative displacement of the second jaw 50 and the push plate 502 based on the output signal of the encoders 1106, 1108 and the known movements of the screws 521 and the screws 503 and 504 can be used to assert the position abso lute of the first jaw 80 and the exit plate 502 at all subsequent times. The absolute position of the second jaw 50 and of the push plate 502 can be fixed and asserted at the time when the surgical apparatus 11 engages for the first time with the flexible shaft 620. Alternatively, the position of the second jaw 50 of the push plate 502 relative to for example the first jaw 80 can be determined based on the output signal of the encoders 1 106, 1108. The surgical apparatus 11 can include as shown in Figure 8 a data connector 1272 adapted in size and configuration to logically and electrically connect to the connector 670 of the second coupler 626. In the inclusion example, the data connector 1272 includes contacts in equal number as the number of terminals 672 of the connector 670. The memory module 501 is it is electrically and logically connected to the data connector 1272. The memory module 501 may be in the form of, for example, EEPROM, EPROM, etc. And it can be found, for example, inside the second jaw 50 of the surgical device 11.

Figure 12 illustrates in a scheme the memory module 501. As seen in Figure 17, the data connector 1272 includes the contacts 1276 each electrically and logically connected to the memory module 501 via a respective line 1278. The module memory 501 can be configured to store for example a data serial number 1 180 an apparatus of type data identifier (ID) 1182 and data usage 1184. Memory module 501 can additionally store other information. Both the data serial number 1180 and / or Data ID 1182 can be stored in a read-only section of the memory module 501. In the inclusion example, the data serial number 1180 can be data only to identify a particular surgical apparatus, while the data ID 1182 may be data identifier of the type of connection, as for example in a system 610 where other types of surgical apparatus or connections are connected thereto. The use of data 1184 represents the use of a particular connection, for example, the number of times the first jaw 80 of the surgical apparatus 11 has been opened or closed or the number of times the pusher plate of the surgical apparatus 11 It has moved. The data usage 1184 can be stored in a read / write section of the memory module. It should be appreciated that the device connectable to the distal end 624 of the flexible shaft 620, the surgical apparatus 11 can be designed and configured to be used only once or multiple times. The device can also be designed and configured to be used a predetermined number of times. In the same way, the use of data 1184 can be used to determine if the surgical apparatus 11 has been used and if the number of uses has exceeded the maximum number of allowed uses. As described below in more detail, it is about using a device after the maximum allowed use and this will generate an ERROR condition.

Referring again to Figure 15, controller 1122 is configured to read data ID 1182 from memory module 501 of surgical apparatus 1 when surgical apparatus 11 is initially connected to flexible shaft 620. Memory module 501 is electrically located and logically connected to the controller 1122 via line 1120 of the data transfer cable 638. Based on the reading of ID 1182, the controller 1122 is configured to read or select from the memory unit 1130 an operating program or algorithm corresponding to the type of surgical instrument or device connected to flexible shaft 620. Memory unit 1130 is configured to store operating programs or algorithms for each type of surgical instrument available, controller 1122 selects and / or reads the operating program or algorithm of the unit of memory 1130 according to the data ID 1182 of the reading of the memory module 501 of an apparatus surgical connected to it. As indicated above, the memory unit 1130 can include a ROM 1132 and / or RAM 1134 remove component. Thus, the operating programs or algorithms stored in the memory unit 1130 can be updated, added, erased, improved or revised as necessary. The operating programs or algorithms stored in the memory unit 1130 can be customized based, for example, on the special needs of the user. A data entry device can be connected, for example, a keyboard, a mouse, a pointing device, a touch screen, etc. They can be connected to the memory unit 1130 via, for example, a data connection port, to facilitate the customization of the operating programs or algorithms. Alternatively or additionally, the operating programs or algorithms can be customized in a preprogrammed memory unit 1130 remotely from the electromechanical drive component 610. It should be appreciated, that the data serial number 1180 and the data usage 1184 can be used to determine which plurality of operating systems or algorithms is read or selected from the memory unit 1130. It is worth mentioning that the operating program or algorithm can be stored alternatively in the memory module 501 of the surgical apparatus 1 and transferred to the controller 1122 via the data transfer cable 638. once the appropriate program of operation or algorithm is read or transferred to the controller 1122, the controller 1122 causes the program The operating or algorithm is executed in accordance with the operations performed by the user via the wired RCU 1150 and / or the wireless RCI 1148. As indicated below the controller 1122 is electrically and logically connected to the first, second, third, fourth , and fifth engines 676,680, 684, 690, 696 via the respective lines 1116, 1118, 1 124, 1128, and is configured to control said engines 67 6, 680, 684, 690, 696 according to the reading of the selected program I algorithm via the respective lines 1116, 1118, 1124, 1126, 1128. It should be recognized that the features described above and operation with respect to the memory unit 501 can be applied to the memory unit 5011, for example figure 8 a corresponding to the staple cartridge configuration 507.

Referring now to fig. 18, a schematic of the wireless RCI 1148 is seen. The wireless RCU 1148 includes a motion or steering controller 1300 which has a plurality of switches 1302, 1304, 1306, 1308 configured under a four-way rocking chair 1310. The operation of the switches 1302, 1304, via the rocking chair 1310 controls the operation of the first and second turn wires 634, 635 via a third motor 684. Similarly, the operation of the switches 1306, 1308, via the rocking chair 1310, controls the operation of the third and fourth turn cables 636, 637 via the fourth motor 692. It should be noted that the rocking chair 1310, and the switches 1302, 1304, 1306, 1308 are configured so that the operation of the switches 1302, 1304 rotates to the flexible shaft 620 in a north / south direction and that the operation of the switches 1306, 1308 turns the flexible axis 62 ° in an east / west direction. The references from north to east and west are made in relation to the coordinate system. Alternatively, a digital joystick, analog etc. may be provided in place of the rocking chair 1310 and the switches 1302, 1034, 1306, 1308. A potentiometer or any other type of activator may be used in place of the switches 1302, 1304, 1306, 1308.

The wireless RCU 1148 includes a turn-on or release coupling switch 1312, the operation of which controls the operation of the fifth motor 696 to selectively couple and uncouple from the turning mechanism. The wireless RCU 1148 also includes a two-way oscillator 1314 that has a first and second switches 1316, 1318 that are operated from it. The operation of these switches 1316, 1318 controls certain functions of the electromechanical drive component 610 and any surgical instrument or attachment such as the surgical apparatus 1 1 connected to the flexible shaft 620 according to the operating programs or algorithms corresponding to the connected device 11. example, the operation of the two-way oscillator 1314 can be to control the opening and closing of the first jaw 80 and the second jaw 50 of the surgical apparatus 11. the wireless RCU 1148 has another switch 1320, the operation of which controls the operation of the electromechanical drive component 610 and the apparatus 11 connected to the flexible shaft 620 according to the operating program or algorithm corresponding to the connected device. For example, the switch operation 1320 can initiate movement of the push plate 502 of the surgical apparatus 11.

The wireless RCU 1148 includes a controller 1322, which is electrically and logically connected with the switches 1302, 1304, 1306, 1308 via line 1324, with switches 1316, 1318 via line 1326 with switch 1312 via line 1328 and switch 1320 with line 1330. the wireless RCU 1148 may include indicators 618 to '618 b', corresponding to the indicators 618 a, 618 b of the front panel 615 and the display apparatus 616 ', corresponding to the display apparatus 616 of the front panel 615. if the indicators 618 'a, 618 b' are logically and electronically connected to controller 1322 via respective lines 1332, 1334 and screen 616 'is logically and electronically connected to controller 1322 via line 1336. Controller 1322 is logically and electronically connected to transceiver 1338 via line 1340, and transceiver 1338 is logically and electrically connected to receiver / transmitter 1324 via a line 1344. A power source for example a battery can be provided with wireless RCU 1148 to give power or current to the same. Thus, the wireless RCU 1148 can be used to control the operation of the electromechanical component 610 and the apparatus 11 connected to the flexible shaft 620 via the wireless connection 1160. The wireless RCU 1148 can include a switch 1346 connected to the controller 1322 via the line 1348. The operation of switch 1346 transmits the data signal to receiver / transmitter 1146 via wireless connection 1160. The data signal is used by controller 1122 to prevent unauthorized operation of electromechanical motor 610 by another wireless RCU. Each subsequent communication between the wireless RCU 1148 and the electromechanical surgical apparatus 610 may include the identification of data. A) Yes, the controller 1122 can discriminate between the wireless RCU and allow a single wireless RCU 1148 to control the operation of the electromechanical component 610 and the apparatus 11 connected to the flexible shaft 620.

Based on the positions of the components of the apparatus connected to the flexible shaft 620, as determined in accordance with the output signals of the encoders 1106, 1108, the controller 1122 can selectively activate or deactivate the functions of the electromechanical component 610 as defined by the operating program or algorithm corresponding to the connected device. For example, the surgical apparatus 11, the firing function controlled by the switch 1320 is deactivated unless the space between the second jaw 50 and the first jaw 80 is determined within the acceptable range.

Referring now to Figure 19, it is seen in this scheme that the wired RCU 1150. In the inclusion example, the wired RCU 1 150 includes the same control elements as the wireless RCU 1148 and a further description is omitted. Similar elements are indicated in Figure 19. It should be noted that the functions of the electromechanical component 610 and the apparatus connected to the flexible shaft, ie the surgical apparatus 11, can be controlled by the wired RCU 1150 and / or another type of RCU 1148. In the case of battery failure, for example, in the wireless RCU 1148, the wired RCU 1150 can be used to control the functions of electromechanical component 610 and the apparatus connected to the flexible shaft 620.

As described above, the front panel 615 of the notch 614 includes a display 616 and indicators 618 a, 618 b, the apparatus 616 may include an alphanumeric display apparatus such as an LCD screen. The apparatus or display 616 may include an audio output apparatus, such as a horn, or bell etc. The screen 616 is operated and controlled by the controller 1122 according to the operating program or algorithm corresponding to the apparatus connected to the flexible shaft 620 ie the surgical apparatus 11. If no surgical device is connected a failure algorithm can be selected. or transmitting by the controller 1122 to control the operation of the display 616 as well as other aspects and functions of the electromechanical component 610. If the surgical apparatus 11 is connected to the flexible shaft 620, the display 616 may show, for example, data indicative of the gap between the second jaw 50 and the first jaw 80 as determined according to the output signal of the coders 1106, 1 108 and as described below.

Similarly the indicators 618 a, 618 b are operated and controlled by the controller 1122 according to the operating program or algorithm corresponding to the apparatus 11, connected to the flexible shaft 620 ie the surgical apparatus 11. The indicator 618 a / or the indicator 618 b as an LED screen, a lamp, a light etc. If the surgical apparatus 11 is connected to the flexible shaft 620, the indicator 618 a may indicate for example, that the electromechanical component 610 is on and the indicator 618 b may be for example to indicate whether the gap between the second jaw 50 and the First jaw 80 is determined within the acceptable range. It should be noted that although two indicators 618 a and 618 b are described, any additional number of indicators can be used as necessary. Additionally, it should be appreciated that although the single screen apparatus 616 is described, additional displays may be employed when necessary.

The display 616 'and the indicators 618a', 618 b 'of the wired RCU 1150 and the display 616"of the indicators 618 a", and 618 b "of the wireless RCU 1148 are similarly operated and controlled by the controller 1322, 1322 'according to the operation program and algorithm of the apparatus connected to flexible shaft 620.

As described above, the surgical apparatus 11 can be configured to hold, cut and staple a section of tissue. The operation of the surgical apparatus 11 will now be described in connection with the removal of a section of cancerous or anomalous tissue that is merely a type of operation that can be performed using the apparatus 11. Generally in operationAfter the cancerous or anomalous tissue in the gastrointestinal tract has been localized, the patient's abdomen is initially opened to expose the viscera. In accordance with the remote activation provided by the electromechanical apparatus 610, the first and second jaws 50, 80 of the surgical apparatus 11 are moved to the open position by the first motor. As described above, the surgical apparatus 11 can be initially held in the open position eliminating the need to move the apparatus in the open position. The intestine tube on the side adjacent to the cancerous tissue is positioned adjacent to the first jaw 80. The second jaw 50 is then rotated in the position illustrated for example in Figure 9. By remote activation the first motor is coupled in reverse and the second jaw 50 moves towards the first jaw 80. Initially, the second jaw 50 moves while being rotated to the position until when the jaws are between the open and closed positions, the second jaw 50 rotates to align with the jaw. the first jaw 80. Once the jaws are vertically aligned in relation to one another, the first and second jaws move toward each other until the first jaw 80 closes over the second jaw 50 holding the bowel section between the jaws. same. Once the intestine section has been sufficiently supported, the second motor engages which causes the holding plate (which has the staple pusher and the knife mounted thereon) to move between a first position as it is illustrated in figure 5 and the second position as illustrated in figure 6, when cutting and stapling the intestine. The second motor engages in reverse which causes the staple pusher and knife to move back to the first position as illustrated in FIG. 5. The first motor engages with the first driver of the jaw 80 and the second one. jaw 50 of the surgical apparatus 11 towards the open position. These steps are repeated on the other side of the cancerous tissue, thus removing the section of intestine that contains the cancerous tissue that is stapled at each end to prevent the contents of the intestines from being watered in the open abdomen.

Specifically, according to an example of inclusion of the present invention, the surgical apparatus 11 is coupled to the connector 626 of the electromechanical motor 610 in such a way that the ticket of the motor 180 is coupled to the first motor shaft 630 of the electromechanical component 610 and the second motor socket 310 is coupled with second motor shaft 632 of electromechanical component 610. Thus, rotation of pinion 508 a (hidden) is realized by rotation of first movement socket 180 which is affected by shaft rotation 630 of the electromechanical component 610. The rotation of the pinion clockwise or counter-clockwise 508a is achieved depending on the direction of rotation of the motor 680. The rotation of the pinion 508 b (hidden) is performed by the rotation of the second socket 310 which is affected by the rotation of the corresponding axis 632 of the electromechanical component 610. The rotation in the direction of the hands those of the watch or against by the pinion 508 b is achieved depending on the direction of the motor 676.

When the surgical apparatus 11 is in the initial open position in Figure 4, the first motor 680 is operated in order to be able to place the surgical apparatus in the open position. Specifically, the first motor 680 corresponding to the first drive shaft 630 is activated, which couples to the first motor of the socket 180 causing the pinion 508 a to turn to a first direction in the clockwise direction. Since the teeth arranged in circumference of the pinion 509 a engage with the teeth disposed in circumference 5291 of the straight gear 529 a, the pinion rotation 508 a causes the straight gear to rotate e first clockwise in the opposite direction to the rotation of the pinion 508 a. the inner hole 5293 of the first straight gear 529 a is coupled to the end 5231 of the first worm 523 a to cause the first worm 523 to rotate in the same direction as the first gear 529 a ie clockwise. The ring or rings 5233 of the worm 523 a engage with the teeth of the gear 5221 of the helical gear 522 to cause the rotation of the helical gear 522 in first an opposite direction to the clock hand when viewed from above. The internal bore of the helical gear 522 engages without rotation with the screw 521 causing the screw 521 to rotate first in the opposite direction to the clock hand when viewed from above. The externally arranged rings 5214 of the screw 521 engage with the rings of the inner hole 5051 of the rotary arm 509 in this manner causing the rotary arm 509 and the anvil connected thereto 505 to move downwards ie away from the first jaw 80. When the cam follower 571 within the movement arm or sleeve engages with the curved portion of the channel 5052 of the rotating arm, the rotating arm 509, the anvil 505 connected thereto, moves in alignment with the first jaw 8u0. The continuous operation of the motor in this manner eventually places the surgical apparatus 11 in the open position, providing space between the first jaw 80 and the second jaw 50 as illustrated in Figure 3.

Then a section of tissue is placed in the first jaw 80 and the second jaw 50. The first 680 motor is operated in reverse to be able to place the surgical apparatus in the closed position.

Specifically, the first motor 680 corresponding to the first axis 630 is activated, which engages the first drive socket 180 which in turn causes the pinion 508 to rotate to a second direction of rotation in a clockwise direction. Since the circular meshing teeth of the pinion 508 a engage with the circumferential teeth 5291 of the straight gear 529 a, the rotation of the pinion 508 a causes the straight gear 529 to rotate in a second direction counter-clockwise. clock which is the opposite direction of rotation of the pinion 508 a. the internal hole 5293 of the first straight gear 529 a engages with the end 5231 of the first helical gear 523 a such that rotation of the first straight gear 529 a causes the first helical gear 523 to rotate in the same direction of the first gear straight 529 a that is in the opposite direction to the clock. The rings 5233 of the helical gear 523 a engage with the teeth of the helical gear 5221 of the helical gear 522, such that the first gear rotation 523 a causes rotation of the helical gear 522 in a second direction clockwise viewed from above. The internal bore of the helical gear 522 engages the screw 521 so that the rotation of the helical gear 522 causes the screws 521 to turn to a second clockwise position when viewed from above. The outer rings 5214 of the screw 521 engage with the rings of the inner ring hole 5051 of the rotary arm 509 in such a way that rotation of the screw 521 causes the movement arm 509 and the anvil 505 connected thereto to move upwardly towards the first jaw 80. Again, the bearing 571 within the rotating arm 570 engages the cabal 5052 of the rotating arm 509 in such a way that the anvil 505 moves vertically towards the first jaw 80, the rotary arm 509 and the anvil 505 rotate to align with the first jaw 80. The end 5181 of pemo518 is inserted into an anvil hole 5057 of the anvil 505 and held in the inserted position in accordance with the deflection of the spring 524 to maintain the section of tissue between the jaws. The continuous operation of the motor in this manner eventually places the surgical apparatus 11 in the closed position, as illustrated in Figure 4, where the tissue is clamped between the first jaw 80 and the second jaw 50. In the closed state, the The section of fabric to be stapled and cut is held between the staple holder 513 and the anvil 505.

To begin the cutting and stapling process, the second motor 676 is activated to be able to move the push plate 502 from the first, raised, contracted position to a second low, extended position. Specifically, the second motor 676 corresponding to the second axis 632 is activated. The second axis 632 is coupled to the second socket 310 such that rotation of the second axis 632 in a first direction clockwise causes the pinion 508 to rotate in a first clockwise direction. The coupling of the end of the pinion 508 n engages with the internal hole 5294 of the coupling element 529 b such that the rotation of the pinion 508 b causes the coupling element 529 b to rotate in a first direction which is the same direction of the direction of rotation of pinion 508 b. the internal hole 5294 of the coupling element 529 b engages with the end 5234 of the second helical gear 523 b, such that the rotation of the coupling element 529 b causes the second helical gear 523 b to rotate in the same direction of the element coupling 529 n ie clockwise. The rings 5236 of the helicoid 523 b are coupled with the teeth of helical gear 5161 of the helical gear 516 so that the rotation of the second helix 523 b causes rotation of the helical gear 516 in a first direction in the opposite direction to the clock hand when viewed from above. The inner ring rings 5164 of helical gear 516 engage the rings of the screw 504 and the push plate 502 move together in a downward direction. Simultaneously the rings 5236 of the helicoid 523 b engage with the teeth of helical gear 5171 of the helical gear 517 in such a way that the rotation that the rotation of the helicoid 523 b causes the rotation of the helical gear 523b causes the rotation of the helical gear 517 in a first direction counterclockwise seen from above. The rings of the inner bore 5174 of the helical gear 517 are coupled with the rings of the screw 503. Because the screw 503 is coupled without rotation to the thrust plate 502, the screw 503 and the plate 502 move together in a downward direction.

Thus, the push plate 502 is lowered continuously and the staple pusher 514 and the knife 519 which are mounted on the lower surface 5022 of the push plate 502 are also lowered continuously.

When the staple pusher 514 is lowered, the downwardly disposed teeth 5143 of the staple pusher 514 are pushed through the slots 5132 of the staple holder 513. The staples 528, which initially lie within the slots 5132, of the fastener of staples 513, are pushed down and out of the lower openings of the grooves 5132 and through the grasped tissue until the legs 5281 of the staples 528 come into contact with the staple guides 5053 of the anvil 505. The staple guides 5053 fold and close the legs 5281 of the staples 528, in this way stapling the fabric. Simultaneously, the knife 519 mounted to the lower surface 5022 of the push plate 502 passes through the longitudinal slot 5131 of the staple holder 513 until it is in contact with the pad of the knife 520 of the anvil 505 in this way by cutting the tissue fastened Once the cutting and stapling procedure is performed, the second motor 676 is activated, to move the push plate 502 from a second downward position to a first raised position. Specifically, the second motor 676 corresponding to the second drive shaft 632 is activated, which in turn engages with the second drive socket 310. The rotation of the second shaft 632 causes the pinion 508 b to rotate in a second direction in the opposite direction to the hands of the clock. The coupling of the end of the pinion 508 b is coupled with the internal hole 5294 of the coupling element 529 b, such that rotation of the pinion 508 b causes the coupling element 529 b to engage the end 5234 of the second helix 523 b, such that rotation of the coupling element 529 b causes the second helix 523 b Turn in a second direction in the opposite direction of the clock. The rings 5236 of the helicoid 523 b engage with the teeth in circumference of the helical gear 5161 of the helical gear 516 in such a way that the rotation of the helicoid 523 b causes the rotation of the helical gear 516 to be in a second direction in the direction of the hands of the clock seen from above. The inner rings of the hole 5164 of helical gear 516 engage with the rings of the screw 504 and because the screw 504 engages without rotation with the push plate 502, the screw 504 and the coupling plate 502 move upwards . Simultaneously, the rings 5236 of the helicoid 523 b engage with the teeth of the helical gear 5171 of the helical gear 517 in such a way that the rotation of the helicoid 523 b causes the rotation of the helical gear 517 in a second direction in the opposite direction to the hands of the helicoid 517. watch when viewed from above. The rings of the hole with internal rings 5174 of the helical gear 517 are coupled with the rings of the screw 503 and because the screw 503 is coupled with the push plate 502, the screw 503 and the push plate 502 move together in the direction upward. Thus, the push plate 502 is raised continuously and the staple pusher 514 and the knife 519 that are mounted on the lower surface 5022 of the push plate 502 also rise continuously to their initial contracted positions.

Having performed the cutting and stapling operation of the tissue and returned the knife 510 to its retracted position, the first motor 680 is activated to place the surgical apparatus in the open position. Specifically, the first motor 680 corresponding to the first drive shaft 630 is activated. The first shaft 630 engages with the first drive socket 180 such that rotation of the first shaft 630 causes the pinion 508 to rotate in a first direction of rotation in a counter-clockwise direction. The gear teeth of the pinion 508 a engage with the gear teeth 5291 of the straight gear 529 a such that rotation of the pinion 508 a causes the straight gear 529 a to engage the end 5231 of the first helix 523 a, in such a way that the rotation of the first straight gear 529 a causes the first helicoid 523 to rotate in the same direction as the first straight gear 529 a in the clockwise direction. The helical gear rings 5233 engage the helical gear teeth 5221 of the helical gear 522, so that the rotation of the helical gear 523 a causes the rotation of the helical gear 522 in a first counterclockwise direction seen from above. The internal bore of the helical gear 522 engages with the screw 521 such that rotation of the helical gear 522 causes the screw 521 to rotate in a first direction counterclockwise when viewed from above. The externally arranged rings 5214 of the screw 521 engage with the inner rings of the hole 5051 of the rotary arm 509 in such a way that the rotation of the screw 521 causes the rotation arm 509 and the anvil 505 connected thereto to move in the direction descending is said to be away from the first jaw 80 and to rotate out of alignment with the first jaw 80. Thus, the second jaw 50 is separated from the first jaw 80 until the surgical apparatus 11 is again in the open position as illustrated in FIG. Figure 3 Hereinafter, the surgical apparatus 11 can be separated from the electromechanical component and replaced with another surgical apparatus 11 so that the clamping and cutting procedure can be performed on a different section of the tissue such as the opposite side of the cancerous tissue or tissue. anomalous. Once the second end of the intestine is also clamped, cut and stapled, the surgical apparatus 11 can be separated from the electromechanical motor components 610. If necessary, an operator can discard the connections or sterilize them for later use.

It should be noted that prior to the activation of the surgical apparatus 11, a calibration procedure can be performed either manually or automatically. Various calibration methods can be employed which according to various inclusions of the present invention are described in the U.S. Provisional Patent Application. No. 60 / 337,544 filed on December 4, 2001 and the U.S. Patent Application. No. 10 / 309,532 entered on December 4, 2002, which are expressly incorporated in their entirety as references.

According to an example of the illustrated inclusions of the present invention of Figure 8 a to 8 e, the surgical apparatus 11 may be non-refillable in the sense that the staple cartridge configuration 507 or some part thereof is to say the fastener of staples 513 may not be removed from the surgical apparatus 11 by the operator to refill the surgical apparatus 11 with a subsequent loading of staples 523 and reuse the surgical apparatus 11 for the same or another patient and another procedure. Thus, after the surgical apparatus 11 has been activated once to staple a section of tissue using the staples 528 in the staple holder 513, the surgical apparatus 11 can no longer be reactivated to staple another section of tissue using a new one. staple group 528 or a new staple holder 513. When configuring the surgical apparatus to not be rechargeable, the risk of contamination or infection is reduced, since the surgical apparatus 11 can not be intentionally or intentionally re-used in two patients different and can not be used again in the same patient.

However, according to an example of inclusion of the present invention, the surgical apparatus can be rechargeable. For example in this inclusion example, the surgical apparatus 11 may be configured in such a way that certain components can be removed from the surgical apparatus 11 and replaced with respect to the surgical apparatus 1 1. For example, according to the example of a Inclusion, the staple cartridge 507 is connected and disconnected within the surgical apparatus 11 and can be removed from the notch 506 after being used to be replaced with another staple cartridge configuration. The replaceable cartridge can be removed when the upper jaw 80 and the lower jaw 50 are in the fully open position to prevent the cartridge from being removed when the upper jaw 80 and the lower jaw 50 are fastened to a section of tissue that is to be cut and stapled. In an inclusion example the cartridge configuration 507 or some part thereof, for example the staple holder 513 slides in and out of the surgical apparatus 11 such that the user can slide a new staple cartridge 507 or the holder of the staple holder 507. staples 513 having a new staple set 528 within the surgical appliance after the first staple set 528 has been used. Alternatively, when the first set of staples 528 in the staple holder 513 has been used, the operator can replace the staples 528 in the same staple holder 513 and reuse the same staple holder 513. In an example of inclusion, the 518 stud it can be retracted out of the hole 5133 of the staple holder 513 in such a way that the lid of the cartridge 5129 can be removed or connected to the notch 506.

According to another example of inclusion of the present invention, the surgical apparatus 11 has limited loading and recharging ability. For example, the surgical apparatus 11 may be configured to allow the staple holder 513 to be replaced once, for clamping, cutting and stapling to be performed twice in a single patient on opposite sides of a section of cancerous tissue but not allows the staple holder 513 to be replaced more than twice.

In another example of inclusion of the present invention, the surgical apparatus 11 can be configured to hold two sets of staples 528 within the staple holder 513, a first set that is used on one side of a section of cancerous tissue and a second set that it is used for another side of the cancerous tissue section. It should be understood that the surgical apparatus 11 can be configured for various uses and the use is determined in accordance with the usage data 1184. That is, the memory module 501 and / or 5011 can be configured to store data representing the number of times that the surgical apparatus 11 is recharged. Thus, according to the operation program, the electromechanical apparatus 610 can limit the number of times the surgical apparatus 11 is recharged and that it can be triggered according to the usage information stored in the memory module 501 and / or 5011 .

A surgical apparatus 11 that is configured to be rechargeable that can be operated in a manner similar to the non-rechargeable apparatus 11 as described above. However, recharging the surgical apparatus 11 allows the operator to perform additional steps during the operation of the surgical apparatus 11. For example, once the surgical apparatus has been initially placed in the open position, the staple holder 513 can be accessed. by the operator and can be inspected to determine when the staples 528 are ready for the procedure and / or if there is a need to replace the staple holder 513 with a more suitable staple holder 513. Similarly, once the cutting and stapling fastening operation has been performed and the staple set 528 has been employed, the staple holder 513 can be accessed again by the operator to replace the staple holder 513 with another staple holder 513 or inserting another set of staples 528 into the same staple holder 513.

In accordance with the inclusions of the present invention illustrated in FIGS. 8 a through 8 b the surgical apparatus 11 can be configured to operate in more than one operating range. This feature provides the advantage that sections of tissue having a different thickness can be more appropriately accommodated in the surgical apparatus 11. Several examples of such features are described in the U.S. Provisional Patent Application. No. 60/346, 656 filed on January 8, 2002 and in the U.S. patent application. No. 10 / 094,051 filed on March 8, 2002, which is expressly incorporated herein by reference in its entirety.

The surgical apparatus 11 according to several examples of inclusions can be used or used with various operating programs to operate the apparatus 11. Examples of said operating programs are described in the provisional application of US Patent No. 60 / 346,656 entered on the 8th. of January of the 2002 and the Application of patent with number of series 10/094, 051 entered the 8 of March of the 2002 that is incorporated to the present like reference.

A problem with conventional surgery devices is that they can limit the approach angle in which the device is used. As previously described, conventional surgical apparatuses typically employ an axis perpendicular to the section of tissue to be cut or stapled. When the conventional apparatus is employed in the body of a patient, the apparatus is limited to a single approach angle to cut and staple the tissue section.

In contrast, the surgical apparatus 11 may not limit the approach angle to several examples of the inclusions including axes 630 and 632 that engage the first jaw 80 at an angle perpendicular to the plane of movement of the first jaw 80 relative to the second jaw 50. In this way when the surgical apparatus 11 is used within the body of the patient, the apparatus 11 may not be limited to a single approach angle.

In contrast, a variety of approach angles can be employed which allows the operator to more effectively use the surgical apparatus in various sections of tissue.

Another problem with conventional surgery devices is that it can be difficult to maneuver inside the patient's body. For example, when a conventional surgical apparatus is used to hold or staple a section of tissue of poor maneuverability, the surgical apparatus is moved. For example, in case a section of gastrointestinal tissue is located near the anus, the tissue section can not be maneuvered before or during the operation. A conventional apparatus can not be employed in such a location because the angle required by the operator may interfere with the patient's pelvis. Furthermore, conventional apparatuses can not be placed satisfactorily in said place because the jaws of the surgical apparatus when they are in the open position, require a large space and are prevented from being placed by the proximity of the surrounding tissues within the patient's body.

In contrast, the surgical apparatus 11 according to various examples of inclusions may be less difficult to maneuver within the patient's body. For example, in the case of above mentioned gastrointestinal tissue located near the anus, the surgical apparatus 11 can be placed at the end of the final section of the gastrointestinal tissue near the anus. Thus, the perpendicular configuration of the axes 630 and 632 relative to the plane of movement of the first jaw 80 relative to the second jaw 50 can improve the maneuverability of the surgical apparatus 11 within the body of the patient. In addition, the rotating jaw of the present invention reduces the space that is required by the jaws when it is in the open position. When the surgical apparatus 11 of the present invention is in the open position, only the first jaw 80 is placed on the distal end of the surgical apparatus 11, the second jaw 50 is rotated out of alignment with the first jaw 80. Using the example of the surgical procedure of fastening, cutting and stapling a tissue section of In the anal region, the first jaw 80 can be placed closer to the anal region as possible unlike conventional surgical devices because the second jaw 50 is rotated away from the tissue located immediately adjacent to the anus. When the surgical apparatus moves within the closed position, the second jaw gradually rotates to align with the first jaw 80. When the second jaw 50 aligns with the first jaw 80 the space required by the two jaws is less than that required When the two jaws are aligned, they are completely open. In this way, the surgical apparatus 11 can provide a better placement within the patient's body.

Thus, the aforementioned objects and advantages of the present invention are obtained more effectively. Those skilled in the art will appreciate the numerous modifications of the inclusions described herein without departing from the spirit and scope of the invention. Although several inclusions have been illustrated in the present invention and disclosed in detail, it should be understood that this invention is not limited in scope and will be determined by the appended claims.

Claims

CLAIMS IT IS CLAIMED: 1. A surgical device that includes: A first jaw; and A second jaw engaged and moving relative to the first jaw between a closed position and an intermediate open position within the plane, the second jaw moving relative to a first jaw between an intermediate position to a position open to a position completely open at least rotating on an axis located within the plane.
2. The apparatus according to claim 1 wherein between the intermediate open position and the fully open position, the second jaw moves relative to the first jaw in a direction parallel to the plane. The apparatus according to claim 2 including a first driver or motor configured to cause relative movement of the first jaw and the second jaw. The apparatus according to claim 2, wherein the first impeller is configured to be coupled to a rotating shaft on the axis of rotation configured in a parallel and non-parallel correspondence with the plane. 5. The apparatus according to claim 1 including: A surgical member disposed within the first jaw; and A second driver configured to cause movement relative to the surgical member in a direction parallel to the plane. The apparatus according to claim 5 wherein the second impeller is configured to engage a second rotary drive shaft on the axis of rotation configured in a non-parallel correspondence with the plane. 7. The apparatus of claim 5 wherein the second driver is configured to engage a second rotary axis on the axis of rotation configured in parallel with the plane. The apparatus of claim 5 wherein the surgical member includes a cutting element, a stapling member and a drive plate to which the cutting element and the stapling element are mounted. The apparatus according to claim 3 including an electromechanical motor configured to rotate to the first rotating shaft. 10. The apparatus of claim 3 wherein the axis of rotation of the first rotating shaft is perpendicular to the plane of the first and second jaw. 11. The apparatus according to claim 3 wherein the first rotating shaft is rotated in a first direction with the effect of extending the jaws and rotating in a second direction opposite to the first direction with the effect or purpose of closing the jaws. 12. The apparatus of claim 2, wherein the first impeller includes at least one straight gear, one helical and one helical gear in mesh and rotation relationship with each other, and one screw with external grooves fixed or connected to one end of the gear. Helical and in coupling with the hole with internal rings of the second jaw, the rotation of the gears cause the relative movement of the first jaw and the second jaw. The apparatus of claim 6 wherein the second rotational axis is rotated in a first direction extending to the surgical member and rotated in a second direction opposite the first direction to retract the surgical member. The apparatus according to claim 5 wherein the second motor includes at least one straight gear and one helicoid in gear and rotate relation to each other with a pair of additional helical gears, each pair of additional helical gears has a central hole with internal rings with a pair of screws with external rings fixedly attached to the surgical member, the rotation of the gears causes relative movement of the surgical member. 15. The apparatus of claim 3 including an electromechanical motor including the first rotatable shaft adapted to move the first and second rotary axes adapted to the second motor. 16. The apparatus of claim 12, wherein the internal hole of the second jaw is located within the arm., the arm configured to move longitudinally in and in relation to the sleeve connected to the first jaw, the sleeve and the arm has a cam configuration that is configured to move the second jaw between the first and second positions. The apparatus of claim 16 wherein the cam configuration includes a channel disposed along at least one of the arms and is marked by a cam follower disposed within the channel. 18. A surgical device that includes: A first rotary drive shaft on the axis of rotation; A first jaw; A second jaw coupled to the first jaw, the second jaw moves relative to the first jaw by rotation of the first drive shaft between a closed position to an intermediate position within a plane, the second jaw moves relative to the first jaw between an open intermediate position and a fully open position at least rotating on the axis located within the plane. 19. The apparatus according to claim 18 wherein between the intermediate open position and the fully open position, the second jaw moves relative to the first jaw in a direction parallel with the plane. 20. The apparatus of claim 19 including a first motor configured to cause relative movement of the first jaw and the second jaw. 21. The apparatus according to claim 19 wherein the first motor is configured to mate with the first axis, the axis of rotation is configured in a parallel and non-parallel correspondence with the plane. 22. The apparatus according to claim 18 which includes: A surgical member disposed in the first jaw and; A second impeller configured to cause the relative movement of the surgical member in a direction parallel with the plane. 23. The apparatus according to claim 22 wherein the second motor is configured to be coupled to a second rotary axis on the axis of rotation configured in non-parallel correspondence with the plane. 24. The apparatus according to claim 22 wherein the second motor is configured to engage a second rotating shaft on the axis of rotation configured in a parallel correspondence with the plane. 25. The apparatus according to claim 22 wherein the surgical member includes a cutting member, a stapling member and a pushing plate to which the cutting element and a stapling element are mounted. 26. The apparatus according to claim 18 which includes an electromechanical motor configured to rotate with the first rotating shaft. 27. The apparatus according to claim 18, wherein the axis of rotation of the first rotating shaft is perpendicular to the plane of the first and second jaws. The apparatus according to claim 18 wherein the first rotating shaft is rotated in a first direction to extend the jaws and rotate them in a second direction opposite the first direction to close the jaws. 29. The apparatus according to claim 19, wherein the first impeller includes at least one straight gear and a helicoid, a helical gear in relation to gear and rotation with each other, and a screw with external rings fixed and connected in a end of the helical gear and in coupling with a hole with internal rings of the second jaw, the rotation of the gears causes the relative movement of the first jaw and the second jaw. 30. the apparatus of claim 22 wherein the second rotating shaft is rotated in a first direction to extend the surgical member and rotate it in a second direction opposite the first direction to retract the surgical member. The apparatus according to claim 22, wherein the second impeller includes at least one pair of straight gears, one helicoid in relation to one another of gear and rotation and one pair of additional helical gears each of these additional helical gears has an internal hole in coupling with a pair of screws with external rings fixedly connected to the surgical member, the rotation of the gears causes relative movement of the surgical member. 32. The apparatus according to claim 19 which includes an electromechanical motor that includes a first rotary shaft adapted to move the first motor and a second rotary shaft to move a second motor. 33. The apparatus according to claim 31 wherein the internal hole of the second jaw is disposed within the arm the arm configured to move longitudinally in and in relation to the sleeve connected to the first jaw, the sleeve and the arm has a cam configuration that is configured to move to the second jaw between the first and second positions. 34. The apparatus according to claim 33 wherein the cam configuration includes a channel disposed along at least one arm and the sleeve, a cam follower disposed within the channel. 35. A method to operate the surgical apparatus that includes steps of: Move a second jaw in relation to the first jaw between a closed position and an intermediate position within the plane; and Moving the second jaw in relation to the first jaw between the intermediate open position and a fully open position at least rotational about the axis located within the plane. 36. The method according to claim 35 which includes the step of rotating the first axis about the axis of rotation, the first axis of rotation configured to move the second jaw between the closed position and intermediate open position and a fully open position. 37. The method according to claim 36 which includes the step of: Turn a second drive shaft; and Moving the surgical apparatus disposed within the first jaw in a direction parallel to the plane and in accordance with the rotation of the second rotary axis. 38. The method of claim 37 wherein the surgical member includes at least one cutting element and a stapling element. 39. The method according to claim 36 wherein the first rotating shaft is rotated by the electromechanical motor. 40. The method according to claim 36 wherein the second rotating shaft is rotated by an electromechanical motor. 41. The method according to claim 36 wherein the first and second jaws include a cam configuration, the method includes the step of engaging the cam configuration when the first and second jaws are moved between the first and second potions. 42. The method according to claim 41 wherein the cam configuration includes a channel arranged along at least one arm and the sleeve, the cam follower disposed within the channel. 43. A surgical device that includes: A first jaw; and A second jaw coupled and movable relative to the first jaw between a closed position to an intermediate open position, wherein between the closed position and the intermediate open position, the clamping or holding surfaces of the first and second jaws define a first and second planes that remain parallel in relation to each other, the second jaw moves relative to the second jaw from an intermediate position of openO to a complete open position between an intermediate position of open to a full position of open, the first and second planes defined by the clamp surfaces of the first and second jaws are moved out of parallel correspondence in relation to one another. 44. The apparatus of claim 43 wherein the closed position of the first jaw and the second jaw are configured in a third plane. 45. The apparatus of claim 44 wherein between the intermediate open position and the fully open position, the second jaw is rotated in relation to the first jaw on an axis perpendicular to a third plane. 46. The apparatus according to claim 45 including a first motor configured to cause relative movement of the first jaw and the second jaw. 47. The apparatus of claim 46 wherein the first motor is configured to engage a first rotary axis that is rotatable about the axis of rotation configured in a parallel and non-parallel correspondence to a third plane. 48. The apparatus according to claim 44 which includes: A surgical member disposed within the first jaw; and A second configured motor that causes relative movement of the surgical member in a direction parallel to the third plane. 49. The apparatus according to claim 48 wherein the second motor is configured to be coupled to a rotating shaft that rotates about the axis of rotation configured in a parallel and non-parallel correspondence of the third plane. 50. The apparatus according to claim 48 wherein the surgical member includes at least one cutting element, a stapling member and a pushing plate to which a cutting element and a stapling element is mounted. 51. The apparatus according to claim 47 including an electromechanical motor configured to rotate a first rotating shaft. The apparatus according to claim 49 including an electromechanical motor configured to rotate the second rotating shaft.