MXPA06008663A - Surgical instrument with an articulating shaft locking mechanism - Google Patents

Abstract

A surgical instrument particularly suited to endoscopic use articulates an end effector by including a laterally sliding member in a proximal portion of a shaft that pivots the end effector to a selected side. Differentially opposing actuating forces (e.g., hydraulic, fluidic, mechanical) act against the laterally sliding member without binding by incorporating guidance mechanisms between the laterally sliding member and a frame of the shaft. A locking member advantageously unlocks automatically as articulation is commanded by resists backdriving of the mechanism.

Description

SURGICAL INSTRUMENT WITH A ARTICULATED BODY SECURITY MECHANISM CROSS REFERENCE TO RELATED REQUESTS The present invention claims the benefit of the U.S. Patent Application. commonly owned, Serial No. 11/061, 908, entitled "SURGICAL INSTRUMENT THAT INCORPORATES AN ARTICULATION MECHANISM CONTROLLED BY FLUID TRANSFER" by Kenneth Waies and Chad Boudreaux, filed on February 18, 2005, the description of which is it is incorporated herein by reference in its entirety.

FIELD OF THE INVENTION The present invention relates in general to surgical instruments that are suitable for endoscopically inserting an end effector (e.g., endocuchillas, handles, blades, staplers, tweezer applicators, access devices, a device for the delivery of a drug / therapy gene, and a device with energy that uses ultrasound, RF, laser, etc.), to a surgical site, and more particularly with such surgical instruments with an articulated body.

BACKGROUND OF THE INVENTION Endoscopic surgical instruments are often preferred over traditional open surgical devices since a smaller incision tends to reduce recovery time and postoperative complications. Accordingly, significant development has been made in a range of endoscopic surgical instruments that are suitable for the precise placement of a distal end effector at a desired surgical site, through a trocar cannula. These distal end effectors hold the tissue in various ways, to achieve a diagnostic or therapeutic effect (e.g., endocuchillas, handles, blades, staplers, tweezer applicators, access devices, a device for the delivery of a drug / therapy gene, and a device with energy that uses ultrasound, RF, laser, etc.). The positioning of the end effector is restricted by the trocar. Generally, these endoscopic surgical instruments include a long body between the end effector and a handle portion manipulated by the clinician. This long body allows insertion to a desired depth and rotation about the longitudinal axis of the body, thereby placing the end effector to a degree. With the sensible placement of the trocar and the use of handles, for example, through another trocar, this amount of positioning is often sufficient. The surgical instruments for stapling and cutting, such as those described in the U.S. Patent. No. 5,465,895, are an example of an endoscopic surgical instrument that successfully positions an end effector by insertion and rotation. Depending on the nature of the operation, it may be desirable to further adjust the positioning of the end effector of an endoscopic surgical instrument. In particular, it is often desirable to orient the end effector to an axis transverse to the longitudinal axis of the instrument body. The transverse movement of the end effector relative to the body of the instrument is conventionally referred to as "articulation". This is typically accomplished by a pivot joint (or joint), which is placed on the extended body just proximal to the staple fitting assembly. This allows the surgeon to articulate the assembly that applies a staple remotely to either side for better surgical placement of the staple lines and easier manipulation and orientation of the tissue. This articulated positioning allows the clinician to more easily hold the tissue in some cases, such as behind an organ. Furthermore, the articulated positioning advantageously allows an endoscope to be positioned behind the end effector without being blocked by the body of the instrument. The procedures for articulating a surgical instrument for stapling and cutting tend to be complicated by the joint control of the joint, together with the end effector closure control to hold the tissue and trigger the end effector (i.e., staple and cut), within the small diameter constraints of an endoscopic instrument. Generally, the three control movements are all transferred through the body as longitudinal translations. For example, the Patent of E.U.A. No. 5,673,840, discloses an articulation mechanism similar to an accordion ("flexible neck") which is articulated by selectively pulling one of the two connecting rods through the body of the implement, each rod deflecting respectively the opposite sides of the center line of the body. The connecting rods are ratcheted through a series of discrete positions. Another example of the longitudinal control of an articulation mechanism is the U.S. Patent. No. 5,865,361, which includes a hinge connection diverted from a pivot driven with cams so that the longitudinal thrust or traction translation of the hinge connection effects the hinge towards a respective side. Similarly, the U.S. Patent. No. 5,797,537, discloses a similar rod that passes through the body to effect articulation. In the patent of E.U.A. No. 5,673,841, certain deficiencies were recognized for the articulated surgical instruments known then, for the stapling, cutting, application of fasteners and endo-surgical fastening. Specifically, when the articulated surgical instruments are loaded, the articulated head of the instrument tends to move. This movement is usually a combination of the deflection of a part of the part and the slope (or recoil) in the articulation mechanism. The high loads of the distal tip of the instrument (for example, tissue clamping and staple firing) are reflected through the articulation device in the control of the joint near the handle and can move (or rotate) the mechanism of control of the joint. In the past, articulation joints were designed with the articulation device that performed a double function as the means to position and secure the articulated head of the instrument. An examination of the application points of the force (tip of the instrument) and the articulation device (near the joint of the joint) reveals a mechanical disadvantage for the articulated device. This disadvantage manifests itself as an amplification of the tolerances or spaces in the articulated device, resulting in significant movements of the head. In response to this recognized deficiency, several assurance mechanisms were proposed. In particular, an assurance mechanism secures a head at an articulation angle at all times, except when it is desired to articulate the head with respect to the body. Upon actuation of the articulation device, for example, by pulling an articulation band toward the proximal end of the instrument, the securing mechanism is released, releasing the head and allowing articulation thereof. The interruption of the articulation step, for example, by stopping the tee forces in the articulation band, causes the securing mechanism to reattach, securing the head of the instrument at its new articulation angle. In another version, a pair of fluid chambers on each side allow the fluid flow to change from side to side to allow the head to rotate with a camera clamp that blocks fluid flow to "secure" the pivot pivot. Although the joint band effectively achieves articulation and unlocks the joint joint simultaneously, it is believed that in certain applications a direct link between the control and the articulation joint may be desirable. Achieving proper dimening of the bands without slippage or breaking can be coered difficult. A degree of slope in the tactile response given by the control of the joint may also be undesirable. In consecuense, there is a significant need for an articulated joint of a surgical instrument that is directly connected to a joint control that advantageously incorporates the automatic securing of the joint of the joint to withstand feedback from the end effector.

BRIEF DESCRIPTION OF THE INVENTION The invention overcomes the deficiencies indicated above and others of the prior art, by providing a surgical instrument whose elongated body is rotatably articulated in response to an articulation connection mechanism. The inadvertent change in this articulation angle and / or the damage of the articulated connection mechanism is prevented by an articulation joint lock that resists the backfeed of the end effector. Therefore, the connection mechanism of the hinge can have, in a desired manner, a small cross section. In one aspect of the invention, a surgical instrument has a control of the joint that a user operates to cause the rotation of an end effector around the joint of an elongated body. In particular, an articulation member extends a distal end of the elongate body in engagement with the end effector, laterally flexed in response to control of the joint to effect articulation. In cooperation with this movement, an securing actuator is pulled proximally from the joint of the joint, uncoupling from a surface that breaks the formation of the arc attached to the end effector and which radiates proximally about an axis of articulation of the joint. joint. Therefore, direct control of joint control is aided by a joint lock that maintains the end effector at a selected joint angle, without having to increase the size and resistance of the joint control, to resist such backload. In another aspect of the invention, a surgical instrument incorporates a joint of the joint that is controlled by the lateral movement of a slide bar in an elongated body. A proximally directed engaging segment attached to the end effector and aligned about a hinge axis of the hinge joint engages a support directed distally on the slide bar. A securing member in the elongate body also moves longitudinally and distally in engagement with the engagement segment to secure the articulation joint in position. Therefore, several advantages provided by the differential movement of a slide bar to effect articulation are realized, such as various forms of motive power, making sure to maintain a desired articulation angle by means of the joint lock. In yet another aspect of the invention, a surgical instrument has an articulated body that is controlled by a slide bar received for lateral movement on the elongated shaft. A securing mechanism attached to the slide bar is advantageously moved in engagement with the elongate body in response to the feedback force on the end effector. These and other objects and advantages of the present invention will become apparent from the accompanying drawings and the description thereof.

BRIEF DESCRIPTION OF THE FIGURES The accompanying drawings, which are incorporated in, and constitute a part of this specification, illustrate the embodiments of the invention, and together with the general description of the invention given above, and the detailed description of the embodiments given below, serve to explain the principles of the present invention. Figure 1 is a front top perspective view of a surgical instrument for stapling and cutting shown with an open end effector, or an assembly that applies the staples, and with the staple cartridge removed. Figure 2 is a front top perspective view of the surgical instrument for stapling and cutting of Figure 1, with an articulation mechanism driven by a fluidic drive control. Figure 3 is a disassembled perspective view of an elongated body and the articulation mechanism of the surgical instrument for stapling and cutting of Figure 1. Figure 4 is a disassembled perspective view of the distal portions of a portion of the implement of the instrument surgical for stapling and cutting of Figure 1, including the assembly that applies the staples and the articulation mechanism. Figure 5 is a top perspective view of the assembly applying the staples of Figure 1 and 4 with the side half of a staple cartridge removed to expose the driven components by a firing movement. Figure 6 is a front perspective view of an implement portion of the surgical instrument of Figure 1, with a double pivot closure sleeve assembly and the end effector removed to expose a ground to the single pivot, articulated frame by a mechanism of fluidic articulation. Figure 7 is a detailed perspective view of an alternating articulated joint for the surgical instrument of Figure 1, which describes a double-pivot closure sleeve mounting assembly in a proximal position with a ground to the single pivot frame. Figure 8 is an exploded bottom right perspective view of the alternating joint of Figure 7, including a thickened thin-walled connection with a double pivot and a ground to the frame incorporating rail guides for a lateral mobile member (FIG. bar T). Figure 9 is an exploded view in upper left perspective of an additional alternating joint joint for the surgical instrument of Figure 1, including an alternate solid wall support plate mechanism, incorporated in a lower connection with double pivot to support a firing bar and includes a laterally moving member guided with a rail (bar T). Figure 10 is a schematic top view of an alternate joint locking mechanism for the surgical instrument of Figure 1, with the closure sleeve assembly removed to expose a retro-loosely decoupled T-bar, for automatic engagement and disengagement of the lock of the joint. Figure 11 is a schematic top view of an additional alternating joint mechanism for the surgical instrument of Figure 1, a spring-loaded bracket on a T-bar with locking features that engage due to the backloading of an end effector . Figure 12 is an alternate T-bar and a ground to the frame incorporating the lateral guide for the surgical instrument of Figure 1. Figure 13 is yet another additional alternating T-bar and a ground to the frame incorporating the lateral guide for the instrument Figure 1 is a disassembled perspective top left view of an alternating articulation mechanism including a double pivot frame assembly and a single pivot closure sleeve assembly for the surgical instrument of the Figure 1. Figure 15 is a lower left perspective view of the alternating articulation mechanism of Figure 14. Figure 16 is a diagram of a laterally moving fluidic articulation mechanism, with a support and a rotating gear segment, described in a non-articulated state. Figure 17 is a front elevational cross-sectional view of the fluidic articulation mechanism of Figure 16, taken along lines 17-17. Figure 18 is a diagram of the fluidic articulation mechanism moving laterally, with a support and a rotating gear segment described in an articulated condition.

Figure 19 is a front elevational cross-sectional view of the fluidic articulation mechanism of Figure 18, taken along lines 19-19. Figure 20 is a schematic top view of a surgical instrument articulated by at least one longitudinally moving member that laterally drives a sliding bar, which in turn, articulates an end effector. Figure 21 is a top schematic view of the surgical instrument of Figure 20 in an articulated state. Figure 22 is a front elevational cross-sectional view of an alternating rotating mechanical control system for a surgical instrument of Figures 16 or 20, for laterally translating, respectively, a T-bar or a slide bar , described in a disjointed state. Figure 23 is a front elevational cross-sectional view in elevation of the reciprocating, rotating mechanical connection control system of Figure 22, in an articulated state. Figure 24 depicts an exploded perspective view of an alternate lateral joint control mechanism for the mechanical control system of the alternating rotating connection of Figure 22. Figure 25 describes a front elevational view in section of the control mechanism of the lateral joint of Figure 24.

Figure 26 describes a detailed view of an assurance block in a coupled state of the lateral articulation control mechanism of Figure 24. Figure 27 describes a detailed view of the lateral articulation control mechanism of Figure 24. in a decoupled state.

DETAILED DESCRIPTION OF THE INVENTION Generalities of the articulated body Returning to the Drawings, where similar numbers denote similar components throughout the various views, Figure 1 depicts a surgical instrument, which, in the illustrative versions is more particularly a surgical instrument for stapling and cutting. , which is capable of practicing the unique benefits of the present invention. In particular, the surgical instrument for stapling and cutting 10 is sized for insertion, in a disarticulated state, as described in Figure 1, through a passage from a cannula of a trocar to a surgical site in a patient (not shown), to perform a surgical procedure. Once the portion of the implement 12 is inserted through the passageway of the cannula, an articulation mechanism 14 incorporated in a distal portion of an elongate body 16 of the portion of the implement 12 can be remotely articulated as described in FIG. Figure 2, by a control of the articulation 18. An end effector, described in the illustrative version as a mounting that applies the staples 20, is attached distally to the articulation mechanism 14. Thus, the remote articulation of the articulation mechanism 14, therefore articulates the assembly that applies the staples 20 from a longitudinal axis of the elongated body 16. Such an angled position can have advantages in approaching the tissue from a desired angle to cut and staple, approaching tissue otherwise obstructed by other organs and tissue and / or allow an endoscope to be placed behind and align with the assembly applying the staples 20 to confirm placement.

Handle The surgical and stapling and cutting instrument 10 includes a handle portion 22, positioned proximal to the implement portion 12 to provide placement, articulation, closure and firing movements thereto. The handle portion 22 includes a gun handle 24 towards which a lock trigger 26 is rotatably and proximally pulled by the clinician to cause the clamping or closing of the mounting that engages the staples 20. A trigger trigger 28 is further towards the outside of the closing trigger 26 and is rotatably pulled by the clinician to cause the stapling and cutting of the tissue held in the assembly that applies the staples 20. Subsequently, a release button of the closure 30 is depressed to release the subject locking trigger 26, and therefore, the cut and stapled ends of the subject tissue. The handle portion 22 also includes a rotation knob 32 engaged for movement with the elongate body 16 to rotate the body 16 and the articulated assembly that engages the staples 20 about the longitudinal axis of the body 16. The handle portion 22 also includes a trigger retraction handle 34 to assist in retracting a trigger mechanism (not described in Figures 1-2) if the lock occurs, so that the opening of the mounting that engages the staples 20 may occur later. It will be appreciated that the terms "proximal" and "distal" are used herein with reference to a clinician holding a handle of an instrument. Thus, the surgical assembly for stapling 20 is distal with respect to the most proximal handle portion 22. It will further be appreciated that for convenience and clarity, spatial terms such as "vertical" and "horizontal" are used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and those terms should not claim to be limiting and absolute. A multi-run handle portion 22 illustrative for the surgical instrument for stapling and cutting 10 of Figures 1-2 is described in greater detail in the U.S. patent application. co-owned and possessed commonly entitled "SURGICAL INSTRUMENT FOR ENGRAPING THAT INCORPORATES A MULTI-RUNNING POINT POSITION INDICATOR AND A RETRACTION MECHANISM", by Swayze and Shelton IV, Serial No. 10 / 674,026, the description of which is incorporated in the present as a reference in its entirety, with additional features and variations as described herein. Although a multi-run handle portion 22 advantageously supports applications with high firing forces over a long distance, applications consistent with the present invention may incorporate a single firing run, such as described in the US patent application. Commonly owned and possessed "SURGICAL INSTRUMENT FOR ENGRAVING THAT HAS SEPARATE SYSTEMS OTHER THAN CLOSURE AND SHOOTING" by Frederick E. Shelton IV, Michael E. Setser and Brian J. Hemmelgarn, Serial No. 10/441, 632, the description of which is incorporated herein by reference in its entirety.

Attachment portion (articulated elongated body and assembly that applies the staples) In Figures 1-5, the portion of the implement 12 advantageously incorporates the multiple movements of longitudinal rotation, articulation, closure and longitudinal firing drive within a small diameter suitable for endoscopic and laparoscopic procedures. The assembly applying the staples 20 ("end effector") has a pair of rotationally opposed jaws, described as an elongate channel 40 with an anvil 42 rotatably attached (Figures 1-2, 4-5). The closing and securing of the anvil 42 to the elongate channel 40 is achieved by longitudinally supporting the elongated channel 40 with a frame assembly 44 (Figure 3) rotatably attached to the handle portion 22 on which a closure sleeve assembly with double pivot 46 moves longitudinally to impart the respective closure and opening to a movement distal and proximal to the anvil 42, even with the articulated assembly that applies the staples 20 as in Figure 2. With particular reference to Figure 3, the assembly frame 44 includes a ground to the single-pivot frame 48 whose proximal end is coupled to the rotary knob 32, with the right half of the cover 50 therein, shown in Figure 3. It will be appreciated that a proximal end of the closure sleeve assembly 46, specifically a straight closure tube 52, encompasses the proximal end of the ground to the frame 48, and the other end further passing internally to the handle portion 2 2 for coupling the closure components (not shown), which longitudinally move the closure sleeve assembly 46. A circular edge 54 at the proximal end of the straight closure tube 52, provides a rotary coupling for such components. The coupling components of the rotation knob 32 pass through a longitudinal slot 56 in a proximal portion of the straight closure tube 52 to engage an opening 58 positioned proximally in the ground to the frame 48. The longitudinal slot 56 is of a length sufficient to allow longitudinal translation of the closing of the closure sleeve assembly 46 even at various rotational angles, adjusted by the rotation knob 32, the closure sleeve assembly 46 and the ground to the frame 48.

The elongate body 16 supports the firing movement by receiving a firing rod 60 which is rotatably coupled with the firing components of the handle portion 22 (not shown). The firing rod 60 enters a proximal opening 62 along the longitudinal center line of the ground to the frame 48. The distal portion of the ground to the frame 48 includes a groove of the firing bar 64 along its bottom , which communicates with the proximal opening 62. A firing bar 66 is longitudinally translated in the groove of the firing bar 64 and includes an upwardly projecting proximal bolt 68 which engages a distal end 70 of the firing rod 60. The elongate body 16 supports the hinge incorporating a rectangular reservoir cavity 72, a lateral portion described in a distal portion of the rotation knob 32. A bottom compartment 74 that resides within the rectangular reservoir cavity 72, has left baffles and right 76, 78 laterally separated. An articulation actuator 80 slides laterally in the upper part of the bottom compartment 74, its left and right flanges 82, 84 laterally downwardly spaced, which are furthest from the deflectors 76, 78, each of which communicates laterally with the left and right push buttons 86, 88 extending outwardly from the respective halves of the cover of the rotation knob 32. The lateral movement of the joint actuator 80 pulls the left and right flanges 82, 84 closer and farther respectively to the left and right deflectors 76, 78, operating against the left and right reservoir chambers 90, 92 of a fluidic articulation system 94, each chamber 90, 92 communicates respectively distally with the fluid conduits or left and right passages 96, 98, which at their they communicate respectively with the left and right drive chambers 100, 102. The latter rotates in an opposite and lateral manner a bar T 104 of the articulation mechanism 14. The frame assembly 44 restricts these fluidic drives, including an upper and lower recessed board. distal 106 from the ground to the frame 48 in which the fluid passages 96, 98 and the drive chambers 100, 102 reside. The bar T 104 also slidably resides in the recessed board 106 between the drive chambers 100, 102 Proximal to the bar T 104, a raised barrier projection 108 is aligned therewith, which serves to prevent inward expansion of the fluid passages 96, 98. The mounting 44 has a rounded upper frame cover (spacer) 110 that slides over the top of the ground to frame 48, preventing vertical expansion to fluid passages 96, 98 and drive chambers 100, 102 as well as restricting any vertical movement of the bar 104. In particular, the cover of the frame 110 includes features that allow it to also provide a joint locking member 111, described in greater detail below as part of a locking mechanism of the hinge 113. A distal end ("support") 112 of bar T 104 engages to rotate a proximally-directed gear segment 115 of an articulated distal frame member 114 of hinge mechanism 14. An articulated lock tube 116 It encompasses the articulated frame member 14 and includes a horseshoe-shaped opening 118 that engages the anvil 42. A joint is formed with a double pivot ent. The straight closing tube 52 and the articulation closing ring 116 are arranged on the articulation mechanism 14, allowing the longitudinal closing movement even when the articulation mechanism 14 is articulated. In particular, the upper and lower rotary tabs projecting distally 118, 120 in the straight closure tube 52 having bolt holes 122, 124, respectively, are longitudinally spaced from the proximally projecting upper and lower rotary tabs 126, 128, in the joint closing ring 116 having bolt holes 130, 132, respectively. An upper connection with double pivot 134 has distal and rear upwardly directed pins 136, 138 longitudinally spaced apart, which couple the holes 122, 130, respectively, and a lower linkage with double pivot 140 has distal and posterior pins projecting downwardly 142 , 144, longitudinally separated, which couple the bolt holes 132, 124, respectively. A vertical hole for bolt 169 disposed distally through the ground to the frame 48 receives a frame pivot pin 171 that rotates on a lower side of the distal frame member 114. With particular reference to FIG. 4, the joint lock ring 116 is shown to improve manufacturing, to include a short tube 146 attached to a linkage collar of the joint 148 that includes the proximally projecting rotary tabs 126, 128. Similarly, the straight closure tube 52 is mounted to from a long closure tube 150 which is attached to a posterior attachment collar 152 that includes the distally projecting rotary tabs 118, 120. The horseshoe-shaped opening 118 in the short closure tube 146 couples an anvil characteristic which projects upwardly 154 slightly proximal to the side pivot pins 156 which engage the recesses of the pivot 158 within the elongated channel 40. The illustrative version of Figure 4 includes a thickening connection 160 whose proximal pin 157 is rotatably attached to the ground to the frame 48 in a frame bore 161 and whose proximal pin 159 rigidly attaches to a proximal bottom surface 162 of the leg member. articulation frame 114, thereby providing a rotating support between them. A groove of the lower longitudinal blade 163 in the thickening connection 160 guides an articulation portion of the firing bar 66. The articulation frame member 114 also includes a lower longitudinal groove 164 for guiding a distal portion of the firing bar 66 Staple Applying Apparatus (End effector) With reference to Figs. 4-5, the firing bar 66 distally terminates an E-beam 165 which includes upper guide pins 166 which enter an anvil groove 168 in the anvil 42, to verify and help maintain the anvil 42 in a closed state during staple formation and cutting. The spacing between the elongated channel 40 and the anvil 42 is further maintained by the E-beam 165 by having intermediate pins 170 that slide along the upper surface of the elongate channel 40 while a lower base 172 slides in opposite manner. along the lower surface of the elongated channel 40, guided by a longitudinal opening 174 in the elongated channel 40. A cutting surface presented distally 176 of the beam in E 164, which is between the upper guide pins 166 and the intermediate pins 170, cuts the grasped tissue while the E-beam drives a replaceable staple cartridge 178 by distally moving a wedge slide 180 which causes the staple drivers 182 to act upwardly with the cams of the staples 184 out of the holes. for staples 186 open upward in a staple cartridge body 188, forming against a lower surface forming staple 190 of anvil 42. U A tray of the staple cartridge 192, covers from the bottom the other components of the staple cartridge 178 to hold them in place. The tray of the staple cartridge 192 includes a rearwardly open slot 194 which covers the longitudinal opening 174 in the elongate channel 40, thus, the intermediate pins 170 pass within the tray of the cartridge of the staples 192. The assembly that applies the staples 20 is described in greater detail in the US Patent Application co-pending and commonly owned Serial No. 10 / 955,042, "SURGICAL INSTRUMENT FOR ENGRAVING, ARTICULATED, INCORPORATING A TWO PIECE SHAFT MECHANISM", by Frederick E. Shelton IV, et al., filed 30 September 2004, the description of which is incorporated herein as a reference in its entirety.

Joint Lock Mechanism In Figures 3-4 and 6-8, a hinge lock mechanism 200 is advantageously incorporated to maintain the assembly that engages the clips 20 at a desired hinge angle. The articulation lock mechanism 200 reduces the loads in the left and right drive chambers 100, 102. In particular, a compression spring 202 (Figure 3) is positioned proximally between a proximal end 204 of the locking member of the articulation 111 and handle portion 22, diverting joint locking member 111 distally. With particular reference to Figure 4, two parallel grooves 206, 208 at a distal end 210 of the hinge locking member 111, respectively receive projecting guide projections 212, 214 on the ground to the frame 48. The projections guide 212, 214 are longitudinally shorter than parallel slots 206, 208 allowing a range of relative longitudinal displacement. Therefore, with particular reference to Figure 8, a selective abutting engagement of a distal frictional surface, described as a serrated recess 216, projecting distally of the hinge locking member 111, engages the segment of corresponding locking gear 217 in a brake plate 218, received in an upper proximal recess 220 (Figure 4) of the articulation frame member 114. The distal and proximal holes 221, 222 in the brake plate 218, receive the distal bolts and proximal 223, 224, projecting upwards from the upper proximal recess 220. With particular reference to Figure 6, the elongated body 16 is described in an articulated position with the closure sleeve assembly 46 removed from around the frame 44 and without the elongated channel 40 and the anvil 42. The articulator actuator 80 is shown moved laterally to the left, to compress the right proximal reservoir chamber 90 and the expanded distal actuator chamber 100 which moves the rod T 104 towards the position shown. Thus, the lateral movement of the joint actuator 80 articulates the distal frame 114 clockwise around the ground to the single pivot frame 48 as shown above. The articulation actuator 80 advantageously also automatically engages and decouples the hinge locking mechanism 200. In particular, a serrated stop surface 225 along the proximal upper surface of the hinge actuator 80 receives a upwardly projecting locking bolt 226 of the proximal end 204 of the joint locking member 111 (not shown in Figure 6). The engagement of the locking bolt 226 within the root of the toothed stopping surface 225 provides sufficient distal movement of the joint locking member 111 for the locking engagement of the locking gear segment 217 on the brake plate 218. Lateral movement by an operator of the compression member 80 proximally pushes the locking bolt 226, and thus disengages the joint locking member 111 from the brake plate 218. When the operator releases the joint 80 actuator, the bolt blocking 226 is urged by the compression spring 202 into the adjacent detent on the stopping surface 225 to lock the locking mechanism 111, and therefore, the assembly applying the staples 20, restricts the articulation mechanism 14 in a desired articulation position, restricting and expanding the inflated shape of the left and right proximal reservoir chambers 90, 92. Alternating In addition, an orifice may be provided within the parallel fluid conduits 96, 98 to control the flow velocity between the distal drive chambers 100, 102, and the proximal reservoir chambers 90, 92. In Figure 10, a mechanism Alternate block 2000 of a joint mechanism 2002 of a surgical instrument 2004, is unlocked normally and is activated by mounting a T-bar that moves laterally 2006 due to backloading. A slot 2008 is located on the ground to the frame 2010 to receive and guide a projection 2012 extending downward from the bar T 2006. A thin longitudinal section 2014, which is orthogonally attached to the projection 2012 is flexed if an effector of end 2016 will backload. For example, as the end effector 2016 is forced to the right as described by the arrow 2018, for example, its proximal gear segment 2020 acts on a support 2022 of the 2006 T-bar, imparting a non-orthogonal feedback force, As described in the arrow 2024. Thus, the thin longitudinal section 2014 is bent, fitting the projection 2012 into the slot 2008. This assembly produces opposing locking forces, as described by the arrows 2026, 2028, which block the T-bar 2006 and avoid additional articulation. The unlocking occurs when the activation of the articulation chambers dismantles the laterally moving T-bar 2006. Subsequently, the projection 2016 can help guide the T-bar 2006. In Figure 11, another locking mechanism of the articulation 2100 for a surgical instrument 2102, which is normally unlocked and activated by the vector of the proximal force of the twenty (20) degree pressure angle of the teeth of the gear 2104 of an end effector 2106 and the teeth of the support 2108 of a bar T 2110. When the end effector 2106 is backfilled, as described by the non-orthogonal arrow 2112, the longitudinal vector of the pressure angle, described as the arrow 2114, moves the bar T 2110 proximally. This longitudinal force vector is applied to a rigid spring 2118 behind a support 2120 of the T-bar 2110. When the spring 2118 flexes as the T-bar 2110 moves proximally, the locking teeth 2126 projecting proximally from the support 2120 are brought into engagement with the locking elements 2122 projecting distally and aligned laterally on a ground to the frame 2124. The locking teeth 2126 and the locking elements 2126 lock 2122, are decoupled when the vector of the proximal force 2014 is reduced or eliminated, by removing the backfeed of the end effector 2106 and allowing the bar T 2110 to move distally of the spring pulse 2118.

Combination of a double pivot and ground lock sleeve with a single pivot With reference to Figures 3-4 and 7, the portion of the implement 12 advantageously incorporates the closure sleeve assembly with double pivot 46 that moves longitudinally over, and covers a land to the frame with a single pivot 48. These mechanisms and their operation, will now be described in greater detail. With particular reference to Figure 7, the articulation mechanism 14 is described in an articulated condition with the closure sleeve assembly 46 retracted proximally toward an open condition of the anvil. With the open anvil 42 (not shown in Figure 7), the control of the articulation control 18 causes the articulated locking ring 116 to rotate about the distal upwardly directed pin 136 and the distally directed downward pin 142 (not shown). in Figure 7), respectively, of the lower closing connections with double pivot 134, 140. The ground to the frame 48 rotates about a single bolt, described as the pivot pin of frame 171 (Figure 3), which joins the ground to the frame 48 to the distal frame member 114. With the anvil 42 open, the pivot pin of the frame 171 of the ground to the frame 48 is aligned with the most distal position of the joints with upper and lower double pivots 134, 140 of the frame assembly. closing sleeve 46. This positioning allows the easy rotation and rotation of the assembly that applies the staples 20, while the anvil 42 is open. When the closure sleeve assembly 46 moves distally to rotate the closed anvil 42, the straight closure tube 52 moves distally around the ground to the frame 48 and the articulated closure ring 116 moves distally along the axis of the housing. articulated distal frame member 114, driven by pivot connections 134, 140. Double rotary bolts 136, 138 and 142, 144 at connections 134, 140, facilitate coupling with straight sealing tube 52 and sealing ring articulated 116 as they are propelled toward the distal closure position when the device is articulated (not shown). In the distal closure position, the pivot pin of the frame 171 is vertically aligned with the proximal pivot pins 138, 144 in the entire hinge, or they may fall at any point between the distal bolts 136, 142 and the proximal pins 138, 144, while they work effectively.

Solid support of the firing bar In Figure 8, the articulation mechanism 14 of Figure 7 is partially exploded and viewed from the bottom, showing a solid wall firing bar support design (connection with thickening 160 ) of Figure 4 which offers advantages over conventional flexible support plates. The supporting plates are used to join the gap and guide and support the firing bar 66 through a single articulation joint of the pivot from the ground to the frame 1801. The flexible firing rods are known, but the incorporation of the rods solid wall firing devices such as those shown in Figures 4, 8 and 9, offer unique advantages. Referring now to Figure 8, the ground to the frame 48 includes a slot in the frame blade 1802 running along the bottom of the ground to the frame 48 and a slot in the distal blade 164 running along the bottom of the frame. a member of the distal articulation frame 114 for sliding reception of the firing bar 66 (not shown) therein. The ground to the frame 48 is described above and includes a direct connection to a single frame pivot pin 171 with the distal frame member 114. The fixed wall thickening connection 160 which is rotatably connected to the end of the proximal pin 157 and movably connected to the end of the distal pin 159, includes left and right side guides 1818, 1820, which define between them a guide slot 1822 for the sliding passage of a trigger bar 66 (Figure 4). A) Yes, for joining the gap between the ground to the frame 48 and the distal frame member 114, the fixed wall swiveling connection 160 is rotatably connected to the ground to the frame 48 and is slidably attached to the frame member 114. The proximal pin 157 of the swivel connection 160 is rotatably received in a bore 1824 in the ground to the frame 48, allowing the swiveling connection 160 to rotate about a socket 1824. A distal pin 159 extends upwards from the swiveling connection 160, and slidably received in a slot 1826 in the distal frame 114. The joint of the assembly which applies the staples 20 at an angle such as 45 degrees from the longitudinal axis, rotates the connection rotary with thickening 116 in the perforation 1824 in its proximal pin 157 and the distal pin 159 slides in a slot 1826 in the frame member dist 114 to bend a firing bar 66 to two spaced apart angles which are half the angle of the mounting which applies the staples 20. Unlike the flexible support plates previously referred to, which bend the firing bar 66 at an angle of 45 degrees, the rotary connection with fixed wall thickening 160 bends the firing bar 66 at two separate angles, such as 22.5 degrees each. By bending the flexible bar or firing bars 66 at half the angle, it cuts the bending stress on the firing rods 66 to half of that found in the conventional articulation supports. The reduction of the bending stress on the firing rods 66, reduces the possibility of permanently bending or putting a deformation on the firing rods, reduces the possibility of firing jams, ensures lower retraction forces of the firearm, and provides a smoother operation of the firing system. In Figure 9, a surgical instrument 1900 includes a double locking pin. A joint of the single-frame swivel joint 1902 shows an alternate solid wall support plate mechanism 1904, which replaces the lower connection with double pivot 140 and the thickening connection 1812. The supports of the left and right firing rods 1906, 1908, extend upwards from the lower connection with double pivot 1910 of a closing sleeve assembly 1912. The space 1914 is provided in a ground to the frame 1916 so that the shooting supports 1906, 1908 move according to the closure sleeve assembly 1912 moves distally to close the anvil 42 (not shown in Figure 9), and proximally to open the anvil 42. As in the swiveling connection 1812 described above, the lower connection with double pivot 1910 alternates , also folds and supports the firing bar 66 (not shown in Figure 9), creating two separate bending angles, which are up to half the angle of f Mounting the assembly to apply the staples 20.

Guide Mechanisms of the Side Member With additional reference to Figure 9, the left and right flanges 1918, 1920 on the ground to frame 1916, include guides for the distal and proximal side bolts 1921, 1922, 1923, 1924, which pass laterally through the holes 1923, 1924 in a T-bar 1926, helping to minimize bending in a hinge mechanism 1928. These guides for the bolts 1921, 1922, are also incorporated in the ground to the frame 48 of the Figure 7. As another example, in Figure 7, the bar T 104 advantageously includes a lateral dovetail guide 1930 that slides laterally within a dovetail channel 1932 formed therein. As yet another example, in Figure 12, a raised projection 1934 on a ground to the frame 1936, is received within a rectangular slot 1938 formed in a T-bar 1940. To further facilitate lateral translation without locking, the lateral bearing tracks distal and proximal each include a respective plurality of ball bearings 1946, 1948. As yet another example, in Figure 13, a plurality of side slots of frame 1950-1954, are formed in a ground to frame 1956 with slots laterals of the corresponding bar 1958-1962 in a bar T 1964. The sliding rollers 1966-1970, reside trapped within the respective pairs of lateral grooves 1950/1958, 1952/1960, 1954/1962. In no way, this is an exhaustive list of side guide members that prevent unwanted mounting or rotation of the 1964 T-bar.

Combination of the ground to the frame with double pivot and closing with a single pivot In Figures 14-15, a ground mechanism to the frame and alternate closing 2200 includes a surgical instrument 2202 that includes a frame assembly with double pivot 2204. In in particular, a ground to the frame 2206 is connected to the distal frame member 2208 by a thickening connection of the double pivot frame 2210 having a proximal pivot pin 2212 which rotatably couples a proximal hole 2214 in the ground to the frame 2206 and a distal pivot bolt 2216 engaging a distal piercing 2218 of a distal frame member 2208. A guide groove 2220 is located on the underside of the thickening connection 2210 for guiding a firing bar 66 (not shown in the Figures) 14-15) in it. The slot of the blade 2222 is located in the distal frame member 2208. As shown, the hinge of the closure ring 2230 at an angle of forty-five (45) degrees articulates the distal frame member 2208 at an angle of forty-five (45) degrees and articulates the connection with thickening of frame 2210 at half that angle. Accordingly, the firing bar 66 is subjected to the two shallow half-bends that are separated and obtains all the benefits listed above. The outermost sleeve sleeve assembly 2224 is different in that only a pivot shaft of the double pivot design of the frame assembly 2204 accommodates its longitudinal closing movement. As shown, a body of the closure tube 2226 has a fork 2228 at a distal end. The fork 2228 is rotatably coupled with a lock ring 2230. In the lock ring 2230 it has a proximal gear 2232 formed at the distal end. A pin 2234 passes through the proximal gear 2232 and rotatably engages an upper pin 2236 of the fork 2228. A lower arm 2238 engages a lower pin 2240 of the fork 2228 by an aligned pin 2241. The holes 2242 in the fork 2228 , receive the side guide bolts 2243 and slidably join to a T-bar 2244, to engage a proximal gear 2232 of the locking ring 2230. Thus, this alternate mechanism 2200 uses an alternate single pivot / double inverse to the of the mechanism previously described. That is, the alternating locking mechanism has a single pivot and the ground to the alternating frame has a double pivot, unlike the double pivot locking mechanism previously described with a ground to the frame of a single pivot.

Laterally moving articulation mechanism In Figures 16-19, a laterally moving articulation mechanism 230 is described schematically to show the lateral movement that is used to effect the articulation of an end effector 232. The movement side is the movement of at least one element towards or away from the longitudinal axis of a surgical device 234. This movement is generally at right angles to the longitudinal axis, which is a horizontal line that bisects mechanism 230, and does not involve the rotational movement or longitudinal movement. The articulating mechanism that moves laterally can be driven with fluid as shown in Figures 16-19 or mechanically driven as shown in Figures 20-23.

Laterally moving fluid articulation mechanism The laterally moving articulation mechanism 230 is shown schematically in Figures 16-19 and includes a fluid control system 235 having left and right, parallel, filled fluid chambers with fluid 236, 238, extending longitudinally therein, which move a side member or bar T 240 laterally, by the movement of the fluids 242. All directions are with reference to the longitudinal axis. Referring to a disarticulated view of Figures 16 and 17, the distally located end effector 232 rotates about the bolt 244 and has a gear segment 246 at a proximal end. The pivot pin 244 is attached to a frame (not shown). A support 248 at a distal end of the bar T 240 operably couples a segment of the gear 246. The bar T 240 and the support 248 move laterally along the axis A-A. A distal portion of the long body and the left and right fluid chambers 236, 238 is laterally positioned to the laterally moving bar T and is laterally constrained within a closure sleeve 250 and vertically constrained by a frame 252 below. and a spacer 254 above. In particular, the left operating fluid chamber 236 has a left distal drive chamber 256, a left fluid passage 258, and a left proximal reservoir chamber 260. The right fluid chamber 238 has a right distal drive chamber 262 , a right fluid passage 264, and a right proximal reservoir chamber 266. A fixed divider 270 extends from the frame 252 and separates the chambers 260, 266 and the fluid passages 258, 264. The fixed divider 270 and the sleeve closure 250 restricts fluid passages 258, 264 and prevents expansion in the fluid passage sections 258, 264 of chambers 236, 238. A laterally moving "C" shaped compression member 272 is included. in the joint control mechanism 273 for compression of one of the proximal reservoir chambers 260, 266 and the articulation of the end effector 232. In addition, other components may be incorporated s as a firing bar 274 that passes through the groove of firing bar 276 in frame 252 (Figures 17, 19). As shown in Figures 18-19, the lateral movement of the C-shaped compression member 272 to the left compresses the right proximal reservoir chamber 266, driving the fluid 242 into the right fluid passage 264 and into the chamber right distal actuator 262. A right distal actuator chamber 262 moves the bar T 240 laterally to the left, the left distal actuator chamber 256 is compressed and the end effector 232 is hinged to the right (in the counter-clockwise direction). watch as seen from the top, as shown). Compression of the left distal drive chamber 256 causes fluid 242 to flow proximally through the left fixed fluid passage 258 and into the left proximal reservoir chamber 260. In particular, a connected right wall 280 of the C-shaped compression member 272 moves to the left, causing compression of the right proximal reservoir chamber 266. A corresponding leftward movement of the attached left wall 278 of the compression member with C-shape 272, provides space for the fluid from the compressed left reservoir chamber 256 as fluid flows into the expanding proximal reservoir chamber 260. This fluid control system 235 for the articulation mechanism 230, provides the less several advantages. First, the orientation of the actuator chambers 256, 262, proximal to the joint mechanism or joint 230, allows the use of larger chambers 236, 238 and longer T-bars 240 within the surgical device 234. As a fluid-operated system , the increase in the output force of the fluid control system 235 can be achieved in two ways. First, for a fixed fluid area in the T 240 bar, the fluid pressure in the fixed area can be increased. Secondly, for a fixed fluid pressure, the contact area of the fluid in the bar T 240 can be increased. The first method results in a more compact design and higher system pressures. The second method results in a longer design and lower system pressures. To decrease the cost, simplify the design, reduce the efforts of the system and reduce the risk of rupture of the chambers, the illustrative version describes long distal operating chambers 256, 262 in an advantageous position proximal to the articulation mechanism 230 within a body elongate of the surgical device 234. It is this positioning of the chambers 256, 262, which allow the chambers 256, 262 to be long and the articulation output force to be high for a low inlet pressure.

Thus, the output force of the articulation mechanism 230 can be increased (for the same inlet pressure) by simply increasing the pressure contact area of the distal chambers (balloons) 256, 262 in the T-bar 240. The increments of the Contact area of pressure are restricted to height and length. Since the diameter of conventional endoscopic surgical instruments is fixed at certain diameters to pass through the insufflation openings, this limits the change in height. The change in the length of the contact area of the pressure has the greatest effect and allows the lateral output force of the device to be refined advantageously (by changing the length), so that it meets any output force required by the system. The fluids used in a laterally moving device may be compressible or incompressible. As used herein, the term "fluid" comprises liquids, gases, gels, microparticles and any other material that can be made to flow between a pressure gradient. Although any fluid can be used, sterile solutions such as physiological saline, mineral oil or silicone are especially preferred.

Mechanical articulation mechanism that moves laterally While mechanisms with fluid are described above to cause lateral movement and articulation, mechanical mechanisms can achieve a similar lateral movement as produced by fluid chambers 236, 238. In the Figures 20-21, an alternating laterally reciprocating joint mechanism 300, employs a mechanical control system, in particular, a longitudinally moving member, to effect lateral movement and articulation for a surgical instrument 301. In the illustrative version , with particular reference to Figure 20, a laterally moving slide bar 302, has at least a pair of angled left and right cam surfaces 304, 306, extending laterally thereof, on opposite sides of a body elongated longitudinal 308. In the illustrative version, another pair of left and right cam surfaces is also included proximal angled jaws 310, 312. A longitudinally moving right connection 314 includes inwardly directed distal and proximal contralateral surfaces 316, 318, which engage and slidably engage the right proximal and distal cam surfaces 306, 312 , so that the distal longitudinal movement of the movable connection 314 causes the lateral movement to the left of the slide bar 302. It should be noted that this inclined contact can be reversed so that the distal movement causes the respective rightward movement. It should be appreciated that a spring tightening (not shown) can be included in the slide bar 302 to drive the slide bar 302 to the right in engagement with the longitudinally moving right joint 314, so that the proximal movement opposite the longitudinally moving right articulation 314, causes the movement to the left of the slide bar 302. Alternately, in the illustrative version, a longitudinally moving left joint 320 includes inwardly directed distal and proximal inclined surfaces 322, 324, which coincide and slidably engage with the right proximal distal and proximal cam surfaces 304, 310, the latter is tilted distally and the former is tilted proximally, so that the distal longitudinal movement of the left joint that moves longitudinally 320, causes a lateral movement to the right of the bar of des Lizamiento 302. It should be appreciated that this inclined contact can be reversed, so that the proximal movement causes the movement to the left. It should be noted that the right and left connections that move longitudinally 314, 320 and the slide bar 302, are supported within an elongated body 326 that allows this longitudinal movement of the first and the lateral movement of the latter. A distal end of the slide bar 302, described as spherical ball 328, is received within the groove of the V-shaped cam 330 aligned proximally and proximal to the pivot pin 332 of an end effector 334. Thus, in the Figure 21, the proximal movement of the longitudinally moving right connection 314 and the distal movement of the longitudinally moving left joint 320, causes the movement to the right of the slide bar 302 with a corresponding rightward movement of the ball-and-socket joint. 328. Thus, the groove of the V-shaped cam 330 is driven to the right, its distal end 336 rotating to the left. Alternatively, the lateral movement of the slide bar 302 can be converted to the articulation of the end effector 334 by the coupling of the support and the gear described above with respect to Figures 16-19. Thus, mechanical systems using longitudinal movement can be used to provide the lateral articulation for the surgical instrument 301.

Rotary Connection In Figures 22 and 23, an additional alternating joint mechanism 400, utilizes a rotary connection 402 for moving a lateral member, described as a laterally moving sliding bar 404, to cause articulation for a surgical instrument 406. The laterally moving slide bar 404 can be operably coupled with a rotary gear to a cam-driven slot as described above for FIGS. 16 and 20 at a proximal end of an end effector (not shown). The rotary connection 402 can be located below the slide bar 404 with at least one arm 408 extending rotatably transverse to the longitudinal axis thereof, to engage with a receptacle 410 within the slide bar 404. The bar Sliding 404 is vertically constrained between an upper spacer 412 and a lower frame 414, the latter having a longitudinal groove 416 that receives the rotary connection 402 and accommodates the rotation of the arm 408. The spacer 412 and the frame 414 are encompassed by a tubular sleeve 418. The rotation of the rotary connection 402 moves the arm 408 in an arc and thereby moves the slide bar 404 laterally in the direction of rotation.

One-way to one-way control actuator In Figures 24-27 it is desirable to provide an automatic locking feature that resists the feedback of the rotary connection 402. For this purpose, the rotary connection 402 is coupled to a lateral joint control 500 which is described for use with different different articulated joints in a US Patent Application No. 10 / 615,972, copendent and commonly owned, entitled "SURGICAL INSTRUMENT WITH A CONTROL OF THE ARTICULATION THAT MOVES LATERALLY", the description of which is incorporated as a reference in its entirety. The control of the lateral joint 500 can be adapted for use in the control of the joint 18 for an alternating articulated surgical instrument 502, similar to that described for Figures 1-6. In particular, the control of the lateral articulation 500 converts a lateral movement into a rotational movement transferred by an articulation drive tube 504 to an articulation mechanism (not shown in Figures 24-27). The adaptation of this to the control of the aforementioned articulation 18 may include acting as a one-way clutch between two laterally moving surfaces. Returning to Figures 24-27, a downwardly projecting gear holder 506 engages a lower side 508 of an actuator of a side control 510 to engage the longitudinally aligned notches 512 on an upper face of the actuator tube. of the articulation 504. An articulation feedback lock 516 is advantageously incorporated in the control of the lateral joint 500 to avoid a force at the end of the end effector (not described in Figures 24-27) of changing the amount of joint. In particular, interposed between the joint control actuator 510 and the gear holder 506 is a support plate 518 which includes a central opening 520 which contains a flexible X-shaped securing member 522. The actuator of the control of the articulation 510 includes two deflection blades 524, 526 projecting downward into the central opening 520 of the support plate 518 and are respectively placed in a distal quadrant and a proximal one defined by the X 522-shaped belay member with respect to to the top view described in Figures 26-27. The gear holder 506 includes two drive blades 532, 534 projecting upward into the central opening 520 of the support plate 518 and are respectively placed in the left and right quadrants 536538 defined by the securing member in the shape of X 522. The central opening 520 of the support plate 518 is shown as being generally rectangular in shape, but with slanted teeth 540, each having a contact surface 542 oriented towards inside and aligned longitudinally. These inclined teeth 540 are positioned along a right and left portion 544, 546 of a distal edge 548 for the ratchet contact of the right and left distal arms 550, 552 respectively of the X 522-shaped belay member. inclined teeth 540 are also positioned along a right and left portion 554, 556 of a proximal edge 558 of a rectangular window 520, for ratchet contact of the right and left proximal arms 560, 562 of the shaped locking member of X 522. With particular reference to Figure 25, the gear holder 518 is illustrated as being attached to a knob 564 and therefore, does not translate laterally with the joint control actuator 510 or the gear holder 506. The lateral movement of the joint control actuator 510 is transferred through the articulation feedback retractor 516 formed within the rectangular window 520 d the frame of the support 518. In contrast, a retroactivating lateral movement of the articulation drive tube 504 and therefore the gear holder 506 is reacted by the articulation feedback lock 516 in the support frame 518 and on knob 560. Thus, the movement of the articulation drive tube 504 is stopped. In use, as described in Figure 26, the control of the lateral joint 500 is centered. Therefore, a visual indication is given to the clinician by the equally extended right and left ends 566, 568 of the joint control actuator 510. The deflection blades 524, 526 are centered on the X 522-shaped belay member. , which do not exert force on the arms 550, 552, 560, 562, so they are allowed to extend into their uncompressed state in abutting contact with the inclined teeth 540, preventing lateral movement of the X-shaped belay member 522. The driving blades 532, 534 of the gear holder 506 are in opposite contact on each side of the X-shaped securing member 522. Any lateral force transferred from the joint drive tube 504 into the gear holder 506 to through the driving blades 532, 534 it is reacted through the X-shaped securing member 522 in the gear holder 506, preventing movement. In contrast, as described in Figure 27, when a clinician moves the joint control actuator 510 to a lateral side, the deflection blades 524, 526 come into contact with a pair of proximal and distal arms (those of the left 552, 562 in Figure 27) comprising the pair away from contact with the rectangular window 520. Thus, the X 522-shaped belay member is allowed to move in that direction, with the pair of rear arms (e.g., rights 550, 560 in Figure 27) that are joined by ratchet. This lateral movement is allowed to continue until the front arms 552, 562 encounter the lateral extension of the rectangular window 520, as described. The drive blades 532, 534 of the gear holder 506 move with the X-shaped securing member 522 and therefore finally, the end effector (not shown in Figure 27) also articulates in response. Although the present invention has been illustrated by the description of various embodiments and although the illustrative embodiments have been described in considerable detail, it is not the intention of the applicant to restrict or limit in any way the scope of the appended claims to such detail. Additional advantages and modifications can easily appear for those skilled in the art. For example, a single fluid transfer process can be incorporated wherein a single fluid actuator expands and compresses to effect articulation, perhaps aided by an opposed elastic member that is not in fluid or pneumatic communication with the handle. An application consistent with such a design, for example, could include only a camera attached to the T-bar, so that when it is compressed by the extraction of the fluid, it pulls the T-bar with it.

Claims (20)

NOVELTY OF THE INVENTION CLAIMS

1. - A surgical instrument, comprising: a proximal portion configured for external manipulation to a patient; an elongate body attached to the proxmal portion; an end effector; an articulated joint that rotatably connects the end effector to the elongate body; a surface that breaks the formation of the arc attached to the end effector and which radiates proximally about an articulation axis of the articulated joint; a control of the joint attached to the proximal portion; a joint member extending to a distal end of the elongated body in engagement with the end effector, the distal end flexes laterally in response to control of the joint to effect articulation; an assurance actuator guided by the elongate body, coupled proximally to the control of the articulation, which ends distally in a securing surface positioned to selectively couple the securing surface.

2. The surgical instrument according to claim 1, further characterized in that the control of the joint comprises a lateral control, configured in an operative manner to proximally drive the securing actuator out of engagement with the end effector during the movement of the control side.

3. - The surgical instrument according to claim 2, further characterized in that the securing member is distally deviated and wherein the coupling surface comprises a proximal pin, and the lateral engagement segment comprises a toothed surface that camly actuates the pin proximally during actuation, allowing the bolt to move distally at a corresponding tooth root on the serrated surface when control of the joint is stopped.

4. The surgical instrument according to claim 2, further characterized in that the lateral control comprises a differential fluid control.

5. The surgical instrument according to claim 1, further characterized in that it comprises: a slide bar with restricted lateral movement within the elongate body; a distal end of the slide bar is positioned in the articulated joint, and a proximal surface of the end effector is coupled to the distal end of the motion of the joint, to convert the lateral movement of the slide bar to a rotary movement of the effector of end.

6. The surgical instrument according to claim 1, further characterized in that the elongate body further comprises a joint driving force that transfers the rotational movement to the articulated joint to effect the pivotal articulation of the end effector, and where the securing actuator comprises a mechanism for securing the backlash interposed between the articulation drive tube and the control of the articulation.

7. The surgical instrument according to claim 6, further characterized in that the retroaccessing securing mechanism comprises: a frame having a window; an assurance member secured laterally in position with the window of the frame and coupled to the lateral engagement support; and a deflection member coupled to the control of the joint and positioned to uncouple and laterally place the securing member. 8.- The surgical instrument in accordance with the claim 6, further characterized in that the articulation drive tube comprises a rotary connection parallel to the slide bar and aligned with a vertical center line of the elongated body, the rotary connection is rotatably connected to a surface near the slide bar , causing lateral movement of the same as the rotating connection rotates. 9. The surgical instrument according to claim 8, further characterized in that the rotary connection includes a plurality of joints rotatable to the slide bar, spaced along a longitudinal section thereof, to maintain alignment during the actuation . 10. A surgical instrument comprising: a proximal portion configured for external manipulation of a patient; an elongate body attached to the proximal portion; an end effector; an articulated joint that rotatably connects the end effector to the elongate body; a segment of the gear directed and connected proximally to the end effector aligned to rotate about a hinge axis of the articulated joint; a slide bar with restricted lateral movement within the elongated body; a support directed distally, attached to the slide bar placed on the articulated joint in engagement with the engagement segment of the end effector; a proximal surface of the end effector coupled to the distal end of the motion of the joint, to convert a lateral movement of the slide bar into a rotational movement of the end effector; and a securing member in the elongated body that moves selectively, distally and longitudinally to engage the engagement segment of the end effector that secures the articulated joint. 11. The surgical instrument according to claim 10, further characterized in that the securing member is distally deviated and includes a proximal bolt, the control of the articulation includes a toothed surface positioned to cam the bolt proximally during the actuation and to allow the proximal pin to move distally at the corresponding tooth root of the toothed surface when control of the joint is stopped. 12. The surgical instrument according to claim 10, further characterized in that it comprises differential articulation actuators placed on opposite sides of the slide bar. 13. The surgical instrument according to claim 12, further characterized in that the articulation actuators comprise fluidic actuators. 14. The surgical instrument according to claim 12, further characterized in that the articulation actuators comprise electromagnetic actuators. 15. The surgical instrument according to claim 12, further characterized in that the articulation actuators comprise cam actuators that move longitudinally. 16. The surgical instrument according to claim 12, further characterized in that the articulation actuators comprise deformation members with positionable proximal ends. 17. A surgical instrument, comprising: a proximal portion configured for external manipulation of a patient; an elongate body attached to the proximal portion; an end effector; an articulated joint that rotatably connects the end effector with the elongate body; a slide bar received for lateral movement in the elongated body and comprising a distal end coupled to rotate the end effector around the joint of the joint and a locking mechanism moved in engagement by engagement with the elongate body in response to the retrodirection force on the end effector. 1

8. The surgical instrument according to claim 17, further characterized in that it comprises a segment of the gear attached to the end effector, the slide bar further comprises a support attached distally coupled to the segment of the gear. 1

9. The surgical instrument according to claim 17, further characterized in that the securing mechanism comprises a channel formed laterally in the elongated body and a flange joined perpendicular to the slide bar and received in the channel, the slide bar comprises in addition a flexible longitudinal portion that connects the flange to the distal end of the slide bar, wherein the back-drive of the end effector flexes the longitudinal portion, thereby mounting the flange into interlocking engagement in the channel. 20. The surgical instrument according to claim 17, further characterized in that the securing mechanism comprises laterally moving engaging teeth close to a lateral engagement surface attached to the elongate body, the surgical instrument further comprises a deflection member that drives the slide bar and the coupling teeth distally , outside the coupling with the lateral coupling surface until the end effector is retroactive.