RU2714166C2 - Surgical instruments with improved closing structures - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: group of inventions relates to medical equipment, specifically to surgical stapling and cutting tools and staples intended for use with them. Surgical stapling instrument comprises a surgical end effector and a closure system. Surgical end effector comprises first and second branch elements. Application of closing movement with respect to at least one of first and second elements of branch results in movement of at least one of first and second elements of branch in closed position relative to other of first and second elements of branch. Closing system comprises axially movable closing element closing actuator and closing transmission. Axially movable closing element is configured to apply closing movement with respect to at least one of first and second members of branch. Closing actuator includes the first part of the actuating mechanism made with the possibility of axial movement along the first section of axial movement at actuation of the closing actuating mechanism. Closing transmission is connected to first part of actuator and comprises second part of actuator, which is connected to the axially movable closing element such that when the closing actuating mechanism actuates, the second actuator part moves the axially movable closing member along the second axial movement portion, which is larger than the first axial movement portion. Actuator first part comprises first axially movable closing rack. Actuator second part comprises second axially movable closing rack, which is in functional connection with first axially movable closing rack. In addition, the closing transmission comprises a transmission rack covering the gear wheel, a connecting gear wheel and a multiplier gear wheel. In a second embodiment, the surgical stapling instrument comprises an end effector. End effector comprises a surgical staple cassette and a stopper. Surgical instrument further comprises a shaft assembly, a handle closing the actuator, an axially movable closing element and a closing transmission.

EFFECT: inventions are characterized by that the second part of the actuator is functionally connected to the first part of the actuator by means of an axially movable transfer rack and gears.

13 cl, 80 dwg

Description

BACKGROUND OF THE INVENTION

The present invention relates to surgical instruments and, in various embodiments, to surgical stapling and cutting instruments and cassettes with brackets for use with them.

The stapling instrument may include two interacting elongated branches, each of which is adapted to be inserted into the patient’s body and positioned relative to the stitched and / or cut tissue. In various embodiments, one of the jaws can support the cassette with brackets with at least two rows of staples contained therein, located in the lateral direction, and the second jaw can support the stop with the recesses forming the bracket, aligned with the rows of staples in the cassette with brackets. Essentially, the stapling tool may further include a pusher rod and a scalpel blade that are movable relative to the jaws for sequentially pushing the staples from the staple cartridge through cam surfaces on the push rod and / or cam surfaces on wedge-shaped slides that are pushed pusher rod. In at least one embodiment, the cam surfaces are configured to move a plurality of staple ejectors located in the cassette and connected to the staples to push the staples to the stop and form laterally rows of deformed staples in the tissue sandwiched between the jaws. In at least one embodiment, the scalpel blade may follow cam surfaces and cut tissue along a line between rows of staples. Examples of such stapling tools are described in US Pat. No. 7,794,475, entitled SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME, the entire disclosure of which is incorporated herein by reference.

The foregoing description is intended only to illustrate various aspects of the relevant technology in the field of application of the invention at present, and should not be construed as limiting the scope of the claims.

A brief description of the graphic materials

The various elements of the embodiments described herein, along with their advantages, can be understood after studying the description below together with the accompanying drawings, moreover:

in FIG. 1 is a perspective view of an embodiment of an electrically powered surgical instrument comprising a handle, a barrel, and an articulated pivot end effector;

in FIG. 2 is a perspective view of an embodiment of a hand-operated surgical instrument comprising a handle, a barrel, and a pivotally rotatable end effector;

in FIG. 3 is a perspective view of an embodiment of a surgical instrument comprising a body, a barrel, and a pivotally rotatable end effector, which is configured to be used with a robotic control system;

in FIG. 4 is a perspective view of an embodiment of a robotic control surgical system;

in FIG. 5 is a perspective view of an embodiment of a pivotable surgical end effector;

in FIG. 6 is a perspective view with a spatial separation of the components of the articulated surgical end effector shown in FIG. 5;

in FIG. 7 is a perspective view of an elongated channel of a surgical end effector shown in FIG. 5 and 6;

in FIG. 8 is a plan view of the elongated channel shown in FIG. 7;

in FIG. 9 is a side elevational view of an elongated channel shown in FIG. 7 and 8;

in FIG. 10 is a top view of the abutment of a surgical end effector shown in FIG. 5 and 6;

in FIG. 11 is a side elevational view of the stop shown in FIG. 10;

in FIG. 12 is a cross-sectional view of the surgical end effector shown in FIG. 5 and 6, with emphasis in the open position;

in FIG. 13 is a side cross-sectional view of the surgical end effector shown in FIG. 12, with emphasis in the closed position and the trigger element in the inactive initial position;

in FIG. 14 is a perspective view of an embodiment of a guide rod assembly;

in FIG. 15 is a perspective cross-sectional view of a launch rod guide assembly shown in FIG. 14;

in FIG. 16 is a partial perspective view of the surgical end effector shown in FIG. 11 and 12;

in FIG. 17 is a plan view of the surgical end effector shown in FIG. 16;

in FIG. 18 is a perspective view of the surgical end effector shown in FIG. 16 and 17 pivotally rotated in a first direction FD;

in FIG. 19 is a top view of the surgical end effector shown in FIG. 18;

in FIG. 20 is a perspective view of the surgical end effector shown in FIG. 16 and 17 pivotally rotated in the second direction SD;

in FIG. 21 is a plan view of the surgical end effector shown in FIG. 20;

in FIG. 22 is a schematic comparison of ranges of motion of two surgical end effectors in the human pelvic region;

in FIG. 23 is a side elevational view with a comparison of the proximal dead zones (PDZ) of two surgical end effectors;

in FIG. 24 is a perspective view of another embodiment of a pivotable surgical end effector;

in FIG. 25 is a perspective view of the spatial separation of the components of the surgical end effector shown in FIG. 24;

in FIG. 26 is a partial perspective view of the surgical end effector shown in FIG. 24 and 25;

in FIG. 27 is another partial perspective view of the surgical end effector shown in FIG. 24-26 articulated in a first direction (FD);

in FIG. 28 is a different perspective view of the surgical end effector shown in FIG. 27 pivotally rotated in a second direction (SD);

in FIG. 29 is a plan view of the end effector shown in FIG. 24 and 25;

in FIG. 30 is another top view of the end effector shown in FIG. 29 pivotally rotated in a first direction (FD);

in FIG. 31 is another top view of the surgical end effector shown in FIG. 29 pivotally rotated in a second direction (SD);

in FIG. 32 is another top view of a portion of the surgical end effector shown in FIG. 29;

in FIG. 33 is an enlarged plan view of a portion of the surgical end effector shown in FIG. 32;

in FIG. 34 is an enlarged top view of part of another embodiment of a surgical end effector;

in FIG. 35 is a perspective view of part of another embodiment of a surgical instrument;

in FIG. 36 is a plan view of the surgical instrument shown in FIG. 35;

in FIG. 37 is another top view of the surgical instrument shown in FIG. 35 and 36, the end effector of which is in a pivotally rotated position;

in FIG. 38 is a perspective view of part of another embodiment of a surgical instrument;

in FIG. 39 is a top view of the surgical instrument shown in FIG. 38;

in FIG. 40 is another top view of the surgical instrument shown in FIG. 38 and 39, the end effector of which is in a pivotally rotated position;

in FIG. 41 is a perspective view of part of another embodiment of a surgical instrument;

in FIG. 42 is an exploded view of the components of a portion of a surgical instrument shown in FIG. 41;

in FIG. 43 is another perspective view of a spatially separated component of a portion of the surgical instrument shown in FIG. 41 and 42;

in FIG. 44 is a plan view of a portion of the surgical instrument shown in FIG. 41-43;

in FIG. 45 is another top view of the surgical instrument shown in FIG. 41-44, the end effector of which is in a pivotally rotated position;

in FIG. 46 is a perspective view of part of another embodiment of a surgical instrument;

in FIG. 47 is a plan view of the surgical instrument shown in FIG. 46;

in FIG. 48 is another top view of the surgical instrument shown in FIG. 46 and 47, the end effector of which is in a pivotally rotated position;

in FIG. 49 is a perspective view of part of another embodiment of a surgical instrument;

in FIG. 50 is a plan view of the surgical instrument shown in FIG. 49;

in FIG. 51 is another top view of the surgical instrument shown in FIG. 49 and 50, the end effector of which is in a pivotally rotated position;

in FIG. 52 is a partial perspective view of an embodiment of a launch rod support assembly;

in FIG. 53 is a perspective view of part of an embodiment of a surgical instrument;

in FIG. 54 is an exploded view of the components of a portion of a surgical instrument shown in FIG. 53;

in FIG. 55 is a perspective view of a portion of a proximal end connector of an elongated channel of an embodiment of an end effector;

in FIG. 56 is a plan view of a portion of the surgical instrument shown in FIG. 53-55;

in FIG. 57 is another top view of the surgical instrument shown in FIG. 53-56, the end effector of which is in a pivotally rotated position;

in FIG. 58 is a perspective view of an articulated surgical instrument shown in FIG. 57;

in FIG. 59 is a perspective view of part of another embodiment of a surgical instrument;

in FIG. 60 is an exploded view of the components of a portion of a surgical instrument shown in FIG. 59;

in FIG. 61 is a plan view of a portion of the surgical instrument shown in FIG. 59 and 60;

in FIG. 62 is a plan view of the surgical instrument shown in FIG. 59-61, the end effector of which is in a pivotally rotated position;

in FIG. 63 is a perspective view of the surgical instrument shown in FIG. 62;

in FIG. 64 is a perspective view of an embodiment of a guide rod assembly;

in FIG. 65 is a perspective view of another embodiment of a guide rod assembly;

in FIG. 66 is a bottom perspective view of the launch rod guide assembly shown in FIG. 65;

in FIG. 67 is a perspective view in cross section of a guide rod assembly shown in FIG. 65 and 66;

in FIG. 68 is a perspective view of another embodiment of a guide rod assembly;

in FIG. 69 is an exploded view of the components of the launch rod guide assembly shown in FIG. 68;

in FIG. 70 is a perspective view of another embodiment of a launch rod guide assembly;

in FIG. 71 is a perspective view of another embodiment of a launch rod guide assembly;

in FIG. 72 is a perspective view of another embodiment of a surgical instrument;

in FIG. 73 is a perspective cross-sectional view of part of a replaceable shaft assembly of a surgical instrument shown in FIG. 72;

in FIG. 74 is a partial perspective view of a portion of the barrel interchangeable assembly shown in FIG. 72;

in FIG. 75 is an exploded view of the components of a portion of the interchangeable barrel assembly shown in FIG. 72-74;

in FIG. 76 is a partial cross-sectional view of the interchangeable barrel assembly shown in FIG. 72-75;

in FIG. 77 is another partial cross-sectional view of the interchangeable barrel assembly shown in FIG. 72-76;

in FIG. 78 are side elevational views of the end effector of the surgical instrument shown in FIG. 72, with emphasis in the open position and in the closed position;

In FIG. 79 is a plan view of a portion of the surgical instrument shown in FIG. 72. and

in FIG. 80 is another top view of the surgical instrument shown in FIG. 79, the end effector of which is shown in a pivotally rotated position.

Corresponding elements in different views are indicated by the corresponding symbols. The examples provided herein in one form illustrate some embodiments of the present invention, and such examples should not be construed as in any way limiting the scope of the present invention.

DETAILED DESCRIPTION

The applicant of this application owns the following patent applications filed March 1, 2013, each of which is fully incorporated into this document by reference:

- US patent application No. 13 / 782,295, entitled Articulatable Surgical Instruments With Conductive Pathways For Signal Communication, currently published US patent application No. 2014/0246471;

- US patent application No. 13 / 782,323, entitled Rotary Powered Articulation Joints For Surgical Instruments, currently US Patent Publication No. 2014/0246472;

- US patent application No. 13 / 782,338, entitled Thumbwheel Switch Arrangements For Surgical Instruments, currently US Patent Publication No. 2014/0249557;

- US patent application No. 13 / 782,499, entitled Electromechanical Surgical Device with Signal Relay Arrangement, currently published US patent application No. 2014/0246474;

- US patent application No. 13 / 782,460, entitled Multiple Processor Motor Control for Modular Surgical Instruments, currently published US patent application No. 2014/0246478;

- US patent application No. 13 / 782,358, entitled Joystick Switch Assemblies For Surgical Instruments, currently US Patent Publication No. 2014/0246477;

- US patent application No. 13 / 782,481, entitled Sensor Straightened End Effector During Removal Through Trocar, currently published US patent application No. 2014/0246479;

- US patent application No. 13 / 782,518, entitled Control Methods for Surgical Instruments with Removable Implement Portions, currently published US patent application No. 2014/0246475;

- US patent application No. 13 / 782,375, entitled Rotary Powered Surgical Instruments With Multiple Degrees of Freedom, currently published US patent application No. 2014/0246473; and

- US patent application No. 13 / 782,536, entitled Surgical Instrument Soft Stop, currently the publication of US patent application No. 2014/0246476.

The applicant of this application also owns the following patent applications filed March 14, 2013, each of which is fully incorporated into this document by reference:

- US patent application No. 13 / 803,097, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, currently published US patent application No. 2014/0263542;

- US Patent Application No. 13 / 803,193, entitled CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT, currently US Patent Publication No. 2014/0263537;

- US patent application No. 13 / 803,053, entitled INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT, currently US patent publication No. 2014/0263564;

- US patent application No. 13 / 803,086, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, currently published US patent application No. 2014/0263541;

- US patent application No. 13 / 803,210, entitled SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS, currently published US patent application No. 2014/0263538;

- US patent application No. 13 / 803,148, entitled MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT, currently US patent publication No. 2014/0263554;

- US patent application No. 13 / 803,066, entitled DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, currently published US patent application No. 2014/0263565;

- US patent application No. 13 / 803,117, entitled ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS, currently published US patent application No. 2014/0263553;

- US patent application No. 13 / 803,130, entitled DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, currently published US patent application No. 2014/0263543; and

- US patent application No. 13 / 803,159, entitled METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT, currently US patent publication No. 2014/0277017.

The applicant of this application owns the patent application presented below, filed March 7, 2014, which is fully incorporated herein by reference:

- US patent application No. 14 / 200,111, entitled CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS, currently US patent publication No. 2014/0263539.

The applicant of this application owns the following patent applications filed March 26, 2014, each of which is fully incorporated into this document by reference:

U.S. Patent Application No. 14 / 226.106 entitled POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS;

U.S. Patent Application No. 14 / 226,099 entitled STERILIZATION VERIFICATION CIRCUIT;

U.S. Patent Application No. 14 / 226,094 entitled VERIFICATION OF NUMBER OF BATTERY EXCHANGES / PROCEDURE COUNT;

U.S. Patent Application No. 14 / 226,117 entitled POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL;

U.S. Patent Application No. 14 / 226,075 entitled MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES;

U.S. Patent Application No. 14 / 226,093, entitled FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS;

U.S. Patent Application No. 14 / 226,116 entitled SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION;

U.S. Patent Application No. 14 / 226,071 entitled SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR;

U.S. Patent Application No. 14/226 097 entitled SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS;

U.S. Patent Application No. 14 / 226.126 entitled INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS;

U.S. Patent Application No. 14 / 226.133 entitled MODULAR SURGICAL INSTRUMENT SYSTEM;

U.S. Patent Application No. 14 / 226,081 entitled SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT;

U.S. Patent Application No. 14 / 226.076 entitled POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION;

U.S. Patent Application No. 14 / 226,111 entitled SURGICAL STAPLING INSTRUMENT SYSTEM; and

U.S. Patent Application No. 14 / 226,125, entitled SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT.

The applicant of this application also owns the following patent applications filed September 5, 2014, each of which is fully incorporated into this document by reference:

U.S. Patent Application No. 14 / 479,103, entitled CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE;

U.S. Patent Application No. 14 / 479,119, entitled ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION;

- US patent application No. 14 / 478,908, entitled MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION;

U.S. Patent Application No. 14 / 478,895 entitled MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSORʹS OUTPUT OR INTERPRETATION;

- US Patent Application No. 14 / 479,110 entitled USE OF POLARITY OF HALL MAGNET DETECTION TO DETECT MISLOADED CARTRIDGE;

U.S. Patent Application No. 14 / 479,098, entitled SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION;

U.S. Patent Application No. 14 / 479,115 entitled MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE; and

- US Patent Application No. 14 / 479.108 entitled LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION.

The applicant of this application also owns the following patent applications filed April 9, 2014, each of which is fully incorporated into this document by reference:

- US patent application No. 14 / 248,590, entitled MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS, currently published US patent application No. 2014/0305987;

- US Patent Application No. 14 / 248,581, entitled SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRING DRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT, currently published US patent application No. 2014/0305989;

- US patent application No. 14 / 248,595, entitled SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING THE OPERATION OF THE SURGICAL INSTRUMENT, currently published US patent application No. 2014/0305988;

- US patent application No. 14 / 248,588, entitled POWERED LINEAR SURGICAL STAPLER, currently published US patent application No. 2014/0309666;

- US patent application No. 14 / 248,591, entitled TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT, currently published US patent application No. 2014/0305991;

- US patent application 14 / 248,584 entitled MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS, currently published US patent application No. 2014/0305994;

- US patent application No. 14 / 248,587, entitled POWERED SURGICAL STAPLER, currently published US patent application No. 2014/0309665;

- US patent application No. 14 / 248,586, entitled DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT, currently published US patent application No. 2014/0305990; and

U.S. Patent Application No. 14 / 248,607 entitled MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS, currently published U.S. Patent Application No. 2014/0305992.

The applicant of this application also owns the following patent applications filed April 16, 2013, each of which is fully incorporated into this document by reference:

- provisional application for US patent No. 61 / 812,365, entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR;

- provisional application for US patent No. 61 / 812,376, entitled LINEAR CUTTER WITH POWER;

- provisional application for US patent No. 61 / 812,382, entitled LINEAR CUTTER WITH MOTOR AND PISTOL GRIP;

- provisional application for US patent No. 61 / 812,385, entitled SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS AND MOTOR CONTROL; and

- provisional application for US patent No. 61 / 812,372, entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR.

The applicant of this application belongs to the following patent applications filed on the same day, each of which is fully incorporated into this document by reference:

- US Patent Application No. _______, entitled SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER; Patent Attorney Dossier No. END7415USNP / 140289;

- US Patent Application No. _______ entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS; Patent Attorney File No. END7416USNP / 140291;

- US Patent Application No. _______, entitled DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS, Patent Attorney File No. END7418USNP / 140292;

- US Patent Application No. _______ entitled LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH ARTICULATABLE SURGICAL END EFFECTORS, Patent Attorney File No. END7417USNP / 140293;

- US Patent Application No. _______, entitled SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE, Patent Attorney Dossier No. END7485USNP / 140295;

US Patent Application No. __________ entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS, Patent Attorney Dossier No. END7489USNP / 140299;

US Patent Application No. __________, entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS, Patent Attorney Dossier No. END7491USNP / 140301;

- US Patent Application No. _______, entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM; Patent Attorney Dossier No. END7492USNP / 140302; and

- U.S. Patent Application No. _______ entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION SYSTEM; Patent Attorney Dossier No. END7494USNP / 140304;

This document provides the detailed information necessary to understand the overall design, functionality, manufacturing features and application of various embodiments, the description of which is provided in the specification and illustrated in the accompanying drawings. The well-known operating principles, components, and elements have not received a detailed description in this document so as not to obscure the embodiments described in the specification. The reader should understand that the embodiments described and illustrated herein are non-limiting examples. It should be understood that certain design and functional features described in this document may be indicative or explanatory. Changes and modifications to the embodiments described and illustrated herein may be made within the scope of the claims.

The terms “contain” (and any of its forms, such as “contains” and “containing”), “have” (and any of its forms, such as “has” and “having”), “include” (and any of its forms, such as “includes” and “including”), “enclose” (and any of its forms, such as “encloses” and “enclosing”) are unlimited connecting verbs. As a result, a surgical system or device that "contains," "has," "includes," or "accommodates" one or more elements has this one or more elements, but possession is not limited to only one or more elements. Similarly, an element of a system or device that “contains”, “has”, “includes” or “accommodates” one or more elements has this one or more elements, but possession is not limited to only one or more elements.

The terms "proximal" and "distal" in this document are defined with respect to the physician managing the handle of the surgical instrument. The term "proximal" refers to the area closest to the doctor, and the term "distal" refers to the area remote from the doctor. It is also proposed to use spatial terms such as “vertical”, “horizontal”, “up” and “down” in relation to the drawings for convenience and clarity. However, since the use of surgical instruments involves many orientations and provisions, these terms should not be interpreted as limiting and (or) absolute.

To perform laparoscopic and minimally invasive surgical interventions, various examples of devices and methods have been proposed. However, the reader will be quite clear that the various methods and devices described herein can be used in many surgical interventions and fields of application, including, for example, those associated with open surgical interventions. When studying this detailed description, the reader will be able to further appreciate that the various tools described in this document can be introduced into the body in any way - either through natural openings, or through an incision or a puncture hole made in the tissues, etc. Working parts or parts of the terminal effectors of such instruments can be inserted directly into the patient’s body or through an access device that has a working channel through which the terminal effector and the elongated surgical trumenta.

A surgical stapling system may include a trunk and an end effector extending from the trunk. The end effector may include a first branch and a second branch. The first branch contains a cassette with staples. The cassette with brackets is configured to be inserted into the first jaw and removed from it; however, other embodiments are provided in which the cassette with brackets is made without being able to be removed from the first jaw, or at least configured to be quickly replaced from the first jaw. The second jaw contains an emphasis made with the possibility of deformation of the brackets ejected from the cassette with brackets. The second jaw is rotatable relative to the first jaw around the axis of closure; however, other embodiments are provided in which the first jaw is rotatable relative to the second jaw. The surgical stapling system further comprises an articulation configured to provide rotation or articulation of the end effector relative to the barrel. The end effector is rotatable around the axis of the articulation passing through the articulation. Other embodiments are provided that do not include articulation.

The cassette with brackets contains the cassette body. The cartridge case includes a proximal end, a distal end, and a platform extending between the proximal end and the distal end. During use, the cassette with brackets is located on the first side of the fabric to be stitched, and the emphasis is located on the second side of the fabric. The emphasis moves to the cartridge with brackets for compression and pressing of fabric to a platform. After that, the staples stored in the cassette with the possibility of extraction can be placed in the fabric. The cassette case includes the brackets formed in it, while the brackets are stored in the brackets for retrieval. Cavities for brackets are located in six longitudinal rows. Three rows of cavity for the brackets are located on the first side of the longitudinal groove, and three rows of cavity for the brackets are located on the second side of the longitudinal groove. Other constructions of staples and cavities for staples are possible.

In the cassette case, the brackets are supported using ejector brackets. The ejectors are arranged to move between the first or inactive position and the second or activated position to eject the brackets from the cavity for the brackets. The pushers are held in the cassette body by means of a latch that extends around the lower part of the cassette body and includes elastic elements capable of gripping the cassette body and holding the latch relative to the cassette body. The pushers are made with the ability to move between their inactive positions and activated positions using the slide. The slide is movable between a proximal position adjacent to the proximal end and a distal position adjacent to the distal end. The slide contains many inclined surfaces made with the possibility of sliding under the ejectors and lifting the ejectors and the brackets supported on them against the stop.

In addition to the above, the slide moves distally with a trigger element. The trigger element is made with the possibility of contact with the slide and pushing the slide to the distal end. A longitudinal groove formed in the cassette body is configured to receive a trigger element. The emphasis also includes a groove configured to receive a trigger element. The trigger element further comprises a first cam that interacts with the first jaw and a second cam that interacts with the second jaw. When extending the trigger element distally, the first cam and the second cam allow you to control the distance, or tissue gap, between the cassette platform with brackets and emphasis. The trigger element also contains a scalpel, made with the possibility of dissection of tissue captured between the cassette with brackets and emphasis. It is desirable to at least partially position the scalpel proximal to the inclined surfaces so that the braces are ejected before the scalpel.

In FIG. 1 shows an example of an engine-driven (or “power”) surgical instrument 10 that includes a body 20, an elongated barrel assembly 100, and an end effector 200 operably connected to the elongated shaft assembly 100. As shown in the figure, the end effector 200 is configured to function as an endocater for fixing, dissecting, and stapling tissue staples. However, it should be understood that various embodiments may include end effectors configured to function as other surgical devices, including, for example, clamps, cutting tools, staplers instruments, clip-ons, access devices, drug / gene therapy drug delivery devices, ultrasound, RF and / or laser devicesetc. As indicated above and will be further described below, various sections of the surgical instrument 10 are driven by an engine. Additional information on many aspects of the motor-driven components of a surgical instrument 10 can be found, for example, in US Patent Application No. 13 / 803,086, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, US Patent Application Publication No. 2014/0263541, which are fully incorporated in this document by reference. However, it should be understood that the various designs of the end effector described in this document can also be successfully used in combination with portable cases (handles) that contain “manual” (that is, not driven by the motor (s)) drive and closing systems, such as those described in the aforementioned publication of US patent application No. 2014/0263541, incorporated herein. For example, in FIG. 2, an end effector 200 is attached to an elongated barrel assembly 100ʹ, which is operatively connected to a body 20ʹ of a surgical instrument 10ʹ that functionally supports a manual closing and starting system.

It should also be understood that the various designs described herein can be effectively used in combination with robotic control surgical systems. For example, the various designs described herein can be used with various robotic systems, tools, components, and methods described in US Patent Application No. 13 / 118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, currently publishing the application for US patent No. 2012/0298719, which is fully incorporated herein by reference. For example, in FIG. 3 shows a surgical instrument 10ʺ well suited for use with a robotic system, such as the robotic system 13 shown in FIG. 4. The surgical instrument 10 ° includes an end effector 200, functionally connected to the node 100 ° of the elongated shaft, which is connected with the housing 20 ° in the form of a node drive tool. In FIG. 4 shows a trolley 15 of a robotic arm configured to actuate a variety of surgical instruments, such as surgical instruments 10ʺ. The trolley 15 of the robotic arm and surgical instruments 10ʺ can be controlled using the main controller 17, which is functionally connected (directly or wirelessly) with them. Various details regarding the functioning of components of robotic systems and drive units of various tools can be found in the aforementioned included published US patent application No. 2012/0298719, as well as in US patent No. 6,132,368, entitled MULTI-COMPONENT TELEPRESENCE SYSTEM AND METHOD, US patent No. 5,878,193, entitled AUTOMATED ENDOSCOPE SYSTEM FOR OPTIMAL POSITIONING, U.S. Patent No. 5,792,135, entitled ARTICULATED SURGICAL INSTRUMENT FOR PERFORMING MINIMALLY INVASIVE SURGERY WITH ENHANCED DEXTERITY AND SENSITIVITY, U.S. Patent No. 6,231,565, US $ 6,231,565, US Pat. OBOTIC SURGICAL TOOL WITH ULTRASOUND CAUTERIZING AND CUTTING INSTRUMENT, US Pat. LINK WRIST MECHANISM, US Pat. No. 7,806,891, entitled REPOSITIONING AND REORIENTATION OF MASTER / SLAVE RELATIONSHIP IN MINIMALLY INVASIVE TELESURGERY, as well as US Pat. by reference.

Thus, as used herein, the term “housing” can also encompass a housing or similar part of a robotic system that accommodates or otherwise functionally supports at least one drive system configured to generate and apply at least one control movement which can be used to actuate the interchangeable shaft assemblies described herein and their corresponding equivalents. The term “frame” may refer to a part of a portable surgical instrument, such as a “pen”. The term “frame” can also be a part of a robotic control surgical instrument and / or a part of a robotic system that can be used to functionally control a surgical instrument.

It should be understood that spatial terms, such as “vertical”, “horizontal”, “right”, “left”, etc., are used in this document with reference to the figures, based on the fact that the longitudinal axis or “axis of the trunk »Surgical instrument 10 (or other examples of surgical instruments described herein) coincides with the central axis of the barrel 100. However, in actual practice, any surgical instrument described herein can be oriented at different angles, and as such these spaces Natural terms apply to the surgical instrument itself. In addition, for a portable case, the term “proximal” is used to mean the angle of view of a doctor who is behind the handle and places the end effector distally, or away from you. As used herein, the phrase “substantially transverse to the longitudinal axis”, where “longitudinal axis” is the axis of the rod, refers to a direction that is almost perpendicular to the longitudinal axis. However, it should be understood that directions that deviate somewhat from the perpendicular with respect to the longitudinal axis are also substantially transverse to the longitudinal axis.

As shown in FIG. 1, the end effector 200 is pivotally coupled to the barrel 100 via an articulation 109. A plurality of articulations and control systems are described in various patents and patent applications, which are incorporated herein by reference. Other articulations and articulation systems are described in US Pat. No. 7,753,245, entitled SURGICAL STAPLING INSTRUMENTS, and US Pat. No. 7,670,334, entitled SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR, the contents of which are incorporated herein by reference in their entirety. Various other means of articulating the end effector 200 are described in more detail below.

As shown in FIG. 5 and 6, the end effector 200 includes, among other things, an elongated channel 210 that is configured to functionally support the cassette 230 with brackets therein. The cassette 230 with brackets includes a cassette body 232, in which there is a centrally located elongated groove 234 of the cassette (FIG. 6). In the presented design, the cassette 230 with staples has three rows 238 of recesses 236 for staples on each side of the elongated groove 234 of the cassette. One or more surgical staples 242 are supported on respective staple ejectors 240, which are functionally supported in staple recesses 236. The cassette tray 215 is attached to the bottom of the cassette body 232. The cassette tray 215 includes a tray groove 217 that aligns with the cassette groove 234 and the channel groove 212 in the elongated channel 210. See FIG. 6.

The surgical instrument 10 further includes a trigger element 300, which is connected to a trigger rod 310 associated with the trigger system, which is supported in the housing 20, 20ʹ or 20ʺ. The starter system may be actuated by a motor structure supported in the handle 20 (FIG. 1), or it may be manually actuated by actuating the trigger 26ʹ (FIG. 2), or it may be actuated by robotic system 13 (FIG. 4). Regardless of the design used, after actuation, the trigger system applies an axial trigger movement to the trigger rod 310 to move the trigger 300 in the distal direction DD. As shown in FIG. 6, the trigger element 300 includes a vertically extending trigger element housing 302, on which a cutting fabric surface or blade 304 is present. The first trigger tag 306 protrudes from the first side 305 of the trigger element housing 302, and the second trigger tag 308 protrudes from the second side 307 housing 302 trigger element. In addition, the first middle tongue (not shown) protrudes from the first side 305 of the starter housing 302, and the second middle tongue 309 protrudes from the second side 307 of the starter housing 302. The trigger element 300 further includes a tab or tab 312 that protrude laterally from the bottom of the trigger element housing 302. The purpose of the reeds 306, 308, 309 and tabs 312 will be described in more detail below. In addition, wedge-shaped slides 320 can be installed inside the cassette body 232 for contact with the trigger element 300 to set it in motion. When the trigger 300 moves distally through the cassette body 232, the beveled surfaces 322 contact the staple ejectors 240 to move the ejectors 240 and the surgical braces 242 supported thereon upward in the cassette body 232.

The end effector 200 further includes an abutment 250, which includes an abutment body 252 on which a bottom surface 254 forming a bracket is present. The abutment 250 also includes an abutment mounting portion 260 for pivotally connecting the abutment 250 to the proximal end portion 211 of the elongated channel 210 for pivoting about it relative to the stationary axis A-A of the abutment. As, in particular, shown in FIG. 6 and 10, the emphasis mounting portion 260 in the present construction comprises a proximal protruding first emphasis branch 262, which includes a first stop trunnion 264 extending inwardly. The illustrated abutment mounting portion 260 further comprises a proximal extending second abutment leg 266 that is spaced apart from the first abutment leg 262. The second pin 268 emphasis protrudes inward from the second branch 266 emphasis. The first stop pin 264 is rotatably held in the socket 214 of the first pin provided in the proximal end portion 211 of the elongated channel 210 (FIG. 8), and the second stop pin 268 is placed to rotate in the second pin socket 216 (FIG. 3, 7, 8 and 9) in the proximal end portion 211 of the elongated channel 210. The sockets 214, 216 of the first and second trunnions serve to form a fixed axis AA of the stop, which is perpendicular to the axis SA-SA of the barrel. When the first stop pin 264 is rotatably mounted in the first pin nest 214 and the second stop pin is rotatably mounted in the second pin nest 216, the stop 250 is movable relative to the elongated channel 210 so that the distal end 253 of the stop 250 can selectively move to the elongated channel 210 and from it.

As shown in FIG. 3, 10 and 11, the abutment mounting portion 260 includes a closing inclined portion 270. The closing inclined portion 270 includes a first inclined segment 272 and a second inclined segment 274, which is located at a distance from the first inclined segment 272 to form a stepped opening 280 for the trigger element between them . See FIG. 10, 12 and 13. As shown in FIG. 12, the upper portion of the trigger 300 may extend into the stepped hole 280 when the stop 250 is in the open position and the trigger 300 is in the initial or inactive position. When the stop 250 is closed, as shown in FIG. 13, the top of the trigger 300 passes through a stepped hole 280. As shown in FIG. 10, an elongated stop groove 290 is provided in the bracket-forming lower surface 254 of the stop 250. In addition, a first closing step 292 and a second closing step 294 are formed on the sides of the stop groove 290. A slope 273 of the first closing step is provided on the closing inclined section 270, and it leads to the first closing step 292, and a slope 275 is provided on the closing inclined section 270. the second closing ledge, and it leads to the second closing ledge 294.

The abutment 250 is moved to the open position (FIG. 12) by means of a spring (not shown) that biases the mounting portion 260 of the abutment upward relative to the proximal end 211 of the elongated channel 210 so that the lower surface 254 of the abutment 250 forming a bracket is located at a distance from the cartridge 230 with surgical staples. The distal end 253 of the abutment 250 is moved to the cassette 230 with surgical staples in a position closed relative to it by actuating a closure system that moves the closure element 110 axially distally into contact with the closure inclined portion 270. For example, in the illustrated embodiment, the closure element 110 comprises a closure tube assembly 120 configured to move axially in response to closure motions caused by a closure system supported in the housing. The closure system may be actuated by a motor structure supported in the handle 20, or it may be manually actuated by actuating the closure trigger 28 (FIG. 1) or 28ʹ (FIG. 2), or it may be driven by action using a robotic system 13 (FIG. 4). Regardless of the design used, the actuation of the closure system may cause an axial closure movement applied to the closure assembly 120 of the barrel assembly 100. In FIG. 12 shows the position of the closure tube assembly 120 before operating the closure system. When moving the closure tube assembly 120 in a distal direction, DD, the distal end 122 of the closure tube assembly 120 is in contact with the closing inclined portion 270 of the abutment portion 260 and rotates the abutment 250 so that its distal end 253 moves to the surgical cassette 230. In FIG. 13 shows the position of the closure tube assembly 120 in the fully closed position. After moving the stop 250 to the fully closed position, the trigger system can be actuated to move the trigger 300 along the axis from the inactive or initial position shown in FIG. 12 and 13, distally through the cassette 230 with staples for cutting tissue, sandwiched between the lower surface 254 of the stop 250 forming the bracket, and the cassette 230 with staples. When the trigger element 300 is moved distally, the first tongue 306 moves upward along the first closing slope 273 on the first closing ledge 292, and the second tongue 308 moves upward along the second closing slope 275 on the second closing ledge 294 at the stop 250. The middle tongues 309 slide along the upper surface of the elongated channel 210, and the tab 312 passes along the lower surface 223 of the elongated channel 210. The first and second tabs 306, 308 on the first and second closing ledges 292, 294, as well as the middle tabs 309 and tab 312, serve to position the bottom 254 of the stop 250 forming the bracket, at the desired distance S from the upper surface or platform of the cassette with surgical braces. See FIG. thirteen.

As shown in FIG. 5, in the illustrated example, the end effector 200 is selectively pivotally rotatable about an articulated axis B-B that is perpendicular to the axis SA-SA of the barrel formed by the elongated barrel assembly 100. In the presented construction, the closure tube assembly 120 includes a proximal segment 123 of the barrel closure tube, which extends to the housing 20, 20ʹ, 20ʺ and interacts functionally with the closure system supported therein. The proximal closure tube segment 123 is rotatably coupled to the distal closure tube segment 130. For example, as shown in FIG. 6, the proximal closure tube segment 123 includes distally protruding upper and lower shanks 124, 126. The distal closure tube segment 130 includes proximal protruding upper and lower shanks 132, 134. The upper double-hinged link 140 includes upwardly extending distal and proximal hinge pins 142, 144, which engage respectively the upper distal pin hole 133 in the upper proximal protruding shank 132 and the upper proximal pin hole 125 in the upper distal protruding m shank 124. The lower double-hinged link 150 includes downwardly extending distal and proximal pivot pins 152, 154 that engage a lower distal pin hole (not shown) in the proximal protruding shank 134 and the pin hole 127 in the distally protruding shank 126, respectively.

In the present construction, as in alternative designs, the elongated barrel assembly 100 further includes a frame assembly or a stem assembly, or a retaining assembly essentially designated 159. For example, in one construction, the frame assembly 159 includes a proximal frame portion 160 and a distal frame portion 170 . The proximal section 160 of the frame is made with the possibility of holding the trigger rod 310 in it with the possibility of movement and, depending on the design, passes back to the housing 20, 20ʹ, 20ʺ. The proximal end (not shown) of the proximal portion 160 of the frame may be operatively coupled to an appropriate control system that can facilitate rotation of the frame assembly 159 (and its associated end effector 200) about the axis SA-SA of the barrel. Further information on the design and operation of such control systems can be found in various referenced documents, which are incorporated herein by reference. As shown in FIG. 6, the distal portion 170 of the frame includes a pivot pin 172 rotatably disposed in a pivot pin hole 220 formed at the proximal end 211 of the elongated channel 210. The pivot pin hole 220 forms an articulated axis B-B around which the pivot pin can rotate. 172. In other words, the elongated channel 210 can be rotated around the pivot pin 172 and around the pivot axis BB, when applied to the elongated channel 210 of pivoting movement. As shown in FIG. 6, the proximal end 211 of the elongated channel 210 includes a drive pin 222 that is operable to interact with the articulated drive element. The drive pin 222 is configured to receive the force exerted thereto by the articulated drive system 500 and, depending on the direction of application of the force to the drive pin 222, forces the end effector 200 to pivot in the first direction FD or in the second opposite direction SD.

The articulated drive system 500 shown may be similar to the articulated drive system described in US Patent Application Publication No. 2014/0263541, the contents of which are incorporated herein by reference in their entirety. For example, in one form, the articulated drive system 500 includes a proximal articulated drive element 510 and a distal articulated drive element 520. See FIG. 6. As described in the above referenced document, the articulated proximal articulated drive member 510 is held for selective axial movement in the distal and proximal directions in response to the articulated steering movements applied to it by the articulated steering control system. The articulated steering control system can, for example, be functionally supported in the housing 20, 20ʹ, 20ʺ depending on the design. When the driving force or articulating control movement of the articulation is transmitted to the proximal articulating actuator 510 in the proximal direction or the distal direction, the actuating force can be transmitted to the distal articulating actuator 520 through the articulating retaining element 550, as described in detail in the above literature, included in this document. Further information on the operation of the distal articulated retaining member 550 is obtained from a review of reference documents; for brevity, this information will not be repeated herein.

As described in detail in the above referenced document, movement of the proximal articulated drive member 510, proximal or distal, releases the articulated locking member 550 that is functionally held in the distal articulated drive member and the distal portion 170 of the frame. For example, in the design shown in FIG. 6, the distal articulated drive member 520 includes a distally extending portion 522 that is rotatably coupled to the intermediate link 524 for corresponding rotational movement about the intermediate axis IA-IA. See FIG. 6. Although this is not shown separately in FIG. 6, the distally protruding portion 522 includes a downwardly extending proximal pin that is rotatably disposed in the proximal hole for the pivot pin in the intermediate link 524. The distal end of the intermediate link 524 includes a distal hole 526 for the pivot pin receiving the drive pin 222. When driven of the proximal articulated drive element 510, the elongated channel 210 is pivotally rotated by the distal articulated drive element and fi siruyuschego articulation member 550. For example, the initial proximal movement of the proximal articulated drive element 510 may unlock the proximal movement of the distal articulated drive element 520 and the articulated retaining member 550, while the additional proximal movement of the proximal articulated drive element 510 can drive the distal articulated drive element 520 articulations and articulated retaining member 550 proximal. Similarly, the initial distal movement of the proximal pulley of the hinge 510 can unlock the distal movement of the distal pulley of the hinge 520 and lock the hinge 550, while the additional distal movement of the proximal pulley of the hinge 510 can cause the distal pulley of the hinge 520 and the locking of the hinge 550 distally.

For example, as shown in FIG. 6, the launch rod 310 may comprise a multilayer structure. This design allows the trigger rod 310 to be sufficiently bent when the end effector 200 is pivotally rotated about an articulated axis B-B. The trigger rod 310 is slidably supported within the groove 162 of the trigger rod in the proximal portion 160 of the frame. The distal end portion 164 of the proximal portion 160 of the frame is formed by two opposing spherical surfaces 166, 168 to provide additional lateral support to the launch rod 310 during articulated rotation.

When working with end effectors, which use trigger rods or trigger elements and which are made with the possibility of articulated rotation in the range of, for example, forty-five degrees, a number of difficulties arise. In order to facilitate the functional articulation of such end effectors, the launch element or the launch rod must be flexible enough to provide such a range of articulation. However, the launch rod or the launch element must also not deform under the action of compressive starting loads. To provide additional support for the launch rod or trigger element, various designs of support or safety plates have been developed. Some of these constructs are described in US Pat. No. 6,964,363, entitled SURGICAL STAPLING INSTRUMENT HAVING ARTICULATION JOINT SUPPORT PLATES FOR SUPPORTING A FIRING BAR, and US Pat. which are fully incorporated herein by reference. The safety plates, which provide essentially deformation resistance, are generally difficult to bend, which contributes to an increase in the forces that must be overcome by the articulation system.

In FIG. 14 and 15 show the trigger rod support assembly 600 in the form of a trigger rod assembly 601, which is used in the surgical instrument 10 shown. As shown in these figures, as well as in FIG. 6, the trigger rod guide assembly 601 includes a proximal end 602 and a distal end 604 that are interconnected by trigger rod support members 606, 608, which are separated by a trigger rod groove 610 that extends through the proximal and distal ends 602, 604. As shown in view in horizontal projection, the node 601 guide launch rod resembles the design of an I-beam element with a groove passing through the Central wall of the rod. As, for example, shown in FIG. 15, the trigger rod support member 606 has a plate shape or comprises a plate that includes an inwardly extending upper edge 607, and the trigger rod support member 608 has a plate-shaped or has a plate that includes an inwardly extending upper edge 609. The upper edges 607, 609 give some the strength of the support elements 606, 608 of the launch rod during bending and can serve to prevent the launch rod 310 from coming off the top of the launch guide assembly 601 when the launch rod 310 is bent. The launch guide assembly 601 The rod can be made, for example, of glass-filled material ISOPLAST®, nylon, glass-filled material VECTRA®, etc., and it can be made in one piece. In other designs, the supporting elements 606, 608 of the launch rod may contain components other than the proximal and distal ends and connected to them by appropriate fastening methods, such as welding, additional molding, etc.

As shown in FIG. 6, the proximal end 602 of the launch rod guide assembly 601 is located in the proximal cavity 169 for the rod formed in the distal end portion 164 of the proximal frame portion 160. The distal end 604 of the launch rod guide assembly 601 is located in the distal shaft cavity 224 formed in the upwardly projecting abutment 1700 formed at the proximal end 211 of the elongated channel 210. To facilitate axial movement of the launch rod guide assembly 601 by articulating the end effector 200, the proximal cavity 169 for the rod has dimensions relative to the proximal end portion 602 of the starting rod support assembly 600, allowing axial movement of the proximal end portion 602 therein. A illogical distal cavity 224 for the rod may have dimensions relative to the distal end portion 604 of the guide assembly 601, the trigger rod to facilitate axial movement of the guide assembly 601 relative to the trigger rod of the elongated channel 210 when the hinge is rotated. In FIG. 17 shows an end effector 200 in a pivotally non-turned position in which the end effector 200 is substantially aligned with the barrel assembly 100. This position of the end effector allows you to enter the end effector 200 and part of the node 100 of the elongated trunk into the patient’s body, for example, through a trocar. In FIG. 18 and 19 show an end effector 200 pivotally rotated in a first direction FD, and in FIG. 20 and 21 show an end effector 200 pivotally rotated in the opposite, second, SD direction.

The end effectors, which are described in this document, as well as the end effectors described in the previously incorporated published patent application No. 2014/0263541, are often used when conducting lower anterior colon resection ("NPR"). CPD is a common surgical procedure for the treatment of colorectal cancer, performed if necessary to remove the affected or torn portion of the intestine in cases of diverticulitis. Access to the target site (s) of the colon using these end effectors when performing CPD may depend on the following factors: (i) the angle of articulation of the trunk, (ii) the distance from the pin or axis of the articulation to the most proximal staple (sometimes called the “proximal dead zone”), (iii) the distance from the most distal staples to the distal end of the end effector (sometimes called the “distal dead zone”), and (iv) the diameter of the trunk. In FIG. 22 compares the range of motion of the end effector 200 in the pelvic region, as described herein, with the range of motion of the end effector 200ʹ of the type that includes an emphasis associated with the possibility of rotation with the possibility of rotation with an elongated channel using the design of an oval-curved groove, as described in the aforementioned and incorporated herein publication of US patent application No. 2014/0263541. For example, in one 200ʹ end effector design, the proximal PDZʺ dead zone has a length of about 3.91 centimeters (1.54 inches). In contrast, the proximal PDZ dead zone resulting from at least one use of the end effector 200, as described herein, can be reduced, for example, by 0.813 centimeters (0.320 inches). See FIG. 23. Thus, PDZ <PDZʹ. For example, as also shown in this figure, in at least one embodiment, the distance from the distal end 201 of the end effector to the axis AA of the articulation or pivot point is less than the distance from the distal end 201ʹ of the end effector 200ʹ to the axis BB of the articulation or pivot point, for example, a value of about 2.3 centimeters (0.9 inches) (length L in FIG. 23). Thus, the control of the end effector 200 represents a significant improvement in the management of the structures of the end effectors of the prior art. In addition, the end effector 200 exhibits a significant increase in mechanical benefits (for example, such as an increase of up to 300% in some cases) of displacing the pivot axis or articulation proximal and displacing the closure member or fulcrum. For example, thanks to such improved access with a 60 mm endocater, it is possible to access the colon at an angle of almost 90 degrees and to perform significantly better cross-section, which minimizes the impact of subsequent triggering of the circular stapling instrument and, thus, reduces the chance of leakage . By reducing the distance from the articulation to the first or proximal bracket itself, a greater degree of freedom of rotation of the endocater relative to the pelvic girdle is provided with an increase in the effective angle of access of the relatively large intestine for the “deep” CPD. The additional movement from cam-to-cam architecture increases the mechanical benefits of the system and thus reduces the loads transferred back to the handle or housing and increases tool strength.

In FIG. 24-31, another surgical instrument 1010 is shown that includes an end effector 1200 that is operatively coupled to an elongated stem assembly 1100. The elongated barrel assembly 1100 may be operatively connected to any of the housings 20, 20ʹ, 20ʺ, as described above. The end effector 1200 is pivotally coupled to the elongated barrel assembly 1100 via articulation 1109. The end effector 1200 includes, among other things, an elongated channel 1210 that is configured to functionally support the cassette 1230 therein. See FIG. 25. The cassette 1230 with brackets includes a cassette body 1232, in which there is a centrally located elongated groove 1234 of the cassette. In the present design, the cassette 1230 with brackets has three rows 1238 of recesses 1236 for the brackets on each side of the elongated groove 1234. One or more brackets 1242 are supported on respective ejectors 1240 brackets that are functionally supported in the recesses 1236 for brackets. A cassette tray 1215 is attached to the bottom of the cassette 1232. The cassette tray 1215 includes a tray groove 1217 that aligns with the cartridge groove 1234 and the channel groove 1212 in the elongated channel 1210.

Surgical instrument 1010 further includes a trigger element 1300 that is connected to a trigger rod 1310, which is connected to a trigger system supported in a housing 20, 20ʹ or 20ʺ. The starter system may be actuated by a motor structure supported in the handle 20 (FIG. 1), or it may be manually actuated by actuating the trigger 26ʹ (FIG. 2), or it may be actuated by robotic system 13 (FIG. 4). Regardless of the design used, after actuation, the trigger system applies an axial trigger movement to the trigger rod 1310 to move the trigger 1300 in the distal direction DD. As shown in FIG. 25, the trigger element 1300 includes a vertically extending trigger element housing 1302 on which a cutting fabric surface or blade 1304 is present. The first trigger tag 1306 protrudes from the first side 1305 of the trigger element housing 1305 and the second trigger tag 1308 protrudes from the second side 1307 housing 1302 trigger element. In addition, the first middle tongue (not shown) protrudes from the first side 1305 of the trigger element housing 1302, and the second middle tongue 1309 protrudes from the second lateral side 1307 of the trigger element housing 1302. The trigger element 1300 further includes a tab or tab 1312 that protrude laterally from the bottom of the trigger element housing 1302. The purpose of the reeds 1306, 1308, 1309 and tabs 1312 will be described in more detail below. In addition, wedge-shaped slides 1320 can be installed inside the cassette 1232 for contact with the trigger element 1300 to set it in motion. As you know, when moving the trigger 1300 distally through the cassette body 1232, the beveled surfaces 1322 contact the staple ejectors 1240 to move the ejectors 1240 and the surgical staples 1242 supported thereon upward in the cassette case 1232.

The end effector 1200 further includes an abutment 1250, which includes an abutment housing 1252 on which a bottom surface 1254 forming a bracket is present. The stop 1250 also includes a mounting portion 1260 of the stop for connecting the stop 1250 with the possibility of rotation with the proximal end section 1211 of the elongated channel 1210 for pivoting movement relative to it. The mounting section 1260 of the emphasis includes two (in FIG. 25-28 only one is shown) laterally extending axles 1264 of the emphasis. The stop pins 1264 are moveable in respective oval-curved grooves 1214 provided in the proximal end portion 1211 of the elongated channel 1210. This design allows the stop 1250 to rotate relative to the elongated channel 1210 when applying closing or opening movements to the mounting portion 1260 of the stop. The abutment mounting portion 1260 includes an upwardly projecting abutment tongue 1263 that is operatively associated with a horseshoe-shaped opening 1131 provided in the closure member 1110.

In the illustrated example, the closure member 1110 comprises a closure tube assembly 1120, including a distal closure tube segment 1130 in which an opening 1131 is provided. The closure tube assembly 1120 includes a proximal barrel closure tube segment 1122 that extends to the housing 20, 20ʹ, 20ʺ and is functionally interacts with the closing system supported in it. The proximal closure tube segment 1123 is rotatably coupled to the distal closure tube segment 1130. For example, as shown in FIG. 25, the proximal closure tube segment 1123 includes distally protruding upper and lower shanks 1124, 1126. The distal closure tube segment 1130 includes proximal protruding upper and lower shanks 1132, 1134. The upper double-hinged link 1140 includes upwardly extending distal and proximal hinge pins 1142, 1144, which engage, respectively, the upper distal pin hole 1133 in the upper proximal protruding shank 1132 and the upper proximal pin hole 1125 in the upper distal height upayuschem shank 1124. The lower double-joint link 1150 includes downwardly projecting distal and proximal pivot pins 1152, 1154 that engage the lower distal pin holes (not shown) in the proximal shank projecting pin holes 1134 and 1127 in a distally projecting tang 1126 respectively. When the distal closure tube 1130 is moved in the distal direction DD, the stop 1250 is rotated to the closed position relative to the surgical cassette 1230 due to the interaction between the hole 1131 in the distal closure tube 1130 and the stop tab 1263, and when the distal closure tube 1130 is moved in the proximal direction PD, the stop 1250 rotates to the open position due to the central tongue 1137 in the distal segment 1130 of the closure tube. The movement of the distal closure tube segment 1130 is controlled by a closure system actuated by a motor structure supported in the handle 20, or manually actuated by actuating the closure trigger 28ʹ (FIG. 2), or actuated by a robotic system 13 (FIG. 4).

The stop 1250 may further have a stop groove and closing ledges, as described above with respect to the stop 250, for engaging with tongues 1306, 1308, as also described in detail above. After moving the stop 1250 to the fully closed position, the trigger system can be actuated to move the trigger 1300 axially from an inactive or initial position distally through the cassette 1230 with tissue cutting brackets sandwiched between the bottom surface 1254 of the stop 1250 forming the bracket and the cassette 1230 with staples. When moving the trigger element 1300 distally, the first tongue 1306 interacts with the ability to move with the first closing ledge, and the second tongue 1308 interacts with the possibility of moving with the second closing ledge in the stop 1250. The middle tongues 1309 slide along the upper surface of the elongated channel 1210, and the tab 1312 runs along the lower surface 1223 of the elongated channel 1210. The first and second tongues 1306, 1308 on the first and second closing ledges, as well as the middle tongues 1309 and tab 1312, serve to locate the lower surface 1254 of the stop 2150, forming a bracket, at the desired distance from the upper surface or platform of the cartridge 1230 with surgical braces.

As shown in FIG. 24-26, in the illustrated example, the end effector 1200 is pivotally rotatable about an axis B-B of the articulation that is perpendicular to the axis SA-SA of the bore formed by the elongated bore assembly 1100. In the present construction, the elongated barrel assembly 1100 further includes a frame assembly or a rod assembly, or a retaining assembly substantially designated 1159. For example, in one construction, the frame assembly 1159 includes a proximal frame portion 1160 and a distal frame portion 1170. The proximal section 1160 of the frame is configured to hold the launch rod 1310 in it with the possibility of movement and, depending on the design, passes back to the housing 20, 20 20, 20ʹ. The proximal end (not shown) of the proximal section 1160 of the frame can be functionally coupled to an appropriate control system that can facilitate rotation of the frame assembly 1159 (and its associated end effector 1200) about the axis SA-SA of the barrel. Further information on the design and operation of such control systems can be found in various referenced documents, which are incorporated herein by reference.

As shown in FIG. 25, the distal portion 1170 of the frame includes a pivot pin 1172 rotatably disposed in a pivot pin hole 1220 formed at the proximal end 1211 of the elongated channel 1210. The pivot pin hole 1120 forms an articulated axis B-B, around which the pivot pin can rotate. 1172. In other words, the elongated channel 1210 can rotate around the pivot pin 1172 and around the pivot axis B-B when pivotally applied to the elongated channel 1210. As shown in FIG. 25, the proximal end 1211 of the elongated channel 1210 includes a drive pin 1222, which is operable to interact with the articulated drive element. The drive pin 1222 is configured to receive the force exerted thereto by the articulated drive system 1500 and, depending on the direction of application of the force to the drive pin 1222, forces the end effector 1200 to swivel in the first direction or in the second, opposite direction around the articulation axis BB .

The articulated drive system 1500 shown may be similar to the articulated drive system described in US Patent Application Publication No. 2014/0263541, the contents of which are incorporated herein by reference in their entirety. For example, in one form, the articulated drive system 1500 includes a proximal articulated drive element 1510 and a distal articulated drive element 1520. As described in the above referenced document, the proximal articulated drive member 1510 is held for selective axial movement in the distal and proximal directions in response to the articulated steering movements applied to it by the articulated steering control system. The articulated steering control system can, for example, be functionally supported in the housing 20, 20ʹ, 20ʺ depending on the design. When the drive force or articulated control movement of the articulation is transmitted to the proximal articulated drive element 1510 in the proximal direction or the distal direction, the drive force can be transmitted to the distal actuator articulated element 1520 of the articulation through the locking element 1550 articulation, as described in detail in the above literature, included in this document. Further information on the operation of the distal articulated locking member 1550 is obtained from a review of reference documents; for brevity, this information will not be repeated herein.

As described in detail in the above referenced document, the movement of the proximal articulated drive member 1510, proximal or distal, releases the articulated locking member 1550 that is functionally held in the distal articulated drive member and the distal portion 1170 of the frame. For example, in the design shown in FIG. 25, the intermediate link 1524 is pivotally coupled to the distal pivot drive member 1520 for corresponding pivotal movement around the intermediate axis IA-IA. As shown in FIG. 25, the pivot pin 1523 is formed in the distal articulated drive member 1520 and extends into the proximal pivot pin 1525 in the intermediate link 1524. The distal end of the intermediate link 1524 includes a distal pivot pin 1526 that receives the pivot pin 1222. When actuating the proximal the articulated drive element 1510 is pivoted by the elongated channel 1210 by the distal articulated drive element and the locking element 1550 articulating. For example, the initial proximal movement of the proximal articulated drive element 1510 can unlock the proximal movement of the distal articulated drive element 1520 and the articulated locking member 1550, while the additional proximal movement of the proximal articulated drive element 1510 can actuate the distal articulated drive element 1520 articulation and locking element 1550 articulated proximal. Similarly, the initial distal movement of the proximal pulley of the hinge 1510 can unlock the distal movement of the distal pulley of the hinge 1520 and lock the hinge 1550, while the additional distal movement of the proximal pulley of the hinge 1510 can actuate the distal pulley of the hinge 1520 and lock the hinge 1550 distally.

In designs that use traditional safety plates to support the launch rod during deformation, depending on the path of curvature (depending on the direction of articulation), only one of the safety plates can work effectively. Thus, in at least some designs, it may be preferable to bind or join together the internal and external parts of the safety plates (or “support elements of the launch rod”) to allow them to function in pairs rather than independently. Such a design can, for example, provide more than double the moment of inertia of only the outer plate, while minimizing the total force required for bending. In some designs, as will be described in more detail below, the safety plates (or supporting elements of the launch rod) are designed so that they can move longitudinally relative to each other. Since none of the elements is located on the center line of the fold, for example, one of the elements has a longer path and the other element has a shorter path.

In the illustrated example, the surgical instrument 1010 further includes a first trigger rod support element 1610 and a second trigger rod support element 1620. Each of the first and second support elements 1610, 1620 of the launch rod may include a plate, for example, made of stainless steel, spring steel, titanium, NITINOL ™, etc. As shown in FIG. 25, the first trigger rod support element 1610 includes a proximal downward mounting tab 1612 and a distal downward mounting tab 1614. The second trigger rod 1620 includes a similar proximal and distal downward tab (not shown in FIG. 25). As shown in FIG. 26, the launch rod 1310 is slidable and extends between the first and second support elements 1610, 1620 of the launch rod. The distal ends of the first and second support elements 1610, 1620 of the launch rod are made with the possibility of sliding and are placed inside the groove 1702 formed in the protruding support ear 1700 formed at the proximal end 1211 of the elongated channel 1210. In FIG. 27 and 30 show the articulated rotation of the end effector 1200 in the first direction FD. As shown in these figures, the first trigger rod support element 1610 moves slightly distally relative to the second trigger rod support element 1620 to provide support for the trigger rod 1310 during bending during articulation. Mounting tabs can serve to limit the degree of axial movement of the supporting elements of the launch rod. In FIG. 28 and 31 show the articulated rotation of the end effector 1200 in the second direction SD. As shown in these figures, the second trigger rod support element 1620 moves slightly distally relative to the first trigger rod support element 1610 to provide bending or support when the trigger rod 1310 is pivotally rotated. As shown in FIG. 30 and 31, this design provides articulated rotation of the end effector 1200 within ranges of about seventy-five degrees (75 °) on both sides of the barrel axis SA-SA. In at least one design, the groove 1702 is dimensioned to provide a clearance between the support elements 1610, 1610 of the launch rod and the trigger rod 1310, for example, about 0.13-0.038 cm (0.05-0.015 inches) to facilitate sliding movement of the support elements 1610, 1620 of the launch rod inside the groove 1702 and the sliding movement of the launch rod 1310 when the tool is triggered (i.e., the axial extension of the launch rod 1310 in the distal direction). For example, in one design, the groove 1702 may have a width (W) of 0.13-0.165 cm (0.05-0.065 inches), each of the supporting elements 1610, 1620 of the launch rod may have a thickness (FBT) of about 0.020-0.038 cm (0.008 -0.015 inches), and the launch rod 1310 may have a thickness (BT) of about 0.114 cm (0.045 inches). See FIG. 32. As shown in FIG. 33, the proximal end 1704 of the groove 1702 extends outward to facilitate bending or bending of the launch rod support elements 1610, 1620 by pivotally turning the end effector 1200. The proximal end 1704 of the groove 1702 has a proximal groove width PW of, for example, about 0.18-0.20 cm (0.07-0.08 inch). Other values may also be characteristic of the groove width. Thus, in the presented example, PT> PW. It should be understood that the support elements 1610 and 1620 of the launch rod help to support the launch rod 1310 by pivotally turning the end effector and prevent deformation of the launch rod 1310 under the action of compressive starting loads.

In FIG. 34 shows a portion of another elongated channel 1210ʹ, which includes an upwardly protruding support eye 1700ʹ, in which a groove 1702ʹ is formed for receiving support elements 1610, 1620 of the launch rod (not shown in FIG. 34) with the possibility of sliding movement, as described above. However, in this design, in the abutment eye 1700 или, a pair of opposing protrusions or retainers 1706ʹ is formed so that, as shown in the figure, the width of the proximal end of the groove 1702 (PW () is less than the width of the groove 1702 (Wʹ). A distal exit 1620 of 1160, preferably an already retaining groove that holds the rod portion L. This “narrowing” is necessary so that the support plates behave like cantilever beams rather than floating articulations, and this can lead to a significant improvement in the launch rod support, which is provided by the launch rod plate. For example, when comparing the cantilever structure with the hinge structure (loose fit), it is assumed that the cantilever structure is able to provide a greater resistance of 4-16, which provides significantly less deflection of the base plate at the very beginning.

As shown in FIG. 35-37, the surgical instrument 1010 &apos; shown herein is substantially identical to the surgical instrument 1010 described in detail above, and it employs a supporting rod 1610 &apos; and 1620 &apos; In FIG. 35 and 36 show the positions of the support elements 1610ʹ, 1620ʹ of the launch rod when the end effector is in a pivotally untwisted position. In FIG. 37 shows an end effector 1200 in a pivotally rotated position. As shown in this figure, during articulated rotation, the supporting elements 1610ʹ, 1620ʹ of the launch rod move longitudinally relative to each other. For example, more specifically, this figure shows the support element 1610ʹ of the launch rod on the short side of the bend.

In FIG. 38-40 show another surgical instrument 2010, which may, for example, be identical to surgical instrument 1010, with the exception of at least some of the differences described below. For example, in a surgical instrument 2010, a launch rod support assembly is used, essentially designated 2600, which includes a first launch rod support 2610 and a second launch rod support 2620. Each of the supporting elements 2610, 2620 of the launch rod contains a structure with a compression tape that, when pivoted, supports the launch rod 1310 in the lateral direction, while facilitating the axial movement of the launch rod 1310 between them and its retraction moves. More specifically, in one design, the first launch rod support member 2610 comprises a first compression tape 2612, which may include, for example, a ribbon element made of spring steel or the like. As shown in FIG. 38-40, the first compression tape 2612 includes a first proximal mounting element 2614 in the form of a first proximal mounting tab 2615, which is configured to fit inside the mounting groove 1162 in the proximal portion 1160 of the frame. In addition, the first proximal compression tape 2612 further includes a first distal mounting element 2616 in the form of a first distal mounting tab 2617, which is arranged to fit inside the first distal mounting groove 1710 in the upwardly supporting abutment 1700 formed at the proximal end 1211 of the elongated channel 1210. As, in particular, shown in FIG. 39, the first distal mounting groove 1710 has a first groove width FSW that is greater than the thickness of the first distal mounting tongue 2617 to facilitate axial movement of the first distal mounting tongue 2617 within the first distal mounting groove 1710. In addition, the first compression tape 2612 includes a first spring portion or fold 2618, which are placed with the possibility of support in the first elongated cavity 1166 in the proximal section 1160 of the frame.

As further shown in FIG. 39, the second launch rod support member 2620 comprises a second compression tape 2622, which may comprise, for example, a ribbon-like member made of spring steel or the like. The second compression tape 2622 includes a second proximal mounting element 2624 in the form of a second proximal mounting tab 2625, which is arranged to fit inside the mounting groove 1164 in the proximal section 1160 of the frame. In addition, the second proximal compression tape 2622 further includes a second distal mounting element 2626 in the form of a second distal mounting tab 2627, which is arranged to fit inside the second distal mounting groove 1712 in the upwardly supporting abutment 1700 formed at the proximal end 1211 of the elongated channel 1210. As, in particular, shown in FIG. 39, the second distal mounting groove 1712 has a second groove width SSW that is greater than the thickness of the second distal mounting tongue 2627 to facilitate axial movement of the second distal mounting tongue 2627 inside the second distal mounting groove 1712. In addition, the second compression tape 2622 includes a second spring portion or fold 2628, which are placed with the possibility of support in the second elongated cavity 1168 in the proximal section 1160 of the frame. As also shown in FIG. 38-40, in the present embodiment, the distal end 1161 of the proximal portion 1160 of the frame has opposing spherical surfaces 1163, 1165, which are configured to laterally support the supporting elements 2610, 2620 of the launch rod while articulating the end effector 1200.

In FIG. 39 shows the positions of the first and second compression tapes 2610, 2620 when the end effector 1200 is in a pivotally untwisted position. In this position, the first and second compression tapes 2610, 2620 act on opposite sides of the flexible trigger rod 1310 with opposing compressive forces CF, while allowing the trigger rod 1310 to move axially during the starting and retracting strokes. In the pivotally untwisted position, each of the first and second compression tapes 2610, 2620 has a first unjoined length CL1, CL2, respectively. In FIG. 40 shows the positions of the first and second compression tapes 2610, 2620 when the end effector 1200 is pivotally rotated in one direction of articulated rotation. As shown in this figure, the first compression tape 2610 is stretched (CL3> CL1), and the second compression tape 2620 is compressed (CL4 <CL2). The spring sections 2618 and 2628 facilitate the elongation and compression of the compression bands 6210, 2620 during articulated rotation, while also retaining lateral compressive forces acting on the trigger rod 1310, thereby preventing deformation of the trigger rod 1310 when moving axially between them.

In FIG. 41-45 show another surgical instrument 2010, which may, for example, be identical to surgical instrument 1010, with the exception of at least some of the differences described below. For example, in a surgical instrument 2010, a trigger rod support assembly is used, essentially designated 2700, which includes a first trigger rod support member 2710 and a second trigger rod support member 2720. Each of the supporting elements 2710, 2720 of the launch rod contains a structure with a compression tape that, when pivoted, supports the launch rod 1310 in the lateral direction, while facilitating the axial movement of the launch rod 1310 between them and its retraction moves. More specifically, in one design, the first launch rod support member 2710 comprises a first compression tape 2712, which may include, for example, a ribbon-like element made of spring steel or the like. As shown in FIG. 42, the first compression tape 2712 includes a first proximal mounting element 2714 in the form of a first proximal mounting tab 2715 configured to fit within the mounting groove 1162 in the proximal portion 1160 of the frame. In addition, the first proximal compression tape 2712 further includes a first distal mounting element 2716 in the form of a first distal mounting tab 2717, which is arranged to fit inside the first distal mounting groove 1710 in the upwardly supporting abutment 1700 formed in the proximal end portion 1211 of the elongated channel 1210 As shown in particular in FIG. 44, the mounting groove 1162 in the proximal portion 1160 of the frame has a first groove width FSW that is greater than the thickness of the first proximal mounting tab 2715 to facilitate axial movement of the first distal mounting tab 2715 within the first proximal mounting groove 1162.

As further shown in FIG. 44, the second launch rod support member 2720 comprises a second compression tape 2722, which may comprise, for example, a ribbon-like member made of spring steel or the like. The second compression tape 2722 includes a second proximal mounting element 2724 in the form of a second proximal mounting tab 2725, which is arranged to fit inside the mounting groove 1164 in the proximal section 1160 of the frame. In addition, the second proximal compression tape 2722 further includes a second distal mounting element 2726 in the form of a second distal mounting tab 2727, which is arranged to fit inside the second distal mounting groove 1712 in the upwardly supporting abutment 1700 formed in the proximal end portion 1211 of the elongated channel 1210 As shown in particular in FIG. 44, the second proximal mounting groove 1164 has a second groove SSW width that is greater than the thickness of the second proximal mounting tongue 2725 to facilitate axial movement of the second proximal mounting tongue 2725 within the second proximal mounting groove 1164. As also shown in FIG. 41, 42 and 44, in the embodiment shown, the distal end 1161 of the proximal portion 1160 of the frame has opposing spherical surfaces 1163, 1165, which are configured to laterally support the support elements 2710, 2720 of the launch rod while articulating the end effector 1200.

As shown in FIG. 41-45, the surgical instrument 2010 further comprises a movable launch rod support assembly 2800, which is configured to provide support for the compression tapes 2712, 2722 by pivotally turning the end effector 1200. In the present construction, the trigger support assembly 2800 is movable support boss assembly 2810, which is configured to rotate and move laterally relative to the boss axis located in the center axis or reference axis BA, cat paradise SA-SA is perpendicular to the axis of the barrel and parallel to the axis B-B articulation. As shown in FIG. 42, the support boss pin 1224 protrudes upward from the distal end portion 1211 of the elongated channel 1210. In the illustrated construction, the support boss pin 1224 is arranged concentrically with respect to the pivot pin 1172 so that the boss axis BA coincides with the pivot axis B-B. For example, in one design, the pin 1224 of the support boss is made in one piece with the rotary pin 1172.

As further shown in FIG. 42, in the present construction, the support boss assembly 2810 includes a housing portion 2812 that includes a first support boss 2820 that is spaced apart from the second support boss 2830. The first support boss 2820 includes a first arcuate support surface 2822, and the second support boss 2830 includes a second arcuate abutment surface 2832. The first arched abutment surface 2822 is located at a distance from the second arched abutment surface 2832 using a groove 2834 that is wide enough to receive the first support element 2710 of the launch rod and the second support element 2720 of the launch rod and to pass between them the launch rod 1310, while the first arcuate support surface keeps tangential contact with the ability to move with the first support element 2710 of the launch rod, and the second arcuate support surface 2832 maintains contact tangentially movable with the second supporting element 2720 of the launch rod by pivotally turning the end effector 1200. In addition, to facilitate such contact between the arched support surface 2822 and the first support element 2710 of the launch rod and between the second arcuate support surface 2832 and the second support element 2720 of the launch rod with articulated rotation of the end effector 1200 node 2810 support boss made not only with the possibility of rotation around the axis BA-BA boss, but also with the ability to move laterally relative to the axis of the BA-BA boss. For example, in the presented construction, a mounting cavity 2814 is formed in the portion of the housing 2812 for receiving the movable boss pin 1224. See FIG. 43. For example, in FIG. 45 illustrates such a lateral movement of the support boss assembly 2810 during articulated rotation, wherein the position of the support boss pin 1224 in the mounting cavity 2814 (shown by dashed lines) is shown by dashed lines. This design allows the node 2810 support boss to move in lateral directions, which, for example, are perpendicular to the axis SA-SA of the barrel. In FIG. 45 shows the articulated rotation of the end effector 1200 about an axis of articulation (not shown) in a first direction FD. As shown in this figure, in addition to the lateral movement and rotation of the support boss assembly 2800, providing lateral (anti-deformation) support of the support elements 2710, 2720 of the trigger rod, as well as the trigger rod 1310, movement of the first proximal mounting tongue 2715 relative to the second proximal mounting tongue can be noticed 2725 along the axis in the corresponding mounting grooves 1164, 1162. Thus, this design provides effective anti-deformation support of the launch rod 1310 with articulation ie end effector 1200, thus allowing the trigger bar 1310 to move along the axis during startup stroke and retraction stroke. Although the trigger support assembly 2800 is suitable for use in conjunction with the trigger support elements and / or various types of compression plate designs described herein, it should also be understood that the trigger support assembly 2800 can be used effectively with surgical instruments that do not include such designs. For example, in such alternative designs, the launch rod support assembly is configured to provide support directly to the launch rod itself during articulated rotation around the articulation.

In FIG. 46-48 show another surgical instrument 2010, which may, for example, be identical to surgical instrument 1010, with the exception of at least some of the differences described below. For example, in a surgical instrument 2010, a trigger rod support assembly is used, essentially designated 2900, which contains a plurality of movable trigger rod supports 2910 that are supported on a portion of the trigger rod 1310. For clarity, the most proximal movable trigger support element the rod has the designation 2910P, and the most distal movable support element of the launch rod has the designation 2910D. In the presented design, each of the movable support elements 2910 of the launch rod has the same shape and configuration. For example, as, in particular, shown in FIG. 47, each movable support element 2910 of the launch rod includes a first support boss 2912, which is located at a distance from the second support boss 2914. The first support boss 2912 includes a first arcuate support surface 2916, and the second support boss 2914 includes a second arcuate support surface 2918 For example, in the embodiment shown, each of the first and second support bosses 2912, 2914 has a circular cross-sectional shape. The first arcuate abutment surface 2916 is located at a distance from the second arcuate abutment surface 2918 using a groove 2919 that is wide enough to accommodate the trigger rod 1310 between them, while the first arcuate abutment surface 2916 maintains tangential contact with the ability to move with a portion of the side wall of the launcher rods 1310, and the second arcuate bearing surface 2918 maintains tangential contact with the ability to move with another section of the side wall of the support element 1310 of the rod during articulated rotation of the end effector 1200. It should be understood that the first and second support bosses 2912, 2914 prevent deformation of the trigger rod 1310 when the articulation and actuation of the trigger rod 1310.

As also shown in FIG. 46-48, each of the movable support elements 2910 of the launch rod has opposed arcuate rounded surfaces 2920 that form the central contact region or reference point 2922. In FIG. 48 shows the positions of the movable support elements 2910 of the launch rod when the end effector 1200 is pivotally rotated. As shown in this figure, the movable support elements 2910 of the launch rod rotate relative to each other, while remaining in contact with each other to support the launch rods 1310 and preventing its deformation during articulated rotation and application. As shown in FIG. 48, the distal end 1161 of the proximal portion 1160 of the frame has opposing spherical surfaces 1163, 1165, which serve to support portions of the most proximal triggered support rod element 2910P during articulation. Similarly, each of the protruding support ears 1700 includes an arcuate or concave surface 1701 to accommodate a portion of the most distal launch rod support element 2910D capable of moving with articulation.

In FIG. 49-51 show the use of elastic elements 2930 to provide support for the movable support elements 2910 of the launch rod and maintain the rounded surfaces 2920 of the adjacent movable support elements 2910 of the launch rod in rotary contact with each other. In one example, two elastic members 2930 are used, and each of them may include a cable or wire member that has a distal end 2932 secured to a protruding support ear 1700. The proximal end (not shown) of each elastic member 2930 may be placed in a handle or housing and can be held in this position with the possibility of movement. In FIG. 51 shows the articulated rotation of the end effector 1200, the elastic elements 2930 holding adjacent movable support elements 2910 of the launch rod in contact with each other, thereby forming an arched support structure to prevent deformation of the launch rod 1310 during articulated rotation. In FIG. 52 illustrates a trigger rod support assembly 2900 that can be used in combination with a pivotable end effector coupled to an elongated barrel using a flexible joint structure, the type of which is described, for example, in US Pat. No. 7,213,736, entitled SURGICAL STAPLING INSTRUMENT INCORPORATING AN ELECTROACTIVE POLYMER ACTUATED FIRING BAR TRACK THROUGH AN ARTICULATION JOINT, which is incorporated herein by reference in its entirety. For example, in this design, the end effector 1200 may be pivotally capable of being pivotally applied to one of the elastic members 2930, depending on the desired direction of pivoting. More specifically, as shown in FIG. 52, in order to make the end effector swivel in the first direction FD, a swivel swivel motion in the form of the first tension force FTF is applied to the first elastic member 2931. The first elastic element 2931 may be affected by a first tension force FTF applied by an actuator structure (not shown) in a handle or body that is configured to tension the first elastic element 2931 in the proximal direction PD. Similarly, in order to make the end effector swivel in the second direction SD, a swivel swivel motion in the form of a second tension force STF is applied to the second elastic member 2933. The second elastic element 2933 can be influenced by the second tension force STF applied by the design of the actuator (not shown) in the handle or housing, which are arranged to tension the second elastic element 2933 in the proximal direction PD.

When the end effector is pivotally rotated, the articulated drive mechanism experiences a certain voltage, as a result of which the trigger rods are more easily deformed and thus the loads transmitted by them are potentially reduced. Such problems can be solved with the various support elements of the launch rod described in this document. In FIG. 53-58, another surgical instrument 3010 is shown, which may, for example, be identical to surgical instrument 10, with the exception of at least some of the differences described below. For example, the surgical instrument 3010 employs a movable launch rod support assembly essentially designated 3100 in combination with a trigger rod support assembly 600, as described in detail above. As described above, the trigger rod guide assembly 601 includes a proximal end 602 and a distal end 604 that are interconnected by trigger rod support members 606, 608, which are separated by a trigger rod groove 610 that extends through the proximal and distal ends 602, 604. Proximal the end 602 of the launch rod guide assembly 601 is located in the proximal cavity 169 for the rod formed in the distal end portion 164 of the proximal frame portion 160. The distal end 604 of the launch rod guide assembly 601 is located in the distal rod cavity 224 formed in the protruding support eye 1700 formed in the proximal end portion 211 of the elongated channel 210. To facilitate axial movement of the launch rod guide assembly 601 when the end effector 200 is articulated, the proximal the cavity 169 for the rod has dimensions relative to the proximal end portion 602 of the node 601 of the guide launch rod, allowing axial movement of the proximal ends in it the first portion 602. Similarly, the distal cavity for the rod 224 may be sized relative to the distal end portion 604 of the guide assembly 601, the trigger rod to facilitate axial movement of the guide assembly 601 relative to the trigger rod of the elongated channel 210 when the hinge is rotated.

As shown in FIG. 54, in the illustrated example, a movable or movable support rod assembly 3100 includes a support base 3102 that is movably supported on a protruding pivot pin 174 formed on the frame assembly 159. More specifically, the pivot pin 174 is rotatably disposed in the pivot pin hole 3104 in the support base 3102 such that the pivot pin 174 extends upwardly through it. The supporting base 3102 is arranged to move around the axis A1-A1 of the base formed by the pivot pin 174. In addition, the supporting base 3102 includes an elongated groove 3106, which is sized to accommodate the movement of the guide pin 1708 of the safety base that is formed at the proximal end section or mounting element 211 of the elongated channel 210. See FIG. 55. In addition, the movable rod support assembly 3100 includes a first movable guide or pin guide 3110 and a second movable guide or pin guide 3120. The first and second movable pin guides 3110, 3120 can move independently of each other and with respect to the support base 3102 about a guide axis GA-GA formed by the pivot pin hole 3108 in the support base 3102. For example, as shown in FIG. 54, the first movable pin guide 3110 includes a first pin guide base 3112 that has a first protruding support element or pin 3114 and a second upward protruding support element or pin 3116. Similarly, the second movable pin guide 3120 comprises the second base 3122 of the guide pin, which has a primary protruding upward support element or pin 3124 and a secondary protruding upward support element or pin 3126. The second main vanie guide pin 3122 includes a mounting pin 3125 which extends through the mounting hole 3113 in the first base 3112 and the guide pin is located in a mounting hole 3108 in the support base 3102.

In the presented example, the first support element or pin 3114 and the primary support element or pin 3124 are movably contactable with the first side plate 606 of the launch rod guide assembly 601, depending on the direction of articulation of the end effector. Similarly, the second support member or pin 3116 and the secondary support member or pin 3126 are movably contactable with the second side plate 608 depending on the direction of articulation. The first and primary pins 3114, 124 are made with the possibility of sliding contact with the first side plate 606, and the second and secondary pins 3116, 3126 are made with the possibility of sliding contact with the second side plate 608, when the end effector is in an articulated non-turned position (aligned with the axis SA -SA trunk). This design serves to support the launch rod during articulated rotation and in front of it. In alternative examples, the movable support rod assembly 3100 can be used without the trigger rod assembly 601 or the trigger support plates, etc. For example, in such designs, the first and primary pins 3114, 3124 can contact directly with the first side portion the trigger rod, and the second and secondary pins 3116, 3126 can contact directly with the second portion of the side of the trigger rod to provide direct anti-deformation support and launch bar.

In FIG. 59-63, another surgical instrument 3010ʹ is shown, which may, for example, be identical to surgical instrument 3010, with the exception of at least some of the differences described below. For example, the movable or movable support assembly 3100ʹ of the launch rod includes only two upwardly protruding support pins 3114ʹ and 3116ʹ. The support base 3102ʹ is substantially similar to the base 3102, except that the upwardly extending pins 3114ʹ and 3116ʹ are connected directly to the base 3102ʹ and move with it.

A movable or movable support rod assembly 3100 and 3100ʹ has several advantages over prior art designs. For example, in this design, there is a relationship between the angle of articulation and the degree of lateral support provided for the launch rod. Such a movable embodiment of an active support not only rotates when the retainer of the distal and proximal channels is pivoted, it also rotates the support elements themselves (made with the possibility of moving the pins) relative to the support plates with a change in the length of the unsupported sections depending on the angle of articulation. Using dynamic analysis, you can adjust the changes in the elasticity of the base plate to provide additional support in a fully articulated position or additional support in a straight position, depending on the requirements. The traditional designs of the base plate and the safety plate do not provide adjustment and provide the same support at any point in the range of articulation. Such a dynamically changing support structure can be configured to support the system when it is in the most vulnerable position, while over compensation can also be avoided when the system is in a strong position. Self-locking rotary structures are made with the possibility of rotation only until they are loaded, after which they are clamped and provide support. Such configurations are relatively easy to manufacture and assemble. “Dynamically changing” means that an unsupported area may vary depending on the risk of deformation. The movable structure can be successfully used in combination with the supporting elements of the various configurations described herein.

The main idea of the active support is to establish the relationship between the angle of articulation and the degree of support that is provided for the launch rod and the support element of the launch rod. This can be achieved by creating a joint that provides a shorter unsupported area in which the deformation of the rods is most likely (i.e., a greater angle of articulation). The movable configurations of the movable structures described herein provide support for the distal and proximal channel retainers and allow the support assembly to rotate and slide relative to them. This design provides support for the outer articulated base plate when it needs a shorter, unsupported area. Another feature is that the right and left support plates are also connected to each other, while the connection itself additionally increases resistance to deformation, since the internal and external support plates are deformed, preventing the system from malfunctioning.

In FIG. 64-71 illustrate various support elements of the launch rod that can be used with various examples of surgical instruments described herein. In FIG. 64 is a perspective view of a launch rod support assembly 600, which is described in detail above. In FIG. 65 and 66 show the trigger rod support assembly 2700ʹ similar to the trigger rod support assembly 2700 described above, with the exception of at least some of the differences described below. For example, the first and second compression tapes 2712ʹ 2722ʹ are freely connected to each other using proximal and distal clamps 2730, 2740, which facilitate the axial movement of compression tapes 2712ʹ, 2722ʹ relative to each other while maintaining compression tapes 2712ʹ, 2722ʹ in compression contact with the trigger rod 1310 the methods described in detail herein. The proximal and distal clamps 2730, 2740 can completely extend around the compression bands 2712ʹ, 2722ʹ. To facilitate the corresponding axial movement of the tapes 2712ʹ, 2722ʹ, the proximal collar 2730 is located in the proximal upper and lower slots 2732ʹ, 2734 in each of the compression tapes 2712ʹ, 2722ʹ, and the distal clamp 2740 is placed in the distal upper and lower slots in each of the compression tapes 2712ʹ, 2722ʹ as shown in the figures. In FIG. 68, another trigger rod support assembly 2700ʺ is shown, which is identical to the trigger rod support assembly 2700ʹ, except that the clamps 2730ʹ and 2740ʹ do not completely extend around both compression bands 2712ʹ, 2722ʹ. In both designs, the proximal and distal clamps allow the compression plates to move axially relative to each other, while they prevent or at least limit the lateral movement of one element from another in directions perpendicular to the axis of the barrel. Thus, this design holds the compression plates in contact with the launch rod during articulated rotation of the end effector. It should also be understood that the axial length of the slots essentially determines the amount of relative axial displacement with which the compression plates can move relative to each other.

In FIG. 68 and 69, another launch rod support assembly 3200 is provided that can be used in combination with surgical instruments, examples of which are described herein. As shown in these figures, the launch rod support assembly 3200 may include a support lock 3210, which is partly box-shaped. In the presented example, the latch 3200 includes solid upper and lower portions 3212, 3214, which are mutually connected by lateral elements 3216, 3218, which are spaced apart from each other, each of which has a number of windows 3220 provided therein for ensuring the bend of the latch (shown by arrow B) in directions Z, but without significant deflection in directions Y. The proximal end 3211 of the support retainer 3210 includes a proximal flange 3213 for installation with the possibility of movement in the hole in the node of the rod or frame of the surgical instrument, as described herein. Similarly, the distal end 3215 of the support latch 3210 includes a distal flange 3217 for installation with the possibility of movement in the hole in the proximal end portion of the elongated channel, as described herein. As shown in the figures, a pair of downwardly extending upper ears 3230 protrudes from an upper portion 3212, and a pair of upwardly extending lower ears 3232 protrudes from a lower portion 3214. Upper and lower ears 3230 and 3232 form a launch rod channel 3240 through which a launch rod (not shown) ) can pass along the axis. In one design, the outer layers of the launch rod are located between the ears 3230 and 3232. However, in the example shown, the first and second friction washers 3250, 3252 can extend between the ears 3230, 3232. In addition, the presented example includes compression plates 3260, 3262 of the type described herein and designs to provide compression support for the launch rod as it passes through the latch to prevent deformation of the launch rod when the surgical tool is pivoted.

In FIG. 70 shows another trigger rod support assembly 3300, which can be used in combination with various surgical instruments, examples of which are described herein. As shown in these figures, the trigger assembly 3300 includes a tubular body 3302, which is made of, for example, nylon, polycarbonate, Isoplast®, etc. Housing 3302 includes a trigger rod (channel) 3304 that houses the trigger rod (not shown) with the possibility of moving through it and which is made with the possibility of bending / deflection in the Z directions. The proximal end 3311 of the support node 3300 of the launch rod includes a proximal flange 3313 for installation with the possibility of movement in the hole in the node of the rod or frame x a tool as described herein. Likewise, the distal end 32315 of the launch rod support assembly 3300 has a distal flange 3317 for installation with the ability to move in a hole in the proximal end portion of the elongated channel, as described herein. In FIG. 71, another launch rod support assembly 3300ʹ is shown, which is identical to the launch rod support assembly 3300, but windows 3310 are formed in its side walls to increase the flexibility of the housing 3302 in the Z directions.

In FIG. 72 shows an example of an engine-driven (or “power”) surgical instrument 4010 that includes a body or handle 4020, an elongated barrel assembly 4100, and an end effector 4200 that is operatively coupled to the elongated barrel assembly 4100. The end effector 4200 is similar to the end effector 200, which is described in detail above. As indicated above and will be discussed in detail below, various parts of the surgical instrument 4010 are driven by a motor. In addition, the elongated barrel assembly 4010 is detachable from the handle 4020. A description of various elements and detailed information about these components can be found in US Patent Application No. 13 / 803,053, entitled INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT, publication of the application for US patent No. 2014/0263564, the contents of which are fully incorporated herein by reference.

The end effector 4200 includes, among other things, an elongated channel 210, which is configured to functionally support the cassette 230 with brackets therein. The end effector 200 further includes an abutment 250, which includes an abutment body 252 on which a bottom surface 254 forming a bracket is present. The closure tube assembly 4120, whose axial extension in the distal and proximal directions is due to the actuation of the closure trigger 4028, moves the stop 250 between the open and closed positions. The closure tube assembly 4120 includes a proximal barrel closure tube segment 4123 that is rotatably coupled to the distal closure tube segment 4130 by methods described herein to facilitate pivoting about the pivot axis B-B. The proximal segment 4123 of the barrel closure tube includes a proximal end portion 4200 operably coupled to the nozzle assembly 4202, the switch drum structure 4204, and the contact ring assembly 4206. Further information about the nozzle assembly, switch drum design, and slip ring assembly can be found in US Patent Application Publication No. 2014/0263564, which is incorporated herein by reference in its entirety, and also in US Patent Application No. 14 / 226,075, filed March 26. 2014, entitled MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES, the contents of which are also fully incorporated herein by reference.

The designs of the closing tubes described in the above referenced documents have a fixed range of closing stroke. Thus, when the closing trigger or other closing structure of the actuator is actuated, the closing tube is axially extended. The amplitude of such axial extension is limited by the size of the space available in the handle or housing to accommodate all the various components of the closure system. For example, in portable embodiments, a handle is convenient to hold and operate with one hand. However, such handle designs have limited space for accommodating the closing and starting systems. As described in detail in the referenced documents, in some designs the trigger is connected with the possibility of movement with a closing shuttle, which is connected to the node of the closing tube. When the closing trigger is actuated, the connecting traction structure advances the closing shuttle and the closing tube assembly axially. Various advantages can be achieved by increasing the size or amplitude of such a closing stroke.

The node 4100 of the barrel includes a chassis 4300, which is made with the possibility of removable connection with the handle 4020 in various ways, described in detail in the above referenced documents. As shown in FIG. 76 and 77, the barrel assembly 4100 includes a proximal portion 4160 of a frame or rod that includes a proximal end 4161 that is rotatably held on the chassis 4300. In the presented example, the proximal end 4141 of the proximal section 4160 of the frame has a thread 4163 formed on it for threaded fastening to the rod support 4180, configured to be supported on the chassis 4300. This design facilitates the rotational connection of the proximal section 4160 of the frame with the chassis 4300 so that the node 4159 of the rod can selectively rotate around the axis SA-SA of the barrel relative to the chassis 4300.

As shown primarily in FIG. 75-77, the interchangeable barrel assembly 4100 includes a closing shuttle 4350, which is slidably supported in the chassis 4300 so that it can move axially relative to it. The proximal closure tube segment 4123 is connected to the closure shuttle 4350 to allow rotation relative to it. For example, a U-shaped connector 263 is inserted into the annular groove 4129 in the proximal segment 4123 of the closure tube and held inside the vertical grooves in the closure shuttle 4350. This design serves to attach the proximal segment 4123 of the closure tube to the closure shuttle 4350 for axial movement with it, however, the proximal segment 4123 of the closing tube can rotate relative to the closing shuttle 4350 around the axis SA-SA of the barrel. The closure spring 4353 rests on the proximal segment of the closure tube 4123 and serves to bias the proximal segment of the closure tube 4123 in the proximal direction PD, which can serve to rotate the closure trigger 4028 to the inactive position when the shaft assembly 4100 is operatively connected to the handle 4020.

The shaft assembly 4100 further includes a closing transmission assembly 4500 to enhance the amount of closing motion that is applied to the closing shuttle 4350 and ultimately to the stop by the closing tube assembly. This design provides various advantages, such as the possibility of increasing the closing stroke, which makes it possible to open the jaws even more. In other words, this possibility of an additional stroke both at the proximal and at the distal end also provides greater retraction of the distal segment of the closure tube in the proximal direction, which allows the stop to open more. As shown in FIG. 75 and 76, the closing transmission 4500 couples the closing shuttle 4350 to the proximal closing hook assembly 4360. The proximal closing hook assembly 4360 includes hooks 4362 that can hook engage with a fastening pin 4033 that is attached to the second closing link 4031 operably connected to trigger 4028, as described in detail in US patent application No. 14 / 226,075. As described in the referenced document, when the trigger closing mechanism 4028 is actuated, the closing link 4031 extends distally and applies a distal closing movement to the proximal closing hook assembly 4360.

In the illustrated example, the closing transmission assembly 4500 includes a proximal closing hook rail 4504 that is connected to the proximal closing hook assembly 4360. In addition, the closing transmission assembly 4500 further includes a transmission rail 4506 supported for movement in the transmission housing 4502. The closing transmission assembly 4500 further includes a distal closing rack 4508 connected to the closing shuttle 4350. The closing gear 4510 is in gear engagement with the closing hook rack 4504 and the transmission rack 4506. The transmission pinion gear 4512 is connected to the pinion gear 4514 and is located in the gear with a transmission rack 4506. The raising gear is in gear engagement with the distal closing rack 4508. Thus, the articulated rotation of the closing trigger The mechanisms 4028 causes distal advancement of rack 4504 of the closure hook, which ultimately leads to the distal advancement of the distal rails 4508 closure hook-and-closing hook 4350. Distal movement of the closure shuttle 4350 causes distal movement of the closure tube assembly.

Thus, the closing transmission assembly substantially comprises means for increasing the closing stroke of the closing tube assembly. For example, a conventional closure design may include a closure actuator that, after actuating it, applies a closure movement to the closure tube assembly. As a result of the application of such a closing movement, an axial movement of the closing tube assembly occurs during the closing stroke with a maximum range of axial closing movement MCT. A surgical instrument that uses a closing transmission assembly, the various types and designs of which are described herein, will also have a closing stroke with a maximum range of axial closing movement of MCT1. Given that all other aspects of these devices are otherwise the same or identical, MCT1> MCT.

As shown in FIG. 78-80, the end effector 200 is connected to the elongated barrel assembly 4100 via a pivot joint 109 of the type and design described above. However, other designs of articulation are also permitted. In the illustrated example, the barrel assembly 4100 includes a closure tube assembly 4120, which includes a proximal closure tube segment 4123. The presented example further includes a flexible closure tube segment 4600, which is connected to the distal end of the distal closure tube segment 4123 for movement with it. The flexible closure tube segment 4600 is dimensioned for distribution over articulation 109 and includes a distal end 4602 and a proximal end 4604. The proximal end 4604 is connected to the distal end of the distal closure segment 4123 of the closure. A flexible tubular segment 4610 extends between the proximal end 4604 and the distal end 4602, and in the example shown includes two spaced apart upper and lower rod elements 4612, 4614 that extend axially. From each side, there are many rib elements 4616 located at a distance from each other, which serve to form a tubular path along which the articulation passes. When the closure tube assembly 4120 extends in the distal direction DD along the axis, the distal end 4602 of the closure tube flexible segment 4600 interacts with the stop 250 in various ways described herein to move the stop 250 to the closed positions. The flexible closure tube segment 4600 also adapts to articulate rotation of the end effector 200, as shown in FIG. 80.

EXAMPLES

Example 1 - A surgical instrument containing a surgical end effector containing the first and second jaw elements, wherein applying a closing movement to at least one of the first and second jaw elements results in the displacement of at least one of the first and second jaw elements in the closed position relative to the other of the first and second jaw elements. The surgical instrument further comprises a closure system, which comprises an axially movable closure element configured to apply a closure movement to at least one of the first and second jaw elements. The closing actuator includes the first part of the actuator, which is made with the possibility of axial movement along the first section of axial movement when the closing actuator is triggered. The closing transmission fits into the first part of the actuator. The closing transmission contains the second part of the actuator, which is joined to the axially movable closing element so that when the closing actuator is activated, the second part of the actuator moves the axially movable closing element along the second section of axial displacement, which is larger than the first section of axial displacement.

Example 2 - The surgical instrument of example 1, in which the closing transmission further comprises a transfer element that can axially move between the first part of the actuator and the second part of the actuator. The transmission element in operative connection with the first part of the actuator is oriented in such a way that the axial movement of the first part of the actuator leads to axial movement of the transmission element. The multiplying element is operatively connected to the transmission element and the second part of the actuator so that the axial movement of the transmission element leads to axial movement of the second part of the actuator.

Example 3 is the surgical instrument of examples 1 or 2, in which the first part of the actuator comprises a first axially movable closure rail and the second part of the actuator contains a second axially movable closure rail that is operatively connected to the first axially movable closure rail.

Example 4 - The surgical instrument of example 3, in which the closing transmission contains a transmission rack, which can axially move between the first axially movable closing rail and the second axially movable closing rail. The closing gear is supported in a functioning engaging connection with the first closing rack and the transmission rack. The gear transmission gear is held in a functioning engaging connection to the transmission rack. The multiplier gear is connected to the gear gear and is oriented in a functioning engaging connection with a second axially movable closure rail.

Example 5 - The surgical instrument of examples 1, 2, 3 or 4, further comprising a housing that functionally holds the closing actuator. The node of the rod is functionally connected to the body and the surgical end effector, the node of the rod contains an axially movable closing element.

Example 6 - The surgical instrument of example 5, in which the shaft assembly is designed for removable functioning fastening to the body.

Example 7 - The surgical instrument of examples 5 or 6, in which the shaft assembly contains a chassis made for removable functioning fastening to the body. The chassis functionally holds the closing transmission.

Example 8 - The surgical instrument of example 5, in which the closing element contains a hollow element made with the possibility of axial movement relative to the portion of the frame of the rod node.

Example 9 - The surgical instrument of examples 1, 2, 3, 4, 5, 6, 7 or 8, in which one of the first and second elements of the jaw contains an elongated channel made with the possibility of holding in it a surgical cassette with brackets, and the other of the first and second elements of the jaw contains an emphasis.

Example 10 - The surgical instrument of example 5, in which the end effector is operatively connected to the node of the rod using the articulation.

Example 11 - The surgical instrument of examples 5 or 10, in which the rod assembly comprises a frame assembly that is connected to the body, and the closure member comprises a closure tube assembly that is axially movable on the frame assembly.

Example 12 - The surgical instrument of example 11, in which the closure tube assembly comprises a proximal closure tube segment that is operatively mated to the closure transmission, and a flexible closure tube segment that is mated to the proximal closure tube segment and extends over the articulation for functional connection with, at least one of the first and second jaw elements.

Example 13 - A surgical instrument comprising a surgical instrument that contains an end effector. The end effector contains a surgical cassette with brackets and

emphasis, and at least one of the surgical cassettes with brackets and the emphasis moves in response to the closing movement attached to it. The surgical instrument further comprises a shaft assembly that is operatively aligned with at least one of the surgical cassettes with brackets and an abutment. The handle is functionally connected to the shaft assembly. The closing actuator is functionally supported by the handle and includes a first part of the actuator, which is axially movable along a predetermined first axial displacement portion when the closing actuator is triggered. The axially movable closure element is adapted to apply a closure movement to at least one of the surgical cassettes with brackets and an abutment. The closing transmission mates with the first part of the actuator and contains the second part of the actuator, which mates with the axially movable closing element so that when the closing actuator is activated, the second part of the actuator moves the axially movable closing element along the second axial displacement section, which is greater than the first section of axial movement.

Example 14 - The surgical instrument of example 13, in which at least one of the surgical cassettes with brackets and abutment is connected to the node of the rod using the articulation.

Example 15 - The surgical instrument of examples 13 or 14, in which the shaft assembly comprises a frame assembly that is connected to a handle and at least one of the surgical cassettes with brackets and an abutment. The closure element comprises a closure tube assembly that is axially movable on the frame assembly.

Example 16 - The surgical instrument of example 15, in which the closure tube assembly comprises a proximal closure tube segment that is operatively mated to the second part of the actuator. The flexible segment of the closure tube fits into the proximal segment of the closure tube and extends over the articulation for functional connection with at least one of the surgical cassettes with brackets and stop.

Example 17 - The surgical instrument of examples 13, 14, 15 or 16, in which the second part of the actuator is operatively connected to the first part of the actuator using an axially movable gear rack and multiple gears.

Example 18 A surgical instrument comprising a surgical end effector comprising first and second jaw elements, wherein applying a closing movement to at least one of the first and second jaw elements results in the displacement of at least one of the first and second jaw elements in the closed position relative to the other of the first and second jaw elements. The surgical instrument further comprises a closure system, which comprises an axially movable closure element configured to apply a closure movement to at least one of the first and second jaw elements. The surgical instrument further comprises a closing actuator, which includes a first part of the actuator, which is arranged to axially move along the first portion of the axial displacement upon actuation of the closing actuator. The surgical instrument further comprises the ability to move the axially movable closing element along the second axial displacement section, which is larger than the first axial displacement section, when the closing actuator is actuated.

Example 19 - The surgical instrument of example 18, in which one of the first and second elements of the jaw contains a surgical cassette with brackets, and the other of the first and second elements of the jaw contains a stop.

Example 20 — The surgical instrument of examples 18 or 19, wherein the closing actuator comprises a closing trigger that is supported on a housing that is operatively connected to the end effector via a shaft assembly.

Full description:

U.S. Patent No. 5,403,312, entitled ELECTROSURGICAL HEMOSTATIC DEVICE, issued April 4, 1995;

U.S. Patent No. 7,000,818, entitled SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, issued February 21, 2006;

U.S. Patent No. 7,422,139, entitled MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK, issued September 9, 2008;

U.S. Patent No. 7,464,849, entitled ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS, issued December 16, 2008;

U.S. Patent No. 7,670,334, entitled SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR, issued March 2, 2010;

US patent No. 7,753,245, entitled SURGICAL STAPLING INSTRUMENTS, issued July 13, 2010;

U.S. Patent No. 8,393,514 entitled SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE, issued March 12, 2013;

U.S. Patent Application No. 11 / 343,803, entitled SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES; US Patent No. 7,845,537;

U.S. Patent Application No. 12 / 031,573, entitled SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES, filed February 14, 2008;

US patent application Ser. No. 12 / 031,873, entitled END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, filed February 15, 2008, currently US Patent No. 7,980,443;

U.S. Patent Application No. 12 / 235,782, entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, currently U.S. Patent No. 8,210,411;

U.S. Patent Application No. 12 / 249,117, entitled POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, currently U.S. Patent No. 8,608,045;

US Patent Application No. 12 / 647,100, entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY, filed December 24, 2009, US Patent No. 8,220,688;

US patent application No. 12 / 893,461, entitled STAPLE CARTRIDGE, filed September 29, 2012, currently US patent No. 8,733,613;

US patent application Ser. No. 13 / 036,647, entitled SURGICAL STAPLING INSTRUMENT, filed February 28, 2011, currently US Patent No. 8,561,870;

U.S. Patent Application No. 13 / 118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, currently published U.S. Patent Application No. 2012/0298719;

U.S. Patent Application No. 13/524,049 entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE; filed June 15, 2012; U.S. Patent Application No. 2013/0334278;

U.S. Patent Application No. 13 / 800,025, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed March 13, 2013;

US Patent Application No. 13/800 067, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed March 13, 2013;

US Published Patent Application No. 2007/0175955, entitled SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM, filed January 31, 2006; and

U.S. Patent Application Laid-Open No. 2010/0264194, entitled SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR, filed April 22, 2010, currently U.S. Patent No. 8,308,040; incorporated herein by reference.

Although various embodiments of products are described herein in connection with certain disclosed embodiments, various modifications and changes may be made to the product. Also, for some components for which the materials are disclosed, other materials may be used. In addition, in accordance with various embodiments, one component can be replaced by several components, and several components by one component (to perform certain functions). The above description and the attached claims cover all these changes and additions.

With regard to the use of essentially any cases of the plural and / or singular for terms herein, those skilled in the art may change the plural to the singular and / or singular to the plural in accordance with the requirements of the context and / or scope. The various singular / plural combinations are not expressly indicated herein for clarity.

The subject matter described herein sometimes illustrates various components contained within or connected to various other components. It should be understood that such architectures shown are merely examples and that many other architectures with the same functionality may actually be implemented. In a conceptual sense, any configuration of components to achieve the same functionality is practically “connected” in such a way as to achieve the desired functionality. Thus, any two components combined in this document to achieve specific functionality can be considered as “connected” to each other so that the desired functionality is achieved, regardless of architectures or intermediate components. Similarly, any two components connected in this way can be considered as “functionally connected” or “functionally connected” to each other to achieve the desired functionality, and any two components that can be connected in this way can also be considered as “functionally connected” each other to achieve the desired functionality. Specific examples of functionally coupled components include, but are not limited to, physically mating and / or physically interacting components and / or wirelessly interacting and / or logically interacting and / or logically interacting components.

Although various embodiments have been described herein, it will be apparent to those skilled in the art that many modifications, variations, substitutions, changes and equivalents may be made to these embodiments. Also, for some components for which the materials are disclosed, other materials may be used. Thus, it should be understood that the above description and the appended claims should cover all such modifications and variations as fall within the scope of the disclosed embodiments. The following claims are intended to cover all such modifications and variations.

The devices described herein can be disposed of after a single use, or they can be made many times. However, in any case, the device can be restored for reuse after at least one use. Recovery may include any combination of the steps of disassembling the device, then cleaning or replacing specific parts, and then reassembling. In particular, the device can be disassembled and any number of specific parts or parts of the device can be selectively replaced or removed in any combination. After cleaning and / or replacing specific parts, the device can be reassembled for later use either in the restoration workshop or by the surgical team immediately before the surgery. It will be apparent to those skilled in the art that various techniques for disassembling, cleaning, replacing, and reassembling can be used to restore the device. The use of such techniques, as well as the resulting reconditioned device, are entirely included in the scope of this application.

Preferably, the subject matter described herein will undergo treatment prior to surgery. First, after receiving a new or already used tool, it is cleaned if necessary. Then the instrument can be sterilized. According to one sterilization method, the instrument is placed in a closed and sealed container, for example a plastic bag or a Tyvek bag (TYVEK). Then the container and the instrument are placed in a field of radiation that can penetrate into the container, such as gamma radiation, x-rays or fast electrons. Radiation destroys bacteria on the instrument and in the container. The sterilized instrument can then be stored in a sterile container. Sealed containers keep the instrument sterile until it is opened in a medical facility.

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 material included does not contradict the existing definitions, provisions and other description material presented in this description. Thus, to the extent necessary, the description, as explicitly presented herein, takes precedence over any conflicting material incorporated herein by reference. Any material or part thereof, 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 no material arises between the included material and the existing description material contradictions.

In general, the use of the principles of the present invention described herein provides many advantages. The above description of one or more embodiments has been presented for purposes of illustration and description. It is believed that the description is not exhaustive or limiting the exact disclosed option. In light of the foregoing, modifications and variations are possible. One or more embodiments have been selected and described to illustrate the principles and methods of practical implementation, whereby allowing a person skilled in the art to use various embodiments of the invention, as well as with various modifications corresponding to the particular intended field of application. It is assumed that the full scope of the invention is defined in the attached claims.

Claims (39)

1. A surgical stapling instrument containing: a surgical end effector that contains the first and second jaw elements, the application of a closing movement in relation to at least one of the first and second jaw elements leads to the displacement of at least one of the first and second jaw elements to the closed position relative to the other of the first and the second elements of the branch; and a closing system comprising: an axially movable closure member configured to apply said closure movement with respect to at least one of said first and second jaw elements; a closing actuator, which includes the first part of the actuator, made with the possibility of axial movement along the first section of the axial movement when the specified closing actuator; and a closing transmission, which is associated with said first part of the actuating mechanism and comprising a second part of the actuating mechanism, which is connected to said axially movable closing element so that when said closing closing mechanism (4028) is actuated, said second part of the actuating mechanism moves said axially movable closing element along a second axial displacement section that is larger than said first axial displacement section, wherein said first part of the actuator comprises a first axially movable closure rail, and said second part of the actuator comprises a second axially movable closure rail that is operatively connected to said first axially movable closure rail, the specified closing transmission further comprises: a gear rack axially movable between said first axially movable closure rail and said second axially movable closure rail; a closing gear, which is supported in a functional engaging connection with said first closing rack and said transmission rack; a gear transmission gear that is supported in a functional engaging connection with said gear rack; and a multiple gear gear that is connected to said gear transmission gear and is operatively engaged with said second axially movable closure rail. 2. The surgical stapling instrument according to claim 1, further comprising: a housing that functionally supports said closing actuator; and a node of the barrel, which is functionally connected with the specified body and the specified surgical end effector, and the specified node of the barrel contains the specified axially movable closing element. 3. The surgical stapling instrument of claim 2, wherein said barrel assembly is removably functionally attached to said body. 4. The surgical stapling instrument according to claim 3, wherein said barrel assembly comprises a chassis configured for removable functional attachment to said housing, said chassis functionally supporting said closure transmission. 5. The surgical stapling instrument of claim 2, wherein said closure member comprises a tubular member configured to axially move relative to the frame portion of said barrel assembly. 6. The surgical stapling instrument of claim 2, wherein one of said first and second jaw elements comprises an elongated channel configured to support a surgical cassette with brackets, and the other of said first and second jaw elements comprises a stop. 7. The surgical stapling instrument according to claim 2, in which the specified end effector is functionally connected to the specified node node using a swivel. 8. The surgical stapling instrument of claim 7, wherein said barrel assembly comprises a frame assembly coupled to said body, and wherein said closure member comprises a closure tube assembly that is axially supported on said frame assembly. 9. The surgical stapling instrument of claim 8, wherein said closing tube assembly comprises: a proximal closure tube segment that is operatively associated with said closure transmission; and a flexible closure tube segment that is coupled to said proximal closure tube segment and extends above said articulation for functional connection with at least one of said first and second jaw elements. 10. A surgical stapling instrument comprising: end effector containing: surgical cassette with staples and an emphasis, wherein at least one of said surgical cassette with brackets and said emphasis moves in response to a closing movement applied to it, and wherein said surgical instrument further comprises: a node of the barrel, which is functionally associated with at least one of the specified surgical cassettes with brackets and the specified emphasis; a handle functionally connected to the specified node of the barrel; a closing actuator, which is functionally supported by the specified handle and includes a first part of the actuator configured to axially move along a predetermined first section of axial movement when the specified closing actuator is triggered; an axially movable closure member configured to apply said closure movement to said at least one of said surgical cassette with brackets and said stop; and closing transmission, which is associated with the specified first part of the actuator and contains the second part of the actuator, which is associated with the specified axially movable closing element so that when the specified closing actuator, the specified second part of the actuator moves the specified axially movable closing element along the second section axial movement, which is greater than the specified first section of the axial movement, wherein said second part of the actuator is operatively connected to said first part of the actuator using an axially movable transmission rack and gears. 11. The surgical stapling instrument of claim 10, in which at least one of the specified surgical cassettes with brackets and the specified emphasis is connected to the specified node of the barrel using a swivel. 12. The surgical stapling instrument of claim 11, wherein said barrel assembly comprises a frame assembly coupled to said handle and at least one of said surgical cassette with brackets and said abutment, and wherein said closure member comprises a closure tube assembly which is supported with the possibility of axial movement on the specified node of the frame. 13. The surgical stapling instrument of claim 12, wherein said closing tube assembly comprises: a proximal segment of the closure tube that is operatively associated with said second part of the actuator; and a flexible segment of the closure tube, which is connected with the specified proximal segment of the closure tube and extends above the specified hinge for functional connection with the specified at least one of the specified surgical cassettes with brackets and the specified emphasis.

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