RU2637625C2 - Replacement cartridge with clips for clip applier - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: surgical device includes a replaceable cassette that contains a bag of clips, a trigger actuator and a trigger chamber. The trigger actuator is reciprocable to push the clip out of the cartridge or position the clip in the cartridge. The clips are subsequently fed into the launch chamber of the cartridge along the feed axis. The trigger element moves along the trigger axis to position the clip located in the trigger chamber. The clip feed axis is transverse to the trigger axis.

EFFECT: reliability increase.

13 cl, 34 dwg

Description

BACKGROUND

Various fasteners can be used to process, fix, fasten, clamp and / or hold the fabric. The clips can be properly positioned relative to the tissue placed in the surgical field on the patient, and then deformed to apply a clamping force, for example, to the tissue.

BRIEF DESCRIPTION OF THE DRAWINGS

Features and advantages of the present invention, as well as a method of achieving them, will become more apparent, and the present invention will become more apparent after reading the following description of embodiments of the present invention in combination with the accompanying drawings, where:

in FIG. 1 is a partial perspective view of a clip attachment;

in FIG. 2 is a cross-sectional view of an end effector of a clip applier shown in FIG. 1, comprising a removable cassette with clips, a reciprocating trigger for sequentially extending the clips, a receiver for receiving clips, and a crimping drive for deforming the clips;

in FIG. 3 is a partial cross-sectional view of the clip applier shown in FIG. 1, in an open configuration;

in FIG. 4 is a partial cross-sectional view of the clip applier shown in FIG. 1, in a closed configuration;

in FIG. 5 is a sectional view of the end effector shown in FIG. 2, in an inactive state;

in FIG. 6 is a sectional view of the end effector shown in FIG. 2 illustrating a trigger actuator in a partially activated state in which a trigger actuator trigger element has advanced a clip into a receiver;

in FIG. 7 is a sectional view of the end effector shown in FIG. 2 illustrating a starting actuator engaged with a compression drive;

in FIG. 8 is a sectional view of the end effector shown in FIG. 2 illustrating a reduction drive in an at least partially activated state;

in FIG. 9 is a sectional view of the end effector shown in FIG. 2 illustrating a starting actuator disengaging from a starting element;

in FIG. 10 is a sectional view of the end effector shown in FIG. 2 illustrating a compression drive in its fully activated state;

in FIG. 11 is a sectional view of the starting drive of the end effector shown in FIG. 2, in a partially drawn-off position in which the starting actuator engages again with the starting element;

in FIG. 12 is a sectional view of the starting drive of the end effector shown in FIG. 2, disengaged from the compression drive;

in FIG. 13 is a perspective view of a clip shown in FIG. 2-12;

in FIG. 14 is a front view of the cartridge shown in FIG. 1-12, comprising a plurality of clips, with parts of the cartridge removed to illustrate clips in the cartridge;

in FIG. 15 is a side view of the cartridge shown in FIG. 14, shown with parts removed to illustrate the clips in the cassette;

in FIG. 16 is a horizontal sectional view of the cartridge depicted in FIG. 14, along the line 16-16 in FIG. fifteen;

in FIG. 17 is a side view of an alternative cassette that can be used in combination with the clip-on applicator shown in FIG. 1-12, or any other suitable clip-on device, in which the cassette is shown with the parts removed to illustrate the biasing element and the plunger plate located between the biasing element and the clips therein;

in FIG. 18 is a side view of a cartridge in accordance with at least one alternative embodiment, shown with removed parts to illustrate a biasing element and a locking plate located between the biasing element and the clips therein;

in FIG. 19 is a cross-sectional view of the cartridge shown in FIG. 18 along line 19-19 of FIG. eighteen;

in FIG. 20 is a side view of an additional alternative cassette that can be used in combination with the clip applier shown in FIG. 1-12, or any other suitable clip-on device, on which the cassette may comprise a housing shown with removed parts to illustrate a lock plate comprising guides configured to cooperate with guides made in the cartridge housing;

in FIG. 21 is a horizontal cross-sectional view of the cartridge shown in FIG. 20 along line 21-21 of FIG. twenty;

in FIG. 22 is a perspective view of a starting actuator comprising a rotary input, a rotary output, a starting nut coupled to a rotary output, and a gear in a starting configuration, in accordance with at least one embodiment;

in FIG. 23 is a perspective view of the trigger actuator shown in FIG. 22 illustrating a starting nut in an inactive position;

in FIG. 24 is a perspective view of the trigger actuator shown in FIG. 22 illustrating a starting nut advanced along a pivoting exit and a cam directed from a starting nut;

in FIG. 25 is a perspective view of the trigger actuator shown in FIG. 22 illustrating a cam of a starting nut engaged with a transmission of a starting drive and transmission in a reverse configuration;

in FIG. 26 is a perspective view of the trigger actuator shown in FIG. 22 illustrating a starter nut in a pulled position and a second cam directed from a starter nut and engaged with a gear to transfer a gear from its reverse configuration to its starter configuration;

in FIG. 27 is a perspective view of a manipulator system of a surgical instrument functionally supporting a plurality of surgical instruments that can be used with the clip applier shown in FIG. 2-12, or any other suitable clip-on device;

in FIG. 28 is a perspective view of a surgical instrument including an actuator module, a rod directed from an actuator module, and a replaceable end effector;

in FIG. 29 is a perspective view of a handle actuator that can be used with

clip applier shown in FIG. 2-12, or any other suitable clip-on device;

in FIG. 30 is a sectional view of the articulation shown in FIG. 2;

in FIG. 31 is a rear perspective view of an alternative actuator module that can be used in place of the actuator module shown in FIG. 28, with at least part of its housing removed;

in FIG. 32 is an exploded view of a portion of a portion of an actuator module depicted in FIG. 31;

in FIG. 33 is a partial sectional view of an actuator module shown in FIG. 31; and

in FIG. 34 is a cross-sectional view of the articulated actuator module of the actuator module shown in FIG. 31.

DETAILED DESCRIPTION

The applicant also owns the following patent applications, which are incorporated herein by reference in their entirety:

US Patent Application No. 13 / 118,259, entitled “A surgical instrument having wireless communication between a manipulator system control unit and a remote sensor”, US Patent Application Publication No. 2011-0295270 A1;

US Patent Application No. 13 / 118,210, entitled “Manipulator-Operated Disposable Loading Module with Electric Drive”, US Patent Application Publication No. 2011-0290855 A1;

US Patent Application No. 13 / 118,194, entitled “Manipulated Channel of the Endoscopic Component”, US Patent Application Publication No. 2011-0295242;

US Patent Application No. 13 / 118,253, entitled “Manipulator-Operated Electric Surgical Instrument”, US Patent Application Publication No. 2011-0295269 A1;

US Patent Application No. 13 / 118,278, entitled "Manipulated Surgical Staplers that Create Shaped Braces of Different Lengths", US Patent Application Publication No. 2011-0290851 A1;

US Patent Application No. 13 / 118,190, entitled “Electrically Driven Cutting and Stapling Instrument Operated by a Manipulator”, US Patent Application Publication No. 2011-0288573 A1;

US Patent Application No. 13 / 118,223, entitled “Manipulator-Guided Rotary Actuator Systems Based on the Shank for Surgical Instruments”, US Patent Application Publication No. 2011-0290854 A1;

US Patent Application No. 13 / 118,263, entitled “Manipulated Surgical Instrument Having Recording Capabilities”, US Patent Application Publication No. 2011-0295295 A1;

US Patent Application No. 13 / 118,272, entitled “Manipulated Surgical Instrument with Force Feedback Capabilities”, US Patent Application Publication No. 2011-0290856 A1;

US Patent Application No. 13 / 118,246, entitled “Manipulated Surgical Instrument with a Three-Horned Element as Ejector,” Publication of US Patent Application No. 2011-0290853 A1; and

US patent application No. 13 / 118,241, entitled "Surgical stapling instruments with rotatable staple configurations."

For a more complete understanding of the design, principles of operation, production and application of the devices and methods described herein, a description of certain examples of implementation. One or more examples of these embodiments are shown in the accompanying drawings. Those skilled in the art will understand that the devices and methods described in detail herein and shown in the accompanying drawings are non-limiting embodiments and that the scope of various embodiments of the present invention is determined solely by the claims. Elements shown or described with reference to one embodiment may be combined with elements of other embodiments. It is intended that the scope of the present invention covers such modifications and variations.

As used herein, the phrases “in various embodiments”, “in some embodiments”, “in one embodiment”, “in an embodiment” and the like do not necessarily refer to the same embodiment. Moreover, the specific elements, structures, or characteristics of one or more embodiments may be combined in any suitable manner in one or more other embodiments. It is intended that the scope of the present invention covers such modifications and variations.

During various surgical interventions, the surgeon or other doctor may clip the patient’s tissue to achieve various effects and / or therapeutic results. As shown in FIG. 1, a surgical instrument, such as, for example, a clip-on device 100, may be configured to lay one or more clips on a tissue placed in a patient's surgical field. Essentially, as shown in FIG. 13, the clip applier 100 may have a structure and configuration for accommodating the clip 140 with respect to tissue for compressing tissue within the clip 140. The clip applier 100 may be configured to deform the clip 140, as shown, for example, in FIG. 3 and 4, and as described in more detail below. Each clip 140 may comprise a base 142 and opposed legs 144 directed from the base 142. The base 142 and legs 144 may be of any suitable shape and may, for example, form a substantially U-shaped and / or substantially V-shaped configuration. The base 142 may include inclined parts 141 that are joined together by a connecting element 143. During use, the legs 144 of the clip 140 can be located on opposite sides of the fabric, and the legs 144 can be pushed against each other to compress the fabric located between the legs 144. The connecting element 143 can be configured to deform the tilted parts 141 of the base 142 and the legs 144 directed outward therefrom. In various circumstances, the clip 140 may be capable of creasing or plastic deforming while compressing the clip 140 sufficiently, although a certain elastic deformation or spring effect may be present in the deformed clip 140.

As shown in FIG. 1 and 2, clip clip 100 may include a rod 110, an end effector 120, and a removable clip cassette, or magazine 130. As shown in FIG. 14-16, the clip cassette 130 may comprise a housing 132 and a plurality of clips 140 located within the housing 132. The housing 132 may form a storage chamber 134 in which clips 140 can be stacked. Storage chamber 134 may include side walls that extend around, or at least substantially around, the perimeter of clips 140. As again shown in FIG. 13, each clip 140 may contain opposed faces, such as an upper face 145 and a lower face 146 on opposite sides of the clip 140, whereby the clips 140 are placed in the housing 132, the upper face 145 of the clip 140 can be placed close to the lower edge 146 of the adjacent clip 140, and the bottom edge 146 of the clip 140 can be positioned close to the upper edge 145 of another adjacent clip 140. In various circumstances, the lower edges 146 of the clips 140 may face down towards one or more supporting shelves, or platforms 135, formed in case 132, and the upper edges 145 of the clips 140 may be facing upward from the supporting shelves 135. The upper edges 145 and the lower edges 146 of the clips 140 may in some cases be the same, or at least substantially the same, while in other cases the upper faces 145 and lower faces 146 may be different. A package of clips 140 shown in FIG. 14-16, contains, for example, five clips 140; however, other embodiments are contemplated in which the clip package 140 may include more than five clips 140 or less than five clips 140. In any case, the clip cassette 130 may further comprise at least one biasing element, such as, for example, a biasing member 136 located between the housing 132 and the upper clip 140 in the clip package 140. As described in more detail below, the biasing element 136 may be configured to bias the lower clip 140 in the clip package 140 or, more specifically, the lower face 146 clips 140 close to the supporting flanges 135 formed in the housing 132. The biasing element 136 may comprise a spring and / or, for example, any suitable compressed resilient element that can be adapted to exert biasing force on the clips 140, or at least apply bias to the upper clip 140, which is transmitted downward through the packet of clips 140.

When the clip 140 is positioned adjacent to the support flanges 135, as described above, the clip 140 can be held in a starting position in which the clip 140 can be advanced and pushed out of the cassette 130. In various circumstances, the support flanges 135 may form at least part of the launch chamber 149 in which the clips 140 may sequentially be placed in the starting position. In some cases, the launch chamber 149 may be completely formed inside the cartridge 130 or, in other cases, the launch chamber 149 may be formed inside and / or between the rod 110 and the cartridge 130. In any case, as described in more detail below, the clip-on device 100 may comprise a trigger drive that can push the trigger into the cartridge 130 and push the clip 140 out of its trigger position when it is adjacent to the support flanges 135 to an activated position in which it is inserted into the clipon end effector 120 stacker 100. As shown primarily in FIG. 14-16, the housing 132 of the cassette 130 may include a proximal opening, or a window, 133 that can be aligned, or at least substantially aligned, with support flanges 135 so that the trigger element can enter the cassette 130 through the proximal opening 133 and push the clip 140 distally from the cassette 130. In at least one such embodiment, the housing 132 may further comprise a distal or discharge opening or window 137, which is also aligned with the support flanges 135 so that the clip 140 can be advanced that, or activated, distally along the launch axis 139, passing, for example, through the proximal opening 133, the launch chamber 149 and the distal opening 137.

To advance the clip 140 from the cartridge 130, in addition to the above, the trigger element of the trigger actuator can be advanced into the cartridge case 132 and, in various circumstances, the trigger chamber 149. As described in more detail below, the trigger element can completely pass through the cartridge 130. for promotion clips 140 to its activated position inside the end effector 120. After the clip 140 located in the launch chamber 149 is distally advanced by the trigger element, as described above, the trigger element can be sufficiently extended remove so that the biasing member 136 can position the other clip 140 close to the support flanges 135. In various circumstances, the biasing member 136 can bias the clip 140 close to the trigger element when the trigger element is located inside the housing 132. Such clip 140 can be called a queued clip . After the trigger element is sufficiently pulled out and slides out from under the queued clip 140, the biasing member 136 can then move the clip 140 close to the support flanges 135, where it is prepared for the next beat of the reciprocating trigger element. As shown primarily in FIG. 2 and 14-16, the cassette 130 may be configured to feed clips 140 into the launch chamber 149 along a predetermined path, such as, for example, the feed axis 138. The feed axis 138 may be transverse to the trigger axis 139, so that the clips 140 are fed into the starting chamber 149 in a direction different from the direction in which the starting element passes through the starting chamber 149. In at least one such embodiment, the feed axis 138 may be, for example, perpendicular or at least substantially perpendicular to the launch axis 139.

As again shown in FIG. 2, the rod 110 may include an opening 131 for the cartridge, or a magazine that can be made in shape and size with the possibility of receiving, for example, a cartridge with clips 130. The hole 131 for the cartridge can be made in shape and size with the possibility of tight insertion the casing 132 of the cartridge 130 into the opening for the cartridge 131. The side walls that form the hole 131 for the cartridge may limit, or at least substantially limit, the lateral movement of the cartridge 130 relative to the rod 110. The rod 110 and / or the cartridge 130 may optionally contain one or more locks, which can be arranged to releasably hold the cartridge 130 in the hole 131 under the cartridge. As shown in FIG. 2, the cartridge 130 can be loaded into the hole 131 under the cartridge along an axis that, in at least one embodiment, is parallel or collinear with the feed axis. 138. As also shown in FIG. 2, the rod 110 may further comprise a plate or seat 118 directed from the side wall 111 of the rod 110, and the plate 118 may be arranged to be inserted and / or engaged with the casing 132 of the cartridge 130. The plate 118 may be made in shape and size with the possibility of tight insertion into the recess 148 formed in the cassette body, so that the plate 118 can limit, or at least substantially limit, the lateral movement of the cartridge 130 relative to the rod 110. The plate 118 can be made in shape and size with the ability to align the cartridge 130 inside the rod 110 and / or support the cassette 132.

After locating and seating the clip cassette 130 inside the shaft bore 131, as shown in FIG. 5 and 6, the trigger drive 160 of the clip attachment 100 can be activated to advance clips 140 from the clip cassette 130, as described above. The trigger actuator 160 may comprise a rotary drive input, such as, for example, a drive screw 161, and a biasable trigger nut 163 operably engaged with a drive screw 161. The drive screw 161 may include at least one drive groove 162, which may be threadedly engaged with a threaded hole passing through the start nut 163. In various embodiments, the clip-on attachment 100 may further include, for example, an electric motor, operably connected with the drive screw 161. In various cases, the drive screw 161 may be operatively connected to a motor of the surgical instrument system comprising, for example, manual or automatic manipulator tool. In any case, the movement of the start nut 163 inside the rod 110 can be limited so that the start nut 163 moves along the longitudinal axis 164 when the drive screw 161 is rotated by the engine around the longitudinal axis 164. For example, when the drive screw 161 is rotated by the engine in the first direction, the drive screw 161 may advance the release nut 163 distally toward the end effector 120, as shown in FIG. 6. When the drive screw 161 is rotated by the engine in a direction opposite to the first direction, the drive screw 161 can pull the starter nut 163 proximally away from the end effector 120. The rod 110 may include one or more bearings that can be rotatably supported a drive screw 161. For example, the bearing 159 may be rotatably supported, for example, the distal end of the drive screw 161, as shown in FIG. 5 and 6.

The trigger actuator 160 may further comprise a trigger member 165 directed from the trigger nut 163, which can be distally advanced and retracted proximally by the trigger nut 163, as described in more detail below. When comparing FIG. 5 and 6, the reader will notice that the start nut 163 and the start element 165 are advanced from the proximal, inactive position shown in FIG. 5 to the distal, activated position shown in FIG. 6, in which the trigger 165 has advanced the clip 14 0 from the clip cassette 130 to the end effector 120. As shown primarily in FIG. 5, the clip cassette 130 is shown as having a plurality of clips 140 inserted therein, one of the clips 140 being in the starting position, as described above. As shown in FIG. 5 and 6, the trigger member 165 may include a distal portion 166 that can be pushed into the cassette with brackets 130 along the trigger axis 167 and engage the clip 140 in the trigger position when the trigger member 165 and the trigger nut 163 move distally. In some cases, the trigger element 165 may include a linear element, while in other cases, the distal end 166 of the trigger element 165 may, for example, extend upward from the trigger element 165. In addition to the above, the trigger element 165 can push the clip 140 distally from the clip cassette 130 along the launch axis 167 and into the receiving cavity 122 formed in the end effector 120.

In various cases, the trigger 165 can be attached to and extend distally from the trigger nut 163, while in other cases the trigger 165 and the trigger nut 163 can be operatively connected to each other by a drive actuator 168. The drive actuator 168 can be pivotally mounted on the trigger member 165 in the hinge 169 and may include a distal arm 170a and a proximal arm 170b that may come into contact with a longitudinal groove 113 formed in the housing 112 of the shaft 110. At least In one such embodiment, each of the arms 170a, 170b may include a protrusion directed therefrom, such as protrusions 171a and 171b, respectively, which may be slidable within the longitudinal groove 113. In addition to the above, the release nut 163 may further include a trigger pin 172 directed from it, which can be adapted to engage the distal arm 170a to advance the actuator 168 and the trigger 165 distally, as described above. During use, as again shown in the sequence depicted in FIG. 5 and 6, the trigger nut 163 can be advanced distally by the drive screw 161, wherein the trigger pin 172, which is located between the distal arm 170a and the proximal arm 170b, can come into contact with the distal arm 170a and push the actuator 168 and the trigger 165 distally. When the actuator 168 is advanced, the distal actuator 168 can be prevented from rotating around the pivot pin 169 so that one or both of the protrusions 171a and 171b sliding in the groove of the rod 113 can be prevented from lateral movement relative to the longitudinal groove of the rod 113 until the actuator mechanism 168 will not reach the position shown in FIG. 6.

When the actuator 168 reaches the position shown in FIG. 6, the distal protrusion 171a may fit into the distal portion of the groove 114 of the longitudinal groove 113, which may be able to pivot the actuator 168 downward or may allow the articulated rotation of the actuator 168 downward, as shown in FIG. 9. In at least one such embodiment, the distal protrusion 171a can come into contact with the side wall of the distal portion of the groove 114, which can guide the distal protrusion 171a down and rotate the actuator 168 around the hinge 169 as the actuator 168 moves forward the trigger nut 163. In this pivotally rotated position, the trigger pin 172 directed from the trigger nut 163 may no longer come into contact with the distal arm 170a of the actuator 168, and further the trigger the nut 163 can move distally independently of the actuator 168, thus leaving behind the actuator 168 and the trigger 165. In other words, the distal end 114 of the longitudinal groove of the rod 113 can deactivate the trigger 165, and at this point the position of the trigger 165 can represent completely the activated or most distal position of the trigger element 165. In this position, the clip 140 will be fully advanced into the receiving cavity, or receiver, 122. Moreover, in addition to the above azannomu, in this position the next clip 140 to advance into the receiving space 122 can be shifted against the upper surface of actuator 165.

After the location of the clip 140 in the receiving cavity 122, in addition to the above, the clip 140 can be deformed, for example, by a compression drive 180. As shown in FIG. 3 and 4, the end effector 120 of the clip applier 100 may further comprise a first jaw 123a and a second jaw 123b, wherein the first jaw 123a and the second jaw 123b may at least partially form a receiving chamber 122. As shown in FIG. 3 and 4, the first jaw 123a may comprise a first channel 124a and the second jaw 123b may comprise a second channel 124b, each of which may be configured to receive and support at least a portion of the clip 140. The first jaw 123a may be pivotally connected to the frame 111 of the rod 110 with a pin 125a, and the second jaw 123b can be pivotally connected to the frame 111 with a pin 125b. During use, the compression drive 180 may be configured to rotate the first jaw 123a to the second jaw 123b and / or rotate the second jaw 123b to the first jaw 123a to compress the clip 140 located between them. At least in one such embodiment, the compression drive 180 may comprise a cam actuator 181, which may be adapted to engage a first curved surface 126a formed on the first jaw 123a, and a second curved surface 126b on the second jaw 123b for the gate of the first and second jaws 123a jaws 123b to each other. The cam actuator 181 may comprise a ring that at least partially surrounds the first jaw 123a and the second jaw 123b. In at least one such embodiment, the ring may comprise an internal curved surface 182, which may be in a shape that makes contact with the curved surfaces 126a, 126b of the jaws 123a, 123b and expels them inward to each other. In various circumstances, the clip 140 located inside the receiving chamber 122 formed in the end effector 120 can be positioned relative to the fabric before activating the compression drive 180. In some circumstances, the compression drive 180 may be at least partially activated before the clip 140 is positioned relative to the fabric for at least as the clip 140 is partially compressed. In some cases, the clip 140 and the receiving chamber 122 can be shaped and sized so that the clip 140 can be biased or bent inward when eva effector 120 is in its inactive state, as shown in FIG. 3. In various cases, the crimping first jaw 123a and the second jaw 123b can be activated to resiliently compress and / or continuously crimp the clip 140 located between them.

In addition to the above, the starting nut 163 may be configured to activate the compression drive 180. More specifically, as shown in FIG. 7, the compression drive 180 may comprise a compression drive 188 operably coupled to the cam actuator 181, the compression drive 188 may be selectively engaged with the release nut 163 as the release nut 163 moves distally, as described above. In at least one such embodiment, the starting nut 163 may further comprise a second starting pin, such as, for example, a starting pin 184 directed therefrom, which may be configured to engage the crimping actuator 188, as the starting nut 163 advances the trigger actuator 168. As again shown in FIG. 7, the compression actuator 188 is in an inactive position, and when the trigger nut 163 is advanced far enough to engage the distal arm 190a of the compression actuator 188, the trigger nut 163 can rotate the compression actuator 188 up to the activated position, as shown in FIG. 8. As also shown in FIG. 8, and the distal arm 190a and the proximal arm 190b may comprise a protrusion directed therefrom, such as protrusions 191a and 191b, respectively, which can be positioned inside a second longitudinal groove formed in the shaft 110, such as, for example, groove 115. When the actuator is rotated the compression mechanism 188 upward from its inactive position around the hinge 189, the protrusions 191a and 191b can move from the proximal curved end 116 of the longitudinal groove 115 to the part of the longitudinal groove 115, which is essentially linear. Similarly to the above, the side walls of the longitudinal groove 115 can be configured to limit the movement of the compression actuator 188 along the longitudinal path and can be performed. with the ability to limit or prevent rotation of the compression actuator 188 after turning the compression actuator 188 up to at least partially activated position, as discussed above. As the reader will understand, both the starting pin 172 of the starting drive 160 and the starting pin 184 of the compression drive 180 extend from the starting nut 163. For convenience and for purposes of demonstration, the starting pins 172 and 184 are shown directed from the same side of the starting nut 163; however, it is envisaged that the trigger pin 172 may extend from the first side of the trigger nut 163, and the trigger pin 184 may extend from the other side of the trigger nut 163. In such circumstances, the trigger actuator 168 may be positioned along the first side of the drive screw 161 and the actuator crimps 188 can be positioned along the opposite side of the drive screw 161. Accordingly, a longitudinal groove 113 can be formed in the first side of the shaft housing 112, and a longitudinal az 115 may be formed on the opposite side of the housing of the rod 112.

In addition to the above, the cam actuator 181 may be operatively connected to the crimp actuator 188 so that when the crimp actuator 188 is moved distally by the start nut 163, the cam actuator 181 can be distally advanced as shown in FIG. 8 and 10, until the distal protrusion 191a directed from the distal shoulder 190a reaches the distal end 117 of the longitudinal groove 115. In this distal position, the cam actuator 181 can be fully extended and the clip 140 located inside the receiving chamber 122 can be in a completely deformed or compressed configuration. After that, the cam actuator 181 can be pulled back and the end effector 120 can be opened again. More specifically, the drive screw 161 can rotate in the opposite direction to move the starting nut 163 proximally and to pull the cam actuator 181, and in some cases, the end effector 120 may further include a biasing element, which may be configured to bias the first branch 123 and the second branch 123b from a closed, or activated, position name in FIG. 4 to the open or inactive position shown in FIG. 3. When pulling the starting nut 163 out of the position shown in FIG. 10, a release pin 184 directed from the release nut 163 can engage the proximal arm 190b of the compression actuator 188 and move the compression actuator 188, and the cam actuator 181 directed therefrom, proximally, as shown in FIG. 12. Similar to the above, the proximal protrusion 191b directed from the proximal arm 190b of the compression actuator 188 may be configured to come into contact with the side wall of the curved proximal end 116, the side wall may guide the compression actuator 188 down and rotate the actuator crimps 188 around the hinge 189. At this point, the release pin 184 may no longer come into contact with the crimp actuator 188, the cam actuator 181 may be fully retracted, and you can continue to pull the starter nut 163 proximally relative to the actuator compression 188.

In addition to the above, as shown in FIG. 11, the starting nut 163 may be configured to re-engage the starting actuator 168 while pulling the starting nut 163 proximally. As discussed above, the trigger actuator 168 rotates downward when the trigger actuator 168 reaches the distal end 114 of the longitudinal groove 113, and as a result, the trigger actuator 168 may still be in its downwardly turned position when the trigger nut 163 is pulled proximally for re-engagement trigger actuator 168. As shown in FIG. 11, the trigger pin 172 directed from the trigger nut 163 can engage the proximal arm 170b of the trigger actuator 168, and as the trigger nut 163 is further pulled, it can rotate the trigger actuator 168 so that the protrusions 171a and 171b directed from the arms 170a and 170b, respectively, can again enter the longitudinal part of the longitudinal groove 113. After that, the start nut 163 can be pulled back until the start actuator 168 and the start element 165 directed from it return to their initial position, or and non-activated, the positions shown in FIG. 5. In such circumstances, the trigger 165 can be pulled out of the clip holder 130 by pulling the trigger 165 proximally with the trigger nut 163, so that the new clip 140 can be biased into the trigger chamber of the clip cartridge 130 with the biasing element 136. After the trigger 165 and the trigger actuator 168 will be pulled to their initial positions and the next clip 140 will be located inside the trigger chamber, the trigger actuator 160 can be activated again to move the trigger nut 163 and the trigger 165 distally to advance the next clip 140 to the end effector 120. Similarly, the starting nut 163 can reactivate the compression drive 180 while moving the starting nut 163 again distally to deform the next clip 140. After that, the starting nut 163 can be pulled back to re-drive compression 180 and starter actuator 160 in the initial position. This method can be repeated until a sufficient number of clips 140 are overlaid on the target fabric and / or until the clips 140 contained in the clip cassette 130 run out. If additional clips 140 are required, the empty clip cassette 130 can be removed from the rod 110 and a removable cassette with clips 130, containing additional clips 140, can be inserted into the rod 110. In some circumstances, at least partially empty cassette with clips 130 can be replaced by the same, or at least practically the same, removable cassette with clips 130, while in other circumstances, the cassette with clips 130 can be replaced by a cassette with clips containing more than or less than five clips 140, and / or, for example, a cassette with clips containing clips other than clips 140.

As again shown in FIG. 6-9, the starting nut 163 of the illustrated embodiment may be operable to disengage with the starting actuator 168 at a time when the starting nut 163 is engaged with the crimping actuator 188. In other words, the starting actuator 160 may be deactivated simultaneously with activation of the compression drive 180. In various circumstances, such synchronization can be achieved, for example, when the distal end 114 of the longitudinal groove 113 is aligned, or at least substantially aligned, with the maximum end 116 of the second longitudinal groove 115. In the illustrated embodiment and / or any other suitable embodiment, there may be a time delay between the deactivation of the trigger drive 160 and the activation of the compression drive 180. Such a delay between the end of the activation cycle of the trigger element 165 and the start of the cam activation cycle an actuator 181 may be created, in some circumstances, to ensure that the clip 140 is fully seated in the receiving chamber 122 Before the clip 140 is deformed by the cam actuator 181. In various circumstances, such a delay can be created, for example, when the distal end 114 of the longitudinal groove 113 is proximal to the proximal end 116 of the second longitudinal groove 115. In the illustrated embodiment and / or any other suitable In an embodiment, deactivation of the trigger drive 160 may occur after activation of the compression drive 180. Such overlap in time between the end of the activation cycle of the trigger element and 165 and the start of the activation stroke of the cam actuator 181 can be created, in some circumstances, for applying at least some inward pressure to the clip 140 when it is moved to the fully seated position in the receiving chamber 122, for example, with a reduction or elimination of the relative movement between the clip 140 and the side walls of the receiving chamber 122. In various circumstances, such overlapping can be created, for example, when the distal end 114 of the longitudinal groove 113 is located distal but with respect to the proximal end 116 of the second longitudinal groove 115.

In the illustrated embodiment depicted in FIG. 1, and / or any other suitable embodiment, as shown in FIG. 17, a clip cassette, such as, for example, a clip cassette 230, may include a pusher plate 248 located between the biasing member 136 and the uppermost clip 140 placed inside the clip cassette 230. The pusher plate 248 may be rigid, or at least is substantially rigid, and may comprise a first abutment surface to which the biasing member 136 can exert a biasing force. The pusher plate 248 may also comprise a second abutment surface that can transmit bias to the upper surface 145 of the uppermost clip 140. The pusher plate 248 may be formed. for example, from a stainless steel plate, although the pusher plate 248 may be of any suitable shape and may be formed of any suitable material. In some cases, the pusher plate 248 may not be attached to the biasing member 136, while in other cases the pusher plate 24 8 may be attached to the biasing member 136 so that the pusher plate 248 does not separate from the cassette body 132. In various circumstances, the pusher plate 248 can be made in shape and size so that it cannot pass through the proximal opening 133 and / or the distal opening 137 formed in the cassette 132.

In the illustrated embodiment depicted in FIG. 1, and / or any other suitable embodiment, as shown in FIG. 18 and 19, a clip cassette, such as, for example, a clip cassette 330, may comprise a blocking element that can be positioned inside the launch chamber 149 of the clip cassette 330 after ejecting all clips 140 contained in the clip cassette 330 from the cassette 330 The locking element may include a locking plate 348, which can be placed between the biasing element 136 and the upper surface 14 5 of the uppermost clip 14 0 contained within the cassette with clips 330. During use, in addition to the above, clips 140 may it is necessary to settle down in the launching chamber 149 of the cartridge with clips 130 and then move distally from the cartridge case 132, and after moving the last clip 140 from the cartridge case 132 and pulling out the launch element 165 from the cartridge with clips 130, the biasing element 136 can shift the blocking plate 348 close to the shelves 135. In this position, the blocking plate 348 can be aligned with the proximal opening 133 and the distal opening 137 so that the trigger 165 cannot enter, or at least substantially enter, the cassette from the clip and 130. In such circumstances, the lock plate 348 can block the trigger 165 from entering into and passing through the housing 132 and as a result prevent unintentional activation klipsonakladyvatelya 100 after the cassette with clips 130 clip end. If the clip attachment operator 100 activates the trigger actuator 160 and attempts to push the trigger 165 into an empty clip cassette 130, the trigger 165 will come into contact and abut against the lock plate 348, and in such circumstances a compressive load may be created in the trigger 165. The clip applier 100 may further include a clutch that may be capable of slipping and functional disconnecting the motor from the drive screw 161 when the compressive load created in the trigger 165 exceeds a certain or predetermined amount. In addition to or instead of clutch, the engine and / or motor controller of the clip-on attachment 100, which, for example, drives the trigger actuator 160, may include a load cell configured to detect a load created inside the trigger 165 and when created inside the trigger 165 the load exceeds a certain or predetermined value, the voltage and / or current supplied to the motor can be disconnected and / or reduced. In any case, the blocking plate 348 can be made in shape and size so that the blocking plate 348 cannot be separated through the distal opening 137 and / or the proximal opening 133 when the trigger 165 is in contact with the blocking plate 348. For reuse clip attachment 100, the clip attachment operator 100 can remove the empty cassette 330 from the rod 110 and, for example, insert a new, clip cassette 330 into the rod 110. At this point, the clip 140 may be located inside the launch chamber 149 but oh cassette with clips 330 and actuator 165 may be advanced distally into a new cassette with clips 330 for placement of clips 140 as described above.

In the embodiment shown in FIG. 1, and / or any other suitable embodiment, as shown in FIG. 20 and 21, the clip cassette, such as, for example, clip cassette 4 30, may include guides that may be configured to limit or. to limit the movement of the locking element inside the cassette with clips 430. Similar to the above, the locking element may contain, for example, a locking plate 448, which can be located between the biasing element 136 and the upper surface 145 of the highest clip 140 contained in the casing 432 of the cassette with clips 430 During use, similar to the above, the lock plate 448 can gradually be pushed down into the launch chamber 149, as the clips 140 are successively pushed out of the cartridge with clips 430. The lock plate 448 can be made in shape and size so that it fits snugly inside the cassette 432, and so that the relative lateral movement between the lock plate 448 and the housing 432 can be limited to reduce or prevent the possibility of mispositioning of the lock plate 448 inside the cassette with clips 430. If the lock plate 448 is improperly located inside the cassette with clips 430, the lock plate 448 may be stuck in the housing 432 and, for example, prevent the application biasing element 136 of the corresponding biasing force to the package of clips 140. As shown in FIG. 20 and 21, the blocking plate 438 may further comprise guide elements 447 directed therefrom, which may be inserted into the guide grooves 44 6 formed in the cassette body 432. The guide elements 447 and the guide grooves 446 may be shaped and sized to so that the guide elements 447 fit tightly into the guide grooves 446, and so that the relative lateral movement between the blocking plate 438 and the cassette body 432 can be limited. Each of the guide grooves 446 may be formed by opposing side walls 445, which may form a distance therebetween which is equal to or slightly greater than the width of the guide element 447 located therein, so that the guide element 447 can slide between the opposite side walls 445 between the top 443 and the bottom 444 of the guide groove 446. Thus, although the guide elements 447 and the guide grooves 446 can be configured to limit lateral movement between them, as described above, the guide members 447 and the guide grooves 446 may be configured to allow relative movement between the blocking plate 438 and the cartridge case 432 along a predetermined path, for example parallel or collinear to the feed axis 138. When the blocking plate 438 is ejected into the starting chamber 149 by the biasing member 136, the blocking plate 438 may impede the advancement of the starting member 165 and operation of the clip applier 100, as described above, until the empty the clip set 430 will not be replaced with another suitable clip tape.

In the embodiment shown in FIG. 1, and / or any other suitable embodiment, as discussed above, the drive screw 161 may rotate in the first direction to advance the release nut 163 distally and rotate in the second or reverse direction to extend the release nut 163 proximally. To rotate the drive screw 161 in the first and second directions, an electric motor operably connected to the drive screw 161 can be started in the first and second directions, respectively. In the embodiment shown in FIG. 1, and / or any other suitable embodiment, an engine that starts only in the first direction can be used in the clip-on applicator, and rotation of the engine in this single direction can be used to advance the starting nut distally and extend the starting nut proximally. As shown in FIG. 22-26, the output of the electric motor can be transmitted to the drive system 560 via a transmission system 550. The transmission system 550 may include an input terminal 552 that rotates in one direction, the transmission system 550 may be configured to switch or transfer between the first state or a configuration in which the transmission system 550 rotates the drive screw 561 of the drive system 560 in a first direction, and a second state, or a configuration in which the transmission system 550 rotates the drive screw 561 in the second, or opposite, direction. The first state of the transmission system 550 is shown in FIG. 22-24, and a second state of the transmission system 550 is shown in FIG. 25 and 26.

As again shown in FIG. 22-24, the input shaft 552 may comprise an input gear 551 mounted thereon, which is operatively connected or engaged to the gear 553, so that the rotation of the input 552 is transmitted to the gear 553. With respect to all gears, discussed herein, gears that are operatively coupled or engaged with each other may include, for example, any suitable gear configuration that can provide transmission of rotation of one gear of this wheel to another. When the input shaft 552 rotates in the first direction, the gear gear 553 rotates in the second or opposite direction. In the first state of the transmission system, the shift gear 553 is in a first position in which the shift gear 553 is operatively connected to the intermediate gear 554, wherein when the shift gear 553 is rotated in the second direction by the input gear 551, as discussed above, the intermediate gear 554 turns in the first direction. Although not shown in the figures, the intermediate gear 554 may be rotatably supported, for example, within the clip 110 of the clip attachment 100. The intermediate gear 554 may also be operatively connected to the output gear 555 mounted on the drive screw 561, so that rotation the intermediate gear 554 may be transmitted to the output gear 555. When the intermediate gear 554 rotates in the first direction of the gear gear 553, as described above, the intermediate The new gear 554 can rotate the output gear 555 and the drive screw 561 in a second direction. Similar to the above, the start nut 563 can be operatively connected to the drive screw 561 and accordingly limited inside the shaft 110, so that when the drive screw 561 rotates in the second direction, the start nut 563 moves distally, as shown by arrow D.

Similar to the above, the starter nut 563 can be advanced to its most distal position shown in FIG. 24 to advance the clip 140 from the clip cassette 130 to the end effector 120 and compress the clip 140, as described above. As shown in FIG. 23 and 24, the starter nut 563 may further comprise a cam strip 569 directed from it, which may be configured to translate the transmission system 550 from its first state to its second state. When comparing FIG. 24 and FIG. 25, the reader will notice that the shift gear 553 is movable between a first position in which the transmission system 550 is in its first state and a second position in which the transmission system 550 is in its second state. More specifically, the shift gear 553 is mounted on a shift member 556 that is rotatable around the input shaft 552 so that the shift gear 553 can be rotated from its first position, in which the shift gear 553 is operatively engaged with the input gear 551 and the intermediate gear 554, in its second position, in which the gear gear 553 functionally disengaged from the intermediate gear 554. Although the gear is switched I 553 is functionally detached from the intermediate gear 554, when the gear 551 is in its second position, the gear 553 can be functionally connected to the input gear 551 and the output gear 555 for transmitting rotational movement from the input shaft 552 to the drive screw 561. As shown in FIG. 24 and 25, the switching element 556 may include a central hole through which the input terminal 552 can pass; however, the switching element 556 may not be operatively engaged with the input terminal 552, and as a result, the rotation of the input terminal 552 may not lead to the rotation of the switching element 556, and, likewise, the rotation of the switching element 556 may not cause the rotation of the input terminal 552. In any In this case, the switching element 556 may further comprise a cam follower 558 directed therefrom, which can be engaged by a cam 568 formed on the cam plate 569 when the starting nut 563 moves distantly ally. When the cam 568 engages the cam follower 558, the cam 568 can rotate the switch 556 and the gear 555 between their first position and their second position, as described above.

When the shift gear 553 is in its second position and the transmission system 550 is in its second state, as described above, both the input shaft 552 and the drive screw 561 can rotate in the first direction. More specifically, the input shaft 552, when rotated in the first direction, can rotate the input gear 551 in the first direction, and since the gear gear 553 is directly engaged with the input gear 551, the gear gear 553 will rotate in the second direction. The reader will notice that the shift gear 553 rotates in the second direction when the transmission system 550 is in its second state, compared with the first or opposite direction when the transmission system 550 is in its first state. When comparing FIG. 24 and 25, in addition to the foregoing, the reader will determine that the intermediate gear 554 is no longer functionally located between the input gear 551 and the gear gear 553 when the transmission system 550 is in its second state, thereby providing different directions of rotation. Since the shift gear 553 is operatively engaged with the input gear 551 and the output gear 555 when the shift gear 553 is in its second position, the shift gear 553 can rotate the output gear 555 and the drive screw 561 connected to the output gear 555 in the first direction. When the drive screw 561 rotates in the first direction, as shown in FIG. 25 and 26, the starter nut 563 can be pulled proximally to allow re-opening of the end effector 120 and delaying of the starter element 165. As shown primarily in FIG. 26, the starter nut 563 may further comprise a second cam plate 567 directed from it, comprising a cam 566 that can be configured to come into contact with the cam follower 558 of the switch member 556 while pulling the starter nut 563 proximal to its fully extended position. In such circumstances, the cam 566 can push the switching member 556 back to its first position and into functional engagement with the intermediate gear 554, so that the transmission system 550 can be returned back to its first state and the clip applier 100 can be reactivated.

As discussed above, the start-up drive of the clip-on applicator 100 may be controlled by a surgical instrument system comprising an electric motor. The manipulator system of a surgical instrument 20 is shown in FIG. 27 and may comprise a plurality of arms 30 movable. Each arm 30 may comprise an actuator module 32, comprising an electric motor configured to provide rotational movement to the bar 110 of the clip applier 100 and / or any other suitable surgical instrument. As shown in FIG. 28, the end effector 620 can be selectively engaged with and disengaged from the clip actuator actuator 610 rod, the end effector 620 may include a proximal end 621 that can be connected to a distal end 611 of the rod 610. The proximal end 621 of the end effector 620 may include an outer casing 629, a frame passing through the outer casing 629, an external driving rod passing through the frame, and an internal driving rod passing through the external driving rod. Similarly, the distal end 611 of the rod 610 may include an outer casing 619 ′, a frame 663 passing through the outer casing 619, an external driving rod 662 passing through the frame 663, and an inner driving rod 661 passing through the outer driving rod 662. In that touches the distal end 611 of the rod 610, the frame 663, the outer drive rod 662 and the inner drive rod 661, each of which may comprise a portion of the tongue connector 613 directed therefrom and a portion of the groove of the connector 612 formed therein, the tongue the connector 613 can be configured to insert into the groove a tongue 623 formed at the proximal end 621 of the end effector 620, and wherein the groove of the tongue 612 can be adapted to receive the reed connector 622 directed from the proximal end 621 of the end effector 620. Similar to the reed connector 613 that passes through the frame 663, the outer drive rod 662 and the inner drive rod 661 of the distal end of the rod 611, the reed connector 622 may pass through the frame, the outer drive rod ny and the inner drive rod of the proximal end 621 of the end effector 620. In addition, similarly to the tongue groove 612, which passes through the frame 663, the external drive rod 662 and the inner drive rod 661 of the distal end of the rod 611, the tongue groove 623 can pass through the frame, the external drive the rod and the inner drive rod of the proximal end 621 of the end effector 620. In the configuration shown in FIG. 28, the tongue connector 622 of the end effector 620 can be slidably inserted laterally into the groove of the tongue 612 of the rod 610 simultaneously with the sliding insertion of the lateral tongue connector 613 of the rod 610 into the groove of the tongue 623 of the end effector 620. Thanks to this assembly, the frame of the end effector 620 can be reliably connected to frame 663 of the rod 610, the external drive rod of the end effector 620 can be functionally connected to the external drive rod 662 of the rod 110 and the internal drive rod of the end effector 620 can be It is optionally connected to the inner drive rod 661 of the rod 110. The reader will notice that parts of the tongue connector 612 are aligned with each other, parts of the tongue of the tongue 613 are aligned with each other, parts of the tongue of the tongue 622 are aligned with each other, and parts of the tongue connector 62 3 are aligned with each other when the end effector 620 is mounted on the rod 610. After installation, the external drive rod 662 of the rod 110 can rotate the external drive rod of the end effector 620, and the internal drive rod 661 of the rod 610 can rotate pull off the inner drive rod of the end effector 620. When the external drive rod 662 and / or the internal drive rod 661 are rotated, parts of the tongue connector 612, parts of the tongue of the tongue 613, parts of the tongue of the tongue 622 and parts of the tongue connector 623 may no longer be aligned. In order to separate the end effector 620 from the shaft 610, the internal drive shaft 661 and / or the external drive shaft 662 can be rotated in one or more of the positions in which the tongue connectors 612 and 623 and the tongue grooves 613 and 622 are sufficiently aligned.

As again shown in FIG. 28, the outer casing 619 of the shaft 610 may further comprise a travel stop 614, which may be configured to limit lateral movement of the end effector 620 while slidingly moving the end effector 620 to the distal end 611 of the shaft 610. The travel stop 614 may define a starting position from which the inner drive rod of the end effector 620 and the inner drive rod 661 of the rod 610 are aligned along the longitudinal axis 615, the outer drive rod of the end effector 620 and the other when the water rod 662 of the rod 610 is aligned along the longitudinal axis 615 and / or the frame of the end effector 620 and the frame 663 of the rod 610 are aligned along the longitudinal axis 615. In addition to the above, the inner drive rod 661 can extend into the actuator module 632, which. may include an electric motor and / or system of gears 664, operatively connected to the inner drive rod 661 and configured to rotate the internal drive rod 661. Moreover, the actuator module 632 may include a second electric motor and a system of gears functionally connected to the second a drive rod 662 and rotatably a second drive rod -662. As described in more detail below, the second electric motor can be used to pivotally end the end effector 620. In addition, in addition to the above, the outer casing 619 and / or the frame 663 of the shaft 610 may further comprise a gear 617 mounted thereon, which is operatively engaged with an electric motor and a system of gears 618, which can be configured to rotate the shaft 610 and the end effector 620 around the longitudinal axis 615. For example, when the electric motor and the gear stems 618 are started in the first direction, the shaft 610 and the end effector 620 can rotate around the axis 615 in a clockwise direction, and when the electric motor and the gear system 618 are started in the second direction, the shaft 610 and the end effector 620 can rotate around the axis 615 counterclockwise to properly position and orientate end effector 620.

As discussed above, the end effector 620 can be selectively attached to and removed from the rod 610. The reader will notice that the principles discussed in connection with the end effector 620 and the rod 610 can equally be applied to the end effector 120 and the rod 110 of the embodiment, disclosed in FIG. 1, among others.

Moreover, as again shown in FIG. 27, one of the automatic manipulators 30 may be selectively engaged with the clip applier end effector 120 or, alternatively, with any other suitable end effector, such as, for example, the end effector of a surgical stapler. In such circumstances, end effector 120 can be selectively replaced with another end effector, and as a result, one automatic manipulator 30 can be used to perform more than one function. In other words, the clip clipper 100 may comprise a removable loading module that can be replaced with or exchanged with another clip clipper loading module and / or any other suitable removable loading module. As shown in FIG. 29, the end effector 120 and the clip 110 of the clip attachment 100 can be used with a surgical instrument system comprising a handle 700. The handle 700 may include an actuator 701 that can be triggered or pressed against the jaw 702 to provide rotational movement to the drive screw 161, as described above. In some cases, the rotation of the actuator 701 may be mechanically transmitted to the drive screw 161, while in other cases, the drive actuator 701 may start a motor operably connected to the drive screw 161.

In addition to the foregoing, the end effector 120 and the clip 110 of the clip attachment 100 can be aligned along the longitudinal axis of the clip attachment 100. As shown in FIG. 30, the end effector 120 and / or the rod 110 may further comprise a pivot joint 101, which may be configured to pivot the end effector 120 relative to the longitudinal axis of the clip attachment 100. The rod 110 may comprise an outer casing, or part of a frame, 119, which may comprise a proximal end 102 and may comprise a distal portion of the articulation 101. A proximal end 102 may comprise, for example, a spherical, or at least substantially spherical, end 102, which can insert into the spherical, or at least substantially spherical cavity 104 formed in the articulated joint 103. The articulated joint 103 may also comprise, for example, a spherical, or at least substantially spherical, end 105 that can be inserted into a spherical , or at least substantially spherical, cavity 107 formed in part of the frame of the shaft 106. The proximal end 102 of the rod 110 can be at least partially trapped inside the cavity 104, so that the proximal end 102 cannot be easily withdrawn from the cavity 104. In this case, the proximal end 102 and the cavity 104 can be made in shape and size with the possibility of rotation of the proximal end 102 in any suitable direction within the cavity 104. As also shown in FIG. 30, the clip applier 100 may further comprise, for example, pivot control devices 108a and 108b that may extend through the articulation 101 and may comprise distal ends mounted within mounting holes 10 9a and 109b, respectively, formed at the proximal end 102 of the shaft body 119 In the process of using the articulated steering control device 108a and 108b, it can be pushed and / or pulled to move the proximal end 102 inside the cavity 104. In addition to the above, the end 105 e The articulation joint 103 can be at least partially gripped inside the cavity 107 formed in part of the frame of the shaft 106, so that the end 105 cannot be easily pulled out of the cavity 107. Moreover, the end 105 and the cavity 107 can be made in shape and size with the possibility of rotation of the end 105 in any suitable direction within the cavity 107, when the end of the rod 102 is pushed and / or pulled by actuators 108a and 108b, as described above.

In addition to the above, as again shown in FIG. 30, the drive screw 161 may be rotated by an input rod, such as, for example, an input terminal 152. The input terminal 152 may extend through an opening 156 formed within a portion of the frame of the shaft 106, articulation 103 and the proximal end 102 of the shaft body 119. Input terminal 152 may include an input gear 151 mounted on its distal end, which can be operatively connected to the output gear 155 mounted on the proximal end of the drive screw 161. In use, the input shaft b 152 can be rotated by the electric motor described above, wherein the input shaft 152 can rotate the drive screw 161. As described above, the articulation 101 can be pivoted to rotate the end effector 120 and at least a portion of the rod 110 relative to the longitudinal axis formed by the clip-on filer 100. To enable such movement, at least a portion of the input shaft 152 passing through the articulation 101 may be sufficiently flexible.

As shown in FIG. 31-35, articulated actuators 108a and 108b may be triggered by an actuator module, such as, for example, module 832. As shown primarily in FIG. 31, the actuator module 832 may comprise a rotatable hinge pulley 833, which may be configured to push and pull the hinged actuators 108a and 108b. The hinge pulley 833 may comprise a cylindrical, or at least substantially cylindrical, ring 835 including an opening 837 that can be adapted to receive at least a portion of the frame of the shaft 106 to rotatably support the ring 835. The hinge pulley 833 may further comprise a portion of the input gear 834, which may be operatively connected to the electric motor and the gear system 831 of the module 832, wherein when the electric motor and the gear system 831 are active iruyutsya, hinge pulley 833 can rotate about the shaft of the frame 106. As shown primarily in FIG. 32 and 34, the hinge pulley 833 may further comprise two curved grooves formed in the side wall of the opening of the ring 837, although the reader will notice that only one curved groove 835a is shown in the above images. The curved groove 835a is configured to receive a cam follower 838a directed from the pulley of the hinge 108a, the cam follower 838a being able to slide inside the curved groove 835a. When the hinge pulley 833 rotates, the spiral-shaped contour of the curved groove 835a, for example, can be configured to push the cam follower 838a distally or to extend the cam follower 838 proximally, depending on the direction in which the hinge pulley 833 rotates. As a result of the proximal or distal cam follower element 838 cam actuator 108a can move proximal or distal, respectively. Although not shown, the hinge pulley 108b may comprise a cam follower similar to the cam follower 838a, which can be slidable within another curved groove, as discussed above. Another curved groove can be made so that when the hinge actuator 108a is distally pushed by the hinge pulley 833 while the hinge pulley 833 is rotated in the first direction, the hinge actuator 108b can be pulled proximally. Similarly, another curved groove may be configured such that when the hinge actuator 108a is pulled proximally by the pulley of the hinge 833 while the pulley of the hinge 833 is rotated in the second direction, the hinge actuator 108b can be distally pushed. As shown primarily in FIG. 32, a portion of the shaft frame 106 may comprise grooves 839 formed therein, through which cam actuators 838 can pass. Although the elements described above have been discussed in connection with actuator module 832, such elements can also be used in connection with other actuator modules disclosed herein.

Examples

The clip-loading device loading module may include a rod including a distal end, a proximal end, and a frame comprising a frame connector. with the possibility of releasable attachment to the frame of the actuator. The clip attachment loading module may further comprise a plurality of clips and an end effector directed from the distal end of the rod, the end effector comprising a first jaw, a second jaw configured for movement, and a receiver formed between the first jaw and the second jaw. The receiver is configured to receive a clip, the second jaw made with the ability to move to the first jaw to deform the clip located in the receiver. The clip attachment loading module may further comprise a trigger actuator comprising a distal portion configured to advance the clip into the receiver and a proximal portion comprising a drive connector configured to releasably attach to the actuator ejector.

The clip-on loading device loading module may include a rod containing a distal end, a proximal end, a frame containing a frame connector configured to releasably attach to and disconnect an actuator unit from the frame, and a bearing. The clip loading device loading module may further comprise a plurality of clips and an end effector directed from the distal end of the rod, the end effector comprising a first jaw, a second jaw movable relative to the first jaw, and a receiver formed between the first jaw and the second jaw, the receiver being made with the ability to take a clip. The clip attachment loading module may further comprise a reciprocating rotary trigger actuator comprising a rotatable ejector comprising a thread, the rotatable ejector being rotatably supported by the bearing, and further, the trigger nut is threadedly engaged with a thread configured to the rotation of the ejector, and the starting nut is made with the possibility of advancement to the distal end when the ejector p It rotates the first direction, wherein the launcher nut adapted to pull from the distal end when the ejector is rotated in a second direction opposite the first direction, and wherein the launcher nut adapted to advance a clip to the receiver when the trigger nut moves towards the distal end.

A clip attachment loading module comprising a shaft including a distal end, a proximal end, a frame and connecting means for releasably attaching the frame to an actuator. The clip applier may further comprise a plurality of clips and an end effector directed from the distal end of the rod, the end effector comprising a first jaw, a second jaw arranged to move, and a receiver formed between the first jaw and the second jaw, the receiver configured to receive the clip, and wherein the second jaw is movable to the first jaw to deform the clip located in the receiver. The clip attachment loading module may further comprise triggers to advance the clip into the receiver.

The clip applier for clipping the fabric may include a shaft including a distal portion, a distal opening formed in the distal portion, and a store opening. The clip applier may further comprise a magazine assembly configured to be removably mounted in the magazine opening, the magazine assembly comprising a housing, a storage chamber formed in the housing, a launch platform, a plurality of clips located within the removable storage chamber, and a biasing member, made with the possibility of shifting the clips to the launch platform. The clip applier may further comprise a trigger actuator configured to advance the clip from the magazine through the distal opening.

The store assembly for use with a clip attachment device may comprise a housing, a storage chamber formed in the housing, a launch platform, a plurality of clips located inside the storage chamber with the possibility of extraction, and a biasing element configured to bias the clips to the launch platform.

The surgical tool of the clip-on applier may comprise a rod including a distal part and a socket for the cartridge, and a cartridge assembly configured to be removably mounted in the socket for the cartridge. The cartridge assembly may include a housing, a storage chamber formed in the housing, an outlet, a packet of clips located inside the retrievable storage chamber, the packet of clips containing a plurality of clips stacked on top of each other, and a biasing member configured to align the clip with outlet The surgical tool of the clip applier may further comprise a trigger actuator configured to advance the clip from the magazine through the outlet.

The cartridge assembly for use with a clip-on applicator may include a housing, a storage chamber formed in the housing, an outlet, a package of clips located inside the storage chamber with the possibility of extraction, and the package of clips contains many clips laid on top of each other, and a biasing element made with the ability to align the clip with the outlet.

A surgical clip-on device may include a shaft including a distal portion, a loading port formed in the distal portion, and an outlet. The surgical device may further comprise a cassette with clips configured to be removably mounted in a loading port, the cassette with clips comprising a packet of clips displacing an element configured to align the clip with an outlet, and a trigger actuator configured to advance the clip from the cassette with clips through the outlet.

The clip cassette for use with the clip attachment device can be removably mounted in the loading port of the clip attachment device, the clip cartridge may include a clip package and a biasing member configured to align the clip with the outlet.

The surgical device for applying clips may include a rod, feeding means for feeding a plurality of clips along the feeding axis, and triggering means for moving the clip from a pre-activated position to an activated position along the starting axis, the feed axis being transverse to the starting axis.

A clip applier for clipping a fabric comprising a rod, a trigger chamber, an end effector directed from the rod, the end effector comprising a crimp chamber, and a magazine assembly comprising a housing, a storage chamber formed in the housing, a plurality of clips located inside the storage chamber with the possibility of extraction, and a biasing element configured to sequentially shift clips from the storage chamber to the launch chamber. The clip applier may further comprise a reciprocating trigger actuator configured to advance the clip located in the trigger chamber into the crimp chamber and the lock plate located between the biasing member and the plurality of clips, the biasing element being configured to bias the locking plate into the trigger chamber after advancing all of the plurality of clips into the crimp chamber, and wherein the locking plate is configured to block the trigger actuator.

The store assembly for use with a clip attachment device may comprise a housing, a storage chamber formed in the housing, a plurality of clips located inside the storage chamber with the possibility of extraction, and a biasing element configured to sequentially shift the clips from the storage chamber to the launch chamber. The store assembly may further comprise a locking plate located between the biasing element and the plurality of clips, the biasing element being configured to bias the locking plate into the launch chamber after moving all of the plural clips from the housing, and the locking plate is configured to block the starting drive from entering launch chamber.

A surgical device for applying clips may include a rod, an end effector containing a receiver, and a cassette containing a housing, a storage chamber formed in the housing, a package of clips located inside the removable storage chamber, a launch platform, and a biasing element configured to sequentially shift the clips from the storage chamber to the launch platform. The surgical device may further comprise a reciprocating trigger actuator configured to advance the clip located on the launch platform into the receiver and a locking element located between the biasing element and the clip package, the biasing element being configured to bias the locking element close to the launch platform after advancing, all the clips to the receiver, and moreover, the blocking element is configured to block the trigger drive.

A cassette for use with a clip-on applicator may comprise a housing, a storage chamber formed in the housing, a package of clips located inside the removable storage chamber, a launch platform and a biasing member configured to sequentially shift clips from the storage chamber onto the launch platform. The cartridge may further comprise a locking element located between the biasing element and the clip package, the biasing element being configured to bias the locking element close to the launch platform after moving all the clips from the housing, and the locking element is configured to block the starting drive from passing through the housing.

A surgical tissue clipping device may include a shaft, an end effector containing a receiver, and a cartridge containing a body, a storage chamber formed in the body, a packet of clips located within the retrievable storage chamber, a launch chamber, and a biasing member configured to sequentially shift the clips from the storage chamber to the launcher. the camera. The surgical device may further comprise a reciprocating trigger actuator configured to advance the clip located in the trigger chamber to the receiver during the trigger cycle, and locking means to make it difficult for the trigger drive to execute the trigger cycle after all clips are advanced to the receiver.

A cassette for use with a clip attachment device may include a housing, a storage chamber formed in the housing, a package of clips located inside the storage chamber with the possibility of extraction, a launch chamber and a biasing element configured to sequentially shift the clips from the storage chamber to the launch chamber. The cassette may further comprise locking means to make it difficult for the trigger drive to start the trigger cycle after all the clips have been advanced from the housing.

The devices described herein can be made with the possibility of both disposable and reusable use. However, in each case, after at least one application, the device can be reused after appropriate restoration. Recovery can include any combination of the following steps: disassembling the device, then cleaning or replacing individual items, followed by reassembly. In particular, the device can be disassembled and selectively replaced or removed in any combination, any number of individual elements or parts of the device. After cleaning and / or replacing individual parts, the device can be reassembled for subsequent use, either at the recovery point or in the operating unit immediately before surgery. Those skilled in the art will appreciate that various methods of disassembling, cleaning / replacing, and reassembling can be used in rebuilding a device. The use of such methods, as well as the resulting reconditioned device, are included in the scope of the present invention.

Although the present invention is described herein with reference to certain disclosed embodiments of the invention, various modifications and variations can be applied to the described embodiments. For example, you can use different types of end effectors. Also, for some components for which the materials are disclosed, other materials may be used. It is intended that the foregoing description and the following claims cover all such modifications and variations.

Full disclosures of US Pat. No. 8,075,571, entitled "METHODS FOR SURGICAL CLIPPING AND LOADING", issued December 13, 2011; US Patent No. 8,038,686, entitled “CLIPS SHOWER EXECUTED WITH THE POSSIBILITY OF PREVENTING AGAINST KLIPS”, issued October 18, 2011; and US Patent No. 7,699,860, entitled "SURGICAL CLIPS", issued April 20, 2010, are fully incorporated herein by reference.

Any patent, publication or other description material, in whole or in part, which is indicated as incorporated herein by reference, is included in this document only to the extent that the materials included do not contradict the existing definitions, statements or other description materials presented in this description. Thus, to the extent necessary, the description, expressly presented in this document, prevails over any conflicting material incorporated herein by reference. Any material or part thereof, indicated as incorporated herein by reference, but contrary to existing definitions, provisions or other description material presented herein, will be included in this document only to the extent that between the included material and the existing description material no contradictions arise.

Claims (26)

1. A clip-on applicator for clipping a fabric, comprising: a rod comprising: distal part; a distal opening formed in said distal portion; and a hole for the store; the store node, made with the possibility of removable installation in the specified hole for the store, and the specified store node contains: housing; a storage chamber formed by the specified housing; launch platform; a package of clips located in the specified chamber for storage with the possibility of extraction; and a biasing element configured to bias said clips toward said launch platform; and a trigger actuator configured to advance the clip from said store through said distal opening, while the biasing element is located between the specified housing and the upper clip from the specified package of clips. 2. The clip clipper according to claim 1, wherein said rod further comprises: proximal part; and articulation connecting rotatably the specified proximal part and the specified distal part of the specified rod. 3. The clip-on applicator according to claim 1, wherein said store assembly further comprises a pusher plate located between said biasing element and said plurality of clips. 4. The clip-on applicator according to claim 1, wherein said housing further comprises a proximal hole configured to receive said trigger actuator. 5. The clip-on applicator according to claim 4, further comprising a blocking plate located between said biasing element and said plurality of clips, said biasing element being adapted to bias said blocking plate until alignment with said proximal hole to block said launcher from entering the chamber for storage after pushing said clips from the specified store node. 6. The clip-on applicator according to claim 5, wherein said interlocking plate comprises a plurality of guides and wherein said housing comprises a plurality of interacting guides configured to interact with said guides to define movement of said interlocking plate along a predetermined path. 7. The clip applicator according to claim 5, wherein said launch platform comprises a shelf, wherein said biasing member is configured to bias said clip close to said shelf and wherein said shelf is aligned with said distal opening. 8. The clip applier according to claim 1, further comprising a first jaw and a second jaw located relative to said distal opening, said first jaw being movable to said second jaw to deform a clip located between said first jaw and said second jaw. 9. The clip-on applicator according to claim 8, further comprising a compression drive configured to move said first jaw to said second jaw, said compression drive being capable of being activated sequentially with said starting drive. 10. The clip-on applicator according to claim 1, further comprising means for blocking said starting drive after ejecting said clips from said store node. 11. The clip-on applicator according to claim 1, wherein said starting element is configured to enter a specified housing along a launch axis, said biasing element being configured to bias said clip into a starting position along a feed axis and said feed axis is transverse to said starting axis. 12. The clip-on applicator according to claim 11, wherein said feed axis is perpendicular to said trigger axis. 13. The clip-on applicator according to claim 1, further comprising a cartridge fuse configured to releasably hold said store assembly in said store opening.

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